BACKGROUND. Body checking is the predominant mechanism of youth ice hockey injuries. The Canadian Hockey Association has allowed body checking from ages 12 to 13 (peewee level) and up. One Canadian province (Ontario) introduced body checking at ages 10 to 11 (atom level) in the competitive leagues, whereas in Quebec body checking has only been allowed at ages 14 to 15 (bantam Level). The purpose of this study was to compare body-checking injuries, fractures, and concussions in boys' minor hockey between jurisdictions in which checking is allowed and jurisdictions in which body checking is not allowed.

There is a paucity of information regarding descriptive epidemiology of paediatric concussions over time, and few studies include both emergency department (ED) and physician office visits. To describe trends in visits for paediatric concussions in both EDs and physician offices according to age and sex. A secondary objective was to describe the cause of concussion for children treated in EDs. A retrospective, population-based study using linked health administrative data from all concussion-related visits to the ED or a physician office by school-age children and youth (three to 18 years of age) in Ontario between April 1, 2003 and March 3, 2011 was conducted. The number of children evaluated in both EDs and a physician offices increased between 2003 and 2010, and this linear trend was statistically significant (P=0.002 for ED visits and P=0.001 for office visits). The rate per 100,000 increased from 466.7 to 754.3 for boys and from 208.6 to 440.7 for girls during the study period. Falls accounted for approximately one-third of the paediatric concussions. Hockey/skating was the most common specific cause of paediatric sports-related concussions. The increasing use of health care services for concussions is likely related to changes in incidence over time and increased awareness of concussion as a health issue. Evidence-based prevention initiatives to help reduce the incidence of concussion are warranted, particularly in sports and recreation programs.

Background: A 30 minute drive time threshold has often been cited as indicative of accessible health services. Cardiac rehabilitation (CR) is a chronic disease management program designed to enhance and maintain cardiovascular health, and geographic barriers to utilization are often cited. The purpose of this study was to empirically test the drive time threshold for CR utilization. Methods: A prospective study, using a multi-level design of coronary artery disease outpatients nested within 97 cardiologists. Participants completed a baseline sociodemographic survey, and reported CR referral, enrollment and participation in a second survey 9 months later. CR utilization was verified with CR sites. Geographic information systems were used to generate drive times at 60, 80 and 100% of the speed limit to the closest CR site from participants' homes, to take into consideration various traffic conditions. Bivariate analysis was used to test for differences in CR referral, enrollment and degree of participation by drive time. Logistic regression was used to test drive time increments where significant differences were found. Results: Drive times were generated for 1209 outpatients. Overall, CR referral was verified for 523 (43.3%) outpatients, with verified enrollment for 444 (36.7%) participating in a mean of 86.4 ± 25.7% of prescribed sessions. There were significant differences in CR referral and enrollment by drive time (ps < .01), but not degree of participation. Logistic regression analysis (ps < .001) revealed that the drive time threshold at 80% of the posted speed limit for physician referral may be 60 minutes (OR = .26, 95% CI: 0.13-0.55), and the threshold for patient CR enrollment may also be 60 minutes (OR = .11, 95% CI: 0.04-0.33). Conclusions: Physicians may be taking geography into consideration when referring patients to CR. Empirical consideration also reveals that patients are significantly less likely to enroll in CR where they must drive 60 minutes or more to the closest program. Once enrolled, distance has no significant effect on degree of participation.

Although injuries related to sports and recreation represent a significant burden to children and youth, few studies have examined the descriptive epidemiology of sports-related injury since 2005, and some sports such as ringette have not been evaluated to date. The primary purpose of this study was to provide the descriptive epidemiology of sports-related injuries treated in emergency departments for children and youth aged 5 – 19.

Evidence related to the effectiveness of speed humps on reducing pedestrian-motor vehicle collisions (PMVC) has been conflicting. The purpose of this study was to determine the association between speed hump installation and changes in PMVC rates in Toronto, Canada. Speed humps were mapped along with police-reported pedestrian collisions from 2000–2011 and built environment roadway characteristics. A quasi-experimental study identified collision counts before and after speed hump installation, modeled using repeated measures Poisson regression adjusted for season and roadway characteristics. Stratified analyses were conducted by age group and injury severity. There were 27,827 PMVC, with 1344 collisions along 409 roadways with speed humps. PMVC incidence rates/meters of road/month decreased after installation of speed humps (IRR 0.78 95 % CI 0.66, 0.91). Winter, collector roads (versus local), pre-amalgamated city centre and increased land use mix were associated with more collisions. The association between speed humps and PMVC rates decreased more for children (IRR 0.57, 95 % CI 0.41, 0.79) than for adults (IRR 0.80, 95 % CI 0.68, 0.95). Speed humps are an easily replicated method of traffic calming which have a significant protective effect on PMVC on the roadways where they are installed, particularly for children. There is a need for an area-wide analysis to determine the effects of the installation of speed humps to ensure that PMVC are not being displaced to surrounding roadways.

Although water-related fatality rates have changed over time, the epidemiology of drowning in Canada has not recently been examined. In spite of the evidence supporting varying drowning death rates by age, information on how characteristics of drowning incidents differ by age group remains limited. The primary objective of this study was to examine the epidemiology of drowning in Canada. A secondary objective was to describe the characteristics of these drowning incidents as they vary by age group. A retrospective descriptive analysis was conducted using data that were collected for incidents occurring in Canada between January 1, 2008 and December 31, 2012. The main outcome variable was a water-related fatality, in the majority of cases (94 %) the primary cause of death was drowning. Age specific frequencies, proportions and rates per 100,000 population were calculated and compared among six age groups. There were 2392 unintentional water-related fatalities identified in Canada between 2008 and 2012. Death rates (per 100,000) varied by age group 0–4 (1.05), 5–14 (0.57), 15–19 (1.27), 20–34 (1.70), 35–64 (1.44), 65+ (1.74). The male to female ratio was 5:1. Differences in the characteristics of drowning by age group were identified across: sex, body of water, urban versus rural location, time of year, activity type, purpose of activity, alcohol involvement, personal flotation device use, accompaniment, and whether a rescue was attempted. The study results suggest that there may be a need for drowning prevention strategies that are tailored to specific age groups. Rural areas in Canada may also benefit from targeted drowning prevention.