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Biomedical subjects

W F Boyce

Publications and source records attributed to W F Boyce.

12 recordsLinked to original sources

Associations between risk behavior and injury and the protective roles of social environments: an analysis of 7235 Canadian school children.

OBJECTIVE: The social etiology of adolescent injury remains poorly understood. The Population Health Framework suggests that the etiology of adolescent injury involves interactions between individual risk factors and the natures of adolescent environments. The purpose of this study was to apply this framework to examination of relationships between adolescent risk taking and injury, and the potential modifying effects of supportive home and school environments. METHODS: The analysis was conducted in a representative sample of 7235 males and females (10-16 years old) from Canada. Results were based on records from the 2001/02 World Health Organization Health Behaviour in School-Aged Children Survey. Individual items and factor analytically derived scales were used to describe and then model injury outcomes, risk behaviors, perceived home, and school climates, and the relationships between these variables in a theory driven etiological analysis. RESULTS: Adolescents with supportive home and school environments experienced lower relative odds of engagement in risk taking behavior and lower relative odds of injury. Gradients were observed between the extent of adolescent risk taking and the occurrence of injury. Interactions were not observed between risk taking behavior, perceived support in home and school climates, and injury. CONCLUSIONS: Risk taking is common among adolescents and plays a role in the etiology of injury. Supportive social climates clearly protect adolescents from engaging in these behaviors, and also the occurrence of some forms of injury. However, once an adolescent chooses to engage in risk taking behaviour, a supportive environment may not protect them from injury.

Adolescent↗

Comparison of overweight and obesity prevalence in school-aged youth from 34 countries and their relationships with physical activity and dietary patterns.

The purposes of this systematic review were to present and compare recent estimates of the prevalence of overweight and obesity in school-aged youth from 34 countries and to examine associations between overweight and selected dietary and physical activity patterns. Data consisted of a cross-sectional survey of 137 593 youth (10-16 years) from the 34 (primarily European) participating countries of the 2001-2002 Health Behaviour in School-Aged Children Study. The prevalence of overweight and obesity was determined based on self-reported height and weight and the international child body mass index standards. Logistic regression was employed to examine associations between overweight status with selected dietary and physical activity patterns. The two countries with the highest prevalence of overweight (pre-obese + obese) and obese youth were Malta (25.4% and 7.9%) and the United States (25.1% and 6.8%) while the two countries with the lowest prevalence were Lithuania (5.1% and 0.4%) and Latvia (5.9% and 0.5%). Overweight and obesity prevalence was particularly high in countries located in North America, Great Britain, and south-western Europe. Within most countries physical activity levels were lower and television viewing times were higher in overweight compared to normal weight youth. In 91% of the countries examined, the frequency of sweets intake was lower in overweight than normal weight youth. Overweight status was not associated with the intake of fruits, vegetables, and soft drinks or time spent on the computer. In conclusion, the adolescent obesity epidemic is a global issue. Increasing physical activity participation and decreasing television viewing should be the focus of strategies aimed at preventing and treating overweight and obesity in youth.

Adolescent↗

Cross national study of injury and social determinants in adolescents.

OBJECTIVES: To compare estimates of the prevalence of injury among adolescents in 35 countries, and to examine the consistency of associations cross nationally between socioeconomic status then drunkenness and the occurrence of adolescent injury. DESIGN: Cross sectional surveys were obtained from national samples of students in 35 countries. Eight countries asked supplemental questions about injury. SETTING: Surveys administered in classrooms. SUBJECTS: Consenting students (n = 146 440; average ages 11-15 years) in sampled classrooms. 37 878 students (eight countries) provided supplemental injury data.Exposure measures: Socioeconomic status (material wealth, poverty) and social risk taking (drunkenness). OUTCOME MEASURES: Specific types and locations of medically treated injury. RESULTS: By country, reports of medically treated injuries ranged from 33% (1060/3173) to 64% (1811/2833) of boys and 23% (740/3172) to 51% (1485/2929) of girls, annually. Sports and recreation were the most common activities associated with injury. High material wealth was positively (OR>1.0; p<0.05) and consistently (6/8 countries) associated with medically treated and sports related injuries. Poverty was positively associated with fighting injuries (6/8 countries). Drunkenness (social risk taking) was positively (p<0.01) and consistently (8/8 countries) associated with medically treated, street, and fighting injuries, but not school and sports related injuries. CONCLUSION: The high prevalence of adolescent injury confirms its importance as a health problem. Social gradients in risk for adolescent injury were illustrated cross nationally for some but not all types of adolescent injury. These gradients were most evident when the etiologies of specific types of adolescent injury were examined. Prevention initiatives should focus upon the etiologies of specific injury types, as well as risk oriented social contexts.

Adolescent↗

Disadvantaged persons' participation in health promotion projects: some structural dimensions.

A structural perspective was used in studying community participation of disadvantaged groups (poor women, street youth, and disabled persons) in health promotion projects. Five community projects in the Canadian Health Promotion Contribution Program were examined in a comparative case study utilizing in-depth interviews, documents, and secondary sources. Analysis revealed relatively low numbers and restricted range of participants, difficulties in recruiting and maintaining participants, declining rates of active participation over time, and limited target group influence and power. This paper reports on the relationship between various dimensions of structure (social-cultural, organizational, political-legal-economic) and the community participation process. Participation was influenced by structural factors such as bureaucratic rules and regulators, perceived minority group rights and relations, agency reputations and responsibilities, available resources, and organizational roles. Control of projects by target group members, rather than by service agencies, was an important overall organizational structural factor which allowed community members to achieve influence in projects. The study concludes that a conceptual model based on structural factors is useful in explaining how key factors from federal and local levels can restrict or facilitate the community participation process.

Adolescent↗

Youth injury data in the Canadian Hospitals Injury Reporting and Prevention Program: do they represent the Canadian experience?

OBJECTIVE: Injuries to Canadian youth (11-15 years) identified from a population based health survey (World Health Organization-Health Behaviour in School-Aged Children Survey, or WHO-HBSC) were compared with youth injuries from a national, emergency department based surveillance system. Comparisons focused on external causes of injury, and examined whether similar rankings of injury patterns and hence priorities for intervention were identified by the different systems. SETTING: The Canadian version of the WHO-HBSC was conducted in 1998. The Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) is the national, emergency room based, surveillance program. Two hospitals involved in CHIRPP collectively provide population based data for Kingston, Ontario. METHOD: Numbers of injuries selected for study varied by data source: WHO-HBSC (n=3673); CHIRPP (n=20,133); Kingston CHIRPP (n=1944). WHO-HBSC and Kingston CHIRPP records were coded according to four variables in the draft International Classification of External Causes of Injury. Existing CHIRPP codes were available to compare Kingston and other CHIRPP data by five variables. Males and females in the three datasets were ranked according to the external causes. Data classified by source and sex were compared using Spearman's rank correlation statistic. RESULTS: Rank orders of four variables describing external causes were remarkably similar between the WHO-HBSC and Kingston CHIRPP (p>0.78; p<0.004) for mechanism, object, location, and activity). The Kingston and other CHIRPP data were also similar (p>0.87; p<0.001) for the variables available to describe external causes of injury (including intent). CONCLUSION: The two subsets of the CHIRPP data and the WHO-HBSC data identified similar priorities for injury prevention among young people. These findings indicate that CHIRPP may be representative of general youth injury patterns in Canada. Our study provides a novel and practical model for the validation of injury surveillance programs.

Accident Prevention↗

Reliability of the Gross Motor Performance Measure.

BACKGROUND AND PURPOSE: The reporting of reliability coefficients and the method of their determination is expected of test developers. The purpose of this study was to estimate the interrater, intrarater, and test-retest reliability of the Gross Motor Performance Measure, a measure of quality of movement designed to accompany the Gross Motor Function Measure. SUBJECTS: Subjects were 28 children (25 with cerebral palsy, 2 nondisabled, 1 with head injury) between the ages of 1 and 10 years. METHODS: Reliability data were obtained from assessments of 19 therapists. RESULTS: Intraclass correlation coefficients for reliability varied from .92 to .96 for the total scores and from .84 to .94 for the five attribute scores. CONCLUSION AND DISCUSSION: When the Gross Motor Performance Measure was administered by therapists who are familiar with the Gross Motor Function Measure and had a 1-day training workshop, reliability of the total scores was above recommended minimums. Scores of single attributes were less reproducible.

Cerebral Palsy↗

The Gross Motor Performance Measure: validity and responsiveness of a measure of quality of movement.

BACKGROUND AND PURPOSE: This article presents the results of a study to validate a measure of gross motor performance for its capacity to detect changes in the quality of movement in children with cerebral palsy aged 0 to 12 years. SUBJECTS AND METHODS: On two occasions, 4 to 6 months apart, physical therapists from three children's treatment centers assessed 106 children with cerebral palsy, 18 children who had sustained an acute head injury, and 29 nondisabled children. Validity was demonstrated by comparing changes on the measure across diagnoses, severity, and age groups. RESULTS: Several a priori hypotheses were supported; however, relationships with parent and therapist ratings were not clearly demonstrated. CONCLUSION AND DISCUSSION: The measure was found to be differentially responsive to changes in "stable" and "responsive" groups.

Analysis of Variance↗

Training users in the gross motor function measure: methodological and practical issues.

BACKGROUND AND PURPOSE: The Gross Motor Function Measure (GMFM) is a criterion-referenced observational measure for assessing change in gross motor function for children with cerebral palsy (CP). The purposes of this report are to present data on the effects of training pediatric developmental therapists to administer and score the GMFM and to discuss some practical and methodological issues associated with training. SUBJECTS AND METHODS: A weighted kappa estimate pretraining and posttraining workshop was used to determine participants' agreement of scoring a videotaped GMFM assessment against experts' scoring of the same videotaped assessment. Several children with CP, representing a spectrum of ages, severities, and levels of function, were shown on the videotape. RESULTS: There was a significant improvement in agreement from a mean kappa of .58 to .82 (t = 15.38, df = 75, P < .001) for the first group and from .81 to .92 (t = 10.91, df = 72, P < .001) for the second group following training. CONCLUSION AND DISCUSSION: Although there are a number of advantages to using videotapes to train test users and to assess scoring reliability, this method does not evaluate participants' ability to administer the measure. Further work is needed to determine whether reliability is maintained in a clinical situation in which it is necessary to both administer and score the GMFM.

Adolescent↗

Measuring quality of movement in cerebral palsy: a review of instruments.

There is a lack of appropriate evaluation instruments in the area of quality of movement in cerebral palsy. Ten measures of quality of movement, or gross motor performance, published between 1965 and 1990, were reviewed according to established criteria. These criteria include the purpose of the measure, validity, reliability, responsiveness, range of items, and description of qualitative components. These measures provide a foundation for further instrument development in the area of quality of movement. [Boyce WF, Gowland C, Rosenbaum PL, et al. Measuring quality of movement in cerebral palsy: a review of instruments.

Cerebral Palsy↗

Development of a quality-of-movement measure for children with cerebral palsy.

Development of a suitable measure of quality of movement, or gross motor performance, for children with cerebral palsy is a complex undertaking. A variety of conceptual, methodological, and practical issues inherent in such a project are discussed in this article. We report on the methodology used in the planning and construction of the Gross Motor Performance Measure. The measure has been developed by a multicenter, interdisciplinary group of therapists, methodologists, research staff, and international experts. Five attributes of gross motor performance have been defined, scaled, and operationalized. Results of content validity studies demonstrate that the measure has adequate completeness, clarity, and potential for evaluating change in quality of movement in children who have cerebral palsy. The measure is currently undergoing extensive testing to determine the reliability, validity, and responsiveness of the obtained scores. [Boyce WF, Gowland C, Hardy S, et al. Development of a quality-of-movement measure for children with cerebral palsy.

Cerebral Palsy↗

Work and power in hemiplegic cerebral palsy gait.

The purpose of this descriptive study was to quantify the work that is accomplished by major muscle groups of the affected limb of 10 children with spastic hemiplegia secondary to cerebral palsy during walking. Cinematographic film and force-plate data were used in a biomechanical link-segment model to calculate the positive and negative work performed by the muscles around each joint. The results revealed that the ankle plantar flexors produced just over a third of the positive work for the affected limb instead of the normal two thirds. The greatest proportion of positive work was performed by the hip muscles. More research using work and power analyses will assist in prescribing and determining the effectiveness of treatments.

Ankle↗