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Biomedical subjects

M MacKay

Publications and source records attributed to M MacKay.

16 recordsLinked to original sources
PubMed2005

Evaluating the acceptability and feasibility of the I Promise Program: a driving program for families with young new drivers.

OBJECTIVES: To evaluate the acceptability and feasibility of the I Promise Program (IPP), a driving program developed for families with young new drivers (YNDs). DESIGN, SETTING, AND SUBJECTS: The IPP consists of a contract between parents and YNDs and a rear window decal (sticker). Program acceptability was assessed through four focus groups with 40 young new drivers (YND), two with 19 parents of YNDs, and two with 15 community members. To determine whether the program's design, materials, and procedures were working as planned, 51 families participated in a six month pilot project. Telephone and in-person interviews were conducted at months 1 and 6, respectively. RESULTS: Participants had problems with the acceptability of the program's underlying message; content, format, and language of the materials; program cost; and proposed participant incentives. Thirty eight (75%) families completed the six month pilot. Most YNDs (75%) and parents (85%) identified the contract as a useful communication tool. Despite positive initial reactions, 50% of YNDs did not recall the content of the contract after six months. Sixty eight percent of families had problems with the decal (for example, did not stay affixed, colors faded) and only 17% of YNDs reported a lasting impact on their driving. Only 20% of families chose to continue in the program after the pilot. CONCLUSIONS: These results highlight the importance of formative and process evaluation in the development of a new prevention strategy to assess a strategy's acceptability and feasibility. In response to participants' feedback, revisions made to the program's materials and delivery model included making its two key components-the contract and decal-available online, independent of each other, and free of charge.

Accidents, Traffic↗
PubMed2004

Looking for the evidence: a systematic review of prevention strategies addressing sport and recreational injury among children and youth.

OBJECTIVES: To examine evidence on the effectiveness of current injury prevention strategies in selected sport and recreational activities, determine the applicability of the evidence to children and youth and discuss the implications related to policy, programming and future research. METHODS: Research questions and relevance criteria were developed a priori. Potentially relevant studies were located through electronic and hand searches. Two independent assessors assessed articles for first relevance and then quality. Relevant articles were abstracted and synthesised for activities that had three or more relevant articles. RESULTS: A total of 21,499 articles identified through database and manual searching yielding 117 that met inclusion criteria. The majority of the studies (93 or 89%) involved eight activities: baseball, basketball, cycling, football, ice hockey, rugby, alpine skiing and soccer. Children and youth were identified as the specific target group in 45% of the studies and another 12% included children in their sample. Studies addressed a range of intervention strategies and varied on quality of evidence. CONCLUSIONS: Surprisingly few well-designed and controlled studies investigating strategies to prevent injuries were found and an even smaller number evaluated strategies to reduce injury in children and youth. As governments in developed countries continue to focus on increasing physical activity among children and youth, thought must be given to the issue of risk of injury and the relative lack of evidence of effective preventive measures.

Adolescent↗
PubMed2004

Strategies for prevention of soccer related injuries: a systematic review.

OBJECTIVES: To examine evidence on the effectiveness of current injury prevention strategies in soccer, determine the applicability of the evidence to children and youth, and make recommendations on policy, programming, and future research. METHODS: Standard systematic review methodology was modified and adopted for this review. Research questions and relevance criteria were developed a priori. Potentially relevant studies were located through electronic and hand searches. Articles were assessed for relevance and quality by two independent assessors, and the results of relevant articles were abstracted and synthesised. RESULTS: A total of 44 potentially relevant articles from electronic (n = 37) and hand (n = 7) searches yielded four that met inclusion criteria. These four studies addressed a range of intervention strategies and varied with respect to results and quality of evidence. CONCLUSIONS: Some of the strategies look promising but lack adequate evaluation or require further research among younger players. Practice, policy, and research recommendations are provided as a result of the synthesis.

Adolescent↗
PubMed2004

Epidemiology of electrical and lightning related deaths and injuries among Canadian children and youth.

Among burn injuries, electrical injuries constitute a small but devastating fraction. To describe the epidemiology of electrical injuries in Canadian children, data on deaths and emergency department visits related to electrical injuries, including lightning strikes, were obtained from provincial coroners' offices and the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) respectively, for the years 1991-96. Twenty one deaths and 606 emergency visits highlight that electrical related deaths, more frequent among school age children, are more likely the result of high voltage and lightning strike, while emergency department visits, more frequent among younger children, are more likely the result of low voltage. While the introduction of legislated standards for child safe outlets and educational programs for parents, children, and youth are recommended strategies toward reducing the frequency of these incidents, these strategies require further evaluation before their effectiveness can be estimated.

Accidents, Home↗
PubMed2001

Surgical resection for intractable epilepsy in "double cortex" syndrome yields inadequate results.

PURPOSE: To analyze the results of surgical treatment of intractable epilepsy in patients with subcortical band heterotopia, or double cortex syndrome, a diffuse neuronal migration disorder. METHODS: We studied eight patients (five women) with double cortex syndrome and intractable epilepsy. All had a comprehensive presurgical evaluation including prolonged video-EEG recordings and magnetic resonance imaging (MRI). RESULTS: All patients had partial seizures, with secondary generalization in six of them. Neurologic examination was normal in all. Three were of normal intelligence, and five were mildly retarded. Six patients underwent invasive EEG recordings, three of them with subdural grids and three with stereotactic implanted depth electrodes (SEEG). Although EEG recordings showed multilobar epileptic abnormalities in most patients, regional or focal seizure onset was recorded in all. MRI showed bilateral subcortical band heterotopia, asymmetric in thickness in three. An additional area of cortical thickening in the left frontal lobe was found in one patient. Surgical procedures included multiple subpial transections in two patients, frontal lesionectomy in one, temporal lobectomy with amygdalohippocampectomy in five, and an additional anterior callosotomy in one. Five patients had no significant improvement, two had some improvement, and one was greatly improved. CONCLUSION: Our results do not support focal surgical removal of epileptogenic tissue in patients with double cortex syndrome, even in the presence of a relatively localized epileptogenic area.

Adolescent↗
PubMed1998

Upper extremity performance and self-care skill changes in children with spastic cerebral palsy following selective posterior rhizotomy.

Changes in upper extremity and self-care performance following selective posterior rhizotomy (SPR) are reported frequently, but rarely quantified. In this study, 36 children with spastic cerebral palsy were assessed preoperatively and 1 year following SPR using the Quality of Upper Extremity Skills Test (QUEST). Twenty-six children were assessed at similar intervals using the Functional Independence Measure for Children (WeeFIM) as a measure of self-care performance. Wilcoxon matched-pair signed-rank tests were used to compare the QUEST total scores and the WeeFIM motor, cognitive, and total scores before and after SPR. One year after SPR, the total QUEST scores were significantly better (median improvement = 3.2%, p < 0.0001), as were the WeeFIM motor (median improvement = 9.5, p < 0. 0001), cognitive (median improvement = 1.0, p < 0.008), and total (median improvement = 11.0, p < 0.0001) scores. The results indicate quantifiable improvements in upper extremity function, and motor and cognitive self-care skills in children 1 year after SPR.

Activities of Daily Living↗
PubMed1995

Arthroscopic treatment for posterior impingement in degenerative arthritis of the elbow.

Twenty-one patients underwent arthroscopic treatment for posterior impingement associated with degenerative elbow arthritis. Anterior debridement and removal of loose bodies was performed first. The posterior procedure consisted of three parts: removal of posterior loose bodies, removal of the posterior olecranon osteophyte, and removal of the osteophytes in the olecranon fossa to the point of fenestration. Patients were assessed for pain, strength, motion, stability, and function. They were classified as excellent, good, fair, or poor. Twenty-one of 25 patients were followed an average of 35 months. There was a statistically significant improvement in all criteria. There were 10 good and 11 fair ratings preoperatively; this improved to 14 excellent and 7 good results postoperatively (P = .0001). Arthroscopic treatment for posterior impingement in the degenerative elbow offers substantial improvement with minimal risk, provided proper intraoperative precautions are followed.

Adolescent↗
PubMed1995

The resistant frozen shoulder. Manipulation versus arthroscopic release.

Frozen shoulder is often a self-limited disease, but approximately 10% of patients have long-term problems. Arthroscopy was done in 40 patients with persistent pain, stiffness, and functional loss for at least 1 year without improvement despite conventional treatment. In the first 20 patients, manipulation was done with an arthroscopy before and afterward; in the second 20 patients, the contracted structures were divided through arthroscopy. This was a prospective cohort study; 2 patients were not available for followup. The arthroscopic division procedure was done in 4 sequential steps: (1) resection of the inflammatory synovium in the interval area between the subscapularis and supraspinatus; (2) progressive division of the anterior superior glenohumeral ligament and anterior capsule; (3) division of the subscapularis tendon but not muscle; and (4) division of the inferior capsule. The results were assessed independently on the basis of pain, stiffness, and function. The followup varied from 2 to 5 years after intervention. Patients treated with arthroscopy and manipulation did as well as the patients treated with arthroscopic division for restoration of range of movement. However, the patients in the arthroscopic division group had significantly better pain relief and restoration of function. Fifteen of 20 patients treated with arthroscopic division had an excellent result compared with 7 of 18 patients treated with arthroscopy and manipulation. Patients with diabetes did worse initially, but the outcome was similar to patients without diabetes. Patients with diabetes in particular may benefit from early intervention.

Adult↗
PubMed1987

Seat belt legislation in Britain.

The background to the passage of the seat belt usage law in Britain is described. Voluntary belt use rates in the 1970's were approximately 30%, with educational campaigns having a minimal effect. The political process and the factors influencing the seat belt legislation are described, particularly the role of the media. The provisions and the consequences of the law are outlined with belt use in the general traffic stream rising to 90%. Deaths and serious injury to front seat car occupant casualties declined by 25% in comparing the year after with the year before the introduction of the law. Changes in other categories of casualties were within normal statistical limits and were uninfluenced by the seat belt legislation.

Accidents, Traffic↗
PubMed1984

Home monitoring for central apnoea.

Between July 1978 and December 1981, 64 infants thought to be at increased risk from sudden infant death syndrome (SIDS) were monitored at home for central apnoea. Twenty four of the infants had had a 'near miss' episode at age, median (range), 6 (1 to 33) weeks, and of these infants 22 had had 335 alarms for apnoea by age 6 months. Stimulation by shaking was carried out on 38 occasions and bag and mask resuscitation on one. The remaining 40 infants were siblings of SIDS victims and of these, 35 were monitored from age 1 week (usually after discharge home). Thirty four of the SIDS siblings had had 573 alarms for apnoea by age 6 months: stimulation by shaking was carried out on 32 occasions and bag and mask resuscitation on one. The duration of home monitoring was, median (range), 34 (8 to 87) weeks for 'near miss' infants and 45 (12 to 70) weeks for SIDS siblings. All infants survived. As part of an over all support system monitors were accepted and greatly appreciated by most parents, especially those with previous experience of SIDS. Home monitoring was practicable but the commitment in time and expertise was great and objective benefits to the infant remain unproved.

Apnea↗