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author:("vernicia, Lee")
1.  Bicycling crash circumstances vary by route type: a cross-sectional analysis 
BMC Public Health  2014;14(1):1205.
Widely varying crash circumstances have been reported for bicycling injuries, likely because of differing bicycling populations and environments. We used data from the Bicyclists’ Injuries and the Cycling Environment Study in Vancouver and Toronto, Canada, to describe the crash circumstances of people injured while cycling for utilitarian and leisure purposes. We examined the association of crash circumstances with route type.
Adult cyclists injured and treated in a hospital emergency department described their crash circumstances. These were classified into major categories (collision vs. fall, motor vehicle involved vs. not) and subcategories. The distribution of circumstances was tallied for each of 14 route types defined in an earlier analysis. Ratios of observed vs. expected were tallied for each circumstance and route type combination.
Of 690 crashes, 683 could be characterized for this analysis. Most (74%) were collisions. Collisions included those with motor vehicles (34%), streetcar (tram) or train tracks (14%), other surface features (10%), infrastructure (10%), and pedestrians, cyclists, or animals (6%). The remainder of the crashes were falls (26%), many as a result of collision avoidance manoeuvres. Motor vehicles were involved directly or indirectly with 48% of crashes. Crash circumstances were distributed differently by route type, for example, collisions with motor vehicles, including “doorings”, were overrepresented on major streets with parked cars. Collisions involving streetcar tracks were overrepresented on major streets. Collisions involving infrastructure (curbs, posts, bollards, street furniture) were overrepresented on multiuse paths and bike paths.
These data supplement our previous analyses of relative risks by route type by indicating the types of crashes that occur on each route type. This information can guide municipal engineers and planners towards improvements that would make cycling safer.
PMCID: PMC4253622  PMID: 25416928
Bicycling injuries; Bike lanes; Traffic accidents
2.  High Uptake of HIV Testing in Pregnant Women in Ontario, Canada 
PLoS ONE  2012;7(11):e48077.
In 1999, Ontario implemented a policy to offer HIV counseling and testing to all pregnant women and undertook measures to increase HIV testing. We evaluated the effectiveness of the new policy by examining HIV test uptake, the number of HIV-infected women identified and, in 2002, the HIV rate in women not tested during prenatal care. We analyzed test uptake among women receiving prenatal care from 1999 to 2010. We examined HIV test uptake and HIV rate by year, age and health region. In an anonymous, unlinked study, we determined the HIV rate in pregnant women not tested. Prenatal HIV test uptake in Ontario increased dramatically, from 33% in the first quarter of 1999 to 96% in 2010. Test uptake was highest in younger women but increased in all age groups. All health regions improved and experienced similar test uptake in recent years. The HIV rate among pregnant women tested in 2010 was 0.13/1,000; in Toronto, the rate was 0.28 per 1,000. In the 2002 unlinked study, the HIV rate was 0.62/1,000 among women not tested in pregnancy compared to 0.31/1,000 among tested women. HIV incidence among women who tested more than once was 0.05/1,000 person-years. In response to the new policy in Ontario, prenatal HIV testing uptake improved dramatically among women in all age groups and health regions. A reminder to physicians who had not ordered a prenatal HIV test appeared to be very effective. In 2002, the HIV rate in women who were not tested was twice that of tested women: though 77% of pregnant women had been tested, only 63% of HIV-infected women were tested. HIV testing uptake was estimated at 98% in 2010.
PMCID: PMC3494693  PMID: 23152762
3.  Mycoplasma genitalium presence, resistance and epidemiology in Greenland 
International Journal of Circumpolar Health  2012;71:10.3402/ijch.v71i0.18203.
Greenland reports the highest rates of chlamydial infection and gonorrhea in the Arctic. Our objective was to determine the presence, and describe the basic epidemiology, of Mycoplasma genitalium for Greenland.
Study design
Cross-sectional study.
314 residents from Nuuk and Sisimiut, between the ages of 15 and 65 years, participated in “Inuulluataarneq” (the Greenland Sexual Health Project) between July 2008 and November 2009. Participants provided self-collected samples for sexually transmitted infection (STI) testing and completed a sexual health survey. Descriptive statistics and logistic regression were used to summarize the basic characteristics of STI cases overall and M. genitalium and Chlamydia trachomatis specifically. Clinically relevant characteristics in each full model were gender (male or female), age (in years), age at sexual debut (in years), number of sexual partners in the past 3 months (continuous) and history of forced sex and community.
The overall prevalence of STIs was 19.0%, specifically: 9.8% for M. genitalium and 9.4% for C. trachomatis; 100% of M. genitalium-positive cases carried macrolide resistance determinants. Being female [OR =3.2; 95% confidence interval (CI): 1.1–9.8] and younger age (OR=0.9; 95% CI: 0.9–1.0) were associated with M. genitalium positivity. Age was also associated with C. trachomatis (OR=0.9; 95% CI: 0.8–0.9) and STI positivity overall (OR=0.9; 95% CI: 0.9–0.9).
We observed a high prevalence of M. genitalium and macrolide resistance in this study. A better understanding of M. genitalium sequelae is needed to inform policy around testing, treatment, control and antibiotic use.
PMCID: PMC3417636  PMID: 22564463
sexually transmitted diseases; Mycoplasma genitalium; antibiotic resistance; indigenous health; health services
4.  Using geographical information systems mapping to identify areas presenting high risk for traumatic brain injury 
The aim of this study is to show how geographical information systems (GIS) can be used to track and compare hospitalization rates for traumatic brain injury (TBI) over time and across a large geographical area using population based data.
Results & Discussion
Data on TBI hospitalizations, and geographic and demographic variables, came from the Ontario Trauma Registry Minimum Data Set for the fiscal years 1993-1994 and 2001-2002. Various visualization techniques, exploratory data analysis and spatial analysis were employed to map and analyze these data. Both the raw and standardized rates by age/gender of the geographical unit were studied. Data analyses revealed persistent high rates of hospitalization for TBI resulting from any injury mechanism between two time periods in specific geographic locations.
This study shows how geographic information systems can be successfully used to investigate hospitalizaton rates for traumatic brain injury using a range of tools and techniques; findings can be used for local planning of both injury prevention and post discharge services, including rehabilitation.
PMCID: PMC3260231  PMID: 22054220
traumatic brain injury; geographic information systems; geographic visualization; spatial analysis
5.  Comparing the effects of infrastructure on bicycling injury at intersections and non-intersections using a case–crossover design 
Injury Prevention  2013;19(5):303-310.
This study examined the impact of transportation infrastructure at intersection and non-intersection locations on bicycling injury risk.
In Vancouver and Toronto, we studied adult cyclists who were injured and treated at a hospital emergency department. A case–crossover design compared the infrastructure of injury and control sites within each injured bicyclist's route. Intersection injury sites (N=210) were compared to randomly selected intersection control sites (N=272). Non-intersection injury sites (N=478) were compared to randomly selected non-intersection control sites (N=801).
At intersections, the types of routes meeting and the intersection design influenced safety. Intersections of two local streets (no demarcated traffic lanes) had approximately one-fifth the risk (adjusted OR 0.19, 95% CI 0.05 to 0.66) of intersections of two major streets (more than two traffic lanes). Motor vehicle speeds less than 30 km/h also reduced risk (adjusted OR 0.52, 95% CI 0.29 to 0.92). Traffic circles (small roundabouts) on local streets increased the risk of these otherwise safe intersections (adjusted OR 7.98, 95% CI 1.79 to 35.6). At non-intersection locations, very low risks were found for cycle tracks (bike lanes physically separated from motor vehicle traffic; adjusted OR 0.05, 95% CI 0.01 to 0.59) and local streets with diverters that reduce motor vehicle traffic (adjusted OR 0.04, 95% CI 0.003 to 0.60). Downhill grades increased risks at both intersections and non-intersections.
These results provide guidance for transportation planners and engineers: at local street intersections, traditional stops are safer than traffic circles, and at non-intersections, cycle tracks alongside major streets and traffic diversion from local streets are safer than no bicycle infrastructure.
PMCID: PMC3786647  PMID: 23411678

Results 1-5 (5)