• Babul, Shelina

    Titles
    Associate Director, Sports Injury Specialist I BC Injury Research & Prevention Unit I  BC Children's Hospital
    Investigator  I Developmental Neurosciences & Child Health I Child & Family Research Institute
    Investigator  I  Djavad Mowafaghian Center for Brain Health, UBC 
    Clinical Assistant Professor I  Department of Pediatrics/Pathology & Laboratory Medicine, UBC
    Degrees / Designations
    B.Sc., PhD
    Primary Area of Research
    Developmental Neurosciences & Child Health
    Secondary Area(s) of Research
    Phone
    604-875-3682
    Fax
    604-875-3569
    Lab Phone
    Assistant
    Dian Lee
    Assistant Phone
    604-875-3776
    Mailing Address
    BC Children's Hospital

    Room F505A, 4480 Oak Street
    Vancouver BC V6H 3V4

    Affiliate Websites
    Research Areas
    • Concussion and mild Traumatic Brain Injuries (mTBI)
    • Sports & recreation injuries
    • Injury prevention and rehabilitation 
    • Childhood injuries prevention 
    • Epidemiology 
    • Mental Health
    Summary

    Concussion and mild traumatic brain injury (mTBI), used synonymously in the literature, have received enormous attention in recent years, both in the popular press and the scientific literature, especially those related to hockey and football. The Centers for Disease Control has estimated that 1.6 to 3.8 million cases of sport-related concussions occur annually in the United States. Sport and recreational activities contribute to about 21% of all traumatic brain injuries among children in the US.

    Concussions are caused by a direct blow to the head or other body part resulting in a rotational movement of the brain within the skull. It is important to recognize that a concussion can occur with or without loss of consciousness and symptoms can be subtle, including headache, confusion, nausea or dizziness, and may not appear for hours or days. Recommended treatment includes both physical and mental rest. If an individual returns to activity too soon and a second concussion is sustained before recovering from the first, a condition known as second-impact syndrome may occur: a swelling of the brain that can result in brain damage causing severe disability or even death. Furthermore, an individual is three times more likely to sustain a second concussion during recovery from a concussion.

    Dr Babul's recent initiatives include looking at trends and patterns of concussions in BC; and knowledge translation activities to raise awareness of concussion and mTBI among targeted audiences, including health practitioners, coaches, parents and athletes, as well as educators. She is the Chair of the BC Concussion Advisory Network, and is also a co-investigator on the "Safe to Play" and the "Alberta Program in Youth Sport and Recreation Injury Prevention" grant-funded projects.

    Current Projects

    Concussion Awareness Training Tool - CATT

    The new Concussion Awareness Training Toolkit (CATT), led by Dr. Shelina Babul, Associate Director/Sports Injury Specialist with the BC Injury Research and Prevention Unit, is based upon the established international principles of the 4th Zurich Concussion Consensus Statement. The aim of CATT is to standardize concussion recognition, diagnosis, treatment and management. Good concussion management may decrease the risk of brain damage and potentially reduce long-term health issues. 

    CATT for Health Practitioners

    • Funded by the BC Children’s Hospital Foundation and Child Health BC, and in collaboration with the BC Medical Association (now Doctors of BC), CATT HP was developed by a team of injury prevention researchers and Emergency Department physicians with extensive provincial and national review. CATT HP features a learner-directed online training module supplemented with diagnostic tools (both adult and child SCAT3) and links to clinical resources, patient handouts, journal articles, related websites and concussion videos. CATT qualifies for MainPro M2 credits for clinicians. CATT HP has demonstrated a statistically significant increase in practices among physicians and nurses. 

    CATT for Parents, Players and Coaches

    • Developed in partnership with the BC Ministry of Health, CATT PPC provides up-to-date educational training on the recognition, management and prevention of concussions in the form of: 
    • The Canadian Paediatric Society recommends that anyone involved in child and youth sport should be educated about the signs and symptoms of concussion and the appropriate management of a child with a concussion. CATT PPC has demonstrated a statistically significant increase in knowledge among parents.

    CATT for Educators

    • Expected to be launched in Spring 2015, CATT ED is currently in development in partnership with the BC Ministry of Health, Ministry of Education and the GF Strong Rehabilitation Centre. CATT ED will provide educators the necessary resources for supporting a concussed student in his/her integration back to school.

    CATT is FREE, available 24/7, updated every two weeks and available online at www.cattonline.com.

    Evaluating the effects of a change in body-checking policy in youth ice hockey

    Ice hockey is one of Canada’s most popular sports, with over 510,000 youth participants, and over 25% of male youth participating. It is amongst the top three injury-producing sports in youth in Canada, leading to a substantial public health burden. Concussion and other significant injuries have been an increasing concern in Canada, particularly in age groups where body checking is permitted. Policy related to body checking is determined provincially, in conjunction with national Hockey Canada policy.

    Our study aims to answer the following questions:  1) Does the risk of concussion and other hockey-related injury differ significantly between players exposed to rules that permit body checking (Alberta) and players in similar divisions exposed to rules that do not permit body checking (British Columbia’s non-elite divisions; the lower 70%)? 2) What is the cost-effectiveness of such a policy change in youth ice hockey?

    Concussion Awareness Training Toolkit (CATT) for Health Practitioners

    The online Concussion Awareness Training Toolkit (CATT) for health practitioners (cattonline.com) was developed to standardize practice regarding concussion recognition, diagnosis, treatment and management. Based upon established international principles, this online toolkit includes learner-directed training in concussion; diagnostic tools; links to clinical resources, patient handouts, journal articles, related websites, concussion videos and study cases; and the Zurich Consensus Statement.

    The purpose of the two-pronged CATT evaluation is to: 1) Determine if knowledge, attitudes and practices are significantly improved among physicians and nurses following completion of CATT; and 2) Determine if patient care at the British Columbia Children’s Hospital, Canada is improved following physician and nurse completion of CATT.

    Good concussion management will potentially reduce related health problems and may decrease the risk of long-term brain damage, potentially lowering total health care costs among these patients. CATT is currently being rolled out provincially in British Columbia, Canada to all doctors and nurses. This work is being accomplished in collaboration with the BC Medical Association, with the ultimate goal of improving patient care throughout the province. Funding for this project was provided by Child Health BC and the BC Children’s Hospital Foundation.

    Burden of Concussion in Children & Youth Report (commissioned by Child Health BC)

    Evidence suggests that children and youth are at greater risk of concussions and more serious head injury than the general population, take longer than adults to recover following a concussion, and that concussions can permanently change the way a child or youth talks, walks, learns, works and interacts with others. Concussion management and appropriate return to activity is crucial, particularly in the pediatric and adolescent populations. Active and timely rehabilitation is essential for concussion patients who remain symptomatic longer than a six week period. This may include physiotherapy, occupational therapy, educational support, neuropsychology and in some case neuropsychiatry.

    The purpose of the report is to provide details on the burden of concussion among children and youth in BC, to be used to facilitate discussion of the need for standardized concussion prevention, diagnosis and management in BC specific to children and youth. Concussions are the most common form of head injury, yet it is believed that they are under-reported owing to both a lack of consensus on the minimum requirements of the definition of a concussion, and the presence of misconceptions among the general public regarding concussions.

    The findings of this report indicate that concussions remain a significant health issue and require further attention given the long-lasting effects. This may include concussion prevention, education and awareness, standardizing care, ensuring correct treatment protocols are adhered to, and appropriate concussion management is employed.

    Concussion in BC Campaign – in partnership with Preventable (preventable.ca)

    British Columbians may not consider concussions to be a serious preventable injury. They regard it as an outcome of accidents or inevitable occurrences. The focus of this campaign was to raise awareness about concussion in sports, targeting parents (25-55 years of age) of school-aged youth in British Columbia. Key objectives were to raise awareness that concussions can happen to anyone, raise awareness that we may not recognize all the symptoms of concussions, highlight the importance of consulting with health practitioner when unsure about whether a concussion has occurred, and to be aware that severe concussions can result in death.

    Selected Publications

    Cripton PA, Shen H, Brubacher JR, Chipman M, Friedman SM, Harris MA, Winters M, Reynolds CCO, Cusimano MD, Babul S, Teschke K. Severity of urban cycling injuries and the relationship with personal, trip, route and crash characteristics: Analyses using four severity metrics. BMJ Open 2015; 5:e006654. PMID: 25564148.

    Teschke K, Frendo T, Shen H, Harris MA, Reynolds CCO, Cripton PA, Brubacher JR, Cusimano MD, Friedman SM, Hunte G, Monro M, Vernich L, Babul S, Chipman M, Winters M. Do bicycling crash circumstances vary by route type? A cross-sectional study. BMC Public Health 2014, In press. PMID: 25416928.

    Harris MA, Reynolds CCO, Winters M, Cripton PA, Shen H, Chipman M, Cusimano MD, Babul S, Brubacher JR, Friedman SM, Hunte G, Monro M, Vernich L., Teschke K (2013). Comparing the effects of infrastructure on bicycling injury at intersections and non-intersections using a case-crossover design. Injury Prevention, 19:303-310. PMID: 23411678.

    Winters M, Babul S, Becker HJEH, Brubacher JR, Chipman M, Cripton PA, Cusimano MD, Friedman SM, Harris MA, Hunte G, Monro M, Reynolds CCO, Shen H, Teschke K. (2012). Safe cycling: How do risk perceptions compare with observed risk? Canadian Journal of Public Health, 103: S42-S47. PMID: 23618088.

    Teschke K, Harris MA, Reynolds CCO, Winters M, Babul S, Chipman M, Cusimano MD, Brubacher J, Friedman, SM, Hunte G, Monro M, Shen H, Vernich L, Cripton PA. (2012). Route infrastructure and the risk of injuries to bicyclists: A case-crossover study. Am J Public Health, 102(12): 2336-43. PMID: 23078480.

    Leadbeater B, Babul S, Jansson M, Scime G, Pike I.: Youth injuries in British Columbia: type, settings, treatment and costs, 2003-2007. Int J Inj Contr Saf Promot. 2010 Jun;17(2):119-27. PMID: 20229380.

    Desapriya E, Scime G, Cripton P, Babul S, Takeo F, Subzwari S, Pike I.: Child restraint seats: Use, Misuse and Strategies for Improved Action. In: Frank Columbus, editor. New York: Nova Science Publishers. 2009.

    Subzwari S, Desapriya E, Babul S, Pike I, Turcotte K, Rajabali F, Kinney J.: Vision screening of older drivers for preventing road traffic injuries and fatalities. Cochrane Database Syst Rev. 2009, Jan 21. Iss 1. Art No: CD006252. PMID: 21412894.

    Subzwari S, Desapriya E, Scime G, Babul S, Jivani K, Pike I.: Effectiveness of cataract surgery in reducing driving-related difficulties: a systematic review and meta-analysis. Injury Prev. 2008 Oct;14(5):324-8. PMID: 18836050.

    Blair J, Perdios A, Babul S, Young K, Beckles J, Pike I, Cripton P, Sasges D, Mulpuri K, Desapriya E.: The appropriate and inappropriate use of child restraint seats in Manitoba. Int J Injury Cont Safe Promo. 2008 Sept;15(3):151–156. PMID: 18821379.

    Desapriya E, Fujiwara T, Babul S, Scime G, Pike I.: Compulsory child restraint seat law and motor vehicle child occupant deaths and injuries in Japan 1994-2005. Int J Injury Contr Safe Promo. 2008 Jul-Sept;15(2):93-97. PMID: 18642166.

    Blair, J., Perdios, A., Babul, S., Young, K., Beckles, J., Pike, I., Cripton, P., Sasges, D., Mulpuri, K.& Desapriya, E. (2008). The Appropriate and inappropriate use of child restraint seats in Manitoba. International Journal of Injury Control and Safety Promotion; 15(3): 151-6. PMID: 18821379.

    Subzwari, S., Desapriya, E., Scime, G., Babul, S., Jivani, K, & Pike. I.  (2008) Effectiveness of cataract surgery in reducing driving-related difficulties: a systematic review and meta-analysis.  Injury Prevention. 14(5):324-8. PMID: 18836050.

    Desapriya, E., Fujiwara, T., Babul, S., Scime, G. & Pike, I. (2008). Compulsory child restraint seat law and motor vehicle child occupant deaths and injuries in Japan 1994-2005: International Journal of Injury Control and Safety Promotion; 15:2, 93-7. PMID: 18642166.

    Babul, S., Olsen, L., McIntee, P. et al. (2007). A randomized trial to assess the effectiveness of an infant home safety program. International Journal of Injury Control & Safety Promotion; 14(2):109-17. PMID: 17510847.

    Reports

    Babul S, Turcotte K. (2015).  Concussion Awareness Training Tool for Parents, Players & Coaches - Evaluation Report. 

    Girardi A, Babul S, Rajabali, Pike I. (2013). Bullying, Suicide, and Self-Harm among Individuals who are Overweight: An Evidence Review. A report prepared for Provincial Health Services Authority. Vancouver, BC.

    Girardi A, Babul S, Rajabali, Pike I. (2013). Injury Consequences of Promoting Physical Activity: An Evidence Review. A report prepared for Provincial Health Services Authority. Vancouver, BC.

    Rajabali F, Ibrahimova A, Turcotte K, Babul S. (2012). The Burden of Concussion in British Columbia. Vancouver, BC.

    Rajabali F, Ibrahimova A, Turcotte K, Babul S. (2012). The Burden of Concussion Among Children and Youth in British Columbia. Vancouver, BC.

    Grants
    Honours & Awards

    Prevention and Awareness Award, Brain Injury Association of Canada - September 2014

    Research Group Members