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Turner S, Allen VM, Graves L, Tanguay R, Green CR, Cook JL. Guideline No. 443a: Opioid Use Throughout Women's Lifespan: Fertility, Contraception, Chronic Pain, and Menopause. J Obstet Gynaecol Can 2023; 45:102143. [PMID: 37977720 DOI: 10.1016/j.jogc.2023.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
OBJECTIVE To provide health care providers with the best evidence on opioid use and women's health. Areas of focus include general patterns of opioid use and safety of use; care of women who use opioids; stigma, screening, brief intervention, and referral to treatment; hormonal regulation; reproductive health, including contraception and fertility; sexual function; perimenopausal and menopausal symptoms; and chronic pelvic pain syndromes. TARGET POPULATION The target population includes all women currently using or contemplating using opioids. OUTCOMES Open, evidence-informed dialogue about opioid use will lead to improvements in patient care and overall health. BENEFITS, HARMS, AND COSTS Exploring opioid use through a trauma-informed approach offers the health care provider and patient with an opportunity to build a strong, collaborative, and therapeutic alliance. This alliance empowers women to make informed choices about their own care. It also allows for the diagnosis and possible treatment of opioid use disorders. Use should not be stigmatized, as stigma leads to poor "partnered care" (i.e., the partnership between the patient and care provider). Therefore, health care providers and patients must understand the potential role of opioids in women's health (both positive and negative) to ensure informed decision-making. EVIDENCE A literature search was designed and carried out in PubMed and the Cochrane Library databases from August 2018 until March 2023 using following MeSH terms and keywords (and variants): opioids, illicit drugs, fertility, pregnancy, breastfeeding, and aging. VALIDATION METHODS The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. See online Appendix A (Tables A1 for definitions and A2 for interpretations of strong and weak recommendations). INTENDED AUDIENCE All health care providers who care for women. TWEETABLE ABSTRACT Opioid use can affect female reproductive function; health care providers and patients must understand the potential role of opioids in women's health to ensure informed decision-making. SUMMARY STATEMENTS RECOMMENDATIONS.
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Turner S, Allen VM, Carson G, Graves L, Tanguay R, Green CR, Cook JL. Guideline No. 443b: Opioid Use Throughout Women's Lifespan: Opioid Use in Pregnancy and Breastfeeding. J Obstet Gynaecol Can 2023; 45:102144. [PMID: 37977721 DOI: 10.1016/j.jogc.2023.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
OBJECTIVE To provide health care providers the best evidence on opioid use and women's health. Areas of focus include pregnancy and postpartum care. TARGET POPULATION The target population includes all women currently using or contemplating using opioids. OUTCOMES Open, evidence-informed dialogue about opioid use will improve patient care. BENEFITS, HARMS, AND COSTS Exploring opioid use through a trauma-informed approach provides the health care provider and patient with an opportunity to build a strong, collaborative, and therapeutic alliance. This alliance empowers women to make informed choices about their own care. It also allows for the diagnosis and possible treatment of opioid use disorders. Opioid use should not be stigmatized, as stigma leads to poor "partnered care" (i.e., the partnership between the patient and care provider). Health care providers need to understand the effect opioids can have on pregnant women and support them to make knowledgeable decisions about their health. EVIDENCE A literature search was designed and carried out in PubMed and the Cochrane Library databases from August 2018 until March 2023 using following MeSH terms and keywords (and variants): opioids, opioid agonist therapy, illicit drugs, fertility, pregnancy, fetal development, neonatal abstinence syndrome, and breastfeeding. VALIDATION METHODS The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. See online Appendix A (Tables A1 for definitions and A2 for interpretations of strong and conditional [weak] recommendations). INTENDED AUDIENCE All health care providers who care for pregnant and/or post-partum women and their newborns. TWEETABLE ABSTRACT Opioid use during pregnancy often co-occurs with mental health issues and is associated with adverse maternal, fetal, and neonatal outcomes; treatment of opioid use disorder with agonist therapy for pregnant women can be safe during pregnancy where the risks outnumber the benefits. SUMMARY STATEMENTS RECOMMENDATIONS.
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Wakai A, Cook JL. Is the MEOWing of emergency department postpartum patients of diagnostic safety value? CAN J EMERG MED 2023:10.1007/s43678-023-00526-x. [PMID: 37264280 DOI: 10.1007/s43678-023-00526-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Abel Wakai
- Department of Emergency Medicine, Beaumont Hospital, Dublin 9, Ireland.
- Emergency Care Research Unit (ECRU), Royal College of Surgeons in Ireland (RCSI), Dublin 2, Ireland.
| | - Jocelynn L Cook
- Department of Obstetrics, Gynaecology and Newborn Care, University of Ottawa, Ottawa, ON, Canada
- The Society of Obstetricians and Gynaecologists of Canada, Ottawa, ON, Canada
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Cook JL, Shea AK, St-André M. Troubles de santé mentale périnataux : Agissons maintenant, ensemble. J Obstet Gynaecol Can 2023; 45:6-8. [PMID: 36725132 DOI: 10.1016/j.jogc.2022.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Jocelynn L Cook
- The Society of Obstetricians and Gynaecologists of Canada, Ottawa, ON
| | - Alison K Shea
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON
| | - Martin St-André
- Clinique de psychiatrie périnatale et du jeune enfant, Centre Hospitalier Universitaire Sainte-Justine, Montréal, QC; Université de Montréal, Montréal, QC
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Cook JL, Shea AK, St-André M. Perinatal Mental Illness: We Need to Act Now. Together. J Obstet Gynaecol Can 2023; 45:4-5. [PMID: 36725129 DOI: 10.1016/j.jogc.2022.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- Jocelynn L Cook
- The Society of Obstetricians and Gynaecologists of Canada, Ottawa, ON
| | - Alison K Shea
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON
| | - Martin St-André
- Clinique de psychiatrie périnatale et du jeune enfant, Centre Hospitalier Universitaire Sainte-Justine, Montréal, QC; Université de Montréal, Montréal, QC
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Abstract
An opioid epidemic has been happening across the world since the 1990s and continues impact individuals, families, communities and societies around the globe. The epidemic has evolved from heroin misuse to the use of synthetic opioids that are easily manufactured and are readily available. Reasons for the continuing opioid epidemic are complex, and include factors related to mental health, addiction, chronic pain relief, and, now, the COVID-19 pandemic. Women have been disproportionally affected by the opioid epidemic and the physical and biosocial effects of opioid use specific to women are an important consideration for healthcare providers. Recent data show that the effects of the opioid epidemic on rates of opioid use disorder (OUD), overdoses, and the economy continue to rise, despite global efforts to understand the drivers and develop effective prevention and intervention strategies, programs, and policies.
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Affiliation(s)
- Jocelynn L Cook
- The Society of Obstetricians and Gynaecologists of Canada and the Department of Obstetrics, Gynaecology and Newborn Care, The University of Ottawa, 2781 Lancaster Rd, Suite 200, Ottawa, ON K1B 1A7, Canada.
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Cook JL. Epidemiology of opioid use in pregnancy. Best Pract Res Clin Obstet Gynaecol 2022; 85:12-17. [PMID: 36045026 DOI: 10.1016/j.bpobgyn.2022.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 07/22/2022] [Accepted: 07/26/2022] [Indexed: 12/14/2022]
Abstract
The world has been experiencing an opioid epidemic for over 20 years, and rates of use and overdose among women, including during pregnancy, have risen markedly. Women receive more prescriptions for opioids compared to men. Data suggest that 20% of women filled at least one prescription for an opioid during their pregnancy, and the prevalence of prenatal exposure averaged 14%. Opioid use by women, especially during pregnancy and while breastfeeding, and management and treatment is complex for healthcare providers, especially related to methadone treatment, pain management during labour, neonatal opioid withdrawal syndrome, nutritional issues and maternal withdrawal. Opioid use during pregnancy has been associated with maternal, foetal and infant complications, and overdose has become a leading cause of death in post-partum women in some countries. Universal screening for opioid use disorder (OUD) is recommended in pregnancy, and prevention and treatment programs that meet the specific needs of women are important to understand and consider as the world continues to try to anticipate and respond to the realities of the opioid epidemic.
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Affiliation(s)
- Jocelynn L Cook
- The Society of Obstetricians and Gynaecologists of Canada and the Department of Obstetrics, Gynaecology and Newborn Care, The University of Ottawa, 2781 Lancaster Rd, Suite 200, Ottawa, ON, K1B 1A7, Canada.
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Cook JL, Wilson RD. Providers need guidance on managing perinatal mental health. CMAJ 2022; 194:E1328. [PMID: 36191938 PMCID: PMC9529566 DOI: 10.1503/cmaj.147105-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Jocelynn L Cook
- Chief scientific officer, The Society of Obstetricians and Gynaecologists of Canada, Ottawa, Ont
| | - R Douglas Wilson
- Obstetrician-gynaecologist, University of Calgary, Calgary, Alta
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Schuster BA, Sowden S, Rybicki AJ, Fraser DS, Press C, Holland P, Cook JL. Dopaminergic Modulation of Dynamic Emotion Perception. J Neurosci 2022; 42:4394-4400. [PMID: 35501156 PMCID: PMC9145228 DOI: 10.1523/jneurosci.2364-21.2022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 03/20/2022] [Accepted: 03/22/2022] [Indexed: 11/21/2022] Open
Abstract
Emotion recognition abilities are fundamental to our everyday social interaction. A large number of clinical populations show impairments in this domain, with emotion recognition atypicalities being particularly prevalent among disorders exhibiting a dopamine system disruption (e.g., Parkinson's disease). Although this suggests a role for dopamine in emotion recognition, studies employing dopamine manipulation in healthy volunteers have exhibited mixed neural findings and no behavioral modulation. Interestingly, while a dependence of dopaminergic drug effects on individual baseline dopamine function has been well established in other cognitive domains, the emotion recognition literature so far has failed to account for these possible interindividual differences. The present within-subjects study therefore tested the effects of the dopamine D2 antagonist haloperidol on emotion recognition from dynamic, whole-body stimuli while accounting for interindividual differences in baseline dopamine. A total of 33 healthy male and female adults rated emotional point-light walkers (PLWs) once after ingestion of 2.5 mg haloperidol and once after placebo. To evaluate potential mechanistic pathways of the dopaminergic modulation of emotion recognition, participants also performed motoric and counting-based indices of temporal processing. Confirming our hypotheses, effects of haloperidol on emotion recognition depended on baseline dopamine function, where individuals with low baseline dopamine showed enhanced, and those with high baseline dopamine decreased emotion recognition. Drug effects on emotion recognition were related to drug effects on movement-based and explicit timing mechanisms, indicating possible mediating effects of temporal processing. Results highlight the need for future studies to account for baseline dopamine and suggest putative mechanisms underlying the dopaminergic modulation of emotion recognition.SIGNIFICANCE STATEMENT A high prevalence of emotion recognition difficulties among clinical conditions where the dopamine system is affected suggests an involvement of dopamine in emotion recognition processes. However, previous psychopharmacological studies seeking to confirm this role in healthy volunteers thus far have failed to establish whether dopamine affects emotion recognition and lack mechanistic insights. The present study uncovered effects of dopamine on emotion recognition in healthy individuals by controlling for interindividual differences in baseline dopamine function and investigated potential mechanistic pathways via which dopamine may modulate emotion recognition. Our findings suggest that dopamine may influence emotion recognition via its effects on temporal processing, providing new directions for future research on typical and atypical emotion recognition.
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Affiliation(s)
- B A Schuster
- School of Psychology, University of Birmingham, Birmingham, B15 2TT, United Kingdom
- Centre for Human Brain Health, University of Birmingham, Birmingham, B15 2TT, United Kingdom
| | - S Sowden
- School of Psychology, University of Birmingham, Birmingham, B15 2TT, United Kingdom
- Centre for Human Brain Health, University of Birmingham, Birmingham, B15 2TT, United Kingdom
| | - A J Rybicki
- School of Psychology, University of Birmingham, Birmingham, B15 2TT, United Kingdom
- Centre for Human Brain Health, University of Birmingham, Birmingham, B15 2TT, United Kingdom
| | - D S Fraser
- School of Psychology, University of Birmingham, Birmingham, B15 2TT, United Kingdom
- Centre for Human Brain Health, University of Birmingham, Birmingham, B15 2TT, United Kingdom
| | - C Press
- Department of Psychological Sciences, Birkbeck University of London, London, WC1E 7HX, United Kingdom
- Wellcome Centre for Human Neuroimaging, University College London, London, WC1N 3AR, United Kingdom
| | - P Holland
- Department of Psychology, Goldsmiths University of London, London, SE14 6NW, United Kingdom
| | - J L Cook
- School of Psychology, University of Birmingham, Birmingham, B15 2TT, United Kingdom
- Centre for Human Brain Health, University of Birmingham, Birmingham, B15 2TT, United Kingdom
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Robert M, Graves LE, Allen VM, Dama S, Gabrys RL, Tanguay RL, Turner SD, Green CR, Cook JL. Guideline No. 425a: Cannabis Use Throughout Women's Lifespans - Part 1: Fertility, Contraception, Menopause, and Pelvic Pain. J Obstet Gynaecol Can 2022; 44:407-419.e4. [PMID: 35400519 DOI: 10.1016/j.jogc.2022.01.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To provide health care providers with the best evidence on cannabis use with respect to women's health. Areas of focus include general patterns of cannabis use as well as safety of use; care for women who use cannabis; stigma; screening, brief intervention, and referral to treatment; impact on hormonal regulation; reproductive health, including contraception and fertility; sexual function; effects on perimenopausal and menopausal symptoms; and use in chronic pelvic pain syndromes. TARGET POPULATION The target population includes all women currently using or contemplating using cannabis. OUTCOMES Open, evidence-informed dialogue about cannabis use, which will lead to improvement in patient care. BENEFITS, HARMS, AND COSTS Exploring cannabis use through a trauma-informed approach provides the health care provider and patient with an opportunity to build a strong, collaborative, therapeutic alliance. This alliance empowers women to make informed choices about their own care. It also allows for the diagnosis and possible treatment of cannabis use disorders. Use should not be stigmatized, as stigma leads to poor "partnered care" (i.e., the partnership between the patient and care provider). Multiple side effects of cannabis use may be mistaken for other disorders. Currently, use of cannabis to treat women's health issues is not covered by public funding; as a result, individual users must pay the direct cost. The indirect costs of cannabis use are unknown. Thus, health care providers and patients must understand the role of cannabis in women's health issues, so that women can make knowledgeable decisions. EVIDENCE PubMed, EMBASE, and grey literature were searched to identify studies of "cannabis use and effect on infertility, contraception, perimenopause and menopausal symptoms, and pelvic pain" published between January 1, 2018 and February 18, 2021. All clinical trials, observational studies, reviews (including systematic reviews and meta-analyses), guidelines, and conference consensus statements were included. Publications were screened for relevance. The search terms were developed using the Medical Subject Headings (MeSH) terms and keywords (and variants), including cannabis, cannabinoids, marijuana, dexanabinol, dronabinol, tetrahydrocannabinol; the specific terms to capture women's health were estrogen, estradiol, medroxyprogesterone acetate, vaginal contraception, oral contraceptives, fertilization, amenorrhea, oligomenorrhea, pelvic pain, dysmenorrhea, endometriosis, interstitial cystitis, vulvodynia, and menopause. VALIDATION METHODS The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. See online Appendix A (Tables A1 for definitions and A2 for interpretations of strong and weak recommendations). INTENDED AUDIENCE All heath care providers who care for women. SUMMARY STATEMENTS RECOMMENDATIONS.
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Graves LE, Robert M, Allen VM, Dama S, Gabrys RL, Tanguay RL, Turner SD, Green CR, Cook JL. Guideline No. 425b: Cannabis Use Throughout Women's Lifespans - Part 2: Pregnancy, the Postnatal Period, and Breastfeeding. J Obstet Gynaecol Can 2022; 44:436-444.e1. [PMID: 35400521 DOI: 10.1016/j.jogc.2022.01.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To provide health care providers with the best evidence on cannabis use and women's health. Areas of focus include screening, dependence, and withdrawal; communication and documentation; pregnancy (including maternal and fetal outcomes); maternal pain control; postpartum care (including second-hand smoking and parenting); and breastfeeding. TARGET POPULATION The target population includes women who are planning a pregnancy, pregnant, or breastfeeding. BENEFITS, HARMS, AND COSTS Discussing cannabis use with women who are planning a pregnancy, pregnant, or breastfeeding allows them to make informed choices about their cannabis use. Based on the limited evidence, cannabis use in pregnancy or while breastfeeding should be avoided, or reduced as much as possible if abstaining is not feasible, given the absence of safety and long-term follow up data on cannabis-exposed pregnancies and infants. EVIDENCE PubMed and Cochrane Library databases were searched for articles relevant to cannabis use during pregnancy and breastfeeding published between January 1, 2018, and February 5, 2021. The search terms were developed using the MeSH terms and keywords and their variants, including cannabis, cannabinoids, cannabidiol, CBD, THC, marijuana, edible, pregnancy, pregnant, prenatal, perinatal, postnatal, breastfeed, breastfed, lactation, nursing, fetus, fetal, neonatal, newborn, and child. In terms of publication type, all clinical trials, observational studies, reviews (including systematic reviews and meta-analyses), guidelines, and conference consensus statements were included. The main inclusion criteria were pregnant and breastfeeding women as the target population, and exposure to cannabis as the intervention of interest. VALIDATION METHODS The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. See online Appendix A (Tables A1 for definitions and A2 for interpretations of strong and weak recommendations). INTENDED AUDIENCE All health care providers who care for women of reproductive age. SUMMARY STATEMENTS RECOMMENDATIONS.
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Cook JL. Alcohol use during pregnancy and fetal alcohol spectrum disorder in Canada: who, what, where? Health Promot Chronic Dis Prev Can 2021; 41:264-266. [PMID: 34549917 PMCID: PMC8565492 DOI: 10.24095/hpcdp.41.9.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Jocelynn L Cook
- Chief Scientific Officer, The Society of Obstetricians and Gynaecologists of Canada, Ottawa, Ontario, Canada
- National Database Lead, Canada FASD Research Network, Vancouver, British Columbia, Canada
- Adjunct Professor, Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Ontario, Canada
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Thorne SA, Cook JL, D'Souza R. The Role of National Pregnancy Surveillance Systems in Improving Maternal Mortality and Morbidity: The Next Steps for Canada. Can J Cardiol 2021; 37:1904-1907. [PMID: 34474122 DOI: 10.1016/j.cjca.2021.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 08/23/2021] [Accepted: 08/24/2021] [Indexed: 10/20/2022] Open
Affiliation(s)
- Sara A Thorne
- Division of Cardiology, Pregnancy and Heart Disease Program, Mount Sinai Hospital & University Health Network, University of Toronto, Toronto, Ontario, Canada.
| | - Jocelynn L Cook
- Department of Obstetrics and Gynecology, University of Ottawa, and the Society of Obstetricians and Gynaecologists of Canada, Ottawa, Ontario, Canada
| | - Rohan D'Souza
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
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Graves L, Carson G, Poole N, Patel T, Bigalky J, Green CR, Cook JL. Guideline No. 405: Screening and Counselling for Alcohol Consumption During Pregnancy. J Obstet Gynaecol Can 2021; 42:1158-1173.e1. [PMID: 32900457 DOI: 10.1016/j.jogc.2020.03.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To establish national standards of care for screening and counselling pregnant women and women of child-bearing age about alcohol consumption and possible alcohol use disorder based on current best evidence. INTENDED USERS Health care providers who care for pregnant women and women of child-bearing age. TARGET POPULATION Pregnant women and women of child-bearing age and their families. EVIDENCE Medline, EMBASE, and CENTRAL databases were searched for "alcohol use and pregnancy." The results were filtered for a publication date between 2010 and September 2018. The search terms were developed using Medical Subject Headings terms and keywords, including pre-pregnancy, pregnant, breastfeeding, lactation, female, women, preconception care, prenatal care, fetal alcohol spectrum disorder, prenatal alcohol exposure, drinking behavior, alcohol abstinence, alcohol drinking, binge drinking, alcohol-related disorders, alcoholism, alcohol consumption, alcohol abuse, benzodiazepines, disulfiram, naltrexane, acamprosate, ondansetron, topiramate, cyanamide, calcium carbimide, alcohol deterrents, disease management, detoxification, Alcoholics Anonymous, alcohol counselling, harm reduction, pre-pregnancy care, prenatal care, incidence, prevalence, epidemiological monitoring, and brief intervention. Evidence was included from clinical trials, observational studies, reviews, systematic reviews and meta-analyses, guidelines, and conference consensus. VALIDATION METHODS The content and recommendations in this guideline were drafted and agreed upon by the authors. The Board of Directors of the Society of Obstetricians and Gynaecologists of Canada approved the final draft for publication. The quality of evidence was rated using the criteria described in the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology framework. BENEFITS, HARMS, COSTS Implementation of the recommendations in these guidelines using validated screening tools and brief intervention approaches may increase obstetrical care provider recognition of alcohol consumption and problematic alcohol use among women of child-bearing age and those who are pregnant. It is anticipated that health care providers will become confident and competent in managing and supporting these women so they can achieve optimal health and pregnancy outcomes. SUMMARY STATEMENTS (GRADE RATINGS IN PARENTHESES) RECOMMENDATIONS (GRADE RATINGS IN PARENTHESES).
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Green CR, Kaminsky KJ, Tough S, Roberts N, Nagpal TS, Cook JL. Perspectives of Canadian Health Care Providers on Fetal Alcohol Spectrum Disorder: Has Anything Changed in 15 years? A Brief Report. J Obstet Gynaecol Can 2021; 43:1086-1089. [PMID: 33581349 DOI: 10.1016/j.jogc.2021.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 01/17/2021] [Accepted: 01/18/2021] [Indexed: 11/26/2022]
Abstract
Initiatives have been implemented to provide training to health care providers (HCPs) on the adverse health outcomes associated with alcohol use during pregnancy, including the risk of fetal alcohol spectrum disorder (FASD). The purpose of this exploratory study was to compare two cross-sectional data sets of HCP perspectives over 15 years. In 2002 and 2017, two samples of HCPs received a survey on FASD. The findings from these surveys may inform the development of ongoing educational initiatives to help HCPs with screening for alcohol use during pregnancy and early diagnosis and prevention of FASD.
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Affiliation(s)
- Courtney R Green
- The Society of Obstetricians and Gynaecologists of Canada, Ottawa, ON
| | - Kyla J Kaminsky
- The Society of Obstetricians and Gynaecologists of Canada, Ottawa, ON
| | - Suzanne Tough
- Cumming School of Medicine, University of Calgary, Calgary, AB
| | - Nicole Roberts
- Better Outcomes Registry & Network (BORN) Ontario, Centre for Practice-Changing Research, Ottawa, ON
| | - Taniya S Nagpal
- The Society of Obstetricians and Gynaecologists of Canada, Ottawa, ON
| | - Jocelynn L Cook
- The Society of Obstetricians and Gynaecologists of Canada, Ottawa, ON.
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Burns J, Badry DE, Harding KD, Roberts N, Unsworth K, Cook JL. Comparing outcomes of children and youth with fetal alcohol spectrum disorder (FASD) in the child welfare system to those in other living situations in Canada: Results from the Canadian National FASD Database. Child Care Health Dev 2021; 47:77-84. [PMID: 33068027 DOI: 10.1111/cch.12817] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 09/29/2020] [Accepted: 10/12/2020] [Indexed: 11/28/2022]
Abstract
AIMS The current study aimed to explore differences in adverse outcomes between youth and adolescents with fetal alcohol spectrum disorder (FASD) living in child welfare care (i.e., foster care or group home) with those living with their biological parent(s) or with adoptive or other family member(s) in Canada. METHODS Data gathered from the Canadian National FASD Database were used for analysis. A total of 665 youth and adolescents with a clinical diagnosis of FASD under the age of 18 living in child welfare care, with biological, adoptive or other family members, were included in the sample. Key areas examined included living situation, legal problems, experience of sexual or physical abuse, mental health (anxiety, conduct disorder, mood disorder and post-traumatic stress disorder) and suicidal ideation. Descriptive statistics and chi-square comparisons were utilized to explore these differences. RESULTS Results revealed a significantly higher rate of reported sexual and physical abuse among individuals in child welfare care compared with those living with biological parents or with adoptive or other family member(s). Rates of difficulty with the law were also higher among those in child welfare care compared with adoptive/other family members. Conversely, the rate of mood disorders was significantly higher among those living with adoptive/other family members compared with child welfare care. Results highlight similar rates of reported suicidal ideation/attempts across all living situations, as well as mental health concerns. CONCLUSIONS Results offer rare insight into the lives of youth and adolescents under age 18 with diagnosed FASD who reside in child welfare care in contrast to those living with biological parent(s) or with adoptive or other family members. These findings increase our awareness of the complexity of mental health concerns and suicide risk across all living environments. Results have further implications for policy, practice and clinical intervention.
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Affiliation(s)
- Jessica Burns
- The Canada FASD Research Network, Vancouver, British Columbia, Canada
| | - Dorothy E Badry
- The Canada FASD Research Network, Vancouver, British Columbia, Canada.,Faculty of Social Work, University of Calgary, Calgary, Alberta, Canada
| | - Kelly D Harding
- The Canada FASD Research Network, Vancouver, British Columbia, Canada.,Psychology Department, Laurentian University, Sudbury, Ontario, Canada
| | | | - Kathy Unsworth
- The Canada FASD Research Network, Vancouver, British Columbia, Canada
| | - Jocelynn L Cook
- The Canada FASD Research Network, Vancouver, British Columbia, Canada.,Department of Obstetrics, Gynaecology and Newborn Care, The University of Ottawa, Ottawa, Ontario, Canada.,The Society of Obstetricians and Gynaecologists of Canada, Ottawa, Ontario, Canada
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Graves LE, Green CR, Robert M, Cook JL. Methamphetamine Use in Pregnancy: A Call for Action. J Obstet Gynaecol Can 2020; 43:1001-1004. [PMID: 33301957 DOI: 10.1016/j.jogc.2020.11.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 11/03/2020] [Accepted: 11/04/2020] [Indexed: 10/22/2022]
Abstract
Substance use during pregnancy continues to be an area of concern in Canada. Rates of substance use appear to be increasing among women of childbearing age, and use during pregnancy may effect maternal and fetal outcomes. Little is known of the prevalence of methamphetamine use during pregnancy and its impact, but maternity care providers are encountering patients who use methamphetamines in their practices. These health care providers are asking for evidence-based recommendations for management and treatment. There is an immediate and urgent need to address this gap in order to improve the health of pregnant women and their babies.
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Affiliation(s)
- Lisa E Graves
- Family and Community Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI
| | - Courtney R Green
- Society of Obstetricians and Gynaecologists of Canada, Ottawa, ON
| | - Magali Robert
- Cumming School of Medicine, University of Calgary, Calgary, AB; Chronic Pain Centre, University of Calgary, Calgary, AB; Department of Obstetrics and Gynaecology, University of Calgary, Calgary, AB; Department of Anesthesiology, Perioperative, and Pain Medicine, University of Calgary, Calgary, AB
| | - Jocelynn L Cook
- Society of Obstetricians and Gynaecologists of Canada, Ottawa, ON; Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, ON.
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18
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Davidson AJF, Park AL, Berger H, Aoyama K, Harel Z, Cohen E, Cook JL, Ray JG. Association of Improved Periconception Hemoglobin A1c With Pregnancy Outcomes in Women With Diabetes. JAMA Netw Open 2020; 3:e2030207. [PMID: 33355674 PMCID: PMC7758806 DOI: 10.1001/jamanetworkopen.2020.30207] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
IMPORTANCE Prepregnancy diabetes is associated with higher perinatal and maternal morbidity, especially if periconception glycemic control is suboptimal. It is not known whether improved glycemic control from preconception to early pregnancy and midpregnancy periods can reduce the risk of adverse perinatal and maternal outcomes. OBJECTIVE To determine whether a net decline in glycated hemoglobin A1c (HbA1c) from preconception to the first half of pregnancy is associated with a lower risk of adverse outcomes for mother and child. DESIGN, SETTING, AND PARTICIPANTS This population-based cohort study was completed in all of Ontario, Canada, from 2007 to 2018. Included were births among women with prepregnancy diabetes whose HbA1c was measured within 90 days preconception and again from conception through 21 weeks completed gestation (early pregnancy to midpregnancy). Statistical analysis was performed from July to September 2020. EXPOSURES Net decrease in HbA1c from preconception to early pregnancy and midpregnancy. MAIN OUTCOMES AND MEASURES The main outcome was a congenital anomaly from birth to age 1 year. Other outcomes included preterm birth or perinatal mortality among offspring as well as severe maternal morbidity (SMM) or death among mothers. Adjusted relative risks (aRRs) were calculated per 0.5% absolute net decline in HbA1c from preconception up to early pregnancy and midpregnancy, adjusting for maternal age at conception, preconception HbA1c and hemoglobin concentration, and gestational age at HbA1c measurement. RESULTS A total of 3459 births were included, with a mean (SD) maternal age of 32.6 (5.0) years at conception. Overall, the mean (SD) HbA1c decreased from 7.2% (1.6%) preconception to 6.4% (1.1%) in early pregnancy to midpregnancy. There were 497 pregnancies (14.4%) with a congenital anomaly, with an aRR of 0.94 (95% CI, 0.89-0.98) per 0.5% net decrease in HbA1c, including for cardiac anomalies (237 infants; aRR, 0.89; 95% CI, 0.84-0.95). The risk was also reduced for preterm birth (847 events; aRR, 0.89; 95% CI, 0.86-0.91). SMM or death occurred among 191 women (5.5%), with an aRR of 0.90 (95% CI, 0.84-0.96) per 0.5% net decrease in HbA1c. CONCLUSIONS AND RELEVANCE These findings suggest that women with prepregnancy diabetes who achieve a reduction in HbA1c may have improved perinatal and maternal outcomes. Further study is recommended to determine the best combination of factors, such as lifestyle changes and/or glucose-lowering medications, that can influence periconception HbA1c reduction.
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Affiliation(s)
| | - Alison L. Park
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
| | - Howard Berger
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine, St Michael’s Hospital, Toronto, Ontario, Canada
- Department of Obstetrics and Gynaecology, St Michael’s Hospital, Toronto, Ontario, Canada
| | - Kazuyoshi Aoyama
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Ziv Harel
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Department of Medicine, St Michael’s Hospital, Toronto, Ontario, Canada
| | - Eyal Cohen
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Jocelynn L. Cook
- Department of Obstetrics and Gynaecology, University of Ottawa, Ottawa, Ontario, Canada
- The Society of Obstetricians and Gynaecologists of Canada, Ottawa, Ontario, Canada
| | - Joel G. Ray
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Department of Medicine, St Michael’s Hospital, Toronto, Ontario, Canada
- Department of Obstetrics and Gynaecology, St Michael’s Hospital, Toronto, Ontario, Canada
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19
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Nagpal TS, Green CR, Cook JL. Vaping During Pregnancy: What Are the Potential Health Outcomes and Perceptions Pregnant Women Have? J Obstet Gynaecol Can 2020; 43:219-226. [PMID: 33187893 DOI: 10.1016/j.jogc.2020.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 05/29/2020] [Accepted: 05/29/2020] [Indexed: 10/23/2022]
Abstract
The prevalence of electronic nicotine delivery systems, such as vaping, is a growing public health concern, and there is limited information on the use of these devices during pregnancy. The objective of this rapid review was to summarize the available literature on human studies of the potential maternal or fetal health effects of vaping or women's perceptions of vaping during pregnancy. A systematic search was completed in the following databases: Medline, EMBASE, Scopus, Web of Science, and CINAHL. A search strategy was developed combining the terms pregnancy and vaping. Findings were divided into two groups and summarized as: 1) Health outcomes following vaping during pregnancy; and 2) Perceptions pregnant women have related to vaping during pregnancy. A total of 760 articles were retrieved and, after applying the inclusion/exclusion criteria and screening, 19 studies were included. Five included studies provided evidence on potential health outcomes and 14 were focused on perceptions. There is emerging evidence that vaping during pregnancy may increase the risk of small for gestational age newborns. Pregnant women generally report that they used vaping products during pregnancy for smoking cessation and perceived that this was a healthier alternative to traditional cigarettes. Overall, there was consensus that there is a lack of information on maternal and fetal health outcomes following vaping during pregnancy. Based on the findings of this rapid review, there is an urgent need for high-quality studies in pregnant women to evaluate the potential in utero and long-term effects of exposure to prenatal vaping.
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Affiliation(s)
- Taniya S Nagpal
- The Society of Obstetricians and Gynaecologists of Canada, Ottawa, ON; Department of Human Kinetics, University of Ottawa, Ottawa, ON.
| | - Courtney R Green
- The Society of Obstetricians and Gynaecologists of Canada, Ottawa, ON
| | - Jocelynn L Cook
- The Society of Obstetricians and Gynaecologists of Canada, Ottawa, ON; Department of Obstetrics and Gynaecology, University of Ottawa, Ottawa, ON
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20
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Nagpal TS, Liu RH, Gaudet L, Cook JL, Adamo KB. Summarizing recommendations to eliminate weight stigma in prenatal health care settings: A scoping review. Patient Educ Couns 2020; 103:2214-2223. [PMID: 32624327 DOI: 10.1016/j.pec.2020.06.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 04/30/2020] [Accepted: 06/17/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE As the prevalence of obesity increases, more women are at risk of potentially experiencing weight stigma in prenatal health care settings. The objective of this scoping review was to summarize the primary literature assessing potential causes of weight stigma in prenatal health care settings and synthesize recommendations for health care providers to improve clinical practice. METHODS A search strategy was developed combining the terms pregnancy, weight stigma, obesity, and prenatal care. A systematic search was completed in the following databases: Medline, EMBASE, PsycInfo, CINAHL, Opengrey, and Proquest. RESULTS Eighteen resources were included in this review, of which 17 were qualitative, and one was a mixed-methods study design. Weight stigma occurred in prenatal health care settings when providers: avoided weight-related discussions, assumed lifestyle behaviors, and had poor communication when discussing risks associated with obesity. Recommendations to prevent weight stigma included: offering sensitivity training to discuss obesity during pregnancy, implementing a patient-centred approach, including evaluating individual health behaviors, and providing educational resources to patients explaining potential risks and referrals. CONCLUSION This review summarizes recommendations to eliminate weight stigma in prenatal health care settings. PRACTICE IMPLICATIONS These recommendations can be implemented in clinical practice and can improve the delivery of prenatal care.
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Affiliation(s)
- Taniya S Nagpal
- Department of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada; Society of Obstetricians and Gynaecologists of Canada, Ottawa, Canada.
| | - Rebecca H Liu
- Department of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada; Women's College Hospital, Institute for Health System Solutions & Virtual Care, Toronto, Ontario, Canada
| | - Laura Gaudet
- Department of Obstetrics and Gynecology, Queen's University, Kingston, Canada
| | - Jocelynn L Cook
- Society of Obstetricians and Gynaecologists of Canada, Ottawa, Canada; Department of Obstetrics and Gynaecology, University of Ottawa, Ottawa, ON, Canada
| | - Kristi B Adamo
- Department of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
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21
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Dubé E, Gagnon D, Kaminsky K, Green CR, Ouakki M, Bettinger JA, Brousseau N, Castillo E, Crowcroft NS, Driedger SM, Greyson D, Fell D, Fisher W, Gagneur A, Guay M, Halperin D, Halperin SA, MacDonald S, Meyer SB, Waite NM, Wilson K, Witteman HO, Yudin M, Cook JL. Vaccination during pregnancy: Canadian maternity care providers' opinions and practices. Hum Vaccin Immunother 2020; 16:2789-2799. [PMID: 32271655 DOI: 10.1080/21645515.2020.1735225] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
A number of countries have implemented vaccination in pregnancy as a strategy to reduce the burden of influenza and pertussis. The aim of this study was to assess the involvement of Canadian maternity care providers in administration of vaccines to their pregnant patients. A cross-sectional web-based survey was sent to family physicians, obstetricians-gynecologists, midwives, pharmacists, and nurses. A multivariable logistic regression model was used to determine variables independently associated with offering vaccination services in pregnancy in providers' practice. A total of 1,135 participants participated. Overall, 64% (n = 724) of the participants reported offering vaccines in their practice and 56% (n = 632) reported offering vaccines to pregnant patients. The main reasons reported for not offering vaccination services in pregnancy were the belief that vaccination was outside of the scope of practice; logistical issues around access to vaccines; or lack of staff to administer vaccines. In multivariable analysis, the main factors associated with vaccination of pregnant patients in practices where vaccination services were offered were: providers' confidence in counseling pregnant patients about vaccines, seeing fewer than 11 pregnant patients on average each week, and being a nurse or a family physician. Although the majority of participants expressed strong support for vaccination during pregnancy, half were not offering vaccination services in their practice. Many were not equipped to offer vaccines in their practice or felt that it was not their role to do so. To enhance vaccine acceptance and uptake in pregnancy, it will be important to address the logistical barriers identified in this study.
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Affiliation(s)
- Eve Dubé
- Direction des risques biologiques et de la santé au travail, Institut National de Santé Publique du Québec , Québec, Canada
| | - Dominique Gagnon
- Direction des risques biologiques et de la santé au travail, Institut National de Santé Publique du Québec , Québec, Canada
| | - Kyla Kaminsky
- Society of Obstetricians and Gynaecologists of Canada , Ottawa, Canada
| | - Courtney R Green
- Society of Obstetricians and Gynaecologists of Canada , Ottawa, Canada
| | - Manale Ouakki
- Direction des risques biologiques et de la santé au travail, Institut National de Santé Publique du Québec , Québec, Canada
| | - Julie A Bettinger
- Vaccine Evaluation Center, University of British Columbia , Vancouver, Canada
| | - Nicholas Brousseau
- Direction des risques biologiques et de la santé au travail, Institut National de Santé Publique du Québec , Québec, Canada
| | - Eliana Castillo
- Cumming School of Medicine, University of Calgary , Calgary, Canada
| | - Natasha S Crowcroft
- Public Health Ontario, Institute for Clinical Evaluative Sciences and University of Toronto , Toronto, Canada
| | - S Michelle Driedger
- Department of Community Health Sciences, University of Manitoba , Winnipeg, Canada
| | - Devon Greyson
- Vaccine Evaluation Center, University of British Columbia , Vancouver, Canada
| | - Deshayne Fell
- School of Epidemiology and Public Health, University of Ottawa , Ottawa, Canada.,Research Institute, Children's Hospital of Eastern Ontario , Ottawa, Canada
| | - William Fisher
- Department of Psychology, Western University , London, Canada
| | - Arnaud Gagneur
- Département des soins de santé communautaire, Université de Sherbrooke , Sherbrooke, Canada
| | - Maryse Guay
- Direction des risques biologiques et de la santé au travail, Institut National de Santé Publique du Québec , Québec, Canada.,Centre de recherche de l'hôpital Charles Le Moyne , Longueuil, Canada
| | - Donna Halperin
- School of Nursing, St. Francis Xavier University , Antigonish, Canada
| | - Scott A Halperin
- Department of Pediatrics, Canadian Center for Vaccinology, Dalhousie University and the IWK Health Centre , Halifax, Canada
| | - Shannon MacDonald
- Faculty of Nursing, School of Public Health, University of Alberta , Edmonton, Canada
| | - Samantha B Meyer
- School of Public Health and Health Systems, University of Waterloo , Waterloo, Canada
| | - Nancy M Waite
- Department of Pharmacy, University of Waterloo , Waterloo, Canada
| | | | - Holly O Witteman
- Département de médecine familiale et de médecine d'urgence, Université Laval , Québec, Canada
| | - Mark Yudin
- Department of Obstetrics and Gynecology, University of Toronto , Toronto, Canada
| | - Jocelynn L Cook
- Society of Obstetricians and Gynaecologists of Canada , Ottawa, Canada
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22
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Graves DL, Carson DG, Poole N, Patel DT, Bigalky J, Green CR, Cook JL. Directive clinique n o 405 : Dépistage et conseils en matière de consommation d'alcool pendant la grossesse. J Obstet Gynaecol Can 2020; 42:1174-1192.e1. [PMID: 32900458 DOI: 10.1016/j.jogc.2020.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIF Établir des normes pancanadiennes fondées sur les meilleures données probantes actuelles sur le dépistage et les conseils en matière de consommation d'alcool et de troubles de consommation d'alcool chez les femmes enceintes ou en âge de procréer. PROFESSIONNELS CONCERNéS: Les fournisseurs de soins qui prodiguent des soins aux femmes enceintes et aux femmes en âge procréer. POPULATION CIBLE Les femmes enceintes, les femmes en âge de procréer et leurs familles. DONNéES PROBANTES: Des recherches ont été effectuées dans les bases de données Medline, Embase et CENTRAL avec le thème « alcohol use and pregnancy ». Les résultats ont été filtrés de façon à obtenir des publications parues entre 2010 et septembre 2018. Les termes de recherche ont été mis au point à partir des termes du thésaurus de référence biomédicale MeSH et de mots clés, dont les suivants : pre-pregnancy, pregnant, breastfeeding, lactation, female, women, preconception care, prenatal care, fetal alcohol spectrum disorder, prenatal alcohol exposure, drinking behavior, alcohol abstinence, alcohol drinking, binge drinking, alcohol-related disorders, alcoholism, alcohol consumption, alcohol abuse, benzodiazepines, disulfiram, naltrexane, acamprosate, ondansetron, topiramate, cyanamide, calcium carbimide, alcohol deterrents, disease management, detoxification, Alcoholics Anonymous, alcohol counselling, harm reduction, pre-pregnancy care, prenatal care, incidence, prevalence, epidemiological monitoring et brief intervention. Les données probantes retenues proviennent d'essais cliniques, d'études observationnelles, de revues de la littérature, d'analyses systématiques et méta-analyses, de lignes directrices et de conférences de consensus. MéTHODES DE VALIDATION: Les auteurs ont rédigé et accepté le contenu et les recommandations de la présente directive. Le conseil d'administration de la Société des obstétriciens et gynécologues du Canada a approuvé la version définitive aux fins de publication. La qualité des données probantes a été évaluée au moyen des critères de l'approche GRADE (Grading of Recommendations Assessment, Development, and Evaluation) (consulter les tableaux A1 et A2 de l'annexe en ligne). BéNéFICES, RISQUES, COûTS: La mise en œuvre des recommandations de la présente directive à l'aide d'outils de dépistage validés et de stratégies d'intervention brève peut améliorer la capacité des fournisseurs de soins obstétricaux à reconnaître la consommation d'alcool et la consommation problématique d'alcool chez les femmes enceintes ou en âge de procréer. Il est attendu des fournisseurs de soins de santé qu'ils deviennent confiants et compétents en matière de prise en charge et de soutien de ces femmes afin qu'elles puissent avoir la meilleure santé possible et une issue de grossesse optimale. DÉCLARATIONS SOMMAIRES (CLASSEMENT GRADE ENTRE PARENTHèSES): RECOMMANDATIONS (CLASSEMENT GRADE ENTRE PARENTHèSES).
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23
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McLachlan K, Flannigan K, Temple V, Unsworth K, Cook JL. Difficulties in Daily Living Experienced by Adolescents, Transition-Aged Youth, and Adults With Fetal Alcohol Spectrum Disorder. Alcohol Clin Exp Res 2020; 44:1609-1624. [PMID: 32472600 DOI: 10.1111/acer.14385] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 05/19/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Individuals with fetal alcohol spectrum disorder (FASD) experience a range of problems in their cognitive, affective, and physical functioning following prenatal alcohol exposure (PAE), in addition to multiple complex difficulties in daily living that impact well-being. Using the Canadian National FASD Database, we sought to profile a range of difficulties in daily living, along with risk factors, in a large cross-sectional cohort of adolescents, transition-aged youth, and adults with PAE, of which a subset was ultimately diagnosed with FASD. METHODS We summarized data for 9 current difficulties in daily living reported at the time of diagnostic assessment for 726 individuals with PAE assessed at 26 FASD diagnostic clinics across Canada, including 443 adolescents (12 to 17 years), 135 transition-aged youth (18 to 24 years), and 148 adults (25 to 60 years). Difficulties included problems related to school disruption, employment, independent living needs, supportive or sheltered housing, legal problems with victimization, legal problems with offending, incarceration, alcohol misuse, and other substance misuse. Risk factors included age, gender, living placement, postnatal trauma, and neurodevelopmental impairment. RESULTS Across the full PAE sample, adolescents, transition-aged youth, and adults presented with high rates of difficulties in daily living, including independent living support needs (63%), alcohol misuse (38%), other substance misuse (46%), employment problems (37%), legal problems with offending (30%), assisted or sheltered housing (21%), school disruption (18%), legal problems with victimization (4%), and incarceration (3%). Difficulty rates were similar for those with FASD irrespective of diagnosis (e.g., with or without sentinel facial features), but rates greater for adults, and those with low overall intellectual functioning (IQ < 70). Controlling for age and IQ, cumulative difficulty was independently associated with gender, living placement, and neurodevelopmental impairment. CONCLUSIONS Adolescents, transition-aged youth, and adults with FASD experienced a range of substantial and complex difficulties at the time of their diagnostic assessment, signaling a high level of service needs. These findings underscore the importance of developmentally informed assessment continued through childhood, as well as ongoing functional and needs-based service provision as youth with FASD transition to adulthood and beyond.
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Affiliation(s)
- Kaitlyn McLachlan
- From the, Department of Psychology (KM), University of Guelph, Guelph, Ontario, Canada
| | - Katherine Flannigan
- Canada Fetal Alcohol Spectrum Disorder Research Network (KF, KU), Vancouver, British Columbia, Canada
| | | | - Kathy Unsworth
- Canada Fetal Alcohol Spectrum Disorder Research Network (KF, KU), Vancouver, British Columbia, Canada
| | - Jocelynn L Cook
- The Society of Obstetricians and Gynaecologists of Canada (JC), Ottawa, Ontario, Canada.,Department of Obstetrics, Gynaecology and Newborn Care (JC), University of Ottawa, Ottawa, Ontario, Canada
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24
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Davidson AJF, Park AL, Berger H, Aoyama K, Harel Z, Cook JL, Ray JG. Risk of severe maternal morbidity or death in relation to elevated hemoglobin A1c preconception, and in early pregnancy: A population-based cohort study. PLoS Med 2020; 17:e1003104. [PMID: 32427997 PMCID: PMC7236974 DOI: 10.1371/journal.pmed.1003104] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 04/13/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The relation between prepregnancy average glucose concentration and a woman's risk of severe maternal morbidity (SMM) is unknown. The current study evaluated whether an elevated preconception hemoglobin A1c (A1c) is associated with SMM or maternal death among women with and without known prepregnancy diabetes mellitus (DM). METHODS AND FINDINGS A population-based cohort study was completed in Ontario, Canada, where there is universal healthcare. The main cohort included 31,225 women aged 16-50 years with a hospital live birth or stillbirth from 2007 to 2015, and who had an A1c measured within 90 days before conception, including 28,075 women (90%) without known prepregnancy DM. The main outcome was SMM or maternal mortality from 23 weeks' gestation up to 42 days postpartum. Relative risks (RRs) were generated using modified Poisson regression, adjusting for the main covariates of maternal age, multifetal pregnancy, world region of origin, and tobacco/drug dependence. The mean maternal age was 31.1 years. Overall, SMM or death arose among 682 births (2.2%). The RR of SMM or death was 1.16 (95% CI 1.14-1.19; p < 0.001) per 0.5% increase in A1c and 1.16 (95% CI 1.13-1.18; p < 0.001) after adjusting for the main covariates. The adjusted relative risk (aRR) was increased among those with (1.11, 95% CI 1.07-1.14; p < 0.001) and without (1.15, 95% CI 1.02-1.29; p < 0.001) known prepregnancy diabetes, and upon further adjusting for body mass index (BMI) (1.15, 95% CI 1.11-1.20; p < 0.001), or chronic hypertension and prepregnancy serum creatinine (1.11, 95% CI 1.04-1.18; p = 0.002). The aRR of SMM or death was 1.31 (95% CI 1.06-1.62; p = 0.01) in those with a preconception A1c of 5.8%-6.4%, and 2.84 (95% CI 2.31-3.49; p < 0.001) at an A1c > 6.4%, each relative to an A1c < 5.8%. Among those without previously recognized prepregnancy diabetes and whose A1c was >6.4%, the aRR of SMM or death was 3.25 (95% CI 1.76-6.00; p < 0.001). Study limitations include that selection bias may have incorporated less healthy women tested for A1c, and BMI was unknown for many women. CONCLUSIONS Our findings indicate that women with an elevated A1c preconception may be at higher risk of SMM or death in pregnancy or postpartum, including those without known prepregnancy DM.
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Affiliation(s)
| | - Alison L. Park
- University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
| | - Howard Berger
- University of Toronto, Toronto, Ontario, Canada
- Department of Medicine, St. Michael’s Hospital, Toronto, Ontario, Canada
- Department of Obstetrics and Gynaecology, St. Michael’s Hospital, Toronto, Ontario, Canada
| | - Kazuyoshi Aoyama
- University of Toronto, Toronto, Ontario, Canada
- Department of Anesthesia and Pain Medicine, the Hospital for Sick Children, Toronto, Ontario, Canada
| | - Ziv Harel
- University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Department of Medicine, St. Michael’s Hospital, Toronto, Ontario, Canada
| | - Jocelynn L. Cook
- Department of Obstetrics and Gynaecology, University of Ottawa, Ottawa, Ontario, Canada
- The Society of Obstetricians and Gynaecologists of Canada, Ottawa, Ontario, Canada
| | - Joel G. Ray
- University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Department of Medicine, St. Michael’s Hospital, Toronto, Ontario, Canada
- Department of Obstetrics and Gynaecology, St. Michael’s Hospital, Toronto, Ontario, Canada
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25
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Wong SPW, Twynstra J, Gilliland JA, Cook JL, Seabrook JA. Risk Factors and Birth Outcomes Associated with Teenage Pregnancy: A Canadian Sample. J Pediatr Adolesc Gynecol 2020; 33:153-159. [PMID: 31634579 DOI: 10.1016/j.jpag.2019.10.006] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 10/06/2019] [Accepted: 10/13/2019] [Indexed: 01/17/2023]
Abstract
STUDY OBJECTIVE To examine the extent to which socioeconomic status, mental health, and substance use are associated with teenage pregnancies in Southwestern Ontario (SWO), and whether these pregnancies are at an elevated risk for adverse birth outcomes, after controlling for medical, behavioral, and socioeconomic status factors. DESIGN Retrospective cohort study using perinatal and neonatal databases. SETTING Tertiary care hospital in SWO. PARTICIPANTS Women residing in SWO who gave birth to singleton infants without congenital anomalies between 2009 and 2014. Teenage pregnancies (19 years of age or younger) were compared with pregnancies of women 20-34 years and 35 years or older. INTERVENTIONS None. MAIN OUTCOME MEASURES Low birth weight (LBW), very LBW, term LBW, preterm birth, very preterm birth, low and very low Apgar score, and fetal macrosomia. RESULTS Of 25,263 pregnant women, 1080 (4.3%) were 19 years of age or younger. Approximately 18% of teenage mothers lived in socioeconomically disadvantaged neighborhoods, compared with 11% of mothers aged 20-34 and 9% of women 35 years of age or older (P < .001). Teenage mothers had higher rates of depression during pregnancy (9.8%) than mothers 20-34 years (5.8%) and those 35 years of age or older (6.8%; P < .001). Young mothers self-reported higher tobacco, marijuana, and alcohol use during pregnancy than adult mothers (P < .001). Teenage pregnancy increased the risk of a low Apgar score (adjusted odds ratio, 1.56; 95% confidence interval, 1.21-2.02), but was not associated with other birth outcomes after adjusting for covariates. CONCLUSION Teenage pregnancy is associated with a higher risk of socioeconomic disadvantage, mental health problems, and substance use during pregnancy, but is largely unrelated to adverse birth outcomes in SWO.
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Affiliation(s)
- Stephanie P W Wong
- School of Food and Nutritional Sciences, Brescia University College, London, Ontario, Canada
| | - Jasna Twynstra
- School of Food and Nutritional Sciences, Brescia University College, London, Ontario, Canada; Department of Medical Biophysics, Western University, London, Ontario, Canada
| | - Jason A Gilliland
- Department of Geography, Western University, London, Ontario, Canada; Human Environments Analysis Laboratory, London, Ontario, Canada; Department of Paediatrics, Western University, London, Ontario, Canada; Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada; Children's Health Research Institute/Lawson Health Research Institute, London, Ontario, Canada; School of Health Studies, Western University, London, Ontario, Canada
| | - Jocelynn L Cook
- Department of Obstetrics and Gynaecology, University of Ottawa, Ottawa, Ontario, Canada
| | - Jamie A Seabrook
- School of Food and Nutritional Sciences, Brescia University College, London, Ontario, Canada; Human Environments Analysis Laboratory, London, Ontario, Canada; Department of Paediatrics, Western University, London, Ontario, Canada; Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada; Children's Health Research Institute/Lawson Health Research Institute, London, Ontario, Canada.
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Temple VK, Cook JL, Unsworth K, Rajani H, Mela M. Mental Health and Affect Regulation Impairment in Fetal Alcohol Spectrum Disorder (FASD): Results from the Canadian National FASD Database. Alcohol Alcohol 2020; 54:545-550. [PMID: 31216355 DOI: 10.1093/alcalc/agz049] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 05/10/2019] [Accepted: 05/26/2019] [Indexed: 01/23/2023] Open
Abstract
AIMS Individuals with fetal alcohol spectrum disorder (FASD) frequently have challenges with regulating emotional arousal, or affect regulation (AR), and experience high rates of mental health disorders. This study examined children and adults with FASD to investigate the relationship between AR impairment and several mental health problems and diagnoses. METHODS Data from the Canadian national FASD database was used for analysis. Seven mental health diagnoses, including attention-deficit/hyperactivity disorder, post-traumatic stress disorder, conduct disorder, attachment disorder, intellectual disability, and language disorder were examined. A history of suicidality was also examined. The prevalence of these mental health problems in individuals with and without AR impairment was compared. RESULTS Individuals with FASD and AR impairment were significantly more likely to be diagnosed with conduct disorder (OR 4.8), attachment disorder (OR 6.1), or post-traumatic stress disorder (OR 8.1) when compared to those without AR impairment. They were also more likely to have a history of suicidality (OR 8.6). AR impairment was most commonly found in those with greater overall neurodevelopmental impairment. Having AR impairment was associated with receiving a diagnosis of FASD at a later age, but was not related to gender, intellectual disability, or language disorder. CONCLUSION AR impairment is strongly related to several mental health diagnoses in those with FASD and presents some promising possibilities for targeted early intervention.
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Affiliation(s)
- Valerie K Temple
- Clinical Psychologist, Surrey Place, 2 Surrey Place, Toronto, Ontario
| | - Jocelynn L Cook
- Scientific Director, The Society of Obstetricians and Gynaecologists of Canada, 2781 Lancaster Road, Ottawa, Ontario K1B 1A7 and Adjunct Professor, Department of Obstetrics and Gynaecology, University of Ottawa, 75 Laurier Ave E, Ottawa, Ontario
| | - Kathy Unsworth
- Managing Director, The Canada FASD Research Network, PO Box 11364 Wessex PO, Vancouver, British Columbia
| | - Hasu Rajani
- Professor Department of Pediatrics, University of Alberta, Edmonton, Alberta
| | - Mansfield Mela
- Professor Department of Psychiatry, University of Saskatchewan, 103 Hospital Dr., Saskatoon, Saskatchewan
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Cook JL, Sprague AE. Measuring Maternal Mortality in Canada: An Update on the Establishment of a Confidential Enquiry System for Preventing Maternal Deaths #savingmoms #savingbabies. J Obstet Gynaecol Can 2019; 41:1768-1771. [PMID: 31591055 DOI: 10.1016/j.jogc.2019.07.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 07/22/2019] [Accepted: 07/22/2019] [Indexed: 10/25/2022]
Abstract
A reduction in maternal mortality has traditionally been used as a critical measure of progress in improving maternal health, and the maternal mortality ratio is one of the main indicators of a country's status in the area. In Canada, maternal mortality is infrequent yet devastating. In many cases, there were no interventions that could have saved the mother's life, but in others, there were opportunities for prevention. There is absolute consensus that the upper limit for a preventable maternal death is zero. The World Health Organization's 2010 report indicated a rise in Canada's maternal mortality and prompted the Society of Obstetricians and Gynaecologists of Canada to work with partners to review national maternal mortality surveillance. Since then, efforts have begun and stalled. We are now in the fortunate position to work with experts and provincial leaders to implement a national system of confidential enquiry into maternal deaths and severe maternal morbidity in Canada. Canada's existing data do not tell the true story of maternal deaths; we cannot learn from each death and its circumstance to identify measures for prevention in the future. Dedicated leaders have been working hard to leverage their collective expertise. Recommendations for definitions, processes, knowledge translation tools, and programs that raise awareness about maternal mortality in Canada have been developed and are being piloted. It is anticipated that, with the appropriate support and appropriate leadership, Canada will have the foundation of a national confidential enquiry system into maternal deaths very soon. This is an update on progress.
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Affiliation(s)
- Jocelynn L Cook
- The Society of Obstetricians and Gynaecologists of Canada, Ottawa, ON; Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, ON.
| | - Ann E Sprague
- Better Outcomes Registry & Network (BORN) Ontario, Ottawa, ON; The Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON
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Affiliation(s)
- Jocelynn L Cook
- The Society of Obstetricians and Gynaecologists of Canada, Ottawa, ON.
| | - Jennifer M Blake
- The Society of Obstetricians and Gynaecologists of Canada, Ottawa, ON
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Henry STV, Spitzer R, Morgan L, Cook JL. Statement of Ethics in Global Health Practice. J Obstet Gynaecol Can 2019; 41:267-269. [PMID: 30784562 DOI: 10.1016/j.jogc.2018.11.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | - Rachel Spitzer
- Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON
| | - Lisa Morgan
- School of Midwifery, Laurentian University, Sudbury, ON
| | - Jocelynn L Cook
- Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, ON; The Society of Obstetricians and Gynaecologists of Canada, Ottawa, ON
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Henry STV, Spitzer R, Morgan L, Cook JL. Énoncé d’éthique sur Les pratiques en santé mondiale. Journal of Obstetrics and Gynaecology Canada 2019; 41:270-272. [DOI: 10.1016/j.jogc.2018.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Dubé E, Gagnon D, Kaminsky K, Green CR, Ouakki M, Bettinger JA, Brousseau N, Castillo E, Crowcroft NS, Driedger SM, Greyson D, Fell D, Fisher W, Gagneur A, Guay M, Halperin D, Halperin SA, MacDonald S, Meyer SB, Waite NM, Wilson K, Witteman HO, Yudin M, Cook JL. Vaccination Against Influenza in Pregnancy: A Survey of Canadian Maternity Care Providers. J Obstet Gynaecol Can 2018; 41:479-488. [PMID: 30409569 DOI: 10.1016/j.jogc.2018.09.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 09/06/2018] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Influenza vaccine uptake among Canadian pregnant individuals is suboptimal. Failure to incorporate vaccination into routine prenatal care and a lack of recommendations from healthcare providers are recognized as barriers to vaccination. The aim of this study was to assess Canadian maternity care providers' knowledge, attitudes, and practices regarding influenza vaccination in pregnancy. METHODS A cross-sectional Web-based questionnaire was sent during July and August 2017 to family physicians, obstetricians-gynaecologists, midwives, pharmacists, and nurses who care for pregnant individuals. A multivariable logistic regression model was used to determine variables independently associated with providers' recommendation of the influenza vaccine in pregnancy. RESULTS The analysis included 1061 providers. Most participants (85%) reported being vaccinated against influenza themselves, and 72% reported recommending the influenza vaccine to all of their pregnant patients during the previous influenza season. Participants' attitudes regarding influenza vaccination during pregnancy were generally positive: 64% strongly agreed that pregnant individuals are at an increased risk of complications from influenza, and 69% strongly agreed that it is safe to vaccinate pregnant individuals against influenza. The main determinants of participants' recommendations for influenza vaccination to all pregnant patients were following official recommendations on influenza vaccination, discussing vaccines with most or all pregnant individuals seen in their practice, and being vaccinated themselves during the previous influenza season. CONCLUSION Enhancing influenza vaccine uptake in pregnancy is largely dependent on maternity care providers' recommendations. This study provides valuable insight on providers' knowledge, attitudes, and practices.
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Affiliation(s)
- Eve Dubé
- Institut national de santé publique du Québec, Québec, QC.
| | | | - Kyla Kaminsky
- Society of Obstetricians and Gynaecologists of Canada, Ottawa, ON
| | - Courtney R Green
- Society of Obstetricians and Gynaecologists of Canada, Ottawa, ON
| | - Manale Ouakki
- Institut national de santé publique du Québec, Québec, QC
| | - Julie A Bettinger
- Vaccine Evaluation Center, University of British Columbia, Vancouver, BC
| | | | - Eliana Castillo
- Cumming School of Medicine, University of Alberta, Edmonton, AB
| | | | - S Michelle Driedger
- Department of Community Health Science, University of Manitoba, Winnipeg, MB
| | - Devon Greyson
- Vaccine Evaluation Center, University of British Columbia, Vancouver, BC
| | - Deshayne Fell
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON
| | - William Fisher
- Department of Psychology, Western University, London, ON
| | - Arnaud Gagneur
- Department of Community Health Medicine, Université de Sherbrooke, Sherbrooke, QC
| | - Maryse Guay
- Department of Community Health Medicine, Université de Sherbrooke, Sherbrooke, QC
| | | | | | | | | | - Nancy M Waite
- School of Pharmacy, University of Waterloo, Waterloo, ON
| | | | | | | | - Jocelynn L Cook
- Society of Obstetricians and Gynaecologists of Canada, Ottawa, ON
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Cook JL, Graves L, Kirkham C. Listeriosis in Pregnancy: Practitioners' Food Safety Counselling Practices to Pregnant Women. J Obstet Gynaecol Can 2018; 40:1139-1147. [PMID: 30030057 DOI: 10.1016/j.jogc.2018.01.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 01/13/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The relative risk of invasive listeriosis in pregnant women is approximately 20 times greater than the general population, and listeriosis during pregnancy can have negative consequences for pregnant women, their fetuses, and their newborns. Health care providers are valuable sources of information, but published data suggest that most providers are unaware of the risk factors for listeriosis or its propensity for pregnant women, and they do not counsel their pregnant patients about risks. The objective of this study was to determine knowledge and practices of Canadian perinatal care providers on food safety counselling to pregnant women. METHODS An anonymous bilingual online questionnaire that sought information about awareness, knowledge of risk factors, practices for counselling pregnant women, and practitioners' learning needs with regard to listeriosis was sent to 3199 nurses, midwives, family physicians, and obstetrician/gynaecologists in Canada, with a response rate of 24.4%. RESULTS Most respondents had heard of listeriosis, provided prenatal care, and attended deliveries. Rates of awareness of listeriosis were the same among professions and were independent of years in practice, whether practice was urban or rural, and province. One third of the respondents (35.7%) were aware that listeriosis was more common in pregnant women; a minority (18.7%) correctly identified the incubation period for listeriosis and the stage in pregnancy in which women are at highest risk (30.4%). Those respondents who did not counsel women about the risks of listeriosis during pregnancy reported a lack of information or knowledge as the main reason. CONCLUSION Advising pregnant women about behaviours and lifestyle habits to prevent infectious diseases remains important, and information about preventive practices needs to be complete and adequate. The health care providers who participated in this study did express a clear need for information related to food safety during pregnancy and listeriosis, as supported by their lack of knowledge in some areas. If that lack is remedied, the knowledge gained could improve counselling practices.
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Affiliation(s)
- Jocelynn L Cook
- Society of Obstetricians and Gynaecologists of Canada, Ottawa, ON; Department of Obstetrics and Gynaecology, University of Ottawa, Ottawa, ON.
| | - Lisa Graves
- Department of Family and Community Medicine, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI
| | - Colleen Kirkham
- Department of Family Practice, University of British Columbia, Vancouver, BC
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Rudavsky A, Cook JL, Docking S. Proximal patellar tendon pathology can develop during adolescence in young ballet dancers-A 2-year longitudinal study. Scand J Med Sci Sports 2018; 28:2035-2041. [PMID: 29658150 DOI: 10.1111/sms.13095] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2018] [Indexed: 12/21/2022]
Abstract
Patellar tendinopathy (tendon pain and dysfunction), or jumper's knee, is prevalent in adult jumping athletes. Pathology in the proximal patellar tendon is a key risk factor for developing patellar tendinopathy. When pathology develops in the proximal patellar tendon is not known, although it is reported to exist in adolescent athletes. The aim of this study was to follow young jumping athletes (ballet dancers) through adolescence to identify whether pathology develops and its relation to the adolescent growth spurt. Fifty-seven elite ballet students between ages 11 and 18 were monitored for 2 years. Data were collected every 6 months, including an ultrasound scan on their left tendons using ultrasound tissue characterization (UTC) to quantify intratendinous changes, anthropometric data to calculate peak height velocity (adolescent growth spurt), participant reports of any injuries or dance modifications, and a VISA-P and single leg decline squat for patellar tendon pain. Nine percentage of adolescent dancers developed pathology during this study, and development was not associated with growth spurt. Peak height velocity and dance participation/volume both at the start and throughout the study were similar in those who did develop pathology and those who did not. Only 2 of 5 participants who developed pathology reported pain associated with their tendon. Pathology in the proximal patellar tendon can develop during adolescence.
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Affiliation(s)
- A Rudavsky
- Department of Clinical Medicine, Institute of Sports Medicine Copenhagen, Bispebjerg-Frederiksberg Hospital, Copenhagen, Denmark
| | - J L Cook
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Vic., Australia
| | - S Docking
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Vic., Australia
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Ridge PA, Cook JL. Stifle stabilisation in dogs without meniscal exam: A counterpoint argument. J Small Anim Pract 2018; 59:448-449. [PMID: 29701250 DOI: 10.1111/jsap.12843] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 03/20/2018] [Indexed: 11/28/2022]
Affiliation(s)
- P A Ridge
- Ridge Referrals, Dawlish, Exeter EX7 0QW, UK
| | - J L Cook
- Orthopaedic Surgery, University of Missouri, Missouri Orthopaedic Institute (4028A), Columbia, MO 65212, USA.,Thompson Laboratory for Regenerative Orthopaedics & Mizzou, University of Missouri, Missouri Orthopaedic Institute (4028A), Columbia, MO 65212, USA.,Orthopaedic Research Division, University of Missouri, Missouri Orthopaedic Institute (4028A), Columbia, MO 65212, USA
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Cook JL, Green CR, Lilley C, Psych R, Anderson S, Baldwin ME, Chudley AE, Conry J, LeBlanc N, Loock CA, Mallon B, McFarlane A, Temple V, Psych C. Response to "A critique for the new Canadian FASD diagnostic Guidelines". J Can Acad Child Adolesc Psychiatry 2018; 27:83-87. [PMID: 29662519 PMCID: PMC5896521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Jocelynn L Cook
- The Society of Obstetricians and Gynaecologists of Canada (SOGC), University of Ottawa, Ottawa, Ontario
- Canada FASD Research Network, Department of Obstetrics and Gynaecology, University of Ottawa, Ottawa, Ontario
| | - Courtney R Green
- The Society of Obstetricians and Gynaecologists of Canada (SOGC), University of Ottawa, Ottawa, Ontario
- Canada FASD Research Network, Department of Obstetrics and Gynaecology, University of Ottawa, Ottawa, Ontario
| | - Christine Lilley
- The Society of Obstetricians and Gynaecologists of Canada (SOGC), University of Ottawa, Ottawa, Ontario
- Canada FASD Research Network, Department of Obstetrics and Gynaecology, University of Ottawa, Ottawa, Ontario
- Compass Clinic, Vancouver, British Columbia
- National Institutes of Health, Bethesda, Maryland, USA
- Fetal Alcohol Spectrum Disorders Clinic, Child Development Services, Alberta Children's Hospital, Calgary, Alberta
- Department of Pediatrics, University of Manitoba, Winnipeg, Manitoba
- Emerita University of British Columbia, Vancouver, British Columbia
- Dr. Georges-L.-Dumont University Hospital Centre, Moncton, New Brunswick
- FASD Centre of Excellence, Université de Moncton and Université de Sherbrooke, Moncton, New Brunswick
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia
- Glenrose Rehabilitation Hospital, Alberta Health Services, Edmonton, Alberta
- Lakeland Centre for FASD, Cold Lake, Alberta
- Surrey Place Centre, Toronto, Ontario
| | - R Psych
- Compass Clinic, Vancouver, British Columbia
| | | | - Mary Ellen Baldwin
- Fetal Alcohol Spectrum Disorders Clinic, Child Development Services, Alberta Children's Hospital, Calgary, Alberta
| | - Albert E Chudley
- Department of Pediatrics, University of Manitoba, Winnipeg, Manitoba
| | - Julianne Conry
- Emerita University of British Columbia, Vancouver, British Columbia
| | - Nicole LeBlanc
- Dr. Georges-L.-Dumont University Hospital Centre, Moncton, New Brunswick
- FASD Centre of Excellence, Université de Moncton and Université de Sherbrooke, Moncton, New Brunswick
| | - Christine A Loock
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia
| | - Bernadene Mallon
- Glenrose Rehabilitation Hospital, Alberta Health Services, Edmonton, Alberta
| | | | - Valerie Temple
- The Society of Obstetricians and Gynaecologists of Canada (SOGC), University of Ottawa, Ottawa, Ontario
- Canada FASD Research Network, Department of Obstetrics and Gynaecology, University of Ottawa, Ottawa, Ontario
- Compass Clinic, Vancouver, British Columbia
- National Institutes of Health, Bethesda, Maryland, USA
- Fetal Alcohol Spectrum Disorders Clinic, Child Development Services, Alberta Children's Hospital, Calgary, Alberta
- Department of Pediatrics, University of Manitoba, Winnipeg, Manitoba
- Emerita University of British Columbia, Vancouver, British Columbia
- Dr. Georges-L.-Dumont University Hospital Centre, Moncton, New Brunswick
- FASD Centre of Excellence, Université de Moncton and Université de Sherbrooke, Moncton, New Brunswick
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia
- Glenrose Rehabilitation Hospital, Alberta Health Services, Edmonton, Alberta
- Lakeland Centre for FASD, Cold Lake, Alberta
- Surrey Place Centre, Toronto, Ontario
| | - C Psych
- Surrey Place Centre, Toronto, Ontario
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Cook JL, Green CR, de la Ronde S, Dell CA, Graves L, Morgan L, Ordean A, Ruiter J, Steeves M, Wong S. Screening and Management of Substance Use in Pregnancy: A Review. J Obstet Gynaecol Can 2018; 39:897-905. [PMID: 28935055 DOI: 10.1016/j.jogc.2017.07.017] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 07/19/2017] [Accepted: 07/19/2017] [Indexed: 11/28/2022]
Abstract
Substance use during pregnancy has important implications for health care providers, policy makers, and can negatively impact a woman's health and the health of her children. Understanding trends, patterns of use and outcomes are critical to prevention campaigns, building awareness, and providing effective care. This review will discuss the current therapeutic approaches and recommendations for screening and patient management for substance use in pregnancy and during the postpartum period, and it is geared towards any care providers who care for patients or those who may care for patients who may be at risk for substance use during pregnancy.
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Affiliation(s)
- Jocelynn L Cook
- The Society for Obstetricians and Gynaecologists of Canada and the Department of Obstetrics and Gynaecology, University of Ottawa, Ottawa, ON.
| | - Courtney R Green
- The Society of Obstetricians and Gynaecologists of Canada, Ottawa, ON
| | | | | | - Lisa Graves
- Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI
| | | | - Alice Ordean
- Department of Family and Community Medicine, University of Toronto and St. Joseph's Health Centre, Toronto, ON
| | | | - Megan Steeves
- School of Public Health, University of Saskatchewan, Saskatoon, SK
| | - Suzanne Wong
- Department of Obstetrics and Gynecology and Department of Family and Community Medicine, University of Toronto, Toronto, ON
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Jarde A, Lutsiv O, Park CK, Beyene J, Dodd JM, Barrett J, Shah PS, Cook JL, Saito S, Biringer AB, Sabatino L, Giglia L, Han Z, Staub K, Mundle W, Chamberlain J, McDonald SD. Effectiveness of progesterone, cerclage and pessary for preventing preterm birth in singleton pregnancies: a systematic review and network meta-analysis. BJOG 2017; 124:1176-1189. [PMID: 28276151 DOI: 10.1111/1471-0528.14624] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Preterm birth (PTB) is the leading cause of infant death, but it is unclear which intervention is best to prevent it. OBJECTIVES To compare progesterone, cerclage and pessary, determine their relative effects and rank them. SEARCH STRATEGY We searched Medline, EMBASE, CINAHL, Cochrane CENTRAL and Web of Science (to April 2016), without restrictions, and screened references of previous reviews. SELECTION CRITERIA We included randomised trials of progesterone, cerclage or pessary for preventing PTB in women with singleton pregnancies at risk as defined by each study. DATA COLLECTION AND ANALYSIS We extracted data by duplicate using a piloted form and performed Bayesian random-effects network meta-analyses and pairwise meta-analyses. We rated evidence quality using GRADE, ranked interventions using SUCRA and calculated numbers needed to treat (NNT). MAIN RESULTS We included 36 trials (9425 women; 25 low risk of bias trials). Progesterone ranked first or second for most outcomes, reducing PTB < 34 weeks [odds ratio (OR) 0.44; 95% credible interval (CrI) 0.22-0.79; NNT 9; low quality], <37 weeks (OR 0.58; 95% CrI 0.41-0.79; NNT 9; moderate quality), and neonatal death (OR 0.50; 95% CrI 0.28-0.85; NNT 35; high quality), compared with control, in women overall at risk. We found similar results in the subgroup with previous PTB, but only a reduction of PTB < 34 weeks in women with a short cervix. Pessary showed inconsistent benefit and cerclage did not reduce PTB < 37 or <34 weeks. CONCLUSIONS Progesterone was the best intervention for preventing PTB in singleton pregnancies at risk, reducing PTB < 34 weeks, <37 weeks, neonatal demise and other sequelae. TWEETABLE ABSTRACT Progesterone was better than cerclage and pessary to prevent preterm birth, neonatal death and more in network meta-analysis.
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Affiliation(s)
- A Jarde
- Department of Obstetrics and Gynaecology, McMaster University, Hamilton, ON, Canada
| | - O Lutsiv
- Department of Obstetrics and Gynaecology, McMaster University, Hamilton, ON, Canada
| | - C K Park
- Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, ON, Canada
| | - J Beyene
- Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, ON, Canada
| | - J M Dodd
- Department of Obstetrics and Gynaecology, University of Adelaide, Adelaide, SA, Australia
| | - J Barrett
- Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - P S Shah
- Department of Paediatrics, University of Toronto, Toronto, ON, Canada
| | - J L Cook
- The Society of Obstetricians and Gynaecologists of Canada, Ottawa, ON, Canada.,Department of Obstetrics and Gynaecology, University of Ottawa, Ottawa, ON, Canada
| | - S Saito
- Department of Obstetrics and Gynaecology, University of Toyama, Toyama, Japan
| | - A B Biringer
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - L Sabatino
- Midwifery Education Program, McMaster University, Hamilton, ON, Canada
| | - L Giglia
- Department of Paediatrics, McMaster University, Hamilton, ON, Canada
| | - Z Han
- The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China
| | - K Staub
- Canadian Premature Babies Foundation, Sherwood Park, AB, Canada
| | - W Mundle
- Maternal Fetal Medicine Clinic, Windsor Regional Hospital, Windsor, ON, Canada
| | - J Chamberlain
- Save the Mothers, Uganda Christian University, Mukono, Uganda
| | - S D McDonald
- Department of Obstetrics and Gynaecology, McMaster University, Hamilton, ON, Canada
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Jarde A, Lutsiv O, Park CK, Barrett J, Beyene J, Saito S, Dodd JM, Shah PS, Cook JL, Biringer AB, Giglia L, Han Z, Staub K, Mundle W, Vera C, Sabatino L, Liyanage SK, McDonald SD. Preterm birth prevention in twin pregnancies with progesterone, pessary, or cerclage: a systematic review and meta-analysis. BJOG 2017; 124:1163-1173. [DOI: 10.1111/1471-0528.14513] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2016] [Indexed: 12/14/2022]
Affiliation(s)
- A Jarde
- Department of Obstetrics and Gynecology; McMaster University; Hamilton ON Canada
| | - O Lutsiv
- Department of Obstetrics and Gynecology; McMaster University; Hamilton ON Canada
| | - CK Park
- Department of Clinical Epidemiology and Biostatistics; McMaster University Hamilton, ON Canada
| | - J Barrett
- Sunnybrook Health Sciences Centre; Toronto ON Canada
| | - J Beyene
- Department of Clinical Epidemiology and Biostatistics; McMaster University Hamilton, ON Canada
| | - S Saito
- Department of Obstetrics and Gynecology; University of Toyama; Toyama Japan
| | - JM Dodd
- Department of Obstetrics and Gynecology; University of Adelaide; Adelaide Australia
| | - PS Shah
- Department of Paediatrics; University of Toronto; Toronto ON Canada
| | - JL Cook
- The Society of Obstetricians and Gynaecologists of Canada; Ottawa ON Canada
| | - AB Biringer
- Department of Family and Community Medicine; University of Toronto; Toronto ON Canada
| | - L Giglia
- Department of Pediatrics; McMaster University; Hamilton ON Canada
| | - Z Han
- The First Affiliated Hospital of Xi'an Jiaotong University; Xi'an Shaanxi Province China
| | - K Staub
- Canadian Premature Babies Foundation; Sherwood Park AB Canada
| | - W Mundle
- Maternal Fetal Medicine Clinic; Windsor Regional Hospital; Windsor ON Canada
| | - C Vera
- Division of Obstetrics and Gynecology; Escuela de Medicina; Pontificia Universidad Católica de Chile; Santiago Chile
| | - L Sabatino
- Midwifery Education Program; McMaster University; Hamilton ON Canada
| | - SK Liyanage
- Department of Obstetrics and Gynecology; McMaster University; Hamilton ON Canada
| | - SD McDonald
- Department of Obstetrics and Gynecology; McMaster University; Hamilton ON Canada
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Jarde A, Lutsiv O, Park CK, Barrett J, Beyene J, Saito S, Dodd JM, Shah PS, Cook JL, Biringer AB, Giglia L, Han Z, Staub K, Mundle W, Vera C, Sabatino L, Liyanage SK, McDonald SD. 307: Preterm birth prevention in twin pregnancies with progesterone, pessary or cerclage, a meta-analysis. Am J Obstet Gynecol 2017. [DOI: 10.1016/j.ajog.2016.11.565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Bobbitt SA, Baugh LA, Andrew GH, Cook JL, Green CR, Pei JR, Rasmussen CR. Caregiver needs and stress in caring for individuals with fetal alcohol spectrum disorder. Res Dev Disabil 2016; 55:100-113. [PMID: 27058320 DOI: 10.1016/j.ridd.2016.03.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2015] [Revised: 01/11/2016] [Accepted: 03/03/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Individuals with FASD experience neurodevelopmental impairments and adverse outcomes, which can result in stress on the caregiver. However, there is little research on the needs of caregivers supporting individuals with FASD and whether they are associated with caregiver stress. METHOD 125 caregivers of individuals with FASD completed a survey with questions adapted from the Family Caregiver Survey and the Perceived Stress Scale. RESULTS Caregivers reported a range of needs and concerns, and high levels of stress. In many areas of caregiver well-being concerns tended to be higher among caregivers with adolescents and adults compared to those with children. Foster parents reported fewer well-being concerns than biological/kinship and adoptive parents. Caregivers who cared for the individuals for longer periods of time reported the most well-being concerns and lowest satisfaction with supports. Caregivers with the lowest income reported higher levels of stress than those with higher incomes. Higher reported stress was highly correlated with more needs/concerns. CONCLUSIONS Caregivers of individuals with FASD have multiple areas of need and concern, and experience high levels of stress. Reducing demands on caregivers and providing resources may help reduce caregiver needs and stress, particularly for those caring for adolescents and adults, and those with lower incomes.
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Affiliation(s)
- Susan A Bobbitt
- Department of Pediatrics, University of Saskatchewan, Alvin Buckwold Child Development Program, Canada.
| | | | - Gail H Andrew
- Department of Pediatrics, University of Alberta, Glenrose Rehabilitation Hospital, Canada
| | - Jocelynn L Cook
- University of Ottawa, Society of Obstetricians and Gynaecologists of Canada, Canada
| | - Courtney R Green
- Society of Obstetricians and Gynaecologists of Canada, Canada FASD Research Network, Canada
| | - Jacqueline R Pei
- Department of Educational Psychology, University of Alberta, Canada
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Cook JL, Rio E, Purdam CR, Docking SI. Revisiting the continuum model of tendon pathology: what is its merit in clinical practice and research? Br J Sports Med 2016; 50:1187-91. [PMID: 27127294 PMCID: PMC5118437 DOI: 10.1136/bjsports-2015-095422] [Citation(s) in RCA: 210] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2016] [Indexed: 11/25/2022]
Abstract
The pathogenesis of tendinopathy and the primary biological change in the tendon that precipitates pathology have generated several pathoaetiological models in the literature. The continuum model of tendon pathology, proposed in 2009, synthesised clinical and laboratory-based research to guide treatment choices for the clinical presentations of tendinopathy. While the continuum has been cited extensively in the literature, its clinical utility has yet to be fully elucidated. The continuum model proposed a model for staging tendinopathy based on the changes and distribution of disorganisation within the tendon. However, classifying tendinopathy based on structure in what is primarily a pain condition has been challenged. The interplay between structure, pain and function is not yet fully understood, which has partly contributed to the complex clinical picture of tendinopathy. Here we revisit and assess the merit of the continuum model in the context of new evidence. We (1) summarise new evidence in tendinopathy research in the context of the continuum, (2) discuss tendon pain and the relevance of a model based on structure and (3) describe relevant clinical elements (pain, function and structure) to begin to build a better understanding of the condition. Our goal is that the continuum model may help guide targeted treatments and improved patient outcomes.
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Affiliation(s)
- J L Cook
- School of Allied Health, La Trobe University, Bundoora, Australia Australian Centre for Research into Injury in Sport and its Prevention, Federation University
| | - E Rio
- School of Allied Health, La Trobe University, Bundoora, Australia Australian Centre for Research into Injury in Sport and its Prevention, Federation University
| | - C R Purdam
- Australian Centre for Research into Injury in Sport and its Prevention, Federation University Department of Physical Therapies, Australian Institute of Sport, Bruce, Australian Capital Territory, Australia
| | - S I Docking
- School of Allied Health, La Trobe University, Bundoora, Australia Australian Centre for Research into Injury in Sport and its Prevention, Federation University
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Cook JL, Green CR, Lilley CM, Anderson SM, Baldwin ME, Chudley AE, Conry JL, LeBlanc N, Loock CA, Lutke J, Mallon BF, McFarlane AA, Temple VK, Rosales T. Fetal alcohol spectrum disorder: a guideline for diagnosis across the lifespan. CMAJ 2015; 188:191-197. [PMID: 26668194 DOI: 10.1503/cmaj.141593] [Citation(s) in RCA: 278] [Impact Index Per Article: 30.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Affiliation(s)
- Jocelynn L Cook
- Canada Fetal Alcohol Spectrum Disorder Research Network (Cook, Green, Lutke); Society of Obstetricians and Gynaecologists of Canada (Cook, Green), Ottawa, Ont.; Department of Obstetrics and Gynaecology (Cook), University of Ottawa, Ottawa, Ont.; Department of Biomedical and Molecular Sciences (Green), Queen's University, Kingston, Ont.; Sunny Hill Health Centre for Children (Lilley), Vancouver, BC; National Institutes of Health (Anderson), Ottawa, Ont.; Fetal Alcohol Spectrum Disorders Clinic (Baldwin), Child Development Services, Alberta Children's Hospital, Calgary, Alta.; Department of Pediatrics (Chudley), University of Manitoba, Winnipeg, Man.; University of British Columbia (Conry [professor emerita]), Vancouver, BC; Department of Pediatrics (LeBlanc), Dr. Georges-L.-Dumont University Hospital Centre, Université de Moncton and Université de Sherbrooke, Moncton, NB; Department of Pediatrics (Looke), University of British Columbia, Vancouver, BC; Glenrose Rehabilitation Hospital (Mallon), Alberta Health Services, Edmonton, Alta.; Lakeland Centre for Fetal Alcohol Syndrome (McFarlane), Cold Lake, Alta.; Surrey Place Centre (Temple), Toronto, Ont.; Faculty of Medicine (Rosales), Memorial University of Newfoundland, St. John's, Nfld.
| | - Courtney R Green
- Canada Fetal Alcohol Spectrum Disorder Research Network (Cook, Green, Lutke); Society of Obstetricians and Gynaecologists of Canada (Cook, Green), Ottawa, Ont.; Department of Obstetrics and Gynaecology (Cook), University of Ottawa, Ottawa, Ont.; Department of Biomedical and Molecular Sciences (Green), Queen's University, Kingston, Ont.; Sunny Hill Health Centre for Children (Lilley), Vancouver, BC; National Institutes of Health (Anderson), Ottawa, Ont.; Fetal Alcohol Spectrum Disorders Clinic (Baldwin), Child Development Services, Alberta Children's Hospital, Calgary, Alta.; Department of Pediatrics (Chudley), University of Manitoba, Winnipeg, Man.; University of British Columbia (Conry [professor emerita]), Vancouver, BC; Department of Pediatrics (LeBlanc), Dr. Georges-L.-Dumont University Hospital Centre, Université de Moncton and Université de Sherbrooke, Moncton, NB; Department of Pediatrics (Looke), University of British Columbia, Vancouver, BC; Glenrose Rehabilitation Hospital (Mallon), Alberta Health Services, Edmonton, Alta.; Lakeland Centre for Fetal Alcohol Syndrome (McFarlane), Cold Lake, Alta.; Surrey Place Centre (Temple), Toronto, Ont.; Faculty of Medicine (Rosales), Memorial University of Newfoundland, St. John's, Nfld
| | - Christine M Lilley
- Canada Fetal Alcohol Spectrum Disorder Research Network (Cook, Green, Lutke); Society of Obstetricians and Gynaecologists of Canada (Cook, Green), Ottawa, Ont.; Department of Obstetrics and Gynaecology (Cook), University of Ottawa, Ottawa, Ont.; Department of Biomedical and Molecular Sciences (Green), Queen's University, Kingston, Ont.; Sunny Hill Health Centre for Children (Lilley), Vancouver, BC; National Institutes of Health (Anderson), Ottawa, Ont.; Fetal Alcohol Spectrum Disorders Clinic (Baldwin), Child Development Services, Alberta Children's Hospital, Calgary, Alta.; Department of Pediatrics (Chudley), University of Manitoba, Winnipeg, Man.; University of British Columbia (Conry [professor emerita]), Vancouver, BC; Department of Pediatrics (LeBlanc), Dr. Georges-L.-Dumont University Hospital Centre, Université de Moncton and Université de Sherbrooke, Moncton, NB; Department of Pediatrics (Looke), University of British Columbia, Vancouver, BC; Glenrose Rehabilitation Hospital (Mallon), Alberta Health Services, Edmonton, Alta.; Lakeland Centre for Fetal Alcohol Syndrome (McFarlane), Cold Lake, Alta.; Surrey Place Centre (Temple), Toronto, Ont.; Faculty of Medicine (Rosales), Memorial University of Newfoundland, St. John's, Nfld
| | - Sally M Anderson
- Canada Fetal Alcohol Spectrum Disorder Research Network (Cook, Green, Lutke); Society of Obstetricians and Gynaecologists of Canada (Cook, Green), Ottawa, Ont.; Department of Obstetrics and Gynaecology (Cook), University of Ottawa, Ottawa, Ont.; Department of Biomedical and Molecular Sciences (Green), Queen's University, Kingston, Ont.; Sunny Hill Health Centre for Children (Lilley), Vancouver, BC; National Institutes of Health (Anderson), Ottawa, Ont.; Fetal Alcohol Spectrum Disorders Clinic (Baldwin), Child Development Services, Alberta Children's Hospital, Calgary, Alta.; Department of Pediatrics (Chudley), University of Manitoba, Winnipeg, Man.; University of British Columbia (Conry [professor emerita]), Vancouver, BC; Department of Pediatrics (LeBlanc), Dr. Georges-L.-Dumont University Hospital Centre, Université de Moncton and Université de Sherbrooke, Moncton, NB; Department of Pediatrics (Looke), University of British Columbia, Vancouver, BC; Glenrose Rehabilitation Hospital (Mallon), Alberta Health Services, Edmonton, Alta.; Lakeland Centre for Fetal Alcohol Syndrome (McFarlane), Cold Lake, Alta.; Surrey Place Centre (Temple), Toronto, Ont.; Faculty of Medicine (Rosales), Memorial University of Newfoundland, St. John's, Nfld
| | - Mary Ellen Baldwin
- Canada Fetal Alcohol Spectrum Disorder Research Network (Cook, Green, Lutke); Society of Obstetricians and Gynaecologists of Canada (Cook, Green), Ottawa, Ont.; Department of Obstetrics and Gynaecology (Cook), University of Ottawa, Ottawa, Ont.; Department of Biomedical and Molecular Sciences (Green), Queen's University, Kingston, Ont.; Sunny Hill Health Centre for Children (Lilley), Vancouver, BC; National Institutes of Health (Anderson), Ottawa, Ont.; Fetal Alcohol Spectrum Disorders Clinic (Baldwin), Child Development Services, Alberta Children's Hospital, Calgary, Alta.; Department of Pediatrics (Chudley), University of Manitoba, Winnipeg, Man.; University of British Columbia (Conry [professor emerita]), Vancouver, BC; Department of Pediatrics (LeBlanc), Dr. Georges-L.-Dumont University Hospital Centre, Université de Moncton and Université de Sherbrooke, Moncton, NB; Department of Pediatrics (Looke), University of British Columbia, Vancouver, BC; Glenrose Rehabilitation Hospital (Mallon), Alberta Health Services, Edmonton, Alta.; Lakeland Centre for Fetal Alcohol Syndrome (McFarlane), Cold Lake, Alta.; Surrey Place Centre (Temple), Toronto, Ont.; Faculty of Medicine (Rosales), Memorial University of Newfoundland, St. John's, Nfld
| | - Albert E Chudley
- Canada Fetal Alcohol Spectrum Disorder Research Network (Cook, Green, Lutke); Society of Obstetricians and Gynaecologists of Canada (Cook, Green), Ottawa, Ont.; Department of Obstetrics and Gynaecology (Cook), University of Ottawa, Ottawa, Ont.; Department of Biomedical and Molecular Sciences (Green), Queen's University, Kingston, Ont.; Sunny Hill Health Centre for Children (Lilley), Vancouver, BC; National Institutes of Health (Anderson), Ottawa, Ont.; Fetal Alcohol Spectrum Disorders Clinic (Baldwin), Child Development Services, Alberta Children's Hospital, Calgary, Alta.; Department of Pediatrics (Chudley), University of Manitoba, Winnipeg, Man.; University of British Columbia (Conry [professor emerita]), Vancouver, BC; Department of Pediatrics (LeBlanc), Dr. Georges-L.-Dumont University Hospital Centre, Université de Moncton and Université de Sherbrooke, Moncton, NB; Department of Pediatrics (Looke), University of British Columbia, Vancouver, BC; Glenrose Rehabilitation Hospital (Mallon), Alberta Health Services, Edmonton, Alta.; Lakeland Centre for Fetal Alcohol Syndrome (McFarlane), Cold Lake, Alta.; Surrey Place Centre (Temple), Toronto, Ont.; Faculty of Medicine (Rosales), Memorial University of Newfoundland, St. John's, Nfld
| | - Julianne L Conry
- Canada Fetal Alcohol Spectrum Disorder Research Network (Cook, Green, Lutke); Society of Obstetricians and Gynaecologists of Canada (Cook, Green), Ottawa, Ont.; Department of Obstetrics and Gynaecology (Cook), University of Ottawa, Ottawa, Ont.; Department of Biomedical and Molecular Sciences (Green), Queen's University, Kingston, Ont.; Sunny Hill Health Centre for Children (Lilley), Vancouver, BC; National Institutes of Health (Anderson), Ottawa, Ont.; Fetal Alcohol Spectrum Disorders Clinic (Baldwin), Child Development Services, Alberta Children's Hospital, Calgary, Alta.; Department of Pediatrics (Chudley), University of Manitoba, Winnipeg, Man.; University of British Columbia (Conry [professor emerita]), Vancouver, BC; Department of Pediatrics (LeBlanc), Dr. Georges-L.-Dumont University Hospital Centre, Université de Moncton and Université de Sherbrooke, Moncton, NB; Department of Pediatrics (Looke), University of British Columbia, Vancouver, BC; Glenrose Rehabilitation Hospital (Mallon), Alberta Health Services, Edmonton, Alta.; Lakeland Centre for Fetal Alcohol Syndrome (McFarlane), Cold Lake, Alta.; Surrey Place Centre (Temple), Toronto, Ont.; Faculty of Medicine (Rosales), Memorial University of Newfoundland, St. John's, Nfld
| | - Nicole LeBlanc
- Canada Fetal Alcohol Spectrum Disorder Research Network (Cook, Green, Lutke); Society of Obstetricians and Gynaecologists of Canada (Cook, Green), Ottawa, Ont.; Department of Obstetrics and Gynaecology (Cook), University of Ottawa, Ottawa, Ont.; Department of Biomedical and Molecular Sciences (Green), Queen's University, Kingston, Ont.; Sunny Hill Health Centre for Children (Lilley), Vancouver, BC; National Institutes of Health (Anderson), Ottawa, Ont.; Fetal Alcohol Spectrum Disorders Clinic (Baldwin), Child Development Services, Alberta Children's Hospital, Calgary, Alta.; Department of Pediatrics (Chudley), University of Manitoba, Winnipeg, Man.; University of British Columbia (Conry [professor emerita]), Vancouver, BC; Department of Pediatrics (LeBlanc), Dr. Georges-L.-Dumont University Hospital Centre, Université de Moncton and Université de Sherbrooke, Moncton, NB; Department of Pediatrics (Looke), University of British Columbia, Vancouver, BC; Glenrose Rehabilitation Hospital (Mallon), Alberta Health Services, Edmonton, Alta.; Lakeland Centre for Fetal Alcohol Syndrome (McFarlane), Cold Lake, Alta.; Surrey Place Centre (Temple), Toronto, Ont.; Faculty of Medicine (Rosales), Memorial University of Newfoundland, St. John's, Nfld
| | - Christine A Loock
- Canada Fetal Alcohol Spectrum Disorder Research Network (Cook, Green, Lutke); Society of Obstetricians and Gynaecologists of Canada (Cook, Green), Ottawa, Ont.; Department of Obstetrics and Gynaecology (Cook), University of Ottawa, Ottawa, Ont.; Department of Biomedical and Molecular Sciences (Green), Queen's University, Kingston, Ont.; Sunny Hill Health Centre for Children (Lilley), Vancouver, BC; National Institutes of Health (Anderson), Ottawa, Ont.; Fetal Alcohol Spectrum Disorders Clinic (Baldwin), Child Development Services, Alberta Children's Hospital, Calgary, Alta.; Department of Pediatrics (Chudley), University of Manitoba, Winnipeg, Man.; University of British Columbia (Conry [professor emerita]), Vancouver, BC; Department of Pediatrics (LeBlanc), Dr. Georges-L.-Dumont University Hospital Centre, Université de Moncton and Université de Sherbrooke, Moncton, NB; Department of Pediatrics (Looke), University of British Columbia, Vancouver, BC; Glenrose Rehabilitation Hospital (Mallon), Alberta Health Services, Edmonton, Alta.; Lakeland Centre for Fetal Alcohol Syndrome (McFarlane), Cold Lake, Alta.; Surrey Place Centre (Temple), Toronto, Ont.; Faculty of Medicine (Rosales), Memorial University of Newfoundland, St. John's, Nfld
| | - Jan Lutke
- Canada Fetal Alcohol Spectrum Disorder Research Network (Cook, Green, Lutke); Society of Obstetricians and Gynaecologists of Canada (Cook, Green), Ottawa, Ont.; Department of Obstetrics and Gynaecology (Cook), University of Ottawa, Ottawa, Ont.; Department of Biomedical and Molecular Sciences (Green), Queen's University, Kingston, Ont.; Sunny Hill Health Centre for Children (Lilley), Vancouver, BC; National Institutes of Health (Anderson), Ottawa, Ont.; Fetal Alcohol Spectrum Disorders Clinic (Baldwin), Child Development Services, Alberta Children's Hospital, Calgary, Alta.; Department of Pediatrics (Chudley), University of Manitoba, Winnipeg, Man.; University of British Columbia (Conry [professor emerita]), Vancouver, BC; Department of Pediatrics (LeBlanc), Dr. Georges-L.-Dumont University Hospital Centre, Université de Moncton and Université de Sherbrooke, Moncton, NB; Department of Pediatrics (Looke), University of British Columbia, Vancouver, BC; Glenrose Rehabilitation Hospital (Mallon), Alberta Health Services, Edmonton, Alta.; Lakeland Centre for Fetal Alcohol Syndrome (McFarlane), Cold Lake, Alta.; Surrey Place Centre (Temple), Toronto, Ont.; Faculty of Medicine (Rosales), Memorial University of Newfoundland, St. John's, Nfld
| | - Bernadene F Mallon
- Canada Fetal Alcohol Spectrum Disorder Research Network (Cook, Green, Lutke); Society of Obstetricians and Gynaecologists of Canada (Cook, Green), Ottawa, Ont.; Department of Obstetrics and Gynaecology (Cook), University of Ottawa, Ottawa, Ont.; Department of Biomedical and Molecular Sciences (Green), Queen's University, Kingston, Ont.; Sunny Hill Health Centre for Children (Lilley), Vancouver, BC; National Institutes of Health (Anderson), Ottawa, Ont.; Fetal Alcohol Spectrum Disorders Clinic (Baldwin), Child Development Services, Alberta Children's Hospital, Calgary, Alta.; Department of Pediatrics (Chudley), University of Manitoba, Winnipeg, Man.; University of British Columbia (Conry [professor emerita]), Vancouver, BC; Department of Pediatrics (LeBlanc), Dr. Georges-L.-Dumont University Hospital Centre, Université de Moncton and Université de Sherbrooke, Moncton, NB; Department of Pediatrics (Looke), University of British Columbia, Vancouver, BC; Glenrose Rehabilitation Hospital (Mallon), Alberta Health Services, Edmonton, Alta.; Lakeland Centre for Fetal Alcohol Syndrome (McFarlane), Cold Lake, Alta.; Surrey Place Centre (Temple), Toronto, Ont.; Faculty of Medicine (Rosales), Memorial University of Newfoundland, St. John's, Nfld
| | - Audrey A McFarlane
- Canada Fetal Alcohol Spectrum Disorder Research Network (Cook, Green, Lutke); Society of Obstetricians and Gynaecologists of Canada (Cook, Green), Ottawa, Ont.; Department of Obstetrics and Gynaecology (Cook), University of Ottawa, Ottawa, Ont.; Department of Biomedical and Molecular Sciences (Green), Queen's University, Kingston, Ont.; Sunny Hill Health Centre for Children (Lilley), Vancouver, BC; National Institutes of Health (Anderson), Ottawa, Ont.; Fetal Alcohol Spectrum Disorders Clinic (Baldwin), Child Development Services, Alberta Children's Hospital, Calgary, Alta.; Department of Pediatrics (Chudley), University of Manitoba, Winnipeg, Man.; University of British Columbia (Conry [professor emerita]), Vancouver, BC; Department of Pediatrics (LeBlanc), Dr. Georges-L.-Dumont University Hospital Centre, Université de Moncton and Université de Sherbrooke, Moncton, NB; Department of Pediatrics (Looke), University of British Columbia, Vancouver, BC; Glenrose Rehabilitation Hospital (Mallon), Alberta Health Services, Edmonton, Alta.; Lakeland Centre for Fetal Alcohol Syndrome (McFarlane), Cold Lake, Alta.; Surrey Place Centre (Temple), Toronto, Ont.; Faculty of Medicine (Rosales), Memorial University of Newfoundland, St. John's, Nfld
| | - Valerie K Temple
- Canada Fetal Alcohol Spectrum Disorder Research Network (Cook, Green, Lutke); Society of Obstetricians and Gynaecologists of Canada (Cook, Green), Ottawa, Ont.; Department of Obstetrics and Gynaecology (Cook), University of Ottawa, Ottawa, Ont.; Department of Biomedical and Molecular Sciences (Green), Queen's University, Kingston, Ont.; Sunny Hill Health Centre for Children (Lilley), Vancouver, BC; National Institutes of Health (Anderson), Ottawa, Ont.; Fetal Alcohol Spectrum Disorders Clinic (Baldwin), Child Development Services, Alberta Children's Hospital, Calgary, Alta.; Department of Pediatrics (Chudley), University of Manitoba, Winnipeg, Man.; University of British Columbia (Conry [professor emerita]), Vancouver, BC; Department of Pediatrics (LeBlanc), Dr. Georges-L.-Dumont University Hospital Centre, Université de Moncton and Université de Sherbrooke, Moncton, NB; Department of Pediatrics (Looke), University of British Columbia, Vancouver, BC; Glenrose Rehabilitation Hospital (Mallon), Alberta Health Services, Edmonton, Alta.; Lakeland Centre for Fetal Alcohol Syndrome (McFarlane), Cold Lake, Alta.; Surrey Place Centre (Temple), Toronto, Ont.; Faculty of Medicine (Rosales), Memorial University of Newfoundland, St. John's, Nfld
| | - Ted Rosales
- Canada Fetal Alcohol Spectrum Disorder Research Network (Cook, Green, Lutke); Society of Obstetricians and Gynaecologists of Canada (Cook, Green), Ottawa, Ont.; Department of Obstetrics and Gynaecology (Cook), University of Ottawa, Ottawa, Ont.; Department of Biomedical and Molecular Sciences (Green), Queen's University, Kingston, Ont.; Sunny Hill Health Centre for Children (Lilley), Vancouver, BC; National Institutes of Health (Anderson), Ottawa, Ont.; Fetal Alcohol Spectrum Disorders Clinic (Baldwin), Child Development Services, Alberta Children's Hospital, Calgary, Alta.; Department of Pediatrics (Chudley), University of Manitoba, Winnipeg, Man.; University of British Columbia (Conry [professor emerita]), Vancouver, BC; Department of Pediatrics (LeBlanc), Dr. Georges-L.-Dumont University Hospital Centre, Université de Moncton and Université de Sherbrooke, Moncton, NB; Department of Pediatrics (Looke), University of British Columbia, Vancouver, BC; Glenrose Rehabilitation Hospital (Mallon), Alberta Health Services, Edmonton, Alta.; Lakeland Centre for Fetal Alcohol Syndrome (McFarlane), Cold Lake, Alta.; Surrey Place Centre (Temple), Toronto, Ont.; Faculty of Medicine (Rosales), Memorial University of Newfoundland, St. John's, Nfld
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Linsenbardt HR, Cook JL, Young EE, Vichaya EG, Young CR, Reusser NM, Storts R, Welsh CJ, Meagher MW. Social disruption alters pain and cognition in an animal model of multiple sclerosis. J Neuroimmunol 2015; 288:56-68. [PMID: 26531695 DOI: 10.1016/j.jneuroim.2015.09.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 09/09/2015] [Accepted: 09/10/2015] [Indexed: 01/29/2023]
Abstract
Although pain and cognitive deficits are widespread and debilitating symptoms of multiple sclerosis (MS), they remain poorly understood. Theiler's murine encephalomyelitis virus (TMEV) infection is an animal model of MS where disease course is exacerbated by prior stressors. Here chronic infection coupled with prior social stress increased pain behavior and impaired hippocampal-dependent memory consolidation during the demyelinating phase of disease in SJL mice. These results suggest that the TMEV model may be useful in investigating pain and cognitive impairments in MS. However, in contrast to prior Balb/cJ studies, stress failed to consistently alter behavioral and physiological indicators of disease course.
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Affiliation(s)
- H R Linsenbardt
- Department of Psychology, Texas A&M University, College Station, TX, United States; Texas A&M Institute for Neuroscience, Texas A&M University, College Station, TX, United States
| | - J L Cook
- Department of Psychology, Texas A&M University, College Station, TX, United States
| | - E E Young
- Department of Psychology, Texas A&M University, College Station, TX, United States
| | - E G Vichaya
- Department of Psychology, Texas A&M University, College Station, TX, United States
| | - C R Young
- Department of Veterinary Integrative Biosciences, Texas A&M University, College Station, TX, United States
| | - N M Reusser
- Department of Psychology, Texas A&M University, College Station, TX, United States
| | - R Storts
- Department of Veterinary Pathobiology, Texas A&M University, College Station, TX, United States
| | - C J Welsh
- Texas A&M Institute for Neuroscience, Texas A&M University, College Station, TX, United States; Department of Veterinary Integrative Biosciences, Texas A&M University, College Station, TX, United States
| | - M W Meagher
- Department of Psychology, Texas A&M University, College Station, TX, United States; Texas A&M Institute for Neuroscience, Texas A&M University, College Station, TX, United States.
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Cook JL, Docking SI. "Rehabilitation will increase the 'capacity' of your …insert musculoskeletal tissue here…." Defining 'tissue capacity': a core concept for clinicians. Br J Sports Med 2015; 49:1484-5. [PMID: 26255142 DOI: 10.1136/bjsports-2015-094849] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 07/17/2015] [Indexed: 11/03/2022]
Affiliation(s)
- J L Cook
- Centre for Sport & Exercise Medicine, La Trobe University, Bundoora, Australia . Australian Centre of Research into Injury in Sport and its Prevention (ACRISP), Federation University, Ballarat, Australia
| | - S I Docking
- Australian Centre of Research into Injury in Sport and its Prevention (ACRISP), Federation University, Ballarat, Australia School of Primary Health Care, Monash University, Frankston, Australia
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Cook JL. The reconstruction of the nasal ala with interpolated flaps from the cheek and forehead: design and execution modifications to improve surgical outcomes. Br J Dermatol 2015; 171 Suppl 2:29-36. [PMID: 25124311 DOI: 10.1111/bjd.13206] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2014] [Indexed: 11/26/2022]
Abstract
The nasal ala, critically important in the function and appearance of the central face, has significant reconstructive demands given the lack of suitable adjacent donor tissue that can be used to repair all but the smallest surgical defects in this area. Interpolated flaps from the forehead and cheek have long been ideal reconstructive alternatives for the repair of larger or more difficult alar wounds, and with the design and execution modifications described here, the dermatological surgeon can offer more appropriate restoration of this critically important aesthetic unit.
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Affiliation(s)
- J L Cook
- Duke University Medical Center, Durham, NC, U.S.A
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Fearon AM, Ganderton C, Scarvell JM, Smith PN, Neeman T, Nash C, Cook JL. Development and validation of a VISA tendinopathy questionnaire for greater trochanteric pain syndrome, the VISA-G. ACTA ACUST UNITED AC 2015; 20:805-13. [PMID: 25870117 DOI: 10.1016/j.math.2015.03.009] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 03/13/2015] [Accepted: 03/17/2015] [Indexed: 12/25/2022]
Abstract
BACKGROUND Greater trochanteric pain syndrome (GTPS) is common, resulting in significant pain and disability. There is no condition specific outcome score to evaluate the degree of severity of disability associated with GTPS in patients with this condition. OBJECTIVE To develop a reliable and valid outcome measurement capable of evaluating the severity of disability associated with GTPS. METHODS A phenomenological framework using in-depth semi structured interviews of patients and medical experts, and focus groups of physiotherapists was used in the item generation. Item and format clarification was undertaken via piloting. Multivariate analysis provided the basis for item reduction. The resultant VISA-G was tested for reliability with the inter class co-efficient (ICC), internal consistency (Cronbach's Alpha), and construct validity (correlation co-efficient) on 52 naïve participants with GTPS and 31 asymptomatic participants. RESULTS The resultant outcome measurement tool is consistent in style with existing tendinopathy outcome measurement tools, namely the suite of VISA scores. The VISA-G was found to be have a test-retest reliability of ICC2,1 (95% CI) of 0.827 (0.638-0.923). Internal consistency was high with a Cronbach's Alpha of 0.809. Construct validity was demonstrated: the VISA-G measures different constructs than tools previously used in assessing GTPS, the Harris Hip Score and the Oswestry Disability Index (Spearman Rho:0.020 and 0.0205 respectively). The VISA-G did not demonstrate any floor or ceiling effect in symptomatic participants. CONCLUSION The VISA-G is a reliable and valid score for measuring the severity of disability associated GTPS.
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Affiliation(s)
- A M Fearon
- ANU Medical School, College of Medicine, Biology and Environment, Australian National University, Canberra, Australia; Trauma and Orthopaedic Research Unit, the Canberra Hospital, Canberra, Australia.
| | - C Ganderton
- School of Physiotherapy, Faculty of Health Science, La Trobe University, Melbourne, Australia
| | - J M Scarvell
- Trauma and Orthopaedic Research Unit, the Canberra Hospital, Canberra, Australia; Discipline of Physiotherapy, Faculty of Health, University of Canberra, Canberra, Australia
| | - P N Smith
- ANU Medical School, College of Medicine, Biology and Environment, Australian National University, Canberra, Australia; Trauma and Orthopaedic Research Unit, the Canberra Hospital, Canberra, Australia
| | - T Neeman
- ANU Medical School, College of Medicine, Biology and Environment, Australian National University, Canberra, Australia
| | - C Nash
- Department of Physiotherapy, School of Primary Health Care, Monash University, Melbourne, Australia
| | - J L Cook
- Department of Physiotherapy, School of Primary Health Care, Monash University, Melbourne, Australia
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van Ark M, Docking SI, van den Akker-Scheek I, Rudavsky A, Rio E, Zwerver J, Cook JL. Does the adolescent patellar tendon respond to 5 days of cumulative load during a volleyball tournament? Scand J Med Sci Sports 2015; 26:189-96. [PMID: 25694241 DOI: 10.1111/sms.12426] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2015] [Indexed: 12/15/2022]
Abstract
Patellar tendinopathy (jumper's knee) has a high prevalence in jumping athletes. Excessive load on the patellar tendon through high volumes of training and competition is an important risk factor. Structural changes in the tendon are related to a higher risk of developing patellar tendinopathy. The critical tendon load that affects tendon structure is unknown. The aim of this study was to investigate patellar tendon structure on each day of a 5-day volleyball tournament in an adolescent population (16-18 years). The right patellar tendon of 41 players in the Australian Volleyball Schools Cup was scanned with ultrasound tissue characterization (UTC) on every day of the tournament (Monday to Friday). UTC can quantify structure of a tendon into four echo types based on the stability of the echo pattern. Generalized estimating equations (GEE) were used to test for change of echo type I and II over the tournament days. Participants played between eight and nine matches during the tournament. GEE analysis showed no significant change of echo type percentages of echo type I (Wald chi-square = 4.603, d.f. = 4, P = 0.331) and echo type II (Wald chi-square = 6.070, d.f. = 4, P = 0.194) over time. This study shows that patellar tendon structure of 16-18-year-old volleyball players is not affected during 5 days of cumulative loading during a volleyball tournament.
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Affiliation(s)
- M van Ark
- Center for Sports Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Department of Physiotherapy, Monash University, Frankston, Victoria, Australia
| | - S I Docking
- Department of Physiotherapy, Monash University, Frankston, Victoria, Australia
| | - I van den Akker-Scheek
- Center for Sports Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - A Rudavsky
- Department of Physiotherapy, Monash University, Frankston, Victoria, Australia
| | - E Rio
- Department of Physiotherapy, Monash University, Frankston, Victoria, Australia
| | - J Zwerver
- Center for Sports Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - J L Cook
- Department of Physiotherapy, Monash University, Frankston, Victoria, Australia
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Hanlon-Dearman A, Green CR, Andrew G, LeBlanc N, Cook JL. Anticipatory guidance for children and adolescents with Fetal Alcohol Spectrum Disorder (FASD): practice points for primary health care providers. J Popul Ther Clin Pharmacol 2015; 22:e27-e56. [PMID: 25599159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Fetal Alcohol Spectrum Disorder (FASD) is an umbrella term that describes the range of effects that can occur in an individual who was prenatally exposed to alcohol and includes an array of complex neurodevelopmental and physical findings. OBJECTIVES To give primary healthcare providers (PHCP) evidence-based recommendations for supporting and managing the symptoms of FASD after patients have received a diagnosis. MethodsPrimary health recommendations for the management of children and adolescents with FASD were developed based on expert clinical judgment and supported by evidence-based research, where appropriate. The format was adapted from other health supervision practice guidelines as developed by the American Academy of Pediatrics. Clinical practice "Points" for the PHCP are highlighted. A reference table of anticipatory recommendations by age is presented. RESULTS In most cases, the initial screening and referral for diagnosis will be made by the PHCP, and they will be responsible for ongoing management. It is anticipated that these recommendations will provide the PHCP with evidence to support the longitudinal health care of children and adolescents with FASD and their families as they transition throughout all developmental stages. CONCLUSION There is a pressing need for the involvement of PHCP in the active care of children and adolescents with FASD and their families over the lifespan. PHCP are trained in screening, prevention, and management of health needs, and are in the position to coordinate sub-specialty referrals as needed. Engaging PHCP will provide a truly integrated care system for individuals with FASD and their families.
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Abstract
Cartilage repair in terms of replacement, or
regeneration of damaged or diseased articular cartilage with functional tissue,
is the ‘holy grail’ of joint surgery. A wide spectrum of strategies
for cartilage repair currently exists and several of these techniques
have been reported to be associated with successful clinical outcomes
for appropriately selected indications. However, based on respective
advantages, disadvantages, and limitations, no single strategy, or
even combination of strategies, provides surgeons with viable options
for attaining successful long-term outcomes in the majority of patients.
As such, development of novel techniques and optimisation of current techniques
need to be, and are, the focus of a great deal of research from
the basic science level to clinical trials. Translational research
that bridges scientific discoveries to clinical application involves
the use of animal models in order to assess safety and efficacy
for regulatory approval for human use. This review article provides
an overview of animal models for cartilage repair. Cite this article: Bone Joint Res 2014;4:89–94.
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Affiliation(s)
- J L Cook
- University of Missouri, ComparativeOrthopaedic Laboratory and Missouri Orthopaedic Institute, Columbia, Missouri, USA
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Docking SI, van Schie JTM, Daffy J, Rosengarten S, Cook JL. BILATERAL CHANGES IN UNILATERAL ACHILLES TENDINOPATHY QUANTIFIED USING ULTRASOUND TISSUE CHARACTERISATION. Br J Sports Med 2013. [DOI: 10.1136/bjsports-2013-092459.47] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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