1
|
Nwizu M, Weiner T, Downs T, Krizo J, Mangira C, Cowan S, Mallat A, Heaney A. Impact of Triage Systems on Time to Diagnosis and Treatment of Traumatic Brain Injuries. J Emerg Med 2024; 66:e304-e312. [PMID: 38429213 DOI: 10.1016/j.jemermed.2023.11.005] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 10/23/2023] [Accepted: 11/04/2023] [Indexed: 03/03/2024]
Abstract
BACKGROUND Intracerebral hemorrhage (ICH) is a potential complication from traumatic brain injury, with a 30-day mortality rate of 35-52%. Rapid diagnosis allows for earlier treatment, which impacts patient outcomes. A trauma activation (TA) is called when injury severity meets institutional criteria. The patient is immediately roomed, and a multispecialty team is present. A trauma evaluation (TE) occurs when injuries are identified after standard triage processes. OBJECTIVES Our aim was to determine whether TA patients with ICH were diagnosed and treated more rapidly than TE patients. METHODS This was a retrospective study of patients presenting to trauma centers within a large hospital system diagnosed with traumatic ICH between January 2018 and December 2018. Patients were categorized as TA or TE patients. The time to diagnosis was compared between groups, and additional times were evaluated, including time to imaging, computed tomography interpretation, and treatment. RESULTS A total of 294 patients were included. Groups had similar demographic characteristics and medical history; there was no difference in head Abbreviated Injury Score, Injury Severity Score, or anticoagulant use. Time to diagnosis was decreased for TA patients compared with TE patients (p < 0.0001). In addition, TA patients received treatment sooner (median 107 min) than TE patients (184.5 min) (p < 0.0001). CONCLUSIONS Diagnosis and treatment times were significantly faster in TA patients than in TE patients. Given the similarities in injury severity between groups, the increased time to treatment may be detrimental for patients. Trauma activations are a resource-heavy process, but TE delays care. These data suggest that an intermediary process may be beneficial.
Collapse
Affiliation(s)
- Marcel Nwizu
- Department of Emergency Medicine, Cleveland Clinic Akron General Medical Center, Akron, Ohio
| | - Thomas Weiner
- Department of Emergency Medicine, Cleveland Clinic Akron General Medical Center, Akron, Ohio
| | - Tony Downs
- Department of Emergency Medicine, Cleveland Clinic Akron General Medical Center, Akron, Ohio
| | - Jessica Krizo
- Department of Emergency Medicine, Cleveland Clinic Akron General Medical Center, Akron, Ohio; Department of Health Sciences, Cleveland Clinic Akron General Medical Center, Akron, Ohio
| | - Caroline Mangira
- Department of Health Sciences, Cleveland Clinic Akron General Medical Center, Akron, Ohio
| | - Stacy Cowan
- Department of Health Sciences, Cleveland Clinic Akron General Medical Center, Akron, Ohio
| | - Ali Mallat
- Department of General Surgery, Cleveland Clinic Akron General, Akron, Ohio; Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Ashley Heaney
- Department of Emergency Medicine, Cleveland Clinic Akron General Medical Center, Akron, Ohio
| |
Collapse
|
2
|
Kinsella R, Pizzari T, Watson L, Cowan S. A comparison of isometric, concentric and eccentric rotator cuff exercises in the physiotherapy management of subacromial pain syndrome: feasibility study for a randomised controlled trial. J Sci Med Sport 2022. [DOI: 10.1016/j.jsams.2022.09.090] [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: 11/17/2022]
|
3
|
Patterson B, King M, Cowan S, Mosler A, Bruder A, Clarke A, Haberfield M, Girdwood M, Culvenor A, Donaldson A, McGhee D, Makdissi M, Barton C, Roughhead E, Lampard S, Chilman K, Crossley K. Self-reported injuries in 2440 women and girls playing community Australian football: a cross-sectional study. J Sci Med Sport 2022. [DOI: 10.1016/j.jsams.2022.09.029] [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: 11/17/2022]
|
4
|
Bruder A, Crossley K, Patterson B, Mosler A, Haberfield M, Hägglund M, Culvenor A, Cowan S, Donaldson A. Collaboratively developed elite injury prevention programs can enhance uptake in a real-world sport setting. J Sci Med Sport 2022. [DOI: 10.1016/j.jsams.2022.09.028] [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: 11/17/2022]
|
5
|
Nwizu M, Downs T, Krizo J, Cowan S, Wiener T, Mallat A, Heaney A. 173 Trauma Activations Are Associated with Decreased Time to Diagnosis & Treatment of Intracerebral Hemorrhage When Compared to Trauma Evaluations. Ann Emerg Med 2020. [DOI: 10.1016/j.annemergmed.2020.09.185] [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]
|
6
|
Lansdown TC, Cowan S, Nioi A, Cowie H, Wendelboe-Nelson C, Rashid S, Ritchie P, Cherrie JW. Vitamin D and UV exposure in construction workers-a randomized control trial using text messaging to promote positive behaviours. J Public Health (Oxf) 2020; 42:594-601. [PMID: 31120504 DOI: 10.1093/pubmed/fdz056] [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: 11/30/2018] [Revised: 03/27/2019] [Accepted: 04/26/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The aim of this study was to determine whether a text messaging intervention (supported by a smartphone application) would be effective in the promotion of sun-safe behaviours. Both excessive and insufficient exposure to ultra-violet (UV) radiation were considered. METHODS A randomized control crossover trial was conducted. 112 participants from nine sites in the United Kingdom contributed to the study. There were three intervention waves, two in winter (Vitamin D-focussed) and one in summer (UV exposure-focussed). Stages of Change, Standard Erythemal (UV) Dose and assayed blood samples (Vitamin D) were employed to evaluate the effectiveness throughout the 21-day data collection periods. RESULTS The intervention was effective in promoting positive progression in Stages of Change for Vitamin D; and this in turn was predictive of increased Vitamin D levels in participants. More limited positive findings were found with respect to UV exposure. Overall, for those in the Intervention, Vitamin D levels were significantly predicted to increase during both of the winter data collection waves. CONCLUSIONS Interventions of this type are recommended to promote healthy Vitamin-D levels in construction workers.
Collapse
Affiliation(s)
| | - S Cowan
- Heriot-Watt University, Edinburgh, EH14 4AS, UK
| | - A Nioi
- Heriot-Watt University, Edinburgh, EH14 4AS, UK
| | - H Cowie
- Institute of Occupational Medicine, Edinburgh, EH14 4AP, UK
| | | | - S Rashid
- Institute of Occupational Medicine, Edinburgh, EH14 4AP, UK
| | - P Ritchie
- Institute of Occupational Medicine, Edinburgh, EH14 4AP, UK
| | - J W Cherrie
- Heriot-Watt University, Edinburgh, EH14 4AS, UK
| |
Collapse
|
7
|
Zinner R, Cowan S, Solomides C, Hooper D, Harshyne L, Lu-Yao G, Yang H, Phan L, Poller D, Leiby B, Werner-Wasik M, Lu B, Johnson J, Axelrod R, Argiris A, Evans N. P3.17-22 Nivolumab Plus Cisplatin/Pemetrexed or Cisplatin/Gemcitabine as Induction in Resectable NSCLC. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1978] [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: 10/28/2022]
|
8
|
Deen L, Cowan S, Wejse C, Holm J, Norredam M. 5.5-O5Refugees and family-reunified immigrants have a high incidence of HIV and late presentation compared with Danish-born: a nationwide register-based cohort study. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky047.189] [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: 11/12/2022] Open
Affiliation(s)
- L Deen
- Section of Immigrant Medicine, Department of Infectious Disease, Copenhagen University Hospital, Denmark
| | - S Cowan
- Department of Infectious Disease Epidemiology, Statens Serum Institut, Denmark
| | - C Wejse
- Centre for Global Health, Department of Public Health, Aarhus University, Denmark
| | - J Holm
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Denmark
| | - M Norredam
- Danish Research Centre for Migration, Ethnicity and Health (MESU), Section for Health Services Research, Department of Public Health, University of Copenhagen, Denmark
| |
Collapse
|
9
|
Cameron ST, Craig A, Sim J, Gallimore A, Cowan S, Dundas K, Heller R, Milne D, Lakha F. Feasibility and acceptability of introducing routine antenatal contraceptive counselling and provision of contraception after delivery: the APPLES pilot evaluation. BJOG 2017; 124:2009-2015. [DOI: 10.1111/1471-0528.14674] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2017] [Indexed: 11/28/2022]
Affiliation(s)
- ST Cameron
- Chalmers Sexual Health Clinic; NHS Lothian; Edinburgh UK
- Simpson Centre for Reproductive Health; NHS Lothian; Royal Infirmary of Edinburgh; UK
| | - A Craig
- Chalmers Sexual Health Clinic; NHS Lothian; Edinburgh UK
| | - J Sim
- Public Health; NHS Lothian Waverley Gate; Edinburgh UK
| | - A Gallimore
- Public Health; NHS Lothian Waverley Gate; Edinburgh UK
| | - S Cowan
- Simpson Centre for Reproductive Health; NHS Lothian; Royal Infirmary of Edinburgh; UK
| | - K Dundas
- Simpson Centre for Reproductive Health; NHS Lothian; Royal Infirmary of Edinburgh; UK
| | - R Heller
- Chalmers Sexual Health Clinic; NHS Lothian; Edinburgh UK
| | - D Milne
- Public Health; NHS Lothian Waverley Gate; Edinburgh UK
| | - F Lakha
- Public Health; NHS Lothian Waverley Gate; Edinburgh UK
| |
Collapse
|
10
|
Franco C, Taylor C, Sevalkumar K, Cowan S, Heilbron B, Tsang M, Hamburger J, Gosal-Sadhra T, Kaila K, Leipsic J, Ramanathan K. WILL INFLAMMATORY MONOCYTE HETEROGENEITY BE THE KEY TO UNLOCKING THE SECRET OF PREMATURE CORONARY ATHEROSCLEROSIS IN SOUTH ASIANS? A PROSPECTIVE EVALUATION OF CANADIAN SOUTH ASIAN AND CAUCASIANS. Can J Cardiol 2016. [DOI: 10.1016/j.cjca.2016.07.103] [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: 11/30/2022] Open
|
11
|
Hart H, Culvenor A, Collins N, Ackland D, Cowan S, Machotka Z, Crossley K. A systematic review and meta-analysis of knee kinematics and moments after ACL reconstruction: Implications for early-onset knee osteoarthritis. J Sci Med Sport 2015. [DOI: 10.1016/j.jsams.2015.12.441] [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: 10/22/2022]
|
12
|
Roston T, Taylor C, Chan S, Potts J, Cloutier-Gill L, Selvakumar K, Cowan S, Cheung C, Franco C, Main T, Verma T, Lee D, Gin K, Ramanathan K. RECURRENT CHEST PAIN IN PATIENTS WITH A HISTORY OF ACUTE CORONARY SYNDROMES: ASSESSING THE GESTALT OF CANADIAN CARDIOLOGISTS. Can J Cardiol 2015. [DOI: 10.1016/j.cjca.2015.07.185] [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: 11/28/2022] Open
|
13
|
Hart H, Collins N, Ackland D, Cowan S, Crossley K. The effects of varus bracing for predominant lateral knee osteoarthritis and valgus malalignment after ACL reconstruction. J Sci Med Sport 2014. [DOI: 10.1016/j.jsams.2014.11.045] [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: 10/24/2022]
|
14
|
Hart H, Collins N, Ackland D, Cowan S, Crossley K. Knee biomechanics in people with predominant lateral or medial knee osteoarthritis after ACL reconstruction, and healthy controls. J Sci Med Sport 2014. [DOI: 10.1016/j.jsams.2014.11.047] [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: 10/24/2022]
|
15
|
Campling B, Lai Y, Ye Z, Axelrod R, Bar Ad V, Lu B, Werner-Wasik M, Cowan S, Nathaniel E, Yang H. Age Disparity Between Current and Former Smokers at Time of Diagnosis of Lung Cancer. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.08.270] [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: 10/24/2022]
|
16
|
Cowan S, Grubisic M, Hawkins N, Raymakers A, Novak P, Gao M, Bashir J. POPULATION-BASED OUTCOMES OF ICD THERAPY IN WOMEN. Can J Cardiol 2014. [DOI: 10.1016/j.cjca.2014.07.601] [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: 10/24/2022] Open
|
17
|
Bar Ad V, Lai Y, Lu B, Palmer J, Myers R, Ye Z, Wang C, Axelrod R, Campling B, Werner-Wasik M, Cowan S, Evans N, Kumar R, Hehn B, Solomides C, Yang H. Prognostic Value of the Pre-Diagnostic Neutrophil-Lymphocyte Ratio (NLR) for the Survival of Patients With Lung Cancer. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.457] [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: 11/28/2022]
|
18
|
Hansen N, Hay G, Cowan S, Jepsen P, Bygum Krarup H, Obel N, Weis N, Brehm Christensen P. Hepatitis B prevalence in Denmark - an estimate based on nationwide registers and a national screening programme, as on 31 December 2007. ACTA ACUST UNITED AC 2013; 18. [PMID: 24300884 DOI: 10.2807/1560-7917.es2013.18.47.20637] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The prevalence of chronic hepatitis B virus (HBV) infection in Denmark is not clear. The primary aim of this study was to estimate the prevalence of chronic HBV infection in Denmark. The capture–recapture method was used to estimate the total population diagnosed with chronic HBV infection in Denmark using four nationwide registers. The population with undiagnosed chronic HBV infection was estimated by incorporating data from a two-year nationwide HBsAg screening programme in pregnant women. We identified 4,466 individuals with chronic HBV infection in the four registers until the end of 2007, and the capture–recapture estimate of the total population diagnosed with chronic hepatitis B was 7,112 (95% confidence interval (CI): 6,953–10,747). Only 17% of the identified patients attended recommended clinical care according to national guidelines. Including undiagnosed patients, the current population alive with HBV infection was 10,668 (95% CI: 10,224–16,164), corresponding to a prevalence of 0.24% (95% CI: 0.23–0.37%) in the Danish population older than 15 years. The estimated prevalence of chronic HBV infection among adults in Denmark was lower than reported from other northern European countries. Only half of the infected population had been diagnosed, and a minority attended specialised clinical care.
Collapse
Affiliation(s)
- N Hansen
- Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark
| | | | | | | | | | | | | | | |
Collapse
|
19
|
Nicoll J, O‘Reilly M, LaBossiere J, Lee T, Cowan S, Bigam D, Cheung P, Schmölzer G. Effect of cardiac output changes on exhaled carbon dioxide in newborn piglets. Resuscitation 2013; 84:1439-42. [DOI: 10.1016/j.resuscitation.2013.05.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2013] [Revised: 05/05/2013] [Accepted: 05/07/2013] [Indexed: 11/25/2022]
|
20
|
Salado-Rasmussen K, Katzenstein TL, Gerstoft J, Cowan S, Hoffmann S, Jensen JS. P1.023 Molecular Typing of Treponema Pallidumfrom an Ongoing Syphilis Outbreak in Denmark. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0244] [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: 11/04/2022]
|
21
|
Chiu W, Cowan S, Kealy J. NP014 The Many Faces of Cardiac Sarcoidosis. Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.829] [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: 10/27/2022] Open
|
22
|
Bashir J, Yamashita M, Cowan S, Tung S, Kerr C, Karim S, Chakrabarti S, Yeung-Lai-Wah J, Gao M. 623 Denouement of the Sprint Fidelis ICD Lead Recall: Results of an Aggressive Canadian Excimer Laser Lead Extraction Program. Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.560] [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: 11/29/2022] Open
|
23
|
Cowan S, Yamashita M, Danter M, Bashir J. 764 Cost Implications of the Sprint Fidelis (SF) Implantable Cardioverter-Defibrillator (ICD) Lead Recall on the Canadian Health Care System. Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.689] [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: 10/27/2022] Open
|
24
|
Gubbels S, Bacci S, Laursen H, Høgenhaven H, Cowan S, Mølbak K, Christiansen M. Description and analysis of 12 years of surveillance for Creutzfeldt–Jakob disease in Denmark, 1997 to 2008. Euro Surveill 2012. [DOI: 10.2807/ese.17.15.20142-en] [Citation(s) in RCA: 11] [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] [Indexed: 11/20/2022] Open
Abstract
Binary file ES_Abstracts_Final_ECDC.txt matches
Collapse
Affiliation(s)
- S Gubbels
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control, Stockholm, Sweden
- Department of Epidemiology, Statens Serum Institut, Copenhagen, Denmark
| | - S Bacci
- Department of Epidemiology, Statens Serum Institut, Copenhagen, Denmark
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - H Laursen
- Neuropathology Laboratory, Rigshospitalet, Copenhagen, Denmark
| | - H Høgenhaven
- Department of Clinical Neurophysiology, Rigshospitalet, Copenhagen, Denmark
| | - S Cowan
- Department of Epidemiology, Statens Serum Institut, Copenhagen, Denmark
| | - K Mølbak
- Department of Epidemiology, Statens Serum Institut, Copenhagen, Denmark
| | - M Christiansen
- Department of Clinical Biochemistry and Immunology, Statens Serum Institut, Copenhagen, Denmark
| |
Collapse
|
25
|
Gubbels S, Bacci S, Laursen H, Hogenhaven H, Cowan S, Molbak K, Christiansen M. Description and analysis of 12 years of surveillance for Creutzfeldt-Jakob disease in Denmark, 1997 to 2008. Euro Surveill 2012; 17:20142. [PMID: 22516048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
Prospective surveillance of Creutzfeldt–Jakob disease (CJD) was initiated in Denmark in 1997, following the observation of variant CJD in the United Kingdom. Demographic, clinical and diagnostic information was collected for each patient with clinical suspicion of CJD. Here we describe the methods for surveillance and the observed outcomes between 1 January 1997 and 31 December 2008. A total of 83 patients were classified as sporadic CJD, 47 were definite diagnoses, 34 probable and two possible. This resulted in a mean incidence of 1.26 patients with probable and definite sporadic CJD per million inhabitants. Two sporadic CJD patients were found to have a genetic variant of unknown significance: Thr201Ser and Glu200Asp. One patient was diagnosed with Gerstmann-Sträussler-Scheinker syndrome. No patients were classified as having variant, iatrogenic or familial CJD. The Danish surveillance system, like those in other countries, has a multidisciplinary approach, which is labour-intensive and time-consuming but ensures the most complete set of information possible. With this approach we think that patients with variant CJD would have been detected had they occurred in Denmark. Certain aspects of CJD surveillance need further discussion at European level and beyond, in order to find a balance between efficiency of the systems and accuracy of surveillance data.
Collapse
Affiliation(s)
- S Gubbels
- Department of Epidemiology, Statens Serum Institut, Copenhagen, Denmark.
| | | | | | | | | | | | | |
Collapse
|
26
|
Toma M, Josan K, Moss R, Bashir J, Cowan S, Kaan A, Ignaszewski A, Cheung A. 248 Right Ventricular Dysfunction Should Not Preclude Left Ventricular Assist Device Explantation in Patients Exhibiting Left Ventricular Recovery. J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.255] [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: 10/28/2022] Open
|
27
|
Cowan S, Toma M, Kaan A, Ignaszewski A, Cheung A. 544 Long-term survival in patients receiving an implantable microaxial ventricular assist device for cardiogenic shock. Can J Cardiol 2011. [DOI: 10.1016/j.cjca.2011.07.452] [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: 11/29/2022] Open
|
28
|
Van Tiggelen D, Cowan S, Thijs Y, Coorevits P, Witvrouw E. Intrinsic risk factors and the effects of prophylactic bracing on the development of patellofemoral pain in male subjects. Br J Sports Med 2011. [DOI: 10.1136/bjsm.2011.084038.200] [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: 11/03/2022]
|
29
|
Wyndow N, Cowan S, Crossley K, Wrigley T. Neuromotor control of the triceps surae during gait in people with and without Achilles tendinopathy. J Sci Med Sport 2010. [DOI: 10.1016/j.jsams.2010.10.628] [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: 11/16/2022]
|
30
|
|
31
|
Cowan S. The role of gluteus medius in patellofemoral pain. J Sci Med Sport 2006. [DOI: 10.1016/j.jsams.2006.12.010] [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: 11/25/2022]
|
32
|
Neal A, Brukner P, Nicol A, Cowan S, Crossley K, Quinn J. 393 Comparison of the effectiveness of oral and intravenous rehydration in recovery following exercise. J Sci Med Sport 2005. [DOI: 10.1016/s1440-2440(17)30890-3] [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: 11/30/2022]
|
33
|
Crossley K, Wrigley T, Cowan S, Hodges P, Bennell K, Herbert R. 45 Quadriceps muscle function is impaired in response to knee pain. J Sci Med Sport 2005. [DOI: 10.1016/s1440-2440(17)30540-6] [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: 11/24/2022]
|
34
|
Cowan S. Syphilis in Denmark-Outbreak among MSM in Copenhagen, 2003-2004. Euro Surveill 2004; 9:25-7. [PMID: 15677850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023] Open
Abstract
Denmark is currently experiencing an outbreak of syphilis that began in 2003 and has continued in 2004. Data from the national surveillance system show that most cases are in men who have sex with men (MSM), and that a large proportion of these patients are also HIV positive. The proportion of known HIV positive cases in MSM notified with syphilis during the outbreak has, however, not been significantly different from previous years. The majority of cases were reported from Copenhagen municipality, and 70% of the cases were acquired domestically. The outbreak does not seem to be affecting the age group under 20 years. We speculate that most of the MSM found with both syphilis and HIV were already HIV positive when they acquired syphilis infection.
Collapse
Affiliation(s)
- S Cowan
- Department of Epidemiology, Statens Serum Institut, Copenhagen, Denmark
| |
Collapse
|
35
|
|
36
|
Cafferata Mf MFL, Althabe F, Belizán JM, Cowan S, Nelson EAS. [Sleeping position to prevent sudden infant death syndrome in Latin-american and Caribbean hospitals]. An Esp Pediatr 2002; 57:558-64. [PMID: 12466080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
Background The prone sleeping position for sleeping has been identified as the principal risk factor for sudden infant death syndrome (SIDS).ObjectiveThe aim of this study was to determine the prevalence of different sleeping positions and other risk factors for SIDS and to identify the advice given to parents in several maternity units in Latin America and the Caribbean through a specially-designed questionnaire.MethodsDescriptive cross-sectional study based in hospitals. All the countries in Latin America and the Caribbean were contacted through the Pan American Health Organization and responses were obtained from 16 countries.ResultsTwo hundred thirteen hospitals answered the survey. The preferred sleeping position for healthy infants was prone in 8.5 % of the hospitals, side in 48.8 %, and supine in 25.2 %. In 17.5 % of the hospitals no position was preferred or the answers were inconsistent.Concerning the recommendations given to parents on the best position for their infants at home, 25.7 % recommended the supine position, 7.6 % the prone position, 59.0 % the side position while 7.6 % made no recommendations.ConclusionsThe results of this study show that in the hospitals surveyed there is a policy of not placing healthy neonates in the prone position. However, the most frequent position was the side, which is not advisable as it increases the risk of SIDS. To reduce in the incidence of SIDS, campaigns to increase the use of the supine position should be carried out in hospitals and among the general public.
Collapse
Affiliation(s)
- M feminine L Cafferata Mf
- Centro Latinoamericano de Perinatología, Organización Panamericana de la Salud. Organización Mundial de la Salud. Montevideo. Uruguay
| | | | | | | | | |
Collapse
|
37
|
|
38
|
Cafferata M, Althabe F, Belizán J, Cowan S, Nelson E. Posición al dormir en hospitales de América Latina y el Caribe para la prevención del síndrome de muerte súbita del lactante. An Pediatr (Barc) 2002. [DOI: 10.1016/s1695-4033(02)78716-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
39
|
Losman J, Chen XP, Jiang H, Pan PY, Kashiwada M, Giallourakis C, Cowan S, Foltenyi K, Rothman P. IL-4 signaling is regulated through the recruitment of phosphatases, kinases, and SOCS proteins to the receptor complex. Cold Spring Harb Symp Quant Biol 2001; 64:405-16. [PMID: 11232315 DOI: 10.1101/sqb.1999.64.405] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- J Losman
- Departments of Medicine and Microbiology, College of Physicians & Surgeons of Columbia University, New York, New York 10032, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
40
|
McKinlay A, Couston M, Cowan S. Nurses' behavioural intentions towards self-poisoning patients: a theory of reasoned action, comparison of attitudes and subjective norms as predictive variables. J Adv Nurs 2001; 34:107-16. [PMID: 11430598 DOI: 10.1046/j.1365-2648.2001.3411728.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The incidence of self-poisoning is on the increase. Most patients who self-poison are dealt with initially in the general hospital. Therefore, the type and quality of care self-poisoning patients receive will depend, in part, on how they are viewed by nursing staff within the general hospital setting. A knowledge and understanding of the attitudes held by nurses towards self-poisoning patients is therefore important to those involved in the planning and delivery of care towards this client group. Previous studies have examined health care professionals' attitudes towards people who self-poison. Usually, however, these have not focused specifically on nurses' attitudes, and they have ignored the relationship between the attitudes expressed by staff and their intentions to engage in subsequent caring behaviour of one sort or another. It is hence unclear how the findings of such studies are relevant or applicable to nursing policy and practice. AIMS The present study aims to address these limitations using a methodology informed by the theory of reasoned action. The study aims to separate out the distinctive roles played by nurses' own attitudes, and the social pressures represented by other people's attitudes, in determining the types of caring behaviour in which nurses intend to engage when dealing with self-poisoning patients. DESIGN/METHODS The study adopts a questionnaire-based approach incorporating two specially designed vignettes. RESULTS The results show that nurses' own attitudes, and what they believe about the attitudes of others, predict their behavioural intentions towards self-poisoning patients. The study also shows that nurses with a more positive orientation towards self-poisoning patients differ in behavioural and normative beliefs from nurses who have a less positive orientation. CONCLUSIONS The implications for future attempts to explore the relationship between nurses' attitudes and subsequent caring behaviour are considered, along with implications for nursing policy and practice.
Collapse
Affiliation(s)
- A McKinlay
- Department of Psychology, University of Edinburgh, UK.
| | | | | |
Collapse
|
41
|
Affiliation(s)
- S Cowan
- Molecular Nature Limited, Plas Gogerddan, Aberystwyth, SY23 3EB, Ceredigion, UK
| | | | | | | | | | | | | |
Collapse
|
42
|
Abstract
Three lignans, pinoresinol (1), 8-hydroxypinoresinol (2) and olivil (3) have been isolated from the leaves of Strophanthus gratus by reversed-phase HPLC.
Collapse
Affiliation(s)
- S Cowan
- Molecular Nature Ltd, Plas Gogerddan, Aberystwyth, Ceredigion SY23 3EB, UK
| | | | | | | | | | | |
Collapse
|
43
|
Tau GZ, von der Weid T, Lu B, Cowan S, Kvatyuk M, Pernis A, Cattoretti G, Braunstein NS, Coffman RL, Rothman PB. Interferon gamma signaling alters the function of T helper type 1 cells. J Exp Med 2000; 192:977-86. [PMID: 11015439 PMCID: PMC2193318 DOI: 10.1084/jem.192.7.977] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/1999] [Accepted: 06/30/2000] [Indexed: 11/13/2022] Open
Abstract
One mechanism regulating the ability of different subsets of T helper (Th) cells to respond to cytokines is the differential expression of cytokine receptors. For example, Th2 cells express both chains of the interferon gamma receptor (IFN-gammaR), whereas Th1 cells do not express the second chain of the IFN-gammaR (IFN-gammaR2) and are therefore unresponsive to IFN-gamma. To determine whether the regulation of IFN-gammaR2 expression, and therefore IFN-gamma responsiveness, is important for the differentiation of naive CD4(+) T cells into Th1 cells or for Th1 effector function, we generated mice in which transgenic (TG) expression of IFN-gammaR2 is controlled by the CD2 promoter and enhancer. CD4(+) T cells from IFN-gammaR2 TG mice exhibit impaired Th1 polarization potential in vitro. TG mice also display several defects in Th1-dependent immunity in vivo, including attenuated delayed-type hypersensitivity responses and decreased antigen-specific IFN-gamma production. In addition, TG mice mount impaired Th1 responses against Leishmania major, as manifested by increased parasitemia and more severe lesions than their wild-type littermates. Together, these data suggest that the sustained expression of IFN-gammaR2 inhibits Th1 differentiation and function. Therefore, the acquisition of an IFN-gamma-unresponsive phenotype in Th1 cells plays a crucial role in the development and function of these cells.
Collapse
Affiliation(s)
- G Z Tau
- Integrated Program in Cell, Molecular and Biophysical Studies, Columbia University, New York, New York 10032, USA
| | | | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Abstract
AIM To identify hospitals in Eastern Europe promoting front infant sleeping position. METHODS Questionnaires were distributed to maternity units in 22 countries during July to November 1999. RESULTS A total of 489 hospitals in 20 countries responded. Preferred position in normal care units was back (26.6%), front (1. 8%), side (65%), or combination/none (6.6%). Corresponding recommendations at discharge were 17.4%, 3.5%, 73%, and 6.1%.
Collapse
Affiliation(s)
- E A Nelson
- Department of Paediatrics, The Chinese University of Hong Kong, 6/F Clinical Science Building, Prince of Wales Hospital, Shatin, Hong Kong.
| | | | | | | |
Collapse
|
45
|
Tappin DM, Lumsden MA, McIntyre D, Mckay C, Gilmour WH, Webber R, Cowan S, Crawford F, Currie F. A pilot study to establish a randomized trial methodology to test the efficacy of a behavioural intervention. Health Educ Res 2000; 15:491-502. [PMID: 11066466 DOI: 10.1093/her/15.4.491] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
How can pregnant women be helped to stop smoking? This was a pilot study of midwife home-based motivational interviewing. Clients were 100 consecutive self-reported smokers booking at clinics in Glasgow from March to May 1997. Smoking guidance is routinely given at booking. In addition, intervention clients received a median of four home-based motivational interviewing sessions from one specially trained midwife. All sessions (n = 171) were audio-taped and interviews (n = 49) from 13 randomly selected clients were transcribed for content analysis. Three 'experts' assessed intervention quality using a recognized rating scale. Cotinine measurement on routine blood samples confirmed self-reported smoking change from late pregnancy telephone interview. Postnatal telephone questionnaire measured client satisfaction. Focus groups of routine midwives explored acceptability, problems and disruption of normal care. Fisher exact, chi 2 and Mann-Whitney tests compared enrolment characteristics. Two-sample t-tests assessed outcome between groups. Motivational interviewing was satisfactory in more than 75% of transcribed interviews. In this pilot study, self-reported smoking at booking (100 of 100 available) corroborated by cotinine (93 of 100) compared with late pregnancy self-reports (intervention 47 of 48; control 49 of 49) and cotinine (intervention 46 of 48; control 47 of 49) showed no significant difference between groups. Tools have been developed to answer the question: 'Can proactive opportunistic home-based motivational interviewing help pregnant smokers reduce their habit?'.
Collapse
Affiliation(s)
- D M Tappin
- Scottish Cot Death Trust, Royal Hospital for Sick Children, Yorkhill, UK
| | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Tappin D, Lumsden M, McKay C, McIntyre D, Gilmour H, Webber R, Cowan S, Crawford F, Currie F. The effect of home-based motivational interviewing on the smoking behaviour of pregnant women: a pilot randomized controlled efficacy study. ACTA ACUST UNITED AC 2000. [DOI: 10.1046/j.1467-0658.2000.00015.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
47
|
Ford RP, Schluter PJ, Cowan S. Changes to infant sleep practices in Canterbury. N Z Med J 2000; 113:8-10. [PMID: 10738493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
AIM "Reducing the risk" is a public health primary initiative to minimise the incidence of Sudden Infant Death Syndrome (SIDS) in New Zealand. A number of SIDS risks relate to infant sleep practices. We describe current prevalences of these practices. METHODS A cohort of Canterbury mothers delivering live infants during May 1997 (n = 411) were mailed a questionnaire in July surveying their infant's sleep practices. Survey results were compared to results derived from the Canterbury control infant component of the 1987-90 New Zealand Cot Death Study (NZCDS) (n = 174). Those mothers using either plastic or rubber mattress covers (n = 63) were issued a subsequent questionnaire pertaining to this mattress-wrapping practice. RESULTS Completed questionnaires were returned by 274 (66.7%) mothers. Room sharing with mother was usual for 133 (48.5%) infants, no different from the 94 (54.0%) recorded in the NZCDS (chi 2 = 5.6, df = 2, p = 0.06). However, of those infants sharing a room with their mother, 101 (75.9%) slept in their own bed compared to 46 (48.9%) in the NZCDS (chi 2 = 57.0, df = 2, p < 0.01). Only 8 (2.9%) infants were regularly placed prone to sleep, considerably fewer than the 69 (39.7%) reported in the NZCDS (chi 2 = 100.1, df = 1, p < 0.01). Mattress-wrapping with plastic (14.6% vs. 4.0%; chi 2 = 12.8, df = 1, p < 0.01) and rubber (8.4% vs. 3.4%; chi 2 = 4.4, df = 1, p = 0.04) has significantly increased since the NZCDS. Results from the subsequent questionnaire, completed by 42 (66.7%) respondents, indicated that most, 25 (59.5%), wrapped their infant's mattress to stop soiling. Less than half, 18 (42.9%), wrapped the mattress for the "safety of their baby". CONCLUSION The "non-prone sleeping" campaign has been successful in Canterbury. Most infants are now routinely placed non-prone for sleep. Of those infants sharing a room with their mothers, an increased proportion is sleeping in separate beds. The use of "drycot" under-blankets and sheepskins has diminished. While impermeable mattress-wrapping usage has significantly increased, over three-quarters of Canterbury mothers did not use plastic or rubber mattress-covers on their infant's beds.
Collapse
Affiliation(s)
- R P Ford
- Community Paediatric Unit, Canterbury Health, Christchurch
| | | | | |
Collapse
|
48
|
Cowan S, Bennell K, Crossley K, Hodges P, McConnell J. Delayed electromyographic onset of vastas medialis oblliquus relative to vastas lateralis in subjects with patellofemoral pain syndrome. J Sci Med Sport 1999. [DOI: 10.1016/s1440-2440(99)80042-5] [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: 10/25/2022]
|
49
|
Cowan S, Bennell K, Crossley K, Hodges P, McConnell J. Delayed electromyographic onset of vastus medialis obliquus relative to vastus lateralis in subjects with patellofemeral pain syndrome. J Sci Med Sport 1999. [DOI: 10.1016/s1440-2440(99)80019-x] [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]
|
50
|
Gelb BD, Cowan S. Consequences of bad publicity: one example. Hosp Health Serv Adm 1999; 39:435-49. [PMID: 10138716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
When Houston's leading newspaper investigated local for-profit psychiatric hospitals and ran a series of stories that ranged from unflattering to shocking, any hospital administrator might reasonably have expected dramatic effects on public perceptions of the specific hospitals named, and also perhaps on other psychiatric hospitals in the metropolitan area. In fact, a survey that tracks consumer awareness and impressions of all Houston-area hospitals found no such outcome. These results may be counterintuitive, but they are easily reconcilable with communications theory.
Collapse
Affiliation(s)
- B D Gelb
- Institute for Health Care Marketing, University of Houston, TX 77204
| | | |
Collapse
|