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4. Variation in Structure and Process of Care in Traumatic Brain Injury: Provider Profiles of European Neurotrauma Centers Participating in the CENTER-TBI Study

Author

Cnossen M. C., Polinder S., Lingsma H. F., Maas A. I. R., Menon D., Steyerberg E. W., Adams H., Alessandro M., Allanson J., Amrein K., Andaluz N., Andelic N., Andrea N., Andreassen L., Anke A., Antoni A., Ardon H., Audibert G., Auslands K., Azouvi P., Baciu C., Bacon A., Badenes R., Baglin T., Bartels R., Barzo P., Bauerfeind U., Beer R., Belda F. J., Bellander B. -M., Belli A., Bellier R., Benali H., Benard T., Berardino M., Beretta L., Beynon C., Bilotta F., Binder H., Biqiri E., Blaabjerg M., Borgen L. S., Bouzat P., Bragge P., Brazinova A., Brehar F., Brorsson C., Buki A., Bullinger M., Buckova V., Calappi E., Cameron P., Carbayo L. G., Carise E., Carpenter C., Castano-Leon A. M., Causin F., Chevallard G., Chieregato A., Citerio G., Coburn M. C., Coles J., Cooper J. D., Correia M., Covic A., Curry N., Czeiter E., Czosnyka M., Dahyot-Fizelier C., Damas F., Damas P., Dawes H., De Keyser V., Della Corte F., Depreitere B., Ding S., Dippel D., Dizdarevic K., Duliere G. -L., Dzeko A., Eapen G., Engemann H., Ercole A., Esser P., Ezer E., Fabricius M., Feigin V. L., Feng J., Foks K., Fossi F., Francony G., Frantzen J., Freo U., Frisvold S., Furmanov A., Gagliardo P., Galanaud D., Gao G., Geleijns K., Ghuysen A., Giraud B., Glocker B., Gomez P. A., Grossi F., Gruen R. L., Gupta D., Haagsma J. A., Hadzic E., Haitsma I., Hartings J. A., Helbok R., Helseth E., Hertle D., Hill S., Hoedemaekers A., Hoefer S., Hutchinson P. J., Haberg A. K., Jacobs B., Janciak I., Janssens K., Jiang J., Jones K., Kalala J. -P., Kamnitsas K., Karan M., Karau J., Katila A., Kaukonen M., Keeling D., Kerforne T., Ketharanathan N., Kettunen J., Kivisaari R., Kolias A. G., Kolumban B., Kompanje E., Kondziella D., Koskinen L. -O., Kovacs N., Kalovits F., Lagares A., Lanyon L., Laureys S., Lauritzen M., Lecky F., Ledig C., Lefering R., Legrand V., Lei J., Levi L., Lightfoot R., Lingsma H., Loeckx D., Lozano A., Luddington R., Luijten-Arts C., MacDonald S., MacFayden C., Maegele M., Majdan M., Major S., Manara A., Manhes P., Manley G., Martin D., Martino C., Maruenda A., Marechal H., Mastelova D., Mattern J., McMahon C., Melegh B., Menovsky T., Morganti-Kossmann C., Mulazzi D., Mutschler M., Muhlan H., Negru A., Nelson D., Neugebauer E., Newcombe V., Noirhomme Q., Nyiradi J., Oddo M., Oldenbeuving A., Oresic M., Ortolano F., Palotie A., Parizel P. M., Patruno A., Payen J. -F., Perera N., Perlbarg V., Persona P., Peul W., Pichon N., Piilgaard H., Piippo A., Pili F. S., Pirinen M., Ples H., Pomposo I., Psota M., Pullens P., Puybasset L., Ragauskas A., Raj R., Rambadagalla M., Rehorcikova V., Rhodes J., Richardson S., Ripatti S., Rocka S., Rodier N., Roe C., Roise O., Roks G., Romegoux P., Rosand J., Rosenfeld J., Rosenlund C., Rosenthal G., Rossaint R., Rossi S., Rostalski T., Rueckert D. L., Ruiz De Arcaute F., Rusnak M., Sacchi M., Sahakian B., Sahuquillo J., Sakowitz O., Sala F., Sanchez-Pena P., Sanchez-Porras R., Sandor J., Santos E., Sasse N., Sasu L., Savo D., Schipper I., Schlosser B., Schmidt S., Schneider A., Schoechl H., Schoonman G., Schou R. F., Schwendenwein E., Scholl M., Sir O., Skandsen T., Smakman L., Smeets D., Smielewski P., Sorinola A., Stamatakis E. L., Stanworth S., Stegemann K., Steinbuchel N., Stevens R., Stewart W., Stocchetti N., Sundstrom N., Synnot A., Szabo J., Soderberg J., Taccone F. S., Tamas V., Tanskanen P., Tascu A., Taylor M. S., Te Ao B., Tenovuo O., Teodorani G., Theadom A., Thomas M., Tibboel D., Tolias C., Tshibanda J. -F. L., Tudora C. M., Vajkoczy P., Valeinis E., Van Hecke W., Van Praag D., Van Roost D., Van Vlierberghe E., Vande Vyvere T., Vanhaudenhuyse A., Vargiolu A., Vega E., Verheyden J., Vespa P. M., Vik A., Vilcinis R., Vizzino G., Vleggeert-Lankamp C., Volovici V., Vulekovic P., Vamos Z., Wade D., Wang K. K. W., Wang L., Wildschut E., Williams G., Willumsen L., Wilson A., Wilson L., Winkler M. K. L., Ylen P., Younsi A., Zaaroor M., Zhang Z., Zheng Z., Zumbo F., De Lange S., De Ruiter G. C. W., Den Boogert H., Van Dijck J., Van Essen T. A., Van Heugten C., Van Der Jagt M., Van Der Naalt J., CENTER-Tbi Invest Participants, Cnossen, M, Polinder, S, Lingsma, H, Maas, A, Menon, D, Steyerberg, E, Adams, H, Alessandro, M, Allanson, J, Amrein, K, Andaluz, N, Andelic, N, Andrea, N, Andreassen, L, Anke, A, Antoni, A, Ardon, H, Audibert, G, Auslands, K, Azouvi, P, Baciu, C, Bacon, A, Badenes, R, Baglin, T, Bartels, R, Barzo, P, Bauerfeind, U, Beer, R, Belda, F, Bellander, B, Belli, A, Bellier, R, Benali, H, Benard, T, Berardino, M, Beretta, L, Beynon, C, Bilotta, F, Binder, H, Biqiri, E, Blaabjerg, M, Borgen, L, Bouzat, P, Bragge, P, Brazinova, A, Brehar, F, Brorsson, C, Buki, A, Bullinger, M, Buckova, V, Calappi, E, Cameron, P, Carbayo, L, Carise, E, Carpenter, C, Castano-Leon, A, Causin, F, Chevallard, G, Chieregato, A, Citerio, G, Coburn, M, Coles, J, Cooper, J, Correia, M, Covic, A, Curry, N, Czeiter, E, Czosnyka, M, Dahyot-Fizelier, C, Damas, F, Damas, P, Dawes, H, De Keyser, V, Della Corte, F, Depreitere, B, Ding, S, Dippel, D, Dizdarevic, K, Duliere, G, Dzeko, A, Eapen, G, Engemann, H, Ercole, A, Esser, P, Ezer, E, Fabricius, M, Feigin, V, Feng, J, Foks, K, Fossi, F, Francony, G, Frantzen, J, Freo, U, Frisvold, S, Furmanov, A, Gagliardo, P, Galanaud, D, Gao, G, Geleijns, K, Ghuysen, A, Giraud, B, Glocker, B, Gomez, P, Grossi, F, Gruen, R, Gupta, D, Haagsma, J, Hadzic, E, Haitsma, I, Hartings, J, Helbok, R, Helseth, E, Hertle, D, Hill, S, Hoedemaekers, A, Hoefer, S, Hutchinson, P, Haberg, A, Jacobs, B, Janciak, I, Janssens, K, Jiang, J, Jones, K, Kalala, J, Kamnitsas, K, Karan, M, Karau, J, Katila, A, Kaukonen, M, Keeling, D, Kerforne, T, Ketharanathan, N, Kettunen, J, Kivisaari, R, Kolias, A, Kolumban, B, Kompanje, E, Kondziella, D, Koskinen, L, Kovacs, N, Kalovits, F, Lagares, A, Lanyon, L, Laureys, S, Lauritzen, M, Lecky, F, Ledig, C, Lefering, R, Legrand, V, Lei, J, Levi, L, Lightfoot, R, Loeckx, D, Lozano, A, Luddington, R, Luijten-Arts, C, Macdonald, S, Macfayden, C, Maegele, M, Majdan, M, Major, S, Manara, A, Manhes, P, Manley, G, Martin, D, Martino, C, Maruenda, A, Marechal, H, Mastelova, D, Mattern, J, Mcmahon, C, Melegh, B, Menovsky, T, Morganti-Kossmann, C, Mulazzi, D, Mutschler, M, Muhlan, H, Negru, A, Nelson, D, Neugebauer, E, Newcombe, V, Noirhomme, Q, Nyiradi, J, Oddo, M, Oldenbeuving, A, Oresic, M, Ortolano, F, Palotie, A, Parizel, P, Patruno, A, Payen, J, Perera, N, Perlbarg, V, Persona, P, Peul, W, Pichon, N, Piilgaard, H, Piippo, A, Pili, F, Pirinen, M, Ples, H, Pomposo, I, Psota, M, Pullens, P, Puybasset, L, Ragauskas, A, Raj, R, Rambadagalla, M, Rehorcikova, V, Rhodes, J, Richardson, S, Ripatti, S, Rocka, S, Rodier, N, Roe, C, Roise, O, Roks, G, Romegoux, P, Rosand, J, Rosenfeld, J, Rosenlund, C, Rosenthal, G, Rossaint, R, Rossi, S, Rostalski, T, Rueckert, D, Ruiz De Arcaute, F, Rusnak, M, Sacchi, M, Sahakian, B, Sahuquillo, J, Sakowitz, O, Sala, F, Sanchez-Pena, P, Sanchez-Porras, R, Sandor, J, Santos, E, Sasse, N, Sasu, L, Savo, D, Schipper, I, Schlosser, B, Schmidt, S, Schneider, A, Schoechl, H, Schoonman, G, Schou, R, Schwendenwein, E, Scholl, M, Sir, O, Skandsen, T, Smakman, L, Smeets, D, Smielewski, P, Sorinola, A, Stamatakis, E, Stanworth, S, Stegemann, K, Steinbuchel, N, Stevens, R, Stewart, W, Stocchetti, N, Sundstrom, N, Synnot, A, Szabo, J, Soderberg, J, Taccone, F, Tamas, V, Tanskanen, P, Tascu, A, Taylor, M, Te Ao, B, Tenovuo, O, Teodorani, G, Theadom, A, Thomas, M, Tibboel, D, Tolias, C, Tshibanda, J, Tudora, C, Vajkoczy, P, Valeinis, E, Van Hecke, W, Van Praag, D, Van Roost, D, Van Vlierberghe, E, Vande Vyvere, T, Vanhaudenhuyse, A, Vargiolu, A, Vega, E, Verheyden, J, Vespa, P, Vik, A, Vilcinis, R, Vizzino, G, Vleggeert-Lankamp, C, Volovici, V, Vulekovic, P, Vamos, Z, Wade, D, Wang, K, Wang, L, Wildschut, E, Williams, G, Willumsen, L, Wilson, A, Wilson, L, Winkler, M, Ylen, P, Younsi, A, Zaaroor, M, Zhang, Z, Zheng, Z, Zumbo, F, De Lange, S, De Ruiter, G, Den Boogert, H, Van Dijck, J, Van Essen, T, Van Heugten, C, Van Der Jagt, M, Van Der Naalt, J, Cnossen, M. C., Polinder, S., Lingsma, H. F., Maas, A. I. R., Menon, D., Steyerberg, E. W., Adams, H., Alessandro, M., Allanson, J., Amrein, K., Andaluz, N., Andelic, N., Andrea, N., Andreassen, L., Anke, A., Antoni, A., Ardon, H., Audibert, G., Auslands, K., Azouvi, P., Baciu, C., Bacon, A., Badenes, R., Baglin, T., Bartels, R., Barzo, P., Bauerfeind, U., Beer, R., Belda, F. J., Bellander, B. -M., Belli, A., Bellier, R., Benali, H., Benard, T., Berardino, M., Beretta, L., Beynon, C., Bilotta, F., Binder, H., Biqiri, E., Blaabjerg, M., Borgen, L. S., Bouzat, P., Bragge, P., Brazinova, A., Brehar, F., Brorsson, C., Buki, A., Bullinger, M., Buckova, V., Calappi, E., Cameron, P., Carbayo, L. G., Carise, E., Carpenter, C., Castano-Leon, A. M., Causin, F., Chevallard, G., Chieregato, A., Citerio, G., Coburn, M. C., Coles, J., Cooper, J. D., Correia, M., Covic, A., Curry, N., Czeiter, E., Czosnyka, M., Dahyot-Fizelier, C., Damas, F., Damas, P., Dawes, H., De Keyser, V., Della Corte, F., Depreitere, B., Ding, S., Dippel, D., Dizdarevic, K., Duliere, G. -L., Dzeko, A., Eapen, G., Engemann, H., Ercole, A., Esser, P., Ezer, E., Fabricius, M., Feigin, V. L., Feng, J., Foks, K., Fossi, F., Francony, G., Frantzen, J., Freo, U., Frisvold, S., Furmanov, A., Gagliardo, P., Galanaud, D., Gao, G., Geleijns, K., Ghuysen, A., Giraud, B., Glocker, B., Gomez, P. A., Grossi, F., Gruen, R. L., Gupta, D., Haagsma, J. A., Hadzic, E., Haitsma, I., Hartings, J. A., Helbok, R., Helseth, E., Hertle, D., Hill, S., Hoedemaekers, A., Hoefer, S., Hutchinson, P. J., Haberg, A. K., Jacobs, B., Janciak, I., Janssens, K., Jiang, J., Jones, K., Kalala, J. -P., Kamnitsas, K., Karan, M., Karau, J., Katila, A., Kaukonen, M., Keeling, D., Kerforne, T., Ketharanathan, N., Kettunen, J., Kivisaari, R., Kolias, A. G., Kolumban, B., Kompanje, E., Kondziella, D., Koskinen, L. -O., Kovacs, N., Kalovits, F., Lagares, A., Lanyon, L., Laureys, S., Lauritzen, M., Lecky, F., Ledig, C., Lefering, R., Legrand, V., Lei, J., Levi, L., Lightfoot, R., Lingsma, H., Loeckx, D., Lozano, A., Luddington, R., Luijten-Arts, C., Macdonald, S., Macfayden, C., Maegele, M., Majdan, M., Major, S., Manara, A., Manhes, P., Manley, G., Martin, D., Martino, C., Maruenda, A., Marechal, H., Mastelova, D., Mattern, J., Mcmahon, C., Melegh, B., Menovsky, T., Morganti-Kossmann, C., Mulazzi, D., Mutschler, M., Muhlan, H., Negru, A., Nelson, D., Neugebauer, E., Newcombe, V., Noirhomme, Q., Nyiradi, J., Oddo, M., Oldenbeuving, A., Oresic, M., Ortolano, F., Palotie, A., Parizel, P. M., Patruno, A., Payen, J. -F., Perera, N., Perlbarg, V., Persona, P., Peul, W., Pichon, N., Piilgaard, H., Piippo, A., Pili, F. S., Pirinen, M., Ples, H., Pomposo, I., Psota, M., Pullens, P., Puybasset, L., Ragauskas, A., Raj, R., Rambadagalla, M., Rehorcikova, V., Rhodes, J., Richardson, S., Ripatti, S., Rocka, S., Rodier, N., Roe, C., Roise, O., Roks, G., Romegoux, P., Rosand, J., Rosenfeld, J., Rosenlund, C., Rosenthal, G., Rossaint, R., Rossi, S., Rostalski, T., Rueckert, D. L., Ruiz De Arcaute, F., Rusnak, M., Sacchi, M., Sahakian, B., Sahuquillo, J., Sakowitz, O., Sala, F., Sanchez-Pena, P., Sanchez-Porras, R., Sandor, J., Santos, E., Sasse, N., Sasu, L., Savo, D., Schipper, I., Schlosser, B., Schmidt, S., Schneider, A., Schoechl, H., Schoonman, G., Schou, R. F., Schwendenwein, E., Scholl, M., Sir, O., Skandsen, T., Smakman, L., Smeets, D., Smielewski, P., Sorinola, A., Stamatakis, E. L., Stanworth, S., Stegemann, K., Steinbuchel, N., Stevens, R., Stewart, W., Stocchetti, N., Sundstrom, N., Synnot, A., Szabo, J., Soderberg, J., Taccone, F. S., Tamas, V., Tanskanen, P., Tascu, A., Taylor, M. S., Te Ao, B., Tenovuo, O., Teodorani, G., Theadom, A., Thomas, M., Tibboel, D., Tolias, C., Tshibanda, J. -F. L., Tudora, C. M., Vajkoczy, P., Valeinis, E., Van Hecke, W., Van Praag, D., Van Roost, D., Van Vlierberghe, E., Vande Vyvere, T., Vanhaudenhuyse, A., Vargiolu, A., Vega, E., Verheyden, J., Vespa, P. M., Vik, A., Vilcinis, R., Vizzino, G., Vleggeert-Lankamp, C., Volovici, V., Vulekovic, P., Vamos, Z., Wade, D., Wang, K. K. W., Wang, L., Wildschut, E., Williams, G., Willumsen, L., Wilson, A., Wilson, L., Winkler, M. K. L., Ylen, P., Younsi, A., Zaaroor, M., Zhang, Z., Zheng, Z., Zumbo, F., De Lange, S., De Ruiter, G. C. W., Den Boogert, H., Van Dijck, J., Van Essen, T. A., Van Heugten, C., Van Der Jagt, M., Van Der Naalt, J., Commission of the European Communities, Molecular Neuroscience and Ageing Research (MOLAR), Menon, David [0000-0002-3228-9692], Apollo - University of Cambridge Repository, and Public Health

Subjects
Questionnaires, Comparative Effectiveness Research, Critical Care and Emergency Medicine, Medical Doctors, Neurologi, Health Care Providers, CENTER-TBI Investigators and Participants, lcsh:Medicine, Poison control, Occupational safety and health, Diagnostic Radiology, Geographical Locations, 0302 clinical medicine, Trauma Centers, Surveys and Questionnaires, Brain Injuries, Traumatic, Medicine and Health Sciences, Brain Damage, Longitudinal Studies, Prospective Studies, Israel, lcsh:Science, Tomography, Trauma Medicine, Multidisciplinary, Radiology and Imaging, traumatic brain injury, Trauma center, Hospitals, 3. Good health, Europe, Hospitalization, Professions, Intensive Care Units, Neurology, Research Design, Intracranial pressure monitoring, Medical emergency, Engineering sciences. Technology, Research Article, medicine.medical_specialty, Imaging Techniques, Traumatic brain injury, General Science & Technology, Concordance, Comparative effectiveness research, Neuroimaging, Research and Analysis Methods, 03 medical and health sciences, Diagnostic Medicine, Physicians, Injury prevention, MD Multidisciplinary, medicine, Humans, Treatment Guidelines, Survey Research, Health Care Policy, business.industry, lcsh:R, Biology and Life Sciences, 030208 emergency & critical care medicine, Length of Stay, medicine.disease, ta3124, Computed Axial Tomography, Health Care, Health Care Facilities, Family medicine, People and Places, lcsh:Q, Population Groupings, business, 030217 neurology & neurosurgery, Neuroscience
Abstract

© 2016 Cnossen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Introduction: The strength of evidence underpinning care and treatment recommendations in traumatic brain injury (TBI) is low. Comparative effectiveness research (CER) has been proposed as a framework to provide evidence for optimal care for TBI patients. The first step in CER is to map the existing variation. The aim of current study is to quantify variation in general structural and process characteristics among centers participating in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. Methods: We designed a set of 11 provider profiling questionnaires with 321 questions about various aspects of TBI care, chosen based on literature and expert opinion. After pilot testing, questionnaires were disseminated to 71 centers from 20 countries participating in the CENTER-TBI study. Reliability of questionnaires was estimated by calculating a concordance rate among 5% duplicate questions. Results: All 71 centers completed the questionnaires. Median concordance rate among duplicate questions was 0.85. The majority of centers were academic hospitals (n = 65, 92%), designated as a level I trauma center (n = 48, 68%) and situated in an urban location (n = 70, 99%). The availability of facilities for neuro-trauma care varied across centers; e.g. 40 (57%) had a dedicated neuro-intensive care unit (ICU), 36 (51%) had an in-hospital rehabilitation unit and the organization of the ICU was closed in 64% (n = 45) of the centers. In addition, we found wide variation in processes of care, such as the ICU admission policy and intracranial pressure monitoring policy among centers. Conclusion: Even among high-volume, specialized neurotrauma centers there is substantial variation in structures and processes of TBI care. This variation provides an opportunity to study effectiveness of specific aspects of TBI care and to identify best practices with CER approaches.

Published
2020

5. Fokus Beatmung, Sauerstofftherapie und Weaning

Author

Fiedler, Mascha O., Reuß, C. J., Bernhard, M., Beynon, C., Hecker, A., Jungk, C., Nusshag, C., Michalski, D., Brenner, T., Weigand, M. A., and Dietrich, M.

Subjects
Cohort Studies, Male, Treatment Outcome, Journal Club, COVID-19, Humans, Female, Middle Aged, Erratum, Respiration, Artificial, Aged, Netherlands, Retrospective Studies
Abstract

Little is known about the practice of ventilation management in patients with COVID-19. We aimed to describe the practice of ventilation management and to establish outcomes in invasively ventilated patients with COVID-19 in a single country during the first month of the outbreak.PRoVENT-COVID is a national, multicentre, retrospective observational study done at 18 intensive care units (ICUs) in the Netherlands. Consecutive patients aged at least 18 years were eligible for participation if they had received invasive ventilation for COVID-19 at a participating ICU during the first month of the national outbreak in the Netherlands. The primary outcome was a combination of ventilator variables and parameters over the first 4 calendar days of ventilation: tidal volume, positive end-expiratory pressure (PEEP), respiratory system compliance, and driving pressure. Secondary outcomes included the use of adjunctive treatments for refractory hypoxaemia and ICU complications. Patient-centred outcomes were ventilator-free days at day 28, duration of ventilation, duration of ICU and hospital stay, and mortality. PRoVENT-COVID is registered at ClinicalTrials.gov (NCT04346342).Between March 1 and April 1, 2020, 553 patients were included in the study. Median tidal volume was 6·3 mL/kg predicted bodyweight (IQR 5·7-7·1), PEEP was 14·0 cm HIn patients with COVID-19 who were invasively ventilated during the first month of the outbreak in the Netherlands, lung-protective ventilation with low tidal volume and low driving pressure was broadly applied and prone positioning was often used. The applied PEEP varied widely, despite an invariably low respiratory system compliance. The findings of this national study provide a basis for new hypotheses and sample size calculations for future trials of invasive ventilation for COVID-19. These data could also help in the interpretation of findings from other studies of ventilation practice and outcomes in invasively ventilated patients with COVID-19.Amsterdam University Medical Centers, location Academic Medical Center.

Published
2020

6. Fokus Neurologische Intensivmedizin

Author

Michalski, D., Jungk, C., Brenner, T., Dietrich, M., Nusshag, C., Reuß, C. J., Fiedler, M. O., Bernhard, M., Beynon, C., and Weigand, M. A.

Subjects
Journal Club
Published
2020

9. Value of intraoperative MRI in functional pituitary adenomas with active hormone secretion – observations from a consecutive retrospective single-centre cohort of 114 cases

Author

Scherer, M, Zerweck, P, Bendszus, M, Unterberg, AW, and Beynon, C

Subjects
ddc: 610, genetic structures, 610 Medical sciences, Medicine
Abstract

Objective: Functional pituitary adenomas (FPA) represent a special sub-entity among pituitary adenomas which come with characteristic challenges for imaging diagnostics, medical and surgical treatment. Transsphenoidal surgery (TSS) is an established treatment option for FPAs aiming at better hormone[for full text, please go to the a.m. URL], 71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie

Published
2020
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10. The impact of AB0 blood group on thromboembolic and haemorrhagic complications after resection of intracranial meningeomas

Author

Beynon, C, Rösner, V, Albrecht, L, Müller, U, Zweckberger, K, and Unterberg, AW

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Objective: Recent studies have suggested an impact of the AB0 blood group on thromboembolic and haemorrhagic events following trauma or surgical procedures. However, only limited data are available on the impact of the AB0 blood group in neurosurgical patients. The goal of the present study was to evaluate[for full text, please go to the a.m. URL], 71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie

Published
2020
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11. Automated pupillometry indicates decompression of the optic chiasm following transsphenoidal resection of pituitary tumours

Author

Beynon, C, Nofal, M, Jesser, J, Dao Trong, P, Zweckberger, K, Santos, E, and Unterberg, AW

Subjects
ddc: 610, genetic structures, sense organs, 610 Medical sciences, Medicine, eye diseases
Abstract

Objective: Pituitary tumours may lead to compression of the optic chiasm and visual impairment in patients. Therefore, decompression of the optic chiasm is a major goal of surgical treatment. Automated pupillometry has been used in various clinical settings for assessing the optic system. The aim of[for full text, please go to the a.m. URL], 71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie

Published
2020
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13. Brain death and postmortem organ donation: report of a questionnaire from the CENTER-TBI study

Author

Van Veen E., Van Der Jagt M., Cnossen M. C., Maas A. I. R., De Beaufort I. D., Menon D. K., Citerio G., Stocchetti N., Rietdijk W. J. R., Van Dijck J. T. J. M., Kompanje E. J. O., Ackerlund C., Adams H., Agnoletti V., Allanson J., Amrein K., Andaluz N., Andelic N., Andreassen L., Antun A., Anke A., Antoni A., Ardon H., Audibert G., Auslands K., Azouvi P., Azzolini M. L., Baciu C., Badenes R., Bartels R., Barzo P., Bauerfeind U., Beauvais R., Beer R., Francisco J. B., Bellander B. -M., Belli A., Bellier R., Benali H., Benard T., Berardino M., Beretta L., Beynon C., Bilotta F., Binder H., Biqiri E., Blaabjerg M., Den Boogert H., Bouzat P., Bragge P., Brazinova A., Brinck V., Brooker J., Brorsson C., Buki A., Bullinger M., Calappi E., Calvi M. R., Cameron P., Lozano G. C., Carbonara M., Carise E., Carpenter K., Castano-Leon A. M., Causin F., Chevallard G., Chieregato A., Coburn M., Coles J., Coles-Kemp L., Collett J., Cooper J. D., Correia M., Covic A., Curry N., Czeiter E., Czosnyka M., Dahyot-Fizelier C., Damas F., Damas P., Dawes H., De Keyser V., Della Corte F., Depreitere B., De Ruiter Godard C. W., Dilvesi D., Ding S., Dippel D., Dixit A., Donoghue E., Dreier J., Duliere G. -L., Eapen G., Engemann H., Ercole A., Esser P., Ezer E., Fabricius M., Feigin V. L., Feng J., Foks K., Fossi F., Francony G., Freo U., Frisvold S., Furmanov A., Gagliardo P., Galanaud D., Gantner D., Gao G., Geleijns K., George P., Ghuysen A., Giga L., Giraud B., Glocker B., Golubovic J., Gomez P. A., Grossi F., Gruen R. L., Gupta D., Haagsma J. A., Haitsma I., Hartings J. A., Helbok R., Helseth E., Hertle D., Hoedemaekers A., Hoefer S., Horton L., Huijben J., Hutchinson P. J., Haberg A. K., Jacobs B., Jankowski S., Jarrett M., Jelaca B., Jiang J. -Y., Jones K., Kamnitsas K., Karan M., Katila A., Kaukonen M., Kerforne T., Kivisaari R., Kolias A. G., Kolumban B., Kolundzija K., Kondziella D., Koskinen L. -O., Kovacs N., Lagares A., Lanyon L., Laureys S., Lecky F., Ledig C., Lefering R., Legrand V., Lei J., Levi L., Lightfoot R., Lingsma H., Loeckx D., Lozano A., MacDonald S., Maegele M., Majdan M., Major S., Manara A., Manley G., Didier M., Martin L. F., Martino C., Maruenda A., Marechal H., Masala A., Mattern J., McFadyen C., McMahon C., Melegh B., Menovsky T., Morganti-Kossmann C., Mulazzi D., Muraleedharan V., Murray L., Muhlan H., Nair N., Negru A., Nelson D., Newcombe V., Nieboer D., Noirhomme Q., Nyiradi J., Oddo M., Oldenbeuving A., Oresic M., Ortolano F., Palotie A., Parizel P. M., Patruno A., Payen J. -F., Perera N., Perlbarg V., Persona P., Peul W., Piippo-Karjalainen A., Floury S. P., Pirinen M., Ples H., Poca M. A., Polinder S., Pomposo I., Posti J., Puybasset L., Radoi A., Ragauskas A., Raj R., Rambadagalla M., Real R., Rehorcikova V., Rhodes J., Ripatti S., Rocka S., Roe C., Roise O., Roks G., Rosand J., Rosenfeld J., Rosenlund C., Rosenthal G., Rossaint R., Rossi S., Rueckert D., Rusnak M., Sacchi M., Sahakian B., Sahuquillo J., Sakowitz O., Sala F., Sanchez-Porras R., Sandor J., Santos E., Sasu L., Savo D., Schaffer N., Schipper I., Schlosser B., Schmidt S., Schoechl H., Schoonman G., Schou R. F., Schwendenwein E., Scholl M., Sir O., Skandsen T., Smakman L., Smeets D., Smielewski P., Sorinola A., Stamatakis E., Stanworth S., Steinbuchel N., Stevanovic A., Stevens R., Stewart W., Steyerberg E. W., Sundstrom N., Synnot A., Taccone F. S., Takala R., Tamas V., Tanskanen P., Taylor M. S., Te Ao B., Tenovuo O., Telgmann R., Teodorani G., Theadom A., Thomas M., Tibboel D., Tolias C., Tshibanda J. -F. L., Trapani T., Tudora C. M., Vajkoczy P., Vallance S., Valeinis E., Van Der Steen G., Van Der Naalt J., Van Essen T. A., Van Hecke W., Van Heugten C., Van Praag D., Vyvere T. V., Van Waesberghe J., Vanhaudenhuyse A., Vargiolu A., Vega E., Velt K., Verheyden J., Vespa P. M., Vik A., Vilcinis R., Vizzino G., Vleggeert-Lankamp C., Volovici V., Voormolen D., Vulekovic P., Vamos Z., Wade D., Wang K. K. W., Wang L., Wessels L., Wildschut E., Williams G., Wilson L., Winkler M. K. L., Wolf S., Ylen P., Younsi A., Zaaroor M., Zhihui Y., Ziverte A., Zumbo F., Intensive Care, Public Health, van Veen, Ernest, van der Jagt, Mathieu, Cnossen, Maryse C., Maas, Andrew I R, de Beaufort, Inez D., Menon, David K., Citerio, Giuseppe, Stocchetti, Nino, Rietdijk, Wim J R, van Dijck, Jeroen T J M, Kompanje, Erwin J O (CENTER-TBI investigators and participants), Beretta, Luigi, Apollo - University of Cambridge Repository, Ragauskas, Arminas, Rocka, Saulius, Vilcinis, Rimantas, „Springer' grupė, Neurokirurgian yksikkö, Clinicum, Van Veen E., Van Der Jagt M., Cnossen M.C., Maas A.I.R., De Beaufort I.D., Menon D.K., Citerio G., Stocchetti N., Rietdijk W.J.R., Van Dijck J.T.J.M., Kompanje E.J.O., Ackerlund C., Adams H., Agnoletti V., Allanson J., Amrein K., Andaluz N., Andelic N., Andreassen L., Antun A., Anke A., Antoni A., Ardon H., Audibert G., Auslands K., Azouvi P., Azzolini M.L., Baciu C., Badenes R., Bartels R., Barzo P., Bauerfeind U., Beauvais R., Beer R., Francisco J.B., Bellander B.-M., Belli A., Bellier R., Benali H., Benard T., Berardino M., Beretta L., Beynon C., Bilotta F., Binder H., Biqiri E., Blaabjerg M., Den Boogert H., Bouzat P., Bragge P., Brazinova A., Brinck V., Brooker J., Brorsson C., Buki A., Bullinger M., Calappi E., Calvi M.R., Cameron P., Lozano G.C., Carbonara M., Carise E., Carpenter K., Castano-Leon A.M., Causin F., Chevallard G., Chieregato A., Coburn M., Coles J., Coles-Kemp L., Collett J., Cooper J.D., Correia M., Covic A., Curry N., Czeiter E., Czosnyka M., Dahyot-Fizelier C., Damas F., Damas P., Dawes H., De Keyser V., Della Corte F., Depreitere B., De Ruiter Godard C.W., Dilvesi D., Ding S., Dippel D., Dixit A., Donoghue E., Dreier J., Duliere G.-L., Eapen G., Engemann H., Ercole A., Esser P., Ezer E., Fabricius M., Feigin V.L., Feng J., Foks K., Fossi F., Francony G., Freo U., Frisvold S., Furmanov A., Gagliardo P., Galanaud D., Gantner D., Gao G., Geleijns K., George P., Ghuysen A., Giga L., Giraud B., Glocker B., Golubovic J., Gomez P.A., Grossi F., Gruen R.L., Gupta D., Haagsma J.A., Haitsma I., Hartings J.A., Helbok R., Helseth E., Hertle D., Hoedemaekers A., Hoefer S., Horton L., Huijben J., Hutchinson P.J., Haberg A.K., Jacobs B., Jankowski S., Jarrett M., Jelaca B., Jiang J.-Y., Jones K., Kamnitsas K., Karan M., Katila A., Kaukonen M., Kerforne T., Kivisaari R., Kolias A.G., Kolumban B., Kolundzija K., Kondziella D., Koskinen L.-O., Kovacs N., Lagares A., Lanyon L., Laureys S., Lecky F., Ledig C., Lefering R., Legrand V., Lei J., Levi L., Lightfoot R., Lingsma H., Loeckx D., Lozano A., MacDonald S., Maegele M., Majdan M., Major S., Manara A., Manley G., Didier M., Martin L.F., Martino C., Maruenda A., Marechal H., Masala A., Mattern J., McFadyen C., McMahon C., Melegh B., Menovsky T., Morganti-Kossmann C., Mulazzi D., Muraleedharan V., Murray L., Muhlan H., Nair N., Negru A., Nelson D., Newcombe V., Nieboer D., Noirhomme Q., Nyiradi J., Oddo M., Oldenbeuving A., Oresic M., Ortolano F., Palotie A., Parizel P.M., Patruno A., Payen J.-F., Perera N., Perlbarg V., Persona P., Peul W., Piippo-Karjalainen A., Floury S.P., Pirinen M., Ples H., Poca M.A., Polinder S., Pomposo I., Posti J., Puybasset L., Radoi A., Ragauskas A., Raj R., Rambadagalla M., Real R., Rehorcikova V., Rhodes J., Ripatti S., Rocka S., Roe C., Roise O., Roks G., Rosand J., Rosenfeld J., Rosenlund C., Rosenthal G., Rossaint R., Rossi S., Rueckert D., Rusnak M., Sacchi M., Sahakian B., Sahuquillo J., Sakowitz O., Sala F., Sanchez-Porras R., Sandor J., Santos E., Sasu L., Savo D., Schaffer N., Schipper I., Schlosser B., Schmidt S., Schoechl H., Schoonman G., Schou R.F., Schwendenwein E., Scholl M., Sir O., Skandsen T., Smakman L., Smeets D., Smielewski P., Sorinola A., Stamatakis E., Stanworth S., Steinbuchel N., Stevanovic A., Stevens R., Stewart W., Steyerberg E.W., Sundstrom N., Synnot A., Taccone F.S., Takala R., Tamas V., Tanskanen P., Taylor M.S., Te Ao B., Tenovuo O., Telgmann R., Teodorani G., Theadom A., Thomas M., Tibboel D., Tolias C., Tshibanda J.-F.L., Trapani T., Tudora C.M., Vajkoczy P., Vallance S., Valeinis E., Van Der Steen G., Van Der Naalt J., Van Essen T.A., Van Hecke W., Van Heugten C., Van Praag D., Vyvere T.V., Van Waesberghe J., Vanhaudenhuyse A., Vargiolu A., Vega E., Velt K., Verheyden J., Vespa P.M., Vik A., Vilcinis R., Vizzino G., Vleggeert-Lankamp C., Volovici V., Voormolen D., Vulekovic P., Vamos Z., Wade D., Wang K.K.W., Wang L., Wessels L., Wildschut E., Williams G., Wilson L., Winkler M.K.L., Wolf S., Ylen P., Younsi A., Zaaroor M., Zhihui Y., Ziverte A., Zumbo F., Section Neuropsychology, RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, RS: FPN NPPP I, Psychiatrie & Neuropsychologie, Menon, David [0000-0002-3228-9692], Ročka, Saulius, Molecular Neuroscience and Ageing Research (MOLAR), CENTER-TBI Investigators, van Veen, E, van der Jagt, M, Cnossen, M, Maas, A, de Beaufort, I, Menon, D, Citerio, G, Stocchetti, N, Rietdijk, W, van Dijck, J, and Kompanje, E

Subjects
Neurology, Internationality, Traumatic/complications, brain death, ethics, postmortem organ donation, traumatic brain injury, ventricular drainage, withdrawing life-sustaining measures, GUIDELINES, Critical Care and Intensive Care Medicine, 0302 clinical medicine, Traumatic brain injury, Trauma Centers, WORLDWIDE, Surveys and Questionnaires, Brain Injuries, Traumatic, Response rate (survey), Brain death, VDP::Medical disciplines: 700::Clinical medical disciplines: 750, VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Tissue and Organ Procurement/legislation & jurisprudence, POLICIES, Europe, VARIABILITY, Neurosurgery, Clinical evaluation, medicine.medical_specialty, Tissue and Organ Procurement, Withdrawing life-sustaining measure, Other Research Radboud Institute for Molecular Life Sciences [Radboudumc 0], Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18], 03 medical and health sciences, Neurological assessment, medicine, Humans, Organ donation, Ethics, Postmortem organ donation, Ventricular drainage, Withdrawing life-sustaining measures, Ethic, business.industry, Research, Brain Injuries, Traumatic/complications, 3112 Neurosciences, 030208 emergency & critical care medicine, ADULTS, lcsh:RC86-88.9, Traumatic brain injury, Brain death, Ethics, Postmortem organ donation, Withdrawing life-sustaining measures, Ventricular drainage, medicine.disease, 3126 Surgery, anesthesiology, intensive care, radiology, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], Trauma Centers/organization & administration, Brain Injuries, Emergency medicine, Human medicine, business, 030217 neurology & neurosurgery, Regional differences
Abstract

Source at https://doi.org/10.1186/s13054-018-2241-4. Licensed CC BY-NC-ND 4.0. Background: We aimed to investigate the extent of the agreement on practices around brain death and postmortem organ donation. Methods: Investigators from 67 Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study centers completed several questionnaires (response rate: 99%). Results: Regarding practices around brain death, we found agreement on the clinical evaluation (prerequisites and neurological assessment) for brain death determination (BDD) in 100% of the centers. However, ancillary tests were required for BDD in 64% of the centers. BDD for nondonor patients was deemed mandatory in 18% of the centers before withdrawing life-sustaining measures (LSM). Also, practices around postmortem organ donation varied. Organ donation after circulatory arrest was forbidden in 45% of the centers. When withdrawal of LSM was contemplated, in 67% of centers the patients with a ventricular drain in situ had this removed, either sometimes or all of the time. Conclusions: This study showed both agreement and some regional differences regarding practices around brain death and postmortem organ donation. We hope our results help quantify and understand potential differences, and provide impetus for current dialogs toward further harmonization of practices around brain death and postmortem organ donation.

Published
2018

14. Point-of-care assessment of inflammation in patients undergoing surgical evacuation of chronic subdural haematoma

Author

Fedorko, S, Walter, J, Younsi, A, Zweckberger, K, Unterberg, A, and Beynon, C

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Objective: Chronic inflammatory processes have been linked with the development of chronic subdural hematomas (cSDH) in patients, e.g. after minor haemorrhage following mild traumatic brain injury. It has been shown previously that elevated blood levels of presepsin, a truncated N-terminal fragment [for full text, please go to the a.m. URL], 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Published
2019
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15. The most common neurosurgical disease in 2030 – clinical management of antithrombotic medication, reoperation risk and outcome of 623 patients with chronic subdural haematoma

Author

Younsi, A, Riemann, L, Habel, C, Beynon, C, Unterberg, AW, and Zweckberger, K

Subjects
ddc: 610, cardiovascular diseases, 610 Medical sciences, Medicine
Abstract

Objective: In our ageing Western society, the incidence of chronic subdural hematomas (cSDH) is raising while more and more affected patients are on antithrombotic drugs (anticoagulants or antiplatelets). In this study, we reviewed our clinical management of cSDH patients on antithrombotic drugs and[for full text, please go to the a.m. URL], 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Published
2019
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16. Variation in neurosurgical management of traumatic brain injury: a survey in 68 centers participating in the CENTER-TBI study (vol 161, pg 453, 2019)

Author

den Boogert H, Cnossen M, Lingsma H, Peul W, Ackerlund C, Adams H, Agnoletti V, Allanson J, Amrein K, Andaluz N, Andelic N, Andreassen L, Antun A, Anke A, Antoni A, Ardon H, Audibert G, Auslands K, Azouvi P, Azzolini M, Baciu C, Badenes R, Bartels R, Barzo P, Bauerfeind U, Beauvais R, Beer R, Belda F, Bellander B, Belli A, Bellier R, Benali H, Benard T, Berardino M, Beretta L, Beynon C, Bilotta F, Binder H, Biqiri E, Blaabjerg M, Bouzat P, Bragge P, Brazinova A, Brinck V, Brooker J, Brorsson C, Buki A, Bullinger M, Calappi E, Calvi M, Cameron P, Carbayo L, Carbonara M, Carise E, Carpenter K, Castano-Leon A, Causin F, Chevallard G, Chieregato A, Citerio G, Coburn M, Coles J, Coles-Kemp L, Collett J, Cooper J, Correia M, Covic A, Curry N, Czeiter E, Czosnyka M, Dahyot-Fizelier C, Damas F, Damas P, Dawes H, De Keyser V, Francesco D, Depreitere B, de Ruiter G, Dilvesi D, Ding S, Dippel D, Dixit A, Donoghue E, Dreier J, Duliere G, Eapen G, Engemann H, Ercole A, Esser P, Ezer E, Fabricius M, Feigin V, Feng J, Foks K, Fossi F, Francony G, Freo U, Frisvold S, Furmanov A, Gagliardo P, Galanaud D, Gantner D, Gao G, Geleijns K, George P, Ghuysen A, Giga L, Giraud B, Ben Glocker, Golubovic J, Gomez P, Grossi F, Gruen R, Gupta D, Haagsma J, Haitsma I, Hartings J, Helbok R, Helseth E, Hertle D, Hoedemaekers A, Hoefer S, Horton L, Huijben J, Hutchinson P, Haberg A, Jacobs B, Jankowski S, Jarrett M, Jelaca B, Jiang J, Jones K, Kamnitsas K, Karan M, Katila A, Kaukonen M, Kerforne T, Kivisaari R, Kolias A, Kolumban B, Kompanje E, Kolundzija K, Kondziella D, Koskinen L, Kovacs N, Lagares A, Lanyon L, Laureys S, Lecky F, Ledig C, Lefering R, Legrand V, Lei J, Levi L, Lightfoot R, Loeckx D, Lozano A, Maas A, MacDonald S, Maegele M, Majdan M, Major S, Manara A, Manley G, Martin D, Martin L, Martino C, Maruenda A, Marechal H, Masala A, Mattern J, McFadyen C, McMahon C, Melegh B, Menon D, Menovsky T, Morganti-Kossmann C, Mulazzi D, Muraleedharan V, Murray L, Muhlan H, Nair N, Negru A, Nelson D, Newcombe V, Nieboer D, Noirhomme Q, Nyiradi J, Oddo M, Oldenbeuving A, Oresic M, Ortolano F, Palotie A, Parizel P, Patruno A, Payen J, Perera N, Perlbarg V, Persona P, Piippo-Karjalainen A, Pili F, Pirinen M, Ples H, Poca M, Polinder S, Pomposo I, Posti J, Puybasset L, Radoi A, Ragauskas A, Raj R, Rambadagalla M, Real R, Rehorcikova V, Rhodes J, Ripatti S, Rocka S, Roe C, Roise O, Roks G, Rosand J, Rosenfeld J, Rosenlund C, Rosenthal G, Rossaint R, Rossi S, Rueckert D, Rusnak M, Sacchi M, Sahakian B, Sahuquillo J, Sakowitz O, Sala F, Sanchez-Porras R, Sandor J, Santos E, Sasu L, Savo D, Schaffer N, Schipper I, Schlosser B, Schmidt S, Schoechl H, Schoonman G, Schou R, Schwendenwein E, Scholl M, Sir O, Skandsen T, Smakman L, Smeets D, Smielewski P, Sorinola A, Stamatakis E, Stanworth S, Steinbuchel N, Stevanovic A, Stevens R, Stewart W, Steyerberg E, Stocchetti N, Sundstrom N, Synnot A, Taccone F, Takala R, Tamas V, Tanskanen P, Taylor M, Ao B, Tenovuo O, Telgmann R, Teodorani G, Theadom A, Thomas M, Tibboel D, Tolias C, Tshibanda J, Trapani T, Tudora C, Vajkoczy P, Vallance S, Valeinis E, Van der Steen G, van der Jagt M, van der Naalt J, van Dijck J, van Essen T, van Hecke W, van Heugten C, van Praag D, Vyvere T, Van Waesberghe J, Vanhaudenhuyse A, Vargiolu A, Vega E, Velt K, Verheyden J, Vespa P, Vik A, Vilcinis R, Vizzino G, Vleggeert-Lankamp C, Volovici V, Voormolen D, Vulekovic P, Vamos Z, Wade D, Wang K, Wang L, Wessels L, Wildschut E, Williams G, Wilson L, Winkler M, Wolf S, Ylen P, Younsi A, Zaaroor M, Yang Z, Ziverte A, Zumbo F, and CENTER-TBI Investigators

Published
2019

20. Variation in monitoring and treatment policies for intracranial hypertension in traumatic brain injury: A survey in 66 neurotrauma centers participating in the CENTER-TBI study

Author

Cnossen, M.C., Huijben, J.A., van der Jagt, M., Volovici, V., van Essen, T., Polinder, S., Nelson, D., Ercole, A., Stocchetti, N., Citerio, G., Peul, W.C., Maas, A.I.R., Menon, D., Steyerberg, E.W., Lingsma, H.F., Adams, H., Alessandro, M., Allanson, J., Amrein, K., Andaluz, N., Andelic, N., Andrea, N., Andreassen, L., Anke, A., Antoni, A., Ardon, H., Audibert, G., Auslands, K., Azouvi, P., Baciu, C., Bacon, A., Badenes, R., Baglin, T., Bartels, R., Barzó, P., Bauerfeind, U., Beer, R., Belda, F.J., Bellander, B.M., Belli, A., Bellier, R., Benali, H., Benard, T., Berardino, M., Beretta, L., Beynon, C., Bilotta, F., Binder, H., Biqiri, E., Blaabjerg, M., Lund, S.B., Bouzat, P., Bragge, P., Brazinova, A., Brehar, F., Brorsson, C., Buki, A., Bullinger, M., Bucková, V., Calappi, E., Cameron, P., Carbayo, L.G., Carise, E., Carpenter, K., Castaño-León, A.M., Causin, F., Chevallard, G., Chieregato, A., Cnossen, M., Coburn, M., Coles, J., Cooper, J.D., Correia, M., Covic, A., Curry, N., Czeiter, E., Czosnyka, M., Dahyot-Fizelier, C., Damas, F., Damas, P., Dawes, H., De Keyser, V., Corte, F.D., Depreitere, B., Ding, S., Dippel, D., Dizdarevic, K., Dulière, G.L., Dzeko, A., Eapen, G., Engemann, H., Esser, P., and on behalf of the CENTER-TBI investigators, .

Subjects
nervous system diseases
Abstract

Background: No definitive evidence exists on how intracranial hypertension should be treated in patients with traumatic brain injury (TBI). It is therefore likely that centers and practitioners individually balance potential benefits and risks of different intracranial pressure (ICP) management strategies, resulting in practice variation. The aim of this study was to examine variation in monitoring and treatment policies for intracranial hypertension in patients with TBI. Methods: A 29-item survey on ICP monitoring and treatment was developed on the basis of literature and expert opinion, and it was pilot-tested in 16 centers. The questionnaire was sent to 68 neurotrauma centers participating in the Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. Results: The survey was completed by 66 centers (97% response rate). Centers were mainly academic hospitals (n=60, 91%) and designated level I trauma centers (n=44, 67%). The Brain Trauma Foundation guidelines were used in 49 (74%) centers. Approximately 90% of the participants (n=58) indicated placing an ICP monitor in patients with severe TBI and computed tomographic abnormalities. There was no consensus on other indications or on peri-insertion precautions. We found wide variation in the use of first- and second-tier treatments for elevated ICP. Approximately half of the centers were classified as using a relatively aggressive approach to ICP monitoring and treatment (n=32, 48%), whereas the others were considered more conservative (n=34, 52%). Conclusions: Substantial variation was found regarding monitoring and treatment policies in patients with TBI and intracranial hypertension. The results of this survey indicate a lack of consensus between European neurotrauma centers and provide an opportunity and necessity for comparative effectiveness research.

Published
2017

21. Prothrombin complex concentrate for coumadin anticoagulation reversal in traumatic intracranial haemorrhage

Author

Beynon, C, Nofal, M, Laible, M, Rizos, T, Potzy, A, and Unterberg, A

Subjects
ddc: 610, macromolecular substances, 610 Medical sciences, Medicine
Abstract

Objective: Several guidelines recommend administration of prothrombin complex concentrate (PCC) for anticoagulation reversal in cases of severe bleeding. However, there is only limited data on its use for anticoagulation reversal in anticoagulated patients with traumatic intracranial haemorrhage (tICH).[for full text, please go to the a.m. URL], 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS)

Published
2017
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22. Reversing oral anticoagulation in non-traumatic intracerebral hemorrhage with prothrombin complex concentrate - a cohort study on the incidence of adverse events

Author

Rizos, T, Jenetzky, E, Beynon, C, Mueller, OJ, Sander, P, Schueler, S, Purrucker, J, Moehlenbruch, M, Steiner, T, Veltkamp, R, Ringleb, PA, Laible, M, and St Marys Development Trust

Subjects
Science & Technology, Neurology & Neurosurgery, Peripheral Vascular Disease, Clinical Neurology, Cardiovascular System & Cardiology, 1103 Clinical Sciences, Neurosciences & Neurology, 1109 Neurosciences, Life Sciences & Biomedicine
Published
2016

23. Point-of-care coagulometry reduces dosage of prothrombin complex concentrate for emergency anticoagulation reversal

Author

Beynon, C, Potzy, A, Sakowitz, OW, and Unterberg, AW

Subjects
warfarin, ddc: 610, phenprocoumon, 610 Medical sciences, Medicine, coagulopathy
Abstract

Objective: With the increased use of oral anticoagulation with vitamin K antagonists, neurosurgeons encounter a growing number of emergency patients requiring rapid reversal of anticoagulant effects. Administration of prothrombin complex concentrates (PCC) is recommended for anticoagulation reversal[for full text, please go to the a.m. URL], 66. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)

Published
2015
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25. DIA/DIG: Rare low-grade neoplasms with very different behaviour patterns

Author

Baechli, H, Beynon, C, von Deimling, A, Sahm, F, Pfister, SM, Witt, O, and Unterberg, A

Subjects
ddc: 610, genetic structures, tumour, 610 Medical sciences, Medicine, pediatric neurosurgery, ganglioglioma
Abstract

Objective: Desmoplastic infantile astrocytomas/gangliogliomas (DAI/DIG) are extremely rare glioneural tumours and are considered benign tumours (World Health Organization [WHO] grade one). In the majority of cases, they occur in infants younger than two years of age. Superficial [for full text, please go to the a.m. URL], 64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)

Published
2013
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26. Retrospective analysis of 21 patients operated with a novel endoscopic technique to evacuate acute intracerebral hemorrhages (ICH)

Author

Orakcioglu, B, Beynon, C, Uozumi, Y, and Unterberg, A

Subjects
body regions, Intrazerebrale Blutung, surgical procedures, operative, ddc: 610, endoscopy neuronavigation, Endoskopie Neuronavigation, cardiovascular diseases, Intracerebral hemorrhage, suction-irrigation technique, 610 Medical sciences, Medicine
Abstract

Objective: Surgical therapy of large and deep seated intracerebral hematomas remains controversial. The intraoperative trauma caused by surgery seems to outweigh the positive effects of hematoma removal. The use of neuronavigation is not common in ICH surgery. However, in theory it may contribute to[for full text, please go to the a.m. URL], 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS)

Published
2012
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27. Telemetric measurement of intracranial pressure (ICP): first experience of an experimental long-term in vivo study (365 days)

Author

Orakcioglu, B., Aschoff, A., Sakowitz, O., Beynon, C., Neumann, J., Eymann, R., Kiefer, M., and Unterberg, A.

Subjects
ddc: 610, hemic and lymphatic diseases, 610 Medical sciences, Medicine
Abstract

Objective: To test two new telemetric intracranial pressure (ICP) probes (NEUROVENT®-P-tel, NEUROVENT®-S-tel) within 365 days in a swine model. The goal was to correlate the new probes intraoperatively to parenchymal ICP-probes and study reliability, drift and infection rate (study ongoing[for full text, please go to the a.m. URL], 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien

Published
2009

28. Introduction of a new intracerebral PbrO2-probe in an experimental swine model

Author

Orakcioglu, B, Kiening, K, Sakwowitz, O, Beynon, C, Neumann, J, and Unterberg, A

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Objective: Neuromonitoring in neurocritically ill patients using continuous PbrO2-measurement has been widely accepted. However, only one reliable PbrO2-neuromonitoring system in clinical use has been sufficiently studied so far. New PbrO2-technologies are now available on the market. Our goal is to[for full text, please go to the a.m. URL], 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien

Published
2009
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30. Chapter 29: Effects of activity-rest schedules on physiological strain and spinal load in hospital-based porters.

Author

Beynon, C., Burke, J., Doran, D., and Nevill, A.

Abstract

Workers in physically demanding occupations require rest breaks to recover from physiological stress and biomechanical loading. Physiological stress can increase the risk of developing musculoskeletal disorders and repeated loading of the spine may increase the potential for incurring back pain. The aim of the study was to assess the impact of an altered activity-rest schedule on physiological and spinal loading in hospital-based porters. An existing 4-h activity-rest schedule was obtained from observations on eight male porters. This schedule formed the normal trial, which included two 5- and one 15-min breaks. An alternative 4-h schedule was proposed (experimental condition) that had two breaks each of 12.5 min. It was hypothesized that the experimental trial is more effective in promoting recovery from physiological strain and spinal shrinkage than the normal trial, due to the 5-min breaks being insufficient to allow physiological variables to return to resting levels or the intervertebral discs to reabsorb fluid. Ten males performed both test conditions and oxygen uptake &Vdot;O2, heart rate, minute ventilation &Vdot;E, perceived exertion and spinal shrinkage were recorded. There were no significant differences in any of the measured variables between the two trials (p> 0.05). Median heart rates were 78 (range 71-93) and 82 (71-90) beats.min-1 for the normal trial and the experimental trial respectively, indicating that the activity was of low intensity. The light intensity was corroborated by the oxygen uptakes (0.75, range 0.65-0.94 1.min-1). Spinal shrinkage occurred to the same extent in the two trials (2.12±3.16 mm and 2.88±2.92 mm in the normal trial and the experimental trial respectively). Varying the length and positioning of the rest breaks did not significantly affect the physiological responses or magnitude of spinal shrinkage between the two trials. More physically demanding work than the porters' schedule should induce greater physiological fatigue and spinal shrinkage. The ratio between activity and rest breaks would then become more important. [ABSTRACT FROM AUTHOR]

Published
2002

33. Impact evaluation of the Northern Fruit and Vegetable Pilot Programme - a cluster-randomised controlled trial.

Author

He M, Beynon C, Sangster Bouck M, St Onge R, Stewart S, Khoshaba L, Horbul BA, Chircoski B, He, Meizi, Beynon, Charlene, Sangster Bouck, Michelle, St Onge, Renée, Stewart, Susan, Khoshaba, Linda, Horbul, Betty A, and Chircoski, Bill

Abstract

Objective: The purpose of this impact evaluation was to measure the influence of a government of Ontario, Canada health promotion initiative, the Northern Fruit and Vegetable Pilot Programme (NFVPP), on elementary school-aged children's psychosocial variables regarding fruit and vegetables, and fruit and vegetable consumption patterns.Design: A cluster-randomised controlled trial design was used. The NFVPP consisted of three intervention arms: (i) Intervention I: Free Fruit and Vegetable Snack (FFVS) + Enhanced Nutrition Education; (ii) Intervention II: FFVS-alone; and (iii) Control group. Using the Pro-Children Questionnaire, the primary outcome measure was children's fruit and vegetable consumption, and the secondary outcome measures included differences in children's awareness, knowledge, self-efficacy, preference, intention and willingness to increase fruit and vegetable consumption.Setting/subjects: Twenty-six elementary schools in a defined area of Northern Ontario were eligible to participate in the impact evaluation. A final sample size of 1,277 students in grades five to eight was achieved.Results: Intervention I students consumed more fruit and vegetables at school than their Control counterparts by 0.49 serving/d (P < 0.05). Similarly, Intervention II students consumed more fruit and vegetables at school than Control students by 0.42 serving/d, although this difference was not statistically significant. Among students in both intervention groups, preferences for certain fruit and vegetables shifted from 'never tried it' towards 'like it'.Conclusions: The NFVPP resulted in positive changes in elementary school-aged children's fruit and vegetable consumption at school, and favourable preference changes for certain fruit and vegetables. [ABSTRACT FROM AUTHOR]

Published
2009
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34. An investigation of the subjective experiences of sex after alcohol or drug intoxication.

Author

Sumnall, H. R., Beynon, C. M., Conchie, S. M., Riley, S. C. E., and Cole, J. C.

Subjects
*SUBSTANCE abuse, *HUMAN sexuality, *ECSTASY (Drug), *CANNABIS (Genus), *DRUG overdose
Abstract

Despite long-standing concern over the sexual health of the population there has been little work undertaken in the UK investigating sexual risk taking and sexual behaviours in the context of: substance use. To investigate this further, 270 non-drug treatment seeking members of the public aged between 18 and 66 were administered a questionnaire containing the Alcohol Use Disorders Identification Test (AUDIT), the Drug Abuse Screening Test (DAST), the Severity of Dependence Scale (SDS), the Sexual Risks Scale and Attitudes toward condom use (SRSA), the Sexual Sensation Seeking Scale (SSSS); the Hospital Anxiety and Depression Scale (HADS), and questions pertaining to sexual episodes proximal to substance use. The population reported a varied history of substances and despite there not being serf-awareness of problematic drug use, 39.4% reported above the cut-off mark of six on the DAST. An even greater percentage (57.8%) reported a score above eight on the AUDIT indicating hazardous or harmful drinking behaviour. The substance most often associated with sexual episodes was alcohol, followed by cannabis and ecstasy, and all were most frequently consumed in private houses. Sexual activity after drug use was most frequently circumstantial (i.e. the individual hadn't taken the substance for the specific purposes of sex), and was significantly associated with use of cannabis and ecstasy. The second most frequently reported association between drug use and sex was facilitation of a sexual encounter (i.e. to lower sexual inhibitions, increase serf esteem and confidence), which was associated with use of alcohol, cannabis, cocaine and ecstasy. Although it was not possible to identify differences in subjective sexual changes after use of particular drugs, subjects reported that compared to sex after alcohol, sex on other drugs was more pleasurable and satisfying, with a greater perception of interpersonal contact with the partner and a greater willingness to sexually experiment. However, this tatter change was not associated with changes in the type of sexual activity engaged in. Regression analysis revealed that the greatest subjective changes in sexual experiences were reported by younger participants who had ingested either ecstasy or cannabis prior to the sexual episode. These results are discussed in the context of sexual risk taking and suggest areas of intervention focus which may address substance use and sexual risk taking together. [ABSTRACT FROM AUTHOR]

Published
2007
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35. Prevalence of overweight and obesity in school-aged children.

Author

He M and Beynon C

Abstract

PURPOSE: Childhood obesity is a public health concern in Canada. Few published anthropometric data are available to indicate obesity prevalence in Canadian children. Obesity prevalence is reported for school-aged children in 11 London, Ontario, schools. METHODS: Data on body weight and height were obtained using standardized procedures. United States Centers for Disease Control and Prevention (CDC) body mass index (BMI)-for-age references and Cole's international BMI reference were used to classify the children's weight categories. RESULTS: The study included 1,570 pupils aged six to 13. The CDC BMI references categorized 16.6% and 11.8% of children as overweight and obese, respectively. In comparison, when the Cole BMI reference and cut-off points were used, 17.5% and 7.6% of children were classified as overweight and obese, respectively. CONCLUSION: Overweight is prevalent in the study population. Public health interventions are warranted to curb the obesity epidemic in school-aged children. [ABSTRACT FROM AUTHOR]

Published
2006

36. New challenges for agency based syringe exchange schemes: analysis of 11 years of data (1991-2001) in Merseyside and Cheshire, United Kingdom.

Author

McVeigh J, Beynon C, and Bellis MA

Abstract

The Merseyside and Cheshire Drug Monitoring Unit has collected attributable data on agency based syringe exchange program (SEP) clients between 1991 and 2001, representing 14,491 individual injectors. On first presentation to a SEP, clients provide information relating to their drug use and drug service contact. Details relating to all subsequent syringe transactions are also recorded. Over 206,000 transactions took place, accounting for 6,595,099 syringes provided and an estimated 7,184,727 returns.There was a sixfold increase in the number of new clients using anabolic steroids (P<0.001) with these users currently constituting the largest group of new clients. The reverse is true for new heroin using clients who have significantly declined over the same period (P<0.05). Service utilisation by opiate and stimulant users has changed over time. Opiate users have attended SEP significantly less frequently (P<0.01) but obtain greater quantities of injecting equipment at each attendance (P<0.001). While the visit rate for stimulant users has fluctuated over time, this group of users are also collecting a significantly greater quantity of needles and syringes at each attendance (P<0.05). [ABSTRACT FROM AUTHOR]

Published
2003
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37. Effects of activity-rest schedules on physiological strain and spinal load in hospital-based porters.

Author

Beynon, C., Burke, J., Doran, D., and Nevill, A.

Subjects
HOSPITAL personnel, WORKING hours, HEALTH
Abstract

Workers in physically demanding occupations require rest breaks to recover from physiological stress and biomechanical loading. Physiological stress can increase the risk of developing musculoskeletal disorders and repeated loading of the spine may increase the potential for incurring back pain. The aim of the study was to assess the impact of an altered activity-rest schedule on physiological and spinal loading in hospital-based porters. An existing 4-h activity-rest schedule was obtained from observations on eight male porters. This schedule formed the normal trial, which included two 5- and one 15-min breaks. An alternative 4-h schedule was proposed (experimental condition) that had two breaks each of 12.5 min. It was hypothesized that the experimental trial is more effective in promoting recovery from physiological strain and spinal shrinkage than the normal trial, due to the 5-min breaks being insufficient to allow physiological variables to return to resting levels or the intervertebral discs to reabsorb fluid. Ten males performed both test conditions and oxygen uptake VO[sub 2], heart rate, minute ventilation VE, perceived exertion and spinal shrinkage were recorded. There were no significant differences in any of the measured variables between the two trials (p > 0.05). Median heart rates were 78 (range 71-93) and 82 (71-90) beats.min [sup - 1] for the normal trial and the experimental trial respectively, indicating that the activity was of low intensity. The light intensity was corroborated by the oxygen uptakes (0.75, range 0.65-0.94 l.min [sup - 1]). Spinal shrinkage occurred to the same extent in the two trials (2.12 ± 3.16 mm and 2.88 ± 2.92 mm in the normal trial and the experimental trial respectively). Varying the length and positioning of the rest breaks did not significantly affect the physiological responses or magnitude of spinal shrinkage between the two trials. More physically demanding work than the porters' schedule should induce greater physiological fatigue and spinal shrinkage. The ratio between activity and rest breaks would then become more important. [ABSTRACT FROM AUTHOR]

Published
2000
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40. Communications to the Fourth International Conference on Sport, Leisure and Ergonomics.

Author

Atkinson, G., Alp, D., Brunskill, A., Baeyens, J.-P., Van Roy, P., Clarys, J.-P., Barbaix, E., Bell, W., Cobner, D.M., Evans, W.D., Beynon, C., Burke, J., Nevill, A., Leighton, D., Reilly, T., Hollander, P., Bunc, V., and Stilec, M.

Subjects
SPORTS sciences, ERGONOMICS
Abstract

Presents research features at the Fourth International Conference on Sports, Leisure and Ergonomics in Cheshire, England. 'A Simple Assessment of Cardiovascular Fitness in Seniors,' by V. Bunc and M. Stilec.

Published
1999
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44. Stereotactic Brainstem Biopsy in a Patient with Coagulopathy of Unclear Etiology: Case Report.

Author

Beynon, C., Hoffmann, T., Wick, W., Unterberg, A. W., and Kiening, K. L.

Subjects
*BRAIN stem, *BIOPSY, *HEMORRHAGE, *DESMOPRESSIN
Abstract

Background: Parenchymal hemorrhage is one of the most feared risks of stereotactic brain biopsies potentially resulting in neurological deficits or even a fatal outcome. Patients with disorders of the coagulation system are at particular risk, so identifying these is one of the main tasks prior to surgery. Some patients may have a bleeding tendency despite normal laboratory values of the hemostatic system. Case Report: We report the case of a patient with coagulopathy of unclear etiology undergoing a stereotactic brainstem biopsy. Conclusion: A medication scheme with tranexamic acid and desmopressin effectively decreased the patient's bleeding time in vivo and the procedure was carried out without complications. [ABSTRACT FROM AUTHOR]

Published
2011
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45. An investigation of musculoskeletal disorders in healthcare professionals

Author

Beynon, C

Subjects
QP Physiology, R Medicine (General), QP, R1
Abstract

The aims of the work within this thesis were to i) establish the prevalence of musculoskeletal disorders among hospital based nurses and physiotherapists and to establish both perceived and possible causes for these disorders, ii) obtain clinical diagnoses and prognoses of nurses and physiotherapy staff attending an Occupational Health Department, iii) to establish which occupational tasks have the greatest potential to cause musculoskeletal disorders and iv) to investigate the effects of simulated nursing tasks and a modified porters' work-rest schedule on spinal shrinkage. In the epidemiological study the annual prevalence of all musculoskeletal disorders was estimated for nurses and physiotherapists in combination as 49%. The point prevalence was 20.7%. The anatomical area most affected was the lower back, buttocks, upper leg area. In total, musculoskeletal disorders accounted for 19% of all absences from work from all respondents within the previous year. Of those staff attending the Occupational Health Department, the main anatomical area affected by musculoskeletal disorders was, again, the back. Whilst a clinical diagnosis could be given to some patients, others were categorised as having 'low-back pain' indicating the often idiopathic nature of the symptoms. Time off work was often extensive and some staff members were retired from their profession as a direct result of their disorder. Patient handling was cited as the major perceived cause of the musculoskeletal disorders experienced. This variable was not significantly associated with the presence of musculoskeletal disorders in a logistic regression analysis. It is likely that all aspects of nursing and physiotherapy require some degree of manual handling and the category as a whole is too broad to enable an association with the presence or absence of a musculoskeletal disorder to be identified. Factors found to be associated with the presence of a musculoskeletal disorder or back pain were the specialty in which the individual worked, the age of the individual, whether physiotherapists' work regularly required the maintenance of stooped postures, the percentage time the individuals spent on their feet during a shift and the psychological variables of work pressure, happiness at work and job aspirations/motivations. The direction of causality for these variables was not established. An ergonomic risk assessment indicated that the tasks with the highest risk potential were manual handling tasks and those involving a static hold/standing of a patient. Manual handling had a high risk score, mainly because of the awkward, non-optimum postures staff were forced to adopt to perform the task. Tasks requiring static flexions scored highly because they were often performed alone and the flexion was maintained for some time. The task's score was also related to other external factors. The final set of studies considered the influence of nurses' and porters' tasks on spinal shrinkage. During a 4-hour simulation of nursing tasks, spinal shrinkage was significantly less with a 20-min seated break than with a 20-min standing break. Ensuring nurses take a 20-min seated break during each shift has the potential to reduce the prevalence of back-pain. A modified work-rest schedule for hospital porters did not have any effect on spinal shrinkage during a 4-hour simulation of occupational activities. The high prevalence of back pain among this group can not be reduced by adopting the modified work-rest schedule. A model detailing the causal factors for musculoskeletal disorders and low-back pain in nurses and physiotherapists has been proposed based on current findings within this thesis. This ergonomic model requires validation in future work.

47. Why physicians and nurses ask (or don’t) about partner violence: a qualitative analysis

Author

Beynon Charlene E, Gutmanis Iris A, Tutty Leslie M, Wathen C, and MacMillan Harriet L

Subjects
Intimate partner violence inquiry, Barriers and facilitators, Public aspects of medicine, RA1-1270
Abstract

Abstract Background Intimate partner violence (IPV) against women is a serious public health issue and is associated with significant adverse health outcomes. The current study was undertaken to: 1) explore physicians’ and nurses’ experiences, both professional and personal, when asking about IPV; 2) determine the variations by discipline; and 3) identify implications for practice, workplace policy and curriculum development. Methods Physicians and nurses working in Ontario, Canada were randomly selected from recognized discipline-specific professional directories to complete a 43-item mailed survey about IPV, which included two open-ended questions about barriers and facilitators to asking about IPV. Text from the open-ended questions was transcribed and analyzed using inductive content analysis. In addition, frequencies were calculated for commonly described categories and the Fisher’s Exact Test was performed to determine statistical significance when examining nurse/physician differences. Results Of the 931 respondents who completed the survey, 769 (527 nurses, 238 physicians, four whose discipline was not stated) provided written responses to the open-ended questions. Overall, the top barriers to asking about IPV were lack of time, behaviours attributed to women living with abuse, lack of training, language/cultural practices and partner presence. The most frequently reported facilitators were training, community resources and professional tools/protocols/policies. The need for additional training was a concern described by both groups, yet more so by nurses. There were statistically significant differences between nurses and physicians regarding both barriers and facilitators, most likely related to differences in role expectations and work environments. Conclusions This research provides new insights into the complexities of IPV inquiry and the inter-relationships among barriers and facilitators faced by physicians and nurses. The experiences of these nurses and physicians suggest that more supports (e.g., supportive work environments, training, mentors, consultations, community resources, etc.) are needed by practitioners. These findings reflect the results of previous research yet offer perspectives on why barriers persist. Multifaceted and intersectoral approaches that address individual, interpersonal, workplace and systemic issues faced by nurses and physicians when inquiring about IPV are required. Comprehensive frameworks are needed to further explore the many issues associated with IPV inquiry and the interplay across these issues.

Published
2012
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48. Gender differences in alcohol-related non-consensual sex; cross-sectional analysis of a student population

Author

Gunby Clare, Carline Anna, Bellis Mark A, and Beynon Caryl

Subjects
Alcohol, Sex, Sexual assault, Law, Gender, AUDIT, Violence, Public aspects of medicine, RA1-1270
Abstract

Abstract Background Sexual offences are a global public health concern. Recent changes in the law in England and Wales have dramatically altered the legal landscape of sexual offences, but sexual assaults where the victim is voluntarily intoxicated by alcohol continue to have low conviction rates. Worldwide, students are high consumers of alcohol. This research aimed to compare male and female students in relation to their knowledge and attitudes about alcohol and sexual activity and to identify factors associated with being the victim of alcohol-related non-consensual sex. Methods 1,110 students completed an online questionnaire. Drinking levels were measured using the Alcohol Use Disorder Identification Test. Non-consensual sexual experiences were measured using the Sexual Experience Survey. Univariate and multivariate analyses were undertaken using chi square and backwards stepwise logistic regression respectively. Results A third of respondents had experienced alcohol-related non-consensual sex. Male and female students differed in the importance they gave to cues in deciding if a person wished to have sex with them and their understanding of the law of consent. 82.2% of women who had experienced alcohol-related non-consensual sex were hazardous drinkers compared to 62.9% who drank at lower levels (P < 0.001). Differences existed between men and women, and between those who had and had not experienced alcohol-related non-consensual sex, in relation to assessments of culpability in scenarios depicting alcohol-related intercourse. A third of respondents believed that a significant proportion of rapes were false allegations; significantly more men than women responded in this way. Conclusions Alcohol-related coerced sexual activity is a significant occurrence among students; attitudinal and knowledge differences between males and females may explain this. Educational messages that focus upon what is deemed acceptable sexual behaviour, the law and rape myths are needed but are set against a backdrop where drunkenness is commonplace.

Published
2012
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49. Feasibility and acceptability of point of care HIV testing in community outreach and GUM drop-in services in the North West of England: A programmatic evaluation

Author

Jelliman Pauline, Harrison Ian, Spaine Vida, Coffey Emer, Jones Kathy, Chawla Anu, MacPherson Peter, Phillips-Howard Penelope, Beynon Caryl, and Taegtmeyer Miriam

Subjects
Public aspects of medicine, RA1-1270
Abstract

Abstract Background In Liverpool, injecting drug users (IDUs), men-who-have-sex-with-men (MSM) and UK Africans experience a disproportionate burden of HIV, yet services do not reach out to these groups and late presentations continue. We set out to: increase testing uptake in targeted marginalized groups through a community and genitourinary medicine (GUM)-based point of care testing (POCT) programme; and conduct a process evaluation to examine service provider inputs and document service user perceptions of the programme. Methods Mixed quantitative, qualitative and process evaluation methods were used. Service providers were trained to use fourth generation rapid antibody/antigen HIV tests. Existing outreach services incorporated POCT into routine practice. Clients completed a semi-structured questionnaire and focus group discussions (FGDs) were held with service providers. Results Between September 2009 and June 2010, 953 individuals underwent POCT (GUM: 556 [59%]; community-based sites: 397 [42%]). Participants in the community were more likely to be male (p = 0.028), older (p < 0.001), of UK African origin (p < 0.001) and IDUs (p < 0.001) than participants from the GUM clinic. Seventeen new HIV diagnoses were confirmed (prevalence = 1.8%), 16 of whom were in risk exposure categories (prevalence: 16/517, 3.1%). Questionnaires and FGDs showed that clients and service providers were supportive of POCT, highlighting benefits of reaching out to marginalised communities and incorporating HIV prevention messages. Conclusions Community and GUM clinic-based POCT for HIV was feasible and acceptable to clients and service providers in a low prevalence setting. It successfully reached target groups, many of whom would not have otherwise tested. We recommend POCT be considered among strategies to increase the uptake of HIV testing among groups who are currently underserved.

Published
2011
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50. The cost of emergency hospital admissions for falls on snow and ice in England during winter 2009/10: a cross sectional analysis

Author

Bellis Mark A, Murphy Karen, Mason Jenny, Robinson Mark, Jarman Ian, Wyke Sacha, Beynon Caryl, and Perkins Clare

Subjects
Industrial medicine. Industrial hygiene, RC963-969, Public aspects of medicine, RA1-1270
Abstract

Abstract Background In the UK, the 2009/10 winter was characterised by sustained low temperatures; grit stocks became depleted and surfaces left untreated. We describe the relationship between temperature and emergency hospital admissions for falls on snow and ice in England, identify the age and gender of those most likely to be admitted, and estimate the inpatient costs of these admissions during the 2009/10 winter. Methods Hospital Episode Statistics were used to identify episodes of emergency admissions for falls on snow and ice during winters 2005/06 to 2009/10; these were plotted against mean winter temperature. By region, the logs of the rates of weekly emergency admissions for falls on snow and ice were plotted against the mean weekly temperature for winters 2005/06 to 2009/10 and a linear regression analysis undertaken. For the 2009/10 winter the number of emergency hospital admissions for falls on snow and ice were plotted by age and gender. The inpatient costs of admissions in the 2009/10 winter for falls on snow and ice were calculated using Healthcare Resource Group costs and Admitted Patient Care 2009/10 National Tariff Information. Results The number of emergency hospital admissions due to falls on snow and ice varied considerably across years; the number was 18 times greater in 2009/10 (N = 16,064) than in 2007/08 (N = 890). There is an exponential increase [Ln(rate of admissions) = 0.456 - 0.463*(mean weekly temperature)] in the rate of emergency hospital admissions for falls on snow and ice as temperature falls. The rate of admissions in 2009/10 was highest among the elderly and particularly men aged 80 and over. The total inpatient cost of falls on snow and ice in the 2009/10 winter was 42 million GBP. Conclusions Emergency hospital admissions for falls on snow and ice vary greatly across winters, and according to temperature, age and gender. The cost of these admissions in England in 2009/10 was considerable. With responsibility for health improvement moving to local councils, they will have to balance the cost of public health measures like gritting with the healthcare costs associated with falls. The economic burden of falls on snow and ice is substantial; keeping surfaces clear of snow and ice is a public health priority.

Published
2011
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