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Childbirths and the Prevalence of Potential Risk Factors for Adverse Perinatal Outcomes among Asylum Seekers in The Netherlands: A Five-Year Cross-Sectional Study.

This five-year cross-sectional study mapped the prevalence of several known risk factors for adverse perinatal outcomes in asylum-seeking women in The Netherlands. Characteristics of 2831 registered childbirths among residents of asylum seekers centers (ASCs) in The Netherlands from 2016 to 2020 were included. Results showed a high general and teenage birthrate (2.15 and 6.77 times higher compared to the Dutch, respectively). Most mothers were pregnant upon arrival, and the number of births was highest in the second month of stay in ASCs. Another peak in births between 9 and 12 months after arrival suggested that many women became pregnant shortly after arrival in The Netherlands. Furthermore, 69.5 percent of all asylum-seeking women were relocated between ASCs at least once during pregnancy, which compromises continuity of care. The high prevalence of these risk factors in our study population might explain the increased rate of adverse pregnancy outcomes in asylum seekers compared to native women found in earlier studies. Incorporating migration-related indicators in perinatal health registration is key to support future interventions, policies, and research. Ultimately, our findings call for tailored and timely reproductive and perinatal healthcare for refugee women who simultaneously face the challenges of resettlement and pregnancy.

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Patients With Higher Treatment Outcome Expectations Are More Satisfied With the Results of Nonoperative Treatment for Thumb Base Osteoarthritis: A Cohort Study

ObjectiveTo investigate how satisfaction with treatment outcome is associated with patient mindset and Michigan Hand Outcome Questionnaire (MHQ) scores at baseline and 3 months in patients receiving nonoperative treatment for first carpometacarpal joint (CMC-1) osteoarthritis (OA). DesignCohort study SettingA total of 20 outpatient locations of a clinic for hand surgery and hand therapy in the Netherlands. ParticipantsPatients (N=308) receiving nonoperative treatment for CMC-1 OA, including exercise therapy, an orthosis, or both, between September 2017 and February 2019. InterventionsNonoperative treatment (ie, exercise therapy, an orthosis, or both) Main Outcome MeasuresSatisfaction with treatment outcomes was measured after 3 months of treatment. We measured total MHQ score at baseline and at 3 months. As baseline mindset factors, patients completed questionnaires on treatment outcome expectations, illness perceptions, pain catastrophizing, and psychological distress. We used multivariable logistic regression analysis and mediation analysis to identify factors associated with satisfaction with treatment outcomes. ResultsMore positive pretreatment outcome expectations were associated with a higher probability of being satisfied with treatment outcomes at 3 months (odds ratio, 1.15; 95% confidence interval, 1.07-1.25). Only a relatively small part (33%) of this association was because of a higher total MHQ score at 3 months. None of the other mindset and hand function variables at baseline were associated with satisfaction with treatment outcomes. ConclusionsThis study demonstrates that patients with higher pretreatment outcome expectations are more likely to be satisfied with treatment outcomes after 3 months of nonoperative treatment for CMC-1 OA. This association could only partially be explained by a better functional outcome at 3 months for patients who were satisfied. Health care providers treating patients nonoperatively for CMC-1 OA should be aware of the importance of expectations and may take this into account in pretreatment counseling.

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Urban Vitality Open Science Support Desk: Report on the pilot phase (1 September 2019 - 3 June 2020)

Deze rapportage omvat de evaluatie van de pilot Open Science Support Desk (OSSD). Het bemensen van de OSSD is een van de activiteiten die erop gericht zijn om de kwaliteit van het onderzoek dat uitgevoerd wordt in de faculteiten Gezondheid (FG), Bewegen, Sport en Voeding (FBSV) en Digitale Media en Creatieve Industrie (FDMCI) te ondersteunen in het kader van de SIA SPRONG subsidie Mensen in Beweging die in 2018 werd toegekend. Bij de OSSD kunnen Urban Vitality onderzoekers terecht voor individueel advies over kwantitatief en kwalitatief onderzoek, open science en over datamanagement. Deze evaluatie bestrijkt de pilotperiode tussen september 2019 en juni 2020. De evaluatie richt zich op: 1. De mening van de gebruikers over de dienstverlening van OSSD; 2. De motivatie van niet-gebruikers om geen gebruik te maken van OSSD; 3. Het inventariseren van wensen van (potentiele) gebruikers voor OSSD diensten; 4. Het geven van aanbevelingen voor de organisatie en toekomst van de OSSD diensten. Gegevensverzameling Gegevens zijn verzameld m.b.v. twee verschillende vragenlijsten: Een vragenlijst voor gebruikers van OSSD en een vragenlijst voor niet-gebruikers die wel tot de doelgroep horen. Daarnaast zijn gegevens gebruikt die in een excel databestand zijn bijgehouden over de dienstverlening, zoals aan wie waarover advies is gegeven en hoeveel tijd daaraan is besteed. Resultaten OSSD-gebruikers waren zeer tevreden over onze diensten en hoe deze werden geleverd. Iets minder hoog scoort de duidelijkheid van waarmee men bij de OSSD kan aankloppen. De onderzoekers die geen gebruik hadden gemaakt van de diensten van de OSSD wisten niet dat hij bestond, waarvoor ze bij de desk terecht kunnen, of hadden geen vragen. Een kanttekening is hierbij dat slechts een kwart van de niet-gebruikers de vragenlijst hebben ingevuld. Een meerderheid van de gebruikers en niet-gebruikers lijkt geinteresseerd in deelname aan journal clubs, hulp bij literatuur zoeken en inloopspreekuren. Verder zijn onder OSSD-gebruikers de belangrijkste onderwerpen voor nieuwe dienstverlening journal clubs over statistiek, datavisualisatie, kwalitatieve analyse, kwalitatieve onderzoeksmethoden, kwantitatieve methoden en open science-tools. De belangrijkste taken voor de OSSD zijn volgens zowel gebruikers als niet-gebruikers advies, co-auteurschap en (data-) analytische ondersteuning. Conclusie De OSSD is geraadpleegd door ongeveer de helft van de potentiele gebruikers. De onderzoekers die advies hebben gekregen zijn (zeer) tevreden over de inhoud van de adviezen en over andere aspecten van de dienstverlening, zoals snelheid van reageren op vragen en de sfeer waarin de consultaties werden uitgevoerd. Daarnaast bestaat er een relatief grote groep die geen gebruik heeft gemaakt van de OSSD. De belangrijkste reden voor het niet gebruiken van de desk lijkt onbekendheid. Dit heeft mogelijk te maken met de huidige onduidelijke positie en inbedding van de OSSD. Aanbevelingen 1. Formaliseer de OSSD binnen het Urban Vitality Center of Expertise (UV) of op faculteitsniveau 2. Stroomlijn de rol van de OSSD in de procedures voorafgaand aan en na toekenning van subsidie en stem deze af met IXA 3. Neem de 14 Open Science principes op in het UV-beleid 4. Zorg er (middels beleid) voor dat de OSSD in een vroeg stadium bij nieuwe onderzoeksvoorstellen betrokken wordt 5. Vervul tijdig de vacature die ontstaat voor een kwalitatief methodoloog 6. Formaliseer de posities van privacy officer en informatiespecialist binnen OSSD 7. Maak glashelder welke lectoraten de OSSD bedient 8. Maak bij een promotieproject duidelijk welke verantwoordelijkheden liggen bij de verschillende instellingen die bij de promotie betrokken zijn 9. Maak een toegankelijk content management systeem om inzicht te hebben in en te kunnen leren van lopend onderzoek 10. Bespreek dit rapport en de aanbevelingen in de stuurgroepen van MiB en van UV en in het management van FG, FBSV en FDMCI.

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La version franco-canadienne du « STrengthening the Reporting of OBservational studies in Epidemiology » (STROBE) Statement : L’outil STROBE

Purpose: The main purpose is to produce a French-Canadian translation of the "STrengthening the Reporting of OBservational studies in Epidemiology" (STROBE) Statement under the proposed name of "outil STROBE" and to assess the cross-cultural validity of its content. The secondary purpose is to examine its preliminary interrater reliability. Method: A modified approach to Vallerand's cross-cultural validation methodology was used. First, professional translators and clinical practitioners produced a parallel reverse translation of the "STROBE Statement." Then, a committee of experts (P1) examined the translated versions and created a first experimental draft of the "outil STROBE." This draft was assessed and modified by a second committee of experts (P2). Finally, 32 future professionals doing their master's degree in physiotherapy and occupational therapy assessed this second experimental version of the tool using an ambiguity scale of 8 points (0 meaning "not at all ambiguous" and 7 meaning "extremely ambiguous"). The main co-researchers examined the problematic elements and proposed final modifications. Ten observational studies published in French after 1980 were assessed by two independent raters using the French-Canadian version of the "outil STROBE." The kappa coefficient was used to examine interrater reliability. Results: For the different elements of the final version of the "outil STROBE," the averages on the ambiguity scale varied from 0.0 to 2.4. No element received an average below 2.4, which showed a high level of clarity. The interrater reliability (n = 2) for the "outil STROBE" is thought to be good for 74% of individual elements, according to the kappa coefficient values obtained. Conclusions: The process's five rigorous steps enabled the production of a valid French-Canadian version of the "STROBE Statement."

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Percutaneous Aponeurotomy and Lipofilling versus Limited Fasciectomy for Dupuytren’s Contracture: 5-Year Results from a Randomized Clinical Trial

In the Dupuytren Rotterdam randomized controlled trial, percutaneous aponeurotomy with lipofilling (PALF) was as effective as limited fasciectomy in correcting primary Dupuytren's contracture after 1 year. The authors report the 5-year results of this trial, with a special focus on recurrence of contractures. The authors invited all patients who had undergone PALF or limited fasciectomy to participate in a posttrial follow-up assessment. Thirty-one PALF patients and 21 limited fasciectomy patients were assessed by an independent examiner for the degree of contracture and whether patients had undergone a secondary procedure. The primary composite endpoint was recurrence rate, defined as either 20 degrees or greater worsening in contracture (relative to week 3) or as having undergone a secondary procedure for a new or worsening contracture. At 5 years, more joints in the PALF group than in the limited fasciectomy group had a recurrence (74 percent versus 39 percent; p = 0.002). When redefining recurrence as a worsening in total extension deficit of at least 30 degrees for treated digits as often reported, this was 77 percent versus 32 percent (p = 0.001). Total extension deficit was also worse for PALF-reated digits (53 degrees versus 31 degrees; p < 0.010). Although the authors previously reported that PALF offers a shorter convalescence and fewer long-term complications but a similar degree of contracture correction at 1-year follow-up, at 5 years, the corrections were less durable than those for limited fasciectomy. This again highlights that limited fasciectomy and different types of needle aponeurotomy have specific advantages and disadvantages to weigh by patients and clinicians. Therapeutic, II.

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Cross cultural adaptation and refinement of an English version of a Dutch patient-reported questionnaire for hand sensitivity: The Radboud Evaluation of Sensitivity

Study DesignLongitudinal clinical measurement. IntroductionSensory alterations in the hand can present as both decreased sensation or numbness, and hyperesthesia, including mechanical allodynia and cold intolerance. However, few patient-reported outcomes have been developed and validated for evaluation, particularly for increased sensitivity. The Radboud Evaluation of Sensitivity was developed in the Netherlands for patient-reported evaluation of hand sensitivity in complex regional pain syndrome. Purpose of the StudyThe purpose of this study was to translate into English and culturally validate the Radboud Evaluation of Sensitivity for the North American context. MethodsForward and backward translation, followed by a psychometric evaluation of the synthesized version of the translated tool, was undertaken in a heterogeneous group of persons after hand injury, including nerve injuries, hand trauma, and complex regional pain syndrome. ResultsThirty-six persons completed test-retest reliability testing, yielding an intraclass correlation coefficient of 0.92 (95% CI 0.85 to 0.96) for single measures. Internal consistency was also high at α = 0.96 in a larger sample (n = 56). Although some support for construct validity was generated, several validity hypotheses were not confirmed. Of interest, there appeared to be significant differences in the scores between persons with hypoesthesia as compared with those with hyperesthesia. ConclusionsThe Radboud Evaluation of Sensitivity, English version appears to be a reliable tool for the self-reported evaluation of sensory alterations in the hand, including both hypoesthesia and hyperesthesia. More research is needed to add to the extent of and confidence in the validity and responsiveness of this assessment. Level of EvidenceLevel II.

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Postoperative Rehabilitation Following Thumb Base Surgery: A Systematic Review of the Literature

ObjectiveTo provide an overview of rehabilitation for patients who underwent first carpometacarpal joint (CMC-1) arthroplasty, with emphasis on early active mobilization. Data SourcesPubMed/MEDLINE, Embase, CINAHL, and Cochrane were searched. Study SelectionArticles written in English that described the postoperative regimen (including immobilization period/method and/or description of exercises/physical therapy, follow-up 6wk) on CMC-1 arthroplasty were included. Data ExtractionThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement was used as guidance in this review, and methodological quality was assessed using the Effective Public Health Practice Project quality assessment tool. Randomized studies were additionally scored using the Physiotherapy Evidence Database scale. Data SynthesisTwenty-seven studies were included consisting of 1015 participants, in whom 1118 surgical procedures were performed. A summary of the components of postoperative rehabilitation used in the included studies of CMC-1 osteoarthritis is presented for different surgical interventions. We found that early active recovery (including short immobilization, early initiation of range of motion and strength exercises) provides positive outcomes for pain, limitations in activities of daily living, and grip and pinch strength, but comparative studies are lacking. Furthermore, 3 postoperative exercises/therapy phases were identified in the literature—the acute phase, the unloaded phase, and the functional phase—but again comparative studies are lacking. ConclusionsEarly active recovery is used more often in the literature and does not lead to worse outcomes or more complications. This systematic review provides guidance for clinicians in the content of postoperative rehabilitation for CMC-1 arthroplasty. The review also clearly identifies the almost complete lack of high-quality comparative studies on postoperative rehabilitation after CMC-1 arthroplasty.

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