Aim A Snapshot study design eliminates changes in treatment and outcome over time. This population based Snapshot study aimed to determine current practice and outcome of rectal cancer treatment... Show moreAim A Snapshot study design eliminates changes in treatment and outcome over time. This population based Snapshot study aimed to determine current practice and outcome of rectal cancer treatment with published landmark randomized controlled trials as a benchmark.Method In this collaborative research project, the dataset of the Dutch Surgical Colorectal Audit was extended with additional treatment and long-term outcome data. All registered patients who underwent resection for rectal cancer in 2011 were eligible. Baseline characteristics and outcome were evaluated against the results of the Dutch TME trial and the COLOR II trial from which the original datasets were obtained.Results A total of 71 hospitals participated, and data were completed for 2102 out of the potential 2633 patients (79.8%). Median follow-up was 41 (interquartile range 25-47) months. Overall circumferential resection margin (CRM) involvement was 9.3% in the Snapshot cohort and 18.5% in the Dutch TME trial. CRM positivity after laparoscopic resection was 7.8% in the Snapshot and 9.5% in the COLOR II trial. Three-year overall local recurrence rate in the Snapshot was 5.9%, with a disease-free survival of 67.1% and overall survival of 79.5%. Benchmarking with the randomized controlled trials revealed an overall favourable long-term outcome of the Snapshot cohort.Conclusion This study showed that current rectal cancer care in a large unselected Dutch population is of high quality, with less positive CRM since the TME trial and oncologically safe implementation of minimally invasive surgery after the COLOR II trial. Show less
Berg, C. van den; Beijersbergen, K.; Nieuwbeerta, P.; Dirkzwager, A. 2017
Empirical literature has revealed that social isolation can affect the rehabilitation of sex offenders after serving their sentence. This process of social isolation can already start during... Show moreEmpirical literature has revealed that social isolation can affect the rehabilitation of sex offenders after serving their sentence. This process of social isolation can already start during incarceration due to strained relationships with fellow prisoners and correctional staff. The current study examined to what extent sex offenders felt socially isolated during incarceration, using survey and registered conviction data on a large sample of male adult prisoners from the Prison Project. It was found that support from and relationships with correctional officers and fellow prisoners were perceived less positive by sex offenders than nonsex offenders. No evidence was found for higher levels of loneliness in sex offenders compared with prisoners convicted for a nonsexual offense. In sum, although the effects were small, sex offenders reported more social isolation during imprisonment compared with nonsex offenders. Show less
