Objective: To investigate patient preferences and the determinants of participation willingness in or-thopaedic diagnostic or invasive surgical randomized controlled trials.Methods: This... Show moreObjective: To investigate patient preferences and the determinants of participation willingness in or-thopaedic diagnostic or invasive surgical randomized controlled trials.Methods: This observational study included one hundred patients visiting an orthopaedic clinic. The pa-tients answered if they were willing to participate in a hypothetical invasive and diagnostic trial among patients with a distal radius fracture.Results: We found no difference in participation willingness in either the invasive surgical (66/100) or the diagnostic trial (68/100, p = 0.76). Willingness to participate was not associated with age, gender, country of origin, level of education, marital status, or distance of home from the hospital with the confidence interval for all odds ratios including the value 1. Patients who expressed willingness to participate do so because they wanted to contribute to science; patients who declined to participate wanted to speak with a doctor and to be better informed.Conclusion: This study showed a high rate of willingness to participate in orthopaedic surgical invasive trials and in diagnostic trials. Nevertheless, to ensure participation, it is recommended to put emphasis on the contribution to science and to give adequate information about the trial including the opportunity to talk to a doctor.(c) 2022 Elsevier Ltd. All rights reserved. Show less
Background Many breast, colorectal, and cervical cancer screening programs were disrupted due to the COVID-19 pandemic. This study aimed to estimate the short-term impact of the temporary shutdown ... Show moreBackground Many breast, colorectal, and cervical cancer screening programs were disrupted due to the COVID-19 pandemic. This study aimed to estimate the short-term impact of the temporary shutdown (from March until May- June) of the cancer screening programs invitations in Flanders (Belgium) by looking at invitation coverage, percentage of people screened after invitation and the screening interval. Methods Yearly invitation coverage was calculated as the number of people who received an invitation, as a proportion of the people who should have received an invitation that year. Weekly response to the invitation was calculated as the number of people who were screened within 40 days of their date of invitation, as a percentage of the people who received an invitation that week (as a proxy for willingness to screen). Weekly screening interval was calculated as the mean number of months between the current screening and the previous screening of all the people who screened that week. The two last indicators were calculated for each week in 2019 and 2020, after which the difference between that week's value in 2020 and 2019 with 95% confidence intervals. Results of these two indicators were also analysed after stratification for gender, age and participation history. Results Invitation coverage was not impacted in the colorectal and cervical cancer screening program. In the breast cancer screening program invitation coverage went down from 97.5% (2019) to 88.7% (2020), and the backlog of invitations was largely resolved in the first six months of 2021. The willingness to screen was minimally influenced by COVID-19. The breast cancer screening program had a temporary increase in screening interval in the first months following the restart after COVID-19 related shutdown, when it was on average 2.1 months longer than in 2019. Conclusions Willingness to screen was minimally influenced by COVID-19, but there may be an influence on screening coverage because of lower invitation coverage, mainly for the for breast Cancer Screening Program. The increases in screening intervals for the three Cancer Screening Program seem reasonable and would probably not significantly increase the risk of delayed screening cancer diagnoses. When restarting a Cancer Screening Program after a COVID-19 related shutdown, monitoring is crucial. Show less
Many cities in the United States are pursuing agendas to implement ICT-based solutions to tackle urban challenges, thus achieving the ‘smart city’ label. While the discussion on this urban... Show moreMany cities in the United States are pursuing agendas to implement ICT-based solutions to tackle urban challenges, thus achieving the ‘smart city’ label. While the discussion on this urban development paradigm has revolved around the intensive use of technologies, the academic literature increasingly calls for shifting the focus to the people living in the cities. This paper argues that to achieve a people-centred smart city, cities should include the perspectives of all the local stakeholders. Under this assumption, this paper provides the views of the local stakeholders in a medium-sized city in Tennessee, Chattanooga. Particularly, this study explores their perceived smart city concept, the ethical standards that should guide smart city projects, the desired future projects in their community, and the barriers to implementing them. The data was collected using a combination of participatory budgeting, five focus groups, and twenty-eight interviews with city dwellers, entrepreneurs, university faculty, non-profit members, and government officials. The results suggest that, far from the image of a highly technological city, the stakeholders envision a city dedicated to improving the quality of life and environmental sustainability. Furthermore, to achieve this smart city, the projects need to be based on full transparency and the promotion of social inclusion. In contrast to the dominant trend towards the privatization of urban space, this study finds that the stakeholders prefer public based smart city projects such as ICT-based public transport services. However, its successful implementation will have to overcome the barriers caused by funding constraints, public acceptance, and political interests. Cities may use the results of this study to design more responsible smart city projects that strike an optimal point between citizen engagement and technological applications and innovations while supporting all stakeholders’ needs. Show less
Objectives: Visuospatial neglect (VSN) is a common cognitive disorder after stroke. The primary aim of this systematic review was to provide an overview of the impact of VSN in 3 aspects: (1)... Show moreObjectives: Visuospatial neglect (VSN) is a common cognitive disorder after stroke. The primary aim of this systematic review was to provide an overview of the impact of VSN in 3 aspects: (1) activities of daily living (ADL), (2) participation, and (3) caregiver burden. The second aim was to investigate the differences in studies focusing on populations with mean age < 65 versus >= 65 years.Methods: PubMed, EMBASE, Web of Science, Cochrane Library, Emcare, PsychINFO, Academic Search Premier and CENTRAL were searched systematically. Quality was assessed with the Mixed Methods Appraisal Tool.Results: Of the 115 included studies, 104 provided outcomes on ADL, 15 on participation (4 studies with mean age >= 65), and 2 on caregiver burden (1 study with mean age >= 65). Quality assessment yielded scores ranging from 0 to 100%. VSN had a negative impact on ADL (i.e., independence during ADL and performance in self-care, household tasks, reading, writing, walking, wheelchair navigation) and participation (i.e., driving, community mobility, orientation, work). The impact of VSN on fulfilling social roles was unclear. VSN had a negative effect on caregiver burden. We found no clear age-related differences.Conclusions and implications: VSN has a negative impact not only on patients' independence but particularly on the performance of ADL. Despite the far fewer studies of VSN as compared with ADL, VSN also seems to hamper participation and increase caregiver burden, but further research is needed. Because of the large impact, VSN should be systematically and carefully assessed during rehabilitation. A considerable number of different instruments were used to diagnose VSN. Diagnosing VSN at more than one level [function (i.e., pen-and-paper test), activities, and participation] is strongly recommended. Consensus is needed on how to assess VSN and its negative impact for research and rehabilitation practice. (C) 2019 Elsevier Masson SAS. All rights reserved. Show less
Uem, J.M.T. van; Marinus, J.; Canning, C.; Lummel, R. van; Dodel, R.; Liepelt-Scarfone, I.; ... ; Maetzler, W. 2016