While some areas of care work show increased recruitment of men, the care-gap remains, especially in low paid occupations. Questions arise how masculinities play a part in this, and if caring...Show moreWhile some areas of care work show increased recruitment of men, the care-gap remains, especially in low paid occupations. Questions arise how masculinities play a part in this, and if caring masculinities obscure gender inequities while at the same time perpetuating them. This qualitative study focusses the negotiation of hegemonic and caring masculinities of men working in residential long-term care in the Netherlands, and its consequences for health. Semi-structured interviews (N = 16) were analyzed thematically, drawing upon gender and intersectionality theory to understand inequities between respondents. Findings describe how men move through long-term care. On entry, men negotiated hegemonic and caring masculinities to gain access, with black men having to work harder. Once inside, men experienced status-loss and performed hegemonic masculinity, materializing in financial and sexual rewards, especially for white heterosexual men. In time, this performance of hegemonic masculinity backlashed with respect to their own health; herein racialized and homosexual men were hit harder. Consequently, all the men in this study aspired to move out or up from low-paid care work, with white heterosexual men doing so more successfully. Our study illustrates the importance of an intersectional perspective on caring masculinities at work, showing how caring masculinities perpetuate male privilege for some men more than for others, creating health and labor market inequities among men. In terms of health, this study shows that gender, racism and sexual discrimination need be on the occupational health agenda. Show less
Fairness and bias are crucial concepts in artificial intelligence, yet they are relatively ignored in machine learning applications in clinical psychiatry. We computed fairness metrics and present... Show moreFairness and bias are crucial concepts in artificial intelligence, yet they are relatively ignored in machine learning applications in clinical psychiatry. We computed fairness metrics and present bias mitigation strategies using a model trained on clinical mental health data. We collected structured data related to the admission, diagnosis, and treatment of patients in the psychiatry department of the University Medical Center Utrecht. We trained a machine learning model to predict future administrations of benzodiazepines on the basis of past data. We found that gender plays an unexpected role in the predictions-this constitutes bias. Using the AI Fairness 360 package, we implemented reweighing and discrimination-aware regularization as bias mitigation strategies, and we explored their implications for model performance. This is the first application of bias exploration and mitigation in a machine learning model trained on real clinical psychiatry data. Show less
Objective To compare the long-term effects of tocolysis with nifedipine or atosiban on child outcome at age 2.5-5.5 years.Design The APOSTEL III trial was a multicentre randomised controlled trial... Show moreObjective To compare the long-term effects of tocolysis with nifedipine or atosiban on child outcome at age 2.5-5.5 years.Design The APOSTEL III trial was a multicentre randomised controlled trial that compared tocolysis with nifedipine or atosiban in 503 women with threatened preterm birth. Neonatal outcomes did not differ between both treatment arms, except for a higher incidence of intubation in the atosiban group.Methods Parents were asked to complete four questionnaires regarding neurodevelopment, executive function, behaviour problems, and general health.Main outcome measures The main long-term outcome measure was a composite of abnormal development at the age of 2.5-5.5 years.Results Of the 426 women eligible for follow-up, 196 (46%) parents returned the questionnaires for 115 children in the nifedipine group and 110 children in the atosiban group. Abnormal development occurred in 32 children (30%) in the nifedipine group and in 38 children (38%) in the atosiban group (OR 0.74, 95% CI 0.41-1.34). The separate outcomes for neurodevelopment, executive function, behaviour, and general health showed no significant differences between the groups. Sensitivity analysis for all children of the APOSTEL III trial, including a comparison of deceased children, resulted in a higher rate of healthy survival in the nifedipine group (64 versus 54%), but there was no significant difference in the overall mortality rate (5.4 versus 2.7%). There were no significant subgroup effects.Conclusion Outcomes on broad child neurodevelopment, executive function, behaviour, and general health were comparable in both groups. Neither nifedipine nor atosiban can be considered as the preferred treatment for women with threatened preterm birth.Tweetable abstract Nifedipine- and atosiban-exposed children had comparable long-term outcomes, including neurodevelopment, executive function, and behaviour. Show less
Bousquet, J.; Farrell, J.; Illario, M.; Onorato, G.L.; Bedbrook, A.; Czarlewski, W.; ... ; ARIA-MASK Study Grp 2020
The reference sites of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) were renewed in 2019. The DG Sante good practice Mobile Airways Sentinel networK was reviewed to... Show moreThe reference sites of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) were renewed in 2019. The DG Sante good practice Mobile Airways Sentinel networK was reviewed to meet the objectives of the EIP on AHA. It included 1) Management of care process, 2) Blueprint of digital transformation, 3) EIP on AHA, innovation to market, 4) Community for monitoring and assessment framework, 5) Political, organizational, technological and financial readiness, 6) Contributing to European co-operation and transferability, 7) Delivering evidence of impact against the triple win approach, 8) Contribution to the European Digital Transformation of Health and Care and 9) scale of demonstration and deployment of innovation. Show less
The nutritional requirements of preterm infants are unique and challenging to meet in neonatal care, yet crucial for their growth, development and health. Normally, the gut microbiota has distinct... Show moreThe nutritional requirements of preterm infants are unique and challenging to meet in neonatal care, yet crucial for their growth, development and health. Normally, the gut microbiota has distinct metabolic capacities, making their role in metabolism of dietary components indispensable. In preterm infants, variation in microbiota composition is introduced while facing a unique set of environmental conditions. However, the effect of such variation on the microbiota's metabolic capacity and on the preterm infant's growth and development remains unresolved. In this review, we will provide a holistic overview on the development of the preterm gut microbiota and the unique environmental conditions contributing to this, in addition to maturation of the gastrointestinal tract and immune system in preterm infants. The role of prematurity, as well as the role of human milk, in the developmental processes is emphasized. Current research stresses the early life gut microbiota as cornerstone for simultaneous development of the gastrointestinal tract and immune system. Besides that, literature provides clues that prematurity affects growth and development. As such, this review is concluded with our hypothesis that prematurity of the gut microbiota may be an inconspicuous clinical challenge in achieving optimal feeding besides traditional challenges, such as preterm breast milk composition, high nutritional requirements and immaturity of the gastrointestinal tract and immune system. A better understanding of the metabolic capacity of the gut microbiota and its impact on gut and immune maturation in preterm infants could complement current feeding regimens in future neonatal care and thereby facilitate growth, development and health in preterm infants. Show less
Costa, M.G. da; Poppelaars, F.; Kooten, C. van; Mollnes, T.E.; Tedesco, F.; Wurzner, R.; ... ; Seelen, M.A. 2018
