Fysaire dysplasie van de femurkop bij een jonge golden retriever

A one-year-old, male, neutered Golden retriever was presented with chronic progressive symptoms of pain and lameness of the hind limbs. Orthopedic examination revealed muscle atrophy of both hind limbs, severe pain reaction at passive extension of the hips and crepitation on palpation of the coxofemoral joints. A ventrodorsal radiograph of the hips showed a heterogeneous appearance with the presence of osteolytic areas of both femoral necks. There was a bilateral cranial displacement of the femoral neck in respect to the head with a fracture through the physeal plate. Bilateral slipped capital femoral epiphysis disease was diagnosed. A bilateral femoral head and neck excision was performed, followed by fysio- and hydrotherapy. The diagnosis of femoral capital physeal dysplasia may be missed because of the subtle radiographic changes in the first stadia of the disease. An early diagnosis is of major importance because treatment options decrease with progression of the condition

Design and process evaluation of an informative website tailored to breast cancer survivors' and intimate partners' post-treatment care needs

BACKGROUND: On-line provision of information during the transition phase after treatment carries great promise in meeting shortcomings in post-treatment care for breast cancer survivors and their partners. The objectives of this study are to describe the development and process evaluation of a tailored informative website and to assess which characteristics of survivors and partners, participating in the feasibility study, are related to visiting the website. METHODS: The development process included quantitative and qualitative assessments of survivors' and partners' care needs and preferences. Participants' use and evaluation of the website were explored by conducting baseline and post-measurements. During the intervening 10--12 weeks 57 survivors and 28 partners were granted access to the website. RESULTS:Fifty-seven percent (n=21) of survivors who took part in the post-measurement indicated that they had visited the website. Compared to non-visitors (n=16), they were more likely to have a partner and a higher income, reported higher levels of self-esteem and had completed treatment for a longer period of time. Partners who consulted the on-line information (42%, n=8) were younger and reported lower levels of social support compared to partners who did not visit the website (n=11). Visitors generally evaluated the content and lay-out positively, yet some believed the information was incomplete and impersonal. CONCLUSIONS: The website reached only about half of survivors and partners, yet was mostly well-received. Besides other ways of providing information and support, a website containing clear-cut and tailored information could be a useful tool in post-treatment care provision

Imaging-based frequency mapping for cochlear implants – Evaluated using a daily randomized controlled trial

BackgroundDue to variation in electrode design, insertion depth and cochlear morphology, patients with a cochlear implant (CI) often have to adapt to a substantial mismatch between the characteristic response frequencies of cochlear neurons and the stimulus frequencies assigned to electrode contacts. We introduce an imaging-based fitting intervention, which aimed to reduce frequency-to-place mismatch by aligning frequency mapping with the tonotopic position of electrodes. Results were evaluated in a novel trial set-up where subjects crossed over between intervention and control using a daily within-patient randomized approach, immediately from the start of CI rehabilitation.MethodsFourteen adult participants were included in this single-blinded, daily randomized clinical trial. Based on a fusion of pre-operative imaging and a post-operative cone beam CT scan (CBCT), mapping of electrical input was aligned to natural place-pitch arrangement in the individual cochlea. That is, adjustments to the CI’s frequency allocation table were made so electrical stimulation of frequencies matched as closely as possible with corresponding acoustic locations in the cochlea. For a period of three months, starting at first fit, a scheme was implemented whereby the blinded subject crossed over between the experimental and standard fitting program using a daily randomized wearing schedule, and thus effectively acted as their own control. Speech outcomes (such as speech intelligibility in quiet and noise, sound quality and listening effort) were measured with both settings throughout the study period.ResultsOn a group level, standard fitting obtained subject preference and showed superior results in all outcome measures. In contrast, two out of fourteen subjects preferred the imaging-based fitting and correspondingly had better speech understanding with this setting compared to standard fitting.ConclusionOn average, cochlear implant fitting based on individual tonotopy did not elicit higher speech intelligibility but variability in individual results strengthen the potential for individualized frequency fitting. The novel trial design proved to be a suitable method for evaluation of experimental interventions in a prospective trial setup with cochlear implants

Occupational therapy and return to work: a systematic literature review

<p>Abstract</p> <p>Background</p> <p>The primary aim of this review study was to gather evidence on the effectiveness in terms of return to work (RTW) of occupational therapy interventions (OTIs) in rehabilitation patients with non-congenital disorders. A secondary aim was to be able to select the most efficient OTI.</p> <p>Methods</p> <p>A systematic literature review of peer-reviewed papers was conducted using electronic databases (Cinahl, Cochrane Library, Ebsco, Medline (Pubmed), and PsycInfo). The search focussed on randomised controlled trials and cohort studies published in English from 1980 until September 2010. Scientific validity of the studies was assessed.</p> <p>Results</p> <p>Starting from 1532 papers with pertinent titles, six studies met the quality criteria. Results show systematic reviewing of OTIs on RTW was challenging due to varying populations, different outcome measures, and poor descriptions of methodology. There is evidence that OTIs as part of rehabilitation programs, increase RTW rates, although the methodological evidence of most studies is weak.</p> <p>Conclusions</p> <p>Analysis of the selected papers indicated that OTIs positively influence RTW; two studies described precisely what the content of their OTI was. In order to identify the added value of OTIs on RTW, studies with well-defined OT intervention protocols are necessary.</p

People living in poverty and their relationship to local church communities: An exploratory qualitative study in Mechelen, Belgium

Much literature on church and poverty issues takes the church as the actor and people living in poverty as the acted upon, those who have to receive care or who will benefit from the church’s diaconal action. Not much is known about experiences of the church and the religion of people living in poverty themselves. The aim of this article is threefold: (1) To learn more about possible difficulties, also possibilities, for participation of people living in poverty in Catholic parishes in Flanders; (2) To give a voice to people living in poverty, to help them to express their ‘ordinary theology’ (Astley 2002) and to make their experiences visible to a broader ecclesial audience; (3) To discuss the ecclesial experiences of people living in poverty and people who know their experiences quite well, in light of church documents. This article presents the results of an exploratory qualitative study in Mechelen, a medium-to-large city in Flanders, Belgium. We present the results of semi-structured interviews with 20 participants – 7 caregivers and 13 people living in poverty. We found both pragmatic difficulties and more religious difficulties for participation in parishes, named by people living in poverty, as well as by (voluntary and professional) caregivers. Pragmatic difficulties are, for example, mobility or time (in relation to working hours on Saturday/Sunday). More religious-related difficulties concern the doubts about God in relation to their own suffering, aspects of the moral teachings of the church (e.g. about homosexuality) and questions about the Eucharist itself, experienced in a non-satisfactory way. More positive experiences concern the silence or rest people experience in the church or the experience of a community. We discuss findings relating to experiences of ‘inclusion’ of people living in poverty within church communities and more private religious practices, named by people living in poverty. In a next step, we compare these results with other empirical research. Finally, we discuss what it can mean to be a ‘church of the poor’ and what ‘friendship with the poor’ might be and how this concept can be evaluated.http://www.hts.org.za/index.php/HTS/article/view/3435/htmlstatus: publishe

Study "Breast cancer and work"

Objectives Due to increasing treatment efficiency, more breast cancer patients can consider work resumption. Because of its multifactorial nature, return to work (RTW) remains a challenge. The objective of this study is to explore facilitators and barriers to the RTW process as experienced by breast cancer patients and to describe their return to work trajectories. Methods Women under treatment in 4 Belgian oncology centres were invited to participate in the survey. Inclusion criteria were primary breast cancer; stage I, II or III; aged between 18 and 60; working at the time of diagnosis as employee or civil servant. Participating patients completed a questionnaire at inclusion (within 3 months of diagnosis) and underwent an in-depth interview six months later. The interview focused on experiences of being work disabled and (preparation of) return to work. The interviews were fully transcribed and a thematic analysis was carried out by two independent researchers. Results A total of 44 women could be included in the study between July 2014 and February 2015. By the time of the interview, 18 women had returned to work; 3 had resumed work while being in treatment; and 11 women had a therapeutic RTW on part-time basis. Breast cancer patients report feelings of fear, guilt, and pressure concerning work resumption. They have complaints of pain, fatigue and loss of concentration. They feel ill-informed about financial implications of being work disabled and of partial work resumption and about possibilities to resume work in a flexible way. They are in favour of a more flexible work schedule at the workplace. Some women aspire to a career transition but feel that such a transition is not realistic at the time being due to their health status, energy level or financial situation. Conclusion Better information from healthcare professionals is needed to support women’s work resumption. Idiosyncratic work resumption trajectories point to the need of an individual approach of work resumption management.Pour un soutien efficace et efficient aux femmes en traitement pour cancer du sein qui souhaitent reprendre ou conserver leurs activité

How do adolescents with chronic fatigue syndrome perceive their social environment? A quantitative study

Abstract Some concern has been raised regarding the inappropriateness of the adult Center for Disease Control criteria for use in children. This resulted in a pediatric case definition being published in 2006. Unfortunately, the case definition does not prevent confusion and doubt with regards to the experienced symptoms in school personnel who deal with young persons with chronic fatigue syndrome (CFS). In order to provide more insight into pediatric chronic fatigue syndrome, twenty-seven chronic fatigue syndrome adolescents were interviewed by means of questionnaires. Results showed that it took about one and a half years before children received a diagnosis of chronic fatigue syndrome. Their symptom pattern seems comparable with that of an adult sample, except for stomach aches. The majority experienced conflicts at school due to their condition. Almost every adolescent with chronic fatigue syndrome abandoned their leisure activities. Adolescents with chronic fatigue syndrome were frequently confronted with negative remarks if they attempted their usual leisure activities