Athletes treated for inguinal-related groin pain by endoscopic totally extraperitoneal (TEP) repair:long-term benefits of a prospective cohort

Purpose: Inguinal-related groin pain (IRGP) in athletes is a multifactorial condition, posing a therapeutic challenge. If conservative treatment fails, totally extraperitoneal (TEP) repair is effective in pain relief. Because there are only few long-term follow-up results available, this study was designed to evaluate effectiveness of TEP repair in IRGP-patients years after the initial procedure. Methods: Patients enrolled in the original, prospective cohort study (TEP-ID-study) were subjected to two telephone questionnaires. The TEP-ID-study demonstrated favorable outcomes after TEP repair for IRGP-patients after a median follow-up of 19 months. The questionnaires in the current study assessed different aspects, including, but not limited to pain, recurrence, new groin-related symptoms and physical functioning measured by the Copenhagen Hip and Groin Outcome Score (HAGOS). The primary outcome was pain during exercise on the numeric rating scale (NRS) at very long-term follow-up.Results: Out of 32 male participants in the TEP-ID-study, 28 patients (88%) were available with a median follow-up of 83 months (range: 69–95). Seventy-five percent of athletes were pain free during exercise (p &lt; 0.001). At 83 months follow-up, a median NRS of 0 was observed during exercise (IQR 0–2), which was significantly lower compared to earlier scores (p &lt;0.01). Ten patients (36%) mentioned subjective recurrence of complaints, however, physical functioning improved on all HAGOS subscales (p &lt;0.05).Conclusion:This study demonstrates the safety and effectivity of TEP repair in a prospective cohort of IRGP-athletes, for whom conservative treatment had failed, with a follow-up period of over 80 months.</p

A Strong Jet Signature in the Late-Time Lightcurve of GW170817

We present new 0.6-10 GHz observations of the binary neutron star merger GW170817 covering the period up to 300 days post-merger, taken with the Karl G. Jansky Very Large Array, the Australia Telescope Compact Array, the Giant Metrewave Radio Telescope and the MeerKAT telescope. We use these data to precisely characterize the decay phase of the late-time radio light curve. We find that the temporal decay is consistent with a power-law slope of t^-2.2, and that the transition between the power-law rise and decay is relatively sharp. Such a slope cannot be produced by a quasi-isotropic (cocoon-dominated) outflow, but is instead the classic signature of a relativistic jet. This provides strong observational evidence that GW170817 produced a successful jet, and directly demonstrates the link between binary neutron star mergers and short-hard GRBs. Using simple analytical arguments, we derive constraints on the geometry and the jet opening angle of GW170817. These results are consistent with those from our companion Very Long Baseline Interferometry (VLBI) paper, reporting superluminal motion in GW170817.Comment: 11 pages, 3 figures, 3 tables. Accepted for publication in ApJ Letter

Patients' Attitudes Toward an Online Patient Portal for Communicating Laboratory Test Results: Real-World Study Using the eHealth Impact Questionnaire

Background: Communicating laboratory test results online has several advantages for patients, such as improving clinical efficiency and accessibility, thereby helping patients to take an active role in managing their health.Objective: This study aimed to investigate the experiences and self-efficacy of patients using an online patient portal that communicates laboratory test results.Methods: We used the online-administered eHealth Impact Questionnaire to explore patients' attitudes toward the portal. Patients visiting the portal were asked to complete the questionnaire. The subscale Information and Presentation assessed the usability of the patient portal and the subscale Motivation and Confidence to Act assessed self-efficacy to determine whether patients were motivated to act on the presented information. We used a cutoff score of 65 or greater to determine whether the portal was rated positively.Results: The questionnaire was completed by 354 of 13,907 patients who viewed their laboratory results in the patient portal, with a response rate of 2.55%. The mean Information and Presentation score was 67.70 (SD 13.12) and the mean Motivation and Confidence to Act score was 63.59 (SD 16.22). We found a positive, significant correlation between the 2 subscales (r(345)=.77, P<.001).Conclusions: Patients participating in the study rated the usability of the portal positively. However, the portal only slightly helped patients to take an active role in managing their own health. The low response rate precludes generalization of the results. Future research should examine avenues to further increase patients' self-efficacy and study whether portal acceptability differs in subgroups. Patient portals conveying laboratory test results in understandable language seem usable and potentially provide a viable way to help patients take a more active role in managing their own health.Prevention, Population and Disease management (PrePoD)Public Health and primary car

Implementation of automatic speech analysis for early detection of psychiatric symptoms:What do patients want?

Psychiatry is in dire need of a method to aid early detection of symptoms. Recent developments in automatic speech analysis prove promising in this regard, and open avenues for implementation of speech-based applications to detect psychiatric symptoms. The current survey was conducted to assess positions with regard to speech recordings among a group (n = 675) of individuals who experience psychiatric symptoms. Overall, respondents are open to the idea of speech recordings in light of their mental welfare. Importantly, concerns with regard to privacy were raised. Given that speech recordings are privacy sensitive, this requires special attention upon implementation of automatic speech analysis techniques. Furthermore, respondents indicated a preference for speech recordings in the presence of a clinician, as opposed to a recording made at home without the clinician present. In developing a speech marker for psychiatry, close collaboration with the intended users is essential to arrive at a truly valid and implementable method

An urban perinatal health programme of strategies to improve perinatal health

Promotion of a healthy pregnancy is a top priority of the health care policy in many European countries. Perinatal mortality is an important indicator of the success of this policy. Recently, it was shown that the Netherlands has relatively high perinatal death rates when compared to other European countries. This is in particular true for large cities where perinatal mortality rates are 20-50% higher than elsewhere. Consequently in the Netherlands, there is heated debate on how to tackle these problems. Without the introduction of measures throughout the entire perinatal health care chain, pregnancy outcomes are difficult to improve. With the support of health care professionals, the City of Rotterdam and the Erasmus University Medical Centre have taken the initiative to develop an urban perinatal health programme called 'Ready for a Baby'. The main objective of this municipal 10-year programme is to improve perinatal health and to reduce perinatal mortality in all districts to at least the current national average of 10 per 1000. Key elements are the understanding of the mechanisms of the large health differences between women living in deprived and nondeprived urban areas. Risk guided care, orientation towards shared-care and improvement of collaborations between health care professionals shapes the interventions that are being developed. Major attention is given to the development of methods to improve risk-selection before and during pregnancy and methods to reach low-educated and immigrant groups

The preventive effect of the bounding exercise programme on hamstring injuries in amateur soccer players:The design of a randomized controlled trial

Background: Hamstring injuries are the most common muscle injury in amateur and professional soccer. Most hamstring injuries occur in the late swing phase, when the hamstring undergoes a stretch-shortening cycle and the hamstring does a significant amount of eccentric work. The incidence of these injuries has not decreased despite there being effective injury prevention programmes focusing on improving eccentric hamstring strength. As this might be because of poor compliance, a more functional injury prevention exercise programme that focuses on the stretch-shortening cycle might facilitate compliance. In this study, a bounding exercise programme consisting of functional plyometric exercises is being evaluated. Methods: A cluster-randomized controlled trial (RCT). Male amateur soccer teams (players aged 18-45 years) have been randomly allocated to intervention and control groups. Both groups are continuing regular soccer training and the intervention group is additionally performing a 12-week bounding exercise programme (BEP), consisting of a gradual build up and maintenance programme for the entire soccer season. The primary outcome is hamstring injury incidence. Secondary outcome is compliance with the BEP during the soccer season and 3 months thereafter. Discussion: Despite effective hamstring injury prevention programmes, the incidence of these injuries remains high in soccer. As poor compliance with these programmes may be an issue, a new plyometric exercise programme may encourage long-term compliance and is expected to enhance sprinting and jumping performance besides preventing hamstring injuries