Association of pelvic fracture patterns, pelvic binder use and arterial angio-embolization with transfusion requirements and mortality rates; a 7-year retrospective cohort study.

Pelvic fractures are severe injuries with frequently associated multi-system trauma and a high mortality rate. The value of the pelvic fracture pattern for predicting transfusion requirements and mortality is not entirely clear. To address hemorrhage from pelvic injuries, the early application of pelvic binders is now recommended and arterial angio-embolization is widely used for controlling arterial bleeding. Our aim was to assess the association of the pelvic fracture pattern according to the Tile classification system with transfusion requirements and mortality rates, and to evaluate the correlation between the use of pelvic binders and arterial angio-embolization and the mortality of patients with pelvic fractures. Single-center retrospective cohort study including all consecutive patients with a pelvic fracture from January 2008 to June 2015. All radiological fracture patterns were independently reviewed and grouped according to the Tile classification system. Data on patient demographics, use of pelvic binders and arterial angio-embolization, transfusion requirements and mortality were extracted from the institutional trauma registry and analyzed. The present study included 228 patients. Median patient age was 43.5 years and 68.9% were male. The two independent observers identified 105 Tile C (46.1%), 71 Tile B (31.1%) and 52 Tile A (22.8%) fractures, with substantial to almost perfect interobserver agreement (Kappa 0.70-0.83). Tile C fractures were associated with a higher mortality rate (p = 0.001) and higher transfusion requirements (p < 0.0001) than Tile A or B fractures. Arterial angio-embolization for pelvic bleeding (p = 0.05) and prehospital pelvic binder placement (p = 0.5) were not associated with differences in mortality rates. Tile C pelvic fractures are associated with higher transfusion requirements and a higher mortality rate than Tile A or B fractures. No association between the use of pelvic binders or arterial angio-embolization and survival was observed in this cohort of patients with pelvic fractures

Between ‘entertainment medicine’ and professionalization of healthcare : an interview study of Belgian doctors

Background: Nowadays, digital self-tracking devices offer a plethora of possibilities to both healthy and chronically ill users who want to closely examine their body. This study suggests that self-tracking in a private setting will lead to shifting understandings in professional care. In order to provide more insight into these shifts, this paper seeks to lay bare the promises and challenges of self-tracking while staying close to the everyday professional experience of the physician. Objective: Our objective is twofold. First, to offer an analysis of how medical doctors evaluate self-tracking methods in their practice. Second, to explore the anticipated shifts that digital self-care will bring about in relation to our findings and those of other studies. Methods: Twelve in-depth semi-structured interviews with general practitioners (GPs) and cardiologists have been conducted in Flanders, Belgium, between November 2015 and November 2016. Thematic analysis was applied to examine the transcripts in an iterative process. Results: Four major themes arise in our body of data: (1) the patient as health manager; (2) health obsession and medicalization; (3) information management; and (4) shifting roles of the doctors and impact on healthcare organization. Our research findings show a nuanced understanding of the potentials and pitfalls of different forms of self-tracking. The necessity of contextualization of self-tracking data, and a professionalization of self-care through digital devices come to the fore as important overarching concepts. Conclusions: This interview study with Belgian doctors examines the potentials and challenges of self-monitoring, while focusing on the everyday professional experience of the physician. The dialogue between our dataset and the existing literature affords a fine-grained image of digital self-care and its current meaning in a medical-professional landscape

Hoe hoger de haze bij diffuus glas, hoe hoger de meerproductie (interview met Jan Janse en Sonny Moerenhout)

Een vroege komkommerteelt onder diffuus glas gaf vanaf het begin een grotere opbrengst dan onder gewoon glas. Jan Janse van Wageningen UR Glastuinbouw durft na de reeks proeven in de afgelopen jaren de conclusie te trekken: hoe hoger de haze, hoe hoger de meerproductie. Dus ook in een vroege teelt

Earlier production, more and heavier fruits: The higher the haze, the greater the extra production (interview with Jan Janse and Sonny Moerenhout)

Early cucumbers grown under diffuse glass have a larger yield than those grown under normal glass right from the start of the cultivation. Following a series of trials carried out over the last few years, Jan Janse of Wageningen UR Greenhouse Horticulture concludes: the higher the haze, the greater the extra production. That includes early crops

Patient health information materials in waiting rooms of family physicians: do patients care?

Tania Moerenhout, Liesbeth Borgermans, Sandrina Schol, Johan Vansintejan, Erwin Van De Vijver, Dirk Devroey Vrije Universiteit Brussel, Department of Family Practice, Brussels, Belgium Background: Patient health information materials (PHIMs), such as leaflets and posters are widely used by family physicians to reinforce or illustrate information, and to remind people of information received previously. This facilitates improved health-related knowledge and self-management by patients. Objective: This study assesses the use of PHIMs by patient. It also addresses their perception of the quality and the impact of PHIMs on the interaction with their physician, along with changes in health-related knowledge and self-management. Methods: Questionnaire survey among patients of family practices of one town in Belgium, assessing: (1) the extent to which patients read PHIMs in waiting rooms (leaflets and posters) and take them home, (2) the patients’ perception of the impact of PHIMs on interaction with their physician, their change in health-related knowledge and self-management, and (3) the patients judgment of the quality of PHIMs. Results: We included 903 questionnaires taken from ten practices. Ninety-four percent of respondents stated they read PHIMs (leaflets), 45% took the leaflets home, and 78% indicated they understood the content of the leaflets. Nineteen percent of respondents reportedly discussed the content of the leaflets with their physician and 26% indicated that leaflets allowed them to ask fewer questions of their physician. Thirty-four percent indicated that leaflets had previously helped them to improve their health-related knowledge and self-management. Forty-two percent reportedly discussed the content of the leaflets with others. Patient characteristics are of significant influence on the perceived impact of PHIMS in physician interaction, health-related knowledge, and self-management. Conclusion: This study suggests that patients value health information materials in the waiting rooms of family physicians and that they perceive such materials as being helpful in improving patient–physician interaction, health-related knowledge, and self-management. Keywords: Patient health information materials, interaction, patients, physician, Belgiu