Interpersonal influence in families: development and psychometric evaluation of the influence in families questionnaire

The objective of this article was to develop and psychometrically evaluate a self-report instrument that would assess interpersonal influence in families. The Influence in Families Questionnaire (IFQ) was developed as a 16-item scale which assesses both positive and negative influence. The IFQ and its sub-scales, when administered to a sample of 581 adolescents and Young adults, showed high internal consistency and exhibited a promising pattern of convergent, divergent and criterion validity in relation to relevant criteria such as impact messages, family and attachment relationships and interpersonal sense of control. Overall, these results suggest that the IFQ is a useful instrument for measuring interpersonal influence within families

Dorpsverhalen:Samen bouwen aan de energietransitie in het Drentsche Aa- gebied

Dorpen in het Nationaal Park Drentsche Aa zijn zich bewust van de kwaliteit van hun omgeving. Tegelijkertijd werken deze dorpen aan lokale energieplannen. Daarbij worden veel resultaten gerealiseerd en lessen gedaan. Met zeven dorpen terug- en vooruitgekeken naar hun initiatieven zodat motieven, doelen, activiteiten (tijdlijn) en lessen konden worden opgetekend in deze publicatie

Dorpsverhalen:Samen bouwen aan de energietransitie in het Drentsche Aa- gebied

Dorpen in het Nationaal Park Drentsche Aa zijn zich bewust van de kwaliteit van hun omgeving. Tegelijkertijd werken deze dorpen aan lokale energieplannen. Daarbij worden veel resultaten gerealiseerd en lessen gedaan. Met zeven dorpen terug- en vooruitgekeken naar hun initiatieven zodat motieven, doelen, activiteiten (tijdlijn) en lessen konden worden opgetekend in deze publicatie

Drehtsche Aa: dit is waar ik voor sta!:Een gedragen aanpak van de energietransitie in het Drentsche Aa-gebied

In het Nationaal Park Drentsche Aa wonen meer dan 30.000 mensen. En één ding staat als een paal boven water: zij voelen zich heel erg verbonden met hun leefomgeving. Daarom willen zij ook graag betrokken zijn bij beslissingen over veranderingen in het gebied. Als woningeigenaar, als inwoner en als gemeenschap. Ook als het gaat om de energietransitie.Deze toegankelijke publicatie geeft aan wat inwoners van het Nationaal Park Drentsche Aa belangrijk vinden bij de energietransitie, mede voorzien van instrumenten voor lokale energie-iniatieven en voorbeelden van dorpen uit het gebied

The ESEP study: Salpingostomy versus salpingectomy for tubal ectopic pregnancy; The impact on future fertility: A randomised controlled trial

<p>Abstract</p> <p>Background</p> <p>For most tubal ectopic pregnancies (EP) surgery is the treatment of first choice. Whether surgical treatment should be performed conservatively (salpingostomy) or radically (salpingectomy) in women wishing to preserve their reproductive capacity, is subject to debate. Salpingostomy preserves the tube, but bears the risks of both persistent trophoblast and repeat ipsilateral tubal EP. Salpingectomy, avoids these risks, but leaves only one tube for reproductive capacity. This study aims to reveal the trade-off between both surgical options: whether the potential advantage of salpingostomy, i.e. a better fertility prognosis as compared to salpingectomy, outweighs the potential disadvantages, i.e. persistent trophoblast and an increased risk for a repeat EP.</p> <p>Methods/Design</p> <p>International multi centre randomised controlled trial comparing salpingostomy versus salpingectomy in women with a tubal EP without contra lateral tubal pathology. Hemodynamically stable women with a presumptive diagnosis of tubal EP, scheduled for surgery, are eligible for inclusion. Patients pregnant after in vitro fertilisation (IVF) and/or known documented tubal pathology are excluded. At surgery, a tubal EP must be confirmed. Only women with a tubal EP amenable to both interventions and a healthy contra lateral tube are included. Salpingostomy and salpingectomy are performed according to standard procedures of participating hospitals. Up to 36 months after surgery, women will be contacted to assess their fertility status at six months intervals starting form the day of the operation.</p> <p>The primary outcome measure is the occurrence of spontaneous viable intra uterine pregnancy. Secondary outcome measures are persistent trophoblast, repeat EP, all pregnancies including those resulting from IVF and financial costs. The analysis will be performed according to the intention to treat principle. A cost-effectiveness analysis will be performed within a decision analysis framework, based on costs per live birth, including IVF treatment whenever a spontaneous pregnancy does not occur. Patients' preferences will be assessed using a discrete choice experiment.</p> <p>Discussion</p> <p>This trial will provide evidence on the trade off between salpingostomy and salpingectomy for tubal EP in view of the pros and cons of both interventions and will offer guidance to clinicians in making the right treatment choice.</p> <p>Trial registration</p> <p>Current Controlled Trials ISRCTN37002267</p

A protocol for developing a core outcome set for ectopic pregnancy

BACKGROUND: Randomised controlled trials (RCTs) evaluating ectopic pregnancy have reported many different outcomes, which are themselves often defined and measured in distinct ways. This level of variation results in an inability to compare results of individual RCTs. The development of a core outcome set to ensure outcomes important to key stakeholders are collected consistently will guide future research in ectopic pregnancy. STUDY AIM: To develop and implement a core outcome set to guide future research in ectopic pregnancy. METHODS AND ANALYSIS: We have established an international steering group of key stakeholders, including healthcare professionals, researchers, and individuals with lived experience of ectopic pregnancy. We will identify potential outcomes from ectopic pregnancy from a comprehensive literature review of published randomised controlled trials. We will then utilise a modified Delphi method to prioritise outcomes. Subsequently, key stakeholders will be invited to score potential core outcomes on a nine-point Likert scale, ranging from 1 (not important) to 9 (critical). Repeated reflection and rescoring should promote whole and individual stakeholder group convergence towards consensus ‘core’ outcomes. We will also establish standardised definitions and recommend high-quality measurements for individual core outcomes. TRIAL REGISTRATION: COMET 1492. Registered in November 2019

The METEX study: Methotrexate versus expectant management in women with ectopic pregnancy: A randomised controlled trial

Background: Patients with ectopic pregnancy (EP) and low serum hCG concentrations and women with a pregnancy of unknown location (PUL) and plateauing serum hCG levels are commonly treated with systemic methotrexate (MTX). However, there is no evidence that treatment in these particular subgroups of women is necessary as many of these early EPs may resolve spontaneously. The aim of this study is whether expectant management in women with EP or PUL and with low but plateauing serum hCG concentrations is an alternative to MTX treatment in terms of treatment success, future pregnancy, health related quality of life and costs. Methods/Design: A multicentre randomised controlled trial in TheNetherlands. Hemodynamically stable patients with an EP visible on transvaginal ultrasound and a plateauing serum hCG concentration < 1,500 IU/L or with a persisting PUL with plateauing serum hCG concentrations < 2,000 IU/L are eligible for the trial. Patients with a viable EP, signs of tubal rupture/abdominal bleeding, or a contra-indication for MTX will not be included. Expectant management is compared with systemic MTX in a single dose intramuscular regimen (1 mg/ kg) in an outpatient setting. Serum hCG levels are monitored weekly; in case of inadequately declining, systemic MTX is installed or continued. In case of hemodynamic instability and/or signs of tubal rupture, surgery is performed. The primary outcome measure is an uneventful decline of serum hCG to an undetectable level by the initial intervention. Secondary outcomes are (re)interventions (additional systemic MTX injections and/or surgery), treatment complications, health related quality of life, financial costs, and future fertility. Analysis is performed according to the intention to treat principle. Quality of life is assessed by questionnaires before and at three time points after randomisation. Costs are expressed as direct costs with data on costs and used resources in the participating centres. Fertility is assessed by questionnaires after 6, 12, 18 and 24 months. Patients' preferences will be assessed using a discrete choice experiment. Discussion: This trial will provide guidance on the present management dilemmas in women with EPs and PULs with low and plateauing serum hCG concentrations