Strange two-baryon interactions using chiral effective field theory

We have constructed the leading order strangeness S=-1,-2 baryon-baryon potential in a chiral effective field theory approach. The chiral potential consists of one-pseudoscalar-meson exchanges and non-derivative four-baryon contact terms. The potential, derived using SU(3)_f symmetry constraints, contains six independent low-energy coefficients. We have solved a regularized Lippmann-Schwinger equation and achieved a good description of the available scattering data. Furthermore a correctly bound hypertriton has been obtained.Comment: 3 pages, 2 PostScript figures, talk to appear in the proceedings of the "20th European Conference on Few-Body Problems in Physics (EFB20), Pisa, Italy, 10-14 September 2007

Economic and Health impact of injuries in the Netherlands and Europe

Acute lichamelijke letsels, veroorzaakt door ongevallen vormen een altijd aanwezig en dynamisch volksgezondheidsprobleem. Elk jaar raken alleen al in Nederland ca 1 miljoen mensen zodanig gewond dat zij onderzocht en behandeld moeten worden op de Spoed Eisende Hulp van een ziekenhuis. In dit proefschrift worden de medische kosten en de ziektelast van ongevallen voor Nederland en Europa bestudeerd. Hiermee kunnen ziekten, risicofactoren, en bevolkingsgroepen geïdentificeerd worden met de grootste behoefte aan zorginterventies. In een Europese studie worden de kosten van acht Europese landen vergeleken met elkaar, waarbij grote internationale verschillen zijn waargenomen. Belangrijke veroorzakers van hoge kosten zijn het veel voorkomen van ernstige letsels (Oostenrijk en Griekenland), verschillen in gezondheidszorgsystemen en traumazorg (hoge opnamekans en opnameduur voor Oostenrijk en Noorwegen), en hoge kostprijzen voor de gezondheidszorg (Noorwegen en Denemarken). Mensen ouder dan 65 jaar, in het bijzonder vrouwen, nemen een groot deel (meer dan een derde) van de totale zorgkosten voor hun rekening, met name veroorzaakt door botbreuken (heup- en knie/onderbeen). Jonge kinderen en mannen van middelbare leeftijd zijn ook groepen met relatief hoge medische kosten. Functionele gevolgen zijn gemeten bij een brede populatie ongevalspatiënten die zijn behandeld op de spoedeisende hulp in Nederland, 2½, 5, 9 en 24 maanden na het ongeval. Ongevalspatiënten die voor langere tijd opgenomen zijn geweest (> 7 dagen), ervaren twee jaar na het ongeval nog steeds aanzienlijke gezondheidsbeperkingen. Leeftijd (65+), Geslacht (vrouwen), specifieke letsels (heupfractuur, ruggenmergletsel, schedel-hersenletsel), en de aanwezigheid van andere ziekten (comorbiditeit) geven een verhoogd risico op langdurige gevolgen van een ongeval

Burden of injury in childhood and adolescence in 8 European countries

Injury is the major cause of death and suffering among children and adolescents, but awareness of the problem and political commitment for preventive actions remain unacceptably low. We have assessed variation in the burden of injuries in childhood and adolescence in eight European countries. Hospital, emergency department, and mortality databases of injury patients aged 0-24 years were analyzed for Austria, Denmark, Ireland, Latvia, Netherlands, Norway, Slovenia and the United Kingdom (England, Wales). Years lost due to premature mortality (YLL), years lived with disability (YLD), and disability adjusted life years (DALYs) were calculated. Differences in the burden of injury in childhood and adolescence are large, with a fourfold gap between the safest countries (Netherlands and UK) in western-Europe and the relatively unsafe countries (Latvia and Slovenia) in the east. Variation between countries is attributable to high variation in premature mortality (YLL varied from 14-58 per 1000 persons) and disability (YLD varied from 3-10 per 1000 persons). Highest burden is observed among males ages 15-24. If childhood and adolescence injuries are reduced to the level of current best injury prevention practices, 6 DALYs per 1000 child years can be avoided. Injuries in childhood and adolescence cause a high disability and mortality burden in Europe. In all developmental stages large inequalities between west and east are observed. Potential benefits up to almost 1 million healthy child years gained across Europe are possible, if proven ways for prevention are more widely implemented. Our children deserve action now

Systematic review of foodborne burden of disease studies: Quality assessment of data and methodology

Burden of disease (BoD) studies aim to identify the public health impact of different health problems and risk factors. To assess BoD, detailed knowledge is needed on epidemiology, disability and mortality in the population under study. This is particularly challenging for foodborne disease, because of the multitude of causative agents and their health effects. The purpose of this study is to systematically review the methodology of foodborne BoD studies. Three key questions were addressed: 1) which data sources and approaches were used to assess mortality, morbidity and disability?, 2) which methodological choices were made to calculate Disability Adjusted Life Years (DALY), and 3) were uncertainty analyses performed and if so, how? Studies (1990-June 2012) in international peer-reviewed journals and grey literature were identified with main inclusion criteria being that the study assessed disability adjusted life years related to foodborne disease. Twenty-four studies met our inclusion criteria. To assess incidence or prevalence of foodborne disease in the population, four approaches could be distinguished, each using a different data source as a starting point, namely 1) laboratory-confirmed cases, 2) cohort or cross-sectional data, 3) syndrome surveillance data and 4) exposure data. Considerable variation existed in BoD methodology (e.g. disability weights, discounting, age-weighting). Almost all studies analyzed the effect of uncertainty as a result of possible imprecision in the parameter values. Awareness of epidemiological and methodological rigor between foodborne BoD studies using the DALY approach is a critical priority for advancing burden of disease studies. Harmonization of methodology that is used and of modeling techniques and high quality data can enlarge the detection of real variation in DALY outcomes between pathogens, between populations or over time. This harmonization can be achieved by identifying substantial data gaps and uncertainty and establish which sequelae of foodborne disease agents should be included in BoD calculations

Soft-core meson-baryon interactions. II. πN\pi N and K+NK^+ N scattering

The $\pi N$ potential includes the t-channel exchanges of the scalar-mesons $\sigma$ and f_0, vector-meson $\rho$, tensor-mesons f_2 and f_2' and the Pomeron as well as the s- and u-channel exchanges of the nucleon N and the resonances $\Delta$, Roper and S_{11}. These resonances are not generated dynamically. We consider them as, at least partially, genuine three-quark states and we treat them in the same way as the nucleon. The latter two resonances were needed to find the proper behavior of the phase shifts at higher energies in the corresponding partial waves. The soft-core $\pi N$-model gives an excellent fit to the empirical $\pi N$ S- and P-wave phase shifts up to T_{lab}=600 MeV. Also the scattering lengths have been reproduced well and the soft-pion theorems for low-energy $\pi N$ scattering are satisfied. The soft-core model for the $K^+ N$ interaction is an SU_f(3)-extension of the soft-core $\pi N$-model. The $K^+ N$ potential includes the t-channel exchanges of the scalar-mesons a_0, $\sigma$ and f_0, vector-mesons $\rho$, $\omega$ and $\phi$, tensor-mesons a_2, f_2 and f_2' and the Pomeron as well as u-channel exchanges of the hyperons $\Lambda$ and $\Sigma$. The fit to the empirical $K^+ N$ S-, P- and D-wave phase shifts up to T_{lab}=600 MeV is reasonable and certainly reflects the present state of the art. Since the various $K^+ N$ phase shift analyses are not very consistent, also scattering observables are compared with the soft-core $K^+ N$-model. A good agreement for the total and differential cross sections as well as the polarizations is found.Comment: 24 pages, 20 PostScript figures, revtex4, submitted to Phys. Rev.

Alternative approaches to derive disability weights in injuries: do they make a difference?

BACKGROUND: In burden of disease studies, several approaches are used to assess disability weights, a scaling factor necessary to compute years lived with disability (YLD). The aim of this study was to quantify disability weights for injury consequences with two competing approaches, (a) standard QALY/DALY model (SQM) which derives disability weights from patient survey data and (b) the annual profile model (APM) which derives weights for the same patient data valued by a panel. METHODS: Disability weights were assessed using (a) EQ-5D data from a postal survey among 8,564 injury patients 2(1/2), 5, and 9 months after attending the Emergency Department, and (b) preferences of 143 laymen elicited with the time trade-off method. RESULTS: Compared with APM, SQM disability weights were consistently higher. YLD calculated with SQM disability weights was more than three times higher compared with YLD

A systematic review of studies measuring health-related quality of life of general injury populations: Update 2010-2018

Background: Studies examining the impact of injury on health-related quality of life (HRQL) over time are necessary to understand the short-and long-Term consequences of injury for population health. The aim of this systematic review was to provide an evidence update on studies that have measured HRQL over time in general injury populations using a generic (general) health state measure. Methods: Studies conducted between 2010 and 2018 that assessed HRQL at more than one time point among general injury populations were eligible for inclusion. Two reviewers independently extracted information from each study on design, HRQL measure used, method of HRQL measure administration, timing of assessment(s), predictive variables, ability to detect change, and findings. Quality appraisals of each study were also completed by two reviewers using items from the RTI Item Bank on Risk of Bias and Precision of Observational Studies and the Guidelines for the Conduction of Follow-up Studies Measuring Injury-Related Disability. Results: Twenty-nine studies (44 articles) that met the inclusion criteria were identified. HRQL was measured using 14 different generic measures; the SF-36, SF-12, and EQ-5D were used most frequently. A varying number of follow-up assessments were undertaken, ranging from one to five. Follow-up often occurred 12 months post-injury. Fewer studies (n = 11) examined outcomes two or more years post-injury, and only one to 10 years post-injury. While most studies documented improvements in HRQL over time since the injury event, study populations had not returned to pre-injury status or reached general population norm HRQL values at post-injury follow-ups. Conclusions: Since 2010 there has been a substantial increase in the number of studies evaluating the HRQL of general injury populations. However, significant variability in study design continues to impede quantification of the impact of injury on population health over time. Variation between studies is particularly evident with respect to timing and number of follow-up assessments, and selection of instruments to evaluate HRQL

Healthcare use and direct medical costs in a cleft lip and palate population:an analysis of observed and protocolized care and costs

This study was performed to describe observed healthcare utilization and medical costs for patients with a cleft, compare these costs to the expected costs based on the treatment protocol, and explore the additional costs of implementing the International Consortium for Health Outcomes Measurement (ICHOM) Standard Set for Cleft Lip and Palate (CL/P). Forty patients with unilateral CL/P between 0 and 24 years of age, treated between 2012 and 2019 at Erasmus University Medical Center, were included. Healthcare services (consultations, diagnostic and surgical procedures) were counted and costs were calculated. Expected costs based on the treatment protocol were calculated by multiplying healthcare products by the product prices. Correspondingly, the additional expected costs after implementing the ICHOM Standard Set (protocol + ICHOM) were calculated. Observed costs were compared with protocol costs, and the additional expected protocol + ICHOM costs were described. The total mean costs were highest in the first year after birth (€5596), mainly due to surgeries. The mean observed total costs (€40,859) for the complete treatment (0–24 years) were 1.6 times the expected protocol costs (€25,198) due to optional, non-protocolized procedures. Hospital admissions including surgery were the main cost drivers, accounting for 42% of observed costs and 70% of expected protocol costs. Implementing the ICHOM Standard Set increased protocol-based costs by 7%.</p

Perceived changes in quality of life in trauma patients:A focus group study

Quality of life (QoL) following a physical trauma is still insufficiently known from a patient perspective. The aim of this study was to qualitatively report perceived changes in QoL after trauma. Focus groups were conducted. Patients admitted to the hospital were eligible for inclusion if they had a lower extremity trauma, severe injuries, or severe traumatic brain injury (TBI). Patients 75 years or older were invited. To analyze the perceived changes in QoL, open coding was used. Patients ( n = 20, M = 55 years) reported comparable consequences. In the first month posttrauma, physical limitations, independency, pain, and anxiety predominated. Later, patients experienced problems with acceptance. The patients’ feelings of the need to have control over their own situation, their own expectations, and a social network were related to QoL. Compared with the other patient groups, TBI patients reported more psychosocial consequences, and elderly patients reported more difficulties in performing (social) activities. Quality of health care was considered an important aspect in the patients’ perceived QoL, and adequate aftercare was missed according to the patients. The impact of a trauma influences QoL in different health domains. Further improving the quality of aftercare may positively influence trauma patients’ perceived QoL. These results indicated that TBI patients and elderly patients deserve specific attention regarding QoL

Palliative care consultation services in hospitals in the Netherlands: The design of the COMPASS study

Background: Patients with an advanced incurable disease are often hospitalised for some time during the last phase of life. Care in hospitals is generally focussed at curing disease and prolonging life and may therefore not in all cases adequately address the needs of such patients. We present the COMPASS study, a study on the effects and costs of consultation teams for palliative care in hospitals. This observational study aims to investigate the use, effects and costs of PCT consultation services for hospitalized patients with incurable cancer in the Netherlands. Methods/design: The study consists of 3 parts: 1. A questionnaire, interviews and a focus group discussion to investigate the characteristics of PCT consultation in 12 hospitals. PCTs will register their activities to calculate the costs of PCT consultation. 2. Cancer patients for whom the attending physician would not be surprised that they would die within 12 month will be included in a medical file search in three hospitals. Medical records will be investigated to compare care, treatment and hospital costs between patients with and patients without PCT consultation. 3. In the other nine hospitals, we will perform a longitudinal study, and compare quality of life between 100 patients for whom a PCT was consulted with 200 patients without PCT consultation. Propensity score matching will be used to adjust for differences between both patient groups. Patients will be followed for three months after inclusion. Quality of life will be assessed with the Palliative Outcome Scale, the EuroQol-5d and the EORTC-QLQ-C15 PAL. Satisfaction with care in the hospital is measured with the IN-PATSAT32. The cost impact of PCT consultation will also be explored. Discussion: This is the first multicenter study on PCT consultation in the Netherlands. The study will give valuable insight in the process, effects and costs of PCT consultation in hospitals. It is anticipated that PCT consultation has a positive effect on patients' quality of life and satisfaction with care and will lead to less hospital care costs