Studying design and use of healthcare technologies in interaction: the social learning perspective in a Dutch quality improvement collaborative program

Designing technologies is a process that relies on multiple interactions between design and use contexts. These interactions are essential to the development and establishment of technologies. This article seeks to understand the attempts of healthcare organisations to integrate use contexts into the design of healthcare technologies following insights of the theoretical approaches of social learning and user representations. We present a multiple case study of three healthcare technologies involved in improving elderly care practice. These cases were part of a Dutch quality improvement collaborative program, which urged that development of these technologies was not “just” development, but should occur in close collaboration with other parts of the collaborative program, which were more focused on implementation. These cases illustrate different ways to develop technologies in interaction with use contexts and users. Despite the infrastructure of the collaborative program, interactions were not without problems. We conclude by arguing that interactions between design and use are not naturally occurring phenomena, but must be actively organised in order to create effect

Recommendations for the conduct of clinical trials for drugs to treat or prevent sarcopenia

PURPOSE: Sarcopenia is an age-related muscle condition which is frequently a precursor of frailty, mobility disability and premature death. It has a high prevalence in older populations and presents a considerable social and economic burden. Potential treatments are under development but, as yet, no guidelines support regulatory studies for new drugs to manage sarcopenia. The objective of this position paper is therefore to suggest a set of potential endpoints and target population definitions to stimulate debate and progress within the medico-scientific and regulatory communities. METHODS: A multidisciplinary expert working group was hosted by the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis, which reviewed and discussed the recent literature from a perspective of clinical experience and guideline development. Relevant parallels were drawn from the development of definition of osteoporosis as a disease and clinical assessment of pharmaceutical treatments for that indication. RESULTS: A case-finding decision tree is briefly reviewed with a discussion of recent prevalence estimations of different relevant threshold values. The selection criteria for patients in regulatory studies are discussed according to the aims of the investigation (sarcopenia prevention or treatment) and the stage of project development. The possible endpoints of such studies are reviewed and a plea is made for the establishment of a core outcome set to be used in all clinical trials of sarcopenia. CONCLUSIONS: The current lack of guidelines for the assessment of new therapeutic treatments for sarcopenia could potentially hinder the delivery of effective medicines to patients at risk

Use of SMS texts for facilitating access to online alcohol interventions: a feasibility study

A41 Use of SMS texts for facilitating access to online alcohol interventions: a feasibility study In: Addiction Science & Clinical Practice 2017, 12(Suppl 1): A4

Socioeconomic status and breast cancer incidence: a prospective cohort study

Socioeconomic status and breast cancer incidence: a prospective cohort study. Van Loon AJ, Goldbohm RA, Van den Brandt PA. University of Limburg, Department of Epidemiology, Maastricht, The Netherlands. BACKGROUND. To gain more insight into the relation between socioeconomic status (SES) and breast cancer risk, we have studied that association, before and after adjustment for traditional risk factors for breast cancer, in a prospective cohort study on lifestyle and cancer that started in 1986 in the Netherlands amongst 62,573 women aged 55-69 years. METHODS. At baseline, data on SES, diet, reproductive factors and other covariates were collected by means of a self-administered questionnaire. For data-analysis a case-cohort approach was used. After 3.3 years of follow-up, 471 incident cases were available for analysis. RESULTS. We did not find a higher age-adjusted risk of breast cancer for those with a higher level of education (RR highest/lowest level of education = 0.94, 95% confidence interval [CI]: 0.63-1.39, trend-P = 0.15). Although upper white-collar workers had a slightly higher breast cancer risk than blue-collar workers (RR = 1.16, 95% CI: 0.83-1.62, trend-P = 0.34), women with a profession of higher social standing did not have a higher risk (RR highest/lowest social standing = 0.73, 95% CI: 0.24-2.23, trend-P = 0.86). Additional adjustment for traditional risk factors did not alter the association between SES and breast cancer risk. CONCLUSIONS. We did not find an association between SES and breast cancer risk. This is not in agreement with studies conducted in other European countries and North Americ