Acceptance and compliance with external hip protectors: A systematic review of the literature

Hip fractures may be prevented by the use of external hip protectors, but compliance is often poor. Therefore, the objective of this study was to assess the determinants of compliance with hip protectors by systematically reviewing the literature. A literature search was performed in PubMed, Embase and the Cochrane Library. Primary acceptance with hip protectors ranged from 37% to 72% (median 68%); compliance varied between 20% and 92% (median 56%). However, in most studies it was not very clear how compliance was defined (e.g., average wearing time on active days and during waking hours, number of user-days per all available follow-up days, percentage falls with hip protector) and how it was measured. To provide more insight in the compliance percentages, the different methods of defining and measuring compliance were presented for the selected studies, when provided. Because of the heterogeneity in study design of the selected studies and the lack of quantitative data in most studies, results regarding the determinants of compliance could not be statistically pooled. Instead a qualitative summary of the determinants of compliance was given. The reasons most frequently mentioned for not wearing hip protectors, were: not being comfortable (too tight/poor fit); the extra effort (and time) needed to wear the device; urinary incontinence; and physical difficulties/illnesses. In conclusion, compliance is a very complex, but important issue in hip protector research and implementation. Based on the experiences of elderly people who wear the hip protectors, adjustments should be made to the protector and the underwear, while maintaining the force attenuation capacity. Furthermore, methods to improve the compliance should be developed, and their effectiveness tested. (aut.ref.

Factors associated with quality of services for marginalized groups with mental health problems in 14 European countries

This research was financially supported by DG-Sanco (contract: 800197; 2007-2010). The authors would like to thank all of the professionals and services who participated in the PROMO assessment of services. A PhD grant from Fundação para a Ciência e Tecnologia–Portugal (SFRH/BD/66388/2009) to the first author is acknowledged

Barriers to home care for terminally ill Turkish and Moroccan migrants, perceived by GPs and nurses: a survey

BACKGROUND: Previous qualitative research proved that relatives of elderly terminally ill Turkish and Moroccan immigrants experience several barriers to the use of Dutch professional home care. The aim of this study was to explore how general practitioners and home care nurses perceive the home care for terminally ill Turkish and Moroccan migrants and their families in the Netherlands. METHODS: Questionnaires were sent to home care organizations and GPs working in areas where most of these migrants are living. 93 nurses and 78 GPs provided information about their experiences and opinions regarding home care for this group of patients. The data were analyzed by descriptive statistics. RESULTS: GPs refer relatively few patients from these migrant groups to home care. They often find it difficult to assess the needs of these patients and their families. In 40% of the GPs' cases in which terminally ill Turkish and Moroccan migrants were not referred to home care, the GP regretted this afterwards: the patients had not received sufficient qualified care, and their informal carers had often become overburdened. In addition, home care nurses often express dissatisfaction with the home care given to terminally ill Turkish or Moroccan patients, because of communication problems, the patients' lack of knowledge of the disease, or difficulties in making suitable appointments with the patient or with the family. CONCLUSIONS: Nurses and GPs cite chiefly similar factors influencing access to and use of home care as family members did in a previous study. However, according to GPs and nurses, the main barrier to the use of home care concerns communication problems, while relatives cited the preference for family care as the main reason for abstaining from the use of home care. (aut. ref.

Gender differences in health and health care utilisation in various ethnic groups in the Netherlands: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>To determine gender differences in health and health care utilisation within and between various ethnic groups in the Netherlands.</p> <p>Methods</p> <p>Data from the second Dutch National Survey of General Practice (2000–2002) were used. A total of 7,789 persons from the indigenous population and 1,512 persons from the four largest migrant groups in the Netherlands – Morocco, Netherlands Antilles, Turkey and Surinam – aged 18 years and older were interviewed. Self-reported health outcomes studied were general health status and the presence of acute (past 14 days) and chronic conditions (past 12 months). And self-reported utilisation of the following health care services was analysed: having contacted a general practitioner (past 2 months), a medical specialist, physiotherapist or ambulatory mental health service (past 12 months), hospitalisation (past 12 months) and use of medication (past 14 days). Gender differences in these outcomes were examined within and between the ethnic groups, using logistic regression analyses.</p> <p>Results</p> <p>In general, women showed poorer health than men; the largest differences were found for the Turkish respondents, followed by Moroccans, and Surinamese. Furthermore, women from Morocco and the Netherlands Antilles more often contacted a general practitioner than men from these countries. Women from Turkey were more hospitalised than Turkish men. Women from Morocco more often contacted ambulatory mental health care than men from this country, and women with an indigenous background more often used over the counter medication than men with an indigenous background.</p> <p>Conclusion</p> <p>In general the self-reported health of women is worse compared to that of men, although the size of the gender differences may vary according to the particular health outcome and among the ethnic groups. This information might be helpful to develop policy to improve the health status of specific groups according to gender and ethnicity. In addition, in some ethnic groups, and for some types of health care services, the use by women is higher compared to that by men. More research is needed to explain these differences.</p

The use of skin-lightening products among foreign women in the Netherlands: prevalence and side-effects.

Background: The use of skin-lightening products is a common though hazardous practice in many African countries that increased over the last three decades. Components such as hydroquinone, corticoids, and mercury are found in OTC products. A previous study showed that it became a common phenomenon in the Netherlands as well. Aim: The aim of this research was to get to the prevalence figures of the use of those products among women from the main immigrated population groups in the Netherlands, i.e. the Turkish, Moroccan, Surinamese, Indonesian, Antillean, Ghanese and Somali populations. Besides, it was striving to get to the determinants of the use of these products, as well as to the possible side-effects provoked by a long-term use of some of their major components. Methods: For fulfilling this triple goal researchers made use of the data from a previous survey on the Migrant health behaviour in the Netherlands (2001), of which scope was a representative sample of 1400 respondents from the four main represented ethnic groups in the Netherlands. Besides, a more focused questionnaire was submitted to both users and non-users of all groups in order to find out about the social factors influencing the use of skin-lightening products as well as to get to know more about possible diseases caused by those agents. Respondents were approached via local organizations in a systematic, snow-ball method . The approach adopted for the data-analysis was a case-control analysis. Cases and controls were matched on age and ethnicity, and the determinants of use were estimated with a logistic regression analysis. Results:This brought results in terms of a "model-user" whose social and cultural profile was most likely to be matched with the characteristic of using skin-lightening products. Conclusions could also be drawn as to the kinds of products used in the Netherlands, their availability on legal and illegal markets and as to the most common diseases affecting the users of those products. Prevalence figures could also beestimated for all populations. This research helped digging up the evidence of a real health issue of which importance has been underestimated in the past years. (aut. ref.

Methodological problems (validitation).

High utilisation of prescribed drugs among migrant groups living in the Netherlands have been reported in several studies. However, other studies reported that drug utilisation rates among ethnic minorities differ little, or are even lower, than in the indigenous population, especially after adjustment for SES or age. Contradictions between the results of the different studies might be related to the different data sources used in the various studies. Aim of our study was to examine to which extent differences in self reported drugs used between ethnic minorities and indigenous population concord with GP's prescription data. (aut.ref.

Risk factors for back pain incidence in industry: A prospective study

The objective of this study was to examine the relationship between physical and psychological risk factors on the one hand, and the occurrence of new episodes of back pain on the other hand. A prospective study was conducted with 12 months follow-up by means of self-administered questionnaires. The study took place in the Cargo Department of a major Dutch airline company. The subjects for this study were 270 workers involved in heavy physical work. Only workers without back pain at baseline were included. Self-reported back pain and sick leave due to back pain during the follow-up period were measured. Of the 238 workers included in the analysis, 73 (31%) developed a new episode of back pain during the follow-up period, and 27 (11%) subjects reported sick leave due to back pain. Multiple logistic regression analysis showed that the history of back pain was the best predictor for the occurrence of a new episode of back pain during follow-up (OR 9.8; 95% CI 2.8-34.4 for subjects who had back pain more than twice in the past year). Low job satisfaction was also associated with an increased risk for the occurrence of back pain during follow-up (OR 1.2; 95% CI 1.01-1.4). Riding a forklift truck appeared to be a protective factor for the occurrence of back pain (OR 0.7; 95% CI 0.5-0.99). In this study the best predictors for the occurrence of back pain were the history of back complaints and low job satisfaction. Although it needs to be confirmed by future intervention studies, the results indicate that increasing job satisfaction may be a successful (co-)intervention for the prevention of back pain at the workplace. Copyright (C) 1998 International Association for the Study of Pain. Published by Elsevier Science B.V

Corticosteroïdinjecties, fysiotherapie of een afwachtend beleid voor patiënten met een epicondylitis lateralis? Een gerandomiseerd onderzoek in de eerste lijn.

Doel: Vergelijking van de effecten van corticosteroïdinjecties, fysiotherapie en een afwachtend beleid voor een epicondylitis lateralis. Methoden: Patiëntenselectie vond plaats in 65 deelnemende huisartsenpraktijken. De belangrijkste insluitcriteria waren: minimaal 6 weken pijn aan de laterale zijde van de elleboog, leeftijd tussen 18 en 70 jaar en enkelzijdige elleboogklachten. Patiënten werden aselect toegewezen aan behandeling met fysiotherapie (n=64), corticosteroïdinjecties (n=62) of een afwachtend gestandaardiseerd beleid conform de NHG-Standaard Epicondylitis (n=59). Uitkomstmaten waren: ervaren herstel, pijn, functionele beperkingen en knijpkracht. De effecten werden na 3, 6, 12, 26 en 52 weken gemeten. Analyse was volgens het intention-to-treatprincipe. Resultaten: We randomiseerden 185 patiënten. Na 6 weken was 92% van de patiënten die met injectietherapie behandeld waren, hersteld. Dit herstelpercentage was in de fysiotherapiegroep en in de groep met afwachtend beleid lager, namelijk 47% en 32%. Het aantal recidieven in de injectiegroep was hoog. Na 1 jaar waren de herstelpercentages 69% voor injectietherapie, 91% voor fysiotherapie en 83% voor afwachtend beleid. Na 26 en 52 weken waren de verschillen tussen injectietherapie en fysiotherapie aanzienlijk (tussen 15 en 20%) en statistisch significant voor alle uitkomstmaten, ten gunste van fysiotherapie. Er zijn geen statistisch significante verschillen gevonden tussen fysiotherapie en het afwachtend beleid. Beschouwing: Artsen en patiënten dienen goed geïnformeerd te zijn over de voor- en nadelen van de drie interventies, zodat in overleg een weloverwogen beslissing kan worden genomen. Een afwachtend beleid zal voor een groot aantal patiënten een passende behandeling zijn. (aut.ref.