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| 3. |
- Bogaerts, Joep M. A., et al.
(författare)
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Consensus based recommendations for the diagnosis of serous tubal intraepithelial carcinoma: an international Delphi study
- 2023
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Ingår i: Histopathology. - : WILEY. - 0309-0167 .- 1365-2559. ; 83:1, s. 67-79
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Tidskriftsartikel (refereegranskat)abstract
- AimReliably diagnosing or safely excluding serous tubal intraepithelial carcinoma (STIC), a precursor lesion of tubo-ovarian high-grade serous carcinoma (HGSC), is crucial for individual patient care, for better understanding the oncogenesis of HGSC, and for safely investigating novel strategies to prevent tubo-ovarian carcinoma. To optimize STIC diagnosis and increase its reproducibility, we set up a three-round Delphi study. Methods and resultsIn round 1, an international expert panel of 34 gynecologic pathologists, from 11 countries, was assembled to provide input regarding STIC diagnosis, which was used to develop a set of statements. In round 2, the panel rated their level of agreement with those statements on a 9-point Likert scale. In round 3, statements without previous consensus were rated again by the panel while anonymously disclosing the responses of the other panel members. Finally, each expert was asked to approve or disapprove the complete set of consensus statements. The panel indicated their level of agreement with 64 statements. A total of 27 statements (42%) reached consensus after three rounds. These statements reflect the entire diagnostic work-up for pathologists, regarding processing and macroscopy (three statements); microscopy (eight statements); immunohistochemistry (nine statements); interpretation and reporting (four statements); and miscellaneous (three statements). The final set of consensus statements was approved by 85%. ConclusionThis study provides an overview of current clinical practice regarding STIC diagnosis amongst expert gynecopathologists. The experts consensus statements form the basis for a set of recommendations, which may help towards more consistent STIC diagnosis.
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| 4. |
- Bouwman, Eline, et al.
(författare)
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Healthcare professionals' perceived barriers and facilitators of health behavior support provision : A qualitative study
- 2023
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Ingår i: Cancer Medicine. - : Wiley. - 2045-7634. ; 12:6, s. 7414-7426
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Tidskriftsartikel (refereegranskat)abstract
- Background: Childhood cancer survivors (CCSs) have an increased risk of developing chronic health conditions. Evidence suggests that poor health behaviors further increase health risks. Healthcare professionals (HCPs) involved in survivorship care have a key role in providing health behavior support (HBS) but can feel limited in their ability to do so. This study aims to explore European HCPs perceived facilitators and barriers to providing HBS to CCSs. Methods: Five focus groups with 30 HCPs from survivorship care clinics across Europe were conducted. Topic guides were informed by the Theoretical Domains Framework (TDF) to capture domains that may influence provision of HBS. Focus groups were analyzed with thematic analysis. Transcripts were inductively coded, after which axial coding was applied to organize codes into categories. Finally, categories were mapped onto the TDF domains. Results: Nine TDF domains were identified in the data. The most commonly reported TDF domains were “Knowledge”, “Skills”, and “Environmental context and resources”. HCPs indicated that their lack of knowledge of the association between late effects and health behaviors, besides time restrictions, were barriers to HBS. Facilitators for HBS included possession of skills needed to pass on health behavior information, good clinic organization, and an established network of HCPs. Conclusions: This study identified education and training of HCPs as key opportunities to improve HBS. Survivorship care clinics should work towards establishing well-integrated structured care with internal and external networks including HBS being part of routine care. Proper understanding of facilitators and barriers should lead to better survivorship care for CCSs.
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| 5. |
- Bouwman, Eline, et al.
(författare)
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Perceived barriers and facilitators to health behaviors in European childhood cancer survivors : A qualitative PanCareFollowUp study
- 2023
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Ingår i: Cancer Medicine. - 2045-7634. ; 12:11, s. 12749-12764
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Tidskriftsartikel (refereegranskat)abstract
- Background: Healthy behaviors, that is, engaging in regular physical activities, maintaining a healthy diet, limiting alcohol consumption, and avoiding tobacco and drug use, decrease the risk of developing late adverse health conditions in childhood cancer survivors. However, childhood cancer survivors may experience barriers to adopting and maintaining healthy behaviors. This study aimed to assess these barriers and facilitators to health behavior adoption and maintenance in childhood cancer survivors. Methods: A focus group (n = 12) and semi-structured telephone interviews (n = 20) were conducted with a selected sample of European and Dutch childhood cancer survivors, respectively. The Theoretical Domains Framework (TDF) was used to inform the topic guide and analysis. Inductive thematic analysis was applied to identify categories relating to barriers and facilitators of health behavior adoption and maintenance, after which they were deductively mapped onto the TDF. Results: Ten TDF domains were identified in the data of which “Knowledge,” “Beliefs about consequences,” “Environmental context and resources,” and “Social influences” were most commonly reported. Childhood cancer survivors expressed a need for knowledge on the importance of healthy behaviors, possibly provided by healthcare professionals. They indicated physical and long-term benefits of healthy behaviors, available professional support, and a supporting and health-consciously minded work and social environment to be facilitators. Barriers were mostly related to a lack of available time and an unhealthy environment. Lastly, (social) media was perceived as both a barrier and a facilitator to healthy behaviors. Conclusion: This study has identified education and available professional support in health behaviors and the relevance of healthy behaviors for childhood cancer survivors as key opportunities for stimulating health behavior adoption in childhood cancer survivors. Incorporating health behavior support and interventions for this population should therefore be a high priority.
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| 6. |
- in''t Veld, Rianne M. H. A. Huis, et al.
(författare)
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A scenario guideline for designing new teletreatments: a multidisciplinary approach
- 2010
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Ingår i: JOURNAL OF TELEMEDICINE AND TELECARE. - : SAGE Publications. - 1357-633X .- 1758-1109. ; 16:6, s. 302-307
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Tidskriftsartikel (refereegranskat)abstract
- Lack of user acceptance of telemedicine services is an important barrier to deployment and stresses the need for involving users, i.e. medical professionals. However, the involvement of users in the service development process of telemedicine services is difficult because of (a) the knowledge gap between the expertise of medical and technical experts; (b) the language gap, i.e. the use of different terminologies between the medical and the technical professions; and (c) the methodological gap in applying requirement methods to multidisciplinary scientific matters. We have developed a guideline in which the medical and technical domains meet. The guideline can be used to develop a scenario from which requirements can be elicited. In a retrospective analysis of a myofeedback-based teletreatment service, the technically-oriented People-Activities-Context-Technology (PACT) framework and medically-oriented principles of evidence-based medicine were incorporated into a guideline. The guideline was developed to construct the content of a scenario which describes the new teletreatment service. This allows the different stakeholders to come together and develop the service. Our approach provides an arena for different stakeholders to take part in the early stages of the design process. This should increase the chance of user acceptance and thus adoption of the service being developed.
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| 9. |
- Larsman, Pernilla, 1976, et al.
(författare)
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Prognostic factors for intervention effect on neck/shoulder symptom intensity and disability among female computer users
- 2009
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Ingår i: Journal of Occupational Rehabilitation. - : Springer Science and Business Media LLC. - 1053-0487 .- 1573-3688. ; 19:3, s. 300-311
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: It has been suggested that treatments may be more effective when they are matched to patient characteristics. This study aimed at investigating potential prognostic factors for clinically relevant improvement in symptom intensity and symptom-related disability among employees with symptoms in the neck/shoulder area, receiving either ergonomics counseling or such counseling in combination with myofeedback training. Methods: A randomized controlled study was performed among female computer users aged 45 or older (n = 36). A clinical examination and a questionnaire survey were performed before inclusion in the study. Symptom intensity and disability was assessed using questionnaires before the start of the interventions (baseline) and at follow-ups directly after the end of the interventions (T0) and after 3 (T3) and 6 (T6) months. Logistis regression analyses were performed in order to assess prognostic factors for clinically relevant improvement in symptom intensity and disability. Results: Improvement in symptom intensity was consistently predicted by symptom intensity at baseline. Diagnosis and stress-induced lack of muscular rest were prognostic factors for improvement in symptom intensity at short-term follow-up. Baseline disability and passive coping consistently served as prognostic factors for outcome in disability. Few substantial differences were found between the interventions in terms of prognostic factors. Conclusions: Myofeedback training in combination with ergonomics counseling seem to be an especially beneficial tool for secondary prevention among employees with moderate levels of symptom intensity and symptom-related disability, who respond to work-related stress by increased/sustained muscle activation, and who tend to employ passive coping to deal with their neck/shoulder symptoms.
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| 10. |
- Sandsjö, Leif, 1958, et al.
(författare)
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Comparative assessment of study groups of elderly female computer users from four European countries: questionnaires used in the NEW study.
- 2006
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Ingår i: European Journal of Applied Physiology. - : Springer Science and Business Media LLC. - 1439-6319 .- 1439-6327. ; 96, s. 122-126
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Tidskriftsartikel (refereegranskat)abstract
- There is a lack of consistent and comprehensive questionnaire forms for the studies of factors associated with work-related musculoskeletal disorders at the European level. One of the results of the EU-funded project, neuromuscular assessment in the elderly worker (NEW), is a set of questionnaires for the screening of musculoskeletal status and the studies of factors that are believed to affect musculoskeletal health. The questionnaires have been used among elderly women (45+) in different occupations and organisations in Denmark, The Netherlands, Sweden and Switzerland. The aim of this short communication is to present the questionnaires used in the NEW study and to evaluate the appropriateness of pooling data gathered in each participating country into a common database. It is concluded that although differences exist among the study samples, these are not of such a magnitude or pattern that data from the four groups cannot be pooled. The questionnaires are available in Danish, Dutch, English, German and Swedish.
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| 11. |
- Sandsjö, Leif, 1958, et al.
(författare)
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MyoTel – a European initiative addressing neck-shoulder complaints at work combining telemedicine and myofeedback training intervention
- 2007
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Ingår i: Ergonomics for a Future - The 39th Nordic Ergonomics Society Conference, NES2007, 1-3 October, Lysekil, Sweden.
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Konferensbidrag (refereegranskat)abstract
- A recent intervention approach addressing neck-shoulder complaints is myofeedback training based on the Cinderella hypothesis. In a randomized controlled trial (RCT) comparing myofeedback training combined with ergonomic counselling to ergonomic counselling alone, the myofeedback intervention was found to have potential in reducing pain intensity and disability in females with neck-shoulder complaints at their regular workplace. This presentation summarise the results of the RCT study. It also describes a European initiative, MyoTel, assembled to draw on the experiences from the RCT study applying telemedicine techniques to increase the method’s applicability and facilitating its use in occupational health services.
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| 12. |
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| 13. |
- Thorn, Stefan, 1971, et al.
(författare)
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Trapezius muscle rest time during standardised computer work - A comparison of female computer users with and without self-reported neck/shoulder complaints
- 2007
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Ingår i: Journal of Electromyography and Kinesiology. - : Elsevier BV. - 1873-5711 .- 1050-6411. ; 17:4, s. 420-427
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Tidskriftsartikel (refereegranskat)abstract
- Work related musculoskeletal disorders (WMSDs) in the shoulder/neck area are a common and increasing problem among European computer workers, especially women. Long-term low-level workloads with low degree of muscle rest are a potential risk factor for developing WMSDs. The purpose of the present study of female computer users (age 45-65 years) in Denmark and Sweden was to investigate if subjects with self-reported neck/shoulder complaints (cases, N = 35) show less trapezius muscle relative rest time (RRT) than controls (N = 44) when performing standardised short-term computer work tasks in controlled laboratory conditions. Surface electromyography (EMG) signals were recorded bilaterally from the upper trapezius muscles during a type, edit, precision and colour word stress task. Besides RRT, 10th percentile RMS values were calculated. On the average, 15 of the cases and 18 of the controls showed analysable EMG files per task. For the colour word stress task, the results showed lower RRT values and higher 10th percentile RMS amplitude levels among cases compared to controls. No such signs could be found for the other tasks performed. The present results indicate an increased motor response to a psychological stressor among subjects with self-reported neck/shoulder complaints. (c) 2006 Elsevier Ltd. All rights reserved.
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| 14. |
- Van Kalsbeek, Rebecca J., et al.
(författare)
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Evaluating the feasibility, effectiveness and costs of implementing person-centred follow-up care for childhood cancer survivors in four European countries : the PanCareFollowUp Care prospective cohort study protocol
- 2022
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 12:11
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Tidskriftsartikel (refereegranskat)abstract
- Long-term survival after childhood cancer often comes at the expense of late, adverse health conditions. However, survivorship care is frequently not available for adult survivors in Europe. The PanCareFollowUp Consortium therefore developed the PanCareFollowUp Care Intervention, an innovative person-centred survivorship care model based on experiences in the Netherlands. This paper describes the protocol of the prospective cohort study (Care Study) to evaluate the feasibility and the health economic, clinical and patient-reported outcomes of implementing PanCareFollowUp Care as usual care in four European countries. Methods and analysis In this prospective, longitudinal cohort study with at least 6 months of follow-up, 800 childhood cancer survivors will receive the PanCareFollowUp Care Intervention across four study sites in Belgium, Czech Republic, Italy and Sweden, representing different healthcare systems. The PanCareFollowUp Care Intervention will be evaluated according to the Reach, Effectiveness, Adoption, Implementation and Maintenance framework. Clinical and research data are collected through questionnaires, a clinic visit for multiple medical assessments and a follow-up call. The primary outcome is empowerment, assessed with the Health Education Impact Questionnaire. A central data centre will perform quality checks, data cleaning and data validation, and provide support in data analysis. Multilevel models will be used for repeated outcome measures, with subgroup analysis, for example, by study site, attained age, sex or diagnosis. Ethics and dissemination This study will be conducted in accordance with the guidelines of Good Clinical Practice and the Declaration of Helsinki. The study protocol has been reviewed and approved by all relevant ethics committees. The evidence and insights gained by this study will be summarised in a Replication Manual, also including the tools required to implement the PanCareFollowUp Care Intervention in other countries. This Replication Manual will become freely available through PanCare and will be disseminated through policy and press releases. Trial registration number Netherlands Trial Register (NL8918; https://www.trialregister.nl/trial/8918).
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| 15. |
- van Kalsbeek, Rebecca J., et al.
(författare)
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The PanCareFollowUp Care Intervention : A European harmonised approach to person-centred guideline-based survivorship care after childhood, adolescent and young adult cancer
- 2022
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Ingår i: European Journal of Cancer. - : Elsevier BV. - 0959-8049. ; 162, s. 34-44
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Tidskriftsartikel (refereegranskat)abstract
- Background: Long-term follow-up (LTFU) care, although endorsed, is not available for the majority of adult survivors of childhood, adolescence and young adult (CAYA) cancer. Barriers to implementation include lack of time, knowledge, personnel and funding. Sustainable solutions are urgently needed to address the needs of CAYA cancer survivors to improve the quality of life and reduce the burden of late effects on survivors, health care systems and society. The European Union–funded PanCareFollowUp project, initiated by the Pan-European Network for Care of Survivors after Childhood and Adolescent Cancer, was established to facilitate the implementation of person-centred survivorship care across Europe. Patients and methods: The PanCareFollowUp Care Intervention was co-developed with survivors as part of the PanCareFollowUp project. It is a person-centred approach to survivorship care, supported by guidelines and with flexibility to adapt to local health care settings. The Care Intervention consists of three steps: (1) previsit completion of a Survivor Questionnaire (by the survivor) and Treatment Summary (by the health care provider [HCP]), (2) a clinic visit including shared decision-making, and (3) a follow-up call to finalise the individualised Survivorship Care Plan. Results: We developed the key components of the PanCareFollowUp Care Intervention: a PanCareFollowUp Survivor Questionnaire, Treatment Summary template, Survivorship Care Plan template, and educational materials for HCPs and survivors. Wide implementation of the PanCareFollowUp Care Intervention will be supported with a freely distributed Replication Manual on completion of the PanCareFollowUp project. Conclusions: The PanCareFollowUp Care Intervention will support the implementation of person-centred, guideline-based LTFU care in different health care settings across Europe to improve survivors’ health and well-being.
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| 16. |
- Voerman, G, et al.
(författare)
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Changes in cognitive-behavioral factors and muscle activation patterns after interventions for work-related neck-shoulder complaints: Relations with discomfort and disability
- 2007
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Ingår i: Journal of Occupational Rehabilitation. ; 17, s. 593-609
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Knowledge regarding the working mechanism of an intervention is essential for obtaining a better understanding of the intervention and contributes to optimize its outcome. This study aimed at investigating whether changes in cognitive-behavioral factors and muscle activation patterns after myofeedback training and ergonomic counseling were associated with outcome, in subjects with work-related musculoskeletal neck-shoulder complaints. Methods: Seventy-nine symptomatic subjects received either myofeedback with ergonomic counseling (Mfb/EC) or ergonomic counseling alone (EC). Outcome measures discomfort and disability, and process factors catastrophizing, pain control, fear-avoidance beliefs, and muscle activation patterns were assessed at baseline, after the interventions (T0), and at 3 months follow-up (T3). Mixed modeling techniques were used for analysis. Results: Outcome in terms of discomfort and disability was generally comparable between both interventions. Catastrophizing was significantly reduced and fear-avoidance beliefs about work slightly increased after the interventions, but no consistent changes in muscle activation patterns were observed. Changes in discomfort were especially associated with changes in catastrophizing at T0 and T3, but R2 was low (\0.14). Reduced catastrophizing at T0 and T3, and also reduced fear-avoidance beliefs about work at T3, were related to reduced disability (R2 between 0.30 and 0.40). No differences between the two intervention groups were observed. Conclusions: Intervention effects were generally non-specific and findings suggested that cognitive-behavioral factors underlie the outcome of these interventions rather than changes in muscle activation patterns. Emphasizing these factors during therapy may increase the beneficial outcome of occupational interventions.
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| 17. |
- Voerman, G. E., et al.
(författare)
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Effects of ambulant myofeedback training and ergonomic counselling in female computer workers with work-related neck-shoulder complaints: A randomized controlled trial
- 2007
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Ingår i: Journal of Occupational Rehabilitation. - : Springer Science and Business Media LLC. - 1053-0487 .- 1573-3688. ; 17:1, s. 137-152
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate the effects of ambulant myofeedback training including ergonomic counselling (Mfb) and ergonomic counselling alone (EC), on work-related neck-shoulder pain and disability. Methods: Seventy-nine female computer workers reporting neck-shoulder complaints were randomly assigned to Mfb or EC and received four weeks of intervention. Pain intensity in neck, shoulders, and upper back, and pain disability, were measured at baseline, immediately after intervention, and at three and six months follow-up. Results: Pain intensity and disability had significantly decreased immediately after four weeks Mfb or EC, and the effects remained at follow up. No differences were observed between the Mfb and EC group for outcome and subjects in both intervention groups showed comparable chances for improvement in pain intensity and disability. Conclusions: Pain intensity and disability significantly reduced after both interventions and this effect remained at follow-up. No differences were observed between the two intervention groups.
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| 18. |
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| 19. |
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| 20. |
- Voerman, G, et al.
(författare)
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Prognostic factors for the effects of two interventions for work-related neck-shoulder complaints: myofeedback training and ergonomic councelling
- 2008
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Ingår i: Applied Ergonomics. - : Elsevier BV. - 0003-6870 .- 1872-9126. ; 39:6, s. 743-753
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To explore prognostic factors for the effects of two interventions (myofeedback training in combination with ergonomic counselling (Mfb/EC) and ergonomic counselling alone (EC)) on discomfort and disability in work-related neck-shoulder complaints. Methods: Thirty-six females completed the interventions. Discomfort and disability were assessed at baseline, immediately after the intervention, and at 3-month follow-up. Potential sociodemographic and psychological prognostic factors were assessed using questionnaires. Data were analysed using multiple regression and general linear modelling. Results: Changes in discomfort were best predicted by baseline discomfort levels. Changes in disability were predicted by baseline disability levels, patient profile, and coping strategy 'ignoring sensations'. A significant difference between the Mfb/EC and EC group was found for coping strategy 'ignoring sensations', which appeared to be a predictor for changes in disability at 3-month follow-up in the Mfb/EC group only. Conclusions: Subjects with high levels of initial discomfort and disability and specific psychological patient profiles benefit most from interventions. Myofeedback training contributes a specific quality to those who ignore pain sensations. © 2007 Elsevier Ltd. All rights reserved.
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| 22. |
- Vollenbroek-Hutten, M., et al.
(författare)
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Are changes in pain induced by myofeedback training related to changes in muscle activation patterns in patients with work-related myalgia?
- 2006
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Ingår i: European Journal of Applied Physiology. - : Springer Science and Business Media LLC. - 1439-6319 .- 1439-6327. ; 96:2, s. 209-215
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this explorative study was to investigate to what extent changes in perceived pain, induced by myofeedback training, are correlated to changes in muscle activation patterns. Thirty subjects with work-related myalgia received myofeedback training. Before (T0), directly after (T1) and 4 weeks or, in a subset of patients, 3 months after (T2) this training, surface electromyography (sEMG) measurements of the upper trapezius muscle were performed during standardized computer tasks; a typing and a stress task. Besides this, visual analogue scales (VAS) were filled in to assess the levels of pain in the neck and shoulders. From the sEMG, root mean square (RMS) and relative rest time (RRT, i.e. the percentage of time RMS is below a certain threshold) were used for data analysis. The relationships between RRT, RMS and VAS at T0 as well as for the changes between T1-T0 and T2- T0 were investigated using Spearman correlation coefficients. The results revealed no significant correlations between VAS and RMS both at baseline (range R = -0.22 to 0.17) and for the observed changes (range R = -0.33 to 0.32). Also, for VAS and RRT, low correlations were found for baseline (range R = -0.27 to 0.21) and for changes between T1-T0 (range R = -0.02 to 0.38). However, for the changes between T2-T0, correlation coefficients for the VAS for the shoulder and the RRT of the right trapezius during both the typing and stress tasks were significant at the P = 0.05 level, whereas the correlation coefficients for the VAS for the neck and both the left and right trapezii during the stress task approached significance (P = 0.05 and P = 0.1, respectively). These results suggest that decreases in pain observed at long term follow up after myofeedback training might occur as a result of an increased ability to relax but not as a result of decreased muscle activation level. However, the largest correlation found was 0.6. This means that the maximal explained variance (R2) is low (36%), and that there are also other processes than the changes in muscle activation that contribute to changes in perceived pain.
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