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Gendered life-course trajectories of childcare and informal care in the Netherlands
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318439.pdf (Publisher’s version ) (Open Access)Unpaid caregiving remains highly gendered both in the context of childcare for young children and informal care provided to ill or ageing family members, friends, or neighbors. Using a life-course framework, this study expands previous research which generally treated these care types as separate life domains, by exploring the variety in caregiving trajectories including both childcare and informal care as integral parts of life courses. In addition to identifying and describing clusters of caregiving trajectories, we examine to what extent these are stratified by gender and education. We use unique retrospective survey data on informal caregiving combined with longitudinal data on childrearing, collected by the LISS Panel in the Netherlands (N = 1631). Using sequence and cluster analysis, we created caregiving trajectories covering up to 50 years of individual life courses and identified six clusters of caregiving trajectories that differed in care-heaviness, based on different combinations of the timing, duration, order, and intensity of care episodes. Our findings indicate path-dependency in care patterns, whereby most individuals who have engaged in unpaid care, provided both childcare and informal care at various points throughout their lives. In addition, while patterns of caregiving over the life course did not differ by gender, women were overrepresented in care-heavier clusters while men were more likely to follow the least care-heavy clusters. Theoretical expectations predicting educational differences based on opportunity costs and normative pressure were not supported. Given the anticipated rise in informal care due to population ageing and welfare state retrenchment, our findings suggest that while both women and men will be increasingly confronted with balancing unpaid care with other commitments, the gender gap in care-heaviness might persist and even widen.24 p
Hormonal biomarkers remain prognostically relevant within the molecular subgroups in endometrial cancer
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312972.pdf (Publisher’s version ) (Open Access
Intrinsically Correct Sorting in Cubical Agda
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316735.pdf (Publisher’s version ) (Open Access)CPP '2
Preface to special issue: EXPRESS/SOS 2019 and EXPRESS/SOS 2020
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316738.pdf (Publisher’s version ) (Open Access
Cast-OFF 2: One Week Versus 3-5 Weeks of Plaster Cast Immobilization for Non- or Minimally Displaced Distal Radius Fractures-A Stepped Wedge Cluster Randomized Controlled Trial.
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315969.pdf (Publisher’s version ) (Open Access)OBJECTIVES: Implementation of 1 week of cast immobilization followed by gradually increasing wrist mobilization for non- or minimally displaced distal radius fracture (DRF) and comparison of the functional outcomes and pain scores with the usual care (3-5 weeks of cast immobilization). DESIGN: A randomized stepped wedge cluster design, prospective cohort. SETTING: Academic and peripheral hospitals in levels 1, 2, and 3 trauma centers. PATIENT SELECTION CRITERIA: All patients between 18 and 85 years old with an isolated non- or minimally and nonreduced DRF were eligible for inclusion. Participating hospitals were randomized to transition from usual care (3-5 weeks of cast immobilization) to 1 week of cast immobilization, following the stepped wedge design. OUTCOME MEASURES AND COMPARISONS: Patient characteristics, secondary dislocation, surgical treatment, visual analog scale, Patient Rated Wrist Evaluation (PRWE), Patient Reported Outcomes Measurement Information System Pain Interference, Pain Catastrophizing Scale 4, and patient satisfaction were compared between control and intervention group at weeks 1, 3-5, 6, months 3, 6, and 12. A difference around 11 points on the PRWE scale was considered clinically significant. RESULTS: Four hundred two patients were included (control n = 197 vs. intervention n = 205, 267/135, female/male). There were no differences in age (53.7 ± 18.6 vs. 53.3 ± 19.5, P = 0.27), sex (66% vs. 67% female, P = 0.44), dominant hand fractured (44% vs. 53%, P = 0.39), and type of fracture (39% vs. 41% extra-articular, P = 0.44). After 6 weeks, the PRWE score showed no clinically significant differences (-4.5 [confidence interval -12.9 to 4.02], P = 0.30). No significant differences were observed for function, pain scores, and patient satisfaction between groups (all P > 0.05). Furthermore, there was no significant difference in secondary dislocation rate (control 1.5% vs. intervention 1.0%, P = 0.32) and operation rate (control 1.5% vs. 1.5% intervention, P = 0.92). CONCLUSIONS: This study compared 1 week of cast immobilization followed by gradually increasing wrist mobilization to the usual care of 3-5 weeks for nonreduced DRF. No clinically significant differences in function, pain scores, patient satisfaction, secondary dislocation, and operations were observed. Therefore, 1 week of plaster immobilization can be safely recommended for the non- or minimally displaced and nonreduced DRF treatment. LEVEL OF EVIDENCE: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence
Towards a Quantum Theory
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314397.pdf (Publisher’s version ) (Open Access
Quality of Life Among Patients With Locally Advanced Pancreatic Cancer: A Prospective Nationwide Multicenter Study.
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317616.pdf (Publisher’s version ) (Open Access)BACKGROUND: Health care providers of patients with cancer should discuss the impact of treatment, such as multiagent chemotherapy and surgery, on quality of life (QoL). However, in the era of shared decision-making, data on QoL in locally advanced pancreatic cancer (LAPC) remain scarce. METHODS: We performed a prospective multicenter study involving patients with LAPC across 13 Dutch centers. These patients were included in both the LAPC registry and the Dutch Pancreatic Cancer Project (PACAP; ClinicalTrials.gov identifier: NCT03513705). The study evaluated QoL over time and assessed the impact of treatment. The primary outcome was global health status (GHS) based on the EORTC Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30). Secondary outcomes included functioning and symptom scores from the EORTC QLQ-C30 and the EORTC QLQ Pancreatic Cancer Module (QLQ-PAN26). Outcomes were measured at diagnosis and at 3-month intervals up to 12 months. Outcomes were compared over time and between groups, with both statistical and clinical significance (Δ ≥10 points) evaluated. RESULTS: A total of 170 patients completed at least one QoL-questionnaire. Most patients (n=152; 89%) received tumor-directed treatment, including 116 (68%) who received chemotherapy (± radiotherapy) alone and 36 (21%) who underwent chemotherapy (± radiotherapy) followed by resection; 18 (11%) patients received best supportive care (BSC). At baseline, GHS was highest among patients who received chemotherapy + resection (mean [SD], 70 [16]) compared with those receiving chemotherapy alone (mean [SD], 64 [20]) and BSC (mean [SD], 48 [21]) (P=.001). The overall mean [SD] GHS at baseline was 63 [20] and remained stable over time (P=.27), including in patients receiving tumor-directed treatment (P=.57). One-third of the QoL subscales (9/28) showed statistically and clinically significant changes over time. Improvements were observed in appetite loss, pancreatic pain, and hepatic symptoms, although patients reported increased diarrhea, flatulence, altered bowel habits, and financial difficulties. Over time, patients reported reduced fear of future health, but a decline in health care satisfaction. CONCLUSIONS: This multicenter study demonstrated that general QoL remained stable during the first year in patients with LAPC, 89% of whom received tumor-directed treatment. Certain symptoms worsened and deserve greater attention from health care providers. These findings can guide shared decision-making and improve symptom management
Towards better outcomes of revision total knee arthroplasty
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317869.pdf (Publisher’s version ) (Open Access)Radboud University, 16 april 2025Promotor : Schreurs, B.W. Co-promotores : Hannink, G.J., Smulders, K.196 p
The association between maternal immune activation and brain structure and function in human offspring: a systematic review
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318116.pdf (Publisher’s version ) (Open Access)Maternal immune activation (MIA) during pregnancy, as a result of infectious or inflammatory stimuli, has gained increasing attention for its potential role in adverse child neurodevelopment, with studies focusing on associations in children born preterm. This systematic review summarizes research on the link between several types of prenatal MIA and subsequent child structural and/or functional brain development outcomes. We identified 111 neuroimaging studies in five MIA areas: inflammatory biomarkers (n = 13), chorioamnionitis (n = 18), other types of infections (n = 18), human immunodeficiency virus (HIV) (n = 42), and Zika virus (n = 20). Overall, there was large heterogeneity in the type of MIA exposure examined and in study methodology. Most studies had a prospective single cohort design and mainly focused on potential effects on the brain up to one year after birth. The median sample size was 53 participants. Severe infections, i.e., HIV and Zika virus, were associated with various types of cerebral lesions (e.g., microcephaly, atrophy, or periventricular leukomalacia) that were consistently identified across studies. For less severe infections and chronic inflammation, findings were generally inconsistent and mostly included deviations in white matter structure/function. Current findings have been mainly observed in the infants' brain, presenting an opportunity for future studies to investigate whether these associations persist throughout development. Additionally, the inconsistent findings, encompassing both regions of interest and null results, call into question whether prenatal exposure to less severe infections and chronic inflammation exerts a small effect or no effect on child brain development
A commentary on Choudhury and Maupin (2025): Revisiting the downsides of shared leadership from a multilevel and resource-oriented perspective
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319310.pdf (Publisher’s version ) (Open Access)21 april 20257 p