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Introduction: This study presents a global research scenario in the broad domain of osteoarthritis (OA) research, using quantitative and qualitative publication and citation indicators. Methods: The study is based on 45,368 global publications, sourced from the Scopus bibliographical database, covering three decades (1994–2023). We studied the performance of the top 12 developed and top 12 developing countries. The key countries, organizations and authors at national and international levels were identified. The broad subject areas and key journals contributing to global OA research were delineated, besides identifying the broad characteristics of highly cited papers in the field. Results: The United States and China were the most productive countries, while the Netherlands and Canada made the largest citation impact. Harvard Medical School and the University of Sydney made the most contribution, while Boston University and Pfizer Inc., USA registered the highest citation impact. Hunter DJ and Guermazi A were the most productive authors, while Lohmander LS, and Hochberg MC registered the highest citation impact. Osteoarthritis and Cartilage (n = 4879) and Annals of the Rheumatic Diseases (n = 786) published the maximum papers, while Arthritis and Rheumatism and Nature Reviews Rheumatology registered the largest citation impact. The highly cited papers with 100 or more citations constituted 6.25% of the total publications. Conclusions: There has been a systematic growth of publications on OA. The research on OA was mainly done in developed countries, with the maximum publications coming from the United States of America, China and Canada. The most impactful publications on OA were from the Netherlands, Canada and the United States of America. [ABSTRACT FROM AUTHOR]

The number of nuisance and negligence tort claims in the US against “Big Oil” companies have grown significantly in the last five years. The Netherlands case of Milieudefensie et al v Royal Dutch Shell represents the first major success of such a claim internationally. While the US cases and Milieudefensie demonstrate starkly different approaches as to how to seek accountability from Big Oil for climate change harms, the increasing judicial engagement on these issues may mean the time is right for similar lawsuits in Canada. Three Canadian common law causes of action are examined: nuisance, negligence, and unjust enrichment. Defences and arguments which stem from society’s (and any potential plaintiff’s) acquiescence and authorization to allow the defendants’ conduct may present difficult barriers to success. This paper focuses on these types of defences, and argues that the responsibility of Big Oil for climate change harms should not be completely vitiated even if governments and plaintiffs have acquiesced, authorized, and arguably contributed to our climate crisis. [ABSTRACT FROM AUTHOR]

The Internet of Things (IoT) is expanding rapidly and can potentially be a huge data source. This study aimed to close the knowledge gap about possible IoT applications in health care. English-language academic publications from the Web of Science (WoS) were used for the present study. Bibliometric networks were used to analyze pertinent publications to examine the connections between authors, nations, and affiliations. Papers on digital health care have been published in more than 1195 sources, among which the most popular was the Journal of Medical Internet Research. Six top institutions were from the Netherlands, making the Vrije Universiteit Amsterdam the most productive institution after Australia and England. This study provides an overview of IoT-related research conducted in digital health care, helping academic researchers, policymakers, and practitioners to better understand the development of digital health care research. [ABSTRACT FROM AUTHOR]

Introduction: Entrustable professional activities (EPAs), discrete profession‐specific tasks requiring integration of multiple competencies, are increasingly used to help define and inform curricula of specialty training programmes. Although guidelines exist to help guide the developmental process, deciding what logic to use to draft a preliminary EPA framework poses a crucial but often difficult first step. The logic of an EPA framework can be defined as the perspective used by its developers to break down the practice of a profession into units of professional work. This study aimed to map dominant logics and their rationales across postgraduate medical education and fellowship programmes. Methods: A scoping review using systematic searches within five electronic databases (Medline, Embase, Google Scholar, Scopus and Web of Science) was performed. Dominant logics of included papers were identified using inductive coding and iterative analysis. Results: In total, 42 studies were included. Most studies were conducted in the United States (n = 22; 52%), Canada (n = 6; 14%) and the Netherlands (n = 4; 10%). Across the reported range of specialties, family medicine (n = 4; 10%), internal medicine (n = 4; 10%), paediatrics (n = 3; 7%) and psychiatry (n = 3; 7%) were the most common. Three dominant logics could be identified, namely, 'service provision', 'procedures' and/or 'disease or patient categories'. The majority of papers (n = 37; 88%) used two or more logics when developing EPA frameworks (median = 3, range = 1–4). Disease or patient groups and service provision were the most common logics used (39% and 37%, respectively). Conclusions: Most programmes used a combination of logics when trying to capture the essential tasks of a profession in EPAs. For each of the three dominant logics, the authors arrived at a definition and identified benefits, limitations and examples. These findings may potentially inform best practice guidelines for EPA development. This study mapped the 3 dominant logics used in development of EPA‐frameworks. For each, a definition is provided with examples, benefits and limitations. [ABSTRACT FROM AUTHOR]

Introduction: Drug reimbursement decisions are often made based on a price set by the manufacturer. In some cases, this price leads to public and scientific debates about whether its level can be justified in relation to its costs, including those related to research and development (R&D) and manufacturing. Such considerations could enter the decision process in collectively financed health care systems. This paper investigates whether manufacturers' costs in relation to drug prices, or profit margins, are explicitly mentioned and considered by health technology assessment (HTA) organisations. Method: An analysis of reimbursement reports for cancer drugs was performed. All relevant Dutch HTA-reports, published between 2017 and 2019, were selected and matched with HTA-reports from three other jurisdictions (England, Canada, Australia). Information was extracted. Additionally, reimbursement reports for three cases of expensive non-oncolytic orphan drugs prominent in pricing debates in the Netherlands were investigated in depth to examine consideration of profit margins. Results: A total of 66 HTA-reports concerning 15 cancer drugs were included. None of these reports contained information on manufacturer's costs or profit margins. Some reports contained general considerations of the HTA organisation which related prices to manufacturers' costs: six contained a statement on the lack of price setting transparency, one mentioned recouping R&D costs as a potential argument to justify a high price. For the case studies, 21 HTA-reports were selected. One contained a cost-based price justification provided by the manufacturer. None of the other reports contained information on manufacturer's costs or profit margins. Six reports contained a discussion about lack of transparency. Reports from two jurisdictions contained invitations to justify high prices by demonstrating high costs. Conclusion: Despite the attention given to manufacturers' costs in relation to price in public debates and in the literature, this issue does not seem to get explicit systematic consideration in the reimbursement reports of expensive drugs. [ABSTRACT FROM AUTHOR]

This paper demonstrates how a qualitative methodology can be used to gain novel insights into the demands of wheelchair racing and the impact of particular racing chair configurations on optimal sport performance via engagement with expert users (wheelchair racers, coaches, and manufacturers). We specifically explore how expert users understand how wheels, tires, and bearings impact sport performance and how they engage, implement, or reject evidence-based research pertaining to these components. We identify areas where participants perceive there to be an immediate need for more research especially pertaining to the ability to make individualized recommendations for athletes. The findings from this project speak to the value of a qualitative research design for capturing the embodied knowledge of expert users and also make suggestions for "next step" projects pertaining to wheels, tires, and bearings drawn directly from the comments of participants. [ABSTRACT FROM AUTHOR]

Almost 80 million people globally are forcibly displaced. A small number reach wealthy western countries and seek asylum. Over half are children. Wealthy reception countries have increasingly adopted restrictive reception practices including immigration detention. There is an expanding literature on the mental health impacts of immigration detention for adults, but less about children. This scoping review identified 22 studies of children detained by 6 countries (Australia, Canada, Hong Kong, Netherlands, the UK and the US) through searches of Medline, PsychINFO, Emcare, CINAHL and Scopus data bases for the period January 1992–May 2019. The results are presented thematically. There is quantitative data about the mental health of children and parents who are detained and qualitative evidence includes the words and drawings of detained children. The papers are predominantly small cross-sectional studies using mixed methodologies with convenience samples. Despite weaknesses in individual studies the review provides a rich and consistent picture of the experience and impact of immigration detention on children's wellbeing, parental mental health and parenting. Displaced children are exposed to peri-migration trauma and loss compounded by further adversity while held detained. There are high rates of distress, mental disorder, physical health and developmental problems in children aged from infancy to adolescence which persist after resettlement. Restrictive detention is a particularly adverse reception experience and children and parents should not be detained or separated for immigration purposes. The findings have implications for policy and practice. Clinicians and researchers have a role in advocacy for reception polices that support the wellbeing of accompanied and unaccompanied children who seek asylum. [ABSTRACT FROM AUTHOR]

Background: Palliative care is insufficiently integrated in the continuum of care for older people. It is unclear to what extent healthcare policy for older people includes elements of palliative care and thus supports its integration. Aim: (1) To develop a reference framework for identifying palliative care contents in policy documents; (2) to determine inclusion of palliative care in public policy documents on healthcare for older people in 13 rapidly ageing countries. Design: Directed documentary analysis of public policy documents (legislation, policies/strategies, guidelines, white papers) on healthcare for older people. Using existing literature, we developed a reference framework and data extraction form assessing 10 criteria of palliative care inclusion. Country experts identified documents and extracted data. Setting: Austria, Belgium, Canada, Czech Republic, England, Japan, Mexico, Netherlands, New Zealand, Singapore, Slovenia, South Korea, Spain. Results: Of 139 identified documents, 50 met inclusion criteria. The most frequently addressed palliative care elements were coordination and continuity of care (12 countries), communication and care planning, care for family, and ethical and legal aspects (11 countries). Documents in 10 countries explicitly mentioned palliative care, nine addressed symptom management, eight mentioned end-of-life care, and five referred to existing palliative care strategies (out of nine that had them). Conclusions: Health care policies for older people need revising to include reference to end-of-life care and dying and ensure linkage to existing national or regional palliative care strategies. The strong policy focus on care coordination and continuity in policies for older people is an opportunity window for palliative care advocacy. [ABSTRACT FROM AUTHOR]

In response to the numerous challenges resident trainees currently face in their ability to competently acquire the requisite skills, knowledge and attitudes upon graduation, medical educators have looked to a competency-based medical education (CBME) approach as a possible solution. As CBME has already been implemented in many jurisdictions around the world, certain challenges in implementation have been experienced. One important challenge identified relates to how regulatory bodies can either assist or unintentionally hinder implementation. By examining the varied experiences from Canada, the USA and the Netherlands in implementing CBME, this paper identifies how regulatory bodies can support and advance worldwide efforts of furthering its implementation. If regulatory bodies restructure accreditation and regulatory criteria to align with CBME principles, work together in a coordinated fashion to ensure alignment of vital regulatory meaures throughout the training and practice continuum of a physician, and allow for (if not incentivize) individuals and programs to be innovative in adapting CBME to meet their local environments, it is likely that the worldwide implementation of CBME will occur successfully. [ABSTRACT FROM AUTHOR]

Aims: This paper presents updated prevalence estimates of awareness, ever‐use, and current use of nicotine vaping products (NVPs) from 14 International Tobacco Control Policy Evaluation Project (ITC Project) countries that have varying regulations governing NVP sales and marketing. Design, Setting, Participants and Measurements: A cross‐sectional analysis of adult (≥ 18 years) current smokers and ex‐smokers from 14 countries participating in the ITC Project. Data from the most recent survey questionnaire for each country were included, which spanned the period 2013–17. Countries were categorized into four groups based on regulations governing NVP sales and marketing (allowable or not), and level of enforcement (strict or weak where NVPs are not permitted to be sold): (1) most restrictive policies (MRPs), not legal to be sold or marketed with strict enforcement: Australia, Brazil, Uruguay; (2) restrictive policies (RPs), not approved for sale or marketing with weak enforcement: Canada, Malaysia, Mexico, New Zealand; (3) less restrictive policies (LRPs), legal to be sold and marketed with regulations: England, the Netherlands, Republic of Korea, United States; and (4) no regulatory policies (NRPs), Bangladesh, China, Zambia. Countries were also grouped by World Bank Income Classifications. Country‐specific weighted logistic regression models estimated adjusted NVP prevalence estimates for: awareness, ever/current use, and frequency of use (daily versus non‐daily). Findings NVP awareness and use were lowest in NRP countries. Generally, ever‐ and current use of NVPs were lower in MRP countries (ever‐use = 7.1–48.9%; current use = 0.3–3.5%) relative to LRP countries (ever‐use = 38.9–66.6%; current use = 5.5–17.2%) and RP countries (ever‐use = 10.0–62.4%; current use = 1.4–15.5%). NVP use was highest among high‐income countries, followed by upper–middle‐income countries, and then by lower–middle‐income countries. Conclusions: With a few exceptions, awareness and use of nicotine vaping products varied by the strength of national regulations governing nicotine vaping product sales/marketing, and by country income. In countries with no regulatory policies, use rates were very low, suggesting that there was little availability, marketing and/or interest in nicotine vaping products in these countries where smoking populations are predominantly poorer. The higher awareness and use of nicotine vaping products in high income countries with moderately (e.g. Canada, New Zealand) and less (e.g. England, United States) restrictive policies, is likely due to the greater availability and affordability of nicotine vaping products. [ABSTRACT FROM AUTHOR]

Background Patients with cancer have an elevated risk of venous thromboembolism. Importantly, patients with cancer, who have metastatic disease, renal insufficiency, or are receiving anticancer therapy, have an even higher risk of a recurrent event. Similarly, the risk of recurrent venous thromboembolism is higher than the risk of an initial event. To reduce the risk, extended duration of prophylaxis for up to six months with low-molecular-weight heparins such as dalteparin, enoxaparin, nadroparin, and tinzaparin is recommended by international guidelines. In this paper, the clinical and economic literature is reviewed to provide evidenced based recommendations based on clinical benefit and economic value. Methods A systematic review of major databases was conducted from January 1996 to October 2016 for randomized controlled trials evaluating the four distinct low-molecular-weight heparins against a vitamin K antagonists control group for the prevention of recurrent venous thromboembolism in patients with active cancer. This was then followed by the application of the National Institute of Health and Clinical Excellence guidance to assess the quality of all trials that met the inclusion criteria. Finally, the cost-effectiveness literature supporting the value proposition of each product was reviewed. Results Six randomized trials met the inclusion criteria. There were one, two, and three trials that compared dalteparin, tinzaparin, and enoxaparin to a vitamin K antagonists control group. However, there were no trials for nadroparin in the setting of secondary venous thromboembolism prevention. In addition, only the dalteparin and one of the tinzaparin trials were of high quality and adequately powered. Of the two studies, only the dalteparin trial reported a statistically significant benefit in terms of venous thromboembolism absolute risk reduction when compared to a vitamin K antagonists control group (HR = 0.48; p = 0.002). In addition, there was robust pharmacoeconomic data from Canada, the Netherlands, France, and Austria supporting the cost-effectiveness of dalteparin for this indication. There were no such studies for any of the other agents. Conclusions The totality of high-quality clinical and cost-effectiveness data supports the use of dalteparin over other low-molecular-weight heparins for preventing recurrent venous thromboembolism in patients with cancer. [ABSTRACT FROM AUTHOR]

Aims To report a systematic review of the psychometric properties of self-report instruments to identify the symptoms of anxiety in pregnancy to help clinicians and researchers select the most suitable instrument. Background Excessive anxiety in pregnancy is associated with adverse birth outcomes, developmental and behavioural problems in infants and postnatal depression. Despite recommendations for routine psychological assessment in pregnancy, the optimal methods to identify anxiety in pregnancy have not been confirmed. Design Psychometric systematic review. Data sources A systematic literature search of the multiple databases (1990-September 2014). Review methods Identification of self-report instruments to measure anxiety in pregnancy using COSMIN guidelines to assess studies reporting a psychometric evaluation of validity and reliability. Results Thirty-two studies were included. Studies took place in the UK, Australia, Belgium, Canada, Germany, Italy, Scandinavia, Spain and the Netherlands. Seventeen different instruments were identified. Measures of validity were reported in 19 papers and reliability in 16. The overall quality of the papers was rated as fair to excellent using the COSMIN checklist. Only one paper scored excellent in more than one category. Conclusion Many instruments have been adapted for use in different populations to those for which they were designed. The State Trait Anxiety Inventory, Edinburgh Postnatal Depression Scale and the Hospital Anxiety and Depression Scale have been tested more frequently than other instruments, yet require further assessment to confirm their value for use in pregnancy. [ABSTRACT FROM AUTHOR]

Abstract: Given the raised profile that parenting support and education is currently receiving on government family policy agendas in many nations, this paper reviews the ways in which parenting support and education policies are embedded within eight OECD countries. Drawing out the similarities and differences of policy and practice, and comparing the financial support each country affords to parenting support, it assesses the effectiveness of parenting support programmes in relation to national expenditure and links parenting policy to child outcomes. The paper concludes with some recommendations for policy makers and programme developers. The countries reviewed are: The UK, Netherlands, Canada, Ireland, the US, Finland, Australia and New Zealand. [Copyright &y& Elsevier]

To identify the patient classification systems used to classify nursing intensity in the assessment of nursing staffing resources currently used in home health care, with a special emphasis on validity, reliability and staff allocation. Scoping review of internationally published and grey literature, based on a methodological framework by Arksey and O'Malley. Searches of the electronic databases Cinahl, Medline, Embase and SweMed, the websites Google and Google Scholar and hand searches of reference lists occurred. Eligibility criteria included (A) a focus on patient classification systems measuring nursing intensity and workload in home health care and (B) published in English between January 2007 and March 2019. In level one testing two team members screened titles and abstracts, in level two testing two team members determined which papers should undergo a full text review. Data were extracted using structured extraction by one team member and verified by two other members. Thirteen peer-reviewed articles and grey literature documents were identified, from Canada, Ireland, the UK, the USA, Scotland, Turkey and the Netherlands. Four patient classification systems had been tested for both validity and reliability. Validity was tested through face validity, predictive validity, concurrent validity or content validity index. Reliability was tested through stability, internal consistency, observer agreement or inter rater reliability. One patient classification system had been tested only for reliability, through interrater reliability and observer agreement. Two patient classification systems had been evaluated through summative evaluation; one qualitatively through focus group interviews and one through semi-structured interviews. Only one patient classification system had been validity and reliability tested and evaluated. Overall, the patient classification systems in the included papers (13) were considered to have benefits and to be appropriate for the measurement of patients' needs, workload and allocation of staff, although specific information was not always given. Little has been published on validity or reliability tested patient classification systems linked to staffing allocation in home health care in the past decade. Limited research was seen where a patient classification system was considered to be fully operational in home health care. [ABSTRACT FROM AUTHOR]

Objective This paper examines how negative experiences with the health-care system create a lack of confidence in receiving medical care in seven countries: Australia, Canada, Germany, the Netherlands, New Zealand, the United Kingdom, and the United States. Methods The empirical analysis is based on data from the Commonwealth Fund International Health Policy Survey 2007, with nationally representative samples of adults aged 18 and over. For the analysis of the experience of cost barriers and confidence in receiving medical care, we conducted pairwise comparisons of group percentages as well as country-wise multivariate logistic regression models. Results Individuals who have experienced cost barriers show a significantly lower level of confidence in receiving safe and quality medical care than those who have not. This effect is most pronounced in the United States, where people who have foregone necessary treatment because of costs are four times as likely to lack confidence as individuals without the experience of cost barriers (adjusted odds ratio 4.00). In New Zealand, Germany, and Canada, individuals with the experience of cost barriers are twice as likely to report low confidence compared with those without this experience (adjusted odds ratios of 1.95, 2.19 and 2.24, respectively). In the Netherlands and UK, cost barriers are only a marginal phenomenon. Conclusions The fact that the experience of financial barriers considerably lowers confidence indicates that financial incentives, such as private co-payments, have a negative effect on overall public support and therefore on the legitimacy of health-care systems. [ABSTRACT FROM AUTHOR]

Background. To date, there has been no attempt to describe or compare physical therapy as practiced globally, nor any evidence that an international data set exists to support this effort. It is known that research evidence can be used in strategic and tactical ways, especially within the highly politicized context of the policy arena. The International Private Practitioners Association recognized the potential value a global evidence base could have in influencing policy and supporting professional development in a number of countries, yet it lacked a mechanism to achieve these aims. Objectives. The purposes of this study were: (1) to identify and test an international data set, definitions, and means of data collection and (2) to establish views in relation to the value of international collaborations. Design. A mixed, prospective design was used in the study. Method. Phase 1 (2006-2007) involved the development of a data set, definitions, and Web-based and paper-based data collection options involving 98 physical therapists from 68 physical therapy practices in 7 countries. Phase 2 (2008-2009) involved testing of the data set in 34 practices involving 3,195 patient episodes and included physical therapist feedback of experience, local relevance of the data set, and value of international collaborations. Results. Testing confirmed the relevance and reliability of the data set and definitions and a preference for Web-based data collection (74.0%). Physical therapist feedback supported these findings. Most respondents (60.0%-100.0%) reported the value of further international collaborations for their profession nationally or internationally. Limitations. Although a true international collaboration, the limited sample size should be recognized. Conclusions. It is possible to develop an agreed-upon international data set and means of data collection. Testing appears to support its acceptability and relevance for use in practice. Participants highly valued the opportunity to undertake international collaborations that may benefit their profession nationally and internationally. Further testing and use of the data set are advocated before final validation is sought. [ABSTRACT FROM AUTHOR]

Questions of timing, phasing and sequence have been central to recent critiques of science policy-making, which have highlighted sustained disjunctures between the relevance and importance given to different stakeholders at different moments in the policy-making process. In this paper we expand upon this recent 'upstream/downstream' literature through a case study analysis of xenotransplantation (XTP), one of the defining controversies of 1990s UK biotechnology regulation. Drawing on insights from the sociology of expectations we trace the emergence of a UK policy narrative concerning the future of XTP and explore how the policy role became narrowly defined as a process of 'reflex regulation', based upon technologically determinist assumptions and producing extremely short-term decision-making. We draw attention to the concrete costs of this delineation of the policy role and reveal that it is neither inevitable or necessary, by considering contrasts between the policy temporalities of the UK, Canada and the Netherlands. [ABSTRACT FROM AUTHOR]

Recently able-bodied people have taken up wheelchair sports. This paper aims to explore why people are taking up a sport which may be considered to 'belong' to disabled people and explore the impact of reverse integration. A questionnaire covering demographic details, experiences of wheelchair sport and perceptions of both able-bodied and disabled wheelchair athletes was distributed by e-mail via elite wheelchair athletic associations in the UK, Canada, The Netherlands and the USA. Twenty participants were recruited (11 disabled athletes, four female, and nine able-bodied athletes, three female). Able-bodied people initially became involved in wheelchair sports in order to share an activity with their disabled friends or family. Continuing participation was reinforced by friendship, challenge, achievement, the opportunity for good competition, development of the sport and to change society's perceptions of disability. Perceptions varied according to the policies relating to inclusion adopted by the sports governing body within the participants' countries. [ABSTRACT FROM AUTHOR]

Background: There is considerable interest today in shared decision-making (SDM), defined as a decision-making process jointly shared by patients and their health care provider. However, the data show that SDM has not been broadly adopted yet. Consequently, the main goal of this proposal is to bring together the resources and the expertise needed to develop an interdisciplinary and international research team on the implementation of SDM in clinical practice using a theory-based dyadic perspective. Methods: Participants include researchers from Canada, US, UK, and Netherlands, representing medicine, nursing, psychology, community health and epidemiology. In order to develop a collaborative research network that takes advantage of the expertise of the team members, the following research activities are planned: 1) establish networking and on-going communication through internet-based forum, conference calls, and a bi-weekly e-bulletin; 2) hold a two-day workshop with two key experts (one in theoretical underpinnings of behavioral change, and a second in dyadic data analysis), and invite all investigators to present their views on the challenges related to the implementation of SDM in clinical practices; 3) conduct a secondary analyses of existing dyadic datasets to ensure that discussion among team members is grounded in empirical data; 4) build capacity with involvement of graduate students in the workshop and online forum; and 5) elaborate a position paper and an international multi-site study protocol. Discussion: This study protocol aims to inform researchers, educators, and clinicians interested in improving their understanding of effective strategies to implement shared decision-making in clinical practice using a theory-based dyadic perspective. [ABSTRACT FROM AUTHOR]

Objectives: The present paper aims to: (i) describe how the Mental Health Commission in New Zealand works and has contributed to the substantial enhancement of mental health resources and services; (ii) determine whether mental health reform policies will ever be implemented properly without an independent monitor with official influence at the highest levels of government; and (iii) demonstrate how variants on this model work in other Western countries and how it can be adapted to the Federated system in Australia.Conclusions: It is recommended that the Australian National Mental Health Plan 2003-2008 should be complemented by a long-standing national mental health commission (or similarly constituted body), which is also able to report independently from and to the government, with direct access to the Prime Minister, Premiers and Australian Health Ministers. Its aims would be to monitor service effectiveness and identify gaps in service provision, training and performance of the work force, management and government. It would be informed by consumer, carer and provider experience, and by reviews of evidence-based research regarding health needs and cost-effective services. It should accurately cost such service gaps, and advise government on a strategy for implementing them. It could also promote and advise formally on enhancing community awareness, decreasing stigma and discrimination and improving workforce recruitment and retention. [ABSTRACT FROM AUTHOR]

Background: The Alberta Infant Motor Scale (AIMS) has been developed in Canada in the 90ies. The AIMS and its Canadian norms are frequently used across the world to monitor infants' gross motor development. Currently, it is disputed whether the Canadian norms are valid for non-Canadian infants.Aims: To compare scores on the AIMS of Dutch infants with that of the Canadian norms, to compare the sequence of motor milestones in Dutch and Canadian infants, and to establish Dutch AIMS norms.Study Design: Cross-sectional study.Subjects: 1697 infants, aged 2-18 months, representative of the Dutch population (gestational age 39.7 weeks (27-42)).Outcome Measure: AIMS assessments, based on standardized video. Perinatal and social information was obtained by questionnaire and medical records. To create Dutch reference values quantile regression with polynomial splines was used.Results: 1236 Dutch infants (73%) scored below the 50th (P50) percentile of the Canadian norms, 653 (38%) below the P10 and 469 (28%) below the P5. In infants aged 6 to 12 months these values were: 567 infants (81%) < P50, 288 infants (41%) < P10, 201 infants (29%) < P5. The sequence of achievement of motor milestones of Dutch and Canadian infants was similar. Dutch norm-reference values of the AIMS were calculated.Conclusions and Implications: Gross motor development of Dutch infants is considerably slower than that of the Canadian AIMS norms sample. To prevent overdiagnosis of developmental delay and overreferral to paediatric physiotherapy Dutch AIMS norms are required. The paper introduces these norms, including percentile ranks. [ABSTRACT FROM AUTHOR]

Background: Patient safety in primary care is an emerging field of research with a growing evidence base in western countries but little has been explored in the Gulf Cooperation Council Countries (GCC) including the Sultanate of Oman. This study aimed to review the literature on the safety culture and patient safety measures used globally to inform the development of safety culture among health care workers in primary care with a particular focus on the Middle East. Methods: A systematic review of the literature. Searches were undertaken using Medline, EMBASE, CINAHL and Scopus from the year 2000 to 2014. Terms defining safety culture were combined with terms identifying patient safety and primary care. Results: The database searches identified 3072 papers that were screened for inclusion in the review. After the screening and verification, data were extracted from 28 papers that described safety culture in primary care. The global distribution of the articles is as follows: the Netherlands (7), the United States (5), Germany (4), the United Kingdom (1), Australia, Canada and Brazil (two for each country), and with one each from Turkey, Iran, Saudi Arabia and Kuwait. The characteristics of the included studies were grouped under the following themes: safety culture in primary care, incident reporting, safety climate and adverse events. The most common theme from 2011 onwards was the assessment of safety culture in primary care (13 studies, 46%). The most commonly used safety culture assessment tool is the Hospital survey on patient safety culture (HSOPSC) which has been used in developing countries in the Middle East. Conclusions: This systematic review reveals that the most important first step is the assessment of safety culture in primary care which will provide a basic understanding to safety-related perceptions of health care providers. The HSOPSC has been commonly used in Kuwait, Turkey, and Iran. [ABSTRACT FROM AUTHOR]