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Purpose: Head and neck cancer (HNC) treatment often leads to physical and psychosocial impairments. Rehabilitation can overcome these limitations and improve quality of life. The aim of this study is to obtain an overview of rehabilitation care for HNC, and to investigate factors influencing rehabilitation provision, in Dutch HNC centers, and to some extent compare it to other countries. Methods: An online survey, covering five themes: organizational structure; rehabilitation interventions; financing; barriers and facilitators; satisfaction and future improvements, among HNC healthcare- and financial professionals of Dutch HNC centers. Results: Most centers (86%) applied some type of rehabilitation care, with variations in organizational structure. A speech language therapist, physiotherapist and dietitian were available in all centers, but other rehabilitation healthcare professionals in less than 60%. Facilitators for providing rehabilitation services included availability of a contact person, and positive attitude, motivation, and expertise of healthcare professionals. Barriers were lack of reimbursement, and patient related barriers including comorbidity, travel (time), low health literacy, limited financial capacity, and poor motivation. Conclusion: Although all HNC centers included offer rehabilitation services, there is substantial practice variation, both nationally and internationally. Factors influencing rehabilitation are related to the motivation and expertise of the treatment team, but also to reimbursement aspects and patient related factors. More research is needed to investigate the extent to which practice variation impacts individual patient outcomes and how to integrate HNC rehabilitation into routine clinical pathways. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the present study was to investigate the effectiveness of a novel approach involving permissive weight bearing (PWB) in surgically treated trauma patients with peri- and intra-articular fractures of the lower extremities. Methods: Prospective comparative multicenter cohort study in one level 1 trauma center and five level 2 trauma centers. Surgically treated trauma patients with peri- and intra-articular fractures of the lower extremities were included. Permissive weight bearing (PWB) in comparison to restricted weight bearing (RWB) was assessed over a 26-week post-surgery follow-up period. Patients' self-perceived outcome levels regarding activities of daily living (ADL), quality of life (QoL), pain and weight bearing compliance were used. Results: This study included 106 trauma patients (N = 53 in both the PWB and RWB groups). Significantly better ADL and QoL were found in the PWB group compared to the RWB group at 2-, 6-, 12- and 26-weeks post-surgery. There were no significant differences in postoperative complication rates between the PWB and RWB groups. Conclusion: PWB is effective and is associated with a significantly reduced time to full weight bearing, and a significantly better outcome regarding ADL and QoL compared to patients who followed RWB regimen. Moreover, no significant differences in complication rates were found between the PWB and RWB groups. Level of evidence: Level II. Registration: This study is registered in the Dutch Trial Register (NTR6077). Date of registration: 01-09-2016. [ABSTRACT FROM AUTHOR]

Purpose: The current rehabilitation for patients with surgically treated displaced intra-articular calcaneal fractures (DIACFs) consists of non-weightbearing for 8–12 weeks. The purpose of the present survey was to investigate the current pre-, peri- and post-operative practices among Dutch foot and ankle surgeons. Moreover, it aims to analyze whether surgeons comply to the Arbeitsgemeinschaft für Osteosynthesefragen (AO) guidelines and which decision criteria were used in the determination of the start of weightbearing. Methods: A survey was distributed among Dutch trauma and orthopaedic surgeons to determine the most common practices in postoperative weightbearing in patients with DIACFs. Results: 75 surgeons responded to the survey. 33% of the respondents adhered to the AO guidelines. 4% of the respondents strictly followed non-weightbearing guidelines, while 96% interpret the AO guidelines or their local protocol freely, in any frequency. When respondents tended to deviate from the AO guidelines or local protocol, a good patients' compliance to therapy was expected. 83% of the respondents started weightbearing on the fracture, based on reported patient complaints. 87% of the respondents did not see any relation between early weightbearing and the occurrence of complications, including loosening of osteosynthesis materials. Conclusion: This study demonstrates that there is limited consensus on the rehabilitation for DIACFs. Moreover, it shows that most surgeons are inclined to interpret the current (AO) guideline or their own local protocol freely. New guidelines, supported with well-founded literature, could help surgeons in a more appropriate daily practice in weightbearing for the rehabilitation of calcaneal fractures. [ABSTRACT FROM AUTHOR]

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Objective: Compared to normally-hearing employees, those with hearing loss suffer from higher Need For Recovery (NFR) after work. The aims of this study are to assess the NFR of employees with hearing loss before and after aural rehabilitation and to examine to what extent change in the NFR can be explained by changes in subjective listening effort, personal adjustments, communication strategies, auditory work demands, and self-reported hearing ability. Methods: We included patients who received aural rehabilitation in two audiological centers in the Netherlands because of hearing complaints in their work situation. Outcomes were measured by questionnaires at baseline and 3 month follow-up. The NFR before and after the rehabilitation was compared with a t test. Hierarchical multiple analyses were performed. Results: In total, 60 patients (aged 22–63, working hours ≥8 per week) participated in the study, of which 50 completed the follow-up questionnaires. The NFR was significantly lower after the aural rehabilitation (M = 45.03) compared to before the aural rehabilitation (M = 51.89), t = −3.43, p < 0.01). Change in NFR could best be explained by the change in personal adjustments (R2 = 0.45, B = −1.23, p < 0.01). Conclusion: The NFR of employees with hearing loss can be improved by aural rehabilitation, but this study shows that current practices reduce the NFR only in part of the employees. Therefore, improving current practices should be considered and evaluated, for example by applying a different combination of rehabilitation components. Especially, interventions that affect personal adjustments may be promising to further reduce the NFR in employees with hearing loss. [ABSTRACT FROM AUTHOR]

Rehabilitation programs have an important place in the treatment of ankylosing spondylitis (AS), but there is no comprehensive bibliometric research that assesses publications on AS rehabilitation in a holistic way. The aim of this study was to investigate the quantity and quality of articles related to AS rehabilitation and to reveal the features of global productivity in this topic. This bibliometric study was conducted utilizing the Web of Science (WoS) database with the keywords 'ankylosing spondylitis rehabilitation', 'ankylosing spondylitis exercise', 'ankylosing spondylitis physical therapy' and 'ankylosing spondylitis physiotherapy'. The number of articles, citations, and main active countries were determined and trend analyses were performed. A total of 792 articles were reviewed. The articles originated from 51 different countries, 22 of which met the main active country criteria. A significant increase trend was detected in the number of articles between 2000 and 2019 (p < 0.001). The five most productive countries were Germany (n = 111; 14.02%), Turkey (n = 98; 12.37%), the United States (n = 71; 8.96%), the United Kingdom (n = 53; 6.69%) and the Netherlands (n = 53; 6.69%). The highest values in number of articles per million population were calculated in Norway, the Netherlands and Austria, respectively. In the analysis according to GDP, Norway, the Netherlands and Turkey were ranked as the first three. The top three countries for the average citation count were France, Netherlands and Germany. This bibliometric study can be considered as an assessment and summary of worldwide scientific production on AS rehabilitation. The data demonstrate an increasing trend in research productivity since 2000. European countries were seen to be at the forefront both quantitatively and qualitatively in this area. [ABSTRACT FROM AUTHOR]

The Wadden Sea is a busy environment in which multiple species share a limited space. Humans use the area for recreation and economic purposes, while it also represents an ecologically valuable space as one of the largest intertidal areas in the world. Sharing the Wadden Sea with multiple species is recognized as a challenge by a seal rehabilitation center in the Netherlands, who cares for seals and their habitat, the Wadden Sea. To diminish harmful effects of human-seal interactions, the seal rehabilitation center educates their visitors to care for the Wadden Sea through at least three different educational practices (seal releases, beach cleanups, and through an exhibition at the visitor center). By taking a relational perspective to analyze these educational moments, it becomes apparent that different "natures" are brought into being. That is, by creating different experiences in multiple circumstances, relations between what is experienced or enacted as being part of the Wadden Sea environment changes. An important focus in this article is the diverse positions humans take up in relation to the Wadden Sea as they are encouraged to care for it and the seals. Instead of taking a human and nature distinction as a starting point, I will show that these educational practices produce fluid and dynamic relations between "humans" and "nature," enabling multiple engagements with the sea and those who inhabit it. [ABSTRACT FROM AUTHOR]