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Purpose: Pelvic fractures in older adults are a major public health problem and socioeconomic burden. The standard of care has changed over the past years, and there is limited consensus on which patients benefit from surgical fixation. There is currently no nationwide treatment protocol to guide the decision-making process. Therefore, the aim of this survey was to provide more insight into if, when, and why patients with a fragility fracture of the pelvis (FFPs) would be considered for additional imaging and surgical fixation by treating physicians. Methods: An online clinical vignette-based survey of hypothetical scenarios was sent out to all orthopedic and trauma surgeons in the Netherlands. The questionnaire comprised multiple-choice questions and radiographic images. Differences between subgroups were calculated using the X2 test or the Fisher exact test. Results: 169 surgeons responded to the survey, with varying levels of experience and working in different types of hospitals. In a patient with a simple pubic ramus fracture and ASA 2 or ASA 4, 32% and 18% of the respondents would always advise a CT scan for further analysis. In the same patients, 11% and 31% of the respondents would not advise a CT scan, respectively. When presented with three cases of increasing severity of co-morbidity (ASA) and/or increasing age and/or different clinical presentation of an FFP type 3c on a CT scan, an increasing number of respondents would not consider surgical fixation. There was significant variation in practice patterns between the respondents who do not work in a hospital performing pelvic and acetabular (P&A) fracture surgery and those who do work in a P&A referral hospital. Most respondents (77%) refer patients 1–5 times a year to an expert center for surgical fixation. Conclusion: There is currently a wide variety of clinical practices regarding the imaging and management of FFPs, which seems to be influenced by the type of hospital the patients are presented to. A regional or national evidence-based treatment protocol should be implemented to ensure a more uniform approach. [ABSTRACT FROM AUTHOR]

Background: Little is known about how conspiracy beliefs and health responses are interrelated over time during the course of the coronavirus disease 2019 (Covid-19) pandemic. This longitudinal study tested two contrasting, but not mutually exclusive, hypotheses through cross-lagged modeling. First, based on the consequential nature of conspiracy beliefs, we hypothesize that conspiracy beliefs predict an increase in detrimental health responses over time. Second, as people may rationalize their behavior through conspiracy beliefs, we hypothesize that detrimental health responses predict increased conspiracy beliefs over time. Methods: We measured conspiracy beliefs and several health-related responses (i.e. physical distancing, support for lockdown policy, and the perception of the coronavirus as dangerous) at three phases of the pandemic in the Netherlands (N = 4913): During the first lockdown (Wave 1: April 2020), after the first lockdown (Wave 2: June 2020), and during the second lockdown (Wave 3: December 2020). Results: For physical distancing and perceived danger, the overall cross-lagged effects supported both hypotheses, although the standardized effects were larger for the effects of conspiracy beliefs on these health responses than vice versa. The within-person change results only supported an effect of conspiracy beliefs on these health responses, depending on the phase of the pandemic. Furthermore, an overall cross-lagged effect of conspiracy beliefs on reduced support for lockdown policy emerged from Wave 2 to 3. Conclusions: The results provide stronger support for the hypothesis that conspiracy beliefs predict health responses over time than for the hypothesis that health responses predict conspiracy beliefs over time. [ABSTRACT FROM AUTHOR]

Simple Summary: Pain associated with cancer diagnoses is a serious concern and one of the most common symptoms reported by cancer patients. The insufficient relief of cancer pain can have a major impact on patients' quality of life. Recent developments in oncology such as new pain management guidelines, drugs and treatment strategies may have had a positive effect on the prevalence and severity of pain. Therefore, the aim of this systematic literature review was to assess the prevalence of pain and pain severity in cancer patients throughout all phases of treatment in the 2014–2021 literature period. Our results show a decline in both the prevalence and severity of cancer pain, compared to previous research. Nevertheless, with 44.5% of cancer patients still experiencing pain, the prevalence remains high, emphasizing the need for ongoing attention regarding the management of cancer pain. Experiencing pain and insufficient relief can be devastating and negatively affect a patient's quality of life. Developments in oncology such as new treatments and adjusted pain management guidelines may have influenced the prevalence of cancer pain and severity in patients. This review aims to provide an overview of the prevalence and severity of pain in cancer patients in the 2014–2021 literature period. A systematic literature search was performed using the databases PubMed, Embase, CINAHL, and Cochrane. Titles and abstracts were screened, and full texts were evaluated and assessed on methodological quality. A meta-analysis was performed on the pooled prevalence and severity rates. A meta-regression analysis was used to explore differences between treatment groups. We identified 10,637 studies, of which 444 studies were included. The overall prevalence of pain was 44.5%. Moderate to severe pain was experienced by 30.6% of the patients, a lower proportion compared to previous research. Pain experienced by cancer survivors was significantly lower compared to most treatment groups. Our results imply that both the prevalence of pain and pain severity declined in the past decade. Increased attention to the assessment and management of pain might have fostered the decline in the prevalence and severity of pain. [ABSTRACT FROM AUTHOR]

This paper examines discrimination against job candidates of Moroccan origin in Spain and the Netherlands. By drawing on insights from group threat theory, we specifically examine how latent ethnic conflicts regarding economic goods or cultural values at the regional level affect discrimination rates of Moroccan minorities in both countries. To this aim, we make use of a cross-nationally standardised field experiment with fictitious candidates applying for real job vacancies in Spain and the Netherlands (n = 3681). We find higher levels of discrimination against job applicants of Moroccan origin in the Netherlands. Whereas job candidates of Moroccan origin are six percentage points less likely to receive a positive response from an employer in Spain, the predicted ethnic gap in call-back rates is fourteen percentage points in the Netherlands. Furthermore, while regional differences in discrimination are not related to regional unemployment figures, we do find some evidence that in the Netherlands a larger share of Moroccans in the region exacerbates discrimination against Moroccan minorities. Altogether, the findings point to the need to give greater weight to the impact of widespread negative beliefs about ethnic minorities and how these beliefs can have a profound adverse impact on the integration of disadvantaged ethnic groups within the labour market. [ABSTRACT FROM AUTHOR]

Introduction: Pelvic fractures can have long-term consequences for health-related quality of life (HRQoL). The main purpose of this study is to provide insight into short-term HRQoL in the first year after pelvic injury and to identify short-term prognostic factors of decreased outcome. Methods: This is a prospective, observational, multicenter, follow-up cohort study in which HRQoL and functional outcomes were assessed during 12-month follow-up of injured adult patients admitted to 1 of 10 hospitals in the county of Noord-Brabant, the Netherlands. The data were collected by self-reported questionnaires at 1 week (including preinjury assessment) and 1, 3, 6 and 12 months after injury. The EuroQoL-5D (EQ-5D), visual analog scale (VAS), Merle d'Aubigné Hip Score (MAHS) and Majeed Pelvic Score (MPS) were used. Multivariable mixed models were used to examine the course of the HRQoL and the prognostic factors for decreased HRQoL and functional outcomes over time. Results: A total of 184 patients with pelvic fractures were identified between September 2015–September 2016; the fractures included 71 Tile A, 44 Tile B and 10 Tile C fractures and 59 acetabular fractures. At the pre-injury, 1 week, and 1, 3, 6 and 12 months after injury time points, the mean EQ-5D Index values were 0.90, 0.26, 0.45, 0.66, 0.77 and 0.80, respectively, and the mean EQ-VAS values were 83, 45, 57, 69, 75 and 75, respectively. At 6 and 12 months after injury, 22 and 25% of the MPS < 65 year group, 38 and 47% of the MPS ≥ 65 year group and 34 and 51% of the MAHS group, respectively, reached the maximum score. Pre-injury score, female gender and high Injury Severity Score (ISS) were important prognostic factors for a decreased HRQoL, and the EQ-5D VAS β = 0.43 (95% CI: 0.31 − 0.57), -6.66 (95% CI: -10.90 − -0.43) and -7.09 (95% CI: -6.11 − -5.67), respectively. Discussion: Patients with pelvic fractures experience a reduction in their HRQoL. Most patients do not achieve the HRQoL of their pre-injury state within 1 year after trauma. Prognostic factors for decreased HRQoL are a low pre-injury score, high ISS and female gender. We do not recommend using the MAHS and MPS in mid- or long-term follow-up of pelvic fractures because of ceiling effects. Trial registration number NCT02508675. [ABSTRACT FROM AUTHOR]