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Objective: The aim was to evaluate the effect of the implementation of an information handover form regarding patients receiving palliative care. Outcome was the information available for the out-of-hours GP co-operative. Design: We conducted a controlled trial. Setting: All GPs in Amsterdam, The Netherlands. Intervention: The experimental group (N = 240) received an information handover form and an invitation for a one-hour training, the control group (N = 186) did not receive a handover form or training. We studied contacts with the GP co-operative concerning patients in palliative care for the presence and quality of information transferred by the patient's own GP. Main outcome measures: Proportion of contacts in which information was available and proportion of adequate information transfer. Results. Overall information was transferred by the GPs in 179 of the 772 first palliative contacts (23.2%). The number of contacts in the experimental group in which information was available increased significantly after intervention from 21% to 30%, compared to a decrease from 23% to 19% in the control group. The training had no additional effect. The content of the transferred information was adequate in 61.5%. There was no significant difference in the quality of the content between the groups. Conclusion: The introduction of a handover form resulted in a moderate increase of information transfers to the GP co-operative. However, the total percentage of contacts in which this information was present remained rather low. GP co-operatives should develop additional policies to improve information transfer. Key Points The out-of-hours period is potentially problematic for the delivery of optimal palliative care, often due to inadequate information transfer. Introduction of a handover form resulted in a moderate increase of transferred information. The percentage of palliative contacts remained low in cases where information was available. Adequate information was transferred in more than half of the cases.

OBJECTIVE: The aim of this randomized controlled trial (RCT) was to investigate the effectiveness of the Stay@Work participatory ergonomics (PE) program to prevent low-back and neck pain. METHODS: A total of 37 departments were randomly allocated to either the intervention (PE) or control group (no PE). During a six-hour meeting, working groups followed the PE steps and composed and prioritized ergonomic measures aimed at preventing low-back and neck pain. Subsequently, working groups were requested to implement the ergonomic measures in the departments. The primary outcomes were low-back and neck pain prevalence and secondary outcomes were pain intensity and duration. Data were collected by questionnaires at baseline, and after 3-, 6-, 9-, and 12-months follow-up. Additionally, the course of low-back and neck pain (transitions from no symptoms to symptoms and from symptoms to no symptoms) was modeled. RESULTS: The randomization procedure resulted in 19 intervention departments (N=1472 workers) and 18 control departments (N=1575 workers). After 12 months, the intervention was not more effective than the control group in reducing the prevalence of low-back and neck pain or reducing pain intensity and duration. PE did not increase the probability of preventing low-back pain [odds ratio (OR) 1.23, 95% confidence interval (95% CI) 0.97–1.57) or neck pain (OR 1.01, 95% CI 0.74–1.40). However, PE increased the probability of recovering from low-back pain (OR 1.41, 95% CI 1.01–1.96), but not from neck pain (OR 0.95, 95% CI 0.72–1.26). CONCLUSION: PE neither reduced low-back and neck pain prevalence nor pain intensity and duration nor was it effective in the prevention of low-back and neck pain or the recovery from neck pain. However, PE was more effective in the recovery from low-back pain.

The constructs optimism, pessimism, hope, treatment credibility and treatment expectancy are associated with outcomes of medical treatment. While these constructs are grounded in different theoretical models, they nonetheless show some conceptual overlap. The purpose of this study was to examine whether currently available measurement instruments for these constructs capture the conceptual differences between these constructs within a treatment setting.Patients undergoing Total Hip and Total Knee Arthroplasty (THA and TKA) (Total N = 361; 182 THA; 179 TKA), completed the Life Orientation Test-Revised for optimism and pessimism, the Hope Scale, the Credibility Expectancy Questionnaire for treatment credibility and treatment expectancy. Confirmatory factor analysis was used to examine whether the instruments measure distinct constructs. Four theory-driven models with one, two, four and five latent factors were evaluated using multiple fit indices and Δχ2 tests, followed by some posthoc models.The results of the theory driven confirmatory factor analysis showed that a five factor model in which all constructs loaded on separate factors yielded the most optimal and satisfactory fit. Posthoc, a bifactor model in which (besides the 5 separate factors) a general factor is hypothesized accounting for the commonality of the items showed a significantly better fit than the five factor model. All specific factors, except for the hope factor, showed to explain a substantial amount of variance beyond the general factor.Based on our primary analyses we conclude that optimism, pessimism, hope, treatment credibility and treatment expectancy are distinguishable in THA and TKA patients. Postdoc, we determined that all constructs, except hope, showed substantial specific variance, while also sharing some general variance.