Papers by Kristien Roelens
European Journal of Public Health, 2019
Background Care for victims of sexual violence is fragmented in Belgium. Therefore, sexual assaul... more Background Care for victims of sexual violence is fragmented in Belgium. Therefore, sexual assault care centers (SACCs) were piloted in three cities from November 2017 onwards. The SACCs offer forensic, medical and acute psychological care through a forensic nurse, while vice inspectors perform an interrogation at the SACC for those wishing to report. The nurse coordinates the follow-up care and a psychologist provides mental health support. A quantitative prospective study was carried out assessing the characteristics of SACC patients, the sexual violence they experienced and the care received, in order to inform the national scale-up of the model. Methods Data on SACC patients was routinely collected in the electronic patient files by the SACC personnel between November 1st 2017 and October 31th 2018. Data was analyzed in SPSS. Results Within the first year SACCs were attended by 930 victims. Mean age was 24,5 years (SD = 12.8), and one third were minors. Eighty-eight percent of v...
Facts, Views & Vision in ObGyn, 2017
Background In 2011 the Belgian Obstetric Surveillance System (B.OSS) was set up to monitor severe... more Background In 2011 the Belgian Obstetric Surveillance System (B.OSS) was set up to monitor severe maternal morbidity in Belgium. Aim The aim of B.OSS is to get an accurate picture of the obstetric complications under investigation and secondly, to improve the quality and safety of obstetric care in Belgium by practical recommendations based on the results. Methodology Data are obtained through prospective active collection of cases by a monthly call according to the principle of nothing-to-report, along with data collection forms that confirm the diagnosis and gather detailed information. Data-collection occurs web-based since August 2013 through www.b-oss.be. Results B.OSS achieves excellent participation rates and response rates. The results of the first registration round are gradually brought out by means of scientific publications and presentations, biennial reports, newsletters and the website. The international comparison of results within the International Network of Obstetr...
Research Square (Research Square), May 27, 2021
Purpose-To critically analyse the literature on the antenatal corticosteroids (ACS)-to-birth inte... more Purpose-To critically analyse the literature on the antenatal corticosteroids (ACS)-to-birth interval from a causal point of view and to present a solution to the problem of bias caused by post-hoc analysis. Methods-Due to the post-hoc nature of the ACS-to-birth interval, a randomised controlled trial (RCT) of ACS versus placebo is not able to examine the importance of the interval. When an RCT is not feasible, for whatsoever reason, a target trial can be set up and an attempt can be made to answer the causal question of interest using observational data. An attempt was made to set up a target trial which could enable to examine the causal effect of the ACS-to-birth interval on neonatal outcomes. An analysis of current literature on the ACS-to-birth interval was done. Results-The majority of studies aimed to examine the causal effect of the interval, but their study design only permitted to nd associations between the interval and neonatal outcomes. Barriers for setting up a target trial are highlighted. Conclusion-Evidence on the superiority of any ACS-to-birth interval is lacking and the question can only be addressed causally and become clinically relevant if baseline randomisation to ACS-to-birth intervals is made possible.
European Journal of Public Health, 2020
Background Increasing male involvement during pregnancy is considered an important, but often ove... more Background Increasing male involvement during pregnancy is considered an important, but often overlooked intervention for improving maternal health in sub-Saharan Africa. This study explores the attitudes and beliefs of health policymakers, health care providers and local communities regarding men's involvement in maternal health in southern Mozambique. Methods Ten key informant interviews with stakeholders were carried out to assess their attitudes and perspectives regarding male involvement in maternal health, followed by 10 days of semi structured observations in health care centers. Subsequently 16 focus group discussions were conducted in the community and at provider level, followed by three in depth couple interviews. Analysis was done by applying a socio-ecological systems theory in thematic analysis. Results Results show a lack of strategy at policy level to stimulate male involvement in maternal health. Invitation cards for men are used as an isolated intervention in h...
Research Square (Research Square), Apr 2, 2020
Research Square (Research Square), Nov 29, 2021
Objective-To compare neonatal magnesemia in the rst fteen days of neonatal life between three gro... more Objective-To compare neonatal magnesemia in the rst fteen days of neonatal life between three groups: a control group not exposed to MgSO 4 , a neuroprotection group, and an eclampsia prevention group, and to explore its' associations with child outcomes. Design-Retrospective single-centre cohort study. Setting-Tertiary care setting. Population-Infants admitted at the neonatal intensive care unit born between 24 and 32 weeks' gestation, regardless of etiology of preterm birth. Methods-Linear mixed regression of neonatal magnesemia on exposure group and day of life. Generalised estimating equations models of child outcomes on neonatal magnesemia according to exposure group and day of life. Main outcome measures-Neonatal magnesemia (mmol/l). Results-Neonatal magnesemia is signi cantly higher in the preeclampsia group compared to the control and neuroprotection group. On the day of birth, this is irrespective of maternal magnesemia (preeclampsia vs control group), and the maternal total dose or duration of MgSO 4 administration (preeclampsia vs neuroprotection group). No differences were found in short-term composite outcome between the three groups. Conclusions-We found mean differences in neonatal magnesemia between children not exposed to MgSO 4 antenatally, children exposed for fetal neuroprotection, and children exposed for maternal eclampsia prevention. A 4g loading and 1g/h maintenance dose, for fetal neuroprotection and eclampsia prevention, appears to be safe on the short term for the neonate. What Is Known Magnesium sulfate is a valuable medicine in obstetrics. The main indications are prevention of eclampsia and fetal neuroprotection. The most used dosage is a 4 or 6 grams loading dose and a 1 or 2 grams per hour maintenance dose. It reduces neuromotor disabilities in extreme to moderate preterm born children. What is new-Maternal concentrations are supraphysiological and the maternal total dose can be high. Concentrations in neonates appear to remain in safe ranges. A dosage of 4 grams loading and 1 gram/hour seems safe for the preterm neonate on the short term.
info:eu-repo/semantics/nonPublishe
Checklist voor de optimale opvang van slachto ers van seksueel geweld in Belgische ziekenhuizen.-... more Checklist voor de optimale opvang van slachto ers van seksueel geweld in Belgische ziekenhuizen.-2-ICRH-Ugent in opdracht van de FOD Volksgezondheid, Gent.
Anaesthesia, Jan 19, 2017
The primary goal of this study was to determine the median effective dose (ED 50) of spinal chlor... more The primary goal of this study was to determine the median effective dose (ED 50) of spinal chloroprocaine for labour analgesia. Thirty-eight parturients requesting neuraxial analgesia were enrolled. Doses of 1% chloroprocaine were determined by the technique of up-down sequential allocation, with an initial dose of 20 mg and steps of 2 mg. The chloroprocaine spinal dose was given as the spinal component of a combined spinal-epidural, which was then supplemented with an epidural dose of 7.5 lg sufentanil in 7 ml saline. Effective analgesia was defined as a score ≤ 10 mm within 15 min on a 100-mm visual analogue pain scale. Using the isotonic regression estimator method, the ED 50 of chloroprocaine for the spinal component of a combined spinal-epidural for labour was calculated to be median (95%CI) 12.0 (9.3-17.0) mg.
Tijdschrift Voor Geneeskunde, 2013
Obstetrische en traumatische fistels vormen nog steeds een groot gezondheidsprobleem in de zich o... more Obstetrische en traumatische fistels vormen nog steeds een groot gezondheidsprobleem in de zich ontwikkelende landen. Wereldwijd zijn er meer dan twee miljoen vrouwen met urogenitale fistels. Gynaecologische fistels worden hoofdzakelijk veroorzaakt door obstetrische verwikkelingen, maar in gebieden die geteisterd worden door etnische conflicten, duiken nu ook meer en meer traumatische fistels op ten gevolge van seksueel geweld. In dit manuscript wordt de ernst van de fistelproblematiek in de streek van Kivu in de Democratische Republiek Congo (DRC) verduidelijkt.
PubMed, Dec 1, 2017
Background: In 2011 the Belgian Obstetric Surveillance System (B.OSS) was set up to monitor sever... more Background: In 2011 the Belgian Obstetric Surveillance System (B.OSS) was set up to monitor severe maternal morbidity in Belgium. Aim: The aim of B.OSS is to get an accurate picture of the obstetric complications under investigation and secondly, to improve the quality and safety of obstetric care in Belgium by practical recommendations based on the results. Methodology: Data are obtained through prospective active collection of cases by a monthly call according to the principle of nothing-to-report, along with data collection forms that confirm the diagnosis and gather detailed information. Data-collection occurs web-based since August 2013 through www.b-oss.be. Results: B.OSS achieves excellent participation rates and response rates. The results of the first registration round are gradually brought out by means of scientific publications and presentations, biennial reports, newsletters and the website. The international comparison of results within the International Network of Obstetric Survey Systems (INOSS) gives important added value. No alternative mandatory data sources are appropriate to check for underreporting. Conclusions: B.OSS is successful in monitoring severe maternal morbidity thanks to the willingness of the Belgian OB-GYNs. The results of the first studies suggest the need to develop nationally adopted guidelines. Furthermore, the results invite to critically evaluate the current organisation of obstetric health care in Belgium. B.OSS aims to monitor the impact on patient safety in future surveys, when guidelines and recommendations are put into practice.
BMC Public Health, May 1, 2014
Background: Although migrants constitute an important proportion of the European population, litt... more Background: Although migrants constitute an important proportion of the European population, little is known about migrant sexual health. Existing research mainly focuses on migrants' sexual health risks and accessibility issues while recommendations on adequate sexual health promotion are rarely provided. Hence, this paper explores how refugees, asylum seekers and undocumented migrants in Belgium and the Netherlands define sexual health, search for sexual health information and perceive sexual health determinants. Methods: Applying Community-based Participatory Research as the overarching research approach, we conducted 223 in-depth interviews with refugees, asylum seekers and undocumented migrants in Belgium and the Netherlands. The Framework Analysis Technique was used to analyse qualitative data. We checked the extensiveness of the qualitative data and analysed the quantitative socio-demographic data with SPSS. Results: Our results indicate that gender and age do not appear to be decisive determinants. However, incorporated cultural norms and education attainment are important to consider in desirable sexual health promotion in refugees, asylum seekers and undocumented migrants in Belgium and the Netherlands. Furthermore, our results demonstrate that these migrants have a predominant internal health locus of control. Yet, most of them feel that this personal attitude is hugely challenged by the Belgian and Dutch asylum system and migration laws which force them into a structural dependent situation inducing sexual ill-health. Conclusion: Refugees, asylum seekers and undocumented migrants in Belgium and the Netherlands are at risk of sexual ill-health. Incorporated cultural norms and attained education are important determinants to address in desirable sexual health promotion. Yet, as their legal status demonstrates to be the key determinant, the prime concern is to alter organizational and societal factors linked to the Belgian and Dutch asylum system. Refugees, asylum seekers and undocumented migrants in Belgium and the Netherlands should be granted the same opportunity as Belgian and Dutch citizens have, to become equally in control of their sexual health and sexuality.
Archives of Gynecology and Obstetrics, Feb 2, 2022
Purpose In this correspondence, we highlight general and domain-specific caveats in the developme... more Purpose In this correspondence, we highlight general and domain-specific caveats in the development and validation of prediction models. Methods Development and use of the "QUiPP" application, a tool for preterm birth prediction which is supported by the United Kingdom National Health Service, is scrutinised and commented on. Results We highlight and elaborate ten points which may be perceived to be unclear or potentially misleading. Conclusion While the QUiPP application has high potential, it lacks transparency (on certain aspects related to model development) and proper validation. This precludes transportability to settings with other treatment policies and to other countries where the app has been made publicly available.
BMC Pregnancy and Childbirth, Oct 6, 2017
Background: We aimed to investigate the impact of a referral-based intervention in a prospective ... more Background: We aimed to investigate the impact of a referral-based intervention in a prospective cohort of women disclosing intimate partner violence (IPV) on the prevalence of violence, and associated outcomes psychosocial health, help-seeking and safety behaviour during and after pregnancy. Methods: Women seeking antenatal care in eleven Belgian hospitals were consecutively invited from June 2010 to October 2012, to participate in a single-blind randomized controlled trial (RCT) and handed a questionnaire. Participants willing to be interviewed and reporting IPV victimisation were randomised. In the Intervention Group (IG) participants received a referral card with contact details of services providing assistance and tips to increase safety behaviour. Participants in the Control Group (CG) received a "thank you" card. Follow-up data were obtained through telephone interview at an average of 10 months after receipt of the card. Results: At follow-up (n = 189), 66.7% (n = 126) of the participants reported IPV victimisation. Over the study-period, the prevalence of IPV victimisation decreased by 31.4% (P < 0.001), psychosocial health increased significantly (5.4/140, P < 0.001), 23.8% (n = 46/193) of the women sought formal help, 70.5% (n = 136/193) sought informal help, and 31.3% (n = 60/192) took at least one safety measure. We observed no statistically significant differences between the IG and CG, however. Adjusted for psychosocial health at baseline, the perceived helpfulness of the referral card seemed to be larger in the IG. Both the questionnaire and the interview were perceived to be significantly more helpful than the referral card itself (P < 0.001). Conclusions: Asking questions can be helpful even for types of IPV of low severity, although simply distributing a referral card may not qualify as the ideal intervention. Future interventions should be multifaceted, delineate different types of violence, controlling for measurement reactivity and designing a tailored intervention programme adjusted to the specific needs of couples experiencing IPV. Trial registration: The trial was registered with the U.S. National Institutes of Health ClinicalTrials.gov registry on July 6, 2010 under identifier NCT01158690).
American Journal of Obstetrics and Gynecology, 2015
Ultrasound in Obstetrics & Gynecology, Sep 1, 2012
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Papers by Kristien Roelens