In cases of sexual assault, the interpretation of biological traces on clothing, and particularly undergarments, may be complex. This is especially so when the complainant and defendant interact socially, for instance as (ex-)partners or by co-habitation. Here we present the results from a study where latent male DNA on female worn undergarments is recovered in four groups with different levels of male-female social interaction. The results conform to prior expectation, in that less interaction tend to result in less male DNA on undergarments. We explore the use of these experimental data for evaluative reporting given activity level propositions in a mock case scenario. We show how the selection of different populations to represent the social interaction between complainant and defendant may affect the strength of the evidence. We further show how datasets of limited size can be used for robust activity level evaluative reporting.
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There appears to be some hesitation within the forensic biology community to formally evaluate and report on findings given activity level propositions. This hesitance in part stems from concerns about the lack of relevant data on the dynamics of biological traces and doubt about the relevance of such expert opinions to the trier of fact. At the Netherlands Forensic Institute formal evaluative opinions on the probability of case findings given propositions at the activity level are provided since 2013, if requested by a mandating authority. In this study we share the results from a retrospective analysis of 74 of such requests. We explore which party initiates requests, the types of cases that are submitted, the sources of data being used to assign probabilities to DNA transfer, persistence, prevalence and recovery (TPPR) events, the conclusions that were drawn by the scientists, and how the conclusions were used by the courts. This retrospective analysis of cases demonstrates that published sources of data are generally available and can be used to address DNA TPPR events in most cases, although significant gaps still remain. The study furthermore shows that reporting on forensic biology findings given activity level propositions has been generally accepted by the district and appeal courts, as well as the other parties in the criminal justice system in the Netherlands.
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To assess the reporting quality of interventions aiming at promoting physical activity (PA) using a wearable activity tracker (WAT) in patients with infammatory arthritis (IA) or hip/knee osteoarthritis (OA). A systematic search was performed in eight databases including PubMed, Embase and Cochrane Library) for studies published between 2000 and 2022. Two reviewers independently selected studies and extracted data on study characteristics and the reporting of the PA intervention using a WAT using the Consensus on Exercise reporting Template (CERT) (12 items) and Consolidated Standards of Reporting Trials (CONSORT) E-Health checklist (16 items). The reporting quality of each study was expressed as a percentage of reported items of the total CERT and CONSORT E-Health (50% or less=poor; 51–79%=moderate; and 80–100%=good reporting quality). Sixteen studies were included; three involved patients with IA and 13 with OA. Reporting quality was poor in 6/16 studies and moderate in 10/16 studies, according to the CERT and poor in 8/16 and moderate in 8/16 studies following the CONSORT E-Health checklist. Poorly reported checklist items included: the description of decision rule(s) for determining progression and the starting level, the number of adverse events and how adherence or fdelity was assessed. In clinical trials on PA interventions using a WAT in patients with IA or OA, the reporting quality of delivery process is moderate to poor. The poor reporting quality of the progression and tailoring of the PA programs makes replication difcult. Improvements in reporting quality are necessary.
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Evaluations of forensic observations considering activity level propositions are becoming more common place in forensic institutions. A measure that can be taken to interrogate the evaluation for robustness is called sensitivity analysis. A sensitivity analysis explores the sensitivity of the evaluation to the data used when assigning probabilities, or to the level of uncertainty surrounding a probability assignment, or to the choice of various assumptions within the model. There have been a number of publications that describe sensitivity analysis in technical terms, and demonstrate their use, but limited literature on how that theory can be applied in practice. In this work we provide some simplified examples of how sensitivity analyses can be carried out, when they are likely to show that the evaluation is sensitive to underlying data, knowledge or assumptions, how to interpret the results of sensitivity analysis, and how the outcome can be reported. We also provide access to an application to conduct sensitivity analysis.
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Forensic DNA Trace Evidence Interpretation: Activity Level Propositions and Likelihood Ratios provides all foundational information required for a reader to understand the practice of evaluating forensic biology evidence given activity level propositions and to implement the practice into active casework within a forensic institution. The book begins by explaining basic concepts and foundational theory, pulling together research and studies that have accumulated in forensic journal literature over the last 20 years.The book explains the laws of probability - showing how they can be used to derive, from first principles, the likelihood ratio - used throughout the book to express the strength of evidence for any evaluation. Concepts such as the hierarchy of propositions, the difference between experts working in an investigative or evaluative mode and the practice of case assessment and interpretation are explained to provide the reader with a broad grounding in the topics that are important to understanding evaluation of evidence. Activity level evaluations are discussed in relation to biological material transferred from one object to another, the ability for biological material to persist on an item for a period of time or through an event, the ability to recover the biological material from the object when sampled for forensic testing and the expectations of the prevalence of biological material on objects in our environment. These concepts of transfer, persistence, prevalence and recovery are discussed in detail in addition to the factors that affect each of them.The authors go on to explain the evaluation process: how to structure case information and formulate propositions. This includes how a likelihood ratio formula can be derived to evaluate the forensic findings, introducing Bayesian networks and explaining what they represent and how they can be used in evaluations and showing how evaluation can be tested for robustness. Using these tools, the authors also demonstrate the ways that the methods used in activity level evaluations are applied to questions about body fluids. There are also chapters dedicated to reporting of results and implementation of activity level evaluation in a working forensic laboratory. Throughout the book, four cases are used as examples to demonstrate how to relate the theory to practice and detail how laboratories can integrate and implement activity level evaluation into their active casework.
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The (pre)school environment is an important setting to improve children’s health. Especially, the (pre)school playground provides a major opportunity to intervene. This review presents an overview of the existing evidence on the value of both school and preschool playgrounds on children’s health in terms of physical activity, cognitive and social outcomes. In addition, we aimed to identify which playground characteristics are the strongest correlates of beneficial effects and for which subgroups of children effects are most distinct. In total, 13 experimental and 17 observational studies have been summarized of which 10 (77%) and 16 (94%) demonstrated moderate to high methodological quality, respectively. Nearly all experimental studies (n = 11) evaluated intervention effects on time spent in different levels of physical activity during recess. Research on the effects of (pre)school playgrounds on cognitive and social outcomes is scarce (n = 2). The experimental studies generated moderate evidence for an effect of the provision of play equipment, inconclusive evidence for an effect of the use of playground markings, allocating play space and for multi-component interventions, and no evidence for an effect of decreasing playground density, the promotion of physical activity by staff and increasing recess duration on children’s health. In line with this, observational studies showed positive associations between play equipment and children’s physical activity level. In contrast to experimental studies, significant associations were also found between children’s physical activity and a decreased playground density and increased recess duration. To confirm the findings of this review, researchers are advised to conduct more experimental studies with a randomized controlled design and to incorporate the assessment of implementation strategies and process evaluations to reveal which intervention strategies and playground characteristics are most effective. https://doi.org/10.1186/1479-5868-11-59 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.
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The Junior Adverse Drug Event Manager (J-ADEM) team is a multifaceted intervention focusing on real-life education for medical students that has been shown to assist healthcare professionals in managing and reporting suspected adverse drug reactions (ADRs) to the Netherlands Pharmacovigilance Centre Lareb. The aim of this study was to quantify and describe the ADRs reported by the J-ADEM team and to determine the clinical potential of this approach. The J-ADEM team consisted of medical students tasked with managing and reporting ADRs in hospitalized patients. All ADRs screened and reported by J-ADEM team were recorded anonymously, and categorized and analysed descriptively. From August 2018 through January 2020, 209 patients on two wards in an academic hospital were screened for ADR events. The J-ADEM team reported 101 ADRs. Although most ADRs (67%) were first identified by healthcare professionals and then reported by the J-ADEM team, the team also reported an additional 33 not previously identified serious ADRs. In 10% of all reported ADRs, the J-ADEM team helped optimize ADR treatment. The ADR reports were largely well-documented (78%), and ADRs were classified as type A (66%), had a moderate or severe severity (85%) and were predominantly avoidable reactions (69%). This study shows that medical students are able to screen patients for ADRs, can identify previously undetected ADRs and can help optimize ADR management. They significantly increased (by 300%) the number of ADR reports submitted, showing that the J-ADEM team can make a valuable clinical contribution to hospital care.
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Background: Emergency department utilization has increased tremendously over the past years, which is accompanied by an increased necessity for emergency medicine research to support clinical practice. Important sources of evidence are systematic reviews (SRs) and meta-analyses (MAs), but these can only be informative provided their quality is sufficiently high, which can only be assessed if reporting is adequate. The purpose of this study was to assess the quality of reporting of SRs and MAs in emergency medicine using the PRISMA statement. Methods: The top five emergency medicine related journals were selected using the 5-year impact factor of the ISI Web of Knowledge of 2015. All SRs and MAs published in these journals between 2015 and 2016 were extracted and assessed independently by two reviewers on compliance with each item of the PRISMA statement. Results: The included reviews (n = 112) reported a mean of 18 ± 4 items of the PRISMA statement adequately. Reviews mentioning PRISMA adherence did not show better reporting than review without mention of adherence (mean 18.6 (SE 0.4) vs. mean 17.8 (SE 0.5); p = 0.214). Reviews published in journals recommending or requiring adherence to a reporting guideline showed better quality of reporting than journals without such instructions (mean 19.2 (SE 0.4) vs. mean 17.2 (SE 0.5); p = 0.001). Conclusion: There is room for improvement of the quality of reporting of SRs and MAs within the emergency medicine literature. Therefore, authors should use a reporting guideline such as the PRISMA statement. Active journal implementation, by requiring PRISMA endorsement, enhances quality of reporting.
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Background: Insufficient amounts of physical activity is a risk factor for (recurrent) stroke. People with a stroke or transient ischemic attack (TIA) have a high risk of recurrent stroke and have lower levels of physical activity than their healthy peers. Though several reviews have looked at the effects of lifestyle interventions on a number of risk factors of recurrent stroke, the effectiveness of these interventions to increase the amounts of physical activity performed by people with stroke or TIA are still unclear. Therefore, the research question of this study was: what is the effect of lifestyle interventions on the level of physical activity performed by people with stroke or TIA? Method: A systematic review was conducted following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Pubmed, Embase and Cumulative Index for Nursing and Allied Health Literature (CINAHL), were searched up to August 2018. Randomised controlled trials that compared lifestyle interventions, aimed to increase the amount of physical activity completed by participants with a stroke or TIA, with controls were included. The Physiotherapy Evidence Database (PEDro) score was used to assess the quality of the articles, and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) method for the best evidence synthesis. Results: Eleven trials (n = 2403) met the inclusion criteria. The quality of the trials was mostly high, with 8 (73%) of trials scoring ≥6 on the PEDro scale. The overall best evidence syntheses showed moderate quality evidence that lifestyle interventions do not lead to significant improvements in the physical activity level of people with stroke or TIA. There is low quality evidence that lifestyle interventions that specifically target physical activity are effective at improving the levels of physical activity of people with stroke or TIA. Conclusion: Based on the results of this review, general lifestyle interventions on their own seem insufficient in improving physical activity levels after stroke or TIA. Lifestyle interventions that specifically encourage increasing physical activity may be more effective. Further properly powered trials using objective physical activity measures are needed to determine the effectiveness of such interventions.
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