Background: Due to differences in the definition of frailty, many different screening instruments have been developed. However, the predictive validity of these instruments among community-dwelling older people remains uncertain. Objective: To investigate whether combined (i.e. sequential or parallel) use of available frailty instruments improves the predictive power of dependency in (instrumental) activities of daily living ((I)ADL), mortality and hospitalization. Design, setting and participants: A prospective cohort study with two-year followup was conducted among pre-frail and frail community-dwelling older people in the Netherlands. Measurements: Four combinations of two highly specific frailty instruments (Frailty Phenotype, Frailty Index) and two highly sensitive instruments (Tilburg Frailty Indicator, Groningen Frailty Indicator) were investigated. We calculated sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for all single instruments as well as for the four combinations, sequential and parallel. Results: 2,420 individuals participated (mean age 76.3 ± 6.6 years, 60.5% female) in our study. Sequential use increased the levels of specificity, as expected, whereas the PPV hardly increased. Parallel use increased the levels of sensitivity, although the NPV hardly increased. Conclusions: Applying two frailty instruments sequential or parallel might not be a solution for achieving better predictions of frailty in community-dwelling older people. Our results show that the combination of different screening instruments does not improve predictive validity. However, as this is one of the first studies to investigate the combined use of screening instruments, we recommend further exploration of other combinations of instruments among other study populations.
Poster presentation, Saxion Research Conference 2018, Enschede A descriptive qualitative study. Aim: to dexcribe the lived experiences of older alduts asking for and receiving care ans support, and their expectations about this in the future.
MULTIFILE
BACKGROUND: Sarcopenia might be a relevant lead for optimization of the condition of patients with head and neck cancer (HNC) before chemoradiotherapy (CRT) to prevent long-term functional swallowing impairment, such as feeding tube dependency.METHODS: Regression analyses were performed to assess the association between skeletal muscle mass index (SMI), as a measure of sarcopenia, and prolonged (>90 days) feeding tube dependency in 128 patients with HNC treated with primary CRT.RESULTS: Sixty-one patients (48%) became prolonged feeding tube-dependent. Lower SMI increased the risk of prolonged feeding tube dependency in multivariable analysis (risk ratio 1.08; 95% confidence interval 1.02-1.14, P = .01) adjusted for body mass index, abnormal diet, and socioeconomic status.CONCLUSIONS: Sarcopenia contributes to the risk of prolonged feeding tube dependency of patients with HNC treated with primary CRT. As sarcopenia might be a modifiable factor prior to treatment, it should be explored as a target for pretreatment patients' condition.
The consistent demand for improving products working in a real-time environment is increasing, given the rise in system complexity and urge to constantly optimize the system. One such problem faced by the component supplier is to ensure their product viability under various conditions. Suppliers are at times dependent on the client’s hardware to perform full system level testing and verify own product behaviour under real circumstances. This slows down the development cycle due to dependency on client’s hardware, complexity and safety risks involved with real hardware. Moreover, in the expanding market serving multiple clients with different requirements can be challenging. This is also one of the challenges faced by HyMove, who are the manufacturer of Hydrogen fuel cells module (https://www.hymove.nl/). To match this expectation, it starts with understanding the component behaviour. Hardware in the loop (HIL) is a technique used in development and testing of the real-time systems across various engineering domain. It is a virtual simulation testing method, where a virtual simulation environment, that mimics real-world scenarios, around the physical hardware component is created, allowing for a detailed evaluation of the system’s behaviour. These methods play a vital role in assessing the functionality, robustness and reliability of systems before their deployment. Testing in a controlled environment helps understand system’s behaviour, identify potential issues, reduce risk, refine controls and accelerate the development cycle. The goal is to incorporate the fuel cell system in HIL environment to understand it’s potential in various real-time scenarios for hybrid drivelines and suggest secondary power source sizing, to consolidate appropriate hybridization ratio, along with optimizing the driveline controls. As this is a concept with wider application, this proposal is seen as the starting point for more follow-up research. To this end, a student project is already carried out on steering column as HIL
Met de opkomst van digitale diensten en de impact van digitale technologie is het vraagstuk van privacy hoog op de maatschappelijke agenda beland. Burgers gebruiken steeds vaker apps en andere online services, met als keerzijde dat we steeds meer informatie over onszelf moeten delen om optimaal gebruik te kunnen maken van deze faciliteiten. Dit kan leiden tot schending van onze privacy. Ook voor de meeste (mkb-)bedrijven is het lastig om inzicht te krijgen in de privacy implicaties van hun online services en in de privacy-eisen om deze implicaties te verzachten. Het privacyvraagstuk is voor deze doelgroepen grijpbaar te maken door de privacy-eisen waar online diensten aan moeten voldoen op een beknopte, overzichtelijke en duidelijke manier te communiceren. Privacy labels, in navolging van energielabels en voedingslabels, zijn hiervoor een veelbelovende methode. Binnen het, door NWO gefinancierde, SERIOUS project is een prototype ontwikkeld om privacy-eisen te visualiseren middels een multidimensionaal privacy label (Barth, Ionita en Hartel, 2020). Op basis van een vragenlijst met betrekking op datacollectie, dataverwerking en datadisseminatie kan de mate van privacy borging en bescherming worden vastgesteld. Het huidige prototype van dit privacy label is generiek. Echter is het mogelijk dat bepaalde elementen van privacy in de praktijk binnen sommige domeinen veel zwaarder wegen dan binnen anderen. Kenniscentrum Creating 010 onderzoekt, naar aanleiding van de vraag vanuit de samenwerkingspartijen van het SERIOUS project, binnen dit project hoe het SERIOUS prototype kan worden doorontwikkeld naar een volwaardig privacy label. Hierbij wordt nagegaan of en hoe het prototype in en voor verschillende sectoren werkt, deze zijn: retail, media en cultuur. Het doel van dit project is om middels een haalbaarheidsstudie de richtlijnen voor een domein-specifiek label te achterhalen en op te stellen die dienen als uitgangspunt voor een vervolgproject voor een domein-specifieke privacy tool.
