ABSTRACT Objective: To evaluate the effectiveness of the WhiteTeeth mobile app, a theory-based mobile health (mHealth) program for promoting oral hygiene in adolescent orthodontic patients. Methods: In this parallel randomized controlled trial, the data of 132 adolescents were collected during three orthodontic check-ups: at baseline (T0), at 6-week follow-up (T1), and at 12-week follow-up (T2). The intervention group was given access to the WhiteTeeth app in addition to usual care (n=67). The control group received usual care only (n=65). The oral hygiene outcomes were the presence and the amount of dental plaque (Al-Anezi and Harradine plaque Index); and the total number of sites with gingival bleeding (Bleeding on Marginal Probing Index). Oral health behavior and its psychosocial factors were measured through a digital questionnaire. We performed linear mixed model analyses to determine the intervention effects. Results: At 6-week follow-up, the intervention led to a significant decrease in gingival bleeding (B=-3.74; 95%CI -6.84 to -0.65), and an increase in the use of fluoride mouth rinse (B=1.93; 95%CI 0.36 to 3.50). At 12-week follow-up, dental plaque accumulation (B=-11.32; 95%CI -20.57 to -2.07) and the number of sites covered. Conclusions: The results show that adolescents with fixed orthodontic appliances can be helped to improve their oral hygiene when usual care is combined with a mobile app that provides oral health education and automatic coaching. Netherlands Trial Registry Identifier: NTR6206: 20 February 2017.
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This study assessed the effect of visitors' personality and emotional response on finding positive meaning in life and the intention to spread positive word of mouth. The sample (n = 260) consists of visitors to Sachsenhausen Memorial and Museum near Berlin. Findings indicate that the emotion of interest positively contributes to finding positive meaning in life and positive word of mouth. The effects of personality are marginal. Personality explains little of the variance in positive meaning and positive word of mouth. Emotional response accounts for 25% of the variance in finding positive meaning in life-in terms of finding personal benefit from the visit, controlled for personality. Despite the dominant negative emotional response, tourists find positive meaning in their visit. These findings correspond with those observed in studies on personal trauma and loss. Positive meaning could potentially contribute to adjustment processes to cope with what occurred. Future research should include address longer term effects on postvisit behavior.
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BackgroundConfounding bias is a common concern in epidemiological research. Its presence is often determined by comparing exposure effects between univariable- and multivariable regression models, using an arbitrary threshold of a 10% difference to indicate confounding bias. However, many clinical researchers are not aware that the use of this change-in-estimate criterion may lead to wrong conclusions when applied to logistic regression coefficients. This is due to a statistical phenomenon called noncollapsibility, which manifests itself in logistic regression models. This paper aims to clarify the role of noncollapsibility in logistic regression and to provide guidance in determining the presence of confounding bias.MethodsA Monte Carlo simulation study was designed to uncover patterns of confounding bias and noncollapsibility effects in logistic regression. An empirical data example was used to illustrate the inability of the change-in-estimate criterion to distinguish confounding bias from noncollapsibility effects.ResultsThe simulation study showed that, depending on the sign and magnitude of the confounding bias and the noncollapsibility effect, the difference between the effect estimates from univariable- and multivariable regression models may underestimate or overestimate the magnitude of the confounding bias. Because of the noncollapsibility effect, multivariable regression analysis and inverse probability weighting provided different but valid estimates of the confounder-adjusted exposure effect. In our data example, confounding bias was underestimated by the change in estimate due to the presence of a noncollapsibility effect.ConclusionIn logistic regression, the difference between the univariable- and multivariable effect estimate might not only reflect confounding bias but also a noncollapsibility effect. Ideally, the set of confounders is determined at the study design phase and based on subject matter knowledge. To quantify confounding bias, one could compare the unadjusted exposure effect estimate and the estimate from an inverse probability weighted model.
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Urban professionals need streamlined methods for identifying climate risks and prioritising equitable adaptation solutions in an inclusive, participatory way. The Netherlands' national discourse on climate adaptation highlights the need to protect the most vulnerable groups. However, current adaptation conventions rely heavily on biophysical data to locate climate hazards through 'stress tests' and prioritise adaptation based on existing infrastructure projects and political agendas. This approach often marginalises vulnerable groups and evades community engagement, resulting in inequitable outcomes. ENGAGED, the Equity Nexus of Governance, Adaptation Planning & Design for Urban Climate Resilience, proposes a novel practice-oriented approach where theoretical knowledge on equitable climate adaptation is empirically tested and applied to the Dutch context, emphasising trans-disciplinarity and equity, aiming to maximise impact. We will assess neighbourhood and block-level risks by extending the 'stress tests' to include demographic, cultural, socio-economic, and health indicators along with biophysical and climate data. We will identify adaptation opportunities that align with diverse planning agendas and prioritise projects based on potential linkages-benefits, and equity considerations. By collaborating with practitioners and community groups, we aim to gain valuable insights and confirm the effectiveness of our approach. The project will explore stakeholder engagement strategies to determine suitable adaptation solutions and identify governance barriers to adoption. We aim to facilitate equitable climate adaptation governance, planning, and design supporting municipalities to serve vulnerable groups more effectively and promote climate justice. ENGAGED will build upon research into climate adaptation and socio-economic issues from a range of projects, including the ZonMW Wijkaanpak Hitte, BEAT THE HEAT, Interreg Cool Cities, Horizon Up2030, KIN Accelerating Just Climate Transitions, NWO Citizen participation in climate adaptation, Interreg Cool Towns, and Buurtdashboard, Sociale kwetsbaarheid hitte and Wijktypen (KlimaatEffectAtlas).
This project has received funding from the Bio-based Industries Joint Undertaking under the European Union's Horizon 2020 research and innovation programme under grant agreement No 720726LIBBIO is a European research project on Andes Lupin (Lupinus mutabilis, tarwi) cropping in marginal lands for enhanced bio economy. Lupin has the ability to fix nitrogen, mobilise soil phosphate and has low nutritional requirements for cultivation. Varieties will be chosen that give high yield of green silage or high yield of seeds which contain more than 20% oil, more than 40% protein and the remaining materials are carbohydrates, mainly oligosaccharides characterized as “prebiotics”. Andes lupin will be grown as a summer crop in N-central Europe and as winter crop in Mediterranean conditions. Pre-industrial processing is developed and optimized for the lupin, properties of the different fractions analysed, their advantage for different industrial use evaluated, and a few products developed as an example. Social and environmental impact will be evaluated as well as techno-economic viability and effect on farm and biorefinery income.This project has received funding from the Bio-based Industries Joint Undertaking under the European Union's Horizon 2020 research and innovation programme under grant agreement No 720726
Indonesia’s peat forests remain severely threatened by forest fires, oil palm plantation development and extractive industries, which leads to biodiversity loss, increased emissions of greenhouse gases, and the marginalization of Indigenous Peoples and local communities. In 2008 the Government of Indonesia introduced the Social Forestry Programme under which Indigenous Peoples and local communities can acquire a 35-year management permit. Since then, about 10 percent of Indonesian State Forest has been designated for community-based forest conservation and restoration initiatives. The devolution of authority to the local level has created a new playing field. The Social Forestry Programme reverses more than a century of centralistic forest policy, and requires a fundamental re-orientation of all actors working in the forestry sector. The central question underlying this proposal is how Dutch civil society organizations (applied universities and NGOs) can effectively support Indigenous Peoples and local communities in the protection and restoration of peat forests in Indonesia. This project aims to set up a Living Lab in Ketapang District in West Kalimantan to study, identify and test novel ways to work together with a variety of stakeholders to effectively conserve and restore peat forest. In Ketapang District, Tropenbos Indonesia has assisted three Village Forest Management Groups (Pematang Gadung, Sungai Pelang and Sungai Besar) in securing a Social Forestry Permit. Students from three Dutch Universities (Van Hall Larenstein, Aeres Hogeschool and Inholland) will conduct research in partnership with students from Universitas Tanjungpura on the integration of local ecological knowledge and technical expertise, on the economic feasibility of community-based forestry enterprises, and on new polycentric governance structures. The results of these studies will be disseminated to policy makers and civil society groups working in Indonesia, using the extensive networks of IUCN NL and Tropenbos Indonesia.
