The purpose of this study was to investigate the effects of training with the Wii-balance board on balance and balance-related skills of children with poor motor performance. Twenty-nine children (23 boys, 6 girls; aged 7–12 years) participated in this study and were randomly assigned to an experimental and control group. All children scored below the 16th percentile on a standardized test of motor ability and balance skills (Movement Assessment Battery for children (M-ABC-2)). Before and after a six-week Wii-intervention (M = 8 h, 22 min, SD = 53 min), the balance skills of the experimental group and control group were measured with the M-ABC-2 and the Bruininks–Oseretsky test of motor proficiency (BOT-2). Both groups improved on all tests. The M-ABC-2 and the BOT-2 total balance-scores of the experimental group improved significantly from pre to post intervention, whereas those of the control group showed no significant progress. This resulted in significant interaction-effects, favoring the experimental children. No transfer-effects of the intervention on balance-related skills were demonstrated. Our findings showed that the Wii-balance board is an effective intervention for children with poor balance control. Further development and investigation of the intervention could be directed toward the implementation of the newly acquired balance-skills in daily life.
MULTIFILE
In clinical practice, formal elements of art products are regularly used in art therapy observation to obtain insight into clients’ mental health and provide directions for further treatment. Due to the diversity of formal elements used in existing studies and the inconsistency in the interpretation, it is unclear which formal elements contribute to insight into clients’ mental health. In this qualitative study using Constructivist Grounded Theory, eight art therapists were interviewed in-depth to identify which formal elements they observe, how they describe mental health and how they associate formal elements with mental health. Findings of this study show that art therapists in this study observe the combination of movement, dynamic, contour and repetition (i.e., primary formal elements) with mixture of color, figuration and color saturation (i.e., secondary formal elements). Primary and secondary elements interacting together construct the structure and variation of the art product. Art therapists rarely interpret these formal elements in terms of symptoms or diagnosis. Instead, they use concepts such as balance and adaptability (i.e., self-management, openness, flexibility, and creativity). They associate balance, specifically being out of balance, with the severity of the clients’ problem and adaptability with clients’ strengths and resources. In the conclusion of the article we discuss the findings’ implications for practice and further research.
BACKGROUND: Increasing evidence indicates the potential benefits of restricted fluid management in critically ill patients. Evidence lacks on the optimal fluid management strategy for invasively ventilated COVID-19 patients. We hypothesized that the cumulative fluid balance would affect the successful liberation of invasive ventilation in COVID-19 patients with acute respiratory distress syndrome (ARDS).METHODS: We analyzed data from the multicenter observational 'PRactice of VENTilation in COVID-19 patients' study. Patients with confirmed COVID-19 and ARDS who required invasive ventilation during the first 3 months of the international outbreak (March 1, 2020, to June 2020) across 22 hospitals in the Netherlands were included. The primary outcome was successful liberation of invasive ventilation, modeled as a function of day 3 cumulative fluid balance using Cox proportional hazards models, using the crude and the adjusted association. Sensitivity analyses without missing data and modeling ARDS severity were performed.RESULTS: Among 650 patients, three groups were identified. Patients in the higher, intermediate, and lower groups had a median cumulative fluid balance of 1.98 L (1.27-7.72 L), 0.78 L (0.26-1.27 L), and - 0.35 L (- 6.52-0.26 L), respectively. Higher day 3 cumulative fluid balance was significantly associated with a lower probability of successful ventilation liberation (adjusted hazard ratio 0.86, 95% CI 0.77-0.95, P = 0.0047). Sensitivity analyses showed similar results.CONCLUSIONS: In a cohort of invasively ventilated patients with COVID-19 and ARDS, a higher cumulative fluid balance was associated with a longer ventilation duration, indicating that restricted fluid management in these patients may be beneficial. Trial registration Clinicaltrials.gov ( NCT04346342 ); Date of registration: April 15, 2020.
Heb je wel eens gemerkt dat de premie voor je autoverzekering verandert als je in een andere wijk gaat wonen? Verzekeraars berekenen dit met een algoritme, wat kan leiden tot indirecte discriminatie. Dit project onderzoekt hoe zulke digitale differentiatie (DD) zowel eerlijk als rendabel kan.
In dit project verricht het lectoraat Familiebedrijven van Hogeschool Windesheim samen met CAH Vilentum in Dronten, LTO Noord, NAJK en agrarische MKB familiebedrijven praktijkgericht onderzoek naar de familiale en bedrijfsmatige aspecten rond opvolging bij agrarische MKB familiebedrijven. Met dit project wordt nieuwe kennis ontwikkeld, die aansluit bij kennis over opvolging in familiebedrijven en die specifiek wordt toegepast binnen de agrarische sector. Bijna de helft van alle agrarische bedrijven in Nederland heeft een bedrijfshoofd van 55 jaar of ouder. Het merendeel van deze bedrijven is een familiebedrijf en heeft te maken met het onderwerp bedrijfsopvolging. Voor een geslaagd opvolgingsproces is het belangrijk dat familiebelangen en bedrijfsbelangen adequaat worden gebalanceerd. In de praktijk blijkt het lastig deze belangen rond overdracht van leiding en eigendom bespreekbaar te maken en goed af te wegen. Vanuit agrarische families is daarom de vraag hoe het opvolgingsproces het beste kan worden vormgegeven en welke instrumenten daarbij kunnen worden ingezet. De belangrijkste doelstelling van dit project is om nieuwe kennis op te doen over het opvolgingsproces bij agrarische familiebedrijven en het opvolgingsproces met instrumenten in positieve zin te veranderen. Door kwalitatief onderzoek worden belemmerende factoren rond opvolging in de agrarische context onderzocht. Op basis van deze nieuwe inzichten worden instrumenten ontwikkeld die het opvolgingsproces faciliteren. Door interventies zal worden vastgesteld of de instrumenten in de praktijk werken. De kennis die uit dit project voortkomt, beoogt daarmee het handelingsvermogen van agrarische families rond bedrijfsopvolging te ondersteunen. Het project levert een bijdrage aan bestaande kennis door gebruik te maken van multi-level onderzoek (perspectief van de opvolger, overdrager, familieleden, familie en bedrijf) en het observeren van gesprekken over het opvolgingsproces, de familie en het bedrijf. Het meest concrete resultaat is een beschrijving van een model opvolgingsproces met bijbehorende instrumenten om belangrijke onderwerpen rond opvolging bespreekbaar te maken, zoals een zelfanalyse instrument, een stappenplan, hulpmiddelen om gesprekken te faciliteren en een model familiestatuut afgestemd op agrarische familiebedrijven.
Due to the existing pressure for a more rational use of the water, many public managers and industries have to re-think/adapt their processes towards a more circular approach. Such pressure is even more critical in the Rio Doce region, Minas Gerais, due to the large environmental accident occurred in 2015. Cenibra (pulp mill) is an example of such industries due to the fact that it is situated in the river basin and that it has a water demanding process. The current proposal is meant as an academic and engineering study to propose possible solutions to decrease the total water consumption of the mill and, thus, decrease the total stress on the Rio Doce basin. The work will be divided in three working packages, namely: (i) evaluation (modelling) of the mill process and water balance (ii) application and operation of a pilot scale wastewater treatment plant (iii) analysis of the impacts caused by the improvement of the process. The second work package will also be conducted (in parallel) with a lab scale setup in The Netherlands to allow fast adjustments and broaden evaluation of the setup/process performance. The actions will focus on reducing the mill total water consumption in 20%.
