How does artistic identity influence the self-confidence of music educators? What is the interconnection between the artistic and the teacher identity? What is actually meant by artistic identity in music education? What is a fruitful environment for the development of artistic self-confidence of music educators and how can institutions contribute to that? This article reflects on these questions from various angles. Brigitte Lion goes into aspects of self-confidence based on her research and experiences in coaching young teachers. In her address, Christine Stöger establishes a link between gaining self-confidence and positive experiences in the artistic area, making the case for a ‘third space’ where interconnections can occur on the cutting edge of artistic performance and pedagogy. Rineke Smilde finally, discusses the question what gaining self-confidence and displaying one’s artistry as a music educator requires of the learning environment in the institutions that train future music educators.
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Purpose: The objective of this study was to develop a questionnaire to assess confidence in wheelchair mobility in Dutch youth (WheelCon-Mobility Dutch Youth). Methods: (1) A forward–backward translation process was used to translate the original WheelCon-M from English to Dutch. (2) Items related to wheelchair mobility in Dutch youth were selected and adapted based on focus groups with youth, parents and health care professionals to create the WheelCon-Mobility Dutch Youth. (3) The WheelCon-Mobility Dutch Youth and the Utrecht Pediatric Wheelchair Mobility Skills Test 2.0 (UP-WMST 2.0) were administered to 62 participants to evaluate internal consistency and construct validity. Results: Translation and cultural adaptation led to general adaptations in instructions, sentence structure and response scale. At the item level, 24 items were included with (n = 17) and without (n = 7) adaptation, 10 items were deleted and 7 new items were included. The WheelCon-Mobility Dutch Youth had an excellent Cronbach’s alpha of 0.924 and a significant correlation (r = 0.44, p < .001) with the UP-WMST 2.0. Conclusions: This study resulted in the adaptation of the WheelCon-M into the WheelCon-Mobility for Dutch youth using a manual wheelchair. Our study suggests there is evidence supporting the internal consistency and construct validity of the WheelCon-Mobility Dutch Youth. Implications for Rehabilitation The WheelCon-Mobility Dutch Youth is a newly developed tool for assessing confidence in wheelchair mobility in Dutch youth using a manual wheelchair. It is important to assess performance and confidence in wheelchair mobility in paediatric rehabilitation.
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In this paper, we explore the design of web-based advice robots to enhance users' confidence in acting upon the provided advice. Drawing from research on algorithm acceptance and explainable AI, we hypothesise four design principles that may encourage interactivity and exploration, thus fostering users' confidence to act. Through a value-oriented prototype experiment and value-oriented semi-structured interviews, we tested these principles, confirming three of them and identifying an additional principle. The four resulting principles: (1) put context questions and resulting advice on one page and allow live, iterative exploration, (2) use action or change oriented questions to adjust the input parameters, (3) actively offer alternative scenarios based on counterfactuals, and (4) show all options instead of only the recommended one(s), appear to contribute to the values of agency and trust. Our study integrates the Design Science Research approach with a Value Sensitive Design approach.
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Background: The diffusion of telehealth into hospital care is still low, partially because of a lack of telehealth competence among nurses. In an earlier study, we reported on the knowledge, skills, and attitudes (KSAs) nurses require for the use of telehealth. The current study describes hospital nurses' confidence in possessing these telehealth KSAs. Method: In a cross-sectional study, we invited 3,543 nurses from three hospitals in the Netherlands to rate their self-confidence in 31 telehealth KSAs on a 5-point Likert scale, using an online questionnaire. Results: A total of 1,017 nurses responded to the survey. Nine KSAs were scored with a median value of 4.0, 19 KSAs with a median value of 3.0, and three KSAs with a median value of 2.0. Conclusion: Given that hospital nurses have self-confidence in only nine of the 31 essential telehealth KSAs, continuing education in additional KSAs is recommended to support nurses in gaining confidence in using telehealth.
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This qualitative study examined how the complex institutional context of gas extraction in Groningen affects relations and processes of trust, and seeks to better understand what is necessary for restoring trust. In the Groningen gas case, responsibilities for dealing with multiple negative consequences of gas extraction are shared by many different organizations who together form a complex institutional system. Numerous professionals are doing their best to help solve the problems. As individuals, case managers and other professionals are seen as benevolent and hard-working people. But as representatives of (large) institutions these professionals struggle to be seen as trustworthy because of persistent problems with institutional performance, with professionals themselves feeling they have insufficient discretionary power. More than interpersonal trust, a different form of trust appears to be at stake here: confidence in the system itself. According to many respondents, confidence in the system is low because the perceived interests of the institutions that shaped this system are not aligned with those of residents and the region. In addition, the positions of power and responsibility within this system are opaque to both residents and professionals. Moreover, the institutional system is perceived to be based on a distrustful attitude toward citizens in general, resulting in elaborate procedures for accountability, control and monitoring. These factors have become obstacles to restoring confidence in the system, no matter how well residents and professionals get along as individuals.
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Purpose: To evaluate the effects of a combination of wheelchair mobility skills (WMS) training and exercise training on physical activity (PA), WMS, confidence in wheelchair mobility, and physical fitness. Methods: Youth using a manual wheelchair (n = 60) participated in this practice-based intervention, with a waiting list period (16 weeks), exercise training (8 weeks), WMS training (8 weeks), and follow-up (16 weeks). Repeated measures included: PA (Activ8), WMS (Utrecht Pediatric Wheelchair Mobility Skills Test), confidence in wheelchair mobility (Wheelchair Mobility Confidence Scale), and physical fitness (cardiorespiratory fitness, (an)aerobic performance) and were analysed per outcome parameter using a multilevel model analyses. Differences between the waiting list and training period were determined with an unpaired sample t-test. Results: Multilevel model analysis showed significant positive effects for PA (p = 0.01), WMS (p < 0.001), confidence in wheelchair mobility (p < 0.001), aerobic (p < 0.001), and anaerobic performance (p < 0.001). Unpaired sample t-tests underscored these effects for PA (p < 0.01) and WMS (p < 0.001). There were no effects on cardiorespiratory fitness. The order of training (exercise before WMS) had a significant effect on confidence in wheelchair mobility. Conclusions: A combination of exercise and WMS training appears to have significant positive long-term effects on PA, WMS, confidence in wheelchair mobility, and (an)aerobic performance in youth using a manual wheelchair.Implications for rehabilitationExercise training and wheelchair mobility skills (WMS) training can lead to a sustained improvement in physical activity (PA) in youth using a manual wheelchair.These combined trainings can also lead to a sustained increase in WMS, confidence in wheelchair mobility, and (an)aerobic performance.More attention is needed in clinical practice and in research towards improving PA in youth using a manual wheelchair.
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Background: Adverse outcome pathway (AOP) networks are versatile tools in toxicology and risk assessment that capture and visualize mechanisms driving toxicity originating from various data sources. They share a common structure consisting of a set of molecular initiating events and key events, connected by key event relationships, leading to the actual adverse outcome. AOP networks are to be considered living documents that should be frequently updated by feeding in new data. Such iterative optimization exercises are typically done manually, which not only is a time-consuming effort, but also bears the risk of overlooking critical data. The present study introduces a novel approach for AOP network optimization of a previously published AOP network on chemical-induced cholestasis using artificial intelligence to facilitate automated data collection followed by subsequent quantitative confidence assessment of molecular initiating events, key events, and key event relationships. Methods: Artificial intelligence-assisted data collection was performed by means of the free web platform Sysrev. Confidence levels of the tailored Bradford-Hill criteria were quantified for the purpose of weight-of-evidence assessment of the optimized AOP network. Scores were calculated for biological plausibility, empirical evidence, and essentiality, and were integrated into a total key event relationship confidence value. The optimized AOP network was visualized using Cytoscape with the node size representing the incidence of the key event and the edge size indicating the total confidence in the key event relationship. Results: This resulted in the identification of 38 and 135 unique key events and key event relationships, respectively. Transporter changes was the key event with the highest incidence, and formed the most confident key event relationship with the adverse outcome, cholestasis. Other important key events present in the AOP network include: nuclear receptor changes, intracellular bile acid accumulation, bile acid synthesis changes, oxidative stress, inflammation and apoptosis. Conclusions: This process led to the creation of an extensively informative AOP network focused on chemical-induced cholestasis. This optimized AOP network may serve as a mechanistic compass for the development of a battery of in vitro assays to reliably predict chemical-induced cholestatic injury.
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In this paper, we explore the design of web-based advice robots to enhance users' confidence in acting upon the provided advice. Drawing from research on algorithm acceptance and explainable AI, we hypothesise four design principles that may encourage interactivity and exploration, thus fostering users' confidence to act. Through a value-oriented prototype experiment and valueoriented semi-structured interviews, we tested these principles, confirming three of them and identifying an additional principle. The four resulting principles: (1) put context questions and resulting advice on one page and allow live, iterative exploration, (2) use action or change oriented questions to adjust the input parameters, (3) actively offer alternative scenarios based on counterfactuals, and (4) show all options instead of only the recommended one(s), appear to contribute to the values of agency and trust. Our study integrates the Design Science Research approach with a Value Sensitive Design approach.
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Even learners with good language ability do not automatically engage in interactional encounters in the foreign language. Affective factors, such as speakers’ willingness to communicate (WTC), self-confidence and enjoyment of oral interaction play an important role in this (e.g. Dewaele & MacIntyre, 2014; MacIntyre, 2002). Little is known, however, about the effects of different instructional approaches on learner affect in oral interaction in the foreign language classroom. In a randomized experiment with Dutch pre-vocational learners (N = 147), we evaluated the effects of three newly developed instructional programmes for English as a foreign language (EFL). These programmes differed in instructional focus (form-focused vs interaction strategies-oriented) and type of task (pre-scripted language tasks vs information gap tasks). Multilevel repeated measures analyses revealed that learners’ enjoyment of EFL oral interaction was not affected by instruction, that WTC decreased over time, and that self-confidence was positively affected by combining information gap tasks with interactional strategies instruction. In addition, regression analyses revealed that development in learners’ WTC and enjoyment did not have predictive value for task achievement in EFL oral interaction, but that development in self-confidence did explain task achievement in trained interactional contexts. These results suggest that it is worthwhile for practitioners to address the development of self-confidence in their language lessons, and that they could do so my combining the use of information gap tasks with interactional strategy instruction that includes compensation-and meaning negotiation strategies.
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BackgroundFluid therapy is a common intervention in critically ill patients. It is increasingly recognised that deresuscitation is an essential part of fluid therapy and delayed deresuscitation is associated with longer invasive ventilation and length of intensive care unit (ICU) stay. However, optimal timing and rate of deresuscitation remain unclear. Lung ultrasound (LUS) may be used to identify fluid overload. We hypothesise that daily LUS-guided deresuscitation is superior to deresuscitation without LUS in critically ill patients expected to undergo invasive ventilation for more than 24 h in terms of ventilator free-days and being alive at day 28.MethodsThe “effect of lung ultrasound-guided fluid deresuscitation on duration of ventilation in intensive care unit patients” (CONFIDENCE) is a national, multicentre, open-label, randomised controlled trial (RCT) in adult critically ill patients that are expected to be invasively ventilated for at least 24 h. Patients with conditions that preclude a negative fluid balance or LUS examination are excluded. CONFIDENCE will operate in 10 ICUs in the Netherlands and enrol 1000 patients. After hemodynamic stabilisation, patients assigned to the intervention will receive daily LUS with fluid balance recommendations. Subjects in the control arm are deresuscitated at the physician’s discretion without the use of LUS. The primary endpoint is the number of ventilator-free days and being alive at day 28. Secondary endpoints include the duration of invasive ventilation; 28-day mortality; 90-day mortality; ICU, in hospital and total length of stay; cumulative fluid balance on days 1–7 after randomisation and on days 1–7 after start of LUS examination; mean serum lactate on days 1–7; the incidence of reintubations, chest drain placement, atrial fibrillation, kidney injury (KDIGO stadium ≥ 2) and hypernatremia; the use of invasive hemodynamic monitoring, and chest-X-ray; and quality of life at day 28.DiscussionThe CONFIDENCE trial is the first RCT comparing the effect of LUS-guided deresuscitation to routine care in invasively ventilated ICU patients. If proven effective, LUS-guided deresuscitation could improve outcomes in some of the most vulnerable and resource-intensive patients in a manner that is non-invasive, easy to perform, and well-implementable.Trial registrationClinicalTrials.gov NCT05188092. Registered since January 12, 2022
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