Objective. Clinicians may use implicit or explicit motor learning approaches to facilitatemotor learning of patients with stroke. Implicit motor learning approaches have shown promising results in healthy populations. The purpose of this study was to assess whether an implicit motor learning walking intervention is more effective compared with an explicit motor learning walking intervention delivered at home regarding walking speed in people after stroke in the chronic phase of recovery. Methods. This randomized, controlled, single-blind trial was conducted in the home environment. The 79 participants, who were in the chronic phase after stroke (age = 66.4 [SD = 11.0] years; time poststroke = 70.1 [SD = 64.3] months; walking speed = 0.7 [SD = 0.3] m/s; Berg Balance Scale score = 44.5 [SD = 9.5]), were randomly assigned to an implicit (n = 38) or explicit (n = 41) group. Analogy learning was used as the implicit motor learning walking intervention, whereas the explicit motor learning walking intervention consisted of detailed verbal instructions. Both groups received 9 training sessions (30 minutes each), for a period of 3 weeks, targeted at improving quality of walking. The primary outcome was walking speed measured by the 10-MeterWalk Test at a comfortable walking pace. Outcomes were assessed at baseline, immediately after intervention, and 1 month postintervention. Results. No statistically or clinically relevant differences between groups were obtained postintervention (between-group difference was estimated at 0.02 m/s [95% CI = −0.04 to 0.08] and at follow-up (between-group difference estimated at −0.02 m/s [95% CI = −0.09 to 0.05]). Conclusion. Implicit motor learning was not superior to explicit motor learning to improve walking speed in people after stroke in the chronic phase of recovery. Impact. To our knowledge, this is the first study to examine the effects of implicit compared with explicit motor learning on a functional task in people after stroke. Results indicate that physical therapists can use (tailored) implicit and explicit motor learning strategies to improve walking speed in people after stroke who are in the chronic phase of recovery.
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Companies in the Brainport region are often characterized as high mix low volume (HMLV) production environments. These companies are distinguished by a wide range of possible products (high product variety), which are produced in low volumes. These are often customer-specific products that are produced once or incidentally. Traditionally, these companies focus on efficient use of resources, where utilisation rate and cost coverage are relevant. The increasing customer demand in the region leads to pressure on production capacity. An initial intuitive response from these companies is to further increase the utilisation rate of machines. To keep costs manageable, the company tries to avoid investing in additional capacity. An undesirable side effect is increasing pressure on timeliness (delivery, such as lead times, delivery reliability, flexibility) and quality. The apparent contradiction between costs and timeliness in these HMLV production environments is a recurring issue in practice-oriented research conducted by Fontys Industrial Engineering and Management students. This results in the following research question: Which sub-aspects may be relevant to the performance regarding Quality, Delivery, and Cost (QDC) of an HMLV production environment?
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Instead of using a passive AC power grid for low power applications, this paper describes a smart plug for DC networks that is capable of providing the correct power to a device (up to 100W) and that allows for communication between different plugs and monitoring of energy consumption across the DC network using the Ethernet protocol in conjunction with a signal modulator to adapt the signals to the DC network. The ability to monitor consumption on a device-per-device basis allows for closer monitoring of in-house energy use and provides an easily scalable platform to monitor consumption at a macro level. In order to make this paper attractive for the consumer market and easily integrable with existing consumer devices, a generally compatible solution is needed. To meet these demands and to take advantage of the trend of charging consumer devices through USB, we opted for the recently adapted USB Power Delivery standard. This standard allows devices to communicate with the plug and demand a specific voltage and current needed for the device to operate. The purpose of this paper is to give the reader insight in the development of a proof of concept of the smart DC/DC power plug. 10.1109/DUE.2014.6827761
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Nationwide and across the globe, the quality, affordability, and accessibility of home-based healthcare are under pressure. This issue stems from two main factors: the rapidly growing ageing population and the concurrent scarcity of healthcare professionals. Older people aspire to live independently in their homes for as long as possible. Additionally, governments worldwide have embraced policies promoting “ageing in place,” reallocating resources from institutions to homes and prioritising home-based services to honour the desire of older people to continue living at home while simultaneously addressing the rising costs associated with traditional institutional care.Considering the vital role of district nursing care and the fact that the population of older people in need of assistance at home is growing, it becomes clear that district nursing care plays a crucial role in primary care. The aim of this thesis is twofold: 1) to strengthen the evidence base for district nursing care; and 2) to explore the use of outcomes for learning and improving in district nursing care. The first part of this thesis examines the current delivery of district nursing care and explores its challenges during the COVID-19 pandemic to strengthen the evidence base and get a better understanding of district nursing care. Alongside the goal of strengthening the evidence for district nursing care, the second part of this thesis explores the use of patient outcomes for learning and improving district nursing care. It focuses on nurse-sensitive patient outcomes relevant to district nursing care, their current measurement in practice, and what is needed to use outcomes for learning and improving district nursing practice.
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For IT services companies, delivering high quality IT services is of eminent importance. IT service quality drives customer satisfaction, which in its turn drives firm performance. It is this link that is addressed in this paper: How can the performance of customer service delivery teams be improved, when looked upon from the perspective of firm performance? Based on the literature on excellent performing organizations, we apply the concepts that, according to Collins (2001), drove the development of 'good' companies to 'great' companies to a case study of an under performing service delivery team that developed into an excellent performing service delivery team. The lessons from this study were that most of the drivers behind the performance improvement of this team were in fact 'soft' factors that concerned the human side of the team more than the organizational, procedural or structural measures.
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Review in het kader van COST Action IS1106 Working group 3 In the review below, we summarize resent empirical research about practising offender supervision in The Netherlands on six theme’s: 1. The roles, characteristics, recruitment and training of key actors in the delivery of offender supervision. 2. Interactions and relationships between key actors in the delivery of offender supervision and other relevant professionals. 3. The delivery/practice/performance of offender supervision. 4. The role of tools and technologies in the delivery of OS. 5. The management, supervision and/or regulation of practitioners and their practice. 6. Reflections / contextual issues Ongoing research is discussed in the descriptions of the different theme’s. We conclude with a short reflection about research on practising supervision in the Netherlands. The review is limited to studies about adults. Studies on community sentences have not yet been addressed, we will do this in the next version.
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This paper analyses the ways in which informal mediation channels facilitate service delivery in the Citizen Service Bureaus at the Municipal Corporation of Delhi and give rise to an interplay between formal and informal institutions. In particular, the personal backgrounds of brokers as informal mediators and how they ensure their acceptance amongst service seekers are explored. Further, the motivations of the service seekers to solicit help from these mediators as well as institutional responses from the municipal administration along with other relevant actors like the Government of National Capital Territory of Delhi are examined.
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The COVID-19 pandemic has accelerated remote working and working at the office. This hybrid working is an indispensable part of today's life even within Agile Software Development (ASD) teams. Before COVID-19 ASD teams were working closely together in an Agile way at the office. The Agile Manifesto describes 12 principles to make agile working successful. These principles are about working closely together, face-to-face contact and continuously responding to changes. To what extent does hybrid working influence these agile principles that have been indispensable in today's software development since its creation in 2001? Based on a quantitative study within 22 Dutch financial institutions and 106 respondents, the relationship between hybrid working and ASD is investigated. The results of this research show that human factors, such as team spirit, feeling responsible and the ability to learn from each other, are the most decisive for the success of ASD. In addition, the research shows that hybrid working creates a distance between the business organization and the IT department. The findings are valuable for Managers, HR professionals and employees working in the field of ASD as emphasizing and fostering Team Spirit, Learning Ability, and a Sense of Responsibility among team members can bolster the Speed of ASD.
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Advanced technology is a primary solution for the shortage of care professionals and increasing demand for care, and thus acceptance of such technology is paramount. This study investigates factors that increase use of advanced technology during elderly care, focusing on current use of advanced technology, factors that influence its use, and care professionals’ experiences with the use. This study uses a mixed-method design. Logfiles were used (longitudinal design) to determine current use of advanced technology, questionnaires assessed which factors increase such use, and in-depth interviews were administered to retrieve care professionals’ experiences. Findings suggest that 73% of care professionals use advanced technology, such as camera monitoring, and consult clients’ records electronically. Six of nine hypotheses tested in this study were supported, with correlations strongest between performance expectancy and attitudes toward use, attitudes toward use and satisfaction, and effort expectancy and performance expectancy. Suggested improvements for advanced technology include expanding client information, adding report functionality, solving log-in problems, and increasing speed. Moreover, the quickest way to increase acceptance is by improving performance expectancy. Care professionals scored performance expectancy of advanced technology lowest, though it had the strongest effect on attitudes toward the technology.
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This book provides insight into an ambitious project to re-invent the educational method practiced at NHL Stenden. The predecessors used different approaches to the delivery of education. One of them used Competency-Based Education, whilst the other practiced Problem-Based Learning. The choice to combine the advantages of both methods, as well as to develop an entirely new concept that provided a better response to the fast and ever-increasing pace of changes in the workplace, was made by both institutions together. This approach was called Design-Based Education (DBE). Given the significant changes required of stakeholders to facilitate learning according to the new DBE approach, it is important to take stock of what these changes mean in terms of teaching and learning and to ascertain from early steps how everybody can stay, or step, on board.
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