In the Netherlands, palliative care is provided by generalist healthcare professionals (HCPs) if possible and by palliative care specialists if necessary. However, it still needs to be clarifed what specialist expertise entails, what specialized care consists of, and which training or work experience is needed to become a palliative care special‑ist. In addition to generalists and specialists, ‘experts’ in palliative care are recognized within the nursing and medical professions, but it is unclear how these three roles relate. This study aims to explore how HCPs working in palliative care describe themselves in terms of generalist, specialist, and expert and how this self-description is related to their work experience and education. Methods A cross-sectional open online survey with both pre-structured and open-ended questions among HCPs who provide palliative care. Analyses were done using descriptive statistics and by deductive thematic coding of open-ended questions. Results Eight hundred ffty-four HCPs flled out the survey; 74% received additional training, and 79% had more than fve years of working experience in palliative care. Based on working experience, 17% describe themselves as a generalist, 34% as a specialist, and 44% as an expert. Almost three out of four HCPs attributed their level of expertise on both their education and their working experience. Self-described specialists/experts had more working experience in palliative care, often had additional training, attended to more patients with palliative care needs, and were more often physicians as compared to generalists. A deductive analysis of the open questions revealed the similarities and dis‑ tinctions between the roles of a specialist and an expert. Seventy-six percent of the respondents mentioned the impor‑tance of having both specialists and experts and wished more clarity about what defnes a specialist or an expert, how to become one, and when you need them. In practice, both roles were used interchangeably. Competencies for the specialist/expert role consist of consulting, leadership, and understanding the importance of collaboration. Conclusions Although the grounds on which HCPs describe themselves as generalist, specialist, or experts difer, HCPs who describe themselves as specialists or experts mostly do so based on both their post-graduate education and their work experience. HCPs fnd it important to have specialists and experts in palliative care in addition to gen‑eralists and indicate more clarity about (the requirements for) these three roles is needed.
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Participation in everyday occupations influences people's health and well-being. To enable individuals to do the activities they want and need to do is the main concern of occupational therapy practice. Many daily occupations are universal, but they also depend on culture. The development of the Activity Card Sort in eight countries has offered the opportunity to describe occupations across cultures. In the developmental process of culturally relevant versions of the Activity Card Sort by occupational therapists in each country, the instrument versions included samples of older adults (N = 468). These data are used in the current description with the aim of identifying central activities across cultures and central activities for Asian and Western cultures. Te n activities were identified as being central across cultures (i.e., more than half of the older adults in all eight countries performed them). They were the following: shopping in a store, doing grocery shopping, doing dishes, doing laundry, reading books or magazines, sitting and thinking, watching television, listening to radio or music, visiting with friends and relatives, and talking on the telephone. Further, 16 additional activities central to Asian culture and 18 activities central to Western culture were identified. The identification of central activities deepens knowledge of activities with cultural significance. This knowledge is needed in clinical practice and multicultural research. This description provides a starting point for further exploration of everyday occupations among older adults.
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A formal description of a database consists of the description of the relations (tables) of the database together with the constraints that must hold on the database. Furthermore the contents of a database can be retrieved using queries. These constraints and queries for databases can very well be formalized. A formal description of a constraint or a query is necessary to describe the constraint or query unambiguously. In other words, a formal description leads to one and only one meaning of the constraint or query. To describe constraints and queries in a formal way we use predicate logic, set theory and tuple relational calculus. The tuple relational calculus is a calculus based on the use of tuple variables. A tuple variable is a variable that ranges over a named relation (i.e. a set of tuples of a relation). This paper describes the use of the relational calculus for databases. A description of the formal notation is given as well as a mapping of these expressions to SQL.
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Background Children with developmental language disorders (DLD) face ongoing challenges in language and communication, impacting their learning, literacy, social interactions, and emotional well-being. Speech and language therapy interventions have been shown to positively influence the language abilities and communication skills of children with DLD. However, these interventions are often not described in full detail, hindering effective implementation, replication, and the advancement of knowledge. Method We used the Template for Intervention Description and Replication (TIDieR) checklist and guide to describe the ENGAGE tool, which supports shared decision-making between parents and SLTs about communicative participation goals for children with DLD. The description was based on the development process, the ENGAGE user manual, and an interview study on its impact on SLT practice. Results We provided a detailed description of the ENGAGE intervention using the 12 items from the TIDieR checklist and guide, facilitating easier implementation and replication. Discussion Reflecting on our findings, we discussed the evolution of shared decision-making models, comparing Elwyn et al.'s (2012) model with the updated goal-based model by Elwyn & Vermunt (2020). The new model highlights the importance of collaborative goal setting in speech and language therapy. Our findings suggest that the ENGAGE tool aligns well with the latest theoretical advancements in shared decision-making.
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Presentatie op congres The Sign Language Proficiency Interview (SLPI) is a tool for assessing functional sign language skill. Based on the Language Aptitude Test, it uses a recorded 20 minute conversation between a skilled interviewer and the candidate. The interview uses an ad hoc series of probing and challenging questions to elicit the candidate’s best use of the sign language in topics relating to the candidate’s work, family/background, and leisure activities. This video language sample is then analyzed to determine the candidate’s rating on the SLPI Rating Scale. The rating process documents vocabulary, grammar and discourse, and follows a specified protocol that includes specific examples from the interview. The SLPI is used widely in the US and Canada with American Sign Language, and one of the presenters has adapted it for use with South African Sign Language. The presenters have recently adapted the SLPI for use with Sign Language of the Netherlands (NGT). While the interview process is the same regardless of the sign language, two aspects of the adaptation for NGT required work: 1) modifying the grammar analysis to match NGT grammar; and 2) modifying the Rating Scale to align with that of the Common European Framework of Reference for languages (CEFR). This ICED presentation will include: 1) a thorough description of SLPI goals, processes and implementation; 2) modifications for NGT grammar; and 3) modifications to align with the CEFR.
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Electrohydrodynamic atomization (EHDA) is a technique which uses the influence of strong electric fields to manipulate the break-up of a liquid, pumped through a capillary nozzle, into droplets. In this work, an extended description of a specific high flow EHDA mode, known as the simple-jet mode, is presented. In it, a review of different works published about the mode is presented as well as results about the droplet population generated with varicose and whipping break-up using water as the atomized liquid. Additionally, experiments were conducted to investigate whether such atomization method could be used to improve the efficiency of droplet inair evaporation, using a single effect evaporation chamber coupled with a EHDA multinozzle system functioning as a shower head. The liquid used in these experiments was a solution of water and NaCl (35 g L−1) to simulate sea water average concentrations. The results have shown that, the manipulation of the droplet diameter, droplet size distribution and spray angle, provided by EHDA, could improve the droplet evaporation efficiency by up to 40% when combinedwith, e.g. forced convection and higher inlet temperatures.
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Study design: A secondary analysis of a systematic review. Background: Manipulations or mobilizations are commonly used interventions in patients with mechanical neck pain. The treatment effects have often been studied in randomized controlled trials (RCT) which are generally considered the gold standard in evaluating the treatment effects, mainly due to its high internal validity. External validity is defined as the extent to which the effects can be generalised to clinical practice. An important prerequisite for this is that interventions used in clinical trials can be replicated in clinical practice. It can be questioned if interventions utilized in randomized controlled trials can be translated into clinical practice. Objectives: The overall aim of this study is to examine whether the quality of the description of manipulation and mobilization interventions is sufficient for to replication of these interventions in clinical practice. Methods: A comprehensive literature search was performed. Two independent researchers used the Template for Intervention Description and Replication (TIDieR) which is a 12-item checklist for describing the completeness of the interventions. Results: Sixty-seven articles were included that used manipulation and/or mobilization interventions for patients with mechanical neck pain. None of the articles describe the intervention e.g. all the items on the TIDieR list. Considering item 8 (a-f) of the TIDieR checklist only one article described the used techniques completely. Conclusion: Manipulation or a mobilization interventions are poorly reported in RCTs, which jeopardize the external validity of RCTs, making it difficult for clinicians and researchers to replicate these interventions.
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