In these uncertain times, politicians and society have been voicinghigh expectations from teacher education asking for evidence ofadded value and impact on the student. In this study a longitudinalmixed-methods approach was used to determine theimpact of in-service Master of Education programmes on teachers(N = 1,917) and their work environment in the Netherlands. Theresults of online surveys were explained by means of realist evaluationusing focus-group and in-depth interviews. The studyshows that Master of Education programmes had an impact onprofessional and pedagogical skills of teachers, and in some casesalso on their work environment. A two-tier mechanism is proposed:the Master’s programmes provide teachers with more indepthknowledge about teaching and learning and a more criticalstance through inquiry and research. Consequently, some teacherscontribute to a culture of inquiry in their schools, provided thatthe schools facilitate them in new roles.
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Background: A hospital group is an organizational integration strategy that has recently been widely implemented in Chinese urban health systems to promote integrated care. This study aims to evaluate the effect of hospital group on integrated care from the perspectives of both patients and care professionals. Methods: Two cross-sectional surveys were conducted in Shenzhen city of China, in June 2018 and July 2021. All 30 community health stations (CHSs) in the hospital group were included in the intervention group, with 30 CHSs in the same district selected as the control group by simple random sampling. All care professionals within both the intervention and the control groups were invited to participate in the surveys. Twelve CHSs were selected from 30 CHSs in the intervention and the control groups by simple random sampling, and 20 patients with type 2 diabetes mellitus (T2DM) were selected from each of these selected CHSs to participate in the survey by systematic sampling. The Chinese version Rainbow Model of Integrated Care Measurement Tool (C-RMIC-MT) was used to assess integrated care. Propensity score matching and difference-in-differences regression (PSM-DID) were used to evaluate the effect of the hospital group on integrated care. Results: After matching, 528 patients and 1896 care professionals were included in the DID analysis. Results from care professionals indicated that the hospital group significantly increased technical competence of the health system by 0.771 points, and cultural competence by 1.423 points. Results from patients indicated that the hospital group significantly decreased organizational integration of the health system by 0.649 points. Conclusion: The results suggests that the effect of the hospital group on integrated care over and above routine strategies for integrated care is limited. Therefore, it is necessary to pay attention to implementing professional, clinical and other integration strategies beyond establishing hospital groups, in urban Chinese health systems.
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Background: Previous studies found that 40-60% of the sarcoidosis patients suffer from small fiber neuropathy (SFN), substantially affecting quality of life. SFN is difficult to diagnose, as a gold standard is still lacking. The need for an easily administered screening instrument to identify sarcoidosis-associated SFN symptoms led to the development of the SFN Screening List (SFNSL). The usefulness of any questionnaire in clinical management and research trials depends on its interpretability. Obtaining a clinically relevant change score on a questionnaire requires that the smallest detectable change (SDC) and minimal important difference (MID) are known. Objectives: The aim of this study was to determine the SDC and MID for the SFNSL in patients with sarcoidosis. Methods: Patients with neurosarcoidosis and/or sarcoidosis-associated SFN symptoms (N=138) included in the online Dutch Neurosarcoidosis Registry participated in a prospective, longitudinal study. Anchor-based and distribution-based methods were used to estimate the MID and SDC, respectively. Results: The SFNSL was completed both at baseline and at 6-months’ follow-up by 89/138 patients. A marginal ROC curve (0.6) indicated cut-off values of 3.5 points, with 73% sensitivity and 49% specificity for change. The SDC was 11.8 points. Conclusions: The MID on the SFNSL is 3.5 points for a clinically relevant change over a 6-month period. The MID can be used in the follow-up and management of SFN-associated symptoms in patients with sarcoidosis, though with some caution as the SDC was found to be higher.
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Background: Currently, the Ponseti method is the gold standard for treatment of clubfeet. For long-term func- tional evaluation of this method, gait analysis can be performed. Previous studies have assessed gait differences between Ponseti treated clubfeet and healthy controls. Research question/purpose: The aims of this systematic review were to compare the gait kinetics of Ponseti treated clubfeet with healthy controls and to compare the gait kinetics between clubfoot patients treated with the Ponseti method or surgically. Methods: A systematic search was performed in Embase, Medline Ovid, Web of Science, Scopus, Cochrane, Cinahl ebsco, and Google scholar, for studies reporting on gait kinetics in children with clubfeet treated with the Ponseti method. Studies were excluded if they only used EMG or pedobarography. Data were extracted and a risk of bias was assessed. Meta-analyses and qualitative analyses were performed. Results: Nine studies were included, of which five were included in the meta-analyses. The meta-analyses showed that ankle plantarflexor moment (95% CI -0.25 to -0.19) and ankle power (95% CI -0.89 to -0.60, were significantly lower in the Ponseti treated clubfeet compared to the healthy controls. No significant difference was found in ankle dorsiflexor and plantarflexor moment, and ankle power between clubfeet treated with surgery compared to the Ponseti method. Significance: Differences in gait kinetics are present when comparing Ponseti treated clubfeet with healthy controls. However, there is no significant difference between surgically and Ponseti treated clubfeet. These results give more insight in the possibilities of improving the gait pattern of patients treated for clubfeet.
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The aim of this study was to understand the motives for using the Internet, and its associations with users' attitudes, social values, and relational involvement. Also, this study attempted to crossculturally compare the difference in the pattern of motives and the associations among three countries ' the US, the Netherlands, and S. Korea. The design of methods was based on examination and revision of uses and gratification approach toward Internet users. Findings from factor analysis revealed that information seeking and Self-Improvement were the dominant and common reasons for using the Internet across three countries. The differences in the composition of motives in each country were also reported. Strong correlations across countries were found between all the motives and satisfaction of the Internet. Expectation and positive evaluation of the Internet were also important attitudes associated with Internet use motives. Postmaterialist value showed strong association with motives of information seeking and Self-Improvement. Community involvement was significantly associated with Internet use motives in Korean users.
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Purpose Worldwide, there are 30 million people with dementia (PWD) in 2009 and 100 million in 2050, respectively.These numbers show the need for a change in care for PWD. Leisure is one of these care aspects. Leisure activities can support PWD in several ways: meeting basic needs, providing comfort and social interaction, and reducing boredom, agitation, and isolation. An exemplary activity targeted at meeting these needs is ‘De Klessebessers (KB)’ (The Chitchatters), which aims to stimulate social interaction among PWD and provide comfort with supporting technology. This is innovative since technology for PWD generally concentrates on safety and monitoring activities. The activity comprises a radio, television, telephone, and treasure box. Method This study’s focus follows from the original aim of the KB-designers; to stimulate social interaction. In a nursing home and day care centre, the KB game was played with different groups of PWD (n=21: 12 females, 9 males, mean MMSE=17, range 3-28). In the morning KB (with technology), and in the afternoon an activity called ‘Questiongame’ (without technology) were played for 45 minutes. These activities were played twice in a two-month period, and outcomes were compared in terms of impact on social interaction. Group sizes ranged from 3 to 8 PWD assisted by 1 or 2 activity therapists. Two researchers observed the players during the activity with the Oshkosh Social Behavior Coding (OSBC) scale, which encompasses both verbal and nonverbal social and nonsocial behaviour. These behaviours can have a person-initiated and otherinitiated character (quantitative study). A total of 6 activity therapists were interviewed on the KB afterwards (qualitative study). Results & Discussion The quantitative results showed significantly higher scores for KB for the total of social interaction compared to Questiongame. Most of the behaviour is other-initiated (activity therapist). PWD with a lower MMSE score showed more non-verbal behaviour. For PWD with a MMSE score below 7, there was no difference in social interaction between the two activities. According to the qualitative research, KB triggered more social interaction, since the movies and music were stimulating the players to initiate a conversation, to which other players responded. The results of this research correspond with earlier research, which concludes that leisure activities with technology can show positive results on well-being.
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This research used a newly developed, full-scale infiltration testing (FSIT) procedure to determine the saturated surface infiltration rate of 16 existing permeable pavement installations in the Netherlands that have been in service for a number of years. Newly installed permeable pavements in the Netherlands must demonstrate a minimum infiltration capacity of 194 mm/h (540 L/s/ha). Only four of the 16 pavements tested in this study had an infiltration capacity higher than 194 mm/h. Most previous research has focused on unsaturated infiltration rates. However, the results of this study show that the difference in infiltration capacity between saturated and unsaturated can differ by up to 300%. If the unsaturated infiltration capacity is used as design input for computer models, the infiltration capacity may be significantly overestimated. The study demonstrated that the FSIT method is a reliable and accurate way to measure surface infiltration rates of permeable pavements. However, it is recommended that a minimum of three different FSIT tests should be undertaken at the same pavement location, and that the results should be averaged, to ensure appropriate infiltration rates are observed, recorded, and used in design. The results of this study should help stormwater managers with the planning, testing, and scheduling of maintenance requirements for permeable pavements with more confidence so that they will continue to perform satisfactorily over their intended design life
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Background: The present study investigates the suitability of various treatment outcome indicators to evaluate performance of mental health institutions that provide care to patients with severe mental illness. Several categorical approaches are compared to a reference indicator (continuous outcome) using pretest-posttest data of the Health of Nation Outcome Scales (HoNOS). Methods: Data from 10 institutions and 3189 patients were used, comprising outcomes of the first year of treatment by teams providing long-term care. Results: Findings revealed differences between continuous indicators (standardized pre-post difference score ES and ΔT) and categorical indicators (SEM, JTRCI, JTCS, JTRCI&CS, JTrevised) on their ranking of institutions, as well as substantial differences among categorical indicators; the outcome according to the traditional JT approach was most concordant with the continuous outcome indicators. Conclusions: For research comparing group averages, a continuous outcome indicator such as ES or ΔT is preferred, as this best preserves information from the original variable. Categorical outcomes can be used to illustrate what is accomplished in clinical terms. For categorical outcome, the classical Jacobson-Truax approach is preferred over the more complex method of Parabiaghi et al. with eight outcome categories. The latter may be valuable in clinical practice as it allows for a more detailed characterization of individual patients.
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This paper presents a method and mock-up design for evaluating the heat-island mitigation effect of porous/water-retentive blocks in a climatic environmental chamber using ambient temperature measurements. To create the proposed method, the heat circulation mechanism of blocks was considered. From this, we specified the climatic chamber design requirements, determined the required components and equipment for the mock-up, and developed the proposed method for evaluating heat-island mitigation performance based on ambient temperature. Using the proposed mock-up design and method, we confirmed that both surface and air temperatures were lower when porous/water-retentive blocks were installed compared to conventional blocks. This method can be used to analyze the difference between surface and ambient temperatures under various conditions to quantify the heat-island mitigation performance of different materials according to ambient temperature.
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Introduction: Retrospective studies suggest that a rapid initiation of treatment results in a better prognosis for patients in the emergency department. There could be a difference between the actual medication administration time and the documented time in the electronic health record. In this study, the difference between the observed medication administration time and documentation time was investigated. Patient and nurse characteristics were also tested for associations with observed time differences. Methods: In this prospective study, emergency nurses were followed by observers for a total of 3 months. Patient inclusion was divided over 2 time periods. The difference in the observed medication administration time and the corresponding electronic health record documentation time was measured. The association between patient/nurse characteristics and the difference in medication administration and documentation time was tested with a Spearman correlation or biserial correlation test. Results: In 34 observed patients, the median difference in administration and documentation time was 6.0 minutes (interquartile range 2.0-16.0). In 9 (26.5%) patients, the actual time of medication administration differed more than 15 minutes with the electronic health record documentation time. High temperature, lower saturation, oxygen-dependency, and high Modified Early Warning Score were all correlated with an increasing difference between administration and documentation times. Discussion: A difference between administration and documentation times of medication in the emergency department may be common, especially for more acute patients. This could bias, in part, previously reported time-to-treatment measurements from retrospective research designs, which should be kept in mind when outcomes of retrospective time-to-treatment studies are evaluated.
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