The six-minute walking test (6MWT) may be a practical test for the evaluation functional exercise capacity in children with end-stage renal disease (ESRD). The aim of this study was to investigate the 6MWT performance in children with ESRD compared to reference values obtained in healthy children and, secondly, to study the relationship between 6MWT performance with anthropometric variables, clinical parameters, aerobic capacity and muscle strength. Twenty patients (13 boys and seven girls; mean age 14.1 ± 3.4 years) on dialysis participated in this study. Anthropometrics were taken in a standardized manner. The 6MWT was performed in a 20-m-long track in a straight hallway. Aerobic fitness was measured using a cycle ergometer test to determine peak oxygen uptake (V⋅O2peak)(V⋅O2peak), peak rate (Wpeak) and ventilatory threshold (VT). Muscle strength was measured using hand-held myometry. Children with ESRD showed a reduced 6MWT performance (83% of predicted, p < 0.0001), irrespective of the reference values used. The strongest predictors of 6MWT performance were haematocrit and height. Regression models explained 59% (haematocrit and height) to 60% (haematocrit) of the variance in 6MWT performance. 6MWT performance was not associated with V⋅O2peakV⋅O2peak, strength, or other anthropometric variables, but it was significantly associated with haematocrit and height. Children with ESRD scored lower on the 6MWT than healthy children. Based on these results, the 6MWT may be a useful instrument for monitoring clinical status in children with ESRD, however it cannot substitute for other fitness tests, such as a progressive exercise test to measure V⋅O2peakV⋅O2peak or muscle strength tests.
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As multifunctional places that combine shopping and hospitality with public space and residential functions, urban consumption spaces are sites where different normative orders surface and sometimes clash. In Amsterdam, such a clash emerged over touristification of consumption spaces, eroding place attachment for local residents and urging the city government to take action. Based on policy analysis and interviews with entrepreneurs and key informants, we demonstrate how Amsterdam’s city government is responding to this issue, using legal pluralism that exists within formal state law. Specifically, the city government combines four instruments to manage touristification of consumption spaces, targeting so-called tourist shops with the aim to drive them out of the inner city. This strategic combination of policy instruments designed on various scales and for different publics to pursue a local political goal jeopardizes entrepreneurs’ rights to legal certainty. Moreover, implicitly based on class-based tastes and distrust towards particular minority groups of entrepreneurs, this policy strategy results in institutional discrimination that has far-reaching consequences for entrepreneurs in itself, but also affects trust relations among local stakeholders.
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Objective: To describe the discrimination and calibration of clinical prediction models, identify characteristics that contribute to better predictions and investigate predictors that are associated with unplanned hospital readmissions.Design: Systematic review and meta-analysis.Data source: Medline, EMBASE, ICTPR (for study protocols) and Web of Science (for conference proceedings) were searched up to 25 August 2020.Eligibility criteria for selecting studies: Studies were eligible if they reported on (1) hospitalised adult patients with acute heart disease; (2) a clinical presentation of prediction models with c-statistic; (3) unplanned hospital readmission within 6 months. Primary and secondary outcome measures: Model discrimination for unplanned hospital readmission within 6 months measured using concordance (c) statistics and model calibration. Meta-regression and subgroup analyses were performed to investigate predefined sources of heterogeneity. Outcome measures from models reported in multiple independent cohorts and similarly defined risk predictors were pooled.Results: Sixty studies describing 81 models were included: 43 models were newly developed, and 38 were externally validated. Included populations were mainly patients with heart failure (HF) (n=29). The average age ranged between 56.5 and 84 years. The incidence of readmission ranged from 3% to 43%. Risk of bias (RoB) was high in almost all studies. The c-statistic was <0.7 in 72 models, between 0.7 and 0.8 in 16 models and >0.8 in 5 models. The study population, data source and number of predictors were significant moderators for the discrimination. Calibration was reported for 27 models. Only the GRACE (Global Registration of Acute Coronary Events) score had adequate discrimination in independent cohorts (0.78, 95% CI 0.63 to 0.86). Eighteen predictors were pooled. Conclusion: Some promising models require updating and validation before use in clinical practice. The lack of independent validation studies, high RoB and low consistency in measured predictors limit their applicability.PROSPERO registration number: CRD42020159839.
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The project Decolonising Education: from Teachers to Leading Learners (DETeLL) aims to develop a multi-site approach for interventions towards inclusion and decolonisation in order to change the hierarchical nature of higher education in the Netherlands. DETeLL identifies the model of the ‘traditional teacher’ as embodying the structural exclusions and discriminations built into the classroom and proposes the figure of a ‘Leading Learner’ as a first step towards a radical change in the educational system. In collaboration with the education departments in the Theatre and Dance Academy at ArtEZ, the post-doc will build up a research and teaching programme that engages with students and teachers in the faculty to create a prototype of an inclusive and diverse educational practice. RELEVANCE: Education should be the critical space in which changes occur in order to shape best possible futures. In DETeLL’s acceptation, decolonisation refers to a complete change in the way of thinking and behaving. It does not refer only to the urgency of dealing with historical colonial legacies embedded in society, but also to the subversion of the deeply oppressive colonial culture that (also unconsciously) regulates public and private living, whether this is related to gender, race, class or sexuality issues. RESULTS: 1) Create a theory and practice-based scientific base-line of decolonisation and art education; 2) Provide a definition of ‘Artist educator as Leading Learner’ following a practice- based methodology of intervention; 3) Design and Pilot a new teaching programme for theatre education at ArtEZ to be then upscaled to all educational departments in a follow-up project); 4) Produce a strong interdisciplinary and international output plan: 3 academic publications, 2 conferences, 4 expert group workshops. NETWORK: ArtEZ; University of Amsterdam (UvA); Ghent University; UCHRI; Hildesheim University; Cape Town University. The partners will serve as steering committee through planned expert group meetings.
This project aims to develop a measurement tool to assess the inclusivity of experiences for people with varying challenges and capabilities on the auditory spectrum. In doing so, we performed an in-depth exploration of scientific literature and findings from previous projects by Joint Projects. Based on this, we developed an initial conceptual model that focuses on sensory perception, emotion, cognition, and e[ort in relation to hearing and fatigue. Within, this model a visitor attraction is seen as an “experienscape” with four key elements: content, medium, context, and individual. In co-creative interviews with experts by experience with varying challenges on the auditory spectrum, they provided valuable insights that led to a significant expansion of this initial model. This was a relevant step, as in the scientific and professional literature, little is known about the leisure experiences of people with troubled hearing. For example, personal factors such as a person’s attitude toward their own hearing loss and the social dynamics within their group turned out to greatly influence the experience. The revised model was then applied in a case study at Apenheul, focusing on studying differences in experience of their gorilla presentation amongst people with varying challenges on the auditory spectrum.Societal issueThe Netherlands is one of the countries in Europe with the highest density of visitor attractions. Despite this abundance, many visitor attractions are not fully accessible to everyone, particularly to visitors with disabilities who sometimes are not eligible to ride due to safety concerns, yet when eligible generally still encounter numerous barriers. Accessibility of visitor attractions can be approached in various ways. However, because the focus often lies on operational and technical aspects (e.g., reducing stimuli at certain times of the day by turning o[ music, o[ering alternative wheelchair entrances), strategic and community-focused approaches are often overlooked. More importantly, there is also a lack of attention to the experience of visitors with disabilities. This becomes apparent from several studies from Joint Projects, where visitor attractions are being visited together with experts by experience with various disabilities. Nevertheless, experience is often being regarded as the 'core product' of the leisure sector. The right to meet, discover, develop, relax and thus enjoy this core product is hindered for many people with disabilities due to a lack of knowledge, inaccessibility (physical, digital, social, communicative as well as financial) and discrimination in society. Additionally, recreation entrepreneurs still face a significant gap in reaching the potential market of guests with disabilities and their networks. Thus, despite the numerous initiatives in the leisure sector aimed at improving accessibility on technical and operational fronts, often people with disabilities are still not being able to experience the same kind of enjoyment as those without. These observations form the pressing impetus for initiating the current research project, tapping into the numerous opportunities for learning, development and growth on making leisure offer more inclusive.Benefit to societyIn total, the current project approach comes with a number of enrichments in terms of both knowledge and methodology: a mixed-methods approach that allows for comparing data from different sources to obtain a more complete picture of the experience; a methodological co-design process that honours the 'nothing about us without us' principle; and benchmarking for a group (i.e., people with challenges on the auditory spectrum) that despite the size of its population has thus far mostly been overlooked.
This project aims to enhance museum experiences through value-driven design of a personalized, interactive AI-powered guide providing tailored information in real-time. Museums often rely on human guides for detailed content, but these services are typically limited to group tours. Audio guides are the common alternative for individual visitors, but they deliver standardized content that doesn't adapt to personal interests, creating a gap in the visitor experience. Additionally, creating content for traditional audio guides is expensive for museums to develop and maintain. Research shows that museum visitors increasingly desire more control over how they interact with exhibits, preferring information that aligns with their personal interests rather than generalized content. Simultaneously, museums are eager to meet this demand by offering more personalized engagement, making visitor experiences more relevant and impactful. In collaboration with Stedelijk Museum Breda and Brabant Cloud, creative professionals will co-design an app that acts as a personal digital guide, adapting its responses to each visitor's preferences. The app will use the museum's existing digital collection infrastructure to deliver customized interaction better connected to visitors' needs, interests, and linguistic abilities. The design approach emphasizes inclusivity and non-discrimination, ensuring accessible experiences for diverse audiences while aligning with the museum's educational objectives. We will test the app at Stedelijk Museum Breda, gathering feedback from three visitor groups and comparing experiences between (1) those using the AI-powered app, (2) those not using the app, and (3) those with a human guide. We anticipate that this creative industries solution will facilitate more engaging and customized experiences while providing a scalable model that could benefit other cultural institutions through Brabant Cloud's regional network.
