Aims and objectives. The Forensic Early Warning Signs of Aggression Inventory (FESAI) was developed to assist nurses and patients in identifying early warning signs and constructing individual early detection plans (EDP) for the prevention of aggressive incidents. The aims of this research were as follows: First, to study the prevalence of early warning signs of aggression, measured with the FESAI, in a sample of forensic patients, and second, to explore whether there are any types of warning signs typical of diagnostic subgroups or offender subgroups. Background. Reconstructing patients’ changes in behaviour prior to aggressive incidents may contribute to identify early warning signs specific to the individual patient. The EDP comprises an early intervention strategy suggested by the patient and approved by the nurses. Implementation of EDP may enhance efficient risk assessment and management. Design. An explorative design was used to review existing records and to monitor frequencies of early warning signs. Methods. Early detection plans of 171 patients from two forensic hospital wards were examined. Frequency distributions were estimated by recording the early warning signs on the FESAI. Rank order correlation analyses were conducted to compare diagnostic subgroups and offender subgroups concerning types and frequencies of warning signs. Results. The FESAI categories with the highest frequency rank were the following: (1) anger, (2) social withdrawal, (3) superficial contact and (4) non-aggressive antisocial behaviour. There were no significant differences between subgroups of patients concerning the ranks of the four categories of early warning signs. Conclusion. The results suggest that the FESAI covers very well the wide variety of occurred warning signs reported in the EDPs. No group profiles of warning signs were found to be specific to diagnosis or offence type. Relevance to clinical practice. Applying the FESAI to develop individual EDPs appears to be a promising approach to enhance risk assessment and management.
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Dementia is often diagnosed after emergency situations have emerged.The social network of elderly was studied in order to find out if persons or institutions could help to discover problems in an earlier phase. It was concluded that family is most important, and that information, rather than detection, is more helpful in the period preceding diagnosis. In: Journal of Clinical Nursing; 19 (1), 89
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Rationale: Diagnosis of sarcopenia in older adults is essential for early treatment in clinical practice. Bio-electrical impedance analysis (BIA) may be a valid means to assess appendicular lean mass (ALM) in older adults, but limited evidence is available. Therefore, we aim to evaluate the validity of BIA to assess ALM in older adults.Methods: In 215 community dwelling older adults (age ≥ 55 years), ALM was measured by BIA (Tanita MC-780; 8-points) and compared with dual-energy X-ray absorptiometry (DXA, Hologic Discovery A) as reference. Validity for assessing absolute values of ALM was evaluated by: 1) bias (mean difference), 2) percentage of accurate predictions (within 5% of DXA values), 3) individual error (root mean squared error (RMSE), mean absolute deviation), 4) limits of agreement (Bland-Altman analysis). For diagnosis of low ALM, the lowest quintile of ALM by DXA was used (below 21.4 kg for males and 15.4 for females). Sensitivity and specificity of detecting low ALM by BIA were assessed.Results: Mean age of the subjects was 71.9 ± 6.4, with a BMI of 25.8 ± 4.2 kg/m2, and 70% were females. BIA slightly underestimated ALM compared to DXA with a mean bias of -0.6 ± 0.2 kg. The percentage accurate predictions was 54% with RMSE 1.6 kg and limits of agreements −3.0 to +1.8 kg. Sensitivity was 79%, indicating that 79% of subjects with low ALM according to DXA also had low ALM with the BIA. Specificity was 90%, indicating that 90% of subjects with ‘no low’ ALM according to DXA also had ‘no low’ ALM with the BIA.Conclusions: This comparison showed a poor validity of BIA to assess absolute values of ALM, but a reasonable sensitivity and specificity to diagnose a low level of ALM in community-dwelling older adults in clinical practice.Disclosure of interest: None declared.
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Rotating machinery, such as centrifugal pumps, turbines, bearings, and other critical systems, is the backbone of various industrial processes. Their failures can lead to significant maintenance costs and downtime. To ensure their continuous operation, we propose a fault diagnosis and monitoring framework that leverages the innovative use of acoustic sensors for early fault detection, especially in components less accessible for traditional vibration-based monitoring strategies. The main objective of the proposed project is to develop a fault diagnosis and monitoring framework for rotating machinery, including the fusion of acoustic sensors and physics-based models. By combining real-time monitoring data from acoustic sensors with an understanding of first principles, the framework will enable maintenance practitioners to identify and categorize different failure modes such as wear, fatigue, cavitation, reduced flow, bearing damage, impeller damage, misalignment, etc. In the initial phase, the focus will be on centrifugal pumps using the existing test set-up at the University of Twente. Sorama specializes in acoustic sensors to locate noise sources and will provide acoustic cameras to capture sound patterns related to pump deterioration during various operating conditions. These acoustic signals will then be correlated with the different failure modes and mechanisms that will be described by physics-based models, such as wear, fatigue, cavitation, corrosion, etc. Furthermore, a recently published data set by the Dynamics Based Maintenance research group that includes vibration analysis data and motor current analysis data of various fault scenarios, such as mentioned above, will be used as validation. The anticipated outcome of this project is a versatile framework for a physics-informed acoustic monitoring system. This system is designed to enhance early fault detection significantly, reducing maintenance costs and downtime across a broad spectrum of industrial applications, from centrifugal pumps to turbines, bearings, and beyond.
