Background: Persons with profound intellectual and multiple disabilities (PIMD) are vulnerable when it comes to experiencing pain. Reliable assessment of pain-related behaviour in these persons is difficult. Aim To determine how pain items can be reliably scored in adults with PIMD.Methods: We developed an instruction protocol for the assessment of pain-related behaviour in four phases. We used videos of 57 adults with PIMD during potentially painful situations. The items were assessed for inter-rater reliability (Cohen's kappa or percentage of agreement).Results: The developed instruction protocol appeared to be adequate. Twelve items had satisfactory inter-rater reliability (n = 9: .30–1.00; n = 3: 85%–100%).Discussion: Calibrating and adjustments to the instructions and item set appeared to be crucial to reliably score 12 items in adults with PIMD. Further research should focus on creating an assessment instrument based on these reliably scored items.
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In het herstellen en behouden van zinvolle bezigheden voor mensen met een lichte of matige vorm van van de ziekte van Alzheimer is doelstelling van groot praktisch belang. De studies gericht op dit doel hebben vertrouwd op de verschillende strategieën van zelfmanagement van instruction cues. Zeven studies werden gevonden die plaats hadden in de periode 2008-2012 (dat wil zeggen, de periode waarin onderzoek op dit gebied daadwerkelijk vorm heeft gekregen). Die strategieën bestaan uit het gebruik van (1) verbale signalen aangeboden via audiorecorders, (2) visuele signalen aangeboden via computersystemen, en (3) een combinatie van verbale en visuele signalen gepresenteerd via computersystemen. Dit artikel geeft een overzicht van de hiervoor genoemde strategieën en bespreekt de resultaten daarvan, hun algemene doeltreffendheid, op prestaties en stemmingen, en hun geschiktheid en bruikbaarheid. Thema's voor toekomstig onderzoek werden eveneens onderzocht. ABSTRACT Helping people with mild or moderate Alzheimer's disease restore and maintain constructive occupations is an objective of great practical importance. Studies targeting this goal have relied on different strategies for self-management of instruction cues. Seven studies were identified in the period 2008- 2012 (i.e. the period in which research in this area has actually taken shape). These strategies consist of the use of (1) verbal cues presented via audio recording devices, (2) pictorial cues presented via computer-aided systems and (3) combinations of verbal and pictorial cues presented via computer-aided systems. This paper reviews these strategies and discusses their outcomes, their overall effectiveness on performance and mood, and their suitability and practicality. Issues for future research are also examined.
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This is the first draft of the large scale 3d printing protocol for granulated thermoplastics. The main purpose of this document is to share the key steps of operating, preparation, data entry, and optimization procedures while handling the robotic 3d printing equipment. One main aspect of this protocol is that it is independent of specific 3d printing hardware or software setups. The aim is to have the users from robotic 3d printing from various technologies follow these steps and be able to set the basics up when it comes to handling such 3d printers.
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Implementing new information systems and devices, in high-reliability organizations such as operating rooms (OR’s) in hospitals, is complex. To improve the success and efficiency of these implementations we constructed a protocol for implementation for digitization and devices in OR’s. This protocol consists of implementation factors, implementation activities, and implementation instructions. In this study, we evaluated this protocol. To gather data, we organized three focus group sessions with participants holding different job roles at different departments: a surgeon, a methodologist, anesthesiologists, a scrub nurse, a training officer, innovations officers, and OR-management. We gathered qualitative data regarding completeness, clearness, and the ability to execute. Sessions were video-recorded, transcribed, and coded in Nvivo for Windows according to Toulmins Argumentative Pattern. Based on this analysis, revisions to factors, activities, and instructions are presented for protocol enhancement; experts confirm that an implementation protocol is needed to increase implementation efficiency and adoption of new devices.
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The rising global demand for district nursing care necessitates effective strategies to support evidence-based decision-making. Despite the extensive development of nursing guidelines, adherence by district nursing teams remains suboptimal, revealing a gap between guideline development and daily practice. The Learning And Reflection for Nurses (LEARN) programme aims to bridge this gap by enhancing guideline use and fostering a learning attitude among district nursing teams. This protocol outlines the programme’s development, components and evaluation approach.
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There is a wide range of literature suggesting that implicit learning is more effective than explicit learning when acquiring motor skills. However, the acquisition of nursing skills in educational settings continues to rely heavily on detailed protocols and explicit instructions. This study aimed to examine the necessity for comprehensive protocols in the acquisition of nursing skills. In the context of bandaging techniques, three studies were conducted to investigate whether students who practiced with an instruction card containing minimal instructions (implicit group) performed comparably to the students who practiced with a protocol containing step-by-step instructions (explicit group). Study 1 was designed to determine whether both groups performed equally well in applying a bandage during training. Study 2 and 3 were designed to determine if both groups performed equally well during a retention and transfer (multitasking) test, administered after a series of three training sessions. In comparison with the explicit group, the implicit group demonstrated comparable performance with their practice attempts in Study 1 and performed equally well during the retention and transfer test in Study 2. Furthermore, several results from Study 3 indicated better performance of the implicit group. In conclusion, the use of protocols with explicit step-by-step instructions may not be essential for the acquisition of nursing skills. Instead, instructional methods that facilitate implicit learning may be preferable, as students in the implicit group demonstrated at least comparable performance in all studies and tended towards greater consistency when multitasking.
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In BMC Oral Health verscheen het volgende artikel van Inholland-docente en promovenda Janneke Scheerman (en collega’s). Background: Adolescents with fixed orthodontic appliances are at high risk of developing dental caries. To date, new smartphone technologies have seldom been used to support them in the preventive behavior that can help prevent dental caries. After an intervention-mapping process, we developed a smartphone application (the WhiteTeeth app) for preventing dental caries through improved oral-health behavior and oral hygiene. The app, which is intended to be used at home, will help adolescents with fixed orthodontic appliances perform their oral self-care behavior. The app is based on the Health Action Process Approach (HAPA) theory, and incorporates several behavior-change techniques that target the psychosocial factors of oral-health behavior. This article describes the protocol of a randomized controlled trial (RCT) to evaluate the effects of the WhiteTeeth app on oral-health behavior and oral-hygiene outcomes (presence of dental plaque and gingival bleeding) compared with those of care as usual, in patients aged 12–16 with fixed orthodontic appliances.
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Digitization of activities in hospitals receives more attention, due to Covid-19 related regulations. The use of e-health to support patient care is increasing and efficient ways to implement digitization of processes and other technological equipment are needed. We constructed a protocol for implementation and in this study, we evaluate this protocol based on a case to implement a device in the OR. We used various data sources to evaluate this protocol: semi-structured interviews, questionnaires, and project documents. Based on these findings, this protocol, including identified implementation activities and implementation instructions can be used for implementations of other devices. Implementation activities include setting up a project plan, organizational and technological preparation, maintenance, and training. In future research, these activities and instructions need to be evaluated in more complex projects and a flexible tool needs to be developed to select relevant activities and instructions for implementations of information systems or devices.
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Cities are confronted with more frequent heatwaves of increasing intensity discouraging people from using urban open spaces that are part of their daily lives. Climate proofing cities is an incremental process that should begin where it is needed using the most cost-efficient solutions to mitigate heat stress. However, for this to be achieved the factors that influence the thermal comfort of users, such as the layout of local spaces, their function and the way people use them needs to be identified first. There is currently little evidence available on the effectiveness of heat stress interventions in different types of urban space.The Cool Towns Heat Stress Measurement Protocol provides basic guidance to enable a full Thermal Comfort Assessment (TCA) to be conducted at street-level. Those involved in implementing climate adaptation strategies in urban areas, such as in redevelopments will find practical support to identify places where heat stress may be an issue and suggestions for effective mitigation measures. For others, such as project developers, and spatial designers such as landscape architects and urban planners it provides practical instructions on how to evaluate and provide evidence-based justification for the selection of different cooling interventions for example trees, water features, and shade sails, for climate proofing urban areas.
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Light profoundly impacts many aspects of human physiology and behaviour, including the synchronization of the circadian clock, the production of melatonin, and cognition. These effects of light, termed the non-visual effects of light, have been primarily investigated in laboratory settings, where light intensity, spectrum and timing can be carefully controlled to draw associations with physiological outcomes of interest. Recently, the increasing availability of wearable light loggers has opened the possibility of studying personal light exposure in free-living conditions where people engage in activities of daily living, yielding findings associating aspects of light exposure and health outcomes, supporting the importance of adequate light exposure at appropriate times for human health. However, comprehensive protocols capturing environmental (e.g., geographical location, season, climate, photoperiod) and individual factors (e.g., culture, personal habits, behaviour, commute type, profession) contributing to the measured light exposure are currently lacking. Here, we present a protocol that combines smartphone-based experience sampling (experience sampling implementing Karolinska Sleepiness Scale, KSS ratings) and high-quality light exposure data collection at three body sites (near-corneal plane between the two eyes mounted on spectacle, neck-worn pendant/badge, and wrist-worn watch-like design) to capture daily factors related to individuals’ light exposure. We will implement the protocol in an international multi-centre study to investigate the environmental and socio-cultural factors influencing light exposure patterns in Germany, Ghana, Netherlands, Spain, Sweden, and Turkey (minimum n = 15, target n = 30 per site, minimum n = 90, target n = 180 across all sites). With the resulting dataset, lifestyle and context-specific factors that contribute to healthy light exposure will be identified. This information is essential in designing effective public health interventions.
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