AIM To examine which instruments used to assess participation of children with acquired brain injury (ABI) or cerebral palsy (CP) align with attendance and/or involvement constructs of participation; and to systematically review measurement properties of these instruments in children with ABI or CP, to guide instrument selection. METHOD Five databases were searched. Instruments that quantified ‘attendance’ and/or ‘involvement’ aspects of participation according to the family of participation-related constructs were selected. Data on measurement properties were extracted and methodological quality of the studies assessed. RESULTS Thirty-seven instruments were used to assess participation in children with ABI or CP. Of those, 12 measured attendance and/or involvement. The reliability, validity, and responsiveness of eight of these instruments were examined in 14 studies with children with ABI or CP. Sufficient measurement properties were reported for most of the measures, but no instrument had been assessed on all relevant properties. Moreover, most psychometric studies have marked methodological limitations. INTERPRETATION Instruments to assess participation of children with ABI or CP should be selected carefully, as many available measures do not align with attendance and/or involvement. Evidence for measurement properties is limited, mainly caused by low methodological study quality. Future studies should follow recommended methodological guidelines.
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The purpose was to perform a systematic review of clinical assessment methods for classifying Generalized Joint Hypermobility (GJH), evaluate their clinimetric properties, and perform the best evidence synthesis of these methods. Four test assessment methods (Beighton Score [BS], Carter and Wilkinson, Hospital del Mar, Rotes‐Querol) and two questionnaire assessment methods (Five‐part questionnaire [5PQ], Beighton Score‐self reported [BS‐self]) were identified on children or adults. Using the Consensus‐based Standards for selection of health Measurement Instrument (COSMIN) checklist for evaluating the methodological quality of the identified studies, all included studies were rated “fair” or “poor.” Most studies were using BS, and for BS the reliability most of the studies showed limited positive to conflicting evidence, with some shortcomings on studies for the validity. The three other test assessment methods lack satisfactory information on both reliability and validity. For the questionnaire assessment methods, 5PQ was the most frequently used, and reliability showed conflicting evidence, while the validity had limited positive to conflicting evidence compared with test assessment methods. For BS‐self, the validity showed unknown evidence compared with test assessment methods. In conclusion, following recommended uniformity of testing procedures, the recommendation for clinical use in adults is BS with cut‐point of 5 of 9 including historical information, while in children it is BS with cut‐point of at least 6 of 9. However, more studies are needed to conclude on the validity properties of these assessment methods, and before evidence‐based recommendations can be made for clinical use on the “best” assessment method for classifying GJH.
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The denim industry faces many complex sustainability challenges and has been especially criticized for its polluting and hazardous production practices. Reducing resource use of water, chemicals and energy and changing denim production practices calls for collaboration between various stakeholders, including competing denim brands. There is great benefit in combining denim brands’ resources and knowledge so that commonly defined standards and benchmarks are developed and realized on a scale that matters. Collaboration however, and especially between competitors, is highly complex and prone to fail. This project brings leading denim brands together to collectively take initial steps towards improving the ecological sustainability impact of denim production, particularly by establishing measurements, benchmarks and standards for resource use (e.g. chemicals, water, energy) and creating best practices for effective collaboration. The central research question of our project is: How do denim brands effectively collaborate together to create common, industry standards on resource use and benchmarks for improved ecological sustainability in denim production? To answer this question, we will use a mixed-method, action research approach. The project’s research setting is the Amsterdam Metropolitan Area (MRA), which has a strong denim cluster and is home to many international denim brands and start-ups.
Everyone has the right to participate in society to the best of their ability. This right also applies to people with a visual impairment, in combination with a severe or profound intellectual and possibly motor disability (VISPIMD). However, due to their limitations, for their participation these people are often highly dependent on those around them, such as family members andhealthcare professionals. They determine how people with VISPIMD participate and to what extent. To optimize this support, they must have a good understanding of what people with disabilities can still do with their remaining vision.It is currently difficult to gain insight into the visual abilities of people with disabilities, especially those with VISPIMD. As a professional said, "Everything we can think of or develop to assess the functional vision of this vulnerable group will help improve our understanding and thus our ability to support them. Now, we are more or less guessing about what they can see.Moreover, what little we know about their vision is hard to communicate to other professionals”. Therefore, there is a need for methods that can provide insight into the functional vision of people with VISPIMD, in order to predict their options in daily life situations. This is crucial knowledge to ensure that these people can participate in society to their fullest extent.What makes it so difficult to get this insight at the moment? Visual impairments can be caused by a range of eye or brain disorders and can manifest in various ways. While we understand fairly well how low vision affects a person's abilities on relatively simple visual tasks, it is much more difficult to predict this in more complex dynamic everyday situations such asfinding your way or moving around during daily activities. This is because, among other things, conventional ophthalmic tests provide little information about what people can do with their remaining vision in everyday life (i.e., their functional vision).An additional problem in assessing vision in people with intellectual disabilities is that many conventional tests are difficult to perform or are too fatiguing, resulting in either no or the wrong information. In addition to their visual impairment, there is also a very serious intellectual disability (possibly combined with a motor impairment), which makes it even more complex to assesstheir functional vision. Due to the interplay between their visual, intellectual, and motor disabilities, it is almost impossible to determine whether persons are unable to perform an activity because they do not see it, do not notice it, do not understand it, cannot communicate about it, or are not able to move their head towards the stimulus due to motor disabilities.Although an expert professional can make a reasonable estimate of the functional possibilities through long-term and careful observation, the time and correct measurement data are usually lacking to find out the required information. So far, it is insufficiently clear what people with VZEVMB provoke to see and what they see exactly.Our goal with this project is to improve the understanding of the visual capabilities of people with VISPIMD. This then makes it possible to also improve the support for participation of the target group. We want to achieve this goal by developing and, in pilot form, testing a new combination of measurement and analysis methods - primarily based on eye movement registration -to determine the functional vision of people with VISPIMD. Our goal is to systematically determine what someone is responding to (“what”), where it may be (“where”), and how much time that response will take (“when”). When developing methods, we take the possibilities and preferences of the person in question as a starting point in relation to the technological possibilities.Because existing technological methods were originally developed for a different purpose, this partly requires adaptation to the possibilities of the target group.The concrete end product of our pilot will be a manual with an overview of available technological methods (as well as the methods themselves) for assessing functional vision, linked to the specific characteristics of the target group in the cognitive, motor area: 'Given that a client has this (estimated) combination of limitations (cognitive, motor and attention, time in whichsomeone can concentrate), the order of assessments is as follows:' followed by a description of the methods. We will also report on our findings in a workshop for professionals, a Dutch-language article and at least two scientific articles. This project is executed in the line: “I am seen; with all my strengths and limitations”. During the project, we closely collaborate with relevant stakeholders, i.e. the professionals with specific expertise working with the target group, family members of the persons with VISPIMD, and persons experiencing a visual impairment (‘experience experts’).
The research proposal aims to improve the design and verification process for coastal protection works. With global sea levels rising, the Netherlands, in particular, faces the challenge of protecting its coastline from potential flooding. Four strategies for coastal protection are recognized: protection-closed (dikes, dams, dunes), protection-open (storm surge barriers), advancing the coastline (beach suppletion, reclamation), and accommodation through "living with water" concepts. The construction process of coastal protection works involves collaboration between the client and contractors. Different roles, such as project management, project control, stakeholder management, technical management, and contract management, work together to ensure the project's success. The design and verification process is crucial in coastal protection projects. The contract may include functional requirements or detailed design specifications. Design drawings with tolerances are created before construction begins. During construction and final verification, the design is measured using survey data. The accuracy of the measurement techniques used can impact the construction process and may lead to contractual issues if not properly planned. The problem addressed in the research proposal is the lack of a comprehensive and consistent process for defining and verifying design specifications in coastal protection projects. Existing documents focus on specific aspects of the process but do not provide a holistic approach. The research aims to improve the definition and verification of design specifications through a systematic review of contractual parameters and survey methods. It seeks to reduce potential claims, improve safety, enhance the competitiveness of maritime construction companies, and decrease time spent on contractual discussions. The research will have several outcomes, including a body of knowledge describing existing and best practices, a set of best practices and recommendations for verifying specific design parameters, and supporting documents such as algorithms for verification.
