Het doel van dit onderzoek is te onderzoeken onder welke omstandigheden en onder welke condities relatief moderne modelleringstechnieken zoals support vector machines, neural networks en random forests voordelen zouden kunnen hebben in medisch-wetenschappelijk onderzoek en in de medische praktijk in vergelijking met meer traditionele modelleringstechnieken, zoals lineaire regressie, logistische regressie en Cox regressie.
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Abstract: Since the first Oxford Survey of Childhood Cancer’s results were published, people have become more aware of the risks associated with prenatal exposure from diagnostic x rays. As a result, it has since been the subject of many studies. In this review, the results of recent epidemiological studies are summarized. The current international guidelines for diagnostic x-ray examinations were compared to the review. All epidemiological studies starting from 2007 and all relevant international guidelines were included. Apart from one study that involved rhabdomyosarcoma, no statistically significant associations were found between prenatal exposure to x rays and the development of cancer during 2007–2020. Most of the studies were constrained in their design due to too small a cohort or number of cases, minimal x-ray exposure, and/or data obtained from the exposed mothers instead of medical reports. In one of the studies, computed tomography exposure was also included, and this requires more and longer follow-up in successive studies. Most international guidelines are comparable, provide risk coefficients that are quite conservative, and discourage abdominal examinations of pregnant women.
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Background: The Nurses in the Lead (NitL) programme consists of a systematic approach and training to 1) empower community nurses in implementing evidence, targeted at encouraging functional activities of older adults, and 2) train community nurses in enabling team members to change their practice. This article aims to describe the process evaluation of NitL. Methods: A mixed-methods formative process evaluation with a predominantly qualitative approach was conducted. Qualitative data were collected by interviews with community nurses (n = 7), focus groups with team members (n = 31), and reviewing seven implementation plans and 28 patient records. Quantitative data were collected among community nurses and team members (N = 90) using a questionnaire to assess barriers in encouraging functional activities and attendance lists. Data analysis was carried out through descriptive statistics and content analysis. Results: NitL was largely executed according to plan. Points of attention were the use and value of the background theory within the training, completion of implementation plans, and reporting in patient records by community nurses. Inhibiting factors for showing leadership and encouraging functional activities were a lack of time and a high complexity of care; facilitating factors were structure and clear communication within teams. Nurses considered the systematic approach useful and the training educational for their role. Most team members considered NitL practical and were satisfied with the coaching provided by community nurses. To optimise NitL, community nurses recommended providing the training first and extending the training. The team members recommended continuing clinical lessons, which were an implementation strategy from the community nurses. Conclusions: NitL was largely executed as planned, and appears worthy of further application in community care practice. However, adaptations are recommended to make NitL more promising in practice in empowering community nurse leadership in implementing evidence.
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