Background: Falls in stroke survivors can lead to serious injuries and medical costs. Fall risk in older adults can be predicted based on gait characteristics measured in daily life. Given the different gait patterns that stroke survivors exhibit it is unclear whether a similar fall-prediction model could be used in this group. Therefore the main purpose of this study was to examine whether fall-prediction models that have been used in older adults can also be used in a population of stroke survivors, or if modifications are needed, either in the cut-off values of such models, or in the gait characteristics of interest. Methods: This study investigated gait characteristics by assessing accelerations of the lower back measured during seven consecutive days in 31 non fall-prone stroke survivors, 25 fall-prone stroke survivors, 20 neurologically intact fall-prone older adults and 30 non fall-prone older adults. We created a binary logistic regression model to assess the ability of predicting falls for each gait characteristic. We included health status and the interaction between health status (stroke survivors versus older adults) and gait characteristic in the model. Results: We found four significant interactions between gait characteristics and health status. Furthermore we found another four gait characteristics that had similar predictive capacity in both stroke survivors and older adults. Conclusion: The interactions between gait characteristics and health status indicate that gait characteristics are differently associated with fall history between stroke survivors and older adults. Thus specific models are needed to predict fall risk in stroke survivors.
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Background to the problem Dutch society demonstrates a development which is apparent in many societies in the 21st century; it is becoming ethnically heterogeneous. This means that children who are secondlanguage speakers of Dutch are learning English, a core curriculum subject, through the medium of the Dutch language. Research questions What are the consequences of this for the individual learner and the class situation?Is a bi-lingual background a help or a hindrance when acquiring further language competences. Does the home situation facilitate or impede the learner? Additionally, how should the TEFL professional respond to this situation in terms of methodology, use of the Dutch language, subject matter and assessment? Method of approach A group of ethnic minority students at Fontys University of Professional Education was interviewed. The interviews were subjected to qualitative analysis. To ensure triangulation lecturers involved in teaching English at F.U.P.E. were asked to fill in a questionnaire on their teaching approach to Dutch second language English learners. Thier response was quantitatively and qualitatively analysed. Findings and conclusions The students encountered surprisingly few problems. Their bi-lingualism and home situation were not a constraint in their English language development. TEFL professionals should bear the heterogeneous classroom in mind when developing courses and lesson material. The introduction to English at primary school level and the assessment of DL2 learners require further research.
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Background: Different surgical approaches for total hip arthroplasty (THA) exist, without predisposition when it comes to dislocation risk. The direct anterior approach (DAA) is thought to have reduced risk since soft tissue trauma is minimalized. Therefore, we assessed the dislocation risk for different surgical approaches, and the relative dislocation risk of DAA compared to other approaches. Methods: Six electronic databases were systematically searched for prospective studies reporting dislocation following THA. Proportion meta-analyses were performed to assess the dislocation rate for subgroups of the surgical approach. Meta-analysis for binary outcomes was performed to determine the relative risk of dislocation for the DAA compared to other approaches. Results: Eleven studies with 2025 patients were included (mean age 64.6 years, 44% male, mean follow-up 10.5 months), of which four studies were also used in the risk ratio meta-analysis. Overall dislocation rate was 0.79% (95% CI 0.37–1.69). Subgroup analyses showed that most dislocations occurred in the posterior approaches group (1.38%), however non-significant. Furthermore, the DAA emerged with a non-significant lower risk of dislocation (RR 0.37, 95% CI 0.05–2.46) compared to other surgical approaches. Conclusion: Current literature shows non-significant predisposition for a surgical approach to THA regarding dislocation risk. To what extent patient characteristics influence the risk of dislocation could not be determined. Future research should focus on this, as well as on the influence of a surgeon's experience with a specific approach.
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The project aim is to improve collusion resistance of real-world content delivery systems. The research will address the following topics: • Dynamic tracing. Improve the Laarhoven et al. dynamic tracing constructions [1,2] [A11,A19]. Modify the tally based decoder [A1,A3] to make use of dynamic side information. • Defense against multi-channel attacks. Colluders can easily spread the usage of their content access keys over multiple channels, thus making tracing more difficult. These attack scenarios have hardly been studied. Our aim is to reach the same level of understanding as in the single-channel case, i.e. to know the location of the saddlepoint and to derive good accusation scores. Preferably we want to tackle multi-channel dynamic tracing. • Watermarking layer. The watermarking layer (how to embed secret information into content) and the coding layer (what symbols to embed) are mostly treated independently. By using soft decoding techniques and exploiting the “nuts and bolts” of the embedding technique as an extra engineering degree of freedom, one should be able to improve collusion resistance. • Machine Learning. Finding a score function against unknown attacks is difficult. For non-binary decisions there exists no optimal procedure like Neyman-Pearson scoring. We want to investigate if machine learning can yield a reliable way to classify users as attacker or innocent. • Attacker cost/benefit analysis. For the various use cases (static versus dynamic, single-channel versus multi-channel) we will devise economic models and use these to determine the range of operational parameters where the attackers have a financial benefit. For the first three topics we have a fairly accurate idea how they can be achieved, based on work done in the CREST project, which was headed by the main applicant. Neural Networks (NNs) have enjoyed great success in recognizing patterns, particularly Convolutional NNs in image recognition. Recurrent NNs ("LSTM networks") are successfully applied in translation tasks. We plan to combine these two approaches, inspired by traditional score functions, to study whether they can lead to improved tracing. An often-overlooked reality is that large-scale piracy runs as a for-profit business. Thus countermeasures need not be perfect, as long as they increase the attack cost enough to make piracy unattractive. In the field of collusion resistance, this cost analysis has never been performed yet; even a simple model will be valuable to understand which countermeasures are effective.
