The purpose of this case report is to illustrate the application of the Anorexia Relapse Prevention Guidelines in nursing practice. In a single case report, the implementation of the intervention was described. A purposive use of the Anorexia Relapse Prevention Guidelines provides insight into the actual process of relapse, which contributes to an early recognition of relapse symptoms and permits early intervention aimed at recovery. Use of the Guidelines will lead to the implementation of well-structured professional procedures which are likely to support the patient's recovery
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The need to reduce carbon emissions calls for more use of renewable generation, particularly distributed resources. The intermittency of renewable generation, and concerns about energy security, require us to become more independent of central grid operation by use of local or regional (micro-grid) electricity systems. Distributed generation, allied to the commercial availability of battery storage products, permits this–the pathway to energy autonomy. This paper reviews the contribution of different renewable energy sources (RES), trends in energy storage technologies to enable energy autonomy, and the centralised and decentralised techniques that coordinate the associated energy management. The paper covers energy autonomy at different scales, ranging from household levels to district levels. The improvements in grid independency are measured accordingly. There is discussion of this measurement and of the economic and ecological benefits from energy autonomy in the context of policy frameworks.
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Entrepreneurship is a viable income-generating option for refugee women. Entrepreneurial work can bypass limits placed on work permits, obstacles in the formal economy, and familial responsibilities. Critical to success is access to and attainment of social capital, but women entrepreneurs are frequently hampered by gender and cultural biases. Due to such limitations, they face difficultly in attaining bridging and linking capitals, which are necessary for gaining access to support networks and target markets within a host society. Non-governmental organisations (NGOs) play a crucial role in enabling refugees to access support and social capital. NGOs become an instrumental component for women refugees to develop business plans, navigate host country laws and practices, access resources for start-ups, and gain mentorship. However, the types of support available are often NGO-specific, which restricts their applicability. Despite intermittent, beneficial encounters encouraged by NGOs, the long-term impact is questionable due to the variability and inconsistency of service offerings.
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The anthocyanin composition of five purple leaves cultivars of Ocimum basilicum L. was investigated by reversed-phase HPLC with mass-spectrometric detection by ESI mode with ion partial fragmentation as well as preparation of dried differently colored forms of anthocyanins encapsulated into maltodextrinmatrix. Analysis of the mass spectra revealed that according to the chromatographic profile the set of basil cultivar anthocyanins under investigation may be divided into two groups with the common feature being ahigh level of acylation with (mainly) p-coumaric, ferulic and malonic acids of the same base: cyanidin-3-dihexoside-5-hexoside. The presence of acylation with substituted cinnamic acids permits us to obtain solutions not only with a red color (the property of the flavylium form) but also with blue shades of coloration due to quinonoid and negatively charged quinonoid forms. All forms except that of flavylium are not stable in solution but stable enough to prepare dried encapsulated forms by lyophilization. Although the loss of anthocyaninswith drying is not negligible, the final product is characterized with high stability for storage in a refrigerator.
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Since the late 1990s, city councils have become increasingly aware of the potential for information technologies (ICTs) to improve the management of cities and as an instrument for economic and social policy. This has resulted in a wave of urban ICT strategies and policies, such as the adoption of ICTs within the city administration itself, projects that facilitate access to ICTs by weaker social groups and policies to improve the urban electronic infrastructure. By comparing eight cities - Barcelona, Cape Town, Eindhoven, Johnnesburg, Manchester, Tampere, the Hague and Venice - this book examines a range of innovative urban e-governance strategies and develops a framework of analysis that permits a common approach. Throughout the book, a distinction is made between access policies (aimed at improving access to ICTs for all citizens), content policies (directed to improve the use of ICTs in the city administration and semi-public domains) and infrastructure policies (to improve the provision of broadband infrastructure). For each of the cities, e-strategies and policies are critically reviewed and compared. The book reveals that urban e-strategies have evolved from an internal and technology-centred orientation to a more outward-looking approach.
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The (pre)school environment is an important setting to improve children’s health. Especially, the (pre)school playground provides a major opportunity to intervene. This review presents an overview of the existing evidence on the value of both school and preschool playgrounds on children’s health in terms of physical activity, cognitive and social outcomes. In addition, we aimed to identify which playground characteristics are the strongest correlates of beneficial effects and for which subgroups of children effects are most distinct. In total, 13 experimental and 17 observational studies have been summarized of which 10 (77%) and 16 (94%) demonstrated moderate to high methodological quality, respectively. Nearly all experimental studies (n = 11) evaluated intervention effects on time spent in different levels of physical activity during recess. Research on the effects of (pre)school playgrounds on cognitive and social outcomes is scarce (n = 2). The experimental studies generated moderate evidence for an effect of the provision of play equipment, inconclusive evidence for an effect of the use of playground markings, allocating play space and for multi-component interventions, and no evidence for an effect of decreasing playground density, the promotion of physical activity by staff and increasing recess duration on children’s health. In line with this, observational studies showed positive associations between play equipment and children’s physical activity level. In contrast to experimental studies, significant associations were also found between children’s physical activity and a decreased playground density and increased recess duration. To confirm the findings of this review, researchers are advised to conduct more experimental studies with a randomized controlled design and to incorporate the assessment of implementation strategies and process evaluations to reveal which intervention strategies and playground characteristics are most effective. https://doi.org/10.1186/1479-5868-11-59 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.
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In dit rapport wordt een verkort overzicht gegeven van de vergunnings- en zorgplichten onder de Omgevingswet voor gebruik van waterstof op de bouwplaats. Het biedt een helder inzicht in de juridische kaders bij waterstof aangedreven aggregaten op de bouwplaats.
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We extend a standard for doing agile scrum teamwork in education that permits individual assessment within teams (IAFOR ECE2020). Since the teacher's bandwidth in education is limited and increasingly under pressure, we focus on course design options that can be used to leverage the bandwidth. One economizing option in courses is to let teams prerecord prototype presentation videos before sprint review takes place. This allocates expensive teacher's time to team interrogation time which enriches interaction and engagement and enables effective sharing between teams to improve communication flow in sparse stakeholder feedback scenarios. We also describe three learning analytic pathways that can be smartly integrated into learning dashboards to monitor student and team progress or into learning recommender systems and chatbots to generate action-directed, just-in-time feedback and advice to students. The first one is for setup that enables control of important team diversity and student inclusion parameters such as demographic, personality and professional traits that are known from the student population in advance and that enables handy attribution of 21st-century skill sets within teams. The second one is the product pathway that builds on a datastream generated from qualitative, quantitative and immersive product features that are known from prototyping. The third one is the process pathway in which information on 21st-century skills is generated that are at play in individual and dynamic team processes. We are convinced that these extensions will further enable effective learning technology that is directed to applying agile scrum in education efficently, both for students as teachers.
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Background: Computed tomography (CT) is one of the most used modalities for diagnostics in paediatric populations, which is a concern as it also delivers a high patient dose. Research has focused on developing computer algorithms that provide better image quality at lower dose. The iterative reconstruction algorithm Sinogram-Affirmed Iterative Reconstruction (SAFIRE) was introduced as a new technique that reduces noise to increase image quality.Purpose: The aim of this study is to compare SAFIRE with the current gold standard, Filtered Back Projection (FBP), and assess whether SAFIRE alone permits a reduction in dose while maintaining image quality in paediatric head CT.Methods: Images were collected using a paediatric head phantom using a SIEMENS SOMATOMPERSPECTIVE 128 modulated acquisition. 54 images were reconstructed using FBP and 5 different strengths of SAFIRE. Objective measures of image quality were determined by measuring SNR and CNR. Visual measures of image quality were determined by 17 observers with different radiographic experiences. Images were randomized and displayed using 2AFC; observers scored the images answering 5 questions using a Likert scale.Results: At different dose levels, SAFIRE significantly increased SNR (up to 54%) in the acquired images compared to FBP at 80kVp (5.2-8.4), 110kVp (8.2-12.3), 130kVp (8.8-13.1). Visual image quality was higher with increasing SAFIRE strength. The highest image quality was scored with SAFIRE level 3and higher.Conclusion: The SAFIRE algorithm is suitable for image noise reduction in paediatric head CT. Our data demonstrates that SAFIRE enhances SNR while reducing noise with a possible reduction of dose of 68%.
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Low heart rate variability (HRV) is related to health problems that are known reasons for sick-leave or early retirement. A 1-minute-protocol could allow large scale HRV measurement for screening of health problems and, potentially, sustained employability. Our objectives were to explore the association of HRV with measures of health. Cross-sectional design with 877 Dutch employees assessed during a Workers’ Health Assessment. Personal and job characteristics, workability, psychological and mental problems, and lifestyle were measured with questionnaires. Biometry was measured (BMI, waist circumference, blood pressure, glucose, cholesterol). HRV was assessed with a 1-minute paced deep-breathing protocol and expressed as mean heart rate range (MHRR). A low MHRR indicates a higher health risk. Groups were classified age adjusted for HRV and compared. Spearman correlations between raw MHRR and the other measures were calculated. Significant univariable correlations (p < 0.05) were entered in a linear regression model to explore the multivariable association with MHRR. Age, years of employment, BMI and waist circumference differed significantly between HRV groups. Significant correlations were found between MHRR and age, workability, BMI, waist circumference, cholesterol, systolic and diastolic blood-pressure and reported physical activity and alcohol consumption. In the multivariable analyses 21.1% of variance was explained: a low HRV correlates with aging, higher BMI and higher levels of reported physically activity. HRV was significantly associated with age, measures of obesity (BMI, waist circumference), and with reported physical activity, which provides a first glance of the utility of a 1-minute paced deep-breathing HRV protocol as part of a comprehensive preventive Workers’ Health Assessment.Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creat ivecommons .org/licen ses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate redit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
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