Background & aimsThe Scored Patient-Generated Subjective Global Assessment (PG-SGA©) is a validated nutritional screening, assessment, monitoring, and triage tool. When translated to other languages, the questions and answering items need to be conceptually, semantically, and operationally equivalent to the original tool. In this study, we aimed to assess linguistic and content validity of the PG-SGA translated and culturally adapted for the Norwegian setting, as perceived by Norwegian cancer patients and healthcare professionals (HCPs).MethodsWe have translated and culturally adapted the original PG-SGA for the Norwegian setting, in concordance with the International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Cancer patients and HCPs, including nurses, dietitians and physicians, were invited to participate. Comprehensibility and difficulty were assessed by patients for the patient component (PG-SGA Short Form), and by HCPs for the professional component. Content validity was assessed for the full PG-SGA by HCPs only. The data were collected by a questionnaire and evaluations were operationalized by a 4-point scale. Item and scale indices were calculated for comprehensibility (Item CI, Scale CI), difficulty (Item DI, Scale DI) and content validity (Item CVI, Scale CVI).ResultsFifty-one cancer patients and 92 HCPs participated in the study. The patients perceived comprehensibility and difficulty of the Norwegian PG-SGA Short Form as excellent (Scale CI = 0.99 and DI = 0.97). However, HCPs perceived comprehensibility and difficulty of the professional component as below acceptable (Scale CI = 0.78 and DI = 0.66), and the physical exam was being rated as the most difficult part (Item DI 0.26 to 0.65). Content validity for the full Norwegian PG-SGA was considered excellent (Scale CVI = 0.99) by the HCPs.ConclusionThe patient component of PG-SGA was considered clear and easy to complete, and the full Norwegian PG-SGA was considered as relevant by HCPs. In the final Norwegian PG-SGA, changes have been made to improve comprehensibility of the professional component. To improve perceived difficulty of completing the professional component, training of professionals is indicated.
The Patient-Generated Subjective Global Assessment (PG-SGA) is an instrument to screen, assess and monitor malnutrition and risk factors, and to triage for interventions. After having translated and culturally adapted the original PG-SGA for the Italian setting, according to International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Principles, we tested linguistic validity, i.e., perceived comprehensibility and difficulty, and content validity (relevance) of the Italian version of the PG-SGA in patients with cancer and a multidisciplinary sample of healthcare professionals (HCPs). Methods: After the translation and cultural adaptation of the original PG-SGA for the Italian setting, the patient component (i.e., PG-SGA Short Form (SF) was tested for linguistic validity (i.e., comprehensibility ad difficulty) in 120 Italian patients with cancer and 81 Italian HCPs. The full PG-SGA, i.e., patient and professional component of the PG-SGA, was tested for content validity, i.e., relevance, in 81 Italian HCPs. The data were collected by a questionnaire and evaluations were operationalized by a 4-point scale. Through item and scale indices we evaluated the comprehensibility (I–CI, S–CI), difficulty (I-DI, S-DI) and content validity (I-CVI, S-CVI). Scale indices 0.80–0.89 were considered acceptable, and scale indices ≥0.90 were considered excellent. Results: Patients perceived comprehensibility and difficulty of the PG-SGA SF (Boxes) as excellent (S–CI = 0.98, S-DI = 0.96). Professionals perceived comprehensibility of the professional component (Worksheets) as excellent (S–CI = 0.92), difficulty as acceptable (S-DI = 0.85), and content validity of the full PG-SGA as excellent (S-CVI = 0.92). Dietitians gave higher scores (indicating better scores) on comprehensibility, difficulty, and content validity of Worksheet 4 (physical exam) than the other professions. In Worksheet 4, four items were considered most difficult to complete and were considered below acceptable range. Relevance was perceived as excellent by professionals for both the patient component (S-CVI = 0.93) and the professional component (S-CVI = 0.90), resulting in S-CVI = 0.92 for the full PG-SGA. Slight textual modifications were implemented resulting in the final version of the Italian PG-SGA. Conclusions: Translation and cultural adaptation of the original PG-SGA resulted in the Italian version of the PG-SGA that maintained its original purpose and meaning and can be completed adequately and easily by patients and professionals. The Italian PG-SGA is considered relevant for screening, assessing and monitoring malnutrition and risk factors, as well as triaging for interventions by Italian HCPs.
Background: Across the world, frailty is part of the guidelines that are being developed in the COVID-19 pandemic for triaging in crisis situations. The Clinical Frailty Scale (CFS) evaluates the ability to perform daily tasks to identify frail individuals, potentially excluding those from intensive care (IC) treatment. Individuals with intellectual disabilities (ID) experience varying degrees of dependence, distinct from age-related physical deterioration. Using the CFS for triage in crisis situations could potentially unjustifiably exclude individuals with ID from IC treatment. Our objective was to compare the classification of individuals with ID into different frailty categories based on the CFS and the well-studied ID-frailty index and to determine suitability of CFS for evaluation of frailty in individuals with ID during the COVID-19 pandemic.Methods: This retrospective analysis of the observational healthy aging and intellectual disabilities (HA-ID) study included 982 individuals with ID of ≥50 years, who were classified according to the CFS and the ID-frailty index.Results: Of the cohort of 982 older adults with ID, 626 (63.7%) would be classified as moderately frail (CFS score 6), but 92% of this group is not moderately frail according to the ID-frailty index. Furthermore, 199 (20.3%) would be classified as at least severely frail (CFS score 7-9), but 74.9% of this group is not severely frail according to the ID-frailty index. Overall, 730 out of 982 (74.9%) individuals would be incorrectly classified by the CFS as too frail to have a good probability of survival. The ID-frailty index predicts mortality better than the CFS in individuals with ID.Conclusions: Our results show the CFS is not suitable to evaluate frailty in individuals with ID, with potential dramatic consequences for triage and decision-making during the COVID-19 pandemic. We strongly recommend using the ID-frailty index when assessing probability of survival for individuals with ID.
Mkb-bedrijven in de maakindustrie vragen steeds meer om de-assemblage oplossingen, voor het uit elkaar halen van producten als deze End-of-Life zijn. De wens van bedrijven om ‘het goede’ te doen voor mens en klimaat, speelt een rol, maar duurzaamheid wordt natuurlijk ook steeds meer afgedwongen door CSRD, CSDDD, ESPR en andere regelgeving. Gezien de tekorten op de arbeidsmarkt zal dit (deels) geautomatiseerd en m.b.v. digitalisering aangepakt moeten worden. Veel bestaande producten zijn ontwikkeld zonder aandacht te besteden aan de-assemblage (ook wel demanufacturing). Werkvoorbereiding voor demanufacturing is nog niet geprofessionaliseerd. ‘Disassemblability’ ofwel de mate waarin een product gemakkelijk uit elkaar gehaald kan worden is een belangrijke variabele (Turkbay Romano et al., 2024). Kennis hierover, die wel door praktijkervaring aanwezig is, is niet geparametriseerd of gekoppeld aan specifieke producteigenschappen, waardoor elk demanufacturing plan ‘to-order’ gemaakt moet worden. Ook triage (Moeten we dit doen? Hoe gaan we het doen?) bij intake van productseries of individuele producten is belangrijk, maar criteria om te bepalen of hergebruik op product, component of materiaalniveau de moeite waard is ontbreken vaak. De stakeholders van dit project zien de noodzaak om stappen te zetten richting het vormgeven van de ‘demanufacturing guide’ in een productpaspoort, en het slim vullen hiervan, zodat ze benodigde de-assemblage handelingen en tools ‘smart’ kunnen bepalen, op basis van de -nu vaak beperkte- beschikbare productinformatie. Het doel van het project is dan ook te komen tot een gestandaardiseerde beschrijving voor de-assemblage, op basis van o.a. het fysieke product zelf, als onderdeel van een digitaal productpaspoort. Zo’n aanpak draagt bij aan hogere productiviteit, maar ook aan het beter voorspellen van de-assemblage kosten en daarmee het selecteren van producten met een interessante circulaire business case.
Fontys University of Applied Science’s Institute of Engineering, and the Dutch Institute for Fundamental Energy Research (DIFFER) are proposing to set up a professorship to develop novel sensors for fusion reactors. Sensors are a critical component to control and optimise the unstable plasma of Tokamak reactors. However, sensor systems are particularly challenging in fusion-plasma facing components, such as the divertor. The extreme conditions make it impossible to directly incorporate sensors. Furthermore, in advanced reactor concepts, such as DEMO, access to the plasma via ports will be extremely limited. Therefore, indirect or non-contact sensing modalities must be employed. The research group Distributed Sensor Systems (DSS) will develop microwave sensor systems for characterising the plasma in a tokamak’s divertor. DSS will take advantage of recent rapid developments in high frequency integrated circuits, found, for instance, in automotive radar systems, to develop digital reflectometers. Access through the divertor wall will be achieved via surface waveguide structures. The waveguide will be printed using 3D tungsten printing that has improved precision, and reduced roughness. These components will be tested for durability at DIFFER facilities. The performance of the microwave reflectometer, including waveguides, will be tested by using it to analyse the geometry and dynamics of the Magnum PSI plasma beam. The development of sensor-based systems is an important aspect in the integrated research and education program in Electrical Engineering, where DSS is based. The sensing requirements from DIFFER offers an interesting and highly relevant research theme to DSS and exciting projects for engineering students. Hence, this collaboration will strengthen both institutes and the educational offerings at the institute of engineering. Furthermore millimeter wave (mmWave) sensors have a wide range of potential applications, from plasma characterisation (as in this proposal) though to waste separation. Our research will be a step towards realising these broader application areas.
Een persisterende infectie met hoog-risico humaan papillomavirus (hrHPV) is de belangrijkste factor voor de ontwikkeling van afwijkingen in de baarmoederhals en het ontstaan van baarmoederhalskanker. Ongeveer 80% van de vrouwen loopt in haar leven een HPV infectie op, toch is het risico op kanker relatief laag. hrHPV infectie is noodzakelijk maar niet de enige factor die bijdraagt aan de ontwikkeling van baarmoederhalskanker. Er zijn aanwijzingen dat vaginoom afwijkingen, zoals een disbalans van micro-organismen in de vagina, cofactoren kunnen zijn voor een persisterende hrHPV infectie. Een eerste analyse van een kleine 1000 uitstrijken (waarvan de helft hrHPV-positief) die in het HPV expertisecentrum van het Jeroen Bosch ziekenhuis getest werden op aanwezigheid van een beperkt aantal verschillende bacteriesoorten liet zien dat dat in het hrHPV-positieve cohort statistisch significant meer vaginoom afwijkingen voorkwamen dan in het hrHPV-negatieve cohort. Dit motiveert ons een haalbaarheidsonderzoek te starten met als doel te bepalen of het vaginoom (het geheel van bacteriën, schimmels en virussen in de vagina) kan dienen als triagemarker voor een persisterende hrHPV infectie, die kan leiden tot baarmoederhalskanker. In dit onderzoek willen we het gehele vaginoom in kaart te brengen van een subgroep van vrouwen met en zonder hrHPV infectie. Sequencing technologieën zijn bij uitstek geschikt voor het in kaart brengen van een diversiteit aan micro-organismen op basis van hun genoom, maar kunnen arbeidsintensief zijn en genereren complexe data waardoor er een IT structuur voor (beveiligde) opslag en analyse nodig is. Samen met het HPV expertisecentrum en MKB partners willen we onderzoeken welke sequencing methode de meest betrouwbare resultaten geeft en het best bruikbaar is in een diagnostische laboratoriumsetting. Daarnaast zal onderzocht worden hoe we om moeten gaan met de gegenereerde data en opslag daarvan.
