Background: Knee and hip osteoarthritis (OA) among older adults account for substantial disability and extensive healthcare use. Effective pain coping strategies help to deal with OA. This study aims to determine the long-term relationship between pain coping style and the course of healthcare use in patients with knee and/or hip OA over 10 years. Methods: Baseline and 10-year follow-up data of 861 Dutch participants with early knee and/or hip OA from the Cohort Hip and Cohort Knee (CHECK) cohort were used. The amount of healthcare use (HCU) and pain coping style were measured. Generalized Estimating Equations were used, adjusted for relevant confounders. Results: At baseline, 86.5% of the patients had an active pain coping style. Having an active pain coping style was significantly (p = 0.022) associated with an increase of 16.5% (95% CI, 2.0–32.7) in the number of used healthcare services over 10 years. Conclusion: Patients with early knee and/or hip OA with an active pain coping style use significantly more different healthcare services over 10 years, as opposed to those with a passive pain coping style. Further research should focus on altered treatment (e.g., focus on self-management) in patients with an active coping style, to reduce HCU.
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The aeronautical industry is still under expansion in spite of the problems it is facing due to the increase in oil prices, limited capacity, and novel regulations. The expansion trends translate into problems at different locations within an airport system and are more evident when the resources to cope with the demand are limited or are reaching to theirs limits. In the check-in areas they are appreciated as excessive waiting times which in turn are appreciated by the customers as bad service levels. The article presents a novel methodology that combines an evolutionary algorithm and simulation in order to give the best results taking into account not only the mandatory hard and soft rules determined by the internal policies of an airport terminal but also the quality indicators which are very difficult to include using an abstract representation. The evolutionary algorithm is developed to satisfy the different mandatory restrictions for the allocation problem such as minimum and maximum number of check-in desks per flight, load balance in the check-in islands, opening times of check-in desks and other restrictions imposed by the level of service agreement. Once the solutions are obtained, a second evaluation is performed using a simulation model of the terminal that takes into account the stochastic aspects of the problem such as arriving profiles of the passengers, opening times physical configurations of the facility among other with the objective to determine which allocation is the most efficient in real situations in order to maintain the quality indicators at the desired level.
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Verifying information is one of the core activities of journalism. However, recent research shows that many stories derive from unchecked information from news agencies and PR material. That being said, reporters who do not use this pre-packaged material, but who instead produce original stories based on independent research, might be journalists who stay devoted to the verification of information. Therefore, this study focuses on in-depth stories that originated inside the newsroom. We expected that these kinds of stories would be checked and double-checked, because time constraints are less important and these stories are characteristic of independent, quality journalism. Contrary to this expectation, the results show that even these kinds of stories are not always vetted. The lack of time was seldom mentioned as an excuse. Our research points to avoidance mechanisms which inhibit journalists from verifying their information.
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Een stappenplan om als sociaal professional het gesprek met gezinnen aan te gaan als er vermoeden is van huiselijk geweld. Goed te gebruiken bij stap 1 en 3 van de landelijke Meldcode Huiselijk Geweld en Kindermishandeling. Met tips een aanbevelingen.
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Waste from raw materials has a direct influence on the final price of a product. However, since waste has no added value to products, customers are unwilling to pay for it. Reducing waste along the production process and supply chain allows companies to decrease costs and remain competitive in product prices. This research is conducted in a medical device manufacturing company located in Tijuana (Mexico). The company found a negative variation in part number 9540, a metallic foil used for hot stamping. During inventory cycle counts, the company found that they were purchasing rawer material than necessary due to a 50% of waste generated along the production process. We implemented two process improvement methodologies, namely Practical Process Improvement (PPI) and the Plan-Do-Check-Act model, to eliminate 100% of the raw material waste, specifically regarding the foil's waste. The improvement project comprised two phases: a) adjusting the parameters of the hot foil stamping machine and b) replacing the hot foil stamping machine with a pad printing machine. In our research, the PPI methodology is presented in 8 detailed stages as a simple problem-solving method, in contrast with five stages reported in other documented cases. This case study presents how a company can apply continuous improvement programs and its managerial implications, even without having a structured and defined systems for quality, such as Six Sigma or Lean Manufacturing implemented. After the two implementation phases, the improvement project led to economic savings of $\$ $ 165,000 in a year.
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OBJECTIVES: Patients with hip or knee osteoarthritis (OA) may experience functional limitations in work settings. In the Cohort Hip and Cohort Knee study (CHECK) physical function was both self-reported and measured performance-based, using Functional Capacity Evaluation (FCE). Relations between self-reported scores on SF-36 and WOMAC (Western Ontario and McMaster Arthritis Index, function scales) and FCE performance were studied, and their diagnostic value for clinicians in predicting observed physical work limitations was assessed.METHODS: Ninety-two subjects scored physical function on SF-36 (scale 0-100, 100 indicating the best health level) and WOMAC (scale 0-68, 68 indicates maximum restriction) and performed the FCE. Correlations were calculated between all scores. Cross-tables were constructed using both questionnaires as diagnostic tests to identify work limitations. Subjects lifting <22.5 kg on the FCE-test 'lifting-low' were labeled as having physical work limitations. Diagnostic aspects at different cut-off scores for both questionnaires were analysed.RESULTS: Statistically significant correlations (Spearman's rho 0.34-0.49) were found between questionnaire scores and lifting and carrying tests. Results of a diagnostic cross-table with cut-off point <60 on SF-36 'physical functioning' were: sensitivity 0.34, specificity 0.97 and positive predictive value (PV+) 0.95. Cut-off point > or =21 on WOMAC 'function' resulted in sensitivity 0.51, specificity 0.88 and PV+ 0.88.CONCLUSION: Low self-reported function scores on SF-36 and WOMAC diagnosed subjects with limitations on the FCE. However, high scores did not guarantee performance without physical work limitations. These results are specific to the tested persons with early OA, in populations with a different prevalence of limitations, different diagnostic values will be found. FCE may be indicated to help clinicians to assess actual work capacity.
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Dit document geeft een overzicht van de bevindingen over het Factory-as-a service concept. Gedurende het SMITZH project heeft het lectoraat Smart Sustainable Manufacturing gezocht naar antwoorden op een aantal vragen: Welke initiatieven bestaan er, waar ondernemers elkaar helpen via het beschikbaar stellen en delen van productiecapaciteit? Wat zijn de randvoorwaarden om zo’n initiatief te laten slagen? Wat kan bijdragen om belemmeringen voor de toekomst weg te nemen? De voordelen zijn zeker aanwezig, maar obstakels ook. Met name dat laatste kan de voortgang en innovatief denken over de inrichting van flexibele en ‘Smart Manufacturing’ in de weg zitten. Het verhogen van de flexibiliteit om de maakindustrie concurrerender en veerkrachtiger te maken is een van de doelstellingen van het Smart Industry Programma, SMITZH en het lectoraat.
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In projects concerning big data, ethical questions need to be answered during the design process. In this paper the Value Sensitive Design method is applied in the context of data-driven health services aimed at disease prevention. It shows how Value Sensitive Design, with the use of a moral dialogue and an ethical matrix, can support the identifcation and operationalization of moral values that are at stake in the design of such services. It also shows that using this method can support meeting the requirements of the General Data Protection Regulation.
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In ons onderzoek naar problemen met de PDCA-cyclus zijn we aanbeland bij de “check”-fase. Daarbij gaat het om het meten in hoeverre we erin geslaagd zijn de gestelde doelen (plan) ook daadwerkelijk uit te voeren (do).
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De PDCA- of Demingcyclus is het hart van de kwaliteitskunde en heeft haar nut bewezen. Het is echter geen panacee, datin alle culturen en op alle tijden even bruikbaar is. Met nanme in andere dan westerse culturen in tijden van snelle veranderingen voldoet Plan-Do-Check-Act niet.
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