Hematological malignancies and treatment with hematopoietic SCT are known to affect patients’ quality of life. The problem profile and care needs of this patient group need clarification, however. This study aimed to assess distress, problems and care needs after allo- or auto-SCT, and to identify risk factors for distress, problems or care needs. In this cross-sectional study, patients treated with allo-SCT or auto-SCT for hematological malignancies completed the Distress Thermometer and Problem List. Three patient groups were created: 0–1, 1–2.5 and 2.5–5.5 years after transplantation. After allo-SCT, distress and the number of problems tended to be lower with longer follow-up. After auto-SCT, distress was highest at 1–2.5 year(s). Patients mainly reported physical problems, followed by cognitive-emotional and practical problems. A minority reported care needs. Risk factors for distress as well as problems after allo-SCT included younger age, shorter time after transplantation and GVHD. A risk factor for distress as well as problems after auto-SCT was the presence of comorbid diseases. Up to 5 years after auto-SCT or allo-SCT, patients continue to experience distress and problems. Judged by prevalence, physical problems are first priority in supportive care, followed by cognitive-emotional and practical problems.
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Identifying factors that predict health-related quality of life (QOL) following hematopoietic SCT, is important in estimating patients’ abilities to adjust to the consequences of their disease and treatment. As the studies that have been published on this subject are scattered, the present study aimed to systematically review prognostic factors for health-related QOL after auto- and allo-SCT in hematological malignancies. A systematic, computerized search in Medline, EMBASE, PsycINFO and the Cochrane Library was conducted from 2002 to June 2010. The methodological quality of the studies was assessed using an adaptation of Hayden's criteria list. Qualitative data synthesis was performed to determine the strength of the scientific evidence. In all, 35 studies fulfilled the selection criteria. Strong–moderate evidence was found for GVHD, conditioning regimen, being female, younger age, receiving less social support and pre-transplant psychological distress as predictors of various aspects of health-related QOL following hematopoietic SCT. The results of this review may help transplant teams in selecting patients at risk for experiencing a diminished health-related QOL following hematopoietic SCT. Follow-up treatment can be provided in order to promote QOL.
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To improve people’s lives, human-computer interaction researchers are increasingly designing technological solutions based on behavior change theory, such as social comparison theory (SCT). However, how researchers operationalize such a theory as a design remains largely unclear. One way to clarify this methodological step is to clearly state which functional elements of a design are aimed at operationalizing a specific behavior change theory construct to evaluate if such aims were successful. In this article, we investigate how the operationalization of functional elements of theories and designs can be more easily conveyed. First, we present a scoping review of the literature to determine the state of operationalizations of SCT as behavior change designs. Second, we introduce a new tool to facilitate the operationalization process. We term the tool blueprints. A blueprint explicates essential functional elements of a behavior change theory by describing it in relation to necessary and sufficient building blocks incorporated in a design. We describe the process of developing a blueprint for SCT. Last, we illustrate how the blueprint can be used during the design refinement and reflection process.
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Second career teachers (SCT) are key role models in vocational education (VE) because they prepare students for the vocational practice they were part of, and they bring up-to-date vocational knowledge and skills into VE schools. Therefore, the early leaving of SCTs in VE is a problem, adding to the worldwide teacher shortages. Induction programs have been developed to support starting teachers to grow into their new profession and to diminish high attrition rates. However, it is argued that current induction programs fail to support SCTs adequately. For instance, induction programs rarely adapt to SCTs’ various needs, such as recognizing and integrating previously developed competencies and specific backgrounds. Further-more, SCTs’ induction programs in the specific context of VE are largely under-studied. This study explores the experiences of SCTs in VE during their induction programs regarding four themes identified in research on SCTs in other education sectors: 1) professional identity development, 2) learning processes, 3) tailor-made coaching, and 4) co-creation of induction programs. Eleven SCTs from eight Dutch VE schools were interviewed. The data show a rich variation of SCTs’ experiences. For example, they experienced the opportunity to develop their professional identity as teachers while preserving and including their former identity as practitioners of the vocation they teach for. Yet, only a few SCTs experienced co-creation of the induction program, which seems to have a positive impact. The insights of this study offer an understanding of what SCTs in VE go through and what might support them during their induction.
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Since 2016, it is mandatory for all future students at the department of Media, Information and Communication, to participate in a study choice test (SCT), prior their enrollment. However, the outcome is not binding and students are still entitled to enter the first year after receiving negative advice. With the help of a structural model, built for my PhD research, the predictive value of the SCT is tested by comparing the time it takes the students to finish all first year exams, their average grade point and attrition, against the results of the SCT. By using the structural model, various background variables are also measured, such as engagement, effort and commitment are also measured. By using the normed fit index (NFI), the comparative fit index (CFI), the Tucker-Lewis Index (TLI) and the root mean square error of approximation (RMSEA), the fit of the model is established. In addition, a comparison of the direct and indirect influence of the SCT will provide more knowledge about the correlations between the different variables, the SCT and ultimately student success.
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Abstract Background: The benefit of MR-only workflow compared to current CT-based workflow for prostate radiotherapy is reduction of systematic errors in the radiotherapy chain by 2–3 mm. Nowadays, MRI is used for target delineation while CT is needed for position verification. In MR-only workflows, MRI based synthetic CT (sCT) replaces CT. Intraprostatic fiducial markers (FMs) are used as a surrogate for the position of the prostate improving targeting. However, FMs are not visible on sCT. Therefore, a semi-automatic method for burning-in FMs on sCT was developed. Accuracy of MR-only workflow using semi-automatically burned-in FMs was assessed and compared to CT/MR workflow. Methods: Thirty-one prostate cancer patients receiving radiotherapy, underwent an additional MR sequence (mDIXON) to create an sCT for MR-only workflow simulation. Three sources of accuracy in the CT/MR- and MR-only workflow were investigated. To compare image registrations for target delineation, the inter-observer error (IOE) of FM-based CT-to-MR image registrations and soft-tissue-based MR-to-MR image registrations were determined on twenty patients. Secondly, the inter-observer variation of the resulting FM positions was determined on twenty patients. Thirdly, on 26 patients CBCTs were retrospectively registered on sCT with burned-in FMs and compared to CT-CBCT registrations. Results: Image registration for target delineation shows a three times smaller IOE for MR-only workflow compared to CT/MR workflow. All observers agreed in correctly identifying all FMs for 18 out of 20 patients (90%). The IOE in CC direction of the center of mass (COM) position of the markers was within the CT slice thickness (2.5 mm), the IOE in AP and RL direction were below 1.0 mm and 1.5 mm, respectively. Registrations for IGRT position verification in MR-only workflow compared to CT/MR workflow were equivalent in RL-, CC- and AP-direction, except for a significant difference for random error in rotation. Conclusions: MR-only workflow using sCT with burned-in FMs is an improvement compared to the current CT/ MR workflow, with a three times smaller inter observer error in CT-MR registration and comparable CBCT registration results between CT and sCT reference scans. Trial registry Medical Research Involving Human Subjects Act (WMO) does apply to this study and was approved by the Medical Ethics review Committee of the Academic Medical Center. Registration number: NL65414.018.18. Date of registration: 21–08-2018.
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First year undergraduate students at the Amsterdam University of Applied Sciences of two different departments, were asked to join self-reported surveys in two succeeding years. Along with background variables, effort and commitment, the surveys asked elements of engagement. The later was analysed with factor analysis. The data of the surveys together with the results of the exams from the first year, were investigated to find out if the mandatory study choice test (SCT) taken before entering the faculty, had any predictive effect on their success. Not only basic statistical analysis like correlation was performed, but also more advanced analysis such as structural equation modelling (SEM) was used to uncover the value of the SCT. After a model was built, the normed fit index (NFI), the comparative fit index (CFI), the Tucker-Lewis Index (TLI) and the root mean square error of approximation (RMSEA), were used to determine the fit of the model. By comparing the influence of the variables on the SCT, the benefits of the latter will be determined and ultimately enhance the knowledge about influences upon student success in higher education.
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Objective: Gaining too much or too little weight in pregnancy (according to Institute of Medicine (IOM) guidelines) negatively affects both mother and child, but many women find it difficult to manage their gestational weight gain (GWG). Here we describe the use of the intervention mapping protocol to design ‘Come On!’, an intervention to promote adequate GWG among healthy pregnant women. Design: We used the six steps of intervention mapping: (i) needs assessment; (ii) formulation of change objectives; (iii) selection of theory-based methods and practical strategies; (iv) development of the intervention programme; (v) development of an adoption and implementation plan; and (vi) development of an evaluation plan. A consortium of users and related professionals guided the process of development. Results: As a result of the needs assessment, two goals for the intervention were formulated: (i) helping healthy pregnant women to stay within the IOM guidelines for GWG; and (ii) getting midwives to adequately support the efforts of healthy pregnant women to gain weight within the IOM guidelines. To reach these goals, change objectives and determinants influencing the change objectives were formulated. Theories used were the Transtheoretical Model, Social Cognitive Theory and the Elaboration Likelihood Model. Practical strategies to use the theories were the foundation for the development of ‘Come On!’, a comprehensive programme that included a tailored Internet programme for pregnant women, training for midwives, an information card for midwives, and a scheduled discussion between the midwife and the pregnant woman during pregnancy. The programme was pre-tested and evaluated in an effect study.
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Objective: Self-management is a core theme within chronic care and several evidence-based interventions (EBIs) exist to promote self-management ability. However, these interventions cannot be adapted in a mere copy-paste manner. The current study describes and demonstrates a planned approach in adapting EBI’s in order to promote self-management in community-dwelling people with chronic conditions. Methods: We used Intervention Mapping (IM) to increase the intervention’s fit with a new context. IM helps researchers to take decisions about whether and what to adapt, while maintaining the working ingredients of existing EBI’s. Results: We present a case study in which we used IM to adapt EBI’s to the Flemish primary care context to promote self-management in people with one or more chronic disease. We present the reader with a contextual analysis, intervention aims, and content, sequence and scope of the resulting intervention. Conclusion: IM provides an excellent framework in providing detailed guidance on intervention adaption to a new context, while preserving the essential working ingredients of EBI’s. Practice Implications: The case study is exemplary for public health researchers and practitioners as a planned approach to seek and find EBI’s, and to make adaptations.
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The central aim of this dissertation is to increase our understanding of changes in identifications and in the professional identity of employees, by investigating the prominent foci of identification, their mix in higher-order social identities and the personal and organisational factors (HRM and supervisory behaviour) that are involved in the change of these professional self definitions. Building upon the assumption that institutions for Higher Education and their workforce are being continually challenged to keep up and adapt to changing societal demands and that it is the quality and flexibility of the workforce which is the key factor to address this turmoil, this dissertation specifically focuses on the understanding of changes in teachers’ professional identity in higher vocational education. For this purpose four related empirical studies have been conducted. Together these studies illustrate the considerable professional diversity in the workforce and shed light on the relationships between foci of identification and professional identities, performance appraisal, leadership, career competencies, customization strategies, professional development and changes in teachers’ identifications over time.
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