Objective: The aim of this study was to obtain insight in specific elements influencing the use, non-use, satisfaction, and dissatisfaction of ankle foot orthoses (AFOs) and the presence of underexposed problems with respect to AFOs. Methods: A questionnaire was composed to obtain information from AFO users to investigate the variables associated with satisfaction and the relation between these variables. A specific feature of this study was the systematic analysis of the remarks made by the respondents about their AFO. Quantitative data analyses were used for analysing the satisfaction and qualitative analyses were used analysing the remarks of the respondents. A total of 211 users completed the questionnaire. Results: Our survey showed that 1 out of 15 AFOs were not used at all. About three quarters of the AFO users were satisfied and about one quarter was dissatisfied. Females and users living alone reported relatively high levels of dissatisfaction, especially in the field of dimensions, comfort, weight, safety and effectiveness. Dissatisfaction with respect to off-the-shelf AFOs for the item durability was higher than that for custom-made AFOs. In the delivery and maintenance process the items ‘maintenance’, ‘professionalism’ and ‘delivery follow-up’ were judged to be unsatisfactory. A large number of comments were made by the respondents to improve the device or process, mainly by the satisfied AFO users. These comments show that even satisfied users experience many problems and that a lot of problems of AFO users are ‘underexposed’. Conclusion: To improve user satisfaction, the user practice has to be identified as an important sub-process of the whole orthopaedic chain especially in the diagnosis and prescription, delivery tuning and maintenance, and evaluation phase.
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The objective of this study was to understand community-dwelling older people’s readiness for receiving telehealth by studying their intention to use videoconferencing and capacities for using digital technology in daily life as indicators. A mixed-method triangulation design was used. First, a cross-sectional survey study was performed to investigate older people’s intention to use videoconferencing, by testing our theoretical framework with a multilevel path analysis (phase 1). Second, for deeper understanding of older people’s actual use of digital technology, qualitative observations of older people executing technological tasks (eg, on a computer, cell phone) were conducted at their homes (phase 2).
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Application of animal manure to soils results in the introduction of manure-derived bacteria and their antimicrobial resistance genes (ARGs) into soils. ResCap is a novel targeted-metagenomic approach that allows the detection of minority components of the resistome gene pool without the cost-prohibitive coverage depths and can provide a valuable tool to study the spread of antimicrobial resistance (AMR) in the environment. We used high-throughput sequencing and qPCR for 16S rRNA gene fragments as well as ResCap to explore the dynamics of bacteria, and ARGs introduced to soils and adjacent water ditches, both at community and individual scale, over a period of three weeks. The soil bacteriome and resistome showed strong resilience to the input of manure, as manuring did not impact the overall structure of the bacteriome, and its effects on the resistome were transient. Initially, manure application resulted in a substantial increase of ARGs in soils and adjacent waters, while not affecting the overall bacterial community composition. Still, specific families increased after manure application, either through the input of manure (e.g., Dysgonomonadaceae) or through enrichment after manuring (e.g., Pseudomonadaceae). Depending on the type of ARG, manure application resulted mostly in an increase (e.g., aph(6)-Id), but occasionally also in a decrease (e.g., dfrB3) of the absolute abundance of ARG clusters (FPKM/kg or L). This study shows that the structures of the bacteriome and resistome are shaped by different factors, where the bacterial community composition could not explain the changes in ARG diversity or abundances. Also, it highlights the potential of applying targeted metagenomic techniques, such as ResCap, to study the fate of AMR in the environment.
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