In the Netherlands an innovative programme for early detection of chronic obstructive pulmonary disease (COPD) in primary care among patients aged 40–70 years has been evaluated in both an effect study and a pilot implementation study. Health-care providers identified four obstacles for successful implementation of a COPD early detection programme. This Brief Communication describes the most important results of a qualitative study using in-depth interviews.
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In recent years, the fight against terrorism and political violence has focused more on anticipating the threats that they pose. Therefore, early detection of ideas by local professionals has become an important part of the preventive approach in countering radicalization. Frontline workers who operate in the arteries of society are encouraged to identify processes toward violent behavior at an early stage. To date, however, little is known about how these professionals take on this screening task at their own discretion. Research from the Netherlands suggests that subjective assessment appears to exist. In this article, we argue that the absence of a clear norm for preliminary judgments affects prejudice or administrative arbitrariness, which may cause side effects due to unjustified profiling.
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Standard SARS-CoV-2 testing protocols using nasopharyngeal/throat (NP/T) swabs are invasive and require trained medical staff for reliable sampling. In addition, it has been shown that PCR is more sensitive as compared to antigen-based tests. Here we describe the analytical and clinical evaluation of our in-house RNA extraction-free saliva-based molecular assay for the detection of SARS-CoV-2. Analytical sensitivity of the test was equal to the sensitivity obtained in other Dutch diagnostic laboratories that process NP/T swabs. In this study, 955 individuals participated and provided NP/T swabs for routine molecular analysis (with RNA extraction) and saliva for comparison. Our RT-qPCR resulted in a sensitivity of 82,86% and a specificity of 98,94% compared to the gold standard. A false-negative ratio of 1,9% was found. The SARS-CoV-2 detection workflow described here enables easy, economical, and reliable saliva processing, useful for repeated testing of individuals.
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Abstract Background Dermoscopy is known to increase the diagnostic accuracy of pigmented skin lesions (PSLs) when used by trained professionals. The effect of dermoscopy training on the diagnostic ability of dermal therapists (DTs) has not been studied so far. Objectives This study aimed to investigate whether DTs, in comparison with general practitioners (GPs), benefited from a training programme including dermoscopy, in both their ability to differentiate between different forms of PSL and to assign the correct therapeutic strategy. Methods In total, 24 DTs and 96 GPs attended a training programme on PSLs. Diagnostic skills as well as therapeutic strategy were assessed, prior to the training (pretest) and after the training (post-test) using clinical images alone, as well as after the addition of dermatoscopic images (integrated post-test). Bayesian hypothesis testing was used to determine statistical significance of differences between pretest, post-test and integrated post-test scores. Results Both the DTs and the GPs demonstrated benefit from the training: at the integrated post-test, the median proportion of correctly diagnosed PSLs was 73% (range 30–90) for GPs and 63% (range 27–80) for DTs. A statistically significant difference between pretest results and integrated test results was seen, with a Bayes factor>100. At 12 percentage points higher, the GPs outperformed DTs in the accuracy of detecting PSLs. Conclusions The study shows that a training programme focusing on PSLs while including dermoscopy positively impacts detection of PSLs by DTs and GPs. This training programme could form an integral part of the training of DTs in screening procedures, although additional research is needed
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ABSTRACT Background: We investigated if the addition of an inter-professional student-led medication review team (ISP-team) to standard care can increase the number of detected ADRs and reduce the number of ADRs 3 months after an outpatient visit. Research design and methods: In this controlled clinical trial, patients were allocated to standard care (control group) or standard care plus the ISP team (intervention group). The ISP team consisted of medical and pharmacy students and student nurse practitioners. The team performed a structured medication review and adjusted medication to reduce the number of ADRs. Three months after the outpatient visit, a clinical pharmacologist who was blinded for allocation performed a follow-up telephone interview to determine whether patients experienced ADRs. Results: During the outpatient clinic visit, significantly more (p < 0.001) ADRs were detected in the intervention group (n = 48) than in the control group (n = 10). In both groups, 60–63% of all detected ADRs were managed. Three months after the outpatient visit, significantly fewer (predominantly mild and moderately severe) ADRs related to benzodiazepine derivatives and antihypertensive causing dizziness were detected in the patients of the intervention group. Conclusions: An ISP team in addition to standard care increases the detection and management of ADRs in elderly patients resulting in fewer mild and moderately severe ADRs
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Over the past three years we have built a practice-oriented, bachelor level, educational programme for software engineers to specialize as AI engineers. The experience with this programme and the practical assignments our students execute in industry has given us valuable insights on the profession of AI engineer. In this paper we discuss our programme and the lessons learned for industry and research.
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The two-year education programme HiPerGreen initiated by Inholland University of Applied Sciences came to a closure on Friday 27th September 2019 at the World Horti Center in Naaldwijk. The Final symposium gave consortium partners and other guests the opportunity to learn about the HiPerGreen’s team achievements and the various outputs the programme delivered. After the welcome word of lector Robotica Cock Heemskerk, Tom KerneyMitchell, biology researcher, summarized the efforts that the team made in plant monitoring (ranging from growth monitoring and prediction, chamber testing research to delivering fusarium maps to growers). Next Lucien Fesselet, project manager at HiPerGreen and CTO of Applied Drone Innovations) took the public through the team’s technology fails, trials and successes over the two-year programme. Sheelagh Bouvier, market researcher for HiPerGreen, shortly explained that she conducted desk research, field visits in greenhouses, interviews with growers and IP research. Then partner Roy van Rosmalen from Ter Laak Orchids, explained how crucial data was in order to run large orchid greenhouses. He saw HiPerGreen’s monitoring solutions such as the drone and the rail system as the answers to current data gaps. Mauro Gallo, lector Biomimicry at InHolland, announced HiPerGreens follow up project Flapping Wings. The symposium’s final speaker was William Simmonds, CEO of Applied Drone Innovations , a spinoff startup born from the HiPerGreen programme. The symposium was concluded with a drink.
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Background: Dermoscopy is known to increase the diagnostic accuracy of pigmented skin lesions (PSLs) when used by trained professionals. The effect of dermoscopy training on the diagnostic ability of dermal therapists (DTs) has not been studied so far. Objectives: This study aimed to investigate whether DTs, in comparison with general practitioners (GPs), benefited from a training programme including dermoscopy, in both their ability to differentiate between different forms of PSL and to assign the correct therapeutic strategy. Methods: In total, 24 DTs and 96 GPs attended a training programme on PSLs. Diagnostic skills as well as therapeutic strategy were assessed, prior to the training (pretest) and after the training (post-test) using clinical images alone, as well as after the addition of dermatoscopic images (integrated post-test). Bayesian hypothesis testing was used to determine statistical significance of differences between pretest, post-test and integrated post-test scores. Results: Both the DTs and the GPs demonstrated benefit from the training: at the integrated post-test, the median proportion of correctly diagnosed PSLs was 73% (range 30–90) for GPs and 63% (range 27–80) for DTs. A statistically significant difference between pretest results and integrated test results was seen, with a Bayes factor>100. At 12 percentage points higher, the GPs outperformed DTs in the accuracy of detecting PSLs. Conclusions: The study shows that a training programme focusing on PSLs while including dermoscopy positively impacts detection of PSLs by DTs and GPs. This training programme could form an integral part of the training of DTs in screening procedures, although additional research is needed.
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Students, researchers, professors and company representatives gathered to share progress and ideas at the second half-year symposium of HiPerGreen at the World Horti Center in Naaldwijk. HiPerGreen is a Raak MKB subsidised research project aiming to bring value to horticultural growers. Cock Heemskerk, head of the HiPerGreen project and lector Robotica at InHolland University of Applied Sciences, welcomed everyone and gave an overall status update. Then Lucien, Fesselet project manager at HiPerGreen, talked about the minimal viable product (MVP) to make automated detection of fusarium in Phalaenopsis (a type of orchid) possible. Three consortium partners were invited to explain what they do for HiPerGreen and what their motives for participation are: Igno Breukers (DB2-Vision, start-up of a new type of multispectral camera for Precision Agriculture), Tim Brander (head grower at Hazeu Orchids) and Tom Kearny-Mitchel (plant biology advisor at Applied Drone Innovations). Next several students summarised their team’s work, findings and failures to the audience. During the live demo Lucien unveiled one of the team’s newly-built technologies: live stream thermal images of plants. The sympoium was concluded with a brainstorm session and drink.
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We investigated to what extent correctional officers were able to apply skills from their self-defence training in reality-based scenarios. Performance of nine self-defence skills were tested in different scenarios at three moments: before starting the self-defence training programme (Pre-test), halfway through (Post-test 1), and after (Post-test 2). Repeated measures analyses showed that performance on skills improved after the self-defence training. For each skill, however, there was a considerable number of correctional officers (range 4–73%) that showed insufficient performance on Post-test 2, indicating that after training they were not able to properly apply their skills in reality-based scenarios. Reality-based scenarios may be used to achieve fidelity in assessment of self-defence skills of correctional officers.Practitioner summary: Self-defence training for correctional officers must be representative for the work field. By including reality-based scenarios in assessment, this study determined that correctional officers were not able to properly apply their learned skills in realistic contexts. Reality-based scenarios seem fit to detect discrepancies between training and the work field. Abbreviations: DJI: Dutch National Agency for Correctional Insitutes; ICC: Intraclass Correlation Coefficient.
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