Accurate modeling of end-users’ decision-making behavior is crucial for validating demand response (DR) policies. However, existing models usually represent the decision-making behavior as an optimization problem, neglecting the impact of human psychology on decisions. In this paper, we propose a Belief-Desire-Intention (BDI) agent model to model end-users’ decision-making under DR. This model has the ability to perceive environmental information, generate different power scheduling plans, and make decisions that align with its own interests. The key modeling capabilities of the proposed model have been validated in a household end-user with flexible loads
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Abstract Objective: To determine the associations between four validated multidimensional self-report frailty scales and nine indices of oral health in communitydwelling older persons. Materials and Methods: This pilot study was conducted in a sample of 208 older persons aged 70 years and older who visited two dental practices in the Netherlands. Frailty status was measured by four different self-report frailty questionnaires: Tilburg Frailty Indicator (TFI), Groningen Frailty Indicator (GFI), Sunfrail Checklist (SC), and the Sherbrooke Postal Questionnaire (SPQ). Oral health was assessed by two calibrated examiners. Results: The prevalence of frailty according to the four frailty measures TFI, GFI, SC, and SPQ was 32.8%, 31.5%, 24.5%, and 49.7%, respectively. The SC correlated with four oral health variables (DMFT, number of teeth, percentage of occlusal contacts, Plaque Index), the TFI with three (number of teeth, percentage of occlusal contacts, Plaque Index), the GFI only with DPSI, and the SPQ with the number of teeth and the number of occlusal contacts. Conclusion: Of the studiedmultidimensional frailty scales, the SC and TFIwere correlated with most oral health variables (four and three, respectively). However, it should be noticed that these correlations were small. Clinical relevance: The SCand TFImight help to identify older people with risk of poor oral health so that preventive care can be used to ensure deterioration of oral health and maintenance of quality of life. Vice versa early detection of frailty by oral care professionals could contribute to interprofessional management of frailty.
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Abstract Background: Children and adolescents in mental healthcare often perceive their care needs and necessary treatment differently from their clinicians. As such discordance between young patients and clinicians may obstruct treatment adherence and compromise treatment outcomes, it is important to understand the factors associated with it. We therefore investigated the factors associated with patient–clinician discordance with regard to care needs in various areas of functioning. Methods: A cross-sectional study involving 244 children/adolescents aged 6–18 participating with their clinicians in treatment at a specialized mental healthcare center. As a previous study conducted by our research group had found the greatest patient–clinician discordance in three CANSAS care needs—“mental health problems,” “information regarding diagnosis and/or treatment,” and “making and/or keeping friends”—we used univariable and multivariable statistics to investigate the factors associated with discordance regarding these three care needs. Results: patient–clinician discordance on the three CANSAS items was associated with child, parent, and family/social-context factors. Three variables were significant in each of the three final multivariable models: dangerous behavior towards self (child level); severity of psychiatric problems of the parent (parent level); and growing up in a single-parent household (family/social-context level). Conclusions: To deliver treatment most effectively and to prevent drop-out, it is important during diagnostic assessment and treatment planning to address the patient’s care needs at all three levels: child, parent and family/social context.
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Although there is an array of technical solutions available for retrofitting the building stock, the uptake of these by owner‐occupants in home improvement activities is lagging. Energy performance improvement is not included in maintenance, redecoration, and/or upgrading activities on a scale necessary to achieve the CO2 reduction aimed for in the built environment. Owner‐occupants usually adapt their homes in response to everyday concerns, such as having enough space available, increasing comfort levels, or adjusting arrangements to future‐proof their living conditions. Home energy improvements should be offered accordingly. Retrofit providers typically offer energy efficiency strategies and/or options for renewable energy generation only and tend to gloss over home comfort and homemaking as key considerations in decision‐making for home energy improvement. In fact, retrofit providers struggle with the tension between customisation requirements from private homeowners and demand aggregation to streamline their supply chains and upscale their retrofit projects. Customer satisfaction is studied in three different Dutch approaches to retrofit owner‐occupied dwellings to increase energy efficiency. For the analysis, a customer satisfaction framework is used that makes a distinction between satisfiers, dissatisfiers, criticals, and neutrals. This framework makes it possible to identify and structure different relevant factors from the perspective of owner‐occupants, allows visualising gaps with the professional perspective, and can assist to improve current propositions.
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De loopbaan van mannen wordt beperkt als ze kiezen voor een werkweek van 4 keer 9 uur, maar vrouwen profiteren juist van zo’n indeling. Dat is een conclusie van het arbeidsmarktonderzoek van economisch geograaf Inge Noback. Uit het onderzoek blijkt verder dat het aantal gewerkte uren per week voor beide seksen nog altijd daalt. Noback: ‘Als de overheid zich zorgen maakt over vergrijzing moet ze niet alleen de pensioenleeftijd verhogen, maar ook meer uren werken op de agenda zetten.’ Noback promoveert op 27 oktober 2011 aan de Rijksuniversiteit Groningen. Voor haar onderzoek naar de verschillen in loopbaanontwikkeling tussen mannen en vrouwen dook Noback in de administratie van een groot Nederlands bedrijf. Door met een loep te kijken hoe de carrière van mannen en vrouwen zich ontwikkelde, gerelateerd aan het aantal uren dat zij werkten, vond zij uit dat de seksen naar verschillende maatstaven worden beoordeeld: ‘Omdat het om één bedrijf gaat kun je niet generaliseren, maar je ziet wel hoe processen werken. Het blijkt dat vier dagen van negen uur voor mannen niet werkt. Zij worden geacht altijd beschikbaar te zijn. Als ze er één dag van de week niet zijn, worden ze daarop afgerekend. Voor vrouwen ligt dat anders, omdat men er toch al van uitgaat dat ze parttime werken. Zij kwamen dus sneller vooruit.’ Regionale verschillen Het onderzoek naar de verschillen in carrière is maar één onderdeel in het arbeidsmarktonderzoek. Noback keek bijvoorbeeld ook naar de regionale verschillen in arbeidsparticipatie. Vrouwen in een stedelijke omgeving blijken vaker en langer te werken dan hun seksegenoten op het platteland. Mannen werken in steden juist minder. Een andere opvallende conclusie is dat vrouwen van werk weerhouden worden niet alleen door zorg voor kinderen, maar ook die voor ouderen in de omgeving. Kinderen In Nederland hebben weliswaar relatief veel vrouwen een baan, maar gemiddeld werken ze veel minder uren dan vrouwen in de meeste andere Europese landen. Ook mannen werken steeds minder uren, zeker na de geboorte van het eerste kind, stelde Noback vast. Dat kan niet lang zo doorgaan, verwacht ze: ‘De overheid moet zorgen voor langere werkweken, want met alleen het verhogen van de pensioenleeftijd redden we het niet. Er is dus meer kinderopvang nodig. Nu zijn kinderen nog allesbepalend voor de loopbaan van vrouwen en eigenlijk is dat helemaal niet vanzelfsprekend. Natuurlijk heb je vrouwen met jonge kinderen die daarvoor een periode willen thuisblijven. Dat moeten ze vooral doen, maar dat hoeft niet de hele loopbaan te bepalen.’ Vingerafdruk Er zijn veel geaggregeerde gegevens beschikbaar over de arbeidsmarkt en ook over arbeidsparticipatie van mannen en vrouwen. Het CBS, de UWV en andere instanties publiceren ze met grote regelmaat. Dat veel vrouwen in Nederland een parttimebaan hebben, maar per saldo minder uren werken dan seksegenoten in veel andere landen is bekend, evenals de trend dat zowel mannen als vrouwen steeds minder werken. Maar Noback kreeg voor haar onderzoek unieke gegevens tot haar beschikking: ‘Ik mocht rondsnuffelen in de microdata van het CBS. Dat betekent geanonimiseerde informatie over tien miljoen individuele banen, en heel specifieke informatie over de dynamiek in bijvoorbeeld het aantal gewerkte uren. In tegenstelling tot de survey data is dat echt nieuw. Je mag ze alleen bekijken, je krijgt toegang vanaf je laptop met een vingerafdruk, dankzij een programma dat ze bij je thuis komen installeren. Echt heel bijzonder.’ Arbeidspotentieel Uit dit Sociaal Statistisch Banen Bestand maakte Noback een selectie van werknemers die tussen 2003 en 2005 dezelfde baan hebben gehouden, maar van wie wel het aantal werkuren kon zijn veranderd. Het blijkt dat de werkuren van vrouwen vaker veranderen dan die van mannen, helemaal als ze eerst een baan hadden van minder dan drie dagen per week. Noback: ‘Dat toont aan dat er nog behoorlijk wat arbeidspotentieel over is.’
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Compared to macroeconomic factors, the financial situation of the individual may provide better insight into the relationship between debt and crime. However, the relationship between debt and crime is still unclear and little is known about the causality of this relationship and the factors that influence it. To obtain more insight into this relationship, a systematic and scoping literature review was conducted. Five articles were analyzed in the systematic review, and 24 articles in the scoping review. The results of the systematic review show a strong association between debt and crime whereby debt is a risk factor for crime, especially for recidivism and regardless of the type of crime, and crime is a risk factor for debt. The scoping review provided additional and in-depth insight, and placed the results of the systematic review in a broader perspective. Moreover, it emphasized the prevalence of debt among offenders, regardless of age, and identified the factors that influence the relationship between debt and crime.
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Wereldwijd worden mensen steeds ouder en het aandeel ouderen binnen de bevolking neemt toe. Dit leidt ook tot een toename van het aantal ouderen dat kwetsbaar is. Ondanks dat de term kwetsbaarheid, in het Engels ‘frailty’ genoemd, vaak gebruikt wordt, is er nog geen consensus over wat dit precies inhoudt. Onderzoekers en zorgprofessionals gebruiken diverse benaderingen met diverse, bijbehorende meetinstrumenten. Desondanks is men het er wel over eens dat kwetsbaarheid leidt tot negatieve gezondheidsuitkomsten. Onderzoek laat zien dat kwetsbare ouderen een verhoogd risico hebben op bijvoorbeeld overlijden, opname in een ziekenhuis en beperkingen in het uitvoeren van dagelijkse activiteiten (ADL). Om dit te voorkomen en mensen te ondersteunen of een behandeling aan te bieden, is het van belang dat we ouderen die kwetsbaar zijn goed kunnen identificeren. Op die manier worden mensen niet onterecht als kwetsbaar aangemerkt. Als namelijk de verkeerde groep mensen behandeld wordt zal het effect van een eventuele behandeling minimaal zijn en zullen de zorgkosten onnodig stijgen. Daarentegen zullen kwetsbare mensen die de zorg wel nodig hebben, deze wellicht niet ontvangen wanneer ze verkeerd gediagnostiseerd worden. De doelen van dit proefschrift zijn: (1) het verkrijgen van meer inzicht in de functionele profielen die behoren bij verschillende stadia van kwetsbaarheid; (2) het onderzoeken welke beschermende factoren het pad van kwetsbaarheid naar (verdere) negatieve gezondheidsuitkomsten kunnen beïnvloeden; en (3) het vergroten van de kennis van psychometrische eigenschappen van veelgebruikte vragenlijsten die kwetsbaarheid meten.
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Background Testing aerobic fitness in youth is important because of expected relationships with health. Objective The purpose of the study was to estimate the validity and reliability of the Shuttle Ride Test in youth who have spina bifida and use a wheelchair for mobility and sport. Design Ths study is a validity and reliability study. Methods The Shuttle Ride Test, Graded Wheelchair Propulsion Test, and skill-related fitness tests were administered to 33 participants for the validity study (age = 14.5 ± 3.1 y) and to 28 participants for the reliability study (age = 14.7 ± 3.3 y). Results No significant differences were found between the Graded Wheelchair Propulsion Test and the Shuttle Ride Test for most cardiorespiratory responses. Correlations between the Graded Wheelchair Propulsion Test and the Shuttle Ride Test were moderate to high (r = .55–.97). The variance in peak oxygen uptake (VO2peak) could be predicted for 77% of the participants by height, number of shuttles completed, and weight, with large prediction intervals. High correlations were found between number of shuttles completed and skill-related fitness tests (CI = .73 to −.92). Intraclass correlation coefficients were high (.77–.98), with a smallest detectable change of 1.5 for number of shuttles completed and with coefficients of variation of 6.2% and 6.4% for absolute VO2peak and relative VO2peak, respectively. Conclusions When measuring VO2peak directly by using a mobile gas analysis system, the Shuttle Ride Test is highly valid for testing VO2peak in youth who have spina bifida and use a wheelchair for mobility and sport. The outcome measure of number of shuttles represents aerobic fitness and is also highly correlated with both anaerobic performance and agility. It is not possible to predict VO2peak accurately by using the number of shuttles completed. Moreover, the Shuttle Ride Test is highly reliable in youth with spina bifida, with a good smallest detectable change for the number of shuttles completed.
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Background: Online contacts with a health professional have the potential to support family caregivers of people with dementia. Objective: The goal of the research was to study the effects of an online self-management support intervention in helping family caregivers deal with behavior changes of a relative with dementia. The intervention—involving among others personal email contacts with a dementia nurse—was compared with online interventions without these email contacts. Methods: A randomized controlled trial was conducted with 81 family caregivers of people with dementia who live at home. Participants were randomly assigned to a (1) major self-management support intervention consisting of personal email contacts with a specialist dementia nurse, online videos, and e-bulletins; (2) medium intervention consisting only of online videos and e-bulletins; or (3) minor intervention consisting of only the e-bulletins. The primary outcome was family caregivers’ self-efficacy in dealing with behavior changes of the relative with dementia. Secondary outcomes were family caregivers’ reports of behavior problems in the people with dementia and the quality of the relationship between the family caregiver and the person with dementia. Measurements were performed at the baseline and at 6 (T1) and 12 weeks (T2) after the baseline. A mixed-model analysis was conducted to compare the outcomes of the 3 intervention arms. Results: Family caregivers participating in the major intervention involving email contacts showed no statistically significant differences in self-efficacy after the intervention compared with the minor intervention involving only e-bulletins (difference –0.02, P=.99). In the adjusted analysis, the medium intervention (involving videos and e-bulletins) showed a negative trend over http://www.jmir.org/2020/2/e13001/ J Med Internet Res 2020 | vol. 22 | iss. 2 | e13001 | p. 1 (page number not for citation purposes) JOURNAL OF MEDICAL INTERNET RESEARCH Huis in het Veld et al XSL•FO RenderX time (difference –4.21, P=.09) and at T1 (difference –4.71, P=.07) compared with the minor intervention involving only e-bulletins. No statistical differences were found between the intervention arms in terms of the reported behavior problems and the quality of the relationship between the family caregiver and the person with dementia. Conclusions: The expectation that an online self-management support intervention involving email contacts would lead to positive effects and be more effective than online interventions without personal email contacts was not borne out. One explanation might be related to the fact that not all family caregivers who were assigned to that intervention actually made use of the opportunity for personal email contact. The online videos were also not always viewed. To obtain more definite conclusions, future research involving extra efforts to reach higher use rates is required.
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Background: Postoperative rehabilitation after primary total hip arthroplasty (p-THA) differs between the Netherlands and Germany. Aim is to compare clinical effectiveness and to get a first impression of cost effectiveness of Dutch versus German usual care after p-THA. Methods: A transnational prospective controlled observational trial. Clinical effectiveness was assessed with self-reported questionnaires and functional tests. Measurements were taken preoperatively and 4 weeks, 12 weeks, and 6 months postoperatively. For cost effectiveness, long-term economic aspects were assessed from a societal perspective. Results: 124 working-age patients finished the measurements. German usual care leads to a significantly larger proportion (65.6% versus 47.5%) of satisfied patients 12 weeks postoperatively and significantly better self-reported function and Five Times Sit-to-Stand Test (FTSST) results. German usual care is generally 45% more expensive than Dutch usual care, and 20% more expensive for working-age patients. A scenario analysis assumed that German patients work the same number of hours as the Dutch, and that productivity costs are the same. This analysis revealed German care is still more expensive but the difference decreased to 8%. Conclusions: German rehabilitation is clinically advantageous yet more expensive, although comparisons are less straightforward as the socioeconomic context differs between the two countries. Trial registration: The study is registered in the German Registry of Clinical Trials (DRKS00011345, 18/11/2016).
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