Background Understanding the kinematic characteristics of relapse clubfoot compared to successfully treated clubfoot could aid early identification of a relapse and improve treatment planning. The usage of a multi segment foot model is essential in order to grasp the full complexity of the multi-planar and multi-joint deformity of the clubfoot. Research question The purpose of this study was to identify differences in foot kinematics, using a multi-segment foot model, during gait between patients with Ponseti treated clubfoot with and without a relapse and age-matched healthy controls. Methods A cross-sectional study was carried out including 11 patients with relapse clubfoot, 11 patients with clubfoot and 15 controls. Gait analysis was performed using an extended Helen Hayes model combined with the Oxford Foot Model. Statistical analysis included statistical parametric mapping and discrete analysis of kinematic gait parameters of the pelvis, hip, knee, ankle, hindfoot and forefoot in the sagittal, frontal and transversal plane. Results The relapse group showed significantly increased forefoot adduction in relation with the hindfoot and the tibia. Furthermore, this group showed increased forefoot supination in relation with the tibia during stance, whereas during swing increased forefoot supination in relation with the hindfoot was found in patients with relapse clubfoot compared with non-relapse clubfoot. Significance Forefoot adduction and forefoot supination could be kinematic indicators of relapse clubfoot, which might be useful in early identification of a relapse clubfoot. Subsequently, this could aid the optimization of clinical decision making and treatment planning for children with clubfoot.
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Ouderen blijven in Nederland steeds langer zelfstandig wonen. Als dat echter niet meer lukt, is opname in een verpleeg- of verzorgingshuis mogelijk. Ongeveer 165 duizend ouderen wonen in Nederland in een dergelijke instelling. Aangezien verpleegkundige zorg datgene is dat de meeste bewoners ontvangen, is het van belang om inzicht te krijgen hoe deze zorg wordt geëvalueerd. Verpleegkundig-sensitieve indicatoren kunnen daarbij behulpzaam zijn.
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Background: Nurse-sensitive indicators and nurses’ satisfaction with the quality of care are two commonly used ways to measure quality of nursing care. However, little is known about the relationship between these kinds of measures. This study aimed to examine concordance between nurse-sensitive screening indicators and nurse-perceived quality of care. Methods: To calculate a composite performance score for each of six Dutch non-university teaching hospitals, the percentage scores of the publicly reported nurse-sensitive indicators: screening of delirium, screening of malnutrition, and pain assessments, were averaged (2011). Nurse-perceived quality ratings were obtained from staff nurses working in the same hospitals by the Dutch Essentials of Magnetism II survey (2010). Concordance between the quality measures was analyzed using Spearman’s rank correlation. Results: The mean screening performances ranged from 63 % to 93 % across the six hospitals. Nurse-perceived quality of care differed significantly between the hospitals, also after adjusting for nursing experience, educational level, and regularity of shifts. The hospitals with high-levels of nurse-perceived quality were also high-performing hospitals according to nurse-sensitive indicators. The relationship was true for high-performing as well as lower-performing hospitals, with strong correlations between the two quality measures (r S = 0.943, p = 0.005). Conclusions: Our findings showed that there is a significant positive association between objectively measured nurse sensitive screening indicators and subjectively measured perception of quality. Moreover, the two indicators of quality of nursing care provide corresponding quality rankings. This implies that improving factors that are associated with nurses’ perception of what they believe to be quality of care may also lead to better screening processes. Although convergent validity seems to be established, we emphasize that different kinds of quality measures could be used to complement each other, because various stakeholders may assign different values to the quality of nursing care.
The overall purpose of this consultancy was to support the activities under the Environmental Monitoring and Assessment Programme of the UN Economic Commission for Europe (UNECE) in developing the 7th pan-European environmental assessment, an indicator based and thematic assessment, implemented jointly with the United Nations Environment Programme (UNEP) and in support of the 2030 Agenda for Sustainable Development. The series of environmental assessments of the pan-European region provide up to-date and policy-relevant information on the interactions between the environment and society. This consultancy was to:> Draft the input on drivers and developments to chapter 1.2 of the assessment related to the environmental theme “4.2 Applying principles of circular economy to sustainable tourism”.> Suggest to UNECE and UNEP the most policy relevant indicators from UNECE-environmental, SDG indicators and from other indicator frameworks such as EEA or OECD for the environmental theme for the sub-chapter 4.2.> Assess the current state, trends and recent developments and prepare the substantive part of sub-chapter 4.2 (summary - part I) and an annex (part II) with the detailed analysis and findings.
In the last decade, the automotive industry has seen significant advancements in technology (Advanced Driver Assistance Systems (ADAS) and autonomous vehicles) that presents the opportunity to improve traffic safety, efficiency, and comfort. However, the lack of drivers’ knowledge (such as risks, benefits, capabilities, limitations, and components) and confusion (i.e., multiple systems that have similar but not identical functions with different names) concerning the vehicle technology still prevails and thus, limiting the safety potential. The usual sources (such as the owner’s manual, instructions from a sales representative, online forums, and post-purchase training) do not provide adequate and sustainable knowledge to drivers concerning ADAS. Additionally, existing driving training and examinations focus mainly on unassisted driving and are practically unchanged for 30 years. Therefore, where and how drivers should obtain the necessary skills and knowledge for safely and effectively using ADAS? The proposed KIEM project AMIGO aims to create a training framework for learner drivers by combining classroom, online/virtual, and on-the-road training modules for imparting adequate knowledge and skills (such as risk assessment, handling in safety-critical and take-over transitions, and self-evaluation). AMIGO will also develop an assessment procedure to evaluate the impact of ADAS training on drivers’ skills and knowledge by defining key performance indicators (KPIs) using in-vehicle data, eye-tracking data, and subjective measures. For practical reasons, AMIGO will focus on either lane-keeping assistance (LKA) or adaptive cruise control (ACC) for framework development and testing, depending on the system availability. The insights obtained from this project will serve as a foundation for a subsequent research project, which will expand the AMIGO framework to other ADAS systems (e.g., mandatory ADAS systems in new cars from 2020 onwards) and specific driver target groups, such as the elderly and novice.
One of the mission-driven innovation policies of the Netherlands is energy transition which sets, among others, the challenge for a carbon-neutral built environment in 2050. Around 41% of Dutch houses do not yet have a registered energy label, and approximately 31% of the registered houses have label C or lower. This calls for action within the housing renovation industry. Bound to the 70 percent rule, a renovation plan requires full (or at least 70 percent) agreement on the renovation between relevant parties, including residents. In practice, agreement indicators focus mostly on economic and energy aspects. When indicators include people’s needs and preferences, it is expected to speed participation and agreement, increasing residents’ satisfaction and enhances the trust in public institutions. Tsavo was founded in 2015 to organise the sustainability of buildings for ambitious clients. Its sustainability process aims to accelerate renovation by keeping at their core value the social needs and preferences of residents. In this project Tsavo and TU Delft work together to optimise the sustainability process so, it includes everyone’s input and results in a sustainability plan that represents everyone. Tsavo’s role will be key in keeping the balance between both a sustainable renovation service that is cheaper and fast yet also attractive and with an impact on the quality of living. In this project, Tsavo’s sustainable renovation projects will be used to implement methods that focus on increasing participation and residents’ satisfaction. TU Delft will explore principles of attractive, accessible and representative activities to stimulate residents to decide on a renovation plan that is essential and meaningful to all.
