Background: The objective of this study was to derive evidence-based physical activity guidelines for the general Dutch population. Methods: Two systematic reviews were conducted of English language meta-analyses in PubMed summarizing separately randomized controlled trials and prospective cohort studies on the relation between physical activity and sedentary behaviour on the one hand and the risk of all-cause mortality and incidence of 15 major chronic diseases and conditions on the other hand. Other outcome measures were risk factors for cardiovascular disease and type 2 diabetes, physical functioning, and fitness. On the basis of these reviews, an expert committee derived physical activity guidelines. In deriving the guidelines, the committee first selected only experimental and observational prospective findings with a strong level of evidence and then integrated both lines of evidence. Results: The evidence found for beneficial effects on a large number of the outcome measures was sufficiently strong to draw up guidelines to increase physical activity and reduce sedentary behaviour, respectively. At the same time, the current evidence did not provide a sufficient basis for quantifying how much physical activity is minimally needed to achieve beneficial health effects, or at what amount sedentary behaviour becomes detrimental. A general tenet was that at every level of current activity, further increases in physical activity provide additional health benefits, with relatively larger effects among those who are currently not active or active only at light intensity. Three specific guidelines on (1) moderate- and vigorous-intensity physical activity, (2) bone- and musclestrengthening activities, and (3) sedentary behaviour were formulated separately for adults and children. Conclusions: There is an unabated need for evidence-based physical activity guidelines that can guide public health policies. Research in which physical activity is measured both objectively (quantity) and subjectively (type and quality) is needed to provide better estimates of the type and actual amount of physical activity required for health.
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The European Union (EU) Horizon Europe project NextGEM provides a framework for generating health-relevant scientific knowledge and data on new exposure scenarios to Radio-Frequency Electromagnetic Fields (RF-EMFs) and developing and validating tools for evidence-based risk assessment. Practical guidelines for different societal stakeholders for RF-EMF exposure awareness and preventive actions will be created. This abstract outlines the goals of these guidelines, the definitions used to keep the guidelines specific and practical and the procedure that will ultimately generate the guidelines.
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It is quite concerning that in a wealthy country, famous for having one of the most equitable health-care systems in the world with free access to care services for everyone, such an unmet need and such sex and socioeconomic inequities are found. Given England's health-care system, we wonder what the situation is like in other countries—and fear that it is probably not any better. Taking the WHO and UNICEF global report into consideration, it would be necessary to develop international guidelines for assistive technology provision, as proposed by Layton and colleagues.4 Such guidelines could have an important role in ensuring high-quality and equitable assistive technology provision across countries.
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Treatment guidelines difer signifcantly, not only between Europe and North America but also among European countries [1–4]. Reasons for these diferences include antimicrobial resistance patterns, accessibility to and reimbursement policies for medicines, and culturally and historically determined prescribing attitudes. The European Association of Clinical Pharmacology and Therapeutics’ Education Working Group has launched several initiatives to improve and harmonize European pharmacotherapy education, but international diferences have proven to be a major barrier to these eforts [5–7]. While we have taken steps to chart these diferences [6, 8], it will probably not be possible to fully resolve them. Rather than viewing these diferences as a barrier, we should perhaps see them as an opportunity for intercultural learning by providing students and teachers a valuable lesson in the context-dependent nature of prescribing medication and the diferent interpretations of evidence-based medicine. Here, we extend our experience with interprofessional student-run clinics [9, 10], to report on our first experiences with the “International and Interprofessional Student-run Clinic.” We organized three successful video meetings with medical and pharmacy students of the Amsterdam UMC, location VU University (the Netherlands), and the University of Bologna (Italy). During these meetings, one of the students presented a real-life case of a patient on polypharmacy. Then, in a 45-min session, the students split into smaller groups (break-out rooms) to review the patient’s medication, using the prescribing optimization method and STOPP/ START criteria [11, 12]. The teachers rotated between the diferent rooms and assisted the students when necessary. Teachers and students reconvened for 60 min for debriefng, with students presenting their fndings and suggestions to revise the medication list and teachers stimulating discussion and indicating how they would alter the medication list. Participation was voluntary, and the meetings were held in the evenings to accommodate students in clinical rotations. Third-to-fnal-year medical and pharmacy students participated in the three meetings (n=17, n=20, n=12, respectively). They reported learning a lot from each other, gaining an international and interprofessional perspective. Moreover, they learned to always consider the patient’s perspective, that evidence-based medicine is context-dependent, and that guidelines should be adapted to the patient’s situation.
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Abstract: Since the first Oxford Survey of Childhood Cancer’s results were published, people have become more aware of the risks associated with prenatal exposure from diagnostic x rays. As a result, it has since been the subject of many studies. In this review, the results of recent epidemiological studies are summarized. The current international guidelines for diagnostic x-ray examinations were compared to the review. All epidemiological studies starting from 2007 and all relevant international guidelines were included. Apart from one study that involved rhabdomyosarcoma, no statistically significant associations were found between prenatal exposure to x rays and the development of cancer during 2007–2020. Most of the studies were constrained in their design due to too small a cohort or number of cases, minimal x-ray exposure, and/or data obtained from the exposed mothers instead of medical reports. In one of the studies, computed tomography exposure was also included, and this requires more and longer follow-up in successive studies. Most international guidelines are comparable, provide risk coefficients that are quite conservative, and discourage abdominal examinations of pregnant women.
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The following guidelines address issues related specifically to sign language tests and testing of children since most of the existing guidelines focus on tests for adult learners. Links are provided to existing guidelines for test development, such as from the International Testing Commission (ITC), or the European Association of Language Testing and Assessment (EALTA), which include more general, construct-independent issues on (language) tests to provide additional/in-depth information. The guidelines stated here serve as a point of reference to develop, evaluate, and use tests, both for children or adult learners of a sign language. To investigate specific topics more in-depth, we recommend using existing guidelines (see Additional resources and guidelines for (language) test development) or refer to publications on sign language test development and adaptation (see Selected references
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The definition of ‘Assistive Technology’ (AT) includes both assistive products and the services or actions necessary for safe and effective provision of the assistive products to people who need them. International standards and product specifications exist for assistive products. Despite huge unmet need for effective AT provision, a variety of service delivery models across different countries, and a shortage of personnel trained in this field, nowidely useable and accepted AT service provision guidelines currently exist. Aligned with contemporary global initiatives to improve access to AT, a scoping review was commissioned to inform the development of globally useable provision guidance. The aim was to deliver a rapid scoping review of the literature regarding quality guidelines for AT service provision. Method: The rapid scoping review utilised a two-tiered approach to identifying relevant publications: 1) systematic search of academic databases; 2) consultation with assistive technology organisations. The review was conducted in March 2023 across four databases (Medline, CINAHL, SCOPUS and Google Scholar) with no date limitations. Systematic outreach to international and global AT networks was used to access expert informants. Non-English publications were included utilizing Google Translate and support from expert informants to verify content. Analysis was guided by the body of work on quality AT provision and service delivery processes in Europe, as well as the World Health Organization-GATE 5P framework for strengthening access to AT. Results: The search strategies yielded 41 publications from diverse countries, and directed at differing assistive products, personnel and provision contexts. Results are reported from the charted data through to the data extraction framework, including type of publication, study design, audience and reach. We report on the type of AT and the AT provision ecosystem elements discussed, and service delivery process or steps and quality criteria service delivery. Conclusion: This review did not find established guidelines or standards for service provision, but it did identify key service delivery steps which may form part of such guidelines, and many of the 3 publications included mentioned the need for practice guidelines. Despite different contexts such as type of assistive product, recipient of the guidance, language, location and authorship, core elements of AT provision including service delivery steps can be identified. Consideration regarding the nuances of vocabulary, of process, and of enabling flexible foci, is recommended in systematizing globally applicable guidance. This review offers a strong starting point for developing guidance for assistive technology provision to meet global need.
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In the aftermath of the systemic financial crises of 2007-9, several scholars argued that the problem of systemic financial crises is not well understood. At the same time, the introduction of digital technologies led to new threats and opportunities for the design of the monetary and financial system. For example, thousands of private cryptocurrencies have been implemented and hundreds of research papers on the (possible) introduction of public digital currencies have been published. It is often not explained why these new forms of digital money are needed and which (systemic) problems they (can) solve. In addition, the literature does not provide requirements nor guidelines to shape the development of the monetary and financial system in the digital age. This thesis applies design science to the monetary and financial system as a whole. The application of this novel methodology offers new possibilities to examine this complex system. The contribution of this thesis is threefold. First, different theories on money, banking and systemic financial crises have been researched through an extensive literature review and balance sheets. Second, those theories have been used to develop design requirements and guidelines. Finally, the consensus and pivotal dissensions about the systemic problem(s) of the current monetary and financial system, requirements and guidelines among experts have been identified through semistructured interviews. This research process results in widely supported requirements that demarcate the design space and widely supported guidelines that aim to give direction within the design space, that is, to the future development of the monetary and financial system.
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Multinational enterprises (MNEs) have become global players in the current globalized labour market and their economic activities are no longer territorially limited, but they extend in different countries, thereby leading to the development of global supply chains. Against this background, companies’ operations are increasingly conducted by foreign subsidiaries and they are being outsourced to business partners worldwide. In both cases, lower working conditions and production costs in foreign countries are one of the driving factors leading to this business choice.
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From the publisher's website: Large groups in society, in particular people with low literacy, lack the necessary proactivity and problem-solving skills to be self-reliant. One omnipresent problem area where these skills are relevant regards filling in forms and questionnaires. These problems could be potentially alleviated by taking advantage of the possibilities of information and communication technology (ICT), for example by offering alternatives to text, interactive self-explaining scales and easily accessible background information on the questionnaires’ rationale. The goal of this paper was to present explorative design guidelines for developing interactive questionnaires for low-literate persons. The guidelines have been derived during a user-centered design process of the Dutch Talking Touch Screen Questionnaire (DTTSQ), an interactive health assessment questionnaire used in physical therapy. The DTTSQ was developed to support patients with low health literacy, meaning they have problems with seeking, understanding and using health information. A decent number of guidelines have been derived and presented according to an existing, comprehensive model. Also, lessons learned were derived from including low-literate persons in the user-centered design process. The guidelines should be made available to ICT developers and, when applied properly, will contribute to the advancement of (health) literacy and empower citizens to fully participate in society
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