Background: Falls in stroke survivors can lead to serious injuries and medical costs. Fall risk in older adults can be predicted based on gait characteristics measured in daily life. Given the different gait patterns that stroke survivors exhibit it is unclear whether a similar fall-prediction model could be used in this group. Therefore the main purpose of this study was to examine whether fall-prediction models that have been used in older adults can also be used in a population of stroke survivors, or if modifications are needed, either in the cut-off values of such models, or in the gait characteristics of interest. Methods: This study investigated gait characteristics by assessing accelerations of the lower back measured during seven consecutive days in 31 non fall-prone stroke survivors, 25 fall-prone stroke survivors, 20 neurologically intact fall-prone older adults and 30 non fall-prone older adults. We created a binary logistic regression model to assess the ability of predicting falls for each gait characteristic. We included health status and the interaction between health status (stroke survivors versus older adults) and gait characteristic in the model. Results: We found four significant interactions between gait characteristics and health status. Furthermore we found another four gait characteristics that had similar predictive capacity in both stroke survivors and older adults. Conclusion: The interactions between gait characteristics and health status indicate that gait characteristics are differently associated with fall history between stroke survivors and older adults. Thus specific models are needed to predict fall risk in stroke survivors.
DOCUMENT
BackgroundOcclusions of intravenous (IV) tubing can prevent vital and time-critical medication or solutions from being delivered into the bloodstream of patients receiving IV therapy. At low flow rates (≤ 1 ml/h) the alarm delay (time to an alert to the user) can be up to 2 h using conventional pressure threshold algorithms. In order to reduce alarm delays we developed and evaluated the performance of two new real-time occlusion detection algorithms and one co-occlusion detector that determines the correlation in trends in pressure changes for multiple pumps.MethodsBench-tested experimental runs were recorded in triplicate at rates of 1, 2, 4, 8, 16, and 32 ml/h. Each run consisted of 10 min of non-occluded infusion followed by a period of occluded infusion of 10 min or until a conventional occlusion alarm at 400 mmHg occurred. The first algorithm based on binary logistic regression attempts to detect occlusions based on the pump’s administration rate Q(t) and pressure sensor readings P(t). The second algorithm continuously monitored whether the actual variation in the pressure exceeded a threshold of 2 standard deviations (SD) above the baseline pressure. When a pump detected an occlusion using the SD algorithm, a third algorithm correlated the pressures of multiple pumps to detect the presence of a shared occlusion. The algorithms were evaluated using 6 bench-tested baseline single-pump occlusion scenarios, 9 single-pump validation scenarios and 7 multi-pump co-occlusion scenarios (i.e. with flow rates of 1 + 1, 1 + 2, 1 + 4, 1 + 8, 1 + 16, and 1 + 32 ml/h respectively). Alarm delay was the primary performance measure.ResultsIn the baseline single-pump occlusion scenarios, the overall mean ± SD alarm delay of the regression and SD algorithms were 1.8 ± 0.8 min and 0.4 ± 0.2 min, respectively. Compared to the delay of the conventional alarm this corresponds to a mean time reduction of 76% (P = 0.003) and 95% (P = 0.001), respectively. In the validation scenarios the overall mean ± SD alarm delay of the regression and SD algorithms were respectively 1.8 ± 1.6 min and 0.3 ± 0.2 min, corresponding to a mean time reduction of 77% and 95%. In the multi-pump scenarios a correlation > 0.8 between multiple pump pressures after initial occlusion detection by the SD algorithm had a mean ± SD alarm delay of 0.4 ± 0.2 min. In 2 out of the 9 validation scenarios an occlusion was not detected by the regression algorithm before a conventional occlusion alarm occurred. Otherwise no occlusions were missed.ConclusionsIn single pumps, both the regression and SD algorithm considerably reduced alarm delay compared to conventional pressure limit-based detection. The SD algorithm appeared to be more robust than the regression algorithm. For multiple pumps the correlation algorithm reliably detected co-occlusions. The latter may be used to localize the segment of tubing in which the occlusion occurs.
LINK
A pre-publication sneak peek into some results emerging from a large-scale study of gender presentation on the front covers of video games. General results show an over-representation of masculine characters during the period, but significantly increased numbers of women by the end of the 11 years.
DOCUMENT
A panel discussing GAMEHEARTS R&D linked to multigender involvement, representation, and policy in video games, with special interest in EU games/policy.
DOCUMENT
Background: Different surgical approaches for total hip arthroplasty (THA) exist, without predisposition when it comes to dislocation risk. The direct anterior approach (DAA) is thought to have reduced risk since soft tissue trauma is minimalized. Therefore, we assessed the dislocation risk for different surgical approaches, and the relative dislocation risk of DAA compared to other approaches. Methods: Six electronic databases were systematically searched for prospective studies reporting dislocation following THA. Proportion meta-analyses were performed to assess the dislocation rate for subgroups of the surgical approach. Meta-analysis for binary outcomes was performed to determine the relative risk of dislocation for the DAA compared to other approaches. Results: Eleven studies with 2025 patients were included (mean age 64.6 years, 44% male, mean follow-up 10.5 months), of which four studies were also used in the risk ratio meta-analysis. Overall dislocation rate was 0.79% (95% CI 0.37–1.69). Subgroup analyses showed that most dislocations occurred in the posterior approaches group (1.38%), however non-significant. Furthermore, the DAA emerged with a non-significant lower risk of dislocation (RR 0.37, 95% CI 0.05–2.46) compared to other surgical approaches. Conclusion: Current literature shows non-significant predisposition for a surgical approach to THA regarding dislocation risk. To what extent patient characteristics influence the risk of dislocation could not be determined. Future research should focus on this, as well as on the influence of a surgeon's experience with a specific approach.
DOCUMENT
Understanding heterogeneity in farm development strategies is important in order to design effective policies and support programs to increase the sustainability of agriculture in relation to its socio-material context. Using a unique case study of 102 dairy farmers in The Netherlands, all operating in a highly similar socio-material context, this paper studies the differences in the relation of farms with the socio-material context. To this end, the concept of three-fold embedding is developed and tested using the ideal-typical characteristics of three patterns of farm development that were identified in the case study: (1) maximising total milk production; (2) optimising milk production using mainly on-farm resources; and (3) diversified on-farm production. Three-fold embedding was conceptualised in relation to the following dimensions: (1) value chain relations; (2) socio-cultural relations; and (3) natural resource relations, while using a scale ranging from a Close to a Stretched set of relations. The concept of three-fold embedding proves to be useful to identify in a non-normative and non-binary manner meaningful differences between patterns of farm development. These differences relate to differences in opportunity identification and strategic decision-making. The concept supports a relational perspective in studying farm strategy development using a sociology of entrepreneurship approach.
DOCUMENT
Background to the problem Dutch society demonstrates a development which is apparent in many societies in the 21st century; it is becoming ethnically heterogeneous. This means that children who are secondlanguage speakers of Dutch are learning English, a core curriculum subject, through the medium of the Dutch language. Research questions What are the consequences of this for the individual learner and the class situation?Is a bi-lingual background a help or a hindrance when acquiring further language competences. Does the home situation facilitate or impede the learner? Additionally, how should the TEFL professional respond to this situation in terms of methodology, use of the Dutch language, subject matter and assessment? Method of approach A group of ethnic minority students at Fontys University of Professional Education was interviewed. The interviews were subjected to qualitative analysis. To ensure triangulation lecturers involved in teaching English at F.U.P.E. were asked to fill in a questionnaire on their teaching approach to Dutch second language English learners. Thier response was quantitatively and qualitatively analysed. Findings and conclusions The students encountered surprisingly few problems. Their bi-lingualism and home situation were not a constraint in their English language development. TEFL professionals should bear the heterogeneous classroom in mind when developing courses and lesson material. The introduction to English at primary school level and the assessment of DL2 learners require further research.
DOCUMENT
In this paper validity and compatibility of the SAM and KLD screening instruments are the central themes. A screening instrument can be called valid if it identifies performance that is important to society. A screening instrument is called compatible if these instruments can be used interchangeably. Validity The outcome of the content-analysis approach suggest that there is clearly not a perfect match between the SAM and KLD instruments and the CSAF, indicating that the SAM and KLD screening instruments taken the CSAF as the standard, cannot be called valid measures of corporate sustainability performance. However, as discussed earlier, assessing validity is not a binary phenomenon. A simple ‘yes’ or ‘no’ will not do. To make things more complicated, the validity of a measure also depends on the aggregation level under observation. It makes a big difference if validity is assessed at a high (i.e. Dimension) or low aggregation (i.e. Sustainability Item) level . At the highest level there is a perfect match with the CSAF, indicating that both screening instruments are valid measures of corporate sustainability performance. At the lowest level the situation is quite different. Here we see that overlap is relatively poor. Besides, the weight distributions of the SAM and KLD instruments and the CSAF are also largely dissimilar. When we break the validity discussion down to the Dimension level, we can see that overlap between the SAM and KLD instruments is also relatively poor, although the SAM instrument is slightly more attuned to the CSAF than the KLD instrument. This most notably applies to the Governance Dimension. The SAM instrument scores relatively poor on environmental issues. This is due to the fact that we analyzed the generic (i.e. non-industry specific) screening instrument. SAM typically addresses environmental issues in industry specific supplements. CompatibilityThe second question in this study concerns the compatibility of the SAM and KLD screening instruments. Or more accurately phrased: the extent to which these rating schemes are compatible. If we would consider compatibility assessment of screening instruments as a binary phenomenon, then we should conclude that the SAM and KLD instruments are not compatible.However, just like validity, assessing the compatibility of screening instruments is not a binary phenomenon. The extent to which the rating schemes of the two SRAs are compatible relates to the aggregation level. At the highest aggregation ( or Dimension) level the screening instruments are perfectly compatible. Both instruments cover governance, social, environmental and economic issues. At the lowest (or Sustainability Item) level the situation is quite different. At this level compatibility of both instruments is poor. Overlap is poor and the weight distributions are hardly correlated. Obviously both instruments are reflect different interpretations of corporate sustainability performance. Compatibility is highest for the Social Dimension. For the Governance, Environment and Economic Dimension compatibility is very poor. The overall conclusion should therefore be that that compatibility of the SAM and KLD screening instruments is (very) poor and that for this reason these instruments cannot
LINK
BACKGROUND: In the Netherlands, the scope of dental hygiene practice was expanded in 2006. The objective of this study was to explore reasons among dentists and dental hygienists for supporting or opposing an extended scope of practice and to find explanatory factors.METHODS: A questionnaire containing pre-defined reasons and an open-ended question was distributed among 1,674 randomly selected members of two Dutch professional associations (874 dentists, 800 dental hygienists). Data were analyzed with binary logistic regression with Bayesian information criterion (BIC) model selection.RESULTS: Response were obtained from 541 practitioners (32.3%): i.e., 233 dentists (43.1%) and 308 dental hygienists (56.9%). Non-response analysis revealed no differences, and representativeness analysis showed similarities between samples and target populations. Most often, dentists reported flexible collaboration (50.2%) and dental hygienists indicated task variation (71.1%) as supportive reasons. As opposing reasons, dentists generally reported quality of care (41.2%) and dental hygienists' self-competence (22.7%). Reasons were explained by profession, gender, and new-style practitioners.CONCLUSION: Dentists and dental hygienists conveyed different reasons for supporting or opposing an extended scope of dental hygiene practice. Outcomes can be categorized as reasons related to economic, professional status, quality, job satisfaction, and flexible collaboration and are not only explained by profession.
DOCUMENT
