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3In this paper, we analyse the development of the term “legal capabilities”. More specifically, we do three things. First, we track the emergence and development of the notion of legal capabilities. The term legal capabilities was used in legal research long before the capability approach was introduced in that field. Early on, its conceptualisation mainly reflected elements of legal literacy. In more recent writings, it is claimed that the notion is based on the capability approach. Second, we critically analyse the current use of the term legal capabilities and show that there is no proper theoretical grounding of this term in the capability approach. This is problematic, because it might give rise to misunderstandings and flawed policy recommendations. Third, we suggest some first steps towards a revision of the notion of legal capabilities. Starting from the concept of “access to justice”, legal capabilities have to be understood as the real opportunities someone has to get access to justice, rather than merely as formal opportunities or internal capabilities.
MULTIFILE
Open access combined with Web 2.0 networking tools is fast changing the traditional journal's functions and framework and the publisher's role. As content is more and more available online in digital repositories and on the web, an integrated, interconnected, multidisciplinary information environment is evolving and Oldenburg's model disintegrates: the journal is no longer the main referring unit for scholarly output, as it used to be, for Scientific, Technical, and Medical disciplines, but scholars' attention is now more focused on the article level. New journals models are thus evolving. The first part of this paper discusses these new experimental journal models, i.e. overlay journals, interjournals and different levels journals. The second part directs readers' attention to the role commercial publishers could play in this digital seamless writing arena. The authors consider that publishers should concentrate much more on value-added services for authors, readers and libraries, such as navigational services, discovery services, archiving and evaluation services.
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The journal was a forum for the work of both theorists and practitioners of philosophical practice with children, and published such work in all forms, including philosophical argument and reflection, classroom transcripts, curricula, empirical research, and reports from the field. The journal also maintained a tradition in publishing articles in the hermeneutics of childhood, a field of intersecting disciplines including cultural studies, social history, philosophy, art, literature and psychoanalysis.
DOCUMENT
BACKGROUND: There are no validated assessment tools for evaluating quality of schoolwork task performance of children living in German-speaking Europe (GSE).
OBJECTIVE: To determine whether the international age-normative means of the School Version of the Assessment of Motor and Process Skills (School AMPS) are valid for use in GSE.
METHODS: The participants were 159 typically-developing children, 3-12 years, from GSE. We examined the proportions of School AMPS measures falling within ±2 standard deviation (SD) of the international age-normative means, and evaluated for significant group differences (p < 0.05) in mean School AMPS measures between the GSE sample and the international age-normative sample using one-sample Z tests. When significant mean differences were found, we evaluated if the differences were clinically meaningful.
RESULTS: At least 95% of the GSE School AMPS measures fell within ±2 SD of the international age-normative means for the School AMPS. The only significant mean differences were for 6- (p < 0.01) and 8-year-olds (p = 0.02), and only the 6-year-old school process mean difference was clinically meaningful.
CONCLUSIONS: Because the only identified clinically meaningful difference was associated with likely scoring error of one rater, the international age-normative means of the School AMPS appear to be valid for use with children in GSE.
DOCUMENT
BACKGROUND: Seclusion is a controversial intervention. Efficacy with regard to aggressive behaviour has not been demonstrated, and seclusion is only justified for preventing safety hazards. Previous studies indicate that nursing staff factors may be predictors for seclusion, although methodological issues may have led to equivocal results.
OBJECTIVE: To perform a prospective cohort study to determine whether nursing staff characteristics are associated with seclusion of adult inpatients admitted to a closed psychiatric ward.
METHOD: We studied the association between nurses' demographics and incidence of seclusion during every shift. Data were collected during five months in 2013. Multiple logistic regression was used for analysis.
RESULTS: In univariable analysis, we found a non-significant association between seclusion and female gender, odds ratio (OR) = 5.27 (0.98-28.49) and a significant association between seclusion and nurses' large physical stature, OR = 0.21 (0.06-0.72). We found that physical stature is the most substantial factor, although not significant: ORadjusted = 0.27 (0.07-1.04).
CONCLUSION: Nurses' gender may be a predictor for seclusion, but it seems to be mediated by the effect of physical stature. We used a rigorous, census-based, prospective design to collect data on a highly detailed level and found a large effect of physical stature of nurses on seclusion. We found nurses' physical stature to be the most substantial predictor for seclusion. These and other factors need to be explored in further research with larger sample size.
DOCUMENT
We investigated the effects of reflex-based self-defence training on police performance in simulated high-pressure arrest situations. Police officers received this training as well as a regular police arrest and self-defence skills training (control training) in a crossover design. Officers' performance was tested on several variables in six reality-based scenarios before and after each training intervention. Results showed improved performance after the reflex-based training, while there was no such effect of the regular police training. Improved performance could be attributed to better communication, situational awareness (scanning area, alertness), assertiveness, resolution, proportionality, control and converting primary responses into tactical movements. As officers trained complete violent situations (and not just physical skills), they learned to use their actions before physical contact for de-escalation but also for anticipation on possible attacks. Furthermore, they learned to respond against attacks with skills based on their primary reflexes. The results of this study seem to suggest that reflex-based self-defence training better prepares officers for performing in high-pressure arrest situations than the current form of police arrest and self-defence skills training. Practitioner Summary: Police officers' performance in high-pressure arrest situations improved after a reflex-based self-defence training, while there was no such effect of a regular police training. As officers learned to anticipate on possible attacks and to respond with skills based on their primary reflexes, they were better able to perform effectively.
DOCUMENT
OBJECTIVES: The aim of the present study was to disentangle the impact of age and that of cancer diagnosis and treatment on functional status (FS) decline in older patients with cancer.
MATERIALS AND METHODS: Patients with breast and colorectal cancer aged 50-69years and aged ≥70years who had undergone surgery, and older patients without cancer aged ≥70years were included. FS was assessed at baseline and after 12months follow-up, using the Katz index for activities of daily living (ADL) and the Lawton scale for instrumental activities of daily living (IADL). FS decline was defined as ≥1 point decrease on the ADL or IADL scale from baseline to 12months follow-up.
RESULTS: In total, 179 older patients with cancer (≥ 70years), 341 younger patients with cancer (50-69years) and 317 older patients without cancer (≥ 70years) were included. FS decline was found in 43.6%, 24.6% and 28.1% of the groups, respectively. FS decline was significantly worse in older compared to younger patients with cancer receiving no chemotherapy (44.5% versus 17.6%, p<0.001), but not for those who did receive chemotherapy (39.4% versus 30.8%, p=0.33). Among the patients with cancer, FS decline was significantly associated with older age (OR 2.63), female sex (OR 3.72), colorectal cancer (OR 2.81), polypharmacy (OR 2.10) and, inversely, with baseline ADL dependency (OR 0.44).
CONCLUSION: Cancer treatment, and older age are important predictors of FS decline. The relation of baseline ADL dependency and chemotherapy with FS decline suggest that the fittest of the older patients with cancer were selected for chemotherapy.
DOCUMENT
BACKGROUND: Intentional weight loss in obese older adults is a risk factor for accelerated muscle mass loss. We investigated whether a high protein diet and/or resistance exercise preserves fat free mass (FFM) during weight loss in overweight and obese older adults.
METHODS: We included 100 overweight and obese adults (55-80 year) in a randomized controlled trial (RCT) with a 2 × 2 factorial design and intention-to-treat analysis. During a 10-week weight loss program all subjects followed a hypocaloric diet. Subjects were randomly allocated to either a high protein (1.3 g/kg body weight) or normal protein diet (0.8 g/kg), with or without a resistance exercise program 3 times/week. FFM was assessed by air displacement plethysmography.
RESULTS: At baseline, mean (±SD) BMI was 32 ± 4 kg/m(2). During intervention, protein intake was 1.13 ± 0.35 g/kg in the high protein groups vs. 0.98 ± 0.29 in the normal protein groups, which reflects a 16.3 ± 5.2 g/d higher protein intake in the high protein groups. Both high protein diet and exercise did not significantly affect change in body weight, FFM and fat mass (FM). No significant protein*exercise interaction effect was observed for FFM. However, within-group analysis showed that high protein in combination with exercise significantly increased FFM (+0.6 ± 1.3 kg, p = 0.011).
CONCLUSION: A high protein diet, though lower than targeted, did not significantly affect changes in FFM during modest weight loss in older overweight and obese adults. There was no significant interaction between the high protein diet and resistance exercise for change in FFM. However, only the group with the combined intervention of high protein diet and resistance exercise significantly increased in FFM.
TRIAL REGISTRATION: Dutch Trial Register, number NTR4556, date 05-01-2014.
DOCUMENT
BACKGROUND: Observation of movement quality (MQ) is an indelible element in the process of clinical reasoning for patients with non-specific low back pain (NS-LBP). However, the observation and evaluation of MQ in common daily activities are not standardized within allied health care. This study aims to describe how Dutch allied health care professionals (AHCPs) observe and assess MQ in patients with NS-LBP and whether AHCPs feel the need to have a specific outcome measure for assessing MQ in patients with NS-LBP.
METHODS: In this cross-sectional digital survey study, Dutch primary care AHCPs (n = 114) answered one open and three closed questions about MQ in NS-LBP management. Qualitative and quantitative analyses were applied.
RESULTS: Qualitative analyses of the answers to the open questions revealed four main themes: 1) movement pattern features, 2) motor control features, 3) environmental influences and 4) non-verbal expressions of pain and exertion. Quantitative analyses clearly indicated that AHCPs observe MQ in the diagnostic (92%), therapeutic (91%) and evaluation phases (86%), that they do not apply any objective measurement of MQ and that 63% of the AHCPs consider it important to have a specific outcome measure to assess MQ. The AHCPs expressed added benefits and critical notes regarding clinical reasoning and quality of care.
CONCLUSION: AHCPs recognize the importance of observing MQ in the assessment and management of LBP in a standardized way. However, there is no consensus amongst AHCPs how MQ should be standardized. Prior to standardization, it will be important to develop a theoretical framework to determine which observable and measurable dimensions of MQ are most valid and relevant for patients with NS-LBP to include in the assessment.
DOCUMENT
Background
Cardiovascular disease (CVD) prevention guidelines stress the importance of smoking cessation and recommend intensive follow-up. To guide the development of such cessation support strategies, we analysed the characteristics that are associated with successful smoking cessation after an acute coronary syndrome (ACS).
MethodsWe used data from the Randomised Evaluation of Secondary Prevention for ACS patients coordinated by Outpatient Nurse SpEcialists (RESPONSE) trial (n = 754). This was designed to quantify the impact of a nurse-coordinated prevention program, focusing on healthy lifestyles, traditional CVD risk factors and medication adherence. For the current analysis we included all smokers (324/754, 43 %). Successful quitters were defined as those who reported abstinence at 1 year of follow-up.
ResultsThe majority of successful quitters quit immediately after the ACS event and remained abstinent through 1 year of follow-up, without extra support (128/156, 82 %). Higher education level (33 vs. 15 %, p < 0.01), no history of CVD (87 vs. 74 %, p < 0.01) and being on target for LDL-cholesterol level at 1 year (78 vs. 63 %, p < 0.01) were associated with successful quitting.
ConclusionThe majority of successful quitters at 1 year stopped immediately after their ACS. Patients in this group showed that it was within their own ability to quit, and they did not relapse through 1 year of follow-up. Our study indicates that in a large group of patients who quit immediately after a life-threatening event, no relapse prevention program is needed.
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