Managers shaping the service triangle: Navigating resident and worker interests through work design in nursing homes

Managers play a key role in shaping the service triangle and navigating stakeholder interests within this. In healthcare, labor shortages are prompting consideration of the consequences of care delivery for service users and staff. Here we consider how senior nursing home managers tasked with balancing resident and worker interests manage tensions using work design. Findings identify a five-cluster typology, reflecting variations in how managers from twenty Flemish nursing homes operationalize the same resident-centred care model. Managers purposively shape a different service triangle in each operationalization, variously prioritizing benefits for residents, seeking the golden mean or attempting to suppress tensions

Automatic segmentation of MR brain images with a convolutional neural network

Automatic segmentation in MR brain images is important for quantitative analysis in large-scale studies with images acquired at all ages. This paper presents a method for the automatic segmentation of MR brain images into a number of tissue classes using a convolutional neural network. To ensure that the method obtains accurate segmentation details as well as spatial consistency, the network uses multiple patch sizes and multiple convolution kernel sizes to acquire multi-scale information about each voxel. The method is not dependent on explicit features, but learns to recognise the information that is important for the classification based on training data. The method requires a single anatomical MR image only. The segmentation method is applied to five different data sets: coronal T2-weighted images of preterm infants acquired at 30 weeks postmenstrual age (PMA) and 40 weeks PMA, axial T2- weighted images of preterm infants acquired at 40 weeks PMA, axial T1-weighted images of ageing adults acquired at an average age of 70 years, and T1-weighted images of young adults acquired at an average age of 23 years. The method obtained the following average Dice coefficients over all segmented tissue classes for each data set, respectively: 0.87, 0.82, 0.84, 0.86 and 0.91. The results demonstrate that the method obtains accurate segmentations in all five sets, and hence demonstrates its robustness to differences in age and acquisition protocol

Environmental and Energy Performance of the Biomass to Synthetic Natural Gas Supply Chain

A quarter of the total primary energy demand in the European Union is met by natural gas. Synthetic natural gas produced through biomass gasification can contribute to a more sustainable energy supply system. A chain analysis of the energetic performance of synthetic natural gas where the upstream, midstream and downstream part are included has not been found in literature. The energy performance of the possible large-scale application of synthetic natural gas is therefore unsure. A model was designed to analyse the performance of the biomass to synthetic natural gas chain and to estimate the effect of 1% synthetic natural gas in the energy system. A break-even distance is introduced to determine whether it is energetically feasible to apply pretreatment. Results show that torrefaction and pelleting are energetically unfeasible within the European Union. Emissions can be reduced with almost 70% compared to a fossil reference scenario. Over 1.2 Mha is required to fulfil 0.25% of the total primary energy demand in the European Union

Infants' implicit rhyme perception in child songs and Its relationship with vocabulary

Rhyme perception is an important predictor for future literacy. Assessing rhyme abilities, however, commonly requires children to make explicit rhyme judgements on single words. Here we explored whether infants already implicitly process rhymes in natural rhyming contexts (child songs) and whether this response correlates with later vocabulary size. In a passive listening ERP study, 10.5 month-old Dutch infants were exposed to rhyming and non-rhyming child songs. Two types of rhyme effects were analysed: (1) ERPs elicited by the first rhyme occurring in each song (rhyme sensitivity) and (2) ERPs elicited by rhymes repeating after the first rhyme in each song (rhyme repetition). Only for the latter a tentative negativity for rhymes from 0 to 200 ms after the onset of the rhyme word was found. This rhyme repetition effect correlated with productive vocabulary at 18 months-old, but not with any other vocabulary measure (perception at 10.5 or 18 months-old). While awaiting future replication, the study indicates precursors of phonological awareness already during infancy and with ecologically valid linguistic stimuli

Balancing responsibilities:Effects of growth of variable renewable energy, storage, and undue grid interaction

Electrical energy storage is often proposed as a solution for the mismatch between supply patterns of variable renewable electricity sources and electricity demand patterns. However, effectiveness and usefulness of storage may vary under different circumstances. This study provides an abstract perspective on the merits of electrical energy storage integrated with decentralized supply systems consisting of solar PV and wind power in a mesolevel, residential sector context. We used a balancing model to couple demand and supply patterns based on Dutch weather data and assess the resultant loads given various scenarios. Our model results highlight differences in storage effectiveness for solar PV and wind power, and strong diminishing-returns effects. Small storage capacities can be functional in reducing surpluses in overdimensioned supply systems and shortages in under-dimensioned supply systems. However, full elimination of imbalance requires substantial storage capacities. The overall potential of storage to mitigate imbalance of variable renewable energy is limited. Integration of storage in local supply systems may have self-sufficiency and cost-effectiveness benefits for prosumers but may have additional peak load disadvantages for grid operators. Adequate policy measures beyond current curtailment strategies are required to ensure proper distribution of benefits and responsibilities associated with variable renewable energy and storage