Dutch Healthcare Professionals’ Opinion on the Allocation of Responsibilities concerning Prescribing and Administering Medically Indicated Vaccines to Immunocompromised Patients

Background: Specific vaccines are indicated for immunocompromised patients (ICPs) due to their vulnerability to infections. Recommendation of these vaccines by healthcare professionals (HCPs) is a crucial facilitator for vaccine uptake. Unfortunately, the responsibilities to recommend and administer these vaccines are not clearly allocated among HCPs involved in the care of adult ICPs. We aimed to evaluate HCPs’ opinions on directorship and their role in facilitating the uptake of medically indicated vaccines as a basis to improve vaccination practices. Methods: A cross-sectional survey was performed among in-hospital medical specialists (MSs), general practitioners (GPs), and public health specialists (PHSs) in the Netherlands to assess their opinion on directorship and the implementation of vaccination care. Additionally, perceived barriers, facilitators, and possible solutions to improve vaccine uptake were investigated. Results: In total, 306 HCPs completed the survey. HCPs almost unanimously (98%) reported that according to them, the primary treating physician is responsible for recommending medically indicated vaccines. Administering these vaccines was seen as a more shared responsibility. The most important barriers experienced by HCPs in recommending and administering were reimbursement problems, a lack of a national vaccination registration system, insufficient collaboration among HCPs, and logistical problems. MSs, GPs and PHSs all mentioned the same three solutions as important strategies to improve vaccination practices, i.e., reimbursement of vaccines, reliable and easily accessible registration of received vaccines, and arrangements for collaboration among the different HCPs that are involved in care. Conclusion: The improvement in vaccination practices in ICPs should focus on better collaboration among MSs, GPs, and PHSs, who should know each other’s expertise; clear agreement on responsibility; reimbursement for vaccines; and the availability of clear registration of vaccination history.</p

We are the Change that we Seek: Information Interactions During a Change of Viewpoint

There has been considerable hype about filter bubbles and echo chambers influencing the views of information consumers. The fear is that these technologies are undermining democracy by swaying opinion and creating an uninformed, polarised populace. The literature in this space is mostly techno-centric, addressing the impact of technology. In contrast, our work is the first research in the information interaction field to examine changing viewpoints from a human-centric perspective. It provides a new understanding of view change and how we might support informed, autonomous view change behaviour. We interviewed 18 participants about a self-identified change of view, and the information touchpoints they engaged with along the way. In this paper we present the information types and sources that informed changes of viewpoint, and the ways in which our participants interacted with that information. We describe our findings in the context of the techno-centric literature and suggest principles for designing digital information environments that support user autonomy and reflection in viewpoint formation

Factorial Design Preparation Of Transparent Conducting Oxide Thin Films

Transparent and conducting properties of Cd2SnO4 films deposited onto glass substrates by the dip coating technique have been obtained using a 24 factorial design. All films were well adhered onto their substrates, presented porous morphology and inverse spinel structure. Statistical factorial design analysis showed that only substrate withdrawal rate and precursor solution concentration had significant effects on average transmission of the films. Cumulative probability graphs of factorial design model coefficients showed that none of the factor levels have significant effects on resistivity. However the films presented significantly higher resistivities using low withdrawal rates and low concentration levels. This indicates resistivity is a more complex function of the factor variables than transmission. 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Formative assessment: Enriching teaching and learning with formative assesment

Formative assessment is a valuable aspect in teaching and learning, and is proven to be an e ective learning method. There is evidence that adding formative assessment to your teaching increases students’ learning results (Black and William, 1998), but in practice many of the possibilities are left unused (Sluijsmans, Joosten-Ten Brinke, & Van der Vleuten, 2013). For this reason we made a second iteration of Feedback.Camp, which is a tool developed by researchers in the Department of Industrial Design (TU/e) to support (a) teachers in providing timely, targeted and dialogical feedback, and (b) students to engage with the teachers in low-threshold, focused feedback conversations. In the latest version we included elements of formative assessment: rubrics. This booklet was written to accompany the tool, as background information on formative assessment. We will outline a vision on what formative assessment entails for contemporary Industrial Design education and beyond, and how formative assessment can be embedded in practice. In writing this booklet, we presume that the reader has some background knowledge and experience in designing and teaching courses. What we aim for is to give you insight into di erent forms of formative assessment and strategies. On the one hand, this will most likely help you to realize that you already apply elements of formative assessment in your practice. On the other hand, this might support you in systematically, structurally and intentionally embedding formative assessment in your practice in such a way that student learning is enhanced. We hope to inspire you to try things out in practice, and thus further enrich your teaching and learning with the use of formative assessment. We are very interested to hear back from you about your experiences with formative assessment, and invite you to send us your feedback and comments. Also, if you are interested in experimenting with our tool Feedback.Camp, you are very welcome to. Please contact us, and we can make it available to you

Hetero diels-alder chemistry for the functionalization of single-walled carbon nanotubes with cyclopentadienyl end-capped polymer strands

Single-walled carbon nanotubes (SWCNTs) are pre-functionalized with a pyridinyl-based dithioester to undergo a hetero Diels-Alder (HDA) reaction with cyclopentadienyl end-capped poly(methyl)methacrylate (Mn = 2700 g mol-1, PDI = 1.14). Fourier transform infrared spectroscopy, thermogravimetric analysis, elemental analysis (EA), and X-ray photoelectron spectroscopy (XPS) evidence the success of the grafting process. The estimated resulting grafting density (from XPS and EA) via the HDA reaction increases by a factor of more than two (0.0774 chains·nm-2 via XPS) compared with typical values obtained via a direct cyclopentadiene driven Diels-Alder conjugation onto non-functional SWCNTs under similar conditions. Cyclopentadienyl end-capped polymer strands react at the surface of pre-functionalized single-walled carbon nanotubes with a pyridine-based dithioester through a hetero Diels-Alder reaction. Elemental analysis and X-ray photoelectron spectroscopy are employed to det ermine the grafting density

Involvement of serine 96 in the catalytic mechanism of ferredoxin-NADP+ reductase: structure--function relationship as studied by site-directed mutagenesis and X-ray crystallography

The crystal structure of ferredoxin-NADP+ reductase (FNR) suggests that Ser96 is directly involved in hydride transfer between the isoalloxazine moiety of FAD and the nicotinamide ring of NADP(H). To probe its role, Ser96 has been mutated to valine (S96V) and glycine (S96G). These mutations primarily affected the interaction of the nicotinamide ring with the flavin. Absorbance, fluorescence, and circular dichroism spectra and the crystal structure of FNR-S96V indicate that this mutant folds properly. FNR-S96V shows only 0.05% of wild-type activity, while the affinities for both ferredoxin and NADP+ are virtually unchanged. However, spectral perturbations induced by NADP+ binding to FNR-S96V strongly resemble those elicited by the binding of 2'-monophosphoadenosine-5'-diphosphoribose, a substrate analog lacking the nicotinamide ring, both to the mutant and wild-type enzymes. Rapid reaction studies on the valine mutant failed to detect charge-transfer intermediates during flavin reduction by NADPH. In addition, no semiquinone formation was seen during photoreduction of FNR-S96V. The three-dimensional structure of the valine mutant shows small, albeit definite, changes only in the isoalloxazine microenvironment. The glycine mutant of FNR displays behavior intermediate between that of wild-type enzyme and that of the valine mutant. It maintains ca. 2% of the wild-type activity as well as the ability to form the charge-transfer species between reduced FNR and NADP+. In photoreduction experiments, the same degree of flavin semiquinone stabilization was observed with FNR-S96G and with the wild-type enzyme. NADP+ binding to the glycine mutant was very similar to that observed in the case of the valine mutant

Rationale and design of the Anti-Xa therapy to lower cardiovascular events in addition to standard therapy in subjects with acute coronary syndrome-thrombolysis in myocardial infarction 51 (ATLAS-ACS 2 TIMI 51) trial: a randomized, double-blind, placebo-controlled study to evaluate the efficacy and safety of rivaroxaban in subjects with acute coronary syndrome.

Item does not contain fulltextBACKGROUND: Although therapy with aspirin or aspirin plus a thienopyridine reduces the incidence of long-term adverse cardiovascular events among patients with acute coronary syndrome (ACS), there remains a significant residual risk of cardiovascular death, recurrent myocardial infarction (MI), and stroke. In a phase 2 trial (ClinicalTrials.gov NCT00402597) in which the addition of the factor Xa inhibitor rivaroxaban was compared with placebo, among ACS patients receiving either aspirin alone or dual-antiplatelet therapy with aspirin and a thienopyridine, the end point of death, MI, or stroke compared with placebo was reduced (87/2331 [3.9%] vs 62/1160 [5.5%]; hazard ratio 0.69, [95% CI 0.50-0.96], P = .027). Two candidate doses of rivaroxaban were selected for further evaluation in a pivotal phase 3. DESIGN: The second ATLAS-ACS 2 TIMI 51 Trial is an international, randomized, double-blind, event-driven (n = 983) phase 3 trial involving more than 15,570 patients hospitalized with ACS (ClinicalTrials.gov NCT00809965). All patients are treated with a background of standard therapy including low-dose aspirin, and patients are stratified by the administration of a thienopyridine (clopidogrel or ticlopidine; stratum 2) or not (stratum 1). Within each stratum, patients are randomly assigned in a 1:1:1 ratio to receive rivaroxaban 2.5 mg twice daily, or rivaroxaban 5 mg twice daily, or placebo twice daily. The primary efficacy end point is the composite of cardiovascular death, MI, or stroke. The primary safety end point is thrombolysis in MI major bleeding not associated with coronary artery bypass graft surgery. SUMMARY: The ATLAS-ACS 2 TIMI 51 is testing the hypothesis that anticoagulation with the oral factor Xa inhibitor rivaroxaban reduces cardiovascular death, MI, and stroke among patients with ACS treated with guideline-based therapies for ACS.1 mei 201