Estimation and Optimization of the Performance of Polyhedral Process Networks

A system-level design methodology such as Daedalus provides designers with a forward synthesis flow for automated design, programming, and implementation of multiprocessor systems-on-chip. Daedalus employs the polyhedral process network model of computation to represent applications. These networks are automatically derived from sequential C code. A forward synthesis flow greatly increases designer productivity. Still, the designer needs to perform a time-consuming forward synthesis step to learn if a network satisfies his performance constraints. Furthermore, it is not trivial to select a set of transformations and transformation parameters for a network such that performance requirements are met. A forward synthesis flow thus solves only part of a design problem, as it does not provide fast feedback on the transformations a designer should apply to meet his performance constraints. This dissertation intro duces different performance estimation techniques for polyhedral process networks. The most promising technique is the profiling-based cprof technique that works directly on the sequential application code. This makes cprof an easy-to-use, robust, and fast technique, without the need to derive a polyhedral process network. This dissertation then discusses four transformations and analyzes factors that affect the efficacy of each transformation.Computer Systems, Imagery and Medi

Morphological development of the Vecht river due to changes in the weir policy

The Vecht river, located in Overijssel in the eastern part of the Netherlands, has been canalized over time by cutting of meanders, constructing weirs, and covering the banks with revetments. However, recently river management practices started focusing on the environmental wellbeing of the river system, which resulted in the formulation of a new vision and implementation of measures to rebuild the Vecht into a semi-natural river (Helder et al., 2017). Such a semi-natural river can be characterized by a.o. the presence of meanders and clearly visible morphological processes like sedimentation and erosion. The current weir policy that is applied in the Vecht is based on maintaining target water levels. A reversed seasonal water level variation is maintained so that water levels are higher in summer than in winter. The weirs also block the flow of water and sediment. This is non-fitting for semi-natural rivers. Implementation of a discharge controlled weir policy is expected to increase the flow through the river and bring back natural seasonal water level variations. Research about the effect of alternative weir policies on the morphology of rivers is limited (Ni et al., 2021). The objective of this exploratory research is therefore to evaluate the effect of certain changes in the weir policy on the morphology of the Vecht

Multidisciplinary care for stroke patients living in the community: A systematic review

Objective: A systematic review of randomized controlled trials was performed to evaluate the effectiveness of multidisciplinary care for stroke patients living in the community. Data sources: Databases PubMed, EMBASE, CINAHL and the Cochrane Library from January 1980 until July 2012. Study selection: Randomized controlled trials focused on multidisciplinary interventions for stroke patients living at home after hospitalization or inpatient rehabilitation were selected. The outcome domains were activities of daily living, social participation and quality of life. A total of 14 studies were included. Data extraction: Two authors independently extracted the data and independently assessed the quality of reporting of the included studies using the Consolidated Standards of Reporting Trials (CONSORT) statement 2010. Data synthesis: None of the studies showed favourable effects of the intervention on activities of daily living and none assessed social participation. Furthermore, two studies reported favourable effects of the intervention in terms of quality of life. These concerned an intervention combining assessment with follow-up care and a rehabilitation intervention. Conclusion: There is little evidence for the effectiveness of multidisciplinary care for stroke patients being discharged home. Additional research should provide more insight into potentially effective multidisciplinary care for community-living stroke patients

Skin areas, clinical severity, duration and risk factors of intertrigo : a secondary data analysis

Aim: To describe the skin areas most often affected by intertrigo, the clinical severity and duration of intertrigo and possible risk factors. Materials and methods: Secondary analysis of data from 2013 to 2016 collected by the International Prevalence Measurement of Care Quality in Dutch hospitals, care homes and community care. Results: In total, n = 7865 (mean age 80.1 years) subjects were included in this analysis. The inguinal, breast and gluteal cleft skin areas were most often affected by intertrigo. The skin was often inflamed but not eroded. Strongest associations between intertrigo at inguinal skin and diabetes mellitus (OR 1.8; 95% CI 1.1-3.1), intertrigo at sub mammary folds and urinary incontinence (OR 1.6; 95% CI 0.9-2.9) and between intertrigo at gluteal cleft and urinary incontinence (OR 2.9; 95% CI 1.4-5.2) were observed. Conclusion: The inguinal region, sub mammary folds and gluteal clefts are most often affected by intertrigo. Female sex, urinary incontinence and high BMI seem to enhance intertrigo risk at all of these skin areas

Effectiveness and cost-effectiveness of a multidisciplinary intervention programme to prevent new falls and functional decline among elderly persons at risk: design of a replicated randomised controlled trial [ISRCTN64716113]

BACKGROUND: Falls are common among community-dwelling elderly people and can have a considerable impact on quality of life and healthcare costs. People who have sustained a fall are at greater risk of falling again. We replicated a British randomised controlled trial which demonstrated the effectiveness of a multidisciplinary intervention programme to prevent falls. The objective is to describe the design of a replication study evaluating a multidisciplinary intervention programme on recurrent falls and functional decline among elderly persons at risk. The study consists of an effect evaluation, an economic evaluation and a process evaluation. METHODS/DESIGN: The programme is aimed at community-dwelling elderly people aged 65 years or over who have visited an accident and emergency department (A&E department) or a general practitioners' cooperative (GP cooperative) because of a fall. The design involves a two-group randomised controlled trial. Participants are followed for twelve months after baseline. The intervention programme consists of a detailed medical and occupational therapy assessment with referral to relevant services if indicated. People in the control group receive usual care. The main outcome measures of the effect evaluation are number of falls and daily functioning. The economic evaluation will be performed from a societal perspective. A process evaluation will be carried out to evaluate the feasibility of the intervention programme

Relationship between location and activity in injurious falls: an exploratory study

<p>Abstract</p> <p>Background</p> <p>Knowledge about the circumstances under which injurious falls occur could provide healthcare workers with better tools to prevent falls and fall-related injuries. Therefore, we assessed whether older persons who sustain an injurious fall can be classified into specific fall types, based on a combination of fall location and activity up to the moment of the fall. In addition, we assessed whether specific injurious fall types are related to causes of the fall, consequences of the fall, socio-demographic characteristics, and health-related characteristics.</p> <p>Methods</p> <p>An exploratory, cross-sectional study design was used to identify injurious fall types. The study population comprised 333 community-dwelling Dutch elderly people aged 65 years or over who attended an accident and emergency department after a fall. All participants received a self-administered questionnaire after being discharged home. The questionnaire comprised items concerning circumstances of the injurious fall, causes of the fall, consequences of the fall, socio-demographic characteristics and health-related characteristics. Injurious fall types were distinguished by analyzing data by means of HOMALS (homogeneity analysis by means of alternating least squares).</p> <p>Results</p> <p>We identified 4 injurious fall types: 1) Indoor falls related to lavatory visits (hall and bathroom); 2) Indoor falls during other activities of daily living; 3) Outdoor falls near the home during instrumental activities of daily living; 4) Outdoor falls away from home, occurring during walking, cycling, and shopping for groceries. These injurious fall types were significantly related to age, cause of the fall, activity avoidance and daily functioning.</p> <p>Conclusion</p> <p>The face validity of the injurious fall typology is obvious. However, we found no relationship between the injurious fall types and severity of the consequences of the fall. Nevertheless, there appears to be a difference between the prevalence of fractures and the cause of the fall between the injurious fall types. Our data suggests that with regard to prevention of serious injuries, we should pay special attention to outdoor fallers and indoor fallers during lavatory visits. In addition, we should have special attention for causes of the fall. However, the conclusions reached in this exploratory analysis are tentative and need to be validated in a separate dataset.</p

‘Zicht op Evenwicht’: een effectieve interventie om bezorgdheid om te vallen en gerelateerd vermijdingsgedrag bij ouderen te verminderen

Valangst en gerelateerd vermijdingsgedrag komen veel voor bij ouderen en kunnen leiden tot een verminderde kwaliteit van leven, verminderd fysiek en psychosociaal functioneren en vervroegde opname in een verpleeghuis. In een gerandomiseerd onderzoek onder 540 zelfstandig wonende ouderen met valangst en gerelateerd vermijdingsgedrag zijn de uitvoerbaarheid en effecten van een cognitief gedragsmatige groepscursus geëvalueerd. De procesgegevens van de interventiegroep (n= 280) en de cursusleiders (n= 6) wees uit dat de cursus goed uitvoerbaar is, positief beoordeeld wordt en dat deelnemers baat hebben bij de cursus (61% rapporteert deze baat tot een jaar na de cursus). Wel meldde 26% van de interventiegroep zich voor de start van de cursus af voor deelname, maar deelnemers die met de cursus begonnen maakten deze doorgaans af (84%). De effectevaluatie liet positieve uitkomsten zien voor de interventiegroep vergeleken met de controle groep (n= 260); na de cursus werd minder bezorgdheid om te vallen en gerelateerd vermijdingsgedrag gerapporteerd en meer dagelijkse activiteit. Ook op de lange termijn waren positieve effecten zichtbaar, onder andere voor bezorgdheid om te vallen en herhaalde valincidenten. Op basis van deze succesvolle resultaten is de implementatie van de cognitief gedragsmatige groepscursus “Zicht op Evenwicht” in de Nederlandse gezondheidszorg gestart

Does Better Quality of Care for Falls and Urinary Incontinence Result in Better Participant‐Reported Outcomes?

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/87129/1/j.1532-5415.2011.03517.x.pd

Evaluating an intervention to reduce fear of falling and associated activity restriction in elderly persons: design of a randomised controlled trial [ISRCTN43792817]

BACKGROUND: Fear of falling and associated activity restriction is common in older persons living in the community. Adverse consequences of fear of falling and associated activity restriction, like functional decline and falls, may have a major impact on physical, mental and social functioning of these persons. This paper presents the design of a trial evaluating a cognitive behavioural group intervention to reduce fear of falling and associated activity restriction in older persons living in the community. METHODS/DESIGN: A two-group randomised controlled trial was developed to evaluate the intervention. Persons 70 years of age or over and still living in the community were eligible for study if they experienced at least some fear of falling and associated activity restriction. A random community sample of elderly people was screened for eligibility; those eligible for study were measured at baseline and were subsequently allocated to the intervention or control group. Follow-up measurements were carried out directly after the intervention period, and then at six months and 12 months after the intervention. People allocated to the intervention group were invited to participate in eight weekly sessions of two hours each and a booster session. This booster session was conducted before the follow-up measurement at six months after the intervention. People allocated to the control group received no intervention as a result of this trial. Both an effect evaluation and a process evaluation were performed. The primary outcome measures of the effect evaluation are fear of falling, avoidance of activity due to fear of falling, and daily activity. The secondary outcome measures are perceived general health, self-rated life satisfaction, activities of daily life, feelings of anxiety, symptoms of depression, social support interactions, feelings of loneliness, falls, perceived consequences of falling, and perceived risk of falling. The outcomes of the process evaluation comprise the performance of the intervention according to protocol, the attendance and adherence of participants, and the participants' and facilitators' opinion about the intervention. Data of the effect evaluation will be analysed according the intention-to-treat and on-treatment principle. Data of the process evaluation will be analysed using descriptive techniques