Having Fun in Learning Formal Specifications

There are many benefits in providing formal specifications for our software. However, teaching students to do this is not always easy as courses on formal methods are often experienced as dry by students. This paper presents a game called FormalZ that teachers can use to introduce some variation in their class. Students can have some fun in playing the game and, while doing so, also learn the basics of writing formal specifications in the form of pre- and post-conditions. Unlike existing software engineering themed education games such as Pex and Code Defenders, FormalZ takes the deep gamification approach where playing gets a more central role in order to generate more engagement. This short paper presents our work in progress: the first implementation of FormalZ along with the result of a preliminary users' evaluation. This implementation is functionally complete and tested, but the polishing of its user interface is still future work

Overeenstemming tussen antropometrische methoden voor de bepaling van de gewichtsstatus.

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Quality of life of older adults and associated factors in Ghanaian urban slums: a cross-sectional study

OBJECTIVE: This study provides insight into the quality of life (QoL) of older adults living in urban slums in Ghana. DESIGN: The study employed a community-based, cross-sectional design to assess QoL among older adults in two slums between April and May 2020. QoL was assessed using the WHO Quality of Life-Brief version (WHOQOL-BREF) questionnaire. SETTINGS: Participants were drawn from two slums in Ghana, one in a fishing-dominated community and the other in an industrial community. PARTICIPANTS: This study included 400 participants aged 60 and above who had lived in either slum for at least 1 month and were able to communicate verbally. RESULTS: Although the means of all participants’ transformed scores were poor in the physical and psychological domains, they were moderate in all other domains. When viewed as a whole, the perceived overall QoL is neither poor nor good and participants were neither satisfied nor dissatisfied with their health. Participants had a moderate level of QoL in the WHOQOL-BREF psychological (mean score 45.7), social (mean score 57.0) and environmental (mean score 51.6) domains. The mean score for physical QoL of older adults was 43.3, which denotes poor QoL. In all domains, male participants have a significantly higher mean QoL than their female counterparts. An analysis of variance comparing the living arrangements of participants showed that those who lived with extended family had high mean scores in environmental QoL, overall QoL and satisfaction with health. Regression analysis revealed that QoL was influenced mostly by the environmental (46.2%), followed by the psychological (43.7%), physical (31%) and social (20.4%) domains. CONCLUSIONS: The findings from this study show that older adults living in slums had moderate psychological, social and environmental QoL and poor physical QoL. Although the mean scores for QoL are higher than anticipated, health policy development must take into account the specific needs of older adults

The quality of nutritional care in hospitals: Austria, Switzerland, and Turkey compared

Objective: The aim of this study was to investigate the differences in the quality of nutritional care among Austria, Switzerland, and Turkey.Methods: This was a cross-sectional multicenter study. Data were collected using a standardized questionnaire. Descriptive statistics and univariate and multivariate logistic regression (adjusted for age, sex, number of diagnoses, and care dependency) analyses were performed.Results: Taking part in the study were 6293 patients from 62 hospitals. The prevalence of risk for malnutrition and the patients was 14.5% in Austria, 16.5% in Switzerland, and 33.7% in Turkey. Standardized screening procedures were applied in 51.3% of Austrian, 53.6% of Swiss, and 38.4% of Turkish patients. The interventions applied in patients at risk varied significantly between Austrian, Swiss, and Turkish hospitals for all but two interventions. Referrals to dietitians were lower in Austria (35.8%) and Switzerland (37.7%) compared with Turkey (61%). Turkish patients received more frequent oral nutritional supplementation, an energy-proteinenriched diet, or parenteral nutrition compared with those in Austrian or Swiss hospitals. The differences in the quality of nutritional care between Austrian and Swiss hospitals were only marginal. Of at-risk patients, 15.3% in Austria, 11.4% in Switzerland, and 5.5% in Turkey did not receive any intervention.Conclusions: The findings of this study indicated that significant differences exist in the prevalence, identification and treatment of malnutrition, and the fulfillment of structural quality indicators. Standards and guidelines need to be developed that can be used by all countries. The severity of the malnutrition situation in hospitals needs further attention in future management policies. (C) 2020 Elsevier Inc. All rights reserved

Bridging the gap: a qualitative exploration of the Scientific Linking Pin role in science and care partnerships

Context: The Living Lab in Ageing and Long-Term Care (Netherlands) and Nurturing Innovation in Care Homes Excellence in Leeds (NICHE-Leeds; UK) are partnerships between science and care. The Scientific Linking Pin (SLP), a senior researcher employed by a university, works one day per week in a LTC organization, and has a pivotal role in the partnership. Objective: To explore the nature of the SLP role Methods: A qualitative approach was used. Fifteen individuals with at least one year’s experience as a SLP in the Living Lab or NICHE-Leeds participated in a semi-structured interview. Data were thematically analyzed. Findings: Participants described how the SLP role gave them insight into what matters to care organizations, and how it enabled them to impact LTC practice. Participants experienced the role to be multifaceted. Goals and activities performed by SLPs included developing relationships, raising awareness of the practice-science partnership, identifying (research) priorities and generating research questions, building committees, brokering knowledge, developing research studies, generating academic output, building links and connections, and assisting with internal projects. Challenges faced were mistrust by care staff and poor engagement, working with staff from different professional backgrounds, research not being a priority, multiple and rapidly changing priorities, and differences in expectations. SLPs addressed these challenges through relationship building, creating a ‘safe’ space for care staff, building engagement, and expectation management. Implications: Partnership working in the care sector is gaining international recognition and adoption, and therefore it is useful to capture and share learning about successful implementation of our approach

Building Consensus on an Integrated Care Pathway in Geriatric Rehabilitation:A Modified Delphi Study Among Professional Experts

To improve continuity and coordination of care in geriatric rehabilitation, an integrated care pathway was developed in the south of the Netherlands. This study aims to reach nationwide consensus on the content and structure of this locally developed pathway using a two-round Delphi study with specialized elderly care physicians (n = 37) as experts. In the first round, experts indicated their level of agreement on 65 statements representing the pathway on a 5-point Likert-type scale. Statements that did not gain consensus (interquartile range > 1) were redistributed to participants in Round 2. Consensus was reached on 56 statements (86%) after Round 1 and on 60 statements (92%) after Round 2. In total, 53 statements were assessed as relevant, seven statements were considered irrelevant, and five statements did not reach consensus. We conclude that there is broad nationwide consensus on the pathway, which therefore has the potential to be disseminated and implemented on a wider scale

The effectiveness of an integrated care pathway in geriatric rehabilitation among older patients with complex health problems and their informal caregivers: a prospective cohort study

Abstract Background To improve continuity and coordination of care in geriatric rehabilitation, an integrated care pathway was developed and implemented in The Netherlands. The purpose of this study was to assess the effects of this pathway on patients and informal caregivers. Methods Two cohorts of patients and their informal caregivers were prospectively recruited before implementation of the pathway (2011–2012) and after implementation of the pathway (2013–2014). Primary outcome measures were dependence in activities of daily living in patients (KATZ-15) and self-rated burden among informal caregivers (SRB-VAS). Secondary outcome measures were the frequency of performing extended daily activities, social participation, psychological well-being, quality of life and discharge location (patients) and quality of life and objective care burden (informal caregivers). Outcomes were measured at baseline, after three and after nine months. Results No effect was shown on the KATZ-15 after three and nine months. However, a larger percentage of patients were discharged home in the care pathway cohort (83% vs 58.1% after three months and 88.6% vs 67.4% after nine months; p = 0.004). Furthermore, after three months, patients from the care pathway cohort performed more extended daily activities (p = 0.014) and informal caregivers experienced a lower self-rated burden (p = 0.05). After nine months, these effects disappeared. No differences were found for the other outcome measures. Conclusions Due to the positive effects of the integrated care pathway, we are inclined to recommend implementing the care pathway in regular care. To have longer lasting effects among patients and informal caregivers, we suggest actively disseminating information about the pathway to primary care providers who are currently still unaware of its content. Trial registration ISRCTN90000867 (date of registration: 07-04-2016)

Process evaluation of an integrated care pathway in geriatric rehabilitation for people with complex health problems

Abstract Background An integrated care pathway in geriatric rehabilitation was developed to improve coordination and continuity of care for community-living older adults in the Netherlands, who go through the process of hospital admission, admission to a geriatric rehabilitation facility and discharge back to the home situation. This pathway is a complex intervention and is focused on improving communication, triage and transfers of patients between the hospital, geriatric rehabilitation facility and primary care organisations. A process evaluation was performed to assess the feasibility of this pathway. Methods The study design incorporated mixed methods. Feasibility was assessed thru if the pathway was implemented according to plan (fidelity and dose delivered), (b) if patients, informal caregivers and professionals were satisfied with the pathway (dose received) and (c) which barriers and facilitators influenced implementation (context). These components were derived from the theoretical framework of Saunders and colleagues. Data were collected using three structured face-to-face interviews with patients, self-administered questionnaires among informal caregivers, and group interviews with professionals. Furthermore, data were collected from the information transfer system in the hospital, patient files of the geriatric rehabilitation facility and minutes of evaluation meetings. Results In total, 113 patients, 37 informal caregivers and 19 healthcare professionals participated in this process evaluation. The pathway was considered largely feasible as two components were fully implemented according to plan and two components were largely implemented according to plan. The timing and quality of medical discharge summaries were not sufficiently implemented according to plan and professionals indicated that the triage instrument needed refinement. Healthcare professionals were satisfied with the implementation of the pathway and they indicated that due to improved collaboration, the quality of care provision improved. Although patients and informal caregivers were also satisfied with the care provision in the pathway, they indicated that the care organisations involved should pay more attention towards providing information about their treatment. Conclusions This process evaluation showed that patients, informal caregivers and professionals are fairly satisfied with the care provision in the pathway and professionals reported that collaboration improved. Extra attention should be paid to the components in the ..