3,566 research outputs found

    Knooppunt van ketens: De meerwaarde van veiligheidshuizen

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    in deze scriptie wordt onderzoek gedaan naar het oprichten van veiligheidshuizen in Nederland. Daarbij komen vragen aan de orde mbt het strafrecht en het lokale zorgstelsel

    Effects of Concurrent Continuous Visual Feedback on Learning the Lane Keeping Task

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    This study investigated the training effectiveness of continuous visual feedback in a simulator-based lane keeping task. Two groups of student drivers (total of 30 participants) were instructed to drive as accurately as possible in the center of the right lane in a self-paced driving task during five 8-min sessions. One group received visual feedback using a horizontal compensatory display positioned on the dashboard, which provided an indication of the momentary distance to the lane center during the three training sessions. During two retention sessions (immediate and one day delayed) both groups drove without the augmented feedback. The augmented feedback resulted in improved performance on a measure lane keeping accuracy, but this effect disappeared during retention. Furthermore, the augmented feedback resulted in increased steering wheel activity during all sessions, and increased driver workload in the delayed retention session. These results provide support for the guidance hypothesis and have possible implications for the use of continuous concurrent feedback in simulatorbased driver training

    The effect of an e-learning supported Train-the-Trainer program on implementation of suicide guidelines in mental health care.

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    AbstractBackgroundRandomized studies examining the effect of training of mental health professionals in suicide prevention guidelines are scarce. We assessed whether professionals benefited from an e-learning supported Train-the-Trainer programme aimed at the application of the Dutch multidisciplinary suicide prevention guideline.Methods45 psychiatric departments from all over the Netherlands were clustered in pairs and randomized. In the experimental condition, all of the staff of psychiatric departments was trained by peers with an e-learning supported Train-the-Trainer programme. Guideline adherence of individual professionals was measured by means of the response to on-line video fragments. Multilevel analyses were used to establish whether variation between conditions was due to differences between individual professionals or departments.ResultsMultilevel analysis showed that the intervention resulted in an improvement of individual professionals. At the 3 month follow-up, professionals who received the intervention showed greater guideline adherence, improved self-perceived knowledge and improved confidence as providers of care than professionals who were only exposed to traditional guideline dissemination. Subgroup analyses showed that improved guideline adherence was found among nurses but not among psychiatrists and psychologists. No significant effect of the intervention on team performance was found.LimitationsThe ICT environment in departments was often technically inadequate when displaying the video clips clip of the survey. This may have caused considerable drop-out and possibly introduced selection bias, as professionals who were strongly affiliated to the theme of the study might have been more likely to finish the study.ConclusionsOur results support the idea that an e-learning supported Train-the-Trainer programme is an effective strategy for implementing clinical guidelines and improving care for suicidal patients.Trial registrationNetherlands Trial Register (NTR3092 www.trialregister.nl)

    Quantum Kinetic Equations and Cosmology

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    We analyse quantum--kinetic effects in the early Universe. We show that quantum corrections to the Vlasov equation give rise to a dynamical variation of the gravitational constant. The value of the gravitational constant at the Grand Unification epoch is shown to differ from its present value to about 10−4÷10−3%10^{-4} \div 10^{-3} \% .Comment: 10 page

    WS1.3 Respiratory microbiota dynamics in newborns with cystic fibrosis and healthy controls: A longitudinal study

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    IEEEMost malware are introduced into a computer system by applications that communicate with the outside world. These applications (called portals) are key components for system security. This paper presents an efficient anti-malware framework un

    Thermal and chemical equilibration in a gluon plasma

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    We show the evolution of a gluon plasma towards equilibrium starting at some early moment when the momentum distribution in the central region is momentaneously isotropic. Using HIJING results for Au+Au collision as initial input, we consider thermalization and chemical equilibration simultaneously at both LHC and RHIC energies. Thermalization is shown to be driven chiefly by inelastic process in our scenario contradicting common assumption that this is the role of elastic process. We argue that only the inelastic dominancy depends on the initial conditions but not the dominance itself.Comment: 14 pages + 4 postscript figures, latex2e file, final version to appear in Nucl. Phys.

    Upper and lower airway cultures in children with cystic fibrosis: Do not neglect the upper airways

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    AbstractBackgroundAirways of cystic fibrosis (CF) patients are colonised with bacteria early in life. We aimed to analyse differences between results of simultaneously taken upper airway (UAW) and lower airway (LAW) cultures, to describe clinical characteristics of patients with positive versus negative cultures and to follow up the patients with P. aeruginosa positive UAW cultures.MethodsBacteriological and clinical data from 157 children were collected during annual check up. The number of positive UAW and LAW cultures and correspondence between these results and clinical characteristics were analysed.ResultsPositive LAW and UAW cultures were found in 79.6% and 43.9% of patients respectively (p<0.001). Patients with positive LAW cultures were significantly older (11.9 vs. 9.8years, p<0.05) and had more LAW symptoms (73.6% vs. 46.7%, p<0.05), especially when P. aeruginosa was found. Patients with positive UAW cultures (especially S. aureus) had more nasal discharge (50.7% vs. 25.0%, p<0.001). In 65% of patients with positive UAW and negative LAW culture for P. aeruginosa the next LAW became P. aeruginosa positive.ConclusionUAW cultures and LAW cultures differ in children with CF and there are differences in clinical characteristics between patients with positive versus negative culture results. P. aeruginosa positive UAW cultures appeared to precede positive LAW cultures in a substantial part of patients, suggesting some kind of cross-infection between the UAW and LAW

    Identification of patients at risk of sudden cardiac death in congenital heart disease:The PRospEctiVE study on implaNTable cardlOverter defibrillator therapy and suddeN cardiac death in Adults with Congenital Heart Disease (PREVENTION-ACHD)

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    BACKGROUND Sudden cardiac death (SCD) is the main preventable cause of death in patients with adult congenital heart disease (ACHD). Since robust risk stratification methods are lacking, we developed a risk score model to predict SCD in patients with ACHD: the PRospEctiVE study on implaNTable cardlOverter defibrillator therapy and suddeN cardiac death in Adults with Congenital Heart Disease (PREVENTION-ACHD) risk score model. OBJECTIVE The purpose of this study was to prospectively study predicted SCD risk using the PREVENTION-ACHD risk score model and actual SCD and sustained ventricular tachycardia/ventricular fibrillation (VT/VF) rates in patients with ACHD. METHODS The PREVENTION-ACHD risk score model assigns 1 point each to coronary artery disease, New York Heart Association class II/III heart failure, supraventricular tachycardia, systemic ejection fraction = 120 ms, and QT dispersion >= 70 ms. SCD risk was calculated for each patient. An annual predicted risk of >= 3% constituted high risk. The primary outcome was SCD or VT/VF after 2 years. The secondary outcome was SCD. RESULTS The study included 783 consecutive patients with ACHD (n=239 (31%) left-sided lesions; n=138 (18%) tetralogy of Fallot; n=108 (14%) dosed atrial septal defect; median age 36 years; interquartile range 28-47 years; n=401 (51%) men). The PREVENTION-ACHD risk score modelidentified 58 high-risk patients. Eight patients (4 at high risk) experienced the primary outcome. The Kaplan-Meier estimates were 7% (95% confidence interval [CI] 0.1%-13.3%) in the high-risk group and 0.6% (95% CI 0.0%-1.1%) in the low-risk group (hazard ratio 12.5; 95% CI 3.1-50.9; P < .001). The risk score model's sensitivity was 0.5 and specificity 93, resulting in a C-statistic of 0.75 (95% CI 0.57-0.90). The hazard ratio for SCD was 12.4 (95% CI 1.8-88.1) (P = .01); the sensitivity and specificity were 0.5 and 0.92, and the C-statistic was 0.81 (95% CI 0.67-0.95). CONCLUSION The PREVENTION-ACHD risk score model provides greater accuracy in SCD or VT/VF risk stratification as compared with current guideline indications and identifies patients with ACHD who may benefit from preventive implantable cardioverterdefibrillator implantation
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