Service Inventory Management : Solution techniques for inventory systems without backorders

Koole, G.M. [Promotor]Vis, I.F.A. [Copromotor

'Movement never lies.' Een conceptuele verkenning naar het uitdragen van verhalen via het lichaam, de ideeën van de danschoreograaf Martha Graham en humanistische geestelijk werk.

Vertrekpunt van dit onderzoek is het doel bij te dragen aan de theoretische ontwikkeling van een visie op de rol van lichamelijkheid binnen humanistisch geestelijk werk. Vanuit een hermeneutisch-dialogische wetenschapspositie wordt een narratieve analyse gecombineerd met fenomenologisch literatuuronderzoek. Het narratief - hier autobiografisch werk - van danschoreograaf Martha Graham wordt geanalyseerd en gekoppeld aan theorieën over lichamelijkheid en humanistisch geestelijk werk. Het lichaam opgevat als biologisch object valt samen met de huidige rationaliserende maatschappij met een mechanistisch wereldbeeld, waarin een tweede benadering van het lichaam als ervarend subject overschaduwd wordt. De narratieve analyse brengt danschoreograaf Graham naar voren als voorbeeld van het belang dat deze twee benaderingswijzen van het lichaam verbonden moeten worden. Het humanisme legt in eerste instantie de nadruk op het rationele vermogen van de mens, maar ziet in het kader van tevens een balans ook belangrijke ruimte voor een hier tegenover staande belevingssfeer (Van Praag, 1953; Mooren, 2012). Echter, simpelweg meer aandacht bieden (los van het ‘hoe’ hiertoe) aan een overschaduwd ‘lichaam-zijn denken’, confronteert ons blijkens dit onderzoek per definitie met het onvermijdelijke verval van ons lichaam. De narratieve analyse bevestigt dit taboe op de thematiek van het verval van het lichaam. Dat uitgerekend Graham niet in het reine lijkt te kunnen komen met haar ouder wordende lichaam, benadrukt sterk de noodzaak een manier te vinden om om te gaan met ‘de kwetsbaarheid van het leven’ die ons menselijk lichaam impliceert. Op precies dit punt is mogelijk een functie gelegen in het humanistisch geestelijk werk. Dit werkveld is namelijk bij uitstek geschikt om stil te staan bij de vraag naar de omgang met onze kwetsbaarheid en hierbij hulp te bieden. Het humanistisch geestelijk werk lijkt dus een passend werkveld om zowel mensen te ondersteunen bij de confrontatie met hun lichaam als ervarend subject als de balans in evenwicht te brengen tussen een lichaam ‘zijn’ en een lichaam ‘hebben’. Vanuit dit onderzoek kan daarom sterk aanbevolen worden om meer onderzoek te doen naar de thematiek van dit dubbele karakter van het lichaam en hoe voor beide benaderingen een plaats te bieden binnen het humanistisch geestelijk werk om zodoende de ‘cliënt’ zo volledig mogelijk tot ontplooiing te brengen vanuit een humanistisch gedachtegoed. Sleutelwoorden: lichaam, lichamelijkheid, narratief onderzoek, fenomenologie, humanisme, geestelijk werk, Martha Graham, autobiografie, dans, egodocumen

Saccadic fatigability in the oculomotor system

BACKGROUND: Fatigue is one of the most common and disabling symptoms in multiple sclerosis (MS), but challenging to quantify. This prospective study investigated if repeated saccadic eye movements enable measurement of oculomotor fatigability and can reflect on perceived fatigue in MS. METHODS: A standardized infrared oculography protocol (DEMoNS) was used for quantifying saccades in MS patients and healthy controls which included a first and a repeated pro-saccadic task (FPT and RPT). Saccadic peak velocity, latency, gain, area under the curve (AUC) and peak velocity divided by amplitude (Pv/Am) were calculated in both tasks. Perception based fatigue was assessed using the Checklist Individual Strength and the Neurological Fatigue Index (NFI). Linear regression models were used for assessing the relation between saccadic parameters and perceived fatigue. RESULTS: This study included 181 MS patients and 58 healthy controls subjects. From FPT to RPT, there were significant changes in saccadic parameters. Latency of both tasks was significantly related to NFI summary score (FPT: β = 0.022, p = .049, RPT: β 0.023, p = .021). These relationships were weakened after adjustment for Expanded Disability Status score (p > .05). There was however no significant group difference in changes in saccadic parameters. CONCLUSIONS: This study presents an objective and reproducible method for measuring saccadic fatigability. Saccadic fatigability was found to be of limited use in MS, and should be tested in conditions affecting ocular muscles or the neuromuscular junction

Inventory control for point-of-use locations in hospitals

Most inventory management systems at hospital departments are characterised by lost sales, periodic reviews with short lead times, and limited storage capacity. We develop two types of exact models that deal with all these characteristics. In a capacity model, the service level is maximised subject to a capacity restriction, and in a service model the required capacity is minimised subject to a service level restriction. We also formulate approximation models applicable for any lost-sales inventory system (cost objective, no lead time restrictions etc). For the capacity model, we develop a simple inventory rule to set the reorder levels and order quantities. Numerical results for this inventory rule show an average deviation of 1% from the optimal service levels. We also embed the single-item models in a multi-item system. Furthermore, we compare the performance of fixed order size replenishment policies and (R, s, S) policies

A standardized protocol for quantification of saccadic eye movements: DEMoNS

OBJECTIVE: Quantitative saccadic testing is a non-invasive method of evaluating the neural networks involved in the control of eye movements. The aim of this study is to provide a standardized and reproducible protocol for infrared oculography measurements of eye movements and analysis, which can be applied for various diseases in a multicenter setting. METHODS: Development of a protocol to Demonstrate Eye Movement Networks with Saccades (DEMoNS) using infrared oculography. Automated analysis methods were used to calculate parameters describing the characteristics of the saccadic eye movements. The two measurements of the subjects were compared with descriptive and reproducibility statistics. RESULTS: Infrared oculography measurements of all subjects were performed using the DEMoNS protocol and various saccadic parameters were calculated automatically from 28 subjects. Saccadic parameters such as: peak velocity, latency and saccade pair ratios showed excellent reproducibility (intra-class correlation coefficients > 0.9). Parameters describing performance of more complex tasks showed moderate to good reproducibility (intra-class correlation coefficients 0.63-0.78). CONCLUSIONS: This study provides a standardized and transparent protocol for measuring and analyzing saccadic eye movements in a multicenter setting. The DEMoNS protocol details outcome measures for treatment trial which are of excellent reproducibility. The DEMoNS protocol can be applied to the study of saccadic eye movements in various neurodegenerative and motor diseases

Association between COVID-19 lockdown measures and the incidence of iatrogenic versus spontaneous very preterm births in the Netherlands:a retrospective study

Background: The COVID-19 pandemic led to regional or nationwide lockdowns as part of risk mitigation measurements in many countries worldwide. Recent studies suggest an unexpected and unprecedented decrease in preterm births during the initial COVID-19 lockdowns in the first half of 2020. The objective of the current study was to assess the effects of the two months of the initial national COVID-19 lockdown period on the incidence of very and extremely preterm birth in the Netherlands, stratified by either spontaneous or iatrogenic onset of delivery, in both singleton and multiple pregnancies. Methods: Retrospective cohort study using data from all 10 perinatal centers in the Netherlands on very and extremely preterm births during the initial COVID-19 lockdown from March 15 to May 15, 2020. Incidences of very and extremely preterm birth were calculated using an estimate of the total number of births in the Netherlands in this period. As reference, we used data from the corresponding calendar period in 2015–2018 from the national perinatal registry (Perined). We differentiated between spontaneous versus iatrogenic onset of delivery and between singleton versus multiple pregnancies. Results: The incidence of total preterm birth < 32 weeks in singleton pregnancies was 6.1‰ in the study period in 2020 versus 6.5‰ in the corresponding period in 2015–2018. The decrease in preterm births in singletons was solely due to a significant decrease in iatrogenic preterm births, both < 32 weeks (OR 0.71; 95%CI 0.53 to 0.95) and < 28 weeks (OR 0.53; 95%CI 0.29 to 0.97). For multiple pregnancies, an increase in preterm births < 28 weeks was observed (OR 2.43; 95%CI 1.35 to 4.39). Conclusion: This study shows a decrease in iatrogenic preterm births during the initial COVID-19-related lockdown in the Netherlands in singletons. Future studies should focus on the mechanism of action of lockdown measures and reduction of preterm birth and the effects of perinatal outcome

ONCOR: design of the Dutch cardio-oncology registry

Background: The relative new subspecialty ‘cardio-oncology’ was established to meet the growing demand for an interdisciplinary approach to the management of cancer therapy–related cardiovascular adverse events. In recent years, specialised cardio-oncology services have been implemented worldwide, which all strive to improve the cardiovascular health of cancer patients. However, limited data are currently available on the outcomes and experiences of these specialised services, and optimal strategies for cardio-oncological care have not been established. / Aim: The ONCOR registry has been created for prospective data collection and evaluation of cardio-oncological care in daily practice. / Methods: Dutch hospitals using a standardised cardio-oncology care pathway are included in this national, multicentre, observational cohort study. All patients visiting these cardio-oncology services are eligible for study inclusion. Data collection at baseline consists of the (planned) cancer treatment and the cardiovascular risk profile, which are used to estimate the cardiotoxic risk. Information regarding invasive and noninvasive tests is collected during the time patients receive cardio-oncological care. Outcome data consist of the incidence of cardiovascular complications and major adverse cardiac events, and the impact of these events on the oncological treatment. / Discussion: Outcomes of the ONCOR registry may aid in gaining more insight into the incidence of cancer therapy–related cardiovascular complications. The registry facilitates research on mechanisms of cardiovascular complications and on diagnostic, prognostic and therapeutic strategies. In addition, it provides a platform for future (interventional) studies. Centres with cardio-oncology services that are interested in contributing to the ONCOR registry are hereby invited to participate

Nifedipine versus atosiban in the treatment of threatened preterm labour (Assessment of Perinatal Outcome after Specific Tocolysis in Early Labour: APOSTEL III-Trial)

Background: Preterm birth is the most common cause of neonatal morbidity and mortality. Postponing delivery for 48 hours with tocolytics to allow for maternal steroid administration and antenatal transportation to a centre wit

Роль страдающей депрессией матери в развитии личности ребенка

С позиций психодинамического подхода показана роль страдающей депрессией матери в формировании личности ребенка на первых этапах его постнатального развития и ее влияние на его психическое здоровье в дальнейшем.The role of the mother with depression in development of the child's personality at the first stages of the postnatal period as well as its influence on his/her mental state in future are shown from the perspective of a psychodynamic approach