From satisfaction to expectation: The patient's perspective in lower limb prosthetic care

Neck pain is a common musculoskeletal complaint and a relationship with reduced work-related functional capacity is assumed. A validated instrument to test functional capacity of patients with neck pain is unavailable. The objective of this study was to develop a Functional Capacity Evaluation (FCE), which is content valid for determining functional capacity in patients with work related neck disorders (WRND). A review of epidemiological review literature was conducted to identify physical risk factors for WRND. Evidence was found that physical risk factors contribute in development of WRND. Physical risk factors were related to repetitive movements, forceful movements, awkward positions and static contractions of the neck or the neck/shoulder region. An FCE was designed based on the risk factors identified. Eight tests were selected to cover all risk factors: repetitive side reaching, repetitive reaching overhead, static overhead work, front carry, forward static bend neck, overhead lift and the neck strength test. Content validity of this FCE was established by providing the rationale, specific objectives and operational definitions of the FCE. Further research is needed to establish reliability and other aspects of validity of the neck-FCE Aim Worldwide, family- centred and co- ordinated care are seen as the two most desirable and effective methods of paediatric care delivery. This study outlines current views on how team collaboration comprising professionals in paediatric rehabilitation and special education and the parents of children with disabilities should be organized, and analyses the policies of five paediatric rehabilitation settings associated with the care of 44 children with cerebral palsy ( CP) in the Netherlands. Methods For an overview of current ideas on collaboration, written statements of professional associations in Dutch paediatric rehabilitation were examined. The policy statements of the five participating settings were derived from their institutional files. Documents detailing the collaborative arrangements involving the various professionals and parents were evaluated at the institutional level and at the child level. Involvement of the stakeholders was analysed based on team conferences. Results Also in the Netherlands collaboration between rehabilitation and education professionals and parents is endorsed as the key principle in paediatric rehabilitation, with at its core the team conference in which the various priorities and goals are formulated and integrated into a personalized treatment plan. As to their collaborative approaches between rehabilitation centre and school, the five paediatric settings rarely differed, but at the child level approaches varied. Teams were large ( averaging 10.5 members), and all three stakeholder groups were represented, but involvement differed per setting, as did the roles and contributions of the individual team members. Conclusion Collaboration between rehabilitation and education professionals and parents is supported and encouraged nationwide. Views on collaboration have been formulated, and general guidelines on family- centred and co- ordinated care are available. Yet, collaborative practices in Dutch paediatric care are still developing. Protocols that carefully delineate the commitments to collaborate and that translate the policies into practical, detailed guidelines are needed, as they are a prerequisite for successful teamwork

Vertrouwd met God en Zijn Woord : een onderzoek naar de aard en functie van de uitdrukking 'staan in de raad van JHWH' in Jeremia 23

In deze scriptie wordt onderzocht wat de betekenis en de functie is van de uitdrukking ‘staan in de raad van JHWH’, zoals die in Jeremia 23 gebezigd wordt. De tekstverzen Jer. 23,18.22 staan in dit onderzoek centraal. Na een inleidend hoofdstuk waarbij naast de vraagstelling ook enkele methodische uitgangspunten kort worden weergeven, komt in hoofdstuk 2 de taalkundige kant van deze uitdrukking aan de orde. Zowel de losse woorden als de samenhang binnen de uitdrukking worden belicht, waarbij het zwaartepunt op het woord ‘raad’ valt. Dit woord wordt zeer gevarieerd gebruikt in de Hebreeuwse Bijbel, hoewel het slechts 21x voorkomt. In het daarop volgende hoofdstuk 3 heb ik Jeremia 23 aan een intensief exegetisch onderzoek onderworpen. Hierdoor is de tekstuele omgeving van de uitdrukking ‘staan in de raad van JHWH’ beter in beeld gekomen. In dit hoofdstuk krijgen de verzen 18 en 22 de meeste aandacht, maar is tegelijkertijd met inachtneming van de doelstellingen van het onderzoek gekeken naar de omliggende verzen. Jer. 23,16-22 is vers voor vers behandeld, terwijl in mindere mate naar de bredere tekstuele omgeving is gekeken. De uitdrukking ‘staan in de raad van JHWH’ staat in een serie polemisch getoonzette profetische uitspraken, gericht aan de inwoners van Jeruzalem. Jeremia’s profetische tegenstanders worden in deze profetieën om diverse redenen daarin gediskwalificeerd. Zij hebben niet in de hemelse raadsvergadering van JHWH gestaan. Hoofdstuk 4 is tweedelig. Allereerst is een rondgang gemaakt door Israëls Umwelt, om overeenkomsten en verschillen te ontdekken met de diverse godenraden die in de daar aanwezige religies voorkwamen. Het Bijbelse spreken over Gods hemelraad is goed te plaatsen in de toenmalige culturele wereld. De tweede helft van hoofdstuk 4 is gevuld met een behandeling van diverse andere Bijbelteksten waarin ofwel het Hebreeuwse woord voor ‘raad’ óf een voorstelling van de hemelraad aanwezig is. Hierbij valt o.a. te denken aan 1 Kon. 22,19-22; Job 1-2 en Ps. 25,14. Elke tekst toont weer eigen facetten van het ‘staan in de raad van JHWH’, waaruit duidelijk wordt dat vluchtig gemaakte tekstverwijzingen in dezen vermeden moeten worden. Hoofdstuk 5 brengt het boek Jeremia opnieuw onder de aandacht. Hierin worden vanuit diverse invalshoeken de tot zover behaalde resultaten vergeleken met andere onderwerpen binnen het boek, zoals de vorm van Gods openbaring en de temporele context van de profeet. De intentie van Jer. 23,18.22 is niet om Jeremia (in tegenstelling tot zijn tegenstanders) wél in JHWH’s raad te plaatsen. Deze conclusie wordt door veel commentatoren echter wel gemaakt. De aard en functie van de tekst komt in het concluderende hoofdstuk 6 tenslotte aan het licht. De tekst stelt het zo voor, dat ‘staan in de raad van JHWH’ een zeer intense en nabije ervaring was voor diverse profeten. Toch mag deze beschrijving niet zonder meer op Jeremia worden geprojecteerd. De tekst beoogt niet op positieve, stellende wijze te zeggen dat Jeremia in Gods hemelraad aanwezig is geweest om daar Gods woord te zien en te horen. De scheiding tussen JHWH en Jeremia’s tegenstanders wordt door middel van deze polemisch getoonzette profetie echter wél des te groter. Voor Jeremia wordt duidelijk dat hij desondanks op een andere wijze met zijn hemelse Zender zeer vertrouwd was. Deze getrouwe profeet kende de verborgenheden van JHWH, om ze vervolgens bekend te maken conform zijn opdracht

Asymptotic theory for a Leidenfrost drop on a liquid pool

Droplets can be levitated by their own vapour when placed onto a superheated plate (the Leidenfrost effect). It is less known that the Leidenfrost effect can likewise be observed over a liquid pool (superheated with respect to the drop), which is the study case here. Emphasis is placed on an asymptotic analysis in the limit of small evaporation numbers, which proves to be a realistic one indeed for not so small drops. The global shapes are found to resemble "superhydrophobic drops" that follow from the equilibrium between capillarity and gravity. However, the morphology of the thin vapour layer between the drop and the pool is very different from that of classical Leidenfrost drops over a flat rigid substrate, and exhibits different scaling laws. We determine analytical expressions for the vapour thickness as a function of temperature and material properties, which are confirmed by numerical solutions. Surprisingly, we show that deformability of the pool suppresses the chimney instability of Leidenfrost drops

Mechanics of cooling liquids by forced evaporation in bubbles

Injecting a non-dissolvable gas into a saturated liquid results in sub-cooling of the liquid due to forced evaporation into the bubble. Previous studies assumed the rate of evaporation of liquid into the bubble to be independent of the degree of sub-cooling. In our study we quantify the bubble growth by direct observation using high speed imaging and prove that this hypothesis is not true. A phenomenological model of the bubble growth as a function of the degree of sub-cooling is developed and we find excellent agreement between the measurements and theory. This bubble cooling process is employed in cooling a liquid. By identification of all heat flows, we can well describe the cool down curve using bubble cooling. Bubble cooling provides an alternative cooling method for liquids without the use of complicated cooling techniques

Criterion validity of the Center for Epidemiologic Studies Depression scale (CES-D): results from a community-based sample of older subject in the Netherlands

The Center for Epidemiologic Studies Depression scale (CES-D) has been widely used in studies of late-life depression. Psychometric properties are generally favourable, but data on the criterion validity of the CES-D in elderly community-based samples are lacking. In a sample of older (55-85 years) inhabitants of the Netherlands, 487 subjects were selected to study criterion validity of the CES-D. Using the 1-month prevalence of major depression derived from the Diagnostic Interview Schedule (DIS) as criterion, the weighted sensitivity of the CES-D was 100%; specificity 88%; and positive predictive value 13.2%. False positives were not more likely among elderly with physical illness, cognitive decline or anxiety. We conclude that the criterion validity of the CES-D for major depression was very satisfactory in this sample of older adults

Pap smear rates among Australian lesbian and bisexual women: some good news but disparities persist

ACO

Pinning-induced folding-unfolding asymmetry in adhesive creases

The compression of soft elastic matter and biological tissue can lead to creasing, an instability where a surface folds sharply into periodic self-contacts. Intriguingly, the unfolding of the surface upon releasing the strain is usually not perfect: small scars remain that serve as nuclei for creases during repeated compressions. Here we present creasing experiments with sticky polymer surfaces, using confocal microscopy, which resolve the contact line region where folding and unfolding occurs. It is found that surface tension induces a second fold, at the edge of the self-contact, which leads to a singular elastic stress and self-similar crease morphologies. However, these profiles exhibit an intrinsic folding-unfolding asymmetry that is caused by contact line pinning, in a way that resembles wetting of liquids on imperfect solids. Contact line pinning is therefore a key element of creasing: it inhibits complete unfolding and gives soft surfaces a folding memory.Comment: 8 pages, 6 figure

Initial solidification dynamics of spreading droplets

When a droplet is brought in contact with an undercooled surface, it wets the substrate and solidifies at the same time. The interplay between the phase transition effects and the contact-line motion, leading to its arrest, remains poorly understood. Here we reveal the early solidification patterns and dynamics of spreading hexadecane droplets. Total internal reflection (TIR) imaging is employed to temporally and spatially resolve the early solidification behaviour. With this, we determine the conditions leading to the contact-line arrest. We quantify the overall nucleation behaviour, \textit{i.e.} the nucleation rate and the crystal growth speed, and show its sensitivity to the applied undercooling of the substrate. By combining the Johnson-Mehl-Avrami-Kolmogorov nucleation theory and scaling relations for the spreading, we can calculate the temporal evolution of the solid area fraction, which is in good agreement with our observations. We also show that for strong enough undercooling it is the rapid growth of the crystals which determines the eventual arrest of the spreading contact line.Comment: 5 pages, 5 figure

Does Centralization of Radical Prostatectomy Reduce the Incidence of Postoperative Urinary Incontinence?

Background: On the basis of previous analyses of the incidence of urinary incontinence (UI) after radical prostatectomy (RP), the hospital RP volume threshold in the Netherlands was gradually increased from 20 per year in 2017, to 50 in 2018 and 100 from 2019 onwards. Objective: To evaluate the impact of hospital RP volumes on the incidence and risk of UI after RP (RP-UI). Design, setting, and participants: Patients who underwent RP during 2016–2020 were identified in the claims database of the largest health insurance company in the Netherlands. Incontinence was defined as an insurance claim for ≥1 pads/d. Outcome measurements and statistical analysis: The relationship between hospital RP volume (HV) and RP-UI was assessed via multivariable analysis adjusted for age, comorbidity, postoperative radiotherapy, and lymph node dissection. Results and limitations: RP-UI incidence nationwide and by RP volume category did not decrease significantly during the study period, and 5-yr RP-UI rates varied greatly among hospitals (19–85%). However, low-volume hospitals (≤120 RPs/yr) had a higher percentage of patients with RP-UI and higher variation in comparison to high-volume hospitals (&gt;120 RPs/yr). In comparison to hospitals with low RP volumes throughout the study period, the risk of RP-UI was 29% lower in hospitals shifting from the low-volume to the high-volume category (&gt;120 RPs/yr) and 52% lower in hospitals with a high RP volume throughout the study period (&gt;120 RPs/yr for 5 yr). Conclusions: A focus on increasing hospital RP volumes alone does not seem to be sufficient to reduce the incidence of RP-UI, at least in the short term. Measurement of outcomes, preferably per surgeon, and the introduction of quality assurance programs are recommended. Patient summary: In the Netherlands, centralization of surgery to remove the prostate (RP) because of cancer has not yet improved the occurrence of urinary incontinence (UI) after surgery. Hospitals performing more than 120 RP operations per year had better UI outcomes. However, there was a big difference in UI outcomes between hospitals.</p

Automatic identification and segmentation of slice of minimal hiatal dimensions in transperineal ultrasound volumes

OBJECTIVE: To develop and validate a tool for automatic selection of the slice of minimal hiatal dimensions (SMHD) and segmentation of the urogenital hiatus (UH) in transperineal ultrasound (TPUS) volumes. METHODS: Manual selection of the SMHD and segmentation of the UH was performed in TPUS volumes of 116 women with symptomatic pelvic organ prolapse (POP). These data were used to train two deep-learning algorithms. The first algorithm was trained to provide an estimation of the position of the SMHD. Based on this estimation, a slice was selected and fed into the second algorithm, which performed automatic segmentation of the UH. From this segmentation, measurements of the UH area (UHA), anteroposterior diameter (APD) and coronal diameter (CD) were computed automatically. The mean absolute distance between manually and automatically selected SMHD, the overlap (dice similarity index (DSI)) between manual and automatic UH segmentation and the intraclass correlation coefficient (ICC) between manual and automatic UH measurements were assessed on a test set of 30 TPUS volumes. RESULTS: The mean absolute distance between manually and automatically selected SMHD was 0.20 cm. All DSI values between manual and automatic UH segmentations were above 0.85. The ICC values between manual and automatic UH measurements were 0.94 (95% CI, 0.87-0.97) for UHA, 0.92 (95% CI, 0.78-0.97) for APD and 0.82 (95% CI, 0.66-0.91) for CD, demonstrating excellent agreement. CONCLUSIONS: Our deep-learning algorithms allowed reliable automatic selection of the SMHD and UH segmentation in TPUS volumes of women with symptomatic POP. These algorithms can be implemented in the software of TPUS machines, thus reducing clinical analysis time and simplifying the examination of TPUS data for research and clinical purposes. © 2021 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology