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Flexible assertive community treatment (FACT) is a recovery-based treatment and its manual describes discharge criteria for clients who are recovered. Yet research on discharge is lacking. In this retrospective and observational study, between 2009 and 2019, we explored how sociodemographic, clinical, and treatment factors are associated with planned discharge or no discharge. We included 1734 clients with a psychotic disorder of which 38.5% were discharged after a mutual decision that FACT was no longer necessary. Logistic regression analysis was used to create a discharge profile which was more favorable for discharged clients. They were older at the start of FACT, had lower HoNOS scores, were diagnosed with another psychotic disorder, and had fewer contacts with non-FACT members. Discharge is a part of FACT and is more common than anticipated. While this study provides preliminary answers, further research is necessary to better understand discharge and its associated factors.

Interrogating the tumor genome in its entirety by whole-genome sequencing (WGS) offers an unprecedented insight into the biology and pathogenesis of cancer, with potential impact on diagnostics, prognostication and therapy selection. WGS is able to detect sequence as well as structural variants and thereby combines central domains of cytogenetics and molecular genetics. Given the potential of WGS in directing targeted therapeutics and clinical decision-making, we envision a gradual transition of the method from research to clinical routine. This review is one out of three within this issue aimed at facilitating this effort, by discussing in-depth analytical validation, clinical interpretation and clinical utility of WGS. The review highlights the requirements for implementing, validating and maintaining a clinical WGS pipeline to obtain high-quality patient-specific data in accordance with the local regulatory landscape. Every step of the WGS pipeline, which includes DNA extraction, library preparation, sequencing, bioinformatics analysis, and data storage, is considered with respect to its logistics, necessities, potential pitfalls, and the required quality management. WGS is likely to drive clinical diagnostics and patient care forward, if requirements and challenges of the technique are recognized and met.

24 januari 2022, Item does not contain fulltext

Aims Patients with cardiac disease are considered high risk for poor outcomes following hospitalization with COVID-19. The primary aim of this study was to evaluate heterogeneity in associations between various heart disease subtypes and in-hospital mortality. Methods and results We used data from the CAPACITY-COVID registry and LEOSS study. Multivariable Poisson regression models were fitted to assess the association between different types of pre-existing heart disease and in-hospital mortality. A total of 16 511 patients with COVID-19 were included (21.1% aged 66-75 years; 40.2% female) and 31.5% had a history of heart disease. Patients with heart disease were older, predominantly male, and often had other comorbid conditions when compared with those without. Mortality was higher in patients with cardiac disease (29.7%; n= 1545 vs. 15.9%; n= 1797). However, following multivariable adjustment, this difference was not significant [adjusted risk ratio (aRR) 1.08, 95% confidence interval (CI) 1.02-1.15; P = 0.12 (corrected for multiple testing)]. Associations with in-hospital mortality by heart disease subtypes differed considerably, with the strongest association for heart failure (aRR 1.19, 95% CI 1.10-1.30; P <0.018) particularly for severe (New York Heart Association class III/IV) heart failure (aRR 1.41, 95% CI 1.20-1.64; P < 0.018). None of the other heart disease subtypes, including ischaemic heart disease, remained significant after multivariable adjustment. Serious cardiac complications were diagnosed in <1% of patients. Conclusion Considerable heterogeneity exists in the strength of association between heart disease subtypes and in-hospital mortality. Of all patients with heart disease, those with heart failure are at greatest risk of death when hospitalized with COVID-19. Serious cardiac complications are rare during hospitalization. [GRAPHICS] .

07 oktober 2019, Item does not contain fulltext, Higher education providers need to deliver graduates with the conceptual understanding required for professional life. Conceptual understanding entails a synthesis of relevant facts, theories and practices that influence occupational performance. To help align curricula with individual student differences, this study investigates differences in international business undergraduates’ conceptual understanding with regard to study progress. Seventy-four international business students of a bachelor’s programme in the Netherlands participated. Students were presented with a complex business problem. They then wrote essays in which they explicated their conceptual understanding of the case. Using a rubric, six components of conceptual understanding were graded on a 5-point scale ranging from negligible to extraordinary. Results indicated three types of conceptual understanding: limited, developing and extensive. Their relationship with study progress was nonlinear, indicating that effects other than curriculum may account for differences between students. Suggestions are made to account for differences, and recommendations are made regarding curriculum development.

The human head-neck system requires continuous muscular stabilization in the presence of gravity and trunk motion. This chapter presents experimental and modeling efforts, applying mechanical perturbations to seated subjects, evaluating trunk and head motion, to investigate postural stabilization. A detailed multisegment neck model has been developed including vestibular/visual and muscular feedback loops and cocontraction. Dynamic validation is presented in the frequency domain in all six motion directions. The neck model captures primary motion responses and interaction terms such as head rotation in response to seat translation. Results show major contributions of vestibular/visual feedback stabilizing the head in space while muscular feedback stabilizes the head on the torso. In addition, muscular feedback is essential to stabilize the individual vertebral joints and prevent neck buckling. The contribution of cocontraction is estimated to be minor in the neck. Validation in impact conditions shows that postural control parameters estimated that fitting the model to small-amplitude experimental data can predict postural responses in high-amplitude loading conditions reasonably well. This manuscript focuses on the neck but also includes experiments with combined stabilization of the complete spine, measuring trunk and head motion, with a perspective toward full spine and full-body modeling. Lumbar stabilization has been captured using a simplified model by assuming a virtual pivot around L4/L5. The model uniquely separates stabilizing contributions of intrinsic stiffness and damping (including muscle cocontraction) and muscle feedback (length, velocity, and acceleration). The model parameters allowed us to estimate the relative contributions of intrinsic and reflexive stabilization and showed intrinsic contributions, similar to or larger than reflexive contributions in lumbar stabilization with horizontal perturbations to the trunk or pelvis. Exp, Green Open Access added to TU Delft Institutional Repository ‘You share, we take care!’ – Taverne project https://www.openaccess.nl/en/you-share-we-take-care Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public., Intelligent Vehicles, Biomechatronics & Human-Machine Control

Thomas Murner’s translation of Virgil’s Aeneid into German (Strasbourg: Johann Grüninger 1515) is accompanied by a selection of 112 of the 143 Aeneid woodcuts from the complete edition of Virgil’s works edited by Sebastian Brant. The latter had been published by Johann Grüninger in Strasbourg in 1502, thirteen years before Murner’s translation. Research has demonstrated that Brant was involved in the production of the woodcuts as a “concepteur”: the extremely detailed interpretation of the text by means of images implies a thorough knowledge of Virgil’s text, while the resulting visual narrative, in addition to the textual understanding supplied by the Latin writing, creates a striking and absorbing display. It can be demonstrated that Thomas Murner knew Brant’s edition and this raises the question of whether Murner was influenced by the familiar woodcuts in his translation of the Aeneid. He, just like Brant, attributed great value not only to the illustrative and mnemonic function of the image, but also to the close relationship between the text and the image. Indeed, the influence of the Aeneid illustrations on Murner’s understanding of the Latin text can be observed in some places in his translation, demonstrating a dual translation process: the transposition of the Latin text into a pictorial form, which was then translated back into the German language.

Persenober oc Constantianobis, published in 1572 by Laurentz Benedicht in Copenhagen, is an early modern Danish translation and adaption of the Old French ‘roman courtois’ Partonopeu de Blois (twelfth century). This article outlines the way in which different forms of transformation and rewriting, or Retextualisierung (Joachim Bumke), have been realized in this edition. Another, now lost, edition from 1560, as well as a manuscript in Old Danish from ca. 1500, originally derived from the Partalopa saga, which is a thirteenth- or fourteenth-century Old Norse-Icelandic prose adaption of the French romance, can be considered as precursors in this complex process of translation, adaptation and rewriting. The 1572 edition, the oldest complete Danish version in print, reveals some characteristics of paratextual and rewriting which seem to be unique in the Danish transmission: an epilogue and the transformation of an important passage (the first meeting between Persenober/Partonopeu and the princess Constantianobis/ Melior) that strengthens the importance of the moral choices of the noble protagonists. Thus, the narrative can offer both nutz und kurtzweyl (usefulness and entertainment) and models for identification to its (mostly aristocratic) readership in sixteenth-century Denmark.

One of the most important issues in vocational education is the interaction between learning at school and at different workplaces. Students need to transfer what they have learned in and between these different learning arenas. However, little agreement exists among researchers on how to conceptualise and empirically study transfer of learning. This article aims to enhance our understanding of this process in technical vocational education by adding a new perspective on transfer: the phenomenological lifeworld approach. Eleven interviews with students enrolled in the Energy and Industry programmes at a Swedish upper-secondary school were conducted. Three transfer themes emerged from the data: learning for new situations, variation and integration of theory and practice. The student perspective, based on the lifeworld approach shows that the different learning arenas – the school and workplaces – can complement each other. The learning arenas offer different opportunities for learning, and learning in both arenas is necessary in order to prepare for an unknown future, according to the students in this study.

19 december 2017, Contains fulltext : 183568.pdf (Publisher’s version ) (Open Access), This article focuses on the development of professional learning communities (PLCs), which are communities within schools, composed of voluntary participating teachers facilitated by school principals with a specific task to accomplish as part of a larger innovation project. Four PLCs were observed during 3 years by using questionnaires and participatory research. The questionnaires revealed that PLCs differed in their group characteristics, collective learning processes and outcomes. Through participatory research, we explored seven elements affecting the development of PLCs, namely, task perceptions, group composition, tensions between roles, beliefs about alignment, reflective dialogues, socialisation and ownership. Beliefs about alignment, ownership and socialisation had sufficient impact on the development of the PLCs. A case study including two contrasting PLCs indicated interrelations between task perceptions and ownership by members and between ownership and socialisation activities. Regarding implications, this research suggests to explicitly create and facilitate reflective dialogues and ownership over time for PLCs to flourish.

The application of the concept of self-organization has grown over time in the field of urban planning, but with various interpretations. This article presents a systematic review that aims to uncover whether different uses of self-organization are tied to epistemic communities. Through coding and bibliographical analysis, it became apparent that there are two epistemic communities that emphasize different conceptualizations of self-organization. They investigate different issues, use different methods, an

Background Effective sensorimotor integration is essential to modulate (adapt) neck stabilization strategies in response to varying tasks and disturbances. This study evaluates the hypothesis that relative to healthy controls cervical dystonia patients have an impaired ability to modulate afferent feedback for neck stabilization with changes in the frequency content of mechanical perturbations. Methods We applied anterior-posterior displacement perturbations (110 s) on the torso of seated subjects, while recording head-neck kinematics and muscular activity. We compared low bandwidth (0.2–1.2 Hz) and high bandwidth (0.2–8 Hz) perturbations where our previous research showed a profound modulation of stabilization strategies in healthy subjects. Cervical dystonia patients and age matched controls performed two tasks: (1) maintain head forward posture and (2) allow dystonia to dictate head posture. Findings Patients and controls demonstrated similar kinematic and muscular responses. Patient modulation was similar to that of healthy controls (P > 0.05); neck stiffness and afferent feedback decreased with high bandwidth perturbations. During the head forward task patients had an increased neck stiffness relative to controls (P < 0.05), due to increased afferent feedback. Interpretation The unaffected modulation of head-neck stabilization (both kinematic and muscular) in patients with cervical dystonia does not support the hypothesis of impaired afferent feedback modulation for neck stabilization.