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Background Experiences with organizational changes in daytime general practices and out-of-hours (OOH) services during the COVID-19 pandemic may help to address the challenges in general practice care that were already a concern before the crisis. This study aimed to describe these experiences and the potential usefulness of the organizational changes for future general practice care and any future pandemics. Methods Semi-structured interviews were performed among 11 directors of OOH services, and 19 (locum) general practitioners (GPs) or practice managers, who were purposively sampled. Video or telephone interviews were performed in two rounds: between November 2020 and January 2021 and between May 2021 and August 2021. The data were analyzed using thematic analysis methods. Results Three themes emerged from the data: (1) Changes in the triage procedures; in GP practices and OOH services, stricter triage criteria were implemented, and GPs were more actively involved in the triage process. These measures helped to reduce the number of ‘low urgency’ face-to-face consultations. (2) Changes in GP care; there was a shift towards video and telephone consultations, allowing GPs to spend more time with patients during the remaining face-to-face consultations. For chronic patients, the shift towards telemonitoring appeared to encourage self-care, and postponing face-to-face consultations for regular checkups appeared to be unproblematic for stable patients. (3) Coordination of GP care and information communication flow during the COVID-19 pandemic; OOH directors perceived a lack of consistency in the information from various governmental and non-governmental parties on containment measures and guidelines related to COVID-19, making it difficult to act on them. The COVID-19 pandemic intensified collaboration between GPs, OOH services, and other healthcare professionals. Conclusions The results of this study indicate that some of the

In nuclear fuel rod bundles, turbulence-induced pressure fluctuations caused by an axial flow can create small but significant vibrations in the fuel rods, which in turn can cause structural effects such as material fatigue and fretting wear. Fluid-structure interaction simulations can be used to model these vibrations, but for affordable simulations based on the URANS approach, a model for the pressure fluctuations must be utilised. Driven by the goal to improve the current state-of-the-art pressure fluctuation model, AniPFM (Anisotropic Pressure Fluctuation Model) was developed. AniPFM can model velocity fluctuations based on anisotropic Reynolds stress tensors, with temporal correlation through the convection and decorrelation of turbulence. From these velocity fluctuations and the mean flow properties, the pressure fluctuations are calculated. The model was applied to several test cases and shows promising results in terms of reproducing qualitatively similar flow structures, as well as predicting the root-mean-squared pressure fluctuations. While further validation is being performed, the AniPFM has already demonstrated its potential for affordable simulations of turbulence-induced vibrations in industrial nuclear applications., Aerodynamics

Social insects depend on communication to regulate social behaviour. This also applies to their larvae, which are commonly exposed to social interactions and can react to social stimulation. However, how social insect larvae sense their environment is not known. Using RNAseq, we characterized expression of sensory-related genes in larvae of the ant Formica fusca, upon exposure to two social environments: isolation without contact to other individuals, and stimulation via the presence of other developing individuals. Expression of key sensory-related genes was higher following social stimulation, and larvae expressed many of the same sensory-related genes as adult ants and larvae of other insects, including genes belonging to the major insect chemosensory gene families. Our study provides first insights into the molecular changes associated with social information perception in social insect larvae.

European Conference on Health Communication, 04 november 2021, Item does not contain fulltext, Immunotherapy constitutes a paradigm shift in medicine: from a “one-size-fits-all” approach to personalized medicine. By targeting a patient’s immune system in a personalized manner, this relatively novel therapy has already proven effective in treating various forms of cancer, allergies, and infectious diseases like COVID-19. As immunotherapy holds tremendous promise, it receives increasing attention both in scientific publications as well as in journalistic outlets. Responsible communication about research results and future expectations is essential for scientists to optimize knowledge exchange and for the general public to be better informed about this innovative approach. Scientific and journalistic discourse about recent developments in science/medicine, such as personalized immunotherapy, often utilizes literary devices such as metaphors. A metaphor is a figure of speech in which a topic, in this case immunotherapy, is described in terms of something else that is more concrete or more familiar, such as a machine or warfare. Scientists use metaphors either as part of their jargon or to discuss novel developments in science. Science journalists use metaphors to simplify complicated and often abstract scientific findings and explain these to the general public. Research on immunotherapy metaphors in scientific and journalistic discourse is scarce. Given that metaphor use reflects the way in which immunotherapy is discussed by experts and communicated to the public, and thereby has the potential to shape these audiences’ thinking, the aim of this study is to map current communication about immunotherapy. To this end, we ask: RQ1a: Which linguistic metaphors are used in the descriptions of immunotherapy? RQ1b: What are the source domains of these metaphors? RQ1c: Which functions do these metaphors have? It is known that journalists sometimes adopt metaphors from academic publications in news articles, but they may also extend existing metaphors or even create new

Contains fulltext : 220986.pdf (publisher's version ) (Open Access), BACKGROUND: Although participatory research is known to have advantages, it is unclear how participatory research can best be performed. This study aims to report on lessons learned in collaboration with service users involved as co-researchers in three participatory teams in long-term care. METHODS: A multiple case study design was chosen to explore the collaboration in three teams, each covering one specific client group receiving long-term care: physically or mentally frail elderly people, people with mental health problems or people with intellectual disabilities. RESULTS: A good working environment and a good collaboration were found to be crucial requirements for participatory research. A good working environment was developed by discussing reasons for engagement and wishes, formulating basic rules, organizing training sessions, offering financial appreciation, and the availability of the researcher to give travel support. The actual collaboration was established by developing a bond and equal positioning, deciding on the role division, holding on to transparency and a clear structure, and have sufficient time for the collaboration. Moreover, the motivations and unique contributions of the co-researchers and differences between the teams were reported. The motivations of co-researchers ranged from individual goals - such as personal development, creating a new social identity and belonging to a social group - to more external goals, such as being valuable for other service users and increasing the quality of care. An inclusive collaboration required valuing the individual contributions of co-researchers and adjustment to team differences. CONCLUSIONS: The results showed the importance of developing a good working environment and establishing a good collaboration for participatory research. Furthermore, the study shows that individual and team differences should be taken into account. These results can be used by researchers for designing and shaping future res

Objectives: Enhancing the active involvement of clients as co-researchers is seen as a promising innovation in quality research. The aim of this study was to assess the feasibility and usability of five qualitative instruments used by co-researchers for assessing the quality of care relationships in long-term care. Design and setting: A qualitative evaluation was performed in three care organisations each focused on one of the following three client groups: frail older adults, people with mental health problems and people with intellectual disabilities. A total of 140 respondents participated in this study. The data comprised observations by researchers and experiences from co-researchers, clients and professionals. Results: Two instruments scored best on feasibility and usability and can therefore both be used by co-researchers to monitor the quality of care relationships from the client perspective in long-term care. Conclusions: The selected instruments let co-researchers interview other clients about their experiences with care relationships. The study findings are useful for long-term care organisations and client councils who are willing to give clients an active role in quality improvement.

Contains fulltext : 202231.pdf (publisher's version ) (Open Access), BACKGROUND: Patient-directed knowledge tools such as patient versions of guidelines and patient decision aids are increasingly developed to facilitate shared decision making. In this paper, we report how consensus was reached within the Netherlands on quality criteria for development, content and governance of these tools. METHOD: A 12-month development and consensus study. The consortium worked on four work packages: (a) reviewing existing criteria; (b) drafting the quality criteria; (c) safe-guarding the acceptability and feasibility of the draft criteria by participatory research in on-going tool development projects; and (d) gaining formal support from national stakeholders on the quality criteria. RESULTS: We reached consensus on a 8-step guidance; describing minimal quality criteria for (a) the team composition; (b) setting the scope; (c) identifying needs; (d) the content and format; (e) testing the draft; (f) finalizing and approval; (g) dissemination and application, and (h) ownership and revision. The participants of the on-going tool development projects were positive about the quality criteria in general, but divided as to the degree of detail. Whereas some expressed a clear desire for procedural standards, others felt that it would be sufficient to provide only general directions. Despite the different views as to the degree of detail, consensus was reached in three stakeholder meetings. DISCUSSION: We successfully collaborated with all stakeholders and achieved formal support from national stakeholders on a set of minimum criteria for the development process, content and governance of patient-directed knowledge tools.

Background: The quality of the care relationship between a client and a professional is important in long-term care, as most clients depend on support for a lengthy period. The three largest client groups who receive long-term care in the Netherlands are older adults who are physically or mentally frail, people with mental health problems and people with intellectual disabilities. There is little clarity about how generic and variable the determinants of the quality of care relationships are across these client groups. The aim of this study is to explore and compare the determinants of the quality of care relationships in these three client groups in long-term care. Methods: This participatory study involving clients as co-researchers was held in three healthcare organizations, each providing long-term care to one client group. The research was conducted by three teams consisting of researchers and co-researchers. We interviewed clients individually and professionals in focus groups. The focus was on care relationships with professionals where there is weekly recurring contact for at least 3 months. Clients and professionals were selected using a convenience sample. The interviews were coded in open, axial and selective coding. The outcomes were compared between the client groups. Results: The study sample consisted of 30 clients and 29 professionals. Determinants were categorized into four levels: client, professional, between client and professional, and context. The findings show that the majority of the determinants apply to the care relationships within all three client groups. At the professional level, eleven generic determinants were found. Eight determinants emerged at the client level of which two were found in two client groups only. At the level between a client and a professional, six determinants were found of which one applied to mental healthcare and disability care only. Five determinants were found at the contextual