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Contains fulltext : 202693.pdf (Publisher’s version ) (Open Access) Schizophrenia is a severe mental disorder characterized by numerous subtle changes in brain structure and function. Machine learning allows exploring the utility of combining structural and functional brain magnetic resonance imaging (MRI) measures for diagnostic application, but this approach has been hampered by sample size limitations and lack of differential diagnostic data. Here, we performed a multi-site machine learning analysis to explore brain structural patterns of T1 MRI data in 2668 individuals with schizophrenia, bipolar disorder or attention-deficit/ hyperactivity disorder, and healthy controls. We found reproducible changes of structural parameters in schizophrenia that yielded a classification accuracy of up to 76% and provided discrimination from ADHD, through it lacked specificity against bipolar disorder. The observed changes largely indexed distributed grey matter alterations that could be represented through a combination of several global brain-structural parameters. This multi-site machine learning study identified a brain-structural signature that could reproducibly differentiate schizophrenia patients from controls, but lacked specificity against bipolar disorder. While this currently limits the clinical utility of the identified signature, the present study highlights that the underlying alterations index substantial global grey matter changes in psychotic disorders, reflecting the biological similarity of these conditions, and provide a roadmap for future exploration of brain structural alterations in psychiatric patients.

Involving teams from seven countries (Austria, Canada, Denmark, Israel, Netherlands, Romania, and Spain) this Ageing + Communication + Technologies (ACT) project offers a unique opportunity to explore possible processes of displacement of traditional dominant media by innovative communication practices within the older audience of new media. Replicating Nimrod’s (2017) study of older audiences, data will be collected on a biannual basis over a five-year period (overall three waves). The first wave was based on surveys with Internet users aged 60 and up, to whom we will return in the following waves. Data was collected by local commercial firms. With the exception of Romania, where the survey was conducted via telephone due to a low rate of Internet users among the older population, all firms applied an online survey. Most data was collected between November and December 2016, with the exception of Canada, where the data were collected between June and July 2017. With varying expected dropout rates, the samples were planned to have a final panel that will comprise about 500 participants per country. For this reason, sample sizes in the first wave were not equal and ranged between 715 (Denmark) and 3,538 (Canada). The overall sample size consisted of 10,527 Internet users aged 60 and over. To reach this sample size, the firms contacted a total of 33,035 individuals. Response rates ranged between 8.9% and 64.6% according to percentage of older people who use the Internet in the country and data collection method. The response rate was at its lowest in Romania, where there was a need to screen out older adults who do not use the Internet, and at its highest in the Netherlands.

Background: Paediatric Early Warning Scores (PEWS) are increasingly being used for early identification and management of clinical deterioration in paediatric patients. A PEWS system includes scores, cut-off points and appropriate early intervention. In 2011, The Dutch Ministry of Health advised hospitals to implement a PEWS system in order to improve patient safety in paediatric wards. The objective of this study was to examine the results of implementation of PEWS systems and to gain insight into the attitudes of professionals towards using a PEWS system in Dutch non-university hospitals. Methods: Quantitative data were gathered at start, midway and at the end of the implementation period through retrospective patient record review (n= 554). Semi-structured interviews with professionals (n= 8) were used to gain insight in the implementation process and experiences. The interviews were transcribed and analysed using an inductive approach. Results: Looking at PEWS systems of the five participating hospitals, different parameters and policies were found. While all hospitals included heart rate and respiratory rate, other variables differed among hospitals. At baseline, none of the hospitals used a PEWS system. After 1 year, PEWS were recorded in 69.2% of the patient records and elevated PEWS resulted in appropriate action in 49.1%. Three themes emerged from the interviews: 1) while the importance of using a PEWS system was acknowledged, professionals voiced some doubts about the effectiveness and validity of their PEWS system 2) registering PEWS required little extra effort and was facilitated by PEWS being integrated into the electronic patient record 3) Without a national PEWS system or guidelines, hospitals found it difficult to identify a suitable PEWS system for their setting. Existing systems were not always considered applic able in a non-university setting. Conclusions: After 1 year, hospitals showed improvements in the use of their PEWS system, although some were decidedly more successful than others. Doubts among staff about validity, effectiveness and communication with other hospitals during transfer to higher level care hospital might hinder sustainable implementation. For these purposes the development of a national PEWS system is recommended, consisting of a “core set” of PEWS, cut-off points and associated early intervention.

This article focuses on Dutch older adults’ use of digital devices in general, and digital games in particular, from an intergenerational perspective. We first present some facts related to provide insight into how Dutch older adults use such new media. Then, the case of the Dutch short film Pony Place is analyzed using a semiotic and narratological approach, to examine how older adults are represented as so-called ‘digital immigrants’, digitally illiterate persons who are unable to master a digital game device. Finally, an intergenerational digital game design approach is presented to show how older adults can actively be involved in the world of digital games, which could lead to a change from their unbalanced representation as digital immigrants to persons who are, like younger players, able to be active in the world of digital games.

Objectives: The pathophysiology of idiopathic sudden sensorineural hearing loss (ISSHL) remains largely unknown. However, it is hypothesized that this disorder may be caused by reduced cochlear blood flow, labyrinth viral infections, intracochlear membrane ruptures or immune-mediated inner ear disease. Hyperbaric oxygen therapy (HBOT) may have a positive effect on ISSHL by raising intracochlear oxygen tension, stimulating angioneogenesis, and having an anti-inflammatory function. The objective of this systematic review was to examine the efficacy of HBOT as a treatment for ISSHL. Methodology: A systematic approach was applied to search for all clinical studies concerning HBOT in ISSHL in the PubMed database. Nineteen studies met the selection criteria: Results: Three out of five studies (60%) recommended adding HBOT to monotherapy with corticosteroids (CS). Four out of seven of the included studies (57%) demonstrated that adding HBOT to multi-drug therapies had a beneficial effect. Two out of two studies (100%) concluded that HBOT was significantly more effective than vasodilators. Three out of five studies (60%) showed a positive indication for the use of HBOT as salvage treatment. Conclusion: HBOT could be useful as an adjunct therapy or salvage treatment for ISSHL, although evidence is still scarce.

In the majority of the western countries the population is aging at a rapid pace. At the same time, society is increasingly becoming more digitalised. Information is supplied to a growing extent, and frequently solely, in digital form. It is obvious, that this trend poses dangers for people, like senior citizens, who have problems using such new media. They risk being excluded from crucial information (Duimel, 2007: 7). A complicating factor is that the landscape in which older people currently reside2 is largely shaped by what De Lange (2007: 23) calls the ‘decollectivisation of the life course’: What does this ‘decollectivisation of the life course’ entail for senior citizens living in an ever more digitised society? Schnabel (1999: 18) pointed out the vital part ICT could play in this respect over a decade ago.

Populations are ageing at a rapid pace in the majority of western countries. At the same time, these countries are increasingly becoming more digitised and information is supplied to a growing extent in digital form. To what extent is there an actual problem for senior citizens who are looking for accessible information? Is age the deciding factor for the way they make use of old and new media to gain access to information or are there other explanations for their information search behaviour? The results of the empirical studies presented in this article (Mante-Meijer & Loos, 2008; Loos & Mante-Meijer 2009 and Loos, 2011) show that the Dutch citizens, young and old, are spread across a ‘digital spectrum’. (Lenhart & Horrigan, 2003), rather than facing one another across the much-touted age-based ‘digital divide’. Prensky’s (2001) ‘digital natives’ and ‘digital immigrants’ do not appear to exist in the Netherlands, at least as far as their information seeking behaviour is concerned. This article will show that not only age but life stages, to some extent socialisation and (as people start to age older) age-related functional limitations also play a role. Adopting a multi-channel approach and designing information sources by the principle of ‘dynamic diversity’ (Gregor et al., 2002) could offer a solution

As inhabitants of a multimedia landscape1 we are increasingly being confronted with new digital roadways intended to lead us to a range of new possibilities. The well-trodden paths, the traditional routes via the old media, cannot so easily lead us to these new destinations. The question is whether all generations are able to appreciate and find these new routes, use them and use them safely – if they wish to. All citizens, including young and old, should at least be entitled to have access to this new realm of online and multimedia possibilities so that they will be able to participate more fully in societies in which these technologies and facilities are increasingly prevalent and increasingly confronting us in our everyday lives. However, ‘entitlement’ and ‘access’ do not in themselves guarantee that users can or choose to engage with them.