In social interactions, people often reason about the beliefs, goals and intentions of others. This theory of mind allows them to interpret the behavior of others, and predict how they will behave in the future. People can also use this ability recursively: they use higher-order theory of mind to reason about the theory of mind abilities of others, as in “he thinks that I don’t know that he sent me an anonymous letter”. Previous agent-based modeling research has shown that the usefulness of higher-order theory of mind reasoning can be useful across competitive, cooperative, and mixed-motive settings. In this paper, we cast a new light on these results by investigating how the predictability of the environment influences the effectiveness of higher-order theory of mind. Our results show that the benefit of (higher-order) theory of mind reasoning is strongly dependent on the predictability of the environment. We consider agent-based simulations in repeated one-shot negotiations in a particular negotiation setting known as Colored Trails. When this environment is highly predictable, agents obtain little benefit from theory of mind reasoning. However, if the environment has more observable features that change over time, agents without the ability to use theory of mind experience more difficulties predicting the behavior of others accurately. This in turn allows theory of mind agents to obtain higher scores in these more dynamic environments. These results suggest that the human-specific ability for higher-order theory of mind reasoning may have evolved to allow us to survive in more complex and unpredictable environments.
Objective: Chemoradiotherapy (CRT) for head and neck cancer (HNC) is associated with high toxicity that adversely affects physical functioning, body composition, fatigue, quality of life and treatment outcomes. Exercise interventions during treatment might counteract these negative effects. We therefore assessed the feasibility of an exercise programme for HNC patients during CRT. Methods: Forty patients were offered a tailored 10-week endurance and resistance training with supervised and home-based sessions. Feasibility endpoints were (1) adherence (main outcome): ≥60% attendance; (2) recruitment: ≥30%; (3) retention rate: ≥85% and (4) compliance rate: ≥60%. Physical performance, muscle strength, body composition, quality of life and fatigue were assessed pre- and post-intervention. Results: Overall adherence was 54%. The recruitment rate was 36%, and the retention rate was 65%. Compliance to the supervised intervention protocol was 66%. Statistically significant decreases were found in mean grip strength, fat-free mass and clinically relevant deteriorations on several domains of quality of life, and fatigue subscales were found. Conclusion: We conclude that this exercise programme for HNC patients during CRT in its current form is feasible for only a minority of patients. We suggest adaptations to improve adherence and retention rates for a definitive multicentre trial. Trial registration: This study is registered at the Netherlands Trial Register (NTR7305), 6 June 2018, retrospectively registered.
Abstract Background The challenging combination of breastfeeding and work is one of the main reasons for early breastfeeding cessation. Although the availability of a lactation room (defined as a private space designated for milk expression or breastfeeding) is important in enabling the combination of breastfeeding and work, little is known about the effects of lactation room quality on mothers’ feelings and thoughts related to breastfeeding and work. We hypothesized that a high-quality lactation room (designed using the Theory of Supportive Design) would cause mothers to experience less stress, have more positive thoughts about milk expression at work, perceive more organizational support, and report more subjective well-being, than a low-quality lactation room. Methods In an online randomized controlled trial (Study 1), Dutch mothers (N = 267) were shown either a high-quality or a low-quality lactation room (using pictures and descriptions for the manipulation) and were then asked about their feelings and thoughts. In a subsequent field experiment (Study 2) we modified the lactations rooms in a large organization in Groningen, the Netherlands, to manipulate lactation room quality, and asked mothers (N = 61) who used either a high-quality or low-quality lactation room to fill out surveys to assess the dependent variables. Results The online study showed that mothers exposed to the high-quality lactation room anticipated less stress, more positive cognitions about milk expression at work, more perceived organizational support, and more subjective well-being than mothers exposed to the low-quality lactation room (p
Background Behaviours that challenge might prevent intellectually impaired individuals from experiencing a good quality of life (QoL). These behaviours arise in interaction with the environment and can be positively or negatively affected by architecture. Aim This scoping review explores how architecture contributes to the QoL of individuals engaging in such behaviours. It aims to identify possible gaps in the existing literature and map areas of future research. Method Four databases were searched using four concepts: architecture, intellectual impairment, challenging behaviour, and QoL. Since only one source covered all concepts, the search criteria were widened to include sources integrating only two or three concepts, nonpeer-reviewed sources, and autism. Eighteen papers, were analysed in terms of their contribution to relations between QoL, behaviours that challenge, and architecture. Results This review shows that architecture, QoL, intellectual impairment, and behaviours that challenge have not yet been studied jointly. Conclusions The contribution of architecture to the QoL of these individuals should be subject of future research, together with the similarities and differences between their needs and those of individuals with autism.
Two strong earthquakes hit Thessaly region on March 3rd, 2021 (M w = 6.3) and on March 4th, 2021 (M w = 6.1). The epicentres of the earthquakes were located at approximately 23 and 29 km respectively NW of Larissa, one of the most populous cities in Greece. Several aftershocks followed thereafter. Although no injuries were recorded, several structures suffered significant damage close to the epicentre, while some others collapsed. Approximately 300 residents of the village of Damasi were transferred to temporary settlements and tents. The event occurred during the COVID19 lockdown and created significant stress and disruption to residents. This paper focuses on the earthquake swarm itself as well as the damages observed in residential buildings, schools, and churches in the earthquake-stricken region. The earthquakes mainly impacted low-rise domestic masonry buildings, while the more modern reinforced concrete structures built following the recent seismic regulations were almost unaffected. The typology of buildings in the region, together with photographs demonstrating the extent of damage are presented herein. Despite the rather satisfactory performance of modern buildings in recent earthquakes in Greece, the preliminary investigations from the Thessaly Earthquakes showed that there is still a significant level of vulnerability in existing masonry building stock constructed using traditional methods and materials. This issue could re-emerge in future earthquakes striking other rural areas of Greece, something that needs to be addressed systematically in the future.
Background To improve older patients’ physical activity (PA) behavior, it is important to identify facilitators and barriers to enhancing PA in older patients (≥ 65 years) during hospitalization from the perspectives of patients, caregivers, and healthcare professionals (HCPs). Methods In this systematic review, a search of PubMed, CINAHL, PsycINFO, EMBASE, and Web of Science (January 2000–May 2021) was performed, and quantitative, qualitative, and mixed-methods studies were included. The methodological quality of included studies was assessed using the Mixed Methods Appraisal Tool. Identified facilitators and barriers were categorized using the social ecological model at the intrapersonal, interpersonal, and institutional levels. Results The 48 included articles identified 230 facilitators and 342 barriers. The main facilitators at the intrapersonal level included: knowledge, awareness, and attitudes; interpersonal level: social support, including encouragement and interdisciplinary collaboration; and institutional level: stimulating physical environment, patient activities and schedules, and PA protocols. The main barriers at the intrapersonal level included: physical health status, having lines or drains, patients’ fear, and HCPs’ safety concerns; interpersonal level: patient-HCP relation and HCPs’ unclear roles; and institutional level: lack of space and resources, including time and equipment. Best evidence synthesis provided moderate level of evidence for three barriers: patients’ unwillingness or refusal to move, patients having symptoms, and patients having lines or drains. No moderate level of evidence was found for facilitators. Conclusion The PA behavior of older adults during hospitalization is multidimensional. Our overview highlights facilitators and barriers on multilevel scale (intrapersonal, interpersonal, and institutional levels) that guides patients, caregivers, HCPs, and researchers in future clinical practice, and intervention development and implementation.
Background In the last decades, autologous fat grafting has been used to treat adherent dermal scars. The observed regenerative and scar-reducing properties have been mainly ascribed to the tissue-derived stromal vascular fraction (tSVF) in adipose tissue. Adipose tissue’s components augment local angiogenesis and mitosis in resident tissue cells. Moreover, it promotes collagen remodeling. We hypothesize that tSVF potentiates fat grafting-based treatment of adherent scars. Therefore, this study aims to investigate the effect of tSVF-enriched fat grafting on scar pliability over a 12-month period. Methods and design A clinical multicenter non-randomized early phase trial will be conducted in two dedicated Dutch Burn Centers (Red Cross Hospital, Beverwijk, and Martini Hospital, Groningen). After informed consent, 46 patients (≥18 years) with adherent scars caused by burns, necrotic fasciitis, or degloving injury who have an indication for fat grafting will receive a sub-cicatricic tSVF-enriched fat graft. The primary outcome is the change in scar pliability measured by the Cutometer between pre- and 12 months post-grafting. Secondary outcomes are scar pliability (after 3 months), scar erythema, and melanin measured by the DSM II Colormeter; scar quality assessed by the patient and observer scales of the Patient and Observer Scar Assessment Scale (POSAS) 2.0; and histological analysis of scar biopsies (voluntary) and tSVF quality and composition. This study has been approved by the Dutch Central Committee for Clinical Research (CCMO), NL72094.000.20. Conclusion This study will test the clinical efficacy of tSVF-enriched fat grafting to treat dermal scars while the underlying working mechanism will be probed into too. Trial registration Dutch Trial Register NL 8461. Registered on 16 March 2020
Communication using manual (hand) gestures is considered a defining property of social robots, and their physical embodiment and presence, therefore we see a need for a comprehensive overview of the state of the art in social robots that use gestures. This systematic literature review aims to address this need by (1) describing the gesture production process of a social robot, including the design and planning steps, and (2) providing a survey of the effects of robot-performed gestures on human-robot interactions in a multitude of domains. We identify patterns and themes from the existing body of literature, resulting in nine outstanding questions for research on robot-performed gestures regarding: developments in sensor technology and AI, structuring the gesture design and evaluation process, the relationship between physical appearance and gestures, the effects of planning on the overall interaction, standardizing measurements of gesture ‘quality’, individual differences, gesture mirroring, whether human-likeness is desirable, and universal accessibility of robots. We also reflect on current methodological practices in studies of robot-performed gestures, and suggest improvements regarding replicability, external validity, measurement instruments used, and connections with other disciplines. These outstanding questions and methodological suggestions can guide future work in this field of research.
Aims and objective: To explore differences in nurses' attitudes regarding the importance of family in nursing care and factors associated with nurses' attitudes across 11 European countries. Background: Family involvement in healthcare has received attention in many European healthcare systems. Nurses have a unique opportunity to promote family involvement in healthcare; however, their attitudes and beliefs may facilitate or impede this practice. Design: A cross-sectional survey across European countries. Method: A broad convenience sample of 8112 nurses across 11 European countries was recruited from October 2017 to December 2019. Data were collected using the Families' Importance in Nursing Care-Nurses' Attitudes (FINC-NA) questionnaire. We used the STROBE checklist to report the results. Results: There were significant differences in nurses' attitudes about families' importance in nursing care across Europe. Country was the factor with the strongest association with the total scores of the FINC-NA. Older age, higher level of education, increased years since graduation, having a strategy for the care of families in the workplace, and having experience of illness within one's own family were associated with a higher total FINC-NA score. Being male and working in a hospital or other clinical settings were associated with a lower total FINC-NA score. Conclusion: Nurses' attitudes regarding the importance of family in nursing care vary across 11 European countries. This study highlights multiple factors associated with nurses' attitudes. Further research is necessary to gain a deeper understanding of the reasons for nurses' different attitudes and to develop a strong theoretical framework across Europe to support family involvement in patient care. The inclusion of family healthcare programs in the baccalaureate curriculum may improve nurses' attitudes. Relevance for clinical practice: In clinical practice, the focus should be on identifying influencing factors on nurses' attitudes to enhance families' importance in nursing care across Europe.
Background Orthopaedic Manual Therapy (OMT) is a specialized area of physiotherapy for the management of neuromusculoskeletal conditions. Although rare, adverse events after OMT are reported in literature. In 2020, the International Framework for Examination of the Cervical Region for potential of vascular pathologies of the neck prior to OMT Intervention was presented. Objective To evaluate the knowledge and implementation status of OMT educational programmes regarding the 2020 International IFOMPT Cervical Framework. Methods An international survey with closed- and open-ended questions was conducted among all IFOMPT educational programmes using an online survey. Formal informed consent was requested at the beginning of the survey and all data were collected anonymously. Results Thirty-nine educational programmes filled in the survey. Twenty-four programmes (61.5%) had already implemented the new Framework. Four programmes (10.3%) answered that they will not implement the new Framework in their educational programme. Positional testing will be kept in about 54% of the programmes. Craniovertebral ligament testing will be kept in about 90% of the programmes. A considerable number of educational programmes still teach end range manipulations in the middle and lower cervical spine (33.3%) and upper cervical spine (25.5%). Conclusions The dissemination and implementation of the International IFOMPT Cervical Framework among educational programmes has been successful. However, although positional testing and craniovertebral ligament testing are excluded from the Framework, most educational programmes will keep these tests in their curriculum, which raises some concern regarding the success and impact of international consensus frameworks.
Numtogenesis is observable in the mammalian genomes resulting in the integration of mitochondrial segments into the nuclear genomes (numts). To identify numts in rabbit, we aligned mitochondrial and nuclear genomes. Alignment significance threshold was calculated and individual characteristics of numts were analysed. We found 153 numts in the nuclear genome. The GC content of numts were significantly lower than the GC content of their genomic flanking regions or the genome itself. The frequency of three mammalian-wide interspersed repeats were increased in the proximity of numts. The decreased GC content around numts strengthen the theory which supposes a link between DNA structural instability and numt integration.
Infiltrating pavements are potentially effective climate adaptation measures to counteract arising challenges related to flooding and drought in urban areas. However, they are susceptible to clogging causing premature degradation. As part of the Dutch Delta Plan, Dutch municipalities were encouraged to put infiltrating pavements into practice. Disappointing experiences made a significant number of municipalities decide, however, to stop further implementation. A need existed to better understand how infiltrating pavements function in practice. Through 81 full-scale infiltration tests, we investigated the performance of infiltrating pavements in practice. Most pavements function well above Dutch and international standards. However, variation was found to be high. Infiltration rates decrease over time. Age alone, however, is not a sufficient explanatory factor. Other factors, such as environmental or system characteristics, are of influence here. Maintenance can play a major role in preserving/improving the performance of infiltrating pavements in practice. While our results provide the first indication of the functioning of infiltrating pavement in practice, only with multi-year measurements following a strict monitoring protocol can the longer-term effects of environmental factors and maintenance actually be determined, providing the basis for the development of an optimal maintenance schedule and associated cost–benefit assessments to the added value of this type of climate adaptation.
Increasingly, discussions on sustainability, in particular in relation to energy transition, are finding their way to the regional and local political arena. Although for analysing transition pathways on these sub-national scales, conceptual frameworks such as the multi-level perspective may be helpful, some issues remain relatively unaddressed: the relevance of citizens and their social networks and the precise interactions between place, the local context, and external conditions. This paper aims to better understand energy transition processes on the local and regional scale by analysing the case of the Dutch island of Ameland. Since 2006, Ameland has been on a sustainability pathway towards self-sufficiency, in particular in terms of reducing CO2 emissions. In this case study, we conducted in-depth empirical analysis, using a mixed-methods approach, including document analysis and ethnographic techniques. In a five-stage development process, a combination of placerelated niche development, regime developments, and the involvement of citizens have created a protective space for several socio-technological innovations to emerge. The unique combination of specific local conditions, in particular political and cultural, and external influences, national policy, and ‘enlightened’ companies have shaped ideal conditions for Ameland to become an inspiring example of innovation in regional transition processes.
The aim of this study was to explore the association between oral health and frailty in community-dwelling Dutch adults aged 55 years and older. Included were 170 participants (n = 95 female [56%]; median age 64 years [IQR: 59-69 years]). Frailty was assessed by the Groningen Frailty Indicator. Oral health was assessed by the Oral Health Impact Profile-14-NL (OHIP-NL14). OHIP-NL14 item scores were analyzed for differences between frail and non-frail participants. Univariate and multivariate logistic regression analyses were performed to assess the association between oral health and presence of frailty. The multivariate analysis included age, gender, and depressive symptoms as co-variables. After adjustment, 1 point increase on the OHIP-NL14 scale was associated with 21% higher odds of being frail (p = 0.000). In addition, significantly more frail participants reported presence of problems on each OHIP-NL14 item, compared to non-frail participants (p < 0.003). Contrast in prevalence of different oral health problems between frail and non-frail was most prominent in 'younger' older adults aged 55-64 years. In conclusion: decreased oral health was associated with frailty in older adults aged ≥55 years. Since oral health problems are not included in most frailty assessments, tackling oral health problems may not be sufficiently emphasized in frailty policies.
Background The capability set for work questionnaire (CSWQ) is being used to measure the new model of sustainable employability building on the capability approach. However, previous studies on the psychometric properties of the instrument are limited and cross-sectional. This two-way study aimed to (1) evaluate the convergent validity of the CSWQ with the theoretically related constructs person-job fit, strengths use, and opportunity to craft and (2) test the predictive and incremental validity of the questionnaire for the well-established work outcomes, including work ability, work engagement, job satisfaction, and task performance. Methods A representative sample of 303 Dutch workers, chosen with probably random sampling, were surveyed using a one-month follow-up, cross-lagged design via the Longitudinal Internet Studies for the Social Sciences panel. The convergent validity was assessed by exploring the strength of associations between the capability set for work questionnaire and the theoretically related constructs using Pearson’s correlations. The predictive and incremental validity was evaluated by performing a series of linear hierarchical regression analyses. Results We found evidence of the convergent validity of the capability set score by moderate correlations with person-job fit, strengths use, and opportunity to craft ( r = 0.51–0.52). A series of multiple regression analyses showed that Time 1 capability set score and its constituents (i.e., importance, ability, and enablement) generally had predictive and incremental validity for work ability, work engagement, job satisfaction, and task performance measured at Time 2. However, the incremental power of the CSWQ over and above conceptually related constructs was modest. Conclusions The findings support the convergent, predictive, and incremental validity of the capability set for work questionnaire with not previously investigated work constructs. This provided further evidence to support its utility for assessing a worker’s sustainable employability for future research and practical interventions.
The aim of this study was to evaluate the impact of the implementation of an Oral Care Program on home care nurses’ attitudes and knowledge about oral health (care) and the impact on older people’s oral health. A pre–post study, without a control group, was conducted. A preventive Oral Care Program (OCP) was designed, focusing on home care nurses and older people, in collaboration with dental hygienists. Implementation was measured with questionnaires at baseline and after 6 months for home care nurses; for older people, implementation was measured at baseline and after 3 months with the Oral Health Assessment Tool and a questionnaire about oral (self) care between January 2018 and September 2019. Although the study design has limitations, the oral health of older people improved significantly after 3 months and the OCP was most beneficial for people with full dentures. The OCP improved knowledge and attitude of home care nurses. The program fitted well with the daily work routines of home care nurses. Individual-centered care plans for older people, education of home care nurses and the expertise of the dental hygienists have added value in home care nursing. Future implementations should focus on older people with natural teeth.
ABSTRACT The nasopharyngeal commensal Streptococcus pneumoniae can become invasive and cause metastatic infection. This requires the pneumococcus to have the ability to adapt, grow, and reside in diverse host environments. Therefore, we studied whether the likelihood of severe disease manifestations was related to pneumococcal growth kinetics. For 383 S. pneumoniae blood isolates and 25 experimental mutants, we observed highly reproducible growth curves in nutrient-rich medium. The derived growth features were lag time, maximum growth rate, maximum density, and stationary-phase time before lysis. First, the pathogenicity of each growth feature was probed by comparing isolates from patients with and without marked preexisting comorbidity. Then, growth features were related to the propensity of causing severe manifestations of invasive pneumococcal disease (IPD). A high maximum bacterial density was the most pronounced pathogenic growth feature, which was also an independent predictor of 30-day mortality (P = 0.03). Serotypes with an epidemiologically higher propensity for causing meningitis displayed a relatively high maximum density (P
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