Suchergebnisse

Using the past to orientate on the present and the future can be seen as one of history's main contributions to educating future citizens of democratic societies. Because teachers often lack useful methods for pursuing this goal, this study explores three pedagogical approaches that may help them making connections between the past, the present and the future: working with longitudinal lines (LL), with enduring human issues (EHI) and with historical analogies (HA). The efficacy of these approaches was examined in three case studies conducted in two Dutch secondary schools with eighth- to tenth-grade students (N=135) and their teachers (N=4) as participants. Explorations took place within the boundaries of the existing history curriculum and in close collaboration with the teachers who participated because they felt a need to motivate their students by means of a pedagogy to make history more useful. Findings suggest that implementing the LL- and EHI-approaches in a traditional history curriculum with chronologically ordered topics is more complicated than implementing the HA-approach. The HA-approach appears to have more potential to encourage students to use historical knowledge in present-day contexts than the other two approaches. In terms of students' appraisals of the relevance of history, the application of the EHI-approach showed positive effects.

According to a governmental decision, all (re)constructions in Dutch cities starting by 2020 have to be climate resilient. Part of this climate resilience is also adaptation to (extreme) heat. Although urban heat, its causes, consequences, and potential adaptation measures, have been extensively studied by scientists all over the world, the understanding of this problem among practitioners is still limited. Local governments are struggling with defining the urgency and finding the right arguments for adaptation to this aspect of climate change. Also questions asked by municipality officers often differ from those asked (and answered) by scientists. How do you define "heat stress"? What are the best adaptation measures for our city? How do we know we have reached "heat resilience"? Or; Shall we just do what they do in Italy? Project Heat Resilient Cities is a cooperation of two research institutes, 13 municipalities, and a water authority in Netherlands. The aim of this project is to bring the current knowledge of urban heat adaptation to practice and to fill in the research gabs. The research focuses on clear visualizations of problematic areas, applicable heat resilient measures in Dutch context, and design guidelines leading towards more heat resilient cities. In this presentation, we will present an overview of practical tools (maps, instruments measures, visualizations, guidelines) that cities could use put heat resilience into practice.

Background Cervical cancer poses a substantial burden in terms of morbidity, mortality, and economic losses, especially in low/middle-income countries. HPV vaccination and/or cervical cancer screening among females may reduce the burden of HPV-related diseases, including cervical cancer. However, limited funds may impede the implementation of population-based programmes. Governmental investments in the prevention of infectious disease may have broader economic and fiscal benefits, which are not accounted in conventional economic analyses. This study estimates the broader economic and fiscal impacts of implementing HPV vaccination and/or cervical cancer screening in Indonesia from the perspective of the government. Methods A government-perspective quantitative analytic framework was applied to assess the Net Present Value (NPV) of investment on cervical cancer prevention strategies including HPV vaccination, cervical screening and its combination in Indonesia. All monetary values were presented in International Dollars (I$). Results Based on a cohort of 10,000,000 Indonesian 12-year-old females, it was estimated that HPV vaccination and/or cervical cancer screening result in a positive NPV for the Indonesian government. The combination of cervical screening and HPV vaccination generated a substantial reduction of cervical cancer incidence and HPV-related mortality of 87,862 and 19,359, respectively. It was estimated that HPV vaccination in combination with cervical screening is the most favorable option for cervical cancer prevention (NPV I $2.031.786.000), followed by HPV vaccination alone (NPV I$1.860.783.000) and cervical screening alone (NPV I$375.244.000). Conclusion In addition to clinical benefits, investing in HPV vaccination and cervical screening may yield considerable fiscal benefits for the Indonesian governments due to lifelong benefits resulting from reduction of cervical cancer-related morbidity and mortality.

AbstractService organizations for people with intellectual disabilities (ID) increasingly look for technological applications to improve their services. DigiContact is an online support service developed by Philadelphia Care Foundation in the Netherlands which enables independently living people with ID to contact specially trained support workers 24/7. The purpose of this study was to explore the support needs for which people with ID use online support. We first conducted interviews with 21 individuals with ID who use the online support service. Transcriptions of the interviews were analyzed using inductive thematic analysis. Second, online support workers registered items regarding the support needs when in contact with support users. These data were analyzed to assess which and how often the support needs were present. Online support is used for a broad variety of issues. Four themes emerged during analysis of the interviews: mental health, social contacts (conflicts with others as well as lack of contacts), practical issues, and physical health. Analysis of the support workers' data showed that making a connection with someone and talking about worries and stress are the two most frequent support needs. Most support needs did not differ across the time of day or across the week. The results suggest that 24/7 online support is a useful way of providing services to independently living people with ID. Unlimited access to support has multiple advantages. It appears to have a signaling and a preventive function with regard to emotional and behavioral problems.

Background Cervical cancer poses a substantial burden in terms of morbidity, mortality, and economic losses, especially in low/middle-income countries. HPV vaccination and/or cervical cancer screening among females may reduce the burden of HPV-related diseases, including cervical cancer. However, limited funds may impede the implementation of population-based programmes. Governmental investments in the prevention of infectious disease may have broader economic and fiscal benefits, which are not accounted in conventional economic analyses. This study estimates the broader economic and fiscal impacts of implementing HPV vaccination and/or cervical cancer screening in Indonesia from the perspective of the government. Methods A government-perspective quantitative analytic framework was applied to assess the Net Present Value (NPV) of investment on cervical cancer prevention strategies including HPV vaccination, cervical screening and its combination in Indonesia. All monetary values were presented in International Dollars (I$). Results Based on a cohort of 10,000,000 Indonesian 12-year-old females, it was estimated that HPV vaccination and/or cervical cancer screening result in a positive NPV for the Indonesian government. The combination of cervical screening and HPV vaccination generated a substantial reduction of cervical cancer incidence and HPV-related mortality of 87,862 and 19,359, respectively. It was estimated that HPV vaccination in combination with cervical screening is the most favorable option for cervical cancer prevention (NPV I $2.031.786.000), followed by HPV vaccination alone (NPV I$1.860.783.000) and cervical screening alone (NPV I$375.244.000). Conclusion In addition to clinical benefits, investing in HPV vaccination and cervical screening may yield considerable fiscal benefits for the Indonesian governments due to lifelong benefits resulting from reduction of cervical cancer-related morbidity and mortality.

OBJECTIVE: The aim of this study is to examine the experience of European surgeons on autologous fat transfer (AFT) and highlight differences between countries and levels of experience. BACKGROUND DATA: The popularity of AFT causes an increase in sophisticated scientific research and clinical implementation. While results from the former are well-documented, important aspects of the latter are far less recognized. METHODS: An international survey study about surgeon background, besides AFT familiarity, technique, and opinion, was distributed among surgeons from 10 European countries. The differences between countries and levels of experience were analyzed using a logistic regression model. RESULTS: The mean respondent age, out of the 358 completed questionnaires, was 46 years. Ninety-seven percent of the respondents were plastic surgeons, who practiced AFT mostly in breast surgery and considered themselves experienced with the technique. The thigh and abdomen were less favored harvest locations by the Belgium and French respondents, respectively, and both the French and Austrian respondents preferred manual aspiration over liposuction in harvesting the fat. Despite minor differences between countries and experience, the intraglandular space was injected in all subgroups. CONCLUSIONS: The expanding use of AFT in Europe will lead to more experience and heterogeneity regarding the technique. However, despite an obvious adherence to Coleman's method, deviations thereof become more apparent. An important example of such a deviation is the ongoing practice of intraglandular AFT despite being a contraindication in various European guidelines. These unsafe practices should be avoided until scientific clarification regarding oncological safety is obtained and should therefore be the focus of surgeon education in Europe.

Objective. The aim of this study is to examine the experience of European surgeons on autologous fat transfer (AFT) and highlight differences between countries and levels of experience. Background Data. The popularity of AFT causes an increase in sophisticated scientific research and clinical implementation. While results from the former are well-documented, important aspects of the latter are far less recognized. Methods. An international survey study about surgeon background, besides AFT familiarity, technique, and opinion, was distributed among surgeons from 10 European countries. The differences between countries and levels of experience were analyzed using a logistic regression model. Results. The mean respondent age, out of the 358 completed questionnaires, was 46 years. Ninety-seven percent of the respondents were plastic surgeons, who practiced AFT mostly in breast surgery and considered themselves experienced with the technique. The thigh and abdomen were less favored harvest locations by the Belgium and French respondents, respectively, and both the French and Austrian respondents preferred manual aspiration over liposuction in harvesting the fat. Despite minor differences between countries and experience, the intraglandular space was injected in all subgroups. Conclusions. The expanding use of AFT in Europe will lead to more experience and heterogeneity regarding the technique. However, despite an obvious adherence to Coleman's method, deviations thereof become more apparent. An important example of such a deviation is the ongoing practice of intraglandular AFT despite being a contraindication in various European guidelines. These unsafe practices should be avoided until scientific clarification regarding oncological safety is obtained and should therefore be the focus of surgeon education in Europe.

The prevalence and identity of Rickettsia and Bartonella in urban rat and flea populations were evaluated in Kisangani, Democratic Republic of the Congo (DRC) by molecular tools. An overall prevalence of 17% Bartonella species and 13% Rickettsia typhi, the agent of murine typhus, was found in the cosmopolitan rat species, Rattus rattus and Rattus norvegicus that were infested by a majority of Xenopsylla cheopis fleas. Bartonella queenslandensis, Bartonella elizabethae, and three Bartonella genotypes were identified by sequencing in rat specimens, mostly in R. rattus. Rickettsia typhi was detected in 72% of X. cheopis pools, the main vector and reservoir of this zoonotic pathogen. Co-infections were observed in rodents, suggesting a common mammalian host shared by R. typhi and Bartonella spp. Thus, both infections are endemic in DRC and the medical staffs need to be aware knowing the high prevalence of impoverished populations or immunocompromised inhabitants in this area.