Modeling the Adenoma and Serrated Pathway to Colorectal CAncer (ASCCA)

Several colorectal cancer (CRC) screening models have been developed describing the progression of adenomas to CRC. Currently, there is increasing evidence that serrated lesions can also develop into CRC. It is not clear whether screening tests have the same test characteristics for serrated lesions as for adenomas, but lower sensitivities have been suggested. Models that ignore this type of colorectal lesions may provide overly optimistic predictions of the screen‐induced reduction in CRC incidence. To address this issue, we have developed the Adenoma and Serrated pathway to Colorectal CAncer (ASCCA) model that includes the adenoma‐carcinoma pathway and the serrated pathway to CRC as well as characteristics of colorectal lesions. The model structure and the calibration procedure are described in detail. Calibration resulted in 19 parameter sets for the adenoma‐carcinoma pathway and 13 for the serrated pathway that match the age‐ and sex‐specific adenoma and serrated lesion prevalence in the COlonoscopy versus COlonography Screening (COCOS) trial, Dutch CRC incidence and mortality rates, and a number of other intermediate outcomes concerning characteristics of colorectal lesions. As an example, we simulated outcomes for a biennial fecal immunochemical test screening program and a hypothetical one‐time colonoscopy screening program. Inclusion of the serrated pathway influenced the predicted effectiveness of screening when serrated lesions are associated with lower screening test sensitivity or when they are not removed. To our knowledge, this is the first model that explicitly includes the serrated pathway and characteristics of colorectal lesions. It is suitable for the evaluation of the (cost)effectiveness of potential screening strategies for CRC.     

The contribution of general features of body movement to the attribution of emotions

The present study was designed to assess the contribution of general features of gross body movements to the attribution of emotions. Eighty-five adult subjects were shown ninety-six videotaped body movements, performed by three actors. Each movement was determined by seven general dimensions: trunk movement, arm movement, vertical direction, sagittal direction, force, velocity and directness. Using rating scales, the subjects judged the compatibility of each movement with each of twelve emotion categories. The results showed which movement features predicted particular ratings. Emotion categories differed as to the amount, type, and weights of predicting movement features. Three factors were extracted from the original ratings and interpreted as Rejection-Acceptance, Withdrawal-Approach, and Preparation-Defeatedness.I wish to thank Jacques van Meel for his stimulating contribution to this study, and the reviewers for their comments on earlier drafts of the final report.     

A chain game for distributed trading and negotiation

This position paper introduces a simulation gaming environment for enacting a production network. The environment aims to be an integrative laboratory for investigating supply networks, as well as being a versatile training tool. The primary focus is on food production networks. The environment enables a number of teams of participants, each representing one actor in a food chain, to conduct business together. The teams can have the role of auction, co-operation, wholesaler, factory, retail chain, and retail outlet. Producers and consumers are either enacted or simulated. The game leaders freely determine the products and production methods in each run of the game. The gaming environment takes performance, process and institutional aspects of chains into account. It is particularly suited for investigating issues of sustainability and trust. Currently the gaming environment is under development. The paper presents version 1B. This version can be found at http://www.chaingame.org. It runs on the Web, enabling to model distributed chains.     

Educational Differences in Adolescents' Sexual Health: A Pervasive Phenomenon in a National Dutch Sample

Educational level is strongly associated with age of first intercourse and risk of unintended pregnancies. This study examined these associations in a large representative sample of Dutch adolescents and also included associations of educational level with other sexual health aspects. Adolescents aged 12 to 25 (3,926 boys and 3,915 girls) completed an online questionnaire that included measures of romantic and sexual experience; the evaluation of their sexual debut; the risk of sexually transmitted infections (STIs) and pregnancy; and sexual attitudes, satisfaction, self-efficacy, knowledge, victimization, and functioning. The results showed that adolescents on a vocational track or who completed fewer years of education were more at risk of several adverse sexual health outcomes than adolescents on an academic track. They had their first sexual experiences at an earlier age; evaluated these experiences less favorably; had less sexual health knowledge and fewer refusal skills; and had a higher risk of unintended pregnancy, STIs, and victimization. Possible explanations for these consistent differences are discussed. Sex education and services should pay specific and targeted attention to less educated young people and tailor their efforts specifically to the needs, characteristics, and realities of this group.     

A systematic review of gait perturbation paradigms for improving reactive stepping responses and falls risk among healthy older adults

Background

Falls are a leading cause of injury among older adults and most often occur during walking. While strength and balance training moderately improve falls risk, training reactive recovery responses following sudden perturbations during walking may be more task-specific for falls prevention. The aim of this review was to determine the variety, characteristics and effectiveness of gait perturbation paradigms that have been used for improving reactive recovery responses during walking and reducing falls among healthy older adults.

Methods

A systematic search was conducted in PubMed, Web of Science, MEDLINE and CINAHL databases in December 2015, repeated in May 2016, using sets of terms relating to gait, perturbations, adaptation and training, and ageing. Inclusion criteria: studies were conducted with healthy participants of 60 years or older; repeated, unpredictable, mechanical perturbations were applied during walking; and reactive recovery responses to gait perturbations or the incidence of laboratory or daily life falls were recorded. Results were narratively synthesised. The risk of bias for each study (PEDro Scale) and the levels of evidence for each perturbation type were determined.

Results

In the nine studies that met the inclusion criteria, moveable floor platforms, ground surface compliance changes, or treadmill belt accelerations or decelerations were used to perturb the gait of older adults. Eight studies used a single session of perturbations, with two studies using multiple sessions. Eight of the studies reported improvement in the reactive recovery response to the perturbations. Four studies reported a reduction in the percentage of laboratory falls from the pre- to post-perturbation experience measurement and two studies reported a reduction in daily life falls. As well as the range of perturbation types, the magnitude and frequency of the perturbations varied between the studies.

Conclusions

To date, a range of perturbation paradigms have been used successfully to perturb older adults’ gait and stimulate reactive response adaptations. Variation also exists in the number and magnitudes of applied perturbations. Future research should examine the effects of perturbation type, magnitude and number on the extent and retention of the reactive recovery response adaptations, as well as on falls, over longer time periods among older adults.

     

The Nanaimo and Charles Camsell Indian Hospitals: First Nations' narratives of health care, 1945 to 1965

First Nations' perspectives on health and health care as delivered by doctors, nurses, and Canada's former Indian hospital system form a significant part of Canada's medical history, as well as a part of First Nations people's personal histories. Oral histories collected in Alberta and British Columbia suggest that First Nations people who experienced the Nanaimo and Charles Camsell Indian hospitals between 1945 and 1965 perceive the value of their experiences to be reflected in their survivance, a concept recalled through narratives emphasizing both humour and pain, as well as past and present personal resilience.     

Low socioeconomic status increases effects of negative life events on antenatal anxiety and depression

Problem

Low socioeconomic status and prior negative life events are documented risk factors for antenatal anxiety and depression, preterm birth and birth weight. We aimed to asses whether the adverse effects of prior negative life events increase with lower socioeconomic status and which aspects of socioeconomic status are most relevant.

How and Why Do Social and Sustainable Initiatives Scale? A Systematic Review of the Literature on Social Entrepreneurship and Grassroots Innovation

VOLUNTAS: International Journal of Voluntary and Nonprofit Organizations - Social and sustainable initiatives generally start small and need to scale to create substantial impact. Our systematic...     

Co-production in an Information Age: Individual and Community Engagement Supported by New Media

Social interactions in every domain of human activity are transformed through the use of new media. This study provides a preliminary assessment of the value of new media for co-production between government and (communities of) citizens. This article analyzes innovative practices in the Netherlands of new media usage to support the coproduction of safety and to facilitate the coproduction public service support. The results of the qualitative research show that both forms of coproduction provide value to governments and citizens but they differ in their value for strengthening citizen communities. Individualized and community coproduction are identified as different outcomes of socio-technological trajectories.