Background: Chronic constipation is common in people with intellectual disabilities, and seems to be highly prevalent in people with severe or profound intellectual and multiple disabilities (SPIMD). However, there is no current widely accepted definition for the constipation experienced by these individuals. Aim: This Delphi study aims to compile a list of operationalized criteria and symptoms of constipation in people with SPIMD based on practical experiences of and consensus between experts supporting them. Methods: A two-round Delphi study with an intermediate evaluation and analyses was conducted. Parents and relatives of persons with SPIMD and support professionals were included. The panel answered statements and open questions about symptoms and criteria of constipation. They were also requested to provide their opinion about classifying criteria and symptoms into domains. Answers to statements were analysed separately after both rounds with regard to consensus rate and displayed qualitatively; answers to open questions were analysed deductively. Results: In the first Delphi round (n = 47), consensus was achieved on criteria within the domains 'Defecation’ and 'Physical features', that were assigned to broader categories. Symptoms retrieved within the domain ‘Behavioural/Emotional’ were brought back to the panel as statements. After the second Delphi round (n = 38), consensus was reached on questions about domains, and for eight criteria (domain ‘Defecation’ n = 5; domain ‘Physical features n = 3). Within the domain ‘Behavioural/Emotional’, consensus was achieved for five symptoms. Criteria and symptoms with consensus >70% were considered ‘generic’ and
In The Guardian, Alan Rushbridger compared the future of newspapers to climate change. Five years ago, many climatologists were sceptical whether climate change was a real and serious issue. Today, most scientists agree that global warm ing is a fact of life. In the world of newspapers, at present, almost everyone agrees that the traditional, particularly quality, newspapers are facing huge problems. The blog ‘Print is dead’ chose a fitting title for Rushbridger’s article: Print is dead: an inconvenient truth. Another traditional icon of the information society, the public library, is facing similar problems as the newspaper industry. The information function, the core business of the library, is under threat. People tend to use search engines at home instead of visiting and accessing the (virtual) library and ask for professional advice. It is important to note that these search engines are more and more driven by commercial interests than by a genuine concern of quality information. Ranking algorithms are more beauty contests and quality stamps. (Local) governments tend to demand more and more new social services included in the library. Commercial publishers’ concerns are understandable. In the United States and Europe the world of the press faces a real crisis, and the battle to survive is a race against the clock. Newspapers, especially the quality press, will only survive if they can persuade the audience of generation Z to read them on the Web. Failure to do this will signal their demise. We will discuss the tensions in this field by addressing the mutual relationships between the stock market driven economic business model and the traditional characteristics of quality journalism as well as the cultural changes in consuming news stories and analyses in print and on the web. The key question is: how these societal tendencies will affect the quality of information consumed by the public and hence the public quality of discourse? This paper aims to address both issues by asking whether quality is really under siege and to what extent can the new, convergent media improve the quality of the information society by fostering the interaction of the roles of journalists and librarians. In the new world of journalism and librarianship both will prove their roles and functions by engagement, enrichment, empowerment and entertainment for both readers and library users.
Seismic risk assessment of two real RC multi-story buildings, located on similar soil profile in Kocaeli, is conducted in respect to code-based linear and nonlinear approaches, as well as to P25-v2 Method, a recently suggested method for risk evaluation and preliminary assessment of existing buildings against life-loss. Twenty-five different parameters and seven different collapse criteria are taken into consideration in the suggested P25-v2 Method, including soil and topographic conditions, earthquake demand, various structural irregularities, material and geometrical properties, and location of the buildings. After summarizing the different methodologies and describing the case study buildings, 3D linear-elastic and static nonlinear analyses are performed in parallel to the application of the P25 Method-v2. One of the two case study buildings totally collapsed during 1999 Kocaeli Earthquake, while the other survived with negligible damage, noting that both had legal construction and occupation permissions. SAP2000 and SeismoStruct software packages have been utilised for the analysis procedure to find out the damage states of the structural members at critical stories and to determine the performance levels of the case study buildings. The code-based performance levels and the final performance scores obtained by the preliminary assessment technique are compared in order to underline the existence of the correlation between the detailed procedure and the suggested preliminary assessment technique with the real damage state. Consequently, structural inadequacies, weak points of the buildings and failure reasons are also discussed in this paper.
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