Zoekresultaten

De stad van morgen

Verslag van het wteede jaar van het Centre of Expertise Smart Sustainable Cities.

Expertise Centre Supported Education

Predicting complex acute wound healing in patients from a wound expertise centre registry

It is important for caregivers and patients to know which wounds are at risk of prolonged wound healing to enable timely communication and treatment. Available prognostic models predict wound healing in chronic ulcers, but not in acute wounds, that is, originating after trauma or surgery. We developed a model to detect which factors can predict (prolonged) healing of complex acute wounds in patients treated in a large wound expertise centre (WEC). Using Cox and linear regression analyses, we determined which patient- and wound-related characteristics best predict time to complete wound healing and derived a prediction formula to estimate how long this may take. We selected 563 patients with acute wounds, documented in the WEC registry between 2007 and 2012. Wounds had existed for a median of 19 days (range 6-46 days). The majority of these were located on the leg (52%). Five significant independent predictors of prolonged wound healing were identified: wound location on the trunk [hazard ratio (HR) 0·565, 95% confidence interval (CI) 0·405-0·788; P = 0·001], wound infection (HR 0·728, 95% CI 0·534-0·991; P = 0·044), wound size (HR 0·993, 95% CI 0·988-0·997; P = 0·001), wound duration (HR 0·998, 95% CI 0·996-0·999; P = 0·005) and patient's age (HR 1·009, 95% CI 1·001-1·018; P = 0·020), but not diabetes. Awareness of the five factors predicting the healing of complex acute wounds, particularly wound infection and location on the trunk, may help caregivers to predict wound healing time and to detect, refer and focus on patients who need additional attention.

Children with language delay referred to Dutch speech and hearing centres: caseload characteristics

Background: Early detection and remediation of language disorders are important in helping children to establish appropriate communicative and social behaviour and acquire additional information about the world through the use of language. In the Netherlands, children with (a suspicion of) language disorders are referred to speech and hearing centres for multidisciplinary assessment. Reliable data are needed on the nature of language disorders, as well as the age and source of referral, and the effects of cultural and socioeconomic profiles of the population served in order to plan speech and language therapy service provision. Aims: To provide a detailed description of caseload characteristics of children referred with a possible language disorder by generating more understanding of factors that might influence early identification. Methods & Procedures: A database of 11,450 children was analysed consisting of data on children, aged 2–7 years (70% boys, 30% girls), visiting Dutch speech and hearing centres. The factors analysed were age of referral, ratio of boys to girls, mono‐ and bilingualism, nature of the language delay, and language profile of the children. Outcomes & Results:Results revealed an age bias in the referral of children with language disorders. On average, boys were referred 5 months earlier than girls, and monolingual children were referred 3 months earlier than bilingual children. In addition, bilingual children seemed to have more complex problems at referral than monolingual children. They more often had both a disorder in both receptive and expressive language, and a language disorder with additional (developmental) problems. Conclusions & Implications: This study revealed a bias in age of referral of young children with language disorders. The results implicate the need for objective language screening instruments and the need to increase the awareness of staff in primary child healthcare of red flags in language development of girls and multilingual children aiming at earlier identification of language disorders in these children.

Praktijkgericht onderzoek dat bijdraagt aan innovatie van opleiding en praktijk

Met deze notitie wil het Netwerk Lectoren Lerarenopleidingen bijdragen aan de discussie over de focus en vormgeving van onderzoek binnen en vanuit delerarenopleidingen, naar aanleiding van de strategische agenda van deVereniging Hogescholen rond de lerarenopleidingen. De auteurs hopen met deze notitie opleiders, onderzoekers, leidinggevenden, bestuurders en beleidsmakers te prikkelen en te inspireren om werk te maken van onderzoek met impact voor opleiders, scholen, leraren, en uiteindelijk voor leerlingen. Als lectoren die intensief betrokken zijn bij de lerarenopleidingen en bij het praktijkgerichte onderzoek dat daarbinnen plaatsvindt, hebben ze de ambitie om het praktijkgericht onderzoek sterker te laten bijdragen aan het ontwikkelen van die gevalideerde kennis. In deze notitie wordt beschreven hoe de kerntaak van lerarenopleidingen ten aanzien van praktijkgericht onderzoek opgevat kan worden. Dit wordt geïllustreerd dit met concrete voorbeelden en met ontwerpcriteria voor Centres of Expertise in de educatieve sector.