Zoekresultaten

Simulating Small-Scale Agricultural Adaptation Decisions in Response to Drought Risk: An Empirical Agent-Based Model for Semi-Arid Kenya

In Eastern Africa, increasing climate variability and changing socioeconomic conditions are exacerbating the frequency and intensity of drought disasters. Droughts pose a severe threat to food security in this region, which is characterized by a large dependency on smallholder rain-fed agriculture and a low level of technological development in the food production systems. Future drought risk will be determined by the adaptation choices made by farmers, yet few drought risk models … incorporate adaptive behavior in the estimation of drought risk. Here, we present an innovative dynamic drought risk adaptation model, ADOPT, to evaluate the factors that influence adaptation decisions and the subsequent adoption of measures, and how this affects drought risk for agricultural production. ADOPT combines socio-hydrological and agent-based modeling approaches by coupling the FAO crop model AquacropOS with a behavioral model capable of simulating different adaptive behavioral theories. In this paper, we compare the protection motivation theory, which describes bounded rationality, with a business-as-usual and an economic rational adaptive behavior. The inclusion of these scenarios serves to evaluate and compare the effect of different assumptions about adaptive behavior on the evolution of drought risk over time. Applied to a semi-arid case in Kenya, ADOPT is parameterized using field data collected from 250 households in the Kitui region and discussions with local decision-makers. The results show that estimations of drought risk and the need for emergency food aid can be improved using an agent-based approach: we show that ignoring individual household characteristics leads to an underestimation of food-aid needs. Moreover, we show that the bounded rational scenario is better able to reflect historic food security, poverty levels, and crop yields. Thus, we demonstrate that the reality of complex human adaptation decisions can best be described assuming bounded rational adaptive behavior; furthermore, an agent-based approach and the choice of adaptation theory matter when quantifying risk and estimating emergency aid needs.

Passive movement therapy in patients with moderate to severe paratonia; study protocol of a randomised clinical trial (ISRCTN43069940)

BACKGROUND: Paratonia, a form of hypertonia, is associated with loss of mobility and with the development of contractures especially in the late stages of the dementia. Passive movement therapy (PMT) currently is the main physiotherapeutic intervention. General doubt about the beneficial effects of this widely used therapy necessitates a randomised clinical trial (RCT) to study the efficacy of PMT on the severity of paratonia and on the improvement of daily care.METHODS/DESIGN: A RCT with a 4-week follow-up period. Patients with dementia (according to the DSM-IV-TR Criteria) and moderate to severe paratonia are included in the study after proxy consent. By means of computerised and concealed block randomisation (block-size of 4) patients are included in one of two groups. The first group receives PMT, the second group receives usual care without PMT. PMT is given according to a protocol by physical therapist three times a week for four weeks in a row. The severity of paratonia (Modified Ashworth scale), the severity of the dementia (Global Deterioration Scale), the clinical improvement (Clinical Global Impressions), the difficulty in daily care (Patient Specific Complaints) and the experienced pain in daily care of the participant (PACSLAC-D) is assessed by assessors blind to treatment allocation at baseline, after 6 and 12 treatments. Success of the intervention is defined as a significant increase of decline on the modified Ashworth scale. The 'proportion of change' in two and four weeks time on this scale will be analysed. Also a multiple logistic regression analysis using declined/not declined criteria as dependent variable with correction for relevant confounders (e.g. stage of dementia, medication, co-morbidity) will be used.DISCUSSION: This study is the first RCT of this size to gain further insight on the effect of passive movement therapy on the severity of paratonia.TRIAL REGISTRATION: Current Controlled Trials ISRCTN43069940.

Negotiating (dis)ability in the context of chronic pain rehabilitation

Chronic pain rehabilitation programs are aimed at helping patients to increase their functioning despite being in pain, thereby improving their quality of life. However, conversations between patients and practitioners about how the patient could deal with his/her pain and pain-related disabilities in a different way can be interactionally challenging. This study adopts a discursive psychological perspective to explore how pain-related disability is negotiated by patients and practitioners during consultations. The analysis shows that pain-related disability is treated by both patients and practitioners as negotiable rather than a fixed reality. Moreover, it shows that patients’ and practitioners’ negotiations of disability are subject to issues of agency, accountability, and blame, and it provides insight into the interactional dilemmas that are at stake, both for patients and practitioners. Revalidatieprogramma’s voor patiënten met chronische pijn zijn gericht op het verbeteren van het functioneren ondanks de pijn, waardoor kwaliteit van leven wordt bevorderd. Conversaties tussen patiënten en behandelaars over de manier waarop de patiënt kan omgaan met de pijn en gerelateerde beperkingen kunnen interactionele uitdagingen met zich meebrengen. Dit hoofdstuk verkent vanuit discursief-psychologisch perspectief hoe beperkingen worden onderhandeld door patiënten en behandelaars in consulten. De analyse toont aan dat de beperkingen worden behandeld als onderhandelbaar in plaats van als een onveranderbare werkelijkheid. Bovendien toont de analyse dat in deze onderhandelingen bepaalde issues relevant worden gemaakt, zoals ‘agency’, verantwoordelijkheid en schuld. Inzicht wordt geboden in de interactionele dilemma’s die op het spel staan voor zowel patiënten als behandelaars.

Traumabehandeling bij kinderen met een licht verstandelijke beperking : Naar een methodiek voor de behandeling van getraumatiseerde kinderen en jongeren met een licht verstandelijke beperking.

Wat motiveert mkb-ers om actie te ondernemen tegen ransomware?

Slachtofferschap van ransomware – software die bestanden of systemen versleutelt als drukmiddel om slachtoffers losgeld te laten betalen – is een groeiend probleem voor bedrijven in Nederland. Tot wel 17% van de Nederlandse mkb’ers zegt ooit slachtoffer te zijn geworden van dit delict. Toch nemen ondernemers nog te weinig maatregelen om hun bedrijf tegen ransomware en andere vormen van cybercriminaliteit te beschermen. Hoe kunnen we de weerbaarheid van het mkb vergroten?

Development and usability of educational material about workplace particulate matter exposure

Background: Particulate matter (PM) exposure is an important health risk, both in daily life and in the workplace. It causes respiratory and cardiovascular diseases and results in 800,000 premature deaths per year worldwide. In earlier research, we assessed workers’ information needs regarding workplace PM exposure, the properties and effects of PM, and the rationale behind various means of protection. We also concluded that workers do not always receive appropriate risk communication tools with regards to PM, and that their PM knowledge appears to be fragmented and incomplete. Methods: We considered several concepts for use as an educational material based on evaluation criteria: ease of use, costs, appropriateness for target audiences and goals, interactivity, implementation issues, novelty, and speed. We decided to develop an educational folder, which can be used to inform employees about the properties, effects and prevention methods concerning PM. Furthermore, we decided on a test setup of a more interactive way of visualisation of exposure to PM by means of exposimeters. For the development of the folder, we based the information needs on our earlier mental models-based research. We adjusted the folder based on the results of ten semi-structured interviews evaluating its usability. Results: The semi-structured interviews yielded commentaries and suggestions for further improvement, which resulted in a number of alterations to the folder. However, in most cases the folder was deemed satisfactory. Conclusion: Based on this study, the folder we developed is suitable for a larger-scale experiment and a practical test. Further research is needed to investigate the efficacy of the folder and the application of the exposimeter in a PM risk communication system.