Experience of collaboration between a Dutch surgical team in a Ghanaian Orthopaedic Teaching Hospital.

Background: Surgery is an indivisible, indispensable part of healthcare. In Africa, surgery may be thought of as the neglected stepchild of global public health. We describe our experience over a 3-year period of intensive collaboration between specialized teams from a Dutch hospital and local teams of an orthopaedic hospital in Effiduase-Koforidua, Ghana. Intervention: During 2010-2012, medical teams from our hospital were deployed to St. Joseph’s Hospital. These teams were completely self-supporting. They were encouraged to work together with the local-staff. Apart from clinical work, effort was also spent on education/ teaching operation techniques/ regional anaesthesia techniques/ scrubbing techniques/ and principles around sterility. Results: Knowledge and quality of care has improved. Nevertheless, the overall level of quality of care still lags behind compared to what we see in the Western world. This is mainly due to financial constraints; restricting the capacity to purchase good equipment, maintaining it, and providing regular education. Conclusion: The relief provided by institutions like Care-to-Move is very valuable and essential to improve the level of healthcare. The hospital has evolved to such a high level that general European teams have become redundant. Focused and dedicated teams should be the next step of support within the nearby future.

Dutch Auctions: The case of fish auction in Bermeo

In this work I will analyze fish auctions focusing on a particular case: fish auctions in Bermeo. The purpose is to explain if at present the Dutch auction is the appropriate mechanism in the field of fish auctions or there are better alternatives for the sale of fish. For the fulfillment of this essay, I will first introduce some general notions on auctions and more particularly on Dutch auctions describing their properties and limitations.

Validation of the 12-item partners in health scale to measure patient self-management behaviour and knowledge in Dutch patients with COPD

The 12-item Partner in Health (PIH) scale was developed in Australia to measure self-management behaviour and knowledge in patients with chronic diseases. The scale has undergone several changes since first published. Our study aim was to validate the latest PIH in Dutch COPD patients.The 12 items of the PIH are scored on a self-rated 9-point Likert scale (range: 0-8; higher scores indicate better self-management), providing total and subscale scores (knowledge, coping, recognition and management of functions, adherence to treatment).We used forward-backward translation of the latest version of the Australian PIH. Dimensionality and reliability analyses were performed to investigate the psychometric properties, and to determine whether the Dutch PIH replicated the same four subscales of self-management as the original PIH.Reanalysis of the original PIH validation study (186 Australian patients with chronic diseases) showed a single scale. Two scales (1. knowledge and coping; 2. recognition and management of symptoms, adherence to treatment) were found for the Dutch PIH (118 Dutch COPD patients). The correlation between the two Dutch scales was 0.43. The lower-bound of the reliability of the total scale was 0.81 (Australian PIH) and 0.84 (Dutch PIH).Different scale structures were found for the original Australian and the Dutch PIH. Our results did not support the 4-scale structure reported previously. To increase comparability and generalisability of our findings, the scale structure of the revised Australian PIH needs to be investigated further. Meanwhile, we advise using the PIH total score or two subscale scores when assessing COPD patients.

Study on yield function and plastic potential under non-associated flow for accurate earing prediction in cup drawing

Prediction of more than four ears in a cup drawing process can be successfully achieved by considering r-value and stress directionalities. Yld2004-18p based on associated flow rule and Yld2000-2D based on non-associated flow rule are the examples. The former, however, is more costly in terms of computational efficiency than the latter. In this work, an anisotropic constitutive model based on non-associated flow rule which combines two different functions, Hill (1948) and Yld2000-2d, is implemented to a user defined material model. The accuracy of the anisotropic directionalities (yield stresses and plastic strain ratios) is evaluated. Simulation of a mini-die cup drawing with a body stock alloy predicted eight ears, in good agreement with the experimental results. The use of Hill (1948) model for the yield function and Yld2000-2d for plastic potential under the framework of non-associated flow rule led to accurate prediction of up to eight ears at the lower computational cost.

Wrinkling during cup drawing with NUMISHEET2014 benchmark test

Wrinkling occurs when a blank is subjected to compressive stresses during the forming process as in the flange of a cup during drawing. Although the failure limit due to plastic flow localization can be simply defined by the FLC at each point of a continuum, the wrinkling limit cannot be defined with simple variables such as strain, stress, and thickness. Wrinkling is strongly affected by the mechanical properties of the sheet material, the geometry of the tools and blank, and contact conditions. The analysis of wrinkling initiation and growth is, therefore, difficult to perform due to the complex synergistic effects of the controlling parameters. Because of these difficulties, the study of wrinkling has generally been conducted case by case. A unique wrinkling criterion, which could be used effectively for various sheet forming processes, has not yet been proposed. There were many investigations on the effect of process parameters (BHF and friction) and geometry on wrinkling. However, there are few reported results on the influence of the material model on wrinkling. This paper shows how strain hardening and r-values affect wrinkle formation in its magnitude, initiation, and direction through the NUMISHEET2014 benchmark test for wrinkling during cup drawing.

Drawing information : what's a map?

Mapping has in recent years become one of the most common architectural strategies to approach the knowledge of reality. Its real or apparent objectivity has led, in many cases, to consider this system as the only valid approximation to an object of study, discarding other more synthetic, intuitive and impervious procedures of systematic analysis for being partial and subjective. Leaving aside these erroneous exclusions, it is undeniable that the sophisticated contemporary development of maps has produced an enormous range of possibilities.

Drawing process : what's a diagram?

Within the architectural universe there have been numerous attempts in recent years to define the term diagram. Etymologically, it means exclusively “through graphic representation”, which does not clarify much (from the Greek, dia, through + gramma, graphic representation). Jennifer Sigler defines it as the minimum graphic element that explains a concept. Federico Soriano borrows from Federico García Lorca, and claims that diagrams are the marrow of form or content. Efforts to clarify the nature of these powerful graphical representations have multiplied at a similar rate as its ever-increasing use in contemporary architectural projects.

Size effects in micro cup drawing

Experimental studies into the effect of blank thickness on the deep drawing response of the coarse-grained and ultrafine-grained copper demonstrated the occurrence of a size effect: the dependence of the maximum load and the limit drawing ratio on the blank thickness in sub-millimetre range. A dislocation based constitutive model taking into account the thickness effects was used for numerical simulations of the process. It was demonstrated that the occurrence of the blank thickness effect is governed by the ratio of the blank thickness t to the grain size D of the material. Critical values of the t/. D ratio below which the size effect comes to bearing were determined. The obtained results can be seen as a demonstration of more general suitability of the model developed for predicting microforming operations with full account of the specimen or work-piece dimensions.

Construct validity of the Dutch version of the 12-item Partners in Health scale : measuring self-management behaviour and knowledge in COPD patients

The 12-item Partner in Health (PIH) scale was developed in Australia to measure self-management behaviour and knowledge in patients with chronic diseases. The scale has undergone several changes since first published. Our study aim was to validate the latest PIH in Dutch COPD patients.The 12 items of the PIH are scored on a self-rated 9-point Likert scale (range: 0-8; higher scores indicate better self-management), providing total and subscale scores (knowledge, coping, recognition and management of functions, adherence to treatment).We used forward-backward translation of the latest version of the Australian PIH. Dimensionality and reliability analyses were performed to investigate the psychometric properties, and to determine whether the Dutch PIH replicated the same four subscales of self-management as the original PIH.Reanalysis of the original PIH validation study (186 Australian patients with chronic diseases) showed a single scale. Two scales (1. knowledge and coping; 2. recognition and management of symptoms, adherence to treatment) were found for the Dutch PIH (118 Dutch COPD patients). The correlation between the two Dutch scales was 0.43. The lower-bound of the reliability of the total scale was 0.81 (Australian PIH) and 0.84 (Dutch PIH).Different scale structures were found for the original Australian and the Dutch PIH. Our results did not support the 4-scale structure reported previously. To increase comparability and generalisability of our findings, the scale structure of the revised Australian PIH needs to be investigated further. Meanwhile, we advise using the PIH total score or two subscale scores when assessing COPD patients.

Exquisite corpse: drawing the uncanny

Exquisite corpseExquisite corpse was a technique created by the surrealists. It was a type of game played by using images. What we would like to look at together is to question where these images come from. And also, why are some images “uncanny”?

Remembering the future : Warlpiri life through the prism of drawing

As well as the truths the drawings might speak, The book concerns itself with the beguiling questions that remain unanswered and the limits of scholarship.

Construct validity of the Dutch version of the 12-item Partners in Health scale: measuring patient self-management behaviour and knowledge in patients with Chronic Obstructive Pulmonary Disease

Objective The 12-item Partners in Health scale (PIH) was developed in Australia to measure self-management behaviour and knowledge in patients with chronic diseases, and has undergone several changes. Our aim was to assess the construct validity and reliability of the latest PIH version in Dutch COPD patients.

Methods The 12 items of the PIH, scored on a self-rated 9-point Likert scale, are used to calculate total and subscale scores (knowledge; coping; recognition and management of symptoms; and adherence to treatment). We used forward-backward translation of the latest version of the Australian PIH to define a Dutch PIH (PIH(Du)). Mokken Scale Analysis and common Factor Analysis were performed on data from a Dutch COPD sample to investigate the psychometric properties of the Dutch PIH; and to determine whether the four-subscale solution previously found for the original Australian PIH could be replicated for the Dutch PIH.

Results Two subscales were found for the Dutch PIH data (n = 118); 1) knowledge and coping; 2) recognition and management of symptoms, adherence to treatment. The correlation between the two Dutch subscales was 0.43. The lower-bound of the reliability of the total scale equalled 0.84. Factor analysis indicated that the first two factors explained a larger percentage of common variance (39.4% and 19.9%) than could be expected when using random data (17.5% and 15.1%).

Conclusion We recommend using two PIH subscale scores when assessing self-management in Dutch COPD patients. Our results did not support the four-subscale structure as previously reported for the original Australian PIH.

The drawing bazaar

Es sorprendente y paradójica la progresiva reducción de la relevancia sufrida por el dibujo en el ámbito de la enseñanza universitaria en las escuelas de arquitectura a lo largo de las últimas décadas. Digo sorprendente, porque es precisamente el dibujo el lenguaje que permite al arquitecto hacer inteligible su propuesta, tanto a sí mismo como a otros. Y digo paradójica, porque esta restricción lingüística con la que se castiga a los estudiantes de arquitectura se produce en el momento histórico en que las opciones y recursos gráficos a su disposición son máximos. La tecnología digital ha ampliado de manera exponencial el ya de por sí amplísimo vocabulario del dibujo tradicional. Sin embargo, esta ilusionante expansión del universo del lenguaje del dibujo, no se ha visto reflejada en una adaptación de la formación universitaria de características similares. The Drawing Bazaar es el compendio de muchos años de esfuerzo por parte de los autores por proporcionar a sus alumnos de la Universidad Europea de Madrid una solución a esta sorprendente paradoja a la que se enfrentaban, quizá sin ser siquiera completamente conscientes de ello. Para ello han estructurado un libro denso y complejo, con múltiples capas de lectura superpuestas que permiten desde el simple paseo, consulta y disfrute de dibujos de excelentes comunicadores gráficos, arquitectos y no arquitectos, hasta el análisis detallado y experto de las más particulares, eficaces y persuasivas estrategias plásticas.