IntroductionTo update the European guidelines for the assessment of voice quality (VQ) in clinical practice.MethodsNineteen laryngologists–phoniatricians of the European Laryngological Society (ELS... Show moreIntroductionTo update the European guidelines for the assessment of voice quality (VQ) in clinical practice.MethodsNineteen laryngologists–phoniatricians of the European Laryngological Society (ELS) and the Union of the European Phoniatricians (UEP) participated to a modified Delphi process to propose statements about subjective and objective VQ assessments. Two anonymized voting rounds determined a consensus statement to be acceptable when 80% of experts agreed with a rating of at least 3/4. The statements with ≥ 3/4 score by 60–80% of experts were improved and resubmitted to voting until they were validated or rejected.ResultsOf the 90 initial statements, 51 were validated after two voting rounds. A multidimensional set of minimal VQ evaluations was proposed and included: baseline VQ anamnesis (e.g., allergy, medical and surgical history, medication, addiction, singing practice, job, and posture), videolaryngostroboscopy (mucosal wave symmetry, amplitude, morphology, and movements), patient-reported VQ assessment (30- or 10-voice handicap index), perception (Grade, Roughness, Breathiness, Asthenia, and Strain), aerodynamics (maximum phonation time), acoustics (Mean F0, Jitter, Shimmer, and noise-to-harmonic ratio), and clinical instruments associated with voice comorbidities (reflux symptom score, reflux sign assessment, eating-assessment tool-10, and dysphagia handicap index). For perception, aerodynamics and acoustics, experts provided guidelines for the methods of measurement. Some additional VQ evaluations are proposed for voice professionals or patients with some laryngeal diseases.ConclusionThe ELS-UEP consensus for VQ assessment provides clinical statements for the baseline and pre- to post-treatment evaluations of VQ and to improve collaborative research by adopting common and validated VQ evaluation approach. Show less
Land-Zandstra, A.M.; Strick, M.; Peeters, W.; de Jong, P. 2023
The need for data to study the relationship between fatigued healthcare professionals and performance outcomes is evident, however, it is unclear which methodology is most appropriate to provide... Show moreThe need for data to study the relationship between fatigued healthcare professionals and performance outcomes is evident, however, it is unclear which methodology is most appropriate to provide these insights. To address this issue, we performed a systematic review of relevant articles by searching the MEDLINE, EMBASE, Cochrane, Web of Science, and CINAHL databases. The literature search identified 2960 unique references, of which 82 were identified eligible. The impact on performance was studied on clinical outcomes, medical simulation, neurocognitive performance, sleep quantification and subjective assessment. In general results on performance are conflicting; impairment, no effect, and improvement were found. This review outlines the various methods currently available for assessing fatigue-impaired performance. The contrasting outcomes can be attributed to three main factors: differences in the operationalisation of fatigue, incomplete control data, and the wide variety in the methods used. We recommend the implementation of a clinically applicable tool that can provide uniform data. Until these data become available, caution should be used when developing regulations that can have implications for physicians, education, manpower planning, and - ultimately - patient care. (C) 2019 Elsevier Ltd. All rights reserved. Show less
The scope of this thesis spanned several issues in the measurement and evaluation of OD. The screening, assessment, and treatment effect for OD have been covered,with a special emphasis on... Show moreThe scope of this thesis spanned several issues in the measurement and evaluation of OD. The screening, assessment, and treatment effect for OD have been covered,with a special emphasis on patient self-evaluation. Show less
Research which explores unchartered waters has a high potential for major impact but also carries a higher uncertainty of having impact. Such explorative research is often described as taking a novel. Show moreResearch which explores unchartered waters has a high potential for major impact but also carries a higher uncertainty of having impact. Such explorative research is often described as taking a novel approach. This study examines the complex relationship between pursuing a novel approach and impact. Viewing scientific research as a combinatorial process, we measure novelty in science by examining whether a published paper makes first-time-ever combinations of referenced journals, taking into account the difficulty of making such combinations. We apply this newly developed measure of novelty to all Web of Science research articles published in 2001 across all scientific disciplines. We find that highly novel papers, defined to be those that make more (distant) new combinations, deliver high gains to science: they are more likely to be a top 1% highly cited paper in the long run, to inspire follow-on highly cited research, and to be cited in a broader set of disciplines and in disciplines that are more distant from their “home” field. At the same time, novel research is also more risky, reflected by a higher variance in its citation performance. We also find strong evidence of delayed recognition of novel papers as novel papers are less likely to be top cited when using short time-windows. In addition, we find that novel research is significantly more highly cited in “foreign” fields but not in their “home” field. Finally, novel papers are published in journals with a lower Impact Factor, compared with non-novel papers, ceteris paribus. These findings suggest that science policy, in particular funding decisions which rely on bibliometric indicators based on short-term citation counts and Journal Impact Factors, may be biased against “high risk/high gain” novel research. The findings also caution against a mono-disciplinary approach in peer review to assess the true value of novel research. Show less
Desmedt, E.; Morin, D.; Pattyn, V.; Brans, M. 2017
Purpose This study of the impact of Belgian Court of Audit on the federal Administration for the 2005 to 2010 period aims to highlight the auditors’ influence on the management of... Show morePurpose This study of the impact of Belgian Court of Audit on the federal Administration for the 2005 to 2010 period aims to highlight the auditors’ influence on the management of governmental organizations through the performance audits they have been conducting since 1998. A set of ten variables allows us to measure the three types of uses of performance auditors’ work by auditees: instrumental, conceptual and strategic uses. Design/methodology/approach A survey was sent out to a total of 148 respondents identified by the authorities of the targeted organizations. 47 usable questionnaires were completed (32% response rate). Findings The Court of Audit’s impact on the audited entities did not provoke radical changes in the auditees’ organizational life but the intervention of the auditors was nevertheless noticeable. The nature of the impact was rather conceptual than strategic or instrumental. And the negative consequences on auditees anticipated in the literature were not observed. Research limitations/implications Given the five-year period covered by the study which was made in 2014 (four years after 2010), it had to deal with the mortality of respondents and the loss of organizational memory. Practical implications The study gives more accurate insights about the influence that Supreme Audit Institutions actually exert on audited Administrations through their performance audits. Originality/value Since Supreme Audit Institutions have been mandated to evaluate government’s economy, efficiency and effectiveness for almost 40 years in the western democracies, it is mandatory that their actual ability to influence Administrations be documented more abundantly and independently by academic researchers. Show less
In the Netherlands, information provision about fertility preservation (FP) for young women with breast cancer is not sufficient. Since an increasing number of Dutch breast cancer patients will... Show moreIn the Netherlands, information provision about fertility preservation (FP) for young women with breast cancer is not sufficient. Since an increasing number of Dutch breast cancer patients will face this preference-sensitive decision each year, there is a clear need for improvement of information provision about FP. The overall aim of this thesis was therefore to (a) develop and (b) evaluate a Decision Aid (DA) about FP that is targeted to improve information provision and decision making about FP for young women with breast cancer. This thesis describes consecutively the development and evaluation of such a DA with values clarification exercise (VCE) Show less
Many topics in surgical skills education have been implemented without a solid scientific basis. For that reason we have tried to find this scientific basis. We have focused on training and... Show moreMany topics in surgical skills education have been implemented without a solid scientific basis. For that reason we have tried to find this scientific basis. We have focused on training and evaluation of minimally invasive surgical skills in a training setting and in practice in the operating room. This thesis has led to an enlarged insight in the organization of surgical skills training during residency training of surgical medical specialists. Show less
This dissertation investigates whether and how gradability is manifested in the nominal domain, as well as the implications this could have for theories of the representation of gradability. It is... Show moreThis dissertation investigates whether and how gradability is manifested in the nominal domain, as well as the implications this could have for theories of the representation of gradability. It is shown that the various gradability diagnostics proposed in the literature not only yield different results, but that they do not actually work as could be expected. In case after case, other factors turn out to underlie the noted effects: epistemicity and evidentiality (cf. the epistemic verb seem and real-type adjectives), the expression of a value judgment (e.g. N of an N constructions), the delineation of salient sub-kinds identifiable by natural consequences (cf. internal such) and abstract size modification (e.g. when a size adjective like big modifies a noun denoting an instance of a property or a set of individuals defined in terms of such an abstract object). Our investigation leads to the unexpected conclusion that,there are no grammatical contexts in the nominal domain that are exclusively reserved for a particular class of nouns that could properly be called gradable. As a result, there is no motivation for postulating a degree structure in the syntactic representation of nouns. In addition, there are no expressions performing the type of semantic operations familiar from degree modification in the adjectival domain that would indicate the existence of a grammatically accessible gradable structure in the semantics of nouns at the lexical level. The tale of this dissertation is therefore a cautionary one: arguments to reduce gradability in the nominal and in the adjectival domain to the same phenomenon are misguided. This study shows the importance of a cross-categorial perspective for a better understanding of gradability. It is of interest to a general syntactic and semantic readership. Show less
In criminology, measuring recidivism is a well-known method of establishing the preventive effect of penal interventions. There are measurements of this kind dating from as early as the 19th... Show moreIn criminology, measuring recidivism is a well-known method of establishing the preventive effect of penal interventions. There are measurements of this kind dating from as early as the 19th century. Recidivism studies have been conducted in the Netherlands too, but the earliest we know of stem from the 1970s. Due to developments in public sector fund accounting methods, interest in reconviction rates is now again on the increase. The Dutch government is looking for clear indicators to gauge the success of implemented policy measures. In the area of penal law recidivism, or rather the absence thereof, is readily embraced as a valid and efficient outcome indicator. Under what circumstances do recidivism statistics provide proof of the efficacy of policy interventions? And how can this construct best be measured? In the Netherlands there is no tradition of recidivism research. The methods used in past evaluation studies vary widely, the measurements were predominantly small-scale, and most studies were conducted at a time when the penal interventions under investigation were still at a developmental stage. Recidivism research in the Netherlands has lacked a sound methodological basis and there is consequently no comprehensive view on the outcome of penal interventions – until recently, that is, since the WODC has meanwhile developed a ‘Recidivism Monitor’. This is a project in which reconviction rates of virtually all offenders who have come into contact with the Dutch judiciary are routinely computed. The development of this instrument and its applications in evaluation research form the central themes of this dissertation. Show less
The European Commission introduced impact assessment (IA) in 2002 following recommendations from the Mandelkern group on Better Regulation. The basic rationale of IA is that proposals must be... Show moreThe European Commission introduced impact assessment (IA) in 2002 following recommendations from the Mandelkern group on Better Regulation. The basic rationale of IA is that proposals must be prepared on the basis of an analysis of whether regulatory intervention is needed and whether it is appropriate to intervene at the EU level. An IA report, published together with the proposal, summarises the results and highlights the trade-offs between the potential economic, social and environmental impacts associated with various policy options. Nowadays, IA is required for all major proposals. It is also increasingly being used throughout the whole legislative process as the European Parliament and the Council of Ministers are implementing their respective commitments to IA. The thesis starts out by developing a typology of possible uses of impact assessment in EU lawmaking, which serves as a framework of reference for the subsequent analysis of the development of EU IA. The idea is explored that the three âco-legislatorsâ are not the only relevant actors in IA processes; national institutions, advisory bodies, review institutions, regulatory bodies, private co-actors and third-country actors all play their part. Case-studies on the new chemicals regulation (REACH), the thematic strategy on air quality (CAFE), the pre-packaging directive and the data retention directive lend empirical backing to the theoretical claims. The thesis arrives at the conclusion that IA is becoming a self-standing normative force in EU lawmaking by contrasting EU IA as 'soft constitutional law' and EU IA as 'meta-regulation'. Show less
