Indian agriculture is widely believed to be in crisis. There is broad consensus among scholar, policymakers and activists that economic hardships and the changing climate have made sustaining a... Show moreIndian agriculture is widely believed to be in crisis. There is broad consensus among scholar, policymakers and activists that economic hardships and the changing climate have made sustaining a livelihood through farming increasingly untenable. There is a strong sense that something has to be done to help farmers deal with the crisis, and in recent years agricultural insurance has been presented as a possible fix for rural distress. This dissertation studies how a new agricultural insurance scheme called PMFBY becomes part of everyday social interactions and experiences. Insurance companies often assert that quantified procedures can accurately - and fairly - calculate the extent of agricultural risk, attach a price tag to it and protect against it. Can quantification really be the antidote to crisis? To answer this question I explore how insurance numbers translate to the everyday experiences of rural people in central Maharashtra. I find that, when seen from the perspective of those encountering them in their daily lives, the numbers are anything but straightforward. The effects of quantification were often arbitrary, and despite promises of transparency, they had a tendency to obscure rather than clarify. In short, the numbers turned out to be inconsistent and ambiguous. The dissertation describes how people attempt to make sense of this ambiguity through their moral understandings. It focusses on the (often heated) discussions, the collective pondering such discussions led to, the personal dilemmas it posed as well as the dreams and aspirations numbers became entwined with. I explore how such quandaries unfold and argue that a focus on the morality of quantification brings to light the social life of numbers beyond their 'objective' factuality. Show less
In dit proefschrift legt Wiersma uit hoe Plato's idee van de democratische mens nog steeds herkenbaar is als probleem voor onze eigen tijd. Hij schetst aan de hand van klassieke en christelijke... Show moreIn dit proefschrift legt Wiersma uit hoe Plato's idee van de democratische mens nog steeds herkenbaar is als probleem voor onze eigen tijd. Hij schetst aan de hand van klassieke en christelijke denkers een alternatief: de aristocratische mens. Voorts laat hij zien hoe de onderwijsfilosofie van de traditionele artes liberales een belangrijke rol kunnen spelen in de transitie van democratisch mens naar aristocratisch mens. Hierin is niet alleen het curriculum van groot belang maar vooral ook de rol van de docent. Show less
BackgroundDiabetes mellitus is one of the most common chronic diseases in childhood. With more advanced care options including ever-evolving technology, allocation of resources becomes increasingly... Show moreBackgroundDiabetes mellitus is one of the most common chronic diseases in childhood. With more advanced care options including ever-evolving technology, allocation of resources becomes increasingly important to guarantee equal care for all. Therefore, we investigated healthcare resource utilization, hospital costs, and its determinants in Dutch children with diabetes.MethodsWe conducted a retrospective, observational analysis with hospital claims data of 5,474 children with diabetes mellitus treated in 64 hospitals across the Netherlands between 2019–2020.ResultsTotal hospital costs were €33,002,652 per year, and most of these costs were diabetes-associated (€28,151,381; 85.3%). Mean annual diabetes costs were €5,143 per child, and treatment-related costs determined 61.8%. Diabetes technology significantly increased yearly diabetes costs compared to no technology: insulin pumps € 4,759 (28.7% of children), Real-Time Continuous Glucose Monitoring € 7,259 (2.1% of children), and the combination of these treatment modalities € 9,579 (27.3% of children). Technology use increased treatment costs significantly (5.9 – 15.3 times), but lower all-cause hospitalisation rates were observed. In all age groups, diabetes technology use influenced healthcare consumption, yet in adolescence usage decreased and consumption patterns changed.ConclusionsThese findings suggest that contemporary hospital costs of children with diabetes of all ages are driven primarily by the treatment of diabetes, with technology use as an important additive factor. The expected rise in technology use in the near future underlines the importance of insight into resource use and cost-effectiveness studies to evaluate if improved outcomes balance out these short-term costs of modern technology. Show less
Rigotti, C.; Puttick, A.; Fosch Villaronga, E.; Kurpicz-Briki, M. 2023
The new connectivity, through mobile phones, social media, and wireless internet, is an agent in social change in the drylands. In this chapter, we present four case studies: the introduction of... Show moreThe new connectivity, through mobile phones, social media, and wireless internet, is an agent in social change in the drylands. In this chapter, we present four case studies: the introduction of mobile apps in Mongolia and Kenya, the role of mobile telephony in the Sahel, and the introduction of online learning in the Negev Desert. Each of these case studies develops an argument around the role of connectivity in ‘giving a voice’ to the people living in drylands. Indeed, as the studies show, the new technology of communication is a resource for such populations, especially when we focus on the benefits of improved communication and access to information. However, the effective use of such a resource is hampered by the lack of knowledge of dryland dynamics among the developers of the new technology and by the imposed power relations of the State. Also, the technology may follow its own pathway, being appropriated by the population in unexpected ways and creating new power relations that may also lead to conflict. Show less
Background Hip and pelvic fractures do commonly occur among older adults. This pilot study aimed to evaluate the effect of introduction of the WOLK hip airbag on the incidence of hip fractures.... Show moreBackground Hip and pelvic fractures do commonly occur among older adults. This pilot study aimed to evaluate the effect of introduction of the WOLK hip airbag on the incidence of hip fractures. Methods A retrospective study was performed among 969 participants residing within 11 long-term care facilities for older patients, belonging to one large healthcare organization in The Netherlands. The intervention concerned application of 45 WOLK hip-airbags, distributed among selected residents of the long-term care facilities. Inclusion criteria; physically active participants with a pelvic circumference between 90-125 cm able to wear the hip airbag. Exclusion criteria; participants who continuously removed the hip airbag themselves or participants who depended on a wheelchair for mobility. Main outcome measures were the occurrence of falls and hip, pelvic and other fractures. Results The incidence of hip and pelvic fractures declined from 3.3/100 person years to 1.8/100 person years during the study for an Incidence Rate Ratio (IRR) of 0.55 (95% confidence interval (95%CI) 0.34-0.87) in the entire study population. The incidence of other fractures did not decline during the study period (IRR 0.72;95%CI 0.37-1.40). The incidence of falls declined to some extent during the study (IRR 0.88; 95%CI 0.83-0.93). Conclusions After introduction of the WOLK hip airbag a reduction of the incidence of hip and pelvic fractures by almost half was observed in older patients residing in long-term care facilities, even though only 45 hip airbags were distributed among the 969 residents. As selection bias cannot be ruled out in this study, the results of this pilot study warrant replication by a future clinical trial to determine true effectiveness of this intervention. Show less
Wewerinke-Singh, M.J.; De Jong, I.; Adelman, S.; Biermann, F.; Burns, W.; Cramer, W.; ... ; Leach, M. 2022
In April 2019, the UK Government’s DCMS released its White Paper for ‘Online Harms’, which would establish in law a new duty of care towards users by platforms to be overseen by an independent... Show moreIn April 2019, the UK Government’s DCMS released its White Paper for ‘Online Harms’, which would establish in law a new duty of care towards users by platforms to be overseen by an independent regulator. Our earlier research outlines how we got to this point, sets out what the White Paper proposes, and criticises its key aspects. Our objections and criticism remain applicable to the UK Government’s Online Safety Bill. The Parliament is now scrutinising the Bill. The House of Lords Report sparked some optimism that the scrutiny could address critical concerns around free speech in particular. The Draft Online Safety Bill Joint Committee Report, however, suggest otherwise. This paper returns to key arguments as to why risk-based regulation and duty of care are not appropriate for policing content and expression online. We focus on the human rights implications of the Bill, in particular, the provider duties to ‘handle’ legal but harmful content. Here, we reemphasise the vague conceptualisation and nature of this harm, as well as the inadequate duties attached to it. We argue that the independence of OFCOM cannot be guaranteed. Show less
Recent technological advancements have led to the development and implementation of robotic surgery in several specialties, including neurosurgery. Our aim was to carry out a worldwide survey among... Show moreRecent technological advancements have led to the development and implementation of robotic surgery in several specialties, including neurosurgery. Our aim was to carry out a worldwide survey among neurosurgeons to assess the adoption of and attitude toward robotic technology in the neurosurgical operating room and to identify factors associated with use of robotic technology. The online survey was made up of nine or ten compulsory questions and was distributed via the European Association of the Neurosurgical Societies (EANS) and the Congress of Neurological Surgeons (CNS) in February and March 2018. From a total of 7280 neurosurgeons who were sent the survey, we received 406 answers, corresponding to a response rate of 5.6%, mostly from Europe and North America. Overall, 197 neurosurgeons (48.5%) reported having used robotic technology in clinical practice. The highest rates of adoption of robotics were observed for Europe (54%) and North America (51%). Apart from geographical region, only age under 30, female gender, and absence of a non-academic setting were significantly associated with clinical use of robotics. The Mazor family (32%) and ROSA (26%) robots were most commonly reported among robot users. Our study provides a worldwide overview of neurosurgical adoption of robotic technology. Almost half of the surveyed neurosurgeons reported having clinical experience with at least one robotic system. Ongoing and future trials should aim to clarify superiority or non-inferiority of neurosurgical robotic applications and balance these potential benefits with considerations on acquisition and maintenance costs. Show less
The work of Fernand Braudel (1949) should have revolutionized the way archaeology conceptualizes temporal scales and builds chronological narratives. Even though Braudel’s general views did impact... Show moreThe work of Fernand Braudel (1949) should have revolutionized the way archaeology conceptualizes temporal scales and builds chronological narratives. Even though Braudel’s general views did impact archaeological theory deeply, his three different time-scales, together with insights into duration as the inner dialectic between different temporalities, remain neglected in archaeological practice.Nowadays, ceramic chronology building in archaeology still relies on two main variables: time-space and pottery styles. This book aims to challenge this paradigm and propose a new way for narrating vital chronologies. The point of departure for this endeavor consists of a longue durée geographical unit, the valley of Juigalpa, in central Nicaragua. Through a view of materials—and especially ceramics—as complex and embodied palimpsests, as the bundling of unfolding traces; a chronology including five different intervals based on ceramic technologies is presented, from the first traces of human practices in 300 CE through to the present. Show less
Background Recent technological advances have led to the development and implementation of machine learning (ML) in various disciplines, including neurosurgery. Our goal was to conduct a... Show moreBackground Recent technological advances have led to the development and implementation of machine learning (ML) in various disciplines, including neurosurgery. Our goal was to conduct a comprehensive survey of neurosurgeons to assess the acceptance of and attitudes toward ML in neurosurgical practice and to identify factors associated with its use. Methods The online survey consisted of nine or ten mandatory questions and was distributed in February and March 2019 through the European Association of Neurosurgical Societies (EANS) and the Congress of Neurosurgeons (CNS). Results Out of 7280 neurosurgeons who received the survey, we received 362 responses, with a response rate of 5%, mainly in Europe and North America. In total, 103 neurosurgeons (28.5%) reported using ML in their clinical practice, and 31.1% in research. Adoption rates of ML were relatively evenly distributed, with 25.6% for North America, 30.9% for Europe, 33.3% for Latin America and the Middle East, 44.4% for Asia and Pacific and 100% for Africa with only two responses. No predictors of clinical ML use were identified, although academic settings and subspecialties neuro-oncology, functional, trauma and epilepsy predicted use of ML in research. The most common applications were for predicting outcomes and complications, as well as interpretation of imaging. Conclusions This report provides a global overview of the neurosurgical applications of ML. A relevant proportion of the surveyed neurosurgeons reported clinical experience with ML algorithms. Future studies should aim to clarify the role and potential benefits of ML in neurosurgery and to reconcile these potential advantages with bioethical considerations. Show less
This thesis focused on the evaluation of an eHealth intervention for cognitive stroke rehabilitation and the perspectives of different stakeholders on the uptake of eRehabilitation in general. The... Show moreThis thesis focused on the evaluation of an eHealth intervention for cognitive stroke rehabilitation and the perspectives of different stakeholders on the uptake of eRehabilitation in general. The studies included in this thesis showed that there was no overall effect of an online brain training programme on cognitive functioning of patients with stroke. Only performances on cognitive function tests that were similar to the games included in the intervention improved, no near transfer effect was found. Moreover, usage of the training was suboptimal and not all of the patients were able to complete it. It would appear important to support stroke patients with CBCR training, since training is not well used by all patients. However, regarding patients’ ICT readiness, wishes and requirements it was also found that a relatively large amount of patients in rehabilitation wish to incorporate ICT in their rehabilitation treatment. In addition, developing tailored implementation strategies to implement eHealth in the bachelor curriculum of health professionals, based on the identified barriers and facilitators in this thesis is highly relevant to make sure that future health professionals are able to work with eHealth. Show less
Much attention has been paid to the exchange of objects, ideas, and people in the Caribbean. Networks of interaction connected local communities across pan-regional scales, shaping indigenous... Show moreMuch attention has been paid to the exchange of objects, ideas, and people in the Caribbean. Networks of interaction connected local communities across pan-regional scales, shaping indigenous socio-political integrations and their responses in colonial situations. This work examines the poorly understood cultural trajectories and reinterpretations of celts and paraphernalia exchanged in the late pre-colonial and early colonial Dominican Republic and the Windward Islands. Reconstructing the biographies of these artefacts traces their ‘object life’ sequences from start to finish. The dissertation principally applies microscopic wear trace analysis supported by experimental archaeology to examine the manufacturing technology and use of the studied objects. Integrated with contextual analysis and provenance data, the reconstructed biographies form a window into cross-cultural patterns of artefact production, function, and circulation. These are interpreted following a relational perspective adopted from Amerindian ontologies. The exchange of ground stone celts is shown to be closely interrelated with regional network structures. Though only specific communities specialised in production activities, requisite technical knowledge was widely shared. Once acquired, even exotic rocks and tool types were polished, hafted, and used in conventional ways. Conversely, the cultural and social values of most carved shell and bone paraphernalia are foremost expressed in local technological traditions and the preservation of inherited practices. These findings produce a better understanding of indigenous material culture and its relation to social interactions in the pre- and early colonial Caribbean. Show less
Controlling mobilities in the EU is increasingly depending on information and information technology. Abolishing permanent border control between Schengen Member States has created the dilemma... Show moreControlling mobilities in the EU is increasingly depending on information and information technology. Abolishing permanent border control between Schengen Member States has created the dilemma of economic benefits versus security issues of the freedom of movement. The solution to this issue is often sought in the development and implementation of information technology. While expectations of information and information technologies are high, empirical research on how such border technologies are used in practice is scarce and subsequently little is known about to what extent the envisioned benefits are actually achieved. This dissertation aims to gain more insight in the use of information and information technology in controlling mobilities in intra-Schengen border areas by using a case study of the Mobile Security Monitor as carried out by the Royal Netherlands Marechaussee. Through extensive observations of border checks, focus groups with border patrol officers, interviews with Marechaussee staff members, discourse analysis of political debates and policy documentation and quantitative data, this dissertation aims to gain insight in the decision-making process on the political, organizational and street-level and the role of information and information technology therein. Show less
This study is an investigation of the relationship between Sri Lankan engineering and Sinhala nationalism, the nationalism of the Sinhalese, the majority community living in the island. It... Show moreThis study is an investigation of the relationship between Sri Lankan engineering and Sinhala nationalism, the nationalism of the Sinhalese, the majority community living in the island. It attempts to understand why the Sinhalese regard themselves as masters in engineering although the actual level of technological development of the island remains very low, and how this particular narrative of Sri Lankan engineering has been held to be legitimate over a long period of time. In order to achieve the above objective this study concentrates on three sites: the Aberdeen Laxapana Hydro Electric Scheme (1900-1936) and the Accelerated Mahaweli Development Project (1978-1985), two important engineering projects commissioned during the twentieth century, as the first two sites, and as the third site - a mythical engineering site, the recent surge of interest among the Sinhalese in Ravana, the ancient king and his technological dynasty (2000-2016). Show less
