Kidney and urogenital abnormalities in Down syndrome: a meta-analysis.

BACKGROUND: Reviews on Down syndrome do not or only marginally address the issue of kidney and urogenital tract abnormalities, and lower urinary tract dysfunctions. Hence, we performed a meta-analysis of the literature.  METHODS: A literature search was undertaken in the Library of Medicine, Web of Science and Excerpta Medica. The search algorithm combined various keywords: (Down syndrome OR trisomy 21 OR mongolism) AND (kidney OR urinary tract OR bladder) AND (malformation OR dysfunction OR anomaly OR abnormality OR size). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement was used. RESULTS: Eight case-control studies were retained for the final analysis. Three studies addressed the prevalence of kidney and urogenital tract abnormalities: an increased pooled relative risk of 5.49 (95%-CI: 1.78-16.93) was observed in Down syndrome. Penile malformations, obstructive malformations (including urethral valves), dilated urinary tract system, and kidney hypodysplasia were especially common. Three reports addressed the prevalence of lower urinary tract dysfunction: an increased pooled relative risk of 2.95 (95%-CI: 1.15-7.56) was observed. Finally, an autoptic study and an ultrasound study disclosed a reduced kidney size in Down syndrome. CONCLUSIONS: This meta-analysis indicates that abnormalities of the kidney and urogenital tract, lower urinary tract dysfunctions, and a reduced kidney size present with an increased frequency in individuals with Down syndrome.

Determinants of intention to leave among nurses and physicians in a hospital setting during the COVID-19 pandemic: A systematic review and meta-analysis.

BACKGROUND: The global outbreak of COVID-19 has brought to light the profound impact that large-scale disease outbreaks can have on healthcare systems and the dedicated professionals who serve within them. It becomes increasingly important to explore strategies for retaining nurses and physicians within hospital settings during such challenging times. This paper aims to investigate the determinants of retention among nurses and physicians during the COVID-19 pandemic. METHOD: A systematic review of other potential determinants impacting retention rates during the pandemic was carried out. Secondly, a meta-analysis on the prevalence of intention to leave for nurses and physicians during the COVID-19 pandemic. FINDINGS: A comprehensive search was performed within four electronic databases on March 17 2023. Fifty-five papers were included in the systematic review, whereas thirty-three papers fulfilled the eligibility criteria for the meta-analysis. The systematic review resulted in six themes of determinants impacting intention to leave: personal characteristics, job demands, employment services, working conditions, work relationships, and organisational culture. The main determinants impacting the intention to leave are the fear of COVID-19, age, experience, burnout symptoms and support. Meta-analysis showed a prevalence of intent to leave the current job of 38% for nurses (95% CI: 26%-51%) and 29% for physicians (95% CI: 21%-39%), whereas intention to leave the profession for nurses 28% (95% CI: 21%-34%) and 24% for physicians (95% CI: 23%-25%). CONCLUSION: The findings of this paper showed the critical need for hospital managers to address the concerning increase in nurses' and physicians' intentions to leave during the COVID-19 pandemic. This intention to leave is affected by a complex conjunction of multiple determinants, including the fear of COVID-19 and the confidence in and availability of personal protective equipment. Moreover, individual factors like age, experience, burnout symptoms, and support are maintained in this review. Understanding the influence of determinants on retention during the COVID-19 pandemic offers an opportunity to formulate prospective strategies for retaining nurses and physicians within hospital settings.

Evaluating the Tobii Pro Glasses 2 and 3 in static and dynamic conditions.

Over the past few decades, there have been significant developments in eye-tracking technology, particularly in the domain of mobile, head-mounted devices. Nevertheless, questions remain regarding the accuracy of these eye-trackers during static and dynamic tasks. In light of this, we evaluated the performance of two widely used devices: Tobii Pro Glasses 2 and Tobii Pro Glasses 3. A total of 36 participants engaged in tasks under three dynamicity conditions. In the "seated with a chinrest" trial, only the eyes could be moved; in the "seated without a chinrest" trial, both the head and the eyes were free to move; and during the walking trial, participants walked along a straight path. During the seated trials, participants' gaze was directed towards dots on a wall by means of audio instructions, whereas in the walking trial, participants maintained their gaze on a bullseye while walking towards it. Eye-tracker accuracy was determined using computer vision techniques to identify the target within the scene camera image. The findings showed that Tobii 3 outperformed Tobii 2 in terms of accuracy during the walking trials. Moreover, the results suggest that employing a chinrest in the case of head-mounted eye-trackers is counterproductive, as it necessitates larger eye eccentricities for target fixation, thereby compromising accuracy compared to not using a chinrest, which allows for head movement. Lastly, it was found that participants who reported higher workload demonstrated poorer eye-tracking accuracy. The current findings may be useful in the design of experiments that involve head-mounted eye-trackers.

[What do parents know of patient rights of minors in the Netherlands?] / Wat weten ouders over de patiëntenrechten van kinderen?

INTRODUCTION: In the Netherlands, medical decision-making without parental permission is allowed from the age of 16. The aim of this study was to examine parents' knowledge of this age-based framework to discover potential knowledge gaps that hinder the communication between doctors, parents, and their children. METHODS: Survey-based research was conducted to examine parents' knowledge of the age-based framework that applies to minors in Dutch healthcare. The survey was based on 5 topics: medical diagnosis and treatment, medical advice, reproductive and sexual health services, abortion, and euthanasia. The survey was sent to 1,010 Dutch parents, aged 35-55 years, with at least one child. The data were analysed using SPSS. Percentages and means were calculated. RESULTS: Parental knowledge of the age-based framework varied depending on the topic. CONCLUSION: This study provides insights into parents' current level of knowledge of the age-based framework that applies to minors in Dutch healthcare. This information is useful in the conversation between health care professional, parents, and their children.

Clinical practice - latest insights in optimizing the care of children with Down syndrome.

An essential part of the care of children with Down syndrome is secondary screening for comorbidity. It is well known that comorbidity frequently occurs in these children. A new update of the Dutch Down syndrome medical guideline was developed to create a sound evidence base for several of these conditions. We present the latest insights and recommendations from this Dutch medical guideline which are based on the most relevant literature currently available and developed with rigorous methodology. The main focus of this revision of the guideline was on obstructive sleep apnea and other airway problems and hematologic disorders, such as transient abnormal myelopoiesis, leukemia, and thyroid disorders. Conclusion: This is a short summary of the latest insights and recommendations from the updated Dutch medical guideline for children with Down syndrome.

On Senders's Models of Visual Sampling Behavior.

OBJECTIVE: We review the sampling models described in John Senders's doctoral thesis on "visual sampling processes" via a ready and accessible exposition. BACKGROUND: John Senders left a significant imprint on human factors/ergonomics (HF/E). Here, we focus on one preeminent aspect of his career, namely visual attention. METHODS: We present, clarify, and expand the models in his thesis through computer simulation and associated visual illustrations. RESULTS: One of the key findings of Senders's work on visual sampling concerns the linear relationship between signal bandwidth and visual sampling rate. The models that are used to describe this relationship are the periodic sampling model (PSM), the random constrained sampling model (RCM), and the conditional sampling model (CSM). A recent replication study that used results from modern eye-tracking equipment showed that Senders's original findings are manifestly replicable. CONCLUSIONS: Senders's insights and findings withstand the test of time and his models continue to be both relevant and useful to the present and promise continued impact in the future. APPLICATION: The present paper is directed to stimulate a broad spectrum of researchers and practitioners in HF/E and beyond to use these important and insightful models.

Shared control versus traded control in driving: a debate around automation pitfalls.

A major question in human-automation interaction is whether tasks should be traded or shared between human and automation. This work presents reflections-which have evolved through classroom debates between the authors over the past 10 years-on these two forms of human-automation interaction, with a focus on the automated driving domain. As in the lectures, we start with a historically informed survey of six pitfalls of automation: (1) Loss of situation and mode awareness, (2) Deskilling, (3) Unbalanced mental workload, (4) Behavioural adaptation, (5) Misuse, and (6) Disuse. Next, one of the authors explains why he believes that haptic shared control may remedy the pitfalls. Next, another author rebuts these arguments, arguing that traded control is the most promising way to improve road safety. This article ends with a common ground, explaining that shared and traded control outperform each other at medium and low environmental complexity, respectively. Practitioner summary: Designers of automation systems will have to consider whether humans and automation should perform tasks alternately or simultaneously. The present article provides an in-depth reflection on this dilemma, which may prove insightful and help guide design. Abbreviations: ACC: Adaptive Cruise Control: A system that can automatically maintain a safe distance from the vehicle in front; AEB: Advanced Emergency Braking (also known as Autonomous Emergency Braking): A system that automatically brakes to a full stop in an emergency situation; AES: Automated Evasive Steering: A system that automatically steers the car back into safety in an emergency situation; ISA: Intelligent Speed Adaptation: A system that can limit engine power automatically so that the driving speed does not exceed a safe or allowed speed.

Parental Opinions on Medical Decision-Making in Adolescence: A Case-Based Survey.

OBJECTIVE: Patient trust and consent are complex topics for health care workers in pediatrics, specifically when relating to adolescent's legal status. In the context of medical decisions, not much work has been performed to understand the opinion of parents on health care decision-making, especially on confidentiality concerning their adolescent children. The purpose of this research was to assess the parental opinions on these decisions and the influence of different perspectives. METHODS: We used a case-based methodology to assess parental opinions on fictional medical decisions. A survey was provided to parents in 2 pediatric outpatient departments in Belgium and the Netherlands. The survey contained cases regarding medical care related to confidentiality and consent about which participants gave their opinion. RESULTS: In total, 222 surveys were completed. Overall, most parents would allow an adolescent to make his/her own decision (58.6%-70.4%), except in the case of confidentiality on alcohol-related trauma (28.9%). The results show a significant difference in how parents responded when answering from the parental perspective or adolescents' perspective. They granted significantly more authority to the adolescent in the latter view. CONCLUSION: Our study shows that parents who were confronted with cases from an adolescent perspective were significantly more likely to give the patient authority. In addition, the medical issue and context influence how the parents responded. These data provide insight into the parental opinions and could lead to more evidence-based frameworks for shared medical decision-making of adolescents and their parents.

How should external human-machine interfaces behave? Examining the effects of colour, position, message, activation distance, vehicle yielding, and visual distraction among 1,434 participants.

External human-machine interfaces (eHMIs) may be useful for communicating the intention of an automated vehicle (AV) to a pedestrian, but it is unclear which eHMI design is most effective. In a crowdsourced experiment, we examined the effects of (1) colour (red, green, cyan), (2) position (roof, bumper, windshield), (3) message (WALK, DON'T WALK, WILL STOP, WON'T STOP, light bar), (4) activation distance (35 or 50 m from the pedestrian), and (5) the presence of visual distraction in the environment, on pedestrians' perceived safety of crossing the road in front of yielding and non-yielding AVs. Participants (N = 1434) had to press a key when they felt safe to cross while watching a random 40 out of 276 videos of an approaching AV with eHMI. Results showed that (1) green and cyan eHMIs led to higher perceived safety of crossing than red eHMIs; no significant difference was found between green and cyan, (2) eHMIs on the bumper and roof were more effective than eHMIs on the windshield, (3) for yielding AVs, perceived safety was higher for WALK compared to WILL STOP, followed by the light bar; for non-yielding AVs, a red bar yielded similar results to red text, (4) for yielding AVs, a red bar caused lower perceived safety when activated early compared to late, whereas green/cyan WALK led to higher perceived safety when activated late compared to early, and (5) distraction had no significant effect. We conclude that people adopt an egocentric perspective, that the windshield is an ineffective position, that the often-recommended colour cyan may have to be avoided, and that eHMI activation distance has intricate effects related to onset saliency.

Why human factors science is demonstrably necessary: historical and evolutionary foundations.

We review the theoretical foundation for the need for human factors science. Over the past 2.8 million years, humans and tools have co-evolved. However, in the last century, technology is introduced at a rate that exceeds human evolution. The proliferation of computers and, more recently, robots, introduces new cognitive demands, as the human is required to be a monitor rather than a direct controller. The usage of robots and artificial intelligence is only expected to increase, and the present COVID-19 pandemic may prove to be catalytic in this regard. One way to improve overall system performance is to 'adapt the human to the machine' via task procedures, operator training, operator selection, a Procrustean mandate. Using classic research examples, we demonstrate that Procrustean methods can improve performance only to a limited extent. For a viable future, therefore, technology must adapt to the human, which underwrites the necessity of human factors science. Practitioner Summary: Various research articles have reported that the science of Human Factors is of vital importance in improving human-machine systems. However, what is lacking is a fundamental historical outline of why Human Factors is important. This article provides such a foundation, using arguments ranging from pre-history to post-COVID.

Replicating five pupillometry studies of Eckhard Hess.

Several papers by Eckhard Hess from the 1960s and 1970s report that the pupils dilate or constrict according to the interest value, arousing content, or mental demands of visual stimuli. However, Hess mostly used small sample sizes and undocumented luminance control. In a first experiment (N = 182) and a second preregistered experiment (N = 147), we replicated five studies of Hess using modern equipment. Our experiments (1) did not support the hypothesis of gender differences in pupil diameter change with respect to baseline (PC) when viewing stimuli of different interest value, (2) showed that solving more difficult multiplications yields a larger PC in the seconds before providing an answer and a larger maximum PC, but a smaller PC at a fixed time after the onset of the multiplication, (3) did not support the hypothesis that participants' PC mimics the pupil diameter in a pair of schematic eyes but not in single-eyed or three-eyed stimuli, (4) did not support the hypothesis of gender differences in PC when watching a video of a male trying to escape a mob, and (5) supported the hypothesis that arousing words yield a higher PC than non-arousing words. Although we did not observe consistent gender differences in PC, additional analyses showed gender differences in eye movements towards erogenous zones. Furthermore, PC strongly correlated with the luminance of the locations where participants looked. Overall, our replications confirm Hess's findings that pupils dilate in response to mental demands and stimuli of an arousing nature. Hess's hypotheses regarding pupil mimicry and gender differences in pupil dilation did not replicate.