Tactus Verslavingszorg

Abstract Background: Pectus carinatum is a congenital chest wall deformity characterized by anterior protrusion of the sternum and costal cartilages. Although less common than pectus excavatum, it represents an important problem because of its cosmetic and psychosocial effects. Recently, non-invasive methods, especially dynamic compression bracing, have become more prominent in treatment. Methods: In this retrospective study, the records of 52 pediatric patients who were diagnosed with pectus carinatum and treated with dynamic compression bracing between 2018 and 2023 were examined. Demographic data, type of deformity, treatment duration, daily brace usage, outcomes, and complications were evaluated. Statistical analyses were performed to determine factors affecting treatment success. Results: Of the 87 patients, 71 (81.6%) were male and 16 (18.4%) were female. The mean age was 14.2 ± 2.1 years. The mean body mass index was 21.3 ± 2.4 kg/m². The mean duration of bracing treatment was 11.4 ± 4.2 months, and the mean daily brace usage was 14.5 ± 2.8 hours. Treatment success was achieved in 76% of patients, partial improvement in 18%, and minimal or no improvement in 6%. Early initiation of treatment (≤ 14 years) and daily usage of more than 12 hours were found to be significant factors for treatment success (p < 0.05). Mild skin irritation occurred in 9% of patients, but no severe complications were observed. Conclusions: Dynamic compression bracing is a safe and effective treatment option for pectus carinatum in pediatric patients. Early initiation of treatment and strict daily compliance are important factors that increase success.

ABSTRACT Introduction Take it Personal!+ is a treatment program for individuals with Mild Intellectual Disability or Borderline Intellectual Functioning (MID-BIF) and Substance Use Disorder (SUD). It is supported by a mobile health application (mHealth), and researchers found it can reduce Substance Use (SU). Aims: This study aimed to explore the usability of the treatment program in as experienced by clients and their confidants. Methods We conducted post-treatment, semi-structured interviews with clients (n = 8) and their confidants (n = 8). We coded transcripts according to thematic analysis and using inductive and deductive methods. Subsequently, we analyzed connections between the codes and grouped them into themes using axial coding. Results Overall clients and confidants experienced the treatment program as usable, and most mentioned the program helped to reduce SU. The clients and confidants reported the presence of a confidant was helpful. Some clients and confidants reported the mHealth application was helpful. Components that were perceived as effective were self-control skills, daily registration exercise and discussing quantity of SU non-judgingly. Perceived impeding factors were video calling and a non-supportive network. Conclusion This study shows that Take it Personal!+ is an useable treatment program for individuals with MID-BIF and SUD, that helps to decrease their self-reported SU. Nevertheless, there is room for improvement for further adapting the treatment, which will be discussed.

This paper explores the integration of green business practices within small and medium-sized enterprises (SMEs) as a pathway toward sustainable development. SMEs play a pivotal role in economic growth, yet their environmental impact is often overlooked, with resource limitations posing significant challenges to adopting sustainable practices. This study examines the objectives, motivations, and barriers faced by SMEs in implementing green business practices and evaluates the broader implications for sustainable development. The research identifies key green practices such as waste reduction, energy efficiency, and sustainable supply chain management, highlighting their potential to reduce environmental footprints while enhancing operational efficiency and competitiveness. Findings indicate that while resource constraints and limited access to sustainable technologies remain significant obstacles, SMEs adopting green practices experience long-term benefits, including cost savings, improved market positioning, and compliance with evolving regulatory demands. Additionally, this paper underscores the importance of policy support, financial incentives, and collaborative networks in facilitating the transition toward greener operations in the SME sector. The study concludes that embracing green business practices not only contributes to environmental stewardship but also positions SMEs as critical drivers of sustainable development. Through strategic adaptation and support, SMEs can align their business objectives with global sustainability goals, fostering resilient economies that prioritize ecological and social well-being. Keywords: Sustainable Development, Small and Medium-Sized Enterprises (SMEs), Green Practices, Responsible Consumption, Climate Action, Economic Growth, Circular Economy, Green Finance, Digital Technologies, Environmental Regulations, Sustainability Certification, Resource Efficiency, Competitive Advantage, Industry Partnerships, Operational Resilience.

This comprehensive review delves into the critical intersection of transparent reporting and equity within the realm of mortgage lending. With the housing market serving as a cornerstone of economic stability and social mobility, the equitable distribution of mortgage loans is paramount for fostering inclusive growth and mitigating systemic disparities. The paper scrutinizes existing literature, regulatory frameworks, and industry practices to assess the extent to which transparency and equity are upheld in mortgage lending processes. By examining key metrics such as loan approval rates, interest rates, and access to credit, this review sheds light on persistent inequities and identifies potential avenues for improvement. Additionally, it explores the role of technology, data analytics, and policy interventions in promoting transparency and equity across various stages of the lending lifecycle. Ultimately, this review underscores the urgent need for concerted efforts from policymakers, financial institutions, and stakeholders to enhance transparency and promote equity in mortgage lending practices. The pursuit of transparent reporting and equity in mortgage lending stands as a cornerstone of fair and accessible housing finance systems globally. This comprehensive review synthesizes current research, regulatory frameworks, and industry practices to illuminate the intricate dynamics shaping mortgage lending equity and transparency. Through a nuanced analysis of factors such as credit scoring mechanisms, discriminatory practices, and regulatory oversight, the review identifies persistent challenges and emerging trends within the mortgage lending landscape. Furthermore, it investigates the potential impact of socioeconomic factors, demographic shifts, and technological advancements on the equitable distribution of mortgage credit. By elucidating the linkages between transparency, equity, and financial stability, this review offers valuable insights for policymakers, practitioners, and researchers seeking to foster more inclusive and resilient mortgage markets. In conclusion, the review calls for concerted action and collaborative initiatives aimed at promoting transparency and equity as foundational principles in mortgage lending practices.

This literature review critically evaluates the fairness of credit scoring models concerning mortgage accessibility for under-reserved populations. The review scrutinizes a diverse range of scholarly articles, reports, and empirical studies spanning various disciplines, including finance, economics, sociology, and public policy. It examines the methodologies, findings, and limitations of existing research to illuminate the multifaceted dimensions of credit scoring fairness and its implications for mortgage accessibility. Firstly, the review outlines the conceptual framework of credit scoring fairness, emphasizing the importance of equality, transparency, and accountability in credit assessment processes. It explores the evolution of credit scoring models and their impact on mortgage lending practices, particularly for historically marginalized communities such as racial minorities, low-income households, and individuals with limited credit histories. Secondly, the review analyzes the methodologies employed in evaluating the fairness of credit scoring models. It identifies key metrics and statistical techniques used to assess disparities in mortgage approval rates, interest rates, and loan terms across demographic groups. Thirdly, the review synthesizes empirical evidence on the extent and persistence of disparities in mortgage accessibility for under-reserved populations. It highlights systemic barriers, including discriminatory lending practices, redlining, and institutionalized biases embedded within credit scoring models. Fourthly, the review discusses the implications of credit scoring fairness for financial inclusion, social equity, and economic mobility. It underscores the need for innovative policy interventions, industry best practices, and consumer education initiatives to address systemic inequities in mortgage lending and promote inclusive homeownership opportunities for under-reserved, Finally, this literature review offers a comprehensive overview of the fairness of credit scoring models in the context of mortgage accessibility for under-reserved populations. By synthesizing empirical evidence, theoretical frameworks, and policy implications, it contributes to a deeper understanding of the challenges and opportunities in promoting equitable access to homeownership and financial security for all.

This paper proposes a groundbreaking theoretical model specifically designed for the FMCG sector, focusing on optimizing supply chain dynamics to balance operational efficiency with customer satisfaction. Drawing on hands-on strategies and problem-solving abilities, the framework aims to offer practical solutions for common challenges faced by FMCG operations managers, such as inventory management, demand forecasting, and efficient resource allocation. The fast-moving consumer goods (FMCG) industry is characterized by intense competition, short product life cycles, and rapidly changing consumer preferences. In this challenging environment, optimizing supply chain dynamics is crucial for FMCG companies to achieve operational efficiency and enhance customer satisfaction. This concept paper presents a novel framework for integrating operational efficiency and customer satisfaction in FMCG supply chains, aiming to provide insights and strategies for FMCG companies to improve their supply chain performance. The framework emphasizes the importance of aligning supply chain strategies with customer needs and preferences. By focusing on key areas such as inventory management, distribution network efficiency, and technology integration, FMCG companies can improve their supply chain agility and responsiveness. Additionally, the framework highlights the importance of leveraging data analytics and technology to enhance supply chain visibility and decision-making. Implementing the framework requires collaboration among stakeholders, including suppliers, manufacturers, distributors, and retailers. By working together to optimize supply chain processes and enhance customer service, FMCG companies can gain a competitive advantage in the marketplace. Overall, the framework offers a comprehensive approach to optimizing FMCG supply chain dynamics, with the ultimate goal of improving operational efficiency, reducing costs, and enhancing customer satisfaction.
 Keywords: FMCG, Supply Chain, Customers, Framework.

Quatre généraux alliés, siégeant côte à côte au sein du comité militaire de l’ otan , se sont prêtés au jeu d’une définition du mot « vaincre ». Loin des définitions académiques, leur analyse révèle le caractère profondément paradoxal de cette notion. Finalement, qu’est-ce que vaincre ?

People with mild to borderline intellectual disability (MBID; IQ=50-85) are at risk for developing an alcohol use disorder (AUD). One factor contributing to this risk is sensitivity to peer pressure. Hence, tailored trainings are needed to practice alcohol refusal in impacted patients. Immersive virtual reality (IVR) appears promising to engage patients in dialogs with virtual humans, allowing to practice alcohol refusal realistically. However, requirements for such an IVR have not been studied for MBID/AUD. This study aims to develop an IVR alcohol refusal training for patients with MBID and AUD. In this work, we cocreated our peer pressure simulation with experienced experts in addiction care. We followed the Persuasive System Design (PSD) model to develop our IVR alcohol refusal training. With 5 experts from a Dutch addiction clinic for patients with MBID, we held 3 focus groups to design the virtual environment, persuasive virtual human(s), and persuasive dialog. Subsequently, we developed our initial IVR prototype and conducted another focus group to evaluate IVR and procedures for clinical usage, resulting in our final peer pressure simulation. Our experts described visiting a friend at home with multiple friends as the most relevant peer pressure situation in the clinical setting. Based on the identified requirements, we developed a social-housing apartment with multiple virtual friends present. Moreover, we embedded a virtual man with generic appearance to exert peer pressure using a persuasive dialog. Patients can respond to persuasive attempts by selecting (refusal) responses with varying degrees of risk for relapse in alcohol use. Our evaluation showed that experts value a realistic and interactable IVR. However, experts identified lacking persuasive design elements, such as paralanguage, for our virtual human. For clinical usage, a user-centered customization is needed to prevent adverse effects. Further, interventions should be therapist delivered to avoid try-and-error in patients with MBID. Lastly, we identified factors for immersion, as well as facilitators and barriers for IVR accessibility. Our work establishes an initial PSD for IVR for alcohol refusal trainings in patients with MBID and AUD. With this, scholars can create comparable simulations by performing an analogous cocreation, replicate findings, and identify active PSD elements. For peer pressure, conveying emotional information in a virtual human's voice (eg, paralanguage) seems vital. However, previous rapport building may be needed to ensure that virtual humans are perceived as cognitively capable entities. Future work should validate our PSD with patients and start developing IVR treatment protocols using interdisciplinary teams.

This paper presents an approach for approximating the reachable space of robotic manipulators based on convex polytopes. The proposed approach predicts the reachable space over a given time horizon based on the robot's actuation limits and kinematic constraints. The approach is furthermore extended to integrate the robot's environment, assuming it can be expressed in a form of linear constraints, and to account for the robot's link geometry.The accuracy of the proposed method is evaluated using simulations of robot's nonlinear dynamics and it is compared against the cartesian space limits, usually provided by manufacturers in standard datasheets.The accuracy analysis results show that the proposed method has good performance for the time horizons up to 250ms, encapsulating most of the simulated robot's reachable space while maintaining comparable volume. For a 7 dof robot, the method has an average execution time of 50ms, independent of the horizon time, potentially enabling real-time applications.