Search results for: Carolijn Van Noort

Authors: Carolijn Van Noort

Abstract:

The aim of this research is to understand how the emerging power bloc BRICS employs infrastructure development narratives to construct a new world order. BRICS is an international body consisting of five emerging countries that collaborate on economic and political issues: Brazil, Russia, India, China, and South Africa. This study explores the projection of infrastructure development narratives through an analysis of BRICS’ attention to infrastructure investment and financing, its support of the New Partnership on African Development and the establishment of the New Development Bank in Shanghai. The theory of Strategic Narratives is used to explore BRICS’ commitment to infrastructure development and to distinguish three layers: system narratives (BRICS as a global actor to propose development reform), identity narratives (BRICS as a collective identity joining efforts to act upon development aspirations) and issue narratives (BRICS committed to a range of issues of which infrastructure development is prominent). The methodology that is employed is a narrative analysis of BRICS’ official documents, media statements, and website imagery. A comparison of these narratives illuminates tensions at the three layers and among the five member states. Identifying tensions among development infrastructure narratives provides an indication of how policymaking for infrastructure development could be improved. Subsequently, it advances BRICS’ ability to act as a global actor to construct a new world order.

Keywords: BRICS, emerging powers, infrastructure development, strategic narratives

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Authors: Anne Heirman, Vincent van der Noort, Rob van Son, Marije Petersen, Lisette van der Molen, Gyorgy Halmos, Richard Dirven, Michiel van den Brekel

Abstract:

Objective: Voice prosthesis leakage significantly impacts laryngectomies patients' quality of life, causing insecurity and frequent unplanned hospital visits and costs. In this study, the concept of prophylactic voice prosthesis replacement was explored to prevent leakages. Study Design: A retrospective cohort study. Setting: Tertiary hospital. Methods: Device lifetimes and voice prosthesis replacements of a retrospective cohort, including all patients with laryngectomies between 2000 and 2012 in the Netherlands Cancer Institute, were used to calculate the number of needed voice prostheses per patient per year when preventing 70% of the leakages by prophylactic replacement. Various strategies for the timing of prophylactic replacement were considered: Adaptive strategies based on the individual patient’s history of replacement and fixed strategies based on the results of patients with similar voice prosthesis or treatment characteristics. Results: Patients used a median of 3.4 voice prostheses per year (range 0.1-48.1). We found a high inter-and intrapatient variability in device lifetime. When applying prophylactic replacement, this would become a median of 9.4 voice prostheses per year, which means replacement every 38 days, implying more than six additional voice prostheses per patient per year. The individual adaptive model showed that preventing 70% of the leakages was impossible for most patients, and only a median of 25% can be prevented. Monte-Carlo simulations showed that prophylactic replacement is not feasible due to the high Coefficient of Variation (Standard Deviation/Mean) in device lifetime. Conclusion: Based on our simulations, prophylactic replacement of voice prostheses is not feasible due to high inter-and intrapatient variation in device lifetime.

Keywords: voice prosthesis, voice rehabilitation, total laryngectomy, prosthetic leakage, device lifetime

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