1 Maternity services across Europe during the pandemic has undergone changes to limit virus transmission; however, many changes are not evidence-based. 2 Although these changes were introduced to keep women, babies and healthcare staff safe, the exclusion of companions and the separation of mothers and babies is particularly antithetical to a human rights-based approach to quality care. 3 A poll of COST Action 18211 network members showed that inconsistency in the application of restrictions was high, and there were significant deviations from the recommendations of authoritative bodies. 4 Concerns have emerged that restrictions in practice may have longer term negative impacts on mothers and their families and, in particular, may impact on the long-term health of babies. 5 When practice changes deviate from evidence-based frameworks that underpin quality care, they must be monitored, appraised and evaluated to minimise unintended iatrogenic effects.
Due to the ageing population, the prevalence of musculoskeletal disorders will continue to rise, as well as healthcare expenditure. To overcome these increasing expenditures, integration of orthopaedic care should be stimulated. The Primary Care Plus (PC+) intervention aimed to achieve this by facilitating collaboration between primary care and the hospital, in which specialised medical care is shifted to a primary care setting. The present study aims to evaluate the referral decision following orthopaedic care in PC+ and in particular to evaluate the influence of diagnostic tests on this decision. Therefore, retrospective monitoring data of patients visiting PC+ for orthopaedic care was used. Data was divided into two periods; P1 and P2. During P2, specialists in PC+ were able to request additional diagnostic tests (such as ultrasounds and MRIs). A total of 2,438 patients visiting PC+ for orthopaedic care were included in the analysis. The primary outcome was the referral decision following PC+ (back to the general practitioner (GP) or referral to outpatient hospital care). Independent variables were consultation- and patient-related predictors. To describe variations in the referral decision, logistic regression modelling was used. Results show that during P2, significantly more patients were referred back to their GP. Moreover, the multivariable analysis show a significant effect of patient age on the referral decision (OR 0.86, 95% CI = 0.81– 0.91) and a significant interaction was found between the treating specialist and the period (p = 0.015) and between patient’s diagnosis and the period (p < 0.001). Despite the significant impact of the possibility of requesting additional diagnostic tests in PC+, it is important to discuss the extent to which the availability of diagnostic tests fits within the vision of PC+. In addition, selecting appropriate profiles for specialists and patients for PC+ are necessary to further optimise the effectiveness and cost of care.
Perceptions and values of care professionals are critical in successfully implementing technology in health care. The aim of this study was threefold: (1) to explore the main values of health care professionals, (2) to investigate the perceived influence of the technologies regarding these values, and (3) the accumulated views of care professionals with respect to the use of technology in the future. In total, 51 professionals were interviewed. Interpretative phenomenological analysis was applied. All care professionals highly valued being able to satisfy the needs of their care recipients. Mutual inter-collegial respect and appreciation of supervisors was also highly cherished. The opportunity to work in a careful manner was another important value. Conditions for the successful implementation of technology involved reliability of the technology at hand, training with team members in the practical use of new technology, and the availability of a help desk. Views regarding the future of health care were mainly related to financial cut backs and with a lower availability of staff. Interestingly, no spontaneous thoughts about the role of new technology were part of these views. It can be concluded that professionals need support in relating technological solutions to care recipients' needs. The role of health care organisations, including technological expertise, can be crucial here.
This project addresses the critical issue of staff shortages and training inefficiencies in the hospitality industry, particularly focusing on the hotel sector. It connects with the urgent need for innovative, and effective training solutions to equip (inexperienced) staff with hospitality skills, thereby improving service quality and sustainable career prospects in the hotel industry. The project develops and tests immersive technologies (augmented and virtual reality, AR/VR) tailored to meet specific training needs of hotels. Traditional training methods such as personal trainings, seminars, and written manuals are proving inadequate in terms of learning effectiveness and job readiness, leading to high working pressure and poor staff well-being. This project aims to break this cycle by co-creating immersive training methods that promise to be more engaging and effective. Hotelschool The Hague has initiated steps in this direction by exploring AR and VR technologies for hotel staff training. This project builds on these efforts, aiming to develop accessible, immersive training tools specifically designed for the hotel sector. Specifically, this project aims to explore the effectiveness of these immersive trainings, an aspect largely overlooked in the rapid development of immersive technology solutions. The central research question is: How do immersive AR and VR training methods impact job readiness and learning effectiveness in the hotel sector? The one-year KIEM project period involves co-creating, implementing, and evaluating immersive training in collaboration with Hotelschool The Hague and Hyatt Andaz Amsterdam Prinsengracht Hotel in real-life settings. The partnership with Warp Industries, a leader in immersive technology, is crucial for the project’s success. Our findings will be co-created and multiplied through relevant sector associations such as House of Hospitality. This project aligns with the MV’s Impact Level 1: Transitions by promoting innovative training strategies that can lead to a fundamental shift in the hospitality industry, thereby enhancing social earning capacities.
Cell-based production processes in bioreactors and fermenters need to be carefully monitored due to the complexity of the biological systems and the growth processes of the cells. Critical parameters are identified and monitored over time to guarantee product quality and consistency and to minimize over-processing and batch rejections. Sensors are already available for monitoring parameters such as temperature, glucose, pH, and CO2, but not yet for low-concentration substances like proteins and nucleic acids (DNA). An interesting critical parameter to monitor is host cell DNA (HCD), as it is considered an impurity in the final product (downstream process) and its concentration indicates the cell status (upstream process). The Molecular Biosensing group at the Eindhoven University of Technology and Helia Biomonitoring are developing a sensor for continuous biomarker monitoring, based on Biosensing by Particle Motion. With this consortium, we want to explore whether the sensor is suitable for the continuous measurement of HCD. Therefore, we need to set-up a joint laboratory infrastructure to develop HCD assays. Knowledge of how cells respond to environmental changes and how this is reflected in the DNA concentration profile in the cell medium needs to be explored. This KIEM study will enable us to set the first steps towards continuous HCD sensing from cell culture conditions controlling cell production processes. It eventually generates input for machine learning to be able to automate processes in bioreactors and fermenters e.g. for the production of biopharmaceuticals. The project entails collaboration with new partners and will set a strong basis for subsequent research projects leading to scientific and economic growth, and will also contribute to the human capital agenda.
The Dutch main water systems face pressing environmental, economic and societal challenges due to climatic changes and increased human pressure. There is a growing awareness that nature-based solutions (NBS) provide cost-effective solutions that simultaneously provide environmental, social and economic benefits and help building resilience. In spite of being carefully designed and tested, many projects tend to fail along the way or never get implemented in the first place, wasting resources and undermining trust and confidence of practitioners in NBS. Why do so many projects lose momentum even after a proof of concept is delivered? Usually, failure can be attributed to a combination of eroding political will, societal opposition and economic uncertainties. While ecological and geological processes are often well understood, there is almost no understanding around societal and economic processes related to NBS. Therefore, there is an urgent need to carefully evaluate the societal, economic, and ecological impacts and to identify design principles fostering societal support and economic viability of NBS. We address these critical knowledge gaps in this research proposal, using the largest river restoration project of the Netherlands, the Border Meuse (Grensmaas), as a Living Lab. With a transdisciplinary consortium, stakeholders have a key role a recipient and provider of information, where the broader public is involved through citizen science. Our research is scientifically innovative by using mixed methods, combining novel qualitative methods (e.g. continuous participatory narrative inquiry) and quantitative methods (e.g. economic choice experiments to elicit tradeoffs and risk preferences, agent-based modeling). The ultimate aim is to create an integral learning environment (workbench) as a decision support tool for NBS. The workbench gathers data, prepares and verifies data sets, to help stakeholders (companies, government agencies, NGOs) to quantify impacts and visualize tradeoffs of decisions regarding NBS.
