Rationale To improve the quality of exercise-based cardiac rehabilitation (CR) in patients with chronic heart failure (CHF) a practice guideline from the Dutch Royal Society for Physiotherapy (KNGF) has been developed. Guideline development A systematic literature search was performed to formulate conclusions on the efficacy of exercise-based intervention during all CR phases in patients with CHF. Evidence was graded (1–4) according the Dutch evidence-based guideline development criteria. Clinical and research recommendations Recommendations for exercise-based CR were formulated covering the following topics: mobilisation and treatment of pulmonary symptoms (if necessary) during the clinical phase, aerobic exercise, strength training (inspiratory muscle training and peripheral muscle training) and relaxation therapy during the outpatient CR phase, and adoption and monitoring training after outpatient CR. Applicability and implementation issues This guideline provides the physiotherapist with an evidence-based instrument to assist in clinical decision-making regarding patients with CHF. The implementation of the guideline in clinical practice needs further evaluation. Conclusion This guideline outlines best practice standards for physiotherapists concerning exercise-based CR in CHF patients. Research is needed on strategies to improve monitoring and follow-up of the maintenance of a physical active lifestyle after supervised CR.
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In the Netherlands municipalities are searching for guidelines for a heat resilient design of the urban space. One of the guidelines which has recently been picked up is that each house should be within a 300 meter of an attractive cool spot outside. The reason is that houses might get too hot during a heat wave and therefor it is important that inhabitants have an alternative place to go. The distance of 300 m has been adopted because of practical reasons. This guideline has been proposed after a research of the University of Amsterdam of applied sciences and TAUW together with 15 municipalities.To help municipalities to take cool spots into account in their urban design the national organization for disseminating climate data has developed a distance to coolness map for all Dutch built up areas. This map shows the cool spots with a minimum of 200 m2 based on a map of the PET for a hot summer day (2*2 m2 spatial resolution). Furthermore the map shows the walking distance for each house (via streets and foot paths) to the nearest cool spot.This map helps as a starting point. Because not all cool spots are attractive cool spots. A research in 2021 showed what further basis and optional characteristics those cool spots should have: e.g. sufficiently large, combination of sun and shadow, benches, quiet, safe and clean. In fact those places should be attractive places to stay for most days of the year.With the distance to attractive cool spots municipalities can easily see which areas lack attractive cool spots. The distance to cool spot maps is therefore a way to simplify complex climate data into an understandable and practical guideline. This is an improvement as compared to using thresholds for temperatures and thresholds for duration of exceedance of those temperatures in a guideline.: Municipalities like this practical approach that combines climate adaptation with improving the livability of a city throughout the year.
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This guide was developed for designers and developers of AI systems, with the goal of ensuring that these systems are sufficiently explainable. Sufficient here means that it meets the legal requirements from AI Act and GDPR and that users can use the system properly. Explainability of decisions is an important requirement in many systems and even an important principle for AI systems [HLEG19]. In many AI systems, explainability is not self-evident. AI researchers expect that the challenge of making AI explainable will only increase. For one thing, this comes from the applications: AI will be used more and more often, for larger and more sensitive decisions. On the other hand, organizations are making better and better models, for example, by using more different inputs. With more complex AI models, it is often less clear how a decision was made. Organizations that will deploy AI must take into account users' need for explanations. Systems that use AI should be designed to provide the user with appropriate explanations. In this guide, we first explain the legal requirements for explainability of AI systems. These come from the GDPR and the AI Act. Next, we explain how AI is used in the financial sector and elaborate on one problem in detail. For this problem, we then show how the user interface can be modified to make the AI explainable. These designs serve as prototypical examples that can be adapted to new problems. This guidance is based on explainability of AI systems for the financial sector. However, the advice can also be used in other sectors.
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Communication of climate-responsive urban design guidelines is becoming increasingly relevant in the light of climate adaptation challenges in cities. Widespread uptake in practice of such guidelines can be promoted by visualizations of the principles on which they are based. The “Really cooling water bodies in cities” research project developed and tested the required knowledge on visual communication. Evidence-based design guidelines assisting designers with creating cooler urban water environments were developed and communicated with 3D animations. The animations were shaped according to three core theoretical criteria about visual representations: “visual clarity”, “trust” and “interest”. We assessed in how far these criteria were met in an inquiry with design professionals, the target group of the design guidelines. The article concludes with recommendations for developing visual design guidelines in climate-responsive urban design: to weigh the level of detail, components and balance between site-specificity/abstraction (“visual clarity”); to make microclimatic processes visible without distorting them (“trust”); and to keep timing short and visual attractiveness high (“interest”). It is argued that taking these aspects into account and setting a clear correspondence between theoretical concepts, representation objectives and options, can largely benefit visual design guidelines communicating climate-responsive urban design knowledge.
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Academic design research often fails to contribute to design practice. This dissertation explores how design research collaborations can provide knowledge that design professionals will use in practice. The research shows that design professionals are not addressed as an important audience between the many audiences of collaborative research projects. The research provides insight in the learning process by design professionals in design research collaborations and it identifies opportunities for even more learning. It shows that design professionals can learn about more than designing, but also about application domains or project organization.
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In 2004 the first adaptive thermal comfort guideline was introduced in the Netherlands. Recently a new, upgraded version of this ISSO 74 (ATG) guideline has been developed. The new requirements are hybrid in nature as the 2014 version of the guideline combines elements of traditional non-adaptive comfort standards with elements of adaptive standards. This paper describes the new guideline and explains the rationale behind it. Also changes in comparison with the original 2004 version and issues related to performance verification are discussed. The information presented in this paper can be used by others (other countries) as inspiration material for other new adaptive comfort guidelines and standards.
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The purpose of this article is the presentation of a multidimensional guideline for the diagnosis of anxiety and anxiety-related behavior problems in people with intellectual disability (ID), with a substantial role for the nurse in this diagnostic process. DESIGN AND METHODS: The guideline is illustrated by a case report of a woman with ID with severe problems. FINDINGS: It appears that a multidimensional diagnostic approach involving multidisciplinary team efforts can result in a more accurate diagnosis and improved subsequent treatment. PRACTICE IMPLICATIONS: Nurses should be engaged in the diagnostic process because of their ability to make direct observations and to actively participate in carrying out all parts of the guideline.
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Background To improve the quality of exercise-based cardiac rehabilitation (CR) in patients with coronary heart disease (CHD) the CR guideline from the Dutch Royal Society for Physiotherapists (KNGF) has been updated. This guideline can be considered an addition to the 2011 Dutch Multidisciplinary CR guideline, as it includes several novel topics. Methods A systematic literature search was performed to formulate conclusions on the efficacy of exercise-based interventions during all CR phases in patients with CHD. Evidence was graded (1–4) according the Dutch evidence-based guideline development (EBRO) criteria. In case of insufficient scientific evidence, recommendations were based on expert opinion. This guideline comprised a structured approach including assessment, treatment and evaluation. Results Recommendations for exercise-based CR were formulated covering the following topics: preoperative physiotherapy, mobilisation during the clinical phase, aerobic exercise, strength training, and relaxation therapy during the outpatient rehabilitation phase, and adoption and monitoring of a physically active lifestyle after outpatient rehabilitation. Conclusions There is strong evidence for the effectiveness of exercise-based CR during all phases of CR. The implementation of this guideline in clinical practice needs further evaluation as well as the maintenance of an active lifestyle after supervised rehabilitation. LinkedIn: https://www.linkedin.com/in/tinusjongert/
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The rising global demand for district nursing care necessitates effective strategies to support evidence-based decision-making. Despite the extensive development of nursing guidelines, adherence by district nursing teams remains suboptimal, revealing a gap between guideline development and daily practice. The Learning And Reflection for Nurses (LEARN) programme aims to bridge this gap by enhancing guideline use and fostering a learning attitude among district nursing teams. This protocol outlines the programme’s development, components and evaluation approach.
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In this paper we explore the influence of the physical and social environment (the design space) son the formation of shared understanding in multidisciplinary design teams. We concentrate on the creative design meeting as a microenvironment for studying processes of design communication. Our applied research context entails the design of mixed physical–digital interactive systems supporting design meetings. Informed by theories of embodiment that have recently gained interest in cognitive science, we focus on the role of interactive “traces,” representational artifacts both created and used by participants as scaffolds for creating shared understanding. Our research through design approach resulted in two prototypes that form two concrete proposals of how the environment may scaffold shared understanding in design meetings. In several user studies we observed users working with our systems in natural contexts. Our analysis reveals how an ensemble of ongoing social as well as physical interactions, scaffolded by the interactive environment, grounds the formation of shared understanding in teams. We discuss implications for designing collaborative tools and for design communication theory in general.
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