Background: Nutritional assessment is considered to be an important element in the nutrition care process of cancer patients, since nutritional status is positively associated with health outcome. The Scored Patient-Generated Subjective Global Assessment (PG-SGA) is a multidimensional nutritional assessment tool, developed for the oncology setting1. The PG-SGA was originally developed in English and until now an official Dutch translation was not available. We primarily aimed to develop a cross-cultural adaptation of the PG-SGA for the Dutch setting. Methods: The study design was developed conform the " Principles of Good Practice for the Translation and Cultural Adaption Process for Patient Reported Outcomes” by the International Society for Pharmacoeconomics and Outcomes Research (ISPOR)2. Results: The patients reported excellent understanding of the Dutch translated PG-SGA and perceived the items as easy to fill in. Comprehensibility of the items completed by the professionals was experienced as 'acceptable’, but they also experienced the items as difficult to complete. Professionals deemed the overall PG-SGA to be relevant and appropriate in the assessment of malnutrition in oncology patients. Overall, the professionals considered layout and time-consuming nature as barriers for applying the Dutch PG-SGA in daily practice. Conclusion: The Dutch cross-cultural adaptation of the PG-SGA was considered easy and was well understood by patients. Professionals evaluated the PG-SGA as relevant, but had some issues with lay out, elaborateness and difficulty of items regarding physical examination. To increase the accessibility and applicability of the PG-SGA for clinicians, training of these professionals is needed.
The purpose of this paper is to discuss the insights gained by testing in a design studio a particular research-by-design strategy, focusing on the generation of innovative solutions for climate change adaptation. The strategy is based on the Design Thinking Process and has been applied in the climate adaptation design studio, which took place in 2022 at a Master of Architecture degree program in the Netherlands. The case study area was the Zernike university campus in Groningen, the Netherlands, which is situated in the verge between the city and the surrounding rural landscape, facing the urgent climate change challenges of the wider region, mainly floodings due to increased frequency of rainfalls and sea level rise. Furthermore, the area faces particular challenges, such as the increasing demand for serving additional needs, beyond the current educational and business related functions, such as (student) housing. Three indicative design research projects were selected to illustrate the tested research-by-design strategy, while systematic input has been collected from the participating students regarding the impact of this strategy on their design process. The results reveal that this strategy facilitates the iterative research-by-design process and hence offers a systematic approach to convert the threats of climate change into opportunities by unravelling the potentials of the study area, resulting in place-based, innovative and adaptive solutions.
Challenges that surveys are facing are increasing data collection costs and declining budgets. During the past years, many surveys at Statistics Netherlands were redesigned to reduce costs and to increase or maintain response rates. From 2018 onwards, adaptive survey design has been applied in several social surveys to produce more accurate statistics within the same budget. In previous years, research has been done into the effect on quality and costs of reducing the use of interviewers in mixed-mode surveys starting with internet observation, followed by telephone or face-to-face observation of internet nonrespondents. Reducing follow-ups can be done in different ways. By using stratified selection of people eligible for follow-up, nonresponse bias may be reduced. The main decisions to be made are how to divide the population into strata and how to compute the allocation probabilities for face-to-face and telephone observation in the different strata. Currently, adaptive survey design is an option in redesigns of social surveys at Statistics Netherlands. In 2018 it has been implemented in the Health Survey and the Public Opinion Survey, in 2019 in the Life Style Monitor and the Leisure Omnibus, in 2021 in the Labour Force Survey, and in 2022 it is planned for the Social Coherence Survey. This paper elaborates on the development of the adaptive survey design for the Labour Force Survey. Attention is paid to the survey design, in particular the sampling design, the data collection constraints, the choice of the strata for the adaptive design, the calculation of follow-up fractions by mode of observation and stratum, the practical implementation of the adaptive design, and the six-month parallel design with corresponding response results.
Het landelijk gebied staat voor ingrijpende veranderingen. In 2050 zal het een geheel ander aanzien hebben. Keuzes van nu, bepalen hoe het toekomstige landschap eruit zal zien. De Europese Commissie en het Rijk zetten hierin de toon waarbij provincies de cruciale uitvoerende regio’s gaan worden. Binnen dit dynamische kader moeten op gebiedsniveau maatwerkoplossingen worden gevonden waarbij publiek/private belanghebbenden samenwerken. Een van de grote landbouw-uitdagingen is de opgave om emissies te reduceren en integraal te verduurzamen. Er is onderzoek nodig om kringlopen (beter) te sluiten, reststromen te verwaarden en onze natuurlijke leefomgeving te beschermen. Uitstoot van CO2, stikstof en methaan heeft aantoonbare schadelijke gevolgen voor onze kwetsbare natuur en het milieu. Hoewel de landbouwsector thans negatief bijdraagt aan de staat van ons milieu kan zij tegelijkertijd ook onderdeel worden van voorgestane oplossingen. Door nabewerkingen van meststromen, kunnen kostbare nutriënten worden teruggewonnen en duurzaam biogas/groengas worden geproduceerd. Aeres, Saxion en VHL (SPRONG-groep), bedrijven en (semi-publieke) overheden kiezen voor een gezamenlijke profilering gericht op een Emissiearme Landbouw en MEstverwaarding iN een gebiedsgerichte contexT (ELEMENT). Het ELEMENT-programma biedt (agrarische) ondernemers uit de mestverwaardingsketen kennis over het hergebruik van meststoffen (verwaarding), sluiten van nutriëntenkringlopen, CO2-neutrale (voedsel)productie, samenwerkingsconcepten voor de optimalisatie van (individuele) bedrijfsresultaten en nieuwe handelingsperspectieven door best practices, business cases en fysieke (mestvergistings en mestverwaardings)installaties te ontwikkelen en te testen. Bovendien worden voornoemde handelingsperspectieven duurzaam verbonden én ingepast in het landelijk/provinciaal geformuleerde gebiedsbeleid en gestelde doelen. Het ELEMENT-programma levert waardevolle bijdragen aan maatschappelijke opgaven in de Sustainable Development Goals, missies van het Horizon Europe-programma gericht op ‘adaption to climate change’, het Gemeenschappelijk Landbouwbeleid (GLB) gericht op milieubescherming, levendige plattelandsgebieden, toekomstbestendigheid van de agrarische sector en aan de missies van de KIA-LWV, KIA-Energietransitie & Duurzaamheid én KIA-Sleuteltechnologieën. Het ELEMENT- programma onderscheidt zich door de actuele integrale aanpak voor nieuwe gebiedsgerichte (landbouw)concepten.
While the creation of an energy deficit (ED) is required for weight loss, it is well documented that actual weight loss is generally lower than what expected based on the initially imposed ED, a result of adaptive mechanisms that are oppose to initial ED to result in energy balance at a lower set-point. In addition to leading to plateauing weight loss, these adaptive responses have also been implicated in weight regain and weight cycling (add consequences). Adaptions occur both on the intake side, leading to a hyperphagic state in which food intake is favored (elevated levels of hunger, appetite, cravings etc.), as well as on the expenditure side, as adaptive thermogenesis reduces energy expenditure through compensatory reductions in resting metabolic rate (RMR), non-exercise activity expenditure (NEAT) and the thermic effect of food (TEF). Two strategies that have been utilized to improve weight loss outcomes include increasing dietary protein content and increasing energy flux during weight loss. Preliminary data from our group and others demonstrate that both approaches - especially when combined - have the capacity to reduce the hyperphagic response and attenuate reductions in energy expenditure, thereby minimizing the adaptive mechanisms implicated in plateauing weight loss, weight regain and weight cycling. Past research has largely focused on one specific component of energy balance (e.g. hunger or RMR) rather than assessing the impact of these strategies on all components of energy balance. Given that all components of energy balance are strongly connected with each other and therefore can potentially negate beneficial impacts on one specific component, the primary objective of this application is to use a comprehensive approach that integrates all components of energy balance to quantify the changes in response to a high protein and high energy flux, alone and in combination, during weight loss (Fig 1). Our central hypothesis is that a combination of high protein intake and high energy flux will be most effective at minimizing both metabolic and behavioral adaptations in several components of energy balance such that the hyperphagic state and adaptive thermogenesis are attenuated to lead to superior weight loss results and long-term weight maintenance.
More and more aged people are joining the traffic, either using a passenger car or through a special low speed two-seater for in-city use. For elderly people, self-management in staying mobile is an essential part of their quality of life. However, with increased involvement of elderly in traffic, the risk of serious accidents increases, especially in cities. Fortunately, a rapid development of innovative technology is shown in vehicle design, with focus on advanced driver support, herewith referred to as ‘ambient intelligence’. This holds a promise to improve the safety situation, under the condition that adaption to the elderly driver’s need is accounted for. And that is not a straightforward issue, since ‘no size fits all’. With increasing age, we see an increased variety in driving skills with emphasis on cognitive, perceptual and physical limitations. In addition, people may suffer from diseases with a neurological background or other (cardiopulmonary disease, obesity or diabetes). The partners in this project have expressed the need to survey the feasibility of ‘ambient intelligence’ technology for low-speed vehicles also addressing E-Health functions to bring people safely home or involve medical help in case of health-critical situations. The MAX Mobiel make their vehicle available for that, and will help to guard the elder customer demand. The HAN Automotive Research team carries out the research, in cooperation with the HAN professorship on E-Health. Hence, both the automotive technology part of the HAN University of Applied Sciences as well as expertise from the Health oriented part of the HAN are included, being essential to successfully extend the relevant technologies to a fully integrated elderly driver support system, in the future. Noldus Information Technology is involved on the basis of their knowledge in human monitoring (drive lab) and data synchronization. The St. Maartenskliniek (Nijmegen) brings in their experience with people being restricted in physical or neurological sense.
