Background: In implementation science, vast gaps exist between theoretical and practical knowledge. These gaps prevail in the process of getting from problem analysis to selecting implementation strategies while engaging stakeholders including care users. Objective: To describe a process of how to get from problem analysis to strategy selection, how to engage stakeholders, and to provide insights into stakeholders’ experiences. Design: A qualitative descriptive design. Setting and participants: The setting was a care organization providing long-term care to people with acquired brain injuries who are communication vulnerable. Fourteen stakeholders (care users, professionals and researchers) participated. Data were collected by a document review, five interviews and one focus group. Inductive content analysis and deductive framework analysis were applied. Intervention: Stakeholder engagement. Main outcome measures: A three-step process model and stakeholders experiences. Results and conclusion: We formulated a three-step process: (a) reaching consensus and prioritizing barriers; (b) categorizing the prioritized barriers and idealization; and (c) composing strategies. Two subthemes continuously played a role in how stakeholders were engaged during the process: communication supportive strategies and continuous contact. The experiences of stakeholder participation resulted in the following themes: stakeholders and their roles, use of co-creation methods and communication supportive strategies, building relationships, stimulus of stakeholders to engage, sharing power, empowerment of stakeholders, feeling a shared responsibility and learning from one another. We conclude that the inclusion of communicationvulnerable care users is possible if meetings are prepared, communication-friendly presentations and reports are used, and relationship building is prioritized.
BackgroundPhysical exercise is an intervention that might protect against doxorubicin‐induced cardiotoxicity. In this meta‐analysis and systematic review, we aimed to estimate the effect of exercise on doxorubicin‐induced cardiotoxicity and to evaluate mechanisms underlying exercise‐mediated cardioprotection using (pre)clinical evidence.Methods and ResultsWe conducted a systematic search in PubMed, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) databases. Cochrane's and Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE) risk‐of‐bias tools were used to assess the validity of human and animal studies, respectively. Cardiotoxicity outcomes reported by ≥3 studies were pooled and structured around the type of exercise intervention. Forty articles were included, of which 3 were clinical studies. Overall, in humans (sample sizes ranging from 24 to 61), results were indicative of exercise‐mediated cardioprotection, yet they were not sufficient to establish whether physical exercise protects against doxorubicin‐induced cardiotoxicity. In animal studies (n=37), a pooled analysis demonstrated that forced exercise interventions significantly mitigated in vivo and ex vivo doxorubicin‐induced cardiotoxicity compared with nonexercised controls. Similar yet slightly smaller effects were found for voluntary exercise interventions. We identified oxidative stress and related pathways, and less doxorubicin accumulation as mechanisms underlying exercise‐induced cardioprotection, of which the latter could act as an overarching mechanism.ConclusionsAnimal studies indicate that various exercise interventions can protect against doxorubicin‐induced cardiotoxicity in rodents. Less doxorubicin accumulation in cardiac tissue could be a key underlying mechanism. Given the preclinical evidence and limited availability of clinical data, larger and methodologically rigorous clinical studies are needed to clarify the role of physical exercise in preventing cardiotoxicity in patients with cancer.RegistrationURL: https://www.crd.york.ac.uk/prospero; Unique identifier: CRD42019118218.
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Game development businesses often choose Lua for separating scripted game logic from reusable engine code. Lua can easily be embedded, has simple interfaces, and offers a powerful and extensible scripting language. Using Lua, developers can create prototypes and scripts at early development stages. However, when larger quantities of engine code and script are available, developers encounter maintainability and quality problems. First, the available automated solutions for interoperability do not take domain-specific optimizations into account. Maintaining a coupling by hand between the Lua interpreter and the engine code, usually in C++, is labour intensive and error-prone. Second, assessing the quality of Lua scripts is hard due to a lack of tools that support static analysis. Lua scripts for dynamic analysis only report warnings and errors at run-time and are limited to code coverage. A common solution to the first problem is developing an Interface Definition Language (IDL) from which ”glue code”, interoperability code between interfaces, is generated automatically. We address quality problems by proposing a method to complement techniques for Lua analysis. We introduce Lua AiR (Lua Analysis in Rascal), a framework for static analysis of Lua script in its embedded context, using IDL models and Rascal.
Designing cities that are socially sustainable has been a significant challenge until today. Lately, European Commission’s research agenda of Industy 5.0 has prioritised a sustainable, human-centric and resilient development over merely pursuing efficiency and productivity in societal transitions. The focus has been on searching for sustainable solutions to societal challenges, engaging part of the design industry. In architecture and urban design, whose common goal is to create a condition for human life, much effort was put into elevating the engineering process of physical space, making it more efficient. However, the natural process of social evolution has not been given priority in urban and architectural research on sustainable design. STEPS stems from the common interest of the project partners in accessible, diverse, and progressive public spaces, which is vital to socially sustainable urban development. The primary challenge lies in how to synthesise the standardised sustainable design techniques with unique social values of public space, propelling a transition from technical sustainability to social sustainability. Although a large number of social-oriented studies in urban design have been published in the academic domain, principles and guidelines that can be applied to practice are large missing. How can we generate operative principles guiding public space analysis and design to explore and achieve the social condition of sustainability, developing transferable ways of utilising research knowledge in design? STEPS will develop a design catalogue with operative principles guiding public space analysis and design. This will help designers apply cross-domain knowledge of social sustainability in practice.
Carboxylated cellulose is an important product on the market, and one of the most well-known examples is carboxymethylcellulose (CMC). However, CMC is prepared by modification of cellulose with the extremely hazardous compound monochloracetic acid. In this project, we want to make a carboxylated cellulose that is a functional equivalent for CMC using a greener process with renewable raw materials derived from levulinic acid. Processes to achieve cellulose with a low and a high carboxylation degree will be designed.
In the Netherlands approximately 2 million inhabitants have one or more disabilities. However, just like most people they like to travel and go on holiday.In this project we have explored the customer journey of people with disabilities and their families to understand their challenges and solutions (in preparing) to travel. To get an understanding what ‘all-inclusive’ tourism would mean, this included an analysis of information needs and booking behavior; traveling by train, airplane, boat or car; organizing medical care and; the design of hotels and other accommodations. The outcomes were presented to members of ANVR and NBAV to help them design tourism and hospitality experiences or all.
