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Transforming Clinical Practice Guideline Usage Through the Use of a Clinical Decision Support System: An explorative study at the University Medical Centre Utrecht

Inventarisatie textielintegreerbare sensoren voor SaxShirt

In het SaxShirt-project wordt een comfortabel shirt ontwikkeld waarmee fysiologische aspecten van de drager kunnen worden gemeten, zonder dat de drager daar extra inspanning voor hoeft te leveren. Dergelijke technologieën noemen we Zero Effort Technologies (Baecker, 2011). De belangrijkste fysiologische aspecten die in eerste instantie gemeten gaan worden zijn: 1)    temperatuur 2)    hartslag 3)    ademhaling. Het project is gestart in september 2013. Het doel is om in oktober 2014 een praktisch demonstratiemodel te hebben van het shirt waarmee de mogelijkheden van de huidige technologie kunnen worden gedemonstreerd. Het is belangrijk dat het shirt niet alleen comfortabel zit, maar ook robuust en eenvoudig te wassen en reinigen is. Voorafgaand aan dit project zijn er al verscheidene onderzoeken en ontwikkelingen geweest om mogelijkheden voor het shirt te onderzoeken. Om een definitief implementatieplan te kunnen opstellen voor het huidige project, was er behoefte om nog eenmaal een korte verbredende onderzoeksfase uit te voeren. Dit rapport is het resultaat van deze fase. Na de verbredende fase zijn in november 2013 besluiten genomen en is begonnen aan de implementatie van het demonstratiemodel. De belangrijke momenten staan in onderstaand overzicht: • Oktober 2013: Start SaxShirt Project • November 2013: Vaststellen Plan van Aanpak (PvA) voor implementatie • Juli 2014: Afronden implementatie • Oktober 2014: Oplevering eerste demonstratiemodel SaxShirt Dit rapport beschrijft de state-of-the art van technieken waarmee bovenstaande fysiologische aspecten kunnen worden gemeten. Het doel van dit rapport is om een overzicht van in textiel-integreerbare fysiologische sensoren te geven. Dit overzicht dient als basis en discussiestuk voor het pan van aanpak voor de implementatie en kan worden gebruikt als introductie voor nieuwe medewerkers op het SaxShirt project.

Personally perceived publication pressure: revising the Publication Pressure Questionnaire (PPQ) by using work stress models

Background: The emphasis on impact factors and the quantity of publications intensifies competition between researchers. This competition was traditionally considered an incentive to produce high-quality work, but there are unwanted side-effects of this competition like publication pressure. To measure the effect of publication pressure on researchers, the Publication Pressure Questionnaire (PPQ) was developed. Upon using the PPQ, some issues came to light that motivated a revision.Method: We constructed two new subscales based on work stress models using the facet method. We administered the revised PPQ (PPQr) to a convenience sample together with the Maslach Burnout Inventory (MBI) and the Work Design Questionnaire (WDQ). To assess which items best measured publication pressure, we carried out a principal component analysis (PCA). Reliability was sufficient when Cronbach's alpha > 0.7. Finally, we administered the PPQr in a larger, independent sample of researchers to check the reliability of the revised version.Results: Three components were identified as 'stress', 'attitude', and 'resources'. We selected 3 × 6 = 18 items with high loadings in the three-component solution. Based on the convenience sample, Cronbach's alphas were 0.83 for stress, 0.80 for attitude, and 0.76 for resources. We checked the validity of the PPQr by inspecting the correlations with the MBI and the WDQ. Stress correlated 0.62 with MBI's emotional exhaustion. Resources correlated 0.50 with relevant WDQ subscales. To assess the internal structure of the PPQr in the independent reliability sample, we conducted the principal component analysis. The three-component solution explains 50% of the variance. Cronbach's alphas were 0.80, 0.78, and 0.75 for stress, attitude, and resources, respectively.Conclusion: We conclude that the PPQr is a valid and reliable instrument to measure publication pressure in academic researchers from all disciplinary fields. The PPQr strongly relates to burnout and could also be beneficial for policy makers and research institutions to assess the degree of publication pressure in their institute.

Telemonitoring for independently living elderly

In this paper we investigate the precise focus required of a telemonitoring system for the domain of independently living elderly. Particularly, we investigate (1) the needs of telemonitoring for this particular domain, and (2) the requirements for such a telemonitoring system. For our investigation, we performed an extensive study of the literature, as well as performed interviews with 36 individuals active in the field. As a result, we established numerous needs to be considered, being foremost information need on safety, with regard to care response on emergencies (e.g., falling incidents, wandering), as well information need on dependence on care, with regard to inactivity, self-neglect and loneliness. Subsequently, we established numerous requirements to be addressed, being foremost the use of non-wearable sensors, unobtrusiveness, durability, reliability, privacy, and ubiquitousness. In our discussion of the requirements, we detailed specifically the topics of focus, functionality, and form of a telemonitoring system for this domain.

Estimated impact of CO2 and NOx emission reduction targets on car ownership and car use in The Netherlands

Densely populated areas are major sources of air, soil and water pollution. Agriculture, manufacturing, consumer households and road traffic all have their share. This is particularly true for the country featured in this paper: the Netherlands. Continuous pollution of the air and soil manifests itself as acification, decalcification and eutrofication. Biodiversity becomes lower and lower in nature areas. Biological farms are also under threat. In case of mobility, local air pollution may have a huge health impact. Effective policy is called for, after high courts blocked construction projects, because of foreseen building- and transport-related NOx emissions. EU law makers are after Dutch governments, because these favoured economics and politics over environmental and liveability concerns. But, people in the Netherlands are strongly divided. The latest provincial elections were dominated by environmental concerns, next to many socio-economic issues. NOx and CO2 emissions by passenger cars are in focus. Technical means and increasing fuel economy norms strongly reduced NOx emissions to a still too high level. A larger number of cars neutralized a technological reduction of CO2 emissions. The question is: What would be the impact of a drastic mandatory reduction in CO2, NOx, and PM10 emissions on car ownership and use in the Netherlands? The authors used literature, scenario analysis and simulation modelling to answer this question. Electric mobility could remove these emissions. Its full impact will only be achieved if the grid-mix, which is still dominated by fossil fuels, becomes green(er), which is a gradual, long-term, process. EVs compete with other consumers of electricity, as many other activities, such as heating, are also electrifying. With the current grid-mix, it is inevitable that the number of km per vehicle per year is reduced to reach the scenario targets (−25% resp. −50% CO2 emissions by cars). This calls for an individual mobility budget per car user.

Longitudinal residential ambient monitoring

Wireless sensor networks are becoming popular in the field of ambient assisted living. In this paper we report our study on the relationship between a functional health metric and features derived from the sensor data. Sensor systems are installed in the houses of nine people who are also quarterly visited by an occupational therapist for functional health assessments. Different features are extracted and these are correlated with a metric of functional health (the AMPS). Though the sample is small, the results indicate that some features are better in describing the functional health in the population, but individual differences should also be taken into account when developing a sensor system for functional health assessment.