Introduction: People on the autism spectrum often struggle to transition smoothly between occupations in daily life. Objective: This qualitative inquiry aimed to understand the human and non-human factors that influence occupational transitions from the perspectives of adults on the autism spectrum. Method: Using a constructivist grounded theory design, this study purposively gathered data from eight adults on the autism spectrum who shared their viewpoints via semi-structured interviews and self-produced written texts. Framed by the Cultural Historical Activity Theory, an iterative process of constant comparative analysis was employed, yielding six categories that constituted the assembly of a working theory on occupational transitions among adults on the autism spectrum. Results: Drawn from eight participants, the six categories were: 1) getting ready, 2) the attributes of the occupation, 3) the others, 4) strategies of the moment, 5) cumulative stress, and 6) possible ends of the process. Conclusion: Our findings revealed a nuanced understanding on occupational transitions for adults with autism. First, materiality (non-human entities) serves various purposes in occupational transitions, implying that in some cases, intangible materials (tacit knowledge) would be enough to initiate, aid, or terminate occupational transitions. Second, doing transitions together through the optimization of social support and resources can make occupational transitions more meaningful for adults in the autism spectrum. It is our ambition that these propositions be tested and emphasized in occupational therapy, healthcare, and social care practices.
Objective: The aim of the study was to assess the effectiveness of intensive care unit (ICU)–initiated transitional care interventions for patients and families on elements of post-intensive care syndrome (PICS) and/or PICS-family (PICS–F). Review method used: This is a systematic review and meta-analysis Sources: The authors searched in biomedical bibliographic databases including PubMed, Embase (OVID), CINAHL Plus (EBSCO), Web of Science, and the Cochrane Library and included studies written in English conducted up to October 8, 2020. Review methods: We included (non)randomised controlled trials focussing on ICU-initiated transitional care interventions for patients and families. Two authors conducted selection, quality assessment, and data extraction and synthesis independently. Outcomes were described using the three elements of PICS, which were categorised into (i) physical impairments (pulmonary, neuromuscular, and physical function), (ii) cognitive impairments (executive function, memory, attention, visuo-spatial and mental processing speed), and (iii) psychological health (anxiety, depression, acute stress disorder, post-traumatic stress disorder, and depression). Results: From the initially identified 5052 articles, five studies were included (i.e., two randomised controlled trials and three nonrandomised controlled trials) with varied transitional care interventions. Quality among the studies differs from moderate to high risk of bias. Evidence from the studies shows no significant differences in favour of transitional care interventions on physical or psychological aspects of PICS-(F). One study with a nurse-led structured follow-up program showed a significant difference in physical function at 3 months. Conclusions: Our review revealed that there is a paucity of research about the effectiveness of transitional care interventions for ICU patients with PICS. All, except one of the identified studies, failed to show a significant effect on the elements of PICS. However, these results should be interpreted with caution owing to variety and scarcity of data. Prospero registration: CRD42020136589 (available via https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020136589).
Importance Older adults acutely hospitalized are at risk of disability. Trials on comprehensive geriatric assessment (CGA) and transitional care present inconsistent results.Objective To test whether an intervention of systematic CGA, followed by the transitional care bridge program, improved activities of daily living (ADLs) compared with systematic CGA alone.Design, Setting, and Participants This study was a double-blind, multicenter, randomized clinical trial conducted at 3 hospitals with affiliated home care organizations in the Netherlands between September 1, 2010, and March 1, 2014. In total, 1070 consecutive patients were eligible, 674 (63.0%) of whom enrolled. They were 65 years or older, acutely hospitalized to a medical ward for at least 48 hours with an Identification of Seniors at Risk–Hospitalized Patients score of 2 or higher, and randomized using permuted blocks stratified by study site and Mini-Mental State Examination score (<24 vs ≥24). The dates of the analysis were June 1, 2014, to November 15, 2014.Interventions The transitional care bridge program intervention was started during hospitalization by a visit from a community care registered nurse (CCRN) and continued after discharge with home visits at 2 days and at 2, 6, 12, and 24 weeks. The CCRNs applied the CGA care and treatment plan.Main Outcomes and Measures The main outcome was the Katz Index of ADL at 6 months compared with 2 weeks before admission. Secondary outcomes were mortality, cognitive functioning, time to hospital readmission, and the time to discharge from a nursing home.Results The study cohort comprised 674 participants. Their mean age was 80 years, 42.1% (n = 284) were male, and 39.2% (n = 264) were cognitively impaired at admission. Intent-to-treat analysis found no differences in the mean Katz Index of ADL at 6 months between the intervention arm (mean, 2.0; 95% CI, 1.8-2.2) and the CGA-only arm (mean, 1.9; 95% CI, 1.7-2.2). For secondary outcomes, there were 85 deaths (25.2%) in the intervention arm and 104 deaths (30.9%) in the CGA-only arm, resulting in a lower risk on the time to death within 6 months after hospital admission (hazard ratio, 0.75; 95% CI, 0.56-0.99; P = .045; number needed to treat to prevent 1 death, 16). No other secondary outcome was significant.Conclusions and Relevance A systematic CGA, followed by the transitional care bridge program, showed no effect on ADL functioning in acutely hospitalized older patients.Trial Registration Netherlands Trial Registry: NTR2384
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.
My research investigates the concept of permacomputing, a blend of the words permaculture and computing, as a potential field of convergence of technology, arts, environmental research and activism, and as a subject of future school curricula in art and design. This concept originated in online subcultures, and is currently restricted to creative coding communities. I study in what way permacomputing principles may be used to redefine how art and design education is taught. More generally, I want to research the potential of permacomputing as a critical, sustainable, and practical alternative to the way digital technology is being taught in art education, where students mostly rely on tools and techniques geared towards maximising productivity and mass consumption. This situation is at odds with goals for sustainable production and consumption. I want to research to what degree the concept of permacomputing can be broadened and applied to critically revised, sustainable ways of making computing part of art and design education and professional practice. This research will be embedded in the design curriculum of Willem de Kooning Academy, focused on redefining the role of artists and designers to contribute to future modes of sustainable organisation and production. It is aligned with Rotterdam University of Applied Sciences sectorplan masters VH, in particular managing and directing sustainable transitions. This research builds upon twenty years of experience in the creative industries. It is an attempt to generalise, consolidate, and structure methods and practices for sustainable art and design production experimented with while I was course director of a master programme at WdKA. Throughout the research I will be exchanging with peers and confirmed interested parties, a.o.: Het Nieuwe Instituut (NL), RUAS Creating 010 kenniscentrum (NL), Bergen Centre for Electronic Arts (NO), Mikrolabs (NO), Varia (NL), Media Arts department at RHU (UK), Media Studies at UvA (NL).
