Digital techniques have enabled us to enjoy music, literature and communication to an unlimited extent. Images, music and other files can even bridge the largest distances on Earth in just a few milliseconds via the World Wild Web (and satellites). Digital connection would be less demanding for the planet and therefore more sustainable than travelling. But is that also true? Unfortunately, the opposite is true. "We 're putting out the fire with gasoline"!
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Objective: To evaluate the delivery, acceptance and experiences regarding a traditional and teletreatment approach to mirror therapy as delivered in a randomized controlled trial. Design: Mixed methods, prospective study. Setting: Rehabilitation centres, hospital and private practices. Subjects: Adult patients with phantom pain following lower limb amputation and their treating physical and occupational therapists. Interventions: All patients received 4 weeks of traditional mirror therapy (n=51), followed by 6 weeks of teletreatment (n=26) or 6 weeks of self-delivered mirror therapy (n=25). Main measures: Patient files, therapist logs, log files teletreatment, acceptance questionnaire and interviews with patients and their therapists. Results: In all, 51 patients and 10 therapists participated in the process evaluation. Only 16 patients (31%) received traditional mirror therapy according to the clinical framework during the first 4 weeks. Between weeks 5 and 10, the teletreatment was used by 14 patients (56%) with sufficient dose. Teletreatment usage decreased from a median number of 31 (weeks 5–10) to 19 sessions (weeks 11–24). Satisfactory teletreatment user acceptance rates were found with patients demonstrating higher scores (e.g. regarding the usefulness to control pain) than therapists. Potential barriers for implementation of the teletreatment perceived by patients and therapists were related to insufficient training and support as well as the frequency of technical problems. Conclusion: Traditional mirror therapy and the teletreatment were not delivered as intended in the majority of patients. Implementation of the teletreatment in daily routines was challenging, and more research is needed to evaluate user characteristics that influence adherence and how technology features can be optimized to develop tailored implementation strategies.
Currently, 4% of older adults reside in long-term care facilities in the Netherlands. Nursing home residents tend to have multimorbidity that is associated with considerable disabilities and a high level of care dependency. In the Dutch adult population the highest estimated prevalence (>40%) of visual impairment (low vision and blindness) was found in the subgroup of residents in nursing homes (NHs). The aim of this study is to describe the current practice of eye care by Dutch nursing home physicians (NHPs). A digital online survey was developed to describe the eye care activities of nursing home physicians and their cooperation in this perspective with other professionals. Of 1573 NHPs present in the Netherlands, 125 (8%) responded. Results show that more than 50% of the NHPs regularly examine ‘distant vision’, ‘near vision’ and ‘the visual field’ . However, 23%, 33% and 45% almost never or never examine the ‘visual field’, ‘near vision’ and ‘distant vision’, respectively. Data regarding eye care, regularly recorded in the client files by more than 50% of the NHPs, are medical data involving ‘use of eye medication’, ‘eye disease’, and ‘eye surgery in the past’. Less commonly recorded is ‘the use of reading glasses’ as well as ‘eye pain’. Inside of the NH, (head) nurses and ward nurses (chi 2 = 309, df = 5, p = 0.000), and outside of the NH, ophthalmologists and low vision specialists are most frequently contacted about eye related issues (chi 2 = 224, df = 4, p = 0.000). Opticians are rarely contacted, and optometrists and orthoptists are ‘never’ contacted by more than 50% of the NHPs. Moreover, 50% of the NHPs noted that collaboration with external eye care professionals is ‘not structural’. This study shows that, according to NHPs, relevant visual aspects are not structurally examined and recorded in the client files. Outside of the NH, NHPs tend to have a less frequent collaborative relationship with optometrists, orthoptists and opticians compared to ophthalmologists and low vision specialists. The NHP’s role in providing eye care can be improved by development of guidelines for structural eye screening, improvement of recording in client files, and exploring plus undertaking collaboration with other eye care professionals.
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De binnenvaart heeft een marktaandeel van 30% binnen het Nederlandse goederenvervoer en vervult daarbij een beduidende logistieke functie. Schepen zijn goedkoop, veroorzaken geen files en hebben een kleinere carbon-footprint dan vrachtwagens (Bureau Voorlichting Binnenvaart, 2019). Echter, is de betrouwbaarheid van de binnenvaart afhankelijk van de klimatologische omstandigheden. In extreem droge tijden kunnen schepen minder lading vervoeren in verband met de diepgang en kunnen schepen met een diepgang van boven de drie meter niet alle drempels passeren. Dit zorgt voor extra druk op het wegennet en verhoogd de transportkosten van ondernemingen. De Bedrijvenkring Zutphen en Provincie Gelderland hebben bereikbaarheid als speerpunt. Daarnaast werkt het Deltaprogramma Rijn aan toekomstscenario’s en adaptatiestrategieën die anticiperen op lange termijn klimaatverandering. De droogte van 2018 heeft er mede toe geleid dat hierbij ook expliciete aandacht is voor eventuele effecten van veranderende rivierafvoeren op de binnenvaart.
Human kind has a major impact on the state of life on Earth, mainly caused by habitat destruction, fragmentation and pollution related to agricultural land use and industrialization. Biodiversity is dominated by insects (~50%). Insects are vital for ecosystems through ecosystem engineering and controlling properties, such as soil formation and nutrient cycling, pollination, and in food webs as prey or controlling predator or parasite. Reducing insect diversity reduces resilience of ecosystems and increases risks of non-performance in soil fertility, pollination and pest suppression. Insects are under threat. Worldwide 41 % of insect species are in decline, 33% species threatened with extinction, and a co-occurring insect biomass loss of 2.5% per year. In Germany, insect biomass in natural areas surrounded by agriculture was reduced by 76% in 27 years. Nature inclusive agriculture and agri-environmental schemes aim to mitigate these kinds of effects. Protection measures need success indicators. Insects are excellent for biodiversity assessments, even with small landscape adaptations. Measuring insect biodiversity however is not easy. We aim to use new automated recognition techniques by machine learning with neural networks, to produce algorithms for fast and insightful insect diversity indexes. Biodiversity can be measured by indicative species (groups). We use three groups: 1) Carabid beetles (are top predators); 2) Moths (relation with host plants); 3) Flying insects (multiple functions in ecosystems, e.g. parasitism). The project wants to design user-friendly farmer/citizen science biodiversity measurements with machine learning, and use these in comparative research in 3 real life cases as proof of concept: 1) effects of agriculture on insects in hedgerows, 2) effects of different commercial crop production systems on insects, 3) effects of flower richness in crops and grassland on insects, all measured with natural reference situations
This project assists architects and engineers to validate their strategies and methods, respectively, toward a sustainable design practice. The aim is to develop prototype intelligent tools to forecast the carbon footprint of a building in the initial design process given the visual representations of space layout. The prediction of carbon emission (both embodied and operational) in the primary stages of architectural design, can have a long-lasting impact on the carbon footprint of a building. In the current design strategy, emission measures are considered only at the final phase of the design process once major parameters of space configuration such as volume, compactness, envelope, and materials are fixed. The emission assessment only at the final phase of the building design is due to the costly and inefficient interaction between the architect and the consultant. This proposal offers a method to automate the exchange between the designer and the engineer using a computer vision tool that reads the architectural drawings and estimates the carbon emission at each design iteration. The tool is directly used by the designer to track the effectiveness of every design choice on emission score. In turn, the engineering firm adapts the tool to calculate the emission for a future building directly from visual models such as shared Revit documents. The building realization is predominantly visual at the early design stages. Thus, computer vision is a promising technology to infer visual attributes, from architectural drawings, to calculate the carbon footprint of the building. The data collection for training and evaluation of the computer vision model and machine learning framework is the main challenge of the project. Our consortium provides the required resources and expertise to develop trustworthy data for predicting emission scores directly from architectural drawings.
