With the approach of the zero emission zone implementation in 30-40 cities mandated by the Dutch Klimaatakkord, comes the need to determine whether the SMEs located within these zones are aware of the coming changes and if they are, how far they have come in their preparation. This paper delves into the development of the zero emission city logistics maturity model tool which is used to indicate the progress of these small to medium enterprises in light of reaching fully zero emission city logistics operations. The paper starts off with a review of existing maturity models which forms the baseline for the zero emission city logistics maturity model in rubric form. A QuickScan analysis is developed in order to facilitate data collection by students who then approach businesses and use the QuickScan results to benchmark the businesses progress against other businesses. This paper then concludes with the preliminary results from the initial QuickScans performed by HBO level students.
Background: Changes in reimbursement have been compelling for Dutch primary care practices to apply a disease management approach for patients with chronic obstructive pulmonary disease (COPD). This approach includes individual patient consultations with a practice nurse, who coaches patients in COPD management. The aim of this study was to gauge the feasibility of adding a web-based patient self-management support application, by assessing patients’ self-management, patients’ health status, the impact on the organization of care, and the level of application use and appreciation. Methods: The study employed a mixed methods design. Six practice nurses recruited COPD patients during a consultation. The e-Health application included a questionnaire that captured information on demographics, self-management related behaviors (smoking cessation, physical activity and medication adherence) and their determinants, and nurse recommendations. The application provided tailored feedback messages to patients and provided the nurse with reports. Data were collected through questionnaires and medical record abstractions at baseline and one year later. Semi-structured interviews with patients and nurses were conducted. Descriptive statistics were calculated for quantitative data and content analysis was used to analyze the qualitative data. Results: Eleven patients, recruited by three nurses, used the application 1 to 7 times (median 4). Most patients thought that the application supported self-management, but their interest diminished after multiple uses. Impact on patients’ health could not be determined due to the small sample size. Nurses reported benefits for the organization of care and made suggestions to optimize the use of the reports. Conclusion: Results suggest that it is possible to integrate a web-based COPD self-management application into the current primary care disease management process. The pilot study also revealed opportunities to improve the application and reports, in order to increase technology use and appreciation.
Introduction. Despite the high number of inactive patients with COPD, not all inactive patients are referred to physical therapy, unlike recommendations of general practitioner (GP) guidelines. It is likely that GPs take other factors into account, determining a subpopulation that is treated by a physical therapist (PT). The aim of this study is to explore the phenotypic differences between inactive patients treated in GP practice and inactive patients treated in GP practice combined with PT. Additionally this study provides an overview of the phenotype of patients with COPD in PT practice. Methods. In a cross-sectional study, COPD patient characteristics were extracted from questionnaires. Differences regarding perceived health status, degree of airway obstruction, exacerbation frequency, and comorbidity were studied in a subgroup of 290 inactive patients and in all 438 patients. Results. Patients treated in GP practice combined with PT reported higher degree of airway obstruction,more exacerbations, more vascular comorbidity, and lower health status compared to patients who were not referred to and treated by a PT. Conclusion. Unequalpatient phenotypes in different primary care settings have important clinical implications. It can be carefully concluded that other factors, besides the level of inactivity, play a role in referral to PT.
Ambtenaren openbare orde en veiligheid spelen een centrale rol in de zorg voor maatschappelijke veiligheid. Hun focus ligt van oudsher op de preventie van slachtofferschap van veelvoorkomende criminaliteit (zoals diefstal, vernielingen en vandalisme) en high impact crime (zoals woninginbraak, overvallen en straatroven) binnen hun verzorgingsgebied. Intussen heeft de digitalisering van de samenleving een ongeëvenaarde gelegenheid voor criminaliteit gecreëerd. De totale maatschappelijke schade van cybercrime werd voor 2018 op 10 miljard euro geschat (1% van BNP). Uit cijfers van het CBS blijkt dat tussen 2012 en 2018 het slachtofferschap van hacken zelfs hoger lag dan dat van fietsendiefstal. Nederlandse gemeenten hebben cybercrime in de afgelopen twee jaar dan ook breed als beleidsprioriteit omarmd. Maar in de vertaling van deze beleidsprioriteit naar concrete acties gaat het mis. Duidelijk is dat de ambtenaren openbare orde en veiligheid een taak voor zichzelf zien in de preventie van cybercrime, maar waar te beginnen? In dit project bundelen professionals uit twaalf gemeenten en vier regionale veiligheidsnetwerken hun slagkracht met onderzoekers van twee hogescholen en het NSCR voor de cyberweerbaarheid van de samenleving. De hoofdvraag van dit project luidt: Met welke interventies kunnen ambtenaren openbare orde en veiligheid de cyberweerbaarheid van burgers en bedrijven binnen hun gemeente vergroten? Middels actieonderzoek werken professionals van gemeenten en regio’s samen met onderzoekers aan het verbeteren van bestaande en het ontwikkelen van nieuwe interventies. Daarbij verscherpen zij hun beeld van de omvang en achtergronden van slachtofferschap van cybercrime. Ook onderzoeken zij achtergronden en verklaringen voor het risicobewustzijn en preventief gedrag onder doelgroepen. Deze inzichten worden in verschillende iteraties aangevuld met effectstudies, om tot een set beproefde interventies te komen waarmee de cyberweerbaarheid van burgers en bedrijven zal toenemen.
