The transition from institutional to community care for vulnerable people has been shaping the welfare system in Europe over the last decades. For the period of 2014-20 deinstitutionalization became one of the highlighted priorities of the European Commission in order to promote reforms in disability and mental health care in the convergence regions, too. Between 2007 and 2013, Estonia as many other Eastern European countries has implemented the first wave of deinstitutionalization and during the new EU budget period a second wave will be occurred in order to continue and hopefully complete the transition. In this study, we try to give an overview on the experiences of different European countries highlighting good practices and possible pitfalls. This study has been conducted at the request of the Estonian Ministry of Social Affairs.
Objective: To predict mortality by disability in a sample of 479 Dutch community-dwelling people aged 75 years or older. Methods: A longitudinal study was carried out using a follow-up of seven years. The Groningen Activity Restriction Scale (GARS), a self-reported questionnaire with good psychometric properties, was used for data collection about total disability, disability in activities in daily living (ADL) and disability in instrumental activities in daily living (IADL). The mortality dates were provided by the municipality of Roosendaal (a city in the Netherlands). For analyses of survival, we used Kaplan–Meier analyses and Cox regression analyses to calculate hazard ratios (HR) with 95% confidence intervals (CI). Results: All three disability variables (total, ADL and IADL) predicted mortality, unadjusted and adjusted for age and gender. The unadjusted HRs for total, ADL and IADL disability were 1.054 (95%-CI: [1.039;1.069]), 1.091 (95%-CI: [1.062;1.121]) and 1.106 (95%-CI: [1.077;1.135]) with p-values <0.001, respectively. The AUCs were <0.7, ranging from 0.630 (ADL) to 0.668 (IADL). Multivariate analyses including all 18 disability items revealed that only “Do the shopping” predicted mortality. In addition, multivariate analyses focusing on 11 ADL items and 7 IADL items separately showed that only the ADL item “Get around in the house” and the IADL item “Do the shopping” significantly predicted mortality. Conclusion: Disability predicted mortality in a seven years follow-up among Dutch community-dwelling older people. It is important that healthcare professionals are aware of disability at early stages, so they can intervene swiftly, efficiently and effectively, to maintain or enhance the quality of life of older people.
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Treatment guidelines difer signifcantly, not only between Europe and North America but also among European countries [1–4]. Reasons for these diferences include antimicrobial resistance patterns, accessibility to and reimbursement policies for medicines, and culturally and historically determined prescribing attitudes. The European Association of Clinical Pharmacology and Therapeutics’ Education Working Group has launched several initiatives to improve and harmonize European pharmacotherapy education, but international diferences have proven to be a major barrier to these eforts [5–7]. While we have taken steps to chart these diferences [6, 8], it will probably not be possible to fully resolve them. Rather than viewing these diferences as a barrier, we should perhaps see them as an opportunity for intercultural learning by providing students and teachers a valuable lesson in the context-dependent nature of prescribing medication and the diferent interpretations of evidence-based medicine. Here, we extend our experience with interprofessional student-run clinics [9, 10], to report on our first experiences with the “International and Interprofessional Student-run Clinic.” We organized three successful video meetings with medical and pharmacy students of the Amsterdam UMC, location VU University (the Netherlands), and the University of Bologna (Italy). During these meetings, one of the students presented a real-life case of a patient on polypharmacy. Then, in a 45-min session, the students split into smaller groups (break-out rooms) to review the patient’s medication, using the prescribing optimization method and STOPP/ START criteria [11, 12]. The teachers rotated between the diferent rooms and assisted the students when necessary. Teachers and students reconvened for 60 min for debriefng, with students presenting their fndings and suggestions to revise the medication list and teachers stimulating discussion and indicating how they would alter the medication list. Participation was voluntary, and the meetings were held in the evenings to accommodate students in clinical rotations. Third-to-fnal-year medical and pharmacy students participated in the three meetings (n=17, n=20, n=12, respectively). They reported learning a lot from each other, gaining an international and interprofessional perspective. Moreover, they learned to always consider the patient’s perspective, that evidence-based medicine is context-dependent, and that guidelines should be adapted to the patient’s situation.
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De synergie tussen Robotica en AI biedt vele oplossingsmogelijkheden voor (internationale) maatschappelijke opgaven waarvoor we staan (SDG’s, de EU Grand-Challenges, KIA’s). Een consortium van thans 9 Hogescholen, TKI-HTSM en Holland Robotics (community >600 organisaties) slaan de handen ineen om de ontwikkeling van praktijkkennis te versnellen, kennis te delen en betekenisvolle oplossingen te realiseren voor allehande vraagstukken op het gebied van de zorg, het klimaat, onze veiligheid, duurzame energievoorziening, het verdienvermogen van de Nederlandse (maak)industrie en het onderwijs. Robotisering en AI biedt publiek/private organisaties nieuwe mogelijkheden om taken, diensten en processen meer efficiënt, veilig en (kosten)effectief uit te voeren. Robots werken (steeds meer) samen met mensen en kunnen gevaarlijke en/of moeilijke taken overnemen. Ze creëren ook nieuwe mogelijkheden, die anders niet mogelijk zijn. Dit platform, aansluitend bij de KIA-Sleuteltechnologieën, heeft ambities om praktijkkennis sneller te ontwikkelen, deze te bundelen en toe te passen in relevante applicatiedomeinen. Alle mooie ontwikkelingen ten spijt, is het lerende vermogen en/of het autonoom handelen van robots nog minder dan dat van mensen. Robots hebben bijvoorbeeld moeite met het omgaan met onvoorziene omstandigheden en werken in ongestructureerde omgevingen. Om robots te kunnen laten denken en doen als mensen, is er nog een lange weg te gaan. De echte synergie tussen Robotica & AI, waarop dit platform zich richt, heeft een veelbelovend potentieel om de volgende sprong te maken om de bovengenoemde uitdagingen aan te gaan. Platformdeelnemers willen, op basis van een gezamenlijk roadmap, nieuwe praktijkkennis delen, ontwikkelen en toepassen in relevante (applicatie)domeinen. Zo worden betekenisvolle bijdragen geleverd aan urgente maatschappelijk vraagstukken. Het platform heeft als doel om in de quintuple helix kennis duurzaam te laten circuleren, een wenkend perspectief te bieden voor alle stakeholders, Applied Smart Robotica & AI-onderzoek beter landelijk en internationaal te positioneren, te focussen op meervoudige waardecreatie en gezamenlijk te werken aan iconische projecten.
CIVITAS is a network of cities for cities dedicated to cleaner, better transport in Europe and beyond. Since it was launched by the European Commission in 2002, the CIVITAS Initiative has tested and implemented over 800 measures and urban transport solutions as a part of demonstration projects in more than 80 Living Lab cities across Europe.The ELEVATE project aims to increase the Europe-wide impact of Research and Innovation Actions on urban mobility policy-making, thereby advancing the CIVITAS community to a higher level of knowledge, exchange, impact and sustainability, while guaranteeing essential high-quality support. ELEVATE is committed to achieving the following objectives:1. Developing the CIVITAS knowledge base and transferring new knowledge.2. Enriching the current CIVITAS generation and feeding future EU initiatives.3. Building a European mobility community able to navigate transition.4. Representing CIVITAS on the international stage.Breda University of Applied Sciences is work package leader for a work package on incubation and CIVINETs.Main collaborating partners:Mobiel21 (project coordinator), DTV Consultants, INOVA, TRT, ICLEI
The Hanze Hogeschool Groningen, the Authoridad Nacional del Agua, and Waterschap Noorderzijlvest, together with several other Dutch and Peruvian universities, co-organise an annual ClimateCafé in the northern Peruvian areas Piura and Tumbes, as part of the Blue Deal project. The ClimateCafé methodology is a multiple-day participatory workshop composed by an international community and powered by individual, corporate, public, and academic climate change adaptation influencers. The aim is to educate and inspire tech and non-tech people, focusing on young professionals in a “learning by doing” interaction.
