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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Abstract: Since the first Oxford Survey of Childhood Cancer’s results were published, people have become more aware of the risks associated with prenatal exposure from diagnostic x rays. As a result, it has since been the subject of many studies. In this review, the results of recent epidemiological studies are summarized. The current international guidelines for diagnostic x-ray examinations were compared to the review. All epidemiological studies starting from 2007 and all relevant international guidelines were included. Apart from one study that involved rhabdomyosarcoma, no statistically significant associations were found between prenatal exposure to x rays and the development of cancer during 2007–2020. Most of the studies were constrained in their design due to too small a cohort or number of cases, minimal x-ray exposure, and/or data obtained from the exposed mothers instead of medical reports. In one of the studies, computed tomography exposure was also included, and this requires more and longer follow-up in successive studies. Most international guidelines are comparable, provide risk coefficients that are quite conservative, and discourage abdominal examinations of pregnant women.
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Background: The objective of this study was to derive evidence-based physical activity guidelines for the general Dutch population. Methods: Two systematic reviews were conducted of English language meta-analyses in PubMed summarizing separately randomized controlled trials and prospective cohort studies on the relation between physical activity and sedentary behaviour on the one hand and the risk of all-cause mortality and incidence of 15 major chronic diseases and conditions on the other hand. Other outcome measures were risk factors for cardiovascular disease and type 2 diabetes, physical functioning, and fitness. On the basis of these reviews, an expert committee derived physical activity guidelines. In deriving the guidelines, the committee first selected only experimental and observational prospective findings with a strong level of evidence and then integrated both lines of evidence. Results: The evidence found for beneficial effects on a large number of the outcome measures was sufficiently strong to draw up guidelines to increase physical activity and reduce sedentary behaviour, respectively. At the same time, the current evidence did not provide a sufficient basis for quantifying how much physical activity is minimally needed to achieve beneficial health effects, or at what amount sedentary behaviour becomes detrimental. A general tenet was that at every level of current activity, further increases in physical activity provide additional health benefits, with relatively larger effects among those who are currently not active or active only at light intensity. Three specific guidelines on (1) moderate- and vigorous-intensity physical activity, (2) bone- and musclestrengthening activities, and (3) sedentary behaviour were formulated separately for adults and children. Conclusions: There is an unabated need for evidence-based physical activity guidelines that can guide public health policies. Research in which physical activity is measured both objectively (quantity) and subjectively (type and quality) is needed to provide better estimates of the type and actual amount of physical activity required for health.
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The pressure on the European health care system is increasing considerably: more elderly people and patients with chronic diseases in need of (rehabilitation) care, a diminishing work force and health care costs continuing to rise. Several measures to counteract this are proposed, such as reduction of the length of stay in hospitals or rehabilitation centres by improving interprofessional and person-centred collaboration between health and social care professionals. Although there is a lot of attention for interprofessional education and collaborative practice (IPECP), the consortium senses a gap between competence levels of future professionals and the levels needed in rehabilitation practice. Therefore, the transfer from tertiary education to practice concerning IPECP in rehabilitation is the central theme of the project. Regional bonds between higher education institutions and rehabilitation centres will be strengthened in order to align IPECP. On the one hand we deliver a set of basic and advanced modules on functioning according to the WHO’s International Classification of Functioning, Disability and Health and a set of (assessment) tools on interprofessional skills training. Also, applications of this theory in promising approaches, both in education and in rehabilitation practice, are regionally being piloted and adapted for use in other regions. Field visits by professionals from practice to exchange experiences is included in this work package. We aim to deliver a range of learning materials, from modules on theory to guidelines on how to set up and run a student-run interprofessional learning ward in a rehabilitation centre. All tested outputs will be published on the INPRO-website and made available to be implemented in the core curricula in tertiary education and for lifelong learning in health care practice. This will ultimately contribute to improve functioning and health outcomes and quality of life of patients in rehabilitation centres and beyond.
Artificial Intelligence (AI) wordt realiteit. Slimme ICT-producten die diensten op maat leveren accelereren de digitalisering van de maatschappij. De grote innovaties van de komende jaren –zelfrijdende auto’s, spraakgestuurde virtuele assistenten, autodiagnose systemen, robots die autonoom complexe taken uitvoeren – zijn datagedreven en hebben een AI-component. Dit gaat de rol van professionals in alle domeinen, gezondheidzorg, bouwsector, financiële dienstverlening, maakindustrie, journalistiek, rechtspraak, etc., raken. ICT is niet meer volgend en ondersteunend (een ‘enabling’ technologie), maar de motor die de transformatie van de samenleving in gang zet. Grote bedrijven, overheidsinstanties, het MKB, en de vele startups in de Brainport regio zijn innovatieve datagedreven scenario’s volop aan het verkennen. Dit wordt nog eens versterkt door de democratisering van AI; machine learning en deep learning algoritmes zijn beschikbaar zowel in open source software als in Cloud oplossingen en zijn daarmee toegankelijk voor iedereen. Data science wordt ‘applied’ en verschuift van een PhD specialisme naar een HBO-vaardigheid. Het stadium waarin veel bedrijven nu verkeren is te omschrijven als: “Help, mijn AI-pilot is succesvol. Wat nu?” Deze aanvraag richt zich op het succesvol implementeren van AI binnen de context van softwareontwikkeling. De onderzoeksvraag van dit voorstel is: “Hoe kunnen we state-of-the-art data science methoden en technieken waardevol en verantwoord toepassen ten behoeve van deze slimme lerende ICT-producten?” De postdoc gaat fungeren als een linking pin tussen alle onderzoeksprojecten en opdrachten waarbij studenten ICT-producten met AI (machine learning, deep learning) ontwikkelen voor opdrachtgevers uit de praktijk. Door mee te kijken en mee te denken met de studenten kan de postdoc overzicht en inzicht creëren over alle cases heen. Als er overzicht is kan er daarna ook gestuurd worden op de uit te voeren cases om verschillende deelaspecten samen met de studenten te onderzoeken. Deliverables zijn rapporten, guidelines en frameworks voor praktijk en onderwijs, peer-reviewed artikelen en kennisdelingsevents.
“Empowering learners to create a sustainable future” This is the mission of Centre of Expertise Mission-Zero at The Hague University of Applied Sciences (THUAS). The postdoc candidate will expand the existing knowledge on biomimicry, which she teaches and researches, as a strategy to fulfil the mission of Mission-Zero. We know when tackling a design challenge, teams have difficulties sifting through the mass of information they encounter. The candidate aims to recognize the value of systematic biomimicry, leading the way towards the ecosystems services we need tomorrow (Pedersen Zari, 2017). Globally, biomimicry demonstrates strategies contributing to solving global challenges such as Urban Heat Islands (UHI) and human interferences, rethinking how climate and circular challenges are approached. Examples like Eastgate building (Pearce, 2016) have demonstrated successes in the field. While biomimicry offers guidelines and methodology, there is insufficient research on complex problem solving that systems-thinking requires. Our research question: Which factors are needed to help (novice) professionals initiate systems-thinking methods as part of their strategy? A solution should enable them to approach challenges in a systems-thinking manner just like nature does, to regenerate and resume projects. Our focus lies with challenges in two industries with many unsustainable practices and where a sizeable impact is possible: the built environment (Circularity Gap, 2021) and fashion (Joung, 2014). Mission Zero has identified a high demand for Biomimicry in these industries. This critical approach: 1) studies existing biomimetic tools, testing and defining gaps; 2) identifies needs of educators and professionals during and after an inter-disciplinary minor at The Hague University; and, 3) translates findings into shareable best practices through publications of results. Findings will be implemented into tangible engaging tools for educational and professional settings. Knowledge will be inclusive and disseminated to large audiences by focusing on communication through social media and intervention conferences.
