Aims: In-hospital prescribing errors may result in patient harm, such as prolonged hospitalisation and hospital (re)admission, and may be an emotional burden for the prescribers and healthcare professionals involved. Despite efforts, in-hospital prescribing errors and related harm still occur, necessitating an innovative approach. We therefore propose a novel approach, in-hospital pharmacotherapeutic stewardship (IPS). The aim of this study was to reach consensus on a set of quality indicators (QIs) as a basis for IPS. Methods: A three-round modified Delphi procedure was performed. Potential QIs were retrieved from two systematic searches of the literature, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. In two written questionnaires and a focus meeting (held between the written questionnaire rounds), potential QIs were appraised by an international, multidisciplinary expert panel composed of members of the European Association for Clinical Pharmacology and Therapeutics (EACPT). Results: The expert panel rated 59 QIs and four general statements, of which 35 QIs were accepted with consensus rates ranging between 79% and 97%. These QIs describe the activities of an IPS programme, the team delivering IPS, the patients eligible for the programme and the outcome measures that should be used to evaluate the care delivered. Conclusions: A framework of 35 QIs for an IPS programme was systematically developed. These QIs can guide hospitals in setting up a pharmacotherapeutic stewardship programme to reduce in-hospital prescribing errors and improve in-hospital medication safety.
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Mechanical power output is a key performance-determining variable in many cyclic sports. In rowing, instantaneous power output is commonly determined as the dot product of handle force moment and oar angular velocity. The aim of this study was to show that this commonly used proxy is theoretically flawed and to provide an indication of the magnitude of the error. To obtain a consistent dataset, simulations were performed using a previously proposed forward dynamical model. Inputs were previously recorded rower kinematics and horizontal oar angle, at 20 and 32 strokes∙min−1. From simulation outputs, true power output and power output according to the common proxy were calculated. The error when using the common proxy was quantified as the difference between the average power output according to the proxy and the true average power output (P̅residual), and as the ratio of this difference to the true average power output (ratiores./rower). At stroke rate 20, P̅residual was 27.4 W and ratiores./rower was 0.143; at stroke rate 32, P̅residual was 44.3 W and ratiores./rower was 0.142. Power output in rowing appears to be underestimated when calculated according to the common proxy. Simulations suggest this error to be at least 10% of the true power output.
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PURPOSE: Athletes require feedback in order to comply with prescribed training programs designed to optimize their performance. In rowing, current feedback parameters on intensity are inaccurate. Mechanical power output is a suitable objective measure for training intensity, but due to movement restrictions related to crew rowing, it is uncertain whether crew rowers are able to adjust their intensity based on power-output feedback. The authors examined whether rowers improve compliance with prescribed power-output targets when visual real-time feedback on power output is provided in addition to commonly used feedback.METHODS: A total of 16 crew rowers rowed in 3 training sessions. During the first 2 sessions, they received commonly used feedback, followed by a session with additional power-output feedback. Targets were set by their coaches before the experiment. Compliance was operationalized as accuracy (absolute difference between target and delivered power output) and consistency (high- and low-frequency variations in delivered power output).RESULTS: Multilevel analyses indicated that accuracy and low-frequency variations improved by, respectively, 65% (P > .001) and 32% (P = .024) when additional feedback was provided.CONCLUSION: Compliance with power-output targets improved when crew rowers received additional feedback on power output. Two additional observations were made during the study that highlighted the relevance of power-output feedback for practice: There was a marked discrepancy between the prescribed targets and the actually delivered power output by the rowers, and coaches had difficulties perceiving improvements in rowers' compliance with power-output targets.
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The Dutch Environmental Vision and Mobility Vision 2050 promote climate-neutral urban growth around public transport stations, envisioning them as vibrant hubs for mobility, community, and economy. However, redevelopment often increases construction, a major CO₂ contributor. Dutch practice-led projects like 'Carbon Based Urbanism', 'MooiNL - Practical guide to urban node development', and 'Paris Proof Stations' explore integrating spatial and environmental requirements through design. Design Professionals seek collaborative methods and tools to better understand how can carbon knowledge and skills be effectively integrated into station area development projects, in architecture and urban design approaches. Redeveloping mobility hubs requires multi-stakeholder negotiations involving city planners, developers, and railway managers. Designers act as facilitators of the process, enabling urban and decarbonization transitions. CARB-HUB explores how co-creation methods can help spatial design processes balance mobility, attractiveness, and carbon neutrality across multiple stakeholders. The key outputs are: 1- Serious Game for Co-Creation, which introduces an assessment method for evaluating the potential of station locations, referred to as the 4P value framework. 2-Design Toolkit for Decarbonization, featuring a set of Key Performance Indicators (KPIs) to guide sustainable development. 3- Research Bid for the DUT–Driving Urban Transitions Program, focusing on the 15-minute City Transition Pathway. 4- Collaborative Network dedicated to promoting a low-carbon design approach. The 4P value framework offers a comprehensive method for assessing the redevelopment potential of station areas, focusing on four key dimensions: People, which considers user experience and accessibility; Position, which examines the station's role within the broader transport network; Place-making, which looks at how well the station integrates into its surrounding urban environment; and Planet, which addresses decarbonization and climate adaptation. CARB-HUB uses real cases of Dutch stations in transition as testbeds. By translating abstract environmental goals into tangible spatial solutions, CARB-HUB enables scenario-based planning, engaging designers, policymakers, infrastructure managers, and environmental advocates.
