Aim To provide insight into the basic characteristics of decision making in the treatment of symptomatic severe aortic stenosis (SSAS) in Dutch heart centres with specific emphasis on the evaluation of frailty, cognition, nutritional status and physical functioning/functionality in (instrumental) activities of daily living [(I)ADL]. Methods A questionnaire was used that is based on the European and American guidelines for SSAS treatment. The survey was administered to physicians and non-physicians in Dutch heart centres involved in the decision-making pathway for SSAS treatment. Results All 16 Dutch heart centres participated. Before a patient case is discussed by the heart team, heart centres rarely request data from the referring hospital regarding patients’ functionality (n = 5), frailty scores (n = 0) and geriatric consultation (n = 1) as a standard procedure. Most heart centres ‘often to always’ do their own screening for frailty (n = 10), cognition/mood (n = 9), nutritional status (n = 10) and physical functioning/functionality in (I)ADL (n = 10). During heart team meetings data are ‘sometimes to regularly’ available regarding frailty (n = 5), cognition/mood (n = 11), nutritional status (n = 8) and physical functioning/functionality in (I)ADL (n = 10). After assessment in the outpatient clinic patient cases are re-discussed ‘sometimes to regularly’ in heart team meetings (n = 10). Conclusions Dutch heart centres make an effort to evaluate frailty, cognition, nutritional status and physical functioning/functionality in (I)ADL for decision making regarding SSAS treatment. However, these patient data are not routinely requested from the referring hospital and are not always available for heart team meetings. Incorporation of these important data in a structured manner early in the decision-making process may provide additional useful information for decision making in the heart team meeting.
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main spatial policy approaches to securing DHC through new developments in Belgium, France, Ireland, the Netherlands and the United Kingdom
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This chapter presents Critical Policy Discourse Analysis (CPDA) which merges critical discourse analysis (CDA) with critical policy studies (CPS). CPDA engages with a discursive analysis of a policy problem, generally drawing on critical discourse analysis for its methodology, in this case Text Oriented Discourse Analysis (TODA). The research addresses the problem of complexity reduction in the process of policy-making and illustrates this with an analysis of the UN Agenda “Transforming the World, the 2030 Agenda for Sustainable Development”, which introduces the sustainable development goals (SDGs). It presents the reader with a detailed example of how to perform a TODA research. It indeed reveals mechanisms of policy reduction such as decontextualization, singularization, a limited spatio-temporal frame reduced to the timespan of the UN. It discusses the potential consequences of this for the effectivity of the SDGs and presents alternative theories and voices that do capture the complexity of real life events. The final section suggests further developments in CPDA and advocates bringing complexity to the fore.
MUSE supports the CIVITAS Community to increase its impact on urban mobility policy making and advance it to a higher level of knowledge, exchange, and sustainability.As the current Coordination and Support Action for the CIVITAS Initiative, MUSE primarily engages in support activities to boost the impact of CIVITAS Community activities on sustainable urban mobility policy. Its main objectives are to:- Act as a destination for knowledge developed by the CIVITAS Community over the past twenty years.- Expand and strengthen relationships between cities and stakeholders at all levels.- Support the enrichment of the wider urban mobility community by providing learning opportunities.Through these goals, the CIVITAS Initiative strives to support the mobility and transport goals of the European Commission, and in turn those in the European Green Deal.Breda University of Applied Sciences is the task leader of Task 7.3: Exploitation of the Mobility Educational Network and Task 7.4: Mobility Powered by Youth Facilitation.
Developing a framework that integrates Advanced Language Models into the qualitative research process.Qualitative research, vital for understanding complex phenomena, is often limited by labour-intensive data collection, transcription, and analysis processes. This hinders scalability, accessibility, and efficiency in both academic and industry contexts. As a result, insights are often delayed or incomplete, impacting decision-making, policy development, and innovation. The lack of tools to enhance accuracy and reduce human error exacerbates these challenges, particularly for projects requiring large datasets or quick iterations. Addressing these inefficiencies through AI-driven solutions like AIDA can empower researchers, enhance outcomes, and make qualitative research more inclusive, impactful, and efficient.The AIDA project enhances qualitative research by integrating AI technologies to streamline transcription, coding, and analysis processes. This innovation enables researchers to analyse larger datasets with greater efficiency and accuracy, providing faster and more comprehensive insights. By reducing manual effort and human error, AIDA empowers organisations to make informed decisions and implement evidence-based policies more effectively. Its scalability supports diverse societal and industry applications, from healthcare to market research, fostering innovation and addressing complex challenges. Ultimately, AIDA contributes to improving research quality, accessibility, and societal relevance, driving advancements across multiple sectors.
National forestry Commission (SBB) and National Park De Biesbosch. Subcontractor through NRITNational parks with large flows of visitors have to manage these flows carefully. Methods of data collection and analysis can be of help to support decision making. The case of the Biesbosch National Park is used to find innovative ways to figure flows of yachts, being the most important component of water traffic, and to create a model that allows the estimation of changes in yachting patterns resulting from policy measures. Recent policies oriented at building additional waterways, nature development areas and recreational concentrations in the park to manage the demands of recreation and nature conservation offer a good opportunity to apply this model. With a geographical information system (GIS), data obtained from aerial photographs and satellite images can be analyzed. The method of space syntax is used to determine and visualize characteristics of the network of leisure routes in the park and to evaluate impacts resulting from expected changes in the network that accompany the restructuring of waterways.