The aim of this research was to study the clinical characteristics and mortality and disability outcomes of patients who present distinct risk profiles for functional decline at admission. A multicenter, prospective cohort study was conducted between 2006 and 2009 in three hospitals in the Netherlands in consecutive patients of 65 years and over, acutely admitted and hospitalized for at least 48 hours. Nineteen geriatric conditions were assessed at hospital admission, and mortality and functional decline were assessed until twelve months after admission. Patients were divided into risk categories for functional decline (low, intermediate or high risk) according to the Identification of Seniors at Risk-Hospitalized Patients.
Wereldwijd worden mensen steeds ouder en het aandeel ouderen binnen de bevolking neemt toe. Dit leidt ook tot een toename van het aantal ouderen dat kwetsbaar is. Ondanks dat de term kwetsbaarheid, in het Engels ‘frailty’ genoemd, vaak gebruikt wordt, is er nog geen consensus over wat dit precies inhoudt. Onderzoekers en zorgprofessionals gebruiken diverse benaderingen met diverse, bijbehorende meetinstrumenten. Desondanks is men het er wel over eens dat kwetsbaarheid leidt tot negatieve gezondheidsuitkomsten. Onderzoek laat zien dat kwetsbare ouderen een verhoogd risico hebben op bijvoorbeeld overlijden, opname in een ziekenhuis en beperkingen in het uitvoeren van dagelijkse activiteiten (ADL). Om dit te voorkomen en mensen te ondersteunen of een behandeling aan te bieden, is het van belang dat we ouderen die kwetsbaar zijn goed kunnen identificeren. Op die manier worden mensen niet onterecht als kwetsbaar aangemerkt. Als namelijk de verkeerde groep mensen behandeld wordt zal het effect van een eventuele behandeling minimaal zijn en zullen de zorgkosten onnodig stijgen. Daarentegen zullen kwetsbare mensen die de zorg wel nodig hebben, deze wellicht niet ontvangen wanneer ze verkeerd gediagnostiseerd worden. De doelen van dit proefschrift zijn: (1) het verkrijgen van meer inzicht in de functionele profielen die behoren bij verschillende stadia van kwetsbaarheid; (2) het onderzoeken welke beschermende factoren het pad van kwetsbaarheid naar (verdere) negatieve gezondheidsuitkomsten kunnen beïnvloeden; en (3) het vergroten van de kennis van psychometrische eigenschappen van veelgebruikte vragenlijsten die kwetsbaarheid meten.
This study focuses on students’ approaches to learning, particularly in innovative learning environments. A person-oriented research perspective was chosen to search for nuances and details that add to existing knowledge on secondary students’ learning. The relation between students’ goal orientations, learning strategies, and different learning environments was investigated via questionnaires and interviews. The questionnaire study revealed four profiles of 673 students’ (meta-)cognitive learning strategies. Differences in student learning were found between students of an innovative school and students of regular schools, indicating that learning strategies are elicited by the learning environments students are confronted with. The interview study with 20 students from the innovative school illustrated their learning in learning environments typical for this school. Results revealed how students from different profiles differed in their goal orientations and learning strategies and that these differences were related to students’ need for teacher support when learning. The results of this study provide qualitative and quantitative insight in (enhancing) secondary students’ learning, doing justice to the learners as persons and individual differences.
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Human kind has a major impact on the state of life on Earth, mainly caused by habitat destruction, fragmentation and pollution related to agricultural land use and industrialization. Biodiversity is dominated by insects (~50%). Insects are vital for ecosystems through ecosystem engineering and controlling properties, such as soil formation and nutrient cycling, pollination, and in food webs as prey or controlling predator or parasite. Reducing insect diversity reduces resilience of ecosystems and increases risks of non-performance in soil fertility, pollination and pest suppression. Insects are under threat. Worldwide 41 % of insect species are in decline, 33% species threatened with extinction, and a co-occurring insect biomass loss of 2.5% per year. In Germany, insect biomass in natural areas surrounded by agriculture was reduced by 76% in 27 years. Nature inclusive agriculture and agri-environmental schemes aim to mitigate these kinds of effects. Protection measures need success indicators. Insects are excellent for biodiversity assessments, even with small landscape adaptations. Measuring insect biodiversity however is not easy. We aim to use new automated recognition techniques by machine learning with neural networks, to produce algorithms for fast and insightful insect diversity indexes. Biodiversity can be measured by indicative species (groups). We use three groups: 1) Carabid beetles (are top predators); 2) Moths (relation with host plants); 3) Flying insects (multiple functions in ecosystems, e.g. parasitism). The project wants to design user-friendly farmer/citizen science biodiversity measurements with machine learning, and use these in comparative research in 3 real life cases as proof of concept: 1) effects of agriculture on insects in hedgerows, 2) effects of different commercial crop production systems on insects, 3) effects of flower richness in crops and grassland on insects, all measured with natural reference situations
Over the past decade, the trend in both the public sector and industry has been to outsource ICT to the cloud. While cost savings are often used as a rationale for outsourcing, another argument that is frequently used is that the cloud improves security. The reasoning behind this is twofold. First, cloud service providers are typically thought to have skilled staff trained in good security practices. Second, cloud providers often have a vastly distributed, highly connected network infrastructure, making them more resilient in the face of outages and denial-of-service attacks. Yet many examples of cloud outages, often due to attacks, call into question whether outsourcing to the cloud does improve security. In this project our goal therefore is to answer two questions: 1) did the cloud make use more secure?and 2) can we provide specific security guidance to support cloud outsourcing strategies? We will approach these questions in a multi-disciplinary fashion from a technical angle and from a business and management perspective. On the technical side, the project will focus on providing comprehensive insight into the attack surface at the network level of cloud providers and their users. We will use a measurement-based approach, leveraging large scale datasets about the Internet, both our own data (e.g. OpenINTEL, a large- scale dataset of active DNS measurements) and datasets from our long-term collaborators, such as CAIDA in the US (BGPStream, Network Telescope) and Saarland University in Germany (AmpPot). We will use this data to study the network infrastructure outside and within cloud environments to structurally map vulnerabilities to attacks as well as to identify security anti-patterns, where the way cloud services are managed or used introduce a weak point that attackers can target. From a business point of view, we will investigate outsourcing strategies for both the cloud providers and their customers. For guaranteeing 100% availability, cloud service providers have to maintain additional capacity at all times. They also need to forecast capacity requirements continuously for financially profitable decisions. If the forecast is lower than the capacity needed, then the cloud is not able to deliver 100% availability in case of an attack. Conversely, if the forecast is substantially higher, the cloud service provider might not be able to make desired profits. We therefore propose to assess the risk profiles of cloud providers (how likely it is a cloud provider is under attack at a given time given the nature of its customers) using available attack data to improve the provider resilience to future attacks. From the costumer perspective, we will investigate how we can support cloud outsourcing by taking into consideration business and technical constraints. Decision to choose a cloud service provider is typically based on multiple criteria depending upon the company’s needs (security and operational). We will develop decision support systems that will help in mapping companies’ needs to cloud service providers’ offers.
The application of sensors in water technology is a crucial step to provide broader, more effi-cient and more circular systems. Among the different technologies used in this filed, ultra-sound based systems are widely used in water technology, basically to generate energy peaks for cell lyse and particle separation. In this work we propose the adaptation of a (cur-rently used for medical applications) ultra sound ecosystem to monitor the vertical profile of solid particles in UASB reactors. Such information is nowadays obtained via long duration (solids) analysis and can compromises the efficiency of such reactors, especially regarding the sludge stabilization and phase separation. The project is a small part of a big effort done by different countries, e.g. Brazil, UK and The Netherlands, to bring international technology and expertise to improve the quality of waste water systems in Brazil, by supporting tech-nology and knowledge sharing. If proven feasible, the concept can generate a big business market to the involved Dutch (SME) partners as well as favor the automation of WWTP in Brazil and around the world.
