The increasing rate of urbanization along with its socio-environmental impact are major global challenges. Therefore, there is a need to assess the boundaries to growth for the future development of cities by the inclusion of the assessment of the environmental carrying capacity (ECC) into spatial management. The purpose is to assess the resource dependence of a given entity. ECC is usually assessed based on indicators such as the ecological footprint (EF) and biocapacity (BC). EF is a measure of the biologically productive areas demanded by human consumption and waste production. Such areas include the space needed for regenerating food and fibers as well as sequestering the generated pollution, particularly CO2 from the combustion of fossil fuels. BC reflects the biological regeneration potential of a given area to regenerate resources as well to absorb waste. The city level EF assessment has been applied to urban zones across the world, however, there is a noticeable lack of urban EF assessments in Central Eastern Europe. Therefore, the current research is a first estimate of the EF and BC for the city of Wrocław, Poland. This study estimates the Ecological Footprint of Food (EFF) through both a top-down assessment and a hybrid top-down/bottom-up assessment. Thus, this research verifies also if results from hybrid method could be comparable with top-down approach. The bottom-up component of the hybrid analysis calculated the carbon footprint of food using the life cycle assessment (LCA) method. The top-down result ofWrocław’s EFF were 1% greater than the hybrid EFF result, 0.974 and 0.963 gha per person respectively. The result indicated that the EFF exceeded the BC of the city of Wrocław 10-fold. Such assessment support efforts to increase resource efficiency and decrease the risk associated with resources—including food security. Therefore, there is a need to verify if a city is able to satisfy the resource needs of its inhabitants while maintaining the natural capital on which they depend intact. Original article at: https://doi.org/10.3390/resources7030052 © 2018 by the authors. Licensee MDPI.
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In November 2019, scholars and practitioners from ten higher education institutions celebrated the launch of the iKudu project. This project, co-funded by Erasmus [1], focuses on capacity development for curriculum transformation through internationalisation and development of Collaborative Online International Learning (COIL) virtual exchange. Detailed plans for 2020 were discussed including a series of site visits and face-to-face training. However, the realities of the COVID-19 pandemic disrupted the plans in ways that could not have been foreseen and new ways of thinking and doing came to the fore. Writing from an insider perspective as project partners, in this paper we draw from appreciative inquiry, using a metaphor of a mosaic as our identity, to first provide the background on the iKudu project before sharing the impact of the pandemic on the project’s adapted approach. We then discuss how alongside the focus of iKudu in the delivery of an internationalised and transformed curriculum using COIL, we have, by our very approach as project partners, adopted the principles of COIL exchange. A positive impact of the pandemic was that COIL offered a consciousness raising activity, which we suggest could be used more broadly in order to help academics think about international research practice partnerships, and, as in our situation, how internationalised and decolonised curriculum practices might be approached. 1. KA2 Erasmus+ Cooperation for innovation and the exchange of good practices (capacity building in the field of Higher Education)
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Het ondergaan van een eenzijdige beenamputatie is een drastische chirurgische ingreep. Mensen, die na een amputatie in staat zijn om te lopen met een prothese, zijn functioneel onafhankelijker, en hebben een hogere kwaliteit van leven dan mensen die in een rolstoel belanden. Het is daarom niet verrassend dat het herwinnen van de oopvaardigheid één van de voornaamste doelen is tijdens de revalidatie. Doel van het onderzoek was om inzicht te krijgen in de factoren die het herwinnen en onderhouden van de loopvaardigheid van mensen na een beenamputatie beïnvloeden. Gebaseerd op de resultaten van het onderzoek kan geconcludeerd worden dat de fysieke capaciteit hierbij een belangrijke rol speelt. Een relatief kleine verbetering in de capaciteit kan al resulteren in significante en klinisch relevante verbeteringen. Hoewel geavanceerde prothesen de mechanische belasting van het lopen met een beenprothese verminderen, kan een ineffectieve balanscontrole deze positieve resultaten weer tenietdoen. ABSTRACT Undergoing a lower limb amputation is a life-changing surgery. The ability to walk greatly influences the subject's functional independence and quality of life. Not surprisingly, regaining walking ability is one of the primary goals during prosthetic rehabilitation. The primary aim of the research performed was to enhance our understanding of some of the factors that influence the ability to regain and maintain walking after a unilateral lower limb amputation. Based on the results we can deduce that a person's physical capacity plays an important role in their walking ability. Relatively small improvements in capacity could lead to significant and clinically relevant improvements in people's walking ability. Furthermore, results show that sophisticated prosthetic feet can reduce the mechanical load experienced when walking with a prosthesis. Interestingly, inefficient balance control strategies can undo any positive effect of these prostheses.
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OBJECTIVE: To further test the validity and clinical usefulness of the steep ramp test (SRT) in estimating exercise tolerance in cancer survivors by external validation and extension of previously published prediction models for peak oxygen consumption (Vo2peak) and peak power output (Wpeak).DESIGN: Cross-sectional study.SETTING: Multicenter.PARTICIPANTS: Cancer survivors (N=283) in 2 randomized controlled exercise trials.INTERVENTIONS: Not applicable.MAIN OUTCOME MEASURES: Prediction model accuracy was assessed by intraclass correlation coefficients (ICCs) and limits of agreement (LOA). Multiple linear regression was used for model extension. Clinical performance was judged by the percentage of accurate endurance exercise prescriptions.RESULTS: ICCs of SRT-predicted Vo2peak and Wpeak with these values as obtained by the cardiopulmonary exercise test were .61 and .73, respectively, using the previously published prediction models. 95% LOA were ±705mL/min with a bias of 190mL/min for Vo2peak and ±59W with a bias of 5W for Wpeak. Modest improvements were obtained by adding body weight and sex to the regression equation for the prediction of Vo2peak (ICC, .73; 95% LOA, ±608mL/min) and by adding age, height, and sex for the prediction of Wpeak (ICC, .81; 95% LOA, ±48W). Accuracy of endurance exercise prescription improved from 57% accurate prescriptions to 68% accurate prescriptions with the new prediction model for Wpeak.CONCLUSIONS: Predictions of Vo2peak and Wpeak based on the SRT are adequate at the group level, but insufficiently accurate in individual patients. The multivariable prediction model for Wpeak can be used cautiously (eg, supplemented with a Borg score) to aid endurance exercise prescription.
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Background: Most studies on older adults' vitality focus on linear connections between determinants and outcomes. To design more comprehensive and impactful approaches to support the vitality of older adults, a better understanding of the interplay among elements that shape their vitality is necessary. Objective: To uncover the underlying dynamic system that drives vitality in older adults, drawing directly from older adults' perspectives. Methods: During three group model-building sessions with 10–12 older adults (≥ 55 years old), a causal loop diagram with relevant feedback loops was developed through co-creation with older adults. The construction and analysis of the causal loop diagram were facilitated using the online modelling tools Vensim and Kumu. The group model-building sessions were guided by Scriptapedia, an online guide to conducting group model-building practices. Results: The final CLD consisted of 15 elements contributing to older adults' vitality, organised into three themes: ‘Psychological and emotional elements’, ‘Social connections and support’ and ‘Lifestyle and habits’. A total of 41 reinforcing feedback loops were identified, with 21 involving all three themes, 15 connecting two themes and 5 within a single theme. Conclusions: This study displays the complex interplay of elements influencing older adults' vitality, highlighting the critical roles of psychological, social and lifestyle-related elements. The participatory-led approach yielded co-produced insights that inform public health strategies, underscoring the need for comprehensive, multidisciplinary approaches to promote older adults' vitality. Such approaches must offer social opportunities and foster individuals' capacity and motivation to engage in meaningful social relationships. Patient or Public Contribution: The study was conducted in collaboration with a municipal policymaker and a coordinator of local community centres, who provided input on participant recruitment, materials, data interpretation, ethical considerations and result dissemination. During data collection, twelve older adults participated in three group model-building sessions, collaboratively developing a causal loop diagram to explore elements of vitality and their interconnections. Ongoing member checking with participants throughout the process ensured the analysis was refined and the researchers' interpretations were validated.
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Battery energy storage (BES) can provide many grid services, such as power flow management to reduce distribution grid overloading. It is desirable to minimise BES storage capacities to reduce investment costs. However, it is not always clear how battery sizing is affected by battery siting and power flow simultaneity (PFS). This paper describes a method to compare the battery capacity required to provide grid services for different battery siting configurations and variable PFSs. The method was implemented by modelling a standard test grid with artificial power flow patterns and different battery siting configurations. The storage capacity of each configuration was minimised to determine how these variables affect the minimum storage capacity required to maintain power flows below a given threshold. In this case, a battery located at the transformer required 10–20% more capacity than a battery located centrally on the grid, or several batteries distributed throughout the grid, depending on PFS. The differences in capacity requirements were largely attributed to the ability of a BES configuration to mitigate network losses. The method presented in this paper can be used to compare BES capacity requirements for different battery siting configurations, power flow patterns, grid services, and grid characteristics.
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Er is volgens mij alle reden zuinig te zijn op de nog resterende Nederlandse en Europese raffinagecapaciteit. “Daarnaast is het wijs het verbruik te beperken, recycling aan te jagen en de raffinagecapaciteit binnen Europa en Nederland voor de kritische materialen te ontwikkelen of vergroten. Dat vraagt helaas veel duurzame energie, veelal baseload, terwijl ook het milieu aandacht behoeft. Het alternatief, onze afhankelijkheid te laten voortduren, zal op termijn minder aantrekkelijk blijken.”
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Background: The COVID-19 pandemic taught us how to rethink care delivery. It catalyzed creative solutions to amplify the potential of personnel and facilities. This paper presents and evaluates a promptly introduced triaging solution that evolved into a tool to tackle the ever-growing waiting lists at an academic ophthalmology department, the TeleTriageTeam (TTT). A team of undergraduate optometry students, tutor optometrists, and ophthalmologists collaborate to maintain continuity of eye care. In this ongoing project, we combine innovative interprofessional task allocation, teaching, and remote care delivery. Objective: In this paper, we described a novel approach, the TTT; reported its clinical effectiveness and impact on waiting lists; and discussed its transformation to a sustainable method for delivering remote eye care. Methods: Real-world clinical data of all patients assessed by the TTT between April 16, 2020, and December 31, 2021, are covered in this paper. Business data on waiting lists and patient portal access were collected from the capacity management team and IT department of our hospital. Interim analyses were performed at different time points during the project, and this study presents a synthesis of these analyses. Results: A total of 3658 cases were assessed by the TTT. For approximately half (1789/3658, 48.91%) of the assessed cases, an alternative to a conventional face-to-face consultation was found. The waiting lists that had built up during the first months of the pandemic diminished and have been stable since the end of 2020, even during periods of imposed lockdown restrictions and reduced capacity. Patient portal access decreased with age, and patients who were invited to perform a remote, web-based eye test at home were on average younger than patients who were not invited. Conclusions: Our promptly introduced approach to remotely review cases and prioritize urgency has been successful in maintaining continuity of care and education throughout the pandemic and has evolved into a telemedicine service that is of great interest for future purposes, especially in the routine follow-up of patients with chronic diseases. TTT appears to be a potentially preferred practice in other clinics and medical specialties. The paradox is that judicious clinical decision-making based on remotely collected data is possible, only if we as caregivers are willing to change our routines and cognitions regarding face-to-face care delivery.
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In deze bijdrage presenteren we een aantal voorbeelden die laten zien dat verdieping van de unitstructuur een levensvatbaar alternatief is voor de vervanging van de unitstructuur door de multidimensionale organisatie (MDO), zoals voorgesteld door Strikwerda en Galbraith. In de MDO wordt gestreefd naar ‘resource efficiency’ en schaalvoordelen, terwijl het verdiepen van de unitstructuur gericht is op het bereiken van ‘flow efficiency’ en flow voordelen.
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