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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Virtual care centres (VCCs) are novel wards of hospitals and facilitate the provision of remote monitoring and home-based patient care by virtual care nurses. Whereas since the COVID-19 pandemic VCCs have rapidly emerged, there is a lack of insight in virtual care nurses’ work and the associated work load. Therefore, the aim of this study was to identify the nursing activities performed in Virtual Care Centers (VCCs) and assess nurses’ perceived workload associated with these activities. A multicentre descriptive, observational cross-sectional study was performed.
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Green data centres are the talk of the day. But who in fact is involved in developing green data centres? What is their contribution? And what does this contribution constitute in practical terms? This article states which stakeholders are involved in green data centres in the Netherlands, what their involvement is and what effect their involvement has. The article starts by giving the definitions for sustainability and by determining the stakeholders and their possibilities in this field. Next, we examine the actual impact of each stakeholder for arriving at greener data centres. This leads to a number of conclusions for achieving a larger degree of sustainability.
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A special Women's Day edition of the podcast with the leading ladies of our Centre of Expertise on Global Governance. Your hosts Mendeltje and Ruud have a talk with Alanna O'Malley, Barbara Warwas en Sylvia Bergh on the international position of women and their research on the UN, alternative ways of conflict resolution and applied research worldwide. A conversation about experiences, education and change.
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Background: Early detection and remediation of language disorders are important in helping children to establish appropriate communicative and social behaviour and acquire additional information about the world through the use of language. In the Netherlands, children with (a suspicion of) language disorders are referred to speech and hearing centres for multidisciplinary assessment. Reliable data are needed on the nature of language disorders, as well as the age and source of referral, and the effects of cultural and socioeconomic profiles of the population served in order to plan speech and language therapy service provision. Aims: To provide a detailed description of caseload characteristics of children referred with a possible language disorder by generating more understanding of factors that might influence early identification. Methods & Procedures: A database of 11,450 children was analysed consisting of data on children, aged 2–7 years (70% boys, 30% girls), visiting Dutch speech and hearing centres. The factors analysed were age of referral, ratio of boys to girls, mono‐ and bilingualism, nature of the language delay, and language profile of the children. Outcomes & Results:Results revealed an age bias in the referral of children with language disorders. On average, boys were referred 5 months earlier than girls, and monolingual children were referred 3 months earlier than bilingual children. In addition, bilingual children seemed to have more complex problems at referral than monolingual children. They more often had both a disorder in both receptive and expressive language, and a language disorder with additional (developmental) problems. Conclusions & Implications: This study revealed a bias in age of referral of young children with language disorders. The results implicate the need for objective language screening instruments and the need to increase the awareness of staff in primary child healthcare of red flags in language development of girls and multilingual children aiming at earlier identification of language disorders in these children.
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Verslag van het wteede jaar van het Centre of Expertise Smart Sustainable Cities.
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The ever increasing technological developments and greater demands from our society for qualitative better, safer, sustainable products, processes and systems are pushing the boundaries of what is possible from an engineer’s perspective. Besides the (local) grand challenges in energy, sustainability, health and mobility the world is getting smaller due to advances in communication and digitalization. The exponential increase of complexity and data driven systems (big data) which are integrated and connected to different networks calls for rethinking and inventing new business models [1]. To stay competitive in the world OEM’s and SME’s have to develop breakthrough technological, innovative and advanced systems and processes. These changes have a major impact on engineering education. The industry needs engineers with different competences and skills to fulfil the challenges and demands mentioned earlier. Universities should follow up on these changes and can only deliver and prepare the engineers of the future by close collaboration with the high tech industry. Fontys University is fully aware of this and developed a Centre of Expertise in High Tech Systems & Materials (CoE HTSM) to close the gap between the university and industry. This CoE is a public-private cooperation where applied research, projects and educational programs for different curricula are being developed and executed. By making the industry partner and giving them a role within the university, the engineering education programs and the future engineering profile can be better aligned in a faster and more structural way.
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Teacher education enables students to grow from ‘novice’ into ‘starting expert’ teachers. In this study, students’ textual peer feedback on video recordings of their teaching practice was analysed to determine the growth of their expertise in relation to blended curriculum design. The degree to which curriculum and literature influenced their feedback was assessed by semantic network analysis of prominent words from the literature that was studied, as well as the lexical richness andsemantic cohesion of students’ peer feedback and reflections. The lexical richness and the semantic cohesion increased significantly by the end of the semester. This means that students incorporated new vocabulary and maintained semantic consistency while using the new words. Regarding the semantic network analysis, we found stronger connections between the topics being discussed by the students at the end of the semester. Active use of video and peer feedback enhances students’ activeknowledge base, thus furthering effective teaching.
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There has probably never been such an intense debate about the layout of the countryside as the one that is currently raging. There are serious concerns about the landscape, which is being rapidly transformed by urbanization and everything associated with this process, and not only in the Netherlands but also far beyond its borders. Everyone has something to say in this society-wide debate, from local to national governments, from environmental factions to the road-user's lobby, and from those who are professionally involved to concerned private parties. In many cases it is a battle between idealized images and economic models, between agricultural reality and urban park landscapes, between ecological concerns and mobility. This issue of OASE explores the potential significance of architectonic design for transformation processes on the regional scale. Besides considering the instruments that are available to the designer to fulfil this task, the authors also consider how the design can exercise a 'positive' influence on such processes. The various contributions shed light on the potential significance of territory in contemporary design practice and offer critical reflection on the topical discourse that has evolved over recent years.
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It is important for caregivers and patients to know which wounds are at risk of prolonged wound healing to enable timely communication and treatment. Available prognostic models predict wound healing in chronic ulcers, but not in acute wounds, that is, originating after trauma or surgery. We developed a model to detect which factors can predict (prolonged) healing of complex acute wounds in patients treated in a large wound expertise centre (WEC). Using Cox and linear regression analyses, we determined which patient- and wound-related characteristics best predict time to complete wound healing and derived a prediction formula to estimate how long this may take. We selected 563 patients with acute wounds, documented in the WEC registry between 2007 and 2012. Wounds had existed for a median of 19 days (range 6-46 days). The majority of these were located on the leg (52%). Five significant independent predictors of prolonged wound healing were identified: wound location on the trunk [hazard ratio (HR) 0·565, 95% confidence interval (CI) 0·405-0·788; P = 0·001], wound infection (HR 0·728, 95% CI 0·534-0·991; P = 0·044), wound size (HR 0·993, 95% CI 0·988-0·997; P = 0·001), wound duration (HR 0·998, 95% CI 0·996-0·999; P = 0·005) and patient's age (HR 1·009, 95% CI 1·001-1·018; P = 0·020), but not diabetes. Awareness of the five factors predicting the healing of complex acute wounds, particularly wound infection and location on the trunk, may help caregivers to predict wound healing time and to detect, refer and focus on patients who need additional attention.
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