The implementation of marine spatial plans as required by the Directive on Maritime Spatial Planning (MSP) of the European Union (EU) poses novel demands for the development of decision support tools (DST). One fundamental aspect is the need for tools to guide decisions about the allocation of human activities at sea in ways that are ecosystem-based and lead to sustainable use of resources. The MSP Directive was the main driver behind the development of spatial and non-spatial DSTs for the analysis of marine and coastal areas across European seas. In this research we develop an analytical framework designed by DST software developers and managers for the analysis of six DSTs supporting MSP in the Baltic Sea, the North Sea, and the Mediterranean Sea. The framework compares the main conceptual, technical and practical aspects, by which these DSTs contribute to advancing the MSP knowledge base and identified future needs for the development of the tools. Results show that all of the studied DSTs include elements to support ecosystem-based management at different geographical scales (from national to macro-regional), relying on cumulative effects assessment and functionalities to facilitate communication at the science-policy interface. Based on our synthesis we propose a set of recommendations for knowledge exchange in relation to further DST developments, mechanisms for sharing experience among the user-developer community, and actions to increase the effectiveness of the DSTs in MSP processes.
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Both because of the shortcomings of existing risk assessment methodologies, as well as newly available tools to predict hazard and risk with machine learning approaches, there has been an emerging emphasis on probabilistic risk assessment. Increasingly sophisticated AI models can be applied to a plethora of exposure and hazard data to obtain not only predictions for particular endpoints but also to estimate the uncertainty of the risk assessment outcome. This provides the basis for a shift from deterministic to more probabilistic approaches but comes at the cost of an increased complexity of the process as it requires more resources and human expertise. There are still challenges to overcome before a probabilistic paradigm is fully embraced by regulators. Based on an earlier white paper (Maertens et al., 2022), a workshop discussed the prospects, challenges and path forward for implementing such AI-based probabilistic hazard assessment. Moving forward, we will see the transition from categorized into probabilistic and dose-dependent hazard outcomes, the application of internal thresholds of toxicological concern for data-poor substances, the acknowledgement of user-friendly open-source software, a rise in the expertise of toxicologists required to understand and interpret artificial intelligence models, and the honest communication of uncertainty in risk assessment to the public.
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Within recent years, Financial Credit Risk Assessment (FCRA) has become an increasingly important issue within the financial industry. Therefore, the search for features that can predict the credit risk of an organization has increased. Using multiple statistical techniques, a variance of features has been proposed. Applying a structured literature review, 258 papers have been selected. From the selected papers, 835 features have been identified. The features have been analyzed with respect to the type of feature, the information sources needed and the type of organization that applies the features. Based on the results of the analysis, the features have been plotted in the FCRA Model. The results show that most features focus on hard information from a transactional source, based on official information with a high latency. In this paper, we readdress and -present our earlier work [1]. We extended the previous research with more detailed descriptions of the related literature, findings, and results, which provides a grounded basis from which further research on FCRA can be conducted.
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Background and Aim: Caregivers in the home environment have an important role in timely detecting and responding to abuse. The aim of this review was to provide insight into both the existing tools for the assessment of and interventions for elder abuse by formal and informal caregivers in the home environment, and to categorize them according to a public health perspective, into primary, secondary, tertiary or quaternary prevention. Methods: We selected the assessment tools and interventions that can be used by caregivers in the home environment included in previous reviews by Gallione et al (2017) and Fearing et al (2017). To identify published studies after these reviews, a search was performed using PubMed, Cochrane Database, CINAHL and Web of Science. Results: In total, fifteen assessment tools and twelve interventions were included. The number of assessment tools for elder abuse for use in the home environment is increasing; however, tools must be validated over different cultures and risk groups. In addition, the tools lack attention for the needs of vulnerable older persons such as persons with dementia. Existing interventions for caregivers in the home environment lack evidence for addressing elder abuse and do not address potential adverse effects (quaternary prevention). Conclusion: Assessment tools for elder abuse need further testing for validity and reliability for use by caregivers in the home environment. For interventions, meaningful outcome measures are needed. Important to note is that quaternary prevention requires more attention. This argues for taking into account perspectives of (abused) older persons and caregivers in the development of assessment tools and interventions protocols.
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Background: Early childhood caries is considered one of the most prevalent diseases in childhood, affecting almost half of preschool-age children globally. In the Netherlands, approximately one-third of children aged 5 years already have dental caries, and dental care providers experience problems reaching out to these children. Objective: Within the proposed trial, we aim to test the hypothesis that, compared to children who receive usual care, children who receive the Toddler Oral Health Intervention as add-on care will have a reduced cumulative caries incidence and caries incidence density at the age of 48 months. Methods: This pragmatic, 2-arm, individually randomized controlled trial is being conducted in the Netherlands and has been approved by the Medical Ethics Research Board of University Medical Center Utrecht. Parents with children aged 6 to 12 months attending 1 of the 9 selected well-baby clinics are invited to participate. Only healthy children (ie, not requiring any form of specialized health care) with parents that have sufficient command of the Dutch language and have no plans to move outside the well-baby clinic region are eligible. Both groups receive conventional oral health education in well-baby clinics during regular well-baby clinic visits between the ages of 6 to 48 months. After concealed random allocation of interventions, the intervention group also receives the Toddler Oral Health Intervention from an oral health coach. The Toddler Oral Health Intervention combines behavioral interventions of proven effectiveness in caries prevention. Data are collected at baseline, at 24 months, and at 48 months. The primary study endpoint is cumulative caries incidence for children aged 48 months, and will be analyzed according to the intention-to-treat principle. For children aged 48 months, the balance between costs and effects of the Toddler Oral Health Intervention will be evaluated, and for children aged 24 months, the effects of the Toddler Oral Health Intervention on behavioral determinants, alongside cumulative caries incidence, will be compared. Results: The first parent-child dyads were enrolled in June 2017, and recruitment was finished in June 2019. We enrolled 402 parent-child dyads. Conclusions: All follow-up interventions and data collection will be completed by the end of 2022, and the trial results are expected soon thereafter. Results will be shared at international conferences and via peer-reviewed publication.
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The relationship between project management and sustainable development is rapidly gaining interest from both practitioners and academics. Studies on the integration of the concepts of sustainability into project management, approach this topic mostly from a conceptual, logical or moral point of view. Given the fact that the relationship between sustainability and project management is still an emerging field of study, these approaches make sense. However, they do not diminish the need for more empirical studies to understand how the concepts of sustainable development are implemented in practice. This paper reports an analysis of 56 case studies on the integration of the concepts of sustainability in the way organizations initiate, develop and manage projects. The research question of the study was: To what extent, do organizations consider the concepts of sustainability in the initiation, development and management of projects? The study uses the maturity model for sustainability integration that was presented at the 2010 IPMA World Congress for the assessment of the level of sustainability consideration. The study found an overall average level of sustainability consideration in the actual situation of 25.9%. For the desired situation, this score is almost 10 percent higher, showing an ambition to take sustainability more into consideration. The study also showed that the way sustainability currently is considered, shows the traditional ‘less bad’ approach to sustainability integration and not a more modern social responsibility approach.
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Like most ocean regions today, the European and contiguous seas experience cumulative impacts from local human activities and global pressures. They are largely in poor environmental condition with deteriorating trends. Despite several success stories, European policies for marine conservation fall short of being effective. Acknowledging the challenges for marine conservation, a 4-year multi-national network, MarCons, supported collaborative marine conservation efforts to bridge the gap between science, management and policy, aiming to contribute in reversing present negative trends. By consolidating a large network of more than 100 scientists from 26 countries, and conducting a series of workshops over 4 years (2016–2020), MarCons analyzed challenges, opportunities and obstacles for advancing marine conservation in the European and contiguous seas. Here, we synthesize the major issues that emerged from this analysis and make 12 key recommendations for policy makers, marine managers, and researchers. To increase the effectiveness of marine conservation planning, we recommend (1) designing coherent networks of marine protected areas (MPAs) in the framework of marine spatial planning (MSP) and applying systematic conservation planning principles, including re-evaluation of existing management zones, (2) designing MPA networks within a broader transboundary planning framework, and (3) implementing integrated land-freshwater-sea approaches. To address inadequate or poorly informed management, we recommend (4) developing and implementing adaptive management plans in all sites of the Natura 2000 European conservation network and revising the Natura 2000 framework, (5) embedding and implementing cumulative effects assessments into a risk management process and making them operational, and (6) promoting actions to reach ‘good environmental status’ in all European waters. To account for global change in conservation planning and management, we further recommend (7) developing conservation strategies to address the impacts of global change, for example identifying climate-change refugia as high priority conservation areas, and (8) incorporating biological invasions in conservation plans and prioritizing management actions to control invasive species. Finally, to improve current practices that may compromise the effectiveness of conservation actions, we recommend (9) reinforcing the collection of high-quality open-access data, (10) improving mechanisms for public participation in MPA planning and management, (11) prioritizing conservation goals in full collaboration with stakeholders, and (12) addressing gender inequality in marine sciences and conservation.
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In the literature about web survey methodology, significant e orts have been made to understand the role of time-invariant factors (e.g. gender, education and marital status) in (non-)response mechanisms. Time-invariant factors alone, however, cannot account for most variations in (non-)responses, especially fluctuations of response rates over time. This observation inspires us to investigate the counterpart of time-invariant factors, namely time-varying factors and the potential role they play in web survey (non-)response. Specifically, we study the effects of time, weather and societal trends (derived from Google Trends data) on the daily (non-)response patterns of the 2016 and 2017 Dutch Health Surveys. Using discrete-time survival analysis, we find, among others, that weekends, holidays, pleasant weather, disease outbreaks and terrorism salience are associated with fewer responses. Furthermore, we show that using these variables alone achieves satisfactory prediction accuracy of both daily and cumulative response rates when the trained model is applied to future unseen data. This approach has the further benefit of requiring only non-personal contextual information and thus involving no privacy issues. We discuss the implications of the study for survey research and data collection.
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Background: Insufficient amounts of physical activity is a risk factor for (recurrent) stroke. People with a stroke or transient ischemic attack (TIA) have a high risk of recurrent stroke and have lower levels of physical activity than their healthy peers. Though several reviews have looked at the effects of lifestyle interventions on a number of risk factors of recurrent stroke, the effectiveness of these interventions to increase the amounts of physical activity performed by people with stroke or TIA are still unclear. Therefore, the research question of this study was: what is the effect of lifestyle interventions on the level of physical activity performed by people with stroke or TIA? Method: A systematic review was conducted following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Pubmed, Embase and Cumulative Index for Nursing and Allied Health Literature (CINAHL), were searched up to August 2018. Randomised controlled trials that compared lifestyle interventions, aimed to increase the amount of physical activity completed by participants with a stroke or TIA, with controls were included. The Physiotherapy Evidence Database (PEDro) score was used to assess the quality of the articles, and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) method for the best evidence synthesis. Results: Eleven trials (n = 2403) met the inclusion criteria. The quality of the trials was mostly high, with 8 (73%) of trials scoring ≥6 on the PEDro scale. The overall best evidence syntheses showed moderate quality evidence that lifestyle interventions do not lead to significant improvements in the physical activity level of people with stroke or TIA. There is low quality evidence that lifestyle interventions that specifically target physical activity are effective at improving the levels of physical activity of people with stroke or TIA. Conclusion: Based on the results of this review, general lifestyle interventions on their own seem insufficient in improving physical activity levels after stroke or TIA. Lifestyle interventions that specifically encourage increasing physical activity may be more effective. Further properly powered trials using objective physical activity measures are needed to determine the effectiveness of such interventions.
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As Vehicle-to-Everything (V2X) communication technologies gain prominence, ensuring human safety from radiofrequency (RF) electromagnetic fields (EMF) becomes paramount. This study critically examines human RF exposure in the context of ITS-5.9 GHz V2X connectivity, employing a combination of numerical dosimetry simulations and targeted experimental measurements. The focus extends across Road-Side Units (RSUs), On-Board Units (OBUs), and, notably, the advanced vehicular technologies within a Tesla Model S, which includes Bluetooth, Long Term Evolution (LTE) modules, and millimeter-wave (mmWave) radar systems. Key findings indicate that RF exposure levels for RSUs and OBUs, as well as from Tesla’s integrated technologies, consistently remain below the International Commission on Non-Ionizing Radiation Protection (ICNIRP) exposure guidelines by a significant margin. Specifically, the maximum exposure level around RSUs was observed to be 10 times lower than ICNIRP reference level, and Tesla’s mmWave radar exposure did not exceed 0.29 W/m2, well below the threshold of 10 W/m2 set for the general public. This comprehensive analysis not only corroborates the effectiveness of numerical dosimetry in accurately predicting RF exposure but also underscores the compliance of current V2X communication technologies with exposure guidelines, thereby facilitating the protective advancement of intelligent transportation systems against potential health risks.
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