Background: Optimizing transitional care by practicing family-centered care might reduce unplanned events for patients who undergo major abdominal cancer surgery. However, it remains unknown whether involving family caregivers in patients’ healthcare also has negative consequences for patient safety. This study assessed the safety of family involvement in patients’ healthcare by examining the cause of unplanned events in patients who participated in a family involvement program (FIP) after major abdominal cancer surgery. Methods: This is a secondary analysis focusing on the intervention group of a prospective cohort study conducted in the Netherlands. Data were collected from April 2019 to May 2022. Participants in the intervention group were patients who engaged in a FIP. Unplanned events were analyzed, and root causes were identified using the medical version of a prevention- and recovery-information system for monitoring and analysis (PRISMA) that analyses unintended events in healthcare. Unplanned events were compared between patients who received care from family caregivers and patients who received professional at-home care after discharge. A Mann-Whitney U test was used to analyze data. Results: Of the 152 FIP participants, 68 experienced an unplanned event and were included. 112 unplanned events occurred with 145 root causes since some unplanned events had several root causes. Most root causes of unplanned events were patient-related factors (n = 109, 75%), such as patient characteristics and disease-related factors. No root causes due to inadequate healthcare from the family caregiver were identified. Unplanned events did not differ statistically (interquartile range 1–2) (p = 0.35) between patients who received care from trained family caregivers and those who received professional at-home care after discharge. Conclusion: Based on the insights from the root-cause analysis in this prospective multicenter study, it appears that unplanned emergency room visits and hospital readmissions are not related to the active involvement of family caregivers in surgical follow-up care. Moreover, surgical follow-up care by trained family caregivers during hospitalization was not associated with increased rates of unplanned adverse events. Hence, the concept of active family involvement by proficiently trained family caregivers in postoperative care appears safe and feasible for patients undergoing major abdominal surgery.
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With the rise of chronic diseases as the number one cause of death and disability among urban populations, it has become increasingly important to design for healthy environments. There is, however, a lack of interdisciplinary approaches and solutions to improve health and well-being through urban planning and design. This case study offers an HCI solution and approach to design for healthy urban structures and dynamics in existing neighborhoods. We discuss the design process and design of ROOT, an interactive lighting system that aims to stimulate walking and running through supportive, collaborative and social interaction.
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The labor productivity of construction projects is low. This urges construction companies to increase their labor efficiency, particularly when demands grow and labor is scarce. This blog introduces an overview that helps practitioners identify causes of low productivity to find and eliminate the root causes.
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Recent research has indicated an increase in the likelihood and impact of tree failure. The potential for trees to fail relates to various biomechanical and physical factors. Strikingly, there seems to be an absence of tree risk assessment methods supported by observations, despite an increasing availability of variables and parameters measured by scientists, arborists and practitioners. Current urban tree risk assessments vary due to differences in experience, training, and personal opinions of assessors. This stresses the need for a more objective method to assess the hazardousness of urban trees. The aim of this study is to provide an overview of factors that influence tree failure including stem failure, root failure and branch failure. A systematic literature review according to the PRISMA guidelines has been performed in databases, supported by backward referencing: 161 articles were reviewed revealing 142 different factors which influenced tree failure. A meta-analysis of effect sizes and p-values was executed on those factors which were associated directly with any type of tree failure. Bayes Factor was calculated to assess the likelihood that the selected factors appear in case of tree failure. Publication bias was analysed visually by funnel plots and results by regression tests. The results provide evidence that the factors Height and Stem weight positively relate to stem failure, followed by Age, DBH, DBH squared times H, and Cubed DBH (DBH3) and Tree weight. Stem weight and Tree weight were found to relate positively to root failure. For branch failure no relating factors were found. We recommend that arborists collect further data on these factors. From this review it can further be concluded that there is no commonly shared understanding, model or function available that considers all factors which can explain the different types of tree failure. This complicates risk estimations that include the failure potential of urban trees.
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Polycyclic aromatic hydrocarbons (PAHs) are a group of more than hundred compounds that are ubiquitous in our environment. Some of these PAHs are known to be carcinogenic, mutagenic and teratogenic. PAHs have been detected in dried herbs that were cultured in The Netherlands as well as in other European countries above the maximum levels in dried herbs set by the EU (EU, 2015) for benzo(a)pyrene and the sum of the following four PAHs benzo(a)pyrene, benzo[a]anthracene, benzo[b]fluoranteen and chrysene. The origin of these PAHs in herbs is unknown. VNK cultivates, harvests and dries herbs including valerian and would like to identify the source of PAHs to comply to the EU limits for PAHs in herbs. The goal of the present study was to identify the source of PAHs found in valerian root, and to identify possible measures to reduce the concentration of PAHs in valerian root.
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See Springer link - available under Open Access
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Objective: To examine the underlying factor structure and psychometric properties of the Assessment of Self-management in Anxiety and Depression (ASAD) questionnaire, which was specifically designed for patients with (chronic) anxiety and depressive disorders. Moreover, this study assesses whether the number of items in the ASAD can be reduced without significantly reducing its precision. Methods: The ASAD questionnaire was completed by 171 participants across two samples: one sample comprised patients with residual anxiety or depressive symptoms, while the other consisted of patients who have been formally diagnosed with a chronic anxiety or depressive disorder. All participants had previously undergone treatment. Both exploratory (EFA) and confirmatory factor analyses (CFA) were conducted. Internal consistency and test–retest reliability were also assessed. Results: Both EFA and CFA indicated three solid factors: Seeking support, Daily life strategies and Taking ownership [Comparative Fit Index = 0.80, Tucker Lewis Index = 0.78, Root Mean Square Error of Approximation = 0.09 (CI 0.08–1.00), Standardized Root Mean Square Residual = 0.09 ($2 = 439.35, df = 168)]. The ASAD was thus reduced from 45 items to 21 items, which resulted in the ASAD-Short Form (SF). All sub-scales had a high level of internal consistency (> a = 0.75) and test–retest reliability (ICC > 0.75). Discussion: The first statistical evaluation of the ASAD indicated a high level of internal consistency and test–retest reliability, and identified three distinctive factors. This could aid patients and professionals’ assessment of types of self-management used by the patient. Given that this study indicated that the 21-item ASAD-SF is appropriate, this version should be further explored and validated among a sample of patients with (chronic or partially remitted) anxiety and depressive disorders. Alongside this, to increase generalizability, more studies are required to examine the English version of the ASAD within other settings and countries.
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A previous study found a variety of unusual sexual interests to cluster in a five-factor structure, namely submission/masochism, forbidden sexual activities, dominance / sadism, mysophilia, and fetishism (Schippers et al., 2021). The current study was an empirical replication to examine whether these findings generalized to a representative population sample. An online, anonymous sample (N = 256) representative of the Dutch adult male population rated 32 unusual sexual interests on a scale from 1 (very unappealing) to 7 (very appealing). An exploratory factor analysis assessed whether similar factors would emerge as in the original study. A subsequent confirmatory factor analysis served to confirm the factor structure. Four slightly different factors of sexual interest were found: extreme, illegal and mysophilic sexual activities; light BDSM without real pain or suffering; heavy BDSM that may include pain or suffering; and illegal but lower-sentenced and fetishistic sexual activities. The model fit was acceptable. The representative replication sample was more sexually conservative and showed less sexual engagement than the original convenience sample. On a fundamental level, sexual interest in light BDSM activities and extreme, forbidden, and mysophilic activities seem to be relatively separate constructs.
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Over recent years, numbers of electric vehicles (EVs) have shown a strong growth and sales are projected to continue to grow. For facilitating charging possibilities for EVs typically two rollout strategies have been applied; demand-driven and strategic rollout. This study focuses on determining the differences in performance metrics of the two rollout strategies by first defining key performance metrics. Thereafter, the root causes of performance differences between the two rollout strategies are investigated. This study analyzes charging data of 1,007,137 transactions on 1742 different CPs by use of 53,850 unique charging cards. This research concludes that demand-driven CPs outperform strategic CPs on weekly energy transfer and connection duration, while strategic CPs outperform their demand-driven counterparts on charging time ratio. Regarding users facilitated, there is a significant change in performance after massive EV-uptake. The root cause analysis shows effects of EV uptake and user type composition on the differences in performance metrics. This research concludes with implications for policy makers regarding an optimal portfolio of rollout strategies.
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Regenerative forms of higher education are emerging, and required, to connect with some of the grand transition challenges of our times. This paper explores the lived experience of 21 students learning to navigate a regenerative form of higher education in the Mission Impact course at The Hague University of Applied Sciences. This semester-length course ran for two iterations with the intention of connecting the students with local transitions towards a more circular society, one where products are lasting and have multiple lives when they are shared, refurbished, or become a source for a new product. At the end of each iteration, the students reflected on their experience using the Living Spiral Framework, which served as basis for an interpretative phenomenological analysis of their journey navigating this transformative course. The results of this study include four themes; (1) Opting in—Choosing RHE, (2) Learning in Regenerative Ways, (3) Navigating Resistance(s), and (4) Transformative Impacts of RHE. These themes can be used by practitioners to design and engage with regenerative forms of higher education, and by scholars to guide further inquiry. van den Berg B, Poldner KA, Sjoer E, Wals AEJ. ‘Sweet Acid’ An Interpretative Phenomenological Analysis of Students’ Navigating Regenerative Higher Education. Education Sciences. 2022; 12(8):533. https://doi.org/10.3390/educsci12080533
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