Little is known about which self-management behaviors have the highest potential to influence exacerbation impact in COPD patients. We aimed to reach expert consensus on the most relevant set of self-management behaviors that can be targeted and influenced to maximize reduction of exacerbation impact. Materials and methods A 2-round Delphi study was performed using online surveys to rate the relevance and feasibility of predetermined self-management behaviors identified by literature and expert opinion. Descriptive statistics and qualitative analyses were used. Results An international expert panel reached consensus on 17 self-management behaviors focusing on: stable phase (n=5): pharmacotherapy, vaccination, physical activity, avoiding stimuli and smoking cessation; periods of symptom deterioration (n=1): early detection; during an exacerbation (n=5): early detection, health care contact, self-treatment, managing stress/anxiety and physical activity; during recovery (n=4): completing treatment, managing stress/anxiety, physical activity and exercise training; and after recovery (n=2): awareness for recurrent exacerbations and restart of pulmonary rehabilitation. Conclusion This study has provided insight into expert opinion on the most relevant and feasible self-management behaviors that can be targeted and influenced before, during and after an exacerbation to exert the highest magnitude of influence on the impact of exacerbations. Future research should focus at developing more comprehensive patient-tailored interventions supporting patients in these exacerbation-related self-management behaviors.
BACKGROUND: Nursing home residents are mainly inactive. Nursing staff can encourage residents to perform functional activities during daily care activities. This study examines 1) the extent to which nursing staff perceive that they encourage functional activity in nursing home residents and 2) the associations between these nursing behaviors and professional characteristics, contextual factors, and information-seeking behaviors. METHODS: In this cross-sectional study, 368 registered nurses and certified nurse assistants, working in somatic and psychogeriatric wards of forty-one nursing homes throughout the Netherlands participated. Self-reported data were collected with a questionnaire, comprising the MAINtAIN-behaviors, which assesses the extent to which nursing staff encourage functional activities, including different activities of daily living (ADL), household activities, and miscellaneous encouraging activities (e.g., discouraging informal caregivers from taking over activities residents can do themselves). Additional data collected included professional characteristics (e.g., age), contextual factors (e.g., ward type), and information-seeking behaviors (e.g., reading professional journals). Descriptive statistics were used to determine the extent to which functional activities were encouraged. Hierarchical linear regression analyses were performed to determine the associations between the encouragement of functional activities and other factors. RESULTS: Nursing staff perceived that household activities (mean 4.1 (scale range 1-9), SD 1.9) were less often encouraged than ADL (mean 6.9, SD 1.2) or miscellaneous activities (mean 6.7, SD 1.5). The percentage of nursing staff stating that different household activities, ADL, or miscellaneous activities were almost always encouraged ranged from 11 to 45%, 41 to 86%, and 50 to 83% per activity, respectively. The extent to which these activities were encouraged differed for some of the professional characteristics, contextual factors, or information-seeking behaviors, but no consistent pattern in associations emerged. CONCLUSIONS: According to nursing staff, household activities are not as often encouraged as ADL or miscellaneous activities. Professional characteristics, contextual factors, and information-seeking behaviors are not consistently associated with the encouragement of functional activity. Nursing staff should also focus on improving the encouragement of household activities. Future research could examine the role of other factors in encouraging functional activity, such as experienced barriers, and assess to what extent the perception of nursing staff corresponds with their actual behavior.
Abusive online behaviors occur at a large scale on all social media, and have dire consequences for their victims. Although the problem is largely acknowledged, technological solutions remain limited to detecting and hiding abusive comments. More can be done to address abusers themselves. We propose to investigate the potential of conversational technologies to dialogue with abusers. In this problem description paper, we outline directions for studying the effectiveness dialogue strategies, e.g., to educate or deter abusers, or keep them busy with chatbots thus limiting the time they spend perpetuating abuses.
MULTIFILE
We live in a society that is increasingly dominated by technology-mediated interactions and consumption of experiences. It has opened pathways to innovative immersive technology concepts in the food and dining context, contributing to the development of a consumption-oriented society. This project addresses the challenge how to stimulate consumers through immersive technology designs to make conscious choices leading to more sustainable behaviors in the food and dining context. This project evolves around designing and testing Extended Reality (XR) technology-mediated immersive food experiences in the food and dining context to stimulate sustainable food consumption behavior. It includes the use of complementing measurement tools to test the effectiveness of XR designs to make better XR technology design choices that can stimulate change in consumption behavior.
The application of sensors in water technology is a crucial step to provide broader, more efficient and circular systems. Among the different technologies used in this field, ultrasound-based systems are widely used, basically to generate energy peaks for cell lysis and particle separation. In this work, we propose the adaptation of an ultrasound system to monitor the concentration of solid particles in wastewater treatment plants settlers as well as to indicate sludge level (real time). A similar sensor was developed and tested in another project which operated successfully at solids concentration up to 1% in UASB reactors. Such measurements are nowadays obtained via time-consuming physical (solids) analysis, which can compromise the efficiency of the settlers and the quality of the effluent. The present project proposes an improved version of the sensor, which will combine solids concentration monitoring and sludge level detection. The defined targets have the intention to make a sensor with a much broader range of applications, been suitable not only for UASB reactors but also to settler and aerobic tanks. The project is a cooperation between the Water Technology lectoraat of NHL Stenden University of Applied Sciences, two SME’s - YNOVIO B.V. and Lamp-ion B.V. - and the INCT group (Brazil). If proven feasible, the concept can generate a big business market to the involved Dutch partners as well as favor the automation of WWTP in the Netherlands, Brazil and around the world.
Performance feedback is an important mechanism of adaptation in learning theories, as it provides one of the motivations for organizations to learn (Pettit, Crossan, and Vera 2017). Embedded in the behavioral theory of the firm, organizational learning from performance feedback predicts the probability for organizations to change with an emphasis on organizational aspirations, which serve as a threshold against which absolute performance is evaluated (Cyert and March 1963; Greve 2003). It postulates that performance becomes a ‘problem’, or the trigger to search for alternative procedures, strategies, products and behaviors, when performance is below that threshold. This search is known as problemistic search. Missing from this body of research, is empirically grounded understanding if the characteristics of performance feedback over time matter for the triggering function of the feedback. I explore this gap. This investigation adds temporality as a dimension of the performance feedback concept guided by a worldview of ongoing change and flux where conditions and choices are not given, but made relevant by actors and enacted upon (Tsoukas and Chia 2002). The general aim of the study is to complement the current knowledge of performance feedback as a trigger for problemistic search with an explicit process temporal approach. The main question guiding this project is how temporal patterns of performance feedback influence organizational change, which I answer in four chapters, each zooming into one sub-question.First, I focus on the temporal order of performance feedback by examining performance feedback and change sequences organizations go through. In this section time is under study and the goal is to explore how feedback patterns have evolved over time, just as the change states organizations pass through. Second, I focus on the plurality of performance feedback by investigating performance feedback from multiple aspiration levels (i.e. multiple qualitatively different metrics and multiple reference points) and how over time clusters of performance feedback sequences have evolved. Next, I look into the rate and scope of change relative to performance feedback sequences and add an element of signal strength to the feedback. In the last chapter, time is a predictor (in the sequences), and, it is under study (in the timing of responses). I focus on the timing of organizational responses in relation to performance feedback sequences of multiple metrics and reference points.In sum, all chapters are guided by the timing problem of performance feedback, meaning that performance feedback does not come ‘available’ at a single point in time. Similarly to stones with unequal weight dropped in the river, performance feedback with different strength comes available at multiple points in time and it is plausible that sometimes it is considered by decision-makers as problematic and sometimes it is not, because of the sequence it is part of. Overall, the investigation is grounded in the general principles of organizational learning from performance feedback, and the concept of time as duration, sequences and timing, with a focus on specification of when things happen. The context of the study is universities of applied sciences and hotels in The Netherlands. Project partner: Tilburg University, School of Social and Behavioral Sciences, Department of Organization Studies
