Er is steeds meer erkenning dat de klimaatcrisis de grootste bedreiging voor de volksgezondheid is en dat zorgprofessionals daarom een professionele verantwoordelijkheid hebben de klimaatgerelateerde gezondheidscrisis te beperken. Zo werkt de gezondheidssector aan verduurzaming van de zorg (Rijksoverheid, 2022), het vergroten van maatschappelijk bewustzijn over de relatie van klimaat en gezondheid (Luyx e.a., 2024) en wordt ook klimaatactivisme steeds meer als een legitieme professionele activiteit gezien (Vossen, 2024; Veen, 2023).
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In indoor comfort research, thermal comfort of care-professionals in hospital environment is a little explored topic. To address this gap, a mixed methods study, with the nursing staff in hospital wards acting as participants,was undertaken. Responses were collected during three weeks in the summer (n = 89), and four weeks in the autumn (n = 43). Analysis of the subjective feedback from nurses and the measured indoor thermal conditions revealed that the existent thermal conditions (varying between 20 and 25 °C) caused a slightly warm thermal sensation on the ASHRAE seven point scale. This led to a slightly unacceptable thermal comfort and a slightly obstructed self-appraised work performance. The results also indicated that the optimal thermal sensation for the nurses—suiting their thermal comfort requirements and work performance—would be closer to‘slightly cool’than neutral. Using a design approach of dividing the hospital ward into separate thermal zones, with different set-points for respectively patient and care-professionals’comfort, would seem to be the ideal solution that contributes positively to the work environment and, at the same time, creates avenues for energy conservation.
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Airborne wind energy (AWE) is an emerging renewable energy technology that uses kites to harvest winds at higher altitudes than wind turbines. Understanding how residents experience a local AWE system (AWES) is important as the technology approaches commercialization. Such knowledge can help adjust the design and deployment of an AWES to fit locals' needs better, thereby decreasing the technology's burden on people. Although the AWE literature claims that the technology affects nature and residents less than wind turbines, empirical evidence has been lacking. This first community acceptance study recruited residents within a 3.5 km radius of an AWE test site in Northern Germany. Using structured questionnaires, 54 residents rated the AWES and the closest wind farm on visual, sound, safety, siting, environmental, and ecological aspects. Contrary to the literature's claims, residents assessed the noise, ecological, and safety impacts similarly for the AWES and the wind farm. Only visual impacts were rated better for the AWES (e.g., no shadows were perceived). Consistent with research on wind turbines, residents who rated the site operation as fairer and the developer as more transparent tended to have more positive attitudes towards the AWES and to experience less noise annoyance. Consequently, recommendations for the AWE industry and policymakers include mitigating technology impacts and implementing evidence-based strategies to ensure just and effective project development. The findings are limited to one specific AWES using soft-wing kites. Future research should assess community responses across regions and different types of AWESs to test the findings' generalizability.
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Abstract: Background: Chronic obstructive pulmonary disease (COPD) and asthma have a high prevalence and disease burden. Blended self-management interventions, which combine eHealth with face-to-face interventions, can help reduce the disease burden. Objective: This systematic review and meta-analysis aims to examine the effectiveness of blended self-management interventions on health-related effectiveness and process outcomes for people with COPD or asthma. Methods: PubMed, Web of Science, COCHRANE Library, Emcare, and Embase were searched in December 2018 and updated in November 2020. Study quality was assessed using the Cochrane risk of bias (ROB) 2 tool and the Grading of Recommendations, Assessment, Development, and Evaluation. Results: A total of 15 COPD and 7 asthma randomized controlled trials were included in this study. The meta-analysis of COPD studies found that the blended intervention showed a small improvement in exercise capacity (standardized mean difference [SMD] 0.48; 95% CI 0.10-0.85) and a significant improvement in the quality of life (QoL; SMD 0.81; 95% CI 0.11-1.51). Blended intervention also reduced the admission rate (relative ratio [RR] 0.61; 95% CI 0.38-0.97). In the COPD systematic review, regarding the exacerbation frequency, both studies found that the intervention reduced exacerbation frequency (RR 0.38; 95% CI 0.26-0.56). A large effect was found on BMI (d=0.81; 95% CI 0.25-1.34); however, the effect was inconclusive because only 1 study was included. Regarding medication adherence, 2 of 3 studies found a moderate effect (d=0.73; 95% CI 0.50-0.96), and 1 study reported a mixed effect. Regarding self-management ability, 1 study reported a large effect (d=1.15; 95% CI 0.66-1.62), and no effect was reported in that study. No effect was found on other process outcomes. The meta-analysis of asthma studies found that blended intervention had a small improvement in lung function (SMD 0.40; 95% CI 0.18-0.62) and QoL (SMD 0.36; 95% CI 0.21-0.50) and a moderate improvement in asthma control (SMD 0.67; 95% CI 0.40-0.93). A large effect was found on BMI (d=1.42; 95% CI 0.28-2.42) and exercise capacity (d=1.50; 95% CI 0.35-2.50); however, 1 study was included per outcome. There was no effect on other outcomes. Furthermore, the majority of the 22 studies showed some concerns about the ROB, and the quality of evidence varied. Conclusions: In patients with COPD, the blended self-management interventions had mixed effects on health-related outcomes, with the strongest evidence found for exercise capacity, QoL, and admission rate. Furthermore, the review suggested that the interventions resulted in small effects on lung function and QoL and a moderate effect on asthma control in patients with asthma. There is some evidence for the effectiveness of blended self-management interventions for patients with COPD and asthma; however, more research is needed. Trial Registration: PROSPERO International Prospective Register of Systematic Reviews CRD42019119894; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=119894
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In this chapter, we first summarise the findings from the country chapters on the multiple meanings of SA, documenting terms, translations and contrasting understandings between citizens and public officials. Second, we highlight how civil mobilisation tends to be cyclical over time and is often mediated by brokers. Strategies to spur stakeholders into action rely on a delicate balance of both collaboration and confrontation. Third, we examine the responses from authorities to SAIs, finding that reactions are uneven and that all civic innovators fear appropriation or co-optation by officials. Fourth, we assess overall outcomes of Arab SAIs and highlight that the transformative potential of SAIs exists especially at municipal level, if four conditions for success are present (trust, proximity, endorsement, evaluation). We also point out that the actual outcomes of SAIs in Arab societies have, so far, been limited due to design deficiencies (emphasising short-term objectives and limited context sensitivity) or because of officials’ resistance in active or passive forms. We characterise SAIs as a discursive action format that is best understood with a relational approach to power. In a final section, we formulate recommendations for activists, officials and donors on how to make SAIs more effective.
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There is an ongoing transition towards renewable energy sources in order to combat climate change. National power grids are suffering due to the rapid introduction of new energy sources and have other disadvantages. Local Energy Systems (LESs) are a beneficial example of an off-grid energy systems that can aid the energy transition. LESs are community driven and require participating and steering members. This can be achieved through empowering end-users to become active participants or steerers. End-users can be empowered to become an active participant through engagement with energy management activities. This does not work for empowering to steer, which begs the question, how to empower end-users or participants to become steerers in Local Energy Systems. Through a literature review this study explores the importance of establishing a group containing steerers with diverse skills, strong leadership, and engagement with the environment and community. Additionally, this study identifies the strategy that empowers end-users to steer. Which is training technological and managemental skills; and training capabilities in establishing relations with local participants and intermediary organisations. To apply these findings more precisely a secondary analysis is conducted on a survey with 599 participants. The original study researched willingness to participate in LESs, however the secondary analysis establishes three important factors to predict willingness to steer. These are energy independence, community trust, and community resistance. Additionally, men with a high level of education are most willing to become steerers per default, thus different demographics generally require more empowerment.
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BACKGROUND: Recent evidence suggests that an increase in baccalaureate-educated registered nurses (BRNs) leads to better quality of care in hospitals. For geriatric long-term care facilities such as nursing homes, this relationship is less clear. Most studies assessing the relationship between nurse staffing and quality of care in long-term care facilities are US-based, and only a few have focused on the unique contribution of registered nurses. In this study, we focus on BRNs, as they are expected to serve as role models and change agents, while little is known about their unique contribution to quality of care in long-term care facilities. METHODS: We conducted a cross-sectional study among 282 wards and 6,145 residents from 95 Dutch long-term care facilities. The relationship between the presence of BRNs in wards and quality of care was assessed, controlling for background characteristics, i.e. ward size, and residents' age, gender, length of stay, comorbidities, and care dependency status. Multilevel logistic regression analyses, using a generalized estimating equation approach, were performed. RESULTS: 57% of the wards employed BRNs. In these wards, the BRNs delivered on average 4.8 min of care per resident per day. Among residents living in somatic wards that employed BRNs, the probability of experiencing a fall (odds ratio 1.44; 95% CI 1.06-1.96) and receiving antipsychotic drugs (odds ratio 2.15; 95% CI 1.66-2.78) was higher, whereas the probability of having an indwelling urinary catheter was lower (odds ratio 0.70; 95% CI 0.53-0.91). Among residents living in psychogeriatric wards that employed BRNs, the probability of experiencing a medication incident was lower (odds ratio 0.68; 95% CI 0.49-0.95). For residents from both ward types, the probability of suffering from nosocomial pressure ulcers did not significantly differ for residents in wards employing BRNs. CONCLUSIONS: In wards that employed BRNs, their mean amount of time spent per resident was low, while quality of care on most wards was acceptable. No consistent evidence was found for a relationship between the presence of BRNs in wards and quality of care outcomes, controlling for background characteristics. Future studies should consider the mediating and moderating role of staffing-related work processes and ward environment characteristics on quality of care.
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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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Based on the theory of embodied cognition we developed NOOT, at tangible tool that allows marking audio-moments during creative sessions. A detailed analysis of using NOOT in practice lead to a reconceptualization of NOOT within processes of external scaffolding. It also spurred a new design project focused on reflection during group sessions
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