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For older adults, acute hospitalization is a high-risk event with poor health outcomes, including functional decline. In absence of practical guidelines and high quality randomized controlled trials, this Delphi study was conducted. The aim of this study was to obtain consensus on an exercise intervention program, a core outcome set (COS) and handover information to prevent functional decline or restore physical function in acutely hospitalized older patients transitioning from hospital to home. An internal panel of experts in the field of exercise interventions for acutely hospitalized older adults were invited to join the study. In the Delphi study, relevant topics were recognized, statements were formulated and ranked on a 9-point Likert scale in two additional rounds. To reaching consensus, a score of 7–9 was classified as essential. Results were expressed as median and semi-interquartile range (SIQR), and consensus threshold was set at SIQR≤0.5. Fifteen international experts from eight countries participated in the panel. The response rate was 93%, 93% and 80% for the three rounds respectively. After three rounds, consensus was reached on 167 of the 185 (90.3%) statements, of which ninety-five (51.4%) were ranked as essential (median Likert-score ≥7.0, SIQR ≤0.5). This Delphi study provides starting points for developing an exercise intervention, a COS and handover information. The results of this Delphi study can assist physical therapists to provide a tailored exercise intervention for older patients with complex care needs after hospital discharge, to prevent functional decline and/or restore physical function.
Full text met een HU Account Objective: To quantify diversity in components of self-management interventions and explore which components are associated with improvement in health-related quality of life (HRQoL) in patients with chronic heart failure (CHF), chronic obstructive pulmonary disease (COPD), or type 2 diabetes mellitus (T2DM). Methods: Systematic literature search was conducted from January 1985 through June 2013. Included studies were randomised trials in patients with CHF, COPD, or T2DM, comparing self-management interventions with usual care, and reporting data on disease-specific HRQoL. Data were analysed with weighted random effects linear regression models. Results: 47 trials were included, representing 10,596 patients. Self-management interventions showed great diversity in mode, content, intensity, and duration. Although self-management interventions overall improved HRQoL at 6 and 12 months, meta-regression showed counterintuitive negative effects of standardised training of interventionists (SMD = 0.16, 95% CI: 0.31 to 0.01) and peer interaction (SMD = 0.23, 95% CI 0.39 to 0.06) on HRQoL at 6 months. Conclusion: Self-management interventions improve HRQoL at 6 and 12 months, but interventions evaluated are highly heterogeneous. No components were identified that favourably affected HRQoL. Standardised training and peer interaction negatively influenced HRQoL, but the underlying mechanism remains unclear. Practice implications: Future research should address process evaluations and study response to selfmanagement on the level of individual patients
KnowledgeFlows in Marine Spatial Planning - Sharing Innovation in Higher Education(KnowledgeFlows) aims at further enforcing the European higher education community to meet the growing demands for knowledge, skills and innovation within the still emerging field of marine or maritime spatial planning (MSP).Marine Spatial Planning (MSP) is an emerging governmental approach towards a more effective use of the sea. MSP is of great interest in Europe and can be considered a societal process to balance conflicting interests of maritime stakeholders and the marine environment. Many different activities take place at sea, ranging from shipping, fisheries, to offshore wind energy activities. Simultaneously, new and evolving policies focus on strategies to integrate different marine demands in space and resources. MSP is now legally binding in the EU and is much needed approach to manage and organize the use of the sea, while also protecting the environment.KnowledgeFlows will contribute to the development of new innovative approaches to higher education and training on MSP by means of problem-based learning schemes, transdisciplinary collaboration, and advanced e-learning concepts. KnowledgeFlows builds on results from former project outputs (Erasmus+ Strategic Partnership for Marine Spatial Planning SP-MSP), such as the online learning platform MSP Education Arena (https://www.sp-msp.uol.de).The strategic partnership consists of a transnational network of experts both in research and in practice based in the north Atlantic, Baltic Sea and North Sea Regions including Aalborg University (DK, lead partner), The University of Oldenburg (D), the University of Liverpool (U.K.), the University of Nantes (F), the Leibniz Institute for Baltic Sea Research (D), the Breda University of Applied Sciences (NL), University of Ulster (U.K.), and the Finnish Environment Institute (FI). Gothenburg University, also being a higher education organisation, will be associated partner.Furthermore, three international organisations, the Marine Spatial Planning Research Network, the Baltic inter-governmental VASAB and the pan-Nordic Nordregio will be involved in the partnership as associated organisations deeply rooted in the MSP community of practice.The further improvement of curricula, exchange of knowledge and experts, and transparency and recognition of learning outcomes to reach higher qualifications in MSP are key components of KnowledgeFlows. A mutual learning environment for MSP higher education will enable problem-driven innovation among students and their educators from research and governance also involving stakeholders. Related activities on intellectual outputs, multiplier events and lecturing will be carried out by all participating organisations.The intellectual outputs are related to three major contributions to the European higher education landscape:1) an advanced level international topical MSP course (Step-up MSP)2) digital learning facilities and tools (MSP Education Arena)3) designing problem-based learning in MSP (MSP directory)The advanced level inter-institutional topical MSP course will include different teaching and training activities within a problem-based learning environment. Digital learning facilities enabling communication and training will include a further enrichment of the MSP Education Arena platform for students, practitioners and lecturers for including modules forcollaborate learning activities, documentation and dissemination, mobilisation/recruitment, thesis opportunities, placements/internships. Designing problem-based learning in MSP will include topics as; the design of didactics and methods; guidance for lecturers, supervisors and students; evaluation and quality assurance; assessment.Five multiplier events back to back or as part of conferences within the MSP community will be organised to mainstream the outputs and innovative MSP didactics among other universities and institutions.Different teaching and training activities feeds into the intellectual output activities, which will include serious gaming sessions (MSP Challenge (http://www.mspchallenge.info/) and others), workshops, excursions, courses/classes as well as a conference with a specific focus on facilitating the exchange of innovative ideas and approaches among students at bachelor´s, master´s and doctoral level and the MSP community of practice.Project management meetings (twice a year) will assure coherence in project planning and implementation. As the core focus of the strategic partnership is on collaboration, mutual learning, and innovation among educators, students, and practitioners in order to meet actual and future needs regarding knowledge exchange and training within the MSP community, the project will be designed to have long lasting effects.Results
In the quest of lowering atmospheric CO2 levels, Zero Emission Fuel (ZEF) B.V. is developing a small-scale microplant unit to produce a liquid fuel (methanol) directly from the air powered by only solar energy. By focusing on numbering up instead of scaling up, ZEF aims to shorten the development cycle of novel chemical processes and products. Within the microplant unit of ZEF, the core process that captures CO2 directly from the atmosphere resembles existing processes that capture CO2 from smokestacks. Therefore, it also inherits the existing challenge of sorbent degradation and short lifetime of chemicals and components: metal inside the process (in pipe, pump, heat exchanger, etc.) act as a catalyst for the lifetime-inhibiting oxidative degradation. A possible solution that could solve the degradation issues is the avoidance of metals altogether, in the entire process. In this project, a consortium of both industry and academic partners will kick off a new development roadmap that scouts, develops, tests and deploys new non-metal materials for CO2 capture processes. The small scale of the ZEF-process allows for fast innovation cycles through an iterative approach. The second industrial partner, Promolding B.V., provides a vast experience in the prototyping and application of novel polymers. The groups of TUD (sustainable Design Engineering at Industrial Design Engineering faculty together with Materials Science and Engineering at 3mE faculty) unlock deep understanding of materials and knowledge how to select, tweak or design novel composite materials until the necessary properties have been found. After this project, the development will continue to result in a chemical process that has longer lifetime, lower cost and is more sustainable. This will not only be at the benefit of the ZEF CO2 capture process, but also at the benefit of the chemical and materials industry as a whole.
Prompt and timely response to incoming cyber-attacks and incidents is a core requirement for business continuity and safe operations for organizations operating at all levels (commercial, governmental, military). The effectiveness of these measures is significantly limited (and oftentimes defeated altogether) by the inefficiency of the attack identification and response process which is, effectively, a show-stopper for all attack prevention and reaction activities. The cognitive-intensive, human-driven alarm analysis procedures currently employed by Security Operation Centres are made ineffective (as opposed to only inefficient) by the sheer amount of alarm data produced, and the lack of mechanisms to automatically and soundly evaluate the arriving evidence to build operable risk-based metrics for incident response. This project will build foundational technologies to achieve Security Response Centres (SRC) based on three key components: (1) risk-based systems for alarm prioritization, (2) real-time, human-centric procedures for alarm operationalization, and (3) technology integration in response operations. In doing so, SeReNity will develop new techniques, methods, and systems at the intersection of the Design and Defence domains to deliver operable and accurate procedures for efficient incident response. To achieve this, this project will develop semantically and contextually rich alarm data to inform risk-based metrics on the mounting evidence of incoming cyber-attacks (as opposed to firing an alarm for each match of an IDS signature). SeReNity will achieve this by means of advanced techniques from machine learning and information mining and extraction, to identify attack patterns in the network traffic, and automatically identify threat types. Importantly, SeReNity will develop new mechanisms and interfaces to present the gathered evidence to SRC operators dynamically, and based on the specific threat (type) identified by the underlying technology. To achieve this, this project unifies Dutch excellence in intrusion detection, threat intelligence, and human-computer interaction with an industry-leading partner operating in the market of tailored solutions for Security Monitoring.