Background: According to the principles of Reablement, home care services are meant to be goal-oriented, holistic and person-centred taking into account the capabilities and opportunities of older adults. However, home care services traditionally focus on doing things for older adults rather than with them. To implement Reablement in practice, the ‘Stay Active at Home’ programme was developed. It is assumed that the programme leads to a reduction in sedentary behaviour in older adults and consequently more cost-effective outcomes in terms of their health and wellbeing. However, this has yet to be proven. Methods/ design: A two-group cluster randomised controlled trial with 12 months follow-up will be conducted. Ten nursing teams will be selected, pre-stratified on working area and randomised into an intervention group (‘Stay Active at Home’) or control group (no training). All nurses of the participating teams are eligible to participate in the study. Older adults and, if applicable, their domestic support workers (DSWs) will be allocated to the intervention or control group as well, based on the allocation of the nursing team. Older adults are eligible to participate, if they: 1) receive homecare services by the selected teams; and 2) are 65 years or older. Older adults will be excluded if they: 1) are terminally ill or bedbound; 2) have serious cognitive or psychological problems; or 3) are unable to communicate in Dutch. DSWs are eligible to participate if they provide services to clients who fulfil the eligibility criteria for older adults. The study consists of an effect evaluation (primary outcome: sedentary behaviour in older adults), an economic evaluation and a process evaluation. Data for the effect and economic evaluation will be collected at baseline and 6 and/or 12 months after baseline using performance-based and self-reported measures. In addition, data from client records will be extracted. A mixed-methods design will be applied for the process evaluation, collecting data of older adults and professionals throughout the study period. Discussion: This study will result in evidence about the effectiveness, cost-effectiveness and feasibility of the ‘Stay Active at Home’ programme.
This video provides small and medium enterprises (SMEs) with a concise breakdown of the costs involved in initiating a data science project. It categorizes expenses into three primary areas: personnel, infrastructure, and data-related costs. Through a practical example of a marketing agency’s venture into customer segmentation, viewers get a tangible sense of potential expenditures. Emphasizing the importance of clear project goals and efficient resource allocation, the session offers insights into making cost-effective decisions in data science endeavors.
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AbstractOBJECTIVES:After hospitalization, many older adults need post-acute care, including rehabilitation or home care. However, post-acute care expenses can be as high as the costs for the initial hospitalization. Detailed information on monthly post-acute health care expenditures and the characteristics of patients that make up for a large share of these expenditures is scarce. We aimed to calculate costs in acutely hospitalized older patients and identify patient characteristics that are associated with high post-acute care costs.DESIGN:Prospective multicenter cohort study (between October 2015 and June 2017).SETTING AND PARTICIPANTS:401 acutely hospitalized older persons from internal medicine, cardiology, and geriatric wards.MEASUREMENTS:Our primary outcome was mean post-acute care costs within 90 days postdischarge. Post-acute care costs included costs for unplanned readmissions, home care, nursing home care, general practice, and rehabilitation care. Three costs categories were defined: low [0-50th percentile (p0-50)], moderate (p50-75), and high (p75-100). Multinomial logistic regression analyses were conducted to assess the associations between costs and frailty, functional impairment, health-related quality of life, cognitive impairment, and depressive symptoms.RESULTS:Costs were distributed unevenly in the population, with the top 10.0% (n = 40) accounting for 52.1% of total post-acute care costs. Mean post-acute care costs were €4035 [standard deviation (SD) 4346] or $4560 (SD 4911). Frailty [odds ratio (OR) 3.44, 95% confidence interval (CI) 1.78-6.63], functional impairment (OR 1.80, 95% CI 1.03-3.16), and poor health-related quality of life (OR 1.89, 95% CI 1.09-3.28) at admission were associated with classification in the high-cost group, compared with the low-cost group.CONCLUSIONS/IMPLICATIONS:Post-acute care costs are substantial in a small portion of hospitalized older adults. Frailty, functional impairment, and poor health-related quality of life are associated with higher post-acute care costs and may be used as an indicator of such costs in practice.
Size measurement plays an essential role for micro-/nanoparticle characterization and property evaluation. Due to high costs, complex operation or resolution limit, conventional characterization techniques cannot satisfy the growing demand of routine size measurements in various industry sectors and research departments, e.g., pharmaceuticals, nanomaterials and food industry etc. Together with start-up SeeNano and other partners, we will develop a portable compact device to measure particle size based on particle-impact electrochemical sensing technology. The main task in this project is to extend the measurement range for particles with diameters ranging from 20 nm to 20 um and to validate this technology with realistic samples from various application areas. In this project a new electrode chip will be designed and fabricated. It will result in a workable prototype including new UMEs (ultra-micro electrode), showing that particle sizing can be achieved on a compact portable device with full measuring range. Following experimental testing with calibrated particles, a reliable calibration model will be built up for full range measurement. In a further step, samples from partners or potential customers will be tested on the device to evaluate the application feasibility. The results will be validated by high-resolution and mainstream sizing techniques such as scanning electron microscopy (SEM), dynamic light scattering (DLS) and Coulter counter.
A-das-PK; een APK-straat voor rijhulpsystemen Uit recent onderzoek en vragen vanuit de autobranche blijkt een duidelijke behoefte naar goed onderhoud, reparatie en borging van de werking van Advanced Driver Assistance Systems (ADAS), vergelijkbaar met de reguliere APK. Een APK voor ADAS bestaat nog niet, maar de branche wil hier wel op te anticiperen en haar clientèle veilig laten rijden met de rijhulpsystemen. In 2022 worden 30 ADAS’s verplicht en zal de werking van deze systemen ook gedurende de levensduur van de auto gegarandeerd moeten worden. Disfunctioneren van ADAS, zowel in false positives als false negatives kan leiden tot gevaarlijke situaties door onverwacht rijgedrag van het voertuig. Zo kan onverwacht remmen door detectie van een niet bestaand object of op basis van verkeersborden op parallelwegen een kettingbotsing veroorzaken. Om te kijken welke gevolgen een APK heeft voor de autobranche wil A-das-PK voor autobedrijven kijken naar de benodigde apparatuur, opleiding en hard- en software voor een goed werkende APK-straat voor ADAS’s, zodat de kansrijke elementen in een vervolgonderzoek uitgewerkt kunnen worden.
De technische en economische levensduur van auto’s verschilt. Een goed onderhouden auto met dieselmotor uit het bouwjaar 2000 kan technisch perfect functioneren. De economische levensduur van diezelfde auto is echter beperkt bij introductie van strenge milieuzones. Bij de introductie en verplichtstelling van geavanceerde rijtaakondersteunende systemen (ADAS) zien we iets soortgelijks. Hoewel de auto technisch gezien goed functioneert kunnen verouderde software, algorithmes en sensoren leiden tot een beperkte levensduur van de gehele auto. Voorbeelden: - Jeep gehackt: verouderde veiligheidsprotocollen in de software en hardware beperkten de economische levensduur. - Actieve Cruise Control: sensoren/radars van verouderde systemen leiden tot beperkte functionaliteit en gebruikersacceptatie. - Tesla: bij bestaande auto’s worden verouderde sensoren uitgeschakeld waardoor functies uitvallen. In 2019 heeft de EU een verplichting opgelegd aan automobielfabrikanten om 20 nieuwe ADAS in te bouwen in nieuw te ontwikkelen auto’s, ongeacht prijsklasse. De mate waarin deze ADAS de economische levensduur van de auto beperkt is echter nog onvoldoende onderzocht. In deze KIEM wordt dit onderzocht en wordt tevens de parallel getrokken met de mobiele telefonie; beide maken gebruik van moderne sensoren en software. We vergelijken ontwerpeisen van telefoons (levensduur van gemiddeld 2,5 jaar) met de eisen aan moderne ADAS met dezelfde sensoren (levensduur tot 20 jaar). De centrale vraag luidt daarom: Wat is de mogelijke impact van veroudering van ADAS op de economische levensduur van voertuigen en welke lessen kunnen we leren uit de onderliggende ontwerpprincipes van ADAS en Smartphones? De vraag wordt beantwoord door (i) literatuuronderzoek naar de veroudering van ADAS (ii) Interviews met ontwerpers van ADAS, leveranciers van retro-fit systemen en ontwerpers van mobiele telefoons en (iii) vergelijkend rij-onderzoek naar het functioneren van ADAS in auto’s van verschillende leeftijd en prijsklassen.
