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Producten 3.056

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A standard for nursing process - clinical decision support systems (NP-CDSS).

A Nursing Process-Clinical Decision Support System (NP-CDSS) Standard with 25 criteria to guide future developments of Nursing Process-Clinical Decision Support Systems was developed. The NP-CDSS Standards' content validity was established in qualitative interviews yielding fourteen categories that demonstrate international expert consensus. All experts judged the Advanced Nursing Process being the centerpiece for Nursing Process-Clinical Decision Support System that should suggest research-based, pre-defined nursing diagnoses and correct linkages between diagnoses, evidence-based interventions and patient outcomes.

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What value structure underlies shared decision making?

Objective: To construct the underlying value structure of shared decision making (SDM) models. Method: We included previously identified SDM models (n = 40) and 15 additional ones. Using a thematic analysis, we coded the data using Schwartz’s value theory to define values in SDM and to investigate value relations. Results: We identified and defined eight values and developed three themes based on their relations: shared control, a safe and supportive environment, and decisions tailored to patients. We constructed a value structure based on the value relations and themes: the interplay of healthcare professionals’ (HCPs) and patients’ skills [Achievement], support for a patient [Benevolence], and a good relationship between HCP and patient [Security] all facilitate patients’ autonomy [Self-Direction]. These values enable a more balanced relationship between HCP and patient and tailored decision making [Universalism]. Conclusion: SDM can be realized by an interplay of values. The values Benevolence and Security deserve more explicit attention, and may especially increase vulnerable patients’ Self-Direction. Practice implications: This value structure enables a comparison of values underlying SDM with those of specific populations, facilitating the incorporation of patients’ values into treatment decision making. It may also inform the development of SDM measures, interventions, education programs, and HCPs when practicing.

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What value structure underlies shared decision making?

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Developing decision support for cybersecurity threat and incident managers

Cybersecurity threat and incident managers in large organizations, especially in the financial sector, are confronted more and more with an increase in volume and complexity of threats and incidents. At the same time, these managers have to deal with many internal processes and criteria, in addition to requirements from external parties, such as regulators that pose an additional challenge to handling threats and incidents. Little research has been carried out to understand to what extent decision support can aid these professionals in managing threats and incidents. The purpose of this research was to develop decision support for cybersecurity threat and incident managers in the financial sector. To this end, we carried out a cognitive task analysis and the first two phases of a cognitive work analysis, based on two rounds of in-depth interviews with ten professionals from three financial institutions. Our results show that decision support should address the problem of balancing the bigger picture with details. That is, being able to simultaneously keep the broader operational context in mind as well as adequately investigating, containing and remediating a cyberattack. In close consultation with the three financial institutions involved, we developed a critical-thinking memory aid that follows typical incident response process steps, but adds big picture elements and critical thinking steps. This should make cybersecurity threat and incident managers more aware of the broader operational implications of threats and incidents while keeping a critical mindset. Although a summative evaluation was beyond the scope of the present research, we conducted iterative formative evaluations of the memory aid that show its potential.

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Developing decision support for cybersecurity threat and incident managers

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Cyber incident response decision making

In case of a major cyber incident, organizations usually rely on external providers of Cyber Incident Response (CIR) services. CIR consultants operate in a dynamic and constantly changing environment in which they must actively engage in information management and problem solving while adapting to complex circumstances. In this challenging environment CIR consultants need to make critical decisions about what to advise clients that are impacted by a major cyber incident. Despite its relevance, CIR decision making is an understudied topic. The objective of this preliminary investigation is therefore to understand what decision-making strategies experienced CIR consultants use during challenging incidents and to offer suggestions for training and decision-aiding. A general understanding of operational decision making under pressure, uncertainty, and high stakes was established by reviewing the body of knowledge known as Naturalistic Decision Making (NDM). The general conclusion of NDM research is that experts usually make adequate decisions based on (fast) recognition of the situation and applying the most obvious (default) response pattern that has worked in similar situations in the past. In exceptional situations, however, this way of recognition-primed decision-making results in suboptimal decisions as experts are likely to miss conflicting cues once the situation is quickly recognized under pressure. Understanding the default response pattern and the rare occasions in which this response pattern could be ineffective is therefore key for improving and aiding cyber incident response decision making. Therefore, we interviewed six experienced CIR consultants and used the critical decision method (CDM) to learn how they made decisions under challenging conditions. The main conclusion is that the default response pattern for CIR consultants during cyber breaches is to reduce uncertainty as much as possible by gathering and investigating data and thus delay decision making about eradication until the investigation is completed. According to the respondents, this strategy usually works well and provides the most assurance that the threat actor can be completely removed from the network. However, the majority of respondents could recall at least one case in which this strategy (in hindsight) resulted in unnecessary theft of data or damage. Interestingly, this finding is strikingly different from other operational decision-making domains such as the military, police and fire service in which there is a general tendency to act rapidly instead of searching for more information. The main advice is that training and decision aiding of (novice) cyber incident responders should be aimed at the following: (a) make cyber incident responders aware of how recognition-primed decision making works; (b) discuss the default response strategy that typically works well in several scenarios; (c) explain the exception and how the exception can be recognized; (d) provide alternative response strategies that work better in exceptional situations.

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Personen 5

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Frans Melissen

Transversal Professor of Sustainability Transitions

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Jessika Weber

Professor

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Michiel van der Ven

Docent-onderzoeker

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Sven Jacobus Gertruda Geelen

Projecten 36

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‘Raising the curve’: impuls aan de instroom van Praktische predictie

Middels een RAAK-impuls aanvraag wordt beoogd de vertraging van het RAAK-mkb project Praktische Predictie t.g.v. corona in te halen. In het project Praktische Predictie wordt een prototype app ontwikkeld waarmee fysiotherapeuten in een vroeg stadium het chronisch worden van lage rugpijn kunnen voorspellen. Om chronische rugpijn te voorkomen is het belangrijk om in een vroeg stadium de kans hierop in te schatten door psychosociale en mogelijk andere risicofactoren op chronische pijnklachten te herkennen en hierop te interveniëren. Fysiotherapeuten zijn met deze vraag naar het lectoraat Werkzame factoren in Fysiotherapie en Paramedisch Handelen van de Hogeschool van Arnhem en Nijmegen gegaan en dit heeft aanleiding gegeven een onderzoek op te zetten waarin een dergelijke methodiek ontwikkeld wordt. De voorgestelde methodiek betreft een Clinical Decision Support Tool waarmee een geïndividualiseerde kans op chronische rugpijn kan worden bepaald gekoppeld aan een behandeladvies conform de lage rugpijn richtlijn. Hiervoor is eerst geïnventariseerd welke methoden fysiotherapeuten reeds gebruiken en welke in de literatuur worden genoemd. Op basis hiervan is een keuze gemaakt ten aanzien van data die digitaal verzameld worden in minimaal 16 fysiotherapiepraktijken waarbij patiënten gedurende 12 weken gevolgd worden. Met de verzamelde data worden met machine learning algoritmes ontwikkeld voor het berekenen van de kans op chroniciteit. De algoritmes worden ingebouwd in de Clinical Decision Support Tool: een gebruiksvriendelijke prototype app. Bij het ontwikkelen van de tool worden eindgebruikers (fysiotherapeuten en patiënten) intensief betrokken. Op deze manier wordt gegarandeerd dat de tool aansluit bij de wensen en behoeften van de doelgroep. De tool berekent de kans op chroniciteit en geeft een behandeladvies. Daarnaast kan de tool gebruikt worden om patiënten te informeren en te betrekken bij de besluitvorming. Vanwege de coronacrisis is er een aanzienlijke vertraging in de patiënten-instroom (doel n= 300) ontstaan die we met ondersteuning van een RAAK-impuls subsidie willen inlopen.

Afgerond

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AI-enhanced Data Analysis

Developing a framework that integrates Advanced Language Models into the qualitative research process.Qualitative research, vital for understanding complex phenomena, is often limited by labour-intensive data collection, transcription, and analysis processes. This hinders scalability, accessibility, and efficiency in both academic and industry contexts. As a result, insights are often delayed or incomplete, impacting decision-making, policy development, and innovation. The lack of tools to enhance accuracy and reduce human error exacerbates these challenges, particularly for projects requiring large datasets or quick iterations. Addressing these inefficiencies through AI-driven solutions like AIDA can empower researchers, enhance outcomes, and make qualitative research more inclusive, impactful, and efficient.The AIDA project enhances qualitative research by integrating AI technologies to streamline transcription, coding, and analysis processes. This innovation enables researchers to analyse larger datasets with greater efficiency and accuracy, providing faster and more comprehensive insights. By reducing manual effort and human error, AIDA empowers organisations to make informed decisions and implement evidence-based policies more effectively. Its scalability supports diverse societal and industry applications, from healthcare to market research, fostering innovation and addressing complex challenges. Ultimately, AIDA contributes to improving research quality, accessibility, and societal relevance, driving advancements across multiple sectors.

Lopend

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Analyzing yachting patterns in the Biesbosch National Park using GIS technology

National forestry Commission (SBB) and National Park De Biesbosch. Subcontractor through NRITNational parks with large flows of visitors have to manage these flows carefully. Methods of data collection and analysis can be of help to support decision making. The case of the Biesbosch National Park is used to find innovative ways to figure flows of yachts, being the most important component of water traffic, and to create a model that allows the estimation of changes in yachting patterns resulting from policy measures. Recent policies oriented at building additional waterways, nature development areas and recreational concentrations in the park to manage the demands of recreation and nature conservation offer a good opportunity to apply this model. With a geographical information system (GIS), data obtained from aerial photographs and satellite images can be analyzed. The method of space syntax is used to determine and visualize characteristics of the network of leisure routes in the park and to evaluate impacts resulting from expected changes in the network that accompany the restructuring of waterways.

Afgerond

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Automated Reasoning on Human Performance Data

The focus of the research is 'Automated Analysis of Human Performance Data'. The three interconnected main components are (i)Human Performance (ii) Monitoring Human Performance and (iii) Automated Data Analysis . Human Performance is both the process and result of the person interacting with context to engage in tasks, whereas the performance range is determined by the interaction between the person and the context. Cheap and reliable wearable sensors allow for gathering large amounts of data, which is very useful for understanding, and possibly predicting, the performance of the user. Given the amount of data generated by such sensors, manual analysis becomes infeasible; tools should be devised for performing automated analysis looking for patterns, features, and anomalies. Such tools can help transform wearable sensors into reliable high resolution devices and help experts analyse wearable sensor data in the context of human performance, and use it for diagnosis and intervention purposes. Shyr and Spisic describe Automated Data Analysis as follows: Automated data analysis provides a systematic process of inspecting, cleaning, transforming, and modelling data with the goal of discovering useful information, suggesting conclusions and supporting decision making for further analysis. Their philosophy is to do the tedious part of the work automatically, and allow experts to focus on performing their research and applying their domain knowledge. However, automated data analysis means that the system has to teach itself to interpret interim results and do iterations. Knuth stated: Science is knowledge which we understand so well that we can teach it to a computer; and if we don't fully understand something, it is an art to deal with it.[Knuth, 1974]. The knowledge on Human Performance and its Monitoring is to be 'taught' to the system. To be able to construct automated analysis systems, an overview of the essential processes and components of these systems is needed.Knuth Since the notion of an algorithm or a computer program provides us with an extremely useful test for the depth of our knowledge about any given subject, the process of going from an art to a science means that we learn how to automate something.

Afgerond

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Collaborative Networks for Sustainability (CONESU)

Collaborative networks for sustainability are emerging rapidly to address urgent societal challenges. By bringing together organizations with different knowledge bases, resources and capabilities, collaborative networks enhance information exchange, knowledge sharing and learning opportunities to address these complex problems that cannot be solved by organizations individually. Nowhere is this more apparent than in the apparel sector, where examples of collaborative networks for sustainability are plenty, for example Sustainable Apparel Coalition, Zero Discharge Hazardous Chemicals, and the Fair Wear Foundation. Companies like C&A and H&M but also smaller players join these networks to take their social responsibility. Collaborative networks are unlike traditional forms of organizations; they are loosely structured collectives of different, often competing organizations, with dynamic membership and usually lack legal status. However, they do not emerge or organize on their own; they need network orchestrators who manage the network in terms of activities and participants. But network orchestrators face many challenges. They have to balance the interests of diverse companies and deal with tensions that often arise between them, like sharing their innovative knowledge. Orchestrators also have to “sell” the value of the network to potential new participants, who make decisions about which networks to join based on the benefits they expect to get from participating. Network orchestrators often do not know the best way to maintain engagement, commitment and enthusiasm or how to ensure knowledge and resource sharing, especially when competitors are involved. Furthermore, collaborative networks receive funding from grants or subsidies, creating financial uncertainty about its continuity. Raising financing from the private sector is difficult and network orchestrators compete more and more for resources. When networks dissolve or dysfunction (due to a lack of value creation and capture for participants, a lack of financing or a non-functioning business model), the collective value that has been created and accrued over time may be lost. This is problematic given that industrial transformations towards sustainability take many years and durable organizational forms are required to ensure ongoing support for this change. Network orchestration is a new profession. There are no guidelines, handbooks or good practices for how to perform this role, nor is there professional education or a professional association that represents network orchestrators. This is urgently needed as network orchestrators struggle with their role in governing networks so that they create and capture value for participants and ultimately ensure better network performance and survival. This project aims to foster the professionalization of the network orchestrator role by: (a) generating knowledge, developing and testing collaborative network governance models, facilitation tools and collaborative business modeling tools to enable network orchestrators to improve the performance of collaborative networks in terms of collective value creation (network level) and private value capture (network participant level) (b) organizing platform activities for network orchestrators to exchange ideas, best practices and learn from each other, thereby facilitating the formation of a professional identity, standards and community of network orchestrators.

Afgerond

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Crossing borders at the Grensmaas

The Dutch main water systems face pressing environmental, economic and societal challenges due to climatic changes and increased human pressure. There is a growing awareness that nature-based solutions (NBS) provide cost-effective solutions that simultaneously provide environmental, social and economic benefits and help building resilience. In spite of being carefully designed and tested, many projects tend to fail along the way or never get implemented in the first place, wasting resources and undermining trust and confidence of practitioners in NBS. Why do so many projects lose momentum even after a proof of concept is delivered? Usually, failure can be attributed to a combination of eroding political will, societal opposition and economic uncertainties. While ecological and geological processes are often well understood, there is almost no understanding around societal and economic processes related to NBS. Therefore, there is an urgent need to carefully evaluate the societal, economic, and ecological impacts and to identify design principles fostering societal support and economic viability of NBS. We address these critical knowledge gaps in this research proposal, using the largest river restoration project of the Netherlands, the Border Meuse (Grensmaas), as a Living Lab. With a transdisciplinary consortium, stakeholders have a key role a recipient and provider of information, where the broader public is involved through citizen science. Our research is scientifically innovative by using mixed methods, combining novel qualitative methods (e.g. continuous participatory narrative inquiry) and quantitative methods (e.g. economic choice experiments to elicit tradeoffs and risk preferences, agent-based modeling). The ultimate aim is to create an integral learning environment (workbench) as a decision support tool for NBS. The workbench gathers data, prepares and verifies data sets, to help stakeholders (companies, government agencies, NGOs) to quantify impacts and visualize tradeoffs of decisions regarding NBS.

Lopend

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Data-driven rehabilitation: Measuring movements in low back pain.

Low back pain is the leading cause of disability worldwide and a significant contributor to work incapacity. Although effective therapeutic options are scarce, exercises supervised by a physiotherapist have shown to be effective. However, the effects found in research studies tend to be small, likely due to the heterogeneous nature of patients' complaints and movement limitations. Personalized treatment is necessary as a 'one-size-fits-all' approach is not sufficient. High-tech solutions consisting of motions sensors supported by artificial intelligence will facilitate physiotherapists to achieve this goal. To date, physiotherapists use questionnaires and physical examinations, which provide subjective results and therefore limited support for treatment decisions. Objective measurement data obtained by motion sensors can help to determine abnormal movement patterns. This information may be crucial in evaluating the prognosis and designing the physiotherapy treatment plan. The proposed study is a small cohort study (n=30) that involves low back pain patients visiting a physiotherapist and performing simple movement tasks such as walking and repeated forward bending. The movements will be recorded using sensors that estimate orientation from accelerations, angular velocities and magnetometer data. Participants complete questionnaires about their pain and functioning before and after treatment. Artificial analysis techniques will be used to link the sensor and questionnaire data to identify clinically relevant subgroups based on movement patterns, and to determine if there are differences in prognosis between these subgroups that serve as a starting point of personalized treatments. This pilot study aims to investigate the potential benefits of using motion sensors to personalize the treatment of low back pain. It serves as a foundation for future research into the use of motion sensors in the treatment of low back pain and other musculoskeletal or neurological movement disorders.

Lopend

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DevelopIng STratEgies by integrating mitigatioN, aDaptation and participation to climate changE Risks

DISTENDER will provide integrated strategies by building a methodological framework that guide the integration of climate change(CC) adaptation and mitigation strategies through participatory approaches in ways that respond to the impacts and risks of climatechange (CC), supported by quantitative and qualitative analysis that facilitates the understanding of interactions, synergies and tradeoffs.Holistic approaches to mitigation and adaptation must be tailored to the context-specific situation and this requires a flexibleand participatory planning process to ensure legitimate and salient action, carried out by all important stakeholders. DISTENDER willdevelop a set of multi-driver qualitative and quantitative socio-economic-climate scenarios through a facilitated participatory processthat integrates bottom-up knowledge and locally-relevant drivers with top-down information from the global European SharedSocioeconomic Pathways (SSPs) and downscaled Representative Concentration Pathways (RCPs) from IPCC. A cross-sectorial andmulti-scale impact assessment modelling toolkit will be developed to analyse the complex interactions over multiple sectors,including an economic evaluation framework. The economic impact of the different efforts will be analyse, including damage claimsettlement and how do sectoral activity patterns change under various scenarios considering indirect and cascading effects. It is aninnovative project combining three key concepts: cross-scale, integration/harmonization and robustness checking. DISTENDER willfollow a pragmatic approach applying methodologies and toolkits across a range of European case studies (six core case studies andfive followers) that reflect a cross-section of the challenges posed by CC adaptation and mitigation. The knowledge generated byDISTENDER will be offered by a Decision Support System (DSS) which will include guidelines, manuals, easy-to-use tools andexperiences from the application of the cases studies.

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Producten 3.056

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A standard for nursing process - clinical decision support systems (NP-CDSS).

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What value structure underlies shared decision making?

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