INTRODUCTION: Mechanical Insufflation-Exsufflation (MI-E) is used as an airway clearance intervention in primary care (home ventilation), long-term care (prolonged rehabilitation after intensive care, neuromuscular diseases, and spinal cord injury), and increasingly in acute care in intensive care units (ICU).AIM: We sought to develop in-depth understanding of factors influencing decision-making processes of health care professionals regarding initiation, escalation, de-escalation, and discontinuation of MI-E for invasively ventilated patients including perceived barriers and facilitators to use.METHODS: We conducted focus groups (3 in the Netherlands; 1 with participants from four European countries) with clinicians representing the ICU interprofessional team and with variable experience of MI-E. The semi-structured interview guide was informed by the Theoretical Domains Framework (TDF). Two researchers independently coded data for directed content analysis using codes developed from the TDF.RESULTS: A purposive sample of 35 health care professionals participated. Experience varied from infrequent to several years of frequent MI-E use in different patient populations. We identified four main themes: (1) knowledge; (2) beliefs; (3) clinical decision-making; and (4) future adoption.CONCLUSION: Interprofessional knowledge and expertise of MI-E in invasively ventilated patients is limited due to minimal available evidence and adoption. Participants believed MI-E a potentially useful intervention for airway clearance and inclusion in weaning protocols when more evidence is available.RELEVANCE TO CLINICAL PRACTICE: This focus group study provides an overview of current practice, knowledge and expertise, and barriers and facilitators to using MI-E in mechanically ventilated patients. From these data, it is evident there is a need to develop further clinical expertise and evidence of efficacy to further understand the role of MI-E as an airway clearance technique for ventilated patients.
Background: Determining what constitutes an excellent allied health care professional (AHCP) is important, since this is what will guide the development of curricula for training future physical therapists, oral hygienists, speech therapists, diagnostic radiographers, and dietitians. This also determines the quality of care.Aim: To describe perspectives of AHCPs on which characteristics are commonly associated with an excellent AHCP.Methods: AHCPs’ perspectives were derived from three focus group discussions. Twenty-one health care professionals participated. The final analysis of the focus group discussions produced eight domains, in which content validity was obtained through a Delphi panel survey of 27 contributing experts.Results: According to the survey, a combination of the following characteristics defines an excellent AHCP: (1) cognizance, to obtain and to apply knowledge in a broad multidisciplinary health care field; (2) cooperativity, to effectively work with others in a multidisciplinary con¬text; (3) communicative, to communicate effectively at different levels in complex situations; (4) initiative, to initiate new ideas, to act proactively, and to follow them through; (5) innovative, to devise new ideas and to implement alternatives beyond current practices; (6) introspective, to self-examine and to reflect; (7) broad perspective, to capture the big picture; and (8) evidence-driven, to find and to use scientific evidence to guide one’s decisions.Conclusion: The AHCPs perspectives can be used as a reference for personal improvement for supervisors and professionals in clinical practice and for educational purposes. These perspectives may serve as a guide against which talented students can evaluate themselves.
De Peer Support Group Kwalitatief Onderzoek van de HU is een groeiende, zelfsturende, HU-brede groep die is ontstaan uit de behoefte van onderzoekers en docenten om als ‘peers’ onderling kennis en ervaring te delen met betrekking tot kwalitatief onderzoek. De logistiek en organisatie van deze groep heeft een zeer fluïde karakter. Zij vormt zich naar de inhoudelijke en organisatorische behoeften van de groep. Deze behoeften zijn continu in beweging door onder andere veranderingen binnen de organisatie van de HU en de verschillende werkvelden en onderzoeksdomeinen waaruit de deelnemers afkomstig zijn. Maar ook door de ontwikkelingen die plaatsvinden op het terrein van kwalitatief onderzoek, binnen de eigen Peer Support Group (PSG) zelf en van de individuen die deel uitmaken van de PSG. In deze bijdrage zal ik nader uiteenzetten hoe complexiteit een rol speelt in het ontstaan en functioneren van de PSG.
Due to societal developments, like the introduction of the ‘civil society’, policy stimulating longer living at home and the separation of housing and care, the housing situation of older citizens is a relevant and pressing issue for housing-, governance- and care organizations. The current situation of living with care already benefits from technological advancement. The wide application of technology especially in care homes brings the emergence of a new source of information that becomes invaluable in order to understand how the smart urban environment affects the health of older people. The goal of this proposal is to develop an approach for designing smart neighborhoods, in order to assist and engage older adults living there. This approach will be applied to a neighborhood in Aalst-Waalre which will be developed into a living lab. The research will involve: (1) Insight into social-spatial factors underlying a smart neighborhood; (2) Identifying governance and organizational context; (3) Identifying needs and preferences of the (future) inhabitant; (4) Matching needs & preferences to potential socio-techno-spatial solutions. A mixed methods approach fusing quantitative and qualitative methods towards understanding the impacts of smart environment will be investigated. After 12 months, employing several concepts of urban computing, such as pattern recognition and predictive modelling , using the focus groups from the different organizations as well as primary end-users, and exploring how physiological data can be embedded in data-driven strategies for the enhancement of active ageing in this neighborhood will result in design solutions and strategies for a more care-friendly neighborhood.
In the last decade, the automotive industry has seen significant advancements in technology (Advanced Driver Assistance Systems (ADAS) and autonomous vehicles) that presents the opportunity to improve traffic safety, efficiency, and comfort. However, the lack of drivers’ knowledge (such as risks, benefits, capabilities, limitations, and components) and confusion (i.e., multiple systems that have similar but not identical functions with different names) concerning the vehicle technology still prevails and thus, limiting the safety potential. The usual sources (such as the owner’s manual, instructions from a sales representative, online forums, and post-purchase training) do not provide adequate and sustainable knowledge to drivers concerning ADAS. Additionally, existing driving training and examinations focus mainly on unassisted driving and are practically unchanged for 30 years. Therefore, where and how drivers should obtain the necessary skills and knowledge for safely and effectively using ADAS? The proposed KIEM project AMIGO aims to create a training framework for learner drivers by combining classroom, online/virtual, and on-the-road training modules for imparting adequate knowledge and skills (such as risk assessment, handling in safety-critical and take-over transitions, and self-evaluation). AMIGO will also develop an assessment procedure to evaluate the impact of ADAS training on drivers’ skills and knowledge by defining key performance indicators (KPIs) using in-vehicle data, eye-tracking data, and subjective measures. For practical reasons, AMIGO will focus on either lane-keeping assistance (LKA) or adaptive cruise control (ACC) for framework development and testing, depending on the system availability. The insights obtained from this project will serve as a foundation for a subsequent research project, which will expand the AMIGO framework to other ADAS systems (e.g., mandatory ADAS systems in new cars from 2020 onwards) and specific driver target groups, such as the elderly and novice.
The postdoc candidate, Giuliana Scuderi, will strengthen the connection between the research group Biobased Buildings (BB), (collaboration between Avans University of Applied Sciences and HZ University of Applied Sciences (HZ), and the Civil Engineering bachelor programme (CE) of HZ. The proposed research aims at deepening the knowledge about the mechanical properties of biobased materials for the application in the structural and infrastructural sectors. The research is relevant for the professional field, which is looking for safe and sustainable alternatives to traditional building materials (such as lignin asphalt, biobased panels for bridge constructions, etc.). The study of the mechanical behaviour of traditional materials (such as concrete and steel) is already part of the CE curriculum, but the ambition of this postdoc is that also BB principles are applied and visible. Therefore, from the first year of the programme, the postdoc will develop a biobased material science line and will facilitate applied research experiences for students, in collaboration with engineering and architectural companies, material producers and governmental bodies. Consequently, a new generation of environmentally sensitive civil engineers could be trained, as the labour market requires. The subject is broad and relevant for the future of our built environment, with possible connections with other fields of study, such as Architecture, Engineering, Economics and Chemistry. The project is also relevant for the National Science Agenda (NWA), being a crossover between the routes “Materialen – Made in Holland” and “Circulaire economie en grondstoffenefficiëntie”. The final products will be ready-to-use guidelines for the applications of biobased materials, a portfolio of applications and examples, and a new continuous learning line about biobased material science within the CE curriculum. The postdoc will be mentored and supervised by the Lector of the research group and by the study programme coordinator. The personnel policy and job function series of HZ facilitates the development opportunity.
