The Northern region of the Netherlands has beautiful landscapes, a nice diversity of green and blue areas, and dispersed settlements. However, some recent population changes can become threats to health and wellbeing in these areas.The rural areas in the three northern provinces - Groningen, Friesland and Drenthe, see youngsters leave the region for which reason they are aging faster than other regions in the Netherlands. As a result, some villages have faced major population decline that is leading to lose of facilities/amenities and decrease in accessibility and social cohesion. Those who still live in these villages; are relatively old, low educated and have low-income. To develop a deeper understanding of the health status of the people living in these areas, and help them to improve their living environment, the GO!-Method is being applied in this study. This method has been developed by the National Institute for Public Health and the Environment (RIVM) of the Netherlands and is inspired by the broad definition of health by Machteld Huber: the ability to adapt and direct control, in terms of the physical, emotional and social challenges of life, while paying extra attention to vulnerable groups. A healthy living environment is defined as an environment that residents find it pleasant, and encourages and supports healthy behavior. The GO!-method integrates six domains that constitutes a healthy living environment: Health and lifestyle, facilities and development, Safety and hygiene, Social cohesion and active citizens, Green areas, and Air and noise pollution.First of all this method will identify opportunities for a healthier living environment using existing information and perceptions of residents and other local stakeholders in order to strengthen social participation and quality of life in these rural areas. Second this approach will connect identified opportunities with available and effective evidence based interventions in order to develop an action plan from the residents and local authorities perspective which will help them to design their municipalities healthier and more resilient. This method is being used for the first time in rural areas to our best knowledge, in close collaboration with the residents and local authorities of the three provinces to create a sustainable process and stimulate social participation.Our paper will present the outcomes of the first phase of this project in collaboration with the municipality of Westerkwartier, located in the northwest of the province of Groningen. And will describe the current situation, and identify local assets, opportunities, and policies relating to healthier environment; as well as needs and challenges to achieve goals. The preliminary results show that rural demographic changes in the northern Netherlands have negative impacts on service provisions and social cohesion, and there is a need to understand this complicated situation and improve the quality of life in those areas.
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A hospital visit is often an anxious and uncertain event for patients andtheir relatives. Patients are often concerned about a diagnosis and/or thetreatment of their disease in an outpatient or inpatient setting. In thesehospital settings, the impact of the environment on patients is still notwell understood. Knowledge regarding the inuence of the hospitalenvironment on patients is essential for facilitating the quality of healthcare. Understanding the experience of patients will allow designers anddecision-makers in hospitals to positively inuence the well-being ofpatients.The aim of this thesis was to gain an improved understanding about amore holistic experience and well-being of patients at specic focalpoints of the entire patient journey from the arrival, to the diagnosis, andto the actual treatment in a hospital. For example, results showed thatpatients sometimes experience diculties in finding their way to anoutpatient clinic, that nature projection during a CT-scan can reduceanxiety, and that (the opportunity of) interaction with other patients is apleasant distraction or, on the contrary, an invasion of their own privacy.Understanding patients' experiences during the patient journey enableshospitals to make more informed decisions about space and serviceswhich enables us to improve experiences and well-being of patients inhospitals.This thesis emphasizes the relations between the hospital environmentand the psychosocial and physical well-being of patients. The resultsshow that it is of great importance to listen carefully to patients’experiences and needs when designing a hospital as many of the resultsshowed individual dierences with patients that emphasize that one sizedoes not t all. The well-being of patients in future hospitals can beimproved by aligning the hospital environment with individual patientcharacteristics, needs, and preferences.
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Organizations are currently facing substantial challenges regarding becoming circular by 2050 – also referred to as Circular Economy (CE). Subsequently, increasing complexity on all organizational levels creates uncertainty about respective organizational and technological capabilities and adequate strategies to develop these capabilities. Organizations are struggling in picking up the CE ambitions and answering the what’s in it for me question. Scholars are developing models and frameworks to enable organizations to measure CE performance. Over 125 assessment methods are available for micro level assessment – measuring up to 365 different metrics. Moreover, extant literature is available presenting barriers and opportunities for CE transformation focusing on industry, sector, region, etc. And, although a more holistic perspective is required to become circular mature, this is currently lacking. In this paper we present a multi-methodology view on approaches and how they are used (or not). Our main goal is to extend the existing body of knowledge with an eye on applicability and research directions to untie the Gordian knot of measuring circularity.
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Abstract: Nurses come into frequent contact with frail older people in all healthcare settings. However, few studies have specifically asked nurses about their views on frailty. The main aim of this study was to explore the opinions of nurses working with older people on the concept of frailty, regardless of the care setting. In addition, the associations between the background characteristics of nurses and their opinions about frailty were examined. In 2021, members of professional association of nurses and nursing assistants in the Netherlands (V&VN) received a digital questionnaire asking their opinions on frailty, and 251 individuals completed the questionnaire (response rate of 32.1%). The questionnaire contained seven topics: keywords of frailty, frailty domains, causes of frailty, consequences of frailty, reversing frailty, the prevention of frailty, and addressing frailty. Regarding frailty, nurses especially thought of physical deterioration and dementia. However, other domains of human functioning, such as the social and psychological domains, were often mentioned, pointing to a holistic approach to frailty. It also appears that nurses can identify many causes and consequences of frailty. They see opportunities to reverse frailty and an important role for themselves in this process.
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Lignocellulose biorefining is a promising technologyfor the sustainable production of chemicals and biopolymers.Usually, when one component is focused on, the chemical natureand yield of the others are compromised. Thus, one of thebottlenecks in biomass biorefining is harnessing the maximumvalue from all of the lignocellulosic components. Here, we describea mild stepwise process in a flow-through setup leading to separateflow-out streams containing cinnamic acid derivatives, glucose,xylose, and lignin as the main components from differentherbaceous sources. The proposed process shows that minimaldegradation of the individual components and conservation oftheir natural structure are possible. Under optimized conditions,the following fractions are produced from wheat straw based ontheir respective contents in the feed by the ALkaline ACid ENzyme process: (i) 78% ferulic acid from a mild ALkali step, (ii) 51%monomeric xylose free of fermentation inhibitors by mild ACidic treatment, (iii) 82% glucose from ENzymatic degradation ofcellulose, and (iv) 55% native-like lignin. The benefits of using the flow-through setup are demonstrated. The retention of the ligninaryl ether structure was confirmed by HSQC NMR, and this allowed monomers to form from hydrogenolysis. More importantly, thecrude xylose-rich fraction was shown to be suitable for producing polyhydroxybutyrate bioplastics. The direct use of the xylose-richfraction by means of the thermophilic bacteria Schlegelella thermodepolymerans matched 91% of the PHA produced with commercialpure xylose, achieving 138.6 mgPHA/gxylose. Overall, the ALACEN fractionation method allows for a holistic valorization of theprincipal components of herbaceous biomasses.
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Cultural heritage buildings and sites are threatened by the effects of climate change, especially in coastal zones. Risks not only include floods and submersion, but also less visible risks such as effects of moisture levels or, alternatively, drought. At the same time, it is important to involve people in the care of heritage buildings and sites, to stimulate them to cherish, admire, and to enrich their lives with the heritage locations, buildings and stories.This paper aims to contribute to our knowledge on the application of valuation approaches. The topic of heritage and sustainability calls for an approach that encompasses a broad range of values. Theoretically, this paper relies on the approach of ‘Design for Values’. This approach starts with the identification of the values that are aspired to in a design project. These values are connected to norms, which describe how the identified value can be reached. On a more technical or concrete level, requirements are noted down, which specify the precise conditions a design must fulfill. In this way, a ‘value hierarchy’ can be outlined, which forms a guide for the designing process. In a value hierarchy, the levels are connected in two ways: downward by ‘specification’, and upwards, by the phrase ‘for the sake of’. After the design is finalized, a verification step is needed to ascertain if the aspired values indeed have been achieved in the design.The empirical case study for this paper is provided by the investigations of the Wisloujcsie Fortress and surrounding area at the SOS-workshop in Gdansk in October 2022. In our investigation of the site several problems and challenges came to light, which we summarized in a SWOT-analysis. For sustainable development of the area and the conservation of cultural and natural heritage we identified values connected to heritage, water, public access, and social values, see figure 1. In the paper, we will further elaborate on the norms and requirements that follow from each of these values. Also, we want to reflect on a preliminary verification step. We conclude that to produce designs that successfully achieve the climate and sustainability goals of the SOS-Climate Waterfront project, a ‘model valuation framework’ could be a useful guide for the design process. The first elements of such a framework are presented in our paper. Applying such a valuation framework stimulates ethical reflection during the design process and evaluation of the result. It thereby strengthens the connections between sustainability goals and urban design.
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For the integrated implementation of Business Process Management and supporting information systems many methods are available. Most of these methods, however, apply a one-size fits all approach and do not take into account the specific situation of the organization in which an information system is to be implemented. These situational factors, however, strongly determine the success of any implementation project. In this paper a method is provided that establishes situational factors of and their influence on implementation methods. The provided method enables a more successful implementation project, because the project team can create a more suitable implementation method for business process management system implementation projects.
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Knowledge management (KM) is difficult to pin down. It means different things in different organisations. The deliberate use of metaphors has been used to communicate what KM is about. This metaphorical communication can be even more enriched using visual as well as language mechanisms: ”a picture paints a thousand words” suggests we can capture more resonances of a complex subject like KM through visuals than through a description alone. In addition, visuals are perceived to transcend the limitations of language, which can be an obstacle to communication. Yet, no method currently exists that we can use to identify KM metaphors used in visuals. This paper describes our search for a method to analyse metaphors used in visuals about knowledge management. Our objective was threefold: 1) identifying new metaphors for KM in visuals that can enrich KM theorizing, 2) developing a way to identify which visuals are the most powerful in communicating KM theory, and 3) improving the use of visuals as a way of assessing students studying KM. We found that analysing metaphors used in KM visuals is possible using a method that focuses on the dominant metaphors in a visual.
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Ageing potentially poses a threat to independent functioning of older adults. Although clinicians commonly focus on physical factors limiting Functional Independence (FI), it is likely that personal and environmental interactions also seem important to maintain FI. Herewith, FI exceeds several professional borders and calls for a uniform, multidisciplinary interdisciplinary supported definition of FI. This study aims to provide such a definition of FI in community dwelling older people. A scoping review was performed. Pubmed/Medline, Psychinfo and CINAHL were searched for studies describing aspects of FI. A literature-based definition of FI was discussed by experts (n = 7), resulting in a formulated final definition of FI and insight into contributing factors to FI. A multidisciplinairy focusgroup a stakeholder consultation (n = 15) ensured clinical relevance for daily practice. Data from the focusgroup stakeholder consultation were analyzed by using Atlas.ti (version 8). Based on the literature search, 25 studies were included. FI was finally defined as “Functioning physically safely and independent from another person, within one’s own context”. The contributing factors of FI comprised physical capacity combined with coping, empowerment and health literacy. Moreover, the level of FI is influenced by someone’s own context. This study confirms the relevance of the physical aspect of FI, but additionally stresses the importance of psychological factors. In addition, this study shows that one’s context may affect the level of FI as well. This underlines the importance of a holistic view and calls for multidisciplinary interdisciplinary collaboration in community-dwelling older people.
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The Heating Ventilation and Air Conditioning (HVAC) sector is responsible for a large part of the total worldwide energy consumption, a significant part of which is caused by incorrect operation of controls and maintenance. HVAC systems are becoming increasingly complex, especially due to multi-commodity energy sources, and as a result, the chance of failures in systems and controls will increase. Therefore, systems that diagnose energy performance are of paramount importance. However, despite much research on Fault Detection and Diagnosis (FDD) methods for HVAC systems, they are rarely applied. One major reason is that proposed methods are different from the approaches taken by HVAC designers who employ process and instrumentation diagrams (P&IDs). This led to the following main research question: Which FDD architecture is suitable for HVAC systems in general to support the set up and implementation of FDD methods, including energy performance diagnosis? First, an energy performance FDD architecture based on information embedded in P&IDs was elaborated. The new FDD method, called the 4S3F method, combines systems theory with data analysis. In the 4S3F method, the detection and diagnosis phases are separated. The symptoms and faults are classified into 4 types of symptoms (deviations from balance equations, operating states (OS) and energy performance (EP), and additional information) and 3 types of faults (component, control and model faults). Second, the 4S3F method has been tested in four case studies. In the first case study, the symptom detection part was tested using historical Building Management System (BMS) data for a whole year: the combined heat and power plant of the THUAS (The Hague University of Applied Sciences) building in Delft, including an aquifer thermal energy storage (ATES) system, a heat pump, a gas boiler and hot and cold water hydronic systems. This case study showed that balance, EP and OS symptoms can be extracted from the P&ID and the presence of symptoms detected. In the second case study, a proof of principle of the fault diagnosis part of the 4S3F method was successfully performed on the same HVAC system extracting possible component and control faults from the P&ID. A Bayesian Network diagnostic, which mimics the way of diagnosis by HVAC engineers, was applied to identify the probability of all possible faults by interpreting the symptoms. The diagnostic Bayesian network (DBN) was set up in accordance with the P&ID, i.e., with the same structure. Energy savings from fault corrections were estimated to be up to 25% of the primary energy consumption, while the HVAC system was initially considered to have an excellent performance. In the third case study, a demand-driven ventilation system (DCV) was analysed. The analysis showed that the 4S3F method works also to identify faults on an air ventilation system.
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