Background and aim Self-management support is an integral part of current chronic care guidelines. The success of self-management interventions varies between individual patients, suggesting a need for tailored self-management support. Understanding the role of patient factors in the current decision making of health professionals can support future tailoring of self-management interventions. The aim of this study is to identify the relative importance of patient factors in health professionals’ decision making regarding self-management support. Method A factorial survey was presented to primary care physicians and nurses. The survey consisted of clinical vignettes (case descriptions), in which 11 patient factors were systematically varied. Each care provider received a set of 12 vignettes. For each vignette, they decided whether they would give this patient self-management support and whether they expected this support to be successful. The associations between respondent decisions and patient factors were explored using ordered logit regression. Results The survey was completed by 60 general practitioners and 80 nurses. Self-management support was unlikely to be provided in a third of the vignettes. The most important patient factor in the decision to provide self-management support as well as in the expectation that self-management support would be successful was motivation, followed by patient-provider relationship and illness perception. Other factors, such as depression or anxiety, education level, self-efficacy and social support, had a small impact on decisions. Disease, disease severity, knowledge of disease, and age were relatively unimportant factors. Conclusion This is the first study to explore the relative importance of patient factors in decision making and the expectations regarding the provision of self-management support to chronic disease patients. By far, the most important factor considered was patient’s motivation; unmotivated patients were less likely to receive self-management support. Future tailored interventions should incorporate strategies to enhance motivation in unmotivated patients. Furthermore, care providers should be better equipped to promote motivational change in their patients.
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In the past 5 years Electric Car use has grown rapidly, almost doubling each year. To provide adequate charging infrastructure it is necessary to model the demand. In this paper we model the distribution of charging demand in the city of Amsterdam using a Cross-Nested Logit Model and sociodemographic statistics of neighborhoods.
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Background: Accurate measurement of health literacy is essential to improve accessibility and effectiveness of health care and prevention. One measure frequently applied in international research is the Short Assessment of Health Literacy (SAHL). While the Dutch SAHL (SAHL-D) has proven to be valid and reliable, its administration is time consuming and burdensome for participants. Our aim was to further validate, strengthen and shorten the SAHL-D using Rasch analysis. Methods: Available cross-sectional SAHL-D data was used from adult samples (N = 1231) to assess unidimensionality, local independence, item fit, person fit, item hierarchy, scale targeting, precision (person reliability and person separation), and presence of differential item functioning (DIF) depending on age, gender, education and study sample. Results: Thirteen items for a short form were selected based on item fit and DIF, and scale properties were compared between the two forms. The long form had several items with DIF for age, gender, educational level and study sample. Both forms showed lower measurement precision at higher health literacy levels. Conclusions: The findings support the validity and reliability of the SAHL-D for the long form and the short form, which can be used for a rapid assessment of health literacy in research and clinical practice.
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In the past 5 years Electric Car use has grown rapidly, almost doubling each year. To provide adequate charging infrastructure it is necessary to model the demand. In this paper we model the distribution of charging demand in the city of Amsterdam using a Cross-Nested Logit Model with socio-demographic statistics of neighborhoods and charging history of vehicles. Models are obtained for three user-types: regular users, electric car-share participants and taxis. Regular users are later split into three subgroups based on their charging behaviour throughout the day: Visitors, Commuters and Residents
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In indoor comfort research, thermal comfort of care-professionals in hospital environment is a little explored topic. To address this gap, a mixed methods study, with the nursing staff in hospital wards acting as participants,was undertaken. Responses were collected during three weeks in the summer (n = 89), and four weeks in the autumn (n = 43). Analysis of the subjective feedback from nurses and the measured indoor thermal conditions revealed that the existent thermal conditions (varying between 20 and 25 °C) caused a slightly warm thermal sensation on the ASHRAE seven point scale. This led to a slightly unacceptable thermal comfort and a slightly obstructed self-appraised work performance. The results also indicated that the optimal thermal sensation for the nurses—suiting their thermal comfort requirements and work performance—would be closer to‘slightly cool’than neutral. Using a design approach of dividing the hospital ward into separate thermal zones, with different set-points for respectively patient and care-professionals’comfort, would seem to be the ideal solution that contributes positively to the work environment and, at the same time, creates avenues for energy conservation.
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Spontaneous speech is an important source of information for aphasia research. It is essential to collect the right amount of data: enough for distinctions in the data to become meaningful, but not so much that the data collection becomes too expensive or places an undue burden on participants. The latter issue is an ethical consideration when working with participants that find speaking difficult, such as speakers with aphasia. So, how much speech data is enough to draw meaningful conclusions? How does the uncertainty around the estimation of model parameters in a predictive model vary as a function of the length of texts used for training?
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Car use in the sprawled urban region of Noord‐Brabant is above the Dutch average. Does this reflect car dependency due to the lack of competitive alternative modes? Or are there other factors at play, such as differences in preferences? This article aims to determine the nature of car use in the region and explore to what extent this reflects car dependency. The data, comprising 3,244 respondents was derived from two online questionnaires among employees from the High‐Tech Campus (2018) and the TU/e‐campus (2019) in Eindhoven. Travel times to work by car, public transport, cycling, and walking were calculated based on the respondents’ residential location. Indicators for car dependency were developed using thresholds for maximum commuting times by bicycle and maximum travel time ratios between public transport and car. Based on these thresholds, approximately 40% of the respondents were categorised as car‐dependent. Of the non‐car‐dependent respondents, 31% use the car for commuting. A binomial logit model revealed that higher residential densities and closer proximity to a railway station reduce the odds of car commuting. Travel time ratios also have a significant influence on the expected directions. Mode choice preferences (e.g., comfort, flexibility, etc.) also have a significant, and strong, impact. These results highlight the importance of combining hard (e.g., improvements in infrastructure or public transport provi-sion) and soft (information and persuasion) measures to reduce car use and car dependency in commuting trips.
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While the optimal mean annual temperature for people and nations is said to be between 13 °C and 18 °C, many people live productive lives in regions or countries that commonly exceed this temperature range. One such country is Australia. We carried out an Australia-wide online survey using a structured questionnaire to investigate what temperature people in Australia prefer, both in terms of the local climate and within their homes. More than half of the 1665 respondents (58%) lived in their preferred climatic zone with 60% of respondents preferring a warm climate. Those living in Australia's cool climate zones least preferred that climate. A large majority (83%) were able to reach a comfortable temperature at home with 85% using air-conditioning for cooling. The preferred temperature setting for the air-conditioning devices was 21.7 °C (SD: 2.6 °C). Higher temperature set-points were associated with age, heat tolerance and location. The frequency of air-conditioning use did not depend on the location but rather on a range of other socio-economic factors including having children in the household, the building type, heat stress and heat tolerance. We discuss the role of heat acclimatisation and impacts of increasing air-conditioning use on energy consumption.
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