Background and objective: Serious pathologies of the neck can potentially result in cranial nerve palsy. Knowledge about cranial nerve examination (CNE) seems sparse, and its use is still unknown. We aim to investigate the knowledge, skills, and utilization of CNE of Italian physiotherapists. Materials and Methods: An online cross-sectional survey. Results: 396 completed the survey, reaching the required sample size. Although Italian physiotherapists consider CNE relevant (mean ± SD = 7.6/10 ± 2.0), over half of all responders (n = 229 (57.8%)) were not trained in the fundamentals and around a third did not use it in their daily practice (n = 138 (34.8%)). Additionally, participants were unconfident and insecure in conducting (n = 152 (38.4%) and n = 147 (37.1%)), interpreting (n = 140 (35.4%) and n = 164 (41.4%)), and managing the CNE (n = 141 (35.6%) and n = 154 (38.9%)). Possessing a musculoskeletal specialization was associated with an increased value attributed to clinical practice guidelines and reduced the lack of confidence in conducting, interpreting, and managing the CNE (respectively, n = 35 (25.5%), p = 0.0001; n = 32 (23.4%) p = 0.0002; n = 32 (23.4%) p = 0.0002). Working in a direct access setting significantly increased the considered relevance of guidelines and the concerns about arterial (p = 0.004) and other serious pathologies (p = 0.021). Pain and visual disturbances were considered the main indicators to CNE, demonstrating limited knowledge of signs and symptoms’ indicating CNE. Participants considered specific training in CNE as relevant (mean ± SD = 7.6/10 = 2.1). Conclusions: a substantial proportion of Italian physiotherapists are not schooled in the fundamentals of cranial nerve examination. Given the number of physiotherapists who work in first contact roles, this is a professional concern.
Humidification is not a common procedure in many buildings in the Netherlands. An exception are buildings used for healthcare, especially hospitals. There, e.g. in operating theatres, relative humidity (RH) generally is controlled stringently at levels around 50%. From an energy point-of-view humidification is an energy-intensive activity. Currently, more than 10% of the total energy used in healthcare buildings is spent on humidification. The basis for an RH of around 50%, however, is not clear. Therefore, we pursued a scoping review to find evidence for specific RH thresholds in such facilities. In addition, an inventory was made of the current practice in the Netherlands. After analyzing the title and abstracts, the remaining references were read by two persons and scored on several topics. Guidelines and current practice were analyzed by referring to existing (inter)national guidelines and standards, and by contacting experts from Dutch hospitals through a survey and semi-structured interviews. Outcomes from the literature review were grouped into four different topics: 1) micro-organisms and viruses, 2) medical devices, 3) human physiology and 4) perception. No scientific evidence was found for the currently generally applied RH set-point of ~50%. Some studies suggest a minimum RH of 30% but the evidence is weak, with exception of medical devices if specifications require it. A lack of research that addresses more long-term exposure (a couple of days) and includes frail subjects, is noted. It was found that RH requirements are strictly followed in all hospitals consulted, some only focusing on the hot zones, but in many cases extended to the whole hospital. Steam humidification is mostly applied for hygienic reasons. but is quite energy-intensive. The conclusion t is that there is no solid evidence to support the RH-setpoints as currently applied in the Netherlands. It merely appears a code of practice. Therefore, there appears room for quick and significant energy savings, and CO2 emission reductions, when considering control at lower RH values or refraining from humidification at all, while still fulfilling the indoor environment requirements and not negatively influencing the health risk. This outcome can be applied directly in current practice with the available techniques.
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Communication of climate-responsive urban design guidelines is becoming increasingly relevant in the light of climate adaptation challenges in cities. Widespread uptake in practice of such guidelines can be promoted by visualizations of the principles on which they are based. The “Really cooling water bodies in cities” research project developed and tested the required knowledge on visual communication. Evidence-based design guidelines assisting designers with creating cooler urban water environments were developed and communicated with 3D animations. The animations were shaped according to three core theoretical criteria about visual representations: “visual clarity”, “trust” and “interest”. We assessed in how far these criteria were met in an inquiry with design professionals, the target group of the design guidelines. The article concludes with recommendations for developing visual design guidelines in climate-responsive urban design: to weigh the level of detail, components and balance between site-specificity/abstraction (“visual clarity”); to make microclimatic processes visible without distorting them (“trust”); and to keep timing short and visual attractiveness high (“interest”). It is argued that taking these aspects into account and setting a clear correspondence between theoretical concepts, representation objectives and options, can largely benefit visual design guidelines communicating climate-responsive urban design knowledge.
Designing cities that are socially sustainable has been a significant challenge until today. Lately, European Commission’s research agenda of Industy 5.0 has prioritised a sustainable, human-centric and resilient development over merely pursuing efficiency and productivity in societal transitions. The focus has been on searching for sustainable solutions to societal challenges, engaging part of the design industry. In architecture and urban design, whose common goal is to create a condition for human life, much effort was put into elevating the engineering process of physical space, making it more efficient. However, the natural process of social evolution has not been given priority in urban and architectural research on sustainable design. STEPS stems from the common interest of the project partners in accessible, diverse, and progressive public spaces, which is vital to socially sustainable urban development. The primary challenge lies in how to synthesise the standardised sustainable design techniques with unique social values of public space, propelling a transition from technical sustainability to social sustainability. Although a large number of social-oriented studies in urban design have been published in the academic domain, principles and guidelines that can be applied to practice are large missing. How can we generate operative principles guiding public space analysis and design to explore and achieve the social condition of sustainability, developing transferable ways of utilising research knowledge in design? STEPS will develop a design catalogue with operative principles guiding public space analysis and design. This will help designers apply cross-domain knowledge of social sustainability in practice.
The pressure on the European health care system is increasing considerably: more elderly people and patients with chronic diseases in need of (rehabilitation) care, a diminishing work force and health care costs continuing to rise. Several measures to counteract this are proposed, such as reduction of the length of stay in hospitals or rehabilitation centres by improving interprofessional and person-centred collaboration between health and social care professionals. Although there is a lot of attention for interprofessional education and collaborative practice (IPECP), the consortium senses a gap between competence levels of future professionals and the levels needed in rehabilitation practice. Therefore, the transfer from tertiary education to practice concerning IPECP in rehabilitation is the central theme of the project. Regional bonds between higher education institutions and rehabilitation centres will be strengthened in order to align IPECP. On the one hand we deliver a set of basic and advanced modules on functioning according to the WHO’s International Classification of Functioning, Disability and Health and a set of (assessment) tools on interprofessional skills training. Also, applications of this theory in promising approaches, both in education and in rehabilitation practice, are regionally being piloted and adapted for use in other regions. Field visits by professionals from practice to exchange experiences is included in this work package. We aim to deliver a range of learning materials, from modules on theory to guidelines on how to set up and run a student-run interprofessional learning ward in a rehabilitation centre. All tested outputs will be published on the INPRO-website and made available to be implemented in the core curricula in tertiary education and for lifelong learning in health care practice. This will ultimately contribute to improve functioning and health outcomes and quality of life of patients in rehabilitation centres and beyond.
The pace of technology advancements continues to accelerate, and impacts the nature of systems solutions along with significant effects on involved stakeholders and society. Design and engineering practices with tools and perspectives, need therefore to evolve in accordance to the developments that complex, sociotechnical innovation challenges pose. There is a need for engineers and designers that can utilize fitting methods and tools to fulfill the role of a changemaker. Recognized successful practices include interdisciplinary methods that allow for effective and better contextualized participatory design approaches. However, preliminary research identified challenges in understanding what makes a specific method effective and successfully contextualized in practice, and what key competences are needed for involved designers and engineers to understand and adopt these interdisciplinary methods. In this proposal, case study research is proposed with practitioners to gain insight into what are the key enabling factors for effective interdisciplinary participatory design methods and tools in the specific context of sociotechnical innovation. The involved companies are operating at the intersection between design, technology and societal impact, employing experts who can be considered changemakers, since they are in the lead of creative processes that bring together diverse groups of stakeholders in the process of sociotechnical innovation. A methodology will be developed to capture best practices and understand what makes the deployed methods effective. This methodology and a set of design guidelines for effective interdisciplinary participatory design will be delivered. In turn this will serve as a starting point for a larger design science research project, in which an educational toolkit for effective participatory design for socio-technical innovation will be designed.
