Introduction The Integrated Recovery Scales (IRS) was developed by the Dutch National Expertise board for routine outcome monitoring with severe mental illnesses. This board aimed to develop a multidimensional recovery measure directed at 1. clinical recovery, 2. physical health, 3. social recovery (work, social contacts, independent living) and 4. existential, personal recovery. The measure had to be short, suited for routine outcome monitoring and present the perspective of both mental health professionals and service users with severe mental illnesses. All aspects are assessed over a period of the pas 6 months. Objectives The objective of this research is validation of the Integral Recovery Scales and to test the revelance for clinical practice and police evaluation. Methods The instrument was tested with 500 individuals with severe mental illnesses (80% individuals with a psychotic disorder), of whom 200 were followed up for 1 year. For the questions concerning clinical recovery, physical health and social recovery mental health care workers conducted semi structured interviews with people living with serious illnesses. The questions concerning personal health were self-rated. We analyzed interrater reliability, convergent and divergent validity and sensitivity to change. Results The instrument has a good validity and is easy to complete for service users and mental health care workers and appropriate for clinical and policy evaluation goals. Conclusions The Integrated Recovery Scales can be a useful instrument for a simple and meaningful routine outcome monitoring. Page: 121
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BACKGROUND: To evaluate the effect of (new) treatments or analyse prevalence and risk factors of contractures, rating scales are used based on joint range of motion. However, cut-off points for levels of severity vary between scales, and it seems unclear how cut-off points relate to function. The purpose of this study was to compare severity ratings of different rating scales for the shoulder and elbow and relate these with functional range of motion.METHODS: Often used contracture severity rating scales in orthopedics, physiotherapy, and burns were included. Functional range of motion angles for the shoulder and elbow were derived from a recent synthesis published by our group. Shoulder flexion and elbow flexion range of motion data of patients three months after a burn injury were rated with each of the scales to illustrate the effects of differences in classifications. Secondly, the shoulder and elbow flexion range of motion angles were related to the required angles to perform over 50 different activities of daily living tasks.RESULTS: Eighteen rating scales were included (shoulder: 6, elbow: 12). Large differences in the number of severity levels and the cut-off points between scales were determined. Rating the measured range of motions with the different scales showed substantial inconsistency in the number of joints without impairment (shoulder: 14-36%, elbow: 26-100%) or with severe impairment (shoulder: < 10%-29%, elbow 0%-17%). Cut-off points of most scales were not related to actual function in daily living.CONCLUSION: There is an urgent need for rating scales that express the severity of contractures in terms of loss of functionality. This study proposes a direction for a solution.
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Self-efficacy and outcome expectations regarding client activation determine professionals’ level of actively engaging clients during daily activities. The Client Activation Self-Efficacy and Outcome Expectation Scales for nurses and domestic support workers (DSWs) were developed to measure these concepts. This study aimed to assess their psychometric properties. Cross-sectional data from a sample of Dutch nurses (n=150) and DSWs (n=155) were analysed. Descriptive statistics were used to examine floor and ceiling effects. Construct validity was assessed by testing research-based hypotheses. Internal consistency was determined with Cronbach’s alpha. The scales for nurses showed a ceiling effect. There were no floor or ceiling effects in the scales for domestic support workers. Three out of five hypotheses could be confirmed (construct validity). For all scales, Cronbach’s alpha coefficients exceeded 0.70. In conclusion, all scales had moderate construct validity and high internal consistency. Further research is needed concerning their construct validity, testretest reliability and sensitivity to change.
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Coastal nourishments, where sand from offshore is placed near or at the beach, are nowadays a key coastal protection method for narrow beaches and hinterlands worldwide. Recent sea level rise projections and the increasing involvement of multiple stakeholders in adaptation strategies have resulted in a desire for nourishment solutions that fit a larger geographical scale (O 10 km) and a longer time horizon (O decades). Dutch frontrunner pilot experiments such as the Sandmotor and Ameland inlet nourishment, as well as the Hondsbossche Dunes coastal reinforcement project have all been implemented from this perspective, with the specific aim to encompass solutions that fit in a renewed climate-resilient coastal protection strategy. By capitalizing on recent large-scale nourishments, the proposed Coastal landSCAPE project C-SCAPE will employ and advance the newly developed Dynamic Adaptive Policy Pathways (DAPP) approach to construct a sustainable long-term nourishment strategy in the face of an uncertain future, linking climate and landscape scales to benefits for nature and society. Novel long-term sandy solutions will be examined using this pathways method, identifying tipping points that may exist if distinct strategies are being continued. Crucial elements for the construction of adaptive pathways are 1) a clear view on the long-term feasibility of different nourishment alternatives, and 2) solid, science-based quantification methods for integral evaluation of the social, economic, morphological and ecological outcomes of various pathways. As currently both elements are lacking, we propose to erect a Living Lab for Climate Adaptation within the C-SCAPE project. In this Living Lab, specific attention is paid to the socio-economic implications of the nourished landscape, as we examine how morphological and ecological development of the large-scale nourishment strategies and their design choices (e.g. concentrated vs alongshore uniform, subaqueous vs subaerial, geomorphological features like artificial lagoons) translate to social acceptance.
TU Delft, in collaboration with Gravity Energy BV, has conducted a feasibility study on harvesting electric energy from wind and vibrations using a wobbling triboelectric nanogenerator (WTENG). Unlike conventional wind turbines, the WTENG converts wind/vibration energy into contact-separation events through a wobbling structure and unbalanced mass. Initial experimental findings demonstrated a peak power density of 1.6 W/m² under optimal conditions. Additionally, the harvester successfully charged a 3.7V lithium-ion battery with over 4.5 μA, illustrated in a self-powered light mast as a practical demonstration in collaboration with TimberLAB. This project aims to advance this research by developing a functioning prototype for public spaces, particularly lanterns, in partnership with TimberLAB and Gravity Energy. The study will explore the potential of triboelectric nanogenerators (TENG) and piezoelectric materials to optimize energy harvesting efficiency and power output. Specifically, the project will focus on improving the WTENG's output power for practical applications by optimizing parameters such as electrode dimensions and contact-separation quality. It will also explore cost-effective, commercially available materials and best fabrication/assembly strategies to simplify scalability for different length scales and power outputs. The research will proceed with the following steps: Design and Prototype Development: Create a prototype WTENG to evaluate energy harvesting efficiency and the quantity of energy harvested. A hybrid of TENG and piezoelectric materials will be designed and assessed. Optimization: Refine the system's design by considering the scaling effect and combinations of TENG-piezoelectric materials, focusing on maximizing energy efficiency (power output). This includes exploring size effects and optimal dimensions. Real-World Application Demonstration: Assess the optimized system's potential to power lanterns in close collaboration with TimberLAB, DVC Groep BV and Gravity Energy. Identify key parameters affecting the efficiency of WTENG technology and propose a roadmap for its exploitation in other applications such as public space lighting and charging.
In the coming decades, a substantial number of electric vehicle (EV) chargers need to be installed. The Dutch Climate Accord, accordingly, urges for preparation of regional-scale spatial programs with focus on transport infrastructure for three major metropolitan regions among them Amsterdam Metropolitan Area (AMA). Spatial allocation of EV chargers could be approached at two different spatial scales. At the metropolitan scale, given the inter-regional flow of cars, the EV chargers of one neighbourhood could serve visitors from other neighbourhoods during days. At the neighbourhood scale, EV chargers need to be allocated as close as possible to electricity substations, and within a walkable distance from the final destination of EV drivers during days and nights, i.e. amenities, jobs, and dwellings. This study aims to bridge the gap in the previous studies, that is dealing with only of the two scales, by conducting a two-phase study on EV infrastructure. At the first phase of the study, the necessary number of new EV chargers in 353 4-digit postcodes of AMA will be calculated. On the basis of the findings of the Phase 1, as a case study, EV chargers will be allocated at the candidate street parking locations in the Amsterdam West borough. The methods of the study are Mixed-integer nonlinear programming, accessibility and street pattern analysis. The study will be conducted on the basis of data of regional scale travel behaviour survey and the location of dwellings, existing chargers, jobs, amenities, and electricity substations.
