Rationale, aims and objective: Primary Care Plus (PC+) focuses on the substitution of hospital-based medical care to the primary care setting without moving hospital facilities. The aim of this study was to examine whether population health and experience of care in PC+ could be maintained. Therefore, health-related quality of life (HRQoL) and experienced quality of care from a patient perspective were compared between patients referred to PC+ and to hospital-based outpatient care (HBOC). Methods: This cohort study included patients from a Dutch region, visiting PC+ or HBOC between December 2014 and April 2018. With patient questionnaires (T0, T1 and T2), the HRQoL and experience of care were measured. One-to-two nearest neighbour calliper propensity score matching (PSM) was used to control for potential selection bias. Outcomes were compared using marginal linear models and Pearson chi-square tests. Results: One thousand one hundred thirteen PC+ patients were matched to 606 HBOC patients with well-balanced baseline characteristics (SMDs <0.1). Regarding HRQoL outcomes, no significant interaction terms between time and group were found (P > .05), indicating no difference in HRQoL development between the groups over time. Regarding experienced quality of care, no differences were found between PC+ and HBOC patients. Only travel time was significantly shorter in the HBOC group (P ≤ .001). Conclusion: Results show equal effects on HRQoL outcomes over time between the groups. Regarding experienced quality of care, only differences in travel time were found. Taken as a whole, population health and quality of care were maintained with PC+ and future research should focus more on cost-related outcomes.
BACKGROUND: During transitions from hospital to home, up to half of all patients experience medication-related problems, such as adverse drug events. To reduce these problems, knowledge of patient experiences with medication use during this transition is needed. This study aims to identify the perspectives of patients on barriers and facilitators with medication use, during the transition from hospital to home.METHODS: A qualitative study was conducted in 2017 among patients discharged from two hospitals using a semi-structured interview guide. Patients were asked to identify all barriers they experienced with medication use during transitions from hospital to home, and facilitators needed to overcome those barriers. Data were analyzed following thematic content analysis and visualized using an "Ishikawa" diagram.RESULTS: In total, three focus groups were conducted with 19 patients (mean age: 70.8 (SD 9.3) years, 63% female). Three barriers were identified; lack of personalized care in the care continuum, insufficient information transfer (e.g. regarding changes in pharmacotherapy), and problems in care organization (e.g. medication substitution). Facilitators to overcome these barriers included a personal medication-counselor in the care continuum to guide patients with medication use and overcome communication barriers, and post-discharge follow-up care (e.g. home visits from healthcare providers).CONCLUSIONS: During transitions from hospital to home patients experience individual-, healthcare provider- and organization level barriers. Future research should focus on personal-medication counselors in the care continuum and post-discharge follow-up care as it may overcome communication, emotional, information and organization barriers with medication use.
Extended Reality (XR) technologies—including virtual reality (VR), augmented reality (AR), and mixed reality (MR)—offer transformative opportunities for education by enabling immersive and interactive learning experiences. In this study, we employed a mixed-methods approach that combined systematic desk research with an expert member check to evaluate existing pedagogical frameworks for XR integration. We analyzed several established models (e.g., TPACK, TIM, SAMR, CAMIL, and DigCompEdu) to assess their strengths and limitations in addressing the unique competencies required for XRsupported teaching. Our results indicate that, while these models offer valuable insights into technology integration, they often fall short in specifying XR-specific competencies. Consequently, we extended the DigCompEdu framework by identifying and refining concrete building blocks for teacher professionalization in XR. The conclusions drawn from this research underscore the necessity for targeted professional development that equips educators with the practical skills needed to effectively implement XR in diverse educational settings, thereby providing actionable strategies for fostering digital innovation in teaching and learning.
MULTIFILE
Carboxylated cellulose is an important product on the market, and one of the most well-known examples is carboxymethylcellulose (CMC). However, CMC is prepared by modification of cellulose with the extremely hazardous compound monochloracetic acid. In this project, we want to make a carboxylated cellulose that is a functional equivalent for CMC using a greener process with renewable raw materials derived from levulinic acid. Processes to achieve cellulose with a low and a high carboxylation degree will be designed.
This project is to investigate Circular Calcium Carbonate (CCC) that is produced by pyrolysis from paper waste in an innovative process developed by the company Alucha Management B.V. (Alucha) located in Arnhem. Although there is a need to use circular materials in rubber formulations it has not yet been proven that the replacement of mined white fillers (e.g. Kaolin, Calcium Carbonate) by CCC in rubber applications is possible without a significant impact on the processing properties and part performance. The scope of this project is to investigate the use of Circular Calcium Carbonate (CCC) in various rubber formulations and articles made thereof.
In order to decrease the environmental impact caused by the construction sector, biobased materials need to be further developed to allow better integration and acceptance in the market. Mycelium composites are innovative products, with intrinsic properties which rise the attention of architects, designers and industrial companies. Both mycelium foam and board material have the potential to substitute conventional toxic materials. The mechanical properties of these products are influenced by their production process. For example, bending and tensile strengths have shown to be higher in heat pressed samples (F. V.W. Appels, 2019). The heat press process related to mycelium boards, needs further development in terms of process timing and of parameters, as temperature, pressure and duration of pressing. It is the need to research mycelium boards which drove the partner companies to approach the Centre of Expertise BioBased Economy (CoEBBE). The project partners are the following: KNN Cellulose BV, Fungalogic and V8 Architects. The interest of each partner is focused on different aspects of mycelium boards, which can be summarised in the following questions: • Is it possible to use cellulose to produce mycelium composites? (KNN Cellulose) • What are the different production parameters and how can these be optimized? (V8 Architects, Fungalogic) • What are the mechanical material properties and (how) can mycelium boards be used for interior or construction purposes? (V8 Architects, Fungalogic) These questions merge together in the research question: is it possible to create a mycelium board with cellulose biomass that can be used as a substitution of conventional board materials? The developed research will bring specific knowledge to each involved partner. In particular, KNN Cellulose will have a new application for their product; Fungalogic will acquire knowledge on board materials and have a potential new product; V8 Architects will gain specific knowledge on mycelium products.
