Zoekresultaten

Design guidelines for the monetary and financial system in the digital age

In the aftermath of the systemic financial crises of 2007-9, several scholars argued that the problem of systemic financial crises is not well understood. At the same time, the introduction of digital technologies led to new threats and opportunities for the design of the monetary and financial system. For example, thousands of private cryptocurrencies have been implemented and hundreds of research papers on the (possible) introduction of public digital currencies have been published. It is often not explained why these new forms of digital money are needed and which (systemic) problems they (can) solve. In addition, the literature does not provide requirements nor guidelines to shape the development of the monetary and financial system in the digital age. This thesis applies design science to the monetary and financial system as a whole. The application of this novel methodology offers new possibilities to examine this complex system. The contribution of this thesis is threefold. First, different theories on money, banking and systemic financial crises have been researched through an extensive literature review and balance sheets. Second, those theories have been used to develop design requirements and guidelines. Finally, the consensus and pivotal dissensions about the systemic problem(s) of the current monetary and financial system, requirements and guidelines among experts have been identified through semistructured interviews. This research process results in widely supported requirements that demarcate the design space and widely supported guidelines that aim to give direction within the design space, that is, to the future development of the monetary and financial system.

Effective components of nurse-coordinated care to prevent recurrent coronary events: a systematic review and meta-analysis

Current guidelines on secondary prevention of cardiovascular disease recommend nurse-coordinated care (NCC) as an effective intervention. However, NCC programmes differ widely and the efficacy of NCC components has not been studied. To investigate the efficacy of NCC and its components in secondary prevention of coronary heart disease by means of a systematic review and meta-analysis of randomised controlled trials. 18 randomised trials (11 195 patients in total) using 15 components of NCC met the predefined inclusion criteria. These components were placed into three main intervention strategies: (1) risk factor management (13 studies); (2) multidisciplinary consultation (11 studies) and (3) shared decision making (10 studies). Six trials combined NCC components from all three strategies. In total, 30 outcomes were observed. We summarised observed outcomes in four outcome categories: (1) risk factor levels (16 studies); (2) clinical events (7 studies); (3) patient-perceived health (7 studies) and (4) guideline adherence (3 studies). Compared with usual care, NCC lowered systolic blood pressure (weighted mean difference (WMD) 2.96 mm Hg; 95% CI 1.53 to 4.40 mm Hg) and low-density lipoprotein cholesterol (WMD 0.23 mmol/L; 95% CI 0.10 to 0.36 mmol/L). NCC also improved smoking cessation rates by 25% (risk ratio 1.25; 95% CI 1.08 to 1.43). NCC demonstrated to have an effect on a small number of outcomes. NCC that incorporated blood pressure monitoring, cholesterol control and smoking cessation has an impact on the improvement of secondary prevention. Additionally, NCC is a heterogeneous concept. A shared definition of NCC may facilitate better comparisons of NCC content and outcomes.

State of the art of cultural tourism interventions. Deliverable D3.1 of the Horizon 2020 project SmartCulTour (GA number 870708).

Analysis of behavioral change techniques used in exercise and nutritional interventions targeting adults around retirement age with sarcopenic obesity in a systematic review

BACKGROUND: Sarcopenic obesity significantly burdens health and autonomy. Strategies to intervene in or prevent sarcopenic obesity generally focus on losing body fat and building or maintaining muscle mass and function. For a lifestyle intervention, it is important to consider psychological aspects such as behavioral change techniques (BCTs) to elicit a long-lasting behavioral change.PURPOSE: The study was carried out to analyze BCTs used in exercise and nutritional interventions targeting community-dwelling adults around retirement age with sarcopenic obesity.METHODS: We conducted an analysis of articles cited in an existing systematic review on the effectiveness of exercise and nutritional interventions on physiological outcomes in community-dwelling adults around retirement age with sarcopenic obesity. We identified BCTs used in these studies by applying a standardized taxonomy.RESULTS: Only nine BCTs were identified. Most BCTs were not used intentionally (82 %), and those used derived from the implementation of lifestyle components, such as exercise classes ("instructions on how to perform a behavior," "demonstration of the behavior," "behavioral practice/rehearsal," and "body changes"). Only two studies used BCTs intentionally to reinforce adherence in their interventions.CONCLUSIONS: Few studies integrated BCTs in lifestyle interventions for community-dwelling persons around retirement age with sarcopenic obesity. Future studies on interventions to counteract sarcopenic obesity should include well-established BCTs to foster adherence and, therefore, their effectiveness.

Human-centered evaluation of explainable AI applications

Explainable Artificial Intelligence (XAI) aims to provide insights into the inner workings and the outputs of AI systems. Recently, there’s been growing recognition that explainability is inherently human-centric, tied to how people perceive explanations. Despite this, there is no consensus in the research community on whether user evaluation is crucial in XAI, and if so, what exactly needs to be evaluated and how. This systematic literature review addresses this gap by providing a detailed overview of the current state of affairs in human-centered XAI evaluation. We reviewed 73 papers across various domains where XAI was evaluated with users. These studies assessed what makes an explanation “good” from a user’s perspective, i.e., what makes an explanation meaningful to a user of an AI system. We identified 30 components of meaningful explanations that were evaluated in the reviewed papers and categorized them into a taxonomy of human-centered XAI evaluation, based on: (a) the contextualized quality of the explanation, (b) the contribution of the explanation to human-AI interaction, and (c) the contribution of the explanation to human- AI performance. Our analysis also revealed a lack of standardization in the methodologies applied in XAI user studies, with only 19 of the 73 papers applying an evaluation framework used by at least one other study in the sample. These inconsistencies hinder cross-study comparisons and broader insights. Our findings contribute to understanding what makes explanations meaningful to users and how to measure this, guiding the XAI community toward a more unified approach in human-centered explainability.

Report on the development of a European competency framework for health and other professionals to support behaviour change in persons self-managing chronic disease and the associated common learning outcomes-based curriculum.

Chronic diseases represent a significant burden for the society and health systems; addressing this burden is a key goal of the European Union policy. Health and other professionals are expected to deliver behaviour change support to persons with chronic disease. A skill gap in behaviour change support has been identified, and there is room for improvement. Train4Health is a strategic partnership involving seven European Institutions in five countries, which seeks to improve behaviour change support competencies for the self-management of chronic disease. The project envisages a continuum in behaviour change support education, in which an interprofessional competency framework, relevant for those currently practising, guides the development of a learning outcomes-based curriculum and an educational package for future professionals (today’s undergraduate students).