Thirty to sixty per cent of older patients experience functional decline after hospitalisation, associated with an increase in dependence, readmission, nursing home placement and mortality. First step in prevention is the identification of patients at risk. The objective of this study is to develop and validate a prediction model to assess the risk of functional decline in older hospitalised patients.
A growing number of higher education programmes in the Netherlands has implemented programmatic assessment. Programmatic assessment is an assessment concept in which the formative and summative function of assessment is intertwined. Although there is consensus about the theoretical principles of programmatic assessment, programs make various specific design choices, fitting with their own context. In this factsheet we give insight into the design choices Dutch higher education programmes make when implementing programmatic assessment.
Ambient activity monitoring systems produce large amounts of data, which can be used for health monitoring. The problem is that patterns in this data reflecting health status are not identified yet. In this paper the possibility is explored of predicting the functional health status (the motor score of AMPS = Assessment of Motor and Process Skills) of a person from data of binary ambient sensors. Data is collected of five independently living elderly people. Based on expert knowledge, features are extracted from the sensor data and several subsets are selected. We use standard linear regression and Gaussian processes for mapping the features to the functional status and predict the status of a test person using a leave-oneperson-out cross validation. The results show that Gaussian processes perform better than the linear regression model, and that both models perform better with the basic feature set than with location or transition based features. Some suggestions are provided for better feature extraction and selection for the purpose of health monitoring. These results indicate that automated functional health assessment is possible, but some challenges lie ahead. The most important challenge is eliciting expert knowledge and translating that into quantifiable features.
Everyone has the right to participate in society to the best of their ability. This right also applies to people with a visual impairment, in combination with a severe or profound intellectual and possibly motor disability (VISPIMD). However, due to their limitations, for their participation these people are often highly dependent on those around them, such as family members andhealthcare professionals. They determine how people with VISPIMD participate and to what extent. To optimize this support, they must have a good understanding of what people with disabilities can still do with their remaining vision.It is currently difficult to gain insight into the visual abilities of people with disabilities, especially those with VISPIMD. As a professional said, "Everything we can think of or develop to assess the functional vision of this vulnerable group will help improve our understanding and thus our ability to support them. Now, we are more or less guessing about what they can see.Moreover, what little we know about their vision is hard to communicate to other professionals”. Therefore, there is a need for methods that can provide insight into the functional vision of people with VISPIMD, in order to predict their options in daily life situations. This is crucial knowledge to ensure that these people can participate in society to their fullest extent.What makes it so difficult to get this insight at the moment? Visual impairments can be caused by a range of eye or brain disorders and can manifest in various ways. While we understand fairly well how low vision affects a person's abilities on relatively simple visual tasks, it is much more difficult to predict this in more complex dynamic everyday situations such asfinding your way or moving around during daily activities. This is because, among other things, conventional ophthalmic tests provide little information about what people can do with their remaining vision in everyday life (i.e., their functional vision).An additional problem in assessing vision in people with intellectual disabilities is that many conventional tests are difficult to perform or are too fatiguing, resulting in either no or the wrong information. In addition to their visual impairment, there is also a very serious intellectual disability (possibly combined with a motor impairment), which makes it even more complex to assesstheir functional vision. Due to the interplay between their visual, intellectual, and motor disabilities, it is almost impossible to determine whether persons are unable to perform an activity because they do not see it, do not notice it, do not understand it, cannot communicate about it, or are not able to move their head towards the stimulus due to motor disabilities.Although an expert professional can make a reasonable estimate of the functional possibilities through long-term and careful observation, the time and correct measurement data are usually lacking to find out the required information. So far, it is insufficiently clear what people with VZEVMB provoke to see and what they see exactly.Our goal with this project is to improve the understanding of the visual capabilities of people with VISPIMD. This then makes it possible to also improve the support for participation of the target group. We want to achieve this goal by developing and, in pilot form, testing a new combination of measurement and analysis methods - primarily based on eye movement registration -to determine the functional vision of people with VISPIMD. Our goal is to systematically determine what someone is responding to (“what”), where it may be (“where”), and how much time that response will take (“when”). When developing methods, we take the possibilities and preferences of the person in question as a starting point in relation to the technological possibilities.Because existing technological methods were originally developed for a different purpose, this partly requires adaptation to the possibilities of the target group.The concrete end product of our pilot will be a manual with an overview of available technological methods (as well as the methods themselves) for assessing functional vision, linked to the specific characteristics of the target group in the cognitive, motor area: 'Given that a client has this (estimated) combination of limitations (cognitive, motor and attention, time in whichsomeone can concentrate), the order of assessments is as follows:' followed by a description of the methods. We will also report on our findings in a workshop for professionals, a Dutch-language article and at least two scientific articles. This project is executed in the line: “I am seen; with all my strengths and limitations”. During the project, we closely collaborate with relevant stakeholders, i.e. the professionals with specific expertise working with the target group, family members of the persons with VISPIMD, and persons experiencing a visual impairment (‘experience experts’).
In the Netherlands, the theme of transitioning to circular food systems is high on the national agenda. The PBL Netherlands Environmental Assessment Agency has stressed that commuting to circular food chains requires a radical transformation of the food chain where (a) natural resources must be effectively used and managed (soil, water, biodiversity, minerals), (b) there must be an optimum use of food by reducing (food) waste . . ., (c) less environmental pressure, and (d) an optimum use of residue streams. The PBL also recognizes that there should be room for tailored solutions and that it is important to establish a benchmark, to be aware of impacts in the production chain and the added value of products. In the line of circular food systems, an integrated nature-inclusive circular farming approach is needed in order to develop a feasible resource-efficient and sustainable business models that brings shared value into the food chain while invigorating the rural areas including those where agricultural vacancy is occurring. Agroforestry is an example of an integrated nature-inclusive circular farming. It is a multifunctional system that diversifies and adapts the production while reducing the carbon footprint and minimizing the management efforts and input costs; where trees, crops and/or livestock open business opportunities in the food value chains as well as in the waste stream chains. To exploit the opportunities that agroforestry as an integrated resource-efficient farming system adds to the advancement towards (a) valuable circular short food chains, (b) nature-based entrepreneurship (nature-inclusive agriculture), and (c) and additionally, the re-use of abandoned agricultural spaces in the Overijssel province, this project mobilizes the private sector, provincial decision makers, financers and knowledge institutes into developing insights over the feasible implementation of agroforestry systems that can bring economic profit while enhancing and maintaining ecosystem services.
Het Lectorenplatform Biobased Economy heeft in de afgelopen twee jaar gewerkt aan een onderzoeksagenda in vier hoofdstukken: ingrediënten/inhoudstoffen, materialen, energie/nutriënten en maatschappij. Op basis van deze agenda zijn verschillende samenwerkingen geïnitieerd en gerealiseerd, zoals GoChem, enkele NWA projecten, de Learning Community Biofuels en de samenwerking met het Lectorenplatform Circulaire Economie op maatschappelijke thema’s. Er is dus al veel gerealiseerd in samenwerking en programmering. Niettemin staan er, terugkijkend, nog enkele ambities uit de eerste twee jaar overeind: het toetsen van de thema’s in meetings met bedrijven; het ontwikkelen van (meer) gezamenlijke onderzoeksprojecten; het ontwikkelen en bestendigen van een meerjarig omvattend (NWO-achtig) programma. Voor dit laatste is GoChem een goede start, maar het zou de komende twee jaar verder moeten groeien, bijvoorbeeld in een biobased SPRONG programma. Daarnaast blijven we werken aan de herkenbaarheid en vindbaarheid van het biobased onderzoek, de lectoraten en de agenda. We breiden de ambities uit naar publieke bekendheid van biobased economy in het algemeen. Verder willen we de mogelijkheid van een eigen publicatiereeks onderzoeken. Nieuw voor de komende jaren is de ambitie om onderzoekskwaliteit beter meetbaar te maken. Hoe meet je kwaliteit in praktijkonderzoek: impact is een ander doel dan wetenschappelijke publicaties. In de eerste termijn van het Lectorenplatform BBE was er additioneel en geoormerkt budget voor internationale samenwerking binnen Living Lab Biobased Brazil (LLBB). Dit budget was gekoppeld aan een gecombineerde Braziliaans/Nederlandse onderzoekscall. Dat is in de komende twee jaar niet voorzien.
