BackgroundHigh-flow nasal oxygen (HFNO) is increasingly used in patients with acute hypoxemic respiratory failure. It is uncertain whether a broadened Berlin definition of acute respiratory distress syndrome (ARDS), in which ARDS can be diagnosed in patients who are not receiving ventilation, results in similar groups of patients receiving HFNO as in patients receiving ventilation.MethodsWe applied a broadened definition of ARDS in a multicenter, observational study in adult critically ill patients with acute hypoxemic respiratory failure due to coronavirus disease 2019 (COVID-19), wherein the requirement for a minimal level of 5 cm H2O PEEP with ventilation is replaced by a minimal level of airflow rate with HFNO, and compared baseline characteristics and outcomes between patients receiving HFNO and patients receiving ventilation. The primary endpoint was ICU mortality. We also compared outcomes in risk for death groups using the PaO2/FiO2 cutoffs as used successfully in the original definition of ARDS. Secondary endpoints were hospital mortality; mortality on days 28 and 90; need for ventilation within 7 days in patients that started with HFNO; the number of days free from HFNO or ventilation; and ICU and hospital length of stay.ResultsOf 728 included patients, 229 patients started with HFNO and 499 patients with ventilation. All patients fulfilled the broadened Berlin definition of ARDS. Patients receiving HFNO had lower disease severity scores and lower PaO2/FiO2 than patients receiving ventilation. ICU mortality was lower in receiving HFNO (22.7 vs 35.6%; p = 0.001). Using PaO2/FiO2 cutoffs for mild, moderate and severe arterial hypoxemia created groups with an ICU mortality of 16.7%, 22.0%, and 23.5% (p = 0.906) versus 19.1%, 37.9% and 41.4% (p = 0.002), in patients receiving HFNO versus patients receiving ventilation, respectively.ConclusionsUsing a broadened definition of ARDS may facilitate an earlier diagnosis of ARDS in patients receiving HFNO; however, ARDS patients receiving HFNO and ARDS patients receiving ventilation have distinct baseline characteristics and mortality rates.Trial registration: The study is registered at ClinicalTrials.gov (identifier NCT04719182).
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The aim of the present study was to investigate if the presence of anterior cruciate ligament (ACL) injury risk factors depicted in the laboratory would reflect at-risk patterns in football-specific field data. Twenty-four female footballers (14.9 ± 0.9 year) performed unanticipated cutting maneuvers in a laboratory setting and on the football pitch during football-specific exercises (F-EX) and games (F-GAME). Knee joint moments were collected in the laboratory and grouped using hierarchical agglomerative clustering. The clusters were used to investigate the kinematics collected on field through wearable sensors. Three clusters emerged: Cluster 1 presented the lowest knee moments; Cluster 2 presented high knee extension but low knee abduction and rotation moments; Cluster 3 presented the highest knee abduction, extension, and external rotation moments. In F-EX, greater knee abduction angles were found in Cluster 2 and 3 compared to Cluster 1 (p = 0.007). Cluster 2 showed the lowest knee and hip flexion angles (p < 0.013). Cluster 3 showed the greatest hip external rotation angles (p = 0.006). In F-GAME, Cluster 3 presented the greatest knee external rotation and lowest knee flexion angles (p = 0.003). Clinically relevant differences towards ACL injury identified in the laboratory reflected at-risk patterns only in part when cutting on the field: in the field, low-risk players exhibited similar kinematic patterns as the high-risk players. Therefore, in-lab injury risk screening may lack ecological validity.
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De afgelopen twee decennia is er veel meer aandacht ontstaan bij onderzoekers en beleidsmakers voor het begrip co-creatie. Bijna altijd wordt de rol van co-creatie als positief en essentieel gezien in een proces waarin maatschappelijke of publieke uitdagingen worden onderzocht en opgelost (zogenaamde sociale innovatie). Het meeste onderzoek naar deze twee begrippen is kwalitatief van aard en gebaseerd op ‘case studies’.In zijn promotieonderzoek kijkt Peter Broekema naar de rol van co-creatie binnen sociale innovatie in Europese samenwerkingsprojecten. In zijn eerste artikel heeft hij de begrippen co-creatie en sociale innovatie tussen 1995 en 2018 binnen de EU geanalyseerd en geconcludeerd dat beide begrippen steeds breder gebruikt worden en samen met het begrip impact zijn getransformeerd tot een beleidsparadigma.In het tweede artikel keek Peter Broekema hoe beide begrippen doorwerken in specifieke subsidieoproepen en hoe consortia deze begrippen toepassen en samenwerken. Hierbij bleek dat er weliswaar verschillende typen consortia bestaan, maar dat zij geen specifieke co-creatiestrategie hadden.In zijn laatste twee artikelen zal hij gedetailleerd kijken naar een aantal EU projecten en vaststellen hoe de samenwerking is verlopen en hoe tevreden de verschillende partners zijn met het resultaat. Peter Broekema maakt hiervoor gebruik van projecten waarin hij zelf participeert (ACCOMPLISSH, INEDIT en SHIINE).EU beleidsparadigma van sociale innovatie in combinatie met co-creatie en impact. Co-creatie vindt vaak binnen eigen type stakehodlers plaatsAbstractSocial innovation and co-creation are both relatively new concepts, that have been studied by scholars for roughly twenty years and are still heavily contested. The former emerged as a response to the more technologically focused concept of innovation and the latter originally solely described the collaboration of end-users in the development of new products, processes or services. Between 2010-2015, both concepts have been adapted and started to be used more widely by for example EU policymakers in their effort to tackle so called ‘grand societal challenges’. Within this narrative – which could be called co-creation for social innovation, it is almost a prerequisite that partners – especially citizens - from different backgrounds and sectors actively work together towards specific societal challenges. Relevance and aimHowever, the exact contribution of co-creation to social innovation projects is still unclear. Most research on co-creation has been focussing on the involvement of end-users in the development of products, processes and services. In general, scholars conclude that the involvement of end-users is effective and leads to a higher level of customer satisfaction. Only recently, research into the involvement of citizens in social innovation projects has started to emerge. However, the majority of research on co-creation for social innovation has been focusing on collaborations between two types of partners in the quadruple helix (citizens, governments, enterprises and universities). Because of this, it is still unclear what co-creation in social innovation projects with more different type of partners entails exactly. More importantly however, is that most research has been based on national case studies in which partners from different sectors collaborate in a familiar ‘national’ setting. Normally institutional and/or cultural contexts influence co-creation (for example the ‘poldermodel’in the Netherlands or the more confrontational model in France), so by looking at projects in a central EU and different local contexts it becomes clear how context effects co-creation for social innovation.Therefore this project will analyse a number of international co-creation projects that aim for social innovation with different types of stakeholders in a European and multi-stakeholder setting.With this research we will find out what people in different contexts believe is co-creation and social innovation, how this process works in different contexts and how co-creation contributes to social innovation.Research question and - sub questionsThe project will answer the following question: “What is the added value of co-creation in European funded collaboration projects that aim for social innovation?” To answer the main question, the research has been subdivided into four sub questions:1) What is the assumed added value of co-creation for social innovation?2) How is the added value of co-creation for social innovation being expressed ex ante and ex post in EU projects that aim specifically for social innovation by co-creation?3) How do partners and stakeholders envision the co-creation process beforehand and continuously shape this process in EU projects to maximise social innovation?4) How do partners and stakeholders regard the added value of co-creation for social innovation in EU projects that that aim for social innovation?Key conceptsThe research will focus on the interplay between the two main concepts a) co-creation and b) social innovation. For now, we are using the following working definitions:a) co-creation is a non-linear process that involves multiple actors and stakeholders in the ideation, implementation and assessment of products, services, policies and systems with the aim of improving their efficiency and effectiveness, and the satisfaction of those who take part in the process.b) social innovation is the invention, development and implementation of new ideas with the purpose to (immediately) relieve and (eventually) solve social problems, which are in the long run directed at the social inclusion of individuals, groups or communities.It is clear that both definitions are quite opaque, but also distinguish roughly the same phases (ideation/invention, development, implementation and assessment) and also distinguish different levels (products/services, policies and systems). Both concepts will be studied within the policy framework of the EU, in which a specific value to both concepts has been attributed, mostly because policymakers regard co-creation with universities and end-users almost as a prerequisite for social innovation. Based on preliminary research, EU policies seem to define social innovation in close reation with ‘societal impact’, which could defined as: “the long lasting effect of an activity on society, because it is aimed at solving social problems”, and therefore in this specific context social innovation seems to encompasses societal impact. For now, I will use this working definition of social innovation and will closely look at the entanglement with impact in the first outlined paper.MethodologyIn general, I will use a qualitative mixed method approach and grounded theory to answer the main research question (mRQ). In order to better understand the added value of co-creation for social innovation in an EU policy setting, the research will:SubRQ1) start with an analysis of academic literature on co-creation and social impact. This analysis will be followed by and confronted with an analysis of EU policy documents. SubRQ2) use a qualitative data analysis at nineteen EU funded projects to understand how co-creation is envisoned within social innovation projects by using the quintuple helix approach (knowledge flows between partners and stakeholders in an EU setting) and the proposed social innovation journey model. By contrasting the findings from the QDA phase of the project with other research on social innovation we will be able to find arachetypes of social innovation in relation with the (perceived) added value of co-creation within social innovation. SubRQ3) These archetypes will be used to understand the process of co-creation for social innovation by looking closely at behavioural interactions within two social innovation projects. This close examination will be carried out by carrying out interviews with key stakeholders and partners and participant observation.SubRQ4) The archetypes will also be used to understand the perceived added value by looking closely at behavioural interactions within two social innovation projects. This close examination will be carried out by carrying out interviews with key stakeholders and partners and participant observation.ImpactThe project will contribute to a better understanding of the relationship between co-creation and social innovation on different levels:a) Theoretical: the research will analyse the concepts of co-creation and social innovation in relation to each other by looking at the origins of the concepts, the adaptation in different fields and the uptake within EU policies;b) Methodological: a model will be developed to study and understand the non-lineair process of co-creation within social innovation, by focusing on social innovation pathways and social innovation strategies within a quintuple helix setting (i) academia, ii) enterprises and iii) governments that work together to improve iv) society in an v) EU setting);c) Empirical: the project will (for the first time) collect data on behavioural interactions and the satisfaction levels of these interactions between stakeholders and partners in an EU project.d) Societal: the results of the research could be used to optimize the support for social innovation projects and also for the development of specific funding calls.
The project Decolonising Education: from Teachers to Leading Learners (DETeLL) aims to develop a multi-site approach for interventions towards inclusion and decolonisation in order to change the hierarchical nature of higher education in the Netherlands. DETeLL identifies the model of the ‘traditional teacher’ as embodying the structural exclusions and discriminations built into the classroom and proposes the figure of a ‘Leading Learner’ as a first step towards a radical change in the educational system. In collaboration with the education departments in the Theatre and Dance Academy at ArtEZ, the post-doc will build up a research and teaching programme that engages with students and teachers in the faculty to create a prototype of an inclusive and diverse educational practice. RELEVANCE: Education should be the critical space in which changes occur in order to shape best possible futures. In DETeLL’s acceptation, decolonisation refers to a complete change in the way of thinking and behaving. It does not refer only to the urgency of dealing with historical colonial legacies embedded in society, but also to the subversion of the deeply oppressive colonial culture that (also unconsciously) regulates public and private living, whether this is related to gender, race, class or sexuality issues. RESULTS: 1) Create a theory and practice-based scientific base-line of decolonisation and art education; 2) Provide a definition of ‘Artist educator as Leading Learner’ following a practice- based methodology of intervention; 3) Design and Pilot a new teaching programme for theatre education at ArtEZ to be then upscaled to all educational departments in a follow-up project); 4) Produce a strong interdisciplinary and international output plan: 3 academic publications, 2 conferences, 4 expert group workshops. NETWORK: ArtEZ; University of Amsterdam (UvA); Ghent University; UCHRI; Hildesheim University; Cape Town University. The partners will serve as steering committee through planned expert group meetings.
The question we have chosen – and been invited – to answer is “What is Europe: Past, Present, and Future.” This sits within the resilient societies theme of the NWA call. The reason for our choice of the ‘resilience’ theme is based on the many disciplines working on the project, which stretch beyond the historic (living history theme) into the societal.It has a deeper conceptual basis, however. It springs from an assumption that a shared sense of belonging and inclusion is one foundation for and aspect of resilience – just as a rope braided together from many strands is stronger than one where the strands are fraying apart. Positive and inclusive expressions of belonging and affiliation are present in education, sports, and music – highly visible sites of representation that have profound reach and impact in society. Racialisation, othering, and selective or stereotypical representations, however, work against resilience. They are circulated widely and generate exclusion and hurt. In these linked work packages, then, we take up the question’s invitation to expand and disrupt, what the NWA’s call itself defines as a normative prior understanding of Europe. In the words of the question, this definition emphasizes Europe’s nature as white, Christian-secular, bounded by the geographic limits of Western Europe, shaped by Greco-Roman heritage and tradition, democratic, and home of the enlightenment. Our consortium seeks to analyze this representation, research and present more expansive and accurate ones in consultative reflective and co-creative processes. Through the process, the new knowledge, and our highly participatory research and dissemination models we will change societal understandings of the bounds of Dutch, and European identities. This will forge a greater sense of belonging across all of the communities, including academia, involved in our project.This project is vital for building resilience through tackling sources of fragmentation and alienation in past and present. It is much needed as we look forward to an increasingly diverse and mixed demographic future.
