As societies age, the development of resources and strategies that foster healthy ageing from the beginning of life become increasingly important. Social and healthcare professionals are key agents in this process; therefore, their training needs to be in agreement with societal needs. We performed a scoping review on professional competences for social and health workers to adequately promote healthy ageing throughout life, using the framework described by Arksey and O’Malley and the Joanna Briggs Institute Guidelines. A stakeholder consultation was held in each of the participating countries, in which 79 experts took part. Results show that current literature has been excessively focused on the older age and that more attention on how to work with younger population groups is needed. Likewise, not all disciplines have equally reflected on their role before this challenge and interprofessional approaches, despite showing promise, have not been sufficiently described. Based on our results, health and social professionals working to promote healthy ageing across the lifespan will need sound competences regarding person-centred communication, professional communication, technology applications, physiological and pathophysiological aspects of ageing, social and environmental aspects, cultural diversity, programs and policies, ethics, general and basic skills, context and self-management-related skills, health promotion and disease prevention skills, educational and research skills, leadership skills, technological skills and clinical reasoning. Further research should contribute to establishing which competences are more relevant to each discipline and at what level they should be taught, as well as how they can be best implemented to effectively transform health and social care systems.
Lectorale rede
With changing retirement ages and an aging workforce, interest is growing on the potential contribution of relevant bundles of HR practices in eliciting well-being and performance among aging workers. Drawing on theories on lifespan development and self-regulation, we distinguished two bundles of HR practices: development HR practices that help individual workers reach higher levels of functioning (e.g. training), and maintenance HR practices that help individual workers maintain their current levels of functioning in the face of new challenges (e.g. performance appraisal). Further, based on lifespan theories, we expected and found that the association between development HR practices and well-being (i.e. job satisfaction, organisational commitment and organisational fairness) weakens, and that the associations between maintenance HR practices and well-being, and between development HR practices and employee performance, strengthen with age. In addition, a third bundle of ‘job enrichment’ HR practices emerged that elicited higher job performance among aging workers.
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De technische en economische levensduur van auto’s verschilt. Een goed onderhouden auto met dieselmotor uit het bouwjaar 2000 kan technisch perfect functioneren. De economische levensduur van diezelfde auto is echter beperkt bij introductie van strenge milieuzones. Bij de introductie en verplichtstelling van geavanceerde rijtaakondersteunende systemen (ADAS) zien we iets soortgelijks. Hoewel de auto technisch gezien goed functioneert kunnen verouderde software, algorithmes en sensoren leiden tot een beperkte levensduur van de gehele auto. Voorbeelden: - Jeep gehackt: verouderde veiligheidsprotocollen in de software en hardware beperkten de economische levensduur. - Actieve Cruise Control: sensoren/radars van verouderde systemen leiden tot beperkte functionaliteit en gebruikersacceptatie. - Tesla: bij bestaande auto’s worden verouderde sensoren uitgeschakeld waardoor functies uitvallen. In 2019 heeft de EU een verplichting opgelegd aan automobielfabrikanten om 20 nieuwe ADAS in te bouwen in nieuw te ontwikkelen auto’s, ongeacht prijsklasse. De mate waarin deze ADAS de economische levensduur van de auto beperkt is echter nog onvoldoende onderzocht. In deze KIEM wordt dit onderzocht en wordt tevens de parallel getrokken met de mobiele telefonie; beide maken gebruik van moderne sensoren en software. We vergelijken ontwerpeisen van telefoons (levensduur van gemiddeld 2,5 jaar) met de eisen aan moderne ADAS met dezelfde sensoren (levensduur tot 20 jaar). De centrale vraag luidt daarom: Wat is de mogelijke impact van veroudering van ADAS op de economische levensduur van voertuigen en welke lessen kunnen we leren uit de onderliggende ontwerpprincipes van ADAS en Smartphones? De vraag wordt beantwoord door (i) literatuuronderzoek naar de veroudering van ADAS (ii) Interviews met ontwerpers van ADAS, leveranciers van retro-fit systemen en ontwerpers van mobiele telefoons en (iii) vergelijkend rij-onderzoek naar het functioneren van ADAS in auto’s van verschillende leeftijd en prijsklassen.
Huntington’s disease (HD) and various spinocerebellar ataxias (SCA) are autosomal dominantly inherited neurodegenerative disorders caused by a CAG repeat expansion in the disease-related gene1. The impact of HD and SCA on families and individuals is enormous and far reaching, as patients typically display first symptoms during midlife. HD is characterized by unwanted choreatic movements, behavioral and psychiatric disturbances and dementia. SCAs are mainly characterized by ataxia but also other symptoms including cognitive deficits, similarly affecting quality of life and leading to disability. These problems worsen as the disease progresses and affected individuals are no longer able to work, drive, or care for themselves. It places an enormous burden on their family and caregivers, and patients will require intensive nursing home care when disease progresses, and lifespan is reduced. Although the clinical and pathological phenotypes are distinct for each CAG repeat expansion disorder, it is thought that similar molecular mechanisms underlie the effect of expanded CAG repeats in different genes. The predicted Age of Onset (AO) for both HD, SCA1 and SCA3 (and 5 other CAG-repeat diseases) is based on the polyQ expansion, but the CAG/polyQ determines the AO only for 50% (see figure below). A large variety on AO is observed, especially for the most common range between 40 and 50 repeats11,12. Large differences in onset, especially in the range 40-50 CAGs not only imply that current individual predictions for AO are imprecise (affecting important life decisions that patients need to make and also hampering assessment of potential onset-delaying intervention) but also do offer optimism that (patient-related) factors exist that can delay the onset of disease.To address both items, we need to generate a better model, based on patient-derived cells that generates parameters that not only mirror the CAG-repeat length dependency of these diseases, but that also better predicts inter-patient variations in disease susceptibility and effectiveness of interventions. Hereto, we will use a staggered project design as explained in 5.1, in which we first will determine which cellular and molecular determinants (referred to as landscapes) in isogenic iPSC models are associated with increased CAG repeat lengths using deep-learning algorithms (DLA) (WP1). Hereto, we will use a well characterized control cell line in which we modify the CAG repeat length in the endogenous ataxin-1, Ataxin-3 and Huntingtin gene from wildtype Q repeats to intermediate to adult onset and juvenile polyQ repeats. We will next expand the model with cells from the 3 (SCA1, SCA3, and HD) existing and new cohorts of early-onset, adult-onset and late-onset/intermediate repeat patients for which, besides accurate AO information, also clinical parameters (MRI scans, liquor markers etc) will be (made) available. This will be used for validation and to fine-tune the molecular landscapes (again using DLA) towards the best prediction of individual patient related clinical markers and AO (WP3). The same models and (most relevant) landscapes will also be used for evaluations of novel mutant protein lowering strategies as will emerge from WP4.This overall development process of landscape prediction is an iterative process that involves (a) data processing (WP5) (b) unsupervised data exploration and dimensionality reduction to find patterns in data and create “labels” for similarity and (c) development of data supervised Deep Learning (DL) models for landscape prediction based on the labels from previous step. Each iteration starts with data that is generated and deployed according to FAIR principles, and the developed deep learning system will be instrumental to connect these WPs. Insights in algorithm sensitivity from the predictive models will form the basis for discussion with field experts on the distinction and phenotypic consequences. While full development of accurate diagnostics might go beyond the timespan of the 5 year project, ideally our final landscapes can be used for new genetic counselling: when somebody is positive for the gene, can we use his/her cells, feed it into the generated cell-based model and better predict the AO and severity? While this will answer questions from clinicians and patient communities, it will also generate new ones, which is why we will study the ethical implications of such improved diagnostics in advance (WP6).
