Energy management and carbon accounting schemes are increasingly being adopted as a corporate response to climate change. These schemes often demand the setting of ambitious targets for the reduction of corporate greenhouse gas emissions. There is however only limited empirical insight in the companies’ target setting process and the auditing practice of certifying agencies that evaluate ambition levels of greenhouse gas reduction targets. We studied the target setting process of firms participating in the CO2 Performance Ladder. The CO2 Performance Ladder is a new certifiable scheme for energy management and carbon accounting that is used as a tool for green public procurement in the Netherlands. This study aimed at answering the question ‘to what extent does the current target setting process in the CO2 Performance Ladder lead to ambitious CO2 emission reduction goals?’. The research methods were interviews with relevant stakeholders (auditors, companies and consultants), document reviews of the certification scheme, and an analysis of corporate target levels for the reduction of CO2 emissions. The research findings showed that several certification requirements for target setting for the reduction of CO2 emissions were interpreted differently by the various actors and that the conformity checks by the auditors did not include a full assessment of all certification requirements. The research results also indicated that corporate CO2 emission reduction targets were not very ambitious. The analysis of the target setting process revealed that there was a semi-structured bottom-up auditing practice for evaluating the corporate CO2 emission reduction targets, but the final assessment whether target levels were sufficiently ambitious were rather loose. The main conclusion is that the current target setting process in the CO2 Performance Ladder did not necessarily lead to establishing the most ambitious goals for CO2 emission reduction. This process and the tools to assess the ambition level of the CO2 emission reduction targets need further improvement in order to maintain the CO2 Performance Ladder as a valid tool for green public procurement.
BACKGROUND: Nurse-coordinated care (NCC) improves the achievement of low-density lipoprotein-cholesterol (LDL-C) targets after an acute coronary syndrome (ACS). We hypothesised that NCC improves achievement of LDL-C targets through more intensive medication titration.METHODS: We used data from Randomised Evaluation of Secondary Prevention by Outpatient Nurse Specialists (RESPONSE), a multicentre randomised trial on the efficacy of NCC in 754 ACS patients. Follow-up data were collected at 6 and 12 months. To enable comparison between the various types and dosages of statins, we used the average lipid-lowering potency (ALLP, % LDL-C lowering) as an indicator of lipid-lowering medication intensity.RESULTS: Most patients in NCC intervention and usual care groups (96%) had started lipid-lowering therapy during the index hospitalisation. At 6 months, titration activities (up or down) were applied in 45% of NCC patients compared with 24% of patients receiving usual care (p<0.001), and a difference was also seen at 12 months follow-up (52% vs 34%, p<0.001). In patients not on LDL-C target at baseline, titration activities at 6 months were recorded in 63% and 30% of NCC and usual care patients respectively (p<0.001), with increased titration activities in both groups at 12 months (69% vs 43%, p<0.001).CONCLUSION: NCC is associated with more frequent and intense lipid-lowering medication titration to reach LDL-C targets as compared with usual care alone. Further, merely starting the guideline-recommended dose is insufficient to reach the guideline-recommended LDL-C target level.TRIAL REGISTRATION NUMBER: TC1290 (Netherlands).
To reach the European Green Deal by 2050, the target for the road transport sector is set at 30% less CO2 emissions by 2030. Given the fact that heavy-duty commercial vehicles throughout Europe are driven nowadays almost exclusively on fossil fuels it is obvious that transition towards reduced emission targets needs to happen seamlessly by hybridization of the existing fleet, with a continuously increasing share of Zero Emission vehicle units. At present, trailing units such as semitrailers do not possess any form of powertrain, being a missed opportunity. By introduction of electrically driven axles into these units the fuel consumption as well as amount of emissions may be reduced substantially while part of the propulsion forces is being supplied on emission-free basis. Furthermore, the electrification of trailing units enables partial recuperation of kinetic energy while braking. Nevertheless, a number of challenges still exist preventing swift integration of these vehicles to daily operation. One of the dominating ones is the intelligent control of the e-axle so it delivers right amount of propulsion/braking power at the right time without receiving detailed information from the towing vehicle (such as e.g. driver control, engine speed, engine torque, or brake pressure, …etc.). This is required mainly to ensure interoperability of e-Trailers in the fleets, which is a must in the logistics nowadays. Therefore the main mission of CHANGE is to generate a chain of knowledge in developing and implementing data driven AI-based applications enabling SMEs of the Dutch trailer industry to contribute to seamless energetic transition towards zero emission road freight transport. In specific, CHANGE will employ e-Trailers (trailers with electrically driven axle(s) enabling energy recuperation) connected to conventional hauling units as well as trailers for high volume and extreme payload as focal platforms (demonstrators) for deployment of these applications.
The energy transition is a highly complex technical and societal challenge, coping with e.g. existing ownership situations, intrusive retrofit measures, slow decision-making processes and uneven value distribution. Large scale retrofitting activities insulating multiple buildings at once is urgently needed to reach the climate targets but the decision-making of retrofitting in buildings with shared ownership is challenging. Each owner is accountable for his own energy bill (and footprint), giving a limited action scope. This has led to a fragmented response to the energy retrofitting challenge with negligible levels of building energy efficiency improvements conducted by multiple actors. Aggregating the energy design process on a building level would allow more systemic decisions to happen and offer the access to alternative types of funding for owners. “Collect Your Retrofits” intends to design a generic and collective retrofit approach in the challenging context of monumental areas. As there are no standardised approaches to conduct historical building energy retrofits, solutions are tailor-made, making the process expensive and unattractive for owners. The project will develop this approach under real conditions of two communities: a self-organised “woongroep” and a “VvE” in the historic centre of Amsterdam. Retrofit designs will be identified based on energy performance, carbon emissions, comfort and costs so that a prioritisation strategy can be drawn. Instead of each owner investing into their own energy retrofitting, the neighbourhood will invest into the most impactful measures and ensure that the generated economic value is retained locally in order to make further sustainable investments and thus accelerating the transition of the area to a CO2-neutral environment.
The project aims to improve palliative care in China through the competence development of Chinese teachers, professionals, and students focusing on the horizontal priority of digital transformation.Palliative care (PC) has been recognised as a public health priority, and during recent years, has seen advances in several aspects. However, severe inequities in the access and availability of PC worldwide remain. Annually, approximately 56.8 million people need palliative care, where 25.7% of the care focuses on the last year of person’s life (Connor, 2020).China has set aims for reaching the health care standards of the developed countries by 2030 through the Healthy China Strategy 2030, where one of the improvement areas in health care includes palliative care, thus continuing the previous efforts.The project provides a constructive, holistic, and innovative set of actions aimed at resulting in lasting outcomes and continued development of palliative care education and services. Raising the awareness of all stakeholders on palliative care, including the public, is highly relevant and needed. Evidence based practice guidelines and education are urgently required for both general and specialised palliative care levels, to increase the competencies for health educators, professionals, and students. This is to improve the availability and quality of person-centered palliative care in China. Considering the aging population, increase in various chronic illnesses, the challenging care environment, and the moderate health care resources, competence development and the utilisation of digitalisation in palliative care are paramount in supporting the transition of experts into the palliative care practice environment.General objective of the project is to enhance the competences in palliative care in China through education and training to improve the quality of life for citizens. Project develops the competences of current and future health care professionals in China to transform the palliative care theory and practice to impact the target groups and the society in the long-term. As recognised by the European Association for Palliative Care (EAPC), palliative care competences need to be developed in collaboration. This includes shared willingness to learn from each other to improve the sought outcomes in palliative care (EAPC 2019). Since all individuals have a right to health care, project develops person-centered and culturally sensitive practices taking into consideration ethics and social norms. As concepts around palliative care can focus on physical, psychological, social, or spiritual related illnesses (WHO 2020), project develops innovative pedagogy focusing on evidence-based practice, communication, and competence development utilising digital methods and tools. Concepts of reflection, values and views are in the forefront to improve palliative care for the future. Important aspects in project development include health promotion, digital competences and digital health literacy skills of professionals, patients, and their caregivers. Project objective is tied to the principles of the European Commission’s (EU) Digital Decade that stresses the importance of placing people and their rights in the forefront of the digital transformation, while enhancing solidarity, inclusion, freedom of choice and participation. In addition, concepts of safety, security, empowerment, and the promotion of sustainable actions are valued. (European Commission: Digital targets for 2030).Through the existing collaboration, strategic focus areas of the partners, and the principles of the call, the PalcNet project consortium was formed by the following partners: JAMK University of Applied Sciences (JAMK ), Ramon Llull University (URL), Hanze University of Applied Sciences (HUAS), Beijing Union Medical College Hospital (PUMCH), Guangzhou Health Science College (GHSC), Beihua University (BHU), and Harbin Medical University (HMU). As project develops new knowledge, innovations and practice through capacity building, finalisation of the consortium considered partners development strategy regarding health care, (especially palliative care), ability to create long-term impact, including the focus on enhancing higher education according to the horizontal priority. In addition, partners’ expertise and geographical location was also considered important to facilitate long-term impact of the results.Primary target groups of the project include partner country’s (China) staff members, teachers, researchers, health care professionals and bachelor level students engaging in project implementation. Secondary target groups include those groups who will use the outputs and results and continue in further development in palliative care upon the lifetime of the project.
