Stochastic fault tree analysis for agropark project appraisal

Agroparks offer in theory a variety of economic advantages and environmental benefits. Since agropark projects are typically capital intensive and with high societal impact, appraisal from lenders and policy makers will play a key role in the realisation of the concept. In practice, however, project appraisal is hampered by the complexity of the concept and the multitude of risks. In this paper, a methodology based on stochastic fault-tree analysis (FTA) was developed to support project managers and policy makers in making agropark investment decisions. The methodology is illustrated with an example agropark project

Lessons learned from inadequate implementation planning of team-based chronic disease management: implementation evaluation.

BACKGROUND: This study was a retrospective evaluation of an unsuccessfully implemented team-based, chronic disease management program, with an aim to understand more about implementation barriers. The program, the Chronic Disease Management Initiative (CDMI) was a new collaborative model of care for patients with COPD. It utilized customized health information and interactive tools, mainly smartphones, for ongoing disease management. The program\u27s goal was to demonstrate that integrated team-based models of care could improve patient care, as well as reduce readmission rates and emergency department visits. The program planning for CDMI began in 2017, followed by the implementation and evaluation period in 2018. After a 10-month implementation period, the program was unable to enroll a sufficient number of patients to examine if there was an improvement in patient outcomes. METHODS: A retrospective case-study design using multiple data sources was used to gather feedback from participants involved in CDMI. Data collection occurred throughout planning and implementation and continued into early 2019. Semi-structured interviews were conducted, and transcripts were analyzed using NVivo 10 software. This was followed by content analysis. RESULTS: Analysis revealed four key themes as barriers to CDMI\u27s implementation: 1) lack of a needs assessment with key stakeholders; 2) lack of buy-in from medical staff; 3) inadequate patient engagement and; 4) contextual barriers. Planners did not conduct a proper needs assessment, nor include patients in the study design. In addition, there was insufficient consideration for how CDMI should be integrated into the usual COPD care plan, leading to confusion in roles and responsibilities. Poor communication between the implementation team and healthcare providers implementing the program, led to a lack of buy-in and engagement. CONCLUSION: The key themes resonate with what is already known in the literature. This study supports the importance of using a theoretically grounded plan for implementation. Using a model only in the planning stages is insufficient even when an intervention is based on evidence to support higher quality care. It is imperative to consider practical and contextual factors of program implementation and their interactions. By detailing the \u27failed implementation\u27 of this intervention, we hope to share important lessons about the need to plan implementation processes early in program planning

Using Visual Methods to Capture Patient Perspectives in Interprofessional Team-Based Care for Chronic Disease Management

Background: Understanding how patients perceive their role in the healthcare team can improve overall satisfaction of care and health outcomes. However, it has been challenging to capture the diversity of patient experiences using traditional research approaches. The goal of this study was to explore the perspectives of patients involved in an interprofessional team-based chronic disease management program for chronic obstructive pulmonary disease using visual research techniques. Methods: Our visual approach began with patients autonomously drawing (or mapping) experiences with their healthcare team. The maps were explored with the patients through focus group discussions. Maps were inductively coded to identify similarities and differences between participants’ perceptions. Focus group transcripts were first analyzed independently, then compared to and integrated into the map analysis. Findings: Overall, participants (n = 13) were satisfied as patients of team-based care. Participants drew multiple healthcare providers, sources of information, and themselves to represent their teams. Relationships and significance were represented using arrows, the size of each team member, facial expressions, and symbols. Four key elements of effective team-based models of care emerged: 1) effective information sharing, 2) diversity of providers’ roles, 3) empowerment through self-management, and 4) enhanced access to care. Conclusion: This study used visualization methodology to obtain patient feedback on the program’s performance, elicit patients’ experiences, and attempt to mitigate some of the limitations of isolated survey and focus group methodology, subsequently obtaining rich data on team-based care. Our research also informs ongoing quality improvement of the team nbased model for chronic disease management

A Bayesian Belief Network to Infer Incentive Mechanisms to Reduce Antibiotic Use in Livestock Production

Efficient policy intervention to reduce antibiotic use in livestock production requires knowledge about the rationale underlying antibiotic usage. Animal health status and management quality are considered the two most important factors that influence farmersâ¿¿ decision-making concerning antibiotic use. Information on these two factors is therefore crucial in designing incentive mechanisms. In this paper, a Bayesian belief network (BBN) is built to represent the knowledge on how these factors can directly and indirectly determine antibiotic use and the possible impact on economic incentives. Since both factors are not directly observable (i.e. latent), they are inferred from measurable variables (i.e. manifest variables) which are influenced by these factors. Using farm accounting data and registration data on antibiotic use and veterinary services in specialized finisher pig production farms, a confirmatory factor analysis was carried out to construct these factors. The BBN is then parameterized through regression analysis on the constructed factors and manifest variables. Using the BBN, possible incentive mechanisms through prices and management training are discusse

Feasible Wrench Set Computation for Legged Robots

During locomotion, legged robots interact with the ground by sequentially establishing and breaking contact. The interaction wrenches that arise from contact are used to steer the robot Center of Mass (CoM) and reject perturbations that make the system deviate from the desired trajectory and often make them fall. The feasibility of a given control target (desired CoM wrench or acceleration) is conditioned by the contact point distribution, ground friction, and actuation limits. In this work, we develop a method to compute the set of feasible wrenches that a legged robot can exert on its CoM through contact. The presented method can be used with any amount of non-co-planar contacts and takes into account actuation limits and limitations based on an inelastic contact model with Coulomb friction. This is exemplified with a planar biped model standing with the feet at different heights. Exploiting assumptions from the contact model, we explain how to compute the set of wrenches that are feasible on the CoM when the contacts remain in position as well as the ones that are feasible when some of the contacts are broken. Therefore, this method can be used to assess whether a switch in contact configuration is feasible while achieving a given control task. Furthermore, the method can be used to identify the directions in which the system is not actuated (i.e. a wrench cannot be exerted in those directions). We show how having a joint be actuated or passive can change the non-actuated wrench directions of a robot at a given pose using a spatial model of a lower-extremity exoskeleton. Therefore, this method is also a useful tool for the design phase of the system. This work presents a useful tool for the control and design of legged systems that extends on the current state of the art.Comment: \c{opyright} 2022 IEEE. Personal use of this material is permitted. Permission from IEEE must be obtained for all other uses, in any current or future media, including reprinting/republishing this material for advertising or promotional purposes, creating new collective works, for resale or redistribution to servers or lists, or reuse of any copyrighted component of this work in other work

Modelling risk aversion to support decision-making for controlling zoonotic livestock diseases

Zoonotic infectious livestock diseases are becoming a significant burden for both animal and human health and are rapidly gaining the attention of decision-makers who manage public health programmes. If control decisions have only monetary components, governments are generally regarded as being risk-neutral and the intervention strategy with the highest expected benefit (lowest expected net costs) should be preferred. However, preferences will differ and alternative intervention plans will prevail if (human) life and death outcomes are involved. A rational decision framework must therefore consider risk aversion in the decision-maker and controversial values related to public health. In the present study, risk aversion and its impact on both the utility for the monetary component and the utility for the nonmonetary component is shown to be an important element when dealing with emerging zoonotic infectious livestock diseases and should not be ignored in the understanding and support of decisionmaking. The decision framework was applied to several control strategies for the reduction of human cases of brucellosis (Brucella melitensis) originating from sheep in Turkey

Biologisch Ondernemen Legpluimvee

Eenmalige uitgave met diverse thema's uit de nederlandse biologische legpluimveehouderij, met bedrijfsvoorbeelden. Onderwerpen: - Werken aan toekomst van hen en bedrijf - Een goed imago én rendement - Goede huisvesting - Mobiele huisvesting - Op zoek naar de ideale hen - De ideale uitloop - Eiwitrijk voer uit eigen regio... kan dat? - Samenwerken aan gezonde koppels in het bedrijfsnetwerk - Kruiden als medicijn - Mest als grondstof - Biologische Pluimveehouders Vereniging: "kijkt over grenzen heen" - Bionext: verbindende schakel - Skal: bio-control

Assisting walking balance using a bio-inspired exoskeleton controller

Background: Balance control is important for mobility, yet exoskeleton research has mainly focused on improving metabolic energy efficiency. Here we present a biomimetic exoskeleton controller that supports walking balance and reduces muscle activity. Methods: Humans restore balance after a perturbation by adjusting activity of the muscles actuating the ankle in proportion to deviations from steady-state center of mass kinematics. We designed a controller that mimics the neural control of steady-state walking and the balance recovery responses to perturbations. This controller uses both feedback from ankle kinematics in accordance with an existing model and feedback from the center of mass velocity. Control parameters were estimated by fitting the experimental relation between kinematics and ankle moments observed in humans that were walking while being perturbed by push and pull perturbations. This identified model was implemented on a bilateral ankle exoskeleton. Results: Across twelve subjects, exoskeleton support reduced calf muscle activity in steady-state walking by 19% with respect to a minimal impedance controller (p < 0.001). Proportional feedback of the center of mass velocity improved balance support after perturbation. Muscle activity is reduced in response to push and pull perturbations by 10% (p = 0.006) and 16% (p < 0.001) and center of mass deviations by 9% (p = 0.026) and 18% (p = 0.002) with respect to the same controller without center of mass feedback. Conclusion: Our control approach implemented on bilateral ankle exoskeletons can thus effectively support steady-state walking and balance control and therefore has the potential to improve mobility in balance-impaired individuals.Support Biomechanical Engineerin