STEM Education And Research At The University Of Aruba For Sustainable Development Of Small Island Developing States: Case Studies On Energy Efficiency And Waste Management.

SISSTEM “Sustainable Island Solutions through Science, Technology, Engineering and Mathematics” is a higher educational programme created in 2019 at the University of Aruba in response to the need for engineering education and research in Small Island Developing States (SIDS). In this contribution, the SISSTEM programme is introduced, and how SISSTEM equips engineering students with hard and soft skills while addressing local sustainability challenges is showcased through two case studies. The first case study presents a bachelor course that combines sustainability theory with a teamwork project in which students conduct an energy audit to a local institution. With this course, students acquire skills to support the energy transition in Aruba. The second case study focuses on the involvement of university students in the creation of a citizen science mobile phone app to tackle waste challenges. This case study presents how students can become agents of change to contribute solving waste management challenges on the island. Overall, these two case studies showcase how by combining theory and project-based education, students learn to integrate STEM knowledge into multidisciplinary solutions to complex sustainability challenges. In fact, given the cross-cutting nature of sustainability transitions, educating students in integrating the natural environment, technical, social, and economic aspects in engineering solutions is key to increase resilience of islands. As such, at SISSTEM, students acquire hard skills related to their engineering specialisation, as well as soft skills such as integration of disciplines, contextualization, and collaboration

Examining the Effect of Depicting a Patient Affected by a Negative Reimbursement Decision in Healthcare on Public Disagreement with the Decision

BackgroundThe availability of increasingly advanced and expensive new health technologies puts considerable pressure on publicly financed healthcare systems. Decisions to not—or no longer—reimburse a health technology from public funding may become inevitable. Nonetheless, policymakers are often pressured to amend or revoke negative reimbursement decisions due to the public disagreement that typically follows such decisions. Public disagreement may be reinforced by the publication of pictures of individual patients in the media. Our aim was to assess the effect of depicting a patient affected by a negative reimbursement decision on public disagreement with the decision.MethodsWe conducted a discrete choice experiment in a representative sample of the public (n = 1008) in the Netherlands and assessed the likelihood of respondents’ disagreement with policymakers’ decision to not reimburse a new pharmaceutical for one of two patient groups. We presented a picture of one of the patients affected by the decision for one patient group and “no picture available” for the other group. The groups were described on the basis of patients’ age, health-related quality of life (HRQOL) and life expectancy (LE) before treatment, and HRQOL and LE gains from treatment. We applied random-intercept logit regression models to analyze the data.ResultsOur results indicate that respondents were more likely to disagree with the negative reimbursement decision when a picture of an affected patient was presented. Consistent with findings from other empirical studies, respondents were also more likely to disagree with the decision when patients were relatively young, had high levels of HRQOL and LE before treatment, and large LE gains from treatment.ConclusionsThis study provides evidence for the effect of depicting individual, affected patients on public disagreement with negative reimbursement decisions in healthcare. Policymakers would do well to be aware of this effect so that they can anticipate it and implement policies to mitigate associated risks

Examining the Effect of Depicting a Patient Affected by a Negative Reimbursement Decision in Healthcare on Public Disagreement with the Decision

BackgroundThe availability of increasingly advanced and expensive new health technologies puts considerable pressure on publicly financed healthcare systems. Decisions to not—or no longer—reimburse a health technology from public funding may become inevitable. Nonetheless, policymakers are often pressured to amend or revoke negative reimbursement decisions due to the public disagreement that typically follows such decisions. Public disagreement may be reinforced by the publication of pictures of individual patients in the media. Our aim was to assess the effect of depicting a patient affected by a negative reimbursement decision on public disagreement with the decision.MethodsWe conducted a discrete choice experiment in a representative sample of the public (n = 1008) in the Netherlands and assessed the likelihood of respondents’ disagreement with policymakers’ decision to not reimburse a new pharmaceutical for one of two patient groups. We presented a picture of one of the patients affected by the decision for one patient group and “no picture available” for the other group. The groups were described on the basis of patients’ age, health-related quality of life (HRQOL) and life expectancy (LE) before treatment, and HRQOL and LE gains from treatment. We applied random-intercept logit regression models to analyze the data.ResultsOur results indicate that respondents were more likely to disagree with the negative reimbursement decision when a picture of an affected patient was presented. Consistent with findings from other empirical studies, respondents were also more likely to disagree with the decision when patients were relatively young, had high levels of HRQOL and LE before treatment, and large LE gains from treatment.ConclusionsThis study provides evidence for the effect of depicting individual, affected patients on public disagreement with negative reimbursement decisions in healthcare. Policymakers would do well to be aware of this effect so that they can anticipate it and implement policies to mitigate associated risks

Systemic design interventions: Using systems thinking and design thinking to intervene in systems

Today’s design professionals are operating in an expansive, and increasingly complex field. Through working in challenging new contexts, we can see a growing number of designers seeking collaborations with experts in other disciplines and developing a design language, methods and tools applicable to new fields. Previously considered as a trade activity, the design profession is evolving by designers adding their value through design thinking to firms trying to innovate and to societies that are trying to make change happen. (Kimbell, 2011) However, in order to be of value, there is an increasing need for designers to adopt system thinking in their approaches to creating new solutions for complex problems.The notion that designers only design objects, is a dominant view, as Christopher Alexander stated in 1971: “The ultimate object of design is form”. However, it is this notion that is still in the process of evolving. In The Sciences of the Artificial (1969), Herbert Simon identified design as the knowledge that is in the domain of professions such as engineering, management, or medicine and saw design as a rational set of procedures responding to a well-defined problem.Systems thinking has a long tradition in science, constantly revealing new ways to approach complexity, from system analytics to scenario planning strategies. For a long time, system thinking has mainly been used in analytics, in the fields of natural science and business sciences. Therefore, combining systems thinking with the more open and creative aspects of design thinking, is a promising approach for design practice. Richard Buchanan’s paper “Wicked Problems in Design Thinking” (1992), shifted design theory towards a more generalized ‘Design Thinking’ which he believed could be applied to everything from a tangible object to an intangible system. Buchanan’s version of design thinking is less concerned with individual designers and how they design, but seeks instead to define design’s role in the world.“Professional design, in particular design as practiced within the studio-based tradition of many art schools, is taking a new place on the world stage”, states design researcher Lucy Kimbell. She specifically refers to the fact that design has been implemented in managerial discourse. But do practitioners from the different fields really speak the same language? What can designers bring to management thinking? And in turn, how can designers use tools and methodologies from business thinking?In this paper we will stress the importance of integrating designers in system thinking in order to deal with the wicked issues of our contemporary society. We will apply the framework of system thinker Meadows and the social toolkit of design thinker Lucy Kimbell to develop a new systematic approach dealing with complex issues facing our society. Leverage points In order to show how designers can be integrated in system thinking it is necessary to pin point the areas of a system where the effects of designers’ interventions will be of strongest value. We will use the leverage points defined by Meadows (1999) to indicate the places in a system where a small change or tweak, can lead to big changes in behavior or outcomes. Meadows indicated a hierarchy of leverage points within systems, the hierarchy of each leverage point being determined by its effectiveness. Leverage points to intervene in a system, Meadows, 1999 12. Constants, parameters, numbers (such as subsidies, taxes, standards) 11. The size of buffers and other stabilizing stocks, relative to their flows 10. The structure of material stocks and flows (such as transport networks, population age structures) 9. The length of delays, relative to the rate of system change 8. The strength of negative feedback loops, relative to the impacts they are trying to connect against 7. The gain around driving positive feedback loops 6. The structure of information flows (who does and does not have access to what kinds of information) 5. The rules of the system (such as incentives, punishments, constraints) 4. The power to add, change, evolve, or self-organize system structure 3. The goals of the system 2. The mindset or paradigm out of which the system – it’s goals, structure, rules, delays, parameters – arises 1. The power to transcend paradigm Different professionals, ranging from accountants and business consultants to engineers and strategists, are already working in the field of system change, focusing on one or another leverage point. Designers, however, have been rather absent. We would like to add designers to this spectrum by recognizing that out of all available professionals, designers, as creatives, have a lot to offer when it comes to tweaking the most difficult leverage points.According to Meadows, paradigms are the sources of systems and are therefore more difficult to change. However, all that is necessary for a shift in paradigms is sparking a new understanding within an individual. This is where we believe designers can fulfill an important role. Following recent developments in designing choice architecture (Thaler, Sunstein, 2008), based on incremental knowledge about our human thinking processes (Tversky, Kahneman), we already see a glimpse of this kind of design thinking in a systemic field as economics. Thaler and Sunstein describe examples on how to ‘nudge’ people’s decisions in wicked problems as choosing the right pension scheme or improving school choices. Another example of a systemic design intervention, is the design research project of Karianne Rygh, ‘Choice Within the Making – Changing Mindsets through Prison Manufacturing’, triggering new understandings both in the inmate and within society. Society shares the idea that inmates are undeserving of anything but ‘lock-up’ and ‘paying their dues’. This idea constitutes a paradigm focusing on punishment rather than the long-term safety of our society. Most prison systems today have one common failure: a large number of re-offenders returning and overpopulating the prisons. Rygh´s systemic design approach to skilled carpentry training within Norwegian prisons, is aimed at reducing the number of re-offenders by using furniture production as a hands-on, informal tool to foster reflective thinking, using time as a tangible form of rehabilitation. As a designer, Rygh saw manufacturing within prison as an overlap between inmates and society, since prison-made furniture is sold to the public. She therefore designed a manual for producing a rocking chair where every step of the process requires the inmate to look back at what he or she did in the previous step, in order to move several steps forward. Triggering new understandings and new modes of thinking can in turn change behavioral patterns and shift paradigms, but for this to happen through the prison system, there needs to be freedom of choice within confinement. Enabling each inmate to include their own form language in a chair while at the same time training them to reflect over their choices within the making, is one approach to a systemic design intervention contributing to the safety of our society and gives added value to the end products being sold outside of prison. With our research we aim to build a framework designers can use to find and use leverage points in order to tweak social and political systems. The framework shall be based on theoretical research, in-depth interviews and case studies within our CRISP (Creative Industries Scientific Program) network, ranging from science to design and business

Context – Goal – Method – Outcome: Alignment in Citizen Science Project Design and its Relation to Supporting the United Nations Sustainable Development Goals

Citizen science (CS) is a diverse practice, with projects emphasizing scientific and/or democratization goals. While the integration of both goals is advocated for sustainability transitions, this implies contextualized methodological choices. This contribution presents an instrument to explore methodological choices in relation to project goals and context, linking these patterns to the United Nations Sustainable Development Goals (SDGs). By way of a PRISMA scoping review, case studies implemented in the Global North (GN) or Global South (GS) were selected and categorized using the instrument to identify notable patterns. GN projects are generally published by GN authors and can predominantly be linked to productivity goals relating to SDGs on biodiversity (SDGs 14, 15). In contrast, GS projects are commonly associated with diverse co-author groups that focus on democratization and/or productivity, and prioritize SDGs on agriculture, health, sustainable communities, and climate change (SDGs 2, 3, 11, 13). The analyzed case studies could contribute directly to three SDG indicators and indirectly to 22. Methodological choices regarding project goals and themes translate into variations in participant selection and recruitment, contribution types, and project outcomes. Further, project design and outcomes can be linked to co-authorships, with larger teams typically associated with co-created projects which in turn focus on democratization or democratization and productivity goals, and produce a wide diversity of outcomes. Qualitative information extracted from the investigated papers was used to contextualize the relevance of combining productivity and democratization goals as well as the related challenges of harmonizing different interests and of resource limitations as well as other project constraints

Daily-Life Monitoring of Stroke Survivors Motor Performance: The INTERACTION Sensing System

The objective of the INTERACTION Eu project is to develop and validate an unobtrusive and modular system for monitoring daily life activities, physical interactions with the environment and for training upper and lower extremity motor function in stroke subjects. This paper describes the development and preliminary testing of the project sensing platform made of sensing shirt, trousers, gloves and shoes. Modular prototypes were designed and built considering the minimal set of inertial, force and textile sensors that may enable an efficient monitoring of stroke patients. The single sensing elements are described and the results of their preliminary lab-level testing are reported

Plurality in the Measurement of Social Media Use and Mental Health: An Exploratory Study Among Adolescents and Young Adults

On a daily basis, individuals between 12 and 25 years of age engage with their mobile devices for many hours. Social Media Use (SMU) has important implications for the social life of younger individuals in particular. However, measuring SMU and its effects often poses challenges to researchers. In this exploratory study, we focus on some of these challenges, by addressing how plurality in the measurement and age-specific characteristics of SMU can influence its relationship with measures of subjective mental health (MH). We conducted a survey among a nationally representative sample of Dutch adolescents and young adults (N=3,669). Using these data, we show that measures of SMU show little similarity with each other, and that age-group differences underlie SMU. Similar to the small associations previously shown in social media-effects research, we also find some evidence that greater SMU associates to drops and to increases in MH. Albeit nuanced, associations between SMU and MH were found to be characterized by both linear and quadratic functions. These findings bear implications for the level of association between different measures of SMU and its theorized relationship with other dependent variables of interest in media-effects research

Daily-life tele-monitoring of motor performance in stroke survivors

The objective of the EU project INTERACTION is to develop an unobtrusive and modular sensing system for objective monitoring of daily-life motor performance of stroke survivors. This will enable clinical professionals to advise their patients about their continued daily-life activity profile and home training, and evaluate and optimize rehabilitation programs.A modular textile-integrated sensing system was developed and performance and capacity measures were proposed and clinically tested in stroke subject.Telemonitoring facilities were developed and tested. In the last stage of the project, the system will be tested during daily-life