Health performance of housing:

Human health is a condition influenced by many aspects: genetic predisposition, food and water, lifestyle, age and the physical and social environment. Outdoor hazards penetrate the house and add to the indoor hazards. The physical housing conditions and also occupant behaviour create health hazards. In maintenance policy and renovation projects, the opportunities to reduce health risks and adapt houses to the health needs of households are not used to their full potential. Health criteria were until recently poorly integrated into sustainable building, and some technical innovations to save energy are associated with health related complaints. Good diagnosis of environmental problems is often a bottleneck for home owners and housing managers. Better insight into health performance qualities and a clear framework and common language can improve health performance. The major question of the project is: What physical parameters and which type of occupancy and behaviour result in exposure to health risk and how can this risk be evaluated and reduced

Climate Change, Radical Uncertainty and Hope:Theology and Economics in Conversation

This research explores a hopeful response to radical uncertainty in the context of climate change. Views on climate change are often either pessimistic or optimistic. But it is not constructive to divide the world into pessimists and optimists. There is a third way, one of hope, to deal with radical uncertainty in the context of climate change. This study develops a response to climate change based on hope, derived from the work of the late Jonathan Sacks, leading British public intellectual and Chief Rabbi. The necessity for this study emerged out of the debate within economics on radical uncertainty in the context of climate change. Radial uncertainty, uncertainty inherent in the human condition (derived from Hannah Arendt), appears not to be adequately addressed by the critical assumptions underlying conventional economic modelling, in particular the social cost-benefit analysis (SCBA). Following Dan Rodrik’s approach to economics, an economic model is only useful when it captures the most relevant aspects of reality. Therefore, this study questions the critical assumptions underlying SCBA. The study argues that Sacks’ understanding of hope, derived from the ancient narrative of the Exodus, lends itself to several alternative critical assumptions to address radical uncertainty: emunah (particular type of trust), chessed (particular type of love), change of identity and two supporting institutions, namely covenant and public Sabbath. Hope appears to be a realistic journey of taking courageous and practical steps together and thereby gradually becoming aware that there is something new and liberating possible in the midst of radical uncertainty. The study develops a conversation or transversal reasoning between Jonathan Sacks and the economists Bart Nooteboom, Samuel Bowles, Dan Ariely and John Kay & Mervyn King, using van Huyssteen’s postfoundational approach. In this conversation the alternative critical assumptions are discussed and the relevance this conversation for a social response to radical uncertainty in the context of climate change is shown. The conversation shows also that hope is not contrary to contemporary economic insights, but remarkably compatible with them. At the same time, it is also shown that both disciplines can learn from one another

An investigation into the development of an advanced ship performance monitoring and analysis system

PhD ThesisThe complete ban on TBT in marine antifouling coatings in 2008, rocketing fuel prices over the past six years, environmental concern and upcoming energy efficiency indices for ships have resulted in a strong interest of the shipping industry to monitor, evaluate and optimise ship performance. Furthermore, the complete ban on TBT in anti-fouling coatings resulted in new types of foul-release hull-coatings, based con silicon, whose effectiveness and performance still needs to be evaluated. Because of the difficulty of measuring coating roughness in service and the large effect of marine bio-fouling on ship performance, a research project was setup at Newcastle University in collaboration with a major paint company to investigate the ways to evaluate hull coating through ship performance monitoring. This thesis describes the details of this project which aimed to investigate the feasibility of a real-time ship performance monitoring and analysis (PM&A) system by implementation and evaluation onboard a 16m research vessel and 300.000dwt VLCC. The thesis starts with a review of the state of art of PM&A systems. The main weaknesses of existing PM&A systems is that often abstract logbook data is used as input and that too little attention is paid to data quality. Furthermore, the systems often act as a black box, showing little insight in data analysis, harming the reliability and trustworthiness of output indicators. Additionally, there are large differences in the way that performance data is corrected to standard conditions, resulting in contradicting and unreliable performance indicators. The thesis focuses therefore on theoretically sound, transparent data analysis and improved data collection. In the thesis, all performance affecting environmental and operational conditions have been reviewed including sensor characteristics and data acquisition aspects. Based on the experience from the analysis of the data collected from both vessels, it reveals that automatic, real-time data collection and rational filtering for periods of acceleration, deceleration, course deviation, drift, shallow water and ship motion is the way forward for accurate performance monitoring. Performance analysis is highly sensitive to errors in shaft torque and ship speed through water. A frequently calibrated/validated shaft torque & RPM sensor and Doppler speed log are therefore the most important sensors for performance monitoring. Speed logs are T.W.F. Hasselaar PhD thesis, 2010 ii affected by many environmental conditions and cannot be used directly for performance monitoring. Other ways to determine ship speed through water, e.g. using the propeller inflow speed, are however affected by hull fouling and loading deviations unless corrected for accordingly. Corrections using full scale trials are then necessary to avoid overestimation of the effects of hull fouling on ship performance. To avoid these errors, a method is described to use the speed log by evaluating its reliability and utilise its reading for performance analysis only in periods where it can be considered reliable. A new transparent analysis method is described to analyse ship performance based on conversion of torque and rpm at constant ship speed. The method differentiates between the hull and propeller performance by empirically correcting the propeller open water diagram for roughness (periodically measured by divers). Evaluation of the proposed PM&A system on both vessels indicates that reliable performance indicatgors can be calculated but that fluctuations in performance indicators of ±12% remain unavoidable due to inaccurate wave observations and errors from the speed log. Trials on the research vessel furthermore show that the system is able to identify fouling, but sensor accuracy requires further research so that fouling can be defined with less performance data and higher reliability. This thesis demonstrates for the first time in open literature that the design and implementation of a transparent and fully automatic, real-time, shipboard PM&A system is perfectly viable and can be installed on any ship with the use of reliable sensors.International Pain

Behavioral determinants of electricity consumption in dutch dwellings

Following the sensitivity analysis on heating energy consumption in Chapter 3, Chapter 4 is an analysis on the determinants of electricity consumptions in Dutch dwellings. The OTB sample was used for analysis, and it was validated with analysis of the WoON sample. The work was published as: This Chapter deals with the Research Question II of this thesis: (Chapter 1, Section 3, pg. 16-17) “II. What is the influence of lighting and appliance use on the total electricity consumption in dwellings?" The sub-questions are: 1. What are the main direct and indirect determinants of electricity consumption? (Direct determinant: such as number of appliances and duration of appliance use … Indirect determinant: such as household size, dwelling size, dwelling type …) 2. How much of the variance in electricity consumption in dwellings can be explained by direct and indirect determinants?” The research reported in this Chapter was conducted by Bedir. The data was collected by a questionnaire prepared by Guerra Santin and Bedir, using OTB’s means of data collection. The analysis was done, and the paper was written by Bedir. The co-authors commented on the drafts and gave advise on the structure, and the content of the paper. The co-authors have given their permission to include the paper in the thesis

De Geest zweeft over de wateren?!

In de Paasnacht wordt in diverse kerken het water gezegend. In die nacht klinkt het bijvoorbeeld in de oud-katholieke liturgie: ‘Uw Geest zweefde bij het begin van de wereld over de wateren, opdat zij toen reeds de kracht der heiligmaking zouden ontvangen’ (Oud-Katholieke Kerk van Nederland 1993, 127). Via het Exodusverhaal beweegt de liturgie zich naar het zegenen van het water vandaag de dag, zodat water ook in het nu een kracht kan zijn ‘… om heel de mensheid te vernieuwen’ (OKK 1993, 128). In protestantse en rooms-katholieke vieringen vinden we een soortgelijke liturgie in de Paasnacht. Dit gebruik in de paasliturgie lijkt haaks te staan op de dagelijkse realiteit. In onze tijd van klimaatverandering lijkt water dikwijls meer een destructieve kracht dan een helende kracht te zijn. Een legitieme vraag die gesteld kan worden is of de Geest vandaag de dag nog wel ‘over de wateren zweeft’. Dit artikel vindt zijn inbedding in het veld van ecotheologie. Het verkent een politiek van hoop. Eerst richt ik me op het werk van Jonathan Sacks. Daarna presenteer ik een case study uit Kaapstad

Optimization of offshore wind farm power cable routing

Up to now methods to optimize cable route layout are only based on a flat seabed and do not take the seabed dynamics into account (Jenkins et al., 2013; Morelissen et al., 2003). The result of this approach is that power cable coverage is not guaranteed over wind farm design lifetime. Cable optimization is mainly executed based on shortest routes instead of cost reduction over the entire design lifespan. The aim of this research is to develop a Matlab based tool, which optimizes power cable route design based on expected morphological behaviour in the design lifetime of an offshore wind farm

Experiences of patients, family and professional caregivers with Integrated Palliative Care in Europe:protocol for an international, multicenter, prospective, mixed method study

Background The number of people living with advanced cancer and chronic disease has increased worldwide. Many of these patients could benefit from palliative care, focusing on optimising the quality of life of patients and their families facing problems resulting from life-threatening diseases. However, fragmentation and discontinuity of palliative care services often result in suboptimal palliative care. In order to overcome these problems, models using an integrated care approach are increasingly advocated in palliative care services. Although several models and definitions of Integrated Palliative Care (IPC) have been developed, the effects of integrated care are still under-investigated. Knowledge of the key components that constitute successful palliative care integration is still lacking. This mixed methods study will examine the experiences of patients, family caregivers and professional caregivers in order to provide insight into the mechanisms that constitute successful palliative care integration. Methods Prospective multiple embedded case study. Three to five integrated palliative care initiatives will be selected in Belgium, Germany, Hungary, The Netherlands and the United Kingdom. Data collection will involve Social Network Analysis (SNA), a patient diary, semi-structured interviews, and questionnaires: Palliative care Outcome Scale (POS), Canhelp Lite, Caregiver Reaction Assessment (CRA). Patients and family caregivers will be followed in 4 consecutive contact moments over 3?months. The diary will be kept weekly by patients. One focus group per initiative will be conducted with professional caregivers. Interviews and focus groups will be tape recorded, transcribed and qualitatively analysed using NVivo 10. SPSS Statistics 20 will be used for statistical analysis. Discussion This study will provide valuable knowledge about barriers, opportunities and good practices in palliative care integration in the selected initiatives across countries. This knowledge can be used in the benchmark of integrated palliative care initiatives across Europe. It will add to the scientific evidence for IPC services internationally and will contribute to improvements in the quality of care and the quality of living and dying of severely ill patients and their relatives in Europe

Accentuating patient values in shared decision-making:A mixed methods development of an online value clarification tool and communication training in the context of early phase clinical cancer trials

Objective: In the shared decision-making (SDM) process for potential early phase clinical cancer trial participation, value clarification is highly recommended. However, exploration and discussion of patient values between patients and oncologists remains limited. This study aims to develop an SDM-supportive intervention, consisting of a preparatory online value clarification tool (OnVaCT) and a communication training. Methods: The OnVaCT intervention was developed and pilot-tested by combining theoretical notions on value clarification, with interview studies with patients and oncologists, focus groups with patient representatives and oncologists, and think aloud sessions with patients, following the Medical Research Council (MRC) framework for complex interventions. These human-centered methodologies enabled a user-centered approach at every step of the development process of the intervention. Results: This study shows relevant patient values and oncologists’ perspectives on value exploration and discussion in daily practice. This has been combined with theoretical considerations into the creation of characters based on real-life experiences of patients in the OnVaCT, and how the tool is combined with a communication training for oncologists to improve SDM

Building a taxonomy of integrated palliative care initiatives:results from a focus group

Background Empirical evidence suggests that integrated palliative care (IPC) increases the quality of care for palliative patients and supports professional caregivers. Existing IPC initiatives in Europe vary in their design and are hardly comparable. InSuP-C, a European Union research project, aimed to build a taxonomy of IPC initiatives applicable across diseases, healthcare sectors and systems. Methods The taxonomy of IPC initiatives was developed in cooperation with an international and multidisciplinary focus group of 18 experts. Subsequently, a consensus meeting of 10 experts revised a preliminary taxonomy and adopted the final classification system. Results Consisting of eight categories, with two to four items each, the taxonomy covers the process and structure of IPC initiatives. If two items in at least one category apply to an initiative, a minimum level of integration is assumed to have been reached. Categories range from the type of initiative (items: pathway, model or guideline) to patients’ key contact (items: non-pc specialist, pc specialist, general practitioner). Experts recommended the inclusion of two new categories: level of care (items: primary, secondary or tertiary) indicating at which stage palliative care is integrated and primary focus of intervention describing IPC givers’ different roles (items: treating function, advising/consulting or training) in the care process. Conclusions Empirical studies are required to investigate how the taxonomy is used in practice and whether it covers the reality of patients in need of palliative care. The InSuP-C project will test this taxonomy empirically in selected initiatives using IPC