Tweede leven voor Amsterdam Arena stadionstoelen: onderzoek circulair ontwerpen HvA (deel 1)

Het urban technology onderzoeksprogramma van de hogeschool van Amsterdam (HvA) doet onderzoek voor de omschakeling naar een circulaire stad. Een van de factoren die hierbij een rol spelen is hoe producten circulair ontworpen kunnen worden

Daily practice performance (Work-as-Done) compared to guidelines (Work-as-Imagined) of medication reconciliation at discharge: Outcomes of a FRAM study

Objectives: Performing medication reconciliation (MR) is an important safety initiative. However, its implementation is complex. We used the Functional Resonance Analysis Method (FRAM) to gain more understanding of healthcare professionals’ low compliance with the standards for MR by comparing Dutch guidelines and hospital protocols (Work-as-Imagined/WAI) with daily clinical practice (Work-as-Done/WAD). Methods: Nine cardiology and orthopaedics wards participated in this study. We applied the FRAM to construct several models to visualise MR at the point of discharge. WAI models were based on national guidelines and hospital protocols. Data to construct the WAD models were collected through semi-structured interviews with the healthcare professionals involved. Results: Sixty-three healthcare professionals were interviewed. These occasionally had to adjust their work in order to manage a lack of time or resources, resulting in variation in healthcare professionals’ performance. This had an impact upon the flow of the reconciliation process due to the interdependency of all the healthcare professionals involved. Conclusion: Collaboration between healthcare professionals is essential to ensure complete reconciliation for discharged patients. We identified a distinction between daily practice and both the guidelines and protocols followed. Future research should indicate the impact of specific variations in practice, and deviations from the protocols on medication safety, during reconciliation

Patient participation during discharge medication counselling: Observing real-life communication between healthcare professionals and patients

Objectives: Previous studies on hospital discharge showed limited patient involvement, despite its positive outcomes. In this study, provider-patient communication used to enhance patient participation during discharge medication counselling was examined. Methods: This study comprises a qualitative descriptive observational study. Thirty-four discharge consultations were observed, audio recorded and analysed. We conducted a deductive analysis, elaborating on findings from earlier research. We selected themes and underlying codes illustrating professional-patient communication. For every theme, we identified examples to demonstrate its manifestation during discharge medication counselling. We also assessed what information healthcare professionals (HCPs) shared. Results: HCPs used cues to increase patient participation, e.g. inquired about patient's preferences, showed empathy and support, and verified understanding of information shared. Patient participation occurred through asking questions, and expressing concerns. A central component in discharge medication counselling was the transmission of information from HCPs to patients. This resulted in HCPs taking a leading role. Conclusions: Several HCP cues were detected inviting patients to participate in consultations. Some patients participated in discharge medication counselling. This was influenced by timing of discharge consults, the performing HCP and presence of a relative. Practice implications: HCPs shared a lot of information with patients. However, this does not automatically mean that patients will be able to understand and apply this information. HCPs should understand the importance of using cues to enable patient participation. One example is using the teach-back method for verifying patient understanding. It may also be desirable to ensure that a relative is present when discharge information is offered

The second life of a stadium seat: Amsterdam Arena: A case study for reuse and recycling of discarded stadium seats

Confronted by more and more global sustainabilityrelated challenges, society is increasingly aiming for a circular economy. Wouldn’t it be ideal if we could contribute to an economic model with closed loops, where products and materials that are at the end of their functional life are reused in new products and systems? As the Netherlands aims to have a fully circular economy (i.e., zero net waste) by 2050, circularity is also a critical theme for the Amsterdam Metropolitan Area. ‘Circular City’ is one of the main urban challenges of the Urban Technology research programme of the Amsterdam University of Applied Sciences (AUAS). Its chair of Circular Design & Business and its research group on Digital Production collaborate with companies, lecturers and students on a range of applied research projects in order to advance the knowledge around circular design and business model strategies making use of digital production to encourage the local reuse of discarded urban materials. Amsterdam ArenA, home base of the Ajax football team and a major concert and events venue, is replacing all stadium seats in the run-up to the European Football Championship in 2020 (UEFA Euro 2020), and wishes to do so in a socially responsible manner. With that purpose, Amsterdam ArenA engaged the expertise of the Urban Technology research programme at the AUAS to study the viability reusing the old seats in a circular manner. The research started from the assumption that these discarded seats not only form a large and relatively homogeneous waste stream, but also have an emotional value that can potentially raise their economic value, beyond that of the material alone. For the AUAS this was an important case study, because the Amsterdam ArenA aspires to be a stage for sustainable innovations, reduce its environmental impact and stimulate the local economy. This project could serve as an example for other stadiums and public buildings with substantial waste streams on how to handle discarded products, and rethink how they can prevent waste in the future. With this mission, the AUAS lined up a team of experts on circular design, digital production, business modelling and impact studies to carry out a comprehensive multi-disciplinary study

“Once my front door – now my coffee table”; Advanced computational design and robotic production with waste wood

Growing volumes of wood are being used in construction, interior architecture, and product design, resulting in increasing amounts of wood waste. Using this waste is challenging, because it is too labor-intensive to process large volumes of uneven wood pieces that vary in geometry, quality, and origin. The project “Circular Wood for the Neighborhood” researches how advanced computational design and robotic production approaches can be used to create meaningful applications from waste wood. shifting the perception of circular wood as a simply harvested stream, towards a material with unique aesthetics of its own right. The complexity of the material is suggested to be tackled by switching from the object-oriented design towards designing soft systems. The system developed uses a bottom-up approach where each piece of wood aggregates according to certain parameters and the designed medium is mainly rule-sets and connections. The system is able to produce many options and bring the end-user for a meaningful co-design instead of choosing from the pre-designed options. Material-driven design algorithms were developed, which can be used by designers and end-users to design bespoke products from waste wood. In the first of three case studies, a small furniture item (“coffee table”) was designed from an old door, harvested from a renovation project. For its production, two principle approaches were developed: with or without preprocessing the wood. The principles were tested with an industrial robotic arm and available waste wood. A first prototype was made using the generated aggregation from the system, parametric production processes and robotic fabrication

Implementation of barcode medication administration (BMCA) technology on infusion pumps in the operating rooms

Background Medication administration errors (MAEs) are a major cause of morbidity and mortality. An updated barcode medication administration (BCMA) technology on infusion pumps is implemented in the operating rooms to automate double check at a syringe exchange.Objective The aim of this mixed-methods before-and-after study is to understand the medication administrating process and assess the compliance with double check before and after implementation.Methods Reported MAEs from 2019 to October 2021 were analysed and categorised to the three moments of medication administration: (1) bolus induction, (2) infusion pump start-up and (3) changing an empty syringe. Interviews were conducted to understand the medication administration process with functional resonance analysis method (FRAM). Double check was observed in the operating rooms before and after implementation. MAEs up to December 2022 were used for a run chart.Results Analysis of MAEs showed that 70.9% occurred when changing an empty syringe. 90.0% of MAEs were deemed to be preventable with the use of the new BCMA technology. The FRAM model showed the extent of variation to double check by coworker or BCMA.Observations showed that the double check for pump start-up changed from 70.2% to 78.7% postimplementation (p=0.41). The BCMA double check contribution for pump start-up increased from 15.3% to 45.8% (p=0.0013). The double check for changing an empty syringe increased from 14.3% to 85.0% (p<0.0001) postimplementation. BCMA technology was new for changing an empty syringe and was used in 63.5% of administrations. MAEs for moments 2 and 3 were significantly reduced (p=0.0075) after implementation in the operating rooms and ICU.Conclusion An updated BCMA technology contributes to a higher double check compliance and MAE reduction, especially when changing an empty syringe. BCMA technology has the potential to decrease MAEs if adherence is high enough

Unlocking Synergy in Bimetallic Catalysts by Core-Shell Design

Extending the toolbox from mono- to bimetallic catalysts is key in realizing efficient chemical processes. Traditionally, the performance of bimetallic catalysts featuring one active and one selective metal is optimized by varying the metal composition, often resulting in a compromise between the catalytic properties of the two metals. Here we show that by designing the atomic distribution of bimetallic Au-Pd nanocatalysts, we obtain a synergistic catalytic performance in the industrially relevant selective hydrogenation of butadiene. Our single crystalline Au-core Pd-shell nanorods were up to 50 times more active than their alloyed and monometallic counterparts, while retaining high selectivity. We find a shell thickness dependent catalytic activity, indicating that not only the nature of the surface but also several sub-surface layers play a crucial role in the catalytic performance, and rationalize this finding using density-functional-theory calculations. Our results open up a novel avenue for the structural design of bimetallic catalysts.</div

Allergen labelling: Current practice and improvement from a communication perspective

Background Allergen information on product labels is crucial in food allergy management, though inadequacy in current labelling practices is one of the major causes for accidental reactions upon consuming prepacked food products. Objective This study analyses current status of communicating allergen information on food labels and provides practical recommendations for improving the label format based on communication theory. Methods Product labels (N 288) of seven food categories from private label products and brands were obtained at three retailers in the Netherlands. Information regarding the 14 EU‐regulated allergens was evaluated by the frequency of emphasizing allergens in the ingredient list, use of precautionary allergen labelling (PAL), icons and an allergen information section. Effectiveness of communication was assessed evaluating readability and findability of information on allergens using principles of Gestalt and Cognitive Load theories. Results As requested by EU regulation 1169/2011, emphasizing allergens in the ingredient list was almost 100%, all other presentations of information on allergens on labels was highly diverse. A separate allergen information section was present on most private label products. This section could, but not necessarily did, repeat allergens from the ingredient list and/or give a PAL. Brands often provided a PAL at the end of the ingredient list. Part of the products displayed an icon at different locations of the label. Label background, a lack of cohesion and variation in location of topics hamper the identification of relevant information on allergens by (allergic) consumers. Recommendations include a standardized order for mandatory and voluntary topics on the label and a separate allergen information section. Conclusion and clinical relevance Overall, consumers encounter a wide and inconsistent range in ways of presentation of allergen information on labels. Standardization according to basic design principles can improve usability and support safe food purchases for allergic consumers

Unlocking synergy in bimetallic catalysts by core–shell design

Extending the toolbox from mono- to bimetallic catalysts is key in realizing efficient chemical processes1. Traditionally, the performance of bimetallic catalysts featuring one active and one selective metal is optimized by varying the metal composition1–3, often resulting in a compromise between the catalytic properties of the two metals4–6. Here we show that by designing the atomic distribution of bimetallic Au–Pd nanocatalysts, we obtain a synergistic catalytic performance in the industrially relevant selective hydrogenation of butadiene. Our single-crystalline Au-core Pd-shell nanorods were up to 50 times more active than their alloyed and monometallic counterparts, while retaining high selectivity. We find a shell-thickness-dependent catalytic activity, indicating that not only the nature of the surface but also several subsurface layers play a crucial role in the catalytic performance, and rationalize this finding using density functional theory calculations. Our results open up an alternative avenue for the structural design of bimetallic catalysts