792 research outputs found
Temporal variations of bicycle demand in the Netherlands: The influence of weather on cycling
The variability in bicycle demand depends strongly on weather. This paper describes a ‘weather’ model that makes demand forecasting possible. The model is based on flow time-series of many years, collected at 16 cycle paths in the Dutch cities of Gouda and Ede. The model is bi-level. The lower level describes how cyclists value the weather. The upper level is the relation between demand and this weather value. The observations show that most cyclists value the weather in a similar way, but recreational demand is much more sensitive to weather than utilitarian demand. Most fluctuations are described by the model, but a significant fraction is still not covered. From a correlation analysis of the residuals, we conclude that about 70% of the remaining variation is locally constrained, and can therefore not be described by a generic model. However, about 30% of this variation is not driven by local effects. The cause of this variation is not yet known. Besides uncovering trends in cycling, the model can also be employed to evaluate the effect of cycling policy interventions, and to correct flow measurements as input in traffic models
De Bergsche Maasveren anno 2001. Maatschappelijke betekenis en effecten van door Rijkswaterstaat voorgestelde maatregelen
Eind negentiende eeuw is in het Noorden van de provincie Noord-Brabant ten behoeve van een betere waterafvoer de Bergsche Maas gegraven. Omdat hierdoor het Land van Heusden en Altena in tweeën werd gesplitst, heeft Rijkswaterstaat ter compensatie van de nadelen een aantal veerponten in de vaart gebracht. Later zijn ook twee bruggen aangelegd. Rijkswaterstaat (directie Noord-Brabant) wil nu in het kader van bezuinigingen de pontveren afstoten. De Vereniging De Bergse Maasveren heeft aan de Wetenschapswinkel van Wageningen UR gevraagd om een onderzoek te bemiddelen dat inzicht verschaft in de maatschappelijke betekenis van de Bergsche Maasveren en mogelijke verkeerskundige, economische, duurzaamheids- en leefbaarheidseffecten van de voorgestelde maatregelen. De Vereniging De Bergse Maasveren wil het onderzoek gebruiken om bezwaren tegen het besluit van Rijkswaterstaat te onderbouwen. Het onderzoek wordt als afstudeerstudie verricht bij de Leerstoelgroep Landgebruiksplanning van Wageningen Universiteit
Health-related quality of life and anemia in hospitalized patients with heart failure
AbstractBackgroundAnemia is a serious and highly prevalent co-morbidity in chronic heart failure (HF) patients. Its influence on health-related quality of life (HR-QoL) has rarely been studied, and no data is available regarding the role it plays in hospitalized HF patients.MethodsBaseline data from the COACH study (Coordinating study evaluating Outcomes of Advising and Counselling in Heart Failure) were used. HR-QoL was assessed by means of generic and disease-specific questionnaires. Analyses were performed using ANOVA and ANCOVA, with covariates of age, gender, eGFR, diabetes, and NYHA class.ResultsIn total, 1013 hospitalized patients with a mean age of 71 (SD 11) years were included; 70% of these patients had no anemia (n=712), 14% had mild anemia (n=141), and 16% had moderate-to-severe anemia (n=160). Independent associations were found between anemia and physical functioning (p=0.019), anemia and role limitations due to physical functioning (p=0.002), anemia and general health (p=0.024), and anemia and global well-being (p=0.003).ConclusionIn addition to the burden of HF itself, anemia is an important factor which influences HR-QoL in hospitalized HF patients, and one that is most pronounced in the domain related to physical functioning and general health
Patient and professional factors that impact the perceived likelihood and confidence of healthcare professionals to discuss Implantable Cardioverter Defibrillator deactivation in advanced heart failure: Results from an international factorial survey
Background: Rate of implantable cardioverter defibrillator (ICD) implantations is increasing in patients with advanced heart failure. Despite clear guideline recommendations, discussions addressing deactivation occur infrequently. Aim: The aim of this article is to explore patient and professional factors that impact perceived likelihood and confidence of healthcare professionals to discuss ICD deactivation. Methods and Results: Between 2015 and 2016, an international sample of 262 healthcare professionals (65% nursing, 24% medical) completed an online factorial survey, encompassing a demographic questionnaire and clinical vignettes. Each vignette had 9 randomly manipulated and embedded patient-related factors, considered as independent variables, providing 1572 unique vignettes for analysis. These factors were determined through synthesis of a systematic literature review, a retrospective case note review, and a qualitative exploratory study. Results showed that most healthcare professionals agreed that deactivation discussions should be initiated by a cardiologist (95%, n = 255) or a specialist nurse (81%, n = 215). In terms of experience, 84% of cardiologists (n = 53) but only 30% of nurses (n = 50) had previously been involved in a deactivation decision. Healthcare professionals valued patient involvement in deactivation decisions; however, only 50% (n = 130) actively involved family members. Five of 9 clinical factors were associated with an increased likelihood to discuss deactivation including advanced age, severe heart failure, presence of malignancy, receipt of multiple ICD shocks, and more than 3 hospital admissions during the previous year. Furthermore, nationality and discipline significantly influenced likelihood and confidence in decision making. Conclusions: Guidelines recommend that healthcare professionals discuss ICD deactivation; however, practice is suboptimal with multifactorial factors impacting on decision making. The role and responsibility of nurses in discussing deactivation require clarity and improvement.Funding Agencies|HFA Nurse Fellowship training grant; Public Health Agency NI (Research & Development Division)</p
Duurzame mobiliteit en vrijetijdsverkeer in het metropolitane buitengebied: paradox of realiseerbaar? Op weg naar een onderzoeksagenda
Met het verder verstedelijken van ons land vervagen de traditionele grenzen tussen stad en land. Door deze ontwikkeling naar een metropolitaan landschap wordt de open ruimte tussen grote steden, het metropolitane buitengebied, steeds belangrijker voor de stedeling als ruimte om zich te bewegen en te ontspannen. Echter, de bereikbaarheid en de aantrekkelijkheid van dit landschap staat damee onder druk. Uiteindelijk komt de stedeling (met het bereiken van deze gebieden en de benodigde infrastructuur) in conflict met zijn eigen wense
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