Best Practices for Training in Sustainable Greenhouse Horticulture

Consumer demands and current legislation require intensive greenhouse horticulture to be sustainable. This poses the challenge of how to teach the concept of sustainable horticulture to all professionals involved in farming. The province of Almeria, in the south-east of Spain, is one of the major horticulture greenhouse areas in Europe, and an expert panel of relevant stakeholders was invited to look into the best pedagogical practices and methods to transfer technology and knowledge, with the goal of improving the sustainability of greenhouse horticulture. A combination of an online questionnaire, a Delphi method, and desk research was, therefore, used as the strategy to collect the data and implement the research design during 2021. On-farm/business demonstrations, virtual education, and classroom education were common pedagogical methods used. On-farm/business demonstrations, participatory education, and co-learning were identified as the best pedagogical methods to use in sustainable agriculture/horticulture training. The expert panel also concluded that participatory education and co-learning should be further explored whereas virtual and classroom education should play a less dominant role in the training activities. This knowledge can help training organizations and designers to avoid common mistakes, tailor their training activities, and be mindful of common barriers and (mis)conceptions. © 2023 by the authors.

Impact of the COVID-19 pandemic on COPD exacerbations during inpatient pulmonary rehabilitation

A significant reduction in hospitalizations for acute exacerbations of COPD (AECOPD) is seen during the COVID-19 pandemic. It remains unclear whether this reduction is the result of avoidance of medical care by patients, or of infection prevention and control (IPC) measures. This study used a real-life inpatient pulmonary rehabilitation (PR) setting to explore the impact of COVID-19-related IPC measures on the incidence of AECOPD, thereby mitigating the potential effect of care avoidance. Patients with COPD admitted for eight weeks of inpatient PR at Ciro (Horn, the Netherlands) were included in this retrospective study. Patients admitted between October 1st 2020 and March 1st 2021, the first winter season with COVID-19-related IPC measures in place, were compared to patients admitted during the same periods in previous years (2017-2018, 2018-2019 and 2019-2020). Electronic medical records were retrospectively screened for the incidence of moderate to severe AECOPD, drop-out and mortality during the PR period. A total of 501 patients with COPD (median age 66.6 [IQR 60.3-71.9] years, 43.1% male, FEV1 35.9 [26.8-50.6] % predicted) were analyzed. During 2020-2021, 22 patients (31.0%) experienced >=1 AECOPD compared to 43 patients (33.6%) in 2019-2020, 55 patients (36.9%) in 2018-2019 and 83 patients (54.2%) in 2017-2018, p=0.077. No differences in the mean AECOPD rate, AECOPD severity, drop-out nor mortality rates were observed. This study is the first to demonstrate that COVID-19-related IPC measures do not affect the incidence of AECOPD during inpatient PR. These findings may therefore suggest that the reduction of AECOPD observed in hospital settings may be related to care avoidance.

[Long COVID: the next challenge for health care]

Long COVID is seen in a growing group of patients who experience a large number of symptoms after previous infection with SARS-CoV-2. The symptoms persist and are accompanied by impaired functioning without a sufficient pathophysiological explanation. While the condition is more commonly seen in patients who have been critically ill, predictive factors for long COVID are lacking. There are also no objective, diagnostic criteria, evidence-based interventions or scientifically based advice for the follow-up of this group. Recent research shows that most symptoms and limitations diminish over time, but also that there is a small group with permanent physical, psychological and/or cognitive problems. This article describes the current definition, epidemiology, and symptoms of long COVID. The functional and structural abnormalities and additional health risks are also discussed. Finally, it mentions a number of challenges that will have to be addressed to prevent this condition from having adverse consequences not only for individual patients but also casting a large shadow on health care and economic recovery.

Identifying the Effects of COVID-19 on Psychological Well-Being Through Unsupervised Clustering for Mixed Data

The COVID-19 pandemic has a strong worldwide impact on not only the health and economic sectors but also the (socio-)psychological functioning of individuals. Since psychological health is an important protective factor to prevent diseases, it is crucial to identify individuals with increased vulnerability during the crisis. 275 adults participated in a German online survey from April until August 2020 which investigated health-related, social, behavioral, and psychological effects of the COVID-19 pandemic. We here introduce an unsupervised clustering approach suitable for mixed data types combining the Gower distance with the Partitioning Around Medoids (PAM) algorithm k-Medoids. We were able to identify three clusters differing significantly in subjects’ well-being, psychological distress, and current financial and occupational concerns. The clusters also differed in age with younger persons reporting greater financial and occupational concerns, increased anxiety, higher psychological distress, and reduced subjective well-being. Features with the strongest impact on the clustering were examined using a wrapping method and the feature importance implemented in the random forest. Particularly, answers regarding financial and occupational concern, psychological distress, and current well-being were decisive for the assignment to a cluster. In summation, the clustering approach can identify persons with weakened psychological protective factors allowing them to provide tailored recommendations for preventive actions based on the cluster affiliation, e.g., via a web application. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

WIBCE – A Web Application Helping People to Reflect Their Infection Risk and Psychological Well-Being and Act Accordingly During the COVID-19 Pandemic

During COVID-19, there has been a need to gather reliable empirical data on the consequences for behavior and psychological well-being in society as well as to inform and educate individuals comprehensively. The WIBCE online survey tool offers the possibility to (1) inform, reflect, and empower participants to be more self-aware regarding psychological, medical, and behavioral factors, and (2) aggregate anonymously shared data to statistically analyze the impact of COVID-19. Thereby, it allows a one-time but also longitudinal (i.e., on a regular basis) participation. Analyzing the collected survey data from April to August 2020, we found two subgroups that differ fundamentally in terms of mental health and psychological well-being. These differences were present not only at one time point but could also be traced longitudinally. The knowledge of the cluster affiliation allows to provide participants specific, personalized feedback as well as individual recommendations. © 2021, The Author(s), under exclusive license to Springer Nature Switzerland AG.

[The nurse's role in the process of advance care planning]. / De rol van de verzorgende en verpleegkundige in het advance care planning proces.

The COVID-19 pandemic and its impact on older and frail people underlines the importance of advance care planning (ACP). ACP is a dynamic communication process involving patients, families and healthcare providers, which serves to discuss and document wishes and goals for future care. Currently, ACP practice is often suboptimal. This implies that important decisions about care and treatment may need to be made acutely in crises. Many factors contribute to suboptimal ACP practice. One such factor is ambiguity regarding roles and responsibilities of different disciplines in the ACP-process. The perception that having ACP conversations is primarily a physician's task is a misconception. Specific skills that could contribute to a holistic and person-centered ACP-process are largely lacking in nursing curricula and therefore, may be insufficient and under-utilized. For instance, nursing staff could involve persons in conversations about meaning, quality of life, loss and grief as a part of ACP. Moreover, they may communicate a patient's wishes to other healthcare providers including physicians. Acknowledgement of this potential role, by physicians as well as by nursing staff themselves, is needed for ACP to become a truly interprofessional process.