Background: Goal setting is an essential step in the clinical reasoning process of speech and language therapists (SLTs) who provide care for children, adolescents and adults with communication disorders. In the light of person-centred care, shared or collaborative goal setting between the SLT and client is advised in (inter)national guidelines. SLTs face challenges in implementing (shared) goal setting as theoretical frameworks and practical interventions are scarce and less applicable to use with a wide range of communication vulnerable populations. Aims: A first step in developing theory and practical interventions is to explore first-hand experiences of SLTs and clients about day-to-day goal-setting practice. This study was guided by the following research question:What are the perspectives and needs of SLTs and persons with communication disorders regarding (shared) goal setting in routine SLT services? Methods & Procedures: The qualitative study was carried out in the setting of routine speech–language therapy services in community practices, primary education and neurological rehabilitation in the Netherlands. Data collection followed the principles of video-reflexive ethnography, using video footage of goal-setting conversations to facilitate semi-structured, reflexive interviews.Data analysis was based on reflexive thematic analysis. A total of 12 interviews were conducted with client–SLT dyads, covering perspectives from children, parents and adults with a range of communication difficulties and their SLTs. Outcomes & Results: Data analysis resulted in four themes, of which two contain subthemes. Each theme represents a central organizing concept found in SLT and client interviews. The themes were identified as: (1) goal setting is a complex process; (2) goal talk needs to be communication accessible; (3) communicative participation goals are hard to grasp; and (4) the importance of relationships. Topics such as power imbalance, communication vulnerability, effective communication strategies, and motivation and trust are explored under these themes. Conclusions & Implications: SLTs are encouraged to view shared goal setting as a process that needs to be explicitly planned and communicated with clients regardless of their age or communication vulnerability. SLTs have expert knowledge and skills when it comes to supporting communication and applying these skills during goal talks might strengthen shared goal setting and foster a therapeutic relationship. There is a need to concretely conceptualize and embed shared goal setting in policy and clinical guidelines. The themes reported have tentative clinical implications for developing such policy, and shared goal-setting interventions for SLT practice, under the condition that SLTs and people with communication disorders are continuously involved.
MULTIFILE
Frailty is the most common manifestation of serious health issues in the world, and it is becoming more prevalent worldwide as the aging population grows. Changes that occur in an individual during the aging process have physical, psychological, social, and environmental aspects that make an individual more frail. In China, older people may live in communities for aging individuals. This study aimed to describe the presence and severity of frailty and to analyze influencing factors among this population in China. The Frailty Index 35 (FI-35) scale, which includes 35 items in physical, psychological, social, and environmental domains, was used to investigate frailty. The FI-35 score ranges from zero to one, with a score closer to one indicating greater frailty. Biographical, socioeconomic, and lifestyle factors were measured as potential determinants of frailty. We relied on the November 2017-February 2018 waves of the Chinese cross-sectional study survey that comprised a sample of 513 adults, aged 60 or older, who were living in China. Linear regression was performed to identify factors associated with FI-35 scores. We categorized the determinants of frailty into three models: Model 1: biographical variables; Model 2: biographical and socioeconomic variables; and Model 3: biographical, economic, and lifestyle variables. Frailty scores ranged from 0.00 to 0.89, with a median of 0.31, and the prevalence of frailty was 67.6%. The final model obtained after variable selection included age, minority status, marriage status, income, diet, and exercise. The adjusted R-squared indicated that the analysis explained 13.8% of the variance in frailty scores. Adding household, marriage status, education level, medical insurance, and income as elements in Model 2 explained 25.7%. Adding diet, smoking, drinking, exercise, and hobbies in Model 3 explained 27.9%. The degree of frailty varies considerably among Chinese community-dwelling older people and is partly determined by biographical, socioeconomic, and lifestyle factors.
Proefschrift van drs. Jeroen Gradener naar de legitimiteit van community development (opbouwwerk). Niet vanzelf krijgen opbouwwerkers een mandaat van bewoners om hen te ondersteunen in het verbeteren van hun eigen leven en hun leefomgeving. Hoe deze opbouwwerkers erin slagen om ondanks weerstanden hun legitimiteit als professional te ontwikkelen is onderwerp van het internationaal vergelijkend promotieonderzoek.
In order to achieve much-needed transitions in energy and health, systemic changes are required that are firmly based on the principles of regard for others and community values, while at the same time operating in market conditions. Social entrepreneurship and community entrepreneurship (SCE) hold the promise to catalyze such transitions, as they combine bottom-up social initiatives with a focus on financially viable business models. SCE requires a facilitating ecosystem in order to be able to fully realize its potential. As yet it is unclear in which way the entrepreneurial ecosystem for social and community entrepreneurship facilitates or hinders the flourishing and scaling of such entrepreneurship. It is also unclear how exactly entrepreneurs and stakeholders influence their ecosystem to become more facilitative. This research programme addresses these questions. Conceptually it integrates entrepreneurial ecosystem frameworks with upcoming theories on civic wealth creation, collaborative governance, participative learning and collective action frameworks.This multidisciplinary research project capitalizes on a unique consortium: the Dutch City Deal ‘Impact Ondernemen’. In this collaborative research, we enhance and expand current data collection efforts and adopt a living-lab setting centered on nine local and regional cases for collaborative learning through experimenting with innovative financial and business models. We develop meaningful, participatory design and evaluation methods and state-of-the-art digital tools to increase the effectiveness of impact measurement and management. Educational modules for professionals are developed to boost the abovementioned transition. The project’s learnings on mechanisms and processes can easily be adapted and translated to a broad range of impact areas.
In the past decades, we have faced an increase in the digitization, digitalization, and digital transformation of our work and daily life. Breakthroughs of digital technologies in fields such as artificial intelligence, telecommunications, and data science bring solutions for large societal questions but also pose a new challenge: how to equip our (future)workforce with the necessary digital skills, knowledge, and mindset to respond to and drive digital transformation?Developing and supporting our human capital is paramount and failure to do so may leave us behind on individual (digital divide), organizational (economic disadvantages), and societal level (failure in addressing grand societal challenges). Digital transformation necessitates continuous learning approaches and scaffolding of interdisciplinary collaboration and innovation practices that match complex real-world problems. Research and industry have advocated for setting up learning communities as a space in which (future) professionals of different backgrounds can work, learn, and innovate together. However, insights into how and under which circumstances learning communities contribute to accelerated learning and innovation for digital transformation are lacking. In this project, we will study 13 existing and developing learning communities that work on challenges related to digital transformation to understand their working mechanisms. We will develop a wide variety of methods and tools to support learning communities and integrate these in a Learning Communities Incubator. These insights, methods and tools will result in more effective learning communities that will eventually (a) increase the potential of human capital to innovate and (b) accelerate the innovation for digital transformation
Single-Use Plastics (SUPs) are at the centre of European Union Agenda aiming at reducing the plastic soup with the EU Directive 2019/904. SUPs reduction is pivotal also in the Dutch Government Agenda for the transition to a Circular Economy by 2050. Worldwide the data on SUPs use and disposal are impressive: humans use around 1.2 million plastic bottles per minute; approximately 91% of plastic is not recycled (www.earthday.org/fact-sheet-single-use-plastics/). While centralised processes of waste collection, disposal, and recycling strive to cope with such intense use of SUPs, the opportunities and constraints of establishing a networked grid of facilities enacting processes of SUPs collection and recycling with the active involvement of local community has remained unexplored. The hospitality sector is characterised by a widespread capillary network of small hospitality firms nested in neighbourhoods and rural communities. Our research group works with small hospitality firms, different stakeholders, and other research groups to prompt the transition of the hospitality sector towards a Circular Economy embracing not only the environmental and economic dimensions but also the social dimension. Hence, this project explores the knowledge and network needed to build an innovative pilot allowing to close the plastic loop within a hospitality facility by combining a 3D printing process with social inclusiveness. This will mean generating key technical and legal knowledge as well as a network of strategic experts and stakeholders to be involved in an innovative pilot setting a 3D printing process in a hospitality facility and establishing an active involvement of the local community. Such active involvement of the local inhabitants will be explored as SUPs collectors and end-users of upcycled plastics items realised with the 3D printer, as well as through opportunities of vocational training and job opportunities for citizens distant from the job market.
