This study focuses on teachers’ group decision making during Dutch allocation meetings. A previous interview study showed that teachers question the objectivity of decisions due to negative interaction experiences and a lack of structure during these meetings. To characterize the structure and interaction of these meetings, 33 student allocations were observed. Results showed a variety of structures and interactions, including differences in the degree to which the meetings met criteria relevant to achieving objective allocation decisions. It can be concluded that – based on the criteria of acceptance, fairness, and transparency as used in this study – allocation meetings need to be well-prepared and substantiated, to allow for every teacher’s opinion to be heard, and follow a procedure that is clear to everyone. In view of students’ future school careers, it is important to pay close attention to functional interaction and structured discussions that ensure transparent, acceptable and fair decision-making.
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In the decision-making environment of evidence-based practice, the following three sources of information must be integrated: research evidence of the intervention, clinical expertise, and the patient’s values. In reality, evidence-based practice usually focuses on research evidence (which may be translated into clinical practice guidelines) and clinical expertise without considering the individual patient’s values. The shared decision-making model seems to be helpful in the integration of the individual patient’s values in evidence-based practice. We aim to discuss the relevance of shared decision making in chronic care and to suggest how it can be integrated with evidence-based practice in nursing. We start by describing the following three possible approaches to guide the decision-making process: the paternalistic approach, the informed approach, and the shared decision-making approach. Implementation of shared decision making has gained considerable interest in cases lacking a strong best-treatment recommendation, and when the available treatment options are equivalent to some extent. We discuss that in chronic care it is important to always invite the patient to participate in the decision-making process. We delineate the following six attributes of health care interventions in chronic care that influence the degree of shared decision making: the level of research evidence, the number of available intervention options, the burden of side effects, the impact on lifestyle, the patient group values, and the impact on resources. Furthermore, the patient’s willingness to participate in shared decision making, the clinical expertise of the nurse, and the context in which the decision making takes place affect the shared decision-making process. A knowledgeable and skilled nurse with a positive attitude towards shared decision making – integrated with evidence-based practice – can facilitate the shared decision-making process. We conclude that nurses as well as other health care professionals in chronic care should integrate shared decision making with evidence- based practice to deliver patient-centred care.
Background: Patient decision aids (PDAs) can support the treatment decision making process and empower patients to take a proactive role in their treatment pathway while using a shared decision-making (SDM) approach making participatory medicine possible. The aim of this study was to develop a PDA for prostate cancer that is accurate and user-friendly. Methods: We followed a user-centered design process consisting of five rounds of semi-structured interviews and usability surveys with topics such as informational/decisional needs of users and requirements for PDAs. Our userbase consisted of 8 urologists, 4 radiation oncologists, 2 oncology nurses, 8 general practitioners, 19 former prostate cancer patients, 4 usability experts and 11 healthy volunteers. Results: Informational needs for patients centered on three key factors: treatment experience, post-treatment quality of life, and the impact of side effects. Patients and clinicians valued a PDA that presents balanced information on these factors through simple understandable language and visual aids. Usability questionnaires revealed that patients were more satisfied overall with the PDA than clinicians; however, both groups had concerns that the PDA might lengthen consultation times (42 and 41%, respectively). The PDA is accessible on http://beslissamen.nl/. Conclusions: User-centered design provided valuable insights into PDA requirements but challenges in integrating diverse perspectives as clinicians focus on clinical outcomes while patients also consider quality of life. Nevertheless, it is crucial to involve a broad base of clinical users in order to better understand the decision-making process and to develop a PDA that is accurate, usable, and acceptable.
The impacts of tourism on destinations and the perceptions of local communities have been a major concern both for the industry and research in the past decades. However, tourism planning has been mainly focused on traditions that promote the increase of tourism without taking under consideration the wellbeing of both residents and visitors. To develop a more sustainable tourism model, the inclusion of local residents in tourism decision-making is vital. However, this is not always possible due to structural, economic and socio-cultural restrictions that residents face resulting to their disempowerment. This study aims to explore and interpret the formal processes around tourism decision-making and community empowerment in urban settings. The research proposes a comparative study of three urban destinations in Europe (The Hague in the Netherlands, San Sebastian in Spain and, Ioannina in Greece) that experience similar degree of tourism growth. The proposed study will use a design-based approach in order to understand tourism decision-making and what empowers or disempowers community participation within the destinations. Based on the findings of primary and secondary data, a community empowerment model will be applied in one the destinations as a pilot for resident engagement in tourism planning. The evaluation of the pilot will allow for an optimized model to be created with implications for tourism planning at a local level that can contribute to sustainable destinations that safeguard the interests of local residents and tourists.
The purpose of this project was to create a roadmap with selected mechanisms to assist destination management organisations to optimize the benefits generated by tourism for their destination communities and ensure that it is shared equitably. By providing tools to identify and address inequality in terms of access to the benefits and value tourism generates, it is envisaged that a more equitable tourism model can be implemented leading to the fair distribution of benefits in destination communities, potentially increasing the value for previously excluded or underserved groups. To produce the roadmap, the study team will explore the range of challenges that hinder the equitable distribution of tourism-induced benefits in destinations as well as the enabling factors that influence the extent to which this is achieved. The central question the research team has set out to answer is the following: What does an equitable tourism model look like for destination communities?Societal issueHowever, while those directly involved in tourism will gain the most, the burden of hosting visitors is widely felt by local communities. This imbalance has, unsurprisingly, sparked civil mobilisations and protests in destinations around the world. It’s clear that placemaking and benefit-sharing must be part of the future of destination management to maintain public support. This project addressed issues around equity (environmental, economic, spatial, cultural and tourism experience). In line with the intentions set out in the CELTH Agenda Conscious Destinations.Benefit to societyBased on 25 case studies around 40 mechanisms were identified that can grow or better distribute the value from tourism, so that more people in destination communities benefit. These mechanisms are real-world practices already in use. DMOs and NTOs can consider introducing the mechanisms that best fit their destination context, pulling levers such as: taxes and revenue sharing, business incubation and training, licencing and zoning, community enterprises and volunteering, and product development..This report also outlines a pathway to an Equity-Driven Management (EDM) approach, which is grounded in participatory decision-making principles and aims to create a more equitable tourism system by strengthening the hand of destination governance and retaining control of local resources.Collaborative partnersNBTC, the Travel Foundation, Destination Think, CELTH, ETFI, HZ.
There's a growing recognition that the mainstream economic system contributes to environmental degradation and climate change. This jeopardizes human prosperity and poses existential risks for all life forms. Not waiting for global politics to solve the problems, Regenerative Placemakers show that we can organize ourselves differently. They engage with realigning human systems to work within planetary boundaries as a well-being economy. However, they face challenges, such as incorporating non-human voices and embracing the complexity of co-creation. Our transdisciplinary, exploratory research project aims to incorporate a lifecentric worldview in the collective transformation process when investigating: What tools, methods, and approaches the Stewards of Place could use to embody the ecosystems thinking and be able to integrate the needs and perspectives of nature in a process of decision-making, such that it is understandable and fitting for different types of contexts? Our research focuses on fostering a post-anthropocentric outlook, where human identity merges with broader ecosystems. Through the development of methodologies, we seek pathways to coexist harmoniously within diverse natural habitats, prioritizing ecosystem health. This perspective fundamentally shifts worldviews, placing ecosystem well-being at the forefront. Our goal is to cultivate an integrated approach to living that acknowledges and respects the interconnectedness of all life forms. Consortium Partners: Practice Partners are Regenerative Placemakers, referred to as Stewards of Place: Impact033's, IMPACT024's, and Oosterhout SDG's Local. Together with WEAllNL, they are optimizing conditions for innovative, regenerative leadership in the "Plekathon” pilot project, which will serve as a Living Lab for this participatory research. Changemaker: Stichting Wellbeing Economy Alliance Nederland (WEAllNL)- Bas Poppel leading development of a learning community of practice. Knowledge Partners: Avans’ Economy in Common Research Group: Lector Dr. Godelieve Spaas and researcher Ewelina Schraven, Miranda van Gendt (Plekmakers_), Luea Ritter (World Ethic Forum), and Nature as an Advisor, Inspiration, and Stakeholder.
