Background Differing perspectives of self-harm may result in a struggle between patients and treatment staff. As a consequence, both sides have difficulty communicating effectively about the underlying problems and feelings surrounding self-harm. Between 2009 and 2011, a programme was developed and implemented to train mental health care staff (nurses, social workers, psychologists, psychiatrists, and occupational therapists) in how to communicate effectively with and care for patients who self-harm. An art exhibition focusing on self-harm supported the programme. Lay experts in self-harm, i.e. people who currently harm themselves, or who have harmed themselves in the past and have the skills to disseminate their knowledge and experience, played an important role throughout the programme. Methods Paired sample t-tests were conducted to measure the effects of the training programme using the Attitude Towards Deliberate Self-Harm Questionnaire, the Self-Perceived Efficacy in Dealing with Self-Harm Questionnaire, and the Patient Contact Questionnaire. Effect sizes were calculated using r. Participants evaluated the training programme with the help of a survey. The questionnaires used in the survey were analysed descriptively. Results Of the 281 persons who followed the training programme, 178 completed the questionnaires. The results show a significant increase in the total scores of the three questionnaires, with large to moderate effect sizes. Respondents were positive about the training, especially about the role of the lay expert. Conclusion A specialised training programme in how to care for patients who self-harm can result in a more positive attitude towards self-harm patients, an improved self-efficacy in caring for patients who self-harm, and a greater closeness with the patients. The deployment of lay experts is essential here
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Purpose: This study analyses how weather shocks influence agricultural entrepreneurs’ risk perception and how they manage these risks. It explores what risks agricultural entrepreneurs perceive as important, and how they face climate change and related weather shock risks compared to the multiple risks of the enterprise. Design/methodology: This paper uses qualitative data from several sources: eight semi-structured interviews with experts in agriculture, three focus groups with experts and entrepreneurs, and 32 semi-structured interviews with agricultural entrepreneurs. Findings: not published yet Originality and value: This study contributes to the literature about risk management by small- and medium-sized agricultural enterprises: it studies factors that shape perceptions about weather shocks and about climate change and how these perceptions affect actions to manage related risks, and it identifies factors that motivate agricultural entrepreneurs to adapt to climate change and changing weather shock risks. Practical implications can lay the foundation for concrete actions and policies to improve the resilience and sustainability of the sector, by adjusting risk management strategies, collaboration, knowledge sharing, and climate adaptation policy support.
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Functional Magnetic Resonance Imaging (fMRI) was used to study the cerebral underpinning of resonance behavior in professional keyboard musicians (n=12). The activation paradigm implied that subjects listened to two-part polyphonic music, while either critically appraising the performance or imagining they were performing themselves. Two-voice audition and bimanual motor imagery circumvented a hemisphere bias associated with a main melody.Both tasks activated ventral premotor and auditory cortices, bilaterally, and the anterior parietal cortex right-dominantly, compared to 12 musically unskilled controls. Although left ventral premotor activation was increased during imagery (compared to judgment), bilateral dorsal premotor and right posterior-superior parietal activations were quite unique to motor imagery, suggesting that musicians not only recruited their manual motor repertoire but alsoperformed a spatial transformation from the vertical perceived pitch axis to the horizontal keyboard. Imagery-specific activations in controls comprised left dorsal parietal-premotor and supplementary motor cortices. Although these activations were less strong compared to musicians, this overlapping distribution indicated the recruitment of a general 'mirror-neuron'circuitry. These two levels of sensori-motor transformations point towards common principles by which the brain organizes audition-driven music performance and visually guided task performance.
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The role of expert knowledge of the environment in decision-making about urban development has been intensively debated, largely in terms of a so-called ‘science-policy gap’. Most contributions to this debate have studied the use of knowledge in the decision-making process from the knowledge providers’ point of view. In this paper, we reverse the perspective and try to unearth how decision-makers use scientific knowledge in decision-making about an urban plan. We confronted municipal administrators, responsible for local urban development, with conceptions of the use of knowledge that were derived from the literature on this issue. From the reactions obtained, we conclude that, in the context of urban redevelopment, local administrators hardly perceive a barrier between themselves as decision-makers and experts – both environmental scientists and urban designers. They do, however, acknowledge that experts and decision-makers have distinct roles: unlike experts, local administrators have to balance all interests relevant to an urban plan. It is argued, therefore, that experts should engage in providing better decision frameworks rather than more or better knowledge.
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Video games have the potential to educate and engage people—especially young people—in climate change and energy issues by facilitating the development of helpful thoughts, feelings, and actions. The objective of the present article is to propose a set of game attributes that could maximise the cognitive, emotional, and behavioural engagement of players, and lay the foundations for future work. We have used semi-structured interviews with experts to identify a set of game attributes and a group discussion with teenagers to validate them. By applying grounded theory in our analysis of the experts’ responses, we have developed a framework for climate change engagement through serious games. It consists of 15 key attributes that we have classified in three dimensions: cognitive, emotional, and behavioural. Literature review drawn on sources in social psychology, communication and education has contributed to further explain and justify the inclusion of each of the attributes.
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The purpose of this paper is to lay the groundwork for a large-scale prescriptive research project on organizing intergenerational communities of practice as a way to help organizations deal with some of the problems an ageing worker population brings with it. After a definition of the problem, a review of four seminal works on communities of practice was done to see if organizing intergenerational communities of practice might in fact be a viable solution to the problems of an ageing organizational population. Results are encouraging and lead to the conclusion that management might start to consider organizing these communities as a way to shed new light on older workers.
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Small and Medium Enterprises (SME) comprise 99% of the European-economy, though, most research and implementation methods concerning Business Process Management Systems (BPMS) focus on large enterprises. We create a BPMS implementation method that is suitable for SMEs. Based on three existing BPMS implementation methods and by incorporating differentiators of SMEs and large enterprises a BPMS implementation method is constructed. The constructed method is validated through a series of interviews with BPMS implementation experts. Experts agree with the constructed method though discussion arise on a more detailed level of activities in the method.
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Introduction: The implementation of oncology care pathways that standardize organizational procedures has improved cancer care in recent years. However, the involvement of “authentic” patients and caregivers in quality improvement of these predetermined pathways is in its infancy, especially the scholarly reflection on this process. We, therefore, aim to explore the multidisciplinary challenges both in practice, when cancer patients, their caregivers, and a multidisciplinary team of professionals work together on quality improvement, as well as in our research team, in which a social scientist, health care professionals, health care researchers, and experience experts design a research project together. Methods and design: Experience-based co-design will be used to involve cancer patients and their caregivers in a qualitative research design. In-depth open discovery interviews with 12 colorectal cancer patients, 12 breast cancer patients, and seven patients with cancer-associated thrombosis and their caregivers, and focus group discussions with professionals from various disciplines will be conducted. During the subsequent prioritization events and various co-design quality improvement meetings, observational field notes will be made on the multidisciplinary challenges these participants face in the process of co-design, and evaluation interviews will be done afterwards. Similar data will be collected during the monthly meetings of our multidisciplinary research team. The data will be analyzed according to the constant comparative method. Discussion: This study may facilitate quality improvement programs in oncologic care pathways, by increasing our real-world knowledge about the challenges of involving “experience experts” together with a team of multidisciplinary professionals in the implementation process of quality improvement. Such co-creation might be challenging due to the traditional paternalistic relationship, actual disease-/treatment-related constraints, and a lack of shared language and culture between patients, caregivers, and professionals and between professionals from various disciplines. These challenges have to be met in order to establish equality, respect, team spirit, and eventual meaningful participation.
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The benefits of collaborative purchasing are many, yet in the healthcare sector, in particular at hospitals, it is still uncommon. In this paper we identify major impediments for collaborative purchasing, resulting in a first component of our proposed collaborative e-purchasing model for hospitals; as a second component it contains a collaborative purchasing typology. After analysis of a first validation round with hospital purchasing professionals, the results show four applicable purchasing types and fourteen collaborative purchasing impediments that are perceived as important for hospitals. The model is further extended by possible IT solutions, identified by experts, addressing the specific fourteen impediments. We conclude that the collaborative e-purchasing model can be used by healthcare consortia, branche organizations, partnering healthcare institutes and multi-site healthcare institutes as a means to help identifying strategies to initiate, manage and evaluate collaborative purchasing practices.
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AimsTo explore the possible extension of the illness script theory used in medicine to the nursing context.DesignA qualitative interview study.MethodsThe study was conducted between September 2019 and March 2020. Expert nurses were asked to think aloud about 20 patient problems in nursing. A directed content analysis approach including quantitative data processing was used to analyse the transcribed data.ResultsThrough the analysis of 3912 statements, scripts were identified and a nursing script model is proposed; the medical illness script, including enabling conditions, fault and consequences, is extended with management, boundary, impact, occurrence and explicative statements. Nurses often used explicative statements when pathophysiological causes are absent or unknown. To explore the applicability of Illness script theory we analysed scripts’ richness and maturity with descriptive statistics. Expert nurses, like medical experts, had rich knowledge of consequences, explicative statements and management of familiar patient problems.ConclusionThe knowledge of expert nurses about patient problems can be described in scripts; the components of medical illness scripts are also relevant in nursing. We propose to extend the original illness script concept with management, explicative statements, boundary, impact and occurrence, to enlarge the applicability of illness scripts in the nursing domain.ImpactIllness scripts guide clinical reasoning in patient care. Insights into illness scripts of nursing experts is a necessary first step to develop goals or guidelines for student nurses’ development of clinical reasoning. It might lay the groundwork for future educational strategies.
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