In the Netherlands, many parents of children with profound intellectual and multiple disabilities care for their children at home. Little is known about how parents and involved healthcare professionals share and align medical care for these children. This study aims to contribute to a better understanding of the dimensions that affect how medical care is shared and how healthcare professionals can align care with family needs. The study design was inspired by grounded theory. We analyzed in-depth interviews with 25 Dutch parents. The analysis identified five dimensions affecting how parents and professionals shared and aligned medical care: fragility, planned care, irregularities, interactions with providers, and parents’ choices. We recognized three distinctive ways these dimensions interplayed, characterizing scenarios of sharing care: dependent care, dialogical care, and autonomous care. The findings illuminated that parental distress decreased when parents could communicate about what they considered important for their child and family and its implications for sharing care. Parents developed their capacity to manage medical care and often evolved in their thinking about the quality of care and life. Sometimes this evolution was due to struggles with the care provided by professionals. Therefore, healthcare professionals may need to broaden the relational work of shared decision-making to include the sharing of medical care. Arrangements need to be continually reassessed as changes in the child’s and family’s situation trigger changes in preferred patterns of sharing care. Commitment to parents’ autonomy implies that healthcare professionals should be attentive to the parents’ emotional and relational needs.
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his paper develops a new, broader, and more realistic lens to study (lacking) linkages between government policy and school practices. Drawing on recent work in organization theory, we advance notions on cluster of organization routines and the logic of complementarities underlying organizational change. This lens allows looking at how schools do (not) change a cluster of organization routines in response to multiple, simultaneous demands posed by government policies. Thirteen purposively selected Dutch secondary schools responding to three central government policies calling for concurrent change were analyzed, taking the schedule of a school as an exemplary case of a cluster of organization routines. Five distinct responses were distinguished, which can be sorted according to their impact on the whole organization. The study fnds that ten of the thirteen schools did not change anything in response to at least one of the three policies we studied. However, all schools changed their cluster of organization routines, which impacted the whole organization in response to at least one of the three government policies. Therefore, looking at combinations of responses and considering the impact of change on school organizations qualifes ideas about schools being resistant to policy or unwilling to change and improve.
Purpose: This conceptual paper explores the problems associated with trying to address culture as one of the key aspects in effective workplace strategies. Design/methodology/approach: This paper critically addresses the relationship between workplace strategies and the behavioural components of locality. It reviews the role that the concept of culture has, so far, played in trying to predict these behavioural consequences as part of (literature discussing) efforts to design appropriate workplace strategies. Findings: The discussion reveals the need to further address this relation through dedicated research. What is more, it is argued that there is a clear need to focus explicitly on work patterns, and how these can be accounted for in workplace strategies, instead of continuing to focus on the concept of culture as a predictor for successfulness. It is argued that the latter does not allow for practical application, whereas the former could help us to better understand and predict the effectiveness of specific workplace strategies in specific (local) circumstances. Practical implications: The outcome of the discussion suggests that organisations consisting of multiple locations could benefit from explicitly accounting for (local) work patterns in setting up workplace strategies for the organisation as a whole. Originality/value: This paper reveals a relevant research gap in current literature on workplace strategies and suggests a shift in focus from culture to work patterns as one of the key aspects to address.
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The reclaiming of street spaces for pedestrians during the COVID-19 pandemic, such as on Witte de Withstraat in Rotterdam, appears to have multiple benefits: It allows people to escape the potentially infected indoor air, limits accessibility for cars and reduces emissions. Before ordering their coffee or food, people may want to check one of the many wind and weather apps, such as windy.com: These apps display the air quality at any given time, including, for example, the amount of nitrogen dioxide (NO2), a gas responsible for an increasing number of health issues, particularly respiratory and cardiovascular diseases. Ships and heavy industry in the nearby Port of Rotterdam, Europe’s largest seaport, exacerbate air pollution in the region. Not surprisingly, in 2020 Rotterdam was ranked as one of the unhealthiest cities in the Netherlands, according to research on the health of cities conducted by Arcadis. Reducing air pollution is a key target for the Port Authority and the City of Rotterdam. Missing, however, is widespread awareness among citizens about how air pollution links to socio-spatial development, and thus to the future of the port city cluster of Rotterdam. To encourage awareness and counter the problem of "out of sight - out of mind," filmmaker Entrop&DeZwartFIlms together with ONSTV/NostalgieNet, and Rotterdam Veldakademie, are collaborating with historians of the built environment and computer science and public health from TU Delft and Erasmus University working on a spatial data platform to visualize air pollution dynamics and socio-economic datasets in the Rotterdam region. Following discussion of findings with key stakeholders, we will make a pilot TV-documentary. The documentary, discussed first with Rotterdam citizens, will set the stage for more documentaries on European and international cities, focusing on the health effects—positive and negative—of living and working near ports in the past, present, and future.
Following the Samen met Muziek pilot research project in 2023-2024 in ZINN Zorg Short Stay rehabilitation departments in the locations De Brink and De Dilgt, REVA BEATS is a co-research project between the research group Music in Context and ZINN Zorg Short Stay departments revalidation of the location De Brink. In this mixed methods research, multiple research foci included: 1) aspects of care innovation and impact measurements will be researched by ZINN Zorg, and 2) aspects of musical expression, communication and wellbeing of musicians and participants, the entrepreneurial skills and development of musicians, and the learning and experiencing of collaborating care professionals will be explored by research group Music in Context. Additionally, there is a PhD-fellow from the HKU researching the practice through the lens of care ethics. The REVA BEATS project will run between February 2025-January 2027, and includes in total 12 music projects, while the preparational work of the projects has started in June 2024.
