Background: Extramuralisation in healthcare has influenced medical and nursing curricula internationally with the incorporation of themes related to primary/ community care. Despite this, students do not easily change their career preferences. The hospital is still favourite, leading to labour market shortages in extramural care. This study investigates how baccalaureate nursing students' perceptions of community care and placement preferences develop over time in a more 'community-care-oriented' curriculum, to gain insights on which curriculum elements potentially influence career choices.Methods: A nursing student cohort of a University of Applied Sciences in the Netherlands (n = 273) underwent a new four-year curriculum containing extended elements of community care. The primary outcome was assessed with the Scale on Community Care Perceptions (SCOPE). Data were collected each year of study. Descriptive statistics were used to investigate students' placement preferences and perceptions, and linear mixed model techniques (LMMs) for measuring how students' perceptions develop over time. Patterns of placement preferences at individual level were visualised.Results: Students' perceptions of community care, as measured with SCOPE, show a slight decrease between year 1 and 4, while items mutually differ substantially. In contrast, the preference of community care for a placement increases from 2.6% in year 1 tot 8.2% in year 4. The hospital is favourite in year 1 (79.8%), and remains most popular. At individual level, students often change placement preferences, although a preference for the hospital is more consistent. The LMMs indicates that, at the four time-points, the estimated marginal means of students' perceptions fluctuate between 6 and 7 (range 1-10). A placement in community care did not positively influence students' perceptions, and an intensive 1 week theoretical programme was only temporarily influential.Conclusions: Although interest for placement in community care increased substantially, it was not clear which curriculum elements stimulated this, nor did the curriculum positively influence students' perceptions. As most students do not look forward to the high responsibility of the field, other curricula with educational tracks for more mature students/ nurses with a vocational training may be an alternative contribution to solving the labour market problems in community care.
In this thesis, a Dutch version of the Brief IPQ is presented to assess IPs in daily physiotherapy practice in The Netherlands. Further, a literature overview of the existing associations and prognosis of IPs on MSP and functioning is presented, and these associations in primary physiotherapy care in The Netherlands are explored. The impact of a matched care physiotherapy package, matched to dysfunctional IPs, and MSP and physical functioning is studied. In this thesis, three themes (ie. measurement, association / prediction and treatment) are explored for their contribution to physiotherapy management of MSP in general, and especially for low back pain
Introduction: Illness Perceptions (IPs) may play a role in the management of persistent low back pain. The mediation and/or moderation effect of IPs on primary outcomes in physiotherapy treatment is unknown. Methods: A multiple single-case experimental design, using a matched care physiotherapy intervention, with three phases (phases A-B-A’) was used including a 3 month follow up (phase A’). Primary outcomes: pain intensity, physical functioning and pain interference in daily life. Analyzes: linear mixed models, adjusted for fear of movement, catastrophizing, avoidance, sombreness and sleep. Results: Nine patients were included by six different primary care physiotherapists. Repeated measures on 196 data points showed that IPs Consequences, Personal control, Identity, Concern and Emotional response had a mediation effect on all three primary outcomes. The IP Personal control acted as a moderator for all primary outcomes, with clinically relevant improvements at 3 month follow up. Conclusion: Our study might indicate that some IPs have a mediating or a moderating effect on the outcome of a matched care physiotherapy treatment. Assessing Personal control at baseline, as a relevant moderator for the outcome prognosis of successful physiotherapy management of persistent low back pain, should be further eplored.
Mode heeft een cruciale functie in de samenleving: zij maakt diversiteit en inclusiviteit mogelijk en is een middel voor individuen om zich uit te drukken. Desalniettemin is mode ook een raadsel op het gebied van duurzaamheid, zowel aan de sociale als aan de milieukant. Er bestaan echter alternatieven voor de huidige praktijken in de mode. Dit project heeft tot doel de ontwikkeling van een van die initiatieven te ondersteunen. In samenwerking met twee Nederlandse MKB bedrijven in de mode-industrie, willen we een of meer business modellen co-designen voor het vermarkten van circulair ontworpen laser geprinte T-shirts. Door lasertechnologie te introduceren in plaats van traditionele inktopties, kunnen de T- shirts hun CO2 voetafdruk verder verkleinen en een verstandig alternatief zijn voor individuen, die op zoek zijn naar duurzame modekeuzes. Maar hoewel de technologische haalbaarheid vaststaat, vereist het vermarkten sterke, schaalbare, bedrijfsmodellen. Via een haalbaarheidsstudie willen we dergelijke businessmodellen ontwikkelen en de commercialisering van deze producten ondersteunen. Wij zijn van plan de reacties van de consument op een dergelijke innovatie te bestuderen, evenals de belemmeringen en stimulansen vanuit het oogpunt van de consument, en de inkoop-, toeleveringsketen- en financiële kwesties die kunnen voortvloeien uit de schaalbaarheid van een potentieel bedrijfsmodel. Om praktische relevantie voor de bredere industrie te verzekeren, streven we ernaar om de resultaten te presenteren op evenementen georganiseerd door een van de consortiumpartners (in 2023), als ook om een teaching case en een wetenschappelijk artikel te ontwikkelen op basis van de resultaten van het project.
The production, use, disposal and recovery of packaging not only generates massive volumes of waste, it also consumes raw materials, water and energy (Fitzpatrick et al. 2012). Simultaneously, consumers have shown an increasing interest in products incorporating sustainable and social attributes (Kletzan et al., 2006). As a result, environmentally friendly packaging, also called ecofriendly or sustainable packaging, has become mainstream. In this context, packaging is more than just ensuring the product's protection and easing transportation, it is also a communicative tool (Palmer, 2000) and it becomes associated with multiple drivers of the purchasing process. Consequently, companies face pressure to innovate responding to consumer demands, and focusing on sustainable solutions that reduce harmful materials and favour green alternatives for both, the product and the packaging. Although the above has triggered research on consumer choice for sustainable products and alternatives on sustainable packaging, the relation between sustainable packaging and consumer behaviour remains underexplored. This research unpacks this relationship, i.e., empirically verifies which dimensions (recyclability, biodegradability, reusability) of sustainable packaging are perceived and valued by consumers. Put differently, this research investigates consumer behaviour towards the functions of sustainable packaging in terms of product protection, convenience, reliability of information and promotion, and scrutinises the perceived credibility of the associated ethical responsibility claims. It aims to identify those packaging materials and/or sustainability characteristics perceived as more sustainable by consumers as well as the factors influencing actual consumer choice towards sustainable packaged products. We aim to gain more insights in the perceptual frame that different types of consumers apply when exposed to sustainable packaging. To this end, we will make use of revealed preference methods to measure consumer valuations of sustainable packaged products. This game-theoretic approach should provide a more complete depiction of consumers' perceptions and preferences.
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.
