Objectives There is a broad call for change towards € new era' quality systems in healthcare, in which the focus lies on learning and improving. A promising way to establish this in general practice care is to combine audit and feedback with peer group discussion. However, it is not known what different stakeholders think of this type of quality improvement. The aim of this research was to explore the opinions of different stakeholders in general practice on peer discussion of audit and feedback and on its opportunities and risks. Second, their thoughts on transparency versus accountability, regarding this system, were studied. Design An exploratory qualitative study within a constructivist paradigm. Semistructured interviews and focus group discussions were held and coded using thematic analysis. Included stakeholders were general practitioners (GP), patients, professional organisations and insurance companies. Setting General practice in the Netherlands. Participants 22 participants were purposively sampled for eight interviews and two focus group discussions. Results Three main opportunities of peer discussion of audit and feedback were identified: deeper levels of reflection on data, adding context to numbers and more ownership; and three main risks: handling of unwilling colleagues, lacking a safe group and the necessity of patient involvement. An additional theme concerned disagreement on the amount of transparency to be offered: insurance companies and patients advocated for complete transparency on data and improvement of outcomes, while GPs and professional organisations urged to restrict transparency to giving insight into the process. Conclusions Peer discussion of audit and feedback could be part of a change movement, towards a quality system based on learning and trust, that is initiated by the profession. Creating a safe learning environment and involving patients is key herein. Caution is needed when complete transparency is asked, since it could jeopardise practitioners' reflection and learning in safety.
Een holistisch perspectief op binnenstedelijke herontwikkeling Spatial Planning http://www.uu.nl/agenda/promotie-een-holistisch-perspectief-op-binnenstedelijke-herontwikkeling Promovendus Rien van Stigt onderzoekt waarom het moeilijk is om milieukwaliteit een prominente plaats te geven in de besluitvorming over ruimtelijke plannen. In zijn proefschrift ontwikkelt hij een holistisch perspectief op het complexe proces van compacte binnenstedelijke herontwikkeling. De kwaliteit van de stedelijke leefomgeving is essentieel in duurzame stedelijke ontwikkeling. Die kwaliteit staat met name bij compacte binnenstedelijke herontwikkeling onder druk, en daarom is milieukwaliteit een belangrijke factor in het plannen van zulke ontwikkelingen. Uit de literatuur over de integratie van milieubeleid blijkt dat dit, vooral op lagere bestuurlijke niveaus, niet altijd goed lukt. Er is nog geen overtuigende verklaring waarom dit zo is. Promotor(es): Prof.dr. P.P.J. Driessen en Prof.dr. T.J.M. Spit
Research Findings: A growing number of stakeholders in early childhood education (ECE) rely on self-assessment to assess and improve the quality of ECE. In this systematic review, we investigated the reliability and validity of self-assessment in ECE, summarizing findings from 27 publications. We meta-analytically synthesized findings from 25 publications for 1,882 groups and 79,163 children aged 0–72 months in center-based childcare. Most studies reported high internal consistency, but one study reported a lower consistency. Inter-rater reliability was generally high. A three-level meta-analysis (k = 13, ES = 45) revealed a positive association between self-assessment ratings and ratings with validated measures of ECE quality (r = .38), indicating a moderate convergent validity. Studies with lower methodological quality and published “peer reviewed” studies reported somewhat higher correlations between self-assessment ratings and ratings with validated measures. The meta-analytic correlation remained significant after removal of studies with lower methodological quality (r = .33) or studies from the “grey” literature (r = .44). A second meta-analysis (k = 16, ES = 71) with a focus on the predictive validity of self-assessment ratings showed a small significant association between self-assessed ECE quality and child outcomes (r = .09); there were no significant moderators. Practice or Policy: Despite empirical evidence for the validity of self-assessment, further studies are needed to investigate potential bias in self-assessment. Future studies should further explore the validity and reliability of self-assessment measures in ECE, including countries outside the United States.
Due to the existing pressure for a more rational use of the water, many public managers and industries have to re-think/adapt their processes towards a more circular approach. Such pressure is even more critical in the Rio Doce region, Minas Gerais, due to the large environmental accident occurred in 2015. Cenibra (pulp mill) is an example of such industries due to the fact that it is situated in the river basin and that it has a water demanding process. The current proposal is meant as an academic and engineering study to propose possible solutions to decrease the total water consumption of the mill and, thus, decrease the total stress on the Rio Doce basin. The work will be divided in three working packages, namely: (i) evaluation (modelling) of the mill process and water balance (ii) application and operation of a pilot scale wastewater treatment plant (iii) analysis of the impacts caused by the improvement of the process. The second work package will also be conducted (in parallel) with a lab scale setup in The Netherlands to allow fast adjustments and broaden evaluation of the setup/process performance. The actions will focus on reducing the mill total water consumption in 20%.
In dit project zal een online onderwijsmodule worden ontworpen. In deze module zal een deel van de output van het project Bouwen met Levende Natuur worden verwerkt tot onderwijs. Het maken van online course materiaal binnen de HZ onderwijsonwikkeling, waar zowel echte casuistiek uit de de beroepspraktijk, als gebruik van ICT mogelijkheden centraal staan. Door de modulaire opbouw zal het mogelijk zijn onderdelen in verschillende courses te verwerken. De docent kan dan de module naar eigen wens, en onafhankelijk van de beschikbaarheid van interne of externe gastdocenten, inzetten voor ‘blended learning’. De benadering binnen de learning unit(s) volgt het constructivisme, activiteiten die te maken hebben met kennisoverdracht, zullen derhalve worden afgewisseld met verwerkingsopdrachten. De volledige onderwijsmodule richt zich vooral op onderwijs op het gebied van Coastal Engineering van de opleiding Civiele Techniek (CT), in eerste instantie van de Delta Academy; CT studenten blijken behoefte te hebben aan een uitleg van ecologische principes vanuit vanuit een meer technisch perspectief. De learning units/onderwijsmodule is uiteraard ook beschikbaar voor andere hbo opleidingen. Het geselecteerde gedeelte, de eerste learning unit, zal ook bruikbaar zijn voor de course Integrated Coastal Zone Management (ICZM), waarin oa het concept Building with Nature wordt uitgelegd. In de huidige vorm wordt dit onderdeel op de klassieke manier gebracht, in de vorm van een hoorcollege. De ontwikkeling van online materiaal maakt de afwisseling met het verwerken van de aangebrachte kennis eenvoudiger; de structuur daarvoor wordt in de online versie al aangebracht. Deze learning unit brengt niet alleen wat aanvullende benaderingen vanuit technisch perspectief, maar is ook een aanpassing, die het geheel hestructureert volgens het constructivisme. De course ICZM is een keuze-course, bedoeld voor Aquatische Ecotechnologie (AET), Delta Management (DM) en CT studenten; waar CT studenten meer behoefte hebben aan een technisch perspectief, heeft deze course ook te maken met DM studenten, die juist wat meer kennis zouden moeten maken met meer technische benaderingen.
Human kind has a major impact on the state of life on Earth, mainly caused by habitat destruction, fragmentation and pollution related to agricultural land use and industrialization. Biodiversity is dominated by insects (~50%). Insects are vital for ecosystems through ecosystem engineering and controlling properties, such as soil formation and nutrient cycling, pollination, and in food webs as prey or controlling predator or parasite. Reducing insect diversity reduces resilience of ecosystems and increases risks of non-performance in soil fertility, pollination and pest suppression. Insects are under threat. Worldwide 41 % of insect species are in decline, 33% species threatened with extinction, and a co-occurring insect biomass loss of 2.5% per year. In Germany, insect biomass in natural areas surrounded by agriculture was reduced by 76% in 27 years. Nature inclusive agriculture and agri-environmental schemes aim to mitigate these kinds of effects. Protection measures need success indicators. Insects are excellent for biodiversity assessments, even with small landscape adaptations. Measuring insect biodiversity however is not easy. We aim to use new automated recognition techniques by machine learning with neural networks, to produce algorithms for fast and insightful insect diversity indexes. Biodiversity can be measured by indicative species (groups). We use three groups: 1) Carabid beetles (are top predators); 2) Moths (relation with host plants); 3) Flying insects (multiple functions in ecosystems, e.g. parasitism). The project wants to design user-friendly farmer/citizen science biodiversity measurements with machine learning, and use these in comparative research in 3 real life cases as proof of concept: 1) effects of agriculture on insects in hedgerows, 2) effects of different commercial crop production systems on insects, 3) effects of flower richness in crops and grassland on insects, all measured with natural reference situations
