Objective To evaluate the effectiveness of a comprehensive workers’ health surveillance (WHS) program on aspects of sustainable employability and cost-benefit. Methods A cluster randomized stepped wedge trial was performed in a Dutch meat processing company from february 2012 until march 2015. In total 305 workers participated in the trial. Outcomes were retrieved during a WHS program, by multiple questionnaires, and from company registries. Primary outcomes were sickness absence, work ability, and productivity. Secondary outcomes were health, vitality, and psychosocial workload. Data were analyzed with linear and logistic multilevel models. Cost-benefit analyses from the employer’s perspective were performed as well. Results Primary outcomes sickness absence (OR = 1.40), work ability (B = −0.63) and productivity (OR = 0.71) were better in the control condition. Secondary outcomes did not or minimally differ between conditions. Of the 12 secondary outcomes, the only outcome that scored better in the experimental condition was meaning of work (B = 0.18). Controlling for confounders did not or minimally change the results. However, our stepped wedge design did not enable adjustment for confounding in the last two periods of the trial. The WHS program resulted in higher costs for the employer on the short and middle term. Conclusions Primary outcomes did not improve after program implementation and secondary outcomes remained equal after implementation. The program was not cost-beneficial after 1–3 year follow-up. Main limitation that may have contributed to absence of positive effects may be program failure, because interventions were not deployed as intended.
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Social needs are important basic human needs; when not satisfied, loneliness and social isolation can occur and subsequently sickness or even premature death. For older people social needs can be more difficult to satisfy because of the loss of resources such as health and mobility. Interventions for older people to satisfy social needs are often not evaluated and when evaluated are not proven successful. Technological interventions can be successful, but the relationship between technology and social wellbeing is complex and more research in this area is needed. The aim of this research is to uncover design opportunities for technological interventions to fulfil social needs of older people. Context-mapping sessions are a way to gain more insight into the social needs of older people and to involve them in the design of interventions to fulfil social needs. Participants of the context-mapping sessions were older people and social workers working with older people. Four sessions with a total of 20 participants were held to generate ideas for interventions to satisfy social needs. The results are transcripts from the discussion parts of the context-mapping sessions and collages the participants created. The transcripts were independently analysed and inductive codes were attached to quotations in the transcripts that are relevant to the research question and subsequently thematic analysis took place. Collages made by the participants were independently analysed by the researchers and after discussion consensus was reached about important themes. The following three main themes emerged: ‘connectedness’, ‘independence’ and ‘meaningfulness’. Technology was not identified as a separate theme, but was addressed in relation to the above mentioned themes. Staying active in a meaningful way, for example by engaging in volunteer work, may fulfil the three needs of being connected, independent and meaningful. In addition, interventions can also focus on the need to be and remain independent and to deal with becoming more dependent. The older people in our study have an ambivalent attitude towards technology, which needs to be taken into account when designing an intervention. We conclude this paper by making recommendations for possible technological interventions to fulfil social needs.
Across all health care settings, certain patients are perceived as ‘difficult’ by clinicians. This paper’s aim is to understand how certain patients come to be perceived and labelled as ‘difficult’ patients in community mental health care, through mixed-methods research in The Netherlands between June 2006 and October 2009. A literature review, a Delphi-study among experts, a survey study among professionals, a Grounded Theory interview study among ‘difficult’ patients, and three case studies of ‘difficult’ patients were undertaken. Analysis of the results of these qualitative and quantitative studies took place within the concept of the sick role, and resulted in the construction of a tentative explanatory model. The ‘difficult’ patient-label is associated with professional pessimism, passive treatment and possible discharge or referral out of care. The label is given by professionals when certain patient characteristics are present and a specific causal attribution (psychological, social or moral versus neurobiological) about the patient’s behaviours is made. The status of ‘difficult’ patient is easily reinforced by subsequent patient and professional behaviour, turning initial unusual help-seeking behaviour into ‘difficult’ or ineffective chronic illness behaviour, and ineffective professional behaviour. These findings illustrate that the course of mental illness, or at least the course of patients’ contact with mental health professionals and services, is determined by patient and professional and reinforced by the social and mental health care system. This model adds to the broader sick role concept a micro-perspective in which attribution and learning principles are incorporated. On a practical level, it implies that professionals need to look into their own role in the perpetuation of difficult behaviours as described here.
Vaak denken mensen bij zwembaden vooral aan het traditioneel aanbod: zwemlessen voor kinderen en zwemmen voor ontspanning of sport. Toch zijn zwembaden de afgelopen jaren veel bezig met innovatie, waarbij ze bv. kijken naar het gebruik van sensoren om zwemmen interessanter te maken of bieden ze geavanceerde trainingen aan voor duikers of militair personeel aan. Toch merken de zwembaden dat het een strijd kan zijn om de aandacht van de mens vast te houden; we leven immers in een samenleving met vele afleidingen. Zwembaden zijn daarom geïnteresseerd in het verkennen van de mogelijkheden van nieuwe technologie om hun activiteiten aantrekkelijker te maken. Zo ook, specifiek voor dit project, de mogelijkheden van Virtual Reality (VR) om de zwembadervaring en de trainingen en educatie die daar gegeven worden, te verrijken. Binnen dit project willen we dus de potentiële waarde van VR te verkennen met zwembaden en de kennis hiervan te delen met de Creatieve Industrie. Centraal hierin staan een aantal onderzoeksvragen om kennis op te doen over de technologie, o.a.: 1) hoe toepasbaar is de techniek van VR binnen de context van zwembaden, 2) hoe kunnen wij de gebruikerservaring veilig en paniekloos voor de gebruiker maken en 3) hoe gaan we om met motion sickness die kan opkomen bij gebruik van VR, in het bijzonder tijdens de ervaring in het water? Om met deze vragen te experimenteren willen we in co-creatie VR-prototypes gaan maken om antwoord te krijgen op bovenstaande vragen en de kennis te delen met de praktijk en de creatieve industrie. Vanuit daar werken we verder aan de doorontwikkeling.
Tijdens de rijopleiding leren bestuurders verkeersregels toe te passen, situaties in te schatten en het voertuig te besturen. Hoewel een beperkt aantal rijopleiders pakketten aanbiedt inclusief lessen in een rijsimulator, is het overgrote deel van de voorbereiding op zowel de theorie- als de praktijkexamen de afgelopen jaren nauwelijks gemoderniseerd door middel van nieuwe technieken. Hier ligt een grote kans voor de creatieve sector. Door gebruik te maken van de sterke punten van VR, zoals immersie, kan de rijopleiding een grote innovatieslag maken. Hierbij is het essentieel te bepalen wat de visuele en interactieve eisen zijn aan een VR omgeving om een comfortabele (geen motion sickness) training in te richten en te bepalen wat de ontwerpruimte is om een gevarieerd en zinvol trainingsaanbod aan te bieden. Deze aanvraag spitst zich toe op de rijopleiding, maar de benodigde visuele en interactieve eisen zijn belangrijke issues voor een breder spectrum van trainingen. De belangrijkste punten van deze aanvraag zijn dan ook het opstellen van generieke ontwerpvoorwaarden 1) voor de benodigde visuele en interactieve elementen, waarbij een 2) comfortabele VR ervaring ten behoeve van een complexe en dynamische taak zoals autorijden een belangrijke focus is. 3) Met deze ontwerpvoorwaarden zullen studententeams enkele prototypes opleveren, welke geëvalueerd zullen worden. 4) Het huidige netwerk zal worden versterkt en verbreed, 5) voor een grotere vervolgaanvraag om de beroepspraktijk van rijopleidingen te vernieuwen én de kennis te vergroten voor de creatieve industrie over het gebruik VR en playful design van effectieve trainingen.
