A first episode of psychosis (FEP) is a stressful, often life-changing experience. Scarce information is available about personal preferences regarding their care needs during and after a FEP. Whereas a more thorough understanding of these preferences is essential to aid shared decision-making during treatment and improve treatment satisfaction. Methods: Face-to-face interviews with participants in remission of a FEP were setup, addressing personal preferences and needs for care during and after a FEP. The interviews were conducted by a female and a male researcher, the latter being an expert with lived experience. Results: Twenty individuals in remission of a FEP were interviewed, of which 16 had been hospitalized. The distinguished themes based on personal preferences were tranquility, peace and quietness, information, being understood, support from significant others, and practical guidance in rebuilding one's life. Our findings revealed that the need for information and the need to be heard were often not sufficiently met. For 16/20 participants, the tranquility of inpatient treatment of the FEP was pre-dominantly perceived as a welcome safe haven. The presence and support of family and close friends were mentioned as an important factor in the process of achieving remission.
MULTIFILE
Background: end-of-life care is not always in line with end-of-life preferences, so patients do not always die at their preferred place of death (PPD). This study aims to identify factors associated with patients' PPD and changes in PPD. Methods: we prospectively collected data on PPD at four time points within 6 months from 230 acutely hospitalised older patients who were part of the control group in a stepped-wedge randomised controlled trial. Associations between patient characteristics and preferences were calculated using multivariable (multinomial) logistic regression analysis. Results: the mean age of participants was 80.7 years. 47.8% of the patients had no PPD at hospital admission. Patients previously admitted to hospital preferred to die at home (home versus no preference: odds ratio [OR] 2.38, 95% confidence interval [CI] 1.15-4.92; home versus healthcare facility: OR 3.25, 95% CI 1.15-9.16). Patients with more chronic diseases preferred the healthcare facility as their PPD (healthcare facility versus no preference: OR 1.33, 95% CI 1.09-1.61; healthcare facility versus home: OR 1.21, 95% CI 1.00-1.47). 32 of 65 patients changed their preference during follow-up, and most of these had no PPD at hospital admission (home versus no preference: OR 0.005, 95% CI ≤0.001-0.095) and poorer self-rated well-being (OR 1.82, 95% CI 1.07-3.08). Conclusions: almost half of the patients had no PPD at baseline. Previous hospital admission, having more chronic diseases and living alone are associated with having a PPD. Introducing PPD could make older people aware of PPD and facilitate optimal palliative care.
Supermarkets are essential urban household amenities, providing daily products, and for their social role in communities. Contrary to many other countries, including nearby ones, the Netherlands have a balanced distribution of supermarkets across villages and urban neighbourhoods. However, spatial supermarket patterns, are subject to influential developments. First, due to economies of scale, there is a tendency for supermarkets to increase their catchment areas and to disappear from peripheral villages. Second, supermarkets are now mainly located in residential areas, although the urban periphery appears to be attractive for the retail sector, perhaps including the rise of hypermarkets. Third, today, online grocery shopping is still lagging far behind on other online shopping products, but a breaks through will dilute population support for in-store supermarkets and can lead to dramatic ‘game changer’ shifts with major spatial and social effects. These three important trends will reinforce each other. Consequences are of natural community meeting places at the expense of social cohesion; reduced accessibility for daily products, leading to more travel, often by car; increasing delivery flows; real estate vacancies, and increasing suburban demand increase for retail and logistics. Expected changes in supermarket patterns require understanding, but academic literature on OGS is still scarce, and does hardly address household behaviour in changing spatial constellations. We develop likely spatial supermarket patterns, and model the consequences for travel demand, social cohesion and real estate demand, as well as the distribution between online and in-store grocery shopping, by developing a stated preference experiment, among Dutch households.
De toenemende verstedelijking levert grote uitdagingen op voor leefbaarheid, gezondheid en kwaliteit van leven in steden. Het is belangrijk dat de openbare ruimte voldoet aan de huidige eisen/wensen van gebruikers en de samenleving, zodat mensen zich veilig en comfortabel voelen en positieve ervaringen hebben in de stad. Er is daarom een groeiende interesse in de relatie tussen de openbare ruimte en de beleving ervan door bewoners, zowel in (wetenschappelijk) onderzoek als bij beleidsmakers. Eerder onderzoek heeft aangetoond dat natuurlijke elementen, zoals parken, groene stroken en bomen, bijdragen aan de subjectieve gezondheid (ontspanning) van gebruikers. Toch is er nog maar weinig bekend over de beleving van specifiek stadsparken en welke kenmerken het meest gewaardeerd worden door gebruikers. Studies die, door middel van innovatieve methodes, de beleving van stadparken analyseren zijn beperkt. Een betrouwbare techniek voor het bepalen van voorkeuren en indirect, beleving, is de stated preference methode. Meestal worden respondenten daarbij gevraagd om hypothetische situaties te beoordelen, gebaseerd op tekstuele beschrijvingen. Virtual reality maakt het echter mogelijk om hypothetische situaties echt te ervaren. Dit project heeft daarom als doel om te analyseren, door middel van een Virtual Reality (VR) Stated Preference experiment, hoe kenmerken van stedelijke parken bijdragen aan de beleving van gebruikers. Beleidsmakers, stedenbouwkundigen en beheerders van de openbare ruimte kunnen deze resultaten gebruiken bij het creëren van parken die aansluiten bij de huidige wensen en behoeften van gebruikers. Ook zal dit project inzicht geven in de bruikbaarheid van VR technologie bij onderzoek naar de beleving van de openbare ruimte.
