Background:Owing to demographic trends and increasing health care costs, quick discharge with geriatric rehabilitation at home is advised and recommended for older adults. Telerehabilitation has been identified as a promising tool to support rehabilitation at home. However, there is insufficient knowledge about how to implement a validated home telerehabilitation system in other contexts. One of the major challenges for rehabilitation professionals is transitioning to a blended work process in which human coaching is supplemented via digital care.Objective:The study aimed to gain an in-depth understanding of the factors that influence the implementation of an evidence-based sensor monitoring intervention (SMI) for older adults by analyzing the perspectives of rehabilitation professionals working in 2 different health ecosystems and mapping SMI barriers and facilitators.Methods:We adopted a qualitative study design to conduct 2 focus groups, 1 in person in the Netherlands during winter of 2017 and 1 on the web via Zoom (Zoom Video Communications; owing to the COVID-19 pandemic) in Canada during winter of 2022, to explore rehabilitation providers’ perspectives about implementing SMI. Qualitative data obtained were analyzed using thematic analysis. Participants were a group of rehabilitation professionals in the Netherlands who have previously worked with the SMI and a group of rehabilitation professionals in the province of Manitoba (Canada) who have not previously worked with the SMI but who were introduced to the intervention through a 30-minute web-based presentation before the focus group.Results:The participants expressed different characteristics of the telerehabilitation intervention that contributed to making the intervention successful for at-home rehabilitation: focus on future participation goals, technology support provides the rehabilitation professionals with objective and additional insight into the daily functioning of the older adults at home, SMI can be used as a goal-setting tool, and SMI deepens their contact with older adults. The analysis showed facilitators of and barriers to the implementation of the telerehabilitation intervention. These included personal or client-related, therapist-related, and technology-related aspects.Conclusions:Rehabilitation professionals believed that telerehabilitation could be suitable for monitoring and supporting older adults’ rehabilitation at home. To better guide the implementation of telerehabilitation in the daily practice of rehabilitation professionals, the following steps are needed: ensuring that technology is feasible for communities with limited digital health literacy and cognitive impairments, developing instruction tools and guidelines, and training and coaching of rehabilitation professionals.
The first part of this paper provides a series of conceptual critiques to illustrate how the recent move to inaugurate a “post-nature” world works to vindicate anthropocentric perspectives and a techno-managerial approach to the environmental crisis. We contend with this premise and suggest that troubling nature has profound implications for education. In the second part, we provide case studies from nature-based programs in The Netherlands and Canada to demonstrate how anthropocentric thinking can be reinscribed even as we work towards “sustainability”. Despite the tenacity of human hubris and the advent of the Anthropocene, we suggest these troubled times are also rich with emerging “post-anthropocentric” perspectives and practices. As such we offer “rewilding” as a means to think about education that moves beyond the romantic vestiges of “Nature” without lapsing into delusions of human exceptionalism. http://dx.doi.org/10.13135/2384-8677/2334 https://www.linkedin.com/in/helenkopnina/
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BACKGROUND: Physician assistant (PA) education has undergone substantial change since the late 1960s. After four decades of development, other countries have taken a page from the American experience and launched their own instructional initiatives. The diversity in how different countries approach education and produce a PA for their nation's needs provides an opportunity to make comparisons. The intent of this study was to document and describe PA programs in Australia, Canada, the United Kingdom, The Netherlands, and the United States.METHODS: We reviewed the literature and contacted a network of academics in various institutions to obtain primary information. Each contact was asked a set of basic questions about the country, the PA program, and the deployment of graduates. Information on US PA programs was obtained from the Physician Assistant Education Association.RESULTS: At year's end 2010, the following was known about PA development: Australia, one program; Canada, four programs; United Kingdom, four programs; The Netherlands, five programs; the United States, 154 programs. Trends in program per capita growth remain the largest in the United States, followed by The Netherlands and Canada. The shortest program length was 24 months and the longest, 36 months. Outside the United States, almost all programs are situated in an academic health center ([AHC] defined as a medical university, a teaching hospital, and a nursing or allied health school), whereas only one-third of US PA programs are in AHCs. All non-US programs receive public/government funding whereas American programs are predominately private and depend on tuition to fund their programs.CONCLUSION: The PA movement is a global phenomenon. How PAs are being educated, trained, and deployed is known only on the basic level. We identify common characteristics, unique aspects, and trends in PA education across five nations, and set the stage for collaboration and analysis of optimal educational strategies. Additional information is needed on lesser-known PA programs outside these five countries.
Collaborative networks for sustainability are emerging rapidly to address urgent societal challenges. By bringing together organizations with different knowledge bases, resources and capabilities, collaborative networks enhance information exchange, knowledge sharing and learning opportunities to address these complex problems that cannot be solved by organizations individually. Nowhere is this more apparent than in the apparel sector, where examples of collaborative networks for sustainability are plenty, for example Sustainable Apparel Coalition, Zero Discharge Hazardous Chemicals, and the Fair Wear Foundation. Companies like C&A and H&M but also smaller players join these networks to take their social responsibility. Collaborative networks are unlike traditional forms of organizations; they are loosely structured collectives of different, often competing organizations, with dynamic membership and usually lack legal status. However, they do not emerge or organize on their own; they need network orchestrators who manage the network in terms of activities and participants. But network orchestrators face many challenges. They have to balance the interests of diverse companies and deal with tensions that often arise between them, like sharing their innovative knowledge. Orchestrators also have to “sell” the value of the network to potential new participants, who make decisions about which networks to join based on the benefits they expect to get from participating. Network orchestrators often do not know the best way to maintain engagement, commitment and enthusiasm or how to ensure knowledge and resource sharing, especially when competitors are involved. Furthermore, collaborative networks receive funding from grants or subsidies, creating financial uncertainty about its continuity. Raising financing from the private sector is difficult and network orchestrators compete more and more for resources. When networks dissolve or dysfunction (due to a lack of value creation and capture for participants, a lack of financing or a non-functioning business model), the collective value that has been created and accrued over time may be lost. This is problematic given that industrial transformations towards sustainability take many years and durable organizational forms are required to ensure ongoing support for this change. Network orchestration is a new profession. There are no guidelines, handbooks or good practices for how to perform this role, nor is there professional education or a professional association that represents network orchestrators. This is urgently needed as network orchestrators struggle with their role in governing networks so that they create and capture value for participants and ultimately ensure better network performance and survival. This project aims to foster the professionalization of the network orchestrator role by: (a) generating knowledge, developing and testing collaborative network governance models, facilitation tools and collaborative business modeling tools to enable network orchestrators to improve the performance of collaborative networks in terms of collective value creation (network level) and private value capture (network participant level) (b) organizing platform activities for network orchestrators to exchange ideas, best practices and learn from each other, thereby facilitating the formation of a professional identity, standards and community of network orchestrators.
Het Lectorenplatform Biobased Economy heeft in de afgelopen twee jaar gewerkt aan een onderzoeksagenda in vier hoofdstukken: ingrediënten/inhoudstoffen, materialen, energie/nutriënten en maatschappij. Op basis van deze agenda zijn verschillende samenwerkingen geïnitieerd en gerealiseerd, zoals GoChem, enkele NWA projecten, de Learning Community Biofuels en de samenwerking met het Lectorenplatform Circulaire Economie op maatschappelijke thema’s. Er is dus al veel gerealiseerd in samenwerking en programmering. Niettemin staan er, terugkijkend, nog enkele ambities uit de eerste twee jaar overeind: het toetsen van de thema’s in meetings met bedrijven; het ontwikkelen van (meer) gezamenlijke onderzoeksprojecten; het ontwikkelen en bestendigen van een meerjarig omvattend (NWO-achtig) programma. Voor dit laatste is GoChem een goede start, maar het zou de komende twee jaar verder moeten groeien, bijvoorbeeld in een biobased SPRONG programma. Daarnaast blijven we werken aan de herkenbaarheid en vindbaarheid van het biobased onderzoek, de lectoraten en de agenda. We breiden de ambities uit naar publieke bekendheid van biobased economy in het algemeen. Verder willen we de mogelijkheid van een eigen publicatiereeks onderzoeken. Nieuw voor de komende jaren is de ambitie om onderzoekskwaliteit beter meetbaar te maken. Hoe meet je kwaliteit in praktijkonderzoek: impact is een ander doel dan wetenschappelijke publicaties. In de eerste termijn van het Lectorenplatform BBE was er additioneel en geoormerkt budget voor internationale samenwerking binnen Living Lab Biobased Brazil (LLBB). Dit budget was gekoppeld aan een gecombineerde Braziliaans/Nederlandse onderzoekscall. Dat is in de komende twee jaar niet voorzien.
De groeiende belangstelling voor gemeenten in het transformeren van steden in Smart Cities, maakt dat er in toenemende technologische ingrepen in het stedelijke weefsel plaatsvinden. Die ingrepen, vaak gericht op het efficiënter inrichten van logistieke, energie technische or ruimtelijke processen, hebben ook impact de sociale, culturele maatschappelijke structuren. Toch staan die ethische aspecten van smart cities maar spaarzaam op de beleidsagenda. Dit terwijl landelijke schandalen, waaronder de Toeslagenaffaire, nopen tot betere morele afwegingen rondom manieren waarop technologie wordt ingezet ten aanzien van burgers. Er is een grote behoefte aan enerzijds minder handelingsverlegenheid in decentrale bestuurslagen in het nemen van techno-ethische besluiten die de slimme stad van de toekomst moeten voorzien van een moreel kompas. Anderzijds is er behoefte aan methoden die ertoe kunnen leiden burgers op een betekenisvolle manier blijvend te betrekken bij het vormen van zo’n ethisch kompas. In dit onderzoek bouwen we voort op opgedane inzichten uit eerdere onderzoeksprojecten rondom ethiek, slimme technologie en slim en en verantwoord bestuur. We bouwen aan een handzame doch genuanceerde strategie om burgers blijvend te laten meedoen met inclusieve besluitvorming die de slimme stad van de toekomst moet vormgeven. Dit doen we door stedelijke ethische commissies, moral labs en lokale bestuursorganen in negen grote steden in Nederland, België, Zweden en Canada aan elkaar te koppelen. Hierdoor wordt expertise, bestuurservaring en burger-expertise duurzaam met elkaar vervlochten. Het doel is om te komen tot een levend, techno-moreel stadskompas waar burgers zich bij thuis voelen, en op basis waarvan bestuurders inclusieve en maatschappelijk verankerde besluiten kunnen nemen. We kiezen daarbij voor een combinatie van methodes waarbij linguïstische analyses, empirische ethiek en vergelijkende methoden uit de sociale wetenschappen middels interventie-design verbinden. Dit doen we in een internationaal ecosysteem van stedelijke gebieden met soortgelijke smart-city-uitdagingen, met een focus op Nederland.
