Background: Rising healthcare costs, an increasing general practitioner shortage and an aging population have made healthcare organization transformation a priority. To meet these challenges, traditional roles of non-medical members have been reconsidered. Within the domain of physiotherapy, there has been significant interest in Extended Scope Physiotherapy (ESP). Although studies have focused on the perceptions of different stakeholders in relation to ESP, there is a large variety in the interpretation of ESP. Aim: To identify a paradigm of ESP incorporating goals, roles and tasks, to provide a consistent approach for the implementation of ESP in primary care. Methods: An exploratory, qualitative multi-step design was used containing a scoping review, focus groups and semi-structured interviews. The study population consisted of patients, physiotherapists, general practitioners and indirect stakeholders such as lecturers, health insurers and policymakers related to primary care physiotherapy. The main topics discussed in the focus groups and semi-structured interviews were the goals, skills and roles affiliated with ESP. The ‘framework’ method, developed by Ritchie & Spencer, was used as analytical approach to refine the framework. Results: Two focus groups and twelve semi-structured interviews were conducted to explore stakeholder perspectives on ESP in Dutch primary care. A total of 11 physiotherapists, six general practitioners, five patients and four indirect stakeholders participated in the study. There was a lot of support for ‘decreasing healthcare costs’, ‘tackling increased health demand’ and ‘improving healthcare effectiveness’ as main goals of ESP. The most agreement was reached on ‘triaging’, ‘referring to specialists’ and ‘ordering diagnostic imaging’ as tasks fitting for ESP. Most stakeholders also supported ‘working in a multidisciplinary team’, ‘working as a consultant’ and ‘an ESP role separated from a physiotherapist role’ as roles of ESP. Conclusions: Based on the scoping review, focus groups and interviews with direct and indirect stakeholders, it appears that there is sufficient support for ESP in the Netherlands. This study provides a clear presentation of how ESP can be conceptualized in primary care. A pilot focused on determining the feasibility of ESP in Dutch primary care will be the next step.
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In dit boek vindt u een beknopte weergave van de ideeën en plannen behorende bij de eerste twee lectoraten van het Kenniscentrum voor Procesinnovatie. In het eerste deel behandelt lector Extended Enterprise Studies Johan Versendaal het concept van de extended enterprise en belangrijke aandachtsgebieden daarbij zoals inkoopvolwassenheid, procesdenken, en e-business ontwikkelingen. Het succes van een extended enterprise is voor een groot deel afhankelijk van de kwaliteit van de architectuur en architecten die de bedrijfsvoering ondersteunen. Dit is dan ook het thema van het tweede deel van dit boek. Hierin neemt lector Architectuur voor Digitale Informatiesystemen Wiebe Wiersema u mee op een tocht die gaat van de opkomst van architectuur tot de knelpunten die zich voordoen binnen het hedendaagse informaticaonderwijs
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ABSTRACT Purpose: This short paper describes the dashboard design process for online hate speech monitoring for multiple languages and platforms. Methodology/approach: A case study approach was adopted in which the authors followed a research & development project for a multilingual and multiplatform online dashboard monitoring online hate speech. The case under study is the project for the European Observatory of Online Hate (EOOH). Results: We outline the process taken for design and prototype development for which a design thinking approach was followed, including multiple potential user groups of the dashboard. The paper presents this process's outcome and the dashboard's initial use. The identified issues, such as obfuscation of the context or identity of user accounts of social media posts limiting the dashboard's usability while providing a trade-off in privacy protection, may contribute to the discourse on privacy and data protection in (big data) social media analysis for practitioners. Research limitations/implications: The results are from a single case study. Still, they may be relevant for other online hate speech detection and monitoring projects involving big data analysis and human annotation. Practical implications: The study emphasises the need to involve diverse user groups and a multidisciplinary team in developing a dashboard for online hate speech. The context in which potential online hate is disseminated and the network of accounts distributing or interacting with that hate speech seems relevant for analysis by a part of the user groups of the dashboard. International Information Management Association
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This project challenges traditional cognition-based research methods. While informative, they do not fully capture the complexity of economic transformation. This hinders our ability to support regenerative entrepreneurs in their journey toward a fair and sustainable economy. At AUAS Centre for Economic Transformation, our search for a more integrative approach to building new business models, led us to arts- and nature-based research. We are intrigued by art- and nature-based research as a tool to integrate cognitive, emotional and practical elements (head/ heart/ hands). Our curiosity led us to the following research question: how can innovative methodologies that focus on lessons from the arts (creativity) and nature (diversity) help to enrich the understanding of economic transformation among researchers and entrepreneurs engaged in regenerative practices. This study employs an action-oriented research approach, including progressive learning and reflective monitoring and evaluation. During workshops the researchers and entrepreneurs go outside and collect pieces of nature. With these materials they compose their own work of art. Participants, under guidance, step-by-step, 'engage in dialogue' with their artwork based on their own question, eventually experiencing (a direction to) an answer. This project brings together researchers with expertise in the diverse fields of entrepreneurship, craftsmanship, co-ownership and economic ecosystems and entrepreneurs of regenerative practices. They emerge themselves in innovative research methods aimed at integrating head, heart, and hands to enhance diversity and creativity and enrich their understanding of economic transformation. The presentation will be enriched by the works of Claudy Jongstra, a Dutch artist and regenerative entrepreneur.
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Reading and writing is modelled in CSP using actions containing the symbols ? and !. These reading actions and writing actions are synchronous, and there is a one-to-one relationship between occurrences of pairs of these actions. In the CPA conference 2017, we introduced the extended half-synchronous al- phabetised parallel operator X ⇕ Y , which disconnects the writing to and reading from a channel in time; the reading processes are divided into sets which are set-wise asynchronous, but intra-set-wise synchronous, giving full flexibility to the reads. In this paper, we allow multiple writers to write to the same channel set-wise asynchronously, but intra-set-wise synchronously and we study the impact on our (Extended) Vertex Removing Synchronised Product. The advantages we accomplish are that the extension of X ⇕ Y gives more flexibility by indexing the writing actions and the reading actions, leading to a straightforward majority vote design. Furthermore, the extension of X ⇕ Y preserves the advantages of the X ⇕ Y operator.
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Often research, education and professional practice are positioned as different activities. Researchers, students and professionals are defined in subject-object relations. For my Phd. thesis I applied another perspective. In dialogue with School Social Workers, Bachelor Social Work students during their internship, Vocational High School (VHS) Teachers and other involved actants I worked on activities to improve the financial health of VHS students. We explored in a relational spacial ethnography the roles of all above mentioned actants as learning professional and inquirer. During this long term project a mixed method participatory approach was applied. However in this ethnography these activities where integral part of developing of a whole set of interventions. It gave us the opportunity to develop new perspectives at developing interventions and learning in a relational dialogue
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In the Netherlands, client and family participation in care for people with intellectual disabilities has been in vogue for a long time, and increasingly receives attention (KPMG and Vilans 2017). However, the perspective and experiential knowledge of service users and relatives is often still insuBiciently used for the co-creation of care. The professional perspective is often still dominant. In addition, professionals mainly focus on clients and less on relatives, even though relatives often play an important role in the client’s (quality of) life (Wiersma 2017). The project ‘Inclusive Collaboration in Disability Care’[1] (ICDC) focusses on enhancing equal communication between people with intellectual disabilities, their relatives, and professional caregivers, and hence contributes to redressing power imbalances in longterm care. It investigates the question: “How can the triangle of client, relative and professional caregiver together co-create better care and support?”.
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Humidification is not a common procedure in many buildings in the Netherlands. An exception are buildings used for healthcare, especially hospitals. There, e.g. in operating theatres, relative humidity (RH) generally is controlled stringently at levels around 50%. From an energy point-of-view humidification is an energy-intensive activity. Currently, more than 10% of the total energy used in healthcare buildings is spent on humidification. The basis for an RH of around 50%, however, is not clear. Therefore, we pursued a scoping review to find evidence for specific RH thresholds in such facilities. In addition, an inventory was made of the current practice in the Netherlands. After analyzing the title and abstracts, the remaining references were read by two persons and scored on several topics. Guidelines and current practice were analyzed by referring to existing (inter)national guidelines and standards, and by contacting experts from Dutch hospitals through a survey and semi-structured interviews. Outcomes from the literature review were grouped into four different topics: 1) micro-organisms and viruses, 2) medical devices, 3) human physiology and 4) perception. No scientific evidence was found for the currently generally applied RH set-point of ~50%. Some studies suggest a minimum RH of 30% but the evidence is weak, with exception of medical devices if specifications require it. A lack of research that addresses more long-term exposure (a couple of days) and includes frail subjects, is noted. It was found that RH requirements are strictly followed in all hospitals consulted, some only focusing on the hot zones, but in many cases extended to the whole hospital. Steam humidification is mostly applied for hygienic reasons. but is quite energy-intensive. The conclusion t is that there is no solid evidence to support the RH-setpoints as currently applied in the Netherlands. It merely appears a code of practice. Therefore, there appears room for quick and significant energy savings, and CO2 emission reductions, when considering control at lower RH values or refraining from humidification at all, while still fulfilling the indoor environment requirements and not negatively influencing the health risk. This outcome can be applied directly in current practice with the available techniques.
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Objective: To explore predictors of dropout of patients with chronic musculoskeletal pain from an interdisciplinary chronic pain management programme, and to develop and validate a multivariable prediction model, based on the Extended Common- Sense Model of Self-Regulation (E-CSM). Methods: In this prospective cohort study consecutive patients with chronic pain were recruited and followed up (July 2013 to May 2015). Possible associations between predictors and dropout were explored by univariate logistic regression analyses. Subsequently, multiple logistic regression analyses were executed to determine the model that best predicted dropout. Results: Of 188 patients who initiated treatment, 35 (19%) were classified as dropouts. The mean age of the dropout group was 47.9 years (standard deviation 9.9). Based on the univariate logistic regression analyses 7 predictors of the 18 potential predictors for dropout were eligible for entry into the multiple logistic regression analyses. Finally, only pain catastrophizing was identified as a significant predictor. Conclusion: Patients with chronic pain who catastrophize were more prone to dropout from this chronic pain management programme. However, due to the exploratory nature of this study no firm conclusions can be drawn about the predictive value of the E-CSM of Self-Regulation for dropout.
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