PurposeThe majority of older patients, scheduled for a cardiac procedure, do not adhere to international dietary intake and physical activity guidelines. The purpose of this study was to explore barriers and facilitators regarding dietary intake and physical activity behaviour change in older patients undergoing transcatheter aortic valve implantation (TAVI).MethodsWe conducted a qualitative study using semi-structured interviews with patients undergoing TAVI. Interviews were analysed by two independent researchers using thematic analysis, the capability, opportunity and motivation behaviour model was used as a framework.ResultsThe study included 13 patients (82 ± 6 years old, 6 females) until data saturation was reached. Six themes were identified, which were all applicable to both dietary intake and physical activity. Three following themes were identified as barriers: (1) low physical capability, (2) healthy dietary intake and physical activity are not a priority at an older age and (3) ingrained habits and preferences. Three following themes were identified as facilitators: (1) knowledge that dietary intake and physical activity are important for maintaining health, (2) norms set by family, friends and caregivers and (3) support from the social environment.ConclusionOur study found that older patients had mixed feelings about changing their behaviour. The majority initially stated that dietary intake and physical activity were not a priority at older age. However, with knowledge that behaviour could improve health, patients also stated willingness to change, leading to a state of ambivalence. Healthcare professionals may consider motivational interviewing techniques to address this ambivalence.
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"Purpose: This study aims to explore the perspectives of psychiatrists with lived experiences and what their considerations are upon integrating the personal into the professional realm. Design/methodology/approach: As part of a qualitative participatory research approach, participant observations during two years in peer supervision sessions (15 sessions with 8 psychiatrists with lived experiences), additional interviews as part of member feedback and a focus group were thematically analysed. Findings: Although the decision to become a psychiatrist was often related to personal experiences with mental distress and some feel the need to integrate the personal into the professional, the actual use of lived experiences appears still in its early stages of development. Findings reveal three main considerations related to the personal (3.1), professionality (3.2) and clinical relevance (3.3) comprising 11 facilitators and 9 barriers to harness lived experiences. Research limitations/implications: This study was conducted locally and there are no similar comparable studies known. It was small in its size due to its qualitative nature and with a homogeneous group and therefore may lack generalisability. Practical implications: Future directions to further overcome shame and stigma and discover the potential of lived experiences are directed to practice, education and research. Originality/value: Psychiatrists with lived experiences valued the integration of experiential knowledge into the professional realm, even though being still under development. The peer supervision setting in this study was experienced as a safe space to share personal experiences with vulnerability and suffering rather than a technical disclosure. It re-sensitised participants to their personal narratives, unleashing its demystifying, destigmatising and humanising potential."
BACKGROUND: Early mobilization (EM) of intensive care (IC) patients is important but complex with facilitators and barriers. Compared to general IC patients, burn IC patients are more hyper-metabolic. They have extensive wounds, lengthy wound dressing changes, and repeated surgeries that may affect possibilities of EM. This study aimed to identify facilitators and barriers of EM in burn IC patients among all disciplines involved. Additionally, we assessed EM practices, i.e. when are which patients considered suitable for EM.METHODS: A survey was sent to 139 professionals involved in EM of burn IC patients (discipline groups: Intensivists, medical doctors, registered nurses, therapists).RESULTS: Response rate was 57 %. The majority found EM very important, yet different definitions were chosen. Perceived barriers mainly concerned patient-level factors, most frequently hemodynamic instability and excessive sedation followed by skin graft surgery, fatigue, and pain management. Most frequent barriers at the provider-level were limited staffing, safety concerns, and conflicting perceptions about the suitability of EM. At the institutional-level, we found no high barriers. Interdisciplinary variation on perceived barriers, when to initiate it, and permitted maximal activity were ascertained.CONCLUSION: Skin grafts and pain management were barriers of EM specific for burn care. Opinions on frequency, dosage and duration of EM varied widely. Improving interdisciplinary communication is key.
Teachers have a crucial role in bringing about the extensive social changes that are needed in the building of a sustainable future. In the EduSTA project, we focus on sustainability competences of teachers. We strengthen the European dimension of teacher education via Digital Open Badges as means of performing, acknowledging, documenting, and transferring the competencies as micro-credentials. EduSTA starts by mapping the contextual possibilities and restrictions for transformative learning on sustainability and by operationalising skills. The development of competence-based learning modules and open digital badge-driven pathways will proceed hand in hand and will be realised as learning modules in the partnering Higher Education Institutes and badge applications open for all teachers in Europe.Societal Issue: Teachers’ capabilities to act as active facilitators of change in the ecological transition and to educate citizens and workforce to meet the future challenges is key to a profound transformation in the green transition.Teachers’ sustainability competences have been researched widely, but a gap remains between research and the teachers’ practise. There is a need to operationalise sustainability competences: to describe direct links with everyday tasks, such as curriculum development, pedagogical design, and assessment. This need calls for an urgent operationalisation of educators’ sustainability competences – to support the goals with sustainability actions and to transfer this understanding to their students.Benefit to society: EduSTA builds a community, “Academy of Educators for Sustainable Future”, and creates open digital badge-driven learning pathways for teachers’ sustainability competences supported by multimodal learning modules. The aim is to achieve close cooperation with training schools to actively engage in-service teachers.Our consortium is a catalyst for leading and empowering profound change in the present and for the future to educate teachers ready to meet the challenges and act as active change agents for sustainable future. Emphasizing teachers’ essential role as a part of the green transition also adds to the attractiveness of teachers’ work.
Om de ambities te behalen zoals geformuleerd in de Sustainable Development Goals, is transdisciplinaire samenwerking nodig tussen overheden, bedrijfsleven, burgers en wetenschap. Dit vraagt om multi-stakeholderbenaderingen waarin leren van en met elkaar centraal staat. Dit onderzoeksvoorstel is een vertaalslag van bovenstaande ambitie zoals geformuleerd in samenwerking met hoger onderwijs partners in Bandung, Indonesië. Het Living Lab Upper Citarum biedt een context om onderzoek te doen binnen een bestaand Living Lab gekenmerkt door de multi-stakeholder setting en de complexiteit van duurzaam beheer van natuurlijke hulpbronnen. Het onderzoek beoogt inzicht te verkrijgen in essentiële ‘21st century skills’ voor deelnemers met faciliterende rollen in een Living Lab. De onderzoeksstrategie wil een bijdrage leveren aan de duurzaamheidsagenda van Living Labs met het ontwerpen, het ervaren, reflecteren en documenteren van praktische interventies in de lokale context. De keuze voor werken op locatie is een eerste benadering in het creëren van een realistische leerervaring voor Living Lab facilitators met diverse achtergronden en valt daarmee te beschrijven als ‘learning by doing’. De algemene onderzoekvraag is als volgt geformuleerd: Which contemporary skills and capabilities are present and which need to be developed to establish a widely shared mind set for trans- or interdisciplinary strategies so that communities and institutions in a Living Lab configuration increase their performance? De onderzoeksstrategie krijgt vorm in een ‘21st century skills exploration’ die een experimentele leerruimte biedt aan medewerkers van diverse instituten en (overheids-)organisaties die actief zijn in het Living Lab om kennis te maken met de creatieve methodes voor publieke participatie. Dit vindt vooral plaats in interactie met lokale gemeenschappen met nadruk op creatieve methodes zoals een poetry route, participatory mapping en film. Na presentatie op locatie worden de resultaten gepresenteerd tijdens een mini-symposium in Bandung.
In line with the ‘Natuur- en milieubeleidsplan Caribisch Nederland 2020-2030 (NMBP)’ the consortium intends with this research proposal to contribute to a prosperous society with a resilient population and healthy natural environment. The Caribbean Netherlands are dealing with a situation where imported vegetables and fruits are mostly imported and hardly affordable. This leads to consuming unhealthy food and high obesities rates as a consequence. A lack of good agricultural practices with regard to water-smart and nature inclusive agriculture, as well as limited coping capacities to deal with hazards and climate change, results in very limited local production and interest. Initiatives that focused only on agrotechnological solutions for food resilient futures turned out to be ineffective due to a lack of local ownership, which jeopardizes sustainability. Moreover, the ‘green’ and ‘blue’ domains are not seen as attractive career perspectives among youth, hampering a bright future for those domains. The aim of this research is to contribute to water-smart and nature inclusive food resilience embedded in a local participatory perspective in the Caribbean Netherlands. To address the above challenges, a living lab approach is adopted, where youth will be trained as (co)-facilitators (WP1) who will contribute to a participatory envisioning process and an articulation of food resilient futures (WP2). Finally, based on the envisioning process local stakeholders will select and implement experiments for food resilient futures followed by dissemination of results among key stakeholders as well as children and youth at the BES islands (WP3). This project strategy will lead to a network of a living lab where professionals and youth work together on food resilient futures. Training manuals and the results of experiments with regard to water and food system alternatives will be used actively to encourage youth to be involved in sustainable agriculture and consumption.
