The transition towards a sustainable and healthy food system is one of the major sustainability challenges of today, next to the energy transition and the transition from a linear to circular economy. This paper provides a timely and evidence-based contribution to better understand the complex processes of institutional change and transformative social-ecological innovation that takes place in the food transition, through a case study of an open innovation and food transition network in The Netherlands, the South-Holland Food Family (Zuid-Hollandse Voedselfamilie). This network is supported by the provincial government and many partners, with the ambition to realize more sustainable agricultural and food chains, offering healthy, sustainable and affordable food for everyone in the Province of South-Holland in five to ten years from now. This ambition cannot be achieved through optimising the current food system. A transition is needed – a fundamental change of the food system’s structure, culture and practice. The Province has adopted a transition approach in its 2016 Innovation Agenda for Sustainable Agriculture. This paper provides an institutional analysis of how the transition approach has been established and developed in practice. Our main research question is what interventions and actions have shaped the transition approach and how does the dynamic interplay between actors and institutional structures influence institutional change, by analysing a series of closely related action situations and their context, looking at 'structure' and 'agency', and at the output-outcomes-impact of these action situations. For this purpose, we use the Transformative Social-Ecological Innovation (TSEI)-framework to study the dynamic interplay between actors and institutional structures influencing institutional change. The example of TSEI-framework application in this paper shows when and how local agents change the institutional context itself, which provides relevant insights on institutional work and the mutually constitutive nature of structure and agency. Above institutional analysis also shows the pivotal role of a number of actors, such as network facilitators and provincial minister, and their capability and skills to combine formal and informal institutional environments and logics and mobilize resources, thereby legitimizing and supporting the change effort. The results are indicative of the importance of institutional structures as both facilitating (i.e., the province’s policies) and limiting (e.g. land ownership) transition dynamics.
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Background: The outbreak of the COVID-19 pandemic influenced family-centred care dramatically due to restricting visiting policies. In this new situation, nurses were challenged to develop new approaches to involve family members in patient care. A better understanding of these changes and the experiences of nurses is essential to make an adaptation of procedures, and to secure a family-centred approach in care as much as possible. Objectives: The aim of this study was to investigate how family involvement had taken place, and to explore the experiences of nurses with family involvement during the COVID-19 outbreak. In addition, we aimed to formulate recommendations for the involvement of family. Methods: We conducted a qualitative study using patient record review and focus-group interviews between April and July 2020. We reviewed records of patients with confirmed COVID-19, who were admitted to the COVID-19 wards at two affiliated university hospitals in the Netherlands. All records were searched for notations referring to family involvement. In two focus-groups, nurses who worked at the COVID-19 wards were invited to share their experiences. The Rigorous and Accelerated Data Reduction (RADaR) method was used to collect, reduce and analyse the data. Results: In total, 189 patient records were reviewed and nine nurses participated in the focus-group meetings. Patient records revealed infrequent and often unstructured communication with focus on physical condition. Nurses confirmed that communication with family was far less than before and that the physical condition of the patient was predominant. The involvement of family in care was limited to practicalities, although more involvement was described in end-of-life situations. Nurses experienced moral distress due to the visiting restrictions, though some acknowledged that they had experienced the direct patient care so intense and burdensome, that family contact simply felt too much. Conclusion: The communication with and involvement of family in hospital care changed enormously during the COVID-19 outbreak. Based on the identified themes, we formulated recommendations that may be helpful for family-centered care in hospitals during periods of restricted visiting policy.
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Background: A paradigm shift in health care from illness to wellbeing requires new assessment technologies and intervention strategies. Self-monitoring tools based on the Experience Sampling Method (ESM) might provide a solution. They enable patients to monitor both vulnerability and resilience in daily life. Although ESM solutions are extensively used in research, a translation from science into daily clinical practice is needed. Objective: To investigate the redesign process of an existing platform for ESM data collection for detailed functional analysis and disease management used by psychological assistants to the general practitioner (PAGPs) in family medicine. Methods: The experience-sampling platform was reconceptualized according to the design thinking framework in three phases. PAGPs were closely involved in co-creation sessions. In the ‘understand’ phase, knowledge about end-users’ characteristics and current eHealth use was collected (nominal group technique – 2 sessions with N = 15). In the ‘explore’ phase, the key needs concerning the platform content and functionalities were evaluated and prioritized (empathy mapping – 1 session with N = 5, moderated user testing – 1 session with N = 4). In the ‘materialize’ phase, the adjusted version of the platform was tested in daily clinical practice (4 months with N = 4). The whole process was extensively logged, analyzed using content analysis, and discussed with an interprofessional project group. Results: In the ‘understand’ phase, PAGPs emphasized the variability in symptoms reported by patients. Therefore, moment-to-moment assessment of mood and behavior in a daily life context could be valuable. In the ‘explore’ phase, (motivational) functionalities, technological performance and instructions turned out to be important user requirements and could be improved. In the ‘materialize’ phase, PAGPs encountered barriers to implement the experience-sampling platform. They were insufficiently facilitated by the regional primary care group and general practitioners. Conclusion: The redesign process in co-creation yielded meaningful insights into the needs, desires and daily routines in family medicine. Severe barriers were encountered related to the use and uptake of the experience-sampling platform in settings where health care professionals lack the time, knowledge and skills. Future research should focus on the applicability of this platform in family medicine and incorporate patient experiences.
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Promoting entrepreneurship is an enabler of smart, sustainable and inclusive growth and it is one objective EU regions have pursued since the EC included it into 2020 Strategy. Entrepreneurship development has economic and social benefits, since it is not only a driving force for job creation, competitiveness and growth; it also contributes to personal fulfillment and to achieve social objectives. That is why the EU encourages entrepreneurial initiatives and to unlock the growth potential of businesses and citizens. However, only a 37% of Europeans (Eurobarometer 2012) would like to be self-employed. The Entrepreneurship Action Plan adopted by the EC in 2013 to reignite Europe’s entrepreneurial spirit includes initiatives for educating young people on entrepreneurship. To ensure that EU economy remains globally competitive, young generations of Europeans need to be inspired to develop their entrepreneurial mindset. EU 2020 Action Plan argues that young people benefitting of a specialised entrepreneurial education are more likely to start-up a business and to better tackle challenges in their professional career and life in general. Hence, there is good reason to ensure better quality of entrepreneurial education. Most approaches in recent years have focused on improving the skills or competences youngsters should obtain only within the education system. However, an integrated approach is needed, where the school, their friends, family and the social environment, shall play each one a relevant role, contributing to generate a more adequate atmosphere to boost their entrepreneurial mindsets, intrapreneurial attitudes and innovation capacities. This project will identify and exchange – through a quadruple helix approach- good practices for creating friendlier entrepreneurial ecosystems and actions to boost entrepreneurship in young people mindsets. The good practices and lessons learnt will be transferred into Action Plans to be included in regional policies.
We had been involved in the redesign of the 4 Period Rooms of the Marquise Palace, also called the Palace of Secrets, in Bergen op Zoom. This design was based on the biography of a historical figure: Marie Anne van Arenberg, whose dramatic life was marked by secrets. Each of the 4 rooms represents a turning moment in Marie Anne’s story: the official marriage, the secret marriage and the betrayal, the dilemma and choice, with, in a final room, the epilogue. These different episodes are reflected in the way the rooms are furnished: the ballroom, the bedroom, the dining room. The Secret Marquise as design and exhibition has brought more visitors to the museum. As designers and researchers, however, we were interested in understanding more about this success, and, in particular, in understanding the visitors experience, both emotionally and sensorially at different moments/situations during the story-driven experience.In the fall of 2021, the visitors’ lived experience was evaluated using different approaches: a quantitative approach using biometric measurements to register people’s emotions during their visit, and a qualitative one consisting of a combination of observations, visual imagery, and interpretative phenomenological analysis (IPA).Qualitatively, our aim was to understand how respondents made sense of Marie Anne’s story in the way in which this was presented throughout the exhibition. We specifically looked at the personal context and frame of reference (e.g., previous experiences, connection to the visitor’s own life story, associations with other stories from other sources). In the design of the rooms, we used a combination of digital/interactive elements (such as a talking portrait, an interactive dinner table, an interactive family painting), and traditional physical objects (some 17th century original objects, some reproductions from that time). The second focal point of the study is to understand how these different elements lead the visitors experience.
