Background: Patient participation and goal setting appear to be difficult in daily physiotherapy practice, and practical methods are lacking. An existing patient-specific instrument, Patient-Specific Complaints (PSC), was therefore optimized into a new Patient Specific Goal-setting method (PSG). The aims of this study were to examine the feasibility of the PSG in daily physiotherapy practice, and to explore the potential impact of the new method. Methods: We conducted a process evaluation within a non-controlled intervention study. Community-based physiotherapists were instructed on how to work with the PSG in three group training sessions. The PSG is a six-step method embedded across the physiotherapy process, in which patients are stimulated to participate in the goal-setting process by: identifying problematic activities, prioritizing them, scoring their abilities, setting goals, planning and evaluating. Quantitative and qualitative data were collected among patients and physiotherapists by recording consultations and assessing patient files, questionnaires and written reflection reports. Results: Data were collected from 51 physiotherapists and 218 patients, and 38 recordings and 219 patient files were analysed. The PSG steps were performed as intended, but the ‘setting goals’ and ‘planning treatment’ steps were not performed in detail. The patients and physiotherapists were positive about the method, and the physiotherapists perceived increased patient participation. They became aware of the importance of engaging patients in a dialogue, instead of focusing on gathering information. The lack of integration in the electronic patient system was a major barrier for optimal use in practice. Although the self-reported actual use of the PSG, i.e. informing and involving patients, and client-centred competences had improved, this was not completely confirmed by the objectively observed behaviour. Conclusion: The PSG is a feasible method and tends to have impact on increasing patient participation in the goal-setting process. However, its full potential for shared goal setting has not been utilized yet. More implementation effort is needed to achieve the required behaviour change and a truly client-centred attitude, to make physiotherapists totally ready for shared goal setting.
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Abstract Study Objective To provide an overview of patients' needs concerning goal‐setting, and indications of how those needs can be met by nurses. Methods A narrative review. Pubmed and Cinahl were searched through March 1, 2020 for: patients' experiences concerning goal‐setting and the role of nursing in rehabilitation. Additional articles were found through snowballing. A total of 22 articles were reviewed on patients' experiences, and 12 on the nursing role. Results Patients need to be prepared for collaborating in goal‐setting and to receive an explanation about their part in that process. The multiplicity of disciplines may cloud patients' understanding of the process. The nurse's planning of the rehabilitation process should be aimed at resolving this issue. Goals need to be meaningful, and patients need support in attaining them. The interpretive, integrative, and consoling functions of Kirkevold's nursing role are suitable to meet these needs. Conclusions Both the literature about patients' needs regarding goal‐setting and the nursing role make clear that the way nurses work in rehabilitation can gain in clarity. Strengthening the role of nurses will improve the goal‐setting process for patients. Interprofessional collaboration, clear work procedures, continuity of care, time and trust, and the physical environment all are important to reinforce this role.
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Abstract Background: Nurses are consistently present throughout the rehabilitation of older patients but are apprehensive about performing goal-centred care in the multidisciplinary team. Objectives: The aim of this review was to explore working interventions on setting goals and working with goals designed for nurses in geriatric rehabilitation, and to describe their distinctive features. Methods: We performed a scoping review. We searched MEDLINE and CINAHL through August 4, 2021. Search terms related to the following themes: nurses, rehabilitation, geriatric, goal and method. We used snowballing to find additional. From the selected studies, we systematically extracted data on means, materials and the nursing role and summarized them in a narrative synthesis, using intervention component analysis. Results: The study includes 13 articles, describing 11 interventions which were developed for six different aims: improving multidisciplinary team care; increasing patient centredness; improving disease management by patients; improving the psychological, and emotional rehabilitation; increasing the nursing involvement in rehabilitation; or helping patients to achieve goals. The interventions appeal to four aspects of the nursing profession: assessing self-care skills incorporating patient's preferences; setting goals with patients, taking into account personal needs and what is medically advisable; linking the needs of the patient with multidisciplinary professional treatment and vice versa; and thus, playing an intermediate role and supporting goal achievement. Conclusions: The interventions show that in goal-centred care, the nurse might play an important unifying role between patients and the multidisciplinary team. With the support of nurses, the patient may become more aware of the rehabilitation process and transfer of ownership of treatment goals from the multidisciplinary team to the patient might be achieved. Not many interventions were found meant to support thenursing role. This may indicate a blind spot in the rehabilitation community to the additional value of its contribution.
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In line with European sustainability goals, small and medium sized enterprises (SMEs) in the Dutch automotive aftermarket face the challenge of maintaining competitiveness while transitioning to circular business models. These models, supported by EU policies such as the Circular Economy Action Plan and the European Green Deal, drive innovation in product lifecycle management, recycling, and sustainability. However, as SMEs adapt to these changes, they must also navigate the growing competition from imported Chinese electric vehicles (EVs), which bring both opportunities and risks. Logistics plays a critical role in this transition, as optimizing supply chains, enhancing resource efficiency, and minimizing waste are essential for achieving circularity. Will the Chinese car manufacturers move their value chain to Europe? Or will they further localize in aftersales businesses? Either scenario would affect a chain of SMEs in automotive aftermarket. Focusing on the auto parts SMEs in the Brainport region, this research examines how SMEs can stay competitive by leveraging logistics strategies to support circular practices, and navigate the challenges posed by the influx of Chinese EVs while remaining resilient and adaptable in the automotive aftermarket value chain. Together with our consortium partners, we help the regional SMEs in the automotive aftermarket with: 1. Mapping out logistical challenges and objectives, 2. Risk mitigation and demand planning, 3. Strategic supply chain development. Involving Fontys International Business graduation projects on data analysis, this project combines quantitative and qualitative insights to examine the transition of automotive aftermarket to an EV-dominated future. The SMEs in our consortium network are drive to adapt to the evolving landscape by investing in new measures. Through scenario assessment, we help them with scenario strategies in circular transition. For a broader impact, this project brings SMEs, branch and public organizations together and presents shared responsibilities in creating a resilient supply chain.
In the Glasgow declaration (2021), the tourism sector promised to reduce its CO2 emissions by 50% and reduce them to zero by 2050. The urgency is felt in the sector, and small steps are made at company level, but there is a lack of insight and overview of effective measures at global level.This study focuses on the development of a necessary mix of actions and interventions that the tourism sector can undertake to achieve the goal of a 50% reduction in greenhouse gases by 2030 towards zero emissions by 2050. The study contributes to a better understanding of the paths that the tourism sector can take to achieve this and their implications for the sector. The aim of the report is to spark discussion, ideas and, above all, action.The study provides a tool that positively engages the sector in the near and more distant future, inspires discussion, generates ideas, and drives action. In addition, there will be a guide that shows the big picture and where the responsibilities lie for the reduction targets. Finally, the researchers come up with recommendations for policymakers, companies, and lobbyists at an international and European level.In part 1 of the study, desk research is used to lay the foundation for the study. Here, the contribution of tourism to global greenhouse gas emissions is mapped out, as well as the image and reputation of the sector on climate change. In addition, this section describes which initiatives in terms of, among other things, coalitions and declarations have already been taken on a global scale to form a united front against climate change.In part 2, 40 policies and measures to reduce greenhouse gas emissions in the sector are evaluated in a simulation. For this simulation, the GTTMdyn simulation model, developed by Paul Peeters from BUAS, is used which works on a global scale and shows the effect of measures on emissions, tourism, transport, economy, and behaviour. In this simulation, the researchers can 'test' measures and learn from mistakes. In the end one or more scenarios will; be developed that reach the goals of 50% reduction in 2030 and zero emissions in 2050. In part 3, the various actions that should lead to the reduction targets are tested against the impacts on the consequences for the global tourism economy, its role in providing leisure and business opportunities and the consequences for certain destinations and groups of industry stakeholders. This part will be concluded with two workshops with industry experts to reflect on the results of the simulation.Part 4 reports the results of the study including an outline of the consequences of possibly not achieving the goal. With this, the researchers want to send a warning signal to stakeholders who may be resistant to participating in the transition.
A major challenge in the textile sector is achieving true circularity while preventing fraud, including false sustainability claims and material mislabelling. The complexity of supply chains and outdated certification systems have resulted in a lack of accountability and transparency. This project addresses these issues by developing and implementing Digital Product Passports, integrated with digital trust mechanisms as verifiable credentials, to create a transparent, responsible, and accountable textile supply chain. The project traces the journey of a corporate fashion t-shirt from cotton sourcing in India to production and distribution in the Netherlands, ensuring full transparency and traceability. Its goal is to drive a shift towards a circular economy by fostering collaboration across the supply chain and empowering stakeholders, particularly Tiers 3 and 4 in the Global South. Schijvens Corporate Fashion leads the effort with regenerative cotton sourcing through Raddis®Cotton, utilising Aware™’s technology solution. Adopting a ‘Fibre-Forward’ approach, the consortium ensures traceability by integrating data from raw material sourcing to end-user. This approach benefits all stakeholders, from farmers to garment producers, by providing verifiable information on fibre origins, social conditions, and ecological impacts. By tracking each fibre and collecting direct data, the project removes the opacity that can undermine sustainability claims. The project enhances accountability and sustainability compliance by utilising decentralised technologies for product verification. Integrating digital identity wallets for individuals and organisations, secured with verifiable credentials, enhances trust and accountability, fostering circular economy practices. Rather than seeing DPPs as the end goal, the project views them as catalysts for systemic change. It prioritises continuous improvement, collaboration, and shared benefits, aiming to establish a regenerative circular economy. Through a practical toolkit, the project will help organisations and policymakers navigate DPP adoption, strengthening transparency and creating a scalable, inclusive system for supply chains across the Global South and -North.
