Many countries and health systems are pursuing integrated care as a means of achieving better outcomes. However, no standard approaches exist for comparing integration approaches across models or settings, and for evaluating whether the key components of integrated care are present in different initiatives. This study sheds light on how integrated care is being implemented in Australia, using a new tool to characterise and compare integration strategies at micro, meso and macro levels. In total, 114 staff from a purposive sample of 38 integrated care projects completed a survey based on the Rainbow Model of Integrated Care. Ten key informants gave follow-up interviews. Participating projects reported using multiple strategies to implement integrated care, but descriptions of implementation were often inconsistent. Micro-level strategies, including clinical-professional service coordination and person-centred care, were most commonly reported. A common vision was often described as an essential foundation for joint work. However, performance feedback appeared under-utilised, as did strategies requiring macro-level action such as data linkages or payment reform. The results suggest that current integrated care efforts are unevenly weighted towards micro-level strategies. Increased attention to macro-level strategies may be warranted in order to accelerate progress and sustain integrated care in Australia.
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In dit artikel wordt verslag gedaan van een exploratief onderzoek naar de relatie tussen metacognitieve opvattingen van leerlingen in 3, 4 en 6 VWO enerzijds en hun oriëntatie ten aanzien van de scheikunde anderzijds. In verband hiermee is een onderscheid gemaakt tussen een macro- en een submicro-oriëntatie. Wat betreft de metacognitieve opvattingen is door middel van vragenlijsten informatie verzameld omtrent de op scheikunde betrekking hebbende leerconcepties, epistemologische opvattingen en doeloriëntaties van de leerlingen. Met behulp van principale componenten analyses is nagegaan hoe deze variabelen onderling samenhangen, waarbij 'competentiegerichtheid' als eerste factor naar voren kwam. Kenmerkend voor de huidige scheikundemethoden is dat wordt uitgegaan van het macro-aspect. Het is daarom niet verwonderlijk dat een ruime meerderheid van de leerlingen in de door hen geproduceerde concept maps blijk gaf van een macro-oriëntatie. Op grond van hun scores op de factor competentiegerichtheid werden de leerlingen ingedeeld in twee categorieën. Vooral de meer competentiegerichte 6 VWO-leerlingen bleken vaak een submicro-oriëntatie te vertonen. Verondersteld wordt dat meer competentiegerichte leerlingen de neiging hebben 'heen-en-weer te denken' tussen het macro- en het submicro-aspect. Het verdient aanbeveling in het scheikundeonderwijs meer aandacht te schenken aan het leren heen-en-weer te denken, omdat deze competentie als essentieel voor de scheikunde kan worden beschouwd.
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Onder scheikundedocenten, chemiedidactici en lerarenopleiders is consensus over de centrale rol die het micro/macro concept zou moeten spelen in een nieuw te ontwerpen scheikundeprogramma voor havo en vwo. Bovendien kan worden geconcludeerd dat naast aandacht voor de plaats van het heen-en-weer denken in het te ontwikkelen lesmateriaal ook de wijze waarop scheikundedocenten in hun lessen dienen om te gaan met dit begrip belangrijk geacht wordt. Om ons een beeld te kunnen vormen van de didactische aspecten van het heen-en-weer denken is het van belang beter zicht te krijgen op de inzichten van scheikundedocenten in het gebruik van micro- en macro-scheikunde.
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Micro and macro algae are a rich source of lipids, proteins and carbohydrates, but also of secondary metabolites like phytosterols. Phytosterols have important health effects such as prevention of cardiovascular diseases. Global phytosterol market size was estimated at USD 709.7 million in 2019 and is expected to grow with a CAGR of 8.7% until 2027. Growing adoption of healthy lifestyle has bolstered demand for nutraceutical products. This is expected to be a major factor driving demand for phytosterols. Residues from algae are found in algae farming and processing, are found as beachings and are pruning residues from underwater Giant Kelp forests. Large amounts of brown seaweed beaches in the province of Zeeland and are discarded as waste. Pruning residues from Giant Kelp Forests harvests for the Namibian coast provide large amounts of biomass. ALGOL project considers all these biomass residues as raw material for added value creation. The ALGOL feasibility project will develop and evaluate green technologies for phytosterol extraction from algae biomass in a biocascading approach. Fucosterol is chosen because of its high added value, whereas lipids, protein and carbohydrates are lower in value and will hence be evaluated in follow-up projects. ALGOL will develop subcritical water, supercritical CO2 with modifiers and ethanol extraction technologies and compare these with conventional petroleum-based extractions and asses its technical, economic and environmental feasibility. Prototype nutraceutical/cosmeceutical products will be developed to demonstrate possible applications with fucosterol. A network of Dutch and African partners will supply micro and macro algae biomass, evaluate developed technologies and will prototype products with it, which are relevant to their own business interests. ALGOL project will create added value by taking a biocascading approach where first high-interest components are processed into high added value products as nutraceutical or cosmeceutical.
Micro and macro algae are a rich source of lipids, proteins and carbohydrates, but also of secondary metabolites like phytosterols. Phytosterols have important health effects such as prevention of cardiovascular diseases. Global phytosterol market size was estimated at USD 709.7 million in 2019 and is expected to grow with a CAGR of 8.7% until 2027. Growing adoption of healthy lifestyle has bolstered demand for nutraceutical products. This is expected to be a major factor driving demand for phytosterols.Residues from algae are found in algae farming and processing, are found as beachings and are pruning residues from underwater Giant Kelp forests. Large amounts of brown seaweed beaches in the province of Zeeland and are discarded as waste. Pruning residues from Giant Kelp Forests harvests for the Namibian coast provide large amounts of biomass. ALGOL project considers all these biomass residues as raw material for added value creation.The ALGOL feasibility project will develop and evaluate green technologies for phytosterol extraction from algae biomass in a biocascading approach. Fucosterol is chosen because of its high added value, whereas lipids, protein and carbohydrates are lower in value and will hence be evaluated in follow-up projects. ALGOL will develop subcritical water, supercritical CO2 with modifiers and ethanol extraction technologies and compare these with conventional petroleum-based extractions and asses its technical, economic and environmental feasibility. Prototype nutraceutical/cosmeceutical products will be developed to demonstrate possible applications with fucosterol.A network of Dutch and African partners will supply micro and macro algae biomass, evaluate developed technologies and will prototype products with it, which are relevant to their own business interests. ALGOL project will create added value by taking a biocascading approach where first high-interest components are processed into high added value products as nutraceutical or cosmeceutical.
Agriculture; Macro-Micro-Macro perspective; Public goods and Public bads; Collective action; Commons; Opposite concerns; Farmers and Peasants; Anthropology