In het middelbaar beroepsonderwijs worden hybride leeromgevingen, waarin de contexten van school en werk worden geïntegreerd, gezien als een veelbelovende manier om onderwijs en praktijk beter op elkaar aan te laten sluiten. Er is weinig bekend over het duurzaam ontwerpen van deze integratieve leeromgevingen binnen een mbo-instelling als geheel, waarbij het gaat om leeromgevingen van verschillende sectoren. In deze meervoudige, tweejarige case study zijn 45 integratieve leeromgevingen op de grens van school en werk, verspreid over zes sectoren binnen één onderwijsinstelling in kaart gebracht. Deze leeromgevingen zijn in focusgroepen geanalyseerd op 1) waar zij zich bevinden op de dimensie school-werk, 2) de ontwerpkenmerken inhoudelijk, sociaal, temporeel, instrumenteel en ruimtelijk, en 3) bevorderende en belemmerende factoren bij het ontwerpen en uitvoeren van integratieve leeromgevingen. Dit onderzoek geeft inzicht in hoe deze leeromgevingen zijn ontworpen en welke factoren daarbij van belang zijn. Integratief samenwerken met het werkveld blijkt in alle sectoren mogelijk. De ontwerpkenmerken inhoudelijk, sociaal en ruimtelijk worden vaker als integratief ervaren dan het ontwerpkenmerk temporeel. Vanuit het temporele perspectief blijken vooral kaders van school leidend en komen daarmee naar voren als een belangrijke factor in het succesvol opschalen en verduurzamen van leeromgevingen.
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We are currently in a transition moving from a linear economy grounded on economic value maximization based on material transformation to a circular economy. Core of this transition is organising value preservation from various yet interlinked perspectives. The underlying fundamental shift is to move away from mere financial value maximization towards multiple value creation (WCED, 1987; Jonker, 2014; Raworth, 2017). This implies moving from mere economic value creation, to simultaneously and in a balanced way creating ecological and social value. A parallel development supporting this transition can be observed in accounting & control. Elkington (1994) introduced the triple bottom line (TBL) concept, referring to the economic, ecological and social impact of companies. The TBL should be seen more as a conceptual way of thinking, rather than a practical innovative accounting tool to monitor and control sustainable value (Rambaud & Richard, 2015). However, it has inspired accounting & control practitioners to develop accounting tools that not only aim at economic value (‘single capital’ accounting) but also at multiple forms of capital (‘multi capital’ accounting or integrated reporting). This has led to a variety of integrated reporting platforms such as Global Reporting Initiative (GRI), International Integrated Reporting Framework (IIRC), Dow Jones Sustainable Indexes (DJSI), True Costing, Reporting 3.0, etc. These integrated reporting platforms and corresponding accounting concepts, can be seen as a fundament for management control systems focussing on multiple value creation. This leads to the following research question: How are management control systems designed in practice to drive multiple value creation?
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The central question in this study is how, for whom, and under which conditions professional youth work contributes to the personal development of socially vulnerable youngsters, the reinforcement of their social network, the enhancement of their social participation, and the timely finding of appropriate specialized care services in relation to contextual factors such as life events and the influence of significant others. This research used a multiple case study with a comparative design. During a 12-month period, youth workers (N = 20) participated in group intervision meetings and kept diaries reporting on their actions and the development of the youngsters (N = 23). An analysis of this data revealed four patterns of development of socially vulnerable youngsters in youth work settings. Each pattern consisted of a specific form of multi-methodic action that resulted in a specific outcome. The study also revealed how these processes of development are influenced by important life events and significant others. The findings suggest that youth work contributes to personal development and social participation and thereby may lessen the need for formal social care services.
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Enhancing communication performance skills may help children with Down Syndrome (DS) to expand their opportunities for participation in daily life. It is a clinical challenge for speech-language pathologists (SLP) to disentangle various mechanisms that contribute to the language and communication problems that children with DS encounter. Without clarity of different levels of functioning, appropriate interventions may be poorly conceived or improperly implemented. In the present study, the International Classification of Functioning, Disability and Health – Children and Youth Version (ICF-CY) framework was used to classify contributing factors to communication performance in a multiple case study of six young children with DS. Within a comprehensive assessment, we identified individual and environmental facilitators and barriers, leading to an integrative profile of communication performance (IPCP) for each child. Whereas these six children shared a developmental, and/or expressive vocabulary age and/or level of communicative intent, the children faced similar but also unique personal and environmental factors that play an important role in their communication performance. Our data reveal that a combination of different factors may lead to the same language outcomes and vice versa, based on a unique pattern of interdependency of ICF-CY domains. Planning SLP interventions for enhancing communication performance in children with DS should therefore be based on a comprehensive view on the competences and limitations of every individual child and its significant communication partners. This evaluation should address facilitators and barriers in body functions, structures, activities, participation and environment, with a specific focus on individual strengths. The ICF-CY provides a useful framework for constructing an IPCP that serves this purpose.
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Learning environment designs at the boundary of school and work can be characterised as integrative because they integrate features from the contexts of school and work. Many different manifestations of such integrative learning environments are found in current vocational education, both in senior secondary education and higher professional education. However, limited research has focused on how to design these learning environments and not much is known about their designable elements (i.e. the epistemic, spatial, instrumental, temporal and social elements that constitute the learning environments). The purpose of this study was to examine manifestations of two categories of integrative learning environment designs: designs based on incorporation; and designs based on hybridisation. Cross-case analysis of six cases in senior secondary vocational education and higher professional education in the Netherlands led to insights into the designable elements of both categories of designs. We report findings about the epistemic, spatial, instrumental, temporal and social elements of the studied cases. Specific characteristics of designs based on incorporation and designs based on hybridisation were identified and links between the designable elements became apparent, thus contributing to a deeper understanding of the design of learning environments that aim to connect the contexts of school and work.
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Background: Multimodal prehabilitation programs are effective at reducing complications after colorectal surgery in patients with a high risk of postoperative complications due to low aerobic capacity and/or malnutrition. However, high implementation fidelity is needed to achieve these effects in real-life practice. This study aimed to investigate the implementation fidelity of an evidence-based prehabilitation program in the real-life context of a Dutch regional hospital.Methods: In this observational cohort study with multiple case analyses, all patients who underwent colorectal surgery from January 2023 to June 2023 were enrolled. Patients meeting the criteria for low aerobic capacity or malnutrition were advised to participate in a prehabilitation program. According to recent scientific insights and the local care context, this program consisted of four exercise modalities and three nutrition modalities. Implementation fidelity was investigated by evaluating: (1) coverage (participation rate), (2) duration (number of days between the start of prehabilitation and surgery), (3) content (delivery of prescribed intervention modalities), and (4) frequency (attendance of sessions and compliance with prescribed parameters). An aggregated percentage of content and frequency was calculated to determine overall adherence.Results: Fifty-eight patients intended to follow the prehabilitation care pathway, of which 41 performed a preoperative risk assessment (coverage 80%). Ten patients (24%) were identified as high-risk and participated in the prehabilitation program (duration of 33-84 days). Adherence was high (84-100%) in five and moderate (72-73%) in two patients. Adherence was remarkably low (25%, 53%, 54%) in three patients who struggled to execute the prehabilitation program due to multiple physical and cognitive impairments.Conclusion: Implementation fidelity of an evidence-based multimodal prehabilitation program for high-risk patients preparing for colorectal surgery in real-life practice was moderate because adherence was high for most patients, but low for some patients. Patients with low adherence had multiple impairments, with consequences for their preparation for surgery. For healthcare professionals, it is recommended to pay attention to high-risk patients with multiple impairments and further personalize the prehabilitation program. More knowledge about identifying and treating high-risk patients is needed to provide evidence-based recommendations and to obtain higher effectiveness.
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Successfully introducing care innovations depends on the type of care setting, the intervention and specific circumstances. In this study the factors influencing the introduction of an evidence based nursing guideline on depression in psychogeriatric nursing home residents were studied.
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The current study analyzed blogs written by four Dutch parents of children with profound intellectual and multiple disabilities, with the aim of deepening the understanding of the parents’ concerns. Thematic analysis was conducted and five main themes were identified: Dealing with uncertainties addressed the impact of unpredictability present in the everyday lives of parents, Love and loss described the complexity of concurrently cherishing the child and grieving various types of loss, Struggling with time, energy and finances detailed imbalances and struggles related to parents’ personal resources, Feeling included in communities and society specified social consequences, and Relating to professional care services reflected on stress and support associated with professional care delivery. The study findings demonstrate how care professionals should acknowledge parents’ vulnerabilities by being aware of their existential distress and empowering parents to exercise control of family thriving.
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Purpose: The purpose of this study is to find determinants about risk resilience and develop a new risk resilience approach for (agricultural) enterprises. This approach creates the ability to respond resiliently to major environmental challenges and changes in the short term and adjust the management of the organization, and to learn and transform to adapt to the new environment in the long term while creating multiple value creation. Design/methodology: The authors present a new risk resilience approach for multiple value creation of (agricultural) enterprises, which consists of a main process starting with strategy design, followed by an environmental analysis, stakeholder collaboration, implement ESG goals, defining risk expose & response options, and report, learn & evaluate. In each step the organizational perspective, as well as the value chain/area perspective is considered and aligned. The authors have used focus groups and analysed literature from and outside the field of finance and accounting, to design this new approach. Findings: Researchers propose a new risk resilience approach for (agricultural) enterprises, based on a narrative about transforming to multiple value creation, founded determinants of risk resilience, competitive advantage and agricultural resilience. Originality and value: This study contributes by conceptualizing risk resilience for (agricultural) enterprises, by looking through a lens of multiple value creation in a dynamic context and based on insights from different fields, actual ESG knowledge, and determinants for risk resilience, competitive advantage and agricultural resilience.
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