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.
MULTIFILE
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.
LINK
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?
MULTIFILE
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.
DOCUMENT
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.
LINK
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.
DOCUMENT
Abstract from AMS Scientific Conference '24, Amsterdam, Netherlands.In the two-year Nature-Based Area Development study researchers at four Dutch universities collaborated with planning professionals in cities, regions and companies to investigate how nature-based urban development can become a forceful reality. The study applied a combination of methods such as co-research sessions with consortium partners, in-depth interviews with experts and a multiple case study analysis of best practices in the Netherlands and abroad.Keywords: nature-based, area development, densification, urban ecosystem services, planning instruments
DOCUMENT
Background: Structured psychotherapy is recommended as the preferred treatment of personality disorders. A substantial group of patients, however, has no access to these therapies or does not benefit. For those patients who have no (longer) access to psychotherapy a Collaborative Care Program (CCP) is developed. Collaborative Care originated in somatic health care to increase shared decision making and to enhance self management skills of chronic patients. Nurses have a prominent position in CCP’s as they are responsible for optimal continuity and coordination of care. The aim of the CCP is to improve quality of life and self management skills, and reduce destructive behaviour and other manifestations of the personality disorder. Methods/design: Quantitative and qualitative data are combined in a comparative multiple case study. This makes it possible to test the feasibility of the CCP, and also provides insight into the preliminary outcomes of CCP. Two treatment conditions will be compared, one in which the CCP is provided, the other in which Care as Usual is offered. In both conditions 16 patients will be included. The perspectives of patients, their informal carers and nurses are integrated in this study. Data (questionnaires, documents, and interviews) will be collected among these three groups of participants. The process of treatment and care within both research conditions is described with qualitative research methods. Additional quantitative data provide insight in the preliminary results of the CCP compared to CAU. With a stepped analysis plan the ‘black box’ of the application of the program will be revealed in order to understand which characteristics and influencing factors are indicative for positive or negative outcomes. Discussion: The present study is, as to the best of our knowledge, the first to examine Collaborative Care for patients with severe personality disorders receiving outpatient mental health care. With the chosen design we want to examine how and which elements of the CC Program could contribute to a better quality of life for the patients.
MULTIFILE
