Aims and objectives: To describe the process of implementing evidence-based practice (EBP) in a clinical nursing setting. Background: EBP has become a major issue in nursing, it is insufficiently integrated in daily practice and its implementation is complex. Design: Participatory action research. Method: The main participants were nurses working in a lung unit of a rural hospital. A multi-method process of data collection was used during the observing, reflecting, planning and acting phases. Data were continuously gathered during a 24-month period from 2010 to 2012, and analysed using an interpretive constant comparative approach. Patients were consulted to incorporate their perspective. Results: A best-practice mode of working was prevalent on the ward. The main barriers to the implementation of EBP were that nurses had little knowledge of EBP and a rather negative attitude towards it, and that their English reading proficiency was poor. The main facilitators were that nurses wanted to deliver high-quality care and were enthusiastic and open to innovation. Implementation strategies included a tailored interactive outreach training and the development and implementation of an evidence-based discharge protocol. The academic model of EBP was adapted. Nurses worked according to the EBP discharge protocol but barely recorded their activities. Nurses favourably evaluated the participatory action research process. Conclusions: Action research provides an opportunity to empower nurses and to tailor EBP to the practice context. Applying and implementing EBP is difficult for front-line nurses with limited EBP competencies. Relevance to clinical practice: Adaptation of the academic model of EBP to a more pragmatic approach seems necessary to introduce EBP into clinical practice. The use of scientific evidence can be facilitated by using pre-appraised evidence. For clinical practice, it seems relevant to integrate scientific evidence with clinical expertise and patient values in nurses’ clinical decision making at the individual patient level.
Urban farming projects often involve the (temporarily) redevelopment of urban space by local co-productions of citizens and/or entrepreneurs. To realize their ambitions these coalitions often need support of public (government) resources such as time, money, space and regulation (Green Deal Stadslandbouw, 2013). This paper asks the question to what extent the development of urban farming projects can be understood as an example of planning through direct citizen participation/ participatory governance (e.g. Cornwall, 2004; Roberts, 2004) and what this means for the role of the municipal planning professional or civil servant in making these projects successful. Literature on the role of the municipal planner or civil servant in urban farming projects mainly concerns the role as enabler of projects given the many difficulties for projects. However, when looked at the development of urban farming as an example of citizen participation/ participatory governance and the transfer of social functions towards society other roles and tasks of planners seem to be important to make urban farming successful. This discussion paper looks to the role of planners and civil servants in some related government domains such as landscape (e.g. Van Dam et al. 2008, 2010, 2011) and neighbourhood development (e.g. Frieling et al., 2014) to complement our understanding of the role of planners in making urban farming projects successful. With this analysis the paper sets the scene for further research into tools for the planning professional or civil servant to support urban farming. In the paper the situation in Amsterdam serves as an example.
Urban renewal and urban area development projects are by nature highly complex processes involving a multiplicity of professionals, stakeholders, and conflicting interests. Adding to this complexity are the formulated ambitions and societal challenges projects have to answer to. One of these ambitions emphasizes a more inclusive planning process, involving the inhabitants in all stages of the planning process. In terms of design, another challenge is to create environments on a human scale while building in high density such as with tall residential buildings. The metropolitan area of Amsterdam intends to have 100,000 new dwellings by 2025. Most of these dwellings have to be added within the existing urban fabric, planned on obsolete inner-city brownfield locations, at the waterfront, nearby highways whereas others are going to be built in deprived neighborhoods. The deprived neighborhoods are mainly located in the postwar areas of Amsterdam, on its northern, western, and south-eastern sides. The deprived neighborhood called the Bijlmermeer located on the south-eastern side of the city, for instance was the first high-rise development project in the Netherlands. It was designed as a single project with identical high-rise buildings in a hexagonal grid surrounded with large green spaces.These deprived, modernistic neighborhoods lack the classic housing block structures with a clear articulation of buildings and street spaces. They appear to be responsible for an ‘inhuman’ scale and demonstrate the lasting impact critical design flaws can have on the daily lives of inhabitants. Hence, the question is how to develop liveable environments where people feel fully supported by building architecture and streetscape configuration. To prevent new urban area developments that will again fail to incorporate human scale, scientific methods and user input are needed to inform the practice of planning and design, and their applied design solutions. Building on two research projects (one on participatory planning and the other on neuroarchitecture research), we explore how the newly emerging field of neuroarchitecture - and the eye-tracker in particular, might enhance urban area developments on a human scale.
DISTENDER will provide integrated strategies by building a methodological framework that guide the integration of climate change(CC) adaptation and mitigation strategies through participatory approaches in ways that respond to the impacts and risks of climatechange (CC), supported by quantitative and qualitative analysis that facilitates the understanding of interactions, synergies and tradeoffs.Holistic approaches to mitigation and adaptation must be tailored to the context-specific situation and this requires a flexibleand participatory planning process to ensure legitimate and salient action, carried out by all important stakeholders. DISTENDER willdevelop a set of multi-driver qualitative and quantitative socio-economic-climate scenarios through a facilitated participatory processthat integrates bottom-up knowledge and locally-relevant drivers with top-down information from the global European SharedSocioeconomic Pathways (SSPs) and downscaled Representative Concentration Pathways (RCPs) from IPCC. A cross-sectorial andmulti-scale impact assessment modelling toolkit will be developed to analyse the complex interactions over multiple sectors,including an economic evaluation framework. The economic impact of the different efforts will be analyse, including damage claimsettlement and how do sectoral activity patterns change under various scenarios considering indirect and cascading effects. It is aninnovative project combining three key concepts: cross-scale, integration/harmonization and robustness checking. DISTENDER willfollow a pragmatic approach applying methodologies and toolkits across a range of European case studies (six core case studies andfive followers) that reflect a cross-section of the challenges posed by CC adaptation and mitigation. The knowledge generated byDISTENDER will be offered by a Decision Support System (DSS) which will include guidelines, manuals, easy-to-use tools andexperiences from the application of the cases studies.
Many entrepreneurs on Texel want to onboard nature into their business. While a legal toolkit is available (“Onboarding Nature”), they still struggle to bring in the perspective of nature and future generations into their activities in a meaningful way. Representing this shared need, the National Park Duinen van Texel initiated a quest: How can local businesses (including the National Park’s Gastheren) on Texel effectively onboard Nature and Future Generations into their companies in order to secure thriving ecosystem? Realizing that a growing number of businesses are ready to consider an eco-centric perspective on how they run their operations, they feel unequipped to make the change. Therefore drawing on the “Onboarding Nature” toolkit (www.onboardingnature.com), the research team seek to tackle the question: How can we establish new methodologies for mindset shifts that help local businesses on Texel move from an anthropocentric to an ecocentric perspective that fosters ecosystemic regeneration for Future Generations of all Life? Through participatory, art and design-based research methodologies the project explores how entrepreneurs incorporate nature’s voice into both their strategic planning and daily operations. The expected result is a guidebook with practices and materials that support reframing towards an ecocentric perspective when Onboarding Nature. Results will complement the existing “Onboarding Nature” toolkit. By the end of the project, Texel’s entrepreneurs will co-develop the tools and gained experiences to become guardians of a thriving ecosystem, including (future) humans. This initiative will serve as a scalable model for other National Parks, empowering them to adopt a similar transformative approach. Partners: • Center of Expertise Wellbeing Economy and New Entrepreneurship Avans University of Applied Sciences • Center of Expertise Digital Operations & Finance The Hague University of Applied Sciences • De Organisatie Activist, • National Park Duinen van Texel • World Ethic Forum, • Nyenrode Business University • Nature
