Background: The substitution of healthcare is a way to control rising healthcare costs. The Primary Care Plus (PC+) intervention of the Dutch ‘Blue Care’ pioneer site aims to achieve this feat by facilitating consultations with medical specialists in the primary care setting. One of the specialties involved is dermatology. This study explores referral decisions following dermatology care in PC+ and the influence of predictive patient and consultation characteristics on this decision. Methods: This retrospective study used clinical data of patients who received dermatology care in PC+ between January 2015 and March 2017. The referral decision following PC+, (i.e., referral back to the general practitioner (GP) or referral to outpatient hospital care) was the primary outcome. Stepwise logistic regression modelling was used to describe variations in the referral decisions following PC+, with patient age and gender, number of PC+ consultations, patient diagnosis and treatment specialist as the predicting factors. Results: A total of 2952 patients visited PC+ for dermatology care. Of those patients with a registered referral, 80.2% (N = 2254) were referred back to the GP, and 19.8% (N = 558) were referred to outpatient hospital care. In the multivariable model, only the treating specialist and patient’s diagnosis independently influenced the referral decisions following PC+. Conclusion: The aim of PC+ is to reduce the number of referrals to outpatient hospital care. According to the results, the treating specialist and patient diagnosis influence referral decisions. Therefore, the results of this study can be used to discuss and improve specialist and patient profiles for PC+ to further optimise the effectiveness of the initiative.
This contribution addresses two studies of the processes and outcomes of English as a foreign language (EFL) in Dutch primary education. Firstly, this article describes a preliminary study of the learning outcomes at the end of primary education, comparing pupils’ language proficiency after either two years or six to eight years of low-intensity EFL programs. Secondly, it describes the outcomes of a subsequent classroom observation study in a high-intensity bilingual primary education pilot in grade 1, focusing on teacher language use and teacher-pupil interaction. Results are related to learning outcome in terms of pupils’ receptive vocabulary knowledge. Conclusions focus on foreign language teaching in primary education in general, and bilingual primary education in particular.
The purpose of this paper is to investigate which theoretical elements of adding value with? real estate are applied in practice in accommodating primary education and in what way these are elements relevant to the stakeholders. A literature study of usual CREM strategies has been used to build a theoretical framework with regard to the value a building can create for different stakeholders. Interviews were then held with various professionally involved people in order to understand to what extent the general theory is taken into account with regard to “added value” for the stakeholders of primary school buildings. The data show that CREM theory also can be applied to the “not for profit” school buildings, but that not all potential possibilities to add value with real estate for primary education seem to be applied in practice.
Designing cities that are socially sustainable has been a significant challenge until today. Lately, European Commission’s research agenda of Industy 5.0 has prioritised a sustainable, human-centric and resilient development over merely pursuing efficiency and productivity in societal transitions. The focus has been on searching for sustainable solutions to societal challenges, engaging part of the design industry. In architecture and urban design, whose common goal is to create a condition for human life, much effort was put into elevating the engineering process of physical space, making it more efficient. However, the natural process of social evolution has not been given priority in urban and architectural research on sustainable design. STEPS stems from the common interest of the project partners in accessible, diverse, and progressive public spaces, which is vital to socially sustainable urban development. The primary challenge lies in how to synthesise the standardised sustainable design techniques with unique social values of public space, propelling a transition from technical sustainability to social sustainability. Although a large number of social-oriented studies in urban design have been published in the academic domain, principles and guidelines that can be applied to practice are large missing. How can we generate operative principles guiding public space analysis and design to explore and achieve the social condition of sustainability, developing transferable ways of utilising research knowledge in design? STEPS will develop a design catalogue with operative principles guiding public space analysis and design. This will help designers apply cross-domain knowledge of social sustainability in practice.
The primary objective of the project is to identify policies for the transformation of the Norwegian tourism sector to become resilient to climate change and carbon risks; to maintain and develop its economic benefits; and to significantly reduce its emissions-intensity per unit of economic output. Collaborative partnersStiftinga Vestlandforsking, Stiftelsen Handelshoyskolen, Stat Sentralbyra, Norges Handelshoyskole, Stiftelsen Nordlandsforskning, Fjord Norge, Hurtigruten, Neroyfjorden Verdsarvpark, Uni Waterloo, Uni Queensland, Desinasjon Voss, Stift Geirangerfjorden Verdsarv, Hogskulen Pa Vestlandet.
Due to societal developments, like the introduction of the ‘civil society’, policy stimulating longer living at home and the separation of housing and care, the housing situation of older citizens is a relevant and pressing issue for housing-, governance- and care organizations. The current situation of living with care already benefits from technological advancement. The wide application of technology especially in care homes brings the emergence of a new source of information that becomes invaluable in order to understand how the smart urban environment affects the health of older people. The goal of this proposal is to develop an approach for designing smart neighborhoods, in order to assist and engage older adults living there. This approach will be applied to a neighborhood in Aalst-Waalre which will be developed into a living lab. The research will involve: (1) Insight into social-spatial factors underlying a smart neighborhood; (2) Identifying governance and organizational context; (3) Identifying needs and preferences of the (future) inhabitant; (4) Matching needs & preferences to potential socio-techno-spatial solutions. A mixed methods approach fusing quantitative and qualitative methods towards understanding the impacts of smart environment will be investigated. After 12 months, employing several concepts of urban computing, such as pattern recognition and predictive modelling , using the focus groups from the different organizations as well as primary end-users, and exploring how physiological data can be embedded in data-driven strategies for the enhancement of active ageing in this neighborhood will result in design solutions and strategies for a more care-friendly neighborhood.
