Abstract Purpose In mental health care, patients and their care providers may conceptualize the nature of the disorder and appropriate action in profoundly diferent ways. This may lead to dropout and lack of compliance with the treatments being provided, in particular in young patients with more severe disorders. This study provides detailed information about patient–provider (dis)agreement regarding the care needs of children and adolescents. Methods We used the Camberwell Assessment of Need (CANSAS) to assess the met and unmet needs of 244 patients aged between 6 and 18 years. These needs were assessed from the perspectives of both patients and their care providers. Our primary outcome measure was agreement between the patient and care provider on unmet need. By comparing a general outpatient sample (n=123) with a youth-ACT sample (n=121), we were able to assess the infuence of severity of psychiatric and psychosocial problems on the extent of agreement on patient’s unmet care needs. Results In general, patients reported unmet care needs less often than care providers did. Patients and care providers had the lowest extents of agreement on unmet needs with regard to “mental health problems” (k=0.113) and “information regarding diagnosis/treatment” (k=0.171). Comparison of the two mental healthcare settings highlighted diferences for three-quarters of the unmet care needs that were examined. Agreement was lower in the youth-ACT setting. Conclusions Clarifcation of diferent views on patients’ unmet needs may help reduce nonattendance of appointments, noncompliance, or dropout. Routine assessment of patients’ and care providers’ perceptions of patients’ unmet care needs may also help provide information on areas of disagreement.
Introduction: Nowadays the Western mental health system is in transformation to recovery-oriented and trauma informed care in which experiential knowledge becomes incorporated. An important development in this context is that traditional mental health professionals came to the fore with their lived experiences. From 2017 to 2021, a research project was conducted in the Netherlands in three mental health organizations, focussing on how service users perceive the professional use of experiential knowledge. Aims: This paper aims to explore service users’ perspectives regarding their healthcare professionals’ use of experiential knowledge and the users’ perceptions of how this contributes to their personal recovery. Methods: As part of the qualitative research, 22 service users were interviewed. A thematic analysis was employed to derive themes and patterns from the interview transcripts. Results: The use of experiential knowledge manifests in the quality of a compassionate user-professional relationship in which personal disclosures of the professional’s distress and resilience are embedded. This often stimulates users’ recovery process. Conclusions: Findings suggest that the use of experiential knowledge by mental health professionals like social workers, nurses and humanistic counselors, demonstrates an overall positive value as an additional (re)source.
Purpose To empirically define the concept of burden of neck pain. The lack of a clear understanding of this construct from the perspective of persons with neck pain and care providers hampers adequate measurement of this burden. An additional aim was to compare the conceptual model obtained with the frequently used Neck Disability Index (NDI). Methods Concept mapping, combining qualitative (nominal group technique and group consensus) and quantitative research methods (cluster analysis and multidimensional scaling), was applied to groups of persons with neck pain (n = 3) and professionals treating persons with neck pain (n = 2). Group members generated statements, which were organized into concept maps. Group members achieved consensus about the number and description of domains and the researchers then generated an overall mind map covering the full breadth of the burden of neck pain. Results Concept mapping revealed 12 domains of burden of neck pain: impaired mobility neck, neck pain, fatigue/concentration, physical complaints, psychological aspects/consequences, activities of daily living, social participation, financial consequences, difficult to treat/difficult to diagnose, difference of opinion with care providers, incomprehension by social environment, and how person with neck pain deal with complaints. All ten items of the NDI could be linked to the mind map, but the NDI measures only part of the burden of neck pain. Conclusion This study revealed the relevant domains for the burden of neck pain from the viewpoints of persons with neck pain and their care providers. These results can guide the identification of existing measurements instruments for each domain or the development of new ones to measure the burden of neck pain.
DISCO aims at fast-tracking upscaling to new generation of urban logistics and smart planning unblocking the transition to decarbonised and digital cities, delivering innovative frameworks and tools, Physical Internet (PI) inspired. To this scope, DISCO will deploy and demonstrate innovative and inclusive urban logistics and planning solutions for dynamic space re-allocation integrating urban freight at local level, within efficiently operated network-of-networks (PI) where the nodes and infrastructure are fixed and mobile based on throughput demands. Solutions are co-designed with the urban logistics community – e.g., cities, logistics service providers, retailers, real estate/public and private infrastructure owners, fleet owners, transport operators, research community, civil society - all together moving a paradigm change from sprawl to data driven, zero-emission and nearby-delivery-based models.
The projectThe overarching goal of DIGNITY, DIGital traNsport In and for socieTY, is to foster a sustainable, integrated and user-friendly digital travel eco-system that improves accessibility and social inclusion, along with the travel experience and daily life of all citizens. The project delves into the digital transport eco-system to grasp the full range of factors that might lead to disparities in the uptake of digitalised mobility solutions by different user groups in Europe. Analysing the digital transition from both a user and provider’s perspective, DIGNITY looks at the challenges brought about by digitalisation, to then design, test and validate the DIGNITY approach, a novel concept that seeks to become the ‘ABCs for a digital inclusive travel system’. The approach combines proven inclusive design methodologies with the principles of foresight analysis to examine how a structured involvement of all actors – local institutions, market players, interest groups and end users – can help bridge the digital gap by co-creating more inclusive mobility solutions and by formulating user-centred policy frameworks.The objectivesThe idea is to support public and private mobility providers in conceiving mainstream digital products or services that are accessible to and usable by as many people as possible, regardless of their income, social situation or age; and to help policy makers formulate long-term strategies that promote innovation in transport while responding to global social, demographic and economic changes, including the challenges of poverty and migration.The missionBy focusing on and involving end-users throughout the process of designing policies, products, or services, it is possible to reduce social exclusion while boosting new business models and social innovation. The end result that DIGNITY is aiming for is an innovative decision support tool that can help local and regional decision-makers formulate digitally inclusive policies and strategies, and digital providers design more inclusive products and services.The approachThe DIGNITY approach combines analysis with concrete actions to make digital mobility services inclusive over the long term. The approach connects users’ needs and requirements with the provision of mobility services, and at the same time connects those services to the institutional framework. It is a multi-phase process that first seeks to understand and bridge the digital gap, and then to test, evaluate and fine-tune the approach, so that it can be applied in other contexts even after the project’s end.Partners: ISINNOVA (Italy), Mobiel 21 (Belgium), Universitat Politechnica deCatalunya Spain), IZT (Germany), University of Cambridge (UK), Factualconsulting (Spain), Barcelona Regional Agencia (Spain), City of Tilburg(Netherlands), Nextbike (Germany), City of Ancona (Italy), MyCicero (Italy),Conerobus (Italy), Vlaams Gewest (Belgium)
Over the past decade, the trend in both the public sector and industry has been to outsource ICT to the cloud. While cost savings are often used as a rationale for outsourcing, another argument that is frequently used is that the cloud improves security. The reasoning behind this is twofold. First, cloud service providers are typically thought to have skilled staff trained in good security practices. Second, cloud providers often have a vastly distributed, highly connected network infrastructure, making them more resilient in the face of outages and denial-of-service attacks. Yet many examples of cloud outages, often due to attacks, call into question whether outsourcing to the cloud does improve security. In this project our goal therefore is to answer two questions: 1) did the cloud make use more secure?and 2) can we provide specific security guidance to support cloud outsourcing strategies? We will approach these questions in a multi-disciplinary fashion from a technical angle and from a business and management perspective. On the technical side, the project will focus on providing comprehensive insight into the attack surface at the network level of cloud providers and their users. We will use a measurement-based approach, leveraging large scale datasets about the Internet, both our own data (e.g. OpenINTEL, a large- scale dataset of active DNS measurements) and datasets from our long-term collaborators, such as CAIDA in the US (BGPStream, Network Telescope) and Saarland University in Germany (AmpPot). We will use this data to study the network infrastructure outside and within cloud environments to structurally map vulnerabilities to attacks as well as to identify security anti-patterns, where the way cloud services are managed or used introduce a weak point that attackers can target. From a business point of view, we will investigate outsourcing strategies for both the cloud providers and their customers. For guaranteeing 100% availability, cloud service providers have to maintain additional capacity at all times. They also need to forecast capacity requirements continuously for financially profitable decisions. If the forecast is lower than the capacity needed, then the cloud is not able to deliver 100% availability in case of an attack. Conversely, if the forecast is substantially higher, the cloud service provider might not be able to make desired profits. We therefore propose to assess the risk profiles of cloud providers (how likely it is a cloud provider is under attack at a given time given the nature of its customers) using available attack data to improve the provider resilience to future attacks. From the costumer perspective, we will investigate how we can support cloud outsourcing by taking into consideration business and technical constraints. Decision to choose a cloud service provider is typically based on multiple criteria depending upon the company’s needs (security and operational). We will develop decision support systems that will help in mapping companies’ needs to cloud service providers’ offers.
