Abstract Background: Approximately one-third of all patients with schizophrenia are treatment resistant. Worldwide, undertreatment with clozapine and other effective treatment options exist for people with treatment-resistant schizophrenia (TRS). In this respect, it appears that regular health care models do not optimally fit this patient group. The Collaborative Care (CC) model has proven to be effective for patients with severe mental illness, both in primary care and in specialized mental health care facilities. The key principles of the CC model are that both patients and informal caregivers are part of the treatment team, that a structured treatment plan is put in place with planned evaluations by the team, and that the treatment approach is multidisciplinary in nature and uses evidence-based interventions. We developed a tailored CC program for patients with TRS. Objective: In this paper, we provide an overview of the research design for a potential study that seeks to gain insight into both the process of implementation and the preliminary effects of the CC program for patients with TRS. Moreover, we aim to gain insight into the experiences of professionals, patients, and informal caregivers with the program. Methods: This study will be underpinned by a multiple case study design (N=20) that uses a mixed methods approach. These case studies will focus on an Early Psychosis Intervention Team and 2 Flexible Assertive Community treatment teams in the Netherlands. Data will be collected from patient records as well as through questionnaires, individual interviews, and focus groups. Patient recruitment commenced from October 2020. Results: Recruitment of participants commenced from October 2020, with the aim of enrolling 20 patients over 2 years. Data collection will be completed by the end of 2023, and the results will be published once all data are available for reporting. Conclusions: The research design, framed within the process of developing and testing innovative interventions, is discussed in line with the aims of the study. The limitations in clinical practice and specific consequences of this study are explained.
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Worldwide, schools implement social-emotional learning programs to enhance students' social-emotional skills. Although parents play an essential role in teaching these skills, knowledge about their perspectives on social-emotional learning is limited. In providing insight into the perspectives of parents from adolescent students this paper adds to this knowledge. An explorative qualitative study was conducted to gain insight into parents' perspectives on adolescent social-emotional learning. A broadly used professional framework for social emotional learning was used as a frame of reference in interviews with parents from diverse backgrounds. Within and across case analyses were applied to analyze the interviews. A conceptual model of four social-emotional skills constructs considered crucial learning by parents emerged from the data: respectful behavior, cooperation, self-knowledge and self-reliance. Parents' language, interpretations and orderings of skills indicate that the model underlying these constructs differs from skills embedded in the professional framework.
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Background: Collaboration between Speech and Language Therapists (SLTs) and parents is considered best practice for children with developmental disorders. However, such collaborative approach is not yet implemented in therapy for children with developmental language disorders (DLD) in the Netherlands. Improving Dutch SLTs’ collaboration with parents requires insight in factors that influence the way SLTs work with parents. Aims: To explore the specific beliefs of Dutch SLTs that influence how they collaborate with parents of children with DLD. Methods and procedures: We conducted three online focus groups with 17 SLTs using a reflection tool and fictional examples of parents to prompt their thoughts, feelings and actions on specific scenarios. Data were organised using the Theoretical Domains Framework (TDF). Outcomes and results: We identified 34 specific beliefs across nine TDF domains on how SLTs collaborate with parents of children with DLD. The results indicate that SLTs hold beliefs on how to support SLTs in collaborating with parents but also conflicting specific beliefs regarding collaborative work with parents. The latter relate to SLTs’ perspectives on their professional role and identity, their approach towards parents, and their confidence and competence in working collaboratively with parents.
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This paper describes the participatory development process of a web-based communication system focusing on disease management, particularly infection control of Methicillin-resistant Staphylococcus aureus (MRSA). These infections are becoming a major public health issue; they can have serious consequences such as pneumonia, sepsis or death [1]. This makes it even more important for people to be provided with up-to-date and reliable information. Users of a bilingual communication system (Dutch and German) participated in the development process via a needs assessment, the co-creation of the content and the system via usability tests, and in the summative evaluation of the usage of the system. The system enabled users to search efficiently and effectively for practical and relevant information. Moreover, we found that the participation of the intended users is a prerequisite to create a fit between the needs and expectations of the end-users, the technology and the social context of usage of technology. The summative evaluation showed that the system was frequently used (approximately 11,000 unique visitors per month). The most popular categories include ‘MRSA in general’ (20%, both languages) and ‘Acquiring MRSA’ (17% NL, 13% GER). Most users enter the site using internet search engines (Google) instead of the on-site search engine. When they are on the site, they prefer convenient searching via FAQ or related questions. Furthermore, the results showed that the participation of stakeholders is a prerequisite for a successful implementation of the system. To guide the participation of stakeholders we developed a roadmap that integrates human-centered development with business modelling activities.
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The continuation of emotional abuse as a normalized practice in elite youth sport has received scholarly attention, often with the use of a Foucauldian framework. The use of sense-making, a theoretical framework that focuses on how meaning is created in ambiguous situations, may give additional insights into the continuation of emotionally abusive coaching practices. The purpose of this study was to apply the seven properties of sense-making to explore how athletes and parents made sense of coaching practices in elite women’s gymnastics. We interviewed 14 elite women gymnasts and their parents to examine how they made sense of what occurred during practices. The results show how the sense-making of athletes and parents was an ongoing activity that resulted in a code of silence and a normalization of abusive coaching practices.
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Phytophthora infestans, the causal agent of late blight, remains the main threat to potato production worldwide. Screening of 19 accessions of Solanum dulcamara with P. infestans isolate Ipo82001 in detached leaf assays revealed strong resistance in an individual belonging to accession A54750069-1. This plant was crossed with a susceptible genotype, and an F(1) population consisting of 63 individuals was obtained. This population segregated for resistance in 1:1 ratio, both in detached leaf assays and in an open-field experiment. Presence of the formerly mapped Rpi-dlc1 gene as the cause of the observed segregating resistance could be excluded. Subsequently, AFLP analyses using 128 primer combinations enabled identification of five markers linked to a novel resistance gene named Rpi-dlc2. AFLP markers did not show sequence similarity to the tomato and potato genomes, hampering comparative genetic positioning of the gene. For this reason we used next-generation mapping (NGM), an approach that exploits direct sequencing of DNA (in our case: cDNA) pools from bulked segregants to calculate the genetic distance between SNPs and the locus of interest. Plotting of these genetic distances on the tomato and potato genetic map and subsequent PCR-based marker analysis positioned the gene on chromosome 10, in a region overlapping with the Rpi-ber/ber1 and -ber2 loci from S. berthaultii. Pyramiding of Rpi-dlc2 and Rpi-dlc1 significantly increased resistance to P. infestans, compared with individuals containing only one of the genes, showing the usefulness of this strategy to enhance resistance against Phytophthora.
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This article discusses the results of a study on children’s perspective (called: inner logic) on disciplinary conflicts with their (foster) parents. Most children accept parental authority, but also defend their personal autonomy and loyalties to peers. Only own children (children who live by their own parents) spoke about fierce resistance to get their own way. Conversely, fierce resistance among foster children was motivated by inner con- flicts and confusion. Obedience among foster children often derived from fear of punishment or a feeling of impotence. The theoretical and pedagogical implications of these findings are discussed.
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Background: Parents of children with profound intellectual and multiple disabilities (PIMD) have extensive care duties. This study describes the phenomenon “parenting a child with PIMD.” Method: We conducted in-depth interviews with 25 Dutch parents. A reflective lifeworld research. Findings: The essential meaning of the phenomenon was understood as “continuously struggling to create and maintain new equilibriums that protect the child and the family from hardship; changing in context through time.” The following eight constituents were identified: (1) medical complexity; (2) multidimensional weariness; (3) care for siblings; (4) social connectedness; (5) uncertainty about the future; (6) wrecking bureaucracy; (7) dependency on healthcare delivery; and (8) financial concerns. Conclusions: Healthcare services should provide families with easy access to assistive technology and services needed to manage family life. Responsiveness to parents’ challenges offers them the possibility to participate in society. Healthcare professionals should address the parents’ perspectives related to the child’s quality of life.
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This article discusses a study of children's perspectives on disciplinary conflicts with their foster parents. Most children accept parental authority, but they also defend their personal autonomy and loyalties to peers. In this study, only birthchildren told real-life stories about fierce resistance to get their own way. Fierce resistance among foster children was motivated by inner conflicts and confusion. Obedience among foster children often derived from fear of punishment or a feeling of impotence. The authors discuss the theoretical and pedagogical implications of these findings.
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What do a grandmaster Jedi and a grandfather have in common? The answer will become clear in this story of two sisters who used the Career Writing method to identify career questions, life themes, and tapped into the wisdom of their childhood heroes. Lengelle, R., Haggerty, E. (2022). Career Writing and the Tale of Two Sisters: The Family Project, Heroic Drive, and How No Sibling Has the Same Parents. In: Schreiber, M. (ed) Narrative Ansätze in Beratung und Coaching (pp. 163-172). Springer, Wiesbaden.
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