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Purpose In this systematic literature review, the effects of the application of a checklist during in hospital resuscitation of trauma patients on adherence to the ATLS guidelines, trauma team performance, and patient-related outcomes were integrated. Methods A systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Metaanalyses checklist. The search was performed in Pubmed, Embase, CINAHL, and Cochrane inception till January 2019. Randomized controlled- or controlled before-and-after study design were included. All other forms of observational study designs, reviews, case series or case reports, animal studies, and simulation studies were excluded. The Effective Public Health Practice Project Quality Assessment Tool was applied to assess the methodological quality of the included studies. Results Three of the 625 identified articles were included, which all used a before-and-after study design. Two studies showed that Advanced Trauma Life Support (ATLS)-related tasks are significantly more frequently performed when a checklist was applied during resuscitation. [14 of 30 tasks (p < 0.05), respectively, 18 of 19 tasks (p < 0.05)]. One study showed that time to task completion (− 9 s, 95% CI = − 13.8 to − 4.8 s) and workflow improved, which was analyzed as model fitness (0.90 vs 0.96; p < 0.001); conformance frequency (26.1% vs 77.6%; p < 0.001); and frequency of unique workflow traces (31.7% vs 19.1%; p = 0.005). One study showed that the incidence of pneumonia was higher in the group where a checklist was applied [adjusted odds ratio (aOR) 1.69, 95% Confidence Interval (CI 1.03–2.80)]. No difference was found for nine other assessed complications or missed injuries. Reduced mortality rates were found in the most severely injured patient group (Injury Severity score > 25, aOR 0.51, 95% CI 0.30–0.89). Conclusions The application of a checklist may improve ATLS adherence and workflow during trauma resuscitation. Current literature is insufficient to truly define the effect of the application of a checklist during trauma resuscitation on patientrelated outcomes, although one study showed promising results as an improved chance of survival for the most severely injured patients was found.
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Background and Objective: To develop a health care value framework for physical therapy primary health care organizations including a definition. Method: A scoping review was performed. First, relevant studies were identified in 4 databases (n = 74). Independent reviewers selected eligible studies. Numerical and thematic analyses were performed to draft a preliminary framework including a definition. Next, the feasibility of the framework and definition was explored by physical therapy primary health care organization experts. Results: Numerical and thematic data on health care quality and context-specific performance resulted in a health care value framework for physical therapy primary health care organizations—including a definition of health care value, namely “to continuously attain physical therapy primary health care organization-centered outcomes in coherence with patient- and stakeholder-centered outcomes, leveraged by an organization’s capacity for change.” Conclusion: Prior literature mainly discussed health care quality and context-specific performance for primary health care organizations separately. The current study met the need for a value-based framework, feasible for physical therapy primary health care organizations, which are for a large part micro or small. It also solves the omissions of incoherent literature and existing frameworks on continuous health care quality and context-specific performance. Future research is recommended on longitudinal exploration of the HV (health care value) framework.
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This document presents the findings of a study into methods that can help counterterrorism professionals make decisions about ethical problems. The study was commissioned by the Research and Documentation Centre (Wetenschappelijk Onderzoeken Documentatiecentrum, WODC) of the Dutch Ministry of Security and Justice (Ministerie van Veiligheid en Justitie), on behalf of the National Coordinator for Counterterrorism and Security (Nationaal Coördinator Terrorismebestrijding en Veiligheid,NCTV). The research team at RAND Europe was complemented by applied ethics expert Anke van Gorp from the Research Centre for Social Innovation (Kenniscentrum Sociale Innovatie) at Hogeschool Utrecht. The study provides an inventory of methods to support ethical decision-making in counterterrorism, drawing on the experience of other public sectors – healthcare, social work, policing and intelligence – and multiple countries, primarily the Netherlands and the United Kingdom
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Background: The COVID-19 pandemic taught us how to rethink care delivery. It catalyzed creative solutions to amplify the potential of personnel and facilities. This paper presents and evaluates a promptly introduced triaging solution that evolved into a tool to tackle the ever-growing waiting lists at an academic ophthalmology department, the TeleTriageTeam (TTT). A team of undergraduate optometry students, tutor optometrists, and ophthalmologists collaborate to maintain continuity of eye care. In this ongoing project, we combine innovative interprofessional task allocation, teaching, and remote care delivery. Objective: In this paper, we described a novel approach, the TTT; reported its clinical effectiveness and impact on waiting lists; and discussed its transformation to a sustainable method for delivering remote eye care. Methods: Real-world clinical data of all patients assessed by the TTT between April 16, 2020, and December 31, 2021, are covered in this paper. Business data on waiting lists and patient portal access were collected from the capacity management team and IT department of our hospital. Interim analyses were performed at different time points during the project, and this study presents a synthesis of these analyses. Results: A total of 3658 cases were assessed by the TTT. For approximately half (1789/3658, 48.91%) of the assessed cases, an alternative to a conventional face-to-face consultation was found. The waiting lists that had built up during the first months of the pandemic diminished and have been stable since the end of 2020, even during periods of imposed lockdown restrictions and reduced capacity. Patient portal access decreased with age, and patients who were invited to perform a remote, web-based eye test at home were on average younger than patients who were not invited. Conclusions: Our promptly introduced approach to remotely review cases and prioritize urgency has been successful in maintaining continuity of care and education throughout the pandemic and has evolved into a telemedicine service that is of great interest for future purposes, especially in the routine follow-up of patients with chronic diseases. TTT appears to be a potentially preferred practice in other clinics and medical specialties. The paradox is that judicious clinical decision-making based on remotely collected data is possible, only if we as caregivers are willing to change our routines and cognitions regarding face-to-face care delivery.
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There is more to be learned from nature as a whole. In practice ‘nature’ is often used in teaching, training, consultancy and organisational development as a metaphor, as a source of inspiration or as an example for all kinds of processes, including leadership, cooperation, relationships and the development of organisations and society. Mainly ecological, and much less frequently biological, processes are generally involved here. The question has gradually arisen whether we can learn more from nature in the social environment than what we ‘see’ on the surface - which is often translated in metaphors. Seen more holistically, this is about the systemic side, the complexity, the context and the coherence. For example, can we demonstrate that applying fundamental ecological principles, such as cycles (learning, self-organising, selfregulating and self-sufficient capacity), succession, diversity and resilience, social and cooperative behaviour, interconnectedness and interdependency within an organisation leads to a sustainable organisation? Mauro Gallo is conducting research into the significance of technical innovation in and for the agricultural and food sector, and into the question whether biomimicry can in fact be backed up in such a way that it contributes to the social sciences domain. At the same time there is a clear teaching issue: Is it logical from the perspective of our green DNA to include biomimicry thinking in our teaching? Is it possible to learn to apply biomimicry, and can biomimicry be applied in teaching/learning? (How) can we apply biomimicry in green VMBO and MBO, pass it on to the teachers of the future in teacher training courses and include it in making current lecturers more professional? Is it conceivable that it could become an integral component of the curricula in green HBO?
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There is more to be learned from nature as a whole. In practice ‘nature’ is often used in teaching, training, consultancy and organisational development as a metaphor, as a source of inspiration or as an example for all kinds of processes, including leadership, cooperation, relationships and the development of organisations and society. Mainly ecological, and much less frequently biological, processes are generally involved here. The question has gradually arisen whether we can learn more from nature in the social environment than what we ‘see’ on the surface - which is often translated in metaphors. Seen more holistically, this is about the systemic side, the complexity, the context and the coherence. For example, can we demonstrate that applying fundamental ecological principles, such as cycles (learning, self-organising, selfregulating and self-sufficient capacity), succession, diversity and resilience, social and cooperative behaviour, interconnectedness and interdependency within an organisation leads to a sustainable organisation? Mauro Gallo is conducting research into the significance of technical innovation in and for the agricultural and food sector, and into the question whether biomimicry can in fact be backed up in such a way that it contributes to the social sciences domain. At the same time there is a clear teaching issue: Is it logical from the perspective of our green DNA to include biomimicry thinking in our teaching? Is it possible to learn to apply biomimicry, and can biomimicry be applied in teaching/learning? (How) can we apply biomimicry in green VMBO and MBO, pass it on to the teachers of the future in teacher training courses and include it in making current lecturers more professional? Is it conceivable that it could become an integral component of the curricula in green HBO?
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In summary we want to discuss:1) Courses and training in the field of nursing (General); elderly care, dementia and physical therapy.2) sending Chinese students to Groningen, Deventer3) training in the use of home automation and application of the technology in care homes, or in residential communities for seniors4) international cooperation, we strive for crossovers between schools and research centers, Hanze & Saxion and the possibility of organizing applied research at the Chinese organizations has been agreed. We now also have a Dutch healthcare organization that can serve as a model, and where we will also conduct research. (Tangenborgh from Emmen)There is a huge spread in the projects in which Heinrich, Jan and Jan Willem collaborate. Subjects range from studying domotica in the process of dementia in elderly care, to the transition from a collectivist society to a more individual society, both within the realm of social scientific research. Moreover, physical, biological and economical processes of change - for instance sampled by sensors- may also form the heart of the applied scientific interest of the team. The common thread is formed by the dynamic system description of the change processes over time. These are sometimes (within certain limits) linear, but much more often there is complex non-linear coherence, which, however, runs according to patterns (and therefore contains systematic components). Emergent properties, instead of determined linear chains. Modern data analysis techniques and insight into system thinking form the core. We work with beta talents, including IT specialists trained at ItVitae, in the Beta lab of Marcel Hurkens.
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Hoofdstuk 20 Part II in Understanding Penal Practice van Ioan Durnescu en Fergus McNeill Criminological and penological scholarship has in recent years explored how and why institutions and systems of punishment change – and how and why these changes differ in different contexts. Important though these analyses are, this book focuses not so much on the changing nature of institutions and systems, but rather the changing nature of penal practice and practitioners The first part of the book focuses on understanding practice and practitioners, exploring how changing social, cultural, political, and organisational contexts influence practice, and how training, development, professional socialisation and other factors influence practitioners. The second part is concerned with how practitioners can be best supported to develop the skills and approaches that seem most likely to generate positive impacts. It contains accounts of new practice models and approaches, as well as reports of research projects seeking both to discover and to encourage effective practices
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Innovation is crucial for higher education to ensure high-quality curricula that address the changing needs of students, labor markets, and society as a whole. Substantial amounts of resources and enthusiasm are devoted to innovations, but often they do not yield the desired changes. This may be due to unworkable goals, too much complexity, and a lack of resources to institutionalize the innovation. In many cases, innovations end up being less sustainable than expected or hoped for. In the long term, the disappointing revenues of innovations hamper the ability of higher education to remain future proof. Against the background of this need to increase the success of educational innovations, our colleague Klaartje van Genugten has explored the literature on innovations to reveal mechanisms that contribute to the sustainability of innovations. Her findings are synthesized in this report. They are particularly meaningful for directors of education programs, curriculum committees, educational consultants, and policy makers, who are generally in charge of defining the scope and set up of innovations. Her report offers a comprehensive view and provides food for thought on how we can strive for future-proof and sustainable innovations. I therefore recommend reading this report.
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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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