Adaptive governance describes the purposeful collective actions to resist, adapt, or transform when faced with shocks. As governments are reluctant to intervene in informal settlements, community based organisations (CBOs) self-organize and take he lead. This study explores under what conditions CBOs in Mathare informal settlement, Nairobi initiate and sustain resilience activities during Covid-19. Study findings show that CBOs engage in multiple resilience activities, varying from maladaptive and unsustainable to adaptive, and transformative. Two conditions enable CBOs to initiate resilience activities: bonding within the community and coordination with other actors. To sustain these activities over 2.5 years of Covid-19, CBOs also require leadership, resources, organisational capacity, and network capacity. The same conditions appear to enable CBOs to engage in transformative activities. How-ever, CBOs cannot transform urban systems on their own. An additional condition, not met in Mathare, is that governments, NGOs, and donor agencies facilitate, support, and build community capacities. This is the peer reviewed version of the following article: Adaptive governance by community-based organisations: Community resilience initiatives during Covid‐19 in Mathare, Nairobi. which has been published in final form at doi/10.1002/sd.2682. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions
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This article draws on Robinson, McNeill and Maruna’s argument (2012) about the adaptability of community sanctions and measures, observed through four distinctive penal narratives, in order to shed light on the regional development of community service in Wroclaw, Poland. While the managerial adaptation of community sanctions is underpinned by an inter-agency cooperation to fulfil the goals of the system, the contemporary rehabilitation iteration has become a toolkit of measures predominantly phrased around risk management, the reparative discourse seeks various means to repair harm, and the punitive orientation represent the turn to desert-based and populist sentencing frameworks. In this article, the first three are reflected upon along with the emerging, restorative adaptation of community sanctions. The last one is added to expand on the findings of previous research, which suggests the viability of the restorative orientation for community service in Poland (Matczak, 2018). A brief discussion of how punishment, probation and restorative justice can be reconciled is followed by the introduction of Polish Probation and the role of probation officers in delivering community service in Poland. Although the penal narratives are visible in the Wrocław model to different degrees and in various combinations, more research is required to evaluate the viability of a progressive orientation to punishment during a gradual optimisation of community orders. Originally published: Anna Matczak, The penal narratives of community sentence and the role of probation: The case of the Wrocław model of community service, European journal of probation (Vol. 13 nr. 1) pp. 72-88. Copyright © 2021year (The Author). DOI: 10.1177/2066220320976105
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Introduction F-ACT is a flexible version of Assertive Community Treatment to deliver care in a changing intensity depending on needs of individuals with severe mental illnesses (Van Veldhuizen, 2007). In 2016 a number of the FACT-teams in the Dutch region of Utrecht moved to locations in neighborhoods and started to work as one network team together with neighborhood based facilities in primary care (GP’s) and in the social domain (supported living, social district teams, etc.). This should create better chances on clinical, social and personal recovery of service users. Objectives This study describes the implementation, obstacles and outcomes for service users. The main question is whether this Collaborative Mental Health Care in the Community produces better outcome than regular FACT. Measures include (met/unmet) needs for care, quality of life, clinical, functional and personal recovery, and hospital admission days. Methods Data on care utilization regarding the innovation are compared to regular FACT. Qualitative interviews are conducted to gain insight in the experiences of service users, their family members and mental health care workers. Changes in outcome measures of service users in pilot areas (N=400) were compared to outcomes of users (matched on gender and level of functioning) in regular FACT teams in the period 2015-2018 (total N=800). Results Data-analyses will take place from January to March 2019. Initial analyses point at a greater feeling of holding and safety for service users in the pilot areas and less hospital admission days. Conclusions Preliminary results support the development from FACT to a community based collaborative care service.
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This project builds upon a collaboration which has been established since 15 years in the field of social work between teachers and lecturers of Zuyd University, HU University and Elte University. Another network joining this project was CARe Europe, an NGO aimed at improving community care throughout Europe. Before the start of the project already HU University, Tallinn Mental Health Centre and Kwintes were participating in this network. In the course of several international meetings (e.g. CARe Europe conference in Prague in 2005, ENSACT conferences in Dubrovnik in 2009, and Brussels in April 2011, ESN conference in Brussels in March 2011), and many local meetings, it became clear that professionals in the social sector have difficulties to change current practices. There is a great need to develop new methods, which professionals can use to create community care.
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Objective To explore predictors of district nursing care utilisation for community-living (older) people in the Netherlands using claims data. To cope with growing demands in district nursing care, knowledge about the current utilisation of district nursing care is important. Setting District nursing care as a part of primary care. Participants In this nationwide study, claims data were used from the Dutch risk adjustment system and national information system of health insurers. Samples were drawn of 5500 pairs of community-living people using district nursing care (cases) and people not using district nursing care (controls) for two groups: all ages and aged 75+ years (total N=22 000). Outcome measures The outcome was district nursing care utilisation and the 114 potential predictors included predisposing factors (eg, age), enabling factors (eg, socioeconomic status) and need factors (various healthcare costs). The random forest algorithm was used to predict district nursing care utilisation. The performance of the models and importance of predictors were calculated. Results For the population of people aged 75+ years, most important predictors were older age, and high costs for general practitioner consultations, aid devices, pharmaceutical care, ambulance transportation and occupational therapy. For the total population, older age, and high costs for pharmaceutical care and aid devices were the most important predictors. Conclusions People in need of district nursing care are older, visit the general practitioner more often, and use more and/or expensive medications and aid devices. Therefore, close collaboration between the district nurse, general practitioner and the community pharmacist is important. Additional analyses including data regarding health status are recommended. Further research is needed to provide an evidence base for district nursing care to optimise the care for those with high care needs, and guide practice and policymakers’ decision-making.
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This paper will discuss the process of the MA program ePedagogy / Visual Knowledge Building during the first semester of the academic year 2005 – 2006. This MA program is a joint venture between the Universities of Helsinki, Hamburg and INHOLLAND. This publication will discuss and evaluate the concrete steps (in terms of learning process) during this first semester. In particular the role of the eTutor will get special attention. This publication is based on the principle of action research. Hart & Bond defines action research as “it is a form of reflective inquiry which enables practitioners to better realise such qualities in their practice. The tests for good action research are very pragmatic ones. Does it improve the professional quality of the transactions between practitioners and clients/colleagues? This action research approach is being realised upon three main sources. As an eTutor and member of the staff of this program I weekly filled in an “Evaluation Log” in which the following questions are centralized: 1. What happened (this week) 2. Significant experience 3. Reflection 4. Actions Secondly I used a little survey which was being used by the staff to evaluate the first semester. All the three Universities filled in a form with the following questions concerning the education and organisation: Education 1. What do you consider most hindering in your teaching? 2. What do you consider most beneficial in your teaching? 3. What kind of teaching methods do you prefer in this program? 4. Do you think the course offers are attractive for the target group? 5. How do you evaluate student’s engagements and motivation in your courses? 6. What can / should be improved in terms of collaborative learning activities and processes? Organisation 1. In what specific context do you spot organisational constraints? 2. Does your organisation recognise and support the MA program? 3. What is your short-, mid- and long term vision on this program? Thirdly an important source for this action research approach was the International Seminar which was hold in the middle of February 2006. In this seminar the changes based on the questions of the questionnaire were discussed and implemented. The theoretical framework in this publication is based on the dissertation of Karel Kreijns (Sociable CSCL Environments). In this dissertation he discussed the collaborative cognitiveand epistemic performance in a CSCLE. The social presence theory takes a central position in this dissertation. In this paper the pitfalls and barriers concerning a sociable CSCLE are being discussed and evaluated. This paper describes, the interventions the staff took, in order to improve the educational context of the program. From this perspective we looked very carefully to the barriers and pitfalls in our Virtual Learning Environment (VLE). We found evidence for the fact that a good CSCLE consists at least a good balance between Content, Community and Pedagogy. In the program we emphasised our focus (too much) on content and (too) little on community and pedagogy. The community was poor because of the fact that we used three content learning systems, which didn’t stimulate the group processes. Pedagogy was too much based on individual eTutor behaviour. In January 2006, after the courses were ended, the Universities organised a little survey. In this survey was shown that we have to some interventions to improve the learning process. At the International Seminar in February 2006 eTutors and students discussed the problems. The following interventions are being considered and implemented: 1. The use of three Virtual Learning Environments should be decreased. Especially the INHOLLAND / Blackboard system doesn’t reflect the open source philosophy. Besides this the accessibility of this system is not very easy for foreign students 2. The collaborative aspect should be increased, by emphasising the interdisciplinaryand international co-operation. The formation of international subgroups is implemented.
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Despite increased healthcare extramuralisation, related to increased elderly patients living at home, most nursing students still see the hospital as career favourite. This is problematic, because of the widespread labour-market shortages in community care in many Western countries. At the Amsterdam University of Applied Sciences, the bachelor nursing programme was redesigned to stimulate students’ interest in community-care. The effect of this ‘community-oriented’ curriculum on students’ perceptions and placement preferences was then investigated. To measure both, the Scale on Community Care Perceptions (SCOPE) was used. The intervention group (170 students graduating in 2018), followed the new curriculum and was compared to a historic control group (477 students) that followed the older, more ‘hospital-oriented’ curriculum (three cohorts graduating 2015-2017). Both groups were compared on placement preferences, and multiple regression was used to investigate the effect of the curriculum-redesign on their perceptions of community care.The redesign consisted of an integrative approach based on the influence of lecturers, placement experiences, and the introduction of new educational elements in the curriculum. Goal was to broaden students’ views, showing that nursing is more than hospital care. While the curriculum was scrutinised on how patient cases were presented, more than 60 of the 110 cases were located in the hospital, compared to four in community care. Thus, this aspect of the ‘hidden curriculum’ was adjusted. Five new themes related to community nursing were integrated in the ‘generalist’ programme in years 1 and 2, namely: (1) fostering patient self-management, (2) shared decision-making, (3) collaboration with the patients’ social system, (4) healthcare technology, and (5) care allocation. A community care week was organised in year 2, in which all students visited a community nursing team. In the last two years of study, a ‘paved way’ to community care was created in the form of an interesting minor programme ‘Complex Community care’ in year 3, a well-organised 30-week placement in year 4, and a concluding case study from their own practice [Figure 1].[Figure 1]Figure 1. Curriculum-redesign to stimulate interest in community care.A comparison between the historic control and intervention group on perceptions of communitycare and placement preferences, measured with SCOPE, showed no significant positive results in both outcomes. The model in the regression analysis, predicting students' perceptions from the type of curriculum (historic/intervention), showed no statistically significant result, F(1,635) = .021, p = .884, and a low explained variance R2 = .001. A preference for a placement in community care decreased from 9.2% in the historic control group to 8.2% in the intervention group. However, the regression analysis revealed that two variables, in contrast with the curriculum, had a significant influence, to wit ‘belonging to a church/religious group’ and ‘working/has been working in community care’.Though described in the literature as the only effective way, this study showed that curriculum-redesign was not effective, despite its holistic approach. A combination of factors might explain this result. Other pathways in the curriculum may have strongly competed. Disappointing experiences during placements, leading to ‘bad-mouthing between peers, may also be a reason. Finally, highly publicised workforce problems leading to shortages of higher-educated role models may have played a role.As in this study, the effect of the curriculum as a whole is measured, more research is needed on the effect of separate more powerful curriculum interventions, for example the theme-week in year 2. A well thought-out large-scale strategy that mostly appeals to young people aiming to promote positive perceptions of community care could be a valuable supplement.
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Background: Recent transitions in long-term care in the Netherlands have major consequences for community- dwelling older adults. A new paradigm expects them to manage and arrange their own care and support as much as possible. Technology can support this shift. A study has been conducted to explore the needs of community- dwelling frail older adults with regard to an online platform. An existing platform was subsequently modified, based upon these needs, resulting in an online community care platform (OCC-platform) comprising of care, health, and communication functions. The purpose of this platform was to support frail older adults in their independence and functioning, by stimulating self-care and providing reliable information, products and services. Methods: The study used a User-Centred Design. The development processes involved the following steps: Step 1) Identification of the User Requirements. To assess the user requirements, direct observations (N = 3) and interviews (N = 14) were performed. Step 2) Modification of an Existing Online Platform. Based upon Step 1, available online platforms were explored to determine whether an existing useful product was available. Two companies collaborated in modifying such a platform; Step 3) Testing the Modified Platform. A total of 73 older adults were invited to test a prototype of the OCC-platform during 6 months, which comprised of two phases: (1) a training phase; and (2) a testing phase. Results: An iterative process of modifications resulted in an interactive software concept on a Standard PC, containing 11 Functions. The Functions of ‘contacts’, ‘services’ and ‘messaging’, were by far, the most frequently used. The use was at its highest during the first 2 weeks of the testing and then its use steadily declined. The vast majority of the subjects (94%) were positive about the usability of the platform. Only a minority of the subjects (27%) indicated that the platform had added value for them. Conclusion: The overall prospect was that an OCC-platform can contribute to the social participation and the self-management competencies of frail older adults, together with their social cohesion in the community. In order to validate these prospects, further research is needed on the characteristics and the impact of online platforms.
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Background: The aging population is increasingly faced with daily life limitations, threatening their Functional Independence (FI). These limitations extend different life domains and require a broad range of community-care professionals to be addressed. The Decision Support Tool for Functional Independence (DST-FI) facilitates community-care professionals in providing uncontradictory recommendations regarding the maintenance of FI in community-dwelling older people. The current study aims to determine the validity and reliability of the DST-FI. Methods: Sixty community-care professionals completed a twofold assessment. To assess construct validity, participants were asked to assign predefined recommendations to fifty cases of older people to maintain their level of FI. Hypotheses were tested regarding the expected recommendations per case. Content validity was assessed by questions on relevance, comprehensiveness, and comprehensibility of the current set of recommendations. Twelve participants repeated the assessment after two weeks to enable both within- and between rater reliability properties, expressed by an Intraclass Correlation Coefficient. Results: Seven out of eight predefined hypotheses confirmed expectations, indicating high construct validity. As the recommendations were indicated 'relevant' and 'complete', content validity was high as well. Agreement between raters was poor to moderate while agreement within raters was moderate to excellent, resulting in moderate overall reliability. Conclusion: The DST-FI suggests high validity and moderate reliability properties when used in a population of community-dwelling older people. The tool could facilitate community-care professionals in their task to preserve FI in older people. Future research should focus on psychometric properties like feasibility, acceptability, and developing and piloting strategies for implementation in community-care.
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