Background: To be accountable to laws and regulations, healthcare professionals spend more than 40% of their time on administrative tasks. The Compulsory Mental Healthcare Act (CMHA) was introduced in Dutch mental healthcare in 2020. It was hypothesized that this legislative amendment would raise the administrative burden for some care professionals. Pilot studies in 2020 and 2021 visualized the exponentially rise of the administrative burden for care professionals, especially psychiatrists due to the transition. However the total response was too small and not generalizable. Aim: gain more nationwide insight in the hypothesized raise of administrative burden of psychiatrists due to the implementation of the CMHA. Method: Under the leadership of an advisory board of three medical director psychiatrists, a Likert scale questionnaire was further developed to investigate the administrative burden of psychiatrists in the Netherlands before and after transition. Open-ended questions provided the opportunity for feedback from the psychiatrists. The study was supported by the Department of Medical Directors (DMD) of The Netherlands Psychiatric Association (NPA). Results: all mental health institutions members of the DMD of the NPA received an invitation to participate. 14 institutions (total N=158) responded. The data show a significant change in the time spent on administrative tasks, the usefulness of the administrative actions, the fit for use and ease of use of supporting systems. The forementioned all decreased significantly after the implementation. Conclusion and discussion: Psychiatrists spend more time on administration than before the legislative amendment instead of helping vulnerable patients. None of the institutions has been able to use the transition to its advantage given the time spent on administrative tasks and the usefulness of these tasks. This is an unacceptable development in the field of mental health in the Netherlands and should be addressed to those who are responsible for the decision making, especially policy makers. These results show that the introduction of the CMHA have made the field of Dutch mental health an impossible area to work for. , Administrative burden, Legislative amendment, Public governance, Information Management
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Scar formation is an important adverse consequence of burns. How patients appraise their scar quality is often studied shortly after sustaining the injury, but information in the long-term is scarce. Our aim was, therefore, to evaluate long-term patient-reported quality of burn scars. Adults with a burn center admission of ≥1 day between August 2011 and September 2012 were invited to complete a questionnaire on long-term consequences of burns. We enriched this sample with patients with severe burns (>20% total body surface area [TBSA] burned or TBSA full thickness >5%) treated between January 2010 and March 2013. Self-reported scar quality was assessed with the Patient Scale of the Patient and Observer Scar Assessment Scale (POSAS). Patients completed this scale for their—in their opinion—most severe scar ≥5 years after burns. This study included 251 patients with a mean %TBSA burned of 10%. The vast majority (91.4%) reported at least minor differences with normal skin (POSAS item score ≥2) on one or more scar characteristics and 78.9% of the patients’ overall opinion was that their scar deviated from normal skin. Patients with severe burns had higher POSAS scores, representing worse scar quality, than patients with mild/intermediate burns, except for color, which was high in both groups. A longer hospital stay predicted reduced scar quality (both mean POSAS and mean overall opinion of the scar) in multivariate analyses. In addition, female gender was also associated with a poorer overall opinion of the scar. In conclusion, this study provides new insights in long-term scar quality. Scars differed from normal skin in a large part of the burn population more than 5 years after burns, especially in those with severe burns. Female gender is associated with a poorer patients’ overall opinion of their scar, which may be an indication of gender differences in perception of scar quality after burns.
Cognitive impairment is a prevalent problem among the homeless and seems related to more psychosocial problems. However, little is known about the care needs of the subgroup of homeless people with an intellectual disability compared to those without an intellectual disability and how their care needs develop over time. This study explores self-reported care needs within a broad range of life domains among Dutch homeless people with and without a suspected intellectual disability to gain insight into the transition of self-reported care needs from baseline to follow-up in both subgroups. This longitudinal study is part of a cohort study among homeless people who had been accepted for an individual programme plan in four major Dutch cities. The initial cohort consisted of 513 participants who were interviewed in 2011. At 1.5-year follow-up, 336 participants (65.5%) were also interviewed and screened for intellectual disability. Of these participants, 31% (95% CI 26.2-36.1) had a suspected intellectual disability. For both groups, between baseline and follow-up, the number of 'unmet care needs' decreased significantly and the number of 'no care needs' increased significantly, while at follow-up, participants with a suspected intellectual disability reported 'no care needs' on significantly fewer life domains than those without a suspected intellectual disability (mean numbers 16.4 vs. 17.5). Between baseline and follow-up, 'met care needs' decreased significantly on housing for both groups, and increased on finances and dental care for participants with a suspected intellectual disability. At follow-up, participants with a suspected intellectual disability more often preferred housing support available by appointment than those without a suspected intellectual disability. These findings suggest that homeless people who had been accepted for an individual programme plan with a suspected intellectual disability have care needs for a longer period of time than those without a suspected intellectual disability. Providing care to homeless people with a suspected intellectual disability might require ongoing care and support, also after exiting homelessness. Support services should take this into account when considering their care provision and planning of services.
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This proposal originates from a pilot of the ‘Frontrunners coalition’ on initiatives for the Circular Economy at the city level. This spin off project studies strategizing in hotels, to find innovative solutions how to manage the integration of circularity in the overall business strategy. The theoretical innovation is to better understand the strategizing process by using the theoretical framework of “strategy-as-practices (S-as-P)”. Exploring in two cases the daily challenges of implementing principles of the circular economy at a luxury and a budget hotel (group). The “strategy-as-practices (S-as-P) framework will be used, emphasizing that strategizing is a joint process of (higher) management and other practitioners (within and outside of the company). The data collection and analysis will be executed by Bachelor and Master students of Hotelschool the Hague and faculty of the research centre. The stages of the Design Oriented Research Approach will be used in this project, with a focus on the stages of Analysis & Diagnoses and Solution Design. The hotels will facilitate this research by giving access and support to the operations and (formal) meetings and additional primary data collection. (Small teams of) Student researchers collect qualitative data based on interviews and observations: they will ‘blend’ in during a 10-week period. Faculty of Hotelschool The Hague will safeguard the continuity and alignment in the project in the several rounds in which these steps are executed. The finding will be presented to the participating companies, the coalition in Amsterdam and the Hospitality industry. Direct societal impact is the showcasing of potential initiative and the responsibility of organizations towards circularity in their environment. Another result is the proposal for a larger follow-up project. This larger project will continue this study within a broader set of hotels but will also be studying and developing potential interventions for improvement the strategizing process.
Mondeling presenteren wordt beschouwd als een essentiële competentie van de hoger opgeleide professional. Toch beschikken ‘young professionals’ zelden over deze competentie en ervaren zij presenteren als één van de meest prominente angsten in sociale situaties. Vooral in tijden waarin studentaantallen toenemen en ruimte voor docent-student interactie afneemt, blijkt het ontwerpen van effectieve leeromgevingen gericht op presenteren een uitdaging. Een systematische literatuurstudie benadrukt dat docentfeedback, peerfeedback én self-assessment cruciale principes zijn voor het ontwerp van effectieve leeromgevingen om te leren presenteren (Van Ginkel, 2019). Hoewel deze drie feedbackbronnen worden beschouwd als essentiële vormen van feedback, toont eerder onderzoek aan dat docentfeedback een significant sterkere impact heeft op de ontwikkeling van presentatievaardigheden dan peerfeedback en self-assessment. In een follow-up veldexperiment is getest of Virtual Reality (VR) als alternatieve feedbackbron kan worden ingezet bij leren presenteren. Deze technologie kan immers zowel reële presentatie-situaties simuleren alsook het leveren van geautomatiseerde feedback faciliteren. Hoewel een eerder veldexperiment de effectiviteit van VR-feedback op leren presenteren aantoonde (Van Ginkel, 2019), blijft het de vraag in hoeverre studenten zelfstandig VR-feedback kunnen interpreteren, omdat destijds de docent nodig was om de rapporten uit de VR-computer te vertalen naar waardevolle feedback voor de student. Recente technologische ontwikkelingen maken het mogelijk om kwantitatieve VR-data automatisch om te zetten naar boodschappen die voldoen aan standaarden van hoogwaardige feedback. Deze postdoc richt zich daarom op het uitvoeren van een uitgebreid veldexperiment om te onderzoeken in hoeverre studenten in staat zijn om de geautomatiseerde feedbackboodschappen, gebaseerd op VR-data, zelfstandig te interpreteren tot effectieve feedback. Bovendien wordt getest of deze geautomatiseerde feedback ook peerfeedback en self-assessment kan verrijken en daarmee de impact op leren presenteren kan verhogen. Deze studies hebben tot doel om onderwijskundige ontwerpprincipes gericht op feedback bij leren presenteren te optimaliseren. Verder beoogt dit onderzoeksproject de resultaten in hoger onderwijscurricula te integreren.
About half of the e-waste generated in The Netherlands is properly documented and collected (184kT in 2018). The amount of PCBs in this waste is projected to be about 7kT in 2018 with a growth rate of 3-4%. Studies indicate that a third of the weight of a PCB is made or recoverable and critical metals which we need as resources for the various societal challenges facing us in the future. Recycling a waste PCB today means first shredding it and then processing it for material recovery mostly via non-selective pyrometallurgical methods. Sorting the PCBs in quality grades (wastebins) before shredding would however lead to more flexibility in selecting when and which recovery metallurgy is to be used. The yield and diversity of the recovered metals increases as a result, especially when high-grade recycling techniques are used. Unfortunately, the sorting of waste PCBs is not easily automated as an experienced operator eye is needed to classify the very inhomogeneous waste-PCB stream in wastebins. In this project, a knowledge institution partners with an e-waste processor, a high-grade recycling technology startup and a developer of waste sorting systems to investigate the efficiency of methods for sensory sorting of waste PCBs. The knowledge gained in this project will lead towards a waste PCB sorting demonstrator as a follow-up project.
