When it comes to hard to solve problems, the significance of situational knowledge construction and network coordination must not be underrated. Professional deliberation is directed toward understanding, acting and analysis. We need smart and flexible ways to direct systems information from practice to network reflection, and to guide results from network consultation to practice. This article presents a case study proposal, as follow-up to a recent dissertation about online simulation gaming for youth care network exchange (Van Haaster, 2014).
Background: Cervical dystonia is characterized by involuntary muscle contractions of the neck and abnormal head positions that affect daily life activities and social life of patients. Patients are usually treated with botulinum toxin injections into affected neck muscles to relief pain and improve control of head postures. In addition, many patients are referred for physical therapy to improve their ability to perform activities of daily living. A recent review on allied health interventions in cervical dystonia showed a lack of randomized controlled intervention studies regarding the effectiveness of physical therapy interventions.Methods/design: The (cost-) effectiveness of a standardized physical therapy program compared to regular physical therapy, both as add-on treatment to botulinum toxin injections will be determined in a multi-centre, single blinded randomized controlled trial with 100 cervical dystonia patients. Primary outcomes are disability in daily functioning assessed with the disability subscale of the Toronto Western Spasmodic Torticollis Rating Scale. Secondary outcomes are pain, severity of dystonia, active range of motion of the head, quality of life, anxiety and depression. Data will be collected at baseline, after six months and one year by an independent blind assessor just prior to botulinum toxin injections. For the cost effectiveness, an additional economic evaluation will be performed with the costs per quality adjusted life-year as primary outcome parameter.Discussion: Our study will provide new evidence regarding the (cost-) effectiveness of a standardized, tailored physical therapy program for patients with cervical dystonia. It is widely felt that allied health interventions, including physical therapy, may offer a valuable supplement to the current therapeutic options. A positive outcome will lead to a greater use of the standardized physical therapy program. For the Dutch situation a positive outcome implies that the standardized physical therapy program forms the basis for a national treatment guideline for cervical dystonia.Trial registration: Number Dutch Trial registration (Nederlands Trial Register): NTR3437.
Generation Z (Gen Z) will account for a growing proportion of the global workforce in the coming years. Therefore, it is vitally important to understand this generation’s unique perspectives and preferences regarding work. This exploratory study examines the prioritisation and desirability of Gen Z work values according to respondents’ nationality. Data for this study was collected through a survey among 1188 undergraduate students enrolled in one university each in China, Germany, the Netherlands and Thailand. ANOVA test and Tukey post-hoc analysis were used to find out the difference between the groups based on nationality. Findings indicate nationality serves as a key differentiator in work value preferences. The findings challenge the concept of a global Generation Z as only two of the measured values, learning and visible results, were found to have universal appeal across the nationality groups. Despite increased levels of global interconnectedness and accompanying crossvergence of values, the results show significant statistical differences in work values based on the respondents’ nationality. Due to the scope and explorative design of the present study, it cannot be certain that the findings are exclusively from Gen Z characteristics or influenced by other, non-cultural, variables. This study suggests there is a need for study programmes at a tertiary level to embed experiential learning components and individual study pathways in their curricula to enable students to develop realistic expectations about the workplace and their place in it. In turn, these programmes will be able to develop a competitive advantage in HE landscape. The insights gained can be leveraged by internationally oriented study programmes, such as International Business (IB), to better address Gen Z needs and expectations.
MULTIFILE
