Zoekresultaten

Illness perceptions; exploring mediators and/or moderators in disabling persistent low back pain

Introduction: Illness Perceptions (IPs) may play a role in the management of persistent low back pain. The mediation and/or moderation effect of IPs on primary outcomes in physiotherapy treatment is unknown. Methods: A multiple single-case experimental design, using a matched care physiotherapy intervention, with three phases (phases A-B-A’) was used including a 3 month follow up (phase A’). Primary outcomes: pain intensity, physical functioning and pain interference in daily life. Analyzes: linear mixed models, adjusted for fear of movement, catastrophizing, avoidance, sombreness and sleep. Results: Nine patients were included by six different primary care physiotherapists. Repeated measures on 196 data points showed that IPs Consequences, Personal control, Identity, Concern and Emotional response had a mediation effect on all three primary outcomes. The IP Personal control acted as a moderator for all primary outcomes, with clinically relevant improvements at 3 month follow up. Conclusion: Our study might indicate that some IPs have a mediating or a moderating effect on the outcome of a matched care physiotherapy treatment. Assessing Personal control at baseline, as a relevant moderator for the outcome prognosis of successful physiotherapy management of persistent low back pain, should be further eplored.

The impact of multiple value creation on management control systems

We are currently in a transition moving from a linear economy grounded on economic value maximization based on material transformation to a circular economy. Core of this transition is organising value preservation from various yet interlinked perspectives. The underlying fundamental shift is to move away from mere financial value maximization towards multiple value creation (WCED, 1987; Jonker, 2014; Raworth, 2017). This implies moving from mere economic value creation, to simultaneously and in a balanced way creating ecological and social value. A parallel development supporting this transition can be observed in accounting & control. Elkington (1994) introduced the triple bottom line (TBL) concept, referring to the economic, ecological and social impact of companies. The TBL should be seen more as a conceptual way of thinking, rather than a practical innovative accounting tool to monitor and control sustainable value (Rambaud & Richard, 2015). However, it has inspired accounting & control practitioners to develop accounting tools that not only aim at economic value (‘single capital’ accounting) but also at multiple forms of capital (‘multi capital’ accounting or integrated reporting). This has led to a variety of integrated reporting platforms such as Global Reporting Initiative (GRI), International Integrated Reporting Framework (IIRC), Dow Jones Sustainable Indexes (DJSI), True Costing, Reporting 3.0, etc. These integrated reporting platforms and corresponding accounting concepts, can be seen as a fundament for management control systems focussing on multiple value creation. This leads to the following research question: How are management control systems designed in practice to drive multiple value creation?

Designable elements of integrative learning environments at the boundary of school and work

Learning environment designs at the boundary of school and work can be characterised as integrative because they integrate features from the contexts of school and work. Many different manifestations of such integrative learning environments are found in current vocational education, both in senior secondary education and higher professional education. However, limited research has focused on how to design these learning environments and not much is known about their designable elements (i.e. the epistemic, spatial, instrumental, temporal and social elements that constitute the learning environments). The purpose of this study was to examine manifestations of two categories of integrative learning environment designs: designs based on incorporation; and designs based on hybridisation. Cross-case analysis of six cases in senior secondary vocational education and higher professional education in the Netherlands led to insights into the designable elements of both categories of designs. We report findings about the epistemic, spatial, instrumental, temporal and social elements of the studied cases. Specific characteristics of designs based on incorporation and designs based on hybridisation were identified and links between the designable elements became apparent, thus contributing to a deeper understanding of the design of learning environments that aim to connect the contexts of school and work.

Het instellingsbreed ontwerpen van hybride leeromgevingen in het middelbaar beroepsonderwijs

In het middelbaar beroepsonderwijs worden hybride leeromgevingen, waarin de contexten van school en werk worden geïntegreerd, gezien als een veelbelovende manier om onderwijs en praktijk beter op elkaar aan te laten sluiten. Er is weinig bekend over het duurzaam ontwerpen van deze integratieve leeromgevingen binnen een mbo-instelling als geheel, waarbij het gaat om leeromgevingen van verschillende sectoren. In deze meervoudige, tweejarige case study zijn 45 integratieve leeromgevingen op de grens van school en werk, verspreid over zes sectoren binnen één onderwijsinstelling in kaart gebracht. Deze leeromgevingen zijn in focusgroepen geanalyseerd op 1) waar zij zich bevinden op de dimensie school-werk, 2) de ontwerpkenmerken inhoudelijk, sociaal, temporeel, instrumenteel en ruimtelijk, en 3) bevorderende en belemmerende factoren bij het ontwerpen en uitvoeren van integratieve leeromgevingen. Dit onderzoek geeft inzicht in hoe deze leeromgevingen zijn ontworpen en welke factoren daarbij van belang zijn. Integratief samenwerken met het werkveld blijkt in alle sectoren mogelijk. De ontwerpkenmerken inhoudelijk, sociaal en ruimtelijk worden vaker als integratief ervaren dan het ontwerpkenmerk temporeel. Vanuit het temporele perspectief blijken vooral kaders van school leidend en komen daarmee naar voren als een belangrijke factor in het succesvol opschalen en verduurzamen van leeromgevingen.

The contribution of professional youth work to the development of socially vulnerable youngsters

The central question in this study is how, for whom, and under which conditions professional youth work contributes to the personal development of socially vulnerable youngsters, the reinforcement of their social network, the enhancement of their social participation, and the timely finding of appropriate specialized care services in relation to contextual factors such as life events and the influence of significant others. This research used a multiple case study with a comparative design. During a 12-month period, youth workers (N = 20) participated in group intervision meetings and kept diaries reporting on their actions and the development of the youngsters (N = 23). An analysis of this data revealed four patterns of development of socially vulnerable youngsters in youth work settings. Each pattern consisted of a specific form of multi-methodic action that resulted in a specific outcome. The study also revealed how these processes of development are influenced by important life events and significant others. The findings suggest that youth work contributes to personal development and social participation and thereby may lessen the need for formal social care services.

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