Background. One of the stakeholders in tackling the rise and health consequences of overweight and obesity is the general practice physician (GP). GPs are in a good position to inform and give nutrition guidance to overweight patients. Objective. Assessment of working mechanism of determinants of the nutrition guidance practice: noticing patients’ overweight and guidance of treatment by GPs [linear analysis of structural relations (LISREL) path model] in a longitudinal study. Methods. This longitudinal study measured data in 1992, 1997 and 2007. The 1992 LISREL path model (Hiddink GJ, Hautvast J, vanWoerkumCMJ, Fieren CJ, vantHofMA. Nutrition guidance by primary-care physicians: LISREL analysis improves understanding. Prev Med 1997; 26: 29–36.) demonstrated that ‘noticing patients’ overweight and guidance of treatment’ was directly and indirectly influenced by predisposing factors, driving forces and perceived barriers. This article defines and discusses the path analysis of the 2007 data (compared with 1997). Results. This analysis shows both similarity and differences inworking mechanism of determinants of noticing patients’ overweight and guidance of treatment between 1997 and 2007. The backbone of themechanism with four predisposing factors is the similarity. The number of driving forces and of paths through intermediary factors to the dependent variable constitutes the difference. Conclusions. The backbone of the working mechanism of determinants of the nutrition guidance practice: noticing patients’ overweight and guidance of treatment by GPs was similar in 2007 and 1997. The influence of GPs task perception on noticing patients’ overweight and guidance of treatment considerably increased in 2007 compared to 1997. The longitudinal character of this article gives a strong practice-based evidence for weight management by GPs.
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In this article we examine the experiences of the first and second author who have changed themselves to become newly attuned to the sun, or who have “become solar”. Motivated by calls to approach solar design in novel, less technocratic ways, we reflect on their one-year journey to gain a new relationship with solar energy as an explicitly more-than-human design (MTHD) approach. We argue that their perception of solar energy progressively worked to decentre them as human actors in this new solar-energy arrangement, revealing other nonhuman actors at play, instigating situations of care and attention to those nonhumans and ultimately guiding them towards what it means to be solar. For solar design, we see this approach as creating a new lens for solar designers to draw from. For MTHD, we see this acting as a practical example for designers seeking to begin transforming themselves in their own practice by taking initial steps towards a MTHD approach.
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The days where memes were plain image macros (an image that consists out of an imagecombined with text) are long behind us. New meme formats, some more obscure than others,are popping up like weeds. Memetic logics are also moving beyond the image into ‘the realworld’ (whatever that may be), but that’s a story for another time.In January 2022, when I was a participant in the Digital Methods Winter School of theUniversity of Amsterdam, my teammates and I came to an interesting conclusion. Inspired bythe forthcoming paper by Richard Rogers and Giulia Giorgi, called ‘What is a Meme TechnicallySpeaking’, we analyzed various meme collections taken from different software environments.1After a close reading of the dominant types of images, their ontology and epistemology, one ofthe most interesting findings, at least for me, was that our meme datasets were full of tweetscreenshots – which felt rather counterintuitive at first. However, once I started thinking aboutit, I realized that I have been noticing meme admins posting tweet screenshots on their pagesfor months now. One of my meme muses even told me that she did not know what her memepage has become, seeing all the tweets and other content she has been sharing lately. It hadme wondering. When leaving the technical and data driven context aside for a minute, has thetweet in its screenshot form become a viral image? Has the tweet become an actualmeme?
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Purpose: To describe nurses' support interventions for medication adherence, and patients' experiences and desired improvements with this care. Patients and methods: A two-phase study was performed, including an analysis of questionnaire data and conducted interviews with members of the care panel of the Netherlands Patients Federation. The questionnaire assessed 14 types of interventions, satisfaction (score 0-10) with received interventions, needs, experiences, and desired improvements in nurses' support. Interviews further explored experiences and improvements. Data were analyzed using descriptive statistics and a thematic analysis approach. Results: Fifty-nine participants completed the questionnaire, and 14 of the 59 participants were interviewed. The satisfaction score for interventions was 7.9 (IQR 7-9). The most common interventions were: "noticing when I don't take medication as prescribed" (n = 35), "helping me to find solutions to overcome problems with using medications" (n = 32), "helping me with taking medication" (n = 32), and "explaining the importance of taking medication at the right moment" (n = 32). Fifteen participants missed ≥1 of the 14 interventions. Most mentioned the following: "regularly asking about potential problems with medication use" (33%), "regularly discussing whether using medication is going well" (29%), and "explaining the importance of taking medication at the right moment" (27%). Twenty-two participants experienced the following as positive: improved self-management of adequate medication taking, a professional patient-nurse relationship to discuss adherence problems, and nurses' proactive attitude to arrange practical support for medication use. Thirteen patients experienced the following as negative: insufficient timing of home visits, rushed appearance of nurses, and insufficient expertise about side effects and taking medication. Suggested improvements included performing home visits on time, more time for providing support in medication use, and more expertise about side effects and administering medication. Conclusion: Overall, participants were satisfied, and few participants wanted more interventions. Nurses' support improved participants' self-management of medication taking and enabled patients to discuss their adherence problems. Adequately timed home visits, more time for support, and accurate medication-related knowledge are desired.
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Technological developments have a major impact on how we live, work and learn together. Several authors refer to a fourth revolution in which robots and other intelligent systems take over an increasing number of the current (routine) tasks carried out by humans (Brynjolfsson & McAfee, 2014; Est et al., 2015; Ford, 2016; Helbing, 2014; Ross, 2017; Schwab, 2016). The relationship between man and machine will change fundamentally as a result. We are already noticing this shift, most specifically in the workplace. E.g., in the field of health care, digitalisation and robotisation can empower patients and their families. Hospitals are primarily intended for clients with complex care needs. This has consequences for the tasks carried out by nurses, who become more of a ‘care director’ or ‘research nurse’. Hospitals approach this in different ways, resulting in considerable diversity as to how these roles are fulfilled. These changes, albeit diverse, can also be seen in the roles of accountants, police officers and financial advisers at banks (Biemans, Sjoer, Brouwer and Potting, 2017). The traditional occupational profiles no longer exist and the essence of these professions is shifting. This does not make such occupations less attractive, but requires different qualities. The demand for more highly educated professionals who can carry out complex tasks in a creative and interdisciplinary manner will increase (McKinsey, 2017). Also, other social developments, such as migration and greenification, prompt us to ask new questions, resulting in new paths towards identifying solutions.
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Kwaliteitsmanagement is lange tijd gekenmerkt geweest door wat je het empirisch paradigma (Van Kemenade & Hardjono, 2018) zou kunnen noemen. Binnen die manier van denken is kwaliteitskunde meten en gaat het onder andere om prestatie-indicatoren. Kwaliteit is voldoen aan de vereisten. Verbetering en verandering is te plannen. Statistiek is zijn belangrijkste wetenschap. De manager controleert. Een risico echter van dit kwaliteitsparadigma is, dat er een enorme bureaucratie ontstaat. Erger nog: ze houdt onvoldoende rekening met de complexiteit van het huidige tijdsgewricht.
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Writing expressive dialogues can be used to assist individuals in developing their career identities – that is: stories that are needed to help people position themselves in relation to the current labour market. Writing expressive dialogues entails having written conversations with various parts of us – much like a playwright does with his characters – and making developmental gains in the process. In Dialogical Self Theory (DST) terms, it means talking to and with various I-positions on the page, perhaps forming coalitions, discovering counter positions, and innovating and integrating the self (Hermans & Hermans-Konopka, 2010, p. 228-234). And as the playwright Miller suggests in the above quote, the creation of identity is an interactive process between self and others. LinkedIn: https://www.linkedin.com/in/reinekke-lengelle-phd-767a4322/
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