Background: The use of patient-reported outcomes to improve burn care increases. Little is known on burn patients’ views on what outcomes are most important, and about preferences regarding online Patient Reported Outcome Measures (PROMs). Therefore, this study assessed what outcomes matter most to patients, and gained insights into patient preferences towards the use of online PROMs. Methods: Adult patients (≥18 years old), 3–36 months after injury completed a survey measuring importance of outcomes, separately for three time periods: during admission, short-term (< 6 months) and long-term (6–24 months) after burn injury. Both open and closed-ended questions were used. Furthermore, preferences regarding the use of patient-reported outcome measures in burn care were queried. Results: A total of 140 patients were included (response rate: 27%). ‘Not having pain’ and ‘good wound healing’ were identified as very important outcomes. Also, ‘physical functioning at pre-injury level’, ‘being independent’ and ‘taking care of yourself’ were considered very important outcomes. The top-ten of most important outcomes largely overlapped in all three time periods. Most patients (84%) had no problems with online questionnaires, and many (67%) indicated that it should take up to 15 minutes. Patients’ opinions differed widely on the preferred frequency of follow-up. Conclusions: Not having pain and good wound healing were considered very important during the whole recovery of burns; in addition, physical functioning at pre-injury level, being independent, and taking care of yourself were deemed very important in the short and long-term. These outcomes are recommended to be used in burn care and research, although careful selection of outcomes remains crucial as patients prefer online questionnaires up to 15 minutes.
DOCUMENT
Peer reviewed paper op SEFI Engineering Education congress 2009 In engineering programs an important part of the learning process takes place in practical assignments like capstone projects, internships and co-op assignments in industry. The assignments are very divers. Students have different roles, work in different environments and the learning outcomes are not uniform. So how can the individual learning outcomes or growth competencies of the assignments be determined? To cope with this question the authors developed and implemented a method to monitor and assess the individual learning outcomes of the assignments. The method can be used to match a student to his next assignment in such a way that he can build his individual learning track. The method defines three aspects of an assignment: the role of the engineer (i.e. project leader, designer, researcher), the domain(s) of the assignment (i.e. user interface, software engineering) and a general results matrix that describes results and the level required to produce them. To manage the process learning outcomes are defined as products so project management methods can be used to plan, monitor and assess learning outcomes. Key aspects of the method are: 1. A general results matrix for engineering assignments 2. Learning outcomes that are defined as results in the matrix and these results can be assessed. 3. The results have levels so the learning outcomes can grow during the programme. 4. The method can be used to match, monitor and assess students on one assignment. 5. The method can be used to match, monitor and assess students for the entire programme. 6. The tools that are developed are based on an industry standard for project management.
DOCUMENT
Background: The maternity care system in the Netherlands is well known for its support of community-based midwifery. However, regular midwifery practices typically do not offer caseload midwifery care – one-to-one continuity of care throughout pregnancy and birth. Because we know very little about the outcomes for women receiving caseload care in the Netherlands, we compared caseload care with regular midwife-led care, looking at maternal and perinatal outcomes, including antenatal and intrapartum referrals to secondary (i.e., obstetrician-led) care. Methods: We selected 657 women in caseload care and 1954 matched controls (women in regular midwife-led care) from all women registered in the Dutch Perinatal Registry (Perined) who gave birth in 2015. To be eligible for selection the women had to be in midwife-led antenatal care beyond 28 gestational weeks. Each woman in caseload care was matched with three women in regular midwife-led care, using parity, maternal age, background (Dutch or non-Dutch) and region. These two cohorts were compared for referral rates, mode of birth, and other maternal and perinatal outcomes. Results: In caseload midwifery care, 46.9% of women were referred to obstetrician-led care (24.2% antenatally and 22.8% in the intrapartum period). In the matched cohort, 65.7% were referred (37.4% antenatally and 28.3% in the intrapartum period). In caseload care, 84.0% experienced a spontaneous vaginal birth versus 77.0% in regular midwife-led care. These patterns were observed for both nulliparous and multiparous women. Women in caseload care had fewer inductions of labour (13.2% vs 21.0%), more homebirths (39.4% vs 16.1%) and less perineal damage (intact perineum: 41.3% vs 28.2%). The incidence of perinatal mortality and a low Apgar score was low in both groups. Conclusions: We found that when compared to regular midwife-led care, caseload midwifery care in the Netherlands is associated with a lower referral rate to obstetrician-led care – both antenatally and in the intrapartum period – and a higher spontaneous vaginal birth rate, with similar perinatal safety. The challenge is to include this model as part of the current effort to improve the quality of Dutch maternity care, making caseload care available and affordable for more women.
DOCUMENT
Research on follow-up outcomes of systemic interventions for family members with an intellectual disability is scarce. In this study, short-term and long-term follow-up outcomes of multisystemic therapy for adolescents with antisocial or delinquent behaviour and an intellectual disability (MST-ID) are reported. In addition, the role of parental intellectual disability was examined. Outcomes of 55 families who had received MST-ID were assessed at the end of treatment and at 6-month, 12-month and 18-month follow-up. Parental intellectual disability was used as a predictor of treatment outcomes. Missing data were handled using multiple imputation. Rule-breaking behaviour of adolescents declined during treatment and stabilized until 18 months post-treatment. The presence or absence of parental intellectual disability did not predict treatment outcomes. This study was the first to report long-term outcomes of MST-ID. The intervention achieved similar results in families with and without parents with an intellectual disability.
DOCUMENT
Integrating internationalisation in learning outcomes and assessment has long been known to be a key issue in higher education. However, getting buy-in from academics and incorporating learning outcomes into a programme’s larger internationalisation goals can present a challenge. LinkedIn: https://www.linkedin.com/in/josbeelen/
MULTIFILE
This paper reports on a case study investigating learning outcomes at the individual and organisational level of a cross-institutional innovation project based on the SOAP approach. SOAP integrates Schooling of teachers, Organisational development of schools, Action- and development-oriented research, and Professional development of teachers. The innovation project was aimed at combining teachers, student teachers, and teacher educators in an alliance to design and develop new competence-based vocational educational arrangements for pupils. An inductive qualitative analysis of 37 semi-structured interviews among the participants revealed seven main categories of individual learning outcomes: attitudes, project design and management, collaboration, action theory, teaching practice, educational principles, and developments within secondary vocational education. Three main categories of organisational learning outcomes were identified: institution-level learning, project-level learning, and combining institution-level and project-level learning. A tension was identified between the participants' individual interests in learning and personal development, and the need for organisational learning aimed at improving organisational processes.
DOCUMENT
Music interventions are used for stress reduction in a variety of settings because of the positive effects of music listening on both physiological arousal (e.g., heart rate, blood pressure, and hormonal levels) and psychological stress experiences (e.g., restlessness, anxiety, and nervousness). To summarize the growing body of empirical research, two multilevel meta-analyses of 104 RCTs, containing 327 effect sizes and 9,617 participants, were performed to assess the strength of the effects of music interventions on both physiological and psychological stress-related outcomes, and to test the potential moderators of the intervention effects. Results showed that music interventions had an overall significant effect on stress reduction in both physiological (d = .380) and psychological (d = .545) outcomes. Further, moderator analyses showed that the type of outcome assessment moderated the effects of music interventions on stress-related outcomes. Larger effects were found on heart rate (d = .456), compared to blood pressure (d = .343) and hormone levels (d = .349). Implications for stress-reducing music interventions are discussed.
DOCUMENT
Purpose In recent years, the effects of the physical environment on the healing process and well-being has proved to be increasingly relevant for the patient, family, carers (PFC), and staff. Moreover, it is a growing concern among health care providers, environmental psychologist, consultants, qualified installers of technologies, and architects. These concerns are about the traditional, institutionally designed health care facilities (HCF) in relation to the well-being of patients. Different studies have found that an improved design of the built environment can enhance the safety and quality, satisfaction of this so-called healing environments. This is an overview of the evidence presented in the literature on healing environments. The scientific research on evidence-based design is ordered and structured. Method The Cochrane Methodology1 was used to search data. Pubmed [Medline], Jstor, and Scopus were searched for relevant articles. A total of 54 keywords were used and structured in four groups, patient, staff, environmental factors, and relevant authors. After eliminating duplicate articles, the remaining articles were examined for further selection. At the final stage, articles were selected based on title and abstract that referred to the physical environment of healthcare facilities in the title and the abstract. To order and structure the evidence regarding healing environments, the framework of integrated building design by Rutten2 and Ulrich3,4 was used and adapted. The studies included in the review were subdivided into two groups, PFC-outcomes and staff outcomes by using methodology according to the pyramid of evidence5 . Results & Discussion Results illustrate the effects of different aspects and dimensions that deal with the physical environmental factors of HFC on PFC and staff. A total of 798 papers were found to fit the inclusion criteria. Of these, 68 articles were selected for the review: less than 50% were classified with a high level of evidence, and 87% were included in the group of PFC-outcomes. The study demonstrates that evidence of staff outcomes is scarce or insufficiently substantiated. With the development of a more customer-oriented management approach to HCF, these results are important for the design and construction of HCF. Some design features to be addressed are: identical rooms, single-patient rooms; and lighting. For future research, the main challenge is to investigate and specify staff needs and integrate these needs into the built environment of HCF.
DOCUMENT
There is a lack of evidence to guide district nurses in using nurse-sensitive patient outcomes as it is unclear how these outcomes are currently used in daily district nursing practice. Therefore, we aimed to explore (1) which nurse-sensitive patient outcomes are measured and how these outcomes are measured, (2) how district nurses use the outcomes to learn from and improve current practice and (3) the barriers and facilitators to using outcomes in current district nursing practice. An exploratory cross-sectional survey study was conducted. The survey was distributed online among nurses working for various district nursing care organisations across the Netherlands. The responses from 132 nurses were analysed, demonstrating that different instruments or questionnaires are available and used in district nursing care as outcome measures. The nurse-sensitive patient outcomes most often measured with validated instruments are pain using the Numeric Rating Scale or Visual Analogue Scale, delirium using the Delirium Observation Scale, weight loss using the Short Nutritional Assessment Questionnaire and caregiver burden using the Caregiver Strain Index or a Dutch equivalent. Falls and client satisfaction with delivered care are most often measured using unvalidated outcome measures. The other nurse-sensitive outcomes are measured in different ways. Outcomes are measured, reported and fed back to the nursing team multiple times and in various ways to learn from and improve current practice. In general, nurses have a positive attitude towards using nurse-sensitive outcomes in practice, but there is a lack of facilitation to support them. Because insight into how nurses can and should be supported is still lacking, exploring their needs in further research is desirable. Additionally, due to the high variation in the utilisation of outcomes in current practice, it is recommended to create more uniformity by developing (inter)national guidelines on using nurse-sensitive patient outcomes in district nursing care.
LINK
Objective To evaluate whether a specific period after birth (in weeks postmenstrual age [PMA]) and specific elements of sucking are associated with abnormal neurodevelopmental outcomes at age 2 years using a longitudinal approach.Study design Fifty-two preterm infants participated in this longitudinal cohort study (mean gestational age,29.5 weeks; mean birth weight, 1197 g). We assessed the infants’ sucking patterns at 37-50 weeks PMA using the Neonatal Oral-Motor Assessment Scale. At age 2 years, based on a neurologic examination and the Dutch version of the Bayley Scales of Infant and Toddler Development, Second Edition, we categorized the children as developing normally (n = 39) or abnormally (n = 13). ORs, including 95% CIs, were calculated to ascertain the risk of abnormal neurodevelopmental outcomes.Results The inability to sustain sucking at 46 weeks PMA (OR, 6.25; 95% CI, 1.29-30.35) and the absence of amature sucking pattern at 44 weeks PMA (OR, 6.30; 95% CI, 1.40-28.32) significantly increased the odds ofabnormal neurodevelopmental outcomes at age 2 years. The ORs of the Neonatal Oral-Motor Assessment Scale items assessing rhythmic jaw movements, rhythmic tongue movements, and coordination among sucking, swallowing, and respiration were high shortly after term, but failed to reach significance.Conclusion Specific elements of sucking at 4-6 weeks postterm are associated with abnormal neurodevelopmental outcomes in preterm infants at age 2 years. This period might be a sensitive time of infant development in which sucking behavior is an early marker of abnormal developmental outcomes. This finding may offer opportunities for early intervention.
DOCUMENT
