Introduction In 2016 a new form of integrated community treatment for patients with serious mental illnesses was implemented in two neighborhoods in the city of Utrecht (335000 inhabitants) in the Netherlands. Treatment is characterized by close collaboration of psychiatric care, somatic care (i.e. general practitioner, nurse practitioner), supported housing and other facilities, i.e. the police officer, and is provided in the direct neighborhood of the patients. This ‘neighborhood based integrated mental health care’ should not contribute solely to clinical recovery, but also specifically to social and personal recovery. Objectives The aim of this research was to investigate the experience of patients with serious mental illnesses themselves receiving this new form of neighborhood-based integrated mental health care. More specific the question is studied if and how neighborhood-based integrated mental health care supports personal and social recovery. Methods To assess the experience of patients in depth qualitative semi-structured interviews were conducted with 20 patients. Patients were asked to participate in interviews directly by the researchers, by their case managers and by experts by experience. Interview topics included personal and social recovery, resilience and self-efficacy related to the collective effort of caregivers. Qualitative data was analyzed by three independent researches with the qualitative computer program Tarzan. Strategies to enhance quality of data analysis (respondent validation) and validity (attention to negative cases) were used. Results The study will be finished in January 2019. Conclusions The results, a brief description of the collaborative care methodology offered and experiences of patients, and conclusions will be presented at the ENMESH conference.
Abstract Background. Fever in children is common and mostly caused by self-limiting infections. However, parents of febrile children often consult in general practice, in particular during out-of-hours care. To improve management, it is important to understand experiences of GPs managing these consultations. Objective. To describe GPs’ experiences regarding management of childhood fever during out-ofhours care. Methods. A descriptive qualitative study using purposeful sampling, five focus group discussions were held among 37 GPs. Analysis was based on constant comparative technique using open and axial coding. Results. Main categories were: (i) Workload and general experience; (ii) GPs’ perceptions of determinants of consulting behaviour; (iii) Parents’ expectations from the GP’s point of view; (iv) Antibiotic prescribing decisions; (v) Uncertainty of GPs versus uncertainty of parents and (vi) Information exchange during the consultation. GPs felt management of childhood fever imposes a considerable workload. They perceived a mismatch between parental concerns and their own impression of illness severity, which combined with time–pressure can lead to frustration. Diagnostic uncertainty is driven by low incidences of serious infections and dealing with parental demand for antibiotics is still challenging. Conclusion. Children with a fever account for a high workload during out-of-hours GP care which provides a diagnostic challenge due to the low incidence of serious illnesses and lacking longterm relationship. This can lead to frustration and drives antibiotics prescription rates. Improving information exchange during consultations and in the general public to young parents, could help provide a safety net thereby enhancing self-management, reducing consultations and workload, and subsequent antibiotic prescriptions.
Author supplied: Abstract How can you provide health clubs with the possibility of offering innovative and differentiating services in an increasingly competitive and rapidly changing environment? This was the issue raised by the Dutch health club industry, which has grown rapidly in recent years. To this end, we conducted extensive research in order to understand the needs of customers and flesh out a customer-driven marketing approach. As the most frequently used models and methods in marketing do not respond to the demands of small businesses, we adapted emerging generative-user research methods from the field of design. We demonstrate how we combined qualitative design research with quantitative customer research in a study for the health club industry. Finally, we discuss how the approach prompted new insights in the context of small business in the service sector through multidisciplinary collaboration. DOI: 10.1504/IJTMKT.2015.070647 http://www.inderscienceonline.com/doi/abs/10.1504/IJTMKT.2015.070647
Due to societal developments, like the introduction of the ‘civil society’, policy stimulating longer living at home and the separation of housing and care, the housing situation of older citizens is a relevant and pressing issue for housing-, governance- and care organizations. The current situation of living with care already benefits from technological advancement. The wide application of technology especially in care homes brings the emergence of a new source of information that becomes invaluable in order to understand how the smart urban environment affects the health of older people. The goal of this proposal is to develop an approach for designing smart neighborhoods, in order to assist and engage older adults living there. This approach will be applied to a neighborhood in Aalst-Waalre which will be developed into a living lab. The research will involve: (1) Insight into social-spatial factors underlying a smart neighborhood; (2) Identifying governance and organizational context; (3) Identifying needs and preferences of the (future) inhabitant; (4) Matching needs & preferences to potential socio-techno-spatial solutions. A mixed methods approach fusing quantitative and qualitative methods towards understanding the impacts of smart environment will be investigated. After 12 months, employing several concepts of urban computing, such as pattern recognition and predictive modelling , using the focus groups from the different organizations as well as primary end-users, and exploring how physiological data can be embedded in data-driven strategies for the enhancement of active ageing in this neighborhood will result in design solutions and strategies for a more care-friendly neighborhood.
Effectiveness of Supported Education for students with mental health problems, an experimental study.The onset of mental health problems generally occurs between the ages of 16 and 23 – the years in which young people follow postsecondary education, which is a major channel in ourso ciety to prepare for a career and enhance life goals. Several studies have shown that students with mental health problems have a higher chance of early school leaving. Supported Education services have been developed to support students with mental health to remain at school. The current project aims to study the effect of an individually tailored Supported Education intervention on educational and mental health outcomes of students with mental health problems at a university of applied sciences and a community college. To that end, a mixed methods design will be used. This design combines quantitative research (Randomized Controlled Trial) with qualitative research (focus groups, monitoring, interviews). 100 students recruited from the two educational institutes will be randomly allocated to either the intervention or control group.
The Dutch main water systems face pressing environmental, economic and societal challenges due to climatic changes and increased human pressure. There is a growing awareness that nature-based solutions (NBS) provide cost-effective solutions that simultaneously provide environmental, social and economic benefits and help building resilience. In spite of being carefully designed and tested, many projects tend to fail along the way or never get implemented in the first place, wasting resources and undermining trust and confidence of practitioners in NBS. Why do so many projects lose momentum even after a proof of concept is delivered? Usually, failure can be attributed to a combination of eroding political will, societal opposition and economic uncertainties. While ecological and geological processes are often well understood, there is almost no understanding around societal and economic processes related to NBS. Therefore, there is an urgent need to carefully evaluate the societal, economic, and ecological impacts and to identify design principles fostering societal support and economic viability of NBS. We address these critical knowledge gaps in this research proposal, using the largest river restoration project of the Netherlands, the Border Meuse (Grensmaas), as a Living Lab. With a transdisciplinary consortium, stakeholders have a key role a recipient and provider of information, where the broader public is involved through citizen science. Our research is scientifically innovative by using mixed methods, combining novel qualitative methods (e.g. continuous participatory narrative inquiry) and quantitative methods (e.g. economic choice experiments to elicit tradeoffs and risk preferences, agent-based modeling). The ultimate aim is to create an integral learning environment (workbench) as a decision support tool for NBS. The workbench gathers data, prepares and verifies data sets, to help stakeholders (companies, government agencies, NGOs) to quantify impacts and visualize tradeoffs of decisions regarding NBS.
