The use of art (e.g. visualized narratives) in social work may stimulate dialogue between community members about family support in their neighbourhood. The Visualized Narratives on Parenting Interactions in the Neighbourhood (VN-PIN) were developed in order to foster this dialogue. The aim of this study was to evaluate the implementation of the VN-PIN in social work practice and to gain insight in mechanisms that stimulate dialogues supported by visualizations. A qualitative process evaluation was conducted to explore the use of the VN-PIN in various urban settings. We observed meetings (N = 14) where the VN-PIN was applied and interviewed professionals and community members (N = 81). The results of this study show that the VN-PIN intervention gives parents a voice and allows them to recognize and reflect on their own parenting behaviour, thereby contributing to mutual exchanges in a supportive community. The conclusion of this study is that the VN-PIN is a useful intervention that social work professionals can use to foster dialogues about parenting within diverse contexts in super-diverse neighbourhoods. The intervention fosters a supportive structure to share experiences of various community members. Future research is needed to further evaluate the experiences and satisfaction of community members with the intervention.
BACKGROUND: Since 2011, a tailored, interdisciplinary head and neck rehabilitation (IHNR) program, covered by the basic healthcare insurance, is offered to advanced head and neck cancer (HNC) patients in the Netherlands Cancer Institute (NKI). This program is developed to preserve or restore patients' functioning, and to optimize health-related quality of life (HRQoL). It applies an integrated approach to define patients' individual goals and provide rehabilitation care throughout the cancer care continuum. The aim of the current study is to assess the (cost-) effectiveness of the IHNR approach compared to usual supportive care (USC) consisting of monodisciplinary and multidisciplinary care in advanced HNC patients.METHODS: This multicenter prospective observational study is designed to compare (cost-)effectiveness of the IHNR to USC for advanced HNC patients treated with chemoradiotherapy (CRT) or bioradiotherapy (BRT). The primary outcome is HRQoL represented in the EORTC QLQ-C30 summary score. Functional HRQoL, societal participation, utility values, return to work (RTW), unmet needs (UN), patient satisfaction and clinical outcomes are secondary outcomes, assessed using the EORTC QLQ-H&N35, USER-P, EQ-5D-5 L, and study-specific questionnaires, respectively. Both patient groups (required sample size: 64 per arm) are requested to complete the questionnaires at: diagnosis (baseline; T0), 3 months (T1), 6 months (T2), 9 months (T3) and 12 months (T4) after start of medical treatment. Differences in outcomes between the intervention and control group will be analyzed using mixed effects models, Chi-square test and descriptive statistics. In addition, a cost-effectiveness analysis (CEA) will be performed by means of a Markov decision model. The CEA will be performed using a societal perspective of the Netherlands.DISCUSSION: This prospective multicenter study will provide evidence on the effectiveness and cost-effectiveness of IHNR compared to USC. RTW and societal participation, included as secondary outcomes, have not been studied sufficiently yet in cancer rehabilitation. Interdisciplinary rehabilitation has not yet been implemented as usual care in all centers, which offers the opportunity to perform a controlled clinical study. If demonstrated to be (cost-)effective, national provision of the program can probably be advised.TRIAL REGISTRATION: The study has been retrospectively registered in the Netherlands Trial Registry on April 24th 2018 ( NTR7140 ).
Due to the ageing population, the prevalence of musculoskeletal disorders will continue to rise, as well as healthcare expenditure. To overcome these increasing expenditures, integration of orthopaedic care should be stimulated. The Primary Care Plus (PC+) intervention aimed to achieve this by facilitating collaboration between primary care and the hospital, in which specialised medical care is shifted to a primary care setting. The present study aims to evaluate the referral decision following orthopaedic care in PC+ and in particular to evaluate the influence of diagnostic tests on this decision. Therefore, retrospective monitoring data of patients visiting PC+ for orthopaedic care was used. Data was divided into two periods; P1 and P2. During P2, specialists in PC+ were able to request additional diagnostic tests (such as ultrasounds and MRIs). A total of 2,438 patients visiting PC+ for orthopaedic care were included in the analysis. The primary outcome was the referral decision following PC+ (back to the general practitioner (GP) or referral to outpatient hospital care). Independent variables were consultation- and patient-related predictors. To describe variations in the referral decision, logistic regression modelling was used. Results show that during P2, significantly more patients were referred back to their GP. Moreover, the multivariable analysis show a significant effect of patient age on the referral decision (OR 0.86, 95% CI = 0.81– 0.91) and a significant interaction was found between the treating specialist and the period (p = 0.015) and between patient’s diagnosis and the period (p < 0.001). Despite the significant impact of the possibility of requesting additional diagnostic tests in PC+, it is important to discuss the extent to which the availability of diagnostic tests fits within the vision of PC+. In addition, selecting appropriate profiles for specialists and patients for PC+ are necessary to further optimise the effectiveness and cost of care.
-Chatbots are being used at an increasing rate, for instance, for simple Q&A conversations, flight reservations, online shopping and news aggregation. However, users expect to be served as effective and reliable as they were with human-based systems and are unforgiving once the system fails to understand them, engage them or show them human empathy. This problem is more prominent when the technology is used in domains such as health care, where empathy and the ability to give emotional support are most essential during interaction with the person. Empathy, however, is a unique human skill, and conversational agents such as chatbots cannot yet express empathy in nuanced ways to account for its complex nature and quality. This project focuses on designing emotionally supportive conversational agents within the mental health domain. We take a user-centered co-creation approach to focus on the mental health problems of sexual assault victims. This group is chosen specifically, because of the high rate of the sexual assault incidents and its lifetime destructive effects on the victim and the fact that although early intervention and treatment is necessary to prevent future mental health problems, these incidents largely go unreported due to the stigma attached to sexual assault. On the other hand, research shows that people feel more comfortable talking to chatbots about intimate topics since they feel no fear of judgment. We think an emotionally supportive and empathic chatbot specifically designed to encourage self-disclosure among sexual assault victims could help those who remain silent in fear of negative evaluation and empower them to process their experience better and take the necessary steps towards treatment early on.
Voldoende bewegen, genoeg slapen en de hoeveelheid zitten en beeldschermgedrag beperken is een vereiste voor een gezonde groei en ontwikkeling van jonge kinderen. Daarnaast wordt in de jongste levensfase de basis gelegd een leven lang bewegen door de ontwikkeling van motorische vaardigheden en het aanleren van actieve beweegroutines. De afgelopen jaren zijn de beweegpatronen van (jonge) kinderen steeds ongezonder geworden en de WHO heeft de toenemende fysieke inactiviteit wereldwijd bestempeld als een urgent probleem. Het doel van dit project is het ontwikkelen van een tool (checklist) om via een ‘whole systems approach’ een gezond 24-uurs beweeggedrag te stimuleren voor kinderen van 0 tot 6 jaar. Deze tool, bedoeld voor meerdere stakeholders zoals gemeenten, kinderopvang- en schooldirecteuren of leerkrachten en pedagogisch professionals, kan de basis vormen voor bewustwording, het ondernemen van actie, toetsing en mogelijk wet- en regelgeving. Items op de checklist zullen onder andere gericht zijn op beleid, scholing van leerkrachten en pedagogisch professionals, interactievaardigheden en de fysieke omgeving. De voorgestelde samenwerking tussen kennispartners in Nederland, Noorwegen en België in combinatie met de adviesraad zorgt voor een unieke basis om de ontwikkeling, implementatie, duurzame inzet en borging van deze tool succesvol te laten verlopen. Het project sluit daarbij ook naadloos aan bij de opgestelde landelijke kennisagenda rondom ‘van jongs af aan vaardig in beweging’ en is in lijn met de Europese onderzoek en innovatieagenda van Horizon Europe 2025-2027. De krachtige internationale netwerkvorming voorziet in een duurzaam karakter door een inhoudelijke expertise matching waarin partners van elkaar kunnen leren en hierdoor een sterke wisselwerking kan plaatsvinden, waarmee een krachtige (inter)nationale positie op het gebied van gezond, actief opgroeien van jonge kinderen kan worden ingenomen. Daarnaast heeft de (kennis)netwerkvorming een positieve weerslag op de regionale ‘twee-snelheden-uitdaging’ waarmee de Brainportregio kampt door een sterke internationale instroom van kenniswerkers.
Aanleiding Kanker is in Nederland de meest voorkomende doodsoorzaak onder kinderen. Onderzoek is vooral gericht op behandelmethoden als chemo-, radiotherapie en chirurgie en niet op 'supportive care' zoals voeding en beweging. Bij de meeste kinderen met kanker is eten en bewegen problematisch. Er treedt onder- of overvoeding op terwijl de spiermassa afneemt. Het ontbreekt professionals aan gevalideerde interventies gericht op het stimuleren van adequaat eet- en beweeggedrag. De situatie verschilt per kind, per type kanker en per behandelfase. Dat maakt dat er ook niet één generieke interventie bestaat. Wat het bovendien complex maakt is dat er zo veel mensen bij zo'n interventie betrokkenen zijn in zowel de ziekenhuis- als privéomgeving van de patiënt. Doelstelling In dit RAAK-project zullen betrokkenen in de privé- en ziekenhuisomgeving van kinderen met kanker samen met professionele ontwerpers twee interventies toepassen, die kleinschalig in een kinderziekenhuis geïmplementeerd en geëvalueerd worden. De methode die daarvoor gebruikt wordt heet participatief ontwerpen. In deze aanpak werken alle betrokkenen samen via creatieve en visuele technieken zoals dagboekmethoden en foto-opdrachten. Via deze methode kunnen betrokkenen communiceren over het onderwerp, niet gehinderd door emoties of barrières voortkomend uit jargon en/of discipline. De interventies zullen worden getoetst op toepasbaarheid en draagvlak. Beoogde resultaten De ervaring die is opgedaan met de participatieve ontwerpmethoden en de toegepaste interventies is vastgelegd, geanalyseerd en verwerkt. Het project resulteert in een toolkit die informatie en inspiratie biedt over voeding en beweging voor kinderen met kanker. Bovendien worden er richtlijnen voor participatief ontwerpen in kinderoncologie opgesteld. De verspreiding van kennis en de implementatie van toolkit en richtlijnen vindt plaats via de project- en netwerkleden.
