Background: Clinicians are currently challenged to support older adults to maintain a certain level of Functional Independence (FI). FI is defined as "functioning physically safely and independent from another person, within one's own context". A Core Outcome Set was developed to measure FI. The purpose of this study was to assess discriminative validity of the Core Outcome Set FI (COSFI) in a population of Dutch older adults (≥ 65 years) with different levels of FI. Secondary objective was to assess to what extent the underlying domains 'coping', 'empowerment' and 'health literacy' contribute to the COSFI in addition to the domain 'physical capacity'. Methods: A population of 200 community-dwelling older adults and older adults living in residential care facilities were evaluated by the COSFI. The COSFI contains measurements on the four domains of FI: physical capacity, coping, empowerment and health literacy. In line with the COSMIN Study Design checklist for Patient-reported outcome measurement instruments, predefined hypotheses regarding prediction accuracy and differences between three subgroups of FI were tested. Testing included ordinal logistic regression analysis, with main outcome prediction accuracy of the COSFI on a proxy indicator for FI. Results: Overall, the prediction accuracy of the COSFI was 68%. For older adults living at home and depending on help in (i)ADL, prediction accuracy was 58%. 60% of the preset hypotheses were confirmed. Only physical capacity measured with Short Physical Performance Battery was significantly associated with group membership. Adding health literacy with coping or empowerment to a model with physical capacity improved the model significantly (p < 0.01). Conclusions: The current composition of the COSFI, did not yet meet the COSMIN criteria for discriminative validity. However, with some adjustments, the COSFI potentially becomes a valuable instrument for clinical practice. Context-related factors, like the presence of a spouse, also may be a determining factor in this population. It is recommended to include context-related factors in further research on determining FI in subgroups of older people.
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In clinical practice, formal elements of art products are regularly used in art therapy observation to obtain insight into clients’ mental health and provide directions for further treatment. Due to the diversity of formal elements used in existing studies and the inconsistency in the interpretation, it is unclear which formal elements contribute to insight into clients’ mental health. In this qualitative study using Constructivist Grounded Theory, eight art therapists were interviewed in-depth to identify which formal elements they observe, how they describe mental health and how they associate formal elements with mental health. Findings of this study show that art therapists in this study observe the combination of movement, dynamic, contour and repetition (i.e., primary formal elements) with mixture of color, figuration and color saturation (i.e., secondary formal elements). Primary and secondary elements interacting together construct the structure and variation of the art product. Art therapists rarely interpret these formal elements in terms of symptoms or diagnosis. Instead, they use concepts such as balance and adaptability (i.e., self-management, openness, flexibility, and creativity). They associate balance, specifically being out of balance, with the severity of the clients’ problem and adaptability with clients’ strengths and resources. In the conclusion of the article we discuss the findings’ implications for practice and further research.
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Summary Project objectives This study fits into a larger research project on logistics collaboration and outsourcing decisions. The final objective of this larger project is to analyze the logistics collaboration decision in more detail to identify thresholds in these decisions. To reach the overall objectives, the first step is to get a clearer picture on the chemical and logistics service providers industry, sectors of our study, and on logistics collaboration in these sectors. The results of this first phase are presented in this report. Project Approach The study consists of two parts: literature review and five case studies within the chemical industry. The literature covers three topics: logistics collaboration, logistics outsourcing and purchasing of logistics services. The five case studies are used to refine the theoretical findings of the literature review. Conclusions Main observations during the case studies can be summarized as follows: Most analyzed collaborative relationships between shippers and logistics service providers in the chemical industry are still focused on operational execution of logistics activities with a short term horizon. Supply management design and control are often retained by the shippers. Despite the time and cost intensive character of a logistics service buying process, shippers tendering on a very regular basis. The decision to start a new tender project should more often be based on an integral approach that includes all tender related costs. A lower frequency of tendering could create more stability in supply chains. Beside, it will give both, shippers and LSPs, the possibility to improve the quality of the remaining projects. Price is still a dominating decision criterion in selecting a LSP. This is not an issue as long as the comparison of costs is based on an integral approach, and when shippers balance the cost criterion within their total set of criteria for sourcing logistics services. At the shippers' side there is an increased awareness of the need of more solid collaboration with logistics service providers. Nevertheless, in many cases this increased awareness does not actually result in the required actions to establish more intensive collaboration. Over the last years the logistics service providers industry was characterized by low profit margins, strong fragmentation and price competition. Nowadays, the market for LSPs is changing, because of an increasing demand for logistics services. To benefit from this situation a more pro-active role of the service providers is required in building stronger relationships with their customers. They should pay more attention on mid and long term possibilities in a collaborative relation, in stead of only be focused on running the daily operation.
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In this project on volunteering in LTH organisation we focus on three aims:1. To explain why organisations in different LTH sectors and regions had, have or need volunteers, how they interact with these volunteers, and the consequences (benefits and challenges) of volunteerism for these organisations.2. To determine how to find the right balance between paid and unpaid staff within the same organisation, considering the LTH sector and region they belong to, in order to create a healthy ecosystem within it (bearing in mind that no organisation can have both volunteers and paid staff do the same job - see above).3. To understand the perspectives, motives and expectations of why people (decide to) volunteer, how they interact with the organisation (management, paid staff) during volunteering, in order to interest them, recruit them, make use of them and retain them. In addition, it is also our aim to explain the benefits and challenges for people to volunteer.In this study, we will use an integrated approach, which implies that we aren’t only interested in the people- or organisation-side of volunteering (actor-side). We will also focus on the interactions between volunteers, paid staff and organisation during volunteering (core of the practice) in a certain LTH organisation, sector and region in the Netherlands (context-side). Studying volunteering in its specific contexts (organisation, sector, region) using an integrated practice approach, hasn’t been done before. In addition, as more and more LTH organisations in the Netherlands rely on volunteers (for their survival), either for economic, social or community (mienskip) reasons (context-related conditions), there is a need for a better understanding of volunteering (as indicated by aim 1-3). Finally, as not much literature has been based on Dutch studies about volunteering and the recruitment and retention of volunteers, this project will fill this gap.Besides the aims as outlined before, a more specific goal of this project is to provide recommendations for a sustainable business model for organisations to embrace volunteerism without affecting the structure of employees. In close cooperation with different LTH organisations, we will develop interventions as policy making instruments (and therefore also for the whole region where they are located). Furthermore, this research will contribute to industry, research (see also below), education (idem) and society. Our ultimate goal is to foster the wellbeing of the volunteers, paid staff and organisations and overall to contribute to social sustainability within The Netherlands.The above-mentioned aims and conceptual model lead to the following research question: How can volunteering in the LTH sectors in Dutch regions be shaped in a sustainable way for both volunteers as well as organisations?In line with what we discussed earlier, this also means contributing to a more stable labour market in hospitality, leisure and tourism in which voluntary work is recognised as an important and indispensable component of a healthy labour ecosystem.The approach we intend to adopt is a qualitative one based on narrative inquiry. While in the literature a quantitative approach using surveys to gather data is mostly used in understanding volunteerism and in measuring motives, we will observe and connect with the volunteers’ work in each sector/case identified and collect and analyse their individual stories. In addition, and in line with our integrated approach, we will investigate how the LTH organisations connected to these cases view the role, value and future of volunteerism.Societal IssueOur insights into volunteers’ work in different sectors will improve their quality of work by revealing drivers of their satisfaction, turnover, motivation, and passion. Managers can use these insights to train and retain volunteers as an integral part of not only their events, but the broader community. It is well-known that robust volunteering programmes are a cornerstone of contemporary social cohesion, and our findings will show how storytelling can strengthen these processes.Benefit to societyThis project will contribute in three ways to the LTH sector. The three outcomes of this study are first around a better understanding of what meaningful volunteering is, second, around the value of volunteers to LTH organisations, and, thirdly, about the value of such activities to Dutch society.The project will provide practical advice to LTH organisations on which interventions to use and in which contexts. This tangible output might take the form of a report, guide(s) mentioned above, and/or another instrument that suits the needs of managers and volunteers. The instrument(s) selected by LTH organisations and volunteers will help to disseminate best practices as well as to highlight the potential of volunteers and volunteering to wider society, other organisations and to current and potential volunteers. By following the steps in or using these instruments, we believe volunteer organisations will be better able to profile themselves and to recruit and retain volunteers.The present study will bring innovation in the field by generating new narratives on volunteerism, and by designing an engaging and appealing path for volunteers to join organisations. At the same time, it will design a structure for organisations to work with volunteers in a sustainable way.Consortium partners: Rodney Westerlaken, Geesje Duursma (both NHL Stenden, Leeuwarden)
