BACKGROUND AND PURPOSE: Paratonia is a motor problem that develops during the course of dementia. Definitions of paratonia used in the literature differ considerably, which has clinical implications and may lead to an undesirable heterogeneity in study populations. For this reason, we initiated a Delphi procedure with known experts in the field to establish an operational consensus definition of paratonia.METHODS: The Delphi procedure involved an anonymous and multistage approach presented as a questionnaire, with each stage building on the results of the previous one in order to reach consensus on the definition of paratonia.RESULTS: Eight of 17 experts agreed to participate in the study. After 4 rounds, the participants reached consensus on the following definition: paratonia is a form of hypertonia with an involuntary variable resistance during passive movement. The nature of paratonia may change with progression of dementia (eg, from active assistance (aka Mitgehen) to active resistance). The degree of resistance depends on the speed of movement (eg, slow > low resistance, fast > high resistance). The degree of paratonia is proportional to the amount of force applied and increases with progression of dementia. The resistance to passive movement is in any direction and there is no clasp-knife phenomenon.CONCLUSION: The Delphi procedure resulted in a comprehensive, operational definition of paratonia. Future research should focus on the reliability and validity of this definition.
Amidst escalating environmental and social challenges, this study explores regenerative business models’ definition and characteristics. While sustainable models have made considerable strides in research, policy, and practice, the advent of regenerative business models offers a progressive leap forward. Regenerative business models aspire to contribute to ecological restoration and societal well-being. The regenerative business model concept is, however, still in its infancy and lacks a comprehensive definition. Our study aims to expand this knowledge, using a Delphi-inspired approach that builds on the knowledge of academic and business experts. Our approach includes three rounds of surveys: an open-ended survey, a survey for rating and ranking the earlier responses of all participants, and a final survey to select key characteristics. We investigate patterns and distinctions among regenerative, regenerative business, and regenerative business models, and analyze their positioning vis-a-vis circular and net-positive models. Findings underscore that organizations adopting regenerative business models focus on planetary health and societal well-being. They generate value across multiple stakeholder levels, including nature, societies, customers, suppliers, shareholders, and employees. Despite overlapping with circular and net-positive models, regenerative business models also emphasize interdependencies between humans and nature, and provide a more holistic approach, centered on restoration rather than mere mitigation.
Background: Nurses play an important role in pharmaceutical care. They are involved in: detecting clinical change; communicating/discussing pharmacotherapy with patients, their advocates, and other healthcare professionals; proposing and implementing medication-related interventions; and ensuring follow-up of patients and medication regimens. To date, a framework of nurses' competences on knowledge, skills, and attitudes as to interprofessional pharmaceutical care tasks is missing. Objectives: To reach agreement with experts about nurses' competences for tasks in interprofessional pharmaceutical care. Methods: A two-phase study starting with a scoping review followed by five Delphi rounds was performed. Competences extracted from the literature were assessed by an expert panel on relevance by using the RAND/UCLA method. The experts (n = 22) involved were healthcare professionals, nurse researchers, and educators from 14 European countries with a specific interest in nurses' roles in interprofessional pharmaceutical care. Descriptive statistics supported the data analysis. Results: The expert panel reached consensus on the relevance of 60 competences for 22 nursing tasks. Forty-one competences were related to 15 generic nursing tasks and 33 competences were related to seven specific nursing tasks. Conclusions: This study resulted in a competence framework for competency-based nurse education. Future research should focus on imbedding these competences in nurse education. A structured instrument should be developed to assess students' readiness to achieve competence in interprofessional pharmaceutical care in clinical practice.
The increasing concentration of people in urban environments in an era of globalisation means that social, economic, and environmental resources for living and working are under pressure. Urban communities experience increased stress levels due to inadequate and overburdened infrastructure and services, challenges due to ethnic and cultural diversity, socio-economic inequalities as well as the impact of environmental degradation. For these communities to build resilience under these circumstances therefore requires a multipronged approach. The underlying question this project will answer is: “What are the key characteristics of experiencescapes that contribute to resilience-building in communities?” The project will dive into the identification of building blocks of experiencescapes and roles of relevant actors that can support communities in building resilience. Within the context of a multidisciplinary approach, this project applies a range of qualitative research methods, such as in-depth interviews, focus groups, participant observation, storytelling techniques, life stories, as well as various biometric quantitative methods, available through the experience lab of BUas. The outcome of the project will enable practitioners and researchers alike in various sectors to understand what and how they can contribute to creating an environment in which people can meaningfully interact in a way that builds resilience in communities. This outcome is communicated not only through academic publications and conference contributions, but also through public reports and a handbook for practitioners and students. These reports and handbooks support identification and application of building blocks of experiencescapes that support building resilience in communities. Finally, the knowledge generated in the project will contribute to the development of curricula of various educational programmes at Breda University of Applied Sciences by expanding the scope of experience design into the area of people-to-people relationships.
