Background: A paradigm shift in health care from illness to wellbeing requires new assessment technologies and intervention strategies. Self-monitoring tools based on the Experience Sampling Method (ESM) might provide a solution. They enable patients to monitor both vulnerability and resilience in daily life. Although ESM solutions are extensively used in research, a translation from science into daily clinical practice is needed. Objective: To investigate the redesign process of an existing platform for ESM data collection for detailed functional analysis and disease management used by psychological assistants to the general practitioner (PAGPs) in family medicine. Methods: The experience-sampling platform was reconceptualized according to the design thinking framework in three phases. PAGPs were closely involved in co-creation sessions. In the ‘understand’ phase, knowledge about end-users’ characteristics and current eHealth use was collected (nominal group technique – 2 sessions with N = 15). In the ‘explore’ phase, the key needs concerning the platform content and functionalities were evaluated and prioritized (empathy mapping – 1 session with N = 5, moderated user testing – 1 session with N = 4). In the ‘materialize’ phase, the adjusted version of the platform was tested in daily clinical practice (4 months with N = 4). The whole process was extensively logged, analyzed using content analysis, and discussed with an interprofessional project group. Results: In the ‘understand’ phase, PAGPs emphasized the variability in symptoms reported by patients. Therefore, moment-to-moment assessment of mood and behavior in a daily life context could be valuable. In the ‘explore’ phase, (motivational) functionalities, technological performance and instructions turned out to be important user requirements and could be improved. In the ‘materialize’ phase, PAGPs encountered barriers to implement the experience-sampling platform. They were insufficiently facilitated by the regional primary care group and general practitioners. Conclusion: The redesign process in co-creation yielded meaningful insights into the needs, desires and daily routines in family medicine. Severe barriers were encountered related to the use and uptake of the experience-sampling platform in settings where health care professionals lack the time, knowledge and skills. Future research should focus on the applicability of this platform in family medicine and incorporate patient experiences.
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Emotions are a key component of tourism experiences, as emotions make experiences more valued and more memorable. Peak-and-end-theory states that overall experience evaluations are best predicted by the emotions at the most intense and final moments of an experience. Peak-and-end-theory has mostly been studied for relatively simple experiences. Recent insights suggest that peak-and-end-theory does not necessarily hold for tourism experiences, which tend to be more heterogeneous and multi-episodic in nature. Through the novel approach of using electrophysiological measures in combination with experience reconstruction, the applicability of the peak-and-end-theory to the field of tourism is addressed by studying a musical theatre show in a theme park resort. Findings indicate that for a multi-episodic tourism experience, hypotheses from the peak-and-end-theory are rejected for the experience as a whole, but supported for individual episodes within the experience. Furthermore, it is shown that electrophysiology sheds a new light on the temporal dynamics of experience
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This is an Accepted Manuscript of an article published by Taylor & Francis in INTERNATIONAL SPECTATOR on 31-01-2022, available online: https://www.tandfonline.com/doi/abs/10.1080/03932729.2021.2007610 In July 2015, after intense negotiations with its creditors, Greece received a bailout in exchange for fiscal restraint. The coalition government at that time, led by the left-wing SYRIZA party, elected on the basis of an anti-austerity platform, eventually accepted the prevalent austerity frames of the creditors. Through the aid of Q-method, an analysis of Greek opinion leaders’ views of the negotiation highlights that this outcome can be explained in two different ways. The first posits that the ideological overtones that ruling SYRIZA injected in its negotiation strategy exhibited a lack of socialisation and undermined Greece’s already weak bargaining position. The second focuses on the institutional status quo bias in the Eurogroup in Germany’s favour, which discourages any change in the Eurozone. These two views may have partly been influenced by questions of political accountability.
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Abstract Managing adverse drug reactions (ADRs) is a challenge, especially because most healthcare professionals are insufficiently trained for this task. Since context-based clinical pharmacovigilance training has proven effective, we assessed the feasibility and effect of a creating a team of Junior-Adverse Drug Event Managers (J-ADEMs). The J-ADEM team consisted of medical students (1st–6th year) tasked with managing and reporting ADRs in hospitalized patients. Feasibility was evaluated using questionnaires. Student competence in reporting ADRs was evaluated using a case-control design and questionnaires before and after J-ADEM program participation. From Augustus 2018 to Augustus 2019, 41 students participated in a J-ADEM team and screened 136 patients and submitted 65 ADRs reports to the Netherlands Pharmacovigilance Center Lareb. Almost all patients (n = 61) found it important that “their” ADR was reported, and all (n = 62) patients felt they were taken seriously by the J-ADEM team. Although attending physicians agreed that the ADRs should have been reported, they did not do so themselves mainly because of a “lack of knowledge and attitudes” (50%) and “excuses made by healthcare professionals” (49%). J-ADEM team students were significantly more competent than control students in managing ADRs and correctly applying all steps for diagnosing ADRs (control group 38.5% vs. intervention group 83.3%, p < 0.001). The J-ADEM team is a feasible approach for detecting and managing ADRs in hospital. Patients were satisfied with the care provided, physicians were supported in their ADR reporting obligations, and students acquired relevant basic and clinical pharmacovigilance skills and knowledge, making it a win-win-win intervention.
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