Background: On two Care Innovation Units in the Netherlands, staff, students and Lecturer Practitioners work intensively together to provide care, create a rich learning environment, and to foster innovation and research. In striving to advance the quality of care and to develop person centred cultures a preference is given to participative forms of research in which diverse experiences and different types of knowledge are valued. Aims and Objectives: The research described here had two overarching aims: the improvement of practice situations and the encouragement of the integration of work and learning. This article focuses on our actions and learning with respect to fostering participation during this project. Design and methods: Within the action research methodology used, participative work-forms and research methods were chosen. For example, a responsive approach to evaluation of practice, use of narratives and the stimulation and use of creativity to help in exploring and sharing feelings, values and different forms of knowledge. In this article we use Arnstein's ladder of citizen participation to frame our reflection on enabling participation within this project. Results Participation took various forms and vacillated throughout the project. In addition to particular facilitation strategies, four factors emerged as influential in enabling or inhibiting aspects of participation among stakeholders: individual motivations and interests, the make-up of and atmosphere within the group, and the time made available to engage in research activities. Conclusions Participation in research is both more complex and dynamic than Arnstein's typology suggests. Moving 'up' the ladder may not be appropriate as a goal in and of itself. Instead, meeting and responding to each other's situations, as stakeholders, seems a more appropriate focus. Taking responsibility, as facilitator, for certain research activities, can free other participants to focus on elements which interest them and from which they derive satisfaction.
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Internationalizing curricula. Needs and wishes of alumni and employers with regard to international competencies. Internationalization has become of great importance for universities acrossthe globe. The labour market is becoming international, with internationalopportunities and international competition. Emerging markets such as India, China and Russia are gaining economic power. Global challenges demand world-wide solutions. Production and marketing networks span the globe and various forms of migration have resulted in a large cultural diversity within nations. As a result, societies and labour markets are changing as well. In order to deal with these societal changes adequately and to succeed in today’s labour market, graduates need to be equipped with international competencies. In a survey among 500 chief executives, ICM Research (on behalf of Think Global and The British Council, 2011) showed that employers strongly value staff members who are able to work in an international and multicultural environment. Similar results were found in Diamond et al. (2011), in which ‘multicultural teamwork’ was considered most important. The Hague University of Applied Sciences seeks to prepare its students adequately for the world of tomorrow. The University’s development plans (e.g. HogeschoolOntwikkelingsPlan, HOP 7, 2009-2013 and HOP 8, 2014-2017) indicate that its vision is to train students to be globally-minded professionals with an international and multicultural perspective, who are world-citizens, interested in global issues and able to deal with diversity in a constructive manner. They are to be professionals, who possess the competencies to function well in an international and intercultural environment. Internationalization is therefore high on the agenda of The Hague University of Applied Sciences (THUAS) which is illustrated by the fact that, as of 2014, new students in all academies have to fill 12.5% (30 ECTS) of their four-year Bachelor program with international activities. These activities can range from an internship or semester abroad (student mobility) to participating in full programs of study or minors in which English is the medium of instruction, or an internationally themed minor (Internationalization at Home, IaH). And this is only the beginning. Internationalization is a means, not an end. All THUAS courses are looking into ways in which they can internationalize their curriculum. And in doing so, they need to be innovative (Leask, 2009) and keep in mind the specific needs and wishes of alumni and their employers with regard to international competences. The THUAS research group International Cooperation supports these internationalization policy objectives by investigating various aspects, such as: • The acquisition and development of international competencies among students. • The extent to which lecturers possess international competencies and what their needs and wishes are for further development. • The international competencies THUAS graduates have acquired as part of their degree and how THUAS has stimulated this development. • The international competencies that employers and alumni consider important. Although international competencies and employability have received growing attention in internationalization research, existing studies have mainly focused on: • The effects of study abroad on the development of international competence (cf. Hoven & Walenkamp, 2013). • The effects of an experience abroad (study, internship, voluntary work) on employability. • A more general analysis of the skills employers look for in prospective employees.
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Background: Community learning is one approach to promote research competencies and to involve nurses and nursing students in research. This study examines the impact of community learning according to participants-both those inside and outside the community-in a joint nursing research project at a hospital. Method: A qualitative design was se-lected using a participatory approach. Data were col-lected through semistructured interviews, reflections, conversations, and patient input during 2 academic years. Results: Thematic analysis showed 11 themes, which were organized into three clusters: realization, transformation, and influencing factors. Participants perceived changes in practice and described how their perspectives have changed on care, education, and research. Reconsiderations led to some new or revised strategies, and influencing factors were associated with the contemporary context, degree of in-volvement, and design/facilitation. Conclusion: The impact of community learning emerged and extended beyond community boundaries, and the indicated influencing factors must be taken into account.
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This book offers a comprehensive, practice-based exploration of Systemic Co-Design (SCD) as it is applied to society’s most complex and urgent transitions. Drawing on collaborative projects from the Expertisenetwork Systemic Co-Design (ESC), it portrays Systemic Co-Design not as a fixed framework but as a reflexive, evolving practice. The chapters present diverse collaborations and inquiries, ranging from inclusive design and digital accessibility to fostering safety cultures and urban co-creation, that illustrate Systemic Co-Design’s capacity to build awareness, trust, and communities, as well as systemic capabilities. The book promotes mutual learning and generates knowledge products such as maps, canvases, cards, games, and embodied interactions that enable meaningful engagement. Key themes that run throughout include continuous reflection, the blending of action research and design experimentation, and collective sense-making across disciplines. The contributions demonstrate how new values, methods, and communities are co-developed with design practitioners, policymakers, educators, and citizens. Together, they demonstrate how Systemic Co-Design achieves practical outcomes while fostering the longterm capacities and cultural shifts necessary for systemic change.
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This thesis describes an Action Research (AR) project aimed at the implementation of Evidence Based Practice in a mental health nursing setting in the Netherlands. The main research question addressed in this thesis is: In what way is Action Research with an empowering appropriate to implement Evidence Based Practice in a mental health nursing setting in the Netherlands and what is the effect of this implementation on the care experienced by the client, the nursing interventions and the context in this setting compared to a comparative setting? To answer this main research question, the following questions derived from it were addressed: What is Evidence Based Practice? What is known about implementing evidence-based practice in nursing through Action Research? Which factors have to be dealt with in a mental health nursing setting, so the implementation of EBP with AR with an empowering intent will be more successful? Which factors have to be dealt with in a mental health nursing setting, so the implementation of EBP with AR with an empowering intent will be successful? How is EBP implemented through AR with an empowering intent and what are the outcomes for the use of evidence, the context and the facilitation in the setting? What is the effect of the implementation of EBP in mental health nursing using AR with an empowering intent on the care experienced by the client, the nursing interventions and the context compared to a comparison setting? The first two questions were answered by a search of the literature while the remaining questions were answered during the AR study conducted in two mental health organisations in the Netherlands.
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In the course of our supervisory work over the years, we have noticed that qualitative research tends to evoke a lot of questions and worries, so-called frequently asked questions (FAQs). This series of four articles intends to provide novice researchers with practical guidance for conducting high-quality qualitative research in primary care. By ‘novice’ we mean Master’s students and junior researchers, as well as experienced quantitative researchers who are engaging in qualitative research for the first time. This series addresses their questions and provides researchers, readers, reviewers and editors with references to criteria and tools for judging the quality of qualitative research papers. This second article addresses FAQs about context, research questions and designs. Qualitative research takes into account the natural contexts in which individuals or groups function to provide an in-depth understanding of real-world problems. The research questions are generally broad and open to unexpected findings. The choice of a qualitative design primarily depends on the nature of the research problem, the research question(s) and the scientific knowledge one seeks. Ethnography, phenomenology and grounded theory are considered to represent the ‘big three’ qualitative approaches. Theory guides the researcher through the research process by providing a ‘lens’ to look at the phenomenon under study. Since qualitative researchers and the participants of their studies interact in a social process, researchers influence the research process. The first article described the key features of qualitative research, the third article will focus on sampling, data collection and analysis, while the last article focuses on trustworthiness and publishing.
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This overview can be regarded as an atlas or travel guide with which the reader can follow a route along the various professorships. Chapter 2 centres on the professorships that are active in the field of Service Economy. Chapter 3 is dedicated to the professorships that are focussed on the field of Vital Region. Chapter 4 describes the professorships operating in the field of Smart Sustainable Industries. Chapter 5 deals with the professorships that are active in the field of the institution-wide themes of Design Based Education and Design Based Research. Lastly, in Chapter 6 we make an attempt to discover one or more connecting themes or procedures in the approach of the various professorships. This publication is not intended to give a definitive answer to the question as to what exactly NHL Stenden means by the concept of Design Based Research. The aim of this publication is to get an idea of everything that is happening in the NHL Stenden professorships and to pique one’s curiosity to find out more.
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Background: Multimodal prehabilitation programs are effective at reducing complications after colorectal surgery in patients with a high risk of postoperative complications due to low aerobic capacity and/or malnutrition. However, high implementation fidelity is needed to achieve these effects in real-life practice. This study aimed to investigate the implementation fidelity of an evidence-based prehabilitation program in the real-life context of a Dutch regional hospital.Methods: In this observational cohort study with multiple case analyses, all patients who underwent colorectal surgery from January 2023 to June 2023 were enrolled. Patients meeting the criteria for low aerobic capacity or malnutrition were advised to participate in a prehabilitation program. According to recent scientific insights and the local care context, this program consisted of four exercise modalities and three nutrition modalities. Implementation fidelity was investigated by evaluating: (1) coverage (participation rate), (2) duration (number of days between the start of prehabilitation and surgery), (3) content (delivery of prescribed intervention modalities), and (4) frequency (attendance of sessions and compliance with prescribed parameters). An aggregated percentage of content and frequency was calculated to determine overall adherence.Results: Fifty-eight patients intended to follow the prehabilitation care pathway, of which 41 performed a preoperative risk assessment (coverage 80%). Ten patients (24%) were identified as high-risk and participated in the prehabilitation program (duration of 33-84 days). Adherence was high (84-100%) in five and moderate (72-73%) in two patients. Adherence was remarkably low (25%, 53%, 54%) in three patients who struggled to execute the prehabilitation program due to multiple physical and cognitive impairments.Conclusion: Implementation fidelity of an evidence-based multimodal prehabilitation program for high-risk patients preparing for colorectal surgery in real-life practice was moderate because adherence was high for most patients, but low for some patients. Patients with low adherence had multiple impairments, with consequences for their preparation for surgery. For healthcare professionals, it is recommended to pay attention to high-risk patients with multiple impairments and further personalize the prehabilitation program. More knowledge about identifying and treating high-risk patients is needed to provide evidence-based recommendations and to obtain higher effectiveness.
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Ecosystem engineering research has recently demonstrated the fundamental importance of non-trophic interactions for food-web structure. Particularly, by creating benign conditions in stressful environments, ecosystem engineers create hot beds of elevated levels of recruitment, growth, and survival of associated organisms; this should fuel food webs and promote production on the ecosystem scale. However, there is still limited empirical evidence of the influence of non-trophic interactions on the classical food-web processes that determine energy transfer, that is, consumer–resource interactions. On the basis of a biomanipulation experiment covering 600 m2 of an intertidal flat, we show that ecosystem engineers influence resource uptake efficiency and the accumulation of algae following nutrient enrichment in a soft-sediment food web. Nutrient additions increased chlorophyll a concentrations in the sediment by 90%, but only in plots where we also introduced high densities (2000 per m2) of a burrowing bivalve, the common cockle Cerastoderma edule. The artificial cockle beds increased the nutrient uptake efficiency of the biofilm and promoted sediment accumulation, which suggests that the cockles facilitated the sediment-living algae by increasing sediment stability. This indicates that ecological interactions, rather than the availability of nutrients per se, set the limits for production in this coastal ecosystem. Our results emphasize the need to include facilitation theory and recognize that positive interactions between species are key to understand, manage, and restore ecosystems under human influence.
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