Zoekresultaten

De Haagse aanpak gezond gewicht in de wijk Bouwlust/Vrederust

Het schooljaar 2011-2012 wordt gezien als de beginfase van de Haagse Aanpak Gezond Gewicht (HAGG) in de wijk Bouwlust/Vrederust. Tijdens deze fase is onderzoek verricht naar het bereik, adoptie en effect van de activiteiten van de HAGG. Voor het onderzoek is gebruik gemaakt van een activiteitenmonitor, interviews met kinderen, ouders en scholen en observatiegegevens van de consumptie van eten/drinken tijdens de ochtendpauze. In totaal zijn twaalf activiteiten georganiseerd gericht op het eten van fruit, het drinken van water of bewegen. De activiteiten hebben met name de doelgroep in de leeftijd van 4 t/m 12 jaar kunnen bereiken. De mate van participatie van wijkpartners in de HAGG activiteiten verschilt per thema, waarbij de participatie voor het thema water het grootste was. Door het instellen van een fruit- of watermoment lijkt het mogelijk om gezond gedrag te stimuleren tijdens schooltijd. ABSTRACT The 2011-12 school year is seen as the initiation phase of "HAGG", the Dutch Healthy Weight community programme in the city of The Hague. During the initiation phase of the programme, data were collected on reach, adoption and effectiveness of the HAGG activities, using an activity database, interviews among children, parents, and schools and observational data on fruit and water consumption during school time. In total, twelve activities were organized. The activities were directed towards fruit consumption, water consumption or physical activity. The activities reached the target population in the age of 4-13 years, especially. At the community level the degree of participation of different community partners was the highest for the drinking water activities. Fruit and drinking water breaks are likely to increase fruit and water consumption during school time.

‘Becommoning': a design-framework for the initiation of new commons

This article explores the establishment of new commons initiatives from an integrated design perspective. Such a deeper understanding of the initial phase of becoming a commons -i.e. becommoning- and its design is crucial as members embark on a laborious, time-consuming and uncertain process in which they need to make critical design choices for their future commons. The design perspective is brought forward by the collective creation through which group values are explicated, the communal resource and its governance take shape and conditions are forged for the commons to emerge. So, the study presents the ‘becommoning’ framework as a first exploration for such a designerly approach to identify the steps and activities communities need to make at the very begin to start unfolding their initiative. The framework is applied in a case study, namely, for exploring the design of housing commons and related genres like cohousing, residential communities that are recognized as microlaboratories offering general insights for pursuing alternative societal models.

Finding your feet

Finding your feet

IntroductionInternational placements challenge students to find the right level of participation, as local practices, language and time pressure may affect their engagement in patient-related tasks or team activities. This study sought to unpack the initiation process during international clinical placements with the ultimate aim to achieve active student participation.MethodsFollowing a constructivist grounded theory approach, we conducted two individual interviews with 15 undergraduate healthcare students (before departure and whilst on placement). To identify emerging themes, we applied an iterative process of data collection and constant comparative analysis. Several team discussions informed further analysis, allowing us to reach a more conceptual level of theory.ResultsFrom our findings we constructed a four-phase model of healthcare students’ initiation of international clinical placements, which brings into focus how the phases of ‘orientation’, ‘adjustment’ and ‘contribution to patient care’ build up towards a ‘sense of belonging’. We identified several factors that induced active student participation in practice, such as a favourable workplace setting, opportunities for learning and a local support network.DiscussionActive student participation is aimed at different goals, depending on the four phases of initiation that eventually lead to a sense of belonging and support workplace learning.

Impact of kinesiophobia on initiation of cardiac rehabilitation

Objectives To identify factors associated with kinesiophobia (fear of movement) after cardiac hospitalisation and to assess the impact of kinesiophobia on cardiac rehabilitation (CR) initiation.Design Prospective cohort study.Setting Academic Medical Centre, Department of Cardiology.Participants We performed a prospective cohort study in cardiac patients recruited at hospital discharge. In total, 149 patients (78.5% male) with a median age of 65 years were included, of which 82 (59%) were referred for CR.Primary and secondary outcome measures We assessed kinesiophobia with the Tampa Scale for Kinesiophobia (TSK). For this study, the total score was used (range 13–52). We assessed baseline factors (demographics, cardiac disease history, questionnaire data on anxiety, biopsychosocial complexity and self-efficacy) associated with kinesiophobia using linear regression with backward elimination. For linear regression, the standardised beta (β) was reported. Prospectively, the impact of kinesiophobia on probability of CR initiation, in the first 3 months after hospital discharge (subsample referred for CR), was assessed with logistic regression. For logistic regression, the OR was reported.Results Moderate and severe levels of kinesiophobia were found in 22.8%. In the total sample, kinesiophobia was associated with cardiac anxiety (β=0.33, 95% CI: 0.19 to 0.48), social complexity (β=0.23, 95% CI: 0.06 to 0.39) and higher education (β=−0.18, 95% CI: −0.34 to −0.02). In those referred for CR, kinesiophobia was negatively associated with self-efficacy (β=−0.29, 95% CI: −0.47 to −0.12) and positively with cardiac anxiety (β=0.43, 95% CI: 0.24 to 0.62). Kinesiophobia decreased the probability of CR initiation (ORRange13–52 points=0.92, 95% CI: 0.85 to 0.99).Conclusion In patients hospitalised for cardiovascular disease, kinesiophobia is associated with cardiac anxiety, social complexity, educational level and self-efficacy. Kinesiophobia decreased the likelihood of CR initiation with 8% per point on the TSK.

Initiation of student participation in practice

Background: Differences in professional practice might hinder initiation of student participation during international placements, and thereby limit workplace learning. This study explores how healthcare students overcome differences in professional practice during initiation of international placements. Methods: Twelve first-year physiotherapy students recorded individual audio diaries during the first month of international clinical placement. Recordings were transcribed, anonymized, and analyzed following a template analysis approach. Team discussions focused on thematic interpretation of results. Results: Students described tackling differences in professional practice via ongoing negotiations of practice between them, local professionals, and peers. Three themes were identified as the focus of students’ orientation and adjustment efforts: professional practice, educational context, and individual approaches to learning. Healthcare students’ initiation during international placements involved a cyclical process of orientation and adjustment, supported by active participation, professional dialogue, and self-regulated learning strategies.Conclusions: Initiation of student participation during international placements can be supported by establishing a continuous dialogue between student and healthcare professionals. This dialogue helps align mutual expectations regarding scope of practice, and increase understanding of professional and educational practices. Better understanding, in turn, creates trust and favors meaningful students’ contribution to practice and patient care.