Perceptions and values of care professionals are critical in successfully implementing technology in health care. The aim of this study was threefold: (1) to explore the main values of health care professionals, (2) to investigate the perceived influence of the technologies regarding these values, and (3) the accumulated views of care professionals with respect to the use of technology in the future. In total, 51 professionals were interviewed. Interpretative phenomenological analysis was applied. All care professionals highly valued being able to satisfy the needs of their care recipients. Mutual inter-collegial respect and appreciation of supervisors was also highly cherished. The opportunity to work in a careful manner was another important value. Conditions for the successful implementation of technology involved reliability of the technology at hand, training with team members in the practical use of new technology, and the availability of a help desk. Views regarding the future of health care were mainly related to financial cut backs and with a lower availability of staff. Interestingly, no spontaneous thoughts about the role of new technology were part of these views. It can be concluded that professionals need support in relating technological solutions to care recipients' needs. The role of health care organisations, including technological expertise, can be crucial here.
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Participatory data collection relies on the commitmentof the participants to report data continuously, whichmakes providing incentives to people crucial. In thiscase study, we describe how we designed a web app byusing different incentive mechanisms to collectparticipatory data for monitoring community health.The insights we gathered through evaluating theprototype in focus groups and the lessons we learnedabout sustaining motivation and interest are discussedin the paper. We expect that these lessons would beuseful for other participatory sensing projects that aimfor constant and systematic data contribution from alarge group of people.
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Youth with chronic diseases or physical disabilities (CDPD) often show reduced fitness and physical activity (PA) levels and participate less in organized sports compared with healthy peers. The purpose of this study was to examine the associations between participation in sports and health-related fitness and PA in youth with CDPD. A total of 163 subjects (mean age 14 years; range 8-19 years) with CDPD were included in this cross-sectional study, with 81 participating in organized sports and 82 not. Subjects were recruited between October 2014 and November 2016. Aerobic and anaerobic fitness, agility, and muscle strength were assessed in the laboratory, whereas PA was monitored in daily life using accelerometry during 1 week. Linear regression analyses were used to assess the associations of sports participation (independent variable) with health-related fitness and PA (dependent variables). Results show that youth with CDPD participating in organized sports 2 times a week performed better on all outcome measures. They reached a higher peak oxygen uptake (difference of 4.9 ml O2·kg-1·min-1, P = 0.001) compared with their peers not participating in sports. Also, anaerobic fitness, agility, muscle strength, and PA were all positively associated with sports participation. Moreover, the association between sports participation and aerobic fitness was mediated by PA for 31% (P = 0.045). In conclusion, participation in sports is associated with both higher levels of PA and health-related fitness in youth with CDPD. Promotion and stimulation of participation in sports seems a good way to promote health-related fitness as well as a healthy active lifestyle in youth with CDPD.
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In leaving the more traditional territories of the concert performance for broader societal contexts, professional musicians increasingly devise music in closer collaboration with their audience rather than present it on a stage. Although the interest for such forms of devising co-creative musicking within the (elderly) health care sector is growing, the work can be considered relatively new. In terms of research, multiple studies have sought to understand the impact of such work on musicians and participants, however little is known about what underpins the musicians’ actions in these settings. With this study, I sought to address this gap by investigating professional musicians’ emerging practices when devising co-creative musicking with elderly people. Three broad concepts were used as a theoretical background to the study: Theory of Practice, co-creative musicking, and Praxialism. Firstly, I used Theory of Practice to help understand the nature of emerging practices in a wider context of change in the field of music and habitus of musicians and participants. Theory of Practice enabled me to consider a practice as “a routinized type of behaviour which consists of several elements, interconnected to one another: forms of bodily activities, forms of mental activities, ‘things’ and their use, a background knowledge in the form of understanding, know-how, states of emotion, and motivational knowledge” (Reckwitz, 2002, p. 249). Secondly, I drew the knowledge from co-creative musicking, which is a concept I gathered from two existing concepts: co-creation and musicking. Musicking (Small, 1998), which considers music as something we do (including any mode of engagement with music), provided a holistic and inclusive way of looking at participation in music-making. The co-creation paradigm encompasses a view on enterprise that consists of bringing together parties to jointly create an outcome that is meaningful to all (Prahalad & Ramaswamy, 2004; Ramaswamy & Ozcan, 2014). The concept served as a lens to specify the jointness of the musicking and challenge issues of power in the engagement of participants in the creative-productive process. Thirdly, Praxialism considers musicking as an activity that encompasses “musical doers, musical doing, something done and contexts in which the former take place” (Elliott, 1995). Praxialism sets out a vision on music that goes beyond the musical work and includes the meanings and values of those involved (Silverman, Davis & Elliott, 2014). The concept allowed me to examine the work and emerging relationships as a result of devising co-creative musicking from an ethical perspective. Given the subject’s relative newness and rather unexplored status, I examined existing work empirically through an ethnographic approach (Hammersley & Atkinson, 2007). Four cases were selected where data was gathered through episodic interviewing (Flick, 2009) and participant observation. Elements of a constructivist Grounded Theory (Charmaz, 2014) were used for performing an abductive analysis. The analysis included initial coding, focused coding, the use of sensitizing concepts (Blumer 1969 in Hammersley, 2013) and memoing. I wrote a thick description (Geertz, 1973) for each case portraying the work from my personal experience. The descriptions are included in the dissertation as one separate chapter and foreshadow the exposition of the analysis in a next chapter. In-depth study of the creative-productive processes of the cases showed the involvement of multiple co-creative elements, such as a dialogical interaction between musicians and audience. However, participants’ contributions were often adopted implicitly, through the musicians interpreting behaviour and situations. This created a particular power dynamic and challenges as to what extent the negotiation can be considered co-creative. The implicitness of ‘making use’ of another person’s behaviour with the other not (always) being aware of this also triggered an ethical perspective, especially because some of the cases involved participants that were vulnerable. The imbalance in power made me examine the relationship that emerges between musicians and participants. As a result of a closer contact in the co-creative negotiation, I witnessed a contact of a highly personal, sometimes intimate, nature. I recognized elements of two types of connections. One type could be called ‘humanistic’, as a friendship in which there is reciprocal care and interest for the other. The other could be seen as ‘functional’, which means that the relationship is used as a resource for providing input for the creative musicking process. From this angle, I have compared the relationship with that of a relationship of an artist with a muse. After having examined the co-creative and relational sides of the interaction in the four cases, I tuned in to the musicians’ contribution to these processes and relationships. I discovered that their devising in practice consisted of a continuous double balancing act on two axes: one axis considers the other and oneself as its two ends. Another axis concerns the preparedness and unpredictability at its ends. Situated at the intersection of the two axes are the musicians’ intentionality, which is fed by their intentions, values and ethics. The implicitness of the co-creation, the two-sided relationship, the potential vulnerability of participants, and the musicians’ freedom in navigating and negotiation, together, make the devising of co-creative musicking with elderly people an activity that involves ethical challenges that are centred around a tension between prioritizing doing good for the other, associated with a eudaimonic intention, and prioritizing values of the musical art form, resembling a musicianist intention. The results therefore call for a musicianship that involves acting reflectively from an ethical perspective. Doctoral study by Karolien Dons
