Abstract: Existing frailty models have enhanced research and practice; however, none of the models accounts for the perspective of older adults upon defining and operationalizing frailty. We aim to propose a mixed conceptual model that builds on the integral model while accounting for older adults’ perceptions and lived experiences of frailty. We conducted a traditional literature review to address frailty attributes, risk factors, consequences, perceptions, and lived experiences of older adults with frailty. Frailty attributes are vulnerability/susceptibility, aging, dynamic, complex, physical, psychological, and social. Frailty perceptions and lived experience themes/subthemes are refusing frailty labeling, being labeled “by others” as compared to “self-labeling”, from the perception of being frail towards acting as being frail, positive self-image, skepticism about frailty screening, communicating the term “frail”, and negative and positive impacts and experiences of frailty. Frailty risk factors are classified into socio-demographic, biological, physical, psychological/cognitive, behavioral, and situational/environmental factors. The consequences of frailty affect the individual, the caregiver/family, the healthcare sector, and society. The mixed conceptual model of frailty consists of interacting risk factors, interacting attributes surrounded by the older adult’s perception and lived experience, and interacting consequences at multiple levels. The mixed conceptual model provides a lens to qualify frailty in addition to quantifying it.
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In this mixed methods study, a moderated mediation model predicting effects of leader-member exchange (LMX) and organizational citizenship behaviors (OCB) on innovative work behaviors, with employability as a mediator, has been tested. Multi-source data from 487 pairs of employees and supervisors working in 151 small and medium-sized enterprises (SMEs) supported our hypothesized model. The results of structural equation modelling provide support for our model. In particular, the benefits of close relationships and high-quality exchanges between employee and supervisor (LMX), and fostering individual development as a result of employees’ OCB have an indirect effect on innovative work behaviors through positive effects on workers’ employability. Innovative work behaviors depend on employees’ knowledge, skills, and expertise. In other words, enhancing workers’ employability nurtures innovative work behaviors. In addition, we found a moderation effect of organizational politics on the relationship between employability and innovative work behaviors. Secondly, qualitative methods focusing on experiences of the antecedents and outcomes of employability were used to complement our quantitative results. All in all, this study has important consequences for managerial strategies and practices in SMEs and call for an awareness of the dysfunctional effect of perceived organizational politics.
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Professional youth workers and their organizations pursue further improvement of quality and transparency in their work. Political developments require to demonstrate the added value of professional youth work to active citizenship. Due to the complex, dynamic and interactive nature of professional youth work, the body of knowledge has been poorly developed. In this paper, we will present a conceptual model for methodic acting of professional youth work. The conceptual model is based on a mixed method design of literature review, document analyses, observations, in depth interviews with youth workers (77), and questionnaires (259 with youth that participate within youth work and 270 control group). Data is collected in 8 different youth work organisations in Amsterdam, Utrecht and Zaandam in the Netherlands. The result is a conceptual model for methodic acting of professional youth work: a multi-methodic approach that consists of thirteen methodical principles. These principles guide the interactions of youth workers with young people. There are indications that the combined use of methods contributes to personal and social development of youth, social support, and youth participation. This conceptual model is a promising framework for professional youth work that allows to legitimize the profession. Because the model is based on the integration of different studies, it is needed to test this model. In the study Power of Youth Work started May 2017, we examine this model together with 100 youth workers, 1600 young people and 11 youth work providers.
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The aim of this research is to explore the potential of Mixed Reality (MR) technologies for Operator Support in order to progress towards Industry 4.0 (I4.0) particularly for SMEs. Through a series of interventions and interviews conducted with local SMEs, potential use cases and their drawbacks have been identified. From this, insights were derived that serve as a starting point for conducting further experiments with MR technology in the smart manufacturing laboratory at the THUAS in Delft. The intervention consisted of a free form workshop in which the participants get ‘tinkering’ time to explore MR in their own work environment. The various levels of awareness were assessed in three stages: during an introductory interview, and after an instruction meeting and some ‘tinkering’. The study took place in the period from January 2022 to July 2022 with 10 local SMEs in the Netherlands. The results show that for all SMEs the awareness and understanding increased. The use cases identified by operators themselves concerned Quality Control, Diagnostics, Instruction, Specification and Improvement of Operations. Drawbacks foreseen related to Ergonomic Concerns, Resistance from operators, Technical considerations, Unavailability of MR device and an insufficient digital infrastructure to support MR in full extent. The use case most promising to the participants was further developed into a physical prototype for an ‘assisted assembly cell’ by which the aspects of ergonomics and the mentioned technical considerations could be analysed.
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Objectives: The aim of this scoping review was threefold: 1. to identify existing definitions of oral frailty and similar terms in gerodontology literature; 2. to assess the oral frailty definitions and analyze whether these are well formulated on a conceptual level; and 3. in the absence of existing definitions meeting the criteria for good conceptual definitions, a new conceptual definition of oral frailty will be presented. Methods: A search was performed in electronic databases and internet search engines. Studies explaining or defining oral frailty or similar terms were of interest. A software-aided procedure was performed to screen titles and abstracts and identify definitions of oral frailty and similar terms. We used a guide to assess the quality of the oral frailty definitions on methodological, linguistic, and content-related criteria. Results: Of the 1,528 screened articles, 47 full-texts were reviewed. Thirteen of these contained seven definitions of oral frailty and ten definitions of similar terms. We found that all definitions of oral frailty contain the same or equivalent characteristics used to define the concepts of ’oral health’, ’deterioration of oral function’, and ’oral hypofunction’. Between the seven definitions, oral frailty is described with a different number and combination of characteristics, resulting in a lack of conceptual consistency. None of the definitions of oral frailty met all criteria. Conclusion: According to our analysis, the current definitions of oral frailty cannot be considered ’good’ conceptual definitions. Therefore, we proposed a new conceptual definition: Oral frailty is the age-related functional decline of orofacial structures.
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Objectives: Promoting unstructured outside play is a promising vehicle to increase children’s physical activity (PA). This study investigates if factors of the social environment moderate the relationship between the perceived physical environment and outside play. Study design: 1875 parents from the KOALA Birth Cohort Study reported on their child’s outside play around age five years, and 1516 parents around age seven years. Linear mixed model analyses were performed to evaluate (moderating) relationships among factors of the social environment (parenting influences and social capital), the perceived physical environment, and outside play at age five and seven. Season was entered as a random factor in these analyses. Results: Accessibility of PA facilities, positive parental attitude towards PA and social capital were associated with more outside play, while parental concern and restriction of screen time were related with less outside play. We found two significant interactions; both involving parent perceived responsibility towards child PA participation. Conclusion: Although we found a limited number of interactions, this study demonstrated that the impact of the perceived physical environment may differ across levels of parent responsibility.
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The model of the Best Practice Unit (BPU) is a specific form of practice based research. It is a variation of the Community of Practice (CoP) as developed by Wenger, McDermott and Snyder (2002) with the specific aim to innovate a professional practice by combining learning, development and research. We have applied the model over the past 10 years in the domain of care and social welfare in the Netherlands. Characteristics of the model are: the interaction between individual and collective learning processes, the development of (new or better) working methods, and the implementation of these methods in daily practice. Multiple knowledge sources are being used: experiential knowledge, professional knowledge and scientific knowledge. Research is serving diverse purposes: articulating tacit knowledge, documenting the learning and innovation process, systematically describing the revealed or developed ways of working, and evaluating the efficacy of new methods. An analysis of 10 different research projects shows that the BPU is an effective model.
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Across all health care settings, certain patients are perceived as ‘difficult’ by clinicians. This paper’s aim is to understand how certain patients come to be perceived and labelled as ‘difficult’ patients in community mental health care, through mixed-methods research in The Netherlands between June 2006 and October 2009. A literature review, a Delphi-study among experts, a survey study among professionals, a Grounded Theory interview study among ‘difficult’ patients, and three case studies of ‘difficult’ patients were undertaken. Analysis of the results of these qualitative and quantitative studies took place within the concept of the sick role, and resulted in the construction of a tentative explanatory model. The ‘difficult’ patient-label is associated with professional pessimism, passive treatment and possible discharge or referral out of care. The label is given by professionals when certain patient characteristics are present and a specific causal attribution (psychological, social or moral versus neurobiological) about the patient’s behaviours is made. The status of ‘difficult’ patient is easily reinforced by subsequent patient and professional behaviour, turning initial unusual help-seeking behaviour into ‘difficult’ or ineffective chronic illness behaviour, and ineffective professional behaviour. These findings illustrate that the course of mental illness, or at least the course of patients’ contact with mental health professionals and services, is determined by patient and professional and reinforced by the social and mental health care system. This model adds to the broader sick role concept a micro-perspective in which attribution and learning principles are incorporated. On a practical level, it implies that professionals need to look into their own role in the perpetuation of difficult behaviours as described here.
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Introduction: Cancer survivors face physical, lifestyle, psychological, and psychosocial challenges. Despite the availability of aftercare services, survivors still have unmet needs. Digital aftercare programs may offer support, but their use is limited. This study aimed to examine what is needed to improve uptake and adoption of these programs. Additionally, it explored sociodemographic and clinical variables that may influence these needs. Methods: A mixed-methods approach was used, involving qualitative interviews and a questionnaire. The research was guided by the COM-B model of behaviour, which considers capability, opportunity, and motivation crucial for behaviour. Qualitative analysis was performed using the framework method. Statistical analyses involved descriptive statistics and regression analysis. Results: Fourteen cancer survivors were interviewed, and 213 participants completed the questionnaire. Findings indicated that most respondents had a positive or neutral attitude towards digital aftercare programs, believing these could address their cancer-related challenges. Still, only a small percentage had experience with them, and most were unaware of their existence. Many expressed a desire to be informed about them. Some were uncertain about their effectiveness. Others were concerned about a lack of reimbursement. No significant influence of the sociodemographic and clinical variables was found. Conclusion: Cancer survivors are generally positive about digital aftercare programs but are often unaware of their availability. Raising awareness, clarifying their value, and providing support and reimbursement could enhance uptake and adoption. Implications for Cancer Survivors: The current insights can help improve participation in digital aftercare programs, ultimately fostering health, well-being, and quality of life of cancer survivors.
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Although governments are investing heavily in big data analytics, reports show mixed results in terms of performance. Whilst big data analytics capability provided a valuable lens in business and seems useful for the public sector, there is little knowledge of its relationship with governmental performance. This study aims to explain how big data analytics capability led to governmental performance. Using a survey research methodology, an integrated conceptual model is proposed highlighting a comprehensive set of big data analytics resources influencing governmental performance. The conceptual model was developed based on prior literature. Using a PLS-SEM approach, the results strongly support the posited hypotheses. Big data analytics capability has a strong impact on governmental efficiency, effectiveness, and fairness. The findings of this paper confirmed the imperative role of big data analytics capability in governmental performance in the public sector, which earlier studies found in the private sector. This study also validated measures of governmental performance.
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