Objectives Most complex healthcare interventions target a network of healthcare professionals. Social network analysis (SNA) is a powerful technique to study how social relationships within a network are established and evolve. We identified in which phases of complex healthcare intervention research SNA is used and the value of SNA for developing and evaluating complex healthcare interventions. Methods A scoping review was conducted using the Arksey and O’Malley methodological framework. We included complex healthcare intervention studies using SNA to identify the study characteristics,level of complexity of the healthcare interventions, reported strengths and limitations, and reported implications of SNA. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews 2018 was used to guide the reporting. Results Among 2466 identified studies, 40 studies were selected for analysis. At first, the results showed that SNA seems underused in evaluating complex intervention research. Second, SNA was not used in the development phase of the included studies. Third, the reported implications in the evaluation and implementation phase reflect the value of SNA in addressing the implementation and population complexity. Fourth, pathway complexity and contextual complexity of the included interventions were unclear or unable to access. Fifth, the use of a mixed methods approach was reported as a strength, as the combination and integration of a quantitative and qualitative method clearly establishes the results. Conclusion SNA is a widely applicable method that can be used in different phases of complex intervention research. SNA can be of value to disentangle and address the level of complexity of complex healthcare interventions. Furthermore, the routine use of SNA within a mixed method approach could yield actionable insights that would be useful in the transactional context of complex interventions.
Background: Despite high prevalence of mental problems among elderly migrants in The Netherlands, the use of psychosocial care services by this group is low. Scientific evidence points at the crucial role of social support for mental health and the use of psychosocial services. We therefore explored the role of social networks in the access to psychosocial care among elderly migrants in The Netherlands. Methods: A qualitative study was conducted using semi-structured group interviews and individual interviews. The eight group and eleven individual interviews (respectively n = 58 and n = 11) were conducted in The Netherlands with Turkish, Moroccan, Surinamese, and Dutch elderly. The data were analysed through coding and comparing fragments and recognizing patterns. Results: Support of the social network is important to navigate to psychosocial care and is most frequently provided by children. However, the social network of elderly migrants is generally not able to meet the needs of the elderly. This is mostly due to poor mental health literacy of the social network, taboo, and stigma around mental illness and the busy lives of the social network members. Conclusions: Strategies to address help-seeking barriers should consider mental health literacy in elderly migrants as well as their social networks, and counteract taboos and stigma of mental health problems.
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This paper reveals how the automatising of protocols ignited a public conflict between Dutch banks and their Small and Medium-sized Enterprise (SME) clients in the years after the Global Financial Crisis. The bank’s “infirmary departments” for Financial Restructuring and Recovery (FR&R) were accused of (mal)treating SMEs. The conflict resulted in no formal regulatory or legal change despite public support. Instead, the banks created self-regulation to improve communication with SMEs, leading to shifts in governing FR&R for SMEs. This way, the banks mitigated significant negative symptoms of automation and solved the conflict with the SMEs while keeping FR&R and ongoing automation intact. The research uses an interdisciplinary analytical framework to understand national financial conflicts in a digitalised (business) world. It contributes to the theory of institutionalising values in discursive contests between action fields. The paper highlights the material and causes of normative conflicts of interest among critical actors in established public-private networks through discourse analysis and process tracing.
Brandweermensen lopen het meeste gevaar als ze onder tijdsdruk een gebouw moeten verkennen, of een brand moeten blussen terwijl de situatie nog niet goed kan worden overzien. Omvallende muren, instortende plafonds of gewoon gestruikeld over door de rook onzichtbare brokstukken leiden tot vermijdbare letsels of zelfs slachtoffers. Met name de inzet bij branden in stedelijke parkeergarages onder woontorens vormen een enorm risico. Het inzetten van onbemande, op afstand bestuurbare voertuigen voor verkenning en bluswerk is een oplossing die binnen de brandweer breed wordt gedragen. De brandweer moet deze innovatieve technologie echter zien te omarmen. Zij werken nu vanuit hun intuïtie en weten direct hoe te acteren op basis van wat zij waarnemen. Praktijkgericht onderzoek heeft echter uitgewezen dat scepsis over de inzet van blusplatforms bij incidenten plaats heeft gemaakt voor zeker vertrouwen. Een blusplatform, voorzien van juiste sensoren kan de Officier van Dienst (OVD) ondersteunen bij het nemen van een beslissing om al dan niet tot een ‘aanval’ over te gaan. Praktijktesten hebben echter laten zien dat de huidige blusplatforms nog niet optimaal functioneren om als volwaardig ‘teamlid’ te kunnen worden ingezet. Dit heeft enerzijds met technologische ontwikkelingen (sensoren en communicatieverbindingen) te maken, maar anderzijds moet de informatievoorziening (human-machine interfacing) naar de brandweer beter worden afgestemd. In dit project gaan Saxion, het instituut fysieke veiligheid, de universiteit Twente, het bedrijfsleven en vijf veiligheidsregio’s onderzoeken hoe en wanneer innovatieve blusplatforms op een intuïtieve manier kunnen worden ingezet door training én (kleine) productaanpassing zodat deze een volwaardig onderdeel kunnen zijn van het brandweerkorps. Een blusplatform kan letselschade en slachtoffers voorkomen, mits goed ingezet en vertrouwd door de mensen die daarvan afhankelijk zijn. Het vak van brandweer, als beroeps of vrijwilliger, is een van de gevaarlijkste die er is. Laten we er samen voor zorgen dat het iets veiliger kan worden.
The goal of UPIN is to develop and evaluate a scalable distributed system that enables users to cryptographically verify and easily control the paths through which their data travels through an inter-domain network like the Internet, both in terms of router-to-router hops as well as in terms of router attributes (e.g., their location, operator, security level, and manufacturer). UPIN will thus provide the solution to a very relevant and current problem, namely that it is becoming increasingly opaque for users on the Internet who processes their data (e.g., in terms of service providers their data passes through as well as what jurisdictions apply) and that they have no control over how it is being routed. This is a risk for people’s privacy (e.g., a malicious network compromising a user’s data) as well as for their safety (e.g., an untrusted network disrupting a remote surgery). Motivating examples in which (sensitive) user data typically travels across the Internet without user awareness or control are: - Internet of Things for consumers: sensors such as sleep trackers and light switches that collect information about a user’s physical environment and send it across the Internet to remote services for analysis. - Medical records: health care providers requiring medical information (e.g., health records of patients or remote surgery telemetry) to travel between medical institutions according to specified agreements. - Intelligent transport systems: communication plays a crucial role in future autonomous transportation systems, for instance to avoid freight drones colliding or to ensure smooth passing of trucks through busy urban areas. The UPIN project is novel in three ways: 1. UPIN gives users the ability to control and verify the path that their data takes through the network all the way to the destination endpoint, both in terms of hops and attributes of routers traversed. UPIN accomplishes this by adding and improving remote attestation techniques for on-path routers to existing path verification mechanisms, and by adopting and further developing in-packet path selection directives for control. 2. We develop and simulate data and control plane protocols and router extensions to include the UPIN system in inter-domain networking systems such as IP (e.g., using BGP and segment routing) and emerging systems such as SCION and RINA. 3. We evaluate the scalability and performance of the UPIN system using a multi-site testbed of open programmable P4 routers, which is necessary because UPIN requires novel packet processing functions in the data plane. We validate the system using the earlier motivating examples as use cases. The impact we target is: - Increased trust from users (individuals and organizations) in network services because they are able to verify how their data travels through the network to the destination endpoint and because the UPIN APIs enable novel applications that use these network functions. - More empowered users because they are able to control how their data travels through inter-domain networks, which increases self-determination, both at the level of individual users as well as at the societal level.
