This chapter discusses the efforts of community workers to obtain consent in local communities as a basis for taking action on issues that are affecting local people’s lives. Crucial here is that community workers resist the initial urge to settle for consensus and as a consequencelimit the possibilities for creativity, exploration and interpersonal development. Drawing on two case studies, one from Amsterdam (the Netherlands) and one from Chelsea (US), the requirements and process of acquiring consent are outlined. Consent in general refers to a form of permission to act or take action. In this chapter we consider it as a sense of approval by neighbourhood community members to engage in a collective course of action. Community workers often play a crucial part in the acquisition of community consent as they support the process of recognition of the diversity of interests, opinions and values that characterises local life. Consent is necessary for creatingsustainable local initiatives, incorporating, instead of eliminating, conflicting positions. This acknowledgement of diversity can be seen as an ethical requirement in community development practice, but also as a strategic issue for community workers. After all, without being able to obtain legitimacy for their engagement with local issues, effective community development work is impossible.This chapter focuses on neighbourhood-based community development work in geographical communities. However, similar principles apply in all forms of community development, including work with communities of interest and identity. We use the term‘community worker’ to refer to someone who takes on a facilitating and coordinating role with members of communities to build community capacity and/or bring about social change. Such workers may be paid and professionally qualified, or unpaid volunteers andactivists. They may live in the communities where they work/are active, or reside outside these areas. These circumstances influence the legitimacy of their interventions, as well as how consent is gained and consensus reached.
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Process Mining can roughly be defined as a data-driven approach to process management. The basic idea of process mining is to automatically distill and to visualize business processes using event logs from company IT-systems (e.g. ERP, WMS, CRM etc.) to identify specific areas for improvement at an operational level. An event log can be described as a database entry that signifies a specific action in a software application at a specific time. Simple examples of these actions are customer order entries, scanning an item in a warehouse, and registration of a patient for a hospital check-up.Process mining has gained popularity in the logistics domain in recent years because of three main reasons. Firstly, the logistics IT-systems' large and exponentially growing amounts of event data are being stored and provide detailed information on the history of logistics processes. Secondly, to outperform competitors, most organizations are searching for (new) ways to improve their logistics processes such as reducing costs and lead time. Thirdly, since the 1970s, the power of computers has grown at an astonishing rate. As such, the use of advance algorithms for business purposes, which requires a certain amount of computational power, have become more accessible.Before diving into Process Mining, this course will first discuss some basic concepts, theories, and methods regarding the visualization and improvement of business processes.
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Aim: To evaluate healthcare professionals' performance and treatment fidelity in the Cardiac Care Bridge (CCB) nurse-coordinated transitional care intervention in older cardiac patients to understand and interpret the study results. Design: A mixed-methods process evaluation based on the Medical Research Council Process Evaluation framework. Methods: Quantitative data on intervention key elements were collected from 153 logbooks of all intervention patients. Qualitative data were collected using semi-structured interviews with 19 CCB professionals (cardiac nurses, community nurses and primary care physical therapists), from June 2017 until October 2018. Qualitative data-analysis is based on thematic analysis and integrated with quantitative key element outcomes. The analysis was blinded to trial outcomes. Fidelity was defined as the level of intervention adherence. Results: The overall intervention fidelity was 67%, ranging from severely low fidelity in the consultation of in-hospital geriatric teams (17%) to maximum fidelity in the comprehensive geriatric assessment (100%). Main themes of influence in the intervention performance that emerged from the interviews are interdisciplinary collaboration, organizational preconditions, confidence in the programme, time management and patient characteristics. In addition to practical issues, the patient's frailty status and limited motivation were barriers to the intervention. Conclusion: Although involved healthcare professionals expressed their confidence in the intervention, the fidelity rate was suboptimal. This could have influenced the non-significant effect of the CCB intervention on the primary composite outcome of readmission and mortality 6 months after randomization. Feasibility of intervention key elements should be reconsidered in relation to experienced barriers and the population. Impact: In addition to insight in effectiveness, insight in intervention fidelity and performance is necessary to understand the mechanism of impact. This study demonstrates that the suboptimal fidelity was subject to a complex interplay of organizational, professionals' and patients' issues. The results support intervention redesign and inform future development of transitional care interventions in older cardiac patients.
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While literature and practice acknowledge the potential of service innovation as well as digitally enabled innovation processes, the diverse innovation process literature lacks a process model which combines these two aspects. This systematic literature review aims at filling this gap by analysing innovation process theories and approaches with a specific focus on service and digital innovation. 25 conceptualisations of innovation processes were distilled and analysed in detail to present a ‘digital innovation process for services’ model which includes steps on three levels. Consequently, this literature review expands the current state-of-research and acts as the groundwork for further innovation research projects.
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This article examines how artistic research practices challenge and reconfigure institutional approaches toresearch ethics. Focusing on the case of Performing Working —a doctoral project in the arts that was the first toundergo ethical review at the University of the Arts Utrecht —it investigates how forms of consent, researcherroles, and institutional responsibility are negotiated when research is processual, embodied, and collaborativelydeveloped.The article draws on a collaborative autoethnographic reflection involving the artist-researcher, a researchparticipant, and members of the ethics committee. Care ethics is used as a conceptual lens to analyse the ethicaldimensions of the case, foregrounding relationality, vulnerability, and attention to power. Rather than treatingethical approval as a one-off procedural hurdle, the analysis highlights ethics as an ongoing, situated practicethat unfolds through dialogue, friction, and mutual attunement.Artistic research is presented here as a ‘hard case’ that reveals structural frictions in existing review systems.At the same time, it offers alternative imaginaries and practices for dealing with complexity, uncertainty, and co-responsibility in research. While grounded in an artistic context, the article speaks to broader concerns inqualitative research methodology, particularly in fields that engage with lived experience, reflexivity, and sharedauthority. Ethics is reframed not merely as compliance, but as integral to how research is shaped, shared, andheld accountable across diverse domains.
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Background: Patient participation and goal setting appear to be difficult in daily physiotherapy practice, and practical methods are lacking. An existing patient-specific instrument, Patient-Specific Complaints (PSC), was therefore optimized into a new Patient Specific Goal-setting method (PSG). The aims of this study were to examine the feasibility of the PSG in daily physiotherapy practice, and to explore the potential impact of the new method. Methods: We conducted a process evaluation within a non-controlled intervention study. Community-based physiotherapists were instructed on how to work with the PSG in three group training sessions. The PSG is a six-step method embedded across the physiotherapy process, in which patients are stimulated to participate in the goal-setting process by: identifying problematic activities, prioritizing them, scoring their abilities, setting goals, planning and evaluating. Quantitative and qualitative data were collected among patients and physiotherapists by recording consultations and assessing patient files, questionnaires and written reflection reports. Results: Data were collected from 51 physiotherapists and 218 patients, and 38 recordings and 219 patient files were analysed. The PSG steps were performed as intended, but the ‘setting goals’ and ‘planning treatment’ steps were not performed in detail. The patients and physiotherapists were positive about the method, and the physiotherapists perceived increased patient participation. They became aware of the importance of engaging patients in a dialogue, instead of focusing on gathering information. The lack of integration in the electronic patient system was a major barrier for optimal use in practice. Although the self-reported actual use of the PSG, i.e. informing and involving patients, and client-centred competences had improved, this was not completely confirmed by the objectively observed behaviour. Conclusion: The PSG is a feasible method and tends to have impact on increasing patient participation in the goal-setting process. However, its full potential for shared goal setting has not been utilized yet. More implementation effort is needed to achieve the required behaviour change and a truly client-centred attitude, to make physiotherapists totally ready for shared goal setting.
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Background The experiences of residents who have communication difficulties such as dysphasia are largely absent from the literature. Aim To illuminate the everyday experiences of four residents with severe communication difficulties living in a residential care setting in the Netherlands. Methodology & Methods A collective case study methodology was used. Seventy-five hours of observation, interview and documentary data was gathered over six weeks. Alternative strategies of communication were developed to enable the co-creation of dialogue between participants and researcher. For example, a participant who could not talk used intentionally created artwork to share her ideas with the researcher. Findings Participants' daily experiences were characterised by struggling against the constraints of the residential setting: having to wait, having unmet needs, experiencing vulnerability and uncertainty. Participants' communication difficulties exacerbated these constraints. Their experiences of struggling were sometimes ameliorated by significant social contact with family or particular staff members, and engaging in enjoyable activities. Occasionally the experiences of enjoying the here-and-now, and being 'seen' as a person by the other, would create beautiful moments in which truly person centred engagement would occur. These moments were neither articulated nor recorded, and were thus invisible after they had occurred. Similarly, the experiences of struggling against the constraints were neither acknowledged nor recorded. Significant experiences in the lives of these four residents were therefore invisible to others. The unifying theme representing the participants' daily experiences was: That which goes unsaid. Discussion It was necessary to develop communication strategies which would by-pass the researcher's assumptions and enable participants to introduce their own ideas and opinions. This ongoing process of co-creation of dialogue required work from, and trust between, participants and researcher. What is new? Expressly seeking the views of residents with communication difficulties Successfully using process consent with participants in this situation Using intentionally created artwork during data gathering in this context What has regional, national or international relevance? The findings indicate that people with communication difficulties may not receive optimal care in residential settings in the Netherlands. Methods are described which could be used by practitioners in their everyday work, and which show facilitators or practice developers how they can help carers to engage in more effective communication with this kind of resident. Additionally, this research contributes to the international discussion about ethical participation of vulnerable people in research.
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Abstract Background: Several interventions have been developed to improve physical health and lifestyle behaviour of people with a severe mental illness (SMI). Recently, we conducted a pragmatic cluster-randomised controlled trial which evaluated the efects of the one-year Severe Mental Illness Lifestyle Evaluation (SMILE) lifestyle intervention compared with usual care in clients with SMI. The SMILE intervention is a 12-month group-based lifestyle intervention with a focus on increased physical activity and healthy food intake. The aim of the current study was to explore the experiences of people with SMI and healthcare professionals (HCPs) regarding implementation feasibility of the SMILE intervention and the fdelity to the SMILE intervention. Methods: A process evaluation was conducted alongside the pragmatic randomized controlled trial. The experiences of clients and HCPs in the lifestyle intervention group were studied. First, descriptive data on the implementation of the intervention were collected. Next, semi-structured interviews with clients (n=15) and HCPs (n=13) were performed. Interviews were audiotaped and transcribed verbatim. A thematic analysis of the interview data was performed using MAXQDA software. In addition, observations of group sessions were performed to determine the fdelity to the SMILE intervention using a standardised form. Results: Ten out of 26 HCPs who conducted the group sessions discontinued their involvement with the intervention, primarily due to changing jobs. 98% of all planned group sessions were performed. Four main themes emerged from the interviews: 1) Positive appraisal of the SMILE intervention, 2) Suggestions for improvement of the SMILE intervention 3) Facilitators of implementation and 4) Barriers of implementation. Both clients and HCPs had positive experiences regarding the SMILE intervention. Clients found the intervention useful and informative. The intervention was found suitable and interesting for all people with SMI, though HCPs sometimes had to tailor the intervention to individual characteristics of patients (e.g., with respect to cognitive functioning). The handbook of the SMILE intervention was perceived as user-friendly and helpful by HCPs. Combining SMILE with daily tasks, no support from other team members, and lack of staf and time were experienced as barriers for the delivery of the intervention Conclusion: The SMILE intervention was feasible and well-perceived by clients and HCPs. However, we also identifed some aspects that may have hindered efective implementation and needs to be considered when implementing the SMILE intervention in daily practice
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This paper presents a comprehensive study on assisting new AI programmers in making responsible choices while programming. The research focused on developing a process model, incorporating design patterns, and utilizing an IDE-based extension to promote responsible Artificial Intelligence (AI) practices. The experiment evaluated the effectiveness of the process model and extension, specifically examining their impact on the ability to make responsible choices in AI programming. The results revealed that the use of the process model and extension significantly enhanced the programmers' understanding of Responsible AI principles and their ability to apply them in code development. These findings support existing literature highlighting the positive influence of process models and patterns on code development capabilities. The research further confirmed the importance of incorporating Responsible AI values, as asking relevant questions related to these values resulted in responsible AI practices. Furthermore, the study contributes to bridging the gap between theoretical knowledge and practical application by incorporating Responsible AI values into the centre stage of the process model. By doing so, the research not only addresses the existing literature gap, but also ensures the practical implementation of Responsible AI principles.
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Airports have undergone a significant digital evolution over the past decades, enhancing efficiency, effectiveness, and user-friendliness through various technological advancements. Initially, airports deployed basic IT solutions as support tools, but with the increasing integration of digital systems, understanding the detailed digital ecosystem behind airports has become crucial. This research aims to classify technological maturity in airports, using the access control process as an example to demonstrate the benefits of the proposed taxonomy. The study highlights the current digital ecosystem and its future trends and challenges, emphasizing the importance of distinguishing between different levels of technological maturity. The role of biometric technology in security access control is examined, highlighting the importance of proper identification and classification. Future research could explore data collection, privacy, and cybersecurity impacts, particularly regarding biometric technologies in Smart Access Level 4.0. The transition from Smart Access Level 3.0 to 4.0 involves process automation and the introduction of AI, offering opportunities to increase efficiency and improve detection capabilities through advanced data analytics. The study underscores the need for global legislative frameworks to regulate and support these technological advancements.
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