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 article examines two areas of tension within environmental ethics literature and relates them to the case study of the animal representation in the Dutch media. On the one hand, there is a tension between those who propagate clear division between anthropocentric and non-anthropocentric views; on the other hand, there is a tension between the land ethics perspective and animal right proponents. This article examines the media representation of animals using content analysis, and links the findings back to the areas of tension within environmental ethics. The main findings indicate that the division between anthropocentric and ecocentric perspectives is still relevant for evaluating the human-animal relations, while the convergence of the land ethics and animal rights perspectives can be helpful in explaining why this division is relevant. This is a post-peer-review, pre-copyedit version of an article published in "Environmental Processes".The final authenticated version is available online at: https://doi.org/10.1007/s40710-014-0025-7 https://www.linkedin.com/in/helenkopnina/
MULTIFILE
In this paper we will describe and present the results of an experiment at the Fontys University of Professional Education in which engineering students work together with students from other disciplines in a multidisciplinary group at the end of their study on a real-life environmental problem outside the university. Since 1994 there has been a possibility for engineering students to graduate in this way, in a multidisciplinary group. First a rough sketch will be given of the background and the educational model. In this sketch attention will be paid to the different role which the student as well as the teacher play in this kind of education. The characteristics of this model will be explained. Then it will be made clear what the results were in the past years with respect to content as well as to the learning of skills. At the end some conclusions will be given.
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