Recent publications
Playing in nature-based places supports early childhood development. In previous years, studies have shown the benefits of nature play for healthy child development, including language development. For early childhood teachers it is insightful to learn together how to develop language education in nature that is supportive of their student’s language development. The aim of this study is to investigate how early childhood education (ECE) teachers make nature-based places function as language learning environments in EC language education. The study took a collaborative action-based research approach and worked in communities of practice (CoP). In these communities, 55 teachers across five schools gathered six times. Based on the analysis of the shared conversations we defined the supportive aspects of nature-based places and related them to the expected outcomes of early childhood language education. We also described the professional changes they made to be able to teach language in nature. These changes were summarized in a model that informs early childhood teachers how to include the pedagogical and linguistic function of nature-based places to work towards the outcomes of EC language education.
Purpose:
(1) To evaluate the effectiveness of personalised psychologically-informed physiotherapy in people with neck pain; (2) To explore the mediating role of changes in illness perceptions.
Method:
In this replicated single-case study, 14 patients with non-specific neck pain at risk for chronicity received a personalised intervention addressing unhelpful illness perceptions and dysfunctional movement behaviour, according to principles of cognitive functional therapy. Outcomes included the mediating role of illness perceptions on overall effect, function, pain intensity and self-efficacy. Linear mixed models were used to analyse the data.
Results:
Repeated measurements (14-20 per patient), including a 3-months follow-up, showed a gradual improvement during and/or after psychologically-informed physiotherapy for overall effect, function, pain and to a lesser extent self-efficacy. Changes in each of the illness perception dimensions showed a mediation effect on overall effect, function and pain. When combining the dimensions "consequences," "personal control," "identity," "concern" and "emotional response," changes in illness perceptions explained approximately 35% of the improvement in overall effect.
Conclusion:
Addressing unhelpful illness perceptions appears valuable in the management of patients with chronic or recurrent non-specific neck pain. Intervention effects extended beyond the treatment period, indicating that patients' improved understanding of their health condition continued to have a positive impact.
In this unblinded multi-center stepped-wedge randomized controlled trial the effectiveness of the nurse-led ZENN-intervention was tested in promoting self-management skills in comparison to standard care among heart, lung and kidney transplant recipients. This intervention is based on behaviour change theories and was conducted in four sessions over 6 months at the outpatient clinic. The experimental group received standard care, plus the ZENN-intervention, while the control group received only standard care. Both groups completed questionnaires at baseline, at 6 months and 1 year follow-up. At baseline, the experimental group (n = 69) scored significantly lower than the control group (n = 106) on the primary outcome Skills and Technique Acquisition (STA). No significant between-group differences were found on the secondary outcomes self-management, self-regulation, quality of life and medication adherence at T1 and T2. There was a significant increase on the self-management scale STA between T0 and T1 in the experimental group. Therefore, participants included in the experimental group had lower self-management skills at baseline and reported significant improvement after completing the intervention. No significant intervention effect was found in the primary analysis, however, for recipients with reduced self-management skills the intervention may be beneficial.
Clinical Trial Registration
https://onderzoekmetmensen.nl/en/trial/24150 , Netherlands Trial Register NL8469.
Some individuals, even when heavily exposed to an infectious tuberculosis patient, do not develop a specific T-cell response as measured by interferon-gamma release assay (IGRA). This could be explained by an IFN-γ-independent adaptive immune response, or an effective innate host response clearing Mycobacterium tuberculosis (Mtb) without adaptive immunity. In heavily exposed Indonesian tuberculosis household contacts (n = 1347), a persistently IGRA negative status was associated with presence of a BCG scar, and - especially among those with a BCG scar - with altered innate immune cells dynamics, higher heterologous (Escherichia coli-induced) proinflammatory cytokine production, and higher inflammatory proteins in the IGRA mitogen tube. Neither circulating concentrations of Mtb-specific antibodies nor functional antibody activity associated with IGRA status at baseline or follow-up. In a cohort of adults in a low tuberculosis incidence setting, BCG vaccination induced heterologous innate cytokine production, but only marginally affected Mtb-specific antibody profiles. Our findings suggest that a more efficient host innate immune response, rather than a humoral response, mediates early clearance of Mtb. The protective effect of BCG vaccination against Mtb infection may be linked to innate immune priming, also termed ‘trained immunity’.
Background
The healthcare sector is facing increasing work pressure, making a healthy workforce essential. Appreciation is a factor influencing well-being, and the COVID-19 pandemic offers valuable insights into this. This study aims to: 1) describe to what extent end-of-life care providers felt appreciated and understood during the first 18 months of the pandemic, 2) examine the impact of appreciation on their well-being, and 3) explore their perceptions of what appreciation should look like.
Methods
A longitudinal mixed methods study among healthcare providers in the Netherlands delivering end-of-life care during the COVID-19 pandemic. Surveys were conducted at four timepoints (n = 302), and interviews were conducted at three timepoints (n = 17) during the first 18 months of the pandemic. Generalized Estimating Equations analysis was performed on the quantitative data and thematic analysis was conducted on the interview data.
Results
This study shows that feeling of appreciation among healthcare providers peaked in the first wave of the pandemic, but significantly dropped in the second wave, with only about half of the healthcare providers feeling appreciated. This slightly improved afterwards. Furthermore, nearly half of healthcare providers felt misunderstood during the first 18 months of the pandemic. Additionally, this study shows that between September 2020 and September 2021 about 1 in 3 healthcare providers had a score on the Well-Being Index indicating higher risk for burnout. Feeling appreciated and not feeling understood were both significantly associated with worse well-being. Interviews revealed that nurses did not always feel understood and appreciated by society, employers, patients and their families, as well as their own friends and family, leading to feelings of sadness, anger, and frustration. Three major themes emerged: ‘recognizing real needs, ‘we are not in this together’ and ‘short-lived appreciation that failed to lead to structural changes’.
Conclusions
This study shows that during the COVID-19 pandemic, healthcare providers often felt neither appreciated nor understood, which is associated with lower scores of well-being. The expressed appreciation often did meet their needs or expectations, from both employers and society. With healthcare provider well-being still under strain, sustained attention to appreciation and understanding is important for retaining the workforce.
Background
Neonatal hyperbilirubinemia is a leading cause of hospitalization during the first week of life. Recent research suggest that phototherapy, the standard treatment, can be safely and effectively administered at home. Some Dutch hospitals have already adopted home-based phototherapy. The TREAT Jaundice@home study aims to contribute to its broader implementation across the Netherlands. Understanding the perspectives, perceptions, and needs of healthcare professionals is essential for facilitating this implementation.
Methods
This cross-sectional survey targeted pediatricians, midwives, and maternity care assistants with and without prior experience with phototherapy at home. The 82-item questionnaire covered respondent background, experience, interests, motivation, responsibilities, logistics, collaboration, knowledge, indications and contraindications, financial aspects, and implementation readiness.
Results
The study included responses from 16 pediatricians, 90 community midwives, and 514 maternity care assistants. Findings indicate a positive reception of phototherapy at home, regardless of prior experience. The majority expressed satisfaction, recognized potential benefits, and/or demonstrated a willingness to adopt this innovation. Key challenges identified include the need for information, the lack of guidelines, coordination and collaboration issues, and concerns about financial compensation.
Discussion
Phototherapy at home is well-received by healthcare professionals. Addressing the identified challenges is imperative for successful implementation, ultimately benefiting neonates, their families, and healthcare systems.
Impact
Phototherapy at home is well-received and perceived as beneficial by healthcare professionals with and without prior experience
Key challenges include the need for better knowledge and guidelines, coordination and collaboration issues among healthcare professionals, and concerns about financial compensation
Addressing these challenges through comprehensive information, standardized protocols, improved collaboration, and adequate financial compensation is essential to successfully implement phototherapy at home on a larger scale
Background
Goal setting is an essential step in the clinical reasoning process of speech and language therapists (SLTs) who provide care for children, adolescents and adults with communication disorders. In the light of person‐centred care, shared or collaborative goal setting between the SLT and client is advised in (inter)national guidelines. SLTs face challenges in implementing (shared) goal setting as theoretical frameworks and practical interventions are scarce and less applicable to use with a wide range of communication vulnerable populations.
Aims
A first step in developing theory and practical interventions is to explore first‐hand experiences of SLTs and clients about day‐to‐day goal‐setting practice. This study was guided by the following research question: What are the perspectives and needs of SLTs and persons with communication disorders regarding (shared) goal setting in routine SLT services?
Methods & Procedures
The qualitative study was carried out in the setting of routine speech–language therapy services in community practices, primary education and neurological rehabilitation in the Netherlands. Data collection followed the principles of video‐reflexive ethnography, using video footage of goal‐setting conversations to facilitate semi‐structured, reflexive interviews. Data analysis was based on reflexive thematic analysis. A total of 12 interviews were conducted with client–SLT dyads, covering perspectives from children, parents and adults with a range of communication difficulties and their SLTs.
Outcomes & Results
Data analysis resulted in four themes, of which two contain subthemes. Each theme represents a central organizing concept found in SLT and client interviews. The themes were identified as: (1) goal setting is a complex process; (2) goal talk needs to be communication accessible; (3) communicative participation goals are hard to grasp; and (4) the importance of relationships. Topics such as power imbalance, communication vulnerability, effective communication strategies, and motivation and trust are explored under these themes.
Conclusions & Implications
SLTs are encouraged to view shared goal setting as a process that needs to be explicitly planned and communicated with clients regardless of their age or communication vulnerability. SLTs have expert knowledge and skills when it comes to supporting communication and applying these skills during goal talks might strengthen shared goal setting and foster a therapeutic relationship. There is a need to concretely conceptualize and embed shared goal setting in policy and clinical guidelines. The themes reported have tentative clinical implications for developing such policy, and shared goal‐setting interventions for SLT practice, under the condition that SLTs and people with communication disorders are continuously involved.
WHAT THIS PAPER ADDS
What is already known on the subject
SLTs want to set meaningful goals together with their patients but lack theory and resources to effectively shape the goal‐setting process. Few studies have directly reported on the perspectives and needs of SLTs and patients regarding goal setting. Patients generally perceive goal setting as a vague activity in which they minimally participate. SLTs want to involve patients in the goal‐setting process and describe the potential benefits, but they also want to report barriers on the systemic and professional competence level.
What this paper adds to the existing knowledge
SLTs and patients perceive shared goal setting as a multifaceted process, rather than a one‐off conversation. This process holds potential vulnerabilities for SLTs and patients alike, and the themes in this study propose potentially helpful ingredients to mediate this vulnerability and shape the goal‐setting process.
What are the potential or clinical implications of this work?
To take the first steps towards effective shared goal setting, SLTs should embrace the element of discovery in goal setting and apply their expert knowledge in supporting communication. To develop practical interventions for SLTs, shared goal setting needs to be further conceptualized and embedded in policy and clinical guidelines.
Background
Self-management support is widely considered a critical aspect of nursing. Still, many studies indicate that nurses frequently experience difficulties in daily practice.
Objective
To gain a deeper understanding of the factors perceived by nurses to impede or promote their support of patients’ self-management within the dynamic environment of the in-patient hospital setting.
Design
Mixed methods design.
Participants
Nurses (n = 269) working in a teaching hospital in the Netherlands completed a questionnaire. Subsequently, 38 nurses participated in interviews.
Methods
The SEPSS-36 questionnaire assessed nurses’ self-efficacy and performance in self-management support. Semi-structured interviews were conducted to address salient results from the questionnaire, focusing on factors influencing self-management support, goal setting, follow-up care, and the nurse's role in a hospital setting.
Results
the response rate for the questionnaire study was 62 %. A paired t-test revealed a significant mean difference of 6.30 95 % CI [5.91–6.69] p ≤ 0.001 between nurses’ perceived self-efficacy (mean = 18.34/24) and their actual performance (mean = 12.03/24) in self-management support. The interviews revealed that nurses typically focus on medical procedures and maintaining patients’ functional status. Spending time with patients to offer emotional support was viewed as ‘something extra’ rather than a core part of their job. High patient turnover hindered nurses from having meaningful conversations with patients.
Conclusions
Short-term priorities such as ‘getting the work done’ dominate nurses’ daily tasks in hospital wards, leading them to overlook often the benefits of supporting patient self-management. This narrow view of their responsibilities can hinder patient care, whereas adopting a broader perspective on the patient journey could be very beneficial.
Introduction
A safe work climate benefits patients and healthcare professionals. Most instruments for evaluating safety climate are lengthy questionnaires focusing on either measuring and benchmarking, or identifying areas for improvement. We aimed to design a communication instrument promoting team discussion about safety in surgical teams: the safety climate thermometer (SCT).
Method
First, a literature study was conducted to identify important safety themes, which were then organized into eight safety climate themes. Behavior-based assessment statements were drafted per theme. Second, an expert panel study with international experts was conducted, soliciting feedback on our initial SCT design. Their feedback led to a redesign into the SCT prototype presented in this study.
Results
The literature search yielded twelve existing instruments and three reviews. Twenty-two experts participated in the panel study. The final SCT prototype framed eight safety climate themes and is organized into two parts. In Part I, team members individually and anonymously evaluate team performance per theme by responding to a single statement to quickly assess global perceptions of that theme. Based on their collective scores, the team chooses one safety climate area to investigate further by scoring one set of eight in-depth statements. In Part II, a structured interdisciplinary team discussion takes place aiming to pinpoint a work floor issue and set actionable goals for improvement.
Discussion/conclusion
The SCT is a communication instrument for surgical teams that first focuses on identifying opportunities for improvement, and then structuring team discussion and follow-up, aiming to improve safety climate.
Sanction screening is a crucial banking compliance process that protects financial institutions from inadvertently engaging with internationally sanctioned individuals or organizations. Given the severe consequences, including financial crime risks and potential loss of banking licenses, effective execution is essential. One of the major challenges in this process is balancing the high rate of false positives, which exceed 90% and lead to inefficiencies due to increased human oversight, with the more critical issue of false negatives, which pose severe regulatory and financial risks by allowing sanctioned entities to go undetected. This study explores the use of Natural Language Processing (NLP) to enhance the accuracy of sanction screening, with a particular focus on reducing false negatives. Using an experimental approach, we evaluated a prototype NLP program on a dataset of sanctioned entities and transactions, assessing its performance in minimising false negatives and understanding its effect on false positives. Our findings demonstrate that while NLP significantly improves sensitivity by detecting more true positives, it also increases false positives, resulting in a trade-off between improved detection and reduced overall accuracy. Given the heightened risks associated with false negatives, this research emphasizes the importance of prioritizing their reduction. The study provides practical insights into how NLP can enhance sanction screening, while recognizing the need for ongoing adaptation to the dynamic nature of the field.
In this study, we argue that organizers of live music have increasingly been confronted with uncertainty and risk in the pre-pandemic era and that the pandemic has clearly put them under further pressure. At the same time, live music venues and festivals have proven to be largely resilient to the extreme crisis of an ongoing industry lockdown. Also, the sector’s culture of carefully cultivated forms of active (emotive, interrelational) trust to counterbalance these risks has played an important role in the industry’s resilience and its response to both internal and external uncertainties. We base these conclusions on a framework of theories on uncertainty and risk from both business studies and sociology and in-depth interviews with directors of music festivals and venues in the Netherlands, both before the pandemic and after 16months of lockdown. This study aims to (1) gain insight into how live music entrepreneurs perceived and experienced uncertainty and risk within the context of a rapidly changing music industry and a volatile and unpredictable market of concerts and festivals – both before the pandemic and at the eve of re-opening after a 16-month lockdown and (2) understand what strategies these entrepreneurs employ to manage these uncertainties and risks.
This article explores the relation between informal human resource management practices and innovation performance in European small and medium-sized enterprises (SMEs). We use the resource-based view and the self-determination theory to develop hypotheses on how informal human resource management practices affect innovation performance. The research was based on data from the European Company Survey 2019. The sample consisted of senior managers in charge of personnel, working in SMEs across 28 European countries. Structural equation modelling showed that informal human resource management practices that satisfy employees’ needs for competence and autonomy positively contributed to innovation performance. Fostering employee needs for relatedness, however, negatively affected innovation performance. The study provides theoretical and practical implications, gives insights for managers and policy makers seeking to foster innovation in SMEs and identifies areas for future research.
Background and aim
Addiction problems also affect the lives of family members. This study aims to examine: (1) young adult family members’ experiences with informal and professional support in coping with the impact of relatives’ addiction problems and (2) how these experiences evolve over time.
Method
A three-year longitudinal qualitative study. Four rounds of in-depth, semi-structured individual interviews were conducted. Thirty students aged 18–30 years, participated in the study at baseline. 93% participated in at least two interviews, and 80% participated three or four times. The Stress-Strain-Information-Coping-Support model was used, and Directed Content Analysis was applied.
Findings
Five major themes were extracted from the data: (1) Informal support; (2) Educational support; (3) Healthcare support; (4) Resilience factors; and (5) Developments over time. Informal and educational support were more often described as effective than healthcare support, although the number of participants who sought healthcare support increased over time. Effective elements of support included being able to discuss their experiences with people listening without judgment or unsolicited advice and having long-term relationships of trust with people from the social environment and professionals. Participants were mainly treated with Cognitive Behavioral Therapy (CBT) and Eye Movement Desensitization and Reprocessing (EMDR). Learning how to distinguish between accurate and inaccurate thoughts, especially about themselves, was considered effective. Body-oriented therapy was remarkably absent. Finding effective healthcare support was often a long and winding road through various therapies and therapists. Participants were not attracted to peer group interventions but needed advice on how to deal with their relatives. They also needed recognition by their relatives for harm done. This recognition was seldom given.
Conclusions
It is recommended to train educational and healthcare professionals to recognize the support needs of young people with relatives with addiction problems, to help them cope, or to refer them adequately. We also suggest broadening the scope of professional support offered to AFMs, including body-oriented and cultural interventions.
Research collaboration between practitioners and research professionals aims to develop both practice and knowledge. However, a tension can arise between these objectives: to preserve local relevance, the content, form, and timing of data collection may vary between cases, complicating the comparability of local data in a multiple case study. Our Research-Practice Partnership found a solution in the 'wallpaper method,' which enriches the Storyline-method with elements from reflexive monitoring and arts-based research. A distinctive feature of the wallpaper method is cumulative joint reflection and interpretation based on previously collected local data. In this contribution, we illustrate the various phases and steps of the method with experiences from our own research in which it was developed and tested. The method resulted in both practice development and an overarching conceptual model. Effective application of the method requires a wide range of professional and research competencies from the collaboration partners. Adequate time and attention are necessary to prepare a partnership for this.
Abstract
A carrier bag praxis of doing research. Fisher, LeGuin and Haraway
In the context of the question concerning the gap between theory and practice, the author explores another approach of educational research, distinguished from the dominant discourse in contemporary education theory; an approach inspired by Donna Haraway’s reception of Ursula LeGuin’s Carrier bag theory of fiction. Alongside the techno-scientific discourse of calculation and control – which is like hunting with a spear – another practice of doing research is highlighted, oriented toward connectedness, response-ability and ongoingness in the living practice of education. A carrier bag approach to doing research, as it is practiced in anthropological and phenomenological traditions.
Keywords: : theory-practice gap, educational research, storytelling, phenomenology, Haraway
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