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Fashioning a Sustainable Future: Circular Models, Emerging Technologies, and Social Responsibility
No full textPatient Participation in Multidisciplinary Team Meetings in Mental Healthcare
No full textDe geestelijke gezondheidszorg (GGZ) ondergaat een aanzienlijke evolutie en verschuift van een paternalistische benadering naar een meer samenlevingsgerichte aanpak, waarbij de nadruk ligt op empowerment en patiëntenbetrokkenheid. Nieuwe visies, zoals herstelgerichte en persoonsgerichte zorg, benadrukken de actieve rol van de patiënt, die steeds meer wordt beschouwd als een partner in zijn eigen zorgproces. Deze verandering bevordert een gelijkwaardige relatie tussen zorgverleners en patiënten, waarbij de ervaringen en kennis van de patiënt centraal staan. In lijn met deze ontwikkeling participeren patiënten steeds vaker in multidisciplinaire teambesprekingen tijdens hun opname in een psychiatrisch ziekenhuis. Dit stelt hen in staat meer regie te nemen over hun zorgproces en actief bij te dragen aan beslissingen over hun behandeling en zorg. Deze benadering versterkt niet alleen de autonomie van patiënten, maar kan tevens bijdragen aan verbeterde behandeluitkomsten, zoals een verbetering in ziekte-inzicht en een effectiever herstelproces. Hoewel patiëntenparticipatie in teambesprekingen de laatste jaren aan belang wint en vaker wordt toegepast in de GGZ, blijft wetenschappelijk onderzoek naar deze vorm van participatie schaars. Eén van de doelstellingen van dit doctoraatsonderzoek was om het bestaande kennistekort met betrekking tot patiëntenparticipatie tijdens multidisciplinaire teambesprekingen in de GGZ aan te vullen. Het onderzoek richtte zich op het verkrijgen van diepgaande inzichten in de percepties en ervaringen van zowel zorgverleners als patiënten. Hierbij stonden vier onderzoeksvragen centraal: (1) Wat zijn de percepties van zorgverleners over patiëntenparticipatie tijdens multidisciplinaire teambesprekingen, (2) Wat zijn de percepties van patiënten over patiëntenparticipatie tijdens multidisciplinaire teambesprekingen, (3) Wat is de geleefde ervaring van patiënten met betrekking tot hun participatie in teambesprekingen tijdens een opname in een psychiatrisch ziekenhuis, en (4) Hoe ontwikkelen patiënten hun rol binnen het proces van participeren tijdens multidisciplinaire teambesprekingen gedurende een opname in een psychiatrisch ziekenhuis, en welke sociale dynamieken spelen hierin een betekenisvolle rol? Het onderzoek werd uitgevoerd in Vlaanderen in diverse psychiatrische ziekenhuizen. Voor het meten van percepties met betrekking tot patiëntenparticipatie tijdens teambesprekingen werd een nieuwe vragenlijst ontwikkeld en gevalideerd. In totaal werden 983 vragenlijsten verzameld, waarvan 701 ingevuld door zorgverleners in de intramurale GGZ en 282 door patiënten. Naast de kwantitatieve gegevensverzameling werden ook diepte-interviews gehouden met twaalf patiënten die waren opgenomen in een psychiatrisch ziekenhuis.
De resultaten tonen aan dat zowel zorgverleners als patiënten over het algemeen veel belang hechten aan patiëntenparticipatie tijdens multidisciplinaire teambesprekingen. Beide groepen erkennen de waarde van participatie als een middel om de zorg te verbeteren en zijn dan ook bereid om hierin te investeren. Daarnaast komt duidelijk naar voren dat zowel zorgverleners als patiënten een sterke voorkeur hebben voor een actieve rol van de patiënt en participatie op hoog niveau. Dit omvat niet alleen het aanwezig zijn van de patiënt tijdens teambesprekingen, maar ook het actief in dialoog gaan met het team en het delen van persoonlijke inzichten over het eigen zorgproces. De resultaten laten echter zien dat er verschillen bestaan tussen de percepties van zorgverleners en patiënten met betrekking tot o.a. de rol van de patiënt in het nemen van beslissingen tijdens multidisciplinaire teambesprekingen. Zorgverleners geven de voorkeur aan een collaboratieve rol, waarbij ze vinden dat de beslissing over de beste behandeling voor de patiënt een gedeelde verantwoordelijkheid is tussen het team en de patiënt. Patiënten, daarentegen, geven aan vaker een passieve rol in het beslissingsproces te verkiezen, waarbij zij de verantwoordelijkheid grotendeels bij het team leggen. Dit geldt met name voor patiënten die zijn opgenomen, terwijl niet-opgenomen patiënten vaker een autonome rol kiezen en meer controle willen uitoefenen over de besluitvorming. Het opnemen van een actieve rol door patiënten is echter geen vanzelfsprekendheid en strekt zich uit voorbij het moment van de teambespreking zelf. Het betreft een breder, doorlopend proces dat zowel vóór als na de teambespreking plaatsvindt. De bevindingen tonen aan dat patiënten in dit proces streven naar een partnerschap met de teamleden, waarin beide partijen vanuit hun eigen perspectief en expertise bijdragen, zonder deze perspectieven als tegenstrijdig te beschouwen of tegenover elkaar te plaatsen. Om deze rol van partner effectief te vervullen, onderscheiden patiënten drie essentiële componenten: goed geïnformeerd en voorbereid worden, gezien en gehoord worden, en in staat zijn om te begrijpen waarom bepaalde dingen gebeuren zoals ze gebeuren. Op basis van hun ervaringen met deze componenten, evenals de mate waarin het team hun inspanningen waardeert, maken patiënten bewuste keuzes over hun participatie. Ze besluiten bijvoorbeeld of ze actief willen blijven deelnemen, terugkeren naar een passieve rol, of volledig willen stoppen met participeren in teambesprekingen. Kleine, maar betekenisvolle factoren blijken een invloed te hebben op dit proces. Zo speelt de ondersteuning van een vertrouwensfiguur, zoals een verpleegkundige, een cruciale rol in het proces van participeren. Ten aanzien van de aanwezigheid van familieleden tijdens de teambesprekingen ervaren patiënten echter gemengde gevoelens.
Dit doctoraatsonderzoek levert een belangrijke bijdrage aan de kennis over patiëntenparticipatie tijdens multidisciplinaire teambesprekingen in de GGZ. Het is de eerste keer dat deze vorm van patiëntenparticipatie vanuit verschillende perspectieven in de context van de GGZ werd onderzocht. Bovendien is dit de eerste studie die erin slaagde om op een grote schaal de percepties van zorgverleners en patiënten in de GGZ te meten over patiëntenparticipatie tijdens deze besprekingen. Hierdoor werd niet alleen een globaal beeld gegenereerd, maar was het ook mogelijk om verschillen te detecteren binnen groepen, evenals tussen groepen. Verder gaf de kwalitatieve studie waardevolle inzichten in de ervaringen en rolontwikkeling van patiënten, wat bijdraagt aan de theorievorming over het participatieconcept. De bevindingen van deze studie benadrukken tevens de positieve verbanden tussen participatie in teambesprekingen, zelfkennis, zelfinzicht en hoop.
De resultaten leiden tot aanbevelingen op verschillende niveaus. Zorgverleners dienen patiënten op een persoonsgerichte manier te ondersteunen in hun zoektocht naar een nieuwe rol als partner. Hierbij is het van belang dat zorgverleners open in dialoog treden en de keuzes van patiënten respecteren. Daarnaast is het belangrijk om patiënten goed te informeren en voor te bereiden, hen echt te zien en te horen, en hen zo te begeleiden dat ze kunnen begrijpen waarom bepaalde dingen gebeuren. Zorginstellingen zouden hun visie op participatie in teambesprekingen moeten expliciteren in een beleidsplan. Het GGZ-beleid kan een cruciale rol spelen in de structurele implementatie van participatie in de GGZ door het uitdragen van een duidelijke visie op participatie. Toekomstig onderzoek zou zich bij voorkeur richten op de ervaringen van zorgverleners, zoals verpleegkundigen, ervaringsdeskundigen, evenals op die van familieleden. Daarnaast wordt aanbevolen de gemeten uitkomsten van participatie tijdens teambesprekingen uit te breiden en verdere exploratie te verrichten naar de factoren die de implementatie van participatie kunnen faciliteren.Mental health care (MHC) is currently undergoing a transformative shift from a paternalistic model to a community-oriented model that emphasizes empowerment and active patient involvement. Emerging frameworks, such as recovery-oriented and person-centered care, highlight the importance of the patient as an active partner in the care process. This shift encourages a more equitable relationship between mental healthcare professionals and patients, with the patient’s experiences and expertise at the forefront. A significant manifestation of this shift is the increasing participation of patients in multidisciplinary team meetings (MTMs) during psychiatric hospitalizations. This participation not only enhances patients' sense of autonomy but also fosters more active involvement in decisions regarding their treatment, potentially leading to improved outcomes, including enhanced self-knowledge and recovery. Despite the growing application of patient participation in MTMs within MHC, there remains a notable lack of scientific research on this specific form of participation. This doctoral research aimed to address this knowledge gap, focusing on the experiences and perceptions of both patients and mental healthcare professionals regarding patient participation during MTMs. Four key research questions guided the study: (1) How do mental healthcare professionals perceive patient participation in MTMs? (2) How do mental health patients perceive patient participation in MTMs? (3) How do patients experience participation in MTMs during psychiatric hospitalization? (4) How do patients develop their role in the participatory process of participating in MTMs during psychiatric hospitalization, and what social dynamics influence this process? The research was conducted in Flanders, involving several psychiatric hospitals that serve patients with mental health vulnerabilities. A novel questionnaire was developed and validated to measure perceptions of patient participation in MTMs. A total of 983 completed questionnaires were collected, comprising responses from 701 mental healthcare professionals and 282 (former) patients. In addition, in-depth interviews were conducted with twelve mental health patients to supplement the quantitative data.
The findings indicate that both healthcare professionals and patients recognize the importance of patient participation in MTMs and view it as a valuable means of improving care. Both groups express a strong preference for a patient role that is active and participatory. This includes not only the patient’s physical presence at the meetings but also their active engagement in dialogue and the sharing of personal insights regarding their care. However, differences were observed between the perceptions of healthcare professionals and patients concerning the patient's involvement in decision-making. Healthcare professionals generally favor a collaborative approach, wherein the responsibility for treatment decisions is shared between the team and the patient. In contrast, patients’ preferences for decision-making vary depending on their hospitalization status. Inpatients tend to adopt a more passive role, often delegating decision-making responsibility to the healthcare team, whereas former patients are more inclined to assume an autonomous role, preferring to take responsibility for their own decisions. Assuming an active role, however, is not a straightforward process for patients and extends beyond the confines of the MTM itself. It represents a broader, ongoing process that begins before and continues after the meeting. Within this process, patients strive to develop a partnership with the team members, characterized by mutual contributions informed by their respective perspectives and expertise. Importantly, these perspectives are not regarded as contradictory or adversarial but as complementary to one another. To effectively assume this role as a partner, patients identify three key components: being well-informed and prepared, being seen and heard, and being able to understand the reasoning behind certain decisions and actions. Based on their experiences with these components, as well as the extent to which the team acknowledges their contributions, patients make deliberate decisions regarding their continued participation. This includes determining whether to remain actively engaged, revert to a more passive role, or disengage entirely from participating in team meetings. Subtle yet significant factors influence this process, with the support of a trusted figure, such as a mental health nurse, playing a pivotal role. Additionally, patients report mixed feelings regarding the presence of family members during team meetings in which they participate.
This doctoral research represents a significant contribution to the field of patient participation in MTMs within MHC. It is the first study to examine this form of participation on such a large scale, incorporating the perspectives of both mental healthcare professionals and mental health patients. The study not only provides a comprehensive overview but also highlights differences in perceptions within and between the two groups. Furthermore, the qualitative component of the research offers valuable insights into the development of patients’ roles and the social dynamics involved, contributing to theoretical advancements in the concept of patient participation. The findings also underscore the positive relationships between participation in team meetings, self-awareness, self-insight, and hope.
The study's results lead to several recommendations at various levels. Healthcare professionals should offer person-centered support to patients as they navigate their role as partners in the participatory process. It is vital that professionals engage in open communication, respect patients’ choices, and ensure that patients are well-informed, heard, and able to understand the reasoning behind actions and treatment decisions. Healthcare organizations are encouraged to formalize their approach to participation by developing a clear participation policy that aligns with a strength-based vision. Mental health care policy should play a pivotal role in facilitating the structural implementation of participatory practices. Future research should further explore the experiences of mental healthcare professionals, including nurses and peer workers, as well as the perspectives of family members. Additionally, expanding the range of outcomes measured in relation to participation in MTMs and investigating the factors that facilitate the effective implementation of this form of participation would be valuable directions for future studies
Van klacht naar kans? Hoe hotels omgaan met taalklachten
No full textStel je boekt via Booking.com een hotel in Amsterdam voor een weekendje weg. Bij de check-in word je in het Engels begroet. En zelfs als je duidelijk maakt dat je Nederlands spreekt, zegt de baliemedewerker: “In English, please”. In online reviews zien we dat Nederlandse toeristen klagen over het Engelse taalgebruik in hotels in eigen land. En hotels pareren dit niet altijd effectief in hun online reacties, laat onderzoek van Mariet Raedts en Irene Roozen zien
Influence of Network Design Parameters on the Morphology Evolution in Diels-Alder Blends via Thermodynamics and Kinetics Control
No full textReversible polymer network blends leverage the advantageous properties of immiscible polymer backbones. Previous work showed that the phase morphology of blends of a hydrophilic poly(propylene oxide) (PPO) and hydrophobic polydimethylsiloxane (PDMS) cured by the reversible Diels-Alder reaction depends on the mass ratio of the two polymers and the maleimide-to-furan ratio used for the reversible network polymerization. This work studies the competition between the reversible Diels-Alder reaction and the phase separation kinetics and thermodynamics to control the phase formation. A furan-functionalized PPO with a molar mass of 4546 g mol-1 was blended with furan-functionalized PDMS with different molar masses, mass ratios of the polymers, and stoichiometric ratios. At the highest molar mass of 4961 g mol-1, the PDMS and PPO separated quickly into separate layers, creating a barrier against both water and oxygen, respectively. The thickness, morphology, and composition of the layers depend on the composition of the blend. At a lower molar mass of the PDMS, the chemistry of the furan end groups becomes more pronounced, which increases the compatibility of the two polymers, reducing the thermodynamic driving force for phase separation. In addition, the increased concentration of furan and maleimide groups increases the Diels-Alder reaction rates and leads to more cross-linked network blends. Mastering the interplay between the thermodynamics of the blends and the kinetics of the network formation and phase separation by judicious combinations of the network design parameters leads to final blend morphologies ranging from kinetically trapped uniform microstructures to almost completely phase-segregated morphologies. Finally, the solvent extraction time was used as a process parameter of the wet blending process. Slow evaporation of the solvent over the course of 1 week resulted in a near-equilibrium separation of the two immiscible polymers into separate layers with perfect interfacial bonding by the same Diels-Alder chemistry. Manipulation of these factors enables the development of Diels-Alder network blends with a wide range of properties that are suitable for a wide variety of applications. The fastest and most efficient autonomous healing is achieved at higher PPO contents and for the highest PDMS molar masses, while the best barriers against water and oxygen are obtained at the highest cross-link densities.The authors would like to acknowledge Mr. Dimitri Adons and Mrs. Riet Henno for their technical support in oxygen permeability tests performed at the Materials and Packaging Research & Services (MPR&S) group of UHasselt. The authors would also like to thank Huntsman Corporation for supplying the Jeffamine D series amine hardeners. This work was supported by the Fonds voor Wetenschappelijk Onderzoek (FWO) Flanders through the SBO project SUBLIME (S007423N) and the senior postdoctoral fellowship of Joost Brancart (12E1123N)
Assessing food by-products macrocomposition by FTIR microspectroscopy
No full textFood by-products offer a promising opportunity for extracting valuable compounds that can be used in the food, pharmaceutical , and polymer industries. However, unpredictable variations in the chemical composition and spatial distribution of the various components within these biological matrices create challenges for new valorization processes. These inconsistencies can lead to variable recovery efficiency and differing quality of extracts. Understanding the chemical composition and spatial distribution of these components is essential, as it will facilitate the effective valorization of these by-products in future applications. Fourier transform infrared (FTIR) microspectroscopy was employed to evaluate the chemical composition and structural organization of industrial food by-products, specifically potato trimmings, carrot pomace, and brewer's spent grain. Frozen sectioning was employed as a sample preparation method. Hierarchical cluster analysis was applied to differentiate the spectral information from the background, allowing the determination of representative average spectra with good reproducibility across sample replicates. Derivative FTIR spectra further revealed previously hidden information by resolving overlapping signals, such as multiple bands in the 1750-1550 cm −1 region, facilitating the assignment of functional groups to compounds of interest such as proteins, lipids, or pectin and the creation of chemical images. However, some macroconstituents exhibited overlapping absorbance peaks, complicating the precise identification of individual components. Despite this limitation, FTIR microspectroscopy provided valuable semi-quantitative information on the composition of these by-products. The results demonstrated that chemical imaging by FTIR microspectroscopy is a valuable tool for food by-product evaluation, providing insight into their composition and supporting the potential for their valorization in industrial applications.Funding
The authors wish to thank VLAIO and Flanders’ FOOD for the funding and support received for this work performed in the framework of the cSBO project EffSep (grant number HBC.2019.0012).
The authors would like to acknowledge Baptiste Vanleenhove, Ben Van den Wouwer, Elien de Laet, and Chenxu Guo for providing the samples utilized in this project. The authors would like to acknowledge Martine Vanhamel for technical support with FTIR analysis
Eye-tracking: Understanding the WHY behind shopping behavior
No full textThis paper discusses a mixed method study in which we combine eye-tracking with semi-structured in-depth interviews, conducted at two similar stores of a retailer in the cosmetics sector. With this study the retailer wanted to investigate, on the one hand, how customers navigate and move around the store and, on the other hand, what they think of the design and experience of the two stores. Through this qualitative research method, you get a very rich set of information that mainly provides insights into the "why" behind shopping behavior. The results concerning shopping behavior indicate that in this store customers mainly navigate at eye level through product recognition. On the evaluation of the shopping experience, customers fairly unanimously recognize which elements are positive and which are more likely to be disruptive in a store design
Van wie is de herinnering? Over gedeelde erfenissen van artistiek collectief handelen
No full textAbstract: Een geheel dat meer is dan de som der delen: een collectief op zijn best. Maar soms beslis je na een tijdje dat het mooi is geweest. Wat doe je als collectief wanneer op een bepaald moment het vuur dooft? Alle tips en tools gaan over starten, maar er is weinig te vinden over hoe je een collectief stopzet of, nog moeilijker, transformeert. Wat blijft er over? Wat neem je mee en laat je achter? En ook: van wie is de herinnering
Early complications after penile implant surgery
No full textcitation ID: qdaf077.229 EARLY COMPLICATIONS AFTER PENILE IMPLANT SURGERY Objectives: Erectile dysfunction is a prevalent condition that may significantly impact psychosocial health and quality of life of patients suffering from this condition. While various treatment modalities exist, penile prosthesis implantation offers a permanent solution for patients that do not respond to or are not suitable for other treatment options. Surgery however, carries inherent risks and potential complications. The aim of this study was to determine the incidence and risk factors of early postoperative complications after penile implant surgery in a large, multicenter, prospective, observational cohort study. Methods: Data were analyzed from patients participating in the PHOENIX registry, an international multicenter study on penile implant surgery conducted by the EAU Research Foundation. Patients were operated on from November 2021 until august 2024 in 30 centers from 8 countries. Data were collected prospectively. Our study was not limited to one device or brand, all available devices were eligible for inclusion. Postoperative complications were registered at different time points during follow-up, up to 2 years post-surgery. For this analysis we studied complications that occurred within 2 weeks after surgery. Results: Data on early complications after penile implant surgery of 1072 patients were analyzed. Patients were on average 61 years old when receiving their penile implant. A total of 639 (60%) patients received a drain peroperatively. A total of 39 patients reported complications within 2 weeks after surgery. Infection occurred in 19 (1.8%) patients, 4 of which within 2 weeks post-surgery. Penoscrotal hematoma occurred in 9 (0.8%) patients, 6 of which within 2 weeks post-surgery. Of those patients who developed an infection, 8 (42%) patients had received a drain and 11 (58%) had not. A total of 278 (26%) patients were known with diabetes mellitus, whereas five (26%) patients with a postoperative infection suffered from diabetes mellitus. Conclusions: This large and only-of-its-kind prospective, international, multicenter study confirms that penile implant surgery is a safe procedure with a low rate of early postoper-ative complications. Moreover, peroperative drain placement and diabetes mellitus do not appear to impact the occurrence of postoperative infections. Conflicts of Interest: Funded by Boston Scientific Corp, Coloplast Corporation
Benthic Food Webs in Antarctica : Would you care for some more (micro)algae?
No full textThe West Antarctic Peninsula (WAP) is experiencing rapid warming, which will impact ecosystem processes, particularly ice-algae dynamics. As they are a vital food source for local primary consumers, this disruption is likely to cascade throughout the communities via trophic interactions. To study these effects, we sampled shallow-water benthic communities along the WAP in February 2023, focusing on Macroalgae Forests (n=2) and Sedimentary Soft Bottoms (n=3) at Dodman Island (66°S) and Blaiklock Island (67.5°S). Basal resources (sediment-associated POM, water-column POM, macroalgae, microphytobenthos) and benthic invertebrates (n=410, 49 morphospecies) were collected for stable isotope analysis. Using carbon and nitrogen ratios and Bayesian tools, we explored differences in food webs between Macroalgae Forests and Sedimentary Soft Bottoms addressing three key questions: 1) Are ice-algae more crucial as basal resource in one habitat? 2) Is there a difference in trophic diversity between Macroalgae Forests and Sedimentary Soft Bottoms? 3) How does the vertical food web structure differs between the two habitats? In the Sedimentary Soft Bottoms communities, consumers stable isotopes ratios showed a switch towards less negative carbon values, typical of ice-algae in Antarctica. This could suggest a higher vulnerability of Sedimentary Soft Bottoms communities along the WAP to alterations of ice-algae dynamics. What is more, in communities of similar species diversity, Layman metrics highlighted a higher trophic diversity in Macroalgae Forests compared to Sedimentary Soft Bottoms, supported by a wider range of basal resources. Altogether, this increased trophic diversity may indicate greater resilience of Macroalgae Forests communities to future changes. Finally, consumers in Sedimentary Soft Bottoms tended to occupy a higher trophic position than those in Macroalgae Forests, resulting in a higher mean trophic position. This may reflect a diet shift by generalist invertebrates—common in Antarctica—toward more consumption of fresh or degraded animal organic matter in habitats with fewer basal resources
Recent and chronic ambient air pollution exposure in association with telomere length and mitochondrial DNA content in the general population
No full textTelomere length (TL) and mitochondrial DNA content (mtDNAc) are biomarkers of biological ageing that respond to multiple stressors, including air pollution. Despite growing research interest, the association between recent and chronic air pollution and these biomarkers in the general population remains unclear. This study investigated the association between air pollution exposure and TL and mtDNAc using data from the 2018 Belgian Health Examination Survey. Multivariable adjusted generalised linear mixed models were applied to assess the exposure to nitrogen dioxide (NO2), fine particulate matter <= 2.5 mu m (PM2.5), and black carbon (BC) over 1-week (recent) and 1-year (chronic) periods prior to participation, estimated with a high-resolution spatiotemporal model. Leucocyte TL and mtDNAc were measured using qPCR. A total of 756 participants (mean age 50.6 years, 49.9 % women) were included in the study. Recent exposure to PM2.5 was associated with a 2.40 % (95 % CI: 0.16, 4.69; p = 0.036) longer TL per IQR increment. Trends of lower mtDNAc were observed for chronic exposure to BC (-3.11, 95 % CI: -6.19, 0.07; p = 0.055) and NO2 (-4.02, 95 % CI: -8.22, 0.36; p = 0.072) per IQR increment. No significant associations were observed between chronic air pollution and TL or recent exposure and mtDNAc. These results suggest an inverse association between chronic air pollution and mtDNAc, and a positive association between recent exposure and TL, providing insight into the time-sensitive and air pollutant effects on ageing biomarkers.This work was supported by Sciensano [(PJ) N◦: 1179-101] and the Methusalem fund. Dries Martens was funded by FWO, Belgium [12X9623N]