De Context-Sensitive Positive Health Questionnaire (CPHQ2.0) is ontwikkeld om brede gezondheid te meten vanuit zowel de Capability-benadering als het gedachtegoed van Positieve Gezondheid. Waar traditionele instrumenten, zoals de EQ-5D-5L en IPH-17, zich vooral richten op gezondheidsstatus, integreert de CPHQ2.0 expliciet persoonlijke en contextuele factoren die van invloed zijn op iemands mogelijkheden om gezond te leven. De doorontwikkeling van de oorspronkelijke CPHQ1.0 naar de CPHQ2.0 omvatte tien focusgroepen, een expertvalidatie, een membercheck en een longitudinaal panelonderzoek ten behoeve van psychometrische analyse (n = 1001). De resultaten tonen een robuuste factorstructuur met acht factoren: mentale ontspanning, sociale acceptatie, welbevinden, vitaliteit, sociale steun, financiële middelen, gezondheidsvaardigheden en mobiliteit. Er is sprake van een goede interne consistentie (CR > 0,77) en test-hertestbetrouwbaarheid (ICC > 0,70). De CPHQ2.0 is inzetbaar binnen de zorgpraktijk, het sociaal domein en gezondheidsbeleid. Correlaties met de IPH-17 en EQ-5D-5L bevestigen de discriminante validiteit, waarbij de CPHQ2.0 zich onderscheidt doordat ze niet alleen inzicht geeft in brede gezondheid, maar ook de mogelijkheden meeneemt die iemand heeft om gezond te leven. De vragenlijst biedt daarmee waardevolle informatie voor gezondheidsbevordering.
OBJECTIVE:This study aims to 1) explore experiences of ethnic minority patients and their relatives regarding shared decision making (SDM) in oncological hospital care, alongside healthcare professionals' (HCPs) experiences of engaging in SDM with ethnic minority patients; 2) identify opportunities to improve SDM for ethnic minorities in oncology, if needed, by linking the findings to a previously developed value structure. METHODS:For this purpose, we interviewed ethnic minority patients (n = 22), relatives (n = 11), and HCPs (n = 14). Using reflexive thematic analysis, we applied Schwartz's value theory, adapted to the context of SDM, to code and analyze the interviews. RESULTS:From the data, we developed three themes: 1) Factors that empower(ed) and disempower(ed) patients in SDM. Knowledge, skills, and competences of both HCP and patient [i.e. Achievement], support [i.e. Benevolence], and a good HCP-patient relationship [i.e. Security] empower patients. A lack of these three disempowers them; 2) Individualizing treatment decisions. Participants individualized treatment decisions through deliberation, negotiation, and choosing; 3) HCPs' limited insight into patients' context. HCPs experienced this due to a lack of cultural competences and perceived cultural differences. CONCLUSION:SDM for ethnic minorities can be enhanced by strengthening HCPs' cultural competencies, increasing the availability of culturally and linguistically tailored information and support, and fostering ongoing relationship-building efforts. These strategies empower patients, enhance HCPs' insight into ethnic minority patients' context, and contribute to more individualized treatment decisions. PRACTICE IMPLICATIONS:We recommend educational programs to increase HCPs' cultural sensitivity in SDM, developing campaigns to focus more on the needs of ethnic minority populations, and incorporating culturally and linguistically tailored support within hospital systems. Importantly, efforts should avoid overemphasizing cultural differences, as many empowering and disempowering factors also apply to the general population, but should be responsive to cultural aspects where relevant.
There are numerous complex societal problems worldwide. Solving these problems requires a generation that can break traditional boundaries and drive change. Transdisciplinary education in higher education (TDE), where students, teachers, researchers, and all come from different disciplines and societal partners, learn, work, and research together on an equal footing on a complex societal problem, responds to this demand. Despite its growing development and implementation in the Netherlands, insights into the factors helping or hindering the establishment of TDE remain limited. This study aims to explore the goals of TDE initiatives and the helping and hindering factors experienced by pioneers in Dutch higher education. This study adopted a qualitative, exploratory approach, conducting semi-structured interviews with 13 pioneers involved in 10 TDE projects across the Netherlands. Participants included educators, program developers, and researchers. Thematic analysis was employed to identify key goals, helping conditions, and barriers to TDE implementation. Four overarching goals emerged: achieving societal impact, fostering collaboration, enhancing learning, and ensuring organizational sustainability. The helping factors included shared goal setting, intrinsic motivation, sustainable collaborations, and psychological safety. Barriers encompassed institutional rigidity, insufficient time and resources, and the challenges of designing assessment frameworks compatible with TDE principles. Participants emphasized the importance of transformative learning, while identifying that the misalignment between traditional academic structures and TDE was a significant obstacle. The findings highlight systemic challenges in embedding TDE within monodisciplinary education systems and underline the necessity of institutional flexibility, long-term partnerships, and adaptable assessment practices. Recommendations for practice include fostering psychological safety, prioritizing inclusive goal setting, and integrating diverse perspectives into TDE projects. Future research should examine stakeholder perspectives beyond those of educators. This study provides insights into the helping and limiting factors of TDE, laying a foundation for optimizing its implementation in higher education and contributing to the development of a comprehensive framework for TDE practices.
Biocomposites reinforced with natural fibres are receiving increased attention due to growing concern over the environmental impacts of their synthetic counterparts. Grass mowed from roadside verges has the potential to serve as an alternative to commonly used natural fibres and as a renewable feedstock for the biocomposite industry. However, it is generally treated as waste due to its high volume, seasonal availability, contamination (e.g., with metals and plastic bottles), and legal status. In this study, a techno-economic assessment was performed for different roadside grass valorisation scenarios covering the entire value chain from mowing and pre-treatment to fibre and biocomposite granule production. In addition, a screening greenhouse gas emissions assessment based on the main energy and material inputs was performed for fibre production. This screening assessment provides an initial indication of the operational environmental performance and is not intended to represent a complete life cycle or integrated sustainability assessment. One scenario investigated a value chain with flail mowing and grass fibres as the final product. Grass fibres can be produced at €528/t when mowing costs are included and as low as €295/t when mowing costs are excluded under the processor/incremental-cost perspective. A reduction of 6.4% in fibre price was estimated for the rotary-mowing scenario when mowing costs were excluded. In comparison, the market price of commonly available natural fibres ranges from €300 to €4000/t, although the price is strongly dependent on fibre quality, which was not considered in this assessment. Another scenario considered biocomposite granules consisting of 25% fibres, 60% polylactic acid, and 15% filler as the final product. The biocomposite granules can be produced at €1073/t and €1013/t with and without mowing costs, respectively. The production cost of the granules is largely influenced by the price of the polymer matrix and the compound composition, while the average market price is approximately €2000/t. Overall, the results indicate that roadside grass fibres may be cost-competitive under the evaluated assumptions. The screening assessment resulted in 364.20–701.32 kg CO2-eq/t fibre for the flail system and 275.96–327.96 kg CO2-eq/t fibre for the rotary system, depending on whether mowing was excluded or included. Drying energy and diesel consumption associated with mowing and collection were identified as the main operational emission sources.
