Inholland University of Applied Sciences

In pharmacology and clinical pharmacology (P&CP) teaching, using generic names of medicines contributes to global comprehensibility. However, brand names are often used in routine clinical practice, which may pose a challenge in the educational setting. This study aimed to explore P&CP teachers’ use of and attitudes towards generic and brand names in undergraduate education, as well as national prescription regulations. A survey was conducted with P&CP teachers from 38 European countries. An electronic questionnaire was used to collect data on the participants’ profiles, the nomenclature used and preferred in undergraduate education, and prescribing practices. The latter were then verified with national regulatory authorities. Sixty-one teachers from 23 countries participated in the study, the majority being physicians (n = 47). In total, 13 (21%) teachers use only generic names in their teaching, while 46 (75%) use both generic and brand names. Thirty-four (56%) teachers preferred listing brand names in case-based teaching, as this reflects real life. Conversely, 37 (61%) teachers stated that students should not be exposed to brand names before graduation. Generic prescribing is either allowed or mandatory in all participating countries except two, where brand-name prescribing is mandatory. This study shows that generic names must remain fundamental in P&CP education, but brand names also play a role, especially in case-based education, reflecting real-life practice. Potential implications of generic and brand prescribing for internationalisation in education could be worth further attention.

Prescribing medication is a complex process, influenced by many factors that can be weighed differently. Four prescriber profiles have been identified: pragmatic-contextual, guideline-oriented, experience-driven and vulnerability-focused. However, the extent to which European prescribers identify with these profiles and the role of these profiles in clinical pharmacology and therapeutics (CPT) education is unclear. Knowledge of this might improve prescribing education and thereby prescribing practice. A cross-sectional survey was conducted among physicians, physician assistants, advanced nurse practitioners and prescribing pharmacists across Europe. Participants ranked how strongly they identified with the four prescriber profiles, whether they recognized them in fellow healthcare professionals and whether these were covered in CPT education. A total of 170 prescribers from 23 European countries and over 40 different medical disciplines participated in this study. Most participants identified themselves as being pragmatic-contextual (36.5%) or guideline-oriented (42.9%) prescribers, whereas few considered themselves experience-driven (11.2%) or vulnerability-focused (9.4%) prescribers. Pragmatic-contextual and guideline-oriented prescribing were covered in current CPT education, whereas vulnerability-focused prescribing was poorly covered in current education. Participants thought that future CPT education should include these prescriber profiles. These findings highlight the influence of professional background, clinical setting and experience on prescribing approaches across Europe. The strong presence of pragmatic-contextual and guideline-oriented profiles in both practice and education is consistent with current CPT curricula. However, experience-based and vulnerability-focused profiles, though regularly seen in practice, are under-represented in education despite their acknowledged importance. To support the development of prescribing practice, educational strategies should include all profiles.

The well-being of students in higher education has received increasing attention, particularly in the aftermath of the Covid-19 pandemic. This study investigates trends in student well-being at a multi-campus university of applied sciences in the Netherlands between 2021 and 2024. Key indicators include depressive symptoms, resilience, emotional exhaustion, student engagement, study stress, and study motivation. Data were collected annually via the Student Well-being Monitor, a digital survey assessing various dimensions of well-being, including a total of 6,609 participants. Statistical analyses, including chi-square tests, one-way ANOVAs, and multivariable regression analyses, were used to examine changes over time. Results show significant improvements in depressive symptoms, emotional exhaustion, and study stress, suggesting a gradual recovery in student mental health. In contrast, trends in positive constructs such as resilience and study motivation were less consistent. The variance explained by cohort year was relatively small for all well-being indicators (0.0%–7.4%), indicating that demographic variables (e.g. gender, age, year of study), which were included as control variables, exerted a stronger influence on well-being outcomes. The findings suggest a recovery in student well-being following the pandemic, marked by reduced mental health challenges. Continued monitoring and tailored interventions are essential to address the diverse needs of students in higher education.

BackgroundDementia risk reduction through lifestyle modification has much potential but is not widely implemented in routine care. Patients referred to memory clinics are at high risk for dementia and tend to have worse health and lifestyle profiles. There is currently no service available to help these persons make lifestyle changes. We aim to improve lifestyle profiles through implementing a personalized and multidomain lifestyle intervention in the memory clinic. Here, we describe the design of our study assessing the effectiveness of this intervention.MethodLifestyle Intervention in the memory clinics of General and academic Hospitals Trial (LIGHT) is a 12‐month multicentre randomized controlled trial investigating the effects of an innovative lifestyle intervention. Starting early 2025, the trial aims to include 300 older adults (≥ 50 years) with subjective cognitive decline (SCD) or mild cognitive impairment (MCI) who have ≥2 modifiable dementia risk factors (to ensure room for improvement) primarily from the memory clinics of Maastricht UMC+ and Amsterdam UMC. Participants are randomized 1:1 to the intervention or usual care with general health advice. The intervention comprises three components: 1) Three individual sessions with a certified lifestyle coach to work on personal goals, 2) Vouchers for access to brain‐healthy activities from local providers, and 3) Online access to a recently developed risk self‐management platform (www.breinzorg.nl). Primary outcome is the 12‐month change in participants dementia risk profiles as measured by the LIfestyle for BRAin Health (LIBRA) index. Secondary outcomes include cognitive functioning, health‐related quality of life, activities of daily living, psychological measures, as well as individual lifestyle components.ResultLIGHT provides insight into the implementability and (cost‐) effectiveness of a lifestyle intervention in a memory clinic setting. Recruitment has started early 2025 and will continue until 2027.ConclusionLIGHT may provide evidence for a personalized multidomain lifestyle intervention for preventing dementia. The results would support implementing personalized lifestyle coaching in the regular service offered by Dutch memory clinics.

Generalists in palliative care and professionals with specialized expertise, including palliative care nurses, achieve high-quality palliative care. To strengthen their role, it is essential to understand the tasks palliative care nurses perform and their position within the organizations. We aim to accomplish this understanding and explore facilitators and barriers to taking on the role as specialized nurses from both the nurses’ and managers’ perspectives. A sequential mixed-method design combined an online survey, followed up by five focus groups. Analysis involved descriptive statistics and thematic coding. A total of 234 palliative care nurses across various care settings answered the survey. They primarily provided physical care (88%), with less focus on psychological (72%), social (68%), and spiritual (68%) domains, and were consulted for fewer than half of their activities. Having no job descriptions often occurred (from 78% in home care and nursing homes to 44% in hospitals). Hospital nurses were more involved in advisory teams (56%) than those in other settings (26% − 28%). Nurses showed leadership by promoting generalists’ expertise, connecting partners, serving as role models, and advocating for palliative care. Focus groups with twelve nurses and nine managers identified facilitators and barriers that palliative care nurses and their managers encounter in embedding their roles and positions. These covered: (1) distinction between generalist and specialist palliative care, (2) collaboration, (3) job descriptions, (4) leadership, (5) visibility, (6) funding and reimbursement. Palliative care nurses fulfill an essential role but experience ambiguity about their role and position. They and their managers emphasized the importance of leadership and advocating for palliative care in their organizations. Visibility, funding, reimbursement, and collaboration are facilitators and barriers to their role and position. There are notable areas for improvement, including joining a palliative care advisory team, having a job description, and finding ways to demonstrate cost-effectiveness.

Abstract Grassroots innovations, emerging as a relatively new phenomenon in citizen-led movements, are distinguished by their focus on sustainable innovation and their bottom-up approach to addressing local challenges. Grassroots innovations prioritize learning and innovation, making them crucial agents of social and sustainable transformation. In eco-social approaches, social workers are committed to work with such communities. This research explores the role of leadership and meaning-making within grassroots innovations, particularly in the creation of transformative spaces that drive sustainable development. By conducting ethnographic case studies of two Dutch grassroots initiatives and employing grounded theory methodology, the study reveals the role of leadership and meaning-making processes. Initiators lead by facilitating a space for transformation, by enhancing community by co-creating neighbourhood-level sustainability, including different voices and the use of narratives in shaping identity and fostering a collective sense of purpose, ultimately offering a hopeful alternative to societal crises. This article aims to inform social work professionals about the leadership dynamics within grassroots innovations and suggest their important role in supporting these initiatives as part of eco-social work. Social professionals should refrain from intervening in the substantive direction of citizen initiatives but should ensure the safeguarding of the three key elements of the leadership process.

To enhance social interaction of residents living with dementia and their (in)formal carers in nursing homes, we examined the effects of a digital, person-centred, Photo-Activity (PA) versus a conversation activity (control). An explorative randomized controlled trial was conducted in 81 resident-informal carer (IC) dyads and 51 formal carers (FC) with three measurements (pre/post-test, 2-week follow-up). Intervention effects were tested using Mann–Whitney U’s, and ANCOVA’s with pre-test scores as covariates. Interaction effects were examined between dementia severity (DS; less/more) and condition (PA/control). A post-test effect was observed in social interaction (INTERACT-subscale: Mood [p = 0.037, ηp2 = 0.07]), with PA residents showing better mood than controls. Residents with less DS showed more positive effects of PA than residents with more DS (interaction effects: INTERACT-subscales Mood [p = 0.017, ηp2 = 0.092], Stimulation Level [p = 0.011, ηp2 = 0.106], and Need for Prompting [p = 0.013, ηp2 = 0.099]). Higher QUALIDEM Positive Affect scores were observed in the PA group, post-test (p = 0.025, ηp2 = 0.082), and follow-up (p = 0.042, d = 0.39). PA FC showed less empathy (IRI; p = 0.006, ηp2 = 0.185;) than controls, but reported getting to know the residents better (p = 0.035, r = 0.299). PA improved mood and positive affect of residents with dementia and led to FC knowing the residents better. Less empathy was observed in FC providing PA, requiring further investigation.

Recently, a cluster-randomised controlled trial was conducted within Dutch ambulatory mental healthcare to assess the effectiveness of a one-year smoking cessation intervention consisting of group sessions, peer support and pharmacological treatment (KISMET). This article presents its process evaluation, exploring the perceptions of patients and mental healthcare professionals (MHPs) regarding the implementation of KISMET. We conducted a mixed methods study, including 26 semi-structured interviews (10 MHPs and 16 patients) following the RE-AIM framework. Qualitative data was thematically analysed with MAXQDA software. We collected additional data on inclusion, drop-out and assessed treatment adherence during on-site observations. Recruitment and subsequent retention of patients in the RCT was found to be challenging (58% drop-out at one-year follow-up). MHPs suggested more motivational enhancement techniques to aid recruitment and reduce study attrition. The intervention components were generally assessed positively. Patients experienced the group and peer support sessions as supportive and beneficial. Inconsistent group attendance was demotivating and disrupted implementation. Pharmacological treatment was found to be helpful, although MHPs mentioned the treating psychiatrist or clinical nurse specialist need to facilitate better to ensure medication supply. The handbook offered MHPs excellent guidance and significantly contributed to treatment fidelity. Surprisingly, the carbon monoxide monitoring (originally included in the study protocol for research purposes) was appraised as a motivational tool. Finally, shortage of staff, limited collaboration and high turnover were barriers for the delivery of the intervention. Implementation heavily depends on the quality of the collaboration between MHPs and patients, as well as the infrastructure created by the organisation. This study demonstrates the benefits, unique demands and challenges of a smoking cessation intervention for people with SMI. Results could guide and improve the implementation of smoking cessation interventions in mental healthcare settings. Fostering a culture of connectivity through team development, along with the provision of supportive and communicative supervision is critical for the effective recruitment and retention in smoking cessation studies in psychiatric care.

Abstract Creating truly equitable education is a challenge. Equity, diversity, and inclusion endeavours are often characterized by a depreciative deficit-thinking and a problem-based view on diversity. In this article, we present the MIXED model (Multi-perspective Inclusive eXchanges for Equity and Diversity), which can support lecturers in establishing an inclusive learning environment by building on different perspectives and talents in the (college) classroom. The model offers both inspiration and practical guidance as it describes a vision, strategies, and examples of learning activities for various classroom settings (online/offline, larger/smaller). We also describe the theoretical framework and the process of development and implementation. The MIXED model, developed at the Vrije Universiteit Amsterdam, unpacks three phases in classroom dynamics. Feedback from lecturers indicates utilizing the model can lead to a more equitable learning environment. This approach aims to educate future academics and professionals who are capable of building on the different perspectives in diverse settings when resolving complex societal problems.