Research team

Primary and interdisciplinary care Antwerp (ELIZA)

Expertise

My expertise covers qualitative and quantitative work in primary health care and medical education in various projects. The most important projects are: In the FAITH consortium (National Institute for Health and Disability Insurance (NIHDI)) we examine innovative and bottom up projects regarding chronic care in Belgium. In the SCUBY project (Horizon 2020) we study best avenues to scale up best evidence practice in Belgium, Slovenia and Cambodia. The Primary Care Academy (Chair of Fonds Dr. Daniël De Coninck) deals with new and innovative tools for patients, practitioners and teachers (goals oriented care, self management and interprofessional care) in Flanders. Capacity building for teaching and research are of majour importance. Two research chairs are supported by me: the Chair Public Mental Health (studying mental health care needs in Flanders and the Antwerp region in particular) and the Chair Care and the Natural Environment (with focus on the relation of the effects of green space and the natural world and build environment on health).

The Primary Care Academy - A research training network. 01/01/2019 - 31/12/2023

Abstract

Primary Care Academy, Interdisciplinary Chair Fund Dr. Daniël De Coninck, King Boudouin Foundation This chair was awarded for a period of five years starting April 1, 2019. Why? Given the changing healthcare needs of the Belgian population, the Primary Care Academy (PCA) aims to help create an optimal primary care experience for care receivers, adapted to the context of the community they live in, and with special attention to equity in Flanders. Who? The Primary Care Academy (PCA) is a research and teaching network of four Flemish universities, six university colleges, the White-Yellow Cross and patient representatives. What? The PCA focuses on building more comprehensive and interdisciplinary primary care for populations with moderately complex care needs in order to prevent avoidable deterioration and increasing complexity. The PCA promotes goal-oriented-care as an innovative strategy for pro-active and person-centred care in an inter-professional collaboration model. Attention is paid as well to the self-management support capacity of the caregiving community by developing a toolbox that enhances the sustainable implementation of self-management support in primary care. The PCA contributes to high quality of care by expanding interdisciplinary care and collaboration, involving, and uniting formal and informal care providers and s. To foster the person-centred and community-based approach whilst taking into account the social determinants of health, new models of interprofessional care networks and collaboration will be developed, tested and implemented. How? Based on academic and practice-oriented research, PCA develops optimal roadmaps and hands-on toolkits for primary care policies, practice and education. These strategies and tools facilitate the implementation of proactive and person-centred primary care for the population experiencing moderately complex difficulties. PCA also creates substantial input into innovative training strategies at the bachelor and master levels as well as in continuing education of health and social care professions. To induce sustainable change, the PCA interacts with policy makers of our health system from the outset.

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Scale Up an integrated care package for diabetes and hypertension for vulnerable people in Cambodia, Slovenia and Belgium (SCUBY). 01/01/2019 - 30/06/2023

Abstract

Background: Diabetes and hypertension are increasingly dominant in the global burden of disease. Effective interventions for prevention, detection, treatment and control of both conditions are available, but do not reach all people in need. Countries are struggling how to scale-up interventions sustainably and effectively. There is an urgent need to develop and document strategies on how to do so. Method: This project examines the scale-up of existing evidence-based packages for control of diabetes and/or hypertension with five components: (a) identification of people with hypertension and/or type 2 diabetes and (b) treatment in primary care services, (c) health education and (d) self-management support to patients and caregivers, and (e) collaboration among caregivers. The project develops, implements and evaluates roadmaps for the national scale-up of this package, in three different types of countries: a low-middle income country with a developing health system (Cambodia), a former socialist country with a centralised health system (Slovenia), and a Western European country with a decentralised system (Belgium). The research objectives are: 1) to analyse the organisational capacity to scale-up the integrated care package and to assess contextual barriers and facilitators; 2) to develop and implement roadmaps for a national scale-up strategy in each country; 3) to evaluate the impact of scale-up on health outcomes and costs; and 4) to generate lessons for other countries. Outcomes: The project will result in comprehensive scale-up strategies and increased diabetes and hypertension control in each country. The involvement of policy-makers, professionals and patients will ensure the local relevance and impact. The project is innovative in applying the conceptual insights from scale-up science to the field of noncommunicable diseases. The lessons on scale-up will benefit policy-makers in other countries with similar contexts.

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Scientific chair 'Public Mental Health'. 01/01/2019 - 31/12/2021

Abstract

Objectives of the Public Mental Health chair Despite the change (s) of the context, we as a society bear the responsibility to provide people with a psychological or psychosocial need the best possible care in a cost-efficient way (with attention to the perception of both healthcare users and caregivers;. With the chair 'Public Mental Health' we want to offer support and guidance to this social responsibility through research, education and services. The research section of the chair will focus on collecting information about the current care needs and the current care offer. After all, there are few data available today about the occurrence of psychosocial and psychological complaints and disorders in Flanders (or Belgium), and their seriousness. The information on the care-delivery side is also incomplete; for example, we have little to no insight into what GPs, freestanding psychiatrists and (primary) psychologists provide to psychological and psychosocial care. We will ask health care users and care providers about (non-filled in) care needs. In addition, existing (linked) databases (from Antwerp care providers and other sources) will be examined in this light. Based on the background of and in combination with international literature, the local findings provide input for the teaching section of the chair. The knowledge about mental health (care) in the general population is relatively limited ('mental health literacy') and the taboo about mental problems and the stigma with regard to people with mental health problems is great, even with ( somatic-oriented) care providers, so that people with mental health problems do not seek help or receive inadequate (somatic) help . With training and education, both for students and for a broader public, this can be tackled. Finally, the research component provides a lot of input for the service part of the chair. With the collected data, we hope to be able to start a data-driven healthcare provision in the province of Antwerp, strengthening the cooperative between the participating hospitals and with other actors in the field. Mental health and mental well-being are gaining weight in society. The zeitgeist is therefore extremely suitable to set up this chair. We are convinced that the chair can act as a lever in the acquisition of additional funds.

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Identifying the motivational mechanisms that determine Type 2 Diabetes self-management in socio-economically disadvantaged populations 01/10/2018 - 30/09/2022

Abstract

The burden of chronic diseases including type two diabetes mellitus (T2D) is increasing rapidly, especially in low- and middle-income countries. In high-income countries, evidence shows that T2D disproportionally affects socio-economically disadvantaged and vulnerable populations, which makes it an important contributor to inequality. Self-management is an essential and effective strategy for people with T2D, but is poorly adopted in vulnerable groups and low-resource settings. Research on self-management support interventions has been focused on the general population of high-income countries, ignoring the populations that need it the most. The objective of this study is to identify the motivational mechanisms that determine self-management outcomes in vulnerable and socio-economic disadvantaged populations living in suburbs in Sweden, an urban slum in South-Africa, and a rural area in Uganda. The study is based on self-determination theory and hypothesizes that higher intrinsic motivation leads to better self-management which will improve physical and psychological outcomes. Moreover, increase of intrinsic motivation happens through fulfillment of the basic psychological needs which are perceived autonomy, competence and relatedness. In the same framework, we hypothesize that higher psychological adjustment – which refers to the absence of mental distress and the ability to cope with change – leads to better self-management and related outcomes. The study builds on an ongoing cluster-randomized experimental trial evaluating the effectiveness of a context-appropriate community intervention to enhance self-management for people with T2D called SMART2D. The aim of this new proposal is to identify the motivational mechanisms that explain the effect of the intervention in the SMART2D trial. More specifically, this new proposal will assess the mediating role of perceived autonomy, perceived relatedness, perceived competence, intrinsic motivation, and psychological adjustment. Quantitative data on these psychological factors will be collected through the SMART2D project. To determine the mediating effect of these latent variables, a structural equation model will be developed and tested. We will use multi-group structural equation modelling to test the model across the three different sites. This new project will also collect additional qualitative data through semi-structural interviews with the people at risk for or with T2D to further explain the differences across the three study settings. This study will inform us on how self-management support interventions need to be developed when targeting populations in disadvantaged or under-resourced areas, in order to make care more equal and inclusive.

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Chair Care and the Natural Living Environment 01/10/2018 - 30/09/2021

Abstract

During three years this Chair will be financed by the Provincie Antwerpen and build on the on-going project "Green light" (see below) in which the research department ELIZA collaborates with the Provincie Antwerpen who also finances that project. From 2019 the Chair will focus on research, education and services regarding a better connection between primary health care and the natural living environment: Integration knowledge and practice: practice oriented research (action-research/implementation research) and research oriented practice (practice-evaluation) Integration attention for nature related health benefits & health risks Inter-professional: collaborative research nature sector – health sector – other relevant sectors; knowledge transfer to and from different sectors

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Nature impact on Mental health distribution (NAMED - second phase). 01/04/2018 - 30/11/2021

Abstract

Mental illnesses are a growing problem in modern societies. The interaction with the urbanised environment is little understood. The BELSPO funded NAMED-project (July 2017 – July 2021) investigates the impact of the (non-)built environment on mental health in the Brussels Capital Region. Methods will combine quantitative and qualitative research. From ELIZA Hans Keune, Hilde Bastiaens & Roy Remmen are involved.

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Matching needs and treatment possibilities in Flemish mental health care. 01/12/2018 - 30/04/2020

Abstract

Psychiatric disorders and psychosocial complaints are highly prevalent and have large personal and societal impacts. Flemish mental health care has changed dramatically over the past few years. How can we provide these patients with the best possible care? In this project, we will develop a valid methodology to inventory the psychiatric and psychosocial needs in society. In addition, we would like to get a better view on what kind of mental health care interventions are provided in primary care, and provide recommendations to improve the match between care needs and care possiblities.

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NESTOR - Flemish Network for Primary Care Service & Teaching Oriented Research. 22/08/2018 - 31/12/2018

Abstract

Previously called NESTOR, the Primary Care Academy is a network being funded by the Koning Boudewijn Stichting. The partners are 4 universities, 6 university colleges , the White Yellow Cross and the Vlaams Patienten Platform.

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Evaluation of the implementation of the local medical-pharmaceutisch consult in Belgium. 01/04/2018 - 31/12/2018

Abstract

Approach In order to evaluate the process of implementation and dissemination of MFO in Belgium, we work in three phases. In the first phase, we explore the views of policy makers and stakeholders regarding the current and future MFO. In a second phase we explore the experiences and opinions of pharmacists and GP's at the local level. And in the third phase, we undertake an action research to enhance the implementation of MFO in Belgium. Research questions  Fase 1: What are the views of policy makers and stakeholders on the current MFO policy and procedures?  Fase 2: What are the experiences of physicians and pharmacists in the local MFO?  Fase 3: How can the process of MFO be further enhanced?

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    Integrated care for chronic diseases in Belgium: scientific support and evaluation of pilot projects. 01/03/2017 - 30/06/2020

    Abstract

    In Belgium, the project ´Integrated care for chronic patients´ was launched ((Integreo). About 20 projects will pilot innovative strategies in catchment areas of 100.000-150.000 inhabitants. The Het FAITH.be consortium (Federated consortium for Appraisal of Integrated care Teams in Health in Belgium) is responsible for the support and evaluation of these chronic care projects in Belgium. Four parts can be distinguished. 1. In the outcome evaluation the Triple Aims goals and job satisfaction of providers of care will be studied. 2. The implementation analysis of the projects 3. Support for the projects ti help them to perform auto analysis 4. Support actions to the federal administration bodies The FAITH consortium consists of six Belgian universities. Besides the University of Antwerpen (Department of Primary and Interdisciplinary care, Centre for General Practice), the UGent, KULeuven, VUB, ULg and UCL (coordinator) are partners in the consortium. For the University of Antwerp you may contact Principal researcher: Elien Colman, PhD (elien.colman@uantwerpen.be) Promotors Universiteit Antwerpen: Sibyl Anthierens (sibyl anthierens@uantwerpen.be) en Roy Remmen (roy.remmen@uantwerpen.be)

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    NAture impact on MEntal health Distribution (NAMED) 01/01/2017 - 15/04/2020

    Abstract

    Mental illnesses are a growing problem in modern societies. The interaction with the urbanised environment is little understood. The BELSPO funded NAMED-project (July 2017 – July 2021) investigates the impact of the (non-)built environment on mental health in the Brussels Capital Region. Methods will combine quantitative and qualitative research. From ELIZA Hans Keune, Hilde Bastiaens & Roy Remmen are involved.

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    A study of the feasibility and risks of the integration of triage and regulation of acue medical care. general practitioners, emergency departments and the 112 help centre. 01/04/2016 - 31/03/2018

    Abstract

    In Belgium, emergency departments and GPs take care of urgent medical care during office and out-of-hours (OOH). Patients have access to the care provider of their choice. Over the last years protocols for triage of unplanned care have been developed by working groups in Belgium. The central aim of the present project is to establish if telephonic triage (using the phone number "1733") with professional call takers using these protocols is feasible, reliable and effective. A pilot project is established in the region Leuven-Tienen, in close collaboration with the emergency departments, the general practice OOH services and the regional emergency call centre which operate in that region. The overall research questions are 1. What is the safety and efficiency of newly developed protocols when used by call takers? 2. What is the epidemiology of unplanned medical care both during office and out-of-hours? 3. What is the influence of telephone triage on the workload and cost of care for unplanned medical problems? Other activities during the project will help to inform the public and the health professionals in the Leuven region. The two year project started May 1, 2016. Results of this study will inform stakeholders about future organisation of OOH care in Belgium. The OOH care research group is part of the General Practice group of the Department of Primary and Interdisciplinary Care Principal investigator: Hilde Philips Co-supervisor Veronique Verhoeven Junior researcher: Hanne Claessen Junior researcher: Annelies Colliers Team member: Roy Remmen

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    Green light. To design a research protocol to study the effects of nature on health, with a focus on frail populations in the Province of Antwerp 01/01/2016 - 31/12/2017

    Abstract

    Green light. To design a research protocol to study the effects of nature on health, with a focus on frail populations in the Province of Antwerp. We will perform qualitative methods to study priority areas among key stakeholders and analyse the possible use of available quantitative data in future research. Principal researcher Dr Hans Keune Co-researchers professor Hilde Bastiaens and Roy Remmen

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    Use of psychoactive substances in adults: prevention and treatment by general practitioners and occupational physicians; data retrieval (UP TO DATE 2). 15/12/2015 - 15/03/2017

    Abstract

    To tailor and implement scientific results of Up to Date 1 in daily practice, in collaboration with primary care organizations, occupational health services and the alcohol and drug work field. Specific objectives - Inform and train GPs and OPs in screening, detection, brief intervention, problem definition of alcohol and other drugs, etc. depending on the context, the person and the product. - Use guidelines in practice. - Facilitate and improve the communication and collaboration between GPs and OPs.

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    Editorship EBMPracticeNet including the ultimate responsibility for the development of the online knowledge database 01/08/2015 - 31/12/2015

    Abstract

    The knowledge database of EBMPracticeNet includes all National Belgian EBM-information products, including the adapted Duodecim guidelines and all Belgian updated monodisciplinary and multidisciplinary guidelines. Within this project the researcher has the ultimate responsibility for the development of the online knowledge base. He/she is responsible for the actualization, coherence and integration of all guidelines and the other Belgian EBM products. There is a strong collaboration with the working group for the development of primary care guidelines, the project leader and the responsible for the clinical decision support system

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    Scientific leadership for the Unit of Guideline Development of Domus Medica 04/06/2015 - 31/12/2015

    Abstract

    Hilde Philips MD PhD chairs the Guideline Development Unit of Domus Medica, the professional organization of general Practitioners in Belgium (Flanders). The Unit develops guidelines and shares expertise as methodologic experts with other organisations and education in guideline development. Both groups cooperate in GIN (Guidelines International Network).

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    Development of a collaborative - multidisciplinary protocol for treatment and follow-up of mayor depression 01/02/2015 - 31/12/2015

    Abstract

    This project represents a formal research agreement between UA and on the other hand the Flemish Public Service. UA provides the Flemish Public Service research results mentioned in the title of the project under the conditions as stipulated in this contract.

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    Improving Care and Research Electronic Data Trust Antwerp (ICAREDATA). 01/09/2014 - 31/12/2018

    Abstract

    This project represents a formal research agreement between UA and on the other hand the Flemish Public Service. UA provides the Flemish Public Service research results mentioned in the title of the project under the conditions as stipulated in this contract.

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    Marché public de services, d'études et de recherches économiques et sociales relatives aux soins de nuit aux personnes âgées fragiles vivant à domicile en Région de Bruxelles-Capitale. 01/09/2014 - 31/03/2015

    Abstract

    This project represents a formal research agreement between UA and on the other hand the client. UA provides the client research results mentioned in the title of the project under the conditions as stipulated in this contract.

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    Scientific evaluation and monitoring of projects and supporting alternative forms of care for vulnerable elderly. 01/04/2014 - 31/05/2017

    Abstract

    In this poject we propose a scientific analysis and evaluation of projects that aim to facilitate to keep frail elderly in their homes in the national programme protocol 3. In protocol 3 the national health insurance organisation invests more tnah 40.000.000 euro in new health facilities to keep elderly in their homes whilst preserving and improving quality of life.

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    To strengthen and build on medical curriculum reform at the UTPL (EI) with emphasis on distance education and modern concepts of learning. 31/12/2013 - 31/12/2015

    Abstract

    The scope of this project is to support medical curriculum reform at the UTPL with emphasis on modern teaching concepts, and to extend this reform to other universities which is in line with the MoH strategy.

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    Initiatives providing support to caregivers: evaluating of options for Belgium. 01/09/2013 - 21/03/2014

    Abstract

    The project will aim to describe the effects of policy measures to assist the informal caregiver (ICG) at the micro level in four countries, Flanders, Wallonia and Brussels. In other part of the larger project conducted by KCE, the grey literature has been explored. An inventory of policy measures supporting ICG in their function was already performed. We will use this information to foster a qualitative in depth, cross country multiple cases study.

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    Evaluation of strategies for dissemination and implementation of clinical practical guidelines: qualitative study of Belgian organizations that produce and disseminate clinical practical guidelines: description of their methods and their organization 15/01/2013 - 30/09/2013

    Abstract

    Various Belgian authorities generate and disseminate good practice with the intention to promote the quality of health care. With a literature review and a qualitative research with Belgian stakeholders, it will study the effectiveness and efficiency of dissemination and implementation strategies of practical guidelines.

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    Prospective intervention study on the implementation of the GP Centre Merksem, ZNA Jan Palfijn. 01/09/2012 - 31/08/2013

    Abstract

    This project represents a formal research agreement between UA and on the other hand ZNA/HAN. UA provides ZNA/HAN research results mentioned in the title of the project under the conditions as stipulated in this contract.

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    Organisation of care for patients with chronic disease in Belgium. SWOT analysis of chronic care in Belgium - Stakeholders views. 20/03/2012 - 30/06/2012

    Abstract

    This study is part of a larger work for the development of a position paper in order to orient the forthcoming health policy on chronic care in Belgium. lts specific objective is to perform a SWOT analysis of the capacity of Belgian health care system to organise care for patients with a chronic disease.This would encompass the perspectives of the important stakeholders of the system. The aim is to develop a set of operational objectives for future actions in the health care system.

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    Scientific Research GP Centre Merksem, ZNA Jan Palfijn. 01/01/2012 - 31/12/2012

    Abstract

    This project represents a formal research agreement between UA and on the other hand OCMW Antwerpen. UA provides OCMW Antwerpen research results mentioned in the title of the project under the conditions as stipulated in this contract.

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    Use of alcohol, illegal drugs, hypnotics and tranquilizers in the Belgian population. Prevention and treatment by general practioners, and health surveillance on the work floor by occupational physicians: knowledge needs and supply (UP TO DATE). 01/12/2011 - 01/12/2014

    Abstract

    The UP-TO-DATE consortium aims at providing an accurate view of the management of addiction in Belgium, from the physicians' perspective. The purpose of this research is to know 1) what the current demand is for care in the front line; 2) to what extent GPs and OPs are involved in this problem, and 3) what resources they are able to use for providing appropriate response to all types of requests for treatment of substance abuse. Other professionals from the addiction sector will also be interviewed to assess if they consider these physicians as a support, and if the role played by GPs is sufficiently valued.

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    Prospective Intervention Study on the implementation of the GP sentry in Merksem, ZNA Palfijn. 31/12/2010 - 31/07/2011

    Abstract

    This research focusses on the implematation of an ouit of hours service in the fysical neighborhoud of a general hospital in Northern Antwerp. Data will be collected before its implementation to study future change of patient fluxes.

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    Scientific evaluation and monitoring of projects and supporting alternative forms of care for vulnerable elderly. 01/04/2010 - 31/03/2014

    Abstract

    In this poject we propose a scientific analysis and evaluation of projects that aim to facilitate to keep frail elderly in their homes in the national programme protocol 3. In protocol 3 the national health insurance organisation invests more tnah 40.000.000 euro in new health facilities to keep elderly in their homes whilst preserving and improving quality of life.

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    Improving and strenghtening quality for Family Medicine training in Ecuador, using capacity building and distance learning. 01/01/2010 - 31/12/2013

    Abstract

    The aim of the project is to improve Primary Health Care and Family Medicine (PHC/FM) in Ecuador. This will be achieved by training family physicians who contribute to primary interdisciplinary health care services, oriented towards the real needs of patients, their family and their community. For this the project has 3 dimensions: research, capacity building and extension. In the first phase, research will include defining indicators for PCH/FM and for medical education in Ecuador. Building, implementing and evaluating a PHC/FM oriented medical curriculum at the local partner university will increase the capacity and the performance of trained doctors on different levels: undergraduate, postgraduate and continuing Medical Education. In the project, 3 PhD will evaluate the effect of the renewal of the curriculum on different aspects, and will be trained and incorporated as teachers and researchers in health care areas, strenghtening the research capacity at the local and national level. Finally, networking will be essnetial to ensure the sustainability of the results of the project. This will include the dissemination of the results of our project towards the different involved stakeholders.

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    Objectives and indicators on the development of practical policies and multi-disciplinary care pathways for primary care. 01/07/2009 - 31/12/2011

    Abstract

    This project represents a formal research agreement between UA and on the other hand Federatie Palliatieve Zorg Vlaanderen. UA provides Federatie Palliatieve Zorg Vlaanderen research results mentioned in the title of the project under the conditions as stipulated in this contract.

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    Training practices for junior doctors: criteria for quality. 01/03/2009 - 28/02/2010

    Abstract

    This project is part of a larger project. Two questions are adressed. What is the current status of training practices for medical specialists in Belgium. A document analysis will be performed. What is known about the quality of traing practices and trainers? For this a systematic review of the literature will be performed.

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    Alternative forms of care and support - Protocol 3 Elderly. 01/12/2008 - 31/12/2009

    Abstract

    (more then 40.000.000 euro). The aim of this project is to make methods, choose instruments and to operationalise the projects for helping frail elderly to living at their homes within the framework of protocol three. protocol three is a national project aiming to find new avenues to keep elderly people in their homes whilst preserving and improving quality of life.

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    Advantages, disadvantages and feasibility of the introduction of programs in Belgium. 01/10/2008 - 30/09/2009

    Abstract

    The aim of the project is to deliver the state of the art concerning pay for quality in helath care. A systematic overview of the literature, a description of foreign countries and Belgium will be executed.

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    Cervicalgie: diagnosis and therapy. 01/08/2008 - 30/06/2009

    Abstract

    This study aims to review scientific literature on diagnosis and treatment of acute and chronic neck pain. The objective is to propose clinical guidelines to diagnose and treat patients who suffer from neck pain. The implentation of the final recommendations in Belgium will also be considered.

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    General Practice: motivations to choose for or to leave the profession. 19/09/2007 - 18/09/2008

    Abstract

    This project focusses on reasons to choose general practice in the undergraduate curriculum, and the reasons to leave practice among young general practitioners. Stakeholders interviews are performed.

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    Quality indicators for general medicine practioner's. 15/12/2006 - 15/12/2007

    Abstract

    The aim of the projcet is to introduce a framework for quality assurance in General Practice in Belgium. Indicators on organisation and clinical indicators will be used.

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    Case study of the intended, perceived and the learned curriculum of basic clinical skills of medical students at the University of Antwerp. 01/10/1996 - 31/12/1997

    Abstract

    In this project we will evaluate the educational situation concerning basic medical skills in the undergraduate course at the University of Antwerp. One cohort of students will be followed during the clinical part of the core curriculum. Five studies will be performed to gather data on the intended, taught and the learned curriculum using both quantitative and qualitative methods.

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