Working at the nexus between public health policy, practice and research : dynamics of knowledge sharing in the Netherlands

BackgroundJoining the domains of practice, research and policy is an important aspect of boosting the quality performance required to tackle complex public health problems. “Joining domains” implies a departure from the linear and technocratic knowledge-translation approach. Integrating the practice, research and policy triangle means knowing its elements, appreciating the barriers, identifying possible cooperation strategies and studying strategy effectiveness under specified conditions.This article examines the dynamic process of developing an Academic Collaborative Centre for Public Health in the Netherlands, with the objective of achieving that the three domains of policy, practice and research become working partners on an equal footing.MethodAn interpretative hermeneutic approach was used to interpret the phenomenon of collaboration at the nexus between the three domains. The project was explicitly grounded in current organizational culture and routines, applied to nexus action. In the process of examination, we used both quantitative (e.g. records) and qualitative data (e.g., interviews and observations). The data were interpreted using the Actor-Network, Institutional Re-Design and Blurring the Boundaries theories.ResultsResults show commitment at strategic level. At the tactical level, however, managers were inclined to prioritize daily routine, while the policy domain remained absent. At the operational level, practitioners learned to do PhD research in real-life practice and researchers became acquainted with problems of practice and policy, resulting in new research initiatives.ConclusionWe conclude that working at the nexus is an ongoing process of formation and reformation. Strategies based on Institutional Re-Design theories in particular might help to more actively stimulate managers’ involvement to establish mutually supportive networks

Academic Collaborative Centre Limburg: A platform for knowledge transfer and exchange in public health policy, research and practice?

Research findings often fail to find their way into policy and practice, which is assumed to limit the effectiveness of public health policies and programmes. We evaluated to what extent the Academic Collaborative Centre Limburg (ACCL), a Dutch boundary organization linking policy, research and practice, has improved knowledge transfer and exchange between the three domains. We used a mixed-methods approach. First, stakeholders jointly defined the ACCL's programme theory, showing how the ACCL was supposed to achieve its intended effects. Second, we assessed the achievements of the ACCL in terms of knowledge transfer and exchange on the basis of the programme theory. The ACCL was found to provide a platform for interaction between actors from the policy, research and practice domains, facilitated by integrated network structures. The number of collaborative projects and actors involved in the ACCL increased, but actual cross-domain interaction patterns did not really change. Cross-domain knowledge transfer and exchange still require major boundary-spanning efforts by the ACCL programme leader. Boundary organizations do not automatically produce cross-domain interactions. In addition to infrastructural arrangements, cross-domain knowledge transfer and exchange could benefit from additional cultural changes, like adopting a deliberative approach to policy making and applying constructivist research designs. (C) 2013 Elsevier Ireland Ltd. All rights reserve

Lokaal gezondheidsbeleid: een beleidsentrepreneur voor integraal beleid

De overheid heeft onder meer tot taak de gezondheid van nederlanders te bevorderen en beschermen. Ook gemeenten delen in die rol. Elke vier jaar legt de gemeente in een beleidsplan vast vanuit welke visie en met welke acties dit gebeurt. De ggd heeft op dit gebied een adviserende rol

Working at the nexus between public health policy, practice and research. Dynamics of knowledge sharing in the Netherlands

Abstract Background Joining the domains of practice, research and policy is an important aspect of boosting the quality performance required to tackle complex public health problems. “Joining domains” implies a departure from the linear and technocratic knowledge-translation approach. Integrating the practice, research and policy triangle means knowing its elements, appreciating the barriers, identifying possible cooperation strategies and studying strategy effectiveness under specified conditions. This article examines the dynamic process of developing an Academic Collaborative Centre for Public Health in the Netherlands, with the objective of achieving that the three domains of policy, practice and research become working partners on an equal footing. Method An interpretative hermeneutic approach was used to interpret the phenomenon of collaboration at the nexus between the three domains. The project was explicitly grounded in current organizational culture and routines, applied to nexus action. In the process of examination, we used both quantitative (e.g. records) and qualitative data (e.g., interviews and observations). The data were interpreted using the Actor-Network, Institutional Re-Design and Blurring the Boundaries theories. Results Results show commitment at strategic level. At the tactical level, however, managers were inclined to prioritize daily routine, while the policy domain remained absent. At the operational level, practitioners learned to do PhD research in real-life practice and researchers became acquainted with problems of practice and policy, resulting in new research initiatives. Conclusion We conclude that working at the nexus is an ongoing process of formation and reformation. Strategies based on Institutional Re-Design theories in particular might help to more actively stimulate managers’ involvement to establish mutually supportive networks.</p

De novo variants in TCF7L2 are associated with a syndromic neurodevelopmental disorder

TCF7L2 encodes transcription factor 7-like 2 (OMIM 602228), a key mediator of the evolutionary conserved canonical Wnt signaling pathway. Although several large-scale sequencing studies have implicated TCF7L2 in intellectual disability and autism, both the genetic mechanism and clinical phenotype have remained incompletely characterized. We present here a comprehensive genetic and phenotypic description of 11 individuals who have been identified to carry de novo variants in TCF7L2, both truncating and missense. Missense variation is clustered in or near a high mobility group box domain, involving this region in these variants' pathogenicity. All affected individuals present with developmental delays in childhood, but most ultimately achieved normal intelligence or had only mild intellectual disability. Myopia was present in approximately half of the individuals, and some individuals also possessed dysmorphic craniofacial features, orthopedic abnormalities, or neuropsychiatric comorbidities including autism and attention-deficit/hyperactivity disorder (ADHD). We thus present an initial clinical and genotypic spectrum associated with variation in TCF7L2, which will be important in informing both medical management and future research