The traditional paternalistic approach in health care is increasingly developing towards a patient-centered care (PCC) approach. However, not all patients are able to take advantage of the positive effects of PCC. Inadequate health literacy (HL) is an important limiting factor in the ability of patients to take on an active role and exchange information with their health care provider effectively. A provenly effective approach to improvement of provider-patient interaction and health outcomes is the use of health-related questionnaires. The aim of the research project described within this thesis was to adapt the most frequently-used questionnaire in Dutch physical therapy practice and add information and communication technology to it. A Dutch and Turkish version of the tool called Talking Touch Screen Questionnaire (TTSQ) was developed and evaluated on both usability and validity aspects. The current prototype of the tool does not yet fully solve the problems native and minority patients with low (health) literacy have with completing the adapted questionnaire. Big challenges in future development and testing the TTSQ are the recruitment of vulnerable members of the hard-to-reach native and minority target populations and finding research methods that suit the abilities and needs of these participants. This is expected to be a very challenging, labor- and time-consuming process. On the other hand, having a usable, valid and reliable TTSQ may well save a lot of time and money in both research and clinical practice in the future.
The traditional paternalistic approach in health care is increasingly developing towards a patient-centered care (PCC) approach. However, not all patients are able to take advantage of the positive effects of PCC. Inadequate health literacy (HL) is an important limiting factor in the ability of patients to take on an active role and exchange information with their health care provider effectively. A provenly effective approach to improvement of provider-patient interaction and health outcomes is the use of health-related questionnaires. The aim of the research project described within this thesis was to adapt the most frequently-used questionnaire in Dutch physical therapy practice and add information and communication technology to it. A Dutch and Turkish version of the tool called Talking Touch Screen Questionnaire (TTSQ) was developed and evaluated on both usability and validity aspects. The current prototype of the tool does not yet fully solve the problems native and minority patients with low (health) literacy have with completing the adapted questionnaire. Big challenges in future development and testing the TTSQ are the recruitment of vulnerable members of the hard-to-reach native and minority target populations and finding research methods that suit the abilities and needs of these participants. This is expected to be a very challenging, labor- and time-consuming process. On the other hand, having a usable, valid and reliable TTSQ may well save a lot of time and money in both research and clinical practice in the future.
Banana is an important commercial fruit crop for smallholder farmers in Arba Minch, southern Ethiopia. However, its sector is experiencing many constraints and limited attention given to productivity and marketing. Therefore, this study was conducted to analyze the banana value chain in order to identify constraints on productivity and marketing, and possibilities of improvements towards a sustainable value chain in Arba Minch. Data were collected through a survey, key informants’ interviews, and focus group discussions. Different analytical and statistical tools were used for data analysis. Results describe actors, supporters, and influencers of the existing banana chain. The current banana chain has three different distribution channels in Arba Minch. The channel that connects with rural consumers has the highest value share for farmers while the channel that includes traveling traders has the lowest value share for farmers. The marketing cooperative channel has an intermediate value share for farmers in the chain. Poor agronomic practice, diseases, pests, and climate change were the major constraints for the banana yield while limited market information, lack of cold store and refrigerated trucks, poor post-harvest handling, lack of alternative markets, and weak capacity of cooperatives were the main constraints for banana marketing in Arba Minch. Economic, social and environmental indicators have a moderate sustainability performance within the Ethiopian context. The chain has an advantage in terms of profitability, employment, emission of air pollutants and constraints in terms of coordination, value share, profit margin, market diversity, product and market information, transportation, waste management, and safety and hygiene.
MULTIFILE
