Background: Osteoarthritis (OA) is the most common rheumatic disease of the musculoskeletal system, with the knee as the most affected joint. The number of people with OA of the knee is likely to increase due to the ageing society and the obesity epidemic. The predominant clinical symptom of knee OA is pain, which is described as worsening by activity and relieving by rest. Knee instability has been recognized as an important clinical feature in persons with knee OA. Pain and knee instability are associated with limitations in performing daily activities. Non-pharmacological options in the management of knee OA consist of education, weight loss, exercise, braces and physical therapy. Knee bracing has been recommended by the Osteoarthritis Research Society International (OARSI). Valgus knee braces designed to decrease loads on the medial compartment of the knee for patients with varus alignment are the most common. It has been shown however, that valgus bracing may have little or no effect on pain and physical functioning, and adherence to this treatment in patients with knee OA is low.Because of ease of use and access, lack of complications and low cost, soft knee braces are commonly used in persons with knee OA. However, the evidence for efficacy of soft knee bracing on pain and activity limitations in knee OA is limited. Therefore, it is important to strengthen the evidence of using a soft brace to reduce pain and activity limitations as well as to evaluate the efficacy of soft knee bracing on knee instability in persons with knee OA. There is also debate about the effectiveness of soft braces in other affected joints of the lower extremity and in conditions other than OA such as rheumatoid arthritis.Objectives: The aim of the study will be to evaluate the effect of wearing a soft brace on dynamic knee instability in patients with OA of the knee.Methods: Persons with knee OA and self-reported knee instability from the Amsterdam Osteoarthritis cohort participated in a single-session lab-experimental study. A within-subject design was used, comparing no brace versus brace, and comparing a non-tight versus a tight brace (standard fit). The primary outcome measure was dynamic knee instability, expressed by the Perturbation Response (PR), i.e., a biomechanics based measure reflecting deviation in the mean knee varus-valgus angle after a controlled mechanical perturbation, standardized to the mean (SD) varus-valgus angle during level walking. Linear mixed-effect model analysis was used to evaluate the effect of a brace on dynamic knee instability.Results: The wearing of a soft brace reduced the knee instability significantly during perturbed walking. Results will also be presented from the literature search and from the lab-experimental study.Conclusion: Wearing a soft brace reduces dynamic knee instability in patients with knee OA. However, longitudinal studies are needed to evaluate the clinical implications of wearing a soft brace.
DOCUMENT
Counting the costs of a certain condition such as Spina Bifida in an economic breeding farm is absurd. We are all consumers that keep the economic engines running, no matter if we are obese, or anorectics, if we do sport or if we don 't, or if we have SB as a condition, or not. Of course, there are necessary costs for SB (surgery, sometimes lifelong incontinence materials, adapted braces, etc.). But for every person, lifelong costs are incurred: food, clothing, entertainment, education, etc. Living with a disease is therefore "fuelling" the economic engine of progress. Consequently, costs cannot be calculated without taking into account the benefits (health care workers earning a living, production of new treatments and materials, etc.). The economic value of lifestyle gurus, magazines and gyms would evaporate immediately if healthy behaviour was self-evident. It’s absurd to opt for life or abortion on the basis of an economic argument. Besides, extra care and costs can only be estimated on average, and therefore do not necessarily apply to the individual in the uterus of the tested mother. Nothing is what it seems!
MULTIFILE
BACKGROUND: Ambulatory children with Spina Bifida (SB) often show a decline in physical activity leading to deconditioning and functional decline. Therefore, assessment and promotion of physical activity is important. Because energy expenditure during activities is higher in these children, the use of existing pediatric equations to predict physical activity energy expenditure (PAEE) may not be valid. AIMS: (1) To evaluate criterion validity of existing predictions converting accelerocounts into PAEE in ambulatory children with SB and (2) to establish new disease-specific equations for PAEE. METHODS: Simultaneous measurements using the Actical, the Actiheart, and indirect calorimetry took place to determine PAEE in 26 ambulatory children with SB. DATA ANALYSIS: Paired T-tests, Intra-class correlations limits of agreement (LoA), and explained variance (R2) were used to analyze validity of the prediction equations using true PAEE as criterion. New equations were derived using regression techniques. RESULTS: While T-tests showed no significant differences for some models, the predictions developed in healthy children showed moderate ICC’s and large LoA with true PAEE. The best regression models to predict PAEE were: PAEE = 174.049 + 3.861 × HRAR – 60.285 × ambulatory status (R2 = 0.720) and PAEE = 220.484 + 0.67 × Actical counts – 60.717 × ambulatory status (R2 = 0.681). CONCLUSIONS: Existing equations to predict PAEE are not valid for use in children with SB for the individual evaluation of PAEE. The best regression model was based on HRAR in combination with ambulatory status, followed by a new model for the Actical monitor. A benefit of HRAR is that it does not require the use of expensive accelerometry equipment. Further cross-validation of these models is still needed.
DOCUMENT
The childhood form of discitis was diagnosed in a 2-year-old girl and a 5-year-old boy. They presented with an antalgic posture, muscular defense and a positive Gowers sign. Characteristic symptoms of this childhood discitis form the triad: unexplained fever, increased erythrocyte sedimentation rate and symptomatic narrowing of an intervertebral space.
DOCUMENT
From the article: "Axiomatic Design and Complexity Theory as described by Suh focus heavily on the coupling often found in functional requirements. This is so fundamental to the analysis of the design that it is the core of the Axiom of Independence which examines the coupling between functional requirements due to chosen design parameters. That said, the mapping between customer needs and functional requirements is often overlooked. In this paper we consider coupling, found due to this mapping, as a possible source of complexity in terms of a user interface to a designed product. We also re-examine the methodology of how customer needs are generated and translated into the other domains to understand how they can give further insight into the customer mindset. Based on this analysis, we believe customer domain complexity should always be examined in design that includes end-user interaction."
MULTIFILE
In BMC Oral Health verscheen het volgende artikel van Inholland-docente en promovenda Janneke Scheerman (en collega’s). Background: Adolescents with fixed orthodontic appliances are at high risk of developing dental caries. To date, new smartphone technologies have seldom been used to support them in the preventive behavior that can help prevent dental caries. After an intervention-mapping process, we developed a smartphone application (the WhiteTeeth app) for preventing dental caries through improved oral-health behavior and oral hygiene. The app, which is intended to be used at home, will help adolescents with fixed orthodontic appliances perform their oral self-care behavior. The app is based on the Health Action Process Approach (HAPA) theory, and incorporates several behavior-change techniques that target the psychosocial factors of oral-health behavior. This article describes the protocol of a randomized controlled trial (RCT) to evaluate the effects of the WhiteTeeth app on oral-health behavior and oral-hygiene outcomes (presence of dental plaque and gingival bleeding) compared with those of care as usual, in patients aged 12–16 with fixed orthodontic appliances.
DOCUMENT
Met dit manifest worden professionals, en met name zij die het leren van anderen begeleiden en organiseren, meenemen in het belang en de werking van ontwikkelidentiteit en een kleine opmaat geven in hoe hiermee te werken. Je ontwikkelidentiteit is dat wat je leren en ontwikkelen (vorm en inhoud) onvervreemdbaar kleur geeft op de verbinding van wie je bent en de context waarin je je bevindt. Wanneer iemand meer inzicht heeft in zijn ontwikkelidentiteit, kan hij beter sturing geven aan zijn leren en ontwikkelen. Je wordt meegenomen langs het ontstaan van ontwikkelidentiteit, hoe dit raakt aan allerlei bewegingen op team, organisatie en maatschappelijk niveau en hoe je je eigen ontwikkelidentiteit kan verkennen. Er wordt afgesloten met een aantal aandachtspunten en denkrichtingen voor wat ons staat te doen als we er meer recht aan willen doen. Bij dit manifest zijn ook dialoogkaarten, genaamd Ons Ontwikkelen Ontward (2022), ontwikkeld die helpen om je ontwikkelidentiteit onder de loep te nemen.
DOCUMENT
This dissertation increases our insight into the role of the service employee’s intercultural competences in the service to culturally diverse customers. Investigating the effect of the intercultural competences of service employees is of major importance because, as a consequence of globalization, the number of intercultural service encounters has increased dramatically and still does. The delivery of service to a culturally diverse customer-base requires a combination of knowledge, skills and attitude; the intercultural competences (also known as Global Mindset). In this study the hotel sector has been investigated specifically. The hotel sector is an important economic player that continues to grow inspite of economic downturn. The special characteristics of hotel services make the sector also very suitable for the research of face-to-face encounters in an international context. In this dissertation, a holistic approach has been chosen, meaning that in the four empirical studies not only the perspective of the manager, but also that of the employee and the customer was investigated. All three of the above-mentioned are actors in intercultural service according to the argumentation of the ‘service-profit chain’ (Heskett, Jones, et al., 1994). Together, the manager, employee and the customer form the so-called ‘service triangle’ (Bitner, 1990).
DOCUMENT
Background: The objective of this study was to derive evidence-based physical activity guidelines for the general Dutch population. Methods: Two systematic reviews were conducted of English language meta-analyses in PubMed summarizing separately randomized controlled trials and prospective cohort studies on the relation between physical activity and sedentary behaviour on the one hand and the risk of all-cause mortality and incidence of 15 major chronic diseases and conditions on the other hand. Other outcome measures were risk factors for cardiovascular disease and type 2 diabetes, physical functioning, and fitness. On the basis of these reviews, an expert committee derived physical activity guidelines. In deriving the guidelines, the committee first selected only experimental and observational prospective findings with a strong level of evidence and then integrated both lines of evidence. Results: The evidence found for beneficial effects on a large number of the outcome measures was sufficiently strong to draw up guidelines to increase physical activity and reduce sedentary behaviour, respectively. At the same time, the current evidence did not provide a sufficient basis for quantifying how much physical activity is minimally needed to achieve beneficial health effects, or at what amount sedentary behaviour becomes detrimental. A general tenet was that at every level of current activity, further increases in physical activity provide additional health benefits, with relatively larger effects among those who are currently not active or active only at light intensity. Three specific guidelines on (1) moderate- and vigorous-intensity physical activity, (2) bone- and musclestrengthening activities, and (3) sedentary behaviour were formulated separately for adults and children. Conclusions: There is an unabated need for evidence-based physical activity guidelines that can guide public health policies. Research in which physical activity is measured both objectively (quantity) and subjectively (type and quality) is needed to provide better estimates of the type and actual amount of physical activity required for health.
DOCUMENT
Although the attention for neurodiversity in human resource management (HRM) is growing, neurodivergent individuals are still primarily supported from a deficit-oriented paradigm, which points towards individuals' deviation from neurotypical norms. Following the HRM process model, our study explored to what extent a strengths-based HRM approach to the identification, use, and development of strengths of neurodivergent groups is intended, implemented, and perceived in organizations. Thirty participants were interviewed, including HRM professionals (n=15), supervisors of neurodivergent employees (n=4), and neurodivergent employees (n=11). Our findings show that there is significant potential in embracing the strengths-based approach to promote neurodiversity-inclusion, for instance with the use of job crafting practices or (awareness) training to promote strengths use. Still, the acknowledgement of neurodivergent individuals' strengths in the workplace depends on the integration of the strengths-based approach into a supportive framework of HR practices related to strengths identification, use, and development. Here, particular attention should be dedicated to strengths development for neurodivergent employees (e.g., optimally balancing strengths use). By adopting the strengths-based HRM approach to neurodiversity as a means of challenging the ableist norms of organizations, we add to the HRM literature by contributing to the discussion on how both research and organizations can optimally support an increasingly diverse workforce by focusing on individual strengths
DOCUMENT
