BACKGROUND: Nursing home residents are mainly inactive. Nursing staff can encourage residents to perform functional activities during daily care activities. This study examines 1) the extent to which nursing staff perceive that they encourage functional activity in nursing home residents and 2) the associations between these nursing behaviors and professional characteristics, contextual factors, and information-seeking behaviors. METHODS: In this cross-sectional study, 368 registered nurses and certified nurse assistants, working in somatic and psychogeriatric wards of forty-one nursing homes throughout the Netherlands participated. Self-reported data were collected with a questionnaire, comprising the MAINtAIN-behaviors, which assesses the extent to which nursing staff encourage functional activities, including different activities of daily living (ADL), household activities, and miscellaneous encouraging activities (e.g., discouraging informal caregivers from taking over activities residents can do themselves). Additional data collected included professional characteristics (e.g., age), contextual factors (e.g., ward type), and information-seeking behaviors (e.g., reading professional journals). Descriptive statistics were used to determine the extent to which functional activities were encouraged. Hierarchical linear regression analyses were performed to determine the associations between the encouragement of functional activities and other factors. RESULTS: Nursing staff perceived that household activities (mean 4.1 (scale range 1-9), SD 1.9) were less often encouraged than ADL (mean 6.9, SD 1.2) or miscellaneous activities (mean 6.7, SD 1.5). The percentage of nursing staff stating that different household activities, ADL, or miscellaneous activities were almost always encouraged ranged from 11 to 45%, 41 to 86%, and 50 to 83% per activity, respectively. The extent to which these activities were encouraged differed for some of the professional characteristics, contextual factors, or information-seeking behaviors, but no consistent pattern in associations emerged. CONCLUSIONS: According to nursing staff, household activities are not as often encouraged as ADL or miscellaneous activities. Professional characteristics, contextual factors, and information-seeking behaviors are not consistently associated with the encouragement of functional activity. Nursing staff should also focus on improving the encouragement of household activities. Future research could examine the role of other factors in encouraging functional activity, such as experienced barriers, and assess to what extent the perception of nursing staff corresponds with their actual behavior.
A growing number of older patients undergo cardiac surgery. Some of these patients are at increased risk of post-operative functional decline, potentially leading to reduced quality of life and autonomy, and other negative health outcomes. First step in prevention is to identify patients at risk of functional decline. There are no current published tools available to predict functional decline following cardiac surgery. The objective was to validate the identification of seniors at risk—hospitalised patients (ISAR-HP), in older patients undergoing cardiac surgery. A multicenter cohort study was performed in cardiac surgery wards of two university hospitals with follow-up 3 months after hospital admission. Inclusion criteria: consecutive cardiac surgery patients, aged ≥65. Functional decline was defined as a decline of at least one point on the Katz ADL Index at follow-up compared with preadmission status.
Given the substantial increase in children attending center-based childcare over the past decades, the consequences of center-based childcare for children’s development have gained more attention in developmental research. However, the relation between center-based childcare and children’s neurocognitive development remains relatively underexplored. The aim of this study was therefore to examine the relations between quantity of center-based childcare during infancy and the neurocognitive development (both functional brain networks and self-regulation) of 584 Dutch children. Small-world brain networks and children’s self-regulation were assessed during infancy (around 10 months of age) and the preschool period (2–6 years of age). The findings revealed that the quantity of center-based childcare during infancy was unrelated to individual differences in children’s functional brain networks. However, spending more hours per week in center-based childcare was positively related to the development of self-regulation in preschool age children, regardless of children’s sex or the levels of exposure to risk and maternal support in the home environment. More insight into the positive effects of center-based childcare on children’s development from infancy to toddlerhood can help to increase our insight into a better work–life balance and labor force participation of parents with young children. Moreover, this study highlights that Dutch center-based childcare offers opportunities to invest in positive child outcomes in children, including self-regulation.
The research proposal aims to improve the design and verification process for coastal protection works. With global sea levels rising, the Netherlands, in particular, faces the challenge of protecting its coastline from potential flooding. Four strategies for coastal protection are recognized: protection-closed (dikes, dams, dunes), protection-open (storm surge barriers), advancing the coastline (beach suppletion, reclamation), and accommodation through "living with water" concepts. The construction process of coastal protection works involves collaboration between the client and contractors. Different roles, such as project management, project control, stakeholder management, technical management, and contract management, work together to ensure the project's success. The design and verification process is crucial in coastal protection projects. The contract may include functional requirements or detailed design specifications. Design drawings with tolerances are created before construction begins. During construction and final verification, the design is measured using survey data. The accuracy of the measurement techniques used can impact the construction process and may lead to contractual issues if not properly planned. The problem addressed in the research proposal is the lack of a comprehensive and consistent process for defining and verifying design specifications in coastal protection projects. Existing documents focus on specific aspects of the process but do not provide a holistic approach. The research aims to improve the definition and verification of design specifications through a systematic review of contractual parameters and survey methods. It seeks to reduce potential claims, improve safety, enhance the competitiveness of maritime construction companies, and decrease time spent on contractual discussions. The research will have several outcomes, including a body of knowledge describing existing and best practices, a set of best practices and recommendations for verifying specific design parameters, and supporting documents such as algorithms for verification.
Mattresses for the healthcare sector are designed for robust use with a core foam layer and a polyurethane-coated polyester textile cover. Nurses and surgeons indicate that these mattresses are highly uncomfortable to patients because of poor microclimatic management (air, moisture, temperature, friction, pressure regulation, etc) across the mattress, which can cause pressure ulcers (in less than a day). The problem is severe (e.g., extra recovery time, medication, increased risk, and costs) for patients with wounds, infection, pressure-sensitive decubitus. There are around 180,000 waterproof mattresses in the healthcare sector in the Netherlands, of which yearly 40,000 mattresses are discarded. Owing to the rapidly aging population it is expected to increase the demand for these functional mattresses from 180,000 to 400,000 in the next 10 years in the healthcare sector. To achieve a circular economy, Dutch Government aims for a 50% reduction in the use of primary raw materials by 2030. As of January 1, 2022, mattress manufacturers and importers are obliged to pay a waste management contribution. Within the scope of this project, we will design, develop, and test a circular & functional mattress for the healthcare (cure & care) sector. The team of experts from knowledge institutes, SMEs, hospital(s), branch-organization joins hands to design and develop a functional (microclimate management, including ease of use for nurses and patients) mattress that deals with uncomfortable sleeping and addresses the issue of pressure ulcers thereby overall accelerating the healing process. Such development addresses the core issue of circularity. The systematic research with proper demand articulation leads to V-shape verification and validation research methodology. With design focus and applied R&D at TRL-level (4-6) is expected to deliver the validated prototype(s) offering SMEs an opportunity to innovate and expand their market. The knowledge will be used for dissemination and education at Saxion.
The clubfoot deformity is one of the most common congenital orthopaedic “conditions”. Worldwide approximately 100,000 children are born with unilateral or bilateral clubfoot every year. In the Netherlands the incidence is approximately 175 every year. This three dimensional deformity of the foot involves, equinus, varus, adductus, and cavus . Left untreated the clubfoot leads to deformity, functional disability and pain. Physical impairments of children with clubfoot might lead to limitations in activities and therefore impede a child’s participation. In clinical practice, the orthopaedic surgeon and physiotherapists are regularly consulted by (parents of) clubfoot patients for functional problems such as impaired walking and other daily activities. This does not only affect long-term and physical health of a child, it will also affect the development of social relationships and skills as well. Since walking is a main activity in children to be able to participate in daily life, our previous study (financially supported by SIA Raak Publiek) focussed on gait differences between children with clubfoot and controls. However, differences in gait characteristics do not necessarily lead to functional limitations and restricted participation. Therefore, providing insight in participation and a child’s performance in other activities than walking is necessary. Insight in a child’s participation will also indicate the functional outcome of the treatment, which on its turn could provide essential information concerning a possible relapse.. Early identification of a relapse is important since it could prevent the need for major surgical interventions. The occurrence of a relapse clubfoot will probably also lead to functional differences in the foot as well as problems during activity and participation. Therefore, the main focus of this study is the functional outcomes of physical activities and the characterisation of participation of children with clubfeet in daily activities of childhood.
