Search results

Children with Generalised Joint Hypermobility and Musculoskeletal Complaints: State of the Art on Diagnostics, Clinical Characteristics, and Treatment

INTRODUCTION: To provide a state of the art on diagnostics, clinical characteristics, and treatment of paediatric generalised joint hypermobility (GJH) and joint hypermobility syndrome (JHS).METHOD: A narrative review was performed regarding diagnostics and clinical characteristics. Effectiveness of treatment was evaluated by systematic review. Searches of Medline and Central were performed and included nonsymptomatic and symptomatic forms of GJH (JHS, collagen diseases).RESULTS: In the last decade, scientific research has accumulated on all domains of the ICF. GJH/JHS can be considered as a clinical entity, which can have serious effects during all stages of life. However research regarding the pathological mechanism has resulted in new potential opportunities for treatment. When regarding the effectiveness of current treatments, the search identified 1318 studies, from which three were included (JHS: n = 2, Osteogenesis Imperfecta: n = 1). According to the best evidence synthesis, there was strong evidence that enhancing physical fitness is an effective treatment for children with JHS. However this was based on only two studies.CONCLUSION: Based on the sparsely available knowledge on intervention studies, future longitudinal studies should focus on the effect of physical activity, fitness, and joint stabilisation. In JHS and chronic pain, the effectiveness of a multidisciplinary approach should be investigated.

Developing a viable business model for community owned solar farms in the Netherlands

The goal of this paper is twofold: i) to design a viable business model for community owned solar farms that will be setup in the north of the Netherlands. ii) To present the findings from this case study, and to propose generalisations that are relevant for the development of artefacts that can be used to facilitate the design of viable business models in a business ecosystem setting.USE 2015

A model of luxury lodge experience quality

Experience quality has been studied for many decades in various contexts. While understanding of experience quality has advanced, its context-specific and multi-dimensional nature has challenged its conceptualisation. With the rise of experiential accommodation in tourism and hospitality, luxury lodges have been increasingly recognised in the industry and by customers as the emblem of luxury experiences, albeit receiving limited scholarly attention. Through a qualitative multiple-case study methodology, utilising high-engagement research techniques, this study explores the dimensions and determinants of luxury lodge experience quality. The study presents an experience quality model grounded in empirical data, bridging various experience quality theoretical perspectives to explain the luxury lodge experience, and demonstrating generalisation capabilities for other service contexts. The study contributes to the ongoing discourse on experience quality, particularly in the context of small luxury accommodation. The study also offers important practical implications for luxury accommodation operators on designing, staging and managing quality experiences.

Clinimetrics: Assessment of generalised joint hypermobility: the Beighton score

The added value of therapist communication on the effect of physical therapy treatment in older adults; a systematic review and meta-analysis

ObjectiveLower physical activity levels in older adults are associated with increased co-morbidities and disability. Physical therapists have a critical role in facilitating increases in physical activity. The communication they use may impact their effectiveness. This study investigates the additional value of therapist’s communication during physical therapy on older adults’ physical activity levels. Methods Systematic review and meta-analysis. Clinical trials were identified in PubMed, CINAHL, Embase, PsycINFO, PEDro, Cochrane, up to July 2016. Communication was classified with the Behavior Change Taxonomy(BCT). Effect sizes were pooled using Cochrane’s Review-Manager. Strength of the evidence was analyzed using GRADE’s criteria. Results Twelve studies were identified. Overall, communication techniques revealed an immediate and long-term effect(ES:0.19;0.24) on self-reported physical activity measures but not on performance-based, with moderate to high strength of evidence. Divided in BCT-categories, only ‘Generalisation of target behavior’, defined as communication aimed to help patients generalise an exercise from one situation to another at home), had a positive effect on self-reported activity(ES:0.34), with low strength of evidence.Conclusion Adding a communication technique to physical therapy is effective on self-reported physical activity measures but not on performance-based measures.Practice implicationsAdd communication to exercise when treatment aims at perceived, but not performed, physical activity.

The added value of business models

An overview of innovations in a particular area, for example retail developments in the fashion sector (Van Vliet, 2014), and a subsequent discussion about the probability as to whether these innovations will realise a ‘breakthrough’, has to be supplemented with the question of what the added value is for the customer of such a new service or product. The added value for the customer must not only be clear as to its direct (instrumental or hedonic) incentives but it must also be tested on its merits from a business point of view. This requires a methodology. Working with business models is a method for describing the added value of products/services for customers in a systematic and structured manner. The fact that this is not always simple is evident from the discussions about retail developments, which do not excel in well-grounded business models. If there is talk about business models at all, it is more likely to concern strategic positioning in the market or value chain, or the discussion is about specifics like earning- and distribution-models (see Molenaar, 2011; Shopping 2020, 2014). Here we shall deal with two aspects of business models. First of all we shall look at the different perspectives in the use of business models, ultimately arriving at four distinctive perspectives or methods of use. Secondly, we shall outline the context within which business models operate. As a conclusion we shall distil a research framework from these discussions by presenting an integrated model as the basis for further research into new services and product.