Aim: The prevalence of age‐related malnutrition is increasing in almost all Western countries. Because of their expertise, dietitians should have a central role in the management of malnutrition. This review aimed to synthesise the literature on the role of the dietitian in the management of malnutrition in the elderly in comparison with other health professionals. Methods: In November 2018, a search of Embase, Medline Ovid, Cinahl Ebscohost, Cochrane Central, Web of Science and Google Scholar was undertaken using ‘dietitian’, ‘elderly’ and ‘malnutrition’ as the main search terms. Qualitative and quantitative empirical research studies that focussed on the role of dietitians as the (main) subject of the study were included. Data extraction and data synthesis were performed by the three authors using a thematic synthesis approach. Results: Three themes emerged from the coding and synthesis of the 21 included studies. The first theme demonstrates that other health professionals' time for, and knowledge of, screening policies negatively affects the role of the dietitian. The second theme demonstrates that the importance of nutritional care is acknowledged. However, this does not always imply familiarity with dietetics nor does it always mean that other health professionals think involving dietitians is worth the effort. The third theme demonstrates that issues of workload appeared to be especially important in crossing or guarding role boundaries. Conclusions: The role of dietitians in managing age‐related malnutrition is not always clear and coherent. Therefore, how dietitians shape their role to provide optimal management of malnutrition in the elderly is open to debate. https://doi.org/10.1111/1747-0080.12546 LinkedIn: https://www.linkedin.com/in/matthijs-fleurke-66279110/ https://www.linkedin.com/in/dorien-voskuil-9b27b115/
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Abstract Introduction: In 2017, the role of coordinating practitioner was introduced in the Netherlands in order to improve quality of care for patients who receive treatment in specialized mental health care. Psychiatric-mental health nurse practitioners (PMHNPs) can fulfil this role. Aim/Question: The aim was to obtain insight into how PMHNPs fulfil the coordinating practitioner role and what is needed to improve fulfilment of this role. Method: A survey among PMHNPs in the Netherlands was conducted between July-September 2018. In total, 381 PMHNP filled out the questionnaire; the response rate was 47.6%. Descriptive analyses were performed using SPSS 22® (IBM). Results: 92% Of the PMHNPs fulfilled the coordinating practitioner role and were generally satisfied with their role performance. The following conditions were formulated to improve this role: 1) recognition and trust in the expertise of PMHNPs, 2) a clear description of their role as coordinating practitioner, 3) strengthening multidisciplinary collaboration, and 4) sufficient training budget and opportunities. Discussion: In Dutch mental health care, PMHNPs have strengthened their position as coordinating practitioner in a short period of time. Follow-up research should be conducted to obtain further insights into elements that contribute to an optimal role as coordinating practitioner. Implications for Practice: Having PMHNPs act as coordinating practitioners can contribute to solving the challenges in mental health care regarding coordination of care and effective multidisciplinary collaboration.
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Background: The dynamics of maternal and newborn care challenge midwifery education programs to keep up-to-date. To prepare for their professional role in a changing world, role models are important agents for student learning. Objective: To explore the ways in which Dutch and Icelandic midwifery students identify role models in contemporary midwifery education. Methods: We conducted a descriptive, qualitative study between August 2017 and October 2018. In the Netherlands, 27 students participated in four focus groups and a further eight in individual interviews. In Iceland, five students participated in one focus group and a further four in individual interviews. All students had clinical experience in primary care and hospital. Data were analyzed using inductive content analysis. Results: During their education, midwifery students identify people with attitudes and behaviors they appreciate. Students assimilate these attitudes and behaviors into a role model that represents their ‘ideal midwife’, who they can aspire to during their education. Positive role models portrayed woman-centered care, while students identified that negative role models displayed behaviors not fitting with good care. Students emphasized that they learnt not only by doing, they found storytelling and observing important aspects of role modelling. Students acknowledged the impact of positive midwifery role models on their trust in physiological childbirth and future style of practice. Conclusion: Role models contribute to the development of students’ skills, attitudes, behaviors, identity as midwife and trust in physiological childbirth. More explicit and critical attention to how and what students learn from role models can enrich the education program.
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Het lopen van een marathon wordt steeds populairder. Naast de vele positieve gezondheidseffecten van duurinspanning, kan duurinspanning ook gepaard gaan met maagdarmklachten. Zo’n 30-90% van de hardlopers heeft last van maagdarmklachten tijdens of in de uren na het hardlopen. Het ontstaan van maagdarmklachten heeft waarschijnlijk te maken met de herverdeling van het bloedvolume, resulterend in minder bloedtoevoer naar het spijsverteringskanaal en een minder goed functionerende darmbarrière. Doordat de darmbarrière minder goed functioneert kunnen er ongewenste stoffen (endotoxinen) de bloedbaan intreden en voor ontstekingsreacties zorgen. De vele micro-organismen in onze darm, gezamenlijk onze darmmicrobiota genoemd, zijn van invloed op de voedselvertering, maar ook op het functioneren van de cellen die de darmwand bekleden en de verbindingen tussen deze cellen. Mogelijk hebben hardlopers met maagdarmklachten tijdens duurinspanning te maken met een afwijkende samenstelling van de darmmicrobiota en/of metabolieten ten opzichte van hardlopers zonder klachten, waardoor de darmbarrière minder goed functioneert en er problemen kunnen optreden. Vandaar dat het voornaamste doel van ons onderzoeksproject is om te onderzoeken of er een relatie bestaat tussen de samenstelling van de darmmicrobiota en/of metabolieten en het ontstaan van maagdarmklachten tijdens duurinspanning. De onderzoeksvragen die zullen worden bestudeerd zijn: 1) Verschilt de samenstelling van de darmmicrobiota en/of metabolieten van hardlopers die wel en niet last krijgen van maagdarmklachten tijdens het lopen van een marathon? En zo ja, hoe? 2) Kan de samenstelling van de darmmicrobiota en/of metabolieten van getrainde sporters die maagdarmklachten ervaren tijdens duurinspanning positief beïnvloed worden door probiotica-suppletie, zodat de kans op en/of intensiteit van maagdarmklachten tijdens duurinspanning wordt verminderd en de sportprestatie verbeterd? Het onderzoeksproject richt zich op de identificatie van sporters die last hebben van maagdarmklachten tijdens duurinspanning. We hopen met de beoogde resultaten bij te kunnen dragen aan op de persoon gerichte preventie van maagdarmklachten door het aanpassen van de darmmicrobiota.
Diverse partijen, zowel marktpartijen als kennisinstellingen, gaan in 2020 samenwerken in een pilot om te toetsen in hoeverre zij de plant kardoen (familie van de artisjok distel) in haar volle potentieel kunnen gebruiken voor diverse commerciële doeleinden, zoals bloemen, voedsel, composiet en een lamp. Er wordt in deze pilot onderzoek gedaan naar: - Gebruik van reststromen als bodemverbeteraar - Teelt van kardoen - Verwerking van kardoen
Recycling of plastics plays an important role to reach a climate neutral industry. To come to a sustainable circular use of materials, it is important that recycled plastics can be used for comparable (or ugraded) applications as their original use. QuinLyte innovated a material that can reach this goal. SmartAgain® is a material that is obtained by recycling of high-barrier multilayer films and which maintains its properties after mechanical recycling. It opens the door for many applications, of which the production of a scoliosis brace is a typical example from the medical field. Scoliosis is a sideways curvature of the spine and wearing an orthopedic brace is the common non-invasive treatment to reduce the likelihood of spinal fusion surgery later. The traditional way to make such brace is inaccurate, messy, time- and money-consuming. Because of its nearly unlimited design freedom, 3D FDM-printing is regarded as the ultimate sustainable technique for producing such brace. From a materials point of view, SmartAgain® has the good fit with the mechanical property requirements of scoliosis braces. However, its fast crystallization rate often plays against the FDM-printing process, for example can cause poor layer-layer adhesion. Only when this problem is solved, a reliable brace which is strong, tough, and light weight could be printed via FDM-printing. Zuyd University of Applied Science has, in close collaboration with Maastricht University, built thorough knowledge on tuning crystallization kinetics with the temperature development during printing, resulting in printed products with improved layer-layer adhesion. Because of this knowledge and experience on developing materials for 3D printing, QuinLyte contacted Zuyd to develop a strategy for printing a wearable scoliosis brace of SmartAgain®. In the future a range of other tailor-made products can be envisioned. Thus, the project is in line with the GoChem-themes: raw materials from recycling, 3D printing and upcycling.
Lectorate, part of NHL Stenden Hogeschool
