Introduction: Shared decision-making is considered to be a key aspect of woman-centered care and a strategy to improve communication, respect, and satisfaction. This scoping review identified studies that used a shared decision-making support strategy as the primary intervention in the context of perinatal care. Methods: A literature search of PubMed, CINAHL, Cochrane Library, PsycINFO, and SCOPUS databases was completed for English-language studies conducted from January 2000 through November 2019 that examined the impact of a shared decision-making support strategy on a perinatal decision (such as choice of mode of birth after prior cesarean birth). Studies that only examined the use of a decision aid were excluded. Nine studies met inclusion criteria and were examined for the nature of the shared decision-making intervention as well as outcome measures such as decisional evaluation, including decisional conflict, decisional regret, and certainty. Results: The 9 included studies were heterogeneous with regard to shared decision-making interventions and measured outcomes and were performed in different countries and in a variety of perinatal situations, such as women facing the choice of mode of birth after prior cesarean birth. The impact of a shared decision-making intervention on women’s perception of shared decision-making and on their experiences of the decision-making process were mixed. There may be a decrease in decisional conflict and regret related to feeling informed, but no change in decisional certainty. Discussion: Despite the call to increase the use of shared decision-making in perinatal care, there are few studies that have examined the effects of a shared decision-making support strategy. Further studies that include antepartum and intrapartum settings, which include common perinatal decisions such as induction of labor, are needed. In addition, clear guidance and strategies for successfully integrating shared decision-making and practice recommendations would help women and health care providers navigate these complex decisions.
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An increasing share of light sports participants (e.g. self-organised runners) challenge traditional ‘Sport for All’ policy systems to target a more diversified array of people participating in sport and physical activity. The main aim of this article is to analyse whether light sport facilities, as a distinct local level policy intervention, can contribute to the goals of attracting ‘light’ and/or new sports participants with public means. The study is carried out in the context of a particular case of running facilities (i.e. bark running tracks, BRTs) in Flanders. The use of BRTs is investigated by structured face-to-face interviews with runners at the location of the BRT (n = 546; RR = 98.8%). The profile of users of BRTs is elaborated based on users’ characteristics (whether or not one started to run due to the provision of a BRT, the frequency and intensity of using the BRT) in bivariate logistic regression analysis. Next, reasons for using BRTs are investigated. It is concluded that BRTs mainly serve as a facility of the fragmented individualised society by reaching a large share of light sports participants (86%). However, it has the ability to reach runners at different levels, who show different patterns of using BRTs. It is suggested that so-called silent expectations in light facilities may function differently for different types of users. In this view, findings are discussed in order to identify policy implications related to Sport for All. …
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Purpose: This study aimed to develop and pretest a systematic conversation approach for nurses to tailor aftercare to oncology patient's goals, unmet needs and wishes. Methods: We used an iterative developmental process for complex interventions: 1. Identifying problems 2. Identifying overall objectives 3. Designing the intervention 4. Pretesting and adapting the intervention. Results: The main results of the problem identification were: non-systematic and incomplete screening of potential issues, caveats in providing information, and shared decision-making. The overall objective formulated was: To develop a model for aftercare conversations based on shared goal-setting and decision-making. The conversation approach consists of four phases: 1. Preparation of the consultation including a questionnaire, 2. Shared goal-setting by means of a tool visualizing domains of life, and 3. Shared care planning by means of an overview of possible choices in aftercare, a database with health care professionals and a cancer survivorship care plan. 4. Evaluation. The results of the pretest revealed that the conversation approach needs to be flexible and tailored to the patient and practice setting, and embedded in the care processes. The conversation approach was perceived as enhancing patient-centeredness and leading to more in-depth consultations. Conclusion: The conversation approach was developed in co-creation with stakeholders. The results of the pretest revealed important implications and suggestions for implementation in routine care. The aftercare conversation approach can be used by nurses to provide tailored patient-centered evidence-based aftercare. Tailored aftercare should support oncology patient's goals, unmet needs and wishes. Further tailoring is needed.
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IntroductionWithin the Entrepreneurship program at the Amsterdam University of Applied Sciences, there are a number of student start-ups that are developing inclusive, sustainable, and innovative solutions. We noticed that, during this process, they need to access certain facilities to develop a proof of concept or minimal viable product. When student start-ups tried to access facilities themselves, they found insufficient information about accessing facilities and contact persons. As Hui & Gerber (2017) stated that accessible facilities like a makerspace have a positive impact on the number of students who are embarking on the venture of a new business. Halbinger, (2020) states that there needs to be more research about university makerspaces in relation to the facilitation of student-entrepreneurship.
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Long-term care facilities are currently installing dynamic lighting systems with the aim to improve the well-being and behaviour of residents with dementia. The aim of this study was to investigate the implementation of dynamic lighting systems from the perspective of stakeholders and the performance of the technology. Therefore, a questionnaire survey was conducted with the management and care professionals of six care facilities. Moreover, light measurements were conducted in order to describe the exposure of residents to lighting. The results showed that the main reason for purchasing dynamic lighting systems lied in the assumption that the well-being and day/night rhythmicity of residents could be improved. The majority of care professionals were not aware of the reasons why dynamic lighting systems were installed. Despite positive subjective ratings of the dynamic lighting systems, no data were collected by the organizations to evaluate the effectiveness of the lighting. Although the care professionals stated that they did not see any large positive effects of the dynamic lighting systems on the residents and their own work situation, the majority appreciated the dynamic lighting systems more than the old situation. The light values measured in the care facilities did not exceed the minimum threshold values reported in the literature. Therefore, it seems illogical that the dynamic lighting systems installed in the researched care facilities will have any positive health effects.
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In recent years video game consoles, such as the Nintendo Wii™ and the Microsoft Kinect™, have been introduced into residential facilities. This paper presents a review of current studies documenting the benefits and detriments the Wii could have on adults aged 60 years and over in residential facilities, concentrating on the common uses of the Wii in care facilities: maintaining physical fitness, promoting mental well-being, encouraging social interaction and both physical and mental rehabilitation. Furthermore, this paper discusses the potential use of the Microsoft Kinect in care for older persons. The Wii can have a positive impact on the physical and mental health of older adults living in care facilities, but additional work should still be conducted, including assessing the use of games outside of Wii Sports and Wii Fit and possible non-gaming application of the Wii in care for older adults. Results for the Wii display potential for use of the Kinect in care facilities but further exploration is required to assess the potential physical impact and interaction viability.
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Background: An estimated 18 million people in the world have to cope with a decline in intellectual functioning that is not a normal part of the ageing process, called dementia. By 2025, this number is expected to reach 34 million. Alzheimer's disease accounts for 50-70 % of all cases of dementia. In the Netherlands, about two thirds of those affected live at home, with or without a partner. The increasing group of older adults with dementia presents great challenges in terms of creating suitable living environments and appropriate housing. Extramural housing needs further development, as opposed to intramural housing, such as nursery homes. The new extramural housing forms account for and compensate decreasing vitality and overall health status through the use of ICT and other technologies to serve human well-being. This should facilitate both residents and alleviate the intensity of care given by voluntary and professional care givers. In order to create these optimal dwellings at cost effective prices, evidence-based introduction of architectural measures and technological applications is essential. Existing knowledge is best viewed as an effort to expand and stimulate thinking on the relationships between dementia and design; thus, knowledge is largely a collection of hypotheses amenable to, and requiring, implementation and validation.This PhD-project will research some of the design aspects and needs, relevant to the technological home environment for older adults with dementia. This PhD project is shared with Hogeschool Utrecht, Lectureship of Demand Driven Care. Aim of research: Assessing thermal, lighting, and acoustic requirements, feasible home modifications and teleservices to sustain independence and well-being, both being the end product of all services rendered. Results so far indicate that requirements of older adults with dementia differ largely from the requirements of healthy older adults.
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In this paper we explore the influence of the physical and social environment (the design space) son the formation of shared understanding in multidisciplinary design teams. We concentrate on the creative design meeting as a microenvironment for studying processes of design communication. Our applied research context entails the design of mixed physical–digital interactive systems supporting design meetings. Informed by theories of embodiment that have recently gained interest in cognitive science, we focus on the role of interactive “traces,” representational artifacts both created and used by participants as scaffolds for creating shared understanding. Our research through design approach resulted in two prototypes that form two concrete proposals of how the environment may scaffold shared understanding in design meetings. In several user studies we observed users working with our systems in natural contexts. Our analysis reveals how an ensemble of ongoing social as well as physical interactions, scaffolded by the interactive environment, grounds the formation of shared understanding in teams. We discuss implications for designing collaborative tools and for design communication theory in general.
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Abstract: This study sought to provide insight into how art activities influence the well-being of long-term care residents, and how artists and caregivers collaborate in offering these activities. In two long-term care facilities for people with dementia and one for older people with chronic psychiatric disorders, an uncontrolled pre- and post-test study was conducted using a mixed-method design. Forty-six residents participated in the study. Three art activities—(a) dance, (b) music and movement, and (c) visual arts—were studied and co-created with the residents and executed by artists and caregivers together in eight to ten weeks. The Face expression scale (FACE) was used to examine the extent to which participating in the art activity influenced resident mood. Qualitative data were collected via group discussions with artists, caregivers, residents, and an informal caregiver. The results indicated that participating in an art activity positively influenced resident mood (p < 0.000). p-values for the three art activities were: p < 0.000 for dance, p = 0.048 for music and movement, and p = 0.023 for visual arts. The qualitative data revealed that joining an art activity provided a positive effect, increased social relationships, and improved self-esteem for residents. The collaboration between artists and caregivers stimulated creativity, beauty, and learning from each other, as well as evoking emotions.
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Europeans are living longer than ever in history, because of the economic growth and advances in hygiene and health care. Today, average life expectancy is over 80, and by 2020 around 25% of the population will be over 65. The increasing group of older people poses great challenges in terms of creating suitable living environments and appropriate housing facilities. The physical indoor environment plays an important role in creating fitting, comfortable and healthy domestic spaces. Our senses are the primary interface with the built environment. With biological ageing, a number of sensory changes occur as a result of the intrinsic ageing process in sensory organs and their association with the nervous system. These changes can in turn change the way we perceive the environment around us. It is important to understand these changes when designing for older occupants, for instance, care homes, hospitals and private homes, as well as office spaces given the developments in the domain of staying active at work until older age.
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