Om de onderzoeksvraag “Waar kan Rijkswaterstaat verantwoord doorgroeibare verhardingen toepassen op verzorgingsplaatsen?” te beantwoorden zijn de volgende methoden gebruikt: literatuuronderzoek, interviews met RWS-medewerkers, inventarisatie van voorbeelden uit praktijk met behulp van ClimateScan.nl.
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Objective To explore predictors of district nursing care utilisation for community-living (older) people in the Netherlands using claims data. To cope with growing demands in district nursing care, knowledge about the current utilisation of district nursing care is important. Setting District nursing care as a part of primary care. Participants In this nationwide study, claims data were used from the Dutch risk adjustment system and national information system of health insurers. Samples were drawn of 5500 pairs of community-living people using district nursing care (cases) and people not using district nursing care (controls) for two groups: all ages and aged 75+ years (total N=22 000). Outcome measures The outcome was district nursing care utilisation and the 114 potential predictors included predisposing factors (eg, age), enabling factors (eg, socioeconomic status) and need factors (various healthcare costs). The random forest algorithm was used to predict district nursing care utilisation. The performance of the models and importance of predictors were calculated. Results For the population of people aged 75+ years, most important predictors were older age, and high costs for general practitioner consultations, aid devices, pharmaceutical care, ambulance transportation and occupational therapy. For the total population, older age, and high costs for pharmaceutical care and aid devices were the most important predictors. Conclusions People in need of district nursing care are older, visit the general practitioner more often, and use more and/or expensive medications and aid devices. Therefore, close collaboration between the district nurse, general practitioner and the community pharmacist is important. Additional analyses including data regarding health status are recommended. Further research is needed to provide an evidence base for district nursing care to optimise the care for those with high care needs, and guide practice and policymakers’ decision-making.
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Introduction: From the patient and staff perspective, care delivery for patients experiencing a mental health problem in ambulance and emergency department (ED) settings is challenging. There is no uniform and internationally accepted concept to reflect people with a mental health problem who require emergency care, be it for, or as a result of, a mental health or physical health problem. On initial presentation to the emergency service provider (ambulance or ED), the cause of their healthcare condition/s (mental health and/or physical health) is often initially unknown. Due to this (1) the prevalence and range of underlying causes (mental and/or physical) of the patients presenting condition is unknown; (2) misattribution of physical symptoms to a mental health problem can occur and (3) diagnosis and treatment of the initial somatic complaint and cause(s) of the mental/physical health problem may be hindered.This study will name and define a new concept: 'mental dysregulation' in the context of ambulance and ED settings. Methods and analysis: A Delphi study, informed by a rapid literature review, will be undertaken. For the literature review, a steering group (ie, persons with lived experience, ED and mental health clinicians, academics) will systematically search the literature to provide a working definition of the concept: mental dysregulation. Based on this review, statements will be generated regarding (1) the definition of the concept; (2) possible causes of mental dysregulation and (3) observable behaviours associated with mental dysregulation. These statements will be rated in three Delphi rounds to achieve consensus by an international expert panel (comprising persons with lived experience, clinicians and academics). Ethics and dissemination: This study has been approved by the Medical Ethical Committee of the University of Applied Sciences Utrecht (reference number: 258-000-2023_Geurt van der Glind). Results will be disseminated via peer-reviewed journal publication(s), scientific conference(s) and to key stakeholders.
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Amsterdam is known worldwide for its historical beauty, liberal lifestyle and tolerant atmosphere. However, it risks becoming a victim of its own popularity. With fewer than one million residents, of whom less than 90 000 inhabit the inner city, Amsterdam received 8.3 million hotel guests in 2017 and is urgently searching for ways to better manage its immense popularity. In this article we will point to a different approach to sharing houses, namely FairBNB.
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The purpose of this study was to identify differences in traumatic and overuse injury incidence between talented soccer players who differ in the timing of their adolescent growth spurt. 26 soccer players (mean age 11.9 ± 0.84 years) were followed longitudinally for 3 years around Peak Height Velocity, calculated according to the Maturity Offset Protocol. The group was divided into an earlier and later maturing group by median split. Injuries were registered following the FIFA consensus statement. Mann-Whitney tests showed that later maturing players had a significantly higher overuse injury incidence than their earlier maturing counterparts both in the year before Peak Height Velocity (3.53 vs.0.49 overuse injuries/1 000 h of exposure,U = 49.50, z = − 2.049, p < 0.05) and the year of Peak Height Velocity (3.97 vs. 1.56 overuse injuries/1 000 h of exposure, U = 50.5, z = − 1.796,p < 0.05). Trainers and coaches should be careful with the training and match load they put on talented soccer players, especially those physically not (yet) able to handle that load. Players appear to be especially susceptible to injury between 13.5 and 14.5 years of age. Training and match load should be structured relative to maturity such that athletic development is maximized and the risk of injury is minimized.
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Purpose – This paper aims to examine the definition of corporate social responsibility (CSR) as propagated by ISO 26000, the global comprehensive guidance standard for CSR, compare it to and position it vis-à-vis other contemporary interpretations of CSR and formulate a critique on the standard’s definition of CSR. Methodology/Approach – This paper aims to examine the definition of CSR as propagated by ISO 26000, the global comprehensive guidance standard for CSR, compare it to and position it vis-à-vis other contemporary interpretations of CSR and formulate a critique on the standard’s definition of CSR. Findings – ISO 26000’s definition of CSR is ‘out of the ordinary' when compared to instrumental CSR definitions that are currently dominant, as it propagates an explicit moral perspective on corporate responsibilities towards society. While it resembles aspects of earlier definitions of CSR, this paper argues that the standard, being the end result of a global stakeholder dialogue, tries to make a strong plea for the return of morality in the CSR debate. Also, it is concluded that the ISO 26000 definition of CSR has several shortcomings, especially on the subject of corporate governance, which are addressed. Practical/implications – While the main gist of this paper is of a theoretical nature, it may have implications for practice as well. For instance, it may inform critical examinations of corporate commitments to CSR through adopting ISO 26000, and may inform future revisions of the standard. Originality/Value – This paper is the first to examine the ISO 26000 definition of CSR in a structured and detailed way.
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Musculoskeletal impact of haemophilia justifies physiotherapy throughout life. Recently the Dutch Health Care Institute constrained their ‘list of chronic conditions’, and withdrew financial coverage of physiotherapy for elderly persons with haemophilia (PWH). This decision was based on lack of scientific evidence and not being in accordance with ‘state of science and practice’. Methods In general, evidence regarding physiotherapy is limited, and especially in rare diseases like haemophilia. ‘Evidence based medicine’ classifies and recommends evidence based on meta‐analyses, systematic reviews and randomized controlled trials, but also means integrating evidence with individual clinical expertise. For the evaluation of physiotherapy – usually individualized treatment – case studies, observational studies and Case Based Reasoning may be more beneficial. Results Overall annual treatment costs for haemophilia care in the Netherlands are estimated over 100 million Euros, of which 95% is covered by clotting factor concentrates. The cost for physiotherapy assessments in all seven Dutch HTCs (seven centres for adult PWH and seven centres for children) is limited at approximately 500 000 Euros annually. Costs of the actual physiotherapy sessions, carried out in our Dutch first‐line care system, will also not exceed 500 000 Euros. Thus, implementation of physiotherapy in haemophilia care the Netherlands in a most optimal way would cost less than 1% of the total budget. Aim The present paper describes the role of physiotherapy in haemophilia care including available evidence and providing suggestions regarding generation of evidence. Establishing the effectiveness and cost‐effectiveness of physiotherapy in haemophilia care is a major topic for the next decennium.
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The relationship between project management and sustainable development is rapidly gaining interest from both practitioners and academics. Studies on the integration of the concepts of sustainability into project management, approach this topic mostly from a conceptual, logical or moral point of view. Given the fact that the relationship between sustainability and project management is still an emerging field of study, these approaches make sense. However, they do not diminish the need for more empirical studies to understand how the concepts of sustainable development are implemented in practice. This paper reports an analysis of 56 case studies on the integration of the concepts of sustainability in the way organizations initiate, develop and manage projects. The research question of the study was: To what extent, do organizations consider the concepts of sustainability in the initiation, development and management of projects? The study uses the maturity model for sustainability integration that was presented at the 2010 IPMA World Congress for the assessment of the level of sustainability consideration. The study found an overall average level of sustainability consideration in the actual situation of 25.9%. For the desired situation, this score is almost 10 percent higher, showing an ambition to take sustainability more into consideration. The study also showed that the way sustainability currently is considered, shows the traditional ‘less bad’ approach to sustainability integration and not a more modern social responsibility approach.
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This paper will describe the rationale and findings from a multinational study of online uses and gratifications conducted in the United States, Korea, and the Netherlands in spring 2003. A survey research method of study was conducted using a questionnaire developed in three languages and was presented to approximately 400 respondents in each country via the Web. Web uses and gratifications were analyzed cross-nationally in a comparative fashion and focused on the perceived involvement in different types of on-line communities. Findings indicate that demographic characteristics, cultural values, and Internet connection type emerged as critical factors that explain why the same technology is adopted differently. The analyses identified seven major gratifications sought by users in each country: social support, surveillance & advice, learning, entertainment, escape, fame & aesthetic, and respect. Although the Internet is a global medium, in general, web use is more local and regional. Evidence of media use and cultural values reported by country and online community supports the hypothesis of a technological convergence between societies, not a cultural convergence.
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Eindrappotage. De virusuitbraak en de maatregelen om die in te dammen, confronteert gezinnen met heel nieuwe uitdagingen. Door een beperking van hun sociale omgeving en fysieke leefruimte, zijn gezinnen noodgedwongen op zichzelf aangewezen. Ze zijn meer beperkt tot hun eigen woning en moeten (thuis)werk, thuisonderwijs en zorgtaken combineren. Ook kunnen er onzekerheden zijn over bijvoorbeeld gezondheid, werk- en financiële situatie en de maatschappelijke impact. Met dit onderzoek wordt onderzocht hoe gezinnen omgaan met de uitdagingen in deze coronatijd en hoe ze de inbreuk op hun normale leefomstandigheden ervaren. Op basis van die ervaringen worden conclusies en aandachtspunten geformuleerd voor de ondersteuning van gezinnen. Het doel van het onderzoek is tweeledig: • Zicht krijgen op een aantal thema’s (combinatie werk-gezin, gezinsfunctioneren, relatie grootouders-kleinkinderen) die aan het gezinsleven raken in deze coronatijd; • Aandachtspunten formuleren voor de ondersteuning van gezinnen.
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