Boek over aids en de bestaansethiek van Foucault.
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Diadema sea-urchins play a vital role in maintaining a balanced coral reef ecosystem and their restoration is essential to assist recovery of the degraded coral reefs around Saba and St. Eustatius. A collaborative effort between University of Applied Sciences Van Hall Larenstein, WUR, STENAPA, CNSI and NIOZ studied settlement rates of sea-urchin larvae. The new findings provide insight into why the Diadema population has not been restored since the massive die-off in the mid 1980’s and are important for developing and implementing effective sea urchin restoration projects.
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Background: Patient decision aids (PDAs) can support the treatment decision making process and empower patients to take a proactive role in their treatment pathway while using a shared decision-making (SDM) approach making participatory medicine possible. The aim of this study was to develop a PDA for prostate cancer that is accurate and user-friendly. Methods: We followed a user-centered design process consisting of five rounds of semi-structured interviews and usability surveys with topics such as informational/decisional needs of users and requirements for PDAs. Our userbase consisted of 8 urologists, 4 radiation oncologists, 2 oncology nurses, 8 general practitioners, 19 former prostate cancer patients, 4 usability experts and 11 healthy volunteers. Results: Informational needs for patients centered on three key factors: treatment experience, post-treatment quality of life, and the impact of side effects. Patients and clinicians valued a PDA that presents balanced information on these factors through simple understandable language and visual aids. Usability questionnaires revealed that patients were more satisfied overall with the PDA than clinicians; however, both groups had concerns that the PDA might lengthen consultation times (42 and 41%, respectively). The PDA is accessible on http://beslissamen.nl/. Conclusions: User-centered design provided valuable insights into PDA requirements but challenges in integrating diverse perspectives as clinicians focus on clinical outcomes while patients also consider quality of life. Nevertheless, it is crucial to involve a broad base of clinical users in order to better understand the decision-making process and to develop a PDA that is accurate, usable, and acceptable.
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Existing methods for risk assessment for medical aids are being surpassed by the rapid rise and availability of apps, serious games and online e-health applications. There is a lack of transparency for end users (consumers, patients, care professionals and consultants, and health insurers) regarding the status, operation and effectiveness of these new tools. At the same time, existing filters for risk assessment of medical aids often lead to excessively strict validation requirements for these new tools, which inhibits their possible contribution to better and more affordable care for the patient. It also erects barriers to new entrepreneurial entrants to the care market and their innovative ideas. This all requires an improved system of risk analysis and validation of e-health applications. A vital condition for an improved system is the introduction of the shortest possible assessment period for this form of quality care, considering the tempo of technological developments in both technical platforms and the applications that run on them (critical time-to-market), so that products do not lose their value before they are released to the market.
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The propagandization of a Net Generation adds nothing to our understanding of the digital behaviour of young people. Indeed, it is becoming increasingly obvious that the whole concept of a Net Generation rests on incorrect assumptions. Hence, arguments based on a Net Generation are not only irrelevant and misleading but precarious as well. Precarious in the sense that they are mobilized as a decisive means of engineering change, not least in education policy. Only when we stop thinking in terms of the Net Generation can we form a more astute vision of when the deployment of digital learning aids will have a realistic chance of success.
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Background: The majority of patients diagnosed with early-stage breast cancer are in a position to choose between having a mastectomy or lumpectomy with radiation therapy (breast-conserving therapy). Since the long-term survival rates for mastectomy and for lumpectomy with radiation therapy are comparable, patients’ informed preferences are important for decision-making. Although most clinicians believe that they do include patients in the decision-making process, the information that women with breast cancer receive regarding the surgical options is often rather subjective, and does not invite patients to express their preferences. Shared decision-making (SDM) is meant to help patients clarify their preferences, resulting in greater satisfaction with their final choice. Patient decision aids can be very supportive in SDM. We present the protocol of a study to β test a patient decision aid and optimise strategies for the implementation of SDM regarding the treatment of early-stage breast cancer in the actual clinical setting. Methods/design: This paper concerns a preimplementation and post-implementation study, lasting from October 2014 to June 2015. The intervention consists of implementing SDM using a patient decision aid. The intervention will be evaluated using qualitative and quantitative measures, acquired prior to, during and after the implementation of SDM. Outcome measures are knowledge about treatment, perceived SDM and decisional conflict. We will also conduct face-to-face interviews with a sample of these patients and their care providers, to assess their experiences with the implementation of SDM and the patient decision aid.
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Dit artikel is eerder gepubliccerd in het Nederlands Vlaams Tijdschrift voor Palliatieve Zorg, 2020-16 https://nvtpz.org/ Samenvatting (Nederlands) Het kwaliteitskader Palliatieve zorg beschrijft als standaard: Proactieve zorgplanning wordt tijdig en op passende wijze aan de orde gesteld, bij voorkeur door de hoofdbehandelaar of centrale zorgverlener of door de patiënt en diens naasten. Voor het palliatief adviesteam van een thuiszorgorganisatie in het oosten van Nederland is in drie deelonderzoeken onderzocht hoe verzorgenden en verpleegkundigen (V&V) proactieve zorgplanning in de praktijk vormgeven. In de deelonderzoeken zijn diverse onderzoeksmethoden toegepast: interviews, vragenlijsten en focusgroepen. In totaal hebben 238 V&V deelgenomen: 4 in interviews, 185 door het invullen van een vragenlijst en 49 in focusgroepen. Uit de resultaten blijkt dat V&V afwachtend zijn in het aangaan van gesprekken over wensen en behoeften. Dit gesprek wordt niet structureel gepland bij zorgvragers die in aanmerking komen voor een palliatieve zorgbenadering. Voornamelijk hbo2 -verpleegkundigen spreken vroegtijdig over het lijden (59%) en overlijden (55%) in de toekomst. Mbo3 -verzorgenden niveau 3 stellen deze onderwerpen het minst aan de orde, resp. 11% en 9%. V&V maken tot op heden geen gebruik van gesprekstools, maar alle drie de geselecteerde gesprekshulpen 1) Gesprekswijzer Proactieve zorgplanning, 2) Flowchart en 3) Wensenboekje lijken als set implementeerbaar in de thuiszorgorganisatie. Samenvatting (Engels)2 The quality framework Palliative care describes as standard: Proactive care planning is addressed in a timely and appropriate manner, preferably by the main professional or central care provider or by the patient and his relatives. For the palliative advisory team of a home care organization in the east of the Netherlands, three sub-studies investigated how nurses and certified nurses perform proactive care planning in practice. Various research methods were applied in the sub-studies: interviews, questionnaires and focus groups. A total of 238 nurses and certified nurses participated: 4 in interviews, 185 in a questionnaire and 49 in focus groups. The results show that (certified) nurses are cautious when entering into discussions about wishes and needs. These discussions are not structurally planned by all care recipients who are eligible for a palliative care approach. Especially, bachelor nurses speak early about the suffering (59%) and death (55%) in the future, whereas certified nurses level 3 addressing these subjects the least, resp. 11% and 9%. Up to now, (certified) nurses do not use conversation aids. All three selected conversation aids by this care organization 1) Conversation guide Proactive care planning, 2) Flowchart and 3) Wish booklet seem to be able to implement as a set
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Introduction: Patient information holds an important role in knee arthroplasty surgery regarding patients’ expectations and outcomes after surgery. The purpose of the present study was to explore the experiences and opinions of patients undergoing knee arthroplasty (KA) surgery on an information brochure provided preoperatively. Methods: A qualitative case study of 8 patients using individual semi-structured interviews was conducted to explore patients’ opinions on an information brochure in KA surgery. Results: Patients rated the brochure as good and recommended its use. Unsatisfactory information regarding wound healing, pain expectations, postoperative exercises and use of walking aids was reported. Patients stated that the table of contents was insufficient and the size of the brochure (A4-format) too large. Patients reported to have no need for additional digital sources (e.g. applications, websites). Conclusion: These opinions support the use of an information brochure. The reported opinions were used to improve the brochure. Future research should focus on the improvement of information sources by involving patients (and other users) in the development process in which the information is tailored towards patient needs.
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Assistive Technology (AT) is any technology that supports people with functional difficulties to perform their daily activities with less difficulty and/or obstruction, thus contributing to a more fulfilling life. This refers to people of all ages and to all kinds of functional limitations, either permanent or temporary. Assistive products can be traditional physical products, such as wheelchairs, eyeglasses, hearing aids, or prostheses, but they can also be special input devices, care robots, computers with accessible software, apps for smartphones, home automation solutions, virtual realities, etc. It is essential to understand that AT involves more than just familiar products, and that it also includes knowledge about the personalized selection of appropriate solutions, provisions, and services, as well as the training of all parties involved, the measurement of outcomes and impacts, awareness of ethical issues, etc.
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