Background: The concept of Functional Independence (FI), defined as ‘functioning physically safe and independent from other persons, within one’s context”, plays an important role in maintaining the functional ability to enable well-being in older age. FI is a dynamic and complex concept covering four clinical outcomes: physical capacity, empowerment, coping flexibility, and health literacy. As the level of FI differs widely between older adults, healthcare professionals must gain insight into how to best support older people in maintaining their level of FI in a personalized manner. Insight into subgroups of FI could be a first step in providing personalized support This study aims to identify clinically relevant, distinct subgroups of FI in Dutch community-dwelling older people and subsequently describe them according to individual characteristics. Results: One hundred fifty-three community-dwelling older persons were included for participation. Cluster analysis identified four distinctive clusters: (1) Performers – Well-informed; this subgroup is physically strong, well-informed and educated, independent, non-falling, with limited reflective coping style. (2) Performers – Achievers: physically strong people with a limited coping style and health literacy level. (3) The reliant- Good Coper representing physically somewhat limited people with sufficient coping styles who receive professional help. (4) The reliant – Receivers: physically limited people with insufficient coping styles who receive professional help. These subgroups showed significant differences in demographic characteristics and clinical FI outcomes. Conclusions: Community-dwelling older persons can be allocated to four distinct and clinically relevant subgroups based on their level of FI. This subgrouping provides insight into the complex holistic concept of FI by pointing out for each subgroup which FI domain is affected. This way, it helps to better target interventions to prevent the decline of FI in the community-dwelling older population.
This study provides an in-depth understanding of the perceptions of patients with T2DM before use (acceptability) and after use (acceptance) regarding 4 different mobile health apps for diabetes control and self-management. This study was part of the TOPFIT Citizenlab project. TOPFIT Citizenlab is a 3-year research and innovation program in the eastern part of the Netherlands. Citizens, health care professionals (HCPs), and companies have joined forces with researchers to develop and implement technology for health and well-being.
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This paper is a case report of why and how CDIO became a shared framework for Community Service Engineering (CSE) education. CSE can be defined as the engineering of products, product-service combinations or services that fulfill well-being and health needs in the social domain, specifically for vulnerable groups in society. The vulnerable groups in society are growing, while fewer people work in health care. Finding technical, interdisciplinary solutions for their unmet needs is the territory of the Community Service Engineer. These unmet needs arise in local niche markets as well as in the global community, which makes it an interesting area for innovation and collaboration in an international setting. Therefore, five universities from Belgium, Portugal, the Netherlands, and Sweden decided to work together as hubs in local innovation networks to create international innovation power. The aim of the project is to develop education on undergraduate, graduate and post-graduate levels. The partners are not aiming at a joined degree or diploma, but offer a shared short track blended course (3EC), which each partner can supplement with their own courses or projects (up to 30EC). The blended curriculum in CSE is based on design thinking principles. Resources are shared and collaboration between students and staff is organized at different levels. CDIO was chosen as the common framework and the syllabus 2.0 was used as a blueprint for the CSE learning goals in each university. CSE projects are characterized by an interdisciplinary, human centered approach leading to inter-faculty collaboration. At the university of Porto, EUR-ACE was already used as the engineering education framework, so a translation table was used to facilitate common development. Even though Thomas More and KU Leuven are no CDIO partner, their choice for design thinking as the leading method in the post-Masters pilot course insured a good fit with the CDIO syllabus. At this point University West is applying for CDIO and they are yet to discover what the adaptation means for their programs and their emerging CSE initiatives. CDIO proved to fit well to in the authentic open innovation network context in which engineering students actively do CSE projects. CDIO became the common language and means to continuously improve the quality of the CSE curriculum.
