De eiwitbehoefte wordt voornamelijk bepaald door de hoeveelheid vetvrije massa (VVM) in het lichaam. In de praktijk wordt de eiwitbehoefte echter gebaseerd op het lichaamsgewicht. In dit onderzoek is de eiwitbehoefte op basis van gemeten VVM vergeleken met de eiwitbehoefte bepaald op basis van gemetenlichaamsgewicht, gecorrigeerd lichaamsgewicht en geschatte VVM met de formule van Gallagher. De onderzoeksvraag luidde: ‘Welke methoden om de eiwitbehoefte te berekenen zijn het beste vergelijkbaar met de referentiemethode: gemeten VVM x 1,5 g eiwit/kg?’MethodeDeze vraag werd onderzocht in twee populaties. De eerste populatie was de ANAC-populatie (Amsterdam Nutritional Assessment Center, Hogeschool van Amsterdam): relatief gezonde volwassenen met overgewicht en obesitas. De tweede populatie was de VUmc-populatie: klinische en poliklinische patiënten met zeer uiteenlopende ziektebeelden. De VVM werd gemeten met BOD POD (ANAC) en bio-elektrische impedantie-analyse (BIA) (VUmc). Drie methoden om de eiwitbehoefte te berekenen werden vergeleken met de referentiemethode (gemeten VVM x 1,5 g eiwit/kg):A. Gemeten lichaamsgewicht x 1,2 g eiwit/kgB. Gecorrigeerd lichaamsgewicht x 1,2 g eiwit/kg (correctie: gewicht bij BMI 20 voor personen met ondergewicht(BMI<18,5) en gewicht bij BMI 27,5 voor personen met overgewicht (BMI>30))C. Geschatte VVM x 1,5 g eiwit/kg. De schatting is uitgevoerd met de formule van Gallagher.De gemiddelde afwijking met spreiding en standaardafwijking werd gebruikt om de validiteit te toetsen van de drie methoden om de eiwitbehoefte te berekenen. Een over- of onderschatting van 5% werd gedefinieerd als klinisch relevant.ResultatenDe afwijking bij methode A was klein in de groep met ondergewicht en groot bij de groep met overgewicht en obesitas. Slechts bij 1% van de obese personen werd de eiwitbehoefte met methode A juist geschat. Dit verbeterde met methode B naar 15-33%. Methode C was voor alle groepen, met uitzondering van depersonen met ondergewicht, het gunstigst. De afwijking varieerde van 14 gram onderschatting tot 28 gram overschatting. Bij 38-54% van de personen met overgewicht en obesitas werd de eiwitbehoefte juist geschat.ConclusieEr is vooral bij overgewicht en obesitas een forse variatie tussen de verschillende methoden voor het berekenen van de eiwitbehoefte. De berekening van de eiwitbehoefte op basis van de gemeten VVM heeft de voorkeur. Als dit niet mogelijk is, volstaat bij deze groep een aanpassing van het gewicht in de berekening naar een gewicht bij BMI 27,5 niet. Toepassing van de formule van Gallagher om de VVM te schatten en daarmee de eiwitbehoefte te berekenen, geeft vooral voor personen met overgewicht en obesitas een betereovereenkomst met de eiwitbehoefte per kilogram gemeten VVM.
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afstudeerscriptie van studente Psychologie Yasmin Gharavi gepubliceerd in BMC Psychiatry: Background: Family members who care for patients with severe mental illness experience emotional distress and report a higher incidence of mental illness than those in the general population. They report feeling inadequately prepared to provide the necessary practical and emotional support for these patients. The MAT training, an Interaction- Skills Training program (IST) for caregivers, was developed to meet those needs. This study used a single-arm pretestposttest design to examine the impact of the training on caregivers’ sense of competence (self-efficacy) and burden.
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This document presents the findings of a study into methods that can help counterterrorism professionals make decisions about ethical problems. The study was commissioned by the Research and Documentation Centre (Wetenschappelijk Onderzoeken Documentatiecentrum, WODC) of the Dutch Ministry of Security and Justice (Ministerie van Veiligheid en Justitie), on behalf of the National Coordinator for Counterterrorism and Security (Nationaal Coördinator Terrorismebestrijding en Veiligheid,NCTV). The research team at RAND Europe was complemented by applied ethics expert Anke van Gorp from the Research Centre for Social Innovation (Kenniscentrum Sociale Innovatie) at Hogeschool Utrecht. The study provides an inventory of methods to support ethical decision-making in counterterrorism, drawing on the experience of other public sectors – healthcare, social work, policing and intelligence – and multiple countries, primarily the Netherlands and the United Kingdom
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This paper reports a study into the relationship between the configuration of the process of Strategic Information Systems Planning (SISP) and the success of SISP. SISP is an important activity in the alignment of information technology systems and services to business requirements. However, despite the obvious importance of a proper planning of information technology and information systems in organizations, success of SISP is not evident. And as the success of SISP is also influenced by the process followed in developing the SISP, the research question for this study was, “How does the configuration of the SISP process influence the success of the SISP?” Based on an explorative multi case study, we concluded that the specificity and comprehensiveness of strategies, goals and decisions in an organization has a positive effect on the success of SISP. Another conclusion was that a more dominant role of the IS/IT organization in the SISP process influences the quality of the SISP deliverable positively, but has a negative effect on the building of partnership between business and IT in the organization. A final conclusion was that following a formal SISP methodology does not seem to have an effect on the success of SISP. These findings provide guidance for practitioners that plan to develop an SISP as part of their efforts to align business and IT.
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Abstract Aims The involvement of an inter-professional healthcare student team in the review of medications used by geriatric patients could not only provide patients with optimized therapy but also provide students with a valuable inter-professional learning experience. We describe and evaluate the clinical and learning outcomes of an inter-professional student-run mediation review program (ISP). Subject and method A variable team consisting of students in medicine, pharmacy, master advanced nursing practice, and master physician assistant reviewed the medication lists of patients attending a specialized geriatric outpatient clinic. Results During 32 outpatient visits, 188 medications were reviewed. The students identified 14 medication-related problems, of which 4 were not recognized by healthcare professionals. The ISP team advised 95 medication changes, of which 68 (71.6%) were directly implemented. Students evaluated this pilot program positively and considered it educational (median score 4 out of 5) and thought it would contribute to their future inter-professional relationships. Conclusion An inter-professional team of healthcare students is an innovative healthcare improvement for (academic) hospitals to increase medication safety. Most formulated advices were directly incorporated in daily practice and could prevent future medication-related harm. The ISP also offers students a first opportunity to work in an inter-professional manner and get insight into the perspectives and qualities of their future colleagues.
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It has become a topic at Dutch educational institutes to feel not only responsible for improvement of theoretical and practical skills, but also of 'competences' in a wider sense. The curriculum of the Fontys University of Applied Sciences (32.000 students) and especially the Electrical and Electronic (E&E) Department has changed enormously in the past decade. At the E&E department we introduced two different ways of working on competences. In the first years of their study students choose different roles in several projects. We have described all the roles and the related tasks for each specific role. While working on a role, the students indirectly work on different competences. This method of working enforces a higher educational level (a student shouldn't work on things he already knows or is able to handle) and the passenger behaviour is reduced. Students now do take responsibility while contributing to the project teams. Inquiries amongst the students confirm these results. Due to a clear role description and individual assessments The second method is working on the specific engineering competences in their traineeship and thesis work in the last part of their study. This was first introduced in the Autumn of 2005 in the E&E department of Fontys.
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Nurse clinician-scientists are increasingly expected to show leadership aimed at transforming healthcare. However, research on nurse clinician-scientists' leadership (integrating researcher and practitioner roles) is scarce and hardly embedded in sociohistorical contexts. This study introduces leadership moments, that is, concrete events in practices that are perceived as acts of empowerment, in order to understand leadership in the daily work of newly appointed nurse clinician-scientists. Following the learning history method we gathered data using multiple (qualitative) methods to get close to their daily practices. A document analysis provided us with insight into the history of nursing science to illustrate how leadership moments in the everyday work of nurse clinician-scientists in the “here and now” can be related to the particular histories from which they emerged. A qualitative analysis led to three acts of empowerment: (1) becoming visible, (2) building networks, and (3) getting wired in. These acts are illustrated with three series of events in which nurse clinician-scientists' leadership becomes visible. This study contributes to a more socially embedded understanding of nursing leadership, enables us to get a grip on crucial leadership moments, and provides academic and practical starting points for strengthening nurse clinician-scientists' leadership practices. Transformations in healthcare call for transformed notions of leadership.
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The purpose of the design-based research reported here is to show – as a proof of principle – how the idea of scaffolding can be used to support primary teachers in a professional development programme (PDP) to design and enact language-oriented science lessons. The PDP consisted of six sessions of 2.5 h each in which twelve primary school teachers took part over a period of six months. It centralised the language support that pupils need to reason during science lessons. In line with the idea of scaffolding, the structure of the PDP targeted teachers' gradual independence in designing lessons. The first research question is how scaffolding was enacted during the PDP. The analysis of video recordings, field notes, researcher and teacher logs, and teacher design assignments focused on the enactment of three scaffolding characteristics: diagnosis, responsiveness and handover to independence. The second research question concerns what teachers learned from the participation in the PDP that followed a scaffolding approach. The data analysis illustrates that these teachers had learned much in terms of designing and enacting language-oriented science lessons. In terms of diagnosis and responsiveness, our PDP approach was successful, but we problematise the ideal of scaffolding approaches focused on handover to independence.
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Despite the increased use of activity trackers, little is known about how they can be used in healthcare settings. This study aimed to support healthcare professionals and patients with embedding an activity tracker in the daily clinical practice of a specialized mental healthcare center and gaining knowledge about the implementation process. An action research design was used to let healthcare professionals and patients learn about how and when they can use an activity tracker. Data collection was performed in the specialized center with audio recordings of conversations during therapy, reflection sessions with the therapists, and semi-structured interviews with the patients. Analyses were performed by directed content analyses. Twenty-eight conversations during therapy, four reflection sessions, and eleven interviews were recorded. Both healthcare professionals and patients were positive about the use of activity trackers and experienced it as an added value. Therapists formulated exclusion criteria for patients, a flowchart on when to use the activity tracker, defined goals, and guidance on how to discuss (the data of) the activity tracker. The action research approach was helpful to allow therapists to learn and reflect with each other and embed the activity trackers into their clinical practice at a specialized mental healthcare center.
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The focus of the thesis is an exploration into students’ vocational knowledge in the context of Dutch vocational education and training (VET). The reason students’ vocational knowledge requires exploration is because there is no consensus among scholars in the field of VET about how to theorise the nature of students’ vocational knowledge; most (not all) scholars rely on dichotomous conceptualisations, such as theory versus practice, general versus specific or explicit versus implicit. However, such commonly used dichotomies are not very helpful to understand the complex nature of vocational knowledge. Vocational knowledge is more than putting bits of theoretical and practical knowledge together, it is characterised by sometimes-intimate relationships between knowledge and actions. As a result of the above-mentioned gap in the VET literature, there is little empirical research on how VET students develop vocational knowledge and the extent to which this is occupation-specific knowledge. To understand students’ vocational knowledge, four different aims are formulated and carried out in four studies. The aim of the first study is to identify powerful vocational learning environments to enable the selection of a case that represents high quality vocational learning and teaching. With an eye on analysing students’ vocational knowledge, the second study aims to conceptualise the nature of vocational knowledge that avoids dichotomies. Therefore, two conceptual frameworks are integrated; the idea of contextualising is introduced which is based on cultural-historical theory to highlight the crucial role activity plays in knowledge development and to understand the relationships between the mind (i.e., what people think (and feel)), and action (i.e., what people do). Secondly, the theory is supplemented with ideas from inferentialism, a philosophical semantic theory of meaning to provide a useful way to focus on students’ processes of knowing and to reveal students’ vocational knowledge in terms of ongoing reasoning processes. The third study uses the conceptualisation of vocational knowledge to explore how students develop vocational knowledge in occupational practice, and to illustrate the process of contextualising. The forth study aims to describe what characterises students’ vocational knowledge using an analytic framework that distinguishes between occupation-specific knowledge components and qualities. This thesis contributes to research scholarship in the field of VET and an understanding of students’ vocational knowledge in practice. The theoretical framework of contextualising supplemented with inferentialism provides an alternative way to focus on students’ processes of knowing and helps to reveal students’ vocational knowledge in terms of reasoning processes. The empirical explorations and illustrations of students’ vocational knowledge contribute to the scholarly literature and practice on understanding the nature of vocational knowledge, how students develop vocational knowledge and what characterises their vocational knowledge. The intention to introduce the idea of contextualising is not about reinventing the wheel but rather an attempt to understand how it turns and how it functions. The intention of this thesis is to encourage dialogue and move the debate about the nature of vocational knowledge further, and hence, to provide some “food for thought”.
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