BackgroundPodiatrists are key professionals in promoting adequate foot self-care for people with diabetes at high-risk of developing foot ulcers. However, merely informing patients about the advantages of foot self-care is insufficient to realise behavioural change. Motivational interviewing (MI) is a promising person-centred communication style that could help to create a working alliance between healthcare providers and patient to improve foot self-care. This study aims to observe and analyse the application of MI in consultations carried out by MI-trained and non-MI-trained podiatrists with their patients, and explore podiatrists’ attitudes and experiences towards MI.MethodsEighteen podiatrists (median age: 28.5 years, 10 female and 8 male) followed a three-day basic training in MI and 4 podiatrists (median age: 38.5 years, 4 female) were not trained in MI. To observe and rate the MI-fidelity in daily clinical practice, audio recordings from the MI-trained and non-MI-trained podiatrists were scored with the Motivational Interviewing Treatment Integrity code. Individual, semi-structed, in-depth interviews were conducted with the MI-trained podiatrists to explore their attitudes towards and experiences with MI. These data sources were triangulated to describe the effect of training podiatrists in MI for their clinical practice.ResultsThe MI-trained podiatrists scored significantly higher than the non-MI-trained podiatrists on two of four global MI-related communication skills (empathy, p = 0.008 and change talk, p = 0.008), on one of five core MI-adherent behaviours (affirmation, p = 0.041) and on one of the other behaviour counts (simple reflections, p = 0.008). The podiatrists mainly reported their attitudes and experiences regarding partnership and cultivating change talk, during the interviews. In addition, they also mentioned facilitators and barriers to using MI and indicated whether they experienced MI as having added value.ConclusionsThe MI-trained podiatrists used the principles of MI at a solid beginner proficiency level in their clinical practice in comparison to the non-MI-trained podiatrists, who did not reach this level. This achievement is in accordance with the basic MI-training they received. This multi-method study reveals that podiatrists can be effectively trained in applying MI in daily clinical practice.Trial registrationNetherlands Trial Register NL7710. Registered: 6 May 2019.
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http://dx.doi.org/10.14261/postit/2B827A9F-E9C0-4A75-B45C19B59DD1E5AAIn 2015 and 2016, Saxion University of Applied Sciences organized the 2nd and 3rd edition of the Regional Innovation and Entrepreneurship Conference (RIEC).The term entrepreneurialism doesn’t exist. In this paper it is coined to distinguish entrepreneurship from entrepreneurial behaviour by employees. In an serious gaming experiment among Physical Therapy students, we tried to design a learning intervention to advance entrepreneurial behaviour in a non-business setting.
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Background The plantar intrinsic foot muscles (PIFMs) have a role in dynamic functions, such as balance and propulsion, which are vital to walking. These muscles atrophy in older adults and therefore this population, which is at high risk to falling, may benefit from strengthening these muscles in order to improve or retain their gait performance. Therefore, the aim was to provide insight in the evidence for the effect of interventions anticipated to improve PIFM strength on dynamic balance control and foot function during gait in adults. Methods A systematic literature search was performed in five electronic databases. The eligibility of peer-reviewed papers, published between January 1, 2010 and July 8, 2020, reporting controlled trials and pre-post interventional studies was assessed by two reviewers independently. Results from moderate- and high-quality studies were extracted for data synthesis by summarizing the standardized mean differences (SMD). The GRADE approach was used to assess the certainty of evidence. Results Screening of 9199 records resulted in the inclusion of 11 articles of which five were included for data synthesis. Included studies were mainly performed in younger populations. Low-certainty evidence revealed the beneficial effect of PIFM strengthening exercises on vertical ground reaction force (SMD: − 0.31-0.37). Very low-certainty evidence showed that PIFM strength training improved the performance on dynamic balance testing (SMD: 0.41–1.43). There was no evidence for the effect of PIFM strengthening exercises on medial longitudinal foot arch kinematics. Conclusions This review revealed at best low-certainty evidence that PIFM strengthening exercises improve foot function during gait and very low-certainty evidence for its favorable effect on dynamic balance control. There is a need for high-quality studies that aim to investigate the effect of functional PIFM strengthening exercises in large samples of older adults. The outcome measures should be related to both fall risk and the role of the PIFMs such as propulsive forces and balance during locomotion in addition to PIFM strength measures.
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ObjectiveTo investigate whether duration of knee symptoms influenced the magnitude of the effect of exercise therapy compared to non-exercise control interventions on pain and physical function in people with knee osteoarthritis (OA).MethodWe undertook an individual participant data (IPD) meta-analysis utilising IPD stored within the OA Trial Bank from randomised controlled trials (RCTs) comparing exercise to non-exercise control interventions among people with knee OA. IPD from RCTs were analysed to determine the treatment effect by considering both study-level and individual-level covariates in the multilevel regression model. To estimate the interaction effect (i.e., treatment x duration of symptoms (dichotomised)), on self-reported pain or physical function (standardised to 0–100 scale), a one-stage multilevel regression model was applied.ResultsWe included IPD from 1767 participants with knee OA from 10 RCTs. Significant interaction effects between the study arm and symptom duration (≤1 year vs >1 year, and ≤2 years vs>2 years) were found for short- (∼3 months) (Mean Difference (MD) −3.57, 95%CI −6.76 to −0.38 and −4.12, 95% CI-6.58 to −1.66, respectively) and long-term (∼12 months) pain outcomes (MD −8.33, 95%CI −12.51 to −4.15 and −8.00, 95%CI −11.21 to −4.80, respectively), and long-term function outcomes (MD −5.46, 95%CI −9.22 to −1.70 and −4.56 95%CI −7.33 to-1.80, respectively).ConclusionsThis IPD meta-analysis demonstrated that people with a relatively short symptom duration benefit more from therapeutic exercise than those with a longer symptom duration. Therefore, there seems to be a window of opportunity to target therapeutic exercise in knee OA.
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Background To gain insight into the role of plantar intrinsic foot muscles in fall-related gait parameters in older adults, it is fundamental to assess foot muscles separately. Ultrasonography is considered a promising instrument to quantify the strength capacity of individual muscles by assessing their morphology. The main goal of this study was to investigate the intra-assessor reliability and measurement error for ultrasound measures for the morphology of selected foot muscles and the plantar fascia in older adults using a tablet-based device. The secondary aim was to compare the measurement error between older and younger adults and between two different ultrasound machines. Methods Ultrasound images of selected foot muscles and the plantar fascia were collected in younger and older adults by a single operator, intensively trained in scanning the foot muscles, on two occasions, 1–8 days apart, using a tablet-based and a mainframe system. The intra-assessor reliability and standard error of measurement for the cross-sectional area and/or thickness were assessed by analysis of variance. The error variance was statistically compared across age groups and machines. Results Eighteen physically active older adults (mean age 73.8 (SD: 4.9) years) and ten younger adults (mean age 21.9 (SD: 1.8) years) participated in the study. In older adults, the standard error of measurement ranged from 2.8 to 11.9%. The ICC ranged from 0.57 to 0.97, but was excellent in most cases. The error variance for six morphology measures was statistically smaller in younger adults, but was small in older adults as well. When different error variances were observed across machines, overall, the tablet-based device showed superior repeatability. Conclusions This intra-assessor reliability study showed that a tablet-based ultrasound machine can be reliably used to assess the morphology of selected foot muscles in older adults, with the exception of plantar fascia thickness. Although the measurement errors were sometimes smaller in younger adults, they seem adequate in older adults to detect group mean hypertrophy as a response to training. A tablet-based ultrasound device seems to be a reliable alternative to a mainframe system. This advocates its use when foot muscle morphology in older adults is of interest.
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Background: Shared decision-making is one key element of interprofessional collaboration. Communication is often considered to be the main reason for inefficient or ineffective collaboration. Little is known about group dynamics in the process of shared decision-making in a team with professionals, including the patient or their parent. This study aimed to evaluate just that. Methods: Simulation-based training was provided for groups of medical and allied health profession students from universities across the globe. In an overt ethnographic research design, passive observations were made to ensure careful observations and accurate reporting. The training offered the context to directly experience the behaviors and interactions of a group of people. Results: Overall, 39 different goals were defined in different orders of prioritizing and with different time frames or intervention ideas. Shared decision-making was lacking, and groups chose to convince the parents when a conflict arose. Group dynamics made parents verbally agree with professionals, although their non-verbal communication was not in congruence with that. Conclusions: The outcome and goalsetting of an interprofessional meeting are highly influenced by group dynamics. The vision, structure, process, and results of the meeting are affected by multiple inter- or intrapersonal factors.
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Background: Successful implementation of multifactorial fall prevention interventions (FPIs) is essential to reduce increasing fall rates in communitydwelling older adults. However, implementation often fails due to the complex context of the community involving multiple stakeholders within and across settings, sectors, and organizations. As there is a need for a better understanding of the occurring context-related challenges, the current scoping review purposes to identify what contextual determinants (i.e., barriers and facilitators) influence the implementation of FPIs in the community. Methods: A scoping reviewwas performed using the Arksey andO’Malley framework. First, electronic databases (Pubmed, CINAHL, SPORTDiscus, PsycINFO) were searched. Studies that identified contextual determinants that influence the implementation of FPIs in the community were included. Second, to both validate the findings from the literature and identify complementary determinants, health and social care professionals were consulted during consensus meetings (CMs) in four districts in the region of Utrecht, the Netherlands. Data were analyzed following a directed qualitative content analysis approach, according to the 39 constructs of the Consolidated Framework for Implementation Research. Results: Fourteen relevant studies were included and 35 health and social care professionals (such as general practitioners, practice nurses, and physical therapists) were consulted during four CMs. Directed qualitative content analysis of the included studies yielded determinants within 35 unique constructs operating as barriers and/or facilitators. The majority of the constructs (n = 21) were identified in both the studies and CMs, such as “networks and communications”, “formally appointed internal implementation leaders”, “available resources” and “patient needs and resources”. The other constructs (n = 14) were identified only in the . Discussion: Findings in this review show that awide array of contextual determinants are essential in achieving successful implementation of FPIs in the community. However, some determinants are considered important to address, regardless of the context where the implementation occurs. Such as accounting for time constraints and financial limitations, and considering the needs of older adults. Also, broad cross-sector collaboration and coordination are required in multifactorial FPIs. Additional context analysis is always an essential part of implementation efforts, as contexts may differ greatly, requiring a locally tailored approach.
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De media die podia inzetten als onderdeel van hun marketingmix kunnen wellicht een belangrijke rol spelen bij het versterken van een gevoel van ‘ medeeigenaarschap’ en binding. Er is nog niet veel bekend over de mogelijkheden die sociale media hierin bieden. Analyse van 155 interviews die zijn afgenomen onder theater- en poppodiumbezoekers in de noordelijke Randstad, laat zien dat incidentele en potentiële bezoekers reserve ervaren in relatie tot de podiumkunsten waardoor gebruik van sociale media voor promotiedoeleinden niet onmiddellijk passend is. Begrijpen hoe de podiumkunsten worden beleefd en betekenis hebben helpt podia in het maken van keuzes in hun marketingbeleid. Het is maar de vraag hoe groot de rol van sociale media (ook wel media 2.0) daarin moet zijn. Om goede keuzes ten aanzien van marketing en 2.0 media te maken, zo luidt de conclusie, is nadere theoretisering nodig van de relatie tussen podiumbezoek, distinctie en gemeenschapsgevoel. Het onderzoek waar dit artikel op gebaseerd is, werd mogelijk gemaakt door een SIA-Raak subsidie. Het project heet Podium voor de Podiumdirecteuren (2011-2013).
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Inleiding voor de bundel Het lectoraat Media, Cultuur en Burgerschap heeft in de periode 2011-2013 onderzoek gedaan naar poppodia en theaters in een samenwerking met de Inholland lectoraten City Marketing en Leisure Management en Media Business en met de brancheverenigingen Vereniging Schouwburg- en Concertgebouwdirecties (VSCD) en de Vereniging van Nederlandse Poppodia en -Festivals (VNPF). Hierbij waren docenten en studenten van diverse opleidingen betrokken (o.a. VTM, Com, MEM & IMM) en het project werd gefinancierd uit een SIA-Raak subsidie (Podium voor de Podiumdirecteuren 2011-2013). Doel van het onderzoek was om de podia te ondersteunen in hun voortdurende vraag naar het verhogen van het culturele en financiële rendement, daarbij de nadruk leggend op de return on investment, in het bijzonder via vernieuwende wegen en middelen. Een van de eindproducten van dit onderzoeksproject is een website, www.podiumpower.nl , die in samenwerking met de Waag Society en het studenten leerwerkbedrijf GNR8 is ontworpen. Inleiding Podiumdirecteuren zitten in een lastig parket: door bezuinigingen en de economische crisis is een daling te zien in de inkomsten van poppodia in Nederland. Overheden snijden in subsidies terwijl tegelijkertijd de publieksinkomsten dalen (VNPF, 2013). Drie lectoraten van Inholland hebben onderzoek uitgevoerd met als doel advies te geven aan podiumdirecteuren over de toegevoegde sociaal-culturele waarde van cultuurcentra voor de podiumkunsten waardoor ze hun podia (waaronder theaters, concertzalen en poppodia) effectiever kunnen verankeren. De podiumdirecteuren zullen in hun exploitatie recht moeten doen aan commerciële eisen, zonder in te leveren op hun artistieke en culturele visie en missie. Dit gezamenlijke onderzoekproject is opgesplitst in meerdere deelonderzoeken. Zo is er onder andere onderzoek gedaan naar marketing accountability, cultuureducatie, nieuwe businessmodellen, publieksegmentatie en sociale media. In dit artikel wordt een kwantitatief deelonderzoek beschreven waarin wij gericht hebben op de vraag of er een samenhang is tussen enerzijds de voorkeuren van bezoekers van poppodia met betrekking tot de frequentie van podiumbezoek, mediagebruik, activiteit op sociale mediaplatforms en informatiebehoefte en anderzijds de voorkeur voor een bepaald muziekgenre. Waarmee moeten podiumdirecteuren rekening houden als ze sociale media willen inzetten als onderdeel van het strategisch marketingcommunicatiebeleid van hun poppodium? Het publiek is de belangrijkste stakeholder voor de inkomsten van poppodia, maar er is natuurlijk niet één publiek. Met name regionale poppodia bedienen een breed gemêleerd publiek: van tieners tot vijftigers, van houseliefhebbers tot rockers, van bezoekers die zelf actief op zoek gaan naar informatie tot mensen die wachten tot informatie naar hen toe komt en van vaste bezoekers die geregeld het podium bezoeken tot incidentele bezoekers die slechts af en toe, of zelfs maar één keer het podium bezoeken (zie ook Hermes en Borghuis, 2013).
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