INLEIDING In deze module worden behandeladviezen gegeven voor de Post-COVID-19 ambulante behandeling in de geriatrische revalidatie gericht op somatische-, functionele- en psychische status. Deze module is een onderdeel van het behandeladvies post-COVID-19 (geriatrische) revalidatie-Verenso. Deze module is in een zeer korte tijd tot stand gekomen en heeft de status van groeidocument. Zorgvuldigheid is betracht om zowel de (beperkte) ervaringskennis, als de actuele stand van de wetenschappelijke literatuur hierin te betrekken. Voor dit behandeladvies is gebruik gemaakt van het door GRZPLUS ontwikkeld ambulant revalidatieprogramma CO FIT+. Bij GRZPLUS is een doorontwikkeling gemaakt op basis van de update behandeladvies post-COVID-19 geriatrische revalidatie van Verenso (Verenso, 19-05-2020) welke is gebaseerd op de principes van longrevalidatie zoals vertaald in het Behandelprogramma geriatrische COPD-revalidatie (van Damvan Isselt et al.) en het Behandelprogramma COVID-19 Post IC, van Revalidatiecentrum de Hoogstraat (Brouwers, de Graaf). Dit is aangevuld met behandeladviezen en leidraden vanuit de beroepsverenigingen en kennis uit wetenschappelijk onderzoek (long-revalidatie) en vanuit het REACH netwerk (REhabilitation After Critical illness and Hospital discharge). De komende maanden zullen zowel de nieuwe wetenschappelijke literatuur als de ervaringen uit de praktijk gebruikt worden om de handreiking te verbeteren en zo nodig aan te vullen. Dat zullen wij doen met specialisten ouderengeneeskunde, revalidatieartsen, klinisch-geriaters, paramedici, longartsen, verpleegkundigen, infectie deskundigen, en andere betrokken beroepsgroepen. De revalidatie van ambulante post-COVID-19 patiënten vereist vooral afstemming binnen de multidisciplinaire zorg. De complexiteit en ernst van de problematiek en de interactie van beperkingen op diverse domeinen maakt dat interdisciplinaire behandeling essentieel is.
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Abstract Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), has challenged healthcare globally. An acute increase in the number of hospitalized patients has neces‑ sitated a rigorous reorganization of hospital care, thereby creating circumstances that previously have been identifed as facilitating prescribing errors (PEs), e.g. a demanding work environment, a high turnover of doctors, and prescrib‑ ing beyond expertise. Hospitalized COVID-19 patients may be at risk of PEs, potentially resulting in patient harm. We determined the prevalence, severity, and risk factors for PEs in post–COVID-19 patients, hospitalized during the frst wave of COVID-19 in the Netherlands, 3months after discharge. Methods: This prospective observational cohort study recruited patients who visited a post-COVID-19 outpatient clinic of an academic hospital in the Netherlands, 3months after COVID-19 hospitalization, between June 1 and October 1 2020. All patients with appointments were eligible for inclusion. The prevalence and severity of PEs were assessed in a multidisciplinary consensus meeting. Odds ratios (ORs) were calculated by univariate and multivariate analysis to identify independent risk factors for PEs. Results: Ninety-eight patients were included, of whom 92% had ≥1 PE and 8% experienced medication-related harm requiring an immediate change in medication therapy to prevent detoriation. Overall, 68% of all identifed PEs were made during or after the COVID-19 related hospitalization. Multivariate analyses identifed ICU admission (OR 6.08, 95% CI 2.16–17.09) and a medical history of COPD / asthma (OR 5.36, 95% CI 1.34–21.5) as independent risk fac‑ tors for PEs. Conclusions: PEs occurred frequently during the SARS-CoV-2 pandemic. Patients admitted to an ICU during COVID19 hospitalization or who had a medical history of COPD / asthma were at risk of PEs. These risk factors can be used to identify high-risk patients and to implement targeted interventions. Awareness of prescribing safely is crucial to prevent harm in this new patient population.
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The timely detection of post-stroke depression is complicated by a decreasing length of hospital stay. Therefore, the Post-stroke Depression Prediction Scale was developed and validated. The Post-stroke Depression Prediction Scale is a clinical prediction model for the early identification of stroke patients at increased risk for post-stroke depression. he study included 410 consecutive stroke patients who were able to communicate adequately. Predictors were collected within the first week after stroke. Between 6 to 8 weeks after stroke, major depressive disorder was diagnosed using the Composite International Diagnostic Interview. Multivariable logistic regression models were fitted. A bootstrap-backward selection process resulted in a reduced model. Performance of the model was expressed by discrimination, calibration, and accuracy.
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Anthropocentrism is the belief that value is focused on human beings and that all other beings are means to human ends. Related to anthropocentrism, humanism privileges the aim of improvement of human welfare. Humanism has underwritten efforts to expose social injustices and improve the welfare of all human beings. In relation to the environment, post-humanism can be defined by a number of characteristics. First, post-humanism exposes anthropocentrism as an attempt to ignore the behavior in which humans focus on themselves at the expanse of all other species. Second, post-humanism critiques exclusive moral focus on human inequalities in relation to environmental protection, emphasizing that inequality between species should remain within the scope of ethical consideration. Third, post-humanism exposes anthropocentrism as an inadequate basis for environmental action as it criticizes anthropocentrism as ethically wrong as well as pragmatically ineffective. https://onlinelibrary.wiley.com/doi/book/10.1002/9781118924396 LinkedIn: https://www.linkedin.com/in/helenkopnina/
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Objective: Post-mortem computed tomography (PMCT) is an established method for disease, complications, and cause of death determination in both clinical and forensic cases. By adding intravascular infusion of contrast medium, computed tomography angiography (PMCTA) provides additional information on vascular structures and hemorrhages. When easily applicable and low in costs, this technique would be more frequently applied and of additional value to clinical and educational purposes, particularly in forensic scientific context. Materials and Methods: PMCTA was performed on 10 bodies of the anatomy department. First, a metal T-piece was inserted into the femoral artery as part of standard practice for conservation. Secondly, surplus contrast medium with sodium chloride was infused into the body through a catheter tube set attached to the metal T-piece, using a readily available enteroclysis pump from our radiology department. Results: With added costs of approximately € 266 (personnel and materials) and an additional procedure time of 15-20 minutes, successful infusion of contrast mixture was achieved with the enteroclysis pump. Partial or complete opacification was measured in 89% of arteries, with enhancement of soft tissue visualization. Conclusion: This study successfully evaluated an inexpensive and easy to use method to perform PMCTA for post-mortem investigations.
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Young widowhood, conceptualized as the loss of one’s spouse before the age of 50, is a profoundly painful and distressing loss (Den Elzen, 2017, 2018). The literature on young widowhood shows the death of a partner generally causes a fragmentation of the self, as it violates expectations of the normal life cycle, namely growing old together (Haase and Johnston, 2012; Levinson, 1997). Premature loss of one’s spouse tends to be experienced by the surviving partner as distressing or traumatizing, such as having witnessed their suffering in illness or through accident (Den Elzen, 2018) or in struggling with unfinished business (Holland et al, 2020). Whilst post-traumatic stress is well-known and has been widely researched across various disciplines, the concept of post-traumatic growth is much newer and by contrast has received less attention. PTG was introduced as a scholarly concept by Tedeschi and Calhoun in the mid-1990s and is defined as a positive psychological change as a result of the struggle with highly challenging life events (2004). Calhoun and Tedeschi’s notion of PTG has been backed by a recent systematic review. In the first meta-analysis of moderate-to-high PTG, Wu et al. found that of the 10,181 subjects, about 50% experienced PTG (2019). They also reported that women, young people and victims of trauma experienced higher levels of PTG than men, the elderly and those who experienced indirect trauma. PTG has attracted some controversy, with some researchers questioning its scientific validity (Jayawickreme and Blackie, 2014). Others caution against the minimization of people’s suffering. Hayward is a trauma counsellor who advises approaching PTG carefully, highlighting that if it is introduced with clients too early it can "often be construed as minimizing someone's pain and suffering and minimizing the impact of the loss" (cited in Collier, 2016, n.p.). In addressing the critique of PTG, Calhoun and Tedeschi (2006) emphasize that the focus on investigating positive psychological change following trauma does not deny the common and well-documented negative psychological responses and distress following severe life stresses: “Negative events tend to produce, for most persons, consequences that are negative” (p.4). They argue however, and their research supports this finding, that for many people distressful events can foster positive psychological changes. We view PTG as a possibility following (profound) loss, and emphasize that PTG may continue to co-exist with painful and/or unresolved emotions regarding the loss itself. We conceptualize PTG as a continuum and not as an either/or binary with grief. Further, we wish to highlight that PTG is a highly individual process that depends on many factors, and we are not suggesting that the absence of PTG is to be seen as a failure. This chapter intends to contribute to the study of PTG through a person-centered approach. The most used method to assess PTG is the 21-item posttraumatic growth inventory developed by Calhoun and Tedeschi in 1996 (Jayawickreme & Blackie, 2014). Self-reported posttraumatic growth has been the foundation of PTG research, which has aimed to identify to what extent PTG evokes improved psychological and physical health. In discussing our own creative narrative processes of PTG, our practice-led-research lens aims to contribute to research on how PTG might be fostered. We propose a Writing-for-wellbeing approach in this context and explore what it offered us both as writers and widows and what it might offer the field of Writing-for-wellbeing and by extension clinical and scholarly practice.
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Ep#5: Carrière met Jouke PostVan Analyse 15 minutesDeze week praat ik met Jouke Post, loopbaanspecialist bij James, een initiatief van CNV Vakbond en gericht op de loopbaanbegeleiding van werkenden en docent theorie en methoden loopbaanbegeleiding bij Saxion, over het begrip carrière. Of carrière? Jouke heeft het liever over loopbaan.
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Art sociologist Pascal Gielen defends the hypothesis that global art scene is an ideal production entity for economic exploitation. These days the workethic of the art world with its ever-present young dynamic, flexible working hours, thematic approach, short-term contracts or lack of contracts and its unlimited energetic freedom is capitalized within the cultural industry and has been converted into a standard production model. In the glow of the creative cities and the creative industry governmetns embrace this post-Henry Ford work model and seamlessly link it to the globally-dominant neo-liberal market economy.
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Vier jaar geleden is het IMPACT-lectoratenprogramma goedgekeurd en gesubsidieerd door het ministerie van Economische Zaken (EZ) . Dit gezamenlijke hoger agrarisch onderwijs (HAO)-brede lectoraatsprogramma is ontwikkeld in een samenwerking tussen EZ en de HAO-instellingen: Aeres Hogeschool Wageningen, Dronten, Hogeschool Inholland, HAS Hogeschool en Van Hall Larenstein. Focus: transities in het agro-food domein. In deze uitdagende context stelde IMPACT een aantal cruciale vragen, zoals: hoe werkt transitie in het agro-food domein en wat is er voor nodig in het onderwijs? Hoe stimuleren we fundamentele systeemveranderingen, wat is daarvoor nodig? Wat werkt, wat niet? Bovenstaande vragen zijn leidend geweest in het onderzoek van de afgelopen vier jaar. Deze vraagstukken zijn vanuit vijf verschillende invalshoeken benaderd en bestudeerd: vanuit ondernemerschap met de zoektocht naar betekenisvolle alternatieve (circulaire) bedrijfsmodellen (Aeres Hogeschool Dronten, HAS Hogeschool), vanuit het doorgronden van processen van sociale innovatie als motor voor transitie (Inholland), vanuit de zoektocht naar gezonde en duurzame voeding als preventiemiddel voor welvaartsziekten (Van Hall Larenstein) en vanuit het onderwijs, het zoeken naar hoe we de ontwikkeling van mensen in de dynamieken van duurzaamheidstransitie het beste kunnen ondersteunen, en hoe het leren en het onderwijs er dan uit zou kunnen zien (Aeres Hogeschool Wageningen). Hoewel elk van de lectoraten binnen IMPACT een specifieke focus had zijn er na vier jaar onderzoek naar transitie in het groene domein veel algemene lessen te trekken. Op deze algemene lessen, die gedurende het gehele traject steeds in gezamenlijkheid zijn opgehaald en besproken, is deze post-ambule gebaseerd. We kijken hier terug op vier jaar onderzoek naar transitie in het groene domein in het kader van IMPACT en geven wij een beeld van hoe wij binnen IMPACT als hbo-kennisprogramma het werken aan transitie in het groene domein hebben ervaren. We beginnen ons artikel met de achtergrond van IMPACT; een schets van de problemen in het agro-food domein en transitie in deze context. Daarna volgt vanuit elk van de vijf lectoraten een casus die relevant is in het licht van werken aan transitie in een hbo-kennisprogramma, vanuit deze cases trekken we algemene lessen waarmee we deze post-ambule ook tevens afsluiten.
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Willem Post is senior fellow bij instituut Clingendael, gespecialiseerd in Amerikaanse politiek en geschiedenis, met een focus op het presidentschap. Hij heeft meerdere boeken over de Verenigde Staten geschreven en is commentator voor Nederlandse en buitenlandse media. In dit gesprek met Mendeltje van Keulen en Ruud Schapenk van de Haagse Hogeschool, laat hij zijn licht schijnen op de veranderende politieke relatie tussen Nederland en de Verenigde Staten in tijden van Trump, Brexit en Corona.
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