Geen samenvatting beschikbaar
DOCUMENT
In 2004 the first adaptive thermal comfort guideline was introduced in the Netherlands. Recently a new, upgraded version of this ISSO 74 (ATG) guideline has been developed. The new requirements are hybrid in nature as the 2014 version of the guideline combines elements of traditional non-adaptive comfort standards with elements of adaptive standards. This paper describes the new guideline and explains the rationale behind it. Also changes in comparison with the original 2004 version and issues related to performance verification are discussed. The information presented in this paper can be used by others (other countries) as inspiration material for other new adaptive comfort guidelines and standards.
DOCUMENT
From the publisher's website: Large groups in society, in particular people with low literacy, lack the necessary proactivity and problem-solving skills to be self-reliant. One omnipresent problem area where these skills are relevant regards filling in forms and questionnaires. These problems could be potentially alleviated by taking advantage of the possibilities of information and communication technology (ICT), for example by offering alternatives to text, interactive self-explaining scales and easily accessible background information on the questionnaires’ rationale. The goal of this paper was to present explorative design guidelines for developing interactive questionnaires for low-literate persons. The guidelines have been derived during a user-centered design process of the Dutch Talking Touch Screen Questionnaire (DTTSQ), an interactive health assessment questionnaire used in physical therapy. The DTTSQ was developed to support patients with low health literacy, meaning they have problems with seeking, understanding and using health information. A decent number of guidelines have been derived and presented according to an existing, comprehensive model. Also, lessons learned were derived from including low-literate persons in the user-centered design process. The guidelines should be made available to ICT developers and, when applied properly, will contribute to the advancement of (health) literacy and empower citizens to fully participate in society
LINK
This special issue (SI) aims to assemble a high-quality set of papers, which improve our understanding of how contextual factors impact the conceptualization, implementation and effectiveness of Talent Management. The context can be used several ways, e.g. to frame the relevance of the study, to interpret results or even by using theoretical frameworks in which the contextual factors and variables are incorporated.
DOCUMENT
Financially vulnerable consumers are often associated with suboptimal financial behaviors. Evaluated financial education programs so far show difficulties to effectively reach this target population. In our attempt to solve this problem, we built a behaviorally informed financial education program incorporating insights from both motivational and behavioral change theories. In a quasi-experimental field study among Dutch financially vulnerable people, we compared this program with both a control group and a traditional program group. In comparison with the control group, we found robust positive effects of the behaviorally informed program on financial skills and knowledge and self-reported financial behavior, but not on other outcomes. Additionally, we did not find evidence that the behaviorally informed program performed better than the traditional program. Finally, we discuss the findings and limitations of this study in light of the financial education literature and provide implications for policymaking and directions for future research.
MULTIFILE
Background: A pragmatic, stepped wedge trial design can be an appealing design to evaluate complex interventions in real-life settings. However, there are certain pitfalls that need to be considered. This paper reports on the experiences and lessons learned from the conduct of a cluster randomized, stepped wedge trial evaluating the effect of the Hospital Elder Life Program (HELP) in a Dutch hospital setting to prevent older patients from developing delirium. Methods: We evaluated our trial which was conducted in eight departments in two hospitals in hospitalized patients aged 70 years or older who were at risk for delirium by reflecting on the assumptions that we had and on what we intended to accomplish when we started, as compared to what we actually realized in the different phases of our study. Lessons learned on the design, the timeline, the enrollment of eligible patients and the use of routinely collected data are provided accompanied by recommendations to address challenges. Results: The start of the trial was delayed which caused subsequent time schedule problems. The requirement for individual informed consent for a quality improvement project made the inclusion more prone to selection bias. Most units experienced major difficulties in including patients, leading to excluding two of the eight units from participation. This resulted in failing to include a similar number of patients in the control condition versus the intervention condition. Data on outcomes routinely collected in the electronic patient records were not accessible during the study, and appeared to be often missing during analyses. Conclusions: The stepped wedge, cluster randomized trial poses specific risks in the design and execution of research in real-life settings of which researchers should be aware to prevent negative consequences impacting the validity of their results. Valid conclusions on the effectiveness of the HELP in the Dutch hospital setting are hampered by the limited quantity and quality of routine clinical data in our pragmatic trial. Executing a stepped wedge design in a daily practice setting using routinely collected data requires specific attention to ethical review, flexibility, a spacious time schedule, the availability of substantial capacity in the research team and early checks on the data availability and quality.
DOCUMENT
Developmental Transformations (DvT), a practice involving interactive, improvisational play in pairs or groups, has gained international appeal as a therapeutic intervention for different populations in a variety of health, care and recreational contexts. However, a rigorous review of the benefits of DvT has not been conducted. The purpose of this study was to review extant literature for the observed benefits of DvT, identify gaps in the literature and make recommendations concerning future research including identifying possible areas for outcome measurement for preliminary studies. The authors, who each completed training in this approach, conducted a scoping review of English-language, published, peer-reviewed and grey DvT literature through 2021. From an initial 745 records retrieved through databases and a manual search, 51 publications met criteria, which, when analysed using in-vivo and pattern coding, resulted in a total of seventeen categories of observed benefits ascribed to DvT. These included six general categories – relational, emotional, social, cognitive, behavioural and physical benefits – and eleven complex categories of benefits to participants across the lifespan. In addition to benefits for participants, benefits of DvT were also observed and reported for facilitators, therapists, teachers and supervisors engaged in this practice. This review revealed inconsistencies regarding the reporting of practitioner training, frequency, format, population, intended goals, assessment measures and outcomes. Future studies with increased experimental rigor, standardized outcome measures and consistent reporting are recommended.
DOCUMENT
Previous research shows that power training can increase power output in older adults and may also improve physical performance, physical functioning, and independence. However, power training interventions have not been optimized for older adults. The aim of this study was to assess the feasibility and preliminary effectiveness of a power training program called Powerful Ageing in older adults. A total of 28 older adults participated in a 12-week power training intervention at an intensity of 20-30% 1RM. The primary outcome, feasibility, was assessed through intervention retention, adherence (attendance and compliance), and safety. Secondary outcomes were measured in health domains of the ICF. In the function domain, muscle power and anaerobic power were assessed using a weighted squat and Wingate test, respectively. In the activities domain, physical performance was measured using the 6-minute walk test, and in the participation domain, physical activity in daily life and health status were evaluated using an accelerometer and the SF-36 questionnaire, respectively.
MULTIFILE
To evaluate the construct validity and the inter-rater reliability of the Dutch Activity Measure for Post- Acute Care “6-clicks” Basic Mobility short form measuring the patient’s mobility in Dutch hospital care. First, the “6-clicks” was translated by using a forward-backward translation protocol. Next, 64 patients were assessed by the physiotherapist to determine the validity while being admitted to the Internal Medicine wards of a university medical center. Six hypotheses were tested regarding the construct “mobility” which showed that: Better “6-clicks” scores were related to less restrictive pre-admission living situations (p¼0.011), less restrictive discharge locations (p¼0.001), more independence in activities of daily living (p¼0.001) and less physiotherapy visits (p<0.001). A correlation was found between the “6-clicks” and length of stay (r¼0.408, p¼0.001), but not between the “6-clicks” and age (r¼0.180, p¼0.528). To determine the inter-rater reliability, an additional 50 patients were assessed by pairs of physiotherapists who independently scored the patients. Intraclass Correlation Coefficients of 0.920 (95%CI: 0.828–0.964) were found. The Kappa Coefficients for the individual items ranged from 0.649 (walking stairs) to 0.841 (sit-to-stand). The Dutch “6-clicks” shows a good construct validity and moderate-toexcellent inter-rater reliability when used to assess the mobility of hospitalized patients.
DOCUMENT
Toenemende prevalentie van overgewicht en obesitas onder jeugd wordt, in ieder geval ten dele, veroorzaakt door te weinig fysieke activiteit. Omdat ieder kind een groot deel van zijn of haar jeugdige leven op school doorbrengt kunnen scholen een centrale rol spelen in het tegengaan van deze bewegingsarmoede. Het meest voor de hand liggende schoolvak lijkt hierbij de lichamelijke opvoeding1 (LO) te zijn. De belangrijkste doelstelling van het schoolvak LO is immers om leerlingen dusdanig te motiveren en enthousiast te maken voor sport en bewegen zodat dit uiteindelijk resulteert in een actieve leefstijl, zowel buiten school als in het verdere leven. Daarnaast is LO tevens het enige verplichte schoolvak waar fysieke activiteit een centrale plek inneemt; de les zelf is in potentie ook een structurele bron van fysieke activiteit. Globaal gezien kan LO dus op een indirecte en een directe manier bijdragen aan de fysieke activiteit van leerlingen, een tweedeling die werd geïntroduceerd in hoofdstuk 1. Waar echter tot op heden onduidelijkheid over bestaat, zeker wat betreft de Nederlandse situatie, is hoe groot de bijdrage van de LO aan dagelijkse fysieke activiteit feitelijk is. De vraag die daarom centraal staat in dit proefschrift is in hoeverre het vak LO, zoals dat op dit moment gegeven wordt op basis- en voortgezet onderwijs, een bijdrage levert aan de fysieke activiteit van kinderen en adolescenten, zowel direct (de les als bron van fysieke activiteit), als indirect (motivatie voor een actieve leefstijl). Voor de beantwoording van deze vraag zijn een aantal studies uitgevoerd. Allereerst is in hoofdstuk 2 door middel van een literatuurstudie onderzocht in hoeverre interventies met een LO-component effectief zijn in het stimuleren van fysieke activiteit. Hieruit blijkt dat er alleen overtuigend bewijs bestaat voor een directe bijdrage van de les LO aan de fysieke activiteit van kinderen en adolescenten. Oftewel, in de les LO zelf wordt er matig-tot-intensief bewogen. De effecten van interventies met een LO component op de fysieke activiteit buiten school of in het latere leven zijn minder overtuigend of zelfs afwezig. In hoofdstuk 3 wordt een cross-sectionele studie beschreven waarin middels het combineren van gegevens vanuit een hartslag-versnellingsmeter met de gegevens uit een activiteitendagboek voor het eerst inzicht verkregen wordt in de daadwerkelijke bijdrage van een reguliere les LO (naast andere fysieke activiteiten zoals fietsen) aan de totale dagelijkse fysieke activiteit van middelbare scholieren. De resultaten wijzen uit dat 17% van de totale hoeveelheid beweging onder schooltijd zijn oorsprong vindt in de lessen LO en dat op dagen dat een leerling een les LO heeft, deze les verantwoordelijk is voor ongeveer 30% van de totale fysieke activiteit op die dag. Opvallend is daarnaast dat 15% van de totale fysieke activiteit op een weekdag zijn oorsprong vindt in het actief transport naar school, voornamelijk fietsen. Hoofdstuk 4 beschrijft een studie waarin de focus ligt op de intensiteit van lessen LO in het voortgezet onderwijs (VO) en het basisonderwijs (BO). Tevens is gekeken naar factoren die de intensiteit van een les beïnvloeden. De resultaten wijzen uit dat 47% en 40% van een les LO op respectievelijk het VO en het BO voldoet aan de intensiteit van bewegen zoals omschreven in de Nederlandse Norm voor Gezond Bewegen (matig-tot-intensief fysiek actief). Dit komt overeen met ongeveer een derde van de dagelijks aanbevolen hoeveelheid beweging voor deze doelgroep. Opvallend is dat op het VO jongens significant actiever zijn tijdens de lessen LO dan meisjes. Dit verschil blijkt zijn oorsprong te hebben in lessen waarin competitieve spelvormen (basketbal, voetbal etc.) centraal staan. Mogelijkerwijs verhindert de dominantie van jongens tijdens spelvormen dat meisjes in een les even actief kunnen zijn als jongens. Dit is een serieuze beperking van de mate waarin een les LO kan bijdragen aan het totale beweeggedrag van meisjes, gezien het feit dat ongeveer 60% van het Nederlandse LO curriculum uit (veelal competitieve) spelvormen bestaat.
DOCUMENT
