In order to achieve a level of community involvement and physical independence, being able to walk is the primary aim of many stroke survivors. It is therefore one of the most important goals during rehabilitation. Falls are common in all stages after stroke. Reported fall rates in the chronic stage after stroke range from 43 to 70% during one year follow up. Moreover, stroke survivors are more likely to become repeated fallers as compared to healthy older adults. Considering the devastating effects of falls in stroke survivors, adequate fall risk assessment is of paramount importance, as it is a first step in targeted fall prevention. As the majority of all falls occur during dynamic activities such as walking, fall risk could be assessed using gait analysis. It is only recent that technology enables us to monitor gait over several consecutive days, thereby allowing us to assess quality of gait in daily life. This thesis studies a variety of gait assessments with respect to their ability to assess fall risk in ambulatory chronic stroke survivors, and explores whether stroke survivors can improve their gait stability through PBT.
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Background: Survivors of lymphoma experience multiple challenges after treatment. However, a lack of knowledge of in-depth experiences of lymphoma survivors in early aftercare persists. Objective: To gain an in-depth understanding of the experiences of lymphoma survivors in early aftercare who have received an aftercare consultation based on evidence-based guideline recommendations, with an advanced practice nurse. Methods: This study used a narrative design. We recruited lymphoma survivors after a best-practice aftercare consultation with an advanced practice nurse. A total of 22 lymphoma survivors and 9 partners participated. Data were collected through narrative interviews and analyzed according to thematic narrative analysis. Results: Six themes emerged: living and dealing with health consequences, coping with work and financial challenges, having a positive outlook and dealing with uncertainty, deriving strength from and experiencing tensions in relationships, getting through tough times in life, and receiving support from healthcare professionals. Conclusions: The stories of lymphoma survivors in early aftercare revealed their experiences of how they coped with a range of challenges in their personal lives. Choosing an aftercare trajectory based on an aftercare consultation that encourages patients to think about their issues, goals, and possible aftercare options may be useful for their transition from treatment to survivorship. Implications for practice: Survivors’ social support and self-management capabilities are important aspects to be addressed in cancer care. An aftercare consultation involving shared goal setting and care planning may help nurses provide personalized aftercare.
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Background: Survivors of lymphoma experience multiple challenges after treatment. However, a lack of knowledge of in-depth experiences of lymphoma survivors in early aftercare persists. Objective: To gain an in-depth understanding of the experiences of lymphoma survivors in early aftercare who have received an aftercare consultation based on evidence-based guideline recommendations, with an advanced practice nurse. Methods: This study used a narrative design. We recruited lymphoma survivors after a best-practice aftercare consultationwith an advanced practice nurse. A total of 22 lymphoma survivors and 9 partners participated. Data were collected through narrative interviews and analyzed according to thematic narrative analysis. Results: Six themes emerged: living and dealing with health consequences, coping with work and financial challenges, having a positive outlook and dealing with uncertainty, deriving strength from and experiencing tensions in relationships, getting through tough times in life, and receiving support from healthcare professionals. Conclusions: The stories of lymphoma survivors in early aftercare revealed their experiences of how they coped with a range of challenges in their personal lives. Choosing an aftercare trajectory based on an aftercare consultation that encourages patients to think about their issues, goals, and possible aftercare options may be useful for their transition from treatment to survivorship. Implications for practice: Survivors’ social support and self-management capabilities are important aspects to be addressed in cancer care. An aftercare consultation involving shared goal setting and care planning may help nurses provide personalized aftercare.
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Worldwide, coral reefs are rapidly declining due to increased sea water temperatures and other environmental stresses (Figure 1). To counter the extinction of major coral reef building species on the island of Bonaire, the non-profit organization Reef Renewal Foundation Bonaire is restoring degraded reef sites using corals that are grown in local nurseries. In these nurseries, corals are propagated on artificial trees using fragmentation. After 6-8 months of growth in the nursery, the corals are transplanted to degraded reef sites around the island. Over the years more than 21.000 corals have been outplanted to reef restoration sites in this way. These corals show high survivorship under natural reef conditions but remain under threat by environmental disturbances, such as increased water temperatures, diseases, and competition with macroalgae. A promising intervention to increase reef persistence and resilience is to manipulate the coral-associated microbiome. At present, the composition of the microbiome in nursery-reared and outplanted corals on Bonaire is unknown. The aim of the current project is to identify and isolate naturally occurring beneficial bacteria that may stimulate the resilience of these corals. Our key objectives are: 1) to assess the presence of functionally beneficial bacteria in corals in nursery and restoration sites on Bonaire using metagenomic screening. 2) to design culture strategies to isolate these functionally beneficial bacteria. In the future, a selection of these beneficial bacteria can be applied to the corals to increase their resilience against environmental disturbances.
In this project, we explore how healthcare providers and the creative industry can collaborate to develop effective digital mental health interventions, particularly for survivors of sexual assault. Sexual assault victims face significant barriers to seeking professional help, including shame, self-blame, and fear of judgment. With over 100,000 cases reported annually in the Netherlands the need for accessible, stigma-free support is urgent. Digital interventions, such as chatbots, offer a promising solution by providing a safe, confidential, and cost-effective space for victims to share their experiences before seeking professional care. However, existing commercial AI chatbots remain unsuitable for complex mental health support. While widely used for general health inquiries and basic therapy, they lack the human qualities essential for empathetic conversations. Additionally, training AI for this sensitive context is challenging due to limited caregiver-patient conversation data. A key concern raised by professionals worldwide is the risk of AI-driven chatbots being misused as therapy substitutes. Without proper safeguards, they may offer inappropriate responses, potentially harming users. This highlights the urgent need for strict design guidelines, robust safety measures, and comprehensive oversight in AI-based mental health solutions. To address these challenges, this project brings together experts from healthcare and design fields—especially conversation designers—to explore the power of design in developing a trustworthy, user-centered chatbot experience tailored to survivors' needs. Through an iterative process of research, co-creation, prototyping, and evaluation, we aim to integrate safe and effective digital support into mental healthcare. Our overarching goal is to bridge the gap between digital healthcare and the creative sector, fostering long-term collaboration. By combining clinical expertise with design innovation, we seek to develop personalized tools that ethically and effectively support individuals with mental health problems.
