Voor u ligt de voorlichtingspublicatie "Onder poeder lassen". Dit blad is een update van het NIL-voorlichtingsblad "Onder poeder lassen" dat in 1988 is opgesteld als onderdeel van het gelijknamige onderzoeksproject dat uitgevoerd is onder supervisie van het Nederlands Instituut voor Lastechniek. Daar er in de periode tussen verschijning van de eerste uitgave en nu een aantal belangrijke ontwikkelingen op het gebied van het onder poeder lassen is geweest, was een aanpassing aan de huidige stand der techniek noodzakelijk. De Nederlandse overheid heeft geld ter beschikking gesteld om een aantal verouderde voorlichtingspublicaties aan te passen aan de stand der techniek; de FME heeft de coördinatie daarvan op zich genomen. Voor de aanpassing van deze publicatie heeft zij het NIL de opdracht gegeven. De oude voorlichtingspublicatie vormt de basis van deze update, zodat verwijzingen naar geraadpleegde literatuur aanvullend aan de oude publicatie zijn.
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Deze publicatie is gemaakt in het kader van het project "Proceskeuze voor de fabricage van producten met hoge nauwkeurigheidseisen te vervaardigen in kleine series" en verschijnt tezamen met de publicatie "Een vergelijking van het laserlassen met conventionele lastechnieken voor kleine series producten". Het doel van deze publicatie is het ondersteunen van de ontwerper en de werkvoorbereider bij het kiezen van het optimale omvormproces wat betreft technologie en economie. Hierbij dient niet alleen te worden uitgegaan van de eisen die aan het eindproduct gesteld worden, maar er dient ook rekening te worden gehouden met de eisen die opvolgende bewerkingen, zoals lasprocessen aan halffabrikaten stellen.
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The background and purpose of this paper is to investigate adherence, exercise performance levels and associated factors in head and neck cancer (HNC) patients participating in a guided home-based prophylactic exercise program during and after treatment [swallowing sparing intensity modulated radiation therapy (SW-IMRT)]. Fifty patients were included in the study. Adherence was defined as the percentage of patients who kept up exercising; exercise performance level was categorized as low: ≤1, moderate: 1–2, and high: ≥2 time(s) per day, on average. Associations between 6- and 12-week exercise performance levels and age, gender, tumour site and stage, treatment, intervention format (online or booklet), number of coaching sessions, and baseline HNC symptoms (EORTC-QLQ-H&N35) were investigated. Adherence rate at 6 weeks was 70% and decreased to 38% at 12 weeks. In addition, exercise performance levels decreased over time (during 6 weeks: 34% moderate and 26% high; during 12 weeks: 28% moderate and 18% high). The addition of chemotherapy to SW-IMRT [(C)SW-IMRT] significantly deteriorated exercise performance level. Adherence to a guided home-based prophylactic exercise program was high during (C)SW-IMRT, but dropped afterwards. Exercise performance level was negatively affected by chemotherapy in combination with SW-IMRT.
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Motor learning is particularly challenging in neurological rehabilitation: patients who suffer from neurological diseases experience both physical limitations and difficulties of cognition and communication that affect and/or complicate the motor learning process. Therapists (e.g.,, physiotherapists and occupational therapists) who work in neurorehabilitation are therefore continuously searching for the best way to facilitate patients during these intensive learning processes. To support therapists in the application of motor learning, a framework was developed, integrating knowledge from the literature and the opinions and experiences of international experts. This article presents the framework, illustrated by cases from daily practice. The framework may assist therapists working in neurorehabilitation in making choices, implementing motor learning in routine practice, and supporting communication of knowledge and experiences about motor learning with colleagues and students. The article discusses the framework and offers suggestions and conditions given for its use in daily practice.
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Dragen sociaalnetwerksites van sportverenigingen (ClubSNSs) bij aan het clubgevoel van leden? 129 leden van sportverenigingen vulden een vragenlijst in over ClubSNSs en clubgevoel. Daaruit blijkt dat leden ClubSNSs informatief, vermakelijk en interactief vinden en ClubSNSs gebruiken voor het volgen van content over sport, leden en de club. Verder blijken ClubSNSs belangrijk voor het clubgevoel van leden, doordat identificatie met de sportvereniging wordt opgebouwd.
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The aim of the research reported in this thesis was to gain knowledge about the implementation of evidence‐based practice (EBP) in nursing to find a way to integrate shared decision making (SDM) with EBP in a chronic care environment in nursing, and to develop a strategy for an integrated approach of EBP and SDM in daily nursing practice in the individual aftercare for cancer survivors.
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Background: The environment affects children’s energy balance-related behaviors to a considerable extent. A context-based physical activity and nutrition school- and family-based intervention, named KEIGAAF, is being implemented in low socio-economic neighborhoods in Eindhoven, The Netherlands. The aim of this study was to investigate: 1) the effectiveness of the KEIGAAF intervention on BMI z-score, waist circumference, physical activity, sedentary behavior, nutrition behavior, and physical fitness of primary school children, and 2) the process related to the implementation of the intervention. Methods: A quasi-experimental, controlled study with eight intervention schools and three control schools was conducted. The KEIGAAF intervention consists of a combined top-down and bottom-up school intervention: a steering committee developed the general KEIGAAF principles (top-down), and in accordance with these principles, KEIGAAF working groups subsequently develop and implement the intervention in their local context (bottom-up). Parents are also invited to participate in a family-based parenting program, i.e., Triple P Lifestyle. Children aged 7 to 10 years old (grades 4 to 6 in the Netherlands) are included in the study. Effect evaluation data is collected at baseline, after one year, and after two years by using a child questionnaire, accelerometers, anthropometry, a physical fitness test, and a parent questionnaire. A mixed methods approach is applied for the process evaluation: quantitative (checklists, questionnaires) and qualitative methods (observations, interviews) are used. To analyze intervention effectiveness, multilevel regression analyses will be conducted. Content analyses will be conducted on the qualitative process data. Discussion: Two important environmental settings, the school environment and the family environment, are simultaneously targeted in the KEIGAAF intervention. The combined top-down and bottom-up approach is expected to make the intervention an effective and sustainable version of the Health Promoting Schools framework. An elaborate process evaluation will be conducted alongside an effect evaluation in which multiple data collection sources (both qualitative and quantitative) are used.
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Dit is het eindrapport van de Global mOralHealth bijeenkomst georganiseerd door de Wereldgezondheidsorganisatie (WHO) en de universiteit van Montpellier. Docent Mondzorgkunde - Janneke Scheerman en lid van het lectoraat GGZ verpleegkunde - woonde deze bijeenkomst in oktober 2018 bij en droeg bij aan het rapport: https://www.inholland.nl/nieuws/be-helthy-be-mobile/ Als vervolg op de Global mOralHealth bijeenkomst wordt het mOralHealth handboek ontwikkeld, waaraan Janneke meeschrijft. In het handboek worden de procedures voor het ontwikkelen van mOralHealth interventies beschreven.
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Hoofdstuk 2 gaat over peer en professionele online support voor ouders bij het opvoeden. In totaal bevat het boek 31 hoofdstukken over sociaal netwerken, geschreven door tientallen onderzoekers wereldwijd.
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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.
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