Inaugural lecture, delivered upon public acceptance of the endowed professorship in Professionalisation of Nursing and Care in Elderly Care by Prof. Dr. Robbert J.J. Gobbens at Tilburg University on 29 September 2023.
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In this article, we examine the relationship between important types of policies for asylum permit holders in the Netherlands and the improvement in their command of Dutch. As far as asylum policy is concerned, we find that participation in activities in the asylum seekers reception centre – and in particular, following Dutch language classes – contribute to an improvement in Syrian asylum permit holders’ command of Dutch. On the other hand, a prolonged period of stay and frequent relocations between reception centres are not favourable. Asylum permit holders who have successfully completed the civic integration programme have a better command of the language than asylum permit holders who are still undergoing the programme. An important finding is that there seems to be a sort of double deficit in the area of civic integration: not only do the elderly and lower educated make less progress in learning Dutch, but they are also the ones more likely to receive a dispensation from the civic integration requirement, which places them at a further disadvantage. Third, we find that early participation in the labour market or as a volunteer is also beneficial for language proficiency.
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Aim: The prevalence of age‐related malnutrition is increasing in almost all Western countries. Because of their expertise, dietitians should have a central role in the management of malnutrition. This review aimed to synthesise the literature on the role of the dietitian in the management of malnutrition in the elderly in comparison with other health professionals. Methods: In November 2018, a search of Embase, Medline Ovid, Cinahl Ebscohost, Cochrane Central, Web of Science and Google Scholar was undertaken using ‘dietitian’, ‘elderly’ and ‘malnutrition’ as the main search terms. Qualitative and quantitative empirical research studies that focussed on the role of dietitians as the (main) subject of the study were included. Data extraction and data synthesis were performed by the three authors using a thematic synthesis approach. Results: Three themes emerged from the coding and synthesis of the 21 included studies. The first theme demonstrates that other health professionals' time for, and knowledge of, screening policies negatively affects the role of the dietitian. The second theme demonstrates that the importance of nutritional care is acknowledged. However, this does not always imply familiarity with dietetics nor does it always mean that other health professionals think involving dietitians is worth the effort. The third theme demonstrates that issues of workload appeared to be especially important in crossing or guarding role boundaries. Conclusions: The role of dietitians in managing age‐related malnutrition is not always clear and coherent. Therefore, how dietitians shape their role to provide optimal management of malnutrition in the elderly is open to debate. https://doi.org/10.1111/1747-0080.12546 LinkedIn: https://www.linkedin.com/in/matthijs-fleurke-66279110/ https://www.linkedin.com/in/dorien-voskuil-9b27b115/
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During the COVID-19 pandemic, the bidirectional relationship between policy and data reliability has been a challenge for researchers of the local municipal health services. Policy decisions on population specific test locations and selective registration of negative test results led to population differences in data quality. This hampered the calculation of reliable population specific infection rates needed to develop proper data driven public health policy. https://doi.org/10.1007/s12508-023-00377-y
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Most European countries have to find a delicate balance between long term economic reform and short term impact on GDP.
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The focus of my research is how Bartholomeus Guesthouse (BG), founded in 1407 by Willem van Abcoude, has organized care over more than 600 years for the elderly and elderly sick people in the Centre of Utrecht. After the reorganization of 1817 -by Royal Law- the 7 (9) Guesthouses were merged to one Board called “College van Regenten der Vereenigde Gods-en Gasthuizen” .They have had their domicile in Bartholomeus Guesthouse. This Guesthouse survived as elderly care centre on particular foundation, which has meant until today that people from different religions were welcome. The properties of the other guesthouses came under supervision of the Board of “Vereenigde Gods-en Gasthuizen”. The heritage of the other foundations was , in terms of property and land, considerable. In my paper I will present the following items: -An inventarisation of the situation after 1817 and the ‘cameren’ (vrij woningen) of the different guesthouses in Utrecht and what their (living) conditions were at that time; -the Policy of the Board supervising the Free Houses/ Cameren for Elderly during this area; the observation of the archive manager S.Muller Fz.is good illustration of the situation in 1900; -the inhabitants of the ‘vrij woningen’; the selection and the rules as part of the social housing policy; - a more general analysis: the policy of poor relief and the debate of who had to take care of the poor? - all subjects give an answer to the question whether or not poor relief can be regarded as a safety valve for the (lower) middle class, in the ninetheenth century.
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The role of smart cities in order to improve older people’s quality of life, sustainability and opportunities, accessibility, mobility, and connectivity is increasing and acknowledged in public policy and private sector strategies in countries all over the world. Smart cities are one of the technological-driven initiatives that may help create an age-friendly city. Few research studies have analysed emerging countries in terms of their national strategies on smart or age-friendly cities. In this study, Romania which is predicted to become one of the most ageing countries in the European Union is used as a case study. Through document analysis, current initiatives at the local, regional, and national level addressing the issue of smart and age-friendly cities in Romania are investigated. In addition, a case study is presented to indicate possible ways of the smart cities initiatives to target and involve older adults. The role of different stakeholders is analysed in terms of whether initiatives are fragmentary or sustainable over time, and the importance of some key factors, such as private–public partnerships and transnational bodies. The results are discussed revealing the particularities of the smart cities initiatives in Romania in the time frame 2012–2020, which to date, have limited connection to the age-friendly cities agenda. Based on the findings, a set of recommendations are formulated to move the agenda forward. CC-BY Original article: https://doi.org/10.3390/ijerph17145202 (This article belongs to the Special Issue Feature Papers "Age-Friendly Cities & Communities: State of the Art and Future Perspectives") https://www.dehaagsehogeschool.nl/onderzoek/lectoraten/details/urban-ageing#over-het-lectoraat
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The significance of effective interprofessional teamwork to improve the quality of care has been widely recognised. Effective interprofessional teamwork calls on good collaboration between professionals and patients, coordination between professionals, and the development of teamwork over time. Effective development of teams also requires support from the wider organisational context. In a Dutch village, healthcare professionals work closely together, and mutual consultations as well as interprofessional meetings take place on a regular basis. The network was created as a precondition for sustainable interprofessional teamwork in elderly care. However, several external barriers were experienced regarding the supportive structure and cooperative attitude of the healthcare insurer and municipality. The aim of the article is to examine these experience-based issues regarding internal organisation, perspective, and definition of effective teamwork. Complicating factors refer to finding the right key figures, and the different perspectives on team development and team effectiveness. Our conclusion is that the organisation of healthcare insurance companies needs to implement fundamental changes to facilitate an interprofessional care approach. Furthermore, municipalities should work on their vision of the needs and benefits of a fruitful collaboration with interprofessional healthcare teams. The challenge for healthcare teams is to learn to speak the language of external partners. To support the development of interprofessional teams, external parties need to recognise and trust in a shared aim to provide quality of care in an efficient and effective way.
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Abstract: Due to rapidly aging human populations, frailty has become an essential concept, as it identifies older people who have higher risk of adverse outcomes, such as disability, institutionalization, lower quality of life, and premature death. The Tilburg Frailty Indicator (TFI) is a user-friendly questionnaire based on a multidimensional approach to frailty, assessing physical, psychologic, and social aspects of human functioning. This review aims to explore the efficiency of the TFI in assessing frailty as a means to carry out research into the antecedents and consequences of frailty, and its use both in daily practice and for future intervention studies. Using a multidimensional approach to frailty, in contexts where health care professionals or researchers may have no time to interview or examine the client, we recommend employing the TFI because there is robust evidence of its reliability and validity and it is easy and quick to administer. More studies are needed to establish whether the TFI is suitable for intervention studies not only in the community, but also for specific groups such as patients in the hospital or admitted to an emergency department. We conclude that it is important to not only determine the deficits that frail older people may have, but also to assess their balancing strengths and resources. In order to be able to meet the individual needs of frail older persons, traditional and often fragmented elderly care should be developed toward a more proactive elderly care, in which frail older persons and their informal network are in charge.
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Abstract Background: One of the most challenging issues for the elderly population is the clinical state of frailty. Frailty is defined as a cumulative decline across psychological, physical, and social functioning. Hospitalization is one of the most stressful events for older people who are becoming frail. The aim of the present study was to determine the effectiveness of interventions focused on management of frailty in hospitalized frail older adults. Methods: A systematic review and meta-analysis of research was conducted using the Medline, Embase, Cochrane, ProQuest, CINAHL, SCOPUS and Web of Science electronic databases for papers published between 2000 and 2019. Randomized controlled studies were included that were aimed at the management of frailty in hospitalized older adults. The outcomes which were examined included frailty; physical, psychological, and social domains; length of stay in hospital; re-hospitalization; mortality; patient satisfaction; and the need for post discharge placement. Results: After screening 7976 records and 243 full-text articles, seven studies (3 interventions) were included, involving 1009 hospitalized older patients. The quality of these studies was fair to poor and the risk of publication bias in the studies was low. Meta-analysis of the studies showed statistically significant differences between the intervention and control groups for the management of frailty in hospitalized older adults (ES = 0.35; 95% CI: 0. 067–0.632; z = 2.43; P < 0.015). However, none of the included studies evaluated social status, only a few of the studies evaluated other secondary outcomes. The analysis also showed that a Comprehensive Geriatric Assessment unit intervention was effective in addressing physical and psychological frailty, re-hospitalization, mortality, and patient satisfaction. Conclusions: Interventions for hospitalized frail older adults are effective in management of frailty. Multidimensional interventions conducted by a multidisciplinary specialist team in geriatric settings are likely to be effective in the care of hospitalized frail elderly. Due to the low number of RCTs carried out in a hospital setting and the low quality of existing studies, there is a need for new RCTs to be carried out to generate a protocol appropriate for frail older people.
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