Background: An estimated 18 million people in the world have to cope with a decline in intellectual functioning that is not a normal part of the ageing process, called dementia. By 2025, this number is expected to reach 34 million. Alzheimer's disease accounts for 50-70 % of all cases of dementia. In the Netherlands, about two thirds of those affected live at home, with or without a partner. The increasing group of older adults with dementia presents great challenges in terms of creating suitable living environments and appropriate housing. Extramural housing needs further development, as opposed to intramural housing, such as nursery homes. The new extramural housing forms account for and compensate decreasing vitality and overall health status through the use of ICT and other technologies to serve human well-being. This should facilitate both residents and alleviate the intensity of care given by voluntary and professional care givers. In order to create these optimal dwellings at cost effective prices, evidence-based introduction of architectural measures and technological applications is essential. Existing knowledge is best viewed as an effort to expand and stimulate thinking on the relationships between dementia and design; thus, knowledge is largely a collection of hypotheses amenable to, and requiring, implementation and validation.This PhD-project will research some of the design aspects and needs, relevant to the technological home environment for older adults with dementia. This PhD project is shared with Hogeschool Utrecht, Lectureship of Demand Driven Care. Aim of research: Assessing thermal, lighting, and acoustic requirements, feasible home modifications and teleservices to sustain independence and well-being, both being the end product of all services rendered. Results so far indicate that requirements of older adults with dementia differ largely from the requirements of healthy older adults.
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Achtergrond: De Two-Minute Step Test (TMST) is een meetinstrument gericht op het beoordelen van uithoudingsvermogen. Verscheidene psychometrische eigenschappen van de TMST-NL (Nederlands vertaalde versie) zijn onderzocht bij intramuraal wonende ouderen. De gevoeligheid voor verandering en de responsiviteit is bij deze patiëntenpopulatie nog niet vastgesteld. Doel: Het vaststellen van de gevoeligheid voor verandering en de responsiviteit (Minimal Clinical Important Difference) van de TMST-NL bij intramuraal wonende ouderen. Design: Prospectief responsiviteitsonderzoek.Methode: De onderzoekspopulatie bestond uit intramuraal wonende ouderen. Deelnemers hebben twee meetmomenten (T0 en T1) ondergaan waartussen ze drie maanden fysiotherapie gericht op uithoudingsvermogen ontvingen. Om de gevoeligheid van verandering te meten werd de distributie methode gebruikt waarbij de correlatie met de 6-minuten wandeltest (6MWT) werd getoetst. Via de anker methode met de Receiver Operating Characteristic (ROC) curve werd de MCID bepaald.Metingen voor het aerobe uithoudingsvermogen werden verricht met de TMST-NL en de 6-minuten wandeltest (6MWT). De Global Rating of Change (GRC) en de Borg Category-Ratio10 (BORG-CR10) werden gebruikt als subjectieve vragenlijsten om verandering van de gezondheidssituatie en vermoeidheid te meten.Resultaten: Intramurale ouderen (N=50) met een gemiddelde (SD) leeftijd van 83,96 jaar (6,96) zijn geïncludeerd. De correlatie tussen de verschilscores van de TMST-NL en de 6MWT over de deelnemerspopulatie die T1 ook hebben afgerond (N= 36) kwam uit op r=0.51 (P <0.05). Vanuit de ROC curve werd een MCID van 8,50 stappen berekend. De AUC-waarde was 0,74 (95% CI 0,54-0,94; P =0.02). Conclusie: De TMST-NL is gevoelig voor verandering en responsief bij intramuraal wonende ouderen. Echter doordat de MCID binnen de minimale meetfout (MDC) valt moeten de resultaten voor individuele evaluatie bij deze doelgroep met voorzichtigheid worden geïnterpreteerd.
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The 'implementation' and use of smart home technology to lengthen independent living of non-instutionalized elderly have not always been flawless. The purpose of this study is to show that problems with smart home technology can be partially ascribed to differences in perception of the stakeholders involved. The perceptual worlds of caregivers, care receivers, and designers vary due to differences in background and experiences. To decrease the perceptual differences between the stakeholders, we propose an analysis of the expected and experienced effects of smart home technology for each group. For designers the effects will involve effective goals, caregivers are mainly interested in effects on workload and quality of care, while care receivers are influenced by usability effects. Making each stakeholder aware of the experienced and expected effects of the other stakeholders may broaden their perspectives and may lead to more successful implementations of smart home technology, and technology in general.
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This study assesses the evolutionary leadership theory and the natural leadership instrument of Van Vugt and Ahuja (2011) in the context of youth elite football. The Evolutionary Leadership Theory is a comprehensive new way of looking at leadership that suggests environmental pressures influence the choice of who becomes the leader. The results revealed that the concept of natural leadership, as measured using the six natural leaders questionnaire, cannot be applied to the context of youth football. The preliminary data showed that natural leadership in youth sport requires a more basic framework of leadership consisting of communication, resources and focus on competition.
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Dit jaar presenteert het lectoraat Maatschappelijk Vastgoed voor het eerst de Barometer Zorgvastgoed met als thema (inter)nationale context. Deze internationale context is van belang omdat de trackrecord voor het investeren in zorgvastgoed in Nederland nog erg beperkt is. Door te reflecteren aan de hand van de internationale context kunnen we wellicht in Nederland leren van ervaringen van anderen. In de Barometer Maatschappelijk Vastgoed 2014 was al te zien dat er veel aandacht is voor zorgvastgoed (Veuger et al., 2014: 129-235). De Barometer Zorgvastgoed is hier dan ook een gevolg van en heeft een drietal relevante en actuele invalshoeken: ontwikkelingen in zorgvastgoed, waardering en financiering van zorgvastgoed en assetmanagement zorgvastgoed. Het belang van de internationalisering van de zorgvastgoed wordt onderschreven door de bijdragen in internationale context en bijdrage van internationale auteurs. Hoewel de ervaringen voor het investeren in zorgvastgoed in Nederland nu nog erg beperkt zijn, gebeurd er in de internationale context veel. Sinds 2012 zijn Nederlandse zorgorganisaties zelf verantwoordelijk voor hun eigen vastgoed. Daarom staat het investeren in zorglocaties in Nederland nog in de kinderschoenen. Maar in de ons omringende landen als het Verenigd Koninkrijk (UK), België en Duitsland is zorgvastgoed anders georganiseerd. Buitenlandse investeerders zien veel pluspunten als ze naar de Nederlandse zorgvastgoedmarkt kijken. Pluspunten zijn dat de Nederlandse instellingen tegen de economische trend in de solvabiliteit en het eigen vermogen groeien. Voor financiering van zorgvastgoed heeft de zorgsector maar een beperkte keuze van een aantal Nederlandse banken die ook met enige regelmaat consortia vormen bij forse investeringen. Private investeerders en institutionele beleggers hebben wel meer belangstelling voor zorgvastgoed maar zijn relatief nog onbekend met investeringen in zorgvastgoed in Nederland. Zorginstellingen nemen steeds vaker het initiatief om een creditrating aan te vragen, op zoek naar vreemd vermogen.
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Our study shows a steady increase in dementia- and DHT-related publications, particularly in areas such as mobile health, virtual reality, artificial intelligence, and sensor-based technologies interventions. This increase underscores the importance of systematic approaches and interdisciplinary collaborations, while identifying knowledge gaps, especially in lower-income regions. It is crucial that researchers worldwide adhere to evidence-based medicine principles to avoid duplication of efforts. This analysis offers a valuable foundation for policy makers and academics, emphasizing the need for an international collaborative task force to address knowledge gaps and advance dementia care globally.
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Although the scientific literature consists of over 10,000 papers on eHealth, remarkably few applications are consistently being used in the healthcare domain. Numerous reasons for this lack of progression have been noted, one of these being the objection of medical professionals to the introduction of interventions that are supposedly lacking evidence of their effectiveness. A study of existing literature and, especially, literature reviews confirms that there does not yet exist scientific evidence of the effectiveness of eHealth. But, this study also comes across insights in the reasons why scientific evidence is hard to come by and possible future directions for healthcare organisations how to take advantage of eHealth despite the current lack of interventions that are truly evidence-based and for eHealth researchers to build collectively a stronger evidence-based case for eHealth interventions.
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Home care patients often use many medications and are prone to drug-related problems (DRPs). For the management of problems related to drug use, home care could add to the multidisciplinary expertise of general practitioners (GPs) and pharmacists. The home care observation of medication-related problems by home care employees (HOME)-instrument is paper-based and assists home care workers in reporting potential DRPs. To facilitate the multiprofessional consultation, a digital report of DRPs from the HOME-instrument and digital monitoring and consulting of DRPs between home care and general practices and pharmacies is desired. The objective of this study was to develop an electronic HOME system (eHOME), a mobile version of the HOME-instrument that includes a monitoring and a consulting system for primary care.
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A 4*4 PitStop is a metaphor for the work method or format used for a pop-up professional network. The method is designed to allow work, innovation and learning to go hand in hand. This format is based on the goals and direction provided by the participating professionals themselves. With this guide, we are sharing the results with professionals who want to start their own 4*4 PitStop.
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Through a qualitative examination, the moral evaluations of Dutch care professionals regarding healthcare robots for eldercare in terms of biomedical ethical principles and non-utility are researched. Results showed that care professionals primarily focused on maleficence (potential harm done by the robot), deriving from diminishing human contact. Worries about potential maleficence were more pronounced from intermediate compared to higher educated professionals. However, both groups deemed companion robots more beneficiary than devices that monitor and assist, which were deemed potentially harmful physically and psychologically. The perceived utility was not related to the professionals' moral stances, countering prevailing views. Increasing patient's autonomy by applying robot care was not part of the discussion and justice as a moral evaluation was rarely mentioned. Awareness of the care professionals' point of view is important for policymakers, educational institutes, and for developers of healthcare robots to tailor designs to the wants of older adults along with the needs of the much-undervalued eldercare professionals.
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