Background: Early childhood caries is considered one of the most prevalent diseases in childhood, affecting almost half of preschool-age children globally. In the Netherlands, approximately one-third of children aged 5 years already have dental caries, and dental care providers experience problems reaching out to these children. Objective: Within the proposed trial, we aim to test the hypothesis that, compared to children who receive usual care, children who receive the Toddler Oral Health Intervention as add-on care will have a reduced cumulative caries incidence and caries incidence density at the age of 48 months. Methods: This pragmatic, 2-arm, individually randomized controlled trial is being conducted in the Netherlands and has been approved by the Medical Ethics Research Board of University Medical Center Utrecht. Parents with children aged 6 to 12 months attending 1 of the 9 selected well-baby clinics are invited to participate. Only healthy children (ie, not requiring any form of specialized health care) with parents that have sufficient command of the Dutch language and have no plans to move outside the well-baby clinic region are eligible. Both groups receive conventional oral health education in well-baby clinics during regular well-baby clinic visits between the ages of 6 to 48 months. After concealed random allocation of interventions, the intervention group also receives the Toddler Oral Health Intervention from an oral health coach. The Toddler Oral Health Intervention combines behavioral interventions of proven effectiveness in caries prevention. Data are collected at baseline, at 24 months, and at 48 months. The primary study endpoint is cumulative caries incidence for children aged 48 months, and will be analyzed according to the intention-to-treat principle. For children aged 48 months, the balance between costs and effects of the Toddler Oral Health Intervention will be evaluated, and for children aged 24 months, the effects of the Toddler Oral Health Intervention on behavioral determinants, alongside cumulative caries incidence, will be compared. Results: The first parent-child dyads were enrolled in June 2017, and recruitment was finished in June 2019. We enrolled 402 parent-child dyads. Conclusions: All follow-up interventions and data collection will be completed by the end of 2022, and the trial results are expected soon thereafter. Results will be shared at international conferences and via peer-reviewed publication.
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Background: The transformation in global demography and the shortage of health care workers require innovation and efficiency in the field of health care. Digital technology can help improve the efficiency of health care. The Mercury Advance SMARTcare solution is an example of digital technology. The system is connected to a hybrid mattress and is able to detect patient movement, based on which the air pump either starts automatically or sends a notification to the app. Barriers to the adoption of the system are unknown, and it is unclear if the solution will be able to support health care workers in their work. Objective: This study aims to gain insight into health care workers’ expectations of factors that could either hamper or support the adoption of the Mercury Advance SMARTcare unit connected to a Mercury Advance mattress to help prevent patients from developing pressure injuries in hospitals and long-term care facilities. Methods: We conducted a generic qualitative study from February to December 2022. Interviews were conducted, and a focus group was established using an interview guide of health care workers from both the United Kingdom and the Netherlands. Thematic analysis was performed by 2 independent researchers. Results: A total of 14 participants took part in the study: 6 (43%) participants joined the focus group, and 8 (57%) participants took part in the individual interviews. We identified 13 factors based on four themes: (1) factors specifically related to SMARTresponse, (2) vision on innovation, (3) match with health care activities, and (4) materials and resources involved. Signaling function, SMARTresponse as prevention, patient category, representatives, and implementation strategy were identified as facilitators. Perception of patient repositioning, accessibility to pressure injury aids, and connectivity were identified as barriers. Conclusions: Several conditions must be met to enhance the adoption of the Mercury Advance SMARTcare solution, including the engagement of representatives during training and a reliable wireless network. The identified factors can be used to facilitate the implementation process. JMIR Nursing 2024;7:e47992
The main objective of this report is to analyse and inform about international labour mobility, particularly within Europe, from the perspective of the Dutch Health and Social Care Sector. The report starts by describing the introduction of a new care system in The Netherlands. The government does not participate directly in the actual provision of care. This is a task principally for private care suppliers. Furthermore, the legal position of the Health and Social Care professions, regulated through the Individual Health Care Professions Act, and questions like the international recognition of degrees and the evaluation of foreign diplomas are discussed. This is followed by a clarification of the Dutch education system, particularly, relating to the study of medicine, nursing education and social work education. Subsequently, some core data on the ageing Dutch population are presented. The grey pressure increases and this will have an impact on health spending, health support and the future labour market. Then what follows is a description of the development of employment in the Dutch Health and Social Care Sector, per branch as well as the professions that are engaged in it. The general picture, at this moment, is that the Health and Social Care labour market is reasonably in balance. This trend will continue in the near future; shortages are expected only in the long term. All research done on the subject indicates that international mobility of medical and social professionals is still low in the Netherlands. The question remains whether a more active recruitment policy would be a solution for the expected long term shortages. The report concludes with a look at recruitment policy and some of its developments at the global, national and local level.
Exercise-friendly Environment Public SpacesOur physical and social environment have a great influence on how people move, whether they are aware of this or not. A public environment in which it is easy to move around can have a preventive effect on people’s health and this way it can make an important contribution to Healthy Ageing. An attractive park is an invitation for people to take a walk or go for a run. A beautiful cycle route through nature is an invitation to go cycling.The way a space that is easy to move around in can affect socialisation also contributes to the quality of life in a neighbourhood and its surroundings. By allowing people to exercise and meet each other, healthcare costs can be cut back and social problems can be reduced. In addition, a dynamic and exercise-friendly natural area makes for an attractive tourist destination, which can contribute positively to a region’s economy.The innovation lab ‘Exercise-friendly Environment Public Spaces’ is aimed at an optimal use of public spaces in order to stimulate an active lifestyle, and with this the economic and social impact on the environment of this space. In the innovation lab knowledge institutions, institutions for healthcare and wellbeing, governments (municipalities, provinces) and housing corporations together with various partners from sports, the catering industry and recreation.
It is essential to look for new forms of care, with an emphasis on Prevention, Relocation and Replacement (Health & Care Knowledge and Innovation Agenda 2020-2030). Especially when it comes to Alcohol Use Disorder (AUD). Globally, more than 5% of all illness and injury are attributable to AUD. Treatment is challenging; 47-75% of AUD patients who are clinically detoxified relapse within one year. Recovry aims to prevent an unhealthy lifestyle due to (alcohol) addiction by developing and testing a Virtual Reality (VR) self-prevention tool (relocating and replacing care treatment). Although research shows that VR is used successfully in health care and in the treatment of alcohol addiction, especially through the creation of presence, it has not been tested for effectiveness and implementation (as an adjuvant in a clinical post-detoxification phase of an AUD- therapy). The question of whether virtual-humans should be used in a VR treatment and whether 3600 recorded VR or computer generated (CG) VR should be selected before. The use of a virtual human in VR has expected advantages (more effect) but also disadvantages (more costs). The expected advantages and disadvantages of 360o VR (cheaper, faster, more personal) and CG VR (more flexible and interactive) also cause choice and implementation problems. Recovry is the first project in which a VR tool is (further) developed in which an AUD treatment can (and will) be tested for the effect and effectiveness of adding virtual humans in CG and 360o VR environments as part of preventive care for patients with an AUD. This project thus serves as a prelude to cooperation in the Netherlands around a more effective implementation of VR in the (self) care system and thus the active and independent integration of former AUD patients in society (“more people, less patients”).
