Plotseling leek er een nieuw maatschappelijk probleem te zijn: hangouderen. Ze zouden hinderlijk met hun rollators rondhangen in winkelcentra en vrouwen beschimpen. De vraag of hier werkelijk sprake was van een maatschappelijk probleem werd onderzocht door de berichtgeving in de media te analyseren, internetsearches te doen en telefonische interviews te houden.
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Plotseling leek er een nieuw maatschappelijk probleem te zijn: hangouderen. Ze zouden hinderlijk met hun rollators rondhangen in winkelcentra en vrouwen beschimpen. De vraag of hier werkelijk sprake was van een maatschappelijk probleem werd onderzocht door de berichtgeving in de media te analyseren, internetsearches te doen en telefonische interviews te houden.
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Hoe kunnen we een rekenles beter laten aansluiten bij een kwalificatiedossier en het rekenexamen? Welk lesmateriaal is er al?
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Background: People with dementia have a yearly risk of falling of 60 to 80 percent. Therefore, a walker is often recommended. However, the use of a walker in people with dementia is associated with a threefold increased odds of falls compared to their healthy peers. Better advice and training could reduce fall risk. Therefore, a tool to assess functional walking skills with a walker is needed. The SUMAC was developed to fill this gap. So far, there is no Dutch instrument available that can assess functional walking skills with a walker in people with dementia. Methods: Reliability was evaluated by scoring videos of people with dementia (n = 9) using a walker performing the SUMAC-NL. ICC was used to assess inter-rater and test-retest reliability. An expert panel (n = 8) evaluated the content validity using the content validity index (CVI) and the content validity ratio (CVR). Results: Inter-rater reliability of the SUMAC-NL was statistically significant for the PF domain (ICC = 0.94, 95%CI (0.84, 0.98, p < 0.001) and for the EQ domain (ICC = 0.79, 95%CI (0.49 – 0.95), p < 0.001). Test-retest reliability was statistically significant for both the PF domain (ICC = 0.95, 95%CI (0.89, 0.99), p < 0.001) and EQ domain (ICC = 0.92, 95%CI (0.82, 0.98), p < 0.001). The SUMAC-NL shows content validity with a CVI >0.79 for both domains and a CVR of 0.53 on the PF domain and 0.78 on the EQ domain. Conclusions: The SUMAC-NL shows good to excellent reliability and content validity for both the PF and the EQ domain. The SUMAC-NL seems to be a promising tool to assess walking with a walker in people with dementia in the Netherlands.
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Ageing in place is een veelvuldig genoemd concept. Echter, het is de vraag wat dit volgens de wetenschappelijke literatuur inhoudt. In dit artikel wordt het concept ageing in place in kaart gebracht aan de hand van de vijf hoofdthema’s zoals die uit de literatuur zijn gedestilleerd. Een meer eenduidig begrip van ageing in place zal professionals, beleidsmakers, onderzoekers en sociale netwerken kunnen helpen de veelzijdigheid van het concept te zien en toe te passen.
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Ageing in place is een veelvuldig genoemd concept. Echter, het is de vraag wat dit volgens de wetenschappelijke literatuur inhoudt. In dit artikel wordt het concept ageing in place in kaart gebracht aan de hand van de vijf hoofdthema’s zoals die uit de literatuur zijn gedestilleerd. Een meer eenduidig begrip van ageing in place zal professionals, beleidsmakers, onderzoekers en sociale netwerken kunnen helpen de veelzijdigheid van het concept te zien en toe te passen.
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Background: In general people after stroke do not meet the recommendations for physical activity to conduct a healthy lifestyle. Programs to stimulate walking activity to increase physical activity are based on the available insights into barriers and facilitators to physical activity after stroke. However, these programs are not entirely successful. The purpose of this study was to comprehensively explore perceived barriers and facilitators to outdoor walking using a model of integrated biomedical and behavioral theory, the Physical Activity for people with a Disability model (PAD). Methods: Included were community dwelling respondents after stroke, classified ≥ 3 at the Functional Ambulation Categories (FAC), purposively sampled regarding the use of healthcare. The data was collected triangulating in a multi-methods approach, i.e. semi-structured, structured and focus-group interviews. A primarily deductive thematic content analysis using the PAD-model in a framework-analysis’ approach was conducted after verbatim transcription. Results: 36 respondents (FAC 3–5) participated in 16 semi-structured interviews, eight structured interviews and two focus-group interviews. The data from the interviews covered all domains of the PAD model. Intention, ability and opportunity determined outdoor walking activity. Personal factors determined the intention to walk outdoors, e.g. negative social influence, resulting from restrictive caregivers in the social environment, low self-efficacy influenced by physical environment, and also negative attitude towards physical activity. Walking ability was influenced by loss of balance and reduced walking distance and by impairments of motor control, cognition and aerobic capacity as well as fatigue. Opportunities arising from household responsibilities and lively social constructs facilitated outdoor walking. Conclusion: To stimulate outdoor walking activity, it seems important to influence the intention by addressing social influence, self-efficacy and attitude towards physical activity in the development of efficient interventions. At the same time, improvement of walking ability and creation of opportunity should be considered
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Demand Driven Care plays a key role in the modernization of the Dutch health care system. This modernization is needed because a) clients needs for care increases quantitatively as well as in diversity, b) the financial means for collective services are inadequate, c) the accessibility of health care will depend on clients own responsibility, and d) shortage of professional care givers is foreseen. In the Netherlands, the need for professional care givers increases with an average of 2% every year. Demand Driven Care is an instrument for liberalization of public activities. The Faculty Chair Demand Driven Care focuses on those activities that will contribute to sufficient care supply. Within the program of the chair, activities are executed under the theme of Integrated Care, Substitution, Patient Centred Care, and Home Care Technology with an emphasis on gerontechnology. The Faculty Chair wants to contribute to a better integration and coherence in care. So that clients live and function independently as long as possible and are able to enhance their self management. In addition, health care professionals should be aware of demand driven processes and should have a demand driven attitude towards clients.
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Background: Impaired upper extremity function due to muscle paresis or paralysis has a major impact on independent living and quality of life (QoL). Assistive technology (AT) for upper extremity function (i.e. dynamic arm supports and robotic arms) can increase a client’s independence. Previous studies revealed that clients often use AT not to their full potential, due to suboptimal provision of these devices in usual care. Objective: To optimize the process of providing AT for impaired upper extremity function and to evaluate its (cost-)effectiveness compared with care as usual. Methods: Development of a protocol to guide the AT provision process in an optimized way according to generic Dutch guidelines; a quasi-experimental study with non-randomized, consecutive inclusion of a control group (n = 48) receiving care as usual and of an intervention group (optimized provision process) (n = 48); and a cost-effectiveness and cost-utility analysis from societal perspective will be performed. The primary outcome is clients’ satisfaction with the AT and related services, measured with the Quebec User Evaluation of Satisfaction with AT (Dutch version; D-QUEST). Secondary outcomes comprise complaints of the upper extremity, restrictions in activities, QoL, medical consumption and societal cost. Measurements are taken at baseline and at 3, 6 and 9 months follow-up.
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