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Pain and disability after first-time spinal fusion for lumbar degenerative disorders: a systematic review and meta-analysis
Koenders, N. ; Rushton, A. ; Verra, M.L. ; Willems, P.C. ; Hoogeboom, T.J. ; Staal, J.B.
2019, Article / Letter to editor (European Spine Journal, vol. 28, iss. 4, (2019), pp. 696-709)
Pain and disability after first-time spinal fusion for lumbar degenerative disorders: a systematic review and meta-analysis.
Koenders, N. ; Rushton, A. ; Verra, M.L. ; Willems, P.C. ; Hoogeboom, T.J. ; Staal, J.B.
2018, Article / Letter to editor (European Spine Journal, (2018))
Pain Exposure Physical Therapy in complex regional pain syndrome: promising enough to warrant further investigation.
Staal, J.B. ; Klomp, F.P. ; Nijhuis-van der Sanden, M.W.G.
2018, Article / Letter to editor (Canadian Journal of Anaesthesia, (2018))
Pain Exposure Physical Therapy versus conventional treatment in complex regional pain syndrome type 1-a cost-effectiveness analysis alongside a randomized controlled trial.
Barnhoorn, K. ; Staal, J.B. ; Dongen, R.T.M. van ; Frölke, J.P.M. ; Klomp, F.P. ; Meent, H. van de ; Adang, Eddy ; Nijhuis-van der Sanden, M.W.G.
2018, Article / Letter to editor (Clinical Rehabilitation, vol. 32, iss. 6, (2018), pp. 790-798)
Pain Management in the Emergency Chain: The Use and Effectiveness of Pain Management in Patients with Acute Musculoskeletal Pain
Pierik, JGJ ; IJzerman, MJ ; Gaakeer, MI ; Berben, SA ; van Eenennaam, FL ; van Vugt, AB ; Doggen, CJM
2015, Article / Letter to editor (Pain Medicine, vol. 16, iss. 5, (2015), pp. 970-984)ObjectiveWhile acute musculoskeletal pain is a frequent complaint in emergency care, its management is often neglected, placing patients at risk for insufficient pain relief. Our aim is to investigate how often pain management is provided in the prehospital phase and emergency department (ED) and how this affects pain relief. A secondary goal is to identify prognostic factors for clinically relevant pain relief. DesignThis prospective study (PROTACT) includes 697 patients admitted to ED with musculoskeletal extremity injury. Data regarding pain, injury, and pain management were collected using questionnaires and registries. ResultsAlthough 39.9% of the patients used analgesics in the prehospital phase, most patients arrived at the ED with severe pain. Despite the high pain prevalence in the ED, only 35.7% of the patients received analgesics and 12.5% received adequate analgesic pain management. More than two-third of the patients still had moderate to severe pain at discharge. Clinically relevant pain relief was achieved in only 19.7% of the patients. Pain relief in the ED was higher in patients who received analgesics compared with those who did not. Besides analgesics, the type of injury and pain intensity on admission were associated with pain relief. ConclusionsThere is still room for improvement of musculoskeletal pain management in the chain of emergency care. A high percentage of patients were discharged with unacceptable pain levels. The use of multimodal pain management or the implementation of a pain management protocol might be useful methods to optimize pain relief. Additional research in these areas is needed.
Parent-professional alliance and outcomes of child, parent, and family treatment : A systematic review.
Greef, M. de ; Pijnenburg, H.M. ; Hattum, M.J.C. van ; McLeod, Bryce D. ; Scholte, R.J.
2017, Article / Letter to editor (Journal of Child and Family Studies, vol. 26, iss. 4, (2017), pp. 961-976)This review systematically explored research examining the relation between parent-professional alliance and outcomes of psychosocial treatments provided to children, and their parents and families. Study findings and methodological characteristics were reviewed to investigate the evidence linking the alliance between parents and professionals to outcomes of child, parent, and family treatment as well as to identify factors that may influence the alliance-outcome association. A systematic review of the literature was conducted that included a search of three electronic databases using specified search terms, followed by a hand search to identify relevant studies. A total of 46 studies (37 published articles and 9 unpublished dissertations) met inclusion criteria. Overall, the findings indicated that higher levels of parent-professional alliance were significantly associated with improved clinical outcomes and stronger treatment engagement. However, some studies found that the parent-professional alliance was not significantly related to clinical outcomes or treatment engagement, and a few studies showed that higher levels of alliance were related to less positive clinical outcomes and lower levels of treatment engagement. Several theoretical (problem type, child age, parent sex) and methodological (source and timing of alliance measurement, alliance-outcome informants, outcome domain, timing of outcome measurement) factors were identified that could influence the alliance-outcome association. Together, our findings emphasize the importance of alliance awareness when working with parents as well as a need for future studies to investigate factors influencing the quality of the parent-professional alliance and alliance-outcome association in child, parent, and family treatment.
Participation as an outcome measure in psychosocial oncology: Content of cancer-specific health-related quality of life instruments
Dijkers, Marcel ; Heerkens, Y.F. ; Mei, Sijrieke van der
2011, Article / Letter to editor (Quality of Life Research, vol. 4, iss. 20 (10), (2011), pp. 1617-1627)To examine to what extent the concept and the domains of participation as defined in the International Classification of Functioning, Disability and Health (ICF) are represented in general cancer-specific health-related quality of life (HRQOL) instruments. Using the ICF linking rules, two coders independently extracted the meaningful concepts of ten instruments and linked these to ICF codes. The proportion of concepts that could be linked to ICF codes ranged from 68 to 95%. Although all instruments contained concepts linked to Participation (Chapters d7-d9 of the classification of Activities and Participation), the instruments covered only a small part of all available ICF codes. The proportion of ICF codes in the instruments that were participation related ranged from 3 to 35%. Major life areas (d8) was the most frequently used Participation Chapter, with d850 remunerative employment as the most used ICF code. The number of participation-related ICF codes covered in the instruments is limited. General cancer-specific HRQOL instruments only assess social life of cancer patients to a limited degree. This studys information on the content of these instruments may guide researchers in selecting the appropriate instrument for a specific research purpose.
Pasteurised donor human milk audit: What is happening in the neonatal critical care unit?
Page, D. van der ; Gilroy, M. ; Joseph, R. ; Meij, B.S. van der
2021, Article / Letter to editor (Journal of Paediatrics and Child Health, (2021))Aim: Human milk with fortification, providing additional energy, protein and micronutrients, is considered the optimal form of nutrition for preterm infants as it provides protection against infections and improves outcomes. Mothers' own milk (MOM) is the preferred choice, however in situations where MOM is insufficient or contraindicated; Pasteurised donor human milk (PDHM) is the preferred alternative. This study aimed to identify whether PDHM during neonatal critical care unit (NCCU) admission is associated with discharge nutrition in preterm infants. Methods: A retrospective observational cohort study was conducted over a 12-month period in 2017. This included all inborn infants admitted to the NCCU with gestational age ≤ 28 weeks or ≤ 1000 g birthweight, who survived until discharge. Multivariate logistic models were used to detect the association between study groups (PDHM vs. No PDHM) and discharge nutrition. Results: Seventy-seven infants were included; 35 infants received PDHM during admission. At discharge, infants who received PDHM were significantly more likely to be on infant formula (IF) (86%) than infants who did not receive PDHM (26%). In contrast, infants who did not receive PDHM (No PDHM) were significantly more likely to be receiving MOM exclusively at discharge (74%), than those who did receive PDHM (14%). The odds of an infant being discharged on IF were 16.91 times higher if they received PDHM. Conclusion: In this study, infants born at ≤28 weeks or ≤ 1000 g who received PDHM were more likely to receive IF at NCCU discharge than infants who did not receive PDHM.
Path following bi-directional controller for articulated vehicles
Kural, K. ; Kusumakar, Rakshith ; Tomar, A.S. ; Naren, A.
2019, Article in monograph or in proceedings (HVTT15)Docking or parking articulated vehicles is a difficult task which further becomes complex with increasing number of articulations, which can be arduous for even professional drivers. Driver’s limited view and perception coupled with divergent instability of articulated vehicles in reverse motion are the primary reasons of complexity of the maneuver. For such, a driver support system is developed using a path following controller based on a virtual tractor principle. This paper presents the control problem formulation together with brief descriptions of relevant components of the closed-loop. An optimization routine is also presented which can be used to tune the controller gains. A proof of concept is presented for a single articulated vehicle using simulations and a second proof of concept is demonstrated using scaled test setup, which also indicates that the presented controller can be implemented in full scale vehicle. Due to a generic description presented in this paper, the controller is flexible and can be extended for double articulated vehicles.
Pathophysiology of diurnal drooling in Parkinson’s disease
Engel-Hoek, Lenie van den ; Kalf, Johanna ; Bloem, Bastiaan ; Borm, George ; Zwarts, Machiel ; Swart, B.J.M. de ; Munneke, Marten
2011, Article / Letter to editor (Movement Disorders, vol. 26, iss. 9, (2011), pp. 1670-1676)Drooling is an incapacitating feature of Parkinsons disease. Better pathophysiological insights are needed to improve treatment. In this study, we tested the hypothesis that the cause of drooling is multifactorial. We examined 15 patients with Parkinsons disease with distinct diurnal saliva loss ("droolers") and 15 patients with Parkinsons disease without drooling complaints ("nondroolers"). We evaluated all factors that could potentially contribute to drooling: swallowing capacity (maximum volume), functional swallowing (assessed with the dysphagia subscale of the Therapy Outcome Measures for rehabilitation specialists), unintentional mouth opening due to hypomimia (Unified Parkinsons Disease Rating Scale item), posture (quantified from sagittal photographs), and nose-breathing ability. We also quantified the frequency of spontaneous swallowing during 45 minutes of quiet sitting, using polygraphy. Droolers had more advanced Parkinsons disease than nondroolers (Unified Parkinsons Disease Rating Scale motor score 31 vs 22; P=.014). Droolers also scored significantly worse on all recorded variables except for nose breathing. Swallowing frequency tended to be higher, possibly to compensate for less efficient swallowing. Logistic regression with adjustment for age and disease severity showed that hypomimia correlated best with drooling. Linear regression with hypomimia as the dependent variable identified disease severity, dysphagia, and male sex as significant explanatory factors. Drooling in Parkinsons disease results from multiple risk factors, with hypomimia being the most prominent. When monitored, patients appear to compensate by increasing their swallowing frequency, much like the increased cadence that is used to compensate for stepping akinesia. These findings can provide a rationale for behavioral approaches to treat drooling.
Patient Centered Professionalism? : Patient Participation in Dutch Mental Health Professional Frameworks
Leemeijer, Aukje ; Trappenburg, Margo
2016, Article / Letter to editor (Professions & Professionalism, vol. 6, iss. 2, (2016), pp. 1-19)Patient participation is an important development in Dutch mental health care. Notwithstanding a generally positive attitude towards patient participation, mental health professionals show ambivalent responses to it due to tensions that may occur between professional values and societal values like (more) patient participa-tion. Professionals vary in their degree of professionalization which is translated to their formal professional frameworks like professional profiles and codes of conduct. To explore how formal professional frameworks of mental health professionals mirror how and to what degree they accommodate patient participation the professional frameworks of four types of mental health care professionals were studied: psychiatrists, psychologists, nurses, and social workers. We hypothesized that the higher professionalized professions were less open to patient participation. The results partly support this hypothesis. Professional frameworks of social workers and nurses indeed show more openness to patient participation, but the picture for psychiatrists and psychologists is ambiguous—more professionalized psychiatrists being more inclined to incorporate patient participation than less professionalized psychologists.
Patient experiences regarding pain management in emergency care : A qualitative study
Kemps, H.H.L.M. ; Vruchte, te M. ; Berben, S.A.A. ; Mans, P.
2010, Article / Letter to editor (Critical Care, vol. 2010, iss. 6, (2010), pp. 16-21)Pijn is één van de meest voorkomende klachten in de spoedzorg. De behandeling van acute pijn in de spoedzorg is echter onvoldoende. Diverse zaken spelen hierbij een rol: bijvoorbeeld mythevorming, spanningsveld tussen pijnbestrijding en patiëntveiligheid tijdens spoedeisende hulp en de aanwezigheid van angst bij patiënten ten aanzien van pijnbestrijding. Daarnaast ontbreekt het veelal aan protocollen voor pijnbestrijding in de acute zorg en is er (dientengevolge) vaak sprake van tegenstrijdig handelen in de diverse schakels van de zorgketen. Het ontwikkelen van een multidisciplinaire, evidence based pijnrichtlijn voor patiënten in de spoedzorg levert antwoord op vragen en mispercepties uit de dagelijkse praktijk en draagt bij aan het verbeteren van de pijnbestrijding in de spoedzorg.
Patient journey following lumbar spinal fusion surgery (FuJourn): A multicentre exploration of the immediate post-operative period using qualitative patient diaries.
Rushton, A. ; Jadhakhan, F. ; Masson, A. ; Athey, V. ; Staal, J.B. ; Verra, M.L. ; Emms, A. ; Reddington, M. ; Cole, A. ; Willems, P.C. ; Benneker, L. ; Heneghan, N.R. ; Soundy, A. et al. sine al.
2020, Article / Letter to editor (PLoS One, vol. 15, iss. 12, (2020), pp. e0241931)The aim of this study was to capture and understand the immediate recovery journey of patients following lumbar spinal fusion surgery and explore the interacting constructs that shape their journey. A qualitative study using Interpretive Phenomenological Analysis (IPA) approach. A purposive sample of 43 adult patients (≥16 years) undergoing ≤4 level instrumented fusion for back and/or leg pain of degenerative cause, were recruited pre-surgery from 4 UK spinal surgery centres. Patients completed a weekly diary expressed in their own words for the first 4 weeks following surgery to capture their life as lived. Diary content was based on previous research findings and recorded progress, recovery, motivation, symptoms, medications, healthcare appointments, rehabilitation, positive/negative thoughts, and significant moments; comparing to the previous week. To maximise completion and data quality, diaries could be completed in paper form, word document, as online survey or as audio recording. Strategies to enhance diary adherence included a weekly prompt. A framework analysis for individual diaries and then across participants (deductive and inductive components) captured emergent themes. Trustworthiness was enhanced by strategies including reflexivity, attention to negative cases and use of critical co-investigators. Twenty-eight participants (15 female; n = 18 (64.3%) aged 45-64) contributed weekly diaries (12 withdrew post-surgery, 3 did not follow through with surgery). Adherence with diaries was 89.8%. Participants provided diverse and vivid descriptions of recovery experiences. Three distinct recovery trajectories were identified: meaningful recovery (engagement in physical and functional activities to return to functionality/mobility); progressive recovery (small but meaningful improvement in physical ability with increasing confidence); and disruptive recovery (limited purpose for meaningful recovery). Important interacting constructs shaped participants' recovery including their pain experience and self-efficacy. This is the first account of immediate recovery trajectories from patients' perspectives. Recognition of a patient's trajectory may inform patient-centred recovery, follow-up and rehabilitation to improve patient outcomes.
Patient journey following lumbar spinal fusion surgery (LSFS): protocol for a multicentre qualitative analysis of the patient rehabilitation experience (FuJourn).
Rushton, A. ; Staal, J.B. ; Verra, M. ; Emms, A. ; Reddington, M. ; Soundy, A. ; Cole, A. ; Willems, P. ; Benneker, L. ; Masson, A. ; Heneghan, N.R. et al. sine al.
2018, Article / Letter to editor (BMJ Open, vol. 8, iss. 1, (2018))
Patient views regarding the impact of hydrotherapy on critically ill ventilated patients: A qualitative exploration study.
Felten-Barentsz, K. ; Oorsouw, R. van ; Haans, A.J.C. ; Staal, J.B. ; Hoeven, J.G. van der ; Nijhuis-van der Sanden, M.W.G.
2018, Article / Letter to editor (Journal of Critical Care, vol. 48, (2018), pp. 321-327)
Patient-Reported Outcome questionnaires for hip arthroscopy: a systematic review of the psychometric evidence
Tijssen, M. ; Cingel, Robert van ; Visser, Tjikke ; Melick, N. van
2011, Article / Letter to editor (BMC Musculoskeletal Disorders, vol. 2011, iss. 12, (2011), pp. 117)Hip arthroscopies are often used in the treatment of intra-articular hip injuries. Patient-reported outcomes (PRO) are an important parameter in evaluating treatment. It is unclear which PRO questionnaires are specifically available for hip arthroscopy patients. The aim of this systematic review was to investigate which PRO questionnaires are valid and reliable in the evaluation of patients undergoing hip arthroscopy.
A patient-safety and professional perspective on non-conveyance in ambulance care: a systematic review
Ebben, R.H.A. ; Vloet, L.C.M. ; Speijers, RF ; Tonjes, NW ; Loef, J. ; Pelgrim, T. ; Hoogeveen, M. ; Berben, S.A.A.
2017, Article / Letter to editor (Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, vol. 25, (2017))Background: This systematic review aimed to describe non-conveyance in ambulance care from patient-safety and ambulance professional perspectives. The review specifically focussed at describing (1) ambulance non-conveyance rates, (2) characteristics of non-conveyed patients, (3) follow-up care after non-conveyance, (4) existing guidelines or protocols, and (5) influencing factors during the non-conveyance decision making process. Methods: We systematically searched MEDLINE, PubMed, CINAHL, EMBASE, and reference lists of included articles, in June 2016. We included all types of peer-reviewed designs on the five topics. Couples of two independent reviewers performed the selection process, the quality assessment, and data extraction. Results: We included 67 studies with low to moderate quality. Non-conveyance rates for general patient populations ranged from 3.7%-93.7%. Non-conveyed patients have a variety of initial complaints, common initial complaints are related to trauma and neurology. Furthermore, vulnerable patients groups as children and elderly are more represented in the non-conveyance population. Within 24 h-48 h after non-conveyance, 2.5%-6.1% of the patients have EMS representations, and 4.6-19.0% present themselves at the ED. Mortality rates vary from 0.2%-3. 5% after 24 h, up to 0.3%-6.1% after 72 h. Criteria to guide non-conveyance decisions are vital signs, ingestion of drugs/alcohol, and level of consciousness. A limited amount of non-conveyance guidelines or protocols is available for general and specific patient populations. Factors influencing the non-conveyance decision are related to the professional (competencies, experience, intuition), the patient (health status, refusal, wishes and best interest), the healthcare system (access to general practitioner/other healthcare facilities/patient information), and supportive tools (online medical control, high risk card). Conclusions: Non-conveyance rates for general and specific patient populations vary. Patients in the nonconveyance population present themselves with a variety of initial complaints and conditions, common initial complaints or conditions are related to trauma and neurology. After non-conveyance, a proportion of patients reenters the emergency healthcare system within 2 days. For ambulance professionals the non-conveyance decisionmaking process is complex and multifactorial. Competencies needed to perform non-conveyance are marginally described, and there is a limited amount of supportive tools is available for general and specific non-conveyance populations. This may compromise patient-safety.
Patients' and clinicians' experiences with stratified exercise therapy in knee osteoarthritis: a qualitative study.
Knoop, J. ; Joode, J.W. de ; Brandt, H. ; Dekker, J ; Ostelo, R.W.J.G.
2022, Article / Letter to editor (BMC Musculoskeletal Disorders, vol. 23, iss. 1, (2022), pp. 559)BACKGROUND: We have developed a model of stratified exercise therapy that distinguishes three knee osteoarthritis (OA) subgroups ('high muscle strength subgroup', 'low muscle strength subgroup', 'obesity subgroup'), which are provided subgroup-specific exercise therapy (supplemented by a dietary intervention for the 'obesity subgroup'). In a large clinical trial, this intervention was found to be no more effective than usual exercise therapy. The present qualitative study aimed to explore experiences from users of this intervention, in order to identify possible improvements. METHODS: Qualitative research design embedded within a cluster randomized controlled trial in a primary care setting. A random sample from the experimental arm (i.e., 15 patients, 11 physiotherapists and 5 dieticians) was interviewed on their experiences with receiving or applying the intervention. Qualitative data from these semi-structured interviews were thematically analysed. RESULTS: We identified four themes: one theme regarding the positive experiences with the intervention and three themes regarding perceived barriers. Although users from all 3 perspectives (patients, physiotherapists and dieticians) generally perceived the intervention as having added value, we also identified several barriers, especially for the 'obesity subgroup'. In this 'obesity subgroup', physiotherapists perceived obesity as difficult to address, dieticians reported that more consultations are needed to reach sustainable weight loss and both physiotherapists and dieticians reported a lack of interprofessional collaboration. In the 'high muscle strength subgroup', the low number of supervised sessions was perceived as a barrier by some patients and physiotherapists, but as a facilitator by others. A final theme addressed barriers to knee OA treatment in general, with lack of motivation as the most prominent of these. CONCLUSION: Our qualitative study revealed a number of barriers to effective application of the stratified exercise therapy, especially for the 'obesity subgroup'. Based on these barriers, the intervention and its implementation could possibly be improved. Moreover, these barriers are likely to account at least partly for the lack of superiority over usual exercise therapy. TRIAL REGISTRATION: The Netherlands National Trial Register (NTR): NL7463 (date of registration: 8 January 2019).
Patients' experience with intermittent catheterisation in everyday life
Cobussen-Boekhorst, H ; Hermeling, E ; Heesakkers, J ; Gaal, B.G.I. van
2016, Article / Letter to editor (Journal of Clinical Nursing, vol. 25, iss. 9-10, (2016), pp. 1253-1261)Aims and objectives. This study reports about the experiences of 11 patients in the Netherlands who use intermittent self-catheterisation to manage their symptoms. The aim of the study was to get insight in underlying barriers and facilitators for patients dealing with intermittent catheterisation in everyday life. Background. Studies show that intermittent catheterisation has an impact on everyday life. A positive effect does not guarantee that patients maintain catheterisation over a longer period of time. After the implementation of a guideline, a quantitative study was performed to determine successful intermittent catheterisation. The patients of this study had previously taken part in this quantitative study. Design. This is a qualitative multicentre study using semistructured in-depth interviews with 11 patients between March-May 2013. Methods. Inclusion criteria included patients of a quantitative study (n=124) with a variety of diagnoses referred to the outpatient clinic. Those who received instruction from the researcher and who at start of the study performed catheterisation <= 3 months were excluded. Of the total number that met the inclusion criteria, every fourth patient was invited to participate in an interview. Patients were asked about the introducing of intermittent catheterisation, the incorporation into everyday life, the progress after the instruction and guidance perceived, the cause of the bladder problem and the motivation to start intermittent catheterisation. Results. Eleven interviews were performed (six males/five females). All patients described the instruction and follow-up care as positive. Barriers were the preparation before the handling, which is more difficult than the catheterisation itself, and the fact that patients felt constrained by the need to plan convenient times to catheterise themselves. ConclusionThis study shows that patients who perform catheterisation are satisfied about the instruction and follow-up care. Important barriers in everyday life are the preparation and the need to plan convenient times. Relevance to clinical practice. Interviewing patients gave important additional information about dealing with intermittent catheterisation in everyday life. Prescribers and teachers of intermittent catheterisation must realise that they often have to high expectations of patients when it comes to being flexible in frequency of catheterisation. It is important to realise that patients experience barriers of which healthcare workers are not always aware of, such as the preparation before the handling and feeling constrained by the need to plan convenient times to catheterise. The outcome of this study can be used to improve the content of patient information brochures and guidelines for intermittent catheterisation.
Patients' Views on the Impact of Stroke on Their Roles and Self: A Thematic Synthesis of Qualitative Studies
Satink, T. ; Cup, Edith ; Ilott, I ; Prins, J ; Swart, B.J.M. de ; Nijhuis-van der Sanden, M.W.G.
2013, Article / Letter to editor (Archives of Physical Medicine and Rehabilitation, vol. 94, iss. 6, (2013), pp. 1171-1183)Objective: To synthesize patients' views on the impact of stroke on their roles and self. Data Sources: PubMed, CINAHL, Embase, PsycINFO, and Cochrane searched from inception to September 2010, using a combination of relevant Medical Subject Headings and free-text terms. This search was supplemented by reference tracking. Study Selection: Qualitative studies reporting the views of people poststroke. The search yielded 494 records. Opinion articles, quantitative studies, or those reporting somatic functioning were excluded. Thirty-three studies were included. Data Extraction: Data extraction involved identifying all text presented as "results" or "findings" in the included studies, and importing this into software for the analysis of qualitative data. Data Synthesis: The abstracted text was coded and then subject to a thematic analysis and synthesis, which was discussed and agreed by the research team. Three overarching themes were identified: (1) managing discontinuity is a struggle; (2) regaining roles: to continue or adapt? and (3) context influences management of roles and self. Regaining valued roles and self was an ongoing struggle, and discontinuity and uncertainty were central to the adjustment process after stroke. Conclusions: The thematic synthesis provides new insights into the poststroke experience. Regaining or developing a new self and roles was problematic. Interventions targeted at self-management should be focused on the recognition of this problem and included in rehabilitation, to facilitate adjustment and continuity as far as possible in life poststroke. (C) 2013 by the American Congress of Rehabilitation Medicine
Patientveiligheid en internationale ontwikkelingen
Mintjes, Joke
2010, Part of book or chapter of book (, pp. 25-29)Fouten maken is menselijk. Zelfs in de zorg. Veel hulpverleners zijn bang om fouten te maken omdat fouten kunnen leiden tot incidenten met soms ernstige gevolgen voor de patiënt. Elk incident is een drama, zowel voor de patiënt als voor de betrokken hulpverleners. Met Patiëntveiligheid, Systematische Incident Reconstructie en Evaluatie (SIRE) kunnen incidenten worden onderzocht en geanalyseerd, en kunnen maatregelen worden bedacht die de kans op soortgelijke incidenten in de toekomst verkleinen. Voor medici, verpleegkundigen, paramedici en leidinggevenden hét middel om op gestructureerde wijze te leren van ongewenste gebeurtenissen in de gezondheidszorg.
Patiëntenlogistiek in het CWZ in tijden van COVID-19: Wendbaarheid door integraliteit
Moeke, D.
2021, Article / Letter to editor (Logistiek+: Tijdschrift voor toegepaste logistiek, (2021))
Patiëntentevredenheid over ambulancezorg : Is er een trend waarneembaar van 2003 tot 2009?
Honigh, M. ; Verhoeven, T. ; Grunsven, P.M. van ; Poppen, H. ; Bengel, P.
2011, Part of book or chapter of book (, pp. 107-116)Er is nog weinig onderzoek gedaan naar factoren die van invloed zijn op patiënttevredenheid binnen de ambulancezorg. Wij veronderstelden dat patiënten die vaker zijn vervoerd met de ambulance mogelijk kritischer zijn. Daarnaast leek het ons dat patiënten die ter plaatse behandeld worden minder tevreden zouden zijn over de zorg dan wanneer zij werden vervoerd. Ook veronderstelden we dat de vervoersurgentie gerelateerd zou kunnen zijn aan tevredenheid; bij spoed (A1 en A2-ritten) een hogere tevredenheid dan bij B-vervoer, omdat de patiënt meer in nood is. De onderzoeksvragen waren: hoe is de huidige patiënttevredenheid over de ambulancezorg in de RAV Gelderland-Zuid? Is de tevredenheid gerelateerd aan eerder vervoer, behandeling ter plaatse of riturgentie? Is er een trend waarneembaar in patiënttevredenheid in vergelijking met de resultaten van onderzoeken uit 2003 en 2006?
Patronen van sturen op vertrouwen
Verstegen, M.F.G.M. ; Wagensveld, J.
2017, Article / Letter to editor (Maandblad voor Accountancy en Bedrijfseconomie, vol. 91, iss. 7/8, (2017), pp. 202-210)
Patterns of social participation among older adults with disabilities and the relationship with well-being: A latent class analysis
Hees, S.G.M. van ; Borne, BHP van den ; Menting, J ; Sattoe, JNT
2020, Article / Letter to editor (Archives of Gerontology and Geriatrics, vol. 86, (2020))Aim: Living with a chronic condition or a disability at older age impacts social participation. Social connections and social activities seem interrelated leading to heterogeneous patterns in social participation. The aim of this study was to identify a typology in social participation among older adults with disabilities, and to relate this typology to their background characteristics and well-being measures. Methods: A total of 1775 older adults with disabilities or chronic conditions aged 65-97 were sampled from a nationwide panel study in the Netherlands. Social participation was assessed by various measures related to social connections, social informal activities, voluntary work, effort to increase social participation, and online social participation. A latent class analysis was carried out to identify a typology of social participation. Differences between these classes were explored with multinomial regression analyses and pairwise comparisons. Results: Four classes were found: social withdrawers (22.5%, n = 399), proximate social dwellers (14.5%, n = 257), moderately active social dwellers (37.2%, n = 660) and pro-active social dwellers (25.9%, n = 459). Background characteristics, such as living alone and severity of disability, differed significantly among classes. Regarding well-being measures, it appeared that pro-active social dwellers had the most positive scores. Social withdrawers were most prone to reduced life satisfaction and health related quality of life and increased loneliness and experienced participation restrictions. Conclusions: A typology with four patterns based on a wide spectrum of social participation aspects in older adults with disabilities was identified. This typology may help to assess the risk for reduced well-being of older adults with disabilities.
Pedagogic Strategies for Improving Students’ Engagement and Development.
Harms, T. ; Hoeve, A. ; Boer, P. den
2017, Part of book or chapter of book (Bruijn, E. de; Billett, S.; Onstenk, J (ed.), Enhancing Teaching and Learning in the Dutch Vocational Education System: Reforms Enacted)
Pedagogisch klimaat : meer dan sfeerbepalend
Strijbosch, Eefje ; Pijnenburg, H.M. ; Greef, M. de
2014, Article / Letter to editor (Jeugdenco, vol. 28, iss. 2, (2014), pp. 20-21)Hoe kunnen teams in de residentiële jeugdzorg een pedagogisch klimaat realiseren én behouden waarin kinderen zich positief kunnen ontwikkelen? Vijftien teams van jeugdzorgorganisaties Juzt en Maashorst onderzochten in de praktijk wat werkt.
Pedagogisch-didactische vormgeving van werkplekleren in het initieel beroepsonderwijs: een internationale reviewstudie.
Nieuwenhuis, A.F.M. ; Hoeve, A. ; Nijman, D.J.J.M. ; Vlokhoven, H.A. van
2017, External research report
Pedagogisch-didactische vormgeving van werkplekleren. Bijdrage aan Symposium “Wat weten we al over over werkplekleren, leeromgevingen op de grens school-beroepspraktijk en het begeleiden van beroepsgericht afstudeeronderzoek? Drie systematische reviewstudies
Nieuwenhuis, A.F.M. ; Hoeve, A. ; Nijman, D.J.J.M. ; Vlokhoven, H.A. van
2017, Article in monograph or in proceedings ()
Perceive, Recall, Plan and Perform (PRPP)-Assessment Based on Parent-Provided Videos of Children with Mitochondrial Disorder: Action Design Research on Implementation Challenges.
Lindenschot, M. ; Groot, I.J.M. de ; -van der Sanden, M.W.G. Nijhuis ; Steultjens, E.M.J. ; Graff, M.J.L. ; Koene, S.
2023, Article / Letter to editor (Physical and Occupational Therapy in Pediatrics, vol. 43, iss. 1, (2023), pp. 74-92)AIMS: Performing the Perceive, Recall, Plan and Perform (PRPP)-Assessment, using video material of everyday life, seems sensible to lower the patient burden, enhance ecological validity, and provide care at a distance. However, receipt of adequate video material is not self-evident and assessing videos can be challenging. Therefore, this study aims to optimize the process of gaining video material and to optimize the PRPP-Assessment based on parent-provided videos. METHODS: An action design research method was used, focusing on implementation of the PRPP-Assessment based on parent-provided videos within the care of children with a mitochondrial disorder or similar symptoms. RESULTS: Five cycles were conducted. To receive input, the cycles used videos of nine children performing activities, written feedback, and semi-structured interviews and focus groups comprising parents (nn=n13), a teacher (nn=n1), occupational therapists (nn=n16), and other professionals (nn=n2) . This led to successful implementation of the PRPP-Assessment. General lessons were learned on (1) instructing parents; (2) handling video material; (3) PRPP-Assessment based on parent-provided videos; and (4) PRPP-Assessment of children (with limited functional abilities). CONCLUSIONS: Lessons learned should be implemented in practice and are incorporated into a manual to guide the implementation of video-based observations with PRPP-Assessment in practice.
Percentiles for skeletal muscle index, area and radiation attenuation based on computed tomography imaging in a healthy Caucasian population.
Werf, A. van der ; Langius, J.A.E. ; Schueren, M.A.E. de van der ; Nurmohamed, S.A. ; Pant, K.A.M.I. van der ; Blauwhoff-Buskermolen, S. ; Wierdsma, N.J.
2018, Article / Letter to editor (European Journal of Clinical Nutrition, vol. 72, iss. 2, (2018), pp. 288-296)
Percepties van HRM
Verburg, Robert
2010, Part of book or chapter of book (, pp. 23-38)Deze bijdrage is een verkorte versie van de intreerede die dr. R.M. Verburg op 24 oktober heeft gehouden bij de aanvaarding van zijn ambt als lector HRM aan de Hogeschool van Arnhem en Nijmegen (HAN). Het ontwikkelen van een effectief personeelsbestand is geen eenvoudige taak. Personeelsmanagers worden steeds vaker geconfronteerd met vragen om het personeelsbeleid te herzien om meer toegevoegde waarde te creëren. Ook worden lijnmanagers steeds meer betrokken bij personeelsbeslissingen, zoals werving, selectie en ontwikkeling van nieuw personeel. In dit artikel worden de eerste ideeën met betrekking tot Human Resource Management (HRM) op het gebied van wetenschappelijk onderzoek behandeld, vervolgens wordt ingegaan op de recente uitdagingen in het veld zoals de link met kennismanagement en innovatie en de daarmee verbonden betekenis hiervan op de huidige praktijk van personeelsmanagement.
Perceptions of interprofessional collaboration in education of dentists and dental hygienists and the impact on dental practice in the Netherlands
Kersbergen, M.J. ; Creugers, N.H.J. ; Hollaar, V.R.Y. ; Laurant, M.G.H.
2020, Article / Letter to editor (European Journal of Dental Education, vol. 24, iss. 1, (2020), pp. 145-153)
Performance and thermoregulation of Dutch Olympic and Paralympic athletes exercising in the heat: Rationale and design of the Thermo Tokyo study: The journal Temperature toolbox.
Korte, J.Q. de ; Bongers, C.C.W.G. ; Hopman, M.T.E. ; Teunissen, L.P.J. ; Jansen, K.M.B. ; Kingma, B.R.M. ; Ballak, S.B. ; Maase, K. ; Moen, M.H. ; Dijk, J.W. van ; Daanen, H.A.M. ; Eijsvogels, T.M.H. et al. sine al.
2021, Article / Letter to editor (Temperature, vol. 8, iss. 3, (2021), pp. 209-222)The environmental conditions during the Tokyo Olympic and Paralympic Games are expected to be challenging, which increases the risk for participating athletes to develop heat-related illnesses and experience performance loss. To allow safe and optimal exercise performance of Dutch elite athletes, the Thermo Tokyo study aimed to determine thermoregulatory responses and performance loss among elite athletes during exercise in the heat, and to identify personal, sports-related, and environmental factors that contribute to the magnitude of these outcomes. For this purpose, Dutch Olympic and Paralympic athletes performed two personalized incremental exercise tests in simulated control (15°C, relative humidity (RH) 50%) and Tokyo (32°C, RH 75%) conditions, during which exercise performance and (thermo)physiological parameters were obtained. Thereafter, athletes were invited for an additional visit to conduct anthropometric, dual-energy X-ray absorptiometry (DXA), and 3D scan measurements. Collected data also served as input for a thermophysiological computer simulation model to estimate the impact of a wider range of environmental conditions on thermoregulatory responses. Findings of this study can be used to inform elite athletes and their coaches on how heat impacts their individual (thermo)physiological responses and, based on these data, advise which personalized countermeasures (i.e. heat acclimation, cooling interventions, rehydration plan) can be taken to allow safe and maximal performance in the challenging environmental conditions of the Tokyo 2020 Olympic and Paralympic Games.
Performance characteristics of selected/deselected under 11 players from a professional youth football academy
Platvoet, S.W.J. ; Opstoel, K. ; Pion, J.A.J. ; Elferink-Gemser, Marije ; Visscher, C.
2020, Article / Letter to editor (International Journal of Sports Science & Coaching, vol. 15, iss. 5-6, (2020))
Performing occupations under pain: the experience of persons with chronic pain.
Aegler, B. ; Satink, T.
2009, Article / Letter to editor (Scandinavian Journal of Occupational Therapy, vol. 16, iss. 1, (2009), pp. 49-56)Chronic pain is known as a complex and subjective phenomenon that challenges healthcare professionals who coach and support clients with chronic pain. The aim of this study was to explore how persons with chronic pain experienced their occupational performance. Eight persons suffering from chronic pain were interviewed and the data was analysed with the constant comparative method. Three themes were identified: "Performing is an ongoing attraction", "Getting used to taking breaks is not easy", and "The challenge to finish performing". "Performing is an ongoing attraction" illustrates the innate need of every human being to be active and also how pleasurable occupations do not influence pain. The ongoing thoughts and emotions while participants stop their performance are described in "Getting used to taking breaks is not easy". This stop and go during every occupation is discussed in the perspective of temporality and occupational performance. In "The challenge to finish performing" the participants describe how they complete certain occupations despite pain. This is discussed with the focus on distraction and flow experience.
Person Centered Planning : Handleiding over benaderingen en uitvoering van PCP
Leeden, L. van der ; Nas, M. ; Magnée, M.J.C.M. ; Teunisse, J.P.W.M.
2012, External research report Deze handleiding is het product van een afstudeeropdracht van studenten Toegepaste Psychologie van de Hogeschool van Arnhem en Nijmegen. De handlediing is ontwikkeld i.s.m. de RIBW, NITransition, San Diego State University en het Lectoraat Levensloopbegeleiding bij Autisme (HAN). De handleiding beschrijft verschillende benaderingen van Person Centered Planning (PCP) en bevat een concreet plan voor de uitvoering van PCP. De handleiding is oorspronkelijk bedoeld voor professionals in de zorg voor mensen met autisme spectrum stoornissen (ASS), maar kan door iedereen gebruikt worden die aan de slag wil met een beproefde planningsmethodiek.
Personal factors in systemic sclerosis and their coverage by patient-reported outcome measures: A multicentre European qualitative study and literature review
Mattsson, M. ; Boström, C. ; Mihai, C. ; Stöcker, J.K. ; Geyh, S. ; Stummvoll, G. ; Gard, G. ; Möller, B. ; Hesselstrand, R. ; Sandqvist, G. ; Draghicescu, O. ; Gherghe, A.M. ; Voicu, M. ; Distler, O. ; Smolen, J.S. ; Stamm, T.A. et al. sine al.
2015, Article / Letter to editor (European Journal of Physical and Rehabilitation Medicine, vol. 51, iss. 4, (2015), pp. 405-21)
Personalized support for well-being at work: an overview of the SWELL project
Kraaij, W. ; Verberne, S. ; Koldijk, S ; Korte, E de ; Dantzig, S van ; Sappelli, M. ; Shoaib, M. ; Bosems, S. ; Achterkamp, R. ; Bonomi, A. ; Schavemaker, J. ; Hulsebosch, B. ; Wabeke, T. ; Vollenbroek-Hutten, M. ; Neerincx, M. ; Sinderen, M. van et al. sine al.
2019, Article / Letter to editor (User Modeling and User-Adapted Interaction, (2019), pp. 1-34)
Persoonlijke professionele herinnering aan Peter Koopman
Mintjes, Joke
2010, Part of book or chapter of book (, pp. 52-53)Liber amicorum voor Peter Koopman: ter gelegenheid van zijn afscheid van Dimence uitgereikt op 12 april 2010
Perspectief op Fair Share in de circulaire economie
Croes, F.
2021, Article / Letter to editor (IN2 Maas & Waal, (2021))
Perspectives on teaching and regulation of learning: a comparison of secondary and university teachers
Oolbekkink, H. ; Driel, Jan van ; Verloop, N
2014, Article / Letter to editor (Teaching in Higher Education, vol. 19, iss. 7, (2014), pp. 799-811)Many factors play a role in the successful transition of students from secondary to university education: one of them is the (university) teacher. In this study the similarities and differences in the perspectives on teaching and learning of secondary and university teachers were investigated. A survey was performed among 675 teachers. Three perspectives on teaching and learning could be distinguished: (1) a development orientation with shared regulation, (2) a knowledge orientation with strong regulation, and (3) an opinion orientation with loose regulation. Secondary teachers scored higher on the first perspective than university teachers who scored higher on the third perspective. These findings have implications for the transition of students from pre-university to university education and especially for teachers' roles.
Physical exercise for patients undergoing hematopoietic stem cell transplantation: systematic review and meta-analyses of randomized controlled trials.
Haren, I.E.P.M. van ; Timmerman, H. ; Potting, C.M. ; Blijlevens, N.M.A. ; Staal, J.B. ; -van der Sanden, M.W.G. Nijhuis
2013, Article / Letter to editor (Physical Therapy, vol. 93, iss. 4, (2013), pp. 514-528)BACKGROUND: The treatment-related burden for patients undergoing hematopoietic stem cell transplantation (HSCT) may be relieved by physical exercises. PURPOSE: The purpose of this study was to summarize and analyze the evidence provided by randomized controlled trials (RCTs) on physical exercise interventions among patients with cancer undergoing HSCT. DATA SOURCES: PubMed, CINAHL, EMBASE, the Cochrane Library, and PEDro were searched for relevant RCTs up to October 1, 2011. STUDY SELECTION: Two reviewers screened articles on inclusion criteria and indentified relevant RCTs. DATA EXTRACTION: Two authors assessed the selected articles for risk of bias. Data extraction was performed by 1 reviewer. Meta-analyses were undertaken to estimate the outcomes quality of life (QOL), psychological well-being and distress, and fatigue. DATA SYNTHESIS: Eleven studies were included, with study populations consisting of recipients undergoing either an allogeneic or autologous HSCT (n=734). Four studies had low risk of bias. The exercise interventions were performed before, during, and after hospitalization for the HSCT. Different exercise programs on endurance, resistance and/or activities of daily living training, progressive relaxation, and stretching were used. Meta-analyses showed that exercise during hospitalization led to a higher QOL (weighted mean difference=8.72, 95% confidence interval=3.13, 14.31) and less fatigue (standardized mean difference=0.53, 95% confidence interval=0.16, 0.91) in patients with an allogeneic HSCT at the moment of discharge from the hospital. No marked effects were found for psychological well-being and distress. Individual study results suggested significant positive effects on QOL, fatigue, psychological well-being and distress, and physical functioning. LIMITATIONS: Prevalent shortcomings in the included studies were the heterogeneity among studies and the lack of blinding of participants, personnel, and outcome assessment. CONCLUSIONS: The results suggest that recipients of HSCT may benefit from physical exercise.
Physical exercise prior to hematopoietic stem cell transplantation: A feasibility study.
Haren, I.E.P.M. van ; Staal, J.B. ; Potting, C.M. ; Atsma, F. ; Hoogeboom, T.J. ; Blijlevens, N.M.A. ; Nijhuis-van der Sanden, M.W.G.
2018, Article / Letter to editor (Physiotherapy Theory and Practice, vol. 16, (2018), pp. 1-10)
Physical exercise prior to hematopoietic stem cell transplantation: A feasibility study.
Haren, I.E.P.M. van ; Staal, J.B. ; Potting, C.M. ; Atsma, F. ; Hoogeboom, T.J. ; Blijlevens, N.M.A. ; -van der Sanden, M.W.G. Nijhuis
2018, Article / Letter to editor (Physiotherapy Theory and Practice, vol. 34, iss. 10, (2018), pp. 747-756)PURPOSE: This study explores the feasibility and preliminary effectiveness of an exercise program in people scheduled for hematopoietic stem cell transplantation (HSCT). METHODS: In this controlled clinical trial, we compare pre-transplantation exercise to no exercise in the waiting period for an allogeneic of autologous HSCT. The supervised individually tailored exercise program (4-6 weeks) consisted of aerobic endurance, muscle strength, and relaxation exercises, administered twice a week in the period prior to HSCT. Feasibility was determined based on inclusion rate, attrition rate, adherence to intervention, safety, and satisfaction (0-10). Preliminary effectiveness was determined primarily by self-perceived physical functioning, quality of life (QOL), and fatigue. Secondary outcomes were global perceived effect (GPE), blood counts, hospital stay, and physical fitness. RESULTS: Forty-six patients were eligible, of whom 29 (69%) participated: 14 in the intervention group and 15 in the control group. The adherence rate to training was 69%. No adverse events or injuries occurred. Satisfaction of training conditions was high (mean 9.2 ±1.3). Positive (follow-up) trends in favor of the intervention group were found for self-perceived physical functioning, QOL, fatigue, GPE, blood counts, and hospital stay. CONCLUSION: Exercise prior to HSCT is safe and feasible, and positive trends suggest favorable preliminary effectiveness. Adherence to the exercise program needs to be optimized in a future trial.
Physical prognostic factors predicting outcome following lumbar discectomy surgery: systematic review and narrative synthesis.
Rushton, A. ; Zoulas, K. ; Staal, J.B.
2018, Article / Letter to editor (BMC Musculoskeletal Disorders, vol. 19, (2018), pp. 326)
Physical therapists and importance of work participation in patients with musculoskeletal disorders: a focus group study.
Hutting, N. ; Oswald, W. ; Staal, J.B. ; Engels, J.A. ; Nouwens, E ; Nijhuis-van der Sanden, M.W.G. ; Heerkens, Y.F.
2017, Article / Letter to editor (BMC Musculoskeletal Disorders, vol. 18, iss. 1, (2017), pp. 196)BACKGROUND: Musculoskeletal disorders are a major health problem resulting in negative effects on wellbeing and substantial costs to society. Work participation is associated with positive benefits for both mental and physical health. Potentially, generalist physical therapists (GPTs) can play an important role in reducing absenteeism, presenteeism and associated costs in patients with musculoskeletal disorders. However, work participation is often insufficiently addressed within generalist physical therapy practice (GPTP). Therefore, this study evaluates whether GPTs take work participation into account as a determining factor in patients with musculoskeletal disorders, and how this might be improved. METHODS: This qualitative study consisted of seven focus groups involving 30 participants: 21 GPTs and 9 occupational physical therapists (OPTs). Based on an interview guide, participants were asked how they integrate work participation within their practice, how they collaborate with other professionals, and how GPTs can improve integration of the patient's work within their practice. RESULTS: Although participants recognized the importance of work participation, they mentioned that the integration of this item in their GPTP could be improved. Generally, GPTs place insufficient priority on work participation. Moreover, there is a lack of cooperation between the generalist physical therapist and (other) occupational healthcare providers (including OPTs), and the borderlines/differences between generalist physcial therapy and occupational health physcial therapy were sometimes unclear. GPTs showed a lack of knowledge and a need for additional information about several important work-related factors (e.g. work content, physical and psychosocial working conditions, terms of employment). CONCLUSIONS: Although a patient's work is important, GPTs take insufficient account of work participation as a determining factor in the treatment of patients with musculoskeletal disorders. GPTs often lack specific knowledge about work-related factors, and there is insufficient cooperation between OPTs and other occupational healthcare providers. The integration of work participation within GPTP, and the cooperation between GPTs and other occupational healthcare providers, show room for improvement.
Physical work load and its assessment among the nursing staff in nursing homes.
Engels, J.A. ; Gulden, J.W. van der ; Senden, T.F. ; Hertog, C.A. ; Kolk, J.J. ; Binkhorst, R.A.
1994, Article / Letter to editor (Jom. Journal of Occupational Medicine, vol. 36, iss. 3, (1994), pp. 338-345)A study was conducted to investigate the physical work load and the prevalence of musculoskeletal complaints of nurses in nursing homes. Thirty-six female subjects selected from three nursing homes in the Netherlands participated in an observational study. In addition, the total nursing staff (n = 668) was invited to take part in a questionnaire survey (response was 94%). It was noticed that almost 60% of the observed time was spent on nonpatient-related activities. Moreover, activities alternated rapidly and seldom lasted longer than 4 minutes on average. Twenty percent of the observed time was spent in "poor" work postures as defined by the Ovako Working Posture Analyzing System (Action Category 2 to 4). Activities contributing most to these poor work postures were patient care and household and preliminary tasks. Perceived exertion as scored on the Borg-CR10 scale was highest during patient-related activities. This holds also for a relative increase of heart rate. Questionnaire results showed prevalences of 41%, 35%, and 20% respectively, for back, arm/neck, and leg complaints. From this study it can be concluded that not only patient-related activities should be taken into consideration for the improvement of work postures and other potential strenuous aspects of nursing work. Household and preliminary tasks, ergonomic layout of the ward, and work pressure also deserve attention.
Physician assistant in de ouderenzorg
Witjes, E. ; Lovink, M.H. ; Vleemink, C. ; Haar, A. ter ; Driesschen, Q. van den ; Vught, A.J.A.H. van
2015, Article / Letter to editor (Tijdschrift voor Ouderengeneeskunde, iss. 6, (2015))
Physician Assistant in de ouderenzorg. Een casestudie naar Taakinvulling en Implementatiefactoren.
Rutten, G.M.J. ; Tordoir, A. ; Hoven-Eveleigh, R. ; Vos, H. ; Laurant, M.G.H. ; Vught, A.J.A.H. van
2020, Article / Letter to editor (Tijdschrift voor Ouderengeneeskunde, iss. 5, (2020), pp. 65-74)

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