2022, Article / Letter to editor (Health Equity, vol. 6, iss. 1, (2022), pp. 40-48)Purpose: Appointment attendance is critical in monitoring health and well-being of children. Low income Medicaid-insured families with newborns often experience social risks that may affect attendance. This project sought to characterize social risk factors present at first newborn visits predictive of future appointment nonattendance. Methods: Retrospective cohort study of minority and Medicaid-insured population at St. Christopher's Hospital for Children using a standardized social risk screener administered at first newborn visits as part of routine clinical care. In total, 720 survey responses between December 2016 and June 2017 were correlated with electronic health record-derived sociodemographic and appointment attendance data in the first 6 months of life. Nonattendance included missed and canceled appointments. Caregiver-reported social risk factors were included as covariates in linear regressions predicting proportion nonattendance outcomes. Results: Newborn caregivers identified many social risk factors including mental health diagnoses (14%), lack of child care support (45%), and food insecurity (9%). Approximately 74% had nonattendance with 41% missing or canceling a quarter or more appointments. Number of siblings (p<0.01) and maternal age (p<0.01) were most predictive for nonattendance, respectively. Other social risks were not significant except for maternal mental health (p=0.01) among those identifying number of risk factors above cohort average (16%). Conclusion: Screening of newborns at first medical visits can be used to characterize social risks. Most social risk factors at first visits were not strongly predictive of nonattendance, although our results suggested associations between non-attendance and maternal demographics, mental health and household makeup.
2017, Article / Letter to editor (Brain and Behavior, (2017), pp. 1-8)Background: Both childhood trauma and negative memory bias are associated with the onset and severity level of several psychiatric disorders, such as depression and anxiety disorders. Studies on these risk factors, however, generally use homogeneous noncomorbid samples. Hence, studies in naturalistic psychiatric samples are lacking. Moreover, we know little about the quantitative relationship between the frequency of traumatic childhood events, strength of memory bias and number of comorbid psychiatric disorders; the latter being an index of severity. The current study examined the association of childhood trauma and negative memory bias with psychopathology in a large naturalistic psychiatric patient sample. Methods: Frequency of traumatic childhood events (emotional neglect, psychological-, physical- and sexual abuse) was assessed using a questionnaire in a sample of 252 adult psychiatric patients with no psychotic or bipolar- I disorder and no cognitive disorder as main diagnosis. Patients were diagnosed for DSM-V Axis-I and Axis-II disorders using a structured clinical interview. This allowed for the assessment of comorbidity between disorders. Negative memory bias for verbal stimuli was measured using a computer task. Results: Linear regression models revealed that the frequency of childhood trauma as well as negative memory bias was positively associated with psychiatric comorbidity, separately and above and beyond each other (all p <.01). Conclusions: The results indicate that childhood trauma and negative memory bias may be of importance for a broader spectrum of psychiatric diagnoses, besides the frequently studied affective disorders. Importantly, frequently experiencing traumatic events during childhood increases the risk of comorbid psychiatric disorders.
2022, Article in monograph or in proceedings (NordiCHI workshop - Age against the machine: A Call for Designing Ethical AI for and with Children)With the development of content-generating Artificial Intelligence (AI) systems, such as generating images from a textual description, new possibilities for using such system in design processes arise. In this position paper, we argue that we need to explicitly incorporate children's values when we develop design methods that incorporate content-generating AI to protect their creative processes. In a mini-inquiry we find that children from different ages have articulate ideas about being in the same design space as a content-generating AI’s. They share concerns about fidelity, transparency and how it changes the level-playing field for them. To setup a safe and ethical design space when co-creating with children we foresee three important steps: 1) explore the value of children with respect to content-generation AI. 2) improve the accessibility of these systems for children and 3) study the effect of using such a system on creativity and innovation in a design process.
2011, Article / Letter to editor (Tussenstand, vol. 2012, (2011))Since the eighties, Dutch residents of care homes have been housed in Assisted Living Facilities (ALFs) in order to age in place and live with higher social quality of housing. Scale, group mix and social quality of housing of these ALFs has not yet been explored. Initiators decide on experience and intuition or guided by policy and exploitation. The question arises: Are choices in scale for assisted living facilities based on quality factors or guided by institutional influences as legislation and financing? A desk research of 593 projects was made besides a multiple case study in 24 projects. Significant relations were found, partly in line with presuppositions on quality drivers, partly inexplicable. Comparing these incongruities with changes in legislation and financing, plausible relations were found. This leads to the conclusion that decisions for ALFs are based more on institutional factors and less strictly on quality choices than is avowed.
2011, Article / Letter to editor (MGV: Maandblad Geestelijke Volksgezondheid, vol. 66, iss. 4, (2011), pp. 222-235)Chroniciteit van psychiatrische ziekte is geen objectieve waarheid maar een concept dat door de jaren heen en vanuit uiteenlopende invalshoeken verschillend is gedefinieerd. In dit artikel wordt stilgestaan bij het interpersoonlijke karakter van het geven en ontvangen van chronische zorg. Met theorie, voorbeelden en casuïstiek wordt de stelling onderbouwd dat een zeer hulpvaardige houding van ggzprofessionals chroniciteit kan uitlokken of versterken. Aan de hand van casuïstiek en drie gespreksmethoden wordt geïllustreerd hoe dit anders kan, waardoor de professional zich mogelijk minder machteloos en de cliënt zich krachtiger voelt.
2014, Article / Letter to editor (Journal of the American College of Cardiology, vol. 63, iss. 17, (2014), pp. 1788-1795)OBJECTIVES: The goal of this study was to test the unverified assumption that chronically elevated cardiac troponin T (cTnT) levels fluctuate randomly around a homeostatic set point. BACKGROUND: The introduction of high-sensitivity cardiac troponin (cTn) assays has improved sensitivity for acute myocardial infarction (AMI). However, many patients with a single positive cTn test result do not have AMI. Therefore, the diagnosis of AMI relies strongly on serial testing and interpretation of cTn kinetics. Essential in this regard is a profound understanding of the biological variation of cTn. METHODS: Two studies were conducted to assess biological cTnT variation and to investigate the presence of a diurnal rhythm of cTnT. Study 1 comprised 23 male subjects with type 2 diabetes, with no acute cardiovascular disease. Serial venous blood samples were drawn over an 11-h period (8:30 am to 7:30 pm). In study 2, the presence of a diurnal cTnT rhythm was investigated by hourly sampling of 7 subjects from study 1 over 25 h. RESULTS: In study 1, we observed a gradual decrease in cTnT concentrations during the day (24 ± 2%). This decrease was present in all participants and was most prominent in subjects with the highest baseline cTnT values (Pearson's R 0.93). Diurnal variation of cTnT, as assessed in study 2, was characterized by peak concentrations during morning hours (8:30 am, 17.1 ± 2.9 ng/l), gradually decreasing values during daytime (8:30 pm, 11.9 ± 1.6 ng/l), and rising concentrations during nighttime (8:30 am the next day, 16.9 ± 2.8 ng/l). CONCLUSIONS: A diurnal cTnT rhythm substantiates the recommendation that all dynamic changes in cTnT should be interpreted in relation to the clinical presentation. Epidemiological studies and risk-stratification protocols with the use of cTnT may benefit from standardized sampling times. (Exercise and Glycemic Control in Type 2 Diabetes; NCT00945165).
2015, Article / Letter to editor (Bioinformatics, vol. 31, iss. 17, (2015), pp. 2867-2869)We have developed CiVi, a user-friendly web-based tool to create custom circular maps to aid the analysis of microbial genomes and sequence elements. Sequence related data such as gene-name, COG class, PFAM domain, GC%, and subcellular location can be comprehensively viewed. Quantitative gene-related data (e.g. expression ratios or read counts) as well as predicted sequence elements (e.g. regulatory sequences) can be uploaded and visualized. CiVi accommodates the analysis of genomic elements by allowing a visual interpretation in the context of: (i) their genome-wide distribution, (ii) provided experimental data and (iii) the local orientation and location with respect to neighboring genes. CiVi thus enables both experts and non-experts to conveniently integrate public genome data with the results of genome analyses in circular genome maps suitable for publication. CONTACT: L.Overmars@gmail.com SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online. AVAILABILITY AND IMPLEMENTATION: CiVi is freely available at http://civi.cmbi.ru.nl.
2009, Article / Letter to editor (Disability and Rehabilitation, vol. 31, iss. 26, (2009), pp. 2150-2163)PURPOSE: A systematic evaluation of the literature to identify health and contextual factors associated with employment in patients with neuromuscular diseases (NMD) and to perform a best evidence synthesis, taking into account the design of studies, methodological quality and the statistical significance of findings. METHOD: Publications were retrieved by a computerised search in medical and psychological databases. Two reviewers assessed titles and abstracts first and assessed the quality of the remaining full text publications independently as well. Of the residual publications, health and contextual factors associated with employment in patients with NMD were extracted. The factors found were included in a recently developed expanded International Classification of Functioning, Disability and Health scheme. RESULTS: Six hundred and sixty-two titles and abstracts were screened. The main reason to exclude a title and/or abstract was the absence of the study population selected: Facioscapulohumeral Muscular Dystrophy (FSHD), Hereditary Motor and Sensory Neuropathy (HMSN) & Myotonic Dystrophy (MD). Of the remaining 20 full-text publications, eight publications fulfilled the inclusion criteria: two repeated survey designs and six cross-sectional studies. Factor extraction resulted in 94 factors related to employment. Ten factors in five publications were indicative for an association with employment status: Disease related factors HMSN, MD & NMD in general), factors related to functions (physical functions, muscle power functions), general personal factors (age, gender and education), work related personal factors (type of occupation, and expressed interest in employment by patients with NMD). CONCLUSION: In the best evidence synthesis ten factors were indicative for an association with employment status in patients with NMD in five publications with good to excellent methodological quality.
2013, Article / Letter to editor (Clinical Biomechanics, vol. 28, iss. 3, (2013), pp. 350-356)BACKGROUND: Plantar pressure is widely used to evaluate foot complaints. However, most plantar pressure studies focus on the symptomatic foot with foot deformities. The purposes of this study were to investigate subjects without clear foot deformities and to identify differences in plantar pressure pattern between subjects with and without forefoot pain. The second aim was to discriminate between subjects with and without forefoot pain based on plantar pressure measurements using neural networks. METHODS: In total, 297 subjects without foot deformities of whom almost 50% had forefoot pain walked barefoot over a pressure plate. Foot complaints and subject characteristics were assessed with a questionnaire and a clinical evaluation. Plantar pressure was analyzed using a recently developed method, which produced pressure images of the time integral, peak pressure, mean pressure, time of activation and deactivation, and total contact time per pixel. After pre-processing the pressure images with principal component analysis, a forward selection procedure with neural networks was used to classify forefoot pain. FINDINGS: The pressure-time integral and mean pressure were significantly larger under the metatarsals II and III for subjects with forefoot pain. A neural network with 14 input parameters correctly classified forefoot pain in 70.4% of the test feet. INTERPRETATION: The differences in plantar pressure parameters between subjects with and without forefoot pain were small. The reasonable performance of forefoot pain classification by neural networks suggests that forefoot pain is related more to the distribution of the pressure under the foot than to the absolute values of the pressure at fixed locations.
2013, Article in monograph or in proceedings (International Conference on Agricultural Engineering)There are several greenhouses built with solar panels integrated into the roof. In summer time this will operate very well, although broad shadow stripes can result in growth and yield differences. In winter the amount of sunlight is further limited by the solar panels and will result in further reduction of light accession to the cultivation space. As a result, the crops suffer from growth problems. These drawbacks are eliminated by the application of Concentrating Power Systems (CSP) with Fresnel lenses. A Fresnel lens works like a normal lens but is much thinner. When the sun shines, the lens receives both direct and indirect sunlight. The lens will concentrate all direct sunlight, which can be collected as thermal energy in the focal point. This
absorbed radiation can be converted with an absorption cooler into cold water for cooling. This cold water can cool the greenhouse without the need of water use. The indirect solar radiation, the diffuse light will not focus and is therefore available as a fairly constant light source in the building or in the greenhouse. The capture of all direct radiation at high intensities will diminish the incoming heat load, which is useful for a better internal climate control of greenhouses and buildings. This lower heat load makes it easier to keep the greenhouse cool with the absorber. In this study the details of energy flows and thermal conversion with absorption cooler is determined. Calculation shows a 47% heat load reduction (from 337 W/m2 to 157 W/m2) with the Fresnel lenses in the covering of the greenhouse. In the case of the collector in focus, only 48% of the captured direct radiation, available as thermal energy, is required to cool the greenhouse further with an absorption cooler. Cooling a greenhouse can result in up to 90% reduction in water consumption of the cultivation. The possibility of light regulation is another important advantage the Fresnel lenses have. The light amount can vary between 15 – 77% of the incoming radiation. The access of the generated energy can be used for extra illumination (light and energy regulation) and/or energy supply and/or a desalination system.
2020, Article / Letter to editor (European Spine Journal, vol. 29, iss. 7, (2020), pp. 1660-1670)PURPOSE: To conduct a meta-analysis to describe clinical course of pain and disability in adult patients post-lumbar discectomy (PROSPERO: CRD42015020806). METHODS: Sensitive topic-based search strategy designed for individual databases was conducted. Patients (>n16 years) following first-time lumbar discectomy for sciatica/radiculopathy with no complications, investigated in inception (point of surgery) prospective cohort studies, were included. Studies including revision surgery or not published in English were excluded. Two reviewers independently searched information sources, assessed eligibility at title/abstract and full-text stages, extracted data, assessed risk of bias (modified QUIPs) and assessed GRADE. Authors were contacted to request raw data where data/variance data were missing. Meta-analyses evaluated outcomes at all available time points using the variance-weighted mean in random-effect meta-analyses. Means and 95% CIs were plotted over time for measurements reported on outcomes of leg pain, back pain and disability. RESULTS: A total of 87 studies (nn=n31,034) at risk of bias (49 moderate, 38 high) were included. Clinically relevant improvements immediately following surgery (>nMCID) for leg pain (0-10, mean before surgery 7.04, 50 studies, nn=n14,910 participants) and disability were identified (0-100, mean before surgery 53.33, 48 studies, nn=n15,037). Back pain also improved (0-10, mean before surgery 4.72, 53 studies, nn=n14,877). Improvement in all outcomes was maintained (to 7 years). Meta-regression analyses to assess the relationship between outcome data and a priori potential covariates found preoperative back pain and disability predictive for outcome. CONCLUSION: Moderate-level evidence supports clinically relevant immediate improvement in leg pain and disability following lumbar discectomy with accompanying improvements in back pain. These slides can be retrieved under Electronic Supplementary Material.
2020, Article / Letter to editor (Nutrition & Dietetics: Journal of Dietitians Australia, vol. 77, iss. 4, (2020), pp. 416-425)This position statement describes the recommendations of the Clinical Oncology Society of Australia (COSA) regarding management of cancer-related malnutrition and sarcopenia. A multidisciplinary working group completed a review of the literature, focused on evidence-based guidelines, systematic reviews and meta-analyses, to develop recommendations for the position statement. National consultation of the position statement content was undertaken through COSA members. All people with cancer should be screened for malnutrition and sarcopenia in all health settings at diagnosis and as the clinical situation changes throughout treatment and recovery. People identified as "at risk" of malnutrition or with a high-risk cancer diagnosis or treatment plan should have a comprehensive nutrition assessment; people identified as "at risk" of sarcopenia should have a comprehensive evaluation of muscle status using a combination of assessments for muscle mass, muscle strength and function. All people with cancer-related malnutrition and sarcopenia should have access to the core components of treatment, including medical nutrition therapy, targeted exercise prescription and physical and psychological symptom management. Treatment for cancer-related malnutrition and sarcopenia should be individualised, in collaboration with the multidisciplinary team (MDT), and tailored to meet needs at each stage of cancer treatment. Health services should ensure a broad range of health care professionals across the MDT have the skills and confidence to recognise malnutrition and sarcopenia to facilitate timely referrals and treatment. The position statement is expected to provide guidance at a national level to improve the multidisciplinary management of cancer-related malnutrition and sarcopenia.
2010, Part of book or chapter of book (, pp. 143-160)Een bedrijf heeft competente medewerkers nodig om klanten te kunnen voorzien van goederen en diensten. Stel nu eens dat we een competente medewerker zien als een product. Niet omdat mensen producten zijn, maar omdat we de indruk hebben dat er met producten zorgvuldiger wordt omgesprongen dan met mensen. We nemen die zorgvuldigheid als minimum en stellen de vraag: In welk proces komt de competente medewerker tot stand? Dan zien we activiteiten van de leidinggevende, van collega’s, van de HR-afdeling, van trainers, van het (hoger, middelbaar en primair) onderwijs, van ouders, en niet te vergeten van de betrokkene zelf. En het valt ons dan op dat er geen regie is in deze keten van activiteiten die zorgt voor zorgvuldige afstemming. Het streven naar één regisseur is het najagen van een fictie. Maar accepteren we dan dat iedere schakel voor zichzelf werkt en niemand voor het geheel? Dan halen we niet de norm van de minimale zorgvuldigheid. Laten we dan serieus werk maken van het alternatief dat iedere actor een stuk regie pakt door zijn beslissingen te nemen met het oog op het optimaliseren van de hele keten en niet alleen van het eigen stuk daarin. Dan is iedere actor (bedrijf, school, uitzendbureau, individu enzovoort) verantwoordelijk voor het zoeken van samenwerking in het ontwikkelen van competente medewerkers. Geen enkele partij is eigenstandig in staat de geïntegreerde leersituatie tot stand te brengen die nodig is voor ompetentieontwikkeling, vandaar cocreatie. Hoe dan de spanning te hanteren tussen de verschillende paradigma’s? Het bedrijfskundige paradigma is gericht op werkprocessen, productiviteit, markt en geld verdienen. Het onderwijskundig paradigma is gericht op leerprocessen, competentie, studentenstromen en diploma’s. En dan heb je nog het leven zelf, van jongeren, van volwassenen, met keuzes die zich vaak aan beide paradigma’s onttrekken.
2011, Book review ((2011))De grote winst van dit boek is dat het autismeteams in Nederland in staat stelt een goed beschreven groepstherapie uit te voeren. Cognitieve gedragtherapeutische principes worden weliswaar al in verschillende vormen toegepast in de autismehulpverlening, maar het ontbreekt nog aan uitgewerkte programma’s die kunnen worden uitgewisseld. De volgende stap zou nu moeten zijn om de werkzaamheid ervan vast te stellen.
2013, Article in monograph or in proceedings (Conceptual Modeling - 32th International Conference, ER 2013, Hong-Kong, China, November 11-13, 2013, Proceedings)
2017, Article / Letter to editor (BMC Health Services Research, vol. 17, (2017))Background: Increasingly, nurse practitioners (NPs) are deployed in teams along with general practitioners (GPs) to help meet the demand for out-of-hours care. The purpose of this study was to explore factors influencing collaboration between GPs and NPs in teams working out-of-hours. Methods: A descriptive qualitative study was done using a total of 27 semi-structured interviews and two focus group discussions. Data was collected between June, 2014 and October, 2015 at an out-of-hours primary care organisation in the Netherlands. Overall, 38 health professionals (GPs, NPs, and support staff) participated in the study. The interviews were audio-taped and transcribed verbatim. Two researchers conducted an inductive content analysis, involving the identification of relevant items in a first phase and clustering into themes in a second phase. Results: The following four themes emerged from the data: clarity of NP role and regulation, shared caseload and use of skills, communication concerning professional roles, trust and support in NP practice. Main factors influencing collaboration between GPs and NPs included a lack of knowledge regarding the NPs' scope of practice and regulations governing NP role; differences in teams in sharing caseload and using each other's skills effectively; varying support of GPs for the NP role; and limited communication between GPs and NPs regarding professional roles during the shift. Lack of collaboration was perceived to result in an increased risk of delay for patients who needed treatment from a GP, especially in teams with more NPs. Collaboration was not perceived to improve over time as teams varied across shifts. Conclusion: In out-of-hours primary care teams constantly change and team members are often unfamiliar with each other or other's competences. In this environment, knowledge and communication about team members' roles is continuously at stake. Especially in teams with more NPs, team members need to use each other's skills to deliver care to all patients on time.
2018, Article in monograph or in proceedings (Joint Proceedings of REFSQ-2018 Workshops, Doctoral Symposium, Live Studies Track, and Poster Trackco-located with the 23rd International Conference on Requirements Engineering: Foundation for Software Quality (REFSQ 2018))
2018, Article in monograph or in proceedings (Keynote at the Social Work Master Programs Summer School 2018, "Social work and cooperation: two of a kind?")
2017, Article / Letter to editor (Journal of Applied Physiology: Respiratory, Environmental and Exercise Physiology, vol. 122, iss. 1, (2017), pp. 210-213)
2022, Article / Letter to editor (Journal of Applied Physiology: Respiratory, Environmental and Exercise Physiology, vol. 132, iss. 5, (2022), pp. 1323-1324)
2009, Article / Letter to editor (Scandinavian Journal of Work, Environment & Health, vol. 35, iss. 4, (2009), pp. 261-281)OBJECTIVE: Based on prospective and retrospective disease cohort studies, the aim of this review was to determine common prognostic factors for work disability among employees with rheumatoid arthritis, asthma, chronic obstructive pulmonary disease, diabetes mellitus, and ischemic heart disease (IHD). METHODS: A systematic literature search in Medline (1990-2008) and Embase (1990-2008) was carried out to identify relevant cohort studies using a well-defined list of inclusion and quality criteria. RESULTS: We identified 43 relevant cohort studies with sufficient methodological quality (20 for rheumatoid arthritis, 3 for asthma and 20 for IHD). The common prognostic factors for work disability found in all the diseases were: perceived health complaints, limitation in daily physical activities caused by the disease (high versus low), heavy manual work, and female gender. The common positive prognostic factors for rheumatoid arthritis and IHD were age (high versus low) and sickness absence. The common negative factors for rheumatoid arthritis and IHD were education (high versus low) and ethnic origin (white versus non-white). CONCLUSIONS: As many prognostic factors for work disability are similar for employees with various chronic diseases, it is possible to detect high risk groups. This information supports the development and implementation of a general disability management intervention for employees suffering from a chronic disease to overcome health-related limitations at work.
2017, Part of book or chapter of book (, pp. 126-129)De afgestudeerde van de toekomst is flexibel en wendbaar en beschikt over de vaardigheden die hem of haar in staat stellen om goed om te gaan met de continue stroom aan nieuwe ontwikkelingen. Om studenten goed voor te bereiden op het veranderende communicatievak in een dynamische en complexe context is het noodzakelijk in de opleiding al aandacht te schenken aan 21st century skills als kritisch kunnen denken, creativiteit en probleemoplossend vermogen. Ook moeten we de persoonlijke ontwikkeling van de student een belangrijke plaats geven in het curriculum.
2008, Article / Letter to editor (Levende Talen Tijdschrift, vol. 9, iss. 3, (2008), pp. 21-29)Wat moeten hbo-studenten kennen en kunnen om competent te kunnen communiceren in het Nederlands als ze na hun opleiding de arbeidsmarkt betreden? Wat betekent dat voor de invulling van een onderwijsprogramma? Dat zijn vragen die bij menige opleiding spelen. In deze bijdrage wordt een model gepresenteerd dat als basis kan dienen voor het opstellen van een doorlopende leerlijn van de communicatieve competentie in het Nederlands.
2010, Article in monograph or in proceedings (-Proceedings of the 2nd European Conference on Intellectual Capital)This paper is about helping human resource development professionals to understand how community of practice theory can inform the design of learning-based programs in order to link individual and organizational learning better. Learning is often considered a major contributor to the success or failure of an organization and, through learning, organizations develop new, and possibly rare competencies that enables them to gain or sustain a lasting competitive advantage and continued sustainable growth. This is an investment in human capital. The purpose of this research is thus to see how communities of practice, as part of a management development trajectory, can serve as the link between individual and organizational learning thus increasing effectiveness of the program. An analytical inductive approach was taken to the research. First, a review of the literature on communities of practice, individual, group and organizational learning led to the development of an analytical framework for understanding learning at each level, and how they could be linked. Quantitative data from participant surveys and qualitative data from a longitudinal case study was used to test the framework. The research showed that individual learning and group innovation are intertwined process occurring naturally in communities of practice. According to the analytical framework developed for this study, organizing communities of practice as part of human resource development trajectories is a valid strategy for increasing their effectiveness. The research has some limitations. For example, factors important to the functioning of the community of practice itself were not assessed or considered. Variations in learning might be attributed to the quality of implementation, guidance, or other unknown reasons and so might have affected the results. There are several practical implications to this work. Most important is the framework for understanding how communities of practice are linked to organizational learning - this can help designers of management development trajectories to improve effectiveness. Also, the added value of human resource development programs can be easier shown. This research is original in being a first attempt at empirically linking human resource development trajectories, communities of practice and organizational learning.
2022, Part of book or chapter of book (Lange, A.H. de; Heijden, B.I.J.M. van der (ed.), Een leven lang inzetbaar? Duurzame inzetbaarheid., pp. 299-316)
2012, Article / Letter to editor (Gait & Posture, vol. 36, iss. 1, (2012), pp. 127-132)The objective of the present study was to examine the attentional demands of gait adaptations required to walk over irregular terrain in community-dwelling people with chronic stroke. Eight community ambulators (>6 months post-stroke, aged 57 ± 15 years) and eight age-matched healthy controls participated in the study. As the primary motor task, participants walked on a treadmill while they quickly reacted to a sudden obstacle in front of the affected (in the stroke group) or left (in healthy controls) leg. The secondary, cognitive task was an auditory Stroop task. Outcomes were avoidance success rate and muscle reaction times of the biceps and rectus femoris (motor task), and a composite score of accuracy and verbal reaction time (cognitive task). Success rates did not differ between single- and dual-task conditions in either group, while muscle reaction times deteriorated equally during the dual task in both groups. However, compared with the Stroop scores just before and after obstacle crossing, the scores while crossing the obstacle deteriorated more in the stroke group than in the controls (p=0.012). The higher dual-task costs on the Stroop task reflect greater attentional demands during walking and crossing obstacles. The absence of dual-task effects on obstacle avoidance performance suggests that the people with stroke used a "posture-first strategy". The results imply that common daily life tasks such as obstacle crossing while walking require disproportionate attention even in well-recovered people with stroke.