2022, Article / Letter to editor (Journal of Social Intervention : Theory and Practice, vol. 31, iss. 1, (2022), pp. 82-88)Moeders die in armoede leven, vertellen dat stress hoort bij het dagelijks leven. Stress van ouders, dus moeders én vaders, is een voorspeller voor het welzijn van de kinderen. Het is dus belangrijk om in onderzoek en praktijk nadrukkelijk óók oog te hebben voor de vaders. En dat is niet vanzelfsprekend
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. 503-516)
2011, Article / Letter to editor (Nederlands Tijdschrift voor Geneeskunde, vol. 2011, iss. 155, (2011), pp. B674)In zijn jongste advies over een investeringsagenda voor nieuwe medische producten kiest de Gezondheidsraad voor het perspectief van eindgebruikers: patiënten en zorgverleners.1 Dat is sympathiek, maar hoe reëel is het eigenlijk? Krijgen patiënten en zorgverleners nu vaker de door hen gewenste medische producten? Of moet er meer gebeuren?
2020, Article / Letter to editor (Jpen, Journal of Parenteral and Enteral Nutrition, vol. 44, iss. 6, (2020), pp. 992-1003)Background The Global Leadership Initiative on Malnutrition (GLIM) created a consensus-based framework consisting of phenotypic and etiologic criteria to record the occurrence of malnutrition in adults. This is a minimum set of practicable indicators for use in characterizing a patient/client as malnourished, considering the global variations in screening and nutrition assessment, and to be used across different healthcare settings. As with other consensus-based frameworks for diagnosing disease states, these operational criteria require validation and reliability testing, as they are currently based solely on expert opinion. Methods Several forms of validation and reliability are reviewed in the context of GLIM, providing guidance on how to conduct retrospective and prospective studies for criterion and construct validity. Results There are some aspects of GLIM that require refinement; research using large databases can be employed to reach this goal. Machine learning is also introduced as a potential method to support identification of the best cut points and combinations of indicators for use with the different forms of malnutrition, which the GLIM criteria were created to denote. It is noted as well that validation and reliability testing need to occur in a variety of sectors and populations and with diverse persons using GLIM criteria. Conclusion The guidance presented supports the conduct and publication of quality validation and reliability studies for GLIM.
2020, Article / Letter to editor (Clinical Nutrition, vol. 39, iss. 9, (2020), pp. 2872-2880)Background: The Global Leadership Initiative on Malnutrition (GLIM) created a consensus-based framework consisting of phenotypic and etiologic criteria to record the occurrence of malnutrition in adults. This is a minimum set of practicable indicators for use in characterizing a patient/client as malnourished, considering the global variations in screening and nutrition assessment, and to be used across different health care settings. As with other consensus-based frameworks for diagnosing disease states, these operational criteria require validation and reliability testing as they are currently based solely on expert opinion. Methods: Several forms of validation and reliability are reviewed in the context of GLIM, providing guidance on how to conduct retrospective and prospective studies for criterion and construct validity. Findings: There are some aspects of GLIM criteria which require refinement; research using large data bases can be employed to reach this goal. Machine learning is also introduced as a potential method to support identification of the best cut-points and combinations of operational criteria for use with the different forms of malnutrition, which the GLIM criteria were created to denote. It is noted as well that the validation and reliability testing need to occur in a variety of sectors, populations and with diverse persons completing the criteria. Conclusion: The guidance presented supports the conduct and publication of quality validation and reliability studies for GLIM. (c) 2020 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism and American Society for Parenteral and Enteral Nutrition [Published by Wiley]. All rights reserved.
2009, Part of book or chapter of book (, pp. 67-78)The reasoning issue of this work is to research and define the efficient methods of global marketing control. The report is focused on the following aspects: the importance of the control systems in global marketing environment, the relationship between planning and controlling, types and the process of establishment of the control systems, common problems and approaches to control.
2019, Article in monograph or in proceedings (Ahram, T. (ed.), Advances in Human Factors in Wearable Technologies and Game Design. AHFE 2019. Advances in Intelligent Systems and Computing, pp. 332-342)
2016, Article / Letter to editor (Scientific Reports, vol. 6, (2016), pp. 31892)Insulin resistance is common among children with overweight and obesity. However, knowledge about glucose fluctuations in these children is scarce. This study aims to evaluate glycaemic profiles in children with overweight and obesity in free-living conditions, and to examine the association between glycaemic profiles with insulin resistance and cardiovascular risk parameters. One hundred eleven children with overweight and obesity were included. 48-hour sensor glucose concentrations in free-living conditions, fasting plasma and post-glucose load concentrations, serum lipid and lipoprotein concentrations, homeostatic model assessment of insulin resistance (HOMA-IR), and blood pressure were evaluated. Hyperglycaemic glucose excursions (≥7.8nmmol/L) were observed in 25% (nn=n28) of the children. The median sensor glucose concentration was 5.0 (2.7-7.3) mmol/L, and correlated with fasting plasma glucose concentrations (rsn=n0.190, pn=n0.046), serum insulin concentrations (rsn=n0.218, pn=n0.021), and HOMA-IR (rsn=n0.230, pn=n0.015). The hyperglycaemic area under the curve (AUC) correlated with waist circumference z-score (rsn=n0.455, pn=n0.025), triacylglycerol concentrations (rsn=n0.425, pn=n0.024), and HOMA-IR (rsn=n0.616, pn<n0.001). In conclusion, hyperglycaemic glucose excursions are frequently observed in children with overweight and obesity in free-living conditions. Children with insulin resistance had higher median sensor glucose concentrations and a larger hyperglycaemic sensor glucose AUC, which are both associated with specific parameters predicting cardiovascular disease risk.
2016, Article / Letter to editor (Diabetes Research and Clinical Practice, vol. 117, (2016), pp. 74-81)AIMS: Despite its general benefits for health, exercise complicates the maintenance of stable blood glucose concentrations in individuals with type 1 diabetes. The aim of the current study was to examine changes in food intake, insulin administration, and 24-h glycemic control in response to consecutive days with prolonged walking exercise (~8h daily) in individuals with type 1 diabetes. METHODS: Ten individuals with type 1 diabetes participating in the worlds' largest walking event were recruited for this observational study. Simultaneous measurements of 24-h glycemic control (continuous glucose monitoring), insulin administration and food intake were performed during a non-walking day (control) and during three subsequent days with prolonged walking exercise (daily distance 40 or 50km). RESULTS: Despite an increase in daily energy (31±18%; p<0.01) and carbohydrate (82±71g; p<0.01) intake during walking days, subjects lowered their insulin administration by 26±16% relative to the control day (p<0.01). Average 24-h blood glucose concentrations, the prevalence of hyperglycemia (blood glucose >10 mmol/L) and hypoglycemia (blood glucose <3.9mmol/L) did not differ between the control day and walking days (p>0.05 for all variables). The prolonged walking exercise was associated with a modest increase in glycemic variability compared with the control day (p<0.05). CONCLUSION: Prolonged walking exercise allows for profound reductions in daily insulin administration in persons with type 1 diabetes, despite large increments in energy and carbohydrate intake. When taking such adjustments into account, prolonged moderate-intensity exercise does not necessarily impair 24-h glycemic control.
2014, Article / Letter to editor (Onderwijsinnovatie, vol. 2014, iss. 3, (2014), pp. 17-26)Het borgen van het eindniveau is in het hbo een actueel en interessant vraagstuk. Wanneer opleidingen kunnen aantonen hoe studenten dit eindniveau binnen hun opleiding behalen, geeft dit het hbo-diploma waarde en biedt dit diploma de student een geode start van een mooie loopbaan.
2011, Part of book or chapter of book (, pp. 43-59)Logistiek krijgt in de gezondheidszorg meer aandacht dan voorheen, zowel omdat zorginstellingen zien dat men daarmee de kwaliteit van de zorg kan verbeteren, als omdat men erkent dat een goede logistieke beheersing zorgprocessen efficiënter maakt. Zorginstellingen weten momenteel onvoldoende waar zij staan in hun goederenlogistiek. Scoren zij beter of slechter dan andere instellingen? De managementinformatie ontbreekt. In dit paper geven we een eerste beeld hoe een aantal Nederlandse ziekenhuizen ten opzichte van elkaar scoren. We laten het benchmark instrument zien dat we daartoe hebben ontwikkeld. Op basis van gestructureerde interviews hebben, we de status van een homogene, geografisch gespreide groep van acht topklinische ziekenhuizen, met vergelijkbaar compleet zorgaanbod, ten opzichte van elkaar vastgesteld qua goederenlogistiek. Op basis van onderzoek zijn 27 kritische succesfactoren benoemd voor het gehele traject vanaf de aankomst van de goederen in het centraal magazijn, tot de levering op de afdelingen van het ziekenhuis. Daarnaast zijn best practices beschreven. Het paper levert een eerste beeld van het niveau en de positie van de goederenlogistiek in topklinische ziekenhuizen. Ons doel is om ziekenhuizen te helpen hun goederenlogistiek te verbeteren, en om dit onderzoek ook in andere sectoren van de zorg uit te voeren, en tegelijk de focus op beleidsmatige vraagstukken te versterken.
2011, Article in monograph or in proceedings (VervoersLogistieke Werkdagen)Logistiek krijgt in de gezondheidszorg meer aandacht dan voorheen, zowel omdat zorginstellingen zien dat men daarmee de kwaliteit van de zorg kan verbeteren, als omdat men erkent dat een goede logistieke beheersing zorgprocessen efficiënter maakt. Zorginstellingen weten momenteel onvoldoende waar zij staan in hun goederenlogistiek. Scoren zij beter of slechter dan andere instellingen? De managementinformatie ontbreekt. In deze paper geven we een eerste beeld hoe een aantal Nederlandse ziekenhuizen ten opzichte van elkaar scoren. We laten het benchmark instrument zien dat we daartoe hebben ontwikkeld. Op basis van gestructureerde interviews hebben we de status van een homogene, geografisch gespreide groep van acht topklinische ziekenhuizen, met vergelijkbaar compleet zorgaanbod, ten opzichte van elkaar vastgesteld qua goederenlogistiek. Op basis van onderzoek zijn 27 kritische succesfactoren benoemd voor het gehele traject vanaf de aankomst van de goederen in het centraal magazijn, tot de levering op de afdelingen van het ziekenhuis. Daarnaast zijn best practices beschreven.
2012, Article / Letter to editor (DISABILITY & SOCIETY, vol. 27, iss. 1, (2012), pp. 81-93)In western welfare states, labour participation is increasingly considered a vital aspect of taking part in society. Vocational rehabilitation programmes are intended to support people in the process of returning to work. These programmes pay much attention to the skills that clients need to develop in order to return to work. We argue, however, that vocational rehabilitation is more than the acquirement of skills, and that further attention should be paid to clients' 'identity work' processes. Based on 45 life-stories, we present an analysis of the identity work expressed by people with a work disability in the Netherlands. We describe 'separative', 'integrative', and 'pending' processes of identity work. The presented typology can help vocational rehabilitation professionals become more sensitive to clients' processes, and supports more inclusive vocational rehabilitation.
2014, Article / Letter to editor (BMC Family Practice, vol. 15, (2014))Background: General practitioners with more positive role security and therapeutic commitment towards patients with hazardous or harmful alcohol consumption are more involved and manage more alcohol-related problems than others. In this study we evaluated the effects of our tailored multi-faceted improvement implementation programme on GPs' role security and therapeutic commitment and, in addition, which professional related factors influenced the impact of the implementation programme. Methods: In a cluster randomised controlled trial, 124 GPs from 82 Dutch general practices were randomised to either the intervention or control group. The tailored, multi-faceted programme included combined physician, organisation, and patient directed alcohol-specific implementation strategies to increase role security and therapeutic commitment in GPs. The control group was mailed the national guideline and patients received feedback letters. Questionnaires were completed before and 12 months after start of the programme. We performed linear multilevel regression analysis to evaluate effects of the implementation programme. Results: Participating GPs were predominantly male (63%) and had received very low levels of alcohol related education before start of the study (0.4 h). The programme increased therapeutic commitment (p = 0.005; 95%-CI 0.13 - 0.73) but not role security (p = 0.58; 95%-CI -0.31 - 0.54). How important GPs thought it was to improve their care for problematic alcohol consumption, and the GPs' reported proportion of patients asked about alcohol consumption at baseline, contributed to the effect of the programme on therapeutic commitment. Conclusions: A tailored, multi-faceted programme aimed at improving GP management of patients with hazardous and harmful alcohol consumption improved GPs' therapeutic commitment towards patients with alcohol-related problems, but failed to improve GPs' role security. How important GPs thought it was to improve their care for problematic alcohol consumption, and the GPs' reported proportion of patients asked about alcohol consumption at baseline, both increased the impact of the programme on therapeutic commitment. It might be worthwhile to monitor proceeding of role security and therapeutic commitment throughout the year after the implementation programme, to see whether the programme is effective on short term but faded out on the longer term.
2012, Article / Letter to editor (Acta Horticulturae, iss. 927, (2012), pp. 43)In previous research a new type of greenhouse with an integrated concentrated photovoltaic system (CPV) was developed based on a circular covering geometry and an integrated filter for reflecting the near infrared radiation (NIR) of the greenhouse and exploiting this radiation in a solar energy system. The performance of the system was promising. In this study further optimalisation of the CPV system is made to avoid the large construction for solar tracing and the high investment. Hereto all parts for the solar concentrating system will be integrated into the greenhouse. The NIR-reflector material is carried out as a NIR-reflective lamellae system and the CPV-module is mounted into the ridge. In this paper the results of the optimization process of the CPV system based on NIR reflecting lamellae is presented. The optimization process is based on a maximal total annual electricity production and is performed with a ray tracing model and actual radiation data. Results show that the optimization of the lamellae greenhouse can be seen from a theoretical and a practical point of view. Theoretically, the number of lamellae for the investigated concept must be high (>100) and focus with a generic focal length of 3.5 m and glazing bars must be avoided. Then the maximal annual electricity output can be over 26 kWh/m2. In practice, mechanical restrictions, plant conditions and costs will determine the implementation. The proposed CPV-system has positive side-effects like reducing the heat load (and the need for cooling) during summer and blocking of the direct radiation which can be harmful for some crops. With this, the feasibility of the system depends greatly on local conditions which require a tailor-made economic analysis.
2020, Article in monograph or in proceedings (Biloria, N. (ed.), Data-driven multivalence in the built environment, pp. 157-180)In this chapter, we explore the possibility to use the living environment (of inpatient and outpatient care settings) for facilitating and encouraging the social inclusion of older adults in an increasingly smart society. We therefore pay attention to the spatial and smart design of emerging housing typologies for older adults in the Netherlands in which social activities and encounters take place.
Our first explorative research question reads: To what extent can the social inclusion of older adults with physical and/or mental disabilities contribute to their well-being? Based on (sociological) theories and existing knowledge from the literature, we can conclude that there are sufficient indications that the social inclusion of senior citizens in society have positive effects on their well-being, by strengthening social resources, in the case of intimate ties, and by stimulating public familiarity and random encounters. Moreover, it can be argued that encounters between elderly people with (either physical or mental) disabilities and healthy others can have a positive influence on the social acceptance of the former.
Following on the above, our second research question examines which spatial and smart interventions in and around inpatient and outpatient care settings can stimulate social inclusion. In this light, we discussed two new housing typologies in the Netherlands that can positively affect the inclusion of senior citizens in society: Farm sharing, which is particularly suitable for vital older adults who want to live independently for as long as possible, and the Care Estate, that seems to be a suitable form of living for vulnerable elderly people with physical and mental comorbidity, such as dementia. These housing typologies demonstrate the existence of an interplay between spatial design and smart technologies, in the sense that these factors can make each other superfluous or can provide added value.
In order to be able to optimize the well-being and health status of their residents, housing typologies must meet the needs of (vulnerable) older adults with regard to care, and social interaction, autonomy as much as possible. The art of designing new suitable housing typologies for older adults therefore should be based on linking different layers of people’s living environment: the care environment, the socio-spatial environment, and the digital environment. The two examples of housing typologies that we cover in this chapter, demonstrate how these different layers can be interconnected in order to design a new suitable housing concept.
2013, Article / Letter to editor (Engagement met Autisme, vol. 2013, iss. 2, (2013), pp. 12-13)In opdracht van de NVA heeft het lectoraat "Levensloopbegeleiding bij Autisme" van de Hogeschool van Arnhem en Nijmegen onderzoek gedaan naar de ondersteuningsbehoeften van mantelzorgers van een of meerdere kinderen met autisme. In dit artikel vindt u een verslag van de resulaten van dit onderzoek.
2022, Article / Letter to editor (Journal of Evaluation in Clinical Practice, vol. 28, iss. 6, (2022), pp. 1147-1156)RATIONALE: Adherence rates to guidelines show room for improvement, and increase in adherence to guidelines may potentially lead to better outcomes and reduced costs of treatment. To improve adherence, it is essential to understand the considerations of physiotherapists regarding the assessment and management of low back pain (LBP). The purpose of this study is to gain insight in the considerations of Dutch physiotherapists on adherence to the national physiotherapy guideline in the treatment of patients with LBP. METHODS: This is a qualitative study, using an interpretive approach of semi-structured interviews with 14 physiotherapists who regularly treat patients with LBP. Thematic analysis was conducted with open coding using an existing framework. This framework distinguishes five components to adherence based on patient factors, provider factors, guideline characteristics, institutional factors and the implementation process. RESULTS: Participating physiotherapists mentioned that the guideline should provide more information about psychosocial prognostic factors and psychosocial treatment options. The participants experienced difficulties in addressing patient expectations that conflict with guideline recommendations. The implementation process of the guideline was considered insufficient. Physiotherapists might rely too much on their experience, and knowledge of evidence-based treatment might be improved. In general, the interviewed physiotherapists thought they were mainly non-adherent to the guidelines. However, when comparing their considerations with the actual guideline recommendations they were mainly adherent. CONCLUSION: To improve adherence, the guideline should provide more information about addressing psychosocial prognostic factors, and Dutch physiotherapists might be trained in communication skills to better address patient expectations. A more extensive implementation process is warranted for the next guideline to increase the physiotherapists' knowledge of evidence-based treatment.
2012, Part of book or chapter of book (, pp. 61-86)In recent publications in International Journals in 2010 and 2011, I described the phenomenon of a new approach to education and training called ‘Gyroscopic Management’ (See list publications). To give the reader an insight and overview of this, I will introduce and explain this gyroscopic management and, based on literature research and my own experiences, I describe how a currently used approach in education and the training of business and management students at Arnhem Business School (ABS) shows that this can lead to added strategic value for management in organizations. This also represents the start of a so-called, ‘Grounded Action’ research about the influence of training and educating for new future managers in organisations, as described in the second part of this paper. The research took place in Romania and The Netherlands and it shows the discovered five stages of ‘gyroscopic management’: “Learning, listening, awareness, accepting, adapting, and advancing.” I explored this explanatory theory further into a so-called ‘Grounded Action’ research approach in which I made an ‘operational theory’ (Simmons & Gregory 2003). This research is implemented in the form of a final applied research in educational and training practice during trainings, lectures at ABS in the Netherlands and at the West University in Timisoara, Romania (UWT).
2010, Part of book or chapter of book (, pp. 185-212)In deze bijdrage bespreken we een zelfontwikkelde methodiek , waarin communicatief handelen en communicatieve sensitiviteit in de docentenrol tot uitdrukking komt. De methodiek komt voort uit onze manier van denken over communiceren, handelen en veranderen en de problemen die zich bij de rol van communicatie in ‘verandermanagement’, als wezenlijk thema van elke economische hbo-opleiding, voordoen binnen een onderwijsorganisatie. Daarbij staat de meerwaarde van de relatie tussen docenten, het onderwijs, de student en de beroepspraktijk centraal. Het gaat daarbij om de volgende vraag: Wat is er nodig om een communicatief goede verandermanager te zijn of te worden en op welke wijze kan gyroscopisch zelfmanagement hierin een rol spelen?
2017, Article / Letter to editor (International Journal of Sport Nutrition and Exercise Metabolism, vol. 27, iss. 2, (2017), pp. 148-157)Although beetroot juice, as a nitrate carrier, is a popular ergogenic supplement among athletes, nitrate is consumed through the regular diet as well. We aimed to assess the habitual dietary nitrate intake and identify the main contributing food sources in a large group of highly trained athletes. Dutch highly trained athletes (226 women and 327 men) completed 2-4 web-based 24-hr dietary recalls and questionnaires within a 2- to 4-week period. The nitrate content of food products and food groups was determined systematically based on values found in regulatory reports and scientific literature. These were then used to calculate each athlete's dietary nitrate intake from the web-based recalls. The median[IQR] habitual nitrate intake was 106[75-170] mg/d (range 19-525 mg/d). Nitrate intake correlated with energy intake (ρ = 0.28, p < .001), and strongly correlated with vegetable intake (ρ = 0.78, p < .001). In accordance, most of the dietary nitrate was consumed through vegetables, potatoes and fruit, accounting for 74% of total nitrate intake, with lettuce and spinach contributing most. When corrected for energy intake, nitrate intake was substantially higher in female vs male athletes (12.8[9.2-20.0] vs 9.4[6.2-13.8] mg/MJ; p < .001). This difference was attributed to the higher vegetable intake in female vs male athletes (150[88-236] vs 114[61-183] g/d; p < .001). In conclusion, median daily intake of dietary nitrate in highly trained athletes was 106 mg, with large interindividual variation. Dietary nitrate intake was strongly associated with the intake of vegetables. Increasing the intake of nitrate-rich vegetables in the diet might serve as an alternative strategy for nitrate supplementation.
2015, Book (monograph) Tijdens een symposium over de kwetsbaarheid van mensen is het boek HAN SOCIAAL Kennisproducten 2015: Praktische hulpmiddelen voor maatschappelijke dienstverlening gepresenteerd. In de bundel staan ruim 40 beschikbare kennisproducten en diensten. Deze zijn bedoeld voor -en zijn ook in nauwe samenwerking ontwikkeld met- professionals en partnerinstellingen in het sociale werkveld, én met collega-docenten en docentonderzoekers van uiteenlopende HAN-opleidingen.
2012, Article / Letter to editor (iss. 4, (2012))De voordelen van modelgebaseerde ontwikkeling van regelsystemen gelden voor het mkb net zo goed als voor grote bedrijven, maar de bijbehorende investeringen zijn lastiger te dragen door kleine en middelgrote bedrijven. De Han ontwikkelt daarom samen met een aantal mkb’ers een betaalbaarder ontwikkelplatform. Zowel bedrijfsleven als onderwijs profiteert hiervan.
2009, Article / Letter to editor (De Lichamelijke Opvoeding, iss. 5, (2009), pp. 29-31)Handbal is in Europa een populaire sport. Het is de door mannen meest beoefende zaalsport en de meest beoefende sport door vrouwen (in georganiseerd verband). In
Nederland wordt handbal door zo’n 60.000 mensen gespeeld. 70 Procent hiervan is
vrouw. Om de jeugd enthousiast te maken voor handbal is het essentieel dat ze al op jonge leeftijd in aanraking komen met de sport. Onderwijs is daarvoor de meest geschikte ingang.
2009, Article / Letter to editor (De Lichamelijke Opvoeding, iss. 6, (2009), pp. 28-30)In het vorige nummer heeft een inleiding gestaan over het aanbieden van handbal in de lessen bewegingsonderwijs aan kinderen in de leeftijd van acht tot zestien jaar.
De auteurs menen dat onbekendheid met de sport de oorzaak is waarom handbal weinig wordt aangeboden aan kinderen in het bewegingsonderwijs. Met deze artikelenserie willen we u handvatten bieden waarmee u handbal in het basis- en voortgezet onderwijs kunt aanbieden.
2009, Article / Letter to editor (De Lichamelijke Opvoeding, iss. 7, (2009), pp. 24-27)In het vorige artikel zijn we ingegaan op het aanleren van basisvaardigheden van het
handbal. In artikel drie besteden we aandacht aan schijnbewegingen, verdedigen en aan tactische principes. De lesstof in dit artikel is meer geschikt voor de vaardigere handbalspelers. We adviseren het toepassen van schijnbewegingen, verdedigen en tactiek aan bod te laten komen in het derde schooljaar van het voortgezet onderwijs of als leerlingen worden voorbereid op een schoolhandbaltoernooi.
2009, Article / Letter to editor (De Lichamelijke Opvoeding, iss. 8, (2009), pp. 24-27)In drie voorgaande artikelen zijn ideeën aangedragen om leerlingen in de bovenbouw van het primair onderwijs en leerlingen in het voortgezet onderwijs basisvaardigheden van het handbal aan te leren. In het derde artikel is oefenstof aangeboden om de meer vaardige leerlingen uitdagende oefeningen aan te bieden. In dit laatste artikel over handbal zullen tactische elementen besproken worden die in de lessen LO in het voortgezet onderwijs kunnen worden behandeld.