2022, External research report Alle moderne auto’s zitten er vol mee en voor de meeste chauffeurs zijn ze een essentieel onderdeel van zijn dagelijks autorijden geworden, de zogeheten ‘Advanced Driver Assistance Systems’ of afgekort ADAS. Deze rijhulpsystemen ondersteunen de autobestuurder actief of passief tijdens het autorijden. Waarom? Om de verkeersveiligheid verhogen! Niet voor niets is de afgelopen decennia zwaar geïnvesteerd in ADAS én heeft de Europese Unie 30 rijhulpsystemen verplicht gesteld voor alle nieuw ontwikkelde voertuigen vanaf 2022 en alle nieuw verkochte auto’s vanaf 2024. Helaas lijken deze systemen ontwikkeld te worden voor de universele gebruiker en ze sluiten daarom niet aan bij de wensen, behoeften en capaciteiten van specifieke doelgroepen, in dit geval bestuurders op leeftijd De potentie van ADAS wordt dus niet optimaal benut voor deze doelgroep. Juist deze bestuurders op leeftijd blijken extra baat te hebben bij een doelgroepgerichte ADAS Uit ongevallenstatistieken komt namelijk naar voren dat deze doelgroep, de oudere automobilist, verhoudingsgewijs vaker betrokken is bij verkeersongevallen Erger nog, de doelgroep blijkt zelfs relatief vaker de veroorzaker van ongevallen. Van de 20 500 zwaargewonden in 2017 was ongeveer 40 ouder dan 65 jaar. Van de verkeersdoden is 45 ouder dan 65 jaar. Bestuurders op leeftijd worden daarom als risicogroep in het verkeer aangeduid. Met
de vergrijzing van Nederland, is de verwachting dat deze percentages de komende jaren zullen stijgen Het aantal ouderen groeit. Het aandeel ouderen op de weg neemt toe Ouderen reizen steeds vaker over langere afstanden. En ouderen bereiken een hogere leeftijd. Veel ouderen zien automobiliteit als een belangrijk element van hun onafhankelijkheid. Hun persoonlijke mobiliteit draagt bij aan het voorkomen van eenzaamheid op hogere leeftijd. Waarom zijn er ( geen doelgroepgerichte ADAS voor de bestuurder op leeftijd? Wanneer, waar of in welke situatie(s), heeft een doelgroepgerichte ADAS de meeste potentie? Wat is de behoefte bij de doelgroep? Eerder uitgevoerde onderzoeken tonen aan dat specifieke rijhulpsystemen het verhoogde ongevalsrisico van de oudere automobilist kunnen verlagen! Tijd voor een onderzoek dus! HAN Automotive Research heeft samen met haar partners V-tron en Max Mobiel de marktmogelijkheden en de businesscase onderzocht BRAVO zet hiermee een eerste stap naar doelgroepgerichte ADAS die kunnen
bijdragen aan de verkeersveiligheid en het zelfstandige mobiliteitsbelang van de bestuurder op leeftijd.
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)
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. 203-212)
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. 429-444)
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. 165-182)
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. 401-414)
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)
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, Article / Letter to editor (BMC Emergency Medicine, vol. 22, iss. 1, (2022), pp. 44)BACKGROUND: Efficient communication between (helicopter) emergency medical services ((H)EMS) and healthcare professionals in the emergency department (ED) is essential to facilitate appropriate team mobilization and preparation for critically ill patients. A correct estimated time of arrival (ETA) is crucial for patient safety and time-management since all team members have to be present, but needless waiting must be avoided. The aim of this study is to investigate the quality of the pre-announcement and the accuracy of the ETA. METHODS: A prospective observational study was conducted in potentially critically ill/injured patients transported to the ED of a Level I trauma center by the (H)EMS. Research assistants observed time slots prior to arrival at the ED and during the initial assessment, using a stopwatch and an observation form. Information on the pre-announcement (including mechanisms of injury, vital signs, and the ETA) is also collected. RESULTS: One hundred and ninety-three critically ill/injured patients were included. Information in the pre-announcement was often incomplete; in particular vital signs (86%). Forty percent of the announced critically ill patients were non-critical at arrival in the ED. The observed time of arrival (OTA) for 66% of the patients was later than the provided ETA (median 5:15nmin) and 19% of the patients arrived sooner (3:10nmin). Team completeness prior to the arrival of the patient was achieved for 66% of the patients. CONCLUSIONS: The quality of the pre-announcement is moderate, sometimes lacking essential information on vital signs. Forty percent of the critically ill patients turned out to be non-critical at the ED. Furthermore, the ETA was regularly inaccurate and team completeness was insufficient. However, none of the above was correlated to the rate of complications, mortality, LOS, ward of admission or discharge location.
2022, Article in monograph or in proceedings (Plaats voor logistiek in autovrije gebiedsontwikkeling: van verschonen en verminderen naar ruimtelijk integreren)
2022, Article / Letter to editor (Tijdschrift voor Beleid, Politiek en Maatschappij, vol. 49, iss. 1, (2022), pp. 53-72)In dit artikel pleiten wij voor een meer op skills gerichte re-integratiebereik. Omdat de 'klassieke' re-integratie - so snel mogelijk terug naar het 'oude' beroep bij de eigen werkgever- minder kansrijk lijkt als de vraag naar arbeid in dat oude beroep sterk verandert, afneemt of zelfs verdwijnt.
2022, Dissertation It is important to get a better understanding of the relationship between sport participation on the one hand and health and health care costs on the other. For that purpose, the research in this thesis shows that sport participation is positively associated to significantly lower risks of morbidity, type 2 diabetes, prediabetes and obesity. However, the relationship between sport participation and health differs between groups. For several health outcomes, the positive effects of sport participation are significantly greater for people with a healthy weight than for obese persons. Another finding is that socioeconomic inequalities in sports participation (with the most vulnerable groups participating the least) seem contribute considerably, and much more than physical activity, to the socioeconomic inequalities in health outcomes. The research also shows that there exists a strong socioeconomic gradient in health care costs in the Netherlands: controlling for the population structure, poor neighborhoods have substantially higher costs than affluent neighborhoods. In addition, neighborhoods with a higher percentage of voluntary sports club members have significantly lower average health care costs. This relationship seems to be independent of the socioeconomic level of a neighborhood. Finally, the research shows that the socioeconomic inequalities in physical activity behavior have increased significantly in the Netherlands due to the Covid-19 pandemic and the measures to prevent the spread of the virus. In conclusion, the research in this thesis demonstrates that sports participation can be an important preventive medicine for improving health, reducing socioeconomic health inequalities, as well as lowering health care costs.
2021, Article / Letter to editor (Quality of Life Research, (2021))Purpose Complementary interventions for persons with severe mental illness (SMI) focus on both personal recovery and illness self-management. This paper aimed to identify the patient-reported outcome measures (PROMs) associated with the most relevant and meaningful change in persons with SMI who attended the Illness Management and Recovery Programme (IMR). Methods The effect of the IMR was measured with PROMs concerning recovery, illness self-management, burden of symptoms and quality of life (QoL). From the QoL measures, an anchor was chosen based on the most statistically significant correlations with the PROMs. Then, we estimated the minimal important difference (MID) for all PROMs using an anchor-based method supported by distribution-based methods. The PROM with the highest outcome for effect score divided by MID (the effect/MID index) was considered to be a measure of the most relevant and meaningful change. Results All PROMs showed significant pre-post-effects. The QoL measure 'General Health Perception (Rand-GHP)' was identified as the anchor. Based on the anchor method, the Mental Health Recovery Measure (MHRM) showed the highest effect/MID index, which was supported by the distribution-based methods. Because of the modifying gender covariate, we stratified the MID calculations. In most MIDs, the MHRM showed the highest effect/MID indexes. Conclusion Taking into account the low sample size and the gender covariate, we conclude that the MHRM was capable of showing the most relevant and meaningful change as a result of the IMR in persons with SMI.
2021, Article / Letter to editor (Journal of Orthopaedic and Sports Physical Therapy, vol. 51, iss. 3, (2021), pp. 103-114)OBJECTIVE: To assess the effectiveness of prehabilitation in patients with degenerative disorders of the lumbar spine who are scheduled for spine surgery. DESIGN: Intervention systematic review with meta-analysis. LITERATURE SEARCH: Seven electronic databases were systematically searched for randomized controlled trials or propensity-matched cohorts. STUDY SELECTION CRITERIA: Studies that measured the effect of prehabilitation interventions (ie, exercise therapy and cognitive behavioral therapy [CBT]) on physical functioning, pain, complications, adverse events related to prehabilitation, health-related quality of life, psychological outcomes, length of hospital stay, use of analgesics, and return to work were included. DATA SYNTHESIS: Data were extracted at baseline (preoperatively) and at short-term (6 weeks or less), medium-term (greater than 6 weeks and up to 6 months), and long-term (greater than 6 months) follow-ups. Pooled effects were analyzed as mean differences and 95% confidence intervals (CIs). Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. RESULTS: Cognitive behavioral therapy interventions were no more effective than usual care for all outcomes. Pooled effect sizes were -2.0 (95% CI: -4.4, 0.4) for physical functioning, -1.9 (95% CI: -5.2, 1.4) for back pain, and -0.4 (95% CI: -4.1, 0.4) for leg pain. Certainty of evidence for CBT ranged from very low to low. Only 1 study focused on exercise therapy and found a positive effect on short-term outcomes. CONCLUSION: There was very low-certainty to low-certainty evidence of no additional effect of CBT interventions on outcomes in patients scheduled for lumbar surgery. Existing evidence was too limited to draw conclusions about the effects of exercise therapy. J Orthop Sports Phys Ther 2021;51(3):103-114. Epub 25 Dec 2020. doi:10.2519/jospt.2021.9748.
2021, Article / Letter to editor (European Journal of Physiotherapy, (2021))Purpose: To translate and culturally adapt the Swedish version of the 'Blue flags' questionnaire into Dutch and to examine the validity and reliability aspects of the Dutch version. Methods: The 'Blue flags' questionnaire was translated and culturally adapted to the Dutch situation. A total of 58 participants filled in the first questionnaire at baseline and 51 participants filled in the second questionnaire sent two weeks later. The data of the participants who filled in the first questionnaire was used to determine internal consistency, structural validity and concurrent validity. The data of the participants who filled in both questionnaires was used to determine test-retest reliability. Results: The internal consistency was good with a Cronbach's alpha of 0.83. The structural validity was satisfactory with a Kaiser-Meyer-Olkin (KMO) test of 0.75 and a significance of p < .001 for the Bartlett's test. Four factors were extracted using principal component analysis (PCA) with varimax rotation with an explained total variance of 70.8%. Spearman's rho for concurrent validity was 0.68 (p < .001). The intraclass correlation coefficient (ICC) for test-retest was 0.80 (p < .001) for the total score. Conclusions: The Dutch version of the 'Blue flags' questionnaire showed good internal consistency, satisfactory structural validity, strong concurrent validity (with mixed item representation results) and strong reliability.
2021, Part of book or chapter of book (Stel, J. van der (ed.), Wetenschap en praktijkgids voor (aankomende) professionals in zorg, welzijn en sociaal werk, pp. 139-145)
2021, Article / Letter to editor (BMC Musculoskeletal Disorders, vol. 22, iss. 1, (2021), pp. 143)BACKGROUND: Neck and shoulder complaints are common in primary care physiotherapy. These patients experience pain and disability, resulting in high societal costs due to, for example, healthcare use and work absence. Content and intensity of physiotherapy care can be matched to a patient's risk of persistent disabling pain. Mode of care delivery can be matched to the patient's suitability for blended care (integrating eHealth with physiotherapy sessions). It is hypothesized that combining these two approaches to stratified care (referred to from this point as Stratified Blended Approach) will improve the effectiveness and cost-effectiveness of physiotherapy for patients with neck and/or shoulder complaints compared to usual physiotherapy. METHODS: This paper presents the protocol of a multicenter, pragmatic, two-arm, parallel-group, cluster randomized controlled trial. A total of 92 physiotherapists will be recruited from Dutch primary care physiotherapy practices. Physiotherapy practices will be randomized to the Stratified Blended Approach arm or usual physiotherapy arm by a computer-generated random sequence table using SPSS (1:1 allocation). Number of physiotherapists (1 or > 1) will be used as a stratification variable. A total of 238 adults consulting with neck and/or shoulder complaints will be recruited to the trial by the physiotherapy practices. In the Stratified Blended Approach arm, physiotherapists will match I) the content and intensity of physiotherapy care to the patient's risk of persistent disabling pain, categorized as low, medium or high (using the Keele STarT MSK Tool) and II) the mode of care delivery to the patient's suitability and willingness to receive blended care. The control arm will receive physiotherapy as usual. Neither physiotherapists nor patients in the control arm will be informed about the Stratified Blended Approach arm. The primary outcome is region-specific pain and disability (combined score of Shoulder Pain and Disability Index & Neck Pain and Disability Scale) over 9 months. Effectiveness will be compared using linear mixed models. An economic evaluation will be performed from the societal and healthcare perspective. DISCUSSION: The trial will be the first to provide evidence on the effectiveness and cost-effectiveness of the Stratified Blended Approach compared with usual physiotherapy in patients with neck and/or shoulder complaints. TRIAL REGISTRATION: Netherlands Trial Register: NL8249 . Officially registered since 27 December 2019. Date of first enrollment: 30 September 2020. Study status: ongoing, data collection.