Governance & Gezondheidszorg: Private, publieke en professionele invloeden op zorgaanbieders in Nederland

Governance in de Nederlandse gezondheidszorg is ingewikkeld. Zorgaanbieders moeten werken in de combinatie van private, publieke en professionals governance. Onderzocht is hoe die combinatie in elkaar zit en hoe governance in de zorg functioneert. Governance bestaat doorgaans uit spelregels en omgangsvormen voor bestuur, toezicht en verantwoording. Deze spelregels en omgangsvormen moeten ervoor zorgen dat organisaties of personen de belangen, die aan hen zijn toevertrouwd, zo goed mogelijk behartigen. Iedere sector in de maatschappij heeft tegenwoordig met governance te maken. Ook de gezondheidszorg. In Nederland wordt zorg en behandeling geleverd door private organisaties en personen. Organisaties zoals ziekenhuizen, verpleeghuizen en thuiszorgorganisaties. Personen zoals huisartsen, medisch specialisten en fysiotherapeuten. Zorg wordt verleend op basis van private contracten tussen zorgaanbieder, zorgvrager en zorgverzekeraar. Zorgaanbieders hebben hun eigen private belangen, zoals de continuïteit van de eigen organisatie. Maar ze moeten ook bijdragen aan de publieke belangen die de overheid voor de gezondheidszorg wil behartigen. En ze dienen rekening te houden met de professionele opvattingen over zorgverlening en de belangen van de zorgprofessionals. Private, publieke en professionele belangen vragen ieder hun eigen governance. Er worden immers verschillende doelen gesteld. Er heersen verschillende morele opvattingen en omgangsvormen, in deze studie aangeduid als moraliteiten. Er gelden verschillende governance principes en er worden verschillende instrumenten gebruikt. Moraliteiten, doelen, principes en instrumenten van private, publieke en professionals governance zijn onderling zo verschillend, dat gesproken kan worden over verschillende governance werelden. Zorgaanbieders moeten functioneren in de combinatie van die drie governance werelden. Ze zijn genoodzaakt steeds afwegingen te maken tussen – en binnen – private, publieke en professionele belangen. Ze hebben te voldoen aan de eisen van de drie governance werelden. Zowel de doelen als de inrichting van de governance kunnen onderling strijdig zijn. In deze studie is onderzocht hoe de combinatie van de private, publieke en professionals governance wereld functioneert voor Nederlandse zorgaanbieders

Evidence-based Clinical Guidelines for Eating Disorders: International Comparison

Purpose of review – This systematic review sought to compare available evidence-based clinical treatment guidelines for all specific eating disorders. Recent findings – Nine evidence-based clinical treatment guidelines were located through a systematic search. The international comparison demonstrated notable commonalities and differences among current evidence-based clinical guidelines for eating disorders. Consistency across guidelines was greatest for treatments with a larger evidence base, while those with a lower evidence base had recommendations that varied considerably. Summary – Evidence-based clinical guidelines represent an important step toward the dissemination and implementation of evidence-based treatments into clinical practice. Despite advances in clinical research on eating disorders, a growing body of literature demonstrates that individuals with eating disorders often do not receive an evidence-based treatment for their disorder. Regarding the dissemination and implementation of evidence-based treatments, current guidelines do endorse the main empirically validated treatment approaches with considerable agreement, but additional recommendations are largely inconsistent. An increased evidence base is critical in offering clinically reliable and consistent guidance for the treatment of eating disorders. Because developing and updating clinical guidelines is time-consuming and complex, an international coordination of guideline development, for example, across the European Union, would be desirable

Review of the burden of eating disorders:mortality, disability, costs, quality of life, and family burden

Purpose of review To review the recent literature on the burden of eating disorders in terms of mortality, disability, quality of life, economic cost, and family burden, compared with people without an eating disorder. Recent findings Estimates are that yearly over 3.3 million healthy life years worldwide are lost because of eating disorders. In contrast to other mental disorders, in anorexia nervosa and bulimia nervosa years lived with disability (YLDs) have increased. Despite treatment advances, mortality rates of anorexia nervosa and bulimia nervosa remain very high: those who have received inpatient treatment for anorexia nervosa still have a more than five times increased mortality risk. Mortality risks for bulimia nervosa, and for anorexia nervosa treated outside the hospital, are lower but still about twice those of controls. In people with an eating disorder, quality of life is reduced, yearly healthcare costs are 48% higher than in the general population, the presence of mental health comorbidity is associated with 48% lower yearly earnings, the number of offspring is reduced, and risks for adverse pregnancy and neonatal outcomes are increased. People with a current or former eating disorder are at risk of increased mortality, high YLD rates, a reduced quality of life, increased costs, and problems with childbearing

Maatschappelijke spin-off van side-events WK CP Voetbal 2011

Onderzoek naar de effectiviteit van het side-event programma bij het wereldkampioenschoep CP Voetbal in Drenthe in 2011. Onderzocht is in welke mate de verschillende side-events een bijdrage leverden aan de doelstellingen van het hoofdevenement. Het onderzoek vond plaats binnen het kader van de pilot van het Ministerie van Volksgezondheid, Welzijn en Sport (VWS) om kennis te ontwikkelen over sportevenementen

Review of the unprecedented impact of the COVID-19 pandemic on the occurrence of eating disorders

Purpose of review To review the recent literature on the impact of the coronavirus disease-2019 (COVID-19) pandemic on incidence and severity of symptoms of eating disorders (EDs). Recent findings A worrying increase of EDs in- and outpatients has been reported since the COVID-19 pandemic began in 2019/2020. Restrictions implemented during the pandemic to protect populations against COVID-19 increased the risk for onset and for worsening of EDs by disrupting eating and exercise routines, social isolation, lack of support, and limited access to healthcare. Substantial increases since the start of the pandemic have been reported for overall incidence (15%), hospital admissions (48%) and emergency department visits (11%) for EDs, with even higher increases among women and children or adolescents with an ED. During the pandemic, ED patients reported increased severity of ED-specific symptoms and increased anxiety, depression and suicidal ideations and -attempts. Treatments shifted largely toward online methods for continuity of care, despite concerns about the quality of care provided and difficulties in self-monitoring. Our review provides preliminary evidence for a similar effectiveness of online treatment to prepandemic face-to-face treatment. In-person assessment remains essential for detecting EDs and for those requiring medical admission. Although the ongoing COVID-2019 pandemic affected mental health globally, research shows that it particularly affected individuals with an ED diagnosis or at risk for an ED, especially women, children and adolescents, and those with anorexia nervosa