Informal caregivers of persons with dementia, their use of and needs for specific professional support: a survey of the national dementia programme

<p>Abstract</p> <p>Background</p> <p>This paper describes both the use of and needs for informal caregivers of people with dementia, based on a questionnaire survey organized within the National Dementia Programme in the Netherlands. The National Dementia Programme is a quality collaborative of the Dutch Alzheimer's Association, the Institute of Quality of Healthcare (CBO) and the Knowledge Centre on Ageing (Vilans), instigated by the Ministry of Health, Welfare and Sport, to improve integrated care for people with dementia and their informal caregivers. The support needs of informal caregivers are important to improve caregiver well-being and delaying institutionalization of the person with dementia.</p> <p>Methods</p> <p>In the period April 2006 - January 2007, the National Dementia Programme questionnaire was completed by 984 informal caregivers. Descriptive statistics were used to analyze the use of and needs for additional professional support by informal caregivers. Chi-square tests were used to assess the relationships between characteristics of the caregivers (spouses, sons/daughters, sons/daughters in-law) and support needs on one hand and to assess the relationship between the living situation of the person with dementia (living at home or living in a nursing home or home for the elderly) and support needs on the other hand.</p> <p>Results</p> <p>Almost all informal caregivers (92.6%) received some professional support. However, two thirds (67.4%) indicated they had one or more needs for additional professional support. Informal caregivers often need additional professional advice about what to do when their relative is frightened, angry of confused. Spouses reported different needs than sons or daughters (in-law): spouses relatively often need emotional support and sons or daughters (in-law) more often need information and coordination of dementia care.</p> <p>Conclusions</p> <p>Most of the informal caregivers report that they need additional information and advice, e.g. about how to cope with behavioral problems of their relative, about the progression of the illness trajectory, emotional support and coordination of dementia care. Future support programmes, e.g. in the field of case management, should address the specific needs of informal caregivers.</p

Improvement of the Trivalent Inactivated Flu Vaccine Using PapMV Nanoparticles

Commercial seasonal flu vaccines induce production of antibodies directed mostly towards hemaglutinin (HA). Because HA changes rapidly in the circulating virus, the protection remains partial. Several conserved viral proteins, e.g., nucleocapsid (NP) and matrix proteins (M1), are present in the vaccine, but are not immunogenic. To improve the protection provided by these vaccines, we used nanoparticles made of the coat protein of a plant virus (papaya mosaic virus; PapMV) as an adjuvant. Immunization of mice and ferrets with the adjuvanted formulation increased the magnitude and breadth of the humoral response to NP and to highly conserved regions of HA. They also triggered a cellular mediated immune response to NP and M1, and long-lasting protection in animals challenged with a heterosubtypic influenza strain (WSN/33). Thus, seasonal flu vaccine adjuvanted with PapMV nanoparticles can induce universal protection to influenza, which is a major advancement when facing a pandemic

Strategisch Onderzoek RIVM jaaroverzicht 2013

Het RIVM brengt jaarlijks verslag uit van het onderzoeksprogramma van het instituut, het Strategisch Onderzoek RIVM (SOR). Dit onderzoeksprogramma is bedoeld om te voorzien in de expertise en kwaliteit om nu en in de toekomst de taken voor de opdrachtgevers adequaat uit te kunnen voeren. SOR-projecten worden in een cyclus van vier jaar uitgevoerd. De jaarrapportage 2013 omvat het derde jaar van de vierjarige cyclus van SOR 2011-2014. Per project is aangegeven wat de doelstelling is, de voortgang en de maatschappelijke relevantie van de behaalde resultaten. Daarnaast liepen er nog projecten door uit de voorgaande SOR-ronde (2007-2010). De genoemde aantallen en bedragen hebben betrekking op alle lopende SOR-projecten. Er zijn 99 publicaties verschenen in peer-reviewed tijdschriften en nog 78 publicaties ingediend. Van de verschenen publicaties zijn er 81 waarvan een RIVM-medewerker eerste, tweede of laatste auteur is. Daarnaast is een groot aantal andere producten gerealiseerd: 18 (brief)rapporten, 101 lezingen op internationale congressen, 34 instrumenten (bijvoorbeeld modellen), 34 databases en 6 websites. De wetenschappelijke impact van de publicaties wordt gemeten aan de hand van een vooraf vastgestelde lijst met referentietijdschriften. Over het algemeen was deze impact in 2013 hoger dan de norm die hier van tevoren voor was bepaald. In 2013 is ongeveer 10,1 miljoen aan SOR-projecten besteed.RIVM publishes an annual report on its research programme RIVM Strategic Research (SOR). The programme is intended to provide the expertise and quality to enable RIVM to competently perform tasks on behalf of its clients in the short and longer term. SOR projects are organised on the basis of a fouryear cycle. The 2013 annual report covers the third year of the 2011-2014 SOR cycle. The report describes the objective of each project, the progress made and the social relevance of the results secured. It also provides information about those projects from the previous SOR cycle (2007-2010) that were still operating during 2013. The statistical and financial data provided in this report cover all active SOR projects.RIV

Distribution planning for a divergent N-echelon network without intermediate stocks under service restrictions

In this paper we discuss a periodic review control policy for general N-echelon distribution networks without batch size or capacity constraints. Only stockpoints at the end of the network are allowed to hold stock, whereas the intermediate stockpoints act as pure distribution centers that allocate incoming goods immediately to downstream stockpoints. Larger distribution networks (N = 3,4, 5) are often encountered in practice and therefore suitable inventory management policies are needed. Instead of defining a cost structure, we apply a service level approach where the main goal is to realize predetermined target service levels in the final stockpoints. A fast and accurate approximation method is presented which enables us to compute the parameters of the control policy; i.e. the system order-up-to-level and the allocation fractions for the allocation policy at the intermediate stockpoints. Finally, some attention is given to the important phenomenon of imbalance, which is caused by highly fluctuating demand processes at the final stockpoints. This phenomenon can affect the service performance of the developed control policy significantly

Target setting for the departments in an aircraft repairable item system

In this paper a repairable item system for the maintenance support of a fleet of aircraft is introduced. The purpose of the system, a complex conjunction of repair departments and stock locations, is the repair and supply of serviceable engines to the maintenance process of the aircraft. The performance of the repairable item system is measured by a service level. If the realized service level corresponds with the required service level, conditions are created among which the maintenance process can be carried out efficiently. Thus the setting of service levels is a means for the control of the repairable item system. To meet the required service level target for the entire repairable item system, it is important that the performance of the individual repair departments and the stock locations of the repairable item system are tuned. In this coordination process, service level targets must also be set for the repair departments and stock locations. In this paper it is show that the deduction of these service level targets can be supported with the help of well-known models such as METRIC and MOD-METRIC. In a numerical analysis it is shown that the targets for the repair departments can be substantially lower than the targets for the downstream stock locations of the repairable item system

RIVM Strategic Research annual report 2012

Strategisch onderzoek RIVM jaaroverzicht 2012 Het RIVM brengt jaarlijks verslag uit van het onderzoeksprogramma van het instituut, het Strategisch Onderzoek RIVM (SOR). Dit onderzoeksprogramma is bedoeld om te voorzien in de expertise en kwaliteit om nu en in de toekomst de taken voor de opdrachtgevers adequaat uit te kunnen voeren. SORprojecten worden in een cyclus van vier jaar uitgevoerd. De jaarrapportage 2012 omvat het tweede jaar van de vierjarige cyclus van SOR 2011-2014. Per project is aangegeven wat de doelstelling is, de voortgang en de maatschappelijke relevantie van de behaalde resultaten. Daarnaast waren er nog doorlopende projecten uit de voorgaande SOR-ronde 2007 - 2010. De genoemde aantallen en bedragen hebben betrekking op alle lopende SORprojecten. Er zijn 85 publicaties verschenen in peer-reviewed tijdschriften en er zijn daarnaast nog 100 publicaties ingediend. Van de verschenen publicaties zijn er 70 waarvan een RIVM-medewerker eerste, tweede of laatste auteur is. Daarnaast is een groot aantal andere producten gerealiseerd: 19 (brief)rapporten, 93 lezingen op internationale congressen, 30 instrumenten (bijvoorbeeld modellen), 12 databases, 8 websites en 1 patent. De wetenschappelijke impact van de publicaties wordt gemeten aan de hand van een vooraf vastgestelde lijst met referentietijdschriften. De uitkomst van deze vergelijking is in 2012 een bovengemiddelde score. In 2012 is ongeveer 13,6 miljoen euro aan SOR besteed.RIVM Strategic Research annual report 2012 RIVM publishes an annual report on its research programme RIVM Strategic Research (SOR). The programme is intended to provide the expertise and quality to enable RIVM to competently perform tasks on behalf of its clients in the short and longer term. SOR projects are organised on the basis of a fouryear cycle. The 2012 annual report covers the second year of the 2011-2014 SOR cycle. The report describes the objective of each project, the progress made and the social relevance of the results secured. It also provides information about those projects from the previous SOR cycle (2007-2010) that were still operating during 2012. Statistical and financial data are provided about the programme, covering all SOR projects that were active during the year. During the year, 85 publications appeared in peer-reviewed journals and a another hundred papers were submitted for publication. Of the publications that appeared, seventy named an RIVM staff member as their first, second or final author. The programme yielded a large number of other products as well: nineteen reports and letter reports, ninety-three presentations at international congresses, thirty models and other tools, twelve databases, eight websites and one patent. The scientific impact of the publications was quantified for the report using a predefined list of reference journals. From the quantification exercise, it is apparent that the impact of the published articles was above average. In 2012, roughly 13.6 million euros were allocated to the SORRIV