The added value of user involvement during the development of a feedback system regarding physical functioning for community-dwelling elderly people

The number of frail elderly people is increasing. Unfortunately, the number of caregivers is not increasing at the same pace, which affects older people, caregivers and healthcare systems. Because of these developments, self-management is becoming more important in healthcare. To support community-dwelling elderly people in their self-management, a system was developed that monitors their physical functioning. This system provides feedback to elderly people and their caregivers regarding physical indicators of frailty. The feedback is provided to elderly people via the screen of a mobile phone. It is important that elderly people understand the content of the feedback and are able to use the mobile phone properly. If not, it is unlikely that the system can support self-management. Many interactive health technologies that have been developed do not fulfil their promises. An important reason for this is that human and other non-technology issues are not sufficiently taken into consideration during the development process

The development of a multidisciplinary fall risk evaluation tool for demented nursing home patients in the Netherlands

BACKGROUND: Demented nursing home patients are at high risk for falls. Falls and associated injuries can have a considerable influence on the autonomy and quality of life of patients. The prevention of falls among demented patients is therefore an important issue. In order to intervene in an efficient way in this group of patients, it is important to systematically evaluate the fall risk profile of each individual patient so that for each patient tailor-made preventive measures can be taken. Therefore, the objective of the present study is to develop a feasible and evidence based multidisciplinary fall risk evaluation tool to be used for tailoring preventive interventions to the needs of individual demented patients. METHODS: To develop this multidisciplinary fall risk evaluation tool we have chosen to combine scientific evidence on the one hand and experts' opinions on the other hand. Firstly, relevant risk factors for falling in elderly persons were gathered from the literature. Secondly, a group of Dutch experts in the field of falls and fall prevention in the elderly were consulted to judge the suitability of these risk factors for use in a multidisciplinary fall risk evaluation tool for demented nursing home patients. Thirdly, in order to generate a compact list of the most relevant risk factors for falling in demented elderly, all risk factors had to fulfill a set of criteria indicating their relevance for this specific target population. Lastly the final list of risk factors resulting from the above mentioned procedure was presented to the expert group. The members were also asked to give their opinion about the practical use of the tool. RESULTS: The multidisciplinary fall risk evaluation tool we developed includes the following items: previous falls, use of medication, locomotor functions, and (correct) choice and use of assistive and protective devices. The tool is developed for the multidisciplinary teams of the nursing homes. CONCLUSION: This evidence and practice based multidisciplinary fall risk evaluation tool targets the preventive interventions aimed to prevent falls and their negative consequences in demented nursing home patients

Predicting ADL disability in community-dwelling elderly people using physical frailty indicators: a systematic review

<p>Abstract</p> <p>Background</p> <p>Disability in Activities of Daily Living (ADL) is an adverse outcome of frailty that places a burden on frail elderly people, care providers and the care system. Knowing which physical frailty indicators predict ADL disability is useful in identifying elderly people who might benefit from an intervention that prevents disability or increases functioning in daily life. The objective of this study was to systematically review the literature on the predictive value of physical frailty indicators on ADL disability in community-dwelling elderly people.</p> <p>Methods</p> <p>A systematic search was performed in 3 databases (PubMed, CINAHL, EMBASE) from January 1975 until April 2010. Prospective, longitudinal studies that assessed the predictive value of individual physical frailty indicators on ADL disability in community-dwelling elderly people aged 65 years and older were eligible for inclusion. Articles were reviewed by two independent reviewers who also assessed the quality of the included studies.</p> <p>Results</p> <p>After initial screening of 3081 titles, 360 abstracts were scrutinized, leaving 64 full text articles for final review. Eventually, 28 studies were included in the review. The methodological quality of these studies was rated by both reviewers on a scale from 0 to 27. All included studies were of high quality with a mean quality score of 22.5 (SD 1.6). Findings indicated that individual physical frailty indicators, such as weight loss, gait speed, grip strength, physical activity, balance, and lower extremity function are predictors of future ADL disability in community-dwelling elderly people.</p> <p>Conclusions</p> <p>This review shows that physical frailty indicators can predict ADL disability in community-dwelling elderly people. Slow gait speed and low physical activity/exercise seem to be the most powerful predictors followed by weight loss, lower extremity function, balance, muscle strength, and other indicators. These findings should be interpreted with caution because the data of the different studies could not be pooled due to large variations in operationalization of the indicators and ADL disability across the included studies. Nevertheless, our study suggests that monitoring physical frailty indicators in community-dwelling elderly people might be useful to identify elderly people who could benefit from disability prevention programs.</p

The impact of continuous and discontinuous alliance strategies on startup innovation performance

The open innovation paradigm emphasises the importance of alliances for improving the innovation performance of firms. However, existing empirical research on innovation performance implications of alliances is dominated by cross-sectional studies. As a result, we do not know how the time frame of alliances might influence innovation performance. In this study, we therefore examine the impact of different time frames of alliance strategies on innovation performance. In order to do so, we collected panel data on 217 Flemish startup firms. The results show a positive association between 'discontinuous alliance strategies' with suppliers, customers and competitors and 'incremental' innovation performance. In addition, we find a positive impact of 'continuous alliance strategies' with suppliers, competitors and universities and other research institutes on 'radical' innovation performance. These findings encourage startup firms to balance their alliance portfolio not only in terms of different kinds of partners but also in terms of different kinds of time frames

Competento: online kenniscentrum voor het vormen van Ondernemerscompetenties

Een van de doelstellingen van het Regeerakkoord 2004 is dat Vlaanderen verder evolueert naar een ondernemende, innoverende, levende en creatieve samenleving. Daartoe moet o.m. gewerkt worden aan een positief imago van het ondernemerschap en van de opleidingen waaruit verhoudingsgewijs veel starters en ondernemers komen. Bondig samengevat: “We maken mensen warm voor ondernemen”. Onderwijs en vorming dragen in belangrijke mate bij tot de bevordering van de ondernemingscompetenties door de juiste instelling te stimuleren, door de aandacht te vestigen op de carrièremogelijkheden als ondernemer en door hiervoor belangrijke vaardigheden te ontwikkelen. Deze ondernemersvaardigheden en -attitudes bieden de maatschappij voordelen die verder reiken dan de toepassing in het bedrijfsleven. De persoonlijke kwaliteiten die belangrijk zijn voor het ondernemerschap, zoals creativiteit, initiatief, zelfsturing en inzicht, kunnen voor iedereen nuttig zijn op het werk en in het dagelijkse leven. Via het Actieplan Ondernemend Onderwijs willen minister Vandenbroucke en minister Moerman en hun respectievelijke departementen in samenwerking met SYNTRA Vlaanderen verder gaan dan het sporadisch ondersteunen van projecten in het onderwijs, zoals bijvoorbeeld de brugprojecten. Zij wensen een kader te creëren om diverse initiatieven inzake het bevorderen van ondernemerszin en ondernemerschap in het onderwijs te coördineren en te versterken door synergie tussen de verschillende initiatieven te stimuleren. Lancering van het Actieplan Ondernemend Onderwijs (Vlaams minister Fientje Moerman en Vlaams minister Frank Vandenbroucke)· Lancering van het Kenniscentrum “Competento – Kenniscentrum voor het vormen van Ondernemerscompetenties” (Vlaams minister Frank Vandenbroucke) · Demo van het Kenniscentrum door SYNTRA Vlaanderen (Stijn Segers

A surface electromyography based objective method to identify patients with nonspecific chronic low back pain, presenting a flexion related movement control impairment

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