Accessible Facilities in Noardwest Fryslân:A study into the current and future development of facilities and services

This report contains a study of the availability and accessibility of several local and regional facilities and services in a rural region in Fryslân. It maps the current service-provision, but also estimates the impact of demographic changes and population decline on the future service-provision and discusses possible future scenario's for dealing with these changes. The research has been conducted by the Faculty of Spatial Sciences, University of Groningen, in collaboration with the Geodienst (RUG) and Partoer (Leeuwarden). It was commissioned by 7 regional municipalities (Harlingen, Franekeradeel, Leeuwarderadeel, Leeuwarden, Littenseradiel, Menameradiel and the Bildt) and the province of Fryslân, as part of the Noardwest Fryslân Regional Agenda

Registering patient reported symptoms in patients with lymphoedema – is there a validated questionnaire with good psychometric properties?

Purpose: Patients with lymphoedema report various symptoms. In Norway objective treatment measures have primarily been utilized. Hence we saw a need to study available questionnaires and identify those which register patient reported symptoms. Method: Standard text books were reviewed and searches made in PubMed, Embase, BNI, Ovid Nursing Database and CINAHL. Text books and the identified articles were reviewed to get an overview of registered symptoms, clinical viability of the questionnaires, their psychometric properties and other relevant factors for registering lymphoedema and evaluating treatment. Results: Fourteen articles met the inclusion criteria, and 16 questionnaires were identified. Swelling or a feeling of swelling, heaviness, numbness, tightness and pain were most frequently registered. Four questionnaires did not describe the psychometric properties and the remaining 12 had varying levels of validity and reliability. Several methods of scoring were utilized; categorical yes/no, various Likert scales and VAS. Several time scales were used. Five questionnaires had 50 questions or more. Conclusion: Several validated questionnaires which register subjective symptoms in patients with lymphoedema were identified. Some provide the means to ensure a more accurate assessment. LYMFQOL arm and LYMFQOL leg assess the most frequently reported subjective symptoms on a user-determined time scale. A 4-part Likert scale for grading the severity of the symptoms is used. Both questionnaires are tested for validity and reliability with satisfactory results. LYMFQOL arm and leg register health related quality of life and can help the physiotherapist to select appropriate treatment. A Norwegian version of both questionnaires has been pilot tested

The perceived importance of facilities for rural citizen in Fryslan, the Netherlands

Many rural regions in Europe are confronted with populationdecline and concomitantly a decline in facilities such as shops, banks andpost offices, as well as basic services such as education, health care andpublic transport. In this paper we discuss the situation in the province ofFryslân, in the North of the Netherlands, as an example of how changes inthe number of facilities matter for rural inhabitants, even in the rural areasof a densely populated and highly urbanised country. This paper starts withexamining changes in the availability and accessibility of facilities. We thenexplore which facilities are perceived as important to maintain in thevillage, and how villagers expect to react to their disappearance. The resultsshow the impact of rural facility decline differs across space and populationgroups, and needs to be understood "in context" - the context of everydaylife, including varying levels of mobility