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Measuring Quality of Life (QOL) can be difficult due to its individual character. To explore the value of personalized QOL measurement for people with dementia, personalized versions of two dementia-specific QOL scales (Dementia quality of Life (DQoL) and Quaility of Life in Alzheimer's Disease (QoL-AD)) were constructed. This study investigated whether the personalized measures are more valid to detect variations in QOL than their standard versions for people with mild to moderate dementia, with sufficient internal consistency. Moreover, the relationship between the personalized QOL measures and severity of dementia was investigated. Finally, the study explored the differences between countries regarding the personalized overall QOL and differences in the importance of QOL domains. This explorative one-group design study used baseline data from the MEETINGDEM study into the implementation of the Meeting Centres Support Programme in Italy, Poland and the UK. The personalized versions of the DQoL and QoL-AD were reliable, but not more valid than their standard versions. No relationship between severity of dementia and personalized QOL was found. While no differences were found between countries for the overall QOL score, some QOL domains were valued differently: people with dementia from the UK rated self-esteem, mood, physical health, energy level and the ability to do chores around the house significantly less important than people from Italy and Poland. The personalized versions of the DQoL and QoL-AD may offer dementia care practice important insights into what domains contribute most to an individual’s QOL.

Implementation of scientific knowledge in practice, specifically healthcare for older adults. Experts of different collaborations between science and practice in the care for older adults will share their experiences. What are common pitfalls, what are facilitators? Which strategies are effective and were successes? what is the magic bullet?

Item does not contain fulltext An important cause of the high prescription levels of psychotropic medication for psychological symptoms is that these symptoms are assessed according to the same model as applied for physical symptoms, the disease model. This has led to a one-sided medical approach to psychological symptoms. A person-centred approach offers an alternative; the positive aspects of the disease-centred approach are retained and attention for the patient and his/her context become the central focal point for the general practitioner. Important elements of the person-centred approach are empathy, a good doctor-patient relationship, a shared approach to problem definition and understanding of the patient's problem, development of a therapeutic alliance, and a focus on the patient's hopes and expectations. If additional primary care-based treatment by mental health practice nurses is indicated, this model could be suitable since it is based on patients' strengths and focuses on personal growth rather than reduction of symptoms.

Depressie is een groot probleem in verpleeghuizen. Gemiddeld heeft zo’n dertig procent van de bewoners een depressie, veel meer dan thuiswonende ouderen. Depressie heeft allerlei negatieve gevolgen voor de gezondheid en het welbevinden, maar is wel behandelbaar. Hoewel het opsporen en behandelen van depressie dus erg belangrijk is, worden depressiesymptomen vaak niet opgemerkt. Zorgmedewerkers weten dikwijls niet waarop ze moeten letten en depressieverschijnselen kunnen op symptomen van andere aandoeningen lijken, zoals dementie, diabetes en hart- en vaatziekten. Het zorgprogramma Doen bij Depressie, ontwikkeld door het Universitair Kennisnetwerk Ouderenzorg Nijmegen (UKON), kan hier uitkomst bieden.

This study analyses the citizenship experiences of young non-western migrants in the Netherlands. Young migrants are in a disadvantaged position in education and in the labour market and this leads to concerns about their integration in Dutch society. The focus of this study is on the participation of migrant youngsters in education, in which an analysis of the experiences and perspectives on education and future labour market participation of migrant youngsters themselves are the central objectives. The expectation is that the experiences of young migrants are influenced by their disadvantaged socio-economic background, social networks, practices of exclusion, social policies, the harsh policy climate, and the negative public debate about migrants in Dutch society. This study also aims to explain the pronounced gender dif­ferences that can be observed: migrant girls outperform migrant boys in education, but in comparison they are less active in the labour market. This study is unique in the sense that the experiences of the migrant youngsters themselves are investigated. This was done by conducting a mixed-method study, in which extensive qualitative and quantitative data were collected. Furthermore, this is a practice-based study, which means the study is relevant from scientific and from societal perspectives. One of the main results of this study is that young migrants experience school in a very positive way. They have a high school satisfaction and are very ambitious about finishing an education at a high level. The support of their social network is very important for young migrants; active communication with their parents and siblings showed to influence their school satisfaction in a positive way. This study furthermore showed that young migrants in the Netherlands are optimistic, and believe that they can seize the opportunities in education and work that Dutch society offers them, even when they know that, for instance, discrimination is working against them. This does not mean however that a minority is losing their way, and this group tends to symbolise the prejudices against this group. Social policies and projects for drop-outs take care of this group, however this study shows that some measures have unintended negative consequences for the youngsters. Migrant youth who, despite setbacks on the home front and the general social climate in education and the labour market, do generally attempt to make a future for themselves, believing that they can succeed where their parents did not. The figures show that increasing numbers of young migrants are participating in education and the labour market, and this is reason for hope, even though social circumstances are still adverse. It can be said in general that migrant youngsters are making steps forward – a fact supported by the figures, and they are making more progress than their parents did. This study showed that, despite obstacles and the changing discourse in the Netherlands, migrant youngsters are optimistic and resilient.

This study analyses the citizenship experiences of young non-western migrants in the Netherlands. Young migrants are in a disadvantaged position in education and in the labour market and this leads to concerns about their integration in Dutch society. The focus of this study is on the participation of migrant youngsters in education, in which an analysis of the experiences and perspectives on education and future labour market participation of migrant youngsters themselves are the central objectives. The expectation is that the experiences of young migrants are influenced by their disadvantaged socio-economic background, social networks, practices of exclusion, social policies, the harsh policy climate, and the negative public debate about migrants in Dutch society. This study also aims to explain the pronounced gender dif­ferences that can be observed: migrant girls outperform migrant boys in education, but in comparison they are less active in the labour market. This study is unique in the sense that the experiences of the migrant youngsters themselves are investigated. This was done by conducting a mixed-method study, in which extensive qualitative and quantitative data were collected. Furthermore, this is a practice-based study, which means the study is relevant from scientific and from societal perspectives. One of the main results of this study is that young migrants experience school in a very positive way. They have a high school satisfaction and are very ambitious about finishing an education at a high level. The support of their social network is very important for young migrants; active communication with their parents and siblings showed to influence their school satisfaction in a positive way. This study furthermore showed that young migrants in the Netherlands are optimistic, and believe that they can seize the opportunities in education and work that Dutch society offers them, even when they know that, for instance, discrimination is working against them. This does not mean however that a minority is losing their way, and this group tends to symbolise the prejudices against this group. Social policies and projects for drop-outs take care of this group, however this study shows that some measures have unintended negative consequences for the youngsters. Migrant youth who, despite setbacks on the home front and the general social climate in education and the labour market, do generally attempt to make a future for themselves, believing that they can succeed where their parents did not. The figures show that increasing numbers of young migrants are participating in education and the labour market, and this is reason for hope, even though social circumstances are still adverse. It can be said in general that migrant youngsters are making steps forward – a fact supported by the figures, and they are making more progress than their parents did. This study showed that, despite obstacles and the changing discourse in the Netherlands, migrant youngsters are optimistic and resilient.

BackgroundFeelings of happiness can be beneficial for health in the elderly and are associated with longevity. Depression in nursing home (NH) residents is more common than in the general population, and it can be both a consequence of medical illness and an influencing factor for morbidity and mortality. It is not clear whether life expectancy in NH residents is mainly associated with the presence of positive emotions such as being happy or hopeful, or with the lack of negative emotions such as pessimism and sadness associated with depression. ObjectivesTo determine whether the presence of positive emotions, and the lack of negative emotions predict life expectancy in NH residents.Methods Design: prospective longitudinal study with a baseline measurement of positive and negative emotions, and mortality rate at 21 months follow-up. Participants: a subsample from a study on depression management in 32 Dutch NH units. Exclusion criteria: no informed consent; cognitive inability to respond to the interview. Measurements: Positive Emotions (PE): sum of ‘yes’ answers on 9 positive-items of the Geriatric Depression Scale (GDS), such as “do you find life very exciting?”; Lack of Negative Emotions (LNE): sum of ‘no’ answers on 21 negative-items of the GDS such as “Do you often feel downhearted and blue?”; Co-morbidity: Charlson index; Cognition: Mini Mental State Examination (MMSE)Procedure: trained interviewers scored the GDS and MMSE; demographical data and co-morbidity were retrieved from medical files. Statistics: Cox Regression was run for survival analysis with age, gender, MMSE and Charlson index as fixed variables, and PE and LNE as predictors for mortality (forward likelihood ratio). Additional survival analyses were run for individual PE, and LNE items.ResultsOf the 250 NH residents included, 158 (63%) were female. The mean age was 79.0 years (SD 11.3), MMSE score was 18.8 (SD 7.5; N=233), and Charlson-index was 2.8 (SD 2.0; N=244). There were 65 deaths (26%). A mean follow-up was 16.8 months. Survival analysis showed that LNE was associated with decreased mortality (adjusted hazard ratio [HR] 0.94 [95% CI: 0.89 to 0.99] P=0.036) whereas PE were redundant (not associated with mortality). Of the LNE-questions, a negative answer to the item “Do you feel that your situation is hopeless?” (HR 0.44 [95% CI: 0.26 to 0.76]; P=0.003) was associated with decreased mortality: 79% and 61% of the residents who answered ‘no’ and ‘yes’, respectively, survived during 21 months. Of the individual PE items, a positive answer to the item “Do you enjoy getting up in the morning?” (HR 0.41 [95% CI: 0.23 to 0.71], P=0.001) was associated with decreased mortality: 80% and 59% of residents who answered ‘yes’ and ‘no’, respectively, survived.ConclusionsThe lack of negative emotions was associated with decreased mortality in NH residents. Residents who did not report that their situation was hopeless and those who enjoyed getting up in the morning lived longer. More research on positive emotions in NH residents is needed due to limited number of positive items of the GDS used in the study.

Contains fulltext : 39388.pdf (Publisher’s version ) (Closed access)

The reliability and validity of three MDS scales for ADL, cognition and depression are described. The scales consist of items of the Minimum Data Set of the Resident Assessment Instrument and are available just after an MDS assessment. Data collection took place in nine Dutch nursing homes (N = 227) and consisted of three MDS assessments within one month to determine reliability. Several criterion measures were assessed in order to determine convergent validity. Intra- and inter-rater reliability and internal consistency were determined as well as correlation coefficients of the criterion measures and the MDS scales. All three MDS scales appear reliable, especially the ADL-Hierarchy has very good psychometric properties (intra- and inter-rater Intra Class Correlation were 0.81 and 0.83, respectively). Convergent validity of the ADL-Hierarchy and the Cognitive Performance Scale is good, the Depression Rating Scale appears valid in residents with moderate cognitive disorders at the most, but the results are more difficult to interpret in residents with severe cognitive disorders. The MDS scales appear useful in clinical practice and for research purposes in the Dutch nursing homes

Contains fulltext : 240328.pdf (Author’s version preprint ) (Open Access) In statistics, samples are drawn from a population in a data-generating process (DGP). Standard errors measure the uncertainty in sample estimates of population parameters. In science, evidence is generated to test hypotheses in an evidence-generating process (EGP). We claim that EGP variation across researchers adds uncertainty: non-standard errors. To study them, we let 164 teams test six hypotheses on the same sample. We find that non-standard errors are sizeable, on par with standard errors. Their size (i) co-varies only weakly with team merits, reproducibility, or peer rating, (ii) declines significantly after peer-feedback, and (iii) is underestimated by participants. 31 mei 2023

Vitamin D is a hormone produced in the skin via a non-enzymatic process involving ultraviolet light.It is well known that the physiology of aging makes older people particularly susceptible to vitamin D deficiency and that, if untreated, it can have serious health consequences. This thesis deliberates on the topics of vitamin D supplementation in older people in light of the current guidelines and on the possible additional effects of ultraviolet light beyond vitamin D synthesis on nursing home residents. We present a cross-sectional study in nursing home residents aged 70 years and over designed to evaluate the efficacy of vitamin D supplementation in achieving vitamin D sufficiency. We also discuss the different supplementation strategies for nursing home residents and community dwelling persons aged 70 years and over based on a survey administered to general practitioners and elderly care physicians in the Netherlands.In the second part we concentrate on additional effects of ultraviolet light beyond vitamin D synthesis. We describe our systematic review of literature on the effect of ultraviolet light, when applied to the skin or eyes, on mood, depression and well-being. We present also our randomized controlled trial on the effect of ultraviolet radiation compared with oral vitamin D supplementation on the well-being of nursing home residents with dementia. Further we use the data of the RCT to carry out a post-hoc analysis to compare the effect of vitamin D alone compared with ultraviolet radiation on the blood pressure of old people with dementia.