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Introductie: Dit onderzoek had als doel de relatie tussen fysieke, sociale en cognitieve kenmerken van kwetsbare ouderen bij ziekenhuisopname te vergelijken van ouderen die wel en niet naar huis werden ontslagen. Methode: Dit retrospectief dossieronderzoek maakte gebruik van gegevens van kwetsbare ouderen tijdens acute ziekenhuisopname in een academisch ziekenhuis (N=49). Naast sociaal-demografische en medische kenmerken zijn bij ziekenhuisopname of kort daarna, metingen uitgevoerd naar het fysiek en cognitief functioneren, waaronder Katz-ADL, handknijpkracht, Timed-Up-and-Go-test, 4-meter-looptest (4MLT) en Six-item-Cognitive-Impairment-Test (6-CIT). Kenmerken van patiënten werden vergeleken tussen de ontslagbestemmingsgroepen ‘naar huis’ en ‘niet naar huis’, door middel van univariate analyses en multivariate logistische regressieanalyse. Resultaten: Van alle patiënten (gemiddelde leeftijd 81 jaar, 49% vrouw), werden er 29 (59%) naar huis ontslagen. De patiënten die niet met ontslag naar huis konden, waren statistisch significant ouder, lagen minder vaak opgenomen vanwege een infectie en scoorden slechter op alle metingen voor het fysiek en het cognitief functioneren. In de multivariate analyse gecorrigeerd voor leeftijd, was alleen slechtere Katz-ADL-score geassocieerd met de ontslagbestemming niet naar huis. Conclusie: Bij ouderen werd slechter cognitief en fysiek functioneren bij ziekenhuisopname geassocieerd met de ontslagbestemming niet naar huis, terwijl voor deze ontslagbestemming in de multivariate analyse alleen de Katz-ADL overbleef.

Purpose: To quantitatively assess changes in recovery of people recovering from COVID-19 treated by a primary care allied health professional, and to qualitatively describe how they dealt with persistent complaints. Materials and methods: This mixed-methods study is part of a Dutch prospective cohort study, from which thirty participants were selected through purposive sampling. Quantitative data on recovery were collected at start of treatment and 6 months. Additionally, by use of semi-structured interviews participants were asked on how persistent complaints influenced their lives, and how they experienced received primary care allied health treatment. Results: Despite reported improvements, most participants still experienced limitations at 6 months. Hospital participants reported a higher severity of complaints, but home participants reported more diverse complaints and a longer recovery. Most participants were satisfied with the primary care allied healthcare. Tender loving care and a listening ear, learning to manage limits, and support and acceptance of building up in small steps were perceived as contributing most to participants' recovery. Conclusion: Although improvements were reported on almost all outcomes, most participants suffered from persistent complaints. Despite these persistent complaints, many participants reported being better able to cope with persistent complaints because they had decreased substantially in their intensity. Trial registration: Clinicaltrials.gov registry (NCT04735744). IMPLICATIONS FOR REHABILITATION: Participants recovering from COVID-19 receiving treatment from primary care allied health professionals reported improvements after 6 months, but still experienced persistent complaints. Home participants reported more persistent complaints and a longer recovery from COVID-19 than hospital participants. Personal attention for patients recovering from COVID-19 is necessary. Next to implementing a treatment plan (e.g. physical exercise), primary care allied health professionals should also pay attention to listening to the patient's story and offering support. Interprofessional collaboration between primary care allied health professionals, with a unified message to patients, is essential. [ABSTRACT FROM AUTHOR]

Objective: To report the study protocol and baseline characteristics of a prospective cohort study to evaluate longitudinal recovery trajectories of patients recovering from COVID-19 who have visited a primary care allied health professional. Design: Report of the protocol and baseline characteristics for a prospective cohort study with a mixed-methods approach. Patients: Patients recovering from COVID-19 treated by primary care dietitians, exercise therapists, occupational therapists, physical therapists and/or speech and language therapists in the Netherlands. Methods: The prospective study will measure primary outcome domains: participation, health-related quality of life, fatigue, physical functioning, and costs, at baseline, 3, 6, 9 and 12 months. Interviews, on the patients’ experiences with allied healthcare, will be held with a subsample of patients and allied health professionals. Results: The cohort comprises 1,451 patients (57% female, mean age 49 (standard deviation 13) years). Preliminary results for the study cohort show that 974 (67%) of the participants reported mild/moderate severity symptoms during the infection period and patients reported severe restrictions in activities of daily living compared with previous research in other patient populations. Both quantitative and qualitative, will provide insight into the recovery of patients who are treated by allied health professionals. Conclusion: In conclusion, this will be the first comprehensive study to longitudinally evaluate the recovery trajectories and related costs of patients recovering from COVID-19 who are treated by allied health professionals in the Netherlands. This study will provide evidence for the optimal strategy to treat patients recovering from COVID-19 infection, including which patients benefit, and to what extent, from treatment, and which factors might impact their recovery course over time. The preliminary results of this study demonstrated the severity of restrictions and complaints at the start of therapy are substantial. LAY ABSTRACT This paper presents the protocol for a prospective study of patients recovering from COVID-19 who are treated by allied health professionals in Dutch primary care. In the forthcoming study, a total of 1,451 patients will be asked to complete questionnaires regarding their social participation in daily life, health-related quality of life, fatigue, physical functioning, and healthcare and societal costs at baseline, 3, 6, 9 (costs only) and 12 months. Furthermore, the allied health professionals will answer questions at the start and end of treatments. This report presents baseline characteristics for the study cohort. Initial findings indicate that patients in the current cohort report severe restrictions in activities of daily living compared with previous studies of other patient populations. This report also describes the protocol of the prospective study, which aims to longitudinally evaluate the recovery trajectories and related costs of patients recovering from COVID-19.

OBJECTIVES:Units deployed to armed conflicts are at high risk for exposure to combat events. Many battle casualties (BCs) have been reported in the recent deployment to Afghanistan. The long-term impact of these combat injuries, at their five-year end point, is currently unknown. To date, no systematic inventory has been performed of an identified group of BCs in comparison to non-injured service members from the same operational theatre. DESIGN:Observational cross-sectional cohort study. SETTING:Open online survey among Dutch BCs that deployed to Afghanistan (2006-2010). PARTICIPANTS:The Dutch BCs (n = 62) were compared to two control groups of non-injured combat groups (battle exposed [n = 53], and non-battle exposed [n = 73]). MAIN OUTCOME MEASURES:Participants rated their impact of trauma exposure (Impact of Events [IES]), post deployment reintegration (Post Deployment Reintegration Scale [PDRS]), general symptoms of distress (Symptom Checklist 90 [SCL-90]), as well as their current perceived quality of life (EuroQol-6D [EQ-6D]). Also cost effectiveness (Short From health survey [SF-36]) and care consumption were assessed (Trimbos/iMTA questionnaire). RESULTS:Over 90% of BCs were still in active duty. The mean scores of all questionnaires (IES, EQ-6D, SF-36, and SCL-90) of the BC group were significantly higher than in the control groups (p

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.futures.2006.03.011 Byline: A. Faber, A.M. Idenburg, H.C. Wilting Abstract: The dynamic input-output model DIMITRI (Dynamic Input-output Model to study the Impacts of Technology Resulted Innovations) can be used for long-term scenario explorations on technology, demand and environmental effects. The model describes at a sectoral level the relations and dynamics between consumption, production and emissions. Technologies are introduced bottom-up at a sectoral level, through variations on the inputs from other sectors and by changes in the coefficients for capital, labour and emissions. This paper presents a methodology for future explorations of technologies in four scenarios, based on the International Panel on Climate Change (IPCC) scenario framework. Trend analysis combines detailed information on specific technologies. Differentiations are made between scenarios, based on their specific storylines. The adjustment of coefficients influences model outcomes such as production, balance of trade and emissions. This paper briefly outlines the methodology and presents the main outcomes for four scenarios for the period 2000-2030. Author Affiliation: Netherlands Environmental Assessment Agency (MNP), P.O. Box 303, 3720 AH Bilthoven, the Netherlands