Windesheim University
  • Zwolle, Netherlands
Recent publications
One of the most convincing studies about the importance of the cutoff date in relative age effects was when Helsen et al. (2000) showed that a shift in the date directly resulted in a change of birth month distributions in soccer. Over the past four decades, the role of the birth year has also been associated with relative age effects (as reflected in constant year effects). In this investigation, two studies attempted to replicate the shift of birth year distributions caused by a change in birth years in international female handball. In Study 1, the results from the female handball world championship 2017 showed a significant within‐year effect overall and a constant year effect for players born 1988 and after. A second study was conducted with female players from world championships in 2009, 2011, 2013, and 2015. Results demonstrated small effect sizes for most tests. However, there was an unexpected trend toward a constant year effect shift at the age of 28 years. Several hypotheses are presented as an explanation for this trend.
Background: Fear of falling (FoF) is a lasting concern about falling that leads to an individual avoiding activities that he/she remains capable of performing. It is a common condition amongst older adults and may occur independently of previous falls. Cognitive behavioural therapy (CBT), a talking therapy that helps change dysfunctional thoughts and behaviour, with and without exercise, may reduce FoF, for example, by reducing catastrophic thoughts related to falls, and modifying dysfunctional behaviour. Objectives: To assess the benefits and harms of CBT for reducing FoF in older people living in the community, and to assess the effects of interventions where CBT is used in combination with exercise. Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL, Issue 1, 2023), MEDLINE Ovid (from 1946 to 11 January 2023), Embase Ovid (from 1980 to 11 January 2023), CINAHL Plus (Cumulative Index to Nursing and Allied Health Literature) (from 1982 to 11 January 2023), PsycINFO (from 1967 to 11 January 2023), and AMED (Allied and Complementary Medicine from 1985 to 11 January 2023). We handsearched reference lists and consulted experts for identifying additional studies. Selection criteria: This review included randomised controlled trials (RCTs), quasi-RCTs, and cluster-RCTs assessing CBT with and without exercise interventions compared to control groups with sham-treatment, or treatment as usual. We defined CBT as a collaborative, time-limited, goal-oriented, and structured form of speaking therapy. Included studies recruited community-dwelling older adults, with a mean population age of at least 60 years minus one standard deviation, and not defined by a specific medical condition. Data collection and analysis: Two review authors used standard methodological procedures expected by Cochrane. For continuous data, as assessed by single- or multiple-item questionnaires, we report the mean difference (MD) with 95% confidence interval (CI) when studies used the same outcome measures, and standardised mean difference (SMD) when studies used different measures for the same clinical outcome. For dichotomous outcomes, we reported the treatment effects as risk ratios (RR) with 95% CIs. We measured the primary outcome, FoF, immediately, up to, and more than six months after the intervention. We analysed secondary outcomes of activity avoidance, occurrence of falls, depression, and quality of life when measured immediately after the intervention. We assessed risk of bias for each included study, using the GRADE approach to assess the certainty of evidence. Main results: We selected 12 studies for this review, with 11 studies included for quantitative synthesis. One study could not be included due to missing information. Of the 11 individual studies, two studies provided two comparisons, which resulted in 13 comparisons. Eight studies were RCTs, and four studies were cluster-RCTs. Two studies had multiple arms (CBT only and CBT with exercise) that fulfilled the inclusion criteria. The primary aim of 10 studies was to reduce FoF. The 11 included studies for quantitative synthesis involved 2357 participants, with mean ages between 73 and 83 years. Study total sample sizes varied from 42 to 540 participants. Of the 13 comparisons, three investigated CBT-only interventions while 10 investigated CBT with exercise. Intervention duration varied between six and 156 hours, at a frequency between three times a week and monthly over an eight- to 48-week period. Most interventions were delivered in groups of between five and 10 participants, and, in one study, up to 25 participants. Included studies had considerable heterogeneity, used different questionnaires, and had high risks of bias. CBT interventions with and without exercise probably improve FoF immediately after the intervention (SMD -0.23, 95% CI -0.36 to -0.11; 11 studies, 2357 participants; moderate-certainty evidence). The sensitivity analyses did not change the intervention effect significantly. Effects of CBT with or without exercise on FoF may be sustained up to six months after the intervention (SMD -0.24, 95% CI -0.41 to -0.07; 8 studies, 1784 participants; very low-certainty evidence). CBT with or without exercise interventions for FoF probably sustains improvements beyond six months (SMD -0.28, 95% CI -0.40 to -0.15; 5 studies, 1185 participants; moderate-certainty of evidence). CBT interventions for reducing FoF may reduce activity avoidance (MD -2.57, 95% CI -4.67 to -0.47; 1 study, 312 participants; low-certainty evidence), and level of depression (SMD -0.41, 95% CI -0.60 to -0.21; 2 studies, 404 participants; low-certainty evidence). We are uncertain whether CBT interventions reduce the occurrence of falls (RR 0.96, 95% CI 0.66 to 1.39; 5 studies, 1119 participants; very low-certainty evidence). All studies had a serious risk of bias, due to performance bias, and at least an unclear risk of detection bias, as participants and assessors could not be blinded due to the nature of the intervention. Downgrading of certainty of evidence also occurred due to heterogeneity between studies, and imprecision, owing to limited sample size of some studies. There was no reporting bias suspected for any article. No studies reported adverse effects due to their interventions. Authors' conclusions: CBT with and without exercise interventions probably reduces FoF in older people living in the community immediately after the intervention (moderate-certainty evidence). The improvements may be sustained during the period up to six months after intervention (low-certainty evidence), and probably are sustained beyond six months (moderate-certainty evidence). Further studies are needed to improve the certainty of evidence for sustainability of FoF effects up to six months. Of the secondary outcomes, we are uncertain whether CBT interventions for FoF reduce the occurrence of falls (very low-certainty evidence). However, CBT interventions for reducing FoF may reduce the level of activity avoidance, and may reduce depression (low-certainty evidence). No studies reported adverse effects. Future studies could investigate different populations (e.g. nursing home residents or people with comorbidities), intervention characteristics (e.g. duration), or comparisons (e.g. CBT versus exercise), investigate adverse effects of the interventions, and add outcomes (e.g. gait analysis). Future systematic reviews could search specifically for secondary outcomes.
The COVID-19 pandemic presented unprecedented challenges to educational inclusivity despite the potential of the internet being the Great Equaliser. This chapter explores how pedagogy could continue to support learning at the intersection of assessment ePortfolio, multimodal literacy, and inclusivity in the context of Malaysian higher education during the pandemic. Focusing on the often-overlooked student voices, the chapter explores the inclusivity of the assessment ePortfolio for multimodal literacy by investigating the affordances and constraints of assessment ePortfolios within the scope of an exploratory case study. The findings indicated that the inclusivity of assessment ePortfolios for multimodal literacy is democratic and sustainable to the extent that participants could orchestrate intermodal relations in multimodal composition to exude creativity. Future research may examine the development of assessment rubrics and explore lecturer feedback in different contexts to be continually inclusive of student needs.
Building community capacity is important for the successful implementation of a Health Promoting School. To identify how capacity building can be encouraged in secondary schools, four schools engaged in the Fit Lifestyle at School and at Home (FLASH) intervention for 3 years. This study explores barriers and facilitators that school personnel, parents and pupils experienced in the capacity-building process. Thirty-one stakeholders were interviewed. Transcripts were analysed thematically based on the five actions of the intervention: (i) appoint a Healthy School coordinator and build a team, (ii) determine ambitions, (iii) design and (iv) implement the action plan and (v) evaluate and improve. The time and support allocated to coordinators helped them evolve their role from executors of health-promotion activities to coordinators, instigators and gatekeepers of the implementation process. Participatory tools helped identify shared values among stakeholders to determine context-specific ambitions and leverage points for interventions. Coordinators indicated that they lacked the skills and authority to engage pupils and parents and to reach the broader community. Coordinators struggled with translating promising ideas into action plans of coherent and mutually supportive activities and embedding them into policy. Strong leadership of Healthy School coordinators, who focus on the capacity-building process and foster collaborative relationships, is essential to build community capacity. In this process, more guidance is needed on how to involve the broader community in various phases. Furthermore, coordinators can benefit from professional development to align jointly designed activities into a comprehensive action plan embedded into Healthy School policies.
This study is an update of the meta‐analysis we published in 2019 on the effectiveness of body‐ and movement‐oriented interventions (BMOIs) for adults with posttraumatic stress disorder (PTSD) in decreasing PTSD symptoms and secondary outcomes of depressive symptoms, sleep disturbance, and interoceptive awareness. Search terms for BMOIs and PTSD were combined to identify eligible studies in four bibliographical databases. Articles were selected if they included adult participants with a primary diagnosis of PTSD, included BMOI as one of the investigated therapies, were designed as a comparative outcome trial with any control condition, and involved a standardized outcome measure for PTSD symptom severity. This resulted in the addition of 14 new studies compared to the 2019 study. The meta‐analysis, which included 29 studies in total, resulted in a mean Hedges’ g effect size of 0.50, 95% CI [0.22, 0.79], in decreasing PTSD symptoms, with very high heterogeneity, I ² = 89%. Meta‐analyses of secondary outcomes resulted in Hedges’ g effect sizes of 0.37, 95% CI [0.08, 0.66] for depressive symptoms; 0.62, 95% CI [0.42, 0.81] for sleep quality; and −0.10, 95% CI [−0.23, 0.43] for interoceptive awareness. The risk of bias analysis resulted in some concerns or high risk of bias in almost all included studies; only one study had a low risk of bias. We conclude that BMOIs may be valuable for patients with PTSD. There is, however, still a lack of high‐quality studies with proper control conditions and long‐term follow‐up periods from which to draw conclusions.
In this research, we developed and empirically tested a dialogic writing intervention, an integrated language approach in which grade 5/6 students learn how to write, talk about their writing with peers, and rewrite. The effectiveness of this intervention was experimentally tested in ten classes from eight schools, using a pretest–posttest control group design. Classes were randomly assigned to the intervention group (5 classes; 95 students) or control group (5 classes; 115 students). Both groups followed the same eight lessons in which students wrote four argumentative texts about sustainability. For each text, students wrote a draft version, which they discussed in groups of three students. Based on these peer conversations, students revised their text. The intervention group received additional support to foster dialogic peer conversations, including a conversation chart for students and a practice-based professional development program for teachers. Improvements in writing were measured by an argumentative writing task (same genre, but different topic; near transfer) and an instructional writing task (different genre and topic; far transfer). Text quality was holistically assessed using a benchmark rating procedure. Results show that our dialogic writing intervention with support for dialogic talk significantly improved students’ argumentative writing skills (ES = 1.09), but that the effects were not automatically transferable to another genre. Based on these results we conclude that a dialogic writing intervention is a promising approach to teach students how to talk about their texts and to write texts that are more persuasive to readers.
Human Resource Development (HRD) finds itself at a critical juncture given the rapidly changing landscape of work and a shift of focus in HRD research and practices. This provides momentum for the HRD discipline to explore new models of workplace learning that exceed the boundaries of one's own organization. Public and private organizations increasingly understand that by joining forces and cocreating knowledge, they are better able to address these challenges and thereby stay innovative. In this paper, we propose a conceptual framework for Public-Private Learning Communities (PPLCs) as a promising approach to prepare organizations and employees for the rapidly changing future. By drawing on the concept of interorganizational learning and learning-network theory, we distinguish essential building blocks that relate to the PPLCs' strategy, structure, process, and culture. With this conceptual paper, we aim to break new ground for HRD theory-building and offer novel directions for HRD researchers and practitioners.
Background: Extended reality (XR) seems promising for rehabilitation for people with acquired brain injury in terms of reducing professional supervision, faster recovery, shorter hospital stays, and reduced expenses. Since there is no overview this scoping review describes how XR can be utilized in rehabilitation, particularly for people with acquired brain injury (ABI). Methods: The Arksey and O'Malley framework and PRISMA-ScR reporting guideline were followed. Studies between 2010 and May 2022 screened from healthcare as well as technical databases were imported in RAYYAN. Three researchers selected relevant articles in three rounds based on title, abstract and full text. Results: 75 articles were included in this scoping review. Most studies used VR as technology with therapy objectives in three main categories: cognitive, physical and diagnostic. The outcomes of the studies show potential and promising results of the use of XR, and enthusiasm with as well patients as professionals. A selection of four domains of the NASSS framework: condition, technology, value proposition and adopters were reported. Important lessons learned by the included studies are development of XR software, improvement of the hardware, improving feeling of safety and giving support to the patient, and support healthcare professionals for acceptance of XR. Discussion: the use of XR for people with ABI has potential and is promising but not common practice yet. Future research should focus on implementation factors with a diverse and inclusive patient group using service modelling.
Ecosystems shaped by habitat-modifying organisms such as reefs, vegetated coastal systems and peatlands, provide valuable ecosystem services, such as carbon storage and coastal protection. However, they are declining worldwide. Ecosystem restoration is a key tool for mitigating these losses but has proven failure-prone, because ecosystem stability often hinges on self-facilitation generated by emergent traits from habitat modifiers. Emergent traits are not expressed by the single individual, but emerge at the level of an aggregation: a minimum patch-size or density-threshold must be exceeded to generate self-facilitation. Self-facilitation has been successfully harnessed for restoration by clumping transplanted organisms, but requires large amounts of often-limiting and costly donor material. Recent advancements highlight that kickstarting self-facilitation by mimicking emergent traits can similarly increase restoration success. In this perspective, we provide a framework for combining expertise from ecologists, engineers and industrial product designers to transition from trial-and-error to emergent trait design-based, cost-efficient approaches to support large-scale restoration.
In their reply to our editorial (Journal of Child Psychology and Psychiatry, 2023, 64, 464), Dekkers et al. (Journal of Child Psychology and Psychiatry, 2023, 64, 470) argue that treatment is the best choice for children with mental disorders because there is 'sound evidence' that interventions are effective, also in the long term. We agree that there is sound evidence for treatment effectiveness in the short-term and there is some evidence for longer-term effects of certain specific treatments, such as behavioral parent training in children with behavioral disorders, as acknowledged in our editorial. However, we strongly disagree that there is sound evidence for long-term effectiveness.
Player development programmes in sports are considered crucial pillars for the development of young players and countries’ international sporting success. As resources are limited, coaches preferably decide which players to select for these programmes at a young age. This is particularly true for early-starting sports such as table tennis. However, the selection criteria used by coaches and the decision-making processes in player selection contexts are widely unknown. To address this gap, we conducted 15 in-depth semi-structured interviews with table tennis coaches with high expertise in the identification and development of talented young players. Here we show that the concept of ‘talent’ and the process of player selection in table tennis are highly complex phenomena with three main areas of interest identified: (a) general aspects regarding ‘talent’ (in table tennis), (b) specific selection criteria including individual as well as environmental aspects, and (c) the process of player selection. One main finding is that coaches see ‘talent’ as dependent on various factors including (relative) age, maturation as well as practice and previous experience. Furthermore, coaches appear to include both individual (e.g., technical skills) and environmental criteria (e.g., parents’ support) in their decision-making process. Finally, the interviews revealed that player selection decisions are usually made by multiple coaches during group meetings, suggesting the relevance of group processes and dynamics. In summary, this study provides new findings regarding the understanding and discovery of ‘talent’ in table tennis that can help practitioners and open new avenues for further research on player selection in sports.
It appears to be a challenge to keep young adolescents involved in sports, while motivation has been confirmed as a key determinant for sport participation. Consequently, the aim of this study was to get a better insight into the motivational aspects and barriers of young adolescents while paying attention to the various contexts of youth sports in the Netherlands (i.e., club, commercial and urban sports). In total, 741 young adolescents (ages 12-15) filled in a questionnaire about the motivation and barriers to participate in sports and starting a new sport. The most important motivational factor in all sports contexts appears to be 'fun/pleasure'. Additionally, they like the atmosphere of sports, and are motivated by learning new skills and becoming better at sports. Furthermore, young adolescents value a positive atmosphere, a skilled trainer and being able to participate at their own level (with others) when starting a new sport. Identified barriers are 'liking other activities', 'a lack of time', and that 'sport is not fun anymore'. Nevertheless, the young adolescents surveyed, even those not active in sports, generally do not experience a high degree of barriers to participate in sports. The findings provide directions for developing future interventions that improve sport participation and prevent dropout.
Introduction: There is increasing interest in the use of experiential knowledge and the development of experiential expertise in mental health. Yet, little is known about how best to use this expertise in the role of a psychiatrist. Objective: This study aims to gain insight into the concerns of psychiatrists using their lived experiences with mental health distress as a source of knowledge for patients, colleagues and themselves. Materials and method: Eighteen psychiatrists with lived experience as patients in mental health care were interviewed with a semi-structured questionnaire. The interviews were analyzed using qualitative narrative thematic analysis. Findings: The majority of the respondents use their lived experience implicitly in the contact with patients, which makes the contact more equal and strengthens the treatment relationship. When explicitly using experiential knowledge in the contact with patients, thought should be given at forehand to its purpose, timing and dosage. Recommendations are that the psychiatrist should be able to reflect on his/her lived experience from a sufficient distance and should take patient factors into account. When working in a team, it is advisable to discuss the use of experiential knowledge in advance with the team. An open organizational culture facilitates the use of experiential knowledge and safety and stability in the team are vital. Current professional codes do not always offer the space to be open. Organizational interests play a role, in the degree of self-disclosure as it can lead to conflict situations and job loss. Respondents unanimously indicated that the use of experiential knowledge in the role of a psychiatrist is a personal decision. Self-reflection and peer supervision with colleagues can be helpful to reflect on different considerations with regard to the use of experiential knowledge. Conclusion: Having personal lived experiences with a mental disorder affects the way psychiatrists think about and performs the profession. The perception of psychopathology becomes more nuanced and there seems to be an increased understanding of the suffering. Even though harnessing experiential knowledge makes the doctor-patient relationship more horizontal it remains unequal because of the difference in roles. However, if adequately used, experiential knowledge can enhance the treatment relationship.
Background: Reducing health inequalities is a challenge for policymakers and civil society. A multisectoral and multilevel approach is most promising to reduce those inequalities. Previous research showed what key elements of Zwolle Healthy City, an integrated community-based approach aimed at reducing socioeconomic health inequalities, are. To fully understand approaches that are complex and context dependent, questions as 'how does the intervention work' and 'in what context does it work' are just as important as 'what works'. The current study aimed to identify mechanisms and contextual factors associated with the key elements of Zwolle Healthy City, using a realist evaluation perspective. Methods: Transcripts of semi-structured interviews with a wide range of local professionals were used (n = 29). Following realist evaluation logic in the analysis of this primary data, context-mechanism-outcome configurations were identified and thereafter discussed with experts (n = 5). Results: How mechanisms (M) in certain contexts (C) were of influence on the key elements (O) of the Zwolle Healthy City approach are described. For example, how, in the context of the responsible aldermen embracing the approach (C), regular meetings with the aldermen (M) increased support for the approach among involved professionals (O). Or, how, in the context of available financial resources (C), assigning a program manager (M) contributed positively to coordination and communication (O). All 36 context-mechanism-outcome configurations can be found in the repository. Conclusion: This study showed what mechanisms and contextual factors are associated with the key elements of Zwolle Healthy City. By applying realist evaluation logic in the analysis of primary qualitative data we were able to disentangle the complexity of processes of this whole system approach and show this complexity in a structured manner. Also, by describing the context in which the Zwolle Healthy City approach is implemented, we contribute to the transferability of this approach across different contexts.
Aims This study explored what informal caregivers of ethnic minority (EM) persons with dementia in the Netherlands perceive as culturally accessible health care and nurses' perceptions of how cultural competence can be improved to facilitate access to health care for EM persons with dementia and their informal caregivers. Design Qualitative description research with semi‐structured individual interviews and focus group discussions (FGDs). Methods Semi‐structured interviews with 15 nurses and 6 informal caregivers provided input for two FGDs with nurses about the need to strengthen their cultural competence to improve access to health care for EM persons with dementia and their informal caregivers. Interview data were collected between September 2020 and April 2021 in the Netherlands. Focus group discussion data were collected between June and September 2021 in the Netherlands. Results Nurses and informal caregivers experienced difficulty building and maintaining a relationship. Contrary to informal caregivers' experiences, nurses felt a shared cultural background with the persons with dementia and informal caregiver is necessary. Although nurses acknowledged the importance of cultural knowledge, cultural skills, in particular, were mentioned as needing improvement. Examples are mapping involved family members and their roles, asking the right questions and letting go of personal judgements. Nurses frequently mentioned stereotypical thinking and seeing ‘the other’ as different, and collaboration with(in) family proved difficult for informal caregivers and nurses. Conclusion Strengthening cultural skills will contribute to facilitating better access to cultural appropriate health care for EM persons with dementia and their informal caregivers. Patient or Public Contribution No patient or public contribution. Impact This study explores what is perceived as culturally accessible health care and what nurses need to improve their cultural competence. We show that strengthening nurses' cultural competence by addressing which skills should be improved can improve access to health care for EM persons with dementia and their informal caregivers.
News organizations try to improve the relationship with their audiences by seeking interaction with them - also known as participatory journalism. But not everyone participates; many news consumers do not surpass reading, watching, or listening to news. The explanations for lagging participation are scattered and not yet comprehensively integrated in an overarching overview. This study provides a more in-depth account of the different motivations of Dutch younger (<30) and older (<50) news users not to use the participatory tools that news websites offer. In this paper the motivations of these different groups are uncovered and compared. Our thematic analysis indicates that both groups are mostly driven by similar motivations. The main motivation both generations bring forward is their aversion towards the online community. Reluctance because of expertise (younger audience members) or career implications (older audience members) seem to be the most important difference between the two groups.
Circular ecosystems can be a role model in the transition to a circular economy, can inspire and motivate other entrepreneurs, and may possibly have a transformative effect in the transition. For example, by deploying knowledge and experience for a targeted lobby for policy change – such as changes in the law and regulations. Four circular ecosystems were studied to discover how they function, and what they may contribute to the transition to a circular economy. The research shows that cooperation in ecosystems can provide circular start-ups with much added value. At the same time, the research also shows that the influence of the four circular ecosystems investigated is limited regarding the local transition to a circular economy. The ecosystems are not examples of a circular economy yet. But ecosystems are not static entities. They are on the move, as this research demonstrates.
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3,565 members
Marike Hettinga
  • Research Group for ICT Innovations in Health Care
Carolien Smits
  • Research Group for Care of Older adults
Anneke Smits
  • Research Group for Educational Innovation and Technology
Bob van Limburg
  • Department of Engineering
Zwolle, Netherlands