Toegankelijke gezondheidsinformatie: een kwestie van leeftijd?

Aging and digitalisation are important trends which have their impact on information accessibility. Accessible information about products and services is of crucial importance to ensure that all citizens can participate fully as active members of society. Senior citizens who have difficulties using new media run the risk of exclusion in today's information society. Not all senior citizens, however, encounter problems with new media. Not by a long shot. There is much to be said for 'aged heterogeneity', the concept that individual differences increase as people age. In two explorative qualitative case studies related to accessible health information--an important issue for senior citizens--that were conducted in the Netherlands, variables such as gender, education level and frequency of internet use were therefore included in the research design. In this paper, the most important results of these case studies will be discussed. Attention will be also paid to complementary theories (socialisation, life stages) which could explain differences in information search behaviour when using old or new media.     

Zorgzwaartebekostiging in de AWBZ: een vertrouwenwekkende ontwikkeling?

Towards a new system of costs reimbursement in Dutch long-term care facilities: a confidence-building development? Against the background of an increasingly ageing society, the Dutch government is redefining its role with regard to providing and financing care for the elderly. This results in restricting the benefits of the Exceptional Medical Expenses Act (AWBZ) to the care for severely dependent elderly – especially old people with dementia – who are in need of long term care that cannot be ensured on the market. In accordance with this policy, geriatric rehabilitation and (medical) care aimed at recovery will be transferred to the basic health insurance. One of the steps towards this restricted coverage of the AWBZ is the introduction of a new, but questionable method of costs reimbursement. Not only does this method lack transparency, it also entails the use of time-consuming, inefficient and bureaucratic questionnaires with a doubtful reliability. The question is raised whether this procedure is a right and trustworthy step to ensure the quality of care for dependent elderly.     

绿色荧光蛋白在een基因表达产物中的应用

ｅｅｎ是一个新的人类急性白血病相关基因,为了确定ｅｅｎ基因在ＣＨＯ细胞中表达产物的作用部位,用绿色荧光蛋白载体将ｅｅｎ基因导入其中并得到表达。结果表明,ｅｅｎ基因的表达产物定位于胞浆中。     

Radiofrequente ablatiebehandeling van de oudere patiënte met een mammacarcinoom

Breast cancer is an important health care problem, especially in the increasing elderly generation. Treatment of these fragile patients is a challenge for the clinician. Undertreatment has been linked to a higher percentage of recurrence and cancer related morbidity, while overtreatment leads to treatment related morbidity and mortality. Minimally invasive techniques do offer new opportunities for patients, who are no candidates for conventional surgery. The tumor lesion is treated locally and selective with minimal damage to surrounding tissue, yielding an adequate local tumor control. Radio frequency ablation technique seems an effective and safe method for treatment of the elderly patient with small (< 3 cm) breast cancer.     

Omgaan met somberheid op oudere leeftijd: een kwalitatieve studie

Background

To gain new insights for support for older people with low mood, we explored the perceptions of ‘screenpositive’ older people on underlying causes and possible solutions.

Design and method

We conducted two in-depth interviews with 38 participants (≥77 years) who screened positive for depressive symptoms in general practice. To investigate the influence of the presence of complex health problems, we included 19 persons with and 19 without complex problems. Complex problems were defined as a combination of functional, somatic, psychological or social problems.

Results

All participants used several cognitive, social or practical coping strategies. Four patterns emerged: mastery, acceptance, ambivalence, and need for support. Some participants, especially those with complex problems, were ambivalent about possible interventions.

Conclusion

Most older participants perceived their coping strategies as sufficient. General practitioners can support self-management by exploring the (effectiveness of) personal coping strategies, providing information, elaborating on perceptions of risks and discussing alternative options with older persons.

     

Aandacht voor de ambiance van maaltijden in verpleeghuizen een medische noodzaak?!

Een goede vocht- en voedselvoorziening in zorginstellingen lijkt een vanzelfsprekende zaak in een welvarend land als Nederland. Niettemin constateerde de Inspectie voor de Gezondheidszorg in 1997 dat lang niet altijd eten en drinken in deze instellingen op de behoefte van de cliënt gerichte zorg is. 1 Sinds 1997 is er veel verbeterd. De betrokken beroepsverenigingen hebben onder auspiciën van ARCARES de handschoen opgepakt en een richtlijn opgesteld die handvatten biedt voor een verantwoord vocht- en voedingsbeleid binnen de instellingen. 2 Helaas blijkt volgens een recent rapport van de Inspectie deze zorg toch nog onvoldoende bij ongeveer een derde van de onderzochte instellingen.     

Passagère cognitieve achteruitgang bij een patiënt met relapsing polychondritis

Patient A, 58 years, is referred by the Rheumatologist to the Geriatrician concerning apathy. History reviews skipping arthritis, reddened and inflamed eyes, apathy and loss of interest. Physical examination revealed red tearing eyes, bradyphrenia and bradykinesia. Laboratory examination showed inflammation markers. The patient develops fever and bilateral reddened and inflamed ears. Diagnosis of relapsing polychondritis is made, the patient is treated with prednisone and the symptoms disappear. Relapsing polychondritis is a chronical disease associated with inflammation and destruction of cartilaginous structures and proteoglycan rich structures. We diagnosed Relapsing Polychondritis with a reversible dementia, probably due to cerebral vasculitis.