This thesis addresses two important issues in midwifery: I) the care and support provided by midwives to women and their families facing vulnerable circumstances during pregnancy and childbirth, and II) the role and tasks of clinical midwives in Dutch hospitals.

Background: Frailty is a common condition in older people, and its prevalence increases with age. With an ageing population, the adverse consequences of frailty cause an increasing appeal to the health care system. The impact of frailty on population level is often assessed using adverse health outcomes, …

Objectives Quality improvements (QIs) in dynamic and complex health care contexts require resilience and take variability into account in quality improvement. The Functional Resonance Analysis Method (FRAM) helps us understand resilience and gain insight into (un)desirable variability in the complex …

This research paper was written for [Company] which is a start-up company from Delft, The Netherlands. [Company] has developed an innovative new product in the MedTech industry which uses robotics and AI to deliver an autonomous Transthoracic Echocardiogram (an ultrasound scan of the heart). [Company] …

Background: It is thought that physical health conditions start at a young age in people with profound intellectual and multiple disabilities (PIMD). Knowledge regarding the prevalence, associations and development of these physical health conditions could be used for purposes of prevention as well as …

Objectives Providing an overview of the clinimetric properties of the steep ramp test (SRT), a short-term maximal exercise test, to assess cardiorespiratory fitness (CRF), describing its underlying physiological responses, and summarizing its applications in current clinical and research practice. Data …

The Dutch food and agricultural market has been focusing on producing efficiently and effectively with the aim of cost minimization and profit maximizing. In addition to positive developments (higher efficiency and more effective production), this market system has created negative impact for nature, …

The healthcare sector has been confronted with rapidly rising health care costs and a shortage of medical staff. At the same time, the field of Artificial Intelligence (AI) has emerged as a promising area of research, offering poten tial benefits for healthcare. Despite the potential of AI to support …

Background: The transformation in global demography and the shortage of health care workers require innovation and efficiency in the field of health care. Digital technology can help improve the efficiency of health care. The Mercury Advance SMARTcare solution is an example of digital technology. The …

Background: Hip and knee osteoarthritis (OA) are highly prevalent worldwide. The guidelines recommend physical activity and education as the core treatments for osteoarthritis. Digital health has the potential to engage people in physical activity and disease management. Therefore, we conducted a pilot …