Thirty to sixty per cent of older patients experience functional decline after hospitalisation, associated with an increase in dependence, readmission, nursing home placement and mortality. First step in prevention is the identification of patients at risk. The objective of this study is to develop and validate a prediction model to assess the risk of functional decline in older hospitalised patients.
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Background: The use of patient-reported outcomes to improve burn care increases. Little is known on burn patients’ views on what outcomes are most important, and about preferences regarding online Patient Reported Outcome Measures (PROMs). Therefore, this study assessed what outcomes matter most to patients, and gained insights into patient preferences towards the use of online PROMs. Methods: Adult patients (≥18 years old), 3–36 months after injury completed a survey measuring importance of outcomes, separately for three time periods: during admission, short-term (< 6 months) and long-term (6–24 months) after burn injury. Both open and closed-ended questions were used. Furthermore, preferences regarding the use of patient-reported outcome measures in burn care were queried. Results: A total of 140 patients were included (response rate: 27%). ‘Not having pain’ and ‘good wound healing’ were identified as very important outcomes. Also, ‘physical functioning at pre-injury level’, ‘being independent’ and ‘taking care of yourself’ were considered very important outcomes. The top-ten of most important outcomes largely overlapped in all three time periods. Most patients (84%) had no problems with online questionnaires, and many (67%) indicated that it should take up to 15 minutes. Patients’ opinions differed widely on the preferred frequency of follow-up. Conclusions: Not having pain and good wound healing were considered very important during the whole recovery of burns; in addition, physical functioning at pre-injury level, being independent, and taking care of yourself were deemed very important in the short and long-term. These outcomes are recommended to be used in burn care and research, although careful selection of outcomes remains crucial as patients prefer online questionnaires up to 15 minutes.
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Background Altered muscle-tendon properties in clubfoot patients could play a role in the occurrence of a relapse and negatively affect physical functioning. However, there is a lack of literature about muscle-tendon properties of clubfoot relapse patients. Research question The aim of this study was to determine whether the muscle architecture of the medial gastrocnemius and the morphology of the Achilles tendon differ between typically developing children (TDC) and clubfoot patients with and without a relapse clubfoot and to determine the relationships between morphological and functional gait outcomes. Methods A cross-sectional study was carried out in clubfoot patients treated according to the Ponseti method and TDC aged 4–8 years. A division between clubfoot patients with and without a relapse was made. Fifteen clubfoot patients, 10 clubfoot relapse patients and 19 TDC were included in the study. Morphologic properties of the medial head of the Gastrocnemius muscle and Achilles tendon were assessed by ultrasonography. Functional gait outcomes were assessed using three-dimensional gait analysis. Mean group differences were analysed with ANOVA and non-parametric alternatives. Relationships between functional and morphologic parameters were determined for all clubfoot patients together and for TDC with Spearman’s rank correlation. Results Morphological and functional gait parameters did not differ between clubfoot patients with and without a relapse, with exception of lower maximal dorsiflexor moment in clubfoot relapse patients. Compared to TDC, clubfoot and relapse patients did show lower functional gait outcomes, as well as shorter and more pennate muscles with a longer Achilles tendon. In all clubfoot patients, this longer relative tendon was related to higher ankle power and plantarflexor moment. Significance In clubfoot and relapse patients, abnormalities in morphology did not always relate to worse functional gait outcomes. Understanding these relationships in all clubfoot patients may improve the knowledge about clubfoot and aid future treatment planning.
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The research proposal aims to improve the design and verification process for coastal protection works. With global sea levels rising, the Netherlands, in particular, faces the challenge of protecting its coastline from potential flooding. Four strategies for coastal protection are recognized: protection-closed (dikes, dams, dunes), protection-open (storm surge barriers), advancing the coastline (beach suppletion, reclamation), and accommodation through "living with water" concepts. The construction process of coastal protection works involves collaboration between the client and contractors. Different roles, such as project management, project control, stakeholder management, technical management, and contract management, work together to ensure the project's success. The design and verification process is crucial in coastal protection projects. The contract may include functional requirements or detailed design specifications. Design drawings with tolerances are created before construction begins. During construction and final verification, the design is measured using survey data. The accuracy of the measurement techniques used can impact the construction process and may lead to contractual issues if not properly planned. The problem addressed in the research proposal is the lack of a comprehensive and consistent process for defining and verifying design specifications in coastal protection projects. Existing documents focus on specific aspects of the process but do not provide a holistic approach. The research aims to improve the definition and verification of design specifications through a systematic review of contractual parameters and survey methods. It seeks to reduce potential claims, improve safety, enhance the competitiveness of maritime construction companies, and decrease time spent on contractual discussions. The research will have several outcomes, including a body of knowledge describing existing and best practices, a set of best practices and recommendations for verifying specific design parameters, and supporting documents such as algorithms for verification.
Mattresses for the healthcare sector are designed for robust use with a core foam layer and a polyurethane-coated polyester textile cover. Nurses and surgeons indicate that these mattresses are highly uncomfortable to patients because of poor microclimatic management (air, moisture, temperature, friction, pressure regulation, etc) across the mattress, which can cause pressure ulcers (in less than a day). The problem is severe (e.g., extra recovery time, medication, increased risk, and costs) for patients with wounds, infection, pressure-sensitive decubitus. There are around 180,000 waterproof mattresses in the healthcare sector in the Netherlands, of which yearly 40,000 mattresses are discarded. Owing to the rapidly aging population it is expected to increase the demand for these functional mattresses from 180,000 to 400,000 in the next 10 years in the healthcare sector. To achieve a circular economy, Dutch Government aims for a 50% reduction in the use of primary raw materials by 2030. As of January 1, 2022, mattress manufacturers and importers are obliged to pay a waste management contribution. Within the scope of this project, we will design, develop, and test a circular & functional mattress for the healthcare (cure & care) sector. The team of experts from knowledge institutes, SMEs, hospital(s), branch-organization joins hands to design and develop a functional (microclimate management, including ease of use for nurses and patients) mattress that deals with uncomfortable sleeping and addresses the issue of pressure ulcers thereby overall accelerating the healing process. Such development addresses the core issue of circularity. The systematic research with proper demand articulation leads to V-shape verification and validation research methodology. With design focus and applied R&D at TRL-level (4-6) is expected to deliver the validated prototype(s) offering SMEs an opportunity to innovate and expand their market. The knowledge will be used for dissemination and education at Saxion.
Recomposing E-Waste introduces circular strategies to sound artists and designers working with digital music instruments (DMIs) such as desktop synthesizers, small keyboards and controllers, and experimental hardware and software for sound art and music production. It explores and documents the re-purposing of obsolete smartphones, transforming them into fully working DMIs that can be used to create new sound works and music. The target groups are artists, designers and musicians working with sound and digital technology who are looking for ways to reinvent their practice in sustainable ways, depending less on the latest ICT equipment. The research is designed to address the goal number 3, “Extending product life”, of the National Circular Economy Programme 2023-2030 (Ministry of Infrastructure and Water Management 2023). Waag Futurelab and Willem de Kooning Academy (Rotterdam University of Applied Sciences, RUAS) will collaborate with Codarts University of the Arts, postmarketOS, Fairphone, ThePhoneLab and FIBER Foundation to develop a prototype DMI made entirely from obsolete smartphones and other repurposed materials. The DMI will be used to teach, validate and disseminate innovative artistic and design research strategies that provide cultural practitioners with training in digital tools, know-how, and a conceptual framework to combine creativity with circularity. It will exemplify how to increase the functional lifespan of mobile devices through reverse-engineering and repurposing, reducing thereby the resource use and waste that often accompanies digital cultural production. The outcomes of the research will equip creatives with practical strategies to resist planned obsolescence, the market strategy the ICT industry deploys to increase the sales of newer devices and make still-working hardware seemingly useless. This will enable artists to play a guiding role in reshaping our society’s relationship with digital devices, not only on a symbolic but also on a functional and material level.
