From the article : "Based on a review of recent literature, this paper addresses the question of how urban planners can steer urban environmental quality, given the fact that it ismultidimensional in character, is assessed largely in subjective terms and varies across time. A novel perspective of urban environmental quality is proposed, simultaneously exploring three questions that are at the core of planning and designing cities: ‘quality of what?’, ‘quality for whom?’ and ‘quality at what time?’. The dilemmas that urban planners face in answering these questions are illustrated using secondary material. This approach provides perspectives for action. Rather than further detailing the exact nature of urban quality, it calls for sustainable urban environmental quality planning that is integrated, participative and adaptive" ( wileyonlinelibrary.com ) DOI: 10.1002/eet.1759 - Preprint available for free download.
Patients undergoing major surgery are at risk of complications and delayed recovery. Prehabilitation has shown promise in improving postoperative outcomes. Offering prehabilitation by means of mHealth can help overcome barriers to participating in prehabilitation and empower patients prior to major surgery. We developed the Be Prepared mHealth app, which has shown potential in an earlier pilot study.
MULTIFILE
PurposeEarly mobilization of critically ill patients improves functional recovery, but is often hampered by tubes, drains, monitoring devices and muscular weakness. A mobile treadmill with bodyweight support facilitates early mobilization and may shorten recovery time to independent ambulation as compared to usual care physiotherapy alone.Materials and methodsSingle center RCT, comparing daily bodyweight supported treadmill training (BWSTT) with usual care physiotherapy, in patients who had been or were mechanically ventilated (≥48 h) with ≥MRC grade 2 quadriceps muscle strength. BWSTT consisted of daily treadmill training in addition to usual care physiotherapy (PT). Primary outcome was time to independent ambulation measured in days, using the Functional Ambulation Categories (FAC-score: 3). Secondary outcomes included hospital length of stay and serious adverse events.ResultsThe median (IQR) time to independent ambulation was 6 (3 to 9) days in the BWSTT group (n = 19) compared to 11 (7 to 23) days in the usual care group (n = 21, p = 0.063). Hospital length of stay was significantly different in favour of the BWSTT group (p = 0.037). No serious adverse events occurred.InterpretationBWSTT seems a promising intervention to enhance recovery of ambulation and shorten hospital length of stay of ICU patients, justifying a sufficiently powered multicenter RCT.Trial registration number: Dutch Trial Register ID: NTR6943.
