BACKGROUND: Early mobilization has been proven effective for patients in intensive care units (ICUs) to improve functional recovery. However, early mobilization of critically ill, often mechanically ventilated, patients is cumbersome because of the attachment to tubes, drains, monitoring devices and muscle weakness. A mobile treadmill with bodyweight support may help to initiate mobilization earlier and more effectively. The aim of this study is to assess the effectiveness of weight-supported treadmill training in critically ill patients during and after ICU stay on time to independent functional ambulation. METHODS: In this randomized controlled trial, a custom-built bedside body weight-supported treadmill will be used and evaluated. Patients are included if they have been mechanically ventilated for at least 48 hours, are able to follow instructions, have quadriceps muscle strength of Medical Research Council sum-score 2 (MRC 2) or higher, can sit unsupported and meet the safety criteria for physical exercise. Exclusion criteria are language barriers, no prior walking ability, contraindications for physiotherapy or a neurological condition as reason for ICU admission. We aim to include 88 patients and randomize them into either the intervention or the control group. The intervention group will receive usual care plus bodyweight-supported treadmill training (BWSTT) daily. The BWSSTT consists of walking on a mobile treadmill while supported by a harness. The control group will receive usual care physiotherapy treatment daily consisting of progressive activities such as bed-cycling and active functional training exercises. In both groups, we will aim for a total of 40 minutes of physiotherapy treatment time every day in one or two sessions, as tolerated by the patient. The primary outcome is time to functional ambulation as measured in days, secondary outcomes include walking distance, muscle strength, status of functional mobility and symptoms of post-traumatic stress. All measurements will be done by assessors who are blinded to the intervention on the regular wards until hospital discharge. DISCUSSION: This will be the first study comparing the effects of BWSTT and conventional physiotherapy for critically ill patients during and after ICU stay. The results of this study contribute to a better understanding of the effectiveness of early physiotherapy interventions for critically ill patients. TRIAL REGISTRATION: Dutch Trial Register (NTR) ID: NL6766. Registered at 1 December 2017.
This review of meta-analyses of outcome studies of adults receiving Computer-Based Health Education (CBHE) has two goals. The first is to provide an overview of the efficacy of CBHE interventions, and the second is to identify moderators of these effects. A systematic literature search resulted in 15 meta-analyses of 278 controlled outcome studies. The meta-analyses were analysed with regard to reported (overall) effect sizes, heterogeneity and interaction effects. The results indicate a positive relationship between CBHE interventions and improvements in health-related outcomes, with small overall effect sizes compared to non-computer-based interventions. The sustainability of the effects was observed for up to six months. Outcome moderators (31 variables) were studied in 12 meta-analyses and were clustered into three categories: intervention features (20 variables), participant characteristics (five variables) and study features (six variables). No relationship with effectiveness was found for four intervention features, theoretical background, use of internet and e-mail, intervention setting and self-monitoring; two participant features, age and gender; and one study feature, the type of analysis. Regarding the other 24 identified features, no consistent results were observed across meta-analyses. To enhance the effectiveness of CBHE interventions, moderators of effects should be studied as single constructs in high-quality study designs. http://www.journalofinterdisciplinarysciences.com/ https://www.linkedin.com/in/leontienvreeburg/
Project aimsNorthSEE aims to achieve greater coherence in Maritime Spatial Planning (processes; MSP) and in Maritime Spatial Plans (outcomes/solutions), capturing synergies and preventing incompatibilities in the North Sea Region (NSR). The project seeks to create better conditions for sustainable development of the area in the fields of shipping, energy and environmental protection. NorthSEE is possible thanks to the financial support from the Interreg North Sea Region programme of the European Union (European Regional Development Fund).Project tasks and resultsTo suggest a multi-level coordination framework capable of supporting ongoing coordination in MSP across the NSR in the long term. To develop an information and planning platform for MSP, enabling planners and stakeholders to share evidence for MSP and test different planning options in the form of scenarios based on real data. The MSP Challenge computer-supported simulation game will became this platform. To increase the capacity of stakeholders in key transnational sectors to actively contribute to MSP To align approaches for taking into account wider environmental issues in MSP To facilitate greater transnational coherence in MSP with respect to offshore energy infrastructure To achieve greater transnational coherence in using MSP to support environmental protection objectives. To facilitate greater transnational coherence in MSP with respect to shipping routes.Our roleThe Academy for Digital Entertainment (ADE) of Breda University of Applied Sciences is a full partner in this project. ADE is responsible for designing and developing the MSP Challenge simulation game concerning the NSR, as well as facilitating its application, all with the aim of developing insights befitting the project aims and thus Maritime Spatial Planning in the North Sea Region (see task 2). We therefore work closely with all NorthSEE partners to define the right requirements and ensure that the simulation game fulfills them. Multiple MSP Challenge sessions are planned to help develop insightful future scenarios and useful planning solutions for the NSR. More information about MSP Challenge is available on NorthSEE (https://northsearegion.eu/northsee) and on its own website (https://www.mspchallenge.info/).
The PANEURAMA project aims to address the mismatches between the output of HEI/VETs and the needs of the industry in the fields of animation, computer games and VFX. It consists of a network of HEIs and VETs in Europe as well as field-relevant industry partners, and is supported by a range of strong associated partners. The hope is to better prepare students and graduates for the emerging needs of their prospective careers, and in doing so building resilience into the European animation, gaming, and media arts sectors.Societal IssueStudents that are insufficiently prepared for their working fields limit the creativity of the sector, are stressed in their workplaces, and create economic problems.Benefit to societyHealthier cultural and creative sectors are a sign of a strong society, with benefits for mental health, cultural harmony, and positive economic impacts.
