BackgroundSurvivors of critical illness experience long-term functional challenges, which are complex, heterogeneous, and multifactorial in nature. Although the importance of rehabilitation interventions after intensive care unit (ICU) discharge is universally recognized, evidence on feasibility and effectiveness of home-based rehabilitation programs is scarce and ambiguous. This study investigates the feasibility of an interdisciplinary rehabilitation program designed for patients with Post-Intensive Care Syndrome (PICS) who are discharged home.MethodsA mixed method, non-randomized, prospective pilot feasibility study was performed with a 6-month follow-up, comparing the intervention (REACH) with usual care. REACH was provided by trained professionals and included a patient-centered, interdisciplinary approach starting directly after hospital discharge. Primary outcomes were patient safety, satisfaction, adherence, referral need and health care usage. Secondary outcomes, measured at 3 timepoints, were functional exercise capacity, self-perceived health status, health-related quality of life (HRQoL), return to work and psychotrauma. Risk of undernutrition was assessed at baseline.Results43 patients with a median mechanical ventilation duration of 8 (IQR:10) days, were included in the study and 79.1% completed 6-month follow-up. 19 patients received the intervention, 23 received usual care. Groups were similar for gender distribution and ICU length of stay. No adverse events occurred. REACH participants showed higher satisfaction with treatment and reported more allied health professional visits, while the usual care group reported more visits to medical specialists. Qualitative analysis identified positive experiences among REACH-professionals related to providing state-of-the-art interventions and sharing knowledge and expertise within an interprofessional network. Similar recovery was seen between groups on all secondary outcomes, but neither group reached reference values for HRQoL at 6 months. Larger return to work rates were seen in the REACH group. Prevalence of undernutrition at hospital discharge was high in both groups (> 80%), warranting the need for careful tuning of physical therapy and nutritional interventions.ConclusionsThis study shows that providing early, home-based rehabilitation interventions for patients with PICS-related symptoms is feasible and perceived positively by patients and professionals. When provided in an interdisciplinary collaborative network state of the art, person-centered interventions can be tailored to individual needs potentially increasing patient satisfaction, adherence, and efficacy.Registered in the Dutch Trial register: NL7792: https://www.trialregister.nl/trial/7792, registered 7-06-2019.
MULTIFILE
Background and aim: Moderate preterm (MP) birth is associated with an increased risk of developmental problems. However, post-discharge support for this group is scarce. The aim of this study was to evaluate the feasibility of a post-discharge parenting program (TOP program) for MP infants. Three feasibility dimensions were evaluated (1) recruitment capability and compliance, (2) intervention acceptability, and (3) limited efficacy testing. Methods: A group of MP infants with a gestational age (GA) between 320/7‐346/7 weeks and their parents received six home visits by a TOP interventionist until 6 months corrected age (CA). A pre-posttest intervention design with quantitative and qualitative measures was used. Recruitment capability and compliance, acceptability, and satisfaction with the intervention were evaluated using a questionnaire, checklists, interviews, and a focus group. Infant socio-emotional development, parental distress, self-efficacy, and reflective functioning were measured with questionnaires. Observation measurements were used for infant motor development and parental sensitivity. Results: Thirty-two families completed the six home visits. The satisfaction rate (scale 0–10) was remarkably high (Mean 9.4, range: 8–10). Parents reported that the program was suitable, enhanced their understanding of their infants' developmental needs, and increased their self-efficacy. The infants showed age-appropriate motor and socio-emotional development post-intervention. Parental self-efficacy, reflective functioning, and sensitivity improved from pre to post intervention, with small to large effect sizes. Conclusion: The study demonstrated high compliance, acceptability, and satisfaction with the TOP program for MP infants with promising infant and parent outcomes. This study contributes to the preparatory work prior to a larger scale evaluation and dissemination.
Background: Due to multimorbidity and geriatric problems, older people often require both psychosocial and medical care. Collaboration between medical and social professionals is a prerequisite to deliver high-quality care for community-living older people. Effective, safe, and person-centered care relies on skilled interprofessional collaboration and practice. Little is known about interprofessional education to increase interprofessional collaboration in practice (IPCP) in the context of community care for older people. This study examines the feasibility of the implementation of an IPCP program in three community districts and determines its potential to increase interprofessional collaboration between primary healthcare professionals caring for older people. Method: A feasibility study was conducted to determine the acceptability and feasibility of data collection and analysis regarding interprofessional collaboration in network development. A questionnaire was used to measure the learning experience and the acquisition of knowledge and skills regarding the program. Network development was assessed by distributing a social network survey among professionals attending the program as well as professionals not attending the program at baseline and 5.5 months after. Network development was determined by calculating the number, reciprocity, value, and diversity of contacts between professionals using social network analysis. Results: The IPCP program was found to be instructive and the knowledge and skills gained were applicable in practice. Social network analysis was feasible to conduct and revealed a spill-over effect regarding network development. Program participants, as well as non-program participants, had larger, more reciprocal, and more diverse interprofessional networks than they did before the program. Conclusions: This study showed the feasibility of implementing an IPCP program in terms of acceptability, feasibility of data collection, and social network analysis to measure network development, and indicated potential to increase interprofessional collaboration between primary healthcare professionals. Both program participants and non-program participants developed a larger, more collaborative, and diverse interprofessional network.
The focus of this project is on improving the resilience of hospitality Small and Medium Enterprises (SMEs) by enabling them to take advantage of digitalization tools and data analytics in particular. Hospitality SMEs play an important role in their local community but are vulnerable to shifts in demand. Due to a lack of resources (time, finance, and sometimes knowledge), they do not have sufficient access to data analytics tools that are typically available to larger organizations. The purpose of this project is therefore to develop a prototype infrastructure or ecosystem showcasing how Dutch hospitality SMEs can develop their data analytic capability in such a way that they increase their resilience to shifts in demand. The one year exploration period will be used to assess the feasibility of such an infrastructure and will address technological aspects (e.g. kind of technological platform), process aspects (e.g. prerequisites for collaboration such as confidentiality and safety of data), knowledge aspects (e.g. what knowledge of data analytics do SMEs need and through what medium), and organizational aspects (what kind of cooperation form is necessary and how should it be financed).
This proposal is a resubmission of an earlier proposal (Dossier nr: GOCH.KIEM.KGC02.079) which was not approved because of the too ambitious planning. As advised by the commission, the focus is kept only on the recycling of the mattress cover. The Netherlands has 180,000+ waterproof mattresses in the healthcare sector, of which yearly 40,000+ mattresses are discarded. Owing to the rapidly aging population it is expected to increase the demand for these waterproof mattresses in the consumer sector as well. Considering the complex nature of functional mattresses, these valuable resources are partly incinerated. To achieve a circular economy, Dutch Government aims for a 50% reduction in the use of primary raw materials in five key economic sectors including ‘consumer products’ by 2030. Within the scope of this research, Saxion together with partners (CFC BV, Deron BV, MRE BV & Klieverik Heli BV) will bring emphasis on Recycling (sustainable chemistry) of mattress covers. Other aspects such as reuse and re-designing are beyond the scope of this project proposal, for which a bigger consortium will be built during the course of this project. A case under study is a water-impermeable mattress cover made of 100% polyester with polyurethane (PU) coatings. The goal is to enable the circular use of textiles with (multilayer) ‘coatings’, which are not recyclable yet. These ‘coatings’ comprise functional coatings as well as adhesion layers. Therefore, novel triggerable molecular systems and the corresponding recycling processes will be developed. The coatings will be activated by a specific trigger (bio)-chemical solvation, heat, pressure, humidity, microwave, or combination of thereof. The emphasis is to develop a scalable coating removal process. Learnings will be used to build larger (inter)-national consortia to develop multiple industry closed-loop solutions required for 100% mattress circularity with desired functionality. The generated knowledge will be used for education at Saxion.
Especially during the summer period, a significant amount of the population experience a health issues caused by the stinging hair of oak-caterpillars. These health complaints are often caused by the skin irritation and allergic reaction when the stinging hair comes in contact with the skin. Additional complaints include swelling and inflammation problems on eyes and throats. The health complaints range from simple itching to serious allergic reactions that can last weeks. Currently, the oak-caterpillars are removed using manual labor, which is labor intensive and time consuming. Cranes are often deployed to reach to various parts of a tree for inspection and combat, which is a slow and an expensive process. In general, since inspection of oak-caterpillars is done with bare eyes of the professionals and detection often occurs at a later stage, significant number of people are affected already. Therefore, a new effective combating methodology is needed. The main goal of this project is to conduct feasibility study of the applicability of semi-autonomous aerial robots (drones) for early stage detection and combat against oak-caterpillars. This innovative solution aspires to use smart aerial robots that employ AI-based techniques for early phase and real-time detection of oak-caterpillars. Once the oak-caterpillars are detected, a direct and selective combating resources will be applied. Within this project, the first proof-of-concepts will be developed. The results of this project will be used to expand the existing network and formulate a bigger project to address additional critical aspects in order to develop a complete oak-caterpillar combating drone. The project will be executed with Research Group of Mechatronics at Saxion, together with the participating innovative SMEs (DronExperts,Drone4Agro). The project will be facilitated by the Municipality of Enschede with respect to polices and the Space53 cluster for networking and testing in operational environments.
