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.
Study design: A secondary analysis of a systematic review. Background: Manipulations or mobilizations are commonly used interventions in patients with mechanical neck pain. The treatment effects have often been studied in randomized controlled trials (RCT) which are generally considered the gold standard in evaluating the treatment effects, mainly due to its high internal validity. External validity is defined as the extent to which the effects can be generalised to clinical practice. An important prerequisite for this is that interventions used in clinical trials can be replicated in clinical practice. It can be questioned if interventions utilized in randomized controlled trials can be translated into clinical practice. Objectives: The overall aim of this study is to examine whether the quality of the description of manipulation and mobilization interventions is sufficient for to replication of these interventions in clinical practice. Methods: A comprehensive literature search was performed. Two independent researchers used the Template for Intervention Description and Replication (TIDieR) which is a 12-item checklist for describing the completeness of the interventions. Results: Sixty-seven articles were included that used manipulation and/or mobilization interventions for patients with mechanical neck pain. None of the articles describe the intervention e.g. all the items on the TIDieR list. Considering item 8 (a-f) of the TIDieR checklist only one article described the used techniques completely. Conclusion: Manipulation or a mobilization interventions are poorly reported in RCTs, which jeopardize the external validity of RCTs, making it difficult for clinicians and researchers to replicate these interventions.
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The authors regret that during a recent review of this work, an erroneous calculation was uncovered. In our discussion we estimated the number of VAD patients annually with recent manipulation in the U.S. If the annual rate of VAD patients in the U.S. population was approximately (318,857,056 × 1.0/100.000) 3188, and of those patients 6.9% received a cervical manipulation, the correct number should be (3188 × 0.069) 220. This had been accidentally calculated as 220,011 instead of 220. Although it does not change the overall conclusions or discussion of the paper, the authors would like to thank dr. Clum for his attentiveness and apologize for any inconvenience caused.
The bio-transition will require mass mobilization of biomass for industrial feedstock, of which lignocellulose from agricultural residues is a promising sustainable source. Agricultural lignocellulosic residues (ALR) are available in varying densities across the EU and offer an opportunity to improve environmental outcomes in agriculture as well as in refining. While technologies are emerging, the future demands of industry for ALR are not understood, limiting the ability of biomass intermediaries to develop a supply chain. This project is a collaboration of Looop, BioGrowth Development (BD), and MNEXT, with the aim to quantify and characterize ALR in the EU and match it to expected demand from the refining industry. The spatial distribution of ALR, as well as the technical requirements of refineries, are critical components to developing a sustainable supply chain. Looop aspires to create circularity between ALRs and industry, and together with the biomass consulting experience of BD have approached MNEXT to leverage their knowledge of biorefinery applications. The focus of the project is to spatially model ALR availability across the EU and identify locations where mobilizing biomass for biorefining is most feasible according to technical, environmental, and logistical considerations. The one-year collaboration enables sufficient mapping, modeling, and exploration of parameters, with a focus on creating results applicable to a wide range of future scenarios. The project makes use of academic and industry knowledge to both create industry solutions and establish a starting point for further research.
Het publieke debat over issues in de huidige samenleving vindt permanent plaats. Publieke debatten kennen een golfbeweging en veranderen soms in een crisis. De gedigitaliseerde samenleving maakt de reactie van organisaties op issues vele malen ingewikkelder. In dit project staat de vraag centraal hoe communicatieprofessionals van publieke organisaties beter kunnen omgaan met publicitaire golfbewegingen van voortdurend debat, regelmatige issues en incidentele crises. Dit onderzoek is medegefinancierd door Regieorgaan SIA onderdeel van de Nederlandse Organisatie voor Wetenschappelijk Onderzoek (NWO) Doel In dit project bekijken we de online geruchtvorming en mobilisatie en de wijze waarop overheden hier mee omgaan. Het doel van het onderzoeksproject is: om inzicht te krijgen in organisatorische, interactionele, taalkundige aspecten van issuemanagement om bruikbare interventies te ontwikkelen Resultaten Het resultaat is een breed toepasbare aanpak voor communicatie bij issues die spelen in publieke organisaties. Deze aanpak wordt vertaald in een toolbox voor communicatieprofessionals en studenten communicatie. Inzichten laten nu al zien dat de data uit de 2 casussen informatie opleveren over framing vanuit de gemeenschap; de organisatie van de communicatie (Doen de juiste mensen de juiste dingen?) en inzichten óver de geruchtvorming. Het lectoraat heeft daarvoor een instrument ontwikkeld waarmee je patronen in online conversaties kunt ontdekken. Dit instrument hebben we ‘BEP’ genoemd. BEP staat voor Birds Eye Perspective. Het perspectief helpt die conversaties en eventueel daaropvolgende interacties op waarde te schatten. Je kunt inzichten uit BEP gebruiken om bewuster te zijn van de gevoeligheden en weerstanden in gesprekken die gaande zijn en aan te sluiten op wat leeft in het publieke debat. Dit stelt je in staat om in gesprek te blijven én de stap te kunnen maken naar een anticiperende communicatiestrategie.) Opgeleverde producten: Bekijk het ontwikkelde instrument via: https://husite.nl/bep/ Bekijk de slotsessie brochure Looptijd 01 februari 2021 - 01 april 2023 Aanpak In drie rondes worden vijf door de praktijkpartners ingebrachte cases onderzocht. De inzichten uit de eerste casus worden meegenomen in de volgende ronde, de gehanteerde methode blijft hetzelfde. Er wordt een combinatie gemaakt van interactieanalyse van: Online en offline data Interviews met professionals Focusgroepen met burgers. In de laatste ronde van het project worden de ontwikkelde inzichten gedeeld in de praktijk, het onderzoeksveld en het onderwijs. Voor de zomer 2021 worden 2 casussen geanalyseerd. de Schoorlse Duinen (waar bomenkap tot heftige speculaties in de media leidt) en het onderhoud aan bruggen (zoals de weg over de Merwedebrug die plots gesloten moest worden). Begin juni vindt het eerste ‘Vakgesprek’ plaats met het newsroomteam van Rijkswaterstaat, en afgevaardigden uit het beroepenveld: (beroepsvereniging Logeion, Academie voor Overheidscommunicatie), onze Communicatie-opleiding, én lectoren Cok Bakker (HU) en Els van der Pool (HAN). Annette Klarenbeek leidt het gesprek. Bekijk dit document dat een overzicht geeft van de aanpak en methodes in het project Studenten gezocht! Gedurende het project kunnen studenten een bijdrage leveren. Communicatiestudenten die betrokken willen zijn bij het vinden van innovatieve oplossingen voor issuemanagement in de gedigitaliseerde samenleving kunnen contact opnemen. Extra informatie Congres beroepspraktijk Training: Monitoring mobilization: A discursive psychological analysis of online mobilizing practices. Sneijder, P., Stinesen, B., Harmelink, M. & Klarenbeek, A The Discourse Analytical Glasses (DAG) Hoofdstuk wetenschappelijk handboek: Sneijder, P., Baukje, S., Harmelink, M. & Klarenbeek, A. (n.d.). The discourse of social movements: online mobilising practices for collective action. In: Demasi, Mirko A., Burke, Shani, Tileagă, Cristian (Eds.) (Scheduled for publication, 2021). Political Communication: Discursive Perspectives. (K/P
