Introduction: Retrospective studies suggest that a rapid initiation of treatment results in a better prognosis for patients in the emergency department. There could be a difference between the actual medication administration time and the documented time in the electronic health record. In this study, the difference between the observed medication administration time and documentation time was investigated. Patient and nurse characteristics were also tested for associations with observed time differences. Methods: In this prospective study, emergency nurses were followed by observers for a total of 3 months. Patient inclusion was divided over 2 time periods. The difference in the observed medication administration time and the corresponding electronic health record documentation time was measured. The association between patient/nurse characteristics and the difference in medication administration and documentation time was tested with a Spearman correlation or biserial correlation test. Results: In 34 observed patients, the median difference in administration and documentation time was 6.0 minutes (interquartile range 2.0-16.0). In 9 (26.5%) patients, the actual time of medication administration differed more than 15 minutes with the electronic health record documentation time. High temperature, lower saturation, oxygen-dependency, and high Modified Early Warning Score were all correlated with an increasing difference between administration and documentation times. Discussion: A difference between administration and documentation times of medication in the emergency department may be common, especially for more acute patients. This could bias, in part, previously reported time-to-treatment measurements from retrospective research designs, which should be kept in mind when outcomes of retrospective time-to-treatment studies are evaluated.
BACKGROUND: Whether hip range of motion (ROM) is a risk factor for groin pain in athletes is not known.OBJECTIVES: To systematically review the relationship between hip ROM and groin pain in athletes in cross-sectional/case-control and prospective studies.STUDY DESIGN: Systematic review, prospectively registered (PROSPERO) according to PRISMA guidelines.METHODS: Pubmed, Embase, CINAHL and SPORTDiscus were systematically searched up to December 2015. Two authors performed study selection, data extraction/analysis, quality assessment (Critical Appraisal Skills Programme) and strength of evidence synthesis.RESULTS: We identified seven prospective and four case-control studies. The total quality score ranged from 29% to 92%. Heterogeneity in groin pain classification, injury definitions and physical assessment precluded data pooling. There was strong evidence that total rotation of both hips below 85° measured at the pre-season screening was a risk factor for groin pain development. Strong evidence suggested that internal rotation, abduction and extension were not associated with the risk or presence of groin pain.CONCLUSION: Total hip ROM is the factor most consistently related to groin pain in athletes. Screening for hip ROM is unlikely to correctly identify an athlete at risk of developing groin pain because of the small ROM differences found and poor ROM measurement properties.
OBJECTIVE: The association between groin pain and range of motion is poorly understood. The aim of this study was to develop a test to measure sport specific range of motion (SSROM) of the lower limb, to evaluate its reliability and describe findings in non-injured (NI) and injured football players.DESIGN: Case-controlled.SETTING: 6 Dutch elite clubs, 6 amateur clubs and a sports medicine practice.PARTICIPANTS: 103 NI elite and 83 NI amateurs and 57 football players with unilateral adductor-related groin pain.MAIN OUTCOME MEASURES: Sport specific hip extension, adduction, abduction, internal and external rotation of both legs were examined with inclinometers. Test-retest reliability (ICC), standard error of measurement (SEM) and minimal detectable change (MDC) were calculated. Non-injured players were compared with the injured group.RESULTS: Intra and inter tester ICCs were acceptable and ranged from 0.90 to 0.98 and 0.50-0.88. SEM ranged from 1.3 to 9.2° and MDC from 3.7 to 25.6° for single directions and total SSROM. Both non-injured elite and amateur players had very similar total SSROM in non-dominant and dominant legs (188-190, SD ± 25). Injured players had significant (p < 0.05) total SSROM deficits with 187(SD ± 31)° on the healthy and 135(SD ± 29)° on the injured side.CONCLUSION: The SSROM test shows acceptable reliability. Loss of SSROM is found on the injured side in football players with unilateral adductor-related groin pain. Whether this is the cause or effect of groin pain cannot be stated due to the study design. Whether restoration of SSROM in injured players leads to improved outcomes should be investigated in new studies.
Cell-based production processes in bioreactors and fermenters need to be carefully monitored due to the complexity of the biological systems and the growth processes of the cells. Critical parameters are identified and monitored over time to guarantee product quality and consistency and to minimize over-processing and batch rejections. Sensors are already available for monitoring parameters such as temperature, glucose, pH, and CO2, but not yet for low-concentration substances like proteins and nucleic acids (DNA). An interesting critical parameter to monitor is host cell DNA (HCD), as it is considered an impurity in the final product (downstream process) and its concentration indicates the cell status (upstream process). The Molecular Biosensing group at the Eindhoven University of Technology and Helia Biomonitoring are developing a sensor for continuous biomarker monitoring, based on Biosensing by Particle Motion. With this consortium, we want to explore whether the sensor is suitable for the continuous measurement of HCD. Therefore, we need to set-up a joint laboratory infrastructure to develop HCD assays. Knowledge of how cells respond to environmental changes and how this is reflected in the DNA concentration profile in the cell medium needs to be explored. This KIEM study will enable us to set the first steps towards continuous HCD sensing from cell culture conditions controlling cell production processes. It eventually generates input for machine learning to be able to automate processes in bioreactors and fermenters e.g. for the production of biopharmaceuticals. The project entails collaboration with new partners and will set a strong basis for subsequent research projects leading to scientific and economic growth, and will also contribute to the human capital agenda.
DOK4CT (in Dutch: Digitale Onderwijsmiddelen en Kennisontsluiting for Control Towers)In this project the practical applied knowledge, derived from innovative projects within the “Topsector logistiek”, is made accessible by Breda University and Deltago. This online Control Tower Course is specifically meant for logistic professionals and students in logistic orientated education. The project was made accesible and supported by the NWO, Netherlands Organisation for Scientific Research. The scope of this project is limited to the area of Cross Chain Control Centers (4C) / Control Towers. The educational valorisation will be executed by the development of digital materials. These are used for student education as well as dissemination towards professionals in the logistics sector. Hereby, the interaction between students and professionals is an important additional benefit under the name of “social learning”. For example the interviews that Marcel Wouterse (Deltago and lecturer at Breda University of Applied Sciences) has created with key partners in the logistics sector were recorded and edited by students. By the use of digital educational tools and serious games, the benefits of Control Towers are now visible for students and professionals. The next phase is to introduce the gained knowledge in future organisations in order to support the Netherlands in the top of the logistics sector.Project goalThe goal of this project is to improve the exploitation of fundamental- and applied knowledge in the expertise area of Cross Chain Control Centers (4C) and Control Towers (CT).The tasks are divided in five subprojects:1. Preparations to transfer existing materials in digital learning tools;2. Shape digital education material (Webinars, online platform, knowledge clips and e-learnings)3. Develop and/or use several serious games (Convoy game / Synchromania)4. Promotion of the course to specified target groups (professionals / international students)5. Project managementExcising knowledge regarding Cross Chain Control Centers and Control Towers is used in this project. New knowledge will not be generated. The project focus lies on the disclosure of acquired knowledge by digital learning tools.
Bewegingsarmoede en aanverwante (gezondheids-gerelateerde) aandoeningen vormen een grote uitdaging in de samenleving. Terwijl veel aandoeningen zich pas relatief laat manifesteren (tijdens volwassenheid), wordt de basis hiervoor gelegd tijdens de jonge kinderjaren. Precies in deze vroege levensfase wordt goed en voldoende bewegen nog als bijvangst beschouwd. Er is weinig specifieke aandacht en ruimte hiervoor binnen de voorschoolse periode en in de kleuterjaren in het basisonderwijs. Oftewel, een goede basis cq. actief fundament ontbreekt, waarmee oneerbiedig gesteld kan worden dat het ‘dweilen met de kraan open is’. Zowel professionals in de kinderopvang (<4 jaar) en in het (kleuter)onderwijs staan zeer welwillend tegenover het faciliteren van meer en beter bewegen voor kinderen, maar ervaren diverse barrières om dit ook goed te kunnen realiseren in de praktijk. Zo ervaren zij bijvoorbeeld handelingsverlegenheid, verschillen in systemen (o.a. wet- en regelgeving) tussen kinderopvang en basisonderwijs die transitie van ene naar andere setting bemoeilijken en een niet-stimulerende fysieke omgeving. De opkomst van Integrale Kindcentra (IKC), die zich richten op de levensfase 0-12 jaar, biedt hierin veel mogelijkheden voor verbetering. Dit projectvoorstel richt zich op het ontwikkelen van passende aanpak op IKC gericht op beweegstimulering en motorische ontwikkeling voor kinderen van 2-7 jaar met als doel beweeggedrag, motorische vaardigheden en sociaal-emotioneel welbevinden van kinderen te verbeteren. In dit longitudinale, quasi-experimenteel onderzoek wordt middels een ontwerpgerichte benadering een passende aanpak gerealiseerd waarin de bestaande barrières structureel worden geslecht. Het project vindt plaats in 3 regio’s in Nederland (Zuid-Limburg, Eindhoven, Amsterdam). In elke regio nemen 3 IKC deel als interventiegroep (totaal 9) en 9 IKC fungeren als controleconditie. Het project wordt vormgegeven vanuit de disciplines sport & bewegen, pedagogiek en gezondheidsbevordering en wordt ondersteund door diverse branche- en belangenorganisaties (zoals BMK, PPinK, BOinK, KVLO) en bestaande landelijke initiatieven (Gezonde School/Gezonde Kinderopvang).
