The Nociception Coma Scale (NCS) is a pain observation tool, developed for patients with disorders of consciousness (DOC) due to acquired brain injury (ABI). The aim of this study was to assess the interrater reliability of the NCS and NCS-R among nurses for the assessment of pain in ABI patients with DOC. A secondary aim was further validation of both scales by assessing its discriminating abilities for the presence or absence of pain. Hospitalized patients with ABI (n = 10) were recorded on film during three conditions: baseline, after tactile stimulation, and after noxious stimulation. All stimulations were part of daily treatment for these patients. The 30 recordings were assessed with the NCS and NCS-R by 27 nurses from three university hospitals in the Netherlands. Each nurse viewed 9 to 12 recordings, totaling 270 assessments. Interrater reliability of the NCS/NCS-R items and total scores were estimated by intraclass correlations (ICC), which showed excellent and equal average measures reliability for the NCS and NCR-R total scores (ICC 0.95), and item scores (range 0.87-0.95). Secondary analysis was performed to assess differences in ICCs among nurses' education and experience and to assess the scales discriminating properties for the presence of pain. The NCS and NCS-R are valid and reproducible scales that can be used by nurses with an associate (of science) in nursing degree or baccalaureate (of science) in nursing degree. It seems that more experience with ABI patients is not a predictor for good agreement in the assessment of the NCS(-R).
Objective To develop and internally validate a prognostic model to predict chronic pain after a new episode of acute or subacute non-specific idiopathic, non-traumatic neck pain in patients presenting to physiotherapy primary care, emphasising modifiable biomedical, psychological and social factors. Design A prospective cohort study with a 6-month follow-up between January 2020 and March 2023. Setting 30 physiotherapy primary care practices. Participants Patients with a new presentation of non-specific idiopathic, non-traumatic neck pain, with a duration lasting no longer than 12 weeks from onset. Baseline measures Candidate prognostic variables collected from participants included age and sex, neck pain symptoms, work-related factors, general factors, psychological and behavioural factors and the remaining factors: therapeutic relation and healthcare provider attitude. Outcome measures Pain intensity at 6 weeks, 3 months and 6 months on a Numeric Pain Rating Scale (NPRS) after inclusion. An NPRS score of ≥3 at each time point was used to define chronic neck pain. Results 62 (10%) of the 603 participants developed chronic neck pain. The prognostic factors in the final model were sex, pain intensity, reported pain in different body regions, headache since and before the neck pain, posture during work, employment status, illness beliefs about pain identity and recovery, treatment beliefs, distress and self-efficacy. The model demonstrated an optimism-corrected area under the curve of 0.83 and a corrected R2 of 0.24. Calibration was deemed acceptable to good, as indicated by the calibration curve. The Hosmer–Lemeshow test yielded a p-value of 0.7167, indicating a good model fit. Conclusion This model has the potential to obtain a valid prognosis for developing chronic pain after a new episode of acute and subacute non-specific idiopathic, non-traumatic neck pain. It includes mostly potentially modifiable factors for physiotherapy practice. External validation of this model is recommended.
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Migraine, tension-type headache (TTH) and headaches attributed to temporomandibular disorders (TMD) are prevalent in patients with TMD-pain. The objective was to describe the course of headache complaints as compared to the course of TMD complaints in TMD-pain patients with headache during usual care multidisciplinary treatment for TMD. This was a 12-week longitudinal observational study following adults with TMD-pain and headache during a usual-care multidisciplinary TMD-treatment. The Graded Chronic Pain Scale was used for both TMD and headache to measure pain-related disability (primary outcome measure), pain intensity, days with pain and days experiencing disability (secondary outcome measures). Stratified for the headache type, general linear modelling for repeated measures was used to analyze changes over time in the TMD complaints and the headache complaints. TMD-pain patients with migraine (n = 22) showed significant decrease of pain-related disability for both TMD and headache complaints over time. No difference in the effect over time was found between the two complaints. Patients with TMD-pain and TTH (n = 21) or headache attributed to TMD (n = 17) did not improve in disability over time. For the secondary outcome measures, the results were equivocal. In conclusion, TMD-pain patients with migraine, improvement in TMD-related disability was comparable to headache-related disability for TMD-pain patients with TTH or with headache attributed to TMD, no improvements in disability were found.
Chemical preservation is an important process that prevents foods, personal care products, woods and household products, such as paints and coatings, from undesirable change or decomposition by microbial growth. To date, many different chemical preservatives are commercially available, but they are also associated with health threats and severe negative environmental impact. The demand for novel, safe, and green chemical preservatives is growing, and this process is further accelerated by the European Green Deal. It is expected that by the year of 2050 (or even as soon as 2035), all preservatives that do not meet the ‘safe-by-design’ and ‘biodegradability’ criteria are banned from production and use. To meet these European goals, there is a large need for the development of green, circular, and bio-degradable antimicrobial compounds that can serve as alternatives for the currently available biocidals/ preservatives. Anthocyanins, derived from fruits and flowers, meet these sustainability goals. Furthermore, preliminary research at the Hanze University of Applied Science has confirmed the antimicrobial efficacy of rose and tulip anthocyanin extracts against an array of microbial species. Therefore, these molecules have the potential to serve as novel, sustainable chemical preservatives. In the current project we develop a strategy consisting of fractionation and state-of-the-art characterization methods of individual anthocyanins and subsequent in vitro screening to identify anthocyanin-molecules with potent antimicrobial efficacy for application in paints, coatings and other products. To our knowledge this is the first attempt that combines in-depth chemical characterization of individual anthocyanins in relation to their antimicrobial efficacy. Once developed, this strategy will allow us to single out anthocyanin molecules with antimicrobial properties and give us insight in structure-activity relations of individual anthocyanins. Our approach is the first step towards the development of anthocyanin molecules as novel, circular and biodegradable non-toxic plant-based preservatives.
Thermoset materials find use in almost all industrial sectors, especially where lightweight, stiffness, resistance and dimensional stability are key performance requirements. However, traditional thermosets suffer from several drawbacks: they are made of fossil-based non-reversible polymers and toxic monomers; more importantly, thermosetting materials are virtually neither recyclable nor reprocessable, due to their crosslinked microstructure. Currently, most thermoset materials are incinerated or accumulated in landfills at the end of their life. Landfill waste degrades to liquids known as landfill leachates that lead to health and environmental problems. A significant part of these wastes originate from thermoset materials used in paints, coatings, sealants and adhesives applied as a thin film to all sorts of surfaces. These unrecyclable materials contribute to nano- and microplastic formation. Despite many efforts in the past years in this context, substantial further developments are required. Production of thermosets from biobased feedstocks using safe and sustainable-by-design approaches is therefore crucial to address the well-being of people and to have a healthy planet.SMARTCASE aims to develop safe and circular carbohydrate-derived reactive polyester resins for coatings, adhesives, sealants and elastomers for application in the building and interior sectors. The new two-component (‘2K’) formulations are designed to replace currently used fossil-based epoxy and urethane resins by biobased and GHS-label-friendly alternatives. This not only improves the safety of workers and end-users of these materials, but also reduces the dependency on fossil resources and facilitates the transition towards abundantly available biobased raw materials.A new class of biobased polyesters resins and thermosets will be designed in SMARTCASE using safe and sustainable by design approaches allowing for more sustainable and feasible end-of-life options. Biobased polyesters in general meet the requirements of circularity, as they can be efficiently recycled back to their monomers at end-of-life. Accordingly, the recycling and degradation behavior of the developed formulations under thermal, mechanical and chemical conditions and their biodegradation will be studied. Hence, the output of the project contributes to the main goals of the NGF BioBased Circular program.The project follows a value-cycle approach with a multi-disciplinary and balanced consortium of industrial representatives from every part of the value chain, from carbohydrate feedstock suppliers to resin formulators and end users. This enables a system innovation instead of a (single) product innovation. The following results are expected within 10 years (mostly by the end of the project ): - Sustainable feedstock platform for novel biobased (BB) platform chemicals- Access to novel monomers and building blocks- Access to safe and novel polyester-based resin components- Access to high performance, safe and circular thermoset formulations- Scale-up of the best thermoset formulations- Validated performance of novel thermoset formulations in industrial applications- Sustainable and circular-by-design thermoset formulations with defined end-of-life solutions - Data on LCA, TEA, toxicity and sustainability- Engaged stakeholders and effective dissemination of project outcomes By ensuring these results are implemented by industrial partners both during and after the project, they will benefit not only stakeholders, chemical industries, and consortium partners but also the general public.
The project ‘Towards resilient leisure, tourism and hospitality (LTH) ecosystems in Europe’ addresses the critical problem of unsustainable practices in the tourism and travel industry. The LTH industry is ‘back on track’ after recovering from the global Covid-19 crisis. Destinations show increased numbers of international arrivals and rapid growth of tourism-related revenues. It is foreseen that cities like Amsterdam, but also vulnerable natural areas, will receive record numbers of visitors in the coming decade. The dominant economic model operating within the industry nonetheless prioritizes short-term gains, resulting in extreme exploitation of resources, labour, and local communities, evidenced by negative impacts in European destinations like Venice and the Canary Islands. The project aims to shift the industry’s focus to long-term sustainability, addressing systemic constraints and facilitating a transition that aligns with European priorities for a sustainable and just future. It builds vital connections between regional, national, and European research priorities by addressing and advocating for climate and social justice. Regionally, it investigates best practices across diverse tourism environments in Finland, Spain, Sweden, the UK, Scotland, and The Netherlands. Nationally, it challenges the status quo by proposing alternative governance frameworks that individual countries could adopt to encourage sustainable tourism practices. On a European scale, the project aligns with EU goals of climate action and sustainable development, supporting objectives of the European Green Deal and the United Nations Sustainable Development Goals (SDGs). It aims to build solid theoretical foundations necessary for a transition towards more resilient and environmentally and socially inclusive LTH ecosystems. Through integrating insights from multiple regions, the project transcends local boundaries and offers scalable solutions that can influence policy and industry standards at both national and European levels. The project's transdisciplinary nature ensures that proposed solutions are grounded in diverse eco-socioeconomic contexts, making them robust and adaptable.
