Description: The Neck Pain and Disability Scale (NPDS or NPAD) is a questionnaire aiming to quantify neck pain and disability.1 It is a patient-reported outcome measure for patients with any type of neck pain, of any duration, with or without injury.1,2 It consists of 20 items: three related to pain intensity, four related to emotion and cognition, four related to mobility of the neck, eight related to activity limitations and participation restrictions and one on medication.1,3 Patients respond to each item on a 0 to 5 visual analogue scale of 10 cm. There is also a nine-item short version.4 Feasibility: The NPDS is published and available online (https://mountainphysiotherapy.com.au/wp-content/uploads/2016/08/Neck-Pain-and-Disability-Scale.pdf).1 The NPDS is an easy to use questionnaire that can be completed within 5 to 8 minutes.1,5 There is no training needed to administer the instrument but its validity is compromised if the questionnaire must be read to the patient.2 Higher scores indicate higher severity (0 for normal functioning to 5 for the worst possible situation ‘your’ pain problem has caused you).2 The total score is the sum of scores on the 20 items (0 to 100).1 The maximum acceptable number of missing answers is three (15%).4 Two studies found a minimum important change of 10 points (sensitivity 0.93; specificity 0.83) and 11.5 points (sensibility 0.74; specificity 0.70), respectively.6,7 The NPDS is available in English, Dutch, Finnish, French, German, Italian, Hindi, Iranian, Korean, Turkish, Japanese and Thai. Reliability and validity: Two systematic reviews have evaluated the clinimetric properties of 11 of the translated versions.5,8 The Finnish, German and Italian translations were particularly recommended for use in clinical practice. Face validity was established and content validity was confirmed by an adequate reflection of all aspects of neck pain and disability.1,8 Regarding structural validity, the NPDS is a multidimensional scale, with moderate evidence that the NPDS has a three-factor structure (with explained variance ranging from 63 to 78%): neck dysfunction related to general activities; neck pain and neck-specific function; and cognitive-emotional-behavioural functioning. 4,5,9 A recent overview of four systematic reviews found moderate-quality evidence of high internal consistency (Cronbach’s alphas ranging from 0.86 to 0.93 for the various factors).10 Excellent test-retest reliability was found (ICC of 0.97); however, the studies were considered to be of low quality.3,10 Construct validity (hypotheses-testing) seems adequate when the NPDS is compared with the Neck Disability Index and the Global Assessment of Change with moderate to strong correlations (r = 0.52 to 0.86), based on limited moderate-quality studies.3,11,12 One systematic review reported good responsiveness to change in patients (r = 0.59).12
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OBJECTIVES: The Behavioral Pain Scale (BPS) and Critical-Care Pain Observation Tool (CPOT) are behavioral pain assessment tools for sedated and unconscious critically ill patients. The aim of this study was to compare the reliability, internal consistency, and discriminant validation of the BPS and the CPOT simultaneously in mechanically ventilated patients after cardiac surgery.DESIGN: A prospective, observational cohort study.SETTING: A 20-bed closed-format intensive care unit with mixed medical, surgical, and cardiac surgery patients in a teaching hospital in Amsterdam, The Netherlands.PARTICIPANTS: The study comprised 72 consecutive intubated and mechanically ventilated patients after cardiac surgery who were not able to self-report pain.MEASUREMENTS AND MAIN RESULTS: Two nurses assessed the BPS and CPOT simultaneously and independently at the following 4 moments: rest, a nonpainful procedure (oral care), rest, and a painful procedure (turning). Both scores showed a significant increase of 2 points between rest and turning. The median BPS score of nurse 1 showed a significant increase of 1 point between rest and the nonpainful procedure (oral care), whereas both median CPOT scores did not change. The interrater reliability of the BPS and CPOT showed fair-to-good agreement of 0.74 overall. During the periods of rest 1 and rest 2, values ranged from 0.24 to 0.46. Cronbach's alpha values for the BPS were 0.62 (nurse 1) and 0.59 (nurse 2) compared with 0.65 and 0.58, respectively, for the CPOT.CONCLUSIONS: The BPS and CPOT are reliable and valid pain assessment tools in a daily clinical setting. However, the discriminant validation of both scores seems less satisfactory in sedated or agitated patients and this topic requires further investigation.
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Pain in critically ill adults with burns should be assessed using structured pain behavioural observation measures. This study tested the clinimetric qualities and usability of the behaviour pain scale (BPS) and the critical-care pain observation tool (CPOT) in this population. This prospective observational cohort study included 132 nurses who rated pain behaviour in 75 patients. The majority of nurses indicated that BPS and CPOT reflect background and procedural pain-specific features (63–72 and 87–80%, respectively). All BPS and CPOT items loaded on one latent variable (≥0.70), except for compliance ventilator and vocalisation for CPOT (0.69 and 0.64, respectively). Internal consistency also met the criterion of ≥0.70 in ventilated and non-ventilated patients for both scales, except for non-ventilated patients observed by BPS (0.67). Intraclass correlation coefficients (ICCs) of total scores were sufficient (≥0.70), but decreased when patients had facial burns. In general, the scales were fast to administer and easy to understand. Cut-off scores for BPS and CPOT were 4 and 1, respectively. In conclusion, both scales seem valid, reliable, and useful for the measurement of acute pain in ICU patients with burns, including patients with facial burns. Cut-off scores associated with BPS and CPOT for the burn population allow professionals to connect total scores to person-centred treatment protocols.
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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.
