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).
Background: In postoperative pain treatment patients are asked to rate their pain experience on a single uni-dimensional pain scale. Such pain scores are also used as indicator to assess the quality of pain treatment. However, patients may differ in how they interpret the Numeric Rating Scale (NRS) score. Objectives: This study examines how patients assign a number to their currently experienced postoperative pain and which considerations influence this process. Methods: A qualitative approach according to grounded theory was used. Twenty-seven patients were interviewed one day after surgery. Results: Three main themes emerged that influenced the Numeric Rating Scale scores (0–10) that patients actually reported to professionals: score-related factors, intrapersonal factors, and the anticipated consequences of a given pain score. Anticipated consequences were analgesic administration—which could be desired or undesired—and possible judgements by professionals. We also propose a conceptual model for the relationship between factors that influence the pain rating process. Based on patients’ score-related and intrapersonal factors, a preliminary pain score was ‘‘internally’’ set. Before reporting the pain score to the healthcare professional, patients considered the anticipated consequences (i.e., expected judgements by professionals and anticipation of analgesic administration) of current Numeric Rating Scale scores. Conclusions: This study provides insight into the process of how patients translate their current postoperative pain into a numeric rating score. The proposed model may help professionals to understand the factors that influence a given Numeric Rating Scale score and suggest the most appropriate questions for clarification. In this way, patients and professionals may arrive at a shared understanding of the pain score, resulting in a tailored decision regarding the most appropriate treatment of current postoperative pain, particularly the dosing and timing of opioid administration.
BackgroundThe Observable Movement Quality scale for patients with low back pain (OMQ-LBP) is a newly developed measurement instrument for use in primary care settings of physical and exercise therapists to assess movement quality (MQ) of patients with low back pain (LBP).ObjectiveThis study aims to determine validity, reliability and feasibility of the OMQ-LBP. The OMQ-LBP consists of a standardized movement circuit (performed twice) consisting of five daily activities problematic for LBP patients, which are scored with an 11-item observation list.MethodsConstruct validity was determined by testing seven hypotheses on associations between constructs (n = 85 patients with LBP) and four hypotheses on known group differences (n = 85 patients with LBP and n = 63 healthy controls; n = 35 matched participant-patients having VAS-pain ≥ 20 mm during and/or after both circuits and healthy controls). Internal consistency was analyzed with Cronbach’s alpha (n = 85 patients with LBP). For inter- and intra-rater reliability Intraclass Correlation Coefficient (ICC) values were examined (n = 14 therapists: seven primary care physical therapists and seven exercise therapists). Additionally, content validity and feasibility were determined using thematic analysis of a brief interview with participants, patients (n = 38) and therapists (n = 14).ResultsAfter Bonferroni correction 2/7 associations between constructs and 2/4 significant group differences were confirmed. Cronbach’s alpha was 0,79. The ICC-values of interrater reliability of the OMQ-LBP total score and the duration score were 0.56 and 0.99 and intra-rater reliability 0.82 and 0,93, respectively. Thematic analysis revealed five themes. Three themes elucidate that both patients and therapists perceived the content of the OMQ-LBP as valid. The fourth theme exhibits that OMQ-LBP provides a clear and unambiguous language for MQ in patients with LBP. Theme 5 depicts that the OMQ-LBP seems feasible, but video recording is time-consuming.ConclusionsThe OMQ-LBP is a promising standardized observational assessment of MQ during the five most problematic daily activities in patients with LBP. It is expected that uniform and objective description and evaluation of MQ add value to clinical reasoning and facilitate uniform communication with patients and colleagues.
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.
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.
Dit strategische partnerschap is een krachtige transnationale samenwerking tussen internationale hogescholen / universiteiten die opleidingen fysiotherapie aanbieden. De samenwerking is gericht op het innoveren, verbeteren en standaardiseren van pijnwetenschap in de bachelor fysiotherapie curricula.Doel De samenwerking is gericht op het innoveren, verbeteren en standaardiseren van pijnwetenschap in de bachelor fysiotherapie curricula. Resultaten Dit project van 2 jaar zal resulteren in drie intellectuele outputs (IO's) gehuisvest op een open pain education resource (OPER). Looptijd 17 januari 2022 - 16 januari 2024 Aanpak We nemen de volgende stappen: O1: BEHOEFTEANALYSE: pijnwetenschap in de bachelor curricula van partners zullen worden vergeleken met internationale best practices (European Pain Federation) om hiaten in het leren te identificeren. O2: CAPACITEITSBOUW: Partners zullen deelnemen aan twee weken durende 'train de trainer'-scholen om hun kennis / vaardigheden in het curriculum te vergroten, door innovatieve onderwijs- en leerpraktijken te integreren op basis van evidence-based professionele praktijk waarin de nieuwste kennis van pijnwetenschap is verwerkt. O3: AANPAK BEPERKINGEN: Er wordt een dynamische OPER ontwikkeld die geïdentificeerde beperkingen aanpakt om academici te ondersteunen bij het leren van studenten in heel Europa en daarbuiten, op creatieve wijze met behulp van een verscheidenheid aan onderwijs- en beoordelingsmethoden om de leermogelijkheden voor studenten te vergroten (e-learning, probleemoplossing -gebaseerd leren en case studies). Het zal ook de output van IO1 (methodologie van leerplanverbeteringsproces) en IO2 (train-de-trainer programmabronnen) opnemen.
