Context: Only 55% of the athletes return to competitive sports after an anterior cruciate ligament (ACL) injury. Athletes younger than 25 years who return to sports have a second injury rate of 23%. There may be a mismatch between rehabilitation contents and the demands an athlete faces after returning to sports. Current return-to-sports (RTS) tests utilize closed and predictable motor skills; however, demands on the field are different. Neurocognitive functions are essential to manage dynamic sport situations and may fluctuate after peripheral injuries. Most RTS and rehabilitation paradigms appear to lack this aspect, which might be linked to increased risk of second injury.Objective: This systematic and scoping review aims to map existing evidence about neurocognitive and neurophysiological functions in athletes, which could be linked to ACL injury in an integrated fashion and bring an extensive perspective to assessment and rehabilitation approaches.Data Sources: PubMed and Cochrane databases were searched to identify relevant studies published between 2005 and 2020 using the keywords ACL, brain, cortical, neuroplasticity, cognitive, cognition, neurocognition, and athletes.Study Selection: Studies investigating either neurocognitive or neurophysiological functions in athletes and linking these to ACL injury regardless of their design and technique were included.Study Design: Systematic review. Level of Evidence: Level 3.Data Extraction: The demographic, temporal, neurological, and behavioral data revealing possible injury-related aspects were extracted and summarized.Results: A total of 16 studies were included in this review. Deficits in different neurocognitive domains and changes in neurophysiological functions could be a predisposing risk factor for, or a consequence caused by, ACL injuries.Conclusion: Clinicians should view ACL injuries not only as a musculoskeletal but also as a neural lesion with neurocognitive and neurophysiological aspects. Rehabilitation and RTS paradigms should consider these changes for assessment and interventions after injury.
The ‘Grand Challenges’ of our times, like climate change, resource depletion, global inequity, and the destruction of wildlife and biodiversity can only be addressed by innovating cities. Despite the options of tele-working, tele-trading and tele-amusing, that allow people to participate in ever more activities, wherever they are, people are resettling in cities at an unprecedented speed. The forecasted ‘rurification’ of society did not occur. Technological development has drained rural society from its main source of income, agriculture, as only a marginal fraction of the labour force is employed in agriculture in the rich parts of the world. Moreover, technological innovation created new jobs in the IT and service sectors in cities. Cities are potentially far more resource efficient than rural areas. In a city transport distances are shorter, infrastructures can be applied to provide for essential services in a more efficient way and symbiosis might be developed between various infrastructures. However, in practice, urban infrastructures are not more efficient than rural infrastructures. This paper explores the reasons why. It digs into the reasons why the symbiotic options that are available in cities are not (sufficiently) utilised. The main reason for this is not of an economic nature: Infrastructure organisations are run by experts who are part of a strong paradigmatic community. Dependence on other organisations is regarded as limiting the infrastructure organisation’s freedom of action to achieve its own goals. Expert cultures are transferred in education, professional associations, and institutional arrangements. By 3 concrete examples of urban systems, the paper will analyse how various paradigms of experts co-evolved with evolving systems. The paper reflects on recent studies that identified professional education as the initiation into such expert paradigms. It will thereby relate lack of urban innovation to the monodisciplinary education of experts and the strong institutionalised character of expertise. https://doi.org/10.1007/978-3-319-63007-6_43 LinkedIn: https://www.linkedin.com/in/karelmulder/
MULTIFILE
Experts like Jouslin de Noray, Shiba and Hardjono discern three paradigms in quality management: control, continuous improvement and breakthrough. Van Kemenade argues that before being able to reach breakthrough you need another paradigm: commitment.
Inzet van serious games als scholingsinstrument voor zorgprofessionals of als patiëntinterventie neemt sterk toe. Serious games kunnen kosten besparen en zorgkwaliteit verbeteren. (Potentiële) afnemers vragen, in lijn met het medische onderzoeksparadigma, vaak naar de klinische effectiviteit (internal validity) van deze games. Het gros van de Nederlandse game-ontwikkelaars bestaat echter uit kleine ondernemingen die het aan middelen en expertise ontbreekt om de hiervoor benodigde longitudinale onderzoekstrajecten uit te voeren. Tegelijkertijd tonen mkb’ers, meestal zonder ervan bewust te zijn, tijdens het game-ontwikkelproces al verschillende validiteitsvormen aan volgens het design-onderzoeksparadigma (face validity, construct validity, e.d.). Door dit niet bij hun afnemers kenbaar te maken, komt een constructieve dialoog over validiteit moeilijk op gang en lopen mkb’ers opdrachten mis. Het ontbreekt hen aan een begrippenkader en praktische handvatten. Bestaande raamwerken zijn nog te theorie-gedreven. Om mkb’ers te helpen de 'clash' te overbruggen tussen het medische en het design-onderzoeksparadigma, ontwikkelen lectoraten ICT-innovaties in de Zorg (Hogeschool Windesheim, penvoerder) en Serious Gaming (NHL Stenden Hogeschool) samen met elf mkb’ers, afnemers, studenten en experts in een learning community drie hulpmiddelen: •Checklist: praktische mkb-richtlijnen voor het vaststellen van validiteit; •Beslisboom: op basis waarvan mkb’ers onderbouwd de juiste validatiemethode kunnenselecteren; •Serious game: om samen met (potentiële) afnemers te spelen, zodat verschillende soortenvaliditeit expliciet benoemd worden. De hulpmiddelen worden inhoudelijk gevoed door casestudies waarin mkb’ers gevolgd worden in hoe validiteit momenteel wordt vastgesteld en geëxpliciteerd in het ontwikkelproces. Vervolgens brengen we de ontworpen hulpmiddelen in de mkb-praktijk voor evaluatie. Opgeleverde hulpmiddelen stellen mkb’ers in staat werkbare validatiemethoden toe te passen gedurende het game-ontwikkelproces om acceptabele bewijslast op te leveren voor potentiële afnemers, waardoor hun marktpositie versterkt. Ook draagt het project bij aan operationalisering van bestaande raamwerken en kunnen de hulpmiddelen in game design-curricula worden geïncorporeerd.
In my PD research, I want to focus on how collectivity is practiced in the arts, by learning from the Indonesian multidisciplinary art collective ruangrupa’s use of [the international art exhibition] ‘documenta’ as a tool, and the potential of continuing the experiences outside this group and context. The art practices programmed by ruangrupa can be understood as complex and ambiguous where art is not at the center of attention but part of a larger communal productivity. And where it is not sufficient to be merely critical, and merely voice opposition, but to engage, and create alternatives in everyday life [without being problem-solving or social design]. My research concerns the potential of continuing these practices and experiences outside this particular artist group and exhibition context. Ruangrupa’s work reveals problems of the current Western art system, how it is (hierarchically) organized, the implicit rules, norms and values it is based on. Ruangrupa's practice thus serves as an exercise and point of departure to answer questions about forms of self-organization within the art field. Its collective and multidisciplinary art practice implies the question whether it also can serve as a model for living together on a larger scale (also outside the arts), beyond hierarchies of social and professional structures. There is currently a lack of research on these particular art practices, so that they are not easily accessible for non-participants. For the art field in particular, this concerns the question whether contemporary art can and needs to take place outside established Western gallery/museum, art/curatorial paradigms and what can be learned from ruangrupa's and documenta fifteen's blending of art practice with daily life practice. This is also an urgent practical issue for art schools (including my school Willem de Kooning Academy) that increasingly develop art study programs outside the studio and gallery art paradigm.
