Objective. To investigate the feasibility and effects of additional preoperative high intensity strength training for patients awaiting total knee arthroplasty (TKA). Design. Clinical controlled trial. Patients. Twenty-two patients awaiting TKA. Methods. Patients were allocated to a standard training group or a group receiving standard training with additional progressive strength training for 6 weeks. Isometric knee extensor strength, voluntary activation, chair stand, 6-minute walk test (6MWT), and stair climbing were assessed before and after 6 weeks of training and 6 and 12 weeks after TKA. Results. For 3 of the 11 patients in the intensive strength group, training load had to be adjusted because of pain. For both groups combined, improvements in chair stand and 6MWT were observed before surgery, but intensive strength training was not more effective than standard training. Voluntary activation did not change before and after surgery, and postoperative recovery was not different between groups (P > 0.05). Knee extensor strength of the affected leg before surgery was significantly associated with 6-minute walk (r = 0.50) and the stair climb (r - = 0.58, P < 0.05). Conclusion. Intensive strength training was feasible for the majority of patients, but there were no indications that it is more effective than standard training to increase preoperative physical performance. This trial was registered with NTR2278.
Background: To avoid overexertion in critically ill patients, information on the physical demand, i.e., metabolic load, of daily care and active exercises is warranted. Objective: The objective of this study was toassess the metabolic load during morning care activities and active bed exercises in mechanically ventilated critically ill patients. Methods: This study incorporated an explorative observational study executed in a university hospital intensive care unit. Oxygen consumption (VO2) was measured in mechanically ventilated (≥48 h) critically ill patients during rest, routine morning care, and active bed exercises. We aimed to describe and compare VO2 in terms of absolute VO2 (mL) defined as the VO2 attributable to the activity and relative VO2 in mL per kilogram bodyweight, per minute (mL/kg/min). Additional outcomes achieved during the activity were perceived exertion, respiratory variables, and the highest VO2 values. Changes in VO2 and activity duration were tested using paired tests. Results: Twenty-one patients were included with a mean (standard deviation) age of 59 y (12). Median (interquartile range [IQR]) durations of morning care and active bed exercises were 26 min (21–29) and 7 min (5–12), respectively. Absolute VO2 of morning care was significantly higher than that of active bed exercises (p = 0,009). Median (IQR) relative VO2 was 2.9 (2.6–3.8) mL/kg/min during rest; 3.1 (2.8–3.7) mL/kg/min during morning care; and 3.2 (2.7–4) mL/kg/min during active bed exercises. The highest VO2 value was 4.9 (4.2–5.7) mL/kg/min during morning care and 3.7 (3.2–5.3) mL/kg/min during active bed exercises. Median (IQR) perceived exertion on the 6–20 Borg scale was 12 (10.3–14.5) during morning care (n = 8) and 13.5 (11–15) during active bed exercises (n = 6). Conclusion: Absolute VO2 in mechanically ventilated patients may be higher during morning care than during active bed exercises due to the longer duration of the activity. Intensive care unit clinicians should be aware that daily-care activities may cause intervals of high metabolic load and high ratings of perceived exertion.
Market competition and global financial uncertainty have been the principal drivers that impel aviation companies to proceed to budget cuts, including decreases in salary and work force levels, in order to ensure viability and sustainability. Under the concepts of Maslow and Herzberg’s motivation theories, the current paper unfolds the influence of employment cost fluctuations on an aviation organization’s accidents attributed to human error. This study exploited financial and accident data over a period of 13 years, and explored if rates of accidents attributed to human errors of flight, maintenance and ramp crews, correlate with the average employment expenditures (N=13). In addition, the study took into account the relationship between average task load (ratio of flying hours per employee) and accident rates related to human error since task load, as part of total workload, is a constraint of modern complex systems. The results revealed strong correlations amongst accident rates linked to human error with the average employment costs and task load. The use of more specific data per aviation organizational department and professional group may further validate the results of this study. Organizations that seek to explore the 2 association between human error and employment budget and task load might appropriately adapt the approach proposed.
In the last decade, the automotive industry has seen significant advancements in technology (Advanced Driver Assistance Systems (ADAS) and autonomous vehicles) that presents the opportunity to improve traffic safety, efficiency, and comfort. However, the lack of drivers’ knowledge (such as risks, benefits, capabilities, limitations, and components) and confusion (i.e., multiple systems that have similar but not identical functions with different names) concerning the vehicle technology still prevails and thus, limiting the safety potential. The usual sources (such as the owner’s manual, instructions from a sales representative, online forums, and post-purchase training) do not provide adequate and sustainable knowledge to drivers concerning ADAS. Additionally, existing driving training and examinations focus mainly on unassisted driving and are practically unchanged for 30 years. Therefore, where and how drivers should obtain the necessary skills and knowledge for safely and effectively using ADAS? The proposed KIEM project AMIGO aims to create a training framework for learner drivers by combining classroom, online/virtual, and on-the-road training modules for imparting adequate knowledge and skills (such as risk assessment, handling in safety-critical and take-over transitions, and self-evaluation). AMIGO will also develop an assessment procedure to evaluate the impact of ADAS training on drivers’ skills and knowledge by defining key performance indicators (KPIs) using in-vehicle data, eye-tracking data, and subjective measures. For practical reasons, AMIGO will focus on either lane-keeping assistance (LKA) or adaptive cruise control (ACC) for framework development and testing, depending on the system availability. The insights obtained from this project will serve as a foundation for a subsequent research project, which will expand the AMIGO framework to other ADAS systems (e.g., mandatory ADAS systems in new cars from 2020 onwards) and specific driver target groups, such as the elderly and novice.
De reclassering geeft haar cognitieve vaardigheidstrainingen vooral in groepen. Solo is de enige training die deelnemers een-op-een volgen. In dit vooronderzoek kijken we of Solo werkzaam is en voorziet in een behoefte. Over Solo Solo is afgeleid van het Engelse geaccrediteerde programma One-To-One. In 2016 zijn wijzingen op de programma-inhoud aangebracht: Solo heeft een praktischer insteek gekregen en is meer op de Nederlandse reclasseringspraktijk aangepast. Anno 2021 is opnieuw behoefte aan aanpassing: de sessies dienen meer op de leerdoelen te worden afgestemd en de delictanalyse kan eenvoudiger worden ingericht. Doel In dit onderzoek willen we het nut en de noodzaak voor de doorontwikkeling van Solo vaststellen, op basis van onderstaande vragen: Wat is de werkzaamheid van Solo? Op welke wijze sluit Solo aan op de behoeften van groepen cliënten en op de veranderende context? Welke regio’s voeren Solo uit (wat zijn redenen om Solo niet uit te voeren)? Welke suggesties voor doorontwikkeling worden gedaan? Als Solo bruikbaar en toepasbaar is, volgt de doorontwikkeling in een later stadium. Looptijd 01 oktober 2021 - 31 januari 2022 Aanpak Voordat aanpassingen in de training zullen worden gedaan, doen we een behoeftepeiling. Managers, coaches, trainers en deelnemers vormen de doelgroep van deze behoeftepeiling. Het vooronderzoek geeft concrete handvatten voor de doorontwikkeling en implementatie van Solo. Er worden meerdere onderzoeksmethoden ingezet: Literatuurstudie Enquête Semi-gestructureerde interviews bij reclasseringswerkers en cliënten Evaluatieformulieren bij cliënten Data-analyse IRIS Downloads en links
Cirkelen rond je onderzoek is een methodiek voor het ontwikkelen van een onderzoeksvoorstel. Binnen het project ‘Cirkelen rond je onderzoek light’ hebben we de resultaten van het project Cirkelen rond je onderzoek toegankelijk gemaakt voor penvoerders, projectleiders en procesbegeleiders door het organiseren van een korte training en het ontwikkelen van lesmateriaal. Doel Cirkelen rond je onderzoek is een methodiek voor het ontwikkelen van een onderzoeksvoorstel voor een praktijkgericht onderzoek. In praktijkgericht onderzoek is het van belang dat iedereen die betrokken is bij het onderwerp van het onderzoek betrokken wordt bij het maken van het onderzoeksvoorstel. Dit is echter niet eenvoudig. Verschillende partijen kunnen een hele andere kijk hebben op de problematiek en hele verschillende dingen willen bereiken met het onderzoek. Daarom leidt de methodiek “Cirkelen rond je onderzoek” je langs negen stappen om samen tot overeenstemming te komen. We leggen dit in 1 minuut uit in onderstaande video. Resultaten Voor penvoerders, projectleiders en procesbegeleiders zijn de volgende hulpmiddelen beschikbaar: Er is een uitgebreide handreiking van de methodiek Handreiking CRJO. Ook zijn er werkbladen beschikbaar: Werkblad Cirkelen rond je onderzoek Werkblad Doelen in je onderzoek Er zijn videokennisclips die ingaan op onderdelen van de methodiek: Toelichting op Cirkelen rond je onderzoek Interview met Niecky Fruneaux die vertelt over haar ervaringen met het toepassen van Cirkelen rond je onderzoek De kaartjesmethodiek Het gebruik van de doelenroos in Cirkelen rond je onderzoek De doelenroos uit Cirkelen rond je onderzoek als hulpmiddel bij het maken van een veranderstrategie Onderzoeksvragen en deelvragen in Cirkelen rond je onderzoek Cirkelen rond je onderzoek in actieonderzoek Rollen en taken in de uitvoeringsfase van het onderzoek Looptijd 01 februari 2022 - 31 december 2022 Aanpak De methodiek is getest binnen het ZonMW programma Langdurige Zorg en Ondersteuning. Het rapport is hier te downloaden.
