Early mobilisation after abdominal surgery is necessary to avoid complications and increase recovery. However, due to a variety of factors, failure of early mobilisation is seen in clinical practice. The aim of this study is to investigate the perspectives of nurses and patients of the Haaglanden Medical Center (HMC) how to increase mobilisation frequency after colorectal surgery in the oncological surgery ward. This explorative study employed qualitative data collection and analysis by means of semi-structured interviews with patients and nurses. Patients were included when they had a colorectal resection, were older than 18 years and spoke Dutch. The interviews were audiotaped and verbatum transcribed. A thematic content analysis was performed. It was concluded that mobilisation can be increased when it is incorporated in daily care activities and family support during visiting hours. Appropriate information about mobilisation and physical activity is needed for nurses, patients and family and the hospital environment should stimulate mobilisation.
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In line with discursive psychology’s re-specification of psychological categories as discursive practices, this chapter focuses on everyday mobilisation as social action. We analyse online communication on Facebook Event pages of local social movements, designed to mobilise for political gatherings such as demonstrations. The aim of the chapter is to explore how language is used to make available the social action of mobilizing for collective events such as demonstrations. In addition to other perspectives on the role of language in mobilisation, the discursive psychological perspective takes into account both the rhetorical and the interactional features of online calls for collective action participation. Members of social movements construct calls for participation in collective action as appropriate or fair by carefully managing their reasonableness. In dit hoofdstuk wordt alledaagse mobilisatie behandeld als een sociale handeling, vanuit een discursief-psychologisch perspectief. Dit perspectief herformuleert psychologische categorieën als discursieve praktijken. We analyseren online communicatie op Facebook Event pagina’s van sociale bewegingen, die ontworpen zijn om mensen op te roepen deel te nemen aan bijeenkomsten zoals demonstraties. Het doel van dit hoofdstuk is in kaart te brengen hoe taal wordt gebruikt om mobilisatie voor collectieve gebeurtenissen mogelijk te maken. In aanvulling op andere perspectieven op de rol van taal in mobilisatie, wordt gekeken naar de interactionele en retorische aspecten van oproepen tot deelname aan collectieve acties. Leden van sociale bewegingen construeren de motieven voor deze oproepen als redelijk en weerleggen daarmee het idee dat ze handelen uit activistische motieven.
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The Middle East and North Africa region has been absent form stocktaking exercises on social accountability initiatives (SAI), an umbrella term to designate citizen-led tools aimed at socio-political change. We argue that this sidelining is unwarranted, given the proliferation of participatory governance initiatives, civic associations and popular mobilisation in Arab societies after 2011. Whereas the struggle for improved accountability in the Arab world remains under-researched, analysis of authoritarian regime tactics has proliferated. The fact is, however, that many Arab societies have experimented with mechanisms to apply political pressure on corrupt elites while international donors have launched diverse SAIs, including community score cards and participatory and gender-responsive budgeting initiatives. In this chapter, we first identify this double gap: not only has the literature on SAIs overlooked the MENA region but scholarship on the Middle East has largely failed to recognise initiatives launched across the region over the past decade as SAIs. Then, we aim to address the blind spot of Arab SAI’s as pathways towards improved governance. Finally, we present an overview of extant literature and introduce a set of four research questions to better understand what social accountability means for people on the ground. These questions focus on the various meanings of social accountability (musā’ala vs muhāsaba), its modes of mobilisation, the responses from authorities to such initiatives and their overall outcomes.
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In this chapter, we first summarise the findings from the country chapters on the multiple meanings of SA, documenting terms, translations and contrasting understandings between citizens and public officials. Second, we highlight how civil mobilisation tends to be cyclical over time and is often mediated by brokers. Strategies to spur stakeholders into action rely on a delicate balance of both collaboration and confrontation. Third, we examine the responses from authorities to SAIs, finding that reactions are uneven and that all civic innovators fear appropriation or co-optation by officials. Fourth, we assess overall outcomes of Arab SAIs and highlight that the transformative potential of SAIs exists especially at municipal level, if four conditions for success are present (trust, proximity, endorsement, evaluation). We also point out that the actual outcomes of SAIs in Arab societies have, so far, been limited due to design deficiencies (emphasising short-term objectives and limited context sensitivity) or because of officials’ resistance in active or passive forms. We characterise SAIs as a discursive action format that is best understood with a relational approach to power. In a final section, we formulate recommendations for activists, officials and donors on how to make SAIs more effective.
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Rationale To improve the quality of exercise-based cardiac rehabilitation (CR) in patients with chronic heart failure (CHF) a practice guideline from the Dutch Royal Society for Physiotherapy (KNGF) has been developed. Guideline development A systematic literature search was performed to formulate conclusions on the efficacy of exercise-based intervention during all CR phases in patients with CHF. Evidence was graded (1–4) according the Dutch evidence-based guideline development criteria. Clinical and research recommendations Recommendations for exercise-based CR were formulated covering the following topics: mobilisation and treatment of pulmonary symptoms (if necessary) during the clinical phase, aerobic exercise, strength training (inspiratory muscle training and peripheral muscle training) and relaxation therapy during the outpatient CR phase, and adoption and monitoring training after outpatient CR. Applicability and implementation issues This guideline provides the physiotherapist with an evidence-based instrument to assist in clinical decision-making regarding patients with CHF. The implementation of the guideline in clinical practice needs further evaluation. Conclusion This guideline outlines best practice standards for physiotherapists concerning exercise-based CR in CHF patients. Research is needed on strategies to improve monitoring and follow-up of the maintenance of a physical active lifestyle after supervised CR.
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Background To improve the quality of exercise-based cardiac rehabilitation (CR) in patients with coronary heart disease (CHD) the CR guideline from the Dutch Royal Society for Physiotherapists (KNGF) has been updated. This guideline can be considered an addition to the 2011 Dutch Multidisciplinary CR guideline, as it includes several novel topics. Methods A systematic literature search was performed to formulate conclusions on the efficacy of exercise-based interventions during all CR phases in patients with CHD. Evidence was graded (1–4) according the Dutch evidence-based guideline development (EBRO) criteria. In case of insufficient scientific evidence, recommendations were based on expert opinion. This guideline comprised a structured approach including assessment, treatment and evaluation. Results Recommendations for exercise-based CR were formulated covering the following topics: preoperative physiotherapy, mobilisation during the clinical phase, aerobic exercise, strength training, and relaxation therapy during the outpatient rehabilitation phase, and adoption and monitoring of a physically active lifestyle after outpatient rehabilitation. Conclusions There is strong evidence for the effectiveness of exercise-based CR during all phases of CR. The implementation of this guideline in clinical practice needs further evaluation as well as the maintenance of an active lifestyle after supervised rehabilitation. LinkedIn: https://www.linkedin.com/in/tinusjongert/
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Study design: A secondary analysis of a systematic review. Background: Manipulations or mobilizations are commonly used interventions in patients with mechanical neck pain. The treatment effects have often been studied in randomized controlled trials (RCT) which are generally considered the gold standard in evaluating the treatment effects, mainly due to its high internal validity. External validity is defined as the extent to which the effects can be generalised to clinical practice. An important prerequisite for this is that interventions used in clinical trials can be replicated in clinical practice. It can be questioned if interventions utilized in randomized controlled trials can be translated into clinical practice. Objectives: The overall aim of this study is to examine whether the quality of the description of manipulation and mobilization interventions is sufficient for to replication of these interventions in clinical practice. Methods: A comprehensive literature search was performed. Two independent researchers used the Template for Intervention Description and Replication (TIDieR) which is a 12-item checklist for describing the completeness of the interventions. Results: Sixty-seven articles were included that used manipulation and/or mobilization interventions for patients with mechanical neck pain. None of the articles describe the intervention e.g. all the items on the TIDieR list. Considering item 8 (a-f) of the TIDieR checklist only one article described the used techniques completely. Conclusion: Manipulation or a mobilization interventions are poorly reported in RCTs, which jeopardize the external validity of RCTs, making it difficult for clinicians and researchers to replicate these interventions.
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Purpose: A model is developed to analyse what personality traits impact entrepreneurial cognitive and social strategic decision-making skills, originating from the effectuation framework. Design/methodology/approach: 128 participants from an entrepreneurial pre-launch programme were assessed by experienced incubator and business coaches. Personality was measured by a Big Five test. Based on a confirmatory factor analysis, the relationships were analysed between personality and three core dimensions of the effectuation framework: 1) the bird-in-hand principle, 2) the crazy quilt principle and 3) the pilot in the plane principle. Findings: Specific patterns (moderation effects) as opposed to levels of personality traits proved to be relevant. The bird-in-hand and the crazy quilt principles are related to the moderating effect between sensitivity to feedback, sociability and ambition. The pilot in the plane principle was related to the whole pattern of entrepreneurial key qualities embedded in the extraversion domain. Furthermore, relationships of personality with key issues in the effectuation framework were found, examples being reflecting on a high diversity of means or on own talents, conducting a thorough risk analysis and engaging in inspirational networking. The final model revealed a direct positive influence of the capacity to conduct a thorough risk analysis on the overall capacity to apply the effectuation principles. Originality/value: The research results offer deeper insights for the mobilisation and development of complex entrepreneurial behaviours. https://doi.org/10.1108/IJEBR-06-2019-0343 LinkedIn: https://www.linkedin.com/in/rainer-hensel-phd-8ba44a43/ https://www.linkedin.com/in/ronald-visser-4591034/
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Surgery is aimed at improving a patient's health. However, surgery is plagued with a risk of negative consequences, such as perioperative complications and prolonged hospitalization. Also, achieving preoperative levels of physical functionality may be delayed. Above all, the "waiting" period before the operation and the period of hospitalisation endanger the state of health, especially in frail patients.The Better in Better out™ (BiBo™) strategy is aimed at reducing the risk of a complicated postoperative course through the optimisation and professionalisation of perioperative treatment strategies in a physiotherapy activating context. BiBo™ includes four steps towards optimising personalised health care in patients scheduled for elective surgery: 1) preoperative risk assessment, 2) preoperative patient education, 3) preoperative exercise therapy for high-risk patients (prehabilitation) and 4) postoperative mobilisation and functional exercise therapy.Preoperative screening is aimed at identifying frail, high-risk patients at an early stage, and advising these high-risk patients to participate in outpatient exercise training (prehabilitation) as soon as possible. By improving preoperative physical fitness, a patient is able to better withstand the impact of major surgery and this will lead to both a reduced risk of negative side effects and better short-term outcomes as a result. Besides prehabilitation, treatment culture and infrastructure should be inherently changing in such a way that patients stay as active as they can, socially, mentally and physically after discharge.
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On the outside, working online is mainly like working on-site. As a result, the switch was made quickly and relatively easily when on-site work was temporarily not an option. Initially, the biggest issues were technical in nature (bad connection). But technical issues are solvable, and the potential benefits are great! In particular, the need to reduce particulate pollution and CO2 as a result of mass mobilisation can be achieved a great deal by working from home. Unfortunately, the non-technical problems of working online are a lot more persistent.
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