Background: Osteoarthritis (OA) is the most common rheumatic disease of the musculoskeletal system, with the knee as the most affected joint. The number of people with OA of the knee is likely to increase due to the ageing society and the obesity epidemic. The predominant clinical symptom of knee OA is pain, which is described as worsening by activity and relieving by rest. Knee instability has been recognized as an important clinical feature in persons with knee OA. Pain and knee instability are associated with limitations in performing daily activities. Non-pharmacological options in the management of knee OA consist of education, weight loss, exercise, braces and physical therapy. Knee bracing has been recommended by the Osteoarthritis Research Society International (OARSI). Valgus knee braces designed to decrease loads on the medial compartment of the knee for patients with varus alignment are the most common. It has been shown however, that valgus bracing may have little or no effect on pain and physical functioning, and adherence to this treatment in patients with knee OA is low.Because of ease of use and access, lack of complications and low cost, soft knee braces are commonly used in persons with knee OA. However, the evidence for efficacy of soft knee bracing on pain and activity limitations in knee OA is limited. Therefore, it is important to strengthen the evidence of using a soft brace to reduce pain and activity limitations as well as to evaluate the efficacy of soft knee bracing on knee instability in persons with knee OA. There is also debate about the effectiveness of soft braces in other affected joints of the lower extremity and in conditions other than OA such as rheumatoid arthritis.Objectives: The aim of the study will be to evaluate the effect of wearing a soft brace on dynamic knee instability in patients with OA of the knee.Methods: Persons with knee OA and self-reported knee instability from the Amsterdam Osteoarthritis cohort participated in a single-session lab-experimental study. A within-subject design was used, comparing no brace versus brace, and comparing a non-tight versus a tight brace (standard fit). The primary outcome measure was dynamic knee instability, expressed by the Perturbation Response (PR), i.e., a biomechanics based measure reflecting deviation in the mean knee varus-valgus angle after a controlled mechanical perturbation, standardized to the mean (SD) varus-valgus angle during level walking. Linear mixed-effect model analysis was used to evaluate the effect of a brace on dynamic knee instability.Results: The wearing of a soft brace reduced the knee instability significantly during perturbed walking. Results will also be presented from the literature search and from the lab-experimental study.Conclusion: Wearing a soft brace reduces dynamic knee instability in patients with knee OA. However, longitudinal studies are needed to evaluate the clinical implications of wearing a soft brace.
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Counting the costs of a certain condition such as Spina Bifida in an economic breeding farm is absurd. We are all consumers that keep the economic engines running, no matter if we are obese, or anorectics, if we do sport or if we don 't, or if we have SB as a condition, or not. Of course, there are necessary costs for SB (surgery, sometimes lifelong incontinence materials, adapted braces, etc.). But for every person, lifelong costs are incurred: food, clothing, entertainment, education, etc. Living with a disease is therefore "fuelling" the economic engine of progress. Consequently, costs cannot be calculated without taking into account the benefits (health care workers earning a living, production of new treatments and materials, etc.). The economic value of lifestyle gurus, magazines and gyms would evaporate immediately if healthy behaviour was self-evident. It’s absurd to opt for life or abortion on the basis of an economic argument. Besides, extra care and costs can only be estimated on average, and therefore do not necessarily apply to the individual in the uterus of the tested mother. Nothing is what it seems!
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BACKGROUND: Ambulatory children with Spina Bifida (SB) often show a decline in physical activity leading to deconditioning and functional decline. Therefore, assessment and promotion of physical activity is important. Because energy expenditure during activities is higher in these children, the use of existing pediatric equations to predict physical activity energy expenditure (PAEE) may not be valid. AIMS: (1) To evaluate criterion validity of existing predictions converting accelerocounts into PAEE in ambulatory children with SB and (2) to establish new disease-specific equations for PAEE. METHODS: Simultaneous measurements using the Actical, the Actiheart, and indirect calorimetry took place to determine PAEE in 26 ambulatory children with SB. DATA ANALYSIS: Paired T-tests, Intra-class correlations limits of agreement (LoA), and explained variance (R2) were used to analyze validity of the prediction equations using true PAEE as criterion. New equations were derived using regression techniques. RESULTS: While T-tests showed no significant differences for some models, the predictions developed in healthy children showed moderate ICC’s and large LoA with true PAEE. The best regression models to predict PAEE were: PAEE = 174.049 + 3.861 × HRAR – 60.285 × ambulatory status (R2 = 0.720) and PAEE = 220.484 + 0.67 × Actical counts – 60.717 × ambulatory status (R2 = 0.681). CONCLUSIONS: Existing equations to predict PAEE are not valid for use in children with SB for the individual evaluation of PAEE. The best regression model was based on HRAR in combination with ambulatory status, followed by a new model for the Actical monitor. A benefit of HRAR is that it does not require the use of expensive accelerometry equipment. Further cross-validation of these models is still needed.
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Recycling of plastics plays an important role to reach a climate neutral industry. To come to a sustainable circular use of materials, it is important that recycled plastics can be used for comparable (or ugraded) applications as their original use. QuinLyte innovated a material that can reach this goal. SmartAgain® is a material that is obtained by recycling of high-barrier multilayer films and which maintains its properties after mechanical recycling. It opens the door for many applications, of which the production of a scoliosis brace is a typical example from the medical field. Scoliosis is a sideways curvature of the spine and wearing an orthopedic brace is the common non-invasive treatment to reduce the likelihood of spinal fusion surgery later. The traditional way to make such brace is inaccurate, messy, time- and money-consuming. Because of its nearly unlimited design freedom, 3D FDM-printing is regarded as the ultimate sustainable technique for producing such brace. From a materials point of view, SmartAgain® has the good fit with the mechanical property requirements of scoliosis braces. However, its fast crystallization rate often plays against the FDM-printing process, for example can cause poor layer-layer adhesion. Only when this problem is solved, a reliable brace which is strong, tough, and light weight could be printed via FDM-printing. Zuyd University of Applied Science has, in close collaboration with Maastricht University, built thorough knowledge on tuning crystallization kinetics with the temperature development during printing, resulting in printed products with improved layer-layer adhesion. Because of this knowledge and experience on developing materials for 3D printing, QuinLyte contacted Zuyd to develop a strategy for printing a wearable scoliosis brace of SmartAgain®. In the future a range of other tailor-made products can be envisioned. Thus, the project is in line with the GoChem-themes: raw materials from recycling, 3D printing and upcycling.
Despite Dutch Hospitality industry’s significant economic value, employers struggle to attract and retain early career professionals at a time when tourism is forecasted to grow exponentially (Ruël, 2018). Universally, hospitality management graduates are shunning hospitality careers preferring other career paths; stimulating the Dutch Hospitality to find innovative ways of attracting and retaining early career professionals. Following calls from the Human Resource Management (HRM) community (Ehnert, 2009), we attribute this trend to personnel being depicted as rentable resources, driving profit’’ often at personal expense. For example, hotels primarily employ immigrants and students for a minimum wage suppressing salaries of local talent (Kusluvan, et al 2010, O’Relly and Pfeffer, 2010). Similarly, flattening organizational structures have eliminated management positions, placing responsibility on inexperienced shoulders, with vacancies commonly filled by pressured employees accepting unpaid overtime jeopardizing their work life balance (Davidson, et al 2010,). These HRM practices fuel attrition by exposing early career professionals to burnout (Baum et al, 2016, Goh et al, 2015, Deery and Jog, 2009). Collectively this has eroded the industry’s employer brand, now characterized by unsocial working hours, poor compensation, limited career opportunities, low professional standing, high turnover and substance abuse (Mooney et al, 2016, Gehrels and de Looij, 2011). In contrast, Sustainable HRM “enables an organizational goal achievement while simultaneously reproducing the human resource base over a long-lasting calendar time (Ehnert, 2009, p. 74).” Hence, to overcome this barrier we suggest embracing the ROC framework (Prins et al, 2014), which (R)espects internal stakeholders, embraces an (O)pen HRM approach while ensuring (C)ontinuity of economic and societal sustainability which could overcome this barrier. Accordingly, we will employ field research, narrative discourse, survey analysis and quarterly workshops with industry partners, employees, union representatives, hotel school students to develop sustainable HRM practices attracting and retaining career professionals to pursue Dutch hospitality careers.
Sinds de corona reset wordt in de culturele en creatieve sector volop geïnnoveerd om tijdelijke sluitingen en financiële verliezen te compenseren. Aanbieders van hoogwaardige culturele programma’s, zoals presentatie-instellingen en zelforganiserende collectieven, coördineren in hoog tempo digitale expositieruimtes, livestreams en online debatten, waarmee ze hun bestaande (offline en lokale) en nieuwe (online en mondiale) publiek bedienen. Soms ook tegelijkertijd, in een hybride evenement; met een beperkt live publiek én een onbeperkt aantal online bezoekers. Hoe zorgen zij dat beide groepen bij deze livecastings een gelijkwaardige ervaring hebben? En hoe benutten ze de potentie van dit opgenomen materiaal voor publicatie en blijvende publieksinteractie in hun digitaal (web)archief? Ad hoc coronaoplossingen behoeven nu toekomstbestendige doorontwikkeling. Met MKB’ers ontwikkelen we een langetermijnvisie op off/online kennisdeling van hun culturele aanbod, op voorwaarden van duurzaamheid en technologische onafhankelijkheid in het beheer en de data-opslag van hun gepubliceerde materiaal. Verregaande digitalisering en klimaatoverwegingen geven namelijk naast corona urgentie aan een visie op hybride programmering. In het onderzoek worden werkende principes ontwikkeld voor een langetermijnvisie op een hybride en kwalitatief hoogwaardig programma-aanbod, met het oog op het bedienen van nieuw en bestaand publiek na de corona reset, via participatieve livecasts van evenementen, de samenhangende verslaglegging daarvan middels publicaties die uiteindelijk in levende archieven te komen: Om het knelpunt van ‘schermmoeheid’ bij eindgebruikers van programma-aanbod te voorkomen, ontwikkelen we werkende principes in het oplossingsgebied ‘participatieve livecasting’, om de succespijler ‘gezamenlijke publiekservaring bij online evenementen’ te bewerkstelligen. Om het knelpunt van ‘gefragmenteerde informatievoorziening’ bij programma-aanbieders te voorkomen, ontwikkelen we werkende principes in het oplossingsgebied ‘hybride publicaties’, om de succespijler ‘samenhang in off/online programma-aanbod’ te bewerkstelligen. Om het knelpunt van een ‘reactieve houding’ bij programma-aanbieders te voorkomen, ontwikkelen we werkende principes in het oplossingsgebied ‘levende archieven’, om de succespijler van een ‘anticiperende houding in de werkwijze van programma-aanbieders’ te bewerkstelligen.
