Background: During hospitalization patients frequently have a low level of physical activity, which is an important risk factor for functional decline. Function Focused Care (FFC) is an evidencebased intervention developed in the United States to prevent functional decline in older patients. Within FFC, nurses help older patients optimally participate in functional and physical activity during all care interactions. FFC was adapted to the Dutch Hospital setting, which led to Function Focused Care in Hospital (FFCiH). FFCiH consists of four components: (1) ‘Environmental and policy assessment’; (2) ‘Education’; (3) ‘Goal setting with the patient’ and (4) ‘Ongoing motivation and mentoring’. The feasibility of FFCiH in the Dutch hospital setting needs to be assessed. Objective: Introduce FFCiH into Dutch hospital wards, to assess the feasibility of FFCiH in terms of description of the intervention, implementation, mechanisms of impact, and context. Design: Mixed method design Setting(s): A Neurological and a Geriatric ward in a Dutch Hospital. Participants: 56 Nurses and nursing students working on these wards. Methods: The implementation process was described and the delivery was studied in terms of dose, fidelity, adaptions, and reach. The mechanisms of impact were studied by the perceived facilitators and barriers to the intervention. Qualitative data were collected via focus group interviews, observations, and field notes. Quantitative data were collected via evaluation forms and attendance/participation lists. Results: A detailed description of FFCiH in terms of what, how, when, and by whom was given. 54 Nurses (96.4%) on both wards attended at least 1 session of the education or participated in bedside teaching. The nurses assessed the content of the education sessions with a mean of 7.5 (SD 0.78) on a 0–10 scale. The patient files showed that different short and long-term goals were set. Several facilitators and barriers were identified, which led to additions to the intervention. An important facilitator was that nurses experienced FFCiH as an approach that fits with the principles underpinning their current working philosophy. The experienced barriers mainly concern the implementation elements of the FFCiH-components ‘Education’ and ‘Ongoing motivation and mentoring’. Optimizing the team involvement, improving nursing leadership during the implementation, and enhancing the involvement of patients and their family were activities added to FFCiH to improve future implementation. Conclusions: FFCiH is feasible for the Dutch hospital setting. Strong emphasis on team involvement, nursing leadership, and the involvement of patients and their families is recommended to optimize future implementation of FFCiH in Dutch hospitals.
BACKGROUND: Physical activity (PA) levels might be a simple overall physical function indicator of recovery in acutely hospitalized older adults; however it is unknown which amount and level of PA is associated with recovery. Our objective was to evaluate the amount and level of post discharge PA and its optimum cut-off values associated with recovery among acutely hospitalized older adults and stratified for frailty.METHODS: We performed a prospective observational cohort study including acutely hospitalized older adults (≥ 70 years). Frailty was assessed using Fried's criteria. PA was assessed using Fitbit up to one week post discharge and quantified in steps and minutes light, moderate or higher intensity. The primary outcome was recovery at 3-months post discharge. ROC-curve analyses were used to determine cut-off values and area under the curve (AUC), and logistic regression analyses to calculate odds ratios (ORs).RESULTS: The analytic sample included 174 participants with a mean (standard deviation) age of 79.2 (6.7) years of whom 84/174 (48%) were frail. At 3-months, 109/174 participants (63%) had recovered of whom 48 were frail. In all participants, determined cut-off values were 1369 steps/day (OR: 2.7, 95% confidence interval [CI]: 1.3-5.9, AUC 0.7) and 76 min/day of light intensity PA (OR: 3.9, 95% CI: 1.8-8.5, AUC 0.73). In frail participants, cut-off values were 1043 steps/day (OR: 5.0, 95% CI: 1.7-14.8, AUC 0.72) and 72 min/day of light intensity PA (OR: 7.2, 95% CI: 2.2-23.1, AUC 0,74). Determined cut-off values were not significantly associated with recovery in non-frail participants.CONCLUSIONS: Post-discharge PA cut-offs indicate the odds of recovery in older adults, especially in frail individuals, however are not equipped for use as a diagnostic test in daily practice. This is a first step in providing a direction for setting rehabilitation goals in older adults after hospitalization.
Objective: This article explores the use of experiential knowledge by traditional mental health professionals and the possible contribution to the recovery of service users. Design and Methods: The review identified scientific publications from a range of sources and disciplines. Initial searches were undertaken in databases PsycINFO, PubMed, and Cochrane using specific near operator search strategies and inclusion and exclusion criteria. Results: Fifteen articles were selected. These were published in a broad range of mental health and psychology journals reporting research in western countries. In the selected articles, a varying conceptualization of experiential knowledge was found, differing from therapeutic self-disclosure embedded in psychotherapeutic contexts to a relational and destigmatizing use in recovery-oriented practices. Nurses and social workers especially are speaking out about their own experiences with mental health distress. Experiential knowledge stemming from lived experience affects the professional’s identity and the system. Only a few studies explored the outcomes for service users’ recovery. Conclusion: A small body of literature reports about the use of experiential knowledge by mental health professionals. The mental health system is still in transformation to meaningfully incorporate the lived experience perspective from traditional professionals. There is little data available on the value for the recovery of service users. This data indicates positive outcomes, such as new understandings of recovery, feeling recognized and heard, and increased hope, trust, and motivation. More research about the meaning of experiential knowledge for the recovery of service users is desirable.
MULTIFILE
Currently, many novel innovative materials and manufacturing methods are developed in order to help businesses for improving their performance, developing new products, and also implement more sustainability into their current processes. For this purpose, additive manufacturing (AM) technology has been very successful in the fabrication of complex shape products, that cannot be manufactured by conventional approaches, and also using novel high-performance materials with more sustainable aspects. The application of bioplastics and biopolymers is growing fast in the 3D printing industry. Since they are good alternatives to petrochemical products that have negative impacts on environments, therefore, many research studies have been exploring and developing new biopolymers and 3D printing techniques for the fabrication of fully biobased products. In particular, 3D printing of smart biopolymers has attracted much attention due to the specific functionalities of the fabricated products. They have a unique ability to recover their original shape from a significant plastic deformation when a particular stimulus, like temperature, is applied. Therefore, the application of smart biopolymers in the 3D printing process gives an additional dimension (time) to this technology, called four-dimensional (4D) printing, and it highlights the promise for further development of 4D printing in the design and fabrication of smart structures and products. This performance in combination with specific complex designs, such as sandwich structures, allows the production of for example impact-resistant, stress-absorber panels, lightweight products for sporting goods, automotive, or many other applications. In this study, an experimental approach will be applied to fabricate a suitable biopolymer with a shape memory behavior and also investigate the impact of design and operational parameters on the functionality of 4D printed sandwich structures, especially, stress absorption rate and shape recovery behavior.
The production, use, disposal and recovery of packaging not only generates massive volumes of waste, it also consumes raw materials, water and energy (Fitzpatrick et al. 2012). Simultaneously, consumers have shown an increasing interest in products incorporating sustainable and social attributes (Kletzan et al., 2006). As a result, environmentally friendly packaging, also called ecofriendly or sustainable packaging, has become mainstream. In this context, packaging is more than just ensuring the product's protection and easing transportation, it is also a communicative tool (Palmer, 2000) and it becomes associated with multiple drivers of the purchasing process. Consequently, companies face pressure to innovate responding to consumer demands, and focusing on sustainable solutions that reduce harmful materials and favour green alternatives for both, the product and the packaging. Although the above has triggered research on consumer choice for sustainable products and alternatives on sustainable packaging, the relation between sustainable packaging and consumer behaviour remains underexplored. This research unpacks this relationship, i.e., empirically verifies which dimensions (recyclability, biodegradability, reusability) of sustainable packaging are perceived and valued by consumers. Put differently, this research investigates consumer behaviour towards the functions of sustainable packaging in terms of product protection, convenience, reliability of information and promotion, and scrutinises the perceived credibility of the associated ethical responsibility claims. It aims to identify those packaging materials and/or sustainability characteristics perceived as more sustainable by consumers as well as the factors influencing actual consumer choice towards sustainable packaged products. We aim to gain more insights in the perceptual frame that different types of consumers apply when exposed to sustainable packaging. To this end, we will make use of revealed preference methods to measure consumer valuations of sustainable packaged products. This game-theoretic approach should provide a more complete depiction of consumers' perceptions and preferences.
Mattresses for the healthcare sector are designed for robust use with a core foam layer and a polyurethane-coated polyester textile cover. Nurses and surgeons indicate that these mattresses are highly uncomfortable to patients because of poor microclimatic management (air, moisture, temperature, friction, pressure regulation, etc) across the mattress, which can cause pressure ulcers (in less than a day). The problem is severe (e.g., extra recovery time, medication, increased risk, and costs) for patients with wounds, infection, pressure-sensitive decubitus. There are around 180,000 waterproof mattresses in the healthcare sector in the Netherlands, of which yearly 40,000 mattresses are discarded. Owing to the rapidly aging population it is expected to increase the demand for these functional mattresses from 180,000 to 400,000 in the next 10 years in the healthcare sector. To achieve a circular economy, Dutch Government aims for a 50% reduction in the use of primary raw materials by 2030. As of January 1, 2022, mattress manufacturers and importers are obliged to pay a waste management contribution. Within the scope of this project, we will design, develop, and test a circular & functional mattress for the healthcare (cure & care) sector. The team of experts from knowledge institutes, SMEs, hospital(s), branch-organization joins hands to design and develop a functional (microclimate management, including ease of use for nurses and patients) mattress that deals with uncomfortable sleeping and addresses the issue of pressure ulcers thereby overall accelerating the healing process. Such development addresses the core issue of circularity. The systematic research with proper demand articulation leads to V-shape verification and validation research methodology. With design focus and applied R&D at TRL-level (4-6) is expected to deliver the validated prototype(s) offering SMEs an opportunity to innovate and expand their market. The knowledge will be used for dissemination and education at Saxion.
