Currently the advances in the field of 3D printing are causing a revolution in the (bio-)medical field. With applications ranging from patient-specific anatomical models for surgical preparation to prosthetic limbs and even scaffolds for tissue engineering, the possibilities seem endless. Today, the most widely used method is FDM printing. However, there is still a limited range of biodegradable and biocompatible materials available. Moreover, printed implants like for instance cardiovascular stents require higher resolution than is possible to reach with FDM. High resolution is crucial to avoid e.g. bacterial growth and aid to mechanical strength of the implant. For this reason, it would be interesting to consider stereolithography as alternative to FDM for applications in the (bio-) medical field. Stereolithography uses photopolymerizable resins to make high resolution prints. Because the amount of commercially available resins is limited and hardly biocompatible, here we investigate the possibility of using acrylates and vinylesters in an effort to expand the existing arsenal of biocompatible resins. Mechanical properties are tailorable by varying the crosslink density and by varying the spacer length. To facilitate rapid production of high-resolution prints we use masked SLA (mSLA) as an alternative to conventional SLA. mSLA cures an entire layer at a time and therefore uses less time to complete a print than conventional SLA. Additionally, with mSLA it takes the same time to make 10 prints as it would to make only one. Several formulations were prepared and tested for printability and mechanical strength.
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PURPOSE: Walking ability in general and specifically for lower limb amputees is of major importance for social mobility and ADL independence. Walking determines prosthesis prescription. The aim of this study was to mathematically analyse factors influencing claimed walking distance of lower limb amputees of 500 m or more.METHOD: A total of 437 patients returned two questionnaires: the Groningen Questionnaire Problems after Leg Amputation, in which walking distance was assessed, and the RAND 36.RESULTS: The chance of walking 500 m or more reduced when a transfemoral amputation was performed. The chance reduced even more when phantom pain or stump pains were present. If the amputation was performed because of vascular disease or because of vascular problems because of diabetes the chance reduced again. Independently of these factors, age reduced the chance of walking 500 m or more.CONCLUSION: The chance of walking 500 m or more reduces with increase in age and a more proximal amputation. The chance reduces even further when the amputation is performed because of diabetes or vascular disease and also if phantom pain and or stump pain is present.
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Assistive Technology (AT) is any technology that supports people with functional difficulties to perform their daily activities with less difficulty and/or obstruction, thus contributing to a more fulfilling life. This refers to people of all ages and to all kinds of functional limitations, either permanent or temporary. Assistive products can be traditional physical products, such as wheelchairs, eyeglasses, hearing aids, or prostheses, but they can also be special input devices, care robots, computers with accessible software, apps for smartphones, home automation solutions, virtual realities, etc. It is essential to understand that AT involves more than just familiar products, and that it also includes knowledge about the personalized selection of appropriate solutions, provisions, and services, as well as the training of all parties involved, the measurement of outcomes and impacts, awareness of ethical issues, etc.
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Background: Non-technical errors, such as insufficient communication or leadership, are a major cause of medical failures during trauma resuscitation. Research on staffing variation among trauma teams on teamwork is still in their infancy. In this study, the extent of variation in trauma team staffing was assessed. Our hypothesis was that there would be a high variation in trauma team staffing. Methods: Trauma team composition of consecutive resuscitations of injured patients were evaluated using videos. All trauma team members that where part of a trauma team during a trauma resuscitation were identified and classified during a one-week period. Other outcomes were number of unique team members, number of new team members following the previous resuscitation and new team members following the previous resuscitation in the same shift (Day, Evening, Night). Results: All thirty-two analyzed resuscitations had a unique trauma team composition and 101 unique members were involved. A mean of 5.71 (SD 2.57) new members in teams of consecutive trauma resuscitations was found, which was two-third of the trauma team. Mean team members present during trauma resuscitation was 8.38 (SD 1.43). Most variation in staffing was among nurses (32 unique members), radiology technicians (22 unique members) and anesthetists (19 unique members). The least variation was among trauma surgeons (3 unique members) and ER physicians (3 unique members). Conclusion: We found an extremely high variation in trauma team staffing during thirty-two consecutive resuscitations at our level one trauma center which is incorporated in an academic teaching hospital. Further research is required to explore and prevent potential negative effects of staffing variation in trauma teams on teamwork, processes and patient related outcomes.
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This study investigates what pupils aged 10-12 can learn from working with robots, assuming that understanding robotics is a sign of technological literacy. We conducted cognitive and conceptual analysis to develop a frame of reference for determining pupils' understanding of robotics. Four perspectives were distinguished with increasing sophistication; psychological, technological, function, and controlled system. Using Lego Mindstorms NXT robots, as an example of a Direct Manipulation Environment, we developed and conducted a lesson plan to investigate pupils' reasoning patterns. There is ample evidence that pupils have little difficulty in understanding that robots are man-made technological and functional artifacts. Pupils' understanding of the controlled system concept, more specifically the complex sense-reason-act loop that is characteristic of robotics, can be fostered by means of problem solving tasks. The results are discussed with respect to pupils' developing technological literacy and the possibilities for teaching and learning in primary education.
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There is more to be learned from nature as a whole. In practice ‘nature’ is often used in teaching, training, consultancy and organisational development as a metaphor, as a source of inspiration or as an example for all kinds of processes, including leadership, cooperation, relationships and the development of organisations and society. Mainly ecological, and much less frequently biological, processes are generally involved here. The question has gradually arisen whether we can learn more from nature in the social environment than what we ‘see’ on the surface - which is often translated in metaphors. Seen more holistically, this is about the systemic side, the complexity, the context and the coherence. For example, can we demonstrate that applying fundamental ecological principles, such as cycles (learning, self-organising, selfregulating and self-sufficient capacity), succession, diversity and resilience, social and cooperative behaviour, interconnectedness and interdependency within an organisation leads to a sustainable organisation? Mauro Gallo is conducting research into the significance of technical innovation in and for the agricultural and food sector, and into the question whether biomimicry can in fact be backed up in such a way that it contributes to the social sciences domain. At the same time there is a clear teaching issue: Is it logical from the perspective of our green DNA to include biomimicry thinking in our teaching? Is it possible to learn to apply biomimicry, and can biomimicry be applied in teaching/learning? (How) can we apply biomimicry in green VMBO and MBO, pass it on to the teachers of the future in teacher training courses and include it in making current lecturers more professional? Is it conceivable that it could become an integral component of the curricula in green HBO?
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There is more to be learned from nature as a whole. In practice ‘nature’ is often used in teaching, training, consultancy and organisational development as a metaphor, as a source of inspiration or as an example for all kinds of processes, including leadership, cooperation, relationships and the development of organisations and society. Mainly ecological, and much less frequently biological, processes are generally involved here. The question has gradually arisen whether we can learn more from nature in the social environment than what we ‘see’ on the surface - which is often translated in metaphors. Seen more holistically, this is about the systemic side, the complexity, the context and the coherence. For example, can we demonstrate that applying fundamental ecological principles, such as cycles (learning, self-organising, selfregulating and self-sufficient capacity), succession, diversity and resilience, social and cooperative behaviour, interconnectedness and interdependency within an organisation leads to a sustainable organisation? Mauro Gallo is conducting research into the significance of technical innovation in and for the agricultural and food sector, and into the question whether biomimicry can in fact be backed up in such a way that it contributes to the social sciences domain. At the same time there is a clear teaching issue: Is it logical from the perspective of our green DNA to include biomimicry thinking in our teaching? Is it possible to learn to apply biomimicry, and can biomimicry be applied in teaching/learning? (How) can we apply biomimicry in green VMBO and MBO, pass it on to the teachers of the future in teacher training courses and include it in making current lecturers more professional? Is it conceivable that it could become an integral component of the curricula in green HBO?
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(‘Co’-)Designing for healthy behaviour greatly benefits from integrating insights about individual behaviour and systemic influences. This study reports our experiences in using insights about individual and systemic determinants of behaviour to inform a large co-design project. To do so, we used two design tools that encourage focusing on individual determinants (Behavioural Lenses Approach) and social / systemic aspects of behaviour (Socionas). We performed a qualitative analysis to identify 1) when and how the team applied the design tools, and 2) how the tools supported or obstructed the design process. The results show that both tools had their distinctive uses during the process. Both tools improved the co-design process by deepening the conversations and underpinnings of the prototypes. Using the Behavioural Lenses under the guidance of a behavioural expert proved most beneficial. Furthermore, the Socionas showed the most potential when interacting with stakeholders, i.c. parents and PPTs.
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In dit abstract wordt de ontwikkeling van een online onderwijsmodule beschreven gericht op eHealth voor leefstijlverbetering
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Introduction Negative pain-related cognitions are associated with persistence of low-back pain (LBP), but the mechanism underlying this association is not well understood. We propose that negative pain-related cognitions determine how threatening a motor task will be perceived, which in turn will affect how lumbar movements are performed, possibly with negative long-term effects on pain. Objective To assess the effect of postural threat on lumbar movement patterns in people with and without LBP, and to investigate whether this effect is associated with task-specific pain-related cognitions. Methods 30 back-healthy participants and 30 participants with LBP performed consecutive two trials of a seated repetitive reaching movement (45 times). During the first trial participants were threatened with mechanical perturbations, during the second trial participants were informed that the trial would be unperturbed. Movement patterns were characterized by temporal variability (CyclSD), local dynamic stability (LDE) and spatial variability (meanSD) of the relative lumbar Euler angles. Pain-related cognition was assessed with the task-specific ‘Expected Back Strain’-scale (EBS). A three-way mixed Manova was used to assess the effect of Threat, Group (LBP vs control) and EBS (above vs below median) on lumbar movement patterns. Results We found a main effect of threat on lumbar movement patterns. In the threat-condition, participants showed increased variability (MeanSDflexion-extension, p<0.000, η2 = 0.26; CyclSD, p = 0.003, η2 = 0.14) and decreased stability (LDE, p = 0.004, η2 = 0.14), indicating large effects of postural threat. Conclusion Postural threat increased variability and decreased stability of lumbar movements, regardless of group or EBS. These results suggest that perceived postural threat may underlie changes in motor behavior in patients with LBP. Since LBP is likely to impose such a threat, this could be a driver of changes in motor behavior in patients with LBP, as also supported by the higher spatial variability in the group with LBP and higher EBS in the reference condition.
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Motor learning is particularly challenging in neurological rehabilitation: patients who suffer from neurological diseases experience both physical limitations and difficulties of cognition and communication that affect and/or complicate the motor learning process. Therapists (e.g.,, physiotherapists and occupational therapists) who work in neurorehabilitation are therefore continuously searching for the best way to facilitate patients during these intensive learning processes. To support therapists in the application of motor learning, a framework was developed, integrating knowledge from the literature and the opinions and experiences of international experts. This article presents the framework, illustrated by cases from daily practice. The framework may assist therapists working in neurorehabilitation in making choices, implementing motor learning in routine practice, and supporting communication of knowledge and experiences about motor learning with colleagues and students. The article discusses the framework and offers suggestions and conditions given for its use in daily practice.
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