Subcutaneous emphysema, pneumothorax and pneumomediastinum are well-known complications of invasive ventilation in patients with acute hypoxemic respiratory failure. We determined the incidences of air leaks that were visible on available chest images in a cohort of critically ill patients with acute hypoxemic respiratory failure due to coronavirus disease of 2019 (COVID-19) in a single-center cohort in the Netherlands. A total of 712 chest images from 154 patients were re-evaluated by a multidisciplinary team of independent assessors; there was a median of three (2–5) chest radiographs and a median of one (1–2) chest CT scans per patient. The incidences of subcutaneous emphysema, pneumothoraxes and pneumomediastinum present in 13 patients (8.4%) were 4.5%, 4.5%, and 3.9%. The median first day of the presence of an air leak was 18 (2–21) days after arrival in the ICU and 18 (9–22)days after the start of invasive ventilation. We conclude that the incidence of air leaks was high in this cohort of COVID-19 patients, but it was fairly comparable with what was previously reported in patients with acute hypoxemic respiratory failure in the pre-COVID-19 era.
Injuries can have a major impact on the physical performance and academic career of physical education teacher education (PETE) students. To investigate the injury problem, risk factors, and the impact of injuries on academic success, 252 PETE students were followed during their first semester. Risk factor analysis was conducted by means of logistic regression analysis with a differentiation for upper body, lower body, acute, overuse, and severe injuries. An incidence of 1.26 injuries/student/semester was found. Most injuries involved the lower body (61%), were new injuries (76%), occurred acutely (66%), and were sustained during curricular gymnastics (25%) or extracurricular soccer (28%). Significant risk factors for lower body acute injuries were age (OR=2.14; P=.01), previous injury (OR=2.23; P=.01), and an injury at the start of the year (OR=2.56; P=.02). For lower body overuse injuries, gender (OR=2.85; P=.02) and the interval shuttle run test score (OR=2.44; P=.04) were significant risk factors. Previous injury (OR=2.59; P=.04) and injury at the start of the year (upper body: OR=4.57; P=.02; lower body: OR=3.75; P<.01) were risk factors for severe injuries. Injury‐related time loss was positively related to total academic success (r=.20; P=.02) and success in theoretical courses (r=.24; P=<.01). No association was found between time loss and academic success for sport courses.
BACKGROUND: Paratonia is a progressive motor problem that is observed in individuals with dementia and is not a well-known phenomenon. This study explores the development and risk factors of paratonia in moderate stage dementia patients.METHODS: A multi-center, longitudinal, one-year follow-up cohort study was performed. Patients with an established diagnosis of dementia, with a score of 6 or lower on the Global Deterioration Scale (GDS) were included. The participants were assessed using the Paratonia Assessment Instrument (PAI), the Timed Up and GO test, the Qualidem, the Global Deterioration Scale (Reisberg et al., 1982) and the Mini-mental State Examination. Information about each patient's diagnosis of dementia, comorbidities and use of medication were obtained from the participant's medical file. The PAI was assessed every three months, the other variables at baseline and after 12 months. Cross-tabulation χ2 and logistic regression tests were used for the statistical analyses.RESULTS: Baseline measures were assessed in the 204 participants - 111 (54%) female and 93 (46%) male, with a mean age of 79.8 years (56-97). Seventy-one patients (34.8%) were diagnosed with paratonia at baseline, and 51 patients developed paratonia over one year. The highest hazard ratio (3.1) for developing paratonia within one year was observed in the vascular dementia group. The logistic regression analysis revealed that the presence of diabetes mellitus (OR = 10.7) was significantly related to the development of paratonia (Wald χ2 p-value < 0.01).CONCLUSIONS: Diabetes mellitus and likely vascular damage are risk factors for the development of paratonia.
The clubfoot deformity is one of the most common congenital orthopaedic “conditions”. Worldwide approximately 100,000 children are born with unilateral or bilateral clubfoot every year. In the Netherlands the incidence is approximately 175 every year. This three dimensional deformity of the foot involves, equinus, varus, adductus, and cavus . Left untreated the clubfoot leads to deformity, functional disability and pain. Physical impairments of children with clubfoot might lead to limitations in activities and therefore impede a child’s participation. In clinical practice, the orthopaedic surgeon and physiotherapists are regularly consulted by (parents of) clubfoot patients for functional problems such as impaired walking and other daily activities. This does not only affect long-term and physical health of a child, it will also affect the development of social relationships and skills as well. Since walking is a main activity in children to be able to participate in daily life, our previous study (financially supported by SIA Raak Publiek) focussed on gait differences between children with clubfoot and controls. However, differences in gait characteristics do not necessarily lead to functional limitations and restricted participation. Therefore, providing insight in participation and a child’s performance in other activities than walking is necessary. Insight in a child’s participation will also indicate the functional outcome of the treatment, which on its turn could provide essential information concerning a possible relapse.. Early identification of a relapse is important since it could prevent the need for major surgical interventions. The occurrence of a relapse clubfoot will probably also lead to functional differences in the foot as well as problems during activity and participation. Therefore, the main focus of this study is the functional outcomes of physical activities and the characterisation of participation of children with clubfeet in daily activities of childhood.
Bullying at school is an emotionally charged topic that significantly tests the relationship between parents and teachers. It is a sensitive issue as it directly relates to the child's upbringing at home. Furthermore, parents and teachers have differing perspectives on the child, and the strategies they adopt to curb bullying are based on different perspectives and spheres of influence. In recent years, a variety of measures have been implemented in order to combat bullying at primary schools. Many different anti-bullying programmes have been developed for schools and a wide range of methods, training courses and tools are available to help teachers work together with parents in order to optimise their child's educational development. However, all of these anti-bullying methods lack concrete advice and tools to help teachers work together with parents whose children are personally involved in an incidence of bullying, despite experts across the board agreeing that cooperation between parents and teachers is of vital importance.The goal of this project is to develop an effective strategy to facilitate cooperation between parents and teachers that can be employed in the event of bullying as a supplement to existing anti-bullying programmes. This consortium's ambition is to boost the social safety of children in primary education by applying expertise in the field of bullying and parental involvement, and by combining past experiences.
Since the COVID-19-pandemic, the enormous societal, medical and financial impact associated with the transfer of infectious pathogens from wild animals to humans and other animals urged for further follow-up in early signalling management of zoonotic diseases. Consequently, the Raad-voor-Dierenaangelegenheden and the Dutch government currently recommend to set up a surveillance system and cooperation with (applied-)scientists to detect zoonotic diseases using data and samples from animals entering wildlife rehabilitation centres. Each year approximately 100,000 wild animals are submitted to ±78 Dutch wildlife rehabilitation centres. This would potentially generate an enormous amount of currently unutilized information, which could reduce disease incidence and avoid the problems of scaling-up disease control if early detection can be improved. The current wild animal health surveillance system could be much enhanced if wild animals taken into care by wildlife rehabilitation centres would be consistently registered, processed and shared. However the processes, technology and biological knowhow to do this are currently not up to standards. Besides for this to work, wildlife rehabilitation centres need to be more strongly aligned and strongly embedded in the current health networks. Therefore, our objective is to develop a sustainable participatory collaboration system in the current health networks, on which first the focus is on valid and reliable data bundling of animals and their diseases from wildlife rehabilitation centres. These data can be made applicable to scientific research and the professional field to be able to signal the risks of (inter)national zoonotic diseases. We will focus our methodology on the societal, technical and biological elements involved. Van Hall Larenstein Hogeschool, Wageningen University, the Dutch Wildlife Health Centre, the National-Institute-for-Public-Health-and-the-Environment, Falcon together with Dutch wildlife rehabilitation centres will develop the fundaments of the surveillance system. The Foundation DierenLot, the Ministry-of-Agriculture-Nature-and-Food-quality, Flemish wildlife rehabilitation centres, vets, and governmental organisations are partners, among others.
