Zoekresultaten

Doxepin cream is not effective in reducing itch in burn scar patients

OBJECTIVE: To evaluate the effect of doxepin hydrochloride 5% cream on reducing pruritus in burn scar patients compared to a placebo cream.METHOD: We conducted a multicenter triple-blind randomized clinical placebo-controlled crossover trial in which burn patients ≥18 years with an itch intensity ≥3 on a Visual Analogue Scale (VAS) were randomized between a doxepin-placebo or placebo-doxepin treatment protocol. Patients used each cream during two weeks with a wash-out period of one week in between. Primary outcome was change in itch intensity in two weeks' time using the VAS. Secondary outcome included the impact of itch (Burn Itch Questionnaire). Other parameters were the use of hydrating cream, silicon treatment, pressure garments, and other antipruritic medication.RESULTS: Twenty-seven patients were included. The change in itch intensity (VAS) was not different during the doxepin and placebo period (p=0.994); neither the doxepin cream nor placebo cream reduced itch intensity. However, based on the Burn Itch Questionnaire, we observed a statistically significant decrease in itch intensity and improvement in impact scores in both treatment groups, but no difference in the degree of reduction between the groups.CONCLUSION: Doxepin cream was not effective in reducing pruritus in our burn patient study population.

Hoe blijf je sterk op hogere leeftijd

Herken je het ook, bij je ouders, bij cliënten op werk of wellicht ook bij jezelf? Opstaan uit de stoel wordt moeilijker, traplopen gaat haast niet meer of de deksel van de jampot openmaken blijkt onmogelijk? Het goede nieuws is dat je met veel bewegen en goede voeding veel langer sterk kunt blijven.

Development and content validity of an application to assess 24-hour movement behaviors in 0–4-year-old children involving end-users and key stakeholders

Background: Recently, research focus has shifted to the combination of all 24-h movement behaviors (physical activity, sedentary behavior and sleep) instead of each behavior separately. Yet, no reliable and valid proxy-report tools exist to assess all these behaviors in 0–4-year-old children. By involving end-users (parents) and key stakeholders (researchers, professionals working with young children), this mixed-methods study aimed to 1) develop a mobile application (app)-based proxy-report tool to assess 24-h movement behaviors in 0–4-year-olds, and 2) examine its content validity. Methods: First, we used concept mapping to identify activities 0–4-year-olds engage in. Parents (n = 58) and professionals working with young children (n = 21) generated a list of activities, sorted related activities, and rated the frequency children perform these activities. Second, using multidimensional scaling and cluster analysis, we created activity categories based on the sorted activities of the participants. Third, we developed the My Little Moves app in collaboration with a software developer. Finally, we examined the content validity of the app with parents (n = 14) and researchers (n = 6) using focus groups and individual interviews. Results: The app has a time-use format in which parents proxy-report the activities of their child, using eight activity categories: personal care, eating/drinking, active transport, passive transport, playing, screen use, sitting/lying calmly, and sleeping. Categories are clarified by providing examples of children’s activities. Additionally, 1–4 follow-up questions collect information on intensity (e.g., active or calm), posture, and/or context (e.g., location) of the activity. Parents and researchers considered filling in the app as feasible, taking 10–30 min per day. The activity categories were considered comprehensive, but alternative examples for several activity categories were suggested to increase the comprehensibility and relevance. Some follow-up questions were considered less relevant. These suggestions were adopted in the second version of the My Little Moves app. Conclusions: Involving end-users and key stakeholders in the development of the My Little Moves app resulted in a tailored tool to assess 24-h movement behaviors in 0–4-year-olds with adequate content validity. Future studies are needed to evaluate other measurement properties of the app.

Implementatie van richtlijnen in de praktijk

Projecten die succesvol waren afgerond in het onderzoeksprogramma Tussen Weten en Doen van ZONMw konden een aanvraag doen voor een subsidie voor verdere verspreiding en implementatie van de resultaten. Op basis van een drietal criteria is een selectie gemaakt en zijn vijf projecten gekozen. Deze criteria waren: de aanwezigheid van een concreet product, een bestaande infrastructuur voor verdere verspreiding en implementatie en een actueel onderwerp. Deze geselecteerde projecten zijn een jaar lang met financiële ondersteuning van ZonMw begeleid en geëvalueerd op proces en productresultaten. Drie onderzoeksinstituten (Sciencia Kennistransfer GGZ, Lectoraat EBP van Fontys Hogeschool Verpleegkunde & UMC St, Radboud IQ Healthcare) hebben dit project gezamenlijk uitgevoerd. Tijdens dit project, het I(implementatie)-impulsproject, werden vijf richtlijnen (Smetten, Orale Mucositis, Misselijkheid en Braken, Omgaan met Jeuk en Vochtbeperking bij Hemodialyse) door 15 personen geïmplementeerd in 11 verschillende zorgorganisaties waaronder ziekenhuizen, thuiszorg en een verpleeghuis.

Gedachtenexperiment met water en energie

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