From an evidence-based perspective, cardiopulmonary exercise testing (CPX) is a well-supported assessment technique in both the United States (US) and Europe. The combination of standard exercise testing (ET) (ie, progressive exercise provocation in association with serial electrocardiograms [ECG], hemodynamics, oxygen saturation, and subjective symptoms) and measurement of ventilatory gas exchange amounts to a superior method to: 1) accurately quantify cardiorespiratory fitness (CRF), 2) delineate the physiologic system(s) underlying exercise responses, which can be applied as a means to identify the exercise-limiting pathophysiologic mechanism(s) and/or performance differences, and 3) formulate function-based prognostic stratification. Cardiopulmonary ET certainly carries an additional cost as well as competency requirements and is not an essential component of evaluation in all patient populations. However, there are several conditions of confirmed, suspected, or unknown etiology where the data gained from this form of ET is highly valuable in terms of clinical decision making
From an evidence-based perspective, cardiopulmonary exercise testing (CPX) is a well-supported assessment technique in both the United States (US) and Europe. The combination of standard exercise testing (ET) [i.e. progressive exercise provocation in association with serial electrocardiograms (ECGs), haemodynamics, oxygen saturation, and subjective symptoms] and measurement of ventilatory gas exchange amounts to a superior method to: (i) accurately quantify cardiorespiratory fitness (CRF), (ii) delineate the physiologic system(s) underlying exercise responses, which can be applied as a means to identify the exercise-limiting pathophysiological mechanism(s) and/or performance differences, and (iii) formulate function-based prognostic stratification. Cardiopulmonary ET certainly carries an additional cost as well as competency requirements and is not an essential component of evaluation in all patient populations. However, there are several conditions of confirmed, suspected, or unknown aetiology where the data gained from this form of ET is highly valuable in terms of clinical decision making.1
BACKGROUND: The study objective was to obtain consensus on physical therapy (PT) in the rehabilitation of critical illness survivors after hospital discharge. Research questions were: what are PT goals, what are recommended measurement tools, and what constitutes an optimal PT intervention for survivors of critical illness?METHODS: A Delphi consensus study was conducted. Panelists were included based on relevant fields of expertise, years of clinical experience, and publication record. A literature review determined five themes, forming the basis for Delphi round one, which was aimed at generating ideas. Statements were drafted and ranked on a 5-point Likert scale in two additional rounds with the objective to reach consensus. Results were expressed as median and semi-interquartile range, with the consensus threshold set at ≤0.5.RESULTS: Ten internationally established researchers and clinicians participated in this Delphi panel, with a response rate of 80 %, 100 %, and 100 % across three rounds. Consensus was reached on 88.5 % of the statements, resulting in a framework for PT after hospital discharge. Essential handover information should include information on 15 parameters. A core set of outcomes should test exercise capacity, skeletal muscle strength, function in activities of daily living, mobility, quality of life, and pain. PT interventions should include functional exercises, circuit and endurance training, strengthening exercises for limb and respiratory muscles, education on recovery, and a nutritional component. Screening tools to identify impairments in other health domains and referral to specialists are proposed.CONCLUSIONS: A consensus-based framework for optimal PT after hospital discharge is proposed. Future research should focus on feasibility testing of this framework, developing risk stratification tools and validating core outcome measures for ICU survivors.
A transition to a circular economy is needed to revolutionize the construction sector and make it more sustainable for present and future generations. While the construction industry and the production of construction materials contribute to environmental pollution, they also offer great potential for addressing many environmental problems. Sheet materials are engineered wood boards that are produced from recycled or solid wood where an adhesive is used to bind the particles together, predominantly used in: Furniture manufacturing, Flooring application, Roofing, Wall sheathing. The most common binder for boards is urea-formaldehyde. Other binders may be used depending on the grade of board and its intended end-use. For example, melamine urea-formaldehyde, phenolic resins and polymeric diphenylmethane diisocyanate (PMDI) are generally used in boards that require improved moisture resistance. Formaldehyde is classified in the in the European Union as a carcinogen and it carries the hazard statement 'suspected of causing cancer'. In this project mycelium composites are developed as a formaldehyde-free, fully natural and biodegradable material with high potential to substitute these hazardous materials. The heat-press process, the feasibility of which was evaluated in a previous Kiem HBO project, is to be further developed towards a process where mycelium sheets with different thicknesses will be obtained. This is considered as a fundamental step to increase the material approachability to the market. Different Material manufacturing techniques are also considered to enable the increase of sample thicknesses and volume. Moreover, a business study will be incorporated to allow further understanding of the material market potential. The consortium composition of V8 Architects, QbiQ, Fairm, Verbruggen Paddestoelen BV, and CoEBBE merges different expertise and guarantees the consideration of the whole material production chain. The research will contribute to bring mycelium composites a step closer to the market, giving them visibility and increasing the possibility to a commercial breakthrough.
Met de start van het Nationaal Lectoren Platform Urban Energy (NL UE), ontstond een unieke nationale onderzoeksgroep voor toegepast onderzoek op het domein Urban Energy. Onze stip op de horizon, de realisatie van Netto energie neutrale steden in 2050, past bij het belang van hogescholen in de regio, de Regionale Energie Strategie (RES) en de wijkgerichte aanpak. De afgelopen jaren werkten we aan een gezamenlijke onderzoeksagenda, organiseerden, een studentenwedstrijd (Zero Energy Award) en deelden we kennis in 16 bijeenkomsten. Een website is ontwikkeld en online gezet (www.nlurbanenergy.nl). De komende jaren zetten we ons in voor: 1. De gezamenlijke onderzoeksagenda (afstemming binnen het platform en met anderen); 2. Uitwisseling van kennis en (nationale) actuele informatie tussen de lectoraten onderling; 3. Fieldlabs Urban Energy ontwikkelen in elke stad waar het platform vertegenwoordigd is; 4. Jaarlijks een conferentie, met demonstratie van onze projecten; 5. Profilering en positionering van toegepast onderzoek in de Nederlandse kennisinfrastructuur; 6. De samenwerking met LEVE, door profilering op de conferentie met impact van het hbo. We verwachten dat we met onze activiteiten op het domein van Urban Energy het praktijkgericht onderzoek van de Universities of Applied Sciences beter toegankelijk en de impact beter zichtbaar kunnen maken. De jaarlijkse conferentie is de plek waar we resultaten presenteren en delen met onze (inter)nationale omgeving. In de fieldlabs doen we dat voor onze regio en vergroten we de toegankelijkheid voor onze directe omgeving. De website ondersteunt dit heel laagdrempelig. Met het lectorenplatform Urban Energy versterken we met onze expertise de energietransitie in Nederland, dragen we bij aan de RES en wijkgerichte aanpak en versterken we de kennispositie van de hogescholen met directe impact in het praktijkgericht onderwijs en de beroepspraktijk.
