Zoekresultaten

A matter of perception

This pilot study explores the possibility of cognitive training software Neurotracker (NT), to have potential beneficial effects for Traumatic Brain Injury patients with Sensory Processing Disorder. Five subjects with TBI and SPD trained for 5 weeks/21 sessions with Neurotracker. Pre-post training cognitive tests (WAIS TMTA, TMTB, LNS) and surveys were conducted to measure possible cognitive differences with no statistical significant results. However, significant improvement in Neurotracker scores were found. =2.73, SD = 0.55) and positive changes associated with attention attention span, divided attention, (multiple) object tracking and motion sickness. LinkedIn: https://www.linkedin.com/in/bernard-de-roosz-28b96b125/

Neurodevelopmental treatment after stroke : a comparative study

Background: Neurodevelopmental treatment (NDT) is a rehabilitation approach increasingly used in the care of stroke patients, although no evidence has been provided for its efficacy. Objective: To investigate the effects of NDT on the functional status and quality of life (QoL) of patients with stroke during one year after stroke onset. Methods: 324 consecutive patients with stroke from 12 Dutch hospitals were included in a prospective, non-randomised, parallel group study. In the experimental group (n = 223), nurses and physiotherapists from six neurological wards used the NDT approach, while conventional treatment was used in six control wards (n = 101). Functional status was assessed by the Barthel index. Primary outcome was ‘‘poor outcome’’, defined as Barthel index ,12 or death after one year. QoL was assessed with the 30 item version of the sickness impact profile (SA-SIP30) and the visual analogue scale. Results: At 12 months, 59 patients (27%) in the NDT group and 24 (24%) in the non-NDT group had poor outcome (corresponding adjusted odds ratio = 1.7 (95% confidence interval, 0.8 to 3.5)). At discharge the adjusted odds ratio was 0.8 (0.4 to 1.5) and after six months it was 1.6 (0.8 to 3.2). Adjusted mean differences in the two QoL measures showed no significant differences between the study groups at six or 12 months after stroke onset. Conclusions: The NDT approach was not found effective in the care of stroke patients in the hospital setting. Health care professionals need to reconsider the use of this approach.

Does economic skills obsolescence increase older workers’ absenteeism?

Objectives This paper is the first multidisciplinary study into the impact of new skill requirements in the job on absenteeism. The aim of this study was to investigate whether economic skills obsolescence (ESO) increased both absence frequency and average duration mediated by burnout and/or work engagement.Methods A longitudinal study was conducted on data from the Dutch Study on Transitions in Employment, Ability and Motivation (N=4493). Structural equation modelling was used to test the specific direct and indirect effects of ESO on absence frequency and average duration, followed by bootstrapping to compute the confidence intervals.Results ESO at baseline had a positive relationship with burnout at follow-up. In turn, burnout was positively related to both absence frequency and average absence duration at follow-up. The bootstrap indirect effect test showed that ESO had a significant positive indirect effect, via burnout and (lower) work engagement, on absence frequency and average duration. Furthermore, ESO at baseline was negatively related to work engagement at follow-up. Work engagement, in turn, was negatively related to absence frequency and average duration at follow-up. The bootstrap test showed that ESO had a significant indirect effect, via work engagement, on absence frequency.Conclusion ESO is associated with subsequent absence frequency and average duration of workers, both mediated by burnout and decreased work engagement.

Tolerance of organ transplant recipients to physical activity during a high-altitude expedition

BACKGROUND: It is generally unknown to what extent organ transplant recipients can be physically challenged. During an expedition to Mount Kilimanjaro, the tolerance for strenuous physical activity and high-altitude of organ transplant recipients after various types of transplantation was compared to non-transplanted controls.METHODS: Twelve organ transplant recipients were selected to participate (2 heart-, 2 lung-, 2 kidney-, 4 liver-, 1 allogeneic stem cell- and 1 small bowel-transplantation). Controls comprised the members of the medical team and accompanying family members (n = 14). During the climb, cardiopulmonary parameters and symptoms of acute mountain sickness were recorded twice daily. Capillary blood analyses were performed three times during the climb and once following return.RESULTS: Eleven of the transplant participants and all controls began the final ascent from 4700 meters and reached over 5000 meters. Eight transplant participants (73%) and thirteen controls (93%) reached the summit (5895m). Cardiopulmonary parameters and altitude sickness scores demonstrated no differences between transplant participants and controls. Signs of hyperventilation were more pronounced in transplant participants and adaptation to high-altitude was less effective, which was related to a decreased renal function. This resulted in reduced metabolic compensation.CONCLUSION: Overall, tolerance to strenuous physical activity and feasibility of a high-altitude expedition in carefully selected organ transplant recipients is comparable to non-transplanted controls.

How do patients come to be seen as ‘difficult’?: A mixed-methods study in community mental health care

Across all health care settings, certain patients are perceived as ‘difficult’ by clinicians. This paper’s aim is to understand how certain patients come to be perceived and labelled as ‘difficult’ patients in community mental health care, through mixed-methods research in The Netherlands between June 2006 and October 2009. A literature review, a Delphi-study among experts, a survey study among professionals, a Grounded Theory interview study among ‘difficult’ patients, and three case studies of ‘difficult’ patients were undertaken. Analysis of the results of these qualitative and quantitative studies took place within the concept of the sick role, and resulted in the construction of a tentative explanatory model. The ‘difficult’ patient-label is associated with professional pessimism, passive treatment and possible discharge or referral out of care. The label is given by professionals when certain patient characteristics are present and a specific causal attribution (psychological, social or moral versus neurobiological) about the patient’s behaviours is made. The status of ‘difficult’ patient is easily reinforced by subsequent patient and professional behaviour, turning initial unusual help-seeking behaviour into ‘difficult’ or ineffective chronic illness behaviour, and ineffective professional behaviour. These findings illustrate that the course of mental illness, or at least the course of patients’ contact with mental health professionals and services, is determined by patient and professional and reinforced by the social and mental health care system. This model adds to the broader sick role concept a micro-perspective in which attribution and learning principles are incorporated. On a practical level, it implies that professionals need to look into their own role in the perpetuation of difficult behaviours as described here.

Using VR to train paramedics to perform triage in complex situations