The road to science for the arts therapies requires research on the full breadths of the spectrum, from systematic case studies to RCTs. It is important that arts therapists and arts therapeutic researchers reflect on the typical characteristics of each research paradigm, research type and research method and select what is appropriate with regard to the particular research question. Questions rather differ. Finding out whether a certain intervention has a particular effect with a large group of clients differs from wanting to know which change occurs at which moment by which interventions in the treatment of an individual client. Research in practice remains close to questions encountered by arts therapists in their daily practice. It concerns questions arts therapists have about their lived experience of acting due to the complexity and variability of practice. By carrying out research in practice that links up with those questions, evidence evolves; evidence that enables the professional to proceed and that makes explicit what often remains implicit and unsaid. What is explicit can be communicated, can be criticised and tested. The professional himself does the road to science of the profession. The investment in professionals’ research in practice is the motor of knowledge-productivity that bridges the theory-practice gap. Research in the arts therapies should lead to ‘knowledge’ in which the ‘art’, nor the ‘subject’ of therapist and client have been lost.
Introduction: Gastroenteropancreatic neuroendocrine neoplasms (GEPNENs) are often diagnosed in an advanced stage. As the optimal sequence of therapy remains largely unclear, all treatment-related outcomes, including health-related quality of life (HRQoL) prospects, should be assessed according to patients' preferences. Methods: A targeted search was performed in PubMed and EMBASE to identify studies on treatment effect and HRQoL, measured using the EORTC QLQ-C30 tool, in patients with advanced, well-differentiated GEPNENs. Study quality was assessed, and meta-analyses were performed for global health status/QOL and tumour response. Results: The search yielded 1,322 records, and 20 studies were included, examining somatostatin analogues (SSA), peptide receptor radionuclide therapies (PRRT), chemotherapy, SSA-based combination therapies, and targeted therapies. Global HRQoL was stable, and rates for disease stabilisation were moderate to high across all treatments. Meta-analyses for global health status/QOL after SSA treatment were not significant (mean difference: –0.3 [95% CI: −1.3 to 0.7]). The highest pooled overall tumour response rate was 33% (95% CI: 24–45%) for PRRT. The highest pooled clinical benefit rate was 94% (95% CI: 65–99%) for chemotherapy. Conclusion: All treatments appeared beneficial for disease stabilisation while maintaining stable global health status/QOL. High-quality HRQoL reporting was lacking. HRQoL should be a central outcome next to well-established outcomes.
Imagery Rehearsal Therapy (IRT) is effective for trauma-related nightmares and is also a challenge to patients in finding access to their traumatic memories, because these are saved in non-verbal, visual, or audiovisual language. Art therapy (AT) is an experiential treatment that addresses images rather than words. This study investigates the possibility of an IRT-AT combination. Systematic literature review and field research was conducted, and the integration of theoretical and practice-based knowledge resulted in a framework for Imagery Rehearsal-based Art Therapy (IR-AT). The added value of AT in IRT appears to be more readily gaining access to traumatic experiences, living through feelings, and breaking through avoidance. Exposure and re-scripting take place more indirectly, experientially and sometimes in a playlike manner using art assignments and materials. In the artwork, imagination, play and fantasy offer creative space to stop the vicious circle of nightmares by changing theme, story line, ending, or any part of the dream into a more positive and acceptable one. IR-AT emerges as a promising method for treatment, and could be especially useful for patients who benefit least from verbal exposure techniques. This description of IR-AT offers a base for further research.
In de chronische fase na de revalidatie woont een groot deel van de mensen die een beroerte (CVA) hebben overleefd weer thuis. Veel mensen na een beroerte ervaren op lange termijn nog beperkingen in hun mobiliteit en fysieke activiteit. Zij hebben daardoor vaak verhoogde gezondheidsrisico’s en gereduceerde mogelijkheid te participeren. Voor hen is er gespecialiseerde interprofessionele zorg nodig. Sinds twee jaar bestaat er een netwerk voor interprofessionele zorg in de eerste lijn voor mensen na Niet Aangeboren Hersenletsel (NAH) zoals een CVA, in de regio Utrecht: het Multidisciplinaire NAH-Netwerk Utrecht (MNNU). Het MNNU wil samenwerken met onderwijs en onderzoek van de Hogeschool Utrecht (HU) om de zorgkwaliteit gericht op reductie van gezondheidsrisico en stimuleren van participatie van mensen na een CVA in de regio optimaliseren. Daartoe wordt de Interprofessionele Community of Practise (CoP) Gezond weer meedoen na CVA gevormd en aan het MNNU gekoppeld. De CoP verbindt het werkveld met onderwijs en onderzoek van de HU, dat gericht is op het optimaliseren van participatie en gezondheid en daarmee de zelfredzaamheid van mensen na een CVA. De beoogde opbrengst van de CoP zijn concepten voor het optimaliseren van de kwaliteit van zorg door delen van kennis en expertise door de professionals uit onderwijs, onderzoek en de zorgprofessionals binnen het MNNU. Daarnaast ontwikkelt de CoP concepten voor bijdragen aan het zorgonderwijs en participeert in de articulatie van vraagstellingen voor praktijkgericht onderzoek en de uitvoering daarvan. Tenslotte zal de CoP bijdragen aan het ontwerp van een interprofessionele scholing voor het MNNU.
Biotherapeutic medicines such as peptides, recombinant proteins, and monoclonal antibodies have successfully entered the market for treating or providing protection against chronic and life-threatening diseases. The number of relevant commercial products is rapidly increasing. Due to degradation in the gastro-intestinal tract, protein-based drugs cannot be taken orally but need to be administered via alternative routes. The parenteral injection is still the most widely applied administration route but therapy compliance of injection-based pharmacotherapies is a concern. Long-acting injectable (LAI) sustained release dosage forms such as microparticles allow less frequent injection to maintain plasma levels within their therapeutic window. Spider Silk Protein and Poly Lactic-co-Glycolic Acid (PLGA) have been attractive candidates to fabricate devices for drug delivery applications. However, conventional microencapsulation processes to manufacture microparticles encounter drawbacks such as protein activity loss, unacceptable residual organic solvents, complex processing, and difficult scale-up. Supercritical fluids (SCF), such as supercritical carbon dioxide (scCO2), have been used to produce protein-loaded microparticles and is advantageous over conventional methods regarding adjustable fluid properties, mild operating conditions, interfacial tensionless, cheap, non-toxicity, easy downstream processing and environment-friendly. Supercritical microfluidics (SCMF) depict the idea to combine strengths of process scale reduction with unique properties of SCF. Concerning the development of long-acting microparticles for biological therapeutics, SCMF processing offers several benefits over conventionally larger-scale systems such as enhanced control on fluid flow and other critical processing parameters such as pressure and temperature, easy modulation of product properties (such as particle size, morphology, and composition), cheaper equipment build-up, and convenient parallelization for high-throughput production. The objective of this project is to develop a mild microfluidic scCO2 based process for the production of long-acting injectable protein-loaded microparticles with, for example, Spider Silk Protein or PLGA as the encapsulating materials, and to evaluate the techno-economic potential of such SCMF technology for practical & industrial production.
Biotherapeutic medicines such as peptides, recombinant proteins, and monoclonal antibodies have successfully entered the market for treating or providing protection against chronic and life-threatening diseases. The number of relevant commercial products is rapidly increasing. Due to degradation in the gastro-intestinal tract, protein-based drugs cannot be taken orally but need to be administered via alternative routes. The parenteral injection is still the most widely applied administration route but therapy compliance of injection-based pharmacotherapies is a concern. Long-acting injectable (LAI) sustained release dosage forms such as microparticles allow less frequent injection to maintain plasma levels within their therapeutic window. Spider Silk Protein and Poly Lactic-co-Glycolic Acid (PLGA) have been attractive candidates to fabricate devices for drug delivery applications. However, conventional microencapsulation processes to manufacture microparticles encounter drawbacks such as protein activity loss, unacceptable residual organic solvents, complex processing, and difficult scale-up. Supercritical fluids (SCF), such as supercritical carbon dioxide (scCO2), have been used to produce protein-loaded microparticles and is advantageous over conventional methods regarding adjustable fluid properties, mild operating conditions, interfacial tensionless, cheap, non-toxicity, easy downstream processing and environment-friendly. Supercritical microfluidics (SCMF) depict the idea to combine strengths of process scale reduction with unique properties of SCF. Concerning the development of long-acting microparticles for biological therapeutics, SCMF processing offers several benefits over conventionally larger-scale systems such as enhanced control on fluid flow and other critical processing parameters such as pressure and temperature, easy modulation of product properties (such as particle size, morphology, and composition), cheaper equipment build-up, and convenient parallelization for high-throughput production. The objective of this project is to develop a mild microfluidic scCO2 based process for the production of long-acting injectable protein-loaded microparticles with, for example, Spider Silk Protein or PLGA as the encapsulating materials, and to evaluate the techno-economic potential of such SCMF technology for practical & industrial production.
