During the past decades deinstitutionalisation policies have led to a transition from inpatient towards community mental health care. Many European countries implement Assertive Community Treatment (ACT) as an alternative for inpatient care for “difficult to reach” children and adolescents with severe mental illness. ACT is a well-organized low-threshold treatment modality; patients are actively approached in their own environment, and efforts are undertaken to strengthen the patient’s motivation for treatment. The assumption is that ACT may help to avoid psychiatric hospital admissions, enhance cost-effectiveness, stimulate social participation and support, and reduce stigma. ACT has been extensively investigated in adults with severe mental illness and various reviews support its effectiveness in this patient group. However, to date there is no review available regarding the effectiveness of youth-ACT. It is unknown whether youth-ACT is as effective as it is in adults. This review aims to assess the effects of youth-ACT on severity of psychiatric symptoms, general functioning, and psychiatric hospital admissions.
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Introduction: Although some adults with autism spectrum disorder (ASD) require intensive and specialized ASD treatment, there is little research on how these adults experience the recovery process. Recovery is defined as the significant improvement in general functioning compared to the situation prior to treatment. Methods: This qualitative study describes the recovery process from the perspective of adults on the autism spectrum during intensive inpatient treatment. Semi-structured interviews (n = 15) were carried out and analyzed according to the principles of grounded theory. Results: Our results indicate that, given the specific characteristics of autism, therapeutic interventions and goal-oriented work cannot be carried out successfully, and the recovery process cannot begin, if no good working relationship has been established, and if care is not organized in ways that a person on the autism spectrum finds clear and predictable.
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Background: Esophageal cancer and curative treatment have a significant impact on the physical fitness of patients. Knowledge about the course of physical fitness during neoadjuvant therapy and esophagectomy is helpful to determine the needs for interventions during and after curative treatment. This study aims to review the current evidence on the impact of curative treatment on the physical fitness of patients with esophageal cancer. Methods: A systematic literature search of PubMed, Embase, Cinahl and the Cochrane Library was conducted up to March 29, 2021. We included observational studies investigating the change of physical fitness (including exercise capacity, muscle strength, physical activity and activities of daily living) from pre-to post-neoadjuvant therapy and/or from pre-to post-esophagectomy. Quality of the studies was assessed and a meta-analysis was performed using standardized mean differences. Results: Twenty-seven articles were included. After neoadjuvant therapy, physical fitness decreased significantly. In the first three months after surgery, physical fitness was also significantly decreased compared to preoperative values. Subgroup analysis showed a restore in exercise capacity three months after surgery in patients who followed an exercise program. Six months after surgery, there was limited evidence that exercise capacity restored to preoperative values. Conclusion: Curative treatment seems to result in a decrease of physical fitness in patients with esophageal cancer, up to three months postoperatively. Six months postoperatively, results were conflicting. In patients who followed a pre- or postoperative exercise program, the postoperative impact of curative treatment seems to be less.
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Recycling of plastics plays an important role to reach a climate neutral industry. To come to a sustainable circular use of materials, it is important that recycled plastics can be used for comparable (or ugraded) applications as their original use. QuinLyte innovated a material that can reach this goal. SmartAgain® is a material that is obtained by recycling of high-barrier multilayer films and which maintains its properties after mechanical recycling. It opens the door for many applications, of which the production of a scoliosis brace is a typical example from the medical field. Scoliosis is a sideways curvature of the spine and wearing an orthopedic brace is the common non-invasive treatment to reduce the likelihood of spinal fusion surgery later. The traditional way to make such brace is inaccurate, messy, time- and money-consuming. Because of its nearly unlimited design freedom, 3D FDM-printing is regarded as the ultimate sustainable technique for producing such brace. From a materials point of view, SmartAgain® has the good fit with the mechanical property requirements of scoliosis braces. However, its fast crystallization rate often plays against the FDM-printing process, for example can cause poor layer-layer adhesion. Only when this problem is solved, a reliable brace which is strong, tough, and light weight could be printed via FDM-printing. Zuyd University of Applied Science has, in close collaboration with Maastricht University, built thorough knowledge on tuning crystallization kinetics with the temperature development during printing, resulting in printed products with improved layer-layer adhesion. Because of this knowledge and experience on developing materials for 3D printing, QuinLyte contacted Zuyd to develop a strategy for printing a wearable scoliosis brace of SmartAgain®. In the future a range of other tailor-made products can be envisioned. Thus, the project is in line with the GoChem-themes: raw materials from recycling, 3D printing and upcycling.
Mycelium biocomposites (MBCs) are a fairly new group of materials. MBCs are non-toxic and carbon-neutral cutting-edge circular materials obtained from agricultural residues and fungal mycelium, the vegetative part of fungi. Growing within days without complex processes, they offer versatile and effective solutions for diverse applications thanks to their customizable textures and characteristics achieved through controlled environmental conditions. This project involves a collaboration between MNEXT and First Circular Insulation (FC-I) to tackle challenges in MBC manufacturing, particularly the extended time and energy-intensive nature of the fungal incubation and drying phases. FC-I proposes an innovative deactivation method involving electrical discharges to expedite these processes, currently awaiting patent approval. However, a critical gap in scientific validation prompts the partnership with MNEXT, leveraging their expertise in mycelium research and MBCs. The research project centers on evaluating the efficacy of the innovative mycelium growth deactivation strategy proposed by FC-I. This one-year endeavor permits a thorough investigation, implementation, and validation of potential solutions, specifically targeting issues related to fungal regrowth and the preservation of sustained material properties. The collaboration synergizes academic and industrial expertise, with the dual purpose of achieving immediate project objectives and establishing a foundation for future advancements in mycelium materials.
Point-of-Care devices are broadly viewed as an important contribution to reduce the costs in our healthcare system. Cheap, quick, and reliable testing close to the point of need, can help early detection and thus reduce treatment costs, while improving the quality of life. An important challenge in the realization is the development of the individual cartridges that should be produced in large quantities at low costs. Especially for applications where high sensitivity is required, these cartrgidges will typically have a complex design. In this project we want to develop a manufacturing strategy for large scale production of cartridges based on photonic sensing chips, currently the most sensitive sensors available. A typical sensor cartridge with photonic sensors would comprise the sensor chip, an interface with active components (light source and detectors), the bio-active layer that captures the biomarkers to be detected and a protective package. In addition, there is the choice to integrate the active components in the package (making the interface an electrical one) or placing them in the read-out unit (making the interface an optical one). Finally, testing of the sensor cartridges should also be part of the process. A suitable manufacturing strategy would offer the lowest total-cost-of-ownership (TCO) of the production and use of the cartrdiges. Important in the considereations is that steps can be carried out at the wafer level, at the die level, and at the cartridge level. Because choices for a specific solution will strongly influence the possibilities for other steps, the development of a producitons strategy is far from straightforward. In this project we want to study the possibilities of the individual processes at the three levels mentioned (wafer, die, and cartridge), and in parallel develop a theoretical framework for finding the best strategy in this type of complex production processes.
