Physiotherapy, Dietetics and Occupational Therapy have been collaborating over recent years to develop an optimal healthcare programme for patients with Post Intensive Care Syndrome (PICS). This case is an example of PICS symptomatology and focuses on the collaboration between Physiotherapy and Dietetics. What is PICS? Owing to healthcare improvements, more and more patients are surviving the intensive Care Unit (ICU), and recovery during and after ICU stay has been receiving more attention [1, 2]. Approximately 30% of the patients admitted to an ICU have persistent symptoms including muscle weakness, reduced walking ability, fatigue, concentration deficits, memory problems, malnutrition, sleep and mood disorders sometimes even years after discharge [3-8]. Since 2012, this combination of physical, cognitive and psychiatric manifestations and reduced quality of life after staying in an ICU has been recognised as Post Intensive Care Syndrome (PICS) [9]. The impact of PICS is often not limited to the patient as it may also impact the mental status of the patient’s immediate family. This is known as PICS-Family (PICS-F) [10-12]. Treatment of PICS: Approximately 80% of PICS patients need primary care physiotherapy. Physiotherapists and GPs are often the only primary care professionals involved in the recovery process of these patients after hospital discharge [13, 14]. Both patients and healthcare professionals report a number of difficulties, e.g. limited transmural continuity in healthcare, coordination of multidisciplinary activities, supportive treatment guidelines and specific knowledge of pathology, treatment and prognosis. Patients report that they are not adequately supported when resuming their professional activities and that medical and allied healthcare treatments do not fully meet their needs at that time [15-18]. The REACH project: In order to improve the situation, the REACH project (REhabilitation After Critical illness and Hospital discharge) was started in Amsterdam region in the Netherlands. Within REACH, a Community of Practice – consisting of professionals (physiotherapists, occupational therapists, dieticians), those who live or have lived with the condition and researchers – has developed a transmural rehab programme. A special attribute of this programme is the integration of the concept of “positive health”. The case in this article describes the treatment of a PICS patient treated within the REACH network.
Catalogustekst bij tentoonstelling Intensive Care: Academie Minerva in het UMCG 2015.
Objective: The aim of the study was to assess the effectiveness of intensive care unit (ICU)–initiated transitional care interventions for patients and families on elements of post-intensive care syndrome (PICS) and/or PICS-family (PICS–F). Review method used: This is a systematic review and meta-analysis Sources: The authors searched in biomedical bibliographic databases including PubMed, Embase (OVID), CINAHL Plus (EBSCO), Web of Science, and the Cochrane Library and included studies written in English conducted up to October 8, 2020. Review methods: We included (non)randomised controlled trials focussing on ICU-initiated transitional care interventions for patients and families. Two authors conducted selection, quality assessment, and data extraction and synthesis independently. Outcomes were described using the three elements of PICS, which were categorised into (i) physical impairments (pulmonary, neuromuscular, and physical function), (ii) cognitive impairments (executive function, memory, attention, visuo-spatial and mental processing speed), and (iii) psychological health (anxiety, depression, acute stress disorder, post-traumatic stress disorder, and depression). Results: From the initially identified 5052 articles, five studies were included (i.e., two randomised controlled trials and three nonrandomised controlled trials) with varied transitional care interventions. Quality among the studies differs from moderate to high risk of bias. Evidence from the studies shows no significant differences in favour of transitional care interventions on physical or psychological aspects of PICS-(F). One study with a nurse-led structured follow-up program showed a significant difference in physical function at 3 months. Conclusions: Our review revealed that there is a paucity of research about the effectiveness of transitional care interventions for ICU patients with PICS. All, except one of the identified studies, failed to show a significant effect on the elements of PICS. However, these results should be interpreted with caution owing to variety and scarcity of data. Prospero registration: CRD42020136589 (available via https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020136589).
Developing a framework that integrates Advanced Language Models into the qualitative research process.Qualitative research, vital for understanding complex phenomena, is often limited by labour-intensive data collection, transcription, and analysis processes. This hinders scalability, accessibility, and efficiency in both academic and industry contexts. As a result, insights are often delayed or incomplete, impacting decision-making, policy development, and innovation. The lack of tools to enhance accuracy and reduce human error exacerbates these challenges, particularly for projects requiring large datasets or quick iterations. Addressing these inefficiencies through AI-driven solutions like AIDA can empower researchers, enhance outcomes, and make qualitative research more inclusive, impactful, and efficient.The AIDA project enhances qualitative research by integrating AI technologies to streamline transcription, coding, and analysis processes. This innovation enables researchers to analyse larger datasets with greater efficiency and accuracy, providing faster and more comprehensive insights. By reducing manual effort and human error, AIDA empowers organisations to make informed decisions and implement evidence-based policies more effectively. Its scalability supports diverse societal and industry applications, from healthcare to market research, fostering innovation and addressing complex challenges. Ultimately, AIDA contributes to improving research quality, accessibility, and societal relevance, driving advancements across multiple sectors.
Kansen voor circulaire beademingszorg De gezondheidszorg is verantwoordelijk voor 7% van de totale Nederlandse CO2-uitstoot. Eén van de meest materiaal intensieve afdelingen in een ziekenhuis is de intensive care. Patiënten op een intensive care worden beademd en ontvangen daarbij zogenaamde beademingszorg. Tijdens beademingszorg wordt gemaakt van hulpmiddelen zoals beademingsslangen, uitzuigslangen, filters en materialen ter infectiepreventie. De meeste hulpmiddelen worden na gebruik weggegooid. Om de zorg te verduurzamen zijn in de Green Deal doelstellingen geformuleerd om grondstoffenverbruik te verminderen in 2030 en uiteindelijk toe te werken naar circulaire zorg 2050. Er is op dit moment echter weinig kennis over de milieubelasting van gebruikte hulpmiddelen tijdens beademingszorg en de mogelijkheden om circulaire strategieën toe te passen. Dit project heeft als doel om een inventarisatie te maken van de milieubelasting en de afvalstromen van hulpmiddelen rondom beademingszorg. Daarbij is het project ook gericht op een inventarisatie van de mate waarin milieubelasting een overweging is bij de besluitvorming door betrokken stakeholders. Vervolgens zal in kaart worden gebracht welke mogelijkheden er zijn om via circulaire strategieën een bijdrage te leveren om de milieubelasting van hulpmiddelen rondom beademingszorg te verminderen. Voor de uitvoering van dit project zijn unieke deskundigheidsgebieden samengebracht in een consortium. De praktijkpartners hebben expertise in zorgverlening op de intensive care afdeling (AmsterdamUMC) en afvalstromen in ziekenhuizen (adviesbureau Innomax). De betrokken kennisinstellingen hebben expertise in onderwijs- en onderzoek rondom duurzaamheid (de Hogeschool van Amsterdam, Technische Universiteit Delft en Radboudumc). Dit consortium is een unieke samenwerking waarbij om kennis van zorgprocessen, afvalstromen en de milieubelasting van de zorgverlening op de intensive care worden gebundeld om de kansen voor duurzame beademingszorg te inventariseren. De resultaten van dit project zullen een praktijkverandering in gang zetten op intensive care afdelingen van AmsterdamUMC en Radboudumc en vervolgens ook verspreid worden via de landelijke en internationale netwerken.
Every year the police are confronted with an ever increasing number of complex cases involving missing persons. About 100 people are reported missing every year in the Netherlands, of which, an unknown number become victims of crime, and presumed buried in clandestine graves. Similarly, according to NWVA, several dead animals are also often buried illegally in clandestine graves in farm lands, which may result in the spread of diseases that have significant consequences to other animals and humans in general. Forensic investigators from both the national police (NP) and NWVA are often confronted with a dilemma: speed versus carefulness and precision. However, the current forensic investigation process of identifying and localizing clandestine graves are often labor intensive, time consuming and employ classical techniques, such as walking sticks and dogs (Police), which are not effective. Therefore, there is an urgent request from the forensic investigators to develop a new method to detect and localize clandestine graves quickly, efficiently and effectively. In this project, together with practitioners, knowledge institutes, SMEs and Field labs, practical research will be carried out to devise a new forensic investigation process to identify clandestine graves using an autonomous Crime Scene Investigative (CSI) drone. The new work process will exploit the newly adopted EU-wide drone regulation that relaxes a number of previously imposed flight restrictions. Moreover, it will effectively optimize the available drone and perception technologies in order to achieve the desired functionality, performance and operational safety in detecting/localizing clandestine graves autonomously. The proposed method will be demonstrated and validated in practical operational environments. This project will also make a demonstrable contribution to the renewal of higher professional education. The police and NVWA will be equipped with operating procedures, legislative knowledge, skills and technological expertise needed to effectively and efficiently performed their forensic investigations.
