This study evaluates psychometric properties of the Individual Recovery Outcomes Counter (I.ROC) in a Dutch population of participants with a schizophrenia spectrum disorder (SSD). B. Esther Sportel1*† , Hettie Aardema1†, Nynke Boonstra2 , Johannes Arends1 , Bridey Rudd3 , Margot J. Metz4 , Stynke Castelein5 and Gerdina H.M. Pijnenborg6
MULTIFILE
Introduction The Integrated Recovery Scales (IRS) was developed by the Dutch National Expertise board for routine outcome monitoring with severe mental illnesses. This board aimed to develop a multidimensional recovery measure directed at 1. clinical recovery, 2. physical health, 3. social recovery (work, social contacts, independent living) and 4. existential, personal recovery. The measure had to be short, suited for routine outcome monitoring and present the perspective of both mental health professionals and service users with severe mental illnesses. All aspects are assessed over a period of the pas 6 months. Objectives The objective of this research is validation of the Integral Recovery Scales and to test the revelance for clinical practice and police evaluation. Methods The instrument was tested with 500 individuals with severe mental illnesses (80% individuals with a psychotic disorder), of whom 200 were followed up for 1 year. For the questions concerning clinical recovery, physical health and social recovery mental health care workers conducted semi structured interviews with people living with serious illnesses. The questions concerning personal health were self-rated. We analyzed interrater reliability, convergent and divergent validity and sensitivity to change. Results The instrument has a good validity and is easy to complete for service users and mental health care workers and appropriate for clinical and policy evaluation goals. Conclusions The Integrated Recovery Scales can be a useful instrument for a simple and meaningful routine outcome monitoring. Page: 121
BACKGROUND: Early mobilization has been proven effective for patients in intensive care units (ICUs) to improve functional recovery. However, early mobilization of critically ill, often mechanically ventilated, patients is cumbersome because of the attachment to tubes, drains, monitoring devices and muscle weakness. A mobile treadmill with bodyweight support may help to initiate mobilization earlier and more effectively. The aim of this study is to assess the effectiveness of weight-supported treadmill training in critically ill patients during and after ICU stay on time to independent functional ambulation. METHODS: In this randomized controlled trial, a custom-built bedside body weight-supported treadmill will be used and evaluated. Patients are included if they have been mechanically ventilated for at least 48 hours, are able to follow instructions, have quadriceps muscle strength of Medical Research Council sum-score 2 (MRC 2) or higher, can sit unsupported and meet the safety criteria for physical exercise. Exclusion criteria are language barriers, no prior walking ability, contraindications for physiotherapy or a neurological condition as reason for ICU admission. We aim to include 88 patients and randomize them into either the intervention or the control group. The intervention group will receive usual care plus bodyweight-supported treadmill training (BWSTT) daily. The BWSSTT consists of walking on a mobile treadmill while supported by a harness. The control group will receive usual care physiotherapy treatment daily consisting of progressive activities such as bed-cycling and active functional training exercises. In both groups, we will aim for a total of 40 minutes of physiotherapy treatment time every day in one or two sessions, as tolerated by the patient. The primary outcome is time to functional ambulation as measured in days, secondary outcomes include walking distance, muscle strength, status of functional mobility and symptoms of post-traumatic stress. All measurements will be done by assessors who are blinded to the intervention on the regular wards until hospital discharge. DISCUSSION: This will be the first study comparing the effects of BWSTT and conventional physiotherapy for critically ill patients during and after ICU stay. The results of this study contribute to a better understanding of the effectiveness of early physiotherapy interventions for critically ill patients. TRIAL REGISTRATION: Dutch Trial Register (NTR) ID: NL6766. Registered at 1 December 2017.
Currently, many novel innovative materials and manufacturing methods are developed in order to help businesses for improving their performance, developing new products, and also implement more sustainability into their current processes. For this purpose, additive manufacturing (AM) technology has been very successful in the fabrication of complex shape products, that cannot be manufactured by conventional approaches, and also using novel high-performance materials with more sustainable aspects. The application of bioplastics and biopolymers is growing fast in the 3D printing industry. Since they are good alternatives to petrochemical products that have negative impacts on environments, therefore, many research studies have been exploring and developing new biopolymers and 3D printing techniques for the fabrication of fully biobased products. In particular, 3D printing of smart biopolymers has attracted much attention due to the specific functionalities of the fabricated products. They have a unique ability to recover their original shape from a significant plastic deformation when a particular stimulus, like temperature, is applied. Therefore, the application of smart biopolymers in the 3D printing process gives an additional dimension (time) to this technology, called four-dimensional (4D) printing, and it highlights the promise for further development of 4D printing in the design and fabrication of smart structures and products. This performance in combination with specific complex designs, such as sandwich structures, allows the production of for example impact-resistant, stress-absorber panels, lightweight products for sporting goods, automotive, or many other applications. In this study, an experimental approach will be applied to fabricate a suitable biopolymer with a shape memory behavior and also investigate the impact of design and operational parameters on the functionality of 4D printed sandwich structures, especially, stress absorption rate and shape recovery behavior.
The production, use, disposal and recovery of packaging not only generates massive volumes of waste, it also consumes raw materials, water and energy (Fitzpatrick et al. 2012). Simultaneously, consumers have shown an increasing interest in products incorporating sustainable and social attributes (Kletzan et al., 2006). As a result, environmentally friendly packaging, also called ecofriendly or sustainable packaging, has become mainstream. In this context, packaging is more than just ensuring the product's protection and easing transportation, it is also a communicative tool (Palmer, 2000) and it becomes associated with multiple drivers of the purchasing process. Consequently, companies face pressure to innovate responding to consumer demands, and focusing on sustainable solutions that reduce harmful materials and favour green alternatives for both, the product and the packaging. Although the above has triggered research on consumer choice for sustainable products and alternatives on sustainable packaging, the relation between sustainable packaging and consumer behaviour remains underexplored. This research unpacks this relationship, i.e., empirically verifies which dimensions (recyclability, biodegradability, reusability) of sustainable packaging are perceived and valued by consumers. Put differently, this research investigates consumer behaviour towards the functions of sustainable packaging in terms of product protection, convenience, reliability of information and promotion, and scrutinises the perceived credibility of the associated ethical responsibility claims. It aims to identify those packaging materials and/or sustainability characteristics perceived as more sustainable by consumers as well as the factors influencing actual consumer choice towards sustainable packaged products. We aim to gain more insights in the perceptual frame that different types of consumers apply when exposed to sustainable packaging. To this end, we will make use of revealed preference methods to measure consumer valuations of sustainable packaged products. This game-theoretic approach should provide a more complete depiction of consumers' perceptions and preferences.
Mattresses for the healthcare sector are designed for robust use with a core foam layer and a polyurethane-coated polyester textile cover. Nurses and surgeons indicate that these mattresses are highly uncomfortable to patients because of poor microclimatic management (air, moisture, temperature, friction, pressure regulation, etc) across the mattress, which can cause pressure ulcers (in less than a day). The problem is severe (e.g., extra recovery time, medication, increased risk, and costs) for patients with wounds, infection, pressure-sensitive decubitus. There are around 180,000 waterproof mattresses in the healthcare sector in the Netherlands, of which yearly 40,000 mattresses are discarded. Owing to the rapidly aging population it is expected to increase the demand for these functional mattresses from 180,000 to 400,000 in the next 10 years in the healthcare sector. To achieve a circular economy, Dutch Government aims for a 50% reduction in the use of primary raw materials by 2030. As of January 1, 2022, mattress manufacturers and importers are obliged to pay a waste management contribution. Within the scope of this project, we will design, develop, and test a circular & functional mattress for the healthcare (cure & care) sector. The team of experts from knowledge institutes, SMEs, hospital(s), branch-organization joins hands to design and develop a functional (microclimate management, including ease of use for nurses and patients) mattress that deals with uncomfortable sleeping and addresses the issue of pressure ulcers thereby overall accelerating the healing process. Such development addresses the core issue of circularity. The systematic research with proper demand articulation leads to V-shape verification and validation research methodology. With design focus and applied R&D at TRL-level (4-6) is expected to deliver the validated prototype(s) offering SMEs an opportunity to innovate and expand their market. The knowledge will be used for dissemination and education at Saxion.
