scholarly journals P147 REHABILITATION AFTER VENTRAL HERNIA SURGERY IN THE NETHERLANDS: A SURVEY

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Elske Berkvens ◽  
Bob Bloemendaal ◽  
Marijn Poelman ◽  
Tammo de Vries Reilingh ◽  
Wegdam Johannes
Keyword(s):  
Physical Therapy ◽  
The Netherlands ◽  
Ventral Hernia ◽  
Early Mobilization ◽  
Hernia Surgery ◽  
Physical Strain ◽  
Electronic Survey ◽  
Myofascial Release ◽  
Rehabilitation Protocols ◽  
Insight Into

Abstract Aim After any type of musculoskeletal surgery, post-operative rehabilitation with advices on weight baring and physical therapy is normal practice. Rehabilitation protocols lead to early mobilization and shorter hospitalization. Although ventral hernia repair (VHR) is musculotendinous surgery with tremendous impact on muscle strength and coordination, standardized and evidenced rehabilitation protocols for VHR are lacking. This survey aims to provide insight into the rehabilitation protocols after VHR, commonly used in the Netherlands. Material and Methods Hernia-surgeons in all Dutch hospitals were addressed in May 2021 by an electronic survey. Three cases were presented; non-complex (2 cm, primary umbilical repair), moderate-complex (8 cm, Rives-Stoppa) and complex (13 cm, myofascial release). Use of abdominal binders, advice on physical strain and referral for physical therapy were surveyed. Results 75 of 75 (100%) Dutch hospitals responded. In order of increasing hernia complexity an abdominal binder was prescribed in respectively 10%, 74% and 92% with various duration. Reduced physical strain was advised in 73%, 90% and 91%, mainly with a duration of 4-6 weeks (40%, 58% and 70%). Patients were referred for physical therapy after discharge in 4%, 15% and 41%. Conclusions This study describes the practice of rehabilitation after VHR in the Netherlands. Although abdominal binder prescription and physical strain advices increases with hernia complexity, there is no uniformity in duration. Physical therapy was advised only in a minority of the VHR patients, even after complex reconstructions. Lack of standardized rehabilitation protocols after VHR underlines the need for guidelines.

scholarly journals Strategies for the assessment of competences during rheumatology training across Europe: results of a qualitative study

RMD Open ◽  
2020 ◽  
Vol 6 (2) ◽  
pp. e001183 ◽  
Author(s):  
Aurélie Najm ◽  
Alessia Alunno ◽  
Francisca Sivera ◽  
Sofia Ramiro ◽  
Catherine Haines
Keyword(s):  
The Netherlands ◽  
Current Practice ◽  
Online Discussion ◽  
Qualitative Approach ◽  
Formative Feedback ◽  
Competence Assessment ◽  
The United Kingdom ◽  
Online Focus Groups ◽  
Assessment Systems ◽  
Insight Into

ObjectivesTo gain insight into current methods and practices for the assessment of competences during rheumatology training, and to explore the underlying priorities and rationales for competence assessment.MethodsWe used a qualitative approach through online focus groups (FGs) of rheumatology trainers and trainees, separately. The study included five countries—Denmark, the Netherlands, Slovenia, Spain and the United Kingdom. A summary of current practices of assessment of competences was developed, modified and validated by the FGs based on an independent response to a questionnaire. A prioritising method (9 Diamond technique) was then used to identify and justify key assessment priorities.ResultsOverall, 26 participants (12 trainers, 14 trainees) participated in nine online FGs (2 per country, Slovenia 1 joint), totalling 12 hours of online discussion. Strong nationally (the Netherlands, UK) or institutionally (Spain, Slovenia, Denmark) standardised approaches were described. Most groups identified providing frequent formative feedback to trainees for developmental purposes as the highest priority. Most discussions identified a need for improvement, particularly in developing streamlined approaches to portfolios that remain close to clinical practice, protecting time for quality observation and feedback, and adopting systematic approaches to incorporating teamwork and professionalism into assessment systems.ConclusionThis paper presents a clearer picture of the current practice on the assessment of competences in rheumatology in five European countries and the underlying rationale of trainers’ and trainees’ priorities. This work will inform EULAR Points-to-Consider for the assessment of competences in rheumatology training across Europe.

Double, triple or quadruple hits? Exploring the impact of cybercrime on victims in the Netherlands

2021 ◽  
pp. 026975802110106
Author(s):  
Raoul Notté ◽  
E.R. Leukfeldt ◽  
Marijke Malsch
Keyword(s):  
Public Opinion ◽  
Literature Review ◽  
The Netherlands ◽  
Public Discourse ◽  
Moral Judgments ◽  
Victim Blaming ◽  
High Prevalence ◽  
Different Types ◽  
The Impact ◽  
Insight Into

This article explores the impact of online crime victimisation. A literature review and 41 interviews – 19 with victims and 22 with experts – were carried out to gain insight into this. The interviews show that most impacts of online offences correspond to the impacts of traditional offline offences. There are also differences with offline crime victimisation. Several forms of impact seem to be specific to victims of online crime: the substantial scale and visibility of victimhood, victimisation that does not stop in time, the interwovenness of online and offline, and victim blaming. Victims suffer from double, triple or even quadruple hits; it is the accumulation of different types of impact, enforced by the limitlessness in time and space, which makes online crime victimisation so extremely invasive. Furthermore, the characteristics of online crime victimisation greatly complicate the fight against and prevention of online crime. Finally, the high prevalence of cybercrime victimisation combined with the severe impact of these crimes seems contradictory with public opinion – and associated moral judgments – on victims. Further research into the dominant public discourse on victimisation and how this affects the functioning of the police and victim support would be valuable.

scholarly journals Staying neutral or intervening?

2021 ◽  
Author(s):  
Maartje Hoogsteyns ◽  
Amalia Muhaimin
Keyword(s):  
Medical Students ◽  
The Netherlands ◽  
Medical Ethics ◽  
Cultural Change ◽  
Moral Distress ◽  
Institutional Constraints ◽  
Neutral Position ◽  
Insight Into ◽  
Proper Response

AbstractEthics teachers are regularly confronted with disturbing cases brought in by medical students in class. These classes are considered confidential, so that everyone can speak freely about their experiences. But what should ethics teachers do when they hear about a situation they consider to be outright alarming, for example where patients/students’ safety is at stake or where systematic power abuse seems to be at hand? Should they remain neutral or should they step in and intervene? In the Netherlands, as in many other countries, there are no clear guidelines for ethics teachers on how to respond. To get more insight into what teachers themselves think a proper response would be, we interviewed 18 Dutch medical ethics teachers. We found that Dutch ethics teachers will address the issue in class, but that they are overall reluctant to intervene; take action outside the scope of class. This reluctance is partly rooted in the conviction that ethicists should stay neutral and facilitate reflection, instead of telling students or physicians what to do. At the same time, this neutral position seems a difficult place to leave for those teachers who would want to or feel they need to. This has to do with various organizational and institutional constraints tied up with their position. The study invites medical ethics teachers to reflect on these constraints together and think about how to proceed from there. This study seeks to contribute to research on cultural change in medicine and medical students’ experiences of moral distress.

Professionals freaking out: the case of accreditation in Dutch higher education

2009 ◽  
Vol 21 (5) ◽  
pp. 473-485 ◽  
Author(s):  
Everard van Kemenade ◽  
Teun W. Hardjono
Keyword(s):  
The Netherlands ◽  
Design Methodology ◽  
Iso 9000 ◽  
Preliminary Survey ◽  
External Evaluation ◽  
Content Type ◽  
Evaluation Systems ◽  
System A ◽  
Engineering And Technology ◽  
Insight Into

PurposeThe purpose of this paper is to define what factors cause willingness and/or resistance among lecturers in universities towards external evaluation systems, especially accreditation.Design/methodology/approachA model has been designed to describe possible factors of willingness and/or resistance towards accreditation based on Ajzen and Metselaar. A literature review has been undertaken on the effects of external evaluation like ISO 9000 as well as accreditation systems such as Accreditation Board for Engineering and Technology and European Quality Improvement System. A questionnaire has been administered to a group of 63 lecturers from three departments at Fontys University in The Netherlands. The results of this preliminary survey have been presented to 1,500 academics in The Netherlands and Flanders to collect empirical data.FindingsResistance to accreditation can be found in the consequences of accreditation for the work of the lecturer (workload), negative emotions (stress and insecurity); the lack of knowledge and experience (help from specialists is needed); and lack of acceptance (other paradigm).Originality/valueThe paper provides more insight into the difficulties that organizations, especially universities, have to commit their employees to external evaluation. It might be possible to generalize the findings to other professionals in other organizations. Little research in this field has been undertaken so far.

scholarly journals Physical Therapist–Established Intensive Care Unit Early Mobilization Program: Quality Improvement Project for Critical Care at the University of California San Francisco Medical Center

2013 ◽  
Vol 93 (7) ◽  
pp. 975-985 ◽  
Author(s):  
Heidi J. Engel ◽  
Shintaro Tatebe ◽  
Philip B. Alonzo ◽  
Rebecca L. Mustille ◽  
Monica J. Rivera
Keyword(s):  
Quality Improvement ◽  
Physical Therapy ◽  
San Francisco ◽  
Physical Therapist ◽  
Medical Center ◽  
Early Mobilization ◽  
Quality Improvement Project ◽  
Improvement Project ◽  
Icu Admission ◽  
Number Of Patients

Background Long-term weakness and disability are common after an intensive care unit (ICU) stay. Usual care in the ICU prevents most patients from receiving preventative early mobilization. Objective The study objective was to describe a quality improvement project established by a physical therapist at the University of California San Francisco Medical Center from 2009 to 2011. The goal of the program was to reduce patients' ICU length of stay by increasing the number of patients in the ICU receiving physical therapy and decreasing the time from ICU admission to physical therapy initiation. Design This study was a 9-month retrospective analysis of a quality improvement project. Methods An interprofessional ICU Early Mobilization Group established and promoted guidelines for mobilizing patients in the ICU. A physical therapist was dedicated to a 16-bed medical-surgical ICU to provide physical therapy to selected patients within 48 hours of ICU admission. Patients receiving early physical therapy intervention in the ICU in 2010 were compared with patients receiving physical therapy under usual care practice in the same ICU in 2009. Results From 2009 to 2010, the number of patients receiving physical therapy in the ICU increased from 179 to 294. The median times (interquartile ranges) from ICU admission to physical therapy evaluation were 3 days (9 days) in 2009 and 1 day (2 days) in 2010. The ICU length of stay decreased by 2 days, on average, and the percentage of ambulatory patients discharged to home increased from 55% to 77%. Limitations This study relied upon the retrospective analysis of data from 6 collectors, and the intervention lacked physical therapy coverage for 7 days per week. Conclusions The improvements in outcomes demonstrated the value and feasibility of a physical therapist–led early mobilization program.

scholarly journals Trauma Mechanisms and Injuries Associated with Go-Karting

2010 ◽  
Vol 4 (1) ◽  
pp. 107-110 ◽  
Author(s):  
Hasan H. Eker ◽  
Esther M.M Van Lieshout ◽  
Dennis Den Hartog ◽  
Inger B Schipper
Keyword(s):  
The Netherlands ◽  
High Index ◽  
Medical Attention ◽  
Associated Injuries ◽  
Injury Patterns ◽  
Safety Measures ◽  
Large Variability ◽  
High Index Of Suspicion ◽  
Insight Into ◽  
Additional Safety

Annually, approximately 600 patients seek medical attention after go-kart accidents in the Netherlands. A large variability in injury patterns can be encountered. Knowledge of the trauma mechanisms of go-kart accidents and insight into the associated injuries is limited and requires improvement. Such additional knowledge may lead to customized trauma protocols for patients with a high index of suspicion on go-kart injuries. Research into trauma mechanisms may also lead to implementation of improved or additional safety measures for go-karting, involving both the go-karts itself as well as prerequisites to the go-kart tracks and qualifications for the drivers. The main trauma mechanisms involved in gokart accidents, and three cases to illustrate the variety of injuries are described in the current manuscript.

scholarly journals To Leave Your Kindred and Your Father’s House. Contemporary Dutch Christian Border Narratives

2017 ◽  
Vol 6 ◽  
pp. 174-196
Author(s):  
Sjoerd-Jeroen Moenandar ◽  
Krina Huisman
Keyword(s):  
The Netherlands ◽  
Life Writing ◽  
Narrative Structure ◽  
Christian Faith ◽  
Border Crossings ◽  
Border Narratives ◽  
The Church ◽  
Insight Into ◽  
Dutch People ◽  
Christian Denomination

In this article the authors analyse a collection of essays written by young Dutch people who grew up in the Reformed Liberated Church, a small Christian denomination in the Netherlands. Traditionally, this church is characterised by its inwards nature: members strive to live their lives within the confinements that the church and its institutions stipulate. This has changed over the last few decades and the essays attest to the effects these changes have had on individual lives. We discuss the underlying narrative structure of their accounts and how the authors negotiate different lifestyles and interpretations of the Christian faith on either side of the borders that demarcate the Reformed Liberated tradition. We discuss if – and how – the essays work towards an outcome of ‘discordant concordance’ (Ricœur) where narrative identities remain whole, despite relatively drastic border crossings in the course of the lives that formed them. We address how these stories give insight into how people use the stories they tell to define what needs to be remembered and forgotten when we cross borders. Finally, we discuss the relevance of these essays and our analysis of them for our understanding of today’s globalised and multicultural societies in which many are in a permanent state of transition. This article was submitted to the European Journal of Life Writing on February 17th and published on August 28th 2017.

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