2023, Article / Letter to editor (Physical and Occupational Therapy in Pediatrics, vol. 43, iss. 1, (2023), pp. 74-92)AIMS: Performing the Perceive, Recall, Plan and Perform (PRPP)-Assessment, using video material of everyday life, seems sensible to lower the patient burden, enhance ecological validity, and provide care at a distance. However, receipt of adequate video material is not self-evident and assessing videos can be challenging. Therefore, this study aims to optimize the process of gaining video material and to optimize the PRPP-Assessment based on parent-provided videos. METHODS: An action design research method was used, focusing on implementation of the PRPP-Assessment based on parent-provided videos within the care of children with a mitochondrial disorder or similar symptoms. RESULTS: Five cycles were conducted. To receive input, the cycles used videos of nine children performing activities, written feedback, and semi-structured interviews and focus groups comprising parents (nn=n13), a teacher (nn=n1), occupational therapists (nn=n16), and other professionals (nn=n2) . This led to successful implementation of the PRPP-Assessment. General lessons were learned on (1) instructing parents; (2) handling video material; (3) PRPP-Assessment based on parent-provided videos; and (4) PRPP-Assessment of children (with limited functional abilities). CONCLUSIONS: Lessons learned should be implemented in practice and are incorporated into a manual to guide the implementation of video-based observations with PRPP-Assessment in practice.
2023, Article / Letter to editor (Molecular Genetics and Metabolism, vol. 138, iss. 3, (2023), pp. 107523)RATIONALE: To date, causal therapy is potentially available for GRIN2B-related neurodevelopmental disorder (NDD) due to loss-of-function (LoF) variants in GRIN2B, resulting in dysfunction of the GluN2B subunit-containing N-methyl-d-aspartate receptor (NMDAR). Recently, in vitro experiments showed that high doses of NMDAR co-agonist d-serine has the potential to boost the activity in GluN2B LoF variant-containing NMDARs. Initial reports of GRIN2B-NDD patients LoF variants, treated with l-serine using different regimens, showed varying effects on motor and cognitive performance, communication, behavior and EEG. Here, this novel treatment using a standardized protocol with an innovative developmental outcome measure is explored further in an open-label observational GRIN2B-NDD study. METHODS: Initially, in vitro studies were conducted in order to functionally stratify two de novo GRIN2B variants present in two female patients (18 months and 4 years old). Functional studies showed that both variants are LoF, and thus the patients were treated experimentally according to an approved protocol with oral l-serine (500 mg/kg/day in 4 doses) for a period of 12 months. Both patients showed a heterogeneous clinical phenotype, however overlapping symptoms were present: intellectual developmental disability (IDD), behavioral abnormalities and hypotonia. Outcome measures included laboratory tests, quality of life, sleep, irritability, stool, and performance skills, measured by, among others, the Perceive-Recall-Plan-Perform System of Task Analysis (PRPP-Assessment). RESULTS: Both patients tolerated l-serine without adverse effects. In one patient, improvement in psychomotor development and cognitive functioning was observed after 12 months (PRPP mastery score 10% at baseline, 78% at twelve months). In the most severe clinically affected patient no significant objective improvement in validated outcomes was observed. Caregivers of both patients reported subjective increase of alertness and improved communication skills. CONCLUSION: Our observational study confirms that l-serine supplementation is safe in patients with GRIN2B-NDD associated with LoF variants, and may accelerate psychomotor development and ameliorate cognitive performance in some but not all patients. The PRPP-Assessment, a promising instrument to evaluate everyday activities and enhance personalized and value-based care, was not performed in the severely affected patient, meaning that possible positive results may have been missed. To generate stronger evidence for effect of l-serine in GRIN2B-NDD, we will perform placebo-controlled n-of-1 trials.
2023, Article / Letter to editor (BMC Musculoskeletal Disorders, vol. 24, iss. 1, (2023), pp. 132)BACKGROUND: Chronic low back pain (CLBP) is the most common chronic pain condition worldwide. Currently, primary care physiotherapy is one of the main treatment options, but effects of this treatment are small. Virtual Reality (VR) could be an adjunct to physiotherapy care, due to its multimodal features. The primary aim of this study is to assess the (cost-)effectiveness of physiotherapy with integrated multimodal VR for patients with complex CLBP, compared to usual primary physiotherapy care. METHODS: A multicenter, two-arm, cluster randomized controlled trial (RCT) including 120 patients with CLBP from 20 physiotherapists will be conducted. Patients in the control group will receive 12nweeks of usual primary physiotherapy care for CLBP. Patients in the experimental group will receive treatment consisting of 12nweeks of physiotherapy with integrated, immersive, multimodal, therapeutic VR. The therapeutic VR consists of the following modules: pain education, activation, relaxation and distraction. The primary outcome measure is physical functioning. Secondary outcome measures include pain intensity, pain-related fears, pain self-efficacy and economic measures. Effectiveness of the experimental intervention compared to the control intervention on primary and secondary outcome measures will be analyzed on an intention-to-treat principle, using linear mixed-model analyses. DISCUSSION: This pragmatic, multicenter cluster randomized controlled trial, will determine the clinical and cost-effectiveness of physiotherapy with integrated, personalized, multimodal, immersive VR in favor of usual physiotherapy care for patients with CLBP. TRIAL REGISTRATION: This study is prospectively registered at ClinicalTrials.gov (identifier: NCT05701891).
2022, Article / Letter to editor (Tijdschrift voor Beleid, Politiek en Maatschappij, vol. 49, iss. 1, (2022), pp. 53-72)In dit artikel pleiten wij voor een meer op skills gerichte re-integratiebereik. Omdat de 'klassieke' re-integratie - so snel mogelijk terug naar het 'oude' beroep bij de eigen werkgever- minder kansrijk lijkt als de vraag naar arbeid in dat oude beroep sterk verandert, afneemt of zelfs verdwijnt.
2022, Article / Letter to editor (Journal of Communication Management, vol. 26, iss. 3, (2022), pp. 236-253)Purpose
Many organisations wrestle with how to develop value-oriented businesses and societies. A humanistic communication approach that promotes understanding and dialogue amongst stakeholders can contribute to a solution. Communication professionals play a pivotal role in achieving a humanistic communication process. This paper aims to determine the significance of humanistic communication professionals and their characteristics.
Design/methodology/approach
A literature review was conducted to identify the characteristics of humanistic communication professionals. Thereafter, the extent to which such characteristics have been implemented in competency models in the Netherlands was investigated. This country’s strong tradition of developing competencies for communication professionals has resulted in competency models that serve as standards for professional development.
Findings
The literature review shows that a humanistic approach to communication is characterised by dialogic engagement and social listening to build and maintain trust, foster transparency and create engagement with stakeholders. Communication professionals can act as “cultural interpreters”, “organisational listeners” and “stewards of meaning”. The human element plays a key factor in the competency standards for communication professionals in the Netherlands, although the extent to which they are embedded varies. The analysis shows a shift from passing on a message towards dialogue and engagement.
Originality/value
Most studies of communication professionals’ competencies have been based on roles or tasks they perform. Little scholarly attention has been paid to competencies that add to developing value-oriented businesses and societies. This paper focuses specifically on how communication professionals can contribute to creating humanistic organisations.
2022, Article / Letter to editor (Journal of Interprofessional Care, (2022))The purpose of this study was to gain insight into change in attitudes held by students in oral healthcare about interprofessional learning and collaboration after one year of work in a student-run dental clinic (SRDC). Third- and fourth-year bachelor of dental hygiene students (n = 221) and first- and second-year master of dentistry students (n = 203) participated in baseline and follow-up measurements and completed 570 questionnaires. The Readiness for Interprofessional Learning Scale (RIPLS) was used to measure changes in attitudes toward Interprofessional Education (IPE) during participation in the SRDC. To validate the questionnaire for the setting, professional groups, and wording of RIPLS, we performed exploratory and confirmatory factor analyses. Two modified subscales remained: "Teamwork & Collaboration" and "Negative Professional Identity." Mixed linear models were used to assess relationships between students' attitudes toward IPE and participation in the SRDC. Overall, the students had positive attitudes toward IPE. At baseline, the attitudes of the dental hygiene and dentistry students were almost equally positive. After one year, dental hygiene students demonstrated a significantly more positive attitude toward collaborative learning and teamwork than the dentistry students. Further research should investigate whether the positive attitudes impact behavior in professional practice.