35 research outputs found

    Regionale clustering biologische landbouw; Randvoorwaarde voor groei?

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    Onderzoek naar het effect van regionale clustering op de groei van de biologische landbouw in Nederland. Op basis van literatuuronderzoek en interviews met woordvoerders van regionale samenwerkingsverbanden worden die activiteiten in de biologische landbouw onderscheiden, waarbij regionale clustering van belang kan zijn. Aan de hand van voorbeelden worden de mogelijke voor- en nadelen en belemmeringen aan de orde gesteld. Bovendien wordt het effect op de groei van de biologische landbouw zo mogelijk gekwantificeerd en wordt ingegaan op de mogelijke rol van de overheid in het kader van regelgeving en stimulering. Research into the effect of regional clustering on the growth of organic farming in the Netherlands. The activities within organic farming in which regional clustering may be important will be distinguished on the basis of literature research and interviews with representatives of regional cooperatives. The possible advantages, disadvantages and obstacles will be addressed using examples. Moreover, the effect on the growth of organic farming will be quantified if possible and the possible role of the government within the framework of regulations and encouragement will be examined

    Effectiveness of Chêneau brace treatment for idiopathic scoliosis: prospective study in 79 patients followed to skeletal maturity

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    <p>Abstract</p> <p>Background</p> <p>Progressive idiopathic scoliosis can negatively influence the development and functioning of 2-3% of adolescents, with health consequences and economic costs, placing the disease in the centre of interest of the developmental medicine. The aim of this study was to evaluate the effectiveness of Chêneau brace in the management of idiopathic scoliosis.</p> <p>Methods</p> <p>A prospective observational study according to SOSORT and SRS recommendations comprised 79 patients (58 girls and 21 boys) with progressive idiopathic scoliosis, treated with Chêneau brace and physiotherapy, with initial Cobb angle between 20 and 45 degrees, no previous brace treatment, Risser 4 or more at the final evaluation and minimum one year follow-up after weaning the brace. Achieving 50° of Cobb angle was considered surgical recommendation.</p> <p>Results</p> <p>At follow-up 20 patients (25.3%) improved, 18 patients (22.8%) were stable, 31 patients (39.2%) progressed below 50 degrees and 10 patients (12.7%) progressed beyond 50 degrees (2 of these 10 patients progressed beyond 60 degrees). Progression concerned the younger and less skeletally mature patients.</p> <p>Conclusion</p> <p>Conservative treatment with Chêneau orthosis and physiotherapy was effective in halting scoliosis progression in 48.1% of patients. The results of this study suggest that bracing is effective in reducing the incidence of surgery in comparison with natural history.</p

    Vital capacity evolution in patients treated with the CMCR brace: statistical analysis of 90 scoliotic patients treated with the CMCR brace

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    <p>Summary</p> <p>Objective</p> <p>To study the evolution of pulmonary capacity during orthopaedic treatment of scoliosis with the CMCR brace.</p> <p>Background</p> <p>Investigating the impact of moderate scoliosis on respiratory capacity and its evolution during CMCR brace treatment with mobile pads.</p> <p>Context</p> <p>Several studies demonstrate the impact of scoliosis on respiratory capacity but few of them focus on the impact of bracing treatment. We studied the evolution of the pulmonary capacity of a cohort of 90 scoliotic patients.</p> <p>Methods</p> <p>This retrospective study included 90 scoliotic patients treated since 1999 with a brace with mobile pads called CMCR (n = 90; mean age: 13 years; 10-16). These patients were diagnosed with an idiopathic scoliosis (mean angulation 20.6°). All patients underwent a radiographic and respiratory evaluation at the beginning, the middle and the end of treatment.</p> <p>Results</p> <p><it>Mean age at treatment start was </it>13. Before treatment, our patients did not have a normal pulmonary capacity: Forced Vital Capacity (FVC) was only 75% of the theoretical value. All curvature types (thoracic, thoraco-lumbar and combined scoliosis) involved this reduced pulmonary capacity, with moderate-angulated scoliosis having a negative impact. At the beginning of brace treatment, the loss of real vital capacity with brace (0.3 litres) was 10% lower than without brace.</p> <p>At CMCR removal, the FVC had increased by 0.4 litre (21% +/- 4.2% compared to the initial value). The theoretical value had increased by 3%. This positive evolution was most important in girls at a low Risser stage (0,1,2), and before 11 years of age.</p> <p>Conclusion</p> <p>These results supported our approach of orthesis conception for adolescent idiopathic scoliosis which uses braces with mobile pads to preserve thorax and spine mobility.</p

    Bodemindicatoren voor duurzaam bodemgebruik in de veenweiden. Ecosysteemdiensten van landbouw- en natuurpercelen in het veenweidegebied van Zuid-Holland, Noord-Holland en Utrecht. Deel A Onderzoeksrapportage

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    Bodemindicatoren voor duurzaam bodemgebruik in de veenweiden : ecosysteemdiensten van landbouw- en natuurpercelen in het veenweidegebied van Zuid-Holland, Noord-Holland en Utrecht. De veenweiden van West Nederland vormen een oud en uniek landschap, zowel wat betreft landbouw als biodiversiteit en natuur. Het organische karakter van de bodem onder dit gewaardeerde cultuurlandschap is echter zowel de kracht als de zwakte ervan. Door de ontwatering voor landbouwgebruik vindt netto afbraak van de bodemorganische stof plaats, met bijbehorende bodemdaling en emissie van broeikasgassen. Om met zo min mogelijk bodemdaling en emissie van broeikasgassen een zo goed mogelijke productie en diversiteit te halen zijn handvaten nodig die gericht zijn op enerzijds de ecosysteemdiensten die de veenweiden leveren en anderzijds de bodemkwaliteit die deze levering van ecosysteemdiensten mogelijk maakt

    Effectiveness of manual therapy compared to usual care by the general practitioner for chronic tension-type headache: design of a randomised clinical trial

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    <p>Abstract</p> <p>Background</p> <p>Patients with Chronic Tension Type Headache (CTTH) report functional and emotional impairments (loss of workdays, sleep disturbances, emotional well-being) and are at risk for overuse of medication. Manual therapy may improve symptoms through mobilisation of the spine, correction of posture, and training of cervical muscles.</p> <p>We present the design of a randomised clinical trial (RCT) evaluating the effectiveness of manual therapy (MT) compared to usual care by the general practitioner (GP) in patients with CTTH.</p> <p>Methods and design</p> <p>Patients are eligible for participation if they present in general practice with CTTH according to the classification of the International Headache Society (IHS).</p> <p>Participants are randomised to either usual GP care according to the national Dutch general practice guidelines for headache, or manual therapy, consisting of mobilisations (high- and low velocity techniques), exercise therapy for the cervical and thoracic spine and postural correction. The primary outcome measures are the number of headache days and use of medication. Secondary outcome measures are severity of headache, functional status, sickness absence, use of other healthcare resources, active cervical range of motion, algometry, endurance of the neckflexor muscles and head posture. Follow-up assessments are conducted after 8 and 26 weeks.</p> <p>Discussion</p> <p>This is a pragmatic trial in which interventions are offered as they are carried out in everyday practice. This increases generalisability of results, but blinding of patients, GPs and therapists is not possible.</p> <p>The results of this trial will contribute to clinical decision making of the GP regarding referral to manual therapy in patients with chronic tension headache.</p

    Non-Surgical Interventions for Adolescents with Idiopathic Scoliosis: An Overview of Systematic Reviews

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    Non-surgical interventions for adolescents with idiopathic scoliosis remain highly controversial. Despite the publication of numerous reviews no explicit methodological evaluation of papers labeled as, or having a layout of, a systematic review, addressing this subject matter, is available.Analysis and comparison of the content, methodology, and evidence-base from systematic reviews regarding non-surgical interventions for adolescents with idiopathic scoliosis.Systematic overview of systematic reviews.Articles meeting the minimal criteria for a systematic review, regarding any non-surgical intervention for adolescent idiopathic scoliosis, with any outcomes measured, were included. Multiple general and systematic review specific databases, guideline registries, reference lists and websites of institutions were searched. The AMSTAR tool was used to critically appraise the methodology, and the Oxford Centre for Evidence Based Medicine and the Joanna Briggs Institute's hierarchies were applied to analyze the levels of evidence from included reviews.From 469 citations, twenty one papers were included for analysis. Five reviews assessed the effectiveness of scoliosis-specific exercise treatments, four assessed manual therapies, five evaluated bracing, four assessed different combinations of interventions, and one evaluated usual physical activity. Two reviews addressed the adverse effects of bracing. Two papers were high quality Cochrane reviews, Three were of moderate, and the remaining sixteen were of low or very low methodological quality. The level of evidence of these reviews ranged from 1 or 1+ to 4, and in some reviews, due to their low methodological quality and/or poor reporting, this could not be established.Higher quality reviews indicate that generally there is insufficient evidence to make a judgment on whether non-surgical interventions in adolescent idiopathic scoliosis are effective. Papers labeled as systematic reviews need to be considered in terms of their methodological rigor; otherwise they may be mistakenly regarded as high quality sources of evidence.CRD42013003538, PROSPERO

    Bodemindicatoren voor duurzaam bodemgebruik in de veenweiden. Ecosysteemdiensten van landbouw- en natuurpercelen in het veenweidegebied van Zuid-Holland, Noord-Holland en Utrecht. Deel A Onderzoeksrapportage

    Get PDF
    Bodemindicatoren voor duurzaam bodemgebruik in de veenweiden : ecosysteemdiensten van landbouw- en natuurpercelen in het veenweidegebied van Zuid-Holland, Noord-Holland en Utrecht. De veenweiden van West Nederland vormen een oud en uniek landschap, zowel wat betreft landbouw als biodiversiteit en natuur. Het organische karakter van de bodem onder dit gewaardeerde cultuurlandschap is echter zowel de kracht als de zwakte ervan. Door de ontwatering voor landbouwgebruik vindt netto afbraak van de bodemorganische stof plaats, met bijbehorende bodemdaling en emissie van broeikasgassen. Om met zo min mogelijk bodemdaling en emissie van broeikasgassen een zo goed mogelijke productie en diversiteit te halen zijn handvaten nodig die gericht zijn op enerzijds de ecosysteemdiensten die de veenweiden leveren en anderzijds de bodemkwaliteit die deze levering van ecosysteemdiensten mogelijk maakt

    Introduction to the "Scoliosis" Journal Brace Technology Thematic Series: increasing existing knowledge and promoting future developments

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    Bracing is the main non-surgical intervention in the treatment of idiopathic scoliosis during growth, in hyperkyphosis (and Scheuermann disease) and occasionally for spondylolisthesis; it can be used in adult scoliosis, in the elderly when pathological curves lead to a forward leaning posture or in adults after traumatic injuries. Bracing can be defined as the application of external corrective forces to the trunk; rigid supports or elastic bands can be used and braces can be custom-made or prefabricated. The state of research in the field of conservative treatment is insufficient and while it can be stated that there is some evidence to support bracing, we must also acknowledge that today we do not have a common and generally accepted knowledge base, and that instead, individual expertise still prevails, giving rise to different schools of thought on brace construction and principles of correction. The only way to improve the knowledge and understanding of brace type and brace function is to establish a single and comprehensive source of information about bracing. This is what the Scoliosis Journal is going to do through the "Brace Technology" Thematic Series, where technical papers coming from the different schools will be published

    SOSORT consensus paper: school screening for scoliosis. Where are we today?

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    This report is the SOSORT Consensus Paper on School Screening for Scoliosis discussed at the 4th International Conference on Conservative Management of Spinal Deformities, presented by SOSORT, on May 2007. The objectives were numerous, 1) the inclusion of the existing information on the issue, 2) the analysis and discussion of the responses by the meeting attendees to the twenty six questions of the questionnaire, 3) the impact of screening on frequency of surgical treatment and of its discontinuation, 4) the reasons why these programs must be continued, 5) the evolving aim of School Screening for Scoliosis and 6) recommendations for improvement of the procedure
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