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Aims To investigate the impact of consecutive perioperative care transitions on in-hospital recovery of patients who had primary total knee arthroplasty (TKA) over an 11-year period. Methods This observational cohort study used electronic health record data from all patients undergoing preoperative screening for primary TKA at a northern netherlands hospital between 2009 and 2020. In this timeframe, three perioperative care transitions were divided into four periods: Baseline care (Joint Care, n = 171; May 2009 to August 2010), Function-tailored (n = 404; September 2010 to October 2013), Fast-track (n = 721; november 2013 to May 2018), and Prehabilitation (n = 601; June 2018 to December 2020). In-hospital recovery was measured using inpatient recovery of activities (IROA), length of stay (LOS), and discharge to preoperative living situation (PLS). Multivariable regression models were used to analyze the impact of each perioperative care transition on in-hospital recovery. Results The four periods analyzed involved 1,853 patients (65.9% female (1,221/1,853); mean age 70.1 years (SD 9.0)). IROA improved significantly with each transition: Function-tailored (0.9 days; p < 0.001 (95% confidence interval (CI) -0.32 to -0.15)), Fast-track (0.6 days; p < 0.001 (95% CI -0.25 to -0.16)), and Prehabilitation (0.4 days; p < 0.001 (95% CI -0.18 to -0.10)). LOS decreased significantly in Function-tailored (1.1 days; p = 0.001 (95% CI -0.30 to -0.06)), Fast-track (0.6 days; p < 0.001 (95% CI -0.21 to -0.05)), and Prehabilitation (0.6 days; p < 0.001 (95%CI -0.27 to -0.11)). Discharge to PLS increased in Function-tailored (77%), Fast-track (91.6%), and Prehabilitation (92.6%). Post-hoc analysis indicated a significant increase after the transition to the Fast-track period (p < 0.001 (95% CI 3.19 to 8.00)). Conclusion This study highlights the positive impact of different perioperative care procedures on in-hospital recovery of patients undergoing primary TKA.

In deze factsheet zijn de prestaties van bedrijven met korte ketens ten opzichte van bedrijven zonder korte ketens op ecologische duurzaamheid, structuur en economie in kaart gebracht. Dit onderzoek is uitgevoerd met data uit het Bedrijveninformatienet van Wageningen Economic Research voor de melkveebedrijven voor 2017 en 2020.

In deze factsheet zijn de prestaties van bedrijven met korte ketens ten opzichte van bedrijven zonder korte ketens op ecologische duurzaamheid, structuur en economie in kaart gebracht. Dit onderzoek is uitgevoerd met data uit het Bedrijveninformatienet van Wageningen Economic Research voor de akkerbouw- en opengrondsgroentebedrijven voor 2017 en 2020.

Aan de hand van het Bedrijveninformatienet van Wageningen Economic Research en de Landbouwtelling van het CBS biedt deze studie een overzicht van kengetallen over de beregening op gewas- en regioniveau in de Nederlandse landbouw. Deze kengetallen zijn relevant voor discussies over het waterverbruik door de landbouw en beregeningsverboden bij droogte in relatie tot andere gebruiksfuncties van water. Het rapport bevat gedetailleerde gegevens voor de belangrijkste akkerbouw-, groente- en voedergewassen in diverse productieregio’s op klei-, veen- en zandgrond.

Risk-based monitoring of veterinary drug residues requires a prioritisation based on the potential occurrenceof these residues as well as their human health effects. Previously, decision trees have been drafted to include these elements allowing for a prioritization of substances into low, medium or high priority to be included in the National Residue Control Plan (NRCP). One decision tree focuses on unauthorised substances (group A) and another on authorised substances (group B). These decision trees have been used previouslyto prioritise veterinary drug residues in livestock production animals. The aim of the current research was to rank the substances for products derived from aquaculture, farmed game, rabbits and honey. The latest draft Implementing Regulation available at the time of the research (i.e. SANTE 11987-2017 Rev 9) was used to determine which substance groups for which animal species needed to be included in the NRCP. Available monitoring data from national monitoring, the rapid alert system for food and feed (RASFF) andEFSA reports were used as input for the prioritisation. Furthermore, potential use of veterinary drugs was assessed based on regulations in relevant import countries, availability of VMP online and internet research on potential use in the specified animal species (e.g. based on internet fora). The current evaluation revealed that limited monitoring data were available for the animal products studied in comparison to the earlier studied animal species. This resulted in a high number (59% of all substance-animal product combinations)of unauthorised substances prioritised as medium or high for precautionary reasons (marked with a proviso). Likewise, for the authorised substances, the conclusion for many substances (77%) was to perform a survey since data were lacking. For 28% of these substances, internet search indicated a potential use and for 1.5%of these substances non-compliances were found in related species.According to the lates

Contains fulltext : 232404.pdf (Publisher’s version ) (Open Access), Background. To gain insight into the current state-of-the-art of shared decision making (SDM) during decisions related to pre and postoperative care process regarding primary total knee replacement (TKR). Methods. A scoping review was performed to synthesize existing scientific research regarding (1) decisional needs and preferences of patients preparing for, undergoing and recovering from TKR surgery, (2) the relation between TKR decision-support interventions and SDM elements (i.e., team talk, option talk, and decision talk), (3) the extent to which TKR decision-support interventions address patients' decisional needs and preferences. Results. 2526 articles were identified, of which 17 articles met the inclusion criteria. Of the 17 articles, ten had a qualitative study design and seven had a quantitative study design. All included articles focused on the decision whether to undergo TKR surgery or not. Ten articles (all qualitative) examined patients' decisional needs and preferences. From these, we identified four domains that affected the patients' decision to undergo TKR: (1) personal factors, (2) external factors, (3) information sources and (4) preferences towards outcome prediction. Seven studies (5) randomized controlled trials and 2 cohort studies) used quantitative analyses to probe the effect of decision aids on SDM and/or clinical outcomes. In general, existing decision aids did not appear to be tailored to patient needs and preferences, nor were the principles of SDM well-articulated in the design of decision aids. Conclusions. SDM in TKR care is understudied; existing research appears to be narrow in scope with limited relevance to established SDM principles and the decisional needs of patients undertaking TKR surgery.

Background. To gain insight into the current state-of-the-art of shared decision making (SDM) during decisions related to pre and postoperative care process regarding primary total knee replacement (TKR). Methods. A scoping review was performed to synthesize existing scientific research regarding (1) decisional needs and preferences of patients preparing for, undergoing and recovering from TKR surgery, (2) the relation between TKR decision-support interventions and SDM elements (i.e., team talk, option talk, and decision talk), (3) the extent to which TKR decision-support interventions address patients’ decisional needs and preferences. Results. 2526 articles were identified, of which 17 articles met the inclusion criteria. Of the 17 articles, ten had a qualitative study design and seven had a quantitative study design. All included articles focused on the decision whether to undergo TKR surgery or not. Ten articles (all qualitative) examined patients’ decisional needs and preferences. From these, we identified four domains that affected the patients’ decision to undergo TKR: (1) personal factors, (2) external factors, (3) information sources and (4) preferences towards outcome prediction. Seven studies (5) randomized controlled trials and 2 cohort studies) used quantitative analyses to probe the effect of decision aids on SDM and/or clinical outcomes. In general, existing decision aids did not appear to be tailored to patient needs and preferences, nor were the principles of SDM well-articulated in the design of decision aids. Conclusions. SDM in TKR care is understudied; existing research appears to be narrow in scope with limited relevance to established SDM principles and the decisional needs of patients undertaking TKR surgery.