21st century (clinical) decision support in nursing and allied healthcare. Developing a learning health system: a reasoned design of a theoretical framework.

In this paper, we present a framework for developing a Learning Health System (LHS) to provide means to a computerized clinical decision support system for allied healthcare and/or nursing professionals. LHSs are well suited to transform healthcare systems in a mission-oriented approach, and is being adopted by an increasing number of countries. Our theoretical framework provides a blueprint for organizing such a transformation with help of evidence based state of the art methodologies and techniques to eventually optimize personalized health and healthcare.

Identifying Patient Characteristics Associated With the Occurrence of Post Treatment Non-serious Adverse Events After Cervical Spine Manual Therapy Treatment in Patients With Neck Pain.

Objectives: To compare prevalence rates of serious and non-serious adverse events after manipulation and mobilization and to identify risk factors of serious and non-serious adverse events following 4 types of manual therapy treatment in patients with neck pain.

Design: A prospective cohort study in primary care manual therapy practice.

Participants: Patients with neck pain (N=686) provided data on adverse events after 1014 manipulation treatments, 829 mobilization treatments, 437 combined manipulation and mobilization treatments, and 891 treatments consisting of "other treatment modality".

Using storytelling methodology to identify barriers and facilitators of sustained physical activity in patients with a chronic disease: a qualitative study.

Objectives: To identify implicit and more profound barriers and facilitators and involving context elements to accomplish sustained physical activity (PA) in patients with a chronic disease. Understanding these barriers and facilitators may help develop future strategies to be used by healthcare professionals in primary care to support patients with a chronic disease to reach sustained PA.

Design And Methods: The qualitative, narrative research method storytelling was applied.

Effects of Head and Neck Positions on Blood Flow in the Vertebral, Internal Carotid, and Intracranial Arteries: A Systematic Review.

Background: Manual therapy interventions targeting the neck include various positions and movements of the craniocervical region. The hemodynamic changes in various spinal positions potentially have clinical relevance.

Objectives: To investigate the effects of craniocervical positions and movements on hemodynamic parameters (blood flow velocity and/or volume) of cervical and craniocervical arteries.

Adverse events following cervical manipulative therapy: consensus on classification among Dutch medical specialists, manual therapists, and patients.

Objectives: To obtain consensus-based agreement on a classification system of adverse events (AE) following cervical spinal manipulation. The classification system should be comprised of clear definitions, include patients' and clinicians' perspectives, and have an acceptable number of categories.

Methods: : A three-round Delphi study.

To What Degree Does Active Cervical Range of Motion Differ Between Patients With Neck Pain, Patients With Whiplash, and Those Without Neck Pain? A Systematic Review and Meta-Analysis.

Objectives: To quantify differences in active cervical range of motion (aCROM) between patients with neck pain and those without neck pain, in patients with whiplash-associated disorders (WADs) and nontraumatic neck pain, and in patients with acute complaints versus those with chronic complaints.

Data Sources: Seven bibliographic databases were searched from inception to April 2015. In addition, a manual search was performed.

Three-dimensional Cervical Movement Characteristics in Healthy Subjects and Subgroups of Chronic Neck Pain Patients Based on Their Pain Location.

Study Design: A cross-sectional observational study of three-dimensional (3D) cervical kinematics in 41 chronic neck pain (CNPs) patients and 156 asymptomatic controls.

Objective: The objective was to investigate 3D cervical kinematics by analyzing and comparing quantitative and qualitative parameters in healthy subjects and CNPs. Furthermore, subgroups were formed to explore the influence of pain-location on cervical kinematics.

Validation of a new questionnaire to assess the impact of Whiplash Associated Disorders: The Whiplash Activity and participation List (WAL).

Valid questionnaires for measuring functional limitations in patients with Whiplash Associated Disorders (WAD) are lacking, since existing measures are not suitable for addressing the specific limitations of these patients and because of cross contamination between theoretical constructs. The objective of this study was to evaluate dimensionality, test-retest reliability, measurement error, construct validity, and responsiveness of a new condition-specific questionnaire for WAD as well as to estimate the minimally important change score. Patients with WAD grade I or II were recruited from physical therapy practices and rehabilitation centers.

Indicating spinal joint mobilisations or manipulations in patients with neck or low-back pain: protocol of an inter-examiner reliability study among manual therapists.

Background: Manual spinal joint mobilisations and manipulations are widely used treatments in patients with neck and low-back pain. Inter-examiner reliability of passive intervertebral motion assessment of the cervical and lumbar spine, perceived as important for indicating these interventions, is poor within a univariable approach. The diagnostic process as a whole in daily practice in manual therapy has a multivariable character, however, in which the use and interpretation of passive intervertebral motion assessment depend on earlier results from the diagnostic process.

Measurement of clinically relevant functional health perceptions in patients with whiplash-associated disorders: the development of the whiplash specific activity and participation list (WAL).

Purpose: The International Classification of Human Functioning Disability and Health (ICF) provides insight into functional health status in patients with whiplash-associated disorders (WAD). In the assessment of functional limitations in patients with WAD, there are several condition-specific questionnaires available. Estimation of the true relationship between the separate constructs of the ICF is only possible if the items of the salient questionnaires measure exactly the constructs of interest, while not simultaneously measuring other constructs of the model.

Content validity of the Dutch version of the Neck Bournemouth Questionnaire.

Objective: Mechanical neck pain is a common human phenomenon. In most cases, no patho-anatomical lesion can be identified with the limitations of current radiological imaging. Therefore it is preferable to assess patients with neck pain with a focus on functioning and health, within a biopsychosocial model.

The effect of training the deep cervical flexors on neck pain, neck mobility, and dizziness in a patient with chronic nonspecific neck pain after prolonged bed rest: a case report.

Study Design: Case report.

Background: Immobilization and chronic neck pain may cause a transformation of muscle tissue fibers. These changes affect the ability to effectively control 3-D movement of the cervical spine.

Practical use of the HOAC II for clinical decision making and subsequent therapeutic interventions in an elite athlete with low back pain.

Study Design: Resident's case problem.

Background: This case report describes the diagnostic process, based on the Hypothesis-Oriented Algorithm for Clinicians II (HOAC II), and subsequent interventions in an elite athlete with subacute low back pain. It also demonstrates the clinical application of the HOAC II and shows how disablement terms, as used in the World Health Organization's International Classification of Functioning, Disability and Health model, can be integrated into patient management in a manner that we believe enhances clinical practice.

The Neck Bournemouth Questionnaire cross-cultural adaptation into Dutch and evaluation of its psychometric properties in a population with subacute and chronic whiplash associated disorders.

Study Design: Cross-cultural adaptation of an outcome questionnaire.

Objective: The aim of the study was to cross-culturally adapt the Neck Bournemouth Questionnaire (NBQ) for the Dutch language in a population of people with subacute and chronic whiplash associated disorders (WAD), and to assess its psychometric qualities.

Summary Of Background Data: The NBQ covers the salient dimensions of the biopsychosocial model of pain, and has been shown to be reliable, valid, and responsive to clinically significant change in patients with non specific neck pain.

Patients with chronic whiplash-associated disorders: relationship between clinical and psychological factors and functional health status.

Objectives: To examine the relative contribution of cervical impairments and psychosocial factors to perceived disability among people with chronic whiplash-associated disorders.

Design: A total of 86 patients with chronic whiplash-associated disorders participated in this observational, cross-sectional study. All patients were presented to outpatient physical therapy clinics.

Functional health status in subjects after a motor vehicle accident, with emphasis on whiplash associated disorders: design of a descriptive, prospective inception cohort study.

Background: The clinical consequences of whiplash injuries resulting from a motor vehicle accident (MVA) are poorly understood. Thereby, there is general lack of research on the development of disability in patients with acute and chronic Whiplash Associated Disorders.

Methods/design: The objective is to describe the design of an inception cohort study with a 1-year follow-up to determine risk factors for the development of symptoms after a low-impact motor vehicle accident, the prognosis of chronic disability, and costs.