Objective The purpose of this study was to investigate the relationship between body mass index (BMI) class and physical activity and sedentary behavior in patients with acute coronary syndrome (ACS) during cardiac rehabilitation (CR). Methods This study was a secondary analysis of the OPTICARE trial. Physical activity and sedentary behavior were measured in participants with ACS (n = 359) using actigraphy at baseline, directly after completion of a multidisciplinary 12-week exercise-based CR program and 9 months thereafter. Outcome measures were step count and duration of time (percentage of wear time) spent in light physical activity, moderate-to-vigorous physical activity, and sedentary behavior. Participants were classified as normal weight (BMI = 18.5–24.99 kg/m2; n = 82), overweight (BMI = 25.0–29.99 kg/m2; n = 182), or obese (BMI ≥ 30.0 kg/m2; n = 95). Linear mixed-effects models were applied to study the relationship between BMI class and physical activity and sedentary behavior. Results At the start of CR, compared with participants with normal weight, participants with obesity made on average 1.11 steps fewer per minute (952 steps/d), spent 2.9% (25 min/d) less time in light physical activity, and spent 3.31% (28 min/d) more time in sedentary behavior. Participants of all BMI classes improved their physical activity and sedentary behavior levels similarly during CR, and these improvements were maintained after completion of CR. Conclusion Participants with ACS who had obesity started CR with a less favorable physical activity and sedentary behavior profile than that of participants with normal weight. Because all BMI classes showed similar improvement during CR, this deficit was preserved. Impact This study indicates that reconsideration of the CR program in the Netherlands for patients with ACS and obesity is warranted, and development of more inclusive interventions for specific populations is needed. A new program for people with obesity should include added counseling on increasing physical activity and preventing sedentary behavior to facilitate weight loss and reduce mortality risk. Lay Summary People with ACS who have obesity are less active and sit more than individuals with normal weight, both during and after CR. This study suggests that CR needs to be changed to help individuals increase their physical activity to help them lose weight and reduce their risk of death.
BACKGROUND: Hospital stays are associated with high levels of sedentary behavior and physical inactivity. To objectively investigate physical behavior of hospitalized patients, these is a need for valid measurement instruments. The aim of this study was to assess the criterion validity of three accelerometers to measure lying, sitting, standing and walking. METHODS: This cross-sectional study was performed in a university hospital. Participants carried out several mobility tasks according to a structured protocol while wearing three accelerometers (ActiGraph GT9X Link, Activ8 Professional and Dynaport MoveMonitor). The participants were guided through the protocol by a test leader and were recorded on video to serve as reference. Sensitivity, specificity, positive predictive values (PPV) and negative predictive values (NPV) were determined for the categories lying, sitting, standing and walking. RESULTS: In total 12 subjects were included with a mean age of 49.5 (SD 21.5) years and a mean body mass index of 23.8 kg/m2 (SD 2.4). The ActiGraph GT9X Link showed an excellent sensitivity (90%) and PPV (98%) for walking, but a poor sensitivity for sitting and standing (57% and 53%), and a poor PPV (43%) for sitting. The Activ8 Professional showed an excellent sensitivity for sitting and walking (95% and 93%), excellent PPV (98%) for walking, but no sensitivity (0%) and PPV (0%) for lying. The Dynaport MoveMonitor showed an excellent sensitivity for sitting (94%), excellent PPV for lying and walking (100% and 99%), but a poor sensitivity (13%) and PPV (19%) for standing. CONCLUSIONS: The validity outcomes for the categories lying, sitting, standing and walking vary between the investigated accelerometers. All three accelerometers scored good to excellent in identifying walking. None of the accelerometers were able to identify all categories validly.
To evaluate the construct validity and the inter-rater reliability of the Dutch Activity Measure for Post- Acute Care “6-clicks” Basic Mobility short form measuring the patient’s mobility in Dutch hospital care. First, the “6-clicks” was translated by using a forward-backward translation protocol. Next, 64 patients were assessed by the physiotherapist to determine the validity while being admitted to the Internal Medicine wards of a university medical center. Six hypotheses were tested regarding the construct “mobility” which showed that: Better “6-clicks” scores were related to less restrictive pre-admission living situations (p¼0.011), less restrictive discharge locations (p¼0.001), more independence in activities of daily living (p¼0.001) and less physiotherapy visits (p<0.001). A correlation was found between the “6-clicks” and length of stay (r¼0.408, p¼0.001), but not between the “6-clicks” and age (r¼0.180, p¼0.528). To determine the inter-rater reliability, an additional 50 patients were assessed by pairs of physiotherapists who independently scored the patients. Intraclass Correlation Coefficients of 0.920 (95%CI: 0.828–0.964) were found. The Kappa Coefficients for the individual items ranged from 0.649 (walking stairs) to 0.841 (sit-to-stand). The Dutch “6-clicks” shows a good construct validity and moderate-toexcellent inter-rater reliability when used to assess the mobility of hospitalized patients.
Leerkrachten in Friese basisscholen zoeken naar goede strategieën om meertaligheid te erkennen en effectief in te zetten. Waar het onderwijs tot nu toe twee- en drietalig was (Fries, Nederlands en Engels), hebben leerkrachten nu in toenemende mate te maken met anderstalige migrantenleerlingen. Leerkrachten willen met deze strategieën antwoorden vinden op twee problemen. Ten eerste ervaren ze problemen in de omgang met migrantentalen: ze geven aan dat ze migrantentalen niet willen negeren, maar waarderen en gebruiken vinden ze moeilijk. Ten tweede willen leerkrachten de kwaliteit van het twee- of drietalige basisonderwijs waarin sprake is van taalscheiding, verbeteren. Er wordt per dag of in het Fries, of in het Nederlands of in het Engels onderwezen en geleerd. Men verwacht dat het verbinden van talen hogere resultaten opbrengt. Dit wordt ondersteund door wetenschappelijk onderzoek. Vierentwintig leerkrachten op twaalf basisscholen willen een innovatieve aanpak voor meertalig onderwijs ontwikkelen, die zowel een kader biedt voor de waardering en het gebruik van migrantentalen, als voor een samenhangend gebruik van het Nederlands, het Fries en het Engels in de scholen. Dat geheel vormt de basis van het project Meer kansen Met Meertaligheid (3M). Wetenschappelijk onderzoek levert gevalideerde benaderingen op die moeten worden uitgebreid, gecombineerd en toegesneden op de eigen schoolsituatie om voor de leerkrachten van nut te kunnen zijn. Het 3M-project richt zich op het samen ontwikkelen (d.m.v. ontwikkelingsonderzoek), uitproberen en evalueren van een nieuwe aanpak en nieuwe didactische tools voor meertalig onderwijs (d.m.v. interventieonderzoek). Alle ontwikkelde tools worden in een digitale 3M-Toolbox ondergebracht, die beschikbaar gesteld zal worden aan alle scholen. In de derde plaats vindt een flankerend effect-onderzoek naar (taal)attitudes plaats. In dit project beoogt het consortium een innovatieve kwaliteitsimpuls aan het meertalig basisonderwijs te geven, niet alleen in Fryslân, maar in heel Nederland.
De digitale transitie van mkb’s, met name in de maakindustrie, is goed onderweg, maar verre van afgerond. Er is een grote vraag naar het invoeren van het (Industrial) Internet of Things om procesdata van productiesystemen te bemachtigen en deze vervolgens te analyseren. Deze analysestap heeft een verdere interesseboost gekregen door de mogelijkheden van artificiële intelligentie (AI), waarmee data-analyses naar een complexer niveau getild kunnen worden. In het RAAK-mkb-project Data in Smart Industry staat deze vraag naar de mogelijkheden van IoT en AI centraal: welke data moeten en kunnen we verzamelen en vervolgens op welke manier analyseren? Met bedrijfspartners uit de maakindustrie zijn verschillende casussen IoT-technologie en machine learning (een subdomein van AI) ingezet in pilot studies. Ter afsluiting van het project wordt, in samenwerking met de brancheorganisatie FME en het smartindustryplatform Boost, en vanuit het RAAK-mkb-project Focus op Vision, een aantal trainingssessies georganiseerd rondom AI. Hierbij wordt het bedrijfsleven onderwezen in het toepassen van AI-technologie vanuit een procesmatig en technisch perspectief, waarbij lering wordt getrokken uit de casussen van het Data in Smart Industry-project. De Top-up-subsidie dient het doel om de geleerde lessen uit het RAAK-mkb-project verder te laten landen in de regio Oost-Nederland. Instrumentaal hierin is TValley, een fieldlab gericht op de ontwikkeling van mechatronische systemen zoals industriële robotica. Met de Top-up-subsidie kan TValley uitgebreid worden met een pijler omtrent IoT en AI, vakgebieden die deels overlap hebben met het huidige domein van het fieldlab. Hiervoor worden de ontwikkelde leermaterialen ingezet en doorontwikkeld om kennis te verspreiden en nieuwe bedrijfscasussen op te starten rondom de thema’s IoT en AI binnen TValley.
Various companies in diagnostic testing struggle with the same “valley of death” challenge. In order to further develop their sensing application, they rely on the technological readiness of easy and reproducible read-out systems. Photonic chips can be very sensitive sensors and can be made application-specific when coated with a properly chosen bio-functionalized layer. Here the challenge lies in the optical coupling of the active components (light source and detector) to the (disposable) photonic sensor chip. For the technology to be commercially viable, the price of the disposable photonic sensor chip should be as low as possible. The coupling of light from the source to the photonic sensor chip and back to the detectors requires a positioning accuracy of less than 1 micrometer, which is a tremendous challenge. In this research proposal, we want to investigate which of the six degrees of freedom (three translational and three rotational) are the most crucial when aligning photonic sensor chips with the external active components. Knowing these degrees of freedom and their respective range we can develop and test an automated alignment tool which can realize photonic sensor chip alignment reproducibly and fully autonomously. The consortium with expertise and contributions in the value chain of photonics interfacing, system and mechanical engineering will investigate a two-step solution. This solution comprises a passive pre-alignment step (a mechanical stop determines the position), followed by an active alignment step (an algorithm moves the source to the optimal position with respect to the chip). The results will be integrated into a demonstrator that performs an automated procedure that aligns a passive photonic chip with a terminal that contains the active components. The demonstrator is successful if adequate optical coupling of the passive photonic chip with the external active components is realized fully automatically, without the need of operator intervention.
