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This paper reports on the first stage of a research project1) that aims to incorporate objective measures of physical activity into health and lifestyle surveys. Physical activity is typically measured with questionnaires that are known to have measurement issues, and specifically, overestimate the amount of physical activity of the population. In a lab setting, 40 participants wore four different sensors on five different body parts, while performing various activities (sitting, standing, stepping with two intensities, bicycling with two intensities, walking stairs and jumping). During the first four activities, energy expenditure was measured by monitoring heart rate and the gas volume of in‐ and expired O2 and CO2. Participants subsequently wore two sensor systems (the ActivPAL on the thigh and the UKK on the waist) for a week. They also kept a diary keeping track of their physical activities, work and travel hours. Machine learning algorithms were trained with different methods to determine which sensor and which method was best able to differentiate the various activities and the intensity with which they were performed. It was found that the ActivPAL had the highest overall accuracy, possibly because the data generated on the upper tigh seems to be best distinguishing between different types of activities and therefore led to the highest accuracy. Accuracy could be slightly increased by including measures of heartrate. For recognizing intensity, three different measures were compared: allocation of MET values to activities (used by ActivPAL), median absolute deviation, and heart rate. It turns out that each method has merits and disadvantages, but median absolute deviation seems to be the most promishing metric. The search for the best method of gauging intensity is still ongoing. Subsequently, the algorithms developed for the lab data were used to determine physical activity in the week people wore the devices during their everyday activities. It quickly turned out that the models are far from ready to be used on free living data. Two approaches are suggested to remedy this: additional research with meticulously labelled free living data, e.g., by combining a Time Use Survey with accelerometer measurements. The second is to focus on better determining intensity of movement, e.g., with the help of unsupervised pattern recognition techniques. Accuracy was but one of the requirements for choosing a sensor system for subsequent research and ultimate implementation of sensor measurement in health surveys. Sensor position on the body, wearability, costs, usability, flexibility of analysis, response, and adherence to protocol equally determine the choice for a sensor. Also from these additional points of view, the activPAL is our sensor of choice.
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.
Bij de behandeling van depressie ligt in de reguliere GGZ een grote nadruk op symptomatisch herstel. Onderzoek toont echter aan dat symptomatisch herstel niet gelijk op gaat met persoonlijk herstel (herstel van identiteit, dagelijks- en sociaal functioneren). Hierdoor ervaren veel patiënten moeilijkheden bij het weer krijgen van grip op hun leven na een depressie. Om in deze lacune te voorzien is STAIRS ontwikkeld, een nieuw programma dat expliciet gebruik maakt van ervaringsdeskundigheid en (online) oefeningen gericht op het vergroten van de benodigde vaardigheden. Als blijkt dat deze training effectief is kan deze breder beschikbaar gesteld worden.
New biobased and circular products and solutions are invented and optimized all the time. Products that might have the potential to improve the world by preventing pollution and saving natural resources. However many of these promising products do not get a significant place in the market and fail to reach their positive impact. The result is a triple waste: in creativity and innovation, in investment of the companies involved and in opportunities to improve society. In this project Avans Expertise Centrum Sustainable Business (ESB), Avans Centre of Expertise Biobased Economy (CoEBBE) and SMEs Upstairs, Wiltec and NPSP look at the reasons why new sustainable products do not manage to achieve a significant market position and which practical guidelines can be designed to improve the success rate of the introduction of sustainable products and solutions. To realize this, we do not solely look at economic success but we start from the perspective that a successful product is one that truly improves society, rather than predominantly being profitable for a specific company. The focus is on creating multiple value (economic, social and ecological). Based on the theories of meaningful marketing and the adoption of innovations, the project analyses why the introduction of sustainable products and solutions will or will not be likely to succeed and also proposes ways to increase the likelihood of success. The learnings are translated to guidelines a SME should consider before product introduction.
Bij de behandeling van depressie ligt in de reguliere GGZ een grote nadruk op symptomatisch herstel. Onderzoek toont echter aan dat symptomatisch herstel niet gelijk op gaat met persoonlijk herstel (herstel van de indentiteit, dagelijks- en sociaal functioneren). Hierdoor ervaren veel patiënten moeilijkheden bij het weer krijgen van grip op hun leven na een depressie. Om in deze lacune te voorzien wordt STAIRS ontwikkeld, een nieuw programma dat expliciet gebruik maakt van ervaringsdeskundigheid en (online) oefeningen gericht op het vergroten van de benodigde vaardigheden. Dit pilot onderzoek richt zich op de eerste ervaringen met STAIRS ter voorbereiding op een multi center RCT.
