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Active Living: development and quasi-experimental evaluation of a school-centered physical activity intervention for primary school children

Background: The worldwide increase in the rates of childhood overweight and physical inactivity requires successful prevention and intervention programs for children. The aim of the Active Living project is to increase physical activity and decrease sedentary behavior of Dutch primary school children by developing and implementing tailored, multicomponent interventions at and around schools. Methods/design: In this project, school-centered interventions have been developed at 10 schools in the south of the Netherlands, using a combined top-down and bottom-up approach in which a research unit and a practice unit continuously interact. The interventions consist of a combination of physical and social interventions tailored to local needs of intervention schools. The process and short- and long-term effectiveness of the interventions will be evaluated using a quasi-experimental study design in which 10 intervention schools are matched with 10 control schools. Baseline and follow-up measurements (after 12 and 24 months) have been conducted in grades 6 and 7 and included accelerometry, GPS, and questionnaires. Primary outcome of the Active Living study is the change in physical activity levels, i.e. sedentary behavior (SB), light physical activity (LPA), moderate-to-vigorous physical activity (MVPA), and counts-per-minute (CPM). Multilevel regression analyses will be used to assess the effectiveness of isolated and combined physical and social interventions on children’s PA levels. Discussion: The current intervention study is unique in its combined approach of physical and social environmental PA interventions both at school(yard)s as well as in the local neighborhood around the schools. The strength of the study lies in the quasi-experimental design including objective measurement techniques, i.e. accelerometry and GPS, combined with more subjective techniques, i.e. questionnaires, implementation logbooks, and neighborhood observations. LinkedIn: https://www.linkedin.com/in/sanned/

Virtual and augmented reality gamifcation of visuospatial neglect treatment

Abstract Background Visuospatial neglect (VSN) is a cognitive disorder after stroke in which patients fail to consciously process and interact with contralesional stimuli. Visual Scanning Training (VST) is the recommended treatment in clinical guidelines. At the moment, several mixed reality versions of Visual Scanning Training (VST) are being developed. The aim of this study was to explore the opinions of end-users (i.e., therapists) on the use of Virtual Reality (VR) and Augmented Reality (AR) in VSN treatment. Methods Therapists played one VR and two AR Serious Games, and subsequently flled out a questionnaire on User Experience, Usability, and Implementation. Results Sixteen therapists (psychologists, occupational, speech, and physiotherapists) played the games, thirteen of them evaluated the games. Therapists saw great potential in all three games, yet there was room for improvement on the level of usability, especially for tailoring the games to the patient’s needs. Therapists’ opinions were comparable between VR and AR Serious Games. For implementation, therapists stressed the urgency of clear guidelines and instructions. Discussion Even though VR/AR technology is promising for VSN treatment, there is no one-size-fts-all applicability. It may thus be crucial to move towards a plethora of training environments rather than a single standardized mixed reality neglect treatment. Conclusion As therapists see the potential value of mixed reality, it remains important to investigate the efcacy of AR and VR training tools.

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A training programme facilitating guideline use of occupational health professionals

BACKGROUND: To evaluate whether a training programme is a feasible approach to facilitate occupational health professionals' (OHPs) use of knowledge and skills provided by a guideline.METHODS: Feasibility was evaluated by researching three aspects: 'acceptability', 'implementation' and 'limited efficacy'. Statements on acceptability and implementation were rated by OHPs on 10-point visual analogue scales after following the training programme (T2). Answers were analysed using descriptive statistics. Barriers to and facilitators of implementation were explored through open-ended questions at T2, which were qualitatively analysed. Limited efficacy was evaluated by measuring the level of knowledge and skills at baseline (T0), after reading the guideline (T1) and directly after completing the training programme (T2). Increase in knowledge and skills was analysed using a non-paramatric Friedman test and post-hoc Wilcoxon signed rank tests (two-tailed).RESULTS: The 38 OHPs found the training programme acceptable, judging that it was relevant (M: 8, SD: 1), increased their capability (M: 7, SD: 1), adhered to their daily practice (M: 8, SD: 1) and enhanced their guidance and assessment of people with a chronic disease (M: 8, SD: 1). OHPs found that it was feasible to implement the programme on a larger scale (M: 7, SD: 1) but foresaw barriers such as 'time', 'money' and organizational constraints. The reported facilitators were primarily related to the added value of the knowledge and skills to the OHPs' guidance and assessment, and that the programme taught them to apply the evidence in practice. Regarding limited efficacy, a significant increase was seen in OHPs' knowledge and skills over time (X2 (2) = 53.656, p < 0.001), with the median score improving from 6.3 (T0), 8.3 (T1) and 12.3 (T2). Post-hoc tests indicated a significant improvement between T0 and T1 (p < 0.001) and between T1 and T2 (p < 0.001).CONCLUSIONS: The training programme was found to be a feasible approach to facilitate OHPs' use of knowledge and skills provided by the guideline, from the perspective of OHPs generally (acceptability and implementation) and with respect to their increase in knowledge and skills in particular (limited efficacy).

Information structure influences depth of syntactic processing: event-related potential evidence for the Chomsky illusion.

Information structure facilitates communication between interlocutors by highlighting relevant information. It has previously been shown that information structure modulates the depth of semantic processing. Here we used event-related potentials to investigate whether information structure can modulate the depth of syntactic processing. In question-answer pairs, subtle (number agreement) or salient (phrase structure) syntactic violations were placed either in focus or out of focus through information structure marking. P600 effects to these violations reflect the depth of syntactic processing. For subtle violations, a P600 effect was observed in the focus condition, but not in the non-focus condition. For salient violations, comparable P600 effects were found in both conditions. These results indicate that information structure can modulate the depth of syntactic processing, but that this effect depends on the salience of the information. When subtle violations are not in focus, they are processed less elaborately. We label this phenomenon the Chomsky illusion.

The influence of information structure on the depth of semantic processing: How focus and pitch accent determine the size of the N400 effect.

To highlight relevant information in dialogues, both wh-question context and pitch accent in answers can be used, such that focused information gains more attention and is processed more elaborately. To evaluate the relative influence of context and pitch accent on the depth of semantic processing, we measured event-related potentials (ERPs) to auditorily presented wh-question-answer pairs. A semantically incongruent word in the answer occurred either in focus or in non-focus position as determined by the context, and this word was either accented or unaccented.Semantic incongruency elicited different N400 effects in different conditions. The largest N400 effect was found when the question-marked focus was accented, while the other three conditions elicited smaller N400 effects. The results suggest that context and accentuation interact. Thus accented focused words were processed more deeply compared to conditions where focus and accentuation mismatched, or when the new information had no marking. In addition, there seems to be sex differences in the depth of semantic processing. For males, a significant N400 effect was observed only when the question-marked focus was accented, reduced N400 effects were found in the other dialogues. In contrast, females produced similar N400 effects in all the conditions. These results suggest that regardless of external cues, females tend to engage in more elaborate semantic processing compared to males.