This paper aims to present a systematic literature review on state-of-the-art Educational Escape Rooms (EERs) with the use of digital technologies. More specifically, the focus of the study is to present the current developments and trends concerning Digital Educational Escape Rooms (DEERs) and investigate how they foster learning outcomes for online learners. Additionally, the present study provides insights into the design process of such technology enhanced EERs. This review is attributed to identifying and covering research gaps since the current literature has focused on the pedagogical aspects of Escape Rooms (ERs) in education, but no studies seem to have been conducted in regard to the pedagogical implications of Digital Escape Rooms (DERs) in educational environments. Based on the exhaustive literature review, an agenda for future research is promised and the implications for designing innovative ER approaches have been highlighted. The anatomy of the fundamental components of conducting systematic literature reviews was followed. The results of the review could be addressed to multidisciplinary teams related to education, game researchers, educational researchers, faculty members, scholars, instructors, and protagonists of educational systems to encourage them to thoroughly study the core elements of DEERs and how they can be applied in virtual educational contexts to facilitate students’ learning achievements.
Het overvoeren van zeer jonge kinderen (0 - 3 jaar) leidt ertoe dat zij later als volwassene een enorm hongergevoel hebben en daardoor in onze maatschappij van automatisering en overvloed overgewicht ontwikkelen. Daarnaast slapen mensen met overgewicht significant korter. In dit artikel wordt uiteengezet wat de evolutionaire verklaring hiervoor zou kunnen zijn. Tevens wordt een toetsbare hypothese opgesteld waarin de voorspelling wordt gedaan dat overvoeren op jonge leeftijd leidt tot overgewicht en korter slapen op latere leeftijd.
Background: Multimodal prehabilitation programs are effective at reducing complications after colorectal surgery in patients with a high risk of postoperative complications due to low aerobic capacity and/or malnutrition. However, high implementation fidelity is needed to achieve these effects in real-life practice. This study aimed to investigate the implementation fidelity of an evidence-based prehabilitation program in the real-life context of a Dutch regional hospital.Methods: In this observational cohort study with multiple case analyses, all patients who underwent colorectal surgery from January 2023 to June 2023 were enrolled. Patients meeting the criteria for low aerobic capacity or malnutrition were advised to participate in a prehabilitation program. According to recent scientific insights and the local care context, this program consisted of four exercise modalities and three nutrition modalities. Implementation fidelity was investigated by evaluating: (1) coverage (participation rate), (2) duration (number of days between the start of prehabilitation and surgery), (3) content (delivery of prescribed intervention modalities), and (4) frequency (attendance of sessions and compliance with prescribed parameters). An aggregated percentage of content and frequency was calculated to determine overall adherence.Results: Fifty-eight patients intended to follow the prehabilitation care pathway, of which 41 performed a preoperative risk assessment (coverage 80%). Ten patients (24%) were identified as high-risk and participated in the prehabilitation program (duration of 33-84 days). Adherence was high (84-100%) in five and moderate (72-73%) in two patients. Adherence was remarkably low (25%, 53%, 54%) in three patients who struggled to execute the prehabilitation program due to multiple physical and cognitive impairments.Conclusion: Implementation fidelity of an evidence-based multimodal prehabilitation program for high-risk patients preparing for colorectal surgery in real-life practice was moderate because adherence was high for most patients, but low for some patients. Patients with low adherence had multiple impairments, with consequences for their preparation for surgery. For healthcare professionals, it is recommended to pay attention to high-risk patients with multiple impairments and further personalize the prehabilitation program. More knowledge about identifying and treating high-risk patients is needed to provide evidence-based recommendations and to obtain higher effectiveness.
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