Purpose (1) To investigate the differences in the course of participation up to one year after stroke between distinct movement behavior patterns identified directly after discharge to the home setting, and (2) to investigate the longitudinal association between the development of movement behavior patterns over time and participation after stroke. Materials and methods 200 individuals with a first-ever stroke were assessed directly after discharge to the home setting, at six months and at one year. The Participation domain of the Stroke Impact Scale 3.0 was used to measure participation. Movement behavior was objectified using accelerometry for 14 days. Participants were categorized into three distinct movement behavior patterns: sedentary exercisers, sedentary movers and sedentary prolongers. Generalized estimating equations (GEE) were performed. Results People who were classified as sedentary prolongers directly after discharge was associated with a worse course of participation up to one year after stroke. The development of sedentary prolongers over time was also associated with worse participation compared to sedentary exercisers. Conclusions The course of participation after stroke differs across distinct movement behavior patterns after discharge to the home setting. Highly sedentary and inactive people with stroke are at risk for restrictions in participation over time. Implications for rehabilitation The course of participation in people with a first-ever stroke up to one year after discharge to the home setting differed based on three distinct movement behavior patterns, i.e., sedentary exercisers, sedentary movers and sedentary prolongers. Early identification of highly sedentary and inactive people with stroke after discharge to the home setting is important, as sedentary prolongers are at risk for restrictions in participation over time. Supporting people with stroke to adapt and maintain a healthy movement behavior after discharge to the home setting could prevent potential long-term restrictions in participation.
MULTIFILE
Objective. Hospital in Motion is a multidimensional implementation project aiming to improve movement behavior during hospitalization. The purpose of this study was to investigate the effectiveness of Hospital in Motion on movement behavior. Methods. This prospective study used a pre-implementation and post-implementation design. Hospital in Motion was conducted at 4 wards of an academic hospital in the Netherlands. In each ward, multidisciplinary teams followed a 10-month step-by-step approach, including the development and implementation of a ward-specific action plan with multiple interventions to improve movement behavior. Inpatient movement behavior was assessed before the start of the project and 1 year later using a behavioral mapping method in which patients were observed between 9:00 am and 4:00 pm. The primary outcome was the percentage of time spent lying down. In addition, sitting and moving, immobility-related complications, length of stay, discharge destination home, discharge destination rehabilitation setting, mortality, and 30-day readmissions were investigated. Differences between pre-implementation and post-implementation conditions were analyzed using the chi-square test for dichotomized variables, the Mann Whitney test for non-normal distributed data, or independent samples t test for normally distributed data. Results. Patient observations demonstrated that the primary outcome, the time spent lying down, changed from 60.1% to 52.2%. For secondary outcomes, the time spent sitting increased from 31.6% to 38.3%, and discharges to a rehabilitation setting reduced from 6 (4.4%) to 1 (0.7%). No statistical differences were found in the other secondary outcome measures. Conclusion. The implementation of the multidimensional project Hospital in Motion was associated with patients who were hospitalized spending less time lying in bed and with a reduced number of discharges to a rehabilitation setting. Impact. Inpatient movement behavior can be influenced by multidimensional interventions. Programs implementing interventions that specifically focus on improving time spent moving, in addition to decreasing time spent lying, are recommended.
Objective: To evaluate the preliminary effectiveness of a goal-directed movement intervention using a movement sensor on physical activity of hospitalized patients. Design: Prospective, pre-post study. Setting: A university medical center. Participants: Patients admitted to the pulmonology and nephrology/gastro-enterology wards. Intervention: The movement intervention consisted of (1) self-monitoring of patients' physical activity, (2) setting daily movement goals and (3) posters with exercises and walking routes. Physical activity was measured with a movement sensor (PAM AM400) which measures active minutes per day. Main measures: Primary outcome was the mean difference in active minutes per day pre- and post-implementation. Secondary outcomes were length of stay, discharge destination, immobility-related complications, physical functioning, perceived difficulty to move, 30-day readmission, 30-day mortality and the adoption of the intervention. Results: A total of 61 patients was included pre-implementation, and a total of 56 patients was included post-implementation. Pre-implementation, patients were active 38 ± 21 minutes (mean ± SD) per day, and post-implementation 50 ± 31 minutes per day (Δ12, P = 0.031). Perceived difficulty to move decreased from 3.4 to 1.7 (0-10) (Δ1.7, P = 0.008). No significant differences were found in other secondary outcomes. Conclusions: The goal-directed movement intervention seems to increase physical activity levels during hospitalization. Therefore, this intervention might be useful for other hospitals to stimulate inpatient physical activity.
Creating and testing the first Brand Segmentation Model in Augmented Reality using Microsoft Hololens. Sanoma together with SAMR launched an online brand segmentation tool based on large scale research, The brand model uses several brand values divided over three axes. However they cannot be displayed clearly in a 2D model. The space of BSR Quality Planner can be seen as a 3-dimensional meaningful space that is defined by the terms used to typify the brands. The third axis concerns a behaviour-based dimension: from ‘quirky behaviour’ to ‘standardadjusted behaviour’ (respectful, tolerant, solidarity). ‘Virtual/augmented reality’ does make it possible to clearly display (and experience) 3D. The Academy for Digital Entertainment (ADE) of Breda University of Applied Sciences has created the BSR Quality Planner in Virtual Reality – as a hologram. It’s the world’s first segmentation model in AR. Breda University of Applied Sciences (professorship Digital Media Concepts) has deployed hologram technology in order to use and demonstrate the planning tool in 3D. The Microsoft HoloLens can be used to experience the model in 3D while the user still sees the actual surroundings (unlike VR, with AR the space in which the user is active remains visible). The HoloLens is wireless, so the user can easily walk around the hologram. The device is operated using finger gestures, eye movements or voice commands. On a computer screen, other people who are present can watch along with the user. Research showed the added value of the AR model.Partners:Sanoma MediaMarketResponse (SAMR)
Wildlife crime is an important driver of biodiversity loss and disrupts the social and economic activities of local communities. During the last decade, poaching of charismatic megafauna, such as elephant and rhino, has increased strongly, driving these species to the brink of extinction. Early detection of poachers will strengthen the necessary law enforcement of park rangers in their battle against poaching. Internationally, innovative, high tech solutions are sought after to prevent poaching, such as wireless sensor networks where animals function as sensors. Movement of individuals of widely abundant, non-threatened wildlife species, for example, can be remotely monitored ‘real time’ using GPS-sensors. Deviations in movement of these species can be used to indicate the presence of poachers and prevent poaching. However, the discriminative power of the present movement sensor networks is limited. Recent advancements in biosensors led to the development of instruments that can remotely measure animal behaviour and physiology. These biosensors contribute to the sensitivity and specificity of such early warning system. Moreover, miniaturization and low cost production of sensors have increased the possibilities to measure multiple animals in a herd at the same time. Incorporating data about within-herd spatial position, group size and group composition will improve the successful detection of poachers. Our objective is to develop a wireless network of multiple sensors for sensing alarm responses of ungulate herds to prevent poaching of rhinos and elephants.
To what extent does receiving information about either popular attractions or less-visited at-tractions, presented as “highlights” of the city, influence the movement of tourists to popular or less-visited attractions, and how does this differ by information channel through which the information is presented? To what extent does receiving information about either popular attractions or less-visited at-tractions, presented as “highlights” of the city, influence tourists’ experience, including their evaluations of the destination, their visit as a whole, and the specific information channel they received, and how does this differ by information channel through which the information is presented? What implementation models and financing mechanisms are available for DMO’s to spread tourists using the information channels tested, contingent on their effectiveness as measured by the previous experiment?Societal issueDestination Management Organisations (DMOs) are looking for interventions that effectively discourage tourists from visiting crowded hotspots and entice them to visit less crowded locations. Interventions like changing infrastructure, charging entrance fees and re-serving site access are either too expensive, too invasive or politically controversial. It is much easier to intervene on tourists' behaviour by informing them about alternatives.Collaborative partnersNHL Stenden, Travel with Zoey, Amsterdam and Partners, Wonderful Copenhagen, Mobidot.
