Malnutrition is a serious and widespread health problem in community-dwelling older adults who receive care in hospital and at home. Hospital and home care nurses and nursing assistants have a key role in the delivery of high-quality multidisciplinary nutritional care. Nursing nutritional care in current practice, however, is still suboptimal, which impacts its quality and continuity. There appear to be at least two reasons for this. First, there is a lack of evidence for nutritional care interventions to be carried out by nurses. Second, there are several factors, that influence nurses’ and nursing assistants’ current behaviour, such as lack of knowledge, moderate awareness of the importance and neutral attitudes. This results in a lack of attention towards nutritional care. Therefore, there is a need to generate more evidence and to focus on targeting the factors that influence nurses’ and nursing assistants’ current behaviour to eventually promote behaviour change. To increase the likelihood of successfully changing their behaviour, an evidence-based educational intervention is appropriate. This might lead to enhancing nutritional care and positively impact nutritional status, health and well-being of community-dwelling older adults. The general objectives of this thesis are: 1) To understand the current state of evidence regarding nutrition-related interventions and factors that influence current behaviour in nutritional care for older adults provided by hospital and home care nurses and nursing assistants to prevent and treat malnutrition. 2) To develop an educational intervention for hospital and home care nurses and nursing assistants to promote behaviour change by affecting factors that influence current behaviour in nutritional care for older adults and to describe the intervention development and feasibility.
Torpedo is a digital learning environment for developing mathematical problem-solving ability through self-study for pre-service teachers in primary teacher education. To achieve this, Torpedo supports and challenges pre-service teachers’ reflection during and after solving non-routine mathematics problems. To investigate the feasibility of the Torpedo approach, 271 pre-service teachers used Torpedo during one month in a pilot study. They used and evaluated Torpedo’s reflective elements differently. The results varied from pre-service teachers who experienced that reflection really contributed to the development of their problem-solving ability, to pre-service teachers who hardly reflected. The last group consisted of those who found the problems too difficult to reflect upon and those who used Torpedo to prepare for the National Mathematics Test and preferred to do so by drill and practice. As a conclusion, the study provides clues for improving Torpedo so that it invites more reflective self-study behaviour. For pre-service teachers who consider reflection valueless, however, self-study in a digital learning environment may be insufficient to change this attitude.
(‘Co’-)Designing for healthy behaviour greatly benefits from integrating insights about individual behaviour and systemic influences. This study reports our experiences in using insights about individual and systemic determinants of behaviour to inform a large co-design project. To do so, we used two design tools that encourage focusing on individual determinants (Behavioural Lenses Approach) and social / systemic aspects of behaviour (Socionas). We performed a qualitative analysis to identify 1) when and how the team applied the design tools, and 2) how the tools supported or obstructed the design process. The results show that both tools had their distinctive uses during the process. Both tools improved the co-design process by deepening the conversations and underpinnings of the prototypes. Using the Behavioural Lenses under the guidance of a behavioural expert proved most beneficial. Furthermore, the Socionas showed the most potential when interacting with stakeholders, i.c. parents and PPTs.
MULTIFILE
Alcohol use disorder (AUD) is a pattern of alcohol use that involves having trouble controlling drinking behaviour, even when it causes health issues (addiction) or problems functioning in daily (social and professional) life. Moreover, festivals are a common place where large crowds of festival-goers experience challenges refusing or controlling alcohol and substance use. Studies have shown that interventions at festivals are still very problematic. ARise is the first project that wants to help prevent AUD at festivals using Augmented Reality (AR) as a tool to help people, particular festival visitors, to say no to alcohol (and other substances). ARise is based on the on the first Augmented Reality Exposure Therapy (ARET) in the world that we developed for clinical treatment of AUD. It is an AR smartphone driven application in which (potential) visitors are confronted with virtual humans that will try to seduce the user to accept an alcoholic beverage. These virtual humans are projected in the real physical context (of a festival), using innovative AR glasses. Using intuitive phone, voice and gesture interactions, it allows users to personalize the safe experience by choosing different drinks and virtual humans with different looks and levels of realism. ARET has been successfully developed and tested on (former) AUD patients within a clinical setting. Research with patients and healthcare specialists revealed the wish to further develop ARET as a prevention tool to reach people before being diagnosed with AUD and to extend the application for other substances (smoking and pills). In this project, festival visitors will experience ARise and provide feedback on the following topics: (a) experience, (b) awareness and confidence to refuse alcohol drinks, (c) intention to use ARise, (d) usability & efficiency (the level of realism needed), and (e) ideas on how to extend ARise with new substances.
This PD project aims to gather new knowledge through artistic and participatory design research within neighbourhoods for possible ways of addressing and understanding the avoidance and numbness caused by feelings of vulnerability, discomfort and pain associated with eco-anxiety and chronic fear of environmental doom. The project will include artistic production and suitable forms of fieldwork. The objectives of the PD are to find answers to the practice problem of society which call for art that sensitises, makes aware and helps initiate behavioural change around the consequences of climate change. Rather than visualize future sea levels directly, it will seek to engage with climate change in a metaphorical and poetic way. Neither a doom nor an overly techno-optimistic scenario seem useful to understand the complexity of flood risk management or the dangers of flooding. By challenging both perspectives with artistic means, this research hopes to counter eco-anxiety and create a sense of open thought and susceptibility to new ideas, feelings and chains of thought. Animation and humour, are possible ingredients. The objective is to find and create multiple Dutch water stories, not just one. To achieve this, it is necessary to develop new methods for selecting and repurposing existing impactful stories and strong images. Citizens and students will be included to do so via fieldwork. In addition, archival materials will be used. Archives serve as a repository for memory recollection and reuse, selecting material from the audiovisual archive of the Institute of Sound & Vision will be a crucial part of the creative work which will include two films and accompanying music.
Onderzoek laat zien dat gedragsproblemen en leesproblemen vaak gelijktijdig voorkomen. Maar waar moet de leerkracht zich op richten; het gedrag of de leesprestaties? Voor de onderwijspraktijk is het relevant om uitsluitsel te krijgen over hoe deze problematiek in elkaar zit.Doel Uit veel onderzoek komt naar voren dat gedragsproblemen en leesproblemen bij veel kinderen min of meer gelijktijdig voorkomen. Leerkrachten zijn in deze situatie geneigd zich eerst te richten op het gedrag aangezien ze daar de meeste last van hebben. De primaire gerichtheid op gedragsproblemen uit zich ook in de grote vraag die er is naar begeleiding van leerkrachten bij het voorkomen en bestrijden van gedragsproblemen en de oververtegenwoordiging van studenten die bij de Master EN bij het Seminarium voor Orthopedagogiek de route Gedrag kiezen. De vraag is of deze gerichtheid terecht is en inderdaad tot de oplossing van de problemen leidt dan wel dat een achterliggend probleem de oorzaak is; namelijk een leesprobleem dat bij de leerling gedragsproblemen veroorzaakt. Het is relevant voor zowel de onderwijspraktijk als de opleidingen om uitsluitsel te krijgen over hoe deze problematiek in elkaar zit. In dit proefschrift wordt beoogd de vraag te beantwoorden of de gerichtheid op gedragsproblemen terecht is. Ook wil hiermee tegemoet worden gekomen aan de behoefte aan onderzoek waarmee de praktijk duidelijkere handvatten aangereikt krijgt om om te gaan met deze problemen en waar te beginnen met het bestrijden en voorkomen van de problemen. De volgende onderzoeksvragen worden beantwoord: 1) Gaan leesproblemen vooraf aan gedragsproblemen, is het andersom of is er sprake van wederzijdse volgtijdelijkheid? 2) Veroorzaken leesproblemen gedragsproblemen, is het andersom of veroorzaken zij elkaar? 3) In welke mate is lezen en gedrag te beïnvloeden door de leerkracht? Resultaten Het gedrag van leerlingen tijdens de leesles (aandacht, verstorend gedrag, emotionele stabiliteit) blijkt niet bij te dragen aan hun leesvaardigheid aan het eind van datzelfde schooljaar (groep 5); het is dus niet zo dat leerlingen die zich beter gedragen aan het begin van het jaar, beter lezen aan het eind van het jaar. Andersom is het wel zo dat leerlingen die aan het begin van het jaar beter lezen, zich aan het eind van het jaar beter gedragen (Brokamp, Houtveen & Van de Grift, 2018b; Brokamp, Houtveen & Van de Grift, submitted). Er wordt momenteel vervolgonderzoek uitgevoerd om te kijken of deze trend hetzelfde is over meerdere leerjaren. Wanneer gekeken wordt naar wat de leerkracht kan doen om zowel het lezen als het gedrag van de leerlingen tijdens de leesles te beïnvloeden, blijkt dat de leerkracht door het geven van een kwalitatief goede leesles ervoor kan zorgen dat de leerlingen beter gaan lezen, maar ook meer gefocust zijn, minder verstorend gedrag vertonen en (in minder mate) meer zelfvertrouwen hebben. Voor de praktijk heeft dit een belangrijke implicatie, namelijk het belang van goed leesonderwijs; het geven van een goede leesles zorgt niet alleen voor verbetering van de leesprestaties maar kan ook in positieve zin bijdragen aan het gedrag van de leerlingen (Brokamp, Houtveen & Van de Grift, 2016; 2018a). Brokamp, S.K., Houtveen, A.A.M., & Van de Grift, W.J.C.M. (submitted). Reading and behavioural and emotional engagement: a bidirectional relationship? Brokamp, S.K., Houtveen, A.A.M., & Van de Grift, W.J.C.M (2016, January). Reading, classroom behaviour and teaching skills. Paper presented at ICSEI 2016 Conference, Glasgow, UK. Brokamp, S.K., Houtveen, A.A.M., & Van de Grift, W.J.C.M (2018a). The relationship among students' reading performance, their classroom behavior, and teacher skills. The Journal of Educational Research. doi: 10.1080/00220671.2017.1411878 Brokamp, S.K., Houtveen, A.A.M., & Van de Grift, W.J.C.M (2018b, Juni). Leesvaardigheid en betrokkenheid tijdens het lezen: een bidirectionele relatie?. Paper gepresenteerd op de ORD 2018 Conferentie, Nijmegen, Nederland. Looptijd 01 december 2012 - 31 december 2020 Aanpak In het onderzoek meten we zowel het gedrag tijdens de leesles als de leesvaardigheid van de leerlingen over meerdere jaren. Ook bekijken we het instructiegedrag en algemeen pedagogisch handelen van de leerkrachten om de vraag te kunnen beantwoorden in welke mate de leerkrachten het lezen en gedrag van de leerlingen kunnen beïnvloeden.
