Patients with coronary artery disease (CAD) are more sedentary compared with the general population, but contemporary cardiac rehabilitation (CR) programmes do not specifically target sedentary behaviour (SB). We developed a 12-week, hybrid (centre-based+home-based) Sedentary behaviour IntervenTion as a personaLisEd Secondary prevention Strategy (SIT LESS). The SIT LESS programme is tailored to the needs of patients with CAD, using evidence-based behavioural change methods and an activity tracker connected to an online dashboard to enable self-monitoring and remote coaching. Following the intervention mapping principles, we first identified determinants of SB from literature to adapt theory-based methods and practical applications to target SB and then evaluated the intervention in advisory board meetings with patients and nurse specialists. This resulted in four core components of SIT LESS: (1) patient education, (2) goal setting, (3) motivational interviewing with coping planning, and (4) (tele)monitoring using a pocket-worn activity tracker connected to a smartphone application and providing vibrotactile feedback after prolonged sedentary bouts. We hypothesise that adding SIT LESS to contemporary CR will reduce SB in patients with CAD to a greater extent compared with usual care. Therefore, 212 patients with CAD will be recruited from two Dutch hospitals and randomised to CR (control) or CR+SIT LESS (intervention). Patients will be assessed prior to, immediately after and 3 months after CR. The primary comparison relates to the pre-CR versus post-CR difference in SB (objectively assessed in min/day) between the control and intervention groups. Secondary outcomes include between-group differences in SB characteristics (eg, number of sedentary bouts); change in SB 3 months after CR; changes in light-intensity and moderate-to-vigorous-intensity physical activity; quality of life; and patients’ competencies for self-management. Outcomes of the SIT LESS randomised clinical trial will provide novel insight into the effectiveness of a structured, hybrid and personalised behaviour change intervention to attenuate SB in patients with CAD participating in CR.
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Background A high sedentary time is associated with increased mortality risk. Previous studies indicate that replacement of sedentary time with light- and moderate-to-vigorous physical activity attenuates the risk for adverse outcomes and improves cardiovascular risk factors. Patients with cardiovascular disease are more sedentary compared to the general population, while daily time spent sedentary remains high following contemporary cardiac rehabilitation programmes. This clinical trial investigated the effectiveness of a sedentary behaviour intervention as a personalised secondary prevention strategy (SIT LESS) on changes in sedentary time among patients with coronary artery disease participating in cardiac rehabilitation. Methods Patients were randomised to usual care (n = 104) or SIT LESS (n = 108). Both groups received a comprehensive 12-week centre-based cardiac rehabilitation programme with face-to-face consultations and supervised exercise sessions, whereas SIT LESS participants additionally received a 12-week, nurse-delivered, hybrid behaviour change intervention in combination with a pocket-worn activity tracker connected to a smartphone application to continuously monitor sedentary time. Primary outcome was the change in device-based sedentary time between pre- to post-rehabilitation. Changes in sedentary time characteristics (prevalence of prolonged sedentary bouts and proportion of patients with sedentary time ≥ 9.5 h/day); time spent in light-intensity and moderate-to-vigorous physical activity; step count; quality of life; competencies for self-management; and cardiovascular risk score were assessed as secondary outcomes. Results Patients (77% male) were 63 ± 10 years and primarily diagnosed with myocardial infarction (78%). Sedentary time decreased in SIT LESS (− 1.6 [− 2.1 to − 1.1] hours/day) and controls (− 1.2 [ ─1.7 to − 0.8]), but between group differences did not reach statistical significance (─0.4 [─1.0 to 0.3]) hours/day). The post-rehabilitation proportion of patients with a sedentary time above the upper limit of normal (≥ 9.5 h/day) was significantly lower in SIT LESS versus controls (48% versus 72%, baseline-adjusted odds-ratio 0.4 (0.2–0.8)). No differences were observed in the other predefined secondary outcomes. Conclusions Among patients with coronary artery disease participating in cardiac rehabilitation, SIT LESS did not induce significantly greater reductions in sedentary time compared to controls, but delivery was feasible and a reduced odds of a sedentary time ≥ 9.5 h/day was observed.
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Purpose: A more dynamic school day that includes less sitting and more physical activity throughout the day may support health in primary school children. In this mixed methodologies study, we assessed which physical activity possibilities are incorporated in the school policies of Dutch primary schools and if this translates into more physical activity in pupils.Methods: Seven primary schools were included in the study. The head teachers completed a questionnaire on the incorporation of physical activity in the school policy. Physical activity policy was assessed for physical education, physical activity during breaks, scheduling of physical activity during lessons, after school physical activity and active transport to school. In each school, actual physical activity was objectively measured using accelerometers in pupils in two classes and planning and logging of PA by teachers.Results: We will assess the impact of the school policy on physical activity in pupils using logistic regression. We will assess the impact of the several school policies on total physical activity in pupils, and on the three (light, moderate and high) modalities of physical activity.Conclusion: The results of this study will give us more insight in the current role of physical activity in Dutch primary schools. The potential impact of the school policy on physical activity levels in pupils can be used as a starting point for a more integral dynamic school day approach.Support/Funding Source: This study was partially funded by “Stichting Westelijke Tuinsteden’
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Leerkrachten in Friese basisscholen zoeken naar goede strategieën om meertaligheid te erkennen en effectief in te zetten. Waar het onderwijs tot nu toe twee- en drietalig was (Fries, Nederlands en Engels), hebben leerkrachten nu in toenemende mate te maken met anderstalige migrantenleerlingen. Leerkrachten willen met deze strategieën antwoorden vinden op twee problemen. Ten eerste ervaren ze problemen in de omgang met migrantentalen: ze geven aan dat ze migrantentalen niet willen negeren, maar waarderen en gebruiken vinden ze moeilijk. Ten tweede willen leerkrachten de kwaliteit van het twee- of drietalige basisonderwijs waarin sprake is van taalscheiding, verbeteren. Er wordt per dag of in het Fries, of in het Nederlands of in het Engels onderwezen en geleerd. Men verwacht dat het verbinden van talen hogere resultaten opbrengt. Dit wordt ondersteund door wetenschappelijk onderzoek. Vierentwintig leerkrachten op twaalf basisscholen willen een innovatieve aanpak voor meertalig onderwijs ontwikkelen, die zowel een kader biedt voor de waardering en het gebruik van migrantentalen, als voor een samenhangend gebruik van het Nederlands, het Fries en het Engels in de scholen. Dat geheel vormt de basis van het project Meer kansen Met Meertaligheid (3M). Wetenschappelijk onderzoek levert gevalideerde benaderingen op die moeten worden uitgebreid, gecombineerd en toegesneden op de eigen schoolsituatie om voor de leerkrachten van nut te kunnen zijn. Het 3M-project richt zich op het samen ontwikkelen (d.m.v. ontwikkelingsonderzoek), uitproberen en evalueren van een nieuwe aanpak en nieuwe didactische tools voor meertalig onderwijs (d.m.v. interventieonderzoek). Alle ontwikkelde tools worden in een digitale 3M-Toolbox ondergebracht, die beschikbaar gesteld zal worden aan alle scholen. In de derde plaats vindt een flankerend effect-onderzoek naar (taal)attitudes plaats. In dit project beoogt het consortium een innovatieve kwaliteitsimpuls aan het meertalig basisonderwijs te geven, niet alleen in Fryslân, maar in heel Nederland.
The focus of this project is on improving the resilience of hospitality Small and Medium Enterprises (SMEs) by enabling them to take advantage of digitalization tools and data analytics in particular. Hospitality SMEs play an important role in their local community but are vulnerable to shifts in demand. Due to a lack of resources (time, finance, and sometimes knowledge), they do not have sufficient access to data analytics tools that are typically available to larger organizations. The purpose of this project is therefore to develop a prototype infrastructure or ecosystem showcasing how Dutch hospitality SMEs can develop their data analytic capability in such a way that they increase their resilience to shifts in demand. The one year exploration period will be used to assess the feasibility of such an infrastructure and will address technological aspects (e.g. kind of technological platform), process aspects (e.g. prerequisites for collaboration such as confidentiality and safety of data), knowledge aspects (e.g. what knowledge of data analytics do SMEs need and through what medium), and organizational aspects (what kind of cooperation form is necessary and how should it be financed).Societal issueIn the Netherlands, hospitality SMEs such as hotels play an important role in local communities, providing employment opportunities, supporting financially or otherwise local social activities and sports teams (Panteia, 2023). Nevertheless, due to their high fixed cost / low variable business model, hospitality SMEs are vulnerable to shifts in consumer demand (Kokkinou, Mitas, et al., 2023; Koninklijke Horeca Nederland, 2023). This risk could be partially mitigated by using data analytics, to gain visibility over demand, and make data-driven decisions regarding allocation of marketing resources, pricing, procurement, etc…. However, this requires investments in technology, processes, and training that are oftentimes (financially) inaccessible to these small SMEs.Benefit for societyThe proposed study touches upon several key enabling technologies First, key enabling technology participation and co-creation lies at the center of this proposal. The premise is that regional hospitality SMEs can achieve more by combining their knowledge and resources. The proposed project therefore aims to give diverse stakeholders the means and opportunity to collaborate, learn from each other, and work together on a prototype collaboration. The proposed study thereby also contributes to developing knowledge with and for entrepreneurs and to digitalization of the tourism and hospitality sector.Collaborative partnersHZ University of Applied Sciences, Hotel Hulst, Hotel/Restaurant de Belgische Loodsensociëteit, Hotel Zilt, DM Hotels, Hotel Charley's, Juyo Analytics, Impuls Zeeland.
De digitale transitie van mkb’s, met name in de maakindustrie, is goed onderweg, maar verre van afgerond. Er is een grote vraag naar het invoeren van het (Industrial) Internet of Things om procesdata van productiesystemen te bemachtigen en deze vervolgens te analyseren. Deze analysestap heeft een verdere interesseboost gekregen door de mogelijkheden van artificiële intelligentie (AI), waarmee data-analyses naar een complexer niveau getild kunnen worden. In het RAAK-mkb-project Data in Smart Industry staat deze vraag naar de mogelijkheden van IoT en AI centraal: welke data moeten en kunnen we verzamelen en vervolgens op welke manier analyseren? Met bedrijfspartners uit de maakindustrie zijn verschillende casussen IoT-technologie en machine learning (een subdomein van AI) ingezet in pilot studies. Ter afsluiting van het project wordt, in samenwerking met de brancheorganisatie FME en het smartindustryplatform Boost, en vanuit het RAAK-mkb-project Focus op Vision, een aantal trainingssessies georganiseerd rondom AI. Hierbij wordt het bedrijfsleven onderwezen in het toepassen van AI-technologie vanuit een procesmatig en technisch perspectief, waarbij lering wordt getrokken uit de casussen van het Data in Smart Industry-project. De Top-up-subsidie dient het doel om de geleerde lessen uit het RAAK-mkb-project verder te laten landen in de regio Oost-Nederland. Instrumentaal hierin is TValley, een fieldlab gericht op de ontwikkeling van mechatronische systemen zoals industriële robotica. Met de Top-up-subsidie kan TValley uitgebreid worden met een pijler omtrent IoT en AI, vakgebieden die deels overlap hebben met het huidige domein van het fieldlab. Hiervoor worden de ontwikkelde leermaterialen ingezet en doorontwikkeld om kennis te verspreiden en nieuwe bedrijfscasussen op te starten rondom de thema’s IoT en AI binnen TValley.
