Background Movement behaviors (i.e., physical activity levels, sedentary behavior) in people with stroke are not self-contained but cluster in patterns. Recent research identified three commonly distinct movement behavior patterns in people with stroke. However, it remains unknown if movement behavior patterns remain stable and if individuals change in movement behavior pattern over time. Objectives 1) To investigate the stability of the composition of movement behavior patterns over time, and 2) determine if individuals change their movement behavior resulting in allocation to another movement behavior pattern within the first two years after discharge to home in people with a first-ever stroke. Methods Accelerometer data of 200 people with stroke of the RISE-cohort study were analyzed. Ten movement behavior variables were compressed using Principal Componence Analysis and K-means clustering was used to identify movement behavior patterns at three weeks, six months, one year, and two years after home discharge. The stability of the components within movement behavior patterns was investigated. Frequencies of individuals’ movement behavior pattern and changes in movement behavior pattern allocation were objectified. Results The composition of the movement behavior patterns at discharge did not change over time. At baseline, there were 22% sedentary exercisers (active/sedentary), 45% sedentary movers (inactive/sedentary) and 33% sedentary prolongers (inactive/highly sedentary). Thirty-five percent of the stroke survivors allocated to another movement behavior pattern within the first two years, of whom 63% deteriorated to a movement behavior pattern with higher health risks. After two years there were, 19% sedentary exercisers, 42% sedentary movers, and 39% sedentary prolongers. Conclusions The composition of movement behavior patterns remains stable over time. However, individuals change their movement behavior. Significantly more people allocated to a movement behavior pattern with higher health risks. The increase of people allocated to sedentary movers and sedentary prolongers is of great concern. It underlines the importance of improving or maintaining healthy movement behavior to prevent future health risks after stroke.
MULTIFILE
Background and purpose The aim of this study is to investigate changes in movement behaviors, sedentary behavior and physical activity, and to identify potential movement behavior trajectory subgroups within the first two months after discharge from the hospital to the home setting in first-time stroke patients. Methods A total of 140 participants were included. Within three weeks after discharge, participants received an accelerometer, which they wore continuously for five weeks to objectively measure movement behavior outcomes. The movement behavior outcomes of interest were the mean time spent in sedentary behavior (SB), light physical activity (LPA) and moderate to vigorous physical activity (MVPA); the mean time spent in MVPA bouts ≥ 10 minutes; and the weighted median sedentary bout. Generalized estimation equation analyses were performed to investigate overall changes in movement behavior outcomes. Latent class growth analyses were performed to identify patient subgroups of movement behavior outcome trajectories. Results In the first week, the participants spent an average, of 9.22 hours (67.03%) per day in SB, 3.87 hours (27.95%) per day in LPA and 0.70 hours (5.02%) per day in MVPA. Within the entire sample, a small but significant decrease in SB and increase in LPA were found in the first weeks in the home setting. For each movement behavior outcome variable, two or three distinctive subgroup trajectories were found. Although subgroup trajectories for each movement behavior outcome were identified, no relevant changes over time were found. Conclusion Overall, the majority of stroke survivors are highly sedentary and a substantial part is inactive in the period immediately after discharge from hospital care. Movement behavior outcomes remain fairly stable during this period, although distinctive subgroup trajectories were found for each movement behavior outcome. Future research should investigate whether movement behavior outcomes cluster in patterns.
MULTIFILE
Movement behaviors, that is, both physical activity and sedentary behavior, are independently associated with health risks. Although both behaviors have been investigated separately in people after stroke, little is known about the combined movement behavior patterns, differences in these patterns between individuals, or the factors associated with these patterns. Therefore, the objectives of this study are (1) to identify movement behavior patterns in people with first-ever stroke discharged to the home setting and (2) to explore factors associated with the identified patterns.
DOCUMENT
In Eastern Africa, increasing climate variability and changing socioeconomic conditions are exacerbating the frequency and intensity of drought disasters. Droughts pose a severe threat to food security in this region, which is characterized by a large dependency on smallholder rain-fed agriculture and a low level of technological development in the food production systems. Future drought risk will be determined by the adaptation choices made by farmers, yet few drought risk models … incorporate adaptive behavior in the estimation of drought risk. Here, we present an innovative dynamic drought risk adaptation model, ADOPT, to evaluate the factors that influence adaptation decisions and the subsequent adoption of measures, and how this affects drought risk for agricultural production. ADOPT combines socio-hydrological and agent-based modeling approaches by coupling the FAO crop model AquacropOS with a behavioral model capable of simulating different adaptive behavioral theories. In this paper, we compare the protection motivation theory, which describes bounded rationality, with a business-as-usual and an economic rational adaptive behavior. The inclusion of these scenarios serves to evaluate and compare the effect of different assumptions about adaptive behavior on the evolution of drought risk over time. Applied to a semi-arid case in Kenya, ADOPT is parameterized using field data collected from 250 households in the Kitui region and discussions with local decision-makers. The results show that estimations of drought risk and the need for emergency food aid can be improved using an agent-based approach: we show that ignoring individual household characteristics leads to an underestimation of food-aid needs. Moreover, we show that the bounded rational scenario is better able to reflect historic food security, poverty levels, and crop yields. Thus, we demonstrate that the reality of complex human adaptation decisions can best be described assuming bounded rational adaptive behavior; furthermore, an agent-based approach and the choice of adaptation theory matter when quantifying risk and estimating emergency aid needs.
MULTIFILE
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
In 2004 the first adaptive thermal comfort guideline was introduced in the Netherlands. Recently a new, upgraded version of this ISSO 74 (ATG) guideline has been developed. The new requirements are hybrid in nature as the 2014 version of the guideline combines elements of traditional non-adaptive comfort standards with elements of adaptive standards. This paper describes the new guideline and explains the rationale behind it. Also changes in comparison with the original 2004 version and issues related to performance verification are discussed. The information presented in this paper can be used by others (other countries) as inspiration material for other new adaptive comfort guidelines and standards.
DOCUMENT
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.
DOCUMENT
ICT in intelligente voertuigen levert innovatieve systemen op. Deze innovatieve systemen richten zich op maatschappelijke knelpunten (verkeersveiligheid, milieubelasting en congestie) en consumenten waarde. Recent wordt meer nadruk gelegd op maatschappelijke knelpunten. Vijf (5) a tien (10) jaar geleden werd de nadruk gelegd op het creëren van consumenten waarde. Deze innovatieve systemen moeten wel geaccepteerd worden door de eindgebruikers. Er is nog maar beperkt onderzoek gedaan naar acceptatie van veiligheidssystemen in intelligente voertuigen. Uit literatuuronderzoek komt naar voren dat verschillende vormen van acceptatie gehanteerd worden. Tevens blijkt dat veel onderzoekers spreken over acceptatie maar de acceptatie niet (kunnen) meten. Om inzicht te krijgen in het gedrag en beleving van bestuurders wordt in dit onderzoek voorgesteld om de evolutie van de cruise control (CC) naar adaptive cruise control (ACC) en naar cooperative adaptive cruise control (C-ACC) te gebruiken om acceptatie te voorspellen en te beoordelen. Er zijn bijzonder veel acceptatiemodellen en theorieën. Deze worden in de praktijk veelvuldig gebruikt binnen de Informatie en Communicatie Technologie (ICT). In deze paper wordt een route uitgezet voor het opzetten van een onderzoek waarbij gebruik gemaakt wordt van het UTAUT-acceptatiemodel. Dit onderzoek moet uitwijzen welke criteria de acceptatie beïnvloeden.
DOCUMENT
This study explores how households interact with smart systems for energy usage, providing insights into the field's trends, themes and evolution through a bibliometric analysis of 547 relevant literature from 2015 to 2025. Our findings discover: (1) Research activity has grown over the past decade, with leading journals recognizing several productive authors. Increased collaboration and interdisciplinary work are expected to expand; (2) Key research hotspots, identified through keyword co-occurrence, with two (exploration and development) stages, highlighting the interplay between technological, economic, environmental, and behavioral factors within the field; (3) Future research should place greater emphasis on understanding how emerging technologies interact with human, with a deeper understanding of users. Beyond the individual perspective, social dimensions also demand investigation. Finally, research should also aim to support policy development. To conclude, this study contributes to a broader perspective of this topic and highlights directions for future research development.
MULTIFILE
To improve retention rate of factual knowledge for health students we set out to design a game which challenges students to continue testing themselves during their studies. Since we intend for them to play this game for at least two years, we had two major challenges to overcome. Firstly, how can students feel motivated to continue playing for two years on end, and secondly, how can enough content be generated for a two-year game play. The first challenge was solved by tapping into a core motivation of health students: many intend to start their own practice and for that, they want to be involved with other practitioners. We, therefore, proposed a sim-type game in which students cannot just practice on virtual patients but also on practitioners logged in as a patient. The second challenge was tackled by building a flexible framework for case collection, and including the production of those cases in the curricula of the involved programmes.
DOCUMENT
