From September 2024 onwards we will start the development of an educational innovation for Dutch primary schools to design a dynamic school day (a school day in which sedentary learning is regularly interrupted by moments of physical activity) for their local context. A number of Dutch primary schools already successfully implemented a more dynamic school day. In this qualitative study, we set out to assess the facilitators and barriers that several stakeholders faced during the implementation of the dynamic school day. We also set out to assess preferences of pupils with respect to a more dynamic school day. In preparation of the development phase, we will conduct semi-structured interviews with stakeholders of 3 Dutch primary schools (spring 2024). The interview guide will be based on the MRC guideline for conducting process evaluations of complex interventions. For each school, we seek to include: 1) the physical education teacher, 2) a classroom teacher who finds it easy to organize physical activities during the school day, 3) a classroom teacher who finds it difficult to organize physical activities during the school day, 4) a member of the management team. If relevant, we will also interview other stakeholders involved in the implementation of the dynamic school day. We will present the factors that may facilitate or hinder the implementation of a dynamic school day in the Dutch context. We will use these results to develop a set of potential implementation strategies that can serve as a source of inspiration for other Dutch primary schools in their process to develop a dynamic school day for their local context.
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Long-term care facilities are currently installing dynamic lighting systems with the aim to improve the well-being and behaviour of residents with dementia. The aim of this study was to investigate the implementation of dynamic lighting systems from the perspective of stakeholders and the performance of the technology. Therefore, a questionnaire survey was conducted with the management and care professionals of six care facilities. Moreover, light measurements were conducted in order to describe the exposure of residents to lighting. The results showed that the main reason for purchasing dynamic lighting systems lied in the assumption that the well-being and day/night rhythmicity of residents could be improved. The majority of care professionals were not aware of the reasons why dynamic lighting systems were installed. Despite positive subjective ratings of the dynamic lighting systems, no data were collected by the organizations to evaluate the effectiveness of the lighting. Although the care professionals stated that they did not see any large positive effects of the dynamic lighting systems on the residents and their own work situation, the majority appreciated the dynamic lighting systems more than the old situation. The light values measured in the care facilities did not exceed the minimum threshold values reported in the literature. Therefore, it seems illogical that the dynamic lighting systems installed in the researched care facilities will have any positive health effects.
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.
Everyone has the right to participate in society to the best of their ability. This right also applies to people with a visual impairment, in combination with a severe or profound intellectual and possibly motor disability (VISPIMD). However, due to their limitations, for their participation these people are often highly dependent on those around them, such as family members andhealthcare professionals. They determine how people with VISPIMD participate and to what extent. To optimize this support, they must have a good understanding of what people with disabilities can still do with their remaining vision.It is currently difficult to gain insight into the visual abilities of people with disabilities, especially those with VISPIMD. As a professional said, "Everything we can think of or develop to assess the functional vision of this vulnerable group will help improve our understanding and thus our ability to support them. Now, we are more or less guessing about what they can see.Moreover, what little we know about their vision is hard to communicate to other professionals”. Therefore, there is a need for methods that can provide insight into the functional vision of people with VISPIMD, in order to predict their options in daily life situations. This is crucial knowledge to ensure that these people can participate in society to their fullest extent.What makes it so difficult to get this insight at the moment? Visual impairments can be caused by a range of eye or brain disorders and can manifest in various ways. While we understand fairly well how low vision affects a person's abilities on relatively simple visual tasks, it is much more difficult to predict this in more complex dynamic everyday situations such asfinding your way or moving around during daily activities. This is because, among other things, conventional ophthalmic tests provide little information about what people can do with their remaining vision in everyday life (i.e., their functional vision).An additional problem in assessing vision in people with intellectual disabilities is that many conventional tests are difficult to perform or are too fatiguing, resulting in either no or the wrong information. In addition to their visual impairment, there is also a very serious intellectual disability (possibly combined with a motor impairment), which makes it even more complex to assesstheir functional vision. Due to the interplay between their visual, intellectual, and motor disabilities, it is almost impossible to determine whether persons are unable to perform an activity because they do not see it, do not notice it, do not understand it, cannot communicate about it, or are not able to move their head towards the stimulus due to motor disabilities.Although an expert professional can make a reasonable estimate of the functional possibilities through long-term and careful observation, the time and correct measurement data are usually lacking to find out the required information. So far, it is insufficiently clear what people with VZEVMB provoke to see and what they see exactly.Our goal with this project is to improve the understanding of the visual capabilities of people with VISPIMD. This then makes it possible to also improve the support for participation of the target group. We want to achieve this goal by developing and, in pilot form, testing a new combination of measurement and analysis methods - primarily based on eye movement registration -to determine the functional vision of people with VISPIMD. Our goal is to systematically determine what someone is responding to (“what”), where it may be (“where”), and how much time that response will take (“when”). When developing methods, we take the possibilities and preferences of the person in question as a starting point in relation to the technological possibilities.Because existing technological methods were originally developed for a different purpose, this partly requires adaptation to the possibilities of the target group.The concrete end product of our pilot will be a manual with an overview of available technological methods (as well as the methods themselves) for assessing functional vision, linked to the specific characteristics of the target group in the cognitive, motor area: 'Given that a client has this (estimated) combination of limitations (cognitive, motor and attention, time in whichsomeone can concentrate), the order of assessments is as follows:' followed by a description of the methods. We will also report on our findings in a workshop for professionals, a Dutch-language article and at least two scientific articles. This project is executed in the line: “I am seen; with all my strengths and limitations”. During the project, we closely collaborate with relevant stakeholders, i.e. the professionals with specific expertise working with the target group, family members of the persons with VISPIMD, and persons experiencing a visual impairment (‘experience experts’).
Physical rehabilitation programs revolve around the repetitive execution of exercises since it has been proven to lead to better rehabilitation results. Although beginning the motor (re)learning process early is paramount to obtain good recovery outcomes, patients do not normally see/experience any short-term improvement, which has a toll on their motivation. Therefore, patients find it difficult to stay engaged in seemingly mundane exercises, not only in terms of adhering to the rehabilitation program, but also in terms of proper execution of the movements. One way in which this motivation problem has been tackled is to employ games in the rehabilitation process. These games are designed to reward patients for performing the exercises correctly or regularly. The rewards can take many forms, for instance providing an experience that is engaging (fun), one that is aesthetically pleasing (appealing visual and aural feedback), or one that employs gamification elements such as points, badges, or achievements. However, even though some of these serious game systems are designed together with physiotherapists and with the patients’ needs in mind, many of them end up not being used consistently during physical rehabilitation past the first few sessions (i.e. novelty effect). Thus, in this project, we aim to 1) Identify, by means of literature reviews, focus groups, and interviews with the involved stakeholders, why this is happening, 2) Develop a set of guidelines for the successful deployment of serious games for rehabilitation, and 3) Develop an initial implementation process and ideas for potential serious games. In a follow-up application, we intend to build on this knowledge and apply it in the design of a (set of) serious game for rehabilitation to be deployed at one of the partners centers and conduct a longitudinal evaluation to measure the success of the application of the deployment guidelines.
The demand for mobile agents in industrial environments to perform various tasks is growing tremendously in recent years. However, changing environments, security considerations and robustness against failure are major persistent challenges autonomous agents have to face when operating alongside other mobile agents. Currently, such problems remain largely unsolved. Collaborative multi-platform Cyber- Physical-Systems (CPSs) in which different agents flexibly contribute with their relative equipment and capabilities forming a symbiotic network solving multiple objectives simultaneously are highly desirable. Our proposed SMART-AGENTS platform will enable flexibility and modularity providing multi-objective solutions, demonstrated in two industrial domains: logistics (cycle-counting in warehouses) and agriculture (pest and disease identification in greenhouses). Aerial vehicles are limited in their computational power due to weight limitations but offer large mobility to provide access to otherwise unreachable places and an “eagle eye” to inform about terrain, obstacles by taking pictures and videos. Specialized autonomous agents carrying optical sensors will enable disease classification and product recognition improving green- and warehouse productivity. Newly developed micro-electromechanical systems (MEMS) sensor arrays will create 3D flow-based images of surroundings even in dark and hazy conditions contributing to the multi-sensor system, including cameras, wireless signatures and magnetic field information shared among the symbiotic fleet. Integration of mobile systems, such as smart phones, which are not explicitly controlled, will provide valuable information about human as well as equipment movement in the environment by generating data from relative positioning sensors, such as wireless and magnetic signatures. Newly developed algorithms will enable robust autonomous navigation and control of the fleet in dynamic environments incorporating the multi-sensor data generated by the variety of mobile actors. The proposed SMART-AGENTS platform will use real-time 5G communication and edge computing providing new organizational structures to cope with scalability and integration of multiple devices/agents. It will enable a symbiosis of the complementary CPSs using a combination of equipment yielding efficiency and versatility of operation.
