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.
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This Special Issue “Ecocentric education” contains articles focused on ecological values in environmental education (EE) and education for sustainable development (ESD). Ecocentric education is based on a critical theory, originating from Erich Fromm [1], Herbert Marcuse [2], and Paulo Freire [3], and on ecological pedagogy (ecopedagogy), developed by Richard Kahn [4]. These critical theorists served as catalysts in the transformation of education towards the recognition of the “domination” of capitalist, corporate, and/or political power in shaping societies, challenging the broadly shared assumptions and practices [5]. Fromm [1] and his peers believed that education makes learners internalize alienation from humanity and nature, a process which is inherent in the industrial capitalist society. This process increases uncritical adherence to dominant values such as consumerism, downplaying the negative side effects of technocratically defined “progress”. https://doi.org/10.3390/educsci10090217 LinkedIn: https://www.linkedin.com/in/helenkopnina/
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In the last decade, the concept on interactions between humans, animals and their environment has drastically changed, endorsed by the One Health approach that recognizes that health of humans and animals are inextricably linked. Consideration of welfare of livestock has increased accordingly and with it, attention into the possibilities to improve livestock health via natural, more balanced nutrition is expanding. Central to effects of healthy nutrition is an optimal gastrointestinal condition which entails a well-balanced functional local immune system leading to a resilient state of well-being. This project proposal, GITools, aims to establish a toolbox of in vitro assays to screen new feed ingredients for beneficial effects on gastrointestinal health and animal well-being. GITools will focus on pig and chicken as important livestock species present in high quantities and living in close proximity to humans. GITools builds on intestinal models (intestinal cell lines and stem cell-derived organoids), biomarker analysis, and in vitro enzymatic and microbial digestion models of feed constituents. The concept of GITools originated from various individual contacts and projects with industry partners that produce animal feed (additives) or veterinary medicines. Within these companies, an urgent need exists for straightforward, well-characterized and standardized in vitro methods that provide results translatable to the in vivo situation. This to replace testing of new feed concepts in live animal. We will examine in vitro methods for their applicability with feed ingredients selected based on the availability of data from (previous) in vivo studies. These model compounds will include long and short chain fatty acids, oligosaccharides and herbal-derived components. GITools will deliver insights on the role of intestinal processes (e.g. dietary hormone production, growth of epithelial cells, barrier function and innate immune responses) in health and well-being of livestock animals and improve the efficiency of testing new feed products.
