OBJECTIVE: 'Better By Moving' is a multifaceted intervention developed and implemented in collaboration with patients and healthcare professionals to improve physical activity in hospitalized adults. This study aimed to understand if, how and why 'Better By Moving' resulted in higher levels of physical activity by evaluating both outcomes and implementation process.DESIGN: Mixed-methods study informed by the Medical Research Council guidance.SETTING: Tertiary hospital.PARTICIPANTS: Adult patients admitted to surgery, haematology, infectious diseases and cardiology wards, and healthcare professionals.MEASURES: Physical activity was evaluated before and after implementation using the Physical Activity Monitor AM400 on one random day during hospital stay between 8 am and 8 pm. Furthermore, the time spent lying on bed, length of stay and discharge destination was investigated. The implementation process was evaluated using an audit trail, surveys and interviews.RESULTS: There was no significant difference observed in physical activity (median [IQR] 23 [12-51] vs 27 [17-55] minutes, P = 0.107) and secondary outcomes before-after implementation. The intervention components' reach was moderate and adoption was low among patients and healthcare professionals. Patients indicated they perceived more encouragement from the environment and performed exercises more frequently, and healthcare professionals signalled increased awareness and confidence among colleagues. Support (priority, resources and involvement) was perceived a key contextual factor influencing the implementation and outcomes.CONCLUSION: Although implementing 'Better By Moving' did not result in significant improvements in outcomes at our centre, the process evaluation yielded important insights that may improve the effectiveness of implementing multifaceted interventions aiming to improve physical activity during hospital stay.
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Surgery aims to improve a patient’s medical condition. However, surgery is a major life event with the risk of negative consequences, like peri- and postoperative complications, prolonged hospitalization and delayed recovery of physical functioning. One of the major common side effects, functional decline, before (in the “waiting” period), during and after hospitalization is impressive, especially in frail people. Preoperative screening aims to identify frail, highrisk patients at an early stage, and advice these high-risk patients to start supervised preoperative home-based exercise training (prehabilitation) as soon as possible. Depending on the health status of the patient and his/her outcomes during the screening and the type of surgery, prehabilitation should focus on respiratory, cardiovascular and/or musculoskeletal parameters to prepare the patient for surgery. By improving preoperative physical fitness, a patient is able to better with stand the impact of major surgery and this will lead to a both reduced risk of negative side effects and better short term outcomes as a result. Besides prehabilitation hospital culture and infrastructure should be inherently activating so that patients stay as active as can be, socially, mentally and physically. In the first part of this chapter the concept of prehabilitation and different parameters that should be trained will be described. The second part focuses on the “Better in, Better out” (BiBo™) strategy, which aims to optimize patient’s pre-, peri- and postoperative physical fitness. Prehabilitation should comprise “shared decisions” between patient and physical therapist regarding experience and evidence based best options for rehabilitation goals, needs, and potential of the individual patient and his/her (in) formal support-system. Next, a case will describe the preoperative care pathway. This chapter will close with conclusions about how moving people before and after surgery will improve their outcomes.
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To support physiotherapists in their role of health promotor and to support physical activity (PA), the Keep Moving Support Tool (KMST) was developed. It is unknown how to align the KMST with everyday practice in a wider variety of primary care physiotherapy clinics in the Netherlands.
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A unique testing ground where the creative sector and education work together to better understand the possibilities around volumetric video capturing. Within a volumetric studio, dozens of cameras capture all the movements of a living subject simultaneously. These recordings are converted into a fully moving and digital image, which results in an image that is barely distinguishable from reality. Chronosphere gives content creators and scientists the unique opportunity to experiment with volumetric capturing, using the newest volumetric studio within De Effenaar. There is room for a total of twenty projects, and proposals can be submitted.Partners:De Effenaar 4DR Studios Wildvreemd Natlab 360 verbeelding Dutch Rose Media Hyperspace Institute Fontys Hogescholen TU/e Center for Humans & Technology
In the Netherlands the business community is pretty active in the biobased economy because it offers plenty of economic opportunities. Innovation and chain development are stimulated towards the development of the bi-obased economy, bioenergy and to biobased materials. The Netherlands is strongly investing on improving inno-vative business and development, developing business cases and removing obstacles of non-technical origin. Importantly, the Dutch business community have recognised that many activities will depend on biomass imports as domestic production is mostly limited. In the Netherlands there is a large demand for biobased biomass, and it is estimated that in the year 2030 about 60-70% of the required biomass will have to be imported. The Dutch Platform Biobased Raw Materials has emphasised the importance of the imports of biomass, and has focused on developing guidelines for transition paths, where international cooperation with biomass-producing countries is essential. The Netherlands has identified Spain as an important provider of biomass resources (19 million ktoe), Spain holds the third position in European ranking of biomass potential. The autonomous community Galicia is the most important forest region in Spain, where the agroforestry sector has been considered as an alternative to yield economic benefits as well as to bring ecological advantages. However, the potential of Galicia as a pro-ducer and supplier of (waste flow) biomass is underdeveloped and underutilised. There is a need for a better un-derstanding of the potential business models that Dutch companies and Spanish stakeholders can apply to devel-op a biobased value chains that lead to the triple bottom line of People, Planet and Profit. To realise this goal, our project focuses on identifying the linkages between the Galicia agroforestry sector and the Dutch biobased industries, and explore the potential business opportunities towards the strengthening of both the local and the Dutch biobased markets. To achieve the latter we centred on the following questions: I. What are the potential new business models that can be applied for a profitable and sustainable biobased chain from the waste flows of the agroforestry sector of Galicia for a steady production and supply to the local and the Dutch markets, leading to a sustainable transition path? II. What are the institutional frameworks required to develop new and profitable biobased value chains within the agroforestry sector in Galicia?
