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.
Background: Major surgery is associated with negative postoperative outcomes such as complications and delayed or poor recovery. Multimodal prehabilitation can help to reduce the negative effects of major surgery. Offering prehabilitation by means of mobile health (mHealth) could be an effective new approach. Objective: The objectives of this pilot study were to (1) evaluate the usability of the Be Prepared mHealth app prototype for people undergoing major surgery, (2) explore whether the app was capable of bringing about a change in risk behaviors, and (3) estimate a preliminary effect of the app on functional recovery after major surgery. Methods: A mixed-methods pilot randomized controlled trial was conducted in two Dutch academic hospitals. In total, 86 people undergoing major surgery participated. Participants in the intervention group received access to the Be Prepared app, a smartphone app using behavior change techniques to address risk behavior prior to surgery. Both groups received care as usual. Usability (System Usability Scale), change in risk behaviors 3 days prior to surgery, and functional recovery 30 days after discharge from hospital (Patient-Reported Outcomes Measurement Information System physical functioning 8-item short form) were assessed using online questionnaires. Quantitative data were analyzed using descriptive statistics, chi-square tests, and multivariable linear regression. Semistructured interviews about the usability of the app were conducted with 12 participants in the intervention group. Thematic analysis was used to analyze qualitative data. Results: Seventy-nine people-40 in the intervention group and 39 in the control group-were available for further analysis. Participants had a median age of 61 (interquartile range 51.0-68.0) years. The System Usability Scale showed that patients considered the Be Prepared app to have acceptable usability (mean 68.2 [SD 18.4]). Interviews supported the usability of the app. The major point of improvement identified was further personalization of the app. Compared with the control group, the intervention group showed an increase in self-reported physical activity and muscle strengthening activities prior to surgery. Also, 2 of 2 frequent alcohol users in the intervention group versus 1 of 9 in the control group drank less alcohol in the run-up to surgery. No difference was found in change of smoking cessation. Between-group analysis showed no meaningful differences in functional recovery after correction for baseline values (β=-2.4 [95% CI -5.9 to 1.1]). Conclusions: The Be Prepared app prototype shows potential in terms of usability and changing risk behavior prior to major surgery. No preliminary effect of the app on functional recovery was found. Points of improvement have been identified with which the app and future research can be optimized. Trial Registration: Netherlands Trial Registry NL8623; https://www.trialregister.nl/trial/8623.
Crime scene investigations are highly complex environments that require the CSI to engage in complex decision-making. CSIs must rely on personal experience, context information, and scientific knowledge about the fundamental principles of forensic science to both find and correctly interpret ambiguous traces and accurately reconstruct a scene. Differences in CSI decision making can arise in multiple stages of a crime scene investigation. Given its crucial role in forensic investigation, CSI decision-making must be further studied to understand how differences may arise during the stages of a crime scene investigation. The following exploratory research project is a first step at comparing how crime scene investigations of violent robberies are conducted between 25 crime scene investigators from nine countries across the world.Through a mock crime scene and semi-structured interview, we observed that CSIs have adopted a variety of investigation approaches. The results show that CSIs have different working strategies and make different decisions when it comes to the construction of relevant hypotheses, their search strategy, and the collection of traces. These different decisions may, amongst other factors, be due to the use of prior information, a CSI’s knowledge and experience, and the perceived goal of their investigation. We suggest the development of more practical guidelines to aid CSIs through a hypothetico-deductive reasoning process, where (a) CSIs are supported in the correct use of contextual information, (b) outside knowledge and expertise are integrated into this process, and (c) CSIs are guided in the evaluation of the utility of their traces.
MULTIFILE
The continuous monitoring of health indicators in biofluids such as sweat, saliva, blood, and urine has great potential for preventive medicine. Techniques that continuously monitor biomarkers still remain a major technological challenge. Recently, a concept of dynamic biosensing was published that is based on mediator particles. Such mediator particles exhibit rapid switching between a bound and unbound state during interaction with a probing structure to which they are connected through a molecular tether (like a balloon on a string). Although the concept of using mediator particles for dynamics biosensing is very promising, the used detection method is not a viable solution as it is not miniaturizable. We propose to use a photonic ring resonator (RR) or Mach-Zender interferometer (MZI) as the probing structure in combination with a highly miniaturizable readout scheme. In this project, we perform preliminary experiments to prove that this photonic approach can be used for the detection of the mediator particles tethered to the photonic waveguide. To bridge the gap with the practical application by health professionals, we will enrich the envisioned solution through OnePlanet's OpenEd program. OpenEd aims to share technology and innovations (e.g. prototypes) with educational institutes (MBO, HBO) that want to further innovate their courses or work methods, such that current and future professionals are well prepared to work with new (digital) technologies. By presenting our use-case as a 'challenge' to teachers, students and practitioners, OpenEd also allows enriching the use-case by involving (future) health professionals that can provide feedback on - or further investigation of - the practical application of our new technology from the health professional's perspective.
The building industry is a major target for resource-efficiency developments, which are crucial in European Union’s roadmaps. Using renewable materials impacts the sustainability of buildings and is set as urgent target in current architectural practice. The building industry needs renewable materials positively impacting the CO2 footprint without drawbacks. The use of wood and timber as renewable construction materials has potentials, but also drawbacks because trees need long time to grow; producing timber generates considerable waste; and the process from trees to applications in buildings requires transportation and CO2 emission. This research generates new scientific knowledge and a feasibility study for a new wood-like bio-material - made of cellulose and lignin from (local) residual biomass via i.e. 3D printing - suitable for applications in the building industry. It contributes to a sustainable built environment as it transforms waste from different sectors into a local resource to produce a low carbon-footprint bio-material for the construction sector. Through testing, the project will study the material properties of samples of raw and 3D printed material, correlating different material recipes that combine lignin and cellulose and different 3D printing production parameters. It will map the material properties with the requirements of the construction industry for different building products, indicating potentials and limits of the proposed bio-material. The project will produce new knowledge on the material properties, a preliminary production concept and an overview of potentials and limits for application in the built environment. The outcome will be used by industry to achieve a marketable new bio-material; as well as in further scientific academic research.
