A healthy lifestyle is indispensable for the prevention of noncommunicable diseases. However, lifestyle medicine is hampered by time constraints and competing priorities of treating physicians. A ...dedicated lifestyle front office (LFO) in secondary/tertiary care may provide an important contribution to optimize patient-centred lifestyle care and connect to lifestyle initiatives from the community. The LOFIT study aims to gain insight into the (cost-)effectiveness of the LFO.
Two parallel pragmatic randomized controlled trials will be conducted for (cardio)vascular disorders (i.e. (at risk of) (cardio)vascular disease, diabetes) and musculoskeletal disorders (i.e. osteoarthritis, hip or knee prosthesis). Patients from three outpatient clinics in the Netherlands will be invited to participate in the study. Inclusion criteria are body mass index (BMI) ≥25 (kg/m
) and/or smoking. Participants will be randomly allocated to either the intervention group or a usual care control group. In total, we aim to include 552 patients, 276 in each trial divided over both treatment arms. Patients allocated to the intervention group will participate in a face-to-face motivational interviewing (MI) coaching session with a so-called lifestyle broker. The patient will be supported and guided towards suitable community-based lifestyle initiatives. A network communication platform will be used to communicate between the lifestyle broker, patient, referred community-based lifestyle initiative and/or other relevant stakeholders (e.g. general practitioner). The primary outcome measure is the adapted Fuster-BEWAT, a composite health risk and lifestyle score consisting of resting systolic and diastolic blood pressure, objectively measured physical activity and sitting time, BMI, fruit and vegetable consumption and smoking behaviour. Secondary outcomes include cardiometabolic markers, anthropometrics, health behaviours, psychological factors, patient-reported outcome measures (PROMs), cost-effectiveness measures and a mixed-method process evaluation. Data collection will be conducted at baseline, 3, 6, 9 and 12 months follow-up.
This study will gain insight into the (cost-)effectiveness of a novel care model in which patients under treatment in secondary or tertiary care are referred to community-based lifestyle initiatives to change their lifestyle.
ISRCTN ISRCTN13046877 . Registered 21 April 2022.
Using a social robot has been proven to have multiple benefits for the training of children with Autism Spectrum Disorder (ASD). However, there is no clarity on the impact of the interaction quality ...between a child with ASD and a robot on the effectiveness of the therapy. Previous research showed that the use of a robot in Pivotal Response Treatment (PRT) could be an effective treatment component in diminishing ASD-related symptoms. Further analyzing the data from a randomized controlled trial of PRT treatment, we looked at the long-term effects of child–robot game interactions to see whether the interaction quality changes over time. The attention and the engagement of six children were measured through the observation of non-verbal behavior at three different stages in the treatment that took 20 sessions per child. The gaze and arm/hand behavior of the participants towards the robot, the game, and other present humans were observed. The analysis showed no significant decrease in the attention and the engagement of the children towards the robot and the game. However, the attention and engagement toward the parents of the children increased. We conclude that the main result of sustained attention and engagement with the robot is due to the personalization of the games to meet the specific needs of this user group. These specific needs are met through inclusion of variability to the level of development and personal choice of each participating child. We see the additional finding of increased attention towards the parents as especially positive since the children are expected to improve in human–human interaction as a result of this treatment.
Spring temperatures in temperate regions have increased over the past 20 years and many organisms have responded to this increase by advancing the timing of their growth and reproduction. However, ...not all populations show an advancement of phenology. Understanding why some populations advance and others do not will give us insight into the possible constraints and selection pressures on the advancement of phenology. By combining two decades of data on 24 populations of tits (Parus sp.) from six European countries, we show that the phenological response to large-scale changes in spring temperature varies across a species' range, even between populations situated close to each other. We show that this variation cannot be fully explained by variation in the temperature change during the pre- and post-laying periods, as recently suggested. Instead, we find evidence for a link between rising temperatures and the frequency of second broods, which results in complex shifts in the laying dates of first clutches. Our results emphasize the need to consider links between different life-history parameters in order to predict the ecological consequences of large-scale climate changes.
Pivotal response treatment (PRT) is a promising intervention focused on improving social communication skills in children with autism spectrum disorder (ASD). Since robots potentially appeal to ...children with ASD and may contribute to their motivation for social interaction, this exploratory randomized controlled trial (RCT) was conducted comparing PRT (PRT and robot-assisted PRT) with treatment-as-usual (TAU). Seventy-three children (PRT:
n
= 25; PRT + robot:
n
= 25; TAU:
n
= 23) with ASD, aged 3–8 years were assessed at baseline, after 10 and 20 weeks of intervention, and at 3-month follow-up. There were no significant group differences on parent- and teacher-rated general social-communicative skills and blindly rated global functioning directly after treatment. However, at follow-up largest gains were observed in robot-assisted PRT compared to other groups. These results suggest that robot-assistance may contribute to intervention efficacy for children with ASD when using game scenarios for robot-child interaction during multiple sessions combined with motivational components of PRT. This trial is registered at
https://www.trialregister.nl/trial/4487
; NL4487/NTR4712 (2014-08-01).
Surgical overhead luminaires and head-mounted luminaires are important tools for surgeons. The optical design of these luminaires focuses on providing shadow free light. Shadows, however, are ...reported as important cues for depth perception in mono- and stereo-visual situations. Because surgeons repeatedly touch delicate tissue with their instruments, their depth-perception should not be hampered. Two experiments were performed to evaluate the influence of shadow on human performance when executing stereo-visual pointing tasks. Experiment 1 studied the effect of the existence of shadows and Experiment 2 studied the effect of the direction of shadows. Subjects were instructed to point random sequences of virtual targets accurately under different shadow situations. Performance was characterized with spatial error E (distance to target, mm). Experiment 1 showed that both large and small high-contrast shadows gave significantly smaller spatial error E (4.8, 4.6 mm, respectively) than either low-contrast shadows (5.6 mm) or no shadows (6.3 mm). Experiment 2 showed that the Error varied (2.1 to 3.2 mm) for different illumination directions. The Error decreased with an increasing angle between the line-of-sight and line-of-light. Illuminating from the center or from the left side of the observer gave better results then from the right side. To maximize depth-perception, surgical luminaires should provide a clear shadow from a light source that illuminates from within the vertical plane through the line-of-sight, and with a 90° angle with respect to the line-of-sight.
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