Saxion University of Applied Sciences

In recent years, microplastics have been detected in fresh- and seawater, the atmosphere, sediments, soils, sewage sludge, biota, and food. However, these microplastics can degrade into even smaller plastic particles in the sub-micron range, referred to as nanoplastics. Due to their smaller dimensions and colloidal properties, nanoplastics could pose an increased hazard to the environment, biota and humans. While there are methods for detecting microplastics, the reliable detection and quantification of size and particle number concentrations of plastic particles less than a micrometre in size are still difficult. In this study, we describe the development and validation of a method for detecting nanoplastics using nanoparticle tracking analysis (NTA) and discuss the limitations of the method in the analysis of nanoplastics. Our method proved accurate and precise for 102 nm polystyrene Nanospheres, with a linear concentration ranging from 5.0 × 10⁶ to 2.0 × 10⁹ particles/mL, and a particle size range from 46 to over 350 nm. However, several limitations of the NTA method became apparent. When measuring polydisperse particle mixtures, NTA tends to underestimate the presence of smaller particles due to lower scattering intensity and overlapping signals. Moreover, NTA cannot chemically discriminate between nanoplastics and other types of nanoparticles, such as natural organic matter, leading to potential overestimation of plastic particle concentrations. Despite these weaknesses, the validated method was applied to eight brands of bottled mineral water. We detected particles with mean particle sizes in the range of 110 to 170 nm, and particle number concentrations between 1.0 × 10⁶ to 2.2 × 10⁷ particles/mL. Particle size distributions showed a particle size range of 50 to 500 nm. However, due to the limitations of NTA, it was not possible to conclusively confirm that the detected particles were nanoplastics, and therefore, the reported concentrations refer to the total particle content rather than specifically to nanoplastics.

Objective Physical activity (PA) has well-established benefits and is a fundamental component in the management of axial spondyloarthritis (axSpA). Our objective was to evaluate (1) compliance with the World Health Organization (WHO) PA recommendations, (2) specific types and duration of PA performed by patients, and (3) association of PA with health status and quality of life (QoL) in two large Dutch cohorts of axSpA patients. Methods In the GLAS and LUMC patient cohorts, the modified (m) and original Short QUestionnaire to ASess Health-enhancing PA (SQUASH) was used to determine fulfillment of recommendations on aerobic and muscle-strengthening PA. Univariable and multivariable linear regressions were used to analyze PA in relation to health status (ASAS-HI) and QoL (ASQoL). Results In the GLAS (n = 148) and LUMC (n = 193) cohorts, patients were 49 ± 13 and 56 ± 14 years old, time since diagnosis was median 11 (IQR 5–21) and 23 (IQR 8–35) years and 59% and 69% were male, respectively. In total, 72% and 77% patients fulfilled the aerobic component, 40% and 36% the muscle-strengthening component and 37% and 34% both components of the WHO PA recommendations. Walking, cycling and gym or aquatic exercises were done most often. Higher (m)SQUASH score was associated with better outcome in disease-related health status (ASAS-HI) and QoL (ASQoL), also after adjusting for age, sex, BMI, disease activity and physical function. Conclusion The minority of axSpA patients fulfilled the WHO PA recommendations. Patients were less likely to meet the muscle strengthening component than the aerobic component. A higher level of PA was associated with better disease-related health status and QoL.

Introduction Positive Health (PH) is a health approach that expands the definition of health, emphasizing social, psychological, and personal perspectives. PH helps healthcare professionals to provide insight into a patient’s perceived health and gives them insight into their health improvement. PH is acknowledged for improving healthcare and quality of life, but the practical implementation of PH and the necessary skills for healthcare professionals remain unexplored. The overall aim of this review is to explore and map the Positive Health skills needed for healthcare professionals in a variety of healthcare settings. Methods A scoping review was conducted. PubMed, Embase, and CINAHL were searched using the key term “Positive Health” AND “healthcare professionals” AND “skills” including synonyms and related keywords. Initial searches yielded fewer relevant studies than expected. Therefore, a revised strategy incorporated “Shared Decision-Making (SDM)” AND “healthcare professionals” AND “skills” to enhance the search. The methodological quality was assessed. A convergent integrated approach synthesized findings and identified overarching skills. An overview was made to visualize the skills. Results After screening, 15 studies were included. The five overarching skills are: “applying a holistic approach”, “communicating and active listening”, “managing time effectively”, “encouraging patient participation”, “reflecting and self-reflection”. Discussion An overview of PH skills was obtained, where the comparison with SDM led to more foundation and more strategies for PH skills. Increasing PH skills in clinical practice may improve implementation. Further research is needed to explore if PH and SDM are mutually reinforcing.

Money muling is an urgent problem among young people. Money mules refer to individuals whose bank account is used to hide and launder the profits of financial-economic cybercrimes. They are key actors in the cybercriminal ecosystem. In order to add to the current body of knowledge and better understand and disrupt pathways into cybercrime, this study explores which individual factors relate to previous exposure to money mule recruiters. Drawing upon existing literature, we developed a survey that measured a number of key demographics and social-psychological variables related to cybercrime involvement. This survey was completed by around 2000 Dutch individuals, aged 16–25. Generalized estimating equation binary logistic regression models revealed that a history of being approached by money mule recruiters was associated with being male and living in large cities, as well as with attitudes in favour of money muling and a higher perceived likelihood of being approached in the future. However, follow-up analysis revealed that relationships were dependent on whether young people were approached in the physical world or online, in which recruiters on social media discriminated less in their potential targets.

With the growing complexity of hospital care, patient safety has become even more critical. This study explores the development and exchange of situation awareness of clinical hospital ward nurses engaged in interdisciplinary and distributed teamwork. A focused ethnographic study was conducted and involved shadowing 10 hospital ward nurses, semi‐structured interviews, group reflections and patient record screenings. In‐depth analysis of three representative clinical cases using state‐space diagrams and a critical decision method was performed. The results show that development and exchange of situational awareness is often not reciprocal, timely or complete, with insufficient information available before decisions are made, which can compromise patient safety. Factors in communication, coordination and learning climate were identified as influential. We argue that the complexity of nurses' work in which sensitivity, alertness and control over key nodes in the healthcare network is required to achieve assimilation and accommodation in situational awareness among involved healthcare professionals. Although challenging, we see opportunities to improve situational awareness transactions through nurses' leadership behaviour. Analysing interdisciplinary and distributed collaboration from the perspective of an information network provides insight into improving situational awareness transactions, the key role nurses play in them, and further promoting patient safety.

Introduction The potential of digital health interventions to optimize healthcare is promising also in the context of spinal surgery. However, a systematic review assessing the quality of digital health interventions for spinal surgery patients and the potential effects on these patients is lacking. Method The objective of the current scoping review was to provide a systematic overview of digital health interventions for spinal surgery patients described in scientific literature. The focus was on describing the current digital health interventions, assessing the quality of these descriptions, reviewing the reported effects and assessing the methodological quality of the included studies. Results A total of 14 full-text articles, describing 11 digital health interventions were included in the final analysis. These digital health interventions ranged from a website and app to a mobile phone messaging system and mobile phone interface. Most digital health interventions aim to improve adherence to rehabilitation guidelines and physical health. The included studies were generally of moderate to high quality and showed significant effects on physical health. Vital aspects of digital interventions such as “working mechanism theory” and “prompts and reminders” were often absent in the description of interventions. Conclusion The study of digital interventions for spinal surgery patient is emerging and promising. However, there is a scarcity of studies using a rigorous design. A more systematic and comprehensive framework for developing and describing digital interventions for spinal surgery patients is highly recommended.

The survey results of 69 small and medium-sized enterprises (SMEs) located in the northern, central, and southern regions of Vietnam are reported in this study. The surveyed enterprises show their ambitions of implementing the circular economy (CE) models in the future. The key motivators for circular business model adoption from the SMEs’ perspectives fall into economic, financial, and market categories. The key barriers to adopting circular business models relate to technological and cultural factors. SMEs in Vietnam still lack experience and knowledge of circular business models. The survey results show a strong need for supporting SMEs in Vietnam to gain a better understanding of the CE approach. The findings from our survey can support a more effective CE adoption and implementation in developing countries.

Relations between load and acute psychophysiological responses have been widely studied in football. However, due to the large heterogeneity in contexts, operationalization, and results, the direction and strength of these relations remain unclear. In this meta-analysis, we examine the relation between load and typical acute (i.e. within one week) responses - wellbeing, recovery, and heart rate measures - in football players from all football codes (soccer, rugby, futsal, American football, and Australian rules football). We consulted PubMed, Web of Science, and CINAHL up to the 19th of June 2024, and included 62 articles and 1,474 participants in the meta-analysis. Subsequently, we estimated 12 meta-analysis models and applied meta-regression models to explore the influence of several moderators. Significant relations were found between load and overall wellbeing (r = -0.33 [95%CI: -0.48; -0.19]), muscle soreness (r = -0.36 [95%CI: -0.49; -0.24]), fatigue (r = -0.41 [95%CI: -0.56; -0.26]), sleep quality (r = -0.21 [95%CI: -0.31; -0.10]), and stress (r = -0.16 [95%CI: -0.26; -0.06]). Given the high risk of bias, inconsistency (wide prediction intervals), and imprecision, the certainty in these findings based on the GRADE assessment is very low. Additionally, the high risk of bias scores indicates that the overall quality of the included studies is low. In conclusion, this meta-analysis provides comprehensive information on the acute responses of the athlete to load, and directions for improvement of the quality of future studies.

The rise of global agricultural value chains presents both opportunities and challenges for rural transformation and economic development. In this regard, we propose that the expansion of the service sector in developing countries significantly influences the development of agricultural value chain, promoting wealth creation. We posit that when global value chains in agriculture are used to interpret rural transformation, the crucial function of services is often underemphasised. We construct an interaction term between the productivity dynamics in services and the evolution of global value chain (GVC) over time. The key finding suggests that the coevolution of service sector development and participation in GVC strongly correlates with increases in agricultural sector productivity. The analysis highlights the importance of considering the stage of development and the specific service subsectors when examining the relationship between services, GVC and rural transformation. We propose that enhancing the institutional environment, particularly with respect to contracts within such value chains, enables a larger role for domestic actors in capturing this value.

The collaborative robot (cobot) has the potential to remove barriers for individual operators when deciding on the deployment of robotics in their work. Ideally, using their opportunities to (re)design work (i.e., job decision latitudes), the operator establishes synergetic human–cobot interdependencies that enable the human–cobot production unit to achieve superior performance and foster more sustainable work perceptions than manual production units. However, it remains scientifically unclear whether the operator is both willing to and capable of using cobot-related job decision latitudes, what this means for designing human–cobot interdependencies, and whether these designs improve unit outcomes. Therefore, we built a manual and three human–cobot production units with distinct job decision latitudes. Forty students participated in the manual production unit and operated one of the human–cobot production units during an assembly simulation. Sophistically accounting for individual differences, the results illustrated that most operators used speed- and task-related job decision latitudes to design their human–cobot interdependencies. These behaviours often led to increased productivity and more motivating working conditions. At the same time, these human–cobot interdependencies frequently resulted in limited human–robot interactions, poor production reliability, and more psychological safety risks. This contribution lays a rich foundation for future research on involving individual operators in developing modern production systems.

Background Patients and informal caregivers experience challenges to express their personal perspectives in conversations with healthcare professionals (HCPs). A prototype toolkit, which consists of a hardcopy version and a website, was developed to address their challenges. The aim of this study is to gain insight into the perceived acceptability of this prototype toolkit. Method Patients and informal caregivers end users and HCPs participated in semi-structured individual or group interviews. This resulted in two databases of qualitative data which were thematically analysed. Results Twenty-two end users and twelve HCPs participated in this study. There is appreciation for the content and use of the prototype toolkit, with the hardcopy version of the toolkit being valued more than the website. Moreover, the use of the toolkit may strengthen end users' power and control and may support HCPs in tailoring communication and care. End users and HCPs recommendations for implementation are to further develop the prototype toolkit, provide HCPs with information, instruction and support and create facilitating conditions in healthcare. Conclusion High appreciation of the hardcopy version and the practical value are positive indicators of end users'and HCPS perceived acceptability of the prototype toolkit. However, the content of the toolkit is experienced as being too extensive, with the hardcopy version experienced as being incomplete without the website and the website is experienced as being too complicated to use. Further development and testing of the prototype toolkit is required to increase its acceptability by end users and HCPs. Innovation In this study a Design Thinking approach was used to test study the acceptability of a prototype toolkit by endusers and HCPs. This approach can contribute to a succesfull implementation of the toolkit and its effectiveness.

The shift from linear to circular business models is critical for sustainability in the construction and manufacturing sectors in the Netherlands. However, many companies face significant challenges in making this transition, including financial constraints, cultural resistance, and regulatory hurdles, which hinder the effective implementation of circular practices. This study employs a qualitative approach, conducting ten in-depth interviews with senior managers holding diverse positions and responsibilities from ten medium-sized enterprises. Using the purposive nonprobability sampling technique this research explores the drivers for transitioning, the barriers encountered, and the strategies used to overcome these challenges. The findings reveal that regulatory pressures, internal environmental advocacy, and market demands for sustainable solutions are key drivers of circular business practices. Barriers identified include limited budgets, high marketing costs, organisational resistance to change, and regulatory complexities. Nevertheless, companies identified various opportunities based on the interview result, such as market differentiation, enhanced sustainability, and strategic partnerships. Companies also noted improvements in brand reputation and customer loyalty as direct benefits of embracing circular practices. This research provides valuable insights into the drivers, barriers, and opportunities in adopting circular business models within the construction and manufacturing sectors in the Netherlands. The findings emphasize the importance of stakeholder engagement, continuous education, and the need for financial and policy support to overcome barriers and leverage opportunities for sustainable business growth. Lastly, this research provides recommendations for future studies including expanding the scope to different industries and regions, adopting mixed-methods approaches, and exploring the impact of specific policies and financial mechanisms on circular business model adoption.

Cervical cancer remains a leading cause of morbidity and mortality among women worldwide, particularly in regions with limited access to advanced medical care. Accurate and timely diagnosis of precancerous changes in the cervix is critical for effective prevention and treatment. This study introduces a deep learning algorithm for colposcopic analysis of the transformation zone of the uterine cervix. Intel & MobileODT Cervical Cancer Screening competition provided a comprehensive dataset designed to advance the application of artificial intelligence (AI) in classifying transformation zones (TZ) of the cervix, a key site where precancerous changes develop due to Human Papillomavirus (HPV) infection. This study highlights the significance of TZ classification for targeted biopsy during colposcopy, a gold-standard diagnostic method. However, challenges such as clinician’s subjectivity and interobserver variability, false negatives and positives interpretations limited accessibility, and resource intensity have spurred the integration of AI into colposcopic evaluations. The dataset comprises diverse cervical images, categorized into three types of TZs, enabling the development of AI models to distinguish between these categories. By leveraging deep learning algorithms, AI has demonstrated potential in enhancing the sensitivity and specificity of colposcopic findings while mitigating subjectivity and observer dependency. This abstract outlines the anatomical basis of cervical pathology, the critical role of colposcopy in diagnosing transformation zone abnormalities, and the transformative potential of AI in improving cervical cancer screening processes. The integration of AI-assisted tools could significantly improve diagnostic accuracy, reduce invasive procedures, and enhance access to cervical cancer prevention measures, particularly in underserved regions.

Objective Sjögren’s disease (SjD) can have a major impact on sexual functioning, but this topic has received limited attention in research and clinical practice. This qualitative study investigated how SjD affects sexual experience and functioning in both women and men. Method Reflexive thematic analysis was performed based on in-depth interviews with patients with SjD. Sexual functioning was measured using the Female Sexual Function Index and International Index of Erectile Function questionnaire. Results 11 female and 9 male patients with SjD, aged between 24 and 65 years, were included. According to questionnaire scores, 64% of female and 67% of male participants reported sexual dysfunction. In both sexes, six themes were identified as important in sexual experience and functioning: chronic stress in life, symptoms of SjD (affecting sexual experience), invisible suffering of SjD, impact of illness perception on coping strategies for sexuality-related symptoms, quality of (sexual) partner relationship and taboo of sexuality. These themes interact with each other and together shape the sexual experience. Conclusion SjD plays a crucial role in the quality of sexual experience. Many participants reported an unmet need for support, advice and treatment of sexuality-related symptoms related to SjD. The themes generated provide valuable insights into understanding the factors that shape sexual experience and underscore the importance of addressing sexuality-related symptoms as part of holistic care for patients with SjD. Due to the complexity of sexual experience and functioning, future research should focus on the patient as a whole person, and not solely on physical sexual functions.

This study examines how different filming techniques can enhance the quality of 3D reconstructions with a particular focus on their use in indoor crime scene investigations. Using Neural Radiance Fields (NeRF) and Gaussian Splatting, we explored how factors like camera orientation, filming speed, data layering, and scanning path affect the detail and clarity of 3D reconstructions. Through experiments in a mock crime scene apartment, we identified optimal filming methods that reduce noise and artifacts, delivering clearer and more accurate reconstructions. Filming in landscape mode, at a slower speed, with at least three layers and focused on key objects produced the most effective results. These insights provide valuable guidelines for professionals in forensics, architecture, and cultural heritage preservation, helping them capture realistic high-quality 3D representations. This study also highlights the potential for future research to expand on these findings by exploring other algorithms, camera parameters, and real-time adjustment techniques.

Aims Hospitals are encouraged to provide care closer to patients’ homes. This study investigates how patients, informal caregivers and nurses experience home-based hospital-level care for decompensated heart failure. Methods and results This mixed-methods study employed semi-structured interviews with 11 patients and 4 informal caregivers, a questionnaire administrated to 16 nurses from the Intensive Care, Cardiac Care and general cardiology ward, and interviews with 4 nurses, supplemented by two group discussions. A convenience sample was utilized, member checks were performed, and two researchers analysed the patient interviews using thematic analysis based on the Normalization Process Theory. Five overarching themes emerged: 1) Appreciation of personal environment, routines, and autonomy. 2) Quality of care. 3) Commitment to the treatment. 4) Influence of personal characteristics. 5) Changing role of informal caregivers. Regarding nurse satisfaction, findings were mapped according to Proctor et al.’s implementation outcomes: Acceptability: hospital-at-home care increases job satisfaction, through increased autonomy, personalized care, and patient satisfaction; Appropriateness: hospital-at-home was perceived positively, although safety and adherence needed attention; Adoption: hospital-at-home was not particularly challenging but offered a refreshing change; Feasibility: On-call duty impacted personal commitments for some nurses; Fidelity: information folders with clear protocols were deemed helpful. Conclusion Patients, caregivers, and nurses generally favour home-based heart failure treatment over hospital-based treatment. Key conditions include comprehensive education on home treatment, adherence support like dietary restriction maintenance, prioritizing patient autonomy, recognizing caregiver burden, and exploring cost-effective strategies such as collaboration with home care organizations.