Stenden University of Applied Sciences

Introduction Early mobilization reduces long-term muscle weakness after intensive care unit (ICU) admission, but barriers (e.g., anxiety, lack of motivation) may complicate patients’ adherence to exercise. Virtual reality (VR) presents immersive stimuli, which may increase motivation and adherence. This study aimed to examine the feasibility of VR-therapy using a VR-headset during ICU- and subsequent general ward admission. Furthermore, physical parameters before and after training were explored. Materials & Methods Ten adult ICU-patients with a median age of 71 [63–79], 70% of male registered birth sex, mechanically ventilated for ≥48 h, and willing to participate, were included. VR-therapy was offered three times a week for 20 minutes in addition to standard care. To train upper extremity functionality, patients were instructed to complete puzzles with increasing level of difficulty. Feasibility was based on patient satisfaction, session efficiency, and adherence levels during the training. Fatigue was measured after each session using the Borg Rating of Perceived Exertion Scale. Patients’ hand-grip strength and Morton Mobility Index (MMI) were evaluated at the start of VR-therapy and after four weeks of training or at hospital discharge. Results On average, patients followed three VR-therapy sessions of 20 min per week with 13 min of actual training time, over the course of 1 to 3 weeks depending on their length of stay. Session efficiency ranged from 25% to 93%. In total, patients adhered to 60% of the VR-therapy sessions. MMI scores increased significantly from the start (26 [24–44]) to the end of the VR-therapy training period (57 [41–85], p = 0.005), indicating improved balance and mobility. Conclusion VR-therapy for upper extremity rehabilitation in ICU-patients is feasible during stay in the ICU and general ward.

As in the present, whale-stranding events in the past have received their own shares of fear and curiosity, as shown by various whale-stranding images (i.e., paintings, etchings, and engravings) produced by artists from countries bordering the North Sea. However, production of these images was not equal among these countries or regions. We catalogued the North Sea regions that produced whale-stranding images between 1500–1900. Possible factors contributing to some countries producing more whale-stranding images than others are examined, and the images’ evolution is assessed. A qualitative anthropological thematic analysis of the images shows that themes shifted over time. Religion, fear or repulsion, public curiosity, spectacles, and scientific inquiries are dominant themes found within the images.

Teacher cognitions of multilingualism influence classroom behaviour and are partly formed during pre-service teacher (PST) education (Borg 2003). In Fryslân, a linguistically diverse region of the Netherlands, Frisian is a compulsory subject, yet teachers feel underprepared to teach it, leading to negative attitudes towards the minority language and multilingualism in general. A survey, dominant language constellation (DLC) artefacts (Ibrahim 2022), and focus groups with vignettes (Barter & Renold 1999) were used to explore 72 PSTs’ cognitions of multilingualism in education and multilingual identities. Our triangulation of methods shows how cog- nitions of multilingualism can be mapped in various ways. PSTs held slightly positive cognitions of multilingualism in education in the survey and identified as multilingual in the DLCs and focus groups. However, PSTs’ cognitions of minority languages should be improved. This study contributes to the understanding of PSTs’ multilingual identities and cognitions and offers guidance on how the concept of teacher cognition can be applied to multilingualism to improve training on multilingual pedagogies for PSTs.

In higher vocational education, innovations are shifting from teacher-oriented to student-oriented education and hybrid learning environments. Designing these innovative environments is complex. This study aimed to gain insight into art and design teachers’ rules of thumb when designing instruction in studios. The rules of thumb from experienced designers of design education provide insight into the practical knowledge essential for creating effective studio learning environments. These rules of thumb, derived from teachers' practical knowledge, outline teachers’ ideas about characteristics design education should have to achieve specific student learning outcomes. Six teachers participated in this case study, to investigate this phenomenon in a real-world context. During interviews, they designed a studio for their teaching practice while thinking aloud, expressing their thoughts, actions, and reasoning. These teachers had at least four years of experience in designing art and design studios and were still active in their roles. Within and cross-case analysis revealed that learning theories are recognizable in teachers’ rules of thumb when designing studio instruction. Teachers and their rules of thumb span a spectrum from cognitivism to social constructivism, with most teachers oriented towards social constructivism. This aligns with strategic design considerations at studios, which are also based on social constructivism. Typical social-constructivist rules of thumb focus on student ownership of their learning process and fostering collaboration between various actors in an authentic context. The rules of thumb from experienced designers are incorporated into the training of current and future studio designers and may inspire those who create similar innovative learning environments.

Teachers use situated knowledge to deal with the complex and diffuse educational contexts they operate in. To be able to take deliberated action, based on the situated knowledge, reflection is necessary during the teacher training. Video cases with common, real world situations are suitable for reflection because of their holistic and diffuse character. Reflection concerns learning experiences with increasing complexity: single-loop (reflecting on a current action), double-loop (reflecting to gain new insights) and triple-loop (reflecting in order to adjust individual identity) learning. The knowledge gained from loop learning is of a situated nature. The current article operationalizes situated knowledge as educational purposes and design patterns; educational purposes determine which course of action (design pattern), is the best option. Using this distinction, we investigate whether the reflection done by fourth-year teachers in training corresponds to what can be expected of a starting expert, namely, reflection on all three levels. The results indicate that three out of four teachers in training can be characterized as starting experts, based on their responses to a video case. They experience learning on all three loop levels, and these experiences contribute to a variety of educational purposes and design patterns. It is the teacher trainers’ challenge to have their students reflects using video cases, so they can use loop-learning to build their situated knowledge. This knowledge will allow them to adequately respond to the complex and diffuse situations in their educational practice.

Poly(lactic acid) (PLA) is regularly blended with poly(butylene adipate‐ co ‐terephthalate) (PBAT) to produce compostable plastic films used in packaging applications, for example. Since PLA and PBAT both contain ester bonds, these PBAT/PLA blends are interesting candidates for enzymatic recycling. This is a new, green recycling technique that allows the use of mild processing conditions to regenerate the pure building blocks of polymers, thereby enabling repolymerization to virgin‐quality plastic. In this work, various PBAT/PLA blends are prepared (20, 40, 60, and 80 wt% PBAT) and incubated with a cutinase enzyme from Humicola insolens (HiC). Enzymatic degradation is characterized by weight loss, scanning electron microscopy (SEM), and proton nuclear magnetic resonance ( ¹ H NMR) spectroscopy. Blends rich in PBAT are effectively degraded by HiC (up to 40% weight loss after 7 days of incubation at 70°C), while PLA‐rich blends are degraded to a lesser extent. HiC is capable of degrading both polymers, although for PLA, the extent of degradation is similar to control experiments without HiC. Furthermore, in the absence of an enzyme, a “shielding” effect is found for nonenzymatic degradation, where a hydrolytically stable PBAT matrix prevents the degradation of the PLA domains. This work provides insight into the enzymatic degradation of uncompatibilized polymer blends and opens up the possibility for the enzymatic recycling of commercial PBAT/PLA blends.

This exploratory study investigates artificial intelligence (AI) integration’s potential impact on the future of talent management in tourism and hospitality. Using the scenario planning method and Dator’s Alternative Futures Framework, four 2035 alternative scenarios were constructed. These scenarios served as a foundation for 3 group and 30 individual scenario-planning sessions with international industry experts and academics, epistemologically aligning the process with exploring the uncertain future of AI. The thematic analysis of the data underscored the importance of balanced integration that enhances rather than replaces human roles. Ethical considerations, the human-centric essence of tourism and hospitality, and the need for ongoing education and skill development in response to AI advancements were considered central. This study’s novel contribution is a conceptual framework to guide AI integration in tourism and hospitality talent management, contributing to the theoretical and practical understanding of AI’s role in talent management.

Introduction Individuals with mental health disorders tend to smoke more frequently and intensely than the general population; however, smoking cessation efforts are still often neglected in mental health care. Methods This position paper advocates for creating a more prominent role for mental health nurses in assisting individuals with severe psychiatric disorders to quit smoking. Results Given their extensive patient contact and holistic care approach, mental health nurses are uniquely positioned to lead smoking cessation initiatives. Consequently, there is an urgent need for increased awareness, mandatory professional training and policy support to empower nurses in this critical role. Conclusions Strengthening the involvement of mental health nurses in smoking cessation programs could lead to reduced premature mortality and improved overall health for individuals with severe mental illnesses.

The biocompatibility and renewability of starch-based hydrogels have made them popular for applications across various sectors. Their tendency to incur damage after repeated use limits their effectiveness in practical applications. Improving the mechanical properties and self-healing of hydrogels simultaneously remains a challenge. This study introduces a new self-healing hydrogel, synthesized by grafting acrylamide onto starch using ceric ammonium nitrate (CAN) as an initiator, followed by borax cross-linking. We systematically examined how the starch-to-monomer ratio, borax concentration, and CAN concentration impact the grafting reactions and overall performance of the hydrogels. The addition of borax significantly reinforced the strength of the hydrogel; the maximum storage modulus increased by 1.8 times. Thanks to dynamic borate ester and hydrogen bonding, the hydrogel demonstrated remarkable recovery properties and responsiveness to temperature. We expect that the present research could broaden the application of starch-based hydrogels in agriculture, sensors, and wastewater treatment.

The Big Five personality factors (PF) are considered to be predictive of mental health problems, but it is unclear if these factors equally contributed to mental health problems during the COVID-19 pandemic compared to before the pandemic. This prospective study aimed to fill this knowledge gap. For this purpose data was extracted from the population-based LISS-panel. We included adult respondents (N males = 1,838, N females = 1892) who participated in three surveys before the pandemic (T1 March-2019 , T2 May-2019 , T3 November-2019 ) and in three surveys during the pandemic in 2020 (T4 March-2020 , T5 May-2020 , T6 november-2020 ). Multivariate logistic regression analyses were used to examine and compare the longitudinal associations between PF at T2 May-2019 and moderate-severe anxiety and depressions symptoms (ADS) at T3 November-2019 , and longitudinal associations between PF at T5 May-2020 and ADS at T5 November-2020 among males and females. Control variables (pre-existing ADS, lack support, demographics) were retrieved from the T1 March-2019 and T4 March-2020 surveys, respectively. For the present study we distinguished five levels (very high to very low) of each PF. For both sexes, those with (very) low emotional stability and/or conscientiousness had considerably higher rates of ADS compared to those with very high levels of the same trait. These findings were similar both before and during the pandemic. Moreover, we found no indications that those with a certain level of a PF during the pandemic were more of less at risk for ADS or persistent ADS, than those with the same level of the same PF before the pandemic. Thus, we found no indications that the pandemic affected the impact of personality factors on moderate-severe anxiety and depressions symptoms.

Background Frailty is a common condition in older people, and its prevalence increases with age. With an ageing population, the adverse consequences of frailty cause an increasing appeal to the health care system. The impact of frailty on population level is often assessed using adverse health outcomes, such as mortality and medication use. Use of community nursing services and services offered through the Social Support Act are hardly used in assessing the impact of frailty. However, these services are important types of care use, especially in relation to ageing in place. In this cross-sectional study, we aimed to assess the impact of frailty on use of Social Support Act services, use of community nursing services, medication use, and mortality. Methods We used a frailty index, the FI-HM37, that was based on data from the Dutch Public Health Monitor 2016, for which respondents ≥ 65 years of age were included (n = 233,498). The association between frailty, the use of Social Support Act services, community nursing services and medication use was assessed using the Zero Inflated Poisson (ZIP) regression method. Survival analysis using Cox proportional hazards regression was conducted to estimate the hazard ratios for the association between frailty and mortality. Results The ZIP regression with a final sample size of 181,350 showed that frailty affected care use even after correcting for several covariates mentioned in the literature. For each unit increase in frailty index (FI) score, the relative probability of using zero Social Support services decreased with 7.7 (p < 0.001). The relative chance of zero community nursing services decreased with 4.0 (p < 0.001) for each unit increase in FI score. Furthermore, for each unit increase in FI score, the likelihood of zero medication use decreased with 2.9 (p < 0.001). Finally, for each unit increase in FI score, the mortality risk was 3.8 times higher (CI = 3.4–4.3; p < 0.001). Conclusions We demonstrated that frailty negatively affects the use of Social Support Act services, the use of community nursing services, medication use, and mortality risk. This study is the first to demonstrate the impact of frailty on Social Support Act services and community nursing services in the Netherlands. Findings emphasize the importance of frailty prevention for older people and public health policy.

This study serves as an example of Conversation Analytic (CA) research with a focus on the interactional management of learning in classroom interactions, while simultaneously illustrating the several steps and procedures used for conducting these analyses. In this case, the method of CA is used to study students’ ‘oh’-prefaced utterances in one-to-one classroom interactions centred around explanations. The interactions are studied from the participants’ perspective by means of a turn-by-turn analysis of the selected fragments on the basis of video recordings and detailed transcripts, as is common practice in CA. This study aligns with previous CA research focusing on the details of classroom interaction relating to students’ learning processes. The results of the close analysis of the data provide insight into the orientation teachers and students show to interactionally exhibited knowledge displays in relation to the entire explanation activity they are involved in. This detailed analysis of one-to-one explanation interactions in secondary school classrooms provides insight into students’ learning processes as well as into the accompanying teacher practices.

Circular business model innovation is critical in the transition to the circular economy, often requiring businesses to undergo significant internal changes. One intervention to better support businesses in this process is circularity training, often provided by an innovation intermediary. However, little is known of the impact on internal barriers and drivers for circular business model innovation after circularity training has been completed. This research tackles this question through a qualitative exploratory approach, using a multiple‐case study, collecting semi‐structured data from businesses after their completion of a circular training course. We find that even after the circular training, a range of barriers continue to influence circular business model innovation, including issues related to the availability of resources, company acceptance, and technology. The research concludes with recommendations for future training programs and the role of innovation intermediaries, based on the internal barriers and drivers that the companies encountered when working toward circularity implementation and circular business model innovation.

Background As our global population ages, malnutrition and sarcopenia are increasingly prevalent. Given the multifactorial nature of these conditions, effective management of (risk of) malnutrition and sarcopenia necessitates interprofessional collaboration (IPC). This study aimed to understand primary and social care professionals’ barriers, facilitators, preferences, and needs regarding interprofessional management of (risk of) malnutrition and sarcopenia in community-dwelling older adults. Methods We conducted a qualitative, Straussian, grounded theory study. We collected data using online semi-structured focus group interviews. A grounded theory data analysis was performed using open, axial, and selective coding, followed by developing a conceptual model. Results We conducted five online focus groups with 28 professionals from the primary and social care setting. We identified five selective codes: 1) Information exchange between professionals must be smooth, 2) Regular consultation on the tasks, responsibilities, and extent of IPC is needed; 3) Thorough involvement of older adults in IPC is preferred; 4) Coordination of interprofessional care around the older adult is needed; and 5) IPC must move beyond healthcare systems. Our conceptual model illustrates three interconnected dimensions in interprofessional collaboration: professionals, infrastructure, and older adults. Conclusion Based on insights from professionals, interprofessional collaboration requires synergy between professionals, infrastructure, and older adults. Professionals need both infrastructure elements and the engagement of older adults for successful interprofessional collaboration.