Thomas More Kempen

This paper presents the design, application, and results of experience-centered design sessions (ECD) involving nonverbal persons with dementia (PwD) and persons with profound intellectual and multiple disabilities (PwPIMD). This study is part of a larger interdisciplinary project dedicated to understanding the personhood of these persons within contexts of care and living. This study is grounded in the belief that sensory experiences and interactions can render their personhood visible, tangible, and accessible. With three participants from each group in six different care facilities, ECD sessions spanned four consecutive days. During these sessions, various tools aimed at providing sensory stimuli were introduced to the participants. These sessions were recorded and later analyzed using reflexive thematic analysis. The reactions, interactions, actions, or the lack thereof, with or without these designed tools, provided insights into which tools and approaches effectively rendered nonverbal personhood visible, tangible, and accessible. Additionally, this study also considers the already existing sensory stimuli within their care setting, which were also observed and included in the analysis. Through these ECD sessions, a metaphorical space was created between the participant, designer-researcher, other actors, and tools present in these facilities. This paper not only explores the immediate and latent results of these sessions on the nonverbal participants but also considers the impact on other actors present within these facilities during the sessions. The paper concludes by providing recommendations to design for nonverbal personhood for designer-researchers working with nonverbal persons in care, while also highlighting ways to include them into research to create new avenues for understanding, recognition, and inclusion.

Successfully implementing care technology to enhance people's health-related quality of life poses several challenges. Although many technological tools are available, we lack consensus on values and principles, regulatory systems, and quality labels. This article describes the FIDE process of the Belgian ‘Teckno 2030' project: Future-thinking Interdisciplinary workshops for the Development of Effectiveness principles, resulting in a framework of eight Caring Technology principles. These principles are built on three overarching values: autonomy, justice, and trust. The framework enables responsible health technology innovation by focusing on the needs of users and society, data security, equity, participatory governance, and quality control. A learning community was established to support the framework’s implementation in projects, organizations, and the broader innovation community. We also discuss the barriers, facilitators, and practical tools developed within this learning community. The FIDE process, caring technology principles, and learning community provide a case study for responsible innovation in care technology.

Sport psychology practitioners are increasingly operating in the esport domain. Yet it remains unclear how practitioners who have exclusively been trained in traditional sport develop a contextually grounded understanding of their practice in esport. This study, framed from an ontological relativism and epistemological interpretivism approach, involved semistructured interviews with 10 qualified practitioners (three female, seven male) who transitioned from traditional sport to esport. Data were analyzed using reflexive thematic analysis and presented via three composite vignettes: (a) My wish was to feel a part of the team, but there’s no team; (b) To be honest, did I have assumptions going into esport? Absolutely!; and (c) Esport is the wild, wild west. Our findings offer insights on the hurdles associated with transitioning from traditional sport to esport, thus highlighting the important role that esport organizations, training routes, and educational institutions have in supporting practitioners to ethically and effectively work in this domain.

Persons with autism spectrum disorder (ASD) and/or intellectual disability (ID) have difficulties in planning, organising and coping with change, which impedes the learning of daily living skills (DLSs), social participation and self-management across different environmental settings. Assistive technologies (ATs) is a broad term encompassing devices and services designed to support individuals with disabilities, and if used in a self-controlled manner, they may contribute inclusion in all domains of participation. This comprehensive literature review aims to critically assess and unify existing research that investigates the use of assistive technology within the practical domain for individuals with ASD and/or ID. The 18 relevant studies included in this review highlighted the benefits of AT for social participation and independence in daily activities of individuals with ASD and/or ID. Professionals working with this target group should be knowledgeable of the speedy progress of AT products and the potential of persons with ASD and/or ID to use mainstream devices to meet their individual needs. This awareness provides an opportunity to advocate for the universal benefits of AT for everyone. Technologies such as virtual reality, mobile applications and interactive software have been shown to improve DLSs, communication and social interaction. These tools offer engaging, user-friendly platforms that address the specific needs of these individuals, enhancing their learning and independence.

Objective Interpersonal violence (IV) in sport is challenging to define, prevent and remedy due to its subjectivity and complexity. The 2024 International Olympic Committee Consensus on Interpersonal Violence and Safeguarding aimed to synthesise evidence on IV and safeguarding in sport, introduce a new conceptual model of IV in sport and offer more accessible safeguarding guidance to all within the sports ecosystem by merging evidence with insights from Olympic athletes. Methods A 15-member expert panel performed a scoping review following Joanna Briggs Institute methodologies. A seminal works-driven approach was used to identify relevant grey literature. Four writing groups were established focusing on: definitions/ epidemiology, individual/interpersonal determinants, contextual determinants and solutions. Writing groups developed referenced scientific summaries related to their respective topics, which were discussed by all members at the consensus meeting. Recommendations were then developed by each group, presented as voting statements and circulated for confidential voting following a Delphi protocol with ≥80% agreement defined a priori as reaching consensus. Results Of 48 voting statements, 21 reached consensus during first-round voting. Second-round and third-round voting saw 22 statements reach consensus, 5 statements get discontinued and 2 statements receive minority dissension after failing to reach agreement. A total of 43 statements reached consensus, presented as overarching (n=5) and topical (n=33) consensus recommendations, and actionable consensus guidelines (n=5). Conclusion This evidence review and consensus process elucidated the characterisation and complexity of IV and safeguarding in sport and demonstrates that a whole-of-system approach is needed to fully comprehend and prevent IV. Sport settings that emphasise mutual care, are athlete centred, promote healthy relationships, embed trauma and violence- informed care principles, integrate diverse perspectives and measure IV prevention and response effectiveness willexemplifysafesport.Asharedresponsibilitybetween all within the sports ecosystem is required to advance effective safeguarding through future research, policy and practice.

Background Identification of groups at a high risk of gastric cancer could facilitate targeted screening in countries with a low gastric cancer incidence. Our aim was to identify such high-risk groups based on individual-level population data on migration history and socioeconomic status (SES) in the Netherlands. Methods In this retrospective cohort study, patient data from the Netherlands Cancer Registry were linked to demographic data of Statistics Netherlands in the period 2010 to 2022. Gastric cancer incidence rates in the 14 largest immigrant populations were compared with those born in the Netherlands. Odds ratios (OR) were computed per birthplace and controlled for age, sex, and SES. Additionally, we investigated gastric cancer risk among second-generation immigrants and by SES. Results Immigrant populations at a significantly higher gastric cancer risk compared with the general population were identified. Specifically, foreign-born first-generation immigrants from Bosnia–Herzegovina (OR, 2.42), Turkey (OR, 2.22), and China (OR, 1.92) showed elevated risk. Whereas low SES increased the odds of developing gastric cancer, first-generation immigrants remained at higher risk even after controlling for SES. Second-generation immigrants did not have a significantly higher risk of developing gastric cancer. Conclusions Certain first-generation immigrants remain at an elevated risk for gastric cancer despite migration to a low-risk region. Identification of these high-risk groups should be used to facilitate targeted gastric cancer prevention. Impact Potential benefits of targeted Helicobacter pylori test-and-treat policy in immigrant populations should be explored in clinical and modeling studies. Primary care physicians should be cognizant of high-risk groups, facilitating the early detection of cancer within these populations.

Objective Our aim was to define the priorities for future research in safeguarding athletes from interpersonal violence (IV) in sport through a Delphi consensus study of researchers in the field. Methods An internet-based three-round Delphi method was used as a multistage facilitation technique to arrive at a group consensus (set at ≥75% agreement). A targeted literature search was conducted to develop a list of potential research priorities that were presented as short statements in the first round. Results A total of 52 participants (researchers in IV in sport) took part in the first round, 52 completed the second round and 44 completed the third round. Respectively, 47 items, 83 items and 60 items were included in each round. The participants achieved consensus on 11 statements in the first round, seven in the second round and 31 in the third round, for a total of 49 consensus research priorities. The first four priorities that reached consensus (78.8–80.8% agreement) directly following the first Delphi round were scored with high importance (between 6.2 and 6.3 on a scale of 7). Those four priorities included: (1) documenting the experiences of children athletes and minors, (2) studying the disclosure or reporting of violence, (3) developing, evaluating and advising on interventions targeting education and training and (4) documenting the experiences of violence of para athletes. Conclusion This study defines research priorities for IV in sport that may elucidate further gaps in current policies and practices.

Objectives A paucity of studies assesses the intersection of physical health (injury and illness), mental health and experiences of interpersonal violence (IV, also known as harassment and abuse) in sport. The objectives of this study were to examine the (a) frequency of self-reported physical and mental health problems of elite athletes in the 12 months prior to the survey, (b) differences in physical and mental health between male and female athletes and (c) relationship of athlete health with experiences of IV. Methods Elite adult athletes from four sports were approached at eight international events to answer an online questionnaire on their physical and mental health, as well as experiences of IV in sport within the past 12 months. Results A total of 562 athletes completed the questionnaire. Overall, 75% reported at least one physical symptom, most commonly headache and fatigue (n=188; 33.5% each), followed by musculoskeletal symptoms (n=169; 29.4%). 65.1% reported at least one mental health symptom, mostly of anxiety or depression. More female than male athletes reported physical (F:81.9%; M:68.3%; p<0.001) and mental (F:71.9%; M:58.4%; p<0.001) health problems, while addiction problems were more frequent in male athletes (F:1.8%; M:6.4%; p=0.006. 53.0% of the female and 42.3% of the male participants reported having experienced at least one form of IV. Linear regression analysis demonstrated that all forms of IV, except physical IV (all p’s<0.001), were associated with an increasing number of physical and mental health symptoms. In addition, the analysis showed that female athletes had a higher increase in symptoms in response to IV than male athletes. Conclusions This study demonstrates the relationship of elite athlete physical and mental health with IV. Injury and illness prevention programmes in international sport should include strategies to reduce IV.

Interest in the nutrition of the yellow mealworm ( Tenebrio molitor L.) larvae is on the rise, leading to an increase in publications on this topic. The absence of a standard protocol and resulting differences in experimental designs reduces comparability among studies and impedes research on mealworm nutrition. To address this, a consensus standardised protocol was developed specifically for the evaluation of mealworm larval growth and performance in feeding trials. The efficacy of this protocol was evaluated through an international ring test involving seven partners using two wheat brans as dry feed (a standard bran and a local bran) at 27 °C and 60% relative humidity. As experimental units, plastic crates filled with 2.1 kg of bran and 10,000 4-week-old larvae were used with six replicates. Agar gel was provided as wet feed ad libitum . The mean individual larval weight and the number of larvae per crate were determined weekly until either three or more replicates ran out of feed or pupation exceeded 10%. At harvest, the total larval fresh biomass and amount of frass was determined. Larval samples were taken for chemical analysis. To assess the protocol, the within (repeatability) and between (reproducibility) laboratory variability was calculated for each parameter. The repeatability was good (limit at 12% (standard) and 14% (local)). The reproducibility was poorer with a limit 2.7 times higher for the standard feed (36%) and 3.8 times higher for the local feed (55%). For both feeds, the total larval fresh harvest, amount of frass and the larval protein concentration were the most consistent both within and among laboratories. The highest variability was observed at the early life stages and for the larvae ash content. The detailed consensus standard protocol and repeatability/reproducibility estimates can be used as basis for future mealworm feeding trials, comparing results and future improvements.

Interpersonal violence in sport has serious consequences for athletes, sports organisations and society at large. Despite recent advances in safeguarding sport participants from interpersonal violence, empirical evidence regarding its prevalence and risk factors across different sports remains scarce. In this study, we investigated differences in the prevalence of interpersonal violence among a convenience sample of 9989 adults from six European countries who participated in organised sport before age 18. Utilising binary logistic regression analyses and CHAID regression tree analyses, we examined variations in reported experiences of neglect, psychological, physical, non-contact sexual and contact sexual forms of interpersonal violence based on gender and three sport classifications: type of sport (individual vs. team), sports attire (non-revealing vs. body-fitting/revealing) and weight-sensitivity (less weight-sensitive vs. weight-sensitive sports). Men participating in team sports reported significantly higher levels of victimisation across all types of interpersonal violence. Women in sports with non-revealing attire and men in less weight-sensitive sports also reported higher prevalence rates. The study underscores the need for a nuanced understanding of interpersonal violence characteristics and dynamics across different sports. Insights into the factors influencing victimisation enable tailored prevention and response strategies to be developed to better address the needs of athletes and sport organisations.

Objectives This exploratory study was conducted to find out how well the concept of evidence-based research (EBR) is known among European health researchers with substantial clinical research experience, and which barriers affect the use of an EBR approach. The concept of EBR implies that researchers use evidence synthesis to justify new studies and to inform their design. Design A cross-sectional exploratory survey study. Setting and participants The survey was conducted among European health researchers. Respondents included 205 health researchers (physicians, nurses, dentists, allied health researchers and members of other professions involved in health research) with a doctoral degree or at least 5 years of research experience. Primary and secondary outcome measures The primary outcome measures were the level of awareness of the concept of EBR and the presence of barriers affecting the use of an EBR approach. Secondary outcome measures include correlations between sociodemographic characteristics (eg, profession) and awareness of EBR. Results We discovered that 84.4% of the respondents initially indicated their awareness of the concept of EBR. Nevertheless, 22.5% of them concluded that, on reading the definition, they either do not know or do not fully comprehend the concept of EBR. The main barriers affecting the use of an EBR approach were related to organisational issues, such as not being attributed resources (30.5% of the respondents), time (24.8%) or access to implement it (14.9%). Conclusions Despite the limitations, this study clearly shows that ongoing initiatives are necessary to raise awareness about the importance of implementing the EBR approach in health research. This paper contributes to a discussion of the issues that obstruct the implementation of the EBR approach and potential solutions to overcome these issues, such as improving the knowledge and skills necessary to practice the EBR approach.

Objectives To assess the clinical competence of sports medicine physicians to recognise and report harassment and abuse in sports, and to identify barriers to reporting and the need for safeguarding education. Methods We implemented a cross-sectional cohort study design recruiting through social media and international sports medicine networks in 2023. The survey captured participant perceptions related to the harmfulness of harassment and abuse. The survey incorporated the reasoned action approach as a theoretical framework to design survey questions to identify attitudes and self-efficacy to detect and report suspicions of harassment and abuse and to identify barriers to reporting. Results Sports medicine physicians (n=406) from 115 countries completed the survey. The situations of harassment and abuse presented in the survey were described by sports medicine physicians as having occurred in the 12 months before participating in the survey. Despite recognising the situations as harmful, sports medicine physicians were somewhat uncomfortable being vigilant for the signs and symptoms and reporting suspicions and disclosures of harassment and abuse (M=2.13, SD=0.67). In addition, just over one-quarter (n = 101, 26.9%) was unaware of where to report harassment and abuse, and over half did not know (n = 114, 28.1%), or were uncertain (n = 95, 23.4%) of who the safeguarding officer was in their sports organisation. Participants identified many barriers to reporting harassment and abuse, including concerns regarding confidentiality, misdiagnosis, fear of reprisals, time constraints and lack of knowledge. Over half felt insufficiently trained (n = 223, 57.6%), and most respondents (n=324, 84.6%) desired more education in the field. Conclusions Educational programmes to better recognise and report harassment and abuse in sports are needed for sports medicine trainees and practising clinicians. An international safeguarding code for sports medicine physicians should be developed.

Ankle–foot orthoses (AFOs) are commonly prescribed to children with cerebral palsy (CP). The conventional AFO successfully controls the first and second ankle rocker, but it fails to correct the third ankle rocker, which negatively effects push-off power. The current study evaluated a new powered AFO (PAFO) design, developed to address the shortcomings of the conventional AFO. Eight children with spastic CP (12.4 ± 3.4 years; GMFCS I-III; 4/4-♂/♀; 3/5-bi/unilateral) were included. Sagittal kinematic and kinetic data were collected from 20 steps during barefoot walking, with conventional AFOs and PAFOs. In the PAFO-condition, an actuation unit was attached to a hinged AFO and through push–pull cables to a backpack that was carried by the child and provided patient-specific assistance-as-needed. SnPM-analysis indicated gait cycle sections that differed significantly between conditions. For the total group, differences between the three conditions were found in ankle kinematics (49.6–66.1%, p = 0.006; 88.0–100%, p = 0.011) and angular velocity (0.0–6.0%, p = 0.001; 45.1–51.1%, p = 0.006; 62.2–73.0%, p = 0.001; 81.2–93.0%, p = 0.001). Individual SnPM-analysis revealed a greater number of significant gait cycle sections for kinematics and kinetics of the ankle, knee, and hip. These individual results were heterogeneous and specific per gait pattern. In conclusion, the new PAFO improved the ankle range-of-motion, angular velocity, and power during push-off in comparison to the conventional AFO.

Due to its potential as a sustainable protein source, the industrial relevance of Tenebrio molitor, known as yellow mealworm, is set to increase substantially. Given the novelty of its application in the food industry, knowledge is lacking regarding the nutritional quality of commercially farmed mealworms. This study investigated the nutritional composition of larvae from four different rearing facilities in Belgium and specifically investigated whether their nutritional profiles adhered to defined European nutrition claims (Regulation (EC) No. 1924/2006). In particular, the European nutrition claims “high in protein”, “high unsaturated fat”, “high in fibre” and “rich in P, Mg, K, Zn and Mn” were applicable for all mealworm samples on a dry matter basis. On a fresh matter basis, yellow mealworms were found to be “high in protein”, “high unsaturated fat” and “low in sugar”.

This research addresses the challenges and opportunities in integrating Intangible Cultural Heritage (ICH) into Cultural Heritage Tourism (CHT) offerings. Despite the growing interest in ICH, comprehensive research on its effective incorporation into CHT is lacking. Qualitative research was used employing interviews with 13 representatives from four case study areas known for their significant ICH offerings in the Dutch-speaking regions of Belgium and the Netherlands. Three research questions were formulated and tested to understand stakeholder collaboration, knowledge levels, and the complexities surrounding the term ‘ICH.’ The findings reveal a deficiency in stakeholder cooperation and varying levels of knowledge among supply-side stakeholders. The term ‘ICH’ itself was found to be complex but manageable through education and ethical sensitivity. The study recommends the involvement of an impartial mediator to facilitate stakeholder collaboration and suggests that heritage communities should be actively engaged in the process. Limitations include focusing on specific cultural and linguistic groups and incomplete stakeholder representation. The research has practical implications for policy formulation and Destination Management Organisations (DMOs) and offers a nuanced understanding of the challenges and solutions for integrating ICH into CHT.

Background: Crisis communication might not reach non-native speakers or persons with low literacy levels, a low socio-economic status, and/or an auditory or visual impairments as easily as it would reach other citizens. The aim of this rapid review was to synthesize the evidence on strategies used to improve inclusive pandemic-related crisis communication in terms of form, channel, and outreach. Methods: After a comprehensive search and a rigorous screening and quality assessment exercise, twelve comparative studies were selected for inclusion in this review. Data were analyzed and represented by means of a structured reporting of available effects using narrative tables. Results: The findings indicate that a higher message frequency (on any channel) may lead to a lower recall rate, audio–visual productions and tailored messages prove to be valuable under certain conditions, and primary healthcare practitioners appear to be the most trusted source of information for most groups of citizens. Trust levels were higher for citizens who were notified in advance of potential exceptions to the rule in the effect of preventive and curative measures promoted. Conclusions: This review contributes to combatting information inequality by providing evidence on how to remove the sensorial, linguistic, cultural, and textual barriers experienced by minorities and other underserved target audiences in COVID-19-related governmental crisis communication in response to the societal, health-related costs of ineffective communication outreach.

The prevalence of sexual harassment and abuse in school sport, specifically by coaches against their athletes, remains a concerning and pervasive issue. In an attempt to better understand and prevent specific coach-behaviours associated with such sexual misconduct, researchers have developed the Sexual Violence Questionnaire in Sport. While the reliability of this measurement tool has been tested in Anglo-Saxon cultural contexts, it is not known whether the questionnaire is applicable to other cultural contexts. This study aimed to analyse the internal consistency and reliability of the questionnaire on sexual harassment in sport, originally designed and developed in English. A sample of 146 (52 female, 94 male) undergraduate students from a university in the Basque Country participated in this cross-sectional study. The questionnaire was administered twice over a two-week period to assess test–retest reliability. The internal consistency of the Sexual Violence Questionnaire in Sport was high, with Cronbach’s alpha values of 0.891 for perceptions and 0.813 for experiences across all participants. Gender-specific analysis showed similar reliability, with females having slightly lower alpha values for perceptions. Although significant differences were observed between the test and the retest on eight perception items and one experience item, Cohen’s kappa analysis indicated agreement on all items; however, some of them were low (e.g., 0.13). In conclusion, the study highlights the questionnaire’s overall reliability and suggests its effectiveness as a tool for measuring sexual violence in sport within the Spanish context. Nonetheless, the findings of this study underscore the need for further research to enhance the instrument’s stability and to better understand gender differences in perceptions and experiences of sexual violence in sport contexts.

Full acceptance of the current state of the world challenges our existing ways of education and thinking. Teaching ecosocial work and being part of transformative education (SDG Target 4.7) are overshadowed by unsustainable material consumption, increased risks, and profound changes within societies. Fully understanding this has a disruptive effect on mental well-being, including eco-anxiety. Learning about climate, biodiversity, resource depletion, water scarcity, forced migration, and global inequality causes cognitive dissonance in young students who hold a progress-oriented worldview. Eco-anxiety and cognitive dissonance require understanding of and support for ecosocial work at institutional level. This chapter draws on the author’s teaching of the global challenges to discuss the need, possibility, and conditions of an eco-centered worldview in social work education in general.