Zoekresultaten

Blueprints: Systematizing Behavior Change Designs

To improve people’s lives, human-computer interaction researchers are increasingly designing technological solutions based on behavior change theory, such as social comparison theory (SCT). However, how researchers operationalize such a theory as a design remains largely unclear. One way to clarify this methodological step is to clearly state which functional elements of a design are aimed at operationalizing a specific behavior change theory construct to evaluate if such aims were successful. In this article, we investigate how the operationalization of functional elements of theories and designs can be more easily conveyed. First, we present a scoping review of the literature to determine the state of operationalizations of SCT as behavior change designs. Second, we introduce a new tool to facilitate the operationalization process. We term the tool blueprints. A blueprint explicates essential functional elements of a behavior change theory by describing it in relation to necessary and sufficient building blocks incorporated in a design. We describe the process of developing a blueprint for SCT. Last, we illustrate how the blueprint can be used during the design refinement and reflection process.

The pros and cons of a study choice test

First year undergraduate students at the Amsterdam University of Applied Sciences of two different departments, were asked to join self-reported surveys in two succeeding years. Along with background variables, effort and commitment, the surveys asked elements of engagement. The later was analysed with factor analysis. The data of the surveys together with the results of the exams from the first year, were investigated to find out if the mandatory study choice test (SCT) taken before entering the faculty, had any predictive effect on their success. Not only basic statistical analysis like correlation was performed, but also more advanced analysis such as structural equation modelling (SEM) was used to uncover the value of the SCT. After a model was built, the normed fit index (NFI), the comparative fit index (CFI), the Tucker-Lewis Index (TLI) and the root mean square error of approximation (RMSEA), were used to determine the fit of the model. By comparing the influence of the variables on the SCT, the benefits of the latter will be determined and ultimately enhance the knowledge about influences upon student success in higher education.

Non-specific neck pain: to match or not to match?

The general aim of this dissertation is to gain insight into the physiotherapeutic validity of physiotherapy research in subjects with non-specific neck pain. Chapter 1 describes the background of the research and the research questions and gives an overview of the studies performed. Chapter 2 presents the results of a systematic review (SR) of the completeness of the clinical reasoning process within the methodology of the RCT in patients with non-specific neck pain. For the SR analysis 122 studies were included. In the majority of studies (70%) the described clinical reasoning process was incomplete. There was scarcely any association between the degree of risk of bias and the completeness of the clinical reasoning process, indicating that better methodological quality does not necessarily imply a better description of clinical reasoning process. Chapter 3 presents the results of a SR in which we sought to identify published classification systems with a targeted treatment approach (treatment-based classification systems (TBCSs)) for patients with non-specific neck pain. Thirteen TBCSs were identified. In conclusion, existing treatment-based classification systems are of moderate quality at best. Moreover, these systems were not more effective than alternative treatments. Therefore, we do not recommend the use of these systems in daily physiotherapy practice. Chapter 4 describes a Delphi study of the clinical reasoning process of physiotherapy experts in unimodal interventions in patients with non-specific neck pain. This study had three goals. First, we aimed explore the expert opinions on the indication for physiotherapy when, other than neck pain, there are no positive signs and symptoms, no positive diagnostic tests or complaints of limitations in functioning or restrictions in participation. Second, we focused on the experts' use of measurement tools and when they are used to support and objectify the clinical reasoning process. Finally, we wanted to reach consensus among experts on the use of unimodal interventions in patients with non-specific neck pain. According to all experts, pain alone was not considered to be an indication for physiotherapy. Patient reported outcome measures were mainly used for evaluative purposes and physical tests for diagnostic and evaluative purposes. Only 6 of the 18 variants of sequential linear clinical reasoning reached a consensus of more than 50%. Chapter 5 describes a review that examined the completeness of the description of manipulation and mobilization interventions in randomized controlled trials of subjects with non-specific neck pain. In conclusion, mobilization or manipulation interventions are poorly reported in RCTs, compromising the external validity of RCTs, making it difficult for clinicians and researchers to replicate these interventions. Chapter 6 investigated the diagnostic physiotherapeutic process regarding limited ROM of the neck. It can be concluded that the overall diagnostic accuracy of physical examination is limited (compared to the CROM measurement). Therefore, a measurement device should be used in daily physical therapy practice to assess if a movement direction is restricted. Chapter 7 describes an exploratory, practice-oriented study into matched treatments in patients with non-specific neck pain. The objective of this study was 1) to establish the measurement error of the used accelerometer; 2) To determine which different treatments are used; 3) To explore if the cervical ROM, pain, (perceived) disability and motor control improved after one treatment. The SCT is a reliable accelerometer for measuring neck ROM, with a small measurement error. Eight different treatments were carried out. Pain, disability and left and right rotation showed a clinically relevant improvements (exceeded the measurement error). Chapter 8 comprises the general discussion. The general discussion presents an overview of this dissertation and discusses the strengths and limitations of the studies and possible implications of the results and recommendations for future research.

Werken in Wijk en Web

In hoofdstuk 1 wordt ingegaan op de aanleiding voor de literatuurstudie, de keuze voor OWO en doel, onderzoeksvragen en verantwoording van de literatuurstudie. Hoofdstuk 2 schetst een beeld van gebiedsgebonden politiewerk en gaat in op de rol en samenstelling van basisteams (onderzoeksvragen 1 en 2). Hoofdstuk 3 gaat in op het begrip digitalisering, beschrijft de digitalisering van gebiedsgebonden politiewerk en inventariseert knelpunten (onderzoeksvraag 3). In hoofdstuk 4 wordt het begrip ‘digitale handelingsbekwaamheid’ verkent, de betekenis van digitale handelingsbekwaamheid voor het GGP wordt in kaart gebracht en in verband gebracht met leerstijlen binnen organisaties. Ook worden de knelpunten ten aanzien van digitale handelingsbekwaamheid geïnventariseerd (onderzoeksvraag 4). In hoofdstuk 5 worden relevante theorieën over het de gebruik en de acceptatie van digitale technologieën, veranderingsbereid en leertheorieën besproken (onderzoeksvraag 5). In hoofdstuk 6 ten slotte wordt het conceptueel model gepresenteerd en verantwoord. Het conceptueel model dient als basis voor het op te stellen Programma van Eisen.

Accuracy of an MR‑only workflow for prostate radiotherapy using semi‑automatically burned‑in fiducial markers

Abstract Background: The benefit of MR-only workflow compared to current CT-based workflow for prostate radiotherapy is reduction of systematic errors in the radiotherapy chain by 2–3 mm. Nowadays, MRI is used for target delineation while CT is needed for position verification. In MR-only workflows, MRI based synthetic CT (sCT) replaces CT. Intraprostatic fiducial markers (FMs) are used as a surrogate for the position of the prostate improving targeting. However, FMs are not visible on sCT. Therefore, a semi-automatic method for burning-in FMs on sCT was developed. Accuracy of MR-only workflow using semi-automatically burned-in FMs was assessed and compared to CT/MR workflow. Methods: Thirty-one prostate cancer patients receiving radiotherapy, underwent an additional MR sequence (mDIXON) to create an sCT for MR-only workflow simulation. Three sources of accuracy in the CT/MR- and MR-only workflow were investigated. To compare image registrations for target delineation, the inter-observer error (IOE) of FM-based CT-to-MR image registrations and soft-tissue-based MR-to-MR image registrations were determined on twenty patients. Secondly, the inter-observer variation of the resulting FM positions was determined on twenty patients. Thirdly, on 26 patients CBCTs were retrospectively registered on sCT with burned-in FMs and compared to CT-CBCT registrations. Results: Image registration for target delineation shows a three times smaller IOE for MR-only workflow compared to CT/MR workflow. All observers agreed in correctly identifying all FMs for 18 out of 20 patients (90%). The IOE in CC direction of the center of mass (COM) position of the markers was within the CT slice thickness (2.5 mm), the IOE in AP and RL direction were below 1.0 mm and 1.5 mm, respectively. Registrations for IGRT position verification in MR-only workflow compared to CT/MR workflow were equivalent in RL-, CC- and AP-direction, except for a significant difference for random error in rotation. Conclusions: MR-only workflow using sCT with burned-in FMs is an improvement compared to the current CT/ MR workflow, with a three times smaller inter observer error in CT-MR registration and comparable CBCT registration results between CT and sCT reference scans. Trial registry Medical Research Involving Human Subjects Act (WMO) does apply to this study and was approved by the Medical Ethics review Committee of the Academic Medical Center. Registration number: NL65414.018.18. Date of registration: 21–08-2018.

Script concordance test; a tool to assess cognitive integration?