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MOTIVE FOR MOVEMENT FROM MOVEMENT TO WELL-BEING SPECIAL EDTION Inaugural lecture John Dierx 20 May 2016 MOTIVE FOR MOVEMENT FROM MOVEMENT TO WELL-BEING SPECIAL EDTION Inaugural lecture John Dierx 20 May 2016 From movement to well-being 2 TOGETHER TOWARDS A HEALTHY SOCIETY. AVANS CENTRE OF EXPERTISE CARING SOCIETY 3.0 Growth begins with knowledge MOTIVE FOR MOVEMENT 3 PREFACE MARGO VAN DER PUT 5 CASE DESCRIPTION CASE TEAM MONT VENTOUX 6 CASE DESCRIPTION FLOW EXPERIENCES FROM A TRAINER AND A PARTICIPANT 8 CASE DESCRIPTION REFUGEES 12 CV JOHN DIERX 16 PROFILES KNOWLEDGE NETWORK MEMBERS AND TRAINEES 18 RESEARCH GROUP DESCRIPTION LIVING IN MOTION RESEARCH GROUP: NOT BECAUSE WE MUST, BUT BECAUSE WE CAN 26 RESEARCH GROUP FIELD OF RESEARCH 30 INFOGRAPHIC FACTS AND FIGURES 36 OPINION PIECE POSITIVE HEALTH 36 BETWEEN THEORY AND PRACTICE 38 COLUMN DIEDERIK ZIJDERVELD 40 APP-REVIEWS 41 PATIENT COMPLIANCE PATIENT COMPLIANCE IN PHYSIOTHERAPY AND PERSUASIVE TECHNOLOGY 42 PERCEPTION IN THE MEDIA 46 LUNCH WALK 48 CONTENTS COLOFON Editor-in-chief John Dierx jaj.dierx@avans.nl Editorial board Geert Braam Editorial office Geert Braam en Regine Retel Helmrich T ext Charlot Lugtigheid, Cindy de Bot, Diederik Zijderveld, Geert Braam, John Dierx, Lieke van Oort, Margo van der Put-van der Vange, Norbert Kuipers, Pim Peeters, Stephanie Monfils,Yasmaine Karel, Yvonne Abbing-Cruijssen Photography Beeldveld, Bob van der Vlist, Dolph Cantrijn Shutterstock, Stockbyte en PhotoDisc Design HeldHavtig bv, Breda Print De Bondt Grafimedia, Barendrecht CONTACT Living in Motion Research Group Regine Retel Helmrich Senior Managementassistent Visiting address Hogeschoollaan 1 4818 CR Breda, the Netherlands Postal address Postbus 90.116 4800 RA Breda, the Netherlands info.ecs@avans.nl 088 525 87 77 From movement to well-being 4 MOTIVE FOR MOVEMENT 5 PREFACE The Living in Motion Research Group, together with the Youth, Fami- ly and Society and Active Ageing Research Groups make up the Cen- tre of Expertise Caring Society 3.0 (ECS 3.0). ECS 3.0 is 1 of 6 Centres of Expertise at Avans and investigates how to improve peoples qual- ity of life in their own environment. The research groups that are part of ECS 3.0 research quality of life at the different phases of life. They strive towards a collective self-reliance by means of an integral and multidisciplinary approach, which takes into account lifestyle, prevention, the social environment and the application of IT and healthcare technology. In this way they encourage citizens to be self-reliant and give support on issues around quality of life. The Living in Motion Research Group has been part of the Centre of Expertise since February 2015 and focuses on working people between the ages of 18 and 67 during their different phases of life. This age group takes care of itself, their families and their parents. The central themes of this research group are: INDEPENDENCE SOCIAL PARTICIPATION MOVEMENT Movement refers to both physical and mental activity expressed in the development or strengthening of competences, skills and behaviour which imbues the concept of quality of life with a more personal relevance. Everyone can personally define this concept using their own experiences, needs, interests and their qualities and capabilities. For those who are struggling to support themselves, quality of life will have a vastly different meaning than to those with a house and job and who have more time to dedicate to self-fulfilment. Under the guidance of Professor John Dierx, 7 knowledge network members, lecturers involved in the 3 Schools associated with ECS 3.0 namely Social Studies Breda (ASB), Social Studies s-Hertogenbosch (ASH) and the School of Health (AGZ) and a lecturer from the School of Communication and Multimedia Design, are passionately working on this theme. These researchers introduce themselves in this magazine. A research group can only be shaped by and with our partners in the professional field and here you can read about many great examples of this collaboration. Enjoy! Margo van der Put-van der Vange Chair steering committee Caring Society 3.0. From movement to well-being 6 By Stijn Reijnen (Recreation and Activity coordinator, IDRIS) On Thursday 16 June 2016 we will be tackling the mountain! With a team consisting of 40 fanatical cyclists we are going to conquer Mont Ventoux, mythically known as the Hell of the South, God of Evil the Giant of Provence or The Bald Mountain. Following our successful participation in 2015, we are now pre- paring for the second edition of the Team Mont Ventoux Amarant Group project. This involves 18 youths who want to prove that they are true go-getters who can take on any challenge and who want to test themselves by falling, standing up and training hard. For the 18 buddies, including 3 previous participants, this presents a special experience to support these youths in their road to the top. While some have never tried cycling on a racing bicycle, others want to lose weight, lead a healthier life, prove to themselves that they can do this or they participated last year and are now a buddy; each of these cyclists is taking on this challenge motivated by their own personal goals. BÉDOIN In the second week of June, we will be taking a team of nearly 50 people consisting of cyclists and the support teams to Bédoin where we will spend 1 week at Camping La Garenne from where we will make 2 practice climbs. The actual climb to the top of Mont Ventoux will take place on Thursday 16 June. SERIOUS TRAINING Of course we are not heading to France completely unprepared; we have been training hard since December. The preparations included sprint training, spinning marathons for raising sponsorships, cycling on a closed track and on the public roads and high altitude training in Limburg. Every Wednesday evening and Saturday or Sunday morning the participants and their buddies worked up a sweat on the pedals. The intensity of the training was increased every week, improving condition and growing the calf muscles. After 3 months of intense training it is safe to say that the cycling bug has bit every single one of the participants. FALLING AND GETTING BACK UP AGAIN As expected, the training sessions included falling and getting back up again in both a literal and figurative way. Some forgot to clip out of their pedals when getting off their bicycles or didnt pay attention and rode straight into the cyclist in front of them. Others were so exhausted at times that they felt like they couldnt go on but they rallied with the support of their teammates and completed the training. This was all part of the long road towards our final goal. The camaraderie that this project has once again inspired amongst the participants this year has been phenomenal. We all work together and help one another to make sure that we all make our way to the top! CASE DESCRIPTION TEAM MONT VENTOUX Yasmaine Karel and Pim Peeters from the research group support the Team Mont Ventoux project by making the contribution of this project to the physical and mental wellbeing of the partici- pants quantifiable. They will be taking 3 different measurements. 1. PHYSICAL CONDITION A physical condition test and weight and fat percentage measu- rements assess to what extent the physical condition of the participants has improved. 2. SELF-IMAGE The contribution of the project to the self-image of participants is researched through questionnaires about self-worth and the perception of control over their lives. 3. PERSONAL GOALS By interviewing the participants at the start and at the end of the project, qualitative research can be conducted about the goals that the participants set for themselves and to what extent participation in the project helps them to achieve these goals. MOTIVE FOR MOVEMENT 7 TOWARDS YOUR PERSONAL BEST PROJECT Team Mont Ventoux Pim Peeters and Yasmaine Karel CONTEXT Amarant helps people with a mild intellectual disability (MID) to lead a normal life. The Team Mont Ventoux project is one of Amarants activities. This project gives participants the oppor- tunity to follow a structured training programme with a clear daily schedule with the ultimate goal of climbing Mont Ventoux by racing bicycle. The intention is to provide participants with a successful experience and to involve them in regular sports and movement programmes. Since the implementation of the Dutch Participation Act, increased attention has been given to the possi- bilities of helping people with reduced employment opportunities to find work. Following the theory that participation improves an individuals sense of purpose, this new health concept establishes the link between participation and personal well-being. It has been established that people who feel good about themselves are more likely to be physically active. Within this context, Avans has announced that it seeks to create 50 jobs for people with MID by 2025. Amarant has requested the Living in Motion Research Group to assess the effectiveness of their exercise programme. Within the context of the research and the goals set by Avans, additional research questions have been included that investigate whether a daily schedule and physical activity contribute to creating the next step that should see individuals functioning in a normal work setting. RESEARCH QUESTION Is there a link between structured activity and a daily schedule and the experiences and sense of purpose of people with MID and does this effect participation in the labour force? PHASING - Phase 1: November 2015 - May 2016 team Mont Ventoux: increasing social participation by teaching a daily schedule to autistic clients with behavioural disorders - Phase 2: September 2016 - August 2017 participation of people with mild intellectual disabilities: possibilities within Avans or its collaborative partners as a start up to long-term participation. From movement to well-being 8 By Cindy de Bot (lecturing researcher) Do you often feel that you are busy all the time? Do you lack the time to exercise or constantly think about all the things that you still need to do? Getting sufficient exercise is good for us in many ways. It helps you stay physically and mentally fit and also keeps your brain healthy. A LITTLE EXERCISE GOES A LONG WAY You dont need to train like a professional athlete. Just 30 minutes of moving every day is enough. All you need to do is get up out of your chair and go for a walk or cycle a bit. People feel mentally invigora- ted after a little physical exertion and are more productive. Different studies have shown that memory is improved if people are active every day while exercise in children stimulates the parts of the brain responsible for optimal intellectual development. These are the same parts to first deteriorate in the ageing process. An inactive lifestyle increases the risk of developing age-associated diseases such as de- mentia. However, exercise is an often neglected aspect of life. People have busy jobs, are occupied with their children and their social lives and this is where it often goes a little haywire. After all, the busier you are at your job the less time you have for mental relaxation or exercise. Yet, daily exercise or relaxation and sports should be a habit, just like showering. Those who get plenty of exercise and take the time to relax will notice that they are more mentally invigorated and this benefits both their work and private lives. While you might feel that you are too busy or too tired to exercise, it will actually give you more time and mental energy. The benefits of exercise on mental health and vice versa are endorsed by Avans University of Applied Sciences. Avans Flow focuses on encouraging an active lifestyle and sustainable em- ployability. Avans Flow believes in the integration of head and heart in education and helps students and staff to take an in-depth look at their emotional life and to develop this so that they can discover their inner talents. It achieves this by giving students and staff the op- portunity to reflect on their own interactions with the world around them. The goal is to create awareness and self-insight with an under- standing that sustainable development starts with you. The research group investigates the motives of Avans staff and students to choose to take a mindfulness or rest management workshop. It also looks at the effectiveness of the workshops that focus on promoting mental exercise. As part of this research, I have asked trainer Ilse Heesterbeek and part-time student Marlijn to share their experiences. Peter van Dongen (62) has the final word. He has been presenting mindfulness courses at Avans Flow for several years and works at the Facility Ma- nagement & ICT Unit at Avans University of Applied Sciences. FLOW EXPERIENCES BY A TRAINER AND A PARTICIPANT CASE DESCRIPTION MOTIVE FOR MOVEMENT 9 Marlijn (19) is a part-time Nursing student. She works at the hospital 32 hours per week and is enrolled in the Bachelor of Nursing part-time study programme at Avans University of Applied Sciences. This makes for a challenging combination of working and learning. Marlijn took the rest management workshop and I asked her the following about her experience: Why did you chose to take part in a rest management workshop instead of exercising as a way of relaxing? “It is difficult to be physically active or to do other things to relax if your head is so full all the time, even though you know its good for you. You simply cant take a breather to make time for it when your head is that full. If I were to go and exercise, I just wouldnt be able to relax. I would constantly be thinking of things that I still need to do or Id be worrying about something. It stops you from being able to enjoy physical activity, so I didnt even bother with it.” What motivated you to search for something that would get you mentally active again? “I was stuck in a downward spiral of negativity. I was always helping others but neglected myself, both at work and in the study programme. I would also constantly worry about whether I could do this or whether I was good enough. I was perfectly aware that this constant worry was unnecessary conside- ring my input and learning capabilities, but I couldnt help it. This was unnecessary stress of which I had to rid myself. I was unhappy and suffered from headaches, neck pain and tiredness. I first tried to change my way of thinking by concentrating on positive thoughts but it just didnt work. I knew that I should enjoy my study program- me and that it shouldnt cause me mountains of stress. I also needed to accept that I was also there to learn and not only to perform. All of this tied in perfectly with the rest management workshop*.” *See the textbox for a description of the workshop. Do you still apply what you learned there to your everyday life? “In the beginning its impossible to apply it subcons- ciously and you need to actively think about what youve learned and what to do with this knowledge. If I get stuck with something I go back to doing the exercises. Tips like relaxing 30 minutes before bedtime have become a part of my daily routine, because the effects are noticeable. But if the effects are not immediate you have to cons- ciously apply the exercises. This takes time and energy but you are guaranteed a positive result. This is why I still use the exercises quite often, so that I can maintain the positive effects.” Which effects have you noticed in your everyday life? “I am less stressed, worry less and sleep better. The physical aches and pains have also become less and I dont have headaches any longer. I also notice that I see people in a more positive light and that Im more interested in their stories. My self-image has become more positive as well and I accept that I can take the time to figure things out and to learn without feeling that urge to perform.” What about the effects on your study programme and your work? “I have become better at accepting that I first need to learn something before I can excel at it. Everyone has to learn the basics. You cant excel without knowing the theory or background. I take more pleasure in learning now and Im much more relaxed about it. I accept that I am a student nurse and am less likely to take mistakes personally. Instead, I now see mistakes as learning mo- ments. I am more relaxed with my patients and think about my own well-being more often by taking a break, for example, and not wor- king non-stop. Moreover, I have become better at setting priorities and delegating tasks.” How do you feel about physical exercise now? “I just bought new running shoes at Decathlon.” REST MANAGEMENT WORKSHOP Studying is important but so is letting go Studying is important but so is learning to let go. But this is easier said than done. How do you set aside your thoughts at the moments that you cant or dont want to study? This work- shop helps you discover how to relax your mind during busy study periods. After all, relaxation is not only a good thing; it is also a vital aspect for effective studying. Aims and objectives getting a grip on your thoughts understanding meaningful and meaningless thoughts: When do you get stuck in your head and when are you lost in thought? When do you feel relaxed? practising to relax and be at peace tips and tricks to empty your head. MINDFULNESS WORKSHOP If you want to become more focused and attentive and have greater insight into your life, then mindfulness is the thing for you. Mindfulness helps you to develop alertness, attentiveness, focus and concentration on the things that are happening around you. This attention is necessary to experience the essence of your life in the midst of the noise of exterior experiences and impressi- ons. You learn to observe both physically and mentally without imposing judgement. This helps you to see and experience the moment as it really is. It creates a clarity and insight from which you can make new and conscious choices. Mindfulness will em- power you with methods that help you to deal with the stress of everyday life as a student. Results: more energy and joy in life improved understanding of yourself and your limits better ways of dealing with stress, pain, illness and psychological issues more inner calm. From movement to well-being 10 Trainer Ilse Heesterbeek Presents rest management work- shops for students and staff of Avans University of Applied Sciences. For Ilse, calmness is not only relaxation but also serves as a basis for movement, creation and development. How did you get started with this and what brought you to where you are now? “At primary school I struggled with an overactive brain that resulted in physical discomfort like tiredness, headaches, dizziness and poor motor control. It was only at high school that it was discovered that an above-average intelligence was the cause for many of these symptoms. In later years I started researching methods to calm my thoughts and to make effective use of them. The results were astounding. My health improved, I had more energy, felt more inspired and life suddenly became fun. Now it is my passion to introduce others to this method. Why do you think people are looking for mental exercise in- stead of physical exercise? ”The advantage of mindfulness is that it can be applied at any moment of the day as soon as you need it. If it gets really busy during a meeting or you are drowning in e-mails, you can immediately do something about it. If physical exercise or a hobby helps to calm your thoughts, you need to make time for it in your schedule and its not always possible to stop worrying or set aside your problems while you are exercising. This results in physical exercise no longer being relaxing.” What type of people come to your workshops? “I see people of all ages whose common denominator is that theyre all thinkers and that theyre ambitious - real go-getters. This combi- nation of attributes means that theyre often so preoccupied with planning and achieving that it becomes incredibly stressful instead of being something which they enjoy doing. This stress often results in physical symptoms such as headaches, tiredness and neck and shoulder pain.” What do people notice first following their first session of the workshop? “People tend to sleep a lot better and feel more relaxed, although some feel heavy and weighed down. After all, its a new way of thinking and defining for yourself which direction you want to take. Doing things yourself and actually doing the exercises is essential for the effectiveness of the workshop.” How do you perceive the effects on the participants? “You can see that the way people think is often shrouded in a grey mist. If you actively work on this you create more clarity for yourself and towards others. You are less caught up in your own thought bubble and so have more time to enjoy that run around the block or playing football. People consciously step outside of their head and are able set aside their thoughts. You can make things incredibly difficult for yourself but by simply engaging with your thoughts you can learn to let go.” What is the message that you would like to pass on? “Exercise is considered to be a physical activity and it is something very important. But being mentally active is just as, if not more, important. If you are not mentally active, you are standing still. You stop learning and are focused on performance alone, which is so- mething that has become rather commonplace in our society. Thats when you avoid new things and avoid taking on new challenges to prevent developing performance anxiety. I recommend that people continue searching for the things that make them happy and that will continue to challenge them.” Peter van Dongen (62), trainer When was the last time you tried something for the first time? “Living in motion is a title that really appeals to me and that is certainly applicable to me as well. I have been physically active my entire life. I tried many different types of sports. I played volleyball, ran and swam for many years and I continue to stay active to this day. Dancing has become an activity that I really enjoy. In terms of sport I have now made the switch to playing golf. I enjoy being outside and its a challenging sport, especially mentally. It helps me to feel healthy and fit. Living in motion certainly includes mental activity. Id prefer to call it a lifetime of learning and developing. Ive definitely done a great deal of that in recent years. Up until then I was preoccupied with changing the world and gaining knowledge by doing work, courses and workshops. The shift occurred when I started to think differently and asked myself what I can do differently to change the world. I took charge of my life and the way I thought. I used to be influenced by the norms and values from my upbringing and society but now I questioned what my personal norms and va- lues were. I revaluated who I was and how I present myself. I embar- ked on an intensive evaluation and through many different courses and workshops I experienced who I was and what my qualities were and how I can use them. This continuous evaluation has become a MOTIVE FOR MOVEMENT 11 set part of my life and it continues to give me deeper sense of calm and freedom. In my experience physical and mental fitness enhance one another: 1+1 = 3” Avans Flow “In 2006, Avans requested that we help them give a broader inter- pretation of what is now Avans Flow. I signed up immediately and the idea to organise workshops was put forward early on. These workshops are presented by and for staff and students. The goal is to introduce people to different ways of personal development. It used to be something that you did in addition to your studies or work but now a vastly changed world has made it necessary to focus on personal development as well. The mindfulness workshop proved successful from the start and continues to be fully booked while demand exceeds availability. Even though there are 4 different programmes now, it continues to be fully booked. There has even been an increased request for workshops from the different schools and services.” Why is mindfulness so popular? “Its accessible and has become more accepted just like yoga and tai chi. Moreover, people are looking for peace and tranquillity. Students and staff are experiencing increasing levels of stress and activity and struggle to deal with this. They are searching for new ways to address this problem. Many studies have investigated the effects of mindfulness in education and have demonstrated positive results. Mindfulness is a method that helps you achieve calmness and to use this sense of calm to assess what is happening in the here and now. I took this training about 10 years ago and applied it to my life with great benefits. I still use it every day to create calm. In the mindfulness workshops I present, I notice that most partici- pants really benefit from it. For many participants its difficult to let go of automatic patterns. They are often swayed by the issues of the day: the patterns in the family and at work. Its an eye-opener to many people that they can take charge of this and that things can be done differently. For many participants its also special to start feeling more. The thinking process is often leading, forcing feelings into the background. Mindfulness creates the space to start feeling more. But, it takes effort to achieve this and you need to practice often to get the right results. You need to see it as an investment in your health and well-being. After just a few workshops participants have learned the necessary tools and exercises that allow them to create calm in their lives. If you want results, I recommend that you try a complete mindfulness course. After all, practice makes perfect. PROJECT Effects of Avans Flow and Vitality on active and sustainably employable staff. Cindy de Bot and Stephanie Monfils CONTEXT People develop on many different levels during their studies or work. The development of knowledge is an important aspect of this but people also feel that they are developing as a person. At Avans, facilities like Avans Flow/Vitality/MovingTalent help people in this consciousness-raising process and in creating awareness of yourself and your environment. RESEARCH QUESTIONS Are the Avans Flow/Vitality/MovingTalent activities effective in encouraging an active lifestyle and sustainable employa- bility amongst staff and students? What motivates staff and students to choose for the activities of Avans Flow/Vitality/MovingTalent? PHASING - January - February 2016: distributing questionnaires - March - May 2016: processing the results of the questionnaires - June 2016: report and formulation of the follow-up research. From movement to well-being 12 SOCIAL ISSUES, MOVEMENTS AND WELL-BEING At the Social Studies schools we educate students about society and the role that social issues play in peoples lives. One of the aspects we address is the relationship between society and mental well-being. We also teach students the different methods used to empower people and how to encourage people to motivate themselves to become active. At the Living in Motion Research Group the focus is on health and well-being and specifically on the ability of the individual to adapt and to take charge of their own life in terms of physical, emoti- onal and social challenges. We believe that this is a perfect combination, as both social studies and the research group address the topic of the abilities and achievements of people in relation to social challenges as well as mental well-being. The focus on social issues, movement in the broadest possible sense and the question of why and when somebody feels well is part of the research that started in January in the Fatima district in Tilburg after the arrival of 400 new residents in the area. The new residents include people who fled the conti- nuing civil war in Syria. Organising facilities and shelter for hundreds of people arriving in a district at the same time gives rise to lo- gistical as well as social issues, uncertainties and challenges. What can we learn from this and what can we take away from this situation and teach our students? ASYLUM SEEKERS AND REFUGEES IN FATIMA In Tilburg the asylum seekers and refugees were initially housed in temporary accom- modation on Ringbaan Oost. Since Decem- ber 2015 they have been housed in the former Sint Jozefzorg healthcare complex in the Fatima district and later also at the for- mer tax offices in the De Reit district. Their arrival here was accompanied by questions, unrest and uncertainties. But several great initiatives were also started. Following the request of the municipality and guided by welfare organisation Contour de Twern, 8 civil society organisations joined forces to provide the refugees and asylum seekers with housing in the city. They called on the city of Tilburg to demonstrate its hospita- lity, resilience and social engagement by making use of each others knowledge and networks and they challenged everyone to work together. This included local residents, volunteers, civil society organisations, businesses, cultural institutions, schools, sports associations, knowledge institutes and the municipality. This initiative has been named Knooppunt Ruimhartig Tilburg (the generous Tilburg hub). We couldnt have asked for a better starting point for our research into how the assets of the different parties could be used to sti- mulate social participation, social cohesion and the experiences of well-being of local residents. CASE DESCRIPTION REFUGEES MOVEMENTS IN FATIMA AND DE REIT, TILBURG By Charlot Lugtigheid (lecturing researcher) and Yvonne Abbing-Cruijssen (lecturing researcher) MOTIVE FOR MOVEMENT 13 Marion Kools and Herman Couwenberg have both been active in the field of social work in Tilburg for more than 20 years. They are both part of the Knoop- punt Ruimhartig Tilburg project and work in the Fatima and the De Reit dis- tricts. Here they share their personal ex- periences and talk about the changing dynamics in the district and the power of multidisciplinary collaboration. A NEW CHALLENGE Marion : I have been working at Contour de Twern for more than 20 years. I worked as the business manager of community centres in Tilburg South in the Jeruzalem, Fatima, Broekhoven and Hoogvenne dis- tricts until last year. In October 2015 I was asked if I would be interested in a position on a project team. This is a position I gladly accepted. Herman: My background is in youth servi- ces and I worked in this field for 26 years. Before this I worked as a unit manager of community welfare workers at Kompaan en De Bocht. In October I was approached by Contour de Twern asking if I would like to work at Knooppunt Ruimhartig Tilburg. It didnt take me very long to think about it and I accepted the position. KNOOPPUNT RUIMHARTIG TILBURG Marion: We launched Knooppunt Ruimhar- tig Tilburg on 1 October 2015, before the arrival of the refugees and asylum seekers. We first had to outline what we wanted to achieve as a hub for civil society organisati- ons and how to go about doing this. During the first 2 weeks we focused on identifying the different organisations in Tilburg and deciding who was going to do what. Herman: We initially did all the work ourselves but then started to focus more on overseeing everything and organising. We no longer do the actual activities ourselves. Marion: Right from the start we were overwhelmed by people wanting to help the refugees and asylum seekers. The type of help being offered was very varied. Some wanted to help the new arrivals to adjust or help with language skills, while others wanted to be more practically involved. We were even offered a sports facility for activities. These offers were entered and organised in a system through which we could link the offers with demand. Herman: It was great to see that so many people were willing to help. Its quite overwhelming. We really got started in mid-October when the 400 refugees and asylum seekers arrived. Our first concern was to make sure that there was food and we really rallied together to provide this basic need. Marion: I remember clearly how I received a telephone call on Thursday evening to let me know that 5 buses with refugees would be arriving at noon the following day. They needed people to serve meals and other things and asked if I could start calling the registered volunteers to ask if they could help out. That was how we really got star- ted - a baptism of fire! MULTIDISCIPLINARY COLLABORATION Herman: Collaboration is key. The objective of Knooppunt Ruimhartig Tilburg is to con- nect the different organisations that work with refugees and asylum seekers. This ensures that we dont all do the same thing or hamper each other in our efforts. In the beginning we had many discussions with businesses, institutions and organisa- tions about how to divide the volunteers and about the Dutch language courses, as multiple parties were involved in this and we needed to coordinate things. Knoop- punt has the leading role in this coordinati- on. Now we only need to meet once every 6 weeks, because all the parties involved are managing quite well by themselves. We still meet with the COA (Central Agency for the Reception of Asylum Seekers) and the municipality every 2 weeks. We are also planning to start a buddy-project which will also require some organisational efforts. PERSONAL EXPERIENCES Marion: An experience that really affected me was the arrival of the first asylum see- kers and refugees. It was heart-wrenching to see these people get off the bus with big bags containing just a few paltry possessi- ons. When I entered the dormitories I was surprised to see that there was no separa- tion between men, women and children. I pointed this out to the coordinator but there was no other solution. Luckily the people sorted it out themselves by hanging the sheets around the bunkbeds to create a little privacy. That was really moving to see. From movement to well-being 14 Herman: It was the images on the televi- sion that motivated me to come and work here. The refugees have nothing while we have so much. You cant just sit back and do nothing. The harrowing journey of these people is what motivated me to do something. Now that they are here we have to help them. The goal is to find them a place in Tilburg society. Thats the objective, but this will likely still take a few years to achieve. Marion: It is important that we listen to the needs of the asylum seekers in everything that we do. If I were to arrive in an Arab country as a refugee, I would also want people to feel concerned and that someone would ask me about my needs. EXPERIENCES OF KNOOPPUNT RUIMHARTIG TILBURG Herman: We arranged meetings where all the parties involved in the project could share their experiences. The meeting was also attended by people from the COA. This was very important, because it gave people a platform to share ideas and their frustrations. We also had individual meet- ings with volunteers to assess their skills and to see how to make the best possible use of them. This is how we transitioned from the crisis situation at the start to a stable organisation. Marion: Koken met Syrische mensen (cooking with Syrians) is a fun activity star- ted by the citizens initiative De wijk helpt (help from the neighbourhood). This brings the local residents and the Syrian people together at the dinner table and that is an incredibly special event. We are now trying to combine all the activities into an activi- ties diary, so that everyone knows whats happening. It also informs the original local residents of the district, as wed love to see them get involved in all of these activities. FATIMA DISTRICT, SHELTER IN SINT JOZEFZORG Marion: There is some discord in the district at the moment. But that was to be expec- ted, as so many people here live below the poverty threshold. They feel cast aside and forgotten when they see what has all been done for the new residents and this is an important point to consider for Knooppunt. It is important to organise activities where both the refugees and the local residents feel welcome. Its not just significant on a social level but it should also emphasi- se that everyone belongs. A community developer has been visiting the district to listen to what the local residents have to say, for example. The community developer then looks at what we as an organisation can do for the local residents. It is also the responsibility of the community developer to improve the foundations in the district to promote a positive social climate. DE REIT DISTRICT, SHELTER IN THE FORMER TAX OFFICES ON PROFESSOR COBBENHAGEN- LAAN Herman: Approximately 450 refugees and asylum seekers are staying at this locati- on but this number can increase to 500. Knooppunt has many active volunteers that help to serve meals and run the activities and students from the nearby Tilburg University are helping groups of refugees to learn basic Dutch. The refugees are com- mitted to learning the language and our collaboration with the university has been excellent; we have found a real partner in the institution. They also allow us to use their sports fields where hockey training is given by a volunteer, which shows that stu- dent associations are keen to get involved as well. CONNECTION AND MOVEMENT Marion: One of our goals is to connect the local residents with the new arrivals and to promote integration and the local residents have been happy with our work so far. They know that they can come to us with questions and that we take their concerns seriously. Id like to take a look at a different district to see how these issues are addressed there. We might even learn something from it that we can apply to our own situation. Herman: The initiatives developed at Knooppunt Ruimhartig Tilburg are creating movement in the district and for the refu- gees and asylum seekers in different ways. During the meals people engage with the refugees and asylum seekers which results in contact and new introductions. Volun- teers also present different types of physical activities for the refugees and asylum seekers which gets them physically moving. Youth organisation R-Newt gets young people from the city involved in helping refugees and asylum seekers through youth work. INVOLVEMENT Marion: It is good to want to get involved and to see what you as an individual can contribute to social cohesion. I believe that this is possible by meeting people and by not being afraid of one another. Learning from one anothers cultures can only be an enriching experience. Herman: My wish for the future is that these people can find their place here in Tilburg. I really want that for them. If you take those images on television to heart, you can understand that this is not a way to live. I find it incredibly difficult to accept that kind of hardship. I can only make a small contribution but I give my all. I hope that people whod like to get involved will come to us. There are more than enough opportunities. Dont just think about it. Do it. We can always use more people. The research group is doing research in the Fatima district on the consequences of the arrival of the asylum seekers and refugees on social cohesion and the different forms of movement in the district. This is the research question: Which assets from the different parties involved can contribute to social participation, social cohesion and the experience of well-being of local residents? Knooppunt Ruimhartig Tilburg is an important partner in this research. MOTIVE FOR MOVEMENT 15 PROJECT Social participation and well-being in the Fatima district in Tilburg Yvonne Abbing and Charlot Lugtigheid CONTEXT In recent years, Europe has faced the influx of an increasing number of asylum seekers and refugees as a result of the wars in the Middle East and North Africa. Looking after these refugees and asylum seekers comes with many logistical challenges in terms of facilities and shelters, but it also gives rise to feelings of insecurity, uncertainties and other challenges. Tilburg has also been confronted with these dilemmas with the arrival of 400 new residents. This group of refugees and asylum seekers is now living in the Fatima district in Tilburg in the former Sint Jozefzorg healthcare complex. The sudden arrival of so many new residents to a new district has had an impact on the social cohesion of the area amongst other things. Several local organisations from Tilburg joined forces and started the Knooppunt Tilburg Ruim- hartig initiative with the goal to work together to take care of the refugees and asylum seekers. The research group is especially interested to investigate what the parties involved contribute to the situation in the district and to social participation, social cohesion and the experiences of well-being. RESEARCH QUESTION Which assets from the different parties involved can contribute to social participation, social cohesion and the experience of well-being of local residents? PHASING - Phase 1 January - February 2016 introductory research and making contact literature survey first interviews with involved parties - March - April 2016 build up rapport with local residents using ethnographic research, observe and interview the local residents, refugees and asylum seekers collecting personal accounts in the district though participant observation - May - June 2016 structure the results of the literature survey, ethnographic research and participant observation semi-structured interviews with local residents, migrants and network partners - July - September 2016 analysis of results explication of the storytelling technique: in-depth interviews conclusion: different focus groups highlight the results and assess whether group dynamics play a role in the experience of the themes - October 2016 feedback of the initial results - Phase 2 November 2016 supplementary interviews with partners supplementary interviews with local residents focus groups if necessary. Other: 2 students from Social Studies support this research project by completing the research for their graduation project in the Fatima district and being responsible for part of the research question. A student assistant from Social Studies is also involved in the research. From movement to well-being 16 CURRICULUM VITAE JOHN DIERX Im busy all of the time. This is one of my essential characte- ristics. Im unable to sit still and Im driven in everything that I do. From childhood my love of sports was combined with my inquisitive nature. I was especially interested in animals and behaviour. I am also quite a know-it-all and always enjoyed explaining to people how things worked or sharing my opini- ons on certain matters. My future career was pretty much set in stone, even though I wasnt even aware of it then. I wanted to be a brain surgeon and study medicine But when I was not selected for my chosen study, as a result of the numerus fixus lottery system operated by universities in the Netherlands, I chose to study Biology instead. This turned out to be a perfect choice. After 1 year studying Biology I was selected to study Medicine, but I didnt enjoy it at all and after another year I made the change back to Biology. I was awarded my PhD in medical biology specialising in neuroen- docrinology. This was actually the only subject that I failed during the propaedeutic phase of my Bachelor of Medicine! At the end of my PhD I realised that fundamental research was too abstract for me. Following a reorientation I once again returned to the field of health and medicine. With a minor degree in Healthcare Education and Promotion from Utrecht University I stared working as the education programme manager at the Nederlandse Hartstichting (The Netherlands Heart Foundation). Unfortunately there were no opportunities to be promoted to departmental management. The Maag Lever Darm Stichting (Dutch foun- dation for gastrointestinal tract research) offered me the chance to gain experience as the Head of Education and Care. Through both foundations I served in an advisory capacity in the setting up of the interactive museum Corpus. Then I noticed a job opening for a prevention program- mes team manager at the Community Health Service in the West-Brabant region. This opportunity was a blessing, becau- se I wanted to move into the public health sector and was already living in Oosterhout in Brabant. The West-Brabant Joint Health Service gave me the opportunity to explore this field and to do a Masters in Public Health. After working on different teams and having further developed the organisati- onal policy, it was time for a new challenge. I started my own company and was able to obtain my teaching qualification at HAN University of Applied Sciences and to teach in their sport, health and management study program- me. This brought together all the things that motivate me, especially when I was asked to supervise the research requests. The SALVO project (Stimuleren Actieve Leefstijl VMBO-Onder- wijs, stimulating an active lifestyle preparatory middle-level vocational education) was eventually approved and I would manage the project. With this programme we motivate pre- paratory middle-level vocational education pupils to use their own assets to create an active lifestyle that fits in with their environment. Now, as a professor of Living in Motion, all this knowledge is brought together. I am glad and proud that I can extend this knowledge at Avans in the next few years and that I can guide my knowledge network members, lecturers and students in setting up and conducting research and asset-based working. In addition to the HAN University of Applied Sciences SALVO project, I am running a project in the Oosterhout municipality with my own company Knowhow2share. In this project I provide consultation services in the validation of interventions in improving healthy lifestyle at of The Netherlands Natio- nal Institute for Public Health and the Environment/Centrum Gezond Leven (RIVM/CGL) and I assess the Sportimpuls appli- cations that connect the areas of sports, healthcare, district, neighbourhood and municipality. These activities allow me to bring a great deal of knowledge and networks to this venture, but I also hope to learn and expand my network. In addition, this will allow me to develop myself, as, after all, you never stop learning. MOTIVE FOR MOVEMENT 17 PROJECT Stimulating an active lifestyle in the neighbourhood John Dierx and Cindy de Bot CONTEXT There are vast differences in health between the different eco- nomic classes. In districts with low socio-economic status (SES) unhealthy behaviour is more prominent, especially inactivity and cases of obesity. Opportunities for mental development in these types of districts are also significantly less. While many interven- tions have taken place in these districts, they appear to have no effect on the socio-economic health differences (SEHD). This can be attributed to the deficit-based approach that all of these interventions have in common. By opting for an asset-based approach you can identify what motivates residents in a district and by tapping into this perception of the environment you are able to connect and motivate the residents. This project connects to the Avans Thuis in de Wijk project (at home in the district) headed by project manager Imke van Gaal and which will be realised in collaboration with Amsterdam University of Applied Sciences and HAN University of Applied Sciences. RESEARCH QUESTION What assets are available in low SES districts and how can resi- dents use these assets to activate themselves and their district? PHASING - 2016: start phase - 2017 - 2019: implementation and evaluation phase. From movement to well-being 18 MEET THE KNOWLEDGE NETWORK MEMBERS > MEET THE KNOWLEDGE NETWORK MEMBERS > MEET THE KNOWLEDGE NETWORK MEMBERS > MOTIVE FOR MOVEMENT 19 MEET THE KNOWLEDGE NETWORK MEMBERS > MEET THE KNOWLEDGE NETWORK MEMBERS > MEET THE KNOWLEDGE NETWORK MEMBERS > From movement to well-being 20 CHILDLIKE CURIOSITY About 10 years ago, having just finished my physiotherapy degree, I decided to start a Master of Science. I was searching for answers and solutions. Physiotherapy appeared to be the perfect degree for me, because I was able to tackle issues that I came across in my professio- nal practice. However, once Id completed my studies, I had to somewhat adjust my romantic notion of academia. I saw PhDs that had evolved into theoretical conundrums and applicati- ons for grants that appeared to have been formulated in the proverbial ivory tower. I find it regrettable that academia and professional practice are often distanced from one ano- ther. I believe that this distance has partly been caused by the dusty and old-fashioned image that students often have of academia, even though academia is everything except boring. The world around us can be seen as one big escape room which we learn to figure out bit by bit through collecting hints and solving puzzles. Its great to often question and think about why things are the way they are and why we do things a certain way. My daughters, aged nearly 4 and 5 and a half, ask me numerous questions during the course of a normal day. Children are amazed by the world around them and are not hindered by assumptions, prejudice and routine. I believe it should be a lecturers mission to help students discover their inner sense of childlike curiosity and the Living in Motion Research Group provi- des the perfect platform for this. CONTINUOUS MOTION For me and for the nursing profession continuous motion is key. Our society is moving at an ever-faster pace and this requires people to be flexible, proactive and to be able to adjust. This results in practical issues that can be investigated. For example, what are the motives of em- ployees to follow a mindfulness course instead of taking a course in sprinting or the other way around? How can you address a health and well-being issue from different disciplines? And what opportunities exist to promote a healthy lifestyle? All of this needs to be approached from the perspective and environment of the individual. The new positive health concept provides sufficient new challenges that the research group can tackle. This applies to current and future healthcare professionals. What does continuous movement mean to them? As a researcher with a PhD with roots in nursing there is little bet- ter than being able to bridge the gap between research, practice and education. I hope that the research of this research group will firstly contribute to a different way of thinking about evidence-based practice and, secondly, that it will promote the positive health experiences of our colleagues at Avans and for nurses in the professional field. As a nurse you can ignore or resist new developments or you can choose to do something with them and use it for your personal development and in the professional field. CINDY DE BOT Lecturing researcher School of Health - Nursing, Living in Motion Research Group LIEKE VAN OORT Lecturing researcher School of Health - Physiotherapy, Living in Motion Research Group MEET THE KNOWLEDGE NETWORK MEMBERS > MEET THE KNOWLEDGE NETWORK MEMBERS > MEET THE KNOWLEDGE NETWORK MEMBERS > MOTIVE FOR MOVEMENT 21 MOVING ACROSS THE CROSSOVER BRIDGE A few years ago I noticed a growing number of health and healthcare-related graduation projects within the Communication & Multimedia Design study programme. I was interested in these projects, as they are often quite challenging in terms of interactive design and the technology that needs to be used. People are the crux of these projects but the target group is never cross sectional. The design requires unique features that need to be taken into account. Whether it concerns people with an acquired brain injury, elderly people with dementia or children undergoing chemotherapy, the solution is never simple. The natural interface tech- nology that is used is just as interesting, as you want the interaction between the person and the machine or media to be as natural as possible In order to effectively solve these types of issues you have to make the crossover to the relevant field. My personal crossover is partici- pating in the Living in Motion Research Group. This allows me to be surrounded by experts from different health and healthcare disciplines and I find this fascinating. In 2002, at the founding of the Bachelor of Communication & Multimedia Design study programme, I had to make the crossover from business informatics to art and design and now my brain is once again being challenged and put into motion. My research is focused on physical movement. The development of movement sensors, including in smartphones, is moving at a rapid pace creating interesting new opportunities for application in physiotherapy, amongst other things. I search for the possibilities of increasing patient compliance with physiotherapy exercises in the home through the application of multimedia. My initial area of focus was smartphones, but this technology is only one aspect of this research. I also have to explore the concept of the patient and behavioural changes, the therapist, the therapy and the exercises, which is both educational and interesting. MAKING A DIRECT CONTRIBUTION TO DAILY PRACTICE I started studying psychology with the intention of becoming a psychotherapist. Mental healthcare has fascinated me since I read a book on human behaviour at the age of 8, which I had found in an old bookcase at my grandmothers house. I didnt end up as a psychothera- pist but decided to do a PhD instead. In the field of behavioural medicine, which is concerned with the psychological influences on physical health, I researched the influence of environ- mental factors on the experience and expression of pain. But my research focused on issues arising in practice rather than on theory. These are the questions that professionals have to face and research projects that make a direct contribution on the care provided. The Team Mont Ventoux project is an example of this. This project has helped Amarant clients reach the top quite literally. With my academic background, I hope to make a contribution to this project by scientifically substantiating the effects of this projects. My heart remains in mental healthcare, albeit in a completely different way than I had plan- ned. The current shift to ambulatory healthcare provision and recovery support services is a challenge that the Dutch Mental Healthcare Association (GGZ) faces today. I am especially interested in how community teams work in this changing context and what they do to help clients with their recovery. The use of the expertise of social workers also keeps me busy. I hope to make my contribution through research and education. NORBERT KUIPERS Lecturing researcher School of Communication and User Experience (ACUE) - Communication and Multimedia Design, Living in Motion Research Group PIM PEETERS Lecturing researcher School of Health - Nursing, Living in Motion Research Group MEET THE KNOWLEDGE NETWORK MEMBERS > MEET THE KNOWLEDGE NETWORK MEMBERS > MEET THE KNOWLEDGE NETWORK MEMBERS > From movement to well-being 22 SUPPORT FOR LEARNING TO MOVE The silent force in the background. This a role that suits me perfectly. Early on in my career I gave lessons as a trainer in addition to my job in management support. I still teach a varied group the finer details of management support during evening education classes. I also work as a volunteer helping youth from socially disadvantaged backgrounds that struggle at school. Together with them I look at how we can put them back on the right path, both at school and in life. Learning processes are a wonderful thing to contribute to. They not only help people advance in their school careers but they also contribute to a positive self-image and a feeling of self-worth. Learning processes enhance peoples enjoyment of life, because they offer the chance to take on new challenges. In my opinion as a counsellor, the biggest challenge is to help people find their own strengths and to use this to develop themselves. Im convinced that this is a continuous process that stretches your entire life. It cant be a coincidence that I ended up in management support at the Living in Motion Research Group. I feel completely at home within this research group which uses individual strength and intrinsic motivation as the central points in practical research focused on getting people moving in all aspects. It is inspiring to be able to do my work surrounded by critical thinkers and people-people and to be a link in a process that is aimed at helping others advance. ALWAYS ON THE MOVE The central themes of the Living in Motion Research Group really appeal to me, because the subjects relate to my field of interest. How can I use smart technology to measure my health and get sufficient physical movement? Does the new definition of health have a positive influence on the costs related to healthcare? How can we develop a minor and which topics should be addressed? These are some of the questions that make up the current research topics at the research group. My research is mainly focused on people who want to return to work. It investigates to what extent the techniques used at home can contribute to patient compliance and the recovery process. As a working mother of 2 young children I am always on the move and I try to balance my work as a lecturer and my private life as best as possible. Both mindfulness and research within the research group can give me the support I need to find this balance. Another advan- tage of participating in this research group is that I have made new contacts in Breda, which stimulates the development and testing of new ideas. Using the Physiotherapy academic workplace as the pivot, I try to motivate students of the Bachelor of Health Technology to take part in week 10 of the Physiotherapy project week. This allows for a short-term exchange between students from different study programmes that sees Physiotherapy students treating patients, while my students research the technical solution for the situation of the patient. I believe that it is important to highlight the activities of the research group within and outside of Avans, so that people can understand what it is that we do and for what they can contact us. In short, there is plenty to do within this research group and I am happy that I took this step. REGINE RETEL HELMRICH Senior management assistant Living in Motion Research Group STEPHANIE MONFILS Lecturing researcher School of Health (AGZ) - Health and Technology, Living in Motion Research Group MEET THE KNOWLEDGE NETWORK MEMBERS > MEET THE KNOWLEDGE NETWORK MEMBERS > MEET THE KNOWLEDGE NETWORK MEMBERS > MOTIVE FOR MOVEMENT 23 USING COMMUNICATION AND CONTACT TO UTILISE STRENGTHS My interests are in other people and different cultures and I am focused on establishing contacts. Because of this my entire career has been shaped by communication. For 10 years I worked as a social worker in youth services where I helped multi-problem families to utilise their strengths. Instead of focusing on the negatives, I wanted to stimulate that which those families are capable of. Thankfully, in the current field of healthcare and well-being, the tendency exists to use peoples abilities and strengths and the focus has shifted from what is lacking to what theyre good at. The assets-based approach of the research group fits perfect- ly into this positive health concept. In the research I did for intercultural communication sciences, specialising in management of cultural diversity, which was my second study, this fascination for strengths and abilities was consolidated. I researched the integration of Somali people with Dutch citizenship in the Netherlands and the factors that made integration successful or more likely to succeed. I also looked at the factors that hindered integration or made it more difficult, but I believe that strengths and abilities are the key to progress. I also focus on strengths and abilities when I teach Bachelor of Social Work and Social Services students. I always try to see what drives students and what their strengths are and encourage them to use these talents to study and develop. In my research for the research group I focus on the residents, including refugees and asylum seekers, of the Fatima district in Tilburg. The objective is to understand the extent of social cohesion and the experience of well-being associated with this after the arrival of 400 refugees and asylum seekers in the district. The keys to success are an important aspect of my research and I believe that we need to learn from the positives instead of focusing on the negatives. WORKING WITH STRENGTHS AND DIVERSITY As a social professional and cultural anthropologist Im fascinated by what motivates people to move in the broadest sense of the word. What gets people to unite and rise up, to identify with a political movement or feel connected to or disconnected from certain social themes? Choosing to become or not become involved in a social sense says something about people but it also says something about the environment in which they are active. To what extent are their strengths utilised and is there space for diversity? Utilising your strengths and opportu- nities was central to my work as a youth worker and as a trainer of primary school teachers in Nicaragua. You need to assess the knowledge that people have and what they want to achieve. Then you find the best way to utilise these talents. By using peoples assets you em- power them to determine for themselves how to become active. In previous research I looked at themes such as social influence, identity and group formation by investigating what made people feel at home. These themes are also focus points of the research group and more specifically of the positive health concept. You look at the ability of the individual to adapt and take charge of their own lives in terms of physical, emotional and social challenges. The ques- tion of when, where and why somebody feels healthy and good is central. This question is also relevant in my research about the residents of the Fatima district in Tilburg. The objective of the research is to understand the ways in which the residents, including the 400 new resi- dents who fled from countries like Syria, experience health and well-being by investigating to what extent social participation, inclusion and social cohesion play a role and whether social movement and physical movement has an influence on this experience. YVONNE ABBING- CRUIJSSEN Lecturing researcher School of Social Studies Breda - Social Work and Social Services, Living in Motion Research Group CHARLOT LUGTIGHEID Lecturing researcher School of Social Studies s-Hertogenbosch - Social Work and Social Services, Living in Motion Research Group MEET THE KNOWLEDGE NETWORK MEMBERS > MEET THE KNOWLEDGE NETWORK MEMBERS > MEET THE KNOWLEDGE NETWORK MEMBERS > From movement to well-being 24 POSITIVE SOCIAL CAPITAL Healthcare in the Netherlands is undergoing a transformation. Future professionals need an extensive range of competencies which enable care users to function independently as far as possible. Being able to function, being in charge of your own life and resilience are central for citizens within this new healthcare concept. Care users are at the core of this approach and through utilising asset management they should be able to take charge of their own health. While citizens and professionals applaud this new concept there are still many challenges, including those faced by citizens initiatives. With my roots in education, research and practice and my training as a physiotherapist and epidemiologist, I want to make a contribution to training the new healthcare professionals of the future. I also want to research the implications and implementation of this changing healthcare concept which creates new positive social capital. This research group enables multiple disciplines to come together to research complex issues. PRISCILLA SANTOS AND ROBIN HAANS Work placement trainees Fourth-year students in the Bachelor of Social Educational Care (SPH) and Bachelor of Social Work and Social Services (MWD) at Avans s-Hertogenbosch. Since we started our studies we have constantly been active in developing ourselves into competent professionals. We are currently working on our graduation project in the Living in Motion Research Group. The world around us keeps moving and everyone needs to find his or her way of moving with it. Every individual is different and is moved by different things, which is what makes research so interesting. We hope that our research will make a contribution to the research group by looking at the significant increase in refugee streams in the past year. This is a topical subject that presents many different angles. We question the influence of citizens initiatives on resi- dents sense of well-being and the ways in which refugees try to assign meaning to their lives. It is wonderful to be part of a larger research project and to be actively involved in research. It has been a very educational period for us and the involvement of the research group has been great and will hopefully continue to lead to new insights. YASMAINE KAREL Lecturing researcher School of Health - Physiotherapy, Living in Motion Research Group MEET THE KNOWLEDGE NETWORK MEMBERS > MEET THE KNOWLEDGE NETWORK MEMBERS > MEET THE KNOWLEDGE NETWORK MEMBERS > MOTIVE FOR MOVEMENT 25 MARTIJN SCHRAM AND NICOLE STEEGHS Work placement trainees We are Communication & Multimedia Design graduate students at Avans University of Applied Sciences Breda. Because of our personal interest in psychological care and follow-up care, it is important to us to develop something during our graduation that can be used in practice. So we formulated our own research question and asked for input from the Living in Motion Research Group who responded with interest. We work together with experts in the different fields to get a better understanding of this very complex target group. We also have an enthusiastic project manager who has extensi- ve knowledge in the fields of cognitive therapy and general mental health treatment in the Netherlands. This project is supported by the combination of a literature survey, target group research and the opinions of experts. Cognitive behavioural therapy (CBT) ensures that healthcare users learn to deal with their vulnerabilities and do not allow these to determine their behaviour. It requires an incredible amount of motivation, concentration and perseverance to keep up this new behaviour, which means that many people are likely to partly or completely fall back into their old habits and behaviour. Vulnerabilities can then return or shift. Using this as our point of departure, we started with the design and testing of an application that contains different modules. This allows healthcare users to create their own, personal, combination. We have developed conceptual models that help with fear, panic, worry and structure that can be used to support healthcare users after their CBT treatment. The goal is to strengthen the resilience of the user in order to obtain improved long-term results. LIEKE DE KOK Work placement trainee I am a research assistant in the Living in Motion Research Group. After studying at Utrecht University for 1 year, I decided to start a higher professional education study programme. I am currently a Social Work and Social Services second-year student at Avans. But I felt that this study lacked the space for research, so when I found out about this research group I was pleasantly surprised by the wide range of research it was involved in. It was interesting for me to work together with different schools. As a research assistant I can make a contribution to large research projects and work with many different people. In the beginning I had to find out where I fit in, to discover what exactly I could do. As our research becomes more defin- ed, so does my role in the research group. Its great to know that there is space in my study programme for me to discover my qualities as a researcher. MEET THE KNOWLEDGE NETWORK MEMBERS > MEET THE KNOWLEDGE NETWORK MEMBERS > MEET THE KNOWLEDGE NETWORK MEMBERS > From movement to well-being 26 Door: John Dierx EVOLUTIE = BEWEGEN De wereld, de natuur - en dus ook de mens - staan nooit stil. Het heelal met de sterren, zon en maan draait rondjes, de aarde draait om zijn as, de zeeën en rivieren stromen en de aardkorst beweegt ook zo nu en dan. In ons lichaam bewegen darmen, hart, spieren en bloed alsof hun leven ervan afhangt. Gaandeweg heeft alles zich ontwikkeld tot wat het nu is. Dit proces heet evolutie. Evolutie is eigenlijk het schoolvoorbeeld van voortdurende beweging en daarmee centraal thema binnen het lectoraat Leven Lang in Beweging. OUTLINE RESEARCH GROUP LIVING IN MOTION RESEARCH GROUP: NOT BECAUSE WE MUST, BUT BECAUSE WE CAN By Professor John Dierx EVOLUTION = MOVEMENT The world, nature and even people are never static. The stars, sun and moon follow their own trajectories, the earth turns on its axis, seas and rivers flow and the earths crust has a way of making its movements known and felt. In the human body the movement of intestines, the heart, muscles and blood are a sign of life. Over many millennia everything has moved towards what it is in the present. This process is known as evolution. Evolution is a classic example of continuous movement and this makes it a central theme for the Living in Motion Research Group. MOTIVE FOR MOVEMENT 27 Because movement is eternal it is surprising that people no longer see the importance of it and are moving less and less. Yet, is this really the case? Has our understanding of movement perhaps evolved? If you ask people what they think the term movement means you will be bombarded with answers about sports clubs, gyms, running shoes and racing bicycles. It also tends to be follo- wed with the caveat that they should perhaps be a bit more active. It is especially a hot topic for new years resolutions. But it begs the question, why? What does it add to your life? What drives people to make the effort and work up a sweat? The answer always resounds: “Because I want to be healthy, of course!” If you had to ask this question a few thousand years ago, the answer would have been somewhat different: “To survive, of course!” But what has caused this shift? What has changed? And moreover, what has remained the same? In short: how do we make movement part of a normal lifestyle? To find the answer to this question we need to look back to prehistoric times. After all, through knowing the past you can understand the present and shape the future. NECESSITY OF MOVEMENT: A BROAD PERSPECTIVE Movement and motion are the essence of existence. In nature, being static or standing still equals death. The first humans had to physi- cally move if they wanted to eat. They had to hunt and gather fruits and plants. If they did nothing they would starve. Inactivity meant not having access to food, while the social relationships in your tribe would also suffer. If you didnt join the hunt or were useful in some other way, you were likely to be ostracised from your tribe. In these early times, being alone meant certain death. If you didnt die of starvation you were likely to end up on the menu of some predator, as there was no one around to help you or protect you. In short, being socially active was a necessity for survival. But, as time went by people became fed up with all that hunting and gathering and realised that life would be a lot easier if the animals and edible plants were kept close by. This also meant that you were less likely to be dinner yourself. These human pioneers started domesticating animals and planting crops to have better food security. But even then people had to be physically active every day. Lazing around was not an option, as it meant that animals and crops would be neglected and this would threaten the food supply. The advantage of having the food supply nearby was that it created a surplus of food. This surplus could be sold or traded for privileges or other goods and gave rise to the trade industry. But then you still had to move, because youd have to take your goods to the market. You also remained socially active, as you would sell more if you knew your customers. Nature is programmed for survival and hence, also to prevent any energy from being wasted. This means that humans, by instinct, have always tried to find the easiest way of doing things. If you can let others or machines do the work for you, so that you can do other things, thats an opportunity youre going to embrace. This mindset let to the mechanisation of agriculture, food production, production of other materials and, eventually, the house- hold as well. For many people this meant that physical movement was no longer necessary for survival. The meaning of movement as a social factor and social activity changed as a result. Employers became a social group who moved in their own circles. This same applied to employees who realised that they had a lot in common. This in turn signalled the start of a division in economic health. FROM THEN TO NOW In the modern age the need for physical movement has completely disappeared. Science and technology have advanced at a phenome- nal speed and everyone has the luxury of not having to move, as most people in the developed world can afford to own their own car, moped or scooter. Moreover, everyone here has a mobile telep- hone these days placing the entire world at their fingertips. People communicate from their own mobile locations and exchange digital, text and verbal messages. Physical social contact is now limited to interaction with family, neighbours, colleagues and friends. You no longer even need to leave your house to get food, as groceries and ready-made meals can be ordered online. Modern infrastructure is designed to facilitate traffic and communi- cation. Simultaneously, neighbourhoods, districts and cities are de- signed to house as many people as possible. Streets and roads have been constructed in such a way that enables safe daily transport. All of this contributes to a sense of autonomy, where everyone feels en- titled to their own living space and to self-fulfilment. However, this leaves little space for green areas, as this would minimise physical sa- fety by restricting the view. This has turned physical movement into a threat to survival in the modern age. Technological progress has not only increased autonomy and changed daily physical and social life, but it has also opened up a wealth of opportunities for the field of medical healthcare. The necessity for physical movement declines further as a result, as the consequences of inactivity such as clogged arteries and veins, problems in the locomotor and gastrointestinal systems and hormonal imbalances are increasingly easier to rectify. Whats more, modern health insurance even covers the costs. From movement to well-being 28 “Most of the time, active people are no better than lazy people, as all people are equal when they are asleep.” Aristotle TOWARDS MOVEMENT 3.0: NOT BECAUSE WE MUST, BUT BECAUSE WE CAN- So, physical movement is no longer necessary... Or is it? From an economic perspective there appears to be no more need for physical activity, as everyone is able to make a living while being seated. However, from a psychosocial and biological, or health, perspective the necessity of physical activity has increased. Signs of increasing feelings of loneliness and the alarming increase in obesity and obe- sity-related illnesses1 are worrying. Sickness absence from work2 as a result of a sedentary lifestyle is also increasing. This increases the costs related to lack of movement for both the healthcare sector and employers. This also debunks the argument that movement is no longer vital from an economic perspective. Where, in the past, movement was a precondition for survival, in the present and quite possibly in the future, it is likely to be about the willingness and ability to move and about lifestyle in general. Being active supports daily optimal functioning in a biological sense. Sciences like physiotherapy ensure that people can become mobile again as quickly as possible, are able to do things independently and make less use of expensive healthcare services. Movement also has a positive effect on the immune system and is beneficial in terms of preventing or recovering from illness.3 Movement also helps you to feel better about yourself4 and encourages you to be more socially active. The positive side-effects of movement also promote sustaina- ble employability in the workplace and social cohesion in society.5 Movement ensures that you are an active member of society now and in the future and that you remain relevant. The concept of movement includes both physical and mental movement. This link was already identified first by the ancient Greeks and captured later by the Romans in the famous phrase: Mens Sana in Corpore Sano (a sound mind in a sound body).6 This is an example of the classic chic- ken-egg causality dilemma in which it doesnt matter whether you move to feel better or because youre starting to feel better and are therefore moving more. If movement has so many different benefits and you can do it every day free of charge, why wouldnt you do it? Find an activity you love and get moving. MOTIVE FOR MOVEMENT 29 MISSION OF THE RESEARCH GROUP Having observed that movement is about willingness rather than necessity, we arrive at the question of how to motivate people to move. While everyone is aware that movement is good for you, not everyone actually moves. This is what the Living in Motion Research Group is hoping to address. We consider a world where movement is a habit and we question what habit means to different people. We investigate how people perceive movement, the motives people have for movement and the needs and desires that movement can meet. In short, what are the motives for movement? What conditions and circumstances stimulate or hamper these motives? Different motives and circumstances involve different types of movement after all and concern varying degrees of physical, mental and social movement. The challenge is to identify the diffe- rent aspects of the circumstances and motives that are not governed by time and location, but that are fundamentally present in people. We have formulated a defined scope of research in order to inves- tigate this. The individual stands at the crux of this research which focuses on people between the ages of 18 and 67. The specific age is not leading for this research. Instead, we focus on the different phases of life. Everyone has their own specific needs and characte- ristics (assets). These assets are partly defined by peoples passions, interests and skills. But they are also located outside of the individual such as the home, neighbourhood, district and the influence of family, friends and neighbours. People base their dreams and goals on their needs and assets and it is these goals that determine the way in which they choose to participate in society through work or as volunteers. Achieving these goals and participating in society is not a given and sometimes people need support in their endeavours. This support can come from healthcare and welfare or from techno- logy. Quite often, however, its a combination of both. The support provided by healthcare and welfare professionals and the technology used has to suit the needs of the healthcare user. Within this context, the research group hopes to find answers to the questions that arise in this relationship. In order to do this, the research group needs lecturers and students to discover the answers and to experience what these answers mean to them and the field of study. The answers to these questions result in new information about how people perceive movement and being active. By applying these answers to the daily reality and perspective of people, they are more likely to move and make activities a part of their daily routine. Through this, the research group can make movement a habit once again. Not because we must, but because we can. Sources 1 Mackenbach, J. (2010). Ziekte in Nederland: gezondheid tussen politiek en biologie. Mouria. 2 CBS (2007). Meer ziekteverzuim bij ernstig overgewicht. PB07-080 21 november 2007CBS Persbericht 3 Bruunsgaard, H., & Pedersen, B. K. (2000). Effects of exercise on the immune system in the elderly population. Immunology and Cell Biology, 78 (5), 523-531. 4 Nam, M. R., Kim, Y. H., Ahn, O. H., & Yang, B. S. (2007). T he Effects of a Low Intensity Excercise Program on Psychosocial Factors of Excercise and Physical Factors in Elderly Women . Journal of Korean Academy of Community Health Nursing, 18(3), 373-381. 5 Aalders, M., Overgoor, L., & van Wieringen, J. (2009). Big! Move: Beweging in Gezondheid. TSG, 87(3), 82-84. 6 Diogenes Laërtius, Lives of the Eminent Philosophers , vertaald door Robert Drew Hick (1925), Loeb Classical Library. From movement to well-being 30 By Professor John Dierx BETWEEN THEORY AND PRACTICE I am regularly asked what it is I do. When I reply that Im a Professor of Living in Motion at AVANS University of Applied Sciences, I am often met with some confused looks. So you teach?, is often the response. I, in turn, explain that I do teach but that I am mostly busy researching what motivates people to move together with a group of researchers who also teach. Quite often this requires some additional explana- tion and people only really get it when I give them concrete examples. This has taught me that while theory is fascinating and engaging, it becomes truly valuable once it is applied to practice. Applying theory to practice is at the crux of working at Avans. Doing research based on questions arising from practice gives students the opportunity to experience practi- cal applications and means that lessons from practice can be applied to education. SCOPE OF RESEARCH But what does the Living in Motion Research Group do exactly and what are the basic principles? First of all, we dont do the type of research where conditions can be controlled. Our research is based on the practical environment and peoples daily lives. We research people in their own homes and the neighbourhoods, districts and municipalities where they interact with their families and friends. We also look at people at their work, their community of faith or sports club. Our research is focused on people between the ages of 18 and 67 during different life phases: from just started working, single, starting a family, families with older children, to people reaching reti- rement. Basically its about people being people and doing the things that people do. During their lifetime, people shift within the health continuum from completely healthy to sick and needing temporary treatment, back to healthy again. As you get older, you might not make the shift back to the completely healthy side of the continuum but this doesnt necessarily mean that you feel ill or think of yourself as a patient. While everyone will experience periods of ill-health in their lifetime, within our research projects people are always con- sidered as individuals and not as patients. The research group also investigates lifestyle and behaviour and behavioural changes with regard to physical movement. This is a complex topic which involves a wide variety of factors. To more narrowly define our research, the Living in Motion Research Group has opted to use a word cloud. In contrast to defining the field of research, the word cloud is more dynamic and is far more suitable to daily practice and continuous social developments. The different research projects contribute to knowledge development and innovation for the concepts of assets, physical, mental and social movement and social participation. In this context, assets literally means possessions and can be defined as, “any factor that ensures that an individual, group, population, social system or institution can control and support their health and well-being.”1 Social participation is broadly defined as volunteer work and work, family and leisure activities. RESEARCH GROUP FIELD OF RESEARCH positive health identity salutogenesis intrinsic motivation ages 18-67 from risks to assets autonomy innovation physical, mental and social movement quality of life individual approach prevention and rehabilitation assets active lifestyle studentparticipatie social participation behavioural change daily functioning persuasive computing MOTIVE FOR MOVEMENT 31 CONNECTING THEORY TO PRACTICE In addition to these concepts, student participation is also an impor- tant concept, as all projects are linked to education. It is the objec- tive of the research group to investigate how the world is changing and this will require professionals who can make a contribution to this. The goal of the projects is to help students, the future profes- sionals, experience the types of things that they will face in their future careers and to teach them how to use the skills they develop during their studies to approach these practical experiences. It also helps lecturers identify which aspects can be used to strengthen edu- cation. This connects learning and working in a continual process. Through practice, the research group wants to find the answers to questions such as: What motivates and keeps people between the ages of 18 and 67 and at different phases of life physically and, as a result, mentally and socially active? Which assets play a role in this? Which types of support and technological support might people need to become active? Which effective elements of technological and other types of support can be generally applied regardless of phase of life and the physical and social environment? What can professionals do to support people? What does this mean for the study programmes in terms of content and working method? There are currently several active projects that will give answers to these questions in the near future. Different disciplines work together within these projects which helps issues to be approached with the input from a variety of perspectives such as nursing, physiotherapy, health technology, social studies and communication and multime- dia design. Each discipline brings its own expertise and assets to the projects and this is essential for their success. After all, if we want professionals from different disciplines to work together, we need to demonstrate that this multidisciplinary collaboration also leads to better results: not only in theory, but also in practice. OUR MISSION The research group wants to assist working people and future workers to harness and intensify their own strengths to promote social participation and quality of life in the different phases of life. The research group motivates these people to take charge of becoming physically active. OUR VISION The research group focuses on working people and future workers between the ages of 18 and 67 at their different phases of life. It applies a behavioural sciences approach to physical movement that influences mental and social movement. Being and staying healthy, also known as a salutogenic approach, is the basic principle. This means focusing on the positive qualities and characteristics of people and their social and physical living environment. In developing and implementing interventions for behavioural changes we consider the perspective and needs of the individual. This ensures that behavioural change is inspired by intrinsic motivation. The research group looks for effective elements within these activities, so that the results can be achie- ved regardless of the living environment and social context. This also applies to the research and development of demand-orien- ted technical support that aids this process. This is done in collaboration with institutes, businesses, government and other knowledge partners 1 Morgan, A. and Ziglio, E. (2007). Revitalising the evidence base for public health: an assets model. Promotion & Education, 2007, Supplement (2): pp 17-22 positive health identity salutogenesis intrinsic motivation ages 18-67 from risks to assets autonomy innovation physical, mental and social movement quality of life individual approach prevention and rehabilitation assets active lifestyle studentparticipatie social participation behavioural change daily functioning persuasive computing From movement to well-being 32 MY DAILY WALK AROUND THE BLOCK MOTIVE FOR MOVEMENT 33 PROJECT Brabantpark and Heusdenhout districts Moving Together Lieke van Oort CONTEXT Breda Actief (active Breda) is an initiative by Breda municipality aimed at getting Breda residents active and to get them involved in sports and other activities on a regular basis. With this mission in mind, Breda Actief recently launched the Samen in Beweging project (moving together) in the Brabantpark and Heusdenhout districts. Through this project, Breda Actief hopes to reach out to people that do not play sports and who want to find out what options exist for them to become more active. Together with local residents this group will be introduced to different activities in a fun and safe way. The goal is to help participants make the step to regularly participating in sports and other activities. The project focuses on local residents between the ages of 50 and 69, as research by the municipality has shown that inactivity is a problem within this age group and that there is currently no programme that directly addresses this group. Breda Actief re- quested the Living in Motion Research Group to add its expertise to this project. In response, the research group organised a Health Check Day at the BRESS sports centre to assess the physical fitness of residents and to find out how these people perceive and experience their health and fitness. RESEARCH QUESTIONS What is the health status of residents aged between 50 and 69 in the Brabantpark and Heusdenhout districts? What is the level of physical activity of residents aged between 50 and 69 in the Brabantpark and Heusdenhout districts? How do residents of the Brabantpark and Heusdenhout districts perceive and experience their health and fitness and, based on this, in what way would they be willing and able to participate in regular sports and activities? PHASING - January - February 2016: orientation and preparation for Health Check Day - 1 March 2016: Health Check Dag - March - April 2016: analysing the data - Mei 2016: report and planning of follow-up events, possible roll-out to other districts in Breda. From movement to well-being 34 FACTS & FIGURES LIVING IN MOTION RESEARCH GROUP INFOGRAPHIC MOTIVE FOR MOVEMENT 35 Interdisciplinairy Collaboration Physical activity of members of research group expertise and experience of research group by terms: Assets Social-societal participation Physical, mental and social movement evidence based practice, multidisciplanairy work, society and culture, multidisciplanairy work, society and culture, diagnostic and prognostic research,(web)technology and natural interfaces. man-woman ratio PhD O Outdoor sports O Gym O Rest outdoor sports Academy Communication & Multimedia Design Health & Technology, Nursing, Physiotherapy Cultural and Societal Development Cultural and Societal Development From movement to well-being 36 By Yasmaine Karel (lecturing researcher) and Professor John Dierx Traditional healthcare focuses on the prevention, diagnosis, treatment and curing of diseases. This makes the term health- care misleading. Sick care would perhaps be a more appro- priate term. In 1948, the WHO issued the following definition: “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” But healthcare has technologi- cally and medically developed in leaps and bounds since 1948. Much has also improved in the fields of prevention and behavioural chan- ges, which has resulted in healthier ageing. While ageing often goes hand-in-hand with illness, especially chronic illnesses for which a cure is the exception rather than the norm, the way in which people expe- rience health or illness has changed. People with chronic conditions can, after a phase of acceptance, still find a way to adapt to the situ- ation. In response to these developments, Huber (2012) formulated a new concept of health that focuses on functioning and experience: “Health is the ability to adapt and self-manage in the face of the social, physical and emotional challenges of life.” With this concept, Huber expands the traditional understanding of physical, mental and social health to include daily functioning, meaning and quality of life. A similar movement had taken place in psychology when Martin Se- ligman became president of the American Psychological Association in 1998. Seligman stimulated the research into factors that promote well-being and happiness and which resulted in the positive psycho- logy movement (Seligman & Csikszentmihalyi, 2000). This positive psychology ties into salutogenesis, a concept developed by medical sociologist Aaron Antonovsky in 1987. ASSETS According to the conventional definition of health, the healthcare professional should focus on identifying actual or potential health issues in patients. This would include problems in physical or psy- chological functioning that are predominantly resolved through care. But this largely ignores the patients own capacities and strengths. Healthcare professionals are also less inclined to consider the patients living environment and the people around them. This, in turn, leaves little space for the perspective, preferences, expectations and experi- ences of the patient (Adamsen & Tewes, 2000; Karkkainen, Bondas, & Eriksson, 2005). This also implies that the patient is not central in the process. All the elements that patients possess can be grouped under the term assets. Within health promotion an asset is defined as “any factor that ensures that an individual, group, population, social system or institution can control and support their health and well-being” (Morgan & Ziglio, 2007). Assets protect patients against stressful situations, allowing them to once again face the social, physical and emotional challenges in life. From the perspective of health promotion and healthcare 3.0, an assets-based approach may be beneficial to problem-focused healthcare which has a deficits-based approached. The added value of assets is tremendous and varied. With an assets-based approach you not only strengthen the capacities of individuals and society to an optimal state of well-being, but you also motivate people to become autonomous. This makes people a part of shaping the healthcare systems of the present and the future. CARE AND WELFARE PROFESSIONALS You cant avoid getting ill, no matter how healthy your lifestyle. And once you get ill or develop a chronic illness, you need someone to help you with these new deficits and problems. This is when assets become an important aspect, because you want to be helped in a way that suits you best. You want advice that is easy for you to follow and that suits your lifestyle. While you can never completely control an illness, you can certainly control the way in which you manage the disease. People who are autonomous appear to recover faster or, at the very least, start to feel better sooner. But not every patient understands this and/or is able to do this. This is where the health and welfare professionals can lend a helping hand before, during and after treatment. In order to help a patient identify their assets, the health and welfare professional has to be able to define their own assets. This skill should be perfected during their work and even the professionals might need guidance or education to do so. Health and welfare professionals must learn to suspend actual treatment until they have a clear understanding of what the patient wants and is capable of considered from all the foundational pillars of positive health and the patients perspective. OPINION PIECEPHIC AUTONOMY IN A CHANGING SOCIETY “This turns health into a dynamic concept.” Machteld Huber 37 Medische feiten Medische waarnemingen Ervaren gezondheid Lichamelijk functioneren Klachten en pijn Energie Cognitief functioneren Emotionele toestand Eigenwaarde en zelfrespect Gevoel controle te hebben, manageability Zelfmanagement en eigen regie Veerkracht, resilience Je situatie begrijpen, comprehensibility Zingeving, meaningfulness Doelen of idealen nastreven Toekomstperspectief Acceptatie Kwaliteit van leven, welbevinden Geluk beleven Genieten Ervaren gezondheid Lekker in je vel zitten Levenslust Balans Sociale en communicatieve vaardigheden Sociale contacten Betekenisvolle relaties Geaccepteerd worden Maatschappelijke betrokkenheid Betekenisvol werk Basis Algemene Dagelijkse Levensverrichtingen (ADL) Instrumentele ADL Werkvermogen Gezondheidsvaardigheden PIJLERS VOOR POSITIEVE GEZONDHEID FOUNDATIONAL PILLARS | OF POSITIVE HEALTH (Source: Institute for Positive Health) When a health and welfare professional has mastered the concept of an assets-based approach, he or she is better equipped to identify the factors that will contribute to the health of the patient. POSITIVE HEALTH IN EDUCATION Implementing this approach in health education contributes to creating a useful set of future-proof skills for the next generation of health and welfare professionals. This implementation can be done on 2 levels. Firstly, assets that improve health can mobilise a patient to display positive health behaviour and to maintain it. Future health and welfare professionals need to develop competencies that help them develop and maintain safe and accepting relationships with their clients. This creates the foundation for effective communication and, in turn, for promoting positive health. The professional will always have their specialised knowledge as an asset, but when it concerns the process and patient contact, the professional has to assume a more following role. When it comes to multidisciplinary collaboration, the care professional has to help design a treatment where his or her assets are combined with those of others. Thus, the care professional has to be able to identify and accept others expertise and assets in order to create an effective and efficient care plan in which the client and his/her needs and qualities are paramount. Secondly, positive health and an assets-based approach will influence the students ability to study and the way in which they interact with lecturers and other students. Within the foundational pillar of meaningfulness, the student must be intrinsically motivated to complete the study programme. To achieve this goal, the student will set new behavioural and other goals every year and connect these to actions (daily functioning). The student will learn how to utilise their lecturers, fellow students and their assets to achieve these goals. In addition, the student will learn to understand the importance of extra-curricular activities for personal and professional development. Once the student becomes conscious of how to define their quality of life, they are able to give meaning to their study. This implies that education has to be presented differently in the future and that the lecturer is only an instrument in this process. POSITIVE HEALTH AS A CONCEPT FOR LIFE The positive health concept was created because the definition of health was no longer encompassing enough. The definition of this new health concept included 6 foundational pillars that are meaningful on several different levels. Firstly, this concept recognises the centrality of the client and his/her general perspective and environment, which makes care more suited to the patient and, possibly, more effective. Furthermore, it also influences the working method and perspective of professionals. Finally, the concept can be applied to the way in which professionals are trained. It needs to connect to the students perspective and his/her intrinsic motivation which, in turn, will positively influence study results. In this sense, positive health is a broadly applicable concept for living instead of just a new approach to health. MOTIVE FOR MOVEMENT From movement to well-being 38 PROJECT Physiotherapy exercises in the home: using smartphones for measurement and support Norbert Kuipers and Lieke van Oort CONTEXT In first and second line physiotherapy rehabilitation and recovery it is important that the exercises suit the client. Currently, patient compliance in physiotherapy is low, which reduces the speed of recovery or may even result in relapse. The use of technology has made customisation in therapy and exercises possible, especially when making use of reminders and incentives through mobile devices. Research into the possibilities presented by smartpho- nes is interesting considering the low costs and easy use of this application. Moreover, smartphones and smartwatches present possibilities for multimedia solutions. RESEARCH QUESTION How can a smartphone with accelerometer and gyroscope be used as a measuring device and as support for physiotherapy exercises and rehabilitation in the home? PHASING - January - February 2016: orientation phase and project design - March 2016: development of prototype for taking measurements - April 2016: testing and evaluating the prototype for taking measurements and further expanding the prototype with an audio-support module - April - May 2016: practical tests of the expanded prototype - May - July 2016: evaluation and report - From September 2016: research into applications that improve patient compliance. PROJECT Improving the transition from hospital to home Stephanie Monfils CONTEXT For an increasing number of health problems revalidation and recovery in the hospital is no longer necessary and is better done at home. Proper multidisciplinary care provision is needed to enable patient compliance and recovery in people who are fit for work but that are temporarily residing in a care institution or have to return to such an institution several times a week due to an illness or injury. These patients would be able to recover at home if the healthcare technology in their living environ- ment enables this process. Home care has several advantages to institutional care. Undergoing the healing process within the home promotes autonomy and independence while home care is also cheaper and patients recover more quickly in their own environment. RESEARCH QUESTIONS Which technological care innovations contribute to rehabilitation in the home, enabling working people between the ages of 18 and 67 to re-enter society at a faster rate? PHASING - April 2016: lunch meeting where different parties discuss demand articulation and the precise research question is formulated using practical experience - May 2016: formulating the research question - From June 2016: development, implementation and evaluation of care innovation participation. MOTIVE FOR MOVEMENT 39 PROJECT Utilising the asset of practical expertise in mental health nursing Pim Peeters CONTEXT In the Netherlands, experiential experts work in mental health- care, welfare and the municipalities. Experiential expertise is the ability to use ones own experiences of recovery to help others recover. Treatment using personal experiences is a generic com- petency and deserves closer investigation in health and welfare education. An extra-curricular programme is being developed for Nursing and Social Work students in every study year that addresses the use of personal experience in supporting others. RESEARCH QUESTIONS To what extent is the perception of Bachelor of Nursing and Bachelor of Social Work students about care and welfare altered by experiential experience? To what extent does professional care provided by social workers with experiential experience differ from that provided by social workers without experiential experience? PHASING - November 2015 - April 2016: focus groups and feedback about working method setting up the programme - April 2016 - August 2016: running the first phase of the programme data collection from the first phase - September 2016: qualitative analysis of the first phase planning for the further running of the programme. From movement to well-being 40 Movement is a must. It keeps you fit and prevents obesity, cardiovascular disease and a wealth of other illnesses. It also helps your joints stay healthy, your muscles stay active and you dont get out of breath that easily. In short, movement comes with an abundance of health benefits. Yet, we are moving less than we should. Perhaps the reason for this can be found in that little word must. People tend to resist anything that they must do and secretly we like to do the things that we shouldnt. Using this as a basic tenet, perhaps we should just ban exercise. When I was younger I used to exercise because I enjoyed it. My pa- rents signed me up at the local football club when I was just 6 years old, but I didnt really have a talent for the sport. But once I discovered tennis, exercise stopped being a chore. I played tennis 2 to 3 times a week during the school term and in the holidays I played every day. I also started playing squash, so that I continued to be active in winter. Unfortunately, 2 slipped discs put an end to tennis and squash. After the second slipped disc I stopped playing sport for a few years. Add a sedentary job to this and I was barely getting any movement at all. My exercise was restricted to a week of skiing once a year and a few walks during the summer holidays. I felt a lot less fit during this time, but this didnt motivate me to get active again. I could always find an excuse to put off exercising. Things got a little better after I moved and I had to cycle 6 km to and from the train station every day to take the train to The Hague and back again at night. But after a few years this stopped as well when I started working at TNO and got a lease car. With the car right there in my driveway, my daily 12 km bicycle ride turned into a daily walk of 12 metres from the car to my office and back again. After having gained 12 kilograms in 12 months, I realised that I had to turn things around. I was exercising again but golf requires a lot of free time and running while playing golf isnt really appreciated, so you dont really get fit from it. So I decided to drop the excuses that stopped me from exercising. I chose the gym, because you can do it alone and its indoors, so the weather is not a factor. I created my own little gym at home, so that there was absolutely no excuse left anymore. I placed a TV next to my exercise bike and rowing ma- chine so that I wouldnt get bored either, and it worked. My intrinsic motive to move is that I feel better if I exercise on a regular basis. But this intrinsic motivation is not exactly very strong - with the exception of the annual Christmas skiing trip - so I made sure that I got rid of all the excuses. I feel great that I have done this, but I have to admit that that extra 12 kilograms has stayed put. But at least it hasnt become more. COLUMN MOVEMENT IS A MUST By Diederik Zijderveld (member of the Avans University of Applied Sciences Executive Board) MOTIVE FOR MOVEMENT 41 MINDFULNESS COACH The Mindfulness coach app by VGZ health insurance is a perfect example of how you can make usually expensive training courses available for free to a broader public. Mindfulness teaches you to live in the present by focusing your awareness on the present moment. This can lead to improved sleep and energy levels. Because repeated exercises are a condition for success in mindfulness, the app has a 5-week programme in which the user performs 25 exercises. The user can plan these exercises and add it to their diary so that a reminder will be sent. The user can also search for a suitable exercise on the app when needed and do the exercise immediately. Peter Blok has narrated the exercises and orally guides the user through the exercises, simplifying the use of the app. For further information, please go to: https://www.vgz.nl/mindfulness-coach-app 5K RUNNER If you are new to running and would like to take part in a running event but are not sure how to get started, the 5K Runner is the perfect app for you. The app provides a training schedule of 30-minute exercises 3 times a week to get yourself in shape for the run. In the starting phase of the training schedule the focus is mostly on speed walking. After a few weeks, the number of walking breaks is reduced and running times become longer. The 5K Runner app uses different ways to ensure that you dont give up on your goal to run 5 kilo- metres. While youre running, the app encourages you and gives you complements. You also receive push notifications on your telephone to remind you that you still have to train today. The app stimulates and motivates you to keep up your training schedule. The 5K Runner will help get you ready for your running event. For further information, please go to: https://itunes.apple.com/nl/app/5k-runner-0-to-5k-trainer./id439852091?mt=8 TAMING THE VOICES The Temstem app is a great example of how serious gaming can be applied to healthcare. This app has been specially developed for people who hear voices in their heads, as a result of psychosis for example. Temstem helps to distract the user, making the voices less intrusive. The app consists of 2 grammar games where the user has to make word combinations and type syllables. Because the user engages the language centres of the brain when playing these games, the vividness of the voices is suppressed. The level of control the user is able to exert over the intensity of the voices enables him or her more freedom to take part in other activities. For further information, please go to: https://www.parnassiagroep.nl/hoe-wij- helpen/online-hulp/temstem ? APP-REVIEWS From movement to well-being 42 By Norbert Kuipers (lecturing researcher) PATIENT COMPLIANCE IN PHYSIOTHERAPY AND PERSUASIVE TECHNOLOGY MOTIVE FOR MOVEMENT 43 “Norbert, have you done all your exercises for the week?” “Uhm, sort of... Ive been very busy and sometimes I just didnt get around to doing to them.” “Just sometimes? You know you have to do the exercises regularly otherwise its just no use.” I have often had this conversation with my physiotherapist. As a dedicated sportsman and frequent sufferer of injuries, I was a familiar face at the physio- therapist. Just like many others, my patient compliance curve resembled a steep downward slope. My last round of physio- therapy was during the time of the rise of the popularity of smartphones. Would technology have helped me stay compliant with my physiotherapy exercises? PATIENT COMPLIANCE Research (Sluijs E. M., 1993) has shown that 3 specific factors ham- per patient compliance with physiotherapy exercises. These are the barriers experienced by the patient, a lack of positive feedback and feelings of helplessness (lack of faith that the exercises are helping). One of the barriers often experienced by patients is a lack of time. Elements of demotivation are clear indicators for the other 2 factors. It is well-established that the physiotherapist plays an important role as a coach and motivator in ensuring patient compliance (Van der Burgt & Verhulst, 2014). But it is more difficult to live up this role when the patient has to do the exercises at home. This is where technology can be a useful aid. Patient compliance is divided into short-term and long-term compliance (Sluijs & Knibbe, 1991), each with its particular characteristics and solutions. PERSUASIVE TECHNOLOGY Improving patient compliance is delineated by behavioural change. During the last 20 years technology for multimedia, mobility and measurement has developed at such a rapid pace that it has beco- me a powerful tool for encouraging behavioural change through persuasion, motivation and support. This is known as persuasive technology or computing. The Runkeeper app is a good example of this. But the question remains whether a compliment from the app can motivate you when youre in a running dip. Despite this, it illustrates what is technologically possible for persuasive applications: it is mobile, measures your activities and uses multimedia to engage, visualise and support. The use of gamification in fitness or physiothe- rapy, for example, is also an example of persuasive design. USER CENTERED DESIGN The proper design of a persuasive application is not easy. Many applications fail, because the motivation or trigger does not appeal to the target group. In such cases the persuasive application is too difficult or too easy, too expensive or hard to get. This includes motion sensing input devices like Kinect; its great if you already have one at home but youre not going to buy it just because you need to do 3 weeks of physiotherapy exercises. Exercise apps where you have to enter all the data yourself after each exercise also fall short of user needs. It is common knowledge in the creative industry that the target group or user has to be the main consideration in the design. In the Communication & Multimedia Design study program- me (CMD), user-centred design is key. But a persuasive application requires more than just this. How are you going to use technology to effect behavioural change? We need psychological and game theory models and connect these to technological possibilities. The Fogg Behavior Model (FBM) (Source: www.behaviormodel.org). FBM The Fogg Behavior Model (FBM), created by Dr B.J. Fogg from Stanford University in 2009, has become a popular model for per- suasive design. The FBM states that 3 factors need to be present at the same time in order to effect behavioural change: 1. Sufficient motivation, 2. The ability to display the behaviour and 3. The person needs a trigger. If all 3 factors are present to a sufficient extent, it is then possible to effect behavioural change. But if the intersection of motivation and ability lies under the imaginary action line, a trigger wont help. Of course, it is difficult to determine the exact values on the axes for a target group but the model is useful for the analysis and design. ABILITY When I tell my physiotherapist that Im too busy, this is an example of ability. In the FBM, time, money and physical and mental effort are grouped under the term ability. If time is an issue for me, an app coupled to my diary could provide a solution. It can do this by sending me a notification as soon as there is a gap in my diary. In the FBM this is called a Facilitator trigger that helps with carrying out an activity. Someone who struggles to do the exercise the right way and at the right rhythm might be helped through audio or visual support. For everyone who has a smartphone it is easier and cheaper to install a free or cheap app instead of buying or borrowing a Kinect. This is why I completely focus on the use of smartphones in my research on patient compliance with physiotherapy exercises in the home. While I understand that this is not applicable to everyone, it does signify a first easy win on the FBM ability axis. From movement to well-being 44 Triggers in the FBM (Source: www.behaviormodel.org). MOTIVATION But Ill be honest; I wasnt completely motivated either. I was a decent amateur in cycling and running but I was definitely not going make a living from it. The need to make the papers has also waned over the years. Now I just want to beat my friends and stay in front of the pack during the annual Tour dAvans. This means that my motivation to exercise is less than that of a top athlete. In the BPM model I might even qualify for a spark trigger. These are triggers with a motivating element from the 3 core motivators of the FBM framework: Sensation (pleasure/pain), Anticipation (hope/fear) and Belonging (social acceptance/rejection). Fogg recognises that the first core motivator is not ideal to translate into triggers, especially with regard to pain. Despite this, I recently came across an example at the Innovation for Health conference in Rotterdam that headed in this direction: Posture by Jeffrey Heiligers (Posture, n.d.) is a shirt that starts to feel uncomfortable if you are not sitting up straight (Huijgevoort, 2015). Physiotherapy exercises are done to promote recovery. This can be connected to the second motivator in the FBM: anticipating hope or fear. In this context these words sound fairly laden, but from the perspective of positive health hope for recovery and the ability to exercise again are useful factors within persuasive design. The acce- lerometer and gyroscope in the smartphone measures movements and repetitions. The collected data provides insight into the patients progress and can also serve as input for providing positive feedback. Professor Brian Caulfield from University College Dublin won the 2015 Google Wearables in Healthcare Pilot Challenge with an appli- cation where a smartphone attached to the lower leg operates as a sensor to measure the performance of knee exercises. Direct visual feedback is given on an iPad in the form of an animation. In addition to supporting the exercises (ability), this app also has a motivational aspect through the feedback it provides. By using the smartphone as a sensor opportunities for gamification are created, where training parameters can be measured and used in game elements. GAMIFICATION Gamification is the application of game-design elements or game principles in a non-game context in order to positively stimulate hu- man behaviour through elements such as rewards, levels and avatars (Gamification, n.d.). Restraint is desired however. In the current de- sign the principle of less is more is leading, as the excessive use of game-design elements can create irritations in certain target groups. However, there are opportunities for certain target groups such as athletes who are more likely to take on a challenge. EXTERNE MOTIVATORS The rise of social media has added an interesting opportunity within persuasive design for the third core motivator in the FBM, Belonging. My partner would like me to continue exercising, thus, she can play a motivating role as well. Through Application Programming Inter- faces (APIs) an app can be connected to social media. It also offers the opportunity to connect to the physiotherapist. But, as soon as the app starts measuring, storing data and has access to the world, issues around privacy and health data legislation have to be addres- sed. SIMPLICITY The final trigger in the model is the signal. This trigger could be a simple reminder in cases of high motivation and ability. A profes- sional athlete is unlikely to need a stimulus. Fogg added several important caveats. The model is not complete in terms of motivation and behavioural change and motivation is, after all, not a constant but fluctuates with time regardless of the application of persuasive technology. Fogg also insists on simplicity in terms of ability. Techno- logy should make it simple and serve a supportive function. MAKING CHOICES Research (Sluijs E. M., 1993) has shown that levels of patient compli- ance is higher in elderly people than in younger people. But because use of technology is higher amongst younger people, this creates new opportunities for persuasive applications. Using young people as the primary target group for persuasive application is an obvious choice then. From the perspective of interactive design it is highly recommendable to select one defined target group per application. Different target groups require different interfaces and multimedia and will have different levels of acceptance of the technology used. Yet, the target group may be selected on quite a broad basis, as the age of acceptance is rising at a rapid pace. FUN Based on interviews with patients and physiotherapists, a group of Portuguese researchers formulated 6 concepts to support physio- therapy exercises in the home (Chandra, 2012). Motivation would be encouraged through the concepts of Understanding, Enjoyment, Results, Scheduling, Support and Peers. These concepts were presen- ted to the interviewees in the form of scenarios. While the results are limited, because of the small group that was interviewed, it has led to several interesting observations. Especially in terms of Motivation MOTIVE FOR MOVEMENT 45 and Enjoyment. On the one hand, patients see the exercises as a serious matter and that fun is not a necessary aspect of this, but in the long-term a game could help maintain and inspire the feeling of making progress. At the same time, however, people prefer to see the actual results of the exercises rather than being awarded badges in a game. One thing from this study is clear however: the target group is incredible diverse. ITERATION Real insight into whether a persuasive application is really working or not can only be retrieved if you can test a prototype with the target group. At Communication & Multimedia Design we use the design spiral. The objective is to quickly design and test a prototype to make multiple iterations in the design. The field of patient compliance and the technology required is too complex to find a solution after just 1 round of literature surveys and interviews. The patient, physiothera- pist and designer have to work on this together in a multidisciplinary approach. As long as the user is central in the design process, I be- lieve that truly useful applications will be designed that help improve patient compliance with physiotherapy exercises in the home. So, the next time I visit the physiotherapist, I hope that I can answer the question of whether Ive done my exercises with a resounding yes. Design spiral tijd (t) tijd (t) vraag/antwoord METHODIEK CMD BREDA / DEN BOSCH onderzoek/vertaling Verbeelding Definitie/evaluatie Evaluatie/Definitie Verkenning Concretisering Definitie/criteria (herziene)Criteria Opdracht/Aanleiding/Briefing Concept Model Prototype VERTALEN VAN VRAAGSTELLING NAAR IDEEËN ONDERZOEK NAAR AANSLUITING/MOGELIJKHEDEN VERTALEN VAN VRAAG NAAR CRITERIA ONDERZOEK NAAR CONTEXT VERTALEN VAN STRUCTUUR NAAR CONCRETE ERVARING ONDERZOEK NAAR CONCRETISERING VERTALEN VAN ERVARING NAAR HERZIENE CRITERIA ONDERZOEK NAAR BEVINDINGEN VERTALEN VAN IDEEËN NAAR VORM EN STRUCTUUR ONDERZOEK NAAR VORM EN STRUCTUUR VERTALEN VAN ERVARINGEN NAAR DEFINIËREN VAN HERZIENE CRITERIA. Sources - A smartphone will soon help you do physio exercises. (2013, September 8). Retrieved from The Journal: http://www.thejournal.ie/ucd-innovation-physio-app-smart- phone-1069221-Sep2013/ - Chandra, H. O. (2012) Designing to support prescribed home exercises: understanding the needs of physiotherapy patients. 7th Nordic Conference on Human-Computer Interaction: Making Sense Through Design (pp. 607-616). ACM. - Fogg, B. J. (2009). A behavior model for persuasive design. 4th international Conference on Persuasive Technology (p. 40). ACM. - Gamificatie. (n.d.). Retrieved from Wikipedia: https://nl.wikipedia.org/wiki/Gamificatie Huijgevoort, S. v. (2015, October 22). rtlZ. Retrieved from nederlandse-ontwerper-maakt-kle- ding-om-houding-achter-bureau-te-verbeteren: http://www.rtlz.nl/life/ nederlandse-ontwerper-maakt-kleding-om-houding-achter-bureau-te-verbeteren - Posture. (n.d.). Retrieved from http://www.jeffreyheiligers.nl/Posture-Women - Runkeeper. (n.d.). Retrieved from http://runkeeper.com/ Sluijs, E. M. (1993). Correlates of exercise compliance in physical therapy. Physical therapy, 73(11), 771-782. - Sluijs, E., & Knibbe, J. (1991, June). Patient compliance with exercise: Different theoretical approaches to short-term and long-term compliance. Patient Education and Counseling, pp. 191-204. - UCD connected health researcher wins 2015 Google wearables in healthcare pilot challenge. (2015, 28 April). Retrieved from UCD: http://www.ucd.ie/news/2015/04APR15/280415-UCD-connected-health-researcher-wins-2015-Google-wearables-in-healthcare-pilot-challenge.html - Van der Burgt, M., & Verhulst, F. (2014). Doen en blijven doen. Bohn Stafleu van Loghum. From movement to well-being 46 By Professor: John Dierx (Lector) It takes just a quick browse through media sources to come to the conclusion that movement is trending. Every week new articles about movement appear in the newspaper. Entire sections are dedicated to health, nutrition and movement. On TV you can zap between channels from one programme to the next that addresses being active or getting active, while social media motivates people to take part in exercise programmes. But what exactly does it all entail? A quick one-week overview of movement in the media. MOVEMENT = EXERCISE? If you keep an eye on media reports it quickly becomes clear that movement is often used synonymously with exercise. We can crea- te a global top 4 from these reports. Firstly, nearly all of the articles or news items talk about exercise as a way of staying healthy. According to Dutch news site RTL Nieuws, exercise tops the list of good inten- tions. This is reflected in other analyses as well. However, a change can now be observed in this perception. Dutch news website NU.nl declared in a headline that movement is important for strengthening bones. But, when you continue reading the article it becomes appa- rent that this conclusion is based on research about young people who play sports and who continued to do so as they got older. Yet, this article is accompanied by a photo of people cycling which sug- gests that movement is more than just sports alone. Provinces in the Netherlands are applying this new interpretation of movement as well, demonstrated by a tweet from the Knowledge Centre for Sport Netherlands. The Knowledge Centre indicates the website of Limburg province which has set aside a substantial budget to motivate people to cycle. Another Dutch news website Metronieuws.nl does exactly the opposite. An article on this news website reports that being active is not always easy but is a conscious choice in a busy lifestyle. Somewhat gender stereotypically, this article is aimed at the busy modern woman who has to take care of everything herself but still wants to look good too. Metronieuws.nl uses an image with this ar- ticle that suggests that gyms are the place to get the desired results, especially with the help of a personal trainer. The woman in the ima- ge does not exactly reflect the average woman in the district where I live... This gives rise to the question to what extent this message realistically applies to the daily reality of this target group. THE FUTURE BELONGS TO THE YOUTH Making exercise a habit for children means it is more likely to stay a standard activity in their adult lives. This can be seen in the number of posts on twitter and other social media about stimulating exercise in children. The focus in these posts is often on primary school child- ren. This group is easy to reach and easier to influence. The demand for more PE lessons at school taught by professional PE teachers is trending. Movement is also being stimulated in the classroom, which appears to improve academic performance. PERCEPTION OF MOVEMENT IN THE MEDIA MOTIVE FOR MOVEMENT 47 But how important do we truly gauge these extra PE classes to be? As soon as these extra classes are considered, counter-arguments immediately arise. It appears to be fairly complex to make PE classes part of the standard curriculum. The demand placed on primary schools is increasing and if choices need to be made, it is often PE classes or professional support that are axed first. In this context exercise is a choice in both the school curriculum and later in the busy life of a working adult. But are we not setting a bad example at the start then? Wouldnt it be beneficial to make exercise a habit at school? If this was done, exercise would no longer have to be planned in and we would no longer require preventative interventions through incenti- ves like putting a sticker on a card as a reward for doing exercise. It almost appears as if wed forgotten to be active throughout the day and to keep moving. Yet, if you read the websites and the tweets youd assume that we are aware of this and that we know that we need to change. Initiatives like cycling to work, moving at work and differently designing work stations attempt to stimulate movement. We are attempting to turn the tide knowing that a lack of exercise can lead to a rise in chronic diseases which, in turn, will lead to an increase in absenteeism from work. The older we get, the weaker our bones become and the more chance we have of breaking them. Nothing we can do about it... Or can we? Regular exercise strengthens our bones. (See NU.nl tex- tbox at the start of this article). Safety foundation Veiligheid.nl pro- motes exercise for elderly people. In addition to strengthening bones, exercise improves coordination which also reduces the risk of falling. This combination is essential for the elderly, as falling often results in hospitalisation, enhanced physical and mental ageing and, eventually, increased risk of social isolation. It then comes as no surprise that movement is promoted amongst the elderly. IN BRIEF We can conclude that the media is full of stories and articles about movement. In these pieces, movement is often associated with exercise but there is an increased understanding that its much more than just that. While movement is initially interpre- ted as a way to stay in shape and prevent obesity, it also includes mental and social movement. Movement helps you to relax at work and contributes to reducing sickness absence in the workplace. As we age, movement helps to prevent falls, resul- ting in increased social activity. So there are many reasons why you should get moving! Yet, it still appears to be necessary to highlight this in the media and movement is still not the norm. Motivating people to start moving and to keep moving is still a matter of falling and getting back up again - in both a literal and figurative way. The legs are the wheels of the soul Aristoteles From movement to well-being 48 Exercise is trending. All your friends are doing it. Everyone is talking about it. TV programmes and magazines tell you exactly what to do. Because its for your own good. You al- most start to feel guilty if youre not running at least 10 km 3 times a week or spend every waking hour in the gym. “Theres absolutely no need for this,” says John Dierx, Professor in the Living in Motion Research Group. “I am a biologist,” explains Dierx. “And I view the world from that perspective. When I consider the relationship between movement and health, I can see that we have taken it a step too far. We are spending hours in the gym and running like our lives depend on it, but we often do this because we feel like we have to, not because we want to. This is an approach that is bound to fail.” THE TEAM SPORT OF NEANDERTHALS The biologist dove into history and made his first stop at the Nean- derthals. At this period in time, the first gym was still a good 50,000 years away. “This was the time of the hunters. The Neanderthals had to move, otherwise there would be no food. Gathering food was a social activity as well and you shared in the responsibility of keeping your group alive. You could actually call it the first version of team sport. Farming, which is part of our more recent history, can be com- pared to this to some extent. Movement was still necessary and free time a luxury. Sports were a rarity. Nature still determined the routine, including what we ate and when. During the summer, humans would eat what the land provided and in the scarce winter months we mostly consumed fats. In times of plenty we stocked up in order to be prepared for times of hardship.” EXERCISING TO RATIO “This simple pattern of survival was changed by the industrial revo- lution. Since then, life has become easier. We physically had to move less and burned less calories, but we didnt reduce our food intake. And that ratio doesnt lead to the best results... Our body begins to signal to our brain that the extra kilograms have to come off and that the muscles need to get moving. So, we do what all our friends are doing and what the media tells us to do: go to the gym. Or we put on our running shoes and go and run 10 kilometres 3 times a week. Some people actually enjoy this, but the majority only do it because they feel they have to or because government health institutions say we should. People feel attacked and act in response to this pressure, instead of exercising because they want to. This means that exercise quickly becomes a burden or even a source of frustration for many people.” GOAL-ORIENTED THINKING According to Dierx, we should focus less on what we think we should do. “You often hear people say: I should exercise more, because its good for my health. But health shouldnt be a goal in and of itself! You have to ask yourself why you want to be healthy, that is what should motivate you. It might be that you want to look good or be- cause you want to remain fit when you get older, so that you can do things with your grandchildren. This is goal-oriented thinking which is about doing something not because you have to, but because you want to. Its about being honest with yourself. After all, the best way of achieving your goals is to do what suits you best in the phase of life in which you find yourself. Want to train for a marathon? Perfect. If you dont like to exercise. maybe walking is a great alternative for you. Dont like walking? Maybe take along your sister who you want to spend more time with anyway... Movement helps you get to whe- re you want to be. Sometimes we just make it too complicated for ourselves and we lose sight of the goal. By taking a new approach to exercising and asking what it is that moves you, you are likely to discover that the answers are closer than you think. It is as simple as playing with your children, gardening, taking a walk over lunch, holding bilateral consultations during a walk, holding standing meet- ings, taking the bicycle to town instead of the car or taking the dog for a walk. Each of these is incredibly easy to do. And whats more, its free. You could complete the circle with the statement that the Neanderthals moved to survive and that we move to live,” concludes Dierx. “Movement is and remains a necessity for every person as an individual but also for the group process. This group process is now also becoming apparent in health insurance. As a group, we all pay towards this with the assumption that we will make economical use of these facilities. But to what extent are we willing to pay for people who consciously choose to live a high-risk lifestyle? Solidarity clearly is and remains a factor. But now its about health expenses and policy excess instead of asking whether youve made a contribution to the hunt.” LUNCH WALK A NEW PERSPECTIVE OF MOVEMENT “STOP EXERCISING, GET MOVING” MOTIVE FOR MOVEMENT 49 From movement to well-being 50 STOP LOOKING, YOUVE BEEN FOUND WANTED: COLLABORATION AND/OR PROJECTS INVOLVING MOVEMENT. MOTIVE FOR MOVEMENT 51 THEME: JUST DO IT! WE ARE LOOKING FOR COLLABORATIONS AND PROJECTS IN WHICH: being and staying healthy is the basic principle the focus is on people between the ages of 18 and 67 the focus is on physical, mental and social movement thinking in terms of opportunities and assets is key technological aids are not avoided the search for effective elements is leading. WE ARE LOOKING FOR COLLABORATIONS AND PROJECTS IN THE FIELDS OF: The healthy district or the healthy municipality in which different disciplines play an active role: nursing physiotherapy healthcare technology mental healthcare welfare/social work communication and multimedia design. WE OFFER KNOWLEDGE AND EXPERIENCE IN THE FIELDS OF: multidisciplinary work society and culture working from an assets-based approach diagnostic and prognostic research web technology and natural interfaces evidence-based practice. JUST DO IT! The research group wants to assist working people and future workers to harness and intensify their own strengths to promote social participation and quality of life in the different phases of life. The research group motivates these people to take charge of becoming physically and/or mentally active. Will you help us take on that challenge? Please contact the Living in Motion Research Group: info.ecs@avans.nl +31 88 525 87 77 Vindt u ook dat kinderen met een lichamelijke beperking gewoon moeten kunnen sporten? De Esther Vergeer Foundation zet zich met het project Join the Club in om kinderen en jongeren met een lichamelijke beperking te laten sporten bij verenigingen in de buurt waar ze wonen. Iedere donatie, groot of klein, levert een bijdrage aan onze projecten. Op onze website http:// esthervergeerfoundation.nl/steun-ons/ vindt u verschillende mogelijkheden om een bijdrage te doen. Alvast dank! STEUN ONS! SUPPORT US! Do you believe that children with a physical disability should be given every opportunity to enjoy taking part in sports? The Esther Vergeer Foundation is dedicated to help children and young people with a physical disability take part in sports at sports clubs in their own neighbourhoods with the Join the Club project. Any donation, big or small, will help us with these projects. Visit our website esthervergeerfoundation.nl/steun-ons to see the different options available for making a contribution. Thank you for your support! MOTIVE FOR MOVEMENT 51 THEME: JUST DO IT! WE ARE LOOKING FOR COLLABORATIONS AND PROJECTS IN WHICH: being and staying healthy is the basic principle the focus is on people between the ages of 18 and 67 the focus is on physical, mental and social movement thinking in terms of opportunities and assets is key technological aids are not avoided the search for effective elements is leading. WE ARE LOOKING FOR COLLABORATIONS AND PROJECTS IN THE FIELDS OF: The healthy district or the healthy municipality in which different disciplines play an active role: nursing physiotherapy healthcare technology mental healthcare welfare/social work communication and multimedia design. WE OFFER KNOWLEDGE AND EXPERIENCE IN THE FIELDS OF: multidisciplinary work society and culture working from an assets-based approach diagnostic and prognostic research web technology and natural interfaces evidence-based practice. JUST DO IT! The research group wants to assist working people and future workers to harness and intensify their own strengths to promote social participation and quality of life in the different phases of life. The research group motivates these people to take charge of becoming physically and/or mentally active. Will you help us take on that challenge? Please contact the Living in Motion Research Group: info.ecs@avans.nl +31 88 525 87 77
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