Pharaon: Some preliminary conclusions from AdSysCo and Christiane Grünloh

Last year Christiane Grünloh was interviewed by Dirk Winkel, Manager of Marketing, Communication & Sales at AdSysCo to talk about the Pharaon project. Below is a repost of this interview (https://adsysco.nl/pharaon-enkele-voorlopige-conclusies/).

 

In early 2020, at the initiative of the European Commission, the Pharaon project started. Pharaon aimed to explore the extent to which digital technologies can support the lives of older people. In Pharaon, AdSysCo participates with the RegiCare customer portal. A higher quality of life with digital discoveries, that's what it's all about.

The Pharaon study will be completed at the end of 2024. So it's too early for final conclusions, but there are already some preliminary. This is evident from a conversation we had with Dr. Christiane Grünloh, senior researcher at RRD and responsible for the smooth running of the six Pharaon pilots. Christiane has long been researching the adoption of technology solutions in healthcare. 

In these six pilots in five countries, all sorts of different technologies are being tried ranging from sensors that monitor people's safety to various forms of video calling via TV. In some care organizations, robots are being tested. In the Netherlands, the emphasis is on social contact around the outings of the PlusBussen of the National Fund for the Elderly. The RegiCare customer portal supports these social activities with digital contact. 

Just after Pharaon started, the COVID-19 pandemic erupted. "This risk was not foreseen in any project plan," said Christiane, "Due to the new measures, our target group (older adults who may be vulnerable) was almost immediately inaccessible to researchers in all countries, at least physically, while the research requires a lot of interaction with the target group." Delay was not an option for the EU, after all, everyone had committed to the program. Besides, Pharaon is all about information and communication technology, so researchers and designers are also creative to explore other ways to interact with people.

The kick-off meeting was still held in-person in Pisa, but after that Pharaon played out behind (boring) computer screens for two years. Due to the pandemic, the recruitment of older adults for the study got off to a slow start. All in all, the Pharaon study has to make do with a limited number of participants, and this applies to all pilots. For quantitative research, this presents a challenge, so more effort has also been put into qualitative research such as interviews. "Of course it is not great to have fewer participants than promised in the research proposal. But there is also an opportunity to go more into depth. Why do people participate or not? What challenges do they run into in their daily lives when they have to start using technology. These insights are super important," Christiane says.

 

Development for and with users

People in healthcare and welfare also had a high workload during the pandemic and hardly any additional capacities available. In addition to the pandemic, doubts against the use of technologies also played a role in many places. "I don't know it", "it doesn't work", "I don't get it" and "what's in it for me?". In Pharaon, we came across all kinds of arguments to not use a solution, and they were all justified. 

Technology can improve care and also make it more efficient and cheaper, Christiane knows, but it has to be developed for and with the users to take their needs into account, and that's often the crux of the matter. "I don't know it", "it doesn't work", "I don't get it" and "what's in it for me?" is well known. Close end-user involvement in the design and step-by-step building and testing of a digital solution for care and well-being is necessary to reduce these problems. "If we develop technology together with the target group and thereby ensure that it really connects with users' needs and values, we can increase acceptance, stimulate use and ultimately have effect and impact," Christiane has learned from her many research projects.

 

Development of RegiCare

AdSysCo recognizes this well. New developments in the RegiCare suite, such as the mobile applications and the customer portal, are developed for and with users. This also applies to the implementation: active involvement and ownership of users is a key success factor. Simply making a nice solution with lots of functionality available without actively involving the end-user in the how, the what and the why misses the mark. "Not the technical solution but the user experience determines success" says Christiane. "It does take more time, but do you want a cheap solution that doesn't work or a slightly more expensive solution that does?" she says smiling.

Once the research is complete, there will be a follow-up conversation between AdSysCo and Christiane.

SenSeeAct is now open-source: allowing digital health developers to benefit from and build on top of our software platform

Written by: Dennis Hofs

 

We have just released the first open-source version of SenSeeAct, our software platform that has driven many of our research projects and applications for more than ten years. During that time the platform has gone through several iterations, growing into a mature, flexible and secure backend with web portals and mobile apps.

The name SenSeeAct reflects the functionalities that the platform focuses on.

 

Sense: Collecting data through questionnaires, diaries, wearables, and smart home devices.

See: Presenting the data in user-friendly ways to both end users and health care professionals.

Act: Coaching users toward healthier behaviour with virtual agents, video exercises and gamification.

 

We now published the SenSeeAct backend as open-source software to help stimulate health technology innovation and collaboration. It facilitates the development of new applications by third parties, and enables organizations to take full control of their data ownership and access.

senseeact_app_portal

We are continuously improving the platform. Some of the new features that we anticipate in the near future are:

  • Enhanced support to author your own questionnaires and use them in our mobile app with your own backend.
  • Improved security with two-factor authentication.
  • A web interface to download your data or the data of your research participants.
  • A major update of our iOS app bringing it to the same level as the Android app.
  • Extending our earlier announced collaboration with DialogueBranch toolkit by Fruit Tree Labs.
  • More documentation and guides to help you get started with the open-source backend.

Read more about it at https://www.senseeact.com/?lng=nl

 

FOTO ERIC BRINKHORST

Dennis Hofs

Email: d.hofs@rrd.nl

Tel: 088 087 5763

 

Major research starts to tackle osteoarthritis on a tailor-made basis

By 2040, osteoarthritis is likely to be the most common chronic disease in the Netherlands. Currently, almost 1.5 million people in our country have osteoarthritis. The nature and extent of the symptoms may vary, but they always have an impact on people’s daily life. Osteoarthritis progresses differently for everyone, which requires tailor-made treatment. In order to be able to offer this as good as possible, insight is needed into the characteristics of the person and the disease process. Until now, that insight has been lacking. But this is about to change thanks to the funded research efforts of a unique partnership.

In November, researchers from the Interdisciplinary Consortium for Clinical Movement Sciences & Technology (ICMS) will start with the TopTreat project. They will follow 500 people with osteoarthritis over the next five years and will comprehensively map their characteristics. The aim is to gain insight into who qualifies for which treatment. The reason for this is because universal treatment is not effective for everyone due to the fact that the diversity among people with osteoarthritis is quite large.

 

Measuring and knowing precisely with a unique technology platform

This is the first time that the various manifestations of osteoarthritis are being measured with advanced technology and collected in a platform. The aim is to map extremely accurately how people with osteoarthritis feel, how they move, how their disease develops and which medicine is most effective for whom. Because physical, psychological and social factors all play a role in health, researchers are looking at the whole spectrum, from cell to well-being, and are conducting the study in consultation with the patients themselves. The insights from the study make it possible to optimally tailor treatment to the person with osteoarthritis. 

The promise of improvement

The research includes existing technologies such as 'joint-on-a-chip', accurate measurements of substances in the body that are indicative of the disease (biomarkers), analysis of movement with sensors, and making computer models of joint movement and load on cartilage. In doing so, the researchers aim to understand and capture specific characteristics of people with osteoarthritis. Based on these insights, practitioners can determine the most promising treatment for their patient.

Broad inclusion

Besides people with advanced osteoarthritis, two groups with an increased risk of osteoarthritis formation will also participate in the study. These are people with a broken or removed meniscus or with a leg amputation.

Moving forward together

TopTreat has a significant relevance for the progress of care of people with osteoarthritis. Moreover, the project is expected to develop a technology platform that is patent-worthy, and can be quickly translated into more healthcare applications. With this ambitious project, ICMS aims to maximise clinical and societal progress.

About ICMS

The Interdisciplinary Consortium for Clinical Movement Sciences & Technology (ICMS) is a unique partnership between RadboudUMC, Sint Maartenskliniek, Roessingh Research and Development and the TechMed Centre of the University of Twente. In TopTreat, these partners work together with ReumaNederland, the companies ATRO Medical and Moveshelf, the Rheumatism Foundation Sint Maartenskliniek, the Twente Graduate School and the Dutch Ministry of Defence. Together with funding from the Top Consortium for Knowledge and Innovation High-tech Systems & Materials, the project involves about EUR 4.8 million.

Roessingh Research and Development and Fruit Tree Labs announce formal collaboration

Summary:

  • Roessingh Research and Development, Impact Lab for Personalised Health Technology in the Netherlands and Fruit Tree Labs, a Portuguese start-up focused on open-source dialogue technology sign a partnership agreement.
  • The agreement formalizes years of existing friendly relations between the two parties.
  • Collaboration paves the way for a deeper integration of two important software platforms: SenSeeAct, the general-purpose eHealth platform by RRD and DialogueBranch, the dialogue-scripting platform by FTL.

 

The fourth quarter of 2023 begins with the happy news of an official collaboration between Roessingh Research and Development and Fruit Tree Labs.

Roessingh Research and Development (RRD) is an Impact Lab for Personalized Health Technology, based in the eastern part of the Netherlands, with close connections to the University of Twente and Roessingh Center for Rehabilitation. RRD provides scientific research on innovative healthcare technology with a focus on the end user. For RRD, co-creation with end users and stakeholders is essential to ensure the innovation meets user needs and fits into the healthcare context.

Fruit Tree Labs (FTL) is a start-up, founded early in 2023 in the Lisbon Metropolitan Area, focused on dialogue-driven interaction. The core product of FTL is a free and open-source dialogue platform that gives complete freedom and creative control to author-scripted conversations between users and virtual agents in serious web- or mobile application contexts.

CEO and Co-Founder of Fruit Tree Labs, Harm op den Akker has started his career working for RRD, obtaining his PhD degree through the University of Twente, and moving into a Senior Researcher position, strengthening the HCI-focused research at RRD between 2013 and 2021. Since then, relations have always remained warm, and collaborations continued through the co-development of open-source software. With the official collaboration agreement that is now in place, these friendly relations are now formalized in a long-lasting partnership.

For both parties, the partnership agreement comes at an exciting and fun time, as both RRD and FTL embark on new adventures in the open-source software community. RRD is in the process of publicly releasing its eHealth platform "SenSeeAct", allowing digital health developers to benefit from and build on top of a highly professional and stable software platform. At the same time, FTL recently launched the DialogueBranch platform made public (fully open-source and MIT licensed) and is looking for new partners and collaboration and funding opportunities.

With the new agreement in place, both parties commit to integrating these two open software platforms, strengthening the offering from both sides and opening new opportunities for potential users of either platform. Are you looking for a stable, highly customizable Digital Health platform, with integrated virtual agent capabilities? The combination of SenSeeAct and DialogueBranch might just be the thing for you!

 

 

Festive farewell to prof. dr. Jaap Buurke

Last week on September 7, we said goodbye to prof. dr. Jaap Buurke, together with family, friends and (former) colleagues from the field.

After working at RRD for more than 30 years, we ushered the retirement of Jaap Buurke. Jaap started his career on September 19th, 1983 as a conscientious objector within Roessingh, centre for Rehabilitation. After completing his conscientious objector period, Jaap started working as a physiotherapist at the rehabilitation centre on May 1st, 1985. Two years later, Jaap started working in the Research & Innovation Department for 18 hours a week. For a long time, he combined his career as a physiotherapist with work as a researcher at RRD.

In 2005, Jaap obtained his PhD on research into the recovery of walking after a stroke. This research formed an important basis for the introduction of neurorehabilitation principles in the Netherlands and the start of successful courses in gait image analysis that are still provided by RRD and Roessingh, Centre for Rehabilitation. On 1 May 2008, Jaap made the full transition to RRD and became a senior researcher there and had a bridging function with the rehabilitation centre. A year later, he became cluster manager and has been a manager within RRD for many years.

In many (inter)national research projects, Jaap focused on further developing rehabilitation technology and gait analysis. He combined these tasks with a position as professor at the University of Twente (UT) in the field of movement analysis and technology. From this position, he supervised many researchers in their PhD trajectories. In addition to his work at RRD and UT, Jaap's positions included adjunct professor at North Western University in Chicago, medical scientific director of IMDI SPRINT, board member of SMALLL and president of the Dutch association for Neurorehabilitation "Keypoint".

Jaap has marked his retirement from RRD, but he will continue to be involved in various courses in gait image analysis in the coming year.

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Scale-Up4Rehab: Important step forward in digitalisation rehabilitation sector

To ensure equal access to rehabilitation care and promote the resilience of health systems across Northwest Europe, a new 5-year project is being launched.

Scale-Up4Rehab will take a major step forward in the digitisation of the rehabilitation sector by being the first to build an open virtual rehabilitation "clinic," which will scale up existing virtual rehabilitation therapies. In five regional pilots (NL/DE/IR/BE/LU), acting as showcases, rehabilitation professionals in different care settings will integrate virtual rehabilitation into their daily practice.

Why is digitalisation in rehabilitation needed?

Remco Hoogendijk, Manager Projects & Innovation Sint Maartenskliniek (The Netherlands): "Access to rehabilitation is unequal, both between and within countries. Technology offers the opportunity to provide efficient care and access to dedicated rehabilitation care, regardless of patient location. Various forms of rehabilitation therapy using virtual technologies are already taking place. However, these digital applications are used only in local settings and economies of scale are not being exploited. Transnational collaboration is needed to achieve these economies of scale and take the digital transformation of the rehabilitation sector to the next level."

Rehabilitation plays an important role in improving the health and well-being of the population and the overall efficiency and sustainability of health systems. With an aging population, the number of people in need of rehabilitation will increase while there is a shortage of health care personnel.

Partners in this new project

Partners in achieving equal access to rehabilitation care and promoting the resilience of health systems throughout Northwest Europe are:

  • Rehabilitation clinics and university medical centers: St. Maartens Clinic, St. Mauritius Therapieklinik, Centre National de Rééducation Fonctionnelle et de Réadaptation, Roessingh Research and Development, University College Dublin, School of Public Health, Physiotherapy and Sports Science, University College Cork, Discipline of Physiotherapy, School of Clinical Therapies, Radboudumc Department of Rehabilitation, UniKlinik RWTH Aachen.
  • Universities, specializing in engineering and computer science research and development: University of Lille, University of Tilburg.
  • Innovation Networks: In4care, Health Valley Netherlands, Eurasanté.

Additionally, we will set-up a group of associated organisations, interested to follow the project, including:

  • Teeside University
  • XR4Rehab collaborative network
  • EIT Health Belgium-Netherlands
  • Shift Medical
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20230907 scaleup4rehab (2)
For additional information about our role in Scale-Up4Rehab, you can contact Stephanie Jansen-Kosterink:
FOTO ERIC BRINKHORST

Stephanie Jansen-Kosterink

Email: s.jansen@rrd.nl

Tel: 088 087 5717

Scale-Up4Rehab obtained a grant of € 6.5 million from Interreg North West Europe
scale up 4rehab europa

Interested in a database full of IMU and EMG data? We present the RRD MyPredict database

Written by: Erik Prinsen

 

Over the past five years, Roessingh Research and Development (RRD) participated in the H2020 MyLeg project (http://www.myleg.eu), coordinated by Raffaella Carloni from the University of Groningen. Within this project, RRD was responsible for the high-level control of a to be developed powered transfemoral prosthesis. The ultimate goal of the project was to create a smart and intuitive prosthesis that was compatible with osseointegration. In adherence to the FAIR principles, all data that was gathered on individuals without an amputation have now been published as open access. We also published an open access article that describes the data which can be found here: https://www.nature.com/articles/s41597-023-02341-6. In this article we explain what we did, what the database is and where it can be found.

 

Intent recognition using EMG

Surface electromyography (sEMG) is a non-invasive technique that could provide meaningful information for human motor intent recognition. Motor intent is the determination to move or change the state one is in. For instance, when we are approaching a staircase, we adapt our steps in such a way that we position our feet perfectly to ascent the steps. This intent can be captured using the signals that command our muscles to contract, precisely what sEMG records and analyzes.

 

The need for a lot of data

There are downsides to sEMG as well. sEMG suffers from confounding factors such as muscle fatigue, electrode placement differences and intra-subject variability. This means that a control schema that utilizes sEMG could work on one day, but could yield poor results on the next day. Therefore, a lot of data is necessary to capture the variability of sEMG between subjects and between days to develop robust human motor intent recognition systems. Furthermore, detecting the change from one activity to another is harder than detecting a continuation of the activity. Therefore it is necessary to have databases that are rich in these transitions so that algorithms can be trained properly.

 

The RRD MyPredict database

In the past three years we have collected the Roessingh Research & Development-MyLeg Database for activity prediction (MyPredict), containing data from 55 subjects in 85 measurement sessions. These subjects performed all kinds of gait-related activities, including regular walking, traversing uneven terrains like grass, and climbing stairs, while transitioning freely from one activity to the next. During these measurements we collected kinematics and sEMG in various forms, using traditional bipolar sEMG as well as 64 channel multi-array sEMG.

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20230725_Robert data (1)

The data it contains

We have made use of wearable measurement systems, enabling us to measure easily inside the laboratory, but also outside. In this way we have a rich dataset containing gait activities in various settings. Next to that, we have measured 10 subjects on four different days in the span of one week. These measurements enables researchers to explore the impact of time and electrode placement on intent recognition systems, a critical aspect in improving the robustness and adaptability of these systems.

 

Data validation

An essential validation step involved comparing the MyPredict database with other publicly available datasets. The results of this comparison demonstrated excellent correlation, confirming the reliability and quality of the MyPredict database. In this way we have shown that this database can be a valuable resource to the research community.

 

What it can be used for

The MyPredict database provides an opportunity for researchers to delve into sEMG data and develop and refine intent recognition systems. This comprehensive dataset offers a foundation for further studies in the field of human motor intent recognition. Researchers can explore innovative algorithms, machine learning techniques, and signal processing methodologies to unlock the full potential of sEMG data. Ultimately, it is the goal to develop practical applications that utilize sEMG signals to enrich human-machine interactions.

 

Where to find it

The database is accessible via this link: https://doi.org/10.4121/20418720. Data collection was supported by the European Union's Horizon 2020 Research and Innovation Programme grant number 780871.

Erik Prinsen

Erik Prinsen

Email: e.prinsen@rrd.nl

Tel: 088 087 5761

STRIDER: new project to improve mobility of stroke survivors

Written by: Christiane Grünloh

 

We are excited to announce that we started a new project together with two partners: Elitac Wearables (Utrecht, The Netherlands) and cereneo foundation (Vitznau, Switzerland).

What is our goal and why is this important?

Worldwide, we have 80 million stroke survivors and every year 14 million people are experiencing a stroke. This often comes with movement impairment and a lack of balance confidence, which are addressed during the rehabilitation. We want to support this rehabilitation and the transition from in-patient rehabilitation to home by building a wearable that gives haptic feedback (for example, a vibration) to the stroke survivor while walking. This feedback will improve their gait and balance confidence already during and also after rehabilitation. We want to help stroke survivors stay confident and active also after being discharged from rehabilitation.

 

How do we do it?

As always at RRD, the people are central to everything we do. Stroke survivors are experts when it comes to living with the consequences of stroke. The design of a feedback device needs to be informed by what stroke survivors need, what works for them and what does not. Therefore, we will carry out workshops and interviews with stroke survivors both in the Netherlands and in Switzerland by our partner cereneo. In addition, we will also interview healthcare professionals, to ensure that STRIDER is well aligned with their work practices and the patient journey, going from rehabilitation centre back home. The technology will be developed in iterations, and we will test early version with stroke survivors to learn quickly, if we get it right and what needs to improve. At the end, we will carry out a study to show that STRIDER indeed improves gait and balance confidence.

 

Where are we in the project?

The project has a duration of 2 years and we started about two months ago in the beginning of May 2023. We are currently carrying out the first workshops with stroke survivors in the Netherlands and Switzerland. More workshops will follow and during the summer we will conduct interviews with stroke survivors and healthcare professionals.

Are you a stroke survivor and interested in this project? Either because you want to be informed or because you want to be interviewed by us? You can always contact us!

Tijdlijn onderzoeken strider project - 20230718 Dutch
Christiane Grünloh

Christiane Grünloh

Email: c.grunloh@rrd.nl

Tel: 088 087 5723

FOTO ERIC BRINKHORST

Marian Hurmuz

Email: m.hurmuz@rrd.nl

Tel: 088 087 5771

In-depth course Gait Image Analysis

Written by: Corien Nikamp

 

Over the past few months, we have, together with colleagues from Nijmegen (Sint Maartenskliniek, Loop Expertise Centrum Nijmegen), been working hard on a new course for everyone who wants to take an extra step in the field of gait image analysis! Do you work in or frequently refer to a gait imaging lab and would you like to gain more knowledge and skills in terms of performing, analysing and understanding the results? Then this in-depth course might be suitable for you!

In January 2024, we will start the in-depth course Gait Image Analysis. During this course, there will be ample opportunity to apply theory directly in practice in the form of active work forms. To participate in the course, you must have attended the course “Movement Analysis in Adults”, at Roessingh Research and Development, or a similar basic course elsewhere.

Would you like to read more about this course or participate? Click here to go the website. Registration will open soon!

20230718 Flyer Verdiepingscursus gangbeeldanalyse 2024 (1)
Corien Nikamp

Corien Nikamp

Email: c.nikamp@rrd.nl

Tel: 088 087 5762

Moving personalised health technology forward: Understand, Create and Impact

Written by: Erik Prinsen

Roessingh Research and Development (RRD) is an impact lab for personalised health technology. Through innovative health technology, RRD contributes to prevention, self-management and optimal participation in society. For RRD, the starting point always is the end-user and the context of use to ensure that innovations meet the user needs and fit the healthcare context. How do we do it? In this blogpost we will introduce the new structure of RRD and highlight our main expertise and research focus.

 

Old wine in new bottles?

Over the past year, we have refined the focus of RRD. Where we used to focus on rehabilitation technology and eHealth as separate themes, we decided to merge these themes and focus on personalised health technology. Within personalised health technology we typically act as the social sciences and humanities (SSH) partner. Our starting point for the development, application and/or evaluation of personalised health technology is always the user and the context of use. We believe that this is essential for impactful personalised health technology and as such contributes to sustainable healthcare. To tackle these challenges, the researchers of RRD work in three flexible teams: Understand, Create and Impact. In the following sections, these teams are introduced.

Understand_NL_Understand - Copy
Create_NL_Create_Create
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Understanding the user and the context

Team Understand performs research to understand the user needs and requirements and the context of use as input for the development of personalised health technology. The starting point for this is our strong base of health-specific knowledge. Researchers in this team use movement analysis, patient journeys and service modelling to gain knowledge about the user’s health status and their interaction with health technology across all levels: in the persons themselves, in their daily life and in the society at large. This knowledge informs which and how health technology can contribute to the prevention, self-management and participation of its user.

 

Create tools to understand users and measure impact

To understand the user and the context of use and being able to measure the impact of personalised health technology, we need to collect data in everyday life. Team Create is working on several applications for this specific purpose. Over the years, RRD has developed its own research data platform called SenSeeAct. The SenSeeAct platform consists of the data platform itself, a web-portal and several Android and iOS applications that run on the data platform. These applications are developed in-house to give feedback to the user, therapist and/or physician. It can also be used to push questionnaires or act as a diary. Next to the SenSeeAct platform, RRD has also developed its own software for ambulant movement analysis with inertial sensors. The strength of this application is its flexibility as it can be adapted to specific use cases. In addition, researchers can have access to the raw measurement data.

 

Measuring the impact

Team Impact has extensive experience and expertise in measuring the impact of (early prototypes of) personalised health technology on its users and the society. Our expertise ranges from formative usability tests (starting level TRL-4) to GCP-compliant multicenter trials that are conducted within the scope of the Medical Device Regulation (MDR) (TRL-9). We have extensive experience in conducting randomized controlled trials. Next to this, we also have expertise in innovative research designs, such as the cohort multiple randomized controlled trial (cmRCT) that may be a better fit in the context of technology development. Besides looking at the impact of technology on its users, we also study the effect of technology on the society by using the Societal Return of Investment (SROI) methodology. With the SROI we can help organisations to understand and quantify the social, environmental and economic value that they are creating with their innovation.

 

All well that ends well

We strongly feel that the restructuring that we did over the past year has helped to shape the story of RRD in a much clearer way and prepare RRD to move towards the future. This doesn’t mean that we will stop moving forwards. We will continue to expand our expertise and knowledge through new innovation projects. Besides offering our expertise in research projects, we also offer our expertise for companies. We can perform a market analysis, give feedback to technology concepts, set-up and perform focus groups for personalised health technology, use of the research data platform for research projects, perform usability tests and perform (clinical) evaluation.

Does the profile of RRD fit with your research proposal or is the expertise of RRD a good fit in your innovation idea? Please do not hesitate to contact us as we love to share our story!

Erik Prinsen
Erik Prinsen Email: e.prinsen@rrd.nl Tel: 088 087 5761
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