A growing body of evidence indicates that natural environments can positively influence people. This study investigated whether the use of motion nature projection in computed tomography (CT) imaging rooms is effective in mitigating psycho-physiological anxiety (vs. no intervention) using a quasirandomized experiment (N ¼ 97). Perceived anxiety and pleasantness of the room were measured using a questionnaire, and physiological arousal was measured using a patient monitor system. A mediation analysis showed that motion nature projection had a negative indirect effect on perceived anxietythrough a higher level of perceived pleasantness of the room. A linear-mixed-model showed that heart rate and diastolic blood pressure were lower when motion nature was projected. In conclusion, by creating a more pleasant imaging room through motion nature projection, hospitals can indirectly reduce patient's psycho-physiological anxiety (vs. no image projection) during a CT scan.
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BACKGROUND: Muscle quantity at intensive care unit (ICU) admission has been independently associated with mortality. In addition to quantity, muscle quality may be important for survival. Muscle quality is influenced by fatty infiltration or myosteatosis, which can be assessed on computed tomography (CT) scans by analysing skeletal muscle density (SMD) and the amount of intermuscular adipose tissue (IMAT). We investigated whether CT-derived low skeletal muscle quality at ICU admission is independently associated with 6-month mortality and other clinical outcomes.METHODS: This retrospective study included 491 mechanically ventilated critically ill adult patients with a CT scan of the abdomen made 1 day before to 4 days after ICU admission. Cox regression analysis was used to determine the association between SMD or IMAT and 6-month mortality, with adjustments for Acute Physiological, Age, and Chronic Health Evaluation (APACHE) II score, body mass index (BMI), and skeletal muscle area. Logistic and linear regression analyses were used for other clinical outcomes.RESULTS: Mean APACHE II score was 24 ± 8 and 6-month mortality was 35.6%. Non-survivors had a lower SMD (25.1 vs. 31.4 Hounsfield Units (HU); p < 0.001), and more IMAT (17.1 vs. 13.3 cm(2); p = 0.004). Higher SMD was associated with a lower 6-month mortality (hazard ratio (HR) per 10 HU, 0.640; 95% confidence interval (CI), 0.552-0.742; p < 0.001), and also after correction for APACHE II score, BMI, and skeletal muscle area (HR, 0.774; 95% CI, 0.643-0.931; p = 0.006). Higher IMAT was not significantly associated with higher 6-month mortality after adjustment for confounders. A 10 HU increase in SMD was associated with a 14% shorter hospital length of stay.CONCLUSIONS: Low skeletal muscle quality at ICU admission, as assessed by CT-derived skeletal muscle density, is independently associated with higher 6-month mortality in mechanically ventilated patients. Thus, muscle quality as well as muscle quantity are prognostic factors in the ICU.TRIAL REGISTRATION: Retrospectively registered (initial release on 06/23/2016) at ClinicalTrials.gov: NCT02817646 .
Objectives: The aim of this study was to assess the predictive value of PMA measurement for mortality. Background: Current surgical risk stratification have limited predictive value in the transcatheter aortic valve implantation (TAVI) population. In TAVI workup, a CT scan is routinely performed but body composition is not analyzed. Psoas muscle area (PMA) reflects a patient's global muscle mass and accordingly PMA might serve as a quantifiable frailty measure. Methods: Multi-slice computed tomography scans (between 2010 and 2016) of 583 consecutive TAVI patients were reviewed. Patients were divided into equal sex-specific tertiles (low, mid, and high) according to an indexed PMA. Hazard ratios (HR) and their confidence intervals (CI) were determined for cardiac and all-cause mortality after TAVI. Results: Low iPMA was associated with cardiac and all-cause mortality in females. One-year adjusted cardiac mortality HR in females for mid-iPMA and high-iPMA were 0.14 [95%CI, 0.05–0.45] and 0.40 [95%CI, 0.15–0.97], respectively. Similar effects were observed for 30-day and 2-years cardiac and all-cause mortality. In females, adding iPMA to surgical risk scores improved the predictive value for 1-year mortality. C-statistics changed from 0.63 [CI = 0.54–0.73] to 0.67 [CI: 0.58–0.75] for EuroSCORE II and from 0.67 [CI: 0.59–0.77] to 0.72 [CI: 0.63–0.80] for STS-PROM. Conclusions: Particularly in females, low iPMA is independently associated with an higher all-cause and cardiac mortality. Prospective studies should confirm whether PMA or other body composition parameters should be extracted automatically from CT-scans to include in clinical decision making and outcome prediction for TAVI.
Erasmus project about training cultural workers for facilitating rural youths culture
MUSE supports the CIVITAS Community to increase its impact on urban mobility policy making and advance it to a higher level of knowledge, exchange, and sustainability.As the current Coordination and Support Action for the CIVITAS Initiative, MUSE primarily engages in support activities to boost the impact of CIVITAS Community activities on sustainable urban mobility policy. Its main objectives are to:- Act as a destination for knowledge developed by the CIVITAS Community over the past twenty years.- Expand and strengthen relationships between cities and stakeholders at all levels.- Support the enrichment of the wider urban mobility community by providing learning opportunities.Through these goals, the CIVITAS Initiative strives to support the mobility and transport goals of the European Commission, and in turn those in the European Green Deal.Breda University of Applied Sciences is the task leader of Task 7.3: Exploitation of the Mobility Educational Network and Task 7.4: Mobility Powered by Youth Facilitation.
In tijden van toenemende culturele diversiteit en arbeidsonzekerheid hebben jongeren in Nederlandse en Duitse stadswijken grote behoefte aan richting met betrekking tot hun toekomstige leven. Ouders en leraren lijken zelf vaak te worden overweldigd door de snel veranderende wereld waarin ze leven. Naast deze veranderingen neemt het gebruik van sociale media sterk toe, waardoor de al bestaande generatiekloof nog groter wordt. Deze ontwikkelingen hebben grote gevolgen voor de levensloopperspectieven van jongeren en leiden er vaak toe dat ze meer dan ooit richting zoeken bij hun leeftijdgenoten. In plaats van dit te zien als een problematische situatie, is dit project erop gericht de netwerken van jongeren te gebruiken als bron voor verbetering van de stadswijken. Het basisidee is jonge adolescenten (in de leeftijd van 12-14 jaar) te empoweren via bepaalde leeftijdgenoten die al gerespecteerd, verantwoordelijk en stabiel in het leven staan. Deze ‘homies’ (vier Nederlandse en vier Duitse jongeren) worden getraind en begeleid door experts op het gebied van oplossingsgericht denken en inspirerende communicatie. Daarna gaan de homies aan de slag in hun eigen wijk, waar ze drie maanden actief zullen zijn. De meeste communicatie met hun leeftijdgenoten zal verlopen via mobiele communicatie en sociale medianetwerken. In het begeleidende onderzoek wordt een analyse gemaakt van de leefsituatie van jongeren in de geselecteerde wijken voor en na de tussenkomst van de homies. De homies houden zelf een (mobiel) dagboek bij dat inzicht zal bieden in hoe zij zelf de veranderingen bij de jongeren in hun wijk zien.
