The objective of this study was to perform a systematic review on training outcomes influencing physical fitness, activity of daily living performance, and quality-of-life in institutionalized older people. We reviewed 27 studies on older people (age, ≥70 yrs) in long-term care facilities and nursing homes. Our ultimate goal was to propose criteria for an evidence-based exercise protocol aimed at improving physical fitness, activity of daily living performance, and quality-of-life of frail institutionalized older people. The interventions, described in the reviewed studies that showed strong or very strong effect sizes were used to form an exercise prescription. The conclusion is that there is firm evidence for training effects on physical fitness, functional performance, activity of daily living performance, and quality-of-life. The training should contain a combination of progressive resistance training, balance training, and functional training. The proposed intensity is moderate to high, assessed on a 0-10 scale for muscle strengthening activities. The training frequency was three times a week, and the total duration was at least 10 wks. PMID:20881587 doi: 10.1097/PHM.0b013e3181f703ef
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Objective: To explore the nature and extent of possible residual complaints among Dutch hypothyroid patients using thyroid replacement therapy, we initiated a comprehensive study measuring health-related quality of life (QoL), daily functioning, and hypothyroidism-associated symptoms in patients and control persons. Methods: An online survey measuring thyroid-specific QoL (ThyPRO), daily functioning, and hypothyroidismassociated symptoms (ThySHI) was distributed among treated hypothyroid patients and control individuals. The advertising text was formulated in an open-ended manner. Patients also provided their most recent thyroid blood values and their thyroid medication. Results: There was a large-sized impairment of QoL (Cohen’s d = 1.04, +93 % ThyPRO score) in hypothyroid patients on thyroid replacement therapy (n = 1195) as compared to controls (n = 236). Daily functioning was significantly reduced i.e., general health (-38 %), problems with vigorous- (+64 %) and moderate activities (+77 %). Almost 80 % of patients reported having complaints despite thyroid medication and in-range thyroid blood values, with 75 % expressing a desire for improved treatment options for hypothyroidism (total n = 1194). Hypothyroid patients experienced 2.8 times more intense hypothyroidism-associated symptoms than controls (n = 865, n = 203 resp). Patients’ median reported serum concentrations were: TSH 0.90 mU/L, FT4 17.0 pmol/L, and FT3 2.67 pmol/L, with 52 % having low T3 levels (<3.1 pmol/L). The QoL was not found to be related to age, sex, BMI, menopausal status, stress, serum thyroid parameters, the origin and duration of hypothyroidism, the type of thyroid medication, or the LT4 dose used. Conclusions: Our study revealed major reductions in quality of life and daily functioning, and nearly three times more intense hypothyroidism-associated symptoms in treated hypothyroid patients as compared to controls, despite treatment and largely in-range serum TSH/FT4 concentrations. The QoL was not associated with serum thyroid parameters. We recommend future research into the origin of persisting complaints and the development of improved treatment modalities for hypothyroidism.
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Loneliness among young adults is a growing concern worldwide, posing serious health risks. While the human ecological framework explains how various factors such as socio-demographic, social, and built environment characteristics can affect this feeling, still, relatively little is known about the effect of built environment characteristics on the feelings of loneliness that young people experience in their daily life activities. This research investigates the relationship between built environment characteristics and emotional state loneliness in young adults (aged 18–25) during their daily activities. Leveraging the Experience Sampling Method, we collected data from 43 participants for 393 personal experiences during daily activities across different environmental settings. The findings of a mixed-effects regression model reveal that built environment features significantly impact emotional state loneliness. Notably, activity location accessibility, social company during activities, and walking activities all contribute to reducing loneliness. These findings can inform urban planners and municipalities to implement interventions that support youngsters’ activities and positive experiences to enhance well-being and alleviate feelings of loneliness in young adults. Specific recommendations regarding the built environment are (1) to create spaces that are accessible, (2) create spaces that are especially accessible by foot, and (3) provide housing with shared facilities for young adults rather than apartments/studios.
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Everyone has the right to participate in society to the best of their ability. This right also applies to people with a visual impairment, in combination with a severe or profound intellectual and possibly motor disability (VISPIMD). However, due to their limitations, for their participation these people are often highly dependent on those around them, such as family members andhealthcare professionals. They determine how people with VISPIMD participate and to what extent. To optimize this support, they must have a good understanding of what people with disabilities can still do with their remaining vision.It is currently difficult to gain insight into the visual abilities of people with disabilities, especially those with VISPIMD. As a professional said, "Everything we can think of or develop to assess the functional vision of this vulnerable group will help improve our understanding and thus our ability to support them. Now, we are more or less guessing about what they can see.Moreover, what little we know about their vision is hard to communicate to other professionals”. Therefore, there is a need for methods that can provide insight into the functional vision of people with VISPIMD, in order to predict their options in daily life situations. This is crucial knowledge to ensure that these people can participate in society to their fullest extent.What makes it so difficult to get this insight at the moment? Visual impairments can be caused by a range of eye or brain disorders and can manifest in various ways. While we understand fairly well how low vision affects a person's abilities on relatively simple visual tasks, it is much more difficult to predict this in more complex dynamic everyday situations such asfinding your way or moving around during daily activities. This is because, among other things, conventional ophthalmic tests provide little information about what people can do with their remaining vision in everyday life (i.e., their functional vision).An additional problem in assessing vision in people with intellectual disabilities is that many conventional tests are difficult to perform or are too fatiguing, resulting in either no or the wrong information. In addition to their visual impairment, there is also a very serious intellectual disability (possibly combined with a motor impairment), which makes it even more complex to assesstheir functional vision. Due to the interplay between their visual, intellectual, and motor disabilities, it is almost impossible to determine whether persons are unable to perform an activity because they do not see it, do not notice it, do not understand it, cannot communicate about it, or are not able to move their head towards the stimulus due to motor disabilities.Although an expert professional can make a reasonable estimate of the functional possibilities through long-term and careful observation, the time and correct measurement data are usually lacking to find out the required information. So far, it is insufficiently clear what people with VZEVMB provoke to see and what they see exactly.Our goal with this project is to improve the understanding of the visual capabilities of people with VISPIMD. This then makes it possible to also improve the support for participation of the target group. We want to achieve this goal by developing and, in pilot form, testing a new combination of measurement and analysis methods - primarily based on eye movement registration -to determine the functional vision of people with VISPIMD. Our goal is to systematically determine what someone is responding to (“what”), where it may be (“where”), and how much time that response will take (“when”). When developing methods, we take the possibilities and preferences of the person in question as a starting point in relation to the technological possibilities.Because existing technological methods were originally developed for a different purpose, this partly requires adaptation to the possibilities of the target group.The concrete end product of our pilot will be a manual with an overview of available technological methods (as well as the methods themselves) for assessing functional vision, linked to the specific characteristics of the target group in the cognitive, motor area: 'Given that a client has this (estimated) combination of limitations (cognitive, motor and attention, time in whichsomeone can concentrate), the order of assessments is as follows:' followed by a description of the methods. We will also report on our findings in a workshop for professionals, a Dutch-language article and at least two scientific articles. This project is executed in the line: “I am seen; with all my strengths and limitations”. During the project, we closely collaborate with relevant stakeholders, i.e. the professionals with specific expertise working with the target group, family members of the persons with VISPIMD, and persons experiencing a visual impairment (‘experience experts’).
PBL is the initiator of the Work Programme Monitoring and Management Circular Economy 2019-2023, a collaboration between CBS, CML, CPB, RIVM, TNO, UU. Holidays and mobility are part of the consumption domains that PBL researches, and this project aims to calculate the environmental gains per person per year of the various circular behavioural options for both holiday behaviour and daily mobility. For both behaviours, a range of typical (default) trips are defined and for each several circular option explored for CO2 emissions, Global warming potential and land use. The holiday part is supplied by the Centre for Sustainability, Tourism and Transport (CSTT) of the BUas Academy of Tourism (AfT). The mobility part is carried out by the Urban Intelligence professorship of the Academy for Built Environment and Logistics (ABEL).The research question is “what is the environmental impact of various circular (behavioural) options around 1) holidays and 2) passenger mobility?” The consumer perspective is demarcated as follows:For holidays, transportation and accommodation are included, but not food, attractions visited and holiday activitiesFor mobility, it concerns only the circular options of passenger transport and private means of transport (i.e. freight transport, business travel and commuting are excluded). Not only some typical trips will be evaluated, but also the possession of a car and its alternatives.For the calculations, we make use of public databases, our own models and the EAP (Environmental Analysis Program) model developed by the University of Groningen. BUAs projectmembers: Centre for Sustainability, Tourism and Transport (AT), Urban Intelligence (ABEL).
Many entrepreneurs on Texel want to onboard nature into their business. While a legal toolkit is available (“Onboarding Nature”), they still struggle to bring in the perspective of nature and future generations into their activities in a meaningful way. Representing this shared need, the National Park Duinen van Texel initiated a quest: How can local businesses (including the National Park’s Gastheren) on Texel effectively onboard Nature and Future Generations into their companies in order to secure thriving ecosystem? Realizing that a growing number of businesses are ready to consider an eco-centric perspective on how they run their operations, they feel unequipped to make the change. Therefore drawing on the “Onboarding Nature” toolkit (www.onboardingnature.com), the research team seek to tackle the question: How can we establish new methodologies for mindset shifts that help local businesses on Texel move from an anthropocentric to an ecocentric perspective that fosters ecosystemic regeneration for Future Generations of all Life? Through participatory, art and design-based research methodologies the project explores how entrepreneurs incorporate nature’s voice into both their strategic planning and daily operations. The expected result is a guidebook with practices and materials that support reframing towards an ecocentric perspective when Onboarding Nature. Results will complement the existing “Onboarding Nature” toolkit. By the end of the project, Texel’s entrepreneurs will co-develop the tools and gained experiences to become guardians of a thriving ecosystem, including (future) humans. This initiative will serve as a scalable model for other National Parks, empowering them to adopt a similar transformative approach. Partners: • Center of Expertise Wellbeing Economy and New Entrepreneurship Avans University of Applied Sciences • Center of Expertise Digital Operations & Finance The Hague University of Applied Sciences • De Organisatie Activist, • National Park Duinen van Texel • World Ethic Forum, • Nyenrode Business University • Nature
