The objective of this thesis is to make a first step towards prevention of the progression of chronic venous disease and the development of a first venous leg ulcer in chronic venous disease patients. The aim is to identify chronic venous disease patients at risk of developing more severe clinical stages, provide insight in the lifestyle related risk factors, and provide an overview of current chronic venous disease care in the Netherlands.
The increasing rate of urbanization along with its socio-environmental impact are major global challenges. Therefore, there is a need to assess the boundaries to growth for the future development of cities by the inclusion of the assessment of the environmental carrying capacity (ECC) into spatial management. The purpose is to assess the resource dependence of a given entity. ECC is usually assessed based on indicators such as the ecological footprint (EF) and biocapacity (BC). EF is a measure of the biologically productive areas demanded by human consumption and waste production. Such areas include the space needed for regenerating food and fibers as well as sequestering the generated pollution, particularly CO2 from the combustion of fossil fuels. BC reflects the biological regeneration potential of a given area to regenerate resources as well to absorb waste. The city level EF assessment has been applied to urban zones across the world, however, there is a noticeable lack of urban EF assessments in Central Eastern Europe. Therefore, the current research is a first estimate of the EF and BC for the city of Wrocław, Poland. This study estimates the Ecological Footprint of Food (EFF) through both a top-down assessment and a hybrid top-down/bottom-up assessment. Thus, this research verifies also if results from hybrid method could be comparable with top-down approach. The bottom-up component of the hybrid analysis calculated the carbon footprint of food using the life cycle assessment (LCA) method. The top-down result ofWrocław’s EFF were 1% greater than the hybrid EFF result, 0.974 and 0.963 gha per person respectively. The result indicated that the EFF exceeded the BC of the city of Wrocław 10-fold. Such assessment support efforts to increase resource efficiency and decrease the risk associated with resources—including food security. Therefore, there is a need to verify if a city is able to satisfy the resource needs of its inhabitants while maintaining the natural capital on which they depend intact. Original article at: https://doi.org/10.3390/resources7030052 © 2018 by the authors. Licensee MDPI.
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The use of the biopsychosocial model in primary care physiotherapy for chronic pain is far from the recommendations given in research and current guidelines. To understand why physiotherapists have difficulty implementing a biopsychosocial approach, more insight is needed on the barriers and facilitators. This scoping review aimed to investigate and map these barriers and facilitators that physiotherapists working in primary care reportedly face when treating patients with chronic musculoskeletal pain from a biopsychosocial perspective. Four electronic databases (PubMed, Embase, CINAHL and ERIC) and the grey literature were searched. Studies were included if they investigated the experiences of physiotherapists in the treatment of chronic pain from a biopsychosocial perspective in primary care. Extracted data were discussed and sub grouped in themes following a qualitative content analysis approach. To align with current use of theories on behavior change, the resulting themes were compared to the Theoretical Domains Framework. After screening, twenty-four studies were included. Eight groups of barriers and facilitators were identified, thematically clustered in six themes: knowledge, skills, and attitudes; environmental context and resources; role clarity; confidence; therapeutic alliance; and patient expectations. The results of this review can be used to inform the development of implementation programs.
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