OBJECTIVE: Juvenile dermatomyositis (DM) is an inflammatory myopathy in which the immune system targets the microvasculature of the skeletal muscle and skin, leading to significant muscle weakness and exercise intolerance, although the precise etiology is unknown. The goal of this study was to investigate the changes in exercise capacity in children with myositis during active and inactive disease periods and to study the responsiveness of exercise parameters.METHODS: Thirteen children with juvenile DM (mean+/-SD age 11.2+/-2.6 years) participated in this study. Patients performed a maximal exercise test using an electronically braked cycle ergometer and respiratory gas analysis system. Exercise parameters were analyzed, including peak oxygen uptake (VO2peak), peak work rate (Wpeak), and ventilatory anaerobic threshold (VAT). All children were tested during an active period of the disease and during a remission period. From these data, 4 different response statistics were calculated.RESULTS: The children performed significantly better during a remission period compared with a period of active disease. Most exercise parameters showed a very large response. The 5 most responsive parameters were Wpeak, Wpeak (percent predicted), oxygen pulse, VO2peak, and power at the VAT.CONCLUSION: We found in our longitudinal study that children with active juvenile DM had significantly reduced exercise parameters compared with a remission period. Moreover, we found that several parameters had very good responsiveness. With previously established validity and reliability, exercise testing has been demonstrated to be an excellent noninvasive instrument for the longitudinal followup of children with myositis.
Background: The purpose of this study is to increase our understanding of environmental correlates that are associated with route choice during active transportation to school (ATS) by comparing characteristics of actual walking and cycling routes between home and school with the shortest possible route to school. Methods: Children (n = 184; 86 boys, 98 girls; age range: 8–12 years) from seven schools in suburban municipalities in the Netherlands participated in the study. Actual walking and cycling routes to school were measured with a GPS-device that children wore during an entire school week. Measurements were conducted in the period April–June 2014. Route characteristics for both actual and shortest routes between home and school were determined for a buffer of 25 m from the routes and divided into four categories: Land use (residential, commercial, recreational, traffic areas), Aesthetics (presence of greenery/natural water ways along route), Traffic (safety measures such as traffic lights, zebra crossings, speed bumps) and Type of street (pedestrian, cycling, residential streets, arterial roads). Comparison of characteristics of shortest and actual routes was performed with conditional logistic regression models. Results: Median distance of the actual walking routes was 390.1 m, whereas median distance of actual cycling routes was 673.9 m. Actual walking and cycling routes were not significantly longer than the shortest possible routes. Children mainly traveled through residential areas on their way to school (>80 % of the route). Traffic lights were found to be positively associated with route choice during ATS. Zebra crossings were less often present along the actual routes (walking: OR = 0.17, 95 % CI = 0.05–0.58; cycling: OR = 0.31, 95 % CI = 0.14–0.67), and streets with a high occurrence of accidents were less often used during cycling to school (OR = 0.57, 95 % CI = 0.43–0.76). Moreover, percentage of visible surface water along the actual route was higher compared to the shortest routes (walking: OR = 1.04, 95 % CI = 1.01–1.07; cycling: OR = 1.03, 95 % CI = 1.01–1.05). Discussion: This study showed a novel approach to examine built environmental exposure during active transport to school. Most of the results of the study suggest that children avoid to walk or cycle along busy roads on their way to school. https://doi.org/10.1186/s12966-016-0373-y
MULTIFILE
Characteristics of the physical childcare environment are associated with children’s sedentary behavior (SB) and physical activity (PA) levels. This study examines whether these associations are moderated by child characteristics. A total of 152 1- to 3-year-old children from 22 Dutch childcare centers participated in the study. Trained research assistants observed the physical childcare environment, using the Environment and Policy Assessment Observation (EPAO) protocol. Child characteristics (age, gender, temperament and weight status) were assessed using parental questionnaires. Child SB and PA was assessed using Actigraph GT3X+ accelerometers. Linear regression analyses including interaction terms were used to examine moderation of associations between the childcare environment and child SB and PA. Natural elements and portable outdoor equipment were associated with less SB and more PA. In addition, older children, boys and heavier children were less sedentary and more active, while more use of childcare and an anxious temperament were associated with more SB. There were various interactions between environmental factors and child characteristics. Specific physical elements (e.g., natural elements) were especially beneficial for vulnerable children (i.e., anxious, overactive, depressive/withdrawn, overweight). The current study shows the importance of the physical childcare environment in lowering SB and promoting PA in very young children in general, and vulnerable children specifically. Moderation by child characteristics shows the urgency of shaping childcare centers that promote PA in all children, increasing equity in PA promotion in childcare.
Using technology to improve the adolescents' journey to school by bike in province of Drenthe and Groningen.All unsafe area that children spotted on the map, are because the lack of traffic safety ( lack of visibility, high speed, etc). In general children do not have a positive perception of cycling to school, and their favourite mode of traveling to school is car. What technology based intervention can make adolescents’ cycling to and from school safer and more attractive for them? Also does it help to encourage those who live far from the school (>10 km) to cycle to and from school more often?
Welke rol kunnen ‘grassroots’ initiatieven spelen bij het tot stand brengen van de grondstoffentransitie? Idealiter voelen lokale gemeenschappen zich eigenaar van hun eigen materiaalkringloop en profiteren ze ervan door minder afval, betaalbare producten en zinvol werk. Stichting Stunt (sociale ondernemer in upcycling) experimenteert al enige jaren met hergebruiken van plastic afval en omwerken naar nieuwe producten die relatief gemakkelijk te maken zijn door mensen met een afstand tot de arbeidsmarkt. Om een prominentere rol te kunnen spelen in de grondstoffentransitie, moeten leerwerkplaatsen en andere sociale ondernemingen de productie opschalen (in volume en naar meer hoogwaardige producten). Het doel van dit project is om inzicht te verkrijgen in hoe de belemmeringen die zij daarbij ervaren verminderd kunnen worden. De belemmeringen zijn o.a.: geen toegang tot goedkopere, robuuste machines voor upcycling; het productieproces is niet zomaar beheersbaar voor mensen met afstand tot de arbeidsmarkt; er zijn geschikte productontwerpen nodig. Hieruit volgt de vraag om een productconfigurator te maken. Dit heeft drie voordelen: -in de configurator kan een klant zelf een product configureren; -het genereren van de werkinstructies kan van daaruit worden geautomatiseerd; -de configurator kan direct feedback geven over de voetafdruk van het product en bv. de benodigde hoeveelheid afval. Stichting Stunt, The Upcycle en lectoraat Smart Sustainable Manufacturing van de Haagse Hogeschool willen samen een pilot uitvoeren om de haalbaarheid van dit principe te testen voor producten uit platen van gerecycled kunststof, omdat een robuuste platenpersmachine relatief gemakkelijk te ontwikkelen en bedienen is. Met behulp van de nieuwe tools kan het upcycle bedrijf aan de slag met: marktonderzoek, productontwerp en procesverbetering. De nieuwe tools zijn ook bruikbaar voor educatie, wat in de toekomst weer een belangrijke rol kan spelen bij het uitbouwen van een lokale upcycle community. Het project draagt hiermee bij aan optimaal hergebruik in lokale kringlopen.
