Mobility Mentoring® combineert het onderwerp armoede met de laatste inzichten vanuit de hersenwetenschap over de effecten van schaarste en armoede en de ontwikkelbaarheid van hersenfuncties. Deze nieuwe aanpak helpt mensen bij de aanpak van hun financiële en sociale problemen. Het lectoraat Schulden & Incasso van de Hogeschool Utrecht, Platform31 en Impuls ambiëren een effectievere aanpak van financiële problematiek van huishoudens en zochten naar organisaties die de inzichten uit de Schaarste-theorie op een vruchtbare manier vertalen naar hun dagelijkse praktijk.
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In the Interreg Smart Shared Green Mobility Hubs project, electric shared mobility is offered through eHUBs in the city. eHUBs are physical places inneighbourhoods where shared mobility is offered, with the intention of changing citizens’ travel behaviour by creating attractive alternatives to private car use.In this research, we aimed to gain insight into psychological factors that influence car owners’ intentions to try out shared electric vehicles from an eHUB in order to ascertain:1. The psychological factors that determine whether car owners are willing to try out shared electric modalities in the eHUBs and whether these factors are identical for cities with different mobility contexts.2. How these insights into psychological determinants can be applied to entice car owners to try out shared electric modalities in the eHUBs.Research was conducted in two cities: Amsterdam (the Netherlands) and Leuven (Belgium). An onlinesurvey was distributed to car owners in both cities inSeptember 2020 and, additionally, interviews wereheld with 12 car owners in each city.In general, car owners from Amsterdam and Leuven seem positive about the prospect of having eHUBs in their cities. However, they show less interest inusing the eHUBs themselves, as they are satisfied with their private car, which suits their mobility needs. Car owners mentioned the following reasons for notbeing interested in trying out the eHUBs: they simply do not see a need to do so, the costs involved with usage, the need to plan ahead, the expected hasslewith registration and ‘figuring out how it works’, having other travel needs, safety concerns, having to travel a distance to get to the vehicle, and a preferencefor ownership. Car owners who indicated that they felt neutral, or that they were likely to try out an eHUB, mentioned the following reasons for doing so:curiosity, attractive pricing, convenience, not owning a vehicle like those offered in an eHUB, environmental concerns, availability nearby, and necessity when theirown vehicle is unavailable.In both cities, the most important predictor determining car owners’ intention to try out an eHUB is the perceived usefulness of trying out an eHUB.In Amsterdam, experience with shared mobility and familiarity with the concept were the second and third factors determining car owners’ interest in tryingout shared mobility. In Leuven, pro-environmental attitude was the second factor determining car owners’ openness to trying out the eHUBs, and agewas the third factor, with older car owners being less likely to try one out.Having established that perceived usefulness was the most important determinant for car owners to try out shared electric vehicles from an eHUB, weconducted additional research, which showed that, in both cities, three factors contribute to perceived usefulness, in order of relevance: (1) injunctive norms(e.g., perceiving that society views trying out eHUBs as correct behaviour); (2) trust in shared electric mobility as a solution to problems in the city (e.g., expecting private car owners’ uptake of eHUBs to contributeto cleaner air, reduce traffic jams in city, and combat climate change); and (3) trust in the quality and safety of the vehicles, including the protection of users’privacy. In Amsterdam specifically, two additional factors contributed to perceived usefulness of eHUBs: drivers’ confidence in their capacity to try out anunfamiliar vehicle from the eHUB and experience of travelling in various modes of transport.Drawing on the relevant literature, the results of our research, and our behavioural expertise, we make the following recommendations to increase car users’ uptake of shared e-mobility:1. Address car owners’ attentional bias, which filters out messages on alternative transport modes.2. Emphasise benefits of (trying out) shared mobility from different perspectives so that multiple goals can be addressed.3. Change the environment and the infrastructure, as infrastructure determines choice of transport.4. For Leuven specifically: target younger car owners and car owners with high pro-environmental attitudes.5. For Amsterdam specifically: provide information on eHUBs and opportunities for trying out eHUBs.
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Background and Purpose: Despite the positive effects of physical activity on numerous aspects of health, many older adults remain sedentary even after participating in physical activity interventions. Standardized exercise programs do not necessarily bring about the behavioral change that is necessary. Therefore, a patient-centered approach is needed. The purpose of this study was to develop and assess the acceptabilityand potential effectiveness of the Coach2Move strategy; a physical therapy (PT) approach aimed at improving the longterm level of physical activity in mobility-limited older adults. Methods: The Coach2Move strategy was developed on the basis of 2 systematic literature studies and expert consultations. Multiple focus group meetings and a Delphi procedure were organized to gain consensus on the Coach2Move strategy.Acceptability and potential effectiveness were studied in a pilot study with a pre-/postdesign in which 2 physical therapists and 12 patients participated. To assess acceptability, patients were interviewed, discussion with the involved physical therapists was held, and health records were studied.Potential effectiveness was tested measuring the level of physical activity, frailty, quality of life, and mobility before and after treatment. Results: The pilot study showed high appraisal of the strategy by both physical therapists and patients. Moreover, a potential effect on the level of physical activity, frailty, quality of life, and mobility was observed. In conclusion, the Coach2Move strategy can be considered acceptable in PT practice and showed potential benefits.
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Purpose: To evaluate the effects of a combination of wheelchair mobility skills (WMS) training and exercise training on physical activity (PA), WMS, confidence in wheelchair mobility, and physical fitness. Methods: Youth using a manual wheelchair (n = 60) participated in this practice-based intervention, with a waiting list period (16 weeks), exercise training (8 weeks), WMS training (8 weeks), and follow-up (16 weeks). Repeated measures included: PA (Activ8), WMS (Utrecht Pediatric Wheelchair Mobility Skills Test), confidence in wheelchair mobility (Wheelchair Mobility Confidence Scale), and physical fitness (cardiorespiratory fitness, (an)aerobic performance) and were analysed per outcome parameter using a multilevel model analyses. Differences between the waiting list and training period were determined with an unpaired sample t-test. Results: Multilevel model analysis showed significant positive effects for PA (p = 0.01), WMS (p < 0.001), confidence in wheelchair mobility (p < 0.001), aerobic (p < 0.001), and anaerobic performance (p < 0.001). Unpaired sample t-tests underscored these effects for PA (p < 0.01) and WMS (p < 0.001). There were no effects on cardiorespiratory fitness. The order of training (exercise before WMS) had a significant effect on confidence in wheelchair mobility. Conclusions: A combination of exercise and WMS training appears to have significant positive long-term effects on PA, WMS, confidence in wheelchair mobility, and (an)aerobic performance in youth using a manual wheelchair.Implications for rehabilitationExercise training and wheelchair mobility skills (WMS) training can lead to a sustained improvement in physical activity (PA) in youth using a manual wheelchair.These combined trainings can also lead to a sustained increase in WMS, confidence in wheelchair mobility, and (an)aerobic performance.More attention is needed in clinical practice and in research towards improving PA in youth using a manual wheelchair.
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The main objective of this report is to analyse and inform about international labour mobility, particularly within Europe, from the perspective of the Dutch Health and Social Care Sector. The report starts by describing the introduction of a new care system in The Netherlands. The government does not participate directly in the actual provision of care. This is a task principally for private care suppliers. Furthermore, the legal position of the Health and Social Care professions, regulated through the Individual Health Care Professions Act, and questions like the international recognition of degrees and the evaluation of foreign diplomas are discussed. This is followed by a clarification of the Dutch education system, particularly, relating to the study of medicine, nursing education and social work education. Subsequently, some core data on the ageing Dutch population are presented. The grey pressure increases and this will have an impact on health spending, health support and the future labour market. Then what follows is a description of the development of employment in the Dutch Health and Social Care Sector, per branch as well as the professions that are engaged in it. The general picture, at this moment, is that the Health and Social Care labour market is reasonably in balance. This trend will continue in the near future; shortages are expected only in the long term. All research done on the subject indicates that international mobility of medical and social professionals is still low in the Netherlands. The question remains whether a more active recruitment policy would be a solution for the expected long term shortages. The report concludes with a look at recruitment policy and some of its developments at the global, national and local level.
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Background: Art therapy (AT) is frequently offered to children and adolescents with psychosocial problems. AT is an experiential form of treatment in which the use of art materials, the process of creation in the presence and guidance of an art therapist, and the resulting artwork are assumed to contribute to the reduction of psychosocial problems. Although previous research reports positive effects, there is a lack of knowledge on which (combination of) art therapeutic components contribute to the reduction of psychosocial problems in children and adolescents. Method: A systematic narrative review was conducted to give an overview of AT interventions for children and adolescents with psychosocial problems. Fourteen databases and four electronic journals up to January 2020 were systematically searched. The applied means and forms of expression, therapist behavior, supposed mechanisms of change, and effects were extracted and coded. Results: Thirty-seven studies out of 1,299 studies met the inclusion criteria. This concerned 16 randomized controlled trials, eight controlled trials, and 13 single-group pre–post design studies. AT interventions for children and adolescents are characterized by a variety of materials/techniques, forms of structure such as giving topics or assignments, and the use of language. Three forms of therapist behavior were seen: non-directive, directive, and eclectic. All three forms of therapist behavior, in combination with a variety of means and forms of expression, showed significant effects on psychosocial problems. Conclusions: The results showed that the use of means and forms of expression and therapist behavior is applied flexibly. This suggests the responsiveness of AT, in which means and forms of expression and therapist behavior are applied to respond to the client's needs and circumstances, thereby giving positive results for psychosocial outcomes. For future studies, presenting detailed information on the potential beneficial effects of used therapeutic perspectives, means, art techniques, and therapist behavior is recommended to get a better insight into (un)successful art therapeutic elements.
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Daily wheelchair ambulation is seen as a risk factor for shoulder problems, which are prevalent in manual wheelchair users. To examine the long-term effect of shoulder load from daily wheelchair ambulation on shoulder problems, quantification is required in real-life settings. In this study, we describe and validate a comprehensive and unobtrusive methodology to derive clinically relevant wheelchair mobility metrics (WCMMs) from inertial measurement systems (IMUs) placed on the wheelchair frame and wheel in real-life settings. The set of WCMMs includes distance covered by the wheelchair, linear velocity of the wheelchair, number and duration of pushes, number and magnitude of turns and inclination of the wheelchair when on a slope. Data are collected from ten able-bodied participants, trained in wheelchair-related activities, who followed a 40 min course over the campus. The IMU-derived WCMMs are validated against accepted reference methods such as Smartwheel and video analysis. Intraclass correlation (ICC) is applied to test the reliability of the IMU method. IMU-derived push duration appeared to be less comparable with Smartwheel estimates, as it measures the effect of all energy applied to the wheelchair (including thorax and upper extremity movements), whereas the Smartwheel only measures forces and torques applied by the hand at the rim. All other WCMMs can be reliably estimated from real-life IMU data, with small errors and high ICCs, which opens the way to further examine real-life behavior in wheelchair ambulation with respect to shoulder loading. Moreover, WCMMs can be applied to other applications, including health tracking for individual interest or in therapy settings.
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This paper introduces and explores the psychological and social factors that both contribute to and inhibit behaviour change vis-à-vis sustainable (tourist) mobility. It is based on papers presented at the Freiburg 2012 workshop. Specifically, it reviews climate change attitudes and perceptions, the psychological benefits of tourism mobilities, addictive elements of mobility and social norming effects, the attitude-behaviour gap (i.e. cognitive dissonance between understandings of, and responses to, climate change), the psychology of modal shifts, the psychology of travel speed/time and psychological explanations for the perceived importance of long distance travel. It notes that anthropogenic climate change is an inescapable reality and that tourism's share of greenhouse gas emissions appears set to rise substantially. There is little prospect of technical solutions adequately addressing this problem. The paper concludes that, while a comprehensive understanding of tourist psychology is necessary to inform policy-makers, it alone will be insufficient to achieve emission reductions, and bring tourism to a climatically sustainable pathway, if treated in isolation. Radical change in the structures of provision is also necessary. That change may take the form of infrastructure planning, including financial and economic infrastructure (e.g. taxation regimes and emission trading schemes) for sustainable mobility.
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To evaluate the construct validity and the inter-rater reliability of the Dutch Activity Measure for Post- Acute Care “6-clicks” Basic Mobility short form measuring the patient’s mobility in Dutch hospital care. First, the “6-clicks” was translated by using a forward-backward translation protocol. Next, 64 patients were assessed by the physiotherapist to determine the validity while being admitted to the Internal Medicine wards of a university medical center. Six hypotheses were tested regarding the construct “mobility” which showed that: Better “6-clicks” scores were related to less restrictive pre-admission living situations (p¼0.011), less restrictive discharge locations (p¼0.001), more independence in activities of daily living (p¼0.001) and less physiotherapy visits (p<0.001). A correlation was found between the “6-clicks” and length of stay (r¼0.408, p¼0.001), but not between the “6-clicks” and age (r¼0.180, p¼0.528). To determine the inter-rater reliability, an additional 50 patients were assessed by pairs of physiotherapists who independently scored the patients. Intraclass Correlation Coefficients of 0.920 (95%CI: 0.828–0.964) were found. The Kappa Coefficients for the individual items ranged from 0.649 (walking stairs) to 0.841 (sit-to-stand). The Dutch “6-clicks” shows a good construct validity and moderate-toexcellent inter-rater reliability when used to assess the mobility of hospitalized patients.
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This is the first meta-analysis focusing on elderly patients with mobility problems, physical disability and/or multi-morbidity. The aim of this study is to assess the effect of physical exercise therapy on mobility, physical functioning, physical activity and quality of life. A broad systematic literature search was performed in the databases PubMed, CINAHL, Embase, PEDro and The Cochrane Library. Relevant study characteristics were reviewed and meta-analyses using standardized mean differences (SMDs) were performed. The results show that physical exercise therapy has a positive effect on mobility (SMD final value: 0.18; 95% CI: 0.05, 0.30; SMD change value: 0.82; 95% CI: 0.54, 1.10) and physical functioning (SMD final value: 0.27; 95% CI: 0.08, 0.46; SMD change value: 2.93; 95% CI: 2.50, 3.36). High-intensity exercise interventions seem to be somewhat more effective in improving physical functioning than low-intensity exercise interventions (SMD final value: 0.22; 95% CI: −0.17, 0.62; SMD change value: 0.38; 95% CI: −0.48, 1.25). These positive effects are of great value for older adults who are already physically impaired. The effect on physical activity and quality of life was not evident and no definite conclusions on the most effective type of physical exercise therapy intervention can be drawn.
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