Abstract: Hypertension is both a health problem and a financial one globally. It affects nearly 30 % of the general population. Elderly people, aged ≥65 years, are a special group of hypertensive patients. In this group, the overall prevalence of the disease reaches 60 %, rising to 70 % in those aged ≥80 years. In the elderly population, isolated systolic hypertension is quite common. High systolic blood pressure is associated with an increased risk of cardiovascular disease, cerebrovascular disease, peripheral artery disease, cognitive impairment and kidney disease. Considering the physiological changes resulting from ageing alongside multiple comorbidities, treatment of hypertension in elderly patients poses a significant challenge to treatment teams. Progressive disability with regard to the activities of daily life, more frequent hospitalisations and low quality of life are often seen in elderly patients. There is discussion in the literature regarding frailty syndrome associated with old age. Frailty is understood to involve decreased resistance to stressors, depleted adaptive and physiological reserves of a number of organs, endocrine dysregulation and immune dysfunction. The primary dilemma concerning frailty is whether it should only be defined on the basis of physical factors, or whether psychological and social factors should also be included. Proper nutrition and motor rehabilitation should be prioritised in care for frail patients. The risk of orthostatic hypotension is a significant issue in elderly patients. It results from an autonomic nervous system dysfunction and involves maladjustment of the cardiovascular system to sudden changes in the position of the body. Other significant issues in elderly patients include polypharmacy, increased risk of falls and cognitive impairment. Chronic diseases, including hypertension, deteriorate baroreceptor function and result in irreversible changes in cerebral and coronary circulation. Concurrent frailty or other components of geriatric syndrome in elderly patients are associated with a worse perception of health, an increased number of comorbidities and social isolation of the patient. It may also interfere with treatment adherence. Identifying causes of non-adherence to pharmaceutical treatment is a key factor in planning therapeutic interventions aimed at increasing control, preventing complications, and improving long-term outcomes and any adverse effects of treatment. Diagnosis of frailty and awareness of the associated difficulties in adhering to treatment may allow targeting of those elderly patients who have a poorer prognosis or may be at risk of complications from untreated or undertreated hypertension, and for the planning of interventions to improve hypertension control.
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The aim of this report is to give an overview of current state of the art in the occurrence and policies regarding affordable age-friendly and eco-friendly solutions in the partner countries. The report consists of the findings from the literature review, the comparative analysis and the reporting of good practices. It aims for the consortium as a whole to gain an understanding of the state of the art and on affordable age and eco-friendly solutions in partner countries and particularly the home and community fields, and to present that knowledge in the form of a written report. The literature review, the analysis of barriers and facilitators, and the survey on existing or even planning good practices in the project countries, will help the partners to build and update a strong knowledge base in these fields. To be closer to the practical issues that define the adaptability of eco and age-friendly solutions in community, the consortium decided to use mostly grey literature and websites for tools and advice, such as governmental pages. Common grey literature publication types include reports (annual, research, technical, project, etc.), working papers, government documents, white papers and evaluations, which will help all partners to reach conclusions around the common field between age and eco-friendly developments. Barriers and facilitators found in each project country will be used for stipulating the right consequence of actions needed, to propose a sound methodology that could – in combination with other actions and stakeholders – promote the implementation of age and eco-friendly principles into the public and private sphere of care for older people. Finally, the selection of good representative practices by each project country can be the basis for a report, and a publication, that depicts the level of maturity and progress of the notions of age-friendliness and eco-friendliness, as well as their impact on the care of older people.
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Objective: The effects of sociodemographic factors on quality of life in older people differ strongly, possibly due to the fact that different measurement instruments have been used. The main aim of this cross-sectional study is to compare the associations of sex, age, marital status, education, and income with quality of life assessed with the Short-Form Health Survey (SF-12), the World Health Organization Quality of Life Questionnaire-BREF (WHOQOL-BREF), and the World Health Organization Quality of Life Questionnaire-Older Adults Module (WHOQOL-OLD). Methods: The associations between sociodemographic factors and eleven quality of life domains were examined using a sample of 1,492 Dutch people aged $50 years. Participants completed the “Senioren Barometer”, a web-based questionnaire including sociodemographic factors, the SF-12, the WHOQOL-BREF, and the WHOQOL-OLD. Results: All the sociodemographic factors together explained a significant part of the variance of all the quality of life domains’ scores, ranging from 5% to 17% for the WHOQOL-BREF, 5.8% to 6.7% for the SF-12, and 1.4% to 26% for the WHOQOL-OLD. Being a woman and being older were negatively associated with two and four quality of life domains, respectively. Being a woman, being married or cohabiting, and having higher education and a higher income were positively associated with six, six, one, and eleven quality of life domains, respectively. Conclusion: Our study showed that the associations of sociodemographic factors and quality of life in middle-aged and older people depend on the instruments used to assess quality of life. We recommend that health care and welfare professionals focus particularly on people with a low income and carry out interventions aimed at improving their quality of life.
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As the Dutch population is aging, the field of music-in-healthcare keeps expanding. Healthcare, institutionally and at home, is multiprofessional and demands interprofessional collaboration. Musicians are sought-after collaborators in social and healthcare fields, yet lesser-known agents of this multiprofessional group. Although live music supports social-emotional wellbeing and vitality, and nurtures compassionate care delivery, interprofessional collaboration between musicians, social work, and healthcare professionals remains marginal. This limits optimising and integrating music-making in the care. A significant part of this problem is a lack of collaborative transdisciplinary education for music, social, and healthcare students that deep-dives into the development of interprofessional skills. To meet the growing demand for musical collaborations by particularly elderly care organisations, and to innovate musical contributions to the quality of social and healthcare in Northern Netherlands, a transdisciplinary education for music, physiotherapy, and social work studies is needed. This project aims to equip multiprofessional student groups of Hanze with interprofessional skills through co-creative transdisciplinary learning aimed at innovating and improving musical collaborative approaches for working with vulnerable, often older people. The education builds upon experiential learning in Learning LABs, and collaborative project work in real-life care settings, supported by transdisciplinary community forming.The expected outcomes include a new concept of a transdisciplinary education for HBO-curricula, concrete building blocks for a transdisciplinary arts-in-health minor study, innovative student-led approaches for supporting the care and wellbeing of (older) vulnerable people, enhanced integration of musicians in interprofessional care teams, and new interprofessional structures for educational collaboration between music, social work and healthcare faculties.
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.
Mensen die moeite hebben met lezen en schrijven (laaggeletterden) zijn ondervertegenwoordigd in onderzoek, waardoor een belangrijke onderzoekspopulatie ontbreekt. Dit is een probleem, omdat zorgbeleid dan onvoldoende op hun behoeften wordt aangepast. Laaggeletterden hebben vaak een lage sociaal economische positie (SEP). Mensen met een lage SEP leven gemiddeld 4 jaar korter en 15 jaar in minder goed ervaren gezondheid vergeleken met mensen met een hoge SEP. Om laaggeletterden te betrekken in onderzoek, is het o.a. nodig om onderzoek toegankelijker te maken. Dit project draagt hieraan bij door de ontwikkeling van een toolbox voor toegankelijke (proefpersonen)informatie (pif) en toestemmingsverklaringen. We ontwikkelen in co-creatie met de doelgroep toegankelijke audiovisuele materialen die breed ingezet kunnen worden door (gezondheids)onderzoekers van (zorggerelateerde) instanties/bedrijven én kennisinstellingen voor de werving voor en informatieverstrekking over onderzoek. In de multidisciplinaire samenwerking met onze partners YURR.studio, Pharos, Stichting ABC, Stichting Crowdience, de HAN-Sterkplaats en de Academische Werkplaats Sterker op eigen benen (AW-SOEB) van Radboudumc stellen we de behoeften van de doelgroep centraal. Middels creatieve sessies en gebruikerservaringen wordt in een iteratief ontwerpende onderzoeksaanpak toegewerkt naar diverse ontwerpen van informatiebrieven en toestemmingsverklaringen, waarbij de visuele communicatie dragend is. Het ontwikkelproces biedt kennisontwikkeling en hands-on praktijkvoorbeelden voor designers en grafisch vormgevers in het toegankelijk maken van informatie. Als laaggeletterden beter bereikt worden d.m.v. de pif-toolbox, kunnen de inzichten van deze groep worden meegenomen. Dit zorgt voor een minder scheef beeld in onderzoek, waardoor (gezondheids)beleid zich beter kan richten op kwetsbare doelgroepen. Hiermee wordt een bijdrage geleverd aan het verkleinen van gezondheidsverschillen.
Centre of Expertise, part of De Haagse Hogeschool
Lectorate, part of NHL Stenden Hogeschool
