Decreased appetite is one of the main risk factors of malnutrition. Little is known on how appetite changes during hospitalization and after discharge and how it relates with sarcopenia-related outcomes. We analyzed data of the Hospital-ADL study, a multicenter prospective cohort study that followed 400 acutely hospitalized older adults (≥70 year). Appetite (SNAQ), handgrip strength (Jamar), muscle mass (BIA), mobility (DEMMI), and physical performance (SPPB) were assessed within 48 h of admission, at discharge, and at one and three months post-discharge. The course of decreased appetite was analysed by Generalised Estimating Equations. Linear Mixed Model was used to analyse the associations between decreased appetite and the sarcopenia-related outcomes. Decreased appetite was reported by 51% at hospital admission, 34% at discharge, 28% one month post-discharge, and 17% three months post-discharge. Overall, decreased appetite was associated with lower muscle strength (β = -1.089, p = 0.001), lower mobility skills (β = -3.893, p < 0.001), and lower physical performance (β = -0.706, p < 0.001) but not with muscle mass (β = -0.023, p = 0.920). In conclusion, decreased appetite was highly prevalent among acute hospitalized older adults and remained prevalent, although less, after discharge. Decreased appetite was significantly associated with negative sarcopenia-related outcomes, which underlines the need for assessment and monitoring of decreased appetite during and post hospitalization.
Alliance has been shown to predict treatment outcome in family-involved treatment for youth problems in several studies.However, meta-analytic research on alliance in family-involved treatment is scarce, and to date, no meta-analytic study on the alliance–outcome association in this field has paid attention to moderating variables. We included 28 studies reporting on the alliance–outcome association in 21 independent study samples of families receiving family-involved treatment for youth problems (N= 2126 families,Mage youth ranging from 10.6 to 16.1). We performed three multilevel meta-analyses of theassociations between three types of alliance processes and treatment outcome, and of several moderator variables. The quality of the alliance was significantly associated with treatment outcome (r= .183,p< .001). Correlations were significantly stronger when alliance scores of different measurement moments were averaged or added, when families were help-seekingrather than receiving mandated care and when studies included younger children. The correlation between alliance improvement and treatment outcome just failed to reached significance (r= .281,p= .067), and no significant correlation was found between split alliances and treatment outcome (r= .106,p= .343). However, the number of included studies reporting onalliance change scores or split alliances was small. Our findings demonstrate that alliance plays a small but significant role in the effectiveness of family-involved treatment. Future research should focus on investigating the more complex systemic aspects of alliance to gain fuller understanding of the dynamic role of alliance in working with families
The world population is ageing rapidly. As society ages, the incidence of physical limitations is dramatically increasing, which reduces the quality of life and increases healthcare expenditures. In western society, ~30% of the population over 55 years is confronted with moderate or severe physical limitations. These physical limitations increase the risk of falls, institutionalization, co-morbidity, and premature death. An important cause of physical limitations is the age-related loss of skeletal muscle mass, also referred to as sarcopenia. Emerging evidence, however, clearly shows that the decline in skeletal muscle mass is not the sole contributor to the decline in physical performance. For instance, the loss of muscle strength is also a strong contributor to reduced physical performance in the elderly. In addition, there is ample data to suggest that motor coordination, excitation-contraction coupling, skeletal integrity, and other factors related to the nervous, muscular, and skeletal systems are critically important for physical performance in the elderly. To better understand the loss of skeletal muscle performance with ageing, we aim to provide a broad overview on the underlying mechanisms associated with elderly skeletal muscle performance. We start with a system level discussion and continue with a discussion on the influence of lifestyle, biological, and psychosocial factors on elderly skeletal muscle performance. Developing a broad understanding of the many factors affecting elderly skeletal muscle performance has major implications for scientists, clinicians, and health professionals who are developing therapeutic interventions aiming to enhance muscle function and/or prevent mobility and physical limitations and, as such, support healthy ageing.
In Nederland krijgen jaarlijks 115.000 mensen te horen dat ze kanker hebben. Na kanker te hebben overwonnen worstelen deze mensen met terugkeer naar de maatschappij en het sociale leven. Naast fysieke klachten spelen hierbij ook mentale klachten en angsten een grote rol. De mentale klachten zijn vergelijkbaar met het verwerken van een trauma. Naast de medische zorg zijn deze mensen op zoek naar hulp voor het verwerken van het trauma en de mentale kracht vinden om verder te gaan. Bij het verwerken van trauma’s en de daarbij horende spanningen en onzekerheden kan de mens-dier interactie een belangrijke rol vervullen als social-support. In Nederland zijn ruim 1500 professionals werkzaam in de branche van paardondersteunde interventies. Paardencoaches ondersteunen mensen met mentale uitdagingen zoals PTSS, anorexia, burn-out, depressies. De groep paardencoaches en zorgverleners met interesse in het inzetten van paardencoaching bij het verwerken van trauma’s groeit snel. In hoeverre paardencoaching specifiek kan bijdragen aan het herstel van ex-kankerpatiënten in Nederland is echter onbekend. In dit KIEM project wil het consortium daarom inventariseren welke ervaringen er zijn onder paardencoaches met (ex-)kankerpatiënten en in hoeverre er vanuit de zorgverleners interesse is in mogelijkheden van paardencoaching voor (ex-)kankerpatiënten. Tenslotte wil dit consortium met een pilot ook inzichtelijk maken wat het effect is van paardencoaching op het mentale welbevinden van de ex-kankerpatiënt. Het consortium van dit KIEM project bestaat uit onderzoekers mens-dier interactie en dierondersteunde interventies van Aeres Hogeschool Dronten, Stichting Langs de Zijlijn, en paardencoaches en opleiders van Centrum voor Paardencoaching en van Caprilli Paardencoaching en Training.
