Lower cardiorespiratory fitness (CRF) and physical activity (PA) associate with higher cardiovascular disease (CVD) risk, but the relationship between CRF and PA in people who have rheumatoid arthritis (RA) at an increased CVD risk (CVD-RA) is not known. The objectives of this study were to determine the levels of CRF and PA in people who have CVD-RA and to investigate the association of CRF with PA in people who have CVD-RA. A total of 24 consecutive patients (19 women) with CVD-RA (> 4% for 10-year risk of fatal CVD development as calculated using the Systematic Coronary Risk Evaluation)-were included in the study. CRF was assessed with a graded maximal exercise test determining maximal oxygen uptake (VO2max). PA was assessed with an accelerometer to determine the amount of step count, sedentary, light and moderate-to-vigorous physical activity (MVPA) minutes per day. Mean age of patients was 65.3 ± 8.3 years. CRF mean values were 16.3 ± 1.2 ml·kg-1 min-1, mean step count per day was 6033 ± 2256, and the mean MVPA time was 16.7 min per day. Significant positive associations were found for CRF with step count (B = 0.001, P = 0.01) and MVPA time (B = 0.15, P = 0.02); a negative association was found for CRF with sedentary time (B = - 0.02, P = 0.03). CRF is low and is associated with step count, sedentary time and MVPA time in people who have RA at an increased CVD risk.
Cardiovascular disease (CVD) morbidity and mortality is highly prevalent in patients with rheumatoid arthritis (RA) with debilitating effects for the individual as well as significant healthcare impact. Current evidence demonstrates that engaging in aerobic and resistance exercise (i.e. structured physical activity) can significantly improve patient-reported and clinical index-assessed outcomes in RA. In addition to this, engagement in exercise programmes improves, in a dose-dependent manner, the risk of developing CVD as well as CVD symptoms and outcomes. The present narrative review uses evidence from systematic reviews and meta-analyses as well as controlled trials, to synthesize the current state-of-the-art on the potential effects of aerobic and resistance exercise on CVD risk factors as well as on cardiac and vascular function and structure in people with RA. Where there is a lack of evidence in RA to explain potential mechanisms, relevant studies from the general population are also discussed and linked to RA.
BACKGROUND: Mobile devices such as smartphones and tablets have surged in popularity in recent years, generating numerous possibilities for their use in health care as mobile health (mHealth) tools. One advantage of mHealth is that it can be provided asynchronously, signifying that health care providers and patients are not communicating in real time. The integration of asynchronous mHealth into daily clinical practice might therefore help to make health care more efficient for patients with rheumatoid arthritis (RA). The benefits have been reviewed in various medical conditions, such as diabetes and asthma, with promising results. However, to date, it is unclear what evidence exists for the use of asynchronous mHealth in the field of RA.OBJECTIVE: The objective of this study was to map the different asynchronous mHealth interventions tested in clinical trials in patients with RA and to summarize the effects of the interventions.METHODS: A systematic search of Pubmed, Scopus, Cochrane, and PsycINFO was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Studies were initially screened and later assessed by two independent researchers. Disagreements on inclusion or exclusion of studies were resolved by discussion.RESULTS: The literature search yielded 1752 abstracts. After deduplication and screening, 10 controlled intervention studies were included. All studies were assessed to be at risk for bias in at least one domain of the Cochrane risk-of-bias tool. In the 10 selected studies, 4 different types of mHealth interventions were used: SMS reminders (to increase medication adherence or physical activity; n=3), web apps (for disease monitoring and/or to provide medical information; n=5), smartphone apps (for disease monitoring; n=1), and pedometers (to increase and track steps; n=1). Measured outcomes varied widely between studies; improvements were seen in terms of medication compliance (SMS reminders), reaching rapid remission (web app), various domains of physical activity (pedometer, SMS reminders, and web apps), patient-physician interaction (web apps), and self-efficacy (smartphone app).CONCLUSIONS: SMS reminders, web apps, smartphone apps, and pedometers have been evaluated in intervention studies in patients with RA. These interventions have been used to monitor patients or to support them in their health behavior. The use of asynchronous mHealth led to desirable outcomes in nearly all studies. However, since all studies were at risk of bias and methods used were very heterogeneous, high-quality research is warranted to corroborate these promising results.
Erasmus project about training cultural workers for facilitating rural youths culture
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.
In tijden van toenemende culturele diversiteit en arbeidsonzekerheid hebben jongeren in Nederlandse en Duitse stadswijken grote behoefte aan richting met betrekking tot hun toekomstige leven. Ouders en leraren lijken zelf vaak te worden overweldigd door de snel veranderende wereld waarin ze leven. Naast deze veranderingen neemt het gebruik van sociale media sterk toe, waardoor de al bestaande generatiekloof nog groter wordt. Deze ontwikkelingen hebben grote gevolgen voor de levensloopperspectieven van jongeren en leiden er vaak toe dat ze meer dan ooit richting zoeken bij hun leeftijdgenoten. In plaats van dit te zien als een problematische situatie, is dit project erop gericht de netwerken van jongeren te gebruiken als bron voor verbetering van de stadswijken. Het basisidee is jonge adolescenten (in de leeftijd van 12-14 jaar) te empoweren via bepaalde leeftijdgenoten die al gerespecteerd, verantwoordelijk en stabiel in het leven staan. Deze ‘homies’ (vier Nederlandse en vier Duitse jongeren) worden getraind en begeleid door experts op het gebied van oplossingsgericht denken en inspirerende communicatie. Daarna gaan de homies aan de slag in hun eigen wijk, waar ze drie maanden actief zullen zijn. De meeste communicatie met hun leeftijdgenoten zal verlopen via mobiele communicatie en sociale medianetwerken. In het begeleidende onderzoek wordt een analyse gemaakt van de leefsituatie van jongeren in de geselecteerde wijken voor en na de tussenkomst van de homies. De homies houden zelf een (mobiel) dagboek bij dat inzicht zal bieden in hoe zij zelf de veranderingen bij de jongeren in hun wijk zien.
