Zoekresultaten

New methods for assessing the fascinating nature of nature experiences

In recent years, numerous environmental psychology studies have demonstrated that contact with nature as opposed to urban settings can improve an individual’s mood, can lead to increased levels of vitality, and can offer an opportunity to recover from stress. According to Attention Restoration Theory (ART) the restorative potential of natural environments is situated in the fact that nature can replenish depleted attentional resources. This replenishment takes place, in part, because nature is deemed to be a source of fascination, with fascination being described as having an ‘‘attentional’’, an‘‘affective’’ and an ‘‘effort’’ dimension. However, the claim that fascination with nature involves these three dimensions is to a large extent based on intuition or derived from introspection-based measurement methods, such as self-reports. In three studies, we aimed to more objectively assess whether these three dimensions indeed applied to experiences related to natural environments, before any (attentional) depletion has taken place. The instruments that were used were: (a) the affect misattribution procedure (Study 1), (b) the dot probe paradigm (Study 2) and (c) a cognitively effortful task (Study 3).These instrument were respectively aimed at verifying the affective, attentional and effort dimension of fascination. Overall, the results provide objective evidence for the claims made within the ART framework, that natural as opposed to urban settings are affectively positive (cfr., affective dimension) and that people have an attentional bias to natural (rather than urban) environments (cfr., attentional dimension). The results regarding the effort dimension are less straightforward, and suggest that this dimension only becomes important in sufficiently difficult cognitive tasks.

Surgery: Moving People, Improving Outcomes

Surgery aims to improve a patient’s medical condition. However, surgery is a major life event with the risk of negative consequences, like peri- and postoperative complications, prolonged hospitalization and delayed recovery of physical functioning. One of the major common side effects, functional decline, before (in the “waiting” period), during and after hospitalization is impressive, especially in frail people. Preoperative screening aims to identify frail, highrisk patients at an early stage, and advice these high-risk patients to start supervised preoperative home-based exercise training (prehabilitation) as soon as possible. Depending on the health status of the patient and his/her outcomes during the screening and the type of surgery, prehabilitation should focus on respiratory, cardiovascular and/or musculoskeletal parameters to prepare the patient for surgery. By improving preoperative physical fitness, a patient is able to better with stand the impact of major surgery and this will lead to a both reduced risk of negative side effects and better short term outcomes as a result. Besides prehabilitation hospital culture and infrastructure should be inherently activating so that patients stay as active as can be, socially, mentally and physically. In the first part of this chapter the concept of prehabilitation and different parameters that should be trained will be described. The second part focuses on the “Better in, Better out” (BiBo™) strategy, which aims to optimize patient’s pre-, peri- and postoperative physical fitness. Prehabilitation should comprise “shared decisions” between patient and physical therapist regarding experience and evidence based best options for rehabilitation goals, needs, and potential of the individual patient and his/her (in) formal support-system. Next, a case will describe the preoperative care pathway. This chapter will close with conclusions about how moving people before and after surgery will improve their outcomes.

The challenges of evidence-based prehabilitation in a real-life context for patients preparing for colorectal surgery - a cohort study and multiple case analysis

Background: Multimodal prehabilitation programs are effective at reducing complications after colorectal surgery in patients with a high risk of postoperative complications due to low aerobic capacity and/or malnutrition. However, high implementation fidelity is needed to achieve these effects in real-life practice. This study aimed to investigate the implementation fidelity of an evidence-based prehabilitation program in the real-life context of a Dutch regional hospital.Methods: In this observational cohort study with multiple case analyses, all patients who underwent colorectal surgery from January 2023 to June 2023 were enrolled. Patients meeting the criteria for low aerobic capacity or malnutrition were advised to participate in a prehabilitation program. According to recent scientific insights and the local care context, this program consisted of four exercise modalities and three nutrition modalities. Implementation fidelity was investigated by evaluating: (1) coverage (participation rate), (2) duration (number of days between the start of prehabilitation and surgery), (3) content (delivery of prescribed intervention modalities), and (4) frequency (attendance of sessions and compliance with prescribed parameters). An aggregated percentage of content and frequency was calculated to determine overall adherence.Results: Fifty-eight patients intended to follow the prehabilitation care pathway, of which 41 performed a preoperative risk assessment (coverage 80%). Ten patients (24%) were identified as high-risk and participated in the prehabilitation program (duration of 33-84 days). Adherence was high (84-100%) in five and moderate (72-73%) in two patients. Adherence was remarkably low (25%, 53%, 54%) in three patients who struggled to execute the prehabilitation program due to multiple physical and cognitive impairments.Conclusion: Implementation fidelity of an evidence-based multimodal prehabilitation program for high-risk patients preparing for colorectal surgery in real-life practice was moderate because adherence was high for most patients, but low for some patients. Patients with low adherence had multiple impairments, with consequences for their preparation for surgery. For healthcare professionals, it is recommended to pay attention to high-risk patients with multiple impairments and further personalize the prehabilitation program. More knowledge about identifying and treating high-risk patients is needed to provide evidence-based recommendations and to obtain higher effectiveness.

“Is there a fit?”

I’m not your stereotype: gendering entrepreneurial education (EE)

Questions we care about (objectives) This study contributes to the body of knowledge of entrepreneurial educators’ strategies to work towards gender inclusion in entrepreneurial education (EE). By illustrating how gender stereotypes and gender bias are constructed and reconstructed in EE. An important insight is taken from the study by (Jones, 2014), this author shows that entrepreneurs are presented in EE as a homogeneous group with similar character traits and an equal 'entrepreneurial mindset' (p. 244). This description portraits a right way to be an entrepreneur which is traditionally been associated with a white western man, masculine behaviour and masculine abilities (Jones, 2014). As a consequence, a paradox in EE appears; training and education reduces the gender gap on the one hand (Cheraghi and Schøtt, 2015), but at the same time it is also the place where the gender gap is maintained because these gender stereotypes are intertwined in this training and education (Korhonen, Komulainen and Räty, 2012). The aim of this paper is to use Social Role Theory in order to better understand the dynamics of gender in EE. This leads to the following research questions: what are the main mechanisms that contribute to gender-inclusive entrepreneurship education (EE) and how are the different mechanisms that contribute to gender inclusive entrepreneurship education (EE) integrated into the current curriculum?Approach In-depth interviews with 12 lecturers that teach/coach in the field of EE from across various faculties in a large University for Applied Sciences combined with newsletters created by one of largest EE programs at this institution (267 pages in 2020) is carried out. A semi-structured questionnaire was used to guide the in-depth interviews. Subsequently, discourse analysis gives insight into gendering in EE at the investigated institution. Results The main findings suggests that when questioned about the topic all respondents stressed the importance of gender equally, only a few seem to be aware of the need to address the issue in their classroom(s) while none of the programs currently adopt a gender perspective while coaching their potential entrepreneurs or when addressing how the entrepreneurial ecosystem functions. Implications These findings and perspectives point to the importance of recognizing that a “one size fits all” approach to curricula may not be appropriate, and that gender-sensitive programming, especially related to dealing with these gender stereotypes and gender bias, are needed. This means that in educational development there are opportunities to create better education and create equal opportunities for male and female students. Value/originalityWomen still form the minority amongst the population of (potential) entrepreneurs and find it more difficult to grow their venture due to a range of (institutional) barriers. This study shows that, thus far, EE insufficiently addresses this topic and points to opportunities for interventions for increasing the gender inclusiveness of the entrepreneurial ecosystem, especially for female ones, instilling in them the awareness and knowledge that as a female entrepreneur starting a business isn’t without gendered challenges. This research therefore adds to the body of knowledge on the construction and reconstruction of gender stereotypes and gender bias in the field of EE.

Validation and refinement of prediction models to estimate exercise capacity in cancer survivors using the steep ramp test

OBJECTIVE: To further test the validity and clinical usefulness of the steep ramp test (SRT) in estimating exercise tolerance in cancer survivors by external validation and extension of previously published prediction models for peak oxygen consumption (Vo2peak) and peak power output (Wpeak).DESIGN: Cross-sectional study.SETTING: Multicenter.PARTICIPANTS: Cancer survivors (N=283) in 2 randomized controlled exercise trials.INTERVENTIONS: Not applicable.MAIN OUTCOME MEASURES: Prediction model accuracy was assessed by intraclass correlation coefficients (ICCs) and limits of agreement (LOA). Multiple linear regression was used for model extension. Clinical performance was judged by the percentage of accurate endurance exercise prescriptions.RESULTS: ICCs of SRT-predicted Vo2peak and Wpeak with these values as obtained by the cardiopulmonary exercise test were .61 and .73, respectively, using the previously published prediction models. 95% LOA were ±705mL/min with a bias of 190mL/min for Vo2peak and ±59W with a bias of 5W for Wpeak. Modest improvements were obtained by adding body weight and sex to the regression equation for the prediction of Vo2peak (ICC, .73; 95% LOA, ±608mL/min) and by adding age, height, and sex for the prediction of Wpeak (ICC, .81; 95% LOA, ±48W). Accuracy of endurance exercise prescription improved from 57% accurate prescriptions to 68% accurate prescriptions with the new prediction model for Wpeak.CONCLUSIONS: Predictions of Vo2peak and Wpeak based on the SRT are adequate at the group level, but insufficiently accurate in individual patients. The multivariable prediction model for Wpeak can be used cautiously (eg, supplemented with a Borg score) to aid endurance exercise prescription.