BACKGROUND: Combining increased dietary protein intake and resistance exercise training for elderly people is a promising strategy to prevent or counteract the loss of muscle mass and decrease the risk of disabilities. Using findings from controlled interventions in a real-life setting requires adaptations to the intervention and working procedures of healthcare professionals (HCPs). The aim of this study is to adapt an efficacious intervention for elderly people to a real-life setting (phase one) and test the feasibility and potential impact of this prototype intervention in practice in a pilot study (phase two).METHODS: The Intervention Mapping approach was used to guide the adaptation in phase one. Qualitative data were collected from the original researchers, target group, and HCPs, and information was used to decide whether and how specified intervention elements needed to be adapted. In phase two, a one-group pre-test post-test pilot study was conducted (n = 25 community-dwelling elderly), to elicit further improvements to the prototype intervention. The evaluation included participant questionnaires and measurements at baseline (T0) and follow-up (T1), registration forms, interviews, and focus group discussions (T1). Qualitative data for both phases were analysed using an inductive approach. Outcome measures included physical functioning, strength, body composition, and dietary intake. Change in outcomes was assessed using Wilcoxon signed-rank tests.RESULTS: The most important adaptations to the original intervention were the design of HCP training and extending the original protein supplementation with a broader nutrition programme aimed at increasing protein intake, facilitated by a dietician. Although the prototype intervention was appreciated by participants and professionals, and perceived applicable for implementation, the pilot study process evaluation resulted in further adaptations, mostly concerning recruitment, training session guidance, and the nutrition programme. Pilot study outcome measures showed significant improvements in muscle strength and functioning, but no change in lean body mass.CONCLUSION: The combined nutrition and exercise intervention was successfully adapted to the real-life setting and seems to have included the most important effective intervention elements. After adaptation of the intervention using insights from the pilot study, a larger, controlled trial should be conducted to assess cost-effectiveness.TRIAL REGISTRATION: Trial registration number: ClinicalTrials.gov NL51834.081.14 (April 22, 2015).
The question of how to design climate-resilient landscapes plays a major role in the European projects in which the green university has been involved, such as Future Cities and F:ACTS!. These are projects in which various European organizations, government authorities and universities have joined forces to find an answer to climate-related issues. Van Hall Larenstein also collaborates with Almere, a relatively new Dutch municipality that is changing rapidly and that prioritizes climate resilience in its development. Over the years there has been a clear development in climate-adaptive planning, both in education and in practice.
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Belevingen maken een landschap interessant om vrije tijd in te besteden. Een vrijetijdslandschap is een gebied waar ontspanning, vermaak en belevenissen een centrale rol in nemen. Maar is elk gebied een potentieel vrijetijdslandschap? En hoe ontstaat zo’n gebied? Gebeurd dit autonoom of zitten er partijen achter de knoppen? Dit essay gaat in op deze aspecten en richt zich specifiek op het Vechtdal en de rol van het programmabureau Ruimte voor de Vecht. Leidend voor de structuur van dit essay zijn de volgende onderzoeksvragen: • Wat zijn vrijetijdslandschappen en hoe komen deze tot ontwikkeling? • Met welke maatregelen zijn de ontwikkeling van vrijetijdslandschappen te ondersteunen? • Hoe zijn de ideeën van een vrijetijdslandschap toe te passen op het Vechtdal? • Welke rollen en acties zijn weggelegd voor het programmabureau Ruimte voor de Vecht om de transitie naar een vrijetijdslandschap te ondersteunen? volgende onderzoeksvragen.