BACKGROUND: Sarcopenic obesity significantly burdens health and autonomy. Strategies to intervene in or prevent sarcopenic obesity generally focus on losing body fat and building or maintaining muscle mass and function. For a lifestyle intervention, it is important to consider psychological aspects such as behavioral change techniques (BCTs) to elicit a long-lasting behavioral change.PURPOSE: The study was carried out to analyze BCTs used in exercise and nutritional interventions targeting community-dwelling adults around retirement age with sarcopenic obesity.METHODS: We conducted an analysis of articles cited in an existing systematic review on the effectiveness of exercise and nutritional interventions on physiological outcomes in community-dwelling adults around retirement age with sarcopenic obesity. We identified BCTs used in these studies by applying a standardized taxonomy.RESULTS: Only nine BCTs were identified. Most BCTs were not used intentionally (82 %), and those used derived from the implementation of lifestyle components, such as exercise classes ("instructions on how to perform a behavior," "demonstration of the behavior," "behavioral practice/rehearsal," and "body changes"). Only two studies used BCTs intentionally to reinforce adherence in their interventions.CONCLUSIONS: Few studies integrated BCTs in lifestyle interventions for community-dwelling persons around retirement age with sarcopenic obesity. Future studies on interventions to counteract sarcopenic obesity should include well-established BCTs to foster adherence and, therefore, their effectiveness.
Purpose of review: To summarize the latest research on the risks and consequences of the burden that may be imposed on informal carers of persons living and dying with advanced heart failure.Recent findings: A systematic search in PubMed over the period 2013–2014 ultimately revealed 24 original articles included in this review. From this research update it can be concluded that the body of knowledge increased with more studies focusing on caregivers of patients with advanced heart failure.Summary: Caregivers are important partners in care and their lives are seriously affected by the condition of advanced heart failure. Studies on the longitudinal effects of the caregiving role on caregiver's quality of life and on caregiver contributions to patient outcomes is still scarce. Focus of current research is moving towards relationship aspects. Dyadic-care typologies and the concept of incongruence within dyads in terms of conflicting perspectives on how to manage the heart failure are new and important concepts presented in studies presented in this review. Heart failure patients and their caregivers still lack sufficient palliative care and communication on prognosis and end-of-life care. More research is needed to determine the optimal time to start palliative interventions to support caregivers of patients with advanced heart failure.
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With regard to the increasing global competition for highly-skilled labour, the group of mobile international students is becoming more and more prominent in the considerations of national policy-makers. One concrete idea is to develop policies in order to bind international students and foreign knowledge workers and make them valuable contributors to the country, economically but also in terms of social and cultural aspects. The Dutch government has put this issue on the agenda and emphasized their interest in binding international talent to the Netherlands. Therefore, it is crucial to learn about the factors, which are decisive in staying and going and which are particularly appealing or unappealing about the Netherlands. In order to contribute to this process, a study was done among international students, alumni, and staff at The Hague University of Applied Sciences. This study's findings have been validated and enriched by the results of a broader survey which has been conducted among the talented international students participating in the Nuffic NL4Talents conference of 4 February 2013 in The Hague. This study suggests that two principal reasons are relevant in residence decisions: career perspective and personal factors, such as having a Dutch partner or circle of friends. Additionally, a number of further factors seems to influence whether internationals want to stay in the Netherlands. All these factors are classified in four groups: those related to the Netherlands in general, to the region/city of residence, personal aspects and aspects related to the university. With regard to the Netherlands, appealing factors appear to be the standard of living, the socio-political environment in the Netherlands and the supposedly welcoming Dutch culture. There are, however, people - in particular those who cannot fully enjoy all rights of the EU citizenship - who feel underprivileged in terms of administrative procedures and in their everyday life in the Netherlands. When it comes to the regional aspects in The Hague, appealing factors are apparently the clean and safe environment to live as well as the availability of several offers for leisure time, including an attractive cultural agenda. Here, the housing situation - more precisely the cost and quality of accommodation - appears as a rather unappealing aspect. In terms of personal considerations, the family-friendly environment in the Netherlands has been rated as particularly appealing. Also having a Dutch partner or Dutch friends may encourage international students to stay and work in the Netherlands. The findings suggest, however, that international students are more embedded in an international circle of friends than linked with the locals. Only few respondents felt being actively excluded from Dutch circles, but a majority agrees that it is difficult to establish bonds with the local population. At the same time, it has been raised that international students voluntarily live in their expat bubble. Lastly, the university experience can contribute to retaining international students. Here, appealing factors were the international study environment which makes the foreign student feel at home, as well as the level and focus of education at The Hague University of Applied Sciences. By contrast, critical views have been raised in relation to a suggested lack of career counselling and support in learning the Dutch language at university. Based on these findings, the report concludes with some recommendations which might serve as a springboard to develop strategies to bind international talent. As the discussion of findings shows, the insights of this study can be validated by insights of a related study that has recently been conducted by Agentschap NL and the advice of the Social and Economic Council of the Netherlands. Based on the findings, the report concludes with a number of recommendations outlining how national, regional, local authorities as well as universities can help to retain more international talent in the Netherlands.
