There is a growing number of eHealth interventionsaiming at enhancing lifestyle to address obesity. However, theexisting interventions do not take the emotional aspects ofobesity into account. Forty percent of the overweight populationis an emotional eater. Emotional eaters gain weight because ofpoor emotion regulation, not just due to bad eating habits. Weaim at developing a personalised virtual coach ‘Denk je zèlf!’providing support for self-regulation of emotions for obeseemotional eaters. This paper presents a research study protocolon validating persuasive coaching strategies in emotionregulation, based on Dialectical Behaviour Therapy, ultimatelytargeting behaviour change. Our goal is to design a personalisedeCoaching framework, allowing us to optimally translatesuccessful behaviour change mechanisms and techniques, suchas dialectical strategies, into personalised persuasive coachingstrategies.
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Societal actors across scales and geographies increasingly demand visual applications of systems thinking – the process of understanding and changing the reality of a system by considering its whole set of interdependencies – to address complex problems affecting food and agriculture. Yet, despite the wide offer of systems mapping tools, there is still little guidance for managers, policy-makers, civil society and changemakers in food and agriculture on how to choose, combine and use these tools on the basis of a sufficiently deep understanding of socio-ecological systems. Unfortunately, actors seeking to address complex problems with inadequate understandings of systems often have limited influence on the socio-ecological systems they inhabit, and sometimes even generate unintended negative consequences. Hence, we first review, discuss and exemplify seven key features of systems that should be – but rarely have been – incorporated in strategic decisions in the agri-food sector: interdependency, level-multiplicity, dynamism, path dependency, self-organization, non-linearity and complex causality. Second, on the basis of these features, we propose a collective process to systems mapping that grounds on the notion that the configuration of problems (i.e., how multiple issues entangle with each other) and the configuration of actors (i.e., how multiple actors relate to each other and share resources) represent two sides of the same coin. Third, we provide implications for societal actors - including decision-makers, trainers and facilitators - using systems mapping to trigger or accelerate systems change in five purposive ways: targeting multiple goals; generating ripple effects; mitigating unintended consequences; tackling systemic constraints, and collaborating with unconventional partners.
MULTIFILE
Abstract Background One of the most problematic expression of ageing is frailty, and an approach based on its early identification is mandatory. The Sunfrail-tool (ST), a 9-item questionnaire, is a promising instrument for screening frailty. Aims • To assess the diagnostic accuracy and the construct validity between the ST and a Comprehensive Geriatric Assessment (CGA), composed by six tests representative of the bio-psycho-social model of frailty; • To verify the discriminating power of five key-questions of the ST; • To investigate the role of the ST in a clinical-pathway of falls’ prevention. Methods In this retrospective study, we enrolled 235 patients from the Frailty-Multimorbidity Lab of the University-Hospital of Parma. The STs’ answers were obtained from the patient’s clinical information. A patient was considered frail if at least one of the CGAs’ tests resulted positive. Results The ST was associated with the CGA’s judgement with an Area Under the Curve of 0.691 (CI 95%: 0.591–0.791). Each CGA’s test was associated with the ST total score. The five key-question showed a potential discriminating power in the CGA’s tests of the corresponding domains. The fall-related question of the ST was significantly associated with the Short Physical Performance Battery total score (OR: 0.839, CI 95%: 0.766–0.918), a proxy of the risk of falling. Discussion The results suggest that the ST can capture the complexity of frailty. The ST showed a good discriminating power, and it can guide a second-level assessment to key frailty domains and/or clinical pathways. Conclusions The ST is a valid and easy-to-use instrument for the screening of frailty.
