ObjectiveThe Joint Effort Initiative (JEI) is an international collaboration of clinicians, researchers, and consumer organisations with a shared vision of improving the implementation of osteoarthritis management programs (OAMPs). This study aimed to identify JEI's future priorities and guide direction. DesignA two-part international survey to prioritise topics of importance to our membership and research stakeholders. Survey one presented a list of 40 topics under 5 themes. Consenting participants were asked to choose their top three topics in each theme. A short list of 25 topics was presented in survey two. Participants were asked to rank the importance (100-point NRS scale, 100 = highest priority). Response frequency (median, IQR) was used to rank the top priorities by theme. Results Ninety-five participants completed survey one (61% female, 48% clinicians) and 57 completed survey two. The top ranked topic/s were: i. Promotion and advocacy: support training for health professionals (median 85, IQR 24). ii. Education and training: incorporating behaviour change into OAMPs (80, 16), advanced OA skills (80, 30), and integration of OA education into clinical training (80, 36). iii. Improving OAMPs delivery: regular updates on changes to best-evidence OA care (84, 24). iv. Future research: improve uptake of exercise, physical activity, and weight-loss (89, 16). v. Enhancing relationships, alliances, and shared knowledge: promote research collaborations (81, 30), share challenges and opportunities for OAMP implementation (80, 23). ConclusionsThese topics will set the JEI's research and collaboration agenda for the next 5 years and stimulate ideas for others working in the field.
MULTIFILE
BACKGROUND: Chronic musculoskeletal pain (CMP), Generalized Joint Hypermobility (GJH) and pain-related fear have influence on physical functioning in adolescents.AIM: to evaluate differences in physical functioning between adolescents with CMP, GJH or the combination of both, and in addition evaluate the potential contribution of pain-related fear.DESIGN: The design of this study was observational and cross-sectional.SETTING: The adolescents with CMP were recruited by a physician in rehabilitation medicine and measured in the university outpatient rehabilitation clinic (Adelante/Maastricht University Medical Center+, the Netherlands). The adolescents without CMP were recruited in the Southern area of the Netherlands and measured in the university outpatient rehabilitation clinic (Adelante/Maastricht University Medical Center+, the Netherlands).POPULATION: Four subgroups of adolescents were included; 21 adolescents with CMP without GJH, 9 adolescents with CMP and GJH, 51 adolescents without CMP without GJH, and 11 adolescents without CMP with GJH.METHODS: Outcome measures were muscle strength and endurance, motor performance, physical activity level, and pain-related fear. Hierarchical regression analyses were used to study differences in physical functioning and the contribution of pain-related fear in adolescents with/without CMP as well as with/without GJH.RESULTS: Adolescents with CMP had decreased muscle strength (P=0.01), endurance (P=0.02), and lower motor performance (P<0.01) compared to adolescents without CMP. Higher levels of pain-related fear were related to decreased muscle strength (P=0.01), endurance (P<0.01), and motor performance (P<0.01). No differences in physical functioning and pain-related fear between hypermobile and non-hypermobile adolescents with CMP were found.CONCLUSIONS: Adolescents with CMP had decreased muscle strength and motor performance associated with increased levels of pain-related fear compared to adolescents without CMP. The association of being hypermobile with physical functioning is not more pronounced in adolescents with CMP.CLINICAL REHABILITATION IMPACT: No differences were found in physical functioning and pain-related fear between hypermobile adolescents with CMP compared to non-hypermobile adolescents with CMP. Future rehabilitation treatment in hypermobile adolescents with CMP should also focus on psychological components, such as pain-related fear.
Young professional dancers find themselves in a demanding environment. GJH within dancers is often seen as aesthetically beneficial and a sign of talent but was found to be potentially disabling. Moreover, high-performing adolescents and young adults (HPAA), in this specific lifespan, might be even more vulnerable to anxiety-related disability. Therefore, we examined the development of the association between the presence of Generalized Joint Hypermobility (GJH) and anxiety within HPAA with a one-year follow-up. In 52.3% of the HPAA, anxiety did not change significantly over time, whereas GJH was present in 28.7%. Fatigue increased significantly in all HPAA at one year follow-up (respectively, females MD (SD) 18(19), p < 0.001 and males MD (SD) 9(19), p < 0.05). A significantly lower odds ratio (ß (95% CI) 0.4 (0.2–0.9); p-value 0.039) for participating in the second assessment was present in HPAA with GJH and anxiety with a 55% dropout rate after one year. This confirms the segregation between GJH combined with anxiety and GJH alone. The fatigue levels of all HPAA increased significantly over time to a serious risk for sick leave and work disability. This study confirms the association between GJH and anxiety but especially emphasizes the disabling role of anxiety. Screening for anxiety is relevant in HPAA with GJH and might influence tailored interventions.
This project aims to develop a measurement tool to assess the inclusivity of experiences for people with varying challenges and capabilities on the auditory spectrum. In doing so, we performed an in-depth exploration of scientific literature and findings from previous projects by Joint Projects. Based on this, we developed an initial conceptual model that focuses on sensory perception, emotion, cognition, and e[ort in relation to hearing and fatigue. Within, this model a visitor attraction is seen as an “experienscape” with four key elements: content, medium, context, and individual. In co-creative interviews with experts by experience with varying challenges on the auditory spectrum, they provided valuable insights that led to a significant expansion of this initial model. This was a relevant step, as in the scientific and professional literature, little is known about the leisure experiences of people with troubled hearing. For example, personal factors such as a person’s attitude toward their own hearing loss and the social dynamics within their group turned out to greatly influence the experience. The revised model was then applied in a case study at Apenheul, focusing on studying differences in experience of their gorilla presentation amongst people with varying challenges on the auditory spectrum.Societal issueThe Netherlands is one of the countries in Europe with the highest density of visitor attractions. Despite this abundance, many visitor attractions are not fully accessible to everyone, particularly to visitors with disabilities who sometimes are not eligible to ride due to safety concerns, yet when eligible generally still encounter numerous barriers. Accessibility of visitor attractions can be approached in various ways. However, because the focus often lies on operational and technical aspects (e.g., reducing stimuli at certain times of the day by turning o[ music, o[ering alternative wheelchair entrances), strategic and community-focused approaches are often overlooked. More importantly, there is also a lack of attention to the experience of visitors with disabilities. This becomes apparent from several studies from Joint Projects, where visitor attractions are being visited together with experts by experience with various disabilities. Nevertheless, experience is often being regarded as the 'core product' of the leisure sector. The right to meet, discover, develop, relax and thus enjoy this core product is hindered for many people with disabilities due to a lack of knowledge, inaccessibility (physical, digital, social, communicative as well as financial) and discrimination in society. Additionally, recreation entrepreneurs still face a significant gap in reaching the potential market of guests with disabilities and their networks. Thus, despite the numerous initiatives in the leisure sector aimed at improving accessibility on technical and operational fronts, often people with disabilities are still not being able to experience the same kind of enjoyment as those without. These observations form the pressing impetus for initiating the current research project, tapping into the numerous opportunities for learning, development and growth on making leisure offer more inclusive.Benefit to societyIn total, the current project approach comes with a number of enrichments in terms of both knowledge and methodology: a mixed-methods approach that allows for comparing data from different sources to obtain a more complete picture of the experience; a methodological co-design process that honours the 'nothing about us without us' principle; and benchmarking for a group (i.e., people with challenges on the auditory spectrum) that despite the size of its population has thus far mostly been overlooked.
The textile industry is responsible for over 8% of global greenhouse gas emissions and 20% of the world’s wastewater, surpassing the emissions from international flights and shipping combined. In the European Union, textile purchases in 2020 led to around 270 kg of CO₂ emissions per person, yet only 1% of used clothing is recycled into new garments. The municipality of Groningen manages an estimated 950 kilotons of textile waste but is only able to collect, sort, and recycle 250 kilotons. To address these challenges, Textile Hub Groningen (THG) seeks to support small and medium-sized enterprises (SMEs) and stakeholders in creating circular textile value chains. However, designing circular value chains presents challenges, including conflicting interests, knowledge gaps on circular design principles, and inadequate tools for collaborative business model development. Potential stakeholders often find current tools too abstract and not conducive to collaboration, learning, or experimentation. As a result, circular value chains remain difficult to achieve from the perspective of individual stakeholders. Serious games have been employed to simulate and experiment with complex adaptive systems , . Research shows that well-designed playful learning enhances both learning and motivation, particularly when social elements are integrated . This project aims to answer the following research question: How can serious games be leveraged to design circular textile value chains in the region? The expected outcomes are: 1. Serious Game: Design, test, and deliver a serious game to facilitate the joint design of circular textile value chains. 2. Publications: Extract insights from the game’s design and evaluation, contributing to both academic and practical discussions. 3. Consortium for Follow-up: Mobilize partners and secure funding for future projects in related fields. Through game-based collaborative circular value chain and business model design experiences, this project overcomes barriers in designing viable circular value chains in the textile industry
The population in rural areas in the northern provinces are aging in a much higher pace than in other parts of the Netherlands. Many young and higher educated citizens move out of these provinces. Quality of life in rural villages decreases likewise and the inhabitants that stay behind are more vulnerable, with lower income and educational levels. Recent decentralization policies put a larger burden on local constituencies to guarantee the quality of the living environment but a lot of them lack sufficient knowledge and capacity to tackle this complex issue.The initiators of this application have joined their knowledge and experience to put together a consortium with the aim to support these smaller constituencies in rural areas in the three northern provinces with a new and innovative methodology: the GO! approach. This approach was developed in the neigborhoods of Utrecht municipality and will be used for the first time in rural communities with a comparable size .This approach consists of the following steps:• First to identify possibilities to create a healthier living environment by analyzing available data on pollution, spatial layout and social cohesion.• To discuss the result of this analysis with local citizens and other local stakeholders in order to link the data with local experiences• To prioritize into major themes as a result of the combination of all this available information.• To link these major themes to combinations effective measures available from RIVM and international databases.• To present these combinations to the local government, their citizens and other local stakeholders in order to let them choose for an effective approach and inplemant it together in order to create a local healthier living environment.The GO! approach will provide local citizens and professionals with the necessary tools and knowledge to work jointly and effectively to realize a healthier living environment. The project partners that jointly started the consortium will put in effort during this first year to build and formalize the consortium and to make arrangements with several constituencies in the three northers provinces to formulate their own specific knowledge agenda as a basis for concrete project proposals in the second stage to be implemented with the support of the formalized consortium.
