Background: A positive association between obesity based on body mass index (BMI) and periodontitis has been reported. Fat tissue-related systemic inflammation acts as the link to periodontal comorbidities of obesity. However, the BMI is unable to distinguish fat and fat-free tissues. More precise measures are required to evaluate body composition, including fat and fat-free tissues. This study aimed to determine the sex differences in the association between dual-energy x-ray absorptiometry (DXA)-measured body composition (i.e., fat mass and muscle mass) and phenotypes with periodontitis. Methods: Cross-sectional data of 3892 participants from the National Health and Nutrition Examination Survey (NHANES) study 2011‒2014 were analyzed. Adiposity indices (fat mass index [FMI] and percentage body fat [%BF]) and muscle mass index (MMI) were calculated. The participants were categorized by the quintiles of FMI, MMI, and %BF. Body composition phenotypes were categorized as: low adiposity-low muscle (LA-LM), low adiposity-high muscle (LA-HM), high adiposity-low muscle (HA-LM), or high adiposity-high muscle (HA-HM), respectively. Periodontitis was defined by the CDC/AAP (Centers for Disease Control and Prevention/American Academy of Periodontology) criteria. Multivariable logistic regression analysis was conducted, stratified by sex. We further adjusted for white blood cell (WBC) counts in the sensitivity analysis. Results: Restricted cubic splines revealed non-linear associations between body composition indices and periodontitis risk. Women with a higher FMI (odds ratio for Q5 vs. Q1 [ORQ5vs1] = 1.787, 95% confidence interval: 1.209–2.640) or %BF (ORQ5vs1 = 2.221, 1.509–3.268) had increased odds of periodontitis. In addition, women with HA-LM phenotype were more likely to develop periodontitis (OR = 1.528, 1.037–2.252). Interestingly, the WBC count, a systemic inflammatory biomarker, attenuated these associations. No statistically significant associations were found in men. Conclusions: The association between DXA-measured body composition and phenotypes with periodontitis differs per sex. Only in women higher adiposity indices and HA-LM phenotype were associated with an increased risk of periodontitis.
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The aim of this observational study was to examine the differences between training variables as intended by coaches and perceived by junior speed skaters and to explore how these relate to changes in stress and recovery. During a 4-week preparatory period, intended and perceived training intensity (RPE) and duration (min) were monitored for 2 coaches and their 23 speed skaters, respectively. The training load was calculated by multiplying RPE by duration. Changes in perceived stress and recovery were measured using RESTQ-sport questionnaires before and after 4 weeks. Results included 438 intended training sessions and 378 executed sessions of 14 speed skaters. A moderately higher intended (52:37 h) versus perceived duration (45:16 h) was found, as skaters performed fewer training sessions than anticipated (four sessions). Perceived training load was lower than intended for speed skating sessions (−532 ± 545 AU) and strength sessions (−1276 ± 530 AU) due to lower RPE scores for skating (−0.6 ± 0.7) or shorter and fewer training sessions for strength (−04:13 ± 02:06 hh:mm). All training and RESTQ-sport parameters showed large inter-individual variations. Differences between intended–perceived training variables showed large positive correlations with changes in RESTQ-sport, i.e., for the subscale’s success (r = 0.568), physical recovery (r = 0.575), self-regulation (r = 0.598), and personal accomplishment (r = 0.589). To conclude, speed skaters that approach or exceed the coach’s intended training variables demonstrated an increased perception of success, physical recovery, self-regulation, and personal accomplishment.
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OBJECTIVES: Assessment of malnutrition-related muscle depletion with computed tomography (CT) using skeletal muscle index (SMI) and muscle radiation attenuation (MRA) at the third lumbar vertebra is well validated. However, SMI and MRA values at other vertebral locations and interchangeability as parameters in different types of cancer are less known. We aimed to investigate whether adult patients with different types of cancer show differences in SMI and MRA at all vertebral levels.METHODS: We retrospectively analyzed CT images from 203 patients:120 with head and neck cancer, esophageal cancer, or lung cancer (HNC/EC/LC) and 83 with melanoma (ME). Univariate and multivariate linear regression analyses determined the association between SMI (cm²/m 2) and MRA (Hounsfield units) and cancer type at each vertebral level (significance corrected for multiple tests, P ≤ 0.002). The multivariate analyses included age, sex, cancer stage, comorbidity, CT protocol, and body mass index (BMI) (MRA analyses). RESULTS: SMI was lower in the HNC/EC/LC group versus the ME group at all vertebral levels, except C4 through C6 in the multivariate analyses. Female sex was associated with lower SMI at almost all levels. MRA was similar at most vertebral levels in both cancer groups but was lower at C1 through C4, T7, and L5 in the multivariate analyses. Use of contrast fluid and BMI were associated with higher MRA at all vertebral levels except T8 to T9 and C1 to C2, respectively.CONCLUSIONS: SMI, but not MRA, was lower in HNC/EC/LC patients than in ME patients at most vertebral levels. This indicates that low muscle mass presents itself across the various vertebral muscle areas. MRA may less consistently mark muscle depletion in malnourished patients.
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To date, it is unknown whether waist circumference can be measured validly and reliably when a subject is in a supine position. This issue is relevant when international standards for healthy participants are applied to persons with severe intellectual, sensory, and motor disabilities. Thus, the aims of our study were (1) to determine the validity of waist circumference measurements obtained in a supine position, (2) to formulate an equation that predicts standing waist circumference from measurements obtained in a supine position, and (3) to determine the reliability of measuring waist circumference in persons with severe intellectual, sensory, and motor disabilities. First, we performed a validity study in 160 healthy participants, in which we compared waist circumference obtained in standing and supine positions. We also conducted a test-retest study in 43 participants with severe intellectual, sensory, and motor disabilities, in which we measured the waist circumference with participants in the supine position. Validity was assessed with paired t-test and Wilcoxon signed rank test. A prediction equation was estimated with multiple regression analysis. Reliability was assessed by Wilcoxon signed rank test, limits of agreement (LOA), and intraclass correlation coefficients (ICC). Paired t-test and Wilcoxon signed rank test revealed significant differences between standing and supine waist circumference measurements. We formulated an equation to predict waist circumference (R(2)=0.964, p<0.001). There were no significant differences between test and retest waist circumference values in disabled participants (p=0.208; Wilcoxon signed rank test). The LOA was 6.36 cm, indicating a considerable natural variation at the individual level. ICC was .98 (p<0.001). We found that the validity of supine waist circumference is biased towards higher values (1.5 cm) of standing waist circumference. However, standing waist circumference can be predicted from supine measurements using a simple prediction equation. This equation allows the comparison of supine measurements of disabled persons with the international standards. Supine waist circumference can be reliably measured in participants with severe intellectual, sensory, and motor disabilities.
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Hoofdstuk 5 in Moresprudentie in de praktijk. Wanneer ouders gaan scheiden, komen kinderen vaak in de knel. De sociale professionals die in dit soort situaties ondersteuning bieden raken verstrikt in een kluwen van belangen. Het risico is groot, dat zij in hun zorg om het belang van het kind, positie kiezen tegenover de ouder. Edith Raap laat in dit hoofdstuk zien dat het ook anders kan en wat dit betekent voor de ethische positie van de hulpverlener zelf.
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Mensen in een lage sociaaleconomische positie geven de voorkeur aan ondernemend sport- en beweegaanbod ten opzichte van verenigingsaanbod. Uit interviews met sleutelfiguren en in straatinterviews met wijkbewoners blijkt dat er verschillende redenen zijn om voor dit ondernemende aanbod te kiezen, zoals flexibiliteit in tijd en intensiteit, beweegschaamte, gemak en toegankelijkheid. Het onderzoek biedt ook inzichten over het verschil tussen commerciële en sociale ondernemende aanbieders, de invloed van taal en aandacht voor mensen in de meest kwetsbare positie. Het onderzoek biedt inzichten voor beleidsmakers en sportaanbieders om hun aanbod toegankelijk te maken voor mensen in een lage sep. Het verkennende kwalitatieve onderzoek is uitgevoerd in opdracht van het Kenniscentrum Sport en Bewegen en is uitgevoerd in de aandachtswijken Poelenburg in Zaanstad en in Haarlem-oost.
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Deze studie onderzoekt de positie van het vmbo binnen het Nederlandse onderwijsstelsel en dient als startdossier bij het advies "Herkenbaar vmbo met sterk vakmanschap" van de Onderwijsraad.
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Social return on investment & positie MKB. Welke condities vergroten voor het MKB de kans op gunning van (semi-)overheidsopdrachten met een social return doelstelling?
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Paper voor ORD 2014 In deze reviewstudie wordt de positie van het voorbereidend middelbaar beroepsonderwijs (vmbo) geanalyseerd als deel van het onderwijsbestel zowel in relatie tot de eerste fase voortgezet onderwijs als in relatie tot de beroepsonderwijskolom. De dualiteit van het vmbo wordt beschouwd ten aanzien van ontwikkelingen in maatschappelijke doelen, keuze- en selectieprocessen, inrichtingskenmerken en deelnamepatronen. Er wordt een historisch perspectief gehanteerd, niet zozeer voor een descriptief overzicht maar om inzicht te krijgen in de ontwikkelingen. Aanvullend vindt een internationale vergelijking plaats met enkele onderwijsstelsels die dezelfde of juist andere kenmerken hebben. Is de meervoudige positie van het vmbo al dan niet herkenbaar in andere stelsels, welke horizontale en verticale verbindingen zijn elders aanwezig, hoe zijn deelnameontwikkelingen vervolgens te begrijpen?
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Verslag van een onderzoek naar de positie van de melkveehouderij op het Kampereiland. Dit rapport heeft als doel om bij te dragen aan het voortgaande gesprek tussen verpachter en pachters over de visie op de ontwikkeling van het gebied.
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