Introduction: Illness Perceptions (IPs) may play a role in the management of persistent low back pain. The mediation and/or moderation effect of IPs on primary outcomes in physiotherapy treatment is unknown. Methods: A multiple single-case experimental design, using a matched care physiotherapy intervention, with three phases (phases A-B-A’) was used including a 3 month follow up (phase A’). Primary outcomes: pain intensity, physical functioning and pain interference in daily life. Analyzes: linear mixed models, adjusted for fear of movement, catastrophizing, avoidance, sombreness and sleep. Results: Nine patients were included by six different primary care physiotherapists. Repeated measures on 196 data points showed that IPs Consequences, Personal control, Identity, Concern and Emotional response had a mediation effect on all three primary outcomes. The IP Personal control acted as a moderator for all primary outcomes, with clinically relevant improvements at 3 month follow up. Conclusion: Our study might indicate that some IPs have a mediating or a moderating effect on the outcome of a matched care physiotherapy treatment. Assessing Personal control at baseline, as a relevant moderator for the outcome prognosis of successful physiotherapy management of persistent low back pain, should be further eplored.
The prevalence of type 2 diabetes (T2D) is relatively high among people with a low socioeconomic status (SES). As lifestyle is crucial in T2D management, patients are advised to live healthily, but incorporating lifestyle changes in daily life is not easy. It may be even more difficult for people with a low SES, as they often struggle with more urgent issues in daily life that supersede healthy lifestyle. How to promote a healthy lifestyle such that the needs of low SES patients are met? A boundary condition is a thorough understanding of the target group, and of the differences between individuals in this group. Too often, people with a low SES receive either general advice, or advice targeted to literacy level or ethnic background, whereas the diversity within the low SES population is much wider than that. We developed personas to identify archetypes of the target group, each reflecting a distinct pattern in goals, attitudes and behaviours, to help grasp the diversity of the target group. Ten interviews with low SES T2D-patients revealed their perceptions and experiences related to what is important in life, a healthy lifestyle, living with diabetes, and lifestyle advice. Following Goodwin’s persona development methodology (2011), three groups were qualitatively extracted from the data. In short, the personas are: 1) the worrisome caregiver: wants to live healthier, but is incapable of incorporating advices into one’s life; caring for others is first priority; 2) the conscious self-confident: willing and able to follow up advice in order to reduce medication use; 3) the selfwilled survivor: dealing with multiple (health) issues, and dedicated to solve things one’s own way. Each persona likely responds differently to health promoting strategies. Additional research is needed to enrich the set of personas, for example by verifying them with the target group’s family or health professionals.
Resilience to adverse events is increasingly recognized as important for human health. Socio-economic status (SES) is also frequently identified as a predictor of resilience. However, it is not well-understood how people define resilience in their everyday lives, and whether individuals have different experiences of resilience based on their SES. This study sought to fill these gaps, in the context of the COVID-19 pandemic and pandemic mitigation policies in the Netherlands.We interviewed high (n = 38) and low (n = 37) SES participants about their understanding and experiences of resilience during this period. Participants took part in individual interviews and focus groups in September 2021. Transcripts were analyzed thematically.A key theme was coping with adversity, in line with commonly-used definitions of resilience. However, we found that resilience was often defined more broadly. Resilience also encompassed aspects of self-reflection and improvement, and faith in oneself, the community and the nation. There were also key differences by SES background: elaborate and optimistic definitions and experiences of resilience were more often described by high SES individuals. For instance, high SES participants more frequently defined resilience as growing and improving. In contrast, low SES participants more commonly experienced resilience as enduring until better times arrived.Having a higher SES seemed to support resilience during the COVID-19 pandemic. This indicates that adverse events may exacerbate pre-existing financial and material difficulties among low SES individuals. This finding underscores the importance of addressing financial precarity prior to adverse events.
MULTIFILE
Our unilateral diet has resulted in a deficiency of specific elements/components needed for well-functioning of the human body. Especially the element magnesium is low in our processed food and results in neuronal and muscular malfunctioning, problems in bone heath/strength, and increased chances of diabetes, depression and cardiovascular diseases. Furthermore, it has also been recognized that magnesium plays an important role in cognitive functioning (impairment and enhancement), especially for people suffering from neurodegenerative diseases (Parkinson disease, Alzheimer, etc). Recently, it has been reported that magnesium addition positively effects sleep and calmness (anti-stress). In order to increase the bioavailability of magnesium cations, organic acids such as citrate, glycerophosphate and glycinate are often used as counterions. However, the magnesium supplements that are currently on the market still suffer from low bio-availability and often do not enter the brain significantly.The preparation of dual/multiple ligands of magnesium in which the organic acid not only functions as a carrier but also has synergistically/complementary biological effects is widely unexplored and needs further development. As a result, there is a strong need for dual/multiple magnesium supplements that are non-toxic, stable, prepared via an economically and ecologically attractive route, resulting in high bioavailability of magnesium in vivo, preferably positively influencing cognition/concentration
Carboxylated cellulose is an important product on the market, and one of the most well-known examples is carboxymethylcellulose (CMC). However, CMC is prepared by modification of cellulose with the extremely hazardous compound monochloracetic acid. In this project, we want to make a carboxylated cellulose that is a functional equivalent for CMC using a greener process with renewable raw materials derived from levulinic acid. Processes to achieve cellulose with a low and a high carboxylation degree will be designed.
The transition towards an economy of wellbeing is complex, systemic, dynamic and uncertain. Individuals and organizations struggle to connect with and embrace their changing context. They need to create a mindset for the emergence of a culture of economic well-being. This requires a paradigm shift in the way reality is constructed. This emergence begins with the mindset of each individual, starting bottom-up. A mindset of economic well-being is built using agency, freedom, and responsibility to understand personal values, the multi-identity self, the mental models, and the individual context. A culture is created by waving individual mindsets together and allowing shared values, and new stories for their joint context to emerge. It is from this place of connection with the self and the other, that individuals' intrinsic motivation to act is found to engage in the transitions towards an economy of well-being. This project explores this theoretical framework further. Businesses play a key role in the transition toward an economy of well-being; they are instrumental in generating multiple types of value and redefining growth. They are key in the creation of the resilient world needed to respond to the complex and uncertain of our era. Varta-Valorisatielab, De-Kleine-Aarde, and Het Groene Brein are frontrunner organizations that understand their impact and influence. They are making bold strategic choices to lead their organizations towards an economy of well-being. Unfortunately, they often experience resistance from stakeholders. To address this resistance, the consortium in the proposal seeks to answer the research question: How can individuals who connect with their multi-identity-self, (via personal values, mental models, and personal context) develop a mindset of well-being that enables them to better connect with their stakeholders (the other) and together address the transitional needs of their collective context for the emergence of a culture of the economy of wellbeing?