ObjectivesInsight into older adults’ physical resilience is needed to predict functional recovery after hospitalization. We assessed functional trajectories in response to acute illness and subsequent hospitalization and investigated baseline variables and dynamic variables associated with these trajectories.DesignProspective observational cohort study (Hospitalization-Associated Disability and impact on daily Life Study).Setting and ParticipantsThis study included 207 older adults (aged 79.8 ± 6.9 years, 49% female, 57% frail) acutely hospitalized in 6 Dutch hospitals.MethodsFunctional disability was assessed using the 15-item modified activities of daily living index retrospectively 2 weeks before admission, and prospectively from admission up to 3 months after discharge. Baseline variables including frailty, somatic, physical, and psychosocial factors were assessed at admission. Dynamic variables (step count, pain, fatigue, and fear of falling) were continuously or repeatedly assessed during hospitalization. We performed individual spline modeling using random effects. Baseline variables and within-person mean levels and variability in the dynamic variables were assessed as predictors of functional trajectories.ResultsFunctional disability significantly increased before admission and decreased from admission to 3 months post discharge. Frail participants had a significantly higher increase in functional disability before admission compared with nonfrail participants. Lower step count, higher pain scores, and higher within-person variability in fear of falling were significantly associated with higher increase in functional disability before admission. Higher within-person variability in fear of falling was associated with more recovery.Conclusions and ImplicationsOlder adults increase in functional disability before hospitalization and start to recover from admission onward. Frailty and dynamic variables are associated with a higher increase in functional disability after acute illness. Our findings give more insight into older adults’ physical resilience, which may improve the prediction of functional recovery and may improve therapeutic decision-making and rehabilitation strategies to improve functional recovery after acute hospitalization.
ObjectivesInsight into older adults’ physical resilience is needed to predict functional recovery after hospitalization. We assessed functional trajectories in response to acute illness and subsequent hospitalization and investigated baseline variables and dynamic variables associated with these trajectories.DesignProspective observational cohort study (Hospitalization-Associated Disability and impact on daily Life Study).Setting and ParticipantsThis study included 207 older adults (aged 79.8 ± 6.9 years, 49% female, 57% frail) acutely hospitalized in 6 Dutch hospitals.MethodsFunctional disability was assessed using the 15-item modified activities of daily living index retrospectively 2 weeks before admission, and prospectively from admission up to 3 months after discharge. Baseline variables including frailty, somatic, physical, and psychosocial factors were assessed at admission. Dynamic variables (step count, pain, fatigue, and fear of falling) were continuously or repeatedly assessed during hospitalization. We performed individual spline modeling using random effects. Baseline variables and within-person mean levels and variability in the dynamic variables were assessed as predictors of functional trajectories.ResultsFunctional disability significantly increased before admission and decreased from admission to 3 months post discharge. Frail participants had a significantly higher increase in functional disability before admission compared with nonfrail participants. Lower step count, higher pain scores, and higher within-person variability in fear of falling were significantly associated with higher increase in functional disability before admission. Higher within-person variability in fear of falling was associated with more recovery.Conclusions and ImplicationsOlder adults increase in functional disability before hospitalization and start to recover from admission onward. Frailty and dynamic variables are associated with a higher increase in functional disability after acute illness. Our findings give more insight into older adults’ physical resilience, which may improve the prediction of functional recovery and may improve therapeutic decision-making and rehabilitation strategies to improve functional recovery after acute hospitalization.
Mensen met autisme redden het vaker niet dan wel op school en op de arbeidsmarkt. Niet kunnen omgaan met stress, bijvoorbeeld door veranderingen in het werk, is de belangrijkste oorzaak. Het zelf kunnen herkennen van stress en nadenken over de oorzaken daarvan is weinig mensen met ASS gegeven, en ook voor mensen in de omgeving (coaches, docenten, collega’s) wordt het vaak pas duidelijk als het te laat is. Vroegtijdige signalering van stress om uitval te voorkomen is derhalve wenselijk. Doel van dit project is het ontwikkelen van een digitale stress duidings- en coachingstool, waarbij zowel het perspectief van begeleiders/coaches als dat van de persoon met autisme zelf wordt ondersteund. Daarbij maken we gebruik van de wetenschappelijk voldoende bewezen technologie van huidweerstand-analyse. Zoals bij alle technologieën die ontwikkeld worden voor stresssignalering geldt ook hier dat menselijke duiding nodig blijft. Centraal in deze aanvraag staan technologische ontwikkelingen die in gang gezet zijn binnen Fontys Hogeschool ICT en Game Solutions Lab om stress-indicatoren te meten en te communiceren, gecombineerd met de domeinkennis van Leo Kanner, Leermakers Zorggroep, de Nederlandse Vereniging voor Autisme (NVA) en Student+. De innovatie kracht van dit project ligt in de combinatie van menselijke kracht én technologische ondersteuning in lijn met het probleemgebied Enabling Adaptation binnen de Roadmap Design for Change. Deze combinatie maakt het mogelijk om op grond van objectieve data sneller en effectiever stressoren in kaart te brengen en zelfduiding te stimuleren op het juiste moment. Hiermee worden niet alleen actuele risico’s beperkt, maar zal ook voor de lange termijn leiden tot betere zelfkennis en meer zelfregie. Hierdoor kan de doelgroep door juiste aanpassingen wel duurzaam onderwijs volgen of aan het werk blijven.
Many Caribbean reefs have shifted from coral-dominated to algal-dominated ecosystems. The high algae cover reduces coral recruitment, making the reef unable to recover from other disturbances and resulting in flatter reefs with lower biodiversity. One of the reasons for the proliferation of algae is a mass die-off of the herbivorous sea urchin Diadema antillarum in the early 1980s. Natural recovery of Diadema populations is slow to non-existent, making active restoration of this important grazer a top priority in Caribbean coral reef management, especially since Diadema densities were reduced by another mass mortality event in 2022. The marine park organizations of Saba and St. Eustatius want to restore Diadema populations by restocking cultured individuals. However, important knowledge gaps need to be addressed before large numbers of Diadema can be restocked on the reef. Current culture methods can only produce a limited number of competent larvae. In addition, only 8% of the settlers survive and after restocking, survival on the reef is low as well. In the RAAK PRO Diadema II project, the bottlenecks in Diadema culture will be addressed by comparing larval survival across multiple culture methods and investigating the relation between larval size and post-settlement survival. Growing-out juveniles at sea is likely to help prepare them for life in the wild, while restocking at an optimal size might also increase survival. Finally, a thorough restocking site selection based on high shelter availability and settlement rates will increase the long-term Diadema densities. The acquired knowledge and developed practices will be verified in a larger scale restocking experiment involving at least 5000 Diadema urchins. By restoring Diadema populations through restocking, macroalgae will be more intensively removed and corals will have a chance to settle and to survive, increasing the ability of the reef to cope with other stressors.
Van forensisch sociale professionals wordt verwacht dat ze adequaat om kunnen gaan met tegenslagen of negatieve gebeurtenissen die tijdens het werk plaats vinden. Er is echter nog weinig bekend over wat zij nodig hebben om zich te beschermen tegen mogelijke of daadwerkelijk schadelijke invloeden die op hen af komen. Wat is er voor nodig om mentaal weerbaar te blijven binnen dit werkveld?Doel Tijdens dit project inventariseren we ervaringen op het gebied van mentale weerbaarheid bij deze professionals, om een algemeen beeld te krijgen van de specifieke stressoren op verschillende gebieden (maatschappij, organisatie, team/collega’s, cliënten, privé) binnen het forensische werkveld. Wat is er nodig om adequaat te functioneren in risicovolle omstandigheden wat is er nodig om te herstellen na een ingrijpende gebeurtenis, wat kan er geleerd worden van een tegenslag en hoe kan dit geleerde ingezet worden binnen het forensische werkveld? Resultaten Dit onderzoek resulteert in inzicht in wat er nodig is om metaal weerbaar te blijven. De opgedane kennis kan worden gebruikt om toekomstige professionals optimaal voor te bereiden. Ook kan deze kennis toegepast worden in het werkveld om ervoor te zorgen dat de professional adequaat kan reageren in risicovolle situaties. Looptijd 01 januari 2020 - 01 januari 2021 Aanpak Enquête over mentale weerbaarheid onder forensisch sociale professionals Interviews: Welke beschermende factoren kunnen bijdragen aan het mentaal gezond zijn en hoe kan er geleerd worden van een tegenslag? Ontwikkelen inzichten en toepassing daarvan in het forensische werkveld Ontwikkelen methodiek en aanpassing onderwijs