Objectives: Promoting unstructured outside play is a promising vehicle to increase children’s physical activity (PA). This study investigates if factors of the social environment moderate the relationship between the perceived physical environment and outside play. Study design: 1875 parents from the KOALA Birth Cohort Study reported on their child’s outside play around age five years, and 1516 parents around age seven years. Linear mixed model analyses were performed to evaluate (moderating) relationships among factors of the social environment (parenting influences and social capital), the perceived physical environment, and outside play at age five and seven. Season was entered as a random factor in these analyses. Results: Accessibility of PA facilities, positive parental attitude towards PA and social capital were associated with more outside play, while parental concern and restriction of screen time were related with less outside play. We found two significant interactions; both involving parent perceived responsibility towards child PA participation. Conclusion: Although we found a limited number of interactions, this study demonstrated that the impact of the perceived physical environment may differ across levels of parent responsibility.
MULTIFILE
Background:Postoperative complications and readmissions to hospital are factors known to negatively influence the short- and long-term quality of life of patients with gastrointestinal cancer. Active family involvement in activities, such as fundamental care activities, has the potential to improve the quality of health care. However, there is a lack of evidence regarding the relationship between active family involvement and outcomes in patients with gastrointestinal cancer after surgery.Objective:This protocol aims to evaluate the effect of a family involvement program (FIP) on unplanned readmissions of adult patients undergoing surgery for malignant gastrointestinal tumors. Furthermore, the study aims to evaluate the effect of the FIP on family caregiver (FC) burden and their well-being and the fidelity of the FIP.Methods:This cohort study will be conducted in 2 academic hospitals in the Netherlands. The FIP will be offered to adult patients and their FCs. Patients are scheduled for oncological gastrointestinal surgery and have an expected hospital stay of at least 5 days after surgery. FCs must be willing to participate in fundamental care activities during hospitalization and after discharge. Consenting patients and their families will choose to either participate in the FIP or be included in the usual care group. According to the power calculation, we will recruit 150 patients and families in the FIP group and 150 in the usual care group. The intervention group will receive the FIP that consists of information, shared goal setting, task-oriented training, participation in fundamental care, presence of FCs during ward rounds, and rooming-in for at least 8 hours a day. Patients in the comparison group will receive usual postoperative care. The primary outcome measure is the number of unplanned readmissions up to 30 days after surgery. Several secondary outcomes will be collected, that is, total number of complications (sensitive to fundamental care activities) at 30 and 90 days after surgery, emergency department visits, intensive care unit admissions up to 30 and 90 days after surgery, hospital length of stay, patients’ quality of life, and the amount of home care needed after discharge. FC outcomes are caregiver burden and well-being up to 90 days after participating in the FIP. To evaluate fidelity, we will check whether the FIP is executed as intended. Univariable regression and multivariable regression analyses will be conducted.Results:The first participant was enrolled in April 2019. The follow-up period of the last participant ended in May 2022. The study was funded by an unrestricted grant of the University hospital in 2018. We aim to publish the results in 2023.Conclusions:This study will provide evidence on outcomes from a FIP and will provide health care professionals practical tools for family involvement in the oncological surgical care setting.
BackgroundSubstance use disorders (SUDs) are prevalent in the general population, tend to follow a chronic course, are associated with many individual and social problems, and often have their onset in adolescence. However, the knowledge base from prospective population surveys and treatment-outcome studies on the course of SUD in adolescents is limited at best. The present study aims to fill this gap and focuses on a subgroup that is particularly at risk for chronicity: adolescents in addiction treatment. We will investigate the rate of persistent SUD and its predictors longitudinally from adolescence to young adulthood among youth with DSM-5 SUD from the start of their addiction treatment to 2 and 4 years following treatment-entry. In addition to SUD, we will investigate the course of comorbid mental disorders, social functioning, and quality of life and their association with SUD over time.Methods/designIn a naturalistic, multi-center prospective cohort design, we will include youths (n = 420), who consecutively enter addiction treatment at ten participating organizations in the Netherlands. Inclusion is prestratified by treatment organization, to ensure a nationally representative sample. Eligible youths are 16 to 22 years old and seek help for a primary DSM-5 cannabis, alcohol, cocaine or amphetamine use disorder. Assessments focus on lifetime and current substance use and SUD, non-SUD mental disorders, family history, life events, social functioning, treatment history, quality of life, chronic stress indicators (hair cortisol) and neuropsychological tests (computerized executive function tasks) and are conducted at baseline, end of treatment, and 2 and 4 years post-baseline. Baseline data and treatment data (type, intensity, duration) will be used to predict outcome – persistence of or desistance from SUD.DiscussionThere are remarkably few prospective studies worldwide that investigated the course of SUD in adolescents in addiction treatment for longer than 1 year. We are confident that the Youth in Transition study will further our understanding of determinants and consequences of persistent SUD among high-risk adolescents during the critical transition from adolescence to young adulthood.Trial registrationThe Netherlands National Trial Register Trial NL7928. Date of registration January 17, 2019.
Ballet en moderne dans zijn een vorm van topsport. De druk op dansers is enorm. Lange en intensieve werkdagen, veel reizen en verschillende werkplekken maken het lastig om lichaam en geest goed te verzorgen. Hierdoor liggen blessures en mentale klachten op de loer. Nederlandse dansgezelschappen willen meer aandacht gaan besteden aan preventieve maatregelen om fysieke en mentale problemen bij hun dansers te voorkomen. Het ontbreekt hen echter aan kennis en kunde om dit innovatieve vraagstuk op te kunnen pakken. Het Nationale Ballet en het Scapino Ballet hebben het lectoraat Performing Arts Medicine van Codarts (Hogeschool voor de Kunsten Rotterdam) benaderd om antwoord te krijgen op de vraag hoe dansers op de hoogste podia, op gezonde wijze, hun beste performance kunnen laten zien. Gezamenlijk is deze praktijkvraag omgevormd naar drie onderzoeksdoelstellingen: 1. Opstellen van meetinstrumenten om de fysieke en mentale gezondheid van dansers te screenen en te monitoren; 2. Ontwerpen van een web-based systeem dat automatisch en real-time informatie uit de ontwikkelde meetinstrumenten kan inlezen, analyseren en interpreteren; 3. Ontwikkelen van een Fit to Perform protocol dat aanbevelingen geeft ten aanzien van het verbeteren van de fysieke en mentale gesteldheid van de danser. Het consortium bestaat uit de volgende organisaties: - Praktijkgerichte onderzoeksinstellingen: Codarts Rotterdam en Hogeschool van Amsterdam; - Universiteiten: ErasmusMC, Technische Universiteit Eindhoven en Vrije Universiteit Amsterdam; - Praktijkinstellingen: Het Nationale Ballet en het Scapino Ballet; - Overige instellingen: het Nederlands Paramedisch Instituut (NPi) en het Nationale Centrum Performing Arts (NCPA). Bij de samenstelling van het consortium is gekozen voor een goede mix tussen praktijkorganisaties, onderzoeksinstituten en onderwijsinstellingen. Daarnaast is er sprake van cross-sectorale samenwerking doordat kennis vanuit de podiumkunsten, sport, gezondheidszorg, onderwijs en technologie met elkaar verbonden wordt.
