News avoidance during the Covid-19 Crisis:Understanding information overload

This study investigates the degree of news avoidance during the first months of the Covid-19 pandemic in the Netherlands. Based on two panel surveys conducted in the period April–June 2020, this study shows that the increased presence of this behavior, can be explained by negative emotions and feelings the news causes by citizens. Moreover, news avoidance indeed has a positive effect on perceived well-being. These findings point to an acting balance for individual news consumers. In a pandemic such as Covid-19 news consumers need to be informed, but avoiding news is sometimes necessary to stay mentally healthy

SIX WEEK CONSISTENCY OF SENSORIMOTOR TEST METHODS

The purpose of this study was to compare sensorimotor testing methods. Therefore 15 healthy and sporty subjects undertook five different sensorimotor tests and repeated the same tests six weeks later without executing any specific sensorimotor training. The main outcome was that movement unspecific and simple tests like the Counter Movement Jump, the maximum isometric force and rate of force development on a blocked leg-press or a single-leg-stance with closed eyes have a better retest-reliability than more specific movements like a balance test on a balance board or a complex movement like a single-legged jump landing. Tests with a specific movement show a learning effect and at complex movements there was almost no correlation, as slight changes in the motion sequence can lead to big differences in the measured scores

The gait and balance of patients with diabetes can be improved: a randomised controlled trial

Aims/hypothesis: Gait characteristics and balance are altered in diabetic patients. Little is known about possible treatment strategies. This study evaluates the effect of a specific training programme on gait and balance of diabetic patients. Methods: This was a randomised controlled trial (n = 71) with an intervention (n = 35) and control group (n = 36). The intervention consisted of physiotherapeutic group training including gait and balance exercises with function-orientated strengthening (twice weekly over 12weeks). Controls received no treatment. Individuals were allocated to the groups in a central office. Gait, balance, fear of falls, muscle strength and joint mobility were measured at baseline, after intervention and at 6-month follow-up. Results: The trial is closed to recruitment and follow-up. After training, the intervention group increased habitual walking speed by 0.149m/s (p < 0.001) compared with the control group. Patients in the intervention group also significantly improved their balance (time to walk over a beam, balance index recorded on Biodex balance system), their performance-oriented mobility, their degree of concern about falling, their hip and ankle plantar flexor strength, and their hip flexion mobility compared with the control group. After 6months, all these variables remained significant except for the Biodex sway index and ankle plantar flexor strength. Two patients developed pain in their Achilles tendon: the progression for two related exercises was slowed down. Conclusions/interpretation: Specific training can improve gait speed, balance, muscle strength and joint mobility in diabetic patients. Further studies are needed to explore the influence of these improvements on the number of reported falls, patients' physical activity levels and quality of life. Trial registration:: ClinicalTrials.gov NCT00637546 Funding:: This work was supported by the Swiss National Foundation (SNF): PBSKP-123446/

Identifying effective behavioural components of Intervention and Comparison group support provided in SMOKing cEssation (IC-SMOKE) interventions: a systematic review protocol

BACKGROUND: Systematic reviews of behaviour change interventions for smoking cessation vary in scope, quality, and applicability. The current review aims to generate more accurate and useful findings by (1) a detailed analysis of intervention elements that change behaviour (i.e. behaviour change techniques (BCTs)) and potential moderators of behaviour change (i.e. other intervention and sample characteristics) and (2) assessing and controlling for variability in support provided to comparison groups in smoking cessation trials. METHODS: A systematic review will be conducted of randomized controlled trials of behaviour change interventions for smoking cessation in adults (with or without pharmacological support), with a minimum follow-up of 6 months, published after 1995. Eligible articles will be identified through the Cochrane Tobacco Addiction Group Specialized Register. Study authors will be asked for detailed descriptions of smoking cessation support provided to intervention and comparison groups. All data will be independently coded by two researchers. The BCT taxonomy v1 (tailored to smoking cessation interventions) and template for intervention description and replication criteria will be used to code intervention characteristics. Data collection will further include sample and trial characteristics and outcome data (smoking cessation rates). Multilevel mixed-effects meta-regression models will be used to examine which BCTs and/or BCT clusters delivered to intervention and comparison groups explain smoking cessation rates in treatment arms (and effect sizes) and what key moderators of behaviour change are. Predicted effect sizes of each intervention will be computed assuming all interventions are compared against comparison groups receiving the same levels of behavioural support (i.e. low, medium, and high levels). Multi-disciplinary advisory board members (policymakers, health care providers, and (ex-)smokers) will provide strategic input throughout the project to ensure the review's applicability to policy and practice. DISCUSSION: By capturing BCTs in intervention and comparison groups, this systematic review will provide more accurate estimates of the effectiveness of smoking cessation interventions, the most promising BCTs and/or BCT clusters associated with smoking cessation rates in intervention and comparison arms, and important moderators of behaviour change. The results could set new standards for conducting meta-analyses of behaviour change interventions and improve research, service delivery, and training in the area of smoking cessation

The role of ARNT in liver and myeloid cell function

Aryl hydrocarbon receptor nuclear translocator (ARNT) is a transcription factor which acts as a general partner for members of the bHLH/PAS family of transcription factors. To investigate the effect of long term ARNT deletion in hepatocyte and myeloid cells, we created 2 lines of mice with ARNT deletion in these cells. Mice lacking hepatocyte ARNT had impaired glucose tolerance, increased gluconeogenesis, decreased ATP and increased post-prandial serum triglycerides. However, in contrast to type 2 diabetes (T2D) hepatic ARNT deletion resulted in decreased liver steatosis. Importantly, these changes became non-significant after high fat diet (HFD). Decreased ARNT in myeloid cells led to decreased cytokine expression, decreased phagocytosis, decreased bactericidal activity, impaired response to infection, and impaired wound healing. Again, the phenotype of impaired wound healing equilibrated in a diabetic milieu. In addition mice lacking ARNT in myeloid cells displayed impaired glucose tolerance on HFD and paradoxically increased liver inflammation. In human monocytes ARNT mRNA correlated negatively with serum cytokine levels of IL-6, IL-8, MCP-1 and TNF-α. This data demonstrates that ARNT has important roles in hepatocyte and myeloid cell function and suggests that modulation of this transcription factor could be used in future therapy for diabetes and disorders of immune function

Unknown makes unloved:A case study on improving integrated health and social care in the Netherlands using a participatory approach

Many initiatives integrating health and social care have been implemented in order to provide adequate care and support to older people living at home. Further development of existing initiatives requires iterative processes of developing, implementing and evaluating improvements to current practice. This case study provides insight into the process of improving an existing integrated care initiative in the Netherlands. Using a participatory approach, researchers and local stakeholders collaborated to develop and implement activities to further improve collaboration between health and social care professionals. Improvement activities included interprofessional meetings focussing on reflection and mutual learning and workplace visits. Researchers evaluated the improvement process, using data triangulation of multiple qualitative and quantitative data sources. According to participating professionals, the improvement activities improved their communication and collaboration by establishing mutual understanding and trust. Enabling factors included the safe and informal setting in which the meetings took place and the personal relationships they developed during the project. Different organisational cultures and interests and a lack of ownership and accountability among managers hindered the improvement process, whereas issues such as staff shortages, time constraints and privacy regulations made it difficult to implement improvements on a larger scale. Still, the participatory approach encouraged the development of partnerships and shared goals on the level of both managers and professionals. This case study highlights that improving communication between professionals is an important first step in improving integrated care. In addition, it shows that a participatory approach, in which improvements are co-created and tailored to local priorities and needs, can help in the development of shared goals and trust between stakeholders with different perspectives. However, stakeholders' willingness and ability to participate in such an improvement process is challenged by many factors

What Adaptation Stories are UK Newspapers Telling? A Narrative Analysis

Media coverage of climate change impacts and adaptation will likely influence how citizens think society can and should adapt. Here, we undertook the first analysis of UK newspaper adaptation coverage. We identified five prominent adaptation narratives: (1) the government should build more flood defences, (2) home owners should buy flood insurance, (3) individuals should become more informed, (4) the farming industry should innovate, (5) and the natural environment should fight for its survival. We find that only some of the more immediate climate change impacts likely to affect the UK are presented as necessitating a response. The government is considered primarily responsible while UK citizens are given few and narrow responsibilities. The range of adaptive actions under consideration is limited and unchallenging to the status quo. In summary, newspaper coverage presents a restricted view as to when the UK should adapt and how it could adapt

Predictors of recruitment and retention in randomized controlled trials of behavioural smoking cessation interventions: a systematic review and meta-regression analysis

AIM: To investigate predictors of participant eligibility, recruitment, and retention in behavioural randomised controlled trials (RCTs) for smoking cessation. METHOD: Systematic review and pre-specified meta-regression analysis of behavioural RCTs for smoking cessation including adult (≥18 years old) smokers. The pre-specified predictors were identified through a literature review and experts' consultation and included participant, trial and intervention characteristics and recruitment and retention strategies. Measurements included eligibility rates (proportion of people eligible for the trials), recruitment rates, retention rates, and differential retention rates. RESULTS: 172 RCTs with 89,639 participants. Eligibility [median 57.6%; IQR 34.7-83.7], recruitment [median 66.4%; IQR 42.7-85.2] and retention rates [median 80.5%; IQR 42.7-85.2] varied considerably across studies. For eligibility rates, the recruitment strategy appeared not to be associated with eligibility rates. For recruitment rates, use of indirect recruitment strategies (e.g., public announcements) [OR 0.30, 95% CI 0.11-0.82] and self-help interventions [OR 0.14, 95% CI 0.03-0.67] were associated with lower recruitment rates. For retention rates, higher retention was seen if the sample had ongoing physical health condition/s [OR 1.66, 95% CI 1.04-2.63] whereas lower retention was seen amongst primarily female samples [OR 0.83, 95% CI 0.71-0.98] and those motivated to quit smoking [OR 0.74, 95% CI 0.55-0.99], when indirect recruitment methods were used [OR 0.60, 95% CI 0.38-0.97], and at longer follow-up assessments [OR 0.83, 95% CI 0.79-0.87]. For differential retention, higher retention in the intervention group occurred when the intervention but not comparator group received financial incentives for smoking cessation [OR 1.35, 95% CI: 1.02-1.77]. CONCLUSIONS: In randomised controlled trials of behavioural smoking cessation interventions, recruitment and retention rates appear to be higher for smoking cessation interventions that include a person-to-person rather than at-a-distance contact; male participants, smokers with chronic conditions, smokers not initially motivated to quit and shorter follow-up assessments seems to be associated with improved retention; financial incentive interventions improve retention in groups receiving them relative to comparison groups

Are older people worse off in 2040 regarding health and resources to deal with it? - Future developments in complex health problems and in the availability of resources to manage health problems in the Netherlands

IntroductionDeveloping sustainable health policy requires an understanding of the future demand for health and social care. We explored the characteristics of the 65+ population in the Netherlands in 2020 and 2040, focusing on two factors that determine care needs: (1) the occurrence of complex health problems and (2) the availability of resources to manage health and care (e.g., health literacy, social support).MethodsEstimations of the occurrence of complex health problems and the availability of resources for 2020 were based on registry data and patient-reported data. Estimations for 2040 were based on (a) expected demographic developments, and (b) expert opinions using a two-stage Delphi study with 26 experts from policy making, practice and research in the field of health and social care.ResultsThe proportion of people aged 65+ with complex health problems and limited resources is expected to increase from 10% in 2020 to 12% in 2040 based on demographic developments, and to 22% in 2040 based on expert opinions. There was high consensus (&gt;80%) that the proportion with complex health problems would be greater in 2040, and lower consensus (50%) on an increase of the proportion of those with limited resources. Developments that are expected to drive the future changes refer to changes in multimorbidity and in psychosocial status (e.g., more loneliness).ConclusionThe expected increased proportion of people aged 65+ with complex health problems and limited resources together with the expected health and social care workforce shortages represent large challenges for public health and social care policy