Development and implementation of a lifestyle intervention to promote physical activity and healthy diet in the Dutch general practice setting: the BeweegKuur programme

<p>Abstract</p> <p>Background</p> <p>The number of patients with diabetes is increasing. BeweegKuur (Dutch for 'Exercise Therapy') is a Dutch lifestyle intervention which aims to effectively and feasibly promote physical activity and better dietary behaviour in primary health care to prevent diabetes.</p> <p>Methods</p> <p>The goal of this paper is to present the development process and the contents of the intervention, using a model of systematic health promotion planning. The intervention consists of a 1-year programme for diabetic and prediabetic patients. Patients are referred by their general practitioner (GP) to a lifestyle advisor (LSA), usually the practice nurse or a physiotherapist. Based on specific inclusion criteria and in close collaboration with the patient, an individual exercise programme is designed and supervised by the LSA. This programme can be attended at existing local exercise facilities or (temporarily) under the supervision of a specialized exercise coach or physiotherapist. All participants are also referred to a dietician and receive diet-related group education. In the first pilot year (2008), the BeweegKuur programme was implemented in 7 regions in the Netherlands (19 GP practices and health centres), while 14 regions (41 GP practices and health centres) participated during the second year. The aim is to implement BeweegKuur in all regions of the Netherlands by 2012.</p> <p>Discussion</p> <p>The BeweegKuur programme was systematically developed in an evidence- and practice-based process. Formative monitoring studies and (controlled) effectiveness studies are needed to examine the diffusion process and the effectiveness and cost-effectiveness of the intervention.</p

Measurement of Permanent Electric Dipole Moments of Charged Hadrons in Storage Rings

Permanent Electric Dipole Moments (EDMs) of elementary particles violate two fundamental symmetries: time reversal invariance (T) and parity (P). Assuming the CPT theorem this implies CP-violation. The CP-violation of the Standard Model is orders of magnitude too small to be observed experimentally in EDMs in the foreseeable future. It is also way too small to explain the asymmetry in abundance of matter and anti-matter in our universe. Hence, other mechanisms of CP violation outside the realm of the Standard Model are searched for and could result in measurable EDMs. Up to now most of the EDM measurements were done with neutral particles. With new techniques it is now possible to perform dedicated EDM experiments with charged hadrons at storage rings where polarized particles are exposed to an electric field. If an EDM exists the spin vector will experience a torque resulting in change of the original spin direction which can be determined with the help of a polarimeter. Although the principle of the measurement is simple, the smallness of the expected effect makes this a challenging experiment requiring new developments in various experimental areas. Complementary efforts to measure EDMs of proton, deuteron and light nuclei are pursued at Brookhaven National Laboratory and at Forschungszentrum Juelich with an ultimate goal to reach a sensitivity of 10^{-29} e cm.Comment: 8 pages, 2 figure

Standardization as emerging content in technology education at all levels of education

Integration of standardization into different levels of technology education has surfaced as a critical issue for educational practitioners and policy makers at national and regional (APEC, EU) level. In this paper, we describe and analyze empirical data collected from 118 educational experiences and practices about technology standards and standardization in 21 countries of a regional variety. Specifically, this research examines standardization education programs these countries have implemented, and explores suggestive indications for the design and development of an educational policy for standardization. Online surveys, offline interviews, face-to-face meetings and case studies have been used to determine the way these standardization education programs are segmented and implemented in different contexts. The findings are consolidated into a framework for standardization education. The framework presents an applicable combination of target groups (who), appropriate learning objectives (why), probable program operators (where), prospective contents modules (what), and preferred teaching methods (how). This framework may contribute to planning and implementing more inclusive standardization education programs

Gradual adaptation of animal influenza A viruses to human-type sialic acid receptors

Influenza A viruses (IAVs) originating from animal reservoirs pose continuous threats to human health as demonstrated by the Spanish flu pandemic. Infection starts by attachment to host receptors, a crucial step that is targeted by immunological, prophylactic, and therapeutic intervention. Fine-tuning of virus hemagglutinin binding to host-specific receptor repertoires needs to remain balanced to receptor-destroying neuraminidase (NA) activity and is a key step in host adaptation. It determines NA-dependent virus motility, enabling IAVs to traverse the mucus layer and to bind to, and migrate over, the epithelial cell surface for reaching a location supporting endocytic uptake. Canonical adaptations in enzootic/zoonotic IAVs enhancing human-type receptor binding are well-known, but the context and timespan required for their selection pose many questions. We discuss recent developments, focusing on the dynamic nature of interactions of IAV with the heterogeneous receptor repertoires present in humans and potential intermediate hosts. Potential pre-adaption toward human-type receptor binding in intermediate hosts will be discussed

Behavioral immune trade-offs: interpersonal value relaxes social pathogen avoidance

Behavioral-immune-system research has illuminated how people detect and avoid signs of infectious disease. But how do we regulate exposure to pathogens that produce no symptoms in their hosts? This research tested the proposition that estimates of interpersonal value are used for this task. The results of three studies (N = 1,694), each conducted using U.S. samples, are consistent with this proposition: People are less averse to engaging in infection-risky acts not only with friends relative to foes but also with honest and agreeable strangers relative to dishonest and disagreeable ones. Further, a continuous measure of how much a person values a target covaries with comfort with infection-risky acts with that target, even within relationship categories. Findings indicate that social prophylactic motivations arise not only from cues to infectiousness but also from interpersonal value. Consequently, pathogen transmission within social networks might be exacerbated by relaxed contamination aversions with highly valued social partners

Behavioral determinants as predictors of return to work after long-term sickness absence: an application of the theory of planned behavior

Background The aim of this prospective, longitudinal cohort study was to analyze the association between the three behavioral determinants of the theory of planned behavior (TPB) model-attitude, subjective norm and self-efficacy-and the time to return-to-work (RTW) in employees on long-term sick leave. Methods The study was based on a sample of 926 employees on sickness absence (maximum duration of 12 weeks). The employees filled out a baseline questionnaire and were subsequently followed until the tenth month after listing sick. The TPB-determinants were measured at baseline. Work attitude was measured with a Dutch language version of the Work Involvement Scale. Subjective norm was measured with a self-structured scale reflecting a person's perception of social support and social pressure. Self-efficacy was measured with the three subscales of a standardised Dutch version of the general self-efficacy scale (ALCOS): willingness to expend effort in completing the behavior, persistence in the face of adversity, and willingness to initiate behavior. Cox proportional hazards regression analyses were used to identify behavioral determinants of the time to RTW. Results Median time to RTW was 160 days. In the univariate analysis, all potential prognostic factors were significantly associated (P < 0.15) with time to RTW: work attitude, social support, and the three subscales of self-efficacy. The final multivariate model with time to RTW as the predicted outcome included work attitude, social support and willingness to expend effort in completing the behavior as significant predictive factors. Conclusions This prospective, longitudinal cohort-study showed that work attitude, social support and willingness to expend effort in completing the behavior are significantly associated with a shorter time to RTW in employees on long-term sickness absence. This provides suggestive evidence for the relevance of behavioral characteristics in the prediction of duration of sickness absence. It may be a promising approach to address the behavioral determinants in the development of interventions focusing on RTW in employees on long-term sick leave