How needs and preferences of employees influence participation in health promotion programs: A six-month follow-up study

Background: Low participation in health promotion programs (HPPs) might hamper their effectiveness. A potential reason for low participation is disagreement between needs and preferences of potential participants and the actual HPPs offered. This study aimed to investigate employees' need and preferences for HPPs, whether these are matched by what their employers provide, and whether a higher agreement enhanced participation. Methods: Employees of two organizations participated in a six-month follow-up study (n = 738). At baseline, information was collected on employees' needs and preferences for the topic of the HPP (i.e. physical activity, healthy nutrition, smoking cessation, stress management, general health), whether they favored a HPP via their employer or at their own discretion, and their preferred HPP regarding three components with each two alternatives: mode of delivery (individual vs. group), intensity (single vs. multiple meetings), and content (assignments vs. information). Participation in HPPs was assessed at six-month

Barriers and facilitators for participation in health promotion programs among employees: A six-month follow-up study

Background: Health promotion programs (HPPs) are thought to improve health behavior and health, and their effectiveness is increasingly being studied. However, participation in HPPs is usually modest and effect sizes are often small. This study aims to (1) gain insight into the degree of participation of employees in HPPs, and (2) identify factors among employees that are associated with both their intention to participate and actual participation in HPPs. Methods. Employees of two organizations were invited to participate in a six-month follow-up study (n = 744). Using questionnaires, information on participation in HPPs was collected in two categories: employees' intention at baseline to participate and their actual participation in a HPP during the follow-up period. The following potential determinants were assessed at baseline: social-cognitive factors, perceived barriers and facilitators, beliefs about health at work, health behaviors, and self-perceived health. Logistic regression analyses, adjusted for demographics and organization, were used to examine associations between potential determinants and intention to participate, and to examine the effect of these determinants on actual participation during follow-up. Results: At baseline, 195 employees (26%) expressed a positive intention towards participation in a HPP. During six months of follow-up, 83 employees (11%) actually participated. Participants positively inclined at baseline to participate in a HPP were more likely to actually participate (OR = 3.02, 95% CI: 1.88-4.83). Privacy-related barriers, facilit

Flexibele arbeidsrelaties in het onderwijs: preadvies

Hervorming Sociale Regelgevin

Feasibility of an Assessment Tool for Children\u27s Competence to Consent to Predictive Genetic Testing: a Pilot Study

Knowledge on children\u27s capacities to consent to medical treatment is limited. Also, age limits for asking children\u27s consent vary considerably between countries. Decision-making on predictive genetic testing (PGT) is especially complicated, considering the ongoing ethical debate. In order to examine just age limits for alleged competence to consent in children, we evaluated feasibility of a standardized assessment tool, and investigated cutoff ages for children\u27s competence to consent to PGT. We performed a pilot study, including 17 pediatric outpatients between 6 and 18 years at risk for an autosomal dominantly inherited cardiac disease, eligible for predictive genetic testing. The reference standard for competence was established by experts trained in the relevant criteria for competent decision-making. The MacArthur Competence Assessment Tool for Treatment (MacCAT-T) served as index test. Data analysis included raw agreement between competence classifications, difference in mean ages between children judged competent and judged incompetent, and estimation of cutoff ages for judgments of competence. Twelve (71 %) children were considered competent by the reference standard, and 16 (94 %) by the MacCAT-T, with an overall agreement of 76 %. The expert judgments disagreed in most cases, while the MacCAT-T judgments agreed in 65 %. Mean age of children judged incompetent was 9.3 years and of children judged competent 12.1 years (p = .035). With 90 % sensitivity, children younger than 10.0 years were judged incompetent, with 90 % specificity children older than 11.8 years were judged competent. Feasibility of the MacCAT-T in children is confirmed. Initial findings on age cutoffs are indicative for children between the age of 12 and 18 to be judged competent for involvement in the informed consent process. Future research on appropriate age-limits for children\u27s alleged competence to consent is needed

Insights into the mechanism of carbon dioxide and propylene oxide ring-opening copolymerization using a Co(III)/K(I) heterodinuclear catalyst

A combined computational and experimental investigation into the catalytic cycle of carbon dioxide and propylene oxide ring-opening copolymerization is presented using a Co(III)K(I) heterodinuclear complex (Deacy, A. C. Co(III)/Alkali-Metal(I) Heterodinuclear Catalysts for the Ring-Opening Copolymerization of CO2 and Propylene Oxide. J. Am. Chem. Soc. 2020, 142(45), 19150−19160). The complex is a rare example of a dinuclear catalyst, which is active for the copolymerization of CO2 and propylene oxide, a large-scale commercial product. Understanding the mechanisms for both product and byproduct formation is essential for rational catalyst improvements, but there are very few other mechanistic studies using these monomers. The investigation suggests that cobalt serves both to activate propylene oxide and to stabilize the catalytic intermediates, while potassium provides a transient carbonate nucleophile that ring-opens the activated propylene oxide. Density functional theory (DFT) calculations indicate that reverse roles for the metals have inaccessibly high energy barriers and are unlikely to occur under experimental conditions. The rate-determining step is calculated as the ring opening of the propylene oxide (ΔGcalc† = +22.2 kcal mol–1); consistent with experimental measurements (ΔGexp† = +22.1 kcal mol–1, 50 °C). The calculated barrier to the selectivity limiting step, i.e., backbiting from the alkoxide intermediate to form propylene carbonate (ΔGcalc† = +21.4 kcal mol–1), is competitive with the barrier to epoxide ring opening (ΔGcalc† = +22.2 kcal mol–1) implicating an equilibrium between alkoxide and carbonate intermediates. This idea is tested experimentally and is controlled by carbon dioxide pressure or temperature to moderate selectivity. The catalytic mechanism, supported by theoretical and experimental investigations, should help to guide future catalyst design and optimization

Correlating metal redox potentials to Co(III)K(I) catalyst performances in carbon dioxide and propene oxide ring opening copolymerization

Carbon dioxide copolymerization is a front-runner CO2 utilization strategy but its viability depends on improving the catalysis. So far, catalyst structure-performance correlations have not been straightforward, limiting the ability to predict how to improve both catalytic activity and selectivity. Here, a simple measure of a catalyst ground-state parameter, metal reduction potential, directly correlates with both polymerization activity and selectivity. It is applied to compare performances of 6 new heterodinuclear Co(III)K(I) catalysts for propene oxide (PO)/CO2 ring opening copolymerization (ROCOP) producing poly(propene carbonate) (PPC). The best catalyst shows an excellent turnover frequency of 389 h−1 and high PPC selectivity of >99 % (50 °C, 20 bar, 0.025 mol% catalyst). As demonstration of its utility, neither DFT calculations nor ligand Hammett parameter analyses are viable predictors. It is proposed that the cobalt redox potential informs upon the active site electron density with a more electron rich cobalt centre showing better performances. The method may be widely applicable and is recommended to guide future catalyst discovery for other (co)polymerizations and carbon dioxide utilizations

Key factors in children's competence to consent to clinical research

Background: Although law is established on a strong presumption that persons younger than a certain age are not competent to consent, statutory age limits for asking children's consent to clinical research differ widely internationally. From a clinical perspective, competence is assumed to involve many factors including the developmental stage, the influence of parents and peers, and life experience. We examined potential determining factors for children's competence to consent to clinical research and to what extent they explain the variation in competence judgments. Methods: From January 1, 2012 through January 1, 2014, pediatric patients aged 6 to 18 years, eligible for clinical research studies were enrolled prospectively at various in- and outpatient pediatric departments. Children's competence to consent was assessed by MacArthur Competence Assessment Tool for Clinical Research. Potential determining child variables included age, gender, intelligence, disease experience, ethnicity and socio-economic status (SES). We used logistic regression analysis and change in explained variance in competence judgments to quantify the contribution of a child variable to the total explained variance. Contextual factors included risk and complexity of the decision to participate, parental competence judgment and the child's or parents decision to participate. Results: Out of 209 eligible patients, 161 were included (mean age, 10.6 years, 47.2 % male). Age, SES, intelligence, ethnicity, complexity, parental competence judgment and trial participation were univariately associated with competence (P∈∈0.05). Conclusions: Age is the factor that explaines most of to the variance in children's competence to consent, followed by intelligence. Experience with disease did not affect competence in this study, nor did other variables. Clinical trial registration: Development and use of a standardized instrument for assessing children's competence to consent in drug trials: Are legally established age limits valid?, NTR3918

Demographic, behavioral, and psychosocial correlates of using the website component of a worksite physical activity and healthy nutrition promotion program: a longitudinal study.

BACKGROUND: Internet-delivered behavior change programs have the potential to reach a large population. However, low participation levels and high levels of attrition are often observed. The worksite could be a setting suitable for reaching and retaining large numbers of people, but little is known about reach and use of Internet-delivered health promotion programs in the worksite setting. OBJECTIVE: This study aimed (1) to gain more insight in the use of the website component of a worksite behavior change intervention and (2) to identify demographic, behavioral, and psychosocial factors associated with website use. METHODS: The study was an observational study among participants from 5 workplaces in a cluster randomized controlled trial. At baseline, all participants visited a study website to fill out the baseline questionnaire. Then a physical health check was done followed by face-to-face advice. After this contact, all participants received an email to promote visiting the website to view their health check results and the personal advice based on the baseline questionnaire. In the subsequent period, only participants in the intervention group received monthly email messages to promote website visits and were offered additional Web-based tools (self-monitors and a food frequency questionnaire [FFQ] assessing saturated fat intake) to support their behavior change. Website use was monitored by website statistics registering website access. Complete data were available for 726 employees. Logistic regression analyses were conducted to identify characteristics of employees who visited and used the website. RESULTS: In total, 43% of the participants visited the website after the email to promote website visits. Participants who were insufficiently physically active were less likely to visit the website (odds ratio [OR] 0.63, 95% confidence interval [CI] 0.45-0.88), whereas individuals with an elevated total cholesterol level visited the website more often (OR 1.44, 95% CI 1.05-1.98). The monthly emails in the intervention group resulted in higher website use during a 3-month period (18% versus 5% in the reference group, OR 3.96, 95% CI 2.30-6.82). Participants with a positive attitude toward increasing physical activity were less likely to visit the website (OR 0.54, 95% CI 0.31-0.93) or to use the self-monitor and FFQ (OR 0.50, 95% CI 0.25-0.99). Female workers visited the website more often to monitor their behavior and to receive advice on fat intake (OR 2.36, 95% CI 1.14-4.90). CONCLUSIONS: Almost half of the participants used the website component of a worksite behavior change program. M