No Self Without Salience: Affective and Self-relevance Ratings of 552 Emotionally Valenced and Neutral Dutch Words.

It is unknown how self-relevance is dependent on emotional salience. Emotional salience encompasses an individual's degree of attraction or aversion to emotionally-valenced information. The current study investigated the interconnection between self and salience through the evaluation of emotional valence and self-relevance. 56 native Dutch participants completed a questionnaire assessing valence, intensity, and self-relevance of 552 Dutch nouns and verbs. One-way repeated-measures ANCOVA investigated the relationship between valence and self, age and gender. Repeated-measures ANCOVA also tested the relationship between valence and self with intensity ratings and effects of gender and age. Results showed a significant main effect of valence for self-relevant words. Intensity analyses showed a main effect of valence but not of self-relevance. There were no significant effects of gender and age. The most important finding presents that self-relevance is dependent on valence. These findings concerning the relationship between self and salience opens avenues to study an individual's self-definition.

Physical activity, sports participation and exercise-related constraints in adult women with primary hypothyroidism treated with thyroid hormone replacement therapy.

Awareness of physical activity (PA) constraints in patients with primary hypothyroidism on thyroid hormone replacement therapy (THR) is important. Hence, this cross-sectional matched case-control study aimed to determine PA and sports participation (SP) in patients with hypothyroidism on THR in comparison to control subjects. Accordingly, survey questions were selected from the National Survey on Injuries and Physical Activity in the Netherlands (IPAN), supplemented with questions related to self-reported clinical characteristics and exercise-related constraints (ERC) of patients. In total, 1,724 female patients (mean age 53.0 years ±11.6) and 1,802 controls (mean age 52.6 ± 13.2) were included. Compared to controls, patients were less likely to comply with the moderate-intensity PA guideline (OR 0.70; 95% CI: 0.611-0.803), although patients were more actively participating in sports (OR 1.40; 95% CI: 1.156-1.706). Two-thirds of patients reported that hypothyroidism was limiting their PA performance. These limitations were more pronounced in patients with autoimmune thyroiditis (AIT) than in patients with hypothyroidism from other aetiology (OR 1.93; 95% CI: 1.518-2.457), representing disease-specific exercise intolerance. In order to establish effective intervention programmes to encourage regular PA in hypothyroid patients on THR with exercise intolerance, further research is warranted to better understand PA barriers.

The effectiveness of functional task exercise and physical therapy as prevention of functional decline in community dwelling older people with complex health problems.

BACKGROUND: A physically active lifestyle in older people contributes to the preservation of good health. We assessed the influence of physiotherapy on daily functioning among community dwelling older people (75+) with complex health problems identified with screening, versus usual care. We also compared functional task exercise (FTE), with problems prioritized by older people, trained in the home environment, versus usual preventive physical therapy (PPT). METHODS: Design: FTE and PPT were compared in a randomized controlled trial (RCT). Both interventions were compared with daily functioning in an observational study: control group. SETTING/PARTICIPANTS: Community-dwelling persons aged ≥75 years with daily activity limitations enlisted in 83 general practices (n = 155). INTERVENTIONS: Both intervention groups (FTE, n = 76 and PPT, n = 79) received individual, 30 min treatments. The control group (n = 228) did not get any experimental intervention offered. MEASUREMENTS: Groningen Activities of Daily Living Restriction Scale (GARS). STATISTICAL ANALYSES: Linear Mixed Model analysis, correcting for age, sex, baseline scores and clustering by physiotherapist were used to compare the different groups. RESULTS: At baseline, 74% percent of the intervention trial group was female vs 79% in the control group. Median ages were 83.9 and 84.7 respectively. The median baseline GARS-score for the control group was 41.0 (25 and 75 percentile): 35.0; 48.0) and 40.0 (25 and 75 percentile: 32.3; 46.0) for the intervention group (FTE + PPT). The mean change over time was 3.3 (2.5; 4.1) for the control group. Mean difference in change over time between the intervention (FTE + PPT) and the control group was - 2.5 (- 4.3; - 0.6) (p = .009). Between FTE and PPT the difference in change was - 0.4 (95% CI: -2.3; 3.0, p = 0.795). CONCLUSION: An exercise intervention led by physiotherapists may slow down decline in self-reported daily functioning in older persons with daily activity limitations, identified by pro-active case finding. TRIAL REGISTRATION: Netherlands trial register ( NTR2407 ). Registered 6th of July 2010.

Decreased physical activity, reduced QoL and presence of debilitating fatigue in patients with Addison's disease.

BACKGROUND: Health-related quality of life in patients with Addison's disease has been assessed in various European countries, indicating a reduced quality of life. However, no studies have addressed the impact of Addison's disease on physical activity. OBJECTIVE: The aim of this study was to investigate the quality of life in Dutch patients with Addison's disease particularly regarding the presence of fatigue and the ability to be physically active. METHODS: In this cross-sectional study, a postal survey was performed among Dutch patients with Addison's disease on stable glucocorticoid replacement therapy with hydrocortisone or cortisone acetate. For quality of life and physical activity assessment, patients completed general and health-related quality of life and physical activity questionnaires, and scores were compared to Dutch controls. RESULTS: A total of 328 patients with Addison's disease were studied. In patients with Addison's disease, only 45·7% met the standard of physical activity (Combinorm) compared to 67·8% of Dutch controls (P < 0·01). Forty-eight per cent of patients showed abnormal fatigue, while 61% had severe fatigue. The CIS fatigue scores were significantly higher compared to controls (P < 0·01). We found reduced general subjective health-related QoL scores in both male and female patients, especially in younger patients <65 years of age. CONCLUSION: Physical activity is decreased in patients with Addison's disease, combined with a reduced subjective health-related QoL and increased fatigue.

Modeling Caries Experience: Advantages of the Use of the Hurdle Model.

In dental epidemiology, the decayed (D), missing (M), and filled (F) teeth or surfaces index (DFM index) is a frequently used measure. The DMF index is characterized by a strongly positive skewed distribution with a large stack of zero counts for those individuals without caries experience. Therefore, standard generalized linear models often lead to a poor fit. The hurdle regression model is a highly suitable class to model a DMF index, but its use is subordinated. We aim to overcome the gap between the suitability of the hurdle model to fit DMF indices and the frequency of its use in caries research. A theoretical introduction to the hurdle model is provided, and an extensive comparison with the zero-inflated model is given. Using an illustrative data example, both types of models are compared, with a special focus on interpretation of their parameters. Accompanying R code and example data are provided as online supplementary material.

A primer on the use of cluster analysis or factor analysis to assess co-occurrence of risk behaviors.

OBJECTIVE: The aim of this paper is to provide a guideline to a universal understanding of the analysis of co-occurrence of risk behaviors. The use of cluster analysis and factor analysis was clarified. METHOD: A theoretical introduction to cluster analysis and factor analysis and examples from literature were provided. A representative sample (N=4395) of the Dutch population, aged 16-40 and participating from fall 2005 to spring 2006, was used to illustrate the use of both techniques in assessing the co-occurrence of risk behaviors. RESULTS: Whereas cluster analysis techniques serve to focus on particular clusters of individuals showing the same behavioral pattern, factor analysis techniques are used to assess possible groups of interrelated health-risk behaviors that can be explained by an unknown common source. Choice between the techniques partly depends on the research question and the aim of the research, and has different implications for inferences and policy. CONCLUSION: By integrating theory and results from an illustrative example, a guideline has been provided that contributes towards a systematic approach in the assessment of co-occurrence of risk behaviors. Following this guideline, a better comparison between outcomes from various studies is expected, leading to improved effectiveness of multiple behavior change interventions.

Severity, not type, is the main predictor of decreased quality of life in elderly women with urinary incontinence: a population-based study as part of a randomized controlled trial in primary care.

BACKGROUND: Urinary incontinence negatively influences the lives of 25-50% of elderly women, mostly due to feelings of shame and being limited in activities and social interactions. This study explores whether differences exist between types of urinary incontinence (stress, urgency or mixed) and severity of the symptoms, with regard to their effects on generic and condition-specific quality of life. METHODS: This is a cross-sectional study among participants of a randomized controlled trial in primary care. A total of 225 women (aged ≥ 55 years) completed a questionnaire (on physical/emotional impact and limitations) and were interviewed for demographic characteristics and co-morbidity. Least squares regression analyses were conducted to estimate differences between types and severity of urinary incontinence with regard to their effect on quality of life. RESULTS: Most patients reported mixed urinary incontinence (50.7%) and a moderate severity of symptoms (48.9%). Stress urinary incontinence had a lower impact on the emotional domain of condition-specific quality of life compared with mixed urinary incontinence (r = -7.81). There were no significant associations between the types of urinary incontinence and generic quality of life. Severe symptoms affected both the generic (r = -0.10) and condition-specific (r = 17.17) quality of life. CONCLUSIONS: The effects on condition-specific quality of life domains differ slightly between the types of incontinence. The level of severity affects both generic and condition-specific quality of life, indicating that it is not the type but rather the severity of urinary incontinence that is the main predictor of decreased quality of life.

Effectiveness of a Multilevel Workplace Health Promotion Program on Vitality, Health, and Work-Related Outcomes.

OBJECTIVE: Evaluation of the effectiveness of a workplace health promotion program on employees' vitality, health, and work-related outcomes, and exploring the influence of organizational support and the supervisors' role on these outcomes. METHODS: The 5-month intervention included activities at management, team, and individual level targeting self-management to perform healthy behaviors: a kick-off session, vitality training sessions, workshops, individual coaching, and intervision. Outcome measures were collected using questionnaires, health checks, and sickness absence data at baseline, after the intervention and at 10 months follow-up. For analysis linear and generalized mixed models were used. RESULTS: Vitality, work performance, sickness absence, and self-management significantly improved. Good organizational support and involved supervisors were significantly associated with lower sickness absence. CONCLUSIONS: Including all organizational levels and focusing on increasing self-management provided promising results for improving vitality, health, and work-related outcomes.