The effect of garden use on quality of life and behavioral and psychological symptoms of dementia in people living with dementia in nursing homes: a systematic review.

Objectives: Considering the importance of going outside in a natural environment for people in general, and people living with dementia in particular, we want to unravel the aspects by which garden use affects quality of life (QoL) and behavioral and psychological symptoms of dementia (BPSD) in people living with dementia in nursing homes. Design: Systematic review. Setting and participants: People living with dementia in nursing homes. Methods: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eight electronic bibliographic databases were searched (May 2022). Quantitative, qualitative and mixed-methods studies describing the effect of garden use on QoL, BPSD, or other outcomes related to QoL or BPSD in people living with dementia in nursing homes were included. The methodological quality of individual studies was assessed with the Mixed Methods Appraisal Tool (MMAT) and a narrative synthesis of the results was performed. Results: After screening title and abstract (N = 498), and full-text assessment (N = 67), 19 publications were included. These described 17 studies and three types of interventions: (1) interventions regarding the evaluation of effects of specifically designed nursing home gardens, (2) participation of the people living with dementia in outside activities, and (3) other interventions, for example, garden visits and different seasons. Conclusions and implications: Overall, first studies appear to suggest positive effects of garden use on QoL, BPSD, or other outcomes related to QoL or BPSD (stress, sleep, and mood) in people living with dementia in nursing homes. However, consensus regarding measurements and key outcomes, taking into account the physical, social, and organizational aspects when designing the garden use intervention, is necessary for the reliable evaluation of these interventions. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=283267, identifier: CRD42021283267.

The opinion of adolescents and adults on Dutch restrictive and educational alcohol policy measures.

OBJECTIVES: The main objective of this study is to explore the opinion of 16-22-year olds on alcohol policy measures compared to the opinion of adults older than 22 years. METHODS: Data was collected in 2008 by using a Dutch panel. This panel was based on a representative probability of households with 8280 members of 16 years and older. The study had a cross-sectional design and questionnaires were filled out through internet. RESULTS: According measures related to the availability of alcohol, the 16-18- and 19-22-year olds are significantly more negative about these policy measures than the respondents older than 22 years. Educational measures were more popular than restrictive availability measures among all three groups, and the opinions of the groups differed significantly from each other. Own alcohol use seemed to be the main predictor for the opinion on restrictive availability measures. CONCLUSIONS: The 16-22-year olds are more negative regarding restrictive availability measures and educational measures than adults older than 22 years, and the restrictive availability measures are less popular than the educational measures among the adolescents.

Diagnosis of sustainable collaboration in health promotion - a case study.

BACKGROUND: Collaborations are important to health promotion in addressing multi-party problems. Interest in collaborative processes in health promotion is rising, but still lacks monitoring instruments. The authors developed the DIagnosis of Sustainable Collaboration (DISC) model to enable comprehensive monitoring of public health collaboratives. The model focuses on opportunities and impediments for collaborative change, based on evidence from interorganizational collaboration, organizational behavior and planned organizational change. To illustrate and assess the DISC-model, the 2003/2004 application of the model to the Dutch whole-school health promotion collaboration is described. METHODS: The study combined quantitative research, using a cross-sectional survey, with qualitative research using the personal interview methodology and document analysis. A DISC-based survey was sent to 55 stakeholders in whole-school health promotion in one Dutch region. The survey consisted of 22 scales with 3 to 8 items. Only scales with a reliability score of 0.60 were accepted. The analysis provided for comparisons between stakeholders from education, public service and public health.The survey was followed by approaching 14 stakeholders for a semi-structured DISC-based interview. As the interviews were timed after the survey, the interviews were used to clarify unexpected and unclear outcomes of the survey as well.Additionally, a DISC-based document analysis was conducted including minutes of meetings, project descriptions and correspondence with schools and municipalities. RESULTS: Response of the survey was 77% and of the interviews 86%. Significant differences between respondents of different domains were found for the following scales: organizational characteristics scale, the change strategies, network development, project management, willingness to commit and innovative actions and adaptations. The interviews provided a more specific picture of the state of the art of the studied collaboration regarding the DISC-constructs. CONCLUSION: The DISC-model is more than just the sum of the different parameters provided in the literature on interorganizational collaboration, organization change, networking and setting-approaches. Monitoring a collaboration based on the DISC-model yields insight into windows of opportunity and current impediments for collaborative change. DISC-based monitoring is a promising strategy enabling project managers and social entrepreneurs to plan change management strategies systematically.