Supporting direct support professionals in enabling people with intellectual disabilities to engage in meaningful activities: protocol for the Meaningful Activities 4 All (MA4A) study based on the human-centred design process.

INTRODUCTION: Meaningful activities (MA) have a positive impact on identity, well-being, participation and inclusion. Although people with intellectual disabilities (PID) depend on their direct support professionals (DSPs) to engage in MA, the DSPs need support which could enable them to offer more qualitative care and support. METHODS AND ANALYSIS: To identify DSPs' needs, and to develop a tool/service, an innovative and iterative approach is developed, based on the human-centred design (HCD) process, combined with traditional qualitative and quantitative research methods. In the inspiration phase (needs analysis), in-depth interviews will be conducted in two day care centres in Flanders using an interpretative phenomenological analyses, one with a supply-driven approach and the other with a demand-driven approach, followed by a survey sent to all Flemish day care centres. In the ideation phase, the insights of phase 1 will guide a cocreation process (comprising a World Cafe, brainstorm and prototype sessions) with the DSPs, PID and other stakeholders. In the implementation phase, the solution will be tested in the two day care centres from phase 1 by means of living labs and a realist evaluation. By adopting this protocol, the functionality, quality, usability and acceptance are expected to increase. This protocol adopts all phases of the HCD process and shows the complementarity of HCD with traditional research methods. PID and the DSPs will benefit as the end result is truly grounded in their specific needs and wishes. ETHICS AND DISSEMINATION: Ethical approval by the Ethics Committee of the University Hospital Ghent, Belgium (reference numbers: B670202042983 and PA2021-091). All participants will sign informed consent forms. Results of this study will be submitted for publication in relevant peer-reviewed journals and will be presented at relevant conferences.

Health-Related Fitness in Adults From Eight European Countries-An Analysis Based on Data From the European Fitness Badge.

BACKGROUND: There are conflicting reports about the fitness status of European adults, partly due to the lack of a standardized fitness test battery used across Europe. The European Fitness Badge (EFB) was developed in 2017 as an online-based tool to assess the health-related fitness of persons aged ≥ 18 years residing in European countries. We examined the demographic characteristics and fitness status of persons who completed the EFB between June 2017 and May 2019. METHODS: We conducted a multinational study in eight European countries. Participants completed the EFB which includes 11 validated motor tests to measure endurance, strength, coordination, and flexibility performance, under the supervision of an EFB instructor in different settings (e.g., sports club sessions, public events). Two different test batteries [test profiles (TPs)] are available to distinguish between less active (TP1) and active individuals (TP2). We calculated descriptive statistics and conducted analyses of variance to examine sample characteristics and a potential impact of sex, age, body mass index (BMI), physical activity, and posture on fitness as assessed by the EFB. RESULTS: The sample included 6,019 adults (68.7% females; mean age 52.7 years; age range 18-89 years). Participants who completed TP1 were older (TP1: 61.4 years; TP2: 44.2 years; p = 0.00), reported a lower level of physical activity (TP1: 3.8; TP2: 4.0; p = 0.00), had a higher BMI (TP1: 25.7; TP2: 24.3; p = 0.00) and a higher frequency of postural abnormalities (TP1: 43%; TP2: 33%; p = 0.00) than TP2 participants. Among 3,034 participants who completed TP2, males had higher performance in endurance, strength, and overall fitness, whereas females performed better in coordination and flexibility tests. In addition, younger age, lower BMI, and higher level of physical activity engagement were associated with better EFB test performance. CONCLUSION: The EFB can be used to assess the health-related fitness status of individuals aged ≥ 18 years. Our results show that TP1 and TP2 were completed by persons from the respective target groups (i.e., less active vs. active), and also confirm findings from previous studies on potential determinants of fitness such as sex or age.

Prolonged Sitting Interrupted by 6-Min of High-Intensity Exercise: Circulatory, Metabolic, Hormonal, Thermal, Cognitive, and Perceptual Responses.

The aim was to examine certain aspects of circulatory, metabolic, hormonal, thermoregulatory, cognitive, and perceptual responses while sitting following a brief session of high-intensity interval exercise. Twelve students (five men; age, 22 ± 2 years) performed two trials involving either simply sitting for 180 min (SIT) or sitting for this same period with a 6-min session of high-intensity exercise after 60 min (SIT+HIIT). At T0 (after 30 min of resting), T1 (after a 20-min breakfast), T2 (after sitting for 1 h), T3 (immediately after the HIIT), T4, T5, T6, and T7 (30, 60, 90, and 120 min after the HIIT), circulatory, metabolic, hormonal, thermoregulatory, cognitive, and perceptual responses were assessed. The blood lactate concentration (at T3-T5), heart rate (at T3-T6), oxygen uptake (at T3-T7), respiratory exchange ratio, and sensations of heat (T3-T5), sweating (T3, T4) and odor (T3), as well as perception of vigor (T3-T6), were higher and the respiratory exchange ratio (T4-T7) and mean body and skin temperatures (T3) lower in the SIT+HIIT than the SIT trial. Levels of blood glucose and salivary cortisol, cerebral oxygenation, and feelings of anxiety/depression, fatigue or hostility, as well as the variables of cognitive function assessed by the Stroop test did not differ between SIT and SIT+HIIT. In conclusion, interruption of prolonged sitting with a 6-min session of HIIT induced more pronounced circulatory and metabolic responses and improved certain aspects of perception, without affecting selected hormonal, thermoregulatory or cognitive functions.

K+ potentiates hyperosmolarity-induced vasorelaxations in rat skeletal muscle arterioles.

Several regulatory mechanisms have been proposed for the exercise hyperemia in skeletal muscles. Since different vasoactive factors might interact during the hyperemic response, we investigated the influence of elevated K(+) concentrations on hyperosmolarity (HO)-induced vasorelaxations. Small gluteal rat arteries were isolated and mounted in an organ bath for isometric tension recording. After precontraction with norepinephrine, 20 (S20), 40 (S40) or 60 mM (S60) sucrose was added in control conditions (5 mM K(+); K5) or in the presence of additional 3 (K8) or 5 mM (K10) K(+). Removal of the endothelium and the addition of ouabain, Ba(2+), iberiotoxin or 18-alpha glycyrrhetinic acid (alphaGA) were used to study the underlying mechanisms. Sucrose evoked significant concentration-dependent vasorelaxations (S20 15.62+/-1.61%; S40 26.47+/-1.71%; S60 43.66+/-2.50%), which were significantly increased on addition of 3 and 5 mM. After removal of the endothelium and in the presence of 5 x 10(-5) M alphaGA, the influence of K(+) was significantly blocked but not in the presence of 5 x 10(-5) M ouabain. The K(IR) channel inhibitor Ba(2+) and BK(Ca) channel inhibitor iberiotoxin totally abolished the potentiating effect. We conclude that K(+) significantly enhances the relaxing effect of HO in gluteal blood vessels. We hypothesize that K(+) may stimulate the endothelial K(IR) channels which elicits the release of a mediator of the BK(Ca) channels. This factor may be transferred through myo-endothelial gap-junctions to the smooth muscle cells where modulation of the BK(Ca) channels sensitizes the arteries for hyperosmolarity-induced relaxations.

Hyperosmolarity causes BK Ca-dependent vasodilatations in rat skeletal muscle arteries.

PURPOSE: The release of different metabolites during skeletal muscle contraction causes a pronounced increase in extracellular osmolarity (hyperosmolarity (HO)). HO has been considered as a possible mediator of the exercise hyperemia. In the present study, we investigated the vasodilatory effect of physiologically relevant increases in the extracellular osmolarity in isolated rat gluteal muscle arterioles. In addition, we analyzed the underlying mechanisms of the HO-induced vasodilatations. METHODS: Rat gluteal arteries were isolated and mounted in an organ bath for isometric tension recording. After precontraction with norepinephrine, 20, 40, or 60 mmol x L(-1) sucrose, mannitol, or urea was added in control conditions, after removal of the endothelium or in the presence of inhibitors. RESULTS: Application of sucrose or mannitol induced large and fast concentration-dependent vasodilatations (up to 46.15% with 60 mmol x L(-1) sucrose). Removal of the vascular endothelium had no effect on this relaxation. Inhibition of the Na+/K+ pumps with ouabain, the Kir IR channels with Ba2+ and the K ATP channels with glibenclamide did not alter the HO-induced relaxations. Incubation with the KCa channel blockers charybdotoxin and apamin significantly inhibited sucrose-induced vasodilatations. In addition, application of the specific BK Ca channel blocker iberiotoxin significantly decreased the HO-induced vasodilatations. CONCLUSION: The present study shows that an increase in the extracellular osmolarity elicits strong, fast, and long-lasting relaxations of rat skeletal muscle arterioles, suggesting an important role both at the onset and during the steady-state phase of an exercise bout. Vascular smooth muscle BK Ca channels seem to play a crucial role in the HO-induced vasorelaxations.

Hyperosmolarity increases K+-induced vasodilations in rat skeletal muscle arterioles.

PURPOSE: Exercise hyperemia is mediated by a multitude of vasoactive metabolites released from the active skeletal muscle. Because several vasoactive factors might interact during the hyperemia response, we investigated the influence of hyperosmolarity (HO) on K(+)-induced relaxations. METHODS: Small gluteal rat arteries (diameter: 245 +/- 6 microm) were isolated and mounted in an organ bath for isometric tension recording. After precontraction with norepinephrine, 1, 2, or 3 mM K(+) was added in both control, moderate, or high hyperosmotic (30 mM (S30) or 60 mM sucrose (S60)) conditions. Endothelial removal and the addition of ouabain, Ba(2+), 5-nitro-2-(3-phenyl-propylamino) benzoic acid (NPPB), or glibenclamide was used to study the underlying mechanisms. RESULTS: The K(+)-induced relaxations were significantly (P < 0.001) increased in the presence of S30 and S60. Endothelial removal and the addition of glibenclamide or ouabain did not reduce the HO-induced increased sensitivity to K(+). The application of Ba abolished the influence of HO on the K(+)-induced relaxations. NPPB, a volume regulated anion channel (VRAC) blocker, mimicked the influence of HO by significantly (P < 0.05) increasing the K(+)-induced relaxations. Remarkably, the application of Ba(2+) abolished the sensitizing effect of NPPB on K(+)-induced relaxations. CONCLUSION: HO increases the sensitivity of the rat gluteal skeletal muscle arteries to the vasodilating effect of K(+). It is hypothesized that HO inhibits VRAC causing smooth muscle hyperpolarization. This possibly sensitizes the K(ir)-channels that are known to be involved in the K-induced relaxations in this type of arteries.

Potassium potently relaxes small rat skeletal muscle arteries.

INTRODUCTION: Skeletal muscle contraction elicits an explosive rise in interstitial potassium (K+) concentration. K+ has been considered as one of the most potent vasoactive metabolites in skeletal muscle arterioles. Studies on isolated blood vessels report large relaxations when extracellular [K+] is increased up to 10 mM. We studied the effects of smaller and physiologically more relevant increases in [K+] (adding 1, 2, and 3 mM) and compared them with relaxations induced by the endothelium derived hyperpolarizing factor (EDHF). METHODS: Rat gluteal arteries were isolated and mounted in an organ bath for isometric tension recording. After precontraction with norepinephrine, acetylcholine or K+ was added in control conditions, after removal of the endothelium or in the presence of ouabain or Ba2+. RESULTS: Application of 1, 2, or 3 mM K+ induced large vasodilations (up to 75.4% with 3 mM) (N = 40), which were more sustained at the higher concentrations. Removal of the vascular endothelium had no effect on this relaxation. Inhibition of the Kir channels with Ba2+ did not alter the K+-induced relaxations, although it significantly inhibited the EDHF-mediated relaxation. Incubation with ouabain significantly decreased the K+- and EDHF-induced relaxation. Simultaneous application of Ba2+ and ouabain totally abolished both K+- and EDHF-induced responses. CONCLUSION: Even small increases in extracellular K+ concentration elicit large endothelium-independent and ouabain-sensitive relaxations in small skeletal muscle arteries. The fact that both K+- and EDHF-induced vasorelaxations show similar characteristics indicates that K+ might be the EDHF in this type of artery.