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Background: \ud The promotion of physical activity and the decrease of inactivity and sedentary behaviour are crucial for a healthy lifestyle and positive quality of life. People with intellectual disabilities are at increased risk of inactivity and sedentary behaviour. Therefore, it is important to increase their physical activity by implementing physical activity guidelines in their daily life. Professional direct care providers can play a decisive role in supporting people with intellectual disabilities to participate in physical activity, but the engagement of direct care providers with this role may be reflective of their own attitudes and beliefs towards physical activity. Therefore, the link between the implementation of current physical activity guidelines for people with intellectual disabilities and direct care providers' own beliefs and behaviour with regard to physical activity is investigated.\ud \ud Method: \ud A total of 104 direct care providers completed self‐reported questionnaires about their own physical activity behaviour (IPAQ‐SF), recommendations for people with intellectual disabilities (adaption of EMIQ‐HP) and questions regarding global physical activity guidelines. They were also asked about potential barriers and facilitators for the recommendation of physical activity in open‐ended questions. \ud \ud Results: \ud Personal physical activity behaviour is related to the recommended physical activity for people with intellectual disabilities (moderate‐to‐vigorous physical activity: r s = 0.408, P = 0.005). However, recommended physical activity behaviour for people with intellectual disabilities is significantly lower than direct care providers' own physical activity behaviour (P < 0.001). 47.1% of the respondents recommended people with intellectual disabilities to participate in less than the 150 min of moderate intensity physical activity per week for that is recommended in global physical activity guidelines. \ud \ud Conclusion: \ud Direct care providers may hold stereotypical views and insecurities about the potential harms associated with people with intellectual disabilities participating in physical activity. Therefore, the dissemination of physical activity recommendations for people with intellectual disabilities should be a major target for health professionals, social workers and scientists to address direct care providers' concerns. Furthermore, we need to emphasise the benefits of regular physical activity to professional direct care providers and directly to people with intellectual disabilities.

Background The promotion of physical activity and the decrease of inactivity and sedentary behaviour are crucial for a healthy lifestyle and positive quality of life. People with intellectual disabilities are at increased risk of inactivity and sedentary behaviour. Therefore, it is important to increase their physical activity by implementing physical activity guidelines in their daily life. Professional direct care providers can play a decisive role in supporting people with intellectual disabilities to participate in physical activity, but the engagement of direct care providers with this role may be reflective of their own attitudes and beliefs towards physical activity. Therefore, the link between the implementation of current physical activity guidelines for people with intellectual disabilities and direct care providers' own beliefs and behaviour with regard to physical activity is investigated. Method A total of 104 direct care providers completed self-reported questionnaires about their own physical activity behaviour (IPAQ-SF), recommendations for people with intellectual disabilities (adaption of EMIQ-HP) and questions regarding global physical activity guidelines. They were also asked about potential barriers and facilitators for the recommendation of physical activity in open-ended questions. Results Personal physical activity behaviour is related to the recommended physical activity for people with intellectual disabilities (moderate-to-vigorous physical activity: rs = 0.408, P = 0.005). However, recommended physical activity behaviour for people with intellectual disabilities is significantly lower than direct care providers' own physical activity behaviour (P < 0.001). 47.1% of the respondents recommended people with intellectual disabilities to participate in less than the 150 min of moderate intensity physical activity per week for that is recommended in global physical activity guidelines. Conclusion Direct care providers may hold stereotypical views and insecurities about the potential harms associated with people with intellectual disabilities participating in physical activity. Therefore, the dissemination of physical activity recommendations for people with intellectual disabilities should be a major target for health professionals, social workers and scientists to address direct care providers' concerns. Furthermore, we need to emphasise the benefits of regular physical activity to professional direct care providers and directly to people with intellectual disabilities. Version of record

Bleeding disorders and thrombotic complications are major causes of morbidity and mortality with many cases being unexplained. Thrombus formation involves aberrant expression and activation of tissue factor in vascular endothelial and smooth muscle cells. Here, we sought to identify factors that modulate tissue factor gene expression and activity in these vascular cells. The LIM-only protein FHL2 is a scaffolding protein modulating signal transduction pathways with crucial functions in endothelial and smooth muscle cells. However, the role of FHL2 in tissue factor regulation and thrombosis remains unexplored. Using a murine venous thrombosis model in mesenteric vessels, we demonstrated that FHL2 deficiency results in exacerbated thrombus formation. Gain and loss of function experiments revealed that FHL2 represses tissue factor expression in endothelial and smooth muscle cells through inhibition of the transcription factors NFκB and AP-1. Furthermore, we observed that FHL2 interacts with the cytoplasmic tail of tissue factor. In line with our in vivo observations, FHL2 decreases tissue factor activity in endothelial and smooth muscle cells whereas FHL2 knockdown or deficiency results in enhanced tissue factor activity. Finally, FHL2 single nucleotide polymorphism (SNP) rs4851770 was associated with venous thrombosis risk in a large population of venous thrombosis cases and control subjects from 12 studies (INVENT consortium). Altogether, our results highlight functional involvement of FHL2 in tissue factor-mediated coagulation and identify FHL2 as a novel gene associated with venous thrombosis in man.