Het leven na de UvH. Zingevingsvragen van Alumni omtrent werk na het afstuderen.

Deze scriptie gaat over de zingevingsvragen betreffende doelgerichtheid, competentie en eigenwaarde van alumni aan de UvH in de transitie van studie naar werk. Aanleiding voor dit empirisch sociaalwetenschappelijk onderzoek is de ontwikkeling naar de laatmoderne samenleving in Nederland waarin jongvolwassenen vele vrijheden hebben gekregen om hun eigen leven naar wens vorm en richting te geven en een eigen identiteit te ontwikkelen. Hierbij worstelen zij met de verantwoordelijkheden die zij hebben gekregen om hun eigen leven in te delen, en keuzes te maken omtrent studie, zichzelf en hun professionele carrière. Tot op heden lijkt er nog weinig onderzoek te zijn gedaan naar betekenisgeving door jongvolwassenen. Met behulp van dit onderzoek wordt verder ingegaan op de existentiële zingevingsvragen die jongvolwassenen zichzelf stellen in de overgang van studie naar werk. Dit onderzoek is een bijdrage aan de bestaande inzichten over zingeving in werk bij jongvolwassenen. De hoofdvraag van dit onderzoek luidt als volgt: Maken alumni binnen geesteswetenschappen een ontwikkeling door in de ervaring van doelgerichtheid, competentie en eigenwaarde in relatie tot werk in de vijf jaar na hun afstuderen, en zo ja, welke? Om antwoord te kunnen geven op bovenstaande vraag zijn negen alumni geïnterviewd en is de data op thematische wijze geanalyseerd. De analyse van de data wijst uit dat alle geïnterviewde zich bezig houden met existentiële vragen, zowel met betrekking tot doelgerichtheid, competentie als eigenwaarde. Zij stellen zichzelf verschillende existentiële vragen als: “wanneer ervaar ik mijn werk als zinvol?” “wat voor werk past bij mijn kwaliteiten?” en “wordt mijn werk gewaardeerd?”. Op verschillende vragen hebben zij al (voorlopige) antwoorden geformuleerd, andere vragen blijven onbeantwoord. Daarnaast heeft er een ontwikkeling in de houding ten opzichte van deze zingevingsvragen plaatsgevonden. Ten opzichte van doelgerichtheid blijken de alumni een steeds helderder beeld te krijgen van hun doelen qua werk. Echter blijven zij kritisch en op zoek naar hun ideale plek in het werkveld. Met betrekking tot competentie komen de alumni er veelal in het werkveld pas achter dat ze meer kennis en vaardigheden bezitten dan bij het afstuderen van zichzelf gedacht. En ten aanzien van eigenwaarde ontstaat er een moment van crisis als het vinden van werk uitblijft na alle jaren van studie, maar met behulp van erkenning en waardering van collega’s en het opdoen van succeservaringen in het werkveld neemt de eigenwaarde in de eerste jaren werk weer toe. Respondenten noemden ook twee elementen die nog beperkt in bestaand onderzoek op het gebied van zingeving en werk aan bod komen: de behoefte aan verbinding op de werkvloer, en het omgaan met tegenslagen

Autoimmune diseases and new-onset atrial fibrillation:a UK Biobank study

AimsThe underlying mechanisms of atrial fibrillation (AF) are largely unknown. Inflammation may underlie atrial remodelling. Autoimmune diseases, related to increased systemic inflammation, may therefore be associated with new-onset AF.Methods and resultsParticipants from the population-based UK Biobank were screened for rheumatic fever, gastrointestinal autoimmune diseases, autoimmune diseases targeting the musculoskeletal system and connective tissues, and neurological autoimmune diseases. Between 2006 and 2022, participants were followed for incident AF. Cox proportional hazards regression analyses were performed to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) to quantify associations. 494 072 participants free from AF were included (median age 58.0 years, 54.8% women). After a median of 12.8 years, 27 194 (5.5%) participants were diagnosed with new-onset AF. Rheumatic fever without heart involvement (HR, 95% CI: 1.47, 1.26–1.72), Crohn’s disease (1.23, 1.05–1.45), ulcerative colitis (1.17, 1.06–1.31), rheumatoid arthritis (1.39, 1.28–1.51), polyarteritis nodosa (1.82, 1.04–3.09), systemic lupus erythematosus (1.82, 1.41–2.35), and systemic sclerosis (2.32, 1.57–3.44) were associated with a larger AF risk. In sex-stratified analyses, rheumatic fever without heart involvement, multiple sclerosis, Crohn’s disease, seropositive rheumatoid arthritis, psoriatic and enteropathic arthropathies, systemic sclerosis and ankylosing spondylitis were associated with larger AF risk in women, whereas only men showed a larger AF risk associated with ulcerative colitis.ConclusionsVarious autoimmune diseases are associated with new-onset AF, more distinct in women. Our findings elaborate on the pathophysiological differences in autoimmunity and AF risk between men and women

No differential susceptibility or diathesis stress to parenting in early adolescence: Personality facets predicting behaviour problems

This multi-sample study investigated the main and interactive effects of parenting (responsiveness, overreactivity) and young adolescents' personality traits (negative-affectivity: irritability and anxiety; and orienting-sensitivity) on behaviour problems during adolescence. Data from two samples (N1 = 222; girls 45.5%; Mean age = 11.54 years; N2 = 252; girls 50.4%; Mean age = 10.85 years) were analysed using a multivariate approach. Parenting and y

Solar radiation, and solar radiation driven cycles in warming and fresh water discharge control seasonal and inter-annual phytoplankton chlorophyll a and taxonomic composition in a high Arctic fjord (Kongsfjorden, Spitsbergen)

Fjords on the west coast of Spitsbergen experience variable Arctic and Atlantic climate signals that drive seasonal and inter-annual variability of phytoplankton productivity and composition, by mechanisms that are not fully resolved. To this end, a time series (2013–2018) of Kongsfjorden (N 78�54.2, E 11�54.0) phytoplankton pigments, ocean physics, nutrient concentrations, and microbial abundances was investigated. Kongsfjorden phy- toplankton dynamics were predominantly governed by solar radiation and cycles of warming and freshwater dis- charge that caused pronounced changes in light and nutrient availability. Phytoplankton growth after the polar night commenced in March in a mixed, nutrient loaded water column, and accelerated in April after weak ther- mal stratification. Spring (weeks 10–22) showed high diatom relative abundance that ceased when silicic acid and nitrate reached limiting concentrations. Summer (weeks 23–35) was characterized by sixfold stronger stratification due to increased freshwater discharge and continued ocean heating. This caused a warm, low salinity surface layer with low nutrient concentrations. Small and diverse flagellates, together with high bacterial and viral abundances, thrived in this regenerative, N or P-limited system. Elevated late summer chlorophyll a (Chl a), and ammonium suggested increased regeneration and nutrient pulses by glacial upwelling. Fall (weeks 36–48) caused rapidly declining Chl a and increasing diatom relative abundance, which persisted throughout the polar night, causing high diatom relative abundance during spring. Despite inter-annual variability in ocean temperature and salinity we observed relatively stable seasonal phytoplankton taxonomic composition and Chl a

Virulence Associated Gene 8 of Bordetella pertussis Enhances Contact System Activity by Inhibiting the Regulatory Function of Complement Regulator C1 Inhibitor.

Bordetella pertussis is a Gram-negative bacterium and the causative agent of whooping cough. Whooping cough is currently re-emerging worldwide and, therefore, still poses a continuous global health threat. B. pertussis expresses several virulence factors that play a role in evading the human immune response. One of these virulence factors is virulence associated gene 8 (Vag8). Vag8 is a complement evasion molecule that mediates its effects by binding to the complement regulator C1 inhibitor (C1-INH). This regulatory protein is a fluid phase serine protease that controls proenzyme activation and enzyme activity of not only the complement system but also the contact system. Activation of the contact system results in the generation of bradykinin, a pro-inflammatory peptide. Here, the activation of the contact system by B. pertussis was explored. We demonstrate that recombinant as well as endogenous Vag8 enhanced contact system activity by binding C1-INH and attenuating its inhibitory function. Moreover, we show that B. pertussis itself is able to activate the contact system. This activation was dependent on Vag8 production as a Vag8 knockout B. pertussis strain was unable to activate the contact system. These findings show a previously overlooked interaction between the contact system and the respiratory pathogen B. pertussis. Activation of the contact system by B. pertussis may contribute to its pathogenicity and virulence

Measuring vital signs in children with fever at the emergency department: an observational study on adherence to the NICE recommendations in Europe

Vital signs can help clinicians identify children at risk of serious illness. The NICE guideline for fever in under-fives recommends a routine measurement of temperature, heart rate, capillary refill and respiratory rate in all febrile children visiting the emergency department (ED). This study aims to evaluate the measurement of paediatric vital signs in European EDs, with specific attention to adherence to this NICE guideline recommendation. In a prospective observational study, we included 4560 febrile children under 16 years from the ED of 28 hospitals in 11 European countries (2014–2016). Hospitals were academic (n = 17), teaching (n = 10) and non-teaching (n = 1) and ranged in annual paediatric ED visits from 2700 to 88,000. Fifty-four percent were male, their median age was 2.4 years (IQR 1.1–4.7). Temperature was measured most frequently (97%), followed by capillary refill (86%), heart rate (73%), saturation (56%) and respiratory rate (51%). In children under five (n = 3505), a complete measurement of the four NICE-recommended vital signs was performed in 48% of patients. Children under 1 year of age, those with an urgent triage level and with respiratory infections had a higher likelihood of undergoing complete measurements. After adjustment for these factors, variability between countries remained. Conclusion: Measuring vital signs in children with fever in the ED occurs with a high degree of practice variation between different European hospitals, and adherence to the NICE recommendation is moderate. Our study is essential as a benchmark for current clinical practice, in order to tailor implementation strategies to different European settings.What is Known:• Vital signs can quickly provide information on disease severity in children in the emergency department (ED), and the NICE guideline for fever in under-fives recommends to routinely measure temperature, heart rate, capillary refill and respiratory rate.• Data regarding measurement of vital signs in routine practice across European EDs is currently unavailable.What is New:• Measurement of vital signs in febrile children is highly variable across European EDs and across patient subgroups, and compliance to the NICE recommendation is <50%.• Children under 1 year of age, those with an urgent triage level and with respiratory infections had a higher likelihood of undergoing complete measurements

RNA-seq and Tn-seq reveal fitness determinants of vancomycin-resistant Enterococcus faecium during growth in human serum

BACKGROUND: The Gram-positive bacterium Enterococcus faecium is a commensal of the human gastrointestinal tract and a frequent cause of bloodstream infections in hospitalized patients. The mechanisms by which E. faecium can survive and grow in blood during an infection have not yet been characterized. Here, we identify genes that contribute to growth of E. faecium in human serum through transcriptome profiling (RNA-seq) and a high-throughput transposon mutant library sequencing approach (Tn-seq). RESULTS: We first sequenced the genome of E. faecium E745, a vancomycin-resistant clinical isolate, using a combination of short- and long read sequencing, revealing a 2,765,010 nt chromosome and 6 plasmids, with sizes ranging between 9.3 kbp and 223.7 kbp. We then compared the transcriptome of E. faecium E745 during exponential growth in rich medium and in human serum by RNA-seq. This analysis revealed that 27.8% of genes on the E. faecium E745 genome were differentially expressed in these two conditions. A gene cluster with a role in purine biosynthesis was among the most upregulated genes in E. faecium E745 upon growth in serum. The E. faecium E745 transposon mutant library was then used to identify genes that were specifically required for growth of E. faecium in serum. Genes involved in de novo nucleotide biosynthesis (including pyrK_2, pyrF, purD, purH) and a gene encoding a phosphotransferase system subunit (manY_2) were thus identified to be contributing to E. faecium growth in human serum. Transposon mutants in pyrK_2, pyrF, purD, purH and manY_2 were isolated from the library and their impaired growth in human serum was confirmed. In addition, the pyrK_2 and manY_2 mutants were tested for their virulence in an intravenous zebrafish infection model and exhibited significantly attenuated virulence compared to E. faecium E745. CONCLUSIONS: Genes involved in carbohydrate metabolism and nucleotide biosynthesis of E. faecium are essential for growth in human serum and contribute to the pathogenesis of this organism. These genes may serve as targets for the development of novel anti-infectives for the treatment of E. faecium bloodstream infections

Long-Term Performance of Epicardial versus Transvenous Left Ventricular Leads for Cardiac Resynchronization Therapy

Aims: to study the technical performance of epicardial left ventricular (LV) leads placed via video assisted thoracic surgery (VATS), compared to transvenously placed leads for cardiac resynchronization therapy (CRT).Methods: From 2001 until 2013, a total of 644 lead placement procedures were performed for CRT. In the case of unsuccessful transvenous LV lead placement, the patient received an epicardial LV lead. Study groups consist of 578 patients with a transvenous LV lead and 66 with an epicardial LV lead. The primary endpoint was LV-lead failure necessitating a replacement or deactivation. The secondary endpoint was energy consumption.Results: The mean follow up was 5.9 years (epicardial: 5.5 ± 3.1, transvenous: 5.9 ± 3.5). Transvenous leads failed significantly more frequently than epicardial leads with a total of 66 (11%) in the transvenous leads group vs. 2 (3%) in the epicardial lead group ( p = 0.037). Lead energy consumption was not significantly different between groups.Conclusions: Epicardial lead placement is feasible, safe and shows excellent long-term performance compared to transvenous leads. Epicardial lead placement should be considered when primary transvenous lead placement fails or as a primary lead placement strategy in challenging cases. </p

Treatment selection of early stage non-small cell lung cancer: The role of the patient in clinical decision making

Background: The objective of this study is to investigate the role and experience of early stage non-small cell lung cancer (NSCLC) patient in decision making process concerning treatment selection in the current clinical practice. Methods: Stage I-II NSCLC patients (surgery 55 patients, SBRT 29 patients, median age 68) were included in this prospective study and completed a questionnaire that explored: (1) perceived patient knowledge of the advantages and disadvantages of the treatment options, (2) experience with current clinical decision making, and (3) the information that the patient reported to have received from their treating physician. This was assessed by multiple-choice, 1-5 Likert Scale, and open questions. The Decisional Conflict Scale was used to assess the decisional conflict. Health related quality of life (HRQoL) was measured with SF-36 questionnaire. Results: In 19% of patients, there was self-reported perceived lack of knowledge about the advantages and disadvantages of the treatment options. Seventy-four percent of patients felt that they were sufficiently involved in decision-making by their physician, and 81% found it important to be involved in decision making. Forty percent experienced decisional conflict, and one-in-five patients to such an extent that it made them feel unsure about the decision. Subscores with regard to feeling uninformed and on uncertainty, contributed the most to decisional conflict, as 36% felt uninformed and 17% of patients were not satisfied with their decision. HRQoL was not influenced by patient experience with decision-making or patient preferences for shared decision making. Conclusions: Dutch early-stage NSCLC patients find it important to be involved in treatment decision making. Yet a substantial proportion experiences decisional conflict and feels uninformed. Better patient information and/or involvement in treatment-decision-making is needed in order to improve patient knowledge and hopefully reduce decisional conflict