Exploring the boundaries of endovascular aneurysm repair:studying an all-comers population

An abdominal aortic aneurysm can be treated endovascularly since the early 1990s. In the endovascular technique, a stent is placed through the groin, which is less invasive than the open technique. An important limitation is that ruptured and complex aneurysms are less suitable and more long-term complications are seen. With the help of registration studies, this thesis investigated how stents function at the extremes of the manufacturers' instructions for use. The thesis shows that in the case of ruptured aneurysms, the technical results are good. Additionally, it is shown that in complex aneurysms the short-term number of complications is not unacceptable, despite the challenging anatomy. The long-term results will have to be determined in the future. The above results can contribute to determining the optimal treatment strategy of ruptured and complex aneurysms

Quantitative estimates of work-related death, disease and injury in New Zealand.

OBJECTIVES: New Zealand lacks comprehensive statistics on work-related injury and illness, and the impact of adverse work conditions on health is therefore not known. The objective of this study was to make quantitative estimates of the annual number of deaths from work-related disease and injury in New Zealand, as well as estimate the number of incident cases of work-related disease and injury. METHODS: Wherever possible, specific data for New Zealand were used, but, where adequate national data were lacking, a combination of New Zealand data and extrapolations from other countries was used. For work-related injury mortality and incidence, published studies and reports of the New Zealand Accident Compensation Corporation were primarily used. For work-related disease mortality, the likely population attributable fractions from overseas studies were mainly used, together with mortality data from New Zealand. For work-related disease incidence, both approaches were used. RESULTS: In New Zealand about 700-1000 deaths were estimated to occur annually from work-related disease and about 100 deaths from work-related injury. About 17 000-20 000 new cases of work-related disease occur annually and about 200 000 work-related accidents result in claims made to the New Zealand Accident Compensation Corporation. CONCLUSIONS: Despite their imprecision, these conservative estimates indicate the burden of work-related death, disease, and injury in New Zealand. The estimates by gender, industry, and disease types provide useful information for policy priorities

The New Zealand workforce survey II: occupational risk factors for asthma.

INTRODUCTION: We conducted a cross-sectional population-based survey in New Zealand that collected information on work history, current workplace exposures, and selected health outcomes. We report here the findings on occupational risk factors for asthma symptoms. METHODS: A random sample of men and women aged 20-64 years were selected from the New Zealand Electoral Roll and invited to take part in a telephone survey. Current asthma was defined as: (i) woken up by shortness of breath in the past 12 months; or (ii) an attack of asthma in the past 12 months; or (iii) currently taking asthma medication. Adult-onset asthma was defined as first attack of asthma at age 18 or over. Prevalence odds ratios (ORs) for all occupations were calculated using logistic regression adjusting for sex, age, smoking, and deprivation. RESULTS: Totally, 2903 participants were included in the analyses. The prevalence of current asthma was 17% and the prevalence of adult-onset asthma was 9%. Prevalence ORs for current asthma were elevated for ever working as a printer [OR = 2.26; 95% confidence interval (CI) = 1.09-4.66], baker (OR = 1.98; 95% CI = 1.02-3.85), sawmill labourer (OR = 3.26; 95% CI = 1.05-10.16), metal processing plant operator (OR = 2.48; 95% CI = 1.22-5.05), and cleaner (OR = 1.60; 95% CI = 1.09-2.35). Excess risks of adult-onset asthma were also found for ever working as a printer, baker, and sawmill labourer as well as ever-working as a market-oriented animal producer (OR = 1.66; 95% CI = 1.14-2.41), and other agricultural worker (OR = 2.08; 95% CI = 1.03-4.20). A number of occupations not previously considered at high risk for asthma were also identified, including teachers and certain sales professionals. CONCLUSION: This population-based study has confirmed findings of previous international studies showing elevated risks in a number of high-risk occupations. The strongest risks were consistently observed for printers, bakers, and sawmill labourers. Several occupations were also identified that have not been previously associated with asthma, suggesting that the risk of occupational asthma may be more widely spread across the workforce than previously assumed

Let them flourish:enhancing higher education students’ well-being

Student well-being in higher education is receiving increasing attention. This is agood development, partly because well-being is related to being able to study successfully.Using the Job Demands-Resources model as a theoretical foundation, this dissertation investigates the well-being and promotion of well-being of students in general and honours students in particular, aiming to answer the research question: What personal resources promote higher education students’ well-being and how can these personal resources be enhanced by education?Exploratory interviews with honours students investigated which personal resources they believe are important for achieving success. Path analysis was then used to investigate which personal resources are most strongly associated with levels of engagement and stress of students. The systematic review that followed described, from 123 included studies, the characteristics of interventions to promote well-being, the underlying theories, the effects of interventions and possible factors influencing effectiveness. Finally, educational design principles are formulated for designing interventions to (further) develop four personal resources of honours students; self-efficacy, optimism, inquiry mindedness, and self-regulation.It is recommended that, based on the findings, further educational design research is conducted to both design effective interventions to develop students' personal resources and further develop the associated theory. In this way, increasingly evidence-based work can be done to promote student well-being

EFFECT OF PHOSPHATE ON NODULE PRIMORDIA OF SOYBEAN (Glycine max Merrill) IN ACID SOILS IN RHIZOTRON EXPERIMENTS

To clarify whether P had a direct or indirect effect on the nodulation  process of soybean grown in acid soils from Sitiung, West Sumatra, Indonesia, a series of rhizotron experiments, with special attention given to formation of nodule primordia, was conducted at Laboratory of  Microbiology, Wageningen University in 1998-2000. It was shown that Ca and P were essential nutrients for root growth, nodule formation, and growth of soybean in the acid soils (Oxisols). Ca increased root growth, number of nodule primordia, nodules, and growth of the soybean plant. This positive effect of Ca was increased considerably by the application of P. Ca and P have a synergistic effect on biological nitrogen fixation (BNF) of soybean in acid soils. Ca is important for the establishment of nodules, whilst P is essential for the development and function of the formed nodules. P increased number of nodule primordia, thus it also has an important role in the initiation of nodule formation. From this study, it can be concluded that Ca and P are the most limiting nutrients for BNF of soybean in the acid soils of Sitiung, West Sumatra, Indonesia

Instability of confined water films between elastic surfaces

We investigated the dynamics of nanometer thin water films at controlled ambient humidity adsorbed onto two atomically smooth mica sheets upon rapidly bringing the surfaces into contact. Using a surface forces apparatus (SFA) in imaging mode, we found that the water films break up into a distribution of drops with a typical thickness of a few nanometers and a characteristic lateral size and spacing of several micrometers. Whereas the characteristic length is found to be independent of the ambient humidity, the characteristic time of the breakup decreases from 1 to 0.01 s with increasing humidity. The existence of characteristic length and time scales shows that this breakup is controlled by an instability rather than a conventional nucleation and growth mechanism for SFA experiments. These findings cannot be explained by a dispersion-driven instability mechanism. In contrast, a model involving the elastic energies for the deformation of both the mica sheets and the underlying glue layer correctly reproduces the scaling of the characteristic length and time with humidity

Upside-Down Gore Excluder as an Endoprosthesis for Aortoiliac Aneurysm Exclusion:A Retrospective Multicenter Study

Objective: The upside-down configuration of a Gore Excluder contralateral leg endoprosthesis has been used to overcome diameter differences in the endovascular treatment of aortoiliac aneurysms. Our goal was not to describe the technique but to study the applicability and safety. Material and methods: Patients were retrospectively enrolled. The indication and details of the procedure were at the discretion of the treating physicians. A case report form was completed including baseline characteristics, indication for treatment, procedural data, and outcomes during follow-up. Results: A total of 31 subjects were enrolled with a range of indications, including 3 patients treated in the emergency setting (9.7%). In 64.5% (n=20), it was a primary intervention for a common iliac aneurysm (n=10), internal iliac aneurysm (n=4), or abdominal aortic aneurysm (n=6). In 11 subjects (35.5%), treatment was performed after previous aortoiliac interventions, including anastomotic iliac artery aneurysm (n=5), type III endoleak (n=3), and endograft thrombus (n=3). Median follow-up was 13 months (range=1-142 months). During follow-up, 2 patients required an upside-down contralateral leg–related secondary intervention, one for an occlusion and another for a type Ia endoleak. There was no type Ib or III endoleak, and no migration, kinking/stenosis, or conversion to open repair was observed. The aneurysm-related mortality was 3.3% (n=1). Conclusion: An upside-down contralateral leg is a valuable technique that can be used to achieve adequate aneurysm exclusion or resolve complications. It is associated with a limited number of complications. Clinical impact: This article studies the use of an upside-down iliac endograft. We describe a wide range of indications in which this previously published technique has been applied. In elective and acute settings and as primary and revision intervention an upside-down iliac endograft was performed successfully. Furthermore, follow-up data is presented showing the effectiveness of the technique. Knowledge of this procedure is a valuable addition to the skillset of every interventionalist.</p

Effect of Phosphate on Nodule Primordia of Soybean (Glycine Max Merrill) in Acid Soils in Rhizotron Experiments

To clarify whether P had a direct or indirect effect on the nodulation process of soybean grown in acid soils from Sitiung, West Sumatra, Indonesia, a series of rhizotron experiments, with special attention given to formation of nodule primordia, was conducted at Laboratory of Microbiology, Wageningen University in 1998-2000. It was shown that Ca and P were essential nutrients for root growth, nodule formation, and growth of soybean in the acid soils (Oxisols). Ca increased root growth, number of nodule primordia, nodules, and growth of the soybean plant. This positive effect of Ca was increased considerably by the application of P. Ca and P have a synergistic effect on biological nitrogen fixation (BNF) of soybean in acid soils. Ca is important for the establishment of nodules, whilst P is essential for the development and function of the formed nodules. P increased number of nodule primordia, thus it also has an important role in the initiation of nodule formation. From this study, it can be concluded that Ca and P are the most limiting nutrients for BNF of soybean in the acid soils of Sitiung, West Sumatra, Indonesia