Doelgericht deelnemen Achtergrondstudie naar burgerparicipatie bij het toezicht

Sinds de jaren tachtig van de vorige eeuw is er groeiende aandacht voor burgerparticipatie in de gezondheidszorg. Participatie vindt niet alleen op het individuele niveau plaats, waar burgers kunnen kiezen en actief kunnen participeren in beslissingen over hun eigen zorg, maar ook op het collectieve niveau. Patiënten worden gevraagd om het patientenperspectief in te brengen in besluitvorming over bijvoorbeeld richtlijnontwikkeling, onderzoeksagenda’s, overheidsbeleid en kwaliteitsbeleid in ziekenhuizen. Ook bij de IGZ staat burgerparticipatie op de kaart. Er is echter nog weinig bekend over participatie bij toezicht. Om meer inzicht te krijgen in deze materie is door het iBMG

Current practices in managing acutely disturbed patients at three hospitals in Rio de Janeiro-Brazil: a prevalence study

The medical management of aggressive and violent behaviour is a critical situation for which there is little evidence. In order to prepare for a randomised trial, due to start in the psychiatric emergency rooms of Rio de Janeiro in 2001, a survey of current practice was necessary. A seven day survey of pharmacological management of aggressive people with psychosis in the emergency rooms of all four public psychiatric hospitals in Rio de Janeiro, Brazil. In one hospital data were not available. Of the 764 people with psychosis attending these ERs, 74 were given IM medication for rapid tranquillisation (9.7%, 2.1/week/100,000). A haloperidol-promethazine mix (with or without other drugs) was used for the majority of patients (83%). The haloperidol-promethazine mix, given intramuscularly for rapid tranquilization, is prevalent in Rio, where it is considered both safe and efficient. However, scientific evaluation of all pharmacological approaches to rapid tranquilization of psychotic people is inadequate or incomplete and a randomized trial of IM haloperidol-promethazine is overdue

A morpholino oligomer therapy regime that restores mitochondrial function and prevents mdx cardiomyopathy

Current clinical trials demonstrate Duchenne muscular dystrophy (DMD) patients receiving phosphorodiamidate morpholino oligomer (PMO) therapy exhibit improved ambulation and stable pulmonary function; however, cardiac abnormalities remain. Utilizing the same PMO chemistry as current clinical trials, we have identified a non-toxic PMO treatment regimen that restores metabolic activity and prevents DMD cardiomyopathy. We propose that a treatment regimen of this nature may have the potential to significantly improve morbidity and mortality from DMD by improving ambulation, stabilizing pulmonary function, and preventing the development of cardiomyopathy

Spatiotemporal endothelial cell-pericyte association in tumors as shown by high resolution 4D intravital imaging

Endothelial cells and pericytes are integral cellular components of the vasculature with distinct interactive functionalities. To study dynamic interactions between these two cells we created two transgenic animal lines. A truncated eNOS (endothelial nitric oxide synthase) construct was used as a GFP tag for endothelial cell evaluation and an inducible Cre-lox recombination, under control of the Pdgfrb (platelet derived growth factor receptor beta) promoter, was created for pericyte assessment. Also, eNOStag-GFP animals were crossed with the already established Cspg4-DsRed mice expressing DsRed fluorescent protein in pericytes. For intravital imaging we used tumors implanted in the dorsal skinfold of these transgenic animals. This setup allowed us to study time and space dependent complexities, such as distribution, morphology, motility, and association between both vascular cell types in all angiogenetic stages, without the need for additional labeling. Moreover, as fluorescence was still clearly detectable after fixation, it is possible to perform comparative histology following intravital evaluation. These transgenic mouse lines form an excellent model to capture collective and individual cellular and subcellular endothelial cell-pericyte dynamics and will help answer key questions on the cellular and molecular relationship between these two cells

Limits of Gaudin algebras, quantization of bending flows, Jucys--Murphy elements and Gelfand--Tsetlin bases

Gaudin algebras form a family of maximal commutative subalgebras in the tensor product of $n$ copies of the universal enveloping algebra U(\g) of a semisimple Lie algebra \g. This family is parameterized by collections of pairwise distinct complex numbers $z_1,...,z_n$. We obtain some new commutative subalgebras in U(\g)^{\otimes n} as limit cases of Gaudin subalgebras. These commutative subalgebras turn to be related to the hamiltonians of bending flows and to the Gelfand--Tsetlin bases. We use this to prove the simplicity of spectrum in the Gaudin model for some new cases.Comment: 11 pages, references adde

Risk Factors for Development of Chronic Kidney Disease in Cats

BACKGROUND: Identification of risk factors for development of chronic kidney disease (CKD) in cats may aid in its earlier detection. HYPOTHESIS/OBJECTIVES: Evaluation of clinical and questionnaire data will identify risk factors for development of azotemic CKD in cats. ANIMALS: One hundred and forty‐eight client‐owned geriatric (>9 years) cats. METHODS: Cats were recruited into the study and followed longitudinally for a variable time. Owners were asked to complete a questionnaire regarding their pet at enrollment. Additional data regarding dental disease were obtained when available by development of a dental categorization system. Variables were explored in univariable and multivariable Cox regression models. RESULTS: In the final multivariable Cox regression model, annual/frequent vaccination (P value, .003; hazard ratio, 5.68; 95% confidence interval, 1.83–17.64), moderate dental disease (P value, .008; hazard ratio, 13.83; 95% confidence interval, 2.01–94.99), and severe dental disease (P value, .001; hazard ratio, 35.35; 95% confidence interval, 4.31–289.73) predicted development of azotemic CKD. CONCLUSION: Our study suggests independent associations between both vaccination frequency and severity of dental disease and development of CKD. Further studies to explore the pathophysiological mechanism of renal injury for these risk factors are warranted

Impaired functional communication between the L-type calcium channel and mitochondria contributes to metabolic inhibition in the mdx heart

Duchenne muscular dystrophy is a fatal X-linked disease characterized by the absence of dystrophin. Approximately 20% of boys will die of dilated cardiomyopathy that is associated with cytoskeletal protein disarray, contractile dysfunction, and reduced energy production. However, the mechanisms for altered energy metabolism are not yet fully clarified. Calcium influx through the L-type Ca2+ channel is critical for maintaining cardiac excitation and contraction. The L-type Ca2+ channel also regulates mitochondrial function and metabolic activity via transmission of movement of the auxiliary beta subunit through intermediate filament proteins. Here, we find that activation of the L-type Ca2+ channel is unable to induce increases in mitochondrial membrane potential and metabolic activity in intact cardiac myocytes from the murine model of Duchenne muscular dystrophy (mdx) despite robust increases recorded in wt myocytes. Treatment of mdx mice with morpholino oligomers to induce exon skipping of dystrophin exon 23 (that results in functional dystrophin accumulation) or application of a peptide that resulted in block of voltage-dependent anion channel (VDAC) “rescued” mitochondrial membrane potential and metabolic activity in mdx myocytes. The mitochondrial VDAC coimmunoprecipitated with the L-type Ca2+ channel. We conclude that the absence of dystrophin in the mdx ventricular myocyte leads to impaired functional communication between the L-type Ca2+ channel and mitochondrial VDAC. This appears to contribute to metabolic inhibition. These findings provide new mechanistic and functional insight into cardiomyopathy associated with Duchenne muscular dystrophy

When is a lifting movement too asymmetric to identify low back loading by 2D analysis

In ergonomics research, two-dimensional (2-D) biomechanical models are often used to study the mechanical loading of the low back in lifting movements. When lifting movements are asymmetric, errors of unknown size may be introduced in a 2-D analysis. In the current study, an estimation of these errors was made by comparing the outcome of a 2-D analysis to the results of a recently developed and validated 3-D model. Four subjects made two repetitions of five lifting movements, differing in the amount of asymmetry. The results showed a significant underestimation of the peak torque by 20, 36 and 61% when the initial position of a box was rotated 30, 60 and 90°with respect to the sagittal plane of the subject. The main cause of this underestimation was a pelvic twist, resulting in an erroneous projection of a pelvic marker on to the sagittal plane due to pelvic twist. It is suggested that from 30°box rotation a 2-D analysis may easily lead to wrong conclusions when it is used to study asymmetric lifting

Self-consistent description of nuclear compressional modes

Isoscalar monopole and dipole compressional modes are computed for a variety of closed-shell nuclei in a relativistic random-phase approximation to three different parametrizations of the Walecka model with scalar self-interactions. Particular emphasis is placed on the role of self-consistency which by itself, and with little else, guarantees the decoupling of the spurious isoscalar-dipole strength from the physical response and the conservation of the vector current. A powerful new relation is introduced to quantify the violation of the vector current in terms of various ground-state form-factors. For the isoscalar-dipole mode two distinct regions are clearly identified: (i) a high-energy component that is sensitive to the size of the nucleus and scales with the compressibility of the model and (ii) a low-energy component that is insensitivity to the nuclear compressibility. A fairly good description of both compressional modes is obtained by using a ``soft'' parametrization having a compression modulus of K=224 MeV.Comment: 28 pages and 10 figures; submitted to PR

Compaction of Rods: Relaxation and Ordering in Vibrated, Anisotropic Granular Material

We report on experiments to measure the temporal and spatial evolution of packing arrangements of anisotropic, cylindrical granular material, using high-resolution capacitive monitoring. In these experiments, the particle configurations start from an initially disordered, low-packing-fraction state and under vertical vibrations evolve to a dense, highly ordered, nematic state in which the long particle axes align with the vertical tube walls. We find that the orientational ordering process is reflected in a characteristic, steep rise in the local packing fraction. At any given height inside the packing, the ordering is initiated at the container walls and proceeds inward. We explore the evolution of the local as well as the height-averaged packing fraction as a function of vibration parameters and compare our results to relaxation experiments conducted on spherically shaped granular materials.Comment: 9 pages incl. 7 figure