Understanding the NSAID related risk of vascular events

Concern is growing about an increased risk of thrombotic events (including myocardial infarction and stroke) during the use of non-steroidal anti-inflammatory drugs (NSAIDs), in particular the so called selective cyclo-oxygenase-2 (COX 2) inhibitors. Although clinical trials give conflicting results with respect to the incidence of vascular events, increasing evidence shows that a class effect might exist for selective COX 2 inhibitors. Even before the massive introduction of selective COX 2 inhibitors, observational studies showed that the use of NSAIDs causes congestive heart failure in elderly patients.1,2 Conversely, the discontinuation of NSAIDs has also been associated with increased risk of myocardial infarction, especially in the first several weeks after stopping chronic NSAID treatment.3Many different mechanisms could explain the different effects of classic NSAIDs and selective COX 2 inhibitors in relation to thrombotic vascular events. In this review we link biochemical facts concerning NSAIDs and COX inhibitors with data from clinical trials

Social stigma is an underestimated contributing factor to unemployment in people with mental illness or mental health issues:Position paper and future directions

Background As yet, little is known about the effects of mental health stigma on sustainable employment. This is surprising, as mental health stigma is common, and because people with severe and common mental disorders are 7 and 3 times more likely to be unemployed, respectively, than people with no disorders. As the global lifetime prevalence of mental disorders is 29%, the high unemployment rates of people with these health problems constitute an important and urgent public health inequality problem that needs to be addressed. Main text The aim of this position paper is to illustrate the assumption that stigma contributes to the unemployment of people with mental illness and mental health issues with evidence from recent scientific studies on four problem areas, and to provide directions for future research. These four problem areas indicate that: (1) employers and line managers hold negative attitudes towards people with mental illness or mental health issues, which decreases the chances of people with these health problems being hired or supported; (2) both the disclosure and non-disclosure of mental illness or mental health issues can lead to job loss; (3) anticipated discrimination, self-stigma and the ‘Why Try’ effect can lead to insufficient motivation and effort to keep or find employment and can result in unemployment; and (4) stigma is a barrier to seeking healthcare, which can lead to untreated and worsened health conditions and subsequently to adverse occupational outcomes (e.g. sick leave, job loss). Conclusions The paper concludes that stigma in the work context is a considerable and complex problem, and that there is an important knowledge gap especially regarding the long-term effects of stigma on unemployment. To prevent and decrease adverse occupational outcomes in people with mental illness or mental health issues there is an urgent need for high quality and longitudinal research on stigma related consequences for employment. In addition, more validated measures specifically for the employment setting, as well as destigmatizing intervention studies are needed

Realist Evaluation : an overview

This report summarises the discussions and presentations of the Expert Seminar ‘Realist Evaluation’ with Gill Westhorp, which took place in Wageningen on March 29, 2011. The Expert Seminar was organised by the Wageningen UR Centre for Development Innovation in collaboration with Learning by Design and Context, international cooperation

Modelling and system identification of a stiff stay wire fence machine

This paper investigates a severe gear backlash problem encountered in a stiff stay machine that is capable of producing a 26 line fence up to 2.6 metres in height at a speed of 80 stays/minute. Related problems in the literature, typically concentrate on the effect of gear backlash on the ability to control a shaft. However, in this case, very good control of the reference speed of the shaft was maintained in spite of the gear backlash. The problem was that the commanded torques were excessively large and threatened to damage the gear box. This problem motivated a complete analysis of the systems dynamics including the development of a model to better understand the response and allow the identification of external loads on the system. It was found that the method of sensing the shaft position (resolvers) was a major factor as well as the upgrading of the motor which was over responding to disturbances in the shaft. The model was validated using several torque limiting experiments and gave accurate prediction of the machine’s major dynamics. The simulation tool developed provides the basis to predict the effect of different loads, wire types and/or motors on the machine for future designs minimizing the amount of experimentation on the machine

Alumnicommissie

Sinds enkele weken heeft de B.I.L. er een nieuwe alumnicommissie bij, Alumni’VO. Ondanks dat deze commissie nog pas net is samengesteld, hebben ze al veel dingen bereikt. Zo hebben zij het budget voor alumni vergroot door te pitchen voor extra geld. Hieronder worden deze vijf toppers aan u voorgesteld

Interview met Natascha van der Zwan

Het Nederlandse pensioenstelsel wordt altijd als een lastig onderwerp ervaren. Waaruit is mijn pensioen opgebouwd? Kan ik later zelf nog wel rekenen op een behoorlijk pensioen? En zo niet, hoe kan ik mijn pensioen aanvullen? Natascha van der Zwan en Sijbren Kuiper gingen samen op zoek naar de antwoorden die zij gebundeld hebben in hun nieuwe boek: Nederland pensioenland, wat je wilt weten over pensioenen