Obesity: exploring neural pathophysiological pathways and improving diagnostic strategies

This thesis describes investigations in the neural pathophysiological mechanisms leading to obesity with a specific focus on the relation of brainstructure and function with behaviour and genetics. Furthermore, it describes investigations in the diagnostic strategy in overweight and obese children. Nutricia Early Life NutritionLUMC / Geneeskunde Repositoriu

Responding to future regime shifts with agrobiodiversity: A multi-level perspective on small-scale farming in Uganda

We analyse the impact of two large-scale regime shifts caused by disease incidence or climate change, and associated crop productivity and price changes, on banana-based smallholders in Uganda. We evaluate these farmers' vulnerability and assess the potential of using increased crop diversity to improve their resilience. We further explore trade-offs and synergies between environmental, economic and nutritional outcomes faced by the farmers in their decision making when a regime shift occurs. We simulate the large-scale scenarios with the IMPACT model and use the results obtained to assess their effect at the local level using the bio-economic farm-household model, FarmDESIGN. Our results indicate that climate change can lead to a regime shift that expands revenue variance, increases soil erosion and reduces vitamin A yield for farmers. Banana disease can negatively impact income levels and species diversity. We show that under both scenarios farmers have scope to reconfigure their farms and recover farm performance. Specifically, we discuss the benefits of species diversity; increasing agrobiodiversity by adding new crops increases the farm's adaptive capacity and resilience, allowing for much higher revenues, on-farm crop diversity and vitamin A production. The conceptual approach and the method we developed can be applied to assess the local synergies and trade-offs between crop diversity conservation, nutrition, environmental protection and human nutrition that farmers face as a result of global drivers. Our results offer a further understanding of how biodiverse systems respond to regime shifts, which can inform effective policy design. Our method can be also useful to help farmers manage their farms in a way to better meet their complex needs.</p

Cardiovascular mortality in women in their forties after hypertensive disorders of pregnancy in the Netherlands : a national cohort study

Peer reviewedPublisher PD

Development of a practical guideline for person centred goal setting in geriatric rehabilitation:A participatory action research

PurposeTo improve goal setting in Geriatric Rehabilitation (GR), by developing an evidence-based practical guideline for patient-centred goal setting.MethodsParticipatory action research (PAR) in a cyclical process, with GR professionals as co-researchers. Each cycle consisted of five phases: problem analysis, literature review, development, practical experience, feedback &amp; evaluation. The evaluation was based on video recordings of goal setting conversations, and on oral and written feedback of the GR professionals who tested the guideline.ResultsIn two PAR-cycles the guideline was developed, consisting of eight recommendations for setting and using goals, and of practical advices elaborating three of the recommendations, concerning conversational skills specific for goal setting conversations. After the second cycle the research team concluded that the guideline was feasible in daily practice and effective when used consciously.ConclusionIn this study, a practical guideline for setting and using goals in GR was developed. GR teams can improve their patient centred working with goals by discussing the recommendations in their team and choosing the recommendations to work on. This can be supported by the development of an interdisciplinary training. The effect on quality of care should be subject to further investigation

In-medium relativistic kinetic theory and nucleon-meson systems

Within the $\sigma-\omega$ model of coupled nucleon-meson systems, a generalized relativistic Lenard--Balescu--equation is presented resulting from a relativistic random phase approximation (RRPA). This provides a systematic derivation of relativistic transport equations in the frame of nonequilibrium Green's function technique including medium effects as well as flucuation effects. It contains all possible processes due to one meson exchange and special attention is kept to the off--shell character of the particles. As a new feature of many particle effects, processes are possible which can be interpreted as particle creation and annihilation due to in-medium one meson exchange. In-medium cross sections are obtained from the generalized derivation of collision integrals, which possess complete crossing symmetries.Comment: See nucl-th/9310032 for revised version which the authors incompetently resubmitted rather than correctly replacing thi