Reconstruction and modelling of Holocene coastal evolution of the western Netherlands

Large-scale coastal evolution in the western Netherlands during the Holocene was characterised by an initial stage of transgression followed by a stage of coastal progradation. The last 2000 years, the position of coastline of the western Netherlands was relatively stable, with local retreat and advance. Coastal deposits from the western Netherlands have been studied in detail at the Ypenburg area, in cores from coast-perpendicular cross sections near Haarlem and Wassenaar and in cores from the modern shoreface. The age of deposition has been determined with AMS 14C dating of single shells. A model has been used to reconstruct the wave-height reduction on the palaeo-shoreface profiles and model simulations have been used to reveal previously unobserved patterns in the large-scale coastal evolution. The combination of traditional sedimentological research with tools like cone-penetration tests (CPT), ground-penetrating radar (GPR), AMS 14C dating, and modelling of palaeo-conditions and stratigraphic modelling used in this thesis, presents a powerful means to unravel the geological past

A large-scale field experiment on salt marsh construction

Salt marshes provide important natural habitats, mitigate effects of subsidence and sea level rise and help in coastal defence. Commissioned by the municipality of Delfzijl, the EcoShape consortium obtained the opportunity to carry out a large-scale field experiment on salt marsh construction as part of their Living Lab for MUD

Diabetes care: reasons for missing HbA1c measurements in general practice

<p>Abstract</p> <p>Background</p> <p>Glycated haemoglobin (HbA_1c) is often used as one of the indicators to measure the quality of diabetes care. Complete registration is difficult to obtain. This study investigated the reasons for missing HbA_1cmeasurements.</p> <p>Findings</p> <p>HbA_1cmeasurements for 1485 patients with diabetes mellitus type 2 who were attended by 19 general practitioners at 4 primary care health centres in south-east Amsterdam were studied. HbA_1cmeasurements were missing for 356 (23.9%) of the patients. The main reason stated in 50% of the cases was that the patient was under specialized care.</p> <p>Conclusions</p> <p>The general practitioners provided multiple reasons for the missing HbA_1cmeasurements. This study provides insight into why HbA_1cmeasurements were not present in the patients' electronic medical record.</p

A trial of a job-specific workers' health surveillance program for construction workers: study protocol

<p>Abstract</p> <p>Background</p> <p>Dutch construction workers are offered periodic health examinations. This care can be improved by tailoring this workers health surveillance (WHS) to the demands of the job and adjust the preventive actions to the specific health risks of a worker in a particular job. To improve the quality of the WHS for construction workers and stimulate relevant job-specific preventive actions by the occupational physician, we have developed a job-specific WHS. The job-specific WHS consists of modules assessing both physical and psychological requirements. The selected measurement instruments chosen, are based on their appropriateness to measure the workers' capacity and health requirements. They include a questionnaire and biometrical tests, and physical performance tests that measure physical functional capabilities. Furthermore, our job-specific WHS provides occupational physicians with a protocol to increase the worker-behavioural effectiveness of their counselling and to stimulate job-specific preventive actions. The objective of this paper is to describe and clarify our study to evaluate the behavioural effects of this job-specific WHS on workers and occupational physicians.</p> <p>Methods/Design</p> <p>The ongoing study of bricklayers and supervisors is a nonrandomised trial to compare the outcome of an intervention (job-specific WHS) group (n = 206) with that of a control (WHS) group (n = 206). The study includes a three-month follow-up. The primary outcome measure is the proportion of participants who have undertaken one or more of the preventive actions advised by their occupational physician in the three months after attending the WHS. A process evaluation will be carried out to determine context, reach, dose delivered, dose received, fidelity, and satisfaction. The present study is in accordance with the TREND Statement.</p> <p>Discussion</p> <p>This study will allow an evaluation of the behaviour of both the workers and occupational physician regarding the preventive actions undertaken by them within the scope of a job-specific WHS.</p> <p>Trial registration</p> <p><a href="http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=3012">NTR3012</a></p