De Politieke Strijd om Veiligheid: Regulering versus spontaniteit in de partijprogramma's

Veiligheid is een topprioriteit voor politieke partijen. Diepgaande analyse van partijprogramma's leert dat er een algemene toename is van de nadruk op repressieve regulering van de samenleving, en een afname van steun voor het stimuleren van spontane burgers

Diabetiske fotsår

Diabetiske fotsår skyldes to senkomplikasjoner av diabetes: nevropati og arteriosklerose. Rask og adekvat behandling av disse ofte krevende sårene er viktig for å forhindre amputasjon. Ideelt sett bør diabetiske fotsår behandles av et tverrfaglig diabetisk fotteam. Behandlingen sikter mot avlastning, behandling av infeksjoner, gjenoppretting av sirkulasjonen og lokalt sårstell. Enkle undersøkelser kan danne grunnlag for vurdering av risiko for utvikling av diabetiske fotsår. Profylakse og riktig håndtering av slike risikopasienter kan bidra til å redusere antallet amputasjoner hos diabetikere. Diabetiske fotsår er et altfor lite påaktet område innen diabetesomsorgen og bør få langt mer oppmerksomhet blant helsepersonell. Når diabetiske fotkomplikasjoner inntreffer, er det dessverre fortsatt alt for ofte overlatt til tilfeldighetene om en pasient beholder funksjonsdyktig ekstremitet eller ikke. I denne artikkelen beskriver vi epidemiologi, patofysiologi, utredning og behandling av diabetiske fotsår basert på tilgjengelig relevant litteratur.måsjekke

Intentions of the Framers of the Commonwealth of Australia Constitution

The thesis examines the speeches and debates in the Australasian Federation Conference of 1890, and the Australasian Federal Conventions of 1891 and 1897-8 for the purpose of establishing what the framers of the Commonwealth Constitution understood to be the meaning and purpose of the individual sections of the Constitution upon which they were called upon either to support or oppose. The particular matters involved in the examination are the manner and form in which the principles of responsible government were incorporated into the constitution, and the relationship of these principles to the powers of the Senate; the crisis in the 1891 Convention in relation to the powers of the Senate over money bills; the significance of the difference in composition of the Convention of 1891 compared with that of 1897-8; the significance of the classification of the Constitution as an indissoluble federation under the Crown; the principles of responsible government and the provisions of s.57 in the context of the deadlock over Supply in 1975; the meaning and purpose of s.41 preserving the rights of voters qualified to vote in State elections for the lower Houses, and the misconceptions in relation thereto the position of aborigines under the Constitution; the meaning and purpose of the special laws power in the light of the 1967 Constitutional referendum, and its interpretation bU the High Court in the Hindmarsh Island Bridge case; the relationship of the intentions of the framers of the Constitution to the interpretation bu the High Court of the Financial Clauses of the Constitution, and the provisions of s.92; and the meaning and purpose of the external affairs power, and the corporations power as understood bu the framers of the Constitution

Molecular characterization of the thermally labile fraction of biochar by hydropyrolysis and pyrolysis-GC/MS

Agroenvironmental benefits and limitations of biochar in soil applications require a full understanding of the stability and fate of the various carbon fractions. Analytical hydropyrolysis (HyPy) enables the determination of the stable black carbon (BCHyPy) and thermally labile (semi-labile; non-BCHyPy) fractions in biochar and soil samples. The non-BCHyPy fraction can be analysed at a molecular level by gas chromatography-mass spectrometry (GC-MS). In the present study, HyPy was applied to the characterisation of biochars produced from pine wood, beech wood and corn digestate with the same pyrolysis unit at low (340–400 °C) and high (600 °C) temperatures. Results were compared with those from Py-GC-MS. HyPy provided consistent information concerning the thermal stability of biochar samples, with BCHyPy levels related with the relative abundance of the charred fraction estimated by Py-GC-MS and the hydrogen/carbon (H/C) ratios. The non-BCHyPy fractions were featured by the presence of polycyclic aromatic hydrocarbons (PAHs) from two to seven rings, including alkylated derivatives up to C4. Partially hydrogenated PAHs were also detected. The yields of non-BCHyPy were higher for those biochars produced at lower temperatures and always more abundant than the levels of solvent-extractable PAHs. The methylated/parent PAH ratios from HyPy and Py-GC-MS exhibited lower values for the most charred biochar. The observed differences in the abundance of the stable fraction and the molecular chemistry of the semi-labile fraction can be usefully utilised to drive the process conditions to the desired properties of the resulting biochars and to predict the impact of biochar amendment to soil organic pools. The concentrations of priority PAHs in the semi-labile fraction was evaluated in the mg g−1 level suggesting that it could be an important fraction of the polyaromatic carbon pool in soil

Differences in Internet use and eHealth needs of adolescent and young adult versus older cancer patients:Results from the PROFILES registry

SIMPLE SUMMARY: The internet has become an important health information source for patients with cancer. AYAs (adolescents and young adults; 18–39 years at time of diagnosis) can be considered as digital natives; they work with the internet and related technologies in their daily lives. It is likely that AYAs are more used to using the internet, while older cancer patients might prefer former ways of information provision to obtain health-related information. The question arises whether internet use and eHealth needs of AYA cancer patients are comparable to those of older ones. By conducting a cross-sectional survey, we evaluated differences in cancer-related internet patterns between AYAs and older cancer patients (40+ years at time of diagnosis). A better understanding of differences between generations will help inform healthcare providers on how to guide cancer patients of different ages regarding cancer-related internet use. ABSTRACT: Background: Our aim was to evaluate differences in cancer-related internet patterns between AYAs (adolescents and young adults; 18–39 years at time of diagnosis) and older adult cancer patients (40+ years). Methods: Cross-sectional surveys were distributed among AYA and older adult cancer patients regarding cancer-related internet use and eHealth needs. Results: 299 AYAs (mean age 31.8 years) and 270 older adults (mean age 55.8 years) participated. AYAs searched significantly more often on the internet on a daily basis just before diagnosis (45% vs. 37%), right after diagnosis (71% vs. 62%) and during treatment (65% vs. 59%) compared to older adults. During follow up, there was a trend that AYAs searched less often on the internet compared to older adults (15% vs. 17%). AYAs searched more often on topics, such as alternative or complementary therapies, treatment guidelines, fertility, end of life, sexuality and intimacy, lifestyle and insurance. AYAs felt significantly better informed (75%) after searching for cancer-related information compared to older adults (65%) and had significantly less unmet needs regarding access to their own medical information (22% vs. 47%). AYAs search more on the internet on a daily basis/several times per week in the diagnosis and treatment phase than older cancer patients. They search on different topics than older adults and seems to have less unmet eHealth needs.It is important that these are easy to find and reliable

Fingerprinting blue carbon: Rationale and tools to determine the source of organic carbon in marine depositional environments

Blue carbon is the organic carbon in oceanic and coastal ecosystems that is captured on centennial to millennial timescales. Maintaining and increasing blue carbon is an integral component of strategies to mitigate global warming. Marine vegetated ecosystems (especially seagrass meadows, mangrove forests, and tidal marshes) are blue carbon hotspots and their degradation and loss worldwide have reduced organic carbon stocks and increased CO2 emissions. Carbon markets, and conservation and restoration schemes aimed at enhancing blue carbon sequestration and avoiding greenhouse gas emissions, will be aided by knowing the provenance and fate of blue carbon. We review and critique current methods and the potential of nascent methods to track the provenance and fate of organic carbon, including: bulk isotopes, compound-specific isotopes, biomarkers, molecular properties, and environmental DNA (eDNA). We find that most studies to date have used bulk isotopes to determine provenance, but this approach often cannot distinguish the contribution of different primary producers to organic carbon in depositional marine environments. Based on our assessment, we recommend application of multiple complementary methods. In particular, the use of carbon and nitrogen isotopes of lipids along with eDNA have a great potential to identify the source and quantify the contribution of different primary producers to sedimentary organic carbon in marine ecosystems. Despite the promising potential of these new techniques, further research is needed to validate them. This critical overview can inform future research to help underpin methodologies for the implementation of blue carbon focused climate change mitigation schemes

Diagnostic and societal impact of implementing the syncope guidelines of the European Society of Cardiology (SYNERGY study)

Background: Syncope management is fraught with unnecessary tests and frequent failure to establish a diagnosis. We evaluated the potential of implementing the 2018 European Society of Cardiology (ESC) Syncope Guidelines regarding diagnostic yield, accuracy and costs.Methods: A multicentre pre-post study in five Dutch hospitals comparing two groups of syncope patients visiting the emergency department: one before intervention (usual care; from March 2017 to February 2019) and one afterwards (from October 2017 to September 2019). The intervention consisted of the simultaneous implementation of the ESC Syncope Guidelines with quick referral routes to a syncope unit when indicated. The primary objective was to compare diagnostic accuracy using logistic regression analysis accounting for the study site. Secondary outcome measures included diagnostic yield, syncope-related healthcare and societal costs. One-year follow-up data were used to define a gold standard reference diagnosis by applying ESC criteria or, if not possible, evaluation by an expert committee. We determined the accuracy by comparing the treating physician’s diagnosis with the reference diagnosis.Results: We included 521 patients (usual care, n = 275; syncope guidelines intervention, n = 246). The syncope guidelines intervention resulted in a higher diagnostic accuracy in the syncope guidelines group than in the usual care group (86% vs.69%; risk ratio 1.15; 95% CI 1.07 to 1.23) and a higher diagnostic yield (89% vs. 76%, 95% CI of the difference 6 to 19%). Syncope-related healthcare costs did not differ between the groups, yet the syncope guideline implementation resulted in lower total syncope-related societal costs compared to usual care (saving €908 per patient; 95% CI €34 to €1782).Conclusions: ESC Syncope Guidelines implementation in the emergency department with quick referral routes to a syncope unit improved diagnostic yield and accuracy and lowered societal costs.Trial registration: Netherlands Trial Register, NTR6268.</p

Diagnostic and societal impact of implementing the syncope guidelines of the European Society of Cardiology (SYNERGY study)

Background: Syncope management is fraught with unnecessary tests and frequent failure to establish a diagnosis. We evaluated the potential of implementing the 2018 European Society of Cardiology (ESC) Syncope Guidelines regarding diagnostic yield, accuracy and costs.Methods: A multicentre pre-post study in five Dutch hospitals comparing two groups of syncope patients visiting the emergency department: one before intervention (usual care; from March 2017 to February 2019) and one afterwards (from October 2017 to September 2019). The intervention consisted of the simultaneous implementation of the ESC Syncope Guidelines with quick referral routes to a syncope unit when indicated. The primary objective was to compare diagnostic accuracy using logistic regression analysis accounting for the study site. Secondary outcome measures included diagnostic yield, syncope-related healthcare and societal costs. One-year follow-up data were used to define a gold standard reference diagnosis by applying ESC criteria or, if not possible, evaluation by an expert committee. We determined the accuracy by comparing the treating physician’s diagnosis with the reference diagnosis.Results: We included 521 patients (usual care, n = 275; syncope guidelines intervention, n = 246). The syncope guidelines intervention resulted in a higher diagnostic accuracy in the syncope guidelines group than in the usual care group (86% vs.69%; risk ratio 1.15; 95% CI 1.07 to 1.23) and a higher diagnostic yield (89% vs. 76%, 95% CI of the difference 6 to 19%). Syncope-related healthcare costs did not differ between the groups, yet the syncope guideline implementation resulted in lower total syncope-related societal costs compared to usual care (saving €908 per patient; 95% CI €34 to €1782).Conclusions: ESC Syncope Guidelines implementation in the emergency department with quick referral routes to a syncope unit improved diagnostic yield and accuracy and lowered societal costs.Trial registration: Netherlands Trial Register, NTR6268.</p