Effectiveness of a multidisciplinary care program on recovery and return to work of patients after gynaecological surgery; design of a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>Return to work after gynaecological surgery takes much longer than expected, irrespective of the level of invasiveness. In order to empower patients in recovery and return to work, a multidisciplinary care program consisting of an e-health intervention and integrated care management including participatory workplace intervention was developed.</p> <p>Methods/Design</p> <p>We designed a randomized controlled trial to assess the effect of the multidisciplinary care program on full sustainable return to work in patients after gynaecological surgery, compared to usual clinical care. Two hundred twelve women (18-65 years old) undergoing hysterectomy and/or laparoscopic adnexal surgery on benign indication in one of the 7 participating (university) hospitals in the Netherlands are expected to take part in this study at baseline. The primary outcome measure is sick leave duration until full sustainable return to work and is measured by a monthly calendar of sickness absence during 26 weeks after surgery. Secondary outcome measures are the effect of the care program on general recovery, quality of life, pain intensity and complications, and are assessed using questionnaires at baseline, 2, 6, 12 and 26 weeks after surgery.</p> <p>Discussion</p> <p>The discrepancy between expected physical recovery and actual return to work after gynaecological surgery contributes to the relevance of this study. There is strong evidence that long periods of sick leave can result in work disability, poorer general health and increased risk of mental health problems. We expect that this multidisciplinary care program will improve peri-operative care, contribute to a faster return to work of patients after gynaecological surgery and, as a consequence, will reduce societal costs considerably.</p> <p>Trial registration</p> <p>Netherlands Trial Register (NTR): <a href="http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2087">NTR2087</a></p

A diverse view of science to catalyse change

Valuing diversity leads to scientific excellence, the progress of science and, most importantly, it is simply the right thing to do. We must value diversity not only in words, but also in actions

A diverse view of science to catalyse change:Valuing diversity leads to scientific excellence, the progress of science and, most importantly, it is simply the right thing to do. we must value diversity not only in words, but also in actions

No abstract available.publishe

The Design and Construction of Novel Near -Infrared Time -Correlated Single Photon Counting Devices for the Identification of Analytes in Multiplexed Applications.

This manuscript details the design, construction, and application of novel near infrared time correlated single photon counting devices to the identification of analytes in analytical separations. The thrust of this research is to provide a simple, low cost technique for the high-speed identification of DNA sequencing bases that are labeled with a series of unique near infrared fluorophores. These fluorophores are unique because they possess the same emission and absorption maxima, but different fluorescence lifetimes. Consequently, they allow analytes to be discriminated by fluorescence lifetime as opposed to color. The first goal of this dissertation research was to implement a time correlated single photon counting system with the use of single mode fiber optics. Utilizing a passively mode locked Ti: Sapphire Laser, a single photon avalanche diode, single mode fiber optics and a mechanical switch a fiber optic based time correlated single photon counting device with subnanosecond resolution was constructed. The experimental results showed that group velocity dispersion was low and that it was possible to perform multiple time correlated single photon counting experiments with a limited number of excitation sources and detectors. It was determined that the average instrumental response of each channel was 181 picoseconds. The fluorescence lifetime of a near infrared dye, aluminum tetrasulfonated naphthalocyanine was determined to be 3.08 nanoseconds. The second phase of this doctoral research involved the construction and characterization of a near infrared time correlated single photon counting scanning device. This integrated device consisted of a pulsed diode laser, single photon avalanche diode, and a time correlated single photon counting board. The instrument response function of this system was determined to be less than 300 ps. The sensitivity and ability to discriminate between various fluorophores was determined. In addition to its application for scanning solid surfaces such as DNA microarrays, the device was utilized to detect analytes in a micro-capillary electrophoresis separation. The fluorescence lifetimes of these analytes were determined on-line

Surface Free Energy Determination of APEX Photosensitive Glass

Surface free energy (SFE) plays an important role in microfluidic device operation. Photosensitive glasses such as APEX offer numerous advantages over traditional glasses for microfluidics, yet the SFE for APEX has not been previously reported. We calculate SFE with the Owens/Wendt geometric method by using contact angles measured with the Sessile drop technique. While the total SFE for APEX is found to be similar to traditional microstructurable glasses, the polar component is lower, which is likely attributable to composition. The SFE was modified at each stage of device fabrication, but the SFE of the stock and fully processed glass was found to be approximately the same at a value of 51 mJ·m−2. APEX exhibited inconsistent wetting behavior attributable to an inhomogeneous surface chemical composition. Means to produce more consistent wetting of photosensitive glass for microfluidic applications are discussed

Reactions of Zn2+, Cd2+ and Hg2+ with Free Adenine

We are reporting the fluorescence quenching, IR, Raman, 1H-NMR, and potentiometric studies for the Zn2+:adenine and the Cd2+:adenine systems under ambient conditions. IR and Raman spectra suggest that Zn2+ and Cd2+ interact with adenine but the modes of interaction differ. Fluorescence spectra indicate that the interaction involving Zn2+ is more favorable than that of Cd2+, and this effect is due to the difference in ionic radii. 1H-NMR, potentiometry, and speciation diagrams indicate the formation of strong metal ion adenine complexes. Potentiometric titrations of the heavier member of group 12 metals (Hg2+) show similar results to that of Zn2+ and Cd2+. Some differences in the 1H-NMR experiments appeared between both (Zn2+ and Cd2+) compared to that of Hg2+. Due to the fluorescence quenching of adenine, adenine can be used as a sensor of Zn2+ and Cd2+