Patroon en beeld tussen informatie en kennis

Rede, uitgesproken bij de aanvaarding van de functie van hoogleraar in de Faculteit der Geneeskunde en Gezondheidswetenschappen van de Erasmus Universiteit te Rotterdam, met de leeropdracht medische informatica in het bijzonder de methodologie van de signaal- en patrooninterpretatie, op donderdag 28 april 198

Job stress in the nursing profession

The central issue in this thesis is the work related causes and consequences of job stress among nurses. The relationships between a wide range of work characteristics and characteristics of the organization and environment on the one hand, and different outcomes (such as job satisfaction and emotional exhaustion) on the other hand are explored in three studies. The influence of goal orientation on the outcomes is studied in a fourth study. Data were gathered by means of questionnaires that were spread among all nurses of the Leiden University Medical Centre in 2000 and in 2003. Nurses’ job satisfaction is influenced by their possibilities to develop nursing skills and by having good working relationships with supervisors. Nurses’ ill health is largely determined by their workload. However, it seems not (necessarily) to be the emotional demand of patient contact that burdens nurses. More likely, ill-health is the effect of the fact that nurses cannot give each patient the attention they want to give, due to too many tasks. The thesis deals with methodological issues such as causality. Moreover, it deals with theoretical issues such as the influence of person and environmental factors on the stress reaction. Finally, practical considerations are outlined.LEI Universiteit LeidenFSW - Self-regulation models for health behavior and Psychopathology - Ou

A new representation of acid-base disturbances

The acid-base status of intensive care patients is monitored on the basis of three quantities. The graphical representation which may be of help for the monitoring task is therefore cumbersome. The classical Siggaard-Andersen acid-base chart is such a representation, but it is only suited for evaluating one acid-base status at a time and not for representing acid-base paths. A new representation, obtained after a principal components transformation is presented. It is shown that the representation is characteristic for the laboratory instrument used. Its most attractive feature is that it is distortionless with respect to the three-dimensional configuration

The logic of aggregated data

A notion of generalization-specialization is introduced that is more expressive than the usual notion from, e.g., the UML or RDF-based languages. This notion is incorporated in a typed formal language for modeling aggregated data. Soundness with respect to a sets-and-functions semantics is shown subsequently. Finally, a notion of congruence is introduced. With it terms in the language that have identical semantics, i.e., synonyms, can be discovered. The resulting formal language is well-suited for capturing faithfully aggregated data in such a way that it can serve as the foundation for corporate metadata management in a statistical office

Mental Condition and Ventricular Size in Arrested Hydrocephalus: an Analysis of 29 Shunt‐independent Children

Measurement of the diameter of the ventricular system, in a series of 29 patients with arrested hydrocephalus who had become shunt‐independent, showed that enlargement of the ventricles does not necessarily play a part in the arrest of hydrocephalus, for in many of these cases the ventricles were normal or only slightly enlarged. A study was made of the relationship between ventricular width and intelligence. Although children with the lowest IQS usually had a very wide ventricular system and those with the highest IQS a ventricular system of normal size, normal intelligence was compatible with ventricles of any size. It is concluded from these findings, and from the fact that removal of the drainage system did not appear to increase the size of the ventricles, that shunt independence in these children did not result in diminished intelligence. Etat mental et dimension ventriculaire dans les hydrocéphalies stabilisées La mesure du diamètre du système ventriculaire chez 29 sujets avec hydrocéphalic stabilisée, devenus autonomes de shunts, a montré que l'élargissement des ventricules ne joue pas nécessairement un r̂ole dans l'évolution de l'hydrocéphalie, car dans de nombreux cas les ventricules étaient normaux ou tres légèrement élargis. Une étude a été faite de la relation existant entre la dimension ventriculaire et Intelligence. En général, les enfants avec les plus bas QI avaient un système ventriculaire très élargi tandis que celui‐ci était de taille normale dans les cas de QI élevé; cependant, une intelligence correcte peut s'observer avec un système ventriculaire de n'importe quelle dimension. A partir de ces données et du fait que la suppression du drain décroit plus qu'elle n'accroit la taille des ventricules, les auteurs concluent que l'autonomie de shunt chez ces enfants ne risque pas de diminuer l'intelligence. Geistige Verfassung und Ventrikelgröβe bei versperrtem Hydrocephalus In einer Serie von 29 Patienten mit versperrtem Hydrocephalus, die vom Shunt unabhängig geworden waren, zeigte die Messung des Durchmessers im Ventrikelsystem, daß die Vergrößerung der Ventrikel nicht unbedingt bei der Versperrung des Hydrocephalus eine Rolle spielen muß, da in vielen Fällen die Ventrikel normal oder nur gering vergrößert waren. Uber die Beziehung zwischen der Weite der Ventrikel und der Intelligenz wurde eine Studie durchgeführt. Obwohl die Kinder mit den niedrigsten IQS gewöhnlich ein sehr weites Ventrikelsystem haben, die mit den höchsten IQS ein Ventrikelsystem von normaler Größe, kann die Intelligenz doch bei alien Ventrikelgrößen festgestellt werden. Aus diesen Befunden und aus der Tatsache, daß die Entfernung des Drainagesystems die Ventrikel eher zu verengen als zu erweitern schien, wurde abgeleitet, daß die Shunt‐Unabhängigkeit bei diesen Kindern nicht eine Verringerung der Intelligenz bewirkte. Estado mental y tamaño ventricular en la hidrocefalia detenida La medición del diámetro del sistema ventricular en una serie de 29 pacientes con hidrocefalia detenida y que se habían convertido en independientes del shunt, mostró que el aumento de volumen de los ventriculos no juega necesariamente una parte en la detentión de la hidrocefalia, ya que en muchos de estos casos los ventriculos eran normales o solo ligeramente aumentados. Se estudió la relacion entre la anchura ventricular y la inteligencia. Aunque los niños con c.i. más bajo generalmente tenian un sistema ventricular muy grande y los de c.i. más alto poseian un sistema ventricular de tamaño normal, la inteligencia era compatible con cualquier tamaño ventricular. Se concluye de estos hallazgos y del hecho de que al eliminar el sistema de drenaje disminuía más bien que aumentaba el tamaño de los ventriculos, que la independencia del shunt en estos niños no daba lugar a una inteligencia disminuida. Copyrigh

New developments and applications in quantitative electron spectroscopic imaging of iron in human liver biopsies

Reliable iron concentration data can be obtained by quantitative analyses of image sequences, acquired by electron spectroscopic imaging. A number of requirements are formulated for the successful application of this recently developed in situ quantitative type of analysis. A demonstration of the procedures is given. By application of the technique it is established that there are no significant differences in the average iron loading of structures analysed in liver parenchymal cells of a patient with an iron storage disease, before and after phlebotomy. This supports the hypothesis that the process of iron unloading is an organelle specific process. Measurement of the binary morphology, represented by the area and contour ratio of the iron containing objects revealed no information about differences between the objects. This finding contradicts the visual suggestion that ferritin clusters are more irregularly shaped than the other iron objects. Also, no differences could be found in this sense between the situations before and after phlebotomy. With respect to the density appearance, objects that have an inhomogeneous iron loading averagely contain more iron. This observation does correspond well with the visual impression of the increasingly irregular appearance of more well-loaded structures