Begeleiding en behandeling bij verslavingsproblematiek

Item does not contain fulltex

Modeling Measles Transmission In The North American Amish And Options For Outbreak Response

Measles outbreaks in the United States continue to occur in subpopulations with sufficient numbers of undervaccinated individuals, with a 2014 outbreak in Amish communities in Ohio pushing the annual cases to the highest national number reported in the last 20 years. We adapted an individual-based model developed to explore potential poliovirus transmission in the North American Amish to characterize a 1988 measles outbreak in the Pennsylvania Amish and the 2014 outbreak in the Ohio Amish. We explored the impact of the 2014 outbreak response compared to no or partial response. Measles can spread very rapidly in an underimmunized subpopulation like the North American Amish, with the potential for national spread within a year or so in the absence of outbreak response. Vaccination efforts significantly reduced the transmission of measles and the expected number of cases. Until global eradication, measles importations will continue to pose a threat to clusters of underimmunized individuals in the United States. Aggressive outbreak response efforts in Ohio probably prevented widespread transmission of measles within the entire North American Amish

The Felix Meritis Concert Programs Database, 1832–1888: From Archival Ephemera to Searchable Performance Data

The Felix Meritis Concert Programs Database 1832–1888 (FMCP Database) provides a full digitisation of the concert programs collection of the most long-standing Dutch concert hall in the nineteenth century: Felix Meritis. Formerly hidden in boxes with archival ephemera, the content of this collection is now unlocked by manually entering the program details into a searchable dataset. The programs give an extremely rich account of a local concert practice, the performed repertoire, and the musicians involved. However, archiving concert programs at item-level presents a challenge: due to inconsistencies in and incompleteness of work descriptions it is often hard to identify and categorize the musical works performed. For the FMCP database, the authors have developed a possible solution to this problem; a strategy for structuring and categorizing concert programming data that aims to include incomplete work descriptions and reflect genre categorizations used in local concert practice. In this paper, the authors will present this categorization method and discuss the attributes and the basic structure of the FMCP database

Clinical tests for the evaluation of postural instability in patients with parkinson's disease.

Item does not contain fulltextOBJECTIVE: To determine which test for postural instability in Parkinson's disease (PD) is reliable, valid, and easy to perform in a clinical setting. DESIGN: Cross-sectional reliability and validity study. SETTING: Academic center for movement disorders. PARTICIPANTS: Forty-two patients with PD and 15 controls. Based on the results of a structured interview, the patients were divided in PD-unstable (n=22) and PD-stable (n=20) groups. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Several variants of the retropulsion test with differences in execution and scoring. Responses were scored on 5 different rating scales (ratings of Nutt, Bloem, Pastor; the Unified Parkinson's Disease Rating Scale [UPDRS]; the Short Parkinson Evaluation Scale). These tests were compared with steady-stance positions. RESULTS: The interrater reliability was high for most ratings, with weighted kappa ranging from.63 for the UPDRS to.98 for both the Pastor rating and steady-stance positions. Most ratings distinguished between the groups. However, the Nutt rating had the highest overall predictive accuracy, with a sensitivity of.63 and a specificity of.88. CONCLUSIONS: The most valid test for postural stability in PD was an unexpected shoulder pull, executed once, with taking more than 2 steps backward considered abnormal. This retropulsion test is easy to use in a clinical setting

Individual-Based Modeling Of Potential Poliovirus Transmission In Connected Religious Communities In North America With Low Uptake Of Vaccination

Background: Pockets of undervaccinated individuals continue to raise concerns about their potential to sustain epidemic transmission of vaccine-preventable diseases. Prior importations of live polioviruses (LPVs) into Amish communities in North America led to their recognition as a potential and identifiable linked network of undervaccinated individuals