Lifting the Shroud: Government, Investment Banks and Power in Post Financial Crisis United Kingdom - A critical deconstruction of the relationship between government and investment banks in the United Kingdom post global financial crisis (2007 – 2011)

The late 2000s Global Financial Crisis swept the advanced world and spilled into the developing, creating chaos in its wake. At the crux of the crisis were the high-risk activities of investment banks in the developed world – and especially United Kingdom. Since then, academic and public discussion has revolved around the questionable relationship between investment banks and government that resulted in subpar regulation and the costly bank ‘bailouts’ of 2008 and 2009. What this thesis will to do is holistically assess how the power relationship between British investment banks and the United Kingdom government has evolved since the crisis, utilising Doris Fuchs’ Three Dimensional Approach to Business Power and Governance and a wide array of research to address those structural, instrumental and discursive elements of business power

Associations of muscle depletion with health status. Another gender difference in COPD?

Item does not contain fulltextBACKGROUND & AIMS: Muscle mass depletion occurring in chronic obstructive pulmonary disease still leaves questions regarding its relation with health status. How health status should be conceived and assessed is a significant obstacle in answering these questions. This study tries to appoint which domains of health status are challenged by muscle depletion and evaluates evidence of gender difference. METHODS: 135 Patients enrolled in a cohort study with initial assessment of health status by the Nijmegen Integral Assessment Framework. In here 4 main domains and 16 sub-domains are recognized. These sub-domains were correlated with fat free mass index using baseline data. Associations of fat free mass and diffusion parameters with sex were elaborated. RESULTS: Muscle depletion occurred predominantly in those with low body mass index, and did not correlate with sub-domains of 3 main domains: Complaints, Functional Impairment and Quality of Life. In Physiological Functioning Hyperinflation correlated weakly. Diffusion capacity significantly correlated with fat free mass index in separate analyses of pulmonary function data. Interestingly, diffusion capacity was significantly lower in women than in men. CONCLUSIONS: Muscle depletion hardly affects health status in COPD. Physiological correlations, however, do exist, pointing to severe disease, especially emphysema, and female sex as important concomitant factors

Learn from the past and create the future: the 2013 ATS/ERS statement on pulmonary rehabilitation

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Perceptions of fatigue in patients with idiopathic pulmonary fibrosis or sarcoidosis

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Assessing the stages of the grieving process in chronic obstructive pulmonary disease (COPD): validation of the Acceptance of Disease and Impairments Questionnaire (ADIQ)

Item does not contain fulltextBACKGROUND: Patients with chronic obstructive pulmonary disease (COPD) encounter many (gradual) losses due to their disease, which trigger a grieving process. This process is characterized by stages of denial, resistance, sorrow, and acceptance. PURPOSE: This study examined whether these stages are conceptually distinct and whether the Acceptance of Disease and Impairments Questionnaire (ADIQ) can validly and reliably measure these stages in three samples of patients with COPD in the Netherlands. METHODS: Exploratory factor analysis (EFA) was performed on 145 outpatients with moderate to severe COPD. Confirmatory factor analyses were performed on 303 outpatients with mild to very severe COPD and 127 patients entering an inpatient pulmonary rehabilitation program. Furthermore, internal reliability, construct validity, sensitivity to change, and floor and ceiling effects were examined. RESULTS: EFA yielded a four-factor solution that explained 73.2 % of variance. Confirmatory factor analyses showed a good fit of the four-factor structure in all study samples. Cronbach's alpha reliability coefficients were .79 or higher. Subscales showed to be sensitive to change. CONCLUSIONS: Four distinct stages of grief are recognized in COPD. The ADIQ is a valid and reliable instrument to measure these stages: denial, resistance, sorrow, and acceptance. Measuring the stages of grieving is important for disease management: addressing patients with a specific therapeutic approach for the stage they are in could help to motivate patients to engage in self-management and change their lifestyle

Comparing health status between patients with COPD in primary, secondary and tertiary care

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An observational, longitudinal study on the home environment of people with chronic obstructive pulmonary disease: the research protocol of the Home Sweet Home study

INTRODUCTION: Chronic obstructive pulmonary disease (COPD) represents an important public health challenge. Patients are confronted with limitations during activities of daily living (ADLs). Resident loved ones of patients with COPD may be uniquely positioned to witness these limitations. COPD may have an impact on not only the patients' life, but also on the lives of the resident loved ones. Furthermore, COPD exacerbation-related hospital admissions often occur in patients with COPD. However, whether and to what extent these admissions influence resident loved ones' burden and health status remains currently unknown. Therefore, the primary objectives of this study are to investigate the differences between patients with COPD and resident loved ones' perceptions of patients' health status and problematic ADLs and to study prospectively the effects of a COPD exacerbation on resident loved ones' perceptions of patients' health status and problematic ADLs. METHODS AND ANALYSIS: An observational, longitudinal study will be performed in 192 patients with COPD and their 192 resident loved ones. Primary outcomes are daily functioning, ADL, disease-specific health status, generic health status and dyspnoea. These will be assessed during home visits at baseline and after 12 months. Additional home visits will be performed when a COPD exacerbation-related hospital admission occurs during the 12-month follow-up period. ETHICS AND DISSEMINATION: This protocol was approved by the Medical Ethics Committee of the Catharina Hospital Eindhoven, the Netherlands (NL42721.060.12/M12-1280) and is registered in the Dutch Trial Register (NTR3941)

Persistence of impaired health status of Q fever patients 4 years after the first Dutch outbreak

A significant proportion of Q fever patients from the first Dutch Q fever outbreak in 2007 showed impairment in health status up to 1 year after infection. Interested in whether this decrease in health status persisted, we set out to determine the health status in the same cohort of patients, 4 years after primary infection and to compare health status scores at the individual patient level between 1 and 4 years follow-up. Health status was assessed with the Nijmegen Clinical Screening Instrument (NCSI). Patients were serologically tested to exclude patients with possible, probable or proven chronic Q fever. Results on the NCSI sub-domains at group level [2008 (n = 54) and 2011 (n = 46)] showed a persistent significant percentage of patients exhibiting clinically relevant ('severe') scores for all NCSI sub-domains. After 4 years, undue fatigue was present in 46% and exactly half of all patients experienced a severely impaired general quality of life. Patients with NCSI scores available in both 2008 and 2011 (n = 37) showed no difference in all sub-domain scores, except for a small decrease in dyspnoea emotions in 2011. In this group, a significant proportion of patients either improved or worsened in one or more sub-domains of health status. We conclude that at the group level, health status of Q fever patients remained impaired 4 years after primary infection. At the individual patient level, health status may change