Staying Positive in a Negative situation:Applying the positive health strategy in preventing distress in lung cancer patients

Background Timely signaling of distress in cancer patients is important. Due to the focus on medical treatment, patients and healthcare providers often overlook other options for leading a higher quality, meaningful life with this critical illness. By shifting the emphasis to resilience and well-being (rather than ill-health), the patient can be empowered and distress may be prevented. Aims To compare the Distress Thermometer and the spider-web diagram, a visualization tool that represents patients’ assessments of different aspects of their lifes. Method A quantitative study was carried out among lung cancer patients (n=112) at the Albert Schweitzer hospital in the Netherlands. They all completed the Distress Thermometer as well as the Spider-Web diagram (Dialogue tool 1.0 of the Institute for Positive Health), and a satisfaction questionnaire (min 1 to max 10). Results The spider-web does not represent an external norm, it reflects the personal evaluation of the situation. Patients' satisfaction scores of the Spider Web exceeded the distress thermometer (8.0 ± 1.3 vs 6.9 ± 1.2). More specifically, they felt more able to state problems and concerns (t (- .67), p Conclusion Satisfaction and preference among patients was in favor of the Spider Web. It is recommended that oncology teams start a conversation about deploying the most appropriate instrument for prevention of distress, preferably aimed at mapping mental well-being and enhancing positive qualities

Evaluatie Politiewet 2012 in de Eenheid Oost-Nederland en landelijke thema's

At the request of the commission ‘Evaluatie Politiewet 2012’, the Rotterdam School of Management, Erasmus University, conducted an evaluation of the functioning of the Police Unit East-Netherlands (Eenheid Oost-Nederland). In addition, the nationally relevant themes with respect to ‘the role of the corps chef’, ‘the use of the right to appoint’, and the ‘construction of the police force as a separate legal entity’ were included in the evaluation at the request of the minister of Security and Justice of the Netherlands. The goal of the evaluation is to gain insights into the consequences of the implementation of the national police for the Unit East-Netherlands. The main question of th

Atomic X-ray Spectroscopy of Accreting Black Holes

Current astrophysical research suggests that the most persistently luminous objects in the Universe are powered by the flow of matter through accretion disks onto black holes. Accretion disk systems are observed to emit copious radiation across the electromagnetic spectrum, each energy band providing access to rather distinct regimes of physical conditions and geometric scale. X-ray emission probes the innermost regions of the accretion disk, where relativistic effects prevail. While this has been known for decades, it also has been acknowledged that inferring physical conditions in the relativistic regime from the behavior of the X-ray continuum is problematic and not satisfactorily constraining. With the discovery in the 1990s of iron X-ray lines bearing signatures of relativistic distortion came the hope that such emission would more firmly constrain models of disk accretion near black holes, as well as provide observational criteria by which to test general relativity in the strong field limit. Here we provide an introduction to this phenomenon. While the presentation is intended to be primarily tutorial in nature, we aim also to acquaint the reader with trends in current research. To achieve these ends, we present the basic applications of general relativity that pertain to X-ray spectroscopic observations of black hole accretion disk systems, focusing on the Schwarzschild and Kerr solutions to the Einstein field equations. To this we add treatments of the fundamental concepts associated with the theoretical and modeling aspects of accretion disks, as well as relevant topics from observational and theoretical X-ray spectroscopy.Comment: 63 pages, 21 figures, Einstein Centennial Review Article, Canadian Journal of Physics, in pres

Risk factors and mechanisms of stroke in young adults: The FUTURE study

Incidence of ischemic stroke and transient ischemic attack in young adults is rising. However, etiology remains unknown in 30–40% of these patients when current classification systems designed for the elderly are used. Our aim was to identify risk factors according to a pediatric approach, which might lead to both better identification of risk factors and provide a stepping stone for the understanding of disease mechanism, particularly in patients currently classified as “unknown etiology”. Risk factors of 656 young stroke patients (aged 18–50) of the FUTURE study were categorized according to the “International Pediatric Stroke Study” (IPSS), with stratification on gender, age and stroke of “unknown etiology”. Categorization of risk factors into ≥1 IPSS category was possible in 94% of young stroke patients. Chronic systemic conditions were more present in patients aged <35 compared to patients ≥35 (32.6% vs. 15.6%, p < 0.05). Among 226 patients classified as “stroke of unknown etiology” using TOAST, we found risk factors in 199 patients (88%) with the IPSS approach. We identified multiple risk factors linked to other mechanisms of stroke in the young than in the elderly. This can be a valuable starting point to develop an etiologic classification system specifically designed for young stroke patients.The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: de Leeuw is supported by a clinical established investigator grant of the Dutch Heart Foundation (grant no. 2014 T060), and by a VIDI innovational grant from The Netherlands Organisation for Health Research and Development ZonMw (grant no. 016-126-351) and has also received research support from the “Dutch Epilepsy Fund” (grant no. 2010-18); Loes Rutten-Jacobs (LR-J) is supported by a British Heart Foundation Immediate Research Fellowship (FS/15/61/31626) (www.bhf.org.uk)