Ethnic differences in Internal Medicine referrals and diagnosis in the Netherlands

As in other Western countries, the number of immigrants in the Netherlands is growing rapidly. In 1980 non-western immigrants constituted about 3% of the population, in 1990 it was 6% and currently it is more than 10%. Nearly half of the migrant population lives in the four major cities. In the municipality of Rotterdam 34% of the inhabitants are migrants. Health policy is based on the ideal that all inhabitants should have equal access to health care and this requires an efficient planning of health care resources, like staff and required time per patient. The aim of this study is to examine ethnic differences in the use of internal medicine outpatient care, specifically to examine ethnic differences in the reason for referral and diagnosis. Methods We conducted a study with an open cohort design. We registered the ethnicity, sex, age, referral reasons, diagnosis and living area of all ne

Photosynthesis and metabolism of seagrasses

© Springer International Publishing AG, part of Springer Nature 2018. Seagrasses have a unique leaf morphology where the major site for chloroplasts is in the epidermal cells, stomata are absent and aerenchyma is present inside the epidermis. This means that the major site for photosynthesis is in the epidermis. Furthermore the lack of stomata means that the route for carbon uptake is via inorganic carbon (C i ) uptake across the vestigial cuticle and through the outer plasma membranes. Since the leaf may at times be in an unstirred situation diffusion through an unstirred layer outside the leaf may be a large obstacle to carbon uptake. The existence of a carbon concentrating mechanism is discussed, but its existence to date is not proven. Active bicarbonate uptake across the plasmalemma does not seem to operate; an external carbonic anhydrase and an extrusion of protons seem to play a role in enhancing CO 2 uptake. There is some evidence that a C4 mechanism plays a role in carbon fixation but more evidence from "omics" is required. Photorespiration certainly occurs in seagrasses and an active xanthophyll cycle is present to cope with damaging high light, but both these biochemical mechanisms need further work. Finally, epiphytes pose a problem which impedes the uptake of C i and modifies the light environment inside the leaves