Changes in health-related quality of life in older patients with acute myocardial infarction or congestive heart failure: a prospective study

OBJECTIVES: To study changes in health-related quality of life (HR-QL) following acute myocardial infarction (AMI) or congestive heart failure (CHF) in older people (greater than or equal to 57 yr).DESIGN: Prospective cohort Study.SETTING: Primary healthcare registers.PARTICIPANTS: Patients were enrolled on the basis of primary healthcare records. Eighty-nine AMI patients (mean age = 69.5) and 119 CHF patients (mean age = 74.5) were included for analysis.MEASUREMENTS: HR-QL was conceptualized and measured by means of physical (activities of daily living (ADL), instrumental activities of daily living (IADL)), psychological (depressive symptoms, anxiety), social, and role functioning. Premorbid data (TO) were available from a 1993 community-based survey. Incident AMI and CHF cases, developed after 1993, were prospectively followed for 12 months. Assessments were performed at 6 weeks (T1) and 6 (T2) and 12 months (T3) after diagnosis.RESULTS: At the premorbid assessment, AMI patients did not significantly differ on HR-QL from a reference group of older people, whereas CHF patients were on average older and had worse HR-QL compared to the reference group. Although CHF had not yet been diagnosed at TO, symptoms were already present and resulted in decreased levels of functioning. At T1, all HR-QL measures showed worse functioning compared with TO, except for depressive symptoms that presented later (at T2). In contrast to the delay in depressive symptoms, a significant increase in anxiety was already seen at T1. The effect of the somatic conditions was the largest on physical functioning. Effects on psychological and social functioning were less pronounced but still significant. Effects were maintained during the 12 months of follow-up.CONCLUSION: The negative consequences on HR-QL in both AMI and CHF patients are not temporary. No recovery of function was seen in AMI patients, and functioning and CHF patients continued to decline in the first year after diagnosis

Religious education in two secular multicultural societies. The Turkish and Dutch case compared

In this paper we present in the first section the historical antecedents of the Turkish and Dutch educational system regarding religion(s) in education. In the second section we will outline the different approaches in religious education in both countries. In the third section the focus is on the relationship between state and church. In the fourth section the issue is how in both countries curricula and textbooks for religious education are constructed, checked and approved. Finally, we will summarize the most remarkable points of comparison between the Dutch and the Turkish case regarding religion(s) in education. © 2011 Published by Elsevier Ltd

London's King's Cross redevelopment: a compact, resource efficient and 'liveable' global city model for an era of climate emergency?

Cities have long been subject to urban containment policies against urban sprawl. Climate change concerns have recently added to the imperative to densify urban space. Urban compaction is often pursued through the creation of ‘exemplar’ urban developments that superficially implement ‘best practice’ ideas from elsewhere. In this paper, we abandon the notion of ‘best practice’ in favour of context-sensitive ‘good practices’. Taking London’s King’s Cross redevelopment as a case study, this paper draws on qualitative methods to examine the contribution of context and path-dependency, as a product of local and non-local forces, to the emergence of King´s Cross as ‘good practice’

Replicating Nanostructures on Silicon by Low Energy Ion Beams

We report on a nanoscale patterning method on Si substrates using self-assembled metal islands and low-energy ion-beam irradiation. The Si nanostructures produced on the Si substrate have a one-to-one correspondence with the self-assembled metal (Ag, Au, Pt) nanoislands initially grown on the substrate. The surface morphology and the structure of the irradiated surface were studied by high-resolution transmission electron microscopy (HRTEM). TEM images of ion-beam irradiated samples show the formation of sawtooth-like structures on Si. Removing metal islands and the ion-beam induced amorphous Si by etching, we obtain a crystalline nanostructure of Si. The smallest structures emit red light when exposed to a UV light. The size of the nanostructures on Si is governed by the size of the self-assembled metal nanoparticles grown on the substrate for this replica nanopatterning. The method can easily be extended for tuning the size of the Si nanostructures by the proper choice of the metal nanoparticles and the ion energy in ion-irradiation. It is suggested that off-normal irradiation can also be used for tuning the size of the nanostructures.Comment: 12 pages, 7 figures, regular paper submitted to Nanotechnolog

Prognosis and course of work-participation in patients with chronic non-specific low back pain: a 12-month follow-up cohort study

AbstractOBJECTIVE:To investigate the clinical course of, and prognostic factors for, work-participation in patients with chronic non-specific low back pain.METHODS:A total of 1,608 patients with chronic non-specific low back pain received a multidisciplinary therapy and were evaluated at baseline and 2-, 5- and 12-month follow-ups. Recovery was defined as absolute recovery if the patient worked 90% of his contract hours at follow-up. Potential factors were identified using multivariable logistic regression analysis.RESULTS:Patients reported a mean increase in work-participation from 38% at baseline to 82% after 12 months. Prognostic factors for ≥ 90% work-participation at 5 months were being married (odds ratio (OR) 1.72 (95% confidence interval (95% CI) 1.12-2.65)), male (OR 1.99 (95% CI 1.24-3.20)), a higher score on disability (OR 1.00 (95% CI 0.997-1.02)) and physical component scale (Short-Form 36 (SF-36)) (OR 1.05 (95% CI 1.02-1.07)), previous rehabilitation (OR 1.85 (95% CI 1.14-2.98)), not receiving sickness benefits (OR 0.52 (95% CI 0.24-1.10)) and more work-participation (OR 4.86 (95% CI 2.35-10.04)). More work-participation (OR 5.22 (95% CI 3.47-7.85)) and male sex (OR 1.79 (95% CI 1.25-2.55)) were also prognostic factors at 12-month follow-up.CONCLUSION:At 12 months 52% of patients reported ≥ 90% work-participation. The strongest prognostic factor was more work-participation at baseline for the recovery of chronic non-specific low back pai

Effectiveness and characteristics of interventions to improve work participation in adults with chronic physical conditions: a systematic review

Purpose: Chronic physical conditions often negatively affect work participation. The objective of this systematic review is to investigate the effectiveness and characteristics of vocational rehabilitation interventions for people with a chronic physical condition. Methods: Searches in five databases up to April 2020 identified 30 studies meeting our inclusion criteria. Two reviewers independently assessed and extracted data. The Grading of Recommendation, Assessment, Development and Evaluation (GRADE) framework was used to evaluate quality of evidence for three outcome measures related to work participation. Results: All vocational rehabilitation interventions consisted of multiple components, but their characteristics varied widely. Analysis of 22 trials yielded a moderate positive effect with moderate certainty of interventions on work status; analysis of five trials with low risk of bias showed a large positive effect with moderate certainty (risk ratio 1.33 and 1.57, respectively). In addition, in eight studies we found a moderate to small positive effect with low certainty on work attitude (standardized mean difference = 0.59 or 0.38, respectively). We found no effect on work productivity in nine studies. Conclusion: The systematic review of the literature showed positive effects of vocational rehabilitation interventions on work status and on work attitude; we found no effect on work productivity.Implications for rehabilitation In rehabilitation, addressing work participation of persons with a chronic physical condition using targeted inte