801 research outputs found

    Van A tot Z : wat kunnen gemeenten doen om duurzaam voedsel te stimuleren?

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    Voedsel leeft en staat volop in de belangstelling. Op veel plaatsen in Nederland zijn er voedselinitiatieven. Streekmarkten worden georganiseerd, school- en moestuinen worden opgezet, de jeugd krijgt smaaklessen en gaat op boerderijbezoek. Voedsel bindt mensen en brengt mensen samen. Verandering van de huidige voedselconsumptie en productie is hard nodig, ondermeer omdat wereldwijd de bevolking toeneemt, voorraden van een aantal cruciale grondstoffen eindig zijn en voedselzekerheid lang niet voor iedereen een gegeven is. Aan de hand van 24 acties van A tot Z laten we zien wat gemeenten (kunnen) doen om de ambities uit de Nota Duurzaam Voedsel te realisere

    The criterion-related validity of the Northwick Park Dependency Score as a generic nursing dependency instrument for different rehabilitation patient groups

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    Objective: To investigate the criterion or concurrent validity of the Northwick Park Dependency Score (NPDS) for determining nursing dependence in different rehabilitation groups, with the Barthel Index (BI) and the Care Dependency Scale (C D S).Design: Cross-sectional study.Setting: Centre for Rehabilitation of the University Medical Center Groningen, The Netherlands.Subjects: Patients after stroke, spinal cord injury, multitrauma, head injury, amputation, rheumatoid arthritis, diabetes mellitus, lung diseases, tuberculosis and coronary artery disease. One hundred and fifty-four patients were included.Measures: The Northwick Park Dependency Score (NPDS), the Barthel Index (BI) and the Care Dependency Scale (CDS).Results: The correlation (rho) between the NPDS and the BI for all groups was - 0.87-1 R-2 = 0.76 (n = 154). Per patient group rho varied from - 0.70 (R-2 = 0.49) to - 0.93 (R-2 = 0.86). The overall correlation between the NPDS and CDS was larger than the criterion of rho = 0.60 (r=- 0.74; R-2 = 0.55) but was &lt;0.60 in the rheumatoid arthritis and tuberculosis group. The overall correlation between BI and CDS exceeded the criterion (r = 0.75; R-2 = 0.56).Conclusions: The NPDS is a generic nursing dependency instrument that can be used as a valid measure across various patient groups in rehabilitation.</p

    Nurses' perceptions in caring for people with dementia in Dutch acute hospitals

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    AIMS AND OBJECTIVES: Overall, this study aimed to describe nursing care for patients with dementia in acute hospitals, with the objectives of describing the provided nursing care (a), nurses’ attitudes and perceptions in caring for patients with dementia (b), and exploring how nurses deal with challenging behaviour (c). Additionally, we determined background variables associated with caring for people with dementia. BACKGROUND: Due to comorbidities, people with dementia are frequently admitted to acute care hospitals. Here, they are at high risk of complications. Nurses strive for good care but regularly experience insufficient knowledge and skills regarding caring for people with dementia. DESIGN: A cross‐sectional survey study design. METHODS: Data were collected in seven Dutch acute hospitals and through social media. In total, 229 hospital nurses completed the questionnaire. We used the Geriatric In‐Hospital Nursing Care Questionnaire and two subscales of Hynninen on managing challenging behaviour. This report followed the STROBE checklist. RESULTS: Nurses express that they often apply general preventive interventions not explicitly related to dementia care. In general, nurses have mixed feelings about the nursing care provided in their department. For challenging behaviour, a variety of approaches, including restrictive measures and medication, is applied. The nurses’ attitudes and perceptions are influenced by the type of hospital where the nurses work, the level of education, the number of hours nurses work, and if the nurses completed a course on dementia in the last year. CONCLUSIONS: Despite a positive attitude, nurses do not have the specific knowledge and skills needed to provide proper care. Nurses who recently completed a course on dementia had more positive attitudes and perceptions towards caring for patients with dementia. RELEVANCE TO CLINICAL PRACTICE: The results of this research can be used to improve the quality of nursing care for patients with dementia in acute hospitals

    Association between Posttraumatic Stress Disorder and Inflammation: A Twin Study

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    The association of posttraumatic stress disorder (PTSD) with cardiovascular disease risk may be mediated by inflammation. Our objective was to examine the association between PTSD and measures of inflammation and to determine whether these associations are due to shared familial or genetic factors. We measured lifetime history of PTSD using the Structured Clinical Interview for DSM-IV in 238 male middle-aged military veteran twin pairs (476 individuals), selected from the Vietnam Era Twins Registry, who were free of cardiovascular disease at baseline. We assessed inflammation using levels of high-sensitivity C-reactive protein (hsCRP), interleukin 6 (IL-6), fibrinogen, white blood cells, vascular cell adhesion molecule-1, and intercellular adhesion molecule-1 (ICAM-1). Geometric mean levels and percent differences by PTSD were obtained from mixed-model linear regression analyses with adjustment for potential confounders. Within-pair analysis was conducted to adjust for shared family environment and genetics (monozygotic pairs). Overall, 12.4% of participants had a lifetime history of PTSD. Adjusted mean levels of hsCRP and ICAM-1 were significantly higher among those with vs. without PTSD [hsCRP: 1.75 vs. 1.31 mg/l (33% difference); ICAM-1: 319 vs. 293 ng/ml (9% difference)]. Adjustment for depression rendered the association of PTSD with hsCRP non-statistically significant. For IL-6, no consistent association was seen. Within-pair analysis produced associations that were similar in direction for all three markers but lesser in magnitude for hsCRP and IL-6. There was no evidence of interaction by zygosity. Elevated hsCRP and ICAM-1 are associated with PTSD, and these associations may be confounded by shared non-genetic, antecedent familial and environmental factors

    Key Areas For Conserving United States\u27 Biodiversity Likely Threatened By Future Land Use Change

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    A major challenge for biodiversity conservation is to mitigate the effects of future environmental change, such as land use, in important areas for biodiversity conservation. In the United States, recent conservation efforts by The Nature Conservancy and partners have identified and mapped the nation\u27s Areas of Biodiversity Significance (ABS), representing the best remaining habitats for the full diversity of native species and ecosystems, and thus the most important and suitable areas for the conservation of native biodiversity. Our goal was to understand the potential consequences of future land use changes on the nation\u27s ABS, and identify regions where ABS are likely to be threatened due to future land use expansion. For this, we used an econometric-based model to forecast land use changes between 2001 and 2051 across the conterminous U. S. under alternative scenarios of future land use change. Our model predicted a total of similar to 100,000 to 160,000 km(2) of natural habitats within ABS replaced by urban, crop and pasture expansion depending on the scenario (5% to 8% habitat loss across the conterminous U.S.), with some regions experiencing up to 30% habitat loss. The majority of the most threatened ABS were located in the Eastern half of the country. Results for our different scenarios were generally fairly consistent, but some regions exhibited notable difference from the baseline under specific policies and changes in commodity prices. Overall, our study suggests that key areas for conserving United States\u27 biodiversity are likely threatened by future land use change, and efforts trying to preserve the ecological and conservation values of ABS will need to address the potential intensification of human land uses

    A Book of Generations – Writing at the Frontier

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    We address the problem of finding viewpoints that preserve the relational structure of a three-dimensional graph drawing under orthographic parallel projection. Previously, algorithms for finding the best viewpoints under two natural models of viewpoint “goodness” were proposed. Unfortunately, the inherent combinatorial complexity of the problem makes finding exact solutions is impractical. In this paper, we propose two approximation algorithms for the problem, commenting on their design, and presenting results on their performance
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