Evaluation of a home-based physical exercise and support intervention for people living with dementia and their informal caregivers: a randomised controlled trial

Pot, A.M. [Promotor]Scherder, E.J.A. [Promotor]Lange, J. de [Copromotor

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Le Nord imaginaire dans quelques œuvres de Sylvain Tesson

Det imaginære nord i noen verk av Sylvain Tesson. Sammendrag - Det imaginære nord fremheves i noen verk av den franske forfatteren Sylvain Tesson (1972– ), særlig reiseskildringer: I disse er forfatterens selvfremstilling sterkt knyttet til litterære figurer og motiver som ofte karakteriserer diskursen om det nordlige. Tessons nord er hovedsakelig Sibirs taiga, sør for 63 ºN. Tekstene analyseres langs tre linjer: kulde, det sublime og det primitive. Hans fremstilling av kulde sammenlignes i en flerfaglig studie med den kvantifiserte kulden. Hans fremstilling til det nordlige tilhører det sublime. Den preges av tomhet og fravær, og bygges på sammenkoblinger mellom kulde, stillhet og ensomhet. Tesson skildrer disse tre temaene hovedsakelig positivt. Tessons diskurs om det nordlige understreker motiver som passer med en imaginær nord mer enn med den virkelige nord.Résumé - Le Nord imaginaire est mis en évidence dans l’œuvre de l’écrivain français Sylvain Tesson (1972– ), en particulier dans des récits de voyage où la représentation de soi repose sur une utilisation de figures et schémas narratifs caractéristiques du discours sur nord. Le nord représenté est principalement celui de la forêt boréale de Sibérie, de latitude inférieure à 63º N. Les textes sont analysés selon trois axes: le froid, le sublime et le primitif. Le froid discursif est confronté au froid mesuré dans une approche pluridisciplinaire. La représentation du nord relève du sublime. Elle est caractérisée par une prévalence du vide et de la privation, et principalement basée sur les interconnections entre le froid, le silence et la solitude, trois thèmes auxquels l’auteur considère généralement avec positivité. Le discours de Tesson met en évidence les éléments qui coïncident avec un nord rêvé plutôt qu’avec un nord réel.The imaginary North in some works by Sylvain Tesson. Abstract - The imaginary North is highlighted in some works by French writer Sylvain Tesson (1972– ), in particular in travel books where his self-representation interacts with literary figures and constructs that are characteristic for the usual discourse on the North. Tessons North is mostly the boreal forest of Siberia at latitudes lower than 63 degrees. The literary works are discussed using three analytical axes: the Cold, the Sublime and the Primitive. The discursive cold is confronted to the quantified cold through a multidisciplinary approach. The representation of North is sublime and characterized by vacuity and privations. It is mostly built on interconnections between the cold, the silence and solitude; these three elements are depicted mostly positively by Tesson. Tessons discourse enhances the elements that fit with an imagined North rather than with a real North

Style and interpretation in the nineteenth‐century German violin school with particular reference to the three sonatas for pianoforte and violin by Johannes Brahms

From the mid nineteenth to early twentieth centuries the performance of Brahms’s music was intricately bound with the performance style of artists within his circle. In violin playing Joseph Joachim (1831‐1907) was the foremost exponent of the German violin school. The stylistic characteristics of this school, which included selective use of a pre‐modern style of vibrato, prominent application of portamento, predominantly legato approach to bow strokes and the frequent and noticeable modification of tempo and rhythm, were considered indispensable expressive devices by Joachim, Brahms and others associated with this circle. While the use of such devices in the nineteenth century has been well documented in published research over the past 15 years or so, there is currently much contention about the extent to which such devices were employed. Importantly, in addition to written documentation and solo recordings, this thesis examines recordings of chamber ensembles—whose members had a connection to the German violin school and/or Brahms—that as yet have been little consulted as primary source evidence. Spectrogram analyses of many of these recordings provide definitive evidence of vibrato that was narrow in width, fast, and applied selectively. Other new evidence in my thesis strongly supports the hypothesis that portamento, tempo modification and rhythmic alteration were used to a much greater extent than today, and this significantly enhanced the rhetorical features in Brahms’s music. A detailed Performance Edition with Critical Notes about Brahms’s three Sonatas for Pianoforte and Violin Opp. 78, 100 and 108, applies the evidence elucidated throughout the thesis

Process evaluation of a multicomponent dyadic intervention study with exercise and support for people with dementia and their family caregivers

BACKGROUND: A randomized controlled trial of a multicomponent dyadic intervention (a translated and adapted version of an intervention that has been shown to be effective for people with dementia in the USA) was performed. The exercise and support intervention was intended to reduce depressive symptoms of people with dementia and their caregivers. The purpose of this process evaluation is to create in-depth insight into the delivery of the intervention and the effect analysis, to prevent drawing inappropriate conclusions on the efficacy or effectiveness of the intervention, and to formulate recommendations for future studies on complex geriatric interventions. METHODS: Qualitative and quantitative data were collected. The process evaluation was performed according to the model presented by Reelick and colleagues, which encompasses the following three process components: (1) success rate of recruitment and quality of the study population; (2) the quality of execution of the complex intervention; and (3) the process of acquisition of the data. RESULTS: The study design met high research standards and the intervention was carefully delivered. Evaluation of the study population quality revealed a profound recruitment process resulting in a reasonable sample size. Attrition rate during follow-up was acceptable. With regard to the evaluation of the intervention quality, most interviewed participants experienced benefits of the intervention. Attendance at the home visits was high and attrition to homework was moderate. Evaluation of the data acquisition showed the positive value of the use of a mixed design; qualitative analysis of the intervention revealed outcomes not measured in the quantitative analysis. CONCLUSIONS: The process evaluation revealed a carefully and soundly performed study. The mixed design contributed to valuable insights. However, there were some restrictions worth considering. The intervention components may have a different feasibility by moderate attrition to homework and some negative experiences of participants, which may be an indication of too intensive an intervention for this frail population in this specific country. As a result, the results of the statistical effect analysis should be interpreted with caution. TRIAL REGISTRATION: The study has been registered at the Netherlands National Trial Register: NTR1802, registration date 6 May 2009

Clonal heterogeneity as a driver of disease variability in the evolution of myeloproliferative neoplasms.

Myeloproliferative neoplasms (MPNs) are clonal hematological diseases in which cells of the myelo-erythroid lineage are overproduced and patients are predisposed to leukemic transformation. Hematopoietic stem cells are the suspected disease-initiating cells, and these cells must acquire a clonal advantage relative to nonmutant hematopoietic stem cells to perpetuate disease. In 2005, several groups identified a single gain-of-function point mutation in JAK2 that associated with the majority of MPNs, and subsequent studies have led to a comprehensive understanding of the mutational landscape in MPNs. However, confusion still exists as to how a single genetic aberration can be associated with multiple distinct disease entities. Many explanations have been proposed, including JAK2V617F homozygosity, individual patient heterogeneity, and the differential regulation of downstream JAK2 signaling pathways. Several groups have made knock-in mouse models expressing JAK2V617F and have observed divergent phenotypes, each recapitulating some aspects of disease. Intriguingly, most of these models do not observe a strong hematopoietic stem cell self-renewal advantage compared with wild-type littermate controls, raising the question of how a clonal advantage is established in patients with MPNs. This review summarizes the current molecular understanding of MPNs and the diversity of disease phenotypes and proposes that the increased proliferation induced by JAK2V617F applies a selection pressure on the mutant clone that results in highly diverse clonal evolution in individuals.This is the author's accepted manuscript. The final version of this paper is published in Experimental Hematology here: http://www.exphem.org/article/S0301-472X(14)00622-5/abstract

Home-based exercise and support programme for people with dementia and their caregivers: study protocol of a randomised controlled trial

<p>Abstract</p> <p>Background</p> <p>Dementia affects the mood of people with dementia but also of their caregivers. In the coming years, the number of people with dementia will increase worldwide and most of them will continue to live in the community as long as possible. Home-based psychosocial interventions reducing the depressive symptoms of both people with dementia and their caregivers in their own home are highly needed.</p> <p>Methods/Design</p> <p>This manuscript describes the design of a Randomised Controlled Trial (RCT) of the effects of a home-based exercise and support programme for people with dementia and their caregivers. The aim is to randomly assign 156 dyads (caregiver and dementia diagnosed person) to an intervention group or a comparison group. The experimental group receives a home programme in which exercise and support for the people with dementia and their caregivers are combined and integrated. The comparison group receives a minimal intervention. Primary outcomes are physical health (people with dementia) and mood (people with dementia and caregivers). In addition, to get more insight in the working components of the intervention and the impact of the intervention on the relationship of the dyads a qualitative sub-study is carried out.</p> <p>Discussion</p> <p>This study aims to contribute to an evidence-based treatment to reduce depressive symptoms among people with dementia and their caregivers independently living in the community.</p> <p>Trial Registration</p> <p>The study has been registered at the Netherlands National Trial Register (NTR), which is connected to the International Clinical Trials Registry Platform of the WHO. Trial number: <a href="http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2040">NTR1802</a>.</p

Index sorting resolves heterogeneous murine hematopoietic stem cell populations.

Recent advances in the cellular and molecular biology of single stem cells have uncovered significant heterogeneity in the functional properties of stem cell populations. This has prompted the development of approaches to study single cells in isolation, often performed using multiparameter flow cytometry. However, many stem cell populations are too rare to test all possible cell surface marker combinations, and virtually nothing is known about functional differences associated with varying intensities of such markers. Here we describe the use of index sorting for further resolution of the flow cytometric isolation of single murine hematopoietic stem cells (HSCs). Specifically, we associate single-cell functional assay outcomes with distinct cell surface marker expression intensities. High levels of both CD150 and EPCR associate with delayed kinetics of cell division and low levels of differentiation. Moreover, cells that do not form single HSC-derived clones appear in the 7AAD(dim) fraction, suggesting that even low levels of 7AAD staining are indicative of less healthy cell populations. These data indicate that when used in combination with single-cell functional assays, index sorting is a powerful tool for refining cell isolation strategies. This approach can be broadly applied to other single-cell systems, both to improve isolation and to acquire additional cell surface marker information.This work was supported by grants from Leukaemia and Lymphoma Research, the Medical Research Council, the National Institute for Health Research Cambridge Biomedical Research Centre, and core support grants by the Wellcome Trust to the Cambridge Institute for Medical Research and Wellcome Trust–MRC Cambridge Stem Cell Institute. DGK is the recipient of a Canadian Institutes of Health Research Postdoctoral Fellowship and a European Hematology Association non-clinical advanced research fellowship. The authors declare that they have no conflict of interest.This is the author accepted manuscript. The final version will be available from Elsevier at http://dx.doi.org/10.1016/j.exphem.2015.05.006

Heave, settlement and fracture of chalk during physical modelling experiments with temperature cycling above and below 0°C

To elucidate the early stages of heave, settlement and fracture of intact frost-susceptible rock by temperature cycling above and below 0°C, two physical modelling experiments were performed on 10 rectangular blocks 450 mm high of fine-grained, soft limestone. One experiment simulated 21 cycles of bidirectional freezing (upward and downward) of an active layer above permafrost, and the other simulated 26 cycles of unidirectional freezing (downward) of a seasonally frozen bedrock in a non-permafrost region. Heave and settlement of the top of the blocks were monitored in relation to rock temperature and unfrozen water content, which ranged from almost dry to almost saturated. In the bidirectional freezing experiment, heave of the wettest block initially occurred abruptly at the onset of freezing periods and gradually during thawing periods (summer heave). After the crossing of a threshold marked by the appearance of a macrocrack in the upper layer of permafrost, summer heave increased by an order of magnitude as segregated ice accumulated incrementally in macrocracks, interrupted episodically by abrupt settlement that coincided with unusually high air temperatures. In the unidirectional freezing experiment, the wet blocks heaved during freezing periods and settled during thawing periods, whereas the driest blocks showed the opposite behaviour. The two wettest blocks settled progressively during the first 15 freeze-thaw cycles, before starting to heave progressively as macrocracks developed. Four processes, operating singly or in combination in the blocks account for their heave and settlement: (1) thermal expansion and contraction caused heave and settlement when little or no water-ice phase change was involved; (2) volumetric expansion of water freezing in situ caused short bursts of heave of the outer millimetres of wet rock; (3) ice segregation deeper in the blocks caused sustained heave during thawing and freezing periods; and (4) freeze-thaw cycling caused consolidation and settlement of wet blocks prior to macrocracking in the unidirectional freezing experiment. Rock fracture developed by growth of segregated ice in microcracks and macrocracks at depths determined by the freezing regime. Overall, the heave, settlement and fracture behaviour of the limestone is similar to that of frost-susceptible soil

Homosociality in the Classical American Stag Film: Off-Screen, On-Screen

The classical American stag film, a body of clandestine short pornographic films produced during the first two-thirds of the 20th century, has received scholarly attention in several quarters, first from heterosexual male scribes and beneficiaries of the `sexual revolution', and more recently by feminist and queer cultural historians. The present article pursues this study by developing the concept of homosociality in relation to the stag film corpus, both its contextual and textual aspects, and demonstrating its inextricable engagement in the social and specular relations along the continuum of masculinity within American culture. In conclusion, the author compares the stags to another quasi-underground corpus of short erotic films, mail order homoerotic `physique' films of the post-war period, and discovers unexpected parallels and dialogue between the two corpuses at the onset of the `sexual revolution'