Gehalten van gebromeerde vlamvertragers (PBDE's) in mengmonsters van Nederlandse voedingsmiddelen

Geen rapportnummer in publicatie.In Nederland wordt de blootstelling aan PolyBroom DifenylEthers (PBDE's) uit voeding berekend door metingen te combineren met voedselconsumptiegegevens (de Mul et al., 2005; Winter-Sorkina et al., 2006; Bakker et al., 2008). Daartoe zijn in 2006 voedingsmiddelen als vis, zuivel, groenten, etc. verzameld en op PBDE's onderzocht. Vraag hierbij was of de toegepaste analytisch-chemische methode, die eigenlijk voor 24-uurs duplicaat voeding ontwikkeld is (Zeilmaker et al., 2008), ook op deze specifieke voedingsmiddelen toegepast kan worden. Deze rapportage beschrijft de toepassing van de meetmethode voor PBDE's in 24-uurs duplicaatvoeding op (meng)monsters van specifieke voedingsmiddelen anno 2006. Voor de volledigheid zijn de gehalten zoals die in 2003/2004 in vergelijkbare mengmonsters gemeten zijn (de Mul et al., 2005) als aparte bijlage in deze rapportage opgenomen.VW

Duplicate 24-hour diet study 1994 Sterols ; method development and intake per person per day

In spring and fall 1994, 123 respondents participated in duplicate 24-hour diet study. Each respondent collected one duplicate of the food and drinks, including drinking water he/she consumed in a continuous 24-hour period. A gas chromatographic method was developed and validated for the determination of sterols. The sterols in the extract are determined by GCGC with FID. Lyophilised subsamples were analysed for cholesterol, coprosterol, brassicasterol, campesterol, stigmasterol and beta-sitosterol content. From these data the sterol intake per capita per day was calculated. The average intake was: for cholesterol 202 mg/person/day, for brassicasterol 1 mg/person/day, for campesterol 27 mg/person/day, for stigmasterol 15 mg/person/day and for beta-sitosterol 102 mg/person/day. The coprosterol intake was below the limit of determination for all samples. The average intake for the plantsterols was 146 mg/person/day and the average total sterol intake was 348 mg/person/day. The cholesterol intake of 32 respondents was above the recommendation of the Netherlands Food and Nutrition Council of a maximum of 33 mg/MJ. The average intake of cholesterol of 25 mg/MJ is below this recommendation. The total sterol intake found in this study corresponds well with the results found in the 1984/1985 duplicate diet study. The sterol intake in mg/MJ found in this study corresponds well with the results from the Dutch National Food Consumption Survey and the Market Basket study.In het voor- en najaar van 1994 hebben 123 respondenten deelgenomen aan een duplicaat voedingenonderzoek. Elke respondent verzamelde een duplicaat van zijn voeding, inclusief drank en drinkwater, in een aaneengesloten periode van 24 uur. Voor het bepalen van de sterolen is een gaschromatografische methode ontwikkeld en gevalideerd. De sterolen in het cyclohexaanextract werden bepaald met behulp van GCGC met FID detectie. Gevriesdroogde deelmonsters zijn onderzocht op het gehalte aan cholesterol, coprosterol, brassicasterol, campesterol, stigmasterol en beta-sitosterol. De gemiddelde inname aan cholesterol bedroeg 202 mg/persoon/dag, aan brassicasterol 1 mg/persoon/dag, aan campesterol 27 mg/persoon/dag, aan stigmasterol 15 mg/persoon/dag en aan beta-sitosterol 102 mg/persoon/dag. Coprosterol is in geen enkel monster aangetoond. De gemiddelde inname aan plantsterolen bedroeg 146 mg/persoon/dag en de gemiddelde totale inname aan sterolen was 348 mg/persoon/dag. Van 32 respondenten was de cholesterolinname hoger dan de huidige aanbeveling van de Voedingsraad van maximaal 33 mg/MJ. De gemiddelde inname aan cholesterol bleef met 25 mg/MJ echter onder deze aanbeveling. De nu bepaalde totale inname aan sterolen kwam goed overeen met de in het 24-uurs duplicaatvoedingenonderzoek van 1984/1985 gevonden inname. Wordt de inname aan sterolen uitgedrukt per energie-eenheid, dan komen de resultaten van de studie goed overeen met die van onderzoeken gebaseerd op Voedselconsumptiepeiling (VCP) en het Market Basket onderzoek

Duplicate 24-hour diet study 1994 Sterols ; method development and intake per person per day

In het voor- en najaar van 1994 hebben 123 respondenten deelgenomen aan een duplicaat voedingenonderzoek. Elke respondent verzamelde een duplicaat van zijn voeding, inclusief drank en drinkwater, in een aaneengesloten periode van 24 uur. Voor het bepalen van de sterolen is een gaschromatografische methode ontwikkeld en gevalideerd. De sterolen in het cyclohexaanextract werden bepaald met behulp van GCGC met FID detectie. Gevriesdroogde deelmonsters zijn onderzocht op het gehalte aan cholesterol, coprosterol, brassicasterol, campesterol, stigmasterol en beta-sitosterol. De gemiddelde inname aan cholesterol bedroeg 202 mg/persoon/dag, aan brassicasterol 1 mg/persoon/dag, aan campesterol 27 mg/persoon/dag, aan stigmasterol 15 mg/persoon/dag en aan beta-sitosterol 102 mg/persoon/dag. Coprosterol is in geen enkel monster aangetoond. De gemiddelde inname aan plantsterolen bedroeg 146 mg/persoon/dag en de gemiddelde totale inname aan sterolen was 348 mg/persoon/dag. Van 32 respondenten was de cholesterolinname hoger dan de huidige aanbeveling van de Voedingsraad van maximaal 33 mg/MJ. De gemiddelde inname aan cholesterol bleef met 25 mg/MJ echter onder deze aanbeveling. De nu bepaalde totale inname aan sterolen kwam goed overeen met de in het 24-uurs duplicaatvoedingenonderzoek van 1984/1985 gevonden inname. Wordt de inname aan sterolen uitgedrukt per energie-eenheid, dan komen de resultaten van de studie goed overeen met die van onderzoeken gebaseerd op Voedselconsumptiepeiling (VCP) en het Market Basket onderzoek.In spring and fall 1994, 123 respondents participated in duplicate 24-hour diet study. Each respondent collected one duplicate of the food and drinks, including drinking water he/she consumed in a continuous 24-hour period. A gas chromatographic method was developed and validated for the determination of sterols. The sterols in the extract are determined by GCGC with FID. Lyophilised subsamples were analysed for cholesterol, coprosterol, brassicasterol, campesterol, stigmasterol and beta-sitosterol content. From these data the sterol intake per capita per day was calculated. The average intake was: for cholesterol 202 mg/person/day, for brassicasterol 1 mg/person/day, for campesterol 27 mg/person/day, for stigmasterol 15 mg/person/day and for beta-sitosterol 102 mg/person/day. The coprosterol intake was below the limit of determination for all samples. The average intake for the plantsterols was 146 mg/person/day and the average total sterol intake was 348 mg/person/day. The cholesterol intake of 32 respondents was above the recommendation of the Netherlands Food and Nutrition Council of a maximum of 33 mg/MJ. The average intake of cholesterol of 25 mg/MJ is below this recommendation. The total sterol intake found in this study corresponds well with the results found in the 1984/1985 duplicate diet study. The sterol intake in mg/MJ found in this study corresponds well with the results from the Dutch National Food Consumption Survey and the Market Basket study.IG

Differential immune-response of congenic mice to ultraviolet-treated major histocompatibility complex class-II incompatible skin-grafts

The influence of ultraviolet (UVB) irradiation on the survival of H-2 class II-disparate skin grafts was studied in congenic mouse strains. Isolated skin was UVB irradiated in vitro at a dose of 40 mJ/cm2 from both sides to remove Ia immunogenicity. Immediately after irradiation the skin was transplanted onto the flank of allogeneic mice. When B10.AQR grafts were transplanted onto B10.T(6R) recipients, a significant prolongation of the survival time was observed, while 50% of the UVB-treated grafts were not rejected at all. However, in the opposite direction--i.e., B10.T(6R) grafts onto B10.AQR recipients, no significant prolongation of the survival was observed. To test whether this effect was due to a difference in susceptibility of the donor skin to UVB irradiation or to a different immune response in the recipients, (B10.T(6R) x B10.AQR) grafts were transplanted onto the parent strains. Similar results were obtained, in that UVB-treated grafts did not show a prolonged survival in B10.AQR recipients, whereas a significant prolongation (50% of the grafts survived more than 100 days) was observed in B10.T(6R) recipients. UVB-treated (B10.T(6R) x B10.AQR)F1 grafts were also transplanted onto (B10.T(6R) x C57B1/10)F1, (B10.AQR x C57B1/10)F1, (B10.T(6R) x Balb/c)F1 and (B10.AQR x Balb/c)F1 recipients--but in none of these combinations was a prolonged survival time observed. These data suggest that, in contrast to all in vitro experiments, the abrogation of the immune response by UVB treatment of the stimulator cells is, in vivo, not a general phenomenon. The genetic constitution of the responder mice seems to play an important role in determining whether or not an immune response takes place

Gehalten van gebromeerde vlamvertragers (PBDE's) in mengmonsters van Nederlandse voedingsmiddelen

Geen rapportnummer in publicatie.<br

Blootstelling aan polygebromeerde difenylethers uit Nederlandse duplicaat voedingen en uit Europese huisstof

Vlamvertragers als polygebromeerde difenylethers (PBDE's) hebben zich vanuit consumenten producten in het milieu verspreid. Van daaruit zijn zij in de voedselketen terechtgekomen. Op dit moment ligt de blootstelling aan PBDE-99 rond de maximaal toelaatbare inname voor deze verbinding. Er kan dus een gezondheidsrisico ontstaan wanneer het gehalte van PBDE-99 in voeding toe zou nemen. Monitoring onderzoek heeft aangegeven dat het gehalte van PBDE-99 in de laatste 30 jaar enigszins is toegenomen. Onderzoek naar PBDE's in voeding blijft daarom nodig. In dit onderzoek is al het voedsel dat iemand in 24 uur consumeert ('24-uurs duplicaat dieet') onderzocht op de aanwezigheid van PBDE's. In Nederland zijn gegevens over deze voedingsmonsters verzameld in 1978, 1984, 1994 en 2004. In de monsters zijn drie PBDE's aangetoond: PBDE-47, PBDE-99 en PBDE-209. In de onderzochte jaren is de hoeveelheid PBDE-47 in de dikten onveranderd gebleven. PBDE-99 laat een consistente toename zien van 1978 tot 1994, waarna het gehalte zich lijkt te stabiliseren. Rekening houdend met blootstelling van PBDEs uit huisstof en bioaccumulerend vermogen is door het RIVM een maximaal dagelijkse toelaatbare humane inname voor PBDE-99 berekend. De blootstelling aan PBDE-99 via voeding blijkt rond deze maximaal toelaatbare inname te liggen. Wat het risico is voor andere PBDE's moet nog onderzocht worden. Aanbevolen wordt daarom om het blootstellingonderzoek te vervolgen en ook maximaal toelaatbare innamen voor andere PBDE's te berekenen.Flame retardants, like polybrominated diphenyl ethers (PBDEs), are applied to consumer products and have entered the human food chain via the environment. At the moment the exposure to PBDE-99 from food is around its maximum allowed human intake level. This indicates that adverse effects on public health may be expected when the level of this compound in food would increase. In this respect monitoring results have revealed that the level of PBDE-99 in food has somewhat increased in the last 3 decades. For this reason the monitoring of PBDEs in food remains necessary. The presence of PBDEs has been investigated in food items which are consumed by individuals over 24 hours ('24-hour duplicate diets'). In the Netherlands, 24-hour duplicate diets have been collected in 1978, 1984, 1994 and 2004. Three PBDEs have been found in the duplicate diets: PBDE-47, PBDE-99 and PBDE-209. In the mentioned period the food levels of PBDE-47 have remained constant. However, food levels of PBDE-99 just showed a consistent, increasing pattern from 1978 to 1994, which seems to level off after 1994. Taking additional exposure to PBDEs from house dust and bioaccumulation into account a maximum allowed human intake level for PBDE-99 has been estimated by the RIVM. The exposure to PBDE-99 from food is around this maximum intake level. Maximum allowed intake levels for other PBDEs still need to be determined. We therefore recommend performing additional studies on exposure assessment and the estimation of maximum allowed intake levels of other PBDEs.VW

Nurses in the lead

Background: Transitions in healthcare delivery, such as the rapidly growing numbers of older people and increasing social and healthcare needs, combined with nursing shortages has sparked renewed interest in differentiations in nursing staff and skill mix. Policy attempts to implement new competency frameworks and job profiles often fails for not serving existing nursing practices. This study is aimed to understand how licensed vocational nurses (VNs) and nurses with a Bachelor of Science degree (BNs) shape distinct nursing roles in daily practice. Methods: A qualitative study was conducted in four wards (neurology, oncology, pneumatology and surgery) of a Dutch teaching hospital. Various ethnographic methods were used: shadowing nurses in daily practice (65h), observations and participation in relevant meetings (n=56), informal conversations (up to 15 h), 22 semi-structured interviews and member-checking with four focus groups (19 nurses in total). Data was analyzed using thematic analysis. Results: Hospital nurses developed new role distinctions in a series of small-change experiments, based on action and appraisal. Our findings show that: (1) this developmental approach incorporated the nurses’ invisible work; (2) nurses’ roles evolved through the accumulation of small changes that included embedding the new routines in organizational structures; (3) the experimental approach supported the professionalization of nurses, enabling them to translate national legislation into hospital policies and supporting the nurses’ (bottom-up) evolution of practices. The new roles required the special knowledge and skills of Bachelor-trained nurses to support healthcare quality improvement and connect the patients’ needs to organizational capacity. Conclusions: Conducting small-change experiments, anchored by action and appraisal rather than by design, clarified the distinctions between vocational and Bachelor-trained nurses. The process stimulated personal leadership and boosted the responsibility nurses feel for their own development and the nursing profession in general. This study indicates that experimental nursing role development provides opportunities for nursing professionalization and gives nurses, managers and policymakers the opportunity of a ‘two-way-window’ in nursing role development, aligning policy initiatives with daily nursing practices.</p

Role of Dutch internal policy advisors in a hospital quality improvement programme and their influence on nurses' role development

Objective Nurses are vital in providing and improving quality of care. To enhance the quality improvement (QI) competencies of nurses, hospitals in the Netherlands run developmental programmes generally led by internal policy advisors (IPAs). In this study, we identify the roles IPAs play during these programmes to enhance the development of nurses' QI competencies and studied how these roles influenced nurses and management. Design An exploratory ethnographical study comprising observations, informal conversations, semistructured interviews, focus groups and a strategy evaluation meeting. Setting A teaching hospital in an urban region in the Netherlands. Participants IPAs (n=7) in collaboration with four teams of nurses (n=131), team managers (n=4), senior managers (n=4) and the hospital director (n=1). Results We identified five distinct advisory roles that IPAs perform in the hospital programme: gatekeeper, connector, converter, reflector and implementer. In describing these roles, we provide insights into how IPAs help nurses to develop QI competencies. The IPA's professional background was a driving force for nurses' QI role development. However, QI development was threatened if IPAs lost sight of different stakeholders' interests and consequently lost their credibility. QI role development among nurses was also threatened if the IPA took on all responsibility instead of delegating it timely to managers and nurses. Conclusions We have shown how IPAs' professional background and advisory knowledge connect organisational, managerial and professional aims and interests to enhance professionalisation of nurses.</p