Effect of manual lymph drainage in addition to guidelines and exercise therapy on arm lymphoedema related to breast cancer: randomised controlled trial

Objective To determine the preventive effect of manual lymph drainage on the development of lymphoedema related to breast cancer

Teaming Teachers: Exploring factors that influence effective team functioning in a vocational education context

This study tries to examine the influence of routines and transformational leadership on group efficacy and team effectiveness in secondary vocational education in the Netherlands, in Vocational Education and Training (VET) colleges. First, a qualitative study was conducted. Next, insights from the literature and the qualitative study were used to develop a conceptual framework for the quantitative studies

Leidinggeven aan interdisciplinair bèta technisch hoger onderwijs

Onderzoeksrapport over leidinggeven aan interdisciplinair beta technisch hoger onderwijs (context Smart Solutions Semester). https://www.techyourfuture.nl/files/downloads/Eindrapport_TYF_Leiderschap_-_okt_2019_DEF.pd

Manual lymph drainage to prevent arm lymphoedema after axillary dissection for breast cancer

status: publishe

Boundary Practices in Interactive Research

At the 2008 ECER conference Ellström introduced the concept of interactive research. Interactive research often takes place in the context of innovation processes. In this proposal we chose to focus on the context of educational innovation. In contemporary Dutch education, particularly in vocational education, many innovation projects take place in which research is incorporated. As there are no clear-cut answers in how to organize the interaction between such innovation and research, we studied three projects in Dutch vocational education from the learning perspective one can take on the interplay between knowledge creation and innovation (Ellström, 2010

Blood pressure reduction after gastric bypass surgery is explained by a decrease in cardiac output

Blood pressure (BP) decreases in the first weeks after Roux-and-Y gastric bypass surgery. Yet the pathophysiology of the BP-lowering effects observed after gastric bypass surgery is incompletely understood. We evaluated BP, systemic hemodynamics, and baroreflex sensitivity in 15 obese women[mean age 42 +/- 7 standard deviation (SD) yr, body mass index 45 +/- 6 kg/m2] 2 wk before and 6 wk following Roux-and-Y gastric bypass surgery. Six weeks after gastric bypass surgery, mean body weight decreased by 13 +/- 5 kg (10%, P < 0.001). Office BP decreased from 137 +/- 10/86 +/- 6 to 128 +/- 12/81 +/- 9 mmHg (P < 0.001, P < 0.01), while daytime ambulatory BP decreased from 128 +/- 14/80 +/- 9 to 114 +/- 10/73 +/- 6 mmHg (P = 0.01, P = 0.05), whereas nighttime BP decreased from 111 +/- 13/66 +/- 7 to 102 +/- 9/62 +/- 7 mmHg (P = 0.04, P < 0.01). The decrease in BP was associated with a 1.6 +/- 1.2 l/min (20%, P < 0.01) decrease in cardiac output (CO), while systemic vascular resistance increased (153 +/- 189 dyn s cm-5, 15%, P < 0.01). The maximal ascending slope in systolic blood pressure decreased (192 mmHg/s, 19%, P = 0.01), suggesting a reduction in left ventricular contractility. Baroreflex sensitivity increased from 9.0 [6.4-14.3] to 13.8 [8.5-19.0] ms/mmHg (median [interquartile range]; P < 0.01) and was inversely correlated with the reductions in heart rate (R = -0.64, P = 0.02) and CO (R = -0.61, P = 0.03). In contrast, changes in body weight were not correlated with changes in either BP or CO. The BP reduction following Roux-and-Y gastric bypass surgery is correlated with a decrease in CO independent of changes in body weight. The contribution of heart rate to the reduction in CO together with enhanced baroreflex sensitivity suggests a shift toward increased parasympathetic cardiovascular control. The reason for the decrease in blood pressure (BP) in the first weeks after gastric bypass surgery remains to be elucidated. We show that the reduction in BP following surgery is caused by a decrease in cardiac output. In addition, the maximal ascending slope in systolic blood pressure decreased suggesting a reduction in left ventricular contractility and cardiac workload. These findings help to understand the physiological changes following gastric bypass surgery and are relevant in light of the increased risk of heart failure in these patient