Aneurysm of the Superior Posterior Pancreatic-Duodenal Artery Presenting with Recurrent Syncopes

We present a 61-year-old woman with hypovolemic shock due to a ruptured aneurysm of the superior posterior pancreatic-duodenal artery in whom recurrent syncopes were the first presenting sign of pancreatic-duodenal artery aneurysm (PDAA). PDAA is a rare but life-threatening condition. The widely varying symptomatology may lead to a delay in diagnosis and treatment. Patients with atypical symptoms, such as vague abdominal pain, recurrent dizziness or syncope, may actually suffer from a sentinel bleeding of the vascular malformation. Radiological imaging, especially selective angiography, may provide a diagnostic as well as a therapeutic tool in these patients

Evaluating and improving quality of colorectal cancer care

  De Dutch Surgical Colorectal Audit (DSCA) evalueert sinds 2009 op landelijk niveau de kwaliteit van colorectale zorg via clinical auditing. In dit proefschrift wordt het principe en effect van clinical auditing beschreven en wordt gekeken waar aangrijpingspunten voor kwaliteitsverbetering zijn en welke verbeteringen er zijn gerealiseerd in Nederland.  LUMC / Geneeskund

Worship with children : agentive participation in Dutch Protestant contexts

proefschrift Protestantse Theologische Universitei

Mind the Relationship: A Multi-Layered Ethical Framework for Citizen Science in Health

There is a heated debate about what citizen science is and is not. We argue that instead of aiming at a definition of citizen science, we should reflect upon its ethical starting points. Based on our practical experiences with citizen science initiatives, we come up with an ethical framework that consists of two core values (respect and justice), five ethical desiderata (relationship between equals; recognition of each other's capacities, knowledge, and agency; reciprocity; openness for different goals; and openness for different research methods and paradigms) and two fundamental qualities (symmetry and transparency). The desiderata reflect ethically problematic practices, such as the use of citizens by academic scientists as mere sensors, and biases in the existing literature, such as labelling the projects that are initiated and led by citizens as “extreme”. The desiderata are supported by two ethical theories: care ethics and the capabilities approach. The aim of our ethical framework is to stimulate and facilitate reflection upon what needs to be considered when co-creating or assessing a citizen science initiative. Fundamentally, citizen science ought to be a humanizing endeavour unlocking the investigative capacities of humans. The ethical framework is meant to help reflect on this endeavour.</p

Living with my diabetes – introducing eHealth into daily practices of patients with type 2 diabetes mellitus

Objective: Diabetes patients can draw on an increasing number of eHealth apps to support them in the self-management of their disease. While studies so far have focused on patients with type 1 diabetes, we explored how patients with type 2 diabetes mellitus (T2DM) integrate eHealth apps into their practices aimed at managing and coping with the disease, which aspects were considered particularly valuable and which challenges users encountered.Methods: Semi-structured interviews and focus group sessions were conducted to explore how patients cope with T2DM in their daily lives and their attitude towards eHealth. In a further step, four eHealth apps were tested by patients and their expectations and experiences studied by way of qualitative interviews and focus groups.Results: The analysis showed that the study participants valued in particular the possibility to use eHealth apps to sense and gain a better understanding of their own body, to learn about specific responses of their body to nutrition and physical activity,and to support changes in daily routines and lifestyle. Key challenges encountered related to difficulties in interpreting the data, matching the data to other bodily sensations, getting overly occupied with the disease and difficulties in integratingthe apps into personal, family, and care practices.Conclusion: Under certain conditions, eHealth can play an important role for patients in developing a nuanced, personal understanding of their body and coping with T2DM. A prerequisite is that eHealth needs to be fitted into the specific practicesof users, and patients desire a strong role by their care professionals in providing support in interpretation of data

Citizens collaborate to discover the best way to combat loneliness

Eenzaamheid is een gezondheidsprobleem dat van invloed is op het dagelijks leven van de betrokkene. Vernauwing van het sociale netwerk is een van de oorzaken van eenzaamheid, een probleem voor veel ouderen. Het is nodig om de bewustwording rond eenzaamheid te vergroten en om eenzaamheid te bestrijden. Dit onderzoek had als doel om samen met oudere inwoners en vrijwilligers uit Nijverdal, Rossum, Albergen en Glanerbrug inzicht te vergroten in methoden van burgerwetenschap om eenzame ouderen te bereiken en eenzaamheid te bestrijden