Het Chronische Vermoeidheidssyndroom, Fibromyalgie & Reuma.

Een onderzoek naar stigmatisering, sociale steun en kwaliteit van leven Het onderwerp van dit onderzoek is stigmatisering, sociale steun en kwaliteit van leven bij mensen met het Chronische Vermoeidheidssyndroom (CVS), Fibromyalgie en Reuma. De eerste twee aandoeningen worden ook wel Medisch Moeilijk Objectiveerbare Aandoeningen (MMOA) genoemd en zijn binnen zowel de wetenschap, de medische wereld als de maatschappij controversieel. Deze afwezigheid van eenduidigheid (en erkenning) maakt het er niet gemakkelijker op om in het dagelijkse leven met één van deze aandoeningen te leven. Omdat Reuma wat betreft klachten (moeheid en pijn) overeenkomt met CVS en Fibromyalgie is ervoor gekozen deze groep als referentiegroep te gebruiken. Hierdoor konden de twee moeilijk objectiveerbare aandoeningen worden vergeleken met een wel objectiveerbare aandoening. De vraagstelling van het onderzoek luidde: Zijn er verschillen in de impact van CVS, Fibromyalgie en Reuma op de ervaren kwaliteit van leven en heeft een grotere mate van stigmatisering en ontevredenheid over het sociale netwerk een negatievere invloed op deze kwaliteit van leven? Uiteindelijk zijn er drie onderzoeksvragen geformuleerd: • Wat is de (directe) invloed van de aandoeningen op de ervaren kwaliteit van leven? Is er een significant verschil in de ervaren kwaliteit van leven tussen de drie aandoeningen? • Wat is de invloed van de aandoeningen op de ervaren mate van stigmatisering en bestaat hierin een gradatie? Is deze gradatie terug te zien in de kwaliteit van leven? • Wat is de invloed van de aandoeningen op de sociale steun? En wat is de invloed van de sociale steun op de kwaliteit van leven

Predictors of disease severity in children presenting from the community with febrile illnesses: a systematic review of prognostic studies.

Early identification of children at risk of severe febrile illness can optimise referral, admission and treatment decisions, particularly in resource-limited settings. We aimed to identify prognostic clinical and laboratory factors that predict progression to severe disease in febrile children presenting from the community. We systematically reviewed publications retrieved from MEDLINE, Web of Science and Embase between 31 May 1999 and 30 April 2020, supplemented by hand search of reference lists and consultation with an expert Technical Advisory Panel. Studies evaluating prognostic factors or clinical prediction models in children presenting from the community with febrile illnesses were eligible. The primary outcome was any objective measure of disease severity ascertained within 30 days of enrolment. We calculated unadjusted likelihood ratios (LRs) for comparison of prognostic factors, and compared clinical prediction models using the area under the receiver operating characteristic curves (AUROCs). Risk of bias and applicability of studies were assessed using the Prediction Model Risk of Bias Assessment Tool and the Quality In Prognosis Studies tool. Of 5949 articles identified, 18 studies evaluating 200 prognostic factors and 25 clinical prediction models in 24 530 children were included. Heterogeneity between studies precluded formal meta-analysis. Malnutrition (positive LR range 1.56-11.13), hypoxia (2.10-8.11), altered consciousness (1.24-14.02), and markers of acidosis (1.36-7.71) and poor peripheral perfusion (1.78-17.38) were the most common predictors of severe disease. Clinical prediction model performance varied widely (AUROC range 0.49-0.97). Concerns regarding applicability were identified and most studies were at high risk of bias. Few studies address this important public health question. We identified prognostic factors from a wide range of geographic contexts that can help clinicians assess febrile children at risk of progressing to severe disease. Multicentre studies that include outpatients are required to explore generalisability and develop data-driven tools to support patient prioritisation and triage at the community level. CRD42019140542

Reproducible resistive switching in nonvolatile organic memories

Resistive switching in nonvolatile, two terminal organic memories can be due to the presence of a native oxide layer at an aluminum electrode. Reproducible solid state memories can be realized by deliberately adding a thin sputtered Al2O3 layer to nominal electron-only, hole-only, and bipolar organic diodes. Before memory operation, the devices have to be formed at an electric field of 10(9) V/m, corresponding to soft breakdown of Al2O3. After forming, the structures show pronounced negative differential resistance and the local maximum in the current scales with the thickness of the oxide layer. The polymer acts as a current limiting series resistance

Positive and negative outcomes of informal caregiving at home and in institutionalised long-term care: A cross-sectional study

Background: Our ageing society is putting tremendous strain on public health and welfare programs to meet the needs of ageing individuals. Promoting informal caregiving is one way for policymakers to reduce this burden. However, caregiving may be experienced as stressful and is associated with adverse health consequences. While quite a lot of research focuses on caregiving for community-dwelling older adults, little is known about informal care in institutionalised long-term care (ILTC). Therefore, the objectives of this study were: 1) to compare characteristics of informal caregivers and care receivers and caregiver outcomes - at home and in ILTC; 2) to study the association between these characteristics and positive and negative caregiver outcomes; 3) to investigate the moderating effect of the setting (at home vs. ILTC) on these associations. Methods: A cross-sectional study was conducted using the TOPICS-MDS DataSet. A total of 5197 Dutch dyads were included. The average age of the care receivers and caregivers was respectively 80.7 years and 63.2 years. Several sociodemographic, health-related and caregiving-related characteristics of care receiver and caregiver and two caregiver outcomes (i.e., subjective burden and care-related quality of life) were included in the analyses. Results: Caregivers in both settings experienced comparable levels of subjective burden. Caregivers at home had slightly lower care-related quality of life than caregivers in ILTC. Several care receiver characteristics (i.e., male sex, married/cohabiting, more morbidities/disability, and less self-perceived health/psychological wellbeing) and several caregiver characteristics (i.e., female sex, being younger, living together with the care receiver, more objective burden, less self-perceived health, and more support) were associated with an increase in burden and/or a decrease in care-related quality of life. Some of these associations were stronger for dyads at home compared to dyads in ILTC. Conclusions: Informal caregiving does not stop with admission to an ILTC facility. Both settings need an informal caregiving policy, which is (1) tailored to the individual characteristics of care receivers and caregivers; (2) pays attention to the identified risk groups; and (3) reduces the negative caregiver outcomes and emphasizes the positive outcomes at the same time