Efficacy of Antidepressant Treatment for Inpatients with Severe Depression

The main aim of this thesis was to evaluate the efficacy of three phases of a treatment algorithm of inpatients with severe depression: phase I optimal antidepressant monotherapy (plasma level targeted dose imipramine or high-dose (375 mg/day) venlafaxine); phase II subsequent lithium addition in case of insufficient improvement of antidepressant monotherapy; phase Ill subsequent ECT in case of insufficient improvement of antidepressant-lithium treatment. Additionally, this thesis aims to further investigate predictors of antidepressant treatment response, i.e. early drug response, gender and menopausal status

Prevalence of Subclinical Psychotic Symptoms in a Normal Nigerian Population, and the Association with Stress and Gender

Clinical and subclinical psychotic symptoms differ quantitatively and lie on a continuum between normality and pathology. This is general supported and is based on prevalence and similarities between symptoms and risk factors, including stress. The vulnerability-stress model assumes that depending on an individual vulnerability threshold and the intensity of evoked stress, psychotic symptoms either regulate themselves or lead to a psychotic episode. There are gender differences in onset and manifestations of the symptoms. The present study is a quantitative assessment of positive, negative and depressive subclinical psychotic symptoms and the association with stress and gender on these symptoms, in a Nigerian population. The study is a replication of a Dutch survey among 829 psychology students, and provides the opportunity to compare psychotic symptoms in both cultures

Voltooiing van de eerste rijpingsdeling in de eicel van de rat

De vorming van voortplantingscellen vindt bij meercellige organismen meestal in speciaal daartoe ingerichte organen, gonaden, plaats. Voortplantingscellen ontstaan bij vrouwelijke zoogdieren uitsluitend in de embryonalepostnatale periode. Na deze periode bevat de vrouwelijke zoogdiergonade een groot aantal rustende voortplantingscellen waarvan er voortdurend een aantal door nog onbekende oorzaak met de ontwikkeling tot bevruchtbare, rijpe eicel begint. De rijpe eicel kan na bevruchting aanleiding geven tot een embryonale ontwikkeling, hetwelk uiteindelijk kan resulteren in een nieuw volwassen individu, dat op zijn beurt weer voortplantingscellen kan vormen. Het vermogen een embryonale ontwikkeling aan te vangen is het resultaat van een gecompliceerd ontwikkelingsproces, waarvan een gedeelte in dit proefschrift nader bekeken wordt. De rustende voortplantingscel wordt omgeven door een dunne laag cellen die tijdens de ontwikkeling tot rijpe eicel uitgroeit tot een blazige met vloeistof gevulde follikel. Na het laatste differentiatieproces, de voltooiing van de eerste rijpingsdeling, komt de eicel vrij. De follikel springt en de rijpe eicel komt buiten de gonade terecht waar bevruchting en embryonale ontwikkeling plaats kunnen vinden

Demand response of medical freezers in a Business Park Microgrid

This paper presents a demand response (DR) framework that utilizes the flexibility inherent to the thermodynamic behavior of four groups of independently-controlled medical freezers in a privately-owned business park microgrid that contains rooftop photovoltaics (PV). The optimization objectives may be chosen from the following 3 options: minimizing electricity exchanges with the public grid; minimizing costs by considering prices and RES availability; and minimizing peak load. The proposed DR framework combines thermodynamic models with automated, genetic-algorithm-based optimization, resulting in demonstrable benefits in terms of cost, energy efficiency, and peak power reduction for the consumer, local energy producer, and grid operator. The resulting optimal DR schedules of the freezers are compared against unoptimized, business-as-usual scenarios with- and without PV. Results show that flexibility can be harnessed from the thermal mass of the freezers and their contents, improving the cost- and energy performance of the system with respect to the business-as-usual scenarios.</p

Value of urinary N-methylhistamine measurements m childhood mastocytosis

Background: Histamine is an indicator of mast cell activation. N- methylhistamine (NMH) is a metabolite of histamine that can be measured in urine. Objective: Our purpose was to assess the usefulness of determining urinary NMH levels for the diagnosis and follow-up of patients with mastocytosis. Methods: Urinary NMH levels were determined in 44 patients and were correlated with disease activity and extension. The control group consisted of 24 children without mastocytosis or any other skin disease. Results: A significant negative correlation was found between NMH and age in patients with active mastocytosis and in the control group. Adjusted for age, NMH values were significantly higher in patients with active mastocytosis. There was a significant difference in NMH values between patients with diffuse cutaneous mastocytosis, patients with active urticaria pigmentosa, and patients with active mastocytomas. However, there was a substantial overlap of NMH values in the different subgroups. Conclusion: Urinary NMH values tend to decrease with age. Urinary NMH values correlated with the extent and the activity of the disease. High NMH values suggest more extensive involvement

Facilitators for maternity waiting home utilisation at Attat Hospital:a mixed-methods study based on 45 years of experience

Objective To describe facilitators for maternity waiting home (MWH) utilisation from the perspectives of MWH users and health staff.Methods Data collection took place over several time frames between March 2014 and January 2018 at Attat Hospital in Ethiopia, using a mixed-methods design. This included seven in-depth interviews with staff and users, three focus group discussions with 28 users and attendants, a structured questionnaire among 244 users, a 2-week observation period and review of annual facility reports. The MWH was built in 1973; consistent records were kept from 1987. Data analysis was done through content analysis, descriptive statistics and data triangulation.Results The MWH at Attat Hospital has become a well-established intervention for high-risk pregnant women (1987-2017: from 142 users of 777 total attended births [18.3%] to 571 of 3693 [15.5%]; range 142-832 users). From 2008, utilisation stabilised at on average 662 women annually. Between 2014 and 2017, total attended births doubled following government promotion of facility births; MWH utilisation stayed approximately the same. Perceived high quality of care at the health facility was expressed by users to be an important reason for MWH utilisation (114 of 128 MWH users who had previous experience with maternity services at Attat Hospital rated overall services as good). A strong community public health programme and continuous provision of comprehensive emergency obstetric and neonatal care (EmONC) seemed to have contributed to realising community support for the MWH. The qualitative data also revealed that awareness of pregnancy-related complications and supportive husbands (203 of 244 supported the MWH stay financially) were key facilitators. Barriers to utilisation existed (no cooking utensils at the MWH [198/244]; attendant being away from work [190/244]), but users considered these necessary to overcome for the perceived benefit: a healthy mother and baby.Conclusions Facilitators for MWH utilisation according to users and staff were perceived high-quality EmONC, integrated health services, awareness of pregnancy-related complications and the husband's support in overcoming barriers. If providing high-quality EmONC and integrating health services are prioritised, MWHs have the potential to become an accepted intervention in (rural) communities. Only then can MWHs improve access to EmONC.</p