Het personeelsbestand van hoveniers- en groenvoorzieningsbedrijven

Dit rapport betreft het personeelsbestand van hoveniers- en groenvoorzieningsbedrijven

Taking Morbidity and Mortality Conferences to a Next Level: The Resilience Engineering Concept

Objective: To explore possibilities to improve morbidity and mortalityconferences using advancing insights in safety science.Summary background data: Mortality and Morbidity conferences (M&M)are the golden practice for case-based learning. While learning from complicationsis useful, M&M does not meet expectations for system-wideimprovement. Resilience engineering principles may be used to improveM&M.Methods: After a review of the shortcomings of traditional M&M, resilienceengineering principles are explored as a new way to evaluate performance.This led to the development of a new M&M format that also reviewssuccessful outcomes, rather than only complications. This ‘‘quality assessmentmeeting’’ (QAM) is presented and the first experiences are evaluatedusing local observations and a survey.Results: During the QAM teams evaluate all discharged patients, addressingteam resilience in terms of surgeons’ ability to respond to irregularities and tomonitor and learn from experiences. The meeting was feasible to implementand well received by the surgical team. Observations reveal that reflection onboth complicated and uncomplicated cases strengthened team morale but alsotriggered reflection on the entire clinical course. The QAM serves as a tool toidentify how adapting behavior led to success despite challenging conditions,so that this resilient performance can be supported.Conclusions: The resilience engineering concept can be used to adjustM&M, in which learning is focused not only on complications but also onhow successful outcomes were achieved despite ever-present challenges. Thisreveals the actual ratio between successful and unsuccessful outcomes,allowing to learn from both to reinforce safety-enhancing behavior.Gynecolog

“Зізнання авантюриста Фелікса Крулля” Томаса Манна як пародія на велику автобіографію

Статтю присвячено розгляду рецепції та відображення “Поезії і правди” Й.-В. Гете в романі Т. Манна “Зізнання авантюриста Фелікса Крулля”. Представлена розвідка продовжує ряд наукових досліджень, присвячених вивченню особливостей рецепції автобіографії Й.-В. Гете, зокрема в німецькомовному літературному просторі. При дослідженні особливостей наявного в аналізованому нами романі пародійного наслідування Й.-В. Гете основна увага зосереджується автором на його стилістичному та тематичному рівнях.Статья посвящена рассмотрению рецепции и отражения “Поэзии и правды” Й.-В. Гете в романе Т. Манна “Признания авантюриста Феликса Крулля”. Представленная статья продолжает ряд научных исследований, посвященных изучению особенностей рецепции автобиографии Й.-В. Гете в частности в немецкоязычном литературном пространстве. При изучении особенностей имеющихся в анализированном нами романе пародийного подражания Й.-В. Гете основное внимание автор сосредотачивает на его стилистическом и тематическом уровнях.The article focuses on the reception of Goethe’s “Poetry and Truth” and its reflection in T. Mann’s novel “The Confession of adventurer Felix Crool”. The given article extends the series of scientific investigations that deal with the peculiarities of Goethe’s reception in German literature. Studying the parody imitation peculiarities of Goethe in the analysed novel, the main attention is paid to the stylistic and theme levels

Occurrence of yeast bloodstream infections between 1987 and 1995 in five Dutch university hospitals

The aim of this study was to identify retrospectively trends in fungal bloodstream infections in The Netherlands in the period from 1987 to 1995. Results of over 395,000 blood cultures from five Dutch university hospitals were evaluated. Overall, there were more than 12 million patient days of care during the nine-year study period. The rate of candidemia doubled in the study period, reaching an incidence of 0.71 episodes per 10,000 patient days in 1995. The general increase in candidemia was paralleled by an increase in non-Candida albicans bloodstream infections, mainly due toCandida glabrata. However, more than 60% of the infections were caused byCandida albicans. Fluconazoleresistant species such asCandida krusei did not emerge during the study period. The increasing rate of candidemia found in Dutch university hospitals is similar to the trend observed in the USA, but the rate is lower and the increase is less pronounced

Improved diagnosis of Trichomonas vaginalis infection by PCR using vaginal swabs and urine specimens compared to diagnosis by wet mount microscopy, culture, and fluorescent staining

Four vaginal cotton swab specimens were obtained from each of 804 women visiting the outpatient sexually transmitted disease clinic of the Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands, for validation of various forms of Trichomonas vaginalis diagnostic procedures. One swab specimen was immediately examined by wet mount microscopy, a second swab was placed in Kupferberg's Trichosel medium for cultivation, and two swabs were placed in phosphate-buffered saline (PBS), pH 7.2. The resulting PBS suspension was used for direct staining with acridine orange and fluorescence microscopy, inoculation of modified Diamond's culture medium, and a PCR specific for T. vaginalis. A total of 70 samples positive in one or more of the tests were identified: 31 (3.8%) infections were detected by wet mount microscopy, and 36 (4.4%) were

Transportomics: screening for substrates of ABC transporters in body fluids using vesicular transport assays

The ATP-binding cassette (ABC) genes encode the largest family of transmembrane proteins. ABC transporters translocate a wide variety of substrates across membranes, but their physiological function is often incompletely understood. We describe a new method to study the substrate spectrum of ABC transporters: We incubate extracts of mouse urine with membrane vesicles prepared from Spodoptera frugiperda Sf9 insect cells overproducing an ABC transporter and determine the compounds transported into the vesicles by LC/MS-based metabolomics. We illustrate the power of this simple “transportomics” approach using ABCC2, a protein present at sites of uptake and elimination. We identified many new substrates of ABCC2 in urine. These included glucuronides of plant-derived xenobiotics, a class of compounds to which humans are exposed on a daily basis. Moreover, we show that the excretion of these compounds in vivo depends on ABCC2: compared to wild-type mice, the urinary excretion of several glucuronides was increased up to 20-fold in Abcc2-/- mice. Transportomics has broad applicability, as it is not restricted to urine and can be applied to other ATP-dependent transport proteins as well.—Krumpochova, P., Sapthu, S., Brouwers, J. F., de Haas, M., de Vos, R., Borst, P., van de Wetering, K. Transportomics: screening for substrates of ABC transporters in body fluids using vesicular transport assay

Discourse Semantics for the Analysis of Change in Language

This paper purports to elaborate and address several issues which lie at the intersection of computational linguistics and psychology. The first issue addressed is that of the interaction between discourse and semantics by virtue of empirical linguistic and psychotherapeutic evidence. This paper then gives a formal account of the knowledge representation and reasoning processes involved in the construction of an XML knowledge base for use in the sematic analysis of psychotherapeutic transcripts. Computational methods for the automatic mark-up and inference of the psychotherapeutic phenomena under investigation are detailed in order to further develop intuitions behind a particular pragmatic theory of language known as the Metamodel. The work presented here ultimately aims to produce a sustainable system for the evaluation of the effectiveness of any given psychotherapeutic technique. The possibility exists for such a system to recognise successful therapeutic mechanisms and further still, to infer new ones, or suggest improvements, or offer novel explanations as to the success or failure of the therapy itself. The work discussed here stems from research in computational linguistics, psychotherapy, and philosophy. The corpus used is a culmination of client transcripts taken before, during, and after therapy. The particular therapeutic technique used here is known as the Metamodel (Bandler and Grinder, 1975). The Metamodel was originally proffered as a method of language analysis suitable for use by practitioners of any psychotherapeutic technique. It theorises that speech utterances are related to a clients deep structure through three primary mechanisms, namely generalisation, deletion, and distortion. Previous hand tagging of our data has proven support for such claims. It is our aim to automate the identification and reasoning process. The issues and processes involved in the automation of such tagging are discussed here. Architectural and philosophical issues relating syntax (or grammar), semantics (Larson and Segal, 1995), and pragmatics (Grice, 1989; Searle, 1969) are raised. Discourse Representation Theory (Kamp, 1981; Asher and Lascarides, 1995) is discussed and used here in order to infer discourse relations.Hosted by the Scholarly Text and Imaging Service (SETIS), the University of Sydney Library, and the Research Institute for Humanities and Social Sciences (RIHSS), the University of Sydney

Physical activity in wheelchair-using youth with spina bifida: an observational study

Background: Even though typically developing youth are already at risk for physical inactivity, youth with spina bifida may be even at higher risk as a consequence of their reduced mobility. No objective data is available for youth with spina bifida who use a manual wheelchair, so the seriousness of the problem is unknown. The purpose of this observational study was to quantify physical activity in wheelchair-using youth with spina bifida and evaluate the intensity of activities. Methods: Fifty-three children and adolescents (5–19 years) with spina bifida who use a manual wheelchair for daily life, long distances or sports were included. To assess time spent in several types of activities VitaMove data of 34 participants were used and were presented as time spent sedentary and time spent physically active. This was compared to reference data of typically developing youth. To assess time spent in several intensities Actiheart data of 36 participants were used. The intensities were categorized according to the American College of Sports Medicine, ranging from very light intensity to near to maximal intensity. Data of 25 participants were used to combine type of activity and intensity. Results: Children and adolescents with spina bifida who use a manual wheelchair were more sedentary (94.3% versus 78.0% per 24 h, p < 0.000) and less physically active (5.0% versus 12.2% per 24 h, p < 0.000) compared to typically developing peers. Physical activity during weekend days was worse compared to school days; 19% met the Guidelines of Physical Activity during school days and 8% during weekend days. The intensities per activity varied extensively between participants. Conclusions: Children and adolescents with spina bifida who use a manual wheelchair are less physically active and more sedentary than typically developing youth. The physical activity levels on school days seem to be more favorable than the physical activity levels on a weekend day. The low levels of physical activity need our attention in pediatric rehabilitation practice. The different intensities during activities indicate the importance of individually tailored assessments and interventions