Verzwegen onderneming : ondernemers, overhead en het einde van het bouwkartel (2001-2005)

Leiden UniversityPolitieke Instituties: Ontwerp, functioneren, effecte

Sarcopenic obesity is associated with adverse clinical outcome after cardiac surgery

Both undernutrition - low fat free mass (FFM) - and obesity - high fat mass (FM) - have been associated with adverse outcome in cardiac surgical patients. However, whether there is an additional effect on outcome of these risk factors present at the same time, that is sarcopenic obesity (SO), is unknown. Furthermore, the association between SO and muscle function is unidentified. In 325 cardiac surgical patients, we prospectively analysed the association between preoperative FFM and FM, measured by bioelectrical impedance spectroscopy, and postoperative adverse outcomes, and their correlation with muscle function - handgrip strength (HGS). SO was associated with postoperative infections (28.2% vs. 5.3%, adj. odds ratio (OR): 7.9; 95% confidence interval (CI): 1.2-54.1; p=0.04). Further, a low FFM index (FFMI; kgm(-2)) was associated with postoperative infections (18.5% vs. 4.7%, adj. OR: 6.6; 95% CI: 1.7-25.2; p=0.01) while a high FM index (FMI; kgm(-2)) was not. Both components of SO, FFMI and FMI, correlated with HGS (FFMI: r=0.570; p <0.001, FMI: r=-0.263; p <0.001). SO is associated with an increased occurrence of adverse outcome after cardiac surgery. Our results suggest an additional risk of a low FFMI and high FMI present at the same time. Furthermore, SO is characterised by less muscle function. We advocate determining body composition in cardiac surgical patients to classify and treat undernourished patients, in particular those who are also obes

Mechanisms of interest sustainment

Sustaining an interest leads to a wealth of positive outcomes for adolescents. Whereas previous research has often attributed interest sustainment to deliberate reasons of the individual, one may argue that processes related to the daily routines and practices might also play a role in sustainment. The present study aims to provide a detailed and differentiated account of interest sustainment, which may shed light on how interest may be sustained beyond the deliberate goals and needs of the individual. In order to do so, an experience sampling method was applied in which 56 adolescents filled in a smartphone application six times, for a period of two weeks, with intervals of three months, to report all their moment-to-moment experiences of interest. By analyzing the content of these 8281 experiences of interest of 334 sustained interests chronologically, we found six mechanisms of interest sustainment. Two mechanisms were found in which individuals deliberately steered their sustainment, while four mechanisms were identified in which the object and/or practice seemed to play a role in the sustainment. Our findings thereby demonstrate that future studies, in order to understand interest sustainment and development, should look beyond the active role of the individual in sustaining interests

Mechanisms of interest sustainment

Sustaining an interest leads to a wealth of positive outcomes for adolescents. Whereas previous research has often attributed interest sustainment to deliberate reasons of the individual, one may argue that processes related to the daily routines and practices might also play a role in sustainment. The present study aims to provide a detailed and differentiated account of interest sustainment, which may shed light on how interest may be sustained beyond the deliberate goals and needs of the individual. In order to do so, an experience sampling method was applied in which 56 adolescents filled in a smartphone application six times, for a period of two weeks, with intervals of three months, to report all their moment-to-moment experiences of interest. By analyzing the content of these 8281 experiences of interest of 334 sustained interests chronologically, we found six mechanisms of interest sustainment. Two mechanisms were found in which individuals deliberately steered their sustainment, while four mechanisms were identified in which the object and/or practice seemed to play a role in the sustainment. Our findings thereby demonstrate that future studies, in order to understand interest sustainment and development, should look beyond the active role of the individual in sustaining interests