Visual complaints in people with multiple sclerosis:looking beyond the optic system

The aim of this study was to provide insight in the prevalence and nature of visual complaints reported by people with multiple sclerosis (MS), to provide a better understanding of the complaints and to make first steps to improve rehabilitation care. A questionnaire (Screening Visual Complaints, SVCq) was developed and used to investigate the prevalence of visual complaints. The SVCq showed to be a valid and reliable tool to quickly screen for visual complaints and can be used in clinical practice to support referrals and further steps in clinical care. The prevalence study showed that up to 90% of people with MS report visual complaints. Frequently reported complaints were needing more time or light, being blinded by bright light and difficulties adjusting to light or dark. Examples of other complaints are double vision, difficulties with depth perception, decreased contrast sensitivity, experiencing shaky images and changes in the visual field. Almost all complaints included in the questionnaire were more frequently reported by people with MS than by people without MS or other severe conditions. The study could not show that reported visual complaints are one-to-one related to decline in visual, visuoperceptual and cognitive functions. These functions therefore may not help us understand the complaints. A diffuse decline of a vision network (comprising of the optic system and other cerebral regions) may contribute the development of visual complaints. Referrals and rehabilitation should not solely rely on measured functional decline or impairment, but an individual’s complaints and experiences should be taken into account

A window for reversibility in pulmonary arterial hypertension

Pulmonary arterial hypertension (PAH) is a rare, chronic lung disease. In patients with PAH, arteries in the lung progressively occlude and cause high pulmonary blood pressure. PAH is a fatal condition that can already present in childhood, for example in children born with a heart defect. Luckily, early diagnosis and correction of the heart defect can completely reverse PAH. But if the surgery is performed too late, the disease has lost its reversibility, the high pulmonary blood pressure will increase and cause heart failure at a young age.It is unknown why PAH loses its reversibility beyond this point of no return, and no treatment is currently available to cure irreversible PAH. In his research, Diederik van der Feen showed that arteries of rats with irreversible PAH contain high numbers of so-called senescent cells: cells that have gone into rapid-ageing and lost their normal function. These cells cannot be cleared, because they are resistant to normal programmed cell death. Accumulation of senescent cells leads to the occlusion and stiffening of the arteries, because these cells continuously excrete inflammatory factors.This research has led to two new experimental treatments, that target the disease process of PAH at different levels. Both drugs were able to reverse the occlusion of the lung vessels and could thus prevent heart failure in rats with irreversible PAH. One of these drugs is currently being tested in a clinical trial in patients with PAH

Piloting Oiconomy Pricing : First experiences of producers applying full cost sustainability assessment of products

The Oiconomy Pricing approach provides an innovative way of measuring and communicating (un)sustainability of products. It expresses (un)sustainability in a virtual monetary unit, the ‘Eco Social Cost Unit’ (ESCU). As closely as possible, the ESCU score of a product equals the externalities, which can also be described as hidden preventative costs. In the context of product sustainability assessment, these are the costs that need to be spent to avoid any damage to the environment or society that the product causes during its entire lifecycle. This paper presents the result of a pilot project with three companies operating in global value chains, applying the Oiconomy Sustainability Assessment Tool. The project encouraged end-producer companies and their value chain partners to calculate the hidden preventative costs and jointly implement sustainable solutions. This article presents the results of these calculations for the three cases, the experiences of the companies and the implications for the market introduction of the tool

Does hand skill asymmetry relate to creativity, developmental and health issues and aggression as markers of fitness?

A remarkable feature of human handedness at the population level is specialization of the hands, the right hand performing usually better than the left. This specialization might have an evolutionary advantage, because it provides the individual and population with a wider range of skill. We therefore investigated the relationships between hand skill asymmetry and potential markers of Darwinian fitness that have been hypothesized to explain the bias in hand preference: creativity, aggression and developmental and health problems. Over twenty thousand participants (56% left-handers) completed an online survey, including a finger-tapping task to measure hand skill asymmetry. Left-skilled individuals were overall more aggressive than right-skilled individuals and rated themselves as more artistically creative. However, when assessed with a questionnaire, they were less creative on problem solving and equally artistically creative compared to right-skilled individuals, who reported more health problems. Conclusion: we found some evidence for current selection on the direction of lateralization of hand skill although the effect sizes were rather low. Strength of lateralization of hand skill showed only a few associations with fitness proxies. We suggest that Darwinian selection on hand preference (Zickert, Feen, van der, Geuze, & Groothuis, 2018. Fitness costs and benefits associated with hand preference in humans: A large internet study in a Dutch sample. Evolution and Human Behavior, 39, 235-248) and hand skill asymmetry (present study) may be attenuated in modern society

Independent outdoor mobility of persons with multiple sclerosis – A systematic review

Background: Multiple sclerosis (MS) can manifest itself in many ways, all of which can affect the independent outdoor mobility of persons with MS (pwMS). In most studies, mobility of pwMS is defined by the ability to walk. However, mobility comprises more than walking alone. This systematic review provides an overview of the literature on several types of independent outdoor mobility of pwMS. We aimed to identify which specific factors may influence outdoor mobility and how the lives of pwMS may be affected by a reduced mobility. Methods: A systematic literature search was performed, using three databases (PubMed, PsychInfo and Web of Science). Studies had to describe a group of pwMS sclerosis and had to concern some type of mobility other than walking. Results: The 57 studies that fulfilled the criteria included in total 10,394 pwMS and in addition, 95,300 pwMS in separate prevalence study. These studies showed that pwMS as a group have a decreased fitness to drive, make use of a wheelchair or mobility scooter more often and have difficulties making use of public transport. Mobility problems especially occur in patients with cognitive problems, secondary progressive MS or high disability scores. Conclusions: The reduced mobility may prevent pwMS participating in society. However, few studies investigating interventions or rehabilitation options to improve mobility were found in the existing literature, highlighting an until now under recognised unmet need