Weidegang in Nederland anno 2008 : Eindmeting Koe & Wij

Het project Koe & Wij werkt aan een sectorbrede bewustwording van het belang van weidegang en enthousiasmeert melkveehouders voor weidegang door het bieden van technische en economische oplossingen voor knelpunten bij weidegang. Het effect van het project Koe & Wij is gemonitord middels een nulmeting bij de start en een eindmeting na afloop. Doel van deze eindmeting is: de verandering (voorjaar 2008 ten opzichte van zomer 2006) van bewustzijn, houding en gedrag van melkveehouders ten aanzien van weidegang vast te leggen; inzicht in de (spreiding van) persoonlijke waarden van melkveehouders; inzicht krijgen in de resultaten van het project Koe & Wij voor een beoordeling van de effectiviteit van het project; ideeën en suggesties voor de invulling van een eventueel vervolgproject. Dit is de rapportage van de eindmeting welke CLM Onderzoek en Advies in het kader van het project Koe & Wij heeft uitgevoerd. Deze eindmeting is uitgevoerd middels een telefonische enquête onder een representatieve groep van 600 melkveehouders verdeeld over het gehele lan

Waardering weidegang : en wat drijft jou?

Op basis van de nulmeting van het project Koe & Wij was al geconcludeerd dat de factor ‘persoonlijke waarden’ een zeer belangrijke rol speelt in de afweging om de koeien al dan niet te weiden. Uit het huidige onderzoek blijkt dat ‘persoonlijke waarden’ een rol spelen bij alle drie de andere afwegingen uit het afwegingskader van Koe & Wij: ‘arbeid’, ‘economie’ en ‘maatschappelijke waarden’. We kunnen op basis van dit onderzoek vier ‘typen’ ondernemers onderscheiden: de zakelijke ondernemer; de genietende ondernemer; de traditionele ondernemer; de overtuigde ondernemer. Elke type ondernemer laat andere waarden meewegen in het maken van de keuze voor weidegang of opstallen

Salpingitis. A rare cause of acute abdomen in a sexually inactive girl: a case report

Salpingitis is an acute inflammation of the fallopian tubes, most commonly caused by sexually transmitted micro-organisms in adolescent and adult women. It is rarely found in sexually inactive girls and generally the result of a blood-borne or genitourinary infection. In young girls without a history of consensual sexual contact, the possibility of sexual abuse should be considered

Microwave Irradiation Effects on Random Telegraph Signal in a MOSFET

We report on the change of the characteristic times of the random telegraph signal (RTS) in a MOSFET operated under microwave irradiation up to 40 GHz as the microwave field power is raised. The effect is explained by considering the time dependency of the transition probabilities due to a harmonic voltage generated by the microwave field that couples with the wires connecting the MOSFET. From the dc current excited into the MOSFET by the microwave field we determine the corresponding equivalent drain voltage. The RTS experimental data are in agreement with the prediction obtained with the model, making use of the voltage data measured with the independent dc microwave induced current. We conclude that when operating a MOSFET under microwave irradiation, as in single spin resonance detection, one has to pay attention into the effects related to microwave irradiation dependent RTS changes.Comment: 3 pages, 4 figure

Deliverable 3.2. Capacity building material for the field trials

In Deliverable 3.1 (Deltares, 2019) the theoretical background, research questions, hypotheses (also summarized in Section 2 of this document) and overall method have been described. This deliverable focuses on the workflow in the field trials and provides capacity materials (templates) to carry out the research. The workflow and templates are meant to help to: 1. Select the climate service(s) that will be adapted for the EVOKED project; 2. Identify ‘usability-gap(s)’ between the information given by the climate service(s) and the information needs of the end-user(s); 3. Think about a new, improved information design (i.e. the way in which information is presented – for a more elaborate explanation on the concept we refer to Deliverbale 3.1 (Deltares, 2019) of the selected climate service(s) to help bridge the aforementioned ‘usability-gap’ through the way information is presented to the user of the climate service(s); 4. To test the new information design (as an experiment). Finally, this document aims to create a coherent data management structure by using the same templates for each case study location. This enables both the cross-comparison between the case studies and the overall analysis regarding EVOKED-hypotheses.EU, Horizon Europe European Research Area for Climate Services JPI Climate The Research Council of Norway Federal Ministry of Education and Research (Germany) NWO FORMA

Pervasive refusal syndrome as part of the refusal–withdrawal–regression spectrum: critical review of the literature illustrated by a case report

Pervasive refusal syndrome (PRS) is a rare child psychiatric disorder characterized by pervasive refusal, active/angry resistance to help and social withdrawal leading to an endangered state. Little has been written about PRS. A literature search yielded only 15 relevant articles, all published between 1991 and 2006. This article presents a critical review of the published literature, illustrated by a case report of an 11-year-old girl. PRS most often affects girls (75%). The mean age of the known population is 10.5 years. A premorbid high-achieving, perfectionist, conscientious personality seems to play an important role in the aetiology of PRS, as can a psychiatric history of parents or child and environmental stressors. PRS shows a symptom overlap with many other psychiatric disorders. However, none of the current DSM diagnoses can account for the full range of symptoms seen in PRS, and the active/angry resistance can be considered as the main distinguishing feature. Treatment should be multidisciplinary and characterized by patience, gentle encouragement and tender loving care. Hospitalization, ideally in a child and adolescent psychiatric unit, is almost always required. Although the recovery process is painfully slow (average duration of therapy 12.8 months), most children recover fully (complete recovery in 67% of known cases). In our opinion, it is important to increase knowledge of PRS, not only because of its disabling, potential life-threatening character, but also because there is hope for recovery through suitable treatment. We therefore propose an incorporation of PRS into the DSM and ICD classifications. However, an adaptation of the current diagnostic criteria is needed. We also consider PRS closely related to regression, which is why we introduce a new concept: “the refusal–withdrawal–regression spectrum”

Prehospital risk stratification in patients with chest pain

OBJECTIVES: The History, ECG, Age, Risk Factors and Troponin (HEART) Score is a decision support tool applied by physicians in the emergency department developed to risk stratify low-risk patients presenting with chest pain. We assessed the potential value of this tool in prehospital setting, when applied by emergency medical services (EMS), and derived and validated a tool adapted to the prehospital setting in order to determine if it could assist with decisions regarding conveyance to a hospital. METHODS: In 2017, EMS personnel prospectively determined the HEART Score, including point-of-care (POC) troponin measurements, in patients presenting with chest pain, in the north of the Netherlands. The primary endpoint was a major adverse cardiac event (MACE), consisting of acute myocardial infarction or death, within 3 days. The components of the HEART Score were evaluated for their discriminatory value, cut-offs were calibrated for the prehospital setting and sex was substituted for cardiac risk factors to develop a prehospital HEART (preHEART) Score. This score was validated in an independent prospective cohort of 435 patients in 2018. RESULTS: Among 1208 patients prospectively recruited in the first cohort, 123 patients (10.2%) developed a MACE. The HEART Score had a negative predictive value (NPV) of 98.4% (96.4-99.3), a positive predictive value (PPV) of 35.5% (31.8-39.3) and an area under the receiver operating characteristic curve (AUC) of 0.81 (0.78-0.85). The preHEART Score had an NPV of 99.3% (98.1-99.8), a PPV of 49.4% (42.0-56.9) and an AUC of 0.85 (0.82-0.88), outperforming the HEART Score or POC troponin measurements on their own. Similar results were found in a validation cohort. CONCLUSIONS: The HEART Score can be used in the prehospital setting to assist with conveyance decisions and choice of hospitals; however, the preHEART Score outperforms both the HEART Score and single POC troponin measurements when applied by EMS personnel in the prehospital setting

Furnace for in situ and simultaneous studies of nano-precipitates and phase transformations in steels by SANS and neutron diffraction

Interphase precipitation occurring during solid-state phase transformations in micro-alloyed steels is generally studied through transmission electron microscopy, atom probe tomography, and ex situ measurements of Small-Angle Neutron Scattering (SANS). The advantage of SANS over the other two characterization techniques is that SANS allows for the quantitative determination of size distribution, volume fraction, and number density of a statistically significant number of precipitates within the resulting matrix at room temperature. However, the performance of ex situ SANS measurements alone does not provide information regarding the probable correlation between interphase precipitation and phase transformations. This limitation makes it necessary to perform in situ and simultaneous studies on precipitation and phase transformations in order to gain an in-depth understanding of the nucleation and growth of precipitates in relation to the evolution of austenite decomposition at high temperatures. A furnace is, thus, designed and developed for such in situ studies in which SANS measurements can be simultaneously performed with neutron diffraction measurements during the application of high-temperature thermal treatments. The furnace is capable of carrying out thermal treatments involving fast heating and cooling as well as high operation temperatures (up to 1200 °C) for a long period of time with accurate temperature control in a protective atmosphere and in a magnetic field of up to 1.5 T. The characteristics of this furnace give the possibility of developing new research studies for better insight of the relationship between phase transformations and precipitation kinetics in steels and also in other types of materials containing nano-scale microstructural features.This work was financially supported equally by the Technology Foundation TTW, as part of the Netherlands Organization for Scientific Research (NWO), and Tata Steel Europe through the Grant No. 14307 under the Project No. S41.5.14548 in the framework of the Materials Innovation Institute (M2i) Partnership Program. The experiments performed at ISIS Neutron and Muon Source were supported by beam-time allocation from the Netherlands Organization for Scientific Research (NWO) through Project No. 721.012.102 (LARMOR) with Experiment No. RB1869024

Presentation and Outcome of Tuberculous Meningitis in a High HIV Prevalence Setting

Mycobacterium tuberculosis is a common, devastating cause of meningitis in HIV-infected persons. Due to international rollout programs, access to antiretroviral therapy (ART) is increasing globally. Starting patients with HIV-associated tuberculous meningitis (TBM) on ART during tuberculosis (TB) treatment may increase survival in these patients. We undertook this study to describe causes of meningitis at a secondary-level hospital in a high HIV/TB co-infection setting and to determine predictors of mortality in patients with TBM.A retrospective review of cerebrospinal fluid findings and clinical records over a six-month period (March 2009-August 2009). Definite, probable and possible TBM were diagnosed according to published case definitions.TBM was diagnosed in 120/211 patients (57%) with meningitis. In 106 HIV-infected patients with TBM, six-month all-cause mortality was lower in those who received antiretroviral therapy (ART) during TB treatment; hazard ratio = 0.30 (95% CI = 0.08-0.82). Factors associated with inpatient mortality in HIV-infected patients were 1) low CD4(+) count at presentation; adjusted odds ratio (AOR) = 1.4 (95% confidence interval [CI] = 1.03-1.96) per 50 cells/µL drop in CD4(+) count and, 2) higher British Medical Research Council TBM disease grade (2 or 3 versus 1); AOR = 4.8 (95% CI = 1.45-15.87).Starting ART prior to or during TB treatment may be associated with lower mortality in patients with HIV-associated TBM. Advanced HIV and worse stage of TBM disease predict in-hospital mortality in patients presenting with TBM