Evaluating positive experiences of very severe dementia patients

We developed a Snoezelen application to promote the wellbeing of people with severe dementia. During a Snoezelen session, patients are provided with positive and pleasurable experiences, through a combination of visual, auditory, olfactory, and haptic stimuli. Because no measure to evaluate appreciation or enjoyment by this target group themselves could be found, a new observation measure was created and compared to existing proxy measures in a visual stimulation study based on the Snoezelen philosophy. This measure contains three domain scales, Attention, Arousal, and Valence; two (Attention and Arousal) were sensitive enough to capture an effect, or at least a trend towards an effect, of stimulus condition. This finding is seen as promising for the further development of these kinds of observational measures for testing designs for and with this target group

Interpretatie en discussie

The Unification of the Mediterranean World (400 BC - 400 AD

Ecologische effecten van metaalverontreiniging in het overstromingsgebied van de Dommel. Triade onderzoek, ecologische risico's en mogelijkheden voor inrichting en beheer

De rivier de Dommel is sterk verontreinigd met cadmium en zink als gevolg van historische activiteiten van de zinkindustrie. Bij overstroming worden deze metalen, gebonden aan organisch stof en kleideeltjes, afgezet op de bodem in het overstromingsgebied. Als gevolg hiervan is ook het overstromingsgebied van de Dommel plaatselijk sterk verontreinigd. De overheid heeft voor een belangrijk deel van het Dommeldal natuurdoelstellingen opgesteld, waaronder het realiseren van de Ecologische Hoofd Structuur. Onduidelijkheid over de invloed van de metaalverontreiniging op de ecologie en natuurontwikkeling heeft geleid tot stagnatie van grondaankopen om deze EHS te kunnen realiseren. Om deze stagnatie op te heffen heeft het projectbureau Actief Bodembeheer de Kempen nader onderzoek laten uitvoeren. Het onderzoek heeft zich gericht op de vraag wat de locatiespecifieke ecologische risico’s zijn van de cadmium- en zinkverontreinigingen bij verschillende natuur(doel)typen die in het Dommeldal aanwezig zijn of ontwikkeld gaan worden. Het betreft hier de natuur(doel)typen die zich in een gebied bevinden dat gemiddeld één of meerdere keren per tien jaar overstroomd wordt. Deze natuur(doel)typen zijn voornamelijk bloemrijk grasland, nat schraalgrasland, moeras en elzenbroekbos. Het onderzoek is stapsgewijs uitgevoerd en wordt TRIADE genoemd vanwege de drie componenten waaruit het is opgebouwd te weten chemie, toxicologie en veldmetinge

Propofol in neonates causes a dose-dependent profound and protracted decrease in blood pressure

Aim: To analyse the effects of different propofol starting doses as premedication for endotracheal intubation on blood pressure in neonates. Methods: Neonates who received propofol starting doses of 1.0 mg/kg (n = 30), 1.5 mg/kg (n = 23) or 2.0 mg/kg (n = 26) as part of a previously published dose-finding study were included in this analysis. Blood pressure in the 3 dosing groups was analysed in the first 60 minutes after start of propofol. Results: Blood pressure declined after the start of propofol in all 3 dosing groups and was not restored 60 minutes after the start of propofol. The decline in b

Study protocol of cost-effectiveness and cost-utility of a biopsychosocial multidisciplinary intervention in the evolution of non-specific sub-acute low back pain in the working population: cluster randomised trial.

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Background: Low back pain (LBP), with high incidence and prevalence rate, is one of the most common reasons to consult the health system and is responsible for a significant amount of sick leave, leading to high health and social costs. The objective of the study is to assess the cost-effectiveness and cost-utility analysis of a multidisciplinary biopsychosocial educational group intervention (MBEGI) of non-specific sub-acute LBP in comparison with the usual care in the working population recruited in primary healthcare centres. Methods/design: The study design is a cost-effectiveness and cost-utility analysis of a MBEGI in comparison with the usual care of non-specific sub-acute LBP.Measures on effectiveness and costs of both interventions will be obtained from a cluster randomised controlled clinical trial carried out in 38 Catalan primary health care centres, enrolling 932 patients between 18 and 65 years old with a diagnosis of non-specific sub-acute LBP. Effectiveness measures are: pharmaceutical treatments, work sick leave (% and duration in days), Roland Morris disability, McGill pain intensity, Fear Avoidance Beliefs (FAB) and Golberg Questionnaires. Utility measures will be calculated from the SF-12. The analysis will be performed from a social perspective. The temporal horizon is at 3 months (change to chronic LBP) and 12 months (evaluate the outcomes at long term. Assessment of outcomes will be blinded and will follow the intention-to-treat principle. Discussion: We hope to demonstrate the cost-effectiveness and cost-utility of MBEGI, see an improvement in the patients' quality of life, achieve a reduction in the duration of episodes and the chronicity of non-specific low back pain, and be able to report a decrease in the social costs. If the intervention is cost-effectiveness and cost-utility, it could be applied to Primary Health Care Centres. Trial registration: ISRCTN: ISRCTN5871969

Chemotactic response and adaptation dynamics in Escherichia coli

Adaptation of the chemotaxis sensory pathway of the bacterium Escherichia coli is integral for detecting chemicals over a wide range of background concentrations, ultimately allowing cells to swim towards sources of attractant and away from repellents. Its biochemical mechanism based on methylation and demethylation of chemoreceptors has long been known. Despite the importance of adaptation for cell memory and behavior, the dynamics of adaptation are difficult to reconcile with current models of precise adaptation. Here, we follow time courses of signaling in response to concentration step changes of attractant using in vivo fluorescence resonance energy transfer measurements. Specifically, we use a condensed representation of adaptation time courses for efficient evaluation of different adaptation models. To quantitatively explain the data, we finally develop a dynamic model for signaling and adaptation based on the attractant flow in the experiment, signaling by cooperative receptor complexes, and multiple layers of feedback regulation for adaptation. We experimentally confirm the predicted effects of changing the enzyme-expression level and bypassing the negative feedback for demethylation. Our data analysis suggests significant imprecision in adaptation for large additions. Furthermore, our model predicts highly regulated, ultrafast adaptation in response to removal of attractant, which may be useful for fast reorientation of the cell and noise reduction in adaptation.Comment: accepted for publication in PLoS Computational Biology; manuscript (19 pages, 5 figures) and supplementary information; added additional clarification on alternative adaptation models in supplementary informatio