Buurttuin! leren van de Jardins Partagés in Frankrijk

Buurtuinen, zijn er in Nederland nog nauwelijks. De publicatie laat zien wat is een buurttuin is en hoe maak je zo'n tuin in de praktijk maakt

Fear of falling in older patients after hip fracture

FoF is possibly one of the most important factors in patients after hip fracture, with a substantial impact on the final results of the rehabilitation process. Moreover, patients with hip fracture who rehabilitate in a SNF with high rates of comorbidity and complications, may have even worse outcomes as a result of FoF. Unfortunately, the role of FoF in the rehabilitation of these older persons has not yet been investigated. The overall aim of the work in this thesis is to study FoF in vulnerable older people with hip fractures who rehabilitate in a SNF. To gain more insight into FoF in older patients with hip fracture, the following research questions are addressed:. 1. What is the prevalence of FoF in older patients with a hip fracture rehabilitating in a SNF? 2. Which factors are related to FoF in older patients with a hip fracture? 3. What is the course of FoF after a hip fracture? 4. Is the FES-I a suitable instrument to measure FoF after a hip fracture? 5. Which interventions reduce FoF after hip fracture? 6. What is the prevalence and what are the consequences of FoF in other patient groups who rehabilitate in a SNF?Zorggroep Solis DeventerUBL - phd migration 201

Immune Checkpoint Inhibitor-related Pancreatitis:A Case Series, Review of the Literature and an Expert Opinion

Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of various malignancies, but are associated with serious adverse events like pancreatitis. Current guidelines are limited to the first step in treating acute ICI-related pancreatitis with steroids but lack treatment advices for steroid dependent pancreatitis. We describe a case series of 3 patients who developed ICI-related pancreatitis with chronic features such as exocrine insufficiency and pancreatic atrophy at imaging. Our first case developed after treatment with pembrolizumab. The pancreatitis responded well after discontinuation of immunotherapy but imaging showed pancreatic atrophy and exocrine pancreatic insufficiency persisted. Cases 2 and 3 developed after treatment with nivolumab. In both, pancreatitis responded well to steroids. However during steroid tapering, pancreatitis recurred and the latter developed exocrine pancreatic insufficiency and pancreatic atrophy at imaging. Our cases demonstrate resemblances with autoimmune pancreatitis based on clinical and imaging findings. In line, both diseases are T-cell mediated and for autoimmune pancreatitis azathioprine is considered as maintenance therapy. Guidelines of other T-cell mediated diseases like ICI-related hepatitis suggest tacrolimus. After adding tacrolimus in case 2 and azathioprine in case 3, steroids could be completely tapered and no new episodes of pancreatitis have occurred. These findings support the idea that the treatment modalities for other T-cell mediated diseases are worthwhile options for steroid dependent ICI-related pancreatitis.</p

De groene metropool; werkbezoek van minister Veerman en bestuurders van de G30 aan Parijs en omgeving, 7, 8 en 9 april 2004

Alterra heeft de minister van LNV samen met een groep bestuurders van de 30 grootste gemeenten in Nederland rondgeleid tijdens een werkbezoek aan opmerkelijke parken en groenstructuren in Parijs en omgeving. Dit rapport is de neerslag van de discussies die naar aanleiding van de geboden inzichten gevoerd zijn over het thema Groen In en Om de stad, van de conclusies die zijn getrokken en van de vervolgafspraken die zijn gemaakt. Het staat vast dat de durf te investeren in groene parels voor de toekomst absoluut zijn vruchten afwerpt

Recreatief gebruik en beleving van Staatsbosbeheerterreinen in de provincie Noord-Brabant

Resultaten van onderzoek naar bezoekersherkomst, bezoekfrequentie, bezoekduur, verrichte activiteiten, voorzieningengebruik en waardering van een aantal bos- en natuurgebieden van Staatsbosbeheer in West-Brabant, uitmondend in een zgn. kwaliteitsscor

Non-classical clinical presentation at diagnosis by male celiac disease patients of older age

BACKGROUND: . In a biopsy-proven adult celiac disease (CeD) cohort from the Netherlands, male patients were diagnosed with CeD at significantly older ages than female patients. OBJECTIVES: To identify which factors contribute to diagnosis later in life and whether diagnostic delay influences improvement of symptoms after starting a gluten-free diet (GFD). METHODS: . We performed a questionnaire study in 211 CeD patients (67:144, male:female) with median age at diagnosis of 41.8 years (interquartile range: 25-58) and at least Marsh 2 histology. RESULTS: . Classical symptoms (diarrhea, fatigue, abdominal pain and/or weight loss) were more frequent in women than men, but sex was not significantly associated with age at diagnosis. In a multivariate analysis, a non-classical presentation (without any classical symptoms) and a negative family history of CeD were significant predictors of older age at diagnosis (coefficients of 8 and 12 years, respectively). A delay of >3 years between first symptom and diagnosis was associated with slower improvement of symptoms after start of GFD, but not with sex, presentation of classical symptoms or age at diagnosis. CONCLUSION: . Non-classical CeD presentation is more prevalent in men and is associated with a diagnosis of CeD later in life. Recognizing CeD sooner after onset of symptoms is important because a long diagnostic delay is associated with a slower improvement of symptoms after starting a GFD