Rafflesia. La plus grande fleur du monde, menacée d'extinction

Attention is called to the recent destruction of a number of rainforest localities where Rafflesia arnoldii and other species of Rafflesiaceae were formerly observed. The nature reserves of South-East Asia where Rafflesiaceae are still present are listed. A plea is made for a more efficient conservation policy of this unique plant famil

Antibiotic prophylaxis in biliary tract surgery

Even in health, man's environment is one of ubiquitous bacterial presence. As a consequence all wounds are, to a certain extent, contaminated, if only from the normal skin flora. Along with a number of other factors, the development of a wound infection is related to the degree of thls bacterial contamination. Prior to Pasteur's studies on bacteriology and Lister's application of them to wounds most, if not all, wounds became infected. The treatment of established wound infections, however, is beyond the scope of this thesis. Attention will focus on the prevention of wound infections. Lowering the incidence of wound infections can be directed to (l) destroying organisms after they have reached the wonnd, and (2) preventing the arrival or growth of organisms in subcutaneous tissues. The aim of antibiotic prophylaxis is to prevent any bacteria, released into the operative field 2.t the time of surgery, from multiplying.. The use of antibiotics for prophylaxis has only recently been accepted as a useful adjuvant to the established principles of antisepsis in surgery. In cholecystectomy, the problems of operative mortality and serious morbidity have been largely solved. At present, the most common complication of traditional cholecystectomy is wound infection5. The importance of reducing this source of morbidity is obvious. Presented in this thesis is a randomized study designed to assess the efficacy of a preoperative, single-dose prophylaxis of cefuroxime. This introductory chapter of the thesis includes some historical aspects of asepsis, an

Asbestschade buiten de werkomgeving

Met de totstandkoming van de TNS-regeling is de noodzaak van verdere ontwikkeling van niet-loondienst-gerelateerde schade niet vervallen. De overheid zal trachten verhaal te zoeken bij verantwoordelijke partijen. Slachtoffers kunnen ook niet van de regeling gebruik maken. Alleen langs de civielrechtelijke weg is volledige schadevergoeding mogelijk

Postoperative mortality after cancer surgery in octogenarians and nonagenarians: results from a series of 5,390 patients

BACKGROUND: To support decisions about surgical treatment of elderly patients with cancer, population-based estimates of postoperative mortality (POM) rates are required. METHODS: Electronic records from the Rotterdam Cancer Registry were retrieved for octogenarians and nonagenarians who underwent resection in the period 1987–2000. POM was defined as death within 30 days of resection and both elective and emergency operations were included. RESULTS: In a series of 5.390 operated patients aged 80 years and older, POM rates were 0.5% for breast cancer, 1.7% for endometrial cancer and 4.2% for renal cancer. For patients with colorectal cancer, POM increased from 8% for the age group 80–84 to 13% for those 85–89 to 20% in nonagenarians. For stomach cancer, the respective figures were 11%, 20% and 44%. CONCLUSION: These results show that resections can be performed at acceptable risk in selected elderly patients with cancer

Unfolding collaborative learning assessment literacy:A reflection on current assessment methods in higher education

Over the past two decades, curricula in higher education have increasingly incorporated collaborative learning. However, due to (a) large variations in students’ domain-specific abilities (e.g. knowledge and/or skills) and the effort they invest into the collaboration and (b) teachers’ limited knowledge about how to assess collaborative learning, two main challenges arise. The first challenge concerns ensuring construct validity of the assessment methods, that is, whether an assessment accurately measures students’ domain-specific abilities. The second challenge originates from the potential of assessment methods to elicit student behaviour that is misaligned with the objectives of collaborative learning (e.g. free-riding behaviour). This paper aims to enhance teachers’, researchers’, and students’ awareness for and need to develop what we refer to as ‘collaborative learning assessment literacy’. In particular, we will discuss the two challenges in relation to three frequently used and discussed methods for assessing collaborative learning - group assessment, individual assessment, and group assessment combined with intra-group peer assessment - with specific attention to the purpose of assessment (i.e. formative and summative). Implications of the two challenges as well as their relation to other core components in the design of any collaborative learning setting (e.g. group constellation) will be discussed

Computerized screening for cognitive impairment in patients with COPD

Purpose:  COPD is associated with cognitive impairment. These impairments should be diagnosed, but due to time- and budget-reasons, they are often not investigated. The aim of this study is to examine the viability of a brief computerized cognitive test battery, Central Nervous System Vital Signs (CNSVS), in COPD patients. Patients and methods:  Patients with COPD referred to tertiary pulmonary rehabilitation were included. Cognitive functioning of patients was assessed with CNSVS before pulmonary rehabilitation and compared with age-corrected CNSVS norms. CNSVS is a 30 minute computerized test battery that includes tests of verbal and visual memory, psychomotor speed, processing speed, cognitive flexibility, complex attention, executive functioning, and reaction time. Results:  CNSVS was fully completed by 205 (93.2%, 105 females, 100 males) of the total group of patients (n=220, 116 females, 104 males). Z-tests showed that COPD patients performed significantly worse than the norms on all CNSVS cognitive domains. Slightly more than half of the patients (51.8%) had impaired functioning on 1 or more cognitive domains. Patients without computer experience performed significantly worse on CNSVS than patients using the computer frequently. Conclusion:  The completion rate of CNSVS was high and cognitive dysfunctions measured with this screening were similar to the results found in prior research, including paper and pen cognitive tests. These results support the viability of this brief computerized cognitive screening in COPD patients, that may lead to better care for these patients. Cognitive performance of patients with little computer experience should be interpreted carefully. Future research on this issue is needed