1,046 research outputs found
Contestation in the Anthropocene:Climate change and civil disobedience
Despite the widespread public understanding of the dangers posed by climate change, action taken by political leaders to prevent, or even slow climate change has not been nearly enough to prevent significant planetary warming. It is widely acknowledged that more needs to be done to reduce the emission of greenhouse gasses. The Paris Treaty of 2015 commits all the signatories to try and prevent warming of more than 2 degrees centigrade, with 1,5 degrees of warming set as an aspirational goal. Despite this commitment, adequate political action to deal effectively with climate change has not been forthcoming. In response to this lack of action, some individuals and groups have turned to civil disobedience as a way of trying to bring about the change necessary to deal with climate crisis. This is a relatively new development and differs in important ways from previous issues where civil disobedience played an important part in the struggle for justice. What sets climate justice civil disobedience campaigns apart from previous struggles is its transnational character and its intergenerational concern.Making sense of how cross-border movements engaging in civil disobedience could justify their actions raises a host of interesting and under-theorised conceptual and normative questions. The aim of this dissertation is to investigate some of these questions in the context of liberal democratic states. The central argument put forward in this dissertation is that civil disobedience in democratic states is a morally permissible way for individuals to act together in pursuit of climate justice
The influence of dietary calcium and phosphorus on bone metabolism
By means of this study it was attempted to obtain a better insight into the possible influence of the diet on the development of human osteoporosis. This disease, which is a consequence of decalcification of the bones, occurs frequently in elderly people, particularly in postmenopausal women.On the basis of data from the literature a model was composed describing a mechanism according to which either a low-calcium diet, a high-phosphorus diet or a diet with a low calcium-to-phosphorus ratio (temporarily) decreases the plasma-ionized calcium concentration, so that the parathyroid glands are stimulated to secrete parathyroid hormone (PTH). This hormone acts on bone and kidney in order to restore the plasma-ionized calcium concentration, which may proceed at the expense of skeletal calcium, so that osteoporosis develops. The model explains why the dietary stimulation of PTH secretion occurs especially when the renal function has decreased and/or when a suboptimal vitamin D status is prevalent. In an observational cross-sectional study in elderly people and in three experimental studies with three month old male rats, the influence of dietary calcium and phosphorus on bone metabolism was investigated.The cross-sectional study was carried out among 89 healthy eldery people (53 women and 36 men), whose age ranged from 57 to 89 years (mean: 70 years). It was investigated whether relationships could be demonstrated which fitted in the proposed model. For this purpose the calcium and phosphorus intake was estimated by the cross-cheek method. The bone mineral content (BMC) and the bone width (BW) were measured on the distal third of the radius (cortical bone) by means of 125I-photon absorptiometry. In addition, parameters of the bone metabolism in serum and urine were estimated. Because of the observational nature of the study, which lacked an experimental basis, it was stressed that the results had to be interpreted with caution. The mean daily calcium intake of the women was 1.04 g and that of the men 1.22 g. These amounts largely exceeded the current Dutch recommended allowance for adults of 0.8 g per day. Phosphorus intake was considered to be high: 25% of the men and women had an intake of more than 1.6 and 2.0 g per day respectively. In the men as well as in the women the serum concentrations of PTH and creatinine were at the upper limit of normality. The level of this latter parameter pointed to a slightly decreased renal function such as could be expected in people of this age group.In the women the amount of cortical bone, corrected for bone width (BMC/BW-ratio) showed a significant negative correlation with age, and the regression corresponded with an annual bone loss of about 0.8%. This loss of bone was associated with a decrease of body height of about 0.35 cm per year, which was considered to be, at least in part, the consequence of vertebral collapse. The BMC/BW-ratio correlated positively with calcium intake and negatively with phosphorus intake, if differences in age, body size and either calcium or phosphorus intake were taken into account. The excretion of phosphorus with the urine also showed a negative correlation with the BMC/BW-ratio, and dietary phosphorus correlated positively with the urinary excretion of phosphorus as well as with that of hydroxyproline. The possibility was discussed that these correlations are-in line with the concept that high-phosphorus diets contribute to bone loss in that they stimulate the secretion of PTH.In the men, loss of cortical bone with advancing age was not observed, and no relations were found between dietary calcium or phosphorus and the amount of this bone. However, a marked loss of height with age (0.45 cm per year) was established and a positive correlation between dietary calcium and body height was found. It was considered that this correlation might reflect a 'protective' action of dietary calcium against loss of trabecular bone from the vertebrae. The urinary excretion of phosphorus showed a negative correlation with the serum phosphorus concentration, and dietary phosphorus correlated positively with the urinary excretion of phosphorus as well as with that of hydroxyproline. The possibility was discussed that these correlations are in line with a concept according to which high-phosphorus diets stimulate the secretion of PTH and increase the bone turnover rate, but do not bring about loss of cortical bone.In the men as well as in the women, the serum concentration of 25-hydroxy-vitamin D (25-HCC) correlated positively with the BMC/BW-ratio despite the fact that serum values of this metabolite (the serum 25-HCC concentration is used as an indicator of the vitamin D status) were within normal limits. The possibility was discussed that this positive correlation might indicate that elderly people require larger amounts of vitamin D as a consequence of diminished renal synthesis of the active vitamin D metabolite.The experiments with rats, which lasted either four, sixteen or forty-two weeks, showed that high-phosphorus (1.2 or 1.3%) diets did not significantly influence calcium retention and/or bone mass, as opposed to diets with either a low (0.15%) or a normal (0.45%) phosphorus content. From histological and chemical analyses of bone samples, it was concluded that the quality of the bone was not obviously affected by the phosphorus content (0. 15 versus 1.20%) of the diet in experiments which lasted four or sixteen weeks. However, in the experiment which lasted forty-two weeks, bone density was found to have been reduced in rats fed 1.3% dietary phosphorus, as opposed to those that had been fed 0.45% dietary phosphorus. It was suggested that the effect of high-phosphorus diets on bone depends either on age or on the duration of feeding these diets. There were consistent and strong indications that the function of the parathyroids and the bone turnover rate were stimulated in rats fed high-phosphorus diets. In addition to the diminished bone density after forty-two weeks, these indications were: decreased renal tubular reabsorption of phosphate, hypophosphataemia, decreased urinary calcium excretion, increased urinary phosphorus excretion, nephrocalcinosis and increased urinary excretion of hydroxyproline. With the exception of nephrocalcinosis and decreased urinary calcium, these biochemical changes were reduced if the calcium content of the diet was elevated. This was associated with an inhibiting effect of dietary calcium on the intestinal phosphorus absorption. In the experiments which lasted tour or sixteen weeks, the cause and consequence of nephrocalcinosis were studied in more detail. It was found that nephrocalcinosis was attributable to the deposition of calcium apatite and that it resulted in a clear but moderate loss of renal function. This loss appeared to increase slowly during the course of the experiments. The extent of nephrocalcinosis and loss of renal function depended on the calcium content of the diet. When the diet contained 1.2% phosphorus, the extent of renal calcification and loss of renal function increased if the calcium content of the diet was raised from 0.3 to 1.2%, but these parameters decreased if the calcium content of the diet was further raised to 2.4%. There were no indications as to whether the loss of renal function had any influence on the composition or metabolism of the bone. In rats fed the low-phosphorus control diets, but not in those fed the high-phosphorus diets, osteoporosis developed when the dietary Ca/P-ratio was low (0.25 or 0.50). It was concluded that this stresses the importance of indicating absolute levels of calcium and phosphorus in the diet and that reporting only the ratio between these nutrients should be avoided.The results of the cross-sectional study of elderly people and those of the experiments with rats gave rise to the framing of a hypothesis. This hypothesis explains why hyperparathyroidism, induced by excess of dietary phosphorus, brings about a decrease in the plasma phosphorus concentration in the elderly man and in the rat, whereas no such effect is seen in the postmenopausal woman.Finally, recommendations were made regarding dietary measures which are considered to be useful in the prevention of osteoporosis in western societies. These measures are: (1) ensure a proper vitamin D status, (2) restrict the intake of phosphorus, (3) take ample calcium, and (4) restrict the intake of protein. In order to reduce the intake of phosphorus and protein, it was suggested that the consumption of meat and poultry should be decreased and the consumption of products which contain added phosphates should be limited. A further discussion was concerned with a regular consumption of dairy products which is necessary to ensure a sufficient intake of calcium
Estimating a frequency unseen:an application to ornithology
The second author is involved in a capture-mark-recapture study of some wader species. Part of his program deals with resight observations. On a particular day he visually inspects a fairly stable population to identify the ringed birds by reading their ring-number. Some ringed birds will be missed, so observations are repeated on other days. The issue of main interest is whether, after some repetitions, we can be sufficiently sure that all the ringed birds in the population have been identified or, equivalently, that the frequency of unseen birds is zero. Most current theory is concerned with an asymptotic setting. In our 'exact' context the emphasis is on the determination of the 'probability' that the frequency of unseen birds is zero. This issue is settled by considering the more general problem of 'estimating' the frequency of the unseen birds by providing a predictive inference in the form of a probability distribution. We develop methods of inference based on the assumption of a bird-independent probability p(i) of identifying a ringed bird on day i, as well as without this assumption. In Section 5 we critically examine these approaches
Boter bij de vis
Het bestrijden van aandoeningen als overgewicht, ouderdomsdiabetes en osteoporose lukt niet zolang de dikker wordende Nederlander niet meer gaat bewegen en tegelijkertijd zijn dagelijkse voedselinname enigszins beperkt. Dat zegt prof.dr.ir. Gertjan Schaafsma in zijn inaugurele rede Boter bij de vis die hij op donderdag 13 maart aan Wageningen Universiteit uitspreekt. Prof. Schaafsma zal de komende vijf jaar de bijzondere leerstoel Voeding en levensmiddelen bekleden
Effectiveness of multifaceted implementation strategies for the implementation of back and neck pain guidelines in health care: a systematic review
Background: For the optimal use of clinical guidelines in daily practice, mere distribution of guidelines and materials is not enough, and active implementation is needed. This review investigated the effectiveness of multifaceted implementation strategies compared to minimal, single, or no implementation strategy for the implementation of non-specific low back and/or neck pain guidelines in health care. Methods: The following electronic databases were searched from inception to June 1, 2015: MEDLINE, Embase, PsycInfo, the Cochrane Library, and CINAHL. The search strategy was restricted to low back pain, neck pain, and implementation research. Studies were included if their design was a randomized controlled trial, reporting on patients (age ≥18years) with non-specific low back pain or neck pain (with or without radiating pain). Trials were eligible if they reported patient outcomes, measures of healthcare professional behaviour, and/or outcomes on healthcare level. The primary outcome was professional behaviour. Guidelines that were evaluated in the studies had to be implemented in a healthcare setting. No language restrictions were applied, and studies had to be published full-text in peer-reviewed journals, thus excluding abstract only publications, conference abstracts, and dissertation articles. Two researchers independently screened titles and abstract, extracted data from included studies, and performed risk of bias assessments. Results: After removal of duplicates, the search resulted in 4750 abstracts to be screened. Of 43 full-text articles assessed for eligibility, 12 were included in this review, reporting on 9 individual studies, and separate cost-effectiveness analyses of 3 included studies. Implementation strategies varied between studies. Meta-analyses did not reveal any differences in effect between multifaceted strategies and controls. Conclusion: This review showed that multifaceted strategies for the implementation of neck and/or back pain guidelines in health care do not significantly improve professional behaviour outcomes. No effects on patient outcomes or cost of care could be found. More research is necessary to determine whether multifaceted implementation strategies are conducted as planned and whether these strategies are effective in changing professional behaviour and thereby clinical practice
Inhalation of the Rho-kinase inhibitor Y-27632 reverses allergen-induced airway hyperresponsiveness after the early and late asthmatic reaction
BACKGROUND: In guinea pigs, we have previously demonstrated that the contribution of Rho-kinase to airway responsiveness in vivo and ex vivo is enhanced after active sensitization with ovalbumin (OA). Using conscious, unrestrained OA-sensitized guina pigs, we now investigated the role of Rho-kinase in the development of airway hyperresponsiveness (AHR) after the allergen-induced early (EAR) and late asthmatic reaction (LAR) in vivo. METHODS: Histamine and PGF(2α )PC(100)-values (provocation concentrations causing 100% increase in pleural pressure) were assessed before OA-challenge (basal airway responsiveness) and after the OA-induced EAR (5 h after challenge) and LAR (23 h after challenge). Thirty minutes later, saline or the specific Rho-kinase inhibitor Y-27632 (5 mM, nebulizer concentration) were nebulized, after which PC(100)-values were reassessed. RESULTS: In contrast to saline, Y-27632 inhalation significantly decreased the basal responsiveness toward histamine and PGF(2α )before OA-challenge, as indicated by increased PC(100 )-values. Both after the allergen-induced EAR and LAR, AHR to histamine and PGF(2α )was present, which was reversed by Y-27632 inhalation. Moreover, there was an increased effectiveness of Y-27632 to reduce airway responsiveness to histamine and PGF(2α )after the EAR and LAR as compared to pre-challenge conditions. Saline inhalations did not affect histamine or PGF(2α )PC(100)-values at all. Interestingly, under all conditions Y-27632 was significantly more effective in reducing airway responsiveness to PGF(2α )as compared to histamine. Also, there was a clear tendency (P = 0.08) to a more pronounced degree of AHR after the EAR for PGF(2α )than for histamine. CONCLUSION: The results indicate that inhalation of the Rho-kinase inhibitor Y-27632 causes a considerable bronchoprotection to both histamine and PGF(2α). Moreover, the results are indicative of a differential involvement of Rho-kinase in the agonist-induced airway obstruction in vivo. Increased Rho-kinase activity contributes to the allergen-induced AHR to histamine and PGF(2α )after both the EAR and the LAR, which is effectively reversed by inhalation of Y-27632. Therefore, Rho-kinase can be considered as a potential pharmacotherapeutical target in allergic asthma
Accounting students' expectations and transition experiences of supervised work experience
Political and economic discourses position employability as a responsibility of higher education, which utilise mechanisms such as supervised work experience (SWE) to embed employability into the undergraduate curriculum. However, sparse investigation of students' contextualised experiences of SWE results in little being known about the mechanisms through which students derive employability benefits from SWE. The aim of this study is to examine the impact of students' expectation and conception of workplace learning on their transition into SWE. Analysis of accounting students' experiences reveal two broad conceptions of workplace learning, the differing impacts of which on transition experience are explored using existing learning transfer perspectives. Students displaying the more common 'technical' conception construct SWE as an opportunity to develop technical, knowledge-based expertise and abilities that prioritize product-based or cognitive learning transfer. Students with an 'experiential' conception were found to construct SWE primarily as an experience through which the development of personal skills and abilities beyond technical expertise are prioritized using process-based or socio-cultural learning transfer. Further data analysis suggests that these two learning transfer approaches have differing impacts on students' employability development which may indicate a need for universities to consider how to develop appropriate student expectations of and approaches to SWE and meaningful support for students' SWE transition
Supporting employees with chronic conditions to stay at work:perspectives of occupational health professionals and organizational representatives
Contains fulltext :
231735.pdf (publisher's version ) (Open Access)Background: Supporting employees with chronic conditions can prevent work-related problems and facilitate sustainable employment. Various stakeholders are involved in providing support to these employees. Understanding their current practices and experienced barriers is useful for the development of an organizational-level intervention to improve this support. The aim of this study was to explore the current practices of occupational physicians and organizational representatives, identifying both barriers to providing support and opportunities for improvement. Methods: Two focus groups with sixteen occupational physicians and seven semi-structured interviews with organizational representatives were held between January and June 2018. Data was analyzed using thematic content analysis. Results: Several barriers to offer support were identified, including barriers at the organizational level (negative organizational attitudes towards employees with chronic conditions), the employee level (employees' reluctance to collaborate with employers in dealing with work-related problems), and in the collaboration between occupational physicians and organizational representatives. In addition, barriers in occupational health care were described, e.g. occupational physicians' lack of visibility and a lack of utilization of occupational physicians' support. Opportunities to optimize support included a shared responsibility of all stakeholders involved, actively anchoring prevention of work-related problems in policy and practice and a more pronounced role of the health care sector in preventing work-related problems. Conclusions: Preventing work-related problems for employees with chronic conditions can be achieved by addressing the identified barriers to provide support. In addition, both occupational physicians and organizational representatives should initiate and secure preventive support at the organizational level and in occupational health care. These insights are helpful in developing an intervention aimed at supporting employees with chronic conditions to stay at work.13 p
Implementation of the participatory approach for supervisors to prevent sick leave: a process evaluation
To perform a process evaluation of a multifaceted strategy to implement the participatory approach for supervisors to prevent sick leave in three organisations. The implementation strategy incorporated a working group meeting with stakeholder representatives, supervisor training, and optional supervisor coaching. Context, recruitment, reach, dose delivered, dose received, fidelity, and satisfaction with the strategy were assessed at organisational and supervisor level using questionnaires and registration forms. At least 4 out of 6 stakeholders were represented in the working group meetings, and 11 % (n = 116) of supervisors could be reached. The working group meetings and supervisor training were delivered and received as planned and were well appreciated within all three organisations. Three supervisors made use of coaching. At 6-month follow-up, 11 out of 41 supervisors (27 %) indicated that they had applied the participatory approach at least one time. The implementation strategy was largely carried out as intended. However, reach of both supervisors and department managers should be improved. Future studies should consider targeting employees with the strategy
- …