Mediamusic (E-Journal)
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Improving the aseptic transfer procedures in hospital pharmacies part C:Evaluation and redesign of the transfer process
No full textOBJECTIVES: To transfer sterile medical devices (SMD), infusion bags (IB), ampoules (A), injection vials (V) and infusion bottles (B) into a laminar airflow cabinet (LAF) or safety cabinet (SC) with a surface bioburden as low as possible.METHODS: Surface bioburden of the outer layer of SMD, IB, A, V and B was determined by contact plates. Surface bioburden determination of critical spots on A, V and B (ampoule necks and stoppers) was determined by high-recovery swabs and contact plates. Particle emission from white cardboard boxes was determined by a particle counter.RESULTS: The chances of a contaminated outer layer of SMD is negligible as long as they stay in their original boxes. The outer layer of double-packed IB can contain a considerable number of micro-organisms. As found in previous studies, the surface bioburden of A, V and B is low as long as they stay in their original cardboard boxes. Particle emission from white boxes is low. The necessity of a final disinfection step inside LAF/SC of critical sspots of A, V and B cannot be proven. SmallSMD, ampoules and injection vials can be transferred into the background areain their original white boxes. Other materials have to be unpacked in front ofthe lock while the operator wear disposable gloves. Disinfection of the outerlayer of IB, before transfer trough the lock, is advised. Tohave materials with a low chance of contamination in LAF/SC, transfer bypresentation for SMD and IB and using a sterile tray for disinfected materialsis an effective procedure. Wiping of ampoule necks and stoppers inside LAF/SC isadvised based on risk assessment.Small SMD, ampoules and injection vials can be transferred into the background areain their original white boxes. Other materials have to be unpacked in front ofthe lock while the operator wear disposable gloves. Disinfection of the outerlayer of IB, before transfer trough the lock, is advised.CONCLUSION: When SMD, ampoules, injection vials and infusion bottles stay in their original boxes as long as possible, the aseptic transfer and the disinfection procedure can be maintained effectively and efficiently.</p
The paradoxical effect of welfare knowledge:Unveiling income cleavage over attitudes to welfare in South Korea
No full textThe extent of the rich–poor divide in attitudes to welfare varies across societies. Existing studies focus on the progressivity of the welfare system and macroeconomic conditions to explain cross-society variation. We shed light on another factor that we believe is key to understanding the variation: the public’s knowledge of the welfare state. We suggest that the prevalent ignorance of how welfare state institutions work dilutes the rich–poor divide over social spending, especially in emerging welfare states. We empirically illustrate our point using original survey data from South Korea, a country where previous studies repeatedly found little or no effect of economic class on welfare state attitudes. We reveal a strong income-based cleavage over social spending in a subset of the Korean population with more accurate knowledge of the welfare system. Our findings carry important implications for understanding and projecting welfare state politics in a broader set of emerging welfare states
Housing Ex-Offenders in the Netherlands:Balancing Neighbourhood Safety and Human Rights
No full textThe Universal Declaration of Human Rights recognises stable housing as a prerequisite for an adequate standard of living. A home provides shelter and enables personal development, thus contributing to the individual’s well-being. Despite this, however, many struggle to find a place to live. In the Netherlands, people with a history of criminal or anti-social behaviour (‘ex-offenders’) are among those whose search for housing is most problematic. They are sometimes viewed as unreliable tenants or denied access to housing out of fear for recidivism. At the same time, Dutch local authorities—responsible for maintaining public order—may (aim to) prevent an ex-offender from (re) settling in their municipality. Recent legislation in the Netherlands furthermore allows local authorities to screen and exclude people from certain urban areas based on their past behaviour. How do Dutch private and administrative actors decide between ex-offenders’ housing rights on the one hand and other persons’ (feelings of) safety and public order on the other? And how do the laws and policies in the Netherlands concerning the housing of ex-offenders relate to the state’s human rights obligations? Using doctrinal legal research methods and applying a normative, human rights framework, this paper concludes that while there are no out-right violations of fundamental rights and freedoms, several approaches in the Netherlands do appear to be problematic and at odds with international obligations
Lower emotional complexity as a prospective predictor of psychopathology in adolescents from the general population
No full textEmotional complexity (EC) involves the ability to distinguish between distinct emotions (differentiation) and the experience of a large range of emotions (diversity). Lower EC has been related to psychopathology in cross-sectional studies. This study aimed to investigate (a) whether EC prospectively predicts psychopathology and (b) whether this effect is contingent on stressful life events. To further explore EC, we compared the effects of differentiation and diversity. Adolescents from the general population (N = 401) rated 8 negatively valenced emotions 10 times a day for 6 consecutive days. Further, they completed the Symptom Checklist-90 (baseline and 1-year follow-up) and a questionnaire on past year's life events at follow-up. Logistic regression analyses tested whether EC-reflected by emotion differentiation (intraclass correlation coefficient [ICC]) and diversity (diversity index [DI])-predicted prognosis (good: remitting or lacking symptoms vs. bad: worsening or persisting symptoms). EC predicted prognoses but only when based on the ICC (OREC.ICC = 1.42, p = .02). An ECICC 1 SD above average increased the probability of good prognosis from .67 to .74. This effect was not related to stressful life events (OREC × Life events = 1.03, p = .86) and disappeared when emotion intensity (mean level) was taken into account (OREC = 1.20, p = .20). Predicting future prognosis does not necessitate complex measures of emotional experience (ICC, DI) but rather might be achieved through simpler indices (mean). The discrepant effects of the ICC and DI on prognosis suggest that impaired emotion representation (ICC) plays a more important role in vulnerability to mental ill health than does low diversity of emotions (DI).</p
Response to: ''Halo Score': missing large vessel giant cell arteritis- do we need a modified 'Halo Score?'' by Chattopadhyay and Ghosh
No full textThe influence of psychological factors and mood on the course of participation up to four years after stroke
No full textPurpose: (1) To explore the course of participation from two months up to four years after stroke, and (2) to examine if adaptive and maladaptive psychological factors and mood measured at two months after stroke are determinants of the course of participation during this period. Materials and methods: Prospective cohort study in which 369 individuals with stroke were assessed at stroke onset, two months, six months, one year, two years and three to four years after stroke. The Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-Participation) restrictions subscale was used to measure participation. Psychological factors were clustered into adaptive (proactive coping, self-efficacy, extraversion and optimism) and maladaptive (passive coping, neuroticism and pessimism) psychological factors. The Hospital Anxiety and Depression Scale was used to assess mood. Results: Although improvements in participation were observed up to one year after stroke, considerable long-term restrictions in social and physical domains persisted. More mood problems and less adaptive psychological factors were independent determinants of worse participation up to four years after stroke. Conclusions: Participation improves in the first 12 months after stroke and stabilizes afterwards. Mood problems and less adaptive psychological factors negatively influence the course of participation over time up to four years after stroke.Implications for rehabilitation Follow-up assessments after stroke should not only focus on cognitive and motor impairment, but also encompass screening on mood problems and adaptive psychological factors. Implementation of a routine follow-up assessment one year after stroke can be beneficial as restrictions in participation are unlikely to diminish spontaneously from then onwards.</p
The Role of Prosocial Attitudes and Academic Achievement in Peer Networks in Higher Education
No full textAfter the transition to university, students need to build a new peer network, which helps them to adapt to university life. This study investigated to what extent students’ prosocial attitudes and academic achievement facilitate the embeddedness in friendship and help-seeking networks, while taking structural network characteristics into account. Participants were 95 first-year bachelor’s degree students and were part of learning communities consisting of 12 students at a university in the Netherlands. Measures included student-reports of prosocial attitudes, peer nominations of friendship and help-seeking networks, and officially registered grades (GPA). Longitudinal social network analysis, stochastic actor based modeling with the package RSiena, revealed that both students’ own prosocial attitudes and achievement played a role in their friendship formation, whereas only students’ own achievement made theformation of their help-seeking relationships more likely. When students were friends, it was more likely that they approached each other for help and vice versa. Similarity in achievement level contributed to relationship formation in friendship and help seeking networks. Overall, the results underscore the importance of both student’ prosocial attitudes and achievement for their social adjustment (i.e., making friends) and only achievement for their academic adjustment (i.e., seeking help) during the first-year of university within the context of small-scale teaching
First-line treatment with infliximab versus conventional treatment in children with newly diagnosed moderate-to-severe Crohn's disease:an open-label multicentre randomised controlled trial
No full textObjective: In newly diagnosed paediatric patients with moderate-to-severe Crohn's disease (CD), infliximab (IFX) is initiated once exclusive enteral nutrition (EEN), corticosteroid and immunomodulator therapies have failed. We aimed to investigate whether starting first-line IFX (FL-IFX) is more effective to achieve and maintain remission than conventional treatment. Design: In this multicentre open-label randomised controlled trial, untreated patients with a new diagnosis of CD (3-17 years old, weighted Paediatric CD Activity Index score (wPCDAI) >40) were assigned to groups that received five infusions of 5 mg/kg IFX at weeks 0, 2, 6, 14 and 22 (FL-IFX), or EEN or oral prednisolone (1 mg/kg, maximum 40 mg) (conventional). The primary outcome was clinical remission on azathioprine, defined as a wPCDAI <12.5 at week 52, without need for treatment escalation, using intention-to-treat analysis. Results: 100 patients were included, 50 in the FL-IFX group and 50 in the conventional group. Four patients did not receive treatment as per protocol. At week 10, a higher proportion of patients in the FL-IFX group than in the conventional group achieved clinical (59% vs 34%, respectively, p=0.021) and endoscopic remission (59% vs 17%, respectively, p=0.001). At week 52, the proportion of patients in clinical remission was not significantly different (p=0.421). However, 19/46 (41%) patients in the FL-IFX group were in clinical remission on azathioprine monotherapy without need for treatment escalation vs 7/48 (15%) in the conventional group (p=0.004). Conclusions: FL-IFX was superior to conventional treatment in achieving short-term clinical and endoscopic remission, and had greater likelihood of maintaining clinical remission at week 52 on azathioprine monotherapy. Trial registration number: ClinicalTrials.gov Registry (NCT02517684). </p