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Research evidence and patient perspective on the impact of lifestyle factors in patients with Sjögren’s disease
No full textModification of lifestyle factors can prevent the development or worsening of chronic diseases and decrease mortality. Optimising lifestyle behaviour can complement pharmacological treatment and enable patients to play an active role in their own care. In this article, we summarise the current research evidence together with the patient perspective on the impact of lifestyle factors in patients with Sjögren’s disease (SjD), with focus on physical activity, diet, stress, sleep, mental wellbeing and participation. Our findings regarding (modifiable) lifestyle factors underline their importance in the management of patients with SjD. A holistic, biopsychosocial approach to disease management, incorporating lifestyle adaptation and psychosocial support, is necessary to address the full spectrum of patient needs and to alleviate the multidimensional burden of the disease.</p
Data-Driven Decisions in Neonatology and Pediatric Surgery:Artificial Intelligence for Necrotizing Enterocolitis
No full textArtificial intelligence assists with complex decisions for vulnerable babiesExtremely premature babies are highly vulnerable. One of the greatest dangers is necrotizing enterocolitis (NEC), a bowel disease that can strike unexpectedly. Within a short time, a baby can become seriously ill and may require surgery.This dissertation investigates how artificial intelligence (AI) can support doctors and parents in cases of NEC. It shows that AI can provide early warnings for this disease based on standard measurements including heart rate and oxygen levels. This allows doctors to be better prepared and to intervene more quickly.AI can also assist with ethical decisions. Sometimes surgery is necessary to save the life of a baby with NEC, but such an operation is invasive, the chances of survival are uncertain, and survivors often have a reduced quality of life. In some cases, it may be better to ensure that the baby can pass away as calmly and painlessly as possible.Using AI, we gained insight into how doctors make these decisions in the Netherlands. In this dissertation, we compared whether AI predictions align with real-world choices. We also developed an AI model to compare decision-making among doctors in Europe.However, AI does not always provide a solution. Using other methods, we investigated how parents make these decisions. These insights help healthcare providers support parents more effectively and make conversations more personal.This research demonstrates how technology can contribute to better care, informed communication between doctors and parents, and greater understanding in emotionally challenging situations
In-Situ H<sub>2</sub>S reduction in biogas fuel for solid oxide fuel cell applications by using cow urine
No full textBiogas, generated from small scale digesters, is a traditional energy source for satisfying the thermal energy demand in off-grid communities. Recent developments in small scale solid oxide fuel cells (SOFCs) technology and progress in research and development of dry reforming, opens perspectives to couple small scale SOFCs with already existing digesters to meet both thermal and electrical energy demand, enabling power access to off-grid communities. However, one of the major challenges for SOFC integration to small scale digesters is the effect of biogas impurities, such as H2S, on the performance of SOFCs. Previous work has shown that local operational practices could influence the biogas quality and particularly the H2S content in the biogas. The here presented research expanded on the use of cow urine instead of water as solvent in manure digestion as a potential operational strategy that enables in-situ reduction of H2S in the evolving biogas. This research investigated the following hypotheses: 1) urine addition results in a high pH that favours HS− over H2S, 2) given the presence of metal elements in the cow urine, insoluble metal sulphides are being formed, reducing the biogas H2S content. The research was carried out by measuring cow urine composition of various samples, assessing the effects of different urine/water/manure mixtures on the evolving biogas-H2S concentration, and verifying the experimental findings with phreeqC equilibrium speciation. Bio-kinetic modelling, using the anaerobic digestion model nr 1 (ADM1), was subsequently performed to explore the influence of different feed compositions on the H2S content in the biogas. It was observed that addition of cow urine in all experiments resulted in an elevated pH of the reactor compared to water dilution, yet both experiments I and II-2 showed an increased maximum H2S content when urine dilution was applied, compared to water dilution. Cow urine and cow dung characterisation in terms of metals and S, showed that experiment II-1 had the highest Fe:S ratio of 1:0.3–1:0.9. Equilibrium modelling confirmed that despite the positive urine-induced pH effect, the measured Fe:S ratios could indeed be decisive, as with an Fe;S ratio of 1:6 and 1:0.5, the H2S production at equilibrium was 61 and 10 mL/ kg of solution, respectively. Furthermore, it was predicted through bio-kinetic modelling that inconsistency in feedstock composition may result in temporary H2S peaks exceeding 400 ppm. Overall, results showed that if a cow urine/manure mixture is characterised by a total metal:S ratio exceeding 1:0.5 and total S content of less than 0.5 mM, then hydrolysed cow urine addition presents an interesting in-situ H2S cleaning strategy for biogas-SOFC applications.</p
Media influences on ethnic majority attitudes toward ethnic minorities:A systematic review and meta-analysis
No full textThe media are widely regarded as critical in shaping ethnic majority attitudes toward ethnic minorities. Yet despite this presumed influence, the mechanisms underlying this influence remain insufficiently understood. This systematic review and meta-analysis synthesizes existing research, identifying three key empirical pathways through which media are thought to operate: salience (prominence of information about ethnic minorities), valence (ranging from negative to positive evaluations of ethnic minorities), and consumption (the overall volume of media exposure). We further examine moderators specific to valence, namely sign (positive versus negative) and source (evaluation by ethnic majority ingroup or ethnic minority outgroup), as well moderators applying across all three pathways: media type (traditional versus social/online) and format (viewing versus reading). Our meta-analysis encompasses 1587 effect sizes from 155 articles published between 2010 and 2022, representing approximately 350,000 respondents. We find that media salience has a weak positive relationship with negative ethnic majority attitudes toward immigration, but not with attitudes toward ethnic minorities themselves. Media valence shows a weak positive relationship with attitudes, with smaller effects for positive valence on positive attitudes and larger effects for negative valence on negative attitudes. Moreover, valence shows a positive relationship with attitudes when the evaluation originates from ethnic out-groups, but no relationship when it originates from ethnic in-groups. Finally, we find no evidence of a significant relationship between media consumption and attitudes. We conclude by identifying critical gaps in the literature and by advocating for an integrative approach that considers how salience, valence, and consumption interrelate in shaping ethnic majority attitudes toward ethnic minorities.</p
From hesitant to loyal ally:the Dutch reaction to 9/11 and post-9/11 US coalition management, September–December 2001
No full textCompared with other NATO allies, the Netherlands reacted with caution and hesitation to the immediate geopolitical and military aftermaths of the 9/11 attacks. Uncomfortable with the Bush administration’s unilateral behaviour and choice for direct military retaliation, and unsure about a strategic situation in which the USA suddenly and unexpectedly was the recipient rather than provider of NATO Article 5 mutual support, the then Dutch Labour-Liberal government stalled for time and hoped for the best. Soon, however, the Dutch leadership could not withstand mounting US pressures to join its military counter-terrorism coalition. Without a proper post-Cold War national security strategy to begin with, and both unable and unwilling to adequately adapt to the international developments of the autumn of 2001, the country was inevitably drawn into the series of Afghanistan interventions that eventually lasted 20 years. Empirically based on official documents never researched before, this article deciphers the hidden history of Dutch policy- and decision-making by the principals and advisers who, in the months following 9/11, were initially hesitant to respond to US and allied demands for loyalty and troops. Who then, based on military and political risk assessments, long kept prioritising other allied peacebuilding commitments closer to home over the new US-led global war on terrorism, and who finally, compromised with small and mostly symbolic military deployments to the US-managed coalition’s Afghanistan efforts, which at the time were mainly focussed on backfilling US deployments far from Afghanistan or on a limited peacekeeping role in Kabul (that the Netherlands hoped would finish soon). In the end, however, the Dutch decisions would prove to be the start, after all, of a series of participations in Operation Enduring Freedom and in the International Security Assistance Force in which troops were increasingly put in harm’s way and from which there was no going back for two decades.</p
The Quandary of Being a Male Nurse in India
No full textThis paper critically examines the gendered dynamics of the nursing profession in India, focusing on the systemic under-representation of male nurses. Despite India’s acute shortage of healthcare workers exacerbated by the COVID-19 pandemic—the nursing sector remains overwhelmingly feminised. This study interrogates the historical, sociocultural, and institutional factors that perpetuate the stigmatisation of male nurses, situating the analysis within feminist scholarship and labour market theories. Through a review of historical narratives, the paper traces how colonial and post-colonial discourses framed nursing as a “feminine” vocation, rooted in patriarchal norms and caste-based hierarchies. The analysis reveals how gendered stereotypes reinforced by media, policy, and societal expectations discourage male participation, despite the profession’s critical role in public health. Institutional barriers, such as gender-based quotas and wage disparities, further entrench these inequalities, while cultural perceptions associate nursing with failure or demasculinisation. The study also explores the lived experiences of male nurses, highlighting their struggles with stigma,workplace discrimination, and societal pressure to conform to hegemonic masculinity. By synthesising theoretical insights with empirical observations, this paper advocates for a reimaginedunderstanding of care work, one that dismantles gendered hierarchies and promotes equitable participation
Physics meets tradition:An ethnophysics study of the Perahu Jong in developing students' science literacy
No full textThe present study investigates the impact of the Perahu Jong cultural festival on students' cultural literacy and their understanding of physics concepts on Rupat Island, Indonesia. Utilizing a convergent mixed-methods approach, the research combined qualitative data from interviews and observations with quantitative data from a validated survey, involving 109 students from six schools. The instrument validation process included an expert panel and reliability analysis to ensure methodological rigor. The findings indicated that students' understanding of physics concepts related to the festival included Newton's Laws, Waves, Equilibrium, Pressure, Static Fluids, and Dynamic Fluids. Despite a generally low level of cultural literacy, Spearman's correlation analysis revealed a statistically significant. However, the correlation was categorized as weakly positive (rs = .266, p = .005) between cultural literacy and physics conceptual literacy, indicating that cultural understanding is related to academic achievement but explains only a limited proportion of the variance in physics literacy.266, p < .001) between cultural literacy and physics conceptual literacy, underscoring the critical role of cultural understanding in academic achievement. This study makes a unique contribution by quantitatively demonstrating the relationship between cultural literacy and physics conceptual literacy, particularly in coastal communities with strong ties to the Perahu Jong tradition, and presents a validated model for culturally responsive pedagogy.</p
The effect of a familiarization critical speed testing session on critical speed determination during treadmill running
No full textBACKGROUND: The effect of familiarization with the critical speed (CS) testing process on the outcome of CS tests has yet to be determined.OBJECTIVES: The main aims of the present study were to determine whether a familiarization session prior to CS testing sessions affects time to task-failure (TTF) on subsequent tests and CS estimations, and whether individual characteristics such as sex and fitness status influence any familiarization effect.METHODS: 27 healthy adults (10 females, 25 ± 4 yrs) performed the following treadmill protocol: i) a maximal incremental test to identify peak speed; ii) a familiarization constant-intensity trial (CTfam) at the intensity of the first constant-intensity trial used for CS determination (CTCS), and iii) four randomly ordered maximal constant-intensity trials at ~ 85%, 92%, 98%, and 105% of peak speed. CS was estimated using 2-parameter hyperbolic, linear, and 1/time models including the CTfam (CS not familiarized) or the CTCS (CS familiarized). Familiarized and not-familiarized TTFs and CSs were compared using Wilcoxon tests. Sex effect was analyzed using Mann-Whitney test on the difference in the TTF between CTCS and CTfam. The correlation between peak speed and difference in the TTF between CTCS and CTfam was assessed using Spearman's rank correlation. α was set at 0.05.RESULTS: CTfam TTF (399 [299] s, median [interquartile range]) was lower (p = 0.009) than CTCS TTF (495[316] s), whereas CS familiarized and not-familiarized were not different in any model (p > 0.05). Sex did not affect the differences between familiarized and not-familiarized TTFs and CS. However, differences in the TTF between CTCS and CTfam were negatively correlated with peak speed (ρ = -0.381, p = 0.050).CONCLUSIONS: Familiarization with constant-intensity trials affected the TTF but not CS. Importantly, the familiarization effect was larger in less fit individuals, showing a negative correlation between the TTF differences (i.e., CTCS minus CTfam) and peak speed.</p
Stakeholder relations in land value capture (LVC) within a government-led decentralized governance system:The case of transport infrastructure development
No full textDiscussions of stakeholder relationships in land value capture (LVC) for transport infrastructure development remain limited, particularly within decentralized systems in the Global South and in multi-level government contexts, where strong government control is present. This paper examines the factors affecting stakeholder relationships and how these relationships influence the implementation of LVC. The case study focuses on Jakarta’s Mass Rapid Transit (MRT) in Indonesia, where LVC is considered a promising financing tool. The findings highlight that in the context of Jakarta, policy and regulations, institutional arrangements, and risk mitigation are the most influential factors. First, while policies and regulations are essential in defining stakeholder responsibilities, they also create rigid boundaries that can limit flexibility for local innovation in exploring LVC instruments. Second, the limited authority of the transit agency indicates the need for more explicit mandates and greater support from governing bodies. Third, public agencies need to take a more proactive role in risk mitigation by developing mutually beneficial partnerships with private entities. Overall, this study bridges theory and practice by placing LVC within a multi-level governance framework that links the governance of transport infrastructure development and land-use management. It shows that successful LVC implementation depends on collaboration among stakeholders from different sectors and requires institutional flexibility and adaptive governance that balance national policy coherence with local discretion. By highlighting these cross-sector and governance dynamics, the study contributes to wider discussions on urban development, transport infrastructure governance, and public–private collaboration, making it relevant to both scholars and practitioners across multiple disciplines