197,374 research outputs found
Patient safety and complex care for older hip fracture patients: A study of the assessment, appraisal, judgement and management of risks.
No full textBijna een vijfde van de oudere patiënten die met een gebroken heup in het ziekenhuis belandt, loopt zorggerelateerde schade op. Een deel van deze schade is potentieel te vermijden. Dat blijkt uit onderzoek van Hanneke Merten. Merten promoveert 26 juni bij Amsterdam UMC.
19% van de patiënten van 65 jaar of ouder loopt zorggerelateerde schade op wanneer zij in het ziekenhuis belanden met een gebroken heup. Bij 8% van de patiënten betreft dit potentieel vermijdbare schade. Deze zorggerelateerde schade lijkt voornamelijk veroorzaakt te worden door het niet correct toepassen van bestaande kennis in een nieuwe en complexe situatie.
Vaak is deze schade gerelateerd aan medicatie. Op basis van deze resultaten concludeert Merten dat er meer training nodig is op het gebied van ouderengeneeskunde. Daarnaast is er ruimte voor verbetering in de overdracht van informatie tussen artsen en verpleging
Strategic traditions. changing livelihoods, access to food and child malnutrition in the Zambian Kafue Flats
No full textZambia has experienced a burst of industrial development which started already in the 1920s.
Large-scale copper-mining made the country to one of the most rapidly ‘modernizing’ states,
and during the 1960s and 1970s it was ranked as “middle-income country”. When the terms
of trade for copper declined sharply after the oil-shock in the 1970s, the Zambian economy
began to deteriorate. After the millenium turn, Zambia figured among the ten poorest
countries of the world. The economic collapse has left the promises of modernity unfulfilled.
Meanwhile a world of plural values and modes of life had emerged.
The crisis was mirrored on the local level in urban and rural areas. When agricultural cashcrop
production, supported by subsidies, as well as veterinary services were established
(starting during colonial administration), the Kafue Flats’ agro-pastoralists profited from these
achievements. At the same time the state took over the control of natural resources. With the
beginning economic crisis the state failed to maintain its services, leading to a declining
agrarian production. Also the use of natural resources (fish, wildlife) was only marginally
controlled. This “open access” constellation attracted migratory fishermen and hunters from
the urban areas. These developments jeopardized the local food basis. ,45674899:;?@4AB!CD:!D?A@4A49D!
Nutrition in the rural areas of the Zambian Kafue Flats still depends to a large extent on
subsistence production. But several pillars of the diversified livelihoods of the local
Ila/Balundwe and Tonga people, the former once famous for their wealth in cattle, have
recently been undermined by rapid economic and environmental change. Nevertheless, local
livelihoods still heavily rely on natural resources of the surrounding area.
Vulnerability of specific parts of the population in times of food shortages cannot be
separated from social transformations due to changes in political power, institutions,
economic and environmental setting and demography. Indirect consequences, such as the
splitting up of large extended families into many individual small households without the old
liabilities leading to a new power-equilibrium and a decline in social security, gave rise to a
local “traditionalism” among both the wealthy and the poor. The affluent are primarily trying
to maintain favourable local inheritance and marriage regulations (polygyny) in order to
legitimise their inherited and acquired property and access rights to pasture and fisheries,
referring to an ethnicity and cultural heritage discourse. Meanwhile, many among the
impoverished equally follow the traditional lifestyle, lacking practicable alternatives and
hoping to restore at least partly their former wealth. The participation in agricultural
intensification programs was not considered profitable enough during the last few years, seen
the low market prices and lack of former subsidies. Hence, local livelihood strategies and
experiences are often contesting the dominant development discourse. This is also shown in
the contradictory way how local people and NGO representatives were interpreting the 2002/3
food crisis. While local rural people perceived the traditional pastoralists households as most
resilient to the crisis, extensive pastoralism was made responsible for the lack of staple crops
in the prevailing development rhetoric. But our data analysis of food consumption and caloric
intake equally support the local interpretation that traditional pastoralists (including the
majority of the polygynous households) were least affected by the crisis, as were households
with more diversified strategies. These local experiences, contradicting dominant agricultural
and development policies, have to be considered as reasons for low adherence to programs
aimed at mitigating food insecurity.
Apart from recurrent droughts over the last years and a decreasing maize production, the main
staple and cash crop, many additional food items are no longer available due to the
increasingly limited access to natural resources such as wildlife or fisheries, and because of a
cattle disease (theileria parva), which killed large parts of the livestock in the area. In
addition, the consumption of wild bush-plants (fruits, nuts, tubers and leaves) has decreased.
Alternative food items need to be purchased at the cost of selling part of the maize yields.
This led to a nutritional transition towards a less diversified diet in addition to periodical famines, promoting chronic as well as acute malnutrition.
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While child malnutrition is a recognised problem and affects many families, most mothers are
well aware of how they should complement the foods for their children with purchased
products. However, many mothers cannot afford to buy food on a regular basis, or they might
not have the bargaining power to convince their husbands to spend money on expensive foods
for their children, implying that child malnutrition is not limited to poor families. Although
only few mothers have not been exposed to health education encompassing information about
a “balanced diet”, many remain with little possibility to actually provide it. Women are
responsible for infant and child feeding, but do not necessarily control the allocation of
money, and only partly the purpose of subsistence products – whether they are produced for
consumption or for sale. This does not remain without impact on child nutrition, neither on
the interpretation of malnutrition symptoms as socially produced. It is partly in the view of
these constraints that it has to be understood how many parents interpret signs of malnutrition
as masoto, a traditional illness, which is perceived as being caused by a transgression of one
of the parents, such as the violation of the postpartum abstinence rule. Contrary to
malnutrition, which can be prevented only if diverse food items can be provided on a regular
basis implying the availability of cash, masoto can be prevented by respectable behaviour. It
has however been shown that masoto did not interfere with the provision of an adequate diet
taking up information of health professionals. It neither prevented the consultation of health
facilities in the vast majority of the cases. But the possibilities to obtain assistance from the
health sector were limited, as only few children could be included in special feeding
programmes.
There are several aspects of masoto, which help to understand the persisting attractiveness of
the concept. The relatively recent impoverishment has left people with the hope to restore the lost wealth, only partly admitting their poverty, which is evoking shame. Illegitimate
behaviour, although equally associated with shame, is easier to deal with than poverty in a
region, which was known to be rich throughout the country until recently. In addition, it
draws on a well-established way of solving potential intra-household conflicts involving both
parents under the custody of other community members (e.g. traditional healers), satisfying
moral and religious concerns. On the contrary, conflicts about money rather remain to be
solved between husbands and wives alone, whereby men are in the decision-making position.
Masoto as a clear representation of an illness asking for defined action, provides mothers with
more bargaining power towards husbands and relatives, than a mere begging for food. In
order to understand why the reference to a local illness concept such as masoto is widespread
despite health education on infant nutrition, this situational framework has to be considered. %H6@I4DI!86C7A8!4HGC>A;!9=!G956@AB!CD:!=99:!4D;6>?@4ABJ!=4;8K=9@K;6L!6L>8CDI6!
The impoverishment and recent livelihood changes have led to an increasing attractiveness of
the fisheries as a resource exploitable for everyone to meet everyday livelihood needs. For
many households in the Kafue Flats, fish became an important protein source to rely on. Due
to the increasing prices of fish in the urban and rural centres compared to other goods
(increasing relative price), the area is facing a massive immigration of fishermen from other
areas of the country and from urban centres, and especially fish trade has become a lucrative
income generating option for local men and women. In the Kafue Flats, many women are
relying on an own income. Fish trade, due to the good market price and the low investments
needed, provides good opportunities especially in the late dry and early rainy season, when
maize prices begin to increase. Partly, though, fish is traded in form of fish-for-sex exchange,
a form of transactional sex, exposing female fish traders and fishermen to a high risk for HIV
transmission. Despite the increasing awareness of HIV/AIDS in the permanent villages, where
people are visibly dying from AIDS, the mobile fishing community along the river and
lagoons is widely ignoring the risk. First, HIV/AIDS prevention campaigns primarily rely on
a Abstinence, Be faithful, or Condom use approach (ABC campaigns). For many of the
mobile fishermen, often coming from other areas of the country and from urban areas, A and
B do not provide an attractive option, and condoms are hardly available in the fishing camps.
Lacking the visibility of AIDS patients due to high mobility, the risk is underestimated.
Local female fish traders, on the other hand, are increasingly exposed to stigmatisation in their villages, as they are seen as a threat to the community. Despite their awareness of the
risk to become infected with the HI-virus, women’s options to protect themselves are very
limited; it has to be acknowledged that many women cannot afford to turn down an offer where they can get free fish, worth several weeks of maize consumption, in exchange for sex.
Seen the good opportunities of fish trade, and especially fish-for-sex exchange throughout the
year without any long-term commitment needed, it is unlikely that income-generating projects
will be able to completely substitute fish-for-sex deals. Moreover, the increasing moral
pressure on women rather motivates them to hide their activities than to stop. Women who get
involved in such arrangements have different strategies to escape the increasing moral
pressure of their communities as well as of health professionals and churches. First of all, they
deny any involvement in fish-for-sex exchange. In a local setting, where “traditions” are still
valorised, some women may refer to a transformed traditional institution regulating extramarital
sexual relations, thus avoiding the association with prostitution, in order to gain
legitimacy towards the community and themselves, and to maintain their reputation.
In the Kafue Flats setting, HIV/AIDS prevention approaches, which primarily rely on moral
messages and empowerment, are showing a low impact. Condoms, on the other hand, are
hardly available in the fishing camps, although there is a clearly expressed demand.
Meanwhile, the HIV/AIDS prevention discourse is taken up by diverse other local actors who
have their own agenda. Apart from a real concern with HIV/AIDS, which is of course a main
worry, prevention messages are additionally used to give legitimacy to own interests
especially in relation to the planning of interventions strengthening economic alternatives to
the fisheries. Hence, the narrative of the dangers, which fish-for-sex deals are encompassing,
is locally used as an argument to serve heterogeneous purposes, and to attract donors, while it
does not always include the interests of those who are most exposed to HIV, namely the
female fish traders and the fishermen
Dr. Duane M. Jackson, Morehouse College, July 2011
No full textThis video is a conversation with Dr. Duane M. Jackson. Dr. Jackson talks about his paper, "Recall and the Serial Position Effect: The Role of Primacy and Recency on Accounting Students' Performance." Jackie Daniel, AUC Woodruff Library, is the interviewer
A novel pathogenic variant p.Asp797Val in IFIH1 in a Japanese boy with overlapping Singleton-Merten syndrome and Aicardi-Goutieres syndrome
No full textPathogenic-activating variants of interferon induced with Helicase C domain 1 (IFIH1) cause Singleton-Merten (S-M) syndrome, which accompanies acro-osteolysis, loss of permanent teeth, and aortic calcification, as well as causing Aicardi-Goutières (A-G) syndrome, which shows progressive encephalopathy, spastic paraplegia, and calcification of basal ganglia. Recently, patients with overlapping syndromes presenting with features of S-M syndrome and A-G syndrome were reported. However, progression of clinical features of this condition has not been fully understood. We report a Japanese boy with a novel pathogenic IFIH1 variant who presented with clinical features of S-M syndrome and A-G syndrome
Singleton-Merten syndrome: an autosomal dominant disorder with variable expression
No full textIn 1973, Singleton and Merten described two females with abnormal dentition, unique radiographic changes especially of the hands, and severe calcification and intimal weakening of the aortic arch and valve. Since then three additional cases with similar features have been reported and the diagnosis was suggested in another three individuals. We present an update of one case and the detailed clinical phenotype of six other cases with Singleton-Merten syndrome. The occurrence of the disorder in six members of two families and vertical male-to-male transmission indicate an autosomal dominant pattern of inheritance. Variability in phenotype, also within a single family, is significant. Core manifestations are marked aortic calcification, dental anomalies (delayed eruption and immature root formation of primarily the anterior permanent teeth, and early loss of permanent teeth due to short roots, acute root resorption, high caries, and aggressive alveolar bone loss), osteopenia and acro-osteolysis, and to a lesser extend also glaucoma, psoriasis, muscle weakness, and joint laxity. Additional clinical characteristics described here include particular facial characteristics (high anterior hairline, broad forehead, smooth philtrum, thin upper vermillion) and abnormal joint and muscle ligaments. The cause and pathogenesis of this syndrome remain unknown. © 2013 Wiley Periodicals, In
A novel pathogenic variant p.Asp797Val in IFIH1 in a Japanese boy with overlapping Singleton-Merten syndrome and Aicardi-Goutieres syndrome
No full textPathogenic-activating variants of interferon induced with Helicase C domain 1 (IFIH1) cause Singleton-Merten (S-M) syndrome, which accompanies acro-osteolysis, loss of permanent teeth, and aortic calcification, as well as causing Aicardi-Goutières (A-G) syndrome, which shows progressive encephalopathy, spastic paraplegia, and calcification of basal ganglia. Recently, patients with overlapping syndromes presenting with features of S-M syndrome and A-G syndrome were reported. However, progression of clinical features of this condition has not been fully understood. We report a Japanese boy with a novel pathogenic IFIH1 variant who presented with clinical features of S-M syndrome and A-G syndrome
"Reflections on the subject of Emigration from Europe with a view to Settlement in the United States" By M. Carey.
No full text"Reflections on the subject of Emigration from Europe with a view to Settlement in the United States: containing bried sketches of the moral and political character of those states.
By M. Carey, member of the American philosophical, and of the American Antiquarian Society, and author of The Olive Branch, Cindiciae Hibernicae, essays on banking, on political economy, and on internal improvement.
To which are now added the English editor's comments on the subject; together with Important Advice to Emigrants, and Cautions Against Impositions Practiced in the Outports
Körpersemantisierungen im #bodylove-Diskurs: Eine Korpusstudie zu Instagram-Posts als multimodales Positionierungsformat
No full textDispelling the Myths Behind First-author Citation Counts
No full textWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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