9 research outputs found
Donor Registration Campaign: Ministry of Public Health Involves Personal Request to 12.2 Million Dutch Citizens > or = 18 Years
No full textPIRLS- en TIMSS-2011: Trends in leerprestaties in lezen, rekenen en natuuronderwijs
No full textItem does not contain fulltextPIRLS Hoe goed zijn onze groep 6 leerlingen in lezen in internationaal perspectief? Zijn de leesprestaties sinds 2001 er op voor- of achteruit gegaan? Waarin wijkt het Nederlandse leesonderwijs af van dat in andere landen? Deze en andere vragen over leesvaardigheid worden in dit rapport beantwoord. In het voorjaar van 2011 zijn namelijk wereldwijd meer dan 600.000 basisschoolleerlingen getoetst in het kader van Progress in International Reading Literacy Study (PIRLS) of in het kader van Trends in International Mathematics and Science Study (TIMSS). Het Nederlandse aandeel in PIRLS is in opdracht van NWO/PROO uitgevoerd door de Radboud Universiteit Nijmegen, in samenwerking met het Expertisecentrum Nederlands. TIMSS Dezelfde vragen komen ook voor rekenen en natuuronderwijs aan bod. De eerste TIMSS stamt al uit 1995. Dit rapport brengt in kaart hoe het niveau in rekenen-wiskunde en natuuronderwijs zich in de afgelopen 17 jaar heeft ontwikkeld en of de prestaties van de Nederlandse leerlingen zich nog steeds kunnen meten aan de internationale top. Voorgaande metingen hebben laten zien dat Nederlandse leerlingen goed presteren in zowel TIMSS als PIRLS. In dit rapport worden daarom ook de resultaten van de drie vakgebieden met elkaar vergeleken. Het Nederlandse aandeel in TIMSS wordt in opdracht van NWO/PROO uitgevoerd door de vakgroep Onderwijskunde van de Universiteit Twente.154 p
Fluid coupling between the elements in a discrete model of cochlear mechanics
No full textWhen analysing the coupled mechanics of the cochlea, due to the interaction between fluid coupling and basilar membrane motion, it is convenient to divide the cochlea longitudinally into a discrete number of sections. This report considers the fluid coupling in such a discrete model. The fluid coupling is analysed using a wavenumber formulation and is separated into long wavelength and short wavelength components. The short wavelength components are then seen as one of a number of sources of additional longitudinal coupling that could be incorporated into a modified model of basilar membrane dynamics. The effects of non-uniformity and asymmetry in the fluid chamber areas can then be taken into account to predict both the pressure difference between the chambers and the mean pressure. The results from the analytic formulation, in which the fluid is assumed to be incompressible, are also compared with those of an acoustic finite element model for the fluid coupling. Although the agreement is good at low frequencies, a resonance is observed at about 11 kHz due to the compressibility of the fluid, although this does not appear to affect the coupled cochlear response
Comparação de metodologia alternativas para detecção de salmonella sp e listeria monocytogenes em carnes e produtos cárneos
No full textTese (doutorado) - Universidade Federal de Santa Catarina, Centro de Ciências Agrárias. Programa de Pós-Graduação em Ciência dos Alimentos.Com o objetivo de validar metodologias analíticas alternativas para detecção de Salmonella spp e Listeria monocytogenes em amostras de carcaças de frango, carnes suínas cruas e, derivados cárneos processados naturalmente contaminados, foram analisadas 503 amostras para detecção de Salmonella spp e 334 amostras para detecção de L. monocytogenes. Na análise de Salmonela spp em amostras de carnes suínas e carcaças de frango, o método AOAC 993-07 (MSRV Acumedia), apresentou maior sensibilidade, seguido do método PCR BAX System®, do Método AOAC 993-07 (MSRV Oxoid) e, do método de referência ISO 6579. Segundo o teste não paramétrico de McNemar, há diferença significativa na comparação do método AOAC 993-07 (MRSV Acumedia) e o método ISO 6579, entre o método ISO 6579 e o método BAX System®, entre o método AOAC 993-07(MRSV Oxoid) e o BAX System® e entre os métodos AOAC 993-07 entre si. Não houve diferença significativa entre os métodos Bax System® e AOAC 993-07 (MRSV Acumedia), e ISO 6579 versus o método 993-07 (MRSV Oxoid). Para a análise de L. monocytogenes em amostras de carnes cruas e produtos processados o método BAX System® apresentou maior sensibilidade, seguido pelo método ISO 11290-1/A1, USDA/FSIS modificado e ISO modificado. Há diferença significativa entre os métodos ISO 11290-1/A1 e o BAX System®, ISO modificado e o método BAX System®e entre o método USDA/FSIS modificado e o BAX System®; Não há diferença significativa entre os métodos ISO 11290-1/A1 e o método USDA/FSIS modificado, entre o método ISO 11290-1/A1 e o método ISO 11290-1/A1 modificado, e, finalmente, entre os métodos ISO 11290-1/A1 modificado e USDA/FSIS modificado. Avaliou-se também a aplicação do Teste de McNemar para a comparação de proporções em amostras dependentes para verificar a conveniência da substituição de um método convencional por um novo, na identificação da presença de Salmonella spp. Resultado deste estudo mostrou que o Teste de McNemar nem sempre é suficiente para a tomada de decisão final do pesquisador em amostras naturalmente contaminadas e que funções apropriadas das proporções necessitam ser estimadas. Neste sentido, o Poder de Teste de McNemar (1 - erro tipo II) foi aqui também estudado no capitulo 4
Metabolism And Toxicity Of Lead In Children And Adults [meta Metabolismo Bolismo E To Toxicidade Xicidade Do Chumbo Humbo Na Criança E No Adulto]
No full textLead does not participate in any metabolic process in humans. Nevertheless, it is the most important non ferrous metal in industry since ancient times. This fact promoted a huge and extensive environmental contamination, allowing for an excessive input of lead by humans through ingestion and inhalation. In this review it is discussed aspects of kinetics and toxicity of lead in its inorganic form, being the most important chemical form presenting in occupational and general environment. As a metal, lead does not suffer biotransformation as other toxic substances. Its metabolism is limited to a complex kinetics of distribution and excretion which depends on its chemical speciation, determining the redox potential, rates of ionization and protein binding; crossing of blood brain and placental barriers; rates of tissue accumulation and renal excretion. Adults absorb 10% after lead ingestion, contrasting with children that can absorb 50%. Lead is distributed rapidly and easily through all tissues, including brain, crossing placental barrier and being secreted in maternal milk. Elimination half lifes can be very different according to the body compartment as follows: for blood = 15 to 30 days (in children under low doses of exposure = 10 to 12 months); soft tissues in general = 60 days; trabecular bone = 90 to 120 days; cortical bone with stable deposits = 25 to 30 years. Lead presents toxic action in the central and peripheral nervous system, renal and hemopoietic systems, by toxic mechanisms that are discussed in the paper.423268276Patterson, C., Ericson, J., Manea-Krichten, M., Shirahata, H., Natural skeletal levels of lead in Homo sapiens sapiens uncontaminated by technological lead (1991) Sci Total Environ, 107, pp. 205-236Paoliello MMB, De Capitani EM. Chumbo. In: Azevedo AA, M. CAA, eds. 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I. The normal metabolism of lead (1961) J R Inst Public Health, 24, pp. 81-97Alessio, L., Lead, F.V., (1983) Human biological monitoring of indutrial chemicals series, p. 188. , Alessio L, Berlin A, Roi R, Boni M, eds, Brussels, Luxembourg: Commission of The European Communities;Henretig FM. Lead. In: Goldfrank LR, ed. Goldfrank's Toxicologic Emergencies. New York: McGraw-Hill2002:1200-27Lauwerys, R., Buchet, J.P., Roels, H., Berlin, A., Smeets, J., Intercomparison program of lead, mercury, and cadmium analysis in blood, urine, and aqueous solutions (1975) Clin Chem, 21, pp. 551-557Holness, D., Nethercott, J., Acute lead intoxication in a group of demolition workers (1988) Appl Ind Hyg, 3, pp. 338-341Feldman, R.G., (1999) Occupational and Environmental Neurotoxicology, , Philadelphia: Lippincott-Raven;Matte, T., Figueroa, J., Burr, G., al e. Lead exposure among leadacid battery workers in Jamaica (1989) Am J Ind Med, 16, pp. 167-177Marino, P., Franzblau, A., Lilis, R., al e. Acute lead poisoning in construction workers: The failure of current protective standards (1989) Arch Environ Health, 44, pp. 140-145Lilis, R., Fischbein, A., Diamond, S., Lead effects among secondary lead smelter workers with blood lead levels below 80 mcg/100ml (1977) Arch Environ Health, pp. 256-266Dahlgren, J., Abdominal pain in lead workers (1978) Arch Environ Health, pp. 156-159Spivey, G., Brown, C., Baloh, R., Subclinical effects of chronic increased lead absorption: A prospective study (1979) J Occup Med, 21, pp. 423-429Cullen, M., Robins, J., Eskenazi, B., Adult inorganic lead intoxication: Presentation of 31 new cases and a review of recent advances in the literature (1983) Medicine, 62, pp. 221-247(1992) Oxford Textbook of Clinical Nephrology, , Cameron S, Davison AM, Grunfeld J-P, Kerr D, Ritz E, eds, Oxford: Oxford, Oxford University Press;Woods, J.S., Hematopoietic system (1995) Metal Toxicology, pp. 287-304. , Goyer RA, Klaassen C, Waalkes M, eds, San Diego: Academic Press;CDC. 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A meta-analysis of modern studies (1990) Jama, 263, pp. 673-678Haenninen, H., Hernberg, S., Mantere, P., Vesanto, R., Jalkanen, M., Psychological performance of subjects with low exposure to lead (1978) J Occup Med, 20, pp. 683-689Hogstedt, C., Hane, M., Agrell, A., Bodin, L., Neuropsychological test results and symptoms among workers with well-de fined long-term exposure to lead (1983) Br J Ind Med, 40, pp. 99-105Batuman, V., Maesaka, J.K., Haddad, B., Tepper, E., Landy, E., Wedeen, R.P., The role of lead in gout nephropathy (1981) N Engl J Med, 304, pp. 520-523Batuman, V., Lead nephropathy, gout, and hypertension (1993) Am J Med Sci, 305, pp. 241-247Emmerson, B.T., Chronic lead nephrompathy: The diagnostic use of calcium EDTA and the association with gout (1963) Aust Ann Med, 12, pp. 310-324Bennet, W., Lead nephropathy (1985) Kidney Int, 28, pp. 212-220Wedeen, R.P., Malik, D.K., Batuman, V., Detection and treatment of occupational lead nephropathy (1979) Arch Intern Med, 139, pp. 53-57Tuppurainen, M., Wagar, G., Kurppa, K., Thyroid function as assessed by routine laboratory tests of workers with longterm lead exposure (1988) Scand J Work Environ Health, 14, pp. 175-180Gennart, J.P., Buchet, J.P., Roels, H., Ghyselen, P., Ceulemans, E., Lauwerys, R., Fertility of male workers exposed to cadmium, lead, or manganese (1992) Am J Epidemiol, 135, pp. 1208-1219Siegel, M., Forsyth, B., Siegel, L., Cullen, M.R., The effect of lead on thyroid function in children (1989) Environ Res, 49, pp. 190-196Huseman, C.A., Varma, M.M., Angle, C.R., Neuroendocrine effects of toxic and low blood lead levels in children (1992) Pediatrics, 90, pp. 186-189Rosen, J.F., Chesney, R.W., Hamstra, A., DeLuca, H.F., Mahaffey, K.R., Reduction in 1,25-dihydroxyvitamin D in children with increased lead absorption (1980) N Engl J Med, 302, pp. 1128-1131Koo, W.W., Succop, P.A., Bornschein, R.L., Serum vitamin D metabolites and bone mineralization in young children with chronic low to moderate lead exposure (1991) Pediatrics, 87, pp. 680-687Alexander, B.H., Checkoway, H., van Netten, C., Semen quality of men employed at a lead smelter (1996) Occup Environ Med, 53, pp. 411-416Lin, S., Hwang, S.A., Marshall, E.G., Stone, R., Chen, J., Fertility rates among lead workers and professional bus drivers: A comparative study (1996) Ann Epidemiol, 6, pp. 201-208Telisman, S., Cvitkovic, P., Jurasovic, J., Pizent, A., Gavella, M., Rocic, B., Semen quality and reproductive endocrine function in relation to biomarkers of lead, cadmium, zinc, and copper in men (2000) Environ Health Perspect, 108, pp. 45-53Hu, H., Knowledge of diagnosis and reproductive history among survivors of childhood plumbism (1991) Am J Public Health, 81, pp. 1070-1072McMichael, A.J., Vimpani, G.V., Robertson, E.F., Baghurst, P.A., Clark, P.D., The Port Pirie cohort study: Maternal blood lead and pregnancy outcome (1986) J Epidemiol Community Health, 40, pp. 18-25Baghurst, P.A., Robertson, E.F., McMichael, A.J., Vimpani, G.V., Wigg, N.R., Roberts, R.R., The Port Pirie Cohort Study: Lead effects on pregnancy outcome and early childhood development (1987) Neurotoxicology, 8, pp. 395-401Ernhart, C.B., Wolf, A.W., Kennard, M.J., Erhard, P., Filipovich, H.F., Sokol, R.J., Intrauterine exposure to low levels of lead: The status of the neonate (1986) Arch Environ Health, 41, pp. 287-291Needleman, H.L., Rabinowitz, M., Leviton, A., Linn, S., Schoenbaum, S., The relationship between prenatal exposure to lead and congenital anomalies (1984) Jama, 251, pp. 2956-295
Virtual environments for stroke rehabilitation: examining a novel technology against end-user, clinical and management demands with reference to UK care provision
No full textIn the field of post-stroke rehabilitation, there appears to be growing interest in the use of
virtual reality (VR)-based systems as adjunct technologies to standard therapeutic practices.
The limitations and the potentials of this technology are not, however, generally well
understood. The present study thus seeks to determine the value of the technology with
reference to end-user requirements by surveying and evaluating its application against a
variety of parameters: user focus, clinical effectiveness, marketability and contextual
meaningfulness, etc. A key theme in the research considers how a technology developed
internationally might interface with care provision demands and cultures specific to the United
Kingdom. The barriers to innovation entry in this context are thus examined. Further practical
study has been conducted in the field with a small sample of post-stroke rehabilitation patients.
The data garnered from these enquiries have informed a detailed system analysis, a strategy
for innovation and a broad theoretical discussion as to the effectiveness of the technology in
delivering VR environments by which the patient can undertake ‘meaningful’ therapeutic
activities. The data reveal that there does appear to be clinical value in using this technology,
yet establishing its maximal value necessitates greater integrity among clinicians and
engineers, and the furthering of progressive channels for innovation by public health
administrators
Architectural Design Quality in Local Authority Private Finance Initiative Sheltered Housing Projects: The Development of an Evaluation Tool
No full textEver since the 1990s, when the Private Finance Initiative (PFI) was developed as the primary method for delivering major public-sector capital projects in the UK, it has been severely criticised for the lack of design quality in the buildings that it produced. The main driver for this thesis was to redress that situation. The development of an Architectural Design Quality Evaluation Tool was based on a live project with a metropolitan council in the North East of England. The aim was to improve the design quality of schemes that had been submitted through a PFI to replace the council’s entire sheltered housing stock. The Tool has two functions. It was a substantial part of the assessment process, which selected the preferred bidding consortium from the original six bidders, through a series of stages. However, it was also directed at improving the quality of all submitted designs through an iterative process. While existing tools provide useful benchmarks, and some offer means of structuring an evaluation, none are totally applicable in the context of PFI competitive bidding processes. Moreover, the existing tools are good for evaluating performance attributes of buildings, and these are important, but do not substantially tackle the less tangible amenity attributes that are vital to engendering the feeling of home. This Tool emphasises the amenity attributes without neglecting performance, thus generating a design quality hierarchy. The criteria for assessment are derived from academic publications. In order to reflect the hierarchy, each criterion was weighted on a scale of one to five, in accordance with multivariable utility theory. The percentage allocation to each main heading of the Tool was determined by the local authority Project Team. A User Guide was developed to assist the evaluation of schemes. The Tool itself was appraised at the final stage, assisting the selection of the preferred bidder. The designs were evaluated in three reviews, thus providing 156 results. The Tool and its development have been published, and the Tool and the User Guide accepted by the Homes and Communities Agency as an example of good practice. Both currently appear on its website. The Tool continues to assist other social housing providers with the design quality of their own projects
Models for providing improved care in residential care homes: a thematic literature review
No full textThis Annotated Bibliography is one output from a review of the available research evidence to support improved care in residential care homes as the needs of older people intensify.
Key findings
The review identified extremely little published evidence on residential care homes; the research base is almost exclusively related to provision of care in nursing homes. Much of this research is from the US or other non-UK sources. Although it could be argued that some findings are generalisable to the UK residential care context, a systematic process is required
to identify which. The literature often makes no distinction between nursing and residential homes; use of generic terms such as ‘care home’ should be avoided.
There is considerable international debate in the quality improvement literature about the relationship between quality of care and quality of life in nursing and residential homes.
Measures of social care, as well as clinical care, are needed. The centrality of the resident’s voice in measuring quality of life must be recognised. Ethnic minority residents are almost entirely absent from the quality improvement literature.
Some clinical areas, internationally identified as key in terms of quality e.g. palliative care, are absent in the general nursing and residential home quality improvement literature. Others such as mental health (dementia and depression), diabetes, and nutrition are present but not fully integrated.
Considerable evidence points to a need for better management of medication in nursing homes. Pharmacist medication reviews have shown a positive effect in nursing homes. It is unclear how this evidence might relate to residential care.
There is evidence that medical cover for nursing and residential care home residents is suboptimal.
Care could be restructured to give a greater scope for proactive and preventive interventions. General practitioners' workload in care homes may be considered against quality-of-care measures.
There is US literature on the relationship between nurse staffing and nursing care home quality, with quality measured through clinical-based outcomes for residents and organisational outcomes. Conclusions are difficult to draw however due to inconsistencies in the evidencebase.
Hospital admission and early discharge to nursing homes research may not be generalisable to residential care. The quality of inter-institutional transfers and ensuring patient safety across settings is important. To date research has not considered transfer from residential to nursing home care.
The literature on district nurse and therapist roles in care homes includes very little research on residential care. Partnership working between district nurses and care home staff appears largely to occur by default at present. There is even less research evidence on therapist input
to care homes.
Set against the context outlined above, the international literature provides evidence of a number of approaches to care improvement, primarily in nursing homes. These include little discussion of cost-effectiveness other than in telecare. Research is needed in the UK on care
improvement in residential homes
