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The UN Sustainable Development Goals (SDGs) and targets are an important achievement. They largely reflect the worldview of Modernity, with its emphasis on scientific and planning rationality and emancipatory ideals. This worldview is no longer evident and dominant, and it is time to systematically explore complementing worldviews. Explicit use of worldviews, as sets of values and beliefs, and ethics enriches the interpretation and implementation of the SDGs. This facilitates the engagement of citizens in their real-world diversity and the development of respect for and empathy and cooperation with people holding other values, beliefs and morals. Dialogue around ‘the middle road’ can give guidance to just, fair and sustainable development pathways.
Physicochemical properties of diets are believed to play a major role in the regulation of digesta transit in the gastro-intestinal tract. Starch, being the dominant nutrient in pig diets, strongly influences these properties. We studied transport of digesta solids and liquids trough the upper gastro-intestinal tract of 90 pigs in a 3x3 factorial arrangement. Dietary treatments varied in starch source (barley, maize, high-amylose maize) and form (isolated starch, ground cereal, extruded cereal). Mean retention times (MRT) of digesta solids ranged 129-225 min for the stomach and 86-124 min for the small intestine (SI). The MRT of solids consistently exceeded that of liquids in the stomach, but not in the SI. Solid digesta of pigs fed extruded cereals remained 29-75 min shorter in the stomach compared with pigs fed ground cereals (P<0.001). Shear stress of whole digesta positively correlated with solid digesta MRT in the stomach (r=0.33, P<0.001), but not in the SI. The saturation ratio (SR), the actual amount of water in stomach digesta as a fraction of the theoretical maximum held by the digesta matrix, explained more variation in digesta MRT than shear stress. The predictability of SR was hampered by the accumulation of large particles in the stomach. In addition, the water holding capacity of gelatinised starch lead to a decreased SR of diets, but not of stomach digesta, which was caused by gastric hydrolysis of starch. Both of these phenomena hinder the predictability of gastric retention times based on feed properties.
Before drawing conclusions on the contribution of an effective intervention to daily practice and initiating dissemination, its quality and implementation in daily practice should be optimal. The aim of this process evaluation was to study these aspects alongside a randomized controlled trial investigating the effects of a multidisciplinary biannual medication review in long-term care organizations (NTR3569).
Process evaluation with multiple measurements.
Thirteen units for people with dementia in six long-term care organizations in the Netherlands.
Physicians, pharmacists, and nursing staff of participating units.
The PROPER intervention is a structured and biannually repeated multidisciplinary medication review supported by organizational preparation and education, evaluation, and guidance.
Web-based questionnaires, interviews, attendance lists of education sessions, medication reviews and evaluation meetings, minutes, evaluation, and registration forms.
Participation rates in education sessions (95%), medication reviews (95%), and evaluation meetings (82%) were high. The intervention’s relevance and feasibility and applied implementation strategies were highly rated. However, the education sessions and conversations during medication reviews were too pharmacologically oriented for several nursing staff members. Identified barriers to implementation were required time, investment, planning issues, and high staff turnover; facilitators were the positive attitude of professionals toward the intervention, the support of higher management, and the appointment of a local implementation coordinator.
Implementation was successful. The commitment of both higher management and professionals was an important factor. This may partly have been due to the subject being topical; Dutch long-term-care organizations are pressed to lower inappropriate psychotropic drug use.
According to cognitive behavioural theory, cognitive factors (i.e. underlying general dysfunctional beliefs and (situation) specific illness beliefs) are theorized to lead to outcomes like anxiety and depression. In clinical practice, general dysfunctional beliefs are generally not tackled directly in short-term-therapy.
The goal of the present study was to investigate the associations of general versus specific illness beliefs on anxiety and depressive symptoms and psychiatric disorders among a subgroup of patients with inflammatory bowel disease (IBD) with poor mental quality of life (QoL).
This study concerns cross-sectional data, collected at baseline from a randomized clinical trial. One hundred and eighteen patients, recruited at four Dutch hospitals, with poor QoL (score ≤23 on the mental health subscale of the Short-Form 36-item Health-Survey; SF-36) were included. General dysfunctional beliefs were measured by the Dysfunctional Attitude Scale (DAS), specific illness beliefs by the Illness Perceptions Questionnaire-Revised (IPQ-R), anxiety and depressive symptoms by the Hospital Anxiety and Depression Scale (HADS), and psychiatric disorders by the Structured Clinical Interview for DSM-IV Axis-I Disorders (SCID-I).
Univariate analyses showed associations between the level of anxiety and/or depression and general dysfunctional beliefs and four specific illness beliefs (consequences, personal control, emotional representations and treatment control). Among patients with IBD with psychiatric disorders, only the DAS was significantly associated with anxiety and depression (DAS added to IPQ-R and IPQ-R added to DAS).
Psychological interventions may have to target general dysfunctional beliefs of patients with IBD with co-morbid psychiatric disorders to be effective. These patients with IBD are especially in need of psychological treatment.
The use of compost bedded pack systems (CBS) has increased over the past 5 years in tropical countries, and studies associating production traits with economical outcomes of this system are warranted. Our objectives were to evaluate productive traits, economic outcomes and the risks of losses of dairy farms that switched from a drylot system (DLS) to a CBS and to compare these with similar farms that did not change their system. We collected data from 18 farms over 36 consecutive months (August 2014 to July 2017). All farms started the study as DLS, and six farms switched to CBS in the second year. The other 12 farms kept their DLS during the 36 months of evaluation. Annual technical and economic indexes per farm were collected and calculated. Additionally, a risk analysis was performed based on a 10-year historical series of milk prices. The results were analysed using a regression model including year and herd as categorical variables (fixed), system and herd size as quantitative variables (fixed), and system × herd as a random variable. Furthermore, a non-metric multidimensional scaling plot was used to evaluate producers’ profiles in each year. Milk fat, milk total solids, and somatic cell count did not change when farms switched from DLS to CBS, and averaged 3.80%, 12.04%, and 256 500 cells/ml, respectively. However, milk protein (%) decreased in CBS farms. The majority of milk production variables were not affected. Nevertheless, farms that switched to CBS increased milk production per cow by 13.3% compared with DLS farms. Total operation costs (296 076.83 $/year) were not affected by the system, and neither were the costs of concentrates, roughage, labour or medicines. Net margin per litre (0.09 $/l), operating profit (14.95%), assets per litre (398.68 $/l per day) and return on assets (10.27%) did not change when farms switched from DLS to CBS. Net margin ($/l and $/cow) and asset turnover rate increased in CBS farms. Risk analysis indicated that the risk was reduced by 38% in CBS farms. Furthermore, our analysis showed that producers who switched to CBS had similar technical and economic indexes in the first year before switching their system. In conclusion, this study demonstrates that CBS systems might be promising for producers in tropical countries who are looking for a more productive and less risky system. We did not observe improvements in animal health as previously reported in the literature.
Rheological properties of digesta play a role in digesta passage kinetics through the gastrointestinal tract, in turn affecting nutrient absorption kinetics. Therefore, we studied the effects of diet viscosity on digesta passage and physicochemical properties in pigs. Twenty male growing pigs (35 kg body weight at the start) were assigned to one of five diets with increasing dietary concentrations of β-glucans (BG; from 0 % to 10 %), in exchange for maize starch. After a 17-day adaptation period, pigs were euthanised and the mean retention time (MRT) of digesta solids (TiO2) and liquids (Cr-EDTA) in the stomach, and proximal and distal half of the small intestine was quantified. In the stomach, the MRT of liquids, but not of solids, increased when dietary BG level increased (6 min per % dietary BG, P = 0.008 and R2 = 0.35). Concomitantly, stomach DM content (5 g/kg per % dietary BG, P < 0.001 and R2 = 0.53) and apparent digesta viscosity (56 Pa × s at 1/s shear rate per % dietary BG, P = 0.003 and R2 = 0.41) decreased. In the proximal half of the small intestine, no effects of dietary BG level were observed. In the distal half of the small intestine, water-binding capacity (WBC) of digesta increased (0.11 g/g digesta DM per % dietary BG, P = 0.028 and R2 = 0.24) and starch digestibility decreased (0.3% per % dietary BG, P = 0.034 and R2 = 0.23) when dietary BG level increased. In the colon, apparent digesta viscosity at 45/s shear rate increased (0.1 Pa × s per % dietary BG, P = 0.03 and R2 = 0.24) in the proximal half of the colon, and digesta WBC increased (0.06 g/g digesta DM per % dietary BG, P = 0.024 and R2 = 0.26) in the distal half of the colon when dietary BG level increased. To conclude, increasing dietary BG level caused the MRT of liquids, but not that of solids, to increase in the stomach, resulting in reduced separation of the solid and liquid digesta fractions. This caused dilution of the stomach content and reduction in digesta viscosity when dietary BG levels increased. Effects of dietary BG level on physicochemical properties in the proximal small intestine were absent and may have been due to a low DM content. The WBC of digesta in the distal small intestine and colon increased when dietary BG level increased, as did apparent digesta viscosity in the proximal colon. This likely reflects the concentration of BG in digesta when moving through the gastrointestinal tract.
The emerging field of biomimicry and learning to design with and for nature has expanded in recent years through a diversity of educational programs. Inspiration following natural forms may give the appearance of being sustainable, but the question remains, how sustainable is it? Misunderstanding the function of these forms may leave designers with products not as sustainable as desired. Biomimicry education addresses these issues by integrating three essential elements into their design thinking phases and by using analogical transfer while doing so. This field learns from nature as model, nature as measure, and nature as mentor, throughout the design process. Through examination, analyses and verification of students designs and reflective processes at The Hague University of Applied Sciences, this research considers natures analogies in educational factors, determining which elements are influential when incorporating biomimicry into design education.
Although anorectal Chlamydia trachomatis (CT) infections are frequently diagnosed in men who have sex with men (MSM) and women, the reason for this infection often remains unexplained, as anal sex is not always reported. Oropharyngeal infections inoculating the gastrointestinal (GI) tract may contribute to anorectal-CT infections, as evidence in animals suggests that chlamydia bacteria undergo GI passage; however, no evidence exists in humans. Longitudinal patient clinic-registry data from MSM (n = 17 125) and women (n = 4120) from two Dutch sexually transmitted infection clinics were analysed. When adjusting for confounding socio-demographics, co-infections and risk behaviour, previous (from 3 weeks up to 24 months) oropharyngeal CT was not a risk factor for subsequent anorectal CT in women (odds ratio (OR) 0.46; 95% confidence interval (CI) 0.18–1.18; P = 0.11) and MSM (OR 1.33; 95% CI 0.86–2.07; P = 0.204). Despite the large dataset, the numbers did not allow for the estimation of risk in specific subgroups of interest. The role of the GI tract cannot be excluded with this epidemiological study, but the impact of preceding oropharyngeal CT on anorectal-CT infection is likely limited.
This is a copy of the slides presented at the meeting but not formally written up for the volume.
Conductive metal patterns can be fabricated through the selective electroless growth of silver on isolated nanocolloidal gold particles, deposited onto chemically functionalized substrates using microcontact printing. The transition from isolated nanoparticles to continuous, conducting silver films is characterised by a percolation threshold. Using spectroscopic ellipsometry in the visible and near-infrared spectral range on homogeneous particulate films, we have investigated this percolation threshold. From the ellipsometry spectra obtained as a function of electroless silver deposition times, the effective thickness as well as the complex dielectric function of the growing films are determined. For short deposition times, the optical spectra exhibit features characteristic of an effectively insulating, particulate layer. A maximum is observed in the imaginary part of the dielectric function, which shifts towards lower energy with increasing amounts of deposited silver. For thicker films, the appearance of a Drude-like free electron contribution to the optical spectra is exhibited by a strong increase of both the real and imaginary parts of the dielectric function towards lower energy. From the optical spectra, the percolation threshold is identified. The ellipsometry results are discussed in relation to DC conductivity measurements, which also reveal a percolation threshold. Furthermore, our conclusions and the advantages of our approach are discussed in relation to recently published in situ experiments, in which the growth of magnetron sputtered silver nanoparticles is monitored real-time yielding similar optical responses.
With increasing numbers of children growing up with conditions that are associated with acquired brain injury, efficient neuropsychological screening for cognitive deficits is pivotal. Brief self-report measures concerning daily complaints can play an important role in such screening. We translated and adapted the pediatric perceived cognitive functioning (PedsPCF) self- and parent-report item bank to Dutch. This study presents (1) psychometric properties, (2) a new short form, and (3) normative data for the short form.
A general population sample of children and parents was recruited. Dimensionality of the PedsPCF was assessed using confirmatory factor analyses and exploratory bifactor analyses. Item response theory (IRT) modeling was used to evaluate model fit of the PedsPCF, to identify differential item functioning (DIF), and to select items for the short form. To select short-form items, we also considered the neuropsychological content of items.
In 1441 families, a parent and/or child participated (response rate 66% at family level). Assessed psychometric properties were satisfactory and the predominantly unidimensional factor structure of the PedsPCF allowed for IRT modeling using the graded response model. One item showed meaningful DIF. For the short form, 10 items were selected.
In this first study of the PedsPCF outside the United States, studied psychometric properties of the translated PedsPCF were satisfactory, and allowed for IRT modeling. Based on the IRT analyses and the content of items, we proposed a new 10-item short form. Further research should determine the relation of PedsPCF outcomes with neurocognitive measures and its ability to facilitate neuropsychological screening in clinical practice.
One of the Sustainable Development Goals, number 10, is about reducing inequality within and between countries. This paper argues that the existing structure of the (international) financial system is, for various reasons, one of the determinants of (growing) inequality. This should receive more attention.
Behavioral economists and social psychologists have shown that extrinsic motivations can crowd out intrinsic motivations to act. This study examines this crowding out effect in the context of legislative behavior. By exploiting the federal nature of Swiss elections, we examine if response rates to requests of voters residing inside or outside a candidate's district vary based on the electoral competition candidate legislators face. We report two main findings. First, we find a high response rate among Swiss candidates (66 percent) which remains high for voters who reside outside a candidate's district (59 percent) suggesting that intrinsic motivations are a key driver of constituency effort. Second, the response to voters who reside inside a candidate's district is more pronounced for candidates confronted with a high degree of electoral competition. This suggests that extrinsic motivations are important for constituency work, but at the same time their presence might crowd out intrinsic motivations. This evidence suggests that the relationship between electoral competition and responsiveness might be less straightforward than assumed.