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In schizophrenia the life expectancy is significantly lower compared to the general population. To monitor their functioning over the course of the illness, a protocol for routine outcome monitoring (ROM) has been developed in the Netherlands.
This study investigated the effectiveness of Routine Outcome Monitoring (ROM) in clinical practice. More specifically, we investigated whether ROM outcomes resulted in treatment in accordance with guidelines for schizophrenia.
Out of the ROM database of 2010 (n=1040), a random sample of 100 patients diagnosed with a psychotic disorder was taken. Data from blood tests, a physical examination, interviews, and standardized questionnaires were used. The prevalence of cardiovascular risk factors, psychosocial problems and sexual dysfunctions was calculated. Offered treatment was investigated with the treatment plans of patients.
The sample consisted of 63 males and 37 females. The average age was 44 and the average duration of illness was 17.7 years. High prevalences of cardiovascular risk factors, psychosocial problems and sexual dysfunctions were found. Cardiovascular risk factors remained untreated in 61% of cases, psychosocial problems remained untreated in 85% of cases and sexual dysfunctions were not treated at all in our sample.
High rates of non-treatment were found for cardiovascular risk factors, psychosocial problems and sexual dysfunctions, despite high prevalences as identified with ROM. Thus, ROM outcomes do not result in treatment in accordance with guidelines for the majority of patients. Steps are necessary to bridge the gap between ROM and treatment to ensure this group of severely mentally ill patients receives the best possible treatment.
Effective infection control measures during norovirus outbreaks are urgently needed in places where vulnerable individuals gather. In the present study, the effect of a number of measures was investigated in daily practice. Forty-nine Dutch nursing homes were monitored prospectively for norovirus outbreaks during two winter seasons. A total of 37 norovirus outbreaks were registered. Control measures were most effective when implemented within 3 days after onset of disease of the first patient. Measures targeted at reduced transmission between persons, via aerosols, and via contaminated surfaces reduced illness in staff and in residents. Reducing illness in staff results in fewer costs for sick leave and substitution of staff and less disruption in the care of residents. The effect of control measures on outbreak duration was limited. This is the first intervention study examining the effect of control measures. Further research is needed to extend and refine the conclusions.
Gyps vulture populations across the Indian subcontinent collapsed in the 1990s and continue to decline. Repeated population surveys showed that the rate of decline was so rapid that elevated mortality of adult birds must be a key demographic mechanism. Post mortem examination showed that the majority of dead vultures had visceral gout, due to kidney damage. The realisation that diclofenac, a non-steroidal anti-inflammatory drug potentially nephrotoxic to birds, had become a widely used veterinary medicine led to the identification of diclofenac poisoning as the cause of the decline. Surveys of diclofenac contamination of domestic ungulate carcasses, combined with vulture population modelling, show that the level of contamination is sufficient for it to be the sole cause of the decline. Testing on vultures of meloxicam, an alternative NSAID for livestock treatment, showed that it did not harm them at concentrations likely to be encountered by wild birds and would be a safe replacement for diclofenac. The manufacture of diclofenac for veterinary use has been banned, but its sale has not. Consequently, it may be some years before diclofenac is removed from the vultures' food supply. In the meantime, captive populations of three vulture species have been established to provide sources of birds for future reintroduction programmes.
In its Asian operations the Dutch United East Indies Company (VOC) (1602–1798) acted both as a territorial ruler and as a trading company. The company shipped large amounts of precious metals to Asia, both in the form of bullion and as coins, to pay for its trade and to provide currency for the areas under its control. The Company faced the problem that silver coins rapidly disappeared from circulation, as demand for silver was high in Asia. The Company attempted to manage the problem with a monetary policy using a unit of account, modelled after the policy of the Dutch Republic. It turned out that the two purposes of the money of account system, viz., putting the bookkeeping on a systematic basis and managing the currency in circulation, were conflicting. The first demanded a fixed unit of account, the second demanded a flexible policy of linking and de-linking the unit of account to real coins. Although the Company managed to muddle through this dilemma, it only succeeded in finding temporary solutions.
Chemical functionalization of bio-molecules, including hemin (an iron porphyrin) and bovine albumin onto Si (100) and GaAs (100) surfaces is reported. Spectroscopic ellipsometry analysis on the optical response of functionalized surfaces provides information on molecular coverage and effective thickness as well as the kinetics of surface attachment. Topographic features of the chemically functionalized surfaces are investigated by atomic force microscopy
Techniques have been developed to produce microbial phytase for addition to diets for simple-stomached animals, with the aim to improve phosphorus availability from phytate-P in plant sources. The activityof the crude microbial phytase showed pH optima at pH 5-5 and 2·5. The enzyme was able to degradephytate in vitro in soya-bean meal, maize and a liquid compound feed for pigs. When microbial phytasewas added to low-P diets for broilers the availability of P increased to over 60 % and the amount of Pin the droppings decreased by 50%. The growth rate and feed conversion ratio on the low-P dietscontaining microbial phytase were comparable to or even better than those obtained on control diets.Addition of microbial phytase to diets for growing pigs increased the apparent absorbability of P by24%. The amount of P in the faeces was 35% lower.
Bonding of polished, polycrystalline diamond films to silicon was performed in ultra high vacuum at 32 MPa of applied uniaxial stress. The transmission electron microscopy (TEM) investigation revealed that the interface of all bonded samples was non-uniform. An abrupt boundary between the two wafers existed only in some parts of the interface, while other parts contained an amorphous interlayer of up to 40 nm in thickness. Electron energy loss spectroscopy (EELS) revealed that this interlayer consisted of oxygen, carbon and silicon. Based on comparison of the microstructure and chemical composition of the interface formed at different bonding temperatures, we propose a model for the silicon/diamond wafer fusion process.
One-dimensional (In,Ga)As quantum dot (QD) arrays are formed on planar singular and shallow-patterned (mesa gratings) GaAs (100) substrates by self-organized anisotropic strain engineering of an (In,Ga)As/GaAs quantum wire (QWR) superlattice (SL) template in molecular beam epitaxy. On planar singular substrates, highly uniform one-dimensional single QD arrays, which are extended over 10 μm length, are realized with efficient photoluminescence. The shallow mesa gratings along [0–11] and  induce two different types of steps which differently affect the surface migration processes crucial for QWR template development, i.e., strain driven In adatom migration along  and surface reconstruction induced adatom migration along [0–11]. While type-A steps along [0–11] have no significant effect on the adatom migration along  and [0–11], type-B steps along  hinder the surface reconstruction induced migration along [0–11] to prevent formation of QWR and ordered QD arrays.
The impact of the 1930s depression on the Philippines shows a mixed picture, differing according to region and social class. Most probably the Philippines as a whole suffered less than neighbouring countries. Comparative figures show that for the years 1934 to 1938, consumption levels in the Philippines were the highest in Asia outside Japan. However, national averages do not tell the whole story. Declining prices hit agrarian commodities unevenly, and as each commodity was concentrated in a particular ecological region, the regional impact of the crisis was uneven.
The economic decline in the advanced capitalist countries was transmitted to the tropical colonies through four mechanisms — the decline in trade, the change in relative prices in favour of the advanced countries, the decline in capital flows to the colonies, and finally a steep decline in the world price level. The Philippines was affected by all these mechanisms, but less severely than some of its neighbours, because its status as a colony and trading partner of the United States provided it with a number of privileges. Although the country could not escape from price declines, some of its export commodities found a protected market in the United States, enabling it to maintain export volumes and (in the case of sugar) its price level.
Trade between the Philippines and the United States had increased very considerably over the years. The Payne-Aldrich Tariff Act of 1909 and the Underwood Tariff Act of 1913 had instituted reciprocal free trade between the two countries. When the depression hit the United States, the American Government adopted various trade restrictions. The Smoot-Hawley Tariff Act of 1930 substantially increased the import duty on Cuban sugar, but not on Philippine sugar. The Jones-Costigan Act of 1934 applied quotas on sugar imports into the United States, but the Philippines received a much more favourable quota than did Cuba.
Behavioural, cognitive, and affective aspects of social functioning of 107 children with
a chronic illness were studied. The aim of the study was twofold: (1) to describe
peer interaction of children with a chronic illness in comparison with normative data
of healthy children; (2) to examine whether peer interaction was related to the
illness characteristics physical restrictions and pain. Peer interaction was assessed with
measures of social activities (CBCL), parent-reported social skills (CABS), child-reported
social skills (MESSY), social self-esteem (SPPC), and social anxiety (SASK). Results showed
no differences between diagnosis groups, suggesting that the social consequences of chronic
illness are not diagnosis specific. Compared with healthy norms, chronically ill children
reported less aggressive behaviour. The parent-report measures suggested a similar trend.
Children with chronic illness also tended to display more submissive behaviour than healthy
norms, as perceived by their parents. With regard to illness characteristics, both physical
restrictions and pain were associated with restricted social activities, but not with other
measures of social peer interaction. Children who display submissive behaviour and children
who are restricted in their social activities should receive extra attention because they are
especially vulnerable for problems in their social development.
Monodisperse silica-tin oxide particles of the core-shell type were prepared via a sol-gel process without formation of agglomerates. After synthesis of silica cores the surface was coated with tin oxide by controlled hydrolysis and condensation of tin(IV) tertiary butoxide. Particle properties were characterized by electron microscopy, dynamic light scattering, N2-sorption (BET), zeta potential and X-ray fluorescence analysis. As a consequence of the variable content of tin oxide numerous possible applications arise, for example introducing X-ray opacity in dental filling materials. In order to use such particles as fillers, an additional surface functionalization with 3-methacryloxypropyltrimethoxysilane was created matching the C=C-functional groups of the polymer resins, e.g. ORMOCER*s. Characterization methods such as diffuse reflectance infrared Fourier transform spectroscopy and elemental analysis were used to confirm the surface coverage.