Melk in de keten

Inaugurele rede Wageningen Universitei

Prevalence and consequences of patient safety incidents in general practice in the Netherlands: a retrospective medical record review study

BACKGROUND Patient safety can be at stake in both hospital and general practice settings. While severe patient safety incidents have been described, quantitative studies in large samples of patients in general practice are rare. This study aimed to assess patient safety in general practice, and to show areas where potential improvements could be implemented. METHODS We conducted a retrospective review of patient records in Dutch general practice. A random sample of 1,000 patients from 20 general practices was obtained. The number of patient safety incidents that occurred in a one-year period, their perceived underlying causes, and impact on patients' health were recorded. RESULTS We identified 211 patient safety incidents across a period of one year (95% CI: 185 until 241). A variety of types of incidents, perceived causes and consequences were found. A total of 58 patient safety incidents affected patients; seven were associated with hospital admission; none resulted in permanent disability or death. CONCLUSIONS Although this large audit of medical records in general practices identified many patient safety incidents, only a few had a major impact on patients' health. Improving patient safety in this low-risk environment poses specific challenges, given the high numbers of patients and contacts in general practice.The Dutch Ministry of Health, Welfare and Sport (VWS) initiated the project and supported the project financially (without restrictions on the scientific work; grant number 313741)

Bootstrapped CNNs for Building Segmentation on RGB-D Aerial Imagery

Detection of buildings and other objects from aerial images has various applications in urban planning and map making. Automated building detection from aerial imagery is a challenging task, as it is prone to varying lighting conditions, shadows and occlusions. Convolutional Neural Networks (CNNs) are robust against some of these variations, although they fail to distinguish easy and difficult examples. We train a detection algorithm from RGB-D images to obtain a segmented mask by using the CNN architecture DenseNet.First, we improve the performance of the model by applying a statistical re-sampling technique called Bootstrapping and demonstrate that more informative examples are retained. Second, the proposed method outperforms the non-bootstrapped version by utilizing only one-sixth of the original training data and it obtains a precision-recall break-even of 95.10% on our aerial imagery dataset.Comment: Published at ISPRS Annals of the Photogrammetry, Remote Sensing and Spatial Information Science

ARSR: Committed to Quality and Breaking New Ground

EditorialAs the incoming editor of the Annual Review of Sex Research (ARSR), I was asked to state my goals for the forthcoming series of issues, and I gladly take this opportunity. From the early years of my own work in sex research, the ARSR has been one of my most important resources. Its contributions always brought me comprehensiveness and scholarly excellence, whatever the topic of the article. Thus, it may not come as a surprise that I am dedicated to maintain this high standard of quality and comprehensiveness of the reviews that make it into ARSR. Below, I highlight some of the quality criteria that color my view of what are good and worthwhile review articles

Understanding sexual pain: A cognitive-motivational account

Article in press: Dewitte M et al. Understanding sexual pain: A cognitive-motivational account. PAIN (2010), doi:10.1016/j.pain.2010.10.051Sexual pain or dyspareunia is a prevalent and disabling health problem in women. It is generally defined as a recurrent or persistent pain during sexual activities, involving vaginal penetration or tactile stimulation of the vulva and vestibule. In many patients, the pain is also elicited by nonsexual activities and is comparable to other pain syndromes in terms of severity, sensory characteristics, and neurological processes. As yet, little is known about the etiology of sexual pain because current research is complicated by a number of factors. First, dyspareunia encompasses multiple pain conditions with varying etiologies, causing nosological confusion. Second, evidence on causal factors is inconclusive because there are no controlled experimental studies that allow discerning cause and effect. Third, research has put more emphasis on physical markers – including neurogenic pelvic inflammation, neurochemical influences, central and peripheral sensitization, and increased vulva–vaginal innervations – rather than considering psychosocial variables that may exacerbate and maintain sexual pain problems. Pain is, however, a multidimensional experience that needs to be addressed in all its dimensions, including biomedical as well as psychosocial aspects. Because much less is known about the psychological and relational determinants of sexual pain, this review focuses specifically on the role of cognitive-motivational factors in relation to pain. Such cognitive-motivational perspective is likely to inform both research and clinical practice

Blood clearance and tissue distribution of PEGylated and non-PEGylated gold nanorods after intravenous administration in rats\ud

Aims: To develop and determine the safety of gold nanorods, whose aspect ratios can be tuned to obtain plasmon peaks between 650 and 850 nm, as contrast enhancing agents for diagnostic and therapeutic applications. Materials & methods: In this study we compared the blood clearance and tissue distribution of cetyl trimethyl ammonium bromide (CTAB)-capped and polyethylene glycol (PEG)-coated gold nanorods after intravenous injection in the tail vein of rats. The gold content in blood and various organs was measured quantitatively with inductively coupled plasma mass spectrometry. Results & discussion: The CTAB-capped gold nanorods were almost immediately (<15 min) cleared from the blood circulation whereas the PEGylation of gold nanorods resulted in a prolonged blood circulation with a half-life time of 19 h and more wide spread tissue distribution. While for the CTAB-capped gold nanorods the tissue distribution was limited to liver, spleen and lung, the PEGylated gold nanorods also distributed to kidney, heart, thymus, brain and testes. PEGylation of the gold nanorods resulted in the spleen being the organ with the highest exposure, whereas for the non-PEGylated CTAB-capped gold nanorods the liver was the organ with the highest exposure, per gram of organ. Conclusion: The PEGylation of gold nanorods resulted in a prolongation of the blood clearance and the highest organ exposure in the spleen. In view of the time frame (up to 48 h) of the observed presence in blood circulation, PEGylated gold nanorods can be considered to be promising candidates for therapeutic and diagnostic imaging purpose

Herziening Besluit Psychotherapeut: kans voor sprong voorwaarts.

Het Besluit Psychotherapeut (bp) 1998 regelt de toegang tot het beroep van psychotherapeut in het big-register. Er klinken geluiden om de definitie van het beroep psychotherapeut opnieuw onder de loep te nemen via een herziening van het bp. Een herziening van dit besluit binnen afzienbare tijd is nuttig en noodzakelijk. De bijdrage van psychotherapieonderzoekers aan de herziening is essentieel, omdat de kwaliteitseisen moeten stoelen op onderzoeksgegevens over de werkzaamheid en kosten)effectiviteit van therapieën in plaats van op theoretische stromingen. Van herziening van het besluit valt een belangrijk effect op de praktijk van de psychotherapeutische hulpverlening te verwachten

Structure and the Physico-Mechanical Properties of the Ceramic Coatings Obtained by the Cumulative -Detonation Device

Dense, with good adhesion to the substrate, hard, wear-resistant coatings from the powder of Al2O3 were obtained on the surface of the steel (STE255) by using the cumulative-detonation device. The results of investigations of the structure and physico-mechanical properties of the coatings by using scanning, optical microscopy, X-ray phase analysis, microhardness and tribological tests are presented. It was found that optimization of plasma spraying to helps reduce the porosity of coatings of Al2O3 less than 1 % and to increase the hardness of them to 1250 HV0.3. The tribological investigations have shown that the coatings of Al2O3 significantly increase the wear resistance of the sample STE255 and provide a low ability to wear out the coating. When you are citing the document, use the following link http://essuir.sumdu.edu.ua/handle/123456789/3546

How to Read a Visualization Research Paper: Extracting the Essentials

Introduction. Women's sexual pain disorders include dyspareunia and vaginismus and there is need for state-of-the-art information in this area. Aim. To update the scientific evidence published in 2004, from the 2nd International Consultation on Sexual Medicine pertaining to the diagnosis and treatment of women's sexual pain disorders. Methods. An expert committee, invited from six countries by the 3rd International Consultation, was comprised of eight researchers and clinicians from biological and social science disciplines, for the purpose of reviewing and grading the scientific evidence on nosology, etiology, diagnosis, and treatment of women's sexual pain disorders. Main Outcome Measure. Expert opinion was based on grading of evidence-based medical literature, extensive internal committee discussion, public presentation, and debate. Results. A comprehensive assessment of medical, sexual, and psychosocial history is recommended for diagnosis and management. Indications for general and focused pelvic genital examination are identified. Evidence-based recommendations for assessment of women's sexual pain disorders are reviewed. An evidence-based approach to management of these disorders is provided. Conclusions. Continued efforts are warranted to conduct research and scientific reporting on the optimal assessment and management of women's sexual pain disorders, including multidisciplinary approaches. van Lankveld JJDM, Granot M, Weijmar Schultz WCM, Binik YM, Wesselmann U, Pukall CF, Bohm-Starke N, and Achtrari C. Women's sexual pain disorders. J Sex Med 2010;7:615-631