Objectives Patients who underwent corrective surgery for tetralogy of Fallot (TOF) have increased long-term risk of cardiovascular morbidity and mortality. Yet, limited information is available on how to evaluate the risk in this population. Therefore, the aim of this study was to investigate the prognostic value of aerobic exercise capacity, along with other related parameters, at medium-term follow-up in adult patients with tetralogy of Fallot. Methods and results Between 2000 and 2003, 92 adults (age 26.2 ± 7.8 years; 63 male) with corrected TOF or TOF-type morphology underwent a cardiopulmonary exercise test (CPET) until exhaustion and echocardiography. During a mean follow-up of 7.3 ± 1.2 years (range 0.9 to 9.3 years), 2 patients died and 26 patients required at least 1 cardiac-related intervention at a mean age of 28.9 ± 7.9 years. Event-free survival tended to be higher in patients with the classical type of TOF (P = 0.061). At multivariate Cox analysis, age at CPET [hazard ratio (HR): 1.13, P = 0.006], age at correction (HR: 0.82, P = 0.037), right ventricular (RV) function (HR: 4.94, P = 0.001), QRS duration (HR: 1.02, P = 0.007), percentage of predicted peak oxygen uptake (peak VO2%) (HR: 0.96, P = 0.029) and ventilatory effi ciency slope (VE/VCO2 slope) (HR: 1.13, P = 0.021) were signifi cantly related to the incidence of death/cardiac-related intervention during medium follow-up. Conclusions Early corrective surgery and a well-preserved RV are associated with a better outcome in adults with corrected TOF. Furthermore, CPET provides important prognostic information; peak VO2% and VE/VCO2 slope are independent predictors for event-free survival in patients with corrected TOF.
The objective was to study the prevalence of eighteen geriatric conditions in older patients at admission, their reporting rate in discharge summaries and the impact of these conditions on mortality and functional decline one year after admission. A prospective multicenter cohort study conducted between 2006 and 2008 in two tertiary university teaching hospitals and one regional teaching hospital in the Netherlands. Patients of 65 years and older, acutely admitted and hospitalized for at least 48 hours, were invited to participate. Eighteen geriatric conditions were assessed at hospital admission, and outcomes (mortality, functional decline) were assessed one year after admission.
OBJECTIVES: The survival and success rate and the quality of survival of partial ceramic restorations bonded employing Immediate (IDS) or Delayed Dentin Sealing (DDS) in vital molar teeth were evaluated in a randomized clinical trial with within-subject comparison study.MATERIALS AND METHODS: 30 patients received two lithium disilicate ceramic (IPS-e.max press, Ivoclar Vivadent) partial restorations on vital first or second molar teeth (N = 60). The two teeth randomly received either IDS (test group, n = 30) or DDS (control group, n = 30). Partial ceramic restorations were luted (Variolink Ultra, Ivoclar Vivadent) two weeks after preparation. Evaluations were performed at 1 week, 12 months and 36 months post-operatively, using qualitative (FDI) criteria. Representative failures were evaluated microscopically (SEM) and by means of simplified qualitative fractography analysis.RESULTS: One absolute failure occurred in the DDS group due to (secondary) caries. The overall survival rate according to Kaplan-Meier after 3 years was 98.3% (FDI criteria score 1-4, n = 59) and the overall success rate was 85% (FDI criteria score 1-3, n = 51), with no significant difference between restorations in the IDS and DDS group (p = 0.32; Kaplan-Meier, Log Rank (Mantel-Cox), CI = 95%). For the quality of the survival, no statistically significant differences were found between IDS and DDS (p = 0.7; Kaplan-Meier, Log Rank (Mantel-Cox), CI = 95%) restorations on any follow-up timepoints for any of the FDI criteria (Wilcoxon, McNemar, p > 0.05)..CONCLUSION: Adhesively luted partial ceramic restorations in vital molar teeth have a good prognosis, however IDS did not show any differences in success and survival rates after 3 years of function.
Many Caribbean reefs have shifted from coral-dominated to algal-dominated ecosystems. The high algae cover reduces coral recruitment, making the reef unable to recover from other disturbances and resulting in flatter reefs with lower biodiversity. One of the reasons for the proliferation of algae is a mass die-off of the herbivorous sea urchin Diadema antillarum in the early 1980s. Natural recovery of Diadema populations is slow to non-existent, making active restoration of this important grazer a top priority in Caribbean coral reef management, especially since Diadema densities were reduced by another mass mortality event in 2022. The marine park organizations of Saba and St. Eustatius want to restore Diadema populations by restocking cultured individuals. However, important knowledge gaps need to be addressed before large numbers of Diadema can be restocked on the reef. Current culture methods can only produce a limited number of competent larvae. In addition, only 8% of the settlers survive and after restocking, survival on the reef is low as well. In the RAAK PRO Diadema II project, the bottlenecks in Diadema culture will be addressed by comparing larval survival across multiple culture methods and investigating the relation between larval size and post-settlement survival. Growing-out juveniles at sea is likely to help prepare them for life in the wild, while restocking at an optimal size might also increase survival. Finally, a thorough restocking site selection based on high shelter availability and settlement rates will increase the long-term Diadema densities. The acquired knowledge and developed practices will be verified in a larger scale restocking experiment involving at least 5000 Diadema urchins. By restoring Diadema populations through restocking, macroalgae will be more intensively removed and corals will have a chance to settle and to survive, increasing the ability of the reef to cope with other stressors.
In this project on volunteering in LTH organisation we focus on three aims:1. To explain why organisations in different LTH sectors and regions had, have or need volunteers, how they interact with these volunteers, and the consequences (benefits and challenges) of volunteerism for these organisations.2. To determine how to find the right balance between paid and unpaid staff within the same organisation, considering the LTH sector and region they belong to, in order to create a healthy ecosystem within it (bearing in mind that no organisation can have both volunteers and paid staff do the same job - see above).3. To understand the perspectives, motives and expectations of why people (decide to) volunteer, how they interact with the organisation (management, paid staff) during volunteering, in order to interest them, recruit them, make use of them and retain them. In addition, it is also our aim to explain the benefits and challenges for people to volunteer.In this study, we will use an integrated approach, which implies that we aren’t only interested in the people- or organisation-side of volunteering (actor-side). We will also focus on the interactions between volunteers, paid staff and organisation during volunteering (core of the practice) in a certain LTH organisation, sector and region in the Netherlands (context-side). Studying volunteering in its specific contexts (organisation, sector, region) using an integrated practice approach, hasn’t been done before. In addition, as more and more LTH organisations in the Netherlands rely on volunteers (for their survival), either for economic, social or community (mienskip) reasons (context-related conditions), there is a need for a better understanding of volunteering (as indicated by aim 1-3). Finally, as not much literature has been based on Dutch studies about volunteering and the recruitment and retention of volunteers, this project will fill this gap.Besides the aims as outlined before, a more specific goal of this project is to provide recommendations for a sustainable business model for organisations to embrace volunteerism without affecting the structure of employees. In close cooperation with different LTH organisations, we will develop interventions as policy making instruments (and therefore also for the whole region where they are located). Furthermore, this research will contribute to industry, research (see also below), education (idem) and society. Our ultimate goal is to foster the wellbeing of the volunteers, paid staff and organisations and overall to contribute to social sustainability within The Netherlands.The above-mentioned aims and conceptual model lead to the following research question: How can volunteering in the LTH sectors in Dutch regions be shaped in a sustainable way for both volunteers as well as organisations?In line with what we discussed earlier, this also means contributing to a more stable labour market in hospitality, leisure and tourism in which voluntary work is recognised as an important and indispensable component of a healthy labour ecosystem.The approach we intend to adopt is a qualitative one based on narrative inquiry. While in the literature a quantitative approach using surveys to gather data is mostly used in understanding volunteerism and in measuring motives, we will observe and connect with the volunteers’ work in each sector/case identified and collect and analyse their individual stories. In addition, and in line with our integrated approach, we will investigate how the LTH organisations connected to these cases view the role, value and future of volunteerism.Societal IssueOur insights into volunteers’ work in different sectors will improve their quality of work by revealing drivers of their satisfaction, turnover, motivation, and passion. Managers can use these insights to train and retain volunteers as an integral part of not only their events, but the broader community. It is well-known that robust volunteering programmes are a cornerstone of contemporary social cohesion, and our findings will show how storytelling can strengthen these processes.Benefit to societyThis project will contribute in three ways to the LTH sector. The three outcomes of this study are first around a better understanding of what meaningful volunteering is, second, around the value of volunteers to LTH organisations, and, thirdly, about the value of such activities to Dutch society.The project will provide practical advice to LTH organisations on which interventions to use and in which contexts. This tangible output might take the form of a report, guide(s) mentioned above, and/or another instrument that suits the needs of managers and volunteers. The instrument(s) selected by LTH organisations and volunteers will help to disseminate best practices as well as to highlight the potential of volunteers and volunteering to wider society, other organisations and to current and potential volunteers. By following the steps in or using these instruments, we believe volunteer organisations will be better able to profile themselves and to recruit and retain volunteers.The present study will bring innovation in the field by generating new narratives on volunteerism, and by designing an engaging and appealing path for volunteers to join organisations. At the same time, it will design a structure for organisations to work with volunteers in a sustainable way.Consortium partners: Rodney Westerlaken, Geesje Duursma (both NHL Stenden, Leeuwarden)
