BACKGROUND: Prednisolone and other glucocorticoids (GCs) are potent anti-inflammatory and immunosuppressive drugs. However, prolonged use at a medium or high dose is hampered by side effects of which the metabolic side effects are most evident. Relatively little is known about their effect on gene-expression in vivo, the effect on cell subpopulations and the relation to the efficacy and side effects of GCs.AIM: To identify and compare prednisolone-induced gene signatures in CD4⁺ T lymphocytes and CD14⁺ monocytes derived from healthy volunteers and to link these signatures to underlying biological pathways involved in metabolic adverse effects.MATERIALS & METHODS: Whole-genome expression profiling was performed on CD4⁺ T lymphocytes and CD14⁺ monocytes derived from healthy volunteers treated with prednisolone. Text-mining analyses was used to link genes to pathways involved in metabolic adverse events.RESULTS: Induction of gene-expression was much stronger in CD4⁺ T lymphocytes than in CD14⁺ monocytes with respect to fold changes, but the number of truly cell-specific genes where a strong prednisolone effect in one cell type was accompanied by a total lack of prednisolone effect in the other cell type, was relatively low. Subsequently, a large set of genes was identified with a strong link to metabolic processes, for some of which the association with GCs is novel.CONCLUSION: The identified gene signatures provide new starting points for further study into GC-induced transcriptional regulation in vivo and the mechanisms underlying GC-mediated metabolic side effects.
Study goal: This study was carried out to answer the following research question: which motivation do healthy volunteers have to participate in phase I clinical trials? - Methods: A literature search was done through Google Scholar and Academic Search Premier, followed by three interviews with volunteers who had recently concluded their participation in a (non-commercial) phase I trial. - Results: Our literature search revealed mainly commercial motives for volunteers to participate in phase I clinical trials. The interviews (with volunteers in a non-commercial trial) showed that other factors may also play a decisive role, such as: (1) wish to support the investigator (2) wish to contribute to science, (3) access to more/better health care (4) sociability: possibility to relax and to communicate with other participants (5) general curiosity. Precondition is that risks and burden are deemed acceptable. - Conclusions: financial remuneration appears to be the predominant motive to participate voluntarily in a clinical trial. Other reasons were also mentioned however, such as general curiosity, the drive to contribute to science and the willingness to help the investigator. In addition, social reasons were given such as possibility to relax and to meet other people. Potential subjects state that they adequately assess the (safety) risks of participating in a trial as part of their decision process.
Background: Collar-related pressure ulcers (CRPU) are a problem in trauma patients with a suspicion of cervical cord injury patients. Indentation marks (IM), skin temperature (Tsk) and comfort could play a role in the development of CRPU. Two comparable cervical collars are the Stifneck® and Philadelphia®. However, the differences between them remain unclear. Aim: To determine and compare occurrence and severity of IM, Tsk and comfort of the Stifneck® and Philadelphia® in immobilized healthy adults. Methods: This single-blinded randomized controlled trial compared two groups of immobilized participants in supine position for 20 min. Results: All participants (n = 60) generated IM in at least one location in the observed area. Total occurrence was higher in the Stifneck®-group (n = 95 versus n = 69; p = .002). Tsk increased significantly with 1.0 °C in the Stifneck®-group and 1.3 °C in the Philadelphia®-group (p = .024). Comfort was rated 3 on a scale of 5 (p = .506). Conclusion: The occurrence of IM in both groups was high. In comparison to the Stifneck®, fewer and less severe IM were observed from the Philadelphia®. The Tsk increased significantly with both collars; however, no clinical difference in increase of Tsk between them was found. The results emphasize the need for a better design of cervical collars regarding CRPU.
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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)
