Validatieonderzoek Welzijnsmeter-dementie

The Well-Being Measure – dementia is a digital observation instrument that assesses the well-being of persons with dementia on four domains of quality of life: Mental well-being, Physical well-being, Participation, and Living arrangements. Its goal is to assess the well-being of persons with dementia in an easy and positive way. Besides illness-related symptoms and problems, the instrument also assesses positive aspects of functioning. It visualizes the results and provides specific behavioural advice to the caregivers. The goal of the present article is to conduct a first psychometric analysis: factor structure, reliability (Cronbach’s alpha), concurrent, and convergent validity.Observations were carried out among 168 persons with dementia in eleven different small-scale psychogeriatric wards. Five existing instruments were used among 63 persons to validate the Well-Being Measure-dementia: quality of life, neuropsychiatric symptoms, care dependency, depression, and agitation.The expected factor structure was found in each of the four domains. Coefficients were high on the expected factor and low on the other factor(s). The scale means were on the positive side, but showed an adequate range and variability. Reliability was satisfactory to good. The relation with existing scales was moderate to strong. The pattern of relations was consistent with the measurement intentions of the different existing instruments.The Well-Being Measure – dementia appears to be a valid and reliable scale. Further studies should assess its test-retest reliability, sensitivity to change and relation with the course of dementia. Current experience shows that the instrument is also useful in everyday practice.     

Use of uterine artery Doppler ultrasonography to predict pre-eclampsia and intrauterine growth restriction: a systematic review and bivariable meta-analysis

Background

Alterations in waveforms in the uterine artery are associated with the development of pre-eclampsia and intrauterine growth restriction. We investigated the predictive accuracy of all uterine artery Doppler indices for both conditions in the first and second trimesters.

Methods

We identified relevant studies through searches of MEDLINE, EMBASE, the Cochrane Library and Medion databases (all records to April 2006) and by checking bibliographies of identified studies and consulting with experts. Four of us independently selected studies, extracted data and assessed study validity. We performed a bivariable meta-analysis of sensitivity and specificity and calculated likelihood ratios.

Results

We identified 74 studies of pre-eclampsia (total 79 547 patients) and 61 studies of intrauterine growth restriction (total 41 131 patients). Uterine artery Doppler ultrasonography provided a more accurate prediction when performed in the second trimester than in the first-trimester. Most Doppler indices had poor predictive characteristics, but this varied with patient risk and outcome severity. An increased pulsatility index with notching was the best predictor of pre-eclampsia (positive likelihood ratio 21.0 among high-risk patients and 7.5 among low-risk patients). It was also the best predictor of overall (positive likelihood ratio 9.1) and severe (positive likelihood ratio 14.6) intrauterine growth restriction among low-risk patients.

Interpretation

Abnormal uterine artery waveforms are a better predictor of pre-eclampsia than of intrauterine growth restriction. A pulsatility index, alone or combined with notching, is the most predictive Doppler index. These indices should be used in clinical practice. Future research should also concentrate on combining uterine artery Doppler ultrasonography with other tests.Pre-eclampsia and intrauterine growth restriction remain important causes of maternal and perinatal morbidity and mortality.^1–3 Maternal complications of pre-eclampsia include coagulopathy, renal and liver failure, and stroke.¹ Adults who were affected by intrauterine growth restriction in utero are at increased risk for cardiovascular disease, hypertension and type 2 diabetes.^4,5Pre-eclampsia and intrauterine growth restriction are characterized by abnormal placenta formation,⁶ which results in inadequate uteroplacental blood flow. This has led to the idea of using Doppler ultrasonography to assess the velocity of uterine artery blood flow as part of routine ultrasound screening.⁷ Low end-diastolic velocities and an early diastolic notch characterize the waveforms of uterine artery blood flow in women who are not pregnant or are in their first trimester. Persistence of a diastolic notch (beyond 24 weeks'' gestation) or abnormal flow velocity ratios have been associated with inadequate trophoblast invasion.⁸Accurate prediction of pre-eclampsia and intrauterine growth restriction is crucial to allow judicious allocation of resources for monitoring and preventive treatment to improve maternal and perinatal outcomes.^9,10 However, studies investigating the predictive accuracy of uterine artery Doppler indices (Box 1) have revealed considerably varied results. Thus, it is questionable whether uterine artery Doppler ultrasonography should be used as a predictive test. We undertook this review to investigate the accuracy of all uterine artery Doppler indices in predicting pre-eclampsia and intrauterine growth restriction.Open in a separate windowBox 1     

Pest species diversity enhances control of spider mites and whiteflies by a generalist phytoseiid predator

To test the hypothesis that pest species diversity enhances biological pest control with generalist predators, we studied the dynamics of three major pest species on greenhouse cucumber: Western flower thrips, Frankliniella occidentalis (Pergande), greenhouse whitefly, Trialeurodes vaporariorum (Westwood), and two-spotted spider mites, Tetranychus urticae Koch in combination with the predator species Amblyseius swirskii Athias-Henriot. When spider mites infested plants prior to predator release, predatory mites were not capable of controlling spider mite populations in the absence of other pest species. A laboratory experiment showed that predators were hindered by the webbing of spider mites. In a greenhouse experiment, spider mite leaf damage was lower in the presence of thrips and predators than in the presence of whiteflies and predators, but damage was lowest in the presence of thrips, whiteflies and predators. Whitefly control was also improved in the presence of thrips. The lower levels of spider mite leaf damage probably resulted from (1) a strong numerical response of the predator (up to 50 times higher densities) when a second and third pest species were present in addition to spider mites, and (2) from A. swirskii attacking mobile spider mite stages outside or near the edges of the spider mite webbing. Interactions of spider mites with thrips and whiteflies might also result in suppression of spider mites. However, when predators were released prior to spider mite infestations in the absence of other pest species, but with pollen as food for the predators, we found increased suppression of spider mites with increased numbers of predators released, confirming the role of predators in spider mite control. Thus, our study provides evidence that diversity of pest species can enhance biological control through increased predator densities.     

Impact of shade on the spatial distribution of Sahlbergella singularis in traditional cocoa agroforests

• 1 Shade management is commonly considered to be an effective pest management strategy for cocoa mirids, yet shade management recommendations are not based on extensive knowledge of the mirid ecology in traditional cocoa agroforests.
• 2 The main objectives of the present study were an assessment of the impact of shade on the spatial distribution of mirid populations and thus the evaluation of shade management strategies.
• 3 Mirid densities were measured and shade was characterized for three plots located in three different agroecological zones in the Centre region of Cameroon. Mirid densities generally followed a negative binomial law. Geostatistical procedures were used to characterize spatial distribution of mirid density. Light conditions were assessed using hemispherical photography.
• 4 Populations of Sahlbergella singularis were highly aggregated in the plots. Semivariance analysis and kriging visualized the spatial dependence of mirid densities. Clearly distinguishable mirid pockets of 20–30 adjacent infested cocoa trees were identified in two of the three plots.
• 5 The high diversity of shade tree species and the large variability in density and size of shade trees resulted in a considerable heterogeneity of plot light conditions. Percentage transmitted light varied in the range 9.4–80.1% in the most heterogeneous plot.
• 6 For two of the three plots, mirid pockets were aggregated in those areas where light transmission was highest. In the third plot, relatively high mirid densities and the presence of an alternative host resulted in a more homogeneous distribution. The importance of these findings for improved mirid control is discussed.

     

The case for Survivin as mitotic regulator

Survivin has been proposed to inhibit apoptosis and to regulate cell division. However, controversy still exists as to whether Survivin can indeed execute these distinct functions and if Survivin somehow coordinates apoptosis and (abnormal) cell division. Recent evidence has demonstrated that Survivin acts as a subunit of the chromosomal passenger complex, which is essential for proper chromosome segregation and cytokinesis. Within this complex, the mitotic kinase Aurora B acts as the enzymatic core, whereas Survivin dictates chromosomal passenger complex localization. This function of Survivin appears to be conserved throughout evolution. Although these findings do not exclude a role for Survivin as apoptosis inhibitor, they make a very strong case for Survivin as mitotic regulator.     

The Banker Plant Method in Biological Control

In the banker plant method, long-lasting rearing units for beneficials are created in the crop by distributing plants infested with herbivores or carrying other food items, such as pollen. The method has been widely investigated over many years and used to aid establishment, development and dispersal of beneficial organisms employed in biological control. In this review, we refine the definition of the banker plant method based on previous concepts and studies and offer the term “banker plant system” to describe the unit that is purposefully added to or established in a crop for control of pests in greenhouses or open field. The three basic elements of a banker plant system (banker plant, food source, beneficials) are discussed and illustrated with examples, and the diversity of banker plant systems (classified by target pest) used or investigated is documented. The benefits of using banker plant systems, such as low cost, increased freshness of beneficials, possibility for preventive control and for integration within IPM frameworks, make the method an interesting plant protection option with potential to enhance adoption of biological control in pest management programs.     

Measuring and Modeling the Effect of Surface Moisture on the Spectral Reflectance of Coastal Beach Sand

Surface moisture is an important supply limiting factor for aeolian sand transport, which is the primary driver of coastal dune development. As such, it is critical to account for the control of surface moisture on available sand for dune building. Optical remote sensing has the potential to measure surface moisture at a high spatio-temporal resolution. It is based on the principle that wet sand appears darker than dry sand: it is less reflective. The goals of this study are (1) to measure and model reflectance under controlled laboratory conditions as function of wavelength () and surface moisture () over the optical domain of 350–2500 nm, and (2) to explore the implications of our laboratory findings for accurately mapping the distribution of surface moisture under natural conditions. A laboratory spectroscopy experiment was conducted to measure spectral reflectance (1 nm interval) under different surface moisture conditions using beach sand. A non-linear increase of reflectance upon drying was observed over the full range of wavelengths. Two models were developed and tested. The first model is grounded in optics and describes the proportional contribution of scattering and absorption of light by pore water in an unsaturated sand matrix. The second model is grounded in soil physics and links the hydraulic behaviour of pore water in an unsaturated sand matrix to its optical properties. The optical model performed well for volumetric moisture content 24% ( 0.97), but underestimated reflectance for between 24–30% ( 0.92), most notable around the 1940 nm water absorption peak. The soil-physical model performed very well ( 0.99) but is limited to 4% 24%. Results from a field experiment show that a short-wave infrared terrestrial laser scanner ( = 1550 nm) can accurately relate surface moisture to reflectance (standard error 2.6%), demonstrating its potential to derive spatially extensive surface moisture maps of a natural coastal beach.     

O2 versus N2O respiration in a continuous microbial enrichment

Despite its ecological importance, essential aspects of microbial N₂O reduction—such as the effect of O₂ availability on the N₂O sink capacity of a community—remain unclear. We studied N₂O vs. aerobic respiration in a chemostat culture to explore (i) the extent to which simultaneous respiration of N₂O and O₂ can occur, (ii) the mechanism governing the competition for N₂O and O₂, and (iii) how the N₂O-reducing capacity of a community is affected by dynamic oxic/anoxic shifts such as those that may occur during nitrogen removal in wastewater treatment systems. Despite its prolonged growth and enrichment with N₂O as the sole electron acceptor, the culture readily switched to aerobic respiration upon exposure to O₂. When supplied simultaneously, N₂O reduction to N₂ was only detected when the O₂ concentration was limiting the respiration rate. The biomass yields per electron accepted during growth on N₂O are in agreement with our current knowledge of electron transport chain biochemistry in model denitrifiers like Paracoccus denitrificans. The culture’s affinity constant (K_S) for O₂ was found to be two orders of magnitude lower than the value for N₂O, explaining the preferential use of O₂ over N₂O under most environmentally relevant conditions.