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positive health:An integrated quantitative approach in patients with chronic gastrointestinal and hepato-pancreatico-biliary disorders

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World Journal of Gastroenterology 2024年第28期30卷 3418-3427页

作者： Anja H W M Lemlijn-Slenter Karolina Ap Wijnands Gijs van der Hamsvoort luuk p van iperen Nico Wolter Angelique E de Rijk Ad AM Masclee Department of Social Medicine Faculty of HealthMedicine and Life sciencesCare and Public Health Research Institute Maastricht UniversityMaastricht 6200 MDLimburgNetherlands Division of Gastroenterology and Hepatology Department of Internal MedicineSchool of Nutrition and Translational Research in MetabolismMaastricht 6200 MDLimburgNetherlands Social Medical Affairs Employee Insurance Agency(UWV)Heerlen 6400 ACLimburgNetherlands Department of Research Academic Knowledge Center Work and Health South-East Netherlands(AKAG-ZON)Heerlen 6400 ACLimburgNetherlands

BACKGROUND The concept of positive health(pH)supports an integrated approach for patients by taking into account six dimensions of *** approach is especially relevant for patients with chronic *** gastrointestinal and hepatopancreatico-biliary(GI-HpB)disorders are among the top-6 of the most prevalent chronically affected organ *** impact of chronic GI-HpB disorders on individuals may be disproportionally high because:(1)The affected organ system frequently contributes to a malnourished state;and(2)persons with chronic GIHpB disorders are often younger than persons with chronic diseases in other organ *** To describe and quantify the dimensions of pH in patients with chronic GI-HpB *** prospective,observational questionnaire study performed between 2019 and 2021 in 235 patients with a chronic GIHpB disorder attending the Outpatient Department of the Maastricht University Medical *** questionnaires and data from patient files were used to quantify the six dimensions of *** consistency was tested with McDonald’s ***-order pearson correlations and t-tests were used to assess associations and differences.A p valuepB patients scored significantly worse in all dimensions of pH compared to control data or norm scores from the general *** quality of life,participation and daily functioning,GI-HpB patients scored in the same range as patients with chronic disorders in other organ systems,but depressive symptoms(in 35%)and malnutrition(in 45%)were more frequent in patients with chronic GI-HpB *** scores between the six dimensions were only very weak to weak,forcing us to quantify each domain *** All six dimensions of pH are impaired in the GI-HpB *** and depressive symptoms are more prevalent compared to patients with chronic disorders in other organ systems.

关键词： positive health Chronic gut disorders Gastrointestinal disorders Hepato-pancreatico-biliary disorders Integrated care

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Watershed management,groundwater recharge and drought resilience:An integrated approach to adapt to rainfall variability in northern Ethiopia

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International Soil and Water Conservation Research 2024年第3期12卷 663-683页

作者： Kifle Woldearegay Berhane Grum Rudi Hessel Frank van Steenbergen luuk Fleskens Eyasu Yazew Lulseged Tamene Kindu Mekonnen Teklay Reda Mulu Haftu School of Earth Science Mekelle UniversityP.O.Box 231MekelleEthiopia School of Civil Engineering Mekelle Institute of Technology-MekelleMekelle UniversityP.O.Box 3185MekelleEthiopia Soil Water and Land Use TeamWageningen Environmental ResearchP.O.Box 476700 AAWageningenThe Netherlands MetaMeta Research Postelstraat 25211EA's-HertogenboschThe Netherlands Soil physics and Land Management Group Wageningen UniversityP.O.Box 476700 AAWageningenThe Netherlands Department of Land Resource Management and Environmental protection Mekelle UniversityP.O.Box231MekelleEthiopia International Centre for Tropical Agriculture(CIAT) Addis AbabaEthiopia International Livestock Research Institute(ILRI) Addis AbabaEthiopia Wukro Saint Mary College WukroTigrayEthiopia

Rainfall variability coupled with poor land and water management is contributing to food insecurity in many sub-Saharan African countries such as *** address such challenges,various efforts have been implemented in *** objective of this study was to evaluate the long-term impacts of different soil and water conservation and water harvesting interventions on groundwater and drought resilience of the Gule watershed,northern *** study involved:(i)documentation of the ap-proaches followed and the technologies implemented in Gule since the 1990s,(ii)monitoring the hy-drological effects of the interventions for ten years,and(iii)evaluation of the effects of the interventions on groundwater(level and quality),spring discharge and suspended sediment concentration(SSC)in *** showed that interventions were implemented at different stages and *** a result of the interventions,the watershed was transformed into a landscape resilient to rainfall variability:(a)dry shallow groundwater wells have become productive and the level of water in wells has raised,(b)the groundwater quality has improved,(c)SSC in high floods has reduced by up to 65%,(d)discharge of existing springs has increased by up to 73%and new springs have started to *** to improved water availability,irrigated land has increased from less than 3.5 ha before 2002 to 166 ha in *** have remained water-secure during an extreme drought in 2015/*** of watershed management practices has transformed the landscape to be resilient to rainfall variability in a semi-arid environment:a lesson for adaptation to climate variability and change in similar environments.

关键词： Climate change Green and blue water Landscape restoration Water harvesting

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Endovascular treatment in anterior circulation stroke beyond 6.5 hours after onset or time last seen well:results from the MR CLEAN Registry

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Stroke & Vascular Neurology 2021年第4期6卷 572-580,I0037-I0048页

作者： luuk Dekker Esmee Venema F Anne V pirson Charles B L M Majoie Bart J Emmer Ivo G H Jansen Maxim J H L Mulder Robin Lemmens Robert-Jan B Goldhoorn Marieke J H Wermer Jelis Boiten Geert J LycklamaàNijeholt Yvo B W E M Roos Adriaan C G M van Es Hester F Lingsma Diederik W J Dippel Wim H van Zwam Robert J van Oostenbrugge Ido R van den Wijngaard on behalf of the MR CLEAN Registry investigators Neurology Leiden University Medical CentreLeidenThe Netherlands Neurology Erasmus MCRotterdamThe Netherlands public Health Erasmus MCRotterdamThe Netherlands Neurology Maastricht University Medical Centre+MaastrichtThe Netherlands Radiology and Nuclear Medicine Amsterdam University Medical CentreLocation AMCAmsterdamThe Netherlands Neurology University Hospitals LeuvenLeuvenBelgium Neurosciences Experimental Neurology and Leuven Brain InstituteUniversity of LeuvenLeuvenBelgium VIB Center for Brain&Disease ResearchLaboratory of NeurobiologyLeuvenBelgium Neurology Haaglanden Medical CentreDen HaagThe Netherlands Radiology Haaglanden Medical CentreDen HaagThe Netherlands Neurology Amsterdam University Medical CentreLocation AMCAmsterdamThe Netherlands Radiology Leiden University Medical CentreLeidenThe Netherlands Radiology Maastricht University Medical Centre+MaastrichtThe Netherlands

Background Randomised controlled trials with perfusion selection have shown benefit of endovascular treatment(EVT)for ischaemic stroke between 6 and 24 hours after symptom onset or time last seen ***,outcomes after EVT in these late window patients without perfusion imaging are largely *** assessed their characteristics and outcomes in routine clinical *** The Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands Registry,a prospective,multicentre study in the Netherlands,included patients with an anterior circulation occlusion who underwent EVT between 2014 and *** perfusion was no standard imaging *** used adjusted ordinal logistic regression analysis to compare patients treated within versus beyond 6.5 hours after propensity score matching on age,prestroke modified Rankin Scale(mRS),National Institutes of Health Stroke Scale,Alberta Stroke programme Early CT Score(ASpECTS),collateral status,location of occlusion and treatment with intravenous *** included 3-month mRS score,functional independence(defined as mRS 0-2),and *** Of 3264 patients who underwent EVT,106(3.2%)were treated beyond 6.5 hours(median 8.5,IQR 6.9-10.6),of whom 93(87.7%)had unknown time of stroke *** perfusion was not performed in 87/106(80.2%)late window *** window patients were younger(mean 67 vs 70 years,ppECTS(median 8 vs 9,pp=0.03).No differences were observed in proportions of functional independence(43.3%vs 40.5%,p=0.57)or death(24.0%vs 28.9%,p=0.28).After matching,outcomes remained similar(adjusted common OR for 1 point improvement in mRS 1.04,95%CI 0.56 to 1.93).Conclusions Without the use of CT perfusion selection criteria,EVT in the 6.5-24-hour time window was not associated with poorer outcome in selected patients with favourable clinical and CT/C

关键词： treatment beyond Registry

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