In many studies on recreation and leisure as a social phenomenon, leisure is regarded as the opposite of work, or to compensate for it. Leisure is also seen as being complementary to an individual's ...line of work. However, a number of scholars question whether this is the most fruitful approach to gain insight into recreation and leisure. According to Philipsen (1963), Roberts (1981), Kelly (1983) and Te Kloeze (1985a), a family or household approach is more productive.
An attempt to resolve the "actor-structure" dilemma in the field of leisure studies can be found in the contextual approach to leisure (Beckers and Van der Poel, 1990), inspired by the theory of structuration (Giddens, several studies). Karsten (1992) conducted an allied study on women's control over leisure and leisure activities. A new approach to the sociology of marriage and the family can be found in Weeda's (1992) ideas and interpretation of man- woman/husband-wife relationships, lifestyles and societal images, all under the title of "gender culture theory". Analogous is Giddens' (1991) idea of "pure relationship".
This paper discusses the theoretical basis for an empirical study on the reciprocal meaning of family and leisure, which is in progress. Concepts from the contextual approach of leisure (control, meaning, daily path, social position and caring role) and from the gender culture theory (sex paradigm) are the central notions of the study and are presented in a conceptual framework.
The family in the Netherlands is once again on the political agenda. Newspapers and television announce discussions between politicians and policymakers. Scientists however, free from the political ...tide, are researching families in an attempt to discover the true developments. In this paper, an account is given of research into the family, upbringing and leisure. The study was carried out for the third time in the south of the Netherlands, in the towns of Arkel and Kedichem. In 1960, the research involved the modern Western family, while in 1972 the plastic family was registered. The third study had the task of getting empirical evidence to support the new family type. The first two studies were virtually identical in set-up, whereas the third study was very different because the questions asked before proved impossible to duplicate. Moreover, the third study consisted of three main themes: general family aspects, family and upbringing, and family and leisure. The content of the paper has mainly to do with the first and third themes. Structured interviews were conducted with 331 mothers who had at least one child aged between 0 and 18. The study illustrated the existence of three family types in rural areas in the Netherlands-the modern Western (contemporary: traditional), the transitional, and the postmodern family with its subtle leaning toward the value of leisure in the family. The general family typology demonstrates that in rural areas in the Netherlands in the late eighties/early nineties, 21% of the families were characterised as modem Western (traditional), 64% as transitional, and 15% as postmodern. Viewed from the family leisure typology angle, these percentages show up as 54%, 34% and 12%: the family leisure typology scores are more conservative than those of the general family typology. The themes under the general family sociological denominator deal with opinions on: sex-specific task division, say in the family; independence in the marriage relation; the institution of marriage; and motherhood. Under the theme family and leisure what was sought were opinions about: task division in leisure time, definition of leisure time, togetherness in leisure time, freedom given to the partner, gender-specific upbringing during leisure time, the importance of television and games, and autonomy of the children in their free time. The results of the study have been examined against the background of individualisation. The discussions relate to beliefs such as "moral responsibility'"(Bauman, 1993), "pure relationship" (Giddens, 1991), "the morphogenetic family versus the morphostatic family" (Scanzoni, 1983) and "the associative versus the hyperindividualistic family" (Te Kloeze, 1989; 1996).
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BFBNIB, NUK, PILJ, SAZU, UL, UM, UPUK
Objectives: One of the main causes of obesity is overconsumption of diets high in fat and sugar. We studied the metabolic changes and food-motivated behavior when rats were subjected to a choice diet ...with chow, lard and a 30% sucrose solution (high fat high sugar (HFHS)-choice diet). Because rats showed considerable variations in the feeding response to HFHS-choice diet and in food-motivated behavior, we investigated whether the motivation to obtain a sucrose reward correlated with the development of obesity when rats were subsequently subjected to HFHS-choice diet. Method: We first studied feeding, locomotor activity and body temperature, fat weights and hormonal concentrations when male Wistar rats were subjected to HFHS-choice diet for 1 week. Second, we studied sucrose-motivated behavior, using a progressive ratio (PR) schedule of reinforcement in rats that were subjected to the HFHS-choice diet for at least 2 weeks, compared to control rats on a chow diet. Third, we measured motivation for sucrose under a PR schedule of reinforcement in rats that were subsequently subjected to HFHS-choice diet or a chow diet for 4 weeks. Fat weights were measured and correlated with the motivation to obtain sucrose pellets. Results: One week on the HFHS-choice diet increased plasma concentrations of glucose and leptin, increased fat stores, but did not alter body temperature or locomotor activity. Moreover, consuming the HFHS-choice diet for several weeks increased the motivation to work for sucrose pellets. Furthermore, the motivation to obtain sucrose pellets correlated positively with abdominal fat stores in rats subsequently subjected to the HFHS-choice diet, whereas this correlation was not found in rats fed on a chow diet. Conclusion: Our data suggest that the motivation to respond for palatable food correlates with obesity due to an obesogenic environment. Conversely, the HFHS-choice diet, which results in obesity, also increased the motivation to work for sucrose. Thus, being motivated to work for sucrose results in obesity, which, in turn, increases food-motivated behavior, resulting in a vicious circle of food motivation and obesity.
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DOBA, EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, IZUM, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UILJ, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Summary Background & aims Exact data on Dutch patients with chronic intestinal failure (CIF) and after intestinal transplantation (ITx) have been lacking. To improve standard care of these patients, ...a nationwide collaboration has been established. Objectives of this study were obtaining an up-to-date prevalence of CIF and characterizing these patients using the specially developed multicenter web-based Dutch Registry of Intestinal Failure and Intestinal Transplantation (DRIFT). Methods Cross-sectional study. CIF was defined as type 3 intestinal failure in which >75% of nutritional requirements were given as home parenteral nutrition (HPN) for ≥ 4 weeks in children and >50% for ≥3 months in adults. All patients with CIF receiving HPN care by the three Dutch specialized centers on January 1, 2013 and all ITx patients were registered in DRIFT ( https://drift.darmfalen.nl ). Results In total, 195 patients with CIF (158 adults, 37 children) were identified, of whom 184 were registered in DRIFT. The Dutch point prevalence of CIF was 11.62 per million (12.24 for adults, 9.56 for children) on January 1, 2013. Fifty-seven patients (31%) had one or more indications for ITx, while 12 patients actually underwent ITx since its Dutch introduction. Four patients required transplantectomy of their intestinal graft and 3 intestinal transplant patients died. Conclusion The multicenter registry DRIFT revealed an up-to-date prevalence of CIF and provided nationwide insight into the patients with CIF during HPN and after ITx in the Netherlands. DRIFT will facilitate the multicenter monitoring of individual patients, thereby supporting multidisciplinary care and decision-making.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Novel virus outbreaks, such as the COVID-19 pandemic, may increase psychological distress among frontline workers. Psychological distress may lead to reduced performance, reduced employability or ...even burnout. In the present study, we assessed experienced psychological distress during the COVID-19 pandemic from a self-determination theory perspective. This mixed-methods study, with repeated measures, used surveys (quantitative data) combined with audio diaries (qualitative data) to assess work-related COVID-19 experiences, psychological need satisfaction and frustration, and psychological distress over time. Forty-six participants (nurses, junior doctors, and consultants) completed 259 surveys and shared 60 audio diaries. Surveys and audio diaries were analysed separately. Quantitative results indicated that perceived psychological distress during COVID-19 was higher than pre-COVID-19 and fluctuated over time. Need frustration, specifically autonomy and competence, was positively associated with psychological distress, while need satisfaction, especially relatedness, was negatively associated with psychological distress. In the qualitative, thematic analysis, we observed that especially organisational logistics (rostering, work-life balance, and internal communication) frustrated autonomy, and unfamiliarity with COVID-19 frustrated competence. Despite many need frustrating experiences, a strong connection with colleagues and patients were important sources of relatedness support (i.e. need satisfaction) that seemed to mitigate psychological distress. The COVID-19 pandemic resulted in an increase of psychological distress among frontline workers. Both need frustration and need satisfaction explained unique variance of psychological distress, but seemed to originate from different sources. Challenging times require healthcare organisations to better support their professionals by tailored formal and informal support. We propose to address both indirect (e.g. organisation) and direct (e.g. colleagues) elements of the clinical and social environment in order to reduce need frustration and enhance need satisfaction.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Glucose intolerance is a major health problem and is associated with increased risk of progression to type 2 diabetes mellitus and cardiovascular disease. However, whether glucose intolerance is ...related to impaired myocardial perfusion is not known. The purpose of the present study was to study the effect of diet-induced glucose intolerance on myocardial function and perfusion during baseline and pharmacological induced hyperaemia.
Male Wistar rats were randomly exposed to a high fat diet (HFD) or control diet (CD) (n = 8 per group). After 4 weeks, rats underwent an oral glucose tolerance test. Subsequently, rats underwent (contrast) echocardiography to determine myocardial function and perfusion during baseline and dipyridamole-induced hyperaemia (20 mg/kg for 10 min).
Four weeks of HFD feeding resulted in glucose intolerance compared to CD-feeding. Contractile function as represented by fractional shortening was not altered in HFD-fed rats compared to CD-fed rats under baseline conditions. However, dipyridamole increased fractional shortening in CD-fed rats, but not in HFD-fed rats. Basal myocardial perfusion, as measured by estimate of perfusion, was similar in CD- and HFD-fed rats, whereas dipyridamole increased estimate of perfusion in CD-fed rats, but not in HFD-fed rats. However, flow reserve was not different between CD- and HFD-fed rats.
Diet-induced glucose intolerance is associated with impaired myocardial function during conditions of hyperaemia, but myocardial perfusion is maintained. These findings may result in new insights into the effect of glucose intolerance on myocardial function and perfusion during hyperaemia.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Objectives Because of the increasing number of interventional endovascular procedures with fluoroscopy and the corresponding high annual dose for interventionalists, additional dose-protecting ...measures are desirable. The purpose of this study was to evaluate the effect of disposable radiation-absorbing surgical drapes in reducing scatter radiation exposure for interventionalists and supporting staff during an endovascular aneurysm repair (EVAR) procedure. Materials This was a randomized control trial in which 36 EVAR procedures were randomized between execution with and without disposable radiation-absorbing surgical drapes (Radpad: Worldwide Innovations & Technologies, Inc., Kansas City, US, type 5511A). Dosimetric measurements were performed on the interventionalist (hand and chest) and theatre nurse (chest) with and without the use of the drapes to obtain the dose reduction and effect on the annual dose caused by the drapes. Results Use of disposable radiation-absorbing surgical drapes resulted in dose reductions of 49%, 55%, and 48%, respectively, measured on the hand and chest of the interventionalist and the chest of the theatre nurse. Conclusions The use of disposable radiation-absorbing surgical drapes significantly reduces scatter radiation exposure for both the interventionalist and the supporting staff during EVAR procedures.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Appropriate emergency disaster preparedness is a key priority for agricultural agencies to allow effective response to serious avian disease outbreaks. There is a need to develop rapid, humane, and ...safe depopulation techniques for poultry that are widely applicable across a range of farm settings. Whole barn depopulation with carbon dioxide (CO(2)) has been investigated as a humane and efficient means of killing large numbers of birds in the event of a reportable disease outbreak. It has also been considered as a method for depopulating barns containing end-of-lay hens, particularly when there is limited local slaughter and rendering capacity. Determining the best method of humanely killing large flocks of birds remains problematic and is being investigated by a coordinated international effort. While whole barn depopulation using CO(2) inhalation has been explored, physiologic responses of chickens have not been characterized in field settings and assessment of animal welfare is hampered without this information. In this study, 12 cull laying hens were surgically instrumented with telemetry transmitters to record electroencephalographs, electrocardiographs, body temperature, and activity during 2 large-scale field CO(2) euthanasia trials of end-of-lay hens. The day following surgery, instrumented hens were placed in barns with other birds, barns were sealed, and animals were killed by CO(2) inhalation delivered via a specially designed liquid CO(2) manifold. Instrumented birds were monitored by infrared thermography, and ambient temperature, CO(2), and O(2) concentrations were recorded. Results from these studies indicate that instrumented hens lost consciousness within 2 min of CO(2) levels reaching 18 to 20%. Mild to moderate head shaking, gasping, and 1 to 2 clonic muscle contractions were noted in hens before unconsciousness; however, brain death followed rapidly (<5 min). Evaluation of welfare costs and benefits suggest clear advantages over catching and transporting cull hens for slaughter. The financial costs with this method are greater, however, than those estimated for traditional slaughter techniques. Results of these studies are being used to develop national protocols for whole barn depopulation of hens by CO(2) inhalation.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Background:
The introduction of new and more advanced technology in healthcare occurs with an increasing speed. Therefore, more attention is needed for safety evaluation of new devices or techniques ...from an end-user perspective, especially when (inter-) national perfusion safety standards are lacking.
A recently increased awareness of the safety risks as a consequence of technical or human error has provoked interest in optimisation of perfusion methodology and devices.
To prevent or reduce the severity or likelihood of failures of new technology, ‘failure mode effect analysis’ is a proven proactive technique. When it is used as a qualitative analysis for possible hazards in patient treatment associated with the use of medical devices, it’s called healthcare failure mode effect analysis (hFMEA).
Methods:
To evaluate the safety of the Extra Corporeal Circulation Optimized (ECCO, Sorin Group, Mirandola, Italy) miniaturized bypass circuit, hFMEA was used. A multi disciplinary team that consisted of two clinical perfusionists, a clinical physicist, a clinical physicist trainee and a technician has performed this analysis.
Results:
The hFMEA demonstrated that failure of the bubble sensor for the electric remote clamping system on the arterial line (Figure 1), activated by air passing the venous bubble trap, had the highest risk score of all failure modes. This has led to the implementation of an extra low-level sensor in the system to prevent air passing through into the centrifugal pump. The hFMEA has also indicated that extra individual simulation training is needed for handling critical failures during the use of the miniature bypass system.
Conclusion:
Early identification of possible technology failures in any process or device can avoid adverse patient outcomes. The technique of hFMEA is a valuable tool in evaluating the use of high-risk apparatus, such as an extracorporeal bypass system, in patient treatment in order to increase patient safety.
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DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
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