In the context of the European project, the diffusion of 10 selected cases of minimally invasive therapy (MIT) in the Dutch health care system was documented and analyzed. In each case the diffusion ...pattern resulting from the balance of stimulating and impeding factors is described, and summarized in a matrix framework. Budgetary pressures, lack of evidence on effectiveness and physician conservatism are the most important factors impeding diffusion of MIT. Patient demand, media reporting and presence of medical innovators are important diffusion-stimulating factors. Finally, a judgment is made on the policy implications of these findings, based on a comparison of the extent and speed of the diffusion of each case, the quality of evidence on effectiveness and cost-effectiveness and, in a few cases, existing policies. In most cases, more active policy making, either stimulating or otherwise guiding diffusion, would be desirable.
Spatiotemporal dynamics near a codimension-two point De Wit A; Lima, D; Dewel, G ...
Physical review. E, Statistical physics, plasmas, fluids, and related interdisciplinary topics,
07/1996, Letnik:
54, Številka:
1
Journal Article
The application of the concept of sustainable development in development co-operation has created a need for additional professional training in The Netherlands. Sustainable development is a ...relatively new concept. Applying this concept in development projects and policies requires professionals with a interdisciplinary, analytical and environmentally-conscious approach. However, most of today's development experts have professional biases. Is it possible to teach development experts the sustainable development approach in a short training course?
This article deals with the implementation of the concept of sustainable development for professional training purposes in the field of development co-operation. It describes the development of a training programme and its two central frameworks, illustrated with case studies. It also reports on experiences and makes evaluative remarks about the impact of the training on the participants.
Since 1991, a one-week training programme has been used to update project staff and desk officers. The training offers: (1) an overview of backgrounds and policies in the field of environment and sustainable development; (2) theory and tools to analyse problems of unsustainability; and (3) theory and tools to (re-)design environmentally-sound activities, projects and programmes.
The present study was undertaken to investigate the hypothesis that multiple oxygen radical generating systems contribute to the tumor necrosis factor (TNF) a-stimulated transcriptional activation of ...the vascular cell adhesion molecule (VCAM)-1 in endothelial cells. Experimental evidence has implicated the cytochrome P450 monooxygenase and a phagocyte type NADPH-oxidase as a source of oxygen radicals in these cells. We show here that endothelial cells exhibit cytochrome P450 activity by measuring the O-dealkylation of the exogenous substrate 7-ethoxyresorufin, but components of the phagocyte-type NADPH oxidase could not be demonstrated in endothelial cells. In that latter respect it was surprising that the NADPH oxidase inhibitor apocynin completely prevented the accumulation of VCAM-1 mRNA. However, we found that apocynin also acts as an inhibitor of cytochrome P450 activity in endothelial cells. Therefore the inhibitory effect of apocynin on the induction of VCAM-1 may no longer be used to demonstrate a role for the NADPH oxidase in this process. Furthermore, different cytochrome P450 inhibitors Co2+, metyrapone, SKF525a decreased the endothelial VCAM-1 expression stimulated by TNFa. Also under hypoxic conditions the expression of VCAM-1 was reduced. On this basis we assume that the oxygen dependent step in the intracel-lular signalling cascade underlying the TNFα stimulated transcriptional activation of VCAM-1 resides in the activity of a cytochrome P450 dependent monooxygenase. The finding that the phospholipase A2 inhibitor bromophenacylbromide inhibited the expression of VCAM-1 may indicate that arachidonic acid serves as a substrate for the cytochrome P450 monooxygenase reaction, but further research is needed to elucidate the particular cytochrome P450 family member mediating the expression of VCAM-1.
In the freshwater snail Biomphalaria glabrata the formation and composition of yolk granules and the role of the follicle cells were studied by histochemical and electron microscopical techniques. ...The rough endoplasmic reticulum and the Golgi apparatus appeared to be involved in yolk formation, which is a continuous process throughout oogenesis. From the very beginning of yolk formation two main types of yolk granules were distinguished morphologically. However, with histochemical and enzyme cytochemical methods no differences were observed between these types. The granules acquire lysosomal enzymes after oviposition, indicating that their main function is probably digestion of perivitelline fluid, which contains nutrients for the developing embryo. Yolk formation and the activity of the follicle cells were studied in successive stages of oogenesis by quantitative electron microscopy. The data strongly suggest that the follicle cells are involved in the formation of the follicular cavity and hence in the ovulation process.
Cognitive correlates of dental anxiety De Jongh, A; Muris, P; ter Horst, G ...
Journal of dental research,
02/1994, Letnik:
73, Številka:
2
Journal Article
Recenzirano
This study examined cognitive correlates of dental anxiety among 24 highly anxious patients and 17 low-anxious patients. In both groups, anxiety expectations, dental trait anxiety, and state anxiety ...(in the waiting room and in the dental chair) were rated. Negative cognitions and cognitive control were also assessed. It was found that dentally high-anxious patients claimed to experience more negative thoughts than those with low anxiety (p < 0.001). None of the highly anxious patients reported relatively few negative cognitions, and none of the patients in the low-anxiety group reported relatively numerous negative cognitions. While patients from both groups reported that cognitive control declined with the imminence of treatment, highly anxious patients were found to have less control over their negative thoughts (p < 0.001). A series of stepwise regression analyses revealed that both the number of negative cognitions and perceived cognitive control accounted for 75% of the variance in dental trait anxiety. The results of the present study suggest that cognitive activities, such as negative thinking (catastrophizing) and cognitive control, are important moderators of dental anxiety.
