Het Effect van de Kanker Nazorg Wijzer* op Werkgerelateerde Problematiek en Kwaliteit van Leven bij Werkende Ex-Kankerpatiënten

Doordat kanker vaker in een vroeg stadium wordt ontdekt en de behandelingen effectiever zijn, is de kans om te overleven toegenomen. Om ex-kankerpatiënten te kunnen begeleiden na hun ziekte is de Kanker Nazorg Wijzer (KNW) ontwikkeld: een online interventie voor ex-kankerpatiënten ter ondersteuning van ervaren problemen op diverse gebieden waaronder werkhervatting. De KNW bestaat uit modules met informatie, advies, training en feedback-op-maat voor die betreffende probleemgebieden. In het huidige onderzoek stond het effect van de KNW op werkgerelateerde problematiek bij werkende ex-kankerpatiënten centraal en werd ook het effect op kwaliteit van leven gemeten. Verwacht werd dat na zes maanden gebruik van de KNW het aantal werkzame uren (werkhervatting), de werktevredenheid en kwaliteit van leven bij de gebruikers (interventiegroep) meer is toegenomen dan bij de niet-gebruikers (controlegroep) en dat de problemen op het werk en de onvervulde behoefte aan werkgerelateerde informatie meer is afgenomen. Additief werd verondersteld dat, binnen de interventiegroep, de respondenten die specifiek de werkmodule hadden gebruikt een groter verschil laten zien tussen de voor- en nameting met betrekking tot de werkgerelateerde problematiek. Op basis van voorgaand onderzoek zijn sekse, leeftijd, opleiding en actieve coping meegenomen als confounders evenals de voormetingscores van de afhankelijke variabelen. Het betreft een gerandomiseerd experiment naar de effecten van de KNW. Respondenten zijn geworven bij 22 Nederlandse ziekenhuizen en werden random toegewezen aan de interventiegroep of controlegroep. Voor de effectmeting is alleen de data van werkende ex-kankerpatiënten gebruikt. Effecten werden getoetst met multiple regressie analyses waarbij werd gecorrigeerd voor de genoemde confouders. In de interventiegroep (N = 245) waren 156 werkende ex-kankerpatiënten (85.3% vrouw, leeftijd M = 50.7) en in de controlegroep (N = 236) waren dit er 134 (85.1% vrouw, leeftijd M = 51.2). De MRA gaf na correctie van de voormetingscores en confounders aan dat het gebruik van de KNW zorgde voor een significante verbetering van kwaliteit van leven op de subschalen fysiek functioneren (p = 0.005), emotioneel functioneren (p = 0.026), sociaal functioneren (p = 0.002) en vermoeidheid (p = 0.021). De MRA gaf geen significant effect van het gebruik van de KNW op de werkgerelateerde problematiek. Additief gaf een vergelijking binnen de interventiegroep tussen de gebruikers van de werkmodule (N = 25) en de niet gebruikers (N = 131) aan dat het aantal gewerkte uren significant meer was toegenomen onder de gebruikers (t (68) = 1.680, p = 0.049).

Supply chain sustainability : a relationship management approach moderated by culture and commitment

This research explores the nature of relationship management on construction projects in Australia and examines the effects of culture, by means of Schwarz’s value survey, on relationships under different contract strategies. The research was based on the view that the development of a sustainable supply chain depends on the transfer of knowledge and capabilities from the larger players in the supply chain through collaboration brought about by relationship management. The research adopted a triangulated approach in which quantitative data were collected by questionnaire, interviews were conducted to explore and enrich the quantitative data and case studies were undertaken in order to illustrate and validate the findings. The aim was to investigate how values and attitudes enhance or reduce the incorporation of the supply chain into the project. From the research it was found that the degree of match and mismatch between values and contract strategy impacts commitment and the engagement and empowerment of the supply chain.

Development of the sustainable building and construction products industry in Australia

This paper draws on a major study the authors conducted for the Australian Government in 2009. It focuses on the diffusion issues surrounding the uptake of sustainable building and construction products in Australia. Innovative sustainable products can minimise the environmental impact during construction, while maximising asset performance, durability and re-use. However, there are significant challenges faced by designers and clients in the selection of appropriate sustainable products in consideration of the integrated design solution, including overall energy efficiency, water conservation, maintenance and durability, low-impact use and consumption. The paper is a review of the current state of sustainable energy and material product innovations in Australia. It examines the system dynamics surrounding these innovations as well as the drivers and obstacles to their diffusion throughout the Australian construction industry. The case product types reviewed comprise: solar energy technology, small wind turbines, advanced concrete technology, and warm-mixed asphalt. The conclusions highlight the important role played by Australian governments in facilitating improved adoption rates. This applies to governments in their various roles, but particularly as clients/owners, regulators, and investors in education, training, research and development. In their role as clients/owners, the paper suggests that government can better facilitate innovation within the construction industry by adjusting specification policies to encourage the uptake of sustainable products. In the role as regulators, findings suggest governments should be encouraging the application of innovative finance options and positive end-user incentives to promote sustainable product uptake. Also, further education for project-based firms and the client/end users about the long-term financial and environmental benefits of innovative sustainable products is required. As more of the economy’s resources are diverted away from business-as-usual and into the use of sustainable products, some project-based firms may face short-term financial pain in re-shaping their businesses. Government policy initiatives can encourage firms make the necessary adjustments to improve innovative sustainable product diffusion throughout the industry.

Retrofitting commercial office buildings for sustainability : tenants’ expectations and experiences

Introduction Buildings, which account for approximately half of all annual energy and greenhouse gas emissions, are an important target area for any strategy addressing climate change. Whilst new commercial buildings increasingly address sustainability considerations, incorporating green technology in the refurbishment process of older buildings is technically, financially and socially challenging. This research explores the expectations and experiences of commercial office building tenants, whose building was under-going green refurbishment. Methodology Semi-structured in-depth interviews with seven residents and neighbours of a large case-study building under-going green refurbishment in Melbourne, Australia. Built in 1979, the 7,008m² ‘B’ grade building consists of 11 upper levels of office accommodation, ground floor retail, and a basement area leased as a licensed restaurant. After refurbishment, which included the installation of chilled water pumps, solar water heating, waterless urinals, insulation, disabled toilets, and automatic dimming lights, it was expected that the environmental performance of the building would move from a non-existent zero ABGR (Australian Building Greenhouse Rating) star rating to 3.5 stars, with a 40% reduction in water consumption and 20% reduction in energy consumption. Interviews were transcribed, with responses analysed using a thematic approach, identifying categories, themes and patterns. Results Commercial property tenants are on a journey to sustainability - they are interested and willing to engage in discussions about sustainability initiatives, but the process, costs and benefits need to be clear. Critically, whilst sustainability was an essential and non-negotiable criterion in building selection for government and larger corporate tenants, sustainability was not yet a core business value for smaller organisations – whilst they could see it as an emerging issue, they wanted detailed cost-benefit analyses, pay-back calculations of proposed technologies and, ideally, wished they could trial the technology first-hand in some way. Although extremely interested in learning more, most participants reported relatively minimal knowledge of specific sustainability features, designs or products. In discussions about different sustainable technologies (e.g., waterless urinals, green-rated carpets), participants frequently commented that they knew little about the technology, had not heard of it or were not sure exactly how it worked. Whilst participants viewed sustainable commercial buildings as the future, they had varied expectations about the fate of existing older buildings – most felt that they would have to be retrofitted at some point to meet market expectations and predicted the emergence of a ‘non-sustainability discount’ for residing in a building without sustainable features. Discussion This research offers a beginning point for understanding the difficulty of integrating green technology in older commercial buildings. Tenants currently have limited understandings of technology and potential building performance outcomes, which ultimately could impede the implementation of sustainable initiatives in older buildings. Whilst the commercial property market is interested in learning about sustainability in the built environment, the findings highlight the importance of developing a strong business case, communication and transition plan for implementing sustainability retrofits in existing commercial buildings.

Discrimination experienced by HIV/AIDS infected persons and its associations with mental health in an Indian sample

Purpose The purpose of this study was to investigate the nature and prevalence of discrimination against people living with HIV/AIDS in West Bengal, India, and how discrimination is associated with depression, suicidal ideation and suicidal attempts. Method Semi-structured interviews and the Beck Depression Inventory were administered to 105 HIV infected persons recruited by incidental sampling, at an Integrated Counseling and Testing Center (ICTC) and through Networks of People Living with HIV/AIDS, in the West Bengal area. Results Findings showed that 40.8% of the sample has experienced discrimination at least in one social setting – such as family (29.1%), health centers (18.4%), community (17.5%) and workplace (6.8%). About two-fifths (40.8%) reported experiencing discrimination in multiple social settings. Demographic factors associated with discrimination were gender, age, occupation, education, and current residence. More than half of the sample was suffering from severe depression while 8.7% had attempted suicide. Discrimination in most areas was significantly associated with suicidal ideation and suicidal attempts. Conclusions Prevalence of discrimination associated with HIV/AIDS is high in our sample from West Bengal. While discrimination was not associated with depressive symptomatology, discrimination was associated with suicidal ideation and attempts. These findings suggest that there is an urgent need for interventions to reduce discrimination of HIV/AIDS in the West Bengal region.

Van der Waals-corrected density functional theory : benchmarking for hydrogen–nanotube and nanotube–nanotube interactions

Density functional theory (DFT) is a powerful approach to electronic structure calculations in extended systems, but suffers currently from inadequate incorporation of long-range dispersion, or Van der Waals (VdW) interactions. VdW-corrected DFT is tested for interactions involving molecular hydrogen, graphite, single-walled carbon nanotubes (SWCNTs), and SWCNT bundles. The energy correction, based on an empirical London dispersion term with a damping function at short range, allows a reasonable physisorption energy and equilibrium distance to be obtained for H2 on a model graphite surface. The VdW-corrected DFT calculation for an (8, 8) nanotube bundle reproduces accurately the experimental lattice constant. For H2 inside or outside an (8, 8) SWCNT, we find the binding energies are respectively higher and lower than that on a graphite surface, correctly predicting the well known curvature effect. We conclude that the VdW correction is a very effective method for implementing DFT calculations, allowing a reliable description of both short-range chemical bonding and long-range dispersive interactions. The method will find powerful applications in areas of SWCNT research where empirical potential functions either have not been developed, or do not capture the necessary range of both dispersion and bonding interactions.

Interface of graphane with copper : a van der Waals density-functional study

Various forms of hydrogenated graphene have been produced to date by several groups, while the synthesis of pure graphane has not been achieved yet. The study of the interface between graphane, in all its possible hydrogenation configurations, and catalyst metal surfaces can be pivotal to assess the feasibility of direct CVD growth methods for this material. We investigated the adhesion of graphane to a Cu(111) surface by adopting the vdW-DF2-C09 exchange-correlation functional, which is able to describe dispersion forces. The results are further compared with the PBE and the LDA exchange-correlation functionals. We calculated the most stable geometrical configurations of the slab/graphane interface and evaluated how graphane's geometrical parameters are modified. We show that dispersion forces play an important role in the slab/graphane adhesion. Band structure calculations demonstrated that in the presence of the interaction with copper, the band gap of graphane is not only preserved, but also enlarged, and this increase can be attributed to the electronic charge accumulated at the interface. We calculated a substantial energy barrier at the interface, suggesting that CVD graphane films might act as reliable and stable insulating thin coatings, or also be used to form compound layers in conjunction with metals and semiconductors.

Author's reply to: Ankylosing spondylitis: evidence for a non-HLA-B*27 protective effect, Sjef Van Der Linden, Desieree Van Der Heijde

As mentioned in the letter by van der Linden and van der Heijde, Jurgen Braun’s excellent recent paper describing a survey of blood donors by questionnaire, clinical, and magnetic resonance imaging examinations revealed a prevalence of ankylosing spondylitis in B27 positive blood donors (6.4%)1-1 very similar to that reported by Gran et al(6.7%).1-2 It is probable that some of the differences in reported prevalence of ankylosing spondylitis by the various studies are because of methodological differences.

Biological application of carbon nanotubes and graphene

Carbon nanotubes (CNTs) and graphene are two representative nanomaterials comprised of purely element carbon [1,2]. Graphene is the two-dimensional, hexagonal sp2-carbon ring networks with one atomic layer thickness, while CNTs can be envisaged as one or several graphene sheets concentrically rolled up into a one-dimensional cylindrical structure, so-called singlewalled (SW) or multi-walled (MW) CNTs, respectively. Figure 12.1 shows the schematic diagram of structures of graphene, SWCNT and MWCNT. Owing to their exceptional mechanical, electrical, optical and thermal properties, CNTs and graphene have been widely considered as a new type of materials with great potentials to revolutionalize many of the biological and medical fields [3–5].

Tombstone of Therese Molling; Amsterdam Cemeteries; Tombs

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Low birth weight in MZ twins discordant for birth weight is associated with shorter telomere length and lower IQ, but not anxiety/depression in later life

Shorter telomere length (TL) has found to be associated with lower birth weight and with lower cognitive ability and psychiatric disorders. However, the direction of causation of these associations and the extent to which they are genetically or environmentally mediated are unclear. Within-pair comparisons of monozygotic (MZ) and dizygotic (DZ) twins can throw light on these questions. We investigated correlations of within pair differences in telomere length, IQ, and anxiety/depression in an initial sample from Brisbane (242 MZ pairs, 245 DZ same sex (DZSS) pairs) and in replication samples from Amsterdam (514 MZ pairs, 233 DZSS pairs) and Melbourne (19 pairs selected for extreme high or low birth weight difference). Intra-pair differences of birth weight and telomere length were significantly correlated in MZ twins, but not in DZSS twins. Greater intra-pair differences of telomere length were observed in the 10% of MZ twins with the greatest difference in birth weight compared to the bottom 90% in both samples and also in the Melbourne sample. Intra-pair differences of telomere length and IQ, but not of TL and anxiety/depression, were correlated in MZ twins, and to a smaller extent in DZSS twins. Our findings suggest that the same prenatal effects that reduce birth weight also influence telomere length in MZ twins. The association between telomere length and IQ is partly driven by the same prenatal effects that decrease birth weight.