In cases of sexual assault, the interpretation of biological traces on clothing, and particularly undergarments, may be complex. This is especially so when the complainant and defendant interact socially, for instance as (ex-)partners or by co-habitation. Here we present the results from a study where latent male DNA on female worn undergarments is recovered in four groups with different levels of male-female social interaction. The results conform to prior expectation, in that less interaction tend to result in less male DNA on undergarments. We explore the use of these experimental data for evaluative reporting given activity level propositions in a mock case scenario. We show how the selection of different populations to represent the social interaction between complainant and defendant may affect the strength of the evidence. We further show how datasets of limited size can be used for robust activity level evaluative reporting.
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Forensic DNA Trace Evidence Interpretation: Activity Level Propositions and Likelihood Ratios provides all foundational information required for a reader to understand the practice of evaluating forensic biology evidence given activity level propositions and to implement the practice into active casework within a forensic institution. The book begins by explaining basic concepts and foundational theory, pulling together research and studies that have accumulated in forensic journal literature over the last 20 years.The book explains the laws of probability - showing how they can be used to derive, from first principles, the likelihood ratio - used throughout the book to express the strength of evidence for any evaluation. Concepts such as the hierarchy of propositions, the difference between experts working in an investigative or evaluative mode and the practice of case assessment and interpretation are explained to provide the reader with a broad grounding in the topics that are important to understanding evaluation of evidence. Activity level evaluations are discussed in relation to biological material transferred from one object to another, the ability for biological material to persist on an item for a period of time or through an event, the ability to recover the biological material from the object when sampled for forensic testing and the expectations of the prevalence of biological material on objects in our environment. These concepts of transfer, persistence, prevalence and recovery are discussed in detail in addition to the factors that affect each of them.The authors go on to explain the evaluation process: how to structure case information and formulate propositions. This includes how a likelihood ratio formula can be derived to evaluate the forensic findings, introducing Bayesian networks and explaining what they represent and how they can be used in evaluations and showing how evaluation can be tested for robustness. Using these tools, the authors also demonstrate the ways that the methods used in activity level evaluations are applied to questions about body fluids. There are also chapters dedicated to reporting of results and implementation of activity level evaluation in a working forensic laboratory. Throughout the book, four cases are used as examples to demonstrate how to relate the theory to practice and detail how laboratories can integrate and implement activity level evaluation into their active casework.
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Abstract: Hypertension is both a health problem and a financial one globally. It affects nearly 30 % of the general population. Elderly people, aged ≥65 years, are a special group of hypertensive patients. In this group, the overall prevalence of the disease reaches 60 %, rising to 70 % in those aged ≥80 years. In the elderly population, isolated systolic hypertension is quite common. High systolic blood pressure is associated with an increased risk of cardiovascular disease, cerebrovascular disease, peripheral artery disease, cognitive impairment and kidney disease. Considering the physiological changes resulting from ageing alongside multiple comorbidities, treatment of hypertension in elderly patients poses a significant challenge to treatment teams. Progressive disability with regard to the activities of daily life, more frequent hospitalisations and low quality of life are often seen in elderly patients. There is discussion in the literature regarding frailty syndrome associated with old age. Frailty is understood to involve decreased resistance to stressors, depleted adaptive and physiological reserves of a number of organs, endocrine dysregulation and immune dysfunction. The primary dilemma concerning frailty is whether it should only be defined on the basis of physical factors, or whether psychological and social factors should also be included. Proper nutrition and motor rehabilitation should be prioritised in care for frail patients. The risk of orthostatic hypotension is a significant issue in elderly patients. It results from an autonomic nervous system dysfunction and involves maladjustment of the cardiovascular system to sudden changes in the position of the body. Other significant issues in elderly patients include polypharmacy, increased risk of falls and cognitive impairment. Chronic diseases, including hypertension, deteriorate baroreceptor function and result in irreversible changes in cerebral and coronary circulation. Concurrent frailty or other components of geriatric syndrome in elderly patients are associated with a worse perception of health, an increased number of comorbidities and social isolation of the patient. It may also interfere with treatment adherence. Identifying causes of non-adherence to pharmaceutical treatment is a key factor in planning therapeutic interventions aimed at increasing control, preventing complications, and improving long-term outcomes and any adverse effects of treatment. Diagnosis of frailty and awareness of the associated difficulties in adhering to treatment may allow targeting of those elderly patients who have a poorer prognosis or may be at risk of complications from untreated or undertreated hypertension, and for the planning of interventions to improve hypertension control.
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PURPOSE: To study the preliminary effects and feasibility of the “Traffic Light Method for somatic screening and lifestyle” (TLM) in patients with severe mental illness. DESIGN AND METHODS: A pilot study using a quasi-experimental mixed method design with additional content analyses of lifestyle plans and logbooks. FINDINGS: Significant improvements were found in body weight and waist circumference. Positive trends were found in patients’ subjective evaluations of the TLM. The implementation of the TLM was considered feasible. PRACTICE IMPLICATIONS: The TLM may contribute to a higher quality of care regarding somatic screening and lifestyle training.
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The objective of this thesis is to make a first step towards prevention of the progression of chronic venous disease and the development of a first venous leg ulcer in chronic venous disease patients. The aim is to identify chronic venous disease patients at risk of developing more severe clinical stages, provide insight in the lifestyle related risk factors, and provide an overview of current chronic venous disease care in the Netherlands.
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Echinoderm mass mortality events shape marine ecosystems by altering the dynamics among major benthic groups. The sea urchin Diadema antillarum, virtually extirpated in the Caribbean in the early 1980s by an unknown cause, recently experienced another mass mortality beginning in January 2022. We investigated the cause of this mass mortality event through combined molecular biological and veterinary pathologic approaches comparing grossly normal and abnormal animals collected from 23 sites, representing locations that were either affected or unaffected at the time of sampling. Here, we report that a scuticociliate most similar to Philaster apodigitiformis was consistently associated with abnormal urchins at affected sites but was absent from unaffected sites. Experimentally challenging naïve urchins with a Philaster culture isolated from an abnormal, field-collected specimen resulted in gross signs consistent with those of the mortality event. The same ciliate was recovered from treated specimens postmortem, thus fulfilling Koch’s postulates for this microorganism. We term this condition D. antillarum scuticociliatosis.
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At the beginning of the twenty first century obesity entered Dutch maternity care as a ‘new illness’ challenging maternity care professionals in providing optimal care for women with higher BMI’s. International research revealed that obese women had more perinatal problems than normal weight women. However, the effect of higher BMIs on perinatal outcomes had never been studied in women eligible for midwife-led primary care at the outset of their pregnancy. In the context of the Dutch maternity care system, it was not clear if obesity should be treated as a high-risk situation always requiring obstetrician-led care or as a condition that may lead to problems that could be detected in a timely manner in midwife-led care using the usual risk assessment tools. With the increased attention on obesity in maternity care there was also increased interest in GWG. Regarding GWG in the Netherlands, the effect of insufficient or excessive GWG on perinatal outcomes had never been studied and there were no validated guidelines for GWG. A midwife’s care for the individual woman in the context of the Dutch maternity care system - characterised by ‘midwife-led care if possible, obstetrician-led care if needed’ - is hampered by the lack of national multidisciplinary consensus regarding obesity and weight gain. Obesity has not yet been included in the OIL and local protocols contain varying recommendations. To enable sound clinical decisions and to offer optimal individual care for pregnant women in the Netherlands more insights in weight and weight gain in relation to perinatal outcomes are required. With this thesis the author intends to contribute to the body of knowledge on weight and weight gain to enhance optimal midwife-led primary care for the individual woman and to guide midwives’ clinical decision-making.
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While consumers have become increasingly aware of the need for sustainability in fashion, many do not translate their intention to purchase sustainable fashion into actual behavior. Insights can be gained from those who have successfully transitioned from intention to behavior (i.e., experienced sustainable fashion consumers). Despite a substantial body of literature exploring predictors of sustainable fashion purchasing, a comprehensive view on how predictors of sustainable fashion purchasing vary between consumers with and without sustainable fashion experience is lacking. This paper reports a systematic literature review, analyzing 100 empirical articles on predictors of sustainable fashion purchasing among consumer samples with and without purchasing experience, identified from the Web of Science and Scopus databases.
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Thermal disinfection is probably the oldest water treatment method ever used. Similarly to other disinfection processes, it targets the inactivation of pathogenic (micro)organisms present in water, wastewater and other media. In this work, a pilot-scale continuous-flow thermal disinfection system was investigated using highly contaminated hospital wastewater as influent without any pre-treatment step for turbidity removal. The results proved that the tested system can be used with influent turbidity as high as 100 NTU and still provide up to log 8 microbial inactivation. Further results have shown energy consumption comparable to other commercially available thermal disinfection systems and relatively low influence on the investigated physical–chemical parameters.
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The objective of this study was to determine if a 3-dimensional computer vision automatic locomotion scoring (3D-ALS) method was able to outperform human observers for classifying cows as lame or nonlame and for detecting cows affected and nonaffected by specific type(s) of hoof lesion. Data collection was carried out in 2 experimental sessions (5 months apart).
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