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.
SIGNIFICANCE: The impact of dry eye disease on patients' daily lives is understood by optometrists, but they seldom use this understanding in their patient management. PURPOSE: Dry eye disease can significantly impact a person's daily life and is known to cause psychological symptoms. Treating and managing patients with dry eye disease can be challenging, as an approach based solely on signs is unlikely to reflect patients' true burden. Because optometrists play a crucial role in the care of dry eye disease patients, it is necessary to examine their awareness of the negative impact of dry eye disease on patients' daily lives and how they manage this during their consultation time, including diagnosis and management. METHODS: This study has an exploratory, qualitative research design. Twelve semistructured online interviews were conducted with optometrists in second-line eye care through a convenience sample. The interviews were recorded, transcribed verbatim, and analyzed after a thematic analysis. RESULTS: The main findings were that few optometrists actively asked about patients' perceived burden, many optometrists did not mention all the possible treatment options or practical advice that could benefit dry eye disease patients, and few were aware of the possible help that other health care providers could provide, besides the optometrist. CONCLUSIONS: Dutch optometrists are aware of the impact that dry eye disease can have on their patients' daily lives, but seldom use this information as part of their management plan.
Europe’s aging population is leading to a growing number of people affected by chronic disease, which will continue over the coming decades. Healthcare systems are under pressure to deliver appropriate care, partly due to the burden imposed on their limited financial and human resources by the growing number of people with (multiple) chronic diseases. Therefore, there is a strong call for patient self-management to meet these patients’ healthcare needs. While many patients experience medication self-management as difficult, it poses additional challenges for people with limited health literacy. This thesis aims to explore the needs of patients with a chronic disease and limited health literacy regarding medication self-management and how support for medication self-management can be tailored to those needs.
Multiple sclerosis (MS) is a severe inflammatory condition of the central nervous system (CNS) affecting about 2.5 million people globally. It is more common in females, usually diagnosed in their 30s and 40s, and can shorten life expectancy by 5 to 10 years. While MS is rarely fatal; its effects on a person's life can be profound, which signifies comprehensive management and support. Most studies regarding MS focus on how lymphocytes and other immune cells are involved in the disease. However, little attention has been given to red blood cells (erythrocytes), which might also be important in developing MS. Artificial intelligence (AI) has shown significant potential in medical imaging for analyzing blood cells, enabling accurate and efficient diagnosis of various conditions through automated image analysis. The project aims to implement an AI pipeline based on Deep Learning (DL) algorithms (e.g., Transfer Learning approach) to classify MS and Healthy Blood cells.
In Nederland lijden 1,4 miljoen mensen aan hart- en vaatziekten. Dit aantal zal oplopen tot 1,9 miljoen in 2030 . Hevige of langdurige stress is een belangrijk risicofactor voor hart- en vaatproblemen. Cardiologen hebben vastgesteld dat omgaan met stress nu als een belangrijk onderdeel van de behandeling wordt beschouwd. Stressmanagement en het verlagen van stress zijn cruciaal voor hartpatiënten, voornamelijk bij specifieke groepen waaronder Ischemia and Non Obstructive Coronary Artery Disease (INOCA). In tegenstelling tot het klassieke beeld van obstructief coronarialijden zijn er bij INOCA-patiënten geen significante obstructies aanwezig en worden klachten medebepaald door spasme en vasculaire disfunctie van de grote en kleinere kransvaten. INOCA Uit verschillende onderzoeken komt naar voren dat muziek kan helpen bij het verlagen van stress en pijn. Echter is de invulling en de impact van sound therapie, waaronder het reductiegehalte van stress, bij hartpatiënten in de eigen leefomgeving nog onvoldoende onderzocht. Binnen het project HARMONIES – stressreductie met muziek voor INOCA-patiënten, is daarom de volgende onderzoeksvraag in samenwerking met de projectpartners en cardiologen vastgelegd: Hoe kan de toepassing van sound therapie in de eigen leefomgeving bijdragen aan het reduceren van stress bij INOCA-patiënten en wat is de impact hiervan op slaap? Het consortium heeft als doel om INOCA-patiënten, die vaak geen hartrevalidatie krijgen, te helpen met het reduceren van stress in de eigen leefomgeving. Door middel van sound therapie in combinatie met biofeedback kan er een gepersonaliseerde oplossing worden aangeboden aan individuele patiënten die leiden aan deze chronische ziekte. Door in te spelen op het verminderen van de stress in de eigen leefomgeving, wordt de behandeling van de chronische ziekte bevorderd en draagt dit bij aan het vergroten van de kwaliteit van leven. Door in te spelen op het verminderen/voorkomen van stress, zal dit ook bijdragen aan preventie en de druk op ziekenhuiszorg.
Since the 1970s, Caribbean reefs have transitioned from coral-dominated to algal-dominated ecosystems. The prevalence of algae reduces coral recruitment, rendering the reefs unable to recover from additional disturbances and jeopardizing crucial ecosystem services, including coastal protection, fisheries, and tourism. One of the main factors to the proliferation of algae is the scarcity of grazers, which is a result of overfishing and disease outbreaks. While fishing supports livelihoods, enhances local food security, and is an integral part of the Caribbean communities' culture, it remains a significant threat to coral reefs. Consequently, the Nature and Environmental Policy Plan (NEPP) 2020-2030, outlining conservation and restoration priorities in the Caribbean Netherlands, underscores the necessity of an integrated approach to tackle the complex challenges of coral reef restoration and fisheries development. The Saba government, and nature management organizations of Bonaire, St. Eustatius, and Saba are implementing the NEPP. Together with University of Applied Sciences Van Hall Larenstein, Wageningen University and WWF, they aim to identify novel species of native invertebrate grazers with the dual purpose of reef restoration and fisheries diversification. The Caribbean king crab (Maguimithrax spinosissimus), the West Indian sea egg (Tripneustes ventricosus), and the West Indian top shell (Cittarium pica) have been identified as potential candidates. Despite their preference to graze on macroalgae, their current densities are inadequate. Population enhancement of these species holds promise for reducing algae, promoting biodiversity, and simultaneously supporting small-scale fisheries. However, there is limited knowledge regarding the ecological effects and socio-economic potential of these grazers. The ReefGrazers project aims to assess the current densities of these herbivores around the BES islands, analyze their impacts on the reef, and evaluate their retention post-restocking. Socio-economic research will quantify current small-scale fishing practices, while market analysis will help assess the potential for the development of these novel resources as sustainable fisheries.
