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  • 1
    Language: English
    In: Gerontology and geriatric medicine, 2015, Vol.1, p.2333721415607833-2333721415607833
    Description: Objective: To explore the value of day services at green care farms (GCFs) in terms of social participation for people with dementia. Method: Semi-structured interviews were conducted with people with dementia who attended day services at a GCF (GCF group, n = 21), were on a waiting list (WL) for day services at a GCF (WL group, n = 12), or attended day services in a regular day care facility (RDCF group, n = 17) and with their family caregivers. Results: People with dementia in the GCF and WL group were primarily males, with an average age of 71 and 76 years, respectively, who almost all had a spousal caregiver. People with dementia in the RDCF group were mostly females with an average age of 85 years, most of whom had a non-spousal caregiver. For both the GCF and RDCF groups, it was indicated that day services made people with dementia feel part of society. The most important domains of social participation addressed by RDCFs were social interactions and recreational activities. GCFs additionally addressed the domains “paid employment” and “volunteer work.” Conclusion: GCFs are valuable in terms of social participation for a particular group of people with dementia. Matching characteristics of adult day services (ADS) centers to the preferences and capacities of people with dementia is of importance. Diversity in ADS centers is therefore desirable.
    Subject(s): adult day care ; adult day services ; Animal Production Systems ; civic engagement ; dementia ; Dierlijke Productiesystemen ; Gezondheid en Maatschappij ; green care farms ; Health and Society ; Leerstoelgroep Dierlijke productiesystemen ; social participation ; WASS
    ISSN: 2333-7214
    E-ISSN: 2333-7214
    Source: PubMed Central
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  • 2
    Language: English
    In: Journal of demographic economics, 2021-03, Vol.87 (1), p.1-31
    Description: Pensions may be provided for in a modern society by a mix of several methods, namely by voluntary individual savings, mandatory fully-funded occupational pension systems, mandatory social security financed by pay-as-you-go, and old-fashioned hoarding in cash. We call a specific mixture of the four systems a pension composition. We assume that individual workers decide on their own individual savings, that the fully-funded occupational system is decided upon by the age cohort of the median worker, and that social security is decided upon by the median voter. We assume that individual and collective pension savings are the only sources of capital supply. When capital supply equals demand from industry, there is equilibrium in the capital market with a corresponding equilibrium interest rate and pension composition. In this paper, we assume a demography with one hundred age brackets and we investigate how changes in the birth rates, survival rates, and the retirement age affect the pension composition and the capital market equilibrium. Our conclusion is that for a given technology, the pension composition and the interest rate are determined by the demography and cannot be modified at will as a long-term political instrument.
    Subject(s): Research Paper
    ISSN: 2054-0892
    E-ISSN: 2054-0906
    Source: Business Source Ultimate
    Source: Alma/SFX Local Collection
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  • 3
    Language: English
    In: Gerontology and geriatric medicine, 2015-10-01, Vol.1
    Description: Objective: To explore the value of day services at green care farms (GCFs) in terms of social participation for people with dementia. Method: Semi-structured interviews were conducted with people with dementia who attended day services at a GCF (GCF group, n = 21), were on a waiting list (WL) for day services at a GCF (WL group, n = 12), or attended day services in a regular day care facility (RDCF group, n = 17) and with their family caregivers. Results: People with dementia in the GCF and WL group were primarily males, with an average age of 71 and 76 years, respectively, who almost all had a spousal caregiver. People with dementia in the RDCF group were mostly females with an average age of 85 years, most of whom had a non-spousal caregiver. For both the GCF and RDCF groups, it was indicated that day services made people with dementia feel part of society. The most important domains of social participation addressed by RDCFs were social interactions and recreational activities. GCFs additionally addressed the domains “paid employment” and “volunteer work.” Conclusion: GCFs are valuable in terms of social participation for a particular group of people with dementia. Matching characteristics of adult day services (ADS) centers to the preferences and capacities of people with dementia is of importance. Diversity in ADS centers is therefore desirable.
    E-ISSN: 2333-7214
    Source: PubMed Central
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  • 4
    Language: English
    In: Computer Science in Economics and Management, 1992-08, Vol.5 (3), p.183-220
    ISSN: 0921-2736
    E-ISSN: 1572-9974
    Source: Springer Online Journal Archives (DFG Nationallizenzen)
    Source: Springer Online Journal Archives (Through 1996)
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  • 5
    Language: English
    In: Journal of the Royal Statistical Society. Series D (The Statistician), 1987-01-01, Vol.36 (2/3), p.83-90
    Description: In earlier work (van Dijk, 1984, Chapter 3) one of the authors discussed the use of Monte Carlo integration methods for the computation of the multivariate integrals that are defined in the posterior moments and densities of the parameters of interest of econometric models. In the present paper we describe the computational steps of one Monte Carlo method, which is known in the literature as importance sampling. Further, a set of standard programs is available, which may be used for the implementation of a simple case of importance sampling. The computer programs have been written in FORTRAN 77.
    Subject(s): Approximation ; Computer software ; Econometrics ; Economic modeling ; Economic models ; Estimators ; Fortran ; Mathematical independent variables ; Parametric models ; Random numbers
    ISSN: 0039-0526
    E-ISSN: 1467-9884
    Source: JSTOR Arts & Sciences I
    Source: Wiley Online Library All Backfiles
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  • 6
    Language: English
    In: The lancet oncology, 2013, Vol.14 (3), p.210-218
    Description: Summary Background Laparoscopic surgery as an alternative to open surgery in patients with rectal cancer has not yet been shown to be oncologically safe. The aim in the COlorectal cancer Laparoscopic or Open Resection (COLOR II) trial was to compare laparoscopic and open surgery in patients with rectal cancer. Methods A non-inferiority phase 3 trial was undertaken at 30 centres and hospitals in eight countries. Patients (aged ≥18 years) with rectal cancer within 15 cm from the anal verge without evidence of distant metastases were randomly assigned to either laparoscopic or open surgery in a 2:1 ratio, stratified by centre, location of tumour, and preoperative radiotherapy. The study was not masked. Secondary (short-term) outcomes—including operative findings, complications, mortality, and results at pathological examination—are reported here. Analysis was by modified intention to treat, excluding those patients with post-randomisation exclusion criteria and for whom data were not available. This study is registered with ClinicalTrials.gov , number NCT00297791. Findings The study was undertaken between Jan 20, 2004, and May 4, 2010. 1103 patients were randomly assigned to the laparoscopic (n=739) and open surgery groups (n=364), and 1044 were eligible for analyses (699 and 345, respectively). Patients in the laparoscopic surgery group lost less blood than did those in the open surgery group (median 200 mL [IQR 100–400] vs 400 mL [200–700], p〈0·0001); however, laparoscopic procedures took longer (240 min [184–300] vs 188 min [150–240]; p〈0·0001). In the laparoscopic surgery group, bowel function returned sooner (2·0 days [1·0–3·0] vs 3·0 days [2·0–4·0]; p〈0·0001) and hospital stay was shorter (8·0 days [6·0–13·0] vs 9·0 days [7·0–14·0]; p=0·036). Macroscopically, completeness of the resection was not different between groups (589 [88%] of 666 vs 303 [92%] of 331; p=0·250). Positive circumferential resection margin (〈2 mm) was noted in 56 (10%) of 588 patients in the laparoscopic surgery group and 30 (10%) of 300 in the open surgery group (p=0·850). Median tumour distance to distal resection margin did not differ significantly between the groups (3·0 cm [IQR 2·0–4·8] vs 3·0 cm [1·8–5·0], respectively; p=0·676). In the laparoscopic and open surgery groups, morbidity (278 [40%] of 697 vs 128 [37%] of 345, respectively; p=0·424) and mortality (eight [1%] of 699 vs six [2%] of 345, respectively; p=0·409) within 28 days after surgery were similar. Interpretation In selected patients with rectal cancer treated by skilled surgeons, laparoscopic surgery resulted in similar safety, resection margins, and completeness of resection to that of open surgery, and recovery was improved after laparoscopic surgery. Results for the primary endpoint—locoregional recurrence—are expected by the end of 2013. Funding Ethicon Endo-Surgery Europe, Swedish Cancer Foundation, West Gothia Region, Sahlgrenska University Hospital.
    Subject(s): Adult ; Aged ; Aged, 80 and over ; Colorectal cancer ; Europe ; Female ; Hematology, Oncology and Palliative Medicine ; Humans ; Laparoscopic surgery ; Laparoscopy ; Laparoscopy - methods ; Lymph Nodes - surgery ; Male ; Middle Aged ; Neoplasm Recurrence, Local - surgery ; Neoplasm Staging ; Rectal Neoplasms - pathology ; Rectal Neoplasms - radiotherapy ; Rectal Neoplasms - surgery ; Treatment Outcome
    ISSN: 1470-2045
    E-ISSN: 1474-5488
    Source: Alma/SFX Local Collection
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  • 7
    Language: English
    In: The Lancet (British edition), 2007, Vol.370 (9605), p.2112-2117
    Description: Summary Background Mechanical bowel preparation is a common practice before elective colorectal surgery. We aimed to compare the rate of anastomotic leakage after elective colorectal resections and primary anastomoses between patients who did or did not have mechanical bowel preparation. Methods We did a multicentre randomised non-inferiority study at 13 hospitals. We randomly assigned 1431 patients who were going to have elective colorectal surgery to either receive mechanical bowel preparation or not. Patients who did not have mechanical bowel preparation had a normal meal on the day before the operation. Those who did were given a fluid diet, and mechanical bowel preparation with either polyethylene glycol or sodium phosphate. The primary endpoint was anastomotic leakage, and the study was designed to test the hypothesis that patients who are given mechanical bowel preparation before colorectal surgery do not have a lower risk of anastomotic leakage than those who are not. The median follow-up was 24 days (IQR 17–34). We analysed patients who were treated as per protocol. This study is registered with ClinicalTrials.gov , number NCT00288496. Findings 77 patients were excluded: 46 who did not have a bowel resection; 21 because of missing outcome data; and 10 who withdrew, cancelled, or were excluded for other reasons. The rate of anastomotic leakage did not differ between both groups: 32/670 (4·8%) patients who had mechanical bowel preparation and 37/684 (5·4%) in those who did not (difference 0·6%, 95% CI −1·7% to 2·9%, p=0·69). Patients who had mechanical bowel preparation had fewer abscesses after anastomotic leakage than those who did not (2/670 [0·3%] vs 17/684 [2·5%], p=0·001). Other septic complications, fascia dehiscence, and mortality did not differ between groups. Interpretation We advise that mechanical bowel preparation before elective colorectal surgery can safely be abandoned.
    Subject(s): Abridged Index Medicus ; Aged ; Anastomosis ; Anastomosis, Surgical - adverse effects ; Anastomosis, Surgical - classification ; Clinical trials ; Colon (Anatomy) ; Colorectal surgery ; Colorectal Surgery - methods ; Elective Surgical Procedures ; Female ; Health aspects ; Humans ; Internal Medicine ; Length of Stay ; Male ; Medical tests ; Mortality ; Patients ; Postoperative Complications ; Preoperative Care - methods ; Risk factors ; Surgery ; Surgical anastomosis ; Teaching hospitals
    ISSN: 0140-6736
    E-ISSN: 1474-547X
    Source: Backfile Package - All of Back Files EBS [ALLOFBCKF]
    Source: Elsevier Journal Backfiles on ScienceDirect (DFG Nationallizenzen)
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  • 8
    Language: English
    In: American journal of respiratory and critical care medicine, 2012, Vol.185 (10), p.1096-1103
    Description: Rationale: Up to one-third of patients with cystic fibrosis (CF) awaiting lung transplantation (LTX) die while waiting. Inclusion of computed tomography (CT) scores may improve survival prediction models such as the lung allocation score (LAS). Objectives: This study investigated the association between CT and survival in patients with CF screened for LTX. Methods: Clinical data and chest CTs of 411 patients with CF screened for LTX between 1990 and 2005 were collected from 17 centers. CTs were scored with the Severe Advanced Lung Disease (SALD) four-category scoring system, including the components infection/inflammation (INF), air trapping/hypoperfusion (AT), normal/hyperperfusion (NOR), and bulla/cysts (BUL). The volume of each component was computed using semiautomated software. Survival analysis included Kaplan-Meier curves and Cox regression Measurements and Main Results: Three hundred and sixty-six (186 males) of 411 patients entered the waiting list (median age, 23 yr; range, 5-58 yr). Subsequently, 67 of 366 (18%) died while waiting, 263 of 366 (72%) underwent LTX, and 36 of 366 (10%) were awaiting LTX at the census date. INF and LAS were significantly associated with waiting list mortality in univariate analyses. The multivariate Cox model including INF and LAS grouped in tertiles, and comparing tertiles 2 and 3 with tertile 1, Conclusions: CT score INF correlates with survival, and adds to the predictive value of LAS.
    Subject(s): Abridged Index Medicus ; Adolescent ; Adult ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Child ; Child, Preschool ; Cohort Studies ; Cystic Fibrosis - diagnostic imaging ; Cystic Fibrosis - mortality ; Cystic Fibrosis - surgery ; Decision Support Techniques ; Female ; Humans ; Intensive care medicine ; Investigative techniques, diagnostic techniques (general aspects) ; Kaplan-Meier Estimate ; Lung Transplantation ; Male ; Medical sciences ; Middle Aged ; Multivariate Analysis ; Prognosis ; Proportional Hazards Models ; Radiodiagnosis. Nmr imagery. Nmr spectrometry ; Respiratory system ; Severity of Illness Index ; Tomography, X-Ray Computed ; Waiting Lists - mortality ; Young Adult
    ISSN: 1073-449X
    E-ISSN: 1535-4970
    Source: Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals
    Source: ProQuest Central
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  • 9
    Language: English
    In: Thorax, 2015-06, Vol.70 (6), p.543-550
    Description: Background Asthma guidelines recommend monitoring of asthma control. However, in a substantial proportion of children, asthma is poorly controlled and the best monitoring strategy is not known. Objectives We studied two monitoring strategies for their ability to improve asthma outcomes in comparison with standard care (SC): web-based monthly monitoring with the (Childhood) Asthma Control Test (ACT or C-ACT) and 4-monthly monitoring of FENO. Methods In this randomised controlled, partly blinded, parallel group multicentre trial with a 1-year follow-up, children aged 4–18 years with a doctor's diagnosis of asthma treated in seven hospitals were randomised to one of the three groups. In the web group, treatment was adapted according to ACT obtained via a website at 1-month intervals; in the FENO group according to ACT and FENO, and in the SC group according to the ACT at 4-monthly visits. The primary endpoint was the change from baseline in the proportion of symptom-free days (SFD). Results Two-hundred and eighty children (mean age 10.4 years, 66% boys) were included; 268 completed the study. Mean changes from baseline in SFD were similar between the groups: −2.1% (web group, n=90), +8.9% (FENO group, n=91) versus 0.15% (SC, n=87), p=0.15 and p=0.78. Daily dose of inhaled corticosteroids (ICS) decreased more in the web-based group compared with both other groups (−200 μg/day, p〈0.01), while ACT and SFD remained similar. Conclusions The change from baseline in SFD did not differ between monitoring strategies. With web-based ACT monitoring, ICS could be reduced substantially while control was maintained. Trial registration number NTR 1995.
    Subject(s): Administration, Inhalation ; Adolescent ; Analysis ; Asthma ; Asthma - drug therapy ; Bronchodilator Agents - administration & dosage ; Bronchodilator Agents - therapeutic use ; Budesonide - administration & dosage ; Budesonide - therapeutic use ; Care and treatment ; Child ; Child, Preschool ; Children ; Female ; Follow-Up Studies ; Glucocorticoids - administration & dosage ; Glucocorticoids - therapeutic use ; Health aspects ; Humans ; Male ; Monitoring, Physiologic - methods ; Netherlands ; Practice guidelines (Medicine) ; Prospective Studies ; Quality of Life ; Respiratory Function Tests - methods ; Single-Blind Method ; Surveys and Questionnaires ; Treatment Outcome
    ISSN: 0040-6376
    E-ISSN: 1468-3296
    Source: HighWire Press (Free Journals)
    Source: Hellenic Academic Libraries Link
    Source: BMJ Journals - NESLi2
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  • 10
    Language: English
    In: Drug metabolism and disposition, 2016-09, Vol.44 (9), p.1517-1523
    Description: Despite recent technological advances in quantifying antibody drug conjugate (ADC) species, such as total antibody, conjugated antibody, conjugated drug, and payload drug in circulation, the correlation of their exposures with the efficacy of ADC outcomes in vivo remains challenging. Here, the chemical structures and concentrations of intratumor catabolites were investigated to better understand the drivers of ADC in vivo efficacy. Anti-CD22 disulfide-linked pyrrolobenzodiazepine (PBD-dimer) conjugates containing methyl- and cyclobutyl-substituted disulfide linkers exhibited strong efficacy in a WSU-DLCL2 xenograft mouse model, whereas an ADC derived from a cyclopropyl linker was inactive. Total ADC antibody concentrations and drug-to-antibody ratios (DAR) in circulation were similar between the cyclobutyl-containing ADC and the cyclopropyl-containing ADC; however, the former afforded the release of the PBD-dimer payload in the tumor, but the latter only generated a nonimmolating thiol-containing catabolite that did not bind to DNA. These results suggest that intratumor catabolite analysis rather than systemic pharmacokinetic analysis may be used to better explain and predict ADC in vivo efficacy. These are good examples to demonstrate that the chemical nature and concentration of intratumor catabolites depend on the linker type used for drug conjugation, and the potency of the released drug moiety ultimately determines the ADC in vivo efficacy.
    Subject(s): Animals ; Antibodies, Monoclonal, Humanized - chemistry ; Antibodies, Monoclonal, Humanized - pharmacokinetics ; Benzodiazepines - chemistry ; Benzodiazepines - pharmacokinetics ; Female ; Immunoconjugates - chemistry ; Immunoconjugates - pharmacokinetics ; Mice ; Mice, SCID ; Neoplasms - metabolism ; Pyrroles - chemistry ; Pyrroles - pharmacokinetics ; Xenograft Model Antitumor Assays
    ISSN: 1521-009X
    ISSN: 0090-9556
    E-ISSN: 1521-009X
    Source: Alma/SFX Local Collection
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