Search

Item does not contain fulltext

Item does not contain fulltext, BACKGROUND: The prevalence of inflicted femur fractures in young children varies (1.5-35.2%), but these data are based on small retrospective studies with high heterogeneity. Age and mobility of the child seem to be indicators of inflicted trauma. OBJECTIVE: This study describes other factors associated with inflicted and neglectful trauma that can be used to distinguish inflicted and neglectful from accidental femur fractures. MATERIALS AND METHODS: This retrospective study included children (0-6 years) who presented with an isolated femur fracture at 1 of the 11 level I trauma centers in the Netherlands between January 2010 and January 2016. Outcomes were classified based on the conclusions of the Child Abuse and Neglect teams or the court. Cases in which conclusions were unavailable and there was no clear accidental cause were reviewed by an expert panel. RESULTS: The study included 328 children; 295 (89.9%) cases were classified as accidental trauma. Inflicted trauma was found in 14 (4.3%), while 19 (5.8%) were cases of neglect. Indicators of inflicted trauma were age 0-5 months (29%, positive likelihood ratio [LR +] 8.35), 6-12 months (18%, LR + 5.98) and 18-23 months (14%, LR + 3.74). Indicators of neglect were age 6-11 months (18%, LR + 4.41) and age 18-23 months (8%, LR + 1.65). There was no difference in fracture morphology among groups. CONCLUSION: It is unlikely that an isolated femur fracture in ambulatory children age > 24 months is caused by inflicted trauma/neglect. Caution is advised in children younger than 24 months because that age is the main factor associated with inflicted trauma/neglect and inflicted femur fractures.

Item does not contain fulltext, OBJECTIVE: We aimed to investigate the prevalence and characteristics of non-accidental trauma (NAT) in children with polytrauma treated at level-I trauma centres (TC). SUMMARY OF BACKGROUND: Data 6-10% Of children who present at the emergency department with injuries, sustain polytrauma. Polytrauma may result from either accidental (AT) or NAT, i.e. inflicted or neglect. The prevalence of NAT among children with polytrauma is currently unclear. METHODS: This is a retrospective study that included children (0-18 years) with an Injury Severity Score >15, who presented at one of the 11 Level-I trauma centers (TC) in the Netherlands between January 1, 2010 and January 1, 2016. Outcomes were classified based on the conclusions of the Child Abuse and Neglect-team. Cases in which conclusions were unavailable and there was no clear accidental cause of injuries were reviewed by an expert panel. RESULTS: The study included 1623 children, 1452 (89%) were classified as AT, 171 (11%) as NAT; 39 (2,4%) inflicted and 132 (8,1%) neglect. Of pre-school aged children (<5 years) 41% sustained NAT (OR26.73, 95%CI 17.70-40.35), 35/342 (10%) inflicted and 104/342 (31%) neglect. Admission due to 'cardiopulmonary arrest' was the result of inflicted trauma (30% vs 0%,p < 0.001). NAT had a higher mortality rate (16% vs 10%, p = 0.006). Indicators of NAT were: (near-)drowning (OR10.74, 95%CI 5.94-19.41), burn (OR8.62, 95%CI 4.08-18.19) and fall from height (OR2.18, 95%CI 1.56-3.02). CONCLUSIONS: NAT was the cause of polytrauma in 11% of children in our nationwide level-I TC study; 41% of these polytrauma were the result of NAT experienced by preschool-aged children. Our data show the importance of awareness for NAT.

Contains fulltext : 282403.pdf (Publisher’s version ) (Open Access)

Item does not contain fulltext, OBJECTIVE: We aimed to investigate the prevalence and characteristics of non-accidental trauma (NAT) in children with polytrauma treated at level-I trauma centres (TC). SUMMARY OF BACKGROUND: Data 6-10% Of children who present at the emergency department with injuries, sustain polytrauma. Polytrauma may result from either accidental (AT) or NAT, i.e. inflicted or neglect. The prevalence of NAT among children with polytrauma is currently unclear. METHODS: This is a retrospective study that included children (0-18 years) with an Injury Severity Score >15, who presented at one of the 11 Level-I trauma centers (TC) in the Netherlands between January 1, 2010 and January 1, 2016. Outcomes were classified based on the conclusions of the Child Abuse and Neglect-team. Cases in which conclusions were unavailable and there was no clear accidental cause of injuries were reviewed by an expert panel. RESULTS: The study included 1623 children, 1452 (89%) were classified as AT, 171 (11%) as NAT; 39 (2,4%) inflicted and 132 (8,1%) neglect. Of pre-school aged children (<5 years) 41% sustained NAT (OR26.73, 95%CI 17.70-40.35), 35/342 (10%) inflicted and 104/342 (31%) neglect. Admission due to 'cardiopulmonary arrest' was the result of inflicted trauma (30% vs 0%,p < 0.001). NAT had a higher mortality rate (16% vs 10%, p = 0.006). Indicators of NAT were: (near-)drowning (OR10.74, 95%CI 5.94-19.41), burn (OR8.62, 95%CI 4.08-18.19) and fall from height (OR2.18, 95%CI 1.56-3.02). CONCLUSIONS: NAT was the cause of polytrauma in 11% of children in our nationwide level-I TC study; 41% of these polytrauma were the result of NAT experienced by preschool-aged children. Our data show the importance of awareness for NAT.

Contains fulltext : 282403.pdf (Publisher’s version ) (Open Access)

Contains fulltext : 288469.pdf (Publisher’s version ) (Open Access), BACKGROUND: The prevalence of inflicted femur fractures in young children varies (1.5-35.2%), but these data are based on small retrospective studies with high heterogeneity. Age and mobility of the child seem to be indicators of inflicted trauma. OBJECTIVE: This study describes other factors associated with inflicted and neglectful trauma that can be used to distinguish inflicted and neglectful from accidental femur fractures. MATERIALS AND METHODS: This retrospective study included children (0-6 years) who presented with an isolated femur fracture at 1 of the 11 level I trauma centers in the Netherlands between January 2010 and January 2016. Outcomes were classified based on the conclusions of the Child Abuse and Neglect teams or the court. Cases in which conclusions were unavailable and there was no clear accidental cause were reviewed by an expert panel. RESULTS: The study included 328 children; 295 (89.9%) cases were classified as accidental trauma. Inflicted trauma was found in 14 (4.3%), while 19 (5.8%) were cases of neglect. Indicators of inflicted trauma were age 0-5 months (29%, positive likelihood ratio [LR +] 8.35), 6-12 months (18%, LR + 5.98) and 18-23 months (14%, LR + 3.74). Indicators of neglect were age 6-11 months (18%, LR + 4.41) and age 18-23 months (8%, LR + 1.65). There was no difference in fracture morphology among groups. CONCLUSION: It is unlikely that an isolated femur fracture in ambulatory children age > 24 months is caused by inflicted trauma/neglect. Caution is advised in children younger than 24 months because that age is the main factor associated with inflicted trauma/neglect and inflicted femur fractures.

In 2020 zijn Vitens, Deltares en Ruimtevolk begonnen aan het driejarige project Flexibiliteit in toekomstige winningen – inspelen op de uitdagingen van de toekomst. Het doel van dit project is het inrichten van bestaande winningen zodat ze flexibel zijn. Onder flexibel verstaan we dat ze schokken vanuit de omgeving kunnen opvangen en geen schokken veroorzaken op de omgeving op het gebied van kwaliteit en kwantiteit.

Aangepast beheer van dijken biedt kansen om natuurwaarden in agrarisch gebied te vergroten. Slaperdijken die tot 1 juli rusten, vormen samen met aangeplant struweel, veilige broed- en foerageergelegenheid voor boerenlandvogels. Ook muizen- en insectenpopulaties kunnen zich er ontwikkelen. Dit blijkt uit resultaten van het pilotproject ‘Natuurrijke Slaperdijken Groningen’.

Groen in en rondom woonhuizen en appartementen is goed voor het (leef)klimaat binnen en buiten de woning. Het heeft een positief effect op de gezondheid en het algehele welbevinden van bewoners en bezoekers en verhoogt de waarde van het vastgoed. Dit document biedt meer inzicht in de voordelen van groen in relatie tot wonen en welbevinden, inclusief verwijzingen naar de wetenschappelijke onderbouwing. Afsluitend vindt u enige tips die helpen om groen succesvol en volwaardig toe te passen.

Groen in en rondom kantoren en andere werkplekken is goed voor het klimaat in en buiten het kantoor en heeft een positief effect op de gezondheid en het algehele welbevinden van medewerkers en bezoekers. Het draagt bij aan concentratie, stressreductie en hogere arbeidsproductiviteit van medewerkers. Dit document biedt meer inzicht in de voordelen van groen in relatie tot werken en welbevinden, inclusief verwijzingen naar de wetenschappelijke onderbouwing. Afsluitend vindt u enige tips die helpen om groen succesvol en volwaardig toe te passen.

Groen in en rondom verzorgingshuizen, ziekenhuizen en overige klinieken is goed voor het klimaat binnen en buiten de instelling en heeft een positief effect op het herstellend vermogen en de gemoedstoestand van patiënten, en het algehele welbevinden van patiënten, medewerkers en bezoekers. Dit document biedt meer inzicht in de voordelen van groen in relatie tot herstellen en welbevinden, inclusief verwijzingen naar de wetenschappelijke onderbouwing. Afsluitend vindt u enige tips die helpen om groen succesvol en volwaardig toe te passen.

Groen heeft meer positieve effecten op onze leefomgeving dan op gezondheid en welbevinden alleen. Groen kan ook een goede rol vervullen voor de waterhuishouding en biodiversiteit in de bebouwde omgeving. En het kan helpen de effecten van geluidsoverlast te beperken. Voorts kan groen een positief effect hebben op de vastgoedwaarde van woningen en kantoren. Dit document biedt meer inzicht in de algemene voordelen van groen en is daarmee een aanvulling op de factsheets die specifiek ingaan op de meerwaarde van groen in relatie tot gezondheid en welbevinden bij Wonen, Werken, Leren en Zorg.

Groen in en rondom scholen, kinderdagverblijven en op campussen is goed voor het klimaat binnen en buiten de onderwijsinstelling. Het heeft een positief effect op de gezondheid en het algehele welbevinden van leerlingen, studenten en personeelsleden. Het verbetert het concentratievermogen en de prestaties van leerlingen en het verbetert het sociale klimaat. Dit document biedt meer inzicht in de voordelen van groen in relatie tot leren en welbevinden, inclusief verwijzingen naar de wetenschappelijke onderbouwing. Afsluitend vindt u enige tips die helpen om groen succesvol en volwaardig toe te passen

Herinrichting van het landelijk gebied wordt steeds vaker genoemd als de weg uit de stikstofcrisis en als oplossing voor andere ruimtelijke problemen, zoals vervuiling van grond- en oppervlaktewater, droogteschade aan huizen en natuur, verlies aan biodiversiteit en bodemorganische stof, en de uitstoot van broeikasgassen.

Item does not contain fulltext, BACKGROUND: Few studies have examined the impact of treatment-related morbidity on long-term, cause-specific mortality in Hodgkin lymphoma (HL) patients. METHODS: This multicenter cohort included 4919 HL patients, treated before age 51 years between 1965 and 2000, with a median follow-up of 20.2 years. Standardized mortality ratios, absolute excess mortality (AEM) per 10 000 person-years, and cause-specific cumulative mortality by stage and primary treatment, accounting for competing risks, were calculated. RESULTS: HL patients experienced a 5.1-fold (AEM = 123 excess deaths per 10 000 person-years) higher risk of death due to causes other than HL. This risk remained increased in 40-year survivors (standardized mortality ratio = 5.2, 95% confidence interval [CI] = 4.2 to 6.5, AEM = 619). At age 54 years, HL survivors experienced similar cumulative mortality (20.0%) from causes other than HL to 71-year-old individuals from the general population. Whereas HL mortality statistically significantly decreased over the calendar period (P < .001), solid tumor mortality did not change in the most recent treatment era. Patients treated in 1989-2000 had lower 25-year cardiovascular disease mortality than patients treated in 1965-1976 (4.3% vs 5.7%; subdistribution hazard ratio = 0.65, 95% CI = 0.46 to 0.93). Infectious disease mortality was not only increased after splenectomy but also after spleen irradiation (hazard ratio = 2.81, 95% CI = 1.55 to 5.07). For stage I-II, primary treatment with chemotherapy (CT) alone was associated with statistically significantly higher HL mortality (P < .001 for CT vs radiotherapy [RT]; P = .04 for CT vs RT+CT) but lower 30-year mortality from causes other than HL (15.8%, 95% CI = 9.7% to 23.3%) compared with RT alone (36.9%, 95% CI = 34.0% to 39.8%, P = .001) and RT and CT combined (29.8%, 95% CI = 26.8% to 32.9%, P = .02). CONCLUSIONS: Compared with the general population, HL survivors have a substantially reduced life expectancy. Optimal

Contains fulltext : 245451.pdf (Publisher’s version ) (Open Access), PURPOSE: Between 0.1-3% of injured children who present at a hospital emergency department ultimately die as a result of their injuries. These events are typically reported as unnatural causes of death and may result from either accidental or non-accidental trauma (NAT). Examples of the latter include trauma that is inflicted directly or resulting from neglect. Although consultation with a forensic physician is mandatory for all deceased children, the prevalence of fatal inflicted trauma or neglect among children is currently unclear. METHODS: This is a retrospective study that included children (0-18 years) who presented and died at one of the 11 Level I trauma centers in the Netherlands between January 1, 2014, and January 1, 2019. Outcomes were classified based on the conclusions of the Child Abuse and Neglect team or those of forensic pathologists and/or the court in cases referred for legally mandated autopsies. Cases in which conclusions were unavailable and there was no clear accidental cause of death were reviewed by an expert panel. RESULTS: The study included 175 cases of childhood death. Seventeen (9.7%) of these children died due to inflicted trauma (9.7%), 18 (10.3%) due to neglect, and 140 (80%) due to accidents. Preschool children (< 5 years old) were significantly more likely to present with injuries due to inflicted trauma and neglect compared to older children (44% versus 6%, p < 0.001, odds ratio [OR] 5.80, 95% confidence interval [CI] 2.66-12.65). Drowning accounted for 14 of the 18 (78%) pediatric deaths due to neglect, representing 8% of the total cases. Postmortem radiological studies and autopsies were performed on 37 (21%) of all cases of childhood death. CONCLUSION: One of every five pediatric deaths in our nationwide Level I trauma center study was attributed to NAT; 44% of these deaths were the result of trauma experienced by preschool-aged children. A remarkable number of fatal drownings were due to neglect. Postmortem radiological studi

Contains fulltext : 235026.pdf (Publisher’s version ) (Open Access), BACKGROUND: Few studies have examined the impact of treatment-related morbidity on long-term, cause-specific mortality in Hodgkin lymphoma (HL) patients. METHODS: This multicenter cohort included 4919 HL patients, treated before age 51 years between 1965 and 2000, with a median follow-up of 20.2 years. Standardized mortality ratios, absolute excess mortality (AEM) per 10 000 person-years, and cause-specific cumulative mortality by stage and primary treatment, accounting for competing risks, were calculated. RESULTS: HL patients experienced a 5.1-fold (AEM = 123 excess deaths per 10 000 person-years) higher risk of death due to causes other than HL. This risk remained increased in 40-year survivors (standardized mortality ratio = 5.2, 95% confidence interval [CI] = 4.2 to 6.5, AEM = 619). At age 54 years, HL survivors experienced similar cumulative mortality (20.0%) from causes other than HL to 71-year-old individuals from the general population. Whereas HL mortality statistically significantly decreased over the calendar period (P < .001), solid tumor mortality did not change in the most recent treatment era. Patients treated in 1989-2000 had lower 25-year cardiovascular disease mortality than patients treated in 1965-1976 (4.3% vs 5.7%; subdistribution hazard ratio = 0.65, 95% CI = 0.46 to 0.93). Infectious disease mortality was not only increased after splenectomy but also after spleen irradiation (hazard ratio = 2.81, 95% CI = 1.55 to 5.07). For stage I-II, primary treatment with chemotherapy (CT) alone was associated with statistically significantly higher HL mortality (P < .001 for CT vs radiotherapy [RT]; P = .04 for CT vs RT+CT) but lower 30-year mortality from causes other than HL (15.8%, 95% CI = 9.7% to 23.3%) compared with RT alone (36.9%, 95% CI = 34.0% to 39.8%, P = .001) and RT and CT combined (29.8%, 95% CI = 26.8% to 32.9%, P = .02). CONCLUSIONS: Compared with the general population, HL survivors have a substantially reduced life expectancy. Optimal

Contains fulltext : 245451.pdf (Publisher’s version ) (Open Access), PURPOSE: Between 0.1-3% of injured children who present at a hospital emergency department ultimately die as a result of their injuries. These events are typically reported as unnatural causes of death and may result from either accidental or non-accidental trauma (NAT). Examples of the latter include trauma that is inflicted directly or resulting from neglect. Although consultation with a forensic physician is mandatory for all deceased children, the prevalence of fatal inflicted trauma or neglect among children is currently unclear. METHODS: This is a retrospective study that included children (0-18 years) who presented and died at one of the 11 Level I trauma centers in the Netherlands between January 1, 2014, and January 1, 2019. Outcomes were classified based on the conclusions of the Child Abuse and Neglect team or those of forensic pathologists and/or the court in cases referred for legally mandated autopsies. Cases in which conclusions were unavailable and there was no clear accidental cause of death were reviewed by an expert panel. RESULTS: The study included 175 cases of childhood death. Seventeen (9.7%) of these children died due to inflicted trauma (9.7%), 18 (10.3%) due to neglect, and 140 (80%) due to accidents. Preschool children (< 5 years old) were significantly more likely to present with injuries due to inflicted trauma and neglect compared to older children (44% versus 6%, p < 0.001, odds ratio [OR] 5.80, 95% confidence interval [CI] 2.66-12.65). Drowning accounted for 14 of the 18 (78%) pediatric deaths due to neglect, representing 8% of the total cases. Postmortem radiological studies and autopsies were performed on 37 (21%) of all cases of childhood death. CONCLUSION: One of every five pediatric deaths in our nationwide Level I trauma center study was attributed to NAT; 44% of these deaths were the result of trauma experienced by preschool-aged children. A remarkable number of fatal drownings were due to neglect. Postmortem radiological studi

Contains fulltext : 235026.pdf (Publisher’s version ) (Open Access), BACKGROUND: Few studies have examined the impact of treatment-related morbidity on long-term, cause-specific mortality in Hodgkin lymphoma (HL) patients. METHODS: This multicenter cohort included 4919 HL patients, treated before age 51 years between 1965 and 2000, with a median follow-up of 20.2 years. Standardized mortality ratios, absolute excess mortality (AEM) per 10 000 person-years, and cause-specific cumulative mortality by stage and primary treatment, accounting for competing risks, were calculated. RESULTS: HL patients experienced a 5.1-fold (AEM = 123 excess deaths per 10 000 person-years) higher risk of death due to causes other than HL. This risk remained increased in 40-year survivors (standardized mortality ratio = 5.2, 95% confidence interval [CI] = 4.2 to 6.5, AEM = 619). At age 54 years, HL survivors experienced similar cumulative mortality (20.0%) from causes other than HL to 71-year-old individuals from the general population. Whereas HL mortality statistically significantly decreased over the calendar period (P < .001), solid tumor mortality did not change in the most recent treatment era. Patients treated in 1989-2000 had lower 25-year cardiovascular disease mortality than patients treated in 1965-1976 (4.3% vs 5.7%; subdistribution hazard ratio = 0.65, 95% CI = 0.46 to 0.93). Infectious disease mortality was not only increased after splenectomy but also after spleen irradiation (hazard ratio = 2.81, 95% CI = 1.55 to 5.07). For stage I-II, primary treatment with chemotherapy (CT) alone was associated with statistically significantly higher HL mortality (P < .001 for CT vs radiotherapy [RT]; P = .04 for CT vs RT+CT) but lower 30-year mortality from causes other than HL (15.8%, 95% CI = 9.7% to 23.3%) compared with RT alone (36.9%, 95% CI = 34.0% to 39.8%, P = .001) and RT and CT combined (29.8%, 95% CI = 26.8% to 32.9%, P = .02). CONCLUSIONS: Compared with the general population, HL survivors have a substantially reduced life expectancy. Optimal

De landbouw heeft in ons land grote verworvenheden gebracht, maar is in zijn huidige vorm niet langer houdbaar. Het jaren ‘90 idee dat marktwerking tot een gezonde agrarische sector leidt, is een illusie gebleken en heeft de sector speelbal gemaakt van stuurloosheid en hindermacht. Het landschap, de natuur en de dieren hebben hiervoor de prijs betaald, evenals alle boeren die voortijdig de ‘race to the bottom’ hebben moeten verlaten. Het is tijd voor een radicale transformatie. Een ruimtelijk plan voor een radicaal andere koers die een doorbraak uit de huidige impasse kan betekenen.

Blauwe kiekendief Circus cyaneus en velduil Asio flammeus zijn twee iconische vogelsoorten van het Waddengebied. Talrijk zijn ze nooit geweest, maar nu dreigen beide soorten als broedvogel uit Nederland te verdwijnen. Terwijl in de eerste helft van de jaren negentig van de vorige eeuw nog ruim honderd paar blauwe kiekendieven in het Waddengebied broedden, gaat het de laatste jaren nog maar om een handvol broedparen. Ook de velduil is met minder dan 10 broedparen op de eilanden een zeer schaarse broedvogel geworden. De achteruitgang van blauwe kiekendief en velduil wordt veroorzaakt door een scala aan factoren met deels internationale dimensies. Eén van de specifieke problemen in Nederland is de verslechtering van de voedselsituatie voor blauwe kiekendief en velduil in zowel duingebied als agrarisch gebied. Wadvogels van Allure voorzag in de uitrol van een relatief nieuwe maatregel voor blauwe kiekendief en velduil in het Waddengebied: de vogelakker. De vogelakker is een meerjarige maatregel waarin zich een muizenpopulatie kan ontwikkelen. Deze muizen zijn het hele jaar door bejaagbaar voor blauwe kiekendief en velduil. Vogelakkers beogen zo bij te dragen aan een verbetering van het voedselaanbod voor muizeneters. In het kader van Wadvogels van Allure zijn verspreid in het Waddengebied 150 ha vogelakkers aangelegd. Deze vogelakkers waren met name geclusterd bij agrariërs en Natuurmonumenten op Texel en bij akkerbouwers in de Oost-Groningse Dollardpolders. De aanleg van vogelakkers ging gepaard met uitgebreide monitoring en aanvullend onderzoek. Dit bestond onder meer uit tellingen van (veld)muizen en vogels in vogelakkers, voedselonderzoek en onderzoek naar habitatgebruik door middel van zenderonderzoek.

Fasting older broiler chickens (>7 d of age) enlarges the intestinal tight junction (TJ) pore size, resulting in high paracellular intestinal permeability. Broiler chickens often do not receive feed and water (nutrition) directly after hatch, which may result in fasting up to 72 h of age. Whether perinatal fasting affects intestinal permeability is minimally studied. We therefore investigated whether delayed access to nutrition after hatch increases intestinal permeability, compared with broilers receiving early access to nutrition. Therefore, 432 hatched broilers received nutrition 72 h after hatch (delayed nutrition [DN]) or directly after hatch (early nutrition [EN]) and were reared under similar conditions until 14 d of age. Two hours after application of an oral pulse dose (3.85 mg) of fluorescein isothiocyanate-dextran (4000 Da) at 4, 10, and 14 d of age, blood plasma concentrations of the marker were measured in 24 to 36 broilers per treatment and time point. Marker concentration in plasma did not differ between DN and EN broilers at any age. The villus width measured in at least 8 broilers per treatment was smaller in DN than in EN broilers at 4 d for both the ileum (92 ± 3 μm vs. 121 ± 4; P < 0.001) and colon (100 ± 3 vs. 120 ± 4; P < 0.01). Real-time quantitative PCR revealed that the expression of TJ protein claudin 3 in the ceca was elevated in DN, compared with EN broilers at 4 d of age, whereas that of zonula occludens 1 in the ileum was reduced. Expression of host defense-related genes was reduced in DN, compared with EN broilers, in the ileum (cyclo-oxygenase 2, mucin 2) and ceca (interleukin 1β, cyclo-oxygenase 2). We conclude that 72-hour DN reduced the BW up to 14 d of age, coinciding with transient effects on the villus width in the ileum and colon, and divergent expression of genes involved in TJ formation and host defense. These effects likely reflect the delayed onset of intestinal and immune development in DN, compared with EN broilers, wh

Greater antigenic exposure might accelerate activation and maturation of the humoral immune system. After hatch, commercial broiler chickens can have early (EN) or delayed (DN) access to nutrition, up to 72 h after hatch. The immune system of EN versus DN broilers is likely more exposed to antigens after hatch. This might contribute to activation and maturation of the immune system, but might also influence the development of oral tolerance, thereby altering later life antibody responses. We studied antibody (IgM, IgY, IgA) responses between 21 and 42 d of age in fast-growing EN and DN broilers, kept under low (LSC) or high sanitary conditions (HSC). In a first experiment (n = 51 broilers), we tested whether early oral exposure to bovine serum albumin (BSA) affected later life antibody responses towards BSA and a novel antigen—rabbit γ-globulin (RGG), under HSC. In a second experiment, a total of 480 EN and DN broilers were housed under either LSC or HSC, and we studied antibody responses against both BSA and RGG (n = 48 broilers per treatment) and growth performance. Broilers kept under LSC versus HSC, had higher antibody levels and their growth performance was severely depressed. Interactions between feeding strategy (EN versus DN) and sanitary conditions, or main effects of feeding strategy, on natural and specific antibody levels, and growth performance were not observed. Levels of IgA were elevated in EN versus DN broilers, in experiment I and in batch 2 of experiment II, but not in the other batches of experiment II. We concluded that EN versus DN contributes minimally to the regulation of antibody responses, irrespective of antigenic pressure in the rearing environment. View Full-Text

Het doel van dit onderzoek is om te meten of er een samenhang is tussen delinquent gedrag van adolescent en zijn of haar beste vriend(in). Daarnaast is onderzocht of positieve en negatieve kenmerken van de kwaliteit van relaties invloed hebben op deze samenhang. Wanneer hier meer duidelijkheid over ontstaat, kunnen preventieve maatregelen getroffen worden ter voorkoming van delinquent gedrag. Er werd een samenhang tussen het delinquent gedrag van adolescent en zijn of haar beste vriend(in) verwacht. Daarnaast werd verwacht dat negatieve kenmerken meer invloed hebben op de samenhang van het delinquente gedrag dan positieve kenmerken. In het onderzoek participeren 497 adolescenten samen met hun beste vriend(in). Participanten zijn gevolgd van hun 12e tot 18e levensjaar. Om het delinquente gedrag te meten hebben de adolescenten en hun beste vriend(in) drie keer per jaar de zelfrapportage delinquent gedrag vragenlijst ingevuld. Om de kwaliteit van relaties te meten hebben zij elk jaar de Nederlandse versie van ‘The Network of Relationships Inventory’ ingevuld. Om de samenhang van delinquent gedrag tussen adolescent en zijn of haar beste vriend(in) te meten is een Spearman’s Rho correlatieanalyse uitgevoerd. Met een meervoudige regressieanalyse is de invloed van kwaliteit van relaties op de samenhang van het delinquente gedrag gemeten. Uit het onderzoek blijkt dat er een samenhang is tussen delinquent gedrag van adolescent en beste vriend(in). Daarnaast is geen moderatie-effect van support en negatieve interactie gevonden. Verder onderzoek naar de invloed van kwaliteit van relaties op delinquent gedrag wordt aangeraden.

Het doel van dit onderzoek is om te meten of er een samenhang is tussen delinquent gedrag van adolescent en zijn of haar beste vriend(in). Daarnaast is onderzocht of positieve en negatieve kenmerken van de kwaliteit van relaties invloed hebben op deze samenhang. Wanneer hier meer duidelijkheid over ontstaat, kunnen preventieve maatregelen getroffen worden ter voorkoming van delinquent gedrag. Er werd een samenhang tussen het delinquent gedrag van adolescent en zijn of haar beste vriend(in) verwacht. Daarnaast werd verwacht dat negatieve kenmerken meer invloed hebben op de samenhang van het delinquente gedrag dan positieve kenmerken. In het onderzoek participeren 497 adolescenten samen met hun beste vriend(in). Participanten zijn gevolgd van hun 12e tot 18e levensjaar. Om het delinquente gedrag te meten hebben de adolescenten en hun beste vriend(in) drie keer per jaar de zelfrapportage delinquent gedrag vragenlijst ingevuld. Om de kwaliteit van relaties te meten hebben zij elk jaar de Nederlandse versie van ‘The Network of Relationships Inventory’ ingevuld. Om de samenhang van delinquent gedrag tussen adolescent en zijn of haar beste vriend(in) te meten is een Spearman’s Rho correlatieanalyse uitgevoerd. Met een meervoudige regressieanalyse is de invloed van kwaliteit van relaties op de samenhang van het delinquente gedrag gemeten. Uit het onderzoek blijkt dat er een samenhang is tussen delinquent gedrag van adolescent en beste vriend(in). Daarnaast is geen moderatie-effect van support en negatieve interactie gevonden. Verder onderzoek naar de invloed van kwaliteit van relaties op delinquent gedrag wordt aangeraden.

Webinar met presentaties van 3 onderzoekers van Wageningen Environmental Research: Sjerp de Vries “Houdt groen de geest gezond?”, Joop Spijker “De zinderende stad; het belang van koelte in de stad”, Robbert Snep “Biodiversiteit in de stad”. Presentatie Gerry Kouwenhoven (Hogeschool Inholland) van het OnderwijsVernieuwingsprogramma. Dit webinar is mogelijk gemaakt door: Ministerie van Landbouw, Natuur & Voedselkwaliteit en Kennis op Maat, De Groene Agenda en Stichting De Groene Stad.

Citizen Science (CS) wordt ook bij watermanagement populairder. Bij het opzetten van een succesvol CS-project komt veel kijken. Wordt er een aspect over het hoofd gezien, dan ontstaat de kans dat het project averechts werkt en de burgerwetenschappers niet gemotiveerd blijven, tot grote ontevredenheid bij alle betrokken partijen. In Delft is het WaterLab ontwikkeld om organisaties en individuen met interesse in wateronderzoek te ondersteunen en faciliteren in het opstarten van CS-projecten.

Door de introductie van de Duurzame Ontwikkelingsdoelen met een specifiek doel gericht op water (SDG 6), is er internationaal meer aandacht gekomen voor duurzaam waterbeheer van de gehele watercyclus. UN-Water is de coördinerende instantie voor VN-organisaties betrokken bij de verschillende water onderwerpen. Om recht te doen aan het integrale karakter van water in de 2030 Agenda, lanceerde UN-Water een Integraal Monitoring Initiatief. Dit artikel beschrijft hoe de Nederlandse ervaringen zijn gedeeld met andere landen en met UN-Water in dit internationale proces. Het integrale waterdoel met zijn deeldoelen en indicatoren (SDG 6) is belangrijk om de mondiale voortgang van landen te kunnen meten, maar geeft de landen onvoldoende informatie om de benodigde maatregelen op nationaal niveau te kunnen bepalen. Om het waterdoel te halen: duurzaam waterbeheer en sanitaire voorzieningen voor allen, is het essentieel dat landen een doorvertaling maken naar nationale doelen en indicatoren om zo de benodigde maatregelen te kunnen nemen., With the introduction of the Sustainable Development Goals (SDGs), attention increased towards water with its own goal number 6, and a more comprehensive focus on sustainably managing the entire water cycle in an equitable manner. To meet the needs of the 2030 Agenda, an Integrated Monitoring Initiative for SDG 6 was launched by UNWater. This article explains the role of the Netherlands in this international process, and how Dutch experiences were shared with other countries as well as with UN-Water. It demonstrates how the established SDG 6 targets and its indicators are useful for a global comparison and analysis of trends but does not suffice for national and local implementation of the SDG targets. Localizing the SDG 6 targets and indicators, or perhaps changing or improving them while considering local circumstances, is essential to receive meaningful data that can enable SDG 6 implementation: sustainable water management and sanitation for all.

Background: Palliative care aims to optimise the quality of life of patients with life-threatening illnesses by diminishing multidimensional suffering. The social and spiritual dimensions still seem underrepresented in Dutch palliative care, as caregivers lack words to describe and discuss the patients’ associated needs. The ars moriendi model centres on five tension fields that may be pivotal in one’s process of dying. They should facilitate communication about needs in the social and spiritual dimension. Recently, these tension fields were integrated into the Utrecht Symptom Diary – 4 Dimensional (USD-4D), a Patient-Reported Outcome Measure (PROM). Aim: This study’s aim was to assess the content validity of social and spiritual items of the USD-4D, in accordance with the Consensus-Based Standards for Selection of Health Measurement Instruments (COSMIN) methodology. Method: A generic qualitative study was conducted using semi-structured interviews from February 2019 to July 2019. Data were analysed independently by two researchers using thematic analysis. Results: A total of 12 participants (male N = 7, age range 53–87 years) possessing a life-limiting illness participated. The instructions and response options were clear for almost all participants. The meaning that the participants provided to the items was expressed in themes: maintaining personal identity and autonomy, resilience, letting go, perceived balance in one’s life, and death and life after death. This corresponded with the items’ intended meaning. Most of the participants found the items relevant and comprehensive. Conclusion: The USD-4D constitutes a content-valid PROM from the patient’s perspective. The items seem to aid in exploring needs from the social and spiritual dimension and appears supportive in the conversation to further explore these needs. Recommendations: Further research is required for the USD-4D’s successful integration in Dutch palliative care.

Youth delinquency is a serious problem concerning both youth and the society. New Perspectives (NP) is an intervention aiming to reduce delinquent behavior among at-risk youth aged 12 to 23 years old. The present study investigated the long term effects of NP on the relationships with friends and whether the effects were influenced by gender. The participants were randomly assigned to the intervention group (NP, n = 12) and care as usual (CAU, n = 7). Data of the participants were retrieved through self-reports. Multivariate analyses (MANOVA) were conducted to examine the main intervention effects and moderator effects. The NP group and CAU group did not differ regarding to deviant and prosocial friends. Furthermore, gender did not moderate the effects of NP on friend relationships. There remains a need for further well-designed research containing a larger sample in order to draw valid conclusions regarding the effectiveness of NP.

Background: Palliative care aims to optimise the quality of life of patients with life-threatening illnesses by diminishing multidimensional suffering. The social and spiritual dimensions still seem underrepresented in Dutch palliative care, as caregivers lack words to describe and discuss the patients’ associated needs. The ars moriendi model centres on five tension fields that may be pivotal in one’s process of dying. They should facilitate communication about needs in the social and spiritual dimension. Recently, these tension fields were integrated into the Utrecht Symptom Diary – 4 Dimensional (USD-4D), a Patient-Reported Outcome Measure (PROM). Aim: This study’s aim was to assess the content validity of social and spiritual items of the USD-4D, in accordance with the Consensus-Based Standards for Selection of Health Measurement Instruments (COSMIN) methodology. Method: A generic qualitative study was conducted using semi-structured interviews from February 2019 to July 2019. Data were analysed independently by two researchers using thematic analysis. Results: A total of 12 participants (male N = 7, age range 53–87 years) possessing a life-limiting illness participated. The instructions and response options were clear for almost all participants. The meaning that the participants provided to the items was expressed in themes: maintaining personal identity and autonomy, resilience, letting go, perceived balance in one’s life, and death and life after death. This corresponded with the items’ intended meaning. Most of the participants found the items relevant and comprehensive. Conclusion: The USD-4D constitutes a content-valid PROM from the patient’s perspective. The items seem to aid in exploring needs from the social and spiritual dimension and appears supportive in the conversation to further explore these needs. Recommendations: Further research is required for the USD-4D’s successful integration in Dutch palliative care.

Youth delinquency is a serious problem concerning both youth and the society. New Perspectives (NP) is an intervention aiming to reduce delinquent behavior among at-risk youth aged 12 to 23 years old. The present study investigated the long term effects of NP on the relationships with friends and whether the effects were influenced by gender. The participants were randomly assigned to the intervention group (NP, n = 12) and care as usual (CAU, n = 7). Data of the participants were retrieved through self-reports. Multivariate analyses (MANOVA) were conducted to examine the main intervention effects and moderator effects. The NP group and CAU group did not differ regarding to deviant and prosocial friends. Furthermore, gender did not moderate the effects of NP on friend relationships. There remains a need for further well-designed research containing a larger sample in order to draw valid conclusions regarding the effectiveness of NP.

Background: Palliative care aims to optimise the quality of life of patients with life-threatening illnesses by diminishing multidimensional suffering. The social and spiritual dimensions still seem underrepresented in Dutch palliative care, as caregivers lack words to describe and discuss the patients’ associated needs. The ars moriendi model centres on five tension fields that may be pivotal in one’s process of dying. They should facilitate communication about needs in the social and spiritual dimension. Recently, these tension fields were integrated into the Utrecht Symptom Diary – 4 Dimensional (USD-4D), a Patient-Reported Outcome Measure (PROM). Aim: This study’s aim was to assess the content validity of social and spiritual items of the USD-4D, in accordance with the Consensus-Based Standards for Selection of Health Measurement Instruments (COSMIN) methodology. Method: A generic qualitative study was conducted using semi-structured interviews from February 2019 to July 2019. Data were analysed independently by two researchers using thematic analysis. Results: A total of 12 participants (male N = 7, age range 53–87 years) possessing a life-limiting illness participated. The instructions and response options were clear for almost all participants. The meaning that the participants provided to the items was expressed in themes: maintaining personal identity and autonomy, resilience, letting go, perceived balance in one’s life, and death and life after death. This corresponded with the items’ intended meaning. Most of the participants found the items relevant and comprehensive. Conclusion: The USD-4D constitutes a content-valid PROM from the patient’s perspective. The items seem to aid in exploring needs from the social and spiritual dimension and appears supportive in the conversation to further explore these needs. Recommendations: Further research is required for the USD-4D’s successful integration in Dutch palliative care.

Greenery in and around houses and apartments is good for the (living) environment in and around the buildings. It has a positive effect on the health and general well-being of residents and visitors. This document provides information on how homes and well-being can benefit from greenery, including references to scientific literature. It concludes with some tips on how to ensure the successful and beneficial inclusion of greenery.

Greenery in and around nursing homes, hospitals and other clinics is good for the climate inside and outside the building, and has a positive effect on patient’s state of mind and ability to recover, as well as the general well-being of patients, staff and visitors. This document provides information on the benefits of greenery for recovery and well-being, including references to scientific literature. It concludes with some tips on how to ensure the successful and beneficial inclusion of greenery.

Greenery in our living environment is beneficial for more than just our health and well-being. It facilitates water management and stimulates biodiversity in built-up areas, and it can also reduce the effects of noise pollution. Greenery also has a positive impact on the property value of homes and offices. This document provides general information on the benefits of greenery, supplementary to the detailed fact sheets on how greenery can improve health and well-being in Residential, Professional, Educational and Healthcare contexts.

Greenery in and around offices and other working environments is good for the climate, and has a positive effect on the health and general well-being of employees and visitors. It aids concentration, helps reduce stress and increases productivity. This document provides information on the benefits of greenery for work and well-being, including references to scientific literature. It concludes with some tips on how to ensure the successful and beneficial inclusion of greenery.

Greenery in and around schools and nurseries and on campuses enhances the ambience of educational institutions, both inside and out. It has a positive effect on the health and general well-being of students and staff alike, improving student’s performance and their ability to concentrate, as well as enhancing the social climate. This document provides insights into the benefits of greenery for learning and well-being, including references to scientific literature. It concludes with some tips on how to ensure the successful and beneficial inclusion of greenery.

Er ligt een grote opgave om met duurzame energiebronnen aan onze energiebehoefte te voldoen en er worden daarom steeds meer zonneparken aangelegd. Dit levert discussie op over het benutten van de schaarse ruimte. Het is daarom belangrijk om inzicht te hebben in de effecten van zonneparken op landbouw, biodiversiteit en beleving van het landschap, én in de kansen voor combinaties. Dit artikel is gebaseerd op een literatuuronderzoek (Van der Zee et al., 2019).

Item does not contain fulltext, OBJECTIVE: To determine the effect of radical prostatectomy (RP) hospital volume on the probability of post-RP incontinence. DESIGN: Retrospective research based on claims-based data of health insurers. METHOD: For every patient with RP the probability of incontinence was determined, based on the definition of claims of one or more incontinence pads per day. Casemix corrections were made based on indicators available in claims-data: age, lymph node dissection, and radiotherapy. No casemix corrections could be made for tumour stage and surgical technique. RESULTS: A total of 1590 patients were included in this study; for 26.0% of these patients, an average of one or more incontinence pads per day were claimed for. A significant relation between the volume of RP per hospital and the claims of incontinence material was observed. The probability of incontinence was significantly lower in hospitals with a volume of more than 100 RP patients per year when compared to hospitals with less than 100 RP patients per year. CONCLUSION: The probability of post-RP incontinence decreases as hospitals conduct more RP procedures. The casemix factors included in the analysis only had a limited impact on this observation.

Item does not contain fulltext

Item does not contain fulltext

Item does not contain fulltext

Item does not contain fulltext

The problem of Symbolic Regression (SR) is to find a mathematical expression which best models a given dataset. Research into SR primarily takes place in Genetic Programming (GP), with the evolutionary algorithm called Standard GP (SGP) at its basis. In this work, we set out to improve upon SGP, using the Sensitivity-based Genetic Programming (SensGP) algorithm. A thorough examination of SR literature in the field of GP led to the conclusion that algorithms which are improvements of SGP frequently enhance the search process. This is accomplished by guiding the evolution by using additional information about parts of solutions, called features. By conducting comparison experiments between algorithms from the literature, we confirmed this conclusion. As a result, the feature-guided evolutionary process was chosen to be the basis for SensGP. At the core of the SensGP algorithm lies the use of sensitivity analysis to measure feature importance. The Mean Squared Error (MSE) of a feature is measured on the original data and on the data for which selected variables have had their values shuffled. The difference in these MSE values is used to calculate a feature importance score, which is later used to reintroduce these features into the population. In addition to the basic SensGP algorithm, we experimented with two variants of SensGP: a Model Dependent approach, in which only the models with the lowest MSE are used for feature importance calculation, and a Variable Importance approach, in which feature importance is measured by the sensitivity of the model they appear in to the variables contained in the feature. These algorithms are compared to SGP in a number of configurations. Although these experiments did not result in a statistically significant difference in model quality between SGP and SensGP, we present a number of ways in which SensGP might be further refined. Further research will have to establish if these adjustments can make SensGP a useful addition to the v

RIVM rapport:Natuur kan positieve effecten hebben op de (mentale) gezondheid en het welbevinden, doordat het mensen stimuleert elkaar te ontmoeten, te ontspannen en te bewegen. Om beter te begrijpen wat 'groenprojecten' in gemeenten concreet opleveren voor de gezondheid is het van belang de effecten te evalueren. Dit kan alleen als voorafgaand aan de verandering het gebruik van een locatie en de lokale gezondheid in beeld worden gebracht (nulmeting). Het RIVM heeft met het onderzoeksinstituut Alterra (tegenwoordige Wageningen Environmental Research) een dergelijke nulmeting uitgevoerd voor een groenproject in Breda. Daar is een park met bewoners van de buurt Geeren-Zuid opnieuw ingericht om het aantrekkelijk te maken voor ontmoetingen, ontspanning en bewegen. In Geeren-Zuid wonen veel mensen met een lage sociaaleconomische status, bij wie naar verwachting het effect van natuur op gezondheid het grootst is. In de nulmeting is het gebruik en de beleving van groen en de gezondheid van bewoners in kaart gebracht voordat het park opnieuw werd ingericht. Daarnaast zijn de betrokken professionals uit de wijk en gemeente geïnterviewd over hun verwachtingen van het effect van de herinrichting van het wijkpark. De bewoners bleken het wijkpark nog maar beperkt te gebruiken, voornamelijk voor korte bezoeken. Zij waren vooral niet tevreden over de inrichting van het groen en de beperkte mogelijkheden om het te gebruiken. Wel dacht de meerderheid dat ze het park meer zouden gaan gebruiken na de herinrichting, vooral om er te zitten, te zonnen en te kletsen, maar ook voor een wandelingetje of om de hond uit te laten. De mentale en ervaren gezondheid van de bewoners van Geeren-Zuid was slechter dan van de gemiddelde Nederlandse bevolking. De betrokken professionals uit de wijk en gemeente verwachtten dat het park door de herinrichting meer zal worden gebruikt. Inmiddels is het wijkpark heringericht en vinden er activiteiten door en met bewoners plaats. Vervolgonderzoek is nodig om te kunnen vas, Nature can have beneficial effects on (mental) health and wellbeing, because it stimulates people to meet, to relax, and to be physical active. To get a better insight into the impacts of local green space interventions on health, it is important to evaluate these green space interventions. This is only possible if the use and the public health status of the residents in the proximity at a location where such an intervention is being planned, is assessed a priori (baseline measurement). RIVM and research institute Alterra (now called Wageningen Environmental Research) have conducted such a baseline measurement in the city of Breda. The municipality and residents of neighbourhood Geeren-Zuid worked together to restructure an urban park there, to make it more convenient for meeting people, relaxation, and physical activity. In this neighbourhood many residents have a low socio-economic status (SES). The hypothesis is that the effect of nature on health is largest in low SES populations. In the baseline measurement the use and perception of green space and health has been assessed before the park was restructured. In addition, the professionals from the municipality have been interviewed on their expectations regarding the effect of the restructuring of the park. The baseline measurement revealed that the residents used the park only to a limited extent, mainly for short visits. They were not satisfied with the design of the park and the possibilities to use it. More than half of the study population expected to use it more after the restructuring, in particular to sit, sunbath, meet, and walk with or without a dog. Furthermore, the mental health and general health of the study population appeared to be worse than that of the average Dutch population. The professionals from the municipality expected that the park would be used more after the restructuring. In the meantime, the park has been restructured and there are activities organised for and with residents. To eval

RIVM rapport:Natuur kan positieve effecten hebben op de (mentale) gezondheid en het welbevinden, doordat het mensen stimuleert elkaar te ontmoeten, te ontspannen en te bewegen. Om beter te begrijpen wat 'groenprojecten' in gemeenten concreet opleveren voor de gezondheid is het van belang de effecten te evalueren. Dit kan alleen als voorafgaand aan de verandering het gebruik van een locatie en de lokale gezondheid in beeld worden gebracht (nulmeting). Het RIVM heeft met het onderzoeksinstituut Alterra (tegenwoordige Wageningen Environmental Research) een dergelijke nulmeting uitgevoerd voor een groenproject in Breda. Daar is een park met bewoners van de buurt Geeren-Zuid opnieuw ingericht om het aantrekkelijk te maken voor ontmoetingen, ontspanning en bewegen. In Geeren-Zuid wonen veel mensen met een lage sociaaleconomische status, bij wie naar verwachting het effect van natuur op gezondheid het grootst is. In de nulmeting is het gebruik en de beleving van groen en de gezondheid van bewoners in kaart gebracht voordat het park opnieuw werd ingericht. Daarnaast zijn de betrokken professionals uit de wijk en gemeente geïnterviewd over hun verwachtingen van het effect van de herinrichting van het wijkpark. De bewoners bleken het wijkpark nog maar beperkt te gebruiken, voornamelijk voor korte bezoeken. Zij waren vooral niet tevreden over de inrichting van het groen en de beperkte mogelijkheden om het te gebruiken. Wel dacht de meerderheid dat ze het park meer zouden gaan gebruiken na de herinrichting, vooral om er te zitten, te zonnen en te kletsen, maar ook voor een wandelingetje of om de hond uit te laten. De mentale en ervaren gezondheid van de bewoners van Geeren-Zuid was slechter dan van de gemiddelde Nederlandse bevolking. De betrokken professionals uit de wijk en gemeente verwachtten dat het park door de herinrichting meer zal worden gebruikt. Inmiddels is het wijkpark heringericht en vinden er activiteiten door en met bewoners plaats. Vervolgonderzoek is nodig om te kunnen vas, Nature can have beneficial effects on (mental) health and wellbeing, because it stimulates people to meet, to relax, and to be physical active. To get a better insight into the impacts of local green space interventions on health, it is important to evaluate these green space interventions. This is only possible if the use and the public health status of the residents in the proximity at a location where such an intervention is being planned, is assessed a priori (baseline measurement). RIVM and research institute Alterra (now called Wageningen Environmental Research) have conducted such a baseline measurement in the city of Breda. The municipality and residents of neighbourhood Geeren-Zuid worked together to restructure an urban park there, to make it more convenient for meeting people, relaxation, and physical activity. In this neighbourhood many residents have a low socio-economic status (SES). The hypothesis is that the effect of nature on health is largest in low SES populations. In the baseline measurement the use and perception of green space and health has been assessed before the park was restructured. In addition, the professionals from the municipality have been interviewed on their expectations regarding the effect of the restructuring of the park. The baseline measurement revealed that the residents used the park only to a limited extent, mainly for short visits. They were not satisfied with the design of the park and the possibilities to use it. More than half of the study population expected to use it more after the restructuring, in particular to sit, sunbath, meet, and walk with or without a dog. Furthermore, the mental health and general health of the study population appeared to be worse than that of the average Dutch population. The professionals from the municipality expected that the park would be used more after the restructuring. In the meantime, the park has been restructured and there are activities organised for and with residents. To eval

In mijn onderzoek naar Muhammad Ali onderzoek ik welke factoren bijdroegen aan de kanteling van zijn imago in de periode 1964-1976. In dit onderzoek destilleer ik drie belangrijke thema’s die bepalend waren voor die kanteling: 1. Zijn associatie met The Nation of Islam, een radicale, voor segregatie pleitende islamitische organisatie voor en door zwarte Amerikanen; 2. Zijn dienstweigering in 1967, toen hij zich op gewetensbezwaren en religieuze overtuiging beriep om af te zien van diensttijd in de Vietnamoorlog; 3. Zijn relatie tot de media. In een kritische analyse van de door mij gebruikte bronnen bepaal ik hoe en waarom juist deze thema’s bijdroegen aan het doen kantelen van Ali’s imago in Amerika en de rest van de wereld.