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Background: Older adults with intellectual disabilities (ID) have a high risk of cardiovascular diseases (CVD). At the same time, challenging diagnostic work-up increases the likelihood of underdiagnosis of CVD in this population. To limit this underdiagnosis, it would be beneficial to use objective measures such as the electrocardiogram (ECG). However, little is known about the feasibility of ECG recording and the prevalence of ECG abnormalities in this population. Therefore, the aims of this study were to investigate the feasibility of resting ECG recording, to study the prevalence of ECG abnormalities, and to compare the frequency of ECG abnormalities with medical records in older adults with ID. Method: A cross-sectional study was performed within a cohort of older adults (≥60 years) with ID as part of the Healthy Ageing and Intellectual Disabilities (HA-ID) study. A resting 12-lead ECG was attempted, and the ECG recording was considered feasible if the recording could be made and if the ECG could be interpreted by a cardiologist and the Modular ECG Analysis System (MEANS). ECGs were assessed for the presence of ECG abnormalities and medical record review was performed. If the cardiologist or MEANS concluded that there was evidence of myocardial infarction, atrial fibrillation or QTc prolongation on the ECG in the absence of this ECG diagnosis in the participant's medical record, this was classified as a previously undiagnosed ECG diagnosis. Results: ECG recording was feasible in 134 of the 200 participants (67.0%). Of these 134 participants (70.6 ± 5.8 years; 52.2% female), 103 (76.9%) had one or more ECG abnormality, with the most prevalent being prolonged P-wave duration (27.6%), QTc prolongation (18.7%), minor T-wave abnormalities (17.9%), first degree atrioventricular block (12.7%) and myocardial infarction (6.7%). Eight out of 9 (88.9%) myocardial infarctions and all cases of (significant) QTc prol

Een groene tuin is niet alleen leuk om naar te kijken, maar ook erg nuttig. Met een groene tuin verwelkom je allerlei dieren. Bovendien ben je beter voorbereid op de gevolgen van klimaatverandering. Tijdens de Week van de Groene Tuin van 4 tot en met 10 april delen wij tips om je tuin te vergroenen. Maar hoe ziet jouw leefomgeving er eigenlijk uit? En wat kun jij zelf nog verbeteren?

Background: Reduced physical fitness is a cardiovascular disease (CVD) risk factor in the general population. However, generalising these results to older adults with intellectual disabilities (ID) may be inappropriate given their pre-existing low physical fitness levels and high prevalence of co-morbidities. Therefore, the aim of this study is to investigate the difference in physical fitness between older adults with ID with and without CVD. Method: Baseline data of a cohort of older adults with borderline to profound ID (HA-ID study) were used (n = 684; 61.6 ± 8.2 years; 51.3% male). CVD status (coronary artery disease, heart failure, stroke) was obtained from medical files. Cardiorespiratory fitness (10-m incremental shuttle walking test), comfortable and fast gait speed (over 5 m distance) and grip strength (hand dynamometer) were measured. Multivariable linear regression models were used to investigate the association between these physical fitness components and the presence of CVD, adjusted for participant characteristics. Results: Of the 684 participants 78 (11.4%) had CVD. Participants with CVD scored lower on cardiorespiratory fitness (−81.4 m, P = 0.002), comfortable gait speed (−0.3 km/h, P = 0.04) and fast gait speed (−1.1 km/h, P = 0.04). No significant differences were found for grip strength (−0.2 kg, P = 0.89). Conclusions: Older adults with CVD had significantly lower physical fitness levels than those without CVD, except for grip strength. Longitudinal research is needed to investigate causality.

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Item does not contain fulltext, BACKGROUND: Concerns have been raised regarding the risks of SARS-CoV-2 breakthrough infections in vaccinated patients with immune-mediated inflammatory diseases treated with immunosuppressants, but clinical data on breakthrough infections are still scarce. The primary objective of this study was to compare the incidence and severity of SARS-CoV-2 breakthrough infections between patients with immune-mediated inflammatory diseases using immunosuppressants, and controls (patients with immune-mediated inflammatory diseases not taking immunosuppressants and healthy controls) who had received full COVID-19 vaccinations. The secondary objective was to explore determinants of breakthrough infections of the delta (B.1.617.2) variant of SARS-CoV-2, including humoral immune responses after vaccination. METHODS: In this substudy, we pooled data collected in two large ongoing prospective multicentre cohort studies conducted in the Netherlands (Target to-B! [T2B!] study and Amsterdam Rheumatology Center COVID [ARC-COVID] study). Both studies recruited adult patients (age ≥18 years) with immune-mediated inflammatory diseases and healthy controls. We sourced clinical data from standardised electronic case record forms, digital questionnaires, and medical files. We only included individuals who were vaccinated against SARS-CoV-2. For T2B!, participants were recruited between Feb 2 and Aug 1, 2021, and for ARC-COVID, participants were recruited between April 26, 2020, and March 1, 2021. In this study we assessed data on breakthrough infections collected between July 1 and Dec 15, 2021, a period in which the delta SARS-CoV-2 variant was the dominant variant in the Netherlands. We defined a SARS-CoV-2 breakthrough infection as a PCR-confirmed or antigen test-confirmed SARS-CoV-2 infection that occurred at least 14 days after vaccination. All breakthrough infections during this period were assumed to be due to the delta variant due to its dominance during the study period. We analysed

Contains fulltext : 251778.pdf (Publisher’s version ) (Open Access), BACKGROUND: Research on the disease severity of COVID-19 in patients with rheumatic immune-mediated inflammatory diseases (IMIDs) has been inconclusive, and long-term prospective data on the development of SARS-CoV-2 antibodies in these patients are lacking. METHODS: Adult patients with rheumatic IMIDs from the Amsterdam Rheumatology and Immunology Center, Amsterdam were invited to participate. All patients were asked to recruit their own sex-matched and age-matched control subject. Clinical data were collected via online questionnaires (at baseline, and after 1-4 and 5-9 months of follow-up). Serum samples were collected twice and analysed for the presence of SARS-CoV-2-specific antibodies. Subsequently, IgG titres were quantified in samples with a positive test result. FINDINGS: In total, 3080 consecutive patients and 1102 controls with comparable age and sex distribution were included for analyses. Patients were more frequently hospitalised compared with controls when infected with SARS-CoV-2; 7% vs 0.7% (adjusted OR: 7.33, 95% CI: 0.96 to 55.77). Only treatment with B-cell targeting therapy was independently associated with an increased risk of COVID-19-related hospitalisation (adjusted OR: 14.62, 95% CI: 2.31 to 92.39). IgG antibody titres were higher in hospitalised compared with non-hospitalised patients, and slowly declined with time in similar patterns for patients in all treatment subgroups and controls. INTERPRETATION: We observed that patients with rheumatic IMIDs, especially those treated with B-cell targeting therapy, were more likely to be hospitalised when infected with SARS-CoV-2. Treatment with conventional synthetic disease-modifying antirheumatic drugs (DMARDs) and biological DMARDs other than B-cell targeting agents is unlikely to have negative effects on the development of long-lasting humoral immunity against SARS-CoV-2.

Contains fulltext : 243898.pdf (Publisher’s version ) (Open Access), OBJECTIVE: There is generally limited but conflicting literature on the incidence, causes, and outcomes of pediatric out-of-hospital cardiac arrest. This study was performed to determine the incidence and outcome of pediatric out-of-hospital cardiac arrest reported by all helicopter emergency medical services in the Netherlands and to provide a description of causes and treatments and, in particular, a description of the specific interventions that can be performed by a physician-staffed helicopter emergency medical service. METHODS: A retrospective analysis was performed of all documented pediatric (0 < 18 years of age) out-of-hospital cardiac arrests from July 2015 to July 2017, attended by all 4 Dutch helicopter emergency medical service teams. RESULTS: Two hundred two out-of-hospital cardiac arrests were identified. The overall incidence in the Netherlands is 3.5 out-of-hospital cardiac arrests in children per 100,000 pediatric inhabitants. The overall survival rate for out-of-hospital cardiac arrest was 11.4%. Eleven (52%) of the survivors were in the drowning group and between 12 and 96 months of age. CONCLUSION: Helicopter emergency medical services are frequently called to pediatric out-of-hospital cardiac arrests in the Netherlands. The survival rate is normal to high compared with other countries. The 12- to 96-month age group and drowning seem to have a relatively favorable outcome.

The design of collaborative robotics, such as driver-assisted operations, engineer a potential automation of decision-making predicated on unobtrusive data gathering of human users. This form of ‘somatic surveillance’ (Hayles, Unthought: the power of the cognitive nonconscious. University of Chicago Press, Chicago, 2017, p. 11) increasingly relies on behavioural biometrics and sensory algorithms to verify the physiology of bodies in cabin interiors. Such processes secure cyber-physical space, but also register user capabilities for control that yield data as insured risk. In this technical re-formation of human–machine interactions for control and communication ‘a dissonance of attribution’ (Hancock et al., Proc Natl Acad Sci 116(16):7684, 2019. https://doi.org/10.1073/pnas.1805770115) is created between perceptions of phenomena, materials and decision-making. This reconfigures relations not only between humans and machines, objects and subjects, but possibly disrupts attributive functions in the social system of Law. What it requires is shifting a legal accountability for action from a sovereignty of the human to a new materialist account based on a ‘cognitive assemblage’ between physiological data, computation and algorithmic sensing. This paper investigates the function of law as a guidance system to acknowledge this account of sensory and algorithmic computation as autonomous ‘sensing agents’ (Hansen, Feed-forward: on the future of twenty-first-century media. University of Chicago Press, Chicago, 2015) that may be accountable in situations of risk. This assemblage of robotic computation and sensory determination requires a clearer legal differentiation across the current static terminologies of person, property, liability and rights that maintain strict separations of object from subject. To neglect this, we argue, law will solely impute attributions of error to humans despite evidence of operation via mutual control.

De sportvereniging met haar traditionele lidmaatschap en sportaanbod staat onder druk. Door veranderingen in de sportsector, en een toename in concurrentie, verliest de sportvereniging terrein aan de anders-georganiseerde sport, zoals sportscholen en informele sportclubjes (Smits et al., 2018). Ook zorgt de veranderende houding van de drukbezette sporter, samen met een ruimere keuze in sportaanbod ervoor dat de sportvereniging niet meer de vanzelfsprekende partij is waar wordt gesport. Vanuit maatschappelijk oogpunt wordt een belang gehecht aan een gevestigde plek voor de sportvereniging in de sportsector, vanwege de aan de sportvereniging toegekende maatschappelijke waarde. Vanuit dit perspectief wordt wel ingezien dat de sportvereniging zich wat moet aanpassen om nog aantrekkelijk te blijven in het licht van de veranderende behoefte van de sporter, en om haar eigen voortbestaan niet in gevaar te brengen. Echter, sportverenigingen zijn vaak veranderingresistente organisaties die intern gericht zijn op de belangen van haar eigen leden, en niet bezig is met de veranderingen buiten de organisatie (Thiel & Mayer, 2009). Een van de manieren die de sportverenigingen kiezen om wel om te gaan met de veranderingen in de sportsector, is het flexibiliseren van het sportaanbod. Dit doen ze door differentiatie in het aanbod, en flexibilisering van de bindingsvormen, bijvoorbeeld door het aanbieden van een andere competitievorm of een korter durend lidmaatschap. Toch lijken sportverenigingen hier in veel gevallen nog beperkt succesvol in te zijn, en zet de verschuiving in sportdeelname naar andere sportaanbieders door (Smits et al., 2018). Er is nog weinig onderzoek gedaan naar hoe sportverenigingen flexibilisering van sportaanbod aanpakken, waar zij tegen aanlopen, en welke spanningen zij ervaren bij deze verandering. Dit onderzoek probeert hieraan bij te dragen door de volgende onderzoeksvraag te beantwoorden: Welke ervaringen hebben sportverenigingen met flexibilisering van s