Impact of wind turbine sound on annoyance, self-reported sleep disturbance and psychological distress.

PURPOSE OF THE RESEARCH: The present government in the Netherlands intends to realize a substantial growth of wind energy before 2020, both onshore and offshore. Wind turbines, when positioned in the neighborhood of residents may cause visual annoyance and noise annoyance. Studies on other environmental sound sources, such as railway, road traffic, industry and aircraft noise show that (long-term) exposure to sound can have negative effects other than annoyance from noise. This study aims to elucidate the relation between exposure to the sound of wind turbines and annoyance, self-reported sleep disturbance and psychological distress of people that live in their vicinity. Data were gathered by questionnaire that was sent by mail to a representative sample of residents of the Netherlands living in the vicinity of wind turbines PRINCIPAL RESULTS: A dose-response relationship was found between immission levels of wind turbine sound and selfreported noise annoyance. Sound exposure was also related to sleep disturbance and psychological distress among those who reported that they could hear the sound, however not directly but with noise annoyance acting as a mediator. Respondents living in areas with other background sounds were less affected than respondents in quiet areas. MAJOR CONCLUSIONS: People living in the vicinity of wind turbines are at risk of being annoyed by the noise, an adverse effect in itself. Noise annoyance in turn could lead to sleep disturbance and psychological distress. No direct effects of wind turbine noise on sleep disturbance or psychological stress has been demonstrated, which means that residents, who do not hear the sound, or do not feel disturbed, are not adversely affected.

A job-related fitness test for the Dutch police.

BACKGROUND: The variety of tasks that characterize police work highlights the importance of being in good physical condition. AIMS: To take a first step at standardizing the administration of a job-related test to assess a person's ability to perform the physical demands of the core tasks of police work. The principal research questions were: are test scores related to gender, age and function and are test scores related to body mass index (BMI) and the number of hours of physical exercise? METHODS: Data of 6999 police officers, geographically spread over all parts of The Netherlands, who completed a physical competence test over a 1 year period were analysed. RESULTS: Women performed the test significantly more slowly than men. The mean test score was also related to age; the older a person the longer it took to complete the test. A higher BMI was associated with less hours of body exercise a week and a slower test performance, both in women and men. CONCLUSIONS: The differences in individual test scores, based on gender and age, have implications for future strategy within the police force. From a viewpoint of 'same job, same standard' one has to accept that test-score differences may lead to the exclusion of certain staff. However, from a viewpoint of 'diversity as a business issue', one may have to accept that on average, both female and older police officers are physically less tailored to their jobs than their male and younger colleagues.

[Proximal femur fractures in the elderly in The Netherlands during the period 1991-2004: incidence, mortality, length of hospital stay and an estimate of the care capacity needed in the future]. / Proximale femurfracturen bij ouderen in Nederland in de periode 1991-2004: incidentie, sterfte, opnameduur en schatting van de in de toekomst benodigde zorgcapaciteit.

OBJECTIVE: To assess the incidence of operations for neck and pertrochanteric femur fractures during the last 15 years and to estimate the future demand for such operations in The Netherlands. DESIGN: Retrospective. METHOD: For the years 1991, 1995, 2000 and 2004, the following anonymised data were collected in the National Medical Registry of Prismant for all patients admitted to Dutch hospitals for a hip fracture: age-group, gender, length of pre- and postoperative hospital stay, destination after discharge and hospital mortality. These data were related to demographic data for the Dutch population from Statistics Netherlands (CBCS) and to estimates for the Dutch population in the future from Primos Prognostic Data. RESULTS: The average absolute increase in the period 1991-2004 was linear, with 230 fractures per year. Women were operated for a hip fracture 1.5-2 times as often as men in the same age range. The age-specific incidence remained constant over the years but the absolute number of elderly persons per age group increased. The average length of pre- and postoperative hospital stay was reduced by half during the period under investigation. The postoperative hospital mortality decreased from 8.1% in 1991 to 5.6% in 2004, and was 1.5 times as high for men aged 70 years or over as for women of the same age group. In 2004 as compared to 1991, 2.5 times as many patients were discharged to a nursing home. In view of the increasing age of the population, the total number of operated hip fractures can be expected to be 20,200 in the year 2010 and 23,900 in the year 2020. CONCLUSION: In the period 1991-2004 there was an annual increase of 230 operations for proximal femur fractures that was closely related to the ageing of the Dutch population. During the years under investigation, the incidence in the same age range was higher in women, but men had a higher hospital mortality. It is estimated that the decreasing hospital mortality and the decrease in the length of hospital stay will increase the need for nursing-home care for this category of patients.

Role of natriuretic peptides in the diagnosis and treatment of patients with carcinoid heart disease.

Carcinoid heart disease (CHD) occurs in 20-70% of the patients with metastatic well-differentiated neuroendocrine tumours (NET). We evaluated whether natriuretic peptides (ANP or NT-proBNP) are useful in early detection of CHD. Blood samples from 32 patients with NET were compared with cardiac ultrasound follow-up. CHD was defined as thickening of the tricuspid valve in the presence of grade III-IV/IV tricuspid valve regurgitation. CHD was found in nine out of 32 patients (28%), all with symptoms of the carcinoid syndrome compared to 65% in the 23 patients without CHD (P=0.04). Median levels of NT-proBNP and 5-HIAA were significantly higher in patients with CHD (894 ng l(-1) and 815 micromol 24 h(-1)) compared to those without (89 and 206 ng l(-1), P<0.001 and P=0.007). No significant differences were detected in ANP levels (P=0.11). Dilatation of the right atrium and ventricle as well as thickening of the tricuspid valve and degree of regurgitation were statistically significant correlated with NT-proBNP levels. The accuracy of NT-proBNP in the diagnosis of CHD was higher than that of ANP. A significantly better survival was observed in case of normal NT-proBNP values. In conclusion, NT-proBNP is helpful as a simple marker in the diagnosis of CHD. Survival is better in patients with normal levels of NT-proBNP.

'Burnout' among Dutch midwives.

OBJECTIVE: to determine the effect of workload on 'burnout' having considered work capacity. DESIGN: cross-sectional study. SETTING: Dutch community midwives in independent practice. PARTICIPANTS: 200 Dutch community midwives. MEASUREMENTS: three-week diary recordings, a questionnaire on practice and personal characteristics, and a questionnaire on 'burnout', social support and coping style. FINDINGS: differences in 'burnout' can be explained partly by the midwife's workload and partly by her work capacity. A high workload may lead to 'burnout' when a midwife is unable to handle stressful situations. KEY CONCLUSIONS: when a higher percentage of the supervised births occurred at the client's own home instead of during a short-stay hospital visit, the chances of 'burnout' are lower. IMPLICATIONS FOR PRACTICE: changes in the organisation of Dutch community midwifery care may contribute to the reduction of 'burnout'. 'Burnout' is a complex phenomenon influenced both by individual and organisational factors. When formulating policy to reduce 'burnout' among midwives specific work-related factors must be considered and emphasis be placed on the importance of personal resources.

An analysis of the nursing diagnosis ineffective management of therapeutic regimen compared to noncompliance and Orem's self-care deficit theory of nursing.

The authors compare the nursing diagnosis ineffective management of therapeutic regimen with that of noncompliance and with Orem's concept of self-care deficit. The article describes how the diagnosis of ineffective management of therapeutic regimen is more comprehensive than noncompliance. A question of patient autonomy is raised considering how the patient manages his or her therapeutic regimen. The major conclusion is that the nursing diagnosis of ineffective management of therapeutic regimen is based on continuous interaction between patient and nurse. The authors recommend that noncompliance be eliminated as a nursing diagnosis.

[Role of the family physician in mental and social problems in homes for the aged]. / De rol van de huisarts bij psychische en sociale problemen in het verzorgingstehuis.

Based on Dutch nationally representative data, this article reports on the number of psychological and social problems that residents of homes for the elderly (n = 2893) present to their general practitioner (GP). Furthermore, the number of encounters residents with psychological or social problems have with the general practice and the interventions which the GP applies are described. A comparison is made with elderly patients living independently (n = 28056). In a three-month period the GP found psychological problems in 33 per cent of the patients from homes for the elderly. For elderly patients living independently this was 17%. Controlling for background variables the patients from homes for the elderly still show considerably more psychological problems. Social problems are reported less frequently to GP's; 8% of patients from homes for the elderly and 5% of patients living independently report these problems. After controlling for background variables no statistically significant differences were found. The most frequently used intervention is the prescription of drugs. In both groups almost 80% of the respondents received drugs. Referral to mental health care is the least frequently used intervention. Many patients living in homes for the elderly have psychological or social problems. This implies a high workload for the GP. However, no evidence is found that GP's treat their patients in homes for the elderly differently from those living independently.

An enzyme-linked immunosorbent assay (ELISA) for monitoring antibodies to SP group Pasteurellaceae in guineapigs.

Cross-reactivity studies with Pasteurellaceae from guineapigs revealed 5 serologically distinct groups, comprising Pasteurella multocida, Sp group bacteria, SP-like bacteria, Pasteurella pneumotropica and an actinobacillus-like bacterium. Guineapig Pasteurellaceae differed serologically from mouse-derived P. pneumotropica NCTC 8284. An enzyme-linked immunosorbent assay (ELISA) using SP group antigen, developed to monitor 'natural' infections by SP group Pasteurellaceae in guineapigs, detected significantly more infection than did cultivation, and was found superior to an ELISA performed with P. pneumotropica NCTC 8284.

[Is compliance part of selfcare or is noncompliance a selfcare deficit?]. / Doet compliance zelfzorg te kort of is noncompliance een zelfzorgtekort?

Compliance has been the subject of a discussion between several branches of science. This discussion is mainly focused on questions of terminology and definition. Common usage of terminology and prevailing definitions have the disadvantage that they tend to stress the subordinate position of the patient in relation to the health expert. In this article an attempt is made to fit compliance into Orem's 'self-care deficit theory of nursing'. Compliance is a part of self-care; noncompliance can be seen as a self-care deficit. In contrast with self-care, compliance is not always performed on behalf of maintaining health and well-being. Whereas a self-care deficit is always a threat to health and well-being non-compliance is not.

Colonization and antibody response in mice and rats experimentally infected with Pasteurellaceae from different rodent species.

Mice and rats were experimentally infected with Pasteurellaceae isolated from mice, rats, hamsters and gerbils. Mice and rats were most heavily colonized by strains originally isolated from mice and rats respectively, and to a lesser extent by Pasteurellaceae from hamsters and gerbils. Colonization was generally accompanied by seroconversion. Gross pathology of the lungs was not observed. We conclude that Pasteurellaceae-free SPF mice and rats can be colonized by members of this bacterial family present in other rodent species.

An enzyme-linked immunosorbent assay (ELISA) for monitoring guineapigs and rabbits for Bordetella bronchiseptica antibodies.

An enzyme-linked immunosorbent assay (ELISA) for monitoring antibodies specific to Bordetella bronchiseptica in guineapigs and rabbits was developed. In conventional and SPF colonies of guineapigs and rabbits, the ELISA was equally successful in detecting infected animals when compared to selective cultivation from the respiratory tract. The ELISA showed a sensitivity of 100% and a specificity of 90% in guineapigs. In rabbits the sensitivity and specificity of the ELISA were 97% and 91% respectively. In rabbit sera from infected colonies, ELISA activity showed a statistically significant correlation with titres obtained in the micro-agglutination test. Since serologically unrelated strains of the bacterium exist, the monitoring of animals for B. bronchiseptica infection by ELISA should be performed with various antigens.

An enzyme-linked immunosorbent assay (ELISA) for monitoring rodent colonies for Streptobacillus moniliformis antibodies.

An enzyme-linked immunosorbent assay (ELISA) to measure Streptobacillus moniliformis antibodies in mice and rats was developed. Twelve S. moniliformis strains originating from cases of rat-bite fever and Haverhill fever in man and from various rodent species, showed considerable serological relationship. The ELISA appeared specific since antibodies to S. moniliformis were absorbed by autologous and homologous antigen, but not by heterologous bacterial antigens. Acholeplasma laidlawii showed partial serological relationship with S. moniliformis. The ELISA was validated using experimental infections in mice and rats. These studies and observations in naturally infected feral rats, confirmed that S. moniliformis is difficult to grow on primary isolation, and that the ELISA for S. moniliformis antibodies revealed more contaminated animals than culture.

Intracardiac metastases, report of three cases.

Three patients with intracardiac metastases are described, diagnosed by means of physical examination, electrocardiography (ECG) and echocardiography. Cardiac involvement of the heart by malignant disease is not uncommon, but intracardiac metastases have only occasionally been reported. There are only a few case reports of metastases to the heart that were diagnosed antemortem, because these are rarely clinically significant. Two of the reported patients had clear physical evidence of cardiac involvement. A third case was diagnosed as the result of an abnormal ECG.

Isolation of Streptobacillus moniliformis from the middle ear of rats.

Streptobacillus moniliformis was isolated from the middle ear of 9 of 16 rats used for otological studies. Examination of rat sera for the presence of anti-Streptobacillus moniliformis antibodies using an ELISA technique resulted in 15 seropositive animals. The source of the S. moniliformis infection was not determined.

Induction of antigen-specific antibody response in human peripheral blood lymphocytes in vitro by a dog kidney cell vaccine against rabies virus (DKCV).

In the present report an in vitro method for obtaining a secondary human antibody response to a dog kidney cell vaccine against rabies virus (DKCV) is described. Cultures of peripheral blood mononuclear cells from normal rabies-immune and nonimmune donors were stimulated in vitro by DKCV. The production of virus-specific antibody in supernatant fluids was monitored by ELISA. Antibody was produced by lymphocytes from rabies-immune individuals, whereas those of nonimmune subjects consistently failed to produce anti-rabies antibodies after in vitro stimulation with DKCV. The generation of the anti-rabies virus antibody response of lymphocytes stimulated with DKCV was shown to be an antigen-dependent, as well as an antigen-specific process. Optimal antigen-specific responses were observed at relatively low concentrations of antigen (10(-1) to 10(-2) micrograms/culture). At increasing concentrations of antigen in culture (greater than 1 microgram/culture), the anti-rabies virus response was suppressed. Antibody produced upon stimulation was capable of neutralizing rabies virus. The response to rabies virus requires T cell help because lymphocytes depleted of SE rosetting cells did not respond to an antigenic stimulus. Studies in which the same individuals were followed over time showed a sequential development of circulating B cell subsets. The system may provide a model for the study of human B cell differentiation in vivo and in vitro and may be valuable for testing the potency of rabies vaccines in vitro.