Gemeente Rotterdam

IntroductionPreventive interventions to reduce overweight and obesity in childhood and adolescence are studied on their effectiveness worldwide. A number with positive results. However, long-term effects of these interventions and their potentially wider influence on well-being and health have been less studied. This study aims to evaluate the long-term effects of a multicomponent intervention in elementary school children targeting individual behaviour as well as environment (Lekker Fit!). The primary outcomeis body mass index and the secondary outcomes are waist circumference, weight status, physical fitness, lifestyle, psychosocial health and academic performance.Methods and analysisIn a naturalistic effect evaluation with a retrospective, controlled design adolescents in secondary schools, from intervention and non-intervention elementary schools, will be compared on a wide set of outcome variables. Data will be collected by questionnaires and through anthropometric and fitness measurements by trained physical education teachers and research assistants. Baseline data consist of measurements from the adolescents at the age of 5 years old and are gathered from preventive youth healthcare records, from before the intervention took place. Multilevel regression models will be used and adjusted for baseline measurements and potential confounding variables on the individual and environmental level. Furthermore, propensity scores will be applied.Ethics and disseminationThe study has been approved by the Medical Research Ethics Committee of the Erasmus Medical Centre, Rotterdam, The Netherlands (permission ID: MEC-2020-0644). Study findings will be disseminated in peer-reviewed journals and by conference presentations.Trial registration numberNL8799. Pre-results.

This paper present several cases in the Port of Rotterdam where both in the design and construction phase several different did not marched as expected. These cases are interesting for both the design as well the construction phase of a project. People will make mistakes however the mistakes describes in this paper have to be judged in time as not always everything was understood during the design and construction and the people of that time still these huge structures.

Bu makale Orta Asya bolgesel guvenlik iliskilerini ve ilgili bolge devletlerinin karsilikli guvenlik bagimliligi sonucu ortaya cikan Sangay Isbirligi Orgutu’nu bolgesel guvenlik kompleksleri teorisi cercevesinde incelemektedir. Ayni zamanda Orta Asya bolgesel guvenlik dinamiklerinden hareketle bolgesel guvenlik kompleksleri teorisini de yeniden gozden gecirmektedir. Barry Buzan ve Ole Waever tarafindan gelistirilen bolgesel guvenlik kompleksleri teorisi guvelik iliskileri uzerinde en cok etkili olan faktorun cografi yakinlik oldugu varsayimindan yola cikar. Buna gore bir bolgedeki devletlerin guvenlik sorunlari birbirlerinden bagimsiz olarak anlasilamayacak sekilde baglantilidir. Orta Asya devletleri de kendi guvenlik iliskileri, karsilikli guvenlik bagimliliklari ve bu anlamda etrafindaki bolgelerden farklilasmasi bakimindan kendi basina ayri bir bolgesel guvenlik kompleksi olusturmaktadir. Rusya ve Cin ise bolge ile ortak sinirlari olan iki buyuk guc olarak Orta Asya guvenlik kompleksine nufuz etmektedir ve bu ozelligi itibariyle Orta Asya bolgesel guvenlik kompleksi iki kutuplu bir buyuk guc kompleksi olarak tanimlanabilir. Bu makale, Sangay Isbirligi Orgutu’nun, Orta Asya bolgesel guvenlik kompleksi icerisindeki soz konusu guvenlik dinamiklerinin kurumsallasma imkani buldugu bir bolgesel guvenlik toplulugu oldugunu savunmaktadir. Fakat bolgesel guvenlik kompleksi teorisinin varsayimlarina da uygun olarak Orta Asya bolgesel guvenlik kompleksi ve Sangay Isbirligi Orgutu zamanla bolge aktorleri arasindaki guvenlik dinamiklerinin degismesiyle bir donusum gecirebilir, sinirlari daralabilir ya da yeni aktorleri de dahil edecek sekilde genisleyebilir. Nitekim 2017 yilinda Hindistan ve Pakistan’in da Sangay Isbirligi Orgutu’ne uye olmasiyla birlikte boyle bir durumla karsi karsiya kalinmistir. Buradan hareketle, makalenin son kisminda, ilk baslarda Orta Asya bolgesel guvenlik kompleksi icerisindeki aktorlerin karsilikli guvenlik bagimliligindan dogmus olan Sangay Isbirligi Orgutu’nun onumuzdeki surecte gecirecegi muhtemel donusumler bolgesel guvenlik kompleksleri teorisinin varsayimlari cercevesinde tartisilmaktadir.

ObjectiveHypercapnia resulting from protective ventilation in acute respiratorydistress syndrome triggers metabolic pH compensation, which is not entirelycharacterized. We aimed to describe this metabolic compensation.MethodsThe data were retrieved from a prospective collected database. Variablesfrom patients' admission and from hypercapnia installation until the thirdday after installation were gathered. Forty-one patients with acuterespiratory distress syndrome were analyzed, including twenty-six withpersistent hypercapnia (PaCO2 > 50mmHg > 24 hours) and 15non-hypercapnic (control group). An acid-base quantitative physicochemicalapproach was used for the analysis.ResultsThe mean ages in the hypercapnic and control groups were 48 ± 18years and 44 ± 14 years, respectively. After the induction ofhypercapnia, pH markedly decreased and gradually improved in the ensuing 72hours, consistent with increases in the standard base excess. The metabolicacid-base adaptation occurred because of decreases in the serum lactate andstrong ion gap and increases in the inorganic apparent strong iondifference. Furthermore, the elevation in the inorganic apparent strong iondifference occurred due to slight increases in serum sodium, magnesium,potassium and calcium. Serum chloride did not decrease for up to 72 hoursafter the initiation of hypercapnia.ConclusionIn this explanatory study, the results indicate that metabolic acid-baseadaptation, which is triggered by acute persistent hypercapnia in patientswith acute respiratory distress syndrome, is complex. Furthermore, furtherrapid increases in the standard base excess of hypercapnic patients involvedecreases in serum lactate and unmeasured anions and increases in theinorganic apparent strong ion difference by means of slight increases inserum sodium, magnesium, calcium, and potassium. Serum chloride is notreduced.

New flood risk management policies account for climate and socio-economic change by embracing a more integrated approach. Their implementation processes require: collaboration between a group of stakeholders; combining objectives and funding from various policy domains; consideration of a range of possible options at all spatial scale levels and for various time horizons. Literature provides limited guidance on how to organise a collaborative planning process to devise integrated flood risk management (IFRM) plans. This paper presents a case study where a recently developed framework for process design and management has been used and evaluates whether or not the collaborative planning process led to an IFRM plan. The case study is Dordrecht (NL) where the new multi-layer-safety (MLS) approach has been applied in the context of the Delta Programme. The Delta Programme investigates how the Netherlands can adapt to the effects of climate change. MLS comprises three flood safety layers to reduce flood risk: flood protection, spatial planning, and emergency response. The framework has been shown to be effective in the delivery of an IFRM plan, it has been enriched by defining the interfaces between and phasing of planning activities, and can be further improved to better guide implementation and governance activities.

Along with Norman Metzler, I will argue that the first petition of the Lord’s prayer: ‘Hallowed be thy Name’ (Mt 6:9b) is not the first petition in proper sense. It rather can be seen as a ‘parenthetical doxological phrase’ that describes closer the address ‘Our Father in Heaven’ (Mt 6:9b), following examples in both Jewish and Muslim traditions. The question will be raised whether the devotional address to God is not a stronger base for respectful co-existence and dialogue with each other than a rather general moral demand of ‘having respect for each other’?

Dieses Kapitel beinhaltet: Allgemeines Gerüte für das Bauen auf See Gründungen in offener Baugrube Schwimmkastengründungen Senkkastengründungen Pfahlgründungen Gründungen für Offshore-Windenergieanlagen Literatur

We describe a clinical study comparing the value of measurements of intact human PTH [hPTH(1-84)] and total PTH immunoreactivity [hPTH-(1-84) plus fragments]. A two-step immunochemical method was used to separate plasma hPTH-(1-84) from all circulating PTH fragments. The first step involved extraction and concentration of plasma PTH using solid phase antiamino-terminal PTH antibodies. After elution, the PTH immunoextract was analyzed using a sensitive mid- and C-region immunoassay. Complete separation in the immunoextraction step was proven by Sephadex G-75 gel filtration. hPTH-(1-84) values in fasting patients showed a clear distinction between those with primary hyperparathyroidism and those with nonparathyroid hypercalcemia, in contrast with small overlap in total immunoreactive PTH values. The hPTH-(1-84) values increased faster and more substantially in response to long EDTA and calcium infusion tests, compared with total PTH immunoreactivity, in normal subjects. Infusion of EDTA (10 mg/kg BW) in 5 min) elicited a readily measurable response of hPTH-(1-84) between 5 and 10 min after starting the infusion. Ingestion of 1000 mg calcium caused a decrease in hPTH-(1-84) in 1 h or less. More than 50% of patients with terminal renal failure had normal hPTH-(1-84) values despite elevated total immunoreactive PTH concentrations. We conclude that the two-step hPTH-(1-84) assay is more specific and sensitive than most regional PTH assays. Measurements of hPTH-(1-84) levels may identify disorders of parathyroid function at an early stage and provide a useful tool for the study of parathyroid physiology.