[Competence education, specifically the application of simulation].
Explore the source record for details and available documents.
Clinical Competence↗
Biomedical subjects
H J van Rossum
Publications and source records attributed to H J van Rossum.
[Curriculum 2000: patient-oriented instruction at the medical faculty groningen].
Explore the source record for details and available documents.
Adult↗
Confirmational analysis of beta-agonists by cryotrapping gas chromatography-Fourier transform infrared spectrometry.
Cryotrapping gas chromatography-Fourier transform infrared spectrometry has been used for confirmation analysis of the beta-agonists clenbuterol, salbutamol, mabuterol, bromobuterol, cimaterol, cimbuterol and mapenterol in urine and liver samples of veal calves, subsequent to selected ion detection gas chromatography-mass spectrometry. Samples have been analysed as their trimethylsilyl and methylboronate derivatives. Methylboronate derivatives yielded strongly diminished chemical background and interference levels in the infrared chromatograms of standards and samples. The limit of identification for methylboronate derivatives was at the low ppb level in incurred samples. The similarity of analyte and reference spectra, together with the retention time, was found to be a useful criterion for confirmation of unknown compounds.
Adrenergic beta-Agonists↗
Liquid chromatographic purification and detection of anabolic compounds.
The role of liquid chromatography within methods of analysis for steroids, related compounds and beta-agonists in biological samples is discussed. Special attention is given to the application of liquid chromatography in sample preparation and extract clean-up. Different forms of liquid chromatography, including immunoaffinity chromatography, are compared and evaluated. Methods for confirmation based on gas chromatography-mass spectrometry and cryotrapping Fourier transform infrared spectrometry are discussed.
Adrenergic beta-Antagonists↗
Why do elderly people seek professional home care? Methodologies compared.
In order to investigate which characteristics, besides physical limitations, of elderly people living at home contribute to the utilization of professional home care, a study was conducted in which 450 elderly people aged 55 and over, 123 with and 327 without professional home care, were interviewed. To obtain a selection for the interviews, a postal questionnaire, containing questions on functional status and care utilization, sent out to a random sample of the elderly people (55+) living at home (n = 2451), preceded the actual interviews. The oral interviews yielded the same information, plus an inventory of aspects of the mental status, the social network, the socio-economic status and the housing condition. Analysis was performed in three ways: bivariate analysis, logistic regression analysis and discriminant analysis. The bivariate analysis revealed that users of professional care were older, more often female and more often not married. Their social network was less extensive, as they received less informal care and lived alone more often. Besides they had more mental and financial problems. From the regression analysis it appeared that, in addition to the functional status, the amount of informal care and the household composition contributed to the utilization of professional home care. For the other characteristics inventoried, no independent association with the utilization of professional care could be established. With hindsight, it appeared that in this study long interviews hardly had additional value over postal questionnaires, in which the contribution of functional status and informal care to professional care was already discovered.
Aged↗
[The influence of biographical details in case reports on diagnostic judgment].
Diagnostic judgment of medical students is influenced by patients they have seen recently. Not only signs and symptoms but also biographic data of the demonstrated patient contribute to this phenomenon. In this study the question is raised whether practising physicians are susceptible to the same influence after reading a case report in a medical journal. A case to be published in this journal was transformed into two patient scripts. The first was based on the same diagnosis and the same signs and symptoms, the second was based on another diagnosis and contained partly similar partly different signs and symptoms. Both scripts contained the same, striking biographic data derived from the original case report. One of the two scripts was presented randomly to a control group of 53 practising doctors before the date of publication. They were asked to rate the probability of 8 diagnoses on a 7-point scale. The experimental group consisted of 16 doctors who stated having read the case report. The scores of both groups were compared using analysis of variance. The experimental group in both cases assigned a significantly higher probability to the diagnosis of the published case report. In the first case they were right, in the second they were wrong. These results are similar to the findings with medical students. The question to be explored further is how to present patient cases in medical education. On one hand they should be attractive with some real life data, on the other hand spectacular biographic data may impair the diagnostic process.
Demography↗
Conformation and quantification of chloramphenicol in cow's urine, muscle and eggs by electron capture negative ion chemical ionization gas chromatography/mass spectrometry.
A method is described for the determination of residues of the antibiotic chloramphenicol in biological samples. The method is based on gas chromatography/negative ion chemical ionization mass spectrometry and uses (37Cl2)chloramphenicol as internal standard. Selective ion monitoring of four analyte-specific ions enables the determination of chloramphenicol levels in urine of 3 micrograms l-1 with a coefficient of variation of 8%. The limit of detection of the method is 0.1 p.p.b. for urine, muscle and egg.
Animals↗
Factors associated with differential utilization of professional care among elderly people: residents of old people's homes compared to elderly people living at home.
To investigate factors that explain differential utilization of professional care among elderly people a study was performed in Maastricht, the Netherlands. For that purpose 657 interviews with elderly people were held. In this article a comparison is made between elderly people living at home, with or without professional home care, and residents of old people's homes. Besides the functional status, as measured by limitations in household activities and activities of daily living, the composition of the household of the elderly person is recognized as a major discriminating factor between the three groups. The role of depressive complaints in care utilization is less prominent than expected from an earlier study. A bivariate analysis clearly showed the frequency of mental problems and the poorly developed social network among elderly persons using professional care. Implications for caregiving and policy planning are discussed.
Activities of Daily Living↗
Effective monitoring of residues of nortestosterone and its major metabolite in bovine urine and bile.
The results of a newly developed method for the detection and identification of residues of nortestosterone (NT) and one of its major metabolites, 17 alpha-nortestosterone (epiNT) are described. The method is based on sample clean-up by immunoaffinity chromatography and detection by high-performance liquid chromatography and/or gas chromatography-mass spectrometry (selected-ion monitoring). All samples of bile from calves that had been treated with NT contained significant amounts of epiNT (6-18 micrograms/l). The NT content of these samples, if detectable, was below 1 microgram/l. Urine contained, with one exception, less than 1 microgram/l epiNT. NT itself if detectable, was, present in urine or bile at levels below 0.1 microgram/l. The results corresponds well with results obtained with a radioimmunoassay procedure.
Animals↗
Multi-immunoaffinity chromatography: a simple and highly selective clean-up method for multi-anabolic residue analysis of meat.
A method for the detection of nortestosterone (NT) in bovine muscle at levels below 1 microgram/kg is described, based on enzymatic digestion of the sample, clean-up by immunoaffinity chromatography after defatting and detection by gas chromatography-mass spectrometry (selected-ion monitoring). The immunoaffinity matrix was prepared after combining the isolated immunoglobulin G fractions from a rabbit antiserum raised against NT and methyltestosterone (MT). Its capacity per millilitre of gel was approximately 10 ng for each of the two steroids. Results for samples containing 0.1 microgram/kg NT and above are described. It is concluded that for multi-residue analysis of samples of muscle at levels as low as 0.1 microgram/kg, multi-immunoaffinity chromatography is a very suitable method of sample clean-up. For purposes of quantification the trideuterated internal standard [16,16,17 alpha-2H3] nortestosterone was synthesized.
Anabolic Agents↗
[The presence of nortestosterone in edible parts from non-castrated male pigs].
Nortestosterone is a major growth-promoting agent in Europe which is often used illegally in various species of meat animal. Recent studies showed that this compound was also present in the urine of young male pigs (boars) to which nortestosterone had not been administered. To determine to which extent nortestosterone may also be present in liver and muscle tissues, samples of the urine, bile, liver and muscle of twenty five boars were analysed. The mean and highest concentrations, detected respectively in muscle were 1.1 and 13 micrograms/kg and were 23 and 200 micrograms/kg in liver. The corresponding concentrations in urine were 55 and 132 micrograms/l and 88 and 212 micrograms/l in bile.
Animals↗
The impact of student ratings on a new course: the general clerkship (ALCO).
In 1980 a new course, called ALCO, was introduced in the faculty of Medicine at the University of Leiden. ALCO is the Dutch abbreviation of Algemeen Coassistentschap, which means general clerkship. This course was designed to bridge the gap between the first 4 years of theoretical studies and the subsequent 2 years of clerkship rotation. Because of the multidisciplinarity of the ALCO and the enormous amount of manpower required for this small-scale educational programme, the Faculty installed an Executive Board to oversee the course and the quality of instruction. By request of this Board the Department of Educational Research and Development set up a regular course evaluation, by having students fill out questionnaires, and reported annually on the outcome. This article presents a reconstruction of the dynamic process of the implementation of a new course in a traditional curriculum over a period of 5 years: on the one hand the impact of student ratings; on the other hand the changes made by the Executive Board in order to adjust the contents, format and methods of instruction. Now, after 5 years of ALCO, there is evidence that the student ratings, on the basis of which most decisions were taken, have contributed substantially to the instructional improvement of the ALCO.
Attitude of Health Personnel↗
[Are preventive home visits to the elderly by district nurses sensible? The debate in The Netherlands and research abroad].
There has been a tradition of preventive home visiting to the elderly by Public Health Nurses for quite a time. There is no agreement as to the effect of these visits; until now no study has been performed on this topic in the Netherlands. Studies from other countries suggest a positive effect: viz. a reduction in mortality and hospital admissions. Recommendations for a replication study in the Netherlands are made.
Aged↗
Quantitative determination of diethylstilboestrol in bovine urine with isotope dilution mass spectrometry.
A method has been described for the quantification of diethylstilboestrol (DES) in bovine urine. The determining step is based on isotope dilution mass spectrometry (IDMS). The chemical work-up consisted of enzymatic deconjugation, Sep-Pak clean-up and high-performance liquid chromatography (HPLC). The labelled compound synthesized for IDMS is hexadeutero DES (DES-2H6). The labelled compound is not only used to quantify DES, but also to check the recovery of the chemical work-up procedure, in order to avoid false negative results. At the 1-5 micrograms l-1 level of urinary DES, the average recovery of 2 micrograms l-1 DES-2H6 is 70 +/- 20% (s.d.).
Animals↗
The Leiden ALCO: an example of systematic present-day clinical teaching in The Netherlands.
Explore the source record for details and available documents.
Clinical Clerkship↗