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Biomedical subjects

J Roorda

Publications and source records attributed to J Roorda.

9 recordsLinked to original sources
PubMed2004

Post-disaster health effects: strategies for investigation and data collection. Experiences from the Enschede firework disaster.

BACKGROUND: Public health policy is increasingly concerned with the care for victims of a disaster. This article describes the design and implementation of an epidemiological study, which seeks to match care services to the specific problems of persons affected by a large scale incident. The study was prompted by the explosion of a firework depot in Enschede, the Netherlands. STUDY POPULATION: All those directly affected by this incident (residents, emergency services personnel, and people who happened to be in the area at the time), some of whom suffered personal loss or injury. The project investigates both the physical and psychological effects of the disaster, as well as the target group's subsequent call on healthcare services. STUDY DESIGN: A questionnaire based follow up survey of those directly affected and an ongoing monitoring of health problems relying on reports from healthcare professionals. The follow up survey started three weeks after the incident and was repeated 18 months and almost four years after the incident. The monitoring is conducted over a four year period by general practitioners, the local mental health services department, occupational health services, and the youth healthcare services department. It provides ongoing information. RESULTS AND CONCLUSIONS: The results of the study are regularly discussed with healthcare professionals and policy makers, and are made known to the research participants. The paper also explains the considerations that were made in designing the study to help others making up their research plans when confronted with possible health effects of a disaster.

Accidents↗
PubMed1996

Evaluating performance of the Revised Trauma score as a triage instrument in the prehospital setting.

In this study, we have evaluated the performance of the Revised Trauma Score (RTS) as a triage instrument in the prehospital setting in The Netherlands. To this end we analysed prehospital and clinical data on 398 injured patients in an urban-rural area in the east of the Netherlands. Our study included injured patients aged over 15 who were alive at the time the ambulance arrived. We found a comparatively low prevalence of major injuries in the prehospital setting, which varied with the definition used (for patients with an HTI-ISS > or = 18, it was 5.8 per cent, for HTI-ISS > or = 20 it was 3.7 per cent; for a modified HTI-ISS criterion it was 5.3 per cent and 2.7 per cent needed major emergency therapy). Estimates of sensitivity were also rather low and varied with the definition used (38 per cent for HTI-ISS > or = 18; 56 per cent for HTI-ISS > or = 20, 45 per cent for the modified HTI-ISS criterion and 76 per cent for major emergency treatment). The specificity and the predictive value of a lowered RTS, however, were 94 per cent and 26 per cent respectively for all definitions used. The conclusion of this study is that the performance of the RTS in this study population is poorer than expected from earlier studies. The low prevalence of major injuries in the prehospital setting in The Netherlands and the distribution of case severity may possibly explain these results.

Adolescent↗
PubMed1995

Role of shoulder ultrasonography in the evaluation of the painful shoulder.

The purpose of this study was to determine the accuracy of ultrasonography in the detection of rotator cuff tears. In a prospective study of 41 patients, the ultrasound results could be compared with the combined results of (CT) arthrography, arthroscopy and operation. The sensitivity of sonography in detecting partial and total rotator cuff tears was 86%, the specificity 91%, the positive predictive value 96% and the negative predictive value 73%. In spite of the relatively small size of this series, our results are comparable with those of most other studies. Based on these results, sonography can provide a non-invasive, rapid and inexpensive diagnostic method for screening patients with shoulder complaints. A disadvantage of the method is its long learning curve.

Adult↗
PubMed1994

An examination of demographic, socio-cultural, and health differences between congregate and home diners in a senior nutrition program.

Building upon prior research, this study investigates characteristics of participants in a senior nutrition program in Hillsborough County, Florida. The Senior Citizens Nutrition and Activities Program serves approximately 2,600 meals per day to county residents 60 years of age and over. In this study, a sample of 1,071 participants are surveyed for background characteristics, interpersonal relationships and emotional closeness, health and economic condition, emotional condition, and participation in the program. Crosstabular analyses are performed on the collected data with age, sex, and race controlled. The results indicate that the program is reaching its goals of promoting good health among the older population of Hillsborough County by providing nutritious meals and reducing social isolation, which often accompanies aging.

Aged↗
PubMed1993

Adrenergic control mechanisms of blood flow in a vascularized canine tibial allograft.

A vascularized canine tibial allograft was used to study the alpha-adrenoreceptor subtypes of the microcirculation of bone. Bone transplantation was performed on six dogs, and the bone blood flow was estimated with the use of serial injections of radiolabeled 15 microns microspheres. After microvascular anastomosis, the mean cortical blood flow in the allografted tibia was 3.6 +/- 2.1 ml/100 g/min. Alpha 1-adrenoreceptor blockade, with prazosin, caused an increase in normalized blood flow in five allografts and a slight decrease in one allograft. The mean increase was 32 +/- 48%, but this was not statistically significant (p < 0.2). The addition of an alpha 2-adrenoreceptor blockade, with rauwolszin, resulted in a significant increase (132 +/- 88%) in normalized blood flow in all allografts (p < 0.02). This ex vivo experiment confirms that both alpha 1 and alpha 2 adrenergic mechanisms play a role in controlling bone blood flow in centrally denervated allografts.

Animals↗
PubMed1993

Effect of ischemic storage on endothelium in canine bone.

The limits of room temperature (24 degrees C) and hypothermic (4 degrees C) storage for preservation of endothelial eccrine function were investigated with use of an ex vivo perfusion apparatus model of the cannulated canine tibia. Norepinephrine-induced contraction of smooth muscles in both the presence and absence of acetylcholine was compared, with and without selective blockade of endothelial-derived relaxing factor (EDRF). At room temperature, release of EDRF deteriorated after 24 h and was absent after 48 h of storage. At 4 degrees C, endothelial eccrine activity appeared unimpaired for as long as 72 h of storage. From 96-192 h of storage at 4 degrees C, release of EDRF was suggested, but with an attenuation of its effect on smooth muscle. At 216 and 504 h of storage at 4 degrees C, no endothelial eccrine activity was demonstrated.

Acetylcholine↗
PubMed1988

Research into quality of life: a qualitative approach in the evaluation of a liver transplant programme.

This article describes and analyses the psycho-social impact of a liver transplant programme. Through in-depth interviews an inventory has been made of experiences of liver patients/their relatives: those who were on the waiting list, those in the green-light phase, patients who were transplanted (with or without success), patients who were turned down. The article is based on qualitative data. This qualitative approach can provide a better understanding of the problems of the liver transplant technology, and in this way it can contribute to the frame of reference of those who draw up the health policy.

Health Policy↗
PubMed1986

The psycho-social impact of a liver transplant programme.

Through in-depth interviews, an inventory has been made of the experiences of 18 liver patients who have been considered for or undergone a liver transplant. Interviews were also held with the patients' relatives. Chronic patients especially seem to regard a transplant as their last chance, and all their hopes become based on it. The strict selection procedure is distressing, and being turned down causes negative feelings. As far as the operation itself is concerned, patients are inclined to create high success rates for themselves in relation to their survival chances and the expectations of quality of life. For some patients a transplant means a marked improvement in the various aspects of their functioning. Others are not so fortunate, but do not give up hope of improvement. From the relatives of the patients who had died post-operatively, no negative feelings were encountered over the 'failure' of the technology'.

Adolescent↗