Jelte Bouma

Wind turbines are favoured in the switch-over to renewable energy. Suitable sites for further developments could be difficult to find as the sound emitted from the rotor blades calls for a sufficient distance to residents to avoid negative effects. The aim of this study was to explore if road traffic sound could mask wind turbine sound or, in contrast, increases

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 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. 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.

The aim of this prospective study was to assess treatment outcome and impact on quality of life of prosthodontic rehabilitation with implant-retained prostheses in head-neck cancer patients. Fifty patients were evaluated by standardized questionnaires and clinical assessment. All received the implants during ablative tumour surgery in native bone in the interforaminal area. About two-thirds of the patients (n=31) needed radiotherapy post-surgery. Both in irradiated and non-irradiated bone two implants were lost 18-24 months after installation. Peri-implant tissues had a healthy appearance. No cases of osteoradionecrosis occurred. In 15 patients no functional implant-retained lower dentures could be made for various reasons. The other 35 patients all functioned well, with an improvement in quality of life. Major improvement was observed in the non-irradiated patients. In the irradiated patients, less improvement in many functional items was observed, while items related to the oral s...

ABSTRACT Doel: Bestuderen of er een samenhang bestaat tussen de kwaliteit van de triage op de Meldkamer en het ontstaan van Eerste Hulp Geen Vervoer-ritten. Opzet: Onafhankelijke beoordeling van bandopnames met 1-1-2-meldingen. Methode: 98 bandopnames van 1-1-2 meldingen zijn door twee onafhankelijk beoordelaars beluisterd en beoordeeld op basis van een aantal criteria, met als belangrijkste criterium de mate waarin de centralist zich aan de Landelijke Standaard Meldkamer Amulancezorg (LSMA) houdt. Resultaten: De meldcode ‘pijn op de borst’ leidt in 20% van de gevallen tot een EHGV-rit, terwijl de meldcode ‘onwelwording’ in 66% van de gevallen een EHGV-rit tot gevolg heeft. Bij ‘pijn op de borst’-klachten wordt in 80% van alle gevallen alle stappen van de LSMA-standaard doorlopen, terwijl dit bij ‘onwelwording’ slechts in 14% van de ritten het geval is. Naarmate centralisten zich minder aan de LSMA-standaard houden, is de kans op een EHGV-rit groter. Conclusie: De kwaliteit van de triage is van invloed op het aantal EHGV-ritten: des te minder zorgvuldig het LSMA-protocol wordt gevolgd, des te vaker monden de ritten uit in een EHGV-rit. De kwaliteit van de triage hangt daarbij wel af van de aard van de klachten van de melder. Abstract Triage on the dispatch centre. The influence of the quality of triage on the incidence of ambulance calls without patient transportation Aim: To determine the relationship between dispatch centre triage and the number of ambulance dispatches that result in first aid on the spot (EHGV). Design: Independent evaluation of tape recordings of emergency calls. Method: 98 tape recordings of emergency calls were monitored independently by two evaluators and scored on the basis of compliance with the LSMA standard. Additionally, it was determined whether a more thorough compliance to the standard resulted in higher first aid on the spot dispatches. Results:When the complaints of the emergency caller are classified as ‘chest pain’, 20% of the corresponding ambulance dispatches end up becoming first aid on the spot dispatches. When they are classified as ‘unwellness’ the percentage of such dispatches rises to 66%. In the case of ‘chest pain’, all steps of the LSMA standard are followed in 80% of all triages. In the case of ‘unwellness’, this is only the case 14% of the time. The more the emergency operator sticks to the standard, the smaller the chance that the dispatch ends in a first aid on the spot dispatch. Conclusion: The quality of the triage, in terms of compliance with the LSMA standard, is negatively correlated with the number of first aid on the spot dispatches; the fewer steps of the LSMA standard followed, the more ambulance emergency drives turn out to be first aid on the spot drives. However, the quality of the triage is strongly correlated with the nature of the emergency caller’s complaints.