Background The evidence-based Dutch Obesity Intervention in Teenagers (DOiT) program is a school-based obesity prevention program for 12 to 14-year olds attending the first two years of prevocational education. This paper describes the study protocol applied to evaluate (a) the nationwide dissemination process of DOiT in the Netherlands, and (b) the relationship between quality of implementation and effectiveness during nationwide dissemination of the program in the Netherlands. Methods In order to explore facilitating factors and barriers for dissemination of DOiT, we monitored the process of adoption, implementation and continuation of the DOiT program among 20 prevocational schools in the Netherlands. The study was an observational study using qualitative (i.e. semi-structured interviews) and quantitative methods (i.e. questionnaires and logbooks). Eight process indicators were assessed: recruitment, context, reach, dosage, fidelity, satisfaction, effectiveness and continuation. All teachers, students and parents involved in the implementation of the program were invited to participate in the study. As part of the process evaluation, a cluster-controlled trial with ten control schools was conducted to evaluate the effectiveness of the program on students’ anthropometry and energy balance-related behaviours and its association with quality of implementation. Discussion The identified impeding and facilitating factors will contribute to an adjusted strategy promoting adoption, implementation and continuation of the DOiT program to ensure optimal use and, thereby, prevention of obesity in Dutch adolescents. Trial registration Current Controlled Trials ISRCTN92755979. PMID:24355056
Jonkman, Sebastiaan N; Jongejan, Ruben; Maaskant, Bob
The Dutch government is in the process of revising its flood safety policy. The current safety standards for flood defenses in the Netherlands are largely based on the outcomes of cost-benefit analyses. Loss of life has not been considered separately in the choice for current standards. This article presents the results of a research project that evaluated the potential roles of two risk metrics, individual and societal risk, to support decision making about new flood safety standards. These risk metrics are already used in the Dutch major hazards policy for the evaluation of risks to the public. Individual risk concerns the annual probability of death of a person. Societal risk concerns the probability of an event with many fatalities. Technical aspects of the use of individual and societal risk metrics in flood risk assessments as well as policy implications are discussed. Preliminary estimates of nationwide levels of societal risk are presented. Societal risk levels appear relatively high in the southwestern part of the country where densely populated dike rings are threatened by a combination of river and coastal floods. It was found that cumulation, the simultaneous flooding of multiple dike rings during a single flood event, has significant impact on the national level of societal risk. Options for the application of the individual and societal risk in the new flood safety policy are presented and discussed. PMID:20883529
den Heijer, Casper D. J.; Penders, John; Donker, Gé A.; Bruggeman, Cathrien A.; Stobberingh, Ellen E.
Few studies have been performed on urinary tract infections (UTIs) in men. In the present study, general practitioners (n = 42) from the Dutch Sentinel General Practice Network collected urinary samples from 560 male patients (≥18 years) suspected of UTI and recorded prescribed antibiotic treatment. In this way, the antibiotic susceptibility of Gram-negative uropathogens, including extended-spectrum beta-lactamase (ESBL-) producing Escherichia coli could be determined. In addition, E. coli susceptibility and antibiotic prescriptions were compared with data from a similar UTI study among women and with data collected 7 years earlier. Of 367 uropathogens (66%) identified (≥103 cfu/mL), most were Gram-negative (83%) and E. coli being isolated most frequently (51%). Antibiotic susceptibility to ciprofloxacin, norfloxacin and nitrofurantoin was 94%, 92% and 88%, respectively, whereas co-amoxiclav (76%) and co-trimoxazole (80%) showed lower susceptibilities. One ESBL (0.5%) was found. A significantly higher proportion of female UTIs was caused by E. coli compared with men (72% versus 51%, P<0.05). E. coli susceptibility tended to be lower in men compared with women, although not reaching statistical significance. No changes in E. coli susceptibility were observed over time (all P>0.05). Co-amoxiclav and nitrofurantoin prescriptions increased over time (11% versus 28% and 16% versus 23% respectively, both P<0.05), whereas co-trimoxazole prescriptions decreased (24% versus 14%, P<0.05). In conclusion, given the observed gender differences in uropathogen distribution and (tendency in) E. coli antibiotic susceptibility, empirical male UTI treatment options should be based on surveillance studies including men only. When awaiting the culture result is clinically not possible, fluoroquinolones are advised as first-choice antibiotics for male UTIs in Dutch general practices based on current antibiotic susceptibility data. The prevalence of ESBL-producers was low and no
Background Schools are regarded as an important setting for the prevention of overweight. This study presents a nationally representative picture of the obesogenity of the school environment, the awareness of schools regarding overweight, and actions taken by the schools aiming at overweight prevention. In addition, differences between school levels were studied. Methods In 2006-2007, questionnaires were sent to all Dutch secondary schools (age group 12-18 years). Prevalences of the outcome variables were calculated for the schools in total and by school level. The association between school level and outcome variables were analysed by a log linear regression. Results Unhealthy foods and drinks are widely available at secondary schools. One third of the schools indicated that overweight has increased among students and half of the schools agreed that schools were (co)responsible for the prevention of overweight. Only 3% of the schools have a policy on overweight prevention. Small differences were observed between vocational education schools and higher education schools. The presence of vending machines did not differ by school level, but at vocational education schools, the content of the vending machines was less healthy. Conclusion This study describes the current situation at schools which is essential for the development and evaluation of future overweight prevention policies and interventions. In general, secondary schools are not actively involved in overweight prevention and the nutritional environment at most schools could be improved. The small differences between school levels do not give reason for a differential approach for a certain school level for overweight prevention. PMID:20109197
Melis, René JF; van Eijken, Monique IJ; Borm, George F; Wensing, Michel; Adang, Eddy; van de Lisdonk, Eloy H; van Achterberg, Theo; Olde Rikkert, Marcel GM
Background Because of their complex clinical presentations and needs frail elderly people require another approach than people who age without many complications. Several inpatient geriatric health services have proven effectiveness in frail persons. However, the wish to live independently and policies that promote independent living as an answer to population aging call for community intervention models for frail elderly people. Maybe models such as preventive home visits, comprehensive geriatric assessment, and intermediate care qualify, but their efficacy is controversial, especially in frail elderly persons living in the community. With the Dutch EASYcare Study Geriatric Intervention Programme (DGIP) we developed a model to study effectiveness of problem based community intervention models in frail elderly people. Methods/Design DGIP is a community intervention model for frail elderly persons where the GP refers elderly patients with a problem in cognition, mood, behaviour, mobility, and nutrition. A geriatric specialist nurse applies a guideline-based intervention with a limited number of follow up visits. The intervention starts with the application of the EASYcare instrument for geriatric screening. The EASYcare instrument assesses (instrumental) activities of daily life, cognition, mood, and includes a goal setting item. During the intervention the nurse regularly consults the referring GP and a geriatrician. Effects on functional performance (Groningen Activity Restriction Scale), health related quality of life (MOS-20), and carer burden (Zarit Burden Interview) are studied in an observer blinded randomised controlled trial. 151 participants were randomised over two treatment arms – DGIP and regular care – using pseudo cluster randomisation. We are currently performing the follow up visits. These visits are planned three and six months after inclusion. Process measures and cost measures will be recorded. Intention to treat analyses will focus on post
Braun, Susy M; Beurskens, Anna J; van Kroonenburgh, Susanne M; Demarteau, Jeroen; Schols, Jos M; Wade, Derick T
Background Mental practice as an additional cognitive therapy is getting increased attention in stroke rehabilitation. A systematic review shows some evidence that several techniques in which movements are rehearsed mentally might be effective but not enough to be certain. This trial investigates whether mental practice can contribute to a quicker and/or better recovery of stroke in two Dutch nursing homes. The objective is to investigate the therapeutic potential of mental practice embedded in daily therapy to improve individually chosen daily activities of adult stroke patients compared to therapy as usual. In addition, we will investigate prognostic variables and feasibility (process evaluation). Methods A randomised, controlled, observer masked prospective trial will be conducted with adult stroke patients in the (sub)acute phase of stroke recovery. Over a six weeks intervention period the control group will receive multi professional therapy as usual. Patients in the experimental group will be instructed how to perform mental practice, and will receive care as usual in which mental practice is embedded in physical, occupation and speech therapy sessions. Outcome will be assessed at six weeks and six months. The primary outcome measure is the patient-perceived effect on performance of daily activities as assessed by an 11-point Likert Scale. Secondary outcomes are: Motricity Index, Nine Hole Peg Test, Barthel Index, Timed up and Go, 10 metres walking test, Rivermead Mobility Index. A sample size of the patients group and all therapists will be interviewed on their opinion of the experimental program to assess feasibility. All patients are asked to keep a log to determine unguided training intensity. Discussion Advantages and disadvantages of several aspects of the chosen design are discussed. Trial registration ISRCTN27582267 PMID:17937798
Mapes, Terry S.; Iverson, Megan M.; Fassbender, Linda L.; Britt, Michelle L.
The purpose of this effort was to create a nationwide snapshot of the current residential building practices in the United States, and to identify trends in building practices as they relate to building energy efficiency. Information on typical insulation levels, heating, ventilation, and air conditioning (HVAC) efficiencies, window profiles, and other residential building components and assemblies provided a foundation for (1) identifying trends in residential building practices over time, (2) assessing energy-efficiency improvements in single-family homes over time and correlating them with the applicable building energy codes if possible, and (3) identifying building energy code adoption and compliance needs. This report seeks to identify trends in the residential building practice from 1996 to 2009.
This course in spoken Dutch is intended for use in introductory conversational classes. The book is divided into five major parts, each containing five learning units and one unit devoted to review. Each unit contains sections including (1) basic sentences, (2) word study and review of basic sentences, (3) listening comprehension, and (4)…
van Gulik, Thomas M; Nimura, Yuji
An isolation policy was adopted in feudal Japan from 1639 to 1853 owing to the fear of foreign influence. During those 200 years of isolation, all foreigners were withheld from the country with the exception of the Dutch, who were permitted to establish a trading post on a small island in the Bay of Nagasaki, called Decima. Western culture and science reached the Japanese exclusively through the Dutch on Decima. Health care on Decima was provided by Dutch barber-surgeons, who introduced Western surgical practice in Japan. Official interpreters were the only Japanese allowed on Decima. It was from among these interpreters that the first Japanese surgeons arose who, having mastered the Dutch language, translated several Dutch anatomic and surgical texts. Genpaku Sugita translated a Dutch anatomy textbook into Japanese, which was completed in 1774. This book, entitled Kaitai Shinsho [New Book on Anatomy], was the first Western scientific monograph to be translated entirely into Japanese. Several Dutch surgical schools were founded through which Dutch surgery, known in Japan as "surgery of the red-haired" was propagated. According to the custom of the surgical guilds in Holland, certificates were granted to Japanese apprentices who had completed their training in Dutch surgery. About 60 Dutch surgeons had served on Decima up to 1850, providing the basis for surgery to develop in Japan. Among them, Philipp Franz von Siebold was an exceptional scholar who also had a great impact in making Japanese culture known to the Western world. PMID:15599736
Rationale, design, and implementation protocol of the Dutch clinical practice guideline Pain in patients with cancer: a cluster randomised controlled trial with short message service (SMS) and interactive voice response (IVR)
Background One-half of patients with cancer have pain. In nearly one out of two cancer patients with pain, this was undertreated. Inadequate pain control still remains an important problem in this group of patients. Therefore, in 2008 a national, evidence-based multidisciplinary clinical practice guideline 'pain in patients with cancer' has been developed. Yet, publishing a guideline is not enough. Implementation is needed to improve pain management. An innovative implementation strategy, Short Message Service with Interactive Voice Response (SVS-IVR), has been developed and pilot tested. This study aims to evaluate on effectiveness of this strategy to improve pain reporting, pain measurement and adequate pain therapy. In addition, whether the active role of the patient and involvement of caregivers in pain management may change. Methods/design A cluster randomised controlled trial with two arms will be performed in six oncology outpatient clinics of hospitals in the Southeastern region of the Netherlands, with three hospitals in the intervention and three in the control condition. Follow-up measurements will be conducted in all hospitals to study the long-term effect of the intervention. The intervention includes training of professionals (medical oncologists, nurses, and general practitioners) and SMS-IVR to report pain in patients with cancer to improve pain reporting by patients, pain management by medical oncologists, nurses, and general practitioners, and decrease pain intensity. Discussion This innovative implementation strategy with technical tools and the involvement of patients, may enhance the use of the guideline 'pain in patients with cancer' for pain management. Short Message Service alerts may serve as a tool to support self-management of patients. Therefore, the SMS-IVR intervention may increase the feeling of having control over one's life. Trail registration Netherlands Trial Register (NTR): NTR2739 PMID:22142327
Hoving, Ciska; Mudde, Aart N.; Dijk, Froukje; de Vries, Hein
Purpose: The purpose of this paper is to test the effectiveness of a computer-tailored smoking cessation intervention, distributed through 75 Dutch general practices (GP) and 65 pharmacies (PH) in a randomised control trial. Design/methodology/approach: Respondents receive a tailored letter or a thank you letter (control condition). Main outcome…
An often-noted contrast between child and adult language is that young children produce sentences both with and without lexical subjects even if subjects are obligatory in the adult system. However, in Dutch, there is no such structural difference between the earliest stages of Dutch child grammar and the adult stage where subjects are concerned.…
Hartsuiker, Robert J.; Kolk, Herman H. J.
Three experiments are reported that showed effects of "structure priming," the tendency to repeat syntactic structure across successive sentences. These effects were demonstrated in Dutch, a previously untested language. All experiments studied spoken sentence production. (Author/JL)
Colman Des Jardins, Angela; Berk Knighton, W.; Larimer, Randal; Mayer-Gawlik, Shane; Fowler, Jennifer; Harmon, Christina; Koehler, Christopher; Guzik, Gregory; Flaten, James; Nolby, Caitlin; Granger, Douglas; Stewart, Michael
The purpose of the Nationwide Eclipse Ballooning Project is to make the most of the 2017 rare eclipse event in four main areas: public engagement, workforce development, partnership development, and science. The Project is focused on two efforts, both student-led: online live video of the eclipse from the edge of space and the study of the atmospheric response to the eclipse. These efforts, however, involving more than 60 teams across the US, are challenging in many ways. Therefore, the Project is leveraging the NASA Space Grant and NOAA atmospheric science communities to make it a success. The first and primary topic of this poster is the NASA Space Grant supported online live video effort. College and high school students on 48 teams from 31 states will conduct high altitude balloon flights from 15-20 locations across the 8/21/2017 total eclipse path, sending live video and images from near space to a national website. Video and images of a total solar eclipse from near space are fascinating and rare. It’s never been done live and certainly not in a network of coverage across a continent. In addition to the live video to the web, these teams are engaged in several other science experiments as secondary payloads. We also briefly highlight the eclipse atmospheric science effort, where about a dozen teams will launch over one hundred radiosondes from across the 2017 path, recording an unprecedented atmospheric data sample. Collected data will include temperature, density, wind, humidity, and ozone measurements.
The results of a follow-up study of euthanasia by the Dutch government, five years after the first study, were published on November 26, 1996. This article provides a detailed review of the two reports comparing and contrasting the statistics cited therein. The author notes that the "rules of careful conduct" proposed by the courts and by the Royal Dutch Society of Medicine were frequently disregarded. Special topics included for the first time in the second study were the notification and non-prosecution procedure, euthanasia of newborns and infants, and assisted suicide in psychiatric practice. The authors of the follow-up report state that it would be desirable to reduce the number of "terminations of life without patients' request," but this must be the common responsibility of the doctor and the patient. They suggest that the person who does not wish to have his life terminated should declare this clearly, in advance, verbally and in writing, preferably in the form of a living will. Involuntary euthanasia was rampant in 1990 and equally rampant in 1995. The author concludes that Dutch doctors who practice euthanasia are not on the slippery slope. From the very beginning, they have been at the bottom. PMID:9479883
Van de Velde, Hans; Kissine, Mikhail; Tops, Evie; van der Harst, Sander; van Hout, Roeland
In this paper a series of studies of standard Dutch pronunciation in Belgium and the Netherlands is presented. The research is based on two speech corpora: a diachronic corpus of radio speech (1935-1995) and a synchronic corpus of Belgian and Netherlandic standard Dutch from different regions at the turn of the millennium. It is shown that two…
Many people hold two common misconceptions about the Pennsylvania Dutch: first, that these people live exclusively in the state of Pennsylvania; second, that their ancestors came from Holland. However, neither assumption is correct. One can find large Pennsylvania Dutch communities in Mary land, West Virginia, Virginia, the Carolinas, Ohio,…
Euthanasia has been legally sanctioned in the Netherlands by a series of court decisions going back to the 1970s. The author discusses the cultural and historical factors that may have contributed to this development. In the past decade, studies sanctioned by the Dutch government reveal that guidelines established for the regulation of euthanasia--a voluntary, well-considered, persistent request, intolerable suffering that cannot be relieved, consultation with a colleague, and reporting of cases--are consistently violated. Of greatest concern is the number of patients who are put to death without their consent--there are more involuntary than voluntary cases. Euthanasia intended originally for the exceptional case has become an accepted way of dealing with the physical and mental distress of serious or terminal illness. In the process palliative care has become one of the casualties while hospice care lags behind that of other countries. Case examples are given. PMID:11925835
van Calmthout, Matijn
A new painting of Albert Einstein's field equation from his 1915 general theory of relativity was unveiled in a ceremony in November 2015 by the Dutch physicist Robbert Dijkgraaf, who is director of the Princeton Institute for Advanced Study in the US.
Tijdink, Joeri K.; Vergouwen, Anton C. M.; Smulders, Yvo M.
Background Publication of scientific research papers is important for professionals working in academic medical centres. Quantitative measures of scientific output determine status and prestige, and serve to rank universities as well as individuals. The pressure to generate maximum scientific output is high, and quantitative aspects may tend to dominate over qualitative ones. How this pressure influences professionals’ perception of science and their personal well-being is unknown. Methods and Findings We performed an online survey inviting all medical professors (n = 1206) of the 8 academic medical centres in The Netherlands to participate. They were asked to fill out 2 questionnaires; a validated Publication Pressure Questionnaire and the Maslach Burnout Inventory. In total, 437 professors completed the questionnaires. among them, 54% judge that publication pressure ‘has become excessive’, 39% believe that publication pressure ‘affects the credibility of medical research’ and 26% judge that publication pressure has a ‘sickening effect on medical science’. The burn out questionnaire indicates that 24% of medical professors have signs of burn out. The number of years of professorship was significantly related with experiencing less publication pressure. Significant and strong associations between burn out symptoms and the level of perceived publication pressure were found. The main limitation is the possibility of response bias. Conclusion A substantial proportion of medical professors believe that publication pressure has become excessive, and have a cynical view on the validity of medical science. These perceptions are statistically correlated to burn out symptoms. Further research should address the effects of publication pressure in more detail and identify alternative ways to stimulate the quality of medical science. PMID:24023865
Hirata, K.; Fujiwara, H.; Nakamura, H.; Osada, M.; Ohsumi, T.; Morikawa, N.; Kawai, S.; Aoi, S.; Yamamoto, N.; Matsuyama, H.; Toyama, N.; Kito, T.; Murashima, Y.; Murata, Y.; Inoue, T.; Saito, R.; Akiyama, S.; Korenaga, M.; Abe, Y.; Hashimoto, N.
In 2012, we began a project of nationwide Probabilistic Tsunami Hazard Assessment (PTHA) in Japan to support various measures (Fujiwara et al., 2013, JpGU; Hirata et al., 2014, AOGS). The most important strategy in the nationwide PTHA is predominance of aleatory uncertainty in the assessment but use of epistemic uncertainty is limited to the minimum, because the number of all possible combinations among epistemic uncertainties diverges quickly when the number of epistemic uncertainties in the assessment increases ; we consider only a type of earthquake occurrence probability distribution as epistemic uncertainty. We briefly show outlines of the nationwide PTHA as follows; (i) we consider all possible earthquakes in the future, including those that the Headquarters for Earthquake Research Promotion (HERP) of Japanese Government, already assessed. (ii) We construct a set of simplified earthquake fault models, called "Characterized Earthquake Fault Models (CEFMs)", for all of the earthquakes by following prescribed rules (Toyama et al., 2014, JpGU; Korenaga et al., 2014, JpGU). (iii) For all of initial water surface distributions caused by a number of the CEFMs, we calculate tsunamis by solving a nonlinear long wave equation, using FDM, including runup calculation, over a nesting grid system with a minimum grid size of 50 meters. (iv) Finally, we integrate information about the tsunamis calculated from the numerous CEFMs to get nationwide tsunami hazard assessments. One of the most popular representations of the integrated information is a tsunami hazard curve for coastal tsunami heights, incorporating uncertainties inherent in tsunami simulation and earthquake fault slip heterogeneity (Abe et al., 2014, JpGU). We will show a PTHA along the eastern coast of Honshu, Japan, based on approximately 1,800 tsunami sources located within the subduction zone along the Japan Trench, as a prototype of the nationwide PTHA. This study is supported by part of the research
A randomised trial of the effect and cost-effectiveness of early intensive multifactorial therapy on 5-year cardiovascular outcomes in individuals with screen-detected type 2 diabetes: the Anglo-Danish-Dutch Study of Intensive Treatment in People with Screen-Detected Diabetes in Primary Care (ADDITION-Europe) study.
Simmons, Rebecca K; Borch-Johnsen, Knut; Lauritzen, Torsten; Rutten, Guy Ehm; Sandbæk, Annelli; van den Donk, Maureen; Black, James A; Tao, Libo; Wilson, Edward Cf; Davies, Melanie J; Khunti, Kamlesh; Sharp, Stephen J; Wareham, Nicholas J; Griffin, Simon J
BACKGROUND Intensive treatment (IT) of cardiovascular risk factors can halve mortality among people with established type 2 diabetes but the effects of treatment earlier in the disease trajectory are uncertain. OBJECTIVE To quantify the cost-effectiveness of intensive multifactorial treatment of screen-detected diabetes. DESIGN Pragmatic, multicentre, cluster-randomised, parallel-group trial. SETTING Three hundred and forty-three general practices in Denmark, the Netherlands, and Cambridge and Leicester, UK. PARTICIPANTS Individuals aged 40-69 years with screen-detected diabetes. INTERVENTIONS Screening plus routine care (RC) according to national guidelines or IT comprising screening and promotion of target-driven intensive management (medication and promotion of healthy lifestyles) of hyperglycaemia, blood pressure and cholesterol. MAIN OUTCOME MEASURES The primary end point was a composite of first cardiovascular event (cardiovascular mortality/morbidity, revascularisation and non-traumatic amputation) during a mean [standard deviation (SD)] follow-up of 5.3 (1.6) years. Secondary end points were (1) all-cause mortality; (2) microvascular outcomes (kidney function, retinopathy and peripheral neuropathy); and (3) patient-reported outcomes (health status, well-being, quality of life, treatment satisfaction). Economic analyses estimated mean costs (UK 2009/10 prices) and quality-adjusted life-years from an NHS perspective. We extrapolated data to 30 years using the UK Prospective Diabetes Study outcomes model [version 1.3; (©) Isis Innovation Ltd 2010; see www.dtu.ox.ac.uk/outcomesmodel (accessed 27 January 2016)]. RESULTS We included 3055 (RC, n = 1377; IT, n = 1678) of the 3057 recruited patients [mean (SD) age 60.3 (6.9) years] in intention-to-treat analyses. Prescription of glucose-lowering, antihypertensive and lipid-lowering medication increased in both groups, more so in the IT group than in the RC group. There were clinically important improvements
van Dam, Frits S A M; Renckens, Cees N M
The Dutch parliament has recently accepted a tax law in which certain groups of alternative therapists can be exempt from VAT. To be eligible for this VAT exemption, the disciplines to which the therapists belong have to meet certain training requirements. In this article it is contended, in agreement with the Royal College of Physicians in the UK, that statutory regulation is inappropriate for disciplines whose therapies are neither of proved benefit nor appropriately tested. It legitimizes harmful therapies. This is illustrated by two serious accidents, previously described in this journal, caused by a chiropractor and a craniosacral therapist. PMID:20298623
The growing acceptance of voluntary active euthanasia by the Dutch is examined in relation to the plastic cards requesting active euthanasia carried by many people in The Netherlands, public opinion polls, and support by leading medical figures of the movement to legalize euthanasia. The author draws upon his experience as a hospital doctor to condemn the practice of active euthanasia, arguing that its voluntariness is often counterfeit and always questionable, that it is inseparable from overtly involuntary forms of euthanasia, and that its promise of sparing the sick person agony is false. "Voluntary" euthanasia also brings an ominous change in society because of the message it sends to the elderly and sick, the weak and the dependent; because the fallibility of medical judgments are inconsistent with the irreversibility of the act; and because the fallacious reasoning of the philosophy threatens to cause irreparable damage to the medical profession. PMID:11650123
Lubeek, Satish F K; Mommers, Roland J M; van der Geer, Eric R; van de Kerkhof, Peter C M; Gerritsen, Marie-Jeanne Rianne P
Skin problems are common within the nursing home population and could have a significant impact on quality of life. As a form of long-distance consultation teledermatology offers several potential benefits within this frail population. In this review we discuss several aspects of teledermatology, especially in relation to the nursing home population. Several studies demonstrated that teledermatology is a cost-effective and easy-to-use consultation method, which could significantly reduce the amount of hospital visits. However, teledermatology is only used in a limited number of Dutch nursing homes in daily practice due to several factors. For the optimal implementation of teledermatological consultation there are some important logistical, legal and financial framework conditions. In conclusion, teledermatology has a lot to offer within the nursing home population and therefore teledermatology will hopefully be increasingly used in daily practice within the near future. PMID:27098424
van Calmthout, Martijn
All 69 winners of the Spinoza prize - the highest award in Dutch science - have signed a petition against proposed reforms to the country's leading funding agency, the Netherlands Organisation for Scientific Research (NWO).
Brandsma, Margreet; van Ommen, Gert-Jan B; Wijmenga, Cisca; Kiemeney, Lambertus A
Modern research, aimed at discovering factors that influence health and disease, requires large collections of data and samples. Collaboration between biobanks is therefore essential. The Dutch hub in the network of biobanks, the Biobanking and Biomolecular Resources Research Infrastructure (BBMRI-NL), is one of the major Dutch biobanking initiatives. It is sponsored by the Dutch government through the Netherlands Organization for Scientific Research (NWO). BBMRI-NL sets up collaboration between approximately 150 existing clinical and population biobanks in the Netherlands, and forms the link with the European BBMRI initiative. BBMRI-NL aims at enrichment and harmonization of existing Dutch biobanks, at data management and analysis, and at laying the legal, social and ethical foundations, in order to improve access and inter-operability, and to render the information and organization up to date. Other major Dutch initiatives are String of Pearls and LifeLines. Together these will create the conditions needed for Dutch researchers to further develop their strong position in the international biobanking field. PMID:21029488
Wissink, Inge B.; Dekovic, Maja; Yagmur, Sengul; Stams, Geert Jan; de Haan, Mariette
The present study examined whether self-esteem mediates the relationship between two aspects of ethnic identity (i.e. ethnic identity exploration and ethnic identity commitment-affirmation) and externalizing problem behaviour in Dutch, Turkish-Dutch and Moroccan-Dutch adolescents living in the Netherlands. A total number of 345 adolescents (115…
... Nationwide Differential Global Positioning System (NDGPS) AGENCY: Coast Guard, DHS and Research and... future user needs and requirements of the Nationwide Differential Global Positioning System (NDGPS). The NDGPS was designed to broadcast signals to improve the accuracy and integrity of the Global...
... 47 Telecommunication 5 2013-10-01 2013-10-01 false Nationwide Public Safety Broadband Network. 90... Safety Broadband Network. Pursuant to the Middle Class Tax Relief and Job Creation Act of 2012, Public... First Responder Network Authority to deploy a nationwide public safety broadband network as...
... 47 Telecommunication 5 2014-10-01 2014-10-01 false Nationwide Public Safety Broadband Network. 90... Safety Broadband Network. Pursuant to the Middle Class Tax Relief and Job Creation Act of 2012, Public... First Responder Network Authority to deploy a nationwide public safety broadband network as...
Howard, Louise M.; Heslin, Margaret; Leese, Morven; McCrone, Paul; Rice, Christopher; Jarrett, Manuela; Spokes, Terry; Huxley, Peter; Thornicroft, Graham
Background There is evidence from North American trials that supported employment using the individual placement and support (IPS) model is effective in helping individuals with severe mental illness gain competitive employment. There have been few trials in other parts of the world. Aims To investigate the effectiveness and cost-effectiveness of IPS in the UK. Method Individuals with severe mental illness in South London were randomised to IPS or local traditional vocational services (treatment as usual) (ISRCTN96677673). Results Two hundred and nineteen participants were randomised, and 90% assessed 1 year later. There were no significant differences between the treatment as usual and intervention groups in obtaining competitive employment (13% in the intervention group and 7% in controls; risk ratio 1.35, 95% CI 0.95–1.93, P = 0.15), nor in secondary outcomes. Conclusions There was no evidence that IPS was of significant benefit in achieving competitive employment for individuals in South London at 1-year follow-up, which may reflect suboptimal implementation. Implementation of IPS can be challenging in the UK context where IPS is not structurally integrated with mental health services, and economic disincentives may lead to lower levels of motivation in individuals with severe mental illness and psychiatric professionals. PMID:20435968
Kuijpers, Chantal C H J; Sluijter, Caro E; von der Thüsen, Jan H; Grünberg, Katrien; van Oijen, Martijn G H; van Diest, Paul J; Jiwa, Mehdi; Nagtegaal, Iris D; Overbeek, Lucy I H; Willems, Stefan M
Differentiation grade of colorectal adenocarcinoma (CRC) is a prognostic factor and important for therapy selection. In patients with stage II colon cancer, poor differentiation is an indication for adjuvant chemotherapy. The variability in daily practice in the grading of CRC was assessed in a nationwide cohort. Using the Dutch Pathology Registry (PALGA), all synoptically reported CRC resections from 2010 to 2013 were identified. Proportions of poorly differentiated (PD) adenocarcinomas were determined and compared between 35 laboratories by univariable and multivariable logistic regression analyses. In total, 11,719 resections of 11,681 patients were included, of which 1427 (12.2%) were PD (range between 35 laboratories: 5.0% to 33.2%). After adjustment for case mix, 4 (11%) laboratories still reported a significantly lower (n=2) or higher (n=2) proportion of PD adenocarcinoma compared with the reference laboratory. Seven of 8 investigated laboratories showed considerable intralaboratory variation between pathologists as well. In a subgroup of 2812 patients (2813 tumors) who could have been eligible for adjuvant chemotherapy solely on the basis of the differentiation grade (stage II colon cancer patients without other high-risk factors [ie, T4, <10 lymph nodes evaluated, perforation, ileus, or angioinvasion]), 258 (9.2%) were PD (range between laboratories: 0% to 22.7%). In this subgroup, 4 laboratories still diagnosed significantly more PD adenocarcinomas after multivariable logistic regression analysis, increasing the number of colon cancer patients eligible for adjuvant therapy. In conclusion, this large nationwide cohort demonstrates considerable interlaboratory and intralaboratory variation in differentiation grading of CRC. Better standardization of grading criteria is needed for optimal determination of prognosis and treatment selection. PMID:26975039
Peters-Veluthamaningal, Cyriac; Winters, Jan C; Groenier, Klaas H; Meyboom-deJong, Betty
Background De Quervain's tenosynovitis is a stenosing tenosynovitis of the first dorsal compartment of the wrist and leads to wrist pain and to impaired function of the wrist and hand. It can be treated by splinting, local corticosteroid injection and operation. In this study effectiveness of local corticosteroid injections for de Quervain's tenosynovitis provided by general practitioners was assessed. Methods Participants with de Quervain's tenosynovitis were recruited by general practitioners. Short-term outcomes (one week after injections) were assessed in a randomised, placebo-controlled trial. Long-term effectiveness was evaluated in an open prospective cohort-study of steroid responders during a follow-up period of 12 months. Participants were randomised to one or two local injections of 1 ml of triamcinolonacetonide (TCA) or 1 ml of NaCl 0.9% (placebo). Non-responders to NaCl were treated with additional TCA injections. Main outcomes were immediate treatment response, severity of pain, improvement as perceived by participant and functional disability using sub items hand and finger function of the Dutch Arthritis Impact Measurement Scale (Dutch AIMS-2-HFF). Results 11 general practitioners included 21 wrists in 21 patients. The TCA-group had better results for short-term outcomes treatment response (78% vs. 25%; p = 0.015), perceived improvement (78% vs. 33%; p = 0.047) and severity of pain (4.27 vs. 1.33; p = 0.031) but not for the Dutch-AIMS-HFF (2.71 vs. 1.92; p = 0.112). Absolute risk reduction for the main outcome short-term treatment response was 0.55 (95% CI: 0.34, 0.76) with a number needed to treat of 2 (95% CI: 1, 3). In the cohort of steroid responders (n = 12) the beneficial effects of steroid injections were sustained during the follow-up of 12 months regarding severity of pain (p = 0.67) and scores of Dutch AIMS-2-HFF (p = 0.36), but not for patient perceived improvement (p = 0.02). No adverse events were observed during the 12 months of follow
Aliabadian, Mansour; Beentjes, Kevin K.; Roselaar, C.S. (Kees); van Brandwijk, Hans; Nijman, Vincent; Vonk, Ronald
Abstract The mitochondrial cytochrome c oxidase subunit I (COI) can serve as a fast and accurate marker for the identification of animal species, and has been applied in a number of studies on birds. We here sequenced the COI gene for 387 individuals of 147 species of birds from the Netherlands, with 83 species being represented by > 2 sequences. The Netherlands occupies a small geographic area and 95% of all samples were collected within a 50 km radius from one another. The intraspecific divergences averaged 0.29% among this assemblage, but most values were lower; the interspecific divergences averaged 9.54%. In all, 95% of species were represented by a unique barcode, with 6 species of gulls and skua (Larus and Stercorarius) having at least one shared barcode. This is best explained by these species representing recent radiations with ongoing hybridization. In contrast, one species, the Lesser Whitethroat Sylvia curruca showed deep divergences, averaging 5.76% and up to 8.68% between individuals. These possibly represent two distinct taxa, S. curruca and S. blythi, both clearly separated in a haplotype network analysis. Our study adds to a growing body of DNA barcodes that have become available for birds, and shows that a DNA barcoding approach enables to identify known Dutch bird species with a very high resolution. In addition some species were flagged up for further detailed taxonomic investigation, illustrating that even in ornithologically well-known areas such as the Netherlands, more is to be learned about the birds that are present. PMID:24453549
Celenk, Ozgur; van de Vijver, Fons J R
We studied mainstream couples in The Netherlands and Turkey as well as Turkish-Dutch immigrant couples to address cultural factors associated with marital satisfaction. A total of 13 Turkish (mainstream couples living in Turkey), 19 Turkish-Dutch (Turkish immigrant couples living in The Netherlands), and 17 Dutch (mainstream couples living in The Netherlands) married dyads (total of 98 individuals) were independently interviewed about positive and negative characteristics of marriages, determinants of general marital satisfaction and dissatisfaction, spousal communication, marital conflict, and marital roles. Multivariate tests revealed ethnic group differences on all marriage-related domains except the conflict resolution strategies. However, univariate analyses showed differences in few themes within domains; main differences were assessed between the Turkish/Turkish-Dutch (who put more emphasis on children and economical aspects) and Dutch couples (who put more emphasis on behavior, and personality of the spouse, reciprocity, emotional sharing, and psychological roles). Turkish-Dutch couples were more similar to Turkish than to Dutch couples. Results were discussed in light of the socioeconomic development and cultural value theories, which are believed to provide a useful framework for understanding the role of culture in marital satisfaction. PMID:23126343
Nabitz, U W; Klazinga, N S
Different approaches to improve quality are used in organizations delivering health care. Donabedian introduced structure, process and outcome, from which other approaches like self-assessment, accreditation, visitation, International Standards Organisation (ISO) and European Foundation for Quality Management (EFQM) can be aligned. The EFQM model is one such approach that has been adopted and adapted by the Dutch Institute for Quality Management. This article describes the background and progress relating to the use of the EFQM business excellence model within Dutch health care organizations. In addition the process for applying for the European Quality Award and the Dutch Quality Award are described in detail. Finally, the reader is enlightened regarding the work of the European ExPeRT research group who are promoting the use of quality models within health care. PMID:10537859
A nationwide census, only the 3rd in the history of the People's Republic of China, will be taken in July 1982, announced Vice-Premier Chen Muhua at a meeting of the census office under the State Council which opened here today. The 1st census was conducted in 1953, and the 2nd in 1964. Chen, who is in charge of the census, told officials, population specialists and statisticians from across China it was unprecedented in both Chinese history and the history of the world to attempt to count a population that has been long estimated at 1 billion. The census has been proposed in order to ascertain a range of 20 demographic factors necessary for the effective administration of the current economic readjustment and China's modernization drive, the vice-premier said. It will assist family planning and population control, facilitate food and clothing supplies, and make possible assessment of construction needs--housing, hospitals, schools, and other public services, she continued. A great deal of trouble in planning and administration has been caused by the inadequacy of available figures, Chen said. The results will be calculated in 2 stages. Figures such as the number of households and people will be announced first, while other more precise breakdowns such as sex, age, nationality, education, marital status, and occupation will be available later. 2 experimental censuses were carried out in July, 1980. The 950,000 residents in both Wuxi City and Wuxi County in east China's Jiangsu Province, were surveyed. The conference, acting on reports and recommendations from these, will establish further experimental counts in the coming months, while preparatory procedures, organizational work, and regulations are to be discussed and consolidated. The 1982 nationwide census has the support of the UN's fund for population activities. PMID:12338073
Discusses Dutch in the Northern France, specifically the historical retreat of Dutch from Pas-de-Calais, historical evolution of the language situation in the Department du Nord, reactions to official language policy and language loss, characteristics of Flemish in France, alienation from other Dutch dialects by communicative isolation, linguistic…
English Language Services, Inc., Washington, DC.
This refresher course in Dutch consists of eight volumes (Books I-IV, each in two parts). Book I, which begins on the intermediate level, presents the sound system of Dutch with accompanying drills. These provide practice in sound-to-spelling correspondence, and contrastive English-Dutch phonology. Books II and III are comprised of six units of…
Legemaate, Johan; Bolt, Ineke
The Dutch Termination of Life on Request and Assisted Suicide Act [Wet toetsing levensbeëindiging op verzoek en hulp bij zelfdoding (Wtl)] came into force in 2002. Its aim is to increase the degree of due care exercised by physicians when terminating a patient's life and to provide a legal framework within which physicians account for their actions in such cases. On the basis of the second evaluation of the Act, published in December 2012, this article provides an overview of the most recent legal developments regarding the Dutch Euthanasia Act. Special attention is given to patients with dementia, psychiatric patients and patient who are "weary of life". PMID:24437331
Dempsey, Walter; Liao, Peng; Klasnja, Pedja; Nahum-Shani, Inbal; Murphy, Susan A.
Data from activity trackers and mobile phones can be used to craft personalised health interventions. But measuring the efficacy of these “treatments” requires a rethink of the traditional randomised trial. PMID:26807137
Biemans, Harm; Van Mil, Marc
This study investigated the extent to which the learning styles of Chinese students differ from those of Dutch students. The study was conducted within the context of English language Bachelor of Science programmes that Wageningen University offers together with China Agricultural University to Dutch and Chinese students. Sixteen Dutch students…
Schulz, Kenneth F; Grimes, David A
The randomised controlled trial sets the gold standard of clinical research. However, randomisation persists as perhaps the least-understood aspect of a trial. Moreover, anything short of proper randomisation courts selection and confounding biases. Researchers should spurn all systematic, non-random methods of allocation. Trial participants should be assigned to comparison groups based on a random process. Simple (unrestricted) randomisation, analogous to repeated fair coin-tossing, is the most basic of sequence generation approaches. Furthermore, no other approach, irrespective of its complexity and sophistication, surpasses simple randomisation for prevention of bias. Investigators should, therefore, use this method more often than they do, and readers should expect and accept disparities in group sizes. Several other complicated restricted randomisation procedures limit the likelihood of undesirable sample size imbalances in the intervention groups. The most frequently used restricted sequence generation procedure is blocked randomisation. If this method is used, investigators should randomly vary the block sizes and use larger block sizes, particularly in an unblinded trial. Other restricted procedures, such as urn randomisation, combine beneficial attributes of simple and restricted randomisation by preserving most of the unpredictability while achieving some balance. The effectiveness of stratified randomisation depends on use of a restricted randomisation approach to balance the allocation sequences for each stratum. Generation of a proper randomisation sequence takes little time and effort but affords big rewards in scientific accuracy and credibility. Investigators should devote appropriate resources to the generation of properly randomised trials and reporting their methods clearly. PMID:11853818
Higher Education and Research in the Netherlands, 1975
A survey is presented of the joint aid in the reconstruction of North and South Vietnam provided by Dutch universities. The hospital project, solid matter physics project, micro-electronics project, agricultural project and dentistry project are defined. (Author/PG)
Bouwman, Harry; Nouwens, John
Discussion of the accessibility of government information focuses on how the Dutch government has tried to improve accessibility in six particular cases of electronic publishing. Topics include public-private partnerships, technological barriers of accessibility, outsourcing, and decentralization. (Author/LRW)
This article compares Dutch rural and non-rural adolescents' delinquent behavior and examines two social correlates of rural delinquency: communal social control and traditional rural culture. The analyses are based on cross-sectional data, containing 3,797 participants aged 13-18 (48.7% females). The analyses show that rural adolescents are only…
Schuurmans, Hanneke; Maarten Verbree, Jan; Leijnse, Hidde; van Heeringen, Klaas-Jan; Uijlenhoet, Remko; Bierkens, Mark; van de Giesen, Nick; Gooijer, Jan; van den Houten, Gert
Since January 2013 Dutch watermanagers have access to innovative high-quality rainfall data. This product is innovative because of the following reasons. (i) The product is developed in a 'golden triangle' construction - corporation between government, business and research institutes. (ii) Second the rainfall products are developed according to the open-source GPL license. The initiative comes from a group of water boards in the Netherlands that joined their forces to fund the development of a new rainfall product. Not only data from Dutch radar stations (as is currently done by the Dutch meteorological organization KNMI) is used but also data from radars in Germany and Belgium. After a radarcomposite is made, it is adjusted according to data from raingauges (ground truth). This results in 9 different rainfall products that give for each moment the best rainfall data. This data will be used, depending on the end-user for several applications: (i) forecasts: input for flood early warning systems, (ii) water system analysis: hydrological model input, (iii) optimization: real time control and (iv) investigation of incidents: in case of flooding, who's responsible. The latter is mainly insight in the return period of heavy rainfall events. More info (in Dutch): www.nationaleregenradar.nl
Paauwe, Jaap, Ed.; Williams, Roger, Ed.
Includes "Seven Key Issues for Management Development" (Paauwe, Williams); "Typology of Management Development" (Jansen, van der Velde, Mul); "Management Development at Royal Dutch/Shell" (Mahieu); "Management Development in Unilever" (Reitsma); "International Co-ordination and Management Development" (Hoeksema, de Jong); "Breaking in of New…
246 Dutch participants aged 8, 10, 12, 14, and 16 years were presented with the Strength of Identification Scale (SoIS; Barrett, 2007) and the National Identity scale based on Cultural and Historical achievements (NICH; derived from the NATID, Keillor & Hult, 1999). The study aimed to examine the extent and nature of Dutch children and adolescents' identification with The Netherlands and to explore whether changes in aspects of national identification are evident across age. Already at age 8 years children identify themselves with the Dutch nation and with increasing age national identification becomes primarily determined by the extent that participants consider themselves to be Dutch and show positive affect towards the Dutch nation. Identification on the basis of cultural and historical achievements of the Dutch people became less evident following the age of 10 years although Dutch historical and cultural achievements contributed significantly to the extent of national identification. PMID:20673993
... SECURITY Nationwide Cyber Security Review (NCSR) Assessment AGENCY: National Protection and Programs.... SUMMARY: The Department of Homeland Security (DHS), National Protection and Programs Directorate (NPPD), Office of Cybersecurity and Communications (CS&C), National Cyber Security Division (NCSD),...
van Rijn, Rogier M; van Os, Anton G; Kleinrensink, Gert-Jan; Bernsen, Roos MD; Verhaar, Jan AN; Koes, Bart W; Bierma-Zeinstra, Sita MA
Background During the recovery period after acute ankle sprain, it is unclear whether conventional treatment should be supported by supervised exercise. Aim To evaluate the short- and long-term effectiveness of conventional treatment combined with supervised exercises compared with conventional treatment alone in patients with an acute ankle sprain. Design Randomised controlled clinical trial. Setting A total of 32 Dutch general practices and the hospital emergency department. Method Adults with an acute lateral ankle sprain consulting general practices or the hospital emergency department were allocated to either conventional treatment combined with supervised exercises or conventional treatment alone. Primary outcomes were subjective recovery (0–10 point scale) and the occurrence of a re-sprain. Measurements were carried out at intake, 4 weeks, 8 weeks, 3 months, and 1 year after injury. Data were analysed using intention-to-treat analyses. Results A total of 102 patients were enrolled and randomised to either conventional treatment alone or conventional treatment combined with supervised exercise. There was no significant difference between treatment groups concerning subjective recovery or occurrence of re-sprains after 3 months and 1-year of follow-up. Conclusion Conventional treatment combined with supervised exercises compared to conventional treatment alone during the first year after an acute lateral ankle sprain does not lead to differences in the occurrence of re-sprains or in subjective recovery. PMID:17925136
Choi, SeungWook; Sim, Jungsuk; Ko, Wonsun; Park, ChanHyung; Lee, Jaeha; Lim, DongHyun; Lee, Juhyuk; Han, Jungu; Lee, Jongsu; Hong, HeonPyo; Choi, Bongsuk
Korea is one of the leading countries in PACS implementation, and over 15% of all hospitals has been introducing and running in PACS. With the support of the Ministry of Health and Welfare, the National Computerization of Agency and National Cancer Center had a plan to try integration of PACS with a purpose of sharing medical image information. The target hospitals have been selected with over 500 beds, and the distance between hospitals from 40km and to 250km. As the vendors of PACS and HIS that had implemented in target hospitals were different, the 'sharing host' has been developed for the purpose of their integration, which enables communication through DICOM and HL7. In order to monitor the communication among the sharing hosts, the 'sharing center' also has been developed. This project was completed by November 2002. We expected that approximate of 100 doctors including 50 radiologists would use this project, high patient"s satisfaction and the decrease in national insurance fee for test and evaluation period. This project is the first attempt that the government has tried to integrate the independent PACS and HIS. On the model of this project, the government will try to expand it through all nation-wide.
Abin, Jorge; Nemeth, Horacio; Friedmann, Ignacio
From a national level to give Internet technology support, the Nationwide Integrated Healthcare System in Uruguay requires a model of Information Systems Architecture. This system has multiple healthcare providers (public and private), and a strong component of supplementary services. Thus, the data processing system should have an architecture that considers this fact, while integrating the central services provided by the Ministry of Public Health. The national electronic health record, as well as other related data processing systems, should be based on this architecture. The architecture model described here conceptualizes a federated framework of electronic health record systems, according to the IHE affinity model, HL7 standards, local standards on interoperability and security, as well as technical advice provided by AGESIC. It is the outcome of the research done by AGESIC and Systems Integration Laboratory (LINS) on the development and use of the e-Government Platform since 2008, as well as the research done by the team Salud.uy since 2013. PMID:26262000
Berkelmans, Gijs H K; Wilts, Bas J W; Kouwenhoven, Ewout A; Kumagai, Koshi; Nilsson, Magnus; Weijs, Teus J; Nieuwenhuijzen, Grard A P; van Det, Marc J; Luyer, Misha D P
required before randomisation. All data will be collected using an online database with adequate security measures. Trial registration numbers NCT02378948 and Dutch trial registry: NTR4972; Pre-results. PMID:27496239
Haffner, Robert; Helmer, Dorine; van Til, Harry
Theoretical studies on the relationship between incentive regulation and investment in network industries generally point out that incentive regulation has a negative impact on investment. However, empirical evidence in this area is scarce. An analysis suggests that in the Dutch electricity and gas networks since 2001, incentive regulation has ensured a more rational and professional approach towards investments, with investment levels coming down somewhat at the start of the regulation but picking up later on. (author)
Nolte, Martijn A; van der Meer, Jos W M
At any given moment, our body is under attack by a large variety of pathogens, which aim to enter and use our body to propagate and disseminate. The extensive cellular and molecular complexity of our immune system enables us to efficiently eliminate invading pathogens or at least develop a condition in which propagation of the microorganism is reduced to a minimum. Yet, the evolutionary pressure on pathogens to circumvent our immune defense mechanisms is immense, which continuously leads to the development of novel pathogenic strains that challenge the health of mankind. Understanding this battle between pathogen and the immune system has been a fruitful area of immunological research over the last century and will continue to do so for many years. In this review, which has been written on the occasion of the 50th anniversary of the Dutch Society for Immunology, we provide an overview of the major contributions that Dutch immunologists and infection biologists have made in the last decades on the inflammatory response to viral, bacterial, fungal or parasitic infections. We focus on those studies that have addressed both the host and the pathogen, as these are most interesting from an immunological point of view. Although it is not possible to completely cover this comprehensive research field, this review does provide an interesting overview of Dutch research on inflammatory responses to infection. PMID:25455597
With respect to pedophilia and the age of consent, the Netherlands warrants special attention. Although pedophilia is not as widely accepted in the Netherlands as sometimes is supposed, developments in the judicial practice showed a growing reservedness. These developments are a spin-off of related developments in Dutch society. The tolerance in the Dutch society has roots that go far back in history and is also a consequence of the way this society is structured. The social changes of the sixties and seventies resulted in a "tolerance at arm's length" for pedophiles, which proved to be deceptive when the Dutch government proposed to lower the age of consent in 1985. It resulted in a vehement public outcry. The prevailing sex laws have been the prime target of protagonists of pedophile emancipation. Around 1960, organized as a group, they started to undertake several activities. In the course of their existence, they came to redefine the issue of pedophilia as one of youth emancipation. PMID:2086632
Chynoweth, E.; Schoenmakers, J.
Dutch chemical producers have negotiated a long-term agreement with government ministries to reduce emissions of a wide range of chemicals. Industry association Vereniging van de Nederlandse Chemische Industrie (VNCI; Leidschendam) says implementing the commitment will cost companies Dfl 10 billion ($5.4 billion) between 1993 and 2000. VNCI technical director Wim Quik welcomes the accord, which he describes as a management contract, saying, Rather than have legislation, there is a certain adjustment available. Peter Santen, managing director of midsized chemicals player Cindu Chemicals (Uithoorn, the Netherlands) voices some concern about the details of the accord, but adds, we are flexible in trying to agree with the contents of the covenant [it] is better than having new rules from law. The Dutch government, traditionally eager for consensus, has struck a number of such deals with Dutch industries - including packaging, metal, and tire - to reduce emissions and set up environmental management programs. The effort is based on the government's National Environmental Policy Plans - NMP and NMP Plus. Targets for emissions reduction by the chemical industry were provided by a government-funded environmental research institute.
Steenis, Leonie J. P.; Verhoeven, Marjolein; Hessen, Dave J.; van Baar, Anneloes L.
Background The Bayley Scales of Infant and Toddler Development-third edition (Bayley-III) are frequently used to assess early child development worldwide. However, the original standardization only included US children, and it is still unclear whether or not these norms are adequate for use in other populations. Recently, norms for the Dutch version of the Bayley-III (The Bayley-III-NL) were made. Scores based on Dutch and US norms were compared to study the need for population-specific norms. Methods Scaled scores based on Dutch and US norms were compared for 1912 children between 14 days and 42 months 14 days. Next, the proportions of children scoring < 1-SD and < -2 SD based on the two norms were compared, to identify over- or under-referral for developmental delay resulting from non-population-based norms. Results Scaled scores based on Dutch norms fluctuated around values based on US norms on all subtests. The extent of the deviations differed across ages and subtests. Differences in means were significant across all five subtests (p < .01) with small to large effect sizes (ηp2) ranging from .03 to .26). Using the US instead of Dutch norms resulted in over-referral regarding gross motor skills, and under-referral regarding cognitive, receptive communication, expressive communication, and fine motor skills. Conclusions The Dutch norms differ from the US norms for all subtests and these differences are clinically relevant. Population specific norms are needed to identify children with low scores for referral and intervention, and to facilitate international comparisons of population data. PMID:26267907
Zhao, Yanjun; Zhang, Jun; Hukkelhoven, Chantal; Offerhaus, Pien; Zwart, Joost; de Jonge, Ank; Geerts, Caroline
Background The caesarean delivery (CD) rate has risen in most countries over the last decades, but it remains relatively low in the Netherlands. Our objective was to analyse the trends of CD rates in various subgroups of women between 2000 and 2010, and identify the practice pattern that is attributable to the relative stability of the Dutch CD rate. Methods A total of 1,935,959 women from the nationwide Perinatal Registry of the Netherlands were included. Women were categorized into ten groups based on the modified CD classification scheme. Trends of CD rates in each group were described. Results The overall CD rate increased slightly from 14.0% in 2000–2001 to 16.7% in 2010. Fetal, early and late neonatal mortality rates decreased by 40–50% from 0.53%, 0.21%, 0.04% in 2000–2001 to 0.29%, 0.12%, 0.02% in 2010, respectively. During this period, the prevalence of non-vertex presentation decreased from 6.7% to 5.3%, even though the CD rate in this group was high. The nulliparous women with spontaneous onset of labor at term and a singleton child in vertex presentation had a CD rate of 9.9%, and 64.7% of multiparous women with at least one previous uterine scar and a singleton child in vertex presentation had a trial of labor and the success rate of vaginal delivery was 45.9%. Conclusions The Dutch experience indicates that external cephalic version for breech presentation, keeping the CD rate low in nulliparous women and encouraging a trial of labor in multiparous women with a previous scar, could help to keep the overall CD rate steady. PMID:27192534
Schworer, William Joseph, III
Previous chapters discussed nationwide mobile communication system technologies and modeled user costs and benefits. This chapter provides a brief overview of mobile communication system economics, the projected U.S. market for nationwide mobile communications, and the potential revenues. The basic cost structure of satellite and meteor-burst systems are also modeled. A combination of all these factors will ultimately govern which systems will be commercially successful. Because of improvements in technology, communication system costs and user terminal costs (A) per unit of capacity tend to decline over time. However, inflation tends to drive the price of an identical product upward over time.
Blom, Elma; De Jong, Jan; Orgassa, Antje; Baker, Anne; Weerman, Fred
Both children with specific language impairment (SLI) and children who acquire a second language (L2) make errors with verb inflection. This overlap between SLI and L2 raises the question if verb inflection can discriminate between L2 children with and without SLI. In this study we addressed this question for Dutch. The secondary goal of the study…
Background Breech presentation occurs in 3 to 4% of all term pregnancies. External cephalic version (ECV) is proven effective to prevent vaginal breech deliveries and therefore it is recommended by clinical guidelines of the Royal Dutch Organisation for Midwives (KNOV) and the Dutch Society for Obstetrics and Gynaecology (NVOG). Implementation of ECV does not exceed 50 to 60% and probably less. We aim to improve the implementation of ECV to decrease maternal and neonatal morbidity and mortality due to breech presentations. This will be done by defining barriers and facilitators of implementation of ECV in the Netherlands. An innovative implementation strategy will be developed based on improved patient counselling and thorough instructions of health care providers for counselling. Method/design The ultimate purpose of this implementation study is to improve counselling of pregnant women and information of clinicians to realize a better implementation of ECV. The first phase of the project is to detect the barriers and facilitators of ECV. The next step is to develop an implementation strategy to inform and counsel pregnant women with a breech presentation, and to inform and educate care providers. In the third phase, the effectiveness of the developed implementation strategy will be evaluated in a randomised trial. The study population is a random selection of midwives and gynaecologists from 60 to 100 hospitals and practices. Primary endpoints are number of counselled women. Secondary endpoints are process indicators, the amount of fetes in cephalic presentation at birth, complications due to ECV, the number of caesarean sections and perinatal condition of mother and child. Cost effectiveness of the implementation strategy will be measured. Discussion This study will provide evidence for the cost effectiveness of a structural implementation of external cephalic versions to reduce the number of breech presentations at term. Trial Registration Dutch Trial Register
In the Netherlands the general practitioner (GP) plays an important role in prevention. Every Dutch citizen has to be registered with one GP and GPs know their patients well. Face-to-face contact is a relatively effective means of influencing behavior; if preventive advice is related to a patient's state of health, compliance may be stimulated. However, Dutch GPs have shown reluctance toward preventive work. Curing rather than preventing disease is emphasized in medical school. Many GPs doubt that they are entitled to interfere with a patients' lifestyle unless asked. Some GPs are aware of their limited knowledge of nutrition. Preventive work requires some reorganization of medical practice and can lead to an increased workload, without financial compensation. Then there is the "prevention paradox": preventive actions that have a demonstrable effect on the whole population bring only small benefits for individuals. Since 1989 the Dutch College of General Practitioners has published 60 standards for general practice. Several of these include advice on lifestyle and diet, eg, for non-insulin-dependent diabetes mellitus, hypertension, hypercholesterolemia, peptic ulcer, and heart failure. Prevention work in general practice must use only interventions proved to be effective and they must be feasible in the context of general practice. A trial collaboration of 118 GPs and 5 public health authorities between 1988 and 1990 for screening and lifestyle management of hypertension was a limited success. It brought to light the practical problems of this type of work in general practice. Present government priorities for GP-public health collaboration are influenza vaccination and cervical screening. PMID:9174499
The Dutch are missing in any U.S. history textbook, in the content standards, and in the nationally endorsed curriculum. Outside of New York State history classes, there is almost no mention of the Dutch influence in early 17th-century America. Fleeting references to the Netherlands as a staging area for the Pilgrims' famous "Mayflower" voyage or…
Verhoeven, Ludo; Schreuder, Robert; Baayen, Harald
Two experiments were carried out to explore the units of analysis used by children to read Dutch bisyllabic pseudowords. Although Dutch orthography is highly regular, several deviations from a one-to-one correspondence occur. In polysyllabic words, the grapheme e may represent three different vowels: /e/, /e/, or [/schwa/]. In Experiment 1, Grade…
Tellings, Agnes; Bouts, Lex
Grade two through six elementary school Dutch children were asked to perform a lexical decision task including 90 pseudowords constructed by changing one or two letters in a Dutch word. Subsequently, the children were asked about the meaning of pseudowords they had not crossed out and that they, apparently, had considered to be words. Multiple…
den Ouden, Dirk-Bart; Hoogduin, Hans; Stowe, Laurie A.; Bastiaanse, Roelien
Dutch speakers with agrammatic Broca's aphasia are known to have problems with the production of finite verbs in main clauses. This performance pattern has been accounted for in terms of the specific syntactic complexity of the Dutch main clause structure, which requires an extra syntactic operation (Verb Second), relative to the basic…
Verhoeven, Ludo; Schreuder, Robert; Haarman, Vera
Two experiments were conducted in order to explore the role of prefix identification in the reading of Dutch bisyllabic words. Although Dutch orthography is highly regular, several deviations from a one-to-one correspondence exist. A case in point is the grapheme E which can represent the vowels epsilon, e and oe in polysyllabic words. In…
den Ouden, Dirk-Bart; Bastiaanse, Roelien
We investigated the processing of violations of the verb position in Dutch, in a group of healthy subjects, by measuring event-related potentials (ERPs) through electroencephalography (EEG). In Dutch, the base position of the verb is clause final, but in matrix clauses, the finite verb is in second position, a construction known as "Verb Second".…
Kok, Peter; Kolk, Herman; Haverkort, Marco
This study investigates effects of verb movement in nine Dutch-speaking agrammatic aphasics. According to linguistic theory, in verb second languages such as Dutch and German, the verb remains in its clause-final base position in embedded clauses, whereas it moves to second position in main clauses. In recent linguistic accounts of agrammatic…
... COMMISSION Nationwide Life Insurance Company, et al.; Notice of Application July 2, 2010. AGENCY: The... thereunder. Applicants: Nationwide Life Insurance Company (``NWL''); Nationwide Variable Account-II (the... life insurance company organized under the laws of the State of Ohio.\\1\\ NWL offers traditional...
A nationwide test of consumer knowledge of high school students conducted in 1991 found that seniors are unprepared for critical purchasing decisions needed after they graduate. Random samples of the population, 428 high school seniors, were asked 250 questions about a range of consumer subjects such as credit, checking/saving accounts, auto…
Capstone design courses are an increasingly common component of engineering curricula nationwide, but how much do we really know about the current practices? How do capstone courses differ across departments and institutions? How have capstone courses changed in the past 10 years? This paper highlights data from a survey of engineering capstone…
Fox, Laura J.; Roehrig, Gillian H.
A nationwide survey of the undergraduate physical chemistry course was conducted to investigate the depth and breadth of content that is covered, how content is delivered, how student understanding is assessed, and the experiences and beliefs of instructors. The survey was administered to instructors of physical chemistry (N = 331) at American…
... Nationwide Change in Postal Delivery Service Standards AGENCY: Postal Regulatory Commission. ACTION: Notice... pair service standards would be modified to move overnight delivery to 2-day delivery, and to move a portion of 2-day delivery to 3-day delivery. Id. at 1. Although changes to service standards...
Malizio, Andrew G.; Whitney, Douglas R.
A nationwide survey examined the role of educational credentials in the employment practices of private sector companies and institutions. In September 1983, surveys were mailed to a random sample of 1,500 members of the American Society for Personnel Administration. A follow-up mailing was conducted a month later. A total of 643 completed surveys…
... SECURITY Nationwide Cyber Security Review (NCSR) Assessment AGENCY: National Protection and Programs... Review (NCSR) Assessment. DHS previously published this ICR in the Federal Register on April 21, 2011... government to complete a cyber network security assessment so that a full measure of gaps and...
...Summary of Application: Applicants seek an order approving the proposed substitutions (the ``Substitutions'') of certain series of Nationwide Variable Insurance Trust (the ``Trust'' or ``NVIT'') for shares of series of other unaffiliated registered investment companies held by the Separate Accounts under certain variable annuity contracts and/or variable life insurance policies issued by the......
... 43 Public Lands: Interior 2 2012-10-01 2012-10-01 false Statewide/nationwide bond. 3106.6-2 Section 3106.6-2 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) OIL AND GAS LEASING Transfers by...
... 43 Public Lands: Interior 2 2011-10-01 2011-10-01 false Statewide/nationwide bond. 3106.6-2 Section 3106.6-2 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) OIL AND GAS LEASING Transfers by...
... 43 Public Lands: Interior 2 2013-10-01 2013-10-01 false Statewide/nationwide bond. 3106.6-2 Section 3106.6-2 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) OIL AND GAS LEASING Transfers by...
... 43 Public Lands: Interior 2 2014-10-01 2014-10-01 false Statewide/nationwide bond. 3106.6-2 Section 3106.6-2 Public Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) OIL AND GAS LEASING Transfers by...
National Eutrophication Survey (NES) data for a nationwide collection of 928 non-point source watersheds were studied for relationships between macro-drainage area characteristics (particularly land use) and nutrient levels in streams. Both the total and inorganic forms of phosph...
Rezaei, Saeed; Khatib, Mohammad; Baleghizadeh, Sasan
The present study is a nationwide survey of language identity among English language learners in Iran. The participants who completed the survey in this research included 1851 English language learners from different parts of the country who belonged to different genders, age groups and English language proficiency levels. The main instrument was…
Lamy, Brigitte; Kodjo, Angeli; Laurent, Frédéric
We report a systematic prospective multicenter nationwide study of clinical Aeromonas infections in France. During 6 months (May to October 2006), 78 cases of aeromonosis were reviewed for risk factors and clinical, microbiological, and antimicrobial susceptibility data. They included wound infections (44%), bacteremia (26%), enteritis (19%), respiratory tract infections (6%), and miscellaneous (5%) infections. PMID:19244464
Okma, K G; Poelert, J D
Most if not all social policies entail redistribution of scarce public resources from central government to regional and local authorities, to individual citizens or non-government agencies. Governments use a wide variety of instruments to allocate public funds, including direct state provision of subsidies and goods and services, setting budgets at different levels, and regulation of social insurance schemes. Most industrialised countries have developed budget models based on implicit or explicit allocation criteria. Governments usually start by determining global budgets for an entire category of public spending and then specifying the amounts allocated for categories of spending, and next, the budgets for individual agencies. Within such a 'cascading' model, the lower level budgets may be more controversial than the global budgets, as they directly affect the amounts available to individual actors in the system, e.g. hospitals or health insurance agencies. Setting budgets not only shifts decision-making authority but also financial risks from the central government to decentralised actors. The introduction of the prospective budgeting model for the Dutch sickness funds illustrates why determining budgets is not merely a matter of choosing objective allocation criteria, but also, of interaction between state and stakeholders. In the typical Dutch neocorporatist policy arena, where organised interests share responsibilities with government for the shaping and implementation of social policies, the health insurance agencies actively participated in the development of the budget model. PMID:11420806
Cuperus, R; Bakermans, M M; De Haes, H A; Canters, K J
The ecological compensation principle was introduced by the Dutch government in 1993. This principle is designed to enhance the input of nature conservation interests in decision-making on large-scale development projects and to counterbalance the ecological impacts of such developments when implemented. This article evaluates the application of the Dutch compensation principle in highway planning. Six current highway projects reveal consistent implementation of this principle, although provincial policies on compensation and a national method for identifying compensation measures are still under development. As the planning process has not yet been completed for all the projects, no general conclusions can be drawn on the impact of the compensation principle on highway decision-making. Nevertheless, several examples show that the principle stimulates project initiators to develop alternative routes or route sections in order to avoid or reduce ecological impacts and the need for coherent compensation measures. If the compensation principle is to be properly implemented in the context of highway planning, particular attention should be paid to the following aspects: (1) sequential assessment of overall project legitimacy and the necessity of intersecting protected areas and compensation measures. (2) the initiator's attempts to avoid and mitigate ecological impacts in developing alternative routes prior to compensation for impacts, and (3) the role of uncertain ecological impacts in identifying compensation measures, especially those concerning habitat isolation. PMID:11083910
Bogers, Rik P; van Leeuwen, Flora E; Grievink, Linda; Schouten, Leo J; Kiemeney, Lambertus A L M; Schram-Bijkerk, Dieneke
Suspicion has been raised about an increased cancer risk among Balkan veterans because of alleged exposure to depleted uranium. The authors conducted a historical cohort study to examine cancer incidence among Dutch Balkan veterans. Male military personnel (n=18,175, median follow-up 11 years) of the Army and Military Police who had been deployed to the Balkan region (1993-2001) was compared with their peers not deployed to the Balkans (n=135,355, median follow-up 15 years) and with the general Dutch population of comparable age and sex. The incidence of all cancers and 4 main cancer subgroups was studied in the period 1993-2008. The cancer incidence rate among Balkan deployed military men was 17% lower than among non-Balkan deployed military men (hazard ratio 0.83 (95% confidence interval 0.69, 1.00)). For the 4 main cancer subgroups, hazard ratios were statistically non-significantly below 1. Also compared to the general population cancer rates were lower in Balkan deployed personnel (standardised incidence rate ratio (SIR) 0.85 (0.73, 0.99). The SIR for leukaemia was 0.63 (0.20, 1.46). The authors conclude that earlier suggestions of increased cancer risks among veterans are not supported by empirical data. The lower risk of cancer might be explained by the 'healthy warrior effect'. PMID:23707157
Background In predicted severe acute pancreatitis, infections have a negative effect on clinical outcome. A start of enteral nutrition (EN) within 24 hours of onset may reduce the number of infections as compared to the current practice of starting an oral diet and EN if necessary at 3-4 days after admission. Methods/Design The PYTHON trial is a randomised controlled, parallel-group, superiority multicenter trial. Patients with predicted severe acute pancreatitis (Imrie-score ≥ 3 or APACHE-II score ≥ 8 or CRP > 150 mg/L) will be randomised to EN within 24 hours or an oral diet and EN if necessary, after 72 hours after hospital admission. During a 3-year period, 208 patients will be enrolled from 20 hospitals of the Dutch Pancreatitis Study Group. The primary endpoint is a composite of mortality or infections (bacteraemia, infected pancreatic or peripancreatic necrosis, pneumonia) during hospital stay or within 6 months following randomisation. Secondary endpoints include other major morbidity (e.g. new onset organ failure, need for intervention), intolerance of enteral feeding and total costs from a societal perspective. Discussion The PYTHON trial is designed to show that a very early (< 24 h) start of EN reduces the combined endpoint of mortality or infections as compared to the current practice of an oral diet and EN if necessary at around 72 hours after admission for predicted severe acute pancreatitis. Trial Registration ISRCTN: ISRCTN18170985 PMID:21392395
Fishman, Elliot; Schepers, Paul; Kamphuis, Carlijn Barbara Maria
The Netherlands is well known for their high bicycle use. We used the Health Economic Assessment Tool and life table calculations to quantify the population-level health benefits from Dutch cycling levels. Cycling prevents about 6500 deaths each year, and Dutch people have half-a-year-longer life expectancy because of cycling. These health benefits correspond to more than 3% of the Dutch gross domestic product. Our study confirmed that investments in bicycle-promoting policies (e.g., improved bicycle infrastructure and facilities) will likely yield a high cost-benefit ratio in the long term. PMID:26066942
Worrell, Ernst; van Sluisveld, Mariësse A E
Packaging materials are one of the largest contributors to municipal solid waste generation. In this paper, we evaluate the material impacts of packaging policy in The Netherlands, focusing on the role of material efficiency (or waste prevention). Since 1991, five different policies have been implemented to reduce the environmental impact of packaging. The analysis shows that Dutch packaging policies helped to reduce the total packaging volume until 1999. After 2000, packaging consumption increased more rapidly than the baseline, suggesting that policy measures were not effective. Generally, we see limited attention to material efficiency to reduce packaging material use. For this purpose, we tried to gain more insight in recent activities on material efficiency, by building a database of packaging prevention initiatives. We identified 131 alterations to packaging implemented in the period 2005-2010, of which weight reduction was the predominant approach. More appropriate packaging policy is needed to increase the effectiveness of policies, with special attention to material efficiency. PMID:23359741
Shell Nederland Raffinaderij B.V. has completed construction of a major upgrade at its refinery in Pernis, The Netherlands. The project, called PER+, centers around the addition of Shell Gasification Hydrogen Process (SGHP) and hydrocracking units. The expansion will increase the complexity of Shell`s Dutch refinery and enable it to convert low-value streams to useful products such as cleaner-burning transportation fuels, hydrogen, and electricity. PER+ is a prime example of the kind of innovative planning necessary for European refineries to stay competitive in a tough market. The project reached mechanical completion early this year, and is scheduled to start up in May. The paper describes the refinery, project objectives, process options, the SGHP process, soot ash removal, syngas treatment, power and hydrogen production, environmental issues, and construction.
Buchner, H H; Savelberg, H H; Schamhardt, H C; Barneveld, A
The complete set of three-dimensional inertial properties (mass, density, centre of mass, inertial tensor) was determined in 26 segments of six Dutch Warmblood horses. The measurements were performed with frozen segments similar to the procedure described by Lephart (1984, J. Biomechanics 17, 537-543). Based on these data linear regression models were developed for the estimation of inertial properties in living horses. The reproducibility of the dissection procedure was found to range between 2 and 9%. Both mean values and regression models are presented for all parameters. The mean standard error of estimation was 8% for the segment mass, 3% of the segment reference length for the position of the centre of mass, and 17% for the moments of inertia. PMID:9165402
Tiktak, Aaldrik; Boesten, Jos; van der Linden, Ton
In the new Dutch pesticide authorisation procedure, the leaching of pesticides to surface waters will be evaluated. The 90th percentile of the peak concentrations in all Dutch ditches will be used for the exposure assessment of aquatic organisms The peak concentration in surface waters is primarily affected by fast transfer routes (amongst others by macropores). For this reason, we developed a macropore version of the pesticide leaching model PEARL. The macropore version of PEARL describes transport of pesticides through the soil matrix and through two preferential flow domains, i.e. a bypass domain and an internal catchment domain. The drainpipe exposure assessment will be done for a single field site. We selected the Andelst field experiment (Scorza Júnior et al., 2004) for this purpose, because at this site sufficient data is available to parameterise and test the model. To assess the effect of weather variability on drainpipe concentration, the model is run for a 20-years period. Hydrological boundary conditions for the 20-years period were taken from nearby weather stations and ground water observation wells. Application of PEARL to this field site showed that the model adequately describes the peak concentration and the later decline of the concentration for two different pesticides. The exposure assessment at the Andelst field site results in 20 annual peak concentrations, that need to be compared with the 90th percentile of the peak concentration in all Dutch ditches, so we performed simulations with a spatially-distributed version of PEARL. This assessment resulted in 20 times n concentrations, with n the number of locations. A contour diagram was used to assess which weather year corresponds with the 90th percentile of all 20 times n peak concentrations. The X-coordinate in the contour diagram corresponds with the percentile of the cumulative distribution of the predicted concentrations due to spatial variability that is obtained for a median weather
Hospitals in The Netherlands are governed by two boards: The Board of Directors, the legal representative of the hospital, responsible for strategic and operational business activities; and the Supervisory Board, made up of co-opted volunteers and responsible for checking and approving of the major decisions of the Board of Directors. The question which arises is whether the system of governance is able to function appropriately and guarantee enough concern about general health problems, moral and ethical questions and the interest of the patients. This paper investigate the successes and shortfalls of such a system of governance in Dutch hospitals. The results and conclusions determine that although copied from the corporate governance model, it does not function well in an environment where the influence of patients and the inhabitants of the region are of great importance and shareholders do not exist. PMID:10977190
Verhave, J P
An epidemic of tertian malaria in some coastal areas of The Netherlands resulted in the setting up of official measures in 1920. A scientific and a propaganda commission were charged with control. Efforts were made to reduce mosquito populations by adult and larval spraying. After the discovery that infected mosquitoes were to be found only inside houses, control operations were focussed against adult mosquitoes. Some later discoveries resulted in a more effective control. a) Spraying ditches with Paris green did not prevent adult mosquitoes from entering the control area. b) Anopheles maculipennis turned out to be a complex of species, with A. atroparvus as the vector. The latter preferred brackish water and did not go into full hibernation. The closing of the Zuyder Sea and the expected desalinization gave hope for less suitable conditions for the vector. c) Plasmodium vivax normally had an incubation period of 8 months. d) Pyrethrum was an effective but short-lasting insecticide. e) Healthy parasite carriers could infect mosquitoes. This knowledge was applied through an extensive system of investigation, including spleen examination of schoolchildren. Suspected houses were sprayed bimonthly from August to November, during which period infected mosquitoes were likely to be present. This system worked extremely well, and during the next epidemic from 1943 to 1947 the thus treated towns remained virtually free of malaria! DDT became available and was either sprayed in suspected houses as before, or through wide-spread coverage of all houses. The epidemic subsided whatever method employed and not only due to the use of DDT. The number of cases even went down to the point of no return and the last case of Dutch malaria was recorded in 1959. The wealth of experience on house-spray control, parasite and mosquito biology and experimental malaria of the Dutch malariologists has had its impact on the international bodies engaged in the battle against malaria. PMID:3334084
The Nationwide Truck Activity and Commodity Survey (NTACS) provides detailed activity data for a sample of trucks covered in the 1987 Truck Inventory and Use Survey (TIUS) for days selected at random over a 12-month period ending in 1990. The NTACS was conducted by the US Bureau of the Census for the US Department of Transportation (DOT). A Public Use File for the NTACS was developed by Oak Ridge National Laboratory (ORNL) under a reimbursable agreement with the DOT. The content of the Public Use File and the detailed design of the NTACS are described in the ORNL Report [open quotes]Technical Documentation for the 1990 Nationwide Truck Activity and Commodity Survey Public Use File[close quotes]. (1992). ORNL Technical Report No. TM-12188, Oak Ridge National Laboratory, Oak Ridge, TN 37831. The main purpose of this summary report is to provide selected tables based on the public use file.
Organochlorine pesticide and PCB residues in starlings from 126 sites within the contiguous 48 states were monitored during fall 1976. The average nationwide level of DDE and PCBs has increased significantly since 1974, but the number of sites reporting PCB residues has decreased fivefold. Dieldrin residues have remained unchanged since 1974. Highest DDE levels occurred in samples from parts of Arizona, Arkansas, California, Louisiana, and New Mexico.
NASA depends on the efforts of several volunteer networks to help implement its formal and informal education goals, to disseminate its key messages related to space and Earth science missions and to support broad public initiatives such as the upcoming Year of the Solar System (YSS), sponsored by the Planetary Science Education and Public Outreach Forum (SEPOF). These highly leveraged networks include programs such as Solar System Ambassadors, Solar System Educators, Night Sky Network, and NASA Explorer Schools. Founded in June 2008, NASA Nationwide: A Consortium of Formal and Informal Education Networks is a program that brings together these volunteer networks by creating an online community and shared resources which broadens the member networks’ base of support and provides opportunities to coordinate, cooperate, and collaborate with each other. Since its inception, NASA Nationwide has grown to include twelve NASA-funded volunteer networks as members and collaborates with three other NASA networks as affiliates. NASA Nationwide’s support for the Year of the Solar System includes management of several recently completed Solar System Nights kits, which will be made available regionally to collaborative teams of volunteers and affiliates for use in connecting with students in underserved, underrepresented and rural populations. In the latter part of 2010, the program will be further enhanced by the debut of the public NASA Nationwide website to showcase the successful efforts of these volunteers, provide information about member organizations and advertise their upcoming events in support of the Year of the Solar System. Through its broad reach and the dedicated enthusiasm of its members, NASA Nationwide will be an essential factor utilized to help achieve Year of the Solar System goals and ensure the ultimate success of the initiative.
Fong, Louis B. C.; Brockman, Paul R.
The winter and spring of 1987 saw the cooperative nationwide network for technology transfer translated from concept to reality. The most obvious of the network relationships which were developed or which are anticipated are summarized. The objective was to help assure that every U.S. business which has the capacity to exploit, or the need to obtain new technology in any form, has access to the technology it needs or can use.
White, D H
Organochlorine pesticide and PCB residues in starlings from 126 sites within the contiguous 48 states were monitored during fall 1976. The average nationwide level of DDE and PCBs has increased significantly since 1974, but the number of sites reporting PCB residues has decreased fivefold. Dieldrin residues have remained unchanged since 1974. Highest DDE levels occurred in samples from parts of Arizona, Arkansas, California, Louisiana, and New Mexico. PMID:111216
Interior view of dutch door, double doorway with operable transom, and typical single doorway with transom, facing south. - Marine Barracks, Panama Canal, Barracks Building, 100' North of Thatcher Highway, Balboa, Former Panama Canal Zone, CZ
Shao, Zeshu; Roelofs, Ardi; Meyer, Antje S
The present study provides Dutch norms for age of acquisition, familiarity, imageability, image agreement, visual complexity, word frequency, and word length (in syllables) for 124 line drawings of actions. Ratings were obtained from 117 Dutch participants. Word frequency was determined on the basis of the SUBTLEX-NL corpus (Keuleers, Brysbaert, & New, Behavior Research Methods, 42, 643-650, 2010). For 104 of the pictures, naming latencies and name agreement were determined in a separate naming experiment with 74 native speakers of Dutch. The Dutch norms closely corresponded to the norms for British English. Multiple regression analysis showed that age of acquisition, imageability, image agreement, visual complexity, and name agreement were significant predictors of naming latencies, whereas word frequency and word length were not. Combined with the results of a principal-component analysis, these findings suggest that variables influencing the processes of conceptual preparation and lexical selection affect latencies more strongly than do variables influencing word-form encoding. PMID:23771428
INTERIOR VIEW OF THE KITCHEN. SHOWING THE DUTCH DOOR TO THE SERVICE PORCH. PANTRY AND DOOR TO THE DINING ROOM ARE TO THE LEFT. VIEW FACING NORTH. - Hickam Field, Officers' Housing Type K, 304 Sixth Street, Honolulu, Honolulu County, HI
Interior view of addition pharmacy showing dutch door and security ceiling grate, facing north. - Albrook Air Force Station, Dispensary, East side of Canfield Avenue, Balboa, Former Panama Canal Zone, CZ
Torgerson, Carole J.
The randomised controlled trial (RCT) is an evaluative method used by social scientists in order to establish whether or not an intervention is effective. This contribution discusses the fundamental aspects of good RCT design. These are illustrated through the use of a recently completed RCT which evaluated an information and communication…
Ras, Marcel; Kruithof, Gijsbert
Over the past years, more and more collections belonging to archives, libraries, media, museums, and knowledge institutes are being digitised and made available online. These are exciting times for ALM institutions. They are realising that, in the information society, their collections are goldmines. Unfortunately most heritage institutions in the Netherlands do not yet meet the basic preconditions for long-term availability of their collections. The digital objects often have no long lasting fixed reference yet. URL's and web addresses change. Some digital objects that were referenced in Europeana and other portals can no longer be found. References in scientific articles have a very short life span, which is damaging for scholarly research. In 2015, the Dutch Digital Heritage Network (NDE) has started a two-year work program to co-ordinate existing initiatives in order to improve the (long-term) accessibility of the Dutch digital heritage for a wide range of users, anytime, anyplace. The Digital Heritage Network is a partnership established on the initiative of the Ministry of Education, Culture and Science. The members of the NDE are large, national institutions that strive to professionally preserve and manage digital data, e.g. the National Library, The Netherlands Institute for Sound and Vision, the Netherlands Cultural Heritage Agency, the Royal Netherlands Academy of Arts and Sciences, the National Archive of the Netherlands and the DEN Foundation, and a growing number of associations and individuals both within and outside the heritage sector. By means of three work programmes the goals of the Network should be accomplished and improve the visibility, the usability and the sustainability of digital heritage. Each programme contains of a set of projects. Within the sustainability program a project on creating a model for persistent identifiers is taking place. The main goals of the project are (1) raise awareness among cultural heritage institutions on the
A computer seems an indispensable tool among twenty-first century households. Computers however, did not come as manna from heaven. The domestication and appropriation of computers in Dutch households was a result of activities by various intermediary actors. Computers became household commodities only gradually. Technophile computer hobbyists imported the first computers into the Netherlands from the USA, and started small businesses from 1975 onwards. They developed a social network in which computer technology was made available for use by individuals. This network extended itself via shops, clubs, magazines, and other means of acquiring and exchanging computer hard- and software. Hobbyist culture established the software-copying habits of private computer users as well as their ambivalence to commercial software. They also made the computer into a game machine. Under the impulse of a national policy that aimed at transforming society into an 'Information Society', clubs and other actors extended their activities and tailored them to this new agenda. Hobby clubs presented themselves as consumer organizations and transformed into intermediary actors that filled the gap between suppliers and a growing group of users. They worked hard to give meaning to (proper) use of computers. A second impulse to the increasing use of computers in the household came from so-called 'private-PC' projects in the late 1980s. In these projects employers financially aided employees in purchasing their own private PCs'. The initially important intermediary actors such as hobby clubs lost control and the agenda for personal computers was shifted to interoperability with office equipment. IBM compatible PC's flooded the households. In the household the new equipment blended with the established uses, such as gaming. The copying habits together with the PC standard created a risky combination in which computer viruses could spread easily. New roles arose for intermediary actors in guiding
Stensrud, Mats Julius
BACKGROUND Genetic information is becoming more easily available, and rapid progress is being made in developing methods of illuminating issues of interest. Mendelian randomisation makes it possible to study causes of disease using observational data. The name refers to the random distribution of gene variants in meiosis. The methodology makes use of genes that influence a risk factor for a disease, without influencing the disease itself. In this review article I explain the principles behind Mendelian randomisation and present the areas of application for this methodology.MATERIAL AND METHOD Methodology articles describing Mendelian randomisation were reviewed. The articles were found through a search in PubMed with the combination «mendelian randomization» OR «mendelian randomisation», and a search in McMaster Plus with the combination «mendelian randomization». A total of 15 methodology articles were read in full text. Methodology articles were supplemented by clinical studies found in the PubMed search.RESULTS In contrast to traditional observational studies, Mendelian randomisation studies are not affected by two important sources of error: conventional confounding variables and reverse causation. Mendelian randomisation is therefore a promising tool for studying causality. Mendelian randomisation studies have already provided valuable knowledge on the risk factors for a wide range of diseases. It is nevertheless important to be aware of the limitations of the methodology. As a result of the rapid developments in genetics research, Mendelian randomisation will probably be widely used in future years.INTERPRETATION If Mendelian randomisation studies are conducted correctly, they may help to reveal both modifiable and non-modifiable causes of disease. PMID:27325033
Kelly, M A; Oldham, J
Several factors constrain the implementation of Randomised Controlled Trials (RCTs). To obtain large sample sizes a multicentred multinational trial may be necessary or a long sampling period. The larger the trial the larger is the unit cost. To allow larger sample sizes, shorter sampling periods and lower unit costs, new methods are needed. The Internet and in particular the WWW provides such an opportunity. The WWW can provide global access, fast interaction and automation. A prototype Internet Trials Service (ITS) is currently being tested with a real international clinical trial (the Growth Restriction Intervention Trial--GRIT). The ITS is hosted on a Web server. It provides a series of HTML documents that describe the GRIT protocol. Registered centres may enter patients into the GRIT trial via ITS. Java applets are used to collect trial data before returning the study number and randomisation. ITS assumes all trial data will be intercepted by a sniffer. Therefore no information is sent that could specifically identify a patient, this must be sent later by more secure means. ITS assumes that trial centres can be spoofed. To authenticate the patients entered into the trial and the trial data sent, a regular audit report is sent to each centre by secure means for confirmation. By using Java, a full functional data entry system can be developed that runs locally within any Java enabled browser. It can perform data validation locally and also provide a sophisticated user interface. PMID:9506401
Hargreaves, James R; Prost, Audrey; Fielding, Katherine L; Copas, Andrew J
In cluster randomised trials, randomisation increases internal study validity. If enough clusters are randomised, an unadjusted analysis should be unbiased. If a smaller number of clusters are included, stratified or matched randomisation can increase comparability between trial arms. In addition, an adjusted analysis may be required; nevertheless, randomisation removes the possibility for systematically biased allocation and increases transparency. In stepped wedge trials, clusters are randomised to receive an intervention at different start times ('steps'), and all clusters eventually receive it. In a recent study protocol for a 'modified stepped wedge trial', the investigators considered randomisation of the clusters (hospital wards), but decided against it for ethical and logistical reasons, and under the assumption that it would not add much to the rigour of the evaluation. We show that the benefits of randomisation for cluster randomised trials also apply to stepped wedge trials. The biggest additional issue for stepped wedge trials in relation to parallel cluster randomised trials is the need to control for secular trends in the outcome. Analysis of stepped wedge trials can in theory be based on 'horizontal' or 'vertical' comparisons. Horizontal comparisons are based on measurements taken before and after the intervention is introduced in each cluster, and are unbiased if there are no secular trends. Vertical comparisons are based on outcome measurements from clusters that have switched to the intervention condition and those from clusters that have yet to switch, and are unbiased under randomisation since at any time point, which clusters are in intervention and control conditions will have been determined at random. Secular outcome trends are a possibility in many settings. Many stepped wedge trials are analysed with a mixed model, including a random effect for cluster and fixed effects for time period to account for secular trends, thereby combining both
Brueton, Valerie C; Tierney, Jayne; Stenning, Sally; Harding, Seeromanie; Meredith, Sarah; Nazareth, Irwin; Rait, Greta
Background Loss to follow-up from randomised trials can introduce bias and reduce study power, affecting the generalisability, validity and reliability of results. Many strategies are used to reduce loss to follow-up and improve retention but few have been formally evaluated. Objectives To quantify the effect of strategies to improve retention on the proportion of participants retained in randomised trials and to investigate if the effect varied by trial strategy and trial setting. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, PreMEDLINE, EMBASE, PsycINFO, DARE, CINAHL, Campbell Collaboration's Social, Psychological, Educational and Criminological Trials Register, and ERIC. We handsearched conference proceedings and publication reference lists for eligible retention trials. We also surveyed all UK Clinical Trials Units to identify further studies. Selection criteria We included eligible retention trials of randomised or quasi-randomised evaluations of strategies to increase retention that were embedded in 'host' randomised trials from all disease areas and healthcare settings. We excluded studies aiming to increase treatment compliance. Data collection and analysis We contacted authors to supplement or confirm data that we had extracted. For retention trials, we recorded data on the method of randomisation, type of strategy evaluated, comparator, primary outcome, planned sample size, numbers randomised and numbers retained. We used risk ratios (RR) to evaluate the effectiveness of the addition of strategies to improve retention. We assessed heterogeneity between trials using the Chi2 and I2 statistics. For main trials that hosted retention trials, we extracted data on disease area, intervention, population, healthcare setting, sequence generation and allocation concealment. Main results We identified 38 eligible retention trials. Included trials evaluated six broad types of strategies to improve retention. These
Gradus, Jaimie L.; Farkas, Dóra Körmendiné; Svensson, Elisabeth; Ehrenstein, Vera; Lash, Timothy L.; Milstein, Arnold; Adler, Nancy; Sørensen, Henrik Toft
Background The association between stress and cancer incidence has been studied for more than seven decades. Despite plausible biological mechanisms and evidence from laboratory studies, findings from clinical research are conflicting. The objective of this study was to examine the association between PTSD and various cancer outcomes. Methods This nation-wide cohort study included all Danish-born residents of Denmark from 1995 – 2011. The exposure was PTSD diagnoses (n = 4,131). The main outcomes were cancer diagnoses including: 1) all malignant neoplasms; 2) hematologic malignancies; 3) immune-related cancers; 4) smoking- and alcohol-related cancers; 5) cancers at all other sites. Standardized incidence ratios (SIR) were calculated. Results Null associations were found between PTSD and nearly all cancer diagnoses examined, both overall (SIR for all cancers = 1.0, 95% confidence interval (CI) = 0.88, 1.2) and in analyses stratified by gender, age, substance abuse history and time since PTSD diagnosis. Conclusions This study is the most comprehensive examination to date of PTSD as a predictor of many cancer types. Our data show no evidence of an association between PTSD and cancer in this nationwide cohort. PMID:25957083
Gradus, Jaimie L; Farkas, Dóra Körmendiné; Svensson, Elisabeth; Ehrenstein, Vera; Lash, Timothy L; Milstein, Arnold; Adler, Nancy; Sørensen, Henrik Toft
The association between stress and cancer incidence has been studied for more than seven decades. Despite plausible biological mechanisms and evidence from laboratory studies, findings from clinical research are conflicting. The objective of this study was to examine the association between PTSD and various cancer outcomes. This nation-wide cohort study included all Danish-born residents of Denmark from 1995 to 2011. The exposure was PTSD diagnoses (n = 4131). The main outcomes were cancer diagnoses including: (1) all malignant neoplasms; (2) hematologic malignancies; (3) immune-related cancers; (4) smoking- and alcohol-related cancers; (5) cancers at all other sites. Standardized incidence ratios (SIR) were calculated. Null associations were found between PTSD and nearly all cancer diagnoses examined, both overall [SIR for all cancers = 1.0, 95 % confidence interval (CI) = 0.88, 1.2] and in analyses stratified by gender, age, substance abuse history and time since PTSD diagnosis. This study is the most comprehensive examination to date of PTSD as a predictor of many cancer types. Our data show no evidence of an association between PTSD and cancer in this nationwide cohort. PMID:25957083
In this study, we evaluated national differences in emergency department (ED) crowding to identify factors significantly associated with crowding in institutes and communities across Korea. This was a cross-sectional nationwide observational study using data abstracted from the National Emergency Department Information System (NEDIS). We calculated mean occupancy rates to quantify ED crowding status and divided EDs into three groups according to their occupancy rates (cutoffs: 0.5 and 1.0). Factors potentially related to ED crowding were collected from the NEDIS. We performed a multivariate regression analysis to identify variables significantly associated with ED crowding. A total of 120 EDs were included in the final analysis. Of these, 73 were categorized as 'low crowded' (LC, occupancy rate < 0.50), 37 as 'middle crowded' (MC, 0.50 ≤ occupancy rate < 1.00), 10 EDs as 'high crowded' (HC, 1.00 ≤ occupancy rate). The mean ED occupancy rate varied widely, from 0.06 to 2.33. The median value was 0.39 with interquartile ranges (IQRs) from 0.20 to 0.71. Multivariate analysis revealed that after adjustment, ED crowding was significantly associated with the number of visits, percentage of patients referred, number of nurses, and ED disposition. This nationwide study observed significant variety in ED crowding. Several input, throughput, and output factors were associated with crowding. PMID:27478347
The data we report on in this column come from the Nationwide Survey of High School Physics Teachers. Since 1987, the American Institute of Physics (AIP) and the American Association of Physics Teachers (AAPT) have sponsored the High School Teacher Survey. Prior to our initial study, much of the previous literature focusing on high school physics employed anecdotal evidence or qualitative surveys for curriculum reviews or explorations of teachers' experiences and pedagogical techniques. As a direct response to this dearth of data, the Nationwide Survey of High School Physics Teachers was initiated in 1986-87 to answer questions about the number of teachers teaching physics, the educational background of these teachers, the number of students enrolled in physics, the variety of physics classes being offered, the demographics of the students and teachers, the textbooks being used, and the number of high schools offering physics regularly. Since the beginning of this study, we have surveyed both public and private high schools in the United States. The results of our study provide the definitive data about physics in U.S. high schools. The initial survey was conducted during the 1986-87 school year. The second was completed during 1989-90. Beginning with the 1992-93 survey, we have conducted the survey every four years. The 2012-13 survey will be the eighth in the series. Thus, we have a rich history of physics teaching in U.S. high schools.
Cha, Won Chul; Ahn, Ki Ok; Shin, Sang Do; Park, Jeong Ho; Cho, Jin Sung
In this study, we evaluated national differences in emergency department (ED) crowding to identify factors significantly associated with crowding in institutes and communities across Korea. This was a cross-sectional nationwide observational study using data abstracted from the National Emergency Department Information System (NEDIS). We calculated mean occupancy rates to quantify ED crowding status and divided EDs into three groups according to their occupancy rates (cutoffs: 0.5 and 1.0). Factors potentially related to ED crowding were collected from the NEDIS. We performed a multivariate regression analysis to identify variables significantly associated with ED crowding. A total of 120 EDs were included in the final analysis. Of these, 73 were categorized as 'low crowded' (LC, occupancy rate < 0.50), 37 as 'middle crowded' (MC, 0.50 ≤ occupancy rate < 1.00), 10 EDs as 'high crowded' (HC, 1.00 ≤ occupancy rate). The mean ED occupancy rate varied widely, from 0.06 to 2.33. The median value was 0.39 with interquartile ranges (IQRs) from 0.20 to 0.71. Multivariate analysis revealed that after adjustment, ED crowding was significantly associated with the number of visits, percentage of patients referred, number of nurses, and ED disposition. This nationwide study observed significant variety in ED crowding. Several input, throughput, and output factors were associated with crowding. PMID:27478347
Weiss, J. A.
A satellite land mobile system using mobile radios in the UHF band, and Ku-band Communications Routing Terminals (earth stations) for a nationwide connection from any mobile location to any fixed or mobile location, and from any fixed location to any mobile location is proposed. The proposed nationwide satellite land mobile service provides: telephone network quality (1 out of 100 blockage) service, complete privacy for all the users, operation similar to the telephone network, alternatives for data services up to 32 Kbps data rates, and a cost effective and practical mobile radio compatible with system sizes ranging from 10,000 to 1,000,000 users. Seven satellite alternatives (ranging from 30 ft diameter dual beam antenna to 210 ft diameter 77 beam antenna) along with mobile radios having a sensitivity figure of merit (G/T) of -15 dB/deg K are considered. Optimized mobile radio user costs are presented as a function of the number of users with the satellite and mobile radio alternatives as system parameters.
Ďurkovič, Jaroslav; Čaňová, Ingrid; Lagaňa, Rastislav; Kučerová, Veronika; Moravčík, Michal; Priwitzer, Tibor; Urban, Josef; Dvořák, Miloň; Krajňáková, Jana
Background and Aims Previous studies have shown that Ophiostoma novo-ulmi, the causative agent of Dutch elm disease (DED), is able to colonize remote areas in infected plants of Ulmus such as the leaf midrib and secondary veins. The objective of this study was to compare the performances in leaf traits between two Dutch elm hybrids ‘Groeneveld’ and ‘Dodoens’ which possess a contrasting tolerance to DED. Trait linkages were also tested with leaf mass per area (LMA) and with the reduced Young's modulus of elasticity (MOE) as a result of structural, developmental or functional linkages. Methods Measurements and comparisons were made of leaf growth traits, primary xylem density components, gas exchange variables and chlorophyll a fluorescence yields between mature plants of ‘Groeneveld’ and ‘Dodoens’ grown under field conditions. A recently developed atomic force microscopy technique, PeakForce quantitative nanomechanical mapping, was used to reveal nanomechanical properties of the cell walls of tracheary elements such as MOE, adhesion and dissipation. Key Results ‘Dodoens’ had significantly higher values for LMA, leaf tissue thickness variables, tracheary element lumen area (A), relative hydraulic conductivity (RC), gas exchange variables and chlorophyll a fluorescence yields. ‘Groeneveld’ had stiffer cell walls of tracheary elements, and higher values for water-use efficiency and leaf water potential. Leaves with a large carbon and nutrient investment in LMA tended to have a greater leaf thickness and a higher net photosynthetic rate, but LMA was independent of RC. Significant linkages were also found between the MOE and some vascular traits such as RC, A and the number of tracheary elements per unit area. Conclusions Strong dissimilarities in leaf trait performances were observed between the examined Dutch elm hybrids. Both hybrids were clearly separated from each other in the multivariate leaf trait space. Leaf growth, vascular and gas
Bijker, Liselotte E
After the publication of the Dutch medical guideline on pharmacological analgesia during childbirth in 2008, the question of whether pharmacological pain relief should be permissible during labour was hotly debated. This discussion has been going on since the second half of the 19th century when the introduction of ether and chloroform was extensively studied and described in Great Britain. This article looks back on the same debate in the Netherlands when inhalational anaesthetics were introduced into obstetrics. Study of historical journals and textbooks, originating in the Netherlands and elsewhere, and of historical medical literature on anaesthesia and obstetrics shows that the Dutch protagonists adopted more nuanced ideas on this issue than many of their foreign colleagues. This description of the first Dutch debate on anaesthesia in obstetrics shows that in fact the issues and arguments are timeless. PMID:25827148
Adriaanse, H; van Reek, J; Rabier, J R
General practitioners' smoking behaviour in The Netherlands is described on the basis of survey data collected in the period 1983-1988. Until 1983 a large majority of the Dutch family physicians were smokers (1957: 82%, 1983: 56%). The smoking prevalence then was higher among physicians than among the male population. After 1983 a new development set in. Three inquiries showed that among Dutch physicians the smoking prevalence in 1988 was lower than that among the male general population (29 versus 37%). Dutch family physicians have stopped smoking to a larger extent than the physicians in any other EC-country (43% ex-smokers). Young entry-level doctors more and more tend to be never-smokers. PMID:2392168
In the seventeenth century, Holland and the allied provinces of the northern Netherlands won final independence from their Spanish overlords and formed a worldwide economic empire. Dutch ships dominated the seas from the Caribbean to Japan and reconnoitred the coasts of Australia and New Zealand. Dutch society was cosmopolitan and supported great painters, philosophers and scientists. In these astonishing years, the physician Nicolaes Tulp [1593-1674] practised medicine in Amsterdam and, in 1641, published a book of his medical observations. This book ran into many editions; the Cowlishaw collection contains one of the last, dated 1716. Tulp is best known as the chief figure in a famous painting by Rembrandt, but his book has been studied by medical historians as a source of early descriptions of cranial surgery, spina bifida, vesical calculi, beriberi and many other conditions. The book is also a mirror of Dutch society in a great period in European history. PMID:17973670
... Desirable Features of a Nationwide Public Safety Broadband Network AGENCY: National Institute of Standards... various possible features of a new nationwide interoperable public safety broadband network. This input... President's Wireless Innovation (WIN) Fund to help drive innovation of next-generation network...
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Background Patients with traumatic knee complaints regularly consult their general practitioner (GP). MRI might be a valuable diagnostic tool to assist GPs in making appropriate treatment decisions and reducing costs. Therefore, this study will assess the cost-effectiveness of referral to MRI by GPs compared with usual care, in patients with persistent traumatic knee complaints. Design and methods This is a multi-centre, open-labelled randomised controlled non-inferiority trial in combination with a concurrent observational cohort study. Eligible patients (aged 18–45 years) have knee complaints due to trauma (or sudden onset) occurring in the preceding 6 months and consulting their GP. Participants are randomised to: 1) an MRI group, i.e. GP referral to MRI, or 2) a usual care group, i.e. no MRI. Primary outcomes are knee-related daily function, medical costs (healthcare use and productivity loss), and quality of life. Secondary outcomes are disability due to knee complaints, severity of knee pain, and patients’ perceived recovery and satisfaction. Outcomes are measured at baseline and at 1.5, 3, 6, 9 and 12 months follow-up. Also collected are data on patient demographics, GPs’ initial working diagnosis, GPs’ preferred management at baseline, and MRI findings. Discussion In the Netherlands, the additional diagnostic value and cost-effectiveness of direct access to knee MRI for patients presenting with traumatic knee complaints in general practice is unknown. Although GPs increasingly refer patients to MRI, the Dutch clinical guideline ‘Traumatic knee complaints’ for GPs does not recommend referral to MRI, mainly because the cost-effectiveness is still unknown. Trial registration Dutch Trial Registration: NTR3689. PMID:24588860
Bastiaanse, Roelien; Edwards, Susan
The effect of two linguistic factors in Broca's and Wernicke's aphasia was examined using Dutch and English subjects. Three tasks were used to test (1) the comprehension and (2) the construction of sentences, where verbs (in Dutch) and verb arguments (in Dutch and English) are in canonical versus non-canonical position; (3) the production of…
Boersema, Jacob R.; Schimmel, Noam
We analyse the way in which the Holocaust is taught in The Netherlands, with an emphasis on critically examining the content of secondary school textbooks used to teach Dutch students about the history of the Holocaust. We also interview Dutch educators, government officials and academics about the state of Dutch Holocaust education. Our findings…
Rourou, Amina; Singer, Elly; Bekkema, Nienke; De Haan, Dorian
In this paper we discuss a study of cultural perspectives on peer conflicts in multicultural child care centres. On the level of child behaviour we did not find differences between native Dutch. Moroccan-Dutch and Antillean-Dutch children with regard to occurrence, duration and actions to solve peer conflicts. On the level of mother' opinions…
Rosenbek, John C
Researchers and clinicians often disagree about what it means to provide the best possible care. This paper's purpose is to propose ways of resolving the disagreements. The first is to have both groups re-examine the three equal components of evidence-based practice, a re-examination that begins with rejection of the randomised clinical trial's tyranny. The second is for researchers to design rehabilitation research based on a biopsychosocial rather than a biomedical model. The third is for both groups to redefine translational research so that it means both translation from the laboratory to the clinic and from the clinic to the laboratory. The fourth is to advocate for a science of dissemination that is as robust as rehabilitation's present science of discovery. Most examples are drawn from the literature on acquired neurologic speech and language disorders. PMID:27124262
Pharmaceutical care for elderly patients shared between community pharmacists and general practitioners: a randomised evaluation. RESPECT (Randomised Evaluation of Shared Prescribing for Elderly people in the Community over Time) [ISRCTN16932128
Wong, I; Campion, P; Coulton, S; Cross, B; Edmondson, H; Farrin, A; Hill, G; Hilton, A; Philips, Z; Richmond, S; Russell, I
Background This trial aims to investigate the effectiveness and cost implications of 'pharmaceutical care' provided by community pharmacists to elderly patients in the community. As the UK government has proposed that by 2004 pharmaceutical care services should extend nationwide, this provides an opportunity to evaluate the effect of pharmaceutical care for the elderly. Design The trial design is a randomised multiple interrupted time series. We aim to recruit 700 patients from about 20 general practices, each associated with about three community pharmacies, from each of the five Primary Care Trusts in North and East Yorkshire. We shall randomise the five resulting groups of practices, pharmacies and patients to begin pharmaceutical care in five successive phases. All five will act as controls until they receive the intervention in a random sequence. Until they receive training community pharmacists will provide their usual dispensing services and so act as controls. The community pharmacists and general practitioners will receive training in pharmaceutical care for the elderly. Once trained, community pharmacists will meet recruited patients, either in their pharmacies (in a consultation room or dispensary to preserve confidentiality) or at home. They will identify drug-related issues/problems, and design a pharmaceutical care plan in conjunction with both the GP and the patient. They will implement, monitor, and update this plan monthly. The primary outcome measure is the 'Medication Appropriateness Index'. Secondary measures include adverse events, quality of life, and patient knowledge and compliance. We shall also investigate the cost of pharmaceutical care to the NHS, to patients and to society as a whole. PMID:15182379
van Ineveld, Martin; van Oostrum, Jeroen; Vermeulen, Rob; Steenhoek, Adri; van de Klundert, Joris
This study addresses the productivity of Dutch hospitals since the start of the health systems reform in 2005. We consider DEA based measures, which include efficiency and quality for the complete set of Dutch hospitals and present cross-sectional and longitudinal analysis. In particular, we consider how hospital efficiency has developed. As the reform created an environment of regulated competition, we pay special attention to relative efficiency. Our results suggest that the differences in efficiency among hospitals have become larger. In the years 2009-2010, the number of hospitals identified as (close to) efficient by DEA analysis decreased. PMID:25774011
ter Maat, Judith; Haasnoot, Marjolijn; van der Vat, Marnix; Hunink, Joachim; Prinsen, Geert; Visser, Martijn
Keywords: uncertainty, policymaking, adaptive policies, fresh water management, droughts, Netherlands, Dutch Deltaprogramme, physically-based complex model, theory-motivated meta-model To prepare the Dutch Delta for future droughts and water scarcity, a nation-wide 4-year project, called Delta Programme, is established to assess impacts of climate scenarios and socio-economic developments and to explore policy options. The results should contribute to a national adaptive plan that is able to adapt to future uncertain conditions, if necessary. For this purpose, we followed a model-based step-wise approach, wherein both physically-based complex models and theory-motivated meta-models were used. First step (2010-2011) was to make a quantitative problem description. This involved a sensitivity analysis of the water system for drought situations under current and future conditions. The comprehensive Dutch national hydrological instrument was used for this purpose and further developed. Secondly (2011-2012) our main focus was on making an inventory of potential actions together with stakeholders. We assessed efficacy, sell-by date of actions, and reassessed vulnerabilities and opportunities for the future water supply system if actions were (not) taken. A rapid assessment meta-model was made based on the complex model. The effects of all potential measures were included in the tool. Thirdly (2012-2013), with support of the rapid assessment model, we assessed the efficacy of policy actions over time for an ensemble of possible futures including sea level rise and climate and land use change. Last step (2013-2014) involves the selection of preferred actions from a set of promising actions that meet the defined objectives. These actions are all modeled and evaluated using the complex model. The outcome of the process will be an adaptive management plan. The adaptive plan describes a set of preferred policy pathways - sequences of policy actions - to achieve targets under
van den Heuvel, Ed
Dutch astronomy and physics experienced two "golden ages". The firstone covered the 17th century, culminating with Christiaan Huygens,inventor of the pendulum clock and the wave theory of light, anddiscoverer of Saturn's rings and largest satellite Titan. The secondone, which lasts till the present, started around 1880 withphysicists Lorentz, van der Waals, Zeeman and Kamerlingh Onnes andastronomer Kapteijn and his pupils De Sitter, van Rhijn, Oort andSchilt. Kapteijn, through his friendship with George Ellery Hale,initiated the strong connection between American and Dutch astronomy,which led to the rise of many Dutch-born astronomers to prominentpositions in the US, from Luyten, Bok, Brouwer, Schilt and Kuiperto Woltjer, Gehrels, and Beckers. The rise of the second "goldenage" appears to be closely related to drastic reforms in the Dutchhigh school and university systems in the last decades of the 19thcentury.
Sullivan, Thomas R; Voysey, Merryn; Lee, Katherine J; Cook, Jonathan A; Forbes, Andrew B
Background: The intention-to-treat principle states that all randomised participants should be analysed in their randomised group. The implications of this principle are widely discussed in relation to the analysis, but have received limited attention in the context of handling errors that occur during the randomisation process. The aims of this article are to (1) demonstrate the potential pitfalls of attempting to correct randomisation errors and (2) provide guidance on handling common randomisation errors when they are discovered that maintains the goals of the intention-to-treat principle. Methods: The potential pitfalls of attempting to correct randomisation errors are demonstrated and guidance on handling common errors is provided, using examples from our own experiences. Results: We illustrate the problems that can occur when attempts are made to correct randomisation errors and argue that documenting, rather than correcting these errors, is most consistent with the intention-to-treat principle. When a participant is randomised using incorrect baseline information, we recommend accepting the randomisation but recording the correct baseline data. If ineligible participants are inadvertently randomised, we advocate keeping them in the trial and collecting all relevant data but seeking clinical input to determine their appropriate course of management, unless they can be excluded in an objective and unbiased manner. When multiple randomisations are performed in error for the same participant, we suggest retaining the initial randomisation and either disregarding the second randomisation if only one set of data will be obtained for the participant, or retaining the second randomisation otherwise. When participants are issued the incorrect treatment at the time of randomisation, we propose documenting the treatment received and seeking clinical input regarding the ongoing treatment of the participant. Conclusion: Randomisation errors are almost inevitable and
Summary Background A high circulating concentration of interleukin 6 is associated with increased risk of coronary heart disease. Blockade of the interleukin-6 receptor (IL6R) with a monoclonal antibody (tocilizumab) licensed for treatment of rheumatoid arthritis reduces systemic and articular inflammation. However, whether IL6R blockade also reduces risk of coronary heart disease is unknown. Methods Applying the mendelian randomisation principle, we used single nucleotide polymorphisms (SNPs) in the gene IL6R to evaluate the likely efficacy and safety of IL6R inhibition for primary prevention of coronary heart disease. We compared genetic findings with the effects of tocilizumab reported in randomised trials in patients with rheumatoid arthritis. Findings In 40 studies including up to 133 449 individuals, an IL6R SNP (rs7529229) marking a non-synonymous IL6R variant (rs8192284; p.Asp358Ala) was associated with increased circulating log interleukin-6 concentration (increase per allele 9·45%, 95% CI 8·34–10·57) as well as reduced C-reactive protein (decrease per allele 8·35%, 95% CI 7·31–9·38) and fibrinogen concentrations (decrease per allele 0·85%, 95% CI 0·60–1·10). This pattern of effects was consistent with IL6R blockade from infusions of tocilizumab (4–8 mg/kg every 4 weeks) in patients with rheumatoid arthritis studied in randomised trials. In 25 458 coronary heart disease cases and 100 740 controls, the IL6R rs7529229 SNP was associated with a decreased odds of coronary heart disease events (per allele odds ratio 0·95, 95% CI 0·93–0·97, p=1·53×10−5). Interpretation On the basis of genetic evidence in human beings, IL6R signalling seems to have a causal role in development of coronary heart disease. IL6R blockade could provide a novel therapeutic approach to prevention of coronary heart disease that warrants testing in suitably powered randomised trials. Genetic studies in populations could be used more widely to help to
van der Pal-de Bruin, K M; van der Pal, S M; Verloove-Vanhorick, S P; Walther, F J
In 1983, data of a unique nationwide cohort of 1338 very preterm (<32 weeks of gestation) or VLBW (birth weight<1500g) infants in the Netherlands was collected and followed at several ages until they reached the age of 19 years. At 19 years of age a more extensive follow-up study was done, including questionnaires, tests on a computer and a full physical exam. These studies provide insight into how Dutch adolescents at 19 years of age, who were born very preterm or with a very low birth weight (VLBW), reach adulthood. At 19 years, 705 POPS participants participated (74% of 959 still alive). Outcome measures at 19 years included: physical outcomes (e.g. blood pressure), cognition, behavior, quality of life, and impact of handicaps. The POPS participants showed more impairments on most outcome measures at various ages, compared to norm data. Major handicaps remained stable as the children grew older, but minor handicaps and disabilities increased. At 19 years of age, only half (47.1%) of the survivors had no disabilities and no minor or major handicaps. Especially those born small for gestational age (SGA) seem most vulnerable. These long-term results help to support preterm and SGA born children and adolescents in reaching independent adulthood, and stress the need for long term follow-up studies and to promote prevention of disabilities and of preterm birth itself. PMID:25590235
Verschoor, A M F; Kuijer, A; Verloop, J; Van Gils, C H; Sonke, G S; Jager, A; van Dalen, T; Elias, S G
Over recent years, adjuvant systemic treatment guidelines (AST) for early-stage breast cancer have changed considerably. We aimed to assess the impact of these guideline changes on the administration of AST in early-stage breast cancer patients and to what extent these guidelines are adhered to at a nation-wide level. We used Netherlands Cancer Registry data to describe trends in AST prescription, adherence to AST guidelines, and to identify clinicopathological determinants of nonadherence. Between 1990 and 2012, 231,648 Dutch patients were diagnosed with early breast cancer, of whom 124,472 received AST. Adjuvant endocrine treatment (ET) use increased from 23 % of patients (1990) to 56 % (2012), and chemotherapy from 11 to 44 %. In 2009-2012, 8 % of patients received ET and 3 % received chemotherapy without guideline indication. Conversely, 10-29 % of patients did not receive ET and chemotherapy, respectively, despite a guideline indication. Unfavorable clinicopathological characteristics generally decreased the chance of undertreatment and increased the chance for overtreatment. Remarkable was the increased chance of ET undertreatment in younger women (RR < 35 vs 60-69 years 1.79; 95 % CI 1.30-2.47) and in women with HER2+ disease (RR 1.64; 95 % CI 1.46-1.85). Over the years, AST guidelines expanded resulting in much more Dutch early breast cancer patients receiving AST. In the majority of cases, AST administration was guideline concordant, but the high frequency of chemotherapy undertreatment in some subgroups suggests limited AST guideline support in these patients. PMID:27514397
Yang, Ling-Yu; Lynn, An-Min; Chen, Tzeng-Ji
Pediatricians play a key role in the healthy development of children. Nevertheless, the practice patterns of pediatricians have seldom been investigated. The current study analyzed the nationwide profiles of ambulatory visits to pediatricians in Taiwan, using the National Health Insurance Research Database. From a dataset that was randomly sampled one out of every 500 records among a total of 309,880,000 visits in 2012 in the country, 9.8% (n = 60,717) of the visits were found paid to pediatricians. Children and adolescents accounted for only 69.3% of the visits to pediatricians. Male pediatricians provided 80.5% of the services and the main workforces were those aged 40–49 years. The most frequent diagnoses were respiratory tract diseases (64.7%) and anti-histamine agents were prescribed in 48.8% of the visits to pediatricians. Our detailed results could contribute to evidence-based discussions on health policymaking. PMID:26540064
Unalaska Bay - Dutch Harbor was digitized from NOAA Marine Charts #16528, #16529, and #16530. Map details include water depth and land. This map was created for EPA Region 10 Water Division to evaluate NPDES permit sites and environmental quality. Visual illustration facilitates ...
Marshall, Ineke Haen; And Others
Historically, the Netherlands liberal approach to the problems related to drug use has been based on tolerance and a pragmatic concern for "harm reduction." Since the early 1980s, however, a shift has taken place in the direction of a tougher policy. This document describes: (1) the main features of the Dutch approach to the control of…
Neijt, Anneke; Schreuder, Robert
Creating compound nouns is the most productive process of Dutch morphology, with an interesting pattern of form variation. For instance, "staat" "nation" simply combines with "kunde" "art" ("staatkunde" "political science, statesmanship"), but needs a linking element "s" or "en" to form staatsschuld "national debt" and "statenbond"…
Collier, Kate L.; Horn, Stacey S.; Bos, Henny M. W.; Sandfort, Theo G. M.
Attitudes toward lesbians and gays vary across national populations, and previous research has found relatively more accepting attitudes in the Netherlands as compared to the U.S. In this study, we compared beliefs about and attitudes toward lesbians and gays in samples of Dutch and American heterosexual adolescents, utilizing survey data from 1,080 American adolescents (mean age = 15.86 years) attending two schools and from 1,391 Dutch adolescents (mean age = 16.27 years) attending eight schools. Findings indicated the Dutch participants were more tolerant of lesbians and gays, after adjusting for the gender, age, and racial/ethnic minority status of the participants. However, between-country differences were attenuated by accounting for the beliefs about lesbians and gays that participants used to justify their attitudes. American participants were more likely to justify their attitudes using beliefs related to social norms and religious opposition, while the Dutch participants were more likely to justify their attitudes using beliefs related to individual rights and the biological/genetic basis of homosexuality. The results suggest that the relative importance of particular beliefs about lesbians and gays to attitudes at the group level may be context-dependent but also that certain beliefs are salient to attitudes across national contexts. PMID:24512056
Jones, Frances Faircloth
Three major issues shape delivery of education in the Caribbean island of Curacao: the Dutch and Papiamentu languages of instruction, the two governmental layers, and scarcity of resources. Despite funding limitations, education is changing. The five-year general secondary education model and the six-year college preparatory program are being…
te Wierik, Mark L. J.; Beishuizen, Jos; van Os, Willem
To enhance student success, a growing number of vocational education and training institutions in the Netherlands are nowadays implementing new career guidance practices in their competence-based approaches to learning. Based on individual-level data of undergraduate first-year full-time students from a Dutch university of applied sciences, this…
Between 1998 and 2002 an estimated 250 mentoring programmes were started in Dutch secondary vocational education in order to decrease motivational problems and drop-out rates, especially among youngsters from ethnic minorities. Currently there are only two schools in secondary vocational education that include mentoring as part and parcel of their…
Borsboom, M; Bras, W; Cerjak, I; Detollenaere, D; Glastra Van Loon, D; Goedtkindt, P; Konijnenburg, M; Lassing, P; Levine, Y K; Munneke, B; Oversluizen, M; Van Tol, R; Vlieg, E
A brief description is given of the design principles and layout of the Dutch-Belgian beamline at the ESRF. This beamline optimizes the use of the available bending-magnet radiation fan by splitting the beam into two branches, each accommodating two experimental techniques. PMID:15263564
Rajaei, Seyed Mehdi; Rafiee, Siamak Mashhady; Ghaffari, Masoud Selk; Masouleh, Mohammad N; Jamshidian, Mahmoud
The purpose of this study was to establish normal values for tear production tests in different breeds of domestic rabbits. Healthy adult rabbits (n = 60; 120 eyes) of 2 different breeds (English angora and Dutch; n = 15 of each sex and breed) were used in this study. Tear production was measured by using the 1-min Schirmer tear test (STT), phenol red thread test (PRTT), and endodontic absorbent paper point tear test (EAPTT). In addition, horizontal palpebral fissure length was evaluated as a measure of ocular adnexal dimensions. Tear production (mean ± 1 SD) in English angora rabbits was 5.4 ± 1.6 mm/min according to the STT, 25.0 ± 2.7 mm in 15 s for the PRTT, and 18.8 ± 2.1 mm/min by the EAPTT; in Dutch rabbits, these values were 4.6 ± 1.2 mm/min, 23.6 ± 2.3 mm in 15 s, and 16.9 ± 1.7 mm/min, respectively. Only the EAPTT revealed a significant difference in tear production between English Angora and Dutch rabbits. These results provide reference values for tear production in English Angora and Dutch rabbits according to 3 different quantitative tear film assessment methods. PMID:27025815
Schuwer, Robert; Mulder, Fred
Over the period 2006-2008, the Dutch Open Universiteit Nederland conducted an experiment in which Open Educational Resources (OER) were offered in an effort to bridge the gap between informal and formal learning and to establish a new style of entry portal to higher education with no barriers at all. OpenER received considerable attention both in…
Reports on investments in the United States (including database activities) by four Dutch publishing companies--Elsevier-NDU, VNU, Kluwer, Wolters Samsom Group. An analysis of the reasons behind these investments, the solidness of the companies, the approach to the U.S. information market, and the knowledge transfer to Europe are highlighted. (EJS)
Doppen, Frans H.
As a result of dramatic demographic changes during the last half century as well as a series of recent events surrounding prominent personas, the Dutch have been engaged in an intense debate about their national identity and how citizenship education can contribute to the integration of Muslim immigrants in particular. This article analyses the…
Bloemert, Jasmijn; Jansen, Ellen; van de Grift, Wim
There is an increasing awareness that the inclusion of literature in foreign language (FL) curricula can be beneficial to language learners. Especially, the move towards integrated language and literature curricula is gaining ground. In this study we investigated the way English as a foreign language (EFL) is approached in Dutch secondary…
Huisman, Jeroen; Jenniskens, Ineke
A discussion of Dutch higher education looks at whether a 1985 proposal for fundamental changes in the relationship between government and higher education institutions has been implemented with regard to curriculum design. It is concluded that, despite policy intentions for increased institutional autonomy, the government retains relatively tight…
Schiltman, Maria J.
This presentation of the Dutch experience with the international exchange of publications focuses on the acquisition of publications from China and Indonesia to illustrate problems of availability. Lack of depository systems, restrictive export policies, inadequate national bibliographies, exorbitant commercial prices, and time consuming delivery…
Ausems, M.; Mesters, I.; van Breukelen, G.; De Vries, H.
Higher rates of smoking initiation and continuation by female compared with male adolescents, as found in many developed countries, may call for gender-specific prevention programs. Risk factors of smoking initiation and continuation were examined prospectively (1997-2002) among 3205 Dutch elementary schoolchildren (mean age 11.64) in an…
van Loo, Jasper B.
HRD is extensively concerned with human capital investment, but only focuses on how skills and knowledge become obsolete to a limited extent. In this paper we look at the speed of obsolescence. Using data from a survey among Dutch public sector employees, we find that the yearly rate of skills obsolescence is 2.6%. Subsequent analyses show that…
The three areas of educational activity recognized by the Dutch have developed historically into distinct and separate institutionalized sectors for educational provision for adults. These areas are knowledge-based, skill-based, and value-based. Each is the responsibility of a different governmental department and cabinet minister. Educational…
de Boer, Harry; Goedegebuure, Leo
As one of the first countries in Europe to do so, The Netherlands moved towards a new relationship between the state and the higher education institutions in the mid-1980s. Autonomy, quality and accountability were key considerations in this move. In 2006 the Dutch government proposed another radical innovation in its approach to higher education…
Quyen, Do Thi Ngoc
The number of contact hours, one of the important institutional context factors, was examined and compared between Dutch and Vietnamese higher education at institute and student levels in Psychology and Business and/or Economics specializations. The quantity of contact hours per credit point given by institutions was investigated in a number of…
Fortuijn, Joos Droogleever
Since the beginning of the 1970s the under-representation of women in geography has been questioned in several publications. Most articles refer to the situation in English-speaking countries. This paper examines the vertical and horizontal gender segregation in human geography departments in Dutch universities. In spite of several policy measures…
Ravesteijn, W; Kroesen, O
Present-day worldwide water problems require new management tools and sustainable system innovations. At Delft University of Technology research is being carried out into water resources and management development aimed at forming such tools and innovations, focused on Integrated River Basin Management (IRBM). One of the case-studies deals with Dutch water management and technology in the context of European IRBM in the form of the 2000 Water Frame Directive. The Netherlands experience many water problems and European IRBM could bring help by offering a framework for both international cooperation and technological innovations. To work as an adequate management tool European IRBM should be tailored to the Dutch water tradition, which recently culminated in Integrated Water Management. Both approaches are in some respects contradicting. Europe pursues, for example, centralized control; while the Dutch have their strongly water boards based decentralized administration. The tensions between both approaches require mutual adaptation, for which the concept of subsidiarity might offer points of departure. This paper describes the first results of the case-research into Dutch water management and technology in the context of Europe as well as the backgrounds and the set-up of the research as a whole. PMID:17851211
Van de Ven, Piet-Hein
In order to address a perceived gap between academic knowledge and education, The Dutch National Advisory Board on Education has suggested that there is a need for more communication between research and practice. For me the gap is more than simply a matter of lack of communication, than a result of the model of Research, Development and Diffusion…
van der Sluis, Sophie; Posthuma, Danielle; Dolan, Conor V.; de Geus, Eco J. C.; Colom, Roberto; Boomsma, Dorret I.
Using multi-group covariance and means structure analysis (MG-CMSA), this study investigated whether sex differences were present on the Dutch WAIS-III, and if so, whether these sex differences were attributable to differences in general intelligence ("g"). The sample consisted of 294 females and 228 males between 18 and 46 years old. Both first…
Zamuner, Tania S.; Kerkhoff, Annemarie; Fikkert, Paula
This research investigates children's knowledge of how surface pronunciations of lexical items vary according to their phonological and morphological context. Dutch-learning children aged 2.5 and 3.5 years were tested on voicing neutralization and morphophonological alternations. For instance, voicing does not alternate between the pair…
van Dellen, Theo; Heidekamp, Ina
This article focuses on the perceived freedom of Dutch employees to embark on workplace learning in terms of whether they feel it is "voluntary" or "compulsory". The paper is based on the findings of a large international explorative survey carried out by the Workplace Learning (WPL) Research Network (RN2) of the Asia-Europe…
van Dellen, Theo; Heidekamp, Ina
This article focuses on the perceived freedom of Dutch employees to embark on workplace learning in terms of whether they feel it is "voluntary" or "compulsory". The paper is based on the findings of a large international explorative survey carried out by the Workplace Learning (WPL) Research Network (RN2) of the Asia-Europe Meeting (ASEM) Lifelong Learning (LLL) Research Hub. The comparative study focused on employees' quest for "freedom of learning for work". This paper reports on the Dutch part of the research, the quantitative results of which seem to indicate that the freedom of learning for work is not as important to Dutch employees as might be expected. In a second phase, to investigate employees' experiences of work-related learning in more depth, the Dutch researchers added a follow-up qualitative study, involving one-on-one interviews. In order to triangulate the results of the quantitative and qualitative research phases, the authors then added a mixed-methods sequential explanatory analysis. They assessed the quality of the collected data in both distinct phases by identifying converging results, which are useful for refining our understanding of learning for work. The paper draws both on rich insights into workplace learning based on this research as well as on theoretical literature which refers to concepts like motivation, subjectivity, work identity and agency in connection with the quest for freedom of learning.
Boezerooy, Petra; Cordewener, Bas; Liebrand, Wim
In "Thinking Ahead: A Vision of the Role of ICT in Education and Research in the Future, 2007-2010," the higher education institutions in the Netherlands agreed on future strategy. Under the direction of SURF, the Dutch national organization, a collaborative strategy for the application of information and communications technology (ICT) was…
den Hartog, Franciska; Wagemakers, Annemarie; Vaandrager, Lenneke; van Dijk, Marieke; Koelen, Maria A.
Objective: BeweegKuur (Exercise Therapy) is a Dutch lifestyle programme in which participants are referred by a general practitioner (GP) to a lifestyle advisor. To support participants, regional and local alliances are established. The present study explored the successes and challenges associated with collaboration processes in local BeweegKuur…
de Waal, A. A.; Oudshoorn, Michella
Purpose: The purpose of this study is to explore the profile of an ideal employee, to be more precise the behavioral characteristics of the Dutch high-performing employee (HPE). Organizational performance depends for a large part on the commitment of employees. Employees provide their knowledge, skills, experiences and creativity to the…
Driessen, Geert; Merry, Michael S.
The central question in this study is whether the language and math delays of the different socio-economic and ethnic minority groups targeted by Dutch educational disadvantage policy have diminished or not. Data are from the years 1995, 1999, 2003 and 2008. Information from a total of 90,000 pupils in Grades 2 and 8 was selected to represent the…
de Graaff, Saskia; Hasselman, Fred; Bosman, Anna M. T.; Verhoeven, Ludo
This study investigated whether task instructions affect sound-isolation performance. The effects of phoneme class and phoneme position were also assessed. Two hundred Dutch kindergartners were presented with a free-sound-isolation task and its constrained counterparts: an initial-, a middle-, and a final-sound-isolation task. All tasks contained…
De Jong, John H. A. L.; Lennig, Matthew; Kerkhoff, Anne; Poelmans, Petra
Based on a parliamentary vote with broad support, the Ministry of Justice of the Netherlands in December 2003 commissioned the development of an examination system to test the Dutch oral language skills of foreigners who want to immigrate permanently to the Netherlands for economic or family reasons. This assessment would take place in the country…
Evers, Arnoud T.; van der Heijden, Beatrice I. J. M.; Kreijns, Karel; Gerrichhauzen, John T. G.
Purpose: The purpose of this paper is to report on a study that investigates the relationship between organisational factors, Teachers' Professional Development (TPD) and occupational expertise. Design/methodology/approach: A survey was administered among 152 Dutch teachers in secondary education. Findings: Analysis of the data revealed that of…
Mackenzie, Isla S; Wei, Li; Rutherford, Daniel; Findlay, Evelyn A; Saywood, Wendy; Campbell, Marion K; Macdonald, Thomas M
WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT * Recruitment is key to the success of clinical trials. * Many clinical trials fail to achieve adequate recruitment. * Public understanding and engagement in clinical research could be improved. WHAT THIS STUDY ADDS * 'Get Randomised' is the first campaign of its kind in the UK. * It is possible to improve public awareness of clinical research using the media. * Further work is needed to determine whether improved public awareness leads to increased participation in clinical research in the future. AIM To increase public awareness and understanding of clinical research in Scotland. METHODS A generic media campaign to raise public awareness of clinical research was launched in 2008. The 'Get Randomised' campaign was a Scotland-wide initiative led by the University of Dundee in collaboration with other Scottish universities. Television, radio and newspaper advertising showed leading clinical researchers, general practitioners and patients informing the public about the importance of randomised clinical trials (RCTs). 'Get Randomised' was the central message and interested individuals were directed to the http://www.getrandomised.org website for more information. To assess the impact of the campaign, cross-sectional surveys were conducted in representative samples of 1040 adults in Scotland prior to campaign launch and again 6 months later. RESULTS There was an improvement in public awareness of clinical trials following the campaign; 56.7% [95% confidence interval (CI) 51.8, 61.6] of the sample recalled seeing or hearing advertising about RCTs following the campaign compared with 14.8% (10.8, 18.9) prior to the campaign launch (difference = 41.4%; 95% CI for difference 35.6, 48.3; P < 0.01). Of those who recalled the advertising, 49% felt that the main message was that people should take part more in medical research. However, on whether they would personally take part in a clinical trial if asked, there was little difference
Ainsworth, Hannah; Hewitt, Catherine E.; Higgins, Steve; Wiggins, Andy; Torgerson, David J.; Torgerson, Carole J.
Randomised controlled trials (RCTs) can be at risk of bias. Using data from a RCT, we considered the impact of post-randomisation bias. We compared the trial primary outcome, which was administered blindly, with the secondary outcome, which was not administered blindly. From 44 schools, 522 children were randomised to receive a one-to-one maths…
Westera, J. J.; Houtzager, B. A.; Overdiek, B.; van Wassenaer, A. G.
The aim of the present study was to evaluate whether the application of Dutch versus US test procedures and norms of the Bayley Scales of Infant Development-2nd edition (BSID-II) leads to different developmental outcomes. The BSID-II was administered to 376 preterm infants (191 males, 185 females; mean gestational age 30wks [SD 2.7], mean…
Rebers, S.; Vermeulen, E.; Brandenburg, A. P.; Stoof, T. J.; Zupan-Kajcovski, B.; Bos, W. J. W.; Jonker, M. J.; Bax, C. J.; van Driel, W. J.; Verwaal, V. J.; van den Brekel, M. W.; Grutters, J. C.; Tupker, R. A.; Plusjé, L.; de Bree, R.; Schagen van Leeuwen, J. H.; Vermeulen, E. G. J.; de Leeuw, R. A.; Brohet, R. M.; Aaronson, N. K.; Van Leeuwen, F. E.; Schmidt, M. K.
Background Despite much debate, there is little evidence on consequences of consent procedures for residual tissue use. Here, we investigated these consequences for the availability of residual tissue for medical research, clinical practice, and patient informedness. Methods We conducted a randomised clinical trial with three arms in six hospitals. Participants, patients from whom tissue had been removed for diagnosis or treatment, were randomised to one of three arms: informed consent, an opt-out procedure with active information provision (opt-out plus), and an opt-out procedure without active information provision. Participants received a questionnaire six weeks post-intervention; a subsample of respondents was interviewed. Health care providers completed a pre- and post-intervention questionnaire. We assessed percentage of residual tissue samples available for medical research, and patient and health care provider satisfaction and preference. Health care providers and outcome assessors could not be blinded. Results We randomised 1,319 patients, 440 in the informed consent, 434 in the opt-out plus, and 445 in the opt-out arm; respectively 60.7%, 100%, and 99.8% of patients’ tissue samples could be used for medical research. Of the questionnaire respondents (N = 224, 207, and 214 in the informed consent, opt-out plus, and opt-out arms), 71%, 69%, and 31%, respectively, indicated being (very) well informed. By questionnaire, the majority (53%) indicated a preference for informed consent, whereas by interview, most indicated a preference for opt-out plus (37%). Health care providers (N = 35) were more likely to be (very) satisfied with opt-out plus than with informed consent (p = 0.002) or opt-out (p = 0.039); the majority (66%) preferred opt-out plus. Conclusion We conclude that opt-out with information (opt-out plus) is the best choice to balance the consequences for medical research, patients, and clinical practice, and is therefore the most optimal consent
Boland, Melinde R S; Kruis, Annemarije L; Tsiachristas, Apostolos; Assendelft, Willem J J; Gussekloo, Jacobijn; Blom, Coert M G; Chavannes, Niels H; Rutten-van Mölken, Maureen P M H
Objectives To investigate the cost-effectiveness of a chronic obstructive pulmonary disease (COPD) disease management (COPD-DM) programme in primary care, called RECODE, compared to usual care. Design A 2-year cluster-randomised controlled trial. Setting 40 general practices in the western part of the Netherlands. Participants 1086 patients with COPD according to GOLD (Global Initiative for COPD) criteria. Exclusion criteria were terminal illness, cognitive impairment, alcohol or drug misuse and inability to fill in Dutch questionnaires. Practices were included if they were willing to create a multidisciplinary COPD team. Interventions A multidisciplinary team of caregivers was trained in motivational interviewing, setting up individual care plans, exacerbation management, implementing clinical guidelines and redesigning the care process. In addition, clinical decision-making was supported by feedback reports provided by an ICT programme. Main outcome measures We investigated the impact on health outcomes (quality-adjusted life years (QALYs), Clinical COPD Questionnaire, St. George's Respiratory Questionnaire and exacerbations) and costs (healthcare and societal perspective). Results The intervention costs were €324 per patient. Excluding these costs, the intervention group had €584 (95% CI €86 to €1046) higher healthcare costs than did the usual care group and €645 (95% CI €28 to €1190) higher costs from the societal perspective. Health outcomes were similar in both groups, except for 0.04 (95% CI −0.07 to −0.01) less QALYs in the intervention group. Conclusions This integrated care programme for patients with COPD that mainly included professionally directed interventions was not cost-effective in primary care. Trial registration number Netherlands Trial Register NTR2268. PMID:26525419
Onozuka, Daisuke; Hagihara, Akihito; Nishimura, Kunihiro; Kada, Akiko; Nakagawara, Jyoji; Ogasawara, Kuniaki; Ono, Junichi; Shiokawa, Yoshiaki; Aruga, Toru; Miyachi, Shigeru; Nagata, Izumi; Toyoda, Kazunori; Matsuda, Shinya; Suzuki, Akifumi; Kataoka, Hiroharu; Nakamura, Fumiaki; Kamitani, Satoru; Nishimura, Ataru; Kurogi, Ryota; Sayama, Tetsuro; Iihara, Koji
Objectives To elucidate the association between antiplatelet use in patients with non-haemorrhagic moyamoya disease before hospital admission and good functional status on admission in Japan. Design Retrospective, multicentre, non-randomised, observational study. Setting Nationwide registry data in Japan. Participants A total of 1925 patients with non-haemorrhagic moyamoya disease admitted between 1 April 2012 and 31 March 2014 in Japan. Main outcome measure We performed propensity score-matched analysis to examine the association between prehospital antiplatelet use and no significant disability on hospital admission, as defined by a modified Rankin Scale score of 0 or 1. Results Propensity-matched patients who received prehospital antiplatelet drugs were associated with a good outcome on hospital admission (OR adjusted for all covariates, 3.82; 95% CI 1.22 to 11.99) compared with those who did not receive antiplatelet drugs prior to hospital admission. Conclusions Prehospital antiplatelet use was significantly associated with good functional status on hospital admission among patients with non-haemorrhagic moyamoya disease in Japan. Our results suggest that prehospital antiplatelet use should be considered when evaluating outcomes of patients with non-haemorrhagic moyamoya disease. PMID:27008684
Lim, Hyeung C.; Adie, Sam; Naylor, Justine M.; Harris, Ian A.
We investigated the proportion of orthopaedic procedures supported by evidence from randomised controlled trials comparing operative procedures to a non-operative alternative. Orthopaedic procedures conducted in 2009, 2010 and 2011 across three metropolitan teaching hospitals were identified, grouped and ranked according to frequency. Searches of the Cochrane Central Register of Controlled Trials (CENTRAL), the Cochrane Database of Systematic Reviews (CDSR) and the Database of Abstracts of Reviews of Effects (DARE) were performed to identify RCTs evaluating the most commonly performed orthopaedic procedures. Included studies were categorised as “supportive” or “not supportive” of operative treatment. A risk of bias analysis was conducted for included studies using the Cochrane Collaboration's Risk of Bias tool. A total of 9,392 orthopaedic procedures were performed across the index period. 94.6% (8886 procedures) of the total volume, representing the 32 most common operative procedure categories, were used for this analysis. Of the 83 included RCTs, 22.9% (19/83) were classified as supportive of operative intervention. 36.9% (3279/8886) of the total volume of procedures performed were supported by at least one RCT showing surgery to be superior to a non-operative alternative. 19.6% (1743/8886) of the total volume of procedures performed were supported by at least one low risk of bias RCT showing surgery to be superior to a non-operative alternative. The level of RCT support for common orthopaedic procedures compares unfavourably with other fields of medicine. PMID:24927114
Background Aphasia is a severely disabling condition occurring in 20 to 25% of stroke patients. Most patients with aphasia due to stroke receive speech and language therapy. Methodologically sound randomised controlled trials investigating the effect of specific interventions for patients with aphasia following stroke are scarce. The currently available evidence suggests that intensive speech and language therapy is beneficial for restoration of communication, but the optimal timing of treatment is as yet unclear. In the Rotterdam Aphasia Therapy Study-3 we aim to test the hypothesis that patients with aphasia due to stroke benefit more from early intensive cognitive-linguistic therapy than from deferred regular language therapy. Methods/design In a single blinded, multicentre, randomised controlled trial, 150 patients with first ever aphasia due to stroke will be randomised within two weeks after stroke to either early intensive cognitive-linguistic therapy (Group A) or deferred regular therapy (Group B). Group A will start as soon as possible, at the latest two weeks after stroke, with a four week period of one hour a day treatment with cognitive-linguistic therapy. In Group B professional speech and language therapy is deferred for four weeks. After this period, patients will follow the conventional procedure of speech and language therapy. Participants will be tested with an extensive linguistic test battery at four weeks, three months and six months after inclusion. Primary outcome measure is the difference in score between the two treatment groups on the Amsterdam-Nijmegen Everyday Language Test, a measure of everyday verbal communication, four weeks after randomisation. Trial registration This trial is registered in the Dutch Trial Register (http://www.trialregister.nl), NTR3271. PMID:23343197
... From the Federal Register Online via the Government Publishing Office FEDERAL COMMUNICATIONS COMMISSION 47 CFR Chapter I Implementing a Nationwide, Broadband, Interoperable Public Safety Network in the 700 MHz Band AGENCY: Federal Communications Commission. ACTION: Final rule. SUMMARY: In this...
In the Dutch e-voting debate, the crucial issue leading to the abandonment of all electronic voting machines was compromising radiation, or tempest: it would be possible to eavesdrop on the choice of the voter by capturing the radiation from the machine. Other countries, however, do not seem to be bothered by this risk. In this paper, we use actor-network theory to analyse the socio-technical origins of the Dutch tempest issue in e-voting, and we introduce concepts for discussing its implications for e-voting beyond the Netherlands. We introduce the term electoral traces to denote any physical, digital or social evidence of a voter’s choices in an election. From this perspective, we provide a framework for risk classification as well as an overview of countermeasures against such traces.
Leshem, Eyal; Segal, Gadi; Barnea, Ada; Yitzhaki, Shmuel; Ostfeld, Iris; Pitlik, Silvio; Schwartz, Eli
Leptospirosis is re-emerging in developed countries as a travel-related infection. In this nationwide study of travel-related leptospirosis in Israel, all cases diagnosed at the Central Reference Laboratory for Leptospirosis, during 2002–2008 were retrospectively reviewed and only travel-related cases were included. During the study years, 20 (42%) of 48 leptospirosis cases in Israel were travel-related. Exposure occurred in Southeast Asia in 15 (75%) of 20 cases. The estimated yearly incidence of travel-related leptospirosis was 1.78/100,000 travelers compared with an incidence of endemic cases of 0.06/100,000 inhabitants (risk ratio = 29.6, 95% confidence interval = 16.7–52.4). Most patients (89%) were infected during water-related activities. Severe disease was present in 10 (55%) of 18 patients; 7 of them were presumptively infected with the Icterohaemorrhagiae serogroup. Thus, travel-related leptospirosis is becoming increasingly important in the epidemiology of leptospirosis in Israel. Leptospirosis should be suspected in any traveler with undifferentiated febrile illness, especially when water exposure is reported. PMID:20207873
Kuroda, Tatsuo; Hoshino, Ken; Nosaka, Shunsuke; Shiota, Yohko; Nakazawa, Atsuko; Takimoto, Tetsuya
The International Society for the Study of Vascular Anomalies (ISSVA) classification divides vascular lesions into two major entities: neoplasms originating from the vascular endothelium and vascular malformations. Although this concept has been widely accepted, little has been established regarding vascular lesions in deep organs, such as infantile hepatic hemangioma (IHH). The current nationwide survey identified 19 critical infantile hemangiomas during the most recent 5 years. On histopathology all the lesions examined were neoplastic, but portovenos shunt was found histologically or clinically in some cases. High-output cardiac failure, consumption coagulopathy, and respiratory distress were the major symptoms, and treatment-resistant coagulopathy seemed to be the most reliable predictor of fatal outcome. Although steroid has been the gold standard treatment for these lesions, 25% of the patients were totally insensitive to steroids, whereas propranolol had a prompt effect in one case. For critical IHH with steroid-insensitive thrombocytopenia and prothrombin time prolongation, novel therapeutic options including beta-blocker therapy, surgery, and liver transplantation should be urgently considered as alterative treatment. The present review summarizes the results of the survey. PMID:24689756
Lee, Sung-Geun; Jheong, Weon-Hwa; Suh, Chang-Il; Kim, Sang-Hyun; Lee, Joong-Bok; Jeong, Yong-Seok; Ko, GwangPyo; Jang, Kyung Lib; Lee, Gyu-Cheol; Paik, Soon-Young
To inspect the norovirus contamination of groundwater in South Korea, a nationwide study was performed in the summer (June to August) and winter (October to December) of 2008. Three-hundred sites designated by the government ministry were inspected. Water samples were collected for analysis of water quality, microorganism content, and viral content. Water quality was assessed by temperature, pH, turbidity, residual chlorine, and nitrite nitrogen content. Microorganism contents were analyzed bacteria, total coliforms, Escherichia coli, and bacteriophage. Virus analyses included panenterovirus and norovirus. Two primer sets were used for the detection of norovirus genotypes GI and GII, respectively. Of 300 samples, 65 (21.7%) were norovirus positive in the summer and in 52 (17.3%) were norovirus positive in the winter. The genogroup GI noroviruses that were identified were GI-1, GI-2, GI-3, GI-4, GI-5, GI-6, and GI-8 genotypes; those in the GII genogroup were GII-4 and GII-Yuri genotypes. The analytic data showed correlative relationships between the norovirus detection rate and the following parameters: water temperature and turbidity in physical-chemical parameters and somatic phage in microbial parameters. It is necessary to periodically monitor waterborne viruses that frequently cause epidemic food poisoning in South Korea for better public health and sanitary conditions. PMID:21183642
Rodriguez, Daniel; Carlos, Heather A; Adachi-Mejia, Anna M; Berke, Ethan M; Sargent, James D
Objective To elucidate how demographics of US Census tracts are related to tobacco outlet density (TOD). Method The authors conducted a nationwide assessment of the association between socio-demographic US Census indicators and the density of tobacco outlets across all 64 909 census tracts in the continental USA. Retail tobacco outlet addresses were determined through North American Industry Classification System codes, and density per 1000 population was estimated for each census tract. Independent variables included urban/rural; proportion of the population that was black, Hispanic and women with low levels of education; proportion of families living in poverty and median household size. Results In a multivariate analysis, there was a higher TOD per 1000 population in urban than in rural locations. Furthermore, higher TOD was associated with larger proportions of blacks, Hispanics, women with low levels of education and with smaller household size. Urban–rural differences in the relation between demographics and TOD were found in all socio-demographic categories, with the exception of poverty, but were particularly striking for Hispanics, for whom the relation with TOD was 10 times larger in urban compared with rural census tracts. Conclusions The findings suggest that tobacco outlets are more concentrated in areas where people with higher risk for negative health outcomes reside. Future studies should examine the relation between TOD and smoking, smoking cessation, as well as disease rates. PMID:22491038
Palmsten, Kristin; Huybrechts, Krista F.; Kowal, Mary K.; Mogun, Helen; Hernández-Díaz, Sonia
Purpose The aim of this study is to assess the validity of preeclampsia, congenital cardiac malformations, and persistent pulmonary hypertension of the newborn (PPHN) diagnoses in the US Medicaid Analytic eXtract (MAX), a nationwide healthcare utilization database that may be useful for perinatal research. Methods Using the 2000–2007 MAX, we identified more than 1 million pregnancies ending in live birth. We identified potential cases based on claims, reviewed their hospital medical records, and calculated the positive predictive values (PPV) and 95% confidence intervals using records as the reference. Results Among 183 women with any preeclampsia diagnoses, the PPV was 66.5% (53.6, 77.4%), but it increased to 94.5% (84.0, 98.3%) for inpatient preeclampsia diagnoses. The PPV for inpatient PPHN diagnoses (N=82) was 68.3% (57.6, 77.4%), but it increased to 89.6% (CI: 77.8, 95.5%) when restricting to infants not transferred to another facility shortly after birth (N=48). The PPV for cardiac malformations was 77.6% (65.7, 86.2%) when requiring inpatient codes on more than one date (N=63). Conclusions These PPVs are conservative, particularly when patients were transferred or received outpatient diagnoses, because we reviewed records from a single hospitalization only. PPVs improve with stringent identification criteria, at the cost of sensitivity, and can be used to correct for measurement error. PMID:24740606
Lee, Sol Min; Huh, Jung-Sik; Baek, Minki; Yoo, Koo Han; Min, Gyeong Eun; Lee, Hyung-Lae; Lee, Dong-Gi
Testicular torsion is a surgical emergency in the field of urology. Knowledge of the epidemiology and pathophysiology is significant to an urologist. However, the epidemiology of testicular torsion in Korea has not been studied. We performed a nationwide epidemiological study to improve knowledge of the epidemiology of testicular torsion. From 2006-2011, the Korean Urologic Association began the patient registry service. The annual number of patients with testicular torsion from 2006 to 2011 were 225, 250, 271, 277, 345, and 210, respectively. The overall incidence of testicular torsion in males was 1.1 per 100,000; However, the incidence in men less than 25 yr old was 2.9 per 100,000. Adolescents showed the highest incidence. Total testicular salvage rate was 75.7% in this survey. There was no geographic difference of testicular salvage rate. Minimizing the possibility of orchiectomy for testicular torsion is important to improve public awareness to expedite presentation and provider education to improve diagnosis and surgery. PMID:25469070
Valle, Jazmine; Gomes, Christian; Godby, Tyler; Coustasse, Alberto
The Nationwide Health Information Network (NHIN) use in health care facilities was examined for utilization and efficacy; although the advantages are abundant, health care facilities have been reluctant to adopt it because of associated costs. The purpose of this study was to analyze the feasibility of a US NHIN by exploring and determining the benefits of an NHIN and assessing the barriers to its implementation. The research methodology applied in examining the implementation of NHIN in the United States was a qualitative literature review, which followed the basic guidelines of a systematic literature review, partnered with a semistructured interview of a chief information officer of a private, nonprofit, 193-bed hospital located in Westminster, Maryland. A total of 33 sources were referenced. The results of this study suggest that implementation and utilization of NHIN by health care industry stakeholders lead to an increased quality of patient care, increased patient-provider communication, and cost-savings opportunities. Increased quality of care is achieved by reducing adverse drug events and medical errors. Cost-savings opportunities are generated by a reduction in spending and prices that is attributable to electronic health record systems' increased efficiency and effectiveness. Nevertheless, barriers to NHIN implementation and utilization still remain throughout the health care industry, the main one being concerns about interoperability. PMID:27111681
Leivonen, Susanna; Chudal, Roshan; Joelsson, Petteri; Ekblad, Mikael; Suominen, Auli; Brown, Alan S; Gissler, Mika; Voutilainen, Arja; Sourander, Andre
This is the first nationwide register-based study to examine the relationship between prenatal maternal smoking and Tourette syndrome. A total of 767 children diagnosed with Tourette syndrome were identified from the Finnish Hospital Discharge Register. Each case was matched to four controls. Information on maternal smoking during pregnancy was obtained from the Finnish Medical Birth Register. Conditional logistic regression models were used for statistical analyses. Prenatal maternal smoking was associated with Tourette syndrome when comorbid with ADHD (OR 4.0, 95 % CI 1.2-13.5, p = 0.027 for exposure during first trimester, OR 1.7, 95 % CI, 1.05-2.7, p = 0.031 for exposure for the whole pregnancy). There was no association between maternal smoking during pregnancy and Tourette syndrome without comorbid ADHD (OR 0.5, 95 % CI 0.2-1.3, p = 0.166, OR 0.9, 95 % CI 0.7-1.3, p = 0.567). Further research is needed to elucidate the mechanisms behind the association between prenatal maternal smoking and Tourette syndrome with comorbid ADHD. PMID:25796373
Sundwall, David; Lenert, Michael Edward
In the midst of a US $30 billion USD investment in the Nationwide Health Information Network (NwHIN) and electronic health records systems, a significant change in the architecture of the NwHIN is taking place. Prior to 2010, the focus of information exchange in the NwHIN was the Regional Health Information Organization (RHIO). Since 2010, the Office of the National Coordinator (ONC) has been sponsoring policies that promote an internet-like architecture that encourages point to-point information exchange and private health information exchange networks. The net effect of these activities is to undercut the limited business model for RHIOs, decreasing the likelihood of their success, while making the NwHIN dependent on nascent technologies for community level functions such as record locator services. These changes may impact the health of patients and communities. Independent, scientifically focused debate is needed on the wisdom of ONC's proposed changes in its strategy for the NwHIN. PMID:22268218
Shao, Zeshu; Stiegert, Julia
In the present study, we report naming latencies and norms for 327 photos of objects in Dutch. We provide norms for eight psycholinguistic variables: age of acquisition, familiarity, imageability, image agreement, objective and subjective visual complexity, word frequency, word length in syllables and letters, and name agreement. Furthermore, multiple regression analyses revealed that the significant predictors of photo-naming latencies were name agreement, word frequency, imageability, and image agreement. The naming latencies, norms, and stimuli are provided as supplemental materials. PMID:26122979
"In 1850 and 1860 the Netherlands ranked eighth among twelve North-Western European nations that contributed to the transatlantic migration. The Dutch emigration pattern reflecting the agrarian crisis of the 1840's resembled the one of Hanover and Westphalia, be it that like in Scandinavia the ecclesiastical situation played a more important part. Besides the motivating forces, conditions such as information, organization, public and official reactions, and transportation are reviewed." (SUMMARY IN ENG) PMID:12311282
van Nijnatten, C H
A few years ago, the Dutch government asked for advice about the legal consequences of various living arrangements. One of the main issues concerned the legal consequences thereof for children. In a letter to parliament, the Dutch cabinet confirmed that couples of the same sex would be excluded from being awarded children for adoption. Legal and psychological reasons play an important role in the reasoning of the Dutch government. The harmonious development of children is supposed to be at risk when the child is reared by two adults of the same sex. This article sets out psychological theories and the results of recent research which contradict the argumentation presented in a number of recent reports published by the government. The outcome of most research is that gay and lesbian parents 'perform' as well as heterosexual parents. Excluding lesbian and gay parents from taking responsibility for children seems to be a poor policy which does not take into account the social capacities of the population. PMID:8868496
van Es, J C
During the years 1992-2000, there was a cooperative programme between the Romanian general practitioners' association (Societatea Nationala de Medicina Generala) in Romania and the Dutch Foundation for the Advancement of Quality in Healthcare in Romania. A succession of programmes were developed and carried out, which were financed by the Dutch government. The purpose of the cooperative programme was to support the development of Romanian general practice in terms of quality and structure. In the first programme, financed by the Dutch Ministry of Health, Welfare and Sport, about 200 Romanian general practitioners received continuing education. This was followed by a social transformation programme (MATRA) that had two parts: (a) the general practitioners association was supported and advised with respect to improving its organisational efficiency and (b) about 50 carefully selected Romanian general practitioners were trained, in post-academic research, management or teaching. The Romanian authorities accredited these trainees as teachers. The co-operation is being continued in 2001 with the setting up of a sentinel station programme in which 100 Romanian general practitioners collect relevant, representative data on health, illness and practice. PMID:11715598
Meeusen, Vera; Hoekman, Jaap; van Zundert, André
In The Netherlands, hospital care production pressure recently increased substantially, while the number of nurse anesthetists available did not match this rise. The longtime existing norm of no night shifts for nurses beyond the age of 55 years was increased to age 57 to meet the demand for more nurse anesthetists. In this pilot study, we aimed to determine the level of fatigue and its correlation with demographic items among this category of employees. A validated questionnaire was distributed to all Dutch nurse anesthetists above 50 years of age working in Dutch hospitals, which asked for their level of fatigue. The Checklist Individual Strength Questionnaire was used to measure fatigue. Overall, 105 of 115 potential participants completed the questionnaire (response rate, 91%). The mean scores (+/- standard deviation) were as follows: total fatigue, 81.3 +/- 8.3; subjective fatigue, 31.4 +/- 3.2; physical activity, 13.1 +/- 2.2; motivation, 16.8 +/- 2.6; and concentration, 20.0 +/- 3.8. No correlation could be demonstrated between demographic characteristics and fatigue. Dutch nurse anesthetists above the age of 50 years show a high fatigue score and therefore need special attention to prevent them from harmful physical and psychological effects and to sustain maximal patient safety. PMID:25109162
Dimitrova, Diana V.; Stowe, Laurie A.; Hoeks, John C. J.
Current research on spoken language does not provide a consistent picture as to whether prosody, the melody and rhythm of speech, conveys a specific meaning. Perception studies show that English listeners assign meaning to prosodic patterns, and, for instance, associate some accents with contrast, whereas Dutch listeners behave more controversially. In two ERP studies we tested how Dutch listeners process words carrying two types of accents, which either provided new information (new information accents) or corrected information (corrective accents), both in single sentences (experiment 1) and after corrective and new information questions (experiment 2). In both experiments corrective accents elicited a sustained positivity as compared to new information accents, which started earlier in context than in single sentences. The positivity was not modulated by the nature of the preceding question, suggesting that the underlying neural mechanism likely reflects the construction of an interpretation to the accented word, either by identifying an alternative in context or by inferring it when no context is present. Our experimental results provide strong evidence for inferential processes related to prosodic contours in Dutch. PMID:25973607
Jeronimus, Bertus F.; Stavrakakis, Nikolaos; Veenstra, René; Oldehinkel, Albertine J.
The literature on relative age position effects is rather inconsistent. In this study we examined intra-classroom age position (or relative age) effects on Dutch adolescents’ school progress and performance (as rated by teachers), physical development, temperamental development (fear and frustration), and depressive symptoms, all adjusted for age at the time of measurement. Data were derived from three waves of Tracking Adolescents' Individuals Lives Survey (TRAILS) of 2230 Dutch adolescents (baseline mean age 11.1, SD = 0.6, 51% girls). Albeit relative age predicted school progress (grade retention ORs = 0.83 for each month, skipped grade OR = 1.47, both p<.001), our key observation is the absence of substantial developmental differences as a result of relative age position in Dutch adolescents with a normative school trajectory, in contrast to most literature. For adolescents who had repeated a grade inverse relative age effects were observed, in terms of physical development and school performance, as well as on depressive symptoms, favoring the relatively young. Cross-cultural differences in relative age effect may be partly explained by the decision threshold for grade retention. PMID:26076384
Fijn, R; de Jong-van den Berg, L T; Brouwers, J R
A survey regarding the management of rational pharmacotherapy was conducted among all Dutch general hospitals in 1998. The response was 99% (n = 120). The presence of a drugs and therapeutics committee and antibiotic policies in Dutch general hospitals appears independent of hospital characteristics. However, formulary agreements and treatment guidelines are less likely to be present in hospitals that employ only 1 pharmacist or those served by community pharmacies. More than half of the hospitals claim to have restrictive formulary agreements. Large hospitals, hospitals in the eastern and southern provinces and those served by hospital pharmacies more often tend to have restrictive agreements compared to small hospitals, hospitals in the northern, central, and western provinces, and those served by community pharmacies. Various methods to impose restriction and ensure formulary compliance are mentioned. It must be noted that hospitals tend to operate rather solely regarding the large number of different formularies. Surprisingly just a small majority of pharmacists evaluates formulary agreements positively as a management tool. Many drawbacks appear to be present. The results of this survey indicate that in the future Dutch hospitals will favour disease management (treatment guidelines) over drug management (formulary agreements) in the management of rational pharmacotherapy and that information technology will be used to influence clinicians' prescribing behaviour. PMID:10380234
Zweegers, J; de Jong, E M G J; Nijsten, T E C; de Bes, J; te Booij, M; Borgonjen, R J; van Cranenburgh, O D; van Deutekom, H; van Everdingen, J J E; de Groot, M; Van Hees, C L M; Hulshuizen, H; Koek, M B G; de Korte, W J A; de Korte, J; Lecluse, L L A; Pasch, M C; Poblete-Gutiérrez, P A; Prens, E P; Seyger, M M B; Thio, H B; Torcque, L A; de Vries, A C Q; van de Kerkhof, P C M; Spuls, Ph I
This document provides a summary of the Dutch S3-guidelines on the treatment of psoriasis. These guidelines were finalized in December 2011 and contain unique chapters on the treatment of psoriasis of the face and flexures, childhood psoriasis as well as the patient's perspective on treatment. They also cover the topical treatment of psoriasis, photo(chemo)therapy, conventional systemic therapy and biological therapy. PMID:24656281
Dahm, Philipp; N'Dow, James; Holmberg, Lars; Hamdy, Freddie
Randomised controlled trials in urology are challenging yet essential for generating high-quality, practice-changing evidence. Future trials should focus on high-priority questions, be conducted by multidisciplinary investigative teams with patient and public stakeholder involvement, and be grounded in successful feasibility studies. PMID:24495465
Topping, K. J.; Miller, D.; Murray, P.; Henderson, S.; Fortuna, C.; Conlin, N.
Background: Large-scale randomised controlled trials (RCT) are relatively rare in education. The present study was an attempt to scale up previous small peer tutoring projects, while investing only modestly in continuing professional development for teachers. Purpose: A two-year RCT of peer tutoring in mathematics was undertaken in one local…
Lynch, Sarah; Styles, Ben; Poet, Helen; White, Richard; Bradshaw, Sally; Rabiasz, Adam
This summary reports the findings from two cluster-randomised trials of Drinkaware's school-based In:tuition life skills and alcohol education intervention: one trial of the programme for 10-11 year olds in primary schools, and another for 12-13 year olds in secondary schools. The trials have been carried out by the National Foundation for…
Background: Donation by individuals of their protected health information (PHI) for evidence-based research potentially benefits all individuals with disease through improved understandings of disease patterns. In the future, a better understanding of how disease features combine into unique patterns of disease will generate new disease classifications, supporting greater specificity in health management techniques. However, without large numbers of people who donate their PHI to disease registries designed for research, it is difficult for researchers to discover the existence of complex patterns or to create more specific evidence-based management techniques. In order to identify new opportunities in disease registry design, an analysis of the current stage of maturity of the newly created U.S. Nationwide Health Information Network (NwHIN) related to large-scale consumer donation of PHI is presented. Methods: Utilizing a use–case analysis methodology, the consumer-centric designs of the policies and technologies created for the NwHIN were examined for the potential to support consumer donations of PHI to research. Results: The NwHIN design has placed the enforcement point for the policy-based release of PHI over the Internet into a specialized gateway accessible to consumer authorization. However, current NwHIN policies leave the final decision regarding release of PHI for research to the health care providers rather than to the consumers themselves. Conclusions: Should disease registries designed for research be established on the NwHIN, consumers might then directly authorize the donation of their PHI to these disease registries. However, under current NwHIN policies, consumer authorization does not guarantee release of PHI by health providers. PMID:21722569
Fazlalizadeh, Reza; Moghadamyeghaneh, Zhobin; Demirjian, Aram N; Imagawa, David K; Foster, Clarence E; Lakey, Jonathan R; Stamos, Michael J; Ichii, Hirohito
AIM: To investigate outcomes and predictors of in-hospital morbidity and mortality after total pancreatectomy (TP) and islet autotransplantation. METHODS: The nationwide inpatient sample (NIS) database was used to identify patients who underwent TP and islet autotransplantation (IAT) between 2002-2012 in the United States. Variables of interest were inherent variables of NIS database which included demographic data (age, sex, and race), comorbidities (such as diabetes mellitus, hypertension, and deficiency anemia), and admission type (elective vs non-elective). The primary endpoints were mortality and postoperative complications according to the ICD-9 diagnosis codes which were reported as the second to 25th diagnosis of patients in the database. Risk adjusted analysis was performed to investigate morbidity predictors. Multivariate regression analysis was used to identify predictors of in-hospital morbidity. RESULTS: We evaluated a total of 923 patients who underwent IAT after pancreatectomy during 2002-2012. Among them, there were 754 patients who had TP + IAT. The most common indication of surgery was chronic pancreatitis (86%) followed by acute pancreatitis (12%). The number of patients undergoing TP + IAT annually significantly increased during the 11 years of study from 53 cases in 2002 to 155 cases in 2012. Overall mortality and morbidity of patients were 0% and 57.8 %, respectively. Post-surgical hypoinsulinemia was reported in 42.3% of patients, indicating that 57.7% of patients were insulin independent during hospitalization. Predictors of in-hospital morbidity were obesity [adjusted odds ratio (AOR): 3.02, P = 0.01], fluid and electrolyte disorders (AOR: 2.71, P < 0.01), alcohol abuse (AOR: 2.63, P < 0.01), and weight loss (AOR: 2.43, P < 0.01). CONCLUSION: TP + IAT is a safe procedure with no mortality, acceptable morbidity, and achieved high rate of early insulin independence. Obesity is the most significant predictor of in-hospital morbidity. PMID
Fan, Ling-Yun; Sun, Yu; Lee, Huey-Jane; Yang, Shu-Chien; Chen, Ta-Fu; Lin, Ker-Neng; Lin, Chung-Chi; Wang, Pei-Ning; Tang, Li-Yu; Chiu, Ming-Jang
Background Evidence of an association between lifestyle and marital status and risk of dementia is limited in Asia. Methods In this nationwide population-based cross-sectional survey, participants were selected by computerized random sampling from all 19 counties in Taiwan. A total of 10432 residents were assessed by a door-to-door in-person survey, among whom 7035 were normal and 929 were diagnosed with dementia using the criteria recommended by National Institute on Aging-Alzheimer’s Association. Premorbid lifestyle habits and demographic data including marital status were compared between normal subjects and participants with dementia. Results After adjustment for age, gender, education, body mass index, smoking, drinking, marital status, sleep habits, exercise, social engagement and co-morbidities including hypertension, diabetes and cerebrovascular diseases, an increased risk for dementia was found in people with widow or widower status (OR 1.42, 95% CI 1.15–1.77) and people who used to take a nap in the afternoon (OR 1.33, 95% CI 1.02–1.72). Decreased risk was found in people with the habit of regular exercise (OR 0.12, 95% CI 0.09–0.16), adequate night sleep (OR 0.55, 95% CI 0.39–0.76) and regular social engagement (OR 0.53, 95% CI 0.36–0.77). Conclusions Our results provide preliminary evidence of possible risk-reduction effects for dementia, including regular exercise even in modest amounts, social engagement and adequate night sleep, whereas people with the widow/widower status or who used to take an afternoon nap might have increased risk of dementia. PMID:26413719
Moriwaka, F; Tashiro, K; Tachibana, S; Yada, K
The nationwide epidemiological survey of syringomyelia was carried out in Japan by sending inquiries to neurologists, child neurologists, neurosurgeons and orthopedic surgeons for the period of 1991 and 1992. A total of 1,243 cases of syringomyelia were ascertained. Among them, 622 were men and 619 women, and the average age of onset was 28 years old. The classification by Barnett et al was used, presenting syringomyelia with Chiari malformation in 684 cases (51.2%), dysraphism in 47 (3.7%), post traumatic syringomyelia in 139 (11%), post-spinal arachnoiditis in 76 (6%), spinal cord tumor in 132 (10.5%) and others in 204. Its predominant clinical course was slowly progressive, but 202 cases (17.9%) showed rather stable course including spontaneous resolution in 29 cases. The main initial symptoms were numbness in 522 cases (42%), motor disturbance in 504 (40.5%), and pain in 296 (23.8%). Neurologic signs noted in the abnormality of deep tendon reflexes in 836 cases (67.3%), motor disturbance in 763 (60.4%) and positive pathological reflexes in 383 (30.1%). Sensory disturbance was found in 942 cases (75.8%) and the dissociated type were 559 out of them (59.3%). It is noteworthy that 982 out of 1,243 were documented by MRI and surgical operations such as foramen magnum decompression, syringo-subarachnoid shunt and others were performed in 829 cases. Syringobulbia was confirmed on MRI in 101 cases of syringomyelia in which spinal cord tumors were most frequently associated. PMID:8752408
Wu, Tung-Pi; Liang, Fu-Wen; Huang, Ya-Li; Chen, Lea-Hua; Lu, Tsung-Hsueh
Background To examine the changes in the maternal mortality ratio (MMR) and causes of maternal death in Taiwan based on nationwide linked data sets. Methods We linked four population-based data sets (birth registration, birth notification, National Health Insurance inpatient claims, and cause of death mortality data) to identify maternal deaths for 2004–2011. Subsequently, we calculated the MMR (deaths per 100,000 live births) and the proportion of direct and indirect causes of maternal death by maternal age and year. Findings Based on the linked data sets, we identified 236 maternal death cases, of which only 102 were reported in officially published mortality data, with an underreporting rate of 57% [(236−102) × 100 / 236]. The age-adjusted MMR was 18.4 in 2004–2005 and decreased to 12.5 in 2008–2009; however, the MMR leveled off at 12.6 in 2010–2011. The MMR increased from 5.2 in 2008–2009 to 7.1 in 2010–2011 for patients aged 15–29 years. Women aged 15–29 years had relatively lower proportion in dying from direct causes (amniotic fluid embolism and obstetric hemorrhage) compared with their counterpart older women. Conclusions Approximately two-thirds of maternal deaths were not reported in officially published mortality data. Routine surveillance of maternal mortality by using enhanced methods is necessary to monitor the health status of reproductive-age women. Furthermore, a comprehensive maternal death review is necessary to explore the preventability of these maternal deaths. PMID:26237411
Kendall, Lindsay; Bashorun, Adedapo; Linda, Christopher; Omoleke, Semeeh; Jeffries, David; Maane, Rahmatulai; Alorse, Beatrice Dei; Alorse, William Dei; Okoi, Catherine Bi; Mlaga, Kodjovi D; Kinteh, Ma Ansu; Donkor, Simon; de Jong, Bouke C; Antonio, Martin; d’Alessandro, Umberto
Abstract Objective To estimate the population prevalence of active pulmonary tuberculosis in Gambia. Methods Between December 2011 and January 2013, people aged ≥ 15 years participating in a nationwide, multistage cluster survey were screened for active pulmonary tuberculosis with chest radiography and for tuberculosis symptoms. For diagnostic confirmation, sputum samples were collected from those whose screening were positive and subjected to fluorescence microscopy and liquid tuberculosis cultures. Multiple imputation and inverse probability weighting were used to estimate tuberculosis prevalence. Findings Of 100 678 people enumerated, 55 832 were eligible to participate and 43 100 (77.2%) of those participated. A majority of participants (42 942; 99.6%) were successfully screened for symptoms and by chest X-ray. Only 5948 (13.8%) were eligible for sputum examination, yielding 43 bacteriologically confirmed, 28 definite smear-positive and six probable smear-positive tuberculosis cases. Chest X-ray identified more tuberculosis cases (58/69) than did symptoms alone (43/71). The estimated prevalence of smear-positive and bacteriologically confirmed pulmonary tuberculosis were 90 (95% confidence interval, CI: 53–127) and 212 (95% CI: 152–272) per 100 000 population, respectively. Tuberculosis prevalence was higher in males (333; 95% CI: 233–433) and in the 35–54 year age group (355; 95% CI: 219–490). Conclusion The burden of tuberculosis remains high in Gambia but lower than earlier estimates of 490 per 100 000 population in 2010. Less than half of all cases would have been identified based on smear microscopy results alone. Successful control efforts will require interventions targeting men, increased access to radiography and more accurate, rapid diagnostic tests. PMID:27274595
Barbara, Giovanni; Cremon, Cesare; Annese, Vito; Basilisco, Guido; Bazzoli, Franco; Bellini, Massimo; Benedetti, Antonio; Benini, Luigi; Bossa, Fabrizio; Buldrini, Paola; Cicala, Michele; Cuomo, Rosario; Germanà, Bastianello; Molteni, Paola; Neri, Matteo; Rodi, Marcello; Saggioro, Alfredo; Scribano, Maria Lia; Vecchi, Maurizio; Zoli, Giorgio; Corinaldesi, Roberto; Stanghellini, Vincenzo
Objective Low-grade intestinal inflammation plays a role in the pathophysiology of IBS. In this trial, we aimed at evaluating the efficacy and safety of mesalazine in patients with IBS. Design We conducted a phase 3, multicentre, tertiary setting, randomised, double-blind, placebo-controlled trial in patients with Rome III confirmed IBS. Patients were randomly assigned to either mesalazine, 800 mg, or placebo, three times daily for 12 weeks, and were followed for additional 12 weeks. The primary efficacy endpoint was satisfactory relief of abdominal pain/discomfort for at least half of the weeks of the treatment period. The key secondary endpoint was satisfactory relief of overall IBS symptoms. Supportive analyses were also performed classifying as responders patients with a percentage of affirmative answers of at least 75% or >75% of time. Results A total of 185 patients with IBS were enrolled from 21 centres. For the primary endpoint, the responder patients were 68.6% in the mesalazine group versus 67.4% in the placebo group (p=0.870; 95% CI −12.8 to 15.1). In explorative analyses, with the 75% rule or >75% rule, the percentage of responders was greater in the mesalazine group with a difference over placebo of 11.6% (p=0.115; 95% CI −2.7% to 26.0%) and 5.9% (p=0.404; 95% CI −7.8% to 19.4%), respectively, although these differences were not significant. For the key secondary endpoint, overall symptoms improved in the mesalazine group and reached a significant difference of 15.1% versus placebo (p=0.032; 95% CI 1.5% to 28.7%) with the >75% rule. Conclusions Mesalazine treatment was not superior than placebo on the study primary endpoint. However, a subgroup of patients with IBS showed a sustained therapy response and benefits from a mesalazine therapy. Trial registration number ClincialTrials.gov number, NCT00626288. PMID:25533646
Aaronson, N K; Muller, M; Cohen, P D; Essink-Bot, M L; Fekkes, M; Sanderman, R; Sprangers, M A; te Velde, A; Verrips, E
The primary objectives of this research were to translate, validate, and generate normative data on the SF-36 Health Survey for use among Dutch-speaking residents of the Netherlands. Translation of the SF-36 into Dutch followed the stepwise, iterative procedures developed by the IQOLA Project. Following extensive pilot testing, the SF-36 was administered to: (1) a random sample of adult residents of Amsterdam (n = 4172); (2) a random, nationwide sample of adults (n = 1742); (3) a sample of migraine sufferers (n = 423); and (4) a sample of cancer patients undergoing active anti-neoplastic treatment (n = 485). Data quality across the four studies was consistently high. The rates of missing data ranged from 1% to 5% at the item level, and from 1.2% to 2.6% at the scale level. Multitrait scaling analysis confirmed the hypothesized scale structure of the SF-36 and associated scale scoring in all four samples. Cronbach's alpha coefficients surpassed the 0.70 criterion for group comparisons in all but one case (the Social Functioning scale in the cancer sample), with a mean alpha coefficient across all scales and samples of 0.84. Known-group comparisons yielded consistent support for the validity of the SF-36. In the two community samples, statistically significant differences in SF-36 mean scale scores were observed as a function of age, gender, and the prevalence of chronic health conditions. In the migraine and cancer samples, mean SF-36 scale scores varied significantly as a function of various indicators of disease severity. The SF-36 profiles for the two community samples were highly similar. The cancer sample yielded the lowest SF-36 scores, with the migraine sample holding an intermediate position. On-going studies will generate data on the responsiveness of the SF-36 to within-group changes in health over time. Efforts are underway to translate and validate the questionnaire for use among ethnic minority groups in the Netherlands. PMID:9817123
Kempen, Bas; Brus, Dick J.; de Vries, Folkert
map with the three soil orders were validated with independent probability sample data. The overall purity of the soil order map was 66% for both mapping areas. For mapping area 1 this was a 12% purity improvement compared to the current 1:50,000 map, for mapping area 2 this was 3%. For area 1, the mean absolute error of the predicted peat thickness was 23.5 cm, and the R2 was 0.50. For area 2 these accuracy measures were 30.9 cm and 0.65. We conclude that nationwide updating the 1:50,000 map with pedometric techniques is feasible. In order to increase the value and usability of the legacy point data as well as the large set of newly acquired field observations and the updated 1:50,000 map, we recommend installation of a soil monitoring network in the Dutch peatlands.
Houben, Carmen H M; Spruit, Martijn A; Wouters, Emiel F M; Janssen, Daisy J A
Introduction Recent research shows that advance care planning (ACP) for patients with chronic obstructive pulmonary disease (COPD) is uncommon and poorly carried out. The aim of the present study was to explore whether and to what extent structured ACP by a trained nurse, in collaboration with the chest physician, can improve outcomes in Dutch patients with COPD and their family. Methods and analysis A multicentre cluster randomised controlled trial in patients with COPD who are recently discharged after an exacerbation has been designed. Patients will be recruited from three Dutch hospitals and will be assigned to an intervention or control group, depending on the randomisation of their chest physician. Patients will be assessed at baseline and after 6 and 12 months. The intervention group will receive a structured ACP session by a trained nurse. The primary outcomes are quality of communication about end-of-life care, symptoms of anxiety and depression, quality of end-of-life care and quality of dying. Secondary outcomes include concordance between patient's preferences for end-of-life care and received end-of-life care, and psychological distress in bereaved family members of deceased patients. Intervention and control groups will be compared using univariate analyses and clustered regression analysis. Ethics and dissemination Ethical approval was received from the Medical Ethical Committee of the Catharina Hospital Eindhoven, the Netherlands (NL42437.060.12). The current project provides recommendations for guidelines on palliative care in COPD and supports implementation of ACP in the regular clinical care. Clinical trial registration number NTR3940. PMID:24384905
Sampimon, Otlis; Barkema, Herman W; Berends, Inge; Sol, Jan; Lam, Theo
A survey was carried out in 2003 in 49 dairy herds to determine the overall and pathogen-specific prevalence of intramammary infection (IMI) in Dutch dairy herds, and to compare the distribution with four studies performed from 1973 to 1985 in The Netherlands. Herds were randomly selected stratified over the 12 Dutch provinces, had at least 40 lactating cows and participated in the Dutch milk recording system. Quarter milk samples were collected from all 408 cows with a somatic cell count (SCC) >or=250,000 cells/ml and 145 heifers with SCC >or=150,000 cells/ml at the last milk test before the farm visit. Additionally, samples were collected from 519 (approximately 25%) of the remaining low-SCC cows and heifers with a SCC at the last milk test before the farm visit of <250 000 and <150 000 cells/ml, respectively. Bacterial growth occurred in 37.3% of milk samples of high-SCC cows and in 21.1% of low-SCC cows. Coagulase-negative staphylococci (CNS) were the most frequently isolated group of bacteria (10.8% of quarters) and were found in all herds. Prevalence of Staphylococcus aureus IMI was lower in 2003 than in 1973, respectively 1.8% and 6.2% of quarters. Prevalence of Streptococcus uberis and Str. dysgalactiae IMI was almost the same in the five samplings during the 30-year period, at 1.1-1.7 and 0.9-1.5%, respectively. Str. agalactiae was not found in this study. Prevalence of CNS IMI was higher in lactating heifers, while prevalence of Str. uberis, Str. dysgalactiae and penicillin-resistant Staph. aureus IMI was higher in older cows. Because distribution of pathogens changes over time, herd-level samples for bacteriological culturing must be taken regularly to monitor udder health. Additionally, national mastitis prevalence studies give important information through monitoring the national udder health status. PMID:19121233
Vucic, Strahinja; de Vries, Esther; Eilers, Paul H C; Willemsen, Sten P; Kuijpers, Mette A R; Prahl-Andersen, Birte; Jaddoe, Vincent W V; Hofman, Albert; Wolvius, Eppo B; Ongkosuwito, Edwin M
Many studies have established dental age standards for different populations; however, very few studies have investigated whether dental development is stable over time on a population level. Therefore, the aim of this study was to analyze changes in dental maturity in Dutch children born between 1961 and 2004. We used 2,655 dental panoramic radiographs of 2- to 16-year-old Dutch children from studies performed in three major cities in the Netherlands. Based on a trend in children born between 1961 and 1994, we predicted that a child of a certain age and gender born in 1963 achieved the same dental maturity on average, 1.5 years later than a child of the same age born 40 years later. After adjusting for the birth year of a child in the analysis, the regression coefficient of the city variable was reduced by 56.6% and it remained statistically significant. The observed trend from 1961 to 1994 was extrapolated to 9- to 10-year-old children born in 2002-2004, and validation with the other samples of children with the same characteristics showed that 95.9%-96.8% of the children had dental maturity within the 95% of the predicted range. Dental maturity score was significantly and positively associated with the year of birth, gender, and age in Dutch children, indicating a trend in earlier dental development during the observation period, 1961-2004. These findings highlight the necessity of taking the year of birth into account when assessing dental development within a population with a wider time span. PMID:24912457
van der Grinten, T E; Kasdorp, J P
In the light of experience that choices in health care appear to be not so much hindered by a lack of insight into how choices should be made in theory, as uncertainty as to how choices could be made in practice, this paper sets out to deepen our insight into the dynamics of health care policy making within the concrete socio-economic and political context. The paper examines how Dutch policy-makers have dealt with the priority issue in health care over the past 10 years by means of a gradual incremental approach. In this approach, use is made of a mix of strategies and shared responsibilities, with an important role for the actors at the meso and the micro levels; while at the same time, the government has not abandoned the tried and trusted policy of national rationing (i.e. keeping the production capacity limited and setting a ceiling on production in order to resist the pressure on the public system of Dutch health care). Looking at the declining percentage of Gross National Product assigned to health care annually, the broad accessibility and the good overall quality of Dutch health care, it may be concluded that the issue of choice has not come off badly under this mixed approach. The degree to which the system can respond adequately to likely developments, such as a recession, worsening waiting lists, further liberalisation (i.e. the application of market forces in health care) and, by way of extension, the ongoing integration of 'Europe' is questioned. PMID:10827303
Larsen, Helle; Kong, Grace; Becker, Daniela; Cousijn, Janna; Boendermaker, Wouter; Cavallo, Dana; Krishnan-Sarin, Suchitra; Wiers, Reinout
Introduction: Research demonstrates that cognitive biases toward drug-related stimuli are correlated with substance use. This study aimed to investigate differences in cognitive biases (i.e., approach bias, attentional bias, and memory associations) between smoking and non-smoking adolescents in the US and the Netherlands. Within the group of smokers, we examined the relative predictive value of the cognitive biases and impulsivity related constructs (including inhibition skills, working memory, and risk taking) on daily smoking and nicotine dependence. Method: A total of 125 American and Dutch adolescent smokers (n = 67) and non-smokers (n = 58) between 13 and 18 years old participated. Participants completed the smoking approach–avoidance task, the classical and emotional Stroop task, brief implicit associations task, balloon analog risk task, the self-ordering pointing task, and a questionnaire assessing level of nicotine dependence and smoking behavior. Results: The analytical sample consisted of 56 Dutch adolescents (27 smokers and 29 non-smokers) and 37 American adolescents (19 smokers and 18 non-smokers). No differences in cognitive biases between smokers and non-smokers were found. Generally, Dutch adolescents demonstrated an avoidance bias toward both smoking and neutral stimuli whereas the American adolescents did not demonstrate a bias. Within the group of smokers, regression analyses showed that stronger attentional bias and weaker inhibition skills predicted greater nicotine dependence while weak working memory predicted more daily cigarette use. Conclusion: Attentional bias, inhibition skills, and working memory might be important factors explaining smoking in adolescence. Cultural differences in approach–avoidance bias should be considered in future research. PMID:24904435
Background: Neuroblastoma (NB) is one of the most malignant neoplasms in childhood. In Japan, while a nationwide screening program at six months of age was introduced in 1985, its efficacy has not been systematically evaluated before or after its introduction. The screening test was changed from a qualitative method to a quantitative method (i.e., high performance liquid chromatography, HPLC) with higher test precision around 1990. However, the Japanese government stopped the program in 2003, after reports which did not show a reduction in mortality from NB. To evaluate the effectiveness of the program, a systematic large-scale epidemiological study was conducted. Methods: A retrospective cohort study was carried out to evaluate the effectiveness of the NB screening with HPLC test at 6 months of age in Japan, in comparing mortality and incidence of NB after 6 months of age between screened children and concurrent non-screened children in the same area. The study cohort was defined retrospectively as those children who were born after the introduction of HPLC test, from its earliest introduction of January 1984 to December 31, 1997, in twenty-five prefectures of Japan, which cover approximately half of the newborn population of Japan. Results: The study cohort consisted of 4.31 million. We identified 66 NB deaths in the study cohort for the analysis after 6 months. Kaplan-Meier estimate of cumulative mortality of NB per million children at 6 years was 15.33 for the screened group and 32.63 for the non-screened group, respectively. The difference of hazard between the two groups was statistically significant. The age specific mortality rate ratio of NB (95% confidence interval (CI)) was statistically lower at 1 - 3 years [0.415 (0.212 - 0.810)]. The rate ratio of NB incidence (95% CI) at the early stage (i.e., 1, 2 and 4S) between them was statistically higher at 6 months - 1 year [9.56 (4.76 - 19.23)]. That of NB incidence at the advanced stage (i.e., 3 and 4) was
Långström, Niklas; Babchishin, Kelly M; Fazel, Seena; Lichtenstein, Paul; Frisell, Thomas
Background: Sexual crime is an important public health concern. The possible causes of sexual aggression, however, remain uncertain. Methods: We examined familial aggregation and the contribution of genetic and environmental factors to sexual crime by linking longitudinal, nationwide Swedish crime and multigenerational family registers. We included all men convicted of any sexual offence (N = 21 566), specifically rape of an adult (N = 6131) and child molestation (N = 4465), from 1973 to 2009. Sexual crime rates among fathers and brothers of sexual offenders were compared with corresponding rates in fathers and brothers of age-matched population control men without sexual crime convictions. We also modelled the relative influence of genetic and environmental factors to the liability of sexual offending. Results: We found strong familial aggregation of sexual crime [odds ratio (OR) = 5.1, 95% confidence interval (CI) = 4.5–5.9] among full brothers of convicted sexual offenders. Familial aggregation was lower in father-son dyads (OR = 3.7, 95% CI = 3.2–4.4) among paternal half-brothers (OR = 2.1, 95% CI = 1.5–2.9) and maternal half-brothers (OR = 1.7, 95% CI = 1.2–2.4). Statistical modelling of the strength and patterns of familial aggregation suggested that genetic factors (40%) and non-shared environmental factors (58%) explained the liability to offend sexually more than shared environmental influences (2%). Further, genetic effects tended to be weaker for rape of an adult (19%) than for child molestation (46%). Conclusions: We report strong evidence of familial clustering of sexual offending, primarily accounted for by genes rather than shared environmental influences. Future research should possibly test the effectiveness of selective prevention efforts for male first-degree relatives of sexually aggressive individuals, and consider familial risk in sexual violence risk assessment. PMID:25855722
Horváth, Anna; Páll, Nóra; Molnár, Katalin; Kováts, Tamás; Surján, György; Vicsek, Tamás; Pollner, Péter
Objective Relapsing polychondritis (RP) is a rare autoimmune inflammatory disease that attacks mainly cartilaginous structures or causes serious damage in proteoglycan-rich structures (the eyes, heart, blood vessels, inner ear). This study shows results regarding the epidemiology, progression, and associations of this highly variable disease by collecting all cases from a 124-million-person-year Central European nationwide cohort. Methods We used the Hungarian Health Care Database to identify all persons with possible RP infection. We followed patients who had International Classification of Diseases 10th edition code M94.1 at least once in their inpatient or outpatient records between January 1, 2002 and December 31, 2013 in Hungary. We classified these patients into disease severity groups by their drug consumption patterns between January 1, 2010 and December 31, 2013. We analyzed the regional distribution of RP incidences as well. Overall maps of comorbidity are presented with network layouts. Results We identified 256 patients with RP among cumulatively 11.5 million registered inhabitants. We classified these patients into four severity classes as “extremely mild” (n=144), “mild” (n=22), “moderate” (n=41), and “severe” (n=4). Two additional groups were defined for patients without available drug data as “suspected only” (n=23) and “confirmed but unknown treatment” (n=22). The age and sex distributions of patients were similar to worldwide statistics. Indeed, the overall survival was good (95% confidence interval for 5 years was 83.6%–92.9% and for 10 years was 75.0%–88.3% which corresponds to the overall survival of the general population in Hungary), and the associations with other autoimmune disorders were high (56%) in Hungary. Almost any disease can occur with RP; however, the symptoms of chromosomal abnormalities are only incidental. Spondylosis can be a sign of the activation of RP, while Sjögren syndrome is the most frequent
Mendsaikhan, Naranpurev; Begzjav, Tsolmon; Lundeg, Ganbold; Brunauer, Andreas; Dünser, Martin W.
In Mongolia, a Central Asian lower-middle income country, intensive care medicine is an under-resourced and–developed medical specialty. The burden of critical illness and capacity of intensive care unit (ICU) services in the country is unknown. In this nationwide census, we collected data on adult and pediatric/neonatal ICU capacities and the number of ICU admissions in 2014. All hospitals registered to run an ICU service in Mongolia were surveyed. Data on the availability of an adult and/or pediatric/neonatal ICU service, the number of available ICU beds, the number of available functional mechanical ventilators, the number of patients admitted to the ICU, and the number of patients admitted to the study hospital were collected. In total, 70 ICUs with 349 ICU beds were counted in Mongolia (11.7 ICU beds/100,000 inhabitants; 1.7 ICU beds/100 hospital beds). Of these, 241 (69%) were adult and 108 (31%) pediatric/neonatal ICU beds. Functional mechanical ventilators were available for approximately half of the ICU beds (5.1 mechanical ventilators/100,000 inhabitants). While all provincial hospitals ran a pediatric/neonatal ICU, only dedicated pediatric hospitals in Ulaanbaatar did so. The number of adult and pediatric/neonatal ICU admissions varied between provinces. The number of adult ICU beds and adult ICU admissions per 100,000 inhabitants correlated (r = 0.5; p = 0.02), while the number of pediatric/neonatal ICU beds and pediatric/neonatal ICU admissions per 100,000 inhabitants did not (r = 0.25; p = 0.26). In conclusion, with 11.7 ICU beds per 100,000 inhabitants the ICU capacity in Mongolia is higher than in other low- and lower-middle-income countries. Substantial heterogeneities in the standardized ICU capacity and ICU admissions exist between Mongolian provinces. Functional mechanical ventilators are available for only half of the ICU beds. Pediatric/neonatal ICU beds make up one third of the national ICU capacity and appear to meet or even exceed the
Moscoso del Prado Martin, Fermin; Deutsch, Avital; Frost, Ram; Schreuder, Robert; De Jong, Nivja H.; Baayen, R. Harald
This study uses the morphological family size effect as a tool for exploring the degree of isomorphism in the networks of morphologically related words in the Hebrew and Dutch mental lexicon. Hebrew and Dutch are genetically unrelated, and they structure their morphologically complex words in very different ways. Two visual lexical decision…
Freudenthal, Daniel; Pine, Julian M.; Aguado-Orea, Javier; Gobet, Fernand
In this study, we apply MOSAIC (model of syntax acquisition in children) to the simulation of the developmental patterning of children's optional infinitive (OI) errors in 4 languages: English, Dutch, German, and Spanish. MOSAIC, which has already simulated this phenomenon in Dutch and English, now implements a learning mechanism that better…
Freudenthal, Daniel; Pine, Julian M.; Gobet, Fernand
In this study we use a computational model of language learning called model of syntax acquisition in children (MOSAIC) to investigate the extent to which the optional infinitive (OI) phenomenon in Dutch and English can be explained in terms of a resource-limited distributional analysis of Dutch and English child-directed speech. The results show…
This article focuses on the meaning of nonfinite clauses ("root infinitives") in Dutch and English child language. I present experimental and naturalistic data confirming the claim that Dutch root infinitives are more often modal than English root infinitives. This cross-linguistic difference is significantly smaller than previously assumed,…
Blom, Elma; Vasic, Nada; de Jong, Jan
Purpose: In this study, the authors investigated whether errors with subject-verb agreement in monolingual Dutch children with specific language impairment (SLI) are influenced by verb phonology. In addition, the productive and receptive abilities of Dutch acquiring children with SLI regarding agreement inflection were compared. Method: An SLI…
Beersmans, Frans; Sudhoelter, Juergen
An interim report on preparations for designing an examination in Dutch. The "unit-credit system" proposed by the Council of Europe is being used. The Dutch certificate will be comparable to the certificates given by the British Council and by the People's Universities. Sample portions are given. (Text is in German.) (IFS/WGA)
De Clerck, Bernard; Colleman, Timothy
In this paper a case of synchronic layering is examined in which Dutch "massa" ("mass") and plural "massa's" ("masses") are attested with lexical uses as a collective noun, quantifying uses ("a large quantity of") and intensifying uses ("very")--with plural "massa's" only--in some Flemish varieties of Dutch. Against the background of…
Delarue, Steven; De Caluwe, Johan
Flanders, the northern, Dutch-speaking part of Belgium, is experiencing growing intra- and interlingual diversity. On the intralingual level, Tussentaal ("in-between-language") has emerged as a cluster of intermediate varieties between the Flemish dialects and Standard Dutch, gradually becoming "the" colloquial language. At the…
Blom, Elma; Polisenska, Daniela; Weerman, Fred
A comparison of the error profiles of monolingual (child L1) learners of Dutch, Moroccan children (child L2) and Moroccan adults (adult L2) learning Dutch as their L2 shows that participants in all groups massively overgeneralize [-neuter] articles to [+neuter] contexts. In all groups, the reverse gender mistake infrequently occurs. Gender…
Despite a public discourse on tolerance, anxiety about immigrants, Islam and the preservation of Dutch values has amplified fear of Muslim youth in the Netherlands. In this context, Dutch-born Muslim youth endure social and systemic discrimination that affects all aspects of their futures, including available educational opportunities and…
van den Berg, Marguerite; van Reekum, Rogier
Parent involvement policies have been central in the Dutch push towards educational governance. How the implementation of these policies plays out on the ground is context-dependent. The ethnic and class cleavages impacting the Dutch educational system should be taken into account. On the basis of 50 in-depth interviews with teachers, social…
van Gent, Robert H.
This paper discusses the observations of the 1761 and 1769 transits of Venus by the Dutch-German clergyman Johan Maurits Mohr (1716-1775) from Batavia (Dutch East Indies). We will investigate how Mohr became interested in observing this phenomenon and how he made the necessary preparations. Finally, the fate of his observatory and his instruments will be discussed.
Evenhuis, Heleen M.; Penning, Corine
Training in scientific research methods and skills is a vital part of Dutch specialist training in intellectual disability medicine. The authors evaluated results of such training at one Dutch university medical facility that had an obligatory research program involving projects conducted by the physicians-in-training (topics, teamwork, acquired…
..., English Kills and their tributaries. 117.801 Section 117.801 Navigation and Navigable Waters COAST GUARD....801 Newtown Creek, Dutch Kills, English Kills and their tributaries. (a) The following requirements apply to all bridges across Newtown Creek, Dutch Kills, English Kills, and their tributaries: (1)...
..., English Kills and their tributaries. 117.801 Section 117.801 Navigation and Navigable Waters COAST GUARD....801 Newtown Creek, Dutch Kills, English Kills and their tributaries. (a) The following requirements apply to all bridges across Newtown Creek, Dutch Kills, English Kills, and their tributaries: (1)...
..., English Kills and their tributaries. 117.801 Section 117.801 Navigation and Navigable Waters COAST GUARD....801 Newtown Creek, Dutch Kills, English Kills and their tributaries. (a) The following requirements apply to all bridges across Newtown Creek, Dutch Kills, English Kills, and their tributaries: (1)...
Verhagen, Josje; Blom, Elma
Across languages, children do not comprehend 3SG/3PL subject-verb agreement before age five, despite early mastery in spontaneous speech. This study investigates subject-verb agreement in a language hitherto not studied in this respect, namely Dutch. The authors examine if (1) Dutch two- and three-year-olds comprehend subject-verb agreement and…
Janssen, Marije; Bosman, Anna M. T.; Leseman, Paul P. M.
The aim of this study was to investigate whether bilingually raised children in the Netherlands, who receive literacy instruction in their second language only, show an advantage on Dutch phoneme-awareness tasks compared with monolingual Dutch-speaking children. Language performance of a group of 47 immigrant first-grade children with various…
Wiefferink, C. H.; Spaai, G. W. G.; Uilenburg, N.; Vermeij, B. A. M.; De Raeve, L.
In the present study, language development of Dutch children with a cochlear implant (CI) in a bilingual educational setting and Flemish children with a CI in a dominantly monolingual educational setting is compared. In addition, we compared the development of spoken language with the development of sign language in Dutch children. Eighteen…