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  1. Children referred for specialist care: a nationwide study in Dutch general practice.

    PubMed Central

    van Suijlekom-Smit, L W; Bruijnzeels, M A; van der Wouden, J C; van der Velden, J; Visser, H K; Dokter, H J

    1997-01-01

    BACKGROUND: Insight into referral patterns provides general practitioners (GPs) and specialists with a frame of reference for their own work and enables assessment of the need for secondary care. Only approximate information is available. AIM: To determine how often, to which specialties and for what conditions children in different age groups are referred, as well as how often a condition is referred given the incidence in general practice. METHOD: From data of the Dutch National Survey of Morbidity and Interventions in General Practice, 63,753 new referrals (acute and non-acute) were analysed for children (0-14 years) from 103 participating practices (161 GPs) who registered. Practices were divided into four groups. Each group of practices participated for three consecutive months covering a whole year altogether. We calculated referral rates per 1000 children per year and referability rates per 100 episodes, which quantifies the a priori chance of a condition being referred for specialist care. RESULTS: The referral rate varied by age from 231 for children under 1 year old to 119 for those aged 10-14 years (mean 159). The specialties mainly involved were ENT, paediatrics, surgery, ophthalmology, dermatology and orthopaedics. Referrals in the first year of life were most frequently to paediatricians (123); among older children the referral rate to paediatricians decreased (mean 36). Referrals to ENT specialists were seen particularly in the age groups 1-4 (71) and 5-9 (53). For surgery, the referral rate increased by age from 19 to 34. Differences between boys and girls were small, except for surgery. The highest referral rates were for problems in the International Classification of Primary Care (ICPC) chapters: respiratory (28); musculoskeletal (25); ear (24) and eye (21). Referability rates were, in general, low for conditions referred to paediatrics and dermatology and high for surgery and ophthalmology. The variation in problems presented to each specialty

  2. The use of individual and societal risk criteria within the Dutch flood safety policy--nationwide estimates of societal risk and policy applications.

    PubMed

    Jonkman, Sebastiaan N; Jongejan, Ruben; Maaskant, Bob

    2011-02-01

    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.

  3. The design of the Dutch EASYcare study: a randomised controlled trial on the effectiveness of a problem-based community intervention model for frail elderly people [NCT00105378

    PubMed Central

    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

    2005-01-01

    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

  4. Randomised, prospective, medico-economic nationwide French study of islet transplantation in patients with severely unstable type 1 diabetes: the STABILOT study protocol

    PubMed Central

    David-Tchouda, Sandra; Margier, Jennifer; Schir, Edith; Wojtusciszyn, Anne; Borot, Sophie; Kessler, Laurence; Morelon, Emmanuel; Thivolet, Charles; Pattou, François; Vantyghem, Marie Christine; Berney, Thierry; Benhamou, Pierre-Yves

    2017-01-01

    Introduction Islet transplantation may be an appropriate treatment option for patients with severely unstable type 1 diabetes experiencing major glucose variability with severe hypoglycaemia despite intensive insulin therapy. Few data are available on the costs associated with islet transplantation in relation to its benefits. The STABILOT study proposes to assess the economic impact of islet transplantation in comparison with the current best medical treatment defined as sensor-augmented pump (SAP) therapy. Methods The trial will adopt an open-label, randomised, multicentred design. The study will include 30 patients with severely unstable type 1 diabetes. Eligible participants will be 18–65 years old, with type 1 diabetes duration >5 years, a negative basal or stimulated C-peptide, and severe instability defined by persistent, recurrent and disabling severe hypoglycaemia, despite optimised medical treatment. Participants will be randomised into two groups: one group with immediate registration for islet transplantation, and one group with delayed registration for 1 year while patients receive SAP therapy. The primary endpoint will be the incremental cost-utility ratio at 1 year between islet transplantation and SAP therapy. Perspectives of both the French Health Insurance System and the hospitals will be retained. Ethics and dissemination Ethical approval has been obtained at all sites. The trial has been approved by ClinicalTrials.gov (Trial registration ID NCT02854696). All participants will sign a free and informed consent form before randomisation. Results of the study will be communicated during national and international meetings in the field of diabetes and transplantation. A publication will be sought in journals usually read by physicians involved in diabetes care, transplantation and internal medicine. Trial registration number NCT02854696; Pre-results. PMID:28219959

  5. Effect of increased convective clearance by on-line hemodiafiltration on all cause and cardiovascular mortality in chronic hemodialysis patients – the Dutch CONvective TRAnsport STudy (CONTRAST): rationale and design of a randomised controlled trial [ISRCTN38365125

    PubMed Central

    Penne, E Lars; Blankestijn, Peter J; Bots, Michiel L; van den Dorpel, Marinus A; Grooteman, Muriel P; Nubé, Menso J; van der Tweel, Ingeborg; ter Wee, Piet M

    2005-01-01

    Background The high incidence of cardiovascular disease in patients with end stage renal disease (ESRD) is related to the accumulation of uremic toxins in the middle and large-middle molecular weight range. As online hemodiafiltration (HDF) removes these molecules more effectively than standard hemodialysis (HD), it has been suggested that online HDF improves survival and cardiovascular outcome. Thus far, no conclusive data of HDF on target organ damage and cardiovascular morbidity and mortality are available. Therefore, the CONvective TRAnsport STudy (CONTRAST) has been initiated. Methods CONTRAST is a Dutch multi-center randomised controlled trial. In this trial, approximately 800 chronic hemodialysis patients will be randomised between online HDF and low-flux HD, and followed for three years. The primary endpoint is all cause mortality. The main secondary outcome variables are fatal and non-fatal cardiovascular events. Conclusion The study is designed to provide conclusive evidence whether online HDF leads to a lower mortality and less cardiovascular events as compared to standard HD. PMID:15907201

  6. Drug adherence and multidisciplinary care in patients with multiple sclerosis: Protocol of a prospective, web-based, patient-centred, nation-wide, Dutch cohort study in glatiramer acetate treated patients (CAIR study)

    PubMed Central

    2011-01-01

    -initiated, prospective, web-based, patient-centred, nation-wide cohort study in the Netherlands. The primary objective is to investigate whether GA adherence is associated with specific disciplines of care or quantities of specific care. The secondary objective is to investigate whether GA adherence is associated with specific aspects of the socio-economic situation, health care and caregivers, disease, treatment or patient characteristics. All data are acquired on-line via a study website. All RRMS patients in the Netherlands starting GA treatment are eligible. Patients are informed by neurologists, nurses, and websites from national MS patient organisations. All data, except on disability, are obtained by patient self-reports on pre-defined and random time points. The number of missed doses and the number of patients having discontinued GA treatment at 6 and 12 months are measures of adherence. Per care discipline the number of sessions and the total duration of care are measures of received care. The full spectrum of non-experimental care that is available in the Netherlands is assessed. Care includes 'physical' contacts, contacts by telephone or internet, health-promoting activities and community care activities. Care received over the preceding 14 days is assessed by patients at baseline and every other week thereafter up to month 12. Every 3 months neurologists and nurses record care disciplines to which patients have been referred. The Dutch Adherence Questionnaire-90 (DAQ-90) is a 90-item questionnaire based on the World Health Organisation (WHO) 2003 report on adherence and comprehensively assesses five domains of evidence-based determinants of adherence: socio-economic, health care and caregivers, disease, treatment, and patient-related factors. In addition, self-efficacy is assessed by the MS Self-Efficacy Scale (MSSES), and mood and health-related quality of life (HRQoL) by the Multiple Sclerosis Quality of Life-54 questionnaire (MSQoL-54). Relapses and adverse events

  7. Nationwide Snapshot

    SciTech Connect

    Mapes, Terry S.; Iverson, Megan M.; Fassbender, Linda L.; Britt, Michelle L.

    2011-09-01

    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.

  8. Addressing risk factors for child abuse among high risk pregnant women: design of a randomised controlled trial of the nurse family partnership in Dutch preventive health care

    PubMed Central

    2011-01-01

    Background Low socio-economic status combined with other risk factors affects a person's physical and psychosocial health from childhood to adulthood. The societal impact of these problems is huge, and the consequences carry on into the next generation(s). Although several studies show these consequences, only a few actually intervene on these issues. In the United States, the Nurse Family Partnership focuses on high risk pregnant women and their children. The main goal of this program is primary prevention of child abuse. The Netherlands is the first country outside the United States allowed to translate and culturally adapt the Nurse Family Partnership into VoorZorg. The aim of the present study is to assess whether VoorZorg is as effective in the Netherland as in the United States. Methods The study consists of three partly overlapping phases. Phase 1 was the translation and cultural adaptation of Nurse Family Partnership and the design of a two-stage selection procedure. Phase 2 was a pilot study to examine the conditions for implementation. Phase 3 is the randomized controlled trial of VoorZorg compared to the care as usual. Primary outcome measures were smoking cessation during pregnancy and after birth, birth outcomes, child development, child abuse and domestic violence. The secondary outcome measure was the number of risk factors present. Discussion This study shows that the Nurse Family Partnership was successfully translated and culturally adapted into the Dutch health care system and that this program fulfills the needs of high-risk pregnant women. We hypothesize that this program will be effective in addressing risk factors that operate during pregnancy and childhood and compromise fetal and child development. Trial registration Current Controlled Trials ISRCTN16131117 PMID:22017924

  9. Colloquial Dutch.

    ERIC Educational Resources Information Center

    Bloomfield, Leonard

    This course in colloquial Dutch was originally prepared for use by American Armed Forces personnel who needed to develop a working command of the spoken language in a short period of time. Thirty-one lessons, based on activities common to Dutch culture, are contained in the text. Each lesson provides three parallel columns of sentences: the…

  10. Dutch audiology.

    PubMed

    Grobben, L M; van Ligtenberg, C L

    1977-01-01

    In the Netherlands audiological care is given at different stages. An attempt is made to screen the hearing of all Dutch babies between the ages of 8 and 12 months. At the age of 4 or over, general audiological care is given by the school medical service; referral is first to a family doctor, who may refer to an otolaryngologist. Curative medical care (examination and therapy) is the province of the family doctor and the otolaryngologist. Otolaryngologists and pediatricians can refer patients to one of 19 Audiological Centers distributed around the country, where a number of workers in different disciplines cooperate for habilitation and rehabilitation. These may include an otolaryngologist in charge, a psychologist, a speech and hearing therapist, an audiologist (usually a physicist or university-trained engineer), social worker, technician, ortho-pedagogue, audiology assistant, and teacher. There are at the moment 25 schools for the hard of hearing and 5 institutes for the deaf. These are often found in conjunction with Audiological Centers, the latter providing paramedical assistance to the pupils by agreement. Finally, the Dutch Organization for Preventive Medicine works to prevent hearing loss in noisy industries.

  11. Effectiveness of a Smoking Cessation Intervention in Dutch Pharmacies and General Practices

    ERIC Educational Resources Information Center

    Hoving, Ciska; Mudde, Aart N.; Dijk, Froukje; de Vries, Hein

    2010-01-01

    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…

  12. Nationwide Eclipse Ballooning Project

    NASA Astrophysics Data System (ADS)

    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

    2016-05-01

    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.

  13. A New Dutch Spelling Guide.

    ERIC Educational Resources Information Center

    Kruyt, J. G.; van Sterkenburg, P. G. J.

    This paper describes the development of two new corpus-based Dutch spelling guides using language data gathered by the Institute for Dutch Lexicology, a research institute subsidized by the Dutch and Belgian governments. The guides were produced in 1990 and 1995. The guides are based on two earlier ones, published in 1866 and 1954, but attempt to…

  14. Neglected tropical diseases: survey and geometry of randomised evidence

    PubMed Central

    Kappagoda, Shanthi

    2012-01-01

    Objective To assess the quantity and distribution of evidence from randomised controlled trials for the treatment of the major neglected tropical diseases and to identify gaps in the evidence with network analysis. Design Systematic review and network analysis. Data sources Cochrane Central Register of Controlled Trials and PubMed from inception to 31 August 2011. Study selection Randomised controlled trials that examined treatment of 16 neglected tropical diseases or complications thereof published in English, French, Spanish, Portuguese, German, or Dutch. Results We identified 971 eligible randomised trials. Leishmaniasis (184 trials, 23 039 participants) and geohelminth infections; 160 trials, 46 887 participants) were the most studied, while dracunculiasis (nine trials, 798 participants) and Buruli ulcer (five trials, 337 participants) were least studied. Relative to its global burden of disease, lymphatic filariasis had the fewest trials and participants. Only 11% of trials were industry funded. Either a single trial or trials with fewer than 100 participants comprised the randomised evidence for first or second line treatments for Buruli ulcer, human African trypanosomiasis, American trypanosomiasis, cysticercosis, rabies, echinococcosis, New World cutaneous leishmaniasis, and each of the foodborne trematode infections. Among the 10 disease categories with more than 40 trials, five lacked sufficient head to head comparisons between first or second line treatments. Conclusions There is considerable variation in the amount of evidence from randomised controlled trials for each of the 16 major neglected tropical diseases. Even in diseases with substantial evidence, such as leishmaniasis and geohelminth infections, some recommended treatments have limited supporting data and lack head to head comparisons. PMID:23089149

  15. Will Dutch Become Flemish? Autonomous Developments in Belgian Dutch

    ERIC Educational Resources Information Center

    Van de Velde, Hans; Kissine, Mikhail; Tops, Evie; van der Harst, Sander; van Hout, Roeland

    2010-01-01

    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…

  16. Pennsylvania Dutch Crafts and Culture

    ERIC Educational Resources Information Center

    Turner, Dianne

    2008-01-01

    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,…

  17. Revisiting the Dutch hypothesis.

    PubMed

    Postma, Dirkje S; Weiss, Scott T; van den Berge, Maarten; Kerstjens, Huib A M; Koppelman, Gerard H

    2015-09-01

    The Dutch hypothesis was first articulated in 1961, when many novel and advanced scientific techniques were not available, such as genomics techniques for pinpointing genes, gene expression, lipid and protein profiles, and the microbiome. In addition, computed tomographic scans and advanced analysis techniques to dissect (small) airways disease and emphysema were not available. At that time, the group of researchers under the visionary guidance of Professor N. G. M. Orie put forward that both genetic and environmental factors can determine whether one would have airway obstructive diseases, such as asthma and chronic obstructive pulmonary disease (COPD). Moreover, they stipulated that the phenotype of obstructive airway disease could be affected by sex and changes with aging. Orie and colleagues' call to carefully phenotype patients with obstructive airways diseases has been adopted by many current researchers in an attempt to determine the heterogeneity of both asthma and COPD to better define these diseases and optimize their treatment. The founders of the Dutch hypothesis were far ahead of their time, and we can learn from their insights. We should fully characterize all patients in our clinical practice and not just state that they have asthma, COPD, or asthma and COPD overlap syndrome. This detailed phenotyping can help in understanding these obstructive airway diseases and provide guidance for disease management.

  18. 33 CFR 330.6 - Authorization by nationwide permit.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Authorization by nationwide permit. 330.6 Section 330.6 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE NATIONWIDE PERMIT PROGRAM § 330.6 Authorization by nationwide permit. (a) Nationwide permit verification. (1)...

  19. Nationwide Databases in Orthopaedic Surgery Research.

    PubMed

    Bohl, Daniel D; Singh, Kern; Grauer, Jonathan N

    2016-10-01

    The use of nationwide databases to conduct orthopaedic research has expanded markedly in recent years. Nationwide databases offer large sample sizes, sampling of patients who are representative of the country as a whole, and data that enable investigation of trends over time. The most common use of nationwide databases is to study the occurrence of postoperative adverse events. Other uses include the analysis of costs and the investigation of critical hospital metrics, such as length of stay and readmission rates. Although nationwide databases are powerful research tools, readers should be aware of the differences between them and their limitations. These include variations and potential inaccuracies in data collection, imperfections in patient sampling, insufficient postoperative follow-up, and lack of orthopaedic-specific outcomes.

  20. English Language Teaching Profile: Belgium (Dutch Speaking).

    ERIC Educational Resources Information Center

    British Council, London (England). English-Teaching Information Centre.

    This profile in outline form discusses the English language teaching situation in the Dutch-speaking and French-speaking areas of Belgium. The situation in the Dutch-speaking region, which includes Flanders and Brussels (the latter having both Dutch and French as official languages), is described in terms of the extent of English instruction…

  1. Report: Nationwide Identification of Hardrock Mining Sites

    EPA Pesticide Factsheets

    Report #2004-P-00005, March 31, 2004. We identified 156 hardrock mining sites nationwide that have the potential to cost between $7 billion and $24 billion total to clean up (at a maximum total cost to EPA of approximately $15 billion).

  2. Dutch museum marks Einstein anniversary

    NASA Astrophysics Data System (ADS)

    van Calmthout, Matijn

    2016-01-01

    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.

  3. Metalinguistic Awareness in Dutch Immigrants.

    ERIC Educational Resources Information Center

    de Bot, Kees

    1992-01-01

    Data are presented on some aspects of metalinguistic awareness in Dutch adults who emigrated to Australia at least 25 years ago. The findings show that the migrants do not differ significantly from a control group in the Netherlands, suggesting that first-language metalinguistic skills are extremely resistant to attrition. (Contains nine…

  4. Nationwide tsunami hazard assessment project in Japan

    NASA Astrophysics Data System (ADS)

    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.

    2014-12-01

    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

  5. 77 FR 10183 - Reissuance of Nationwide Permits

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-21

    ...The U.S. Army Corps of Engineers (Corps) is reissuing 48 of the 49 existing nationwide permits (NWPs), general conditions, and definitions, with some modifications. The Corps is also issuing two new NWPs, three new general conditions, and three new definitions. The effective date for the new and reissued NWPs will be March 19, 2012. These NWPs will expire on March 18, 2017. The NWPs will......

  6. Mainstream and Special School Attendance among a Dutch Cohort of Children with Down Syndrome

    PubMed Central

    van Wouwe, Jacobus P.; van Gameren-Oosterom, Helma B. M.; Verkerk, Paul H.; van Dommelen, Paula; Fekkes, Minne

    2014-01-01

    Object To determine the level of mainstream education in a nationwide cohort of adolescents with Down Syndrome (DS), and to find characteristics related to mainstream or special school attendance. Method Dutch children with DS born in 1992, 1993 or 1994, were assessed when 16–19 years old. Parents scored school enrolment between the age of 4–18 years, general characteristics and the levels of intellectual disability using the Dutch Social Competence Rating Scale. Associations between disability and years in mainstream school were assessed by ordinal logistic regression, adjusting for sex and parental education. Results We collected data from 170 boys and 152 girls (response 63%); mean age 18.3 years (ranges 16.8–19.9). Intellectual disability was mostly moderate (43%). Most children (74%) entered mainstream education between 4 and 6 years of age. At 13 years 17% was in mainstream school and 7% stayed in up to 16 years. From the age of 8 years onwards the majority was in special education, while 6% never attended school. Girls were more often in mainstream school and stayed in longer. Level of disability was significantly associated with number of years in mainstream education. Conclusion Three out of four Dutch children with DS entered mainstream primary education, however late entry and high dropout are common. PMID:24638156

  7. Value Orientations of the Dutch Educational Elite.

    ERIC Educational Resources Information Center

    Karsten, Sjoerd; And Others

    1995-01-01

    Value orientations that influence opinions on educational policy issues were examined among Dutch leaders of educationally influential organizations. Their attitudes reflected Dutch society's segmentation along, but cooperation across, religious and ideological dividing lines, as well as optimism about educational reform through state…

  8. [Dutch parliament legitimizes harmful quackery].

    PubMed

    van Dam, Frits S A M; Renckens, Cees N M

    2010-01-01

    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.

  9. How contagious is Dutch disease

    SciTech Connect

    Laney, L.O.

    1982-03-01

    Into the vernacular of economists has come the term Dutch Disease from the Netherland's experience as a net energy exporter. After outlining characterisics of the affliction and the ways in which it can be manifested, this article looks at the economies of United Kingdom, Norway, and Mexico. While the stage of economic development, the structure of the balance of payments, and the exchange-rate regime are at least somewhat different for each, all have economies that are feeling the impact of the energy sector. Common factors are a higher value for the exchange rate than would otherwise be the case and a squeeze on nonenergy sectors of the economy. 4 figures.

  10. 47 CFR 90.19 - Nationwide Public Safety Broadband Network.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 5 2014-10-01 2014-10-01 false Nationwide Public Safety Broadband Network. 90.19 Section 90.19 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES PRIVATE LAND MOBILE RADIO SERVICES Public Safety Radio Pool § 90.19 Nationwide...

  11. 47 CFR 90.19 - Nationwide Public Safety Broadband Network.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 5 2013-10-01 2013-10-01 false Nationwide Public Safety Broadband Network. 90.19 Section 90.19 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES PRIVATE LAND MOBILE RADIO SERVICES Public Safety Radio Pool § 90.19 Nationwide...

  12. A nationwide parasite eradication campaign. Indonesia.

    PubMed

    1996-01-01

    On January 6, 1996, Dr. Haryono Suyono, Minister of State for Population and Chairman of BKKBN, the Minister of Health, and the Governor of West Java inaugurated the revitalization of village population and development institutions throughout Indonesia. The event was coined "The Movement of One Million Village Institutions." It highlighted progress made by village community institutions which successfully implemented nationwide polio vaccination and the village health insurance scheme for needy families. The movements are based upon community self-reliance and sharing, with the government providing assistance when and where needed. Relatively more affluent families are encouraged to help the less well-off in their villages meet their basic needs, including health and educational expenses. These institutions have now gone beyond promoting just family planning, but also help family income generation and village insurance schemes, provide fellowships to children of the less privileged, and help families build clean, cement house floors.

  13. Systems Architecture for a Nationwide Healthcare System.

    PubMed

    Abin, Jorge; Nemeth, Horacio; Friedmann, Ignacio

    2015-01-01

    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.

  14. Randomised controlled trial of local corticosteroid injections for de Quervain's tenosynovitis in general practice

    PubMed Central

    Peters-Veluthamaningal, Cyriac; Winters, Jan C; Groenier, Klaas H; Meyboom-deJong, Betty

    2009-01-01

    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

  15. Development concept for Dutch user support

    NASA Astrophysics Data System (ADS)

    Pronk, C. N. A.; Koopman, N.; Dehoop, D.

    1992-06-01

    The main development approaches and some technologies developed in support of the different objectives of the Dutch Utilization Center (DUC) are reported. The DUC acts as a point of coordination of Dutch user support activities. The support needs of the user are analyzed and from there the required support efforts of the entities in the Dutch User Support Organization (DUSO) are activated. The main objectives of the DUSO are to promote the availability of the Columbus Space Station infrastructure among potential Dutch users, and to assist the users during the process of experiment definition, development, execution, and results evaluation. The DUSO support activities cover promotion and familiarization, and administrative, scientific, technical, and operational support to microgravity and space experimentation. The DUC developmental approaches consist of two approaches: a top down or formal approach; and a bottom up approach.

  16. Randomised trials for the Fitbit generation.

    PubMed

    Dempsey, Walter; Liao, Peng; Klasnja, Pedja; Nahum-Shani, Inbal; Murphy, Susan A

    2015-12-01

    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.

  17. 47 CFR 90.763 - EA, Regional and nationwide system operations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 5 2010-10-01 2010-10-01 false EA, Regional and nationwide system operations... Frequencies in the 220-222 MHz Band Policies Governing the Licensing and Use of Phase II Ea, Regional and Nationwide Systems § 90.763 EA, Regional and nationwide system operations. (a) A nationwide...

  18. National Information Utility Seeks to Serve Schools Nationwide.

    ERIC Educational Resources Information Center

    Platzer, Nancy

    1985-01-01

    Outlines the pros and cons of the National Information Utility Program, which is designed to provide current updatable courseware to schools nationwide. The information is broadcast over FM radio and television signals to facilities subscribing to the utility. (MD)

  19. Current concepts in the treatment of intra-articular calcaneal fractures: results of a nationwide survey

    PubMed Central

    van Lieshout, E. M. M.; van Ginhoven, T. M.; Heetveld, M. J.; Patka, P.

    2007-01-01

    The treatment of intra-articular calcaneal fractures is controversial and randomised clinical trials are scarce. Moreover, the socio-economic cost remains unclear. The aim of this study was to estimate the incidence, treatment preferences and socio-economic cost of this complex fracture in the Netherlands. This data may aid in planning future clinical trials and support education. The method of study was of a cross-sectional survey design. A written survey was sent to one representative of both the traumatology and the orthopaedic staff in each hospital in the Netherlands. Data on incidence, treatment modalities, complications and follow-up strategies were recorded. The socio-economic cost was calculated. The average response rate was 70%. Fracture classifications, mostly by Sanders and Essex-Lopresti, were applied by 29%. Annually, 920 intra-articular calcaneal fractures (0.4% incidence rate) were treated, mainly with ORIF (46%), conservative (39%) and percutaneous (10%) treatment. The average non-weight-bearing mobilisation was 9 weeks (SD 2 weeks). An outcome score, mainly AOFAS, was documented by 7%. A secondary arthrodesis was performed in 21% of patients. The socio-economic cost was estimated to be €21.5–30.7 million. Dutch intra-articular calcaneal fracture incidence is at least 0.4% of all fractures presenting to hospitals. Better insight into treatment modalities currently employed and costs in the Netherlands was obtained. PMID:17564705

  20. Implementation of nationwide image sharing system

    NASA Astrophysics Data System (ADS)

    Choi, SeungWook; Sim, Jungsuk; Ko, Wonsun; Park, ChanHyung; Lee, Jaeha; Lim, DongHyun; Lee, Juhyuk; Han, Jungu; Lee, Jongsu; Hong, HeonPyo; Choi, Bongsuk

    2003-05-01

    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.

  1. A Nationwide Analysis of Kidney Autotransplantation.

    PubMed

    Moghadamyeghaneh, Zhobin; Hanna, Mark H; Fazlalizadeh, Reza; Obi, Yoshitsugu; Foster, Clarence E; Stamos, Michael J; Ichii, Hirohito

    2017-02-01

    There are limited data regarding outcomes of patients underwent kidney autotransplantation. This study aims to investigate outcomes of such patients. The nationwide inpatient sample database was used to identify patients underwent kidney autotransplantation during 2002 to 2012. Multivariate analyses using logistic regression were performed to investigate morbidity predictors. A total of 817 patients underwent kidney autotransplantation from 2002 to 2012. The most common indication of surgery was renal artery pathology (22.7%) followed by ureter pathology (17%). Overall, 97.7 per cent of operations were performed in urban teaching hospitals. The number of procedures from 2008 to 2012 were significantly higher compared with the number of them from 2002 to 2007 (473 vs 345, P < 0.01). The overall mortality and morbidity of patients were 1.3 and 46.2 per cent, respectively. The most common postoperative complications were transplanted kidney failure (10.7%) followed by hemorrhagic complications (9.7%). Obesity [adjusted odds ratio (AOR): 9.62, P < 0.01], fluid and electrolyte disorders (AOR: 3.67, P < 0.01), and preoperative chronic kidney disease (AOR: 1.80, P = 0.03) were predictors of morbidity in patients. In conclusion, Kidney autotransplantation is associated with low mortality but a high morbidity rate. The most common indications of kidney autotransplantation are renal artery and ureter pathologies, respectively. A kidney transplant failure rate of 10.7 per cent was observed in patients with kidney autotransplantation. The most common postoperative complication was hemorrhagic in nature.

  2. 1. PANORAMA, SHOWING COMMAND POST RELATION TO DUTCH HARBOR AND ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. PANORAMA, SHOWING COMMAND POST RELATION TO DUTCH HARBOR AND UNALASKA FROM THE TOP OF LITTLE SOUTH AMERICA - Naval Operating Base Dutch Harbor & Fort Mears, Hill 400 Fixed Defense Battery Command Post, Unalaska, Aleutian Islands, AK

  3. PANORAMA, SHOWING COMMAND POST RELATION TO DUTCH HARBOR AND UNALASKA ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    PANORAMA, SHOWING COMMAND POST RELATION TO DUTCH HARBOR AND UNALASKA FROM THE TOP OF LITTLE SOUTH AMERICA - Naval Operating Base Dutch Harbor & Fort Mears, Hill 400 Fixed Defense Battery Command Post, Unalaska, Aleutian Islands, AK

  4. DNA barcoding of Dutch birds

    PubMed Central

    Aliabadian, Mansour; Beentjes, Kevin K.; Roselaar, C.S. (Kees); van Brandwijk, Hans; Nijman, Vincent; Vonk, Ronald

    2013-01-01

    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

  5. Metrical Segmentation in Dutch: Vowel Quality or Stress?

    ERIC Educational Resources Information Center

    Quene, Hugo; Koster, Mariette L.

    1998-01-01

    Examines metrical segmentation strategy in Dutch. The first experiment shows that stress strongly affects Dutch listeners' ability and speed in spotting Dutch monosyllabic words in disyllabic nonwords. The second experiment finds the same stress effect when only the target words are presented without a subsequent syllable triggering segmentation.…

  6. A Reference Grammar of Dutch, with Exercises and Key.

    ERIC Educational Resources Information Center

    Fehringer, Carol

    This textbook provides an accessible reference grammar of the Dutch language for English-speaking students of Dutch to help consolidate their knowledge through practical exercises on a whole range of grammatical topics. It is intended both for beginners and intermediate level students. Advanced learners of Dutch wishing to review particular…

  7. The Dutch Perspective on NATO Development during the Korean War

    DTIC Science & Technology

    2012-06-08

    government tried to get a favorable defensive line accepted in NATO, covering as much territory as possible. The Dutch lobbied for a blue water naval...interests within NATO. The Dutch government tried to get a favorable defensive line accepted in NATO, covering as much territory as possible. The Dutch...

  8. Learning Styles of Chinese and Dutch Students Compared within the Context of Dutch Higher Education in Life Sciences

    ERIC Educational Resources Information Center

    Biemans, Harm; Van Mil, Marc

    2008-01-01

    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…

  9. Nutritional route in oesophageal resection trial II (NUTRIENT II): study protocol for a multicentre open-label randomised controlled trial

    PubMed Central

    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

    2016-01-01

    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

  10. Government as Electronic Publishers? The Dutch Case.

    ERIC Educational Resources Information Center

    Bouwman, Harry; Nouwens, John

    1999-01-01

    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)

  11. Preaccentual Pitch and Speaker Attitude in Dutch.

    ERIC Educational Resources Information Center

    Grabe, Esther; Gussenhoven, Carlos; Haan, Judith; Marsi, Erwin; Post, Brecht Je

    1998-01-01

    Focuses on the communicative significance of the pitch of the initial unstressed syllables in Dutch intonation contours, as may be heard, for instance, on unstressed utterance-initial function words like "Ze zijn" in "Ze zijn klaar (they are ready), or the initial unstressed syllables of utterance-initial polysyllabic words, like…

  12. Delinquent Behavior of Dutch Rural Adolescents

    ERIC Educational Resources Information Center

    Weenink, Don

    2011-01-01

    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…

  13. School Leadership and Equity: Dutch Experiences

    ERIC Educational Resources Information Center

    Leeman, Yvonne

    2007-01-01

    There is little empirical evidence describing how school principals respond to the changing socioeconomic position and ethnic identities of the urban population. In this paper such empirical evidence is presented in respect of three primary school leaders in the Dutch cities of Amsterdam and Rotterdam. The schools selected were identified as…

  14. Dutch national rainfallradar project: a unique corporation

    NASA Astrophysics Data System (ADS)

    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

    2013-04-01

    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

  15. Nationwide Trends in Molecular Epidemiology of HIV-1 in China.

    PubMed

    Li, Xiaoshan; Li, Wei; Zhong, Ping; Fang, Kun; Zhu, Kexin; Musa, Taha Hussein; Song, Yue; Du, Guoping; Gao, Rong; Guo, Yan; Yan, Wenjuan; Xuan, Yang; Wei, Pingmin

    2016-09-01

    To estimate the nationwide and regional distribution of HIV-1 genotypes in China in the past three decades, province-specific HIV-1 molecular epidemiology data were derived from 260 independent studies of HIV molecular prevalence through searching PubMed, VIP Chinese Journal Database (VIP), China National Knowledge Infrastructure, and Wanfang Data from January 1981 to December 2015. The nationwide and regional distribution of HIV-1 genotypes was estimated by weighting the genotype distribution from each province- and risk-specific subpopulation with the number of reported cases in the corresponding subgroups in the relevant periods. A sharp transition of HIV-1 subtypes and recombinant distribution was observed in various risk groups and regions over time. CRF01_AE has rapidly surged among almost all risk groups and in all areas, and it has become dominant among men who have sex with men and heterosexuals. A wide variety of new circulating recombinant forms (CRFs) and unique recombinant forms (URFs) were rapidly appearing in several risk groups and regions. After 2007, CRF01_AE was the most prevalent strain, accounting for 42.5% of all national infections, followed by CRF07_BC (28.9%), subtype B'/B (10.9%), CRF08_BC (10.0%), and subtype C (2.8%). URFs and other CRFs were responsible for 2.6% and fewer than 1% of infections nationwide, respectively. The nationwide and regional distributions of HIV-1 subtypes and recombinants were sharply shifting in China. CRF01_AE and new CRFs played an increasing role in the nationwide or regional HIV pandemic. The nationwide diversity of HIV-1 poses a formidable challenge to HIV vaccine development and disease prevention.

  16. Do Dutch doctors communicate differently with immigrant patients than with Dutch patients?

    PubMed

    Meeuwesen, Ludwien; Harmsen, Johannes A M; Bernsen, Roos M D; Bruijnzeels, Marc A

    2006-11-01

    The aim of this study was to gain deeper insight into relational aspects of the medical communication pattern in intercultural consultations at GP practices in the Netherlands. We ask whether there are differences in the verbal interaction of Dutch GPs with immigrant and Dutch patients. Data were drawn from 144 adult patient interviews and video observations of consultations between the patients and 31 Dutch GPs. The patient group consisted of 61 non-Western immigrants (Turkish, Moroccan, Surinamese, Antillean, Cape Verdian) and 83 Dutch participants. Affective and instrumental aspects of verbal communication were assessed using Roter's Interaction Analysis System (RIAS). Patients' cultural background was assessed by ethnicity, language proficiency, level of education, religiosity and cultural views (in terms of being more traditional or more modern). Consultations with the non-Western immigrant patients (especially those from Turkey and Morocco) were well over 2 min shorter, and the power distance between GPs and these patients was greater when compared to the Dutch patients. Major differences in verbal interaction were observed on the affective behavior dimensions, but not on the instrumental dimensions. Doctors invested more in trying to understand the immigrant patients, while in the case of Dutch patients they showed more involvement and empathy. Dutch patients seemed to be more assertive in the medical conversation. The differences are discussed in terms of patients' ethnic background, cultural views (e.g. practicing a religion) and linguistic barriers. It is concluded that attention to cultural diversity does matter, as this leads to different medical communication patterns. A two-way strategy is recommended for improving medical communication, with implications for both doctor and patient behavior.

  17. Language Identity among Iranian English Language Learners: A Nationwide Survey

    ERIC Educational Resources Information Center

    Rezaei, Saeed; Khatib, Mohammad; Baleghizadeh, Sasan

    2014-01-01

    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…

  18. Nationwide Techer Opinion Poll, 1979. NEA Research Memo, September 1979.

    ERIC Educational Resources Information Center

    National Education Association, Washington, DC.

    The 1979 Nationwide Teacher Opinion Poll conducted by the National Education Association was sent to 2,148 of the nation's approximately 2,185,000 public school teachers. The response rate to the poll was 82.7 percent. In this report the analysis of the responses are grouped according to the following topical areas: (1) teacher demographics; (2)…

  19. Planning for a Nationwide System of Library Statistics.

    ERIC Educational Resources Information Center

    Palmer, David C., Ed.

    A design for a nationwide system of library statistics is provided along with specific recommendations for its structure and development. The proposed system depends upon a much more active role of the states and upon the input of research, interaction of advisory groups, inservice training, and relatively small amounts of money at strategic…

  20. Nationwide Survey of the Undergraduate Physical Chemistry Course

    ERIC Educational Resources Information Center

    Fox, Laura J.; Roehrig, Gillian H.

    2015-01-01

    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…

  1. Where Are We Now? Statistics on Capstone Courses Nationwide

    ERIC Educational Resources Information Center

    Howe, Susannah

    2010-01-01

    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…

  2. 76 FR 22409 - Nationwide Cyber Security Review (NCSR) Assessment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-21

    ... a cyber network security assessment so that a full measure of gaps and capabilities can be completed... SECURITY Nationwide Cyber Security Review (NCSR) Assessment AGENCY: National Protection and Programs.... SUMMARY: The Department of Homeland Security (DHS), National Protection and Programs Directorate...

  3. 76 FR 43696 - Nationwide Cyber Security Review (NCSR) Assessment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-21

    ... government to complete a cyber network security assessment so that a full measure of gaps and capabilities... SECURITY Nationwide Cyber Security Review (NCSR) Assessment AGENCY: National Protection and Programs...: The Department of Homeland Security (DHS), National Protection and Programs Directorate (NPPD),...

  4. Verb inflection in monolingual Dutch and sequential bilingual Turkish-Dutch children with and without SLI.

    PubMed

    Blom, Elma; de Jong, Jan; Orgassa, Antje; Baker, Anne; Weerman, Fred

    2013-01-01

    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 was to investigate variation in error types and error profiles across groups. Data were collected from 6-8-year-old children with SLI who acquire Dutch as their first language (L1), Dutch L1 children with a typical development (TD), Dutch L2 children with SLI, and Dutch L1 TD children who were on average 2 years younger. An experimental elicitation task was employed that tested use of verb inflection; context (3SG, 3PL) was manipulated and word order and verb type were controlled. Accuracy analyses revealed effects of impairment in both L1 and L2 children with SLI. However, individual variation indicated that there is no specific error profile for SLI. Verb inflection use as measured in our study discriminated fairly well in the L1 group but classification was less accurate in the L2 group. Between-group differences emerged furthermore for certain types of errors, but all groups also showed considerable variation in errors and there was not a specific error profile that distinguished SLI from TD.

  5. Half a century of Dutch transplant immunology.

    PubMed

    van Rood, Jon J; Claas, Frans H J; Brand, Anneke; Tilanus, Marcel G J; van Kooten, Cees

    2014-12-01

    The sixties have not only witnessed the start of the Dutch Society for Immunology (NvvI), but were also the flourishing beginning of the discipline of transplant immunology. The interest in immunology in the Netherlands had its start in the context of blood transfusions and not for instance in the field of infectious disease, as in many other countries. It began in the 1950-ties thanks to Joghem van Loghem at that time director of the Central Laboratory of Blood Transfusion in Amsterdam. The discoveries of these times have had major impact for transfusion medicine, hematopoietic stem cell transplantation and organ transplantation. In this review we will look back at some early highlights of Dutch transplant immunology and put them in the perspective of some recent developments.

  6. More than 95% completeness of reported procedures in the population-based Dutch Arthroplasty Register

    PubMed Central

    van Steenbergen, Liza N; Spooren, Anneke; van Rooden, Stephanie M; van Oosterhout, Frank J; Morrenhof, Jan W; Nelissen, Rob G H H

    2015-01-01

    Background and purpose A complete and correct national arthroplasty register is indispensable for the quality of arthroplasty outcome studies. We evaluated the coverage, completeness, and validity of the Dutch Arthroplasty Register (LROI) for hip and knee arthroplasty. Patients and methods The LROI is a nationwide population-based registry with information on joint arthroplasties in the Netherlands. Completeness of entered procedures was validated in 2 ways: (1) by comparison with the number of reimbursements for arthroplasty surgeries (Vektis database), and (2) by comparison with data from hospital information systems (HISs). The validity was examined by conducting checks on missing or incorrectly coded values in the LROI. Results The LROI contains over 300,000 hip and knee arthroplasties performed since 2007. Coverage of all Dutch hospitals (n = 100) was reached in 2012. Completeness of registered procedures was 98% for hip arthroplasty and 96% for knee arthroplasty in 2012, based on Vektis data. Based on comparison with data from the HIS, completeness of registered procedures was 97% for primary total hip arthroplasty and 96% for primary knee arthroplasty in 2013. Completeness of revision arthroplasty was 88% for hips and 90% for knees in 2013. The proportion of missing or incorrectly coded values of variables was generally less than 0.5%, except for encrypted personal identity numbers (17% of which were missing) and ASA scores (10% of which were missing). Interpretation The LROI now contains over 300,000 hip and knee arthroplasty procedures, with coverage of all hospitals. It has a good level of completeness (i.e. more than 95% for primary hip and knee arthroplasty procedures in 2012 and 2013) and the database has high validity. PMID:25758646

  7. Razors versus clippers. A randomised controlled trial.

    PubMed

    Taylor, Tracy; Tanner, Judith

    2005-12-01

    The purpose of this randomised controlled trial was to determine if patients showed a preference for preoperative hair removal with razors or clippers and to identify if one method was associated with more trauma or postoperative infections. The trial took place in a day surgery unit with patients who were having a range of surgical procedures including hernias and varicose veins. This study was sponsored by an award from the NATN/3M Clinical Fellowship.

  8. Patient safety in elderly hip fracture patients: design of a randomised controlled trial

    PubMed Central

    2011-01-01

    Background The clinical environment in which health care providers have to work everyday is highly complex; this increases the risk for the occurrence of unintended events. The aim of this randomised controlled trial is to improve patient safety for a vulnerable group of patients that have to go through a complex care chain, namely elderly hip fracture patients. Methods/design A randomised controlled trial that consists of three interventions; these will be implemented in three surgical wards in Dutch hospitals. One surgical ward in another hospital will be the control group. The first intervention is aimed at improving communication between care providers using the SBAR communication tool. The second intervention is directed at stimulating the role of the patient within the care process with a patient safety card. The third intervention consists of a leaflet for patients with information on the most common complications for the period after discharge. The primary outcome measures in this study are the incidence of complications and adverse events, mortality rate within six months after discharge and functional mobility six months after discharge. Secondary outcome measures are length of hospital stay, quality and completeness of information transfer and patient satisfaction with the instruments. Discussion The results will give insight into the nature and scale of complications and adverse events that occur in elderly hip fracture patients. Also, the implementation of three interventions aimed at improving the communication and information transfer provides valuable possibilities for improving patient safety in this increasing patient group. This study combines the use of three interventions, which is an innovative aspect of the study. Trial registration The Netherlands National Trial Register NTR1562 PMID:21418630

  9. Implementation of the external cephalic version in breech delivery. Dutch national implementation study of external cephalic version

    PubMed Central

    2010-01-01

    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

  10. Ultrasound imaging to tailor the treatment of acute shoulder pain: a randomised controlled trial in general practice

    PubMed Central

    Ottenheijm, Ramon P G; Cals, Jochen W L; Winkens, Bjorn; Weijers, René E; de Bie, Rob A; Dinant, Geert-Jan

    2016-01-01

    Objective To determine the clinical effectiveness of ultrasound tailored treatment in patients with acute subacromial disorders. Design Pragmatic randomised controlled trial. Setting Dutch general practice. Participants Patients aged 18–65 years with acute (duration <3 months) unilateral shoulder pain and no previous treatment, in whom the general practitioner suspected a subacromial disorder was enrolled. Interventions All patients underwent ultrasound imaging of the affected shoulder. Patients who were still symptomatic after a qualification period of 2 weeks with standard treatment were randomised to treatment tailored to ultrasound diagnosis (disclosure of the ultrasound diagnosis) or usual care (non-disclosure of the ultrasound diagnosis). Primary outcome measure Patient-perceived recovery using the Global Perceived Effect questionnaire at 1 year. Results 129 patients were included. 18 patients recovered during the 2-week qualification period, resulting in 111 randomised patients; 56 were allocated to ultrasound tailored treatment and 55 to usual care. After 1 year, no statistically significant differences in recovery were found between the ultrasound tailored treatment group (72.5% (37/51)) and the usual care group (60% (30/50), OR 2.24 (95% CI 0.72 to 6.89; p=0.16)). Also, healthcare use was similar. Conclusions This study has shown no clinically significant difference in the primary outcome measure between the ultrasound tailored treatment and usual care groups. Furthermore, there was no overall difference in healthcare resources used between groups. Although no formal cost data are included, one can only assume that the ultrasound examinations are additional costs for the intervention group, which cannot be justified in routine practice based on this trial. Based on this study, no change in current pragmatic guidelines to incorporate early ultrasound imaging can be recommended. Trial registration number NTR2403; Results. PMID:27872111

  11. 1990 Nationwide Truck Activity and Commodity Survey selected tabulations

    SciTech Connect

    Not Available

    1993-06-01

    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.

  12. NASA Nationwide and the Year of the Solar System (Invited)

    NASA Astrophysics Data System (ADS)

    Ferrari, K.

    2010-12-01

    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.

  13. Development of a nationwide network for technology transfer

    NASA Technical Reports Server (NTRS)

    Fong, Louis B. C.; Brockman, Paul R.

    1987-01-01

    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.

  14. Do Hebrew Electronic Books Differ from Dutch Electronic Books? A Replication of a Dutch Content Analysis

    ERIC Educational Resources Information Center

    Korat, Ofra; Shamir, Adina

    2004-01-01

    This replication study of Hebrew versus Dutch electronic books for young children was based on De Jong & Bus's content analysis, which explored whether e-books are appropriate supports for young children's literacy development. Our criteria for analysing 43 Hebrew e-books for young children included book processing, multimedia in pictures,…

  15. Nephrogenic Systemic Fibrosis in Denmark– A Nationwide Investigation

    PubMed Central

    Elmholdt, Tina R.; Olesen, Anne B. B.; Jørgensen, Bettina; Kvist, Stinne; Skov, Lone; Thomsen, Henrik S.; Marckmann, Peter; Pedersen, Michael

    2013-01-01

    Background Nephrogenic systemic fibrosis is a debilitating and painful disorder with an increased stimulation of the connective tissue in the skin and systemic tissues. The disease is associated with exposure to gadolinium-based contrast agent used in magnetic resonance imaging in patients with renal impairment. Methods The prevalence of nephrogenic systemic fibrosis has so far never been determined at a national level. In 2009, Denmark was the first country to design a guideline for the tracing of nephrogenic systemic fibrosis patients. The aim of this paper is to communicate the main findings of this quest. Results The outcome of the nationwide investigation revealed that Denmark had 65 patients with nephrogenic systemic fibrosis and thereby the highest prevalence of nephrogenic systemic fibrosis worldwide with 65 per 5.6 million inhabitants, or 12 per million. Conclusions The nationwide investigation in Denmark revealed the highest prevalence of NSF worldwide. This may be rooted in a high level of awareness of NSF both among doctors, politicians and, not least, the media, combined with the fact that a nationwide NSF investigation was initiated. PMID:24349178

  16. The Dutch Are Missing in the American Curriculum

    ERIC Educational Resources Information Center

    Claunch, Ann

    2009-01-01

    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"…

  17. The Electrophysiological Manifestation of Dutch Verb Second Violations

    ERIC Educational Resources Information Center

    den Ouden, Dirk-Bart; Bastiaanse, Roelien

    2009-01-01

    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".…

  18. National Identification of Dutch Youth: An Exploratory Study

    ERIC Educational Resources Information Center

    Oppenheimer, Louis

    2011-01-01

    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…

  19. Neural Correlates of Dutch Verb Second in Speech Production

    ERIC Educational Resources Information Center

    den Ouden, Dirk-Bart; Hoogduin, Hans; Stowe, Laurie A.; Bastiaanse, Roelien

    2008-01-01

    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…

  20. The Dutch Open Telescope on La Palma

    NASA Astrophysics Data System (ADS)

    Rutten, R. J.; Bettonvil, F. C. M.; Hammerschlag, R. H.; Jägers, A. P. L.; Leenaarts, J.; Snik, F.; Sütterlin, P.; Tziotziou, K.; de Wijn, A. G.

    The Dutch Open Telescope (DOT) on La Palma is an innovative solar telescope combining open telescope structure and an open support tower with a multi-wavelength imaging assembly and with synchronous speckle cameras to generate high-resolution movies which sample different layers of the solar atmosphere simultaneously and co-spatially at high resolution over long durations. The DOT test and development phase is nearly concluded. The installation of an advanced speckle processor enables full science utilization including "Open-DOT" time allocation to the international community. Co-pointing with spectropolarimeters at other Canary Island telescopes and with TRACE furnishes valuable Solar-B precursor capabilities.

  1. Sustainable Phoenix: Lessons from the Dutch Model

    NASA Astrophysics Data System (ADS)

    Lara, Jesus J.

    In only fifty years, the Phoenix metropolitan area has expanded from a small desert town into one of the largest urban areas in the United States. Today, it has one of the fastest rates of growth in the nation with an annual rate of 4.5%. This area has grown during a period in urban development that largely ignored local topography, climate, culture, and history. The result has been a sprawling metropolitan area with an ever increasing ecological footprint and a standardized urban design and infrastructure that works against its environmental setting rather than with it. Currently, the city of Phoenix is going through a process of urban revitalization with an increasing demand for urban living and commerce. This research explores sustainable urban design and its potential applications in the metropolitan Phoenix area through an investigation of the Dutch model. The Dutch have successfully dealt with sustainable urban design approaches and their practices represent an unusual learning opportunity for Phoenix. The Netherlands' experience suggests three strategies/themes for rendering Phoenix a more sustainable urban form. These include the strategic planning and development of urban extensions, compact infill, and modernizing infrastructure.

  2. Cancer incidence in Dutch Balkan veterans.

    PubMed

    Bogers, Rik P; van Leeuwen, Flora E; Grievink, Linda; Schouten, Leo J; Kiemeney, Lambertus A L M; Schram-Bijkerk, Dieneke

    2013-10-01

    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'.

  3. 77 FR 60680 - Development of the Nationwide Interoperable Public Safety Broadband Network

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-04

    ... nationwide wireless network called for under the Act, including ubiquitous coverage, reliable, redundant, and... particularly interested in receiving innovative ideas on how it can deploy a reliable, ubiquitous,...

  4. Self management of oral anticoagulation: randomised trial

    PubMed Central

    Fitzmaurice, D A; Murray, E T; McCahon, D; Holder, R; Raftery, J P; Hussain, S; Sandhar, H; Hobbs, F D R

    2005-01-01

    Objective To determine the clinical effectiveness of self management compared with routine care in patients on long term oral anticoagulants. Design Multicentre open randomised controlled trial. Setting Midlands region of the UK. Participants 617 patients aged over 18 and receiving warfarin randomised to intervention (n = 337) and routine care (n = from 2470 invited; 193/337 (57%) completed the 12 month intervention. Intervention Intervention patients used a point of care device to measure international normalised ratio twice a week and a simple dosing chart to interpret their dose of warfarin. Main outcome measure Percentage of time spent within the therapeutic range of international normalised ratio. Results No significant differences were found in percentage of time in the therapeutic range between self managment and routine care (70% v 68%). Self managed patients with poor control before the study showed an improvement in control that was not seen in the routine care group. Nine patients (2.8/100 patient years) had serious adverse events in the self managed group, compared with seven (2.7/100 patient years) in the routine care arm (χ2(df = 1) = 0.02, P = 0.89). Conclusion With appropriate training, self management is safe and reliable for a sizeable proportion of patients receiving oral anticoagulation treatment. It may improve the time spent the therapeutic range for patients with initially poor control. Trial registration ISRCTN 19313375. PMID:16216821

  5. [Mendelian randomisation - a genetic approach to an epidemiological method].

    PubMed

    Stensrud, Mats Julius

    2016-06-01

    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.

  6. [Prevalence of Tritrichomonas foetus among Dutch cats].

    PubMed

    van Doorn, D C K; de Bruin, M J; Jorritsma, R A; Ploeger, H W; Schoormans, A

    2009-09-01

    Prevalence of Tritrichomonas foetus among Dutch cats The aim of this study was to determine the prevalence of and risk factors for, Tritrichomonas foetus among cats in the Netherlands. A total of 154 faecal samples were collected from three groups of cats: cats with diarrhoea (n=53), cattery cats (n=47), and healthy pet cats (n=54). Faecal samples were examined with a T. foetus specific real-time PCR. All PCR-positive samples were run on gel electrophoresis for definitive diagnosis. The prevalence of T. foetus was 2% among cats with diarrhoea and 4% among cattery cats; T. foetus was not prevalent among pet cats (none of the samples tested positive). Questionnaires had been distributed to cat and cattery owners to determine risk factors for T. foetus, but the low prevalence precluded statistical analysis of the questionnaire results.

  7. Subacute ruminal acidosis in Dutch dairy herds.

    PubMed

    Kleen, J L; Hooijer, G A; Rehage, J; Noordhuizen, J P T M

    2009-05-30

    The prevalence of subacute ruminal acidosis (SARA) was determined in 197 dairy cows in 18 herds in the Dutch province of Friesland. Samples of rumen fluid were taken by rumenocentesis from between five and 19 animals on each farm and the pH of each sample was determined. The body condition of 139 of the cows was scored approximately three weeks before they calved and three weeks after they calved. The overall prevalence of SARA was 13.8 per cent, and the prevalence on individual farms ranged between 0 per cent (on seven of the farms) and 38 per cent (on one farm). The stage of lactation did not influence the prevalence of SARA but the cows with the condition lost more body condition over the calving period.

  8. Development of a Dutch Drainpipe exposure scenario

    NASA Astrophysics Data System (ADS)

    Tiktak, Aaldrik; Boesten, Jos; van der Linden, Ton

    2010-05-01

    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

  9. The art of governance of Dutch hospitals.

    PubMed

    Hoek, H

    1999-01-01

    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.

  10. The Dutch school of malaria research.

    PubMed

    Verhave, J P

    1987-01-01

    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.

  11. Immigrants and preterm births: a nationwide epidemiological study in Sweden.

    PubMed

    Li, Xinjun; Sundquist, Jan; Sundquist, Kristina

    2013-08-01

    To examine, nationwide, if there is an association between country of birth in mothers and preterm birth and to study whether any such association remains in second-generation immigrant women. In this follow-up study, a nationwide research database located at Lund University, Sweden, was used to identify all preterm born singletons in Sweden between January 1, 1982, and December 31, 2006. Incidence ratios were standardized with regard to maternal age at birth, marital status, geographical region, body height, and smoking history as well as period of birth, family income, and gender of the infant. Singletons of mothers born in Sweden were used as the reference group. There were 2,192,843 records for singletons over the study period, of whom 4.9 % were preterm births and 0.8 % were very preterm births. Increased risk of preterm birth was observed for mothers from Austria, Yugoslavia, Romania, Central Europe, and Asia. Increased risk of very preterm birth was observed for mothers from Eastern Europe, Central Europe, Africa, and Asia; these increased risk disappeared, however, in the second-generation female immigrants. Country of birth in mothers affected the risk of preterm birth; maternity care should pay special attention to women from certain population groups.

  12. Emergency Department Crowding Disparity: a Nationwide Cross-Sectional Study

    PubMed Central

    2016-01-01

    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

  13. Low cost satellite land mobile service for nationwide applications

    NASA Technical Reports Server (NTRS)

    Weiss, J. A.

    1978-01-01

    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.

  14. Interior view of addition pharmacy showing dutch door and security ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    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

  15. Emerson Parcel of Dutch Slough Tidal Marsh Restoration Project

    EPA Pesticide Factsheets

    Information about the SFBWQP Emerson Parcel of Dutch Slough Tidal Marsh Restoration Project, part of an EPA competitive grant program to improve SF Bay water quality focused on restoring impaired waters and enhancing aquatic resources.

  16. 24 CFR 3400.205 - HUD's establishment of nationwide mortgage licensing system and registry.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... mortgage licensing system and registry. 3400.205 Section 3400.205 Housing and Urban Development Regulations... Originator Licensing System and Nationwide Mortgage Licensing and Registry System § 3400.205 HUD's establishment of nationwide mortgage licensing system and registry. If HUD determines that the NMLSR...

  17. 24 CFR 3400.205 - HUD's establishment of nationwide mortgage licensing system and registry.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... mortgage licensing system and registry. 3400.205 Section 3400.205 Housing and Urban Development Regulations... Originator Licensing System and Nationwide Mortgage Licensing and Registry System § 3400.205 HUD's establishment of nationwide mortgage licensing system and registry. If HUD determines that the NMLSR...

  18. 24 CFR 3400.205 - HUD's establishment of nationwide mortgage licensing system and registry.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... mortgage licensing system and registry. 3400.205 Section 3400.205 Housing and Urban Development Regulations... Originator Licensing System and Nationwide Mortgage Licensing and Registry System § 3400.205 HUD's establishment of nationwide mortgage licensing system and registry. If HUD determines that the NMLSR...

  19. 77 FR 64382 - Agency Information Collection (Nation-Wide Customer Satisfaction Surveys) Activities Under OMB...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-19

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS AFFAIRS Agency Information Collection (Nation-Wide Customer Satisfaction Surveys) Activities Under OMB....'' SUPPLEMENTARY INFORMATION: Title: Nation-wide Customer Satisfaction Surveys, VA Forms 10-1465- 2 through...

  20. 75 FR 25320 - Agency Information Collection (Nation-wide Customer Satisfaction Surveys) Activities Under OMB...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-07

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS AFFAIRS Agency Information Collection (Nation-wide Customer Satisfaction Surveys) Activities Under OMB... INFORMATION: Title: Nation-wide Customer Satisfaction Surveys, VA Forms 1465-2 through 1465-4. OMB...

  1. 75 FR 9277 - Proposed Information Collection (Nation-Wide Customer Satisfaction Surveys) Activity: Comment...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-01

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS AFFAIRS Proposed Information Collection (Nation-Wide Customer Satisfaction Surveys) Activity: Comment.... Title: Nation-wide Customer Satisfaction Surveys, VA Forms 1465-2 through 1465-4. OMB Control...

  2. 77 FR 2349 - Proposed Information Collection (Nation-wide Customer Satisfaction Surveys) Activity: Comment...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-17

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS AFFAIRS Proposed Information Collection (Nation-wide Customer Satisfaction Surveys) Activity: Comment... forms of information technology. Title: Nation-wide Customer Satisfaction Surveys, VA Forms 10-1465-...

  3. The Hawthorne Effect: a randomised, controlled trial

    PubMed Central

    McCarney, Rob; Warner, James; Iliffe, Steve; van Haselen, Robbert; Griffin, Mark; Fisher, Peter

    2007-01-01

    Background The 'Hawthorne Effect' may be an important factor affecting the generalisability of clinical research to routine practice, but has been little studied. Hawthorne Effects have been reported in previous clinical trials in dementia but to our knowledge, no attempt has been made to quantify them. Our aim was to compare minimal follow-up to intensive follow-up in participants in a placebo controlled trial of Ginkgo biloba for treating mild-moderate dementia. Methods Participants in a dementia trial were randomised to intensive follow-up (with comprehensive assessment visits at baseline and two, four and six months post randomisation) or minimal follow-up (with an abbreviated assessment at baseline and a full assessment at six months). Our primary outcomes were cognitive functioning (ADAS-Cog) and participant and carer-rated quality of life (QOL-AD). Results We recruited 176 participants, mainly through general practices. The main analysis was based on Intention to treat (ITT), with available data. In the ANCOVA model with baseline score as a co-variate, follow-up group had a significant effect on outcome at six months on the ADAS-Cog score (n = 140; mean difference = -2.018; 95%CI -3.914, -0.121; p = 0.037 favouring the intensive follow-up group), and on participant-rated quality of life score (n = 142; mean difference = -1.382; 95%CI -2.642, -0.122; p = 0.032 favouring minimal follow-up group). There was no significant difference on carer quality of life. Conclusion We found that more intensive follow-up of individuals in a placebo-controlled clinical trial of Ginkgo biloba for treating mild-moderate dementia resulted in a better outcome than minimal follow-up, as measured by their cognitive functioning. Trial registration Current controlled trials: ISRCTN45577048 PMID:17608932

  4. Strategies to improve retention in randomised trials

    PubMed Central

    Brueton, Valerie C; Tierney, Jayne; Stenning, Sally; Harding, Seeromanie; Meredith, Sarah; Nazareth, Irwin; Rait, Greta

    2013-01-01

    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

  5. Decision support for dutch drought management and climate change with the Netherland Hydrological Modeling Instrument

    NASA Astrophysics Data System (ADS)

    Hunink, J.; Hoogewoud, J. C.; Prinsen, G.; Veldhuizen, A.

    2012-04-01

    Netherlands Hydrological Modeling Instrument Decision support for dutch drought management and climate change. J. Hunink , J.C.Hoogewoud , A. Veldhuizen , G. Prinsen , The Netherlands Hydrological modeling Instrument (NHI) is the center point of a framework of models, to coherently model the hydrological system and the multitude of functions it supports. Dutch hydrological institutes Deltares, Alterra, Netherlands Environmental Assessment Agency, RWS Waterdienst, STOWA and Vewin are cooperating in enhancing the NHI for adequate decision support. The instrument is used by three different ministries involved in national water policy matters, for instance drought management, manure policy and climate change issues. The basis of the modeling instrument is a state-of-the-art on-line coupling of the groundwater system (MODFLOW), the unsaturated zone (metaSWAP) and the surface water system (MOZART-DM). It brings together hydro(geo)logical processes from the column to the basin scale, ranging from 250x250m plots to the river Rhine and includes salt water flow. The NHI is validated with an eight year run (1998-2006) with dry and wet periods and is updated every year. During periods of water scarcity the NHI is used for operational forecasting and decision support system for the National Board of water Distribution. It provides data on nationwide calculated water demands, development of water levels in reservoirs and possible los of yield in agricultural area's. For the exploration of the future of fresh water supply in the Netherlands an extensive study is set up using the NHI. In this study different climate scenarios are being evalueated. In the first phase the focus is on describing the range of possible effects, the second phase focuses on adaptive measures and preparing for decisions how to alter the hydrological system. Results from the first phase show that in future scenario's fresh water may not be available to current water users. Important decisions about the

  6. Persistent Identifiers for Dutch cultural heritage institutions

    NASA Astrophysics Data System (ADS)

    Ras, Marcel; Kruithof, Gijsbert

    2016-04-01

    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

  7. Trial by Dutch laboratories for evaluation of non‐invasive prenatal testing. Part I—clinical impact

    PubMed Central

    Oepkes, Dick; Page‐Christiaens, G. C. (Lieve); Bax, Caroline J.; Bekker, Mireille N.; Bilardo, Catia M.; Boon, Elles M. J.; Schuring‐Blom, G. Heleen; Coumans, Audrey B. C.; Faas, Brigitte H.; Galjaard, Robert‐Jan H.; Go, Attie T.; Henneman, Lidewij; Macville, Merryn V. E.; Pajkrt, Eva; Suijkerbuijk, Ron F.; Huijsdens‐van Amsterdam, Karin; Van Opstal, Diane; Verweij, E. J. (Joanne); Weiss, Marjan M.

    2016-01-01

    Abstract Objective To evaluate the clinical impact of nationwide implementation of genome‐wide non‐invasive prenatal testing (NIPT) in pregnancies at increased risk for fetal trisomies 21, 18 and 13 (TRIDENT study). Method Women with elevated risk based on first trimester combined testing (FCT ≥ 1:200) or medical history, not advanced maternal age alone, were offered NIPT as contingent screening test, performed by Dutch University Medical laboratories. We analyzed uptake, test performance, redraw/failure rate, turn‐around time and pregnancy outcome. Results Between 1 April and 1 September 2014, 1413/23 232 (6%) women received a high‐risk FCT result. Of these, 1211 (85.7%) chose NIPT. One hundred seventy‐nine women had NIPT based on medical history. In total, 1386/1390 (99.7%) women received a result, 6 (0.4%) after redraw. Mean turn‐around time was 14 days. Follow‐up was available in 1376 (99.0%) pregnancies. NIPT correctly predicted 37/38 (97.4%) trisomies 21, 18 or 13 (29/30, 4/4 and 4/4 respectively); 5/1376 (0.4%) cases proved to be false positives: trisomies 21 (n = 2), 18 (n = 1) and 13 (n = 2). Estimated reduction in invasive testing was 62%. Conclusion Introduction of NIPT in the Dutch National healthcare‐funded Prenatal Screening Program resulted in high uptake and a vast reduction of invasive testing. Our study supports offering NIPT to pregnant women at increased risk for fetal trisomy. © 2016 The Authors. Prenatal Diagnosis published by John Wiley & Sons, Ltd. © 2016 The Authors. Prenatal Diagnosis published by John Wiley & Sons, Ltd. PMID:27750376

  8. [Dutch computer domestication, 1975-1990].

    PubMed

    Veraart, Frank

    2008-01-01

    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

  9. Clinical decision making in spinal fusion for chronic low back pain. Results of a nationwide survey among spine surgeons

    PubMed Central

    de Bie, Rob; Öner, Cumhur; Castelein, René; de Kleuver, Marinus

    2011-01-01

    Objectives To assess the use of prognostic patient factors and predictive tests in clinical decision making for spinal fusion in patients with chronic low back pain. Design and setting Nationwide survey among spine surgeons in the Netherlands. Participants Surgeon members of the Dutch Spine Society were questioned on their surgical treatment strategy for chronic low back pain. Primary and secondary outcome measures The surgeons' opinion on the use of prognostic patient factors and predictive tests for patient selection were addressed on Likert scales, and the degree of uniformity was assessed. In addition, the influence of surgeon-specific factors, such as clinical experience and training, on decision making was determined. Results The comments from 62 surgeons (70% response rate) were analysed. Forty-four surgeons (71%) had extensive clinical experience. There was a statistically significant lack of uniformity of opinion in seven of the 11 items on prognostic factors and eight of the 11 items on predictive tests, respectively. Imaging was valued much higher than predictive tests, psychological screening or patient preferences (all p<0.01). Apart from the use of discography and long multisegment fusions, differences in training or clinical experience did not appear to be of significant influence on treatment strategy. Conclusions The present survey showed a lack of consensus among spine surgeons on the appreciation and use of predictive tests. Prognostic patient factors were not consistently incorporated in their treatment strategy either. Clinical decision making for spinal fusion to treat chronic low back pain does not have a uniform evidence base in practice. Future research should focus on identifying subgroups of patients for whom spinal fusion is an effective treatment, as only a reliable prediction of surgical outcome, combined with the implementation of individual patient factors, may enable the instalment of consensus guidelines for surgical decision

  10. Shifts in the architecture of the Nationwide Health Information Network.

    PubMed

    Lenert, Leslie; Sundwall, David; Lenert, Michael Edward

    2012-01-01

    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.

  11. Nationwide peritoneal dialysis nurse training in Thailand: 3-year experience.

    PubMed

    Thaiyuenwong, Jutiporn; Mahatanan, Nanta; Jiravaranun, Somsong; Boonyakarn, Achara; Rodpai, Somrak; Eiam-Ong, Somchai; Tungsanga, Kriang; Dhanakijcharoen, Prateep; Kanjanabuch, Talerngsak

    2011-09-01

    Peritoneal dialysis (PD) center is not possible to operate if there is no availability of dedicated PD nurse. Generally, the nurse has to play many roles, including educator coordinator, and sometimes leader. As professionalism, the PD nurses need to have both theoretical and practical skills. With the tremendous leap of PD population after the launch of "PD First" policy in Thailand, the shortage of skillful PD nurse is concerned. Hence, the nationwide PD nurse training course was established with the collaborations of many organizations and institutes. Until now, 3 generations of 225 PD nurses are the productions of the course. This number represents 80 percent of PD nurses distributed throughout the whole nation. The survey operated in the year 2010 demonstrated that the output of the course was acceptable in terms of quality since most of the trained PD nurses had a confidence in taking care of PD patients. The quality of patient care is good as indicated by KPIs.

  12. Infections as risk factor for autoimmune diseases - A nationwide study.

    PubMed

    Nielsen, Philip Rising; Kragstrup, Tue Wenzel; Deleuran, Bent Winding; Benros, Michael Eriksen

    2016-11-01

    Viruses, bacteria and other infectious pathogens are the major postulated environmental triggers of autoimmunity. In the present nation-wide study we describe the association between infections and 29 autoimmune diseases. We used the Danish Civil Registration System to identify 4.5 million persons born between 1945 and 2000. Information on infections and autoimmune diseases was obtained from the Danish Hospital Register. The cohort was followed from 1977 to 2012. Incidence rate ratios for developing an autoimmune disease were estimated using poisson regression. We found an association between hospital admission for an infection and 29 autoimmune diseases. This study shows that infections are risk factors for a broad spectrum of autoimmune diseases in a dose-response and temporal manner, in agreement with the hypothesis that infections are an environmental risk factor contributing to the etiology of autoimmune diseases together with genetic factors.

  13. Nationwide Mobile Communication Systems. Volume 3. Appendix B - D

    DTIC Science & Technology

    1990-06-01

    34 ’U- COPY NAVAL POSTGRADUATE SCHOOL 00> Monterey, California CV) N F.L-FATT -’ -m% DTIC THESIS A U I" 0 NATIONWIDE MOBILE COMMUNICATION SYSTEMS by...the radio spectrum. Frequency jub-bands are also designated by the letters listed in Talble 31 [Ref. 52:pp. 212-213]. 492 o o >1 0 0 V z -- >1 u ra r- o...01 0J U u a .40 4- 0 0 r 4- - -4 So a -4 HM P4 49 3 TABLE 31 LETTER BAND DESIGNATIONS Band Frequency RanQe C 3.7-6.425 GHz K 10.7-18 GHz K8 18-304

  14. EURAMOS-1, an international randomised study for osteosarcoma: results from pre-randomisation treatment†

    PubMed Central

    Whelan, J. S.; Bielack, S. S.; Marina, N.; Smeland, S.; Jovic, G.; Hook, J. M.; Krailo, M.; Anninga, J.; Butterfass-Bahloul, T.; Böhling, T.; Calaminus, G.; Capra, M.; Deffenbaugh, C.; Dhooge, C.; Eriksson, M.; Flanagan, A. M.; Gelderblom, H.; Goorin, A.; Gorlick, R.; Gosheger, G.; Grimer, R. J.; Hall, K. S.; Helmke, K.; Hogendoorn, P. C. W.; Jundt, G.; Kager, L.; Kuehne, T.; Lau, C. C.; Letson, G. D.; Meyer, J.; Meyers, P. A.; Morris, C.; Mottl, H.; Nadel, H.; Nagarajan, R.; Randall, R. L.; Schomberg, P.; Schwarz, R.; Teot, L. A.; Sydes, M. R.; Bernstein, M.; Pickering, James; Joffe, Nicola; Kevric, Matthias; Sorg, Benjamin; Villaluna, Doojduen; Wang, Caroline; Perisoglou, Martha; Trani, Leonardo; Potratz, Jenny; Carrle, Dorothe; Wilhelm, Miriam; Zils, Katja; Teske, Carmen

    2015-01-01

    Background Four international study groups undertook a large study in resectable osteosarcoma, which included two randomised controlled trials, to determine the effect on survival of changing post-operative chemotherapy based on histological response. Patients and methods Patients with resectable osteosarcoma aged ≤40 years were treated with the MAP regimen, comprising pre-operatively of two 5-week cycles of cisplatin 120 mg/m2, doxorubicin 75 mg/m2, methotrexate 12 g/m2 × 2 (MAP) and post-operatively two further cycles of MAP and two cycles of just MA. Patients were randomised after surgery. Those with ≥10% viable tumour in the resected specimen received MAP or MAP with ifosfamide and etoposide. Those with <10% viable tumour were allocated to MAP or MAP followed by pegylated interferon. Longitudinal evaluation of quality of life was undertaken. Results Recruitment was completed to the largest osteosarcoma study to date in 75 months. Commencing March 2005, 2260 patients were registered from 326 centres across 17 countries. About 1334 of 2260 registered patients (59%) were randomised. Pre-operative chemotherapy was completed according to protocol in 94%. Grade 3–4 neutropenia affected 83% of cycles and 59% were complicated by infection. There were three (0.13%) deaths related to pre-operative chemotherapy. At definitive surgery, 50% of patients had at least 90% necrosis in the resected specimen. Conclusions New models of collaboration are required to successfully conduct trials to improve outcomes of patients with rare cancers; EURAMOS-1 demonstrates achievability. Considerable regulatory, financial and operational challenges must be overcome to develop similar studies in the future. The trial is registered as NCT00134030 and ISRCTN 67613327. PMID:25421877

  15. [Dutch radiodiagnosis from an international viewpoint].

    PubMed

    de Valois, J C

    1990-06-02

    A quantitative description of diagnostic radiology is given in terms of radiological density (the number of radiological examinations per 1000 inhabitants), consumption of roentgen film and contrast media. The data concerning examinations were recorded by a yearly inquiry system addressing all Dutch radiologists. The consumption of film and contrast media were derived from the data banks of the industries. In comparing these data with the data for Western Europe, Japan and the United States it is remarkable that diagnostic radiology scores lowest in regard to density, film consumption and use of contrast media. Only in the use of 35 mm cinefilm (coronary angiography) is The Netherlands number 2 on the list preceded by the United States. As a consequence radiation exposure of the population caused by diagnostic radiology is low in The Netherlands. Although the technical condition of the equipment is good due to regular and preventive service the life-span of the radiological equipment is gradually increasing beyond the limits of the normal economic depreciation. Growing arrears are found in the application of new technology: ultrasound, computer tomography and magnetic resonance imaging. The substitution of high osmolar contrast media by low osmolar media is also lagging behind.

  16. Dutch Open Telescope: status, results, prospects

    NASA Astrophysics Data System (ADS)

    Rutten, Robert J.; Sütterlin, Peter; de Wijn, Alfred G.; Hammerschlag, Robert H.; Bettonvil, Felix C. M.; Hoogendoorn, Piet W.; Jägers, Aswin P. L.

    2002-12-01

    The Dutch Open Telescope (DOT) on La Palma is a revolutionary telescope achieving high-resolution imaging of the solar surface. The DOT combines a pioneering open design at an excellent wind-swept site with image restoration through speckle interferometry. Its open principle is now followed in major solar-telescope projects elsewhere. In the past three years the DOT became the first solar telescope to regularly obtain 0.2" resolution in extended image sequences, i.e., reaching the diffraction limit of its 45-cm primary mirror. Our aim for 2003-2005 is to turn the DOT into a 0.2" tomographic mapper of the solar atmosphere with frequent partnership in international multi-telescope campaigns through student-serviced time allocation. After 2005 we aim to triple the DOT resolution to 0.07" by increasing the aperture to 140 cm and to renew the speckle cameras and the speckle pipeline in order to increase the field size and sequence duration appreciably. These upgrades will maintain the DOT's niche as a tomographic high-resolution mapper in the era when GREGOR, Solar-B and SDO set the stage.

  17. Dutch Open Telescope: Status and Prospects

    NASA Astrophysics Data System (ADS)

    Rutten, R. J.; Hammerschlag, R. H.; Bettonvil, F. M.; Suetterlin, P.

    2000-10-01

    The Dutch Open Telescope (DOT) on La Palma in the Canary Islands is a small but revolutionary solar telescope of which the image quality matches the superb imaging of the Swedish Vacuum Solar Telescope (from whose building the DOT is operated). The DOT is an open parabolic 45cm reflector on an open 15m high tower, relying on mirror flushing by the trade winds that bring the best seeing at La Palma to avoid internal turbulence. A water-cooled field stop in the primary image reflects most sunlight and heat out of the telescope. The first data from the DOT combined with speckle reconstruction have yielded sunspot movies of outstanding quality. At present, a multi-channel imaging system is in construction for simultaneous registration of speckle sequences in the G band, in Ca II K and in Hα. The data pipeline permits continuous speckle data acquisition up to 0.5 Tb per day. The advantage of speckle reconstruction over adaptive optics is the much larger field of the restored scene, with the DOT camera's 100x130 arcsec at 0.2 arcsec resolution. The DOT science program is to study magnetic topology and dynamics throughout the photosphere and chromosphere.

  18. Promoting public awareness of randomised clinical trials using the media: the 'Get Randomised' campaign.

    PubMed

    Mackenzie, Isla S; Wei, Li; Rutherford, Daniel; Findlay, Evelyn A; Saywood, Wendy; Campbell, Marion K; Macdonald, Thomas M

    2010-02-01

    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

  19. Sources of dietary protein and risk of hypertension in a general Dutch population.

    PubMed

    Altorf-van der Kuil, Wieke; Engberink, Mariëlle F; Geleijnse, Johanna M; Boer, Jolanda M A; Monique Verschuren, W M

    2012-11-28

    Evidence suggests a small beneficial effect of dietary protein on blood pressure (BP), especially for plant protein. We examined the relationship between several types of dietary protein (total, plant, animal, dairy, meat and grain) and the risk of hypertension in a general population of 3588 Dutch adults, aged 26-65 years, who were free of hypertension at baseline. Measurements were done at baseline and after 5 and 10 years of follow-up. Hazard ratios (HR), with 95 % CI, for incident hypertension were obtained in tertiles of energy-adjusted protein, using time-dependent Cox regression models. Models were adjusted for age, sex, BMI, education, smoking, baseline systolic BP, dietary confounders and protein from other sources (if applicable). Mean BP was 118/76 mmHg at baseline. Protein intake was 85 (sd 22) g/d (approximately 15 % of energy) with 62 % originating from animal sources. The main sources of protein were dairy products (28 %), meat (24 %) and grain (19 %). During the follow-up, 1568 new cases of hypertension were identified (44 % of the participants). Energy-adjusted intake of total protein, plant protein and animal protein was not significantly associated with hypertension risk (all HR approximately 1·00, P>0·60). Protein from grain showed a significant inverse association with incident hypertension, with a HR of 0·85 (95 % CI 0·73, 1·00, P trend = 0·04) for the upper tertile ( ≥ 18 g/d) v. the lower tertile ( < 14 g/d), whereas dairy protein and meat protein were not associated with incident hypertension. In conclusion, higher intake of grain protein may contribute to the prevention of hypertension, which warrants confirmation in other population-based studies and randomised controlled trials.

  20. The Effect of Souvenaid on Functional Brain Network Organisation in Patients with Mild Alzheimer’s Disease: A Randomised Controlled Study

    PubMed Central

    de Waal, Hanneke; Stam, Cornelis J.; Lansbergen, Marieke M.; Wieggers, Rico L.; Kamphuis, Patrick J. G. H.; Scheltens, Philip; Maestú, Fernando; van Straaten, Elisabeth C. W.

    2014-01-01

    Background Synaptic loss is a major hallmark of Alzheimer’s disease (AD). Disturbed organisation of large-scale functional brain networks in AD might reflect synaptic loss and disrupted neuronal communication. The medical food Souvenaid, containing the specific nutrient combination Fortasyn Connect, is designed to enhance synapse formation and function and has been shown to improve memory performance in patients with mild AD in two randomised controlled trials. Objective To explore the effect of Souvenaid compared to control product on brain activity-based networks, as a derivative of underlying synaptic function, in patients with mild AD. Design A 24-week randomised, controlled, double-blind, parallel-group, multi-country study. Participants 179 drug-naïve mild AD patients who participated in the Souvenir II study. Intervention Patients were randomised 1∶1 to receive Souvenaid or an iso-caloric control product once daily for 24 weeks. Outcome In a secondary analysis of the Souvenir II study, electroencephalography (EEG) brain networks were constructed and graph theory was used to quantify complex brain structure. Local brain network connectivity (normalised clustering coefficient gamma) and global network integration (normalised characteristic path length lambda) were compared between study groups, and related to memory performance. Results The network measures in the beta band were significantly different between groups: they decreased in the control group, but remained relatively unchanged in the active group. No consistent relationship was found between these network measures and memory performance. Conclusions The current results suggest that Souvenaid preserves the organisation of brain networks in patients with mild AD within 24 weeks, hypothetically counteracting the progressive network disruption over time in AD. The results strengthen the hypothesis that Souvenaid affects synaptic integrity and function. Secondly, we conclude that advanced EEG

  1. Relevance of randomised controlled trials in oncology.

    PubMed

    Tannock, Ian F; Amir, Eitan; Booth, Christopher M; Niraula, Saroj; Ocana, Alberto; Seruga, Bostjan; Templeton, Arnoud J; Vera-Badillo, Francisco

    2016-12-01

    Well-designed randomised controlled trials (RCTs) can prevent bias in the comparison of treatments and provide a sound basis for changes in clinical practice. However, the design and reporting of many RCTs can render their results of little relevance to clinical practice. In this Personal View, we discuss the limitations of RCT data and suggest some ways to improve the clinical relevance of RCTs in the everyday management of patients with cancer. RCTs should ask questions of clinical rather than commercial interest, avoid non-validated surrogate endpoints in registration trials, and have entry criteria that allow inclusion of all patients who are fit to receive treatment. Furthermore, RCTs should be reported with complete accounting of frequency and management of toxicities, and with strict guidelines to ensure freedom from bias. Premature reporting of results should be avoided. The bar for clinical benefit should be raised for drug registration, which should require publication and review of mature data from RCTs, post-marketing health outcome studies, and value-based pricing.

  2. Writing to patients: a randomised controlled trial.

    PubMed

    O'Reilly, Máire; Cahill, Mary R; Perry, Ivan J

    2006-01-01

    It has been suggested that consultants should consider writing directly to patients with a summary of their outpatient consultation. In a controlled trial involving consecutive new referrals to a haematology outpatient clinic, we randomised patients to receive either a personal letter from their consultant summarising their consultation (n = 77) or a brief note thanking them for attending the clinic (n = 73). Patients were assessed for recall of and satisfaction with the consultation by a single independent observer, using standardised methods. At the second visit to outpatients, the patients' median percentage recall of items discussed during the consultation was 67% (IQ range 50-80%) in the intervention group, versus 57% (IQ range 43-76%) in the control group (p = 0.3). Strongly positive views on the personal letter were expressed by patients and referring clinicians. The findings suggest that although personal letters do not substantially improve recall of the clinical encounter, they are feasible, highly valued by patients and acceptable to referring clinicians.

  3. Preparing the Dutch delta for future droughts: model based support in the national Delta Programme

    NASA Astrophysics Data System (ADS)

    ter Maat, Judith; Haasnoot, Marjolijn; van der Vat, Marnix; Hunink, Joachim; Prinsen, Geert; Visser, Martijn

    2014-05-01

    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

  4. Intake of dietary phytoestrogens by Dutch women.

    PubMed

    Boker, Lital Keinan; Van der Schouw, Yvonne T; De Kleijn, Miriam J J; Jacques, Paul F; Grobbee, Diederick E; Peeters, Petra H M

    2002-06-01

    Higher consumption of phytoestrogens might be protective against certain chronic diseases. Accurate quantification of habitual phytoestrogen intake is important for assessing associations between phytoestrogens and risk for certain diseases. The aim of this study was to estimate dietary intake of phytoestrogens in Dutch middle-aged and elderly women and to describe their main sources. Women were recruited between 1993 and 1997 and aged 50-69 y at enrollment (Prospect-EPIC; n = 17,357). A detailed food frequency questionnaire referring to the preceding year was filled in at recruitment. A literature search was conducted to obtain data regarding content of the isoflavones daidzein, genistein, formononetin, biochanin A, the coumestan coumesterol and the lignans matairesinol and secoisolariciresinol in relevant food items. Concentrations of each phytoestrogen in each food item were subsequently grouped by seven categories; group scores were multiplied by daily intakes of food items and then summed across food items to produce for each participant a total daily intake score for each phytoestrogen. Approximately 75% of participants were postmenopausal at recruitment. The mean age was 57 y. Geometric means of daily intake of daidzein, genistein, formononetin, biochanin A, coumesterol, matairesinol and secoisolariciresinol were 0.15, 0.16, 0.08, 0.001, <0.001, 0.07 and 0.93 mg, respectively. The main sources for isoflavones were peas and beans, nuts, grain products, coffee, tea and soy products. The main sources for coumestans were peas, beans and other vegetables. The main sources of lignans were grain products, fruit and alcoholic beverages (red and white wines). We conclude that intake levels of phytoestrogen in our study population are low; however, they are comparable with intake levels previously reported for other Western cohorts. In this population, phytoestrogen intake consisted largely of lignans.

  5. A Randomised Controlled Trial of Consent Procedures for the Use of Residual Tissues for Medical Research: Preferences of and Implications for Patients, Research and Clinical Practice

    PubMed Central

    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.

    2016-01-01

    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

  6. Is Dutch Just Another Berber? An Investigation into the Language Preferences of Immigrants in the Netherlands.

    ERIC Educational Resources Information Center

    Weltens, Bert; de Bot, Kees

    1995-01-01

    Reports a study of language learning and language attitudes among immigrants to the Netherlands. Questionnaires obtained from college students studying Dutch showed no evidence that Dutch was threatened by English and indicated that the importance attached to English as an international language did not lessen the value of Dutch for living in the…

  7. Word Order and Finiteness in Dutch and English Broca's and Wernicke's Aphasia

    ERIC Educational Resources Information Center

    Bastiaanse, Roelien; Edwards, Susan

    2004-01-01

    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…

  8. Dutch Social Democrats and the Struggle for Parental Choice in Education (1890-1940).

    ERIC Educational Resources Information Center

    Karsten, Sjoerd

    2003-01-01

    Asserts the Dutch educational systems' key feature is the principle that parents should be given the opportunity to organize and choose the kind of education they desire. Focuses on the role of the Dutch Social Democrats, the Groningen motion, and the outcome and intellectual foundation of publicly run Dutch schools. (KDR)

  9. Challenging Dutch Holocaust Education: Towards a Curriculum Based on Moral Choices and Empathetic Capacity

    ERIC Educational Resources Information Center

    Boersema, Jacob R.; Schimmel, Noam

    2008-01-01

    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…

  10. [The first Dutch debate on anaesthesia in obstetrics].

    PubMed

    Bijker, Liselotte E

    2015-01-01

    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.

  11. Leaf trait dissimilarities between Dutch elm hybrids with a contrasting tolerance to Dutch elm disease

    PubMed Central

    Ďurkovič, Jaroslav; Čaňová, Ingrid; Lagaňa, Rastislav; Kučerová, Veronika; Moravčík, Michal; Priwitzer, Tibor; Urban, Josef; Dvořák, Miloň; Krajňáková, Jana

    2013-01-01

    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

  12. Effect of pelvic floor muscle training compared with watchful waiting in older women with symptomatic mild pelvic organ prolapse: randomised controlled trial in primary care

    PubMed Central

    Wiegersma, Marian; Panman, Chantal M C R; Kollen, Boudewijn J; Berger, Marjolein Y; Lisman-Van Leeuwen, Yvonne

    2014-01-01

    Objective To compare the effects of pelvic floor muscle training and watchful waiting on pelvic floor symptoms in a primary care population of women aged 55 years and over with symptomatic mild pelvic organ prolapse. Design Randomised controlled trial. Setting Dutch primary care. Participants Women aged 55 years or over with symptomatic mild prolapse (leading edge above the hymen) were identified by screening. Exclusion criteria were current prolapse treatment or treatment in the previous year, malignancy of pelvic organs, current treatment for another gynaecological disorder, severe/terminal illness, impaired mobility, cognitive impairment, and insufficient command of the Dutch language. Interventions Pelvic floor muscle training versus watchful waiting. Main outcome measures The primary outcome was change in bladder, bowel, and pelvic floor symptoms measured with the Pelvic Floor Distress Inventory-20 (PFDI-20), three months after the start of treatment. Secondary outcomes were changes in condition specific and general quality of life, sexual function, degree of prolapse, pelvic floor muscle function, and patients’ perceived change in symptoms. Results Of the 287 women who were randomised to pelvic floor muscle training (n=145) or watchful waiting (n=142), 250 (87%) completed follow-up. Participants in the intervention group improved by (on average) 9.1 (95% confidence interval 2.8 to 15.4) points more on the PFDI-20 than did participants in the watchful waiting group (P=0.005). Of women in the pelvic floor muscle training group, 57% (82/145) reported an improvement in overall symptoms from the start of the study compared with 13% (18/142) in the watchful waiting group (P<0.001). Other secondary outcomes showed no significant difference between the groups. Conclusions Although pelvic floor muscle training led to a significantly greater improvement in PFDI-20 score, the difference between the groups was below the presumed level of clinical relevance (15 points

  13. 47 CFR Appendix B to Part 1 - Nationwide Programmatic Agreement for the Collocation of Wireless Antennas

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Collocation of Wireless Antennas B Appendix B to Part 1 Telecommunication FEDERAL COMMUNICATIONS COMMISSION... the Collocation of Wireless Antennas Nationwide Programmatic Agreement for the Collocation of Wireless Antennas Executed by the Federal Communications Commission, the National Conference of State...

  14. 47 CFR Appendix B to Part 1 - Nationwide Programmatic Agreement for the Collocation of Wireless Antennas

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Collocation of Wireless Antennas B Appendix B to Part 1 Telecommunication FEDERAL COMMUNICATIONS COMMISSION... the Collocation of Wireless Antennas Nationwide Programmatic Agreement for the Collocation of Wireless Antennas Executed by the Federal Communications Commission, the National Conference of State...

  15. 47 CFR Appendix B to Part 1 - Nationwide Programmatic Agreement for the Collocation of Wireless Antennas

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Collocation of Wireless Antennas B Appendix B to Part 1 Telecommunication FEDERAL COMMUNICATIONS COMMISSION... the Collocation of Wireless Antennas Nationwide Programmatic Agreement for the Collocation of Wireless Antennas Executed by the Federal Communications Commission, the National Conference of State...

  16. 47 CFR Appendix B to Part 1 - Nationwide Programmatic Agreement for the Collocation of Wireless Antennas

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Collocation of Wireless Antennas B Appendix B to Part 1 Telecommunication FEDERAL COMMUNICATIONS COMMISSION... the Collocation of Wireless Antennas Nationwide Programmatic Agreement for the Collocation of Wireless Antennas Executed by the Federal Communications Commission, the National Conference of State...

  17. 47 CFR Appendix B to Part 1 - Nationwide Programmatic Agreement for the Collocation of Wireless Antennas

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Collocation of Wireless Antennas B Appendix B to Part 1 Telecommunication FEDERAL COMMUNICATIONS COMMISSION... the Collocation of Wireless Antennas Nationwide Programmatic Agreement for the Collocation of Wireless Antennas Executed by the Federal Communications Commission, the National Conference of State...

  18. Corps of Engineers Final New and Modified Replacement Nationwide Permits 2000

    EPA Pesticide Factsheets

    Final new and modified replacement Nationwide Permits require that the Corps be notified of activities impacting more than one-tenth of an acre. The NWPs also provide additional protections to critical resource waters, 100-yr floodplains, and streams.

  19. 76 FR 51271 - Implementing a Nationwide, Broadband, Interoperable Public Safety Network in the 700 MHz Band

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-18

    ... deployment and evolution of the nationwide network. DATES: Effective: August 18, 2011, except Sec. 90.1407(f.... The Commission designated Long Term Evolution (LTE), in particular at least 3GPP Standard,...

  20. Psoriasis and Sleep Apnea: A Danish Nationwide Cohort Study

    PubMed Central

    Egeberg, Alexander; Khalid, Usman; Gislason, Gunnar Hilmar; Mallbris, Lotus; Skov, Lone; Hansen, Peter Riis

    2016-01-01

    Study Objectives: Psoriasis and sleep apnea are associated with significant morbidity and mortality. Although both diseases have been linked with systemic inflammation, studies on their potential bidirectional association are lacking. We investigate the potential association between psoriasis and sleep apnea. Methods: All Danish citizens age 18 y or older between January 1, 1997 and December 31, 2011 (n = 5,522,190) were linked at individual level in nationwide registries. Incidence rates (IRs) per 10,000 person-years were calculated and incidence rate ratios (IRRs) adjusted for age, sex, socioeconomic status, smoking history, alcohol abuse, medication, and comorbidity were estimated by Poisson regression. Results: There were 53,290, 6,885, 6,348, and 39,908 incident cases of mild psoriasis, severe psoriasis, psoriatic arthritis, and sleep apnea, respectively. IRRs (95% confidence interval) for sleep apnea were 1.30 (1.17–1.44), 1.65 (1.23–2.22), and 1.75 (1.35–2.26) in subjects with mild and severe psoriasis, and psoriatic arthritis, and IRRs for mild and severe psoriasis, and psoriatic arthritis in sleep apnea without continuous positive airway pressure (CPAP) therapy were 1.62 (1.41–1.86), 2.04 (1.47–2.82), and 1.94 (1.34–2.79), respectively. In patients with sleep apnea and CPAP therapy (i.e., severe sleep apnea) the IRRs were 1.82 (1.43–2.33), 3.27 (2.03–5.27), and 5.59 (3.74–8.37), respectively. Conclusions: Psoriasis was associated with increased risk of sleep apnea, and sleep apnea was associated with increased risk of psoriasis. The clinical significance of this bidirectional relationship warrants further study. Citation: Egeberg A, Khalid U, Gislason GH, Mallbris L, Skov L, Hansen PR. Psoriasis and sleep apnea: a Danish nationwide cohort study. J Clin Sleep Med 2016;12(5):663–671. PMID:26715401

  1. End-of-life decisions in dutch neonatology.

    PubMed

    Moratti, Sofia

    2010-01-01

    This contribution describes the regulation of end-of-life decisions in neonatology in the Netherlands. An account is given of the process of formulating rules, which includes a report by the Dutch Association for Paediatrics, two Court rulings, a report by a Consultation Group appointed by the Ministry of Health and a professional Protocol regulating deliberate ending of life in neonatology that was subsequently adopted as the regulation of this type of decision-making at the national level. The paper presents Dutch and comparative data on the attitude of the medical profession towards end-of-life decisions in neonatology and the frequency of such decisions in medical practice.

  2. CONSORT 2010 statement: extension to randomised pilot and feasibility trials.

    PubMed

    Eldridge, Sandra M; Chan, Claire L; Campbell, Michael J; Bond, Christine M; Hopewell, Sally; Thabane, Lehana; Lancaster, Gillian A

    2016-01-01

    The Consolidated Standards of Reporting Trials (CONSORT) statement is a guideline designed to improve the transparency and quality of the reporting of randomised controlled trials (RCTs). In this article we present an extension to that statement for randomised pilot and feasibility trials conducted in advance of a future definitive RCT. The checklist applies to any randomised study in which a future definitive RCT, or part of it, is conducted on a smaller scale, regardless of its design (eg, cluster, factorial, crossover) or the terms used by authors to describe the study (eg, pilot, feasibility, trial, study). The extension does not directly apply to internal pilot studies built into the design of a main trial, non-randomised pilot and feasibility studies, or phase II studies, but these studies all have some similarities to randomised pilot and feasibility studies and so many of the principles might also apply. The development of the extension was motivated by the growing number of studies described as feasibility or pilot studies and by research that has identified weaknesses in their reporting and conduct. We followed recommended good practice to develop the extension, including carrying out a Delphi survey, holding a consensus meeting and research team meetings, and piloting the checklist. The aims and objectives of pilot and feasibility randomised studies differ from those of other randomised trials. Consequently, although much of the information to be reported in these trials is similar to those in randomised controlled trials (RCTs) assessing effectiveness and efficacy, there are some key differences in the type of information and in the appropriate interpretation of standard CONSORT reporting items. We have retained some of the original CONSORT statement items, but most have been adapted, some removed, and new items added. The new items cover how participants were identified and consent obtained; if applicable, the prespecified criteria used to judge

  3. Historical Notes on the Dutch and American-Dutch "schools" in Astronomy and Their Relations with Physics

    NASA Astrophysics Data System (ADS)

    van den Heuvel, Ed

    2006-04-01

    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.

  4. A nationwide survey of pediatric acquired demyelinating syndromes in Japan

    PubMed Central

    Yamaguchi, Y.; Kira, R.; Ishizaki, Y.; Sakai, Y.; Sanefuji, M.; Ichiyama, T.; Oka, A.; Kishi, T.; Kimura, S.; Kubota, M.; Takanashi, J.; Takahashi, Y.; Tamai, H.; Natsume, J.; Hamano, S.; Hirabayashi, S.; Maegaki, Y.; Mizuguchi, M.; Minagawa, K.; Yoshikawa, H.; Kira, J.; Kusunoki, S.; Hara, T.

    2016-01-01

    Objective: To investigate the clinical and epidemiologic features of pediatric acquired demyelinating syndromes (ADS) of the CNS in Japan. Methods: We conducted a nationwide survey and collected clinical data on children with ADS aged 15 years or younger, who visited hospitals between 2005 and 2007. Results: Among 977 hospitals enrolled, 723 (74.0%) responded to our inquiries and reported a total of 439 patients as follows: 244 with acute disseminated encephalomyelitis (ADEM), 117 with multiple sclerosis (MS), 14 with neuromyelitis optica (NMO), and 64 with other ADS. We collected and analyzed detailed data from 204 cases, including those with ADEM (66), MS (58), and NMO (10). We observed the following: (1) the estimated annual incidence rate of pediatric ADEM in Japan was 0.40 per 100,000 children (95% confidence interval [CI], 0.34–0.46), with the lowest prevalence in the north; (2) the estimated prevalence rate of MS was 0.69 per 100,000 children (95% CI, 0.58–0.80), with the lowest prevalence in the south; (3) NMO in Japan was rare, with an estimated prevalence of 0.06 per 100,000 children (95% CI, 0.04–0.08); and (4) the sex ratio and mean age at onset varied by ADS type, and (5) male/female ratios correlated with ages at onset in each ADS group. Conclusions: Our results clarify the characteristic clinical features of pediatric ADS in the Japanese population. PMID:27742816

  5. Nationwide Cyprinid herpesvirus 3 contamination in natural rivers of Japan.

    PubMed

    Minamoto, Toshifumi; Honjo, Mie N; Yamanaka, Hiroki; Uchii, Kimiko; Kawabata, Zen'ichiro

    2012-08-01

    Cyprinid herpesvirus 3 (CyHV-3) disease is a significant threat for common and koi carp cultivators and for freshwater ecosystems. To determine the prevalence of CyHV-3 in Japanese rivers, a nationwide survey of all national class-A rivers was undertaken in the Summer of 2008. The virus was concentrated from river water samples using the cation-coated filter method. CyHV-3 DNA was detected in 90 rivers, representing 90% of 103 successfully analysed rivers. More than 100,000 copies of CyHV-3 DNA per litre of sample were detected in four rivers, higher than that reported during the Yura River outbreak in 2007. For CyHV-3-positive rivers, the log CyHV-3 density was negatively correlated with the water temperature on the sampling date and positively correlated with the suspended solids and dissolved oxygen, which are annually averaged for each river. Our results demonstrate that virus detection using molecular biology techniques is a powerful tool for monitoring the presence of CyHV-3 in natural environments.

  6. Prenatal Maternal Smoking and Tourette Syndrome: A Nationwide Register Study.

    PubMed

    Leivonen, Susanna; Chudal, Roshan; Joelsson, Petteri; Ekblad, Mikael; Suominen, Auli; Brown, Alan S; Gissler, Mika; Voutilainen, Arja; Sourander, Andre

    2016-02-01

    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.

  7. Nationwide survey of bednet use in rural Gambia.

    PubMed Central

    D'Alessandro, U.; Aikins, M. K.; Langerock, P.; Bennett, S.; Greenwood, B. M.

    1994-01-01

    A nationwide survey was carried out to investigate the use of bednets in rural areas of the Gambia, particularly among children under 5 years old and among pregnant women. A stratified multistage design was used; 360 compounds in 60 villages were visited. Overall, 58% of beds had a net, with very little difference between villages with primary health care (PHC) facilities and those without (non-PHC). Bednet use was higher in the Central Region (76%) than in the Western and Eastern Regions (both 51%). It was highest among the Jola ethnic group (77%) and lowest among Sarahulis and other minority groups. Use of bednets was higher among target groups (such as infants, children under 5 years old, and pregnant women) than among the general population, and reached a level of over 90% in these groups in the Central Region. Use was associated with possession of a metal bed and a radio. Previous trials of impregnated bednets in the Gambia have been carried out in the Central Region, where bednet use is highest. The efforts of the National Impregnated Bednet Programme should therefore concentrate on the other regions and among the minority ethnic groups in order to increase bednet ownership. PMID:8062396

  8. Nationwide trends in total shoulder arthroplasty and hemiarthroplasty for osteoarthritis.

    PubMed

    Trofa, David; Rajaee, Sean S; Smith, Eric L

    2014-04-01

    Recent literature reports an increase in the rate of shoulder arthroplasties, particularly total shoulder arthroplasties (TSAs), being performed in the United States. However, the national epidemiology of use of hemiarthroplasty (HA) and TSA as treatments for glenohumeral osteoarthritis has not been elucidated. We conducted a study to analyze trends in using HA and TSA as treatments for glenohumeral osteoarthritis from 2000 to 2010, and to compare patient characteristics and inpatient complications. US Nationwide Inpatient Sample patients with a primary inpatient diagnosis of shoulder arthritis and a principal procedure of HA or TSA were identified using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) procedural codes. From 2000 to 2010 the nationally adjusted population rate of shoulder arthroplasty performed for osteoarthritis increased 3.7-fold. Specifically, the population rate of TSA increased 5.0-fold, and that of HA increased 1.9-fold. In 2010, 80.3% of patients having shoulder arthroplasty for arthritis underwent TSA. TSA patients were older (P < .0001) and had a higher mean number of chronic illnesses (P = .034). TSA-associated discharges had a higher rate of surgical and medical care complications (P = .011) and blood transfusions (P = .041) after adjusting for comorbidities.

  9. Patterns of Psychiatric Outpatient Practice in Taiwan: A Nationwide Survey

    PubMed Central

    Dai, Ying-Xiu; Chen, Mu-Hong; Chen, Tzeng-Ji; Lin, Ming-Hwai

    2016-01-01

    (1) Background: Limited studies have utilized nationwide data to assess the patterns of psychiatric practice in other countries. In this study, data from the National Health Insurance Research Database in Taiwan (NHIRD-TW) for 2012 was analyzed to determine the patterns of psychiatric outpatient practice in Taiwan; (2) Methods: To determine the patterns of psychiatric outpatient practice in Taiwan, the data were drawn from the datasets of Taiwan’s National Health Insurance Research Database for 2012, with 619,760 records of outpatient visits representing 1/500 of all the claims in Taiwan for that year. The analysis of psychiatric outpatient visits included patient demographics, diagnoses, and prescribed medications; (3) Results: Neurotic disorders were the most prevalent diagnoses (43.1%, n = 5714). Hypnotics-sedatives and anxiolytics were prescribed in 51.7% (n = 6850) and 39.1% (n = 5181) of psychiatric visits, respectively, with zolpidem being the most commonly prescribed drug (22.6%, n = 2998); and (4) Conclusion: Hypnotics and sedatives were widely prescribed for the outpatient population, and zolpidem had the highest annual prevalence of use. These findings deserve the attention of clinicians and policy makers for monitoring the abuse and dependence of these agents and subsequent adverse events. PMID:27690067

  10. Travel-Related Leptospirosis in Israel: A Nationwide Study

    PubMed Central

    Leshem, Eyal; Segal, Gadi; Barnea, Ada; Yitzhaki, Shmuel; Ostfeld, Iris; Pitlik, Silvio; Schwartz, Eli

    2010-01-01

    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

  11. A nationwide assessment of outcomes after bile duct reconstruction

    PubMed Central

    Eskander, Mariam F; Bliss, Lindsay A; Yousafzai, Osman K; de Geus, Susanna W L; Ng, Sing Chau; Callery, Mark P; Kent, Tara S; Moser, A James; Khwaja, Khalid; Tseng, Jennifer F

    2015-01-01

    Background Bile duct reconstruction (BDR) is used to manage benign and malignant neoplasms, congenital anomalies, bile duct injuries and other non-malignant diseases. BDR outcomes overall, by year, and by indication were compared. Methods Retrospective analysis of Nationwide Inpatient Sample discharges (2004–2011) including ICD-9 codes for BDR. All statistical testing was performed using survey weighting. Univariate analysis of admission characteristics by chi square testing. Multivariate modelling for inpatient complications and inpatient death by logistic regression. Results Identified 67 160 weighted patient admissions: 2.5% congenital anomaly, 37.4% malignant neoplasm, 2.3% benign neoplasm, 9.9% biliary injury, 47.9% other non-malignant disease. Most BDRs were performed in teaching hospitals (69.6%) but only 25% at centres with a BDR volume more than 35/year. 32.3% involved ≥ 1 complication, and 84.7% were discharges home. There was a 4.2% inpatient death rate. The complication rate increased but the inpatient death rate decreased over time. The rates of acute renal failure increased. Significant multivariate predictors of inpatient death include indication of biliary injury or malignancy, and predictors of any complication include public insurance and non-elective admission. Conclusion This is the first national description of BDRs using a large database. In this diverse sampling, both procedure indication and patient characteristics influence morbidity and mortality. PMID:26096061

  12. How Dutch Employees Experience Freedom of Learning for Work

    ERIC Educational Resources Information Center

    van Dellen, Theo; Heidekamp, Ina

    2015-01-01

    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…

  13. Measurement of Tear Production in English Angora and Dutch Rabbits.

    PubMed

    Rajaei, Seyed Mehdi; Rafiee, Siamak Mashhady; Ghaffari, Masoud Selk; Masouleh, Mohammad N; Jamshidian, Mahmoud

    2016-03-01

    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.

  14. Smoking among Dutch Elementary Schoolchildren: Gender-Specific Predictors

    ERIC Educational Resources Information Center

    Ausems, M.; Mesters, I.; van Breukelen, G.; De Vries, H.

    2009-01-01

    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…

  15. Developing Classroom Formative Assessment in Dutch Primary Mathematics Education

    ERIC Educational Resources Information Center

    van den Berg, M.; Harskamp, E. G.; Suhre, C. J. M.

    2016-01-01

    In the last two decades Dutch primary school students scored below expectation in international mathematics tests. An explanation for this may be that teachers fail to adequately assess their students' understanding of learning goals and provide timely feedback. To improve the teachers' formative assessment practice, researchers, curriculum…

  16. Genetic parameters of insect bite hypersensitivity in Dutch Friesian broodmares.

    PubMed

    Schurink, A; Ducro, B J; Heuven, H C M; van Arendonk, J A M

    2011-05-01

    Insect bite hypersensitivity (IBH) is a seasonal allergic skin disease in horses caused by bites of certain Culicoides spp. The aim of our study was to investigate the maternal effect on IBH and to estimate the heritability and repeatability of IBH in the Dutch Friesian horse population. Data consisted of 3,453 Dutch Friesian broodmares with 3,763 visual observations on IBH clinical symptoms scored by 12 inspectors during organized foal inspections in 2004 and 2008. Nine percent of the mares (n = 310) were scored in both years. Mares descended from 144 sires and 2,554 dams and 26.2% of the dams (n = 669) had more than 1 offspring in the data set (range: 2 to 6). Insect bite hypersensitivity was analyzed as a binary trait with a threshold animal model with and without a maternal effect, using a Bayesian approach. Observed IBH prevalence in Dutch Friesian broodmare population was 18.2%. Heritability on the liability scale was 0.16 (SD = 0.06); heritability on the observed scale was 0.07; and repeatability was 0.89 (SD = 0.03). Maternal effect was 0.17 (SD = 0.06) and significantly differed from zero, although the animal model without a maternal effect fitted the data better. These results show that genetic and permanent environmental factors affect IBH in Dutch Friesian horses. The dam affected the IBH development of her offspring through an additive genetic influence but also by being part of their rearing environment.

  17. Two Dutch brothers with Borrone dermato-cardio-skeletal syndrome.

    PubMed

    van Steensel, M A M; Ceulen, R P M; Delhaas, T; de Die-Smulders, C

    2007-06-01

    In 1993, Borrone et al. described two Italian brothers affected by a syndrome of severe acne, mitral valve prolapse, dysmorphic facies, and Scheuermann-like changes of the vertebral column. Since then, no further cases have been reported. Here, we report on two Dutch brothers with many features suggestive of this rare syndrome.

  18. A Collaborative Dialogue--Research in Dutch Language Education

    ERIC Educational Resources Information Center

    Van de Ven, Piet-Hein

    2007-01-01

    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…

  19. How Dutch employees experience freedom of learning for work

    NASA Astrophysics Data System (ADS)

    van Dellen, Theo; Heidekamp, Ina

    2015-12-01

    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.

  20. Phonotactics and Morphophonology in Early Child Language: Evidence from Dutch

    ERIC Educational Resources Information Center

    Zamuner, Tania S.; Kerkhoff, Annemarie; Fikkert, Paula

    2012-01-01

    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…

  1. OpenER, a Dutch Initiative in Open Educational Resources

    ERIC Educational Resources Information Center

    Schuwer, Robert; Mulder, Fred

    2009-01-01

    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…

  2. Development of a Test of Spoken Dutch for Prospective Immigrants

    ERIC Educational Resources Information Center

    De Jong, John H. A. L.; Lennig, Matthew; Kerkhoff, Anne; Poelmans, Petra

    2009-01-01

    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…

  3. Citizenship Education and the Dutch National Identity Debate

    ERIC Educational Resources Information Center

    Doppen, Frans H.

    2010-01-01

    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…

  4. Two Profiles of the Dutch High Performing Employee

    ERIC Educational Resources Information Center

    de Waal, A. A.; Oudshoorn, Michella

    2015-01-01

    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…

  5. Collaboration on ICT in Dutch Higher Education: The SURF Approach

    ERIC Educational Resources Information Center

    Boezerooy, Petra; Cordewener, Bas; Liebrand, Wim

    2007-01-01

    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)…

  6. Evaluation of Transition in Dutch Senior Secondary Vocational Education.

    ERIC Educational Resources Information Center

    Lazonder, Ard W.; de Jong, Frank P. C. M.

    1999-01-01

    Survey responses from 55 Dutch agricultural vocational schools show that administrators believe that transition, the ability of students to change between training modes or qualification levels easily, has enhanced the flexibility of the qualification system developed under recent national reforms. (SLD)

  7. Dutch Treat for U.S. Database Producers.

    ERIC Educational Resources Information Center

    Boumans, Jak

    1984-01-01

    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)

  8. Alliances in the Dutch BeweegKuur Lifestyle Intervention

    ERIC Educational Resources Information Center

    den Hartog, Franciska; Wagemakers, Annemarie; Vaandrager, Lenneke; van Dijk, Marieke; Koelen, Maria A.

    2014-01-01

    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…

  9. Gender Representation and Participation in Dutch Human Geography Departments. Symposium

    ERIC Educational Resources Information Center

    Fortuijn, Joos Droogleever

    2004-01-01

    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…

  10. Cognitive and Linguistic Constraints on Phoneme Isolation in Dutch Kindergartners

    ERIC Educational Resources Information Center

    de Graaff, Saskia; Hasselman, Fred; Bosman, Anna M. T.; Verhoeven, Ludo

    2008-01-01

    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…

  11. Attitudes toward Lesbians and Gays among American and Dutch Adolescents

    PubMed Central

    Collier, Kate L.; Horn, Stacey S.; Bos, Henny M. W.; Sandfort, Theo G. M.

    2014-01-01

    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

  12. Equality on Different Terms: The Case of Dutch Hindu Schools

    ERIC Educational Resources Information Center

    Merry, Michael S.; Driessen, Geert

    2012-01-01

    In this article the authors examine the reasons for the establishment of Hindu schools in the Netherlands and how the Dutch system of education facilitates these and other voluntarily separate schools. In particular, the authors explore the manner in which Hindu schools aim to cultivate and sustain attachments to their own group through a…

  13. Organisational Factors and Teachers' Professional Development in Dutch Secondary Schools

    ERIC Educational Resources Information Center

    Evers, Arnoud T.; van der Heijden, Beatrice I. J. M.; Kreijns, Karel; Gerrichhauzen, John T. G.

    2011-01-01

    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…

  14. Career Guidance and Student Success in Dutch Higher Vocational Education

    ERIC Educational Resources Information Center

    te Wierik, Mark L. J.; Beishuizen, Jos; van Os, Willem

    2015-01-01

    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…

  15. Exploring EFL Literature Approaches in Dutch Secondary Education

    ERIC Educational Resources Information Center

    Bloemert, Jasmijn; Jansen, Ellen; van de Grift, Wim

    2016-01-01

    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…

  16. Sex Differences on the Dutch WAIS-III

    ERIC Educational Resources Information Center

    van der Sluis, Sophie; Posthuma, Danielle; Dolan, Conor V.; de Geus, Eco J. C.; Colom, Roberto; Boomsma, Dorret I.

    2006-01-01

    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.…

  17. Trends in Educational Disadvantage in Dutch Primary School

    ERIC Educational Resources Information Center

    Driessen, Geert; Merry, Michael S.

    2014-01-01

    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…

  18. The Prevalence of Poor Reading in Dutch Special Elementary Education

    ERIC Educational Resources Information Center

    van Bon, Wim H. J.; Bouwmans, Mieke; Broeders, Ivy N. L. D. C.

    2006-01-01

    The relative frequency of poor readers in Dutch general elementary education (GEE) and special elementary education (SEE) and the characteristics of their reading performance were investigated using a lexical decision procedure. According to the same norms that identified 9% of students as poor readers in GEE, no less than 73% of the students in…

  19. Stylizing Standard Dutch by Moroccan Boys in Antwerp

    ERIC Educational Resources Information Center

    Jaspers, Jurgen

    2006-01-01

    This article examines ethnographic data that show Belgian adolescents of Moroccan descent stylizing Standard Dutch. Analysis addresses the importance of this variety in Belgian-Flemish society and in the school these boys attended, and shows how in interviews with Moroccan boys the hegemonic status of this variety is generally accepted. In…

  20. Outcomes in a Randomised Controlled Trial of Mathematics Tutoring

    ERIC Educational Resources Information Center

    Topping, K. J.; Miller, D.; Murray, P.; Henderson, S.; Fortuna, C.; Conlin, N.

    2011-01-01

    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…

  1. Variation in the prion protein sequence in Dutch goat breeds.

    PubMed

    Windig, J J; Hoving, R A H; Priem, J; Bossers, A; van Keulen, L J M; Langeveld, J P M

    2016-10-01

    Scrapie is a neurodegenerative disease occurring in goats and sheep. Several haplotypes of the prion protein increase resistance to scrapie infection and may be used in selective breeding to help eradicate scrapie. In this study, frequencies of the allelic variants of the PrP gene are determined for six goat breeds in the Netherlands. Overall frequencies in Dutch goats were determined from 768 brain tissue samples in 2005, 766 in 2008 and 300 in 2012, derived from random sampling for the national scrapie surveillance without knowledge of the breed. Breed specific frequencies were determined in the winter 2013/2014 by sampling 300 breeding animals from the main breeders of the different breeds. Detailed analysis of the scrapie-resistant K222 haplotype was carried out in 2014 for 220 Dutch Toggenburger goats and in 2015 for 942 goats from the Saanen derived White Goat breed. Nine haplotypes were identified in the Dutch breeds. Frequencies for non-wild type haplotypes were generally low. Exception was the K222 haplotype in the Dutch Toggenburger (29%) and the S146 haplotype in the Nubian and Boer breeds (respectively 7 and 31%). The frequency of the K222 haplotype in the Toggenburger was higher than for any other breed reported in literature, while for the White Goat breed it was with 3.1% similar to frequencies of other Saanen or Saanen derived breeds. Further evidence was found for the existence of two M142 haplotypes, M142 /S240 and M142 /P240 . Breeds vary in haplotype frequencies but frequencies of resistant genotypes are generally low and consequently selective breeding for scrapie resistance can only be slow but will benefit from animals identified in this study. The unexpectedly high frequency of the K222 haplotype in the Dutch Toggenburger underlines the need for conservation of rare breeds in order to conserve genetic diversity rare or absent in other breeds.

  2. Serum vitamin C and spinal pain: a nationwide study.

    PubMed

    Dionne, Clermont E; Laurin, Danielle; Desrosiers, Thérèse; Abdous, Belkacem; Le Sage, Natalie; Frenette, Jérôme; Mondor, Myrto; Pelletier, Sylvie

    2016-11-01

    Back pain brings about one of the heaviest burden of disease. Despite much research, this condition remains poorly understood, and effective treatments are frustratingly elusive. Thus, researchers in the field need to consider new hypotheses. Vitamin C (ascorbic acid) is an essential cofactor for collagen crosslinks, a key determinant of ligament, tendon, and bone quality. Recent studies have reported high frequency of hypovitaminosis C in the general population. We hypothesized that lack of vitamin C contributes to poor collagen properties and back pain. We conducted this study to examine the associations between serum concentration of vitamin C and the prevalence of spinal pain and related functional limitations in the adult general population. This study used nationwide cross-sectional data from the U.S. National Health and Nutrition Examination Survey (NHANES) 2003-2004. Data were available for 4742 individuals aged ≥20 years. Suboptimal serum vitamin C concentrations were associated with the prevalence of neck pain (adjusted odds ratio [aOR]: 1.5; 95% confidence interval [CI]: 1.2-2.0), low back pain (aOR: 1.3; 95% CI: 1.0-1.6), and low back pain with pain below knee (aOR: 1.3; 95% CI: 1.0-1.9) in the past 3 months, self-reported diagnosis of arthritis/rheumatism (aOR: 1.4; 95% CI: 1.2-1.7), and related functional limitations' score (adjusted difference of means [aB]: 0.03; 95% CI: 0.00-0.05). The prevalence of hypovitaminosis C in the general population is high. Our study shows associations between vitamin C and spinal pain that warrant further investigation to determine the possible importance of vitamin C in the treatment of back pain patients.

  3. Marital Status, Lifestyle and Dementia: A Nationwide Survey in Taiwan

    PubMed Central

    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

    2015-01-01

    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

  4. Vascular comorbidities in multiple sclerosis: a nationwide study from Denmark.

    PubMed

    Thormann, Anja; Magyari, Melinda; Koch-Henriksen, Nils; Laursen, Bjarne; Sørensen, Per Soelberg

    2016-12-01

    To investigate the occurrence of vascular comorbidities before and after the clinical onset of multiple sclerosis. In this combined case-control and cohort study, all Danish born citizens with onset of multiple sclerosis 1980-2005 were identified from the Danish Multiple Sclerosis Registry and randomly matched with controls regarding year of birth, gender, and municipality on January 1st in the year of multiple sclerosis (MS) onset (index date). Individual-level information on comorbidities was obtained from several independent nationwide registries and linked to the study population by unique personal identification numbers. To assess the presence of vascular comorbidities before and after MS onset, cases and controls were followed from January 1977 to the index date, and from the index date through December 2012. We used logistic regression to calculate odds ratios (ORs) and Cox regression to calculate hazard ratios (HRs). Before the index date, MS cases had a decreased probability for cerebrovascular comorbidity [OR 0.69 (95 % CI 0.48-0.99, p = 0.043)], and a numerically but not statistically significant decreased probability for cardiovascular comorbidity [OR 0.87 (95 % CI 0.71-1.07, p = 0.188)]. After the index date, MS cases had an increased risk for cerebrovascular comorbidity [HR 1.84 (95 % CI 1.69-2.00, p < 0.0005)], and for cardiovascular comorbidity [HR 1.08 (95 % CI 1.02-1.15, p = 0.013)]. The lower occurrence of cerebrovascular comorbidities in cases prior to MS onset could be due to protective immune mechanisms, while the higher occurrence of vascular comorbidities in cases after MS onset could be because of converging causal pathways of the coexisting diseases. These findings deserve to be studied closer in a broader spectrum of comorbidities in MS.

  5. Internet addiction among Iranian adolescents: a nationwide study.

    PubMed

    Ahmadi, Khodabakhsh

    2014-01-01

    Problematic use of the Internet by children and adolescents is a newly emerging disorder that has alerted health authorities throughout the world. In Iran, despite the very high speed rate of Internet spread, there is not enough data on the rate of Internet addiction among the adolescents. This study is the first nationwide study that addresses this issue. Overall 4500 students of high school or pre-college schools were recruited from 13/31 provinces of Iran by a cluster sampling method and 4342 (96%) participated. Two self-rated questionnaires (one demographics and one Young's Internet addiction scale) were filled b the participants. Data were analyzed by SPSS software. 962 (22.2%) of the study participants were labeled as having "internet addiction." Males were significantly more likely to be an internet addict (P<0.001). Students whose father and/or mother had a doctorate degree were most likely to have Internet addiction (P<0.001 for both). Job engagement of mothers was significantly associated with students' internet addiction, and the least rate of addiction was observed when the mother was a housewife (P<0.001); having no exercise was associated with the highest rate of Internet addiction (P<0.001). Stepwise logistic regression models showed gender (male), older age, mother's occupation, family's financial status (either very high or very low), low quality of family relationship, and students' lower levels of religious devotion were significantly associated with having Internet addiction. This study showed that Internet addiction in Iranian adolescents is prevalent, and has several independent factors, from which, family relations is most likely to be modifiable. Improvements in family relations and more strict parental supervision, especially when mothers have active job employment, are recommended.

  6. Nationwide community survey of tuberculosis epidemiology in Saudi Arabia.

    PubMed

    al-Kassimi, F A; Abdullah, A K; al-Hajjaj, M S; al-Orainey, I O; Bamgboye, E A; Chowdhury, M N

    1993-08-01

    In the first nationwide community-based survey of the epidemiology of tuberculosis in Saudi Arabia, 7721 subjects were screened in the 5 provinces (using an equal proportional allocation formula) for 2 parameters: (1) prevalence of positive Mantoux test in non BCG vaccinated subjects; (2) prevalence of bacillary cases on sputum culture. The prevalence of positive Mantoux reaction in children aged 5-14 years was 6% +/- 1.8; higher in urban areas (10%), and lower in rural areas (2%), thus classifying Saudi Arabia among the middle prevalence countries. These relatively good results (by Third World standards) could reflect the rise of the standard of living and wide availability of free treatment for active cases with a lowered risk of infection in the community. This view is supported by the fact that in our survey, only one subject grew Mycobacterium tuberculosis in the sputum. However, there were foci of high prevalence of Mantoux reaction in the urban communities in the Western province (20% +/- 8.7 urban; 1% +/- 1.9 rural). The problem may be caused by the fact that the province receives every year over a million pilgrims, some of whom are known to settle illegally and escape the usual screening for tuberculosis imposed on foreign labourers. In conclusion, even in the absence of an enforceable national programme for the eradication of tuberculosis, the economic standard and wide availability of free treatment for active cases has resulted in relatively low rates of prevalence of tuberculin sensitivity in children. The foci of high prevalence in the Western Province require special screening arrangements.

  7. Sustaining Fidelity Following the Nationwide PMTO™ Implementation in Norway

    PubMed Central

    Forgatch, Marion S.; DeGarmo, David S.

    2011-01-01

    This report describes three studies from the nationwide Norwegian implementation of Parent Management Training – Oregon Model (PMTO™), an empirically supported treatment for families of children with behavior problems (Forgatch and Patterson 2010). Separate stages of the implementation were evaluated using a fidelity measure based on direct observation of intervention sessions. Study 1 assessed growth in fidelity observed early, mid, and late in the training of a group of practitioners. We hypothesized increased fidelity and decreased variability in practice. Study 2 evaluated method fidelity over the course of three generations of practitioners trained in PMTO. Generation 1 (G1) was trained by the PMTO developer/purveyors; Generation 2 (G2) was trained by selected G1 Norwegian trainers; and Generation 3 (G3) was trained by G1 and G2 trainers. We hypothesized decrease in fidelity with each generation. Study 3 tested the predictive validity of fidelity in a cross-cultural replication, hypothesizing that higher fidelity scores would correlate with improved parenting practices observed in parent-child interactions before and after treatment. In Study 1, trainees' performance improved and became more homogeneous as predicted. In Study 2, a small decline in fidelity followed the transfer from the purveyor trainers to Norwegian trainers in G2, but G3 scores were equivalent to those attained by G1. Thus, the hypothesis was not fully supported. Finally, the FIMP validity model replicated; PMTO fidelity significantly contributed to improvements in parenting practices from pre- to post-treatment. The data indicate that PMTO was transferred successfully to Norwegian implementation with sustained fidelity and cross-cultural generalization. PMID:21671090

  8. Total pancreatectomy and islet autotransplantation: A decade nationwide analysis

    PubMed Central

    Fazlalizadeh, Reza; Moghadamyeghaneh, Zhobin; Demirjian, Aram N; Imagawa, David K; Foster, Clarence E; Lakey, Jonathan R; Stamos, Michael J; Ichii, Hirohito

    2016-01-01

    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

  9. Sleep Apnea and Cancer: Analysis of a Nationwide Population Sample

    PubMed Central

    Gozal, David; Ham, Sandra A.; Mokhlesi, Babak

    2016-01-01

    Study Objectives: Epidemiological evidence from relatively small cohorts suggests that obstructive sleep apnea (OSA) is associated with higher cancer incidence and mortality. Here we aimed to determine whether cancer incidence for major cancer types and risk of metastases or mortality from cancer are increased in the presence of OSA. Methods: All OSA diagnoses included in an employee-sponsored health insurance database spanning the years 2003–2012 were identified and 1:1 matched demographically based on age, gender, and state of residence, or alternatively matched by comorbidities. The incidence of 12 types of cancer was assessed. In addition, another cohort of patients with a primary diagnosis of cancer was retrieved, and the risk of metastatic disease or cancer mortality was determined as a function of the presence or absence of OSA. Multivariate Cox proportional hazards regression models were fitted to assess the independent associations between OSA and outcomes of interest. Results: Based on a cohort of ∼5.6 million individuals, the incidence of all cancer diagnoses combined was similar in OSA and retrospectively matched cases. However, the adjusted risk of pancreatic and kidney cancer and melanoma were significantly higher in patients with OSA, while the risk of colorectal, breast, and prostate cancers appeared to be lower. Among individuals with a diagnosis of cancer, the presence of OSA was not associated with an increased risk for metastasis or death. Conclusions: In a large nationally representative health insurance database, OSA appears to increase the risk for only a very selective number of cancer types, and does not appear to be associated with an increased risk of metastatic cancer or cancer-related deaths. Citation: Gozal D, Ham SA, Mokhlesi B. Sleep apnea and cancer: analysis of a nationwide population sample. SLEEP 2016;39(8):1493–1500. PMID:27166241

  10. Randomised controlled trial of mesalazine in IBS

    PubMed Central

    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

    2016-01-01

    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

  11. Applying Dutch and US Versions of the BSID-II in Dutch Children Born Preterm Leads to Different Outcomes

    ERIC Educational Resources Information Center

    Westera, J. J.; Houtzager, B. A.; Overdiek, B.; van Wassenaer, A. G.

    2008-01-01

    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…

  12. Nationwide updating of the 1:50,000 soil map of the Netherlands with digital soil mapping

    NASA Astrophysics Data System (ADS)

    Kempen, Bas; Brus, Dick J.; de Vries, Folkert

    2015-04-01

    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.

  13. A nationwide study of the epidemiology of relapsing polychondritis

    PubMed Central

    Horváth, Anna; Páll, Nóra; Molnár, Katalin; Kováts, Tamás; Surján, György; Vicsek, Tamás; Pollner, Péter

    2016-01-01

    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

  14. Sexual offending runs in families: A 37-year nationwide study

    PubMed Central

    Långström, Niklas; Babchishin, Kelly M; Fazel, Seena; Lichtenstein, Paul; Frisell, Thomas

    2015-01-01

    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

  15. Epidemiology of Staphylococcus aureus in Italy: First nationwide survey, 2012.

    PubMed

    Campanile, Floriana; Bongiorno, Dafne; Perez, Marianna; Mongelli, Gino; Sessa, Laura; Benvenuto, Sabrina; Gona, Floriana; Varaldo, Pietro E; Stefani, Stefania

    2015-12-01

    A 3-month epidemiological study to determine the prevalence and antibiotic resistance of Staphylococcus aureus nosocomial infections was performed in 52 centres throughout Italy in 2012. A total of 21,873 pathogens were analysed. The prevalence of S. aureus among all nosocomial pathogens isolated in that period was 11.6% (n=2541), whilst the prevalence of methicillin-resistant S. aureus (MRSA) among the S. aureus was 35.8% (n=910). All tested antimicrobials demonstrated ≥92.2% susceptibility against methicillin-susceptible S. aureus, with the exception of clindamycin (89.7%) and erythromycin (84.2%). Among MRSA, percentages of resistance ranged from 12.6% to >39% for tetracycline, rifampicin, clindamycin and gentamicin; higher percentages were found for erythromycin (65.4%) and fluoroquinolones (72.3-85.8%). Overall, the glycopeptide minimum inhibitory concentration (MIC) distribution showed that 58.3% of strains possessed MICs of 1-2mg/L and few strains were linezolid- or daptomycin-resistant. Molecular characterisation was performed on 102 MRSA selected from Northern, Central and Southern regions. Five major clones were found: Italian/ST228-I (t001-t023-t041-t1686-t3217), 33.3%; USA500/ST8-IV (t008), 17.6%; E-MRSA15/ST22-IVh (t020-t025-t032-t223), 16.7%; USA100/ST5-II (t002-t653-t1349-t2164-t3217-t388), 14.7%; and Brazilian/ST239/241-III (t030-t037), 3.9%. Five PVL-positive CA-MRSA isolates, belonging to USA300 and minor clones, were also identified. In conclusion, this first nationwide surveillance study showed that in Italy, S. aureus infections accounted for 11.6% of all nosocomial infections; MRSA accounted for approximately one-third of the S. aureus isolates and these were multidrug-resistant organisms. Five major MRSA epidemic clones were observed and were inter-regionally distributed, with ST228-SCCmecI becoming predominant.

  16. A security framework for nationwide health information exchange based on telehealth strategy.

    PubMed

    Zaidan, B B; Haiqi, Ahmed; Zaidan, A A; Abdulnabi, Mohamed; Kiah, M L Mat; Muzamel, Hussaen

    2015-05-01

    This study focuses on the situation of health information exchange (HIE) in the context of a nationwide network. It aims to create a security framework that can be implemented to ensure the safe transmission of health information across the boundaries of care providers in Malaysia and other countries. First, a critique of the major elements of nationwide health information networks is presented from the perspective of security, along with such topics as the importance of HIE, issues, and main approaches. Second, a systematic evaluation is conducted on the security solutions that can be utilized in the proposed nationwide network. Finally, a secure framework for health information transmission is proposed within a central cloud-based model, which is compatible with the Malaysian telehealth strategy. The outcome of this analysis indicates that a complete security framework for a global structure of HIE is yet to be defined and implemented. Our proposed framework represents such an endeavor and suggests specific techniques to achieve this goal.

  17. Patient-centeredness and quality management in Dutch diabetes care organizations after a 1-year intervention

    PubMed Central

    Campmans-Kuijpers, Marjo JE; Lemmens, Lidwien C; Baan, Caroline A; Rutten, Guy EHM

    2016-01-01

    Background More focus on patient-centeredness in care for patients with type 2 diabetes requests increasing attention to diabetes quality management processes on patient-centeredness by managers in primary care groups and outpatient clinics. Although patient-centered care is ultimately determined by the quality of interactions between patients and clinicians at the practice level, it should be facilitated at organizational level too. This nationwide study aimed to assess the state of diabetes quality management on patient-centeredness at organizational level and its possibilities to improve after a tailored intervention. Methods This before–after study compares the quality management on patient-centeredness within Dutch diabetes care groups and outpatient clinics before and after a 1-year stepwise intervention. At baseline, managers of 51 diabetes primary care groups and 28 outpatient diabetes clinics completed a questionnaire about the organization’s quality management program. Patient-centeredness (0%–100%) was operationalized in six subdomains: facilitating self-management support, individualized care plan support, patients’ access to medical files, patient education policy, safeguarding patients’ interests, and formal patient involvement. The intervention consisted of feedback and benchmark and if requested a telephone call and/or a consultancy visit. After 1 year, the managers completed the questionnaire again. The 1-year changes were examined by dependent (non) parametric tests. Results Care groups improved significantly on patient-centeredness (from 47.1% to 53.3%; P=0.002), and on its subdomains “access to medical files” (from 42.0% to 49.4%), and “safeguarding patients’ interests” (from 58.1% to 66.2%). Outpatient clinics, which scored higher at baseline (66.7%) than care groups, did not improve on patient-centeredness (65.6%: P=0.54) or its subdomains. “Formal patient involvement” remained low in both care groups (23.2%) and

  18. Sudden cardiac death: a nationwide cohort study among the young.

    PubMed

    Risgaard, Bjarke

    2016-12-01

    Sudden cardiac death (SCD) is a tragic event affecting millions of individuals worldwide. Although several studies have investigated the epidemiology of SCD, these studies may have been affected by reporting and referral biases, which are reflected in the very different incidence rates and causes of deaths that have previously been reported. Among SCD victims aged < 36 years, inherited cardiac diseases are well known to play an important role. However, the extent to which inherited cardiac diseases also play a role in SCD victims aged < 50 years has not been completely described. Additionally, SCD in children is of particular interest. These deaths are often described as a part of the deaths of young adolescents up to 40 years of age, and the focus has recently shifted towards the prevention of these deaths. The SCD incidence rate among patients with psychiatric disease has also gained significant attention. Finally, the incidence rate of sports-related sudden cardiac death (SrSCD) has been thoroughly investigated in young competitive athletes. However, whether competitive athletes are at increased risk for SrSCD compared with non-competitive athletes remains unknown. These data should be available prior to discussing optimal screening strategies for (competitive) athletes. In this thesis, we investigated the SCD burden in Danes aged 1-49 years between 2007 and 2009. By using the unique Danish death certificates, autopsy reports, discharge summaries, and registries, we included all deaths in a nationwide setting. We described the incidence rates and causes of death, and we performed a sub-group analysis of SCD in children (1-18 years, 2000-2006). Furthermore, we described the SCD burden in competitive and non-competitive athletes and investigated how often SCD occurred in patients with previous psychiatric disease. SCD has an incidence rate of 8.6 (95% confidence interval (CI) 8.0-9.2) per 100,000 person-years in persons aged 1-49 years. We found a steep increase

  19. Combatting Electoral Traces: The Dutch Tempest Discussion and Beyond

    NASA Astrophysics Data System (ADS)

    Pieters, Wolter

    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.

  20. Epilepsy and self-identity among the Dutch.

    PubMed

    Reis, R

    2001-01-01

    This article discusses the relationship between societal images of epilepsy and the self-identity of Dutch people with epilepsy. I show that the condition of having epilepsy is only constructed as chronic if people continue to have seizures. Chronic epilepsy, or "real epilepsy" as it is sometimes called, is not burdened with such classic stereotypes as "the epileptic personality" or "the epileptic genius." However, Dutch people replace these stereotypes with stereotypes based on ideas about "tension" and "weak spots"--phenomena that are allegedly linked to "sensitive," "brooding" types of people and that are thought to trigger epileptic seizures. Thus there develops a notion of self related to frequency of epileptic seizures. Those who are close to people with epilepsy--relatives and non-medical professionals--play an important role in this development.

  1. Processing grammatical gender in Dutch: Evidence from eye movements.

    PubMed

    Brouwer, Susanne; Sprenger, Simone; Unsworth, Sharon

    2017-03-03

    Previous research has demonstrated that grammatical gender in Dutch is typically acquired late. Most of this work used production data only, and consequently children's knowledge of Dutch gender may have been underestimated. In this study, therefore, we examined whether 49 4- to 7-year-old Dutch-speaking children (and 19 adult controls) were able to use gender marking in the article preceding the object label during online sentence processing to (a) anticipate the upcoming object label or to (b) facilitate the processing of that label as it is presented. In addition, we investigated whether children's online processing and production of gender marking on articles were related. In an eye-tracking task, participants were presented with sentences and visual displays with two objects, representing nouns of either the same gender (uninformative) or different genders (informative). Children were divided into a non-targetlike group and a targetlike group on the basis of their scores for neuter nouns in the production task. Our analyses examined whether participants could use gender marking anticipatorily (i.e., before the onset of the noun) and facilitatively (i.e., from noun onset). Results showed that Dutch-speaking adults and children who were successful in production used gender marking anticipatorily. However, children who did not systematically produce gender-marked articles used gender marking only facilitatively. These findings reveal that successful online comprehension may in part be possible before targetlike production is completely in place, but at the same time targetlike production may be a trigger for online comprehension to be completely successful.

  2. Autosomal dominant congenital Horner's syndrome in a Dutch family.

    PubMed Central

    Hageman, G; Ippel, P F; te Nijenhuis, F C

    1992-01-01

    A Dutch family is reported with congenital Horner's syndrome in five cases spanning five generations, with symptoms of varying degree but mainly ptosis and meiosis. Heterochromia iridium, anhidrosis, and enophthalmos were not present. The site of the lesion may be in the region between Gasser's ganglion and the short vertical segment of the internal carotid artery near the siphon. There are only four previous reports showing autosomal dominant inheritance of congenital Horner's syndrome. Images PMID:1548493

  3. Autosomal dominant congenital Horner's syndrome in a Dutch family.

    PubMed

    Hageman, G; Ippel, P F; te Nijenhuis, F C

    1992-01-01

    A Dutch family is reported with congenital Horner's syndrome in five cases spanning five generations, with symptoms of varying degree but mainly ptosis and meiosis. Heterochromia iridium, anhidrosis, and enophthalmos were not present. The site of the lesion may be in the region between Gasser's ganglion and the short vertical segment of the internal carotid artery near the siphon. There are only four previous reports showing autosomal dominant inheritance of congenital Horner's syndrome.

  4. Predictors of photo naming: Dutch norms for 327 photos.

    PubMed

    Shao, Zeshu; Stiegert, Julia

    2016-06-01

    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.

  5. Probabilistic environmental risk assessment of zinc in Dutch surface waters.

    PubMed

    Van Sprang, Patrick A; Verdonck, Frederik A M; Vanrolleghem, Peter A; Vangheluwe, Marnix L; Janssen, Colin R

    2004-12-01

    In the framework of the European Union (EU) New and Existing Chemicals Policy, a regional risk assessment for Zn according to the current technical guidance documents and a probabilistic approach, by mathematically integrating both best-fitting exposure concentrations and species-sensitivity distributions into a probabilistic risk quotient distribution using Monte Carlo analysis, was explored for The Netherlands. Zinc is an essential element, and the current probability distributions may not adequately deal with this property. The threshold Pareto distribution provided the best fit to the chronic Zn toxicity data, resulting in a predicted-no-effect concentration (PNECadd) for dissolved Zn of 34.2 microg/L, whereas use of the conventional normal distribution resulted in a PNECadd for dissolved Zn of 14.6 microg/L. The extracted exposure data resulted in a regional predicted environmental concentration (PEC) for dissolved Zn in the Dutch surface waters of 20.1 microg/L and in PECadd values for dissolved Zn of between 15.5 and 17.3 microg/L, depending on the background correction used. The conventional deterministic risk characterization identified a regional risk for Zn in the Dutch surface waters. The more comprehensive probabilistic approach used in the present study, however, identified only very limited potential risks for the Dutch region. A probabilistic median risk, that the environmental concentration is greater than the no-observed-effect concentration of a species in Dutch surface waters (0.5-0.6%), depending on the inclusion of background correction, was obtained from the best-fitting distributions. Because probabilistic approaches provide a quantifiable and improved assessment of risk and quantification of the uncertainty associated with that assessment, these techniques may be considered as a way to improve the EU risk assessment procedures for data-rich substances.

  6. Nationwide Defense against Nuclear Weapons: Properties of Prim-Read Deployments

    DTIC Science & Technology

    1981-04-01

    p,6 IDA PAME P-1395 NATIONWIDE DEFENSE AGAINST NUCLEAR WEAPONS: PROPERTIES OF PRIM- READ DEPLOYMENTS Alan F. Karr April 1981 DTIC 4t JUL. 2 98...DEFENSE AGAINST NUCLEAR WEAPONS Final PROPERTIES OF PRIM- READ DEPLOYMENTS 4 19F0111N o.4100 U*6 7. Am W~~I UYN~ nQ~n MUMUWN611t Alan F. Karr IDA...E el*,iSdfuoE a iuv it. ICU wols EmEMan rwmae "oi WeMW11,6 M Nationwide defense, Prim- Read deployment, Interceptor deployment, defense against

  7. 47 CFR 54.1302 - Calculation of incumbent local exchange carrier portion of nationwide loop cost expense...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... exchange carrier portion of nationwide loop cost expense adjustment for rate-of-return carriers. (a... 47 Telecommunication 3 2014-10-01 2014-10-01 false Calculation of incumbent local exchange carrier portion of nationwide loop cost expense adjustment for rate-of-return carriers. 54.1302 Section...

  8. A Research Report of Small/Rural School Districts in New Mexico Compared to School Districts of Similiar Size Nationwide.

    ERIC Educational Resources Information Center

    Barker, Bruce O.; Muse, Ivan D.

    A 1982-83 survey produced data used to compare 17 small/rural K-12 New Mexico school districts (900 students or fewer) with 642 similar districts nationwide. Of New Mexico's 88 school districts, 43 were identified as qualifying (48.9%, enrolling 16,648 students), for comparison to 4,125 similar districts nationwide. A questionnaire mailed to…

  9. The Stanford Hypnotic Susceptibility Scale, Form C: normative data of a Dutch student sample.

    PubMed

    Näring, G W; Roelofs, K; Hoogduin, K A

    2001-04-01

    Norms for the Dutch language version of the Standford Hypnotic Susceptibility Scale, Form C (SHSS:C; Weitzenhoffer & Hilgard, 1962) are presented. These norms are based upon a sample of 135 students at a Dutch university. Generally, the psychometric properties of the Dutch version of the SHSS:C are similar to other language versions. However, the mean score was somewhat lower than that found in the original norming studies at Stanford University.

  10. Sexual orientation of parents and Dutch family law.

    PubMed

    van Nijnatten, C H

    1995-01-01

    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.

  11. Young Dutch people's experiences of trading sex: a qualitative study.

    PubMed

    van de Walle, Robert; Picavet, Charles; van Berlo, Willy; Verhoeff, Arnoud

    2012-01-01

    In recent years, the subject of transactional sex among young Dutch people has generated a heated social debate in the Netherlands. However, accurate data on this phenomenon are scarce. This article describes the findings of a qualitative study on young Dutch people's experiences of having sex in return for money or a material reward. Thirty in-depth interviews were conducted with young Dutch men and women aged 14 to 24. Participants came from diverse backgrounds in terms of gender, ethnicity, sexual orientation, and socioeconomic status. Experiences of trading sex differed in terms of the motivation to trade sex, the presence or absence of coercion, and the availability of other options for earning money. Participants' feelings about their experiences varied. For most participants, the sex itself was unpleasant and required considerable emotion management. Still, some felt adequately compensated by the reward or felt trading sex was preferable to other jobs. Gender played an important role, with feelings of disgust or shame reported especially by female participants, whereas male participants reported more positive experiences. Interactions involving coercion or financial dependence on trading sex generally had a negative emotional impact. Participants stressed the differences between their own experiences and professional prostitution.

  12. Relative Age Effects in Dutch Adolescents: Concurrent and Prospective Analyses

    PubMed Central

    Jeronimus, Bertus F.; Stavrakakis, Nikolaos; Veenstra, René; Oldehinkel, Albertine J.

    2015-01-01

    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

  13. Lexical frequency and voice assimilation in complex words in Dutch

    NASA Astrophysics Data System (ADS)

    Ernestus, Mirjam; Lahey, Mybeth; Verhees, Femke; Baayen, Harald

    2004-05-01

    Words with higher token frequencies tend to have more reduced acoustic realizations than lower frequency words (e.g., Hay, 2000; Bybee, 2001; Jurafsky et al., 2001). This study documents frequency effects for regressive voice assimilation (obstruents are voiced before voiced plosives) in Dutch morphologically complex words in the subcorpus of read-aloud novels in the corpus of spoken Dutch (Oostdijk et al., 2002). As expected, the initial obstruent of the cluster tends to be absent more often as lexical frequency increases. More importantly, as frequency increases, the duration of vocal-fold vibration in the cluster decreases, and the duration of the bursts in the cluster increases, after partialing out cluster duration. This suggests that there is less voicing for higher-frequency words. In fact, phonetic transcriptions show regressive voice assimilation for only half of the words and progressive voice assimilation for one third. Interestingly, the progressive voice assimilation observed for higher-frequency complex words renders these complex words more similar to monomorphemic words: Dutch monomorphemic words typically contain voiceless obstruent clusters (Zonneveld, 1983). Such high-frequency complex words may therefore be less easily parsed into their constituent morphemes (cf. Hay, 2000), favoring whole word lexical access (Bertram et al., 2000).

  14. [Dutch-Romanian cooperation in the area of family practice].

    PubMed

    van Es, J C

    2001-10-27

    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.

  15. [Topics in clinical dentistry. Trends in the Dutch dental literature].

    PubMed

    van der Sanden, W J; Mettes, T G; Grol, R; Plasschaert, A J; Verdonschot, E H

    1999-10-01

    Aim of the study was to evaluate a method for selecting topics suitable for developing dental clinical practice guidelines in the Netherlands, based on an analysis of Dutch dental journals. A search for dental clinical topics was conducted by analysing Dutch dental journals, magazines and series over the period 1992-1997. The numbers of publications per topic were plotted against the publication years. The number of publications as well as the value of the slope of the linear regression were considered to be indicators of the importance of a topic. 'Dental implants (indication)' had the highest number of publications, followed by 'orthodontic treatment planning' and 'periodontology (indication)'. The topic 'practice hygiene' showed the highest value of the slope of the linear regression, followed by 'TMJ dysfunction' and 'dental implants (indication)'. With this method, it is feasible to detect changes and tendencies in the Dutch dental literature. It permits a selection of clinically relevant topics over a time span. It was concluded that this method may be very useful in the selection of a topic, but should probably be combined with other methods.

  16. When Correction Turns Positive: Processing Corrective Prosody in Dutch

    PubMed Central

    Dimitrova, Diana V.; Stowe, Laurie A.; Hoeks, John C. J.

    2015-01-01

    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

  17. Pain exposure physical therapy (PEPT) compared to conventional treatment in complex regional pain syndrome type 1: a randomised controlled trial

    PubMed Central

    Barnhoorn, Karlijn J; van de Meent, Henk; van Dongen, Robert T M; Klomp, Frank P; Groenewoud, Hans; Samwel, Han; Nijhuis-van der Sanden, Maria W G; Frölke, Jan Paul M; Staal, J Bart

    2015-01-01

    Objective To compare the effectiveness of pain exposure physical therapy (PEPT) with conventional treatment in patients with complex regional pain syndrome type 1 (CRPS-1) in a randomised controlled trial with a blinded assessor. Setting The study was conducted at a level 1 trauma centre in the Netherlands. Participants 56 adult patients with CRPS-1 participated. Three patients were lost to follow-up. Interventions Patients received either PEPT in a maximum of five treatment sessions, or conventional treatment following the Dutch multidisciplinary guideline. Measurements Outcomes were assessed at baseline and at 3, 6 and 9 months after randomisation. The primary outcome measure was the Impairment level Sum Score—Restricted Version (ISS-RV), consisting of visual analogue scale for pain (VAS-pain), McGill Pain Questionnaire, active range of motion (AROM) and skin temperature. Secondary outcome measures included Pain Disability Index (PDI); muscle strength; Short Form 36 (SF-36); disability of arm, shoulder and hand; Lower Limb Tasks Questionnaire (LLTQ); 10 m walk test; timed up-and-go test (TUG) and EuroQol-5D. Results The intention-to-treat analysis showed a clinically relevant decrease in ISS-RV (6.7 points for PEPT and 6.2 points for conventional treatment), but the between-group difference was not significant (0.96, 95% CI −1.56 to 3.48). Participants allocated to PEPT experienced a greater improvement in AROM (between-group difference 0.51, 95% CI 0.07 to 0.94; p=0.02). The per protocol analysis showed larger and significant between-group effects on ISS-RV, VAS-pain, AROM, PDI, SF-36, LLTQ and TUG. Conclusions We cannot conclude that PEPT is superior to conventional treatment for patients with CRPS-1. Further high-quality research on the effects of PEPT is warranted given the potential effects as indicated by the per protocol analysis. Trial registration numbers NCT00817128 and NTR 2090. PMID:26628523

  18. Summary of the Dutch S3-guidelines on the treatment of psoriasis 2011. Dutch Society of Dermatology and Venereology.

    PubMed

    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

    2014-03-17

    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.

  19. Minimally invasive 'step-up approach' versus maximal necrosectomy in patients with acute necrotising pancreatitis (PANTER trial): design and rationale of a randomised controlled multicenter trial [ISRCTN38327949

    PubMed Central

    Besselink, Marc GH; van Santvoort, Hjalmar C; Nieuwenhuijs, Vincent B; Boermeester, Marja A; Bollen, Thomas L; Buskens, Erik; Dejong, Cornelis HC; van Eijck, Casper HJ; van Goor, Harry; Hofker, Sijbrand S; Lameris, Johan S; van Leeuwen, Maarten S; Ploeg, Rutger J; van Ramshorst, Bert; Schaapherder, Alexander FM; Cuesta, Miguel A; Consten, Esther CJ; Gouma, Dirk J; van der Harst, Erwin; Hesselink, Eric J; Houdijk, Lex PJ; Karsten, Tom M; van Laarhoven, Cees JHM; Pierie, Jean-Pierre EN; Rosman, Camiel; Bilgen, Ernst Jan Spillenaar; Timmer, Robin; van der Tweel, Ingeborg; de Wit, Ralph J; Witteman, Ben JM; Gooszen, Hein G

    2006-01-01

    Background The initial treatment of acute necrotizing pancreatitis is conservative. Intervention is indicated in patients with (suspected) infected necrotizing pancreatitis. In the Netherlands, the standard intervention is necrosectomy by laparotomy followed by continuous postoperative lavage (CPL). In recent years several minimally invasive strategies have been introduced. So far, these strategies have never been compared in a randomised controlled trial. The PANTER study (PAncreatitis, Necrosectomy versus sTEp up appRoach) was conceived to yield the evidence needed for a considered policy decision. Methods/design 88 patients with (suspected) infected necrotizing pancreatitis will be randomly allocated to either group A) minimally invasive 'step-up approach' starting with drainage followed, if necessary, by videoscopic assisted retroperitoneal debridement (VARD) or group B) maximal necrosectomy by laparotomy. Both procedures are followed by CPL. Patients will be recruited from 20 hospitals, including all Dutch university medical centres, over a 3-year period. The primary endpoint is the proportion of patients suffering from postoperative major morbidity and mortality. Secondary endpoints are complications, new onset sepsis, length of hospital and intensive care stay, quality of life and total (direct and indirect) costs. To demonstrate that the 'step-up approach' can reduce the major morbidity and mortality rate from 45 to 16%, with 80% power at 5% alpha, a total sample size of 88 patients was calculated. Discussion The PANTER-study is a randomised controlled trial that will provide evidence on the merits of a minimally invasive 'step-up approach' in patients with (suspected) infected necrotizing pancreatitis. PMID:16606471

  20. Effectiveness of manual therapy compared to usual care by the general practitioner for chronic tension-type headache: design of a randomised clinical trial

    PubMed Central

    Castien, René F; van der Windt, Daniëlle AWM; Dekker, Joost; Mutsaers, Bert; Grooten, Anneke

    2009-01-01

    Background Patients with Chronic Tension Type Headache (CTTH) report functional and emotional impairments (loss of workdays, sleep disturbances, emotional well-being) and are at risk for overuse of medication. Manual therapy may improve symptoms through mobilisation of the spine, correction of posture, and training of cervical muscles. We present the design of a randomised clinical trial (RCT) evaluating the effectiveness of manual therapy (MT) compared to usual care by the general practitioner (GP) in patients with CTTH. Methods and design Patients are eligible for participation if they present in general practice with CTTH according to the classification of the International Headache Society (IHS). Participants are randomised to either usual GP care according to the national Dutch general practice guidelines for headache, or manual therapy, consisting of mobilisations (high- and low velocity techniques), exercise therapy for the cervical and thoracic spine and postural correction. The primary outcome measures are the number of headache days and use of medication. Secondary outcome measures are severity of headache, functional status, sickness absence, use of other healthcare resources, active cervical range of motion, algometry, endurance of the neckflexor muscles and head posture. Follow-up assessments are conducted after 8 and 26 weeks. Discussion This is a pragmatic trial in which interventions are offered as they are carried out in everyday practice. This increases generalisability of results, but blinding of patients, GPs and therapists is not possible. The results of this trial will contribute to clinical decision making of the GP regarding referral to manual therapy in patients with chronic tension headache. PMID:19216763

  1. Internal Structure and Measurement Invariance of the Dutch Eating Behavior Questionnaire (DEBQ) in a (Nearly) Representative Dutch Community Sample.

    PubMed

    Barrada, Juan Ramón; van Strien, Tatjana; Cebolla, Ausiàs

    2016-11-01

    The Dutch Eating Behavior Questionnaire is a widely used instrument for assessment of emotional, external and restrained eating. The aim of the present study is to (i) analyse its internal structure using exploratory structural equation modelling; (ii) to assess its measurement invariance with respect to sex, BMI, age and level of education; and (iii) to evaluate the relations of the factors with these variables. Except that women were slightly over-represented, the sample (n = 2173) closely followed the sociodemographic characteristics of the overall Dutch population. The three theoretical factors that emerged from the analysis were in close correspondence with the three scales for emotional, external and restrained eating. Only two items (item 3 - 'desire to eat when nothing to do…' and item 21 - 'resist delicious food...') presented problematic loadings. The questionnaire showed satisfactory measurement invariance, and expected patterns of mean differences and relations were found. All in all, the results highlight the adequate psychometric properties of the Dutch Eating Behavior Questionnaire. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.

  2. Mindfulness-based stress reduction for GPs: results of a controlled mixed methods pilot study in Dutch primary care

    PubMed Central

    Verweij, Hanne; Waumans, Ruth C; Smeijers, Danique; Lucassen, Peter LBJ; Donders, A Rogier T; van der Horst, Henriëtte E; Speckens, Anne EM

    2016-01-01

    Background Burnout is highly prevalent in GPs and can have a negative influence on their wellbeing, performance, and patient care. Mindfulness-based stress reduction (MBSR) may be an effective intervention to decrease burnout symptoms and increase wellbeing. Aim To gain insight into the feasibility and effectiveness of MBSR on burnout, empathy, and (work-related) wellbeing in GPs. Design and setting A mixed methods pilot study, including a waiting list-controlled pre-/post-study and a qualitative study of the experiences of participating GPs in the Netherlands. Method Participants were sent questionnaires assessing burnout, work engagement, empathy, and mindfulness skills, before and at the end of the MBSR training/waiting period. Qualitative data on how GPs experienced the training were collected during a plenary session and with evaluation forms at the end of the course. Results Fifty Dutch GPs participated in this study. The MBSR group reported a greater decrease in depersonalisation than the control group (adjusted difference −1.42, 95% confidence interval [CI] = −2.72 to −0.21, P = 0.03). Dedication increased more significantly in the MBSR group than in the control group (adjusted difference 2.17, 95% CI = 0.51 to 3.83, P = 0.01). Mindfulness skills increased significantly in the MBSR group compared with the control group (adjusted difference 6.90, 95% CI = 1.42 to 12.37, P = 0.01). There was no significant change in empathy. The qualitative data indicated that the MBSR course increased their wellbeing and compassion towards themselves and others, including their patients. Conclusion The study shows that MBSR for GPs is feasible and might result in fewer burnout symptoms and increased work engagement and wellbeing. However, an adequately powered randomised controlled trial is needed to confirm the study’s findings. PMID:26823271

  3. Asthma and Attention-Deficit/Hyperactivity Disorder: A Nationwide Population-Based Prospective Cohort Study

    ERIC Educational Resources Information Center

    Chen, Mu-Hong; Su, Tung-Ping; Chen, Ying-Sheue; Hsu, Ju-Wei; Huang, Kai-Lin; Chang, Wen-Han; Chen, Tzeng-Ji; Bai, Ya-Mei

    2013-01-01

    Background: Previous cross-sectional studies have suggested an association between asthma and attention-deficit/hyperactivity disorder (ADHD), but the temporal relationship was not determined. Using a nationwide population-based prospective case-control cohort study (1:4, age-/gender-matched), we hypothesized that asthma in infanthood or early…

  4. Curricula Development in Library Science: A Nation-Wide Core Curriculum?

    ERIC Educational Resources Information Center

    Georgy, Ursula

    2011-01-01

    Aim of the project: Curriculum development is a time-consuming process and often interminable. Pursuing the idea of creating a nationwide core curriculum is one opportunity to develop a curriculum in library and information science (LIS). It can be supposed that a project like this can be the initial point stimulating and encouraging the widest…

  5. Evaluation of Nationwide Health Costs of Air Pollution and Cigarette Smoking

    ERIC Educational Resources Information Center

    Williams, J. R.; Justus, C. G.

    1974-01-01

    The findings of this study indicate cigarette smoking causes more respiratory diseases than does air pollution. The 1970 nationwide health cost of respiratory diseases is estimated at $6.22 billion. The effect of air pollution accounts for between 1 and 5 percent of this total cost while cigarette smoking represents 68 percent. (MLB)

  6. A Nationwide Random Sampling Survey of Potential Complicated Grief in Japan

    ERIC Educational Resources Information Center

    Mizuno, Yasunao; Kishimoto, Junji; Asukai, Nozomu

    2012-01-01

    To investigate the prevalence of significant loss, potential complicated grief (CG), and its contributing factors, we conducted a nationwide random sampling survey of Japanese adults aged 18 or older (N = 1,343) using a self-rating Japanese-language version of the Complicated Grief Brief Screen. Among them, 37.0% experienced their most significant…

  7. Methods of Suicide among Cancer Patients: A Nationwide Population-Based Study

    ERIC Educational Resources Information Center

    Chung, Kuo-Hsuan; Lin, Herng-Ching

    2010-01-01

    A 3-year nationwide population-based data set was used to explore methods of suicide (violent vs. nonviolent) and possible contributing factors among cancer patients in Taiwan. A total of 1,065 cancer inpatients who committed suicide were included as our study sample. The regression shows that those who had genitourinary cancer were 0.55 times (p…

  8. 75 FR 10246 - Nationwide Categorical Waivers Under Section 1605 (Buy American) of the American Recovery and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-05

    ... Doc No: 2010-4679] DEPARTMENT OF ENERGY Office of Energy Efficiency and Renewable Energy Nationwide... (Recovery Act) AGENCY: Office of Energy Efficiency and Renewable Energy (EERE), U.S. Department of Energy (DOE). ACTION: Notice. SUMMARY: The Office of Energy Efficiency and Renewable Energy of the...

  9. 75 FR 14592 - Nationwide Limited Public Interest Waivers Under Section 1605 (Buy American) of the American...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-26

    ... of Energy Efficiency and Renewable Energy Nationwide Limited Public Interest Waivers Under Section... of Energy Efficiency and Renewable Energy, U.S. Department of Energy (DOE). ACTION: Notice of limited waivers. SUMMARY: The Office of Energy Efficiency and Renewable Energy (EERE) of the U.S. Department...

  10. Forensic Psychiatric Perspective on Criminality Associated with Intellectual Disability: A Nationwide Register-Based Study

    ERIC Educational Resources Information Center

    Mannynsalo, L.; Putkonen, H.; Lindberg, N.; Kotilainen, I.

    2009-01-01

    Background: Contrasting views exist over the association of intellectual disability (ID) and criminal offending. This nationwide study attempts to shed further light to expand understanding to substantiate the relation between socio-demographic characteristics, psychiatric co-morbidity and criminal behaviour among the Finnish forensic population…

  11. 78 FR 48865 - Nationwide Categorical Waivers Under the American Recovery and Reinvestment Act of 2009 (Recovery...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-12

    ... of Energy Efficiency and Renewable Energy Nationwide Categorical Waivers Under the American Recovery and Reinvestment Act of 2009 (Recovery Act) AGENCY: Office of Energy Efficiency and Renewable Energy... and Recovery Act of 2009 (Recovery Act Buy American provisions) in EERE- funded projects limiting...

  12. 77 FR 20806 - Nationwide Categorical Waivers Under the American Recovery and Reinvestment Act of 2009 (Recovery...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-06

    ... of Energy Efficiency and Renewable Energy Nationwide Categorical Waivers Under the American Recovery and Reinvestment Act of 2009 (Recovery Act) AGENCY: Office of Energy Efficiency and Renewable Energy... 1605 of the Recovery Act under the authority of Section 1605(b)(2), (iron, steel, and the...

  13. 78 FR 48868 - Nationwide Categorical Waivers Under the American Recovery and Reinvestment Act of 2009 (Recovery...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-12

    ... of Energy Efficiency and Renewable Energy Nationwide Categorical Waivers Under the American Recovery and Reinvestment Act of 2009 (Recovery Act) AGENCY: Office of Energy Efficiency and Renewable Energy... and Recovery Act of 2009 (Recovery Act Buy American provisions) in EERE- funded projects for LED...

  14. 78 FR 48867 - Nationwide Categorical Waivers Under the American Recovery and Reinvestment Act of 2009 (Recovery...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-12

    ... of Energy Efficiency and Renewable Energy Nationwide Categorical Waivers Under the American Recovery and Reinvestment Act of 2009 (Recovery Act) AGENCY: Office of Energy Efficiency and Renewable Energy... 1605 of the Recovery Act under the authority of Section 1605(b)(2), (iron, steel, and the...

  15. 78 FR 48866 - Nationwide Categorical Waivers Under the American Recovery and Reinvestment Act of 2009 (Recovery...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-12

    ... of Energy Efficiency and Renewable Energy Nationwide Categorical Waivers Under the American Recovery and Reinvestment Act of 2009 (Recovery Act) AGENCY: Office of Energy Efficiency and Renewable Energy... 1605 of the Recovery Act under the authority of Section 1605(b)(2), (iron, steel, and the...

  16. Child Poverty as a Determinant of Life Outcomes: Evidence from Nationwide Surveys in Japan

    ERIC Educational Resources Information Center

    Oshio, Takashi; Sano, Shinpei; Kobayashi, Miki

    2010-01-01

    We attempt to examine the extent to which poverty in childhood adversely affects success in adulthood, using micro data from nationwide surveys in Japan and taking into account the recursive structure of life outcomes. We use retrospective assessments of income class at the age of 15, because longitudinal data on household income are not…

  17. 47 CFR 90.763 - EA, Regional and nationwide system operations.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... authorized pursuant to § 90.761 may construct and operate any number of land mobile or paging base stations...-nationwide base stations as follows: (i) The EA or Regional licensee must locate its land mobile or paging base stations, or fixed stations transmitting on base station transmit frequencies, at least 120...

  18. 47 CFR 90.763 - EA, Regional and nationwide system operations.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... authorized pursuant to § 90.761 may construct and operate any number of land mobile or paging base stations...-nationwide base stations as follows: (i) The EA or Regional licensee must locate its land mobile or paging base stations, or fixed stations transmitting on base station transmit frequencies, at least 120...

  19. 47 CFR 90.763 - EA, Regional and nationwide system operations.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... authorized pursuant to § 90.761 may construct and operate any number of land mobile or paging base stations...-nationwide base stations as follows: (i) The EA or Regional licensee must locate its land mobile or paging base stations, or fixed stations transmitting on base station transmit frequencies, at least 120...

  20. 47 CFR 90.763 - EA, Regional and nationwide system operations.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... authorized pursuant to § 90.761 may construct and operate any number of land mobile or paging base stations...-nationwide base stations as follows: (i) The EA or Regional licensee must locate its land mobile or paging base stations, or fixed stations transmitting on base station transmit frequencies, at least 120...

  1. Gender-Specific Risk Factors for Intimate Partner Homicide: A Nationwide Register-Based Study

    ERIC Educational Resources Information Center

    Weizmann-Henelius, Ghitta; Gronroos, Matti; Putkonen, Hanna; Eronen, Markku; Lindberg, Nina; Hakkanen-Nyholm, Helina

    2012-01-01

    The present study examined gender differences in intimate partner homicide (IPH) and offender characteristics with the focus on putative gender-specific risk factors in a nationwide consecutive sample of homicide offenders. Data on all offenders (N = 642; 91 females, 551 males) convicted of homicide and subjected to a forensic psychiatric…

  2. Protein, fat, moisture, and cooking yields from a nationwide study of retail beef cuts.

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Nutrient data from the U.S. Department of Agriculture (USDA) are an important resource for U.S. and international databases. To ensure the data for retail beef cuts in USDA’s National Nutrient Database for Standard Reference (SR) are current, a comprehensive, nationwide, multiyear study was conducte...

  3. Scaling up Comprehensive Sexuality Education in Nigeria: From National Policy to Nationwide Application

    ERIC Educational Resources Information Center

    Huaynoca, Silvia; Chandra-Mouli, Venkatraman; Yaqub, Nuhu, Jr.; Denno, Donna Marie

    2014-01-01

    Nigeria is one of few countries that reports having translated national policies on school-based comprehensive sexuality education (CSE) into near-nationwide implementation. We analysed data using the World Health Organization-ExpandNet framework, which provides a systematic structure for planning and managing the scaling up of health innovations.…

  4. Alcohol Education Provided to Opioid Treatment Program Patients: Results of a Nationwide Survey

    ERIC Educational Resources Information Center

    Strauss, Shiela M.; Harris, Gavin; Katigbak, Carina; Rindskopf, David M.; Singh, Sheena; Greenblum, Ilana; Brown, Lawrence S.; Kipnis, Steven; Kritz, Steven A.; Parrino, Mark W.

    2010-01-01

    Alcohol-related problems are especially common among opioid treatment program (OTP) patients, suggesting that educating OTP patients about alcohol and its harmful effects needs to be a priority in OTPs. Using data collected in interviews with a nationwide U.S. sample of OTP directors (N = 200) in 25 states, we identified factors that differentiate…

  5. Inclusionary Practices: A Nationwide Survey of Mainstream Camps Serving All Youth.

    ERIC Educational Resources Information Center

    Brannan, Steve; And Others

    1997-01-01

    A nationwide survey of 31 residential summer camps indicated that disabled and nondisabled campers attended the same camp sessions; that camps served youth with a wide range of disabilities; that disabled and nondisabled campers jointly participated in meals, recreation, evening programs, and arts and crafts; and that camps were willing to…

  6. 75 FR 72822 - Nationwide Categorical Waivers Under Section 1605 (Buy American) of the American Recovery and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-26

    ... of Energy Efficiency and Renewable Energy Nationwide Categorical Waivers Under Section 1605 (Buy...) of section 1605 of the American Reinvestment and Recovery Act of 2009 (Recovery Act Buy American.... SUPPLEMENTARY INFORMATION: Under the authority of Recovery Act, Public Law 111-5, section 1605(b)(2), the...

  7. 12 CFR 1008.205 - The Bureau's establishment of nationwide mortgage licensing system and registry.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 8 2014-01-01 2014-01-01 false The Bureau's establishment of nationwide mortgage licensing system and registry. 1008.205 Section 1008.205 Banks and Banking BUREAU OF CONSUMER FINANCIAL PROTECTION S.A.F.E. MORTGAGE LICENSING ACT-STATE COMPLIANCE AND BUREAU REGISTRATION...

  8. 12 CFR 1008.205 - The Bureau's establishment of nationwide mortgage licensing system and registry.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 8 2012-01-01 2012-01-01 false The Bureau's establishment of nationwide mortgage licensing system and registry. 1008.205 Section 1008.205 Banks and Banking BUREAU OF CONSUMER FINANCIAL PROTECTION S.A.F.E. MORTGAGE LICENSING ACT-STATE COMPLIANCE AND BUREAU REGISTRATION...

  9. 12 CFR 1008.205 - The Bureau's establishment of nationwide mortgage licensing system and registry.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 8 2013-01-01 2013-01-01 false The Bureau's establishment of nationwide mortgage licensing system and registry. 1008.205 Section 1008.205 Banks and Banking BUREAU OF CONSUMER FINANCIAL PROTECTION S.A.F.E. MORTGAGE LICENSING ACT-STATE COMPLIANCE AND BUREAU REGISTRATION...

  10. Relative Income and Happiness in Asia: Evidence from Nationwide Surveys in China, Japan, and Korea

    ERIC Educational Resources Information Center

    Oshio, Takashi; Nozaki, Kayo; Kobayashi, Miki

    2011-01-01

    This study attempts to examine relative income effects on perceived happiness in three major Asian countries--China, Japan, and Korea--in comparison with the United Sates, on the basis of largely comparable nationwide surveys in these countries. Consistent with the results from previous studies in Western countries, comparisons with an…

  11. 76 FR 58286 - Notice of Availability of Draft Programmatic Environmental Assessment for the Nationwide...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-20

    ... Programmatic Environmental Assessment (PEA) for the proposed nationwide implementation of the Interagency... material on the Draft PEA. All comments received will be posted, without change, to http://www.regulations... material received during the comment period. Viewing the comments, PEA, and associated documents: To...

  12. 16 CFR 610.3 - Streamlined process for requesting annual file disclosures from nationwide specialty consumer...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Practices FEDERAL TRADE COMMISSION THE FAIR CREDIT REPORTING ACT FREE ANNUAL FILE DISCLOSURES § 610.3 Streamlined process for requesting annual file disclosures from nationwide specialty consumer reporting... specialty consumer reporting agency only: (1) To provide the annual file disclosure or other...

  13. A Nationwide Survey of Nonspeech Oral Motor Exercise Use: Implications for Evidence-Based Practice

    ERIC Educational Resources Information Center

    Lof, Gregory L.; Watson, Maggie M.

    2008-01-01

    Purpose: A nationwide survey was conducted to determine if speech-language pathologists (SLPs) use nonspeech oral motor exercises (NSOMEs) to address children's speech sound problems. For those SLPs who used NSOMEs, the survey also identified (a) the types of NSOMEs used by the SLPs, (b) the SLPs' underlying beliefs about why they use NSOMEs, (c)…

  14. 76 FR 15302 - Nationwide Categorical Waivers Under Section 1605 (Buy American) of the American Recovery and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-21

    ... Department of the Air Force Nationwide Categorical Waivers Under Section 1605 (Buy American) of the American Recovery and Reinvestment Act of 2009 (Recovery Act) AGENCY: Department of the Air Force, 772d Enterprise... Force, 772d ESS/PK, Senior Center Contracting Official (SOCO) hereby provides notice that on 4...

  15. Developing a Successful State-Level Environmental Education Organization: A Nationwide Assessment

    ERIC Educational Resources Information Center

    Smaldone, David; Dey, Shannon E.

    2010-01-01

    The purpose of this study was to conduct a nationwide assessment of state-level environmental education (EE) organizations to determine the components that are essential to the establishment and success of these organizations. E-mail surveys were used to collect data from North American Association for Environmental Education state affiliates, and…

  16. 76 FR 30145 - Nationwide Categorical Waivers Under Section 1605 (Buy American) of the American Recovery and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-24

    ... regional centers with substantial knowledge of, and connections to, the domestic manufacturing sector. MEP uses their regional centers to `scout' for current or potential manufacturers of the product(s.... The MEP then used their network of nationwide centers to scout for domestic manufacturers. In...

  17. A Nationwide Communication System for the Hearing Impaired: Strategies Toward Commercial Implementation. Final Report.

    ERIC Educational Resources Information Center

    Allan, Daniel S.; And Others

    The purpose of this report is to assess the viability of developing commercial computer communications networks to provide communications services to the deaf community on a nationwide basis. Access to this network is considered for existing Baudot/Weitbrecht Telecommunications Devices for the Deaf (TDDs) and ASCII terminals with Bell modems. The…

  18. Nationwide Network of TalentPoints: The Hungarian Approach to Talent Support

    ERIC Educational Resources Information Center

    Csermely, Peter; Rajnai, Gabor; Sulyok, Katalin

    2013-01-01

    In 2006 a novel approach to talent support was promoted by several talent support programmes in Hungary. The new idea was a network approach. The nationwide network of so-called TalentPoints and its framework, the Hungarian Genius Program, gained substantial European Union funding in 2009, and today it is growing rapidly. A novel concept of talent…

  19. 76 FR 56165 - Soliciting Input on Research and Development Priorities for Desirable Features of a Nationwide...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-12

    ... network that meets the needs of local, state, Tribal, and Federal public safety communities.\\1\\ The... safety is in areas not covered by the public safety broadband network. Network sharing: The shared use of... Desirable Features of a Nationwide Public Safety Broadband Network AGENCY: National Institute of...

  20. 77 FR 66588 - Development of the Nationwide Interoperable Public Safety Broadband Network

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-06

    ... Interoperable Public Safety Broadband Network AGENCY: National Telecommunications and Information Administration... meeting of the First Responder Network Authority (FirstNet) as well as to invite input on other network.../comments-nationwide-interoperable-public-safety-broadband-network-noi . All personal...

  1. Roll the Presses: A Group of Talented Students Works to Produce Brochures for Nationwide Distribution.

    ERIC Educational Resources Information Center

    Olsen, Lee Ann

    1993-01-01

    Four middle school students from Groton, Connecticut, wrote and illustrated two booklets about Lyme Disease which are being distributed nationwide to health departments. The project involved having students view ticks under a microscope at Pfizer laboratories, having Pfizer mentors helping students refine their work, and visiting the publisher to…

  2. Improving Physics Teaching through Action Research: The Impact of a Nationwide Professional Development Programme

    ERIC Educational Resources Information Center

    Grace, Marcus; Rietdijk, Willeke; Garrett, Caro; Griffiths, Janice

    2015-01-01

    This article presents an independent evaluation of the Action Research for Physics (ARP) programme, a nationwide professional development programme which trains teachers to use action research to increase student interest in physics and encourage them to take post-compulsory physics. The impact of the programme was explored from the perspective of…

  3. Bridging the Gap between Science and Practice: The Effective Nationwide Transport of MST Programs in Norway

    ERIC Educational Resources Information Center

    Ogden, Terje; Christensen, Bernadette; Sheidow, Ashli J.; Holth, Per

    2008-01-01

    The successful nationwide transport and evaluation of Multisystemic Therapy (MST) programs in Norway is described. This description is provided within the context of the nation's movement towards the adoption of evidence-based practices (EBPs) during the past decade, the conduct of a multisite randomized clinical trial to examine the effectiveness…

  4. Provision of Hepatitis C Education in a Nationwide Sample of Drug Treatment Programs.

    ERIC Educational Resources Information Center

    Astone, Janetta; Strauss, Shiela M.; Vassilev, Zdravko P.; Des Jarlais, Don C.

    2003-01-01

    Using a nationwide sample of drug treatment programs, reports the results of an analysis that differentiates programs providing Hepatitis C virus (HCV) education to all of their patients versus programs that do not. Fifty-four percent of the programs provide HCV education to all of their patients. Findings indicate a need to increase HCV…

  5. Socioeconomic inequality in clinical outcome among hip fracture patients: a nationwide cohort study.

    PubMed

    Kristensen, P K; Thillemann, T M; Pedersen, A B; Søballe, K; Johnsen, S P

    2017-04-01

    The evidence is limited regarding the association between socioeconomic status and the clinical outcome among patients with hip fracture. In this nationwide, population-based cohort study, higher education and higher family income were associated with a substantially lower 30-day mortality and risk of unplanned readmission after hip fracture.

  6. What's the Link? New Organization To Promote Nationwide Environmental Health Tracking.

    ERIC Educational Resources Information Center

    O'Hara, Jim

    2000-01-01

    Reports that the Environmental Protection Agency (EPA) has been tracking the levels of lead, which is linked to increased behavioral disorders, retardation, and anemia in children, in the United States since the 1970s. Provides statistics on the current state of chronic diseases in the U.S. and asserts that there is a need for a nationwide heath…

  7. Parenting with Intellectual Disability in Germany: Results of a New Nationwide Study

    ERIC Educational Resources Information Center

    Pixa-Kettner, Ursula

    2008-01-01

    Background: A nationwide questionnaire survey conducted in Germany in 2005 found 1584 families headed by persons with intellectual disability with 2164 adults becoming parents between 1990 and 2005. Materials and Methods: In spite of a lower response rate and a more limited time frame compared with a previous study undertaken in the early 1990s…

  8. 47 CFR 90.18 - Public Safety 700 MHz Nationwide Broadband Network.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 5 2012-10-01 2012-10-01 false Public Safety 700 MHz Nationwide Broadband Network. 90.18 Section 90.18 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES PRIVATE LAND MOBILE RADIO SERVICES Public Safety Radio Pool § 90.18 Public...

  9. Teacher Shortage Areas Nationwide Listing: 1990-91 thru 2005-06

    ERIC Educational Resources Information Center

    US Department of Education, 2006

    2006-01-01

    The nationwide Teacher Shortage Area (TSA) lists for the 2004-05 and 2005-06 school years have been completed and are listed by state in this document. A state that desires to propose teacher shortage areas for designation must submit the information required under the program regulations for the following programs: (1) Targeted teacher deferment…

  10. Mass Communication and Journalism Faculty and Their Electronic Communication with College Students: A Nationwide Examination

    ERIC Educational Resources Information Center

    Brunner, Brigitta R.; Yates, Bradford L.; Adams, Jennifer Wood

    2008-01-01

    Nearly 700 U.S. journalism and mass communication faculty reported their perceptions of student e-mail use via a Web-based survey. This nationwide study focused on content of e-mail received by faculty and made comparisons based on faculty gender. Nearly half of the respondents reported that they occasionally receive e-mails from students before a…

  11. 76 FR 10295 - Implementing a Nationwide, Broadband, Interoperable Public Safety Network in the 700 MHz Band

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-24

    ..., namely (1) Internet access; (2) Virtual Private Network (VPN) access to any authorized site and to home... additional requirements to further promote and enable nationwide interoperability among public safety... the instructions for submitting comments. Agency Web Site: http://www.fcc.gov . Follow...

  12. 5 CFR Appendix B to Subpart B of... - Nationwide Schedule of Nonappropriated Fund Regular Wage Surveys

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Fund Regular Wage Surveys B Appendix B to Subpart B of Part 532 Administrative Personnel OFFICE OF.... 532, Subpt. B, App. B Appendix B to Subpart B of Part 532—Nationwide Schedule of Nonappropriated Fund.... Wyoming Laramie July Even. Editorial Note: For Federal Register citations affecting appendix B to...

  13. 5 CFR Appendix B to Subpart B of... - Nationwide Schedule of Nonappropriated Fund Regular Wage Surveys

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Fund Regular Wage Surveys B Appendix B to Subpart B of Part 532 Administrative Personnel OFFICE OF.... 532, Subpt. B, App. B Appendix B to Subpart B of Part 532—Nationwide Schedule of Nonappropriated Fund.... Editorial Note: For Federal Register citations affecting appendix B to subpart B of part 532, see the...

  14. 5 CFR Appendix B to Subpart B of... - Nationwide Schedule of Nonappropriated Fund Regular Wage Surveys

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Fund Regular Wage Surveys B Appendix B to Subpart B of Part 532 Administrative Personnel OFFICE OF.... 532, Subpt. B, App. B Appendix B to Subpart B of Part 532—Nationwide Schedule of Nonappropriated Fund... B to subpart B of part 532, see the List of CFR Sections Affected, which appears in the Finding...

  15. 5 CFR Appendix B to Subpart B of... - Nationwide Schedule of Nonappropriated Fund Regular Wage Surveys

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Fund Regular Wage Surveys B Appendix B to Subpart B of Part 532 Administrative Personnel OFFICE OF.... 532, Subpt. B, App. B Appendix B to Subpart B of Part 532—Nationwide Schedule of Nonappropriated Fund.... Editorial Note: For Federal Register citations affecting appendix B to subpart B of part 532, see the...

  16. 5 CFR Appendix B to Subpart B of... - Nationwide Schedule of Nonappropriated Fund Regular Wage Surveys

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Fund Regular Wage Surveys B Appendix B to Subpart B of Part 532 Administrative Personnel OFFICE OF.... 532, Subpt. B, App. B Appendix B to Subpart B of Part 532—Nationwide Schedule of Nonappropriated Fund.... Editorial Note: For Federal Register citations affecting appendix B to subpart B of part 532, see the...

  17. 75 FR 52713 - Nationwide Aerial Application of Fire Retardant on National Forest System Lands

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-27

    ... Forest Service Nationwide Aerial Application of Fire Retardant on National Forest System Lands AGENCY... aerial application of fire retardant on National Forest System lands. The responsible official for this.... Comments may also be sent via e- mail to FireRetardantEIS@fs.fed.us . FOR FURTHER INFORMATION CONTACT:...

  18. Playing It Safe: The Sixth Nationwide Safety Survey of Public Playgrounds.

    ERIC Educational Resources Information Center

    Weintraub, Rachel; Cassady, Alison

    The sixth nationwide investigation of public playgrounds by the Consumer Federation ofAmerica (CFA) and the State Public Interest Research Groups (PIRGs) found that amajority of U.S. playgrounds pose hidden threats to youngsters. From March-May 2002, the State PIRGs and other CFA member organizations investigated 1,037 playgrounds in 36 states…

  19. Food Hygiene Education in UK Secondary Schools: A Nationwide Survey of Teachers' Views

    ERIC Educational Resources Information Center

    Egan, M. B.; Bielby, G.; Eves, A.; Lumbers, M. L.; Raats, M. M.; Adams, M. R.

    2008-01-01

    Objective: A nationwide survey of teachers investigated the teaching of food hygiene in UK secondary schools. Previous studies have focused on effective strategies in consumer food hygiene training but there is little research focusing on school-based education. Design: The questionnaire was developed based on the results of in-depth interviews…

  20. 75 FR 81284 - Nationwide Use of High Frequency and Ultra High Frequency Active SONAR Technology; Draft...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-27

    ... SONAR technologies that operate at frequencies of 50 kiloHertz (kHz) and greater from mobile platforms... proposes to use HF and UHF SONAR technology from mobile platforms nationwide. Mobile platforms include...-specific, non-mobile operating scenarios or newly developed technologies fall outside of the scope of...

  1. A Framework for evaluating the costs, effort, and value of nationwide health information exchange

    PubMed Central

    Zafar, Atif; Overhage, J Marc

    2010-01-01

    Objective The nationwide health information network (NHIN) has been proposed to securely link community and state health information exchange (HIE) entities to create a national, interoperable network for sharing healthcare data in the USA. This paper describes a framework for evaluating the costs, effort, and value of nationwide data exchange as the NHIN moves toward a production state. The paper further presents the results of an initial assessment of the framework by those engaged in HIE activities. Design Using a literature review and knowledge gained from active NHIN technology and policy development, the authors constructed a framework for evaluating the costs, effort, and value of data exchange between an HIE entity and the NHIN. Measurement An online survey was used to assess the perceived usefulness of the metrics in the framework among HIE professionals and researchers. Results The framework is organized into five broad categories: implementation; technology; policy; data; and value. Each category enumerates a variety of measures and measure types. Survey respondents generally indicated the framework contained useful measures for current and future use in HIE and NHIN evaluation. Answers varied slightly based on a respondent's participation in active development of NHIN components. Conclusion The proposed framework supports efforts to measure the costs, effort, and value associated with nationwide data exchange. Collecting longitudinal data along the NHIN's path to production should help with the development of an evidence base that will drive adoption, create value, and stimulate further investment in nationwide data exchange. PMID:20442147

  2. Relative Immaturity and ADHD: Findings from Nationwide Registers, Parent- and Self-Reports

    ERIC Educational Resources Information Center

    Halldner, Linda; Tillander, Annika; Lundholm, Cecilia; Boman, Marcus; Långström, Niklas; Larsson, Henrik; Lichtenstein, Paul

    2014-01-01

    Background: We addressed if immaturity relative to peers reflected in birth month increases the likelihood of ADHD diagnosis and treatment. Methods: We linked nationwide Patient and Prescribed Drug Registers and used prospective cohort and nested case-control designs to study 6-69 year-old individuals in Sweden from July 2005 to December 2009…

  3. Alzheimer's Disease and Related Disorders in State Mental Hospitals: Data from a Nationwide Survey.

    ERIC Educational Resources Information Center

    Moak, Gary S.; Fisher, William H.

    1990-01-01

    Reports data from nationwide survey of state mental hospitals, providing exploratory look at patients with Alzheimer's disease and related disorders currently residing in state hospitals. Describes admissions trends, reasons for admission, and sources of referral. Discusses civil commitment of nursing home patients with dementing illnesses and…

  4. Promotion of health and physical activity improves the mental health of elderly immigrants: results of a group randomised controlled trial among Turkish immigrants in the Netherlands aged 45 and over

    PubMed Central

    Reijneveld, S; Westhoff, M; Hopman-Rock, M

    2003-01-01

    Design: Randomised controlled trial. Setting: Welfare services in six Dutch cities. Participants: 126 people born in Turkey and aged 45 years and over, of whom 92 completed the trial. Intervention: Eight, two hour sessions consisting of health education and exercises. Topics in health education focused on means to maintain a good health. Education was adapted to the culture and knowledge of older Turks and offered by a Turkish peer educator, in Turkish. Main outcome measures: Physical and mental wellbeing, and mental health based on the SF-12/36; knowledge on health and disease; physical activity. Results: Participants were highly disadvantaged; 52% had not completed primary school and 49% had considerable problems in speaking Dutch. Participants in the intervention group showed an improvement in mental health (effect size: 0.38 SD (95% confidence intervals 0.03 to 0.73), p=0.03); the oldest subgroup also in mental wellbeing (effect size 0.75 SD (0.22 to 1.28), p=0.01). No improvements were seen in physical wellbeing and activity, nor in knowledge. Conclusions: Health education and physical exercise improve the mental state of deprived immigrants. Painstaking cultural adaptations to contents and method of delivery are essential to reach this effect. PMID:12775784

  5. Transluminal endoscopic step-up approach versus minimally invasive surgical step-up approach in patients with infected necrotising pancreatitis (TENSION trial): design and rationale of a randomised controlled multicenter trial [ISRCTN09186711

    PubMed Central

    2013-01-01

    Background Infected necrotising pancreatitis is a potentially lethal disease that nearly always requires intervention. Traditionally, primary open necrosectomy has been the treatment of choice. In recent years, the surgical step-up approach, consisting of percutaneous catheter drainage followed, if necessary, by (minimally invasive) surgical necrosectomy has become the standard of care. A promising minimally invasive alternative is the endoscopic transluminal step-up approach. This approach consists of endoscopic transluminal drainage followed, if necessary, by endoscopic transluminal necrosectomy. We hypothesise that the less invasive endoscopic step-up approach is superior to the surgical step-up approach in terms of clinical and economic outcomes. Methods/Design The TENSION trial is a randomised controlled, parallel-group superiority multicenter trial. Patients with (suspected) infected necrotising pancreatitis with an indication for intervention and in whom both treatment modalities are deemed possible, will be randomised to either an endoscopic transluminal or a surgical step-up approach. During a 4 year study period, 98 patients will be enrolled from 24 hospitals of the Dutch Pancreatitis Study Group. The primary endpoint is a composite of death and major complications within 6 months following randomisation. Secondary endpoints include complications such as pancreaticocutaneous fistula, exocrine or endocrine pancreatic insufficiency, need for additional radiological, endoscopic or surgical intervention, the need for necrosectomy after drainage, the number of (re-)interventions, quality of life, and total direct and indirect costs. Discussion The TENSION trial will answer the question whether an endoscopic step-up approach reduces the combined primary endpoint of death and major complications, as well as hospital stay and related costs compared with a surgical step-up approach in patients with infected necrotising pancreatitis. PMID:24274589

  6. Prevalence and Risk Factors of Ovarian Metastases in Breast Cancer Patients < 41 Years of Age in the Netherlands: A Nationwide Retrospective Cohort Study

    PubMed Central

    Peters, Inge T. A.; van Zwet, Erik W.; Smit, Vincent T. H. B. M.; Liefers, Gerrit Jan; Kuppen, Peter J. K.; Hilders, Carina G. J. M.; Trimbos, J. Baptist

    2017-01-01

    Purpose Breast cancer is one of the primary indications for cryopreservation and subsequent autotransplantation of ovarian tissue. The safety of this fertility preservation method remains questionable, as the presence of disseminated breast tumor cells cannot yet be excluded in the ovarian autografts. We explored the prevalence of ovarian metastases among young breast cancer patients and determined risk factors for the development of ovarian metastases. Methods Using the nationwide database of the Dutch Pathology Registry (PALGA), we identified a cohort of 2648 women with primary invasive breast cancer at age < 41 years in the period 2000–2010 in the Netherlands who subsequently underwent an oophorectomy. From this source population, all cases who had histologically confirmed ovarian metastases were included. For each case of whom clinical data were available, one control without ovarian metastases who matched the time interval between breast cancer diagnosis and oophorectomy was selected. Data were collected on patient characteristics, diagnosis, treatment and follow-up. Results Ovarian metastases were found in 63 out of 2648 patients who met the inclusion criteria. The risk of developing ovarian metastases increased with time passed since breast cancer diagnosis. Multivariate logistic regression analyses showed significant association between tumor stage and the development of ovarian metastases (p = 0.024). Conclusions The prevalence of ovarian metastases was 2.4% among young breast cancer patients. Early ovary removal may reduce the risk of developing ovarian metastases. In breast cancer patients with tumors > 5 cm and/or inflammatory carcinoma, we recommend a cautious approach to ovarian tissue autotransplantation. PMID:28125710

  7. Experimental Evaluation of the IP Address Space Randomisation (IASR) Technique and Its Disruption to Selected Network Services

    DTIC Science & Technology

    2014-11-01

    Experimental evaluation of the IP address space randomisation (IASR) technique and its disruption to selected network services Maxwell Dondo DRDC...secu- rity approach. MTD is a set of network defence techniques such as randomisation, deception, etc., that significantly increases the attacker’s work...effort. One randomi- sation technique , called internet protocol (IP) address space randomisation (IASR), periodically or aperiodically makes random

  8. 75 FR 48736 - Culturally Significant Objects Imported for Exhibition Determinations: “Miró: The Dutch Interiors”

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-11

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF STATE Culturally Significant Objects Imported for Exhibition Determinations: ``Mir : The Dutch Interiors'' SUMMARY..., I hereby determine that the objects to be included in the exhibition ``Mir : The Dutch...

  9. Intralesional cryotherapy versus excision and corticosteroids or brachytherapy for keloid treatment: study protocol for a randomised controlled trial

    PubMed Central

    2013-01-01

    Background Keloids are a burden for patients due to physical, aesthetic and social complaints and treatment remains a challenge because of therapy resistance and high recurrence rates. The main goal of treatment is to improve the quality of life (QoL); this implies that, apart from surgical outcomes, patient-reported outcome measures (PROMs) need to be taken into account. Decision making in keloid treatment is difficult due to heterogeneity of the condition and the lack of comparative studies. Methods/Design This is a multicentre, randomised controlled open trial that compares 1) intralesional cryotherapy versus excision and corticosteroids for primary keloids, and 2) intralesional cryotherapy versus excision and brachytherapy for therapy-resistant keloids. The primary outcome is the Patient and Observer Scar Assessment Scale (POSAS), a 12-item scale (with score 12 indicating the best and 120 indicating the worst scar imaginable). A difference of six points on the total score is considered to be of clinical importance. Secondary outcomes are recurrence rates, volume reduction, Skindex-29 scores, SF-36 scores and complication rates. Primary and secondary outcome measurements are taken at baseline, and at 2, 12, 26 and 52 weeks postoperatively. For analysis, a linear mixed model is used. A total of 176 patients will be included over a period of 2.5 years. The protocol is approved by the Medical Ethics Committee of the Erasmus University Medical Centre Rotterdam and follows good clinical practice guidelines. Discussion The outcomes of this study will improve evidence-based decision making for the treatment of keloids, as well as patient education. Trial registration Dutch Trial Register NTR4151. PMID:24354714

  10. Eight Years of Specialist Training of Dutch Intellectual Disability Physicians: Results of Scientific Research Education

    ERIC Educational Resources Information Center

    Evenhuis, Heleen M.; Penning, Corine

    2009-01-01

    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…

  11. Zertifikat Niederlaendisch: Examen en getuigschrift Nederlands als vreemde taal (Certificate in Dutch)

    ERIC Educational Resources Information Center

    Beersmans, Frans; Sudhoelter, Juergen

    1976-01-01

    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)

  12. Modality, Infinitives, and Finite Bare Verbs in Dutch and English Child Language

    ERIC Educational Resources Information Center

    Blom, Elma

    2007-01-01

    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,…

  13. On-Line Access to Linguistically Annotated Text Corpora of Dutch via Internet.

    ERIC Educational Resources Information Center

    Kruyt, J. G.; Raaijmakers, S. A.; van der Kamp, P. H. J.; van Strien, R. J.

    Corpora of present-day Dutch developed by the Institute for Dutch Lexicology include two linguistically annotated corpora that can be accessed via Internet: a 5-million word corpus covering a variety of topics and text types, and a 27-million word newspaper corpus. The texts of both were acquired in machine-readable form and have been lemmatized…

  14. 33 CFR 117.801 - Newtown Creek, Dutch Kills, English Kills and their tributaries.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false Newtown Creek, Dutch Kills, 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...

  15. 33 CFR 117.801 - Newtown Creek, Dutch Kills, English Kills and their tributaries.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Newtown Creek, Dutch Kills, 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...

  16. 33 CFR 117.801 - Newtown Creek, Dutch Kills, English Kills and their tributaries.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Newtown Creek, Dutch Kills, 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...

  17. 33 CFR 117.801 - Newtown Creek, Dutch Kills, English Kills and their tributaries.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Newtown Creek, Dutch Kills, 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...

  18. 33 CFR 117.801 - Newtown Creek, Dutch Kills, English Kills and their tributaries.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Newtown Creek, Dutch Kills, 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...

  19. A Comparison of Dutch and US Teachers' Perceptions of the Incidence and Management of ADHD

    ERIC Educational Resources Information Center

    Havey, J. Michael

    2007-01-01

    Dutch and US teachers were questioned about their perceptions of the incidence and causes of ADHD, as well as their views of appropriate treatments. Dutch teachers were more likely than US teachers to think the etiology of the disorder lay in biochemistry, while US teachers were more likely to believe in a combination of environmental and…

  20. In the Shadow of Tolerance: The Discursive Context of Dutch-Born Muslim Youth

    ERIC Educational Resources Information Center

    Zaal, Mayida

    2014-01-01

    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…

  1. From Noun to Intensifier: Massa and Massa's in Flemish Varieties of Dutch

    ERIC Educational Resources Information Center

    De Clerck, Bernard; Colleman, Timothy

    2013-01-01

    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…

  2. Production and Processing of Subject-Verb Agreement in Monolingual Dutch Children with Specific Language Impairment

    ERIC Educational Resources Information Center

    Blom, Elma; Vasic, Nada; de Jong, Jan

    2014-01-01

    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…

  3. Phoneme Awareness, Vocabulary and Word Decoding in Monolingual and Bilingual Dutch Children

    ERIC Educational Resources Information Center

    Janssen, Marije; Bosman, Anna M. T.; Leseman, Paul P. M.

    2013-01-01

    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…

  4. Home Language and Language Proficiency; A Large-Scale Longitudinal Study in Dutch Primary Schools.

    ERIC Educational Resources Information Center

    Driessen, Geert; van der Slik, Frans; De Bot, Kees

    2002-01-01

    Reports on a large-scale longitudinal study into the development of language proficiency of Dutch primary school children aged 7-10. Data on language proficiency and a range of background variables were analyzed. Results suggest that while immigrant children develop their language skill in Dutch considerably over 2 years, they are nonetheless…

  5. A 16-Year Longitudinal Study of Language Attrition in Dutch Immigrants in Australia.

    ERIC Educational Resources Information Center

    de Bot, Kees; Clyne, Michael

    1994-01-01

    Speech material gathered from Dutch-English bilinguals in Australia questioned in 1971 and 1987 was analyzed, showing no evidence of attrition in Dutch. It is concluded that first-language attrition does not necessarily occur in an immigrant setting and that immigrants who maintain their language in the first years of their stay will likely remain…

  6. Do Mothers Have the Right to Bring up Their Own Children? How Facts Do Not Determine (Dutch) Government Policy

    ERIC Educational Resources Information Center

    Allewijn, Ellen

    2010-01-01

    The Dutch government has a double moral message for Dutch parents. On the one hand, they expect mothers to work more hours outside the home; on the other hand, they expect parents to perform better in their parental tasks. New research shows again that in spite of all stimulation measures, Dutch women with children prefer their part-time jobs, and…

  7. Social Integration and Religious Identity Expression among Dutch Muslims: The Role of Minority and Majority Group Contact

    ERIC Educational Resources Information Center

    Maliepaard, Mieke; Phalet, Karen

    2012-01-01

    Against the background of contrasting religious versus secular norms in immigrant communities and in Dutch society, this study examines how religious identity expression is related to the social integration of Dutch Muslims within (a) Turkish or Moroccan minority groups and (b) Dutch majority groups. Using nationally representative survey data (N…

  8. 75 FR 54692 - Culturally Significant Objects Imported for Exhibition Determinations: “Miró: The Dutch Interiors”

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-08

    ... Culturally Significant Objects Imported for Exhibition Determinations: ``Mir : The Dutch Interiors'' ACTION... ''Mir : The Dutch Interiors.'' The reference notice is corrected to accommodate an additional object to... determine that the additional object to be included in the exhibition ``Mir : The Dutch...

  9. The Prevalence of Tooth Wear in the Dutch Adult Population

    PubMed Central

    Wetselaar, Peter; Vermaire, Jan H.; Visscher, Corine M.; Lobbezoo, Frank; Schuller, Annemarie A.

    2016-01-01

    This study aimed to assess the prevalence of tooth wear in different age groups of the Dutch adult population and to determine this tooth wear distribution by gender, socioeconomic class, and type of teeth. Results were compared with the outcomes of a previous study in a comparable population. As part of a comprehensive investigation of the oral health of the general Dutch adult population in 2013, tooth wear was assessed among 1,125 subjects in the city of ‘s-Hertogenbosch. The data collected were subjected to stratified analysis by 5 age groups (25-34, 35-44, 45-54, 55-64, and 65-74 years), gender, socioeconomic class, and type of teeth. Tooth wear was assessed using a 5-point ordinal occlusal/incisal grading scale. The number of teeth affected was higher in older age groups. Men showed more tooth wear than women, and subjects with low socioeconomic status (low SES) showed on average higher scores than those with high SES. Tooth wear prevalence found in this study was higher in all age groups than in the previous study. The present study found prevalences of 13% for mild tooth wear and 80% for moderate tooth wear, leading to the conclusion that these are common conditions in the Dutch adult population. Severe tooth wear (prevalence 6%) may however be characterized as rare. A tendency was found for there to be more tooth wear in older age groups, in men as compared with women, in persons with lower SES, and in the present survey as compared with the previous one. PMID:27694757

  10. Dutch Minister of Science Visits ESO Facilities in Chile

    NASA Astrophysics Data System (ADS)

    2005-05-01

    Mrs. Maria van der Hoeven, the Dutch Minister of Education, Culture and Science, who travelled to the Republic of Chile, arrived at the ESO Paranal Observatory on Friday afternoon, May 13, 2005. The Minister was accompanied, among others, by the Dutch Ambassador to Chile, Mr. Hinkinus Nijenhuis, and Mr. Cornelis van Bochove, the Dutch Director of Science. The distinguished visitors were able to acquaint themselves with one of the foremost European research facilities, the ESO Very Large Telescope (VLT), during an overnight stay at this remote site, and later, with the next major world facility in sub-millimetre and millimetre astronomy, the Atacama Large Millimeter Array (ALMA). At Paranal, the guests were welcomed by the ESO Director General, Dr. Catherine Cesarsky; the ESO Council President, Prof. Piet van der Kruit; the ESO Representative in Chile, Prof. Felix Mirabel; the Director of the La Silla Paranal Observatory, Dr. Jason Spyromilio; by one of the Dutch members of the ESO Council, Prof. Tim de Zeeuw; by the renowned astrophysicist from Leiden, Prof. Ewine van Dishoek, as well as by ESO staff members. The visitors were shown the various high-tech installations at the observatory, including many of the large, front-line VLT astronomical instruments that have been built in collaboration between ESO and European research institutes. Explanations were given by ESO astronomers and engineers and the Minister gained a good impression of the wide range of exciting research programmes that are carried out with the VLT. Having enjoyed the spectacular sunset over the Pacific Ocean from the Paranal deck, the Minister visited the VLT Control Room from where the four 8.2-m Unit Telescopes and the VLT Interferometer (VLTI) are operated. Here, the Minister was invited to follow an observing sequence at the console of the Kueyen (UT2) and Melipal (UT3) telescopes. "I was very impressed, not just by the technology and the science, but most of all by all the people involved

  11. Patient safety in Dutch primary care: a study protocol

    PubMed Central

    2010-01-01

    Background Insight into the frequency and seriousness of potentially unsafe situations may be the first step towards improving patient safety. Most patient safety attention has been paid to patient safety in hospitals. However, in many countries, patients receive most of their healthcare in primary care settings. There is little concrete information about patient safety in primary care in the Netherlands. The overall aim of this study was to provide insight into the current patient safety issues in Dutch general practices, out-of-hours primary care centres, general dental practices, midwifery practices, and allied healthcare practices. The objectives of this study are: to determine the frequency, type, impact, and causes of incidents found in the records of primary care patients; to determine the type, impact, and causes of incidents reported by Dutch healthcare professionals; and to provide insight into patient safety management in primary care practices. Design and methods The study consists of three parts: a retrospective patient record study of 1,000 records per practice type was conducted to determine the frequency, type, impact, and causes of incidents found in the records of primary care patients (objective one); a prospective component concerns an incident-reporting study in each of the participating practices, during two successive weeks, to determine the type, impact, and causes of incidents reported by Dutch healthcare professionals (objective two); to provide insight into patient safety management in Dutch primary care practices (objective three), we surveyed organizational and cultural items relating to patient safety. We analysed the incidents found in the retrospective patient record study and the prospective incident-reporting study by type of incident, causes (Eindhoven Classification Model), actual harm (severity-of-outcome domain of the International Taxonomy of Medical Errors in Primary Care), and probability of severe harm or death. Discussion

  12. A Randomised Controlled Trial of complete denture impression materials

    PubMed Central

    Hyde, T.P.; Craddock, H.L.; Gray, J.C.; Pavitt, S.H.; Hulme, C.; Godfrey, M.; Fernandez, C.; Navarro-Coy, N.; Dillon, S.; Wright, J.; Brown, S.; Dukanovic, G.; Brunton, P.A.

    2014-01-01

    Objectives There is continuing demand for non-implant prosthodontic treatment and yet there is a paucity of high quality Randomised Controlled Trial (RCT) evidence for best practice. The aim of this research was to provide evidence for best practice in prosthodontic impressions by comparing two impression materials in a double-blind, randomised, crossover, controlled, clinical trial. Methods Eighty-five patients were recruited, using published eligibility criteria, to the trial at Leeds Dental Institute, UK. Each patient received two sets of dentures; made using either alginate or silicone impressions. Randomisations determined the order of assessment and order of impressions. The primary outcome was patient blinded preference for unadjusted dentures. Secondary outcomes were patient preference for the adjusted dentures, rating of comfort, stability and chewing efficiency, experience of each impression, and an OHIP-EDENT questionnaire. Results Seventy-eight (91.8%) patients completed the primary assessment. 53(67.9%) patients preferred dentures made from silicone impressions while 14(17.9%) preferred alginate impressions. 4(5.1%) patients found both dentures equally satisfactory and 7 (9.0%) found both equally unsatisfactory. There was a 50% difference in preference rates (in favour of silicone) (95%CI 32.7–67.3%, p < 0.0001). Conclusion There is significant evidence that dentures made from silicone impressions were preferred by patients. Clinical significance Given the strength of the clinical findings within this paper, dentists should consider choosing silicone rather than alginate as their material of choice for secondary impressions for complete dentures. Trial Registration: ISRCTN 01528038.

 This article forms part of a project for which the author (TPH) won the Senior Clinical Unilever Hatton Award of the International Assocation for Dental Research, Capetown, South Africa, June 2014. PMID:24995473

  13. Practice variation in the Dutch long-term care and the role of supply-sensitive care: Is access to the Dutch long-term care equitable?

    PubMed

    Duell, Daisy; Koolman, Xander; Portrait, France

    2017-03-02

    Universal access and generous coverage are important goals of the Dutch long-term care (LTC) system. It is a legal requirement that everyone eligible for LTC should be able to receive it. Institutional care (IC) made up for 90% of Dutch LTC spending. To investigate whether access to IC is as equitable as the Dutch government aspires, we explored practice variation in entitlements to IC across Dutch regions. We used a unique dataset that included all individual applications for Dutch LTC in January 2010-December 2013 (N = 3,373,358). This dataset enabled an accurate identification of the need for care. We examined the local variation in the probability of being granted long-term IC and in the intensity of the care granted given that individuals have applied for LTC. We also investigated whether the variation observed was related to differences in the local availability of care facilities. Although our analyses indicated the presence of some practice variation, its magnitude was very small by national and international standards (up to 3%). Only a minor part of the practice variation could be accounted for by local supply differences in care facilities. Overall, we conclude that, unlike many other developed countries, the Dutch system ensured equitable access to long-term IC.

  14. [Psychotherapy in bipolar disorders -- randomised controlled trials of treatment efficacy].

    PubMed

    Rode, Sibylle; Wagner, Petra; Bräunig, Peter

    2006-03-01

    On the basis of a vulnerability-stress-model psycho-educative, cognitive-behavioural, family-oriented and interpersonal approaches of psychotherapy for bipolar disorders are described. This is followed by a review of randomised controlled trials investigating the treatment efficacy of psychotherapeutic interventions. These studies show positive results particularly for psychoeducation, cognitive-behavioural therapy and family-oriented therapy. Finally, it is discussed in which respects evidence for the successful implementation of psychotherapy is still missing and why it is so important to move towards manualized psychotherapeutic programs.

  15. Dutch Consumers' Willingness to Pay for Broiler Welfare.

    PubMed

    Mulder, Machiel; Zomer, Sigourney

    2017-02-06

    This article analyzes Dutch consumers' willingness to pay (WTP) for the welfare of broiler chickens and the consequences for nonhuman animal welfare policies. Using data from a discrete-choice experiment and a random parameter logit model, this study showed that consumers particularly value opportunities for outdoor access and the method used for anesthesia before slaughter. The WTP was also positively related to the number of consumers buying the same product, indicating that they experience the public-good dilemma. Moreover, the WTP was higher if consumers knew that animal welfare practices were subject to public or collective supervision. Women, people with more education, those with higher income, and nonreligious people had relatively high WTP values. For 87.5% of the respondents, the WTP exceeded the price difference between a broiler with a higher level of animal welfare and a regular chicken. The findings suggest that the Dutch market for broiler chickens can be improved by raising consumer confidence in the labeling system.

  16. Lexical frequency and acoustic reduction in spoken Dutch

    NASA Astrophysics Data System (ADS)

    Pluymaekers, Mark; Ernestus, Mirjam; Baayen, R. Harald

    2005-10-01

    This study investigates the effects of lexical frequency on the durational reduction of morphologically complex words in spoken Dutch. The hypothesis that high-frequency words are more reduced than low-frequency words was tested by comparing the durations of affixes occurring in different carrier words. Four Dutch affixes were investigated, each occurring in a large number of words with different frequencies. The materials came from a large database of face-to-face conversations. For each word containing a target affix, one token was randomly selected for acoustic analysis. Measurements were made of the duration of the affix as a whole and the durations of the individual segments in the affix. For three of the four affixes, a higher frequency of the carrier word led to shorter realizations of the affix as a whole, individual segments in the affix, or both. Other relevant factors were the sex and age of the speaker, segmental context, and speech rate. To accommodate for these findings, models of speech production should allow word frequency to affect the acoustic realizations of lower-level units, such as individual speech sounds occurring in affixes.

  17. [Multiresistant Brachyspira hyodysenteriae in a Dutch sow herd].

    PubMed

    Duinhof, T F; Dierikx, C M; Koene, M G J; van Bergen, M A P; Mevius, D J; Veldman, K T; van Beers-Schreurs, H M G; de Winne, R T J A

    This case study describes the isolation ofa multiresistant strain ofBrachyspira hyodysenteriae in April 2007 in a Dutch sow herd with recurrent diarrhoea. Examination of faecal samples taken from 7-month-old breeding gilts with diarrhoea revealed the presence of resistance against tiamulin, lincomycin, tylosin, doxycycline, and tylvalosin (the active substance in Aivlosin) in four of five samples. Tiamulin resistance has not been reported in The Netherlands before. The repeated use of tiamulin on the affected farm was assumed to be the main cause of the development of resistance to the drug. The farmer was advised to adopt a medication strategy and to implement management practices that would prevent an ongoing cycle of infection on the farm. It is important that the Dutch swine industry appreciates that tiamulin-resistant strains of B. hyodysenteriae may be found on other farms as well. The appropriate and prudent use of antibiotics is essential in order to prevent the development of resistance against the last option left to cure B. hyodysenteriae infections: valnemulin.

  18. The Importance of Relationships with Parents and Best Friends for Adolescents' Romantic Relationship Quality: Differences between Indigenous and Ethnic Dutch Adolescents

    ERIC Educational Resources Information Center

    Ha, Thao; Overbeek, Geertjan; de Greef, Marieke; Scholte, Ron H. J.; Engels, Rutger C. M. E.

    2010-01-01

    This study examined how the quality of relationships with parents and friends were related to intimacy, commitment, and passion in adolescents' romantic relationships for indigenous Dutch and ethnic Dutch adolescents. Self-report survey data were used from 444 (88.9%) indigenous Dutch and 55 (11.1%) ethnic Dutch adolescents between 12 and 18 years…

  19. Rapid Exposure Assessment of Nationwide River Flood for Disaster Risk Reduction

    NASA Astrophysics Data System (ADS)

    Kwak, Y.; Park, J.; Arifuzzaman, B.; Iwami, Y.; Amirul, Md.; Kondoh, A.

    2016-06-01

    considerably increased. For flood disaster risk reduction, it is important to identify and characterize flood area, locations (particularly lowland along rivers), and durations. For this purpose, flood mapping and monitoring are an imperative process and the fundamental part of risk management as well as emergency response. Our ultimate goal is to detect flood inundation areas over a nationwide scale despite limitations of optical and multispectral images, and to estimate flood risk in terms of affected people. We propose a methodological possibility to be used as a standard approach for nationwide rapid flood exposure assessment with the use of the multi-temporal Moderate Resolution Imaging Spectrometer (MODIS), a big contributor to progress in near-real-time flood mapping. The preliminary results in Bangladesh show that a propensity of flood risk change strongly depends on the temporal and spatial dynamics of exposure such as distributed population.

  20. 1990 Nationwide Truck Activity and Commodity Survey selected tabulations. Summary report

    SciTech Connect

    Not Available

    1993-06-01

    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.

  1. Improving venous ulcer healing: designing and reporting randomised controlled trials.

    PubMed

    Weller, Carolina D; McNeil, John; Evans, Sue; Reid, Christopher

    2010-02-01

    The randomised controlled trial (RCT) is often considered the gold standard for judging the benefits of treatments. The application of randomised controlled clinical trials to treatments of venous ulcer healing has lagged behind that of other areas of medicine. To interpret the results of an RCT, readers must understand a variety of aspects of their design, analysis and interpretation. Venous ulcer disease has a high prevalence and has a significant socioeconomic impact in most parts of the world. The management of venous ulcers causes a considerable strain on the health system and is likely to worsen in future. The multi-layer high compression system is described as the current gold standard for treating venous ulcers. A recent meta-analysis of bandaging systems found that multi-layer compression bandages appeared to be superior to single-layer bandages in promoting venous ulcer healing. However, it was noted that many of the studies had small sample sizes and the quality of research in the area was poor. The consolidating standards of reporting trials (CONSORT) statement can help clinicians to discern high-quality studies from ones of poorer quality. This paper discusses how CONSORT can help clinicians and researchers to design and report quality studies to contribute to evidence-based venous ulcer healing.

  2. Volunteers or victims: patients' views of randomised cancer clinical trials.

    PubMed Central

    Slevin, M.; Mossman, J.; Bowling, A.; Leonard, R.; Steward, W.; Harper, P.; McIllmurray, M.; Thatcher, N.

    1995-01-01

    Randomised clinical trials are essential for the objective evaluation of different treatment strategies in cancer. However, in the field of oncology, very few of the eligible patients are entered into trials, and most treatments have only been tested on a small percentage of patients. For doctors, a major deterrent to participating in trials is the lack of resources--particularly time, but often also the local facilities. This report suggests that patients themselves are willing to take part in clinical research, and are attracted by being treated by a doctor with a specialist interest in the disease and encouraged by the possibility that their progress will be monitored closely. With the recent NHS changes, it is timely for the Department of Health and other national health departments to consider carefully what can be done to ensure that no new treatments are adopted without effective evaluation. This will require departments of health to identify and implement ways to facilitate accrual of appropriate numbers of patients onto research protocols (whether non-randomised phase I or phase II studies or large, multicentre phase III trials) over short time periods. PMID:7779722

  3. 76 FR 81922 - Nationwide Categorical Waivers Under Section 1605 (Buy American) of the American Recovery and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-29

    ...The U.S. Department of Energy (DOE) is hereby granting a nationwide limited waiver of the Buy American requirements of section 1605 of the Recovery Act under the authority of Section 1605(b)(2), (iron, steel, and the relevant manufactured goods are not produced in the United States in sufficient and reasonably available quantities and of a satisfactory quality), with respect to Recovery Act......

  4. Nationwide Surveillance of Macrolide-Resistant Mycoplasma pneumoniae Infection in Pediatric Patients

    PubMed Central

    Kawai, Yasuhiro; Kubo, Mika; Akaike, Hiroto; Kato, Atsushi; Nishizawa, Yoko; Saito, Aki; Kondo, Eisuke; Teranishi, Hideto; Wakabayashi, Tokio; Ogita, Satoko; Tanaka, Takaaki; Kawasaki, Kozo; Nakano, Takashi; Terada, Kihei; Ouchi, Kazunobu

    2013-01-01

    We conducted nationwide surveillance to investigate regional differences in macrolide-resistant (MR) Mycoplasma pneumoniae strains in Japan. The prevalence of MR M. pneumoniae in pediatric patients gradually increased between 2008 and 2012. Although regional differences were observed, high levels of MR genes were detected in all seven surveillance areas throughout Japan and ranged in prevalence from 50% to 93%. These regional differences were closely related to the previous administration of macrolides. PMID:23716043

  5. Community treatment orders and reduced time in hospital: a nationwide study, 2007–2012

    PubMed Central

    Taylor, Mark; Macpherson, Melanie; Macleod, Callum; Lyons, Donald

    2016-01-01

    Aims and method Community treatment orders (CTOs) were introduced in Scotland in 2005, but are controversial owing to a lack of supportive randomised evidence. The non-randomised studies provide mixed results on their efficacy and utility. We aimed to examine hospital bed day usage across Scotland both before and after CTOs were initiated in a national cohort of patients, spanning 5 years. Results In total, 1558 individuals who were subject to a CTO between 2007 and 2012, of whom 63% were male, were included. After CTO initiation the number of hospital bed days fell, on average, from 66 to 39 per annum per patient. Those with a longer psychiatric history appeared to benefit more from a CTO, in terms of reduced time in hospital. Clinical implications Our data offer cautious support for the use of CTOs in routine practice, in terms of reducing time spent in psychiatric hospital. This finding is balanced by the more rigorous randomised studies which do not find any benefit to CTOs. PMID:27280031

  6. Medicalization and obstetric care: an analysis of developments in Dutch midwifery.

    PubMed

    Smeenk, Anke D J; ten Have, Henk A M J

    2003-01-01

    The Dutch system of obstetric care is often recommended for midwife-attended births, the high number of home deliveries, and the low rate of intervention during pregnancy and labour. In this contribution, the question is addressed whether processes of medicalization can be demonstrated in the Dutch midwife practice. Medicalization of pregnancy and childbirth is often criticized because it creates dependency on the medical system and infringement of the autonomy of pregnant women. It is concluded that medicalization is present in the practice of Dutch independent midwives, however it is less clear and outspoken than in hospital policies.

  7. Flood detention area modelling based on nationwide topographic data: ALS-DTMs vs. conventional DTMs

    NASA Astrophysics Data System (ADS)

    Vesakoski, Jenni-Mari; Alho, Petteri; Hyyppä, Juha; Holopainen, Markus; Flener, Claude; Hyyppä, Hannu

    2014-05-01

    Topographic depressions have an important role in hydrology. These effects on hydrological processes are caused by changes in the water balance and runoff response of a watershed. Nevertheless, research has focused in detail neither on the effects of acquisition and processing methods nor on the effects of resolution of nationwide grid digital terrain models (DTMs) on topographic depressions. Recently, many countries have conducted nationwide ALS (Airborne laser scanning) surveys for DTM purposes. Thus, detailed comparison between nationwide ALS-DTMs with different grid sizes and DTMs that represent more conventional acquisition methods, such as photogrammetric methods, is needed for different study fields. In here, the objective is to delineate the difference of depression variables between nationwide DTMs with different acquisition methods, processing methods and grid sizes. Our depression detection is based on nationwide 25x25 m and 10x10 m DTMs and 2x2 m ALS-DTM produced by NLS of Finland. ALS-DTM2 was resampled to 10x10 and 25x25 m DTMs. Thus, it was possible to compare DTMs that represent the same grid size but different acquisition and processing methods. The variables considered are the mean depth of the depression, the number of its pixels, and its area and volume. Shallow and single-pixel depressions and the impact of mean filtering on ALS-DTM were also examined. Quantitative methods and error models were applied. According to our study, the depression variables were dependent on the scale, area and acquisition method. When the depths of depression pixels were compared with the most accurate DTM based on accurate VRNS-GNSS (Virtual Reference Stations, Global Navigation Satellite Systems) field survey data, the maximum errors created the largest differences between DTMs and hence represented the amount of the depth error. The mean filtering of ALS-DTM2 focuses on the small and shallow depressions, and is thus suitable for using in flood risk management

  8. Shared decision making in the Netherlands, is the time ripe for nationwide, structural implementation?

    PubMed

    van der Weijden, Trudy; van Veenendaal, Haske; Drenthen, Ton; Versluijs, Martine; Stalmeier, Peep; Koelewijn-van Loon, Marije; Stiggelbout, Anne; Timmermans, Danielle

    2011-01-01

    WHAT ABOUT POLICY REGARDING SDM? The Dutch health care system has been reformed in 2006 to make it more patient-oriented and demand-driven. We shortly describe four strategies of this health care reform. Although research projects are now fully spread over the country, a coordinated research agenda on SDM is lacking. WHAT ABOUT TOOLS - DECISION SUPPORT FOR PATIENTS? The Dutch governmental healthcare internet portal for patients hosts 16 patient decision aids. WHAT ABOUT PROFESSIONAL INTEREST AND IMPLEMENTATION? There is quite a strong patient participation movement in the Netherlands, on macro and meso level. Limited effort, related to the local research projects has been put into training professionals in SDM skills. WHAT DOES THE FUTURE LOOK LIKE? We need concerted action on the level of educating health care professionals, empowering patients, making patient decision aids easily accessible, supporting the professionals in this new task, and measuring the process of SDM in performance indicators used in quality assurance. The Dutch Platform for SDM that will be launched in Maastricht in June 2011 is therefore a timely and relevant initiative.

  9. Intoxication and criminal responsibility in Dutch criminal Law.

    PubMed

    van Kalmthout, A

    1998-09-01

    This article deals with the question in how far an offence committed in the Netherlands under the influence of alcohol or other drugs can be imputed to the offender. Unlike many other countries the Dutch Penal Code does not contain specific provisions with respect to the criminal liability of addicted or intoxicated offenders. In principle, they are held responsible for their offences, even when the dolus or culpa is absent at the moment they commit their offence. Doctrine and jurisprudence found this liability on the principle of 'culpa/dolus in causa', by accepting an anterior dolus or culpa, which is situated at the moment the offender takes alcohol or other drugs. As is shown in this article, the - nondogmatic - interpretation of this culpa in causa doctrine leaves hardly any space for a claim to impunity.

  10. The Time Course of Verb Processing in Dutch Sentences

    PubMed Central

    Shapiro, Lewis P.; Wester, Femke; Swinney, David A.; Bastiaanse, Roelien

    2012-01-01

    The verb has traditionally been characterized as the central element in a sentence. Nevertheless, the exact role of the verb during the actual ongoing comprehension of a sentence as it unfolds in time remains largely unknown. This paper reports the results of two Cross-Modal Lexical Priming (CMLP) experiments detailing the pattern of verb priming during on-line processing of Dutch sentences. Results are contrasted with data from a third CMLP experiment on priming of nouns in similar sentences. It is demonstrated that the meaning of a matrix verb remains active throughout the entire matrix clause, while this is not the case for the meaning of a subject head noun. Activation of the meaning of the verb only dissipates upon encountering a clear signal as to the start of a new clause. PMID:19452278

  11. [Dutch Zoological Gardens (until 1940) in historical context].

    PubMed

    Zwart, P

    2009-01-01

    The history of the zoological gardens is an example of transformation through the ages; it is one of the ways men are dealing with their enviroment. Through the ages there were six reasons to keep wild animals: (1) Religion; 2. Power and Richness; (3) To get acquainted with animals (from tropical regions); (4) Study and Education; (5) Amusement and (6) Preservation of the species. The first Dutch "zoos", of the Dukes of Guelders in the 14th and of the stadholders in the 19th century, can serve as examples of the will to demonstrate power and richness. The Amsterdam Zoological Garden, "Artis", the zoological gardens of Rotterdam and of The Hague were founded for reasons of study and/ or education. Burgers' Dierenpark (Arnhem), Ouwehand's Dierenpark (Rhenen), Dierenpark Emmen en Dierenpark Wassenaar originated as leisure activities of their owners.

  12. Emotional, external, restrained eating and overweight in Dutch adolescents.

    PubMed

    Snoek, Harriëtte M; van Strien, Tatjana; Janssens, Jan M A M; Engels, Rutger C M E

    2007-02-01

    The purpose of this study was to determine how emotional, external and restrained eating behavior and other health-related lifestyle factors were associated with being overweight in adolescents. Moreover, demographic and ethnic differences in eating behavior have been examined. The respondents were 10,087 Dutch adolescents aged 11-16 years (M= 13.0, SD= 0.8). Self-reported eating behavior was measured with the DEBQ. Health-related lifestyle was determined by physical activity, breakfasting, fruit consumption and snacking. High restrained, and low external eating were positively associated with being overweight, whereas no significant association between emotional eating and being overweight was found for girls, and a negative association for boys. Adolescents who ate breakfast on a daily basis were less likely to be overweight than those who ate breakfast irregularly or never. Being overweight was positively associated with fruit consumption for girls and negatively with physical activity for boys.

  13. Narcissistic Personality Inventory: structure of the adapted Dutch version.

    PubMed

    Barelds, Dick P H; Dijkstra, Pieternel

    2010-04-01

    The present study examined the structure of a Dutch adaptation of the 40-item Narcissistic Personality Inventory (Raskin & Terry, 1988) in a community sample (n = 460) and a student sample (n = 515). Altering the response format of the NPI to a Likert-scale had no apparent effect on the responses. Confirmatory factor analyses supported neither the four-factor structure reported by Emmons (1984), nor the seven-factor structure reported by Raskin and Terry (1988). Instead, exploratory factor analyses supported either a single-factor solution (general narcissism), or a two-factor solution (Authority/Power and Self-Admiration). The validity of the NPI was supported by its relations with sex, age, personality, self-esteem, shame, guilt and social desirability.

  14. [The Dutch College of General Practitioners practice guideline 'Eczema'].

    PubMed

    de Vries, Corlien J H; de Witt-de Jong, Anne W F; Dirven-Meijer, Pauline C; Burgers, Jako S; Opstelten, Wim

    2014-01-01

    The Dutch College of General Practitioners practice guideline 'Eczema' provides recommendations for the diagnosis and treatment of common types of eczema: atopic dermatitis, contact dermatitis, acro-vesicular eczema, nummular eczema, hypostatic eczema, and asteatotic eczema. Age is an important factor when determining the type of eczema. According to the guideline, patient history and physical examination are sufficient in the diagnosis of eczema; additional investigations are rarely indicated. Moisturizing the skin with neutral emollients is the cornerstone of treatment for patients with eczema. If treatment with glucocorticoids is indicated, it is recommended that patients should start with short-term twice daily application, decreasing to once daily application. The guideline advises not to treat eczema patients with tar preparations. General practitioners are also advised not to prescribe calcineurin inhibitors. How work may affect eczema, or how eczema may affect work, should be considered in adult patients.

  15. Polyunsaturated fatty acid status of Dutch vegans and omnivores.

    PubMed

    Fokkema, M R; Brouwer, D A; Hasperhoven, M B; Hettema, Y; Bemelmans, W J; Muskiet, F A

    2000-11-01

    We compared the polyunsaturated fatty acid (PUFA) status of Dutch vegans and omnivores to investigate whether disparities can be explained by different diets and long chain PUFA (LCP) synthesis rates. Dietary intakes and fatty acid compositions of erythrocytes (RBC), platelets (PLT), plasma cholesterol esters (CE) and plasma triglycerides (TG) of 12 strict vegans and 15 age- and sex-matched omnivores were determined. Vegans had higher omega 6 (CE, TG), 18:2 omega 6 (RBC, CE, TG), 18:3 omega 6 (TG), 20:3 omega 6 (TG), 22:4 omega 6 (TG), 22:5 omega 3 (RBC, PLT), 22:5 omega 3/22:6 omega 3 (RBC, PLT) and 22:5 omega 6/22:6 omega 3 (RBC, PLT), and lower 22:4 omega 6 (RBC, PLT), 22:4 omega 6/22:5 omega 6 (RBC, PLT), omega 3 (CE), LCP omega 3 (CE, TG), 20:5 omega 3 (RBC, PLT, CE), 22:5 omega 3 (TG) and 22:6 omega 3 (all compartments). Vegans had lower 20:4 omega 6 (TG) after normalization of PUFA to 100%, and normalization of eicosanoid precursors to 100% revealed similar 20:4 omega 6 (all), higher 20:3 omega 6 (TG) and lower 20:5 omega 3 (all). High omega 6 (notably 18:2 omega 6) and low omega 3 (notably 20:5 omega 3, 22:6 omega 3) status in Dutch vegans derives from low dietary LCP omega 3 and 18:3 omega 3/18:2 omega 6 ratio. Higher 18:3 omega 6 and 20:3 omega 6 in their TG may reflect higher hepatic 20:4 omega 6 production rate, whereas higher 20:4 omega 6 and 22:4 omega 6 in omnivores indicates 20:4 omega 6 intake from meat.

  16. Sex differences among recipients of benzodiazepines in Dutch general practice.

    PubMed Central

    van der Waals, F W; Mohrs, J; Foets, M

    1993-01-01

    OBJECTIVE--To analyse sex differences among recipients of benzodiazepines in Dutch general practice. DESIGN--Study of consultations and associated interventions as recorded in the Dutch national survey of general practice. SETTING--Practices of 45 general practitioners monitored during 1 April to 30 June 1987. SUBJECTS--61,249 patients (29,035 (47.4%) men in the age groups 19-44, 45-64, and 65 years and over. MAIN OUTCOME MEASURES--Symptoms among recipients of repeat as well as new benzodiazepine prescriptions stratified by sex and age. RESULTS--Prescriptions for benzodiazepines were found to be significantly more common among women than among men, (a) after correcting for the sex distribution of the total patient population, and (b) in the two oldest age groups after correcting for the number of consultations. Of all prescriptions for benzodiazepines, 89% (6055/6777) were repeats and 70% (4759/6777) requests. Only 9% (439/4759) of these were authorized by the general practitioner, the rest being issued by the general practitioner's assistant after he or she had referred to the diagnosis in the patient's record. In contrast, only three (1%) of the 492 first time recipients of benzodiazepines had requested a prescription and were not seen by the general practitioner. Women (43/96; 45%) aged 45-64 years received their first prescription for benzodiazepines almost twice as often as men (15/63; 24%) without symptoms or a diagnosis being an indication (female to male relative risk 1.88 (95% confidence interval 1.15 to 3.08)). CONCLUSIONS--The sex difference among first time recipients of benzodiazepines seems to be due to general practitioners being less stringent when prescribing this drug for women. The difference continues in repeat prescriptions, physicians failing to check adequately the need for these. PMID:8104066

  17. Black Pete through the Eyes of Dutch Children

    PubMed Central

    Mesman, Judi; Janssen, Sofie; van Rosmalen, Lenny

    2016-01-01

    The traditional figure of Black Pete seen during the December festivities around Sinterklaas (the Dutch Santa Claus) in the Netherlands has sparked fierce debates about his racial stereotypical characteristics and his potentially negative effects on children’s opinions about black people. The Black Pete phenomenon has even been discussed by the United Nations Committee on the Elimination of Racial Discrimination, resulting in a report urging the Netherlands to eliminate this form of racial stereotyping. The adult debate about Black Pete is clearly important, but Sinterklaas is essentially a children’s holiday. Surprisingly, there have never been any systematic studies to examine children’s views on Black Pete. The current study is the first to do so. In a sample of 201 children aged 5–7 years, we collected free descriptions of Black Pete, asked children to group him in relation to other figures, and to assign characteristics to him and comparison figures. The results showed that (1) Children are clearly aware of Black Pete’s skin color and subordinate status; (2) Children associate Black Pete more with clowns than with black people; (3) Children evaluate Black Pete very positively, but the positive characteristics do not generalize to their evaluation of black people. The findings illustrate the deep-rooted childhood origins of many Dutch people’s affection for Black Pete and their lack of awareness of his relation to racial stereotypes. This explains the resistance to changing the Black Pete figure and the slowness of the change process on this front. PMID:27322583

  18. Risk assessment for drugs of abuse in the Dutch watercycle.

    PubMed

    van der Aa, Monique; Bijlsma, Lubertus; Emke, Erik; Dijkman, Ellen; van Nuijs, Alexander L N; van de Ven, Bianca; Hernández, Felix; Versteegh, Ans; de Voogt, Pim

    2013-04-01

    A screening campaign of drugs of abuse (DOA) and their relevant metabolites in the aqueous environment was performed in the Netherlands. The presence of DOA, together with the potential risks for the environment and the possible human exposure to these compounds through consumption of drinking water was investigated. Sewage water (influent and effluent), surface water of the rivers Rhine and Meuse, and drinking water (raw and finished) were analysed by four different laboratories using fully in-house validated methods for a total number of 34 DOA and metabolites. In this way, data reported for several compounds could also be confirmed by other laboratories, giving extra confidence to the results obtained in this study. In total 17 and 22 DOA were detected and quantified in influent and effluent sewage samples, respectively. The tranquilizers oxazepam and temazepam, and cocaine and its metabolite benzoylecgonine were found in high concentrations in sewage water. Nine compounds were possibly not efficiently removed during treatment and were detected in surface waters. The results indicated that substantial fractions of the total load of DOA and metabolites in the rivers Rhine and Meuse enter the Netherlands from abroad. For some compounds, loads appear to increase going downstream, which is caused by a contribution from Dutch sewage water effluents. As far as data are available, no environmental effects are expected of the measured DOA in surface waters. In raw water, three DOA were detected, whereas in only one finished drinking water out of the 17 tested, benzoylecgonine was identified, albeit at a concentration below the limit of quantification (<1 ng/L). Concentrations were well below the general signal value of 1 μg/L, which is specified for organic compounds of anthropogenic origin in the Dutch Drinking Water Act.

  19. Randomised phase III trial of S-1 versus capecitabine in the first-line treatment of metastatic colorectal cancer: SALTO study by the Dutch Colorectal Cancer Group.

    PubMed

    Kwakman, J J M; Simkens, L H J; van Rooijen, J M; van de Wouw, A J; Ten Tije, A J; Creemers, G J M; Hendriks, M P; Los, M; van Alphen, R J; Polée, M B; Muller, E W; van der Velden, A M T; van Voorthuizen, T; Koopman, M; Mol, L; van Werkhoven, E; Punt, C J A

    2017-04-05

    Hand-foot syndrome (HFS) is a common side effect of capecitabine. S-1 is an oral fluoropyrimidine with comparable efficacy to capecitabine in gastrointestinal cancers but associated with a lower incidence of HFS in Asian patients. This study compares the incidence of HFS between S-1 and capecitabine as first-line treatment in Western metastatic colorectal cancer (mCRC) patients.

  20. Crime and mental disorders among native Dutch and ethnic minority juvenile defendants in the Netherlands.

    PubMed

    Vinkers, David J; Duits, Nils

    2011-01-01

    We examined the prevalence of mental disorders and the recommendations regarding criminal responsibility and treatment in pre-trial mental health evaluations requested by Dutch juvenile courts for youths between the ages of 12 to 17. Youths of native Dutch (n=2694) and of ethnic minority background (n=1393) were compared. The prevalence of mental disorders was similar for both groups (76.8% versus 74.4%). Criminal responsibility in native Dutch youth was more often considered 'diminished' or 'strongly diminished' than in ethnic minority youth. Admission to a juvenile institution was more often recommended for ethnic minority juveniles than for native Dutch juveniles. It remains unclear from our data whether these differences reflect a false stereotype of ethnic minority populations as being more dangerous and threatening.

  1. Dysbacteriosis in silver-stained cervical smears of Dutch-Moroccan immigrants: HPV infection and preneoplasia.

    PubMed

    Verbruggen, Banut-Sabine M; Boon, Mathilde E; van Schie, Marieke A; Wijsman-Grootendorst, Rian; Kok, Lambrecht P

    2006-01-01

    The vaginal/cervical smears of a group of Moroccan immigrants were used to compare vaginal dysbacteriosis (i.e., a bacterial population change with a decrease in lactobacilli and an increase of coccoid bacteria in vaginal/cervical smears) with Dutch women. From our archives, 779 smears from Moroccan immigrants were compared with 1,060 smears of age-matched Dutch women. For bacterial flora, Jones-Marres silver stains were used to define four groups. Koilocytosis and cervical intraepithelial neoplasia (CIN) were also recorded. The bacterial vaginal flora of Moroccan immigrants and Dutch women was different. The Moroccan women had a lower dysbacteriosis than Dutch women (3% vs. 24%). Koilocytosis and CIN were less frequent in the immigrant population. The possible synergy of a disturbed vaginal flora with human papillomavirus (HPV), HIV, or cervical preneoplasia indicates that vaginal hygiene and a normal flora may have positive effects on the uterine cervix.

  2. Dutch elm disease. (Latest citations from the Life Sciences Collection database). Published Search

    SciTech Connect

    Not Available

    1994-03-01

    The bibliography contains citations concerning the spread and control of Dutch elm disease. Dutch elm disease is a lethal fungal disease in elm trees which is transmitted via bark beetles. Topics included methods to treat the disease and to control the disease-carrying beetle, biochemistry and genetic information on the disease fungus and its phytotoxin, ecological effects of the disease, evidence of fungicide tolerance by the disease fungus, and attempts to breed disease resistant elm trees. Distribution of Dutch elm disease in Iran, Scotland, the United States, Yugoslavia, and Sweden is described. This information is useful, for example, in the development of methods for detection and treatment of Dutch elm disease. (Contains a minimum of 128 citations and includes a subject term index and title list.)

  3. Influence of the Ford-Carter Debates on Dutch TV Viewers.

    ERIC Educational Resources Information Center

    de Bock, Harold

    1978-01-01

    Reports that, for Dutch viewers, the televised debates between Gerald Ford and Jimmy Carter helped develop a presidential preference, regardless of the viewers' own political orientations, and that the debates may have benefited Carter. (GW)

  4. Interior building details of Building A, Room A109 Dutch door, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Interior building details of Building A, Room A109 Dutch door, room A-108 single panel wood door with wood trim northerly view - San Quentin State Prison, Building 22, Point San Quentin, San Quentin, Marin County, CA

  5. Educational Television as Part of a Learning Environment: Dilemmas for the Dutch Open School Broadcasts.

    ERIC Educational Resources Information Center

    Rosendaal, Bastiaan

    1986-01-01

    Dutch television producers investigated methods of redesigning thematic educational broadcasts directed at independent adult learning. Results focused on context and image, content, form, and appeal to the audience. (Author/LRW)

  6. The UK Lung Cancer Screening Trial: a pilot randomised controlled trial of low-dose computed tomography screening for the early detection of lung cancer.

    PubMed Central

    Field, John K; Duffy, Stephen W; Baldwin, David R; Brain, Kate E; Devaraj, Anand; Eisen, Tim; Green, Beverley A; Holemans, John A; Kavanagh, Terry; Kerr, Keith M; Ledson, Martin; Lifford, Kate J; McRonald, Fiona E; Nair, Arjun; Page, Richard D; Parmar, Mahesh Kb; Rintoul, Robert C; Screaton, Nicholas; Wald, Nicholas J; Weller, David; Whynes, David K; Williamson, Paula R; Yadegarfar, Ghasem; Hansell, David M

    2016-01-01

    the control arm. A total of 1994 participants underwent CT scanning: 42 participants (2.1%) were diagnosed with lung cancer; 36 out of 42 (85.7%) of the screen-detected cancers were identified as stage 1 or 2, and 35 (83.3%) underwent surgical resection as their primary treatment. Lung cancer was more common in the lowest socioeconomic group. Short-term adverse psychosocial consequences were observed in participants who were randomised to the intervention arm and in those who had a major lung abnormality detected, but these differences were modest and temporary. Rollout of screening as a service or design of a full trial would need to address issues of outreach. The health-economic analysis suggests that the intervention could be cost-effective but this needs to be confirmed using data on actual lung cancer mortality. CONCLUSIONS The UK Lung Cancer Screening (UKLS) pilot was successfully undertaken with 4055 randomised individuals. The data from the UKLS provide evidence that adds to existing data to suggest that lung cancer screening in the UK could potentially be implemented in the 60-75 years age group, selected via the Liverpool Lung Project risk model version 2 and using CT volumetry-based management protocols. FUTURE WORK The UKLS data will be pooled with the NELSON (Nederlands Leuvens Longkanker Screenings Onderzoek: Dutch-Belgian Randomised Lung Cancer Screening Trial) and other European Union trials in 2017 which will provide European mortality and cost-effectiveness data. For now, there is a clear need for mortality results from other trials and further research to identify optimal methods of implementation and delivery. Strategies for increasing uptake and providing support for underserved groups will be key to implementation. TRIAL REGISTRATION Current Controlled Trials ISRCTN78513845. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health

  7. Vegetarian diet in mild hypertension: a randomised controlled trial.

    PubMed Central

    Margetts, B M; Beilin, L J; Vandongen, R; Armstrong, B K

    1986-01-01

    In a randomised crossover trial 58 subjects aged 30-64 with mild untreated hypertension were allocated either to a control group eating a typical omnivorous diet or to one of two groups eating an ovolactovegetarian diet for one of two six week periods. A fall in systolic blood pressure of the order of 5 mm Hg occurred during the vegetarian diet periods, with a corresponding rise on resuming a meat diet. The main nutrient changes with the vegetarian diet included an increase in the ratio of polyunsaturated to saturated fats and intake of fibre, calcium, and magnesium and a decrease in the intake of protein and vitamin B12. There were no consistent changes in urinary sodium or potassium excretion or body weight. In untreated subjects with mild hypertension, changing to a vegetarian diet may bring about a worthwhile fall in systolic blood pressure. PMID:3026552

  8. Early treatment of posterior crossbite - a randomised clinical trial

    PubMed Central

    2013-01-01

    Background The aim of this randomised clinical trial was to assess the effect of early orthodontic treatment in contrast to normal growth effects for functional unilateral posterior crossbite in the late deciduous and early mixed dentition by means of three-dimensional digital model analysis. Methods This randomised clinical trial was assessed to analyse the orthodontic treatment effects for patients with functional unilateral posterior crossbite in the late deciduous and early mixed dentition using a two-step procedure: initial maxillary expansion followed by a U-bow activator therapy. In the treatment group 31 patients and in the control group 35 patients with a mean age of 7.3 years (SD 2.1) were monitored. The time between the initial assessment (T1) and the follow-up (T2) was one year. The orthodontic analysis was done by a three-dimensional digital model analysis. Using the ‘Digimodel’ software, the orthodontic measurements in the maxilla and mandible and for the midline deviation, the overjet and overbite were recorded. Results Significant differences between the control and the therapy group at T2 were detected for the anterior, median and posterior transversal dimensions of the maxilla, the palatal depth, the palatal base arch length, the maxillary arch length and inclination, the midline deviation, the overjet and the overbite. Conclusions Orthodontic treatment of a functional unilateral posterior crossbite with a bonded maxillary expansion device followed by U-bow activator therapy in the late deciduous and early mixed dentition is an effective therapeutic method, as evidenced by the results of this RCT. It leads to three-dimensional therapeutically induced maxillary growth effects. Dental occlusion is significantly improved, and the prognosis for normal craniofacial growth is enhanced. Trial registration Registration trial DRKS00003497 on DRKS PMID:23339736

  9. [Population born in Indonesia or in the former Dutch East-Indies].

    PubMed

    Prins, C J

    1997-04-01

    "The number of persons born in Indonesia or in the former Dutch East Indies and residing in the Netherlands decreases every year. This is primarily caused by ageing. Moreover, immigration from Indonesia has been at a relatively low level for many years. About 178 thousand persons born in Indonesia or in the former Dutch East Indies were living in the Netherlands on 1 January 1996." Information is included on parents' nationality, length of time in the Netherlands, migration policy, and spatial distribution. (EXCERPT)

  10. A causal model for longitudinal randomised trials with time-dependent non-compliance.

    PubMed

    Becque, Taeko; White, Ian R; Haggard, Mark

    2015-05-30

    In the presence of non-compliance, conventional analysis by intention-to-treat provides an unbiased comparison of treatment policies but typically under-estimates treatment efficacy. With all-or-nothing compliance, efficacy may be specified as the complier-average causal effect (CACE), where compliers are those who receive intervention if and only if randomised to it. We extend the CACE approach to model longitudinal data with time-dependent non-compliance, focusing on the situation in which those randomised to control may receive treatment and allowing treatment effects to vary arbitrarily over time. Defining compliance type to be the time of surgical intervention if randomised to control, so that compliers are patients who would not have received treatment at all if they had been randomised to control, we construct a causal model for the multivariate outcome conditional on compliance type and randomised arm. This model is applied to the trial of alternative regimens for glue ear treatment evaluating surgical interventions in childhood ear disease, where outcomes are measured over five time points, and receipt of surgical intervention in the control arm may occur at any time. We fit the models using Markov chain Monte Carlo methods to obtain estimates of the CACE at successive times after receiving the intervention. In this trial, over a half of those randomised to control eventually receive intervention. We find that surgery is more beneficial than control at 6months, with a small but non-significant beneficial effect at 12months.

  11. Satellite data-based phenological evaluation of the nationwide reforestation of South Korea.

    PubMed

    Jeong, Su-Jong; Ho, Chang-Hoi; Choi, Sung-Deuk; Kim, Jinwon; Lee, Eun-Ju; Gim, Hyeon-Ju

    2013-01-01

    Through the past 60 years, forests, now of various age classes, have been established in the southern part of the Korean Peninsula through nationwide efforts to reestablish forests since the Korean War (1950-53), during which more than 65% of the nation's forest was destroyed. Careful evaluation of long-term changes in vegetation growth after reforestation is one of the essential steps to ensuring sustainable forest management. This study investigated nationwide variations in vegetation phenology using satellite-based growing season estimates for 1982-2008. The start of the growing season calculated from the normalized difference vegetation index (NDVI) agrees reasonably with the ground-observed first flowering date both temporally (correlation coefficient, r = 0.54) and spatially (r = 0.64) at the 95% confidence level. Over the entire 27-year period, South Korea, on average, experienced a lengthening of the growing season of 4.5 days decade(-1), perhaps due to recent global warming. The lengthening of the growing season is attributed mostly to delays in the end of the growing season. The retrieved nationwide growing season data were used to compare the spatial variations in forest biomass carbon density with the time-averaged growing season length for 61 forests. Relatively higher forest biomass carbon density was observed over the regions having a longer growing season, especially for the regions dominated by young (<30 year) forests. These results imply that a lengthening of the growing season related to the ongoing global warming may have positive impacts on carbon sequestration, an important aspect of large-scale forest management for sustainable development.

  12. Exploring the feasibility of a nationwide earthquake early warning system in Italy

    NASA Astrophysics Data System (ADS)

    Picozzi, M.; Zollo, A.; Brondi, P.; Colombelli, S.; Elia, L.; Martino, C.

    2015-04-01

    When accompanied by appropriate training and preparedness of a population, Earthquake Early Warning Systems (EEWS) are effective and viable tools for the real-time reduction of societal exposure to seismic events in metropolitan areas. The Italian Accelerometric Network, RAN, which consists of about 500 stations installed over all the active seismic zones, as well as many cities and strategic infrastructures in Italy, has the potential to serve as a nationwide early warning system. In this work, we present a feasibility study for a nationwide EEWS in Italy obtained by the integration of the RAN and the software platform PRobabilistic and Evolutionary early warning SysTem (PRESTo). The performance of the RAN-PRESTo EEWS is first assessed by testing it on real strong motion recordings of 40 of the largest earthquakes that have occurred during the last 10 years in Italy. Furthermore, we extend the analysis to regions that did not experience earthquakes by considering a nationwide grid of synthetic sources capable of generating Gutenberg-Richter sequences corresponding to the one adopted by the seismic hazard map of the Italian territory. Our results indicate that the RAN-PRESTo EEWS could theoretically provide for higher seismic hazard areas reliable alert messages within about 5 to 10 s and maximum lead times of about 25 s. In case of large events (M > 6.5), this amount of lead time would be sufficient for taking basic protective measures (e.g., duck and cover, move away from windows or equipment) in tens to hundreds of municipalities affected by large ground shaking.

  13. Data mining analysis of factors influencing children's blood pressure in a nation-wide health survey

    NASA Astrophysics Data System (ADS)

    Wasiewicz, Piotr; Kulaga, Zbigniew; Litwin, Mieczyslaw

    2009-06-01

    Blood pressure in childhood and adolescents is important indicator of good health and strong predictor of BP in adulthood. Genetic susceptibility, environmental and socioeconomic factors are related both with life style, obesity and cardiovascular risk including elevated BP. Increased body mass index is strictly correlated with BP, and obesity and overweight is main intermediate phenotype of childhood hypertension. However, despite current obesity epidemic available data do not fully support the hypothesis that it has resulted in increase of BP in children. We analysed data obtained from 7591 children participating in nation-wide health survey using data mining methodology. Results reveal relationships of obesity and high blood pressure with school environment characteristics.

  14. Nationwide residues of organochlorine compounds in wings of adult mallards and black ducks, 1976-77

    USGS Publications Warehouse

    White, D.H.

    1979-01-01

    Organochlorine residues in wings of adult mallards and black ducks were monitored nationwide during the 1976-77 hunting season. DDE was found in all samples. Levels were unchanged since the 1972-73 collections in all migratory routes except the Pacific Flyway, in which residue levels declined significantly. Dieldrin levels had not changed in any flyway and residues remained low. PCB levels declined significantly in the Atlantic Flyway but remained stable in other flyways. Heptachlor epoxide, mirex, endrin, hexachlorobenzene, and chlordane isomers were detected in low amounts in some samples.

  15. Technical documentation for the 1990 Nationwide Truck Activity and Commodity Survey Public Use File

    SciTech Connect

    Not Available

    1992-09-01

    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 design of the NTACS are described in this document.

  16. Management of historical waste from research reactors: the Dutch experience

    SciTech Connect

    Van Heek, Aliki; Metz, Bert; Janssen, Bas; Groothuis, Ron

    2013-07-01

    Most radioactive waste emerges as well-defined waste streams from operating power reactors. The management of this is an on-going practice, based on comprehensive (IAEA) guidelines. A special waste category however consists of the historical waste from research reactors, mostly originating from various experiments in the early years of the nuclear era. Removal of the waste from the research site, often required by law, raises challenges: the waste packages must fulfill the acceptance criteria from the receiving storage site as well as the criteria for nuclear transports. Often the aged waste containers do not fulfill today's requirements anymore, and their contents are not well documented. Therefore removal of historical waste requires advanced characterization, sorting, sustainable repackaging and sometimes conditioning of the waste. This paper describes the Dutch experience of a historical waste removal campaign from the Petten High Flux research reactor. The reactor is still in operation, but Dutch legislation asks for central storage of all radioactive waste at the COVRA site in Vlissingen since the availability of the high- and intermediate-level waste storage facility HABOG in 2004. In order to comply with COVRA's acceptance criteria, the complex and mixed inventory of intermediate and low level waste must be characterized and conditioned, identifying the relevant nuclides and their activities. Sorting and segregation of the waste in a Hot Cell offers the possibility to reduce the environmental footprint of the historical waste, by repackaging it into different classes of intermediate and low level waste. In this way, most of the waste volume can be separated into lower level categories not needing to be stored in the HABOG, but in the less demanding LOG facility for low-level waste instead. The characterization and sorting is done on the basis of a combination of gamma scanning with high energy resolution of the closed waste canister and low

  17. Dutch dairy farmers' need for microbiological mastitis diagnostics.

    PubMed

    Griffioen, Karien; Hop, Geralda E; Holstege, Manon M C; Velthuis, Annet G J; Lam, Theo J G M

    2016-07-01

    Although several microbiological mastitis diagnostic tools are currently available, dairy farmers rarely use them to base treatment decisions on. In this study, we conducted a telephone interview among 195 randomly selected Dutch dairy farmers to determine their current use of and their need for microbiological diagnostics for clinical mastitis (CM), subclinical mastitis (SCM), and dry-cow treatment (DCT), followed by the test characteristics they consider important. A structured questionnaire was used, based on face-to-face interviews previously held with other farmers. The answers were registered in a database and analyzed using descriptive statistics and univariable and multivariable models. Antimicrobial treatment decisions for CM, SCM, and DCT were mainly based on clinical signs and somatic cell count. In case of CM, 34% of farmers indicated that they currently submit milk samples for bacteriological culture (BC). This would increase to 71% if an on-farm test resulting in treatment advice within 12 h were available. For SCM, use would increase from 22 to 55%, and for DCT, from 7 to 34%, if the same 12-h test were available. For CM and DCT, the preferred test outcome was advice on which antibiotic to use, according to 58 and 15% of the farmers, respectively. For SCM, the preferred test outcome was the causative bacterium for 38% of the farmers. Farmers who currently submit CM milk samples for BC were 13.1 times more likely to indicate, as the preferred test outcome, advice on which antibiotic to use, compared with farmers who do not currently submit CM milk samples for BC. Fourteen percent of the farmers indicated not being interested at all in microbiological mastitis diagnostics for CM. For SCM and DCT, 27 and 55%, respectively, were not interested in microbiological mastitis diagnostics. Regarding test characteristics that farmers considered important, reliability was most often indicated (44-51% of the farmers). Additionally, a preferred time-to-result of

  18. Population-based prevention of influenza in Dutch general practice.

    PubMed Central

    Hak, E; Hermens, R P; van Essen, G A; Kuyvenhoven, M M; de Melker, R A

    1997-01-01

    BACKGROUND: Although the effectiveness of influenza vaccination in high-risk groups has been proven, vaccine coverage continues to be less than 50% in The Netherlands. To improve vaccination rates, data on the organizational factors, which should be targeted in population-based prevention of influenza, is essential. AIM: To assess the organizational factors in Dutch general practice, which were associated with the influenza vaccination rate in 1994. METHOD: A retrospective questionnaire study was undertaken in 1586 of the 4758 Dutch general practices, which were randomly selected. A total of 1251 (79%) practices returned a questionnaire. The items verified were practice profile, urbanization, delegation index, use of computer-based patient records, influenza vaccination characteristics and influenza vaccination rate. RESULTS: No differences were found with regard to the percentage of single-handed practices (65%), practices situated in urban area (38%), practices with a pharmacy (12%), patients insured by the National Health Service (59%) and use of computer-based patient records (57%) when compared with national statistics. The mean overall influenza vaccination rate was 9.0% (SD 4.0%). Using a logistic regression analysis, a high vaccination rate (> or = 9%) was associated with the use of personal reminders (odds ratio (OR) 1.7, 1.3-2.2), monitoring patient compliance (OR 1.8, 1.3-2.4), marking risk patients in computer-based patient records (OR 1.3, 1.0-1.6), a small number of patients per full-time practice assistant (OR 1.5, 1.1-1.9), urban areas (OR 1.6, 1.3-2.1) and single-handed practices (OR 1.5, 1.1-1.9). CONCLUSION: Improvement of vaccination rates in high-risk patients may be achievable by promoting the use of personal reminders and computer-based patient records, as well as monitoring patient compliance. In addition, the role of practice assistants with regard to preventive activities should be developed further. Practices situated in rural areas and

  19. Dutch survey of congenital coronary artery fistulas in adults

    PubMed Central

    Said, S.A.M.; van der Werf, T.

    2006-01-01

    Aims This Dutch survey focused on the clinical presentation, noninvasive and invasive diagnostic methods, and treatment modalities of adult patients with congenital coronary artery fistulas (CAFs). Methods Between 1996 and 2003, the initiative was taken to start a registry on congenital CAFs in adults. In total 71 patients from a diagnostic coronary angiographic population of 30,829 at 28 hospitals were collected from previously developed case report forms. Patient demographic data, clinical presentation, noninvasive and invasive techniques and treatment options were retrospectively collected and analysed. Results Out of 71 patients with angiographically proven CAFs, 51 (72%) had 63 congenital solitary fistulas and 20 (28%) had 31 congenital coronary-ventricular multiple microfistulas. Patients with pseudofistulas were excluded from the registry. Coronary angiograms were independently re-analysed for morphology and specific fistula details. The majority (72%) of the fistulas were unilateral, 24% were bilateral and only 4% were multilateral. The morphological characteristics of these 94 fistulas were as follows: the origin was multiple in 47% and single in 53%; the termination was multiple in 52% and single in 48%; and the pathway of the fistulous vessels was tortuous/multiple in 66%, tortuous/single in 28%, straight/multiple in 3% and straight/single in 3%. Percutaneous transluminal embolisation (PTE) was performed in two (3%) patients; surgical ligation was undertaken in 13 (18%) patients. The overwhelming majority of the patients (56; 79%) were treated with conservative medical management. The total mortality was 6% (4/71) at a mean follow-up period of approximately five years. Cardiac mortality accounted for 4% (3/71); in all three patients, death could possibly be attributed to the presence of the fistula. Conclusion Registry of congenital coronary artery fistulas in adults in the Netherlands is feasible. In spite of restrictions imposed by the Dutch Privacy

  20. Design of the Dutch Obesity Intervention in Teenagers (NRG-DOiT): systematic development, implementation and evaluation of a school-based intervention aimed at the prevention of excessive weight gain in adolescents

    PubMed Central

    Singh, Amika S; Chin A Paw, Marijke JM; Kremers, Stef PJ; Visscher, Tommy LS; Brug, Johannes; van Mechelen, Willem

    2006-01-01

    Background Only limited data are available on the development, implementation, and evaluation processes of weight gain prevention programs in adolescents. To be able to learn from successes and failures of such interventions, integral written and published reports are needed. Methods Applying the Intervention Mapping (IM) protocol, this paper describes the development, implementation, and evaluation of the Dutch Obesity Intervention in Teenagers (DOiT), a school-based intervention program aimed at the prevention of excessive weight gain. The intervention focussed on the following health behaviours: (1) reduction of the consumption of sugar-sweetened beverages, (2) reduction of energy intake derived from snacks, (3) decrease of levels of sedentary behaviour, and (4) increase of levels of physical activity (i.e. active transport behaviour and sports participation). The intervention program consisted of an individual classroom-based component (i.e. an educational program, covering 11 lessons of both biology and physical education classes), and an environmental component (i.e. encouraging and supporting changes at the school canteens, as well as offering additional physical education classes). We evaluated the effectiveness of the intervention program using a randomised controlled trial design. We assessed the effects of the intervention on body composition (primary outcome measure), as well as on behaviour, behavioural determinants, and aerobic fitness (secondary outcome measures). Furthermore, we conducted a process evaluation. Discussion The development of the DOiT-intervention resulted in a comprehensive school-based weight gain prevention program, tailored to the needs of Dutch adolescents from low socio-economic background. PMID:17173701

  1. Ethnic differences in BMI among Dutch adolescents: what is the role of screen-viewing, active commuting to school, and consumption of soft drinks and high-caloric snacks?

    PubMed Central

    Singh, Amika S; Chinapaw, Mai JM; Brug, Johannes; Kremers, Stef PJ; Visscher, Tommy LS; van Mechelen, Willem

    2009-01-01

    Background The threats posed by the rising prevalence of overweight and obesity on public health have been widely acknowledged. Several population groups, which deserve special attention because of their higher prevalence rates, have been identified. These include adolescents and ethnic sub-groups. The aim of the present study was twofold: (1) to assess ethnic differences in body mass index (BMI) and in behaviours that are related to both energy intake and energy expenditure, and (2) to examine whether these behaviours explain the relationship between ethnicity and BMI. Methods We conducted a cross-sectional data analysis among 957 Dutch adolescents (mean age = 12.7 years). Body height and weight were measured using a standardized protocol. Adolescents completed a questionnaire on screen-viewing behaviour, physical activity, consumption of sugar-containing beverages, and consumption of high-caloric snacks. Results In our study sample 121 adolescents (= 13%) were of Non-Western origin. BMI was significantly higher in Non-Western adolescents (boys: 19.9 kg/m2, SD = 3.0, girls: 20.9 kg/m2, SD = 3.8) compared to Dutch adolescents (boys: 18.4 kg/m2, SD = 2.8, girls: 19.0 kg/m2, SD = 3.0). Our results show that time spent on television viewing, active commuting to school, and consumption of fruit juices partially mediated the association between BMI and ethnicity. Conclusion Behaviours related to both energy expenditure and energy intake may contribute to the ethnic differences in BMI in adolescents and should be considered when tailoring overweight prevention programs to ethnic subpopulations. Trial registration International Standard Randomised Controlled Trial Number ISRCTN87127361 PMID:19383136

  2. ALIFE@Work: a randomised controlled trial of a distance counselling lifestyle programme for weight control among an overweight working population [ISRCTN04265725

    PubMed Central

    van Wier, Marieke F; Ariëns, Geertje AM; Dekkers, Johanna C; Hendriksen, Ingrid JM; Pronk, Nico P; Smid, Tjabe; van Mechelen, Willem

    2006-01-01

    Background The prevalence of overweight is increasing and its consequences will cause a major public health burden in the near future. Cost-effective interventions for weight control among the general population are therefore needed. The ALIFE@Work study is investigating a novel lifestyle intervention, aimed at the working population, with individual counselling through either phone or e-mail. This article describes the design of the study and the participant flow up to and including randomisation. Methods/Design ALIFE@Work is a controlled trial, with randomisation to three arms: a control group, a phone based intervention group and an internet based intervention group. The intervention takes six months and is based on a cognitive behavioural approach, addressing physical activity and diet. It consists of 10 lessons with feedback from a personal counsellor, either by phone or e-mail, between each lesson. Lessons contain educational content combined with behaviour change strategies. Assignments in each lesson teach the participant to apply these strategies to every day life. The study population consists of employees from seven Dutch companies. The most important inclusion criteria are having a body mass index (BMI) ≥ 25 kg/m2 and being an employed adult. Primary outcomes of the study are body weight and BMI, diet and physical activity. Other outcomes are: perceived health; empowerment; stage of change and self-efficacy concerning weight control, physical activity and eating habits; work performance/productivity; waist circumference, sum of skin folds, blood pressure, total blood cholesterol level and aerobic fitness. A cost-utility- and a cost-effectiveness analysis will be performed as well. Physiological outcomes are measured at baseline and after six and 24 months. Other outcomes are measured by questionnaire at baseline and after six, 12, 18 and 24 months. Statistical analyses for short term (six month) results are performed with multiple linear regression

  3. Dutch occupational physicians and general practitioners wish to improve cooperation

    PubMed Central

    Buijs, P.; van Amstel, R.; van Dijk, F.

    1999-01-01

    OBJECTIVES: To investigate cooperation between occupational physicians (OPs) and general practitioners (GPs). METHODS: Literature review; structured interviews; questionnaires sent to randomised samples of OPs (n = 232) and GPs (n = 243). RESULTS: Actual cooperation is poor. However, more than 80% of both groups responded that they want to improve their cooperation, aiming at better quality of care. Obstacles identified by OPs include insufficient knowledge among GPs about occupational health services (OHSs) (57%) and their patients' working conditions (52%). OPs also consider that GPs suspect them of serving employers more than employees (44%) and of verifying reasons of absence, with information from GPs (34%). Responses from GPs confirm these two suspicions (48%, response 58%), adding obstacles like commercialisation of OHS, lack of financial incentives, etc. Both groups are unanimous about prerequisites for improvement, especially guaranteeing the professional autonomy of OPs (OPs 86%, GPs 76%). CONCLUSION: As a first step to overcome obstacles to cooperation, OPs must clarify their position to GP colleagues. Initiatives have been taken after presenting this study.   PMID:10658552

  4. Twenty years of measurement of polycyclic aromatic hydrocarbons (PAHs) in UK ambient air by nationwide air quality networks.

    PubMed

    Brown, Andrew S; Brown, Richard J C; Coleman, Peter J; Conolly, Christopher; Sweetman, Andrew J; Jones, Kevin C; Butterfield, David M; Sarantaridis, Dimitris; Donovan, Brian J; Roberts, Ian

    2013-06-01

    The impact of human activities on the health of the population and of the wider environment has prompted action to monitor the presence of toxic compounds in the atmosphere. Toxic organic micropollutants (TOMPs) are some of the most insidious and persistent of these pollutants. Since 1991 the United Kingdom has operated nationwide air quality networks to assess the presence of TOMPs, including polycyclic aromatic hydrocarbons (PAHs), in ambient air. The data produced in 2010 marked 20 years of nationwide PAH monitoring. This paper marks this milestone by providing a novel and critical review of the data produced since nationwide monitoring began up to the end of 2011 (the latest year for which published data is available), discussing how the networks performing this monitoring has evolved, and elucidating trends in the concentrations of the PAHs measured. The current challenges in the area and a forward look to the future of air quality monitoring for PAHs are also discussed briefly.

  5. Guided and unguided internet-based vestibular rehabilitation versus usual care for dizzy adults of 50 years and older: a protocol for a three-armed randomised trial

    PubMed Central

    van der Wouden, Johannes C; Bosmans, Judith E; Smalbrugge, Martin; van Diest, Willianne; Essery, Rosie; Yardley, Lucy; van der Horst, Henriëtte E; Maarsingh, Otto R

    2017-01-01

    Introduction Dizziness is a common symptom in general practice with a high prevalence among older adults. The most common cause of dizziness in general practice is peripheral vestibular disease. Vestibular rehabilitation (VR) is a safe and effective treatment for peripheral vestibular disease that entails specific exercises to maximise the central nervous system compensation for the effects of vestibular pathology. An internet-based VR intervention has recently been shown to be safe and effective. Online interventions are low cost and easily accessible, but prone to attrition and non-adherence. A combination of online and face-to-face therapy, known as blended care, may balance these advantages and disadvantages. Methods and analysis A single-blind, three-arm, randomised controlled trial among patients aged 50 years and over presenting with dizziness of vestibular origin in general practice will be performed. In this study, we will compare the clinical and cost-effectiveness of stand-alone internet-based VR and internet-based VR with physiotherapeutic support (‘blended care’) with usual care during 6 months of follow-up. We will use a translated Dutch version of a British online VR intervention. Randomisation will be stratified by dizziness severity. The primary outcome measure is the Vertigo Symptoms Scale—Short Form. Intention-to-treat analysis will be performed, adjusting for confounders. The economic evaluation will be conducted from a societal perspective. We will perform an additional analysis on the data to identify predictors of successful treatment in the same population to develop a clinical decision rule for general practitioners. Ethics and dissemination The ethical committee of the VU University Medical Center approved ethics and dissemination of the study protocol. The insights and results of this study will be widely disseminated through international peer-reviewed journals and conference presentations. Trial registration number Pre

  6. Making randomised trials more efficient: report of the first meeting to discuss the Trial Forge platform.

    PubMed

    Treweek, Shaun; Altman, Doug G; Bower, Peter; Campbell, Marion; Chalmers, Iain; Cotton, Seonaidh; Craig, Peter; Crosby, David; Davidson, Peter; Devane, Declan; Duley, Lelia; Dunn, Janet; Elbourne, Diana; Farrell, Barbara; Gamble, Carrol; Gillies, Katie; Hood, Kerry; Lang, Trudie; Littleford, Roberta; Loudon, Kirsty; McDonald, Alison; McPherson, Gladys; Nelson, Annmarie; Norrie, John; Ramsay, Craig; Sandercock, Peter; Shanahan, Daniel R; Summerskill, William; Sydes, Matt; Williamson, Paula; Clarke, Mike

    2015-06-05

    Randomised trials are at the heart of evidence-based healthcare, but the methods and infrastructure for conducting these sometimes complex studies are largely evidence free. Trial Forge ( www.trialforge.org ) is an initiative that aims to increase the evidence base for trial decision making and, in doing so, to improve trial efficiency.This paper summarises a one-day workshop held in Edinburgh on 10 July 2014 to discuss Trial Forge and how to advance this initiative. We first outline the problem of inefficiency in randomised trials and go on to describe Trial Forge. We present participants' views on the processes in the life of a randomised trial that should be covered by Trial Forge.General support existed at the workshop for the Trial Forge approach to increase the evidence base for making randomised trial decisions and for improving trial efficiency. Agreed upon key processes included choosing the right research question; logistical planning for delivery, training of staff, recruitment, and retention; data management and dissemination; and close down. The process of linking to existing initiatives where possible was considered crucial. Trial Forge will not be a guideline or a checklist but a 'go to' website for research on randomised trials methods, with a linked programme of applied methodology research, coupled to an effective evidence-dissemination process. Moreover, it will support an informal network of interested trialists who meet virtually (online) and occasionally in person to build capacity and knowledge in the design and conduct of efficient randomised trials.Some of the resources invested in randomised trials are wasted because of limited evidence upon which to base many aspects of design, conduct, analysis, and reporting of clinical trials. Trial Forge will help to address this lack of evidence.

  7. Nationwide Trends

    MedlinePlus

    ... Alerts Alcohol Club Drugs Cocaine Hallucinogens Heroin Inhalants Marijuana MDMA (Ecstasy/Molly) Methamphetamine Opioids Prescription Drugs & Cold ... mostly reflects a recent rise in use of marijuana, the most commonly used illicit drug. Marijuana use ...

  8. Simulating Nationwide Pandemics: Applying the Multi-scale Epidemiologic Simulation and Analysis System to Human Infectious Diseases

    SciTech Connect

    Dombroski, M; Melius, C; Edmunds, T; Banks, L E; Bates, T; Wheeler, R

    2008-09-24

    This study uses the Multi-scale Epidemiologic Simulation and Analysis (MESA) system developed for foreign animal diseases to assess consequences of nationwide human infectious disease outbreaks. A literature review identified the state of the art in both small-scale regional models and large-scale nationwide models and characterized key aspects of a nationwide epidemiological model. The MESA system offers computational advantages over existing epidemiological models and enables a broader array of stochastic analyses of model runs to be conducted because of those computational advantages. However, it has only been demonstrated on foreign animal diseases. This paper applied the MESA modeling methodology to human epidemiology. The methodology divided 2000 US Census data at the census tract level into school-bound children, work-bound workers, elderly, and stay at home individuals. The model simulated mixing among these groups by incorporating schools, workplaces, households, and long-distance travel via airports. A baseline scenario with fixed input parameters was run for a nationwide influenza outbreak using relatively simple social distancing countermeasures. Analysis from the baseline scenario showed one of three possible results: (1) the outbreak burned itself out before it had a chance to spread regionally, (2) the outbreak spread regionally and lasted a relatively long time, although constrained geography enabled it to eventually be contained without affecting a disproportionately large number of people, or (3) the outbreak spread through air travel and lasted a long time with unconstrained geography, becoming a nationwide pandemic. These results are consistent with empirical influenza outbreak data. The results showed that simply scaling up a regional small-scale model is unlikely to account for all the complex variables and their interactions involved in a nationwide outbreak. There are several limitations of the methodology that should be explored in future

  9. Nationwide occurrence of radon and other natural radioactivity in public water supplies

    SciTech Connect

    Horton, T. R.

    1985-10-01

    The nationwide study, which began in November of 1980, was designed to systematically sample water supplies in all 48 contiguous states. The results of the study will be used, in cooperation with EPA's Office of Drinking Water, to estimate population exposures nationwide and to support possible future standards for radon, uranium, and other natural radioactivity in public water supplies. Samples from more than 2500 public water supplies representing 35 states were collected. Although we sampled only about five percent of the total number of groundwater supplies in the 48 contiguous states of the US, those samples represent nearly 45 percent of the water consumed by US groundwater users in the 48 contiguous states. Sample results are summarized by arithmetic mean, geometric mean, and population weighted arithmetic mean for each state and the entire US. Results include radon, gross alpha, gross beta, Ra-226, Ra-228, total Ra, U-234, U-238, total U, and U-234/U-238 ratios. Individual public water supply results are found in the appendices. 24 refs., 91 figs., 51 tabs.

  10. Epidemiology and use of compression treatment in venous leg ulcers: nationwide claims data analysis in Germany.

    PubMed

    Heyer, Kristina; Protz, Kerstin; Glaeske, Gerd; Augustin, Matthias

    2017-04-01

    Chronic venous diseases are the most common causes of leg ulcers. Compression treatment (CT) is a central component of venous leg ulcer (VLU) therapy along with prevention based on guidelines and clinical evidence. However, large-scale data on the use of CT are rare. In particular, there have not yet been published nationwide data for Germany. We analysed data from a large German statutory health insurance (SHI) on incident VLU between 2010 and 2012. VLUs were identified by ICD-10 diagnoses. The status of active disease was defined by wound-specific treatments. Compression stockings and bandages were identified by SHI medical device codes. The overall estimated incident rate of active VLU of all insured persons was 0·34% from 2010 to 2012. Adapted to the overall German population, n = 229 369 persons nationwide had an incident VLU in 2010-2012. Among all VLU patients, only 40·6% received CT within 1 year, including 83·3% stockings, 31·8% bandages and 3·1% multi-component compression systems. Compression rates showed significant differences by gender and age. Large regional variations were observed. Validity of data is suggested by high concordance with a primary cohort study. Although recommended by guidelines, there is still a marked under-provision of care, with CT in incident VLUs in Germany requiring active measures.

  11. Exposure to Mebendazole and Pyrvinium during Pregnancy: A Danish Nationwide Cohort Study

    PubMed Central

    Torp-Pedersen, A.; Jimenez-Solem, E.; Andersen, J. T.; Broedbaek, K.; Torp-Pedersen, C.; Poulsen, H. E.

    2012-01-01

    Purpose. Families with children are frequently exposed to pinworm infection and treatment involves the whole family. Information on consequences of exposure during, pregnancy is limited. The aim of this study was to investigate the exposure to pyrvinium and mebendazole before, during, and after pregnancy in a Danish nationwide cohort. Methods. From nationwide administrative registers, we identified 718, 900 births in Denmark between January 1997 and December 2007 as well as maternal prescription data of anthelmintics and maternal characteristics. Redemption of a prescription for pyrvinium or mebendazole was used to identify exposure. Results. 4715 women redeemed a prescription for pyrvinium or mebendazole during pregnancy; 1606 for pyrvinium, 2575 for mebendazole, and 534 for both drugs. Having >2 children compared to having no previous children was associated with exposure to pyrvinium (OR: 7.1, 95% CI: 5.8–8.7) and mebendazole (OR: 20.8, 95% CI: 17.3–24.9). Conclusion. 4715 pregnant women redeemed a prescription for either mebendazole or pyrvinium. We believe the exposure to be even higher since pyrvinium is also sold over-the-counter. Limited information on birth outcomes is available at present time, and considering the number of exposed pregnancies, we recommend that studies are to be undertaken to assess the safety of pyrvinium and mebendazole during pregnancy. PMID:23028209

  12. A nation-wide survey on indoor radon from 2007 to 2010 in Japan.

    PubMed

    Suzuki, Gen; Yamaguchi, Ichiro; Ogata, Hiromitsu; Sugiyama, Hideo; Yonehara, Hidenori; Kasagi, Fumiyoshi; Fujiwara, Saeko; Tatsukawa, Yoshimi; Mori, Ippei; Kimura, Shinzo

    2010-01-01

    In two previous nation-wide surveys in the late 1980s and early 1990s, Japanese indoor radon concentrations increased in homes built after the mid 1970s. In order to ascertain whether this trend continued, a nation-wide survey was conducted from 2007 to 2010. In total 3,900 houses were allocated to 47 prefectures by the Neyman allocation method and 3,461 radon measurements were performed (88.7% success). The fraction of reinforced concrete / concrete block buildings was 32.4%, similar to the value from national statistics. Arithmetic mean (standard deviation, SD) and geometric mean (geometric SD) of radon concentration after adjusting for seasonal fluctuation were 14.3 (14.7) and 10.8 (2.1) Bq/m(3). The corresponding population-weighted values were 13.7 (12.3) and 10.4 (2.0) Bq/m(3), respectively. It was estimated that only 0.1% of dwellings exceed 100 Bq/m(3), a new WHO reference level for indoor radon. Radon concentrations were highest in houses constructed in the mid 1980s and decreased thereafter. In conclusion, arithmetic mean indoor radon in the present survey was slightly lower than in previous surveys and significant reductions in indoor radon concentrations in both wooden and concrete houses can be attributed to alterations in Japanese housing styles in recent decades.

  13. Is Canada Ready for Nationwide Collaboration on Medical School Admissions Practices and Policies?

    PubMed

    Hanson, Mark D; Moineau, Geneviève; Kulasegaram, Kulamakan Mahan; Hammond, Robert

    2016-11-01

    The report by the Association of Faculties of Medicine of Canada (AFMC) entitled "The Future of Medical Education in Canada: A Collective Vision for MD Education" includes recommendations to enhance admissions processes and increase national collaboration. To achieve these goals, the AFMC conducted a nationwide environmental scan appraising medical schools' readiness for national collaboration and progress toward establishing "made-in-Canada" admissions processes. A critical narrative review of the academic and gray literature was conducted as part of this environmental scan. Four core admissions practice and policy domains were identified: (1) social accountability strategies, (2) standardized admissions testing, (3) interviewing procedures, and (4) application procedures.In this article, the authors summarize and discuss the findings of this narrative review with regard to the four domains. They provide documentation of historical and present-day admissions factors relevant to Canadian medical schools' readiness for nationwide collaboration and a descriptive analysis of the facilitators and barriers to establishing "made-in-Canada" admissions processes.All four domains had facilitators and barriers. One barrier, however, cut across multiple domains-medical schools' pursuit of prestige and its potential to conflict with the goals of the other domains. The authors recommend holding a national forum to debate these issues and to advance the AFMC's goals, a process that will not be straightforward. Yet, national collaboration holds promise for applicants, medical schools, and Canada's diverse population of patients, so efforts toward this end must continue.

  14. Traditional Chinese patent medicines for cancer treatment in China: a nationwide medical insurance data analysis.

    PubMed

    Wu, Min; Lu, Peng; Shi, Luwen; Li, Shao

    2015-11-10

    Based on the nationwide survey into inpatients' utilization of the health service covered by China's urban basic medical insurance from 2008 to 2010, we analyzed the use rate, cancer profile and combined use of anticancer Chinese patent medicines (CPMs) on 51,382 insured cancer patients by using statistical, bi-clustering and network methods. We found that 42.4% of 51,382 cancer patients used 33 anticancer CPMs, and 51.7% used 71 anticancer Western medicines (WMs). The CPMs were most often used in lung (52%) and nasopharynx (52%) cancer patients, and least in bladder cancer (21%) and leukemia of unspecified cell type (21%) patients. The cost per patient for all 33 anticancer CPMs was 2069RMB, lower than that of the WMs (3458RMB). The cancer profile of commonly used CPMs and WMs for the top 17 cancers (>500 sampled patients) were provided, indicating anticancer CPMs had a broad spectrum of cancers and lacked selectivity in cancer treatment (CPM mean CV = 49%; WM mean CV = 152%). Moreover, 24.8% of the cancer patients used both CPMs and WMs, and CPM-WM combined use networks were constructed for four major cancers. This first nationwide analysis revealed the use characteristics and herb-drug combined use patterns of insurance covered anticancer CPMs in China. The study offers valuable information to guide future studies of the precision, safety and standard use of CPMs.

  15. Inflammatory bowel disease nurse specialists for patients on biological therapies: a nationwide Italian survey

    PubMed Central

    Guarini, Alessandra; Marinis, Francesca De; Kohn, Anna; Orzes, Nicoletta; D’Incà, Renata; Iannone, Teresa; Giaquinto, Antonella; Rivara, Cinzia; Ridola, Lorenzo; Lorenzetti, Roberto; Zullo, Angelo

    2016-01-01

    Background Management of inflammatory bowel disease (IBD) patients requires a multidisciplinary approach. Among the working team, the role of IBD nurse is expected to be particularly relevant when managing patients receiving biological therapies. We performed a survey to assess the presence of IBD nurse in centers where patients were receiving biologics. Methods For this Italian nationwide survey a specific questionnaire was prepared. IBD nurse was defined as a nurse directly involved in all phases of biological therapy, from pre-therapy screening, administration and monitoring during therapy, to follow up performed by a dedicated helpline, completed a specific training on biological therapy therapy, and observed international guidelines. Results A total of 53 Italian IBD centers participated in the survey, and 91 valid questionnaires were collected. Overall, 34 (37.4%) nurses could be classified as IBD specialists. IBD nurses had a significantly higher educational level than other nurses, they were more frequently operating in Central or Southern than in Northern Italy, they were working in an Academic center rather than in a General hospital, and in IBD centers with >25 patients on biological therapy. On the contrary, mean age, gender distribution, years of nursing, and years working in the IBD unit did not significantly differ between IBD and other nurses. Conclusions Our nationwide survey showed that the presence of an IBD nurse is still lacking in the majority of Italian IBD centers where patients receive biological therapies, suggesting a prompt implementation. PMID:27708516

  16. Urban–rural differences in pediatric traumatic head injuries: A prospective nationwide study

    PubMed Central

    Halldorsson, Jonas G; Flekkoy, Kjell M; Gudmundsson, Kristinn R; Arnkelsson, Gudmundur B; Arnarson, Eirikur Orn

    2007-01-01

    Aims To estimate differences in the incidence of recorded traumatic head injuries by gender, age, severity, and geographical area. Methods The study was prospective and nationwide. Data were collected from all hospitals, emergency units and healthcare centers in Iceland regarding all Icelandic children and adolescents 0–19 years old consecutively diagnosed with traumatic head injuries (N = 550) during a one-year period. Results Annual incidence of minimal, mild, moderate/severe, and fatal head injuries (ICD-9 850–854) was 6.41 per 1000, with 95% confidence interval (CI) 5.9, 7.0. Annual incidence of minimal head injuries (ICD-9 850) treated at emergency units was 4.65 (CI 4.2, 5.1) per 1000, mild head injuries admitted to hospital (ICD-9 850) was 1.50 (CI 1.3, 1.8) per 1000, and moderate/severe nonfatal injuries (ICD-9 851–854) was 0.21 (CI 0.1, 0.3) per 1000. Death rate was 0.05 (CI 0.0, 0.1) per 1000. Young children were at greater risk of sustaining minimal head injuries than older ones. Boys were at greater risk than girls were. In rural areas, incidence of recorded minimal head injuries was low. Conclusions Use of nationwide estimate of the incidence of pediatric head injury shows important differences between urban and rural areas as well as between different age groups. PMID:19300630

  17. Nationwide Benthic Macroinvertebrate Assemblage Multimetric Indices: Identifying Inconsistencies and Limitations in Reporting Stream Impairment Status, USA

    NASA Astrophysics Data System (ADS)

    Lau, J. K.; Lauer, T. E.

    2015-07-01

    The objective of this study was to identify the current status of stream water-quality assessment and reporting methods for four states in the Ohio River basin (Indiana, Ohio, Tennessee, and Virginia), as required by the 305(b) section of the United States (US) Clean Water Act. Specifically, we clarified the discrepancies that exist among stream-impairment status classified by benthic macroinvertebrate multimetric indices (MMIs) and depicted using Geographic Information Systems shapefiles. In addition, we provided guidance in solving some of the comparability problems that arise when developing state-specific MMIs and depicting stream-impairment status using Geographic Information Systems technology. The MMI variation among states and differences in shapefile formats resulted in a nationwide dataset, which cannot be directly compared. Incorporating the changes suggested in this study allow for a uniform assessment and reporting method nationwide. Successful implementation of these changes would strengthen the US Environmental Protection Agency efforts to identify impaired streams and sources of those impairments without the limitations of state-by-state .developed assessment methods.

  18. Nationwide benthic macroinvertebrate assemblage multimetric indices: identifying inconsistencies and limitations in reporting stream impairment status, USA.

    PubMed

    Lau, J K; Lauer, T E

    2015-07-01

    The objective of this study was to identify the current status of stream water-quality assessment and reporting methods for four states in the Ohio River basin (Indiana, Ohio, Tennessee, and Virginia), as required by the 305(b) section of the United States (US) Clean Water Act. Specifically, we clarified the discrepancies that exist among stream-impairment status classified by benthic macroinvertebrate multimetric indices (MMIs) and depicted using Geographic Information Systems shapefiles. In addition, we provided guidance in solving some of the comparability problems that arise when developing state-specific MMIs and depicting stream-impairment status using Geographic Information Systems technology. The MMI variation among states and differences in shapefile formats resulted in a nationwide dataset, which cannot be directly compared. Incorporating the changes suggested in this study allow for a uniform assessment and reporting method nationwide. Successful implementation of these changes would strengthen the US Environmental Protection Agency efforts to identify impaired streams and sources of those impairments without the limitations of state-by-state .developed assessment methods.

  19. Traditional Chinese patent medicines for cancer treatment in China: a nationwide medical insurance data analysis

    PubMed Central

    Wu, Min; Lu, Peng; Shi, Luwen; Li, Shao

    2015-01-01

    Based on the nationwide survey into inpatients' utilization of the health service covered by China's urban basic medical insurance from 2008 to 2010, we analyzed the use rate, cancer profile and combined use of anticancer Chinese patent medicines (CPMs) on 51,382 insured cancer patients by using statistical, bi-clustering and network methods. We found that 42.4% of 51,382 cancer patients used 33 anticancer CPMs, and 51.7% used 71 anticancer Western medicines (WMs). The CPMs were most often used in lung (52%) and nasopharynx (52%) cancer patients, and least in bladder cancer (21%) and leukemia of unspecified cell type (21%) patients. The cost per patient for all 33 anticancer CPMs was 2069RMB, lower than that of the WMs (3458RMB). The cancer profile of commonly used CPMs and WMs for the top 17 cancers (>500 sampled patients) were provided, indicating anticancer CPMs had a broad spectrum of cancers and lacked selectivity in cancer treatment (CPM mean CV = 49%; WM mean CV = 152%). Moreover, 24.8% of the cancer patients used both CPMs and WMs, and CPM-WM combined use networks were constructed for four major cancers. This first nationwide analysis revealed the use characteristics and herb-drug combined use patterns of insurance covered anticancer CPMs in China. The study offers valuable information to guide future studies of the precision, safety and standard use of CPMs. PMID:26513017

  20. Effectiveness of the Assessment of Burden of COPD (ABC) tool on health-related quality of life in patients with COPD: a cluster randomised controlled trial in primary and hospital care

    PubMed Central

    Slok, Annerika H M; Kotz, Daniel; van Breukelen, Gerard; Chavannes, Niels H; Rutten-van Mölken, Maureen P M H; Kerstjens, Huib A M; van der Molen, Thys; Asijee, Guus M; Dekhuijzen, P N Richard; Holverda, Sebastiaan; Salomé, Philippe L; Goossens, Lucas M A; Twellaar, Mascha; in ‘t Veen, Johannes C C M; van Schayck, Onno C P

    2016-01-01

    Objective Assessing the effectiveness of the Assessment of Burden of COPD (ABC) tool on disease-specific quality of life in patients with chronic obstructive pulmonary disease (COPD) measured with the St. George's Respiratory Questionnaire (SGRQ), compared with usual care. Methods A pragmatic cluster randomised controlled trial, in 39 Dutch primary care practices and 17 hospitals, with 357 patients with COPD (postbronchodilator FEV1/FVC ratio <0.7) aged ≥40 years, who could understand and read the Dutch language. Healthcare providers were randomly assigned to the intervention or control group. The intervention group applied the ABC tool, which consists of a short validated questionnaire assessing the experienced burden of COPD, objective COPD parameter (eg, lung function) and a treatment algorithm including a visual display and treatment advice. The control group provided usual care. Researchers were blinded to group allocation during analyses. Primary outcome was the number of patients with a clinically relevant improvement in SGRQ score between baseline and 18-month follow-up. Secondary outcomes were the COPD Assessment Test (CAT) and the Patient Assessment of Chronic Illness Care (PACIC; a measurement of perceived quality of care). Results At 18-month follow-up, 34% of the 146 patients from 27 healthcare providers in the intervention group showed a clinically relevant improvement in the SGRQ, compared with 22% of the 148 patients from 29 healthcare providers in the control group (OR 1.85, 95% CI 1.08 to 3.16). No difference was found on the CAT (−0.26 points (scores ranging from 0 to 40); 95% CI −1.52 to 0.99). The PACIC showed a higher improvement in the intervention group (0.32 points (scores ranging from 1 to 5); 95% CI 0.14 to 0.50). Conclusions This study showed that use of the ABC tool may increase quality of life and perceived quality of care. Trial registration number NTR3788; Results. PMID:27401361

  1. Epidemiology of Campylobacter spp. at two Dutch broiler farms.

    PubMed

    Jacobs-Reitsma, W F; van de Giessen, A W; Bolder, N M; Mulder, R W

    1995-06-01

    Broiler flocks on two Dutch poultry farms were screened weekly for the presence of campylobacter in fresh caecal droppings during eight consecutive production cycles. Hatchery and fresh litter samples were taken at the start of each new cycle. Water, feed, insects, and faeces of domestic animals, present on the farms were also included in the sampling. Penner serotyping of isolates was used to identify epidemiological factors that contribute to campylobacter colonization in the broiler flocks. Generally, broiler flocks became colonized with campylobacter at about 3-4 weeks of age with isolation percentages of 100%, and stayed colonized up to slaughter. A similar pattern of serotypes was found within the various broiler houses on one farm during one production cycle. New flocks generally showed also a new pattern of serotypes. Most serotypes isolated from the laying hens, pigs, sheep and cattle were different from those isolated from the broilers at the same time. Campylobacter serotypes from darkling beetles inside the broiler houses were identical to the ones isolated from the broilers. No campylobacter was isolated from any of the hatchery, water, feed or fresh litter samples. Conclusive evidence of transmission routes was not found, but results certainly point towards horizontal transmission from the environment. Horizontal transmission from one broiler flock to the next one via a persistent contamination within the broiler house, as well as vertical transmission from breeder flocks via the hatchery to progeny, did not seem to be very likely.

  2. Timing of pitch movements and accentuation of syllables in Dutch.

    PubMed

    Hermes, D J

    1997-10-01

    In this study, the relation between the timing of a rising or falling pitch movement and the syllable it accentuates is investigated. The five-syllable utterance /mamamamama/ was provided with a relatively fast rising or falling pitch movement. The timing of the movement was systematically varied and Dutch subjects were asked to indicate which syllable they perceived as accented. In order to find out where in the pitch movement the cue which induces the percept of accentuation is located, the duration of the pitch movement was varied. In order to find out which segments of the utterance this characteristic is linked to, the duration of the /m/ was varied. The results showed that the percept of accentuation is induced by a change in pitch at the start of the movement. The moment at which the course of pitch starts to change significantly determines which syllable is perceived as accented. If this moment lies some tens of milliseconds before the P-center, i.e., the perceptual moment of occurrence of the syllable, the preceding syllable is perceived as accented. For a rise, a high accent is perceived; for a fall, a low accent. If the pitch change occurs after this moment, the syllable with this P-center is perceived as accented. For the rise, a low accent is then perceived; for the fall, a high accent. This will be discussed in the light of earlier research on accentuation and of theoretical knowledge about pitch accents.

  3. Gas treatment installed on Dutch North Sea platform

    SciTech Connect

    Festen, L.J.F.M.; Bronneberg, J.P.A.; Brugman, W.P.T.; Hartmann, D.W.; Huber, B.L.

    1995-03-20

    Installation offshore of a treating system for Amoco Netherlands Petroleum Co. to bring natural gas and condensate up to sales specifications runs counter to conventional development practices of putting such systems on land. The processing scheme is for the P/15-P/18 project in the Dutch North Sea. The project is integrated with the nearby Rijn field production. The field produces up to 13.4 million standard cu m/day (scmd; 500 MMscfd) of gas and 1,900 cu m/day (cmd) of hydrocarbon condensate (12,000 b/d). Four interconnected process units (gas dew point control, vapor recovery, condensate stabilization, and CH{sub 3}OH recovery) were designed to split completely the fluids from the inlet system into pipeline quality gas, stable condensate, clean water, and CH{sub 3}OH for reinjection. The paper describes the platforms and pipelines, the processing units, vapor and methanol recovery utilities, and start up. The methanol is injected into the initial gas stream to control hydrate formation.

  4. Transmission profile of the Dutch Open Telescope Hα Lyot filter

    NASA Astrophysics Data System (ADS)

    Koza, J.; Hammerschlag, R. H.; Rybák, J.; Gömöry, P.; Kučera, A.; Schwartz, P.

    Context Accurate knowledge of the spectral transmission profile of a Lyot filter is important, in particular in comparing observations with simulated data. The paper summarizes available facts about the transmission profile of the Dutch Open Telescope (DOT) Hα Lyot filter pointing to a discrepancy between sidelobe-free Gaussian-like profile measured spectroscopically and signatures of possible leakage of parasitic continuum light in DOT Hα images. We compute wing-to-center intensity ratios resulting from convolutions of Gaussian and square of the sinc function with the Hα atlas profile and compare them with the ratios derived from observations of the quiet Sun chromosphere at disk center. We interpret discrepancies between the anticipated and observed ratios and the sharp limb visible in the DOT Hα image as an indication of possible leakage of parasitic continuum light. A method suggested here can be applied also to indirect testing of transmission profiles of other Lyot filters. We suggest two theoretical transmission profiles of the DOT Hα Lyot filter which should be considered as the best available approximations. Conclusive answer can only be given by spectroscopic re-measurement of the filter.

  5. Multi-wavelength imaging system for the Dutch Open Telescope

    NASA Astrophysics Data System (ADS)

    Bettonvil, Felix C.; Suetterlin, Peter; Hammerschlag, Robert H.; Jagers, Aswin P.; Rutten, Robert J.

    2003-02-01

    The Dutch Open Telescope (DOT) is an innovative solar telescope, completely open, on an open steel tower, without a vacuum system. The aim is long-duration high resolution imaging and in order to achieve this the DOT is equipped with a diffraction limited imaging system in combination with a data acquisition system designed for use with the speckle masking reconstruction technique for removing atmospheric aberrations. Currently the DOT is being equipped with a multi-wavelength system forming a high-resolution tomographic imager of magnetic fine structure, topology and dynamics in the photosphere and low- and high chromosphere. Finally the system will contain 6 channels: G-band (430.5 nm), Ca II H (K) (396.8 nm), H-α (656.3 nm), Ba II (455.4 nm), and two continuum channels (432 and 651 nm). Two channels are in full operation now and observations show that the DOT produces real diffraction limited movies (with 0.2" resolution) over hours in G-band (430.5 nm) and continuum (432 nm).

  6. Gender Nonconformity, Sexual Orientation, and Dutch Adolescents' Relationship with Peers.

    PubMed

    Bos, Henny; Sandfort, Theo

    2015-07-01

    Same-sex attraction and gender nonconformity have both been shown to negatively affect the relationships of adolescents with their peers. It is not clear, though, whether same-sex attracted adolescents are more likely to have negative peer relationships because they are same-sex attracted or because they are more likely to be gender nonconforming. It is also possible that both stressors affect peer relationships independently or amplify each other in their impact. We explored these questions in a sample of 486 Dutch adolescents (M age = 14.02 years). We found that same-sex attraction and gender nonconformity both had an independent effect and that gender nonconformity moderated, but not mediated, the associations between same-sex attraction and peer relationships at school. Same-sex attraction was more strongly associated with poorer relationships with peers in adolescents who were more gender nonconforming. These findings indicate the importance of including gender nonconformity in the understanding of same-sex attracted adolescents' relationships and suggest that in order to improve same-sex attracted adolescents' social position at school, acceptance of gender diversity should be promoted as well.

  7. An overview of concept mapping in Dutch mental health care.

    PubMed

    Nabitz, Udo; van Randeraad-van der Zee, Carlijn; Kok, Ineke; van Bon-Martens, Marja; Serverens, Peter

    2017-02-01

    About 25 years ago, concept mapping was introduced in the Netherlands and applied in different fields. A collection of concept mapping projects conducted in the Netherlands was identified, in part in the archive of the Netherlands Institute of Mental Health and Addiction (Trimbos Institute). Some of the 90 identified projects are internationally published. The 90 concept mapping projects reflect the changes in mental health care and can be grouped into 5-year periods and into five typologies. The studies range from conceptualizing the problems of the homeless to the specification of quality indicators for treatment programs for patients with cystic fibrosis. The number of concept mapping projects has varied over time. Growth has been considerable in the last 5 years compared to the previous 5 years. Three case studies are described in detail with 12 characteristics and graphical representations. Concept mapping aligns well with the typical Dutch approach of the "Poldermodel." A broad introduction of concept mapping in European countries in cooperation with other countries, such as the United States and Canada, would strengthen the empirical basis for applying this approach in health care policy, quality, and clinical work.

  8. Body satisfaction and sexual health in Dutch female university students.

    PubMed

    van den Brink, Femke; Smeets, Monique A M; Hessen, David J; Talens, Jona G; Woertman, Liesbeth

    2013-01-01

    Studies in the field of body image have primarily addressed its negative aspects, such as body dissatisfaction. The present study focused instead on women who are satisfied with their bodies and on how body satisfaction relates to sexual health. A sample of 319 Dutch female university students completed an online survey that included items about body image evaluation, body image investment, overweight preoccupation, body image affect during sexual activity, sexual frequency, sexual functioning, and sexual self-esteem. We found that the level of body dissatisfaction was minimal in our sample. The majority reported neutral or mildly positive body evaluations, and in 30% of the sample these evaluations were clearly positive. Comparisons between women who reported positive versus neutral body evaluations showed that the body-satisfied women had lower body mass indexes (BMIs) and reported less body image investment, less overweight preoccupation, and less body self-consciousness during sexual activity. With regard to sexual health, they reported higher sexual self-esteem and better sexual functioning. Furthermore, we found that body image self-consciousness was negatively associated with sexual functioning, sexual self-esteem, and frequency of sexual activity with a partner. Body satisfaction did not account for a portion of the relationship of body self-consciousness during sexual activity with sexual health.

  9. Phytolith aided paleoenvironmental studies from the Dutch Neolithic

    NASA Astrophysics Data System (ADS)

    Persaits, Gergő; Gulyás, Sándor; Náfrádi, Katalin; Sümegi, Pál; Szalontai, Csaba

    2015-11-01

    There is increasing evidence for crop cultivation at sites of the Neolithic Swifterbant culture from ca. 4300 B.C. onwards. Presence of cereal fields at the Swifterbant S2, S3 and S4 sites has been corroborated from micro morphological studies of soil samples. Swifterbant sites with evidence for cultivated plants are still scarce though and only emerging, and have produced very low numbers of charred cereals only. The major aim of our work was to elucidate the environmental background of the Dutch Neolithic site Swifterbant S4 based on the investigation of phytolith remains retrieved from soil samples. In addition to find evidence for crop cultivation independently from other studies. Samples were taken at 1 cm intervals vertically from the soil section at the central profile of site S4. Additional samples were taken from pocket-like structures and adjacent horizons above and below. Pig coprolites yielded an astonishing phytolith assemblage which was compared to that of the soil samples. A pig tooth also yielded evaluable material via detailed investigation using SEM. The evaluation of phytolith assemblages retrieved from the soil horizons plus those ending up in the droppings of pigs feasting in the area enabled to draw a relatively reliable environmental picture of the area. All these refer to the presence of a Neolithic horticulture (cereal cultivation) under balanced micro-climatic conditions as a result of the vicinity of the nearby floodplain. These findings corroborate those of previous soil micro-morphological studies.

  10. Characteristics of stuttering in Dutch-speaking individuals.

    PubMed

    Boey, Ronny A; Wuyts, Floris L; Van De Heyning, Paul H; Heylen, Louis; De Bodt, Marc S

    2009-04-01

    Clinical diagnostic procedures to distinguish stuttering from non-stuttering individuals partially rely on the observation of characteristics of stuttered words or syllables. The purpose of this study was to examine the sensitivity and specificity of such a procedure, and to describe the observed characteristics of stuttered words. Methods involved the recording of the frequency, duration, and physical tension of stuttered words in conversational speech samples (total 43, 100 words) and in an oral reading task (total 43, 100 words). In this manner, 351 native Dutch speaking people, aged 8-53, who stutter were compared to a group of non-stuttering peers (n = 80). Findings suggest that applying a criterion of 3% stuttered words in conversational speech makes it possible to distinguish stuttering from non-stuttering individuals with high sensitivity (.9345) and perfect specificity (1.0000). Frequency, duration, and physical tension accompanying stuttered words are described for the group of stuttering participants, and these characteristics were compared to the group of non-stuttering speakers.

  11. Host responses and metabolic profiles of wood components in Dutch elm hybrids with a contrasting tolerance to Dutch elm disease

    PubMed Central

    Ďurkovič, Jaroslav; Kačík, František; Olčák, Dušan; Kučerová, Veronika; Krajňáková, Jana

    2014-01-01

    Background and Aims Changes occurring in the macromolecular traits of cell wall components in elm wood following attack by Ophiostoma novo-ulmi, the causative agent of Dutch elm disease (DED), are poorly understood. The purpose of this study was to compare host responses and the metabolic profiles of wood components for two Dutch elm (Ulmus) hybrids, ‘Groeneveld’ (a susceptible clone) and ‘Dodoens’ (a tolerant clone), that have contrasting survival strategies upon infection with the current prevalent strain of DED. Methods Ten-year-old plants of the hybrid elms were inoculated with O. novo-ulmi ssp. americana × novo-ulmi. Measurements were made of the content of main cell wall components and extractives, lignin monomer composition, macromolecular traits of cellulose and neutral saccharide composition. Key Results Upon infection, medium molecular weight macromolecules of cellulose were degraded in both the susceptible and tolerant elm hybrids, resulting in the occurrence of secondary cell wall ruptures and cracks in the vessels, but rarely in the fibres. The 13C nuclear magnetic resonance spectra revealed that loss of crystalline and non-crystalline cellulose regions occurred in parallel. The rate of cellulose degradation was influenced by the syringyl:guaiacyl ratio in lignin. Both hybrids commonly responded to the medium molecular weight cellulose degradation with the biosynthesis of high molecular weight macromolecules of cellulose, resulting in a significant increase in values for the degree of polymerization and polydispersity. Other responses of the hybrids included an increase in lignin content, a decrease in relative proportions of d-glucose, and an increase in proportions of d-xylose. Differential responses between the hybrids were found in the syringyl:guaiacyl ratio in lignin. Conclusions In susceptible ‘Groeneveld’ plants, syringyl-rich lignin provided a far greater degree of protection from cellulose degradation than in ‘Dodoens’, but

  12. Objectively monitored patching regimens for treatment of amblyopia: randomised trial

    PubMed Central

    Stewart, Catherine E; Stephens, David A; Fielder, Alistair R

    2007-01-01

    Objectives To compare visual outcome in response to two prescribed rates of occlusion (six hours a day and 12 hours a day). Design Unmasked randomised trial. Setting Research clinics in two London hospitals. Participants 97 children with a confirmed diagnosis of amblyopia associated with strabismus, anisometropia, or both. Interventions: 18 week period of wearing glasses (refractive adaptation) followed by occlusion prescribed (“patching”) for six or 12 hours a day. Main outcome measures Visual acuity measured by logMAR letter recognition; objectively monitored rate of occlusion (hours a day). Results The mean age of children at study entry was 5.6 (SD 1.5) years. Ninety were eligible for occlusion but 10 dropped out in this phase, leaving 80 children who were randomised to a prescribed dose rate of six (n=40) or 12 (n=40) hours a day. The mean change in visual acuity of the amblyopic eye was not significantly different (P=0.64) between the two groups (0.26 (95% confidence interval 0.21 to 0.31) log units in six hour group; 0.24 (0.19 to 0.29) log units in 12 hour group). The mean dose rates (hours a day) actually received, however, were also not significantly different (4.2 (3.7 to 4.7) in six hour group v 6.2 (5.1 to 7.3) in 12 hour group; P=0.06). The visual outcome was similar for those children who received three to six hours a day or more than six to 12 hours a day, but significantly better than that in children who received less than three hours a day. Children aged under 4 required significantly less occlusion than older children. Visual outcome was not influenced by type of amblyopia. Conclusions Substantial (six hours a day) and maximal (12 hours a day) prescribed occlusion results in similar visual outcome. On average, the occlusion dose received in the maximal group was only 50% more than in the substantial group and in both groups was much less than that prescribed. Younger children required the least occlusion. Trials registration Clinical Trials

  13. Strategies for Increasing Recruitment to Randomised Controlled Trials: Systematic Review

    PubMed Central

    Caldwell, Patrina H. Y.; Hamilton, Sana; Tan, Alvin; Craig, Jonathan C.

    2010-01-01

    Background Recruitment of participants into randomised controlled trials (RCTs) is critical for successful trial conduct. Although there have been two previous systematic reviews on related topics, the results (which identified specific interventions) were inconclusive and not generalizable. The aim of our study was to evaluate the relative effectiveness of recruitment strategies for participation in RCTs. Methods and Findings A systematic review, using the PRISMA guideline for reporting of systematic reviews, that compared methods of recruiting individual study participants into an actual or mock RCT were included. We searched MEDLINE, Embase, The Cochrane Library, and reference lists of relevant studies. From over 16,000 titles or abstracts reviewed, 396 papers were retrieved and 37 studies were included, in which 18,812 of at least 59,354 people approached agreed to participate in a clinical RCT. Recruitment strategies were broadly divided into four groups: novel trial designs (eight studies), recruiter differences (eight studies), incentives (two studies), and provision of trial information (19 studies). Strategies that increased people's awareness of the health problem being studied (e.g., an interactive computer program [relative risk (RR) 1.48, 95% confidence interval (CI) 1.00–2.18], attendance at an education session [RR 1.14, 95% CI 1.01–1.28], addition of a health questionnaire [RR 1.37, 95% CI 1.14–1.66]), or a video about the health condition (RR 1.75, 95% CI 1.11–2.74), and also monetary incentives (RR1.39, 95% CI 1.13–1.64 to RR 1.53, 95% CI 1.28–1.84) improved recruitment. Increasing patients' understanding of the trial process, recruiter differences, and various methods of randomisation and consent design did not show a difference in recruitment. Consent rates were also higher for nonblinded trial design, but differential loss to follow up between groups may jeopardise the study findings. The study's main limitation was the necessity of

  14. Trends in Expanded-Spectrum Cephalosporin-Resistant Escherichia coli and Klebsiella pneumoniae among Dutch Clinical Isolates, from 2008 to 2012

    PubMed Central

    van der Steen, Matthijs; Leenstra, Tjalling; Kluytmans, Jan A. J. W.; van der Bij, Akke K.

    2015-01-01

    We investigated time trends in extended-spectrum cephalosporin-resistant Escherichia coli and Klebsiella pneumoniae isolates from different patient settings in The Netherlands from 2008–2012. E. coli and K. pneumoniae isolates from blood and urine samples of patients > = 18 years were selected from the Dutch Infectious Disease Surveillance System-Antimicrobial Resistance (ISIS-AR) database. We used multivariable Poisson regression to study the rate per year of blood stream infections by susceptible and resistant isolates, and generalized estimating equation (GEE) log-binomial regression for trends in the proportion of extended-spectrum cephalosporin-resistant isolates. Susceptibility data of 197,513 E. coli and 38,244 K. pneumoniae isolates were included. The proportion of extended-spectrum cephalosporin-resistant E. coli and K. pneumoniae isolates from urine and blood samples increased in all patient settings, except for K. pneumoniae isolates from patients admitted to intensive care units. For K. pneumoniae, there was a different time trend between various patient groups (p<0.01), with a significantly higher increase in extended-spectrum cephalosporin-resistant isolates from patients attending a general practitioner than in isolates from hospitalized patients. For E. coli, the increasing time trends did not differ among different patient groups. This nationwide study shows a general increase in extended-spectrum cephalosporin-resistant E. coli and K. pneumoniae isolates. However, differences in trends between E. coli en K. pneumoniae underline the importance of E. coli as a community-pathogen and its subsequent influence on hospital resistance level, while for K. pneumoniae the level of resistance within the hospital seems less influenced by the resistance trends in the community. PMID:26381746

  15. Trends in Expanded-Spectrum Cephalosporin-Resistant Escherichia coli and Klebsiella pneumoniae among Dutch Clinical Isolates, from 2008 to 2012.

    PubMed

    van der Steen, Matthijs; Leenstra, Tjalling; Kluytmans, Jan A J W; van der Bij, Akke K

    2015-01-01

    We investigated time trends in extended-spectrum cephalosporin-resistant Escherichia coli and Klebsiella pneumoniae isolates from different patient settings in The Netherlands from 2008-2012. E. coli and K. pneumoniae isolates from blood and urine samples of patients > = 18 years were selected from the Dutch Infectious Disease Surveillance System-Antimicrobial Resistance (ISIS-AR) database. We used multivariable Poisson regression to study the rate per year of blood stream infections by susceptible and resistant isolates, and generalized estimating equation (GEE) log-binomial regression for trends in the proportion of extended-spectrum cephalosporin-resistant isolates. Susceptibility data of 197,513 E. coli and 38,244 K. pneumoniae isolates were included. The proportion of extended-spectrum cephalosporin-resistant E. coli and K. pneumoniae isolates from urine and blood samples increased in all patient settings, except for K. pneumoniae isolates from patients admitted to intensive care units. For K. pneumoniae, there was a different time trend between various patient groups (p<0.01), with a significantly higher increase in extended-spectrum cephalosporin-resistant isolates from patients attending a general practitioner than in isolates from hospitalized patients. For E. coli, the increasing time trends did not differ among different patient groups. This nationwide study shows a general increase in extended-spectrum cephalosporin-resistant E. coli and K. pneumoniae isolates. However, differences in trends between E. coli en K. pneumoniae underline the importance of E. coli as a community-pathogen and its subsequent influence on hospital resistance level, while for K. pneumoniae the level of resistance within the hospital seems less influenced by the resistance trends in the community.

  16. Changes in school environment, awareness and actions regarding overweight prevention among Dutch secondary schools between 2006–2007 and 2010–2011

    PubMed Central

    2013-01-01

    Background Schools can be an important setting for the prevention of overweight. This nation-wide survey investigated changes in the obesogenity of the school environment, the awareness of schools regarding overweight, school health policy, and actions taken by schools to prevent overweight. Methods In 2006/2007 and 2010/2011, questionnaires were sent to all Dutch secondary schools, (n = 1250 and n = 1145, response rate 44% and 33% respectively, repeated data for 187 schools). Results The percentage of schools with vending machines for soft drinks (~90%) and sweets (~80%) remained fairly stable, whereas slightly more schools indicated to have a canteen (87%-91%). The food supply was reported to be healthier in 2010/2011 compared to 2006/2007. Canteens and/or vending machines offered more often fresh fruits (+8%), sandwiches (+11%), water (+11%) and salad (+7%) and less often sugar sweetened soft drinks (−10%). However, unfavorable changes such as an increase in the supply of pizza slices (+13%) and milk and yoghurt drinks with added sugar (+12%) were also reported. Between 2006/2007 and 2010/2011, the presence of water coolers increased (12% versus 33%) as well as facilities for physical activity (67% versus 77%). However, more schools had vending places of unhealthy foods in the vicinity (73% versus 85%). Compared to 2006/2007, a higher percentage of schools indicated that they have taken actions to stimulate healthy eating behavior (72% versus 80%) or to prevent overweight (34% versus 52%) in 2010/2011. Less schools indicated that they expect to pay more attention to overweight prevention in the near future (56% versus 43%), but none of them expected to pay less attention. Conclusions Several aspects of the school environment changed in a positive way. However, schools should be encouraged to contribute to the prevention of overweight, or to continue to do so. PMID:23870483

  17. Practicalities of Using a Modified Version of the Cochrane Collaboration Risk of Bias Tool for Randomised and Non-Randomised Study Designs Applied in a Health Technology Assessment Setting

    ERIC Educational Resources Information Center

    Robertson, Clare; Ramsay, Craig; Gurung, Tara; Mowatt, Graham; Pickard, Robert; Sharma, Pawana

    2014-01-01

    We describe our experience of using a modified version of the Cochrane risk of bias (RoB) tool for randomised and non-randomised comparative studies. Objectives: (1) To assess time to complete RoB assessment; (2) To assess inter-rater agreement; and (3) To explore the association between RoB and treatment effect size. Methods: Cochrane risk of…

  18. The prevalence and characteristics of patients with classic locked-in syndrome in Dutch nursing homes.

    PubMed

    Kohnen, R F; Lavrijsen, J C M; Bor, J H J; Koopmans, R T C M

    2013-06-01

    To establish the point prevalence and characteristics of patients with locked-in syndrome (LIS), particularly of the classic type, residing in Dutch nursing homes, a cross-sectional survey of Dutch nursing homes was conducted. The classic form of LIS was defined according to the criteria of the American Congress of Rehabilitation Medicine (1995). All Dutch long-term care organisations (n = 187) were asked if they had any patients with classic LIS as of December 5, 2011. The treating Elderly Care Physicians were then contacted to provide patient characteristics. Of all organisations, 91.4% responded, and 11 organisations reported a total of 12 patients. After analysing the questionnaires, it was determined that ten patients had LIS, and two patients were characterised with vegetative state. Only two patients met the criteria for classic LIS, while six patients showed partial LIS. One of these patients was admitted to the nursing home after December 5, 2011, and was therefore, excluded. LIS without accompanying pontine lesion was observed in the remaining two patients. For the first time, the prevalence of classic LIS has been established at 0.7/10,000 somatic nursing home beds in all Dutch long-term care organisations. Possible explanations for this low prevalence could be the Dutch provision of home care or the influence of end-of-life decisions, such as euthanasia and withholding or withdrawing all medical treatment, including artificial nutrition and hydration. These alternate outcomes should be explored in further studies.

  19. Healthy habits are no fun: How Dutch youth negotiate discourses about food, fit, fat, and fun.

    PubMed

    van Amsterdam, Noortje; Knoppers, Annelies

    2017-01-01

    In this article, we use the notion of "biopedagogical practices" to explore how Dutch youth respond to health messages that focus on body weight. Previous studies suggest that such health messages encourage body dissatisfaction in youth. Few studies, however, focus on the local/cultural specificity of youth's responses to these biopedagogical practices. In this article, we address questions about the re-interpretation of and resistance to health messages that Dutch youth engage in and how these can be understood in their local context. The data were drawn from two previously conducted studies in which a total of 64 Dutch teenagers (aged 12-18 years) took part. We employed a variety of qualitative data collection methods and a feminist poststructuralist perspective to analyze how Dutch youth negotiate biopedagogical practices about health. The results show that our participants constructed health in terms of appearance and reproduced negative constructions regarding fat embodiment. Yet they also often circumvented "healthy" lifestyle behaviors prescribed by biopedagogies of health. They did so first by avoiding physical activities because they were afraid of displaying fat embodiment in the settings of sport and physical education where surveillance is omnipresent. Second, they disregarded advice about healthy eating by drawing on having fun as an alternative discursive resource. We argue that having fun is both part of youth culture and characteristic of the discourse about sociability ( gezelligheid) that is a central element of Dutch culture.

  20. Antibiotic treatment of pneumonia and bronchiolitis. A prospective randomised study.

    PubMed Central

    Friis, B; Andersen, P; Brenøe, E; Hornsleth, A; Jensen, A; Knudsen, F U; Krasilnikoff, P A; Mordhorst, C H; Nielsen, S; Uldall, P

    1984-01-01

    Routine administration of antibiotics in the treatment of pneumonia and bronchiolitis in infants and small children was evaluated in an open randomised prospective trial. From 1979-82 136 children between the age of 1 month and 6 years were allocated to one of two treatment groups shortly after their admission to a paediatric ward. Group A patients were to be given antibiotics but those in group B were not. None of the children had received antibiotics before hospital admission. A viral infection was diagnosed in 38 of the 72 patients from group A and in 34 of the 64 patients from group B. Respiratory syncytial virus was detected in 84% of these patients. Samples of tracheal secretions showed no differences between the groups in respect of cytology and bacterial flora. Nor were there any significant differences in the course of acute disease, the frequency of fever relapse and pulmonary complications. Fifteen patients from group B were subsequently treated with antibiotics: two of these developed secondary purulent infections of the middle ear and one showed a slight pleural effusion. These results do not support the routine use of antibiotics in infants and small children admitted to hospital with pneumonia and bronchiolitis. PMID:6391389

  1. Exercise therapy for osteoporosis: results of a randomised controlled trial.

    PubMed Central

    Preisinger, E; Alacamlioglu, Y; Pils, K; Bosina, E; Metka, M; Schneider, B; Ernst, E

    1996-01-01

    OBJECTIVE: To define the effects of therapeutic exercise on bone density and back complaints. METHODS: A randomised controlled trial with parallel groups was conducted in an outpatient clinic, Medical School, University of Vienna. Ninety two sedentary post-menopausal women with back problems were randomly allocated to either exercise (groups 1 and 2) or control (group 3, no exercise, n = 31); the exercise group was retrospectively subdivided into compliant (group 1, n = 27) and not fully compliant patients (group 2, n = 34). Regular, initially supervised therapeutic exercise aimed at restoring biomechanical function was performed for four years. Bone density in the forearm was measured by single photon absorptiometry at entry and after four years; subjective back complaints were documented. RESULTS: A significant decrease in bone density was observed in groups 2 and 3; no change was noted in group 1; back complaints decreased in group 1 only. CONCLUSIONS: Sedentary postmenopausal women may benefit from regular long term therapeutic exercise in terms of subjective back complaints and slowed loss of bone mass. PMID:8889112

  2. Randomised controlled trial of cisapride in preterm infants

    PubMed Central

    McClure, R; Kristensen, J; Grauaug, A

    1999-01-01

    AIM—To determine the effect of cisapride on gastrointestinal motility in preterm infants.
METHODS—Cisapride (0.2 mg/kg, 8 hourly ) or placebo was given first for seven days in a double blind randomised crossover study of 10 preterm infants. Gastrointestinal motility was assessed on day 3 of each treatment. The half gastric emptying time (GET1/2) was determined by using ultrasonography to measure the decrease in the gastric antral cross sectional area after a feed. The whole gastrointestinal transit time (WGTT) was assessed by timing the transit of carmine red through the gut. Treatments were compared using the Wilcoxon matched pairs signed ranks test.
RESULTS—Median (range) birthweight was 1200 (620, 1450) g and postconceptional age 33 (29, 34) weeks at recruitment. GET1/2 was significantly longer during cisapride treatment than during placebo; the median of the differences (95% confidence interval) was 19.2 (11, 30minutes, p=0.008). WGTT was also longer during cisapride treatment, but the difference was not significant; the median of the differences was 11(−18, 52 hours, p=0.1).
CONCLUSIONS—Cisapride delays gastric emptying and may delay WGTT in preterm infants. Its use to promote gastrointestinal motility in this group cannot be recommended.

 PMID:10212076

  3. Radiotherapy enhances laser palliation of malignant dysphagia: a randomised study.

    PubMed Central

    Sargeant, I R; Tobias, J S; Blackman, G; Thorpe, S; Glover, J R; Bown, S G

    1997-01-01

    BACKGROUND/AIMS: A major drawback of laser endoscopy in the palliation of malignant dysphagia is the need for repeated treatments. This study was designed to test whether external beam radiotherapy would reduce the necessity for repeated laser therapy. PATIENTS/METHODS: Sixty seven patients with inoperable oesophageal or gastric cardia cancers and satisfactory swallowing after initial laser recanalisation were randomised to palliative external beam radiotherapy (30 Gy in 10 fractions) or no radiotherapy. All patients underwent a 'check' endoscopy five weeks after initial recanalisation and were subsequently reendoscoped only for recurrent dysphagia, which occurred in 59 patients. RESULTS: Dysphagia was relieved equally well in both groups and the improvement was maintained with further endoscopic treatment. The initial dysphagia controlled interval and the duration between procedures required to maintain lifelong palliation (treatment interval) increased from five to nine weeks (median) in the radiotherapy group (p < 0.01 both parameters). Radiotherapy was well tolerated in all but three patients. One perforation occurred and two fistulae opened after dilatation in patients who received radiotherapy. CONCLUSION: Additional radiotherapy reduces the necessity for therapeutic endoscopy for a patient's remaining life. It has an important role in relatively well patients who are likely to survive long enough to benefit. PMID:9135526

  4. Panax ginseng in randomised controlled trials: a systematic review.

    PubMed

    Shergis, Johannah L; Zhang, Anthony L; Zhou, Wenyu; Xue, Charlie C

    2013-07-01

    Panax ginseng C.A. Meyer is a common herb with many purported health benefits. However, there is no conclusive evidence supporting its use in the treatment of any particular disease. We conducted a systematic review to evaluate randomised controlled trials. Four English databases were searched with no publication date restriction. Included studies evaluated P. ginseng in patients with any type of disease or in healthy individuals. We assessed the quality of studies using the Cochrane risk of bias tool. Of the 475 potentially relevant studies, 65 met the inclusion criteria. These studies examined P. ginseng's effects on psychomotor performance (17 studies), physical performance (ten), circulatory system (eight), glucose metabolism (six), the respiratory system (five), erectile dysfunction (four), immunomodulation (four), quality of life/mood (four), antioxidant function (two), cancer (two), menopausal symptoms (two) and dry mouth (one). The risk of bias was unclear in most studies. Authors evaluated adverse events in 40 studies, with 135 minor events and no serious adverse events reported. P. ginseng shows promising results for improving glucose metabolism and moderating the immune response. This may have implications for several diseases including type 2 diabetes and chronic respiratory conditions. Further studies are needed to explore P. ginseng's potential as an effective treatment for these and other health conditions.

  5. Umbilical cord clamping and preterm infants: a randomised trial.

    PubMed Central

    Kinmond, S; Aitchison, T C; Holland, B M; Jones, J G; Turner, T L; Wardrop, C A

    1993-01-01

    OBJECTIVE--To investigate the clinical effects of regulating umbilical cord clamping in preterm infants. DESIGN--A prospective randomised study. SETTING--The Queen Mother's Hospital, Glasgow. SUBJECTS--36 vaginally delivered infants over 27 and under 33 weeks' gestation. INTERVENTION--Holding the infant 20 cm below the introitus for 30 seconds before clamping the umbilical cord ("regulated" group, 17 patients), or conventional management ("random" group, 19 patients). MAIN OUTCOME MEASURES--Initial packed cell volume, peak serum bilirubin concentrations, red cell transfusion requirements, and respiratory impairment (assessed by ventilatory requirements, arterial-alveolar oxygen tension ratio over the first day in ventilated infants, and duration of dependence on supplemental oxygen). RESULTS--There were statistically significant differences between the two groups in mean initial packed cell volume (regulated group 0.564, random group 0.509) and median red cell transfusion requirements (regulated group zero, random group 23 ml/kg). 13 infants from each group underwent mechanical ventilation and showed significant differences in mean minimum arterial-alveolar oxygen tension ratio on the first day (regulated group 0.42, random group 0.22) and in median duration of dependence on supplemental oxygen (regulated group three days, random group 10 days). Differences in final outcome measures such as duration of supplemental oxygen dependence and red cell transfusion requirements were mediated primarily through arterial-alveolar oxygen tension ratio and also packed cell volume. CONCLUSIONS--This intervention at preterm deliveries produces clinical and economic benefits. PMID:8443480

  6. An Introduction to Methodological Issues When Including Non-Randomised Studies in Systematic Reviews on the Effects of Interventions

    ERIC Educational Resources Information Center

    Reeves, Barnaby C.; Higgins, Julian P. T.; Ramsay, Craig; Shea, Beverley; Tugwell, Peter; Wells, George A.

    2013-01-01

    Background: Methods need to be further developed to include non-randomised studies (NRS) in systematic reviews of the effects of health care interventions. NRS are often required to answer questions about harms and interventions for which evidence from randomised controlled trials (RCTs) is not available. Methods used to review randomised…

  7. Curved versus Straight Stem Uncemented Total Hip Arthroplasty Osteoarthritis Multicenter trial (CUSTOM): design of a prospective blinded randomised controlled multicentre trial

    PubMed Central

    van Beers, Loes W A H; van Oldenrijk, Jakob; Scholtes, Vanessa A B; Geerdink, Carel H; Niers, Bob B A M; Runne, Wouter; Bhandari, Mohit; Poolman, Rudolf W

    2016-01-01

    Introduction Answering the demands of an increasingly young and active patient population, recent developments in total hip arthroplasty (THA) have shifted towards minimising tissue damage. The Collum Femoris Preserving (CFP) stem was developed to preserve the trochanteric region of the femur, which potentially preserves the insertion of the gluteus musculature. This might accelerate early postoperative rehabilitation and improve functional outcome. Currently the functional results of the CFP stem have not been compared with conventional straight stems in a randomised controlled trial (RCT). The primary purpose of this trial is to compare the functional result of CFP stem THA with conventional uncemented straight stem THA, measured by the Dutch Hip disability and Osteoarthritis Outcome Score (HOOS) at 3-month follow-up. Methods A prospective blinded multicentre RCT will be performed. We aim to recruit 150 patients. The patients will be randomly allocated to a THA with a straight or a curved stem. All patients, research assistants, clinical assessors and investigators will be blinded for the type of prosthesis for 5 years. Clinical assessments and roentgenograms will be taken preoperative, at 6 weeks after surgery, at 1, 2, 3, 4 and 5 years after surgery. Patient reported outcome measures (PROMs) will be obtained at the same follow-up moments. In addition, the PROMs will also be sent to the patients at 3 and 6 months after surgery. The HOOS at 3-month follow-up will be our primary outcome. Ethics and dissemination This trial will be performed in accordance with the Declaration of Helsinki. A local ethics committee has approved this trial. Written informed consent will be obtained from all participating patients. All serious adverse events will be reported to the ethics committee. Results Results will be submitted for publication to an orthopaedics related journal. Trial registration number NTR1560. PMID:27009147

  8. Cost-effectiveness analysis of an 18-week exercise programme for patients with breast and colon cancer undergoing adjuvant chemotherapy: the randomised PACT study

    PubMed Central

    May, Anne M; Bosch, Marcel J C; Velthuis, Miranda J; van der Wall, Elsken; Steins Bisschop, Charlotte N; Los, Maartje; Erdkamp, Frans; Bloemendal, Haiko J; de Roos, Marnix A J; Verhaar, Marlies; ten Bokkel Huinink, Daan; Peeters, Petra H M; de Wit, G Ardine

    2017-01-01

    Objective Meta-analyses show that exercise interventions during cancer treatment reduce cancer-related fatigue. However, little is known about the cost-effectiveness of such interventions. Here we aim to assess the cost-effectiveness of the 18-week physical activity during cancer treatment (PACT) intervention for patients with breast and colon cancer. The PACT trial showed beneficial effects for fatigue and physical fitness. Design Cost-effectiveness analyses with a 9-month time horizon (18 weeks of intervention and 18 weeks of follow-up) within the randomised controlled multicentre PACT study. Setting Outpatient clinics of 7 hospitals in the Netherlands (1 academic and 6 general hospitals) Participants 204 patients with breast cancer and 33 with colon cancer undergoing adjuvant treatment including chemotherapy. Intervention Supervised 1-hour aerobic and resistance exercise (twice per week for 18 weeks) or usual care. Main outcome measures Costs, quality-adjusted life years (QALY) and the incremental cost-effectiveness ratio. Results For colon cancer, the cost-effectiveness analysis showed beneficial effects of the exercise intervention with incremental costs savings of €4321 and QALY improvements of 0.03. 100% of bootstrap simulations indicated that the intervention is dominant (ie, cheaper and more effective). For breast cancer, the results did not indicate that the exercise intervention was cost-effective. Incremental costs were €2912, and the incremental effect was 0.01 QALY. At a Dutch threshold value of €20 000 per QALY, the probability that the intervention is cost-effective was 2%. Conclusions Our results suggest that the 18-week exercise programme was cost-effective for colon cancer, but not for breast cancer. Trial registration number ISRCTN43801571. PMID:28264824

  9. The Sooner the Better? An Investigation into the Role of Age of Onset and Its Relation with Transfer and Exposure in Bilingual Frisian-Dutch Children

    ERIC Educational Resources Information Center

    Blom, Elma; Bosma, Evelyn

    2016-01-01

    In this study, age of onset (AoO) was investigated in five- and six-year-old bilingual Frisian-Dutch children. AoO to Dutch ranged between zero and four and had a positive effect on Dutch receptive vocabulary size, but hardly influenced the children's accurate use of Dutch inflection. The influence of AoO on vocabulary was more prominent than the…

  10. Variability of annual CO2 exchange from Dutch Grasslands

    NASA Astrophysics Data System (ADS)

    Jacobs, C. M. J.; Jacobs, A. F. G.; Bosveld, F. C.; Hendriks, D. M. D.; Hensen, A.; Kroon, P. S.; Moors, E. J.; Nol, L.; Schrier-Uijl, A.; Veenendaal, E. M.

    2007-05-01

    An intercomparison is made of the Net Ecosystem Exchange of CO2, NEE, for eight Dutch grassland sites; four natural grasslands, two production grasslands and two meteorological stations within a rotational grassland region. At all sites the NEE was determined during at least 10 months per site, using the eddy-covariance (EC) technique, but in different years. The photosynthesis-light response analysis technique is used along with the respiration-temperature response technique to partition NEE among Gross Primary Production (GPP) and Ecosystem Respiration (Re) and to obtain the eco-physiological characteristics of the sites at the field scale. Annual sums of NEE, GPP and Re are then estimated using the fitted response curves with observed radiation and air temperature from a meteorological site in the centre of The Netherlands as drivers. These calculations are carried out for four years (2002-2005). The estimated annual Re for all individual sites is more or less constant per site and the average for all sites amounts to 1390±30 gC m-2 a-1. The narrow uncertainty band (±2%) reflects the small differences in the mean annual air temperature. The mean annual GPP was estimated to be 1325 g C m-2 a-1, and displays a much higher standard deviation, of ±100 gC m-2 a-1 (8%), which reflects the relatively large variation in annual solar radiation. The mean annual NEE amounts to -65±85 gC m-2 a-1, which implies that on average the grasslands act as a source, with a relatively large standard deviation. From two sites, four-year records of CO2 flux were available and analyzed (2002-2005). Using the weather record of 2005 with optimizations from the other years, standard deviation of annual GPP was estimated to be 171-206 gC m-2 a-1 (8-14%), of annual Re 227-247 gC m-2 a-1 (14-16%) and of annual NEE 176-276 gC m-2 a-1. The inter-site standard deviation was higher for GPP and Re, 534 gC m-2 a-1 (37.3%) and 486 gC m-2 a-1 (34.8%), respectively. However, the inter

  11. The Selection of Intonation Contours by Chinese L2 Speakers of Dutch: Orthographic Closure vs. Prosodic Knowledge

    ERIC Educational Resources Information Center

    He, Xuliang; van Heuven, Vincent J.; Gussenhoven, Carlos

    2012-01-01

    Chinese learners of Dutch and a control group of native speakers of Dutch were presented with 26 sentences in the order they come in a story, visually as well as auditorily as spoken with four intonation contours. Participants were instructed to select the most appropriate intonation contour for each sentence in a forced choice task. Chinese…

  12. Making Dutch Pupils Media Conscious: Preadolescents' Self-Assessment of Possible Media Risks and the Need for Media Education

    ERIC Educational Resources Information Center

    Kuter-Luks, Theresa; Heuvelman, Ard; Peters, Oscar

    2011-01-01

    Despite clear European and Dutch policies about media education, there is currently no media education curriculum in Dutch schools. A survey among preadolescents (n = 257) in six primary schools in the Netherlands included questions regarding media access, fears, risks, parental mediation of television and the internet, and the need for media…

  13. Bird mortality following DDT spray for Dutch elm disease

    USGS Publications Warehouse

    Wurster, D.H.; Wurster, C.F.; Strickland, W.N.

    1965-01-01

    Avian populations in Hanover, N. H., a town that has sprayed its elms with DDT for many years in an attempt to control Dutch elm disease, were compared with those in Norwich, Vt., a town 1 mile (1.6 km) west of Hanover that has never sprayed. Hanover applied 109 lb DDT/acre (2.1 kg/hectare) in April 1963, then used Methoxychlor in April 1964. Population surveys were taken regularly during spring and early summer of these years, dead birds were collected in both towns, and 106 birds were analyzed for DDT, DDE, and DDD. Severe mortality of both resident and migrant birds occurred in Hanover during spring 1963, and the evidence implicates DDT as its cause. Robin loss was estimated at 70% of the resident population, or 350 to 400 individuals, but mortality among other species of widely varied feeding habits was also substantial. Feeding habits suggest that some birds acquired the toxicant by eating living insects carrying DDT, presenting the paradox of survival of the intended DDT victims, and death, instead, of insectivorous birds. Organ and whole bird analyses are presented and criteria for establishing cause of death are discussed. Most of the DDT had been converted to DDE and DDD, and residues were found in all organs analyzed. Robin mortality was reduced, but not eliminated following Methoxychlor application in 1964; these losses were believed caused by residual DDT in the soil. There was no evidence DDT poisoning among other species in 1964, though the dead birds collected were not analyzed.

  14. Health literacy of Dutch adults: a cross sectional survey

    PubMed Central

    2013-01-01

    Background Relatively little knowledge is available to date about health literacy among the general population in Europe. It is important to gain insights into health literacy competences among the general population, as this might contribute to more effective health promotion and help clarify socio-economic disparities in health. This paper is part of the European Health Literacy Survey (HLS-EU). It aims to add to the body of theoretical knowledge about health literacy by measuring perceived difficulties with health information in various domains of health, looking at a number of competences. The definition and measure of health literacy is still topic of debate and hardly any instruments are available that are applicable for the general population. The objectives were to obtain an initial measure of health literacy in a sample of the general population in the Netherlands and to relate this measure to education, income, perceived social status, age, and sex. Methods The HLS-EU questionnaire was administered face-to-face in a sample of 925 Dutch adults, during July 2011. Perceived difficulties with the health literacy competences for accessing, understanding, appraising and applying information were measured within the domains of healthcare, disease prevention and health promotion. Multiple linear regression analyses were applied to explore the associations between health literacy competences and education, income, perceived social status, age, and sex. Results Perceived difficulties with health information and their association with demographic and socio-economic variables vary according to the competence and health domain addressed. Having a low level of education or a low perceived social status or being male were consistently found to be significantly related to relatively low health literacy scores, mainly for accessing and understanding health information. Conclusions Perceived difficulties with health information vary between competences and domains of

  15. Diagnostic exome sequencing in 266 Dutch patients with visual impairment.

    PubMed

    Haer-Wigman, Lonneke; van Zelst-Stams, Wendy Ag; Pfundt, Rolph; van den Born, L Ingeborgh; Klaver, Caroline Cw; Verheij, Joke Bgm; Hoyng, Carel B; Breuning, Martijn H; Boon, Camiel Jf; Kievit, Anneke J; Verhoeven, Virginie Jm; Pott, Jan Wr; Sallevelt, Suzanne Ceh; van Hagen, Johanna M; Plomp, Astrid S; Kroes, Hester Y; Lelieveld, Stefan H; Hehir-Kwa, Jayne Y; Castelein, Steven; Nelen, Marcel; Scheffer, Hans; Lugtenberg, Dorien; Cremers, Frans Pm; Hoefsloot, Lies; Yntema, Helger G

    2017-02-22

    Inherited eye disorders have a large clinical and genetic heterogeneity, which makes genetic diagnosis cumbersome. An exome-sequencing approach was developed in which data analysis was divided into two steps: the vision gene panel and exome analysis. In the vision gene panel analysis, variants in genes known to cause inherited eye disorders were assessed for pathogenicity. If no causative variants were detected and when the patient consented, the entire exome data was analyzed. A total of 266 Dutch patients with different types of inherited eye disorders, including inherited retinal dystrophies, cataract, developmental eye disorders and optic atrophy, were investigated. In the vision gene panel analysis (likely), causative variants were detected in 49% and in the exome analysis in an additional 2% of the patients. The highest detection rate of (likely) causative variants was in patients with inherited retinal dystrophies, for instance a yield of 63% in patients with retinitis pigmentosa. In patients with developmental eye defects, cataract and optic atrophy, the detection rate was 50, 33 and 17%, respectively. An exome-sequencing approach enables a genetic diagnosis in patients with different types of inherited eye disorders using one test. The exome approach has the same detection rate as targeted panel sequencing tests, but offers a number of advantages. For instance, the vision gene panel can be frequently and easily updated with additional (novel) eye disorder genes. Determination of the genetic diagnosis improved the clinical diagnosis, regarding the assessment of the inheritance pattern as well as future disease perspective.European Journal of Human Genetics advance online publication, 22 February 2017; doi:10.1038/ejhg.2017.9.

  16. Trends in Antibiotic Prescribing in Adults in Dutch General Practice

    PubMed Central

    Haeseker, Michiel B.; Dukers-Muijrers, Nicole H. T. M.; Hoebe, Christian J. P. A.; Bruggeman, Cathrien A.; Cals, Jochen W. L.; Verbon, Annelies

    2012-01-01

    Background Antibiotic consumption is associated with adverse drug events (ADE) and increasing antibiotic resistance. Detailed information of antibiotic prescribing in different age categories is scarce, but necessary to develop strategies for prudent antibiotic use. The aim of this study was to determine the antibiotic prescriptions of different antibiotic classes in general practice in relation to age. Methodology Retrospective study of 22 rural and urban general practices from the Dutch Registration Network Family Practices (RNH). Antibiotic prescribing data were extracted from the RNH database from 2000–2009. Trends over time in antibiotic prescriptions were assessed with multivariate logistic regression including interaction terms with age. Registered ADEs as a result of antibiotic prescriptions were also analyzed. Principal Findings In total 658,940 patients years were analyzed. In 11.5% (n = 75,796) of the patient years at least one antibiotic was prescribed. Antibiotic prescriptions increased for all age categories during 2000–2009, but the increase in elderly patients (>80 years) was most prominent. In 2000 9% of the patients >80 years was prescribed at least one antibiotic to 22% in 2009 (P<0.001). Elderly patients had more ADEs with antibiotics and co-medication was identified as the only independent determinant for ADEs. Conclusion/Discussion The rate of antibiotic prescribing for patients who made a visit to the GP is increasing in the Netherlands with the most evident increase in the elderly patients. This may lead to more ADEs, which might lead to higher consumption of health care and more antibiotic resistance. PMID:23251643

  17. Exposure to polycyclic aromatic hydrocarbons among Dutch children

    SciTech Connect

    Wijnen, J.H. van; Slob, R.; Jongmans-Liedekerken, G.

    1996-05-01

    We determined the urinary 1-hydroxypyrene (1-HP) concentration and the creatinine-adjusted 1-HP concentration in 644 randomly selected Dutch children, aged 1-6 years and living in five areas with roughly different levels of polycyclic aromatic hydrocarbons (PAHs) in soil and ambient air. The presence of other factors that might influence the exposure to PAHs was studied using a questionnaire. To evaluate the reliability of a single urinary 1-HP determination, measurements were repeated after 3 weeks for approximately 200 children. The mean urinary 1-HP content of the total study population was 2.06 nmol/1. This varied from 1.58 nmol/l in the reference area (Flevoland) to 2.71 nmol/l in the valley of the Geul. Only indoor sources of PAHs showed a small, positive association with urinary 1-HP. The urinary 1-HP concentrations of children from the valley of the Geul were higher (p<0.01) and those of children from a suburb of Amsterdam were lower (p<0.01) than those of children from the reference area. The possible ambient environment-related differences were probably too small to be detected in the variations of the intake of PAHs from the daily diet. The reliability of a single 1-HP measurement was low. Similar results were obtained with the creatinine-adjusted data. In one neighborhood built on coal-mine tailings, the urinary 1-HP content in children was weakly but positively associated with the PAH content in the upper soil layer of the garden of their homes. However, this association was not found for the children from the other neighborhood built on coal-mine tailings and with similar PAH levels in soil. 25 refs., 4 tabs.

  18. Equality or Equity, Player or Guardian? The Dutch Government and Its Role in Providing Access Opportunities for Government Sponsored International Secondary Education, 1979-2009

    ERIC Educational Resources Information Center

    Prickarts, Boris

    2010-01-01

    This article focuses on the Dutch government's International Baccalaureate (IB) Diploma Programme (DP) Pilot, allowing Dutch pre-university students to take part in the IB DP. Is it likely to create "equal", or rather "equitable", access opportunities for government-sponsored Dutch international secondary schools? The article…

  19. The Dutch Linguistic Intraoperative Protocol: a valid linguistic approach to awake brain surgery.

    PubMed

    De Witte, E; Satoer, D; Robert, E; Colle, H; Verheyen, S; Visch-Brink, E; Mariën, P

    2015-01-01

    Intraoperative direct electrical stimulation (DES) is increasingly used in patients operated on for tumours in eloquent areas. Although a positive impact of DES on postoperative linguistic outcome is generally advocated, information about the neurolinguistic methods applied in awake surgery is scarce. We developed for the first time a standardised Dutch linguistic test battery (measuring phonology, semantics, syntax) to reliably identify the critical language zones in detail. A normative study was carried out in a control group of 250 native Dutch-speaking healthy adults. In addition, the clinical application of the Dutch Linguistic Intraoperative Protocol (DuLIP) was demonstrated by means of anatomo-functional models and five case studies. A set of DuLIP tests was selected for each patient depending on the tumour location and degree of linguistic impairment. DuLIP is a valid test battery for pre-, intraoperative and postoperative language testing and facilitates intraoperative mapping of eloquent language regions that are variably located.

  20. The processing of singular and plural nouns in English, French, and Dutch: New insights from megastudies.

    PubMed

    Gimenes, Manuel; Brysbaert, Marc; New, Boris

    2016-12-01

    In this study, we explored the processing of singular and plural word forms, using megastudies in French, English, and Dutch. For singulars, we observed a base frequency effect but no surface frequency effect. For plurals, the effect depended on the frequency of the word form. When the word form had a frequency above a threshold value, we observed both surface and base frequency effects; for the frequencies below the threshold, we found a base frequency effect only, suggesting full decomposition for these words. The threshold differed between the languages, suggesting that more plurals are decomposed in French than in Dutch and more in Dutch than in English. In contrast, for all languages the singular form seems to be coactivated whenever the plural form is processed. These results are interpreted in light of some of the main models of morphological processing. (PsycINFO Database Record

  1. Anatomist on the dissecting table? Dutch anatomical professionals' views on body donation.

    PubMed

    Bolt, Sophie; Venbrux, Eric; Eisinga, Rob; Gerrits, Peter O

    2012-03-01

    Anatomical professionals know better than anyone else that donated bodies are a valuable asset to anatomical science and medical education. They highly value voluntary donations, since a dearth of bodies negatively affects their profession. With this in mind, we conducted a survey (n = 54) at the 171st scientific meeting of the Dutch Anatomical Society in 2009 to see to what extent anatomical professionals are willing to donate their own body. The results reveal that none of the survey participants are registered as a whole body donor and that only a quarter of them would consider the possibility of body donation. We argue that the two main constraints preventing Dutch anatomical professionals from donating their own body are their professional and their social environments. In contrast to the absence of registered body donors, half of the anatomical professionals are registered as an organ donor. This figure far exceeds the proportion of registered organ donors among the general Dutch population.

  2. 47 CFR 36.603 - Calculation of incumbent local exchange carrier portion of nationwide loop cost expense...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... incumbent local exchange carrier portion of nationwide loop cost expense adjustment for rate-of-return...-of-return local exchange carriers shall not include rate-of-return carriers affiliated with price cap... 47 Telecommunication 2 2012-10-01 2012-10-01 false Calculation of incumbent local exchange...

  3. 18 CFR Appendix C to Part 2 - Nationwide Proceeding Computation of Federal Income Tax Allowance Independent Producers, Pipeline...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 18 Conservation of Power and Water Resources 1 2011-04-01 2011-04-01 false Nationwide Proceeding... Continental U.S.-1972 Data (Docket No. R-478) C Appendix C to Part 2 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY GENERAL RULES GENERAL POLICY...

  4. The Ripple Effect of Virginia Tech: Assessing the Nationwide Impact on Campus Safety and Security Policy and Practice

    ERIC Educational Resources Information Center

    Rasmussen, Chris; Johnson, Gina

    2008-01-01

    This report is the result of a nationwide survey conducted in March 2008 of student life officers and campus safety directors to assess the impact of the April 2007 shootings at Virginia Tech on campus safety and security policy and practice. Discussion areas include: (1) Student Privacy vs. Need-to-Know; (2) Prevention, Mitigation and Recovery;…

  5. 47 CFR 36.603 - Calculation of incumbent local exchange carrier portion of nationwide loop cost expense...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... the immediately preceding calendar year, multiplied times one plus the Rural Growth Factor calculated... calendar year thereafter, the total annual amount of the incumbent local exchange carrier portion of the nationwide loop cost expense adjustment shall not exceed the amount for the immediately preceding...

  6. 76 FR 18537 - Notice-Nationwide Categorical Waivers Under Section 1605 (Buy American) of the American Recovery...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-04

    ... Department of the Air Force Notice--Nationwide Categorical Waivers Under Section 1605 (Buy American) of the..., DOD, Air Force. SUMMARY: The U.S. Department of Air Force, 772d ESS/PK, Senior Center Contracting... Head Flood Light w/270 Degree Motion Sensor & Brushed Nickel Finish; Ground Fault Circuit...

  7. 18 CFR Appendix C to Part 2 - Nationwide Proceeding Computation of Federal Income Tax Allowance Independent Producers, Pipeline...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 18 Conservation of Power and Water Resources 1 2013-04-01 2013-04-01 false Nationwide Proceeding Computation of Federal Income Tax Allowance Independent Producers, Pipeline Affiliates and Pipeline Producers... Total computed revenue 9,465,231,966 8,985,807,669 2,336,439,376 16(gross income) 17 18...

  8. 18 CFR Appendix C to Part 2 - Nationwide Proceeding Computation of Federal Income Tax Allowance Independent Producers, Pipeline...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 18 Conservation of Power and Water Resources 1 2012-04-01 2012-04-01 false Nationwide Proceeding Computation of Federal Income Tax Allowance Independent Producers, Pipeline Affiliates and Pipeline Producers... Total computed revenue 9,465,231,966 8,985,807,669 2,336,439,376 16(gross income) 17 18...

  9. 18 CFR Appendix C to Part 2 - Nationwide Proceeding Computation of Federal Income Tax Allowance Independent Producers, Pipeline...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Nationwide Proceeding Computation of Federal Income Tax Allowance Independent Producers, Pipeline Affiliates and Pipeline Producers... Total computed revenue 9,465,231,966 8,985,807,669 2,336,439,376 16(gross income) 17 18...

  10. A Research Report of Small/Rural School Districts in Texas Compared to School Districts of Similar Size Nationwide.

    ERIC Educational Resources Information Center

    Barker, Bruce O.; Muse, Ivan D.

    The study compared nationwide research findings about the districts, superintendents, teachers, programs, and student performance in 642 public school districts with an enrollment of 900 or less to data from a random sample of school districts of similar size in Texas. Data were gathered from superintendents by questionnaire during the 1982-83…

  11. A Recap of the Fourth Nationwide Vocational Education Dissemination Conference. The Proceedings (Columbus, Ohio, November 17-19, 1981).

    ERIC Educational Resources Information Center

    Singer, Norman M., Comp.; Grieve, Shelley, Comp.

    These proceedings summarize the Fourth Nationwide Vocational Education Dissemination Conference that concentrated on the knowledge, tools, techniques, and topical areas needed by disseminators, linkers, and other change agents. Introductory materials are a conference overview, reflections on the conference, and the agenda. Brief summaries follow…

  12. THE OCCURRENCE OF DISINFECTION BY-PRODUCTS OF HEALTH CONCERN IN DRINKING WATER: RESULTS OF A NATIONWIDE DBP OCCURRENCE STUDY

    EPA Science Inventory

    The motivation for this Nationwide Disinfection By-product (DBP) Occurrence Study was two-fold: First, more than 500 DBPs have been reported in the literature, yet there is almost no quantitative occurrence information for most. As a result, there is significant uncertainty ove...

  13. 77 FR 28857 - Development of the State and Local Implementation Grant Program for the Nationwide Public Safety...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-16

    ... Local Implementation Grant Program for the Nationwide Public Safety Broadband Network AGENCY: National... enumerates several areas for consultation, including: (i) Construction of a core network and any radio access network build-out; (ii) placement of towers; (iii) coverage areas of the network, whether at the...

  14. Unplanned Excision of Extremity Soft Tissue Sarcoma in Korea: A Nationwide Study Based on a Claims Registry.

    PubMed

    Kang, Seungcheol; Kim, Han-Soo; Han, Ilkyu

    2015-01-01

    Unplanned excision of extremity soft tissue sarcoma (STS) is common and has detrimental effects not only on patients' oncologic outcomes but also on functional and economic issues. However, no study has analyzed a nationwide population-based database. To estimate the incidence and treatment pattern of unplanned excision in extremity STS in the Korean population, a nationwide epidemiologic study was performed using the Korean Health Insurance Review and Assessment Service database, a centralized nationwide healthcare claims registry of Korea that covers the entire Korean population. Among 1,517 patients with extremity STS in the 4-year study period, 553 (36.5%) underwent unplanned excision (unplanned group). About 80% of unplanned excisions were performed in tertiary or general hospitals. Of the unplanned group, 240 (43.4%) underwent re-excision with or without radiation therapy and/or chemotherapy, and 51 (9.2%) did not undergo re-excision but were treated with radiation therapy and/or chemotherapy; whereas, 262 (47.4%) did not undergo any further treatment following unplanned excision. This study is the first nationwide population-based study on the unplanned excision of extremity STS. The results may have implications in establishing preventive or therapeutic measures to reduce the burden of unplanned excision of extremity STS.

  15. 47 CFR 90.717 - Channels available for nationwide systems in the 220-222 MHz band.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ..., commercial Phase I systems. (c) Channels 111-115 and 116-120 are 5-channel blocks available for Government... 47 Telecommunication 5 2010-10-01 2010-10-01 false Channels available for nationwide systems in... (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES PRIVATE LAND MOBILE RADIO SERVICES Regulations...

  16. Epilepsy in Individuals with a History of Asperger's Syndrome: A Danish Nationwide Register-Based Cohort Study

    ERIC Educational Resources Information Center

    Mouridsen, Svend Erik; Rich, Bente; Isager, Torben

    2013-01-01

    We performed a nationwide, register-based retrospective follow-up study of epilepsy in all people who were born between January 1, 1980 and June 29, 2006 and registered in the Danish Psychiatric Central Register with Asperger's syndrome on February 7, 2011. All 4,180 identified cases with AS (3,431 males and 749 females) were screened through the…

  17. When Schools Compete, How Do They Compete? An Assessment of Chile's Nationwide School Voucher Program. Occasional Paper.

    ERIC Educational Resources Information Center

    Hsieh, Chang-Tai; Urquiola, Miguel

    In 1981, Chile introduced nationwide school choice by providing vouchers to any student wishing to attend private school. As a result, more than 1,000 private schools entered the market, and the private enrollment rate increased by 20 percentage points, with greater impacts in larger, more urban, and wealthier communities. Using differences across…

  18. Unplanned Excision of Extremity Soft Tissue Sarcoma in Korea: A Nationwide Study Based on a Claims Registry

    PubMed Central

    Kang, Seungcheol; Kim, Han-Soo; Han, Ilkyu

    2015-01-01

    Unplanned excision of extremity soft tissue sarcoma (STS) is common and has detrimental effects not only on patients’ oncologic outcomes but also on functional and economic issues. However, no study has analyzed a nationwide population-based database. To estimate the incidence and treatment pattern of unplanned excision in extremity STS in the Korean population, a nationwide epidemiologic study was performed using the Korean Health Insurance Review and Assessment Service database, a centralized nationwide healthcare claims registry of Korea that covers the entire Korean population. Among 1,517 patients with extremity STS in the 4-year study period, 553 (36.5%) underwent unplanned excision (unplanned group). About 80% of unplanned excisions were performed in tertiary or general hospitals. Of the unplanned group, 240 (43.4%) underwent re-excision with or without radiation therapy and/or chemotherapy, and 51 (9.2%) did not undergo re-excision but were treated with radiation therapy and/or chemotherapy; whereas, 262 (47.4%) did not undergo any further treatment following unplanned excision. This study is the first nationwide population-based study on the unplanned excision of extremity STS. The results may have implications in establishing preventive or therapeutic measures to reduce the burden of unplanned excision of extremity STS. PMID:26237049

  19. 18 CFR Appendix C to Part 2 - Nationwide Proceeding Computation of Federal Income Tax Allowance Independent Producers, Pipeline...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... Continental U.S.-1972 Data (Docket No. R-478) C Appendix C to Part 2 Conservation of Power and Water Resources... INTERPRETATIONS Pt. 2, App. C Appendix C to Part 2—Nationwide Proceeding Computation of Federal Income Tax...) times col. (4), plus cols. (3) and (5). 7 See composites mailed to all parties on Feb. 13, 1974....

  20. 78 FR 58272 - Notice of Intent To Review Online Homeownership Education Courses for Nationwide Use in the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-23

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF AGRICULTURE Rural Housing Service Notice of Intent To Review Online Homeownership Education Courses for Nationwide... online counseling. It also outlines the requirements an education provider and their course must meet...

  1. 78 FR 74104 - Notice of Intent To Review Online Homeownership Education Courses for Nationwide Use in the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-10

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF AGRICULTURE Rural Housing Service Notice of Intent To Review Online Homeownership Education Courses for Nationwide... Direct Program published a Notice in the Federal Register, ''Notice of Intent To Review...

  2. Sequence Analysis of the Mitochondrial Genomes from Dutch Pedigrees with Leber Hereditary Optic Neuropathy

    PubMed Central

    Howell, Neil; Oostra, Roelof-Jan; Bolhuis, Piet A.; Spruijt, Liesbeth; Clarke, Lorne A.; Mackey, David A.; Preston, Gwen; Herrnstadt, Corinna

    2003-01-01

    The complete mitochondrial DNA (mtDNA) sequences for 63 Dutch pedigrees with Leber hereditary optic neuropathy (LHON) were determined, 56 of which carried one of the classic LHON mutations at nucleotide (nt) 3460, 11778, or 14484. Analysis of these sequences indicated that there were several instances in which the mtDNAs were either identical or related by descent. The most striking example was a haplogroup J mtDNA that carried the 14484 LHON mutation. Four different but related mitochondrial genotypes were identified in seven of the Dutch pedigrees with LHON, including six of those described by van Senus. The control region of the founder sequence for these Dutch pedigrees with LHON matches the control-region sequence that Macmillan and colleagues identified in the founder mtDNA of French Canadian pedigrees with LHON. In addition, we obtained a perfect match between the Dutch 14484 founder sequence and the complete mtDNA sequences of two Canadian pedigrees with LHON. Those results indicate that these Dutch and French Canadian 14484 pedigrees with LHON share a common ancestor, that the single origin of the 14484 mutation in this megalineage occurred before the year 1600, and that there is a 14484/haplogroup J founder effect. We estimate that this lineage—including the 14484 LHON mutation—arose 900–1,800 years ago. Overall, the phylogenetic analyses of these mtDNA sequences conservatively indicate that a LHON mutation has arisen at least 42 times in the Dutch population. Finally, analysis of the mtDNA sequences from those pedigrees that did not carry classic LHON mutations suggested candidate pathogenic mutations at nts 9804, 13051, and 14325. PMID:12736867

  3. Organizational challenges in developing one of the Nationwide Health Information Network trial implementation awardees.

    PubMed

    Dobalian, Aram; Claver, Maria L; Pevnick, Joshua M; Stutman, Harris R; Tomines, Alan; Fu, Paul

    2012-04-01

    Health care in the United States is rarely delivered in a coordinated manner. Current methods to share patient information are inefficient and may lead to medical errors, higher readmission rates, and delays in the delivery of needed health services. This qualitative study describes lessons learned concerning the early implementation of one Nationwide Health Information Network (NHIN) site in Long Beach, CA during its first year of operation. The Long Beach Network for Health (LBNH) focused on an incremental effort to exchange health information. Despite a limited concentration on emergency department care, virtually all respondents noted concerns regarding the sustainability, or business case, for the exchange of health information. Nevertheless, respondents were encouraged by progress on technological challenges and user requirements during this first year. The early gains in this process may, in turn, have laid the groundwork for future efforts to expand beyond the emergency department.

  4. Developing data content specifications for the Nationwide Health Information Network Trial Implementations

    PubMed Central

    Blair, Jeffrey S; Franck, Richard A; Devaraj, Savithri; Low, Alexander F H

    2010-01-01

    In 2007, the Department of Health and Human Services commissioned the Nationwide Health Information Network (NHIN) Trial Implementations project to demonstrate the secure exchange of data among health information exchange organizations around the country. The project's Core Services Content Work Group (CSCWG) developed the content specifications for the project. The CSCWG developed content specifications for a summary patient record and for eight use cases that were implemented in demonstration events in 2008. The CSCWG developed tools to represent the specifications and facilitate implementation. The experience revealed that, in general, the Health Information Technology Standards Panel (HITSP) constructs served as a suitable starting point for the development of content specifications for interoperability. The ability to adhere to specified terminologies still presents significant challenges. This paper describes the process of developing the content specifications and lessons learned. PMID:20064795

  5. Differences in nationwide cohorts of acupuncture users identified using structured and free text medical records.

    PubMed

    Redd, Doug; Kuang, Jinqiu; Zeng-Treitler, Qing

    2014-01-01

    Integrative medicine including complementary and alternative medicine (CAM) has become more available through mainstream health providers. Acupuncture is one of the most widely used CAM therapies, though its efficacy for treating various conditions requires further investigation. To assist with such investigations, we set out to identify acupuncture patient cohorts using a nationwide clinical data repository. Acupuncture patients were identified using both structured data and unstructured free text notes: 44,960 acupuncture patients were identified using structured data consisting of CPT codes;. Using unstructured free text clinical notes, we trained a support vector classifier with 86% accuracy and was able to identify an additional 101,628 acupuncture patients not identified through structured data (a 226% increase). In addition, characteristics of the patients identified through structured and unstructured data were compared, which show differences in geographic locations and medical service usage patterns. Patients identified with structured data displayed a consistently higher use of the Veterans Health Administration (VHA) medical system.

  6. Rural Health Clinic efficiency and effectiveness: insight from a nationwide survey.

    PubMed

    Ortiz, Judith; Meemon, Natthani; Tang, Chiung-Ya; Wan, Thomas T H; Paek, Seung Chun

    2011-08-01

    This study reports the results of a nationwide survey of Rural Health Clinics (RHCs). The purpose was to identify factors that contribute to efficiency and effectiveness in RHCs. Factors related to cost efficiency were analyzed using multiple regression; factors related to the likelihood of providing preventive diabetic care, an effectiveness indicator, were analyzed using logistic regression. The study found: (1) technical efficiency to be positively related to cost efficiency; (2) non-profit control to be inversely related to cost efficiency in independent RHCs; and (3) provider-based RHCs and technology use to be related to the likelihood of providing preventive diabetic care. Implications for RHCs are: (1) improvement in technical efficiency could enhance cost efficiency; (2) visits to PAs and NPs, an indicator of process efficiency, may not guarantee the provision of preventive diabetic care; and (3) strategies for improving RHC efficiency and effectiveness may be different for provider-based and independent clinics.

  7. The Crisis Map of the Czech Republic: the nationwide deployment of an Ushahidi application for disasters.

    PubMed

    Pánek, Jiří; Marek, Lukáš; Pászto, Vít; Valůch, Jaroslav

    2017-01-06

    Crisis mapping is a legitimate component of both crisis informatics and disaster risk management. It has become an effective tool for humanitarian workers, especially after the earthquake in Haiti in 2010. Ushahidi is among the many mapping platforms on offer in the growing field of crisis mapping, and involves the application of crowdsourcing to create online and interactive maps of areas in turmoil. This paper presents the Crisis Map of the Czech Republic, which is the first such instrument to be deployed nationwide in Central Europe. It describes the methodologies used in the preparatory work phase and details some practices identified during the creation and actual employment of the map. In addition, the paper assesses its structure and technological architecture, as well as its potential possible development in the future. Lastly, it evaluates the utilisation of the Crisis Map during the floods in the Czech Republic in 2013.

  8. American preferences for "smart" guns versus traditional weapons: Results from a nationwide survey.

    PubMed

    Wallace, Lacey Nicole

    2016-12-01

    This study examines Americans' preferences regarding smart guns. The study builds on prior research by including previously unexamined factors, specifically victimization and comfort sharing gun ownership status with a doctor. Further, this study examines differences in preference patterns among gun owners and non-owners. Data were obtained from a nationwide online survey with 524 respondents in February 2016. The study finds that, among non-owners, older respondents and those with pro-gun attitudes are less likely to prefer smart guns to traditional firearms. Among gun owners, those with moderate political views, those with a history of victimization, and those residing in the Northeast are all more likely to prefer smart guns. Males and those with pro-gun attitudes are less likely to prefer smart guns. Education, income, race, marital status, presence of children in the home, and comfort discussing gun ownership with a doctor had no significant association with smart gun preference. Practical implications of these findings are discussed.

  9. Adoption of a Nationwide Shared Medical Record in France: Lessons Learnt after 5 Years of Deployment

    PubMed Central

    Séroussi, Brigitte; Bouaud, Jacques

    2016-01-01

    Information sharing among health practitioners, either for coordinated or unscheduled care, is necessary to guarantee care quality and patient safety. In most countries, nationwide programs have provided tools to support information sharing, from centralized care records to health information exchange between electronic health records (EHRs). The French personal medical record (DMP) is a centralized patient-controlled record, created according to the opt-in consent model. It contains the documents health practitioners voluntarily push into the DMP from their EHRs. Five years after the launching of the program in December 2010, there were nearly 570,000 DMPs covering only 1.5% of the target population in December 2015. Reasons for this poor level of adoption are discussed in the perspective of other countries’ initiatives. The new French governmental strategy for the DMP deployment in 2016 is outlined, with the implementation of measures similar to the US Meaningful Use. PMID:28269907

  10. Strategies from a nationwide health information technology implementation: the VA CART story.

    PubMed

    Box, Tamára L; McDonell, Mary; Helfrich, Christian D; Jesse, Robert L; Fihn, Stephan D; Rumsfeld, John S

    2010-01-01

    The VA Cardiovascular Assessment, Reporting, and Tracking (CART) system is a customized electronic medical record system which provides standardized report generation for cardiac catheterization procedures, serves as a national data repository, and is the centerpiece of a national quality improvement program. Like many health information technology projects, CART implementation did not proceed without some barriers and resistance. We describe the nationwide implementation of CART at the 77 VA hospitals which perform cardiac catheterizations in three phases: (1) strategic collaborations; (2) installation; and (3) adoption. Throughout implementation, success required a careful balance of technical, clinical, and organizational factors. We offer strategies developed through CART implementation which are broadly applicable to technology projects aimed at improving the quality, reliability, and efficiency of health care.

  11. The role of ERTS in the establishment and of a nationwide land cover information system

    NASA Technical Reports Server (NTRS)

    Abram, P.; Tullos, J.

    1974-01-01

    The economic potential of utilizing an ERTS type satellite in the development, updating, and maintenance of a nation-wide land cover information system in the post-1977 time frame was examined. Several alternative acquisition systems were evaluated for land cover data acquisition, processing, and interpretation costs in order to determine, on a total life cycle cost basis, under which conditions of user demand (i.e., area of coverage, frequency of coverage, timeliness of information, and level of information detail) an ERTS type satellite would be cost effective, and what the annual cost savings benefits would be. It was concluded that a three satellite system with high and low altitude aircraft and ground survey team utilizing automatic interpretation and classification techniques is an economically sound proposal.

  12. Collecting Family Health History using an Online Social Network: a Nationwide Survey among Potential Users

    PubMed Central

    Welch, Brandon M.; O’Connell, Nathaniel S.; Qanungo, Suparna; Halbert-Hughes, Chanita; Schiffman, Joshua D.

    2015-01-01

    Family health history (FHx) is one of the most important risk factors for disease. Unfortunately, collection and use of FHx is under-utilized in the clinical setting. Efforts to improve collection of FHx have had minimal impact. A novel approach to collect FHx using social networking capabilities is being explored. We conducted a nationwide survey of 5,258 respondents to 1- assess the interest in using an online social network for FHx, 2- identify if such a tool would have clinical utility, and 3- identify notable trends and potential concerns. We found survey respondents to be very supportive of the proposed approach and interesting trends related to age, education, and race were identified. Results from this survey will be used to guide future research and development of a proposed FHx social network application. PMID:26958272

  13. Acculturation-related predictors of very light smoking among Latinos in California and nationwide

    PubMed Central

    Rodriquez, Erik J.; Stoecklin-Marois, Maria T.; Hennessy-Burt, Tamara E.; Tancredi, Daniel J.; Schenker, Marc B.

    2013-01-01

    Background The prevalence of light smoking has increased among Latinos. The purpose of this study was to identify demographic and acculturation-related factors associated with very light smoking, defined as smoking 1-5 cigarettes per day (CPD), among Latinos in California and nationwide. Methods Latino smokers in the 2007-2008 National Health and Nutrition Examination Survey (NHANES) or the 2009 California Health Interview Survey (CHIS) were analyzed. Logistic regression assessed factors associated with very light smoking. Results Among NHANES smokers, those born in Mexico or who lived fewer years in the U.S. were more likely to be very light smokers than 6+ CPD smokers. Among CHIS smokers, those born in Mexico, in another Spanish speaking country, or who spent smaller percentages of their life in the U.S. were more likely to be very light smokers. Discussion Findings from this study can be used to design tobacco control media campaigns that include very light smokers. PMID:23942990

  14. An updated nation-wide epidemiological survey of feline immunodeficiency virus (FIV) infection in Japan.

    PubMed

    Nakamura, Yuki; Nakamura, Yuichi; Ura, Asami; Hirata, Momoko; Sakuma, Masato; Sakata, Yoshimi; Nishigaki, Kazuo; Tsujimoto, Hajime; Setoguchi, Asuka; Endo, Yasuyuki

    2010-08-01

    An updated nation-wide epidemiological survey of feline immunodeficiency virus (FIV) infection was conducted in Japan. Blood samples were collected from 1,770 outdoor accessing cats from March to October 2008. Serologically, 410 cats (23.2%) were positive for anti-FIV antibody. Proviral DNA of the FIV env V3-V5 region isolated from 348 cases could be phylogenetically analyzed. The present study disclosed a geographic distribution of four subtypes (A, B, C and D) of FIV in Japan. Even though an FIV vaccine was introduced in Japan, we do not currently know whether this vaccine is effective against all strains of FIV in Japan or not. Therefore, close attention still has to be paid to epidemic and genotypic trends of FIV.

  15. The Next Generation of NASA Night Sky Network: A Searchable Nationwide Database of Astronomy Events

    NASA Astrophysics Data System (ADS)

    Ames, Z.; Berendsen, M.; White, V.

    2010-08-01

    With support from NASA, the Astronomical Society of the Pacific (ASP) first developed the Night Sky Network (NSN) in 2004. The NSN was created in response to research conducted by the Institute for Learning Innovation (ILI) to determine what type of support amateur astronomers could use to increase the efficiency and extent of their educational outreach programs. Since its creation, the NSN has grown to include an online searchable database of toolkit resources, Presentation Skills Videos covering topics such as working with kids and how to answer difficult questions, and a searchable nationwide calendar of astronomy events that supports club organization. The features of the NSN have allowed the ASP to create a template that amateur science organizations might use to create a similar support network for their members and the public.

  16. The Nationwide Speech Project: A new corpus of American English dialects☆

    PubMed Central

    Clopper, Cynthia G.; Pisoni, David B.

    2011-01-01

    Perceptual and acoustic research on dialect variation in the United States requires an appropriate corpus of spoken language materials. Existing speech corpora that include dialect variation are limited by poor recording quality, small numbers of talkers, and/or small samples of speech from each talker. The Nationwide Speech Project corpus was designed to contain a large amount of speech produced by male and female talkers representing the primary regional varieties of American English. Five male and five female talkers from each of six dialect regions in the United States were recorded reading words, sentences, passages, and in interviews with an experimenter, using high quality digital recording equipment in a sound-attenuated booth. The resulting corpus contains nearly an hour of speech from each of the 60 talkers that can be used in future research on the perception and production of dialect variation. PMID:21423815

  17. Budget cuts and U.S. Poison Centers - regional challenges create a nationwide problem.

    PubMed

    Giffin, S; Heard, S E

    2009-09-01

    Federal funding of poison centers (PCs) in the United States was established in 2000 through the Poison Control Center Enhancement and Awareness Act. Unfortunately, the problems with financial stability of PCs that this legislation was intended to improve persist because of continued reliance on fragile local funding sources. In the past few months budget cuts have had an impact on PC activity and threaten the continued existence of a nationwide network of PCs in the United States. This commentary discusses the problems faced by PCs in this changing environment and illustrates the many competing tasks that the PC network performs for the U.S. population. PCs face continuing challenges in coming months and a unified approach at a national level may provide the best opportunity for a solution to this crisis.

  18. Training workshops positively impact beliefs about contingency management in a nationwide dissemination effort.

    PubMed

    Rash, Carla J; Dephilippis, Dominick; McKay, James R; Drapkin, Michelle; Petry, Nancy M

    2013-09-01

    In 2011, the Veterans Administration called for nationwide implementation of contingency management (CM) in its intensive outpatient substance use disorders treatment programs, and this study evaluated the impact of the initial 1 and ½ day training workshops on knowledge and perceptions about CM among 159 clinical leaders from 113 clinics. Workshop attendance significantly increased CM-related knowledge (d=1.88) and changed attendees' perceptions of CM (ds=0.26-0.74). Endorsement of barriers to CM adoption decreased and positive impressions of CM increased. These perceptions about CM emerged as key correlates of post-training preparedness to implement CM. Results suggest that training workshops can be an effective avenue for increasing CM-related knowledge, as well as addressing persistent misperceptions about CM that may impede adoption efforts. Continued efforts to introduce educational materials and offer training and consultation opportunities may increase understanding about this evidence-based intervention among clinicians, thereby leading to improved patient outcomes.

  19. The psychiatrist as administrator: the career of W.F. Theunissen in the Dutch East Indies.

    PubMed

    Pols, Hans

    2012-01-01

    W. F. Theunissen (1882-1961) was a leading psychiatrist in the Dutch East Indies. He was the medical director of several large mental hospitals after which he became director of the Dutch East Indies Public Health Service. Theunissen was not known for his research into the causes of mental illness. Instead, he made his mark as an administrator greatly reducing the expenses of the Lawang mental hospital by expanding occupational therapy in new and innovative ways. His accomplishments earned him the position of director of the Indies Public Health Department, where he oversaw the decentralisation of health services and the development of public health initiatives.

  20. Eutrophication, water management, and the functioning of dutch estuaries and coastal lagoons

    SciTech Connect

    Nienhuis, P.H. )

    1992-12-01

    A number of European rivers (especially the Rhine) have a prevailing influence on the nutrient cycling of most Dutch estuaries. Owing to the increased loading of the estuaries with nitrogen and phosphorous compounds, effects of eutrophication on the biological communities are most evident in the tidal Western Wadden Sea and in a nontidal brackish lagoon, Veerse Meer. Whether the relation between changed nutrient loadings and changed biomass and production of primary and secondary producers in the turbid tidal Dutch ecosystems should be considered as a causal relation is questionable. The very widespread practice of lagoon modification confuses the effects of nutrient loading. 29 refs., 7 figs., 2 tabs.

  1. Native dialect matters: perceptual assimilation of Dutch vowels by Czech listeners.

    PubMed

    Chládková, Kateřina; Podlipský, Václav Jonáš

    2011-10-01

    Naive listeners' perceptual assimilations of non-native vowels to first-language (L1) categories can predict difficulties in the acquisition of second-language vowel systems. This study demonstrates that listeners having two slightly different dialects as their L1s can differ in the perception of foreign vowels. Specifically, the study shows that Bohemian Czech and Moravian Czech listeners assimilate Dutch high front vowels differently to L1 categories. Consequently, the listeners are predicted to follow different paths in acquiring these Dutch vowels. These findings underscore the importance of carefully considering the specific dialect background of participants in foreign- and second-language speech perception studies.

  2. Identifying Chinese herbal medicine for premenstrual syndrome: implications from a nationwide database

    PubMed Central

    2014-01-01

    Background Premenstrual syndrome (PMS) occurs in women during their reproductive age with a quite negative impact on their daily lives. Women with PMS experience a wide range of physical or psychological symptoms and seek treatment for them. Chinese herb medicine (CHM) is commonly used for PMS and the goal of this study is to investigate the prescription patterns of CHM for PMS by using a nationwide database. Methods Prescriptions of CHM were obtained from two million beneficiaries randomly sampled from the National Health Insurance Research Database, a nationwide database in Taiwan. The ICD-9 code 625.4 was used to identify patients with PMS. Association rule mining and social network analysis were used to explore both the combinations and the core treatments for PMS. Results During 1998-2011, a total of 14,312 CHM prescriptions for PMS were provided. Jia-Wei-Xiao-Yao-San (JWXYS) was the CHM which had the highest prevalence (37.5% of all prescriptions) and also the core of prescription network for PMS. For combination of two CHM, JWXYS with Cyperus rotundus L. was prescribed most frequently, 7.7% of all prescriptions, followed by JWXYS with Leonurus heterophyllus Sweet, 5.9%, and Cyperus rotundus L. with Leonurus heterophyllus Sweet, 5.6%. Conclusions JWXYS-centered CHM combinations were most commonly prescribed for PMS. To the best of our knowledge, this is the first pharmaco-epidemiological study to review CHM treatments for PMS. However, the efficacy and safety of these commonly used CHM were still lacking. The results of this study provide valuable references for further clinical trials and bench studies. PMID:24969368

  3. A nationwide survey of NDMA in raw and drinking water in Japan.

    PubMed

    Asami, Mari; Oya, Masami; Kosaka, Koji

    2009-05-15

    A nationwide survey of N-nitrosodimethylamine (NDMA) in both raw and finished water samples from drinking water treatment plants (DWTPs) in Japan was conducted. NDMA was analyzed by solid-phase extraction (SPE) followed by ultra performance liquid chromatography (UPLC) coupled with tandem mass spectrometry (MS/MS). NDMA was detected in 15 of 31 raw water samples collected in the summer at concentrations up to 2.6 ng/L, and in 9 of 28 raw water samples collected in winter at concentrations up to 4.3 ng/L. The NDMA concentrations were higher in raw water samples collected from treatment plants with catchment areas that have high population densities. The NDMA concentrations were higher in river water samples collected from the east and west of Japan than in those collected from other areas. NDMA was detected in 10 of 31 finished samples collected in summer at reduced concentrations of up to 2.2 ng/L, while 5 of 28 finished samples collected in winter showed NDMA concentrations up to 10 ng/L. The highest NDMA levels were detected in finished water samples collected from the Yodo River basin DWTP, which uses ozonation. Furthermore, evaluation of the process water produced at six advanced water treatment plants was conducted. Influent from the Yodo River indicated that the NDMA concentration increased during ozonation to as high as 20 ng/L, and then decreased with subsequent biological activated carbon treatment. To our knowledge, this is the first nationwide evaluation of NDMA concentrations in water conducted in Japan to date.

  4. Korean Gastric Cancer Association Nationwide Survey on Gastric Cancer in 2014

    PubMed Central

    2016-01-01

    Purpose The Korean Gastric Cancer Association (KGCA) has conducted nationwide surveys every 5 years, targeting patients who received surgical treatment for gastric cancer. We report the results of the 2014 nationwide survey and compare them to those of the 1995, 1999, 2004, and 2009 surveys. Materials and Methods From March 2015 to January 2016, a standardized case report form was sent to every member of the KGCA via e-mail. The survey consisted of 29 questions, regarding patient demographics as well as tumor-, and surgery-related factors. The completed data forms were analyzed by the KGCA information committee. Results Data on 15,613 patients were collected from 69 institutions. The mean age was 60.9±12.1 years, and the proportion of patients more than 70 years of age increased from 9.1% in 1995 to 25.3% in 2014. Proximal cancer incidence steadily increased from 11.2% in 1995 to 16.0% in 2014. Early gastric cancer incidence consistently increased and accounted for 61.0% of all cases in 2014. The surgical approach was diversified in 2014, and 7,818 cases (50.1%) were treated with a minimally invasive approach. The most common anastomosis was Billroth I (50.2%) after distal gastrectomy, and the proportion of Roux-en-Y anastomoses performed increased to 8.6%. Conclusions The results of this survey are expected to be important data for future studies and to be useful for generating a national cancer control program. PMID:27752390

  5. Sense and Sensibility: The Case for the Nationwide Inclusion of Engineering in the K-12 Curriculum

    NASA Technical Reports Server (NTRS)

    Lindberg, Robert E.; Pinelli, Thomas E.; Batterson, James G.

    2008-01-01

    The competitive status of the United States is inextricably linked to innovation just as innovation is inseparable from science, technology, engineering, and mathematics. To stay competitive in innovation requires that the United States produce a 21st century workforce complete with requisite education, training, skills, and motivation. If we accept a priori that science, technology, engineering, and mathematics education are crucial to competitiveness and innovation and that, in terms of innovation, mathematics, science, and engineering are interdependent, why are mathematics and science uniformly ubiquitous in the K-12 curriculum while engineering is conspicuously absent? We are passionate in our belief that the uniform addition of engineering to the K-12 curriculum will help ensure that the nation has "the right" 21st Century workforce. Furthermore, we believe that a nationwide effort, led by a coalition of engineering academics, practitioners, and societies is required to turn this goal into reality. However, accomplishing this goal necessitates, as we are reminded by the title of Jane Austen's timeless novel, "Sense and Sensibility", a workable solution that seeks the "middle ground" between passion and reason. We begin our paper by making two essential points: Engineers are not scientists. Engineering exists separate from science, has its own specialized knowledge community apart from science, and it is largely responsible for many of the most significant advancements and improvements in the quality of our life. Our workable solution requires that K-12 education, nationwide, accommodate the inclusion of engineering as a stand alone curriculum and we offer three reasons to support our position: (1) workforce development, (2) stimulating interest in STEM (science, technology, engineering, and mathematics) courses and careers, and (3) creating a technologically literate society. We conclude with some thoughts on how this important goal can be accomplished.

  6. Risk Factors for Fatal Hyperglycaemia Confirmed by Forensic Postmortem Examination - A Nationwide Cohort in Sweden

    PubMed Central

    Walz, Lotta; Jönsson, Anna K.; Zilg, Brita; Östgren, Carl Johan; Druid, Henrik

    2016-01-01

    Aims/Hypothesis The aim of this study was to identify risk factors associated with confirmed fatal hyperglycaemia, which could predispose potentially preventable deaths in individuals on glucose lowering drugs. Methods A retrospective register-based case-control study conducted on a nationwide cohort with individuals who died due to hyperglycaemia as determined by forensic postmortem examination, in Sweden August 2006 to December 2012. Vitreous glucose was used to diagnose hyperglycaemia postmortem. The forensic findings stored in the National Forensic Medicine Database were linked to nationwide registers. Cases that died due to confirmed hyperglycemia with dispensed glucose lowering drugs were identified and living controls with dispensed glucose lowering drugs were randomly selected in the Swedish prescribed drug register and matched on age and sex. Information on comorbidities, dispensed pharmaceuticals, clinical data and socioeconomic factors were obtained for cases and controls. Adjusted multiple logistic regression models were used to identify risk factors associated with fatal hyperglycaemia. Results During the study period 322 individuals, mostly males (79%) with the mean age of 53.9 years (SD.± 14) died due to confirmed hyperglycaemia. Risk factors for fatal hyperglycaemia included; insulin treatment (OR = 4.40; 95%CI,1.96, 9.85), poor glycaemic control (OR = 2.00 95%CI,1.23, 3.27), inadequate refill-adherence before death (OR = 3.87; 95%CI,1.99, 7.53), microvascular disease (OR = 3.26; 95% CI, 1.84, 5.79), psychiatric illness (OR = 2.30; 95% CI,1.32, 4.01), substance abuse (OR = 8.85; 95%CI,2.34, 35.0) and/or living alone (OR = 2.25; 95%CI,1.21, 4.18). Conclusions/Interpretation Our results demonstrate the importance of clinical attention to poor glycaemic control in subjects with psychosocial problems since it may indicate serious non-adherence, which consequently could lead to fatal hyperglycaemia. PMID:27768720

  7. Educational achievements of children of parents with multiple sclerosis: A nationwide register-based cohort study.

    PubMed

    Moberg, J Y; Magyari, M; Koch-Henriksen, N; Thygesen, L C; Laursen, B; Soelberg Sørensen, P

    2016-11-01

    Little is known about the impact of parental multiple sclerosis (MS) on offspring's educational attainment. The objective of the study was to examine educational achievements in offspring of parents with MS compared with matched children of parents without MS in a nationwide register-based cohort study. Children of all Danish-born residents with onset between 1950 and 1986 were identified by linking the Danish Multiple Sclerosis Registry with the Civil Registration System. Twins, children with MS, and emigrated persons were excluded. The reference cohort consisted of randomly drawn individuals from the Civil Registration System without parental MS matched 8:1 to the MS offspring by sex and year of birth. Information about education was linked to the cohorts from nationwide educational registries. We included 4177 children of MS parents and 33,416 reference persons. Children of MS parents achieved statistically significant higher average grades than the reference cohort in their final exam of basic school with a mean grade difference of 0.46 (95 % CI 0.22-0.69; p = 0.0002). We found no difference in achievement of educational level above basic school (OR 1.04; 95 % CI 0.98-1.10; p = 0.20). There was a trend toward more MS offspring attaining health-related educations (OR 1.10; 95 % CI 1.00-1.21; p = 0.06). In conclusion, children of MS parents showed a small advantage in grade point average in final examinations in basic school, and they more often tended toward health-related educations. This study revealed no negative consequences of parental MS on grades and highest educational level achieved.

  8. [Structures and concepts for nationwide outbreak management in a federal state].

    PubMed

    Leidel, J; Feil, F

    2013-01-01

    With pandemic influenza in 2009/2010 and an EHEC outbreak in 2011, the Federal Republic of Germany experienced two extensive outbreaks in the course of only 3 years. Although both infectiological crises were comparatively successfully coped with, certain aspects have been critically examined. One point of criticism has been the presumption that federal structures may not be well suited for the management of a nationwide outbreak. This has been linked to the request for a central authority with responsibility. In fact, centralized as well as federal structures have advantages and disadvantages during infectiological crises. However, the "first response," i.e., immediate action against the spreading of infectious diseases, has to take place locally anyway. Regional differences, even in the context of a nationwide outbreak, might well demand regional action. After all, the federal structure of the Republic of Germany is deliberately firmly rooted in the German constitution, and there are no indications that this may change in the near future. Suitable concepts and structures should be used so as to benefit from the advantages and avoid the disadvantages of a federal state. The current structures are described, and improvements that may be necessary are discussed. The existing structures are shown to be entirely appropriate in allowing necessary decisions to be made and a fast transmission of information even in a federal state. Occasional shortcomings are seen as mainly due to the inadequate implementation of already existing regulations and partly to the ambition of a few spotlight seekers rather than to actual inadequacies of existing federal structures.

  9. A new approach to nationwide sanitation planning for developing countries: Case study of Indonesia.

    PubMed

    Kerstens, S M; Spiller, M; Leusbrock, I; Zeeman, G

    2016-04-15

    Many developing countries struggle to provide wastewater and solid waste services. The backlog in access has been partly attributed to the absence of a functional sanitation planning framework. Various planning tools are available; however a comprehensive framework that directly links a government policy to nationwide planning is missing. Therefore, we propose a framework to facilitate the nationwide planning process for the implementation of wastewater and solid waste services. The framework requires inputs from government planners and experts in the formulation of starting points and targets. Based on a limited number of indicators (population density, urban functions) three outputs are generated. The first output is a visualization of the spatial distribution of wastewater and solid waste systems to support regional priority setting in planning and create awareness. Secondly, the total number of people served, budget requirements and distribution of systems is determined. Thirdly, the required budget is allocated to the responsible institution to assure effective implementation. The determined budgets are specified by their beneficiaries, distinguishing urban, rural, poor and non-poor households. The framework was applied for Indonesia and outputs were adopted in the National Development Plan. The required budget to reach the Indonesian government's 2019 target was determined to be 25 billion US$ over 5years. The contribution from the national budget required a more than fivefold increase compared to the current budget allocation in Indonesia, corresponding to an increase from 0.5 to 2.7 billion US$ per year. The budget for campaigning, advocacy and institutional strengthening to enable implementation was determined to be 10% of the total budget. The proposed framework is not only suitable for Indonesia, but could also be applied to any developing country that aims to increase access to wastewater and solid waste facilities.

  10. Shrinking the Lymphatic Filariasis Map of Ethiopia: Reassessing the Population at Risk through Nationwide Mapping

    PubMed Central

    Assefa, Ashenafi; Cano, Jorge; Deribe, Kebede; Gonzalez-Escalada, Alba; Shafi, Oumer; Davey, Gail; Brooker, Simon J.; Kebede, Amha; Bockarie, Moses J.

    2015-01-01

    Background Mapping of lymphatic filariasis (LF) is essential for the delineation of endemic implementation units and determining the population at risk that will be targeted for mass drug administration (MDA). Prior to the current study, only 116 of the 832 woredas (districts) in Ethiopia had been mapped for LF. The aim of this study was to perform a nationwide mapping exercise to determine the number of people that should be targeted for MDA in 2016 when national coverage was anticipated. Methodology/Principal Finding A two-stage cluster purposive sampling was used to conduct a community-based cross-sectional survey for an integrated mapping of LF and podoconiosis, in seven regional states and two city administrations. Two communities in each woreda were purposely selected using the World Health Organization (WHO) mapping strategy for LF based on sampling 100 individuals per community and two purposely selected communities per woreda. Overall, 130 166 people were examined in 1315 communities in 658 woredas. In total, 140 people were found to be positive for circulating LF antigen by immunochromatographic card test (ICT) in 89 communities. Based on WHO guidelines, 75 of the 658 woredas surveyed in the nine regions were found to be endemic for LF with a 2016 projected population of 9 267 410 residing in areas of active disease transmission. Combining these results with other data it is estimated that 11 580 010 people in 112 woredas will be exposed to infection in 2016. Conclusions We have conducted nationwide mapping of LF in Ethiopia and demonstrated that the number of people living in LF endemic areas is 60% lower than current estimates. We also showed that integrated mapping of multiple NTDs is feasible and cost effective and if properly planned, can be quickly achieved at national scale. PMID:26539700

  11. Photodynamic therapy with polyhematoporphyrin for malignant biliary obstruction: A nationwide retrospective study of 150 consecutive applications

    PubMed Central

    Schwaighofer, Hubert; Hellmich, Brigitte; Stadler, Bernhard; Spaun, Georg; Plieschnegger, Wolfgang; Hebenstreit, Arnold; Weber-Eibel, Jutta; Siebert, Franz; Emmanuel, Klaus; Knoflach, Peter; Gschwantler, Michael; Vogel, Wolfgang; Trauner, Michael; Püspök, Andreas

    2016-01-01

    Background Photodynamic therapy (PDT) is a palliative treatment for malignant biliary obstruction. Objective The objective of this article is to assess the feasibility and safety of this technique. Methods In this nationwide, retrospective study of prospectively collected clinical data, all patients treated with PDT using polyhematoporphyrin in Austria from March 2004 to May 2013 were included. Feasibility, adverse events, stent patency and mortality rates were investigated. Results Eighty-eight patients (54 male, 34 female, median age 69 years) underwent 150 PDT procedures at seven Austrian referral centers for biliary endoscopy. The predominant underlying disease was Klatskin tumor (79/88). All PDT procedures were feasible without technical issues. Cholangitis was the most frequent adverse event (21/88). Stent patency was 246 days (95% CI 203–289) median and was significantly longer for metal than for plastic stents (269 vs. 62 days, p < 0.01). The median survival was 12.4 months (95% CI 9.7–14.9 m) calculated from first PDT and 15.6 months (95% CI 12.3–18.7 m) calculated from initial diagnosis. In patients suffering from biliary tract cancer, Cox regression revealed the number of PDT treatment sessions as the only independent predictor of survival at a multivariate analysis (p = 0.048). Conclusion PDT using polyhematoporphyrin was feasible and safe in this nationwide analysis. Survival data suggest a benefit of PDT in this unselected real-life patient population. Prospective trials comparing PDT to other palliative treatments will help to define its role in the management of malignant biliary obstruction. The study is registered at ClinicalTrials.gov number: NCT02504957.

  12. Abuse-related trauma forward medical care in a randomly sampled nationwide population

    PubMed Central

    Ho, Cheng-Maw; Lee, Chih-Hsin; Wang, Jann-Yuan; Lee, Po-Huang; Lai, Hong-Shiee; Hu, Rey-Heng; Chen, Jin-Shing

    2016-01-01

    Abstract Abuse-related trauma remains a global health issue. However, there is paucity in nationwide reports. We aim to estimate the incidence of abuse-related trauma forward medical care and identify its characteristics and clinical course in Taiwan. Patients with trauma between 2005 and 2007 that occurred 3 months before or after a diagnosis of abuse were identified from a randomly sampled nationwide longitudinal health insurance database of 1 million beneficiaries. The patients’ demographic data, injury pattern, and medical resource utilization were measured, stratified by age and sex, and compared using chi-square test. Risk factors of next trauma event were identified using Cox regression analysis. Ninety-three patients (65 females) were identified (mean age, 20.6 ± 16.3 years), including 61.3% under 18 years of age. For the first trauma event, 68 patients (73.1%) visited the emergency room, 63 (67.7%) received intervention, and 14 (15.1%) needed hospital care. Seven (7.5%), all less than 11 years old, had intracranial hemorrhage and required intensive care. Thirty-three (35.5%) left with complications or sequelae, or required rehabilitation, but all survived. Of the 34 victims of sexual abuse, 32 were aged less than 18 years. Men received more mood stabilizers or antipsychotics (50.0% vs 10.7%, P = 0.030) and reeducative psychotherapy (25.0% vs 0, P = 0.044). Risk factors for a next trauma event were injury involving the extremities (hazard ratio [HR]: 5.27 [2.45–11.33]) and use of antibiotics (HR: 4.21 [1.45–12.24]) on the first trauma event. Abuse-related trauma has heterogeneous presentations among subgroups. Clinicians should be alert in providing timely diagnosis and individualized intervention. PMID:27787382

  13. Evaluating a Nationwide Recreational Football Intervention: Recruitment, Attendance, Adherence, Exercise Intensity, and Health Effects

    PubMed Central

    Fløtum, Liljan av; Ottesen, Laila S.; Krustrup, Peter

    2016-01-01

    The present study evaluated a nationwide exercise intervention with Football Fitness in a small-scale society. In all, 741 adult participants (20–72 yrs) were successfully recruited for Football Fitness training in local football clubs, corresponding to 2.1% of the adult population. A preintervention test battery including resting heart rate (RHR), blood pressure, and body mass measurements along with performance tests (Yo-Yo Intermittent Endurance level 1 (Yo-Yo IE1), the Arrowhead Agility Test, and the Flamingo Balance Test) were performed (n = 502). Training attendance (n = 310) was 1.6 ± 0.2 sessions per week (range: 0.6–2.9), corresponding to 28.8 ± 1.0 sessions during the 18 wk intervention period. After 18 wks mean arterial pressure (MAP) was −2.7 ± 0.7 mmHg lower (P < 0.05; n = 151) with even greater (P < 0.05) reductions for those with baseline MAP values >99 mmHg (−5.6 ± 1.5 mmHg; n = 50). RHR was lowered (P < 0.05) by 6 bpm after intervention (77 ± 1 to 71 ± 1 bpm). Yo-Yo IE1 performance increased by 41% (540 ± 27 to 752 ± 45 m), while agility and postural balance were improved (P < 0.05) by ~6 and ~45%, respectively. In conclusion, Football Fitness was shown to be a successful health-promoting nationwide training intervention for adult participants with an extraordinary recruitment, a high attendance rate, moderate adherence, high exercise intensity, and marked benefits in cardiovascular health profile and fitness. PMID:27437401

  14. An expanded nationwide view of chronic kidney disease in Aboriginal Australians

    PubMed Central

    Mott, Susan A; Mc Donald, Stephen P

    2016-01-01

    Abstract We summarize new knowledge that has accrued in recent years on chronic kidney disease (CKD) in Indigenous Australians. CKD refers to all stages of preterminal kidney disease, including end‐stage kidney failure (ESKF), whether or not a person receives renal replacement therapy (RRT). Recently recorded rates of ESKF, RRT, non‐dialysis CKD hospitalizations and CKD attributed deaths were, respectively, more than sixfold, eightfold, eightfold and threefold those of non‐Indigenous Australians, with age adjustment, although all except the RRT rates are still under‐enumerated. However, the nationwide average Indigenous incidence rate of RRT appears to have stabilized. The median age of Indigenous people with ESKF was about 30 years less than for non‐Indigenous people, and 84% of them received RTT, while only half of non‐Indigenous people with ESKF did so. The first‐ever (2012) nationwide health survey data showed elevated levels of CKD markers in Indigenous people at the community level. For all CKD parameters, rates among Indigenous people themselves were strikingly correlated with increasing remoteness of residence and socio‐economic disadvantage, and there was a female predominance in remote areas. The burden of renal disease in Australian Indigenous people is seriously understated by Global Burden of Disease Mortality methodology, because it employs underlying cause of death only, and because deaths of people on RRT are frequently attributed to non‐renal causes. These data give a much expanded view of CKD in Aboriginal people. Methodologic approaches must be remedied for a full appreciation of the burden, costs and outcomes of the disease, to direct appropriate policy development. PMID:27075933

  15. Increased risk of herpes zoster in children with cancer: A nationwide population-based cohort study.

    PubMed

    Lin, Hsiao-Chuan; Chao, Yu-Hua; Wu, Kang-Hsi; Yen, Ting-Yu; Hsu, Yu-Lung; Hsieh, Tsung-Hsueh; Wei, Hsiu-Mei; Wu, Jhong-Lin; Muo, Chih-Hsin; Hwang, Kao-Pin; Peng, Ching-Tien; Lin, Cheng-Chieh; Li, Tsai-Chung

    2016-07-01

    Herpes zoster is rare in healthy children, but immunocompromised persons have an increased risk of herpes zoster and severe diseases. Considering the very limited information on herpes zoster in children with cancer, we performed a nationwide population-based cohort study to estimate the incidence of herpes zoster in children with cancer and to explore the association between the 2 diseases.Data were obtained from the National Health Research Institutes Database in Taiwan. A total of 4432 children with newly diagnosed cancer between 2000 and 2007 were identified as the cancer cohort, and 17,653 children without cancer frequency-matched by sex and age at entry were considered the noncancer cohort. The association between herpes zoster and childhood cancer was determined.Children with cancer had a higher risk of herpes zoster. The incidence rate of herpes zoster was higher in the cancer cohort than in the noncancer cohort (20.7 vs 2.4 per 10,000 person-years; IRR = 8.6; 95% CI = 4.8-15.6). The cumulative incidence was significantly higher in the cancer cohort (P < 0.0001). Leukemia, lymphoma, and solid tumor were all associated with the increased risk, and leukemia had the highest magnitude of strength of association.This nationwide population-based cohort study demonstrated that children with cancer were associated with an increased risk of herpes zoster. In addition to early antiviral treatment, vaccination with heat-treated zoster vaccine or adjuvanted subunit vaccine could be an appropriate policy to decrease the incidence in children with cancer.

  16. Nationwide incidence and treatment pattern of benign prostatic hyperplasia in Korea

    PubMed Central

    Lee, Young Ju; Lee, Jeong Woo; Park, Juhyun; Seo, Seong Il; Chung, Jae Il; Yoo, Tag Keun

    2016-01-01

    Purpose To investigate the incidence of benign prostatic hyperplasia (BPH) in Korea and treatment patterns for 3 years after the diagnosis in a nationwide database. Materials and Methods We created a cohort of patients diagnosed of BPH between 2007 and 2011 from the Health Insurance Review & Assessment database, a nationwide database of reimbursement. The diagnosis of BPH was defined as having the diagnosis of BPH (N40.0 in International Classification of Diseases, 10th revision) as a primary or secondary diagnosis ≥2 times in 2008. The incidence of BPH in 2008 was calculated. Treatment patterns were determined in 3 months interval and traced for 3 years. The incidence and timing of surgery were also determined. For patients taking medications preoperatively, medication-free rate was calculated. Results The incidence of BPH was 2,105 per 100,000 men (mean age, 59.7±11.4 years), and increased with age. Surgery was performed for 7,955 patients (2.1%), half of the surgery being performed within the first 6 months. Transurethral resection of the prostate was the most commonly performed surgery. The proportion of treatment increased with age until the 7th decade of life. The patients taking medication for >1 year after the initial diagnosis was 21.4%. On average, 82% of patients became medication-free at postoperative 1 year. For patients taking preoperative anticholinergics, 1 year medication-free rate was 73.3%. Conclusions The incidence of BPH increased with age. Surgery was performed in 2.1% of patients. More than 4/5 patients discontinued medication after surgery, while patients taking preoperative anticholinergics were less likely to. PMID:27847916

  17. Evolutionary analysis of HBV "S" antigen genetic diversity in Iranian blood donors: a nationwide study.

    PubMed

    Pourkarim, Mahmoud Reza; Sharifi, Zohre; Soleimani, Ali; Amini-Bavil-Olyaee, Samad; Elsadek Fakhr, Ahmed; Sijmons, Steven; Vercauteren, Jurgen; Karimi, Gharib; Lemey, Philippe; Maes, Piet; Alavian, Seyed Moayed; Van Ranst, Marc

    2014-01-01

    The genetic diversity of the HBV S gene has a significant impact on the prophylaxis and treatment of hepatitis B infection. The effect of selective pressure on this genetic alteration has not yet been studied in Iranian blood donors. To explore HBV evolution and to analyze the effects and patterns of hepatitis B surface antigen (HBsAg) mutations on blood screening assays, 358 Iranian blood donors diagnosed as asymptomatic HBV carriers were enrolled in this nationwide study. Large S and partial S genes were amplified and sequenced. HBV (sub) genotypes and synonymous and nonsynonymous mutations were investigated. The impact of naturally occurring mutations on HBsAg ELISA results was explored. Phylogenetic analyses revealed that isolated strains were of genotype D. The dominant subgenotype/subtype was D1/ayw2. Deletions and naturally occurring stop codons in the pre-S1 and major hydrophilic region (MHR) were identified. In total, 32.8% of the studied strains harbored 195 single or multiple mutations in the MHR, the majority of which were located at the first loop of the "a determinant" domain. The ayw2 subtype showed a significant effect on the ELISA signal/cut-off value and carried fewer mutations in the MHR. Nonsynonymous/synonymous substitution value indicated that negative selection was the dominant evolutionary force in the HBV S gene. This nationwide study revealed that mutation frequency of HBsAg among Iranian blood donors was much higher than previous reports from the different local regions. These findings regarding the significant differences in reactivity of ELISA among different subtypes of HBV and its correlation with the number of mutations at the MHR will be valuable to public health authorities.

  18. Evaluating a Nationwide Recreational Football Intervention: Recruitment, Attendance, Adherence, Exercise Intensity, and Health Effects.

    PubMed

    Fløtum, Liljan Av; Ottesen, Laila S; Krustrup, Peter; Mohr, Magni

    2016-01-01

    The present study evaluated a nationwide exercise intervention with Football Fitness in a small-scale society. In all, 741 adult participants (20-72 yrs) were successfully recruited for Football Fitness training in local football clubs, corresponding to 2.1% of the adult population. A preintervention test battery including resting heart rate (RHR), blood pressure, and body mass measurements along with performance tests (Yo-Yo Intermittent Endurance level 1 (Yo-Yo IE1), the Arrowhead Agility Test, and the Flamingo Balance Test) were performed (n = 502). Training attendance (n = 310) was 1.6 ± 0.2 sessions per week (range: 0.6-2.9), corresponding to 28.8 ± 1.0 sessions during the 18 wk intervention period. After 18 wks mean arterial pressure (MAP) was -2.7 ± 0.7 mmHg lower (P < 0.05; n = 151) with even greater (P < 0.05) reductions for those with baseline MAP values >99 mmHg (-5.6 ± 1.5 mmHg; n = 50). RHR was lowered (P < 0.05) by 6 bpm after intervention (77 ± 1 to 71 ± 1 bpm). Yo-Yo IE1 performance increased by 41% (540 ± 27 to 752 ± 45 m), while agility and postural balance were improved (P < 0.05) by ~6 and ~45%, respectively. In conclusion, Football Fitness was shown to be a successful health-promoting nationwide training intervention for adult participants with an extraordinary recruitment, a high attendance rate, moderate adherence, high exercise intensity, and marked benefits in cardiovascular health profile and fitness.

  19. Rare Causes of Primary Adrenal Insufficiency: Genetic and Clinical Characterization of a Large Nationwide Cohort

    PubMed Central

    Buonocore, Federica; Saka, Nurcin; Ozbek, Mehmet Nuri; Aycan, Zehra; Bereket, Abdullah; Bas, Firdevs; Darcan, Sukran; Bideci, Aysun; Guven, Ayla; Demir, Korcan; Akinci, Aysehan; Buyukinan, Muammer; Aydin, Banu Kucukemre; Turan, Serap; Agladioglu, Sebahat Yilmaz; Atay, Zeynep; Abali, Zehra Yavas; Tarim, Omer; Catli, Gonul; Yuksel, Bilgin; Akcay, Teoman; Yildiz, Metin; Ozen, Samim; Doger, Esra; Demirbilek, Huseyin; Ucar, Ahmet; Isik, Emregul; Ozhan, Bayram; Bolu, Semih; Ozgen, Ilker Tolga; Suntharalingham, Jenifer P.; Achermann, John C.

    2016-01-01

    Context: Primary adrenal insufficiency (PAI) is a life-threatening condition that is often due to monogenic causes in children. Although congenital adrenal hyperplasia occurs commonly, several other important molecular causes have been reported, often with overlapping clinical and biochemical features. The relative prevalence of these conditions is not known, but making a specific diagnosis can have important implications for management. Objective: The objective of the study was to investigate the clinical and molecular genetic characteristics of a nationwide cohort of children with PAI of unknown etiology. Design: A structured questionnaire was used to evaluate clinical, biochemical, and imaging data. Genetic analysis was performed using Haloplex capture and next-generation sequencing. Patients with congenital adrenal hyperplasia, adrenoleukodystrophy, autoimmune adrenal insufficiency, or obvious syndromic PAI were excluded. Setting: The study was conducted in 19 tertiary pediatric endocrinology clinics. Patients: Ninety-five children (48 females, aged 0–18 y, eight familial) with PAI of unknown etiology participated in the study. Results: A genetic diagnosis was obtained in 77 patients (81%). The range of etiologies was as follows: MC2R (n = 25), NR0B1 (n = 12), STAR (n = 11), CYP11A1 (n = 9), MRAP (n = 9), NNT (n = 7), ABCD1 (n = 2), NR5A1 (n = 1), and AAAS (n = 1). Recurrent mutations occurred in several genes, such as c.560delT in MC2R, p.R451W in CYP11A1, and c.IVS3ds+1delG in MRAP. Several important clinical and molecular insights emerged. Conclusion: This is the largest nationwide study of the molecular genetics of childhood PAI undertaken. Achieving a molecular diagnosis in more than 80% of children has important translational impact for counseling families, presymptomatic diagnosis, personalized treatment (eg, mineralocorticoid replacement), predicting comorbidities (eg, neurological, puberty/fertility), and targeting clinical genetic testing in the

  20. Immunosuppression for progressive membranous nephropathy: a UK randomised controlled trial

    PubMed Central

    Howman, Andrew; Chapman, Tracey L; Langdon, Maria M; Ferguson, Caroline; Adu, Dwomoa; Feehally, John; Gaskin, Gillian J; Jayne, David RW; O'Donoghue, Donal; Boulton-Jones, Michael; Mathieson, Peter W

    2013-01-01

    Summary Background Membranous nephropathy leads to end-stage renal disease in more than 20% of patients. Although immunosuppressive therapy benefits some patients, trial evidence for the subset of patients with declining renal function is not available. We aimed to assess whether immunosuppression preserves renal function in patients with idiopathic membranous nephropathy with declining renal function. Methods This randomised controlled trial was undertaken in 37 renal units across the UK. We recruited patients (18–75 years) with biopsy-proven idiopathic membranous nephropathy, a plasma creatinine concentration of less than 300 μmol/L, and at least a 20% decline in excretory renal function measured in the 2 years before study entry, based on at least three measurements over a period of 3 months or longer. Patients were randomly assigned (1:1:1) by a random number table to receive supportive treatment only, supportive treatment plus 6 months of alternating cycles of prednisolone and chlorambucil, or supportive treatment plus 12 months of ciclosporin. The primary outcome was a further 20% decline in renal function from baseline, analysed by intention to treat. The trial is registered as an International Standard Randomised Controlled Trial, number 99959692. Findings We randomly assigned 108 patients, 33 of whom received prednisolone and chlorambucil, 37 ciclosporin, and 38 supportive therapy alone. Two patients (one who received ciclosporin and one who received supportive therapy) were ineligible, so were not included in the intention-to-treat analysis, and 45 patients deviated from protocol before study end, mostly as a result of minor dose adjustments. Follow up was until primary endpoint or for minimum of 3 years if primary endpoint was not reached. Risk of further 20% decline in renal function was significantly lower in the prednisolone and chlorambucil group than in the supportive care group (19 [58%] of 33 patients reached endpoint vs 31 [84%] of 37, hazard

  1. Famciclovir for ophthalmic zoster: a randomised aciclovir controlled study

    PubMed Central

    Tyring, S.; Engst, R.; Corriveau, C.; Robillard, N.; Trottier, S.; Van Slycken, S.; Crann, R.; Locke, L.; Saltzman, R.; Palestine, A.

    2001-01-01

    AIMS—To compare the efficacy and safety of famciclovir with aciclovir for the treatment of ophthalmic zoster.
METHODS—Randomised, double masked, aciclovir controlled, parallel group in 87 centres worldwide including 454 patients with ophthalmic zoster of trigeminal nerve (V1) comprised the intent to treat population. Oral famciclovir 500 mg three times daily or oral aciclovir 800 mg five times daily for 7 days. Assessments included day 0 (screening), days 3 and 7 (during treatment), days 10, 14, 21, 28 and monthly thereafter, up to 6 months (follow up). Proportion of patients who experienced ocular manifestations, severe manifestations and non-severe manifestations; loss of visual acuity was the main outcome measure.
RESULTS—The percentage of patients who experienced one or more ocular manifestations was similar for famciclovir (142/245, 58.0%) and aciclovir (114/196, 58.2%) recipients, with no significant difference between groups (OR 0.99; 95% CI 0.68, 1.45). The percentage of patients who experienced severe and non-severe manifestations was similar between groups, with no significant difference. The prevalence of individual ocular manifestations was comparable between groups. There was no significant difference between groups for visual acuity loss.
CONCLUSION—Famciclovir 500 mg three times daily was well tolerated and demonstrated efficacy similar to aciclovir 800 mg five times daily.

 PMID:11316720

  2. Thermoregulatory effects of swaddling in Mongolia: a randomised controlled study

    PubMed Central

    Tsogt, Bazarragchaa; Manaseki-Holland, Semira; Pollock, Jon; Blair, Peter S; Fleming, Peter

    2016-01-01

    Objective To investigate thermal balance of infants in a Mongolian winter, and compare the effects of traditional swaddling with an infant sleeping-bag in apartments or traditional tents (Gers). Design A substudy within a randomised controlled trial. Setting Community in Ulaanbaatar, Mongolia. Subjects A stratified randomly selected sample of 40 swaddled and 40 non-swaddled infants recruited within 48 h of birth. Intervention Sleeping-bags and baby outfits of total thermal resistance equivalent to that of swaddled babies. Outcome measure Digital recordings of infants’ core, peripheral, environmental and microenvironmental temperatures at 30-s intervals over 24 h at ages 1 month and 3 months. Results In Gers, indoor temperatures varied greatly (<0–>25°C), but remained between 20°C and 22°C, in apartments. Despite this, heavy wrapping, bed sharing and partial head covering, infant core and peripheral temperatures were similar and no infants showed evidence of significant heat or cold stress whether they were swaddled or in sleeping-bags. At 3 months, infants in sleeping-bags showed the ‘mature’ diurnal pattern of a fall in core temperature after sleep onset, accompanied by a rise in peripheral temperature, with a reverse pattern later in the night, just before awakening. This pattern was not related to room temperature, and was absent in the swaddled infants, suggesting that the mature diurnal pattern may develop later in them. Conclusions No evidence of cold stress was found. Swaddling had no identifiable thermal advantages over sleeping-bags during the coldest times, and in centrally heated apartments could contribute to the risk of overheating during the daytime. Trial registration number ISRTN01992617. PMID:26515228

  3. Metacognitive training for schizophrenia: a multicentre randomised controlled trial.

    PubMed

    Briki, Malick; Monnin, Julie; Haffen, Emmanuel; Sechter, Daniel; Favrod, Jérôme; Netillard, Christian; Cheraitia, Elisabeth; Marin, Karine; Govyadovskaya, Svetlana; Tio, Grégory; Bonin, Bernard; Chauvet-Gelinier, Jean-Christophe; Leclerc, Stéphanie; Hodé, Yann; Vidailhet, Pierre; Berna, Fabrice; Bertschy, Anna Zinetti; Vandel, Pierre

    2014-08-01

    A psychotherapeutic approach for schizophrenia is now recommended as an adjuvant for psychopharmacology, since antipsychotic medications only have a partial impact especially as regards positive symptoms and insight. In addition, cognitive distortions and the lack of metacognitive skills might increase positive symptoms leading to poor social functioning. This underlines the need for specific approaches which target cognitive processes relevant for insight, and abilities in metacognition. Metacognitive training (MCT) is a structured group intervention, which enhances a patient's reflection on cognitive biases and improves problem-solving. The aim of our study was to assess MCTs' short term impact on insight, symptoms and quality of life. Fifty patients with schizophrenia or schizoaffective disorders and persistent positive symptoms (delusions or hallucinations) were enrolled in the study. After baseline assessment participants were randomised either to supportive therapy or MCT. Both groups used the same design (1h-session twice a week during 8weeks) although the basic knowledge given to participants was different between interventions. Participants were assessed at eight weeks based on the Scale to Assess Unawareness of Mental Disorder, Positive and Negative Syndrome Scale (PANSS), Psychotic Symptom Rating Scales, the Calgary Depression Scale for Schizophrenia and the Quality of Life Scale. Between-group differences were significant in favour of MCT on the PANSS positive scale. Between-group differences in post- and pre-test values showed a trend in favour of MCT for insight on hallucinations. Results of our study indicate that the MCT has an effect on reducing positive symptomatology, and a trend impact on insight and social functioning.

  4. Motivational interviewing for modifying diabetes risk: a randomised controlled trial

    PubMed Central

    Greaves, Colin J; Middlebrooke, Andrew; O'Loughlin, Lucy; Holland, Sandra; Piper, Jane; Steele, Anna; Gale, Tracy; Hammerton, Fenella; Daly, Mark

    2008-01-01

    Background Around 10–15% of adults aged over 40 years have pre-diabetes, which carries a high risk of progression to type 2 diabetes. Intensive lifestyle intervention reduces progression by as much as 58%. However, the cost and personnel requirements of these interventions are major obstacles to delivery in NHS primary care. Aim To assess the effectiveness of a low-cost intervention, delivered in primary care by non-NHS staff, to reduce the risk of diabetes through weight loss and physical activity. Design of study Pragmatic single-blind randomised controlled trial with researchers and statistician blinded to group allocation. Setting UK primary care. Method One-hundred and forty-one participants with a body mass index of 28 kg/m2 or more, but without diabetes or heart disease, received either information leaflets or individual behavioural counselling using motivational interviewing techniques. The intervention was delivered by five counsellors recruited from the local community. The primary outcomes were the proportions of participants meeting predefined targets for weight loss (5%) and moderate physical activity (150 minutes/week) after 6 months. Results Using intention-to-treat analysis, more people in the intervention group achieved the weight-loss target (24% versus 7% for controls; odds ratio [OR] = 3.96; 95% confidence interval [Cl] = 1.4 to 11.4; number needed to treat [NNT] = 6.1 (95% Cl = 4 to 21). The proportion achieving the physical activity target did not increase significantly (38% versus 28% for controls; OR = 1.6; 95% Cl = 0.7 to 3.8). Conclusion Short-term weight loss, at a level which, if sustained, is clinically meaningful for reducing diabetes risk, is achievable in primary care, without excessive use of NHS monetary or personnel resources. PMID:18682011

  5. Chinese Obstetrics & Gynecology journal club: a randomised controlled trial

    PubMed Central

    Tsui, Ilene K; Dodson, William C; Kunselman, Allen R; Kuang, Hongying; Han, Feng-Juan; Legro, Richard S; Wu, Xiao-Ke

    2016-01-01

    Objectives To assess whether a journal club model could improve comprehension and written and spoken medical English in a population of Chinese medical professionals. Setting and participants The study population consisted of 52 medical professionals who were residents or postgraduate master or PhD students in the Department of Obstetrics and Gynecology, Heilongjiang University of Chinese Medicine, China. Intervention After a three-part baseline examination to assess medical English comprehension, participants were randomised to either (1) an intensive journal club treatment arm or (2) a self-study group. At the conclusion of the 8-week intervention participants (n=52) were re-tested with new questions. Outcome measures The primary outcome was the change in score on a multiple choice examination. Secondary outcomes included change in scores on written and oral examinations which were modelled on the Test of English as a Foreign Language (TOEFL). Results Both groups had improved scores on the multiple choice examination without a statistically significant difference between them (90% power). However, there was a statistically significant difference between the groups in mean improvement in scores for both written (95% CI 1.1 to 5.0; p=0.003) and spoken English (95% CI 0.06 to 3.7; p=0.04) favouring the journal club intervention. Conclusions Interacting with colleagues and an English-speaking facilitator in a journal club improved both written and spoken medical English in Chinese medical professionals. Journal clubs may be suitable for use as a self-sustainable teaching model to improve fluency in medical English in foreign medical professionals. Trial registration number NCT01844609. PMID:26823180

  6. Ghost Authorship in Industry-Initiated Randomised Trials

    PubMed Central

    Gøtzsche, Peter C; Hróbjartsson, Asbjørn; Johansen, Helle Krogh; Haahr, Mette T; Altman, Douglas G; Chan, An-Wen

    2007-01-01

    Background Ghost authorship, the failure to name, as an author, an individual who has made substantial contributions to an article, may result in lack of accountability. The prevalence and nature of ghost authorship in industry-initiated randomised trials is not known. Methods and Findings We conducted a cohort study comparing protocols and corresponding publications for industry-initiated trials approved by the Scientific-Ethical Committees for Copenhagen and Frederiksberg in 1994–1995. We defined ghost authorship as present if individuals who wrote the trial protocol, performed the statistical analyses, or wrote the manuscript, were not listed as authors of the publication, or as members of a study group or writing committee, or in an acknowledgment. We identified 44 industry-initiated trials. We did not find any trial protocol or publication that stated explicitly that the clinical study report or the manuscript was to be written or was written by the clinical investigators, and none of the protocols stated that clinical investigators were to be involved with data analysis. We found evidence of ghost authorship for 33 trials (75%; 95% confidence interval 60%–87%). The prevalence of ghost authorship was increased to 91% (40 of 44 articles; 95% confidence interval 78%–98%) when we included cases where a person qualifying for authorship was acknowledged rather than appearing as an author. In 31 trials, the ghost authors we identified were statisticians. It is likely that we have overlooked some ghost authors, as we had very limited information to identify the possible omission of other individuals who would have qualified as authors. Conclusions Ghost authorship in industry-initiated trials is very common. Its prevalence could be considerably reduced, and transparency improved, if existing guidelines were followed, and if protocols were publicly available. PMID:17227134

  7. Vitamin E supplementation and macular degeneration: randomised controlled trial

    PubMed Central

    Taylor, Hugh R; Tikellis, Gabriella; Robman, Luba D; McCarty, Catherine A; McNeil, John J

    2002-01-01

    Objective To determine whether vitamin E supplementation influences the incidence or rate of progression of age related maculopathy (AMD). Design Prospective randomised placebo controlled clinical trial. Setting An urban study centre in a residential area supervised by university research staff. Participants 1193 healthy volunteers aged between 55 and 80 years; 73% completed the trial on full protocol. Interventions Vitamin E 500 IU or placebo daily for four years. Main outcome measures Primary outcome: development of early age related macular degeneration in retinal photographs. Other measures included alternative definitions of age related macular degeneration, progression, changes in component features, visual acuity, and visual function Results The incidence of early age related macular degeneration (early AMD 3) was 8.6% in those receiving vitamin E versus 8.1% in those on placebo (relative risk 1.05, 95% confidence interval 0.69 to 1.61). For late disease the incidence was 0.8% versus 0.6% (1.36, 0.67 to 2.77). Further analysis showed no consistent differences in secondary outcomes. Conclusion Daily supplement with vitamin E supplement does not prevent the development or progression of early or later stages of age related macular degeneration. What is already known on this topicAge related macular degeneration is the leading cause of loss of vision and blindness in elderly people; for people aged ⩾90 years, two out of every three will be affected and one in four will become blindCurrently, there are no methods of prevention or treatment in most cases, though a third of cases are due to cigarette smokingAntioxidant vitamins have been suggested as a possible preventionWhat this study addsDaily supplementation with 500 mg vitamin E for four years did not alter the incidence or progression of AMD PMID:12098721

  8. Alcohol-Specific Socialization Practices and Alcohol Use in Dutch Early Adolescents

    ERIC Educational Resources Information Center

    Koning, Ina M.; Engels, Rutger C. M. E.; Verdurmen, Jacqueline E. E.; Vollebergh, Wilma A. M.

    2010-01-01

    The present study examined the associations of alcohol-specific socialization practices and heavy parental drinking with alcohol use in early adolescents. Cross-sectional nationwide survey data from 2599 parent-adolescent (mean age = 12.16) dyads were used to conduct logistic regression analyses. Onset of alcohol use as well as infrequent and…

  9. Aperture Increase Options for the Dutch Open Telescope

    NASA Astrophysics Data System (ADS)

    Hammerschlag, R. H.; Bettonvil, F. C. M.; Jägers, A. P. L.; Rutten, R. J.

    2007-05-01

    This paper is an invitation to the international community to participate in the usage and a substantial upgrade of the Dutch Open Telescope on La Palma (DOT, http://dot.astro.uu.nl). We first give a brief overview of the approach, design, and current science capabilities of the DOT. It became a successful 0.2-arcsec-resolution solar movie producer through its combination of (i) an excellent site, (ii) effective wind flushing through the fully open design and construction of both the 45-cm telescope and the 15-m support tower, (iii) special designs which produce extraordinary pointing stability of the tower, equatorial mount, and telescope, (iv) simple and excellent optics with minimum wavefront distortion, and (v) large-volume speckle reconstruction including narrow-band processing. The DOT's multi-camera multi-wavelength speckle imaging system samples the solar photosphere and chromosphere simultaneously in various optical continua, the G band, Ca II H (tunable throughout the blue wing), and Hα (tunable throughout the line). The resulting DOT data sets are all public. The DOT database (http://dotdb.phys.uu.nl/DOT) now contains many tomographic image sequences with 0.2-0.3 arcsec resolution and up to multi-hour duration. You are welcome to pull them over for analysis. The main part of this contribution outlines DOT upgrade designs implementing larger aperture. The motivation for aperture increase is the recognition that optical solar physics needs the substantially larger telescope apertures that became useful with the advent of adaptive optics and viable through the DOT's open principle, both for photospheric polarimetry at high resolution and high sensitivity and for chromospheric fine-structure diagnosis at high cadence and full spectral sampling. Our upgrade designs for the DOT are presented in an incremental sequence of five options of which the simplest (Option I) achieves 1.4 m aperture using the present tower, mount, fold-away canopy, and multi

  10. Selenium speciation and extractability in Dutch agricultural soils.

    PubMed

    Supriatin, Supriatin; Weng, Liping; Comans, Rob N J

    2015-11-01

    The study aimed to understand selenium (Se) speciation and extractability in Dutch agricultural soils. Top soil samples were taken from 42 grassland fields and 41 arable land fields in the Netherlands. Total Se contents measured in aqua regia were between 0.12 and 1.97 mg kg(-1) (on average 0.58 mg kg(-1)). Organic Se after NaOCl oxidation-extraction accounted for on average 82% of total Se, whereas inorganic selenite (selenate was not measurable) measured in ammonium oxalate extraction using HPLC-ICP-MS accounted for on average 5% of total Se. The predominance of organic Se in the soils is supported by the positive correlations between total Se (aqua regia) and total soil organic matter content, and Se and organic C content in all the other extractions performed in this study. The amount of Se extracted followed the order of aqua regia > 1 M NaOCl (pH8) > 0.1 M NaOH>ammonium oxalate (pH3) > hot water>0.43 M HNO3 > 0.01 M CaCl2. None of these extractions selectively extracts only inorganic Se, and relative to other extractions 0.43 M HNO3 extraction contains the lowest fraction of organic Se, followed by ammonium oxalate extraction. In the 0.1M NaOH extraction, the hydrophobic neutral (HON) fraction of soil organic matter is richer in Se than in the hydrophilic (Hy) and humic acid (HA) fractions. The organic matter extracted in 0.01 M CaCl2 and hot water is in general richer in Se compared to the organic matter extracted in 0.1M NaOH, and other extractions (HNO3, ammonium oxalate, NaOCl, and aqua regia). Although the extractability of Se follows to a large extent the extractability of soil organic carbon, there is several time variations in the Se to organic C ratios, reflecting the changes in composition of organic matter extracted.

  11. Failure and preventive costs of mastitis on Dutch dairy farms.

    PubMed

    van Soest, Felix J S; Santman-Berends, Inge M G A; Lam, Theo J G M; Hogeveen, Henk

    2016-10-01

    Mastitis is an important disease from an economic perspective, but most cost assessments of mastitis include only the direct costs associated with the disease (e.g., production losses, culling, and treatment), which we call failure costs (FC). However, farmers also invest time and money in controlling mastitis, and these preventive costs (PC) also need to be taken into account. To estimate the total costs of mastitis, we estimated both FC and PC. We combined multiple test-day milk records from 108 Dutch dairy farms with information on applied mastitis prevention measures and farmers' registration of clinical mastitis for individual dairy cows. The aim was to estimate the total costs of mastitis and to give insight into variations between farms. We estimated the average total costs of mastitis to be €240/lactating cow per year, in which FC contributed €120/lactating cow per year and PC contributed another €120/lactating cow per year. Milk production losses, discarded milk, and culling were the main contributors to FC, at €32, €20, and €20/lactating cow per year, respectively. Labor costs were the main contributor to PC, next to consumables and investments, at €82, €34, and €4/lactating cow per year, respectively. The variation between farmers was substantial, and some farmers faced both high FC and PC. This variation may have been due to structural differences between farms, different mastitis-causing pathogens, the time at which preventive action is initiated, stockmanship, or missing measures in PC estimates. We estimated the minimum FC to be €34 per lactating cow per yr. All farmers initiated some preventive action to control or reduce mastitis, indicating that farmers will always have mastitis-related costs, because mastitis will never be fully eradicated from a farm. Insights into both the PC and FC of a specific farm will allow veterinary advisors and farmers to assess whether current udder health strategies are appropriate or whether there

  12. Parental Work Demands and Parent-Child, Family, and Couple Leisure in Dutch Families: What Gives?

    ERIC Educational Resources Information Center

    Roeters, Anne; Treas, Judith K.

    2011-01-01

    This study uses data on 898 Dutch couples with minor children to examine whether parental work demands are related differently to one-on-one parent-child, family, and couple leisure activities. The authors presume that the impact of working hours and work arrangements is smaller on activities that are prioritized highly and that are easier and…

  13. Analyzing English Lexical Elements in the Language of Dutch Immigrants in the United States.

    ERIC Educational Resources Information Center

    Schatz, Henriette F.

    A study investigated the general occurrence of English lexical elements in the recorded speech of 285 Dutch pre-World War I immigrants and their descendants in Massachusetts, Iowa, and Wisconsin. The problems encountered in analyzing a massive data corpus and the methods used to resolve these problems are the focus of the paper. The difficulties…

  14. Dutch Adolescents' Tolerance of Practices by Muslim Actors: The Effect of Issue Framing

    ERIC Educational Resources Information Center

    Gieling, Maike; Thijs, Jochem; Verkuyten, Maykel

    2012-01-01

    This research, conducted in the Netherlands, examines whether native adolescents' tolerance of practices by Muslim immigrants (e.g., the founding of Islamic schools) is affected by the type of considerations (e.g., educational freedom vs. integration of Muslims in Dutch society). Using an experimental questionnaire design (N = 970), the findings…

  15. Elm genetic diversity and hybridization in the presence of Dutch elm disease

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Dutch elm disease (DED) has devastated native North American elm species for more than 75 years. The impact of DED on the genetic diversity of one native elm species, U. rubra or slippery elm, is summarized and its potential impact on the genetic diversity of the other four North American native elm...

  16. The Novaco Anger Scale--Provocation Inventory (1994 Version) in Dutch Forensic Psychiatric Patients

    ERIC Educational Resources Information Center

    Hornsveld, Ruud H. J.; Muris, Peter; Kraaimaat, Floris W.

    2011-01-01

    We examined the psychometric properties of the Novaco Anger Scale--Provocation Inventory (NAS-PI, 1994 version) in Dutch violent forensic psychiatric patients and secondary vocational students. A confirmatory factor analysis of the subscale structure of the NAS was carried out, reliability was investigated, and relations were calculated between…

  17. An Exploratory Case Study of Dutch Children's Attitudes toward Consumption: Implications for Environmental Education

    ERIC Educational Resources Information Center

    Kopnina, Helen

    2013-01-01

    This critical essay based on empirical study draws upon research on the differences in attitudes toward consumption among Dutch upper-elementary school children with different socioeconomic backgrounds. This article examines two strands of theory: critical literature on the conceptualization and practice of sustainable consumption, and the theory…

  18. The Resilience of Recently Graduated and Unemployed Dutch Academics in Coping with the Economic Crisis

    ERIC Educational Resources Information Center

    Dekker, Jeroen J. H.; Amsing, Hilda T. A.; Hahurij, Lisa; Wichgers, Inge

    2014-01-01

    Some years after the world-wide crisis starting in 2008, also many recently graduated Dutch academics were confronted with the problem of how to cope with getting a job. This article focuses on the coping strategies they use when searching after a job, spending the day, and coping with limited financial means. 91 graduated academics completed a…

  19. Pre-Conditions, Benefits and Costs of Privatized Public Services: Lessons from the Dutch Educational System.

    ERIC Educational Resources Information Center

    James, Estelle

    The system in the Netherlands of "privatization," a government policy of financially supporting private schools and encouraging people to use them, depends on conditions in Dutch society that are conducive to a large nongovernment, nonprofit sector. These include cultural heterogeneity, coupled with the lack of a single dominant culture…

  20. Multiple Identities and Religious Transmission: A Study among Moroccan-Dutch Muslim Adolescents and Their Parents

    ERIC Educational Resources Information Center

    Verkuyten, Maykel; Thijs, Jochem; Stevens, Gonneke

    2012-01-01

    This study investigates the relation between religious group identification and ethnic and national identity among Moroccan-Dutch Muslim adolescents (11-18 years) and their parents (n = 369). Compared to their parents, adolescents showed higher national identification and lower religious and ethnic group identification. However, for adolescents…