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Sample records for randomised nationwide dutch

  1. Exploring facilitating factors and barriers to the nationwide dissemination of a Dutch school-based obesity prevention program “DOiT”: a study protocol

    PubMed Central

    2013-01-01

    Background The evidence-based Dutch Obesity Intervention in Teenagers (DOiT) program is a school-based obesity prevention program for 12 to 14-year olds attending the first two years of prevocational education. This paper describes the study protocol applied to evaluate (a) the nationwide dissemination process of DOiT in the Netherlands, and (b) the relationship between quality of implementation and effectiveness during nationwide dissemination of the program in the Netherlands. Methods In order to explore facilitating factors and barriers for dissemination of DOiT, we monitored the process of adoption, implementation and continuation of the DOiT program among 20 prevocational schools in the Netherlands. The study was an observational study using qualitative (i.e. semi-structured interviews) and quantitative methods (i.e. questionnaires and logbooks). Eight process indicators were assessed: recruitment, context, reach, dosage, fidelity, satisfaction, effectiveness and continuation. All teachers, students and parents involved in the implementation of the program were invited to participate in the study. As part of the process evaluation, a cluster-controlled trial with ten control schools was conducted to evaluate the effectiveness of the program on students’ anthropometry and energy balance-related behaviours and its association with quality of implementation. Discussion The identified impeding and facilitating factors will contribute to an adjusted strategy promoting adoption, implementation and continuation of the DOiT program to ensure optimal use and, thereby, prevention of obesity in Dutch adolescents. Trial registration Current Controlled Trials ISRCTN92755979. PMID:24355056

  2. The effectiveness of critical time intervention for abused women and homeless people leaving Dutch shelters: study protocol of two randomised controlled trials

    PubMed Central

    2013-01-01

    Background One of the main priorities of Dutch organisations providing shelter services is to develop evidence-based interventions in the care for abused women and homeless people. To date, most of these organisations have not used specific intervention models and the interventions which have been implemented rarely have an empirical and theoretical foundation. The present studies aim to examine the effectiveness of critical time intervention (CTI) for abused women and homeless people. Methods In two multi-centre randomised controlled trials we investigate whether CTI, a time-limited (nine month) outreach intervention, is more effective than care-as-usual for abused women and homeless people making the transition from shelter facilities to supported or independent housing. Participants were recruited in 19 women’s shelter facilities and 22 homeless shelter facilities across The Netherlands and randomly allocated to the intervention group (CTI) or the control group (care-as-usual). They were interviewed four times in nine months: once before leaving the shelter, and then at three, six and nine months after leaving the shelter. Quality of life (primary outcome for abused women) and recurrent loss of housing (primary outcome for homeless people) as well as secondary outcomes (e.g. care needs, self-esteem, loneliness, social support, substance use, psychological distress and service use) were assessed during the interviews. In addition, the model integrity of CTI was investigated during the data collection period. Discussion Based on international research CTI is expected to be an appropriate intervention for clients making the transition from institutional to community living. If CTI proves to be effective for abused women and homeless people, shelter services could include this case management model in their professional standards and improve the (quality of) services for clients. Trial registration NTR3463 and NTR3425 PMID:25927562

  3. 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.

  4. Rationale, design, and implementation protocol of the Dutch clinical practice guideline Pain in patients with cancer: a cluster randomised controlled trial with short message service (SMS) and interactive voice response (IVR)

    PubMed Central

    2011-01-01

    Background One-half of patients with cancer have pain. In nearly one out of two cancer patients with pain, this was undertreated. Inadequate pain control still remains an important problem in this group of patients. Therefore, in 2008 a national, evidence-based multidisciplinary clinical practice guideline 'pain in patients with cancer' has been developed. Yet, publishing a guideline is not enough. Implementation is needed to improve pain management. An innovative implementation strategy, Short Message Service with Interactive Voice Response (SVS-IVR), has been developed and pilot tested. This study aims to evaluate on effectiveness of this strategy to improve pain reporting, pain measurement and adequate pain therapy. In addition, whether the active role of the patient and involvement of caregivers in pain management may change. Methods/design A cluster randomised controlled trial with two arms will be performed in six oncology outpatient clinics of hospitals in the Southeastern region of the Netherlands, with three hospitals in the intervention and three in the control condition. Follow-up measurements will be conducted in all hospitals to study the long-term effect of the intervention. The intervention includes training of professionals (medical oncologists, nurses, and general practitioners) and SMS-IVR to report pain in patients with cancer to improve pain reporting by patients, pain management by medical oncologists, nurses, and general practitioners, and decrease pain intensity. Discussion This innovative implementation strategy with technical tools and the involvement of patients, may enhance the use of the guideline 'pain in patients with cancer' for pain management. Short Message Service alerts may serve as a tool to support self-management of patients. Therefore, the SMS-IVR intervention may increase the feeling of having control over one's life. Trail registration Netherlands Trial Register (NTR): NTR2739 PMID:22142327

  5. 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…

  6. 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.

  7. 75 FR 66806 - Nationwide Life Insurance Company, et al.,

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-29

    ... COMMISSION Nationwide Life Insurance Company, et al., Notice of Application October 25, 2010. AGENCY...: Nationwide Life Insurance Company (``NWL''), Nationwide Life and Annuity Insurance Company (``NLAIC... contracts and/or variable life insurance policies issued by the Insurance Companies (collectively,...

  8. 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…

  9. 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,…

  10. 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. PMID:27579813

  11. Sisters in Dutch hospitals.

    PubMed

    van den Bergh-Braam, A H

    1985-11-01

    This study focuses on hospital sisters in 30 Dutch hospitals. The so-called role-set approach has been adopted. In this approach the sisters are the focal persons. Direct superiors, specialists, registered nurses and student nurses acted as role-senders. The possible number of respondents is 600 (120 of each group). The response of hospital sisters is 100%, that of role-senders 88%. The study started out as an attempt to collect background information on the causes of wastage of sisters. High wastage rates are generally regarded as an indication of an unfavourable working environment. Since hospital sisters occupy a key position in hospitals, the ward problems will be studied from their angle. Although wastage rates have dropped recently, it does not necessarily follow that the working environment has improved. Wastage is known to act as a safety valve, thus allowing tensions to resolve. The threat of unemployment clogs this outlet, which increases the tensions on the hospital ward. Data from the study show that work overload is one of the major stress factors for sisters. Analyses demonstrated that there exists a relationship between work overload and tensions with the management and direct superiors, tensions in job execution, irritableness on the ward, low self-esteem, health complaints and psychological condition. Sisters with an excessive job involvement refer to work overload more often than their moderate colleagues. There is a relationship between an unfavourable working environment and irritableness of sisters.

  12. 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.

  13. A randomised trial of the effect and cost-effectiveness of early intensive multifactorial therapy on 5-year cardiovascular outcomes in individuals with screen-detected type 2 diabetes: the Anglo-Danish-Dutch Study of Intensive Treatment in People with Screen-Detected Diabetes in Primary Care (ADDITION-Europe) study.

    PubMed Central

    Simmons, Rebecca K; Borch-Johnsen, Knut; Lauritzen, Torsten; Rutten, Guy Ehm; Sandbæk, Annelli; van den Donk, Maureen; Black, James A; Tao, Libo; Wilson, Edward Cf; Davies, Melanie J; Khunti, Kamlesh; Sharp, Stephen J; Wareham, Nicholas J; Griffin, Simon J

    2016-01-01

    BACKGROUND Intensive treatment (IT) of cardiovascular risk factors can halve mortality among people with established type 2 diabetes but the effects of treatment earlier in the disease trajectory are uncertain. OBJECTIVE To quantify the cost-effectiveness of intensive multifactorial treatment of screen-detected diabetes. DESIGN Pragmatic, multicentre, cluster-randomised, parallel-group trial. SETTING Three hundred and forty-three general practices in Denmark, the Netherlands, and Cambridge and Leicester, UK. PARTICIPANTS Individuals aged 40-69 years with screen-detected diabetes. INTERVENTIONS Screening plus routine care (RC) according to national guidelines or IT comprising screening and promotion of target-driven intensive management (medication and promotion of healthy lifestyles) of hyperglycaemia, blood pressure and cholesterol. MAIN OUTCOME MEASURES The primary end point was a composite of first cardiovascular event (cardiovascular mortality/morbidity, revascularisation and non-traumatic amputation) during a mean [standard deviation (SD)] follow-up of 5.3 (1.6) years. Secondary end points were (1) all-cause mortality; (2) microvascular outcomes (kidney function, retinopathy and peripheral neuropathy); and (3) patient-reported outcomes (health status, well-being, quality of life, treatment satisfaction). Economic analyses estimated mean costs (UK 2009/10 prices) and quality-adjusted life-years from an NHS perspective. We extrapolated data to 30 years using the UK Prospective Diabetes Study outcomes model [version 1.3; (©) Isis Innovation Ltd 2010; see www.dtu.ox.ac.uk/outcomesmodel (accessed 27 January 2016)]. RESULTS We included 3055 (RC, n = 1377; IT, n = 1678) of the 3057 recruited patients [mean (SD) age 60.3 (6.9) years] in intention-to-treat analyses. Prescription of glucose-lowering, antihypertensive and lipid-lowering medication increased in both groups, more so in the IT group than in the RC group. There were clinically important improvements

  14. A randomised trial of the effect and cost-effectiveness of early intensive multifactorial therapy on 5-year cardiovascular outcomes in individuals with screen-detected type 2 diabetes: the Anglo-Danish-Dutch Study of Intensive Treatment in People with Screen-Detected Diabetes in Primary Care (ADDITION-Europe) study.

    PubMed Central

    Simmons, Rebecca K; Borch-Johnsen, Knut; Lauritzen, Torsten; Rutten, Guy Ehm; Sandbæk, Annelli; van den Donk, Maureen; Black, James A; Tao, Libo; Wilson, Edward Cf; Davies, Melanie J; Khunti, Kamlesh; Sharp, Stephen J; Wareham, Nicholas J; Griffin, Simon J

    2016-01-01

    BACKGROUND Intensive treatment (IT) of cardiovascular risk factors can halve mortality among people with established type 2 diabetes but the effects of treatment earlier in the disease trajectory are uncertain. OBJECTIVE To quantify the cost-effectiveness of intensive multifactorial treatment of screen-detected diabetes. DESIGN Pragmatic, multicentre, cluster-randomised, parallel-group trial. SETTING Three hundred and forty-three general practices in Denmark, the Netherlands, and Cambridge and Leicester, UK. PARTICIPANTS Individuals aged 40-69 years with screen-detected diabetes. INTERVENTIONS Screening plus routine care (RC) according to national guidelines or IT comprising screening and promotion of target-driven intensive management (medication and promotion of healthy lifestyles) of hyperglycaemia, blood pressure and cholesterol. MAIN OUTCOME MEASURES The primary end point was a composite of first cardiovascular event (cardiovascular mortality/morbidity, revascularisation and non-traumatic amputation) during a mean [standard deviation (SD)] follow-up of 5.3 (1.6) years. Secondary end points were (1) all-cause mortality; (2) microvascular outcomes (kidney function, retinopathy and peripheral neuropathy); and (3) patient-reported outcomes (health status, well-being, quality of life, treatment satisfaction). Economic analyses estimated mean costs (UK 2009/10 prices) and quality-adjusted life-years from an NHS perspective. We extrapolated data to 30 years using the UK Prospective Diabetes Study outcomes model [version 1.3; (©) Isis Innovation Ltd 2010; see www.dtu.ox.ac.uk/outcomesmodel (accessed 27 January 2016)]. RESULTS We included 3055 (RC, n = 1377; IT, n = 1678) of the 3057 recruited patients [mean (SD) age 60.3 (6.9) years] in intention-to-treat analyses. Prescription of glucose-lowering, antihypertensive and lipid-lowering medication increased in both groups, more so in the IT group than in the RC group. There were clinically important improvements

  15. Self-esteem and the evaluation of ethnic identity among Turkish and Dutch adolescents in The Netherlands.

    PubMed

    Verkuyten, M

    1990-06-01

    A nationwide sample of Turkish and Dutch adolescents was used to answer two questions. Do Turkish youths in the Netherlands demonstrate negative effects of minority status on global self-esteem or specific components of self-esteem? What is the meaning of ethnic identity for the self-concept of these youngsters? The results showed that Turkish adolescents had a lower score for global self-esteem and a higher score for three components--academic ability, sports achievements, and evaluation of one's ethnic identity. However, in terms of the percentage of variance explained, the differences were very small. The results also showed that ethnic identity was a more salient and more important aspect of self-concept for the Turkish subjects than for the Dutch. It was not, however, a dominant component of their self-concept: The other components had a greater impact on global self-esteem. Body image was the most important component in this respect.

  16. Dutch and English Demonstratives: A Comparison.

    ERIC Educational Resources Information Center

    Piwek, P. L. A.; Cremers, A. H. M.

    1996-01-01

    Examines the differences between English and Dutch demonstratives and concludes that English proximate demonstratives ("this") are used when the referent is identifiable by the addressee, whereas in Dutch they are used for low-accessibility referents, as opposed to distal demonstratives ("that") that are also used for readily accessible terms. (11…

  17. Randomised trials for the Fitbit generation

    PubMed Central

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

    2016-01-01

    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. PMID:26807137

  18. Seven myths of randomisation in clinical trials.

    PubMed

    Senn, Stephen

    2013-04-30

    I consider seven misunderstandings that may be encountered about the nature, purpose and properties of randomisation in clinical trials. Some concern the practical realities of clinical research on patients. Others are to do with the value and purpose of balance. Still others are to do with a confusion about the role of conditioning in valid statistical inference. I consider a simple game of chance involving two dice to illustrate some points about inference and then consider the seven misunderstandings in turn. I conclude that although one should not make a fetish of randomisation, when proposing alternatives to randomisation in clinical trials, one should be very careful to be precise about the exact nature of the alternative being considered if one is to avoid the danger of underestimating the advantages that randomisation can offer. PMID:23255195

  19. 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.

  20. A case against Dutch euthanasia.

    PubMed

    Fenigsen, Richard

    1989-01-01

    The growing acceptance of voluntary active euthanasia by the Dutch is examined in relation to the plastic cards requesting active euthanasia carried by many people in The Netherlands, public opinion polls, and support by leading medical figures of the movement to legalize euthanasia. The author draws upon his experience as a hospital doctor to condemn the practice of active euthanasia, arguing that its voluntariness is often counterfeit and always questionable, that it is inseparable from overtly involuntary forms of euthanasia, and that its promise of sparing the sick person agony is false. "Voluntary" euthanasia also brings an ominous change in society because of the message it sends to the elderly and sick, the weak and the dependent; because the fallibility of medical judgments are inconsistent with the irreversibility of the act; and because the fallacious reasoning of the philosophy threatens to cause irreparable damage to the medical profession.

  1. [Teledermatology within Dutch nursing homes].

    PubMed

    Lubeek, Satish F K; Mommers, Roland J M; van der Geer, Eric R; van de Kerkhof, Peter C M; Gerritsen, Marie-Jeanne Rianne P

    2016-06-01

    Skin problems are common within the nursing home population and could have a significant impact on quality of life. As a form of long-distance consultation teledermatology offers several potential benefits within this frail population. In this review we discuss several aspects of teledermatology, especially in relation to the nursing home population. Several studies demonstrated that teledermatology is a cost-effective and easy-to-use consultation method, which could significantly reduce the amount of hospital visits. However, teledermatology is only used in a limited number of Dutch nursing homes in daily practice due to several factors. For the optimal implementation of teledermatological consultation there are some important logistical, legal and financial framework conditions. In conclusion, teledermatology has a lot to offer within the nursing home population and therefore teledermatology will hopefully be increasingly used in daily practice within the near future. PMID:27098424

  2. Dutch research reforms cause a stir

    NASA Astrophysics Data System (ADS)

    van Calmthout, Martijn

    2015-02-01

    All 69 winners of the Spinoza prize - the highest award in Dutch science - have signed a petition against proposed reforms to the country's leading funding agency, the Netherlands Organisation for Scientific Research (NWO).

  3. [Dutch government invests in existing biobanks].

    PubMed

    Brandsma, Margreet; van Ommen, Gert-Jan B; Wijmenga, Cisca; Kiemeney, Lambertus A

    2010-01-01

    Modern research, aimed at discovering factors that influence health and disease, requires large collections of data and samples. Collaboration between biobanks is therefore essential. The Dutch hub in the network of biobanks, the Biobanking and Biomolecular Resources Research Infrastructure (BBMRI-NL), is one of the major Dutch biobanking initiatives. It is sponsored by the Dutch government through the Netherlands Organization for Scientific Research (NWO). BBMRI-NL sets up collaboration between approximately 150 existing clinical and population biobanks in the Netherlands, and forms the link with the European BBMRI initiative. BBMRI-NL aims at enrichment and harmonization of existing Dutch biobanks, at data management and analysis, and at laying the legal, social and ethical foundations, in order to improve access and inter-operability, and to render the information and organization up to date. Other major Dutch initiatives are String of Pearls and LifeLines. Together these will create the conditions needed for Dutch researchers to further develop their strong position in the international biobanking field.

  4. Ethnic Identity, Externalizing Problem Behaviour and the Mediating Role of Self-Esteem among Dutch, Turkish-Dutch and Moroccan-Dutch Adolescents

    ERIC Educational Resources Information Center

    Wissink, Inge B.; Dekovic, Maja; Yagmur, Sengul; Stams, Geert Jan; de Haan, Mariette

    2008-01-01

    The present study examined whether self-esteem mediates the relationship between two aspects of ethnic identity (i.e. ethnic identity exploration and ethnic identity commitment-affirmation) and externalizing problem behaviour in Dutch, Turkish-Dutch and Moroccan-Dutch adolescents living in the Netherlands. A total number of 345 adolescents (115…

  5. 76 FR 22409 - Nationwide Cyber Security Review (NCSR) Assessment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-21

    ... SECURITY Nationwide Cyber Security Review (NCSR) Assessment AGENCY: National Protection and Programs.... SUMMARY: The Department of Homeland Security (DHS), National Protection and Programs Directorate (NPPD), Office of Cybersecurity and Communications (CS&C), National Cyber Security Division (NCSD),...

  6. Partial validation of the Dutch model for emission and transport of nutrients (STONE).

    PubMed

    Overbeek, G B; Tiktak, A; Beusen, A H; van Puijenbroek, P J

    2001-11-17

    The Netherlands has to cope with large losses of N and P to groundwater and surface water. Agriculture is the dominant source of these nutrients, particularly with reference to nutrient excretion due to intensive animal husbandry in combination with fertilizer use. The Dutch government has recently launched a stricter eutrophication abatement policy to comply with the EC nitrate directive. The Dutch consensus model for N and P emission to groundwater and surface water (STONE) has been developed to evaluate the environmental benefits of abatement plans. Due to the possibly severe socioeconomic consequences of eutrophication abatement plans, it is of utmost importance that the model is thoroughly validated. Because STONE is applied on a nationwide scale, the model validation has also been carried out on this scale. For this purpose the model outputs were compared with lumped results from monitoring networks in the upper groundwater and in surface waters. About 13,000 recent point source observations of nitrate in the upper groundwater were available, along with several hundreds of observations showing N and P in local surface water systems. Comparison of observations from the different spatial scales available showed the issue of scale to be important. Scale issues will be addressed in the next stages of the validation study.

  7. 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.

  8. 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

  9. 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

  10. 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

  11. 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

  12. 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…

  13. Tolerance at arm's length: the Dutch experience.

    PubMed

    Schuijer, J

    1990-01-01

    With respect to pedophilia and the age of consent, the Netherlands warrants special attention. Although pedophilia is not as widely accepted in the Netherlands as sometimes is supposed, developments in the judicial practice showed a growing reservedness. These developments are a spin-off of related developments in Dutch society. The tolerance in the Dutch society has roots that go far back in history and is also a consequence of the way this society is structured. The social changes of the sixties and seventies resulted in a "tolerance at arm's length" for pedophiles, which proved to be deceptive when the Dutch government proposed to lower the age of consent in 1985. It resulted in a vehement public outcry. The prevailing sex laws have been the prime target of protagonists of pedophile emancipation. Around 1960, organized as a group, they started to undertake several activities. In the course of their existence, they came to redefine the issue of pedophilia as one of youth emancipation.

  14. [Organization of the Dutch Cat Fancy].

    PubMed

    Gerrits, P O

    1998-11-01

    The present study of the foundation 'Overleg Platform van de Nederlandse Cat Fancy' describes the organization and structure of the Dutch Cat Fancy, and is subdivided into three parts. The first part presents a survey of the number of cat clubs, date of their establishment, number of members, associated breed clubs and participation in the foundation 'Overleg Platform van de Nederlandse Cat Fancy'. The second part describes the basic organization of Dutch cat clubs, including their membership, cattery registration, breed registration, exhibitions and judges, cat magazines, health care and welfare, and breed clubs. The third part focuses attention on other organizational forms such as clubs for a particular breed, seen within the Dutch Cat Fancy.

  15. [The Dutch Cancer Society Cancer Risk Test].

    PubMed

    Elias, Sjoerd G; Grooters, Hilda G; Bausch-Goldbohm, R A Sandra; van den Brandt, Piet A; Kampman, Ellen; van Leeuwen, Flora E; Peeters, Petra H M; de Vries, Esther; Wigger, Stefan; Kiemeney, L A L M Bart

    2012-01-01

    The Dutch Cancer Society developed the 'KWF Kanker Risico Test' (Cancer Risk Test) to improve the information available to the Dutch population regarding cancer risk factors. This Internet test, based under licence on the American 'Your Disease Risk' test, informs users about risk factors for 12 common types of cancer. The test provides an estimate of individual risk of a specific type of cancer and gives specific lifestyle advice that could lower that risk. This paper describes the development of the test, how it works, and its strengths and limitations.

  16. The Dutch penal law and homosexual conduct.

    PubMed

    Salden, M

    The history of changes in Dutch penal law regulating homosexual conduct since the 18th century are traced and their effects on homosexual behavior described. Changes in policies and practices regarding enforcement are reviewed. The article discusses the Dutch criminal code of 1886, the criminalization of homosexual contacts involving minors in 1911, the criminalization of male homosexuality from 1941 to 1945, and the progressive relaxation of the law since World War II, resulting in the decriminalization in 1971 of homosexual contacts involving minors and the draft in 1981 for a bill that would prohibit discrimination against homosexuals.

  17. National identification of Dutch youth: an exploratory study.

    PubMed

    Oppenheimer, Louis

    2011-06-01

    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 adolescents' identification with The Netherlands and to explore whether changes in aspects of national identification are evident across age. Already at age 8 years children identify themselves with the Dutch nation and with increasing age national identification becomes primarily determined by the extent that participants consider themselves to be Dutch and show positive affect towards the Dutch nation. Identification on the basis of cultural and historical achievements of the Dutch people became less evident following the age of 10 years although Dutch historical and cultural achievements contributed significantly to the extent of national identification.

  18. The Dutch Experience with Weighted Student Funding

    ERIC Educational Resources Information Center

    Fiske, Edward B.; Ladd, Helen F.

    2010-01-01

    Weighted student funding (WSF) is used in several U.S. cities as a method for providing more funds to schools with high concentrations of disadvantaged students. The practice has been used successfully in the Netherlands since 1985. Several factors make the success of the Dutch system unlikely to transfer to the United States, including the Dutch…

  19. Dutch Universities' Joint Aid to Vietnam

    ERIC Educational Resources Information Center

    Higher Education and Research in the Netherlands, 1975

    1975-01-01

    A survey is presented of the joint aid in the reconstruction of North and South Vietnam provided by Dutch universities. The hospital project, solid matter physics project, micro-electronics project, agricultural project and dentistry project are defined. (Author/PG)

  20. 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…

  1. 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

  2. Management Development from a Dutch Perspective.

    ERIC Educational Resources Information Center

    Paauwe, Jaap, Ed.; Williams, Roger, Ed.

    2001-01-01

    Includes "Seven Key Issues for Management Development" (Paauwe, Williams); "Typology of Management Development" (Jansen, van der Velde, Mul); "Management Development at Royal Dutch/Shell" (Mahieu); "Management Development in Unilever" (Reitsma); "International Co-ordination and Management Development" (Hoeksema, de Jong); "Breaking in of New…

  3. 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…

  4. 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. PMID:16928417

  5. 75 FR 39589 - Nationwide Life Insurance Company,et al.; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-09

    ... COMMISSION Nationwide Life Insurance Company, et al.; Notice of Application July 2, 2010. AGENCY: The... thereunder. Applicants: Nationwide Life Insurance Company (``NWL''); Nationwide Variable Account-II (the... life insurance company organized under the laws of the State of Ohio.\\1\\ NWL offers traditional...

  6. Educational Credentials in Employment: A Nationwide Survey. GED Research Brief.

    ERIC Educational Resources Information Center

    Malizio, Andrew G.; Whitney, Douglas R.

    A nationwide survey examined the role of educational credentials in the employment practices of private sector companies and institutions. In September 1983, surveys were mailed to a random sample of 1,500 members of the American Society for Personnel Administration. A follow-up mailing was conducted a month later. A total of 643 completed surveys…

  7. Prospective Nationwide Study of Aeromonas Infections in France▿

    PubMed Central

    Lamy, Brigitte; Kodjo, Angeli; Laurent, Frédéric

    2009-01-01

    We report a systematic prospective multicenter nationwide study of clinical Aeromonas infections in France. During 6 months (May to October 2006), 78 cases of aeromonosis were reviewed for risk factors and clinical, microbiological, and antimicrobial susceptibility data. They included wound infections (44%), bacteremia (26%), enteritis (19%), respiratory tract infections (6%), and miscellaneous (5%) infections. PMID:19244464

  8. 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…

  9. Student Consumer Knowledge: Results of a Nationwide Test.

    ERIC Educational Resources Information Center

    Brobeck, Stephen

    A nationwide test of consumer knowledge of high school students conducted in 1991 found that seniors are unprepared for critical purchasing decisions needed after they graduate. Random samples of the population, 428 high school seniors, were asked 250 questions about a range of consumer subjects such as credit, checking/saving accounts, auto…

  10. 78 FR 22554 - Nationwide Differential Global Positioning System (NDGPS)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-16

    ... records notice regarding our public dockets in the January 17, 2008 issue of the Federal Register (73 FR... needs and systems requirements of the inland (terrestrial) component of the NDGPS (72 FR 42219). On... Nationwide Differential Global Positioning System (NDGPS) AGENCY: Coast Guard, DHS and Research...

  11. 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…

  12. 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…

  13. Variability in treatment advice for elderly patients with aortic stenosis: a nationwide survey in the Netherlands

    PubMed Central

    Bouma, B; van der Meulen, J H P; van den Brink, R B A; Arnold, A; Smidts, A; Teunter, L; Lie, K; Tijssen, J

    2001-01-01

    OBJECTIVE—To determine how the decisions of Dutch cardiologists on surgical treatment for aortic stenosis were influenced by the patient's age, cardiac signs and symptoms, and comorbidity; and to identify groups of cardiologists whose responses to these clinical characteristics were similar.
DESIGN—A questionnaire was produced asking cardiologists to indicate on a six point scale whether they would advise cardiac surgery for each of 32 case vignettes describing 10 clinical characteristics.
SETTING—Nationwide postal survey among all 530 cardiologists in the Netherlands.
RESULTS—52% of the cardiologists responded. There was wide variability in the cardiologists' advice for the individual case vignettes. Six groups of cardiologists explained 60% of the variance. The age of the patient was most important for 41% of the cardiologists; among these, 50% had a high and 50% a low inclination to advise surgery. A further 24% were influenced equally by the patient's age and by the severity of the aortic stenosis and its effect on left ventricular function; among these, 62% had a high and 38% a low inclination to advise surgery. Finally, 23% of the cardiologists were mainly influenced by the left ventricular function and 12% by the aortic valve area. The presence of comorbidity always played a minor role.
CONCLUSIONS—There were systematic differences among groups of cardiologists in their inclination to advise aortic valve replacement for elderly patients, as well as in the way their advice was influenced by the patients' characteristics. These results indicate the need for prospective studies to identify the best treatment for elderly patients according to their clinical profile.


Keywords: aortic stenosis; aortic valve replacement; elderly patients; clinical decision making PMID:11156672

  14. Pancreatitis, very early compared with normal start of enteral feeding (PYTHON trial): design and rationale of a randomised controlled multicenter trial

    PubMed Central

    2011-01-01

    Background In predicted severe acute pancreatitis, infections have a negative effect on clinical outcome. A start of enteral nutrition (EN) within 24 hours of onset may reduce the number of infections as compared to the current practice of starting an oral diet and EN if necessary at 3-4 days after admission. Methods/Design The PYTHON trial is a randomised controlled, parallel-group, superiority multicenter trial. Patients with predicted severe acute pancreatitis (Imrie-score ≥ 3 or APACHE-II score ≥ 8 or CRP > 150 mg/L) will be randomised to EN within 24 hours or an oral diet and EN if necessary, after 72 hours after hospital admission. During a 3-year period, 208 patients will be enrolled from 20 hospitals of the Dutch Pancreatitis Study Group. The primary endpoint is a composite of mortality or infections (bacteraemia, infected pancreatic or peripancreatic necrosis, pneumonia) during hospital stay or within 6 months following randomisation. Secondary endpoints include other major morbidity (e.g. new onset organ failure, need for intervention), intolerance of enteral feeding and total costs from a societal perspective. Discussion The PYTHON trial is designed to show that a very early (< 24 h) start of EN reduces the combined endpoint of mortality or infections as compared to the current practice of an oral diet and EN if necessary at around 72 hours after admission for predicted severe acute pancreatitis. Trial Registration ISRCTN: ISRCTN18170985 PMID:21392395

  15. 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

  16. Randomised Controlled Trials in Education Research: A Case Study of an Individually Randomised Pragmatic Trial

    ERIC Educational Resources Information Center

    Torgerson, Carole J.

    2009-01-01

    The randomised controlled trial (RCT) is an evaluative method used by social scientists in order to establish whether or not an intervention is effective. This contribution discusses the fundamental aspects of good RCT design. These are illustrated through the use of a recently completed RCT which evaluated an information and communication…

  17. 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

  18. 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.

  19. 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.

  20. Nationwide residues of organochlorine compounds in starlings (Sturnus vulgaris), 1976

    USGS Publications Warehouse

    White, D.H.

    1979-01-01

    Organochlorine pesticide and PCB residues in starlings from 126 sites within the contiguous 48 states were monitored during fall 1976. The average nationwide level of DDE and PCBs has increased significantly since 1974, but the number of sites reporting PCB residues has decreased fivefold. Dieldrin residues have remained unchanged since 1974. Highest DDE levels occurred in samples from parts of Arizona, Arkansas, California, Louisiana, and New Mexico.

  1. 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.

  2. LP-gas marketers nationwide reveal hardships encountered during crisis

    SciTech Connect

    Not Available

    1990-04-01

    The authors report on a survey of 150 randomly-selected LP-gas marketers nationwide. Replies were solicited from every major geographical region. The purpose of the survey was to obtain a comprehensive sampling of information on local price increases, shipping difficulties, relations with customers, and strategies for the future. This paper presents a profile that sums up the effects of the propane emergency on marketers and customers.

  3. Verb inflection in Monolingual Dutch and Sequential Bilingual Turkish-Dutch Children with and without SLI

    ERIC Educational Resources Information Center

    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…

  4. 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,…

  5. 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

  6. Dutch Elementary School Children's Attribution of Meaning to Written Pseudowords

    ERIC Educational Resources Information Center

    Tellings, Agnes; Bouts, Lex

    2011-01-01

    Grade two through six elementary school Dutch children were asked to perform a lexical decision task including 90 pseudowords constructed by changing one or two letters in a Dutch word. Subsequently, the children were asked about the meaning of pseudowords they had not crossed out and that they, apparently, had considered to be words. Multiple…

  7. 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…

  8. Units of Analysis in Reading Dutch Bisyllabic Pseudowords

    ERIC Educational Resources Information Center

    Verhoeven, Ludo; Schreuder, Robert; Baayen, Harald

    2003-01-01

    Two experiments were carried out to explore the units of analysis used by children to read Dutch bisyllabic pseudowords. Although Dutch orthography is highly regular, several deviations from a one-to-one correspondence occur. In polysyllabic words, the grapheme e may represent three different vowels: /e/, /e/, or [/schwa/]. In Experiment 1, Grade…

  9. Parental Reports of Symptoms of Childhood Disorders in Dutch Children

    ERIC Educational Resources Information Center

    Scholte, Evert M.; Van Berckelaer-Onnes, Ina A.; Van der Ploeg, Jan D.; Van den Bergh, Peter M.

    2008-01-01

    The number of children displaying childhood disorders in the Netherlands is estimated through a questionnaire referencing DSM-IV symptoms filled out by the parents of 2,563 4-18-year-old Dutch children randomly taken from the general Dutch Youth population in 2004. The number of impaired children was estimated by applying the DSM-IV criteria for…

  10. 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…

  11. 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" voyage or…

  12. 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".…

  13. Prefix Identification in the Reading of Dutch Bisyllabic Words

    ERIC Educational Resources Information Center

    Verhoeven, Ludo; Schreuder, Robert; Haarman, Vera

    2006-01-01

    Two experiments were conducted in order to explore the role of prefix identification in the reading of Dutch bisyllabic words. Although Dutch orthography is highly regular, several deviations from a one-to-one correspondence exist. A case in point is the grapheme E which can represent the vowels epsilon, e and oe in polysyllabic words. In…

  14. Randomised controlled trial of brief neonatal exposure to cows' milk on the development of atopy

    PubMed Central

    de Jong, M. H; Linden, V.; Aalberse, R.; Oosting, J.; Tijssen, J.; de Groot, C. J

    1998-01-01

    OBJECTIVE—To determine the effect of brief early exposure to cows' milk on atopy in the first 2 years of life.
DESIGN—Double blind, placebo controlled, randomised feeding intervention trial (Bokaal study).
SETTING—Dutch midwifery practices.
PARTICIPANTS—1533 breast fed neonates.
INTERVENTION—Exposure to cows' milk protein (n = 758) or a protein free placebo (n = 775) during the first 3 days of life.
MAIN OUTCOME MEASURES—Clinical atopic disease and any positive radioallergosorbent (RAST) tests at 1 year of age.
RESULTS—Atopic disease in the first year was found in 10.0% (cows' milk) v 9.3% (placebo) of the children, with a relative risk of 1.07; in the second year, atopic disease was found in 9.6% v 10.2%, respectively, with a relative risk of 0.94. Per protocol analysis showed similar results. Any RAST positive test was found in 9.4% (cows' milk) v 7.9% (placebo) of children, with a relative risk of 1.19. Stratified analysis for high family risk of allergy showed a doubled incidence of atopic disease but no effect from the intervention.
CONCLUSION—Early and brief exposure to cows' milk in breast fed children does not increase the risk of atopic disease in the first 2years.

 PMID:9797592

  15. 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

  16. How important is randomisation in a stepped wedge trial?

    PubMed

    Hargreaves, James R; Prost, Audrey; Fielding, Katherine L; Copas, Andrew J

    2015-01-01

    In cluster randomised trials, randomisation increases internal study validity. If enough clusters are randomised, an unadjusted analysis should be unbiased. If a smaller number of clusters are included, stratified or matched randomisation can increase comparability between trial arms. In addition, an adjusted analysis may be required; nevertheless, randomisation removes the possibility for systematically biased allocation and increases transparency. In stepped wedge trials, clusters are randomised to receive an intervention at different start times ('steps'), and all clusters eventually receive it. In a recent study protocol for a 'modified stepped wedge trial', the investigators considered randomisation of the clusters (hospital wards), but decided against it for ethical and logistical reasons, and under the assumption that it would not add much to the rigour of the evaluation. We show that the benefits of randomisation for cluster randomised trials also apply to stepped wedge trials. The biggest additional issue for stepped wedge trials in relation to parallel cluster randomised trials is the need to control for secular trends in the outcome. Analysis of stepped wedge trials can in theory be based on 'horizontal' or 'vertical' comparisons. Horizontal comparisons are based on measurements taken before and after the intervention is introduced in each cluster, and are unbiased if there are no secular trends. Vertical comparisons are based on outcome measurements from clusters that have switched to the intervention condition and those from clusters that have yet to switch, and are unbiased under randomisation since at any time point, which clusters are in intervention and control conditions will have been determined at random. Secular outcome trends are a possibility in many settings. Many stepped wedge trials are analysed with a mixed model, including a random effect for cluster and fixed effects for time period to account for secular trends, thereby combining both

  17. 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'. PMID:23707157

  18. 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

  19. DANBIO: a nationwide registry of biological therapies in Denmark.

    PubMed

    Hetland, M L

    2005-01-01

    Since the year 2000, Danish rheumatologists have been collecting data on a routine basis in the nationwide DANBIO registry, which includes all rheumatologic patients receiving biological drugs. Demographic data, markers of disease activity, current treatment, serious and non-serious adverse events and reasons for discontinuation are registered at each visit either on paper forms or on-line. By June 2005, approximately 3000 treatment courses (18,000 visits) were in the registry, corresponding to close to 90% of eligible patients. Rheumatoid arthritis was the most prevalent diagnosis (75%) followed by ankylosing spondylitis (11%) and psoriatic arthritis (7%). Infections occurred in 43% of the treatment series. PMID:16273809

  20. Lessons from randomised direct comparative trials.

    PubMed

    Achiron, Anat; Fredrikson, Sten

    2009-02-01

    For over a decade, four immunomodulatory therapies have been available for the treatment of relapsing remitting multiple sclerosis. However, few direct comparative data were available to facilitate the choice of treatment. This choice has been influenced by the perception that interferon-beta preparations have greater efficacy than glatiramer acetate, due to apparently more rapid and robust reduction of gadolinium-enhancing lesions seen on magnetic resonance imaging in the pivotal trials of these agents. This situation has changed in the last year, with the outcomes of three randomised clinical trials comparing the efficacy and safety of glatiramer acetate with that of a high-dose interferon-beta in relapsing remitting multiple sclerosis. These are the REGARD, BEYOND and BECOME trials. In the REGARD trial, 764 patients were randomised to treatment with either interferon-beta 1a sc 44 microg or glatiramer acetate for 96 weeks; no significant difference in the time to first relapse was observed. The largest of the three comparative studies, the BEYOND trial, compared treatment with interferon-beta 1b sc 500 microg, interferon-beta 1b sc 250 microg or glatiramer acetate for two years in 2,244 patients. The hazard ratio for multiple relapses was close to unity for comparisons between all groups, indicating equivalent efficacy in all three treatment arms. Relapse rates (around 0.3 relapses/year) in all these studies were much lower than anticipated and lower than those reported a decade previously in the pivotal trials of beta-interferons and glatiramer acetate. No unexpected safety issues were identified in any of these studies. The completion of these direct comparative studies has considerably enriched the clinical evidence database by contributing large numbers of patients. This provides an invaluable contribution for helping the physician make an informed choice about treatment. The results of the direct comparative studies provide evidence that glatiramer acetate

  1. Dutch X-band SLAR calibration

    NASA Technical Reports Server (NTRS)

    Groot, J. S.

    1990-01-01

    In August 1989 the NASA/JPL airborne P/L/C-band DC-8 SAR participated in several remote sensing campaigns in Europe. Amongst other test sites, data were obtained of the Flevopolder test site in the Netherlands on August the 16th. The Dutch X-band SLAR was flown on the same date and imaged parts of the same area as the SAR. To calibrate the two imaging radars a set of 33 calibration devices was deployed. 16 trihedrals were used to calibrate a part of the SLAR data. This short paper outlines the X-band SLAR characteristics, the experimental set-up and the calibration method used to calibrate the SLAR data. Finally some preliminary results are given.

  2. Material efficiency in Dutch packaging policy.

    PubMed

    Worrell, Ernst; van Sluisveld, Mariësse A E

    2013-03-13

    Packaging materials are one of the largest contributors to municipal solid waste generation. In this paper, we evaluate the material impacts of packaging policy in The Netherlands, focusing on the role of material efficiency (or waste prevention). Since 1991, five different policies have been implemented to reduce the environmental impact of packaging. The analysis shows that Dutch packaging policies helped to reduce the total packaging volume until 1999. After 2000, packaging consumption increased more rapidly than the baseline, suggesting that policy measures were not effective. Generally, we see limited attention to material efficiency to reduce packaging material use. For this purpose, we tried to gain more insight in recent activities on material efficiency, by building a database of packaging prevention initiatives. We identified 131 alterations to packaging implemented in the period 2005-2010, of which weight reduction was the predominant approach. More appropriate packaging policy is needed to increase the effectiveness of policies, with special attention to material efficiency. PMID:23359741

  3. 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.

  4. Moral problems among Dutch nurses: a survey.

    PubMed

    van der Arend, A J; Remmers-van den Hurk, C H

    1999-11-01

    This article reports on a survey of the moral problems that Dutch nurses experience during their everyday practice. A questionnaire was developed, based on published literature, panel discussions, in-depth interviews and participation observations. The instrument was tested in a pilot study and proved to be useful. A total of 2122 questionnaires were sent to 91 institutions in seven different health care settings. The results showed that nurses were not experiencing important societal issues such as abortion and euthanasia as morally the most problematic, but rather situations such as verbally aggressive behaviour of colleagues towards patients, keeping silent about errors, and medical treatment given against the wishes of patients. Moral problems occurred especially when nurses experienced feelings of powerlessness with regard to the well-being of patients. Moreover, these moral problems proved to be related to institutional organization, leadership, and collaboration with colleagues and other disciplines. Nurses appeared to have a limited awareness of the moral dimensions of their practice.

  5. 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.

  6. 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. PMID:3334084

  7. 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

  8. Applying the intention-to-treat principle in practice: Guidance on handling randomisation errors

    PubMed Central

    Sullivan, Thomas R; Voysey, Merryn; Lee, Katherine J; Cook, Jonathan A; Forbes, Andrew B

    2015-01-01

    Background: The intention-to-treat principle states that all randomised participants should be analysed in their randomised group. The implications of this principle are widely discussed in relation to the analysis, but have received limited attention in the context of handling errors that occur during the randomisation process. The aims of this article are to (1) demonstrate the potential pitfalls of attempting to correct randomisation errors and (2) provide guidance on handling common randomisation errors when they are discovered that maintains the goals of the intention-to-treat principle. Methods: The potential pitfalls of attempting to correct randomisation errors are demonstrated and guidance on handling common errors is provided, using examples from our own experiences. Results: We illustrate the problems that can occur when attempts are made to correct randomisation errors and argue that documenting, rather than correcting these errors, is most consistent with the intention-to-treat principle. When a participant is randomised using incorrect baseline information, we recommend accepting the randomisation but recording the correct baseline data. If ineligible participants are inadvertently randomised, we advocate keeping them in the trial and collecting all relevant data but seeking clinical input to determine their appropriate course of management, unless they can be excluded in an objective and unbiased manner. When multiple randomisations are performed in error for the same participant, we suggest retaining the initial randomisation and either disregarding the second randomisation if only one set of data will be obtained for the participant, or retaining the second randomisation otherwise. When participants are issued the incorrect treatment at the time of randomisation, we propose documenting the treatment received and seeking clinical input regarding the ongoing treatment of the participant. Conclusion: Randomisation errors are almost inevitable and

  9. 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

  10. 1. FRONT CORNER, LOOKING NORTHEAST, TOP HALF OF 'DUTCH DOORS' ...

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

    1. FRONT CORNER, LOOKING NORTHEAST, TOP HALF OF 'DUTCH DOORS' LEANING AGAINST FRONT WALL. - A. D. Wilcox Drift Mine, Boiler Cabin, Linda Creek near Dalton Highway, Bettles, Yukon-Koyukuk Census Area, AK

  11. Predicting naming latencies for action pictures: Dutch norms.

    PubMed

    Shao, Zeshu; Roelofs, Ardi; Meyer, Antje S

    2014-03-01

    The present study provides Dutch norms for age of acquisition, familiarity, imageability, image agreement, visual complexity, word frequency, and word length (in syllables) for 124 line drawings of actions. Ratings were obtained from 117 Dutch participants. Word frequency was determined on the basis of the SUBTLEX-NL corpus (Keuleers, Brysbaert, & New, Behavior Research Methods, 42, 643-650, 2010). For 104 of the pictures, naming latencies and name agreement were determined in a separate naming experiment with 74 native speakers of Dutch. The Dutch norms closely corresponded to the norms for British English. Multiple regression analysis showed that age of acquisition, imageability, image agreement, visual complexity, and name agreement were significant predictors of naming latencies, whereas word frequency and word length were not. Combined with the results of a principal-component analysis, these findings suggest that variables influencing the processes of conceptual preparation and lexical selection affect latencies more strongly than do variables influencing word-form encoding.

  12. 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

  13. 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...

  14. 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...

  15. 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-...

  16. 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...

  17. 33 CFR 330.5 - Issuing, modifying, suspending, or revoking nationwide permits and authorizations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., or revoking nationwide permits and authorizations. 330.5 Section 330.5 Navigation and Navigable....5 Issuing, modifying, suspending, or revoking nationwide permits and authorizations. (a) General... revoking NWPs and authorizations under NWPs. (b) Chief of Engineers. (1) Anyone may, at any time,...

  18. 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

    .../Whitepaper%20-%20Self%20Organizing%20Networks%20for%20In-Plant%20Applications.pdf . Meshing (ad-hoc device-to... Desirable Features of a Nationwide Public Safety Broadband Network AGENCY: National Institute of Standards... various possible features of a new nationwide interoperable public safety broadband network. This...

  19. Physical Activity during Cancer Treatment (PACT) Study: design of a randomised clinical trial

    PubMed Central

    2010-01-01

    Background Fatigue is a major problem of cancer patients. Thirty percent of cancer survivors report serious fatigue three years after finishing treatment. There is evidence that physical exercise during cancer treatment reduces fatigue. This may also lead to an improvement of quality of life. Such findings may result in a decrease of healthcare related expenditures and societal costs due to sick leave. However, no studies are known that investigated these hypotheses. Therefore, the primary aim of our study is to assess the effect of exercise during cancer treatment on reducing complaints of fatigue and on reducing health service utilisation and sick leave. Methods/Design The Physical Activity during Cancer Treatment study is a multicentre randomised controlled trial in 150 breast and 150 colon cancer patients undergoing cancer treatment. Participants will be randomised to an exercise or a control group. In addition to the usual care, the exercise group will participate in an 18-week supervised group exercise programme. The control group will be asked to maintain their habitual physical activity pattern. Study endpoints will be assessed after 18 weeks (short term) and after 9 months (long term). Validated questionnaires will be used. Primary outcome: fatigue (Multidimensional Fatigue Inventory and Fatigue Quality List) and cost-effectiveness, health service utilisation and sick leave. Secondary outcome: health related quality of life (European Organisation Research and Treatment of Cancer-Quality of Life questionnaire-C30, Short Form 36 healthy survey), impact on functioning and autonomy (Impact on functioning and autonomy questionnaire), anxiety and depression (Hospital Anxiety and Depression Scale), physical fitness (aerobic peak capacity, muscle strength), body composition and cognitive-behavioural aspects. To register health service utilisation and sick leave, participants will keep diaries including the EuroQuol-5D. Physical activity level will be measured

  20. Similar associations between personality dimensions and anxiety or depressive disorders in a population study of Turkish-Dutch, Moroccan-Dutch, and native Dutch subjects.

    PubMed

    Schrier, Agnes C; de Wit, Matty A S; Krol, Anneke; Fassaert, Thijs J L; Verhoeff, Arnoud P; Kupka, Ralph W; Dekker, Jack; Beekman, Aartjan T F

    2013-05-01

    It is well established that personality traits are associated with anxiety and depressive disorders in Western populations, but it is not known whether this is true also for people from non-Western cultures. In this study, we examined whether ethnicity moderates the association between personality dimensions and anxiety or depressive disorders or symptoms. In a random urban population sample, stratified by ethnicity, in Amsterdam, the Netherlands, we interviewed 309 native Dutch subjects, 203 Turkish-Dutch subjects, and 170 Moroccan-Dutch subjects. Dimensions of personality were measured using the NEO Five-Factor Inventory. Anxiety and depressive disorders and symptom levels were assessed with the Composite International Diagnostic Interview and the Symptom Checklist-90-Revised. The association between personality factors and disorders or symptoms of anxiety and depression was very similar in the three ethnic groups: all show the typical profile of high neuroticism and low extraversion, agreeableness, and conscientiousness.

  1. 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

  2. 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

  3. Sources of Bias in Outcome Assessment in Randomised Controlled Trials: A Case Study

    ERIC Educational Resources Information Center

    Ainsworth, Hannah; Hewitt, Catherine E.; Higgins, Steve; Wiggins, Andy; Torgerson, David J.; Torgerson, Carole J.

    2015-01-01

    Randomised controlled trials (RCTs) can be at risk of bias. Using data from a RCT, we considered the impact of post-randomisation bias. We compared the trial primary outcome, which was administered blindly, with the secondary outcome, which was not administered blindly. From 44 schools, 522 children were randomised to receive a one-to-one maths…

  4. 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

  5. A nation-wide study comparing sporadic and familial adenomatous polyposis-related desmoid-type fibromatoses.

    PubMed

    Nieuwenhuis, Marry H; Casparie, Mariel; Mathus-Vliegen, Lisbeth M H; Dekkers, Olaf M; Hogendoorn, Pancras C W; Vasen, Hans F A

    2011-07-01

    Desmoid-type fibromatoses are neoplasms of fibroblastic origin, occurring sporadically or associated with familial adenomatous polyposis (FAP) coli. By comparing sporadic and FAP-associated desmoid-type fibromatoses, we tried to identify clinical characteristics, which may indicate FAP. Histopathology data of all Dutch patients with desmoid-type fibromatoses diagnosed between 1999 and 2009 were retrieved from PALGA, the nation-wide network and registry of histopathology in the Netherlands. For calculation of incidence rates, person-years from the general matched population were used. Based on polyp counts in pathological records, the cohort was divided into a FAP group and a non-FAP group. Patient- and tumor characteristics were compared between the two groups. A total number of 519 patients older than 10 years with a confirmed diagnosis of desmoid-type fibromatoses were included. Thirty-nine (7.5%) desmoid patients were documented of having FAP. The incidences of sporadic and FAP-related desmoid-type fibromatoses were 3.42 and 2,784 per million person-years, respectively. The majority of FAP patients developed desmoid-type fibromatoses after the diagnosis of FAP. Having FAP was associated with male gender [odds ratio (OR) 2.0, p = 0.034], desmoid diagnosis at an earlier age (mean 36 vs. 42 years, p = 0.031), and desmoid localization intra-abdominally (OR 18.9, p ≤ 0.001) or in the abdominal wall (OR 4.8, p ≤ 0.001), compared to extra-abdominal desmoid localization. In conclusion, patients with desmoid-type fibromatoses are at risk of underlying FAP. Especially cases with desmoid localization intra-abdominal or in the abdominal wall, and all patients younger than 60 years, have a substantial increased risk and should be referred for colonoscopy.

  6. [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

  7. Cost savings of developmental screenings: Evidence from a nationwide program.

    PubMed

    Halla, Martin; Pruckner, Gerald J; Schober, Thomas

    2016-09-01

    Early intervention is considered the optimal response to developmental disorders in children. We evaluate a nationwide developmental screening program for preschoolers in Austria and the resulting interventions. Identification of treatment effects is determined by a birthday cutoff-based discontinuity in the eligibility for a financial incentive to participate in the screening. Assigned preschoolers are 14.5 percentage points more likely to participate in the program. For participants with high socio-economic status (SES), we find little evidence for interventions and consistently no effect on healthcare costs in the long run. For low SES preschoolers, we find evidence for substantial interventions, but only weak evidence for cost savings in the long run. PMID:27415588

  8. Ambulatory Care Visits to Pediatricians in Taiwan: A Nationwide Analysis

    PubMed Central

    Yang, Ling-Yu; Lynn, An-Min; Chen, Tzeng-Ji

    2015-01-01

    Pediatricians play a key role in the healthy development of children. Nevertheless, the practice patterns of pediatricians have seldom been investigated. The current study analyzed the nationwide profiles of ambulatory visits to pediatricians in Taiwan, using the National Health Insurance Research Database. From a dataset that was randomly sampled one out of every 500 records among a total of 309,880,000 visits in 2012 in the country, 9.8% (n = 60,717) of the visits were found paid to pediatricians. Children and adolescents accounted for only 69.3% of the visits to pediatricians. Male pediatricians provided 80.5% of the services and the main workforces were those aged 40–49 years. The most frequent diagnoses were respiratory tract diseases (64.7%) and anti-histamine agents were prescribed in 48.8% of the visits to pediatricians. Our detailed results could contribute to evidence-based discussions on health policymaking. PMID:26540064

  9. Cost savings of developmental screenings: Evidence from a nationwide program.

    PubMed

    Halla, Martin; Pruckner, Gerald J; Schober, Thomas

    2016-09-01

    Early intervention is considered the optimal response to developmental disorders in children. We evaluate a nationwide developmental screening program for preschoolers in Austria and the resulting interventions. Identification of treatment effects is determined by a birthday cutoff-based discontinuity in the eligibility for a financial incentive to participate in the screening. Assigned preschoolers are 14.5 percentage points more likely to participate in the program. For participants with high socio-economic status (SES), we find little evidence for interventions and consistently no effect on healthcare costs in the long run. For low SES preschoolers, we find evidence for substantial interventions, but only weak evidence for cost savings in the long run.

  10. Adjuvant systemic therapy in early breast cancer: impact of guideline changes and clinicopathological factors associated with nonadherence at a nation-wide level.

    PubMed

    Verschoor, A M F; Kuijer, A; Verloop, J; Van Gils, C H; Sonke, G S; Jager, A; van Dalen, T; Elias, S G

    2016-09-01

    Over recent years, adjuvant systemic treatment guidelines (AST) for early-stage breast cancer have changed considerably. We aimed to assess the impact of these guideline changes on the administration of AST in early-stage breast cancer patients and to what extent these guidelines are adhered to at a nation-wide level. We used Netherlands Cancer Registry data to describe trends in AST prescription, adherence to AST guidelines, and to identify clinicopathological determinants of nonadherence. Between 1990 and 2012, 231,648 Dutch patients were diagnosed with early breast cancer, of whom 124,472 received AST. Adjuvant endocrine treatment (ET) use increased from 23 % of patients (1990) to 56 % (2012), and chemotherapy from 11 to 44 %. In 2009-2012, 8 % of patients received ET and 3 % received chemotherapy without guideline indication. Conversely, 10-29 % of patients did not receive ET and chemotherapy, respectively, despite a guideline indication. Unfavorable clinicopathological characteristics generally decreased the chance of undertreatment and increased the chance for overtreatment. Remarkable was the increased chance of ET undertreatment in younger women (RR < 35 vs 60-69 years 1.79; 95 % CI 1.30-2.47) and in women with HER2+ disease (RR 1.64; 95 % CI 1.46-1.85). Over the years, AST guidelines expanded resulting in much more Dutch early breast cancer patients receiving AST. In the majority of cases, AST administration was guideline concordant, but the high frequency of chemotherapy undertreatment in some subgroups suggests limited AST guideline support in these patients. PMID:27514397

  11. From randomised trials to rational practice.

    PubMed

    van Gijn, J

    2005-01-01

    From the age of Enlightenment onwards, philosophical thinking has become increasingly influenced by empiricism: observations lead to theories, but experiments are needed to put the reasoning to the test. However, it was not until the middle of the 20th century that well-designed experiments were at last introduced in medical treatment, in the form of randomised controlled clinical trials. This design is now standard in medicine, but in everyday practice a multitude of management decisions must still be taken without good evidence. There are several reasons for this: there may not be a trial at all or only a single trial; trial results may be equivocal; patients may be different from those enrolled in trials; new procedures require practice, or a trial may not be feasible. 'Logical reasoning', with all its fallacies, is still required - not only to fill the gaps in empirical knowledge but also to interpret existing evidence and to plan new trials. In fact, the generation of new knowledge is a continuous, cyclical process in which newly gained insights in pathophysiology give rise to new therapeutic experiments, the results of which generate fresh hypotheses, and so on. Compassion, curiosity and doubt are the essential forces that keep the cycle moving. Conversely, the progress is slowed down by present-day legalism, which distorts investigator accountability and patient autonomy.

  12. Bicycle weight and commuting time: randomised trial

    PubMed Central

    2010-01-01

    Objective To determine whether the author’s 20.9 lb (9.5 kg) carbon frame bicycle reduced commuting time compared with his 29.75 lb (13.5 kg) steel frame bicycle. Design Randomised trial. Setting Sheffield and Chesterfield, United Kingdom, between mid-January 2010 and mid-July 2010. Participants One consultant in anaesthesia and intensive care. Main outcome measure Total time to complete the 27 mile (43.5 kilometre) journey from Sheffield to Chesterfield Royal Hospital and back. Results The total distance travelled on the steel frame bicycle during the study period was 809 miles (1302 km) and on the carbon frame bicycle was 711 miles (1144 km). The difference in the mean journey time between the steel and carbon bicycles was 00:00:32 (hr:min:sec; 95% CI –00:03:34 to 00:02:30; P=0.72). Conclusions A lighter bicycle did not lead to a detectable difference in commuting time. Cyclists may find it more cost effective to reduce their own weight rather than to purchase a lighter bicycle. PMID:21148220

  13. Cost-effectiveness of integrated COPD care: the RECODE cluster randomised trial

    PubMed Central

    Boland, Melinde R S; Kruis, Annemarije L; Tsiachristas, Apostolos; Assendelft, Willem J J; Gussekloo, Jacobijn; Blom, Coert M G; Chavannes, Niels H; Rutten-van Mölken, Maureen P M H

    2015-01-01

    Objectives To investigate the cost-effectiveness of a chronic obstructive pulmonary disease (COPD) disease management (COPD-DM) programme in primary care, called RECODE, compared to usual care. Design A 2-year cluster-randomised controlled trial. Setting 40 general practices in the western part of the Netherlands. Participants 1086 patients with COPD according to GOLD (Global Initiative for COPD) criteria. Exclusion criteria were terminal illness, cognitive impairment, alcohol or drug misuse and inability to fill in Dutch questionnaires. Practices were included if they were willing to create a multidisciplinary COPD team. Interventions A multidisciplinary team of caregivers was trained in motivational interviewing, setting up individual care plans, exacerbation management, implementing clinical guidelines and redesigning the care process. In addition, clinical decision-making was supported by feedback reports provided by an ICT programme. Main outcome measures We investigated the impact on health outcomes (quality-adjusted life years (QALYs), Clinical COPD Questionnaire, St. George's Respiratory Questionnaire and exacerbations) and costs (healthcare and societal perspective). Results The intervention costs were €324 per patient. Excluding these costs, the intervention group had €584 (95% CI €86 to €1046) higher healthcare costs than did the usual care group and €645 (95% CI €28 to €1190) higher costs from the societal perspective. Health outcomes were similar in both groups, except for 0.04 (95% CI −0.07 to −0.01) less QALYs in the intervention group. Conclusions This integrated care programme for patients with COPD that mainly included professionally directed interventions was not cost-effective in primary care. Trial registration number Netherlands Trial Register NTR2268. PMID:26525419

  14. 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

  15. Prehospital antiplatelet use and functional status on admission of patients with non-haemorrhagic moyamoya disease: a nationwide retrospective cohort study (J-ASPECT study)

    PubMed Central

    Onozuka, Daisuke; Hagihara, Akihito; Nishimura, Kunihiro; Kada, Akiko; Nakagawara, Jyoji; Ogasawara, Kuniaki; Ono, Junichi; Shiokawa, Yoshiaki; Aruga, Toru; Miyachi, Shigeru; Nagata, Izumi; Toyoda, Kazunori; Matsuda, Shinya; Suzuki, Akifumi; Kataoka, Hiroharu; Nakamura, Fumiaki; Kamitani, Satoru; Nishimura, Ataru; Kurogi, Ryota; Sayama, Tetsuro; Iihara, Koji

    2016-01-01

    Objectives To elucidate the association between antiplatelet use in patients with non-haemorrhagic moyamoya disease before hospital admission and good functional status on admission in Japan. Design Retrospective, multicentre, non-randomised, observational study. Setting Nationwide registry data in Japan. Participants A total of 1925 patients with non-haemorrhagic moyamoya disease admitted between 1 April 2012 and 31 March 2014 in Japan. Main outcome measure We performed propensity score-matched analysis to examine the association between prehospital antiplatelet use and no significant disability on hospital admission, as defined by a modified Rankin Scale score of 0 or 1. Results Propensity-matched patients who received prehospital antiplatelet drugs were associated with a good outcome on hospital admission (OR adjusted for all covariates, 3.82; 95% CI 1.22 to 11.99) compared with those who did not receive antiplatelet drugs prior to hospital admission. Conclusions Prehospital antiplatelet use was significantly associated with good functional status on hospital admission among patients with non-haemorrhagic moyamoya disease in Japan. Our results suggest that prehospital antiplatelet use should be considered when evaluating outcomes of patients with non-haemorrhagic moyamoya disease. PMID:27008684

  16. Rotterdam Aphasia Therapy Study (RATS) – 3: “The efficacy of intensive cognitive-linguistic therapy in the acute stage of aphasia”; design of a randomised controlled trial

    PubMed Central

    2013-01-01

    Background Aphasia is a severely disabling condition occurring in 20 to 25% of stroke patients. Most patients with aphasia due to stroke receive speech and language therapy. Methodologically sound randomised controlled trials investigating the effect of specific interventions for patients with aphasia following stroke are scarce. The currently available evidence suggests that intensive speech and language therapy is beneficial for restoration of communication, but the optimal timing of treatment is as yet unclear. In the Rotterdam Aphasia Therapy Study-3 we aim to test the hypothesis that patients with aphasia due to stroke benefit more from early intensive cognitive-linguistic therapy than from deferred regular language therapy. Methods/design In a single blinded, multicentre, randomised controlled trial, 150 patients with first ever aphasia due to stroke will be randomised within two weeks after stroke to either early intensive cognitive-linguistic therapy (Group A) or deferred regular therapy (Group B). Group A will start as soon as possible, at the latest two weeks after stroke, with a four week period of one hour a day treatment with cognitive-linguistic therapy. In Group B professional speech and language therapy is deferred for four weeks. After this period, patients will follow the conventional procedure of speech and language therapy. Participants will be tested with an extensive linguistic test battery at four weeks, three months and six months after inclusion. Primary outcome measure is the difference in score between the two treatment groups on the Amsterdam-Nijmegen Everyday Language Test, a measure of everyday verbal communication, four weeks after randomisation. Trial registration This trial is registered in the Dutch Trial Register (http://www.trialregister.nl), NTR3271. PMID:23343197

  17. 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

  18. 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…

  19. Acquiring Reading and Vocabulary in Dutch and English: The Effect of Concurrent Instruction

    ERIC Educational Resources Information Center

    van der Leij, Aryan; Bekebrede, Judith; Kotterink, Mieke

    2010-01-01

    To investigate the effect of concurrent instruction in Dutch and English on reading acquisition in both languages, 23 pupils were selected from a school with bilingual education, and 23 from a school with education in Dutch only. The pupils had a Dutch majority language background and were comparable with regard to social-economic status (SES).…

  20. Gender-Marked Determiners Help Dutch Learners' Word Recognition when Gender Information Itself Does Not

    ERIC Educational Resources Information Center

    van Heugten, Marieke; Johnson, Elizabeth K.

    2011-01-01

    Dutch, unlike English, contains two gender-marked forms of the definite article. Does the presence of multiple definite article forms lead Dutch learners to be delayed relative to English learners in the acquisition of their determiner system? Using the Preferential Looking Procedure, we found that Dutch-learning children aged 1 ; 7 to 2 ; 0 use…

  1. Cultural Perspectives on Peer Conflicts in Multicultural Dutch Child Care Centres

    ERIC Educational Resources Information Center

    Rourou, Amina; Singer, Elly; Bekkema, Nienke; De Haan, Dorian

    2006-01-01

    In this paper we discuss a study of cultural perspectives on peer conflicts in multicultural child care centres. On the level of child behaviour we did not find differences between native Dutch. Moroccan-Dutch and Antillean-Dutch children with regard to occurrence, duration and actions to solve peer conflicts. On the level of mother' opinions…

  2. 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…

  3. Shocked materials from the Dutch Peak diamictite, Utah

    NASA Technical Reports Server (NTRS)

    Hoerz, F.; Bunch, T. E.; Oberbeck, V. R.

    1994-01-01

    Evidence of shock metamorphism in the Dutch Peak diamictite in the Sheeprock Mountains, Utah, is reported. The Dutch Peak diamictite is of Proterozoic age and is a minor part of the Dutch Peak formation. A shocked sample, specimen A250, was collected during a brief visit of the Harker Canyon area of the Sheeprock Mountains. This sample consists of equant, anhedral grains of quartz, K-feldspar, and plagioclase. The crystallographic orientation of 244 lamellae systems in 106 grains was measured. It is presently difficult to evaluate the significance of this single specimen. Without additional and substantial field work, and petrographic characterization of this formation, a number of scenarios for the presence of a shocked clast and the emplacement of the entire formation remain viable.

  4. [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.

  5. 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

  6. 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,...

  7. 76 FR 62309 - Implementing a Nationwide, Broadband, Interoperable Public Safety Network in the 700 MHz Band

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-07

    ... From the Federal Register Online via the Government Publishing Office FEDERAL COMMUNICATIONS COMMISSION 47 CFR Chapter I Implementing a Nationwide, Broadband, Interoperable Public Safety Network in the 700 MHz Band AGENCY: Federal Communications Commission. ACTION: Final rule. SUMMARY: In this...

  8. Why did an effective Dutch complex psycho-social intervention for people with dementia not work in the German healthcare context? Lessons learnt from a process evaluation alongside a multicentre RCT

    PubMed Central

    Graff, Maud; Leonhart, Rainer; Hüll, Michael; Rikkert, Marcel Olde; Vernooij-Dassen, Myrra

    2011-01-01

    Background The positive effects of the Dutch Community Occupational Therapy in Dementia programme on patients' daily functioning were not found in a multicentre randomised controlled trial (RCT) in Germany. Objectives To evaluate possible effect modification on the primary outcome within the German RCT with regard to (1) participant characteristics, (2) treatment performance and (3) healthcare service utilisation; and (4) to compare the design and primary outcome between the German and the original Dutch study. Methods (1) The impact of participant baseline data on the primary outcome was analysed in exploratory ANCOVA and regression analyses. (2) Therapists completed questionnaires on context and performance problems. The main problems were identified by a qualitative content analysis and focus-group discussion. Associations of the primary outcome with scores of participant adherence and treatment performance were evaluated by regression analysis. (3) Utilisation rates of healthcare services were controlled for significant group differences. (4) Differences in the Dutch and German study design were identified, and the primary outcome was contrasted at the item level. Results (1) Participant characteristics could not explain more than 5% of outcome variance. (2) The treatment performance of some active intervention components was poor but not significantly associated with the primary outcome. (3) There were no significant group differences in the utilisation of healthcare resources. (4) In contrast to the Dutch waiting-control group, the active intervention in the German control group may have reduced group differences in the current RCT. The German patients demonstrated a higher independence at baseline and less improvement in instrumental activities of daily living. Conclusion The differences in outcome may be explained by a more active control treatment, partially poor experimental treatment and less room for improvement in the German sample. Future cross

  9. Pow-wowing: the Pennsylvania Dutch way to heal.

    PubMed

    Offner, J

    1998-12-01

    Since ancient times, Germanic tribes from the Palatine valley relied on faith healers, brauchers, when health problems developed. Several hundred years ago, brauchers immigrated to the New World with various Germanic religious sects. Cooperative, instructional meetings, or pow wows, between Native American medicine men and newly immigrated brauchers allowed the newcomers to learn about herbs and remedies indigenous to North America. The brauchers, now known as pow wowers, practice within Pennsylvania Dutch communities across the country, especially in the Lancaster, Pennsylvania region. A review of the literature explores the history and development of the Pennsylvania Dutch practice of pow-wowing.

  10. 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…

  11. Randomised Trial Evaluation of the In:tuition Programme

    ERIC Educational Resources Information Center

    Lynch, Sarah; Styles, Ben; Poet, Helen; White, Richard; Bradshaw, Sally; Rabiasz, Adam

    2015-01-01

    This summary reports the findings from two cluster-randomised trials of Drinkaware's school-based In:tuition life skills and alcohol education intervention: one trial of the programme for 10-11 year olds in primary schools, and another for 12-13 year olds in secondary schools. The trials have been carried out by the National Foundation for…

  12. 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.

  13. The Feasibility of the Nationwide Health Information Network.

    PubMed

    Valle, Jazmine; Gomes, Christian; Godby, Tyler; Coustasse, Alberto

    2016-01-01

    The Nationwide Health Information Network (NHIN) use in health care facilities was examined for utilization and efficacy; although the advantages are abundant, health care facilities have been reluctant to adopt it because of associated costs. The purpose of this study was to analyze the feasibility of a US NHIN by exploring and determining the benefits of an NHIN and assessing the barriers to its implementation. The research methodology applied in examining the implementation of NHIN in the United States was a qualitative literature review, which followed the basic guidelines of a systematic literature review, partnered with a semistructured interview of a chief information officer of a private, nonprofit, 193-bed hospital located in Westminster, Maryland. A total of 33 sources were referenced. The results of this study suggest that implementation and utilization of NHIN by health care industry stakeholders lead to an increased quality of patient care, increased patient-provider communication, and cost-savings opportunities. Increased quality of care is achieved by reducing adverse drug events and medical errors. Cost-savings opportunities are generated by a reduction in spending and prices that is attributable to electronic health record systems' increased efficiency and effectiveness. Nevertheless, barriers to NHIN implementation and utilization still remain throughout the health care industry, the main one being concerns about interoperability. PMID:27111681

  14. The development of a nationwide registry of wheelchair users.

    PubMed

    Fitzgerald, Shirley G; Kelleher, Annmarie; Teodorski, Emily; Collins, Diane M; Boninger, Michael; Cooper, Rory A

    2007-11-01

    This paper provides an overview of the development of a wheelchair users registry and subsequently describes a population of individuals who use wheelchairs. The characteristics of Americans who permanently use wheelchairs and scooters are currently unknown. As the result of developing a Registry of individuals who use wheeled mobility devices for systematic recruitment for research studies, this study provides a description of a nationwide sample of over 1000 individuals who used wheelchairs or scooters for their daily mobility. The Registry is predominantly Caucasian (83%), 63% male, with a mean age of 50 years. Some 54% used manual wheelchairs for an average of 16 years. When quality of wheelchairs was compared, results indicated those in more customizable manual wheelchairs were significantly more likely to be younger. Males were significantly more likely to receive more customizable, heavy duty power wheelchairs than females. The Wheelchair Users Registry provides an organized and systematic way to maintain contact with previous research participants. Expected to grow in size, the Registry may enable an even more diverse pool of subjects interested in participating in research studies.

  15. 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

  16. Nationwide groundwater surveillance of noroviruses in South Korea, 2008.

    PubMed

    Lee, Sung-Geun; Jheong, Weon-Hwa; Suh, Chang-Il; Kim, Sang-Hyun; Lee, Joong-Bok; Jeong, Yong-Seok; Ko, GwangPyo; Jang, Kyung Lib; Lee, Gyu-Cheol; Paik, Soon-Young

    2011-02-01

    To inspect the norovirus contamination of groundwater in South Korea, a nationwide study was performed in the summer (June to August) and winter (October to December) of 2008. Three-hundred sites designated by the government ministry were inspected. Water samples were collected for analysis of water quality, microorganism content, and viral content. Water quality was assessed by temperature, pH, turbidity, residual chlorine, and nitrite nitrogen content. Microorganism contents were analyzed bacteria, total coliforms, Escherichia coli, and bacteriophage. Virus analyses included panenterovirus and norovirus. Two primer sets were used for the detection of norovirus genotypes GI and GII, respectively. Of 300 samples, 65 (21.7%) were norovirus positive in the summer and in 52 (17.3%) were norovirus positive in the winter. The genogroup GI noroviruses that were identified were GI-1, GI-2, GI-3, GI-4, GI-5, GI-6, and GI-8 genotypes; those in the GII genogroup were GII-4 and GII-Yuri genotypes. The analytic data showed correlative relationships between the norovirus detection rate and the following parameters: water temperature and turbidity in physical-chemical parameters and somatic phage in microbial parameters. It is necessary to periodically monitor waterborne viruses that frequently cause epidemic food poisoning in South Korea for better public health and sanitary conditions.

  17. 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.

  18. Validity of maternal and infant outcomes within nationwide Medicaid data

    PubMed Central

    Palmsten, Kristin; Huybrechts, Krista F.; Kowal, Mary K.; Mogun, Helen; Hernández-Díaz, Sonia

    2014-01-01

    Purpose The aim of this study is to assess the validity of preeclampsia, congenital cardiac malformations, and persistent pulmonary hypertension of the newborn (PPHN) diagnoses in the US Medicaid Analytic eXtract (MAX), a nationwide healthcare utilization database that may be useful for perinatal research. Methods Using the 2000–2007 MAX, we identified more than 1 million pregnancies ending in live birth. We identified potential cases based on claims, reviewed their hospital medical records, and calculated the positive predictive values (PPV) and 95% confidence intervals using records as the reference. Results Among 183 women with any preeclampsia diagnoses, the PPV was 66.5% (53.6, 77.4%), but it increased to 94.5% (84.0, 98.3%) for inpatient preeclampsia diagnoses. The PPV for inpatient PPHN diagnoses (N=82) was 68.3% (57.6, 77.4%), but it increased to 89.6% (CI: 77.8, 95.5%) when restricting to infants not transferred to another facility shortly after birth (N=48). The PPV for cardiac malformations was 77.6% (65.7, 86.2%) when requiring inpatient codes on more than one date (N=63). Conclusions These PPVs are conservative, particularly when patients were transferred or received outpatient diagnoses, because we reviewed records from a single hospitalization only. PPVs improve with stringent identification criteria, at the cost of sensitivity, and can be used to correct for measurement error. PMID:24740606

  19. A nationwide epidemiological study of testicular torsion in Korea.

    PubMed

    Lee, Sol Min; Huh, Jung-Sik; Baek, Minki; Yoo, Koo Han; Min, Gyeong Eun; Lee, Hyung-Lae; Lee, Dong-Gi

    2014-12-01

    Testicular torsion is a surgical emergency in the field of urology. Knowledge of the epidemiology and pathophysiology is significant to an urologist. However, the epidemiology of testicular torsion in Korea has not been studied. We performed a nationwide epidemiological study to improve knowledge of the epidemiology of testicular torsion. From 2006-2011, the Korean Urologic Association began the patient registry service. The annual number of patients with testicular torsion from 2006 to 2011 were 225, 250, 271, 277, 345, and 210, respectively. The overall incidence of testicular torsion in males was 1.1 per 100,000; However, the incidence in men less than 25 yr old was 2.9 per 100,000. Adolescents showed the highest incidence. Total testicular salvage rate was 75.7% in this survey. There was no geographic difference of testicular salvage rate. Minimizing the possibility of orchiectomy for testicular torsion is important to improve public awareness to expedite presentation and provider education to improve diagnosis and surgery. PMID:25469070

  20. [Nationwide antimicrobial susceptibility survey of Neisseria gonorrhoeae isolates in Japan].

    PubMed

    Tanaka, Masatoshi; Shimojima, Masahiro; Saika, Takeshi; Iyoda, Takako; Ikeda, Fumiaki; Kanayama, Akiko; Kobayashi, Intetsu

    2011-07-01

    In a nationwide antimicrobial susceptibility survey of 494 Nesseria gonorrhoeae isolates collected from February 2008 to December 2009 in 3 regions of Japan, 112 (22.7%) were collected from western Japan (Kinki, Chugoku, Shikoku, and Kyushu), 277 (56.1%) from mid-eastern Japan (Kanto), and 105 (21.1%) from eastern Japan (Tokai, Hokuriku, Koushinetsu, Tohoku, and Hokkaido). Resistance to ciprofloxacin (CPFX) was 72.8%, to penicillin G (PCG) 19.8%, and to tetracycline (TC) 18.2%. Intermediate resistance to CPFX was 1.8%, to PCG 73.7%, and to TC 43.7%. These results indicate that both types of resistance to the 3 agents were very high. Intermediate resistance to cefixime (CFIX) was 38.1% and to cefozidim (CDZM) 13.4%. Resistance to CFIX was only 0.4% and to CDZM 0%. Susceptibility to azithromycin was 96.6%, to ceftriaxone 99.8%, and to spectinomycin 100%. No significant difference in resistance was seen to different antimicrobial agent classes tested in the 3 regions, although intermediate resistance to CFIX in western Japan was significantly higher than in mid-eastern Japan.

  1. Social Media Adoption in Local Health Departments Nationwide

    PubMed Central

    Mueller, Nancy L.; Snider, Doneisha

    2013-01-01

    Objectives. We examined whether characteristics of local health departments (LHD) and their geographic region were associated with using Facebook and Twitter. We also examined the number of tweets per month for Twitter accounts as an indicator of social media use by LHDs. Methods. In 2012, we searched for Facebook and Twitter accounts for 2565 LHDs nationwide, and collected adoption date and number of connections for each account. Number of tweets sent indicated LHD use of social media. LHDs were classified as innovators, early adopters, or nonadopters. Characteristics of LHDs were compared across adoption categories, and we examined geographic characteristics, connections, and use. Results. Twenty-four percent of LHDs had Facebook, 8% had Twitter, and 7% had both. LHDs serving larger populations were more likely to be innovators, tweeted more often, and had more social media connections. Frequency of tweeting was not associated with adoption category. There were differences in adoption across geographic regions, with western states more likely to be innovators. Innovation was also higher in states where the state health department adopted social media. Conclusions. Social media has the potential to aid LHDs in disseminating information across the public health system. More evidence is needed to develop best practices for this emerging tool. PMID:23865660

  2. A nationwide epidemiological study of testicular torsion in Korea.

    PubMed

    Lee, Sol Min; Huh, Jung-Sik; Baek, Minki; Yoo, Koo Han; Min, Gyeong Eun; Lee, Hyung-Lae; Lee, Dong-Gi

    2014-12-01

    Testicular torsion is a surgical emergency in the field of urology. Knowledge of the epidemiology and pathophysiology is significant to an urologist. However, the epidemiology of testicular torsion in Korea has not been studied. We performed a nationwide epidemiological study to improve knowledge of the epidemiology of testicular torsion. From 2006-2011, the Korean Urologic Association began the patient registry service. The annual number of patients with testicular torsion from 2006 to 2011 were 225, 250, 271, 277, 345, and 210, respectively. The overall incidence of testicular torsion in males was 1.1 per 100,000; However, the incidence in men less than 25 yr old was 2.9 per 100,000. Adolescents showed the highest incidence. Total testicular salvage rate was 75.7% in this survey. There was no geographic difference of testicular salvage rate. Minimizing the possibility of orchiectomy for testicular torsion is important to improve public awareness to expedite presentation and provider education to improve diagnosis and surgery.

  3. 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

  4. 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…

  5. The Role of Dutch Government in Curriculum Design and Change.

    ERIC Educational Resources Information Center

    Huisman, Jeroen; Jenniskens, Ineke

    1994-01-01

    A discussion of Dutch higher education looks at whether a 1985 proposal for fundamental changes in the relationship between government and higher education institutions has been implemented with regard to curriculum design. It is concluded that, despite policy intentions for increased institutional autonomy, the government retains relatively tight…

  6. Library Service for Multicultural Groups in Dutch Prisons.

    ERIC Educational Resources Information Center

    Reijnders, Katinka

    1996-01-01

    Recognizing that the Netherlands is a multicultural society and prisoners from other cultures are especially isolated, the Dutch prison library service attempts to provide materials in different languages. A network of centers of support responsible for specific languages and a computerized catalog help prison libraries serve varied prisoner…

  7. The Dutch-French Language Border in Belgium.

    ERIC Educational Resources Information Center

    Willemyns, Roland

    2002-01-01

    Describes language border fluctuations in Belgium as far as its Dutch-French portion is concerned. Examines the status and function of the language border in Belgium and of actual border fluctuations. Discusses two problem areas in detail: the "Voerstreek, and the Brussels suburban region. Language shift and language change through erosion in…

  8. 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…

  9. 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…

  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. 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…

  12. 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…

  13. 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. Both first…

  14. "Modern" Governance and Codes of Conduct in Dutch Higher Education

    ERIC Educational Resources Information Center

    de Boer, Harry; Goedegebuure, Leo

    2007-01-01

    As one of the first countries in Europe to do so, The Netherlands moved towards a new relationship between the state and the higher education institutions in the mid-1980s. Autonomy, quality and accountability were key considerations in this move. In 2006 the Dutch government proposed another radical innovation in its approach to higher education…

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

    PubMed Central

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

    2016-01-01

    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. PMID:27025815

  16. Contact Hours in Dutch and Vietnamese Higher Education: A Comparison

    ERIC Educational Resources Information Center

    Quyen, Do Thi Ngoc

    2009-01-01

    The number of contact hours, one of the important institutional context factors, was examined and compared between Dutch and Vietnamese higher education at institute and student levels in Psychology and Business and/or Economics specializations. The quantity of contact hours per credit point given by institutions was investigated in a number of…

  17. 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…

  18. 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

  19. 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…

  20. Commentary: Flexner and Dutch medical education: a misinterpretation?

    PubMed

    Custers, Eugène J F M

    2010-11-01

    Abraham Flexner's 1910 report, Medical Education in the United States and Canada, was hardly noticed in the Netherlands, and though his 1925 book, Medical Education: A Comparative Study, was extensively discussed in the Dutch Medical Journal, it did not and could not affect medical education in the Netherlands. Until the 1970s, the medical curriculum in the Netherlands consisted of four phases: the propaedeutic year (premedical sciences), two preclinical years, two theoretical clinical years, and one-and-a-half to two years of clerkships. When in the 1970s interest in curriculum innovation arose in the Netherlands, it was based on developments in North America that challenged "Flexnerian" norms in medical education. As hardly anyone in the Netherlands cared to study Flexner's work closely, his name became synonymous with the conventional curriculum just as it had in North America. However, the Dutch conventional curriculum was quite different from the American conventional curriculum, so attributing its origins to Flexner's work was a serious misrepresentation. In this commentary, the author clarifies common misconceptions about the history of Dutch medical education and argues that the curriculum as Flexner saw it differed considerably from the Dutch medical curriculum a century ago.

  1. 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…

  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. 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…

  4. The Speed of Obsolescence: Evidence from the Dutch Public Sector

    ERIC Educational Resources Information Center

    van Loo, Jasper B.

    2007-01-01

    HRD is extensively concerned with human capital investment, but only focuses on how skills and knowledge become obsolete to a limited extent. In this paper we look at the speed of obsolescence. Using data from a survey among Dutch public sector employees, we find that the yearly rate of skills obsolescence is 2.6%. Subsequent analyses show that…

  5. 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)

  6. Developments and Issues in Dutch Adult Education Policy.

    ERIC Educational Resources Information Center

    Hake, Barry

    The three areas of educational activity recognized by the Dutch have developed historically into distinct and separate institutionalized sectors for educational provision for adults. These areas are knowledge-based, skill-based, and value-based. Each is the responsibility of a different governmental department and cabinet minister. Educational…

  7. 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…

  8. 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…

  9. 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…

  10. 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.

  11. 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…

  12. 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…

  13. 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) was…

  14. Teacher Interpersonal Competence for Dutch Secondary Multicultural Classrooms

    ERIC Educational Resources Information Center

    Wubbels, Theo; den Brok, Perry; Veldman, Ietje; van Tartwijk, Jan

    2006-01-01

    In the Netherlands, as in many European countries, classrooms display a growing cultural diversity. There are only very limited empirically supported data on the interpersonal competence teachers need in Dutch classrooms and studies from other countries cannot be generalized because of differences in the composition of the student population. This…

  15. Mentoring in Dutch Vocational Education: An Unfulfilled Promise

    ERIC Educational Resources Information Center

    Meijers, Frans

    2008-01-01

    Between 1998 and 2002 an estimated 250 mentoring programmes were started in Dutch secondary vocational education in order to decrease motivational problems and drop-out rates, especially among youngsters from ethnic minorities. Currently there are only two schools in secondary vocational education that include mentoring as part and parcel of their…

  16. Tensions in water management: Dutch tradition and European policy.

    PubMed

    Ravesteijn, W; Kroesen, O

    2007-01-01

    Present-day worldwide water problems require new management tools and sustainable system innovations. At Delft University of Technology research is being carried out into water resources and management development aimed at forming such tools and innovations, focused on Integrated River Basin Management (IRBM). One of the case-studies deals with Dutch water management and technology in the context of European IRBM in the form of the 2000 Water Frame Directive. The Netherlands experience many water problems and European IRBM could bring help by offering a framework for both international cooperation and technological innovations. To work as an adequate management tool European IRBM should be tailored to the Dutch water tradition, which recently culminated in Integrated Water Management. Both approaches are in some respects contradicting. Europe pursues, for example, centralized control; while the Dutch have their strongly water boards based decentralized administration. The tensions between both approaches require mutual adaptation, for which the concept of subsidiarity might offer points of departure. This paper describes the first results of the case-research into Dutch water management and technology in the context of Europe as well as the backgrounds and the set-up of the research as a whole.

  17. Pirfenidone treatment in idiopathic pulmonary fibrosis: nationwide Danish results

    PubMed Central

    Salih, Goran Nadir; Shaker, Saher Burhan; Madsen, Helle Dall; Bendstrup, Elisabeth

    2016-01-01

    Background Pirfenidone was approved by the European Medicines Agency and introduced in most European countries in 2011 for treatment of idiopathic pulmonary fibrosis (IPF). Objective To describe the national Danish experiences of pirfenidone treatment for IPF during 30 months with respect to target population, safety, adherence to the treatment and effect analysis in a well-characterised IPF population in a real-life setting. Methods Retrospective data collection from medical records of all patients in Denmark with IPF from 2011 to 2014. Data included baseline demographics, high-resolution computed tomography (HRCT), histopathology, forced vital capacity (FVC) and 6-min walk test (6MWT). Longitudinal data on FVC, walk test, adherence to the treatment and vital status were also collected. Results Pirfenidone treatment was initiated in 113 patients. Mean age was 69.6±8.1 years (±SD), and 71% were male. Definite IPF diagnosis required thoracoscopic lung biopsy in 45 patients (39.8%). The remaining 68 cases had a definite (64 patients) or possible usual interstitial pneumonia (four patients) pattern on HRCT. Patients were followed for 0.1–33.8 months (median 9.4 months). Fifty-one patients (45.2%) needed dose adjustment, 18 (16%) patients discontinued therapy and 13 patients (11.5%) died. The annual mean decline in FVC was 164 ml (SE 33.2). The decline in 6MWT was 18.2 m (SE 11.2). Nausea (44.2%), fatigue (38.9%) and skin reactions (32.7%) were frequent adverse events. Conclusion Patients with IPF treated with pirfenidone experienced tolerable adverse events. Patients were maintained on treatment due to a careful follow-up and dose adjustment programme. The annual decline in physiological parameters and mortality rate was comparable to previous randomised controlled trials. PMID:27616539

  18. 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.

  19. 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

  20. 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

  1. A tuberculosis nationwide prevalence survey in Gambia, 2012

    PubMed Central

    Kendall, Lindsay; Bashorun, Adedapo; Linda, Christopher; Omoleke, Semeeh; Jeffries, David; Maane, Rahmatulai; Alorse, Beatrice Dei; Alorse, William Dei; Okoi, Catherine Bi; Mlaga, Kodjovi D; Kinteh, Ma Ansu; Donkor, Simon; de Jong, Bouke C; Antonio, Martin; d’Alessandro, Umberto

    2016-01-01

    Abstract Objective To estimate the population prevalence of active pulmonary tuberculosis in Gambia. Methods Between December 2011 and January 2013, people aged ≥ 15 years participating in a nationwide, multistage cluster survey were screened for active pulmonary tuberculosis with chest radiography and for tuberculosis symptoms. For diagnostic confirmation, sputum samples were collected from those whose screening were positive and subjected to fluorescence microscopy and liquid tuberculosis cultures. Multiple imputation and inverse probability weighting were used to estimate tuberculosis prevalence. Findings Of 100 678 people enumerated, 55 832 were eligible to participate and 43 100 (77.2%) of those participated. A majority of participants (42 942; 99.6%) were successfully screened for symptoms and by chest X-ray. Only 5948 (13.8%) were eligible for sputum examination, yielding 43 bacteriologically confirmed, 28 definite smear-positive and six probable smear-positive tuberculosis cases. Chest X-ray identified more tuberculosis cases (58/69) than did symptoms alone (43/71). The estimated prevalence of smear-positive and bacteriologically confirmed pulmonary tuberculosis were 90 (95% confidence interval, CI: 53–127) and 212 (95% CI: 152–272) per 100 000 population, respectively. Tuberculosis prevalence was higher in males (333; 95% CI: 233–433) and in the 35–54 year age group (355; 95% CI: 219–490). Conclusion The burden of tuberculosis remains high in Gambia but lower than earlier estimates of 490 per 100 000 population in 2010. Less than half of all cases would have been identified based on smear microscopy results alone. Successful control efforts will require interventions targeting men, increased access to radiography and more accurate, rapid diagnostic tests. PMID:27274595

  2. 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. PMID:26991480

  3. 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…

  4. The practical and ethical defects of surgical randomised prospective trials.

    PubMed Central

    Byer, A

    1983-01-01

    This paper presents a strong criticism of the current enthusiasm for clinical randomised prospective studies in surgery. In the process, the author probes the 'intellectualism' or lack thereof in present day surgical attitudes. The subjects are examined against a framework of ethics and inescapable dilemmas. Ways of correcting the more obvious weaknesses are suggested. The manuscript is, and is meant to be, provocative and is particularly aimed at the academic audience served by this journal. PMID:6876104

  5. 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

  6. 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

  7. A Nationwide Census of ICU Capacity and Admissions in Mongolia

    PubMed Central

    Mendsaikhan, Naranpurev; Begzjav, Tsolmon; Lundeg, Ganbold; Brunauer, Andreas; Dünser, Martin W.

    2016-01-01

    In Mongolia, a Central Asian lower-middle income country, intensive care medicine is an under-resourced and–developed medical specialty. The burden of critical illness and capacity of intensive care unit (ICU) services in the country is unknown. In this nationwide census, we collected data on adult and pediatric/neonatal ICU capacities and the number of ICU admissions in 2014. All hospitals registered to run an ICU service in Mongolia were surveyed. Data on the availability of an adult and/or pediatric/neonatal ICU service, the number of available ICU beds, the number of available functional mechanical ventilators, the number of patients admitted to the ICU, and the number of patients admitted to the study hospital were collected. In total, 70 ICUs with 349 ICU beds were counted in Mongolia (11.7 ICU beds/100,000 inhabitants; 1.7 ICU beds/100 hospital beds). Of these, 241 (69%) were adult and 108 (31%) pediatric/neonatal ICU beds. Functional mechanical ventilators were available for approximately half of the ICU beds (5.1 mechanical ventilators/100,000 inhabitants). While all provincial hospitals ran a pediatric/neonatal ICU, only dedicated pediatric hospitals in Ulaanbaatar did so. The number of adult and pediatric/neonatal ICU admissions varied between provinces. The number of adult ICU beds and adult ICU admissions per 100,000 inhabitants correlated (r = 0.5; p = 0.02), while the number of pediatric/neonatal ICU beds and pediatric/neonatal ICU admissions per 100,000 inhabitants did not (r = 0.25; p = 0.26). In conclusion, with 11.7 ICU beds per 100,000 inhabitants the ICU capacity in Mongolia is higher than in other low- and lower-middle-income countries. Substantial heterogeneities in the standardized ICU capacity and ICU admissions exist between Mongolian provinces. Functional mechanical ventilators are available for only half of the ICU beds. Pediatric/neonatal ICU beds make up one third of the national ICU capacity and appear to meet or even exceed the

  8. Overview of randomised trials of diuretics in pregnancy.

    PubMed Central

    Collins, R; Yusuf, S; Peto, R

    1985-01-01

    Over the past 20 years at least 11 randomised trials of the prevention with diuretics of pre-eclampsia and its sequelae have been undertaken. Nine of these were reviewed. Reliable data from the remaining two were not available. The nine reviewed had investigated a total of nearly 7000 people. Significant evidence of prevention of "pre-eclampsia" was overwhelming, even when oedema was not included as a diagnostic criterion. But as the definitions of pre-eclampsia that had been used depended heavily on increases in blood pressure this evidence may simply have reflected the well known ability of diuretics to reduce blood pressure. When the data on perinatal death were reviewed a little difference was seen in postnatal survival. The incidence of stillbirths was reduced by about one third with treatment, but, perhaps owing to small numbers (only 37 stillbirths), the difference was not significant. Thus these randomised trials failed to provide reliable evidence of either the presence or the absence of any worthwhile effects of treatment with diuretics on perinatal mortality. The implications of this for current and future trials of beta blockers and other agents in the prevention of pre-eclampsia and its sequelae are that extremely large, ultra simple randomised trials are needed, of a size sufficient to permit direct assessment of the effects of treatment not on pre-eclampsia but on perinatal mortality itself. This may require the study of tens of thousands of pregnancies. PMID:3917318

  9. Randomised trials in surgery: the burden of evidence.

    PubMed

    Lassen, Kristoffer; Hϕye, Anne; Myrmel, Truls

    2012-08-01

    A randomised controlled trial (RCT) is considered the hierarchical peak of evidence-based medicine and a general demand for any result to be evaluated by RCTs has evolved. Yet, many advances in operative surgery do not result from RCTs and many controversies remain without an RCT being conducted. A randomised comparison of laparoscopic versus open liver resection has recently been called for. Using such a trial and others as examples, we examine the limitations of randomised design in skill-dependant interventions. Surgical procedures are skill-dependant, constantly developing, irreversible and traumatising. Additionally, placebo control is usually unethical and adequate blinding difficult or impossible to accomplish. Under these circumstances, surgeon and patient participation will be problematic and the resulting data will tend to have low external validity. While some of these obstacles can be modified, others will remain. Nonrandomised, prospective cohort comparison has other weaknesses, but may add complementary data with good external validity. An alternative hierarchy of evidence is warranted in this field.

  10. Moderate alcohol consumption increases insulin sensitivity and ADIPOQ expression in postmenopausal women: a randomised, crossover trial

    PubMed Central

    Beulens, J. W. J.; Kersten, S.; Hendriks, H. F. J.

    2008-01-01

    Aims/hypothesis To determine whether 6 weeks of daily, moderate alcohol consumption increases expression of the gene encoding adiponectin (ADIPOQ) and plasma levels of the protein, and improves insulin sensitivity in postmenopausal women. Methods In a randomised, open-label, crossover trial conducted in the Netherlands, 36 apparently healthy postmenopausal women who were habitual alcohol consumers, received 250 ml white wine (∼25 g alcohol/day) or 250 ml of white grape juice (control) daily during dinner for 6 weeks. Randomisation to treatment allocation occurred according to BMI. Insulin sensitivity and ADIPOQ mRNA and plasma adiponectin levels were measured at the end of both periods. Insulin sensitivity was estimated using the homeostasis model assessment of insulin resistance (HOMA-IR). Levels of ADIPOQ mRNA in subcutaneous adipose tissue were determined by RT-PCR. Results All subjects completed the study. Six weeks of white wine consumption reduced fasting insulin (mean ± SEM 40.0 ± 3.4 vs 46.5 ± 3.4 pmol/l; p < 0.01) and HOMA-IR (1.42 ± 0.13 vs 1.64 ± 0.13; p = 0.02) compared with 6 weeks of grape juice consumption. ADIPOQ mRNA levels (1.09 ± 0.15 vs 0.98 ± 0.15; p = 0.04) and plasma levels of total (13.1 ± 0.8 vs 12.0 ± 0.8 μg/ml; p < 0.001) and high molecular weight (HMW) adiponectin (9.9 ± 1.2 vs 8.8 ± 1.2 μg/ml; p = 0.02) significantly increased after alcohol compared with juice consumption. Changes in ADIPOQ mRNA levels correlated with changes in plasma levels of total adiponectin (ρ = 0.46; p < 0.01). Both fasting triacylglycerol (8.2%; p = 0.04) and LDL-cholesterol levels (7.8%; p < 0.0001) decreased, whereas HDL-cholesterol increased (7.0%; p < 0.0001) after prolonged moderate alcohol intake. No notable adverse effects were reported. Conclusions/interpretation Moderate alcohol consumption for 6 weeks improves insulin sensitivity, adiponectin

  11. Harm to Others from Substance Use and Abuse: The Underused Potential in Nationwide Registers

    PubMed Central

    Lund, Ingunn Olea; Bukten, Anne

    2015-01-01

    This article considers the potential in using nationwide registers to study harm to others from substance use and abuse. The advantages of using registry data include the opportunity to include the data on the entire population nationwide and continuously updated longitudinal datasets; they allow for studying small subpopulations and have little missing data. Personal identification numbers and family numbers enable linkage of data from different registers. Such datasets can include extensive information on individual and family levels. In this article, we provide an introduction to nationwide registers and explain how they can be applied to investigate two types of third-party harms: harm to children and harm to partners/spouses from substance use and abuse in parents and partners/spouses. Finally, we discuss challenges, benefits, and ethical considerations regarding the use of such data. PMID:26560694

  12. 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.

  13. 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

  14. A Dutch perspective: the limits of lawful euthanasia.

    PubMed

    de Vries, Ubaldus

    2004-01-01

    Dutch author Ubaldus de Vries reviews the current state of the euthanasia law in the Netherlands. The legislation, enacted in 2001, creates a medical exception that allows for euthanasia in cases where patients experience "hopeless and unbearable suffering." A brief history of the Dutch approach to euthanasia is set forth, case law is reviewed, and the unique role of the doctor is examined in seeking to understand the extent of one's right to euthanasia in the Netherlands. Because the courts must determine what constitutes "hopeless and unbearable suffering," Professor de Vries analyzes the judicial interpretation of "suffering" and concludes that judicial interpretation has reached its limits, and thus by implication, the limits of lawful euthanasia have been reached.

  15. 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.

  16. Chinese and Dutch parents' perceptions of their children's personality.

    PubMed

    Zhang, Yuching; Kohnstamm, Geldolph; Slotboom, Anne-Marie; Elphick, Eric; Cheung, Ping Chung

    2002-06-01

    The authors coded Chinese (n = 401) and Dutch (n = 324) parents' free descriptions of their 3- to 14-year-old children's personalities using a 14-category coding system partially based on the Big Five. Of the Chinese and Dutch personality descriptors, 86% and 77%, respectively, could be classified in the first 5 main categories resembling the five-factor model of adult personality. No significant differences were found for gender, socio-economic status, or city in these categories. Chinese parents of school age children generated many more descriptors, mostly critical, in the domain of conscientiousness. The findings reflect Chinese high achievement orientation and show that the classification system, which presently serves as a basis for developing indigenous questionnaires for personality assessment of children in China and some Western countries, is sensitive to cultural differences.

  17. "Culture of death" in The Netherlands: Dutch perspectives.

    PubMed

    Cohen-Almagor, R

    2001-01-01

    During the summer of 1999, extensive interviews with some of the leading authorities on euthanasia policy were conducted in the Netherlands. They were asked: Daniel Callahan argues that there is a 'culture of death' in the Netherlands. What do you think? The majority of interviewees disagreed with the statement. They said that the Netherlands is not fundamentally different than other countries. If at all, the Dutch culture is open and tolerant, welcomes debates and plurality of views, and physicians are decent people who wish to help their patients, not to kill them. A small minority acknowledged that there is some truth in Callahan's observations, arguing that the Dutch actually do not welcome critique and are quite conservative in their liberal attitude toward euthanasia. PMID:11816935

  18. 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

  19. Effectiveness of integrated disease management for primary care chronic obstructive pulmonary disease patients: results of cluster randomised trial

    PubMed Central

    Boland, Melinde R S; Assendelft, Willem J J; Gussekloo, Jacobijn; Tsiachristas, Apostolos; Stijnen, Theo; Blom, Coert; Sont, Jacob K; Rutten-van Mölken, Maureen P H M; Chavannes, Niels H

    2014-01-01

    Objective To investigate the long term effectiveness of integrated disease management delivered in primary care on quality of life in patients with chronic obstructive pulmonary disease (COPD) compared with usual care. Design 24 month, multicentre, pragmatic cluster randomised controlled trial Setting 40 general practices in the western part of the Netherlands Participants Patients with COPD according to GOLD (Global Initiative for COPD) criteria. Exclusion criteria were terminal illness, cognitive impairment, alcohol or drug misuse, and inability to fill in Dutch questionnaires. Practices were included if they were willing to create a multidisciplinary COPD team. Intervention General practitioners, practice nurses, and specialised physiotherapists in the intervention group received a two day training course on incorporating integrated disease management in practice, including early recognition of exacerbations and self management, smoking cessation, physiotherapeutic reactivation, optimal diagnosis, and drug adherence. Additionally, the course served as a network platform and collaborating healthcare providers designed an individual practice plan to integrate integrated disease management into daily practice. The control group continued usual care (based on international guidelines). Main outcome measures The primary outcome was difference in health status at 12 months, measured by the Clinical COPD Questionnaire (CCQ); quality of life, Medical Research Council dyspnoea, exacerbation related outcomes, self management, physical activity, and level of integrated care (PACIC) were also assessed as secondary outcomes. Results Of a total of 1086 patients from 40 clusters, 20 practices (554 patients) were randomly assigned to the intervention group and 20 clusters (532 patients) to the usual care group. No difference was seen between groups in the CCQ at 12 months (mean difference –0.01, 95% confidence interval –0.10 to 0.08; P=0.8). After 12 months, no differences

  20. 50 years of Dutch immunology--founders, institutions, highlights.

    PubMed

    Gmelig-Meyling, Frits H J; Meyaard, Linde; Mebius, Reina E

    2014-12-01

    At the occasion of the 50th anniversary of the Dutch Society for Immunology (DSI, de Nederlandse Vereniging voor Immunologie), this contribution deals with some highlights of 50 years of Immunology in the Netherlands. It narrates about the founders and first board members of the DSI, their institutes, progeny and patrimony, describes major centers of immunological activities, mentions key persons in the field, and touches upon some events dear to the Society and its members.

  1. 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…

  2. 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... public safety broadband network. NTIA intends to use the input from this process to inform the... the Obama Administration to create a single, nationwide interoperable public safety broadband...

  3. 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.

  4. When correction turns positive: processing corrective prosody in Dutch.

    PubMed

    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.

  5. 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

  6. 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

  7. [Infection prevention in Dutch hospitals; results say more than process indicators].

    PubMed

    Bonten, Marc J M; Friedrich, Alexander; Kluytmans, Jan A J W; Vandenbroucke-Grauls, Christina M J E; Voss, Andreas; Vos, Margreet C

    2014-01-01

    The Dutch Health Care Inspectorate investigated the preparedness of Dutch hospitals for the emergence of antibiotic resistance, and concluded that hospitals are not well prepared and are insufficiently aware that infection prevention is a prerequisite for patient safety. These conclusions are based on observations of process indicators of current practice guidelines, without including the available outcome indicators that demonstrate the persistently low incidence of infections with antibiotic resistant bacteria in Dutch hospitals. The conclusions may have negative effects on the quality of infection prevention in Dutch hospitals. Therefore, it is advisable to use outcome indicators rather than process indicators to evaluate the quality of infection prevention.

  8. Is an Intervention Using Computer Software Effective in Literacy Learning? A Randomised Controlled Trial

    ERIC Educational Resources Information Center

    Brooks, G.; Miles, J. N. V.; Torgerson, C. J.; Torgerson, D. J.

    2006-01-01

    Background: Computer software is widely used to support literacy learning. There are few randomised trials to support its effectiveness. Therefore, there is an urgent need to rigorously evaluate computer software that supports literacy learning. Methods: We undertook a pragmatic randomised controlled trial among pupils aged 11-12 within a single…

  9. 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

    2014-03-01

    This document provides a summary of the Dutch S3-guidelines on the treatment of psoriasis. These guidelines were finalized in December 2011 and contain unique chapters on the treatment of psoriasis of the face and flexures, childhood psoriasis as well as the patient's perspective on treatment. They also cover the topical treatment of psoriasis, photo(chemo)therapy, conventional systemic therapy and biological therapy. PMID:24656281

  10. Effects of Dementia-Care Mapping on Residents and Staff of Care Homes: A Pragmatic Cluster-Randomised Controlled Trial

    PubMed Central

    van de Ven, Geertje; Draskovic, Irena; Adang, Eddy M. M.; Donders, Rogier; Zuidema, Sytse U.; Koopmans, Raymond T. C. M.; Vernooij-Dassen, Myrra J. F. J.

    2013-01-01

    Background The effectiveness of dementia-care mapping (DCM) for institutionalised people with dementia has been demonstrated in an explanatory cluster-randomised controlled trial (cRCT) with two DCM researchers carrying out the DCM intervention. In order to be able to inform daily practice, we studied DCM effectiveness in a pragmatic cRCT involving a wide range of care homes with trained nursing staff carrying out the intervention. Methods Dementia special care units were randomly assigned to DCM or usual care. Nurses from the intervention care homes received DCM training and conducted the 4-months DCM-intervention twice during the study. The primary outcome was agitation, measured with the Cohen-Mansfield agitation inventory (CMAI). The secondary outcomes included residents’ neuropsychiatric symptoms (NPSs) and quality of life, and staff stress and job satisfaction. The nursing staff made all measurements at baseline and two follow-ups at 4-month intervals. We used linear mixed-effect models to test treatment and time effects. Results 34 units from 11 care homes, including 434 residents and 382 nursing staff members, were randomly assigned. Ten nurses from the intervention units completed the basic and advanced DCM training. Intention-to-treat analysis showed no statistically significant effect on the CMAI (mean difference between groups 2·4, 95% CI −2·7 to 7·6; p = 0·34). More NPSs were reported in the intervention group than in usual care (p = 0·02). Intervention staff reported fewer negative and more positive emotional reactions during work (p = 0·02). There were no other significant effects. Conclusions Our pragmatic findings did not confirm the effect on the primary outcome of agitation in the explanatory study. Perhaps the variability of the extent of implementation of DCM may explain the lack of effect. Trial Registration Dutch Trials Registry NTR2314. PMID:23844003

  11. 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…

  12. Literature Search; A Planning Document for the Establishment of a Nationwide Educational Telecommunications System.

    ERIC Educational Resources Information Center

    Synergetics, Inc., Washington, DC.

    A literature search, made to provide a data base for a proposed nationwide educational telecommunications system, reviews and summarizes existing literature in the field. Educational telecommunications is divided into eight categories: instructional television, educational radio, telephone instruction, dial access information retrieval systems,…

  13. 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…

  14. 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…

  15. 47 CFR 90.18 - Public Safety 700 MHz Nationwide Broadband Network.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Network. 90.18 Section 90.18 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND... 700 MHz Nationwide Broadband Network. The 763-768/793-798 MHz band is dedicated to a broadband public..., pursuant to a Network Sharing Agreement and such other agreements as the Commission may require....

  16. 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

    ... SECURITY Coast Guard Nationwide Use of High Frequency and Ultra High Frequency Active SONAR Technology... of High Frequency (HF) and Ultra High Frequency (UHF) Sound Navigation and Ranging (SONAR) Technology... in the January 17, 2008, issue of the Federal Register (73 FR 3316). Background and Purpose...

  17. 78 FR 70567 - Nationwide Use of High Frequency and Ultra High Frequency Active SONAR Technology; Final...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-26

    ... SECURITY Coast Guard Nationwide Use of High Frequency and Ultra High Frequency Active SONAR Technology...) and Ultra High Frequency (UHF) Sound Navigation and Ranging (SONAR) Technology and Finding of No... less than two weeks; however, for environmental disasters such as the Deepwater Horizon oil...

  18. 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...

  19. 12 CFR 1022.136 - Centralized source for requesting annual file disclosures from nationwide consumer reporting...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... source Web site and telephone number regarding how to make a request by all request methods required... consumers to make a single request to obtain annual file disclosures from all nationwide consumer reporting..., providing a statement that the consumers' identity cannot be verified; and directions on how to complete...

  20. 12 CFR 1022.136 - Centralized source for requesting annual file disclosures from nationwide consumer reporting...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... source Web site and telephone number regarding how to make a request by all request methods required... consumers to make a single request to obtain annual file disclosures from all nationwide consumer reporting..., providing a statement that the consumers' identity cannot be verified; and directions on how to complete...

  1. 12 CFR 1022.137 - Streamlined process for requesting annual file disclosures from nationwide specialty consumer...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... shall: (1) Accept the consumers request; or (2) Instruct the consumer how to make the request using the..., providing a statement that the consumers identity cannot be verified; and directions on how to complete the..., and how to submit such information. (b) Requirement to anticipate. A nationwide specialty...

  2. 16 CFR 610.3 - Streamlined process for requesting annual file disclosures from nationwide specialty consumer...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... agency shall: (1) Accept the consumers request; or (2) Instruct the consumer how to make the request..., providing a statement that the consumers identity cannot be verified; and directions on how to complete the..., and how to submit such information. (b) Requirement to anticipate. A nationwide specialty...

  3. 12 CFR 1022.137 - Streamlined process for requesting annual file disclosures from nationwide specialty consumer...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... shall: (1) Accept the consumers request; or (2) Instruct the consumer how to make the request using the..., providing a statement that the consumers identity cannot be verified; and directions on how to complete the..., and how to submit such information. (b) Requirement to anticipate. A nationwide specialty...

  4. 12 CFR 1022.137 - Streamlined process for requesting annual file disclosures from nationwide specialty consumer...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... shall: (1) Accept the consumers request; or (2) Instruct the consumer how to make the request using the..., providing a statement that the consumers identity cannot be verified; and directions on how to complete the..., and how to submit such information. (b) Requirement to anticipate. A nationwide specialty...

  5. 16 CFR 610.3 - Streamlined process for requesting annual file disclosures from nationwide specialty consumer...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... agency shall: (1) Accept the consumers request; or (2) Instruct the consumer how to make the request..., providing a statement that the consumers identity cannot be verified; and directions on how to complete the..., and how to submit such information. (b) Requirement to anticipate. A nationwide specialty...

  6. 12 CFR 1022.136 - Centralized source for requesting annual file disclosures from nationwide consumer reporting...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... source Web site and telephone number regarding how to make a request by all request methods required... consumers to make a single request to obtain annual file disclosures from all nationwide consumer reporting..., providing a statement that the consumers' identity cannot be verified; and directions on how to complete...

  7. 16 CFR 610.3 - Streamlined process for requesting annual file disclosures from nationwide specialty consumer...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... agency shall: (1) Accept the consumers request; or (2) Instruct the consumer how to make the request..., providing a statement that the consumers identity cannot be verified; and directions on how to complete the..., and how to submit such information. (b) Requirement to anticipate. A nationwide specialty...

  8. 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…

  9. 77 FR 4030 - Nationwide Limited Public Interest Waiver Under the American Recovery and Reinvestment Act of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-26

    ... of Energy Efficiency and Renewable Energy Nationwide Limited Public Interest Waiver Under the... Renewable Energy, U.S. Department of Energy (DOE). ACTION: Notice of limited public interest waiver. SUMMARY... requirements of section 1605 of the Recovery Act under the authority of section 1605(b)(1) (amended...

  10. 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…

  11. 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:...

  12. 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…

  13. 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…

  14. 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)…

  15. The ICD Survey II: Employing Disabled Americans. A Nationwide Survey of 920 Employers. Study No. 864009.

    ERIC Educational Resources Information Center

    National Council on the Handicapped, Washington, DC.

    A survey explored what 921 managers nationwide are doing to employ disabled people and return disabled employees to work. It identified barriers that prevent employers from hiring disabled people and steps public and private sectors could take to increase their employment. Employers gave their disabled employees high marks as hard working,…

  16. 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…

  17. 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…

  18. 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

    ... of Energy Efficiency and Renewable Energy Nationwide Categorical Waivers Under Section 1605 (Buy... Efficiency and Renewable Energy (EERE), U.S. Department of Energy (DOE). ACTION: Notice. SUMMARY: The Office of Energy Efficiency and Renewable Energy of the U.S. Department of Energy hereby provides...

  19. 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...

  20. 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…

  1. 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…

  2. 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…

  3. 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)

  4. 47 CFR 90.18 - Public Safety 700 MHz Nationwide Broadband Network.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Network. 90.18 Section 90.18 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND... 700 MHz Nationwide Broadband Network. The 763-768/793-798 MHz band is dedicated to a broadband public..., pursuant to a Network Sharing Agreement and such other agreements as the Commission may require....

  5. 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…

  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. 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…

  8. 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…

  9. 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.…

  10. Collateral Damage: The Nationwide Reach of the Racial Controversy at Harvard University.

    ERIC Educational Resources Information Center

    Journal of Blacks in Higher Education, 2002

    2002-01-01

    Discusses the nationwide impact of Harvard University president Lawrence Summers' controversial words on affirmative action and the impact of this controversy on Harvard's continuing ability to attract the best African American students and academics. Explains that the fundamental issue is of institutional legitimacy. (SM)

  11. 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…

  12. Education Sector Planning for Development of Nation-Wide Learning Systems. OLC Paper Number 2.

    ERIC Educational Resources Information Center

    Harbison, Frederick H.

    The sector approach to analysis of nation-wide learning services is a means of viewing all aspects of national development from the perspective of human resources. Such an approach requires a descriptive national profile; an analysis in terms of dynamics, output, goals, and constraints; a strategy to achieve the goals; and a plan to actualize…

  13. 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…

  14. 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…

  15. 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…

  16. 40 CFR 136.4 - Application for and approval of alternate test procedures for nationwide use.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... alternate test procedures for nationwide use. 136.4 Section 136.4 Protection of Environment ENVIRONMENTAL... Procedure (ATP) Program Coordinator (National Coordinator), Office of Science and Technology (4303T), Office of Water, U.S. Environmental Protection Agency, 1200 Pennsylvania Ave. NW., Washington, DC 20460....

  17. 40 CFR 136.4 - Application for and approval of alternate test procedures for nationwide use.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... alternate test procedures for nationwide use. 136.4 Section 136.4 Protection of Environment ENVIRONMENTAL... Procedure (ATP) Program Coordinator (National Coordinator), Office of Science and Technology (4303T), Office of Water, U.S. Environmental Protection Agency, 1200 Pennsylvania Ave. NW., Washington, DC 20460....

  18. 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…

  19. 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…

  20. 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...

  1. Presentation of continuous outcomes in randomised trials: an observational study

    PubMed Central

    Savage, Dan F; Altman, Douglas G

    2012-01-01

    Objective To characterise the percentage of available outcome data being presented in reports of randomised clinical trials with continuous outcome measures, thereby determining the potential for incomplete reporting bias. Design Descriptive cross sectional study. Data sources A random sample of 200 randomised trials from issues of 20 medical journals in a variety of specialties during 2007–09. Main outcome measures For each paper’s best reported primary outcome, we calculated the fraction of data reported using explicit scoring rules. For example, a two arm trial with 100 patients per limb that reported 2 sample sizes, 2 means, and 2 standard deviations reported 6/200 data elements (1.5%), but if that paper included a scatterplot with 200 points it would score 200/200 (100%). We also assessed compliance with 2001 CONSORT items about the reporting of results. Results The median percentage of data reported for the best reported continuous outcome was 9% (interquartile range 3–26%) but only 3.5% (3–7%) when we adjusted studies to 100 patients per arm to control for varying study size; 17% of articles showed 100% of the data. Tables were the predominant means of presenting the most data (59% of articles), but papers that used figures reported a higher proportion of data. There was substantial heterogeneity among journals with respect to our primary outcome and CONSORT compliance. Limitations We studied continuous outcomes of randomised trials in higher impact journals. Results may not apply to categorical outcomes, other study designs, or other journals. Conclusions Trialists present only a small fraction of available data. This paucity of data may increase the potential for incomplete reporting bias, a failure to present all relevant information about a study’s findings. PMID:23249670

  2. Randomised clinical trials with clinician-preferred treatment.

    PubMed

    Korn, E L; Baumrind, S

    1991-01-19

    The standard design for randomised clinical trials may be inappropriate when the clinician believes that one of the treatments being tested is superior for the patient, or when the clinician has a preference for one of the treatments. For such instances the suggestion is that the patient is randomly allocated to treatment only when there is clinical disagreement about treatment of choice for that patient, and then the patient is assigned to a clinician who had thought that the regimen allocated is the one most appropriate for that patient.

  3. 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...

  4. 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...

  5. 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...

  6. 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...

  7. 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...

  8. Changing Places: A Cross-Language Perspective on Frequency and Family Size in Dutch and Hebrew

    ERIC Educational Resources Information Center

    Moscoso del Prado Martin, Fermin; Deutsch, Avital; Frost, Ram; Schreuder, Robert; De Jong, Nivja H.; Baayen, R. Harald

    2005-01-01

    This study uses the morphological family size effect as a tool for exploring the degree of isomorphism in the networks of morphologically related words in the Hebrew and Dutch mental lexicon. Hebrew and Dutch are genetically unrelated, and they structure their morphologically complex words in very different ways. Two visual lexical decision…

  9. Social Workers' Orientation toward the Evidence-Based Practice Process: A Dutch Survey

    ERIC Educational Resources Information Center

    van der Zwet, Renske J. M.; Kolmer, Deirdre M. Beneken genaamd; Schalk, René

    2016-01-01

    Objectives: This study assesses social workers' orientation toward the evidence-based practice (EBP) process and explores which specific variables (e.g. age) are associated. Methods: Data were collected from 341 Dutch social workers through an online survey which included a Dutch translation of the EBP Process Assessment Scale (EBPPAS), along with…

  10. Parent Involvement as Professionalization: Professionals' Struggle for Power in Dutch Urban Deprived Areas

    ERIC Educational Resources Information Center

    van den Berg, Marguerite; van Reekum, Rogier

    2011-01-01

    Parent involvement policies have been central in the Dutch push towards educational governance. How the implementation of these policies plays out on the ground is context-dependent. The ethnic and class cleavages impacting the Dutch educational system should be taken into account. On the basis of 50 in-depth interviews with teachers, social…

  11. 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…

  12. 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…

  13. Eliminating Social Inequality by Reinforcing Standard Language Ideology? Language Policy for Dutch in Flemish Schools

    ERIC Educational Resources Information Center

    Delarue, Steven; De Caluwe, Johan

    2015-01-01

    Flanders, the northern, Dutch-speaking part of Belgium, is experiencing growing intra- and interlingual diversity. On the intralingual level, Tussentaal ("in-between-language") has emerged as a cluster of intermediate varieties between the Flemish dialects and Standard Dutch, gradually becoming "the" colloquial language. At the…

  14. 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)

  15. 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…

  16. Articles, Adjectives and Age of Onset: The Acquisition of Dutch Grammatical Gender

    ERIC Educational Resources Information Center

    Blom, Elma; Polisenska, Daniela; Weerman, Fred

    2008-01-01

    A comparison of the error profiles of monolingual (child L1) learners of Dutch, Moroccan children (child L2) and Moroccan adults (adult L2) learning Dutch as their L2 shows that participants in all groups massively overgeneralize [-neuter] articles to [+neuter] contexts. In all groups, the reverse gender mistake infrequently occurs. Gender…

  17. 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…

  18. 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…

  19. Asymmetries in the Acquisition of Subject-Verb Agreement in Dutch: Evidence from Comprehension and Production

    ERIC Educational Resources Information Center

    Verhagen, Josje; Blom, Elma

    2014-01-01

    Across languages, children do not comprehend 3SG/3PL subject-verb agreement before age five, despite early mastery in spontaneous speech. This study investigates subject-verb agreement in a language hitherto not studied in this respect, namely Dutch. The authors examine if (1) Dutch two- and three-year-olds comprehend subject-verb agreement and…

  20. Modeling the Developmental Patterning of Finiteness Marking in English, Dutch, German, and Spanish Using MOSAIC

    ERIC Educational Resources Information Center

    Freudenthal, Daniel; Pine, Julian M.; Aguado-Orea, Javier; Gobet, Fernand

    2007-01-01

    In this study, we apply MOSAIC (model of syntax acquisition in children) to the simulation of the developmental patterning of children's optional infinitive (OI) errors in 4 languages: English, Dutch, German, and Spanish. MOSAIC, which has already simulated this phenomenon in Dutch and English, now implements a learning mechanism that better…

  1. Acquiring reading and vocabulary in Dutch and English: the effect of concurrent instruction.

    PubMed

    van der Leij, Aryan; Bekebrede, Judith; Kotterink, Mieke

    2010-03-01

    To investigate the effect of concurrent instruction in Dutch and English on reading acquisition in both languages, 23 pupils were selected from a school with bilingual education, and 23 from a school with education in Dutch only. The pupils had a Dutch majority language background and were comparable with regard to social-economic status (SES). Reading and vocabulary were measured twice within an interval of 1 year in Grade 2 and 3. The bilingual group performed better on most English and some of the Dutch tests. Controlling for general variables and related skills, instruction in English contributed significantly to the prediction of L2 vocabulary and orthographic awareness at the second measurement. As expected, word reading fluency was easier to acquire in Dutch with its relatively transparent orthography in comparison to English with its deep orthography, but the skills intercorrelated highly. With regard to cross-linguistic transfer, orthographic knowledge and reading comprehension in Dutch were positively influenced by bilingual instruction, but there was no indication of generalization to orthographic awareness or knowledge of a language in which no instruction had been given (German). The results of the present study support the assumption that concurrent instruction in Dutch and English has positive effects on the acquisition of L2 English and L1 Dutch.

  2. Influence of Linguistic Environment on Children's Language Development: Flemish versus Dutch Children

    ERIC Educational Resources Information Center

    Wiefferink, C. H.; Spaai, G. W. G.; Uilenburg, N.; Vermeij, B. A. M.; De Raeve, L.

    2008-01-01

    In the present study, language development of Dutch children with a cochlear implant (CI) in a bilingual educational setting and Flemish children with a CI in a dominantly monolingual educational setting is compared. In addition, we compared the development of spoken language with the development of sign language in Dutch children. Eighteen…

  3. The effects of an Internet based self-help course for reducing panic symptoms - Don't Panic Online: study protocol for a randomised controlled trial

    PubMed Central

    2011-01-01

    Background Internet based self-help for panic disorder (PD) has proven to be effective. However, studies so far have focussed on treating a full-blown disorder. Panic symptoms that do not meet DSM-IV criteria are more prevalent than the full-blown disorder and patients with sub-clinical panic symptoms are at risk of developing PD. This study is a randomised controlled trial aimed to evaluate an Internet based self-help intervention for sub-clinical and mild PD compared to a waiting list control group. Methods Participants with mild or sub-clinical PD (N = 128) will be recruited in the general population. Severity of panic and anxiety symptoms are the primary outcome measures. Secondary outcomes include depressive symptoms, quality of life, loss of production and health care consumption. Assessments will take place on the Internet at baseline and three months after baseline. Discussion Results will indicate the effectiveness of Internet based self-help for sub-clinical and mild PD. Strengths of this design are the external validity and the fact that it is almost completely conducted online. Trial registration Netherlands Trial Register (NTR): NTR1639 The Netherlands Trial Register is part of the Dutch Cochrane Centre. PMID:21396089

  4. Effectiveness and cost-effectiveness of an injury prevention programme for adult male amateur soccer players: design of a cluster-randomised controlled trial

    PubMed Central

    Krist, Mark R; Schmikli, Sandor L; Stubbe, Janine H; de Wit, G Ardine; Inklaar, Han; van de Port, Ingrid G L; Backx, Frank J G

    2010-01-01

    Background and aims Approximately 16% of all sports injuries in the Netherlands are caused by outdoor soccer. A cluster-randomised controlled trial has been designed to investigate the effectiveness and cost-effectiveness of an injury prevention programme (‘The11’) for male amateur soccer players. The injury prevention programme The11, developed with the support of the World Football Association FIFA, aims to reduce the impact of intrinsic injury risk factors in soccer. Methods Teams playing at first-class amateur level in two districts in the Netherlands are participating in the study. Teams in the intervention group were instructed to apply The11 during each practice session throughout the 2009–10 season. All participants of the control group continued their practice sessions as usual. All soccer-related injuries and related costs for each team were systematically reported online by a member of the medical staff. Player exposure to practice sessions and matches was reported weekly by the coaches. Also the use of The11 during the season after the intervention season will be monitored. Discussion Our hypothesis is that integrating the The11 exercises in the warm-up for each practice session is effective in terms of injury incidence, injury severity, healthcare use, and its associated costs and/or absenteeism. Prevention of soccer injuries is expected to be beneficial to adult soccer players, soccer clubs, the Royal Dutch Football Association (KNVB), health insurance companies and society. PMID:21177664

  5. 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...

  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. The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions

    PubMed Central

    Downs, S. H.; Black, N.

    1998-01-01

    OBJECTIVE: To test the feasibility of creating a valid and reliable checklist with the following features: appropriate for assessing both randomised and non-randomised studies; provision of both an overall score for study quality and a profile of scores not only for the quality of reporting, internal validity (bias and confounding) and power, but also for external validity. DESIGN: A pilot version was first developed, based on epidemiological principles, reviews, and existing checklists for randomised studies. Face and content validity were assessed by three experienced reviewers and reliability was determined using two raters assessing 10 randomised and 10 non- randomised studies. Using different raters, the checklist was revised and tested for internal consistency (Kuder-Richardson 20), test-retest and inter-rater reliability (Spearman correlation coefficient and sign rank test; kappa statistics), criterion validity, and respondent burden. MAIN RESULTS: The performance of the checklist improved considerably after revision of a pilot version. The Quality Index had high internal consistency (KR-20: 0.89) as did the subscales apart from external validity (KR-20: 0.54). Test-retest (r 0.88) and inter-rater (r 0.75) reliability of the Quality Index were good. Reliability of the subscales varied from good (bias) to poor (external validity). The Quality Index correlated highly with an existing, established instrument for assessing randomised studies (r 0.90). There was little difference between its performance with non-randomised and with randomised studies. Raters took about 20 minutes to assess each paper (range 10 to 45 minutes). CONCLUSIONS: This study has shown that it is feasible to develop a checklist that can be used to assess the methodological quality not only of randomised controlled trials but also non-randomised studies. It has also shown that it is possible to produce a checklist that provides a profile of the paper, alerting reviewers to its particular

  9. The distribution of suspended matter in the Dutch coastal zone

    NASA Astrophysics Data System (ADS)

    Visser, M.; de Ruijter, W. P. M.; Postma, L.

    Results are presented of suspended matter observations taken at bi-weekly intervals during the period 1975-1983, in a strip 70 km wide along the Dutch coast. The average distribution showed a (weak) minimum zone located north of Noordwijk at a distance of about 30 km from and parallel to the Dutch coast, between the salinity maximum and the coast. Variability was large between different years, seasons and individual cruises. A clear seasonal cycle emerged from the observed suspended-matter patterns: in winter a pronounced minimum existed, while in summer generally a monotonically decreasing concentration was measured, to open-sea values much lower than in winter. This seasonal cycle may be explained by a combination of variation in wind, river discharge and the activity of suspended-matter sources. The Flemish Banks and Channel waters are the main sources supplying suspended matter to the Dutch coastal area. Especially the varying transport through the Strait of Dover, large in winter, small in summer, determines the seasonal variation in the total amount of suspended matter. The existence of a localized turbidity minimum is tied to relatively large discharges from the Rhine and associated steep salinity gradients, also occurring mainly in winter and early spring. A simple model of cross-shore density-driven circulation shows the possible influence of the strong salinity gradients on the sedimentation of suspended matter. Particles with a settling rate comparable to the vertical velocity component of the circulation are forced to move offshore until they reach an area they sink out of the surface layer. The strength of this circulation is determined by the cross-shore density gradient due to the inflow of fresh water from the Rhine-Meuse estuary.

  10. Secular trend of dental development in Dutch children.

    PubMed

    Vucic, Strahinja; de Vries, Esther; Eilers, Paul H C; Willemsen, Sten P; Kuijpers, Mette A R; Prahl-Andersen, Birte; Jaddoe, Vincent W V; Hofman, Albert; Wolvius, Eppo B; Ongkosuwito, Edwin M

    2014-09-01

    Many studies have established dental age standards for different populations; however, very few studies have investigated whether dental development is stable over time on a population level. Therefore, the aim of this study was to analyze changes in dental maturity in Dutch children born between 1961 and 2004. We used 2,655 dental panoramic radiographs of 2- to 16-year-old Dutch children from studies performed in three major cities in the Netherlands. Based on a trend in children born between 1961 and 1994, we predicted that a child of a certain age and gender born in 1963 achieved the same dental maturity on average, 1.5 years later than a child of the same age born 40 years later. After adjusting for the birth year of a child in the analysis, the regression coefficient of the city variable was reduced by 56.6% and it remained statistically significant. The observed trend from 1961 to 1994 was extrapolated to 9- to 10-year-old children born in 2002-2004, and validation with the other samples of children with the same characteristics showed that 95.9%-96.8% of the children had dental maturity within the 95% of the predicted range. Dental maturity score was significantly and positively associated with the year of birth, gender, and age in Dutch children, indicating a trend in earlier dental development during the observation period, 1961-2004. These findings highlight the necessity of taking the year of birth into account when assessing dental development within a population with a wider time span. PMID:24912457

  11. Choices in Dutch health care: mixing strategies and responsibilities.

    PubMed

    van der Grinten, T E; Kasdorp, J P

    1999-12-01

    In the light of experience that choices in health care appear to be not so much hindered by a lack of insight into how choices should be made in theory, as uncertainty as to how choices could be made in practice, this paper sets out to deepen our insight into the dynamics of health care policy making within the concrete socio-economic and political context. The paper examines how Dutch policy-makers have dealt with the priority issue in health care over the past 10 years by means of a gradual incremental approach. In this approach, use is made of a mix of strategies and shared responsibilities, with an important role for the actors at the meso and the micro levels; while at the same time, the government has not abandoned the tried and trusted policy of national rationing (i.e. keeping the production capacity limited and setting a ceiling on production in order to resist the pressure on the public system of Dutch health care). Looking at the declining percentage of Gross National Product assigned to health care annually, the broad accessibility and the good overall quality of Dutch health care, it may be concluded that the issue of choice has not come off badly under this mixed approach. The degree to which the system can respond adequately to likely developments, such as a recession, worsening waiting lists, further liberalisation (i.e. the application of market forces in health care) and, by way of extension, the ongoing integration of 'Europe' is questioned.

  12. Autonomic and Climatic Impacts on the Dutch Coastal Groundwater System

    NASA Astrophysics Data System (ADS)

    van Baaren, E. S.; Oude Essink, G. H.

    2008-12-01

    Half of the Netherlands is located below sea level and still land subsidence is taking place. As saline groundwater is found within a couple of meters below ground surface, salinization of the freshwater resources is taking place. Above mentioned process together with anthropogenic activities like groundwater exploitation and differentiated water level management is called the autonomic process. As a consequence, salt seepage affects the quality of surface water and reduces the freshwater volume necessary for drinking, environmental, industrial and agricultural purposes. Apart from this autonomic process, the Dutch delta will be jeopardized by climate change due to two effects: sea level rise and a combination of changing precipitation and evapotranspiration. Calculations with a regional density dependent 3D model for the coastal province of Zuid-Holland show increasing piezometric heads for all implemented climate scenarios due to sea level rise. This will, however, only happen at areas less than 10-20 km from the coastline or large rivers. Up to 5 km from the coast, the piezometric heads will increase with more than 50% of the sea level rise. In the inland areas, land subsidence causes decreasing piezometric heads. Salinization of the groundwater system will take place in most parts of the Dutch delta. Around the islands of Zuid-Holland, the main cause for salinization is sea level rise. The autonomic process on the other hand dominates the salinization of the polders. Due to increasing piezometric heads and salinization, the salt seepage will increase up to 20% for inland polders and up to 75% for coastal polders. The effects of the changes in recharge and evapotranspiration are small in general and depend on the climate scenario and area. Adaptive and mitigative activities like land reclamation offshore and desalinization of saline groundwater show some positive effects on the chloride concentrations of the groundwater. Nevertheless, this cannot reverse the

  13. Achieving lipid goals in real life: the Dutch DISCOVERY study.

    PubMed

    Bots, A F E; Kastelein, J J P

    2005-12-01

    DISCOVERY Netherlands was an open-label, randomised, multicentre study (D3560/L00003) designed to compare the effects of rosuvastatin with those of atorvastatin, simvastatin or pravastatin on low-density lipoprotein cholesterol (LDL-C) goal achievement in a primary care setting. Patients (n = 1,215) with type IIa or type IIb hypercholesterolaemia and cardiovascular risk of >20% or a history of coronary heart or other atherosclerotic vascular disease were randomised to receive treatment with rosuvastatin 10 mg (n = 621), atorvastatin 10 mg (n = 189), simvastatin 20 mg (n = 194) or pravastatin 40 mg (n = 211) for 12 weeks. Significantly, more patients achieved 1998 and 2003 European LDL-C goals with rosuvastatin than with other statins after 12 weeks (p < 0.001). Rosuvastatin reduced LDL-C and total cholesterol levels significantly more than other statins, both in patients who were statin-naïve and in patients who had received previous statin treatment (p < 0.05). All treatments were similarly well tolerated. In conclusion, greater reductions in LDL-C were achieved with rosuvastatin compared with atorvastatin, simvastatin and pravastatin, enabling more patients to achieve European LDL-C goals.

  14. 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

  15. [Assessing and measuring language development in the child. The Reynell Scales in a Dutch language area].

    PubMed

    Schaerlaekens, A

    1995-01-01

    This article deals with the recent adaptation of the Reynell Developmental Language Scales to the Dutch language. The existing language tests for the Dutch language are reviewed and the need to adapt a test for young children, measuring both receptive and expressive language development, is argued. The adaptation of the original Reynell Developmental Language Scales to the Dutch language is described. An extensive standardisation was carried out with 1,288 Dutch-speaking children, carefully selected geographically and according to socio-economic status. The psychodiagnostic results of the standardisation are discussed. As a result there are now norms for children between 2 and 5 years, both for receptive and expressive language development. The adaptation of the original Reynell Scales to Dutch functions under the new name RTOS (Reynell Taalontwikkelingsschalen).

  16. Phonological and morphological consistency in the acquisition of vowel duration spelling in Dutch and German.

    PubMed

    Landerl, Karin; Reitsma, Pieter

    2005-12-01

    In Dutch, vowel duration spelling is phonologically consistent but morphologically inconsistent (e.g., paar-paren). In German, it is phonologically inconsistent but morphologically consistent (e.g., Paar-Paare). Contrasting the two orthographies allowed us to examine the role of phonological and morphological consistency in the acquisition of the same orthographic feature. Dutch and German children in Grades 2 to 4 spelled singular and plural word forms and in a second task identified the correct spelling of singular and plural forms of the same nonword. Dutch children were better in word spelling, but German children outperformed the Dutch children in nonword selection. Also, whereas German children performed on a similar level for singular and plural items, Dutch children showed a large discrepancy. The results indicate that children use phonological and morphological rules from an early age but that the developmental balance between the two sources of information is constrained by the specific orthography. PMID:15975590

  17. Randomised trials in context: practical problems and social aspects of evidence-based medicine and policy.

    PubMed

    Pearce, Warren; Raman, Sujatha; Turner, Andrew

    2015-01-01

    Randomised trials can provide excellent evidence of treatment benefit in medicine. Over the last 50 years, they have been cemented in the regulatory requirements for the approval of new treatments. Randomised trials make up a large and seemingly high-quality proportion of the medical evidence-base. However, it has also been acknowledged that a distorted evidence-base places a severe limitation on the practice of evidence-based medicine (EBM). We describe four important ways in which the evidence from randomised trials is limited or partial: the problem of applying results, the problem of bias in the conduct of randomised trials, the problem of conducting the wrong trials and the problem of conducting the right trials the wrong way. These problems are not intrinsic to the method of randomised trials or the EBM philosophy of evidence; nevertheless, they are genuine problems that undermine the evidence that randomised trials provide for decision-making and therefore undermine EBM in practice. Finally, we discuss the social dimensions of these problems and how they highlight the indispensable role of judgement when generating and using evidence for medicine. This is the paradox of randomised trial evidence: the trials open up expert judgment to scrutiny, but this scrutiny in turn requires further expertise. PMID:26341114

  18. Randomised trials in context: practical problems and social aspects of evidence-based medicine and policy.

    PubMed

    Pearce, Warren; Raman, Sujatha; Turner, Andrew

    2015-09-01

    Randomised trials can provide excellent evidence of treatment benefit in medicine. Over the last 50 years, they have been cemented in the regulatory requirements for the approval of new treatments. Randomised trials make up a large and seemingly high-quality proportion of the medical evidence-base. However, it has also been acknowledged that a distorted evidence-base places a severe limitation on the practice of evidence-based medicine (EBM). We describe four important ways in which the evidence from randomised trials is limited or partial: the problem of applying results, the problem of bias in the conduct of randomised trials, the problem of conducting the wrong trials and the problem of conducting the right trials the wrong way. These problems are not intrinsic to the method of randomised trials or the EBM philosophy of evidence; nevertheless, they are genuine problems that undermine the evidence that randomised trials provide for decision-making and therefore undermine EBM in practice. Finally, we discuss the social dimensions of these problems and how they highlight the indispensable role of judgement when generating and using evidence for medicine. This is the paradox of randomised trial evidence: the trials open up expert judgment to scrutiny, but this scrutiny in turn requires further expertise.

  19. Sample size slippages in randomised trials: exclusions and the lost and wayward.

    PubMed

    Schulz, Kenneth F; Grimes, David A

    2002-03-01

    Proper randomisation means little if investigators cannot include all randomised participants in the primary analysis. Participants might ignore follow-up, leave town, or take aspartame when instructed to take aspirin. Exclusions before randomisation do not bias the treatment comparison, but they can hurt generalisability. Eligibility criteria for a trial should be clear, specific, and applied before randomisation. Readers should assess whether any of the criteria make the trial sample atypical or unrepresentative of the people in which they are interested. In principle, assessment of exclusions after randomisation is simple: none are allowed. For the primary analysis, all participants enrolled should be included and analysed as part of the original group assigned (an intent-to-treat analysis). In reality, however, losses frequently occur. Investigators should, therefore, commit adequate resources to develop and implement procedures to maximise retention of participants. Moreover, researchers should provide clear, explicit information on the progress of all randomised participants through the trial by use of, for instance, a trial profile. Investigators can also do secondary analyses on, for instance, per-protocol or as-treated participants. Such analyses should be described as secondary and non-randomised comparisons. Mishandling of exclusions causes serious methodological difficulties. Unfortunately, some explanations for mishandling exclusions intuitively appeal to readers, disguising the seriousness of the issues. Creative mismanagement of exclusions can undermine trial validity.

  20. Alcohol intake and cardiovascular risk factors: A Mendelian randomisation study

    PubMed Central

    Cho, Yoonsu; Shin, So-Youn; Won, Sungho; Relton, Caroline L; Davey Smith, George; Shin, Min-Jeong

    2015-01-01

    Mendelian randomisation studies from Asia suggest detrimental influences of alcohol on cardiovascular risk factors, but such associations are observed mainly in men. The absence of associations of genetic variants (e.g. rs671 in ALDH2) with such risk factors in women – who drank little in these populations – provides evidence that the observations are not due to genetic pleiotropy. Here, we present a Mendelian randomisation study in a South Korean population (3,365 men and 3,787 women) that 1) provides robust evidence that alcohol consumption adversely affects several cardiovascular disease risk factors, including blood pressure, waist to hip ratio, fasting blood glucose and triglyceride levels. Alcohol also increases HDL cholesterol and lowers LDL cholesterol. Our study also 2) replicates sex differences in associations which suggests pleiotropy does not underlie the associations, 3) provides further evidence that association is not due to pleiotropy by showing null effects in male non-drinkers, and 4) illustrates a way to measure population-level association where alcohol intake is stratified by sex. In conclusion, population-level instrumental variable estimation (utilizing interaction of rs671 in ALDH2 and sex as an instrument) strengthens causal inference regarding the largely adverse influence of alcohol intake on cardiovascular health in an Asian population. PMID:26687910

  1. Mendelian Randomisation Study of Childhood BMI and Early Menarche.

    PubMed

    Mumby, Hannah S; Elks, Cathy E; Li, Shengxu; Sharp, Stephen J; Khaw, Kay-Tee; Luben, Robert N; Wareham, Nicholas J; Loos, Ruth J F; Ong, Ken K

    2011-01-01

    To infer the causal association between childhood BMI and age at menarche, we performed a mendelian randomisation analysis using twelve established "BMI-increasing" genetic variants as an instrumental variable (IV) for higher BMI. In 8,156 women of European descent from the EPIC-Norfolk cohort, height was measured at age 39-77 years; age at menarche was self-recalled, as was body weight at age 20 years, and BMI at 20 was calculated as a proxy for childhood BMI. DNA was genotyped for twelve BMI-associated common variants (in/near FTO, MC4R, TMEM18, GNPDA2, KCTD15, NEGR1, BDNF, ETV5, MTCH2, SEC16B, FAIM2 and SH2B1), and for each individual a "BMI-increasing-allele-score" was calculated by summing the number of BMI-increasing alleles across all 12 loci. Using this BMI-increasing-allele-score as an instrumental variable for BMI, each 1 kg/m(2) increase in childhood BMI was predicted to result in a 6.5% (95% CI: 4.6-8.5%) higher absolute risk of early menarche (before age 12 years). While mendelian randomisation analysis is dependent on a number of assumptions, our findings support a causal effect of BMI on early menarche and suggests that increasing prevalence of childhood obesity will lead to similar trends in the prevalence of early menarche.

  2. A randomised controlled trial of treatment for idiopathic intracranial hypertension.

    PubMed

    Ball, Alexandra K; Howman, Andrew; Wheatley, Keith; Burdon, Michael A; Matthews, Timothy; Jacks, Andrew S; Lawden, Mark; Sivaguru, Arul; Furmston, Alexandra; Howell, Steven; Sharrack, Basil; Davies, M Brendan; Sinclair, Alexandra J; Clarke, Carl E

    2011-05-01

    The cause of idiopathic intracranial hypertension (IIH) remains unknown, and no consensus exists on how patients should be monitored and treated. Acetazolamide is a common treatment but has never been examined in a randomised controlled trial. The objectives of this pilot trial are to prospectively evaluate the use of acetazolamide, to explore various outcome measures and to inform the design of a definitive trial in IIH. Fifty patients were recruited from six centres over 23 months and randomised to receive acetazolamide (n = 25) or no acetazolamide (n = 25). Symptoms, body weight, visual function and health-related quality-of-life measures were recorded over a 12-month period. Recruited patients had typical features of mild IIH and most showed improvement, with 44% judged to have IIH in remission at the end of the trial. Difficulties with recruitment were highlighted as well as poor compliance with acetazolamide therapy (12 patients). A composite measure of IIH status was tested, and the strongest concordance with final disease status was seen with perimetry (Somers' D = 0.66) and optic disc appearance (D = 0.59). Based on the study data, a sample size of 320 would be required to demonstrate a 20% treatment effect in a substantive trial. Clinical trials in IIH require pragmatic design to involve sufficiently large numbers of patients. Future studies should incorporate weighted composite scores to reflect the relative importance of common outcome measures in IIH.

  3. Relation between burden of disease and randomised evidence in sub-Saharan Africa: survey of research

    PubMed Central

    Isaakidis, Petros; Swingler, George H; Pienaar, Elizabeth; Volmink, Jimmy; Ioannidis, John P A

    2002-01-01

    Objective To evaluate whether the amount of randomised clinical research on various medical conditions is related to the burden of disease and health needs of the local populations in sub-Saharan Africa. Design Construction and analysis of comprehensive database of randomised controlled trials in sub-Saharan Africa based on Medline, the Cochrane Controlled Trials Register, and several African databases. Setting Sub-Saharan Africa. Main outcome measures Number of trials and randomised subjects for each category of disease in the global burden of disease taxonomy; ratios of disability adjusted life years (DALYs) per amount of randomised evidence. Results 1179 eligible randomised controlled trials were identified. The number of trials published each year increased over time. Almost half of the trials (n=565) had been done in South Africa. There was relatively good correlation between the estimated burden of disease at year 2000 and the number of trials performed (r=0.53, P=0.024) and the number of participants randomised (r=0.68, P=0.002). However,some conditions—for example, injuries (over 20 000 DALYs per patient ever randomised)—were more neglected than others. Conclusion Despite recent improvements, few clinical trials are done in sub-Saharan Africa. Clinical research in this part of the world should focus more evenly on the major contributors to burden of disease. What is already known on this topicSub-Saharan Africa has a large burden of diseaseLittle clinical research is conducted for problems affecting sub-Saharan AfricaWhat this study addsOnly 1179 randomised controlled trials conducted in sub-Saharan Africa in the past 50 years were identifiedCorrelation between the amount of randomised evidence and the estimated burden of disease was fairly goodHowever, some disease categories were more neglected than others, with the worst being injuries PMID:11909786

  4. Rationing and competition in the Dutch health-care system.

    PubMed

    Schut, Frederik T; Van de Ven, Wynand P M M

    2005-09-01

    In this paper we examine the goals and effects of health-care policy in the Netherlands over the period 1980--2000. During this period Dutch health-care policy is marked by a peculiar combination of increasingly stringent cost-containment policies alongside a persistent pursuit of market-oriented reforms. The main goal of cost containment was to keep labour costs down under the restriction of universal equal access to health care. Supply and price control policies were quite successful in achieving cost containment, but in due course prolonged quantity rationing began to jeopardise universal physical access to health services. The main goal of market-oriented health-care reforms is to increase the system's efficiency and its responsiveness to patient's needs, while maintaining equal access. The feasibility of the reforms crucially hinges on the realisation of adequate methods of risk adjustment, product classification and quality measurement, an appropriate consumer information system and an effective competition policy. Realising these preconditions requires a lengthy and cautious implementation process. Although considerable progress has been made in setting the appropriate stage for regulated competition in Dutch health care, the role of the market is still limited. PMID:16161190

  5. A change of direction in the Dutch health care system?

    PubMed

    Lapré, R M

    1988-08-01

    The Dutch health care system seems to be undergoing a clear change of direction. The publication of the Report of the Committee of the Structure and Financing of the Health Care System is a prominent document which marks the emergence of a new trend. After an analysis of the characteristics of the Dutch health care system in the periods 1960-1975 and 1975-1985, an account is given of the most important proposals of the committee. The proposals clearly alter the trend towards more governmental involvement. They envisage a more market-oriented approach and freedom of operation while at the same time paying attention to aspects such as solidarity and social justice. The Committee's suggestions include the introduction of a basic insurance scheme for every citizen with a coverage determined by law, and in addition a voluntary supplementary insurance scheme in which the insured can decide what coverage he requires and that the insurer is obliged to accept him. The fact that there is a certain amount of agreement, at least over the direction that the strategy for change should take, justifies the expectation that many of the committee's proposals will be implemented. PMID:10288395

  6. [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.

  7. Control of VTEC in Dutch livestock and meat production.

    PubMed

    Reinders, R D; Weber, M F; Lipman, L J; Verhoeff, J; Bijker, P G

    2001-05-21

    The Dutch government and the meat industry, recognising VTEC as having important public health, meat quality and economic implications, have taken a number of initiatives within the last 5 years to control VTEC in livestock and meat. These initiatives, brought together last year in a 'Masterplan VTEC', include short-, middle- and long-term priorities. Short-term priorities include advice on interventions in the cases of an outbreak of VTEC associated with a cattle herd, the implementation of handbooks for Good Manufacturing Practice (GMP) in slaughterhouses and deboning plants, and the execution of an action programme on zero-tolerance to faecal contamination of carcasses. Mid-term activities include surveillance of the occurrence of VTEC and other enteropathogens in livestock and meat, and the investigations of VTEC population dynamics in dairy farms, transportation and farm hygiene. In the longer term, this programme aims to produce a system of Integrated Quality Assurance, consolidating effective measures to control VTEC in Dutch livestock and meat, and integrating emerging means for control and prevention. PMID:11407551

  8. The disappearance of Dutch malaria and the Rockefeller Foundation.

    PubMed

    Verhave, J P

    2000-06-01

    Sixty years ago Professor Nico Swellengrebel wrote his famous book 'Malaria in the Netherlands' (Swellengrebel and de Buck, 1938). At that time tertian malaria was still endemic, with its epidemic ups and downs. Malaria disappeared as recently as 1960 and the Rockefeller Foundation (RF) contributed substantially to this effect. The Rockefeller Archives proved a valuable source of anecdotal information, which puts the scientific publications of the Dutch malariologists in a more vivid perspective. Following the course of history, first the already existing links with the RF are explained along with some peculiarities of tertian malaria in the Dutch temperate climate. The emergence of a new epidemic during the war years and the implication of new tools and principles for control as advocated by the RF are described. The subsequent shriveling of the vector population and the disappearance of malaria are presented, along with some details about the reluctance of WHO to declare the Netherlands malaria-free. Finally, recent unrest about possible return of malaria is put into perspective.

  9. 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.

  10. An acoustical study of the voicing distinction in Dutch plosives

    NASA Astrophysics Data System (ADS)

    van Alphen, Petra M.

    2002-05-01

    Dutch has two voiced plosives, namely /b/ and /d/. They are said to have a negative VOT (i.e., are prevoiced), while the voiceless plosives /p/ and /t/ have a small, positive VOT. A production study was designed to investigate two questions. First, how does prevoicing vary in spoken Dutch? Second, what other cues in the acoustic signal might contribute to the perceptual distinction between voiced and voiceless plosives? Ten subjects were asked to produce a list of monosyllabic words which were chosen to study the following factors: place of articulation (labial versus alveolar), following phoneme (vowel versus consonant), lexical status of the carrier stimulus (word versus nonword), and lexical competitor environment of the carrier stimulus. Results will be reported on the relative contribution of various durational, spectral, and energy measures to the voiced-voiceless distinction. The data showed that 25% of all tokens were produced without prevoicing. The prevoicing of the voiced plosive was omitted more often when the plosive was followed by a consonant than when it was followed by a vowel. Although both spectral and energy cues signal the voicing distinction, and although prevoicing is often omitted, VOT appears to be the primary cue to this distinction.

  11. Black Pete through the Eyes of Dutch Children.

    PubMed

    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

  12. Residential mental health assessment within Dutch criminal cases: a discussion.

    PubMed

    van der Leij, J B; Jackson, J L; Malsch, M; Nijboer, J F

    2001-01-01

    In Dutch criminal cases in which doubts arise about the defendant's mental health, a forensic assessment will be requested. This is provided either by the multidisciplinary staff of residential clinics who conduct forensic evaluations for the court, or by mental health professionals contracted on a part-time basis by district courts. This article discusses the procedures applied in such cases as well as the relevant legal provisions. It focuses particularly on the clinical observation, evaluation, and reporting that is carried out over a number of weeks in the residential setting of the Pieter Baan Centrum. Specific attention is paid to procedures applied in this clinic. It is suggested that Dutch procedures for the use of mental health expertise can best be characterized by three aspects: multidisciplinary observation and reporting, the use of a sliding scale for indicating degree of responsibility, and, finally, the involvement and payment of experts by the state as such, rather than by the prosecution and/or the defense.

  13. 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…

  14. 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

  15. Technical support functions in a commercial PET environment: The challenge of a nationwide network

    NASA Astrophysics Data System (ADS)

    Zigler, Steven S.; Torres, Steven P.

    2007-08-01

    The short half-life of positron-emitting radionuclides requires a highly distributed network to provide a nationwide supply of radiopharmaceuticals for PET. Such a network creates unique challenges that are previously unknown in the production and delivery of traditional radiopharmaceuticals used in diagnostic nuclear medicine studies. Technical support plays a key role in any production process, but is especially critical in a distributed PET production environment. The infrastructure required to provide effective technical support in PET on a nationwide level has not been previously described. This paper describes PETNET's efforts to develop a cost-effective technical support system, including: (a) operations training, (b) real-time support for equipment and process related problems, (c) development of process improvements and (d) technical documentation.

  16. 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.

  17. 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.

  18. Clinicoepidemiologic status of mother-to-child infections: a nationwide survey in Japan.

    PubMed

    Torii, Yuka; Kimura, Hiroshi; Ito, Yoshinori; Hayakawa, Masahiro; Tanaka, Toshihiro; Tajiri, Hitoshi; Yoto, Yuko; Tanaka-Taya, Keiko; Kanegane, Hirokazu; Nariai, Akiyoshi; Sakata, Hiroshi; Tsutsumi, Hiroyuki; Oda, Megumi; Yokota, Shumpei; Morishima, Tsuneo; Moriuchi, Hiroyuki

    2013-06-01

    We conducted a nationwide survey of the present status of 10 representative mother-to-child infections in Japan. Congenital syphilis, vertical human T-cell leukemia virus type 1 infection, congenital rubella and vertical HIV infection, for which effective preventative strategies have been established, were rare. Cytomegalovirus was the most common congenital pathogen in Japan, although most infants with congenital cytomegalovirus infection may remain undiagnosed. PMID:23429560

  19. Deprescribing in Frail Older People: A Randomised Controlled Trial

    PubMed Central

    Potter, Kathleen; Flicker, Leon; Page, Amy; Etherton-Beer, Christopher

    2016-01-01

    Objectives Deprescribing has been proposed as a way to reduce polypharmacy in frail older people. We aimed to reduce the number of medicines consumed by people living in residential aged care facilities (RACF). Secondary objectives were to explore the effect of deprescribing on survival, falls, fractures, hospital admissions, cognitive, physical, and bowel function, quality of life, and sleep. Methods Ninety-five people aged over 65 years living in four RACF in rural mid-west Western Australia were randomised in an open study. The intervention group (n = 47) received a deprescribing intervention, the planned cessation of non-beneficial medicines. The control group (n = 48) received usual care. Participants were monitored for twelve months from randomisation. Primary outcome was change in the mean number of unique regular medicines. All outcomes were assessed at baseline, six, and twelve months. Results Study participants had a mean age of 84.3±6.9 years and 52% were female. Intervention group participants consumed 9.6±5.0 and control group participants consumed 9.5±3.6 unique regular medicines at baseline. Of the 348 medicines targeted for deprescribing (7.4±3.8 per person, 78% of regular medicines), 207 medicines (4.4±3.4 per person, 59% of targeted medicines) were successfully discontinued. The mean change in number of regular medicines at 12 months was -1.9±4.1 in intervention group participants and +0.1±3.5 in control group participants (estimated difference 2.0±0.9, 95%CI 0.08, 3.8, p = 0.04). Twelve intervention participants and 19 control participants died within 12 months of randomisation (26% versus 40% mortality, p = 0.16, HR 0.60, 95%CI 0.30 to 1.22) There were no significant differences between groups in other secondary outcomes. The main limitations of this study were the open design and small participant numbers. Conclusions Deprescribing reduced the number of regular medicines consumed by frail older people living in residential care with no

  20. A pragmatic cluster randomised trial evaluating three implementation interventions

    PubMed Central

    2012-01-01

    Background Implementation research is concerned with bridging the gap between evidence and practice through the study of methods to promote the uptake of research into routine practice. Good quality evidence has been summarised into guideline recommendations to show that peri-operative fasting times could be considerably shorter than patients currently experience. The objective of this trial was to evaluate the effectiveness of three strategies for the implementation of recommendations about peri-operative fasting. Methods A pragmatic cluster randomised trial underpinned by the PARIHS framework was conducted during 2006 to 2009 with a national sample of UK hospitals using time series with mixed methods process evaluation and cost analysis. Hospitals were randomised to one of three interventions: standard dissemination (SD) of a guideline package, SD plus a web-based resource championed by an opinion leader, and SD plus plan-do-study-act (PDSA). The primary outcome was duration of fluid fast prior to induction of anaesthesia. Secondary outcomes included duration of food fast, patients’ experiences, and stakeholders’ experiences of implementation, including influences. ANOVA was used to test differences over time and interventions. Results Nineteen acute NHS hospitals participated. Across timepoints, 3,505 duration of fasting observations were recorded. No significant effect of the interventions was observed for either fluid or food fasting times. The effect size was 0.33 for the web-based intervention compared to SD alone for the change in fluid fasting and was 0.12 for PDSA compared to SD alone. The process evaluation showed different types of impact, including changes to practices, policies, and attitudes. A rich picture of the implementation challenges emerged, including inter-professional tensions and a lack of clarity for decision-making authority and responsibility. Conclusions This was a large, complex study and one of the first national randomised

  1. A progress report on a prospective randomised trial of open and robotic prostatectomy.

    PubMed

    Gardiner, Robert A; Coughlin, Geoffrey D; Yaxley, John W; Dunglison, Nigel T; Occhipinti, Stefano; Younie, Sandra J; Carter, Rob C; Williams, Scott G; Medcraft, Robyn J; Samaratunga, Hema M; Perry-Keene, Joanna L; Payton, Diane J; Lavin, Martin F; Chambers, Suzanne K

    2014-03-01

    A randomised trial of robotic and open prostatectomy commenced in October 2010 and is progressing well. Clinical and quality of life outcomes together with economic costs to individuals and the health service are being examined critically to compare outcomes.

  2. Ethical considerations in placebo-controlled randomised clinical trials

    PubMed Central

    2015-01-01

    Summary Ethical considerations in standard medical care and clinical research are underpinnings to quality medicine. Similarly, the placebo-controlled double-blind randomised clinical trial is the gold standard for medical research and fundamental to the development of evidence-based medicine. Researchers and clinicians are challenged by ethical concerns in the informed consent with a need to maximise understanding and minimise therapeutic misconception. This editorial expands on themes raised by Chen et al’s article ‘Disclosing the Potential Impact of Placebo Controls in Antidepressant Trials’ and serves as an invitation for further submissions to BJPsych Open on ethics, research design and informed consent. Declaration of interest None. Copyright and usage © The Royal College of Psychiatrists 2015. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence.

  3. Bronchodilators for treatment of mild bronchiolitis: a factorial randomised trial.

    PubMed Central

    Wang, E E; Milner, R; Allen, U; Maj, H

    1992-01-01

    A randomised double blind trial was conducted to determine the efficacy of inhaled bronchodilators, salbutamol and ipratropium bromide, compared with placebo in the treatment of bronchiolitis. Patients, who were 2 months to 2 years of age and without underlying cardiac or pulmonary disease, received drug 1 (salbutamol or saline placebo) followed one hour later by drug 2 (ipratropium bromide or placebo). Both agents were administered every four hours. The patients were allocated to one of four groups according to a factorial design. The four groups were similar in demographic characteristics, initial oxygenation, and clinical score. The change in oxygen saturation of recipients of both agents was significantly better than that of recipients of salbutamol alone or ipratropium bromide alone. This change, however, was not statistically different from that of the control group. No difference was observed in the clinical score or hospital duration. Inhaled bronchodilators did not improve the condition of hospitalised mild bronchiolitis. PMID:1533504

  4. Randomised controlled trials in primary care: scope and application.

    PubMed Central

    Sheikh, Aziz; Smeeth, Liam; Ashcroft, Richard

    2002-01-01

    There is now widespread acknowledgement of the absence of a sound evidence base underpinning many of the decisions made in primary care. Randomised controlled trials represent the methodology of choicefor determining efficacy and effectiveness of interventions, yet researchers working in primary care have been reluctant to use intervention studies, favouring observational study designs. Unfamiliarity with the different trial designs now available, and the relative advantages and disadvantages conferred by each, may be one factor contributing to this paradox. In this paper, we consider the principal trial designs available to primary care researchers, discussing the contexts in which a particular design may prove most useful. This information will, we hope, also prove useful to primary care clinicians attempting to interpret trial findings. PMID:12236280

  5. 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

  6. Prevalence and treatment of personality disorders in Dutch forensic mental health services.

    PubMed

    de Ruiter, Corine; Trestman, Robert L

    2007-01-01

    Offenders with serious personality disorders challenge forensic systems throughout the world. In this article, the authors describe the legal system that shapes the forensic treatment of personality-disordered offenders in the Dutch psychiatric and correctional systems. The evolution of laws and regulations are addressed, as is the bifurcation of treatment between forensic hospitals and correctional settings. Prevalence data of personality disorders in the Dutch systems are presented, and comparisons between the Dutch and American systems are delineated. Current treatment modalities are described. Research initiatives and future directions for the system are presented. PMID:17389350

  7. Prevalence and treatment of personality disorders in Dutch forensic mental health services.

    PubMed

    de Ruiter, Corine; Trestman, Robert L

    2007-01-01

    Offenders with serious personality disorders challenge forensic systems throughout the world. In this article, the authors describe the legal system that shapes the forensic treatment of personality-disordered offenders in the Dutch psychiatric and correctional systems. The evolution of laws and regulations are addressed, as is the bifurcation of treatment between forensic hospitals and correctional settings. Prevalence data of personality disorders in the Dutch systems are presented, and comparisons between the Dutch and American systems are delineated. Current treatment modalities are described. Research initiatives and future directions for the system are presented.

  8. Native dialect influences second-language vowel perception: Peruvian versus Iberian Spanish learners of Dutch.

    PubMed

    Escudero, Paola; Williams, Daniel

    2012-05-01

    Peruvian Spanish (PS) and Iberian Spanish (IS) learners were tested on their ability to categorically discriminate and identify Dutch vowels. It was predicted that the acoustic differences between the vowel productions of the two dialects, which compare differently to Dutch vowels, would manifest in differential L2 perception for listeners of these two dialects. The results show that although PS learners had higher general L2 proficiency, IS learners were more accurate at discriminating all five contrasts and at identifying six of the L2 Dutch vowels. These findings confirm that acoustic differences in native vowel production lead to differential L2 vowel perception.

  9. HIV prevention in Mexican schools: prospective randomised evaluation of intervention

    PubMed Central

    Walker, Dilys; Gutierrez, Juan Pablo; Torres, Pilar; Bertozzi, Stefano M

    2006-01-01

    Objective To assess effects on condom use and other sexual behaviour of an HIV prevention programme at school that promotes the use of condoms with and without emergency contraception. Design Cluster randomised controlled trial. Setting 40 public high schools in the state of Morelos, Mexico. Participants 10 954 first year high school students. Intervention Schools were randomised to one of three arms: an HIV prevention course that promoted condom use, the same course with emergency contraception as back-up, or the existing sex education course. Self administered anonymous questionnaires were completed at baseline, four months, and 16 months. Students at intervention schools received a 30 hour course (over 15 weeks) on HIV prevention and life skills, designed in accordance with guidelines of the joint United Nations programme on HIV/AIDS. Two extra hours of education on emergency contraception were given to students in the condom promotion with contraception arm. Main outcome measures Primary outcome measure was reported condom use. Other outcomes were reported sexual activity; knowledge and attitudes about HIV and emergency contraception; and attitudes and confidence about condom use. Results Intervention did not affect reported condom use. Knowledge of HIV improved in both intervention arms and knowledge of emergency contraception improved in the condom promotion with contraception arm. Reported sexual behaviour was similar in the intervention arms and the control group. Conclusion A rigorously designed, implemented, and evaluated HIV education course based in public high schools did not reduce risk behaviour, so such courses need to be redesigned and evaluated. Addition of emergency contraception did not decrease reported condom use or increase risky sexual behaviour but did increase reported use of emergency contraception. PMID:16682420

  10. Treatment of irritable bowel syndrome: a review of randomised controlled trials

    PubMed Central

    AKEHURST, R; KALTENTHALER, E

    2001-01-01

    Irritable bowel syndrome (IBS) is a common chronic disorder that is associated with significant disability and health care costs. The purpose of this paper is to review and assess published randomised controlled trials examining the clinical effectiveness of interventions for IBS for 1987-1998. A literature search was conducted to identify randomised controlled trials of IBS treatments: 45 studies were identified that described randomised controlled trials and of these, six fulfilled all three criteria used to assess the quality of randomised controlled trials, as described by Jadad and colleagues.1 These criteria are: adequate description of randomisation, double blinding, and description of withdrawals and dropouts. It is concluded that there are few studies which offer convincing evidence of effectiveness in treating the IBS symptom complex. This review strongly suggests that future work should include well designed trials that: describe the randomisation method; use internationally approved diagnostic criteria; and are double blinded and placebo controlled. Clear well defined outcome measures are necessary. Inclusion of quality of life measures allows comparison between trials in different therapeutic areas. Conducting such studies will help to overcome some of the difficulties identified in this review.

 PMID:11156653

  11. 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.

  12. Does Media Use Result in More Active Communicators? Differences Between Native Dutch and Turkish-Dutch Patients in Information-Seeking Behavior and Participation During Consultations With General Practitioners.

    PubMed

    Schinkel, Sanne; Van Weert, Julia C M; Kester, Jorrit A M; Smit, Edith G; Schouten, Barbara C

    2015-08-01

    This study investigates differences between native Dutch and Turkish-Dutch patients with respect to media usage before and patient participation during medical consultations with general practitioners. In addition, the authors assessed the relation between patient participation and communication outcomes. The patients were recruited in the waiting rooms of general practitioners, and 191 patients (117 native Dutch, 74 Turkish-Dutch) completed pre- and postconsultation questionnaires. Of this sample, 120 patients (62.8%; 82 native Dutch, 38 Turkish-Dutch) agreed to have their consultations recorded to measure patient participation. Compared with Turkish-Dutch patients of similar educational levels, results showed that native Dutch patients used different media to search for information, participated to a greater extent during their consultations and were more responsive to their general practitioner. With respect to the Turkish-Dutch patients, media usage was related to increased patient participation, which was correlated with having fewer unfulfilled information needs; however, these relations were not found in the native Dutch patient sample. In conclusion, interventions that enhance participation among ethnic minority patients will better fulfill informational needs when such interventions stimulate information-seeking behavior in that group before a medical consultation.

  13. The Dutch N-cascade in the european perspective.

    PubMed

    Erisman, Jan Willem; Domburg, Nelleke; de Vries, Wim; Kros, Hans; de Haan, Bronno; Sanders, Kaj

    2005-12-01

    The Netherlands is "well known" for its nitrogen problems; it has one of the highest reactive nitrogen (Nr) emission densities in the world. It is a small country at the delta of several large European rivers. Ever since the industrial revolution, there has been a growing excess of nutrients and related emissions into the atmosphere (ammonia, nitrogen oxides and nitrous oxide) and into groundwater and surface water (nitrate), leading to a large range of cascading environmental impacts. Vehicular traffic, sewage and animal husbandry are the main sources of oxidized and reduced forms of Nr. This paper provides an overview of the origin and fate of nitrogen in the Netherlands, the various reported impacts of nitrogen, the Dutch and European policies to reduce nitrogen emissions and related impacts. In addition, ways are presented to go forward to potentially solve the problems in a European perspective. Solutions include the improvement of nitrogen efficiencies in different systems, technological options and education. PMID:16512205

  14. The Dutch N-cascade in the European perspective.

    PubMed

    Erisman, Jan Willem; Domburg, Nelleke; de Vries, Wim; Kros, Hans; de Haan, Bronno; Sanders, Kaj

    2005-09-01

    The Netherlands is "well known" for its nitrogen problems; it has one of the highest reactive nitrogen (Nr) emission densities in the world. It is a small country at the delta of several large European rivers. Ever since the industrial revolution, there has been a growing excess of nutrients and related emissions into the atmosphere (ammonia, nitrogen oxides and nitrous oxide) and into groundwater and surface water (nitrate), leading to a large range of cascading environmental impacts. Vehicular traffic, sewage and animal husbandry are the main sources of oxidized and reduced forms of Nr. This paper provides an overview of the origin and fate of nitrogen in the Netherlands, the various reported impacts of nitrogen, the Dutch and European policies to reduce nitrogen emissions and related impacts. In addition, ways are presented to go forward to potentially solve the problems in a European perspective. Solutions include the improvement of nitrogen efficiencies in different systems, technological options and education. PMID:20549438

  15. Consumer choice in Dutch health insurance after reform.

    PubMed

    Maarse, Hans; Meulen, Ruud Ter

    2006-03-01

    This article investigates the scope and effects of enhanced consumer choice in health insurance that is presented as a cornerstone of the new health insurance legislation in the Netherlands that will come into effect in 2006. The choice for choice marks the current libertarian trend in Dutch health care policymaking. One of our conclusions is that the scope of enhanced choice should not be overstated due to many legal and non-legal restrictions to it. The consumer choice advocates have great expectations of the impact of enhanced choice. A critical analysis of its impact demonstrates that these expectations may not become true and that enhanced consumer choice should not be perceived as the 'magic bullet' for many problems in health care. PMID:17137018

  16. Secondary traumatization in partners and parents of Dutch peacekeeping soldiers.

    PubMed

    Dirkzwager, Anja J E; Bramsen, Inge; Adèr, Herman; van der Ploeg, Henk M

    2005-06-01

    This study examines secondary traumatization among 708 partners and 332 parents of Dutch peacekeepers (i.e., personnel who participated in military actions implemented by international organizations such as the United Nations). Partners or parents of peacekeepers with 4 levels of posttraumatic stress symptoms were compared on posttraumatic stress, health problems, the quality of the marital relationship, and social support. In comparison with partners of peacekeepers without posttraumatic stress disorder (PTSD) symptoms, partners of peacekeepers with PTSD symptoms reported more sleeping and somatic problems, reported more negative social support, and judged the marital relationship as less favorable. No significant differences were found for parents. Thus, peacekeepers' stress reactions were related to various problems of their partners. A systemic approach to the treatment of persons with PTSD appears appropriate. PMID:15982097

  17. [Noma: Dutch history of a nearly forgotten disease].

    PubMed

    Marck, K W

    2001-12-22

    Noma is an orofacial gangrene that may develop in malnourished and debilitated children. It was once a common disorder in the Netherlands. The medical history of noma has some important Dutch contributions. In 1595, Carel Baten was the first to describe noma as a clinical entity and in 1680, Cornelis van de Voorde coined the name 'noma' for this orofacial gangrene, thereby replacing the term 'water cancer' which was then in common usage. One of the first facial reconstruction operations on a noma patient was performed by Leendert Stelwagen in 1779. Noma gradually disappeared in the Netherlands during the second half of the nineteenth century due to an improved nutritional status amongst the poorest in society. Yet in other parts of the world approximately 110,000 children a year still die from this disorder, which has been largely forgotten in the Western world.

  18. Morphologic and anthropometric characteristics of high level Dutch korfball players.

    PubMed

    Godinho, M; Fragoso, I; Vieira, F

    1996-02-01

    In this study a morphologic and anthropometric characterisation of Dutch korfball players (N = 36) is performed. Data, compared with those of other sports populations, showed that (1) korfball athletes are smaller and lighter than basketball and volleyball players but heavier and taller than other team-sport players; (2) korfball players have less relative body fat, more lean body mass, more limb fat, and less or similar trunk fat than the other athletes. (3) Male korfball players presented a somatotype (1.9-4.4-3.4) similar to endurance athletes and an endomorphic value lower than or similar to the other athletes. (4) The only apparent similarity between female korfball somatotype (3.2-4.0-2.8) and other athletes' somatotypes is the dominance of mesomorphy.

  19. [The feeding of Dutch sled dogs in training].

    PubMed

    Ebing, L; Beynen, A C

    1999-12-01

    To evaluate the diet of Dutch sled dogs, we investigated the dietary history of the dogs of 5 mushers. The animals were offered a commercial dry diet supplemented with a protein-rich product, a fat-rich product, and/or vitamins. At our request, the mushers prepared for 'their average dog' (a 20-kg Siberian husky) a daily ration of which the composition was calculated and chemically analysed. The calculated energy content of the rations was up to 50% higher than the requirement of the 'average dog' for maintenance. The composition of the rations was adequate from a nutritional viewpoint. However, the distribution of energy between macronutrients was not optimal in terms of the physiology of extreme endurance running: the rations had a relatively low fat content and a high content of carbohydrates.

  20. 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

  1. 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.

  2. 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.

  3. [Twisting and turning; the development of the Dutch science shops].

    PubMed

    Lursen, M; Mulder, H; Lieshout, M

    2000-01-01

    The concept of science shops (Wetenschapswinkels) originates from the Netherlands. Science shops were based on the idea that universities had to play a more prominent role in the solution of social problems - an outcome of the discussion, initiated by students, on the democratisation of universities in the early 1970s. Starting as voluntary student organisations supported by individual staff members from the universities, they were devoted to give oppressed minority groups and the financially weak access to scientific research. Slowly, acknowledgement came. Science shops began to receive financial support from university boards. Support also came from the Dutch government. By now science shops have professionalized and most of them are well embedded in their universities. Many developments within society and the universities influenced the work and structure of the science shops. Positive developments were professionalization, growth, becoming embedded, and the introduction of new research themes. There were also negative developments, such as budget cuts and the fact that 'service to society' ceased to be a government objective for the universities. These led to recurring struggles for survival, which were not always won. Interest in the science shop concept has grown in other countries over the last years. In the 1980s, the system spread within Western Europe. Similar activities, based on the Dutch model, have started in North America and Eastern Europe in the 1990s. The activities on the international level led to an E.U. financial project to prepare an international network of science shops, which commenced in 1999. With information exchange and international cooperation as its major goals, the network will create new opportunties for the future. PMID:11640527

  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. A simple method for calculating the characteristics of the Dutch roll motion of an airplane

    NASA Technical Reports Server (NTRS)

    Klawans, Bernard B

    1956-01-01

    A simple method for calculating the characteristics of the Dutch roll motion of an airplane is obtained by arranging the lateral equations of motion in such form and order that an iterative process is quickly convergent.

  6. Jacob Jongbloed (1895-1974): a Dutch pioneer of aviation medicine.

    PubMed

    von Lünen, Alexander

    2011-06-01

    Jacob Jongbloed (nick-named "Janus") was a Dutch aviation physiologist and avid aviator. While lack of funding hindered his work tremendously, he nonetheless became an important figure in aeromedical research between World War I and II, chiefly in the field of the effects of acceleration on the human organism. Most of his work was published in Dutch and German journals, rendering him an unknown force in the English-speaking world. Only after World War II did he make a name for himself in Anglo-American circles, primarily due to his involvement in various international organizations dealing with aeromedical matters and his part in developing the first Dutch heart-lung machine. Due to his many posts and his scientific work in the field, he could be regarded as the "father" of Dutch aviation medicine.

  7. The Involvement of Dutch Universities in Development Cooperation: The Current Situation

    ERIC Educational Resources Information Center

    van der Horst, G. J. C.

    1976-01-01

    Discusses the contribution Dutch universities can make to development cooperation through collaboration in the fields of higher education and research with partners from Third World countries. (Author/RK)

  8. Psychometric Characteristics of the Psychopathic Personality Inventory in a Dutch-Speaking Population.

    ERIC Educational Resources Information Center

    Maesschalck, Christine; Vertommen, Hans; Hooghe, An

    2002-01-01

    Administered the Dutch adaptation of the Psychopathic Personality Inventory (R. Lilienfeld and B. Andrews, 1996) to 314 adults in Flanders and studied the factorial structure and scale characteristics. Results support the usefulness of the instrument. (SLD)

  9. 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.)

  10. Promotion of physical activity and fitness in sedentary patients with Parkinson’s disease: randomised controlled trial

    PubMed Central

    van Nimwegen, Marlies; Speelman, Arlène D; Overeem, Sebastiaan; van de Warrenburg, Bart P; Smulders, Katrijn; Dontje, Manon L; Borm, George F; Backx, Frank J G; Munneke, Marten

    2013-01-01

    Objective To evaluate whether a multifaceted behavioural change programme increases physical activities in patients with Parkinson’s disease. Design Multicentre randomised controlled trial. Setting 32 community hospitals in the Netherlands, collaborating in a nationwide network (ParkinsonNet). Participants 586 sedentary patients with idiopathic Parkinson’s disease aged between 40 and 75 years with mild to moderate disease severity (Hoehn and Yahr stage ≤3). Intervention Patients were randomly assigned to the ParkFit programme or a matched general physiotherapy intervention. ParkFit is a multifaceted behavioural change programme, designed specifically to achieve an enduring increase in the level of physical activity (coaches using motivational strategies; ambulatory feedback). Main outcome measures The primary endpoint was the level of physical activity, measured every six months with a standardised seven day recall (LASA physical activity questionnaire—LAPAQ). Secondary endpoints included two other measures of physical activity (activity diary and ambulatory activity monitor), quality of life (Parkinson’s disease questionnaire—PDQ-39), and fitness (six minute walk test). Results 540 (92.2%) patients completed the primary outcome. During follow-up, overall time spent on physical activities (LAPAQ) was comparable between the groups (adjusted group difference 7%, 95% confidence interval −3 to 17%; P=0.19). Analyses of three secondary outcomes indicated increased physical activity in ParkFit patients, as suggested by the activity diary (difference 30%; P<0.001), the activity monitor (difference 12%; P<0.001), and the six minute walk test (difference 4.8 m; P=0.05). PDQ-39 did not differ between ParkFit patients and controls (difference −0.9 points; P=0.14). The number of fallers was comparable between ParkFit patients (184/299; 62%) and controls (191/287; 67%). Conclusions The ParkFit behavioural change programme did not increase overall physical

  11. Strong increase in total delta-THC in cannabis preparations sold in Dutch coffee shops.

    PubMed

    Pijlman, F T A; Rigter, S M; Hoek, J; Goldschmidt, H M J; Niesink, R J M

    2005-06-01

    The total concentration of THC has been monitored in cannabis preparations sold in Dutch coffee shops since 1999. This annual monitoring was issued by the Ministry of Health after reports of increased potency. The level of the main psychoactive compound, Delta9-tetrahydrocannabinol (THC), is measured in marijuana and hashish. A comparison is made between imported and Dutch preparations, and between seasons. Samples of cannabis preparations from randomly selected coffee shops were analyzed using gas chromatography (GC-FID) for THC, CBD and CBN. In 2004, the average THC level of Dutch home-grown marijuana (Nederwiet) (20.4% THC) was significantly higher than that of imported marijuana (7.0% THC). Hashish derived from Dutch marijuana (Nederhasj) contained 39.3% THC in 2004, compared with 18.2% THC in imported hashish. The average THC percentage of Dutch marijuana, Dutch hashish and imported hashish was significantly higher than in previous years. It nearly doubled over 5 years. During this period, the THC percentage in imported marijuana remained unchanged. A higher price had to be paid for cannabis with higher levels of THC. Whether the increase in THC levels causes increased health risks for users can only be concluded when more data are available on adjusted patterns of use, abuse liability, bioavailability and levels of THC in the brain. PMID:16191670

  12. [Family care for Moluccan ans Dutch elderly persons: a comparative study of readiness and expectations].

    PubMed

    Stevens, F C; ten Have, M L; Philipsen, H; Serpenti, L; Elmas, T

    1994-10-01

    Care expectations of Moluccan and Dutch elderly (n = 48), and the willingness of their children (n = 25) to provide care are explored. It appeared, that Moluccan elderly received more family care than the Dutch comparison group. Moluccan children were considered to be responsible for the care of the elderly as well as for arranging additional care. Dutch elder persons stressed that they didn't want to become a 'burden' to their children, and were more willing to call in professional help. However, all elderly persons were reluctant concerning the involvement of professional care. Dutch elder persons stressed their loss of independency. For Moluccan elderly, professional care did not fit in with their traditional (care) beliefs. In general, Moluccan children were more willing to provide care than Dutch children. However, many of them expected problems in combining family life, a job and the care of their parents. In this respect opinions of Moluccan and Dutch children were more alike than those of their parents. PMID:7974640

  13. The TOPSHOCK study: Effectiveness of radial shockwave therapy compared to focused shockwave therapy for treating patellar tendinopath - design of a randomised controlled trial

    PubMed Central

    2011-01-01

    Background Patellar tendinopathy is a chronic overuse injury of the patellar tendon that is especially prevalent in people who are involved in jumping activities. Extracorporeal Shockwave Therapy is a relatively new treatment modality for tendinopathies. It seems to be a safe and promising part of the rehabilitation program for patellar tendinopathy. Extracorporeal Shockwave Therapy originally used focused shockwaves. Several years ago a new kind of shockwave therapy was introduced: radial shockwave therapy. Studies that investigate the effectiveness of radial shockwave therapy as treatment for patellar tendinopathy are scarce. Therefore the aim of this study is to compare the effectiveness of focussed shockwave therapy and radial shockwave therapy as treatments for patellar tendinopathy. Methods/design The TOPSHOCK study (Tendinopathy Of Patella SHOCKwave) is a two-armed randomised controlled trial in which the effectiveness of focussed shockwave therapy and radial shockwave therapy are directly compared. Outcome assessors and patients are blinded as to which treatment is given. Patients undergo three sessions of either focused shockwave therapy or radial shockwave therapy at 1-week intervals, both in combination with eccentric decline squat training. Follow-up measurements are scheduled just before treatments 2 and 3, and 1, 4, 7 and 12 weeks after the final treatment. The main outcome measure is the Dutch VISA-P questionnaire, which asks for pain, function and sports participation in subjects with patellar tendinopathy. Secondary outcome measures are pain determined with a VAS during ADL, sports and decline squats, rating of subjective improvement and overall satisfaction with the treatment. Patients will also record their sports activities, pain during and after these activities, and concurrent medical treatment on a weekly basis in a web-based diary. Results will be analysed according to the intention-to-treat principle. Discussion The TOPSHOCK study is the

  14. Guidance strategies for a participatory ergonomic intervention to increase the use of ergonomic measures of workers in construction companies: a study design of a randomised trial

    PubMed Central

    2014-01-01

    Background More than seven out of 10 Dutch construction workers describe their work as physically demanding. Ergonomic measures can be used to reduce these physically demanding work tasks. To increase the use of ergonomic measures, employers and workers have to get used to other working methods and to maintaining them. To facilitate this behavioural change, participatory ergonomics (PE) interventions could be useful. For this study a protocol of a PE intervention is adapted in such a way that the intervention can be performed by an ergonomics consultant through face-to-face contacts or email contacts. The objective of this study is to evaluate the effectiveness of the face-to-face guidance strategy and the e-guidance strategy on the primary outcome measure: use of ergonomic measures by individual construction workers, and on the secondary outcome measures: the work ability, physical functioning and limitations due to physical problems of individual workers. Methods/Design The present study is a randomised intervention trial of six months in 12 companies to establish the effects of a PE intervention guided by four face-to-face contacts (N = 6) or guided by 13 email contacts (N = 6) on the primary and secondary outcome measures at baseline and after six months. Construction companies are randomly assigned to one of the guidance strategies with the help of a computer generated randomisation table. In addition, a process evaluation for both strategies will be performed to determine reach, dose delivered, dose received, precision, competence, satisfaction and behavioural change to find possible barriers and facilitators for both strategies. A cost-benefit analysis will be performed to establish the financial consequences of both strategies. The present study is in accordance with the CONSORT statement. Discussion The outcome of this study will help to 1) evaluate the effect of both guidance strategies, and 2) find barriers to and facilitators of both guidance

  15. Return to work of workers without a permanent employment contract, sick-listed due to a common mental disorder: design of a randomised controlled trial

    PubMed Central

    2014-01-01

    Background Workers without a permanent employment contract represent a vulnerable group within the working population. Mental disorders are a major cause of sickness absence within this group. Common mental disorders are stress-related, depressive and anxiety disorders. To date, little attention has been paid to effective return to work interventions for this type of sick-listed workers. Therefore, a participatory supportive return to work program has been developed. It combines elements of a participatory return to work program, integrated care and direct placement in a competitive job. The objective of this paper is to describe the design of a randomised controlled trial to evaluate the cost-effectiveness of this program compared to care as usual. Methods/Design The cost-effectiveness of the participatory supportive return to work program will be examined in a randomised controlled trial with a follow-up of twelve months. The program strongly involves the sick-listed worker in the identification of obstacles for return to work and possible solutions, resulting in a consensus based action plan. This plan will be used as a starting point for the search of suitable competitive employment with support of a rehabilitation agency. During this process the insurance physician of the sick-listed worker contacts other caregivers to promote integrated care. Workers eligible to participate in this study have no permanent employment contract, have applied for a sickness benefit at the Dutch Social Security Agency and are sick-listed between two and fourteen weeks due to mental health problems. The primary outcome measure is the duration until first sustainable return to work in a competitive job. Outcomes are measured at baseline and after three, six, nine and twelve months. Discussion If the participatory supportive return to work program proves to be cost-effective, the social security system, the sick-listed worker and society as a whole will benefit. A cost

  16. 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.

  17. 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

    2015-01-01

    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. PMID:26044814

  18. Relation between sampling device and detection of abnormality in cervical smears: a meta-analysis of randomised and quasi-randomised studies.

    PubMed Central

    Buntinx, F.; Brouwers, M.

    1996-01-01

    OBJECTIVE: To assess the diagnostic yield of different sampling devices used in cervical screening. DESIGN: Meta-analysis of randomised and quasi-randomised studies. SETTING: All randomised and quasi-randomised studies comparing the yield of cytological or histological abnormalities when two or more different sampling devices were used. SUBJECTS: 85,000 patients included in 29 studies reported in 28 papers. MAIN OUTCOME MEASURES: Pooled relative risk and 95% confidence interval of the yield of mild dysplasia or worse in smears recovered by each sampling method versus each other method with which it was compared; sensitivity or positive predictive value, or both, of cytological versus histological results in six studies from which sufficient data were available. RESULTS: There were no substantial differences in the yield of cytological abnormalities between the Ayre spatula, the Cytobrush, and the cotton swab used alone. There were also no substantial differences in the yield of cytological abnormalities between the extended tip spatula, the Ayre spatula combined with the Cytobrush or cotton swab, or the Cervex brush. The Ayre spatula, Cytobruah, or cotton swab used alone generally performed significantly worse than the combinations, the extended tip spatula, or the Cervex brush. There were no substantial differences in sensitivity or positive predictive value between the sampling methods. CONCLUSIONS: These results support the use of either the extended tip spatula, a combination of any spatula plus the Cytobrush or cotton swab, or the Cervex brush for cervical screening. PMID:8942687

  19. Trends and current status of general thoracic surgery in Japan revealed by review of nationwide databases

    PubMed Central

    2016-01-01

    Nationwide databases of cases treated for thoracic disease have been established by several academic associations in Japan, which contain information showing trends and current status in regard to surgical treatment. The Japanese Association of Thoracic Surgery (JATS), Japanese Association of Chest Surgery (JACS), Japan Lung Cancer Society (JLCS), Japanese Respiratory Society (JRS), and Japan Society for Respiratory Endoscopy (JSRE) have maintained databases of lung cancer cases treated in Japan. In 1986, the number of general thoracic surgery cases was 15,544, which increased to 75,306 in 2013. Furthermore, the number of lung cancer operations performed in 2013 was 37,008, occupying 49.1% of all general thoracic operations. Also, the proportions of adenocarcinoma, female patients, aged patients, stage I disease, and limited resection procedures are increasing in lung cancer surgery cases. While the 5-year overall post-operative survival rate of lung cancer patients was 47.8% in those undergoing surgery in 1989, it was 69.6% in those of 2004, which means 22% increase during 15 years. JATS, JACS, and the Japanese Association for Research of the Thymus (JART) have maintained retrospective databases of thymic epithelial tumor cases. The number of mediastinal tumors surgically treated is also increasing and was 4,780 in 2013, among which thymoma was the most prevalent. The Japanese Association for Lung and Heart-Lung Transplantation has developed a prospective nationwide database of lung transplantation cases in Japan, which contains clinical data for 466 patients who received lung transplantation or heart-lung transplantation from 1998 to 2015. Nationwide databases are currently being utilized for clinical studies and will also contribute to international projects related to the Union for International Cancer Control (UICC) tumor, node, and metastasis (TNM) classification system. PMID:27651932

  20. Management of acute pancreatitis in Japan: Analysis of nationwide epidemiological survey

    PubMed Central

    Hamada, Shin; Masamune, Atsushi; Shimosegawa, Tooru

    2016-01-01

    Acute pancreatitis (AP) is an acute inflammatory disease of the exocrine pancreas. In Japan, nationwide epidemiological surveys have been conducted every 4 to 5 years by the Research Committee of Intractable Pancreatic Diseases, under the support of the Ministry of Health, Labour, and Welfare of Japan. We reviewed the results of the nationwide surveys focusing on the severity assessment and changes in the therapeutic strategy for walled-off necrosis. The severity assessment system currently used in Japan consists of 9 prognostic factors and the imaging grade on contrast-enhanced computed tomography. By univariate analysis, all of the 9 prognostic factors were associated with AP-related death. A multivariate analysis identified 4 out of the 9 prognostic factors (base excess or shock, renal failure, systemic inflammatory response syndrome criteria, and age) that were associated with AP-related death. Receiver-operating characteristics curve analysis showed that the area under the curve was 0.82 for these 4 prognostic factors and 0.84 for the 9 prognostic factors, suggesting the comparable utility of these 4 factors in the severity assessment. We also examined the temporal changes in treatment strategy for walled-off necrosis in Japan according to the 2003, 2007, and 2011 surveys. Step-up approaches and less-invasive endoscopic therapies were uncommon in 2003 and 2007, but became popular in 2011. Mortality has been decreasing in patients who require intervention for walled-off necrosis. In conclusion, the nationwide survey revealed the comparable utility of 4 prognostic factors in the severity assessment and the increased use of less-invasive, step-up approaches with improved clinical outcomes in the management of walled-off necrosis.

  1. Trends and current status of general thoracic surgery in Japan revealed by review of nationwide databases

    PubMed Central

    2016-01-01

    Nationwide databases of cases treated for thoracic disease have been established by several academic associations in Japan, which contain information showing trends and current status in regard to surgical treatment. The Japanese Association of Thoracic Surgery (JATS), Japanese Association of Chest Surgery (JACS), Japan Lung Cancer Society (JLCS), Japanese Respiratory Society (JRS), and Japan Society for Respiratory Endoscopy (JSRE) have maintained databases of lung cancer cases treated in Japan. In 1986, the number of general thoracic surgery cases was 15,544, which increased to 75,306 in 2013. Furthermore, the number of lung cancer operations performed in 2013 was 37,008, occupying 49.1% of all general thoracic operations. Also, the proportions of adenocarcinoma, female patients, aged patients, stage I disease, and limited resection procedures are increasing in lung cancer surgery cases. While the 5-year overall post-operative survival rate of lung cancer patients was 47.8% in those undergoing surgery in 1989, it was 69.6% in those of 2004, which means 22% increase during 15 years. JATS, JACS, and the Japanese Association for Research of the Thymus (JART) have maintained retrospective databases of thymic epithelial tumor cases. The number of mediastinal tumors surgically treated is also increasing and was 4,780 in 2013, among which thymoma was the most prevalent. The Japanese Association for Lung and Heart-Lung Transplantation has developed a prospective nationwide database of lung transplantation cases in Japan, which contains clinical data for 466 patients who received lung transplantation or heart-lung transplantation from 1998 to 2015. Nationwide databases are currently being utilized for clinical studies and will also contribute to international projects related to the Union for International Cancer Control (UICC) tumor, node, and metastasis (TNM) classification system.

  2. Management of acute pancreatitis in Japan: Analysis of nationwide epidemiological survey

    PubMed Central

    Hamada, Shin; Masamune, Atsushi; Shimosegawa, Tooru

    2016-01-01

    Acute pancreatitis (AP) is an acute inflammatory disease of the exocrine pancreas. In Japan, nationwide epidemiological surveys have been conducted every 4 to 5 years by the Research Committee of Intractable Pancreatic Diseases, under the support of the Ministry of Health, Labour, and Welfare of Japan. We reviewed the results of the nationwide surveys focusing on the severity assessment and changes in the therapeutic strategy for walled-off necrosis. The severity assessment system currently used in Japan consists of 9 prognostic factors and the imaging grade on contrast-enhanced computed tomography. By univariate analysis, all of the 9 prognostic factors were associated with AP-related death. A multivariate analysis identified 4 out of the 9 prognostic factors (base excess or shock, renal failure, systemic inflammatory response syndrome criteria, and age) that were associated with AP-related death. Receiver-operating characteristics curve analysis showed that the area under the curve was 0.82 for these 4 prognostic factors and 0.84 for the 9 prognostic factors, suggesting the comparable utility of these 4 factors in the severity assessment. We also examined the temporal changes in treatment strategy for walled-off necrosis in Japan according to the 2003, 2007, and 2011 surveys. Step-up approaches and less-invasive endoscopic therapies were uncommon in 2003 and 2007, but became popular in 2011. Mortality has been decreasing in patients who require intervention for walled-off necrosis. In conclusion, the nationwide survey revealed the comparable utility of 4 prognostic factors in the severity assessment and the increased use of less-invasive, step-up approaches with improved clinical outcomes in the management of walled-off necrosis. PMID:27605870

  3. Trends and current status of general thoracic surgery in Japan revealed by review of nationwide databases.

    PubMed

    Okumura, Meinoshin

    2016-08-01

    Nationwide databases of cases treated for thoracic disease have been established by several academic associations in Japan, which contain information showing trends and current status in regard to surgical treatment. The Japanese Association of Thoracic Surgery (JATS), Japanese Association of Chest Surgery (JACS), Japan Lung Cancer Society (JLCS), Japanese Respiratory Society (JRS), and Japan Society for Respiratory Endoscopy (JSRE) have maintained databases of lung cancer cases treated in Japan. In 1986, the number of general thoracic surgery cases was 15,544, which increased to 75,306 in 2013. Furthermore, the number of lung cancer operations performed in 2013 was 37,008, occupying 49.1% of all general thoracic operations. Also, the proportions of adenocarcinoma, female patients, aged patients, stage I disease, and limited resection procedures are increasing in lung cancer surgery cases. While the 5-year overall post-operative survival rate of lung cancer patients was 47.8% in those undergoing surgery in 1989, it was 69.6% in those of 2004, which means 22% increase during 15 years. JATS, JACS, and the Japanese Association for Research of the Thymus (JART) have maintained retrospective databases of thymic epithelial tumor cases. The number of mediastinal tumors surgically treated is also increasing and was 4,780 in 2013, among which thymoma was the most prevalent. The Japanese Association for Lung and Heart-Lung Transplantation has developed a prospective nationwide database of lung transplantation cases in Japan, which contains clinical data for 466 patients who received lung transplantation or heart-lung transplantation from 1998 to 2015. Nationwide databases are currently being utilized for clinical studies and will also contribute to international projects related to the Union for International Cancer Control (UICC) tumor, node, and metastasis (TNM) classification system. PMID:27651932

  4. 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.

  5. Management of acute pancreatitis in Japan: Analysis of nationwide epidemiological survey.

    PubMed

    Hamada, Shin; Masamune, Atsushi; Shimosegawa, Tooru

    2016-07-28

    Acute pancreatitis (AP) is an acute inflammatory disease of the exocrine pancreas. In Japan, nationwide epidemiological surveys have been conducted every 4 to 5 years by the Research Committee of Intractable Pancreatic Diseases, under the support of the Ministry of Health, Labour, and Welfare of Japan. We reviewed the results of the nationwide surveys focusing on the severity assessment and changes in the therapeutic strategy for walled-off necrosis. The severity assessment system currently used in Japan consists of 9 prognostic factors and the imaging grade on contrast-enhanced computed tomography. By univariate analysis, all of the 9 prognostic factors were associated with AP-related death. A multivariate analysis identified 4 out of the 9 prognostic factors (base excess or shock, renal failure, systemic inflammatory response syndrome criteria, and age) that were associated with AP-related death. Receiver-operating characteristics curve analysis showed that the area under the curve was 0.82 for these 4 prognostic factors and 0.84 for the 9 prognostic factors, suggesting the comparable utility of these 4 factors in the severity assessment. We also examined the temporal changes in treatment strategy for walled-off necrosis in Japan according to the 2003, 2007, and 2011 surveys. Step-up approaches and less-invasive endoscopic therapies were uncommon in 2003 and 2007, but became popular in 2011. Mortality has been decreasing in patients who require intervention for walled-off necrosis. In conclusion, the nationwide survey revealed the comparable utility of 4 prognostic factors in the severity assessment and the increased use of less-invasive, step-up approaches with improved clinical outcomes in the management of walled-off necrosis. PMID:27605870

  6. Trends and current status of general thoracic surgery in Japan revealed by review of nationwide databases.

    PubMed

    Okumura, Meinoshin

    2016-08-01

    Nationwide databases of cases treated for thoracic disease have been established by several academic associations in Japan, which contain information showing trends and current status in regard to surgical treatment. The Japanese Association of Thoracic Surgery (JATS), Japanese Association of Chest Surgery (JACS), Japan Lung Cancer Society (JLCS), Japanese Respiratory Society (JRS), and Japan Society for Respiratory Endoscopy (JSRE) have maintained databases of lung cancer cases treated in Japan. In 1986, the number of general thoracic surgery cases was 15,544, which increased to 75,306 in 2013. Furthermore, the number of lung cancer operations performed in 2013 was 37,008, occupying 49.1% of all general thoracic operations. Also, the proportions of adenocarcinoma, female patients, aged patients, stage I disease, and limited resection procedures are increasing in lung cancer surgery cases. While the 5-year overall post-operative survival rate of lung cancer patients was 47.8% in those undergoing surgery in 1989, it was 69.6% in those of 2004, which means 22% increase during 15 years. JATS, JACS, and the Japanese Association for Research of the Thymus (JART) have maintained retrospective databases of thymic epithelial tumor cases. The number of mediastinal tumors surgically treated is also increasing and was 4,780 in 2013, among which thymoma was the most prevalent. The Japanese Association for Lung and Heart-Lung Transplantation has developed a prospective nationwide database of lung transplantation cases in Japan, which contains clinical data for 466 patients who received lung transplantation or heart-lung transplantation from 1998 to 2015. Nationwide databases are currently being utilized for clinical studies and will also contribute to international projects related to the Union for International Cancer Control (UICC) tumor, node, and metastasis (TNM) classification system.

  7. Developing built environment programs in local health departments: lessons learned from a nationwide mentoring program.

    PubMed

    Rube, Kate; Veatch, Maggie; Huang, Katy; Sacks, Rachel; Lent, Megan; Goldstein, Gail P; Lee, Karen K

    2014-05-01

    Local health departments (LHDs) have a key role to play in developing built environment policies and programs to encourage physical activity and combat obesity and related chronic diseases. However, information to guide LHDs' effective engagement in this arena is lacking. During 2011-2012, the New York City Department of Health and Mental Hygiene (DOHMH) facilitated a built environment peer mentoring program for 14 LHDs nationwide. Program objectives included supporting LHDs in their efforts to achieve built environment goals, offering examples from DOHMH's built environment work to guide LHDs, and building a healthy built environment learning network. We share lessons learned that can guide LHDs in developing successful healthy built environment agendas.

  8. Crossed wires: how yesterday's privacy rules might undercut tomorrow's nationwide health information network.

    PubMed

    Greenberg, Michael D; Ridgely, M Susan; Hillestad, Richard J

    2009-01-01

    More than a decade after passage of the Health Insurance Portability and Accountability Act (HIPAA), concerns about the privacy and security of personal health information remain a major policy issue. Now, the emergence of the Nationwide Health Information Network (NHIN) presents deeper underlying privacy challenges, which will require renewed attention from policymakers as federal and state privacy rules need to be revisited. This is necessary because the current framework of privacy laws is not well suited for regulating a transformed health care system, where computer networks supersede conventional communications media. PMID:19276003

  9. 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.

  10. 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.

  11. Mental Health of Parents as Caregivers of Children with Disabilities: Based on Japanese Nationwide Survey

    PubMed Central

    Yamaoka, Yui; Tamiya, Nanako; Moriyama, Yoko; Sandoval Garrido, Felipe Alfonso; Sumazaki, Ryo; Noguchi, Haruko

    2015-01-01

    The number of children with disability is increasing gradually in Japan. Previous researches in other countries have reported that parents as caregivers (CGs) of children with disability have mental health problems, but the actual situation has not been examined nationwide in Japan so far. The aim of this study was to evaluate the association between mental health of CGs who had children with disability and characteristics of children, CGs, and household based on the nation-wide survey. This study utilized data from 2010 Comprehensive Survey of the Living Conditions, and defined children with disability aged 6 to 17. Individual data of children and CGs were linked, and 549 pairs of them were extracted. The Japanese version of Kessler 6 (K6) was used to assess mental health status of caregiver, scored 5 and over represented to general psychological distress. Logistic regression was used to evaluate the associations of interest. The almost half (44.4%) of CGs had psychological distress (k6 score; 5 +) in nationwide, and 8.9% of CGs might have serious mental illness (K6 score; 13+). After adjusting covariates of child, CG, and household factors, CG having a current symptom (OR, 95% CI: 3.26, 1.97–5.39), CG's activity restriction (OR, 95% CI: 2.95, 1.38–6.32), low social support (OR, 95%CI: 9.31, 1.85–46.8), three generation family (OR, 95% CI: 0.49, 0.26–0.92), and lower 25% tile group of monthly household expenditure (OR, 95% CI:1.92, 1.05–3.54), were significantly associated with psychological distress of CGs. This study encourages health care providers to pay more attentions toward parent's mental health, especially for in case of having low social support, and lower income family. Further research should examine the detailed information of child's disease and disability, medical service use, and quality and quantity of social support in nationwide to straighten the system for supporting services of both children with disabilities and their CGs. PMID

  12. Crossed wires: how yesterday's privacy rules might undercut tomorrow's nationwide health information network.

    PubMed

    Greenberg, Michael D; Ridgely, M Susan; Hillestad, Richard J

    2009-01-01

    More than a decade after passage of the Health Insurance Portability and Accountability Act (HIPAA), concerns about the privacy and security of personal health information remain a major policy issue. Now, the emergence of the Nationwide Health Information Network (NHIN) presents deeper underlying privacy challenges, which will require renewed attention from policymakers as federal and state privacy rules need to be revisited. This is necessary because the current framework of privacy laws is not well suited for regulating a transformed health care system, where computer networks supersede conventional communications media.

  13. 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.

  14. Introduction to Danish (nationwide) registers on health and social issues: structure, access, legislation, and archiving.

    PubMed

    Thygesen, Lau Caspar; Daasnes, Camilla; Thaulow, Ivan; Brønnum-Hansen, Henrik

    2011-07-01

    Danish registers contain information on many important health and social issues. Because all Danish citizens have a unique personal identification number, linkage at the individual level between these nationwide registers and other data sources is possible and feasible. In this paper we briefly introduce selected Danish registers and the data structure and requirements forgetting access to data at Statistics Denmark, which is the main provider of register data. We introduce the Danish Data Archive and briefly present the Act on Processing of Personal Data, which is the legal foundation for analyses of register-based data in Denmark.

  15. Nation-wide primary healthcare research network: a privacy protection assessment.

    PubMed

    De Clercq, Etienne; Van Casteren, Viviane; Bossuyt, Nathalie; Moreels, Sarah; Goderis, Geert; Bartholomeeusen, Stefaan; Bonte, Pierre; Bangels, Marc

    2012-01-01

    Efficiency and privacy protection are essential when setting up nationwide research networks. This paper investigates the extent to which basic services developed to support the provision of care can be re-used, whilst preserving an acceptable privacy protection level, within a large Belgian primary care research network. The generic sustainable confidentiality management model used to assess the privacy protection level of the selected network architecture is described. A short analysis of the current architecture is provided. Our generic model could also be used in other countries.

  16. 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

  17. 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

  18. 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…

  19. 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

  20. 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

  1. SWIM (sickle with ibuprofen and morphine) randomised controlled trial fails to recruit: lessons learnt

    PubMed Central

    Cho, Gavin; Anie, Kofi A; Buckton, Jacky; Kiilu, Patricia; Layton, Mark; Alexander, Lydia; Hemmaway, Claire; Sutton, Dorothy; Amos, Claire; Doré, Caroline J; Kahan, Brennan; Meredith, Sarah

    2016-01-01

    Objectives Sickle With Ibuprofen and Morphine (SWIM) trial was designed to assess whether co-administration of ibuprofen (a non-steroidal anti-inflammatory drug) resulted in a reduction of opioid consumption delivered by patient-controlled analgesia (PCA) for acute pain in sickle cell disease. Design A randomised, placebo-controlled, double-blind trial. Setting UK multicentre trial in acute hospital setting. Participants Adults with sickle cell disease of any gender and phenotype aged 16 years and over. Interventions Oral ibuprofen at a dose of 800 mg three times daily or placebo in addition to opioids (morphine or diamorphine) administered via PCA pump for up to 4 days. Main outcome measures The primary outcome measure was opioid consumption over 4 days following randomisation. Results The SWIM trial closed early because it failed to randomise to its target of 316 patients within a reasonable time. Conclusions The key issues identified include the unanticipated length of time between informed consent and randomisation, difficulties in randomisation of patients in busy emergency departments, availability of trained staff at weekends and out of hours, fewer centres than expected using PCA routinely for sickle cell pain treatment, lack of research staff and support for participation, and the trial design. There are implications for future UK trials in sickle cell disease. Trial registration number ISRCTN97241637, NCT00880373; Pre-results. PMID:27288381

  2. 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

  3. Nationwide Trends

    MedlinePlus

    ... Charts Emerging Trends and Alerts Alcohol Club Drugs Cocaine Hallucinogens Heroin Inhalants Marijuana MDMA (Ecstasy/Molly) Methamphetamine ... includes ecstasy and LSD) in the past month. Cocaine use has gone down in the last few ...

  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. PMID:23636622

  5. Psychological rehabilitation after myocardial infarction: multicentre randomised controlled trial.

    PubMed Central

    Jones, D. A.; West, R. R.

    1996-01-01

    OBJECTIVE: To evaluate rehabilitation after myocardial infarction. DESIGN: Randomised controlled trial of rehabilitation in unselected myocardial infarction patients in six centres, baseline data being collected on admission and by structured interview (of patients and spouses) shortly after discharge and outcome being assessed by structured interview at six months and clinical examination at 12 months. SETTING: Six district general hospitals. SUBJECTS: All 2328 eligible patients admitted over two years with confirmed myocardial infarction and discharged home within 28 days. INTERVENTIONS: Rehabilitation programmes comprising psychological therapy, counselling, relaxation training, and stress management training over seven weekly group outpatient sessions for patients and spouses. MAIN OUTCOME MEASURES: Anxiety, depression, quality of life, morbidity, use of medication, and mortality. RESULTS: At six months there were no significant differences between rehabilitation patients and controls in reported anxiety (prevalence 33%) or depression (19%). Rehabilitation patients reported a lower frequency of angina (median three versus four episodes a week), medication, and physical activity. At 12 months there were no differences in clinical complications, clinical sequelae, or mortality. CONCLUSIONS: Rehabilitation programmes based on psychological therapy, counselling, relaxation training, and stress management seem to offer little objective benefit to patients who have experienced myocardial infarction compared with previous reports of smaller trials. PMID:8978226

  6. Should desperate volunteers be included in randomised controlled trials?

    PubMed

    Allmark, P; Mason, S

    2006-09-01

    Randomised controlled trials (RCTs) sometimes recruit participants who are desperate to receive the experimental treatment. This paper defends the practice against three arguments that suggest it is unethical first, desperate volunteers are not in equipoise. Second clinicians, entering patients onto trials are disavowing their therapeutic obligation to deliver the best treatment; they are following trial protocols rather than delivering individualised care. Research is not treatment; its ethical justification is different. Consent is crucial. Third, desperate volunteers do not give proper consent: effectively, they are coerced. This paper responds by advocating a notion of equipoise based on expert knowledge and widely shared values. Where such collective, expert equipoise exists there is a prima facie case for an RCT. Next the paper argues that trial entry does not involve clinicians disavowing their therapeutic obligation; individualised care based on insufficient evidence is not in patients best interest. Finally, it argues that where equipoise exists it is acceptable to limit access to experimental agents; desperate volunteers are not coerced because their desperation does not translate into a right to receive what they desire.

  7. 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.

  8. Autotitrating versus standard noninvasive ventilation: a randomised crossover trial.

    PubMed

    Jaye, J; Chatwin, M; Dayer, M; Morrell, M J; Simonds, A K

    2009-03-01

    The aim of the present study was to compare the efficacy of automatic titration of noninvasive ventilation (NIV) with conventional NIV in stable neuromuscular and chest wall disorder patients established on long-term ventilatory support. In total, 20 neuromuscular and chest wall disease patients with nocturnal hypoventilation treated with long-term NIV completed a randomised crossover trial comparing two noninvasive pressure support ventilators: a standard bilevel ventilator (VPAP III) and a novel autotitrating bilevel ventilator (AutoVPAP). Baseline physiological measurements, overnight polysomnography and Holter monitoring were repeated at the end of each 1-month treatment period. Nocturnal oxygenation was comparable between the autotitrating device and standard ventilator, as were sleep efficiency, arousals and heart rate variability. However, there was a small significant increase in mean overnight transcutaneous carbon dioxide tension (median (interquartile range) 7.2 (6.7-7.7) versus 6.7 (6.1-7.0) kPa) and a decrease in percentage stage 1 sleep (mean+/-sd 16+/-9 versus 19+/-10%) on autotitrating NIV compared with conventional NIV. Autotitrating noninvasive ventilation using AutoVPAP produced comparable control of nocturnal oxygenation to standard nonivasive ventilation, without compromising sleep quality in stable neuromuscular and chest wall disease patients requiring long-term ventilatory support for nocturnal hypoventilation. PMID:19251798

  9. Stepping down inhaled corticosteroids in asthma: randomised controlled trial

    PubMed Central

    Hawkins, Gillian; McMahon, Alex D; Twaddle, Sara; Wood, Stuart F; Ford, Ian; Thomson, Neil C

    2003-01-01

    Objectives To determine whether the dose of inhaled corticosteroids can be stepped down in patients with chronic stable asthma while maintaining control. Design One year, randomised controlled, double blind, parallel group trial. Setting General practices throughout western and central Scotland. Participants 259 adult patients with asthma receiving regular treatment with inhaled corticosteroids at high dose (mean dose 1430 μg beclomethasone dipropionate). Interventions Participants were allocated to receive either no alteration to their dose of inhaled corticosteroid (control) or a 50% reduction in their dose if they met criteria for stable asthma (stepdown). Main outcome measures Comparison of asthma exacerbation rates, asthma related visits to general practice and hospital, health status measures, and corticosteroid dosage between the two groups. Results The proportions of subjects with asthma exacerbations were not significantly different (stepdown 31%, control 26%, P=0.354). Similarly, the numbers of visits to general practice or hospital and the disease specific and generic measures of health status over the one year period were not significantly different. On average the stepdown group received 348 μg (95% confidence interval 202 μgto494 μg) of beclomethasone dipropionate less per day than the controls (a difference of 25%), with no difference in the annual dose of oral corticosteroids between the two treatment regimens. Conclusions By adopting a stepdown approach to the use of inhaled steroids at high doses in asthma a reduction in the dose can be achieved without compromising asthma control. PMID:12763981

  10. Mendelian randomisation: a tool for assessing causality in observational epidemiology.

    PubMed

    Sheehan, Nuala A; Meng, Sha; Didelez, Vanessa

    2011-01-01

    Detection and assessment of the effect of a modifiable risk factor on a disease with view to informing public health intervention policies are of fundamental concern in aetiological epidemiology. In order to have solid evidence that such a public health intervention has the desired effect, it is necessary to ascertain that an observed association or correlation between a risk factor and a disease means that the risk factor is causal for the disease. Inferring causality from observational data is difficult, typically due to confounding by social, behavioural, or physiological factors which are difficult to control for and particularly difficult to measure accurately. A possible approach to inferring causality when confounding is believed to be present but unobservable, as it may not even be fully understood, is based on the method of instrumental variables and is known under the name of Mendelian randomisation if the instrument is a genetic variant. While testing for the presence of a causal effect using this method is generally straightforward, point estimates of such an effect are only obtainable under additional parametric assumptions. This chapter introduces the concept and illustrates the method and its assumptions with simple real-life examples. It concludes with a brief discussion on pitfalls and limitations.

  11. 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

  12. 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.

  13. 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. PMID:25832346

  14. 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

  15. 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.

  16. 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

  17. 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.

  18. 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

  19. Epidemiologic and clinical characteristics of cardiomyopathies in Japan: results from nationwide surveys.

    PubMed

    Matsumori, Akira; Furukawa, Yutaka; Hasegawa, Koji; Sato, Yukihito; Nakagawa, Hideaki; Morikawa, Yuko; Miura, Katsuyuki; Ohno, Yoshiyuki; Tamakoshi, Akiko; Inaba, Yutaka; Sasayama, Shigetake

    2002-04-01

    Nationwide clinico-epidemiological surveys of cardiomyopathies in Japan were carried out. Disorders surveyed included idiopathic dilated cardiomyopathy (DCM), hypertrophic cardiomyopathy (HCM), restrictive cardiomyopathy (RCM), arrhythmogenic right ventricular dysplasia (ARVD), mitochondrial disease, Fabry's disease of the heart and prolonged Q-T interval syndrome. The total number of patients was estimated at 17,700 for DCM, 21,900 for HCM, 300 for RCM, 520 for ARVD, 640 for mitochondrial disease, 150 for Fabry's disease of the heart, and 1,000 for prolonged Q-T interval syndrome. The prevalence of both DCM and HCM was higher in men than women: the male-to-female ratios were 2.6 and 2.3 for DCM and HCM, respectively. Detailed data on patients with DCM or HCM were collected by a follow-up survey. In 1 year more patients with DCM (5.6%) died than with HCM (2.8%): congestive heart failure (CHF) and arrhythmias were the leading causes of death for DCM and HCM, respectively. Angiotensin converting enzyme inhibitors (64.6%) and beta-adrenergic blockers (40.9%) are commonly used to treat the CHF complicating DCM and may be associated with the clinical improvement in a significant number of DCM patients. Thus, the nationwide surveys of Japanese patients have yielded important current epidemiological and clinical information on the characteristics of cardiomyopathies in Japan.

  20. A single-blind randomised controlled trial of the effects of a web-based decision aid on self-testing for cholesterol and diabetes. study protocol

    PubMed Central

    2012-01-01

    Background Self-tests, tests on body materials to detect medical conditions, are widely available to the general public. Self-testing does have advantages as well as disadvantages, and the debate on whether self-testing should be encouraged or rather discouraged is still ongoing. One of the concerns is whether consumers have sufficient knowledge to perform the test and interpret the results. An online decision aid (DA) with information on self-testing in general, and test specific information on cholesterol and diabetes self-testing was developed. The DA aims to provide objective information on these self-tests as well as a decision support tool to weigh the pros and cons of self-testing. The aim of this study is to evaluate the effect of the online decision aid on knowledge on self-testing, informed choice, ambivalence and psychosocial determinants. Methods/Design A single blind randomised controlled trial in which the online decision aid 'zelftestwijzer' is compared to short, non-interactive information on self-testing in general. The entire trial will be conducted online. Participants will be selected from an existing Internet panel. Consumers who are considering doing a cholesterol or diabetes self-test in the future will be included. Outcome measures will be assessed directly after participants have viewed either the DA or the control condition. Weblog files will be used to record participants' use of the decision aid. Discussion Self-testing does have important pros and cons, and it is important that consumers base their decision whether they want to do a self-test or not on knowledge and personal values. This study is the first to evaluate the effect of an online decision aid for self-testing. Trial registration Dutch Trial Register: NTR3149 PMID:22216905

  1. Preliminary results, methodological considerations and recruitment difficulties of a randomised clinical trial comparing two treatment regimens for patients with headache and neck pain

    PubMed Central

    De Hertogh, Willem; Vaes, Peter; Devroey, Dirk; Louis, Paul; Carpay, Hans; Truijen, Steven; Duquet, William; Oostendorp, Rob

    2009-01-01

    Background Headache is a highly prevalent disorder. Irrespective of the headache diagnosis it is often accompanied with neck pain and -stiffness. Due to this common combination of headache and neck pain, physical treatments of the cervical spine are often considered. The additional value of these treatments to standard medical care or usual care (UC) is insufficiently documented. We therefore wanted to compare the treatment effects of UC alone and in combination with manual therapy (MT) in patients with a combination of headache and neck pain. UC consisted of a stepped treatment approach according to the Dutch General Practitioners Guideline for headache, the additional MT consisted of articular mobilisations and low load exercises. Due to insufficient enrolment the study was terminated prematurely. We aim to report not only our preliminary clinical findings but also to discuss the encountered difficulties and to formulate recommendations for future research. Methods A randomised clinical trial was conducted. Thirty-seven patients were included and randomly allocated to one of both treatment groups. The treatment period was 6 weeks, with follow-up measurements at weeks 7, 12 and 26. Primary outcome measures were global perceived effect (GPE) and the impact of the headache using the Headache Impact Test (HIT-6). Reduction in headache frequency, pain intensity, medication intake, absenteeism and the use of additional professional help were secondary outcome measures Results Significant improvements on primary and secondary outcome measures were recorded in both treatment groups. No significant differences between both treatment groups were found. The number of recruited patients remained low despite various strategies. Conclusion It appears that both treatment strategies can have equivalent positive influences on headache complaints. Additional studies with larger study populations are needed to draw firm conclusions. Recommendations to increase patient inflow in

  2. 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

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

    PubMed Central

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

    1995-01-01

    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. PMID:7781729

  4. 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.

  5. [Acute otitis media: do not change the Dutch practice guideline].

    PubMed

    Damoiseaux, Roger A M J

    2012-01-01

    Two recent clinical trials have again shown that antibiotics are effective in the management of young children with acute otitis media (AOM). Should this change our reserved attitude towards the use of antibiotics? According to the rules for evidence-based medicine, we cannot ignore the vast body of evidence already existing unless new trials are methodologically better and their results differ from previous trials. This does not seem to be the case. The patient characteristics of these trials are similar to those of a previously published individual patient data meta-analysis. The primary outcome 'symptom scores' reported by Hoberman et al. is also comparable, but Tähtinen et al. may have overestimated the effect of antibiotics. Their primary outcome 'time to treatment failure' does not take later improvement or recovery into account. In both trials, the greatest benefit is related to otoscopic recovery of AOM, which is clinically not the most relevant outcome. For now, there is no reason to adapt the current AOM practice guideline of the Dutch College of General Practitioners.

  6. A Dutch Survey on Circumpatellar Electrocautery in Total Knee Arthroplasty

    PubMed Central

    van Jonbergen, Hans-Peter W.; Barnaart, Alexander F.W.; Verheyen, Cees C.P.M.

    2010-01-01

    Introduction: Anterior knee pain following total knee arthroplasty is estimated to occur in 4-49% of patients. Some orthopedic surgeons use circumpatellar electrocautery (diathermy) to reduce the prevalence of postsurgical anterior knee pain; however, the extent of its use is unknown. Materials and Methodology: In April 2009, a postal questionnaire was sent to all 98 departments of orthopedic surgery in The Netherlands. The questions focused on the frequency of total knee arthroplasties, patellar resurfacing, and the use of circumpatellar electrocautery. Results: The response rate was 92%. A total of 18,876 TKAs, 2,096 unicompartmental knee arthroplasties, and 215 patellofemoral arthroplasties are performed yearly in The Netherlands by the responding orthopedic surgeons. Of the orthopedic surgeons performing TKA, 13% always use patellar resurfacing in total knee arthroplasty for osteoarthritis, 49% use selective patellar resurfacing, and 38% never use it. Fifty-six percent of orthopedic surgeons use circumpatellar electrocautery when not resurfacing the patella, and 32% use electrocautery when resurfacing the patella. Conclusion: There is no consensus among Dutch orthopedic surgeons on the use of patellar resurfacing or circumpatellar electrocautery in total knee replacement performed for osteoarthritis. A prospective clinical trial is currently underway to fully evaluate the effect of circumpatellar electrocautery on the prevalence of anterior knee pain following total knee arthroplasty. PMID:21228917

  7. Dissociative symptoms and amnesia in Dutch concentration camp survivors.

    PubMed

    Merckelbach, Harald; Dekkers, Theo; Wessel, Ineke; Roefs, Anne

    2003-01-01

    We examined to what extent dissociative phenomena in concentration camp survivors are related to post-traumatic stress symptoms. Self-reports of amnesia for traumatic war events and other dissociative experiences were studied in a sample of 31 Dutch survivors of World War II (WWII) Japanese concentration camps. Seventeen survivors treated for war-related psychiatric symptoms were compared to 14 concentration camp survivors who had no psychiatric diagnosis. Although survivors who received treatment scored significantly higher on the Impact of Event Scale and the Post-Traumatic Symptom Scale than control survivors, the two groups did not differ in terms of accessibility of war memories or dissociative experiences. Levels of post-traumatic stress symptoms were not significantly correlated with dissociative experiences. In both groups, reports of psychogenic amnesia for traumatic events were rare. Our results support previous studies demonstrating that post-traumatic stress symptoms are not necessarily accompanied by dissociative experiences. They also contradict the suggestion that amnesia is a common phenomenon in people who have been exposed to war atrocities.

  8. Extensive Genetic Diversity within the Dutch Clinical Cryptococcus neoformans Population

    PubMed Central

    Hagen, Ferry; Illnait-Zaragozí, María-Teresa; Meis, Jacques F.; Chew, William H. M.; Curfs-Breuker, Ilse; Mouton, Johan W.; Hoepelman, Andy I. M.; Spanjaard, Lodewijk; Verweij, Paul E.; Kampinga, Greetje A.; Kuijper, Ed J.; Klaassen, Corné H. W.

    2012-01-01

    A set of 300 Dutch Cryptococcus neoformans isolates, obtained from 237 patients during 1977 to 2007, was investigated by determining the mating type, serotype, and AFLP and microsatellite genotype and susceptibility to seven antifungal compounds. Almost half of the studied cases were from HIV-infected patients, followed by a patient group of individuals with other underlying diseases and immunocompetent individuals. The majority of the isolates were mating type α and serotype A, followed by αD isolates and other minor categories. The most frequently observed genotype was AFLP1, distantly followed by AFLP2 and AFLP3. Microsatellite typing revealed a high genetic diversity among serotype A isolates but a lower diversity within the serotype D set of isolates. One patient was infected by multiple AFLP genotypes. Fluconazole and flucytosine had the highest geometric mean MICs of 2.9 and 3.5 μg/ml, respectively, while amphotericin B (0.24 μg/ml), itraconazole (0.08 μg/ml), voriconazole (0.07 μg/ml), posaconazole (0.06 μg/ml), and isavuconazole (0.03 μg/ml) had much lower geometric mean MICs. One isolate had a high flucytosine MIC (>64 μg/ml), while decreased susceptibility (≥16 μg/ml) for flucytosine and fluconazole was found in 9 and 10 C. neoformans isolates, respectively. PMID:22442325

  9. The success of SEA in the Dutch planning practice

    SciTech Connect

    Van Buuren, Arwin; Nooteboom, Sibout

    2010-02-15

    In this article we answer the question how Strategic Environmental Assessment (SEA) may assist collaborative planning. We argue that successful collaborative planning generates specific demands on the production of policy-relevant knowledge, which SEA may help to meet. Important criteria for usable knowledge in governance processes are its interactive production, its flexible character to cope with the dynamics of collaborative processes, its openness to stakeholder involvement, and its focus on close interplay between policy and knowledge developers. The SEA procedure may fit well into collaborative planning processes, depending on how policy makers apply and use this procedure. From two rather controversial Dutch planning cases we learn that SEA, applied wisely, plays an important role in realizing meaningful stakeholder involvement, joint fact-finding and interaction between lay people and experts, agreement about the policy problem, the alternative solutions and their effects, and knowledge which is feasible to facilitate decision-making in a context of highly polarized positions and value-laden conflicts. We can conclude that SEA seems to be perhaps not formally intended to facilitate collaborative governance processes, but that it can do so when the users translate its principles in accordance to the general principles of successful collaborative governance and joint fact finding.

  10. Dutch guideline for the management of hypertensive crisis -- 2010 revision.

    PubMed

    van den Born, B J H; Beutler, J J; Gaillard, C A J M; de Gooijer, A; van den Meiracker, A H; Kroon, A A

    2011-05-01

    Hypertensive crises are divided into hypertensive urgencies and emergencies. Together they form a heterogeneous group of acute hypertensive disorders depending on the presence or type of target organs involved. Despite better treatment options for hypertension, hypertensive crisis and its associated complications remain relatively common. In the Netherlands the number of patients starting renal replacement therapy because of 'malignant hypertension' has increased in the past two decades. In 2003, the first Dutch guideline on hypertensive crisis was released to allow a standardised evidence-based approach for patients presenting with a hypertensive crisis. In this paper we give an overview of the current management of hypertensive crisis and discuss several important changes incorporated in the 2010 revision. These changes include a modification in terminology replacing 'malignant hypertension' with 'hypertensive crisis with retinopathy and reclassification of hypertensive crisis with retinopathy under hypertensive emergencies instead of urgencies. With regard to the treatment of hypertensive emergencies, nicardipine instead of nitroprusside or labetalol is favoured for the management of perioperative hypertension, whereas labetalol has become the drug of choice for the treatment of hypertension associated with pre-eclampsia. For the treatment of hypertensive urgencies, oral administration of nifedipine retard instead of captopril is recommended as first-line therapy. In addition, a section on the management of hypertensive emergencies according to the type of target organ involved has been added. Efforts to increase the awareness and treatment of hypertension in the population at large may lower the incidence of hypertensive crisis and its complications.

  11. High risk of tick bites in Dutch gardens.

    PubMed

    Mulder, Sara; van Vliet, Arnold J H; Bron, Wichertje A; Gassner, Fedor; Takken, Willem

    2013-12-01

    Lyme borreliosis is the most prevalent tick-borne disease throughout the Northern Hemisphere. Because the disease has large socioeconomic consequences, there is an urgent need to further educate the public to stimulate preventive behavior. Unfortunately, risk factors for tick bites are poorly known. In this study, we determined the habitats and activities at risk for tick bites for people of different age categories using reports of Dutch citizens. Most people, 43%, were bitten in the forest, and an unexpected large number of people reported tick bites from their gardens (31%). Hiking, hobby gardening, and playing were the most-mentioned activities during which tick bites were received; people aged from 50 to 69 and children below 10 were bitten most. Different age categories were bitten in different habitats and during different activities. People aged from 0 to 60 reported most tick bites related to visiting a forest and hiking, whereas people older than 60 were mainly bitten in gardens. The percentage of garden and hobby gardening tick bites increased with age, but was also high for children less than 10 years of age. We suggest that these findings should be taken into account for the development of prevention strategies aiming to decrease the number of Lyme borreliosis cases.

  12. 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

  13. 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

  14. A review of a new Dutch guideline for management of recurrent varicose veins.

    PubMed

    Lawson, James A; Toonder, Irwin M

    2016-03-01

    In 2013, the new Dutch guideline for "Venous Pathology" was published. The guideline was a revision and update from the guideline "Diagnostics and Treatment of Varicose Veins" from 2009 and the guideline "Venous Ulcer" from 2005. A guideline for "Deep Venous Pathology" and one for "Compression Therapy" was added to the overall guideline "Venous Pathology." The chapter about treatment of recurrent varicose veins after initial intervention was recently updated in 2015 and is reviewed here. The Dutch term "recidief varices" or the French "récidive de varices" should be used analogous to the English term "recurrent varicose veins." The DCOP Guideline Development Group Neovarices concluded that "recidief" in Dutch actually suggests recurrence after apparent successful treatment and ignores the natural progression of venous disease in its own right. So the group opted to use the term "neovarices." In the Dutch guideline, neovarices is meant to be an all embracing term for recurrent varicose veins caused by technical or tactical failure, evolvement from residual refluxing veins or natural progression of varicose vein disease at different locations of the treated leg after intervention. This report reviews the most important issues in the treatment of varicose vein recurrence, and discusses conclusions and recommendations of the Dutch Neovarices Guideline Committee.

  15. A pilot randomised controlled trial of cognitive behavioural therapy for antenatal depression

    PubMed Central

    2013-01-01

    Background Few trials have evaluated the effectiveness of psychological treatment in improving depression by the end of pregnancy. This is the first pilot randomised controlled trial (RCT) of individual cognitive behavioural therapy (CBT) looking at treating depression by the end of pregnancy. Our aim was to assess the feasibility of delivering a CBT intervention modified for antenatal depression during pregnancy. Methods Women in North Bristol, UK between 8–18 weeks pregnant were recruited through routine contact with midwives and randomised to receive up to 12 sessions of individual CBT in addition to usual care or to continue with usual care only. Women were eligible for randomisation if they screened positive on a 3-question depression screen used routinely by midwives and met ICD-10 criteria for depression assessed using the clinical interview schedule – revised version (CIS-R). Two CBT therapists delivered the intervention. Follow-up was at 15 and 33 weeks post-randomisation when assessments of mental health were made using measures which included the CIS-R. Results Of the 50 women assessed for the trial, 36 met ICD-10 depression criteria and were randomised: 18 to the intervention and 18 to usual care. Thirteen of the 18 (72%) women who were allocated to receive the intervention completed 9 or more sessions of CBT before the end of pregnancy. Follow-up rates at 15 and 33 weeks post-randomisation were higher in the group who received the intervention (89% vs. 72% at 15 weeks and 89% vs. 61% at 33 weeks post-randomisation). At 15 weeks post-randomisation (the end of pregnancy), there were more women in the intervention group (11/16; 68.7%) who recovered (i.e. no longer met ICD-10 criteria for depression), than those receiving only usual care (5/13; 38.5%). Conclusions This pilot trial shows the feasibility of conducting a large RCT to assess the effectiveness of CBT for treating antenatal depression before the end of pregnancy. The intervention could

  16. Neonatal ECMO Study of Temperature (NEST) - a randomised controlled trial

    PubMed Central

    2010-01-01

    Background Existing evidence indicates that once mature neonates with severe cardio-respiratory failure become eligible for Extra Corporeal Membrane Oxygenation (ECMO) their chances of intact survival are doubled if they actually receive ECMO. However, significant numbers survive with disability. NEST is a multi-centre randomised controlled trial designed to test whether, in neonates requiring ECMO, cooling to 34°C for the first 48 to 72 hours of their ECMO course leads to improved later health status. Infants allocated to the control group will receive ECMO at 37°C throughout their course, which is currently standard practice around the world. Health status of both groups will be assessed formally at 2 years corrected age. Methods/Design All infants recruited to the study will be cared for in one of the four United Kingdom (UK) ECMO centres. Babies who are thought to be eligible will be assessed by the treating clinician who will confirm eligibility, ensure that consent has been obtained and then randomise the baby using a web based system, based at the National Perinatal Epidemiology Unit (NPEU) Clinical Trials Unit. Trial registration. Babies allocated ECMO without cooling will receive ECMO at 37°C ± 0.2°C. Babies allocated ECMO with cooling will be managed at 34°C ± 0.2°C for up to 72 hours from the start of their ECMO run. The minimum duration of cooling will be 48 hours. Rewarming (to 37°C) will occur at a rate of no more than 0.5°C per hour. All other aspects of ECMO management will be identical. Primary outcome: Cognitive score from the Bayley Scales of Infant and Toddler Development, 3rd edition (Bayley-III) at age of 2 years (24 - 27 months). Discussion For the primary analysis, children will be analysed in the groups to which they are assigned, comparing the outcome of all babies allocated to "ECMO with cooling" with all those allocated to "ECMO" alone, regardless of deviation from the protocol or treatment received. For the primary outcome the

  17. 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…

  18. 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

  19. 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. PMID:24972754

  20. 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

  1. Inflammatory markers in a randomised soya intervention among men.

    PubMed

    Maskarinec, Gertraud; Oum, Robert; Chaptman, Ann K; Ognjanovic, Simona

    2009-06-01

    The present analysis investigated the effect of soya foods on serum levels of six inflammatory markers, leptin, adiponectin, monocyte attractant protein 1 (MCP-1), macrophage inflammatory protein-1b (MIP-1b), IL-6 and C-reactive protein (CRP), and their relationship with BMI and lifetime soya intake. We randomised twenty-four men to a high- (two daily servings with 30-35 mg isoflavones per serving) or a low-soya diet for 3 months. After a 1-month washout period, the men crossed over to the other treatment. We used a multiplex bead immunoassay to measure leptin, adiponectin, MCP-1 and MIP-1b and ELISA assays for IL-6 and CRP. The statistical analysis applied mixed models that incorporated the four repeated measurements. The men had a mean age of 58.7 (sd 7.2) years and a mean BMI of 28.4 (sd 4.9) kg/m2. We observed no significant intervention effect of the soya treatment on any of the six markers. After adjustment for age and ethnicity, highly significant associations of BMI and body weight with leptin and MCP-1 emerged. Men with high soya intake early in life also had higher levels of leptin and MCP-1, whereas no association was seen for soya intake during adulthood. MIP-1b, adiponectin, IL-6 and CRP were not related to BMI, body weight or soya intake at any time in life. No intervention effect of soya foods on markers of inflammation was observed in this small study, but adiposity and early-life soya intake were related to higher leptin and MCP-1 levels.

  2. Randomised controlled trial of intrapartum fetal heart rate monitoring.

    PubMed Central

    Mahomed, K.; Nyoni, R.; Mulambo, T.; Kasule, J.; Jacobus, E.

    1994-01-01

    OBJECTIVE--To compare effectiveness of different methods of monitoring intrapartum fetal heart rate. DESIGN--Prospective randomised controlled trial. SETTING--Referral maternity hospital, Harare, Zimbabwe. SUBJECTS--1255 women who were 37 weeks or more pregnant with singleton cephalic presentation and normal fetal heart rate before entry into study. INTERVENTIONS--Intermittent monitoring of fetal heart rate by electronic monitoring, Doppler ultrasound, use of Pinard stethoscope by a research midwife, or routine use of Pinard stethoscope by attending midwife. MAIN OUTCOME MEASURES--Abnormal fetal heart rate patterns, need for operative delivery for fetal distress, neonatal mortality, Apgar scores, admission to neonatal unit, neonatal seizures, and hypoxic ischaemic encephalopathy. RESULTS--Abnormalities in fetal heart rate were detected in 54% (172/318) of the electronic monitoring group, 32% (100/312) of the ultrasonography group, 15% (47/310) of the Pinard stethoscope group, and 9% (28/315) of the routine monitoring group. Caesarean sections were performed for 28% (89%), 24% (76), 10% (32), and 15% (46) of the four groups respectively. Neonatal outcome was best in the ultrasonography group: hypoxic ischaemic encephalopathy occurred in two, one, seven, and 10 cases in the four groups respectively; neonatal seizures occurred only in the last two groups (six and nine cases respectively); and deaths occurred in eight, two, five, and nine cases respectively. CONCLUSIONS--Abnormalities in fetal heart rate were more reliably detected by Doppler ultrasonography than with Pinard stethoscope, and its use resulted in good perinatal outcome. The use of relatively cheap ultrasound monitors should be further evaluated and promoted in obstetric units caring for high risk pregnancies in developing countries with scarce resources. PMID:8136665

  3. 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…

  4. Having Faith: Religious Optimism in Dutch Parochial Schools during the 1960s as a Case for Secularisation

    ERIC Educational Resources Information Center

    Mellink, Bram

    2013-01-01

    In the Netherlands of the late nineteenth century, primary education became one of the central issues in relation to raising political awareness and mobilising previously quiescent Dutch citizens. Protestants and Catholics alike claimed that Dutch public education left insufficient space for religious education and teamed up to struggle for…

  5. Acquiring a New Second Language Contrast: An Analysis of the English Laryngeal System of Native Speakers of Dutch

    ERIC Educational Resources Information Center

    Simon, Ellen

    2009-01-01

    This study examines the acquisition of the English laryngeal system by native speakers of (Belgian) Dutch. Both languages have a two-way laryngeal system, but while Dutch contrasts prevoiced with short-lag stops, English has a contrast between short-lag and long-lag stops. The primary aim of the article is to test two hypotheses on the acquisition…

  6. 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…

  7. 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.

  8. Dutch approach to develop efficient water quality monitoring schemes

    NASA Astrophysics Data System (ADS)

    Schoumans, O. F.; van Tol-Leenders, T. P.; van der Bolt, F. J. E.; Siderius, C.; Kroes, J.; Roelsma, J.; Löschner-Wolleswinkel, R.; Walvoort, D.

    2009-04-01

    In 2003 a study started to determine a monitoring procedure in order to quantify the impact of the Dutch manure legislation on water quality at catchment scale. Four catchments were selected to develop such a methodology. One peat catchment, one clay catchment and two sandy catchments were selected as representative catchments for the major soil types that occur in The Netherlands. The contribution of land to the diffuse pollution of surface water depends on a lot of factors, such as meteorological circumstances, hydrological conditions, soil characteristics, soil properties and soil status, land use, manure and fertilizer application rates, hydraulic conditions etc. As a result different sources and pathways can be distinguished, that will changes over time. As a result of this complexity it is impossible to determine the influence of all these factors separately and independently just by measuring the water quality of the surface water. For this reason a monitoring scheme was developed for catchment scale in which measurements were combined with process oriented modeling approaches for the land-water-system as a whole. A validated process oriented modeling approach is necessary in order to understand the fate of nutrients applied with manure and fertilizers and to assess what will happen over time for each specific catchment system. Furthermore, the model can be used to adjust the location of the gauging stations and the frequency of the measurements and can fill in gaps in the data of the measurements. In fact the whole monitoring procedure is an iterative process between measurements and modeling and will end up in an efficient monitoring approach. Furthermore, the measurements are used to increase the validation of the tools. In the near future this monitoring approach of measuring and modeling will be used to determine to what extend the different management strategies will effect diffuse nutrient losses to surface water. So, Measuring, Modeling and

  9. Feasibility of the Dutch ICF Activity Inventory: a pilot study

    PubMed Central

    2010-01-01

    Background Demographic ageing will lead to increasing pressure on visual rehabilitation services, which need to be efficiently organised in the near future. The Dutch ICF Activity Inventory (D-AI) was developed to assess the rehabilitation needs of visually impaired persons. This pilot study tests the feasibility of the D-AI using a computer-assisted telephone interview. Methods In addition to the regular intake, the first version of the D-AI was assessed in 20 patients. Subsequently, patients and intake assessors were asked to fill in an evaluation form. Based on these evaluations, a new version of the D-AI was developed. Results Mean administration time of the D-AI was 88.8 (± 41.0) minutes. Overall, patients and assessors were positive about the D-AI assessment. However, professionals and 60% of the patients found the administration time to be too long. All included items were considered relevant and only minor adjustments were recommended. Conclusion The systematic character of the revised D-AI will prevent topics from being overlooked and indicate which needs have the highest priority from a patient-centred perspective. Moreover, ongoing assessment of the D-AI will enhance evaluation of the rehabilitation process. To decrease administration time, in the revised D-AI only the top priority goals will be fully assessed. Using the D-AI, a rehabilitation plan based on individual needs can be developed for each patient. Moreover, it enables better evaluation of the effects of rehabilitation. A larger validation study is planned. PMID:21110871

  10. The 2015 Dutch food-based dietary guidelines.

    PubMed

    Kromhout, D; Spaaij, C J K; de Goede, J; Weggemans, R M

    2016-08-01

    The objective of this study was to derive food-based dietary guidelines for the Dutch population. The dietary guidelines are based on 29 systematic reviews of English language meta-analyses in PubMed summarizing randomized controlled trials and prospective cohort studies on nutrients, foods and food patterns and the risk of 10 major chronic diseases: coronary heart disease, stroke, heart failure, diabetes, breast cancer, colorectal cancer, lung cancer, chronic obstructive pulmonary disease, dementia and depression. The committee also selected three causal risk factors for cardiovascular diseases or diabetes: systolic blood pressure, low-density lipoprotein cholesterol and body weight. Findings were categorized as strong or weak evidence, inconsistent effects, too little evidence or effect unlikely for experimental and observational data separately. Next, the committee selected only findings with a strong level of evidence for deriving the guidelines. Convincing evidence was based on strong evidence from the experimental data either or not in combination with strong evidence from prospective cohort studies. Plausible evidence was based on strong evidence from prospective cohort studies only. A general guideline to eat a more plant food-based dietary pattern and limit consumption of animal-based food and 15 specific guidelines have been formulated. There are 10 new guidelines on legumes, nuts, meat, dairy produce, cereal products, fats and oils, tea, coffee and sugar-containing beverages. Three guidelines on vegetables, fruits, fish and alcoholic beverages have been sharpened, and the 2006 guideline on salt stayed the same. A separate guideline has been formulated on nutrient supplements. Completely food-based dietary guidelines can be derived in a systematic and transparent way. PMID:27049034

  11. Linkage heterogeneity among 59 Dutch hereditary breast cancer families

    SciTech Connect

    Cornelis, R.S.; Vliet, M. van; Leeuwen, I. van

    1994-09-01

    We have investigated 59 Dutch kindreds with at least three first-degree relatives with breast and/or ovarian cancer for linkage to BRCA1 on 17q12-q21, using at least 4 microsatellite markers flanking BRCA1 on either side. Assuming no heterogeneity, the overall multipoint lod score in this group of families was -7.59. A marked clustering of lod scores >0.5 was observed among the 13 families with a mean age of onset lower than 45 (total lod score: +3.36). Among the 8 kindreds with a mean age of onset lower than 45 and {ge}3 cases diagnosed under 45, the lod score was +4.43. Interestingly, most of the evidence against linkage was found in 17 families with a mean age of onset between 45 and 54 (total lod score of -8.72). It was estimated that 28% of the breast-only families might be caused by BRCA1. Over the 16 breast-ovarian cancer families a lod score of -3.78 was obtained under homogeneity. The highest lod score was +0.57, assuming heterogeneity with 33% of the families being linked to BRCA1. One family gave a multipoint lod score of -2.01 and thereby satisfies the conventional criterion of an unlinked family. Our results support the conclusions from earlier work by others, namely that BRCA1 predisposes particularly to early-onset breast cancer. The proportion of breast-ovarian cancer families we found linked to BRCA1 is much lower than that found by the Breast Cancer Linkage Consortium. This might be caused by the single unlinked family against an insufficient number of families able to give conclusive positive lod scores.

  12. Urban Climate Map System for Dutch spatial planning

    NASA Astrophysics Data System (ADS)

    Ren, Chao; Spit, Tejo; Lenzholzer, Sanda; Yim, Hung Lam Steve; Heusinkveld, Bert; van Hove, Bert; Chen, Liang; Kupski, Sebastian; Burghardt, René; Katzschner, Lutz

    2012-08-01

    Facing climate change and global warming, outdoor climatic environment is an important consideration factor for planners and policy makers because improving it can greatly contribute to achieve citizen's thermal comfort and create a better urban living quality for adaptation. Thus, the climatic information must be assessed systematically and applied strategically into the planning process. This paper presents a tool named Urban Climate Map System (UCMS) that has proven capable of helping compact cities to incorporate climate effects in planning processes in a systematic way. UCMS is developed and presented in a Geographic Information System (GIS) platform in which the lessons learned and experience gained from interdisciplinary studies can be included. The methodology of UCMS of compact cities, the construction procedure, and the basic input factors - including the natural climate resources and planning data - are described. Some literatures that shed light on the applicability of UMCS are reported. The Municipality of Arnhem is one of Dutch compact urban areas and still under fast urban development and urban renewal. There is an urgent need for local planners and policy makers to protect local climate and open landscape resources and make climate change adaptation in urban construction. Thus, Arnhem is chosen to carry out a case study of UCMS. Although it is the first work of Urban Climatic Mapping in The Netherlands, it serves as a useful climatic information platform to local planners and policy makers for their daily on-going works. We attempt to use a quick method to collect available climatic and planning data and create an information platform for planning use. It relies mostly on literature and theoretical understanding that has been well practiced elsewhere. The effort here is to synergize the established understanding for a case at hand and demonstrate how useful guidance can still be made for planners and policy makers.

  13. Dutch male teenagers on their role in prevention.

    PubMed

    Vennix, P; Ketting, E; Curfs, P

    1993-10-01

    During 1991-93, a research project was conducted by the Netherlands Institute of Social Sexological Research to ascertain how Dutch adolescent males perceive and manage the prevention of unwanted pregnancy and sexually transmitted diseases (STDs). A structured questionnaire was administered to a random sample of 215 males aged 18-22 inquiring retrospectively about preventive behavior during their first intercourse. 22 in-depth interviews were also conducted. Findings indicated that the youths received most of their information about contraception and the prevention of STDs from the media, from instructional materials, and from their social lives. Their girlfriends provided them with information about contraception. They were also fully aware of the risks of unprotected sex vis-a-vis pregnancy and STD infection. Most males had the opinion that contraception and the prevention of STDs was the joint responsibility of both man and women. The typical age at first intercourse was 16-17 years. 1 in 4 males had had only 1 sexual affair; two-thirds had a steady relationship; and most had had a 1-month relationship before intercourse occurred. 46% used the condom and 33% used the pill, but only 7% used both. Nothing was used in 1 in 10 cases. When the woman did not use the pill, 1 in 4 males did not use a condom. Females seemed to take the initiative just as often as males did. Condoms were mainly used to prevent pregnancy. Discussion about STDs were avoided as someone else's problem. Only 18% of males used the condom in steady relationships, and most couples started using pills after a few sexual encounters. The condom was discontinued mostly because of inconvenience and unreliability. The initiation of pill use was in most cases the female's task or a joint decision. Young male adolescents should be instructed about the real risk of contracting STDs such as chlamydia and gonorrhea, the perceived risk of which among them, in addition to AIDS, is low.

  14. Manifestations of integrated public health policy in Dutch municipalities.

    PubMed

    Peters, Dorothee; Harting, Janneke; van Oers, Hans; Schuit, Jantine; de Vries, Nanne; Stronks, Karien

    2016-06-01

    Integrated public health policy (IPHP) aims at integrating health considerations into policies of other sectors. Since the limited empirical evidence available may hamper its further development, we systematically analysed empirical manifestations of IPHP, by placing policy strategies along a continuum of less-to-more policy integration, going from intersectoral action (IA) to healthy public policy (HPP) to health in all policies (HiAP). Our case study included 34 municipal projects of the Dutch Gezonde Slagkracht Programme (2009-15), which supports the development and implementation of IPHP on overweight, alcohol and drug abuse, and smoking. Our content analysis of project application forms and interviews with all project leaders used a framework approach involving the policy strategies and the following policy variables: initiator, actors, policy goals, determinants and policy instruments. Most projects showed a combination of policy strategies. However, manifestations of IPHP in overweight projects predominantly involved IA. More policy integration was apparent in alcohol/drugs projects (HPP) and in all-theme projects (HiAP). More policy integration was related to broad goal definitions, which allowed for the involvement of actors representing several policy sectors. This enabled the implementation of a mix of policy instruments. Determinants of health were not explicitly used as a starting point of the policy process. If a policy problem justifies policy integration beyond IA, it might be helpful to start from the determinants of health (epidemiological reality), systematically transform them into policy (policy reality) and set broad policy goals, since this gives actors from other sectors the opportunity to participate.

  15. 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 advances the position…

  16. 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... Allowance Independent Producers, Pipeline Affiliates and Pipeline Producers Continental U.S.—1972...

  17. 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 Computation of Federal Income Tax Allowance Independent Producers, Pipeline Affiliates and Pipeline Producers... Allowance Independent Producers, Pipeline Affiliates and Pipeline Producers Continental U.S.—1972...

  18. 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

    ... 18 Conservation of Power and Water Resources 1 2014-04-01 2014-04-01 false Nationwide Proceeding Computation of Federal Income Tax Allowance Independent Producers, Pipeline Affiliates and Pipeline Producers... Allowance Independent Producers, Pipeline Affiliates and Pipeline Producers Continental U.S.—1972...

  19. 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... Allowance Independent Producers, Pipeline Affiliates and Pipeline Producers Continental U.S.—1972...

  20. 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... Allowance Independent Producers, Pipeline Affiliates and Pipeline Producers Continental U.S.—1972...

  1. 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…

  2. Food Consumption: Households in the Northeast, Spring 1977. Nationwide Food Consumption Survey 1977-78. Report No. H-2.

    ERIC Educational Resources Information Center

    Department of Agriculture, Washington, DC.

    This report presents data for spring 1977 from the household portion of the Nationwide Food Consumption survey in the Northeast conducted by the U.S. Department of Agriculture during April 1977 through March 1978. Statistics are presented on food consumption by consumers with incomes ranging from under $5,000 through $20,000 and over. Information…

  3. Student-Faculty Opinion Poll, 1973. Nationwide Surveys on Student and Faculty Opinions of Free Market Philosophy.

    ERIC Educational Resources Information Center

    Keating, Karl

    This nationwide survey was designed specifically to ascertain student and faculty attitudes toward free enterprise, the free market philosophy, and government intervention. A total of 39,705 survey forms were received by students and faculty members around the country; 14,098 of these were returned for a response rate of 35.15%. Results indicated…

  4. 47 CFR 90.717 - Channels available for nationwide systems in the 220-222 MHz band.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Licensing and Use of Frequencies in the 220-222 MHz Band § 90.717 Channels available for nationwide systems in the 220-222 MHz band. (a) Channels 51-60, 81-90, and 141-150 are 10-channel blocks available to..., and 156-160 are 5-channel blocks available to non-Government applicants only for...

  5. 47 CFR 90.717 - Channels available for nationwide systems in the 220-222 MHz band.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Licensing and Use of Frequencies in the 220-222 MHz Band § 90.717 Channels available for nationwide systems in the 220-222 MHz band. (a) Channels 51-60, 81-90, and 141-150 are 10-channel blocks available to..., and 156-160 are 5-channel blocks available to non-Government applicants only for...

  6. 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

    ... 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 54.1302 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) UNIVERSAL SERVICE High Cost Loop Support...

  7. 75 FR 2557 - Interim Policy for the Sharing of Information Collected by the Coast Guard Nationwide Automatic...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-15

    ... SECURITY Coast Guard Interim Policy for the Sharing of Information Collected by the Coast Guard Nationwide Automatic Identification System AGENCY: Coast Guard, DHS. ACTION: Notice of policy and request for comments. SUMMARY: The Coast Guard has developed an interim policy for the access and sharing of...

  8. From Nationwide Standardized Testing to School-Based Alternative Embedded Assessment in Israel: Students' Performance in the Matriculation 2000 Project.

    ERIC Educational Resources Information Center

    Dori, Yehudit J.

    2003-01-01

    Introduces Matriculation 2000, a 5-year-old project aimed at moving from the nationwide traditional examination system in Israel to a school-based alternative embedded assessment. Describes research conducted during the fifth year of the Project at two experimental and two control schools. Investigates students' learning outcomes in chemistry and…

  9. 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...

  10. 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;…

  11. Mass Communication and Journalism Faculty's Perceptions of the Effectiveness of Email Communication with College Students: A Nationwide Study

    ERIC Educational Resources Information Center

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

    2009-01-01

    Nearly 700 US journalism and mass communication faculty (all teaching personnel) reported their perceptions of student email use via a web-based survey. This nationwide study focused on the content of email sent by faculty to students, email's effectiveness, and email's effect on student learning. Comparisons were made based on faculty gender,…

  12. 28 CFR 16.131 - Exemption of Department of Justice (DOJ)/Nationwide Joint Automated Booking System (JABS), DOJ-005.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... the Privacy Act § 16.131 Exemption of Department of Justice (DOJ)/Nationwide Joint Automated Booking... would constitute an unwarranted invasion of the personal privacy of collateral record subjects or other... that medical and psychiatric personnel provide information regarding the subject's behavior,...

  13. 28 CFR 16.131 - Exemption of Department of Justice (DOJ)/Nationwide Joint Automated Booking System (JABS), DOJ-005.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... the Privacy Act § 16.131 Exemption of Department of Justice (DOJ)/Nationwide Joint Automated Booking... would constitute an unwarranted invasion of the personal privacy of collateral record subjects or other... that medical and psychiatric personnel provide information regarding the subject's behavior,...

  14. [Military veterinary services in the former Dutch East Indies 1849-1950].

    PubMed

    Steltenpool, Bas

    2008-01-01

    The former Dutch colony is a vast archipelago and Java was the center of the Dutch colonial authority. In the outlying districts this authority had lesser influence. The army had a double task, at the one hand the protection of Java against foreign aggression and on the other hand police actions in the outlying districts. As usual during the 19th century, the army used animals, principally horses, but elephants were also used for provisioning the remote districts. In the beginning the veterinary care was in the hands of empiricists, but in 1830 the first officer horsedoctor was active and little by little a military veterinary service was developed and well trained vets came to the colony They were at the basis of the development of; veternnary medicine in the Dutch East Indies. PMID:20642140

  15. [The Dutch version of the Radner Reading Chart for assessing vision function].

    PubMed

    Maaijwee, K J M; Meulendijks, C F M; Radner, W; van Meurs, J C; Hoyng, C B

    2007-11-10

    A chart for measuring visual acuity is a better functional test than the routine distance visual acuity testing with single optotypes. The characteristics of a good reading chart are: logarithmically diminishing print size, simultaneous measurement of reading acuity and reading speed, and the calculation of one score for reading acuity corrected for the number of reading errors. The original German-language Radner Reading Chart meets all these requirements, and above all emphasizes the principle of 'sentence optotypes' i.e. highly standardized sentences, because sentence complexity also influences reading performance. Sentence optotypes were created in the Dutch language and tested according to Radner's strict principles. The most equally matched sentence optotypes in terms of reading speed and number of reading errors were selected for the introduction and printing of the first Dutch version of the Radner Reading Chart. The Dutch Radner Reading Chart is precise and practical and therefore useful for research and daily practice.

  16. 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.

  17. [Mental illness in the former Dutch Indies--four psychiatric syndromes: amok, latah, koro and neurasthenia].

    PubMed

    Bartelsman, M; Eckhardt, P P

    2007-12-22

    --At the beginning of the 20th century Dutch psychiatrists in the former Dutch Indies encountered exotic psychiatric syndromes and variant expressions of psychopathological diseases that were also prevalent in Europe. --The amok and latah syndromes were reported relatively frequently and were considered typical endemic psychopathologies. Amok is an acute condition of insanity in which the affected individual, a man, attempts to kill others. Latah is a shock-like condition in which the affected individual, a woman, mimics the movements and sounds of those nearby against her will. --The koro syndrome is considered a typical but rare psychosis seen primarily among the Chinese population of the former Dutch Indies. Patients have a recurring fear of the penis retracting into the body. --A diagnosis of 'tropical neurasthenia' was frequently made in Europeans for what today would be referred to as dysthymic disorder or minor depressive disorder.

  18. 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. PMID:25526520

  19. 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.

  20. 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.

  1. 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.

  2. A nationwide survey of hepatitis C services provided by drug treatment programs.

    PubMed

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

    2002-03-01

    Drug treatment programs are a site of opportunity for the delivery of primary and secondary hepatitis C (HCV) prevention services to drug users, a population at great risk for contracting and transmitting the virus. Using data collected from a random nationwide sample (N = 439) of drug treatment programs in the United States, this study examines the extent to which various types of HCV services are provided to their patients. Findings indicate that the majority of drug treatment programs educate at least some of their patients about HCV, and provide some type of support for patients who are infected with the virus. Only 29 of the programs in the sample test all of their patients for HCV, however, and 99 programs test none of them. For the most part, residential treatment programs offer more HCV related services than outpatient drug-free programs. PMID:11932130

  3. 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.

  4. 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.

  5. Income inequality, perceived happiness, and self-rated health: evidence from nationwide surveys in Japan.

    PubMed

    Oshio, Takashi; Kobayashi, Miki

    2010-05-01

    In this study, we examined how regional inequality is associated with perceived happiness and self-rated health at an individual level by using micro-data from nationwide surveys in Japan. We estimated the bivariate ordered probit models to explore the associations between regional inequality and two subjective outcomes, and evaluated effect modification to their sensitivities to regional inequality using the categories of key individual attributes. We found that individuals who live in areas of high inequality tend to report themselves as both unhappy and unhealthy, even after controlling for various individual and regional characteristics and taking into account the correlation between the two subjective outcomes. Gender, age, educational attainment, income, occupational status, and political views modify the associations of regional inequality with the subjective assessments of happiness and health. Notably, those with an unstable occupational status are most affected by inequality when assessing both perceived happiness and health.

  6. An Assessment of Turkish Young Pupils' Environmental Literacy: A nationwide survey

    NASA Astrophysics Data System (ADS)

    Erdogan, Mehmet; Ok, Ahmet

    2011-11-01

    The purpose of this nationwide survey was to assess young Turkish pupils' environmental literacy (EL) level by considering six EL components. The sample of the study comprised of 2,412 fifth graders selected from 78 elementary schools (26 private and 52 public) in 26 provinces of Turkey. Data were obtained through the use of an elementary school environmental literacy instrument (ESELI) including five parts and total of 75 items. The results revealed that the composite EL score of the students was found to be 149.66 (SD = 26.19), suggesting a moderate level of EL among 61% percent of the students (n = 1,545). On the other hand, more than a quarter of the participants (27.3%, n = 659) held high level EL, whereas only 22 students (0.9%) showed low level EL. The implications of the results to policy, practice, and further research were discussed at the end of the study.

  7. Developing Built Environment Programs in Local Health Departments: Lessons Learned From a Nationwide Mentoring Program

    PubMed Central

    Rube, Kate; Veatch, Maggie; Huang, Katy; Lent, Megan; Goldstein, Gail P.; Lee, Karen K.

    2014-01-01

    Local health departments (LHDs) have a key role to play in developing built environment policies and programs to encourage physical activity and combat obesity and related chronic diseases. However, information to guide LHDs’ effective engagement in this arena is lacking. During 2011–2012, the New York City Department of Health and Mental Hygiene (DOHMH) facilitated a built environment peer mentoring program for 14 LHDs nationwide. Program objectives included supporting LHDs in their efforts to achieve built environment goals, offering examples from DOHMH’s built environment work to guide LHDs, and building a healthy built environment learning network. We share lessons learned that can guide LHDs in developing successful healthy built environment agendas. PMID:24625166

  8. Quantifying Potential of Integrated Energy Systems with Varying Levels of Nationwide Deployment

    SciTech Connect

    Jalalzadeh-Azar, A.

    2002-11-01

    This study presents a parametric assessment of the energy-saving potential resulting from a nationwide deployment of DER/IES technologies for building applications. Three hypothetical IES scenarios are evaluated to demonstrate the sensitivity of the national energy consumption to the IES system configuration with respect to the buildings' electrical and thermal equipment compositions. A variable for implementation level of DER is incorporated to examine the impact of incremental transformation of the existing centralized energy resources to a fully decentralized model on the national primary energy consumption. To accommodate the continuing advancement of prime movers, a wide range of fuel-to-electricity conversion efficiency is considered for both centralized and decentralized power generation systems. The fact that the demands for electricity and thermal energy in buildings are not always congruent, and implementation of thermal energy storage technology is uncertain is acknowledged by incorporating a variable waste heat utilization index.

  9. 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

  10. Statistical analyses in Swedish randomised trials on mammography screening and in other randomised trials on cancer screening: a systematic review

    PubMed Central

    Boniol, Mathieu; Smans, Michel; Sullivan, Richard; Boyle, Peter

    2015-01-01

    Objectives We compared calculations of relative risks of cancer death in Swedish mammography trials and in other cancer screening trials. Participants Men and women from 30 to 74 years of age. Setting Randomised trials on cancer screening. Design For each trial, we identified the intervention period, when screening was offered to screening groups and not to control groups, and the post-intervention period, when screening (or absence of screening) was the same in screening and control groups. We then examined which cancer deaths had been used for the computation of relative risk of cancer death. Main outcome measures Relative risk of cancer death. Results In 17 non-breast screening trials, deaths due to cancers diagnosed during the intervention and post-intervention periods were used for relative risk calculations. In the five Swedish trials, relative risk calculations used deaths due to breast cancers found during intervention periods, but deaths due to breast cancer found at first screening of control groups were added to these groups. After reallocation of the added breast cancer deaths to post-intervention periods of control groups, relative risks of 0.86 (0.76; 0.97) were obtained for cancers found during intervention periods and 0.83 (0.71; 0.97) for cancers found during post-intervention periods, indicating constant reduction in the risk of breast cancer death during follow-up, irrespective of screening. Conclusions The use of unconventional statistical methods in Swedish trials has led to overestimation of risk reduction in breast cancer death attributable to mammography screening. The constant risk reduction observed in screening groups was probably due to the trial design that optimised awareness and medical management of women allocated to screening groups. PMID:26152677

  11. 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. PMID:24150816

  12. 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

  13. [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. PMID:23275961

  14. Design and implementation of the first nationwide, web-based Chinese Renal Data System (CNRDS)

    PubMed Central

    2012-01-01

    Background In April 2010, with an endorsement from the Ministry of Health of the People's Republic of China, the Chinese Society of Nephrology launched the first nationwide, web-based prospective renal data registration platform, the Chinese Renal Data System (CNRDS), to collect structured demographic, clinical, and laboratory data for dialysis cases, as well as to establish a kidney disease database for researchers and policy makers. Methods The CNRDS program uses information technology to facilitate healthcare professionals to create a blood purification registry and to deliver an evidence-based care and education protocol tailored to chronic kidney disease, as well as online forum for communication between nephrologists. The online portal https://www.cnrds.net is implemented as a Java web application using an Apache Tomcat web server and a MySQL database. All data are stored in a central databank to establish a Chinese renal database for research and publication purposes. Results Currently, over 270,000 clinical cases, including general patient information, diagnostics, therapies, medications, and laboratory tests, have been registered in CNRDS by 3,669 healthcare institutions qualified for hemodialysis therapy. At the 2011 annual blood purification forum of the Chinese Society of Nephrology, the CNRDS 2010 annual report was reviewed and accepted by the society members and government representatives. Conclusions CNRDS is the first national, web-based application for collecting and managing electronic medical records of patients with dialysis in China. It provides both an easily accessible platform for nephrologists to store and organize their patient data and acts as a communication platform among participating doctors. Moreover, it is the largest database for treatment and patient care of end-stage renal disease (ESRD) patients in China, which will be beneficial for scientific research and epidemiological investigations aimed at improving the quality of life of

  15. 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.

  16. [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.

  17. Clostridium difficile Infection in Hospitalized Liver Transplant Patients: A Nationwide Analysis

    PubMed Central

    Ali, Muhammad; Ananthakrishnan, Ashwin N.; Ahmad, Shahryar; Kumar, Nilay; Kumar, Gagan; Saeian, Kia

    2012-01-01

    Introduction Incidence of Clostridium difficile infection (CDI) is increasing among hospitalized patients. Liver transplant patients are at higher risk for acquiring CDI. Small, single-center studies, but no nation-wide analyses, have assessed this association. Methods We used the Healthcare Cost and Utilization Project- Nationwide Inpatient Sample (HCUP-NIS) from years 2004–2008 for this retrospective cross sectional study. Patients with any discharge diagnosis of liver transplant comprised the study population and were identified using ICD-9-CM codes. Those with a discharge diagnosis of CDI were considered cases. Our primary outcomes were prevalence of CDI and effect of CDI on inpatient mortality. Our secondary outcomes included length of stay and hospitalization charges. Regression analysis was used to derive odds ratios adjusted for potential confounders. Results There were 193,714 discharges with a diagnosis of liver transplant from 2004–2008. Prevalence of CDI was 2.7% in liver transplant population compared to 0.9% in non liver transplant population (p <0.001). Most of the liver transplant patients were in the 50–64 age group. Liver transplant patients were at higher odds of developing CDI (OR 2.88, 95% CI 2.68–3.10). Increasing age, increasing comorbidity, IBD and NG tube placement were also independent risk factors for CDI. CDI in liver transplant was associated with a higher mortality, 5.5% as compared to 2.3% in liver transplant only population (adjusted OR 1.7, 95% CI 1.3–2.2). Conclusions Liver transplant patients have a higher prevalence of CDI as compared to non liver transplant patients (2.7% vs. 0.9%).CDI was an independent risk factor for mortality in liver transplant population. PMID:22505356

  18. 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

  19. Trends of Incidence, Mortality, and Future Projection of Spinal Fractures in Korea Using Nationwide Claims Data

    PubMed Central

    2016-01-01

    Spinal fractures have been recognized as a major health concern. Our purposes were to evaluate the trends in the incidence and mortality of spinal fractures between 2008 and 2012 and predict the number of spinal fractures that will occur in Korea up to 2025, using nationwide data from the National Health Insurance Service (NHIS). A nationwide data set was evaluated to identify all new visits to medical institutes for spinal fractures in men and women aged 50 years or older between 2008 and 2012. The incidence, mortality rates and estimates of the number of spinal fractures were calculated using Poisson regression. The number of spinal fractures increased over the time span studied. Men and women experienced 14,808 and 55,164 vertebral fractures in 2008 and 22,739 and 79,903 in 2012, respectively. This reflects an increase in the incidence of spinal fractures for both genders (men, 245.3/100,000 in 2008 and 312.5/100,000 in 2012; women, 780.6/100,000 in 2008 and 953.4/100,000 in 2012). The cumulative mortality rate in the first year after spinal fractures decreased from 8.51% (5,955/69,972) in 2008 to 7.0% (7,187/102,642) in 2012. The overall standardized mortality ratio (SMR) of spinal fractures at 1 year post-fracture was higher in men (7.76, 95% CI: 7.63-7.89) than in women (4.70, 95% CI: 4.63-4.76). The total number of spinal fractures is expected to reach 157,706 in 2025. The incidence of spinal fractures increased in Korea in the last 5 years, and the socioeconomic burden of spinal fractures will continue to increase in the near future. PMID:27134505

  20. Methadone and Buprenorphine Prescribing and Referral Practices in US Prison Systems: Results from a Nationwide Survey

    PubMed Central

    Nunn, Amy; Zaller, Nickolas; Dickman, Samuel; Trimbur, Catherine; Nijhawan, Ank; Rich, Josiah D.

    2009-01-01

    Background More than 50% of incarcerated individuals have a history of substance use, and over 200,000 individuals with heroin addiction pass through American correctional facilities annually. Opiate replacement therapy (ORT) with methadone or buprenorphine is an effective treatment for opiate dependence and can reduce drug-related disease and recidivism for inmates. Provision of ORT is nevertheless a frequently neglected intervention in the correctional setting. Objective and Methods We surveyed the 50 state; Washington, District of Columbia (DC); and Federal Department of Corrections' medical directors or their equivalents about their facilities' ORT prescribing policies and referral programs for inmates leaving prison. Results We received responses from 51 of 52 prison systems nationwide. Twenty-eight prison systems (55%) offer methadone to inmates in some situations. Methadone use varies widely across states: over 50% of correctional facilities that offer methadone do so exclusively for pregnant women or for chronic pain management. Seven states' prison systems (14%) offer buprenorphine to some inmates. The most common reason cited for not offering ORT was that facilities “prefer drug-free detoxification over providing methadone or buprenorphine.” Twenty-three states' prison systems (45%) provide referrals for some inmates to methadone maintenance programs after release, which increased from 8% in 2003; 15 states' prison systems (29%) provide some referrals to community buprenorphine providers. Conclusion Despite demonstrated social, medical, and economic benefits of providing ORT to inmates during incarceration and linkage to ORT upon release, many prison systems nationwide still do not offer pharmacological treatment for opiate addiction or referrals for ORT upon release. PMID:19625142

  1. 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

  2. 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.

  3. 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. PMID:26849332

  4. 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.

  5. Areca Nut Chewing and Risk of Atrial Fibrillation in Taiwanese Men: A Nationwide Ecological Study

    PubMed Central

    Tsai, Wei-Chung; Chen, Chung-Yu; Kuo, Hsuan-Fu; Wu, Ming-Tsang; Tang, Wei-Hua; Chu, Chih-Sheng; Lin, Tsung-Hsien; Su, Ho-Ming; Hsu, Po-Chao; Jhuo, Shih-Jie; Lin, Ming-Yen; Lee, Kun-Tai; Sheu, Sheng-Hsiung; Lai, Wen-Ter

    2013-01-01

    Background: Areca nut chewing is associated with the risk of obesity, metabolic syndrome, hypertension, and cardiovascular mortality. Although a few case reports or case series have suggested the link between areca nut chewing and cardiac arrhythmias, information about the relationship between areca nut chewing and atrial fibrillation (AF) is lacking. Thus, a nationwide ecological study was conducted to investigate this. Methods: Two national datasets, the nationwide population-based 2005 Taiwan National Health Insurance Research dataset (NHIRD) and the 2005 National Health Interview Survey (NHIS), were used for analyses. The clinical characteristics, inhabited area and medical histories for 375,360 eligible males were retrieved from the 2005 NHIRD. Health related behaviors including areca nut chewing, cigarette smoking, infrequent vegetable eating, and exercise habit were collected from the 2005 NHIS. The prevalence of AF and the areca nut chewing rate were evaluated by multivariate analysis. Results: Of the 375,360 males (mean age, 44 years old), 1,326 (0.35%) were diagnosed with AF. The higher areca nut chewing rate, the higher prevalence rate of AF in Taiwan (Spearman correlation coefficient r = 0.558, p = 0.007). After adjusting for other covariates, the current areca nut chewing rate was found to be independently associated with the prevalence of AF. The adjusted odd ratio for areca nut chewing was 1.02 (95% CI = 1.00-1.04) in risk of AF prevalence. Conclusions: Areca nut chewing is independently associated with the prevalence of AF in Taiwanese men. However, further exploration of the underlying mechanisms is necessary. PMID:23794944

  6. 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. PMID:27437401

  7. 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

  8. Design of the Nationwide Nursery School Survey on Child Health Throughout the Great East Japan Earthquake

    PubMed Central

    Matsubara, Hiroko; Ishikuro, Mami; Kikuya, Masahiro; Chida, Shoichi; Hosoya, Mitsuaki; Ono, Atsushi; Kato, Noriko; Yokoya, Susumu; Tanaka, Toshiaki; Isojima, Tsuyoshi; Yamagata, Zentaro; Tanaka, Soichiro; Kuriyama, Shinichi; Kure, Shigeo

    2016-01-01

    Background The Great East Japan Earthquake inflicted severe damage on the Pacific coastal areas of northeast Japan. Although possible health impacts on aged or handicapped populations have been highlighted, little is known about how the serious disaster affected preschool children’s health. We conducted a nationwide nursery school survey to investigate preschool children’s physical development and health status throughout the disaster. Methods The survey was conducted from September to December 2012. We mailed three kinds of questionnaires to nursery schools in all 47 prefectures in Japan. Questionnaire “A” addressed nursery school information, and questionnaires “B1” and “B2” addressed individuals’ data. Our targets were children who were born from April 2, 2004, to April 1, 2005 (those who did not experience the disaster during their preschool days) and children who were born from April 2, 2006, to April 1, 2007 (those who experienced the disaster during their preschool days). The questionnaire inquired about disaster experiences, anthropometric measurements, and presence of diseases. Results In total, 3624 nursery schools from all 47 prefectures participated in the survey. We established two nationwide retrospective cohorts of preschool children; 53 747 children who were born from April 2, 2004, to April 1, 2005, and 69 004 children who were born from April 2, 2006, to April 1, 2007. Among the latter cohort, 1003 were reported to have specific personal experiences with the disaster. Conclusions With the large dataset, we expect to yield comprehensive study results about preschool children’s physical development and health status throughout the disaster. PMID:26460382

  9. Nationwide trends in glucose-lowering drug use, Denmark, 1999–2014

    PubMed Central

    Christensen, Diana Hedevang; Rungby, Jørgen; Thomsen, Reimar Wernich

    2016-01-01

    Purpose The objective of this study was to examine nationwide population-based time trends in the utilization of all glucose-lowering drugs in Denmark from 1999 to 2014. Methods Based on nationwide data from the Register of Medicinal Products Statistics, we retrieved sales statistics on glucose-lowering drugs and reported the total number of users and the prevalence of users per 1,000 inhabitants in 1-year intervals for all glucose-lowering drug classes. Results The annual prevalence of glucose-lowering drug users increased more than twofold from 19 per 1,000 inhabitants in 1999 (n=98,362) to 41 per 1,000 in 2014 (n=233,230). Metformin use increased more than sevenfold during the period and was used by 30 of 1,000 inhabitants in 2014, while the prevalence of insulin use increased 1.8-fold to 13 per 1,000 in 2014. After peaking in 2007, use of sulfonylurea halved to 6 per 1,000 in 2014. Newer drug classes including the glucagon-like peptide 1 receptor agonists, the dipeptidylpeptidase-4 inhibitors, and the sodium–glucose cotransporter 2 inhibitors had reached a considerable position by 2014, with 4 per 1,000, 6 per 1,000, and 0.8 per 1,000 inhabitants, respectively; however, the use of glucagon-like peptide 1 receptor agonists and sodium–glucose cotransporter 2 inhibitors in elderly people remained low. Thiazolidinediones decreased to virtually no use (0.03 per 1,000) in 2014. Conclusion The use of glucose-lowering drugs has doubled during 1999–2014. The pattern of glucose-lowering drug use has changed substantially reflecting the recommendations of metformin as first-line treatment. The newer glucose-lowering drug classes have been well received. PMID:27789974

  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. 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

  12. 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. PMID:27472677

  13. 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.

  14. Animals inside. Anatomy, interiority and virtue in the early modern Dutch Republic.

    PubMed

    Knoeff, Rina

    2008-01-01

    People in the early modern period frequently gave accounts of little animals (such as worms, flies, slugs and even dogs) living and breeding inside their bodies. This article investigates descriptions of "animals inside" in the works of Dutch anatomist Frederik Ruysch. It links the occurrence of such animals to the fear of pile worms endangering Dutch dikes and houses, and thereby the safety of society. The animals embodied pain and discomfort and were often associated with immorality and sexuality. As powerful symbols of interior corruption, they served as tangible reminders of the corruption of individuals as well as of the nation.

  15. Ideology, politics, and personality: shaping forces in Dutch psychology of religion, 1907-1957.

    PubMed

    Belzen, Jacob A

    2009-08-01

    Although the academic establishment of the psychology of religion in the Netherlands has been stronger than in any other Western country, the start of these developments has been remarkably late (in 1957), especially when taking into account that Dutch academic life: (1) before World War II modeled itself after Germany (where psychology of religion flourished); and (2) was to a considerable extent included in the system of pillarization, which characterized Dutch society at large. The general factors that can be distinguished as having played an important role in the shaping of the situation for psychology of religion in the Netherlands had different impacts in the several universities under consideration.

  16. 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.

  17. 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.

  18. HLM in Cluster-Randomised Trials--Measuring Efficacy across Diverse Populations of Learners

    ERIC Educational Resources Information Center

    Hegedus, Stephen; Tapper, John; Dalton, Sara; Sloane, Finbarr

    2013-01-01

    We describe the application of Hierarchical Linear Modelling (HLM) in a cluster-randomised study to examine learning algebraic concepts and procedures in an innovative, technology-rich environment in the US. HLM is applied to measure the impact of such treatment on learning and on contextual variables. We provide a detailed description of such…

  19. Randomised Items in Computer-Based Tests: Russian Roulette in Assessment?

    ERIC Educational Resources Information Center

    Marks, Anthony M.; Cronje, Johannes C.

    2008-01-01

    Computer-based assessments are becoming more commonplace, perhaps as a necessity for faculty to cope with large class sizes. These tests often occur in large computer testing venues in which test security may be compromised. In an attempt to limit the likelihood of cheating in such venues, randomised presentation of items is automatically…

  20. Skills Training to Avoid Inadvertent Plagiarism: Results from a Randomised Control Study

    ERIC Educational Resources Information Center

    Newton, Fiona J.; Wright, Jill D.; Newton, Joshua D.

    2014-01-01

    Plagiarism continues to be a concern within academic institutions. The current study utilised a randomised control trial of 137 new entry tertiary students to assess the efficacy of a scalable short training session on paraphrasing, patch writing and plagiarism. The results indicate that the training significantly enhanced students' overall…