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This paper presents a statistical method for estimating probabilities of soiling and withdrawal of bank notes. The method is applied to seven circulation trials of Dutch bank notes of different denominations. The best fitting distribution for the soiling process is selected for each trial and its parameters are estimated. Then the average soiling time and the average life of the notes are calculated. A notable aspect of our analysis is that large differences with respect to the soiling process were found among notes of one and the same denomination in different circulation trials. [ABSTRACT FROM AUTHOR]

Background: Achieving people-centred health care systems requires new and innovative strategies to capture information about whether, and to what degree, health care is successful in improving health from the perspective of the patient. Patient-reported outcome measures (PROMs) and Patient-reported experience measures (PREMs) can bring some of these new insights, and are increasingly used in research, clinical care, and policymaking.Methods: This paper reflects the ongoing discussions and findings of the OECD PaRIS Working Group on Patient-reported Indicators for Mental Health Care.Results: The OECD has been measuring quality of care for mental health conditions over the last 14 years through the Health Care Quality and Outcomes (HCQO) program; nonetheless, information on how persons with mental health problems value the services they receive, and impact of the services, remains limited. As of 2018, a survey from the OECD showed that only five of the twelve countries surveyed (Australia, Israel, Netherlands, Sweden, United Kingdom) reported PROMs and PREMs collection on a regular basis in mental health settings. The paper details some of the challenges specific to the collection and use of PROMs and PREMs in mental health care, and examples from countries which have implemented comprehensive programmes to gather information about PROMs and PREMs for individuals receiving mental health services.Conclusions: Given the health and economic impact of mental ill-health across all OECD countries, there is significant value to being able to assess the quality and outcomes of care in this area using internationally-comparable measures. Continued international harmonisation of PROMs and PREMs for mental health through international coordination is a key way to facilitate the sharing of national experiences, promote the use of PROMs and PREMs, and create meaningful indicators for national and international benchmarking. [ABSTRACT FROM AUTHOR]

Objective To investigate medication prescription patterns among children with JIA, including duration, sequence and reasons for medication discontinuation. Methods This study is a single-centre, retrospective analysis of prospective data from the electronic medical records of JIA patients receiving systemic therapy aged 0–18 years between 1 April 2011 and 31 March 2019. Patient characteristics (age, gender, JIA subtype) and medication prescriptions were extracted and analysed using descriptive statistics, Sankey diagrams and Kaplan–Meier survival methods. Results Over a median of 4.2 years follow-up, the 20 different medicines analysed were prescribed as monotherapy (n  = 15) or combination therapy (n  = 48 unique combinations) among 236 patients. In non-systemic JIA, synthetic DMARDs were prescribed to almost all patients (99.5%), and always included MTX. In contrast, 43.9% of non-systemic JIA patients received a biologic DMARD (mostly adalimumab or etanercept), ranging from 30.9% for oligoarticular persistent ANA-positive JIA, to 90.9% for polyarticular RF-positive JIA. Among systemic JIA, 91.7% received a biologic DMARD (always including anakinra). When analysing medication prescriptions according to their class, 32.6% involved combination therapy. In 56.8% of patients, subsequent treatment lines were initiated after unsuccessful first-line treatment, resulting in 68 unique sequences. Remission was the most common reason for DMARD discontinuation (44.7%), followed by adverse events (28.9%) and ineffectiveness (22.1%). Conclusion This paper reveals the complexity of pharmacological treatment in JIA, as indicated by: the variety of mono- and combination therapies prescribed, substantial variation in medication prescriptions between subtypes, most patients receiving two or more treatment lines, and the large number of unique treatment sequences. [ABSTRACT FROM AUTHOR]

Objectives In the Netherlands, a case of euthanasia of an incompetent patient with dementia and an advance euthanasia directive (AED) caused great societal unrest and led to a petition signed by more than 450 physicians. In this paper, we investigate these physicians' reasons and underlying motives for supporting the 'no sneaky euthanasia' petition, with the aim of gaining insight into the dilemmas experienced and to map out topics in need of further guidance. Methods Twelve in-depth interviews were conducted with physicians recruited via the webpage 'no sneaky euthanasia'. General topics discussed were: reasons for signing the petition, the possibilities of euthanasia in incompetent patients and views on good end-of-life care. Data were interpreted using thematic content analysis and the framework method. Results Reasons for supporting the petition are dilemmas concerning 'sneaky euthanasia', the over-simplified societal debate, physicians' personal moral boundaries and the growing pressure on physicians. Analysis revealed three underlying motives: aspects of handling a euthanasia request based on an AED, good end-of-life care and the doctor as a human being. Conclusions Although one of the main reasons for participants to support the petition was the opposition to 'sneaky euthanasia', our results show a broader scope of reasons. This includes their experience of growing pressure to comply with AEDs, forcing them to cross personal boundaries. The underlying motives are related to moral dilemmas around patient autonomy emerging in cases of decision-making disabilities in advanced dementia. To avoid uncertainty regarding patients' wishes, physicians express their need for reciprocal communication. [ABSTRACT FROM AUTHOR]

Background: Achieving people-centred health care systems requires new and innovative strategies to capture information about whether, and to what degree, health care is successful in improving health from the perspective of the patient. Patient-reported outcome measures (PROMs) and Patient-reported experience measures (PREMs) can bring some of these new insights, and are increasingly used in research, clinical care, and policymaking.Methods: This paper reflects the ongoing discussions and findings of the OECD PaRIS Working Group on Patient-reported Indicators for Mental Health Care.Results: The OECD has been measuring quality of care for mental health conditions over the last 14 years through the Health Care Quality and Outcomes (HCQO) program; nonetheless, information on how persons with mental health problems value the services they receive, and impact of the services, remains limited. As of 2018, a survey from the OECD showed that only five of the twelve countries surveyed (Australia, Israel, Netherlands, Sweden, United Kingdom) reported PROMs and PREMs collection on a regular basis in mental health settings. The paper details some of the challenges specific to the collection and use of PROMs and PREMs in mental health care, and examples from countries which have implemented comprehensive programmes to gather information about PROMs and PREMs for individuals receiving mental health services.Conclusions: Given the health and economic impact of mental ill-health across all OECD countries, there is significant value to being able to assess the quality and outcomes of care in this area using internationally-comparable measures. Continued international harmonisation of PROMs and PREMs for mental health through international coordination is a key way to facilitate the sharing of national experiences, promote the use of PROMs and PREMs, and create meaningful indicators for national and international benchmarking. [ABSTRACT FROM AUTHOR]

Background The use of foresight studies is common in some policy fields, but not in public health. Interest in such studies is growing. This paper gives a general overview of the Dutch Public Health Foresight Study (PHFS) 2018, providing insight into what performing a broad scenario exercise in the field of public health entails and its societal impacts. Methods The aim of the PHFS-2018 was: (a) to show how public health and healthcare in the Netherlands will develop over the next 25 years if we pursue our current course and detect 'new' developments; (b) to give options for dealing with the major future societal challenges. Part a was addressed by means of a quantitative business-as-usual scenario exercise complemented with qualitative thematic studies, and part b by elaborating courses of action for three key challenges, based on stakeholder consultation. Typical aspects of the PHFS methods are a multidisciplinary, participatory and conceptual approach and using a broad definition of health. Results The PHFS-2018 is the basis for the upcoming National Health Policy Memorandum and the Trend Scenario is the baseline for the National Prevention Agreement. Unexpectedly, the findings about increasing mental pressure in young people received most attention. There still is room for expanding use of the study to its full potential. Conclusions Long-term thinking could be stimulated by using back casting techniques and stronger involvement of policy-makers in the elaboration of options for action. Lessons learned from developing intersectoral policy at the local level could be applied at the national level. [ABSTRACT FROM AUTHOR]

Our paper investigates the emergence and development of quality assurance (QA) for teaching in the Netherlands since the mid-1980s. We conceptualise our paper on the background of the multi-level study of New Public Management (NPM) as a narrative of political change, as a choice of certain policy instruments and distinct organisational forms, and as a set of practical control technologies. We show how the specific policy regime of corporatist negotiations and Rechtsstaat instruments deflected QA as a 'hard' NPM-policy. QA has nevertheless been instrumental within a wider NPM-inspired policy mix for achieving new ways of governmental control of universities and managerialist control within universities. We conclude by arguing that an important function of QA has been to provide 'legitimacy through procedures'. [ABSTRACT FROM AUTHOR]

This paper focuses on the lessons drawn by the Dutch railways in their contacts with the Japanese railway sector over the last two decades. The transfers described in this paper do not result from a thorough problem analysis by policy-makers followed by a conscious policy transfer. Rather they result from largely uncoordinated actions that led to a growing consciousness within the Dutch railway sector of the existence of a useful benchmark located in the Japanese railway practices. The paper attempts to provide an answer to a number of questions: how have these contacts appeared, which factors contributed to or impeded their appearance, which lessons were learned, how are these lessons perceived by the railway sector, how much has been implemented, and is there more to come? To do this, the paper starts by providing an overview of the Dutch railway context, highlighting a few elements that were conducive to more openness for new solutions and presenting the main differences between the Dutch and Japanese institutional contexts, before presenting the contacts that took place, some resulting publications and their main findings. Using an explorative survey method, the paper then presents the perceptions of top and senior representatives of the Dutch railway sector who visited Japan, shedding more light on the perception that the sector currently has of the nature of the Japanese lessons and on the extent to which these are likely to be implemented. The paper then draws some general conclusions about this learning process, the change in stance that took place during the last two decades and on the remaining challenges for further learning. [ABSTRACT FROM AUTHOR]

We provide new evidence on the level and probability distribution of consumers' long-term expectations of inflation in the euro area and the Netherlands, using a new monthly representative Dutch survey before and during the COVID-19 pandemic. We find that consumers' expectations of euro area and Dutch inflation 10 years ahead have not been well anchored at the ECB's inflation aim of below, but close to 2%. Median expectations have remained elevated above the European Central Bank's (ECB) inflation aim throughout the pandemic. Moreover, individual probability distributions show that expected probabilities of higher inflation (4% or higher) have continuously been larger than those of lower inflation (0% or lower). While policymakers are currently concerned about a possible de-anchoring of inflation expectations on the downside, our results suggest that from a consumer's point of view de-anchoring of long-term inflation expectations is mainly due to expected high inflation rather than low inflation. [ABSTRACT FROM AUTHOR]

Objective. To describe work status and factors associated with work disability (WD) in patients with SSc.Methods. A systematic search strategy in various electronic databases from 1990 to 2011 was performed. All clinical studies concerning SSc patients containing quantitative information on work status and/or factors associated with WD were selected. Extracted were study characteristics, data on work status and/or factors associated with WD. The methodological quality was evaluated in three quality aspects (selection bias, information bias and statistical analysis bias). A best evidence synthesis was employed to analyse the association between potential determinants and WD.Results. Twelve studies, described in 13 papers, including 2758 SSc patients were selected. The methodological quality of one study was high. Employment rates varied between 11 and 82% after an average disease duration ranging from 2.5 to 14 years. There was moderate evidence for an association between more functional disability, more disease-specific symptoms and poorer quality of life on one side and presence of WD on the other. There was moderate evidence for the absence of an association between WD and age, sex and disease subset. Inconsistent evidence was seen for an association between WD and education and disease duration.Conclusion. WD is a major consequence of the disease in patients with SSc and is associated with more functional disability, more disease-specific symptoms and poorer quality of life. This emphasizes the need for research into interventions to prevent or reduce WD in patients with SSc, especially in those with a poorer health status. [ABSTRACT FROM PUBLISHER]

Microvascular dysfunction (MVD) is a common pathophysiological change that occurs in various diseases, such as type 2 diabetes mellitus (T2DM), heart failure, dementia, and depression. Recent technical advances have enabled noninvasive measurement and quantification of microvascular changes in humans. In this paper, we describe the protocols of the microvascular measurements applied in the Maastricht Study, an ongoing prospective, population-based cohort study of persons aged 40–75 years being carried out in the southern part of the Netherlands (baseline data assessment, November 2010–January 2020). The study includes a variety of noninvasive measurements in skin, retina, brain, and sublingual tissue, as well as plasma and urine biomarker assessments. Following this, we summarize our main findings involving these microvascular measurements through the end of 2018. Finally, we provide a brief perspective on future microvascular investigations within the framework of the Maastricht Study. [ABSTRACT FROM AUTHOR]

Study Question: Can we develop a web-based sex education programme (programme running in a web browser) that addresses the needs of subfertile couples who are advised expectant management for at least 6 months?Summary Answer: The 'Pleasure & Pregnancy' programme addresses couples' needs, is likely to improve couples' sexual functioning, and is subsequently hypothesised to improve the chance of natural pregnancy.What Is Known Already: According to professional guidelines (e.g. the Netherlands and UK) couples with unexplained subfertility and a good chance of natural pregnancy, should be advised at least 6 months of expectant management. Adherence to expectant management is challenging as couples and gynaecologist prefer a more active approach. Targeting sexuality may be useful as subfertility is a risk factor for decreased sexual functioning.Study Design, Size, Duration: A novel programme was developed according to the three steps of the Medical Research Councils' (MRC) framework. First, relevant literature was explored. Second, an interdisciplinary expert panel developed a theory (based on a systematic literature review and patient interviews) on how the chance of natural conception can be improved. Third, the expected process and outcomes were modelled.Participants/materials, Setting, Methods: Two licenced clinical sexologists, two gynaecologists, a clinical embryologist and two midwife-researchers, all from Belgium and the Netherlands, proposed components for the sex education programme. PubMed was searched systematically for randomised controlled trials (RCTs) evaluating the proposed components in different patient populations. The needs of 12 heterosexual Dutch or Belgian couples who were advised expectant management were explored with in-depth interviews. The content and delivery characteristics of the novel programme were described in detail with the aid of 'Intervention Taxonomy'. To model the outcomes, a protocol for an RCT was designed, registered and submitted for publication.Main Results and the Role Of Chance: To help maintain or improve sexual functioning, mainly pleasure, and hence increase pregnancy rates, the web-based Pleasure & Pregnancy programme contains a combination of psychosexual education and couple communication, mindfulness and sensate focus exercises. Information on the biology of conception and interaction with fertility clinic staff and peers were added based on couples' needs to increase potential acceptability.Limitations and Reason For Caution: This paper outlines the development phase of a sex education programme according to the MRC-framework. Whether the Pleasure & Pregnancy programme actually is acceptable, improves sexual functioning, increases pregnancy rates and is cost-effective remains to be determined.Wider Implications Of the Findings: No previous interactive web-based sex education programme has aimed to increase the natural pregnancy rate of subfertile couples by targeting their sexual pleasure. The Pleasure & Pregnancy programme addresses couples' needs and its effect on sexual functioning and pregnancy rate is plausible but remains to be demonstrated by an RCT which is currently ongoing.Study Funding/competing Interest(s): Funding was provided by The Netherlands Organisation for Health Research and Development (ZonMw), Flanders Research Foundation and the University of Amsterdam. C.B.L. is editor-in-chief of Human Reproductionbut was blinded to all parts of the peer review process. The remaining authors have no conflict of interest to report.Trial Registration Number: Not applicable. [ABSTRACT FROM AUTHOR]

Study Question: Is there an association between maternal occupational exposure to solvents, pesticides and metals as assessed by expert-based assessment and congenital anomalies in the offspring?Summary Answer: There is an association between maternal occupational exposure to solvents and congenital anomalies in the offspring, including neural tube defects, congenital heart defects and orofacial clefts.What Is Known Already: One important environmental risk factor for development of congenital anomalies is maternal occupational exposure to chemicals in the workplace prior to and during pregnancy. A number of studies have assessed the association with often conflicting results, possibly due to different occupational exposure assessing methods.Study Design, Size, Duration: For this systematic review with meta-analysis, the search terms included maternal occupation, exposure, congenital anomalies and offspring. Electronic databases MEDLINE and EMBASE were searched for English studies up to October 2017.Participants/materials, Setting, Methods: Two reviewers independently screened all citations identified by the search. Case-control studies and cohort studies were included if (I) they reported on the association between maternal occupational exposure to solvents, pesticides or metals and congenital anomalies, and (II) assessment of occupational exposure was performed by experts. Data on study characteristics, confounders and odds ratios (ORs) were extracted from the included studies for four subgroups of congenital anomalies. Methodological quality was assessed using the Newcastle-Ottawa Scale. In the meta-analysis, random effects models were used to pool estimates.Main Results and the Role Of Chance: In total, 2806 titles and abstracts and 176 full text papers were screened. Finally, 28 studies met the selection criteria, and 27 studies could be included in the meta-analysis. Our meta-analysis showed that maternal occupational exposure to solvents was associated with neural tube defects (OR: 1.51, 95%CI: 1.09-2.09) and congenital heart defects (OR: 1.31, 95%CI:1.06-1.63) in the offspring. Also maternal occupational exposure to glycol ethers, a subgroup of solvents, was associated with neural tube defects (OR: 1.93, 95%CI: 1.17-3.18) and orofacial clefts (OR: 1.95, 95%CI: 1.38-2.75) in the offspring. Only one study investigated the association between maternal occupational exposure to solvents and hypospadias and found an association (OR: 3.63, 95%CI: 1.94-7.17). Results of the included studies were consistent. In our meta-analysis, we found no associations between occupational exposure to pesticides or metals and congenital anomalies in the offspring.Limitations, Reasons For Caution: A limited number of studies was included, which made it impossible to calculate pooled estimates for all congenital anomalies, analyse individual chemicals or calculate exposure-response relations. Bias could have been introduced because not all included studies corrected for potentially confounding factors.Wider Implications Of the Findings: Employers and female employees should be aware of the possible teratogenic effects of solvent exposure at the workplace. Therefore, is it important that clinicians and occupational health specialist provide women with preconception advice on occupational solvent exposure, to reduce the congenital anomaly risk.Study Funding/competing Interest(s): NSp was paid by the Graduate School of Medical Sciences (MD/PhD program), UMCG, Groningen, the Netherlands. EUROCAT Northern Netherlands is funded by the Dutch Ministry of Health, Welfare and Sports. There are no competing interests.Registration Number: CRD42017053943. [ABSTRACT FROM AUTHOR]

Background Healthcare requires patient feedback to improve outcomes and experience. This study undertook a systematic review of the depth, variability, and digital suitability of current patient-reported outcome measures (PROMs) in patients undergoing laparoscopic cholecystectomy. Methods A PROSPERO-registered (registration number CRD42021261707) systematic review was undertaken for all relevant English language articles using PubMed version of MEDLINE, Scopus, and Web of Science electronic databases in June 2021. The search used Boolean operators and wildcards and included the keywords: laparoscopic cholecystectomy AND patient outcome OR patient-reported outcome OR patient-reported outcome measure OR PRO OR PROM. Medical Subjects Heading terms were used to search PubMed and Scopus. Articles published from 1 January 2011 to 2 June 2021 were included. Results A total of 4960 individual articles were reviewed in this study, of which 44 were found to evaluate PROMs in patients undergoing laparoscopic cholecystectomy and underwent methodological index for non-randomized studies (MINORS) grading. Twenty-one articles spanning 19 countries and four continents met all inclusion criteria and were included in the qualitative data synthesis. There was significant heterogeneity in PROMs identified with eight different comprehensive PROM tools used in the 21 studies. There was wide variation in the time points at which PROMs were recorded. Fourteen of 21 studies recorded PROMs before and after surgery, and 7 of 21 recorded PROMs only after surgery. Follow-up intervals ranged from 3 days to 2 years after surgery. Conclusions This study identified that while post-laparoscopic cholecystectomy PROMs are infrequently measured currently, tools are widely available to achieve this in clinical practice. PROMs may not capture all the outcomes but should be incorporated into future cholecystectomy outcome research. The EQ-5D™ (EuroQoL Group, Rotterdam, the Netherlands) provides a simple platform for the modern digital era. [ABSTRACT FROM AUTHOR]

Background Young adults in Neither in Employment, Education nor Training (NEET) are at risk of adverse labour market outcomes. Earlier studies often measured NEET status at one time point or compared persistent NEETs with non-NEETs, neglecting other patterns of NEET status. Evidence on early life factors associated with NEET patterns is lacking. This study aims to (i) identify patterns of NEET status over time and (ii) examine whether factors in childhood and adolescence are associated with these patterns. Methods Data were used from 1499 participants of the TRacking Adolescents' Individual Lives Survey (TRAILS), a Dutch prospective cohort study with 15-year follow-up. NEET status was assessed at ages 19, 22 and 26. Socioeconomic status of parents (SES), intelligence and negative life events were measured at age 11, educational attainment at age 26 and mental health problems at ages 11, 13.5 and 16. Data were analyzed using multinomial logistic regression analysis. Results Four NEET patterns were identified: (i) non-NEETs (85.2%), (ii) early NEETs (4.5%), (iii) late NEETs (5.7%) and (iv) persistent NEETs (4.5%). Reporting internalizing problems at age 11 was a risk factor for early and late NEETs [odds ratio (OR) 2.77, 95% confidence interval (CI) 1.16–6.62; OR 5.00, 95% CI 2.22–11.3, respectively]. Low parental SES, lower intelligence scores and negative life events (≥3) were risk factors for persistent NEETs (OR 4.45, 95% CI 2.00–9.91; OR 0.96, 95% CI 0.94–0.98; OR 4.42, 95% CI 1.62–12.08, respectively). Conclusions The results highlight the importance of timing and duration of NEET status and emphasize the need for tailored interventions to prevent specific NEET patterns. [ABSTRACT FROM AUTHOR]

In some Western societies, inquiries into fatal abuse of children known to agencies are nowadays a common phenomenon. They have been carried out in the UK for many years, but have recently also emerged in the Netherlands. The main aim of these inquiries is to improve child welfare and protection practice in order to reduce the chance of further child deaths. However, there is reason to critically consider the feasibility of this aim, as British research into child death investigations suggests that they have hardly worked and even may have had counter productive consequences. This paper examines for the first time all Dutch public inquiry reports into child abuse fatalities. It is shown that the problems highlighted in the reports are highly similar to those recurring in their British counterparts. Furthermore, there are considerable similarities between Dutch and British investigations regarding the solutions they propose. Like British inquiries and reviews, Dutch inquiries largely focus on changing procedures, introducing decision-making instruments and increasing monitoring. This one-sided emphasis on bureaucratic measures, the paper argues, does not rate the human side of child protection work at its true value, and makes it questionable whether the inquiries will contribute to improving practice. [ABSTRACT FROM PUBLISHER]

This paper examines the power of discourse in experiments with deliberative governance. It argues that discursive power enters deliberations regardless of the procedural attempts to ensure an optimal deliberative setting. This papers focuses on the experiences of a Community of Practice (COP) that was created to redevelop old industrial sites for the creative economy in the Netherlands. To account for discursive power in these deliberations, it draws on the conceptual framework of "boundary work". Boundary work involves drawing boundaries around discourse to gain credibility for an argument in a deliberation. This reinforces a discourse and reproduces its power. The empirical study demonstrates how actors relapsed into a dominant 'entrepreneurship' discourse but also disrupted it through an exploration of an alternative discourse called 'cultural entrepreneurship'. This exploration was facilitated by deliberative procedures in combination with the content of boundary-transcending concepts. [ABSTRACT FROM AUTHOR]

Background: Incidents and quality problems are a prime cause why health care leaders are calling to redesign health care delivery. One of the concepts used is lean thinking. Yet, lean often leads to resistance. Also, there is a lack of high quality evidence supporting lean premises. In this paper, we present an overview of lean thinking and its application to health care. [ABSTRACT FROM PUBLISHER]

The article discusses the Provincial Council of Utrecht in the Netherlands during the Enlightenment. This paper focuses on the marginal groups of Catholics stranded in Protestant republic and their dilemma of being cut off by the papacy. This gave a picture of afflicted member in the early church where sympathetic churchmen in Catholic Europe came to their aid in the role of epistolary communicants. Civic humanism is the central theme in this paper where the characteristics of apostolic church is given full account.

Independence and maintaining social contact are important factors of elderly persons' quality of life. An electric scooter may support people with mobility problems to achieve these goals. In the Netherlands, needs assessors have been appointed to evaluate clients' eligibility for electric scooters. They have to cope with a twofold job assignment: allocating services to only those clients who are eligible according to pre- determined criteria, but also acting in their client's best interest, for the system of needs assessment should be client oriented. This paper examines how needs assessors apply eligibility criteria and act in the client's interest at the same time. A qualitative study was performed, observing twelve house calls of clients requesting an electric scooter. Interviews were held with needs assessors and a document analysis was made. We found that needs assessors used their discretionary room to create their own policy regarding who deserves an electric scooter and who does not. They did this by concealing or emphasizing certain information. Especially when needs assessors sympathized with their clients, they did their best to sustain the case. The paper concludes with the suggestion that needs assessors would benefit from discussing their personal values, not only to agree on their norms as a professional group but also to avoid illegitimate arguments influence the decision. Furthermore, needs assessor should try to influence local social policy, gearing it towards the needs of the local community. [ABSTRACT FROM AUTHOR]

European migration and border control has occupied a prominent spot on the European political agenda. The news media present the topic in a polarized fashion and reports conflicting viewpoints on how the European Union (EU) and national governments should address the issue. We argue that this conflict in news messages can have a polarizing effect on public perceptions regarding the EU's performance on this topic, and that this effect can be moderated by the valence of news messages. A two-wave online panel survey experiment was conducted on a representative sample of the Dutch population (n = 376). The results indicate that conflict reinforces and thus polarizes policy attitudes, whereas a message's valence can change people's attitudes, which reduces the attitudinal gap. The implications of these findings concerning European border control and migration are discussed in the final section of this paper. [ABSTRACT FROM AUTHOR]

This paper reports the effects of inter-generational transmission of resources and of the pooling of resources within families on the transition into first-time home-ownership of couples, using detailed life-course data from the 1992/3 Netherlands Family Survey. Strong relationships are found between the socioeconomic characteristics and wealth - particularly self-employment and home-ownership - of the parents of both members of the couple and home-ownership of the couple. Parents who are self-employed or own a home have more opportunities than parents who rent their home to help their children financially and they do, in fact, provide help substantially more often. Socialization towards home-ownership arguably also plays a role. The results further show that the cumulation of home-ownership within families is increased by assortative mating. If the parents of one of the members of the couple own a house, or offer help, the probability that the other partner's parents also own a house or offer help increases. With regard to the partners' own characteristics, the current work status, self-employment, and education of the man are more important than those of the woman, but the socioeconomic status of the woman is found to be almost as important as that of the man. [ABSTRACT FROM AUTHOR]

Background Understanding if and how pain influences activities of daily living (ADL) in dementia is essential to improving pain management and ADL functioning. This study examined the relationship between the course of pain and change in ADL functioning, both generally and regarding specific ADL functions. Methods Participants were Dutch nursing home residents (n  = 229) with advanced dementia. ADL functioning was assessed with the Katz ADL scale, and pain with the Dutch version of the Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC-D). Changes of PACSLAC-D and Katz ADL scores were computed based on the difference in scores between baseline, 3-month and 6-month follow-up. Multivariate linear regression models were used to assess the relationships between change in pain score, change in total ADL score and specific ADL item scores during follow-up. Results At baseline, residents had a median ADL score of 18 (interquartile range 13–22, range 6–24) and 48% of the residents were in pain (PACSLAC-D ≥ 4). Residents with pain were more ADL dependent than residents without pain. A change in pain score within the first 3 months was a significant predictor for a decline in ADL functioning over the 6-month follow-up (B = 0.10, SE = 0.05, P  = 0.045), and specifically, a decline on the items 'transferring' over the 6-month follow-up and 'feeding' during the first 3 months of follow-up. Conclusions Pain is associated with ADL functioning cross-sectionally, and a change in pain score predicts a decline in ADL functioning, independent of dementia severity. Awareness of (changes in) ADL activities is clearly important and might result in both improved recognition of pain and improved pain management. [ABSTRACT FROM AUTHOR]

Reports on the 1993 Holland Early Music Festival held at Utrecht on August 27 to September 5, 1993. Concerts given; Works of Monteverdi performed; Papers read and discussed.

In this paper we first raise the factual question of whether wives of unemployed husbands have a higher chance of unemployment than wives of employed husbands. Data for Australia, Canada, the Netherlands and the USA in the first half of the 1980s indicate that this indeed is the case. We then seek to explain this finding. According to one explanation, (un)employment homogamy is a by-product of educational homogamy combined with a relation at the individual level between education and unemployment. Although the existence of educational homogamy in Canada, the Netherlands and the USA could be ascertained, and although in these countries unemployment is higher when education is lower, these findings could not fully explain the observed extent of (un)employment homogamy in these countries. According to a more complex explanation, the phenomenon of (un)employment homogamy will disappear when we allow, after these effects of education, for similar effects of age and region. This explanation was tested for the USA, and did not explain the observed extent of (un)employment homogamy in this country either. These findings show that labour market inequalities (unemployed persons have less education, are very young or very old, live in certain places) are aggravated by marriage market outcomes (educational and age homogamy). But, in addition, the finding of persistent couple effects suggests that, apart from labour market and marriage market effects, other processes taking place after marriage make for (un)employment homogamy. [ABSTRACT FROM AUTHOR]

Clinical and research staff who work around magnetic resonance imaging (MRI) scanners are exposed to the static magnetic stray fields of these scanners. Although the past decade has seen strong developments in the assessment of occupational exposure to electromagnetic fields from MRI scanners, there is insufficient insight into the exposure variability that characterizes routine MRI work practice. However, this is an essential component of risk assessment and epidemiological studies. This paper describes the results of a measurement survey of shift-based personal exposure to static magnetic fields (SMF) (B) and motion-induced time-varying magnetic fields (dB/dt) among workers at 15 MRI facilities in the Netherlands. With the use of portable magnetic field dosimeters, >400 full-shift and partial shift exposure measurements were collected among various jobs involved in clinical and research MRI. Various full-shift exposure metrics for B and motion-induced dB/dt exposure were calculated from the measurements, including instantaneous peak exposure and time-weighted average (TWA) exposures. We found strong correlations between levels of static (B) and time-varying (dB/dt) exposure (r = 0.88–0.92) and between different metrics (i.e. peak exposure, TWA exposure) to express full-shift exposure (r = 0.69–0.78). On average, participants were exposed to MRI-related SMFs during only 3.7% of their work shift. Average and peak B and dB/dt exposure levels during the work inside the MRI scanner room were highest among technical staff, research staff, and radiographers. Average and peak B exposure levels were lowest among cleaners, while dB/dt levels were lowest among anaesthesiology staff. Although modest exposure variability between workplaces and occupations was observed, variation between individuals of the same occupation was substantial, especially among research staff. This relatively large variability between workers with the same job suggests that exposure classification based solely on job title may not be an optimal grouping strategy for epidemiological purposes. [ABSTRACT FROM AUTHOR]

Information about several papers discussed at the festival "Siglos de Oro" regarding Spanish Renaissance music in Utrecht is presented. Topics include transmission and circulation of music in Spain, ceremonial and urban music-making, and Renaissance music. It also features several speakers including Cristina Diego Pacheco, Juan Carlos Asensio, and Bruno Turner.

Background The European Union has used Healthy Life Years (HLY) as an indicator to monitor the health of its aging populations. Scholarly and popular interest in HLY across countries has grown, particularly regarding the ranking of countries. It is important to note that HLY is based on self-assessments of activity limitations, raising the possibility that it might be influenced by differences in health reporting behaviours between populations, a phenomenon known as differential item functioning (DIF). Methods We estimated DIF-adjusted HLY at age 50 for Belgium, France, Germany, Greece, Italy, the Netherlands, Spain, and Sweden to determine the extent to which differences in HLY might be influenced by reporting heterogeneity across countries. We used anchoring vignettes, taken from the 2004 Survey of Health, Ageing and Retirement in Europe, to estimate DIF-adjusted prevalence rates of activity limitations measured by the Global Activity Limitations Indicator (GALI). The Sullivan method was used to calculate DIF-adjusted HLY. Results Changes in HLY before and after adjustment ranged from a 1.20-year decrease for men in Italy to a 1.61-year increase for women in Spain. Adjustment for DIF produced changes in the rankings of the countries by HLY, with upward and downward movements of up to three positions. Conclusion Our results show that DIF is likely to affect HLY estimates, thereby posing a challenge to the validity of comparisons of HLY across European countries. The findings suggest that HLY should be used to monitor population health status within a country, rather than to make comparisons across countries. [ABSTRACT FROM AUTHOR]

Background Experiencing financial scarcity taxes cognitive bandwidth. This leaves less capacity to withhold temptations and makes relying on easiest default options more likely. Whether this default option is (un)healthy may depend on the amount of cultural capital acquired during life course. This study examined whether the association between financial scarcity and health behaviours is moderated by cultural capital. Methods Self-reported data were used from Dutch adults of the 2014-survey of the GLOBE study (N  = 2466). Using linear regression analysis, financial strain (no, some, great) and cultural capital (institutionalized, objectivized, incorporated) were related to body mass index (BMI), alcohol intake, sports participation, cycling and walking, fruit intake and vegetable consumption. The interaction between financial strain and cultural capital was used to assess moderation. Results Experiencing some financial strain was associated with a higher BMI (0.7 kg/m2) and less sport participation (−31.8 min/week). Great financial strain was associated with less sport participation (−41.4 min/week). Being in the lowest tertile of cultural capital was associated with a higher BMI (1.3 kg/m2), drinking less alcohol (−10.0 units/week), less sport participation (−31.5 min/week) and consuming less fruit (−2.9 pieces/week). Cultural capital had no significant moderating effect on the relationship between financial strain and these health behaviours. Conclusion Financial strain and cultural capital seem associated with different health behaviours. Cultural capital had no moderating effect on the relationship between financial strain and different health behaviours. While financial strain and cultural capital could both be entry points for interventions to improve health behaviour, underlying mechanisms require further attention. [ABSTRACT FROM AUTHOR]

Issue Research has often stressed the significance of reducing door movement during surgery for preventing surgical site infections. This study investigated the possible effect of a lean A3 intervention on the reduction of door movement during surgery in a university medical center in the Netherlands. Initial assessment A digital counter recorded door movement during 8009 surgical procedures during 8 months. The number of door movements per surgical procedure ranged from 0 to 555, with a mean of 24 door movements per hour across 26 specialisms. Choice of solution We aimed to reduce door movement in one operating room for orthopedic surgery by a lean A3 intervention. This intervention was executed by means of an A3 report that promotes structured problem solving based on a Plan-Do-Check-Act cycle. Implementation The steps of the A3 report was followed and completed one-by-one by a multidisciplinary team. The effect of the changes was monitored over the course of 12 months. Evaluation The use of a lean A3 intervention resulted in a sustainable decrease of door movements by 78%, from a mean of 24 to a mean of 4 door movements per hour during orthopedic surgery at one OR. Lessons learned This paper shows the relevance of and the possibility for a reduction of door movement during surgery by lean management methods in general and an A3 intervention in particular. This intervention stimulated dialogue and encouraged knowledge-sharing and collaboration between specialized healthcare professionals and this resulted in a thorough root-cause analysis that provided synergy in the countermeasures—with, according to respondents, a sustainable result. [ABSTRACT FROM AUTHOR]

STUDY QUESTION Are there differences between clinics in the chances of natural conception of couples? SUMMARY ANSWER We found significant differences between clinics in the couples' natural conception chances, which could not be explained by differences in characteristics of the patients or the clinics. WHAT IS KNOWN ALREADY In pooled data from multiple centers the synthesis prediction model for natural conception was found to be valid, yet the outcome of interest (i.e. natural conception) might differ between centers. Possible differences between clinics in natural conception rates, as well as the validity of the prediction model in each individual clinic are addressed in this paper. STUDY DESIGN, SIZE AND DURATION A secondary data-analysis of a prospective cohort study among 3020 subfertile couples recruited in 38 clinics in the Netherlands between January 2002 and December 2004. Clinics with less than 20 couples were excluded from the analyses, resulting in 21 clinics with 2916 couples. PARTICIPANTS/MATERIALS, SETTING, METHODS Inclusion of 2916 subfertile couples who underwent a basic fertility work-up. Couples were excluded who had a fertility disorder (one or two-sided tubal pathology, ovulation disorder, total motile sperm count <3 × 106). Included couples were counseled for expectant management for at least six months or followed until the first day of treatment. Follow-up began at the completion of the fertility work-up. Couples lost to follow-up were censored at the last day of contact. Kaplan–Meier survival curves and a log-rank statistic were estimated. Crude and adjusted hazard ratios were determined, adjusted for patient characteristics and the type of clinic (university hospitals with an assisted conception unit (ACU), non-university hospitals with an ACU and non-university hospitals without an ACU). Hazard ratios were also ascertained with empirical Bayes (EB) estimates. Validation of the prediction model per clinic was performed through calibration. MAIN RESULTS AND THE ROLE OF CHANCE We found significant differences between clinics in the chance of ongoing pregnancy (P < 0.001); even after adjustment for female age, duration of subfertility, percentage of progressive motile sperm, primary/secondary subfertility and post-coital test (P < 0.001). Adjusted hazard ratios and EB estimates ranged from 0.50 to 2.21 and 0.58 to 1.53, respectively. Among the 21 clinics, there were 4 university hospitals, 10 non-university hospitals with an ACU and 7 non-university hospitals without an ACU. In the multivariable analysis, the type of clinic was not significant (P = 0.11). Calibration gave an average intercept of −0.25 (95% range: −1.04–0.53) and average slope of 0.81 (95% range: 0.03–1.60). Six clinics had a negative intercept that differed significantly from zero and three clinics had a negative or positive slope that differed significantly from one. LIMITATIONS, REASONS FOR CAUTION A more extensive model including more predictors could give less variation in the differences between the clinics. Variation in work-up protocol between clinics could also have played a role. In fertility prediction research the Cox proportional hazards regression is the most widely used statistical model, but as the underlying assumptions have rarely been evaluated, this model could lead to biased outcomes. WIDER IMPLICATIONS OF THE FINDINGS Our findings suggest that the synthesis model to predict natural conception is useful overall in clinical practice but in a minority of clinics the model is not well calibrated. Updating the synthesis model to include a center-specific baseline chance might improve the synthesis model for certain clinics. STUDY FUNDING/COMPETING INTEREST(S) The study (on which this secondary data-analysis was based) was ... [ABSTRACT FROM PUBLISHER]

In 2007 The Netherlands Association for Cardio-Thoracic Surgery (Nederlandse Vereniging voor Thoraxchirurgie, NVT) instituted the Adult Cardiac Surgery Database. The dataset comprises demographic factors, type of intervention, in-hospital mortality and 18 risk factors for mortality after cardiac surgery, according to the European System for Cardiac Operative Risk Evaluation definitions. Currently, this procedural database contains over 60 000 interventions. Completeness of data is excellent and national coverage of all 16 Dutch cardio-thoracic surgery centres has been achieved since the start. The primary goal of the database is to control and maintain the quality of care by evaluation of outcomes. This is accomplished by regular feedback and comparison of outcomes. For a subset of the database (procedures from 10 out of 16 centres) longer-term follow-up has been established by means of data linkage to two national registries. This provides information on survival status, causes of death and readmissions. The database has recently been used for research, resulting in methodological papers aimed at optimizing comparison of outcomes. In future, clinical issues will also be addressed, for example survival after coronary artery bypass grafting and valve surgery. [ABSTRACT FROM PUBLISHER]

Background: Tobacco companies consistently work to prevent and undermine smoke-free laws. The tobacco industry and its allies have funded hospitality associations and other third parties to oppose smoke-free laws, argue that smoke-free laws will economically damage hospitality venues, promote ventilation and voluntary smoker ‘accommodation’ as an alternative to smoke-free laws, and to challenge smoke-free laws in court. In 2008, the Netherlands extended its smoke-free law to hospitality venues. Methods: We triangulated news articles, government documents, scientific papers, statistical reports and interviews to construct this case study. Results: Despite widespread public support for smoke-free hospitality venues, opponents successfully represented these laws as unpopular and damaging to small bars. These challenges and related smokers’ rights activities resulted in non-compliance among all bars and reinstating an exemption for small, owner-run venues. This policy reversal was the result of a weak implementing media campaign (which failed to present the law as protecting nonsmokers), smoking room exemptions and reactive (vs. proactive) measures by the Ministry of Health and civil society. Conclusion: The policy failure in the Netherlands is the result of poor implementation efforts and the failure to anticipate and deal with opposition to the law. When implementing smoke-free laws it is important to anticipate opposition, used the media to target non-smokers to reinforce public support, and actively enforce the law. [ABSTRACT FROM PUBLISHER]

. The aim of the paper is to investigate the effect of measurement error on low pay transition probabilities. Our approach combines the virtues of panel regression and latent class models, though it does not require the use of validation or reinterview data. Using British, German and Dutch panel data, we show that the true estimated low pay transition probability is much lower that what previous research has found. This implies that almost half of the observed transitions can be attributed to measurement error. The highest low pay transition probabilities are found in Germany and the lowest in the Netherlands. When applying this correction for measurement error in a multivariate model of low pay transitions, the results indicate that measurement error attenuates considerably the effects of the main covariates, such as training, job change, change in the type of employment contract and shift from part-time to full-time employment. [ABSTRACT FROM AUTHOR]

Introduction. This is an international study of the epidemiology of family medicine (FM) in three practice populations from the Netherlands, Malta and Serbia. Diagnostic associations between common reasons for encounter (RfEs) and episodes titles are compared and similarities and differences are described and analysed. Methodology. Participating family doctors (FDs) recorded details of all their patient contacts in an ‘episode of care (EoC)’ structure using the International Classification of Primary Care (ICPC). RfEs presented by the patient and episode titles (diagnostic labels of EoCs) were classified with ICPC. The relationships between RfEs and episode titles were studied with Bayesian methods. Results. Distributions of diagnostic odds ratios (ORs) from the three population databases are presented and compared. Conclusions. ICPC, the RfE and the EoC data model are appropriate tools to study the process of diagnosis in FM. Distributions of diagnostic associations between RfEs and episode titles in the Transition Project international populations show remarkable similarities and congruencies in the process of diagnosis from both the RfE and the episode title perspectives. The congruence of diagnostic associations between populations supports the use of such data from one population to inform diagnostic decisions in another. Differences in the magnitude of such diagnostic associations are significant, and population-specific data are therefore desirable. We propose that both an international (common) and a local (health care system specific) content of FM exist and that the empirical distributions of diagnostic associations presented in this paper are a reflection of both these effects. We also observed that the frequency of exposure to such diagnostic challenges had a strong effect on the confidence intervals of diagnostic ORs reflecting these diagnostic associations. We propose that this constitutes evidence that expertise in FM is associated with frequency of exposure to diagnostic challenges. [ABSTRACT FROM PUBLISHER]

Background. To date, there has been no attempt to describe or compare physical therapy as practiced globally, nor any evidence that an international data set exists to support this effort. It is known that research evidence can be used in strategic and tactical ways, especially within the highly politicized context of the policy arena. The International Private Practitioners Association recognized the potential value a global evidence base could have in influencing policy and supporting professional development in a number of countries, yet it lacked a mechanism to achieve these aims. Objectives. The purposes of this study were: (1) to identify and test an international data set, definitions, and means of data collection and (2) to establish views in relation to the value of international collaborations. Design. A mixed, prospective design was used in the study. Method. Phase 1 (2006-2007) involved the development of a data set, definitions, and Web-based and paper-based data collection options involving 98 physical therapists from 68 physical therapy practices in 7 countries. Phase 2 (2008-2009) involved testing of the data set in 34 practices involving 3,195 patient episodes and included physical therapist feedback of experience, local relevance of the data set, and value of international collaborations. Results. Testing confirmed the relevance and reliability of the data set and definitions and a preference for Web-based data collection (74.0%). Physical therapist feedback supported these findings. Most respondents (60.0%-100.0%) reported the value of further international collaborations for their profession nationally or internationally. Limitations. Although a true international collaboration, the limited sample size should be recognized. Conclusions. It is possible to develop an agreed-upon international data set and means of data collection. Testing appears to support its acceptability and relevance for use in practice. Participants highly valued the opportunity to undertake international collaborations that may benefit their profession nationally and internationally. Further testing and use of the data set are advocated before final validation is sought. [ABSTRACT FROM AUTHOR]

This paper investigates the intersection of two types of reproduction over generations: the transmission of offending and of occupational status. According to Farrington's (2002) risk factor mechanism, the effect of parental offending on offspring offending should decrease when the intergenerational transmission of occupational status is taken into account. To test this mechanism, we use a longitudinal prospective multi-generation research design, containing data from the Netherlands on offending and occupational status during the twentieth century. Results show that a substantial part of the intergenerational association in offending is indeed mediated by risk factors such as low occupational status and, especially, low educational attainment. [ABSTRACT FROM PUBLISHER]

In this paper, the authors compare subgroup analyses as outlined in grant applications and their related publications. Grants awarded by the Netherlands Organization for Health Research and Development (ZonMw) from 2001 onward that were finalized before March 1, 2010, were studied. Of the 79 grant proposals, 50 (63%) were intervention studies, 18 (23%) were diagnostic studies, and 6 (8%) were prognostic studies. Subgroups were mentioned in 49 (62%) grant applications and in 53 (67%) publications. In 20 of the 79 projects (25%), the publications were completely in agreement with the grant proposal; that is, subgroups that were prespecified in the grant proposal were reported and no new subgroup analyses were introduced in the publications. Of the 149 prespecified subgroups, 46 (31%) were reported in the final report or scientific publications, and 143 of the 189 (76%) reported subgroups were based on post-hoc findings. For 77% of the subgroup analyses in the publications, there was no mention of whether these were prespecified or post hoc. Justification for subgroup analysis and methods to study subgroups were rarely reported. The authors conclude that there is a large discrepancy between grant applications and final publications regarding subgroup analyses. Both nonreporting prespecified subgroup analyses and reporting post-hoc subgroup analyses are common. More guidance is clearly needed. [ABSTRACT FROM PUBLISHER]

In most EU countries and the United States, immigration detention is defined as an administrative, non-punitive measure to facilitate expulsion. This paper argues that immigration detention in the Netherlands serves three informal functions in addition to its formal function as an instrument of expulsion: (1) deterring illegal residence, (2) controlling pauperism and (3) managing popular anxiety by symbolically asserting state control. These informal functions indicate that society has not found a definitive solution for the presence of migrants who are not admitted but are also difficult to expel. The analysis, which is placed against the background of the functions of penal detention, is based on policy documents, survey data, administrative data and fieldwork in a Dutch immigration detention centre. [ABSTRACT FROM AUTHOR]

Background: Surrogacy was prohibited in the Netherlands until 1994, at which time the Dutch law was changed from the general prohibition of surrogacy to the prohibition of commercial surrogacy. This paper describes the results from the first and only Dutch Centre for Non-commercial IVF Surrogacy between 1997 and 2004.Methods: A prospective study was conducted of all intended parents, and surrogate mothers and their partners (if present), in which medical, psychological and legal aspects of patient selection were assessed by questionnaires and interviews developed for this study.Results: More than 500 couples enquired about surrogacy by telephone or e-mail. More than 200 couples applied for surrogacy in the Centre, of which, after extensive screening, 35 couples actually entered the IVF programme and 24 completed the treatment, resulting in 16 children being born to 13 women. Recommendations for non-commercial surrogacy are given, including abandoning the 1-year waiting period before adoption, currently dictated by law, avoiding a period of unnecessary psychological distress.Conclusions: Our study has shown that non-commercial IVF surrogacy is feasible, with good results in terms of pregnancy outcome and psychological outcome for all parents, and with no legal problems relating to the adoption procedures arising. The extensive screening of medical, psychological and legal aspects was a key element in helping to ensure the safety and success of the procedure. [ABSTRACT FROM AUTHOR]

Background. GPs with a special interest and with specific training in palliative medicine (GP advisors) supported professional carers (mostly GPs) through a telephone advisory service. Each telephone call was formally documented on paper and subsequently evaluated. [ABSTRACT FROM PUBLISHER]

Social network sites (SNS) have become very popular, especially among adolescents and young adults. Consequently, politicians started to use them for their campaigns. This paper examines how this personalized soft campaigning strategy worked in the 2006 Dutch elections and how interaction with potential voters can influence the evaluation of the candidates. The first question is answered by a web survey among active users of Hyves, the largest Dutch SNS. The second question is answered by a web experiment on a fictive candidate. The survey showed that SNS provide an opportunity to reach individuals less interested in politics. Viewing a candidate's profile further strengthened existing attitudes. However, the politicians did not fully use the interactive features of SNS during the 2006 campaign. The web experiment showed that politicians who react on the comments of users were perceived more favorable. This effect was stronger for right-wing politicians and left-wing voters. [ABSTRACT FROM AUTHOR]

To enable improvements in school health promotion, this paper examines associations between the number of health-promotion issues addressed by primary school teachers in the Netherlands and factors thought to influence this behavior. The main factors studied are context characteristics and constructs of attitude, social influence, self-efficacy (SE) and perceived barriers. A total of 180 primary school teachers teaching 9- to 12-year olds (Grades 6, 7 and 8) participated in a cross-sectional survey. The results show that it is possible to differentiate between teachers addressing three or more health issues per year versus those who address fewer based on grade level (more health issues are addressed at higher grades), perceived disadvantages, SE and staff support. The latter seems to exert the greatest influence and may be one of the most promising focus points for improvements of school health promotion in the Netherlands. [ABSTRACT FROM AUTHOR]

Background: In the Netherlands, managed competition between health plans has been introduced. For Dutch health plans this implies that they need to collect data about their own performance and that of the care providers they contract. To that end, Consumer Assessment of Health Plan Surveys (CAHPS) instruments have recently been adopted by a large Dutch health plan. Objectives: This paper presents the results of a validation study of the Dutch version of the CAHPS Adult Commercial questionnaire. The questions addressed are as follows: Can this questionnaire be adapted for use in the context of the Dutch insurance system? and Can it generate valid information about the quality of health care and the performance of Dutch health plans? Methods: The translated questionnaire has been mailed to a sample of 977 enrollees. The psychometric properties of the translated instrument have been studied, and the results have been compared with those of other Dutch and American studies. Results: The net response rate was 51% (n = 500). In general, the questionnaires were filled out completely and consistently. Principal component analyses revealed a factor that can be labelled as patient-centredness in the primary process. It contains the domains that in the CAHPS literature are described as 'courteous/helpful staff' and 'doctors communicating well'. Conclusions: The translated version of the CAHPS Adult Commercial questionnaire is a promising tool for Dutch health plans. More research is needed on the external and the content validity of these questionnaires in the Dutch context. [ABSTRACT FROM AUTHOR]

Aims: To clarify alcohol and illicit drug use within the emergency room population in three different regions in The Netherlands, focusing on whether interventions for these substances should be region specific. Methods: Alcohol and illicit drug use were assessed using a self-report questionnaire filled in by the patients, and by combining self-report with staff judgement on alcohol and illicit drug use. Results: Data on alcohol use (self-reported and staff judgement combined) resulted in prevalence rates of 4.9-18.2%. Patients positive for alcohol are more likely to be male, aged 48-58 years, more likely to be a frequent excessive drinker, and to have injuries as a result of violence. Patients positive for illicit drugs are more likely to be male, aged 28-38 years, unemployed, and frequent excessive drinkers. Among men aged 18-35 years with a Dutch cultural background, some differences emerge regarding alcohol consumption between the various hospitals, but most variation exists in the case of illicit drug use. Conclusions: This paper confirms that the emergency room seems to provide an opportunity to initiate interventions regarding alcohol use and seems to suggest that this is independent of the region concerned. However, in the case of illicit drug use interventions seem to be more region specific. [ABSTRACT FROM AUTHOR]

For over a century, scholars and practitioners have assumed rehabilitation stands as the progressive opposite of repression. Elaborating on previous warnings and anomalous findings, a representative survey of the Dutch population (N = 1,892) points out that this received view is flawed. When measured separately, no significant correlation exists between support for rehabilitation and support for repression, rehabilitation is equally popular among the constituencies of conservative and progressive political parties, and no negative relationship exists between rehabilitation and authoritarianism. Decriminalization rather than rehabilitation proves to constitute the progressive converse of repression. By way of conclusion, we discuss the remarkable persistence of the received view reassessed in this paper, even in the face of convincing earlier contradictory evidence. [ABSTRACT FROM AUTHOR]

This paper will focus on three galleries in the Netherlands that once specialized in decorative arts and crafts. The period of study is between the years 1898 and roughly 1930. In all three galleries women played an important role. The discussion includes how these galleries can be linked to the gendering of art forms, interaction between 'high' and 'low' decorative art, and the notion of cross-culturalism. The three galleries explored concentrated on different aspects of the European decorative arts' reform movement: 'high' Arts and Crafts made by trained artist-designers, non- Western crafts coming from areas in the Far East, and home-made domestic folk arts and crafts from Northern and Central Europe. In addition to considering the actual employment of women as designers and gallery managers--which in itself was an important development--the issue of gender is addressed in a broader context. The discussion extends to rationality and notions of Nature with regard to primitiveness, femininity and masculinity. I hope to show that constructions of gender ideologies can correlate with an actual historical situation. Although the galleries reflect the Dutch case at the time, they can be seen to exemplify a more general trend. [ABSTRACT FROM AUTHOR]

This paper argues that the case for real wage growth restraint, and the consequent restoration of profitability, which the mainstream consensus regards as a necessary condition for sustained output and productivity growth, is based on weak foundations, because it neglects the negative impact of wage moderation on productivity growth. Using a general Keynesian growth model, which integrates a (wage-led or profit-led) demand regime and a productivity regime (incorporating the productivity-growth enhancing effects of higher demand and higher real wages), the conditions are identified under which real wage restraint fails to raise output and productivity growth. The model is applied empirically to the Netherlands (1960-2000). [ABSTRACT FROM AUTHOR]

In the Netherlands, there is a research tradition that measures fraud against regulations by interviewing eligible individuals using a survey. In these studies the sensitive questions about fraud are posed by using a randomized response method. The paper describes the results of a Dutch study into the consequences of replacing home interviews by trained interviewers with Internet-delivered interviews in a survey on fraud in the area of disability benefits. Both surveys used computer-assisted self-interviews with randomized response questions. This study has three goals: first to present the research tradition that makes use of randomized response, second to compare the results of home interviews and the Internet survey and finally to introduce an adapted weighted logistic regression method to test the relationship between the probability of fraud and explanatory variables. The results show that there are no systematic differences between modes of interview, either for estimates of the prevalence of fraud or for the identification of associated variables. These outcomes result in the conclusion that the Internet survey is a useful and cost-effective instrument for measuring fraud in a population, and that it is unlikely that replacing home interviews with the Internet survey will result in a significant break with tradition. [ABSTRACT FROM AUTHOR]

In modern society, education has become a major element of stratification and differentiation. This paper examines how educational differences across and within family relationships affect the content of the relationship, thereby focusing on proximity and contact between parents and adult children and between siblings. Hypotheses are developed about why education should matter, using theoretical arguments about preferences and constraints. The hypotheses are tested using a large new survey on family relationships in the Netherlands, the Netherlands Kinship Panel Study. Family relationships are pooled into one dataset which is analyzed using multilevel regression. The results show sharp but nonlinear educational effects on proximity and distance, although most of the educational effect on contact is indirect, via distance. Educational differences within family relationships lead to greater distances and less contact, confirming the classic mobility thesis, but the effects are generally weak and the effects on contact are indirect. Implications of the findings for the different theoretical perspectives on family relationships are discussed. [ABSTRACT FROM AUTHOR]