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Organizations offer activities and programmes to improve their employees' health. These workplace health promotion (WHP) activities usually have an individualized and top-down focus, a low uptake among employees, and are perceived to be out of line with employees' experiences and definitions of health. This paper follows up on studies that have broadened the focus of WHP by including social relations and delves deeper into how daily practices and experiences of (un)belonging at work relate to workplace health. Based on ethnographic research in two companies in the Netherlands, this paper analyses how (un)belonging is expressed and experienced by employees. The paper shows that employees define health at work as a social practice. It also demonstrates how dynamics at work shape different dimensions of (un)belonging that, in turn, affect employees' perceived health at work. These findings indicate the importance of including (un)belonging in the workplace as an ingredient of WHP. [ABSTRACT FROM AUTHOR]

The paper addresses the problem of evaluating the Implicit McMillan degree |$\delta{m}$| of |$W^{-1}(s)$|⁠ , where |$W^{-1}(s)$| denotes the transfer function of a passive |$RLC$| electrical network.1 The Implicit McMillan degree |$\delta{m}$| specifies the minimum number of dynamic elements needed to completely characterize the passive |$RLC$| network, i.e. an electrical network that contains only passive elements (capacitors, inductors and resistors) and associates it with the rank properties of the passive element matrices. A fact that in the circuit literature is intuitively accepted but not rigorously proved is that this degree must be equal to the minimum number of independent dynamical elements in the network Livada (2017, Implicit network descriptions of RLC networks and the problem of re engineering. Ph.D. Thesis, City, University of London) and Leventides et al. (2014, McMillan degree of impedance, admittance functions of RLC networks. In 21st International Symposium on Mathematical Theory of Networks and Systems. The Netherlands: Groningen). In this paper, we investigate this finding, showing that the maximum possible Implicit McMillan degree |$\delta{m}$| of such networks is given by |$rankL+rankC$| and that this value is reached when certain necessary and sufficient conditions are satisfied. 1 [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]

Does partisan ideology influence whether Europeans are willing to use nuclear weapons, and if so, how? The US nuclear weapons stationed in Europe have been at the core of European security since the Cold War, but we have still yet to learn what would make Europeans be willing to support their use. In this paper, we present the results of a survey, in which we asked citizens in Germany and the Netherlands about their views on the use of the US nuclear weapons stationed on their territory in four distinct scenarios. Our results indicate that voters of right-wing parties are more likely to approve of the use of nuclear weapons in both countries. There are, however, important differences between the two countries in terms of the degree to which the participants oppose the use of nuclear weapons. These results have implications for NATO's nuclear deterrence posture. [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: 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]

The current COVID-19 pandemic confines people to their homes, disrupting the fragile social fabric of deprived neighbourhoods and citizen's participation options. In deprived neighbourhoods, community engagement is central in building community resilience, an important resource for health and a prerequisite for effective health promotion programmes. It provides access to vulnerable groups and helps understand experiences, assets, needs and problems of citizens. Most importantly, community activities, including social support, primary care or improving urban space, enhance health through empowerment, strengthened social networks, mutual respect and providing a sense of purpose and meaning. In the context of inequalities associated with COVID-19, these aspects are crucial for citizens of deprived neighbourhoods who often feel their needs and priorities are ignored. In this perspectives paper, illustrated by a varied overview of community actions in the UK and The Netherlands, we demonstrate how citizens, communities and organizations may build resilience and community power. Based on in-depth discussion among the authors we distilled six features of community actions: increase in mutual aid and neighbourhood ties, the central role of community-based organizations (CBOs), changing patterns of volunteering, use of digital media and health promotion opportunities. We argue that in order to enable and sustain resilient and confident, 'disaster-proof', communities, areas which merit investment include supporting active citizens, new (digital) ways of community engagement, transforming formal organizations, alignment with the (local) context and applying knowledge in the field of health promotion in new ways, focussing on learning and co-creation with citizen initiatives. [ABSTRACT FROM AUTHOR]

This paper focuses on the accuracy of COVID-19-related knowledge during the 2020 pandemic. We look at the effects of traditional vs. digital news use and distinguish between positive (number of recoveries) and negative (number of casualties) knowledge. Importantly, the moderating role of crisis context is examined when tracing media effects on knowledge. Relying on a four-wave panel survey fielded in the Netherlands, we find that people's knowledge became more accurate over the course of the crisis. News exposure did not lead to more accuracy, in fact, a negative relation was found. The impact of digital news use weakened as the crisis continued. [ABSTRACT FROM AUTHOR]

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]

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]

Aims: The European Society of Cardiology (ESC) guidelines state that heart failure nurse specialists (heart-failure nurses) with specific competences are essential for a successful heart-failure-management programme. Thus, the Heart Failure Association (HFA) of the ESC developed the heart failure nurse curriculum (HFA curriculum). Several ESC member states developed cardiovascular education programmes to enable nurses to deliver high specialist care, but little is known of whether these curricula are in line with the HFA curriculum. Therefore, this paper describes the extent to which cardiovascular education programmes in Belgium, The Netherlands and Germany correspond to the HFA curriculum. Methods and results: A case study approach was adopted to obtain an in-depth understanding of the programme contents in relation to the HFA curriculum. For this purpose, representatives of the educational programmes and/or delegates of the national cardiovascular nursing organization shared their educational curricula. All of the studied cardiovascular education programmes aim to provide heart failure and/or cardiovascular nurses with essential competences for implementation of evidence based and guideline derived care. However, every cardiovascular education programme has a different focus/area of attention. Cardiovascular education in Belgium discusses aspects of all core-learning objectives of the HFA curriculum and emphasizes mostly knowledge aspects of these. Learning objectives in cardiovascular education in The Netherlands focus on chronic diseases in general and on learning objectives concerning patient education, support in self-care and management of device and pharmacological therapy. Cardiovascular education in Germany discusses most learning objectives; however, not all learning objectives receive equal attention. Conclusions: Although local cardiovascular education programmes adopt certain aspects of the HF curriculum, the curriculum as a whole is not adopted. [ABSTRACT FROM AUTHOR]

The value of 'the arts' in community development is increasingly being recognized. This paper contributes to emerging insights on the various impacts of the arts on communities by highlighting when and how they can have binding and dividing effects on a community. We draw on a participatory research project conducted in Pingjum, a village in the Netherlands that hosts many cultural activities and in which many artists live. We discuss how the arts in Pingjum influence the community in the village. In our discussion, we pay attention to the sense of community that the arts generate, the meeting opportunities they provide and how the community is engaged by some artists. Our study shows that the influence of the arts is context-dependent, with the arts having both binding and dividing effects on the community in Pingjum. In terms of the value of the arts for community development, we emphasize three key issues: that the arts (i) do not have only advantages for a community; (ii) do not engage the entire community; and (iii) could potentially contribute to community fragmentation. Given these issues, we argue that the arts should be considered as one of several supportive means in community development processes. Ideally, they are integrated into a wider community development strategy and planning, and exist alongside other associations and activities in a community. In this way, the arts can contribute to the robustness of a community and assist it in developing the capacity and resources to flourish. [ABSTRACT FROM AUTHOR]

Introduction: The demand for alternative nicotine/tobacco products is not well established. This paper uses a behavioral economic approach to test whether smokers have differential demand for conventional factory-made, electronic, and very low nicotine content cigarettes (FMCs/ECs/VLNCs) and uses the prospective cohort design to test the predictive validity of demand indices on subsequent use of commercially available FMCs and ECs.Methods: Daily smokers (≥16 years) from the Netherlands completed an online survey in April 2014 (N = 1215). Purchase tasks were completed for FMCs, ECs, and VLNCs. Participants indicated the number of cigarettes they would consume in 24 h, across a range of prices (0-30 euro). The relationship between consumption and price was quantified into four indices of demand (intensity, Pmax, breakpoint, and essential value). A follow-up survey in July 2015 measured FMC and EC use.Results: At baseline, greater demand was observed for FMCs relative to ECs and VLNCs across all demand indices, with no difference between ECs and VLNCs. At follow-up, greater baseline FMC demand (intensity, essential value) was associated with lower quit rates and higher relapse. EC demand (Pmax, breakpoint, essential value) was positively associated with any EC use between survey waves, past 30 day EC use, and EC purchase between waves.Conclusions: Smokers valued FMCs more than ECs or VLNCs, and FMCs were less sensitive to price increases. Demand indices predicted use of commercially available products over a 15 month period. To serve as viable substitutes for FMCs, ECs and VLNCs will need to be priced lower than FMCs.Implications: Purchase tasks can be adapted for novel nicotine/tobacco products as a means to efficiently quantify demand and predict use. Among current daily smokers, the demand for ECs and VLNCs is lower than FMCs. [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]

Over the past 20 years, the care for transgender adolescents has developed throughout many countries following the 'Dutch Approach' initiated in the 90s in pioneer countries as the Netherlands, United States and Canada, with increasing numbers of children and adolescents seeking care in transgender clinics. This medical approach has considerable positive impacts on the psychological outcomes of these adolescents, and several studies have been recently published underlining the relative safety of such treatments. This paper reviews the current standards of care for transgender children and adolescents with particular emphasis on disparities among countries and short-tomedium-term outcomes. Finally, it highlights ethical considerations regarding categorization of gender dysphoria, timing of treatment initiation, infertility and how to deal with the long-term consequences. [ABSTRACT FROM AUTHOR]

Extramarital sexuality has always been regarded as a transgression of the accepted norms. The increasing criminalization of extramarital sexuality after the Reformation led to an intensification of the prosecution of illegitimacy by secular authorities. But in the pluriform early modern legal landscape, a whole range of judicial, semi-judicial and extrajudicial institutions and mechanisms existed to exercise control over deviant behavior.  This paper focuses on the institutional setting in which social control over illegitimacy was exercised in the early modern period in Holland and Germany, working with Martin Dinges' concept of the "uses of justice." Both regions experienced several waves of criminalization of sexuality during and after the Reformation, and women were disproportionately affected by this. However, research for both regions has shown that women were not only "passive victims" in this process but also shaped the institutions by actively making use of them. It has been suggested in the literature that, in the early modern period, Dutch women enjoyed a rather favorable position compared to women in neighboring countries and that they were granted considerable leeway in social and legal respects. Considering the differences in the legal system in both countries, the question arises whether there were fundamental differences in the way that social control was exercised over illegitimacy in Germany and the Netherlands and whether Dutch women were truly granted more leeway in a social and legal respect with regard to illegitimacy. [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]

School-based health-promoting interventions show promising results in improving various health outcomes of adolescents. Unfortunately, much is still unknown about the relations between health behaviors and school performances, while improving these would give schools a stronger incentive to invest in health promotion. This paper presents the associations of several health behaviors with school performances and studies the mediating effects of psychosocial problems. Health behavior and sociodemographic data were gathered from 905 Dutch high school students via an online survey, completed in-class. These data were matched with school records of the students' overall grade average (GA) on the three core subjects in Dutch high schools (Dutch, English and Math). The associations between health behaviors and school performances, and the potentially mediating effects of psychosocial problems, were studied via mixed-effects regression models. Smoking, being bullied, compulsive and excessive internet use and low physical activity were directly associated with lower school grades. Additionally, being bullied, bullying, smoking, excessive and compulsive internet use were associated with students' grades via mediation of psychosocial problems. This means that lower school grades were (also) associated with those behaviors through the effects of psychosocial problems in those students. This study showed the strong links between health behaviors and academic achievements among adolescents. Schools and health promoters should be educated more on these relations, so that they are aware of this common interest to get more support for health-promoting interventions. Additionally, the role of psychosocial problems in the relations between behaviors and school performances should be studied further in future research. [ABSTRACT FROM AUTHOR]

This paper builds on the existing triple helix literature and connects this stream of thought with the literature on complexity, networks, and partnerships. The paper then discusses the possibilities of researching triple helix organizations and the measurement problems in assessing complex organizations. A case from The Netherlands is presented to demonstrate a possible approach for researching the success of networks of triple helix organizations. This case, a triple helix organization working on innovation for sustainable mobility, is considered on the basis of the results of a survey among the project leaders and program managers of the organization. The paper concludes that creating a full triple helix encounters problems in practice. It also includes suggestions for further research on these problems. [ABSTRACT FROM AUTHOR]

This paper investigates the varying effects of a changing institutional environment on academic research practices in three fields of Dutch animal science. Our analysis shows that the shifts in funding have stimulated interactions with societal stakeholders in fields where this has helped to sustain a basic research agenda. In other fields researchers experience a tension between satisfying the needs of application-oriented funding sources and reaching high scores on evaluations dominated by bibliometric indicators. The paper concludes with the identification of three field characteristics that seem to moderate the effects of institutional changes on academic research practices. [ABSTRACT FROM AUTHOR]

This paper explores the role of research in the context of the Dutch spatial planning procedure 'Room for the River'. We start from the idea that research is strategically used to create space in negotiation processes, where stakeholders often have competing claims on natural resources. Multiple data collection techniques allow us to reconstruct and understand the critical events that led to the decision to depolder De Noordwaard. Within each critical event we describe and analyse how research and other resources were mobilized by policy-makers and other stakeholders to open up or close down negotiation space. By doing so, this paper contributes insights into the factors that influence the effective mobilization and contribution of research towards exploring sustainable solutions to complex environmental problems. [ABSTRACT FROM AUTHOR]

Over the past decade, horizon scanning has been recognised as part of forward-looking government processes in a number of industrialised countries. It helps policy-makers in addressing the diversity of future societal and environmental challenges and in addressing the potential of emerging areas of science and technology in an integrated way. This paper discusses the usefulness of horizon scanning as an additional tool for future-oriented technology analysis activities, such as technology foresight and scenario building. Analysing the national horizon scans of the UK, the Netherlands and Denmark in a joint horizon pilot project initiated under the ERA-Net ForSociety, this paper makes a series of recommendations regarding horizon scanning processes at the national level and the construction of common future-oriented policies. [ABSTRACT FROM AUTHOR]

Under certain conditions, statistical evidence is more persuasive than anecdotal evidence in supporting a claim about the probability that a certain event will occur. In three experiments, it is shown that the type of argument is an important condition in this respect. If the evidence is part of an argument by generalization, statistical evidence is more persuasive compared with anecdotal evidence (Experiments 1 and 2). In the case of argument by analogy, statistical and anecdotal evidences are equally persuasive (Experiments 2 and 3). However, if the case in the anecdotal evidence is dissimilar from the case in the claim, statistical evidence is again more persuasive (Experiment 3). The implications of these results for the concept of argument quality are discussed. Zhaiyao Author Note Dans quelles conditions les preuves statistiques sont-elles supérieures aux preuves anecdotiques en soutien á une affirmation? Le rôle du type d'argument Hans Hoeken (Ph.D., University of Tilburg, 1995) is a professor at the Department of Business Communication Studies, Centre for Language Studies, Radboud University Nijmegen, the Netherlands. His research focuses on language and persuasion. Lettica Hustinx (Ph.D., Radboud University Nijmegen, 1996) is an associate professor at the department of Dutch language and culture, Centre for Language Studies, Radboud University Nijmegen, the Netherlands. Her research interest focuses on argumentation and persuasion. This research was supported by a grant from NWO (360-80-020), the Dutch Research Foundation. We thank Hans Beentjes, Berna Hendriks, Margot van Mulken, Donna Rouner, and two anonymous reviewers for their insightful comments and advice on earlier versions of this paper. Résumé Correspondence concerning this paper should be addressed to Hans Hoeken, Department of Business Communication Studies, Radboud University Nijmegen, P.O. Box 9103, NL 6500 HD, The Netherlands. E-mail: . [ABSTRACT FROM AUTHOR]

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.

The delegation of authority in research funding to multi-actor networks that include users is seen as a way to make research more responsive to users' needs. This paper analyzes multi-actor networks for the planning and execution of agricultural research in The Netherlands. It shows that delegation of authority to networks also generates several tensions, and requires substantial role adjustments and institutional learning for the actors involved (government, researchers, intermediaries such as research councils, and user groups) in order to effectively operate in the network. The paper indicates that the principal--agent perspective often used for analyzing the science--policy relationship can be a useful tool for analyzing the multilateral relationships in networks, but needs to be complemented by theories that better capture the notion of co-production in such 'webs of cross-cutting ties'. [ABSTRACT FROM AUTHOR]

In this paper, we develop indicators for the responsiveness of the research system to the changing knowledge needs that follow from changes in social and policy priorities. In this paper we use coastal defense research as a case. Using four different approaches -- an analysis of coastal defense policy documents to identify the demand knowledge; a document analysis to identify the Netherlands' coastal research field; a bibliometric analysis; and a focus group with involved practitioners, researchers and intermediary actors -- we identified the main demand for coastal defense research, the way the research system responds to it, as well as the bottlenecks that hinder optimal responsiveness of the research system. [ABSTRACT FROM AUTHOR]

This paper explores the impact of a regulated society such as the Netherlands on the lives of refugees in general and on those of Iranian women refugees in particular. Two periods are distinguished in regard to Dutch asylum policies: the 1980s and post-1990. For the 1980s when refugee reception was less restricted, I use empirical material collected between 1995 and 2000. The women I interviewed during this period were leftist activists involved in the Iranian revolution of 1979 and had to leave Iran because of their political backgrounds. The material used for the post- 1990 or more restricted period, is mainly from secondary sources, supplemented by occasional, informal visits to asylum seeker centres. The paper argues that a strict refugee policy—especially the policy that was put in place during the 1990s—has a direct effect on the affected refugees by making them dependents of the state. These restricted policies reinforce the image of refugees as problems in society and have an effect, albeit less direct, on the lives of the refugees who arrived prior to the 1990s and who are now Dutch citizens. [ABSTRACT FROM AUTHOR]

This paper discusses some first results of a study among Dutch people who have close contact with asylum seekers and refugees due to their work as (voluntary) refugee workers or language tutors. In most cases these people are directly or indirectly associated with the Dutch Refugee Council, which has working groups throughout the Netherlands. The study is based on the assumption that integration is an interactive process of change that involves both refugees and people of the host society. This paper discusses the impact of direct contact with refugees on the specific circles of Dutch people who participated in the study. It is found that, due to this contact, participants generally gained a more differentiated insight into the reality of refugees as well as into the characteristics of their own society. However, if humanitarian commitment is not accompanied by sufficient political awareness about refugee issues and inter‐ethnic relations, direct contact can also lead to disappointment and new prejudices. [ABSTRACT FROM PUBLISHER]

Objectives: High-quality teaching performance is important to ensure patient safety and encourage residents' learning. This study aims to explore the content and phrasing of suggestions for improvement that residents provide to support excellent teaching performance of their supervisors.Methods: From February 2010 to November 2011, 577 residents were invited to evaluate 501 teachers from both surgical and medical residency training programmes from 20 hospitals. Feedback was collected through a validated formative feedback system named System for Evaluation of Teaching Qualities. Two researchers independently coded the suggestions for improvement with literature-based coding schemes on (1) content and (2) linguistic characteristics. Besides these qualitative outcomes, descriptive statistics were calculated using SPSS.Results: In total, 422 residents (73%) evaluated 488 teachers (97%), yielding 4184 evaluations. Of all teachers, 385 (79%) received suggestions for improvement focusing on teaching skills (TS), 390 (80%) on teaching attitude (TA) and 151 (31%) on personal characteristics. For 13%-47% of the suggestions for improvement, residents added (1) the location or situation where the observed TS or TA had taken place, (2) concrete examples of what teachers could do to improve or (3) (expected) effects of what the change in TS or TA would mean for residents.Conclusions: Residents provide mainly relevant suggestions for improvement that mirror important aspects of teaching performance. However, these comments often lack specific phrasing limiting their value for performance improvement. Therefore, residents are recommended to increase the specificity of the suggestions for improvement. The paper provides directions to phrase narrative feedback. [ABSTRACT FROM AUTHOR]

Linked Article: Sarkany et al. Br J Dermatol 2022; 186:713–720. Xeroderma pigmentosum (XP) is a genetic disease in which the system that repairs damage caused by ultraviolet (UV) radiation (which mainly comes from the sun) is faulty. Patients with XP develop eye and skin cancers from childhood and usually die in early adulthood. The main means of preventing the cancers and increasing lifespan is extreme protection against the UV found in daylight, particularly for the face, which is where the cancers mostly occur. Not enough is known about how well patients with XP protect against UV radiation. In this paper, with authors from the UK, the Netherlands and Denmark, a new method was used to estimate face exposure in 36 patients with XP over 3 weeks in the summer. The method combines measurements from a wrist‐worn UV detector with an 'activity diary' of what patients did to protect their face when outside. Some patients with XP protected themselves well whereas others did not. The difference between the face UV dose in the best and worst protecting patients was over 100‐fold. Those patients protecting themselves the least from UV exposure had exposure levels similar to healthy adults. Adults and children with XP had similar exposure to UV but achieved it differently. Adults protected less well when outside but went outside less whereas children went outside more but protected better. This variation in UV exposure is important. Poor protection in patients with XP is likely to cause cancers and premature death. As well as being useful in XP, this new method to estimate facial UV exposure may also be useful in other more common diseases, particularly patients at high risk of basal and squamous cell carcinomas, which are mostly caused by UV and mainly affect the face. Linked Article: Sarkany et al. Br J Dermatol 2022; 186:713–720. [ABSTRACT FROM AUTHOR]

Although the concept of a "wicked legal system" has become well-known, it is not clear how to define such a system or which actors are crucial in bringing it about. This paper discusses from a historical, international, and jurisprudential perspective the Dutch Supreme Court's 1942 Review Case, in which the Court notoriously grants measures issued by the Nazi occupier the status of Dutch legislation. Although this small tale of the relationship between law, politics, and morality is little known outside the Netherlands, it raises most relevant questions about the constitutional role of a domestic judiciary during foreign occupation and about the ethos of the judiciary beyond the mere obedience of civil servants. [ABSTRACT FROM AUTHOR]

Type 2 diabetes is highly prevalent among South Asian origin groups around the world. Not only is prevalence higher than in other ethnic groups, age at presentation is lower and these groups are more likely to experience complications. Evidence suggests that lifestyle interventions may prevent or delay the onset of diabetes. However, little is known about diabetes prevention in South Asians (SA). DH!AAN is a diabetes prevention program designed for Surinamese SA in The Netherlands. In this paper, we describe the theoretical frameworks and formative research that guided the development and cultural adaptation of DH!AAN. Cultural adaptation was based on analysis of the determinants of diet and physical activity, including socio-cultural factors, within our study population. This led to the incorporation of surface and deep structure elements in the intervention. One-to-one counseling by dieticians using motivational interviewing (MI) was the basis for the intervention. Additionally, we aimed to generate social support by including family members in parts of the intervention and group sessions to address issues relating to traditional food habits. We discuss our reflections on the development process and the choices made in developing this intervention. The results of DH!AAN will provide insight into the use of MI for this population group. Moreover, DH!AAN will provide evidence regarding the feasibility of diabetes prevention among South Asian populations. [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]

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]

To investigate the cross-national relevance of community health promotion, this paper compared community variation in alcohol use and risk and protective factors for adolescents in Australia (State of Victoria, 2009) and the Netherlands (2007/2008). Multi-level analyses examined community variation in heavy episodic (binge) alcohol use [≥5 drinks in a session ≥once in the prior fortnight (>63 ml of ethanol)] and associations with predictors. Representative community samples of adolescents (12–17 years) were recruited. The participants were 7812 students from 36 Australian communities and 15 082 adolescents from 124 Dutch communities. Predictors included adolescent reports of family, school, peer and neighbourhood environments and community predictors (rural, disadvantage). The overall prevalence of alcohol use prevalence was similar in both nations. Australia had higher use at younger ages and no difference between genders. In the Netherlands older adolescents and males used alcohol at significantly higher rates. Although individual predictors were mostly similar, binge drinking was more strongly associated with poor family management, friends' use of drugs and community disorganization in Australia. Significant community variation in adolescent heavy alcohol use was observed in both countries, but was higher in the Netherlands [inter class correlation 6.1%, (95% CI: 4.5–8.3%)] than Australia (ICC 2.4%, 1.3–4.5%). Youth from rural areas drank at a higher level, especially in the Netherlands. Targeting community level adolescent alcohol use appears feasible in both countries. Although behavioural patterns and risk and protective influences are similar in the Netherlands and Australia, important differences should be taken into account in tailoring community interventions. [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]

Marinova, Nadejda K. and Patrick James. (2012) The Tragedy of Human Trafficking: Competing Theories and European Evidence. Foreign Policy Analysis, doi: 10.1111/j.1743-8594.2011.00162.x This paper explores an issue that is both domestic and international: whether legalization of prostitution leads to an increase in human trafficking. For both theory and public policy, this is an important query to answer, with implications beyond the cases in question. The principal domains of investigation are Germany, Sweden, and the Netherlands. These states subscribe to UN, EU, Council of Europe and OSCE agreements and are located in the same geographic region, yet have adopted opposite approaches to prostitution. The Netherlands and Germany legalized prostitution in 2000 and 2002, respectively. Sweden outlawed it in 1999 and imposed criminal penalties for the purchase of illicit sex. The preceding characteristics make these states ideal for a comparative exercise in the context of competing perspectives on human trafficking and legalized prostitution. We find that legalization leads to an increase in trafficking. The dynamics of trafficking are also associated with numerous factors, among which the most critical are government efforts specifically targeting the activity in the field of law enforcement. Implications for theory and public policy are offered, along with ideas about future research. [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]

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]

This paper answers five questions about the societal impact of research. Firstly, we examine the opinions of research group leaders about the increased emphasis on societal impact, i.e. does it influence their research agenda, communication with stakeholders, and knowledge dissemination to stakeholders? Furthermore, we investigate the quality of their societal output. We also study whether the societal and scholarly productivity of academic groups are positively or negatively related. In addition, we investigate which managerial and organisational factors (e.g. experience of the principal investigator, group size and funding) influence societal output. Finally, we show for one case (virology) that societal impact is also visible through indirect links. Our study shows that research group leaders have a slightly positive attitude towards the increased emphasis on the societal impact of research. The study also indicates a wide variety of societal-oriented output. Furthermore, the societal and scientific productivity of academic groups are unrelated, suggesting that stimulating social relevance requires specific organisational and contextual interventions. [ABSTRACT FROM AUTHOR]

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]

Public health policies and services are increasingly scrutinized for their quality and accountability and 'evidence-based' ways of working are becoming more important in most public sector activities. In the Netherlands this led to the development of academic collaborative centers (ACCs) for public health: formal, long-term collaborations between municipal health services, university departments and other stakeholders. In this paper we argue that discussing issues of research uptake or research utilization in terms of 'gaps' that need to be 'bridged' is unproductive when analyzing structural collaborations or partnerships between researchers, policy-makers and practitioners. Within collaborative settings such as the ACCs, the clear distinction between what counts as 'science' and what counts as 'policy' is only one side of the story. We use the notions of 'boundary organization' and 'front stage and back stage settings' to analyze a case study of a collaborative project conducted within one of the ACCs. [ABSTRACT FROM AUTHOR]

Questions of timing, phasing and sequence have been central to recent critiques of science policy-making, which have highlighted sustained disjunctures between the relevance and importance given to different stakeholders at different moments in the policy-making process. In this paper we expand upon this recent 'upstream/downstream' literature through a case study analysis of xenotransplantation (XTP), one of the defining controversies of 1990s UK biotechnology regulation. Drawing on insights from the sociology of expectations we trace the emergence of a UK policy narrative concerning the future of XTP and explore how the policy role became narrowly defined as a process of 'reflex regulation', based upon technologically determinist assumptions and producing extremely short-term decision-making. We draw attention to the concrete costs of this delineation of the policy role and reveal that it is neither inevitable or necessary, by considering contrasts between the policy temporalities of the UK, Canada and the Netherlands. [ABSTRACT FROM AUTHOR]

Alongside the gradual increase in use of participatory technology assessment (PTA), a tool to democratize decision-making on controversial technologies, a growing body of literature on how to assess the impact of PTA has developed. A distinction can be made between two generations of impact assessment studies. The first generation includes evaluations of the effects of PTAs on the state as a bounded unit of political decision-making. The second generation of assessment studies acknowledges a wider range of loci to study impact. However, neither provides insights into how a PTA impacts the relationships between the multiple arenas of political influence and political judgment. This paper develops a framework for impact assessment from a dynamic, process-oriented perspective. It draws on the 'dynamics of contention' theory proposed by McAdam et al. in Dynamics of Contention (Cambridge University Press, 2001). The framework is applied to three cases of PTA on controversial medical technologies: xenotransplantation (in the Netherlands and Switzerland) and genetic testing (in Austria). [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]