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This qualitative study was designed to identify a framework for the quality of OBL in adult education (AE), which are of interest to the needs of students. Following a review of the literature, we opted for the theoretical framework as proposed by Ossiannilsson and Landgren (2012). This framework suggests success factors for OBL that are of interest to the needs of students. Qualitative data was collected through group interviews (n=12 groups) with stakeholders involved in AE. Professionals from five institutions, at the policy level (n=17) or programme level (n=20) were interviewed. Findings were discussed and agreed upon by the researchers to validate a quality framework for OBL in AE. At the level of the success factors, it is useful to underpin the adoption of OBL, to formulate a mission statement. The indicators can help set goals, identify resources and strategies and measure whether the provision aligns with adult students' needs. All success factors and indicators are linked to quality areas and dimensions most existing quality frames are built on. At this level the framework is useful to mainstream the quality of OBL into traditional frameworks.

Quality models for online and blended learning (OBL) have mainly been developed in higher education. The literature indicates that these models are often conceptualised from the providers' perspective. What is important for the quality of OBL from the students' perspective has recently received increased attention in the literature. Consensus among stakeholders about students' quality needs is useful to support dialogue between professionals to strategically adopt OBL and to ensure that the needs of students are met. This study aims to validate a quality instrument for OBL, taking a set of 74 quality indicators and analysing them in terms of seven success factors (credibility, accessibility, transparency, flexibility, interactivity, personalisation, productivity). The Delphi method was selected as most suited. Participants from adult education were asked to indicate on a 7-point Likert scale to what extent the indicators add to OBL quality to meet students' needs. After four Delphi rounds, the participants agreed on definitions of success factors and 30 indicators. The results are useful for institutions, ministries of education and external quality assessment agencies to assess the quality of OBL and can support institutions to implement improvement actions to ensure that the needs of students are met.

Purpose: Chronic idiopathic diarrhea is the passage of loose stools >3 times daily, or a stool weight >200 g/d, persisting for >4 weeks without clear clinical cause. Patients refractory to standard anti-diarrhetics have limited treatment options. Somatostatin analogues have the ability to reduce gastrointestinal secretions and motility. This study evaluated the efficacy and safety of lanreotide Autogel(*) 120 mg in chronic idiopathic diarrhea., Methods: Other anti-diarrhetics were not allowed during the study and were stopped at screening. Patients received lanreotide Autogel 120 mg at baseline and day 28. Stool frequency and consistency (Bristol Stool Scale) were recorded; quality of life (QoL) was assessed using the 36-item Short Form Health Survey and irritable bowel syndrome QoL questionnaires; adverse events were monitored. The primary outcome was the proportion of patients with a reduction of ≥50% or normalization to a mean of ≤3 stools/d at day 28., Findings: Thirty-three patients with >3 stools/d at baseline were included; mean (SD) age was 55.2 (16.4) years. Fourteen patients (42.4%) had a response to lanreotide Autogel at day 28 and 17 (51.5%) at day 56. Mean (SD) number of stools decreased significantly from 5.7 (2.2) at baseline to 3.7 (2.2) at day 56 overall (n = 32; P < 0.001). Significant and clinically meaningful improvements in disease-specific QoL were found in the overall populations. No new safety signals emerged., Implications: Lanreotide Autogel 120 mg decreased symptoms in these patients with chronic idiopathic refractory diarrhea, and meaningfully improved QoL. These finding have to be confirmed in further clinical trials. ClinicalTrials.gov, Identification: NCT00891371; Eudract CT 2009-009356-20., (Copyright © 2016 Elsevier HS Journals, Inc. All rights reserved.)

We report the case of a 26-year-old man with a chronic Budd-Chiari syndrome with ascites, caused by a hereditary Protein S deficiency, in a Turkish family with consanguinity. In this family, the father, the two sisters and the young brother suffered from severe venous thrombosis of the limbs, with pulmonary embolism in two of them. Those thrombotic events are caused by a hitherto not reported mutation in the PROS 1 gene on chromosome 3, resulting in a severe familial Protein S deficiency. No other thrombophilic defect was detected in the family, despite extensive investigation. Furthermore, we observe hereditary twenty-nail dystrophy in this family, the two genes probably segregating independently. Prophylaxis is discussed.