Search

The UK has the highest rate of cannabis use among young people worldwide. Dr. Alan Leshner, Director of the National Institute of Drug Abuse reports, "Every year more than 100,000 people, most of them adolescents, seek treatment for their inability to control their marijuana use." According to the Scottish Drug Misuse Statistics in Scotland 2002, 51% of individuals under 20 years have used cannabis. Cannabis use is not limited to youth; it is also the single-most used illicit drug among adults. Because of their widespread negative impact, illicit drugs have become a focus of the agenda of the English Parliament and there is ongoing debate on how to combat this problem. As the research assistant of Michael Matheson (MSP), the author compiled this report to gather information on cannabis and to assess approaches that would form the most effective cannabis policy. This research explores whether or not the recent change toward decriminalization is adequate, or if it needs further revising.

Objective: To identify the 100 most-cited articles in DH and analyze their characteristics. Material and Methods: A search was performed on the Web of Science (WoS) and the 100 most-cited articles were selected. The following data were extracted: citations, year of publication, authorship, institution, country, journal, language, study design, topic of interest, conflict of interest (COI), and sponsorship. The VOSviewer software was used to visualize bibliometric networks. Poisson regression analysis was performed to measure associations between several citations and the characteristics of the studies. Results: The number of citations ranged from 346 to 48. The most-cited article was published in 1997 by Holland in the Journal of Clinical Periodontology. This journal published the most papers, followed by the Journal of Oral Rehabilitation and Journal of Dentistry. Laboratory research, review, and clinical trial were the study designs most prevalent. Reviews (p<0.05; PR= 1.853) and method development studies (p<0.05; PR= 1.853) had a more chance to present more citations. The main topics of interest were the clinical effectiveness of desensitizers and in vitro analysis of dentin morphology. Sponsorship and COI were underreported. England and USA presented the greatest number of citations and connections in the coauthorship network map. Conclusion: Most of the articles were original research, and their topics of interest were mainly the clinical effectiveness of desensitizing agents and dentin morphology. [ABSTRACT FROM AUTHOR]

Electronic portfolios offer many advantages to their paper-based counterparts, including, but not limited to working on ICT skills, adding multimedia and easier sharing of the portfolio. Previous research showed that the quality of a portfolio does not depend on the medium used. In this article the perceived support for self-reflection of an electronic portfolio and a paper-based portfolio in the same ecological setting are compared. We made use of the fact that during this study about half of the first year medical students was using an electronic portfolio (n = 157) and the other half a paper-based portfolio (n = 190). Nine questions were added to the standard end of the block evaluation, which is handed to 25 percent of year one educational groups. Findings suggest that perceptions about the support for self-reflection, and the usefulness of compiling a portfolio, do not differ between students using an electronic portfolio and students using a paper-based portfolio.

The EU has set the ambitious target of raising the share of EU energy consumption produced from renewable resources to 32% by 2030, with a target of climate neutrality by 2050. The aim of this paper is to assess the role of biomass usage in the context of these targets. The paper identifies the progress made between 2013 and 2022 by focusing on a selection of EU countries. The largest bioenergy increments of 130, 77, and 60 PJ were reported for Poland, Sweden, and the Netherlands. This study evaluates the crucial role of co-generation and heat in EU regions, with biomass usage between 55 and 80% of the combined heat and power (CHP) energy in Nordic countries. The future perspectives for bioenergy based on EU policies, biomass resources, and technical issues were addressed. The EU possesses around 9% of the global biomass supply, ensuring a certain level of biomass resource dependence. Thus, the biomass usage demand in energy production, non-energy sectors, and transport is expected to rise, leading to increments of 13–76% on biomass imports. It appears that bioenergy development is mostly limited by economic issues and uneven support for bioenergy in different EU countries as well as environmental issues. The study shows a promising and sustainable potential of bioenergy in the EU as a renewable energy source while minimizing negative impacts on the environment and the economy. By 2050, liquid biofuels are likely to be increasingly used in the transport sector. Non-energy sector usage of biomass is still in an early stage of development, except for the pulp and paper industry, and significant use of biomass in non-energy sectors seems unlikely in the near future. [ABSTRACT FROM AUTHOR]

This paper traces the transnational entanglements in the Dutch digital media archive, with a focus on the propaganda battle between pro-Nazi and pro-Allied Dutch media during the Second World War. Reflecting on newspaper and radio source materials in the CLARIAH Media Suite, it points out significant differences in the availability of these two source collections. It argues that these imbalances can be explained by the historical context in which these sources were created as well as by archival policies after 1945. The main problem lies in the digitized radio archive which contains only a relatively small amount of audio and leaves out the enormous amount of documents, such as transcripts and monitoring reports. With our article, we ask for more attention for this form of 'audio on paper', which has previously been overlooked by scholars and archivists. In the conclusion we argue for the digitization of these source materials and inclusion in the Media Suite as a first step towards redrawing the borders of media archives, enabling a new research agenda aimed at studying transnational entanglements in war time propaganda. [ABSTRACT FROM AUTHOR]

Abstract: The pulp and paper industry both uses and produces large amounts of energy and rising fuel prices bring along significant challenges to the sector. Several strategies can be applied in order to remain competitive e.g. an increase in energy efficiency, a switch in fuel and/or a novel energy conversion technology. In this study, we investigate if improved energy conversion strategies can reduce energy costs, primary energy use and CO2 emissions of paper mills within different European countries (The Netherlands, Poland and Sweden). Our results show that differences in history and availability of resources has led to different conversion strategies in the three countries. We found that a natural gas combined cycle, which is largely implemented in The Netherlands due to long term domestic availability of natural gas, has the lowest primary energy demand. Due to a long history of low electricity prices, CHP has not been common in Sweden. Many Swedish mills use biomass as an energy source and due to low CO2 emissions of the national grid the CO2 emission profile of the Swedish paper industry is very low. Our results imply that future conversion routes for the Swedish paper and board industry are again wood based; in case of increasing electricity prices these would be biomass gasification based CHP solutions. With a reduction of 800kg CO2/ton paper on average, a switch from coal to biomass would reduce CO2 emissions in the Polish pulp and paper industry with approximately 0.6Mton/year. A carbon price of 20–25€/ton would, according to our results, be enough to provoke this switch. Due to the high share of natural gas, the CO2 emission reduction potential of the Dutch paper industry (1.5Mton/year) is even larger than in Poland. Due to high biomass prices and relative low CO2 emission profile of natural gas, a carbon prices of more than 60€/ton CO2 would be needed to provoke a switch in The Netherlands. Provided with few alternatives, the most effective strategy in The Netherlands would be an increase in energy efficiency. [Copyright &y& Elsevier]

A scrapbook compiled between 1660 and 1687 by Gesina ter Borch (1631–1690), a female artist from the small town of Zwolle in the Netherlands, contains an intriguing painting on paper of a full-length portrait of a young Iranian. Although the figure wears the attributes in vogue at the Safavid court of Isfahan, certain elements seem rather incongruous and peculiar. The general composition appears static and rigid, an impression reinforced by an unusual black painted background. Stylistic differences within the painting were also observed, hinting at alterations to the original painting. To investigate the history of the painting and to reconstruct the original composition and identify the later additions, perhaps made by Gesina herself, the painting was examined with different imaging and analytic techniques available at the Conservation and Science Department of the Rijksmuseum. This allowed the research team to discriminate between pigments used for the original composition and pigments used to conceal damaged areas of the painting and added pictorial elements. After interpreting scientific results, as well as historical findings, it was possible to shed light on the use of specific pigments, namely lead white and smalt, and on the possible misinterpretation of some details, such as the cup held by the young man. The results of macro X-ray fluorescence scanning (MA-XRF) and lead isotope analysis, viewed in the light of information about the economic and cultural exchanges between Iran and the Netherlands in the seventeenth century, fed new theories about the origin and history of this painting. The painting, originally made in Iran in the style of Riza Abbasi, the head of the Emperor Shah Abbas' library, ended up in Gesina ter Borch's workshop and may have been 'restored' by the artist to improve its condition and to match her tastes. [ABSTRACT FROM AUTHOR]

The study assesses highly cited research works in the area Business, Management and Accounting retrieving data from Scopus database for the period 1998-2017. It found total 49417 publications which received 769676 citations. The study identifies about one third (32.88%) of papers have remained uncited during the period. Among rest, papers' having one citation (10.60%) is higher. It is inferred from the analysis that older publications get more citations. Indian citation distribution is almost similar with global citation distribution pattern. The study identifies Cranfield University of UK has greater impact. International collaboration brings higher citations and Netherlands has higher citation per paper (27.33) due to its international collaborative research. Besides, language may be a barrier of research communication. Clusters and the new is highly cited paper. Out of top ten highly cited research papers, six papers are single authored and two papers have international collaboration. Maximum authors are from USA. Harvard business review is the quality journal. [ABSTRACT FROM AUTHOR]

Abstract: In the policy-making process concerning energy and environmental issues, cooperation between government and firms is a means to create a more efficient energy and environmental policy. Intermediary organizations can play an important role in this policy-making process. Aim of this study is to get insight into the role of one specific intermediary organization: the industry association. In this paper, we focus on the Dutch paper and board industry. Important policy themes for this industry are waste water, waste, and energy efficiency. We distinguished four types of governmental policy instruments: top-down regulation, interactive regulation, negative economic instruments, and positive economic instruments. We analyzed the role of the industry association in the policy-making process for all of these four instruments. The results clearly show different (relative) roles of the industry association in different steps of the policy-making processes and for different types of instruments. [Copyright &y& Elsevier]

Background: A large number of nondigitized electrocardiograph (ECG) strips are routinely collected in larger cohort studies such as the ADDITION study (Anglo-Danish-Dutch Study of Intensive Treatment in People with Screen-Detected Diabetes in Primary Care). These ECG strips are routinely read manually but may contain overlooked information revealing cardiac autonomic dysfunction. The aim of this study was to investigate whether clinical information may be lost using manual R wave to R wave (RR) interval measurements in the calculation of heart rate variability (HRV) in patients with type 2 diabetes mellitus (T2DM)., Method: From the Danish part of the ADDITION study, we randomly selected 120 T2DM patients at baseline of the ADDITION study. Analysis of the ECG strips was performed using two different methods: (1) by experienced technicians using rulers and (2) by experienced technicians using a high-resolution computer-assisted method. Calculation of heart rate and time domain HRV [standard deviation of normal-to-normal RR intervals (SDNN) and root mean square of successive differences (RMSSD)] were performed with the same software., Results: When comparing results from the two methods, the following values of Pearson's r are obtained: 0.98 for heart rate, 0.76 for SDNN, and 0.68 for RMSSD. These results indicate that heart rate and HRV measurements by the computer-assisted and manually based methods correlate. However, Bland-Altman plots and Pitman's test of difference in variance revealed poor agreements (p < .01) for both HRV measurements (SDNN and RMSSD); only heart rate showed substantiated agreement (p = .54) between the two methods. Low HRV was statistically significantly associated to high heart rate, systolic blood pressure, and diastolic blood pressure in these screen-detected T2DM patients., Conclusions: Paper ECG strips may contain overlooked clinical information on the status of autonomic function in patients with T2DM. In our study, manual measurements of RR intervals were inferior to the computer-assisted method. Based on this study, we recommend cautiousness in the clinical use and interpretation of HRV based on manual or low resolution measurements of RR intervals from ECG strips. High resolution measurements of RR intervals reveal significant associations between low HRV and high heart rate, systolic blood pressure, and diastolic blood pressure among patients with screen-detected T2DM. It is feasible to use a computer-assisted method to determine RR intervals in patients with T2DM., (© 2012 Diabetes Technology Society.)

Background: radiotherapy is one of the major treatments for lung cancer and has been a hot research area for years. This bibliometric analysis aims to present the research trends on lung cancer radiotherapy. Method: On August 31, 2022, the authors identified 9868 articles on lung cancer radiotherapy by the Web of Science (Science Citation Indexing Expanded database) and extracted their general information and the total number of citations. A bibliometric analysis was carried out to present the research landscape, demonstrate the research trends, and determine the most cited papers (top-papers) as well as top-journals on lung cancer radiotherapy. After that, the authors analyzed the recent research hotspots based on the latest publications in top-journals. Results: These 9868 papers were cited a total of 268,068 times. "Durvalumab after chemoradiotherapy in stage III non-small-cell lung cancer" published in 2017 by Antonia et al. was the most cited article (2110 citations). Among the journals, New England Journal of Medicine was most influential. Moreover, J. Clin. Oncol. and Int. J. Radiat. Oncol. Biol. Phys. was both influential and productive. Corresponding authors represented the USA (2610 articles) and China mainland (2060 articles) took part in most publications and articles with corresponding authors from Netherlands were most cited (46.12 citations per paper). Chemoradiotherapy was the hottest research area, and stereotactic body radiotherapy has become a research hotspot since 2006. Radiotherapy plus immunotherapy has been highly focused since 2019. Conclusions: This bibliometric analysis comprehensively and quantitatively presents the research trends and hotspots based on 9868 relevant articles, and further suggests future research directions. The researchers can benefit in selecting journals and in finding potential collaborators. This study can help researchers gain a comprehensive picture of the research landscape, historical development, and recent hotspots in lung cancer radiotherapy and can provide inspiration for future research. [ABSTRACT FROM AUTHOR]

Objectives: Dysfunction after transient ischaemic attack (TIA) and minor stroke is often underestimated by clinical measures. Patient-reported outcome measures used in value-based healthcare may help in detecting these problems. The Patient-Reported Outcomes Measurement Information System 10-Question Short Form (PROMIS-10 Global Health) is a concise patient-centred outcome measuring tool proposed for assessing health status in patients who had stroke. This study aims to address the validity of the Dutch PROMIS-10 in patients who had stroke in the Netherlands and also aims to compare telephone versus on-paper assessment., Design: Observational cohort study., Setting: Single-centre hospital in the Netherlands., Participants: 75 patients who were diagnosed with TIA or minor stroke and discharged without rehabilitation treatment 1 year ago (between December 2014 and January 2016) completed the study., Primary and Secondary Outcome Measures: PROMIS-10 physical (PH) and mental health (MH) scores assessed 1 year poststroke on paper (n=37) and by telephone (n=38) was compared with RAND-36 physical and mental component scores assessed on paper., Results: PROMIS-10 and RAND-36 correlated significantly in PH, r=0.81 (95% CI 0.69 to 0.88), and MH, r=0.76 (95% CI 0.64 to 0.85). Paper-and-pencil assessed correlations were r=0.87 and 0.79 for PH and MH, respectively. Telephone assessed correlations were r=0.76 and 0.73 for PH and MH, respectively. Internal consistency analysis indicated high reliabilities for both health components of the PROMIS-10, all Cronbach's α>0.70., Conclusions: The Dutch PROMIS-10 was found to strongly correlate with the RAND-36. Paper-and-pencil assessment was found to have a higher correlation than telephone assessment. This study provides support for the use of the Dutch PROMIS-10 in assessing health status in patients after TIA and minor stroke., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Across the European Union costs for the treatment of oral disease is expected to rise to €93 Billion by 2020 and be higher than those for stroke and dementia combined. A significant proportion of these costs will relate to the provision of care for older people. Dental caries severity and experience is now a major public health issue in older people and periodontal disease disproportionately affects older adults. Poor oral health impacts on older people's quality of life, their self-esteem, general health and diet. Oral health care service provision for older people is often unavailable or poor, as is the standard of knowledge amongst formal and informal carers. The aim of this discussion paper is to explore some of the approaches that could be taken to improve the level of co-production in the design of healthcare services for older people., Main Text: People's emotional and practical response to challenges in health and well-being and the responsiveness of systems to their needs is crucial to improve the quality of service provision. This is a particularly important aspect of care for older people as felt, expressed and normative needs may be fundamentally different and vary as they become increasingly dependent. Co-production shifts the design process away from the traditional 'top-down' medical model, where needs assessments are undertaken by someone external to a community and strategies are devised that encourage these communities to become passive recipients of services. Instead, an inductive paradigm of partnership working and shared leadership is actively encouraged to set priorities and ultimately helps improve the translational gap between research, health policy and health-service provision., Discussion: The four methodological approaches discussed in this paper (Priority Setting Partnerships, Discrete Choice Experiments, Core Outcome Sets and Experience Based Co-Design) represent an approach that seeks to better engage with older people and ensure an inductive, co-produced process to the research and design of healthcare services of the future. These methods facilitate partnerships between researchers, healthcare professionals and patients to produce more responsive and appropriate public services for older people.

The article discusses the prints that were made for the secular feast of Twelfth Night as it was celebrated in Holland and Flanders. The Twelfth Night celebration has two aspects: the secular family party and the religious holiday. The Christian holiday of Epiphany is celebrated on January 6 and is part of the liturgical calendar. While in the Western Church, it focuses on the visit of the Three Kings to Christ. In Holland, it is called 'Driekoningenfeest, and it took place on the same day as Epiphany or on the night before, twelve days after Christmas.

Scientometrics is a sub field of bibliometrics. Mapping of research outputs on Dyslexia: A Scientometric study during 2015-2019. There are 1677 research papers were contributed by 7623 authors during 2015 - 2019, Single authors have contributed 134 research papers and Triple authors have contributed 314 research papers. The author Tzipi Horowitz-Kraus have contributed 12 research papers, Average relative growth rate is 0.027 and doubling time is 13.227. Country wide, United states have contributed 398 research papers on Dyslexia occupy the first rank and India have contributed 13 research papers occupy the 20th rank, Preferred language of authors are found to be English 1639(97.73%) on Dyslexia research. The journal "Dyslexia "(Chichester, England) have contributed 134(7.99%) research papers occupy 1st rank. Prolific contributed institutions, First Rank occupied by Behavioral Science Institute the Netherlands have contributed 15 research papers, the degree of collaboration by Subramaniam formula the mean degree of collaboration is 0.920. shows that 92% of contributions are from collaborative authors. Dyslexia research shows remarkably low by India, it is necessary to give awareness to people on Dyslexia. The funding agencies and Government of India should take initiation to encourage the researchers to contribute more research papers on Dyslexia. The researchers should collaborate with other countries to enrich their knowledge on Dyslexia. [ABSTRACT FROM AUTHOR]

The dataset includes data from the two studies reported in our 'Terror Management in a Multicultural Society' paper. The data was collected at the psychology lab at the Vrije Universiteit Amsterdam in 2013/2014 among Dutch-speaking student samples. The dataset consists of the measures described in the paper. The data can be used for replication purposes, meta-analyses, and exploratory analyses, as well as cross-cultural comparisons of mortality salience effects. The authors also welcome collaborative research based on re-analyses of the data. [ABSTRACT FROM AUTHOR]

The article offers information on Physical therapy was no inferior to partial meniscectomy for improving knee function in patients with no obstructive meniscal tears.

Cardiac rehabilitation (CR) has evolved as an important part of the treatment of patients with cardiovascular disease. However, to date, its full potential is fairly underutilised. This review discusses new developments in CR aimed at improving participation rates and long-term effectiveness in the general cardiac population. It consecutively highlights new or challenging target groups, new delivery modes and new care pathways for CR programmes. These new or challenging target groups include patients with atrial fibrillation, obesity and cardiovascular disease, chronic coronary syndromes, (advanced) chronic heart failure with or without intracardiac devices, women and frail elderly patients. Also, the current evidence regarding cardiac telerehabilitation and loyalty programmes is discussed as new delivery modes for CR. Finally, this paper discusses novel care pathways with the integration of CR in residual risk management and transmural care pathways. These new developments can help to make optimal use of the benefits of CR. Therefore we should seize the opportunities to reshape current CR programmes, broaden their applicability and incorporate them into or combine them with other cardiovascular care programmes/pathways. [ABSTRACT FROM AUTHOR]

Environmental classifications are of paramount importance for assessing the impacts of land-use changes, for prioritizing conservation efforts, and for developing effective management strategies to mitigate the negative impacts of human activities. The aim of our research was to provide as complete an analysis as possible of the studies that have been carried out using the Braun-Blanquet approach. The global review of studies based on the Braun-Blanquet approach includes 1168 papers and was conducted using the PRISMA 2009 methodological recommendations, strict criteria for the selection/quality of papers, and modern methods of data analysis and visualization using VOSviewer software developed by Nees Jan van Eck and Ludo Waltman (Centre for Science and Technology Studies (CWTS) of Leiden University in the Netherlands) (version 1.6.18), which ensures a representative sample, minimization of subjective judgements, and reliability of conclusions. It was noted that the number of publications on Braun-Blanquet is growing exponentially. This is an indication of the scientific interest in this methodology and its continuous further development. Based on a detailed analysis of the keywords, the main research directions and challenges are identified. These include improving the conceptual and methodological foundations of the Braun-Blanquet approach; improvement in regional vegetation classifications, synthesizing them and producing a comprehensive classification for large areas as a basis for biodiversity conservation and sustainable land use; expansion of the geography; compilation and updating of databases of phytosociological data; management of dynamics and vegetation; discussion of the important problem of continuity and discreteness of vegetation in the context of ecological classifications; and vegetation mapping. The top 20 journals publishing the most cited articles were identified, as well as the top 20 most cited journals whose high citation rate is due to the large number of high-quality articles. The analysis of the bibliographic network of papers in dynamics has shown that the structure of relationships is not constant and has changed significantly. The analysis of the authors' publication activity showed that the vast majority of researchers have a low publication activity and have published only one to three papers. A peculiarity also emerges: if all the most cited authors are concentrated in Eurasia, then most of the most actively published authors are outside Eurasia. The importance of the Braun-Blanquet approach for the study and classification of forest vegetation should be emphasized. In this case, the Braun-Blanquet approach is integrated into forest typologies, increasing their ecological validity and environmental relevance. [ABSTRACT FROM AUTHOR]

The article presents the authors' views in response to a comment on their paper "Patterns of Low and Lowest-Low Fertility in Europe," published in a 2004 issue of the journal "Population Studies." In their comment, the critics have argued that the cohort-fertility analysis in the aforesaid paper is weak on theoretical grounds and the empirical analysis is incomplete. The authors affirm that they agree with the comment that, as a society, the Netherlands differs from Southern Europe and even more from Central and Eastern Europe. Nevertheless, from a contemporary global perspective, these differences should not be overemphasized. They say that in their analyses, they used the Netherlands as a reference case of a country with an extraordinary pattern of late childbearing that is not associated with lowest-low fertility levels. However, the critics believe that these unusual characteristics invalidate the use of the Dutch example in the paper. So, this criticism is misconceived. It is precisely the unusualness of the fertility pattern in the Netherlands that makes it a useful reference point in the study of low and lowest-low fertility.

The use of radiation to treat keloid scars has gained popularity during the last few decades. However, few bibliometric analyses have been performed on the published articles. This research aimed to demonstrate and evaluate the trends, top-cited articles, and frontier areas. In this cross-sectional study, Web of Science (WOS) and Scopus database literature was searched for all MESH terms related to "keloid" and "radiotherapy." The bibliometric analysis was carried out by VOSviewer 1.6.15. Articles with Web of Science-based citations of ≥20 were included. The citation per year index (CPYI) of articles was calculated for further inclusion of papers if they had CPYI higher than the mean value. There were 95 papers on keloid radiation that satisfied the inclusion criteria and were published between 1942 and 2019. The CPYI ranged from 0.38 to 11.3. Most studies were published in the "International Journal of Radiation Oncology, Biology, and Physics" (9 papers). The United States has the most papers (14), followed by Japan (9), the Netherlands (7), and Germany (5). To the best of our knowledge, this is the first bibliometric analysis of top-cited papers on keloid radiotherapy. From 2014 to the present, it seems that this title has resurfaced as a popular topic, with radiotherapy within 24 h of surgery being the most commonly recommended treatment plan. Since around 2011, high-dose-rate brachytherapy (HDR-BT) has been used as an effective treatment for keloid control. Individualization of therapy and dose/technique based on the location is strongly suggested. [ABSTRACT FROM AUTHOR]

Introduction: Stroke care is complex and often provided by various healthcare organisations. Integrated care solutions are needed to optimise stroke care. In this paper, we describe the development of integrated stroke care in the region of Maastricht during the last 15 years. Description of integrated care case: Located in the south of the Netherlands, the region of Maastricht developed integrated stroke care to serve a population of about 180,000 people. Integration was needed to improve the continuity, coordination and quality of stroke care. The development of integrated care in Maastricht was a phased process. The last phase emphasized early discharge from hospital and assessing the best individual rehabilitation track in a specialized nursing home setting. Discussion and lessons learned: The development and implementation of integrated stroke care in the region of Maastricht led to fewer days in hospital, more patients being directly admitted to the stroke unit and an earlier start of rehabilitation. The implementation of early discharge from the hospital and rehabilitation assessment in a nursing home led to some unforeseen problems and lessons learned. [ABSTRACT FROM AUTHOR]

Following curative treatment for colorectal cancer (CRC), 30% to 50% of patients will develop recurrent disease. For CRC there are several lines of evidence supporting the hypothesis that early detection of metachronous disease offers a second opportunity for cure. This paper revisits the potential role of serum carcinoembryonic antigen (CEA) in follow-up. A comprehensive review of the literature (1978-2008) demonstrates that the initial promise of serum CEA as an effective surveillance tool has been tarnished through perpetuation of poorly designed studies. Specific limitations included: testing CEA as only an 'add-on' diagnostic tool; lack of standardization of threshold values; use of static thresholds; too low measurement frequency. Major changes in localizing imaging techniques and treatment of metastatic CRC further cause a decrease of clinical applicability of past trial outcomes. In 1982, Staab hypothesized that the optimal benefit of serum CEA as a surveillance tool is through high-frequency triage using a dynamic threshold (HiDT). Evidence supporting this hypothesis was found in the biochemical characteristics of serum CEA and retrospective studies showing the superior predictive value of a dynamic threshold. A multi-centred randomized phase III study optimizing the usage of HiDT against resectability of recurrent disease is commencing recruitment in the Netherlands. [ABSTRACT FROM AUTHOR]

A mission statement that identifies the goals and aims of an honors program is a key step in program development. The National Collegiate Honors Council's Basic Characteristics of a Fully Developed Honors Program states unequivocally that a successful honors program "has a clear mandate from the institution's administration in the form of a mission statement or charter document that includes the objectives and responsibilities of honors and defines the place of honors in the administrative and academic structure of the institution." Such mission statements have now become standard for honors programs and colleges. Following a brief history of mission statements outside of the academic world, this paper examines the online mission statements of current honors programs. This study investigates the link between the content of U.S. honors programs' mission statements, goals to be achieved, performance indicators, and outcomes in order to determine if mission statements in the U.S. have served the purpose for which they are designed. Such a determination can offer important guidance to developing honors programs in other parts of the world.

BACKGROUND: Posttraumatic stress disorder (PTSD) is often associated with impaired fear inhibition and decreased safety cue processing; however, studies capturing the cognitive aspect of inhibition and contextual cue processing are limited. In this fMRI study, the role of contextual cues in response inhibition was investigated. METHODS: Male medication-naive war veterans with PTSD, male control veterans (combat controls) and healthy nonmilitary men (healthy controls) underwent fMRI while performing the stop-signal anticipation task (SSAT). The SSAT evokes 2 forms of response inhibition: reactive inhibition (outright stopping) and proactive inhibition (anticipation of stopping based on contextual cues). RESULTS: We enrolled 28 veterans with PTSD, 26 combat controls and 25 healthy controls in our study. Reduced reactive inhibition was observed in all veterans, both with and without PTSD, but not in nonmilitary controls, whereas decreased inhibition of the left pre/postcentral gyrus appeared to be specifically associated with PTSD. Impaired behavioural proactive inhibition was also specific to PTSD. Furthermore, the PTSD group showed a reduced right inferior frontal gyrus response during proactive inhibition compared with the combat control group. LIMITATIONS: Most patients with PTSD had comorbid psychiatric disorders, but such comorbidity is common in patients with PTSD. Also, the education level (estimate of intelligence) of participants, but not of their parents, differed among the groups. CONCLUSION: Our findings of reduced proactive inhibition imply that patients with PTSD show reduced contextual cue processing. These results complement previous findings on fear inhibition and demonstrate that contextual cue processing in patients with PTSD is also reduced during cognitive processes, indicating a more general deficit. [ABSTRACT FROM AUTHOR]

Background: Medical students in clerkship are continuously confronted with real and relevant patient problems. To support clinical problem solving skills, students perform a Critical Appraisal of a Topic (CAT) task, often resulting in a paper. Because such a paper may contain errors, students could profit from discussion with peers, leading to paper revision. Active peer discussion by a Computer Supported Collaborative Learning (CSCL) environment show positive medical students perceptions on subjective knowledge improvement. High students' activity during discussions in a CSCL environment demonstrated higher task-focussed discussion reflecting higher levels of knowledge construction. However, it remains unclear whether high discussion activity influences students' decisions revise their CAT paper. The aim of this research is to examine whether students who revise their critical appraisal papers after discussion in a CSCL environment show more task-focussed activity and discuss more intensively on critical appraisal topics than students who do not revise their papers., Methods: Forty-seven medical students, stratified in subgroups, participated in a structured asynchronous online discussion of individual written CAT papers on self-selected clinical problems. The discussion was structured by three critical appraisal topics. After the discussion, the students could revise their paper. For analysis purposes, all students' postings were blinded and analysed by the investigator, unaware of students characteristics and whether or not the paper was revised. Postings were counted and analysed by an independent rater, Postings were assigned into outside activity, non-task-focussed activity or task-focussed activity. Additionally, postings were assigned to one of the three critical appraisal topics. Analysis results were compared by revised and unrevised papers., Results: Twenty-four papers (51.6%) were revised after the online discussion. The discussions of the revised papers showed significantly higher numbers of postings, more task-focussed activities, and more postings about the two critical appraisal topics: "appraisal of the selected article(s)", and "relevant conclusion regarding the clinical problem"., Conclusion: A CSCL environment can support medical students in the execution and critical appraisal of authentic tasks in the clinical workplace. Revision of CAT papers appears to be related to discussions activity, more specifically reflecting high task-focussed activity of critical appraisal topics.

Objective: The aim of this study is to investigate differences in responses related to (mental) health and behavior between two methods of data collection: web-based (web) and paper-and-pencil (p&p)., Study Design: Within each participating school all third-grade classes (mainly 14-15-year-old pupils) were randomly assigned to either the Internet condition (n=271) or the paper-and-pencil condition (n=261)., Principal Findings: Significant but small differences were found for the strengths and difficulties subscales "emotional symptoms" (p&p>web) and "prosocial behavior" (p&p>web), and carrying a weapon (web>p&p). Perceived level of privacy and confidentiality did not differ between the two modes., Conclusions: The findings suggest that in a controlled school setting, web-based administration of health indicators yields almost the same results as paper-and-pencil administration. To generalize these findings, we recommend repeated studies in other populations and settings., (© Health Research and Educational Trust.)

Aims: In this study we evaluated indicators of the feasibility, reliability, and validity of the Child Health Questionnaire-Child Form (CHQ-CF). We compared the results in a subgroup of adolescents who completed the standard paper version of the CHQ-CF with the results in another subgroup of adolescents who completed an internet version, i.e., an online, web-based CHQ-CF questionnaire., Methods: Under supervision at school, 1,071 adolescents were randomized to complete the CHQ-CF and items on chronic conditions by a paper questionnaire or by an internet administered questionnaire., Results: The participation rate was 87%; age range 13-17 years. The internet administration resulted in fewer missing answers. All but one multi-item scale showed internal consistency reliability (Cronbach's alpha > 0.70). All scales clearly discriminated between adolescents with no, a few, or many self-reported chronic conditions. The paper administration resulted in statistically significant, higher scores on 4 of 10 CHQ-CF scales compared with the internet administration (P < 0.05), but Cohen's effect sizes d were

The Internet has become an inevitable tool for collecting health and health behavior questionnaires. This study compared the feasibility, presence of score differences, and subjective evaluations by children between Internet and identical paper (asthma/fruit) questionnaires in elementary schools. A randomized crossover design was applied, with children starting with one administration mode before completing (5 minutes later) the other mode. Ten Dutch elementary schools with 270 school children (fifth grade, 10-12 years) were approached to participate. Response was 92%. The Internet mode had significantly less missing/nonunique answers than the paper mode (p < .01). The completion times did not differ significantly between the Internet and the paper mode. Except for perceived self-efficacy to eat sufficient fruit (p < .05), no differences in the asthma and fruit scores were found when comparing between the 2 modes. All variables showed strong intraclass correlation coefficients (166 >or= 0.64) between modes. Most items had good to very good agreement (kappa 0.61-0.95). The percentages for global and exact agreement ranged per item from 61.3 to 100. Most children preferred the Internet mode on "general preference" and "ease of use" aspects but rated no preference on "understandability." The majority rated the evaluation aspects of the Internet mode positively. Thus, Internet administration of a health and health behavior questionnaire is feasible at elementary schools, gives comparable responses, and is well accepted and preferred by children compared to the paper version. Therefore, it is recommended to use Internet as a tool in health and health behavior research among children.

For endangered species with limited dispersal capacity, the preservation of individual patches or sites is extremely important. The quality and size of habitat patches and their isolation from other patches are the main parameters for an assessment of population persistence, but translating persistence probabilities into practical measures is still a weak link in conservation management. I provide a quantitative conservation approach for the endangered myrmecophilous butterfly Maculinea alcon in the Netherlands. All 127 colonies known on heathland since 1990 were investigated for patch quality, size, and isolation. I assessed habitat quality in three 10 × 10 m plots for most colonies. Site occupancy in 1998–1999 was only 56%. Occupancy was best explained by a logistic regression including patch area, host ant presence, host plant abundance, overall heathland area, and connectivity between sites ( 2= 0.410, < 0.0001); it correctly classified the occupied or vacant status for 82% of the sites. Connectivity contributed only 3.6% to the total explained variation of site occupancy, indicating that habitat characteristics were more important than isolation in determining population persistence at the examined scale level (>500 m). Grazing and sod cutting had a beneficial impact, but in combination these practices proved detrimental. Hydrological measures to prevent drainage were also associated with lowered occupancy. I used the different components in the logistic regression to formulate objective management recommendations. These consisted of sod cutting, reduction of management intensity, enlargement of habitat, or combinations of these recommendations. The results highlight the importance of careful management when site quality is determined by multiple factors. The quantitative conservation approach followed here can be fruitfully extended to other endangered species, provided enough is known about their ecological requirements and how management actions affect them. [ABSTRACT FROM AUTHOR]

Background: Questionnaires are widely used in survey research, especially in cohort studies. However, participation in questionnaire studies has been declining over the past decades. Because high participation rates are needed to limit the risk of selection bias and produce valid results, it is important to investigate invitation strategies which may improve participation. Objectives: The purpose of this study is to investigate the effect of Web-based versus paper-based questionnaires on participation rates in a questionnaire survey on late effects among childhood cancer survivors (CCSs). Methods: A total of 750 CCSs were randomized across 3 study arms. The initial invitation in study arms 1 and 2 consisted of a Web-based questionnaire only, whereas in study arm 3 this invitation was complemented with a paper-based version of the questionnaire. The first postal reminder, sent to the nonresponding CCSs in all 3 study arms, consisted of either a reminder letter only (study arms 1 and 3) or a reminder letter complemented with a paper-based questionnaire (study arm 2). The second postal reminder was restricted to CCSs in study arms 1 and 2, with only those in study arm 1 also receiving a paper-based questionnaire. CCSs in study arm 3 received a second reminder by telephone instead of by mail. In contrast to CCSs in study arm 3, CCSs in study arms 1 and 2 received a third reminder, this time by telephone. Results: Overall, 58.1% (436/750) of the CCSs participated in the survey. Participation rates were equal in all 3 study arms with 57.4% (143/249) in arm 1, 60.6% (152/251) in arm 2, and 56.4% (141/250) in arm 3 (P=.09). Participation rates of CCSs who received an initial invitation for the Web-based questionnaire only and CCSs who received an invitation to complete either a paper-based or Web-based questionnaire did not differ (P=.55). After the first postal reminder, participation rates of CCSs invited for the Web-based questionnaire only also did not differ compared with CCSs invited for both the Web-based and paper-based questionnaires (P=.48). In general, CCSs preferred the paper-based over the Web-based questionnaire, and those completing the paper-based questionnaire were more often unemployed (P=.004) and lower educated (P<.001). Conclusion: Invitation strategies offering a Web-based questionnaire without a paper-based alternative at first invitation can be used without compromising participation rates of CCS. Offering the choice between paper- and Web-based questionnaires seems to result in the highest accrual participation rate. Future research should look into the quality of the data delivered by both questionnaires filled in by respondents themselves. Trial Registration: International Standard Randomized Controlled Trial Number (ISRCTN): 84711754; http://www.controlled-trials.com/ISRCTN84711754 (Archived by WebCite at http://www.webcitation.org/6c9ZB8paX) [ABSTRACT FROM AUTHOR]

This review is aimed at summarizing the current state of knowledge about the relationship between environmental exposure to the bioaerosol emitted by intensive livestock farming and changes in the microbiome of people living in livestock farm vicinity. The PubMed, Scopus and Web of Science databases were searched by crossing keywords from the following 3 groups: a) "livestock," "animal farms," "animal breeding"; b) "microbiome," "resistome"; c) "livestock vicinity," "farm vicinity," "neighborhoods and health" in 2010-2022. Literature screening did not reveal any paper related to the full microbiome composition in the population studied. In the study, the authors included 7 papers (5 from the Netherlands, 1 from the USA, and 1 from China). The studies confirmed the carriage of Staphylococcus aureus, including methicillin-resistant S. aureus (MRSA), livestockassociated MRSA (LA-MRSA MC398) and multidrug-resistant S. aureus (MDRSA) in the nasal microbiome of adults and children living within 500-2000 m from a livestock farm. Clostridium difficile, including LA-ribotype RT078 carriage, was detected in the intestinal microbiome of adults living within 500-1000 m. Extended-spectrum β-lactamase (ESBL) producing Enterobacteriaceae were confirmed in the intestinal microbiome of adults living within 500-6200 m. Knowledge on the composition of the microflora of people living in livestock farm vicinity is insufficient to conclude about changes in the microbiome caused by the environmental emission of bioaerosol. The carriage prevalence of the LA-bacteria, including both strains with antimicrobial resistance and antimicrobial resistance genes, confirms the presence of zoonotic bacteria in the human microflora in populations without occupational contact with animals. It cannot be ruled out that zoonotic bacteria, as a component of the microbiome, have a negative impact on people's health. Int J Occup Med Environ Health. 2024;37(2):138-52. [ABSTRACT FROM AUTHOR]

Background: Few examples exist of research capacity building (RCB) in midwifery. As in other jurisdictions, at the turn of this century midwives in the Netherlands lagged in research-based practice. Dutch professional and academic organisations recognised the need to proactively undertake RCB. This paper describes how a large national research project, the DELIVER study, contributed to RCB in Dutch midwifery. Methods: Applying Cooke's framework for RCB, we analysed the impact of the DELIVER study on RCB in midwifery with a document analysis comprising the following documents: annual reports on research output, websites of national organizations that might have implemented research findings, National Institute for Public Health and the Environment (RIVM)), midwifery guidelines concerning DELIVER research topics, publicly available career information of the PhD students and a google search using the main research topic and name of the researcher to look for articles in public papers. Results: The study provided an extensive database with nationally representative data on the quality and provision of midwifery-led care in the Netherlands. The DELIVER study resulted in 10 completed PhD projects and over 60 publications. Through close collaboration the study had direct impact on education of the next generation of primary, midwifery care practices and governmental and professional bodies. Discussion: The DELIVER study was intended to boost the research profile of primary care midwifery. This reflection on the research capacity building components of the study shows that the study also impacted on education, policy, and the midwifery profession. As such the study shows that this investment in RCB has had a profound positive impact on primary care midwifery in the Netherlands. [ABSTRACT FROM AUTHOR]

Background: The topic of minimal residual disease (MRD) has emerged as a crucial subject matter in the domain of oncology in recent years. The detection and monitoring of MRD have become essential for the diagnosis, treatment, and prognosis of various types of malignancy. Aims: The purpose of this study is to explore the research trends, hotspots, and frontiers of MRD in the last two decades through bibliometric analysis. Methods: We employed Web of Science databases to carry out a bibliometric visualization analysis of research on 8,913 academic papers about MRD research from 2002 to 2022. VOSviewer, CiteSpace, RStudio, and a bibliometric online analysis platform were mainly used to conduct co-occurrence analysis and cooperative relationship analysis of countries/regions, institutions, journals, and authors in the literature. Furthermore, co-occurrence, co-citation, and burst analyses of keyword and reference were also conducted to generate relevant knowledge maps. Results: In the past 20 years, the number of MRD research papers has presented an overall rising trend, going through three stages: a plateau, development, and an explosion. The output of articles in the United States was notably superior and plays a dominant role in this field, and the Netherlands had the highest average citation per article. The most productive and influential institution was the University of Texas MD Anderson Cancer Center. Blood published the most papers and was the most cited journal. A collection of leading academics has come to the fore in the research field, the most prolific of which is Kantarjian HM. It was found that the application of MRD in "acute myeloid leukemia", "acute lymphoblastic leukemia", "multiple myeloma", as well as the detection technology of MRD, are the research hotspots and frontiers in this domain. Furthermore, we analyzed the co-citation network of references and found that the top 10 co-cited references were all associated with MRD in hematological malignancies. Conclusion: This bibliometric visualization analysis conducted a thorough exploration into the research hotspots and trends in MRD from 2002 to 2022. Our findings can aid researchers in recognizing possible collaborations, guiding future research directions, and fostering the growth of MRD detection and monitoring technologies. [ABSTRACT FROM AUTHOR]

University Libraries play a crucial role in moving towards Open Science, contributing to more transparent, reproducible and reusable research. The Center for Digital Scholarship (CDS) at Leiden University (LU) library is a scholarly lab that promotes open science literacy among Leiden's scholars by two complementary strategies: existing top-down structures are used to provide training and services, while bottom-up initiatives from the research community are actively supported by offering the CDS's expertise and facilities. An example of how bottom-up initiatives can blossom with the help of library structures such as the CDS is ReproHack. ReproHack -- a reproducibility hackathon -- is a grass-root initiative by young scholars with the goal of improving research reproducibility in three ways. First, hackathon attendees learn about reproducibility tools and challenges by reproducing published results and providing feedback to authors on their attempt. Second, authors can nominate their work and receive feedback on their reproducibility efforts. Third, the collaborative atmosphere helps building a community interested in making their own research reproducible. A first ReproHack in the Netherlands took place on November 30th, 2019, co-organised by the CDS at the LU Library with 44 participants from the fields of psychology, engineering, biomedicine, and computer science. For 19 papers, 24 feedback forms were returned and five papers were reported as successfully reproduced. Besides the researchers' learning experience, the event led to recommendations on how to enhance research reproducibility. The ReproHack format therefore provides an opportunity for libraries to improve scientific reproducibility through community engagement. [ABSTRACT FROM AUTHOR]

Background: Physical activity surveillance systems are important for public health monitoring but rely mostly on self-report measurement of physical activity. Integration of device-based measurements in such systems can improve population estimates, however this is still relatively uncommon in existing surveillance systems. This systematic review aims to create an overview of the methodology used in existing device-based national PA surveillance systems. Methods: Four literature databases (PubMed, Embase.com, SPORTDiscus and Web of Science) were searched, supplemented with backward tracking. Articles were included if they reported on population-based (inter)national surveillance systems measuring PA, sedentary time and/or adherence to PA guidelines. When available and in English, the methodological reports of the identified surveillance studies were also included for data extraction. Results: This systematic literature search followed the PRISMA guidelines and yielded 34 articles and an additional 18 methodological reports, reporting on 28 studies, which in turn reported on one or multiple waves of 15 different national and 1 international surveillance system. The included studies showed substantial variation between (waves of) systems in number of participants, response rates, population representativeness and recruitment. In contrast, the methods were similar on data reduction definitions (e.g. minimal number of valid days, non-wear time and necessary wear time for a valid day). Conclusions: The results of this review indicate that few countries use device-based PA measurement in their surveillance system. The employed methodology is diverse, which hampers comparability between countries and calls for more standardized methods as well as standardized reporting on these methods. The results from this review can help inform the integration of device-based PA measurement in (inter)national surveillance systems. [ABSTRACT FROM AUTHOR]

Background: BERT models have seen widespread use on unstructured text within the clinical domain. However, little to no research has been conducted into classifying unstructured clinical notes on the basis of patient lifestyle indicators, especially in Dutch. This article aims to test the feasibility of deep BERT models on the task of patient lifestyle classification, as well as introducing an experimental framework that is easily reproducible in future research. Methods: This study makes use of unstructured general patient text data from HagaZiekenhuis, a large hospital in The Netherlands. Over 148 000 notes were provided to us, which were each automatically labelled on the basis of the respective patients' smoking, alcohol usage and drug usage statuses. In this paper we test feasibility of automatically assigning labels, and justify it using hand-labelled input. Ultimately, we compare macro F1-scores of string matching, SGD and several BERT models on the task of classifying smoking, alcohol and drug usage. We test Dutch BERT models and English models with translated input. Results: We find that our further pre-trained MedRoBERTa.nl-HAGA model outperformed every other model on smoking (0.93) and drug usage (0.77). Interestingly, our ClinicalBERT model that was merely fine-tuned on translated text performed best on the alcohol task (0.80). In t-SNE visualisations, we show our MedRoBERTa.nl-HAGA model is the best model to differentiate between classes in the embedding space, explaining its superior classification performance. Conclusions: We suggest MedRoBERTa.nl-HAGA to be used as a baseline in future research on Dutch free text patient lifestyle classification. We furthermore strongly suggest further exploring the application of translation to input text in non-English clinical BERT research, as we only translated a subset of the full set and yet achieved very promising results. [ABSTRACT FROM AUTHOR]

Sectorization of a water distribution network (WDN) into district meter areas (DMAs) is considered a key strategy for an efficient management of WDNs. Typically, it involves a two-stage procedure: a clustering stage, in which the division of the WDN into clusters is performed, and a dividing stage, which involves the placement of valves and flow meters on the cluster's boundary pipes to define the DMAs. While recently published methods attempt to enhance both the clustering and dividing stages, they fail to provide decision-making flexibility. They also neglect to consider the presence of existing valves in the WDN, which can significantly affect the evaluated implementation cost, often considered the primary decision-driving factor. This paper presents improvements to the previously introduced DeNSE method for sectorization of WDNs, aiming to address these deficiencies. The methodology consists of a clustering stage, based on the network uniformity index, and a dividing stage, in which the originally used heuristic procedure is replaced with Genetic Algorithm (GA) optimization, minimizing implementation cost. Consideration of existing valves in WDN and criteria for water supply security are also included in the dividing stage to offer a better estimate of implementation costs and post-sectorized operational efficiency of the WDN. Finally, GIS visualization is implemented, and a hydraulic model of the sectorized WDN (EPANET file) is generated, providing practitioners with valuable insights and decision-making flexibility. The methodology is tested on a part of the Amsterdam WDN in the Netherlands, serving as a pilot for methodology evaluation. A range of feasible sectorization solutions is generated and compared based on implementation cost and three performance indicators (PIs). The paper provides an in-depth discussion on the selection of preferable sectorization solution. The reported results demonstrate the method's efficiency in optimizing sectorization solutions with minimum implementation cost whilst preserving the WDN operational efficiency and meeting the local design criteria. [ABSTRACT FROM AUTHOR]

Background: This study takes on the challenge of quantifying a complex causal loop diagram describing how poverty and health affect each other, and does so using longitudinal data from The Netherlands. Furthermore, this paper elaborates on its methodological approach in order to facilitate replication and methodological advancement. Methods: After adapting a causal loop diagram that was built by stakeholders, a longitudinal structural equation modelling approach was used. A cross-lagged panel model with nine endogenous variables, of which two latent variables, and three time-invariant exogenous variables was constructed. With this model, directional effects are estimated in a Granger-causal manner, using data from 2015 to 2019. Both the direct effects (with a one-year lag) and total effects over multiple (up to eight) years were calculated. Five sensitivity analyses were conducted. Two of these focus on lower-income and lower-wealth individuals. The other three each added one exogenous variable: work status, level of education, and home ownership. Results: The effects of income and financial wealth on health are present, but are relatively weak for the overall population. Sensitivity analyses show that these effects are stronger for those with lower incomes or wealth. Physical capability does seem to have strong positive effects on both income and financial wealth. There are a number of other results as well, as the estimated models are extensive. Many of the estimated effects only become substantial after several years. Conclusions: Income and financial wealth appear to have limited effects on the health of the overall population of The Netherlands. However, there are indications that these effects may be stronger for individuals who are closer to the poverty threshold. Since the estimated effects of physical capability on income and financial wealth are more substantial, a broad recommendation would be that including physical capability in efforts that are aimed at improving income and financial wealth could be useful and effective. The methodological approach described in this paper could also be applied to other research settings or topics. [ABSTRACT FROM AUTHOR]

Background: The Disease Control Priorities 3 (DCP3) project provides long-term support to Pakistan in the development and implementation of its universal health coverage essential package of health services (UHC-EPHS). This paper reports on the priority setting process used in the design of the EPHS during the period 2019-2020, employing the framework of evidence-informed deliberative processes (EDPs), a tool for priority setting with the explicit aim of optimising the legitimacy of decision-making in the development of health benefit packages. Methods: We planned the six steps of the framework during two workshops in the Netherlands with participants from all DCP3 Pakistan partners (October 2019 and February 2020), who implemented these at the country level in Pakistan in 2019 and 2020. Following implementation, we conducted a semi-structured online survey to collect the views of participants in the UHC benefit package design about the prioritisation process. Results: The key steps in the EDP framework were the installation of advisory committees (involving more than 150 members in several Technical Working Groups [TWGs] and a National Advisory Committee [NAC]), definition of decision criteria (effectiveness, cost-effectiveness, avoidable burden of disease, equity, financial risk protection, budget impact, socio-economic impact and feasibility), selection of interventions for evaluation (a total of 170), and assessment and appraisal (across the three dimensions of the UHC cube) of these interventions. Survey respondents were generally positive across several aspects of the priority setting process. Conclusion: Despite several challenges, including a partial disruption because of the COVID-19 pandemic, implementation of the priority setting process may have improved the legitimacy of decision-making by involving stakeholders through participation with deliberation, and being evidence-informed and transparent. Important lessons were learned that can be beneficial for other countries designing their own health benefit package such as on the options and limitations of broad stakeholder involvement. [ABSTRACT FROM AUTHOR]

In The Netherlands, women who experience domestic violence can rely on public policies that aim to support them, such as shelters. Drawing on the lived experiences, through 10 interviews and observations, of women with different cultural backgrounds and nationalities staying in a shelter, and on 37 interviews with social workers working with these women, we observed that this support falls short for them. We argue that immigration rules, together with policies on domestic violence and housing, (unintentionally) often work in tandem with violent partners to prevent women with migration backgrounds from leaving violent relationships. The paper draws on a perspective of institutional considerations of solidarity to unpack the relations between domestic violence, cultural constraints, and public policies but looks also at the positive experiences of women of migrant backgrounds with these Dutch policies. This research indicates that there is a lack of institutional solidarity towards women, especially those arriving as marriage migrants, who have experienced domestic violence. In exploring the intersections of domestic violence and often exclusionary state policies, the paper reflects on how The Netherlands can provide more support to those women and how intersectional justice and solidarity might be expressed. [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Psychotraumatology is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To investigate whether the use of the think-aloud method with propositional analysis could be helpful in the design of a Clinical Decision Support System (CDSS) providing guideline recommendations about long-term follow-up of childhood cancer survivors.Materials and Methods: The think-aloud method was used to gain insight into healthcare professionals' information processing while reviewing a paper-based guideline. A total of 13 healthcare professionals (6 physicians and 7 physician assistants) prepared 2 fictitious patient consults using the paper-based guideline. Propositional analysis was used to analyze verbal protocols of the think-aloud sessions. A prototype CDSS was developed and a usability study was performed, again with the think-aloud method.Results: The analysis revealed that the paper-based guideline did not support healthcare practitioners in finding patient-specific recommendations. An information processing model for retrieving recommendations was developed and used as input for the design of a CDSS prototype user interface. Usability analysis of the prototype CDSS showed that the navigational structure of the system fitted well with healthcare practitioners' daily practices.Conclusions: The think-aloud method combined with propositional analysis of healthcare practitioners' verbal utterances while they processed a paper-based guideline was useful in the design of a usable CDSS providing patient-specific guideline recommendations. [ABSTRACT FROM AUTHOR]

Flood defences are often situated in public spaces and are mostly multi‐functional, multi‐financed and multi‐managed. Cooperation in flood defence asset management is important because roles and responsibilities are fragmented within and between organisations. This complex context calls for mutual understanding from responsible role‐holders. Research has shown that serious games are instrumental to reflect situations in which technical and social complexity both play a role. Serious games motivate participants to learn and to change the way they learn. This paper presents the development, application, and results of a serious game 'Dike Dilemmas Under Pressure' that aims to create better mutual understanding between actors in flood defence asset management. The game was played with 67 professionals that fulfil a diversity of roles related to flood defence asset management in the Netherlands. The analysis of the results in this paper clearly shows different preferred cooperative attitudes between different groups of role‐holders and indicates potential misperceptions. The game participants were enthusiastic about the insights gained. They indicated that it helped them to recognise the broad variety of asset management dilemmas and become aware of their own cooperative attitudes and those of their colleagues towards dealing with these dilemmas. Future application of the game is recommended to monitor the cooperative attitudes of professionals in flood defence and to support the development of teams. [ABSTRACT FROM AUTHOR]

Flood defences are in practice often multi‐used, multi‐managed and multi‐financed. Flood defence asset management contains technical, organizational and spatial complex issues involving multiple organizations. In the literature, little attention has been given to the conditions for successful cooperation between organizations in flood defence asset management. This paper elaborates on this aspect of mature asset management from a practical point of view. Although the importance of a fit‐for‐purpose cooperation seems trivial, practice shows that the shape of cooperation is often the coincidental result of implicit or ad‐hoc choices and is not deliberately designed. This paper reports on empirical data gathered in a case consisting of five different situations related to collaboration in flood defence management. The management context consists of three main tasks: performance assessment, reinforcement and daily management, and three decision levels: strategic, tactical and operational, resulting in nine different management environments and related interfaces. For effectively achieving desired outcomes, the shape of cooperation has to be explicitly chosen dependent on the complexity of content and organizational context, and relevant external circumstances: situational cooperation. [ABSTRACT FROM AUTHOR]

In times of climate change, periods of drought will occur more frequently. This causes challenges for water use, ranging from limitations on the navigability of water courses, limited availability of water for irrigation and drinking water supply, reduced hydropower production, increasing concentrations of pollutants, deteriorating water quality, and ecosystem degradation. Dealing with droughts, however, is a complex puzzle due to the multi-level governance characteristics of international river basins and the need to meet the freshwater demands of all sectors involved. This increases the need to address drought issues in a coordinated way, along all levels of decision making. Thus far, the way this must be executed has been under-researched. This paper addresses this knowledge gap as it aims to provide design principles for good multi-level drought risk governance in international river basins. In order to meet our aim, we first reviewed literature on multi-level and good governance and established an assessment framework. This framework was applied in a case study on drought risk governance in the international Rhine basin. Policy documents were analyzed and key informants interviewed. We found that although the governance practice in the basin meets most of our framework criteria, differences between the international level, the Netherlands, Germany, and Switzerland also occurred. We have synthesized our findings into a list of 10 design principles for good multi-level drought risk governance, which could function as a starting point for the analysis and improvement of other multi-level drought risk governance practices. [ABSTRACT FROM AUTHOR]

Background: The role of patient participation and representation during crises, such as the COVID‐19 pandemic, has been under‐researched. Existing studies paint a pessimistic picture of patient representation during the pandemic. However, there are indications that patient representatives have adapted to the new situation and can contribute to the resilience of healthcare systems. This paper aims to further explore the potential contribution of patient representatives for healthcare system resilience during the COVID‐19 pandemic. Methods: The study used a qualitative approach. We conducted a thematic analysis on the following data: interviews with client council members (n = 32) and representatives from patient organizations (n = 6) and focus groups (n = 2) to investigate patient representation on both the national policy level and organizational level in the Netherlands. Results: We identified the crisis discourse, the dependent position, the diversity of patient perspectives and the layered decision‐making structure as themes that help to understand what made patient representation in pandemic times a struggle for national and local patient representatives. The analysis of the subjects these representatives put forward during decision‐making shows that their input can play an important role in broadening discussions, challenging decisions, and suggesting alternatives during a crisis. We identified several strategies (e.g., collaborating with other actors, proactively putting subjects on the policy agenda, finding new ways of contacting their 'constituency') used by the patient representatives studied to exert influence despite the difficulties encountered. Conclusions: The struggle for patient representation during pandemic decision‐making is a missed opportunity for resilient healthcare systems as these representatives can play a role in opening up discussions and putting different perspectives to the fore. Moreover, the adaptive strategies used by representatives to influence decision‐making offer lessons for future representation activities. However, adaptations to the crisis decision‐making structure are also needed to enable patient representatives to play their role. Patient Contribution: We conducted interviews with patient representatives and discussed our preliminary findings with patient representatives during the focus groups. Zorgbelang, a patient organization supporting client councils and enabling and organizing patient participation for organizations and municipalities, was partner in this research and contributed to the interview guide, conducting interviews and focus groups. Additionally, the analysis made by the first author was discussed and refined multiple times with the partners of Zorgbelang and one of them co‐authored this paper. [ABSTRACT FROM AUTHOR]

This paper presents the methodology for the construction of the KNMI'23 national climate scenarios for the Netherlands. We have developed six scenarios, that cover a substantial part of the uncertainty in CMIP6 projections of future climate change in the region. Different sources of uncertainty are disentangled as much as possible, partly by means of a storyline approach. Uncertainty in future emissions is covered by making scenarios conditional on different SSP scenarios (SSP1‐2.6, SSP2‐4.5, and SSP5‐8.5). For each SSP scenario and time horizon (2050, 2100, 2150), we determine a global warming level based on the median of the constrained estimates of climate sensitivity from IPCC AR6. The remaining climate model uncertainty of the regional climate response at these warming levels is covered by two storylines, which are designed with a focus on the annual and seasonal mean precipitation response (a dry‐trending and wet‐trending variant for each SSP). This choice was motivated by the importance of future water management to society. For users with specific interests we provide means how to account for the impact of the uncertainty in climate sensitivity. Since CMIP6 GCM data do not provide the required spatial detail for impact modeling, we reconstruct the CMIP6 responses by resampling internal variability in a GCM‐RCM initial‐condition ensemble. The resulting climate scenarios form a detailed storyline of plausible future climates in the Netherlands. The data can be used for impact calculations and assessments by stakeholders, and will be used to inform policy making in different sectors of Dutch society. Plain Language Summary: To prepare society for the effects of future climate change, we need to know what the future climate will be like. In this paper we explain the method that is used to construct six different scenarios that describe possible future climates of the Netherlands. The scenarios make assumptions about future greenhouse gas emissions, and are based on the outcomes of climate models that simulate the response of the climate to these emissions. The KNMI'23 climate scenarios show that strongly reducing global emissions strongly reduces the expected changes in the climate of the Netherlands. In the scenario in which global emissions continue to rise until 2080, Dutch society will have to adapt to a much stronger increases in heat and precipitation extremes, increased risks of droughts with low river discharge in summer, and increased risk of flooding due to high river discharges in winter. In the coming years the climate scenario data will be used to evaluate what needs to be done to keep the country a safe place for people to live in and to thrive in, under changing climate conditions. Key Points: We present a methodology for the construction of regional climate scenarios using a storyline approach to partition uncertaintyResults from CMIP6 are reconstructed with a GCM‐RCM initial condition ensemble to produce high‐resolution scenario data for end‐usersSix scenario variants cover emission uncertainty (high, moderate, low) and uncertainty in the regional response (dry‐trending, wet‐trending) [ABSTRACT FROM AUTHOR]