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Highly educated ethnic minority entrants in Western countries need more time to find a job compared to their Western ethnic majority counterparts. The present study examined whether this differential job access is partly explained by the way ethnic minorities present themselves in their résumés. To this end, a comparison between 100 non-Western ethnic minority graduate résumés and 100 native Western ethnic majority graduate résumés was made. Non-Western ethnic minorities score significantly lower on reported organisational internships, leadership experiences, and extracurricular activities. Although most effects were small, these differences in résumé content resulted in lower job suitability ratings for non-Western ethnic minorities compared to Western ethnic majorities, as judged by professional recruiters/HR experts. Résumé presentation (e.g. layout and grammar) also was a significant predictor of job suitability ratings, but no ethnicity effects were found in these résumé characteristics. Because rater effects which may be related to hiring discrimination were controlled for, it can be concluded that the reported human capital in résumés can explain differential job access of ethnic minority compared to ethnic majority graduates. Theoretical and practical implications for assessing ethnic minorities upon organisational entry are discussed. [ABSTRACT FROM AUTHOR]

BackgroundMuch is still unclear about the role of personality in the structure of common psychiatric disorders such as depressive/anxiety disorders and alcohol dependence. This study will therefore examine whether various traits of negative emotionality and impulsivity showed shared or specific associations with these disorders. Method Cross-sectional data were used from the Netherlands Study of Depression and Anxiety (NESDA), including individuals with no DSM-IV psychiatric disorder (n = 460), depressive/anxiety disorder only (i.e. depressive and/or anxiety disorder; n = 1398), alcohol dependence only (n = 32) and co-morbid depressive/anxiety disorder plus alcohol dependence (n = 358). Aspects of negative emotionality were neuroticism, hopelessness, rumination, worry and anxiety sensitivity, whereas aspects of impulsivity included disinhibition, thrill/adventure seeking, experience seeking and boredom susceptibility. Results Aspects of negative emotionality formed a homogeneous dimension, which was unrelated to the more heterogeneous construct of impulsivity. Although all aspects of negative emotionality were associated with alcohol dependence only, associations were much stronger for depressive/anxiety disorder only and co-morbid depressive/anxiety disorder with alcohol dependence. The results for impulsivity traits were less profound and more variable, with disinhibition and boredom susceptibility showing modest associations with both depressive/anxiety disorder and alcohol dependence, whereas low thrill/adventure seeking and high disinhibition were more strongly related with the first and the latter, respectively. Conclusions Our results suggest that depressive/anxiety disorder and alcohol dependence result from shared as well as specific aetiological pathways as they showed the same associations with all aspects of negative emotionality, disinhibition and boredom susceptibility as well as specific associations with thrill/adventure seeking and disinhibition. [ABSTRACT FROM AUTHOR]

Background: Maternal depression and anxiety during pregnancy have been associated with offspring-attention deficit problems. Aim: We explored possible intrauterine effects by comparing maternal and paternal symptoms during pregnancy, by investigating cross-cohort consistency, and by investigating whether parental symptoms in early childhood may explain any observed intrauterine effect. Methods: This study was conducted in two cohorts (Generation R, n = 2,280 and ALSPAC, n = 3,442). Pregnant women and their partners completed questionnaires to assess symptoms of depression and anxiety. Child attention problems were measured in Generation R at age 3 with the Child Behavior Checklist, and in ALSPAC at age 4 with the Strengths and Difficulties Questionnaire. Results: In both cohorts, antenatal maternal symptoms of depression (Generation R: OR 1.23, 95% CI 1.05-1.43; ALSPAC: OR 1.33, 95% CI 1.19-1.48) and anxiety (Generation R: OR 1.24, 95% CI 1.06-1.46; ALSPAC: OR 1.32, 95% CI 1.19-1.47) were associated with a higher risk of child attention problems. In ALSPAC, paternal depression was also associated with a higher risk of child attention problems (OR 1.11, 95% CI 1.00-1.24). After adjusting for maternal symptoms after giving birth, antenatal maternal depression and anxiety were no longer associated with child attention problems in Generation R. Moreover, there was little statistical evidence that antenatal maternal and paternal depression and anxiety had a substantially different effect on attention problems of the child. Conclusions: The apparent intrauterine effect of maternal depression and anxiety on offspring-behavioural problems may be partly explained by residual confounding. There was little evidence of a difference between the strength of associations of maternal and paternal symptoms during pregnancy with offspring-attention problems. That maternal symptoms after childbirth were also associated with offspring-behavioural problems may indicate a contribution of genetic influences to the association. [ABSTRACT FROM AUTHOR]

Objective: The responsiveness of a new participation measure, the Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-Participation) was compared with that of the Impact on Particpation and Autonomy (IPA). Furthermore, the concurrent validity of these two measures was assessed. Method: Participants were patients with brain injury or neuromuscular disease, who received occupational therapy as part of a multidisciplinary outpatient rehabilitation programme. They completed the IPA and the USER-Participation at the start and end of the programme, and at three-month follow-up. Responsiveness was analysed using the effect size (ES) and the standardized response mean (SRM). Results: Responsiveness figures were small to moderate (-0.4 to 0.5) and similar for the IPA and the USER-Participation. The USER-Participation showed a consistent result, with Frequency scores declining and Restriction and Satisfaction scores inclining over time, and the IPA showed mixed results, with the different domain scores both inclining and declining over time. Correlations between IPA and USER-Participation scales were all significant, but by far strongest for the USER-Participation Satisfaction scale (-0.64 to -0.81). Conclusion: The USER-Participation was at least as responsive as the IPA. Further, satisfaction with participation as measured with the USER-Participation is highly similar to the concept of autonomy in participation as measured with the IPA. [ABSTRACT FROM AUTHOR]

Objective This longitudinal study aims to determine which child, family and environmental variables measured at 2 years of age predict leisure participation in formal and informal activities in school aged children with cerebral palsy (CP). Methods Parents of 46 children with CP (mean age at baseline: 2 years 6 months, SD 0 years 1 month; at follow-up 6 years 7 months, SD 0 years 9 months; n = 26 boys, n = 20 girls; Gross Motor Classification System I = 30%, II = 7%, III = 28%, IV = 24%, V = 11%) completed the Children's Assessment of Participation and Enjoyment indicating their child's participation. Multivariate regression models were used to identify early predictors of participation. Results Movement ability was a significant child-related predictor for formal activities ( R2 17%, P < 0.05). Movement ability and social skills were most predictive ( R2 62%, P < 0.00) for informal activities. The feeling of being restricted in family participation was the single most predictive factor for formal and informal activities at family level ( R2 12%, P < 0.05, R2 25%, P < 0.05). Type of daycare was the only environmental variable that was predictive, and only for informal activities ( R2 16%, P < 0.05). In the overall model movement ability was most predictive for leisure participation in formal activities ( R2 17%, P < 0.05). Movement ability and social skills are the most important predictors for informal leisure participation ( R2 62%, P < 0.01). Conclusions Several variables are found to be related to formal and informal participation at age 6. Movement ability and social skills at age 2 are most predictive of leisure participation when the child is 6 years old. [ABSTRACT FROM AUTHOR]

Background The importance of a partnership between parents and professionals in the support of children with disabilities is widely acknowledged and is one of the key elements of 'family-centred care'. To what extent family-centred principles are also applied to the support of persons with profound intellectual and multiple disabilities (PIMD) is not yet known. Aim The purpose of this exploratory study was to examine what parents with a child with PIMD find important in the support of their child. In addition, we examined which child or parent characteristics influence these parental opinions. Method In total, 100 parents completed an adapted version of the Measure of Processes of Care. Mean unweighted and weighted scale scores were computed. Non-parametric tests were used to examine differences in ratings due to child (gender, age, type and number of additional disabilities, type of services used and duration of service use) and parent characteristics (gender, involvement with support and educational level). Results Parents rated situations related to ' Respectful and Supportive Care' and ' Enabling and Partnership' with averages of 7.07 and 6.87 respectively on a scale from 1 to 10. They were generally satisfied with the services provided, expressed in a mean score of 6.88 overall. The age of the child significantly affected the scores for ' Providing Specific Information about the Child'. Parents of children in the '6-12 years' age group gave significantly higher scores on this scale than did parents of children in the '≥17 years' age group ( U = 288, r = −0.34). Conclusion This study shows that parents with children with PIMD find family-centred principles in the professional support of their children important. Although the majority of parents are satisfied with the support provided for their children, a substantial minority of the parents indicated that they did not receive the support they find important. [ABSTRACT FROM AUTHOR]

Summary: In a prospective cohort study of 395 geriatric outpatients, mortality after 3 years was associated with prevalent vertebral fractures at baseline. The mortality risk was independently associated with the presence of three or more vertebral fractures at baseline. In the surviving patients, the risk of incident fractures was noteworthy, occurring in 26 % of these patients. Introduction: The purpose of this study is to determine mortality rate and the incidence of vertebral fractures in a geriatric outpatient group, during a 3-year follow-up period, in a teaching hospital in Amsterdam, The Netherlands. Methods: This study includes a prospective cohort study of 395 geriatric patients who had their baseline visit at a diagnostic day hospital in 2007 and 2008. They were invited for follow-up 3 years later. Lateral X-rays of the lumbar spine and chest were performed at baseline and after 3 years; vertebral fractures were scored in all patients according to the semi-quantitative method of Genant. Results: After 3 years, mortality was 46 % and associated with prevalent vertebral fractures at baseline (odds ratio (OR), 1.83; 95 % CI, 1.23-2.74). The presence of three or more vertebral fractures at baseline was an independent risk factor for mortality (OR, 3.32; 95 % CI, 1.56-7.07). Other independently associated risk factors were greater age, higher co-morbidity score, and having more prescriptions. Higher cognitive capacity protected against mortality after 3 years. In 72 patients, radiography was repeated. Nineteen patients (26 %) had an incident radiographic vertebral fracture: 16 in those with a prevalent fracture, and 3 in those without a prevalent vertebral fracture at baseline. Conclusions: In geriatric outpatients, mortality after 3 years was associated with prevalent vertebral fractures at baseline, and the mortality risk was independently associated with 3 or more vertebral fractures at baseline. In survivors, the risk of incident fractures was noteworthy, since these occurred in 26 % of the patients, particularly in those with a prevalent vertebral fracture. [ABSTRACT FROM AUTHOR]

Relations between maternal sensitivity and physiological reactivity to infant crying were examined using measures of heart rate (HR) and respiratory sinus arrhythmia (RSA) in 49 mothers of second-born infants. Using the Ainsworth Sensitivity Scale, an independent assessment of maternal sensitivity was made during maternal free play and bathing of their infants. Physiological reactivity was measured while mothers listened to three blocks of infant cry sounds in a standard cry paradigm. Mothers scoring high on sensitivity were compared to less sensitive mothers on both their physiological reactivity to the presented crying sounds and their physiological mean-level differences. Significant interaction effects were found for both HR and RSA. Highly sensitive mothers showed a larger increase in HR and stronger RSA withdrawal in response to the first block of cry sounds compared to less sensitive mothers. Main effects showed that highly sensitive mothers had lower mean overall HR, and higher mean RSA levels across all three blocks of crying sounds compared to less sensitive mothers. RSA withdrawal and accompanying HR increases are discussed from a polyvagal perspective as indicative of a better capability in responding to infant signals of negative affect. [ABSTRACT FROM AUTHOR]

Background The measurement of subjective well-being in people with severe and profound intellectual disabilities ( ID) is a difficult challenge. As they cannot self-report about their life satisfaction, because of severe communicative and cognitive limitations, behavioural observations of their emotions and moods are important in the measurement of their subjective well-being. It is, however, not known if observations of mood and emotion can be differentiated in people with severe and profound ID and if mood and emotions can give unique information about their affect. Therefore, the aim of this study is to examine the relationship between mood and emotions in people with severe and profound ID, using behavioural observations. As recommended in the literature, we investigated the frequency and intensity of the emotion separately. Method In a period of 3 weeks 27 participants with severe and profound ID were presented with four staff-selected negative and four staff-selected positive stimuli. During the presentation participants were videotaped using the observational method of Petry & Maes where each behaviour is coded on a 5-point scale, ranging from indicating a very negative emotion to indicating a very positive emotion. As a measure of mood, the staff completed the MIPQ in the beginning of the 3 weeks. Results We found a positive relationship between mood and respectively the total emotion score and the frequency of the emotion when the stimuli were positive but not when the stimuli were negative. There was no relationship between mood and the intensity of the emotion. Conclusions Our results indicate that mood and emotions can be distinguished from each other using behavioural observations. Both can give specific information about the affective life of people with severe or profound ID. Moreover, if further research could replicate the results of this study, an implication is that the direct support workers should be aware of a decline in the frequency of their clients reactions to positive stimuli as this could indicate a decline in their mood. [ABSTRACT FROM AUTHOR]

Background A previous study found an association between maternal cell phone use during pregnancy and maternal-reported child behaviour problems at age 7. Together with cell phones, cordless phones represent the main exposure source of radiofrequency-electromagnetic fields to the head. Therefore, we assessed the association between maternal cell phone and cordless phone use during pregnancy and teacher-reported and maternal-reported child behaviour problems at age 5. Methods The study was embedded in the Amsterdam Born Children and their Development study, a population-based birth cohort study in Amsterdam, the Netherlands (2003–2004). Teachers and mothers reported child behaviour problems using the Strength and Difficulties Questionnaire at age 5. Maternal cell phone and cordless phone use during pregnancy was asked when children were 7 years old. Results A total of 2618 children were included. As compared to non-users, those exposed to prenatal cell phone use showed an increased but non-significant association of having teacher-reported overall behaviour problems, although without dose-response relationship with the number of calls (OR=2.12 (95% CI 0.95 to 4.74) for <1 call/day, OR=1.58 (95% CI 0.69 to 3.60) for 1–4 calls/day and OR=2.04 (95% CI 0.86 to 4.80) for ≥5 calls/day). ORs for having teacher-reported overall behaviour problems across categories of cordless phone use were below 1 or close to unity. Associations of maternal cell phone and cordless phone use with maternal-reported overall behaviour problems remained non-significant. Non-significant associations were found for the specific behaviour problem subscales. Conclusion Our results do not suggest that maternal cell phone or cordless phone use during pregnancy increases the odds of behaviour problems in their children. [ABSTRACT FROM AUTHOR]

Background. To evaluate long-term local control, survival, radiation side effects and functional outcome after limb-sparing surgery followed by postoperative radiotherapy (RT) for soft tissue sarcoma (STS). Material and methods. Between 1995 and 2010, 118 patients with STS of an extremity were treated with limb-sparing surgery and postoperative RT. Follow-up was complete for all patients. Acute and late radiation related toxicities were scored using CTCAE v4.0. Results. Median follow-up was 93 months. RT dose was 60 Gy in 92.4% of the patients; 5.1% received 66 Gy; 2.5% 50-56 Gy. Actuarial local recurrence rates at five and 10 years were 9% and 12%. Five- and 10-year overall survival rates were 69% and 51%. Acute radiation toxicities occurred in 91% of the patients; 19% were grade 3, 2% grade 4. Late radiation toxicities were reported in 71% of the patients: 50% grade 1, 18% grade 2, and 3% grade 3. Limb and joint function after treatment were good, 19% having mild limitation of motion, 1.5% moderate, and 2.5% severe limitations. Conclusion. Limb-sparing surgery with 60 Gy postoperative radiotherapy for patients with STS provides excellent local control and high survival rates with acceptable toxicity and functional outcomes. [ABSTRACT FROM AUTHOR]

Previous research established that children with ADHD and comorbid anxiety have a later age of ADHD onset, show less off-task and hyperactive behavior, and have more school problems than children with ADHD alone. Comorbid anxiety appears to ameliorate behavioral inhibition deficits, worsen working memory problems, and lengthen reaction times in ADHD. This study investigated the effect of comorbid anxiety on a broad range of neurocognitive functions and includes child-, parent- and teacher reports of anxiety. The sample consisted of 509 children in the age range 5-19 years, including 238 children with a diagnosis of ADHD combined subtype and 271 normal control children. Children were tested on a broad battery of neurocognitive tasks that proved highly sensitive to ADHD in previous work. Linear Structural Equation Modeling (SEM) was used to estimate the effect of comorbid anxiety on the neurocognitive functions. Child reported anxiety was associated with slower motor speed and response speed and better behavioral inhibition. Teacher reported anxiety was related to worse time production. Parent reported anxiety was not significantly associated with any of the neurocognitive functions. Compared to parent and teacher reports of anxiety, child reported comorbid anxiety shows foremost the largest associations with the neurocognitive dysfunctions observed in children with ADHD. This stresses the importance of including child self-reported anxiety assessments in clinical and research practice. [ABSTRACT FROM AUTHOR]

Aim: To measure functional recovery and determine risk factors for failure to return to the prefracture level of mobility of hip fracture patients 1 year postoperatively. Methods: A prospective cohort follow-up study of 390 hip fracture patients aged 65 years and older was carried out. Patients were stratified in categories based on prefracture mobility: mobile without aid, with aid in- and outdoors, or only mobile indoors. Immobile patients were excluded. Risk factors for not regaining prefracture mobility were identified. Results: Nearly half of all patients regained their prefracture level of mobility after 1 year. Mobile patients without an aid were less likely to return to their prefracture mobility level compared with patients who were mobile with aid or mobile indoors. After 1 year, 18.7% of all patients had become immobile. Most important independent risk factors for failure to return to the prefracture level of mobility were a limited prefracture level of activities of daily living and a delirium during admission. Conclusions: The risk not to regain prefracture mobility is highest in mobile patients without an aid. The risk of becoming immobile is higher in those having a lower prefracture mobility. Activities of daily living dependence and delirium were the main risk factors for not regaining mobility. Geriatr Gerontol Int 2013; 13: 334-341. [ABSTRACT FROM AUTHOR]

Background: The incidence of soccer (football) injuries is among the highest in sports. Despite this high rate, insufficient evidence is available on the efficacy of preventive training programmes on injury incidence. Objective: To systematically study the evidence on preventive exercise-based training programmes to reduce the incidence of injuries in soccer. Data sources: The databases EMBASE/MEDLINE, PubMed, CINAHL, Cochrane Central Register of controlled trials, PEDro and SPORTDiscus™ were searched for relevant articles, from inception until 20 December 2011. The methodological quality of the included studies was assessed using the PEDro scale. Study selection: The inclusion criteria for this review were (1) randomized controlled trials or controlled clinical trials; (2) primary outcome of the study is the number of soccer injuries and/or injury incidence; (3) intervention focusing on a preventive training programme, including a set of exercises aimed at improving strength, coordination, flexibility or agility; and (4) study sample of soccer players (no restrictions as to level of play, age or sex). The exclusion criteria were: (1) the article was not available as full text; (2) the article was not published in English, German or Dutch; and (3) the trial and/or training programme relates only to specific injuries and/or specific joints. To compare the effects of the different interventions, we calculated the incidence risk ratio (IRR) for each study. Results: Six studies involving a total of 6,099 participants met the inclusion criteria. The results of the included studies were contradictory. Two of the six studies (one of high and one of moderate quality) reported a statistical significant reduction in terms of their primary outcome, i.e. injuries overall. Four of the six studies described an overall preventive effect (IRR<1), although the effect of one study was not statistically significant. The three studies that described a significant preventive effect were of high, moderate and low quality. Conclusions: Conflicting evidence has been found for the effectiveness of exercise-based programmes to prevent soccer injuries. Some reasons for the contradictory findings could be different study samples (in terms of sex and soccer type) in the included studies, differences between the intervention programmes implemented (in terms of content, training frequency and duration) and compliance with the programme. High-quality studies investigating the best type and intensity of exercises in a generic training programme are needed to reduce the incidence of injuries in soccer effectively. [ABSTRACT FROM AUTHOR]

Objective. To study the impact of generalized joint hypermobility (GJH) in professional dancers on physical fitness, musculoskeletal complaints and psychological distress.Methods. Thirty-six professional dancers were recruited and compared with control subjects (mean age 20.1, range 17–27). Height, weight, Beighton score, physical fitness (walking distance, muscle strength, estimated VO2max), musculoskeletal complaints (pain, fatigue) and psychological distress (anxiety, depression) were measured.Results. Univariate analysis revealed, in between-group analysis, that dancers (with and without GJH) had higher physical fitness [the six-minute walk test (6MWT): ΔD = +8.4%, P = 0.001; VO2max: ΔD = +12.8%, P = 0.01], fatigue (checklist individual strength: ΔD = +80.3%, P < 0.0001) and greater psychological distress (Hospital Anxiety and Depression Scale: ΔD = +115.0%, P < 0.0001). When comparing dancers and control subjects with GJH to those without GJH, lower levels of physical fitness (muscle strength: ΔD = −11.3%, P < 0.0001; 6MWT: ΔD = −9.9%, P < 0.0001), more fatigue (checklist individual strength: ΔD = +84.4%, P < 0.0001) and greater psychological distress (Hospital Anxiety and Depression Scale: ΔD = +79.6%, P < 0.0001) were observed in subjects with GJH. Multivariate analysis showed that dancers have higher levels of physical fitness (6MWT, P = 0.001; VO2max, P = 0.020); however, when taking GJH into account, this advantage disappeared, indicating lower levels of physical fitness in comparison with control subjects (6MWT, P = 0.001; muscle strength, P < 0.0001; VO2max, P = 0.040). Dancers experienced more fatigue (P = 0.001) and psychological distress (P < 0.0001). This was associated with even more fatigue (P = 0.010) and psychological distress (P = 0.040) when GJH was present.Conclusion. Dancers with GJH seem more vulnerable to musculoskeletal and psychological complaints. In addition, GJH was also associated with lower physical fitness, despite training. Caregivers for professional dancers should monitor closely the physical capabilities and the amount of psychological strain. [ABSTRACT FROM PUBLISHER]

This study uses a multi-level approach to examine the moderating influence of two aspects of the ethical context on the relationship between ethical leadership and follower helping and courtesy. Using multi-source data from a field sample of leaders and followers and controlling for transformational leadership, we found that shared perceptions of moral awareness and empathic concern of the work group moderated the relationship between ethical leadership and follower helping and courtesy. Relationships between individual and group-level perceptions of ethical leadership and these two follower behaviors were positive when moral awareness was low, whereas these relationships weakened when moral awareness was higher. The relationship between individual and group perceptions of ethical leadership and courtesy was positive when empathic concern was high, whereas this relationship weakened when empathic concern was lower. Thus, although ethical leadership relates positively to follower helping and courtesy, the strength of this relationship differs depending on the level of empathic concern and moral awareness in the work group. [ABSTRACT FROM AUTHOR]

The present study was conducted with the aim to identify comorbid psychiatric disorders in children with autism spectrum disorders (ASD) ( n = 40) and to compare those comorbidity rates to those in children with attention deficit hyperactivity disorder (ADHD) ( n = 40). Participants were clinically referred children aged 7-18 years. DSM-IV classifications were used for the primary diagnosis (ASD/ADHD), while comorbid psychiatric disorders were assessed using a structured diagnostic interview, the structured clinical interview for DSM-IV, childhood diagnoses (KID-SCID). Twenty-three children with ASD (57.5 %) had at least one comorbid disorder, whereas 16 children with ADHD (40.0 %) were classified as having at least one comorbid disorder. No group differences were found with respect to this comorbidity rate or for the rate of comorbid externalizing disorders (ODD and/or CD). However, children with ASD had more comorbid internalizing disorders compared to children with ADHD. More specifically, children with ASD had higher rates of anxiety disorders, but not mood disorders. No associations between comorbidity and age or between comorbidity and the intelligence quotient was found. It is important for clinicians to always be aware of, and screen for, comorbidity, and to consider treatment for these comorbid disorders. In addition, research should focus on establishing valid and reliable screening tools as well as effective treatment options for these comorbid disorders. [ABSTRACT FROM AUTHOR]

Objective:To investigate: (1) the course of coronary heart disease risk factors (lipid profiles and body mass index (BMI)) in the first five years after discharge from inpatient spinal cord injury (SCI) rehabilitation and (2) the association between lifestyle (physical activity, self-care related to fitness, smoking, alcohol, body mass and low-fat diet) and coronary heart disease risk factors during that period.Design:Prospective cohort study.Participants/methods:Individuals with SCI (N=130). Total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides (TG) and BMI were determined at discharge from inpatient rehabilitation and 1 and 5 years after discharge. Using multilevel regression models, the effects of lifestyle (drinking alcohol, smoking, active lifestyle and self-care) on the lipid profiles and BMI were determined.Results:After correction for lesion and personal characteristics, no changes in lipid profiles in the five years after discharge were seen, whereas the BMI increased significantly with 1.8 kg m−2. A high percentage was at risk of cardiovascular disease due to high BMI (63-75%) or HDL (66-95%). The individuals who indicated to maintain their fitness level as good as possible and the individuals with a low BMI showed better lipid profiles. Individuals with a more active lifestyle showed higher HDL levels. Individuals who avoid smoking showed a 1.5 kg m−2 higher BMI.Conclusion:Lipid profiles seem to stabilize in the years after discharge from inpatient SCI rehabilitation, whereas the BMI increased. Lifestyle factors associated with a favorable lipid profile and BMI could be identified. [ABSTRACT FROM AUTHOR]

Purpose: Identification of risk factors for impaired renal function at hospital discharge in critically ill patients with acute kidney injury (AKI) requiring renal replacement therapy (RRT). Methods: A single-center retrospective cohort study was performed evaluating demographic and clinical parameters as potential risk factors for a modest to severely impaired renal function at hospital discharge in patients with AKI requiring RRT in the intensive care unit. Results: Of the 353 patients in our cohort, 90 (25.5%) patients had pre-existing chronic kidney disease (CKD). An estimated glomerular filtration rate (eGFR) ≤60 mL min-1 1.73 m-2 at hospital discharge occurred in 64.0% of which 63.7% without known renal impairment before hospital admission and 8.2% of all cases left the hospital dialysis-dependent. Multivariable logistic regression showed that age (OR = 1.051, P < .001), serum creatinine concentration at start of RRT (OR = 1.004, P < .001) and administration of iodine-containing contrast fluid (OR = 0.830, P = .045) were associated with an eGFR ≤60 mL min-1 1.73 m-2. Furthermore, a medical history of CKD (OR = 5.865, P < .001) was associated with dialysis dependence. Conclusions: Elderly and patients with pre-existing CKD are at a high risk for modest to severely impaired renal function at hospital discharge after AKI requiring RRT. [ABSTRACT FROM AUTHOR]

Little is known about the extent to which transplant recipients face emotional problems with the receipt of a transplanted organ. The Transplant Effects Questionnaire (TxEQ) enables the quantification of these problems. This study evaluates the psychometric properties of the Dutch translation of the TxEQ (TxEQ-NL) in a group of liver transplant recipients. Confirmatory factor analyses of the TxEQ-NL revealed an adequate fit with the original version. However, four items showed factor loadings <.40. Internal consistency was acceptable (.66-.79). The small correlations between the TxEQ-NL and generic measures of psychological functioning indicated that the constructs measured are related but distinguishable. Therefore, the TxEQ-NL adds a new dimension to the measurement of psychological functioning of transplant recipients. © 2013 Wiley Periodicals, Inc. Res Nurs Health 36:203-215, 2013 [ABSTRACT FROM AUTHOR]

This study separately assessed the associations of maternal and paternal psychological distress during pregnancy with early growth in preschool children. The study was based on data from a population-based cohort study involving 5,283 children and their parents (with data collected beginning in early pregnancy) in Rotterdam, the Netherlands, from 2002 to 2006. Information on parental psychological distress (symptoms of depression, anxiety, hostility, and family stress) was obtained by questionnaire in the second trimester of gestation by using the Brief Symptom Inventory and the “general functioning” subscale of the McMaster Family Assessment Device. Child height, weight, and body mass index (weight (kg)/height (m)2) were measured repeatedly from age 3 months to age 4 years. We observed no consistent associations between overall maternal psychological symptoms, depression, anxiety, or hostility and child height, weight, or body mass index after adjustment for confounders. All maternal psychological distress scores were positively associated with the risk of overweight in childhood; however, these associations attenuated toward the null and became nonsignificant after adjusting for potential confounders. We did not observe consistent associations between paternal psychological distress and growth in childhood. These results indicate that social, behavioral, or environmental factors that cluster with parental psychological distress may explain the previously suggested associations between maternal psychological distress and early childhood growth and risk of overweight. [ABSTRACT FROM PUBLISHER]

Although homophobic verbal victimization has been associated with negative mental health outcomes, little actually is known about its general prevalence and relationship to mental health among adolescents. In addition, the relationship of homophobic name-calling to mental health in gender non-conforming adolescents is not well understood. This study examined the relationship between homophobic verbal victimization and mental health in adolescents, accounting for their sexual orientation and level of gender non-conformity. Survey data was collected from 513 adolescents (ages 11-17) who attended eight schools in and around Amsterdam, the Netherlands; 56.7 % of the participating adolescents were female and 11.1 % reported same-sex attractions. As hypothesized, male adolescents and those with same-sex attractions were more likely to report victimization from homophobic name-calling than were their female and non-same-sex attracted peers. Contrary to expectations, homophobic name-calling was not independently associated with psychological distress after controlling for gender, sexual attractions, gender non-conformity, and other negative treatment by peers. The hypothesis that homophobic name-calling would be more strongly associated with psychological distress in male, same-sex attracted, and gender non-conforming adolescents was also not supported. The results suggest that same-sex attracted and gender non-conforming youth are particularly vulnerable to homophobic name-calling, in the Netherlands as in other contexts, but also that other forms of peer victimization may be more strongly related to mental health. [ABSTRACT FROM AUTHOR]

Background: many instruments are available to identify frail older adults who may benefit from geriatric interventions. Most of those instruments are time-consuming and difficult to use in primary care.Objective: to select a valid instrument to identify frail older adults in primary care, five simple instruments were compared.Methods: instruments included clinical judgement of the general practitioner, prescription of multiple medications, the Groningen frailty indicator (GFI), PRISMA-7 and the self-rated health of the older adult. Fried's frailty criteria and a clinical judgement by a multidisciplinary expert panel were used as reference standards. Data were used from the cross-sectional Dutch Identification of Frail Elderly Study consisting of 102 people aged 65 and over from a primary care practice in Amsterdam. In this study, frail older adults were oversampled. We estimated the accuracy of each instrument by calculating the area under the ROC curve. The agreement between the instruments and the reference standards was determined by kappa.Results: frailty prevalence rates in this sample ranged from 11.6 to 36.4%. The accuracy of the instruments ranged from poor (AUC = 0.64) to good (AUC = 0.85).Conclusion: PRISMA-7 was the best of the five instruments with good accuracy. Further research is needed to establish the predictive validity and clinical utility of the simple instruments used in this study. [ABSTRACT FROM AUTHOR]

Background: The dopamine D4 receptor gene (DRD4) has been linked to attention deficit hyperactivity disorder (ADHD) and reading disorders. In this study, we examined whether diminished anticipatory dopamine cell firing - typical of the long variant of the DRD4 allele - is related to emergent and advanced alphabetic skills, and whether executive attention is a mediator between this allele and alphabetic skills. Method: We tested alphabetic skills in a normative sample of 159 children in both kindergarten and Grade 1, and executive attention 1 year earlier. Cheek cells were collected and genomic DNA was isolated from the samples using the Chemagic buccal swab kit on a chemagen Module I workstation. Results: Thirty-seven percent of the children were carriers of at least one DRD4 7-repeat allele. Carriers of the long variant scored lower on alphabetic skills, and executive attention appeared to be a mediator of the relation between characteristics of DRD4 and alphabetic skills in kindergarten and first grade. Conclusion: This study shows how a genetic factor which has been shown to relate to variation in attention and regulatory behavior can explain delays in alphabetic skills. A practical implication is that in many cases early interventions should not only target reading skills, but also support children's engagement in tasks. [ABSTRACT FROM AUTHOR]

The article discusses a randomized controlled trial conducted on cost-effectiveness and return-on-investment analysis of a worksite vitality intervention among older hospital workers. The intervention was for six months and consisted of yoga and aerobic exercises. Result was neither cost-effective nor cost-saving.

Aim We studied the effects of early mother-child relationship quality and child temperament on the development of child compliance and active resistance in a large population-based cohort study ( n= 534). Background Parenting and the quality of the parent-child relationship can either hamper or support the development of child compliance directly or in interplay with child temperament. Methods Mother-infant dyads were observed at 14 and 36 months and maternal and child behaviours were independently coded. The quality of compliance was assessed at 36 months in a clean-up task. Child behaviour was coded using a system differentiating between two dimensions: Compliance and Active Resistance. Results Controlling for concurrent maternal sensitivity, child temperament, and gender children with a more insecure attachment relationship showed higher levels of active resistance during Clean-Up than more securely attached children. The effect was stronger for boys than for girls and mainly driven by attachment avoidance. Conclusions Early attachment is an important contributor to child socialization of moral behaviour. [ABSTRACT FROM AUTHOR]

Aim: To investigate impacts of practice environment factors, nurse perceptions of workload and self-reported burnout at the unit-level on job outcomes and nurse-assessed quality of care in psychiatric hospitals. Background: Associations between practice environments and nurse and patient outcomes have been widely described in acute care hospitals in nursing research examining variables primarily at the respondent level. Research on this topic in psychiatric hospitals is sparse. Design: A cross-sectional design with a survey. Method: Samples of registered nurses, licenced practical nurses and non-registered caregivers from 32 clinical units in two psychiatric hospitals were surveyed. Validated instruments were used to measure work environment, workload, burnout, job outcomes and nurse-perceived quality of care. Unit-level associations were examined using multilevel modelling techniques. Results: Multiple multilevel models identified depersonalization and nurse-physician relations as predictors of turnover intentions and quality of care of the interdisciplinary team. Ratings of nursing management at the unit level were predictors of all of the quality of care variables. Emotional exhaustion was predictive of quality of care at the unit level. While workload was correlated with burnout, it was not predictive of any of the outcomes examined in multiple multilevel models. Conclusion: While relatively low levels of burnout and fairly favourable job and quality of care outcomes were reported by the mental health personnel surveyed, differences across units in ratings of practice environment factors such as nurse-physician relations and nurse management as well as levels of depersonalization were predictive of outcomes. While most findings are consistent with those from other studies of acute care settings, some (slight) differences were also identified. [ABSTRACT FROM AUTHOR]

cramm j.m., strating m.m.h. & nieboer a.p. (2013) The influence of organizational characteristics on employee solidarity in the long-term care sector. Journal of Advanced Nursing 69(3), 526-534. doi: 10.1111/j.1365-2648.2012.06027.x Abstract Aim. This article is a report of a study that identifies organizational characteristics explaining employee solidarity in the long-term care sector. Background. Employee solidarity reportedly improves organizations' effectiveness and efficiency. Although general research on solidarity in organizations is available, the impact of the organizational context on solidarity in long-term care settings is lacking. Design. Cross-sectional survey. Method. The study was carried out in Dutch long-term care. A total of 313 nurses, managers and other care professionals in 23 organizations were involved. Organizational characteristics studied were centralization, hierarchical culture, formal and informal exchange of information and leadership style. The study was carried out in 2009. Findings. All organizational characteristics significantly correlated with employee solidarity in the univariate analyses. In the multivariate analyses hierarchical culture, centralization, exchange of formal and informal information and transformational leadership appears to be important for solidarity among nurses, managers and other professionals in long-term care organizations, but not transactional and passive leadership styles. Conclusion. The study increased our knowledge of solidarity among nurses, managers and other professionals in the long-term care settings. Organizational characteristics that enhance solidarity are high levels of formal and informal information exchange, less hierarchical authority, decentralization and transformational leadership styles. [ABSTRACT FROM AUTHOR]

Objectives. Joint pain comorbidity (JPC) is common in individuals with knee OA. This study investigates the longitudinal association between JPC and health-related quality of life (HRQoL) and physical activity levels in individuals with knee OA.Methods. Data from the progression cohort of the Osteoarthritis Initiative (n = 1233; age 61 years and 58% females) were analysed. JPC was considered present if individuals reported pain in three or more joint groups, including the knee joints. HRQoL was assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS) Quality of Life subscale, and self-reported physical activity was determined using the Physical Activity Scale for the Elderly (PASE). Generalized estimating equation (GEE) analyses were performed, adjusted for age, sex, duration of complaints, medical comorbidity, and physical and mental functioning.Results. Over the 4-year period, 32% of participants never reported JPC, whereas 12% always reported JPC. GEE modelling demonstrated that having JPC was negatively associated with HRQoL [regression coefficient β (95% CI) −3.57 (−4.69, −2.44)] and not associated with physical activity [−1.32 (−6.61, 3.98)].Conclusion. Considering the impact of JPC on the HRQoL of individuals with knee OA, the assessment of JPC in individuals with knee OA might be a daily routine. [ABSTRACT FROM AUTHOR]

Scand J Caring Sci; 2013; 27; 44-50 Are informal caregivers less happy than noncaregivers? Happiness and the intensity of caregiving in combination with paid and voluntary work Informal caregivers are one of the pillars of home health care. In the Netherlands, the free help they provide to sick or disabled family members, acquaintances or friends exceeds the number of hours of home care provided by professionals. While the government welcomes their contribution, there is concern about the potential burden their work imposes on them. On the one hand, there is concern that informal caregiving could be experienced as a burden and diminish subjective well-being; on the other, helping others as a meaningful activity might increase their subjective well-being. Happiness ratings (as an indicator of subjective well-being) of persons whose involvement in informal caregiving, voluntary work and paid work ranged from none to full time were analysed using multivariate regression models, which also took into account levels of physical disability and socio-economic characteristics (age, sex, household composition, education level). The sample consisted of 336 informal caregivers and 1765 noncaregivers in the Dutch population. In line with the subjective well-being assumption, the results suggest that caregivers are happier than noncaregivers when they provide care for <6 hours a week; and in line with the burden assumption, the results show that providing care for more than 11 hours a week is associated with lower levels of happiness. Other results contradicted the burden assumption that combining caregiving with paid or voluntary work is associated with more time burden and less happiness. The result that combining caregiving with paid employment or volunteering is related to higher rates of happiness confirms the subjective well-being assumption. It is concluded that these cross-sectional results open ways to longitudinal research that can inform governments in the development of policies to support informal caregivers. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: To compare available instruments and investigate which best measure the quality of end-of-life care (QOC) and quality of dying (QOD) in long term care settings, in terms of validity, reliability, and feasibility. Design: Family and professional caregivers of long term care decedents completed postdeath interviews and questionnaires between November 2007 and April 2009. Setting: Nursing home and residential care/assisted living settings in the United States and the Netherlands. Participants: Two hundred and sixty four families of decedents with (48%) and without (52%) dementia in the United States, and 70 families and 103 professional caregivers of decedents with dementia in the Netherlands. Measurements: Ten instruments to evaluate the QOC and QOD in long term care, an additional overall assessment of QOC/QOD, and an assessment of the perception of the relevance and ease of use of each instrument. Criteria for validity, reliability, and feasibility were set forth for good, intermediate, and poor performance. Results: None of the instruments scored positively on all criteria. In both countries, of the QOC instruments, the End-of-Life in Dementia-Satisfaction With Care (EOLD-SWC) best met the criteria, followed by the Family Assessment of Treatment at the End-of-Life Short Version, the Family Perception of Care Scale, and Family Perception of Physician-Family Caregiver Communication. Of the QOD instruments, the End-of-Life in Dementia–Comfort Assessment at Dying (EOLD-CAD) and Mini-Suffering State Examination (MSSE) met more of the criteria than others. The EOLD-CAD performed better on content and construct validity than the MSSE. The MSSE performed better on feasibility. Conclusion: We recommend the EOLD-SWC to measure QOC, and the EOLD-CAD and MSSE to measure QOD in populations with dementia and in mixed long term care populations of nursing home or residential care home/assisted living residents, because they performed best in both countries. Use of the same instruments allows for comparison of the results between studies. [Copyright &y& Elsevier]

Abstract: Objective: Previous studies suggest that care dependency may predict survival in hospitalized patients, but the prognostic value of care dependency in clinically stable outpatients with advanced chronic organ failure remains unknown. The objective of this study was to assess whether and to what extent care dependency predicts 2-year survival in patients with advanced chronic organ failure. Design: Longitudinal observational study. Setting: Patients were recruited at the outpatient clinic of one academic and six general hospitals in the Netherlands. Participants: A total of 265 clinically stable outpatients with advanced chronic obstructive pulmonary disease (n = 105), chronic heart failure (n = 80), and chronic renal failure (n = 80) were included at baseline. Measurements: Care dependency was assessed using the Care Dependency Scale (CDS), a 15-item self-administered questionnaire. In addition, patients performed a Timed Up and Go test to assess mobility. Finally, demographics, clinical characteristics, and 2-year survival were recorded. Results: At baseline, 116 patients (43.8%) reported a CDS score ≤ 68 points and were considered as care dependent. In total, 66 patients (24.9%) died within 2 years. The Cox regression model showed that a higher CDS score (lower level of care dependency) was associated with a lower probability of dying within 2 years (hazard ratio, 0.95; 95% CI: 0.90–0.97), whereas older age was associated with a greater probability of dying within 2 years (hazard ratio, 1.06; 95% CI, 1.03–1.09). Conclusion: The level of care dependency independently predicts 2-year survival among clinically stable outpatients with advanced chronic organ failure. Therefore, regular assessment of the level of care dependency should be included in clinical care for patients with advanced chronic organ failure. [Copyright &y& Elsevier]

Aims Depression is common in people with diabetes, and related to higher HbA1c levels. Depression, however, is a heterogeneous construct that involves a variety of symptoms. As little is known about the associations of individual depressive symptoms with HbA1c, we explored these associations in outpatients with diabetes. Methods The study was conducted in three tertiary diabetes clinics in the Netherlands. At baseline, the presence of the nine depressive symptoms that are listed in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition was assessed with the nine-item Patient Health Questionnaire ( PHQ-9). At baseline and after a 1-year follow-up, HbA1c was derived from the medical charts. Results A total of 288 out of 646 subjects with diabetes (45%) reported one or more depressive symptom(s). Depressed mood (β = 0.11, P = 0.005), sleeping difficulties (β = 0.16, P < 0.001), appetite problems (β = 0.15, P < 0.001) and suicidal ideation (β = 0.14, P = 0.001) were significantly related to higher baseline HbA1c values. Furthermore, depressed mood (β = 0.09, P = 0.03) sleeping difficulties (β = 0.12, P = 0.004), appetite problems (β = 0.11, P = 0.01) and psychomotor agitation/retardation (β = 0.09, P = 0.04) were significantly related to higher HbA1c values at 1-year follow-up. Associations were more pronounced in Type 1 diabetes than in Type 2 diabetes. None of the depressive symptoms were related to change in HbA1c over time, except suicidal ideation. Conclusion In people with diabetes, several individual depressive symptoms were related to higher HbA1c levels. These associations persisted over time. More research is needed to investigate potential mechanistic pathways. [ABSTRACT FROM AUTHOR]

The integration within existing health care systems of preventive initiatives to maintain independent living among older people is increasingly emphasized. This article describes the development and refinement of the [G]OLD home visitation programme: an eight-step programme, including a comprehensive geriatric assessment, for the early detection of health and well-being problems among older people (≥75 years) by general practices. A single group post-test study using a mixed model design is performed to evaluate (a) the feasibility of the home visitation programme in general practice, (b) the practical usefulness of the geriatric assessment instrument, and (c) programme implementation with respect to reinventions introduced by general practitioners (GPs) and practice nurses (PNs). Within 3 months time, 22 PNs of 18 participating general practices visited 240 community-dwelling older people (mean age = 82.0 years; SD 4.2) who had not been in contact with their general practice for more than 6 months. Mean time investment of the programme per older person was 118.1 min (SD 27.0) for GPs and PNs combined. Evaluation meetings revealed that GPs and PNs considered the home visitation programme to be feasible in daily practice. They judged the geriatric assessment to be useful, although minor adjustments are needed (e.g., lay-out, substitution of tests). PNs often failed to register follow-up actions for detected problems in a care and treatment plan. Future training for PNs should address this issue. No reinventions were introduced that threatened fidelity of implementation. The findings are used to improve the home visitation programme before its evaluation in a large-scale controlled trial. [ABSTRACT FROM AUTHOR]

Introduction To improve guideline adherence by insurance physicians (IPs), an implementation strategy was developed and investigated in a randomized controlled trial. This implementation strategy involved a multifaceted training programme for a group of IPs in applying the guidelines for depression. In this study we report the impact of the implementation strategy on the physicians' attitude, intention, self-efficacy, and knowledge and skills as behavioural determinants of guideline adherence. Any links between these self-reported behavioural determinants and levels of guideline adherence were also determined. Methods Just before and 3 months after the implementation of the multifaceted training, a questionnaire designed to measure behavioural determinants on the basis of the ASE (attitude, social norm, self-efficacy) model was completed by the intervention (n = 21) and the control group (n = 19). Items of the questionnaire were grouped to form scales of ASE determinants. Internal consistency of the scales was calculated using Cronbach's alphas. Differences between groups concerning changes in ASE determinants, and the association of these changes with improvements in guideline adherence, were analyzed using analysis of covariance. Results The internal consistency of the scales of ASE determinants proved to be sufficiently reliable, with Cronbach's alphas of at least 0.70. At follow-up after 3 months, the IPs given the implementation strategy showed significant improvement over the IPs in the control group for all ASE determinants investigated. Changes in knowledge and skills were only weakly associated with improvements in guideline adherence. Conclusions The implementation strategy developed for insurance physicians can increase their attitude, intention, self-efficacy, and knowledge and skills when applying the guidelines for depression. These changes in behavioural determinants might indicate positive changes in IPs' behaviour towards the use of the guidelines for depression. However, only changes in knowledge and skills related to the use of the guidelines were associated with improvements in IPs' actual performance when applying the guidelines. [ABSTRACT FROM AUTHOR]

Cross-sectional studies have shown a positive association between expressive suppression and depressive symptoms. These results have been interpreted as reflecting the impact of emotion regulation efforts on depression. However, it is also possible that depression may alter emotion regulation tendencies. The goal of the present study was to prospectively examine the bidirectional association between habitual use of suppression and depressive symptoms in young adolescents. Participants were 1,753 adolescents (mean age = 13.8 years) who reported their use of suppression and depressive symptoms at two time points with a 1-year interval. Suppression and depressive symptoms were correlated within each time point. Depressive symptoms preceded increased use of suppression 1 year later, but suppression did not precede future depressive symptoms. Overall, the findings suggest depressive symptoms may be a potential precursor of habitual use of suppression during adolescence. [ABSTRACT FROM AUTHOR]

Background: The realization of an organizational context that succeeds to retain nurses within their job is one of the most effective strategies of dealing with nursing shortages. Objectives: First, to examine the impact of nursing practice environments, nurse staffing and nurse education on nurse reported intention to leave the hospital. Second, to provide understanding of which best practices in the organization of nursing care are being implemented to provide sound practice environments and to retain nurses. Methods: 3186 bedside nurses of 272 randomly selected nursing units in 56 Belgian acute hospitals were surveyed. A GEE logistic regression analysis was used to estimate the impact of organization of nursing care on nurse reported intention to leave controlling for differences in region (Walloon, Flanders, and Brussels), hospital characteristics (technology level, teaching status, and size) and nurse characteristics (experience, gender, and age). For the second objective, in-depth semi-structured interviews with the chief nursing officers of the three high and three low performing hospitals on reported intention to leave were held. Results: 29.5% of Belgian nurses have an intention-to-leave the hospital. Patient-tonurse staffing ratios and nurse work environments are significantly (p < 0.05) associated with intention-to-leave. Interviews with Chief Nurse Officers revealed that high performing hospitals showing low nurse retention were - in contrast to the low performing hospitals - characterized by a flat organization structure with a participative management style, structured education programs and career opportunities for nurses. Conclusion: This study, together with the international body of evidence, suggests that investing in improved nursing work environments is a key strategy to retain nurses. [ABSTRACT FROM AUTHOR]

BackgroundThe extent to which specific factors influence diagnostic delays in dementia is unclear. Therefore, the aim of the present study was to compare duration from symptom onset to diagnosis for young-onset dementia (YOD) and late-onset dementia (LOD) and to assess the effect of age at onset, type of dementia, gender, living situation, education and family history of dementia on this duration.MethodData on 235 YOD and 167 LOD patients collected from caregivers from two prospective cohort studies were used. Multiple linear regression analysis was performed.ResultsThe duration between symptom onset and the diagnosis of YOD exceeded that of LOD by an average of 1.6 years (2.8 v. 4.4 years). Young age and being diagnosed with frontotemporal dementia were related to increases in the time to diagnosis. Subjects with vascular dementia experienced shorter time to diagnosis.ConclusionsThere is a need to raise special awareness of YOD to facilitate a timely diagnosis. [ABSTRACT FROM PUBLISHER]

Objective: Commercially available virtual reality systems can possibly support rehabilitation objectives in training upper arm function in children with Cerebral Palsy (CP). The present study explored the effect of the Nintendo Wii™ training on upper extremity function in children with CP. Methods: During six weeks, all children received twice a week training with the Wii™, with their most affected arm. The Melbourne Assessment of Upper Limb Function and ABILHAND-Kids were assessed pre- and post- training. In addition, user satisfaction of both children and health professionals was assessed after training. Enjoyment in gaming was scored on a visual analogue scale scale after each session by the children. Results: Fifteen children with CP participated in the study. The quality of upper extremity movements did not change (−2.1, p > 0.05), while a significant increase of convenience in using hands/arms during performance of daily activities was found (0.6, p < 0.05). Conclusion: Daily activities seem to be easier performed after Wii™ training for most of the included children with CP. [ABSTRACT FROM AUTHOR]

timmermans o., van linge r., van petegem p., van rompaey b. & denekens j. (2012) A contingency perspective on team learning and innovation in nursing. Journal of Advanced Nursing 69(2), 363-373. doi: 10.1111/j.1365-2648.2012.06014.x Abstract Aims. To report a correlational study of the relation between team learning activities and implementation-effectiveness of innovations in nursing teams. Background. Non-compliance to implementation of innovations is a problem in nursing teams. In the literature, team learning is proposed as a facilitator for change. Still, studies reporting the effects of team learning activities on the implementation of innovations in nursing teams are scarce. To address this gap in the literature, this study explored the influence of team learning on the implementation of two innovations. Design. A cross-sectional survey. Methods. The survey was conducted in 2008-2009 with a sample of 469 nurses, representing 30 nursing teams from The Netherlands and Belgium. The relationship between variables representing team learning and the use and the knowledge of an incremental ( n = 14) or a radical innovation ( n = 16) was examined by correlation and multiple regression analyses. Results. Correlation analyses revealed positive relationships between the team learning activities handling production-oriented information and implementation-effectiveness of an incremental innovation. In addition, team learning activities about development-oriented information positively affected the implementation of a radical innovation. Multiple regression yielded models that explain 83% of the variance on the use of an incremental variable, 73% on knowledge of a radical innovation, and 80% on use of a radical innovation. Conclusion. In nursing teams, team learning activities that relate to the production of nursing care affect the implementation of an incremental innovation. The implementation of a radical innovation is effected by team learning activities that relate to the development of the provided nursing care. [ABSTRACT FROM AUTHOR]

Context During clinical rotations, students move from one clinical situation to another. Questions exist about students' strategies for coping with these transitions. These strategies may include a process of social comparison because in this context it offers the student an opportunity to estimate his or her abilities to master a novel rotation. These estimates are relevant for learning and performance because they are related to self-efficacy. We investigated whether student estimates of their own future performance are influenced by the performance level and gender of the peer with whom the student compares him- or herself. Methods We designed an experimental study in which participating students ( n = 321) were divided into groups assigned to 12 different conditions. Each condition entailed a written comparison situation in which a peer student had completed the rotation the participant was required to undertake next. Differences between conditions were determined by the performance level (worse, similar or better) and gender of the comparison peer. The overall grade achieved by the comparison peer remained the same in all conditions. We asked participants to estimate their own future performance in that novel rotation. Differences between their estimates were analysed using analysis of variance ( anova). Results Students' estimates of their future performance were highest when the comparison peer was presented as performing less well and lowest when the comparison peer was presented as performing better (p < 0.001). Estimates of male and female students in same-gender comparison conditions did not differ. In two of three opposite-gender conditions, male students' estimates were higher than those of females (p < 0.001 and p < 0.05, respectively). Conclusions Social comparison influences students' estimates of their future performance in a novel rotation. The effect depends on the performance level and gender of the comparison peer. This indicates that comparisons against particular peers may strengthen or diminish a student's self-efficacy, which, in turn, may ease or hamper the student's learning during clinical rotations. The study is limited by its experimental design. Future research should focus on students' comparison behaviour in real transitions. [ABSTRACT FROM AUTHOR]

Objective: To investigate the relationships between public stigma, stigma by association (SBA), psychological distress, perceived closeness, perceived heredity, and the type of family relationship among family members of people with a mental illness. Method: In this cross-sectional survey, data from 527 family members of people with a mental illness were analyzed. Results: Perceptions of public stigma were found to be positively related to SBA and SBA correlated with greater psychological distress and less perceived closeness. SBA also mediated relationships between perceived public stigma and psychological distress, and between perceived public stigma and perceived closeness. Further, among participants who reported SBA, immediate family members showed lower levels of perceived closeness than extended family members. Also, the perceived heredity of mental illness was associated with perceptions of public stigma and psychological distress. Conclusion: The findings suggest that family members of people with a mental illness could benefit from education on mental illnesses, their treatment, and the extent to which they are hereditary. Additionally, particular attention should be paid to the psychological needs that arise from being a caregiver of someone with a mental illness. [ABSTRACT FROM AUTHOR]

Study design:Retrospective cohort study.Objective:To assess development of arm hand skilled performance (AHSP) during and after in-patient rehabilitation in persons with cervical spinal cord injury (CSCI) and to determine factors that influence the outcome.Setting:Eight rehabilitation centres in the Netherlands with specialised spinal cord injury departments.Methods:AHSP was assessed using the Van Lieshout test (VLT) in persons admitted with recent CSCI. Assessment was carried out at the beginning (t1), after 3 months (t2), at the end (t3) of in-patient rehabilitation, and 1 and 5 years thereafter (t4, t5). Multilevel regression analysis was performed to determine development of AHSP and associations between AHSP and age, gender, motor completeness, lesion level (high or low CSCI), motor scores of upper extremity (MSUE), and pain in the tested arm.Results:Fifty-five participants were included with mean age 38 years (range 18-64). There were 73% male, 80% had high CSCI (C3-C6) and 69% had motor complete lesion. Scores of VLT improved significantly during in-patient rehabilitation (mean: t1=25; t3=33) (P=0.005), scores remained unchanged at 1 year (t4=32) and 5 years (t5=32) (P=0.903) after in-patient rehabilitation. Motor completeness, MSUE and pain were significantly related to the VLT score (P<0.001, P<0.001, P=0.015, respectively). Age, gender and lesion level had no significant relationship.Conclusion:AHSP improved during in-patient rehabilitation. It was then stable during the next 5 years after discharge. Persons with an incomplete lesion, high MSUE and no pain in the tested arm perform best on the VLT. [ABSTRACT FROM AUTHOR]

Introduction and purpose: The controversy between the 'scoop and run' versus the 'stay and play' approach in severely injured trauma patients has been an ongoing issue for decades. The present study was undertaken to investigate whether changes in prehospital care for patients with severe traumatic brain injury in the Netherlands have improved outcome. Methods: In this retrospective study, files ( n = 60) were analyzed from a prospectively collected database including all patients admitted to one of six hospitals in the Limburg region in the Netherlands with a Glasgow Coma Scale (GCS) score ≤8 on admittance over the period from January 2006 to December 2008. All patients had traumatic brain damage proven on computed tomography (CT) or magnetic resonance imaging (MRI). Relevant prehospital and clinical data from the present cohort were compared to data from a similar study ( n = 30) conducted 20 years ago. The primary outcome assessed was mortality. Results: The two study groups had similar characteristics with regard to the GCS score. In the historic cohort, Basic Life Support (BLS) and the 'scoop and run' approach in patients with major traumatic brain injury was common, with an average time on scene of 7.5 min. Currently, prehospital care is performed mainly on the level of prehospital Advanced Life Support (ALS), with the average time on scene being about four times as long as in the historic cohort. However, the overall mortality rate for the current cohort compared to the historic cohort has not changed. Conclusion: Despite more on-site ALS in severely head injured patients nowadays compared to the historic cohort, there was no reduction in mortality. [ABSTRACT FROM AUTHOR]

Background: Neuroimaging findings have provided evidence for a relation between variations in brain structures and Attention Deficit/Hyperactivity Disorder (ADHD). However, longitudinal neuroimaging studies are typically confined to children who have already been diagnosed with ADHD. In a population-based study, we aimed to characterize the prospective association between brain structures measured during infancy and executive function and attention deficit/hyperactivity problems assessed at preschool age. Methods: In the Generation R Study, the corpus callosum length, the gangliothalamic ovoid diameter (encompassing the basal ganglia and thalamus), and the ventricular volume were measured in 784 6-week-old children using cranial postnatal ultrasounds. Parents rated executive functioning at 4 years using the Behavior Rating Inventory of Executive Function-Preschool Version in five dimensions: inhibition, shifting, emotional control, working memory, and planning/organizing. Attention Deficit/Hyperactivity Problems were assessed at ages 3 and 5 years using the Child Behavior Checklist. Results: A smaller corpus callosum length during infancy was associated with greater deficits in executive functioning at 4 years. This was accounted for by higher problem scores on inhibition and emotional control. The corpus callosum length during infancy did not predict Attention Deficit/Hyperactivity Problem at 3 and 5 years, when controlling for the confounders. We did not find any relation between gangliothalamic ovoid diameter and executive function or Attention Deficit/Hyperactivity Problem. Conclusions: Variations in brain structures detectible in infants predicted subtle impairments in inhibition and emotional control. However, in this population-based study, we could not demonstrate that early structural brain variations precede symptoms of ADHD. [ABSTRACT FROM AUTHOR]

The article focuses on a study conducted to evaluate the importance of process of intervention and explore the link between process measures and compliance. The study was carried out through mindfulness intervention program based on the intervention mapping protocol It reveals that mindfulness intervention program was implemented well on the level of mindfulness training but poorly on e coaching and homework time investment.