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Student--teacher gender congruence is suggested to be related to increased student performance, but little is known about the contexts in which these effects occur. Based on literature on gender stereotypes this study hypothesizes different effects of student-teacher gender congruence for male and female students across school subjects and in different educational contexts. Using administrative data of secondary schools in The Netherlands (N > 50,000), this study examined to what extent student-teacher gender congruence is associated with male and female students' performance in the subjects math, physics, Dutch language, and French language. Further this study explored the role of students' educational level, schools' religiousness, and schools' location in these relations. As expected, we found that gender congruence was positively related to female students' performance in math and physics and to male students' performance in Dutch language and French language. However, the role of educational context differed for male and female students across subjects and lacked a clear pattern that corresponded to the gender stereotypes hypotheses. This study emphasizes that effects of student-teacher gender congruence can differ in magnitude and direction in different contexts, encouraging future research to use qualitative methods to examine how context influences the role of gender in education.

This cross-national European comparison examined gender representation and stereotypes in mathematics and language textbooks from Germany, Italy, Lithuania, the Netherlands and Romania. The results showed that female characters were numerically underrepresented. Female characters were also less often a main character or individually portrayed compared to male characters, but not proportionally to the overall lower number of female characters. Characters in occupational roles were less often female than male, whereas among characters with gender non-conform characteristics, these were more often female than male in some textbooks. There was no sexual diversity among characters. The differences in gender representation are found within each country, but gender differences were smaller in more gender-egalitarian countries. If textbooks are to offer the same learning benefits to both boys and girls, students should be equally represented in a diversity of roles and occupations.

This study applies a "within-family, age-snapshot design" to investigate differences between siblings in the development of compliance during the preschool years by disaggregating situational, within-family, and between-family effects. The aim of the study was to investigate the relation between sibling differences in compliance and the within-family factors birth order and differential parenting, as well as interactions between these factors. Using observational data of 311 Dutch families (self-identified as culturally Dutch) with 2 children when each child was 3 and 4 years old (firstborns: 36.2 months old; SD = 3.6; 48% girls, second-borns (2 years later): 36.67 months old; SD = 0.62; 47% girls) and both parents. Three-level cross-classified multilevel models showed main effects of observed sibling noncompliance and differential verbal discipline on noncompliance. In addition, second-born children were more compliant than their firstborn siblings, but only when the firstborn was disciplined physically more often than his/her younger sibling. The results provide evidence that birth-order effects may partially be explained by differential parenting and suggest that differences between siblings cannot be fully understood without taking into account the influence of both direct and indirect sibling effects.

In this study, we examined gender and sexuality representation in language and math textbooks for Dutch secondary education. We analyzed all male and female characters in 13 language textbooks (N = 7,347) and 12 math textbooks (N = 4,591). Our results confirmed our expectations based on the theory of the hidden curriculum: female characters were underrepresented in all textbooks (40% in language, 44% in math textbooks), but overrepresented in household tasks and EHW (Education, Health, and Welfare) professions. Male characters were overrepresented in occupational roles, especially in STEM (Science, Technology, Engineering, and Math) professions and technical tasks. Further, female characters in language textbooks were overrepresented in parental roles, and male characters were overrepresented among characters with disharmonious traits and behaviors. We found no characters from sexual minorities in any of the textbooks. In conclusion, in line with theories of the hidden curriculum, Dutch textbooks include gender stereotypic messages and are heteronormative. These findings are relevant in light of previous studies demonstrating the negative impact of these biases on children. Publishers and schools that want to be more inclusive are recommended to be more critical in their selection of stories and role models in their books.

The emotional availability scales (EAS), 4th edition, are widely used in research and clinical practice to assess the quality of parent-child interaction. This study examined the short-term reliability and continuity of the EAS (4th ed.) assessed in two similar observational contexts over a one-week interval. Sixty-two Dutch parents (85% mothers) and their 9- to 12-month-old infants (M[subscript age] = 10.07 months, SD = 0.47, 53% boys) were videotaped twice while they interacted with each other during several tasks (free play, structured play, book reading, toys taken away). The videotapes were coded with the EAS 4th edition by two reliable coders. Moderate to strong test-retest reliability was found for the three EA parent-dimensions: sensitivity, structuring, and nonintrusiveness. Child involvement was not reliable over a one-week period, and child responsiveness could only be reliably assessed in boys. Test-retest reliability of structuring was also higher for boys than for girls. Regarding continuity, mean levels of sensitivity, structuring, nonintrusiveness, and involvement did not change over a one-week interval, but responsiveness increased for girls only. Thus, the parenting dimensions of the 4th edition of the EAS reflect stable and consistent characteristics of the parent-child dyad on the short term, but the child measures do not.

This study examined parent-child similarities in homophobic attitudes and observed parental discomfort with coming-out vignettes in interactions with their adolescent children (14–18 years old). Based on gender schema theory and the family process model we expected parent-child similarities in homophobic attitudes to be stronger in same-gender dyads. Further, we expected that observed parental discomfort with coming-out vignettes would occur and is stronger when the gender of the parent, child, and character in the vignette match. We used questionnaires and observation data from 199 White Dutch families in the Netherlands. Our results showed that parents' homophobic attitudes were associated with their children's homophobic attitudes. For same-sex kissing and (imagining) having a gay son, these associations were stronger between parents and children of the same gender. Further, parental discomfort with coming-out vignettes occurred and was stronger when parents and children had the same gender, regardless of the gender of the vignette character. In conclusion, policies aiming at gay and lesbian inclusion should not be limited to accepting gay/lesbian identities, but also pay attention to the acceptance of same-sex intimacy expressions, having gay or lesbian family members, and normalizing discussions about gay/lesbian lives. [ABSTRACT FROM AUTHOR]

To examine the effects of child age and birth order on sensitive parenting, 364 families with 2 children were visited when the second-born children were 12, 24, and 36 months old, and their older siblings were on average 2 years older. Mothers showed higher levels of sensitivity than fathers at all assessments. Parental sensitivity increased from infancy to toddlerhood, and then decreased into early childhood. The changes in parental sensitivity with child age were similar for mothers and fathers, and mothers' and fathers' sensitivity levels were related over time. However, the changes in parental sensitivity toward the firstborn and second-born child were not related to each other, suggesting that parents' experiences with the firstborn child do not have implications for their sensitivity toward their second-born child. Instead, the child's own unique characteristics and developmental stage seem to play a more important role. These findings highlight the importance of considering developmental child characteristics in the study of parenting, and suggest that individual differences in attaining developmental milestones may affect parental sensitivity.

Background Confirming the efficacy of dolutegravir/lamivudine in clinical practice solidifies recommendations on its use. Methods Prospective cohort study (DUALING) in 24 human immunodeficiency virus (HIV) treatment centers in the Netherlands. HIV RNA–suppressed cases were on triple-drug antiretroviral regimens without prior virological failure or resistance and started dolutegravir/lamivudine. Cases were 1:2 matched to controls on triple-drug antiretroviral regimens by the use of dolutegravir-based regimens, age, sex, transmission route, CD4+ T-cell nadir, and HIV RNA zenith. The primary endpoint was the treatment failure rate in cases versus controls at 1 year by intention-to-treat and on-treatment analyses with 5% noninferiority margin. Results The 2040 participants were 680 cases and 1380 controls. Treatment failure in the 390 dolutegravir-based cases versus controls occurred in 8.72% and 12.50% (difference: −3.78% [95% confidence interval {CI}, −7.49% to.08%]) by intention-to-treat and 1.39% and 0.80% (difference: 0.59% [95% CI, –.80% to 1.98%]) by on-treatment analyses. The treatment failure risk in 290 non-dolutegravir-based cases was also noninferior to controls. Antiretroviral regimen modifications unrelated to virological failure explained the higher treatment failure rate by intention-to-treat. A shorter time on triple-drug antiretroviral therapy and being of non-Western origin was associated with treatment failure. Treatment failure, defined as 2 consecutive HIV RNA >50 copies/mL, occurred in 4 cases and 5 controls but without genotypic resistance detected. Viral blips occured comparable in cases and controls but cases gained more weight, especially when tenofovir-based regimens were discontinued. Conclusions In routine care, dolutegravir/lamivudine was noninferior to continuing triple-drug antiretroviral regimens after 1 year, supporting the use of dolutegravir/lamivudine in clinical practice. Clinical Trials Registration NCT04707326. [ABSTRACT FROM AUTHOR]

This study examined adolescents' gender‐stereotypic attitudes towards HEED (Health care, Early Education, Domestic) occupations and gender‐stereotypic interest in HEED careers and the role of parental gender‐stereotypic attitudes, role model behaviour and socialization values. We used questionnaire data from 501 White Dutch families. Our results showed that adolescents' gender‐stereotypic attitudes towards HEED predicted their stereotypic interest in these careers. Further, parental gender‐stereotypic attitudes, stereotypical role model behaviour and socializing values of self‐expression predicted adolescents' gender‐stereotypic attitudes towards HEED. From these parental characteristics, only a stereotypic division of household tasks predicted boys' lower interest in HEED careers. In conclusion, reducing gender‐stereotypic attitudes and, for boys, encouraging self‐expression seems important in fostering more male representation in HEED occupations and deserves more attention from policymakers, educators and parents. [ABSTRACT FROM AUTHOR]

Background: The childcare environment offers a wide array of developmental opportunities for children. Providing children with a feeling of security to explore this environment is one of the most fundamental goals of childcare. Objective: In the current study the effectiveness of Video-feedback Intervention to promote Positive Parenting-Child Care (VIPP-CC) was tested on children's wellbeing in home-based childcare in a randomized controlled trial. Methods: Forty-seven children and their caregivers were randomly assigned to the intervention group or control group. Children's wellbeing, caregiver sensitivity, and global childcare quality were observed during a pretest and a posttest. Results: We did not find an overall intervention effect on child wellbeing, but a significant interaction effect with months spent with a trusted caregiver was present. Children who were less familiar with the caregiver showed an increase in wellbeing scores in both the intervention and control group, but for the group of children who were more familiar with the caregiver, wellbeing increased only in the intervention group. Conclusions: Although there was no overall effect of the VIPP-CC on children's wellbeing, the VIPP-CC seems effective in children who have been cared for by the same trusted caregiver for a longer period of time.

Sharing is an important indicator of internalised prosocial values. We examined predictors of sharing of 302 preschoolers with their younger siblings in a one-year longitudinal study. Sharing was observed during different home visits, once with father and once with mother. We examined the following predictors: both children's externalising behaviour, observed parental sensitivity, and situational factors. Preschoolers' sharing was stable and increased with age. Preschoolers shared more when sharing was preceded by a structured interaction with a parent compared to free play with an unfamiliar adult. At age 4 they shared more in fathers' presence than in mothers' presence. Neither parental sensitivity nor child behaviour were related to sharing. These findings demonstrate stability and the importance of situational factors in the development of prosocial behaviour.

Background: An important element of value-based health care (VBHC) is interprofessional collaboration in integrated practice units (IPUs) for the delivery of the complete cycle of care. High levels of interprofessional collaboration between clinical and nonclinical staff in IPUs are assumed rather than proven. Factors that may stimulate interprofessional collaboration in the context of VBHC are underresearched. Purpose: The aim of this study was to examine relational coordination (RC) in VBHC and its antecedents. Approach: A questionnaire was used to examine the association of both team practices and organizational conditions with interprofessional collaboration in IPUs. Gittell's Relational Coordination Survey was drawn upon to measure interprofessional collaboration by capturing the relational dynamics in coordinated working. The questionnaire also included measures of team practices (team meetings and boundary spanning behavior) and organizational conditions (task interdependence and time constraints). Results: The number of different professional groups participating in team meetings is positively associated with RC in IPUs. Boundary spanning behavior, task interdependence, and time constraints are not associated with RC. Conclusions: In IPUs, the diversity within interprofessional team meetings is important for establishing high-quality communication and relationships. Practice Implications: Hospital managers should prioritize facilitating and encouraging shared meetings to enhance RC levels among professional groups in IPUs. [ABSTRACT FROM AUTHOR]

The current study examined professional caregivers' perceived and physiological stress, and associations with the quality of care they provide. Participants were 55 female caregivers from childcare homes and 46 female caregivers from childcare centers in the Netherlands. In both types of settings, equivalent measures and procedures were used. On non-work days, caregivers' salivary cortisol levels decreased between 11 am and 3 pm, whereas on work days, caregivers' cortisol levels remained at the same level during this period. Caregivers' cortisol levels and perceived stress did not differ across the two types of settings. In home-based childcare, caregivers offered higher-quality caregiving, compared to caregivers in center-based childcare. In home-based childcare--but not in center care--caregivers' negative appraisal was associated with less positive caregiver behavior. These findings suggest that work at childcare influences cortisol secretion in professional caregivers, and that perceived stress but not cortisol is associated with quality of care. (Contains 3 tables and 2 figures.)

A cross-country comparison of children's cortisol levels at child care was performed in relation to their cortisol levels at home and the quality and quantity of child care they received. Participants were toddlers visiting child care centers in Spanish Basque Country (N = 60) and the Netherlands (N = 25) with substantial variation in structural child care quality (group sizes, child:caregiver ratios). Salivary cortisol was measured at mid-morning and mid-afternoon, both at child care and at home. Children's actual experiences in child care (global quality), as measured with the Early Childhood Environment Rating Scale-Revised edition (ECERS-R), did not differ significantly across the two countries. Overall, children did not produce more cortisol at child care than at home. Results suggest that factors other than structural quality and quantity of care are responsible for cortisol diurnal changes. Global quality matters in explaining cortisol diurnal change in children visiting child care centers. (Contains 1 figure and 6 tables.)

Purpose: The aims of this study are: to present a training evaluation based on the "four levels model"; to demonstrate the value of experimental designs in evaluation studies; and to take a first step in the development of an evidence-based training program. Design/methodology/approach: The Kirkpatrick four levels model was used to evaluate the effectiveness of management training. Hypotheses about the effects of internal/external "locus" of control and experiential learning styles were tested. Measures gathered at several points of time were compared to measures taken from a control group. "Level four" results were obtained by 360-degree feedback appraisal. Findings: Trainees' knowledge improved significantly. Trained managers also demonstrated more "good" management behaviors and they scored higher on long-term results. Trained supervisors with an internal "locus" of control acquired more knowledge than trained supervisors with an external "locus" of control. However, internals did not differ significantly from externals on actual behavior measures. The hypothesized relationship between learning style and training effectiveness was not supported. The four levels method gives detailed insights in results. Attention should be paid to trainees' "locus" of control. Originality/value: The paper outlines the value of the "four levels model" of training evaluations and contributes to the "theory-based, evidence-based" approach to the development of training programs. (Contains 6 tables and 2 figures.)

In this study, we examined gender and sexuality representation in language and math textbooks for Dutch secondary education. We analyzed all male and female characters in 13 language textbooks (N = 7,347) and 12 math textbooks (N = 4,591). Our results confirmed our expectations based on the theory of the hidden curriculum: female characters were underrepresented in all textbooks (40% in language, 44% in math textbooks), but overrepresented in household tasks and EHW (Education, Health, and Welfare) professions. Male characters were overrepresented in occupational roles, especially in STEM (Science, Technology, Engineering, and Math) professions and technical tasks. Further, female characters in language textbooks were overrepresented in parental roles, and male characters were overrepresented among characters with disharmonious traits and behaviors. We found no characters from sexual minorities in any of the textbooks. In conclusion, in line with theories of the hidden curriculum, Dutch textbooks include gender stereotypic messages and are heteronormative. These findings are relevant in light of previous studies demonstrating the negative impact of these biases on children. Publishers and schools that want to be more inclusive are recommended to be more critical in their selection of stories and role models in their books. [ABSTRACT FROM AUTHOR]

To describe the course of depressive symptoms during the first 12 months post-stroke and its association with unmet needs. A prospective cohort study among stroke patients admitted to inpatient rehabilitation. Depressive symptoms were assessed 3, 6, and 12 months post-stroke using the Hospital Anxiety and Depression Scale, and categorized into three trajectories: no (all times <8), non-consistent (one or two times ≥8), or persistent (all times ≥8) depressive symptoms. Unmet needs were assessed using the Longer-Term Unmet Needs questionnaire. Multivariable logistic regression analyses were used to investigate the association between depressive symptoms and unmet needs. One hundred and fifty-one patients were included, of whom 95 (62.9%), 38 (25.2%), and 18 (11.9%) had no, non-consistent, or persistent depressive symptoms, respectively. Depressive symptoms three months post-stroke persisted in 43.9% and recurred in 19.5% of patients during the first 12 months post-stroke. Depressive symptoms were significantly associated with the occurrence and number of unmet needs (odds ratio 6.49; p = 0.003 and odds ratio 1.28; p = 0.005, respectively). Depressive symptoms three months post-stroke were likely to persist or recur during the first 12 months post-stroke. Depressive symptoms are associated with unmet needs. These results suggest that routine monitoring of depressive symptoms and unmet needs should be considered post-stroke. Patients with depressive symptoms three months post-stroke have a high risk of developing persistent or recurrent depressive symptoms during the first 12 months post-stroke. Unmet needs are associated with both non-consistent and persistent depressive symptoms post-stroke. These results suggest that health professionals should routinely screen for depressive symptoms and health care needs around three months post-stroke. In patients with depressive symptoms at three months post-stroke early treatment of depressive symptoms and addressing unmet needs should be considered and depressive symptoms should be routinely monitored during the first 12 months post-stroke. [ABSTRACT FROM AUTHOR]

Although public management and human resource management research has extensively investigated the motivational effects of organizational rules, the original utility of organizational rules—uncertainty reduction—has remained overlooked. This study takes a cognitive perspective by examining how organizational rules relate to uncertainty experiences of public professionals. In this study, we provide a dynamic perspective on the relationship between organizational rules and uncertainty through a 2-week daily online diary study among 65 public professionals in the Netherlands. The results indicate that the amount and consistency of rules are related to professionals' daily uncertainty experiences. Moreover, within-person experiences of rules and uncertainty are highly variable over time. We argue that a cognitive perspective of uncertainty reduction can broaden our understanding of the consequences of organizational rules in managing people, and that the dynamic nature of organizational rule experiences cannot be a mere footnote in future public administration and human resource management research. [ABSTRACT FROM AUTHOR]

Selective M1 muscarinic acetylcholine receptor (mAChR) agonists are being developed as symptomatic treatment for neurodegenerative and neuropsychiatric disorders that lead to cognitive dysfunction. Demonstrating cognition‐enhancing effects in early‐phase clinical development in healthy subjects is difficult. A challenge with the M1 mAChR antagonist biperiden could be used to demonstrate procognitive and pharmacological effects of selective M1 mAChR agonists. The aim of this study was to develop such a model. To this end, 12 healthy elderly subjects participated in a randomized, placebo‐controlled, 3‐way crossover study investigating tolerability, pharmacokinetic (PK) and pharmacodynamic (PD) effects of 2 and 4 mg biperiden. Repeated PD assessments were performed using neurocognitive tasks and electrophysiological measurements. A population PK‐PD model was developed. Four milligrams of biperiden showed significant impairment of sustained attention (−2.1 percentage point in adaptive tracking [95%CI, −3.043 to −1.148], verbal memory (2‐3 fewer words recalled [95%CI, −5.9 to −0.2]) and working memory (up to a 50‐millisecond increase in the n‐back task reaction time [95%CI, 21.854‐77.882]) compared with placebo. The PK data were best fitted by a 2‐compartment model and showed high interoccasion and intersubject variability. Population PK‐PD analysis quantified significant concentration‐effect relationships for the n‐back reaction time, n‐back accuracy, and adaptive tracking. In conclusion, biperiden caused M1 mAChR‐related dose‐ and concentration‐dependent temporary declines in cognitive functioning. Therefore a biperiden pharmacological challenge model can be used for proof‐of‐pharmacology studies and to demonstrate cognition‐enhancing effects of new cholinergic compounds that are being developed. [ABSTRACT FROM AUTHOR]

Introduction: HTL0018318 is a selective muscarinic M1 receptor partial agonist under development for the symptomatic treatment of dementias, including Alzheimer's disease. Clinically, HTL0018318 would likely be used alone or in conjunction with cholinesterase inhibitors (e.g. donepezil). Objective: We investigated the safety, tolerability, and pharmacokinetics of HTL0018318 given alone and in combination with donepezil. Methods: This was a randomized, double-blind, placebo-controlled trial in 42 (to deliver 36 with combination treatment) healthy elderly subjects investigating the effects of oral HTL0018318 15 and 25 mg given alone and combined with donepezil 10 mg at steady state on adverse events (AEs), vital signs, saliva production, sleep quality, pulmonary function, subjective feelings, and pharmacokinetics. Results: AEs were reported by lower percentages of subjects after HTL0018318 alone than after donepezil alone. There was no increase in the percentage of subjects reporting AEs after co-administration than after donepezil alone. Supine systolic blood pressure was 1.6 mmHg (95% confidence interval [CI] −3.1 to −0.1) lower after HTL0018318 alone than after combination treatment. This was comparable with results from placebo alone: 1.7 mmHg (95% CI −3.2 to 0.2) lower than with combination treatment. Supine pulse rate was 3.3 bpm (95% CI 1.5–5.1) higher after HTL0018318 alone than with co-administration. HTL0018318 and donepezil did not meaningfully affect each other's pharmacokinetics. Conclusion: HTL0018318 was well tolerated when given alone and in combination with donepezil. HTL0018318 and donepezil do not demonstrate pharmacokinetic or pharmacodynamic interactions, indicating that HTL0018318 can be safely administered in combination with donepezil. Clinical trial registration: Netherlands Trial register identifier NL5915, registered on 28 October 2016. [ABSTRACT FROM AUTHOR]

BACKGROUND: Improving communication and information services for people receiving a total joint (knee or hip) arthroplasty (TJA) depends on the differences in patient communication needs and personal characteristics. PURPOSE: The purpose of this study was to further examine individual differences in TJA patient preferences regarding communication and information provision. METHODS: Nineteen patients participated in generative research, which meant they actively reflected on their TJA experiences and communication preferences through creative exercises (e.g., collage making). Audio transcripts of their shared reflections were qualitatively analyzed through an inductive approach. RESULTS: Some participants wanted detailed health education, others did not. Participants also reported different support needs (e.g., at hospital discharge or during rehabilitation). Moreover, participant preferences for social connections with care providers differed. CONCLUSIONS: An individual patient's mindset, his or her social support needs, physical condition, and medical history should guide the provision of tailored services. [ABSTRACT FROM AUTHOR]

Background: FLU-v is a broad-spectrum influenza vaccine that induces antibodies and cell-mediated immunity.Objective: To compare the safety, immunogenicity, and exploratory efficacy of different formulations and dosing regimens of FLU-v versus placebo.Design: Randomized, double-blind, placebo-controlled, single-center phase 2b clinical trial. (ClinicalTrials.gov: NCT02962908; EudraCT: 2015-001932-38).Setting: The Netherlands.Participants: 175 healthy adults aged 18 to 60 years.Intervention: 0.5-mL subcutaneous injection of 500 µg of adjuvanted (1 dose) or nonadjuvanted (2 doses) FLU-v (A-FLU-v or NA-FLU-v) or adjuvanted or nonadjuvanted placebo (A-placebo or NA-placebo) (2:2:1:1 ratio).Measurements: Vaccine-specific cellular responses at days 0, 42, and 180 were assessed via flow cytometry and enzyme-linked immunosorbent assay. Solicited information on adverse events (AEs) was collected for 21 days after vaccination. Unsolicited information on AEs was collected throughout the study.Results: The AEs with the highest incidence were mild to moderate injection site reactions. The difference between A-FLU-v and A-placebo in the median fold increase in secreted interferon-γ (IFN-γ) was 38.2-fold (95% CI, 4.7- to 69.7-fold; P = 0.001) at day 42 and 25.0-fold (CI, 5.7- to 50.9-fold; P < 0.001) at day 180. The differences between A-FLU-v and A-placebo in median fold increase at day 42 were 4.5-fold (CI, 2.3- to 9.8-fold; P < 0.001) for IFN-γ-producing CD4+ T cells, 4.9-fold (CI, 1.3- to 40.0-fold; P < 0.001) for tumor necrosis factor-α (TNF-α), 7.0-fold (CI, 3.5- to 18.0-fold; P < 0.001) for interleukin-2 (IL-2), and 1.7-fold (CI, 0.1- to 4.0-fold; P = 0.004) for CD107a. At day 180, differences were 2.1-fold (CI, 0.0- to 6.0-fold; P = 0.030) for IFN-γ and 5.7-fold (CI, 2.0- to 15.0-fold; P < 0.001) for IL-2, with no difference for TNF-α or CD107a. No differences were seen between NA-FLU-v and NA-placebo.Limitation: The study was not powered to evaluate vaccine efficacy against influenza infection.Conclusion: Adjuvanted FLU-v is immunogenic and merits phase 3 development to explore efficacy.Primary Funding Source: SEEK and the European Commission Directorate-General for Research and Innovation, European Member States within the UNISEC (Universal Influenza Vaccines Secured) project. [ABSTRACT FROM AUTHOR]

Introduction and aim: Many caregivers of stroke patients experience a high burden. This study aims to describe the course of burden in individual caregivers in the first year after stroke. Methods: This study is part of the Stroke Cohort Outcomes of REhabilitation study, a multicentre, longitudinal cohort study including consecutive stroke patients admitted to two rehabilitation facilities. Caregivers were asked to complete the Caregiver Strain Index and questions on their sociodemographic characteristics 6 and 12 months post admission. Patients' sociodemographic and clinical characteristics were extracted from medical records. Results: A total of 129 caregivers were included, 72 completed the Caregiver Strain Index twice. Of them, 19 (26.4%) were men, median age 59 (range 27–78) years. A consistently high or low burden was reported by 15 (20.8%) and 49 (68.1%), respectively, whereas 8 (11.1%) reported a high burden at either 6 (n = 3) or 12 months (n = 5). Discussion: In the majority of caregivers of stroke patients the perceived caregiver burden is consistent over time. However, as in 11.1% caregiver burden changes from 6 to 12 months, caregiver burden should be measured repeatedly until 12 months after stroke. Caregivers living together with a patient who suffered a haemorrhagic stroke seem to be more at risk for a high burden. Many caregivers of stroke patients experience a high burden. The Caregiver Strain Index score at 6 months is a good predictor for the score at 12 months. In some caregivers the high burden is not yet present at 6 months, therefore monitoring caregiver burden throughout the first year after stroke seems warranted. Caregivers living together with a patient who suffered a haemorrhagic stroke seem to be more at risk for a high burden. [ABSTRACT FROM AUTHOR]

Background: Little is known of the vitamin D status of young infants and toddlers and its determinants in West Europe. The prevalence and determinants of vitamin D deficiency of children aged 6–48 months in the centre of the Netherlands (52°N) is investigated. Methods: In a cross-sectional population study, randomly recruited infants and toddlers (n = 150) were studied using an online questionnaire and a physical examination either in late summer (n = 52) or in late winter (n = 98). Vitamin D analysis was performed by capillary blood sampling using dried bloodspots plus LC-MS/MS. Results: In late winter, 32% of the children were vitamin D deficient (<50 nmol/L 25OH vitamin D3) with 5% severely deficient (<25 nmol/L). In late summer, 2% were deficient. The odds of vitamin D deficiency were higher in children aged 24–48 months, for those not using formula milk and those not adhering to the supplementation guidelines. Conclusion: One-third of Dutch infants and toddlers were found to be vitamin D deficient in late winter. Suggested strategies for raising the vitamin D status may include improving the adherence to supplementation, a sensible sun exposure or the use of fortified foods. Special attention is needed for the children aged 24–48 months. [ABSTRACT FROM AUTHOR]

This study evaluates feasibility of a multidisciplinary intervention combining occupational counselling with physical exercise to enhance cancer patients’ return to work, assesses whether care providers and patients were satisfied with the intervention, and describes barriers to and facilitators of execution. Newly diagnosed cancer patients, treated with chemotherapy and on sick leave from (self‐)employment participated. Patients received counselling from an oncological occupational physician (OOP), were assessed by a sports physician, and performed a 12‐week training programme supervised by physiotherapists. Care providers completed registration forms to collect data on reach, dose delivered and received in executing the protocol and were interviewed about their satisfaction and barriers to and facilitators of execution. Patients completed three questionnaires on satisfaction and usefulness of the intervention. Fifty‐six per cent of all patients were eligible (reach). In total, 123 patients participated. For all intervention components dose delivered exceeded 75%; dose received ranged from 49%–79%. Overall, patients and care providers were satisfied and perceived the intervention as useful. Care providers considered the intervention feasible, while execution was facilitated by highly motivated patients and impeded by physical limitations hindering exercise. It is feasible to conduct this multidisciplinary intervention in cancer patients during curative treatment. Patients and care providers were satisfied with the intervention. [ABSTRACT FROM AUTHOR]

In line with psychological and economic discrimination theories, street‐level bureaucracy studies show a direct effect of citizen characteristics on officials' judgements, or show how street‐level bureaucrats employ stereotypical reasoning in making decisions. Relying on sociological double standards theory, this study hypothesizes that citizen‐clients' status characteristics influence officials' evaluations not only directly, but also indirectly and more pervasively by influencing the interpretation of other signals. By means of a policy‐capturing study among Dutch frontline tax officials, this study takes a first step in testing double standards propositions in the context of official–citizen encounters. The findings support only some hypotheses, but indicate that citizen‐clients' level of education could serve as a moderating context affecting the interpretation of cues. The article provides important theoretical and methodological guidelines for future research on stereotyping at the front line. [ABSTRACT FROM AUTHOR]

Background: Clusters of infectious diseases are frequently detected late. Real-time, detailed information about an evolving cluster and possible associated conditions is essential for local policy makers, travelers planning to visit the area, and the local population. This is currently illustrated in the Zika virus outbreak.Methods: In the Netherlands, ICARES (Integrated Crisis Alert and Response System) has been developed and tested on three syndromes as an automated, real-time tool for early detection of clusters of infectious diseases. From local general practices, General Practice Out-of-Hours services and a hospital, the numbers of routinely used syndrome codes for three piloted tracts i.e., respiratory tract infection, hepatitis and encephalitis/meningitis, are sent on a daily basis to a central unit of infectious disease control. Historic data combined with information about patients' syndromes, age cohort, gender and postal code area have been used to detect clusters of cases.Results: During the first 2 years, two out of eight alerts appeared to be a real cluster. The first was part of the seasonal increase in Enterovirus encephalitis and the second was a remarkably long lasting influenza season with high peak incidence.Conclusions: This tool is believed to be the first flexible automated, real-time cluster detection system for infectious diseases, based on physician information from both general practitioners and hospitals. ICARES is able to detect and follow small regional clusters in real time and can handle any diseases entity that is regularly registered by first line physicians. Its value will be improved when more health care institutions agree to link up with ICARES thus improving further the signal-to-noise ratio. [ABSTRACT FROM AUTHOR]

Objective. With depression being present in approximately 20% of people with type 2 diabetes mellitus (T2DM), we expect equally frequent prescription of antidepressants, anxiolytics, and hypnotics. Nevertheless, prescription data in people with T2DM is missing and the effect of depression on glycaemic control is contradictory. The aim of this study was to assess the prevalence of antidepressants, anxiolytics, and/or hypnotics use in a large, managed, primary care system cohort of people with T2DM and to determine the sociodemographic characteristics, comorbidities, T2DM medication, and metabolic control associated with its use. Method. The prevalence of antidepressants, anxiolytics, and/or hypnotics use in the years 2007–2012 was assessed in the Hoorn Diabetes Care System Cohort from the Netherlands. Results. From the 7016 people with T2DM, 500 people (7.1%) used antidepressants only, 456 people (6.5%) used anxiolytics and/or hypnotics only, and 254 people (3.6%) used a combination. Conclusion. We conclude that in our managed, primary care system 17% of all people with T2DM used antidepressants, anxiolytics, and/or hypnotics. Users of antidepressants, anxiolytics, and/or hypnotics were more often female, non-Caucasian, lower educated, and more often treated with insulin. [ABSTRACT FROM AUTHOR]

This longitudinal study examines the association between child gender and child aggression via parents' physical control, moderated by parents' gender-role stereotypes in a sample of 299 two-parent families with a 3-year-old child in the Netherlands. Fathers with strong stereotypical gender-role attitudes and mothers were observed to use more physical control strategies with boys than with girls, whereas fathers with strong counterstereotypical attitudes toward gender roles used more physical control with girls than with boys. Moreover, when fathers had strong attitudes toward gender roles (stereotypical or counterstereotypical), their differential treatment of boys and girls completely accounted for the gender differences in children's aggressive behavior a year later. Mothers' gender-differentiated parenting practices were unrelated to gender differences in child aggression. [ABSTRACT FROM AUTHOR]

The current study focuses on the effects of sibling gender configuration on family processes during early childhood. In a sample of 369 two-parent families with two children (youngest 12 months, oldest about 2 years older), both siblings’ noncompliant and oppositional behaviors and fathers’ and mothers’ sensitivity and discipline strategies were observed. Both siblings’ aggressive behaviors and empathy of the oldest sibling were assessed with parent-reports. Children in families with two sons showed more problematic interaction patterns compared with children in families with an oldest girl. In families with two boys, older siblings were more aggressive and fathers were less sensitive toward their youngest child in comparison with families with two girls. Furthermore, in boy–boy families older siblings showed more oppositional behavior and younger siblings more noncompliance compared with girl–boy families. These findings highlight the importance of sibling gender configuration in the development of child behavior and parent–child interactions. [ABSTRACT FROM AUTHOR]

In this study we tested whether the relation between fathers' and mothers' psychopathology symptoms and child social-emotional development was mediated by parents' use of emotion talk about negative emotions in a sample of 241 two-parent families. Parents' internalizing and externalizing problems were measured with the Adult Self Report and parental emotion talk was observed while they discussed a picture book with their children (child age: 3 years). Children's parent-reported internalizing and externalizing problems and observed prosocial behaviors were assessed at the age of 3 years and again 12 months later. We found that mothers' use of emotion talk partially mediated the positive association between fathers' internalizing problems and child internalizing problems. Fathers' internalizing problems predicted more elaborative mother-child discussions about negative emotions, which in turn predicted more internalizing problems in children a year later. Mothers' externalizing problems directly predicted more internalizing and externalizing problems in children. These findings emphasize the importance of examining the consequences of parental psychological difficulties for child development from a family-wide perspective. [ABSTRACT FROM AUTHOR]

Background: Return-to-work (RTW)-interventions support cancer survivors in resuming work, but come at additional healthcare costs. The objective of this study was to assess the budget impact of a RTW-intervention, consisting of counselling sessions with an occupational physician and an exercise-programme. The secondary objective was to explore how the costs of RTW-interventions and its financial revenues are allocated among the involved stakeholders in several EU-countries.Methods: The budget impact (BI) of a RTW-intervention versus usual care was analysed yearly for 2015-2020 from a Dutch societal- and from the perspective of a large cancer centre. The allocation of the expected costs and financial benefits for each of the stakeholders involved was compared between the Netherlands, Belgium, England, France, Germany, Italy, and Sweden.Results: The average intervention costs in this case were €1,519/patient. The BI for the Netherlands was €-14.7 m in 2015, rising to €-71.1 m in 2020, thus the intervention is cost-saving as the productivity benefits outweigh the intervention costs. For cancer centres the BI amounts to €293 k in 2015, increasing to €1.1 m in 2020. Across European countries, we observed differences regarding the extent to which stakeholders either invest or receive a share of the benefits from offering a RTW-intervention.Conclusion: The RTW-intervention is cost-saving from a societal perspective. Yet, the total intervention costs are considerable and, in many European countries, mainly covered by care providers that are not sufficiently reimbursed. [ABSTRACT FROM AUTHOR]

Children with younger brothers or sisters are exposed to parenting directed towards themselves as well as parenting directed towards their siblings. We examined the hypothesis that mothers' and fathers' sensitive parenting towards their second-borns predicts compliance and sharing behavior in their firstborns, over and above their parenting towards their firstborns. In a sample of 388 families with a toddler and infant, parental sensitivity, child sharing behavior, and child compliance were observed during two different home visits, one with father and one with mother present. The results showed that toddlers shared more with their younger siblings and showed more compliance when their fathers were more sensitive towards them, but only if fathers showed low sensitivity towards the younger siblings. We suggest two explanations: toddlers may show more positive behavior to ensure continuation of their favored position, or they may compensate for the lack of fathers' sensitivity towards the younger siblings. Our study highlights the importance of the broader family context of parenting for child socio-emotional development. [ABSTRACT FROM AUTHOR]

Objective.This study examines mothers’ and fathers’ gender talk with their daughters and sons and investigates the association between parental gender talk and parental implicit gender stereotypes.Design.Mothers’ and fathers’ gender talk was examined in 304 families with two children aged 2 and 4 years old, using the newly developedGender Stereotypes Picture Book. Parental implicit gender stereotypes were assessed with the action inference paradigm.Results.The picture book elicited different forms of gender talk, including use of gender labels, evaluative comments related to gender, and comments about gender stereotypes. Mothers used positive evaluative comments more than fathers to convey messages about gender, but fathers made more comments confirming gender stereotypes than mothers. Fathers with two boys were more inclined to emphasize appropriate male behavior in their gender talk than fathers in other family types. Implicit gender stereotypes were associated with gender talk to the children only for mothers.Conclusion.The assessment of gender talk with theGender Stereotypes Picture Bookcan provide insights into the roles of mothers and fathers in child gender socialization. [ABSTRACT FROM PUBLISHER]

Aim To analyse the impact of six job characteristics on the intention of nurses to leave their organization, specifically focusing on long-term care settings: nursing homes, care homes and home care. Background When nurses leave their organization, this can negatively affect organizational performance. Organizations have to recruit new nurses and tacit knowledge is lost. Furthermore, organizational turnover could contribute to the nursing shortage, which will increasingly become a problem given the ageing population. This article adds to the literature, given: (a) its focus on long-term care; and (b) by explicating the differences between nursing and care homes (intramural) on one hand and home care (extramural) on the other. Design Survey. Method Survey of 9982 nurses in 156 Dutch organizations in 2010-2011, 6321 nurses in nursing and care homes and 3661 nurses working in home care, based on the ActiZ Benchmark in Healthcare. Results First, the most important reason for nurses' intention to leave is insufficient development and career opportunities. Secondly, a negative working atmosphere strongly influenced intention to leave. The impact of the working atmosphere is not often examined in the literature. However, this research shows that it is an important reason. Thirdly, intention to leave is partly context dependent. More specifically, when nurses in home care felt that their autonomy was reduced, this strongly influenced their intention to leave, although this was not the case for nurses working in nursing and care homes. Conclusion This article provides guidelines for organizations on how to retain their nurses. [ABSTRACT FROM AUTHOR]

Gender stereotypes of children and their parents were examined. Participants included 355 three-year-old children, their one-year-old siblings, and their mothers and fathers. Families were selected from the Western region of the Netherlands. Implicit gender stereotypes were assessed with computerized versions of the Action Inference Paradigm (AIP; both child and parents) and the Implicit Association Test (parent only). Parental explicit gender stereotypes were measured with the Child Rearing Sex-Role Attitude Scale. Findings revealed that mothers had stronger implicit gender stereotypes than fathers, whereas fathers had stronger explicit stereotypes than mothers. Fathers with same-gender children had stronger implicit gender stereotypes about adults than parents with mixed-gender children. For the children, girls' implicit gender stereotypes were significantly predicted by their mother's implicit gender stereotypes about children. This association could only be observed when the AIP was used to assess the stereotypes of both parent and child. A family systems model is applicable to the study of gender stereotypes. [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]

EU member states require farmers growing transgenic maize to respect a minimum distance from fields with non-transgenic maize. Previous studies have theoretically argued that such minimum distance requirements may lead to a so-called ‘domino effect’ where farmers who want to grow transgenic maize are forced to grow the non-transgenic variety and in turn impose the same constraints on their neighbors. This article applies a spatially explicit farm model to a dairy region in the Southern Netherlands to assess how farmers growing non-transgenic maize limit other farmers'' potential to grow transgenic herbicide-resistant maize. The results indicate that the minimum distance requirements can severely limit the benefits from herbicide resistant maize. Having different land use options in one farm, however, enables dairy farmers to grow transgenic maize despite having one or more neighbors growing non-transgenic maize. We also find that the share of the domino effect in the overall impact of minimum distance requirements decreases with the density of farmers not growing transgenic maize. [Copyright &y& Elsevier]

Background Critically ill patients with circulatory shock sometimes need rescue treatment with high doses of norepinephrine, a treatment that may be associated with a poor outcome because of excessive vasoconstriction. Objective To evaluate the outcome of treatment and its determinants in patients with circulatory shock who received high doses of norepinephrine in the intensive care unit and to identify indicators of futility for the treatment. Methods A retrospective study was done on 113 consecutive patients with circulatory shock who received 0.9 μg/kg per minute or greater of norepinephrine during at least 1 hour at any time in the intensive care unit. Data were extracted from the electronic patient data management system according to a predefined checklist. Results A total of 39 patients survived for 28 days after admission to the intensive care unit. The variables independently associated with 28-day mortality in multivariable models included low urine flow, high lactate levels, high organ failure score, high prothrombin time, and need for epinephrine cotreatment. The reason, dose, and duration of norepinephrine administration did not have prognostic significance. Scores greater than 40 on the Acute Physiology and Chronic Health Evaluation II, bicarbonate levels less than 9.0 mEq/L, or receipt of an epinephrine dose of 0.25 μg/kg per minute or greater were associated with 100% mortality. Conclusions Although the cause of shock and treatment with norepinephrine were not predictive of death when high doses of the drug were deemed necessary, rescue treatment with high-dose norepinephrine is futile in patients with severe disease and metabolic acidemia. [ABSTRACT FROM AUTHOR]

This article centers on a comparison of diversity policies in Dutch public and private sector organizations and their effectiveness in improving ethnic minority representation. Data have been obtained from 8,283 annual reports of Dutch organizations in 2001 and 2002. Three types of diversity policies are analyzed: (a) policies designed to analyze ethnic minority representation, (b) policies designed to improve the influx of ethnic minorities in organizations, and (c) policies designed to improve the management of a diverse workforce in organizations. Results show that public sector organizations report more diversity policies and different types of diversity policies than do private sector organizations. In terms of effectiveness, only policies designed to improve the management of a diverse workforce seem to affect the representation of ethnic minorities in organizations in the short term. No sectoral differences in the effectiveness of various policy types were found. [ABSTRACT FROM PUBLISHER]

Purpose – The purpose of this paper is to examine gender differences in promotion probabilities of the academic staff of a large university in The Netherlands, taking into account the sex segregated context of the faculty. Design/methodology/approach – The study uses records of the university's personnel information system from 1990 to 2006, covering the data of 1,792 employees in the academic ranks who have entered since 1990. Cox regression models are used to test three hypotheses. Findings – The findings show that women have lower promotion probabilities than men. The gender differences are primarily explained by differences in years of service and external mobility, and not by the sex segregated context of the faculty. A higher share of women decreases the odds of being promoted for both men and women. Gender differences in working hours do not explain the gender differences in promotion probabilities. Originality/value – The paper adds to the existing literature because event history analyses have hardly been applied to personnel records for investigating the impact of the sex segregated context on promotion probabilities. [ABSTRACT FROM AUTHOR]

Labour market integration of ethnic minority women is central for economic integration, as they may experience a double disadvantage: both as a woman and as a migrant. This presumed double disadvantage has recently become the focus of both Dutch integration and emancipation policy. To test several assumptions underlying this, we analyse to what extent labour market participation of different groups of women and the hours they work are influenced by human capital and household characteristics. Our results show some remarkable differences in employment patterns. Controlling for educational level, partnership and the presence of children, it was found that native women more often work in part-time jobs than ethnic minority women. For native Dutch women, the number of children influences both the employment decision and the number of hours worked, whereas for ethnic minority women, this only effects full-time employment. [ABSTRACT FROM AUTHOR]

BACKGROUND: There is an association between blood transfusion and pulmonary complications in cardiac surgery. Mediators of increased pulmonary vascular leakage after transfusion are unknown. We hypothesized that factors may include antibodies or bioactive lipids, which have been implicated in transfusion-related acute lung injury. STUDY DESIGN AND METHODS: We performed a prospective cohort study in two university hospital intensive care units in the Netherlands. Pulmonary vascular permeability was measured in cardiac surgery patients after receiving no, restrictive (one or two transfusions), or multiple (five or more transfusions) transfusions (n = 20 per group). The pulmonary leak index (PLI), using 67Ga-labeled transferrin, was determined within 3 hours postoperatively. Blood products were screened for bioactive lipid accumulation and the presence of antibodies. RESULTS: The PLI was elevated in all groups after cardiac surgery. Transfused patients had a higher PLI compared to nontransfused patients (33 × 10−3 ± 20 × 10−3 vs. 23 × 10−3 ± 11 × 10−3/min, p < 0.01). The amount of red blood cell (RBC) products, but not of fresh-frozen plasma or platelets, was associated with an increase in PLI (β, 1.6 [0.2-3.0]). Concerning causative factors in the blood product, neither the level of bioactive lipids nor the presence of antibodies was associated with an increase in PLI. Patient factors such as surgery risk and time on cardiopulmonary bypass did not influence the risk of pulmonary leakage after blood transfusion. CONCLUSIONS: Transfusion in cardiothoracic surgery patients is associated with an increase in pulmonary capillary permeability, an effect that was dose dependent for RBC products. The level of bioactive lipids or the presence of HLA or HNA antibodies in the transfused products were not associated with increased pulmonary capillary permeability. [ABSTRACT FROM AUTHOR]

Background. Diastolic dysfunction is common among dialysis patients and is associated with increased morbidity and mortality. Novel echocardiographic speckle tracking strain analysis permits accurate assessment of left ventricular diastolic function, independent of loading conditions and taking all myocardial segments into account. The aim of the study was to evaluate the prevalence of diastolic dysfunction in chronic dialysis patients using this novel technique, and to identify its determinants among clinical and echocardiographic variables. Methods. Patients currently enrolled in the ICD2 study protocol were included for this analysis. Next to conventional echo measurements diastolic function was also assessed by global diastolic strain rate during isovolumic relaxation (SRIVR). Results. A total of 77 patients were included (age 67±8 years, 74% male).When defined as E/SRIVR ⩾ 236, the prevalence of diastolic dysfunction was higher compared to more conventional measurements (48% versus 39%). Left ventricular mass (OR 1.02, 95% CI 1.00-1.04, P = 0.014) and pulse wave velocity (OR 1.34, 95% CI 1.07-1.68, P = 0.01) were independent determinants of diastolic dysfunction. Conclusion. Diastolic dysfunction is highly prevalent among dialysis patients and might be underestimated using conventional measurements. Left ventricular mass and pulse wave velocity were the only determinants of diastolic dysfunction in these patients. [ABSTRACT FROM AUTHOR]

Groeneveld, R. A. 2011. Quantifying fishers' and citizens' support for Dutch flatfish management policy. – ICES Journal of Marine Science, 68: 919–928.Fisheries policy is most effective when supported by fishers and the general public. Dutch citizens' and fishers' support for a selection of policy alternatives to enhance the sustainability of the Dutch North Sea cutter fleet is estimated, and the same groups' support for policy alternatives is expressed in monetary terms. A stated-choice survey was held among a representative sample of the Dutch population to assess their average willingness to pay for a selection of policy objectives, and among Dutch flatfish fishers to estimate their willingness to accept a selection of policy measures. The results indicate that citizens are most concerned about the impact of beam trawling on benthic megafauna, because they are on average willing to pay €21.46 per year to reduce the impact, but reducing fishing pressure in the plaice (Pleuronectes platessa) spawning period and restoring spawning-stock biomass of plaice and sole (Solea solea) to the levels of maximum sustainable yield are also supported. Fishers seem to support enhanced fines for the use of illegal fishing gear, but they are most opposed to increasing the minimum landing size of sole. [ABSTRACT FROM PUBLISHER]

Introduction: The acute respiratory distress syndrome (ARDS) is a severe and frequently seen complication in multi-trauma patients. ARDS is caused by an excessive innate immune response with a clear role for neutrophils. As ARDS is more frequently seen in trauma patients with chest injury, we investigated the influence of chest injury on the systemic neutrophil response and the development of ARDS. Materials and methods: Thirteen patients with isolated blunt chest injury [abbreviated injury score (AIS) 2-5] were included. To avoid systemic inflammation caused by tissue damage outside the thorax, injuries to other regions than the chest did not exceed an AIS of 2. At 3, 9 and 24 h after injury, the expression of circulating activating molecules on neutrophils and levels of circulating interleukine (IL)-6 were determined. Blood samples from eight healthy volunteers were used as control. Results: Blunt chest injury resulted in the activation of circulating neutrophils, as characterized by a decreased expression of l-selectin (CD62L), CXCR2 (CD182b) and C5aR (CD88) compared to control ( p < 0.05). Expression of l-selectin, CXCR2 and C5aR was partially restored at 24 h after injury. In addition, the mean expression of FcγRIII (CD16) dropped ( p < 0.001), indicating the recruitment of young neutrophils into the circulation. IL-6 levels increased to a maximum mean concentration of 86 ± 31 pg/ml at 24 h postinjury. None of the patients developed ARDS. Conclusion: Blunt chest trauma caused a systemic inflammatory reaction with transient activation of neutrophils and mobilization of young neutrophils into the circulation. Isolated chest injury, however, was not abundant enough to cause ARDS, so a second hit appears crucial. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effectiveness of a lifestyle intervention for male workers in the construction industry at risk of cardiovascular disease (CVD). Methods: In a randomized controlled trial performed in the Netherlands between 2007 and 2009, usual care was compared to 6months of individual counseling using motivational interviewing techniques, delivered face to face and by telephone. Participants aimed at improving energy balance-related behavior or smoking cessation. Linear regression analyses were performed to determine the effects. Results: Body weight had significantly decreased at 6 (β =−1.9, 95% CI −2.6; −1.2) and 12months (β =−1.8, 95%CI −2.8; −1.1). The intervention effects were also significant for diastolic blood pressure at 6months (β=−1.7, 95% CI −3.3; −0.1). Among participants who had aimed at energy balance, the intervention had a significant favorable effect on body weight at 6 (β =−2.1, 95% CI −2.9; −1.3) and 12months (β =−2.2, 95% CI −3.1; −1.3) and at HDL cholesterol (β=0.05, 95% CI 0.01; 0.10) and HbA1c (β =−0.06, 95%CI −0.12; −0.001) at 12months, although there was no intervention effect on these variables over time. Conclusion: Individual-based counseling resulted in significant beneficial long-term effects on body weight. This is an important finding for occupational health, considering the rising prevalence of obesity and CVD. [Copyright &y& Elsevier]

De Amsterdamsche Keurkamer, founded in 1932, was the first National Socialist publishing house in the Netherlands. Under the management of author and poet George Kettmann the firm grew to become one of the major cultural mainstays of National Socialism in Holland. Kettmann earned himself some sort of reputation in the late thirties when he brought out a Dutch translation of Hitler's Mein Kampf. In the years of the occupation his company succeeded in defining the position and character of the 'official' literature - 'official' meaning in line with National Socialist ideology. [ABSTRACT FROM AUTHOR]

Objective: To determine treatment satisfaction in patients with gastrooesophageal reflux disease (GORD) when switched to esomeprazole. Methods: This observational, multicentre study conducted in the Netherlands included primary-care patients being treated with a proton pump inhibitor (PPI) [omeprazole, pantoprazole, rabeprazole or lansoprazole] for GORD who were switched to esomeprazole by their physician. After a median of 28 days' esomeprazole therapy, patients' satisfaction was assessed using a questionnaire. Patients self-rated whether they were 'more satisfied', felt there was 'no difference' or were 'less satisfied' with esomeprazole compared with previous PPI therapy. Symptom control, concomitant medication use and tolerability were also assessed. Results: Overall, 4929 patients were included in this study; of these, only 21.9% were satisfied with PPI treatment at consultation (i.e. prior to switching to esomeprazole). Following switching to esomeprazole therapy, 88.0%of patients were satisfied with therapy and only 26.9% of patients were still experiencing symptoms (vs 84.0% at consultation); 71.3% were more satisfied with esomeprazole than with their previous PPI, most frequently because they had fewer or no symptoms. Among patients who had been using concomitant therapy to control GORD symptoms, 62.0% were no longer using any such medication. Of the 1069 patients who had been satisfied with their previous PPI therapy, 39.4% were even more satisfied with esomeprazole. Esomeprazole was well tolerated; the most commonly reported adverse events were nausea/vomiting and headache, and no treatment-related serious adverse events occurred. Conclusion: Among primary-care patients receiving PPI therapy for GORD, switching to esomeprazole therapy impacts positively on treatment satisfaction and symptom control. [ABSTRACT FROM AUTHOR]

Wind farms are often planned offshore where wind conditions are favourable and the visual impact is less important. Wind farms have both positive and negative effects on the marine environment. Negative effects include bird collisions, underwater sounds and electromagnetic fields, whilst positive effects constitute functioning as artificial reef and acting as no-take zones for fish, with possible spill-over effects. This paper presents a spatially explicit framework to analyze effects of wind farms on the marine environment and aims to evaluate how wind farms can contribute to protection of the marine environment through strategic and economically viable location choices. The functioning and the applicability of the model are demonstrated in a numerical example for the Dutch exclusive economic zone. We find that the careful spatial planning of wind farms is a key factor for profitability and environmental protection, and that, if carefully planned, the environment can benefit from offshore wind farms. [Copyright &y& Elsevier]