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This study examined the discriminative ability of the revised Autism Diagnostic Observation Schedule module 4 algorithm (Hus and Lord in "J Autism Dev Disord" 44(8):1996-2012, 2014) in 93 Dutch males with Autism Spectrum Disorder (ASD), schizophrenia, psychopathy or controls. Discriminative ability of the revised algorithm ASD cut-off resembled the original algorithm ASD cut-off: highly specific for psychopathy and controls, lower sensitivity than Hus and Lord (2014; i.e. ASD 0.61, AD 0.53). The revised algorithm AD cut-off improved sensitivity over the original algorithm. Discriminating ASD from schizophrenia was still challenging, but the better-balanced sensitivity (0.53) and specificity (0.78) of the revised algorithm AD cut-off may aide clinicians' differential diagnosis. Findings support using the revised algorithm, being conceptually conform the other modules, thus improving comparability across the lifespan.

This study examined the discriminative ability of the revised Autism Diagnostic Observation Schedule module 4 algorithm (Hus and Lord in J Autism Dev Disord 44(8):1996-2012, ) in 93 Dutch males with Autism Spectrum Disorder (ASD), schizophrenia, psychopathy or controls. Discriminative ability of the revised algorithm ASD cut-off resembled the original algorithm ASD cut-off: highly specific for psychopathy and controls, lower sensitivity than Hus and Lord (; i.e. ASD .61, AD .53). The revised algorithm AD cut-off improved sensitivity over the original algorithm. Discriminating ASD from schizophrenia was still challenging, but the better-balanced sensitivity (.53) and specificity (.78) of the revised algorithm AD cut-off may aide clinicians' differential diagnosis. Findings support using the revised algorithm, being conceptually conform the other modules, thus improving comparability across the lifespan. [ABSTRACT FROM AUTHOR]

Aims and objectives: The Critical Nursing Situation Index (CNSI) is a checklist to detect nursing protocol violations. The objectives of this study were to determine incidences and severities of nursing protocol violations and to check whether corrective actions were taken. Design: Prospective observational audit. Methods: This study was performed in the Intensive Care Unit of the Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands. The CNSI was applied in the period February 2009 to February 2010 by 14 purpose-trained nurses whose interrater reliability had proved sufficient. The checklist addressed nine domains of nursing care: Basic care, Circulation, Respiration, Digestive tract, Infection, Invasive catheters, Medication, ECMO and Central nervous system. The trained nurses also recorded whether violations were discussed with the bedside nurse, whether they could be corrected; and whether they were justifiable. Protocol violations are justifiable when protocol adherence carries greater risk of harm to the patient. Results: Protocol violations were identified for 987 of 8107 items (12·2%) checked in 238 observations in 126 patients. The percentage of protocol violations varied from 5% in the Medication domain to 26% in the Digestive tract domain. More than fifty percent (53·4%) of all protocol violations were corrected in the same shift; 22·3% of all protocol violations proved justifiable, however, these were rarely documented (6·4% of cases). Nurses' classification of the severity of the protocol violations was not reliable because linearly weighted kappa varied from 0 to 0·33. Conclusions: The CNSI is a useful tool to monitor and correct nursing protocol violations. Relevance to clinical practice: Timely identification and correction of protocol violations will reduce possible adverse events resulting from these violations. Furthermore, this study made us aware that protocol violations may be justifiable in clinical practice provided they are well documented. [ABSTRACT FROM AUTHOR]

Background. Cosmetic products contribute considerably to the incidence of contact dermatitis. In response to a resolution of the Council of Europe, the National Institute for Public Health and the Environment (RIVM) in The Netherlands set up a pilot project to report undesirable effects attributed to cosmetic products. Objectives. To provide an overview of undesirable effects attributed to cosmetic products and to identify the ingredients involved. The information could contribute to the assessment of whether current EU legislation on cosmetics provides adequate protection. Patients/methods. General practitioners, dermatologists and consumers in The Netherlands completed questionnaires on reported undesirable effects of cosmetics. Dermatologists also carried out patch tests and, where necessary, tests with specific batch ingredients of the associated cosmetic product. A website and a public awareness campaign were launched to encourage consumers to report undesirable effects. Results. Between July 2009 and May 2011, the RIVM received more than 1600 reports. Severe undesirable effects were claimed in 1-4% of the cases. The most frequently reported cosmetic products were make-up and moisturisers, and the most frequently identified allergens were isothiazolinones and fragrance ingredients. Three patients tested positive for co-polymers/cross-polymers. Conclusions. Further investigations are recommended on the prevalence of isothiazolinone-induced allergic contact dermatitis and the allergenic potential of co-polymers/cross-polymers. [ABSTRACT FROM AUTHOR]

Autism Diagnostic Observation Schedule (ADOS) module 4 was investigated in an independent sample of high-functioning adult males with an autism spectrum disorder (ASD) compared to three specific diagnostic groups: schizophrenia, psychopathy, and typical development. ADOS module 4 proves to be a reliable instrument with good predictive value. It can adequately discriminate ASD from psychopathy and typical development, but is less specific with respect to schizophrenia due to behavioral overlap between autistic and negative symptoms. However, these groups differ on some core items and explorative analyses indicate that a revision of the algorithm in line with Gotham et al. (J Autism Dev Disord 37: 613-627, ) could be beneficial for discriminating ASD from schizophrenia. [ABSTRACT FROM AUTHOR]

Abstract: Background: In separate randomized, crossover trials, patients with diabetes reported a preference for durable insulin pen NovoPen® 4 compared with NovoPen 3 and OptiClik®. Objective: This large post-marketing observational study evaluated treatment satisfaction with NovoPen 4 versus previous treatments, which included NovoPen 3 and other devices, in insulin-treated and insulin-naive patients. Methods: During regular clinical practice in Canada, Germany, and the Netherlands, health care professionals assigned adult patients with type 1 or type 2 diabetes to treatment with insulin administered via NovoPen 4 after training according to the device''s instruction manual. The primary end point was change in treatment satisfaction as determined by the Diabetes Treatment Satisfaction Questionnaire given to patients at the beginning and after 12 weeks of treatment. Two additional questionnaires were used at study end to identify why patients preferred either NovoPen 4 or their previously used insulin devices, which included NovoPen 3 and other devices (eg, HumaPen® Ergo and OptiPen® Pro). Adverse events were also recorded. Results: Two thousand eighteen participants (mean age, 55 years; males, 53%; type 1/type 2 diabetes, 28%/71%; mean duration of disease, 13 years; previously on insulin, 89.8%; insulin-naïve, 2.9%) participated. NovoPen 3 was previously used by 1059, HumaPen Ergo by 256, OptiPen Pro by 217, and other devices by 385 patients. Diabetes Treatment Satisfaction Questionnaire scores increased from a mean (SD) baseline of 26.5 (7.2) to 30.5 (5.0) at study end for a median difference of 4.0 (95% CI, 3.5–4.5; Wilcoxon test score: 22.7; P < 0.0001). Over 70% of patients found NovoPen 4 easier to set, read, correct, inject the dose, and change the insulin cartridge than with their previously used device (P < 0.0001). A total of 83.8% rated NovoPen 4 easier to use overall (P < 0.0001). Health care professionals (97.2%) would recommend NovoPen 4 to other patients. No adverse events associated with the device were recorded. Conclusions: Patients reported a significant preference for NovoPen 4 compared with previous treatment with NovoPen 3 or other insulin device. The high ratings NovoPen 4 received for ease of use and learning could potentially lead to improved acceptance of and compliance with prescribed insulin therapy. Further study is warranted to determine the possible health benefits of using this insulin device. [Copyright &y& Elsevier]

Studies the relation between the incidence of type 1 diabetes and nitrate levels in drinking water in the Netherlands. Adequacy of established standards for nitrate in drinking water in preventing diabetes; Mean nitrate levels in drinking water in the country; Effect of increasing age of children on the incidence of diabetes.

Discusses a case study evaluating risk exposure to heavy metal in soils by inhabitants living near the riverbanks in relation to the flooding of the river Meuse, Netherlands during the winter of 1993-1994. Concentration of pollutant in vegetation, beef and dairy products; Factors affecting heavy metal uptake by plants.

Reports on the performance of a human health risk assessment in relation to recreational activities in two artificial freshwater lakes along the river Meuse in The Netherlands. Health risk for lead and zinc poisoning; Detection limits for heavy metals in sediment/suspended matter; Sediment heavy metal; Polycyclic aromatic hydrocarbons.

The article offers information on the findings of a study on the effect of NovoPen® 4, a new durable insulin injection device, on diabetes treatment satisfaction during insulin therapy conducted in the Netherlands. Healthcare professionals (HCPs) stated that teaching patients to use the new device required ≤10 minutes in 89.4 percent of cases. A large proportion of diabetics found NovoPen® 4 easier to handle than their previous device.

Presents a study which investigated the possible relationship between nitrate levels in drinking water and the incidence of type 1 diabetes in children in the Netherlands. Methodology; Results and discussion; Conclusions.