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To ease the transition to university, preparation in secondary school is often seen as a first step. This study investigated longitudinal relationships between teacher practices in secondary education (i.e., emotional support, autonomy support, and student-centred teacher practices) and first-year students' academic achievement and social and emotional adjustment at university. We focused on students' perceptions of their teachers' practices to, on the one hand, take individual differences into account and, on the other hand, to investigate differences in teacher practices between schools. In a three-wave longitudinal study, 235 students were followed from their final year of secondary school to the end of the first year at university. The results indicated that teacher practices related to students' social and emotional adjustment across the transition to university, but not to their academic achievement. Specifically, we found that perceived teachers' emotional support was related to students' social adjustment at university whereas autonomy support was associated with emotional adjustment. Differences in teacher practices between schools were quite small. This study indicated that teachers in secondary education might play a pivotal role in preparing students for university. This role goes beyond preparing students for academic achievement, as teachers may have a long-term impact on first-year students' social and emotional adjustment.

The goal of this study was to examine differences in university success between first-year students by analyzing three domains simultaneously: students' academic achievement, critical thinking disposition, and social-emotional adjustment to university life. Participants were 307 students who completed an online questionnaire. Latent class cluster analysis revealed three patterns of success: (1) average-achieving well-adjusted students (64%), (2) high-achieving average-adjusted students (14%), and (3) low-achieving low-adjusted students (22%). Follow-up ANCOVAs indicated that low-achieving low-adjusted students most strongly experienced that their social life hindered their study, whereas average-achieving high-adjusted students experienced the least interference from their study on their social life. These results indicated that student success is a multi-domain concept, with subgroups of first-year students showing specific patterns of success. The results of this study help to understand the feasibility of and tensions between domains of student success and provide suggestions for universities to adjust their support to specific student needs.

A fascinating and rich landscape of personal views and approaches can be seen in architectural design and in architectural design education. This variation may be confusing for students. This paper focuses on the question: is the framework of generic elements that we developed for explicating the design process helpful to compare the differences in architectural design approaches? The results of interviewing a variety of 15 architectural, urban and landscape designers show all kinds of personal approaches that have a set of five underlying generic elements in common. Therefore, the framework may be helpful for teachers and students to describe these personal approaches and may help students in understanding differences and similarities and in finding out what their own personal approach may be.

Bullying is a problem in many schools around the world. It is seen as an unwanted phenomenon in education and in many contexts the reduction of bullying is a target of national and local education policy. In practice, the extent to which bullying occurs differs widely across classrooms. Part of these differences may be explained by teachers' management of bullying. The goal of the present study was to combine two perspectives on teacher behavior to identify their impact on pupils' bullying behavior at school, namely teachers' bullying-specific and their general interpersonal behaviors. Data were collected by means of questionnaires from 33 upper-grade primary school teachers and their 784 pupils. Results of multilevel regression analyses showed that teachers' bullying-specific and general interpersonal behaviors independently contributed to pupils' bullying behavior. Lower levels of bullying were established when teachers were less likely to discipline the bully, and showed more interpersonal behaviors with high levels of control and closeness, and less interpersonal behaviors with low levels of control and closeness. These findings suggest that teachers' bullying-specific and general interpersonal behaviors are two different pathways through which teachers can manage bullying. This underlines the need of taking teacher's strengths into account in designing anti-bullying programs.

We examined the effects of visual control training on expert wheelchair basketball shooting, a skill more difficult than in regular basketball, as players shoot from a seated position to the same rim height. The training consisted of shooting with a visual constraint that forced participants to use target information as late as possible. Participants drove under a large screen that initially blocked the basket. As soon as they saw the basket they shot. When training with the screen, shooting percentages increased. We conclude that visual control training is an effective method to improve wheelchair basketball shooting. The findings support the idea that perceptual-motor learning can be enhanced by manipulating relevant constraints in the training environment, even for expert athletes. (Contains 1 table and 2 figures.)

Nowadays many schools in higher education implement problem-based learning to foster active learning processes by students. In some schools with a number of years of experience with this approach, phenomena can be observed which indicate signs of wear. The implementation of a large-scale innovation such as problem-based learning (PBL) seems to provoke different activities and attitudes in those actors who are most involved. Students and staff members seem to behave in a way which could be counterproductive to the development of self-directed learning. In the first part of this paper, we briefly describe the cognitive psychological background of PBL. In the second part various adjustments observed in problem-based curricula and their effects on students' learning are analyzed. Arguments are presented about adverse effects on the implementation of this educational innovation. Special attention is given to teachers' concerns. In the third part suggestions are made about ways to revitalize PBL processes as well as suggestions about effecting educational innovations on a more solid basis.

Purpose: To collect long-term survival data in anterior traumatised teeth on the outcome of Regenerative Endodontic Treatments (RET) with a network of dentists working in different clinics to overcome the problem of anecdotical evidence. Methods: The seven dentists from Paediatric REsearch Project (PREP) performed RET treatments following the same protocol in five different secondary dental care clinics in the Netherlands. Treatment resulting in pain, apical problems, sinus tracts, resorption or fracture were considered as failure of treatment. Results: 47 teeth in 38 children were treated between January 2009 and September 2017 and had at least 6 month follow-up (mean 35 months). Apical closure was seen in 27 teeth (25 cases) and root length growth in 6 teeth (6 cases). Thickening of the root walls was seen in 20 teeth (20 cases) and obliteration of the root canal in 30 teeth (25 cases). Of 38 teeth with apical inflammation at the start of treatment, no radiographic sign of apical inflammation was visible at 3 months in 13 of 28 teeth; taking up to 42 months for radiographic signs of apical inflammation to be not visible. Nineteen of 35 teeth showed discoloration at the beginning of treatment. After 18 months two teeth showed signs of ankylosis, but were still functional. After 36 months one more tooth showed signs of new apical inflammation and 2 months later it was extracted. Conclusions: With three failures in 47 treated teeth, RET seems to be a promising treatment for difficult to treat anterior traumatised teeth with an open apex. [ABSTRACT FROM AUTHOR]

Background: For years, the benefits of septoplasty have been questioned. Due to the scarce and inconclusive literature, several National Health Service (NHS) Clinical Commissioning Groups in England decided to add septal surgery to their list of restricted procedures with low clinical value. Recently, evidence was obtained that septoplasty is actually more effective than non-surgical management for nasal obstruction in adults with a deviated septum. However, the relation between costs and effects of septoplasty remains unknown.Methods: We conducted an economic evaluation alongside an open, multicenter, pragmatic randomized controlled trial in two tertiary and 16 secondary referral hospitals in the Netherlands. Adults with nasal obstruction and a deviated septum were randomized to (1) septoplasty with or without concurrent turbinate surgery or (2) non-surgical management consisting of (a combination of) medical treatment and watchful waiting. Analyses were performed on an intention-to-treat basis. Single imputation nested in the bootstrap percentile method (using 5000 bootstrap replications) was performed to assess the effect of missing data. After 12 and 24 months, we assessed the incremental costs per quality-adjusted life year (QALY) gained from a healthcare and a societal perspective.Results: A total of 203 adults were randomly assigned to septoplasty (N = 102) or non-surgical management (N = 101). After 12 months, the mean cost difference between septoplasty and non-surgical management using a healthcare or societal perspective was €1181 (95%CI €1038 to €1323) or €2192 per patient (95%CI €1714 to €2670), respectively. The mean QALY difference was 0.03 per patient (95%CI - 0.01 to 0.07). Incremental costs per QALY gained from a healthcare or societal perspective were €41,763 or €77,525, respectively. After 24 months, the mean cost difference between the two groups using a healthcare or societal perspective decreased to €936 (95%CI €719 to €1153) or €1671 per patient (95%CI €952 to €2390), respectively. The mean QALY difference increased to 0.05 per patient (95%CI - 0.03 to 0.14). Incremental costs per QALY gained from a healthcare or societal perspective became €17,374 or €31,024, respectively. Analyses of imputed data did not alter our findings.Conclusions: Depending on the selected perspective, cost-effectiveness threshold, and time horizon, septoplasty has the potential to be cost-effective. Despite considerable uncertainty, septoplasty seems to be cost-effective from a healthcare perspective, after 24 months against a threshold of €20,000 per QALY. From a societal perspective, septoplasty is not yet cost-effective after 24 months, but it comes closer to the cost-effectiveness threshold as time passes by.Trial Registration: Nederlands Trial Register, NTR3868 (https://www.trialregister.nl/trial/3698). Prospectively registered on February 21, 2013. [ABSTRACT FROM AUTHOR]

A researcher analyzed problems faced by beginning teachers in the Netherlands. The teachers' problems are viewed as the result of the need to adjust from a permissive to a custodial stance. Implications for teacher education curriculum are discussed. (PP)

Background: A Dutch online patient decision aid to support prosthetic heart valve selection was recently developed. A multicenter randomized controlled trial was conducted to assess whether use of the patient decision aid results in optimization of shared decision making in prosthetic heart valve selection.Methods and Results: In a 5-center randomized controlled trial, patients were allocated to receive either standard preoperative care (control group) or additional access to the patient decision aid (intervention group). Legally capable adult patients accepted for elective isolated or combined aortic and mitral valve replacement were included. Primary outcome was preoperative decisional conflict (Decisional Conflict Scale); secondary outcomes included patient knowledge, involvement in valve selection, anxiety and depression, (valve-specific) quality of life, and regret. Out of 306 eligible patients, 155 were randomized (78 control and 77 intervention). Preoperative decisional conflict did not differ between the groups (34% versus 33%; P=0.834). Intervention patients felt better informed (median Decisional Conflict Scale informed subscore: 8 versus 17; P=0.046) and had a better knowledge of prosthetic valves (85% versus 68%; P=0.004). Intervention patients experienced less anxiety and depression (median Hospital Anxiety and Depression Scale score: 6 versus 9; P=0.015) and better mental well-being (mean Short Form Health Survey score: 54 versus 50; P=0.032). Three months postoperatively, valve-specific quality of life and regret did not differ between the groups.Conclusions: A patient decision aid to support shared decision making in prosthetic heart valve selection does not lower decisional conflict. It does result in more knowledgeable, better informed, and less anxious and depressed patients, with a better mental well-being.Clinical Trial Registration: http://www.trialregister.nl. Unique identifier: NTR4350. [ABSTRACT FROM AUTHOR]

BACKGROUND: Using the newer lower limit of normal criterion instead of the conventional cutoff values to define pulmonary function abnormalities may result in different predictors of pulmonary function impairment in patients with heart failure. Therefore, we assessed predictors of pulmonary function impairment in subjects with chronic heart failure according to the lower limit of normal in comparison with conventional cutoff values. METHODS: In this prospective cross-sectional study, 164 chronic heart failure subjects (age 68 ± 10 y, 78% men, 88% New York Heart Association class I-II) with left ventricular ejection fraction <40% underwent pulmonary function tests. Predictors of pulmonary function impairment were assessed using the lower limit of normal and conventional cutoff values (ie, 80% predicted value and the fixed ratio of FEV1/FVC <0.7). RESULTS: The lower limit of normal criterion identified an extra independent predictor of diffusion impairment compared with the 80% predicted value; in addition to body mass index, pack-years, and alveolar volume, female sex also turned out to be an independent predictor. A smoking history of ≥ 10 pack-years was a significant predictor of diffusion impairment and airway obstruction using the lower limit of normal criterion but not using the conventional cutoff values. However, lowering the cutoff points of conventional criteria to match the more stringent lower limit of normal and thus avoid overdiagnosis of diffusion impairment and airway obstruction in the elderly produced similar results as the lower limit of normal. CONCLUSIONS: The lower limit of normal identifies more predictors of diffusion impairment and airway obstruction compared with conventional cutoff values in subjects with chronic heart failure with left ventricular systolic dysfunction. However, lowering the conventional cutoff points yielded similar results as the lower limit of normal. [ABSTRACT FROM AUTHOR]

We tested the hypothesis that second-trimester exposure to influenza is a risk factor for schizophrenia in the child. The dates of birth of Dutch schizophrenic in-patients were examined for any effect of the 1957 A2 influenza epidemic. Individuals who were in their second trimester of foetal life at the peak of the epidemic were at no greater risk of developing schizophrenia than controls. As the present study has a larger sample size than all previous European studies, and is supported by a large study in the USA, it provides strong evidence against the hypothesis that second-trimester exposure to influenza is a risk factor for schizophrenia. [ABSTRACT FROM AUTHOR]

Wet loads after steam sterilization of medical devices in healthcare facilities are unacceptable. However, little is known about their frequency in daily practice. An online survey was distributed via four national sterilization associations, in Australia (Sterilising Research Advisory Council of Australia (Vic), Inc. (VIC SRACA)), Belgium (Vereniging sterilisatie in het ziekenhuis (VSZ)), Italy (Associazione Italiana Operatori Sanitari addetti alla Sterilizzazione - Società Scientifica (AIOS)), and The Netherlands (Vereniging van Deskundigen Steriele Medische Hulpmiddelen (VDSMH)). Seventy-eight percent of 125 hospital sterilization facilities recognized wet loads, occurring at frequencies ranging from monthly to every load. Usually, wet loads were identified by the presence of water droplets; these loads were repacked and resterilized. Given the pervasiveness of wet loads, and their impact on reprocessing times and costs, strategies to reduce their frequency are needed., (Copyright © 2019. Published by Elsevier Ltd.)

The Dutch population of first generation Turkish and Moroccan migrants is ageing. Among them hypertension and diabetes mellitus are frequent findings, which will probably cause an increased incidence of dementia. The language barrier, low education and cultural differences make the diagnosis more difficult. To what extent the MMSE can be used as a cognitive screener in this population will be investigated in this retrospective study.Patients received standard diagnostics, a professional translator addressed the language barrier. Correspondence was scored on characteristics of dementia, a procedure was used to diagnose without including the MMSE score. The optimal cut-off was calculated with the Youden Index and Area under the ROC (AUROC).106 patients were included, 61% had no education. Average MMSE-score was 16, with dementia 12, without 19. The AUROC was 0.85, optimal cut-off was 18 with a Youden index of 0.61.By using a professional translator the MMSE can possibly be used as a cognitive screener in this population. However, the cognitive skills addressed by the MMSE require an education and language skills. Developing a test that is independent of education and language barrier will probably be better.

In the next decade the number of non-western elderly immigrants will double in the Netherlands. Because of specific risk factors (hypertension, diabetes), the number of elderly immigrants with dementia will probably increase. Memory clinics are not well prepared for these patients, because health professionals lack knowledge about important obstacles in intercultural dementia diagnostics. They should consider language barriers, cultural differences, low level of education and illiteracy, as well as ignorance about dementia, shame and special care expectations of patients and their families. We give recommendations to improve communication, (neuropsychological) testing and counseling in clinical practice.

Study Design: Prospective cohort study., Objective: This study investigates the role of pain catastrophizing and causal beliefs with regard to severity and persistence of neck complaints after motor vehicle accidents. SUMMARY OF BACKGROUND DATA.: In previous research on low back pain, somatoform disorders and chronic fatigue syndrome, pain catastrophizing and causal beliefs were found to be related to perceived disability and prognosis. Furthermore, it has been argued with respect to whiplash that culturally dependent symptom expectations are responsible for a chronic course., Methods: Individuals involved in traffic accidents who initiated compensation claim procedures with a Dutch insurance company were sent questionnaires (Q1) containing the Neck Disability Index, the Pain Catastrophizing Scale, and the Causal Beliefs Questionnaire-Whiplash. Of 1252 questionnaires dispatched, 747 (59.7%) were returned. Only car occupants with neck complaints were included in this study (n = 140). Complaints were monitored using additional questionnaires administered 6 (Q2) and 12 months (Q3) after the accident., Results: Pain catastrophizing and causal beliefs were related to the severity of concurrent whiplash disability. The severity of initial complaints was related to the severity and persistence of whiplash complaints. Attributing initial neck complaints to whiplash was found to predict the persistence of disability at 6 and 12 months follow-up, over and above the severity of the initial complaints., Conclusion: The results suggest that causal beliefs may play a major role in the perceived disability and course of neck complaints after motor vehicle accidents, whereas pain catastrophizing is predominantly related to concurrent disability.The current findings are consistent with the view that an early conviction that neck complaints are caused by the medico-cultural entity whiplash has a detrimental effect on the course of symptoms.

Steam sterilization is the most common method of sterilization used in hospitals and by companies sterilizing for hospitals. This study validated 197 steam sterilizers with respect to technical condition, various production processes and routine control tests, according to the European norms and standards for steam sterilization. Overall, only 40% of the validated steam sterilizers met the norms and standards. We recommend that adequate measures need to be taken, based on the comments in the validation reports, in order to guarantee the sterility of processed medical items.

The availability of adequate treatment for erectile dysfunction (ED) triggers studies into the prevalence of ED in the general population. Yet, previous studies showed different prevalence estimates partly due to differences in patient selection, in (unclear) definitions of ED and in assessment. ENIGMA has been designed to study the prevalence of ED in the general population of The Netherlands, using the WHO definition with a description of the way of assessment. In all, 5721 mail surveys were sent to all men, aged 18 y and older in 12 general practices in The Netherlands. A total of 5601 were included in the study and 2117 (38%) were completed. A total of 38% of the men reported to have ever had some kind of erectile problem. The prevalence of ED was 17% (6% mild, 4% moderate and 7% complete). Age, diabetes, cardiovascular diseases, penile disorders, irradiation in the pelvic region, relational problems, fear for failure, surmenage, medication use and regular consumption of alcohol were independently related to ED. Men with ED were less content with their (sexual) life and had less confidence in sexual performance. Presence of ED was negatively related to affected happiness in life. ED is commonly found in men and is related to age, medication, comorbidity and lifestyle factors. Men with ED perceive a lower quality of (sex)life. Doctors should be aware of the presence of ED and its consequences in patients.

The prevalence estimates of erectile dysfunction (ED) vary considerably across studies. These differences may be attributed to used definitions of ED. Quantitative data on the effect of different definitions of ED on the prevalence are lacking, because precise information on the used definition and questionnaire is often absent. Aim of this study was to quantify the effect of using different questionnaires for ED on the prevalence estimates. In all, 5721 mail surveys on sexual problems and ED were sent to all men (aged >18 y) in 12 general practices in the middle of the Netherlands of which 2117 were completed. The questionnaire contained Enigma (WHO), International Index of Erectile Function (IIEF), Cologne Erectile Inventory (KEED) and one question (Boxmeer, Krimpen). The prevalence of ED based on the various questionnaires and the effect of these questionnaires on risk factor relationships was compared. IIEF gave the highest age specific and overall ED prevalence, KEED the lowest. The difference in prevalence was 16.8%. The agreement (kappa coefficient) between the various ED definitions varied from 0.52 (IIEF & KEED) to 0.95 (Enigma & Boxmeer). The number of risk factor relations were similar for the Dutch studies, reduced for the IIEF and KEED. This study provides evidence that differences in questionnaires to assess ED have a considerable effect on the (age specific) prevalence estimates and little on the risk factor relations. The number of questions of the survey appears not to be responsible for differences in the prevalence of ED and risk factor relations, however they affect the response rate. Uniform use is strongly recommended, since a 'golden standard' for ED assessment (by questionnaire) is lacking. A short questionnaire with one or two questions is recommended for example the one from the Boxmeer-study. These data may be used to adjust (age-specific) prevalence rates comparing ED prevalence in the open population across studies.

Aim of the study was to analyse quality of life and psychological functioning in patients with sprain of the neck, to analyse the relationship between complaints, quality of life, psychological functioning and personality factors, and to analyse the profile of patients with whiplash associated disorders (WAD), 4 years after trauma. From the University Hospital Groningen 193 patients with the diagnose sprain of the neck filled out a questionnaire. Of this group 100 subjects did not have complaints before the accident and were therefore at risk for the development of complaints as a result of sprain of the neck. Quality of life and psychological functioning were assessed using the RAND-36 and the SCL-90, respectively. Personality was assessed by means of the Dutch Personality Questionnaire. Of the group at risk (56% women and 44% men, mean age: 33.9, SD: 14.6) quality of life was significantly worse in subjects with complaints (mean: 78.4, SD: 15.5) compared to subjects without complaints (mean: 87.5, SD: 8.7). Psychological functioning did not differ significantly between the group with complaints compared to group without complaints. Personality did not differ between the groups. Personality and complaints together were significantly related to quality of life (r: 0.77) and psychological functioning (r: 0.85). No specific profile of WAD patients was found. In conclusion, personality and complaints influence quality of life and psychological functioning to a considerable extent.