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The abilities of citizens to make themselves heard and listen to each other are essential for the functioning of democratic societies. Schools are practice grounds for these citizenship competences. This study investigates whether students' experiences with voice in school are related to their attitudes towards voice (contributing and listening democratically), and how a democratic school culture affects this relation. Overall, 5297 students, from 240 classrooms, in 81 Dutch secondary schools, participated in the study. Results of multilevel analyses revealed that students' voice experiences at school, their own and those of their classmates, are positively related to students' attitudes towards contributing and listening democratically. This relation is not affected by a democratic school culture. These findings underline the relevance of opportunities to practice voice at school for all students and of the social nature of practicing voice. More generally, this study illustrates the importance of understanding schools as practice grounds for citizenship.

Learning to become aware of one's own values to be able to cope with value conflicts is an important part of a higher vocational education curriculum. Higher vocational education teachers are used to offering cognitive learning experiences to students to teach them how to deal with value conflicts, disregarding the affective aspect of values. In this qualitative study, we argue that inter-affective learning experiences are needed to encourage students to deal with value conflicts through affective involvement. We had two research questions: (1) How do teachers and students reflect on an inter-affective learning experience that aims to promote interactive affective sharing of a value conflict? and (2) What should characterize guidance for inter-affective learning experiences aimed at promoting interactive affective sharing of a value conflict? The research was carried out at a Dutch University of Applied Science offering higher vocational education programs. Four groups of teachers and two groups of students participated in an inter-affective learning experience about a value conflict, followed by a focus group discussion on the experience with group members. Teachers and students agreed that they need support in learning to sense their own experience of inner feelings. The reflections led to recommendations for guiding students' inter-affective learning experiences to encourage affective involvement in a value conflict.

The actions and feelings questionnaire (AFQ) provides a short, self-report measure of how well someone uses and understands visual communicative signals such as gestures. The objective of this study was to translate and cross-culturally adapt the AFQ into Dutch (AFQ-NL) and validate this new version in neurotypical and autistic populations. Translation and adaptation of the AFQ consisted of forward translation, synthesis, back translation, and expert review. In order to validate the AFQ-NL, we assessed convergent and divergent validity. We additionally assessed internal consistency using Cronbach's alpha. Validation and reliability outcomes were all satisfactory. The AFQ-NL is a valid adaptation that can be used for both autistic and neurotypical populations in the Netherlands.

Parental socioeconomic status (SES) is a strong predictor of children's educational achievement (EA), with an increasing effect throughout development. Inequality in educational outcomes between children from different SES backgrounds exists in all Western countries. It has been proposed that a cause of this inequality lies in the interplay between genetic effects and SES on EA, which might depend on society and the equality of the education system. This study adopted two approaches, a classical twin design and polygenic score (PGS) approach, to address the effect of parental SES on EA in a large sample of 12-year-old Dutch twin pairs (2479 MZ and 4450 DZ twin pairs with PGSs for educational attainment available in 2335 children) from the Netherlands Twin Register (NTR). The findings of this study indicated that average EA increased with increasing parental SES. The difference in EA between boys and girls became smaller in the higher SES groups. The classical twin design analyses based on genetic covariance structure modeling pointed to lower genetic, environmental, and thus phenotypic variation in EA at higher SES. Independent from a child's PGS, parental SES predicted EA. However, the strength of the association between PGS and EA did not depend on parental SES. In a within-family design, the twin with a higher PGS scored higher on EA than the co-twin, demonstrating that the effect of the PGS on EA was at least partly independent from parental SES. To conclude, EA depended on SES both directly and indirectly, and SES moderated the additive genetic and environmental components of EA. Adding information from PGS, in addition to parental SES, improved the prediction of children's EA.

Primary caregivers experience consequences from being in close contact to a person with autism spectrum disorder (ASD). This study used the Involvement Evaluation Questionnaire to explore the level of consequences of 104 caregivers involved with adults with High Functioning ASD (HF-ASD) and compared these with the consequences reported by caregivers of patients suffering from depression and schizophrenia. Caregivers involved with adults with an HF-ASD experience overall consequences comparable to those involved with patients with depression or schizophrenia. Worrying was the most reported consequence. More tension was experienced by the caregivers of ASD patients, especially by spouses. More care and attention for spouses of adults with an HF-ASD appears to be needed.

While various screening instruments for autism spectrum disorders are widely used in diagnostic assessments, their psychometric properties have not been simultaneously evaluated in the outpatient setting where these instruments are used most. In this study, we tested the Ritvo Autism Asperger Diagnostic Scale-Revised and two short versions of the Autism-Spectrum Quotient, the AQ-28 and AQ-10, in 210 patients referred for autism spectrum disorder assessment and in 63 controls. Of the 210 patients, 139 received an autism spectrum disorder diagnosis and 71 received another psychiatric diagnosis. The positive predictive values indicate that these tests correctly identified autism spectrum disorder patients in almost 80% of the referred cases. However, the negative predictive values suggest that only half of the referred patients without autism spectrum disorder were correctly identified. The sensitivity and specificity of each of these instruments were much lower than the values reported in the literature. In this study, the sensitivity of the Ritvo Autism Asperger Diagnostic Scale-Revised was the highest (73%), and the Autism-Spectrum Quotient short forms had the highest specificity (70% and 72%). Based on the similar area under the curve values, there is no clear preference for any of the three instruments. None of these instruments have sufficient validity to reliably predict a diagnosis of autism spectrum disorder in outpatient settings.

Objective: To review findings on attention-deficit/hyperactivity disorder and attention problems (AP) in children, adolescents, and adults, as established in the database of the Netherlands Twin Register and increase the understanding of stability in AP across the lifespan as a function of genetic and environmental influences. Method: A longitudinal model was fitted on Netherlands Twin Register AP scores from 44,607 child (less than 12-year-old), adolescent (12- to 18-year-old), and adult (greater than 18-year-old) twins. Results: Mean AP showed a downward trend with age. Age-to-age correlations ranged from 0.33 (50-[greater than or equal to]60 years old) to 0.73 (10-12 years old). Stability in individual differences in AP was due to genetic and environmental factors, and change was due primarily to environmental factors. Nonadditive genetic influences were present from childhood to adulthood. Total genetic variance decreased slightly throughout aging, whereas environmental variance increased substantially with the switch from maternal to self-ratings at 12 years of age. As a result, heritability coefficients decreased from 0.70 to 0.74 in childhood (maternal ratings) to 0.51 to 0.56 in adolescence (self-ratings), and 0.40 to 0.54 in adulthood (self-ratings). In childhood, male subjects scored higher than female subjects. After the rater switch at 12 years of age, female subjects tended to score higher than male subjects. Conclusions: Stability of AP is the result of genetic and environmental stability. The decrease in estimated heritability at 12 years of age is due to an increase in occasion-specific environmental variance and likely reflects a methodologic effect. Because environmental influences have lasting effects on AP, their early detection is crucial. (Contains 2 figures and 3 tables.)

Developing a descriptive framework is one step in the complex process of theory development in qualitative research. This complexity is especially evident when analysing data about how teachers interpret the inherent moral significance of their classroom interactions. A common way of gathering data is to follow an iterative process, in which both theoretical concepts and empirical data play an important part. Theoretical concepts to describe teachers' interpretations of the inherent moral significance of their classroom interactions could be offered by continental European "pedagogiek". However, because of difficulties connecting these "pedagogische" theories to empirical data directly, an intermediary operation was required. To meet this requirement the central "pedagogische" question: "Who should be taught what, how, when, and why?" was used as the starting point for the development of the framework. This article sets out in detail the process of getting from this question to a framework that is able to describe teachers' interpretations of the inherent moral significance of their classroom interactions. (Contains 1 figure, 12 tables and 3 notes.)

Can existing post-treatment prognostic models for predicting neck pain recovery (primarily in terms of disability and secondarily in terms of pain intensity and perceived improvement) be externally validated and updated at the end of the treatment period and at 6 and 12 weeks of follow-up in a new Dutch cohort of people with neck pain treated with guideline-based usual care physiotherapy? External validation and model updating in a new prospective cohort of three previously developed prognostic models. People with (sub)acute neck pain and registered for primary care physiotherapy treatment. Recovery of disability, pain intensity, and perceived recovery at 6 and 12 weeks and at the end of the treatment period. Discriminative performance (c-statistic) of the disability model at 6 weeks was 0.73 (95% CI 0.69 to 0.77) and reasonably well calibrated after intercept recalibration. The disability model at 12 weeks and at the end of the treatment period showed discriminative c-statistic performance values of 0.69 (95% CI 0.64 to 0.73) and 0.68 (95% CI 0.63 to 0.72), respectively, and was well calibrated. Pain models and perceived recovery models did not reach acceptable performance. Cervical mobility added value to the disability models and pain catastrophising to the disability and pain models at 6 weeks. Broad external validation of the disability model was successful in people with (sub)acute neck pain and clinicians may use this model in clinical practice with reasonable accuracy. Further research is required to assess the disability model's clinical impact and generalisability, and to identify additional valuable model predictors. https://osf.io/a6r3k/ [ABSTRACT FROM AUTHOR]

Do measures of state anxiety and trait anxiety in people with acute low back pain (ALBP) improve prediction of chronic low back pain (CLBP), defined as pain or pain-related disability at 12 weeks? Observational multi-centre prospective cohort study in primary physiotherapy care with measurements at baseline and at 12 weeks of state and trait anxiety, as well as other established prognostic factors for CLBP. People with nonspecific ALBP, aged 18 to 60 years, who had been pain free for ≥ 3 months before their current ALBP, and who were being treated according the Dutch clinical guidelines. CLBP was defined as a pain score ≥ 3/10 on the Numerical Pain Rating Scale (primary outcome), and as a pain-related disability score ≥ 19/70 on the Pain Disability Inventory. Univariate and multivariate logistic regression analyses estimated how the risk of CLBP differed with state and trait anxiety and other established prognostic factors. Most (204 of 225) participants completed both assessments. State anxiety was an independent predictor of CLBP, whether defined as pain or pain-related disability at 12 weeks, in contrast to trait anxiety. State anxiety improved the predictive performance of the model, with area under the curve (AUC) increasing from 0.64 (95% CI 0.56 to 0.71) to 0.75 (95% CI 0.68 to 0.82) and Nagelkerke's R 2 increasing from 0.08 to 0.24 for the primary outcome measure, pain. For the secondary outcome measure, pain-related disability: AUC 0.63 (95% CI 0.54 to 0.72) improved to 0.73 (95% CI 0.65 to 0.82) and Nagelkerke's R 2 increased from 0.05 to 0.16. Adding trait anxiety to the prognostic model for pain improved the AUC from 0.64 (95% CI 0.56 to 0.71) to 0.70 (95% CI 0.62 to 0.77) and Nagelkerke's R 2 from 0.08 to 0.15. State anxiety in patients with ALBP improved prediction of CLBP, defined as pain and pain-related disability at 12 weeks. [ABSTRACT FROM AUTHOR]