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To develop and explore underlying dimensions of the Self-Regulation Assessment (SeRA) and psychometric features of potential components. Further, to identify associations between the SeRA and disability-management self-efficacy, type of diagnosis, and type of rehabilitation. Based on a previously developed model of self-regulation, expert and patient opinions, and cognitive interviews, a list of 22 items on self-regulation (the SeRA) was constructed. The SeRA was included in a cross-sectional survey among a multi-diagnostic group of 563 former rehabilitation patients. Exploratory analyses were conducted. Respondents had a mean age of 56.5 (SD 12.7) years. The largest diagnostic groups were chronic pain disorder and brain injury. Four components were found within the SeRA, labelled as "insight into own health condition," "insight into own capabilities," "apply self-regulation," and "organization of help." Cronbach's alpha was high (total scale: 0.93, subscales: range 0.85–0.89). Only scores on the first subscale showed a ceiling effect. Subscale three showed the highest correlation with a self-efficacy measure. Small differences in SeRA total scores (range 71.6–78.1) were found between different diagnostic groups. The SeRA is a new self-regulation measure with four subscales. Further research is needed to establish the validity and reliability of the SeRA. The Self-Regulation Assessment (SeRA) was developed to provide a comprehensive measurement of self-regulation among rehabilitation populations. The SeRA could potentially be used to identify persons with self-regulation problems at the start of rehabilitation treatment and measure outcomes of rehabilitation for self-regulation. The SeRA could potentially be used to help analyse outcomes of rehabilitation practice as well as evaluate interventions on self-regulation. [ABSTRACT FROM AUTHOR]

The aim of this study was to: (1) assess work participation among young adults with spina bifida, (2) identify problems perceived in finding employment, and (3) examine which determinants are related to work participation. This cross-sectional study was a follow-up study to the Adolescents with SPina bifida In the Netherlands (ASPINE) study. Data regarding work participation and problems finding employment were collected with questionnaire developed by the authors. Data on disease characteristics were taken from the ASPINE database. Responses of 136 participants were analyzed (77 females, 59 males; mean age 26 years 1 month [SD 3y1mo], range 21-32y). Twenty participants had spina bifida occulta and 116 had spina bifida aperta, 96 of whom also had hydrocephalus. Work participation rate was 62.5%, of which 22.4% was in a sheltered workplace. Significant determinants of having paid work for at least 1 hour a week were: level of education, level of lesion, hydrocephalus, IQ, functional independence, and ambulation. Significant determinants of full-time employment were the same, plus sex and type of spina bifida. In a multivariate backward logistic regression analysis, however, only level of education remained a significant predictor of work participation. Sex, level of education, and self-care independence were significant predictors of full-time employment. This study shows the importance of educational support and self-care independence training for children with spina bifida. (Contains 4 tables.)

As in many countries, in The Netherlands governmental organisations are acquiring 3D city models to support their public tasks. However, this is still being done within individual organisation, resulting in differences in 3D city models within one country and sometimes covering the same area: i.e. differences in data structure, height references used, update cycle, data quality, use of the 3D data etc. In addition, often only large governmental organisations can afford investing in 3D city models (and the required knowledge) and not small organisations, like small municipalities. To address this problem, the Dutch Kadaster is collaborating with the 3D Geoinformation research group at TU Delft to generate and disseminate a 3D city model covering the whole of the Netherlands and to do this in a sustainable manner, i.e. with an implementation that ensures periodical updates and that aligns with the 3D city models of other governmental organisations, such as large cities. This article describes the workflow that has been developed and implemented. [ABSTRACT FROM AUTHOR]

This paper presents our contribution to the development of a standardized 3D input data model for solar photovoltaic potential estimation. Presently, different input data and processing steps influence the calculation for estimating the potential of solar energy in the Netherlands. The variety in characteristics of input data and issues with temporal accuracy extracted from the national registers and databases makes it challenging to obtain a consistent and reliable result. To address this issue, we created a point cloud dataset that integrated from LiDAR point cloud and dense image matching which is complete, recent and positionally accurate. Furthermore, we made a 3D building model from the integrated point cloud and identified the effect of finer resolution in the photovoltaic potential analysis. [ABSTRACT FROM AUTHOR]

Background: Balloon pulmonary angioplasty (BPA) is an emerging treatment in patients with chronic thromboembolic pulmonary hypertension (CTEPH) and chronic thromboembolic disease (CTED). We describe the first safety and efficacy results of BPA in the Netherlands. Methods: We selected all consecutive patients with inoperable CTEPH and CTED accepted for BPA treatment who had a six-month follow-up in the St. Antonius Hospital in Nieuwegein and the Amsterdam University Medical Center (UMC) in Amsterdam. Functional class (FC), N‑terminal pro-brain natriuretic peptide (NT-proBNP), 6‑minute walking test distance (6MWD) and right-sided heart catheterisation were performed at baseline and six months after last BPA. Complications for each BPA procedure were noted. Results: A hundred and seventy-two BPA procedures were performed in 38 patients (61% female, mean age 65 ± 15 years). Significant improvements six months after BPA treatment were observed for functional class (63% FC I/II to 90% FC I/II, p = 0.014), mean pulmonary artery pressure (−8.9 mm Hg, p = 0.0001), pulmonary vascular resistance (−2.8 Woods Units (WU), p = 0.0001), right atrial pressure (−2.0 mm Hg, p = 0.006), stroke volume index (+5.7 ml/m2, p = 0.009) and 6MWD (+48m, p = 0.007). Non-severe complications occurred in 20 (12%) procedures. Conclusions: BPA performed in a CTEPH expert centre is an effective and safe treatment in patients with inoperable CTEPH. [ABSTRACT FROM AUTHOR]

The article discusses importance and objectives of the national registries like PulmoCor registry for pulmonary hypertension (PH) . Topics discussed include goals of the registry like describing patients with PH and its impact on them, the registry aiming to optimize patient care and research related to PH and the registry expected to increase awareness about PH in Netherlands. Other topics include use of secured database by PH centres for the registration of patients with PH.

Study design:Prospective cohort study.Objective:To assess functional hindrance due to spasticity during inpatient rehabilitation and 1 year thereafter in individuals with spinal cord injury (SCI) and to determine factors that influence the hindrance.Setting:Eight specialized rehabilitation centres in the Netherlands.Methods:A total of 203 patients with recent SCI rated the hindrance they perceived due to spasticity in daily living at the start of active rehabilitation (t1), 3 months later (t2), at discharge (t3) and 1 year after discharge (t4). Hindrance was dichotomized into absent or negligible and present. Multilevel regression analyses were performed to determine the course of functional hindrance due to spasticity and its associations with possible determinants-namely, age, gender, cause, lesion level, motor completeness, spasticity and anti-spasticity medication.Results:The percentage of individuals that indicated functional hindrance due to spasticity ranged from 54 to 62% over time and did not change significantly over time (Δt3t1 odds ratio (OR)=0.85, P=0.44; Δt3t2 OR=1.20, P=0.41; Δt3t4 OR=0.91, P=0.67). The percentage of individuals who experienced a lot of hindrance due to spasticity during specific activities ranged from 4 to 27%. The odds for experiencing functional hindrance due to spasticity were significantly higher for individuals with tetraplegia (OR=2.17, P=0.0001), more severe spasticity (OR=5.51, P<0.0001) and for those using anti-spasticity medication (OR=4.18, P<0.0001).Conclusion:Functional hindrance due to spasticity occurred in the majority of persons with SCI and did not change significantly during inpatient rehabilitation and 1 year thereafter. Factors that influence hindrance were determined. [ABSTRACT FROM AUTHOR]

Study design:This is a prospective cohort study.Objectives:The objective of this study was to predict the progress of healing of pressure ulcers (PUs) in spinal cord injury (SCI) patients after the first 4 weeks.Setting:The study was conducted in a specialized SCI rehabilitation unit in The Netherlands.Methods:Weekly measurements of length, width and depth/undermining of grades II-IV PUs under sacrum or ischial tuberosity in SCI patients with the 'Decu-stick' were taken. The speed of reduction of the greatest dimension in the first 4 weeks of the granulation-epithelization (G-E) phase was compared with the speed of reduction of this dimension after week 4 until the end of observation.Results:Fifty-one PUs in 45 patients were measured. During the first 4 weeks of the G-E phase, the greatest dimension of 23/51 PUs reduced with a speed of ⩾0.5 cm per week. In 22 of these 23 PUs, this speed remained ⩾0.5 from week 4 until the end of observation (weeks 5-22). Closure: 21 patients (pts); operation: 2 pts. Of 28/51 PUs, this dimension reduced with <0.5 cm per week. In 27/28 PUs, this speed remained <0.5 from week 4 until the end of observation (weeks 9-37). Closure: 6 pts; operation: 16 pts; discharge with open ulcer: 6 pts.Conclusion:Measurement of PUs in SCI patients with the 'Decu-stick' provides a reliable, quick, cheap and easy-to-learn bedside method to predict the progress of healing in PUs in SCI patients after 4 weeks of conservative treatment with a positive predictive value of 0.95 and an negative predictive value of 0.96. This provides a scientific basis for the decision on operative or alternative conservative treatment. [ABSTRACT FROM AUTHOR]

Study design:Prospective multicentre cohort study.Objectives:To determine mortality, causes and determinants of death of individuals with spinal cord injury (SCI) within five years after first inpatient rehabilitation.Setting:The Netherlands.Methods:Patients were included on admission to first clinical rehabilitation after traumatic or nontraumatic SCI. Inclusion criteria: age between 18 and 65, American Spinal Injury Association impairment scale A-D and expected long-term wheelchair dependency. Information about survival, cause of death, relevant comorbidity and psychosocial circumstances was obtained from the rehabilitation physician or general practitioner. Determinants of death were retrieved from a prospectively collected database. Deceased persons and survivors were compared using χ2-test and t-test. Cox regression analysis was performed to describe independent predictors of death. The Kaplan-Meier method was used to calculate survival curves for independent predictors. Excess mortality was described by a standardized mortality ratio (SMR).Results:Mean duration of follow up was 6.2 years. A total of 27 persons (12.2%) died during this period (SMR 5.3). Main causes of death were cardiovascular disease (37.0%), pulmonary disease (29.6%) and neoplasm (14.8%). Older age at injury, nontraumatic SCI, family history of cardiovascular disease, less social support and a history of other medical conditions on admission were related to death. Older age at injury, nontraumatic SCI and a history of other medical conditions were independent predictors of death.Conclusion:Twelve per cent of persons with SCI who had survived the acute hospital phase died during follow up (SMR 5.3). The main causes of death were cardiovascular and pulmonary disease. [ABSTRACT FROM AUTHOR]

Study design:Retrospective files study.Objective:To update epidemiological data on the incidence of traumatic spinal cord injury (TSCI) in The Netherlands.Setting:The NetherlandsMethods:From the Dutch National acute-care hospital database, all records of patients discharged with International Classification of Diseases 9th edition codes 806 or 952 in 2010 were selected. For each record, we requested an anonymised copy of the hospital discharge letter. We analysed the received letters for TSCI, defined as a newly acquired traumatic transverse lesion of the spinal cord or cauda equina, resulting in loss of motor, sensory, bladder or bowel function below the level of the lesion, lasting longer than 2 weeks. We further extracted data on demographic and SCI characteristics and discharge destination.Results:We received 372 discharge letters or a confirmation that the patient did not have TSCI. A total of 185 patients with TSCI were identified, of whom 30 died during acute-care hospital stay. We estimated the incidence of TSCI as 14.0 per million per annum including patients and 11.7 per million per annum excluding patients who did not survive the acute phase. Most patients were male (74%), had tetraplegia (69%) and an motor incomplete lesion (62%). Median age was 62 years (range 13-96). Discharge destination was a rehabilitation centre specialized in SCI in 78% of patients with motor complete TSCI and 47% of patients with motor incomplete TSCI.Conclusion:The estimated incidence of TSCI surviving the acute phase was 11.7 per million per annum in the Netherlands in 2010. A substantial proportion of these patients was not referred to a specialized rehabilitation centre. [ABSTRACT FROM AUTHOR]

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

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

Study design:Cross-sectional study 5 years after discharge from inpatient rehabilitation.Objective:To examine the psychometric properties of the Mental Health subscale (MHI-5) of the 36-Item Short Form Health Survey (SF-36) in persons with spinal cord injury (SCI).Setting:Eight Dutch rehabilitation centres with specialised SCI units.Methods:Possible floor and ceiling effects were assessed, and Cronbach′s α coefficient was calculated to assess internal consistency. Concurrent and divergent validity were assessed using Spearman correlations between the MHI-5 and measures of life satisfaction, neuroticism, vitality, general health, functional independence, participation, lesion characteristics and demographics.Results:There were no floor or ceiling effects, but the total MHI-5 score was slightly skewed (−1.15). Internal consistency was good (α=0.79). Concurrent validity was shown by significant Spearman correlations between the MHI-5 and life satisfaction (0.53), neuroticism (−0.55), vitality (0.53) and general health (0.37). Divergent validity was shown by weak and, in part, non-significant correlations between the MHI-5 and functional independence (0.09), participation (−0.28) and lesion characteristics (range −0.01-0.19).Conclusion:The MHI-5 showed reliability and validity as a measure of mood in persons with SCI, and is a promising measurement instrument to assess mental health problems in this population. [ABSTRACT FROM AUTHOR]

Study design:Cross-sectional study.Objectives:To describe the satisfaction of the manual wheelchair user with hand rim wheelchair-related aspects (for example, dimensions, weight and comfort) and wheelchair service-related aspects and to determine the relationship between wheelchair users' satisfaction, personal and lesion characteristics, and active lifestyle and participation in persons with a spinal cord injury (SCI).Setting:Eight Dutch rehabilitation centers with a specialized SCI unit.Methods:The Dutch version of the Quebec user evaluation of satisfaction with assistive technology (D-QUEST) was filled out by 109 participants 1 year after discharge from inpatient SCI rehabilitation. Relationships between the D-QUEST scores and personal and lesion characteristics, and active lifestyle and participation (physical activity scale for individuals with physical disabilities (PASIPD), Utrecht activity list (UAL), mobility range and social behavior subscales of the SIP68 (SIPSOC)) were determined.Results:A high level of satisfaction was found with wheelchair-related aspects. The participants were less satisfied with the service-related aspects. Participants with an incomplete lesion were slightly more satisfied regarding both aspects than those with a complete lesion. A higher satisfaction regarding wheelchair dimensions and a higher overall satisfaction were related to a more active lifestyle. Persons who were more satisfied with the simplicity of use of the wheelchair had a better participation score.Conclusion:Dutch persons with SCI are in general quite satisfied with their hand rim wheelchair. Some aspects of the wheelchair (dimensions and simplicity of use) are important to optimize as these are related to an active lifestyle and participation. [ABSTRACT FROM AUTHOR]

Study design:Multicenter prospective cohort study.Objectives:To determine the occurrence and predictors for pressure ulcers in patients with spinal cord injury (SCI) during primary in-patient rehabilitation.Setting:Eight Dutch rehabilitation centres with specialized SCI units.Methods:The occurrence, location and stage of pressure ulcers were registered between admission and start of functional rehabilitation (called acute rehabilitation phase) and between start of functional rehabilitation and discharge. Possible risk factors for the occurrence of pressure ulcers during functional rehabilitation (personal and lesion characteristics, complications and functional independence) were measured at the start of functional rehabilitation and were entered as predictors in univariate and multivariate logistic regression analysis with pressure ulcers during functional rehabilitation as the dependent variable.Results:Data for 193 patients (86%) were available. The occurrence of pressure ulcers, including stage 1, was 36.5% during acute rehabilitation phase and 39.4% during functional rehabilitation. Most pressure ulcers were located at the sacrum (43%), followed by heel (19%) and ischium (15%). The significant risk factors for pressure ulcers during functional rehabilitation were motor completeness of the lesion, tetraplegia, pressure ulcer during acute rehabilitation phase, pneumonia and/or pulmonary disease, low score on the Functional Independence Measure (FIM) self-care, continence, transfers, locomotion and total FIM motor score. Having had a pressure ulcer during acute rehabilitation phase was the strongest risk factor.Conclusion:The occurrence of pressure ulcers was comparable with other studies. A few significant risk factors were found, of which having had a pressure ulcer during acute rehabilitation phase being the strongest predictor. [ABSTRACT FROM AUTHOR]

Study design:Cross-sectional survey.Objectives:To describe the care received, care needs and preventability of secondary conditions according to persons with long-term spinal cord injury (SCI) living at home.Setting:The Netherlands.Methods:A questionnaire was sent to all members of the Dutch SCI Patient Organisation. From a list of 26 SCI secondary conditions, participants chose the five conditions they perceived as most important. For each of these conditions, they described the type of care they received, their need for (extra) care and its preventability.Results:Response rate was 45% (n=453) and mean time after injury was 13.3 years. In case of secondary conditions, participants were more likely to visit their general practitioner (58%) than another medical specialist (29%) or rehabilitation specialist (25%). For all most-important secondary conditions, care was received in 47% and care, or extra care, was needed in 41.3%. Treatment was the type of care most often received (29.5%) and needed (17.2%). However, for information and psychosocial care, the care needed (12.2 and 9.9%, respectively) was higher than the care received (7.6 and 5.9%, respectively). Thirty-four percent of all most-important secondary conditions were perceived as preventable, the rate increasing to 52.8% for pressure sores, of which 29.9% were considered to be preventable by the participants themselves.Conclusions:This study showed substantial unmet care needs in persons with long-term SCI living at home and underlines the further improvement of long-term care for this group. Information, psychosocial care and self-efficacy seem to be the areas to be enhanced. [ABSTRACT FROM AUTHOR]

Study design:A multicenter prospective cohort study.Objective:To determine the longitudinal relationship between physical capacity and lipid profile in persons with spinal cord injury (SCI) during and 1 year after rehabilitation.Setting:Eight Dutch rehabilitation centers with a specialized SCI unit.Methods:A total of 206 subjects with SCI (78 with tetraplegia) participated. The longitudinal relationship between lipid profiles (total cholesterol (TC), high- (HDL) and low-density lipoprotein (LDL) and triglycerides (TG) and physical capacity (peak power output (POpeak), peak oxygen uptake (VO2peak), and muscle strength) was investigated during inpatient SCI rehabilitation (start, 3 months later, discharge) and 1 year after discharge. A correction was made for the possible confounding variables age, body mass index, gender, time since injury, lesion level and completeness.Results:HDL and the ratios LDL/HDL and TC/HDL showed a significant and favorable relationship with VO2peak, POpeak and muscle strength. TG was positively related to POpeak and muscle strength.Conclusions:More favorable lipid profiles were seen in people with a higher physical capacity after correction for personal and lesion characteristics. Therefore, improving the physical capacity by being active during daily life or in sport may further improve the lipid profile and thus reduce the risk for coronary heart disease.Spinal Cord (2008) 46, 344–351; doi:10.1038/sj.sc.3102147; published online 20 November 2007 [ABSTRACT FROM AUTHOR]

Objective: To evaluate whether transmural care for people with spinal cord injury living in the community has more impact on health outcomes than traditional follow-up care within the Netherlands. Design: Quasi-experiment with 12 months of follow-up. Setting: Eight Dutch rehabilitation centres. Subjects: Thirty-one patients who received transmural care in two 'experimental' rehabilitation centres were compared with a matched sample of 31 patients having received 'usual follow-up care' in six other rehabilitation centres. Intervention: The core component of the transmural care consists of a transmural nurse, who 'liaises' between former patients living in the community, primary care professionals and the rehabilitation team. The transmural care model provides activities to support patients and their family/partners and activities to promote continuity of care. Main measures: The prevalence of pressure sores and urinary tract infections; the number and duration of re-admissions to hospital and rehabilitation centre due to pressure sores, bladder and bowel problems; and the experienced quality of follow-up care. Results: The transmural care, as implemented, did not influence the health outcomes. The prevalence of pressure sores, urinary tract infections and the number of re-admissions (due to pressure sores, bladder and bowel problems) was respectively 13, 13 and 4 in the intervention group versus 14, 15 and 6 in the usual follow-up care group. Since the transmural care had been incompletely implemented and there were methodological and practical limitations, we formulated no final conclusions regarding its effectiveness. Conclusion: Implementing the transmural care model strictly according to protocol may improve its effectiveness. [ABSTRACT FROM AUTHOR]

STUDY DESIGN::Cross-sectional survey. OBJECTIVES::(1) To describe the support given to persons with spinal cord injuries (SCI) by their partners, (2) to describe the perceived burden of support by partners and (3) to examine predictors of perceived burden of support. SETTING::The Netherlands. METHODS::All members of the Dutch patients organisation DON (N=1004) and their caregivers, if applicable, were invited. Physical disability of the person with SCI was measured using the Barthel Index (BI). A number of secondary conditions, other practical problems and psychosocial problems were recorded. Partner support was described using a list of ADLsupport, other practical support and emotional support. Burden of support was measured by a six-item measure (Cronbach's alpha 0.92), Nonparametric descriptive statistics and correlations were used. Linear regression was used to identify predictors of caregiver burden. RESULTS::Responses were obtained from 461 persons with SCI. Of 265 couples, patient as well as partner data were available. Mean age of the partners was 49.4 years (SD 12.2) and 69.8%were women. Mean BI of the persons with SCI was12.3 (SD 4.7) on a 0-20 scale and 60.4%were seriously disabled (BI<15). Most partners provided various kinds of support. ADL-support and other practical support were given much more often by partners of persons with serious disability, but less difference was seen regarding emotional support. Professional (paid) support was obtained by 45.3%of all couples. Perceived burden of support was high in 24.8%of partners of persons with serious disabilities against 3.9%of partners of persons with minor disabilities. Significant predictors of caregiver burden were (in order of importance) the amount of ADL support given, psychological problems of the patient, partner age, partner gender, BI score and time after injury (total explained variance 47%). CONCLUSION::A substantial proportion of partners of persons with SCI suffer from serious burden of support. Prevention of caregiver burnout should be part of the lifelong care for persons with SCI.Spinal Cord (2005) 43, 311-319. doi:10.1038/sj.sc.3101704 Published online 1 February 2005 [ABSTRACT FROM AUTHOR]

STUDY DESIGN:&EMSP;:Retrospective descriptive study. OBJECTIVES:&EMSP;:To ascertain the incidence of spinal cord injury in The Netherlands. METHODS:&EMSP;:From all patients, discharged from a Dutch general hospital in 1994 with the ICD-9 diagnosis code 806 (fracture of the spine with injury of the spinal cord) and 952 (injury to the spinal cord without apparent spinal fracture), a copy of the anonymized medical correspondence was requested. The received correspondence was analyzed for the diagnosis of traumatic spinal cord injury with motor, sensory, bladder and bowel symptoms lasting longer than 2 weeks. RESULTS:&EMSP;:479 cases with the ICD-9 codes 806 or 952 were identified. On 329 cases we received information. According to our criteria 126 cases had a spinal cord injury with persisting symptoms. Of these 126 cases 18 died during hospital stay. Sex (77% male), level (57% tetra), completeness (48.7% complete), age distribution, cause of injury and incidence of stabilizing operation (44.2%) were assessed. Mean hospital stay was 31 days and of the subjects who survived the initial hospital phase, 70% were referred to a rehabilitation centre or a rehabilitation ward. CONCLUSION:&EMSP;:The incidence of spinal cord injury surviving the acute phase in The Netherlands in 1994 was 10.4/million/annum. SPONSORSHIP:&EMSP;:De Hoogstraat Scientific Foundation.Spinal Cord (2000) 38, 420–424. [ABSTRACT FROM AUTHOR]

This article discusses service delivery for Spinal Cord Injured (SCI) in the Netherlands. In this wealthy country, almost everyone has access to domestic adaptations and other equipment, regardless of income and with low, or without user contributions. However, satisfaction with this system or its products is rarely examined. Subjects in this research are 318 SCI individuals between 18 and 65 years of age, living in the community at a mean time of 3.6 years after injury. Availability of accessible housing, domestic adaptations, wheelchairs and outdoor transportation is investigated. Satisfaction with available services and satisfaction with service delivery procedures is measured by self-developed questionnaires. Relationships between these satisfaction scores and measures for functional health status (SIP68) and life satisfaction (LSQ) are analyzed. The presence of domestic adaptations is high, and 78.3% said their houses were sufficiently adapted at the time of the interview. Wheelchairs were generally available and most respondents had more than one. However, many users had complaints about their wheelchairs: 35.9% about their manual wheelchairs and 47.5% about their electric wheelchairs. Public transport was rarely used, 51.1% of respondents had an adapted car. Having an adapted car was significantly related to the ability to drive independently. Satisfaction with available services was acceptable, but satisfaction with service delivery procedures was very low. Satisfaction with available services did have a significant relationship with functional health status when the influence of the type of injury was taken into account. Satisfaction with available services also had a significant relationship with life satisfaction, after the influence of functional health status was taken into account. Further research on this topic is recommended. [ABSTRACT FROM AUTHOR]