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The importance of generic skills for life scientists is commonly recognised by employers, graduates, and higher education institutes. As it remains unclear which generic skills are relevant for different life sciences career paths, this study aims to give an overview to inform and inspire universities and students, by analysing 179 Dutch entry-level job postings. We deductively coded nine career paths, namely: life sciences industry, PhD-student, quality compliance, research-related, sales & business, communication/education, information technology, consultancy, and policy. We coded generic skills using an adapted categorisation consisting of 46 generic skills within four categories, which were: self, others, information, and tasks. The descriptive statistics and cluster analysis results showed that although language, communication, and collaboration were the most requested skills, differences in requested generic skills between career paths and cluster composition were observed as well. We concluded that although some generic skills are important in general, other generic skills are relevant for specific life sciences career paths. To educate skilled life scientists, universities should consider the flexible integration of these generic skills in their life sciences programmes.

A cornerstone of inclusive education is teacher's readiness to respond adequately to different educational needs of students in their diverse classroom. Differentiated instruction, referring to the process by which teachers carefully monitor students' needs and progress, and adapt their instruction according to these differences, is a means to meet the needs of students of different levels. High-quality differentiated instruction is a complex process for teachers which needs careful preparation. This makes teachers' intentions relating to differentiated instruction particularly relevant. In this article we compare two theoretical models to explain teachers' intentions to differentiate: the Theory of Planned Behavior (TPB) and Self-determination theory (SDT). Secondary school teachers (n = 180) responded to a questionnaire in which we measured their intentions and predictor variables relating to both of the theoretical models. Linear regression showed that both the TPB as well as the SDT model significantly predicted teachers' intentions (p < 0.01), but that the TPB model showed a better fit with the data (48 versus 32% explained variance). We conclude that in addition to the factors included in the TPB, autonomy might be a relevant factor in explaining teachers' intentions.

This research investigates how the acculturation motivation (AM) of new international students develops over time, and which factors play a role in this development. In the context of a Dutch university, we interviewed 25 students from 17 countries three times over eight months. The findings show that initial AM levels can be categorized as high or low. These AM levels evolved into four patterns in the three interview rounds: high-low-low, high-low-high, low-high-low, and low-high-high. After four months, twelve factors emerged as affecting the development of students' AM levels. Prominent factors were prior international experience, language issues, and perceived student identities. After eight months, seven additional factors contributed to subsequent changes in students' AM levels, including the perceived international learning environment, friendship networks, and teachers' role in intercultural contacts. Findings suggest that universities can introduce interventions which could improve international students' acculturation experiences at specific times.

Research routinely suggests that international students often struggle in engaging with other student groups. This study, therefore, examines to what extent and how the intercultural attitudes and intentions of new international students in three Dutch educational institutions related to their acculturation orientation preferences (AOPs) during the "honeymoon" stage. Their AOPs were investigated across four social contact domains: living, schoolwork, friendships, and general interactions. Using structural equation modelling, results from 198 respondents indicate that intercultural intentions predicted their AOPs, with multicultural integration the most preferred strategy and marginalization the least preferred. Results of a simple mediation analysis show that intercultural intentions mediated the effect of intercultural attitudes for students adopting multicultural integration and separation strategies. Interview findings from 25 participants indicate that students sometimes adopted different orientations across the social contact domains. Internationally oriented higher education institutions should further support new students in their planning for intercultural interactions.

Perceived negative consequences of dyslexia entail the degree to which an individual perceives negative outcomes, such as low academic achievement or feelings of anxiety and depression, and attributes these experiences to the disorder. In the current study, we examined how perceived consequences of dyslexia are influenced by person and environmental factors. Perceived consequences were evaluated for the academic domain and the domain of mental health (depression, anxiety). Participants were 123 Dutch students with dyslexia. Cognitive person factors (literacy skills and verbal IQ), socio-emotional person factors (self-perceived literacy skills and coping ability), and environmental factors (literacy demands, support from the institution, reactions of teachers and peers) were included as predictors. Results indicated that perceived negative consequences were not related to cognitive person factors. In contrast, better self-perceived literacy skills were associated with less perceived negative consequences in all domains (academic, depression, anxiety) and coping contributed to depression consequences. With respect to environmental factors, negative reactions in the academic environment contributed to perceived negative consequences of depression and anxiety. As such, findings indicate that individuals with dyslexia perceive negative consequences in the academic, anxiety, and depression domains which cannot be fully accounted for by their objective reading and writing problems. These factors should feature more prominently in future studies on dyslexia and should be addressed in treatment of dyslexia as well.

The Wechsler Intelligence Scale for Children--Fifth Edition (WISC-V; Wechsler, 2014) provides a general intelligence score, representing "g," and five index scores, reflecting underlying broad factors. Within person differences between the overall performance across subtests and index scores, denoted as index difference scores, are often used to examine profiles of strengths and weaknesses. In this study, the validity of such profiles was examined for the Dutch WISC-V. In line with previous studies, broad factors explained little variance in index scores. A simulation study showed that variation in index difference scores also reflected little broad factor variance. The simulation study further revealed that, as a consequence, a significant discrepancy between an index score and overall performance was accompanied in only 40%-74% of the cases by a discrepancy on the underlying broad factor. Overall, these results provide little support for the validity and thereby clinical use of WISC-V profiles.

To aid in teaching dialogue skills a virtual simulator called "Communicate!" was developed at Utrecht University. Teachers can build scenarios for students to practice dialogues with a virtual character. In two experiments (n = 128 and 133, a year apart), we investigated if and how "Communicate!" can be an effective aid to study and practice dialogue skills, by comparing it to traditional "passive" learning tools, such as literature-study and a lecture, in an undergraduate psychology dialogue-skills course. Students were divided into four groups, two of which both read an article about conducting a bad-news dialogue and played a "bad-news-dialogue-scenario" (but in a different order), while the third group only played the scenario. The final group only read the article (expt. 1) or also attended a lecture on the topic (expt. 2). Playing a scenario improved performance on a different scenario played later. It increased the students' reported engagement and motivation to learn about this topic, compared to reading the article, whereas their reported self-efficacy decreased, which may indicate a recognized learning need. It also increased the score on an MC-knowledge test on this type of dialogue. This suggests that online dialogue simulations aid studying (basic) dialogue skills, by providing flexible, authentic learning experiences.

This article investigates attitudes to societal impact of research as an entry point into understanding academic identities. Conceptually, we position academic identity at the intersection of global scientific fields and national science policies. We argue that the degree of alignment or misalignment between the two can create coherent academic identities, or on the contrary, tensions in academics' identity. Empirically, we use the disciplines of philosophy and anthropology as proxies for scientific fields in the social sciences and humanities (SSH). The study is based on sixteen semi-structured interviews with mid-career philosophers and anthropologists in the United Kingdom and the Netherlands, and an analysis of how societal impact is positioned in the two national evaluation systems. We conclude that 'coercive' national impact policies (like the one in the UK) are less likely to be aligned with global disciplinary norms in the SSH and therefore create tensions in academic identity; these can undermine academics' agency and be counterproductive in terms of reaching policy objectives. By contrast, 'enabling' national impact policies (like the one in the Netherlands) are conducive to more coherent academic identities that are better aligned with disciplinary notions of societal impact. By discussing academic identities in a comparative context, the study highlights the struggles of reconciling disciplinary and national notions of societal impact. To realise the potential societal impact of academic research, we recommend that impact is integrated into a wider ecosystem of interactions where policy-driven notions are aligned with disciplinary norms and values.

Purpose: Transfer motivation has been identified as a pivotal factor influencing transfer of training. However, the role of training content has often been overlooked as explanatory variable for the rate of transfer motivation. This study aims to examine to what extent experiences in transfer motivation and its personal and contextual antecedents depend on whether the training content is soft or hard skill. To this end, this study used the perspective of the unified model of task-specific motivation. Design/methodology/approach: A total of 1,122 trainees (462 soft skill and 660 hard skill) filled out a questionnaire representing the components of transfer motivation and its personal- and contextual antecedents. Data were analyzed by means of multi group structural equation modeling. Findings: The results showed mean differences between soft- and hard-skill trainings in personal and contextual antecedents of transfer motivation and for different types of transfer motivation. However, no differences in transfer intention were found. Practical implications: The outcomes provide insight as to what practitioners and trainers could do in training design and work environments to raise personal and contextual antecedents and to what extent a differentiation should be made between soft- and hard-skill trainings. This can eventually help them in raising transfer motivation among trainees. Originality/value: To the best of the authors' knowledge, this study is the first that examines whether experiences in personal and contextual antecedents of transfer motivation, transfer motivation and transfer intention differ for trainings consisting of different characteristics.

Purpose: This study aims to investigate the merits of the unified model of task-specific motivation (UMTM) in predicting transfer of training and to investigate (relationships between) changes in UMTM components over time. In doing so, this study takes the multidimensionality of transfer motivation into account. Design/methodology/approach: The authors collected data among 514 employees of the judiciary who filled in the UMTM questionnaire directly after the training and after three weeks. The data were analyzed by means of structural equation modelling. Findings: The outcomes show that transfer motivation predicts transfer intention and transfer of training over time. Moreover, the study shows that (change in) transfer motivation is predicted by (change in) personal and contextual factors identified by the UMTM as antecedents of motivation. Originality/value: This study describes the first longitudinal evaluation of the UMTM in the literature and shows its applicability for predicting transfer of training. It is also one of the few studies that investigate transfer motivation multidimensionally and the role it plays for transfer of training. As such, this study informs other transfer of training models about the nature of transfer motivation and how transfer of training could be predicted.

Background: To better understand physical activity behavior and its health benefits in people living with health conditions, we studied people with and without 20 different self-reported health conditions with regard to (1) their physical activity levels, (2) factors correlated with these physical activity levels, and (3) the association between physical activity and all-cause mortality. Methods: We used a subsample (n = 88,659) of the Lifelines cohort study from the Netherlands. For people living with and without 20 different self-reported health conditions, we studied the aforementioned factors in relation to physical activity. Physical activity was assessed with the Short Questionnaire to Assess Health-Enhancing Physical Activity Questionnaire, and mortality data were obtained from the Dutch death register. Results: People with a reported health condition were less likely to meet physical activity guidelines than people without a reported health condition (odds ratios ranging from 0.55 to 0.89). Higher body mass index and sitting time, and lower self-rated health, physical functioning, and education levels were associated with lower odds of meeting physical activity guidelines across most health conditions. Finally, we found a protective association between physical activity and all-cause mortality in both people living with and without different health conditions. Conclusion: People living with different health conditions are generally less physically active compared with people living without a health condition. Both people living with and without self-reported health conditions share a number of key factors associated with physical activity levels. We also observed the expected protective association between physical activity and all-cause mortality. [ABSTRACT FROM AUTHOR]

School principals and teachers are expected to continuously innovate their practices in changing school environments. These innovation processes can be shared more widely through collaboration between principals and teachers, i.e. "collaborative innovation." In order to gain more insight into how school principals enact their leadership practices in leading collaborative innovation, we interviewed 22 school principals of primary, secondary and vocational education in the Netherlands. All participants have implemented the same collaborative innovation programme, aimed at enhancement of collaboration between teachers and school principals within schools, that has already been implemented by 900 Dutch schools. They were interviewed twice during the implementation year. Interview transcripts were analysed using an open coding strategy looking for leadership practices. Based on 11 leadership practices, we described two main leadership patterns: school principals enacting leadership practices as either a "team player" or as a "facilitator." We conclude that our findings suggest a wider repertoire of leadership practices than is reported in previous studies. Future studies would need to address the generalisability of the practices and patterns as found in this specific context of collaborative innovation.

Giving feedback to peers can be a powerful learning tool because of the feedback provider's active cognitive involvement with the products to be reviewed. The quality of peers' products is naturally an important factor that might influence not only the quality of the feedback that is given, but also the learning arising from this process. This experimental study investigated the effect of the level of quality of the reviewed product on the knowledge acquisition of feedback providers, as well as the role of prior knowledge in this. Dutch secondary-school students (n = 77) were assigned to one of three conditions, which varied in the quality of the learning products (concept maps) on which students had to give feedback while working in an online physics inquiry learning environment. Post-test knowledge scores, the quality of students' own concept maps and the quality of the feedback given were analyzed to determine any effect of condition on the learning of feedback providers. Students providing feedback on the lower-quality concept maps gave better feedback and had higher post-test scores. There was no interaction with level of prior knowledge. Possible implications for practice and further research directions are discussed.

A multiple case study has been carried out of four teacher groups who engaged in collective lesson design, observation, and reflection to support their professional learning. The teacher groups were examined on what and how they learned from their collaboration over time. For each meeting, teachers' learning logs and transcripts were analysed. The results show that the groups differed in the amount, consistency, and stability of self-reported learning outcomes throughout the meetings. Differences between groups also relate to the number and type of dialogic moves between the teachers within each group. A main conclusion includes that challenging each other in their dialogues supported teachers' learning. Additional explanations of learning outcomes relate to teachers' collective participation and facilitation in the group.Keywords: teacher professional learning; teacher collaboration; collaborative learning activities; teacher dialogue; secondary education

Inquiry learning is an effective learning approach if learners are properly guided. Its effectiveness depends on learners' prior knowledge, the domain, and their relationship. In a previous study we developed an Experiment Design Tool (EDT) guiding learners in designing experiments. The EDT significantly benefited low prior knowledge learners. For the current study the EDT was refined to also serve higher prior knowledge learners. Two versions were created; the "Constrained EDT" required learners to design minimally three experimental trials and apply CVS before they could conduct their experiment, and the "Open EDT" allowed learners to design as many trials as they wanted, and vary more than one variable. Three conditions were compared in terms of learning gains for learners having distinct levels of prior knowledge. Participants designed and conducted experiments within an online learning environment that (1) did not include an EDT, (2) included the Constrained EDT, or (3) included the Open EDT. Results indicated low prior knowledge learners to benefit most from the Constrained EDT (non-significant), low-intermediate prior knowledge learners from the Open EDT (significant), and high-intermediate prior knowledge learners from no EDT (non-significant). We advocate guidance to be configurable to serve learners with varying levels of prior knowledge.

Purpose: Behavior and temperament (e.g., emotional reactivity, self-regulation) have been considered relevant to stuttering and its developmental course, but the direction of this relation is still unknown. Knowledge of behavior difficulties and temperament in childhood stuttering can improve screening and intervention. The current study examined both directions of the relationship between stuttering and behavior difficulties and temperament and between persistent stuttering and behavior difficulties and temperament across childhood. Method: This study was embedded in the Generation R Study, a population-based cohort from fetal life onward in the Netherlands. We analyzed data from 145 children (4.2%) with a history of stuttering (118 recovered, 27 persistent) and 3,276 children without such a history. Behavior and temperament were repeatedly assessed using parental questionnaires (Child Behavior Checklist) and Infant/Child Behavior Questionnaire between 0.5 and 9 years of age. Multiple logistic and linear regression analyses were performed. Results: Six-month-old children who were less able to "recover from distress," indicating poor self-regulation, were more likely to develop persistent stuttering later in childhood (odds ratio = 2.05, 95% confidence interval (CI) [1.03, 4.05], p = 0.04). In the opposite direction, children with a history of stuttering showed more negative affectivity ([beta] = 0.19, 95% CI [0.02, 0.37], p = 0.03) at 6 years of age than children without such a history. Stuttering persistence was associated with increased internalizing behaviors ([beta] = 0.38, 95% CI [0.03, 0.74], p = 0.04) and higher emotional reactivity ([beta] = 0.53, 95% CI [0.09, 0.89], p = 0.02) at the age of 9 years. Conclusions: Behavior and temperament were associated with stuttering persistency--seemingly as both predictor and consequence--but did not predict a history of stuttering. We suggest that children who persist in stuttering should be carefully monitored, and if behavioral or temperamental problems appear, treatment for these problems should be offered.

The opaque English orthography complicates learning to read, as irregular words, such as the word "pint," cannot be Addread accurately by decoding. Studies with first language (L1) English children show that vocabulary facilitates word reading, especially in the case of irregular words. It is unclear whether this influence of vocabulary extends to children learning to read English as a foreign language (EFL). When learning EFL, words are often encountered in print first, potentially making orthographic knowledge especially important. Orthographic knowledge might partially account for the effect of vocabulary on irregular word reading. In this study, 455 Dutch students in their first year of formal English education (11-13 years, Grade 7) were followed. Their English vocabulary, orthographic knowledge, and irregular, regular and pseudoword reading skills were assessed in fall and spring. Commonality analyses showed that vocabulary contributed more to irregular than to regular or pseudoword reading, even when controlling for orthographic knowledge. Additionally, orthographic knowledge was related to irregular word reading concurrently, independent of vocabulary. Longitudinal analyses showed that vocabulary and orthographic knowledge also had independent effects on the "development" of irregular word reading, but not on regular or pseudoword reading. Overall, the predictors for EFL word reading were in line with previous L1 findings. Both EFL and L1 learners use vocabulary and orthographic knowledge to read irregular words. This suggests that the relationship between vocabulary and word reading is related to aspects of the English orthography itself. To enable EFL learners to read irregular words, it is important to teach the other constituents of word knowledge, that is, vocabulary and orthography.

Availability of orthography during word learning has been found to facilitate learning the word's spelling and pronunciation and has been proposed to facilitate learning its meaning. This has not been studied in second language (L2) learning yet, in which word learning often corresponds to translation learning. Therefore, an L2 word learning experiment was carried out. Grade 6 Dutch students (n = 92) were taught English words, with orthography available or absent. Words were divided into those that are spelled entirely like they sound (consistent, e.g., "lilt") and those that are not (inconsistent, e.g., "budgie"). Students learned the words using forward translation (Dutch to English) or backward translation (English to Dutch). At post-test spelling, reading and forward as well as backward translation were measured. Results indicate that availability of orthography mainly facilitated word spelling and reading. There was a trend for orthography to affect learning the translation. Learning consistent words benefited most from orthography, especially when the post-test demanded forward translation. As forward translation requires retrieval of the word's pronunciation, it is likely that students used orthographic mapping to better remember the pronunciations of the English words. Forward translation was easier if words were learned in the same direction, but backward translation was not affected by learning direction. Together, these results imply that orthography supports translation learning, although this is likely caused by learning the word's pronunciation and not by establishing a direct link between orthography and word meaning.

Previous research indicates that infant-directed speech (IDS) is usually slower than adult-directed speech (ADS) and mothers prefer placing a focused word in isolation or utterance-final position in (English) IDS, which may benefit word learning. This study investigated the speaking rate and word position of IDS in two typologically-distinct languages: Dutch and Mandarin Chinese. We used a storybook-telling task to elicit semi-spontaneous ADS and IDS. The storybook contained target words that were familiar or unfamiliar to children. For each language, we asked: (1) whether IDS was slower than ADS; (2) whether mothers slowed down to highlight unfamiliar words; (3) whether the speaking rate of IDS changed between 18 and 24 months; and (4) whether mothers preferred placing unfamiliar words in isolation or utterance-final position in IDS. Results suggest that Dutch IDS, but not Mandarin Chinese IDS, was slower than ADS. Also, only Dutch mothers slowed down specifically when introducing unfamiliar words in IDS. In both languages, mothers placed target words in isolation (but not in utterance-final position) more frequently in IDS. These results suggest that the temporal modifications in IDS may vary across languages. Thus, language-specificity of IDS and its implications for language acquisition should be considered in future research.

In order to support professional development of their teachers 14 Dutch secondary schools developed and implemented a series of interventions. The concept of School as Professional Learning Community was used to frame these school interventions. Data were collected through project documents, interviews with school principals and project leaders, group interviews with teachers and focus groups with project leaders. Interventions can be grouped into five clusters: 1) Shared school vision on learning; 2) Professional learning opportunities for all staff; 3) Collaborative work and learning; 4) Change of school organisation, and 5) Learning leadership. Interventions aimed at teacher-leaders, team leaders and school principals were relatively rare. Interventions belonging to the clusters Professional learning opportunities and Collaborative work and learning were the ones most frequently mentioned including formal and informal teacher groups working and learning together. In general, we conclude that the more embedded an intervention was in the organisation and culture of a school, the more sustainable it appeared to be.

Mentoring relationships between research supervisors and doctoral students play a key role in doctoral students' success. Self-determination theory assumes that the quality of these relationships can be defined in terms of fulfillment of students' basic psychological needs for autonomy, competence, and relatedness. Studies on how supervisors and students build need-supportive relationships are, however, lacking. Taking a schema-based perspective, this article investigates supervisors' and doctoral students' (mis)alignments in schemas on how to fulfill students' basic needs in their relationship. Qualitative data were obtained from a sample of 18 interviews (nine dyads) to reveal the schema-driven sensemaking of students and their supervisors. Findings show that the idea of schema similarity might be too simple: For each of the three basic needs, tensions arise between students' and supervisors' schemas. These need-based schemas in action offer a fresh perspective for understanding why some supervisor-doctoral student relationships are experienced as successful while others are not.

Purpose: In professional learning communities (PLCs), teachers collaborate and learn with the aim of improving students' learning. The aim of this study is to gain insight into teachers' perceptions of their schools' changing toward PLCs and conditions which support or hamper this change. Design/methodology/approach: Questionnaires were completed by a total of 2.111 teachers from 15 Dutch secondary schools for three years. With the use of multilevel regression analyses, the research questions were answered. Findings: Although the development of a school toward a PLC seems to be a slow process, the findings demonstrate the influence of school conditions on this development. Human resource management (HRM) stands out, as this school condition has a direct and longitudinal effect on the change. Practical implications: The main recommendation is to embed PLC elements in HRM policies such as facilitating teachers to collaboratively work and learn and aligning teachers' professional development with schools' vision and ambitions. Originality/value: PLCs have been studied occasionally in longitudinal in-depth case studies or in large-scale, cross-sectional research. This large-scale longitudinal study provides insights into the sustainability of schools as PLCs and the school conditions that are associated with sustainability.

This paper describes the design process for a digital instructional sequence on introductory quantum physics for upper secondary education. Based on a collaboration between teachers and physics education researchers, this sequence incorporates relevant theoretical foundations from the field of science teaching to promote meaningful and conceptual learning of quantum physics. The sequence is composed of units, which are being developed using the Go-Lab ecosystem (www.golabz.eu), a free online platform for teachers to create digital inquiry-based lessons. So far, the sequence covers the photoelectric effect, wave-particle duality, and tunnelling phenomena. This paper focuses on the sequence's first unit, addressing the photoelectric effect. The unit is used in this paper to exemplify the incorporation of the sequence's theoretical foundations: digital inquiry-based learning with simulations, collaborative learning, and conceptual change. The unit was pilot-tested with 114 students in four Dutch high schools. Answers to multiple-choice and open-ended questions were collected through the Go-Lab platform. Analyses showed the unit's potential to promote correct reasoning about the role of the intensity and frequency variables and revealed students' difficulties in grasping light's particle nature at the end of the lesson. These preliminary results are used to draw conclusions about how to improve this unit and inform the design of new instructional sequences.

The Active Recovery Triad (ART) model provides a framework for recovery-oriented care in long-term mental health settings. The aim of this study is to gain insight into the experiences and views of service users and their significant others regarding care and support they receive from teams working with the ART model. Semi-structured interviews were performed with nineteen service users and five significant others of teams operating in Dutch long-term mental health care. Data were analyzed using thematic analysis. The three core principles of the ART model formed the deductive basis of the analysis and for every principle themes were identified inductively. Under the principle 'Active', service users mentioned that they feel motivated, work actively on personal recovery goals and have dreams for the future. Service users valued the service as a safe environment, but several service users also preferred to live more independently. Under the principle 'Recovery', participants reported how the dimensions of recovery (health, personal identity, daily life and community functioning) were addressed in care and support. Also, specific conditions for recovery-oriented care were identified, for example regarding specific expertise of care providers. Under the principle 'Triad' the support from significant others, contact with care workers and with other service users were identified as important. The insights regarding what is important for service users and their significant others may contribute to the improvement of care and support in long-term mental health care. In addition, the findings of this study provide directions for the further development of the ART model. [ABSTRACT FROM AUTHOR]

Background: After initial COVID-19, immune dysregulation may persist and drive post-acute sequelae of COVID-19 (PASC). We described longitudinal trajectories of cytokines in adults up to 6 months following SARS-CoV-2 infection and explored early predictors of PASC. Methods: RECoVERED is a prospective cohort of individuals with laboratory-confirmed SARS-CoV-2 infection between May 2020 and June 2021 in Amsterdam, the Netherlands. Serum was collected at weeks 4, 12 and 24 of follow-up. Monthly symptom questionnaires were completed from month 2 after COVID-19 onset onwards; lung diffusion capacity (DLCO) was tested at 6 months. Cytokine concentrations were analysed by human magnetic Luminex screening assay. We used a linear mixed-effects model to study log-concentrations of cytokines over time, assessing their association with socio-demographic and clinical characteristics that were included in the model as fixed effects. Results: 186/349 (53%) participants had ≥2 serum samples and were included in current analyses. Of these, 101/186 (54%: 45/101[45%] female, median age 55 years [IQR = 45–64]) reported PASC at 12 and 24 weeks after COVID-19 onset. We included 37 reference samples (17/37[46%] female, median age 49 years [IQR = 40–56]). In a multivariate model, PASC was associated with raised CRP and abnormal diffusion capacity with raised IL10, IL17, IL6, IP10 and TNFα at 24 weeks. Early (0–4 week) IL-1β and BMI at COVID-19 onset were predictive of PASC at 24 weeks. Conclusions: Our findings indicate that immune dysregulation plays an important role in PASC pathogenesis, especially among individuals with reduced pulmonary function. Early IL-1β shows promise as a predictor of PASC. [ABSTRACT FROM AUTHOR]

The article presents a study which evaluated direct oral anticoagulants (DOAC) levels in frail older patients with acute illnesses, indicating an essential aspect of their anticoagulant management. Topics discussed include expected rise in DOAC use in frail older patients, patients with higher rates of bleeding, patient demographic and medical data at admission, and a trend observed for rivaroxaban use and DOAC levels above the on-therapy range.

Introduction: The aim of our study was to validate the original Charlson Comorbidity Index (1987) (CCI) and adjusted CCI (2011) as a prediction model for 30-day and 1-year mortality after hip fracture surgery. The secondary aim of this study was to verify each variable of the CCI as a factor associated with 30-day and 1-year mortality. Methods: A prospective database of two-level II trauma teaching hospitals in the Netherlands was used. The original CCI from 1987 and the adjusted CCI were calculated based on medical history. To validate the original CCI and the adjusted CCI, the CCI was plotted against the observed 30-day and 1-year mortality, and the area under the curve (AUC) was calculated. Results: A total of 3523 patients were included in this cohort study. The mean of the original CCI in this cohort was 5.1 (SD ± 2.0) and 4.6 (SD ± 1.9) for the adjusted CCI. The AUCs of the prediction models were 0.674 and 0.696 for 30-day mortality for the original and adjusted CCIs, respectively. The AUCs for 1-year mortality were 0.705 and 0.717 for the original and adjusted CCIs, respectively. Conclusions: A higher original and adjusted CCI is associated with a higher mortality rate. The AUC was relatively low for 30-day and 1-year mortality for both the original and adjusted CCIs compared to other prediction models for hip fracture patients in our cohort. The CCI is not recommended for the prediction of 30-day and 1-year mortality in hip fracture patients. [ABSTRACT FROM AUTHOR]

An ongoing global shortage of verteporfin (Visudyne®) limits the treatment possibilities for several chorioretinal diseases, including central serous chorioretinopathy, choroidal hemangioma, and polypoidal choroidal vasculopathy. Verteporfin is required to perform photodynamic therapy in these ocular diseases. Therefore, the current situation has a substantial impact on eye care worldwide. The worldwide supply of verteporfin appears to be manufactured by a single factory, which is situated in the United States. The distribution of verteporfin is done by different companies for different regions of the world. Official communication on the shortage by the responsible companies has been scarce and over the past years several promises with regards to resolution of the shortage have not been fulfilled. The delivery of new batches of verteporfin is at irregular intervals, unpredictable, and may not be fairly balanced between different regions or countries in the world. To ensure a fair distribution of available verteporfin within a country, several measures can be taken. In the Netherlands, a national committee, consisting of ophthalmologists, is in place to arrange this. On the European level, the European Union and European Medicine Agency have plans to monitor medicine shortages more closely and to intervene if necessary. With a more intensified monitoring and regulation of medicine supplies, future impending shortages may be prevented. Remarkably, the amount of medicine shortages is increasing, having a significant and sometimes irreversible impact on patient care. Thus, efforts should be undertaken to minimize the consequences and, whenever possible, to prevent future medicine shortages. [ABSTRACT FROM AUTHOR]

Course materials play a vital role in the foreign language classroom. Relatively little attention has been paid, however, to analyzing the activities that foster oral interactional ability in course materials for English as a foreign language (EFL). For the purpose of this study, a coding scheme was designed that focuses specifically on the development of interactional ability. This was used to analyse the three most commonly used EFL course books for pre-vocational learners in the Netherlands. The analysis revealed that course books focus more on developing language knowledge than on developing the ability to use this knowledge in interaction, that interactional strategies practice is missing, and that interactional practice is limited to the personal and public context. We conclude that EFL course books lag behind current theories of second language acquisition (SLA) in the practical application of activities focused on developing interactional ability. Recommendations to strengthen the link between theory and practice are made.

This study investigates the pitch properties of infant-directed speech (IDS) specific to word-learning contexts in which mothers introduce unfamiliar words to children. Using a semi-spontaneous story-book telling task, we examined (1) whether mothers made distinctions between unfamiliar and familiar words with pitch in IDS compared to adult-directed speech (ADS); (2) whether pitch properties change when mothers address children from 18 to 24 months; and (3) how Mandarin Chinese and Dutch IDS differ in their pitch properties in word-learning contexts. Results show that the mean pitch of Mandarin Chinese IDS was already ADS-like when children were 24 months, but Dutch IDS remained exaggerated in pitch at the same age. Crucially, Mandarin Chinese mothers used a higher pitch and a larger pitch range in IDS when introducing unfamiliar words, while Dutch mothers used a higher pitch specifically for familiar words. These findings contribute to the language-specificity of prosodic input in early lexical development.

Pervasive inbreeding is a major genetic threat of population fragmentation and can undermine the efficacy of population connectivity measures. Nevertheless, few studies have evaluated whether wildlife crossings can alleviate the frequency and length of genomic autozygous segments. Here, we provided a genomic inbreeding perspective on the potential effectiveness of mammal population defragmentation measures. We applied a SNP-genotyping case study on the ~2500 wild boar Sus scrofa population of Veluwe, The Netherlands, a 1000-km2 Natura 2000 protected area with many fences and roads but also, increasingly, fence openings and wildlife crossings. We combined a 20K genotyping assessment of genetic status and migration rate with a simulation that examined the potential for alleviation of isolation and inbreeding. We found that Veluwe wild boar subpopulations are significantly differentiated (FST-values of 0.02-0.13) and have low levels of gene flow. One noteworthy exception was the Central and Southeastern subpopulation, which were nearly panmictic and appeared to be effectively connected through a highway wildlife overpass. Estimated effective population sizes were at least 85 for the meta-population and ranged from 31 to 52 for the subpopulations. All subpopulations, including the two connected subpopulations, experienced substantial inbreeding, as evidenced through the occurrence of many long homozygous segments. Simulation output indicated that whereas one or few migrants per generation could undo genetic differentiation and boost effective population sizes rapidly, genomic inbreeding was only marginally reduced. The implication is that ostensibly successful connectivity restoration projects may fail to alleviate genomic inbreeding of fragmented mammal populations. We put forward that defragmentation projects should allow for (i) monitoring of levels of differentiation, migration and genomic inbreeding, (ii) anticipation of the inbreeding status of the meta-population, and, if inbreeding levels are high and/or haplotypes have become fixed, (iii) consideration of enhancing migration and gene flow among meta-populations, possibly through translocation. [ABSTRACT FROM AUTHOR]

Aims: Knowledge about adverse drug events caused by drug–drug interactions (DDI‐ADEs) is limited. We aimed to provide detailed insights about DDI‐ADEs related to three frequent, high‐risk potential DDIs (pDDIs) in the critical care setting: pDDIs with international normalized ratio increase (INR+) potential, pDDIs with acute kidney injury (AKI) potential, and pDDIs with QTc prolongation potential. Methods: We extracted routinely collected retrospective data from electronic health records of intensive care units (ICUs) patients (≥18 years), admitted to ten hospitals in the Netherlands between January 2010 and September 2019. We used computerized triggers (e‐triggers) to preselect patients with potential DDI‐ADEs. Between September 2020 and October 2021, clinical experts conducted a retrospective manual patient chart review on a subset of preselected patients, and assessed causality, severity, preventability, and contribution to ICU length of stay of DDI‐ADEs using internationally prevailing standards. Results: In total 85 422 patients with ≥1 pDDI were included. Of these patients, 32 820 (38.4%) have been exposed to one of the three pDDIs. In the exposed group, 1141 (3.5%) patients were preselected using e‐triggers. Of 237 patients (21%) assessed, 155 (65.4%) experienced an actual DDI‐ADE; 52.9% had severity level of serious or higher, 75.5% were preventable, and 19.3% contributed to a longer ICU length of stay. The positive predictive value was the highest for DDI‐INR+ e‐trigger (0.76), followed by DDI‐AKI e‐trigger (0.57). Conclusion: The highly preventable nature and severity of DDI‐ADEs, calls for action to optimize ICU patient safety. Use of e‐triggers proved to be a promising preselection strategy. [ABSTRACT FROM AUTHOR]

Background: Psoriasis is a prevalent, chronic skin disease with a potential impact on work productivity, medical consumption costs, and quality of life. The influence of the extent of skin lesions on these outcomes is not well known. Objective: We determined associations of self-reported skin lesions with self-reported work productivity, medical consumption costs, and health-related quality of life in respondents with psoriasis. Methods: In this cross-sectional study, we included respondents with self-reported psoriasis in the Netherlands in an online questionnaire. We assessed the self-reported percentage body surface area (BSA) of psoriasis lesions. We used validated instruments to assess work productivity (WPAI-PsO), medical consumption costs (iMCQ), and health-related quality of life (EQ-5D-5L and the DLQI). We used ordinal logistic regression to associate BSA categories >1% versus 0-1% with outcomes adjusted for multiple confounders. Results: We included 501 respondents with a mean age of 43±12years; 64% were men. Median BSA was 2% (interquartile range 1–5%). A higher BSA was associated with higher overall work impairment due to psoriasis (common odds ratio [cOR] 2.44, 95% confidence interval [CI] 1.40–4.29; n=205), higher medical consumption costs (cOR 2.06, 95% CI 1.45–2.94) and lower health-related quality of life. Associations were strongest with a BSA cutoff of 0% or 1% compared to 2% or higher categories. Discussion: In our study, having few to no lesions in psoriasis was associated with lower overall work impairment due to psoriasis, lower medical consumption costs, and higher health-related quality of life. [ABSTRACT FROM AUTHOR]

The shift to a knowledge information society has given rise to a need for lifelong learning programmes. Such programmes are especially relevant for public health professionals, whose dynamic field of practice is subject to changes due to rapidly developing technologies, evolving expectations of the labour market and new health treats. Lifelong learning programmes for public health should address topics like planning, organisation, leadership, teamwork and research methods, and schools of public health should introduce innovative educational approaches that enable professionals to learn from the experiences of others. This paper describes the rationale for the development of a European online problem-based course on leadership for public health professionals in Europe, the first pilot evaluation and its impact on the final shape of the course. Problem-based learning (PBL) is an excellent approach for a course focused on lifelong learning, because it stimulates constructive, collaborative, and self-directed learning from authentic problems that are relevant to professional practice, and thereby facilitates the transfer of knowledge. Blended learning, which combines face-to-face and online learning, provides new opportunities for working professionals, enabling participation in international student teams and attendance of lectures by international experts without the need to travel. This makes blended problem-based learning a highly effective and efficient learning strategy for continuing professional development. The paper presents a structure for an online pilot leadership course underpinned by a review of the literature and developed and implemented by an international collaboration of four European universities. The curriculum consisted of eight sessions. Each session was developed and offered by a different university center. Two first sessions were delivered face-to-face and the other sessions were online. The seven-step approach of Maastricht University was suitable for a blended mode of PBL. Twelve public health professionals for NHS took part in the course and final evaluation. They found it difficult to use online communication tools for learning and professional activities. Based on the results of the pilot the leadership course was adapted. The training at the beginning was extended with information on behaviour during online sessions. Online practice sessions were integrated before the course. The problems were reformulated and build around a common theme. Educational institutions who would like to embark on a similar project, should consider complexities related to coordination, development and implementation of such a complex educational practice.

This study describes the socio-cognitive dynamics of collaborative online knowledge-building discourse among Dutch Master of Education students from the perspective of openness. A socio-cognitive openness framework consisting of four social and four cognitive components was used to analyze contributions to online collective knowledge building processes in two Knowledge Forum® databases. Analysis revealed that the contributions express a moderate level of openness, with higher social than cognitive openness. Three cognitive indicators of openness were positively associated with follow-up, while the social indicators of openness appeared to have no bearings on follow-up. Findings also suggested that teachers' contributions were more social in nature and had less follow-up compared to students' contributions. From the perspective of openness, the discourse acts of building knowledge and expressing uncertainty appear to be key in keeping knowledge building discourse going, in particular through linking new knowledge claims to previous claims and simultaneously inviting others to refine the contributed claim.

Since the new millennium, the issue of financial inclusion of young people has increasingly gained recognition, especially in relation to those living in deprived circumstances. Financial inclusion can be promoted through education that specifically aims for the strengthening of young persons' financial capabilities. In 2013, a participatory action research project was started in a rural region of Colombia to improve the research capacity of a local university through the development and implementation of a demonstration project on the financial inclusion of young people. University teachers, students and employees of a financial cooperative were trained in conducting qualitative methods with a specific aim of being responsive to the life stories of their interviewees. This paper shares the experiences from an international team of educational scholars who aim for the democratisation of research capacity and the dissemination of localised knowledge. This is done by working closely together with stakeholders and ultimately giving a voice to youth employed in the informal economy as they are usually the ones being most deprived from access to financial services.

Although phonological awareness (PA) and rapid automatized naming (RAN) are confirmed as early predictors of reading in a large number of orthographies, it is as yet unclear whether the predictive patterns are universal or language specific. This was examined in a longitudinal study across Grades 1 and 2 with 1,120 children acquiring one of five alphabetic orthographies with different degrees of orthographic complexity (English, French, German, Dutch, and Greek). Path analyses revealed that a universal model could not be confirmed. When we specified the best-fitting model separately for each language, RAN was a consistent predictor of reading fluency in all orthographies, whereas the association between PA and reading was complex and mostly interactive. We conclude that RAN taps into a language-universal cognitive mechanism that is involved in reading alphabetic orthographies (independent of complexity), whereas the PA--reading relationship depends on many factors like task characteristics, developmental status, and orthographic complexity.

Little is known about the effects of different instructional approaches on learner affect in oral interaction in the foreign language classroom. In a randomized experiment with Dutch pre-vocational learners (N = 147), we evaluated the effects of 3 newly developed instructional programs for English as a foreign language (EFL). These programs differed in instructional focus (form-focused vs. interaction strategies-oriented) and type of task (pre-scripted language tasks vs. information gap tasks). Multilevel analyses revealed that learners' enjoyment of EFL oral interaction was not affected by instruction, that willingness to communicate (WTC) decreased over time, and that self-confidence was positively affected by combining information gap tasks with interactional strategies instruction. In addition, regression analyses revealed that development in learners' WTC and enjoyment did not have predictive value for achievement in EFL oral interaction, but that development in self-confidence did explain achievement in EFL oral interaction in trained interactional contexts.

The high rates of comorbidity with substance use disorders in general psychiatry patients demand enhanced competences from psychiatry residents in addiction medicine. The aim of this article is to improve knowledge, skills and attitudes in psychiatric residents in treating patients with comorbid substance-related disorders (SUD). Four seminars with all residents on relevant and actual knowledge on substance-related disorders and a small group experience of five sessions on improving skills and attitudes in dealing with patients are described and evaluated quantitatively and qualitatively. Both quantitative evaluations show that seminars and small group experiences are highly appreciated. Concerning the seminar, residents appreciated, in particular, to study and present selected up-to-date literature and the positive learning environment. The small group experience resulted in sharing feelings and thoughts about patients with SUD and mutual support. The results show that the goals of these two methods of education have been met. This means that these two methods can be integrated in the training of residents in psychiatry to increase knowledge, skills and attitudes concerning addiction.

Opportunities for academic libraries to enrich their products and services through facilitating open education (OE) in higher education are presented in an overview of good practices. A case study of open textbook publishing was performed at TU Delft to study how these products and services could stimulate educators to adopt OE. A simplified user acceptance model of innovation was developed and applied to the case study, to study the educator's mind-set before and after they published an open textbook with the support of the TU Delft Library. Using the insights that were gained from the case study and from good practices of other university libraries, recommendations are presented for professionalizing products and services by academic libraries to facilitate the adoption of OE into educational practice and to develop institutional policies and regulations that support educators with these practices.

Two explanations for resolving dyslexia were investigated, one assuming resolving underlying deficits and another assuming compensatory mechanisms based on cognitive strengths. Thirty-six Dutch gifted secondary-school students with either persistent (n = 18) or resolving (n = 18) dyslexia participated. Groups, matched on IQ, were assessed on dyslexia- and intelligence-related cognitive risk and protective factors. Findings for the risk factors showed support for both the resolving-deficit and compensatory-mechanism theories: Resolving and persistent groups were comparable on phoneme deletion and nonalphanumeric rapid automatized naming, but resolvers outperformed students with persistent dyslexia on spoonerisms and alphanumeric rapid automatized naming. For the protective factors, resolvers consistently showed more pronounced cognitive strengths in verbal areas relevant for literacy development, which is in line with the compensatory-mechanism theory. We conclude that, besides underlying deficits resolving to some extent, compensation is a plausible explanation for resolving literacy difficulties in gifted students.

This study investigates which subjects teachers talk about with parents in parent--teacher conferences and other contact moments, and how they communicate with regard to these subjects. Fifty-five in-depth interviews were carried out with teachers from special education schools, at-risk schools serving low socio-economic status children and mainstream primary education schools in the southern part of the Netherlands. The results illustrate that (1) two-way communication is used the most in at-risk schools, (2) teachers find it difficult to involve parents in the decision-making process concerning special care for the child, and (3) the teachers' attitude towards parents is best when it comes to difficult discussion topics. When situations are really difficult, teachers stand alongside the parents instead of addressing them from their expert role, asking them 'How can we solve this together?'. Teachers should be more aware of this quality, and not be afraid to address difficult subjects or conflicts.

A central question in the field of foreign language acquisition is whether the processes involved in reading development in a foreign language are universal or dependent on characteristics of the specific language involved. We investigated the impact of orthographic depth and writing system on word reading acquisition in a foreign orthography, by studying children who are proficient readers in the transparent alphabetic Dutch orthography and who learn to read simultaneously in the transparent alphabetic Spanish orthography, the nontransparent alphabetic French orthography and the nonalphabetic Chinese orthography. Results showed that the skills that underlie foreign language word reading are not universal, but are different for alphabetic and nonalphabetic orthographies, and are also different for transparent and nontransparent alphabetic orthographies, albeit to a lesser extent. Word reading acquisition in transparent alphabetic Spanish depended mainly on reading skills in the native language. In contrast, in nontransparent alphabetic French and nonalphabetic Chinese, word reading was mainly influenced by cognitive skills: French word reading by phonological awareness and verbal intelligence, and Chinese word reading by verbal and nonverbal intelligence. Findings thus suggest that the processes underlying foreign language word reading acquisition are not universal but rather depend on the specific language involved.

Introduction: Refugees and their healthcare providers face numerous challenges in receiving and providing maternal and newborn care. Research exploring how these challenges are related to adverse perinatal and maternal outcomes is scarce. Therefore, this study aims to identify suboptimal factors in maternal and newborn care for asylum-seeking and refugee women and assess to what extent these factors may contribute to adverse pregnancy outcomes in the Netherlands. Methods: We conducted a retrospective analysis of national perinatal audit data from 2017 to 2019. Our analysis encompassed cases with adverse perinatal and maternal outcomes in women with a refugee background (n = 53). Suboptimal factors in care were identified and categorized according to Binder et al.'s Three Delays Model, and the extent to which they contributed to the adverse outcome was evaluated. Results: We identified 29 suboptimal factors, of which seven were related to care-seeking, six to the accessibility of services, and 16 to the quality of care. All 53 cases contained suboptimal factors, and in 67.9% of cases, at least one of these factors most likely or probably contributed to the adverse perinatal or maternal outcome. Conclusion: The number of suboptimal factors identified in this study and the extent to which they contributed to adverse perinatal and maternal outcomes among refugee women is alarming. The wide range of suboptimal factors identified provides considerable scope for improvement of maternal and newborn care for refugee populations. These findings also highlight the importance of including refugee women in perinatal audits as it is essential for healthcare providers to better understand the factors associated with adverse outcomes to improve the quality of care. Adjustments to improve care for refugees could include culturally sensitive education for healthcare providers, increased workforce diversity, minimizing the relocation of asylum seekers, and permanent reimbursement of professional interpreter costs. [ABSTRACT FROM AUTHOR]

BACKGROUND: Overweight and obesity impose a considerable individual and social burden, and the urban environments might encompass factors that contribute to obesity. Nevertheless, there is a scarcity of research that takes into account the simultaneous interaction of multiple environmental factors. OBJECTIVES: Our objective was to perform an exposome-wide association study of body mass index (BMI) in a multicohort setting of 15 studies. METHODS: Studies were affiliated with the Dutch Geoscience and Health Cohort Consortium (GECCO), had different population sizes (688–141,825), and covered the entire Netherlands. Ten studies contained general population samples, others focused on specific populations including people with diabetes or impaired hearing. BMI was calculated from self-reported or measured height and weight. Associations with 69 residential neighborhood environmental factors (air pollution, noise, temperature, neighborhood socioeconomic and demographic factors, food environment, drivability, and walkability) were explored. Random forest (RF) regression addressed potential nonlinear and nonadditive associations. In the absence of formal methods for multimodel inference for RF, a rank aggregation-based meta-analytic strategy was used to summarize the results across the studies. RESULTS: Six exposures were associated with BMI: five indicating neighborhood economic or social environments (average home values, percentage of high-income residents, average income, livability score, share of single residents) and one indicating the physical activity environment (walkability in 5-km buffer area). Living in high-income neighborhoods and neighborhoods with higher livability scores was associated with lower BMI. Nonlinear associations were observed with neighborhood home values in all studies. Lower neighborhood home values were associated with higher BMI scores but only for values up to e300,000. The directions of associations were less consistent for walkability and share of single residents. DISCUSSION: Rank aggregation made it possible to flexibly combine the results from various studies, although between-study heterogeneity could not be estimated quantitatively based on RF models. Neighborhood social, economic, and physical environments had the strongest associations with BMI. [ABSTRACT FROM AUTHOR]

Background: Healthcare systems around the world are facing significant challenges because higher costs and an increase in demand for care has not been matched by a corresponding growth in the health workforce. Without reform, healthcare systems are unsustainable. Relocating care, such as from hospitals to general practices, is expected to make a key contribution to ensuring healthcare remains sustainable. Relocating care has a significant impact upon general practitioners (GPs). Therefore, we investigated which care, according to GPs, could be relocated and under which conditions. Method: GPs were recruited through Nivel's GPs network on eHealth and innovation, located in the Netherlands. One exploratory focus group and 12 in-depth interviews were conducted. Interview transcripts were analyzed using the qualitative research principles of thematic analysis. Results: According to the participants, some diagnostic and follow-up care could be relocated from hospitals to GPs once certain prerequisites are fulfilled. An important condition of relocating care from the hospital to the GP is that GPs have sufficient time to take over these tasks. The types of care that can be relocated from the GP to other settings are those questions where the medical knowledge of the GP can offer nothing extra or where problems in navigating the health system cause patients to either turn to, or stay with, their GP. Conclusion: Care should first be relocated from the GP to other settings before attempting to organize the relocation of care from the hospital to the GP. When this, and other conditions are met, some diagnostic and follow-up care can be relocated from the hospital to the GP. [ABSTRACT FROM AUTHOR]

To interpret the Medical Device Regulation for occupational therapists in the Netherlands involved in prescribing and manufacturing custom-made assistive devices and to develop a roadmap for implementation. Four online iterative co-design workshops were organized under supervision of a senior quality manager to assist in the interpretation of the MDR framework with a focus on custom-made assistive devices; and to assist the implementation by generating guidelines and forms. The workshops for seven participating occupational therapists had an interactive character with Q&A, small and homework assignments, and oral evaluations. Next to occupational therapists, participants with different backgrounds joined such as 3D printing experts, engineers, managers, and researchers. The participants experienced the interpretation of the MDR as informative, but also as complex. Complying with the MDR requires considerable documentation activities that are currently not part of care professionals tasks. This initially raised concerns regarding implementation in daily practice. To facilitate the MDR implementation, forms were created and evaluated for a selected design case together with the participants for future reference. Additionally, instructions were given which forms should be filled out only once per organization, which forms could be reused for similar types of custom-made devices, and which forms should be filled out for each individual custom-made device. This study provides practical guidelines and forms to support occupational therapists in the Netherlands to prescribe and manufacture custom-made medical devices complying with the MDR. It is recommended to involve engineers and/or quality managers in this process. Occupational therapists are considered legal manufacturer when they prescribe and manufacture custom-made medical devices for their clients. As such they are legally obliged to meet the Medical Device Regulation (MDR). When designing and manufacturing "in-house" custom-made medical devices, care organizations need to follow and document activities to demonstrate compliance with the MDR. This study offers practical guidelines and forms to facilitate this. [ABSTRACT FROM AUTHOR]

Background: It is unclear whether patients with basal ganglia calcifications (BGC) should undergo infectious disease testing as part of their diagnostic work-up. We investigated the occurrence of possibly associated infections in patients with BGC diagnosed with Fahr's disease or syndrome and consecutively performed a systematic review of published infectious diseases associated with BGC. Methods: In a cross-sectional study, we evaluated infections in non-immunocompromised patients aged ≥ 18 years with BGC in the Netherlands, who were diagnosed with Fahr's disease or syndrome after an extensive multidisciplinary diagnostic work-up. Pathogens that were assessed included the following: Brucella sp., cytomegalovirus, human herpesvirus type 6/8, human immunodeficiency virus (HIV), Mycobacterium tuberculosis, rubella virus, and Toxoplasma gondii. Next, a systematic review was performed using MEDLINE and Embase (2002–2023). Results: The cross-sectional study included 54 patients (median age 65 years). We did not observe any possible related infections to the BGC in this population. Prior infection with Toxoplasma gondii occurred in 28%, and in 94%, IgG rubella antibodies were present. The positive tests were considered to be incidental findings by the multidisciplinary team since these infections are only associated with BGC when congenitally contracted and all patients presented with adult-onset symptoms. The systematic search yielded 47 articles, including 24 narrative reviews/textbooks and 23 original studies (11 case series, 6 cross-sectional and 4 cohort studies, and 2 systematic reviews). Most studies reported congenital infections associated with BGC (cytomegalovirus, HIV, rubella virus, Zika virus). Only two studies reported acquired pathogens (chronic active Epstein–Barr virus and Mycobacterium tuberculosis). The quality of evidence was low. Conclusions: In our cross-sectional study and systematic review, we found no convincing evidence that acquired infections are causing BGC in adults. Therefore, we argue against routine testing for infections in non-immunocompromised adults with BGC in Western countries. [ABSTRACT FROM AUTHOR]

Community-acquired Pneumonia (CAP) guidelines generally recommend to admit patients with moderate-to-severe CAP and start treatment with intravenous antibiotics. This study aims to explore the clinical outcomes of oral antibiotics in patients with moderate-to-severe CAP. We performed a nested cohort study of an observational study including all adult patients presenting to the emergency department of the Haga Teaching Hospital, the Netherlands, between April 2019 and May 2020, who had a blood culture drawn. We conducted propensity score matching with logistic and linear regression analysis to compare patients with moderate-to-severe CAP (Pneumonia Severity Index class III–V) treated with oral antibiotics to patients treated with intravenous antibiotics. Outcomes were 30-day mortality, intensive care unit admission, readmission, length of stay (LOS) and length of antibiotic treatment. Of the original 314 patients, 71 orally treated patients were matched with 102 intravenously treated patients. The mean age was 73 years and 58% were male. We found no significant differences in outcomes between the oral and intravenous group, except for an increased LOS of + 2.6 days (95% confidence interval 1.2–4.0, p value < 0.001) in those treated intravenously. We conclude that oral antibiotics might be a safe and effective treatment for moderate-to-severe CAP for selected patients based on the clinical judgement of the attending physician. [ABSTRACT FROM AUTHOR]