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Managing properties and people’s interests in complex multi-level developments is rapidly increasing the last decade and as a result, current cadastral information systems are facing a growing demand to capture, register, maintain, visualise and disseminate 3D spatial information. This has led to a continuous research, at the international scenery, for 3D models and standardization initiatives that help communicate the legal and spatial notions of the built environment.Each of Australia’s states has already established a well-functioning Cadastral Information System, which are progressively moving towards 3D Cadastre. Alongside, the LADM ISO 19152 has gained ground and since its adoption as international standard there have been several attempts by different jurisdictions worldwide to adopt LADM. This however, does not apply for Australia, as only one country profile has been developed – for Queensland – back in 2012.Considering that the LADM edition I revision has already started and through this process improvement and extensions of the current conceptual model, technical LADM specifications through application schemas and encodings, as well as process models will be discussed and investigated, it was a challenge to investigate the possibilities of adopting LADM in Victoria.Given this background, at this paper an approach to model the spatial counterpart of a future LADM-based profile for Victoria is presented, in the context of exploring the implementation issues of 3D Cadastre in Victoria, Australia using LADM. The current status of 2D and 3D cadastral developments in Victoria is presented and the direction towards the adoption of LADM in Victoria is introduced.To be able to develop a LADM Victoria country profile, which will describe the existing situation, but at the same time will be future proof, as first step the mapping between the two existing data models and LADM classes is performed.

Dense urbanisation has led to an increasing demand and pressure for land development, resulting in the partition of 3D space into different owners sharing delimited property interests on, above or below the land surface. Consequently, cadastral spatial units range from simple, but most common, 2D, to complex 3D collections of spaces worldwide, that are more difficult to handle in terms of surveying, storing in a database, maintaining, visualising, etc. Subsequently, this asks for the categorization and organization of the different types of spatial units that are physically identified and legally recognised in various jurisdictions worldwide. In the context of the Land Administration Domain Model (LADM) (ISO 19152, 2012), the “level” concept (LA_Level class) provides a framework for organising the different types of spatial units. Based on that, five levels of encoding are defined in ISO19152, providing a framework of categorisation of 2D spatial units, represented by five spatial profiles included in Annex E of ISO 19152.Six years after the publication of the first edition of LADM as ISO standard, a lot of research has been carried out by experts from all over the world, and today, the ground seems to be mature for the LADM (edition I) revision, which started in May 2018, as a joint activity with many stakeholders involved (ISO TC211, OGC, FIG, etc.). One of the goals of the revision, among others, is to improve LADM’s current 3D support. This can be achieved through the design of new 3D spatial profiles for the different types of spatial units that are recognised by cadastral authorities in various jurisdictions. New and different 3D spatial units’ types may be considered for inclusion in the standard.To this end, the aim of this paper is to investigate, examine and review - in the context of LADM revision- the different types of real-world spatial units, as they have initially been organised by Thompson et al (2015). Based on the revised taxonomy, spatial profiles for the spatial units’ categories are introduced and (several) are further explored and designed. Hence, the focus on this paper lies on two levels: the taxonomy and the spatial profiles, while the level of encoding is not included in the scope of this paper. However, the investigation of the technical encodings that will be used for the implementation of the 3D spatial profiles is introduced at the paper as future work, underlying its importance. Within this concept, the scope and ambition of LADM revision are discussed.

This paper presents the development of database for the conceptual model of LADM-IndoorGML. The aim of this work is to investigate all issues that related to generating the database and visualizing the content of the database. Based on the result of the transformation from conceptual model to the technical model that has been proposed by (Alattas et al., 2018), we have selected some classes of the conceptual model of LADM-IndoorGML to create a database in PostgreSQL with the extension of PostGIS. By converting those classes from class diagram to SQL DDL, a database has been generated and stored different type of data. A visualization tool has been used to visualize indoor spaces based on RRRs for the users.

Many countries are extending their cadastral visualization systems in the third dimension. The reason for this stems from the increasing complexity of contemporary cities, the growing 3D approach in other fields (including 3D spatial data acquisition, spatial data processing and visualization), which made 3D cadastre technologically feasible, and the need to overcome the issues of 2D visualization. The visualization of cadastral parcels in 3D is a challenge, since legal boundaries are, in many cases, invisible in the real world; so how can we properly represent something that is not visible to our eyes? This paper results from research that looks into problems of occlusion and ambiguous perception (in terms of position, size and shape) of objects in the context of 3D cadastre visualization. The exploration of specific interaction techniques is essential to overcome these issues.The aim of this paper is to provide ’lessons learned’ resulting from the implementation of a 3D cadastre prototype that was built with the specific goal of trying out several visualization options of 3D cadastral information in a web environment. A usability test was carried out to obtain feedback from different groups of users. Usability is meant in terms of effectiveness and efficiency of the system and users’ satisfaction. The test users were subdivided into groups according to different professional domains and expertise. During the test, the users are asked to perform a series of tasks typical of cadastral systems. Each task is accompanied by a description to give the users some context. Then, each user is asked to answer a questionnaire about his or her experience. The results are used to extract general feedback. The outcome of the usability test is crucial to point out the detected limitations in this early stage of the prototype development. Design changes can then be made according to the feedback of the test users.

Property valuation is a process of estimating value of an immovable property. The legal, geometric, physical and environmental characteristics of the immovable property together with the economic indicators are taken into consideration during this process. Traditional cadastral systems only provide two-dimensional (2D) legal and geometric information about property units. However, today’s complex valuation practices (e.g. computer aided mass appraisal) would benefit significantly from three dimensional (3D) information on not only property units but also their physical counterparts (e.g. buildings, building parts). Moreover, 2D and 3D environmental information is needed for determining environmental conditions about immovable properties to better estimate the values of them.A collaborative research initiative has proposed an international valuation information model that extends the LADM for specifying semantics of valuation registries maintained by public authorities. The current version of the LADM Valuation Information Model, however, does not include detailed specification for the environmental characteristics of immovable properties (e.g. presence of views, level of visibility and distance to amenities) which can be derived with 2D and 3D geospatial analyses by means of various data sources.The purpose of this paper is to examine which geospatial analyses, especially 3D analyses, can be used to provide information about immovable properties including environmental and locational characteristics for property valuation activities. Furthermore, it is investigated that how property valuation can benefit from data sources including semantically rich 3D building, city and cadastral models for deriving environmental and locational characteristics of property units. To achieve these objectives, the data sources and geospatial analyses are initially investigated in the context of property valuation. Then, the paper focuses more on viewshed analysis. By using open topography, building and height datasets of the Netherlands and 3D GIS analysis, a viewshed analysis is presented to show how it can be utilized using different data sources for better understanding and explanation of values of the properties. The paper is concluded with a discussion to what extent it is possible and meaningful to include (derived) environmental characteristics of properties in the LADM Valuation Information Model.

Item does not contain fulltext OBJECTIVE: Parents and health professionals believe that recurrent respiratory tract infections (RRTI) have a large impact on children with Down syndrome (DS). We studied the relation between parent-reported RRTI and development, behaviour and health-related quality of life (HRQoL) in 8-year-old children with DS. METHOD: During a 3-year period, 325 children with DS were recruited for inclusion in this observational study. Parents were asked to fill in the Child Behavior Checklist and TNO-AZL Children's Quality of Life Parent Form. A psychological assistant administrated the McCarthy Scales of Children's Abilities. The children were divided into a group with presence of RRTI (RRTI (+) ) and a group without RRTI (RRTI (-) ), on the basis of parental report. Linear regression analyses were performed to assess the effect of RRTI, while correcting for the influence of confounders. RESULTS: Compared with RRTI (-) children (n = 176), RRTI (+) children (n = 149, 46%) showed decreased mental and motor development (mean developmental age 3.67 vs. 4.08 years), more behavioural problems and lower scores on most HRQoL scales (P < 0.05). Moreover, school enrolment is less favourable in RRTI (+) children. CONCLUSION: In 8-year-olds with DS, the children with parent-reported RRTI show more delayed development, more behavioural problems and lower HRQoL compared with the children without RRTI. Although this association does not prove a causal relationship, further studies should focus on this, because RRTI are potentially preventable. 01 november 2013

Utilities, buildings and infrastructure digital representations are very important set of spatial data for quality and sustainable spatial management and development of community in general. Many countries are on the way of the establishment of the 3D cadastre. Existing 2D cadastral systems are able to make gradual transition to 3D cadastre, but for the implementation of real 3D cadastre in many countries it is necessary to change the regulations. A topographic sign or topographic symbol is representation of a topographicobject on map. In combination with other geodetic and cartographic products we can get to very useful information, often quite relevant in order to provide reference context for a 3D cadastre. Topographic signs on topographic maps and on other geodetic products give a representation of complex real-world situations that are not usually drawn in the cadastral maps. The real world, physical, objects as included on topographic maps, prove the context/reference for the legal spaces. This is true for both the 2D, but perhaps even more for the 3D case. Performing an overlay, if needed after proper orientation, it is easy to combine geodetic and cartographic products in today’s digital environment. Special attention is needed for the tunnels, overpasses, underpasses, bridges and other objects to be registered in 3D cadastrebecause their 2D cadastral description does not meet the needs of modern society. In case of 3D topographic data (e.g. 3D CityGML model), then it would also well possible to implement this into 3D cadastre and combine 3D legal spaces with the 3D real world items from the 3D topographical model. However, this combination/integration is usually not feasible with the cadastral plans (survey plans, field sketches) as those are not draws to scale (in both 2D and3D).

Powered by WebGL, some renderers have recently become available for the visualization of point cloud data over the web, for example Plasio or Potree. We have extended Potree to be able to visualize massive point clouds and we have successfully used it with the second national Lidar survey of the Netherlands, AHN2, with 640 billion points. In addition to the visualization, the publicly available service at http://ahn2.pointclouds.nl/ also features a multi-resolution download tool, a geographic name search bar, a measurement toolkit, a 2D orientation map with field of view depiction, a demo mode and the tuning of the visualization parameters. Potree relies on reorganizing the point cloud data into an multi-resolution octree data structure. However, this reorganization is very time consuming for massive data sets. Hence, we have used a divide and conquer approach to decrease the octree creation time. To achieve such performance improvement we divided the entire space into smaller cells, generated an octree for each of them in a distributed manner and then we merged them into a single massive octree. The merging is possible because the extent of all the nodes of the octrees is known and fixed. All the developed tools are free and open-source (FOSS) and they can be used to visualize over the web other massive point clouds.

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Uit onderzoek blijkt dat veel kinderen soms of regelmatig gepest worden en dat ouders en leerkrachten vaak niet op de hoogte zijn van pestproblematiek. De piek van het aantal pestgevallen ligt bij 9-14-jarigen. De JGZ kan een belangrijke rol vervullen in signalering, verwijzing en kan bijdragen aan een structureel anti-pestbeleid. Ook kan de JGZ pestende kinderen signaleren. Deze JGZ-richtlijn biedt JGZ-professionals handvatten voor voorlichting, preventie en vroege opsporing,, ondersteuning en behandeling én verwijzing en nazorg.

Doel Bepalen welke mate van zelfredzaamheid en sociaal functioneren jongeren met Down-syndroom bereiken. Opzet Dwarsdoorsnedeonderzoek. Methode We vroegen ouders van een kind met Down-syndroom dat was geboren in 1992, 1993 of 1994, via de Stichting Downsyndroom een schriftelijke vragenlijst in te vullen over hun kind. De vragenlijst bevatte de gestandaardiseerde lijsten ‘Sociale redzaamheid voor zwakzinnigen’, ‘Child behavior checklist’ en ‘Vragenlijst voor inventarisatie van sociaal gedrag van kinderen’, en aanvullende vragen over achtergrondkenmerken. We vergeleken de uitkomsten van dit Nederlandse cohort met beschikbare gegevens van leeftijdsgenoten zonder Down-syndroom. Resultaten We verkregen de gegevens van 322 jongeren met Down-syndroom met een gemiddelde leeftijd van 18,4 jaar (uitersten: 16,8-19,9) (respons: 63%). Bijna 60% van de deelnemers beheerste basisvaardigheden van zelfstandig functioneren, zoals zichzelf verzorgen en wassen, ontbijten en ten minste 30 min alleen thuis kunnen zijn. Ongeveer 10% van de deelnemers beheerste vaardigheden als koken of betalen in een winkel. 9 van de 10 deelnemers hadden meer problemen met sociaal functioneren dan hun leeftijdsgenoten zonder Down-syndroom, met name in sociale interactie, het verwerken van informatie en het reguleren van emoties. De helft van de deelnemers had klinisch relevante gedragsproblemen. Conclusie De resultaten van dit onderzoek wijzen erop dat jongeren met Down-syndroom beperkte praktische en sociale vaardigheden hebben en meer gedragsproblemen dan hun leeftijdsgenoten zonder Down-syndroom. Ze zijn in het dagelijks leven in meer of mindere mate afhankelijk van anderen en hebben hun leven lang begeleiding nodig.

Object. To determine the level of mainstream education in a nationwide cohort of adolescents with Down Syndrome (DS), and to find characteristics related to mainstream or special school attendance. Method. Dutch children with DS born in 1992, 1993 or 1994, were assessed when 16–19 years old. Parents scored school enrolment between the age of 4–18 years, general characteristics and the levels of intellectual disability using the Dutch Social Competence Rating Scale. Associations between disability and years in mainstream school were assessed by ordinal logistic regression, adjusting for sex and parental education. Results. We collected data from 170 boys and 152 girls (response 63%); mean age 18.3 years (ranges 16.8–19.9). Intellectual disability was mostly moderate (43%). Most children (74%) entered mainstream education between 4 and 6 years of age. At 13 years 17% was in mainstream school and 7% stayed in up to 16 years. From the age of 8 years onwards the majority was in special education, while 6% never attended school. Girls were more often in mainstream school and stayed in longer. Level of disability was significantly associated with number of years in mainstream education. Conclusion. Three out of four Dutch children with DS entered mainstream primary education, however late entry and high dropout are common.

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Background. Undescended testis (UDT) or cryptorchidism is the most common genital anomaly seen in boys and can be treated surgically by orchidopexy. The age at which orchidopexy should be performed is controversial for both congenital and acquired UDT. Methods. A decision analysis is performed in which all available knowledge is combined to assess the outcomes of orchidopexy at different ages. Results. Without surgery, unilateral congenital UDT and bilateral congenital UDT are associated with average losses in quality-adjusted life-years (QALYs) of 1.53 QALYs (3% discounting 0.66 QALYs) and 5.23 QALYs (1.91 QALYs), respectively. Surgery reduces this QALY loss to on average 0.84 QALYs (0.21 QALYs) for unilateral UDT and 1.66 QALYs (0.40 QALYs) for bilateral UDT. Surgery at detection will lead to the lowest QALY loss of 0.91 (0.34) and 1.73 (0.60) QALYs, respectively, for unilateral and bilateral acquired UDT compared with surgery during puberty and no surgery. No sensitivity analysis is able to change the preferences for these strategies. Conclusions. Based on our decision analytic model using societal valuations of health outcomes, surgery for unilateral UDT (both congenital and acquired) yielded the lowest loss in QALYs. Given the modest differences in outcomes, there is room for patient (or parent) preference with respect to the performance and timing of surgery in case of unilateral UDT. For bilateral UDT (both congenital and acquired), orchidopexy at any age provides considerable benefit, in particular through improved fertility. As there is no strong effect of timing, the age at which orchidopexy is performed should be discussed with the parents and the patient. More clinical evidence on issues related to timing may in the future modify these results and hence this advice.

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In this thesis, four studies on children and adolescents with Down syndrome are described. The first study showed that the number of live births of children with Down syndrome in the Netherlands remained stable over the period 1997-2007 on 14.6 per 10,000 births. Of these, 85% were live born. In the second study is observed that growth retardation in children with Down syndrome meanly occurs in three critical periods of growth, resulting in shorter final stature and smaller head circumference than the general Dutch population shows. Furthermore, Dutch children with Down syndrome have alarmingly high prevalence rates of overweight and obesity during childhood and adolescence. The third study showed that eight-year-old children with Down syndrome have an average developmental delay of four years, more often have emotional and behavioral problems, and have a less favorable health-related quality of life (HRQoL) compared with children from the general population. Children with Down syndrome and recurrent respiratory tract infections showed relatively more delayed development. In the fourth study, results showed that adolescents with Down syndrome remain dependent to a large degree and have serious difficulties in functioning socially. Additionally, results showed that serious problem behavior is highly prevalent in adolescents with Down syndrome.

Huilen is een onderdeel van normaal gedrag van baby’s, maar kan ouders erg onzeker maken. Zeker als een baby excessief huilt. Als JGZ-professionals kun je ouders ondersteunen en empoweren op een manier die aansluit bij de behoeften van ouders en kind. De richtlijn geeft professionals handvatten voor de preventie, signalering en het komen tot een eenduidige ketenaanpak van excessief huilen.

Survival of children with Down syndrome (DS) has improved considerably, but insight into their level of daily functioning upon entering adulthood is lacking. We collected cross-sectional data from a Dutch nationwide cohort of 322 DS adolescents aged 16-19 (response 62.8%) to assess the degree to which they master various practical and social skills, using the Dutch Social competence rating scale and the Children's Social Behavior Questionnaire. Up to 60% mastered some of the skills required for independent functioning, such as maintaining adequate standards of personal hygiene and preparing breakfast. Less than 10% had achieved basic skills such as basic cooking and paying in a shop. It is difficult for DS people to master all the skills necessary to live independently. Ninety percent of adolescents with DS experience significant problems in social functioning.

Jongeren met downsyndroom zijn sterk afhankelijk en hebben veel moeite om goed sociaal te functioneren. Een deel van hen kan tot op zekere hoogte voor zichzelf zorgen, bijvoorbeeld zelfstandig opstaan, eten met mes en vork en een computer of televisie bedienen. Een op de drie heeft echter 24 uur per dag begeleiding nodig. Dat blijkt uit onderzoek van TNO naar de groei, de ontwikkeling en het functioneren van kinderen en jongeren met downsyndroom.

Het project heeft zich gericht op de vraag hoe je goed onderbouwde user interfaces kunt ontwerpen (voor toegang tot AV-content) voor de VB-doelgroep, waarbij op een systematische manier gebruik gemaakt wordt van kennis van cognitieve functies (zoals geheugen, probleem-oplossen, aandacht, taalbegrip (lezen en luisteren), rekenen, visueel begrip), en mens-machine interface principes en richtlijnen (zoals keuze van functionaliteit, navigatie, lay-out, voorlezen van tekst, gebruik van iconen, afbeeldingen, filmpjes). De gekozen aanpak voor het project was ‘situated Cognitive Engineering’, waarin drie fasen worden onderscheiden: Foundation, Specification en Evaluation. Het project had een tweeledige aanpak. Enerzijds is literatuuronderzoek verricht en zijn experts geconsulteerd, en anderzijds is een praktisch ontwerptraject doorlopen waarin enkele functionaliteiten voor toegang tot AV-content zijn uitgewerkt en geëvalueerd met de doelgroep en hun begeleiders. Het ontwerptraject diende als een toetsing van de gevonden functies, principes en richtlijnen. Het project heeft vooral kennis opgeleverd voor de Foundation, met name: • Operationele eisen: de stakeholders, de gebruikers (doelgroep van personen met LVB en MVB, begeleiders), doelen en taken van gebruikers, de fysieke, sociale en technische omgeving.• Kennis menselijke factoren;- Algemene cognitieve functies, sociaal-emotionele en motivationele factoren relevant voor het ontwerpen van user interfaces.- Algemene ontwerpprincipes en –richtlijnen voor het ontwerpen van user interfaces.- Kennis over hoe de doelgroep LVB en MVB in een ontwerpproces te betrekken.- Beoogde technologieën: bestaande toepassingen voor toegang tot AV-content, bestaande toepassingen voor de VB doelgroep, metadata, privacy. • Tools die ontwerpers ondersteunen om kennis uit de Foundation te vertalen naar user interface specificaties, toegespitst op de doelgroepen LVB en MVB, zoals persona’s, inspiratiekaarten en een overzicht van MMI-oplossingen gekoppeld aan cognitieve functies.Daarnaast heeft het project als bijdrage aan de Specification twee uitgewerkte design patterns opgeleverd voor het zoeken in AV-content: ‘Verstoppen van video’s’ (aansluitend bij het MVB niveau) en ‘Aanmaken gebruikersprofiel’(voor de begeleiders van LVB en MVB). Onderbouwd door kennis uit de Foundation, de ontwikkelde ontwerptools en design patterns is een aantal schetsen van gebruikersinterfaces voor toegang tot AV-content ontwikkeld en geëvalueerd met de doelgroep LVB en MVB. Hieruit bleek duidelijk dat bepaalde oplossingen meer geschikt waren voor de ene dan voor de andere doelgroep. De lessons learned uit deze evaluatie vormen weer input voor de Foundation. Met de gebruikte aanpak is bereikt dat de ontwikkelde user interfaces goed lijken te compenseren voor beperkingen van de LVB en MVB doelgroepen. Het project kan hiermee beschouwd worden als een geslaagde ‘proof of principle’ van de aanpak. Samenvatting 2 1 Inleiding 4 1.1 Probleemstelling en huidige stand van zaken 4 1.2 Doel 4 1.3 Methode 5 1.4 Bijdragen van KING aan sCE 5 1.5 Leeswijzer 7 2 Foundation 9 2.1 Operationele eisen 9 2.2 Kennis menselijke factoren: Cognitieve kenmerken en vaardigheden 10 2.3 Kennis menselijke factoren: Kenmerken VB doelgroep 12 2.4 Kennis menselijke factoren: User interface-aspecten 13 2.5 Kennis menselijke factoren: Inclusive design met VB doelgroep 17 2.6 Beoogde technologieën 17 2.7 Van Foundation naar Specification: tools voor ontwerpers 18 3 Specification 26 4 Evaluation 36 4.1 Expert review van foundation en ontwerphulpmiddelen 36 4.2 Gebruikersevaluatie van test-user interface schetsen 36 4.3 Lessons learned 37 5 Conclusies en aanbevelingen 42 6 Referenties 44

OBJECTIVE: This study aims to evaluate trends in prevalence of Down syndrome (DS) births in the Netherlands over an 11-year period and how they have been affected by maternal age and introduction of prenatal screening.METHOD: Nationwide data of an 11-year birth cohort (1997-2007) from the Netherlands Perinatal Registry were analyzed. First-trimester combined screening was introduced in 2002, free of charge only for women 36 years of age or older and only on patients' request. Changes in maternal age, prevalence of DS births, and rates of births at

Huidafwijkingen komen frequent voor, ook in de jeugdgezondheidszorg (JGZ). Sommige huidafwijkingen ontstaan door een onderliggende ziekte, syndroom of kindermishandeling en het is daarom van groot belang deze vroegtijdig te signaleren. • Huidafwijkingen kunnen een grote psychosociale impact hebben op het kind en de ouder. Mede daarom is preventie, signalering, diagnostiek, behandeling, verwijzing, uniforme advisering en begeleiding van groot belang.• In de JGZ-richtlijn wordt ingegaan op voorlichting en advies, criteria voor verwijzen naar de eerste of tweede lijn en verzorging van de huid in het algemeen. Daarnaast wordt beschreven welke aandoeningen actief opgespoord moeten worden. • Ook is er aandacht voor specifieke aspecten van de donkere huid en etnische diversiteit en de impact van huidafwijkingen op het algemeen welzijn. • In de bijbehorende web-based tool zijn de bewijsvoering en meningen van deskundigen over meer dan 75 huidafwijkingen opgenomen, inclusief afbeeldingen en een beslisboom, om tot een behandelplan te komen.

Background and aims Becoming independent is for young people with Down syndrome (DS) not a standard development, because of their intellectual impairment. Parents often wonder what level their child with DS might reach. This study aims to measure the level of self-sufficiency and problem behaviour in a large population based sample of 16–19-year-old people with DS. Methods Parents of Dutch children with DS born in 1992, 1993 and 1994 were invited to participate (n=513). Data were collected by a written questionnaire for the parents, containing the Dutch SRZ (measuring social independence), the Child Behaviour Checklist, the Children’s Social Behaviour Questionnaire, and additional questions on skills and background. Differences between mean values were evaluated using t-tests. Results Mean age of the 322 participating young people with DS was 18.3 years (52.8% boys). Considering their basic daily skills, they reached a level of around 70% of independent functioning. Girls had a higher level of functioning than boys (p

Doel van deze richtlijn is het bieden van handvatten voor: 1) advisering over houding, hantering en positionering ter preventie van voorkeurshouding en plagiocefalie, 2) tijdige en correcte signalering, diagnose en/of eventuele verwijzing naar huisarts en/of kinderfysiotherapeut, 3) verzorgingsadviezen na signalering, 4) monitoring van het vervolg na verwijzing.

De JGZ speelt een belangrijke rol bij een goede signalering, registratie en diagnostiek bij niet-scrotale testis (NST). Waar nodig wordt verwezen naar de kinderchirurg/-uroloog voor nader onderzoek en eventuele operatieve behandeling.

The objective of the evidence-based guidelines 'Asthma in children (ages 0-19)' for youth healthcare (CHC) is the prevention and reduction of asthma symptoms. The guidelines contain a lot of recommendations that apply to all disciplines in healthcare that deal with children. Primary prevention (preventing asthma): the main proven effective intervention is no smoking, neither passive nor active. Breastfeeding has a small protective effect. Starting at the first home visit at two weeks, the CHC nurse advises no smoking and to breastfeed. Secondary prevention (early detection): at all routine check-ups, the professional at CHC should inquire about signs of dyspnoea and wheezing. Patients suspected of having asthma should be referred to the GP. Tertiary prevention (reducing symptoms in children with asthma): the main advice is no smoking (neither passive nor active) and to follow the advice of the treating physician.