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Met de veelheid aan rapporten over de leesvaardigheid en leesmotivatie van Nederlandse en Vlaamse leerlingen zijn er allerlei discussies losgebarsten over het leesonderwijs. Zo stelt het onderwijsveld de status van ‘begrijpend lezen’ als apart vak ter discussie en vragen ook sommige wetenschappers zich af in hoeverre het leescurriculum moet focussen op versterking van bijvoorbeeld leesstrategiegebruik of juist op leesplezier en kennis over de wereld. In dit artikel bespreken we onderzoeksresultaten die deze polarisering helpen tegen te gaan. Daarbij laten we zien dat tekststructuuronderwijs kansen biedt om gelijktijdig aan leesvaardigheid, kennisopbouw én leesplezier te werken.

Although knowledge of informational text structures can promote text comprehension, this topic receives little attention in the Dutch primary school curriculum. 201 Dutch students in grades 4-6 participated with their teachers (n = 10) in this quasi-experimental study with a switching-panels replication design. Students either first followed a text structure intervention (TOP) and then went back to business-as-usual, or the other way around. During the intervention, teachers taught their students about the characteristics of four informational text structures, and how to use structure-specific graphic organizers to organize main ideas for each structure. In addition, several writing tasks related to the different text structures were included. At three measurement occasions, students completed text structure tests, reading comprehension tests, summarization tasks, and writing tasks. Only the fourth graders in one iteration of the intervention showed immediate effects over and above the effect of business-as-usual lessons on the text structure test (d = 0.50), the reading comprehension test (d = 0.53), the summarization task (d = 0.48). In both iterations of the intervention, an immediate effect was found on writing (d = 0.33 and d = 0.39). These findings are discussed in the light of test-related issues and implementation fidelity data.

Purpose: Potential drug-drug interactions (pDDIs) may harm patients admitted to the Intensive Care Unit (ICU). Due to the patient's critical condition and continuous monitoring on the ICU, not all pDDIs are clinically relevant. Clinical decision support systems (CDSSs) warning for irrelevant pDDIs could result in alert fatigue and overlooking important signals. Therefore, our aim was to describe the frequency of clinically relevant pDDIs (crpDDIs) to enable tailoring of CDSSs to the ICU setting. Materials & methods: In this multicenter retrospective observational study, we used medication administration data to identify pDDIs in ICU admissions from 13 ICUs. Clinical relevance was based on a Delphi study in which intensivists and hospital pharmacists assessed the clinical relevance of pDDIs for the ICU setting. Results: The mean number of pDDIs per 1000 medication administrations was 70.1, dropping to 31.0 when considering only crpDDIs. Of 103,871 ICU patients, 38% was exposed to a crpDDI. The most frequently occurring crpDDIs involve QT-prolonging agents, digoxin, or NSAIDs. Conclusions: Considering clinical relevance of pDDIs in the ICU setting is important, as only half of the detected pDDIs were crpDDIs. Therefore, tailoring CDSSs to the ICU may reduce alert fatigue and improve medication safety in ICU patients.

OBJECTIVE Differences in clinical outcomes between centers and countries may reflect variation in patient characteristics, diagnostic and therapeutic policies, or quality of care. The purpose of this study was to investigate the presence and magnitude of between-center and between-country differences in outcome after aneurysmal subarachnoid hemorrhage (aSAH). METHODS The authors analyzed data from 5972 aSAH patients enrolled in randomized clinical trials of 3 different treatments from the Subarachnoid Hemorrhage International Trialists (SAHIT) repository, including data from 179 centers and 20 countries. They used random effects logistic regression adjusted for patient characteristics and timing of aneurysm treatment to estimate between

Background: A cardiac origin in ischemic stroke is more frequent than previously assumed, but it is not clear which patients benefit from cardiac work-up if obvious cardiac pathology is absent. We hypothesized that thromboembolic stroke with a cardiac source occurs more frequently in the posterior circulation compared with thromboembolic stroke of another etiology. Methods: We performed a multicenter observational study in 3,311 consecutive patients with ischemic stroke who were enrolled in an ongoing prospective stroke registry of 8 University hospitals between September 2009 and November 2014 in The Netherlands. In this

OBJECTIVE: There is evidence that placebo effects may influence hormone secretion. However, few studies have examined placebo effects in the endocrine system, including oxytocin placebo effects. We studied whether it is possible to trigger oxytocin placebo effects using a classical conditioning paradigm. METHODS: Ninety-nine women were assigned to a conditioned, control, or drug control group. In the two-phase conditioning paradigm, participants in the conditioned and drug control groups received an oxytocin nasal spray combined with a distinctive smell (conditioned stimulus [CS]) for three acquisition days, whereas the control group received placebo spray. Subsequently, the conditioned and control groups received placebo spray with the CS and the drug control group received oxytocin spray for three evocation days. Salivary oxytocin was measured several times during each day. Pain sensitivity and facial evaluation tests previously used in oxytocin research were also administered. RESULTS: On evocation day 1, in the conditioned group, oxytocin significantly increased from baseline to 5 minutes after CS (B[slope] = 19.55, SE = 5.88, p < .001) and remained increased from 5 to 20 (B = -10.42, SE = 5.81, p = .071) and 50 minutes (B = -0.70, SE = 3.37, p = .84). On evocation day 2, a trend for increase in oxytocin was found at 5 minutes (B = 15.22, SE = 8.14, p = .062). No placebo effect was found on evocation day 3 (B = 3.57, SE = 3.26, p = .28). Neither exogenous nor conditioned oxytocin affected pain or facial tasks. CONCLUSIONS: Results indicate that oxytocin release can be conditioned and that this response extinguishes over time. Triggering hormonal release by placebo manipulation offers various clinical possibilities, such as enhancing effects of pharmacological treatments or reducing dosages of medications. TRIAL REGISTRATION: The study was registered as a clinical trial on www.trialregister.nl (number NTR5596).

This master thesis looks into the writing education as practised in vocational colleges in The Netherlands: how do teachers in these colleges attempt to get their students to produce written texts at the quality required of the students to graduate; this quality is dictated by law? And how effective are these methods. In summary there are two methods used by these teachers that are apparently quite effective: one method lets students write an assignment, receive feedback and, based on said feedback, rewrite the assignment. The other method is that students observe a finished product written by a professional, and in the process not only read this product but analyse how it was set up and think about the writing process that is needed to make that product, before they start writing their own assignment. It seems this method works best with short texts such as business letters.