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Background: The role of patient participation and representation during crises, such as the COVID‐19 pandemic, has been under‐researched. Existing studies paint a pessimistic picture of patient representation during the pandemic. However, there are indications that patient representatives have adapted to the new situation and can contribute to the resilience of healthcare systems. This paper aims to further explore the potential contribution of patient representatives for healthcare system resilience during the COVID‐19 pandemic. Methods: The study used a qualitative approach. We conducted a thematic analysis on the following data: interviews with client council members (n = 32) and representatives from patient organizations (n = 6) and focus groups (n = 2) to investigate patient representation on both the national policy level and organizational level in the Netherlands. Results: We identified the crisis discourse, the dependent position, the diversity of patient perspectives and the layered decision‐making structure as themes that help to understand what made patient representation in pandemic times a struggle for national and local patient representatives. The analysis of the subjects these representatives put forward during decision‐making shows that their input can play an important role in broadening discussions, challenging decisions, and suggesting alternatives during a crisis. We identified several strategies (e.g., collaborating with other actors, proactively putting subjects on the policy agenda, finding new ways of contacting their 'constituency') used by the patient representatives studied to exert influence despite the difficulties encountered. Conclusions: The struggle for patient representation during pandemic decision‐making is a missed opportunity for resilient healthcare systems as these representatives can play a role in opening up discussions and putting different perspectives to the fore. Moreover, the adaptive strategies used by representatives to influence decision‐making offer lessons for future representation activities. However, adaptations to the crisis decision‐making structure are also needed to enable patient representatives to play their role. Patient Contribution: We conducted interviews with patient representatives and discussed our preliminary findings with patient representatives during the focus groups. Zorgbelang, a patient organization supporting client councils and enabling and organizing patient participation for organizations and municipalities, was partner in this research and contributed to the interview guide, conducting interviews and focus groups. Additionally, the analysis made by the first author was discussed and refined multiple times with the partners of Zorgbelang and one of them co‐authored this paper. [ABSTRACT FROM AUTHOR]

Background: Informal care features high on the policy agenda of many countries to deal with workforce shortages. As a consequence, care provision increasingly takes place in the care triad of care recipients, informal caregivers and care professionals. How collaboration between care partners takes shape depends on how the different partners perceive this collaboration. This paper aims to investigate the relative importance of the different aspects of collaboration from the perspectives of care recipients, informal caregivers and care professionals in the context of the care for older persons in The Netherlands. Methods: Using Q‐methodology, 32 participants ranked 28 statements that reflect different aspects of collaboration in the care triad and explained their ranking during a follow‐up interview. Participants comprised 9 older persons, 10 informal caregivers and 13 care professionals. Data were analysed using by‐person factor analysis to identify common patterns in the rankings of the statements. Emerging patterns were interpreted and described as views on collaboration using aggregated rankings and qualitative data from the interviews. Results: Five distinct views on collaboration were found: (1) Emphasizing warm collaboration, (2) trusting care professional's expertise, (3) open and compassionate care professionals, (4) responsive decision‐making by autonomous care professionals and (5) prioritizing care recipient's and informal caregiver's interests. Care recipients and/or informal caregivers were associated with views 1, 3 and, 5, whereas care professionals were associated with all five views. Conclusions: Our study highlights the importance of recognizing the potential diversity of views between and within different partner groups in care triads. Governmental and organizational policy makers, as well as healthcare professionals who aim to increase or support the involvement of informal caregivers, should take this heterogeneity into consideration. Patient or Public Contribution: An advisory board of older persons (care recipients and informal caregivers) was involved in the recruitment of the participants, the formulation of the statements and the reflection on the findings of the study and potential implications. [ABSTRACT FROM AUTHOR]

Background Study: Technology‐supported learning environments, act as significant observational and enabling indicators for evaluating and encouraging the digital revolution of education, are of vital importance in current educational research. Keeping track of the dynamics of technology‐supported learning environment research allows for the enrichment of theoretical studies and a prompt innovation of talent‐training environments. Objectives: The present study carried out a bibliometric analysis of the core collection of WoS database over the last two decades. Method: This study is a bibliometric research. We applied CiteSpace and VOSviewer for co‐occurrence and evolution analysis. In addition, we extracted the fundamental ideas and thoughts through reading and analysis. Results: First, the study found that technology‐supported learning environment research is in a growth phase, with core journals such as Interactive Learning Environments or Computers & Education. The findings show that a core research team comprised of such scholars as Hwang Gwo‐Jen, Lester James C. and Wong Lung‐Hsiang. Key nations of publishing and research strength are from China, the United States, the United Kingdom and the Netherlands. Second, the hot topics in research on technology‐supported learning environments were virtual learning environments, technology‐enabled learning environments and interactive learning environments. Nine study specifics were derived from these three topics such as moulding function, generating scenario, stimulating sensation, effect verification, design idea, research reflection, inquiry and research, virtual community, and mixed environment. Lastly, the frontier evolution offers a pattern of development from enhancing performance to changing mode to incorporating experience. Conclusion: Looking ahead, our research recommendations for the field of technology‐supported learning environments include a multifaceted approach. We should aim to enhance research designs and methodologies, develop contemporary guiding theories and strive for a balanced representation across various educational domains, expanding our scope to encompass all academic disciplines. In terms of practical application, it is imperative to focus on the design and implementation of technology‐supported learning environments from three critical perspectives: "change‐demand," "student‐learning" and "online‐offline." These approaches will collectively ensure that technology‐supported learning environments are both innovative and responsive to the diverse needs of the educational landscape. Lay Description: What is already known about this topic: Technology‐supported learning environments are currently a focal and hot research topic in the field of education.Although numerous studies have been conducted on the learning environment of technical support, there has yet to be a systematic and comprehensive review of the related research. What this paper adds: This study provides a comprehensive review of research on the technology‐supported learning environments over the past two decades.This study primarily presents an overview of research on the technology‐supported learning environments over the past two decades, focusing on main literature, research strength, hot topics and frontier evolution. Implications for practice and/or policy: Researchers need to further advance research on technology‐supported learning environments by enriching research designs and methods, constructing up‐to‐date guiding theories and achieving a balance across different educational domains while extending the reach to all disciplines.Educational practitioners need to pay attention to the design and implementation of technology‐supported learning environments from the three viewpoints of "change‐demand," "student‐learning" and "online‐offline." [ABSTRACT FROM AUTHOR]

Background: Reading comprehension is an interactive process. Yet, instructional needs are usually identified with isolated componential tests. This study examined whether a dynamic approach, in which componential abilities are measured within the same text and global text comprehension is facilitated via feedback, can help in understanding variation in children's reading comprehension. Objectives: With a pretest‐posttest control group design, componential abilities before and after feedback were related to growth in global text comprehension within the same text. Methods: At pretest, third to fifth graders read 30 short texts, each followed by one global text comprehension question. This was repeated at posttest, but additional questions were asked with feedback prior to each global text comprehension question. The vocabulary group received two vocabulary questions with feedback (n = 97). The vocabulary plus integration group received two vocabulary questions and one sentence‐integration question with feedback (n = 98). The control group (n = 98) only answered the global text comprehension questions. Results and Conclusion: Participants in the experimental conditions who needed feedback (i.e., lower‐skilled) experienced a decrease in global text comprehension, whereas this was not found for the control group and participants in the experimental groups who did not need feedback (i.e., higher‐skilled). There was also less decrease among those lower‐skilled participants who had profited from the feedback. Implications: It is concluded from explorative analyses that not feedback but the overall design caused the decrease. Conceptually, the dynamic approach is worth further research. Lay Description: What is already known about this topic: Reading comprehension is a complex interaction of several componential abilities at word level, sentence level, and text level (e.g., vocabulary and sentence‐integration).Instruction should adapt to the profile of strengths and weaknesses in componential abilities.Assessing componential abilities with isolated tests does not align with the interactive processes in reading comprehension.Measuring learning ability can help to identify children with low responsiveness to instruction. What this paper adds: Reading comprehension is profiled by asking questions on vocabulary, sentence‐integration, and global text comprehension for the same text in third to fifth graders (8–11 years olds).Feedback is provided after a mistake in a vocabulary and sentence‐integration question, and the feedback effect on global text comprehension is measured with a pretest‐posttest design.Children who receive feedback decrease in global text comprehension but children with higher skills in componential abilities decrease less.Explorative analyses and previous research indicate that the assessment design had a negative impact on performance, for example, via cognitive load, attention, self‐esteem, and motivation. Implications for practice and/or policy: Global text comprehension cannot always be facilitated by providing feedback on vocabulary and sentence‐integration within the same text.The design of the assessment and its influence on performance should be carefully considered by instructional designers, educators, and researchers, especially in case of young learners.It remains unclear from this study if facilitating global text comprehension via feedback with a dynamic approach is useful to understand variation in children's reading comprehension.The dynamic approach with a proper design may potentially still provide a useful insight in individual differences. [ABSTRACT FROM AUTHOR]

In this paper, we revisit this well‐established linear relationship of person‐organisation, demands‐abilities, and needs‐supply fit with job satisfaction, commitment, and OCBs, and propose that this relationship may be linear for affective work outcomes but curvilinear for behavioural ones. We test this idea in a two‐wave sample of 212 employees, with measures taken 4 weeks apart. The results support the idea that the relationship between fit and behavioural outcomes can, indeed, be curvilinear. Overall, this study contributes to a better understanding of the nature of the relationship between fit and work outcomes by challenging the long‐held 'more fit is better' logic that pervades much of the PE fit research to date. [ABSTRACT FROM AUTHOR]

Adolescents in secure residential care mostly suffer from serious behavioural problems, often accompanied by trauma and adverse family circumstances. This paper presents findings of a comparison of behavioural problems and risk factors of 255 boys and girls (aged 12 to 18 years) in secure residential care in the Netherlands and their association with behavioural problems. A cross‐sectional design and standardized questionnaires were used to measure behavioural problems and individual and familial risk factors. By using independent‐sample t tests, the severity of these factors in boys and girls was compared, and by using structural equation modelling (SEM), associations between these factors and behavioural problems were investigated. The findings of the study show that post‐traumatic stress disorder (PTSD) symptoms, maladaptive emotion regulation, impaired perceived competence and internalizing behavioural problems were more severe in girls than in boys. Boys experienced more severe externalizing behavioural problems and more family problems than girls. Maladaptive emotion regulation, PTSD symptoms, perceived competence and parenting problems were related to behavioural problems. The results indicate that treatment for girls should address PTSD symptoms, perceived competence and maladaptive emotion regulation and that extra attention for family problems in the treatment of boys is warranted. [ABSTRACT FROM AUTHOR]

Background: Frailty is an important concept for risk stratification in clinical practice, but it is hardly acknowledged at all in mental healthcare settings. This paper aims to assess the impact of frailty on the course of depression and anxiety, and the impact of these affective disorders on the course of frailty. Methods: Lifelines, a prospective population‐based cohort study, evaluated 167,729 people living in the northern Netherlands. Frailty was based on the deficit accumulation model, which resulted in a 60‐item frailty index (FI) at baseline and a 35‐item FI at baseline and 5‐year follow‐up. Current depressive and anxiety disorders were assessed with the Mini International Neuropsychiatric Interview according to DSM‐IV criteria. Bidirectional associations between frailty and affective disorders were investigated using separate multivariable regression analyses in younger (<60 years) and older adults (≥60 years). Results: The FI was associated with the onset of a depressive disorder (younger adults: odds ratio [OR] = 1.12; 95% confidence interval [CI] 1.11–1.13; older adults: OR = 1.13; 95% CI 1.09–1.16) as well as any anxiety disorder (younger adults: OR = 1.10; 95% CI 1.09–1.10; older adults: OR = 1.07; 95% CI 1.04–1.09). The other way around, depressive disorder and anxiety disorders were associated with an accelerated increase of frailty over time (depressive disorder: younger adults: beta [β] = 0.03, p < 0.001; older adults: β = 0.04, p < 0.001; and any anxiety disorder: younger adults: β = 0.02, p < 0.001; older adults: β = 0.01, p < 0.142), although the effect of anxiety disorders was less equivocal among older adults. Conclusions: Affective disorders are reciprocally related to frailty. Results with respect to the impact of anxiety disorders on frailty suggest most impact at lower levels of frailty. Our results might imply that interventions to slow biological aging should be broadened towards younger and middle‐aged people as well as non‐frail older patients. To develop targeted treatment, future clinical and epidemiologic studies on the underlying pathways of this bidirectional association are needed. [ABSTRACT FROM AUTHOR]

Background: In the management of epidemics, like COVID‐19, trade‐offs have to be made between reducing mortality and morbidity and minimizing socioeconomic and political consequences. Traditionally, epidemic management (EM) has been guided and executed attentively by experts and policymakers. It can, however, still be controversial in the public sphere. In the last decades, public engagement (PE) has been successfully applied in various aspects of healthcare. This leads to the question if PE could be implemented in EM decision‐making. Methods: From June to October 2020, seven deliberative discussion focus groups were executed with 35 Dutch citizens between 19 and 84 years old. Their views on PE in COVID‐19 management were explored. The deliberative approach allows for the education of participants on the topic before the discussion. The benefits, barriers, timing and possible forms of PE in EM were discussed. Results: Almost all participants supported PE in EM, as they thought that integrating their experiences and ideas would benefit the quality of EM, and increase awareness and acceptance of measures. A fitting mode for PE was consultation, as it was deemed important to provide the public with possibilities to share ideas and feedback; however, final authority remained with experts. The publics could particularly provide input about communication campaigns and control measures. PE could be executed after the first acute phase of the epidemic and during evaluations. Conclusions: This paper describes the construction of an empirically informed framework about the values and conditions for PE in EM from the perspective of the public. Participants expressed support to engage certain population groups and considered it valuable for the quality and effectiveness of EM; however, they expressed doubts about the feasibility of PE and the capabilities of citizens. In future studies, these results should be confirmed by a broader audience. Patient or Public Contribution: No patients or members of the public were involved in the construction and execution of this study. This study was very exploratory, to gain a first insight into the views of the public in the Netherlands, and will be used to develop engagement practices accordingly. At this stage, the involvement of the public was not yet appropriate. [ABSTRACT FROM AUTHOR]

Background: Online and blended learning need an appropriate assessment strategy which ensures academic integrity. During the pandemic, many universities have chosen for online proctoring. Although some earlier examples suggest that online proctoring may reduce cheating, the potential side‐effects of proctoring are largely unknown. Objectives: Therefore, this study aims to identify the effects of proctoring on students' self‐reported temptation to cheat and potentially undesirable side‐effects, including test anxiety, perceived exam difficulty, and performance. In addition, we examine which contextual and student characteristics affect test anxiety during online exams. Methods: For this, we collected four waves of survey data throughout a year of teaching during the pandemic at one faculty of a Dutch university, resulting in a total sample of 1760 students within 105 courses. Results and Conclusions: Multi‐level analyses showed that while proctoring had no effect on the temptation to cheat, exam difficulty or performance, students reported higher levels of test anxiety. Some learning strategies, internet literacy, access to a reliable technology and a dedicated study space as well as gender and financial stress affect their test anxiety. To conclude, the decision to use online proctoring needs to consider the undesirable side‐effect on test anxiety. We discuss practical implications for university administrators, educational designers and teachers to reduce test anxiety. Lay Description: What is already known about this topic: Proctoring is often used to ensure academic integrity in online exams.Some evidence shows that proctoring reduces cheating.Little is known about the potential negative side‐effects of proctoring. What this paper adds: The use of proctoring has no effect on the temptation to cheat.The use of proctoring results in increased test anxiety.Several student characteristics and contextual factors reduce text anxiety. Implications for practice: Consider potential negative side‐effects when choosing for proctoring.Time management and internet literacy training might reduce test anxiety.Simulating the exam environment might be used to reduce test anxiety. [ABSTRACT FROM AUTHOR]

Background: Mastering fractions seems among the most critical mathematical skills for students to acquire in school as fraction understanding significantly predicts later mathematic achievements, but also broader academic and vocational prospects. As such, identifying longitudinal predictors of fraction understanding (e.g., mastery of numbers and operations) is highly relevant. However, almost all existing studies identifying more basic numerical skills as predictors of fraction understanding rest on data acquired in face‐to‐face testing—mostly in classrooms. Objectives: In this article, we evaluated whether results obtained in these previous studies generalized to data from the curriculum‐based online learning environment Bettermarks for mathematics used in schools in the Netherlands. Methods: We considered data from more than 5000 students who solved over 1 million mathematical problem sets on basic mathematical skills, fractions, but also algebra. Results and Conclusions: In line with previous findings, we found that fraction understanding was predicted significantly by more basic mathematical skills. Our analyses also indicated that algebra achievement was predicted significantly by fraction understanding beyond influences of more basic mathematical skills. Implications: Together, these findings generalized previous results based on face‐to‐face testing to the context of data from online learning environments and thus, indicate that data from such large‐scale online learning environments may well qualify to provide significant insights into the hierarchical development of mathematical skills. Lay Description: What is already known about this topic: Understanding fractions is one of the most difficult mathematical skill for students to learn in school.Longitudinal studies using face‐to‐face testing indicated that fraction understanding as well as achievements in algebra can robustly be predicted by prior mathematics skills. What this paper adds: We evaluated data from more than 5,000 Dutch students who performed over 1 million curriculum‐based mathematical problem sets in an online learning environment.Our analyses showed that fraction understanding as well as achievements in algebra and can be predicted by prior mathematics skills. Implications for practitioners: These results indicated that previous results from face‐to‐face testing generalize to data obtained from large‐scale online learning environments.Thus, these results open up a new avenue for research using online learning environments on the development of mathematical skills. [ABSTRACT FROM AUTHOR]

Background: Creating concept maps can help students overcome challenges of accurate knowledge monitoring and thus foster learning. However, students' knowledge often contains gaps and misconceptions, even after concept map creation. Theoretically, students could benefit from additional support, but it is unclear whether this might also be the case for (more practical‐oriented) secondary vocational students. Objectives: This study investigated whether the effectiveness of concept maps for learning could be improved by providing students with expert examples and reflection prompts in addition to their self‐generated concept maps. Methods: First‐year secondary vocational students (N = 91, Mage = 17.3 years) participated in this study, which utilized a pretest‐intervention‐posttest design. Regarding the intervention, students worked in two successive online learning environments, in which they had to present their knowledge in concept maps. After creation, students' concept maps were, depending on condition, supplemented with (1) an expert example with comparative feedback (a combined concept map) and related reflection prompts, (2) the combined concept map only, or (3) no combined concept map and no prompts. Results and Conclusions: Analyses based on students' domain knowledge demonstrate that students significantly increased their knowledge in all conditions. Data indicate that there was no significant difference in knowledge gain between conditions. Further analysis showed that students in the experimental conditions demonstrated higher learning gains if they consulted the combined concept map more often than their peers. Implications: Access to an example in addition to students' self‐generated concept maps seems promising in fostering their knowledge acquisition. However, secondary vocational students might need additional ways of support to guarantee higher learning gains. Avenues to increase the effectiveness of support are discussed. Lay Description: What is currently known about the subject matter: Creating a concept map can be an effective means to promote student learning by facilitating their knowledge monitoring.Students' knowledge often contains gaps and misconceptions, even after concept map creation.There is evidence that feedback is needed to realize an effect on students' learning. What is the paper adding to this: Innovative implementation of concept map feedback in a self‐directed online learning environment.Exploration of the added value of support to process concept map feedback.Focus on a generally overlooked and unique target group: secondary vocational students. What are the implications of study findings for practitioners: The adopted unique implementation of concept map feedback seems promising for increasing students' learning.When designing support for secondary vocational students it is necessary to take the unique characteristics of these learners into account. [ABSTRACT FROM AUTHOR]

In the present study, a 5‐week tablet‐based word reading efficiency game intervention (Reading Turbo) was integrated in a comprehensive phonics‐based reading curriculum. The aims of the study were to examine whether the game would advance children's word reading efficiency, and to determine the extent to which pre‐reading capacities and in‐game mechanisms could explain individual variation in responsiveness to the game. To do so, word reading efficiency scores of first graders in an intervention group (n = 132) and a control group that continued with the usual reading curriculum (n = 118) were compared prior to, directly after, and 2 months after the 5‐week intervention period. Individual variation in responsiveness was examined by relating reading precursors (i.e., phonological awareness, letter efficiency, rapid automatized naming (RAN), and verbal working memory) measured at the onset of the intervention, and in‐game accuracy and efficiency to word reading efficiency outcomes in untrained words. Results indicated that playing the word reading game significantly enhanced first graders' word reading efficiency directly after the intervention, but the effect was no longer significant 2 months after the intervention. With respect to individual variation in game responsiveness, it was found that phonological awareness, letter efficiency, and verbal working memory predicted responsiveness to the game via in‐game accuracy. In addition, phonological awareness and RAN predicted responsiveness to the game via in‐game efficiency, and letter efficiency and verbal working memory were directly related to responsiveness. The effectiveness of the word reading game thus differentiated between children with higher and lower pre‐reading capacities, and operated via in‐game child affordances. [ABSTRACT FROM AUTHOR]

Nowadays, students often practice problem‐solving skills in online learning environments with the help of examples and problems. This requires them to self‐regulate their learning. It is questionable how novices self‐regulate their learning from examples and problems and whether they need support. The present study investigated the open questions (1) to what extent students' (novices) task selections align with instructional design principles and (2) whether informing them about these principles would improve their task selections, learning outcomes, and motivation. Higher education students (N = 150) learned a problem‐solving procedure by fixed sequences of examples and problems (FS‐condition), or by self‐regulated learning (SRL). The SRL participants selected tasks from a database, varying in format, complexity, and cover story, either with (ISRL‐condition) or without (SRL‐condition) watching a video detailing the instructional design principles. Students' task‐selection patterns in both SRL conditions largely corresponded to the principles, although tasks were built up in complexity more often in the ISRL‐condition than in the SRL‐condition. Moreover, there was still room for improvement in students' task selections after solving practice problems. The video instruction helped students to better apply certain principles, but did not enhance learning and motivation. Finally, there were no test performance or motivational differences among conditions. Although these findings might suggest it is relatively 'safe' to allow students to independently start learning new problems‐solving tasks using examples and problems, caution is warranted: It is unclear whether these findings generalize to other student populations, as the students participating in this study have had some experience with similar tasks or learning with examples. Moreover, as there was still room for improvement in students' task selections, follow‐up research should investigate how we can further improve self‐regulated learning from examples and practice problems. Lay Description: What is (not) known about the subject matter: Learning new problem‐solving skills online with examples and problems is becoming more commonInstructional design principles (IDP) detail how to sequence tasks to optimize learning and motivationIt is unclear whether students spontaneously adhere to IDP when they select learning tasksNot much is known about how to support students to make better task selections What is the contribution of this paper: Students received a fixed task sequence (FS‐condition) or selected tasks themselves (SRL)Prior to SRL, SRL‐students watched a video about IDP (ISRL‐condition) or not (SRL‐condition)Results showed that (I)SRL‐students' task‐selections matched quite well with IDPThere were no differences among the FS and (I)SRL conditions in performance or motivation What are the implications of the findings: Students were quite capable of self‐regulating their learning from examples and problemsSRL was even as effective, efficient, and motivating as a fixed task sequenceWatching a video on IDP affected students' task‐selections, but did not enhance learning and motivationFuture research should examine how to further support SRL from examples and problems [ABSTRACT FROM AUTHOR]

Background: Early detection and remediation of language disorders are important in helping children to establish appropriate communicative and social behaviour and acquire additional information about the world through the use of language. In the Netherlands, children with (a suspicion of) language disorders are referred to speech and hearing centres for multidisciplinary assessment. Reliable data are needed on the nature of language disorders, as well as the age and source of referral, and the effects of cultural and socioeconomic profiles of the population served in order to plan speech and language therapy service provision. Aims: To provide a detailed description of caseload characteristics of children referred with a possible language disorder by generating more understanding of factors that might influence early identification. Methods & Procedures: A database of 11,450 children was analysed consisting of data on children, aged 2–7 years (70% boys, 30% girls), visiting Dutch speech and hearing centres. The factors analysed were age of referral, ratio of boys to girls, mono‐ and bilingualism, nature of the language delay, and language profile of the children. Outcomes & Results: Results revealed an age bias in the referral of children with language disorders. On average, boys were referred 5 months earlier than girls, and monolingual children were referred 3 months earlier than bilingual children. In addition, bilingual children seemed to have more complex problems at referral than monolingual children. They more often had both a disorder in both receptive and expressive language, and a language disorder with additional (developmental) problems. Conclusions & Implications: This study revealed a bias in age of referral of young children with language disorders. The results implicate the need for objective language screening instruments and the need to increase the awareness of staff in primary child healthcare of red flags in language development of girls and multilingual children aiming at earlier identification of language disorders in these children. What this paper addsWhat is already known on the subjectIdentifying language disorders before children enter school can foster the initiation of early interventions before these problems interfere with formal education and behavioural adjustment. Information on caseload characteristics is important to plan speech and language therapy service provision. There are only a few studies on the caseload characteristics of children at first referral for language assessment.What this paper adds to existing knowledgeThis study provides a detailed description of the caseload characteristics of children referred to Dutch speech and hearing centres. The results reveal an age bias in referral: boys were referred earlier than girls, and monolingual children were revealed earlier than bilingual children. On top of that, bilingual children seemed to have more complex problems at referral.What are the potential or actual clinical implications of this work?This study indicates that it is important to be aware of bias in the age of referral of subgroups of children with language disorders. Solutions might be to implement a language screening instrument designed for use by non‐speech–language therapists, and training in early recognition of girls and multilingual children with (less complex) language disorders for health professionals in key positions in child healthcare. In addition, it might be worthwhile to assign speech and language therapists with diverse ethnic and language backgrounds and/or with experience with bilingual/cultural children in a regional mentoring function to support referral agents and parents. [ABSTRACT FROM AUTHOR]

Noticing and interpreting classroom events (professional vision) is an important element of preservice teachers' (PSTs) interpersonal competence. This paper presents a mixed‐method study about a classroom simulation using 360‐degree videos combined with theoretical lectures in teacher education, intended to improve PSTs' interpretations of noticed events. Furthermore, this study examined how PSTs evaluate technological and educational affordances of 360‐degree videos. Results indicate that participating PSTs improved in noticing classroom events and in applying a more theory‐based terminology to describe these events. PSTs perceived observing other teachers teach as an educational affordance for mastering theory and for developing insights about interpersonal teacher behaviour. Concerning technological affordances, mainly physical discomforts and technical hindrances, was reported by PSTs. The results of this study imply that 360‐degree videos can be useful for teacher education to improve PSTs' interpretation of noticed events. Practitioner Notes: What is already known: Professional interpersonal vision is considered an important element of preservice teachers' (PSTs) interpersonal competence.Interpersonal competence can be practiced using computer‐based classroom simulations.One type of content in simulations is video, which can provide PSTs authentic cases.Recent technological developments enable enrichment of video simulations using 360‐degree cameras. What this paper adds: Findings indicate that classroom simulations using 360‐degree videos added with theoretical lectures can improve PSTs' level of interpretations of noticed classroom events as part of their professional interpersonal vision.Technological and educational affordances of classroom simulation using 360‐degree videos evaluated by PSTs. Implications for practitioners: Classroom simulations using 360‐degree are a useful method to prepare PSTs for educational practice.Classroom simulations using 360‐degree videos help PSTs learn theory about interpersonal teacher behaviour.Classroom simulations using 360‐degree videos help PSTs develop insights about teaching styles that influence teacher–student relationships.This study advises good quality VR‐environments to improve the immersive experience. [ABSTRACT FROM AUTHOR]

Background: To guide the development of high‐quality care for people with multiple chronic conditions, partners of the European Joint Action CHRODIS developed the Integrated Multimorbidity Care Model. To assess its suitability for improving care for people with multimorbidity in the Netherlands, the model was piloted in a primary care setting with both patients and care providers. Aim: This paper reports on the patient perspective, and aims to explore the priorities, underlying values and preferences for care of people with multimorbidity. Participants and methods: Twenty persons with multimorbidity (selected from general practice registries) participated in a focus group or telephone interview. Subsequently, a questionnaire was completed by 863 persons with multimorbidity registered with 14 general practices. Qualitative data were thematically analysed and quantitative data by means of descriptive statistics. Results: Frequently prioritized elements of care were the use of shared electronic health records, regular comprehensive assessments, self‐management support and shared decision making, and care coordination. Preferences for how these elements should be specifically addressed differed according to individual values (eg weighing safety against privacy) and needs (eg ways of coping with multimorbidity). Conclusion: The JA‐CHRODIS Integrated Multimorbidity Care Model reflects the priorities and preferences for care of people with multimorbidity in the Netherlands, which supports its relevance to guide the development of person‐centred integrated care for people with multiple chronic conditions in the Netherlands. Patient contribution: European patient experts contributed to the development and applicability assessment of the JA‐CHRODIS Integrated Multimorbidity Care Model; Dutch patients participated in focus groups, interviews and a survey. [ABSTRACT FROM AUTHOR]

Learners in the process of developing complex skills need a rich mental model of what such skills entail. Textual analytics rubrics (TR) are a widely used instrument to support formative assessment of complex skills, supporting feedback, reflection, and thus mental model development of complex skills. However, the textual nature of a rubric limits the possibility to deliver contextual and dynamic (time‐and behaviour‐oriented) information. In the Viewbrics online tool, we developed a version supporting the delivery of contextual and dynamic information by adding video‐modelling examples with embedded self‐explanation prompts to textual analytics rubrics. We called this combination as video‐enhanced rubrics (VERs). Our current study investigates whether the Viewbrics online tool supports complex skills development and whether either textual‐ or video‐enhanced rubrics best support complex skills' mastery. The study was a three‐group (VERS n = 49, TR n = 54, control n = 50) within‐subjects design. Learners' performance of complex skills was measured through expert, peer, and self‐assessment using the Viewbrics online tool. A multilevel regression analysis shows learners in the TR and VERS conditions consistently outperforming the control condition to varying degrees across skills. However, no differences have been found between the two experimental conditions. Positive results across different complex skills indicate the Viewbrics online tool can be used to support the development of a wide range of complex skills in secondary education. Lay Description: Known about the subject matter: The acquisition of cross‐curricular complex skills such is crucial for pupils in secondary education.It is important that students and teachers develop a concrete and consistent picture of (aspects of) these so‐called 21st century skills in order to streamline both their acquisition.Textual rubrics may still have room for improvement, as many aspects of desired behavior can hardly be put into words.Many schools in secondary education are struggling with how to teach and assess cross‐curricular skills. What their paper adds to this: So, we designed a online (online) formative assessment methodology, with textual rubrics and the video‐enhanced rubrics.And measured complex skill performance in two secondary, pre‐university education schools for 24 weeks and compared with existing educational practice.Both experimental groups perform significantly better in the three complex skills compared to the control group.However, the video‐enhanced group did not outperform the textual rubric group. The implications of study findings for practitioners: Supporting the formative assessment of complex skills is a recommendable activity for practitioners, that will likely bear fruit.However, incorporating video modeling examples into an online assessment methodology does not result in improvement in complex skill mastery. [ABSTRACT FROM AUTHOR]

This study aimed to investigate children's potential for reasoning by analogy utilizing a newly‐developed computerized dynamic test, and the potential differential influence of executive functions (cognitive flexibility, attention, and planning) on static and dynamic measures of analogical reasoning. Participants included 64 children (mean age = 7.55). The study employed a two‐session experimental test‐training‐test design. Based on randomized blocking, half of the children received a graduated prompts training between pre‐test and post‐test, and the other half did not. Trained children improved more than control children in both their accuracy scores and number of accurately applied transformations from pre‐test to post‐test. It was further found that cognitive flexibility, attention and planning, is associated with successful solving of analogies. Training children in analogical reasoning seemed to reduce the effect of executive functions. It was also found that that children who were more cognitively flexible needed more prompts during the training. Lay Description: What is already known about this topic: Analogical reasoning is of great importance to scholastic performance and everyday learning.Computerized dynamic tests are promising for measuring children's potential for analogical reasoning.Executive functions have been found to influence analogical reasoning performance.Dynamic testing compensates for the influence of executive functions What this paper adds: A newly developed computerized dynamic test of analogical reasoning can detect individualized learning paths and instructional needs of children of various ability levels.Training children in analogical reasoning as part of a computerized dynamic test seems to reduce the effect of executive functioning.Children's instructional needs are related to cognitive flexibility. Implications for practice and/or policy: Computerized dynamic testing of analogical reasoning is a useful instrument for identification purposes.These tests provide information about children's problem‐solving behaviour, and the type and number of instructions they need when solving new tasks, offering insights relevant for individualized education plans.Individual differences in children's (improvements in) analogical reasoning seem to be related to their executive functioning. [ABSTRACT FROM AUTHOR]

Providing first language (L1) translations in L2 vocabulary interventions may be beneficial for L2 vocabulary learning. However, in linguistically diverse L2 classrooms, teachers cannot provide L1 translations to all children. Social robots do offer such opportunities, as they can be programmed to speak any combination of languages. This study investigates whether providing L1 translations in a robot‐assisted L2 vocabulary training facilitates children's learning. Participants were Turkish‐Dutch kindergartners (n = 67) who were taught six Dutch (L2) words for which they knew the L1 (Turkish), but not the L2 Dutch form. Half of these words were taught by a Turkish‐Dutch bilingual robot, alongside their Turkish translations; the other half by a monolingual Dutch robot. Children also completed Dutch and Turkish receptive vocabulary tests. Results of generalized linear regression models indicated better performance in the Dutch‐only condition than in the Turkish‐Dutch condition. Children with well‐developed Turkish and Dutch vocabulary knowledge outperformed children with less well‐developed vocabulary knowledge. The majority of children preferred working with the bilingual robot, but children's preference did not affect word learning. Thus, contrary to our prediction, we found no evidence for a facilitating effect of providing L1 translations through a robot on bilingual children's L2 word learning. Lay Description: What is already known about this topic: Turkish‐Dutch children often lag behind their monolingual Dutch peers in terms of Dutch (L2) language skills, which means that supporting these children's L2 development is highly relevant.Children may boost their L2 vocabulary learning using their Turkish (L1) vocabulary knowledge.Social robots that can speak a vast variety of languages can be used to provide L1 input in linguistically diverse classrooms. What this paper adds: Using an experimental design with a social robot, we investigated whether children learned more L2 words when L1 translations were provided by a bilingual Turkish‐Dutch robot.Children learned more L2 target words when the robot spoke only L2, compared to when the robot also provided L1 translations.>70% of the children preferred to play again with the bilingual robot, as compared to the monolingual robot. Implications for practice and/or policy: More research is needed to investigate how children's L1 can help L2 vocabulary learning, perhaps a more L1‐inclusive school context.Technological developments (e.g., in automatic speech recognition) are needed to further improve the interaction between robot and child. [ABSTRACT FROM AUTHOR]

Background: Subjective well‐being (SWB) and quality of life (QOL) are intricately related constructs. Recent research shows both constructs share some facets, but are distinct entities. It is unclear, both internationally and in the Netherlands, if and how SLTs address SWB in clinical practice. The current study was set up to explore Dutch SLTs' perceptions of SWB in relation to the management of people with aphasia. Aims: To describe how Dutch SLTs, working with people with aphasia in a private practice or a healthcare setting, address patient's SWB during diagnosis and treatment, and to identify barriers and facilitators they experience when addressing SWB. Methods & Procedures: A qualitative research design with a phenomenological approach was used. SLTs from private practices and healthcare settings were invited to participate in individual interviews and a focus group. The data were analysed thematically using a combination of inductive and deductive methods. Outcomes & Results: Eight SLTs participated in the study. The SLTs' experiences were captured in four themes that emerged from the data: (1) SWB is a multifaceted concept and depends on patient‐specific factors: premorbid factors, life priorities and time post‐stroke; (2) SLTs experience more responsibility for patients' SWB than their profession allows; (3) collaboration between SLTs and patients, patients' network and other healthcare professionals is required to address SWB during diagnosis and treatment; and (4) misinterpretations are inevitable when SLTs or the patients' network address patients' SWB. Conclusions & Implications: The results showed that SLTs feel responsible for addressing SWB in the management of people with aphasia. Their perception of the concept of SWB is similar to the definition used in the literature and is multifaceted. They feel responsible for the part of SWB that is related to communicative functioning, but less so for the more heuristic aspects of SWB. This is related to their experienced limitation of influence on SWB, which for some leaves them feeling out of depth and uncertain about boundaries between professionals. Addressing SWB in a multidisciplinary team is therefore considered important in order to adequately and fully capture someone's SWB and reduce to clinicians' experienced burden and responsibility. What this paper addsWhat is already known on this subjectRecent studies suggest that quality of life measures may lack facets related to subjective well‐being (SWB). Aphasia is likely to impact on SWB of a stroke survivor, but it is unclear if and how SWB is addressed by speech and language therapists in diagnosis, and treatment of Dutch PWA.What this study addsThis study provides insight into the operationalization of SWB in Dutch clinical practice, including barriers SLTs experience when addressing SWB.Clinical implications of this studyMonitoring and influencing SWB of people with aphasia is a complex process, that SLTs consider only possible in multi‐disciplinary teams. Clear guidelines on roles and responsibilities between various disciplines involved are necessary to improve care for people with aphasia. [ABSTRACT FROM AUTHOR]

The diverse nature of 21st‐century organizations has compelled leaders to minimize discrimination and bring about inclusion amongst their employees. One of the ways this can be achieved is through authentic, respectful, and inclusive leadership. The aim of the present paper was to (1) explore whether the three leadership styles can promote inclusion and curtail discrimination in the South African context and (2) ascertain whether this relationship has any bearing on well‐being across Dutch, German, Icelandic, Indonesian, and South African contexts. To reach these aims, two cross‐sectional studies have been conducted. In Study 1, 569 employees were surveyed, and results indicated that all three leadership styles loaded on a common latent factor (positive leadership) that was positively associated with both inclusion and discrimination. In Study 2, 1,926 employees were surveyed across the five countries. Results indicated that once again, the latent, positive leadership factor was positively associated with both inclusion and discrimination. Furthermore, inclusion, when compared to discrimination seemed to be a stronger mediator in the relationship between positive leadership and well‐being. We propose leadership development that will cultivate positive leadership behaviors for the benefit of employee well‐being and collaboration in increasingly diverse teams. [ABSTRACT FROM AUTHOR]

Eye movement modelling examples (EMMEs) are instructional videos of a model's demonstration and explanation of a task that also show where the model is looking. EMMEs are expected to synchronize students' visual attention with the model's, leading to better learning than regular video modelling examples (MEs). However, synchronization is seldom directly tested. Moreover, recent research suggests that EMMEs might be more effective than ME for low prior knowledge learners. We therefore used a 2 × 2 between‐subjects design to investigate if the effectiveness of EMMEs (EMMEs/ME) is moderated by prior knowledge (high/low, manipulated by pretraining), applying eye tracking to assess synchronization. Contrary to expectations, EMMEs did not lead to higher learning outcomes than ME, and no interaction with prior knowledge was found. Structural equation modelling shows the mechanism through which EMMEs affect learning: Seeing the model's eye movements helped learners to look faster at referenced information, which was associated with higher learning outcomes. Lay Description: What is already known about this topic: Modelling, which involves an expert model showing learners the completion of a task, is an important form of teaching.Learning from modelling examples can be enhanced by showing eye movements of the model, so‐called eye movement modelling examples (EMMEs).Results regarding the effectiveness of EMMEs are mixed, which could be caused by differences in learners' prior knowledge.Eye‐tracking technology can be used to investigate how EMMEs enhance learning from modelling examples. What this paper adds: EMMEs effectively guide attention: Students follow the models' gaze better and look faster at relevant information.No differences in learning were found between EMMEs and a modelling example without eye movements.We manipulated prior knowledge but found that it did not moderate the effectiveness of EMMEs.The working mechanism of EMMEs seems to be that it helps learners to attend to relevant information faster. Implications for practice and/or policy: A video of a model's gaze can help learners attend to relevant information.Such videos are particularly useful if learners need to quickly look at relevant information (e.g., in learning from animations).For some tasks, EMMEs and regular modelling examples are equally effective.Training task‐specific picture–word correspondences before presenting a modelling example supports learning. [ABSTRACT FROM AUTHOR]

To assist higher education institutions in meeting the challenge of limited student engagement in the implementation of Learning Analytics services, the Questionnaire for Student Expectations of Learning Analytics (SELAQ) was developed. This instrument contains 12 items, which are explained by a purported two‐factor structure of "Ethical and Privacy Expectations" and "Service Feature Expectations." As it stands, however, the SELAQ has only been validated with students from UK university, which is problematic on account of the interest in Learning Analytics extending beyond this context. Thus, the aim of the current work was to assess whether the translated SELAQ can be validated in three contexts (an Estonian, a Spanish, and a Dutch University). The findings show that the model provided acceptable fits in both the Spanish and Dutch samples, but was not supported in the Estonian student sample. In addition, an assessment of local fit is undertaken for each sample, which provides important points that need to be considered in future work. Finally, a general comparison of expectations across contexts is undertaken, which are discussed in relation to the General Data Protection Regulation (2018). Lay Description: What is currently known about the subject matter: Accounting for student expectations allows for a service that is meaningful.SELAQ measures student expectations towards Learning Analytics services.The 12 items of the SELAQ can be explained by a two‐factor structure (Ethical and Privacy Expectations and Service Feature Expectations). What their paper adds to this: Validation of the SELAQ in three contextsA discussion of localized sources of strainAn assessment of measurement quality in each contextA general comparison of student expectations across contexts The implications of study findings for practitioners: SELAQ can be used with Spanish and Dutch students.SELAQ responses provide a much needed input from end‐users in Learning Analytics implementations. [ABSTRACT FROM AUTHOR]

We investigated pictorial versus contextual support effects over and above teaching of definitions on children's word learning and retention as well as the moderating role of reading comprehension. In a between‐subject pre‐post‐retention test control group design, Dutch fourth graders learned concrete and abstract Dutch words. The context group received definitions and context sentences, the picture group received definitions and pictures, and the control group only received definitions. Children in the picture group outperformed children in the context group but not the control group on all words directly after learning. This learning gain, however, disappeared over time because participants in the context group retrieved the word meanings better than in the other groups 1 day later. Interestingly, reading comprehension moderated the forgetting effect, as low comprehenders in the experimental groups forgot less than those in the control group. Adding pictures to definitions, thus, leads to richer long‐term knowledge for low comprehenders. [ABSTRACT FROM AUTHOR]

This study investigated the effect of a touch‐typing course on the spelling and narrative‐writing skills on the computer of elementary school students. Data of 207 students in Grades 4, 5, and 6 were analysed using a pretest–posttest design. Students in the experimental group (n = 154) followed a touch‐typing course, and those in the control group (n = 53) did not. The experimental group showed more progress in typing, spelling, and narrative‐writing skills on the computer than the control group. It can be concluded that the touch‐typing course had a positive effect, not only on typing skills but also on spelling and narrative‐writing skills on the computer. Lay Description: What is known Typing skills are important for the quality of the typewritten text output.In touch‐typing with automaticity of transcription, workting‐memory load is decreased.Studies on the effect of a touch‐typing course are rare. What this paper adds This study investigated the effect of a touch‐typing course on spelling and narrative writing.We used a design with an experimental (with typing‐course) and a control group (no course)The experimental group showed more improvement in typing, spelling and narrative writing. Implications for practitioners It is important for the quality of student's text output to learn how to touch‐typeTouch‐typing can be learned in a teacher-directed course, containing 15 training sessions of 1.5 hours eachPractice of 20 minutes a day is necessary [ABSTRACT FROM AUTHOR]

In the present study, we investigated whether online learning behaviours (navigation and writing activities) mediated the relation between learner characteristics (prior knowledge, vocabulary knowledge, working memory, and motivation) and declarative knowledge. Specifically, we investigated whether the quality of participants' written assignments could further explain this relation. For this purpose, 62 fifth‐grade children participated in a WebQuest hypermedia assignment on the subject of the heart. Results showed that online learning behaviours did not mediate the relations between learner characteristics and declarative knowledge when the assignment quality was not included in the model. Adding assignment quality, however, revealed two serial mediation models. Prior knowledge predicted declarative knowledge via the writing activity "copying behaviour" and assignment quality, and vocabulary knowledge predicted declarative knowledge via the navigation activity "time spent on assignment pages" and assignment quality. These results show the importance of taking into account assignment quality when investigating knowledge acquisition in hypermedia environments. Lay Description: What is currently known about the subject matter: Learning in hypermedia creates high cognitive load and is therefore difficult for children.Prior knowledge, vocabulary, working memory, and motivation predict declarative knowledge.It is unclear how online learning behaviour and assignment quality affect this relation. What this paper adds: Quality of children's written assignment is important in hypermedia learning.Prior knowledge predicts declarative knowledge via copying behaviour and assignment quality.Vocabulary marginally predicts declarative knowledge via the time spent reading instructions and assignment quality. Implications of study findings for practitioners: How well children perform their hypermedia assignment affects their declarative knowledge.Practitioners should monitor if children with low vocabulary understand assignment instructions.Practitioners should help weaker students to distinguish between main points and side issues. [ABSTRACT FROM AUTHOR]

Abstract: Increasingly, experts as deemed by personal experience or mental health service use, are involved in the education of nurses; however, accompanying research is limited and focuses primarily on opinions of nurse educators and students. The aim of this study was to develop an understanding of the potential contribution to mental health nursing education by those with experience of mental health service use. The research was part of the international COMMUNE (Co‐production of Mental Health Nursing Education) project, established to develop and evaluate co‐produced mental health content for undergraduate nursing students. A qualitative descriptive design was adopted with data collected through focus group interviews in seven sites across Europe and Australia. Experts by experience (people with experience of distress, service use, and recovery) co‐produced the project in partnership with nursing academics. Co‐production enriched the process of data collection and facilitated the analysis of data from multiple perspectives. Two themes are presented in this paper. The first focuses on how experts by experience can enhance students’ understanding of recovery by seeing the strengths inherent in the ‘human’ behind the diagnostic label. The second highlights the importance of communication and self‐reflection on personal values, where students can explore their own thoughts and feelings about mental distress alongside those with lived experience. Interacting with experts by experience in the classroom can assist in challenging stigmatizing attitudes prior to nursing placements. These findings can be used to inform international nursing curricula by increasing the focus on nursing skills valued by those who use the services. [ABSTRACT FROM AUTHOR]

Rationale, aims and objectives Structuring the diagnostic section of the medical record ( MR) improves diagnosis and communication between doctors. However, little is known about the therapeutic section of the MR. The aim of this study was to gain insight into the extent to which MRs are structured for therapeutic information, to determine which therapeutic data registrars and clinical consultants consider should be recorded in the MR and to what extent registrars record this information themselves. Methods A multicentre observational study was carried out in the internal medicine outpatient clinics of five teaching hospitals in the Netherlands. Preformatted structure, importance and actual recording of therapeutic information was compared with a reference list of 35 therapeutic items based on the WHO Guide to Good Prescribing (e.g. drug name, indication for drug). Results The preformatted structure of four paper MRs and one electronic MR was assessed. Eight of the 35 therapeutic items were listed in the paper MRs and 18 items in the electronic MR. Registrars and consultants agreed on the importance of recording most of the therapeutic items in the MR, 25 and 27 out of the 35 items, respectively; however, registrars recorded only 11 of the 35 items in the paper MR and 20 of the 35 items in the electronic MR. Conclusions The structure and content of paper and electronic MRs are not adequate. While both registrars and consultants agree on the importance of recording therapeutic items in the MR, registrars fail to record most of this information in practice. The results of this study can be used as starting point for the discussion regarding the necessity of structured recording of therapeutic information in the MR and its possible benefits with regard to medication safety and training of the new generation of prescribers. [ABSTRACT FROM AUTHOR]

Abstract: Background: Family‐centred services (FCS) is widely regarded as the best practice approach in early interventions. Creating a therapeutic environment, which also stimulates collaboration between parents and service professionals, is a way to conform to the principles of FCS. The present paper describes the project entitled @home, involving the implementation of home consultations by a specialized team working with children aged 0–5 years at our rehabilitation centre in the Netherlands. The objectives of this article are to (a) describe the development and implementation of home consultations as part of regular care and (b) share the experiences of parents and service providers with home consultations. Method: The implementation process was divided into 3 steps: (1) interviewing experts, (2) adjusting current rehabilitation trajectories, and (3) service providers offering consultations to children at home. The experiences with the home consultations were immediately incorporated in the system, making the implementation an iterative process. Results: In 82% of the 133 home conducted consultations, the service professionals reported that it was more valuable to offer home consultations than seeing the child at the rehabilitation centre. The semistructured interviews revealed that parents and service providers found that they received and provided more tailored advice, perceived a more equal partnership between service professionals and parents, and reported that the home consultations provided a good natural therapeutic environment where a child can be itself and where the child performs best. Conclusion: By using the @home system based on the 3 service models, home consultations are now part of the regular paediatric rehabilitation system at our rehabilitation centre. [ABSTRACT FROM AUTHOR]

Abstract: Background and Purpose: Physiotherapy (PT) and occupational therapy (OT) are key professions providing treatment for the arm after stroke; however, knowledge about the content of these treatments is scant. Detailed data are needed to replicate interventions, evaluate their effective components, and evaluate PT and OT practice. This paper describes PT and OT treatment for the severely affected arm in terms of duration, content according to components and categories of the International Classification of Human Functioning, Disability and Health, and to analyze differences between professions. Methods: Design: This is a retrospective analysis of randomized trial data. Participants: 46 patients after stroke with poor arm motor control recruited from inpatient neurological units from three rehabilitation centers in the Netherlands. Procedure: PTs and OTs recorded duration and content of arm treatment interventions for 8 weeks using a bespoke treatment schedule with 15 International Classification of Human Functioning, Disability and Health categories. Results: PTs and OTs spent on average 4–7 min per treatment session (30 min) on arm treatment. OTs spent significantly more time providing arm treatment and treatment at the activities level than PTs. PTs spent 79% of their arm treatment time on body functions, OTs 41%. OTs spent significantly more time on “moving around using transportation,” “self care,” and “household tasks” categories. Conclusions: Patients after stroke with a severely affected arm and an unfavorable prognosis for arm motor recovery receive little arm‐oriented PT and OT. Therapists spent most arm treatment time on body functions. There was a considerable overlap in the content of PT and OT in 12 of the 15 categories. Results can be generalized only to patients with poor arm motor control and may not represent practice in other countries. [ABSTRACT FROM AUTHOR]

Nurse middle managers are in an ideal position to facilitate patient-centred care. However, their contribution is underexposed in literature due to difficulties to articulate this in practice. This paper explores how nurse middle managers contribute to patient-centred care in hospitals. A combination of time-use analysis and ethnographic work was used to disclose their contribution to patient-centred care at a micro level. Sixteen nurse managers were shadowed for over 560 hours in four hospitals. Some nurse middle managers seldom contribute to patient-centred care. Others are involved in direct patient care, but this does not result in patient-centred practices. At one hospital, the nurse middle managers did contribute to patient-centred care. Here balancing between 'organizing work' and 'caring work' is seen as a precondition for their patient-centeredness. Other important themes are feedback mechanisms; place matters; with whom to talk and how to frame the issues at stake; and behavioral style. Both 'hands-on' and 'heads-on' caring work of nurse middle managers enhances their patient-centeredness. This study is the first of its kind to obtain insight in the often difficult to articulate 'doings' of nurse middle managers with regard to patient-centred care through combining time-use analysis with ethnographic work. [ABSTRACT FROM AUTHOR]

Context The handover represents a high-risk event in which errors are common and lead to patient harm. A better understanding of the cognitive mechanisms of handover errors is essential to improving handover education and practice. Objectives This paper reports on an experiment conducted to study the effects of learner knowledge, case complexity (i.e. cases with or without a clear diagnosis) and their interaction on handover accuracy and cognitive load. Methods Participants were 52 Dutch medical students in Years 2 and 6. The experiment employed a repeated-measures design with two explanatory variables: case complexity (simple or complex) as the within-subject variable, and learner knowledge (as indicated by illness script maturity) as the between-subject covariate. The dependent variables were handover accuracy and cognitive load. Each participant performed a total of four simulated handovers involving two simple cases and two complex cases. Results Higher illness script maturity predicted increased handover accuracy (p < 0.001) and lower cognitive load (p = 0.007). Case complexity did not independently affect either outcome. For handover accuracy, there was no interaction between case complexity and illness script maturity. For cognitive load, there was an interaction effect between illness script maturity and case complexity, indicating that more mature illness scripts reduced cognitive load less in complex cases than in simple cases. Conclusions Students with more mature illness scripts performed more accurate handovers and experienced lower cognitive load. For cognitive load, these effects were more pronounced in simple than complex cases. If replicated, these findings suggest that handover curricula and protocols should provide support that varies according to the knowledge of the trainee. [ABSTRACT FROM AUTHOR]

The purpose of this study was threefold, namely (1) to differentiate between multiproblem families and control families on characteristics and processes within the family based on a theoretical framework, (2) to identify multiproblem families by establishing cut-off scores on various questionnaires, and (3) to categorize multiproblem families into subtypes by cluster analyses. Various questionnaires were administered to multiproblem families (n = 85) and control families (n = 150). Results showed that what we propose to refer to as multiproblem families present a broad range of problems on seven domains: (1) child factors, (2) parental factors, (3) childrearing problems (inadequate or inconsistent parenting), (4) family functioning problems, (5) contextual problems, (6) social network problems, and (7) mental health care problems. Further, reliable cut-off scores were established for various questionnaires. Finally, three types of families were found: (1) community-problem families, (2) multiproblem families, and (3) child-focused mild-problem families. This paper looks to advance an evidence-based definition and assessment of 'multiproblem families' suggesting the possible value of defining and assessing multiproblem families in relation to these seven dimensions. Moreover, the classification of multiproblem families stresses the importance of providing tailored treatments. [ABSTRACT FROM AUTHOR]

This paper aims to improve our understanding of demonstrators' atmosphere perceptions, that is, demonstrators' affective state, which is induced by the protest environment. We examined how demonstrators perceive protest atmosphere, why they do so, and whether atmosphere perceptions influence demonstrators' future collective action preparedness. We hypothesized that demonstrators' atmosphere perceptions diverge on a dimension of pleasure, and relate to their grievance (i.e., perceived societal intolerance), group identification, empowerment, and perceived police aggression. A pleasant atmosphere perception was expected to stimulate a demonstrator's future action preparedness. We tested these hypotheses with a mixed-methods dataset of two Dutch protests, staged by Lesbians, Gays, Bisexuals, and Transgenders and anti-monarchists. Our analyses revealed that demonstrators' atmosphere perceptions diverge on a dimension of pleasure, and relate to group identification, empowerment, and, for anti-monarchists, perceived societal intolerance. A pleasant atmosphere perception deters a demonstrator's future action preparedness and also stimulates his or her group identification and empowerment, which, then, stimulate his or her action preparedness. Copyright © 2015 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Computer-assisted instruction ( CAI) programs are considered as a way to improve learning outcomes of students. However, little is known on the schools who implement such programs as well as on the effectiveness of similar information and communication technology programs. We provide a literature review that pays special attention to the existing causal evidence of computer-assisted programs on learning outcomes. The paper relies on a rich data set consisting of (i) pupil-level information on the use of a Dutch computer-assisted program and (ii) detailed school-level information on, among others, outcomes on national exams. The results suggest that schools with lower educational attainments use more frequently CAI programs. This suggests that they use CAI programs to catch up on learning outcomes. Moreover, using an instrumental variable design, we argue that given the participation in the CAI program, making more exercises leads to higher test results. Working with a CAI program seems therefore effective. [ABSTRACT FROM AUTHOR]

Rationale, aims and objectives Interventions aimed at improving guideline adherence should take into account the specific features of the target users; however, it is unclear how general practitioners ( GPs) evaluate the different types of interventions. The aim of this paper was to identify GPs' preferences for interventions to improve guideline adherence in practice and whether these differ across key guideline recommendations. Method An electronic survey was conducted among 703 GPs working in the south-western part of the Netherlands. Each survey focused on two of four guidelines: cerebrovascular accident, eye inflammation, thyroid disorders and urinary tract infection. GPs were asked to rate potential interventions in terms of their usefulness in improving guideline adherence in general and for specific key guideline recommendations. Results 264 GPs (38%) completed the questionnaire. In general, GPs preferred interactive small group meetings (84% rated this as much or very much encouraging), audit and feedback (53%), organizational interventions (50%) and the use of local opinion leaders (50%) as methods for improving guideline adherence. Financial interventions (24%), distribution of educational materials (22%) and big group educational meetings (21%) were of least interest. Some interventions were preferred by GPs irrespective of the specific key recommendations (e.g. audit and feedback), while ratings for other interventions differed across key recommendations (reminders/computer support). Conclusions To implement guidelines, interventions need to be identified that are acceptable and appealing to the target group. GPs seem to have general and recommendation-specific preferences regarding interventions, these should be taken into account when developing plans for guideline implementation to encourage the uptake of guidelines in practice. [ABSTRACT FROM AUTHOR]

The aim was to determine predictors for the development of complaints of temporomandibular disorders ( TMD) in a large sample of Dutch scuba divers who were free of any TMD complaints before they started diving actively. Five-hundred and thirty-six scuba divers (mean ± SD age = 40·4 ± 11·9 years; 34·1% women) completed a specifically developed questionnaire, either online or on paper. Stepwise forward logistic regression analysis was performed to predict the presence of TMD pain, with several potential risk factors as predictors. Four hundred and eighty-five of the 536 respondents were free of any TMD pain before they started diving actively. In this sample, TMD pain was present in 214 persons (44·1%). Four predictors contributed significantly to the presence of TMD pain, viz., clenching ( OR = 2·466), warm water ( OR = 1·685), biting on the mouthpiece ( OR = 1·598), and the quality rating of the mouthpiece ( OR = 0·887, that is, a higher rating means a smaller odds of having TMD pain). TMD pain is a common complaint among scuba divers who were free of such complaints before they started diving actively. Clenching, biting on the mouthpiece, and a low rating of the mouthpiece are predictors for the presence of TMD pain in scuba divers, while diving in cold water serves as a protective factor for TMD pain. [ABSTRACT FROM AUTHOR]

Background and Aims A strong correlation exists between smoking and the use of alcohol and cannabis. This paper uses polygenic risk scores to explore the possibility of overlapping genetic factors. Those scores reflect a combined effect of selected risk alleles for smoking. Methods Summary-level P-values were available for smoking initiation, age at onset of smoking, cigarettes per day and smoking cessation from the Tobacco and Genetics Consortium ( n between 22 000 and 70 000 subjects). Using different P-value thresholds (0.1, 0.2 and 0.5) from the meta-analysis, sets of 'risk alleles' were defined and used to generate a polygenic risk score (weighted sum of the alleles) for each subject in an independent target sample from the Netherlands Twin Register ( n = 1583). The association between polygenic smoking scores and alcohol/cannabis use was investigated with regression analysis. Results The polygenic scores for 'cigarettes per day' were associated significantly with the number of glasses alcohol per week ( P = 0.005, R2 = 0.4-0.5%) and cannabis initiation ( P = 0.004, R2 = 0.6-0.9%). The polygenic scores for 'age at onset of smoking' were associated significantly with 'age at regular drinking' ( P = 0.001, R2 = 1.1-1.5%), while the scores for 'smoking initiation' and 'smoking cessation' did not significantly predict alcohol or cannabis use. Conclusions Smoking, alcohol and cannabis use are influenced by aggregated genetic risk factors shared between these substances. The many common genetic variants each have a very small individual effect size. [ABSTRACT FROM AUTHOR]