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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]

Aim: To investigate spoken language comprehension (SLC), single‐word comprehension (SWC), functional communication development, and their determinants, in children with cerebral palsy. Method: This was a prospective cohort study in the Netherlands spanning 2 years 6 months. The main outcomes were SLC and SWC, assessed by the Computer‐Based instrument for Low motor Language Testing (C‐BiLLT) and the Peabody Picture Vocabulary Test‐III‐NL (PPVT‐III‐NL) respectively; and functional communication, measured by a subscale of the Focus on the Outcomes of Communication Under Six‐34 (FOCUS‐34). Linear mixed models were used to determine developmental trajectories, which were compared with norm and reference data. Potential determinants, for example intellectual functions, speech production, functional communication level (classified with the Communication Function Classification System, CFCS), and functional mobility, were added to assess their effects. Results: Children with cerebral palsy (n = 188; mean age 59 months, range 17–110) were monitored for 2 years 6 months. Developmental trajectories for SLC (C‐BiLLT) and SWC (PPVT‐III‐NL) were nonlinear; those for functional communication (FOCUS‐34) were linear. Compared with norm and reference groups, significantly delayed SLC, SWC, and functional communication development were found. Determinants for SLC and SWC were intellectual functions and functional communication level (CFCS); and for functional communication development (FOCUS‐34), speech production and arm–hand functioning. Interpretation: Children with cerebral palsy showed delayed SLC, SWC, and functional communication development compared with norm and reference groups. Remarkably, functional mobility was not associated with the development of SLC, SWC, or functional communication. What this paper adds: Children with cerebral palsy have delayed spoken language comprehension (SLC), single‐word comprehension (SWC), and functional communication development, compared to norm and reference data.Determinants for SLC and SWC development are intellectual functions and functional communication level.Determinants for functional communication development are speech production and arm–hand functioning.Functional mobility is not associated with SLC, SWC, or functional communication. What this paper adds: Children with cerebral palsy have delayed spoken language comprehension (SLC), single‐word comprehension (SWC), and functional communication development, compared to norm and reference data.Determinants for SLC and SWC development are intellectual functions and functional communication level.Determinants for functional communication development are speech production and arm–hand functioning.Functional mobility is not associated with SLC, SWC, or functional communication. Video Podcast: https://youtu.be/x09Tac7tsz0 [ABSTRACT FROM AUTHOR]

Long baseline bistatic radar systems herald enhanced sensitivity and metric accuracy for space objects in geosynchronous orbits and beyond. Radio telescopes are ideal participants in such a system; in particular, they often feature large apertures with low‐noise temperatures and have stable, synchronised clocks. Pairing radio telescopes with high‐power radars creates new methodologies for Space Domain Awareness. This paper describes long baseline bistatic measurements using the Millstone Hill Radar in the USA, the Tracking and Imaging Radar in Germany, multiple receivers of the enhanced multi‐element remotely linked interferometer network array in the United Kingdom, and the Westerbork Synthesis Radio Telescope in the Netherlands. The authors, a Research Task Group formed by the NATO Science and Technology Organisation Sensors and Electronic Technology Panel (SET‐293), performed novel bistatic and monostatic radar imaging experiments with real on‐orbit tumbling rocket bodies. These experiments on tumbling objects at near‐geosynchronous orbits highlight successful demonstrations of advanced bistatic Doppler characterisation across diverse imaging geometries. Specialised Doppler processing on tumbling targets, such as the Doppler superpulse algorithm, enables high‐fidelity rotation period estimation and determination of minimum target size. [ABSTRACT FROM AUTHOR]

For endangered species with limited dispersal capacity, the preservation of individual patches or sites is extremely important. The quality and size of habitat patches and their isolation from other patches are the main parameters for an assessment of population persistence, but translating persistence probabilities into practical measures is still a weak link in conservation management. I provide a quantitative conservation approach for the endangered myrmecophilous butterfly Maculinea alcon in the Netherlands. All 127 colonies known on heathland since 1990 were investigated for patch quality, size, and isolation. I assessed habitat quality in three 10 × 10 m plots for most colonies. Site occupancy in 1998–1999 was only 56%. Occupancy was best explained by a logistic regression including patch area, host ant presence, host plant abundance, overall heathland area, and connectivity between sites ( 2= 0.410, < 0.0001); it correctly classified the occupied or vacant status for 82% of the sites. Connectivity contributed only 3.6% to the total explained variation of site occupancy, indicating that habitat characteristics were more important than isolation in determining population persistence at the examined scale level (>500 m). Grazing and sod cutting had a beneficial impact, but in combination these practices proved detrimental. Hydrological measures to prevent drainage were also associated with lowered occupancy. I used the different components in the logistic regression to formulate objective management recommendations. These consisted of sod cutting, reduction of management intensity, enlargement of habitat, or combinations of these recommendations. The results highlight the importance of careful management when site quality is determined by multiple factors. The quantitative conservation approach followed here can be fruitfully extended to other endangered species, provided enough is known about their ecological requirements and how management actions affect them. [ABSTRACT FROM AUTHOR]

Global reanalyzes like ERA5 accurately capture atmospheric processes at spatial scales of O(10) $\mathcal{O}(10)$ km or larger. By downscaling ERA5 with large‐eddy simulation (LES), LES can provide details about processes at spatio‐temporal scales down to meters and seconds. Here, we present an open‐source Python package named the "Large‐eddy simulation and Single‐column model—Large‐Scale Dynamics," or (LS)2D in short, designed to simplify the downscaling of ERA5 with doubly‐periodic LES. A validation with observations, for several sensitivity experiments consisting of month‐long LESs over Cabauw (the Netherlands), demonstrates both its usefulness and limitations. The day‐to‐day variability in the weather is well captured by (LS)2D and LES, but the setup under‐performs in conditions with broken or near overcast clouds. As a novel application of this modeling system, we used (LS)2D to study surface solar irradiance variability, as this quantity directly links land‐surface processes, turbulent transport, and clouds, to radiation. At a horizontal resolution of 25 m, the setup reproduces satisfactorily the solar irradiance variability down to a timescale of seconds. This demonstrates that the coupled LES‐ERA5 setup is a useful tool that can provide details on the physics of turbulence and clouds, but can only improve on its host reanalysis when applied to meteorological suitable conditions. Plain Language Summary: Modern global weather models are accurate in predicting atmospheric processes at scales of around 10 km or larger, but are less good at predicting smaller scale processes, like for example, the interaction between solar radiation, individual clouds, and the resulting clouds shadows that are cast onto the land surface. High spatio‐temporal resolution research models are able to capture these smaller scale processes, but require a coupling to a weather model to account for the day‐to‐day variability in our weather. In this paper, we present a framework to couple large to small scale models, and demonstrate both the benefits and challenges of using this coupled model setup. The coupled setup excels in capturing the aforementioned high frequency interactions between small clouds and surface solar radiation. However, the chaotic nature of broken to overcast clouds is proven difficult to represent. The coupled model setup is published as open‐source code, and is therefore freely available to the research community. Key Points: We developed an open‐source Python package named (LS)2D, designed to downscale the ERA5 reanalysis with turbulence and cloud‐resolving large‐eddy simulation (LESs)One month long experiments with (LS)2D and MicroHH over the Netherlands demonstrate both the skill and limitations of the coupled setupCapturing high‐frequency interactions between clouds and surface solar irradiance requires high resolution (O $\mathcal{O}$(10) m) LES [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]

In this paper, we report on a wind observation method based on the movement of hot‐air balloons (HABs). A quality assessment was carried out by comparing against wind observations at the meteorological tower of Cabauw in the Netherlands during May–September 2018, and the obtained standard deviations in error were σu=0.65ms−1$$ {\sigma}_u=0.65\;{\mathrm{ms}}^{-1} $$ and σv=0.69ms−1$$ {\sigma}_v=0.69\;{\mathrm{ms}}^{-1} $$ for the measured zonal and meridional wind components, respectively. Subsequent comparison against short‐term forecasts of the HARMONIE‐AROME model showed a standard deviation of 2.5 ms−1 for the wind vector difference. From the HAB observation set, a case was selected with a rapidly changing wind field belonging to a small intensifying depression. The HAB wind observation was applied in data assimilation as a proof of principle for a single‐observation experiment. It is shown that in a complex baroclinic situation, the model state is slightly improved. [ABSTRACT FROM AUTHOR]

Most atmospheric models consider radiative transfer only in the vertical direction (1D), as 3D radiative transfer calculations are too costly. Thereby, horizontal transfer of radiation is omitted, resulting in incorrect surface radiation fields. The horizontal spreading of diffuse radiation results in darker cloud shadows, whereas it increases the surface radiation in clear sky patches (cloud enhancement). In this study, we developed a simple method to account for the horizontal transfer of diffuse radiation. We spatially filter the surface diffuse radiation field with a Gaussian filter, which is conceptually simple and computationally efficient. We applied the filtering to the results of Large‐Eddy Simulations for two summer days in Cabauw, the Netherlands, on which shallow cumulus clouds formed during the day. We obtained the optimal filter size by matching the simulation results with detailed high‐quality observations (1 Hz). Without the filtering, cloud enhancements are not captured, and the probability distribution of global radiation is unimodal, whereas the observed distribution is bimodal. After filtering, the probability distribution of global radiation is bimodal and cloud enhancements are simulated, in line with the observations. We found that small changes in the filter width do not strongly influence the results. Furthermore, we showed that the width of the filter can be parameterized as a linear function of for example, the cloud cover. Hence, this work presents a proof‐of‐concept for our method to come to more realistic surface irradiances by filtering diffuse radiation at the surface. Plain Language Summary: The pattern of radiation at the surface is characterized by the presence of cloud shadows and peaks in the radiation caused by scattering of light by clouds. The amount of solar radiation that reaches the Earth's surface determines how much energy is produced by solar panels and how much heat and moisture is supplied to the clouds, thus it influences how the clouds develop. Existing models neglect the scattering of radiation in the horizontal direction, therefore the high peaks in the radiation are not modeled. In this paper, we show for 2 days with shallow cumulus clouds how we can include the effect of the horizontal propagation of radiation. We redistribute the radiation at the surface, and we compare our model results with measurements. After the redistribution, the high peaks in radiation are modeled. In general, we get a good match between the observed and modeled radiation distribution. We show that the redistribution can be made a function of the clouds in the model. Hence, this work presents a proof‐of‐concept for our method to come to more realistic surface radiation, without complex calculations. Key Points: We correct simulations of shallow cumulus cloud days with 1D radiative transfer for the 3D radiative effects in a post‐processing stepThe probability distributions of diffuse and global radiation closely match the observations after filtering the surface diffuse radiationThe filter size can be parameterized as a linear function of one or multiple cloud variables, resulting in a minimal computational overhead [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]

This paper provides an overview of regional science research in the Netherlands since the 1960s. It adopts a contextual thematic approach in identifying and interpreting regional science research topics, practices and methodologies, inspired by Toynbee's challenge and response concept. It argues that place‐based, cultural and historical conditions in the Netherlands have prompted a pragmatic and evidence‐based scientific approach, in which in particular an innovative quantitative orientation accompanied by a methodological heterogeneity has given Dutch regional science a high international profile. Over the past decades, numerous regional scientists in the country have contributed to this achievement, too many to be mentioned in this overview. This paper has its limitations and offers mainly thematic examples of original—often quantitative—research undertaken by various Dutch regional scientists, that make a difference compared to general approaches in Europe and world‐wide. From our concise review we conclude that – despite the small size of the country – the challenge and creative response model of Dutch regional science has been rather successful. [ABSTRACT FROM AUTHOR]

Pharmacogenomics (PGx) relates to the study of genetic factors determining variability in drug response. Implementing PGx testing in paediatric patients can enhance drug safety, helping to improve drug efficacy or reduce the risk of toxicity. Despite its clinical relevance, the implementation of PGx testing in paediatric practice to date has been variable and limited. As with most paediatric pharmacological studies, there are well‐recognised barriers to obtaining high‐quality PGx evidence, particularly when patient numbers may be small, and off‐label or unlicensed prescribing remains widespread. Furthermore, trials enrolling small numbers of children can rarely, in isolation, provide sufficient PGx evidence to change clinical practice, so extrapolation from larger PGx studies in adult patients, where scientifically sound, is essential. This review paper discusses the relevance of PGx to paediatrics and considers implementation strategies from a child health perspective. Examples are provided from Canada, the Netherlands and the UK, with consideration of the different healthcare systems and their distinct approaches to implementation, followed by future recommendations based on these cumulative experiences. Improving the evidence base demonstrating the clinical utility and cost‐effectiveness of paediatric PGx testing will be critical to drive implementation forwards. International, interdisciplinary collaborations will enhance paediatric data collation, interpretation and evidence curation, while also supporting dedicated paediatric PGx educational initiatives. PGx consortia and paediatric clinical research networks will continue to play a central role in the streamlined development of effective PGx implementation strategies to help optimise paediatric pharmacotherapy. [ABSTRACT FROM AUTHOR]

Background: In the Netherlands, all women aged 30–60 years are invited to participate in the national cervical cancer screening programme, which is aimed at early detection and treatment of precancerous lesions. One fourth of the Dutch population has a migration background, with Turkish and Moroccan immigrants being the largest immigrant populations. Turkish‐ and Moroccan‐Dutch women show lower screening participation rates and a higher incidence of cervical cancer, compared to native Dutch women. Since current information materials are not tailored to these women's needs, we developed a short culturally sensitive educational video to facilitate informed decision‐making for cervical cancer screening among Turkish‐ and Moroccan‐Dutch women. This article describes the development process of this video and the lessons learned. Methods: Using the Entertainment–Education communication strategy, we collaborated with an interdisciplinary team of Turkish‐ and Moroccan‐Dutch women, researchers, public health experts, and creative media professionals. We developed the video following the different stages of the Media Mapping model: Orientation, Crystallization, Design/Production, Implementation, and Dissemination. Each stage is described in the paper. Results: The video was developed in Moroccan‐Arabic, ‐Berber and Turkish, and emphasized three main themes: (1) more certainty about having cervical (pre)cancer and the possibility to prevent treatment, surgery, or premature death, and because of this, being there for the children, (2) according to the Islam, a woman should take good care of her health, and (3) anxiety, shame, and privacy. Conclusions: A short culturally sensitive educational video, delivered as part of a larger intervention together with the current information brochure, was developed based on theory and grounded in the needs of Turkish‐ and Moroccan‐Dutch women. The value and effectiveness of this intervention to facilitate informed cervical cancer screening decisions are evaluated in a randomised controlled trial. Patient or Public Contribution: We collaborated with Turkish‐ and Moroccan‐Dutch women during the development process of a short culturally sensitive educational video. Turkish‐ and Moroccan‐Dutch women were also invited to watch the raw footage to verify whether the content and presentation matched their needs and requirements. [ABSTRACT FROM AUTHOR]

Abstract: This paper examines the role of human capital as a location factor in the context of long‐distance firm relocations. Using rich register data on single‐plant firms in the Netherlands 2006–2011, the paper enquires into whether relocation is motivated by the wish to improve the access to employees and the quality of labour force. Not disrupting existing spatial relationships is a prominent consideration of relocating firms, yet in general, relocation does not result in a better spatial match. Some evidence is found for firm‐specific human capital functioning as a keep factor. Relocating firms retain predominantly highly skilled employees, but general human capital itself functions neither as a keep factor nor as a pull factor. [ABSTRACT FROM AUTHOR]

Background: Community engagement is seen as key to citizen‐centred and sustainable healthcare systems as involving citizens in the designing, implementation and improvement of services and policies is thought to tailor these more closely to communities' own needs and experiences. Organizations have struggled to reach out to and involve disadvantaged citizens. This paper examines how if, why, and when low‐income citizens wish to be involved. Methods: For this qualitative realist case‐study, 19 interviews (one dyad) were held with (20) low‐income citizens in two Dutch municipalities. Additionally, the results were discussed with a reference panel consisting of professionals and citizens to enrich the results and to ensure the results had face validity. Results: The results showed four different ways in which low‐income citizens wished to be involved: (a) in a practical/volunteer way; (b) as a buddy; (c) as a lay expert; (d) not involved at all. The factors affecting citizens' interest and capacity to participate include citizens' own experiences of the services they access and their personal situations, e.g. their mental or physical health, extent of financial crisis, family situation, home environment. None of the interviewees was currently involved, but all had ideas for improving health(care) services and policies. Citizens' experiences of the services they accessed acted as a motivator for some to be involved as they wanted to ensure others would not have the same struggles, while for others their own needs and an apathetic system remained too high a barrier. To enable involvement, citizens need continued support for their own health(care) and financial situation, better communication and accessibility from services, practical support (e.g., training and bus passes) and recognition for their input (e.g., monetary compensation). Conclusion: The study shows that citizens' experiences of the services they accessed influenced if and how they wanted to be involved with health and care services. Despite the fact that all participants had shared solid ideas for improving services and policies, they were hindered by a bureaucratic, impersonal and inaccessible system. Organizations seem to underestimate the required investments to reach out to low‐income citizens and the support required to ensure their involvement. Patient and Public Involvement (PPI) in Study: Citizens as well as PPI organizations were members of the reference panel who helped formulate the research questions and recruitment strategy. The local reference panel also helped to interpret and refine the initial findings. [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]

During early summer 2019, the Netherlands experienced an outbreak of the exotic oak processionary caterpillar. The vast number of caterpillars, which live in large nests on oak trees before they turn into moths, possess thousands of small, barbed hairs (setae) that are disseminated with the wind. The hairs cause a range of primarily dermatologic problems. However, Dutch ophthalmologists started reporting patients with ophthalmologic complaints caused by the penetrating hairs of the oak processionary caterpillar. This paper focuses on the ophthalmologic complications caused by the caterpillar hairs. We collected a series of four cases with reports ranging from a corneal erosion with hairs lodged into the cornea, to a sterile endophthalmitis in which hairs were found in the vitreous. A literature review for similar cases was performed using the PubMed and Embase database. Together with the Dutch Ophthalmic Society (Nederlands Oogheelkundig Gezelschap, NOG), a national survey was issued to determine the scale of this new problem. This showed that oak processionary caterpillar related complaints are primarily limited to the south of the Netherlands. Suggested ophthalmic treatment guidelines are presented. With the next summer at the doorstep, and limited preventative measures against the caterpillar hairs, we expect a new wave of ophthalmologic complaints coming year as well. [ABSTRACT FROM AUTHOR]

Aim: To determine neurocognitive performance and behavioural problems in children with Panayiotopoulos syndrome.Method: All 18 children (10 females, 8 males; mean age 4y 7mo; SD 1y 10mo) diagnosed with Panayiotopoulos syndrome at the Kempenhaeghe Epilepsy Center in the Netherlands between 2010 and 2017 were analysed retrospectively. All underwent a neuropsychological/behavioural assessment, an academic assessment, and a 24-hour electroencephalogram.Results: Mean full-scale IQ (93.5; range 76-123; p=0.04) and performance IQ (93.2; range 76-126; p=0.04) were within the normal range, although significantly lower compared to the normative mean. Verbal IQ (96.3; range 76-118) and processing speed (96.1; range 74-114) were not significantly lower. Simple auditory/visual reaction times, visual attention, visual-motor integration, and verbal memory were significantly lower compared to normative values. On average, patients with Panayiotopoulos syndrome were 8 months behind in arithmetic speed and 11 months behind in reading speed for the number of months in school. Behavioural questionnaires revealed significantly higher scores on reported internalizing behavioural problems.Interpretation: Children with Panayiotopoulos syndrome demonstrated diffuse cognitive dysfunction in full-scale IQ, performance IQ, visual attention, visual-motor integration, and verbal memory. A high incidence of internalizing behavioural problems was reported. This strongly suggests neuropsychological and behavioural comorbidity in children with Panayiotopoulos syndrome.What This Paper Adds: Children with Panayiotopoulos syndrome are at risk for cognitive deficits in various cognitive domains. Children with Panayiotopoulos syndrome are also prone to internalizing behavioural problems. Mild-to-severe academic underachievement was present in more than half of the children with Panayiotopoulos syndrome. [ABSTRACT FROM AUTHOR]

Aims: To examine changes in objective and subjective drooling severity measures after submandibular botulinum neurotoxin A injection in children with neurodevelopmental disabilities, explore their relationship, and evaluate if clinically relevant responses relate to changes in the impact of drooling.Method: This longitudinal, observational cohort study involved 160 children (92 males, 68 females; 3-17y, mean 9y 1mo, SD 3y 6mo) treated between 2000 and 2012 at the Radboud University Medical Center, Nijmegen, the Netherlands. Repeated measures analysis of variance was used to compare the 5-minute Drooling Quotient (DQ5) and Visual Analogue Scale (VAS) for drooling severity pretreatment and posttreatment, and Pearson's rho to assess their association. A parent questionnaire was used to assess drooling impact in responders (defined as ≥50% reduction in DQ5 and/or ≥2 SD reduction in VAS for drooling severity 8wks postintervention) and non-responders.Results: One hundred and twelve children (70%) were responders. Their mean VAS for drooling severity and DQ5 scores were significantly lower 32 weeks postintervention compared to baseline. At baseline, the VAS for drooling severity-DQ5 relationship was 'weak' (rs =0.15, p=0.060), whereas it was 'fair' at 8 weeks (rs =0.43, p=0.000) and 32 weeks (rs =0.30, p=0.000). For responders, a significant change was found regarding the impact of drooling on daily care and social interactions at 8 weeks after intervention; most of these effects were maintained at 32 weeks.Interpretation: A clinically relevant response based on a combination of objective and subjective measures of drooling severity was accompanied by positive changes regarding the impact of drooling on daily care and social interactions.What This Paper Adds: Botulinum neurotoxin A injection into the submandibular glands reduced drooling severity in 70% of children with neurodevelopmental disabilities. Objective (5-minute Drooling Quotient) and subjective (Visual Analogue Scale for drooling severity) measures correlated 8 and 32 weeks after treatment. Objective and subjective measures complemented each other when changes in drooling severity were assessed. Reduced drooling severity was accompanied by positive changes with regard to the impact of drooling. [ABSTRACT FROM AUTHOR]

Abstarct: Purpose: Children with Down syndrome (DS) more often have strabismus, refractive errors, accommodative lags and reduced visual acuity (VA) than typically developing children. In this study, we compare the effects of bifocal glasses with those of unifocal glasses in children with DS. Changes in angle of strabismus, accommodation and refractive error were analysed in this paper. Methods: In a multicentre randomized controlled trial, 119 children with DS, aged 2–16, were randomly allocated for bifocal or unifocal glasses (with full correction of refractive error in cycloplegia). The 15 centres, all in the Netherlands, followed the participants for 1 year. Changes in refractive error, accommodative accuracy, strabismus, binocularity and stereopsis were compared across 4 subsequent visits. Results: Refractive errors and accommodative errors showed no significant change throughout the course of our study in either intervention group. The manifest angle of strabismus, however, reduced significantly in the bifocal group. This improvement was observed shortly after the children received their new correction (~6 weeks) (linear regression: t = 3.652, p < 0.001) and remained present in the final measurements after 1 year (linear regression: t = 3.604, p < 0.001). The percentage of children with positive binocularity and stereo tests showed no significant differences between the groups. Conclusion: Bifocals with full correction of refractive error reduce the manifest angle of strabismus within a few weeks. No effects on accommodation, refractive error, stereopsis and binocularity occurred over the course of 1 year. [ABSTRACT FROM AUTHOR]

Citizen‐science thermometer measurements have the potential to provide information about surface air temperature fields on scales smaller than is typically quantified by the official monitoring network. As such, national meteorological services are becoming increasingly interested in these measurements as a possible source of data for use in weather monitoring or forecasting. However, in order for the information to be used, biases in the data need to be assessed. The most important source of bias is the potential overheating of the thermometer due to inadequate shielding or exposure. Previous research has indicated that information about the nature of the instrument and its exposure is important for correcting this bias. However, in the majority of cases this information is unavailable for amateur stations. In this paper a statistical correction for short wave radiation bias is developed for the air temperature data recorded at 159 Weather Observations Website (WOW) stations across the Netherlands during the period 2015–2016. Generalized additive mixed modelling (GAMM) is used to quantify and correct for short wave radiation bias in the hourly measurements using a background temperature field generated from the official 34 automatic weather stations along with satellite‐derived short wave radiation estimates. It is demonstrated that the corrected WOW data add local detail to the hourly temperature field, which may provide a useful source of data to supplement official measurements. [ABSTRACT FROM AUTHOR]

Aim: To determine development curves of communication and social interaction from childhood into adulthood for individuals with cerebral palsy (CP).Method: This Pediatric Rehabilitation Research in the Netherlands (PERRIN)-DECADE study longitudinally assessed 421 individuals with CP, aged from 1 to 20 years at baseline, after 13 years (n=121 at follow-up). Communication and social interactions were assessed using the Vineland Adaptive Behavior Scales. We estimated the average maximum performance limit (level) and age at which 90% of the limit was reached (age90 ) using nonlinear mixed-effects modeling.Results: One-hundred individuals without intellectual disability were aged 21 to 34 years at follow-up (39 females, 61 males) (mean age [SD] 28y 5mo [3y 11mo]). Limits of individuals without intellectual disability, regardless of Gross Motor Function Classification System (GMFCS) level, approached the maximum score and were significantly higher than those of individuals with intellectual disability. Ages90 ranged between 3 and 4 years for receptive communication, 6 and 7 years for expressive communication and interrelationships, 12 and 16 years for written communication, 13 and 16 years for play and leisure, and 14 and 16 years for coping. Twenty-one individuals with intellectual disability were between 21 and 27 years at follow-up (8 females, 13 males) (mean age [SD] 24y 7mo [1y 8mo]). Individuals with intellectual disability in GMFCS level V showed the least favourable development, but variation between individuals with intellectual disability was large.Interpretation: Individuals with CP and without intellectual disability show developmental curves of communication and social interactions similar to typically developing individuals, regardless of their level of motor function. Those with intellectual disability reach lower performance levels and vary largely in individual development.What This Paper Adds: Communication and social interactions in individuals with cerebral palsy without intellectual disability develop similarly to typically developing individuals. Communication and social interactions of individuals with intellectual disability develop less favourably and show large variation. [ABSTRACT FROM AUTHOR]

The composite image shows highlights of select papers from the Proceedings of the Scientific Detector Workshop 2022. From top left, clockwise: The Euclid NISP Near‐Infrared Focal Plane under test at the CEA/LAM facility in Marseilles, France (see J. Beletic et al., e230136); The Acuros CQD sensors from SWIR Vision Systems (see C. Mackay, e230104); The Original lab book entry made at Bell Labs by Willard S. Boyle and George E. Smith on October 19th, 1969 (see M.M. Roth, e230066); The focal plane of the Dark Energy Survey (see S.E. Holland, p. xx4); The DECam CCD wafer (see S.E. Holland, e230072); The 2048 × 2048 detector array of JWST NIRCam supplied by Teledyne (see G. Rieke, e230065); Mosaic of three integrated FPA + Linear variable filters (see, J. Beletic et al., e230136). [ABSTRACT FROM AUTHOR]

Background: Patient‐directed knowledge tools such as patient versions of guidelines and patient decision aids are increasingly developed to facilitate shared decision making. In this paper, we report how consensus was reached within the Netherlands on quality criteria for development, content and governance of these tools. Method: A 12‐month development and consensus study. The consortium worked on four work packages: (a) reviewing existing criteria; (b) drafting the quality criteria; (c) safe‐guarding the acceptability and feasibility of the draft criteria by participatory research in on‐going tool development projects; and (d) gaining formal support from national stakeholders on the quality criteria. Results: We reached consensus on a 8‐step guidance; describing minimal quality criteria for (a) the team composition; (b) setting the scope; (c) identifying needs; (d) the content and format; (e) testing the draft; (f) finalizing and approval; (g) dissemination and application, and (h) ownership and revision. The participants of the on‐going tool development projects were positive about the quality criteria in general, but divided as to the degree of detail. Whereas some expressed a clear desire for procedural standards, others felt that it would be sufficient to provide only general directions. Despite the different views as to the degree of detail, consensus was reached in three stakeholder meetings. Discussion: We successfully collaborated with all stakeholders and achieved formal support from national stakeholders on a set of minimum criteria for the development process, content and governance of patient‐directed knowledge tools. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to estimate long-term impairment attributable to congenital cytomegalovirus infection (cCMV).Method: This nationwide cohort study retrospectively assessed cCMV in children born in 2008 in the Netherlands, testing 31 484 stored neonatal dried blood spots. Extensive medical data of cCMV-positive children (n=133) and matched cCMV-negative comparison children (n=274) up to 6 years of age were analysed.Results: Moderate to severe long-term impairment was diagnosed in 24.8% (33 out of 133) of all cCMV-positive children (53.8% in symptomatic, 17.8% in asymptomatic), compared with 12.0% (33 out of 274) of cCMV-negative children. Sensorineural hearing loss was seen only in five cCMV-positive children (3.8%). Developmental delays were diagnosed more often in cCMV-positive children than cCMV-negative children: motor (12.0% vs 1.5%), cognitive (6.0% vs 1.1%), and speech-language (16.5% vs 7.3%). Long-term impairment in multiple domains was more frequent in symptomatic (19.2%) and asymptomatic (8.4%) cCMV-positive children than cCMV-negative children (1.8%).Interpretation: Children with cCMV were twice as likely to have long-term impairment up to the age of 6 years, especially developmental delays and sensorineural hearing loss, than cCMV-negative comparison children, with a risk difference of 12.8%. These insights into the risk of cCMV-associated impairment can help optimize care and stimulate preventive measures.What This Paper Adds: Congenital cytomegalovirus infection (cCMV) leads to impairment in 25% of cases. Fifty per cent of children with cCMV symptoms at birth have long-term impairment. The risk difference of moderate to severe long-term impairment between children with and without cCMV is 13%, attributable to cCMV. cCMV leads to motor, cognitive, and speech-language developmental delay in children. [ABSTRACT FROM AUTHOR]

Recent literature suggests two mechanisms through which the start-up of new firms contributes to economic development: the growth of start-ups and competition among incumbent firms induced by the start-ups. While existing studies derive the competition effect indirectly, this paper deploys a direct measure, called market mobility, to approximate the induced competition effect. The empirical results are consistent with the idea that both effects are important in explaining the long-term economic impact of start-ups. First, the most successful start-ups grow to become high-growth firms, and second, the entry of new firms stimulates incumbent firms to perform better. [ABSTRACT FROM AUTHOR]

The present paper addresses two crafting strategies employees may display in different life domains in order to attain desired outcomes. On the one hand, job crafting is targeted at increasing social and structural job resources and challenging job demands. On the other hand, leisure crafting is the proactive pursuit of leisure activities targeted at goal setting, human connection, learning, and personal development. We hypothesized that job crafting relates positively to employee work engagement and meaning-making, especially when occupational role salience is high. Furthermore, we hypothesized that leisure crafting relates positively to meaning-making, especially when job crafting opportunities are low. Using a sample of 105 Dutch employees and a weekly survey with three measurements, we found support for most of our hypotheses. All job crafting dimensions related positively to work engagement when occupational role salience was high. Also, increasing structural resources related positively to meaning-making when occupational role salience was high. Leisure crafting related positively to meaning-making when job crafting opportunities were low. We discuss directions for future research on work and leisure, and suggest how employees and organizations may benefit by encouraging job and leisure crafting. Practitioner points Employees can proactively build their own work engagement using job crafting, especially when they view their work as a source of personal satisfaction and development., In workplaces where opportunities to craft are low, employees could focus on their leisure time as a source of meaning and self-reflection., Managers can empower and coach employees to proactively seek growth and self-fulfilment both at work and outside work, via job crafting and leisure crafting., Organizations and managers should encourage employees to flourish not only at work but also during leisure time, communicating that work and leisure are two life domains that can help and complement each other. [ABSTRACT FROM AUTHOR]

Multi-establishment firms can create local spatial monopolies in the form of clusters of own establishments without competition. This paper examines the existence of spatial monopolies for Dutch supermarkets in 2009. It is found that 23 percent of consumers can be qualified as being locked-in in a spatial monopoly of a specific supermarket brand. Resumen. Las empresas con múltiples establecimientos pueden crear monopolios espaciales locales en forma de conglomerados de sus propios establecimientos sin que haya competencia. Este artículo examina la existencia de monopolios espaciales de supermercados en los Países Bajos en 2009. Se encontró que el 23 por ciento de consumidores pueden clasificarse como cautivos de un monopolio espacial de alguna marca de supermercado específica. [ABSTRACT FROM AUTHOR]

Was the crisis of historicism an exclusively German affair? Or was it a “narrowly academic crisis,” as is sometimes assumed? Answering both questions in the negative, this paper argues that crises of historicism affected not merely intellectual elites, but even working-class people, not only in Germany, but also in the Netherlands. With an elaborated case study, the article shows that Dutch “neo-Calvinist” Protestants from the 1930s onward experienced their own crisis of historicism. For a variety of reasons, this religious subgroup came to experience a collapse of its “historicist” worldview. Following recent German scholarship, the paper argues that this historicism was not a matter of Rankean historical methods, but of “historical identifications,” or modes of identity formation in which historical narratives played crucial roles. Based on this Dutch case study, then, the article develops two arguments. In a quantitative mode, it argues that more and different people suffered from the crisis of historicism than is usually assumed. In addition, it offers a qualitative argument: that the crisis was located especially among groups that derived their identity from “historical identifications.” Those who suffered most from the crisis of historicism were those who understood themselves as embedded in narratives that connected past, present, and future in such a way as to offer identity in historical terms. [ABSTRACT FROM AUTHOR]

In this paper we investigate the relationship between geographic mobility and education-job mismatch in the Netherlands. We focus on the role of geographic mobility in reducing the probability of graduates working (i) jobs below their education level; (ii) jobs outside their study field; (iii) part-time jobs; (iv) flexible jobs; or (v) jobs paid below the wage expected at the beginning of the career. For this purpose we use data on secondary and higher vocational education graduates in the period 1996–2001. We show that graduates who are mobile have higher probability of finding jobs at the acquired education level than those who are not. Moreover, mobile graduates have higher probability of finding full-time or permanent jobs. This suggests that mobility is sought to prevent not only having to take a job below the acquired education level, but also other education-job mismatches; graduates are spatially flexible particularly to ensure full-time jobs. [ABSTRACT FROM AUTHOR]

‘Redlining’ is a form of place-based exclusion. It is widely documented in the US, but not in Europe. This paper focuses on a comparative analysis of redlining practices in the two largest cities of the Netherlands: Amsterdam and Rotterdam. It shows that redlining was common practice in Rotterdam in 1999. In 2001, no signs of redlining were found in Rotterdam. However,‘yellowlining’ (lower loan-to-value ratios) was still common in some parts of Rotterdam. In Amsterdam, no neighbourhoods were faced with redlining in either 1999 or 2001. However, in 1999 some neighbourhoods were yellowlined. This paper aims to get a better understanding of the nature and the institutional context of redlining in the Netherlands by explaining how the differences in redlining practices between Amsterdam and Rotterdam, and between 1999 and 2001, can be explained. The National Mortgage Guarantee as well as socio-historical, and housing and mortgage market differences and changes, are instrumental in explaining these differences in redlining practices. [ABSTRACT FROM AUTHOR]

The Netherlands is currently the only country in the world in which euthanasia is legally permissible. More specifically, Dutch law (briefly explained) allows that a doctor terminates the life of a patient of hers on his voluntary, well-considered and sustained request, if he is suffering unbearably and hopelessly. The aim of this paper is to reconstruct the Dutch debate on the moral permissibility of euthanasia so as to clarify and strengthen the various views that can be advanced in support of euthanasia. On the one view, The Pure Autonomy View (TPAV), the justification of euthanasia rests solely on the principle of respect for autonomy. That is, the reason for performing and permitting euthanasia is the patient's voluntary, well-considered and sustained, in one word: autonomous, request for euthanasia. On the alternative view, The Joint View (TJV), the principle of respect for autonomy and the principle of beneficence morally justify euthanasia together. That is, euthanasia is ethical if and partly because, since the patient is suffering unbearably and hopelessly, euthanasia is in his interest. According to this paper, there is no easy argument for one of these views rather than the other. Instead, as yet both TPA V and TJV seem inherently problematic. TPA V is unable to give a doctor a reason for performing euthanasia that appeals to her in her capacity as a doctor, such as relief of suffering. And TJV begs the question — for example, if a state were to legalize euthanasia on grounds of TJV, it would force the view upon its citizens that it may be in a person interest to die. [ABSTRACT FROM AUTHOR]

External peer review was introduced in general hospitals in the Netherlands in 1994 to assess and improve the multidisciplinary team approach in cancer care. This paper aims to explore the value, perceived impact, and (future) role of external peer review in cancer care. Semistructured interviews were held with clinicians, oncology nurses, and managers from fifteen general hospitals that participated in three rounds of peer review over a period of 16 years. Interviewees reflected on the goals and expectations, experiences, perceived impact, and future role of external peer review. Transcriptions of the interviews were coded to discover recurrent themes. Improving clinical care and organization were the main motives for participation. Positive impact was perceived on multiple aspects of care such as shared responsibilities, internal prioritization of cancer care, improved communication, and a clear structure and position of cancer care within general hospitals. Establishing a direct relationship between the external peer review and organizational or clinical impact proved to be difficult. Criticism was raised on the content of the program being too theoretical and organization-focussed after three rounds. According to most stakeholders, external peer review can improve multidisciplinary team work in cancer care; however, the acceptance is threatened by a perceived disbalance between effort and visible clinical impact. Leaner and more clinically focused programs are needed to keep repeated peer reviews challenging and worthwhile. [ABSTRACT FROM AUTHOR]

The Glock and Stark theoretical framework on Christian beliefs and anti-Semitism implies that orthodox religious beliefs perpetuate secular anti-Semitism via particularism and religious anti-Semitism. Several critics have argued that the major weakness of this study is its failure to examine explanatory variables other than religious beliefs. This paper addresses these issues using data from a 1990-91 national Dutch survey. Although the results tend to support the assumption that nonreligious variables are far more important to the explanation of anti-Semitism and, too, that they attenuate the impact of Christian orthodoxy, the effects of the latter are by no means spurious. The most important conclusion of this paper is therefore that there still is, in Holland at least, a religious factor at work, albeit a modest one, generating anti-Semitic beliefs. [ABSTRACT FROM AUTHOR]

In half of Obsessive Compulsive Disorder (OCD) patients the disorder runs a chronic course despite treatment. The factors determining this unfavourable outcome remain unknown. The Netherlands Obsessive Compulsive Disorder Association (NOCDA) study is a multicentre naturalistic cohort study of the biological, psychological and social determinants of chronicity in a clinical sample. Recruitment of OCD patients took place in mental health organizations. Its design is a six-year longitudinal cohort study among a representative clinical sample of 419 OCD patients. All five measurements within this six-year period involved validated semi-structured interviews and self-report questionnaires which gathered information on the severity of OCD and its co-morbidity as well as information on general wellbeing, quality of life, daily activities, medical consumption and key psychological and social factors. The baseline measurements also include DNA and blood sampling and data on demographic and personality variables. The current paper presents the design and rationale of the study, as well as data on baseline sample characteristics. Demographic characteristics and co-morbidity ratings in the NOCDA sample closely resemble other OCD study samples. Lifetime co-morbid Axis I disorders are present in the majority of OCD patients, with high current and lifetime co-morbidity ratings for affective disorders (23.4% and 63.7%, respectively) and anxiety disorders other than OCD (36% current and 46.5% lifetime). Copyright © 2012 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Please cite this paper as: Bogers et al. (2012) Complications of the 2009 influenza A/H1N1 pandemic in pregnant women in The Netherlands: a national cohort study. Influenza and Other Respiratory Viruses 6(5), 309-312. The 2009 influenza A/H1N1 pandemic caused an increase in complications in pregnant women. To be well prepared for a next pandemic, we investigated the obstetric and maternal complications of this pandemic. In our national cohort of 59 pregnant women who were admitted to the hospital, no major complications apart from preterm birth and admission to the neonatal intensive care unit were observed. Although the small size of this study precludes us drawing any definitive conclusions, comparing our results with those in other countries suggests that the influenza A/H1N1 pandemic had a relatively benign course in pregnant women in The Netherlands. [ABSTRACT FROM AUTHOR]

Objective This paper examines how negative experiences with the health-care system create a lack of confidence in receiving medical care in seven countries: Australia, Canada, Germany, the Netherlands, New Zealand, the United Kingdom, and the United States. Methods The empirical analysis is based on data from the Commonwealth Fund International Health Policy Survey 2007, with nationally representative samples of adults aged 18 and over. For the analysis of the experience of cost barriers and confidence in receiving medical care, we conducted pairwise comparisons of group percentages as well as country-wise multivariate logistic regression models. Results Individuals who have experienced cost barriers show a significantly lower level of confidence in receiving safe and quality medical care than those who have not. This effect is most pronounced in the United States, where people who have foregone necessary treatment because of costs are four times as likely to lack confidence as individuals without the experience of cost barriers (adjusted odds ratio 4.00). In New Zealand, Germany, and Canada, individuals with the experience of cost barriers are twice as likely to report low confidence compared with those without this experience (adjusted odds ratios of 1.95, 2.19 and 2.24, respectively). In the Netherlands and UK, cost barriers are only a marginal phenomenon. Conclusions The fact that the experience of financial barriers considerably lowers confidence indicates that financial incentives, such as private co-payments, have a negative effect on overall public support and therefore on the legitimacy of health-care systems. [ABSTRACT FROM AUTHOR]

Reliably predicting vegetation distribution requires habitat distribution models (HDMs) that are ecologically sound. Current correlative HDMs are increasingly criticized because they lack sufficient functional basis. To include functional information into these models, we integrated two concepts from community ecology into a new type of HDM. We incorporated: 1) species selection by their traits in which only those species that pass the environmental filter can be part of the community (assembly theory); 2) that the occurrence probability of a community is determined by the extent to which the community mean traits fit the required traits as set by the environment. In this paper, our trait-based HDM is presented and its predictive capacity explored. Our approach consists of two steps. In step 1, four plant traits (stem-specific density and indicator values for nutrients, moisture and acidity) are predicted from four dominant environmental drivers (disturbance, nutrient supply, moisture supply and acidity) using regression. In step 2, these traits are used to predict the occurrence probability of 13 vegetation types, covering the majority of vegetation types across the Netherlands. The model was validated by comparison to the observed vegetation type for 263 plots in the Netherlands. Model performance was within the range of conventional HDMs and decreased with increasing uncertainty in the environment-trait relationships and with an increasing number of vegetation types. This study shows that including functionality into HDMs is not necessarily at the cost of model performance, while it has several conceptual advantages among including an increased insight in the functional characteristics of the vegetation and sources of unpredictability in community assembly. As such it is a promising first step towards more functional HDMs. Further development of a trait-based HDM hinges on replacing indicator values by truly functional traits and the translation of these relationships into mechanistic relationships. [ABSTRACT FROM AUTHOR]

Understanding the mechanisms of trait selection at the scale of plant communities is a crucial step toward predicting community assembly. Although it is commonly assumed that disturbance and resource availability constrain separate suites of traits, representing the regenerative and established phases, respectively, a quantification and test of this accepted hypothesis is still lacking due to limitations of traditional statistical techniques. In this paper we quantify, using structural equation modeling (SEM), the relative contributions of disturbance and resource availability to the selection of suites of traits at the community scale. Our model specifies and reflects previously obtained ecological insights, taking disturbance and nutrient availability as central drivers affecting leaf, allometric, seed, and phenology traits in 156 (semi-) natural plant communities throughout The Netherlands. The common hypothesis positing that disturbance and resource availability each affect a set of mutually independent traits was not consistent with the data. Instead, our final model shows that most traits are strongly affected by both drivers. In addition, trait-trait constraints are more important in community assembly than environmental drivers in half of the cases. Both aspects of trait selection are crucial for correctly predicting ecosystem processes and community assembly, and they provide new insights into hitherto underappreciated ecological interactions. [ABSTRACT FROM AUTHOR]

ABSTRACT One of the requirements in the Dutch regulation for euthanasia and assisted suicide is that the doctor must be satisfied 'that the patient's suffering is unbearable, and that there is no prospect of improvement.' In the notorious Chabot case, a psychiatrist assisted a 50 year old woman in suicide, although she did not suffer from any somatic disease, nor strictly speaking from any psychiatric condition. In Seduced by Death, Herbert Hendin concluded that apparently the Dutch regulation now allows physicians to assist anyone in suicide simply because he or she is unhappy. In this paper, I reject Hendin's conclusion and in particular his description of Mrs Boomsma as someone who was 'simply unhappy.' After a detailed narration of her lifestory, I turn to the American philosopher Harry Frankfurt's account of volitional incapacity and love for a more accurate characterization of her suffering. Having been through what she had, she could only go on living as another person than the one she had been when she was a happy mother. That would have violated her integrity, and that she could not bring herself to do. [ABSTRACT FROM AUTHOR]

Please cite this paper as: van Gageldonk-Lafeber et al. (2011) The relative clinical impact of 2009 pandemic influenza A (H1N1) in the community compared to seasonal influenza in the Netherlands was most marked among 5-14 year olds. Influenza and Other Respiratory Viruses 5(6), e513-e520. Background So far, most pandemic influenza reports were based on case studies focusing on severe disease. For public health policy, it is essential to consider the overall impact of the pandemic, including mild diseases. Objectives The aim of our study is to gain insight into the epidemiology of 2009 pandemic influenza in the community and to estimate the relative impact of pandemic compared to seasonal influenza. Methods The relative impact of pandemic influenza in the general population was assessed as the influenza-like illness (ILI) incidence during the pandemic season compared with that during regular seasons. Influenza-like illness incidences and virus diagnostics were derived from continuous sentinel surveillance systems. The incidence of hospital admissions, based on the mandatory notification of pandemic influenza, was used to relate the impact of severe disease to that in the community. Results The overall incidence of general practitioners-attended ILI was 96 consultations per 10 000 persons. Highest incidences were reported in children and lowest in persons aged ≥65 years. For 5-14 year olds, the incidence during the pandemic was higher than during all preceding seasons. Samples originating from 5 to 19 year olds were statistically significant more often positive for pandemic influenza A (H1N1) 2009 virus as compared with samples from 0 to 4 year olds. Moreover, the incidence of hospital admission owing to pandemic influenza was highest in the youngest children. Conclusions Our study showed that while the absolute incidences of 2009 pandemic influenza were highest in children aged 0-4 years, the relative clinical impact in the community compared to seasonal influenza in previous years was most noticeable in healthy children 5-14 years of age. [ABSTRACT FROM AUTHOR]

ABSTRACT In the Netherlands fertility doctors increasingly formulate protocols, which oblige patients to quit their unhealthy lifestyle before they are admitted to IVF procedures. We argue that moral arguments could justify parenting protocols that concern all future parents. In the first part we argue that want-to-be parents have moral responsibilities towards their future children to prevent them from harm by diminishing or eliminating risk factors before as well as during the pregnancy. This is because of the future children's potential to become of a certain type, more specifically: a person that will be the want-to-be parents' child. Want-to-be parents intend to become pregnant and therefore have an additional moral reason to diminish the risks. Also, people who become pregnant unintentionally have the responsibility to prevent their children from harm, unless they become pregnant due to contraception failure. All people not wanting to become pregnant should use contraception methods carefully. In the second part of this paper we translate the want-to-be parents' responsibilities into practice. We distinguish four determinants of risk factors: modifiability, chance, severity and effort. We examine some evidence-based risk factors based on these variables and deduce levels of responsibility. In conclusion, formulating informal requirements for want-to-be parents is morally required and therefore also for want-to-be parents in need of medical assistance. The protocols developed by fertility doctors in the Netherlands could be seen as the precursor for a general, informal Parenting Protocol that could be developed on the basis of an extended and thoroughly debated risk-responsibility analysis. [ABSTRACT FROM AUTHOR]

The psychiatric epidemiological population study NEMESIS-2 (Netherlands Mental Health Survey and Incidence Study-2) replicates and expands the first Netherlands Mental Health Survey and Incidence Study (NEMESIS-1) conducted from 1996 to 1999. The main objectives of the new study are to provide up-to-date figures on the prevalence, incidence, course and consequences of mental disorders, and to study trends in mental disorders and service use, with the use of a new sample. New topics not included in NEMESIS-1 were added, e.g. impulse-control disorders, and genetic correlates of mental disorders through gathering DNA from saliva samples. This paper gives an overview of the design of NEMESIS-2, especially of its recently completed first wave. NEMESIS-2 is a prospective study among Dutch-speaking subjects aged 18–64 years from the general Dutch population. Its baseline wave included 6646 subjects. Three waves are planned with three year-intervals between the waves. A multistage, stratified random sampling procedure was applied. The baseline wave of NEMESIS-2 was performed between November 2007 and July 2009. Face-to-face interviews were administered with the Composite International Diagnostic Interview (CIDI) 3.0. The response rate was 65.1%, and 76.4% of the respondents donated saliva. The sample was reasonably nationally representative, but younger subjects were somewhat underrepresented. In conclusion, we were able to build a comprehensive dataset of good quality, permitting several topics to be studied in the future. Copyright © 2010 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

In this paper I explore the specific properties associated with the new knowledge produced by inter- or transdisciplinary research. Using my analysis of a land use planning study in the Meuse valley in The Netherlands, I argue that the process of knowledge integration requires the exercise of value judgement and that the outcomes are emergent. I also show that the selection of a boundary object as objective facilitates interdisciplinary research because it is shared amongst disciplines and because it necessitates judgement in its implementation. [ABSTRACT FROM AUTHOR]

This paper aimed to discuss functioning, quality of life, (QoL) and lifespan care issues of adolescents and young adults with childhood-onset physical disability from a clinical, scientific, and personal perspective. We present a résumé of results of recently performed studies in rehabilitation-based samples of (young) adults with childhood-onset conditions such as cerebral palsy (CP) and spina bifida (SB), and different models of transition and lifespan care. The studies showed that many young adults with a childhood-onset disability experience health-related problems such as functional deterioration, pain or fatigue, and an inactive lifestyle. A significant number are restricted in participation in work, housing, and intimate relationships. They perceive a lower health-related and global QoL compared with a reference group. In some centres in the UK and the Netherlands specialized outpatient services are available or being developed. In conclusion, transition to adulthood is a critical phase for reaching autonomous participation in adult life. There is an international challenge to incorporate a lifespan perspective in paediatric, transition, and adult health care services for persons with a childhood-onset disability. [ABSTRACT FROM AUTHOR]

Aim Distribution maps of species based on a grid are useful for investigating relationships between scale and the number or area of occupied grid cells. A species is scaled up simply by merging occupied grid cells on the observation grid to successively coarser cells. Scale–occupancy relationships (SORs) obtained in this way can be used to extrapolate species down, in other words to compute occupancies at finer scales than the observation scale. In this paper we demonstrate that the SOR is not unique but depends on where one positions the origin of the grid map. Innovation The effect of grid origin on SORs was explored with the aid of the Dutch national data base FLORBASE, which contains the observation records of all 1410 wild vascular plants in the Netherlands on a 1-km square basis. For each species, we generated 2500 unique SORs by scaling up from 1 km, in steps of 1 km, to squares of 50 km. We computed the sensitivity of the SOR to the grid origin for each species, and subsequently analysed the factors that determined this sensitivity. The effect of grid origin on downscaling was demonstrated by means of a simple power function that we used to extrapolate down from both a 2-km and a 5-km grid, to the original 1-km grid. It appeared that the position of grid origin could have a substantial effect on SORs. The sensitivity of SORs to the position of the grid origin depended on three characteristics of a species’ spatial distribution: rarity, degree of spatial clustering and the position of the distribution relative to the border of the investigated area. Rare species with a clustered distribution near the border were particularly highly sensitive. The dependence of SOR on grid origin caused unpredictable and non-random errors in downscaled occupancies. Main conclusions In future, the whole bandwidth of scaled occupancies should be considered when testing and interpreting mathematical relationships between scale and occupancy. Moreover, downscaled occupancies should be interpreted cautiously. [ABSTRACT FROM AUTHOR]

Alternatives to donor blood have been developed in part to meet increasing demand. However, new biotechnologies are often associated with increased perceptions of risk and low acceptance. This paper reviews developments of alternatives and presents data, from a field-based experiment in the UK and Holland, on the risks and acceptance of donor blood and alternatives (chemical, genetically modified and bovine). UK groups perceived all substitutes as riskier than the Dutch. There is a negative association between perceived risk and acceptability. Solutions to increasing acceptance are discussed in terms of implicit attitudes, product naming and emotional responses. [ABSTRACT FROM AUTHOR]

1. During recent decades, the ecological corridor has become a popular concept among ecologists, politicians and nature conservationists. However, it has been criticized from a scientific point of view. In this paper we question why this concept has been accepted so readily in policy and practice. 2. We present a conceptual framework to analyse the rise of the concept, especially in the Netherlands. We have studied the Dutch literature from the period 1980–2005, including the main ecological journal Landschap ( Landscape), policy documents and reports from the leading Dutch policy-orientated ecology research centre. 3. Many actors, including politicians, stakeholders and scientists, were involved in the development of the ecological corridor and the related National Ecological Network on the national and regional levels. The involvement of these actors changed the character of the concept into the multifunctional ‘robust corridor’. 4. The ecological corridor was probably so influential because its vague and flexible character facilitated the coming together of various stakeholders and scientists. It also functions as a metaphor, applicable to well-known entities such as construction and transport. Finally, scientists from the policy-orientated research centre were able to link the concept to fundamental science, policy and practice. In some stages of the policy-defining process, however, conflicts arose between the proponents of scientific soundness and those of social robustness that reduced the role of scientists. 5. Synthesis and applications. To make ecological concepts both scientifically sound and socially robust, several changes must take place in current interactions between ecology and society. First, during concept development it requires the existence of extensive, largely interactive peer groups with clearly defined relationships between scientists and non-scientists. Secondly, the concepts should be flexible and relatable to relevant knowledge, insights, values and practices. Thirdly, several feedback loops between science and non-science should be set up during the various stages of concept development and implementation. [ABSTRACT FROM AUTHOR]