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Interdisciplinarity in the classroom is predominantly championed around a need to address pressing social problems by integrating knowledge from diverse disciplines. But can interdisciplinary teaching take shape without the usual problem-solving frame? And are there new methods/mediums through which to explore interdisciplinarity? These questions have led to new and promising developments related to podcasting, active learning, and interdisciplinarity in the classroom. Through the lens of Travelling Concepts, we reflect on our experiences in the making and using of the podcast series -- Travelling Concepts on Air -- to better understand interdisciplinarity. We show the value of students not only listening to podcasts as a supplementary means of learning, but also creating podcasts as a form of active learning.

The current study examined ethnic representation and stereotypes in textbooks from two core secondary school subjects: maths and Dutch. We examined all 25 hard-copy textbooks used in first-year secondary schools in the Netherlands in 2019, and coded characters' ethnic background, competence-related activities, and occupational status. Ethnicity was identifiable for 8897 characters. Results indicate that characters of colour were underrepresented in the text and images in the textbooks compared to Dutch population statistics. Additionally, subtle stereotypical patterns were found in which characters of colour were less competent and lower in occupational status than White characters. These findings suggest that implicit biases influence which groups are featured and how they are portrayed. To help all students to reach their full potential and develop an inclusive worldview, we recommend publishers use publicly available tools (e.g. random name generators) to make their textbooks more inclusive.

Although cooperative learning is an effective instructional method, it cannot be taken for granted that students will gain new knowledge when engaging in a cooperative activity. Even if cooperative learning is effectively designed, problems might arise regarding cognitive, behavioral and motivational aspects of learning. For students to gain knowledge, cognition, metacognition, behavior and motivation should be collectively regulated by the group, which is called the socially shared regulation of learning (SSRL). However, up until now, there has been no consensus about how SSRL is manifested during cooperative learning. This study investigated how SSRL is manifested during cooperative learning by means of a grounded theory approach. This was done to identify what is necessary for effective SSRL and what its consequences are. A theoretical model was built based on the data in order to portray these prerequisites and consequences of SSRL. This study also investigated whether equal participation fostered SSRL. In this study, participants were students from the fourth, fifth and sixth grades of elementary school, working together in groups of four (n = 104). The data indicated that SSRL is a rare process, the absence of which caused less structured collaboration in groups who were not prompted to participate equally.

Imagining what it was like to live in the past may help secondary school students to understand historical developments and situations. In this case study, the opportunities of a drama task are explored by using a mixed-method approach. In small groups, Dutch 14-15-year-old students examined historical sources and produced a short film clip on daily life in the Netherlands during the Cold War. Results indicated that both the students and their teacher perceived the drama task as motivating. The group discussions were rich in on-task utterances, and the students reported that they thought the task was valuable for gaining insight into thoughts and feelings of people in the past. However, the clips were relatively poor in information, and the assessment proved to be a challenge for the teacher.

Background: The transition from primary to secondary education can be difficult for children. This paper reports on an intervention in the Netherlands known as the Talent Classrooms (TC), which aimed to support students' primary-secondary school transition. The goal of TC was to increase the match between the personal environment of the student and the school environment to facilitate a successful transition, and to help students achieve their potential at secondary school. Purpose: With the needs described in the review by Symonds and Galton (2014) taken as a starting point for this investigation, we sought to explore the extent to which TC supported six specific needs during students' primary-secondary transition period, according to participants' longer term reflections about their earlier TC experiences. Methods: In this qualitative study, in-depth interviews were conducted with ten former TC students, four to five years after they had participated in the intervention. Data were analysed qualitatively. Findings: The analysis suggested that, according to the participants, TC had fostered most needs and this helped to support their transition experience. In particular, participants reported that, via their involvement in TC, they had become more familiar with the physical environment and routine of secondary school, were able to form lasting friendships and enjoyed a challenging curriculum and extracurricular activities. However, findings also indicated that the intervention did not fully succeed in supporting some needs, mainly in the areas of autonomy, competency, and identity development, as it did not seem to have prepared all participants sufficiently for the requirement for independent working they subsequently encountered in secondary school. Conclusions: This study highlights how emphasis on the development of autonomy-related skills might be beneficial for interventions designed to assist students with the transition to secondary education. Moreover, it draws attention to the importance of tailoring support to individual students' specific, varied and evolving needs during this stage of development.

In this study, we examined gender and sexuality representation in language and math textbooks for Dutch secondary education. We analyzed all male and female characters in 13 language textbooks (N = 7,347) and 12 math textbooks (N = 4,591). Our results confirmed our expectations based on the theory of the hidden curriculum: female characters were underrepresented in all textbooks (40% in language, 44% in math textbooks), but overrepresented in household tasks and EHW (Education, Health, and Welfare) professions. Male characters were overrepresented in occupational roles, especially in STEM (Science, Technology, Engineering, and Math) professions and technical tasks. Further, female characters in language textbooks were overrepresented in parental roles, and male characters were overrepresented among characters with disharmonious traits and behaviors. We found no characters from sexual minorities in any of the textbooks. In conclusion, in line with theories of the hidden curriculum, Dutch textbooks include gender stereotypic messages and are heteronormative. These findings are relevant in light of previous studies demonstrating the negative impact of these biases on children. Publishers and schools that want to be more inclusive are recommended to be more critical in their selection of stories and role models in their books.

School closures due to the COVID-19 pandemic raised concerns about increases in educational inequality. We examined the magnitude of the impact of the first school closure for vulnerable student groups in particular. This study was conducted among 886 Grade 3-5 students in the Netherlands in schools serving a high percentage of students from disadvantaged backgrounds. Piecewise growth analyses indicated that the school closures caused discontinuity in students' achievement growth on national standardized tests and led to an average learning loss of 2.47 months in mathematics and 2.35 in reading comprehension, exceeding the duration of the school closure. Findings suggest that school closures contribute to educational inequality and indicate which students may particularly need additional support to overcome the adverse consequences of the lockdowns.

The moment a child walks into a new classroom, teachers and classmates form an impression based on minimal information. Yet, little is known about the accuracy of such impressions when it concerns children's social functioning at school. The current study examined the accuracy of children's, teachers' and adults' impressions of 18 unacquainted children based on thin slices of behavior. The likeability, popularity, prosocial behavior, aggression, and exclusion of these children were judged by 101 children, 79 elementary school teachers, and 68 young adults based on 20-second video clips. Judges were better than chance in predicting popularity and prosocial behavior, but worse than chance in predicting aggression and exclusion. Female judges were more accurate judging social exclusion of same-sex than other-sex targets. Teachers were more accurate than children in their judgments of prosocial behavior. The current study shows that confidence in one's impression of aggression and exclusion in unacquainted children based on minimal information is not warranted.

This study follows a group of modern foreign languages (MFL) teachers in the Netherlands during a nine-month professional development project around the theme of 'Content in MFL'. The project was initiated following proposals to refocus the MFL curriculum on the basis of integrated learning outcomes for both language proficiency and areas of language-related content in the areas of Language Awareness and Cultural Awareness. The aims of the study were to explore the areas of content that teachers viewed as relevant to their MFL teaching, as well as the extent to which the introduction of MFL-specific content addressed teachers' concerns regarding their practice. Perceived obstacles to the refocused curriculum were also addressed. Findings suggest that cultural content was a more relatable concept than language-related content for teachers in this study but also that language proficiency remained their central concern. Implications for the further development of the proposed content-focused curriculum are discussed.

Although research on the home literacy environment and its impact on early literacy has long focused on mothers, the past decade has seen a shift in scholarly attention to the role of fathers. Building on this shift, we examined whether the nature of parent–child interactions during shared storybook reading varies with parent gender, child gender and the interaction between the two, and we analysed whether possible differences in the nature of mother– and father–child interactions are related to story comprehension. We made video observations of mothers and fathers within 36 relatively highly educated families reading a storybook with their kindergartener (age 4 – 5) and registered the use of cognitively challenging (i.e. decontextualized) talk during these activities. After each shared reading session, we additionally administered a test assessing children's understanding of the story being read. Two-way mixed ANOVA's revealed no effects of parent gender or child gender on either the use of cognitively challenging talk or children's story comprehension, nor did we find interaction effects of parent and child gender. The extent of cognitively challenging talk was significantly correlated to children's comprehension scores for fathers, but not for mothers. This correlation seems to have masked another association, however: when correlations were computed separately for girls and boys, we found that the proportion of cognitively challenging utterances of both parents was correlated to comprehension scores for boys, but not for girls. The absence of parent gender effects provides further insights into the way mothers and fathers shape interactions during shared reading, but also stresses the need for studies with larger, more diverse samples. The observation that more frequent use of cognitively challenging talk was paralleled by better story comprehension for boys invites further research on the specific effects of shared reading for boys. [ABSTRACT FROM AUTHOR]

Background: Cystitis is commonly treated with antibiotics, although non-antibiotic options could be considered for healthy non-pregnant women. Shared decision making (SDM) can be used in cystitis management to discuss the various treatment options but is not frequently applied in general practice. Aim: To identify barriers and facilitators for applying SDM in cystitis management in general practice. Design & setting: Qualitative explorative research in general practice with healthcare professionals (HCPs; GPs and GP assistants) and healthy non-pregnant women with a recent history of cystitis (patients). Method: Individual semi-structured interviews were conducted between May and October 2022. We applied a combination of thematic and framework analysis. Results: Ten GPs, seven GP assistants, and 15 patients were interviewed. We identified the following three main barriers and one key facilitator: (1) applying SDM is deemed inefficient; (2) HCPs assume that patients expect antibiotic treatment and some HCPs consider non-antibiotic treatment inferior; (3) patients are largely unaware of the various non-antibiotic treatment options for cystitis; and (4) HCPs recognise some benefits of applying SDM in cystitis management, including reduced antibiotic use and improved patient empowerment, and patients appreciate involvement in treatment decisions, but preferences for SDM vary. Conclusion: SDM is infrequently applied in cystitis treatment in general practice owing to the current focus on efficient cystitis management that omits patient contact, HCPs' perceptions, and patient unawareness. Nevertheless, both HCPs and patients recognise the long-term benefits of applying SDM in cystitis management. Our findings facilitate the development of tailored interventions to increase the application of SDM, which should be co-created with HCPs and patients, and fit into the current efficient cystitis management. [ABSTRACT FROM AUTHOR]

Content and Language Integrated Learning (CLIL) has been said to increase not only foreign language proficiency but also learner motivation (Coyle, D., P. Hood, and D. Marsh. 2010. "CLIL: Content and Language Integrated Learning." Cambridge: Cambridge University Press). In contexts where CLIL is elective, however, the question can be raised as to whether its motivational effects can be distinguished from the pre-existing motivation that may have influenced the learner's choice of educational route. The current study examined motivational differences between learners in Dutch-English bilingual and mainstream education. The aim was to establish whether the learner groups were differently motivated and whether their motivation appeared to be diachronically related to their chosen educational format. 581 learners in the first three years of general secondary education completed a questionnaire exploring their views on (language) learning. Results were analysed in terms of differences between bilingual and mainstream learners and across year-groups. Learners in bilingual education displayed more motivation in nearly all of the areas examined. There was little evidence, however, of this being a result of exposure to bilingual education, reinforcing the idea that motivation may be inherent to this group of CLIL learners.

Children tell prosocial lies from the age of three years onward, but little is known about for whom they are inclined to lie. This preregistered study examined children's (N = 138, 9-12 years) prosocial lying behavior toward minimal in-group and out-group peers. Additionally, children evaluated vignettes in which an in-group peer told a prosocial lie to an in-group or out-group peer. Results show that only older children told more prosocial lies for the benefit of in-group compared with out-group peers. Further, in the vignettes children of all ages were more accepting of prosocial lying in favor of in-group members compared with out-group members. These findings underscore the importance of considering intergroup relations in children's prosocial lying behavior and advocate for broadening the scope of research on children's intergroup prosociality.

Background: Earlier studies show that to gain more understanding of the concept of social inclusion, the views and experiences of people with intellectual disabilities are needed. The aim of this study was to investigate their perspective on neighbourhood social inclusion from an ecological point of view. Method: We carried out a photovoice study with 18 people with intellectual disabilities in three neighbourhoods in the Netherlands. Participants took photographs in their neighbourhood they considered relevant, and these photographs were discussed during an interview. Results: Six themes emerged from qualitative analysis: attractiveness of the neighbourhood, social contacts in the neighbourhood, activities in the neighbourhood, social roles in the neighbourhood, independence and public familiarity. Conclusions: As regards neighbourhood social inclusion, participants were often focused on small and informal activities and situations. Public familiarity proved very important. Framing the concept of neighbourhood social inclusion within an ecological approach may help to better understand processes of social inclusion.

The proposal to allow assisted dying for people who are not severely ill reignited the Dutch end‐of‐life debate when it was submitted in 2016. A key criticism of this proposal is that it is too radical a departure from the safe and well‐functioning system the Netherlands already has. The goal of this article is to respond to this criticism and question whether the Dutch system really can be described as safe and well functioning. I will reconsider the usefulness of the suffering criterion, and I will ultimately argue this criterion should be rejected altogether. Instead, we should consider moving towards an autonomy‐only approach to assisted dying. This would resolve some significant issues occurring under the current system of assisted dying in the Netherlands and ultimately make the process safer and better functioning. I will then consider some possible objections to adopting an autonomy‐only approach and provide some preliminary responses to these also. I will finally highlight some potential areas where further research may be necessary, namely, how to mitigate the effect of external factors such as poverty or other life aspects that may have the potential to distort the individual's ability to make autonomous decisions. I will also consider some possible international lessons that can be taken from both current as well as the proposed practice in the Netherlands. [ABSTRACT FROM AUTHOR]

Video tutorials for software training are becoming more and more popular, but their construction and effectiveness is understudied. This paper presents a theoretical model that combines demonstration-based training (DBT) and multimedia learning theory as a framework for design. The study investigated the effects of video tutorials on motivation, task accomplishment and learning with special attention being paid to the role of reviews. Three tutorials were compared: preview and demonstration (control condition), preview and demonstration and review (review condition) and preview and demonstration and 2nd demonstration (2-demo condition). Participants were 65 students from the upper grades of elementary school. Participant logs revealed a significant decrease in coverage for video types following the preview. All tutorials significantly raised self-efficacy and procedural knowledge (i.e., task performances during training, immediate and delayed post-test), but no effects of condition were found. The discussion addresses issues concerning the design of the tutorials (overlap between video types) and usage conditions (blocked video access during training tests) that may have negatively affected coverage and the effectiveness of the reviews. A limitation of the study is that no process data were gathered that could shed light on the relationships between design features and observational learning processes.

Two studies examined when and why children (10-13 years) help ethnic in-group and out-group peers. In Study 1 (n = 163) children could help an out-group or in-group peer with a word-guessing game by entering codes into a computer. While children evaluated the out-group more negatively than the in-group, they helped out-group peers "more" than in-group peers. Study 2 (n = 117) conceptually replicated the findings of Study 1. Additionally the results suggest that when children endorsed the stereotype that the out-group is "less smart," this increased their intention to help out-group peers and it decreased their intention to enter codes for in-group peers. The results suggest that the specific content of a negative stereotype can guide helping responses toward out-group and in-group members.

Due to processes of financialisation, financial parties increasingly penetrate the healthcare domain and determine under which conditions care is delivered. Their influence becomes especially visible when healthcare organisations face financial distress. By zooming‐in on two of such cases, we come to know more about the considerations, motives and actions of financial parties in healthcare. In this research, we were able to examine the social dynamics between healthcare executives, banks and health insurers involved in a Dutch hospital and mental healthcare organisation on the verge of bankruptcy. Informed by interviews, document analysis and translation theory, we reconstructed the motives and strategies of executives, banks and health insurers and show how they play a crucial role in decision‐making processes surrounding the survival or downfall of healthcare organisations. While parties are bound by legislation and company procedures, the outcome of financial distress can still be influenced. Much depends on how executives are perceived by financial stakeholders and how they deal with threats of destabilisation of the network. We further draw attention to the consequences of financialisation processes on the practices of healthcare organisations in financial distress. [ABSTRACT FROM AUTHOR]

Growth is one of the most direct and common ways fish respond to climate change, as fish growth is intimately linked to the temperature of the environment. Observational studies on the effect of shifts in temperature on fish growth are scarce for freshwater fish, and particularly lacking for lake populations. Here, changes in growth rate of bream (Abramis brama), perch (Perca fluviatilis), pikeperch (Sander lucioperca), and roach (Rutilus rutilus) over three decades were studied and compared with changes in temperature in the two largest lakes of western Europe: Lake IJsselmeer and Lake Markermeer in the Netherlands. In the autumnal survey catches of bream, perch, and roach, the mean length of YOY increased significantly between 1992 and 2021 in both lakes, but for YOY pikeperch, no temporal changes were found. In a length‐stratified dataset of age groups of bream, roach, and perch, the relationship between length and age differed significantly between time periods. In the more recent time periods, indications for higher growth rates across multiple ages were found. Temperature during the growth season increased in the same decades and showed significant correlations with the YOY mean length, for bream, perch, and roach in both lakes, and for pikeperch in Lake Markermeer. These results point toward consistent temperature‐induced increases in growth over the age groups for bream, roach, and perch. These increases were found despite the simultaneous process of de‐eutrophication in this water system and its potential negative effect on food production. For pikeperch, it is hypothesized that the absence of temporal increase in YOY growth rate is related to its necessary switch to piscivory and subsequent food limitation; the lower thermal range of its main prey smelt, Osmerus eperlanus, is hypothesized to have inhibited food availability for YOY pikeperch and its opportunity to achieve higher growth rates. [ABSTRACT FROM AUTHOR]

Adolescents' autonomy is considered to be shaped within family and peer contexts. However, the specific dynamics of the within-person associations between parental autonomy support, adolescents' general autonomy, and peer resistance over time remain unclear. To address this, random-intercept cross-lagged panel models were employed in a sample of 290 Dutch youth in early adolescence (Mage = 11.58, SD = 0.44 at T1; 49.3% boys) and 220 Dutch youth in middle to late adolescence (Mage = 17.79, SD = 1.47 at T1; 25.0% boys), who were followed over two years across four time points. Results showed that changes in adolescents' general autonomy were concurrently associated with changes in their parental autonomy support and peer resistance at the within-person level. However, these associations were not observed longitudinally over a six-month period. These findings suggest that increases in supportive parenting and peer resistance co-occur with increases in adolescents' autonomy within individuals. [ABSTRACT FROM AUTHOR]

Tasks which invite students to identify with historical actors and describe their perspectives are a common phenomenon in history education. The aim of this study is to explore the differences in students' answers when completing a writing task in first person ("imagine you are in the past") or in third person ("imagine someone in the past"), or a task in which such imagination is not explicitly asked. Furthermore we investigated the effects of the type of task on topic knowledge and situational interest. Students in Dutch secondary education (N = 254) participated by completing a task on the Dutch Iconoclasm. Our analysis of student answers focused on aspects of historical empathy: historical contextualization, affective elements and perspective taking. Results were that all students gained some knowledge from the task, regardless of the type of task they completed. Students' situational interest also did not differ between the three tasks. However, students' written work showed that the first- and third-person writing tasks stimulated students to imagine concrete details of the past and emotions of historical actors. Students who were not explicitly asked to imagine themselves or someone in the past included more perspectives into their writings. Students who completed the task in first person tended to show more presentism and moral judgements of the past than students who completed a task in third person.

Since the number of medical treatment options for Ulcerative Colitis (UC) has expanded over the last decades, patients and physicians face challenges regarding decisions about the medication options. We aimed to identify patients' preferences about their UC treatment options in the Netherlands. Furthermore, we assessed after how many failed treatment options, patients are willing to consider surgical treatment. We conducted a web-based, multicenter, discrete choice experiment (DCE) among adult UC patients. Patients were repeatedly asked to choose between two hypothetical medicinal treatment options. The choice tasks were based on administration route, administration location, chance of symptom reduction (on short and long term) and chances on infection and other adverse events. Data were analyzed by using Hierarchical Bayes estimation. A total of 172 UC patients participated in the DCE. More than half were anti-TNF experienced (52.9%). The chance of symptom reduction after one year (relative importance (RI) 27.7 (95% CI 26.0–29.4)) was most important in choosing between medicinal treatments, followed by the chance of infection (RI 22.3 (21.4 − 23.3)) and chance of symptom reduction after eight weeks (RI 19.5 (18.3 − 20.6)). Considering surgical treatment, nineteen patients (14.3%) would not even consider surgery after failing eight treatment options without any new available therapies left. Nine patients would consider surgery before trying any treatment options. We found that symptom reduction after one year was the most important attribute in choosing between treatments in UC patients. These outcomes can help understand the trade-offs and preferences of UC patients. [ABSTRACT FROM AUTHOR]

This study examined adolescents' gender‐stereotypic attitudes towards HEED (Health care, Early Education, Domestic) occupations and gender‐stereotypic interest in HEED careers and the role of parental gender‐stereotypic attitudes, role model behaviour and socialization values. We used questionnaire data from 501 White Dutch families. Our results showed that adolescents' gender‐stereotypic attitudes towards HEED predicted their stereotypic interest in these careers. Further, parental gender‐stereotypic attitudes, stereotypical role model behaviour and socializing values of self‐expression predicted adolescents' gender‐stereotypic attitudes towards HEED. From these parental characteristics, only a stereotypic division of household tasks predicted boys' lower interest in HEED careers. In conclusion, reducing gender‐stereotypic attitudes and, for boys, encouraging self‐expression seems important in fostering more male representation in HEED occupations and deserves more attention from policymakers, educators and parents. [ABSTRACT FROM AUTHOR]

This article provides insight into the motivation of young women to join the armed forces and to choose a career in the military. This insight explains why women are still underrepresented in the Netherlands armed forces and can optimize future recruitment programs. An online Dutch questionnaire was completed by 148 women (out of a total of 483 respondents). We analyzed the data of these young women in comparison to the men in this sample to better interpret the descriptive findings. Three research questions focus on whether young Dutch women are interested in the armed forces, how they perceive the Netherlands armed forces, and what their motivation is for choosing a career in the military. Women are very enthusiastic and interested in the armed forces. They know what they want, but they are not aware of the military's efforts to be an inclusive organization. Society's stereotypical thinking about the role of women and the image of the military may have led women to assume that the military environment is not such a good fit after all. Descriptive and injunctive norms, intrinsic motivating work aspects and the self-efficacy of young women appear to be important aspects in the motivation of young women and should be taken into consideration when designing new recruitment and communication strategies and promoting inclusiveness. Women also need more information about the different types of flexible contracts and career paths available within the armed forces. Female role models are important to inform, empower and win over women. The Netherlands armed forces should invest in the recruitment process and anticipate the interest, perception and motivation of young Dutch women to encourage them to apply and reduce stereotypical thinking. [ABSTRACT FROM AUTHOR]

Introduction: People who are homeless might be more at risk for getting infected by the SARS-COV-2 virus or for experiencing severe course of the infection due to their often more fragile health, unmet health needs, and poorer living conditions. This study aims to gain insight into the morbidity and mortality of the SARS-COV-2 virus among the homeless population in the Netherlands. Methods: In this observational retrospective study, anonymized data about patients experiencing homelessness who contacted a street doctor were gathered in nine cities in the Netherlands from March 2020 until March 2021. Data included patient characteristics, COVID-19 -related symptoms, diagnosis, and disease course of a SARS-COV-2 infection. Results: Of the total 1419 patients in whom 1544 COVID-19 related consults were registered, 16% tested positive for a SARS-COV-2 infection, and an additional 12% were clinically suspected of having a SARS-COV-2 infection but were seen before there were any COVID-19 tests available in General Practice or for some other reason not tested. Significantly more (p = <0.001) patients born outside the European Union tested positive for a SARS-COV-2 infection (36%) compared to the remainder of the population (20%). The most discerning symptom for being tested positive was loss of taste and smell (29% vs 6% in the negative tested group and 2% in the suspected group), fever (24% vs 13% in the negative tested group but 18% in the suspected group), and headache (26% vs 17% resp 14%), and fatigue (29% vs 20 resp 17%). Cough, dyspnea and common cold were more often seen in the clinically suspected but not tested group). Of the group that tested positive for a SARS-COV-2 infection, 10% were hospitalized. Two patients were admitted to intensive care and one patient died. Of patients who were clinically suspected of a SARS-COV-2 infection, 5% were hospitalized. Conclusion: COVID-19 was not widespread among people experiencing homelessness in the Netherlands, but the number of hospitalizations in this study was relatively high. Monitoring this population during a pandemic is necessary to take prompt action when needed. [ABSTRACT FROM AUTHOR]

The aim of the study was to investigate the effects of support on knowledge acquisition of gifted learners and their flow and mood during inquiry learning. Sixty-four gifted primary school children were randomly assigned to one of three conditions differing in support given in an inquiry task. Results showed that learners who were allowed to experiment themselves learned more, experienced more flow, and felt more positive toward the task than those who were not given this opportunity, but only when they were guided through the inquiry cycle by prompts to generate hypotheses, perform experiments, and draw conclusions. The overall conclusion is that gifted children benefit more from open, complex tasks when their learning process is externally regulated.

Background: Given the estimated high rate of unintended pregnancies, it is important to investigate long-term effects on psychological distress in women carrying an unintended pregnancy to term. However, research into associations between unintended pregnancies carried to term and psychological distress postpartum is mixed, and especially, evidence on long-term associations is scarce. Objective: To examine whether carrying an unintended pregnancy to term is associated with maternal psychological distress later in life, up to 12 years postpartum. Design: This study is based on the population-based birth cohort study 'Amsterdam Born Children and their Development' study, which included pregnant people in 2003 (n = 7784) and followed them up until 12 years postpartum. Methods: Unintended pregnancy was measured as a multidimensional construct, based on self-reported data around 16 weeks gestation on pregnancy mistiming, unwantedness and unhappiness. Symptoms of maternal psychological distress were assessed around 3 months, 5 years and 12 years postpartum using multiple questionnaires measuring symptoms of depression, anxiety and stress. Multiple structural equation modelling models were analysed, examining the associations between dimensions of unintended pregnancy and maternal psychological distress per time point, while controlling for important co-occurring risks. Results: Pregnancy mistiming and unhappiness were significant predictors of more maternal psychological distress around 3 months postpartum. Around 5 years postpartum, only pregnancy mistiming was positively associated with maternal psychological distress. Dimensions of unintended pregnancy were no longer associated with maternal psychological distress around 12 years postpartum. Strikingly, antenatal psychological distress was a much stronger predictor of maternal psychological distress than pregnancy intention dimensions. Conclusion: Those who carried a more unintended pregnancy to term reported more symptoms of psychological distress at 3 months and 5 years postpartum. People carrying an unintended pregnancy to term may benefit from extra support, not because of the pregnancy intentions per se, but because they may be related to antenatal psychological distress. Plain Language Summary: Carrying an unintended pregnancy to term and maternal psychological distress over time Every unintended pregnancy is different, like every person is different. Nevertheless, carrying an unintended pregnancy to term might be stressful, that might impact mental health (e.g. depression or anxiety) of people carrying an unintended pregnancy to term. Research into long-term effects of carrying an unintended pregnancy to term on maternal mental health is scarce. In this study, we investigated effects of carrying an unintended pregnancy to term on maternal mental health up to 12 years postpartum. We used data from 7784 pregnant people living in Amsterdam, who participated in the Amsterdam Born Children and their Development (ABCD) study in 2003. Participants were followed up to 12 years postpartum. During pregnancy, participants answered questions about pregnancy mistiming (did the pregnancy happen at the right time), unwantedness (did they want to become pregnant) and unhappiness (how did they feel when they found out they were pregnant). We investigated these 'dimensions' of unintended pregnancy separately, to grasp to complexity of unintended pregnancy. Furthermore, participants answered multiple questions about experienced symptoms of depressions and anxiety around 3 months, 5 years and 12 years postpartum. People, who reported that their pregnancy was more mistimed, reported more mental health problems up to 5 years postpartum. Furthermore, people who reported more unhappiness with their pregnancy, reported more mental health problems around 3 months postpartum. People with an unintended pregnancy reported no longer more mental health problems around 12 years after birth, compared to people with more intended pregnancy. Strikingly, the mental health of people during pregnancy was more important for their mental health later in life, compared to their unintended pregnancy. Thus, the (emotional) circumstances around the pregnancy might be more influential for mental health later in life, compared to their pregnancy intentions. People carrying an unintended pregnancy to term may benefit from extra support, tailored to their individual needs and circumstances. Nevertheless, our results also showed that people are also resilient to deal with the many events and challenges faced during the periods after birth, since the effect of unintended pregnancy on maternal mental health disappeared over time. [ABSTRACT FROM AUTHOR]

Background: Previous studies found that tobacco outlets were unevenly distributed by area socioeconomic status (SES). However, evidence from continental Europe is limited. This study aims to assess differences in tobacco outlet presence, density and proximity by area SES in the Netherlands. Methods: All tobacco outlets in four Dutch cities (Amsterdam, and medium-sized cities Eindhoven, Haarlem, and Zwolle) were mapped between September 2019 and June 2020. We estimated associations between average property value of neighbourhoods (as an indicator of SES, grouped into quintiles) and (1) tobacco outlet presence in the neighbourhood (yes/no), (2) density (per km2), and (3) proximity to the closest outlet (in meters), using logistic and linear regression models. Results: 46% of neighbourhoods contained at least one tobacco outlet. Tobacco outlets were mostly situated in city centres, but the distribution of tobacco outlets varied per city due to differences in urban structures and functions. In the medium-sized cities, each quintile higher neighbourhood-SES was associated with lower tobacco outlet presence (OR:0.71, 95%CI:0.59;0.85), lower density (B:-1.20 outlets/km2, 95%CI:-2.20;-0.20) and less proximity (B:40.2 m, 95%CI 36.58;43.83). Associations were the other way around for Amsterdam (OR:1.22, 95%CI:1.05;1.40, B:3.50, 95%CI:0.81;6.20, and B:-18.45, 95%CI:-20.41;-16.49, respectively). Results were similar for most types of tobacco outlets. Conclusion: In medium-sized cities in the Netherlands, tobacco outlets were more often located in low-SES neighbourhoods than high-SES. Amsterdam presented a reverse pattern, possibly due to its unique urban structure. We discuss how licensing might contribute to reducing tobacco outlets in low-SES neighbourhoods. [ABSTRACT FROM AUTHOR]

This paper describes a research project conducted in collaboration with 10 "pupil co-researchers" (PCRs) and their classes in a secondary school in the Netherlands. The main research tools employed were online and face-to-face group discussions, in which PCRs contributed as consultants, co-designers and assistants. The research proved a learning experience for both the adults and the young people involved and led to the collection of insightful qualitative data. Working collaboratively with pupils, however, presented a number of challenges. Ethical issues such as consent, inclusion and the pressure placed on pupils, and logistical challenges such as the availability of time and resources, were particularly prominent. Perhaps the most valuable challenge, however, was the opportunity that this research presented to the adult researcher to reflect upon the role played by her own assumptions when working with young people.

Summary: Background: Tofacitinib is an oral Janus kinase (JAK) inhibitor and is registered for the treatment of ulcerative colitis (UC). The effectiveness of tofacitinib has been evaluated up to 12 months of treatment. Aim: The aim of this study was to assess the effectiveness and safety of 24 months of tofacitinib use in UC patients in the Netherlands. Methods: Patients initiating tofacitinib treatment were included in the ICC Registry, a nationwide, observational registry. Patients were prospectively evaluated for up to 24 months. The primary outcome was corticosteroid‐free clinical remission (CSFR, Simple Clinical Colitis Activity Index [SCCAI] ≤2) at week 104. Secondary outcomes included biochemical remission (C‐reactive protein (CRP) ≤5 mg/L and faecal calprotectin (FC) ≤250 μg/g), safety, and discontinuation rate. Results: We included 110 patients of whom 104 (94.5%) were anti‐TNF experienced. After 104 weeks of tofacitinib, 31.8% (34/107) were in CSFR, 23.4% (25/107) in biochemical remission and 18.7% (20/107) in combined clinical and biochemical remission. Of the patients in CSFR at week 52, 76.5% (26/34) remained so after 104 weeks of treatment. Sixty‐one patients (55.5%) discontinued tofacitinib after a median duration of 13 weeks (IQR 7–34). The main reasons for discontinuation were non‐response (59%), loss of response (14.8%), and adverse events (18%). There were 33.9 possible tofacitinib‐related adverse events per 100 patient‐years during follow‐up. Adverse events most probably related to tofacitinib were skin reactions and headaches. There were 6.4 herpes zoster infections per 100 patient‐years. Conclusion: Tofacitinib was effective in 31.8% of patients after 24 months of treatment. [ABSTRACT FROM AUTHOR]

Background: Gestational age is positively associated with cognitive development, but socio‐demographic factors also influence school performance. Previous studies suggested possible interaction, putting children with low socio‐economic status (SES) at increased risk of the negative effects of prematurity. Objectives: To investigate the association between gestational age in weeks, socio‐demographic characteristics, and school performance at the age of 12 years among children in regular primary education. Methods: Population‐based cohort study among liveborn singletons (N = 860,332) born in the Netherlands in 1999–2006 at 25–42 weeks' gestation, with school performance from 2011 to 2019. Regression analyses were conducted investigating the association of gestational age and sociodemographic factors with school performance and possible interaction. Results: School performance increased with gestational age up to 40 weeks. This pattern was evident across socio‐demographic strata. Children born at 25 weeks had −0.57 SD (95% confidence interval −0.79, −0.35) lower school performance z‐scores and lower secondary school level compared to 40 weeks. Low maternal education, low maternal age, and non‐European origin were strongly associated with lower school performance. Being born third or later and low socioeconomic status (SES) were also associated with lower school performance, but differences were smaller than among other factors. When born preterm, children from mothers with low education level, low or high age, low SES or children born third or later were at higher risk for lower school performance compared to children of mothers with intermediate education level, aged 25–29 years, with intermediate SES or first borns (evidence of interaction). Conclusions: Higher gestational age is associated with better school performance at the age of 12 years along the entire spectrum of gestational age, beyond the cut‐off of preterm birth and across socio‐demographic differences. Children in socially or economically disadvantaged situations might be more vulnerable to the negative impact of preterm birth. Other important factors in school performance are maternal education, maternal age, ethnicity, birth order and SES. Results should be interpreted with caution due to differential loss to follow‐up. [ABSTRACT FROM AUTHOR]

Although theories suggest transactional associations between adolescents' autonomy and relationships with parents and friends, few studies have examined these within‐person effects. This longitudinal study examined the within‐person co‐development of adolescents' autonomy and relationships with parents and friends. Adolescents (N = 244 Mage = 11.54, SD = 0.43 at T1; 50% boys) participated in a four‐wave study across 2 years in the Netherlands. In random‐intercept cross‐lagged panel models, within‐person results showed that higher levels of autonomy predicted less parental psychological control but not vice versa. However, no lagged‐effects between friend support and autonomy were found. This study suggests that adolescents' autonomy steers changes in parental psychological control. [ABSTRACT FROM AUTHOR]

Background: The Gene Expression Classifier (GEC) and Genomic Sequencing Classifier (GSC) were developed to improve risk stratification of indeterminate nodules. Our aim was to assess the clinical utility in a European population with restrictive diagnostic workup. Methods: Clinical utility of the GEC was assessed in a prospective multicenter cohort of 68 indeterminate nodules. Diagnostic surgical rates for Bethesda III and IV nodules were compared to a historical cohort of 171 indeterminate nodules. Samples were post hoc tested with the GSC. Results: The GEC classified 26% as benign. Surgical rates between the prospective and historical cohort did not differ (72.1% vs. 76.6%). The GSC classified 59% as benign, but misclassified six malignant lesions as benign. Conclusion: Implementation of GEC in management of indeterminate nodules in a European country with restrictive diagnostic workup is currently not supported, especially in oncocytic nodules. Prospective studies with the GSC in European countries are needed to determine the clinical utility. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic was managed in Aotearoa New Zealand (NZ) by a COVID-19 elimination policy, involving border closure and an initial national lockdown. This was different to most other countries including Northern Ireland (NI) and the Netherlands (NED). We quantify the effect of these policies on the diagnosis of three major cancers, comparing NZ with these two European countries. Method: Data from NED, NZ and NI population-based cancer registries were used to assess trends in all pathologically diagnosed (PD) lung, breast, and colorectal cancers from March to December 2020 (pandemic period) and compared to the similar pre-pandemic period (2017–2019). Trend data were also collated on COVID-19 cases and deaths per 100,000 in each population. Results: Comparing the pre-pandemic period to the pandemic period there were statistically significant reductions in numbers of lung (↓23%) and colorectal (↓15%) PD cancers in NI and numbers of breast (↓18%) and colorectal cancer (↓18.5%) diagnosed in the NED. In NZ there was no significant change in the number of lung (↑10%) or breast cancers (↑0.2%) but a statistically significant increase in numbers of colorectal cancer diagnosed (↑5%). Conclusion: The impact of COVID-19 on cancer services was mitigated in NZ as services continued as usual reflecting minimal healthcare disruption and protected cancer services linked with the elimination approach adopted. The reduction in PD cases diagnosed in NED and NI were linked with higher COVID-19 rates and reflect societal restrictions which resulted in delayed patient presentation to primary and secondary care, disruption to screening and healthcare services as a result of COVID-19 infections on staff and the need to shift intensive care to COVID-19 patients. Reductions in PD cancers in NI and the NED and in particularly lung cancers in NI, highlight the need for targeted public health campaigns to identify and treat 'missing' patients. Protecting cancer services should be a priority in any future pandemic or systemic healthcare system disruption. [ABSTRACT FROM AUTHOR]

BACKGROUND: Do-it-yourself technologies such as 3D printing offer interesting opportunities for creating custom-made assistive devices for people with disabilities. Although these opportunities are increasingly acknowledged, it remains unclear how 3D printing technology should be implemented in assistive devices delivery processes. OBJECTIVE: In three separate action research projects carried out in Belgium, Italy and The Netherlands, workflows were designed and evaluated that incorporate 3D printing as a standard option for providing clients with suitable assistive devices. METHODS: In this paper we describe and compare the three workflows that were conceived simultaneously, yet independently from each other. RESULTS: Based on the evaluations of these workflows, and the experiences of the researchers who developed the workflows, we provide recommendations for implementing 3D printing as a common approach in assistive device delivery processes in practice. Most importantly, designing and manufacturing should be done by means of a client-centered co-creation process by interdisciplinary teams of clinicians, clients, and 3D printing experts. We provide several recommendations for facilitating and supporting collaborations within such teams. CONCLUSIONS: The three workflows presented in this paper are strikingly similar and therefore provide a convincing starting point for interdisciplinary design teams who wish to embark on 3D printing custom-made assistive devices. [ABSTRACT FROM AUTHOR]

Aims: The aims of the study were to explore the impact of caring for patients carrying multi‐drug resistant organisms on nursing staff and identify factors predicting their intention to use personal protective equipment and their ability to comply with advised infection prevention and control measures. Background: Carriage of multi‐drug resistant organisms and corresponding infection prevention and control measures have a major impact on patients. Limited research has been done to investigate the impact of caring for these patients on nursing staff. Design: A cross‐sectional design. Methods: Online survey among Dutch nursing staff in various healthcare settings. Prediction analyses were conducted using random forest. The STROBE checklist was used preparing the manuscript. Results: 974 respondents were included. The majority of nursing staff reported to have experience in caring for patients carrying multi‐drug resistant organisms. Relevant dilemmas in daily practice were identified. Important predictors of the intention to use protective equipment were practicing hand hygiene, usable protocols, favourable attitudes and perceptions, as well as knowledge. Important predictors of the ability to comply with advised measures were usable and findable protocols, a suitable work environment and practicing hand hygiene. Conclusion: We have gained comprehensive insight into experiences, attitudes, perceptions, knowledge and dilemmas in daily practice of nursing staff caring for patients carrying multi‐drug resistant organisms. To enhance their intention to use protective equipment and their ability to comply with advised measures, activities should focus on improving hand hygiene and the usability of protocols. Additionally, efforts are needed to improve knowledge, provide better resources and a more supportive work environment. All of which need to be specifically tailored to each healthcare setting. Relevance to clinical practice: The results can be used in the development of interventions to improve nursing care while reducing the unfavourable impact on nursing staff and supporting adherence to advised measures. [ABSTRACT FROM AUTHOR]

This study compared the affordances of 4 multimedia learning environments for specific learning processes. The environments covered the same domain but used different instructional approaches: (a) hypermedia learning, (b) observational learning, (c) self-explanation-based learning, and (d) inquiry learning. Although they all promote an active attitude, they differ in the specific learning processes they intend to foster. In earlier research (Eysink et al., 2009), we found that learners involved in self-explanation-based or inquiry learning had the highest learning outcomes. In these approaches learners were required to generate (parts of) the subject matter, from which we concluded that they presumably stimulated learners to elaborate. Therefore, in the present study we expected that learners involved in self-explanation-based or inquiry learning would engage in more learning processes connected to elaboration than would learners involved in hypermedia or observational learning. Forty participants worked through the learning environments while thinking aloud; their protocols were coded using a generic learning processes scheme. Results showed that self-explanation-based learning and inquiry learning led to greater engagement in learning processes in general and more elaborative processes in particular. The results suggest that elaboration is indeed the key process explaining differences in learning across different instructional approaches within multimedia learning environments. (Contains 11 tables and 7 figures.)

In this paper, we introduce the Exploratory Behavior Scale (EBS), a quantitative measure of young children's interactivity. More specifically, the EBS is developed from the psychological literature on exploration and play and measures the extent to which preschoolers explore their physical environment. A practical application of the EBS in a science museum is given. The described study was directed at optimizing parent guidance to improve preschoolers' exploration of exhibits in science center NEMO. In Experiment 1, we investigated which adult coaching style resulted in the highest level of exploratory behavior at two exhibits. In Experiment 2, we investigated whether informing parents about an effective way of coaching influenced preschoolers' exploratory behavior at two exhibits. The results of the study demonstrate the added value of the EBS in visitor behavior research: compared to existing global measures of visitor interactivity; the EBS adds information about the quality of the hands-on behavior. Compared to existing detailed measures of visitor interactivity, the EBS has the advantage of being applicable in different museum settings and enabling comparisons between exhibits or exhibitions. In addition, the EBS allows for quantification of unanticipated behavior. (Contains 5 figures, 1 table, and 7 footnotes.)

In this study, the authors compared four multimedia learning arrangements differing in instructional approach on effectiveness and efficiency for learning: (a) hypermedia learning, (b) observational learning, (c) self-explanation-based learning, and (d) inquiry learning. The approaches all advocate learners' active attitude toward the learning material but show differences in the specific learning processes they intend to foster. Learning results were measured on different types of knowledge: conceptual, intuitive, procedural, and situational. The outcomes show that the two approaches asking learners to generate (parts of) the subject matter (either by self-explanations or by conducting experiments) led to better performance on all types of knowledge. However, results also show that emphasis on generating subject matter by the learner resulted in less efficient learning. (Contains 12 tables and 2 figures.)

Objective: It is unknown whether ustekinumab (UST) levels can predict clinical outcomes in Crohn's disease (CD) patients. We assessed the exposure–response relationship of UST trough concentrations with biochemical outcomes at week 24 in a prospective, real-world setting. Methods: We performed a prospective study in patients with CD starting UST in four academic centres in the Netherlands. All patients received a weight-adjusted intravenous (IV) UST induction dose, followed by one subcutaneous (SC) dose of 90 mg UST at 8 weeks. Maintenance therapy consisted of 90 mg subcutaneous UST every 8 or 12 weeks. Individual UST concentration time course during treatment were estimated using a population pharmacokinetic (PK) model. Quartile analysis and logistic regression were performed to analyse if UST concentrations at week 8 were associated with biochemical remission rates at week 24 (C-reactive protein (CRP) ≤ 5 mg/L and / or faecal calprotectin (FC) ≤ 250 mg/kg). Results: In total, 124 patients with CD were included. Patients achieving biochemical remission at week 12 and 24 had significantly higher UST levels at week 8 compared to patients without biochemical remission (6.6 µg/mL versus 3.9 µg/mL, P < 0.01 and 6.3 µg/mL versus 3.9 µg/mL, P < 0.01, respectively). In quartile analysis, patients with UST levels in the highest quartile (≥ 6.3 µg/mL at week 8) had higher biochemical remission rates at week 12 and week 24. There was no association between UST levels at and corticosteroid-free clinical remission rates. Conclusion: In this real-world cohort of patients with CD, UST levels in the highest quartile (≥ 6.3 µg/mL) at week 8 were associated with higher biochemical remission rates at week 24. [ABSTRACT FROM AUTHOR]

Background: The first HPV-vaccine eligible cohorts in the Netherlands will enter the cervical screening program in 2023. However, a substantial number of young women already have had a cervical sample taken before entry into the regular screening program. This study was initiated to explore early effects of HPV vaccination on detection of cytological abnormalities in cervical samples of women younger than the screening age. Methods: Results of cervical samples were obtained from the Dutch National Pathology Databank (PALGA) and were linked to the women's HPV vaccination status from the national vaccination registry (Praeventis) (N = 42,171). Occurrence of low-grade and high-grade squamous intraepithelial lesions or worse (LSIL and HSIL+) and high-risk HPV positive tests (hrHPV) in the first cervical sample were compared between vaccinated and unvaccinated women by multivariable logistic regression analysis, corrected for age at cervical sampling and age of vaccination (12/13 years, = = 14 years). Results: For fully vaccinated women (three-or two-dose schedule), statistically significant reductions were seen for all outcomes compared to unvaccinated women (hrHPV: adjusted OR, 0.70, 95% CI, 0.63-0.79; LSIL: 0.70, 0.61-0.80; HSIL+: 0.39, 0.30-0.51). Conclusions: By linking nation-wide registries on pathology and vaccination, we show significant beneficial early effects of HPV-vaccination on LSIL, HSIL+, CIN3/AIS/carcinoma and hrHPV detection in young women upto 24 years of age who have a cervical sample taken before entry into the cervical cancer screening program. [ABSTRACT FROM AUTHOR]

In this study, we examined gender and sexuality representation in language and math textbooks for Dutch secondary education. We analyzed all male and female characters in 13 language textbooks (N = 7,347) and 12 math textbooks (N = 4,591). Our results confirmed our expectations based on the theory of the hidden curriculum: female characters were underrepresented in all textbooks (40% in language, 44% in math textbooks), but overrepresented in household tasks and EHW (Education, Health, and Welfare) professions. Male characters were overrepresented in occupational roles, especially in STEM (Science, Technology, Engineering, and Math) professions and technical tasks. Further, female characters in language textbooks were overrepresented in parental roles, and male characters were overrepresented among characters with disharmonious traits and behaviors. We found no characters from sexual minorities in any of the textbooks. In conclusion, in line with theories of the hidden curriculum, Dutch textbooks include gender stereotypic messages and are heteronormative. These findings are relevant in light of previous studies demonstrating the negative impact of these biases on children. Publishers and schools that want to be more inclusive are recommended to be more critical in their selection of stories and role models in their books. [ABSTRACT FROM AUTHOR]

Background This prospective study assesses symptoms 3 months after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection compared to test-negative and population controls, and the effect of vaccination prior to infection. Methods Participants enrolled after a positive (cases) or negative (test-negative controls) SARS-CoV-2 test, or after invitation from the general population (population controls). After 3 months, participants indicated presence of 41 symptoms and severity of 4 symptoms. Permutation tests were used to select symptoms significantly elevated in cases compared to controls and to compare symptoms between cases that were vaccinated or unvaccinated prior to infection. Results In total, 9166 cases, 1698 symptomatic but test-negative controls, and 3708 population controls enrolled. At 3 months, 13 symptoms, and severity of fatigue, cognitive impairment, and dyspnea were significantly elevated incases compared to controls. Of cases, 48.5% reported ≥1 significantly elevated symptom compared to 29.8% of test-negative controls and 26.0% of population controls. Effect of vaccination could be determined for cases aged <65 years, and was significantly protective for loss of smell and taste but not for other symptoms. Discussion Three months after SARS-CoV-2 infection, almost half of cases report symptoms, which was higher than background prevalence and test-negative prevalence. Vaccination prior to infection was protective against loss of smell and taste in cases aged <65 years. [ABSTRACT FROM AUTHOR]

Examines adolescents and adults on the reporting of cognitive coping strategies and their relationship to symptoms of depression and anxiety. Results reveal that all cognitive coping strategies were reported by adolescents to a significantly lesser extent than by adults. Additionally, a considerable percentage of the variance in symptomatology was explained by the use of cognitive coping strategies. (Contains 17 references and 2 tables.) (GCP)

Aims: Exposure to tobacco products and advertising at the point of sale may be associated with pro‐smoking cognitions. However, previous studies on this topic measured exposure based on self‐report and did not include European countries. The aim of this study was to assess the association between objectively measured exposure to tobacco outlets and non‐smoking adolescents' smoking attitudes, beliefs and norms. Design: This cross‐sectional study combined survey data with Global Positioning Systems data using geographic information system. Setting: The four Dutch cities of Amsterdam, Eindhoven, Haarlem and Zwolle. Participants: We retrieved data of 308 13 to 17‐year‐old non‐smoking adolescents, mainly girls (61%), adolescents attending pre‐university secondary education (71%) and without smoking friends (58%). Measurements Exposure was measured with a smartphone app registering for 2 weeks how often participants were within 10 m of a tobacco outlet. We distinguished between outlets without visible tobacco promotion (i.e. supermarkets), with only internal visibility and with both internal and external visibility. Participants' reported smoking cognitions were dichotomised into pro‐smoking or anti‐smoking. We applied multi‐level logistic regression analyses and adjusted for age, sex, educational level and smoking friends. Findings On average, adolescents were exposed to 1.18 (SD = 1.23) tobacco outlets per day. Higher exposure to tobacco outlets was associated with higher odds of pro‐smoking injunctive norm (OR = 1.35, 95% CI = 1.04–1.75). Associations with attitude (OR = 1.12, 95% CI = 0.91–1.38), social beliefs (OR = 1.15, 95% CI = 0.93–1.43), health beliefs (OR = 1.18, 95% CI = 0.97–1.44) and descriptive norm (OR = 1.15, 95% CI = 0.91–1.44) were also positive, but non‐significant. Overall, associations were strongest for outlets with internal visibility, for instance, for injunctive norm (OR = 1.37, 95% CI = 1.03–1.81). Conclusions: Global Positioning Systems‐measured exposure to tobacco outlets was associated with pro‐smoking cognitions among non‐smoking adolescents in the Netherlands. [ABSTRACT FROM AUTHOR]

Facial palsy rehabilitation therapy plays an essential role in treating facial palsy. This study aimed to gain insight into therapists' perceptions and attitudes toward facial palsy rehabilitation therapy and to examine whether therapists could be categorized into distinct groups based on these attitudes and perceptions. Thirteen semi-structured, in-depth interviews were conducted in a purposive sample of therapists. Interviews were analyzed using thematic analysis. Next, a questionnaire containing questions about therapists' characteristics and perceptions and attitudes toward facial palsy rehabilitation therapy was sent to all facial palsy rehabilitation therapists in the Netherlands and Flanders (n = 292). Latent class analysis (LCA) was performed to identify and analyze distinct groups of therapists. Seven themes were derived from the interviews: treatment goals, therapy content, indications, measurement instruments, factors influencing success, emotional support, and cooperation with colleagues. The questionnaire was filled out by 127 therapists. A 2-group structure consisting of a positive class and a negative class was found to fit the questionnaire data best. No distinction could be made regarding therapists' characteristics. Considerable variation in stated treatment practices was present among therapists. Therapists could be classified into 2 groups. This study raises several hypotheses that require further study. [ABSTRACT FROM AUTHOR]

Purpose: Psychosocial health problems, such as social isolation, loneliness, depression and anxiety, have gained attention during the COVID-19 pandemic and are commonly co-occurring. We investigated the network of psychosocial health constructs during the COVID-19 pandemic. Methods: This study included 4553 participants (mean age: 68.6 ± 11.2 years, 56% women) from the prospective Rotterdam Study, who filled out a questionnaire between April and July 2020, the time of the first COVID-19 wave in the Netherlands. Psychosocial health constructs included were depressive symptoms (Center for Epidemiological Studies Depression scale), anxiety symptoms (Hospital Anxiety and Depression scale), loneliness (University of California, Los Angeles loneliness scale), social connectedness (five items) and pandemic-related worry (five items). We estimated mixed graphical models to assess the network of items of these constructs and whether age and sex affected the network structure. Results: Within the network of psychosocial constructs, a higher depressive symptoms score was particularly associated with items of loneliness and social connectedness, whereas overall anxiety was particularly associated with items of pandemic-related worry. Between people from different sex and age, the network structure significantly altered. Conclusion: This study demonstrates that within the same network of psychosocial health constructs, depressive symptom score is particularly associated with loneliness and social connectedness, whereas anxiety symptom score is associated with pandemic-related worry during the first COVID-19 lockdown. Our results support that psychosocial constructs should be considered in conjunction with one another in prevention and treatment efforts in clinical care, and that these efforts need to be tailored to specific demographic groups. [ABSTRACT FROM AUTHOR]

Research describes several sexual and gender identity-based microaggressions that sexual and gender minority (SGM) people might experience. We aimed to examine the occurrence of different sexual and gender identity-based microaggressions among SGM youth and to identify differences by sexual and gender identity, and sex assigned at birth. Open-ended questions about daily experiences were coded for 16 types of sexual and gender identity-based microaggressions in two daily diary studies among Dutch SGM youth (Study 1: N = 90, M age = 17.64 SD = 1.78; Study 2: N = 393, M age = 18.36 SD = 2.65). Several types of microaggressions were identified, and there was sizable variability in the reported frequency. Overall, lesbian women and bisexual youth were less likely to report microaggressions than gay youth. Bisexual youth were less likely to report use of heterosexist or transphobic terminology than gay youth and youth assigned male at birth were less likely to report invalidation of LGBTQ identity than youth assigned female at birth. Last, gender minority youth were more likely to report familial microaggressions, invalidation of LGBTQ identity, and threatening behaviors than cisgender youth. Overall, this study provides empirical support using mixed qualitative and quantitative methods for theorized typologies of microaggressions among Dutch SGM youth. [ABSTRACT FROM AUTHOR]