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Aim To provide insight into the basic characteristics of decision making in the treatment of symptomatic severe aortic stenosis (SSAS) in Dutch heart centres with specific emphasis on the evaluation of frailty, cognition, nutritional status and physical functioning/functionality in (instrumental) activities of daily living [(I)ADL]. Methods A questionnaire was used that is based on the European and American guidelines for SSAS treatment. The survey was administered to physicians and non-physicians in Dutch heart centres involved in the decision-making pathway for SSAS treatment. Results All 16 Dutch heart centres participated. Before a patient case is discussed by the heart team, heart centres rarely request data from the referring hospital regarding patients’ functionality (n = 5), frailty scores (n = 0) and geriatric consultation (n = 1) as a standard procedure. Most heart centres ‘often to always’ do their own screening for frailty (n = 10), cognition/mood (n = 9), nutritional status (n = 10) and physical functioning/functionality in (I)ADL (n = 10). During heart team meetings data are ‘sometimes to regularly’ available regarding frailty (n = 5), cognition/mood (n = 11), nutritional status (n = 8) and physical functioning/functionality in (I)ADL (n = 10). After assessment in the outpatient clinic patient cases are re-discussed ‘sometimes to regularly’ in heart team meetings (n = 10). Conclusions Dutch heart centres make an effort to evaluate frailty, cognition, nutritional status and physical functioning/functionality in (I)ADL for decision making regarding SSAS treatment. However, these patient data are not routinely requested from the referring hospital and are not always available for heart team meetings. Incorporation of these important data in a structured manner early in the decision-making process may provide additional useful information for decision making in the heart team meeting.

BackgroundThe current study aimed to evaluate changes in treatment delay and outcome for ST-segment elevation myocardial infarction (STEMI) in the Netherlands during the first coronavirus disease 2019 (COVID-19) outbreak, thereby comparing regions with a high and low COVID-19 hospitalisation rate.MethodsClinical characteristics, STEMI timing variables, 30-day all-cause mortality and cardiovascular complications of all consecutive patients admitted for STEMI from 1 January to 30 June in 2020 and 2019 to six hospitals performing a high volume of percutaneous coronary interventions were collected retrospectively using data from the Netherlands Heart Registry, hospital records and ambulance report forms. Patient delay, pre-hospital delay and door-to-balloon time before and after the outbreak of COVID-19 were compared to the equivalent periods in 2019.ResultsA total of 2169 patients were included. During the outbreak median total treatment delay significantly increased (2 h 51 min vs 2 h 32 min;p = 0.043) due to an increased patient delay (1 h 20 min vs 1 h;p = 0.030) with more late presentations > 24 h (1.1% vs 0.3%) in 2020. This increase was particularly evident during the peak phase of COVID-19 in regions with a high COVID-19 hospitalisation rate. During the peak phase door-to-balloon time was shorter (38 min vs 43 min;p = 0.042) than in 2019. All-cause 30-day mortality was comparable in both time frames (7.8% vs 7.3%;p = 0.797).ConclusionsDuring the outbreak of COVID-19 patient delay caused an increase in total ischaemic time for STEMI, with a more pronounced delay in high-endemic regions, stressing the importance of good patient education during comparable crisis situations.

Introduction The Brief Coping Orientation to Problems Experienced (Brief-COPE) measures individuals' coping strategies. There is limited evidence on the psychometric properties of this measure in a perinatal population. The aim of this study is to explore the psychometric properties of the Brief COPE in pregnant and postpartum women. Methods The Dutch/Flemish version of the Brief-COPE was administrated in a sample of 754 antenatal (n = 432) and postpartum (n = 322) women living in Belgium. Exploratory factor analyses assessed the factor structure of the Brief-COPE and its convergent validity in an antenatal and postpartum sample. Cronbach's alpha was calculated for internal consistency reliability of the Brief-COPE items. Results Exploratory factor analysis showed a five-factor antenatal model, presented by the subscales: (1) Active coping (alpha = 0.86), (2) Self-blame and Disengagement (alpha = 0.70), (3) Alcohol use (alpha = 0.96), (4) Humour (alpha = 0.79), and (5) Spirituality (alpha = 0.81). For the postpartum sample, a three-factor model emerged, presented by the subscales: (1) Active coping (alpha = 0.85), (2) Self-blame (alpha = 0.85) and (3) Spirituality (alpha = 0.74). Conclusions We observed differences and similarities in coping strategies between antenatal and postpartum women - information to be of merit for clinical practice and research. The Brief-COPE is a promising tool for the use of identifying women's coping strategies during pregnancy and the postpartum period, specifically for women in a similar cultural context as the women in this study, mainly in terms of antenatal alcohol use.

This study investigates the differential effects of a task-based inside-school intervention and an outside-school project intervention on the development of speaking skills of 56 beginner second language (L2)-learners. The study extends previous research by looking at development across multiple occasions instead of two (i.e., a pretest and posttest), and by assessing speaking development by means of a non-intrusive task eliciting an informal conversation, rather than a formal test. To measure students’ development of Dutch speaking skills, syntactic complexity, lexical diversity, accuracy, fluency, and communicative effectiveness were assessed. Multilevel analyses revealed differential effects for both interventions. The task-based intervention inside school led to significant positive development of communicative effectiveness and syntactic complexity measured by length and subordination, but also to more breakdowns in fluency. The outside-school project intervention, however, did not result in any significant speaking development. The findings demonstrate the learning potential of a task-based inside-school intervention for developing various aspects of informal speaking skills, except for fluency. From a methodological perspective, this study illustrates the complexity of test and measure selection when assessing L2 speaking development.

Objective Becoming a mother is a process of transition that is subject to constant change and may last for over one year postpartum. Bonding is an important component of this transition to motherhood and can be measured with the Postpartum Bonding Questionnaire (PBQ). Most often, the PBQ is used among mothers up to 12 weeks postpartum. However, the transition to motherhood – and thus bonding – takes much longer and usually continues until 12 months postpartum. Design Validation study to test the PBQ for validity and reliability for use among mothers up to one year postpartum. Internal consistency and construct validity were established using Cronbach’s Alpha, exploratory factor analysis (EFA) and subsequent confirmatory factor analysis (CFA). Setting – mothers living in Flanders, Belgium Participants The sample was composed of 254 Flemish mothers who had given birth to healthy neonates up to one year earlier. Findings The EFA (principal component analysis) resulted in a uni-dimensional factor, “Impaired Bonding”, consisting of 21 items. Four items were excluded because of a low factor load. This uni-dimensional version of the PBQ was checked with CFA, resulting in an acceptable model-of-fit: significant X2 (p < 0.001), CMIN/df = 2.61, CFI = 0.85, RMSEA = 0.08. The internal consistency of the 21-item version showed a Cronbach's alpha of 0.89. Key conclusion The 21-item version of the PBQ is a valid and reliable tool to identify bonding in a general population of Flemish mothers up to one year postpartum. Further research is of merit. Implications for practice After testing the Postpartum Bonding Questionnaire among a population of Flemish mothers up to one year postpartum, one dimension remained: “Impaired bonding”, implying to play an important role during transition to motherhood. Measuring in this period emphasizes that in addition to monitoring the mother-infant bonding during pregnancy and early postpartum, it is of importance to extend the period of monitoring, that is, up to 12 months postpartum.

In a cell-based non-invasive prenatal test (cbNIPT), intact circulating trophoblasts (CTs) are isolated from maternal blood for subsequent genetic analysis. Enrichment of these CTs from maternal blood is the most challenging step in the cbNIPT workflow. This study aims to assess the suitability of the filtration-based Metacell® technology to enrich CTs from maternal blood at week 10 to 13 of gestation. The Metacell® technology is a novel size-based enrichment technology that combines blood filtration through 8 μm pores with an in vitro culture method. Three protocols were evaluated. First, 8 mL or 16 mL of maternal blood was filtered and subsequently cultured in vitro on the separation membrane for 3 days in RPMI 1640. In addition, 16 mL of maternal blood was filtered, and immediately processed without further culturing. Y-chromosome-specific qPCR or STR analysis was performed to evaluate the enrichment of CTs. A total of 44 samples from pregnant women, out of which 26 were carrying a male fetus, were processed. Although five enriched male fetus samples show detectable male DNA quantities, it cannot be excluded that the obtained positive signal is caused by cell-free fetal DNA sticking to the Metacell® separation membrane. In conclusion, the Metacell® technology, tested as described, is not suitable for consistent enrichment of CTs.

Dit artikel beschrijft de doelen en inhoud van de KOALA-test, een screeningsinstrument taalvaardigheid Nederlands ontwikkeld door het Centrum voor Taal en Onderwijs (KU Leuven) in opdracht van de Vlaamse overheid. ispartof: Welwijs: Wisselwerking Onderwijs en Welzijnswerk vol:32 issue:3 pages:21-23 status: published

This article provides a critical analysis of the language policy measures that were taken by the Flemish government (Belgium) to improve the quality of the teaching of the national language (Dutch) in compulsory education in Flanders and in the Flemish education system in Brussels. It builds on Van den Branden (2006a), which documented the implementation of task-based language teaching (TBLT) in primary, secondary and adult education in Flanders in the period between 1995 and 2005. Focusing on primary education, this article examines the different periods and trends in the government’s attempts to push the innovation of Dutch language education, and analyses its impact on the practice of teaching the language of schooling. The article highlights the gradual shift in focus from introducing TBLT materials and supporting the individual teacher to mandating the design of a school-wide language policy involving the whole school team, and from a top-down implementation to a more bottom-up driven, collaborative innovation process. The major aim of the article is to identify the factors that impacted on the effects of the innovation policy, against the backdrop of the growing influx of pupils who do not acquire Dutch (the main medium of instruction) as their mother tongue.