Citizenship Status and Pressure Group Action

This thesis investigates the intersection between citizenship status and pressure group action. It asks a two-pronged question. First, does variation in citizenship status (to be citizen or noncitizen) produce variation in pressure group action? Second, where there is variation, how is it that citizenship status matters; where there is no variation, how is it that citizenship status (a decidedly political status) does not matter? In response to this two-part question, a two-part theoretical framework has been developed. To answer the question of whether citizenship status matters, an interactive model of action has been developed. This provides a common measure through which similarities and differences in action-paths between citizen and non-citizen pressure groups can be uncovered. It is found that citizenship status does have an effect on pressure group action, notably in a pressure group’s interaction with a) their constituency; b) potential allies; c) other-state political institutions; and d) other-state media. To answer the question of how citizenship matters and does not matter, the idea of the capability mechanism has been developed. This asserts that variation in citizenship status - understood through either a rights or identity framework - produces, reduces, or removes capabilities. This, in turn, shapes action. This model is also used to explain similarities. Both the empirical findings and the theoretical frameworks developed within this thesis are useful for further analysis of the significance of citizen or non-citizen status on one’s relationship to political systems

The 2009 framework for undergraduate medical education in the Netherlands

The 2009 Framework defines the joint Dutch national learning outcomes to be attained by medical students after completing their three-year master programme in medicine. The Framework thus helps to guarantee to society at large and to patients in particular that medical graduates who are starting out as practitioners have attained a certain professional level. This level is the aggregate of the physicians’ target profile, physicians’ (sub-) competencies to be achieved and the list of issues relating to illness and health. In addition, the Framework also defines the profile of the bachelor and the learning outcomes of the bachelor programme in medicine

The 2009 framework for undergraduate medical education in the Netherlands

The 2009 Framework defines the joint Dutch national learning outcomes to be attained by medical students after completing their three-year master programme in medicine. The Framework thus helps to guarantee to society at large and to patients in particular that medical graduates who are starting out as practitioners have attained a certain professional level. This level is the aggregate of the physicians’ target profile, physicians’ (sub-) competencies to be achieved and the list of issues relating to illness and health. In addition, the Framework also defines the profile of the bachelor and the learning outcomes of the bachelor programme in medicine

Identity and Interests: Understanding the Meltdown in Israeli-Turkish Relations 2002-2012

The recent deterioration of the strong bilateral alliance between Israel and Turkey has significant affects on the balance of power within the Middle East. As such, it is important that scholars determine why this meltdown has occurred. This thesis sought to explain the deterioration of relations between Israel and Turkey and overcome gaps in the existing literature concerned with this meltdown of bilateral relations by taking a fresh look into the role of identity and the interests it creates. Hence, the framework of Wendtian constructivism was applied in order to examine the social origins and impacts of identity and interests on alliance formation and deterioration. In this thesis, I suggested that Israel’s identity has changed slowly over the past decade and as such, should be perceived as ‘relatively’ stable. Conversely, however, Turkey’s national identity changed sharply, drifting away from the Ataturk agenda of Westernisation and secularism towards an Islamic heritage. In order to strengthen my argument that this shift in Turkish identity has primarily accounted for the deterioration of its relations with Israel, I analysed Turkish attitudes towards foreign policies other than its bilateral relationship with Israel, as well as its newly defined interests. Thus, whereas Israel’s relatively stable national identity and domestic policies were matched by its relatively stable foreign interests over the past decade, deep changes to Turkey’s national identity redirected its domestic policies under Recep Tayyip Erdoğan’s government. Consequently, Turkey has employed a number of political tensions and events as pretexts in order to unilaterally disengage from its relations with Israel so that it can further new foreign policies and interests. Identity matters, and for better or worse, identity changes precede foreign policy change, a lesson we must not forget

Analytical and experimental characterization of a miniature calorimetric sensor in pulsatile flow

The behaviour of a miniature calorimetric sensor, which is under consideration for catheter-based coronary artery flow assessment, is investigated in both steady and pulsatile tube flow. The sensor is composed of a heating element operated at constant power, and two thermopiles that measure flow-induced temperature differences over the sensor surface. An analytical sensor model is developed, which includes axial heat conduction in the fluid and a simple representation of the solid wall, assuming a quasi-steady sensor response to the pulsatile flow. To reduce the mathematical problem, described by a two-dimensional advection-diffusion equation, a spectral method is applied. A Fourier transform is then used to solve the resulting set of ordinary differential equations and an analytical expression for the fluid temperature is found. To validate the analytical model, experiments with the sensor mounted in a tube have been performed in steady and pulsatile water flow with various amplitudes and Strouhal numbers. Experimental results are generally in good agreement with theory and show a quasi-steady sensor response in the coronary flow regime. The model can therefore be used to optimize the sensor design for coronary flow assessment

One year cost effectiveness of sirolimus eluting stents compared with bare metal stents in the treatment of single native de novo coronary lesions: an analysis from the RAVEL trial

OBJECTIVE: To assess the balance between costs and effects of the sirolimus eluting stent in the treatment of single native de novo coronary lesions in the RAVEL (randomised study with the sirolimus eluting Bx Velocity balloon expandable stent in the treatment of patients with de novo native coronary artery lesions) study. DESIGN: Multicentre, double blind, randomised trial. SETTING: Percutaneous coronary intervention for single de novo coronary lesions. PATIENTS: 238 patients with stable or unstable angina. INTERVENTIONS: Randomisation to sirolimus eluting stent or bare stent implantation. MAIN OUTCOME MEASURES: Patients were followed up to one year and the treatment effects were expressed as one year survival free of major adverse cardiac events (MACE). Costs were estimated as the product of resource utilisation and Dutch unit costs. RESULTS: At one year, the absolute difference in MACE-free survival was 23% in favour of the sirolimus eluting stent group. At the index procedure, sirolimus eluting stent implantation had an estimated additional procedural cost of 1286. At one year, however, the estimated additional cost difference had decreased to 54 because of the reduction in the need for repeat revascularisations in the sirolimus group (0.8% v 23.6%; p < 0.01). After adjustment of actual results for the consequences of angiographic follow up (correction based on data from the BENESTENT (Belgium Netherlands stent) II study), the difference in MACE-free survival was estimated at 11.1% and the addit

Substantial and sustained improvement of serrated polyp detection after a simple educational intervention: Results from a prospective controlled trial

Objective: Serrated polyps (SPs) are an important cause of postcolonoscopy colorectal cancers (PCCRCs), which is likely the result of suboptimal SP detection during colonoscopy. We assessed the long-term effect of a simple educational intervention focusing on optimising SP detection. Design: An educational intervention, consisting of two 45 min training sessions (held 3 years apart) on serrated polyp detection, was given to endoscopists from 9 Dutch hospitals. Hundred randomly selected and untrained endoscopists from other hospitals were selected as control group. Our primary outcome measure was the proximal SP detection rate (PSPDR) in trained versus untrained endoscopists who participated in our faecal immunochemical test (FIT)-based population screening programme. Results: Seventeen trained and 100 untrained endoscopists were included, who performed 11 305 and 51 039 colonoscopies, respectively. At baseline, PSPDR was equal between the groups (9.3% vs 9.3%). After training, the PSPDR of trained endoscopists gradually increased to 15.6% in 2018. This was significantly higher than the PSPDR of untrained endoscopists, which remained stable around 10% (p=0.018). All below-average (ie, PSPDR ≤6%) endoscopists at baseline improved their PSPDR after training session 1, as did 57% of endoscopists with average PSPDR (6%-12%) at baseline. The second training session further improved the PSPDR in 44% of endoscopists with average PSPDR after the first training. Conclusion: A simple educational intervention was associated with substantial long-term improvement of PSPDR in a prospective controlled trial within FIT-based population screening. Widespread implementation of such interventions might be an easy way to improve SP detection, which may ultimately result in fewer PCCRCs. Trial registration number: NCT03902899

Falsely elevated plasma testosterone concentrations in neonates : importance of LC-MS/ MS measurements

CITATION: Hamer, H.M. et al. 2018. Falsely elevated plasma testosterone concentrations in neonates : importance of LC-MS/ MS measurements. Clinical Chemistry and Laboratory Medicine (CCLM), 56(6):e141–e143, doi:10.1515/cclm-2017-1028.The original publication is available at https://www.degruyter.com/view/j/cclmIn newborns with atypical genitalia, suspicious for a disorder of sex development (DSD), measurement of testosterone is an essential part in the diagnostic workup. Previously, direct testosterone immunoassays have proven to be inaccurate because they tend to overestimate testosterone concentrations in the lower ranges, such as those in females and infants, but specifically also in neonates. Based on the concern for cross-reactivity in neonatal samples, the recently revised UK guideline on the initial evaluation of DSD from the UK Society for Endocrinology recommends that steroids in plasma or serum are measured by either LC-MS/MS or immunoassays after organic solvent extraction. The use of LC-MS/MS was considered superior by a recent consensus meeting of DSD experts across Europe, although validation and quality control remain challenging.Publishers versio