Inzichten van Dhr. Nauta op de Huidige Situatie: dit artikel is geschreven aan de hand van een interview

Het proefschrift van Dhr. Nauta roept enkele vragen op die toelichti ng verdienen, zoals over de aarzeling van Nederland om harder in te grijpen op de Eilanden. Het bestuur zou immers sterk verbeterd kunnen worden als de Nederlandse overheid meer gebruik zou maken van haar bevoegdheden. Dat Nederland zich terughoudend opstelt, wat toezicht en ingrijpen betreft , is volgens Nauta het gevolg van het pijnlijke koloniale verleden van Nederland. Internati onaal gezien was het voor Nederland niet haalbaar om veel grip te houden op de eilanden. Verwijten van ‘neokoloniale prakti jken’ moesten worden voorkomen

Verder kijken dan de gemeentegrenzen

Het is interessant om aandacht te besteden aan de relatie tussen de gemeente en de Europese Unie. Welke positie nemen gemeenten in ten opzichte van het Rijk? Wat betekent ‘Europa’ voor de gemeenten? Maar ook: Wat betekenen deze ontwikkelingen voor de burger? Wij gaan op deze vragen in tijdens een gesprek met Caspar van den Berg

Politieke duizendpoot over Nederland

Met het thema Politieke Ambities snijdt deze editie een zowel actueel als controversieel thema aan. Het huidige kabinet VVD-PvdA kwam immers niet zonder slag of stoot tot stand. Om meer inzicht te verkrijgen in het huidige politieke klimaat in Nederland spraken we met prof. dr. Ruud Koole, onderzoeker, docent én lid van de Eerste Kamer, over zijn werkzaamheden binnen de politiek, de politieke ontwikkelingen van de afgelopen jaren en zijn visie op het huidige kabinet

Commissie B.I.L.dspraak

Ook dit jaar zal er hard gewerkt worden om een paar mooie edities van de Bestuurskundige Berichten neer te zetten. De drijvende kracht hierachter is de commissie Bestuurskundige Berichten 2012-2013. Maak kennis met B.I.L.dspraak

Progesterone regulation of implantation-related genes: new insights into the role of oestrogen

Genomic profiling was performed on explants of late proliferative phase human endometrium after 24-h treatment with progesterone (P) or oestradiol and progesterone (17β-E2+P) and on explants of menstrual phase endometrium treated with 17β-E2+P. Gene expression was validated with real-time PCR in the samples used for the arrays, in endometrium collected from early and mid-secretory phase endometrium, and in additional experiments performed on new samples collected in the menstrual and late proliferative phase. The results show that late proliferative phase human endometrium is more responsive to progestins than menstrual phase endometrium, that the expression of several genes associated with embryo implantation (i.e. thrombomodulin, monoamine oxidase A, SPARC-like 1) can be induced by P in vitro, and that genes that are fully dependent on the continuous presence of 17β-E2 during P exposure can be distinguished from those that are P-dependent to a lesser extent. Therefore, 17β-E2 selectively primes implantation-related genes for the effects of P

The Epidemic of Hip Fractures: Are We on the Right Track?

Background: Hip fractures are a public health problem, leading to hospitalization, long-term rehabilitation, reduced quality of life, large healthcare expenses, and a high 1-year mortality. Especially older adults are at greater risk of fractures than the general population, due to the combination of an increased fall risk and osteoporosis. The aim of this study was to determine time trends in numbers and incidence rates of hip fracture-related hospitalizations and admission duration in the older Dutch population. Methods and Findings: Secular trend analysis of all hospitalizations in the older Dutch population (≥65 years) from 1981 throughout 2008, using the National Hospital Discharge Registry. Numbers, age-specific and age-adjusted incidence rates (per 10,000 persons) of hospital admissions and hospital days due to a hip fracture were used as outcome measures in each year of the study. Between 1981 and 2008, the absolute number of hip fractures doubled in the older Dutch population. Incidence rates of hip fracture-related hospital admissions increased with age, and were higher in women than in men. The age-adjusted incidence rate increased from 52.0 to 67.6 per 10,000 older persons. However, since 1994 the incidence rate decreased (percentage annual change -0.5%, 95% CI: -0.7; -0.3), compared with the period 1981-1993 (percentage annual change 2.3%, 95% CI: 2.0; 2.7). The total number of hospital days was reduced by a fifth, due to a reduced admission duration in all age groups. A possible limitation was that data were obtained from a linked administrative database, which did not include information on medication use or co-morbidities. Conclusions: A trend break in the incidence rates of hip fracture-related hospitalizations was observed in the Netherlands around 1994, possibly as a first result of efforts to prevent falls and fractures. However, the true cause of the observation is unknown

The Economics of Dementia-Care Mapping in Nursing Homes:A Cluster-Randomised Controlled Trial

Background: Dementia-care mapping (DCM) is a cyclic intervention aiming at reducing neuropsychiatric symptoms in people with dementia in nursing homes. Alongside an 18-month cluster-randomized controlled trial in which we studied the effectiveness of DCM on residents and staff outcomes, we investigated differences in costs of care between DCM and usual care in nursing homes. Methods: Dementia special care units were randomly assigned to DCM or usual care. Nurses from the intervention care homes received DCM training, a DCM organizational briefing day and conducted the 4-months DCM-intervention twice during the study. A single DCM cycle consists of observation, feedback to the staff, and action plans for the residents. We measured costs related to health care consumption, falls and psychotropic drug use at the resident level and absenteeism at the staff level. Data were extracted from resident files and the nursing home records. Prizes were determined using the Dutch manual of health care cost and the cost prices delivered by a pharmacy and a nursing home. Total costs were evaluated by means of linear mixed-effect models for longitudinal data, with the unit as a random effect to correct for dependencies within units. Results: 34 units from 11 nursing homes, including 318 residents and 376 nursing staff members participated in the cost analyses. Analyses showed no difference in total costs. However certain changes within costs could be noticed. The intervention group showed lower costs associated with outpatient hospital appointments over time (p = 0.05) than the control group. In both groups, the number of falls, costs associated with the elderly-care physician and nurse practitioner increased equally during the study (p Conclusions: DCM is a cost-neutral intervention. It effectively reduces outpatient hospital appointments compared to usual care. Other considerations than costs, such as nursing homes' preferences, may determine whether they adopt the DCM method