A Dutch guideline for the treatment of scoliosis in neuromuscular disorders

<p>Abstract</p> <p>Background</p> <p>Children with neuromuscular disorders with a progressive muscle weakness such as Duchenne Muscular Dystrophy and Spinal Muscular Atrophy frequently develop a progressive scoliosis. A severe scoliosis compromises respiratory function and makes sitting more difficult. Spinal surgery is considered the primary treatment option for correcting severe scoliosis in neuromuscular disorders. Surgery in this population requires a multidisciplinary approach, careful planning, dedicated surgical procedures, and specialized after care.</p> <p>Methods</p> <p>The guideline is based on scientific evidence and expert opinions. A multidisciplinary working group representing experts from all relevant specialties performed the research. A literature search was conducted to collect scientific evidence in answer to specific questions posed by the working group. Literature was classified according to the level of evidence.</p> <p>Results</p> <p>For most aspects of the treatment scientific evidence is scarce and only low level cohort studies were found. Nevertheless, a high degree of consensus was reached about the management of patients with scoliosis in neuromuscular disorders. This was translated into a set of recommendations, which are now officially accepted as a general guideline in the Netherlands.</p> <p>Conclusion</p> <p>In order to optimize the treatment for scoliosis in neuromuscular disorders a Dutch guideline has been composed. This evidence-based, multidisciplinary guideline addresses conservative treatment, the preoperative, perioperative, and postoperative care of scoliosis in neuromuscular disorders.</p

Culture and capital in the 1990s: private support for the arts and urban change in the Netherlands

In this paper I will describe the historical process of the development of arts and culture in the process of the modernization of the urban environment in the Netherlands. The development of cultural life in the city is placed against the background of the economic transformation of the city, the expansion of the government's cultural policy and the cultural changes in the urban environment. Special attention will be given to the efforts and involvement of the business community in the city's cultural life. This private initiative is described as those individuals or institutions who devoted themselves to the emergence of the cultural life in their environment. I will argue that the private initiative is slowly gaining importance. The paper will follow the historical development of the private initiative in the cultural life of the city in the Netherlands. I will distinguish three periods in this development. The first from the second half of the 19th century to WWII. The second runs from the WWII to 1980; and the third from 1980 onwards. -from Autho