Corporate Governance in the Netherlands

This study answers some elimentary questions about Dutch shareholding structures, such as the structure in the Netherlands in comparison with other countries and the change in investors groups' interests in shares investments. We concentrate on banks. Banks have a particular position in that they can be a lender as well as an investor in a certain company. Their investments' possibilities in risky assets have always been restricted in order to protect the bank's creditors, though these restrictions weakened in the early eighties. We provide insights in their portfolio investments' behaviour. In addition to this statistical evidence, the recent Dutch discussion on corporate governance is summarized. This can encourage an international discussion

How about your peers? Cystic fibrosis questionnaire data from healthy children and adolescents

Contains fulltext : 97967.pdf (publisher's version ) (Open Access)BACKGROUND: The Cystic Fibrosis Questionnaire (CFQ) is widely used in research as an instrument to measure quality of life in patients with cystic fibrosis (CF). In routine patient care however, measuring quality of life is still not implemented in guidelines. One of the reasons might be the lack of consensus on how to interpret CFQ scores of an individual patient, because appropriate reference data are lacking. The question which scores reflect normal functioning and which scores reflect clinically relevant problems is still unanswered. Moreover, there is no knowledge about how healthy children and adolescents report on their quality of life (on the CFQ). With regard to quality of life the effect of normal development should be taken into account, especially in childhood and adolescence. Therefore, it is important to gain more knowledge about how healthy children and adolescents report on their quality of life and if there are any difference in a healthy populations based on age or gender. Without these data we cannot adequately interpret the CFQ as a tool in clinical care to provide patient-tailored care. Therefore this study collected data of the CFQ in healthy children and adolescents with the aim to refer health status of CF youngsters to that of healthy peers. METHODS: The CFQ was completed by 478 healthy Dutch children and adolescents (aged 6-20) in a cross-sectional study. RESULTS: The majority of healthy children (over 65%) did not reach maximum scores on most domains of the CFQ. Median CFQ-scores of healthy children and adolescents ranged from 67 to 100 (on a scale of 0-100) on the different CFQ-domains. Significant differences in quality of life exist among healthy children and adolescents, and these depend on age and gender. CONCLUSIONS: Reference data of quality of life scores from a healthy population are essential for adequate interpretation of quality of life in young patients with CF. Clinicians should be aware that the perception of health-related quality of life is not as disease-specific as one might think and also relies on factors such as age, normal maturation and gender

Heuristics for practitioners of policy design: Rules-of-thumb for structuring unstructured problems

This article is an attempt to bridge the divide between academics and practitioners. Informed by both design theory and the reality of policy work, its focus is on ‘problems’. From a practitioners’ perspective, policy design is both an intellectual and political process, an inevitable oscillation between ‘puzzling’ and ‘powering’, in which ‘messy’ or unstructured problems are re-structured from problems as webs of ‘undesirable situations’ to problems as specific, time-and-space bound ‘opportunities for improve- ment’. This requires a questioning habitus in practitioners of policy design. Using a socio-cognitive theory of problem processing, this paper shows how policy design is an iterative process of problem sensing, problem categorization, problem decompos- ition and problem definition. For each of these stages, appropriate rules-of-thumb for questioning and answering can be suggested that induce thought habits and styles for responsive and solid policy designs

The global impact of non-communicable diseases on macro-economic productivity: a systematic review

© 2015, The Author(s). Non-communicable diseases (NCDs) have large economic impact at multiple levels. To systematically review the literature investigating the economic impact of NCDs [including coronary heart disease (CHD), stroke, type 2 diabetes mellitus (DM), cancer (lung, colon, cervical and breast), chronic obstructive pulmonary disease (COPD) and chronic kidney disease (CKD)] on macro-economic productivity. Systematic search, up to November 6th 2014, of medical databases (Medline, Embase and Google Scholar) without language restrictions. To identify additional publications, we searched the reference lists of retrieved studies and contacted authors in the field. Randomized controlled trials, cohort, case–control, cross-sectional, ecological studies and modelling studies carried out in adults (>18 years old) were included. Two independent reviewers performed all abstract and full text selection. Disagreements were resolved through consensus or consulting a third reviewer. Two independent reviewers extracted data using a predesigned data collection form. Main outcome measure was the impact of the selected NCDs on productivity, measured in DALYs, productivity costs, and labor market participation, including unemployment, return to work and sick leave. From 4542 references, 126 studies met the inclusion criteria, many of which focused on the impact of more than one NCD on productivity. Breast cancer was the most common (n = 45), followed by stroke (n = 31), COPD (n = 24), colon cancer (n = 24), DM (n = 22), lung cancer (n = 16), CVD (n = 15), cervical cancer (n = 7) and CKD (n = 2). Four studies were from the WHO African Region, 52 from the European Region, 53 from the Region of the Americas and 16 from the Western Pacific Region, one from the Eastern Mediterranean Region and none from South East Asia. We found large regional differences in DALYs attributable to NCDs but especially for cervical and lung cancer. Productivity losses in the USA ranged from 88 million US dollars (USD) for COPD to 20.9 billion USD for colon cancer. CHD costs the Australian economy 13.2 billion USD per year. People with DM, COPD and survivors of breast and especially lung cancer are at a higher risk of reduced labor market participation. Overall NCDs generate a large impact on macro-economic productivity in most WHO regions irrespective of continent and income. The absolute global impact in terms of dollars and DALYs remains an elusive challenge due to the wide heterogeneity in the included studies as well as limited information from low- and middle-income countries.WHO; Nestle´ Nutrition (Nestec Ltd.); Metagenics Inc.; and AX

Identity, presence and signification of chlorination products of humuc acid in aqueous medium.

During chlorination of cyanoethanoic acid at pH=10 a number of compounds is formed. The compounds were confirmed with synthetic standards with GC and mass-spectrometry (MSD). The endproducts of the reaction at pH=10 were dichloroacetic acid, dichloromalonic acid and a small amount of trichloroacetic acid. Intermediates were dichloroacetonitrile (DCAN) and N-chloroacetamides. These N-chloroacetamides were previously errorneously identified as hydroxamoyl chlorides. Mutagenicity tests showed that only DCAN is mutagenic. The total of the mutagenicity of the chlorination mixture can be declared by this compound. In samples drinking water derived from plants where chlorine is used DCAN is detected (0.04-1.05 mug/L). At this concentration level the health risks are very small. The strong bacterial mutagen 'MX' is detected in chlorinated river water (Rhine and Meuse). In these samples the accounted contribution of MX on the measured mutagenic activity (Salmonella typhimurium TA 100) is appr. 20%. In samples drinking water no MX is detected. By chlorination with a higher dose than used for postdesinfection the compound can be formed. It seems to be that the most important mutagens will be organic acids isolated at low pH. The application of chlorine during the production of drinking water has to be limited for emergencies to maintain the bacteriologic quality.DGM/DWB-D Trouwborst

The chlorination of cyanoethanoic acid in aqueous medium

Bij de chlorering van aminozuren, aanwezig in humuszuren, in waterig milieu ontstaan cyaanalkaanzuren. Vooral cyaanazijnzuur reageert snel met chloor ; bij pH 10 werden naast zuren meerdere intermediairen gevormd, deze werden als amides en hydroxamoylchlorides geidentificeerd. In een vooronderzoek bleek de mutageniteit van het reactiemengsel aanzienlijk te zijn. In dit onderzoek zijn de verschillende verbindingen gesynthetiseerd om de identificatie te bevestigen en de mutageniteit van de afzonderlijke stoffen te testen. Bij de reactie van cyaanazijnzuur met chloor in waterig milieu bij verschillende pH waarden werden dichloorazijnzuur, dichloormalonzuur en in mindere mate trichloorazijnzuur gevormd als eindprodukt. Bij pH 4 en 7 werd alleen dichlooracetonitril als intermediair gedetecteerd, terwijl bij pH 10 ook nog N-chloor dichlooraceetamide, N-chloor trichlooraceetamide en N-chloor dichloormalonmonoamide werden aangetoond. Door een ongebruikelijke reactie van N-chlooramides met diazomethaan waarbij imidaten werden gevormd zijn deze ten onrechte als gemethyleerde amides en hydroxamoylchlorides geidentificeerd. De mutageniteit van het reactiemengsel kon worden verklaard door de hoeveelheid dichloroacetonitril die werd aangetroffen.DGM/DWB-D /Trouwborst

Determination of halo-acetic acids, chlorite and chlorate in drinking water.

A method was developed to determine halo-acetic acids with a detection limit of 0.1 mug/L. Halo-acetic acids were determined in samples drinking water derived from surface- and bankfiltrated water however, not in drinking water derived from groundwater. Halo-acetic acids were found in chlorinated and non-chlorinated drinking waters. The total acetic-acid concentrations were in the range of 0.1-14.7 mug/L. In chlorinated drinking water the total amount of these acids was always higher than in non-chlorinated drinking water. Brominated acetic-acids accounted for 65% of the total acid concentration showing that brominated compounds form a large part of the halogenated products. In a few samples river water and drinking water chlorite and chlorate were analysed. These compounds were found in river water and in drinking water derived from bank filtrated water. The results of the analyses have to be confirmed. The chlorate in the drinking water samples can be originated in the raw water source and/or as a pollution in sodium-hypochlorite solution used for chlorination. More research has has to be done to examine this phenomenon into more detail.DGM/DWB-

Nerve conduction studies after decompression in painful diabetic polyneuropathy

Purpose: To investigate the influence of nerve decompression at potential entrapment sites in the lower extremity in painful diabetic polyneuropathy on nerve conduction study variables. Methods: Forty-two patients with painful diabetic polyneuropathy were included in this prospective randomized controlled trial. Preoperative nerve conduction studies were performed bilaterally. Each patient underwent unilateral surgical decompression of the tibial nerve and common, superficial, and deep peroneal nerves. The contralateral side was used as a control: within-patient comparison. One year postoperatively, the nerve conduction studies were repeated. Univariate paired sample T-tests and a multivariate analysis of variance were performed to compare data. Results: In univariate analysis of the peroneal nerve, the distal compound muscle action potential amplitude measured at the extensor digitorum brevis muscle of the intervention legs decreased significantly, as did the area drop measured at the extensor digitorum brevis muscle of the control legs. The distal motor latency measured at the extensor digitorum brevis muscle of the intervention legs increased significantly, as did the distal compound muscle action potential amplitude measured at the anterior tibial muscle of the control legs. For the tibial nerve, the distal compound muscle action potential duration decreased significantly in the control legs. The multivariate analysis showed no significance overall. Conclusions: Decompression of nerves of the lower extremity in patients with painful diabetic polyneuropathy has no beneficial effect on nerve conduction study variables 12 months after surgery