Normering van kwaliteitszorg in de rechterlijke organisatie : een verkenning

In deze bijdrage zal ik eerst ingaan op kwaliteitsmanagement en de normering van kwaliteit in het algemeen. Vervolgens ga ik in op spanning tussen centrale sturing en autonomie en de betekenis van die spanning voor dienstverlenende organisaties van de overheid. Daarbij leg ik een verband met kwaliteitszorg als taakstelling voor deze organisatie. De uitkomsten van deze verkenning spits ik toe op de rechterlijke organisatie en op de vraag wat de wetgever met betrekking tot kwaliteitszorg zou moeten normeren. Ik sluit concluderend af met enige aanbevelingen voor de wetgever en voor rechters en gerechten

Архитектоника комплекса «Русской Правды» П.И. Пестеля

Данная статья посвящена П.И. Пестелю, одному из идеологов декабристского движения, лидеру Южного общества. Автор статьи исследует комплекс "Русской Правды" П.И. Пестеля, его структуру и основные пласты.Ця стаття присвячена П.І.Пєстелю, одному з ідеологів декабристського руху, лідеру Південного товариства. Автор статті досліджує комплекс "Російської Правди" П.І. Пєстеля, його структуру та головні пласти

Design of the muscles in motion study: a randomized controlled trial to evaluate the efficacy and feasibility of an individually tailored home-based exercise training program for children and adolescents with juvenile dermatomyositis

BACKGROUND: Juvenile dermatomyositis (JDM) is a rare, often chronic, systemic autoimmune disease of childhood, characterized by inflammation of the microvasculature of the skeletal muscle and skin. Prominent clinical features include significant exercise intolerance, muscle weakness, and fatigue. Despite pharmacological improvements, these clinical features continue to affect patients with JDM, even when the disease is in remission. Exercise training is increasingly utilized as a non-pharmacological intervention in the clinical management of (adult) patients with chronic inflammatory conditions; however no randomized controlled trials (RCT) have been performed in JDM. In the current study, the efficacy and feasibility of an exercise training program in patients with JDM will be examined. METHODS/DESIGN: Subjects (n = 30) will include 8–18 year olds diagnosed with JDM. The intervention consists of an individually tailored 12-weeks home-based exercise training program in which interval training on a treadmill is alternated with strength training during each session. The program is based on previous literature and designed with a defined frequency, intensity, time, and type of exercise (FITT principles). Primary outcome measures include aerobic exercise capacity, isometric muscle strength, and perception of fatigue. The study methodology has been conceived according to the standards of the CONSORT guidelines. The current study will be a multi-center (4 Dutch University Medical Centers) RCT, with the control group also entering the training arm directly after completion of the initial protocol. Randomization is stratified according to age and gender. DISCUSSION: The current study will provide evidence on the efficacy and feasibility of an individually tailored 12-week home-based exercise training program in youth with JDM. TRIAL REGISTRATION: Medical Ethics Committee of the University Medical Center Utrecht, the Netherlands: 11–336; Netherlands Trial Register (NTR): NTR 3184

Toedeling van zaken aan en binnen gerechten (2 delen)

This international comparative study was set up to make an inventory of ways to manage case assignment between and within courts. Index Part IIAustriaEngland and WalesItalyNetherlandsNorwayPortugalQuébec, CanadaDe doelstelling van dit project is om inzicht te verkrijgen in de wijze waarop andere landen hun stelsel van rechtspraak hebben ingericht (absolute en relatieve competentie). De huidige bepalingen over relatieve competentie worden als knellend ervaren. Zij raken aan belangrijke vragen over het rechtsbestel, bijvoorbeeld betreffende toegankelijkheid, beheersmatig optimale omvang, aansluiting bij competentie ketenpartners (politie, OM, deurwaarder, advocaten). Vragen: Hoe hebben te selecteren landen hun stelsel van rechtspraak ingericht? Welke knelpunten doen zich daarbij voor? Worden deze opgelost en zo ja hoe

Training specialists to write appropriate reply letters to general practitioners about patients with medically unexplained physical symptoms; A cluster-randomized trial.

Objective: To evaluate effects of a communication training for specialists on the quality of their reply letters to general practitioners (GPs) about patients with medically unexplained physical symptoms (MUPS). Methods: Before randomization, specialists included ≤3 MUPS patients in a multi-center cluster-randomized trial. In 14 h of MUPS-specific communication training, 2.5 h focused on reply letters. Letters were discussed with regard to reporting and answering GPs' referral questions and patients' questions, and to reporting findings, explaining MUPS with perpetuating factors and giving advice. After the training, all doctors again included ≤3 MUPS patients. Reply letters to GPs were assessed for quality and blindly rated on a digital scale. Results: We recruited 478 MUPS patients and 123 specialists; 80% of the doctors wrote ≥1 reply letters, 285 letters were assessed. Trained doctors reported (61% versus 37%, OR=2.55, F(1281)=6.60, pgroup*time=.01) and answered (63% versus 33%, OR=3.31, F(1281)=5.36, pgroup*time=.02) patients' questions more frequently than untrained doctors. Conclusion: Training improves reply letters with regard to patients' questions, but not with regard to the following: GPs' referral questions, somatic findings, additional testing, explaining, and advice. Practice implications: Training specialists to write appropriate reply letters needs more focus on explanation and advice