De stad Groningen als roltrap van Noord-Nederland

De bevolkingsgroei van Noord-Nederland neemt sinds 2001 gestaag af. In 2005 werd het voorlopige dieptepunt bereikt en daalde het aantal inwoners van de noordelijke provincies zelfs licht. Achter deze bevolkingsontwikkeling gaat een interessante dynamiek schuil, waarbij de drie noordelijke provincies zeer verschillende verhuispatronen blijken te hebben. Het stadsgewest Groningen functioneert als 'opwerkfabriek' voor jongeren die uit alle uithoeken van Noord-Nederland naar het stadsgewest trekken. Na enkele jaren van vergaren van kenniskapitaal stromen de dan wat oudere jongeren weer uit. Ze vertrekken vooral naar West- Nederland, waar ze een grotere kans maken op inkomensstijging. Deze ontwikkelingen zijn een indicatie van de braindrain uit de regio

Frequency of alterations in qSOFA, SIRS, MEWS and NEWS scores during the emergency department stay in infectious patients:a prospective study

BACKGROUND: For emergency department (ED) patients with suspected infection, a vital sign-based clinical rule is often calculated shortly after the patient arrives. The clinical rule score (normal or abnormal) provides information about diagnosis and/or prognosis. Since vital signs vary over time, the clinical rule scores can change as well. In this prospective multicentre study, we investigate how often the scores of four frequently used clinical rules change during the ED stay of patients with suspected infection. METHODS: Adult (≥ 18 years) patients with suspected infection were prospectively included in three Dutch EDs between March 2016 and December 2019. Vital signs were measured in 30-min intervals and the quick Sequential Organ Failure Assessment (qSOFA) score, the Systemic Inflammatory Response Syndrome (SIRS) criteria, the Modified Early Warning Score and the National Early Warning Score (NEWS) score were calculated. Using the established cut-off points, we analysed how often alterations in clinical rule scores occurred (i.e. switched from normal to abnormal or vice versa). In addition, we investigated which vital signs caused most alterations. RESULTS: We included 1433 patients, of whom a clinical rule score changed once or more in 637 (44.5%) patients. In 6.7–17.5% (depending on the clinical rule) of patients with an initial negative clinical rule score, a positive score occurred later during ED stay. In over half (54.3–65.0%) of patients with an initial positive clinical rule score, the score became negative later on. The respiratory rate caused most (51.2%) alterations. CONCLUSION: After ED arrival, alterations in qSOFA, SIRS, MEWS and/or NEWS score are present in almost half of patients with suspected infection. The most contributing vital sign to these alterations was the respiratory rate. One in 6–15 patients displayed an abnormal clinical rule score after a normal initial score. Clinicians should be aware of the frequency of these alterations in clinical rule scores, as clinical rules are widely used for diagnosis and/or prognosis and the optimal moment of assessing them is unknown

The impact of family structure and disruption on intergenerational emotional exchange in Eastern Europe

Demographic trends across Europe involve a decrease in fertility and mortality rates, and an increase in divorce and stepfamily formation. Life courses and living arrangements have become less standardized and the structure of families has changed. In this article, we examine to what extent contemporary family structure and composition resulting from demographic changes affect emotional exchange between children and their parents, both from adult child to parent and from parent to child. Because the general level of well-being has been shown to be lower in Eastern Europe, thereby potentially affecting emotional exchange within families, we focus our research on Eastern Europe. We use the “conservation of resources theory” to derive hypotheses on how family structure may affect intergenerational emotional exchange. Family ties are assumed to be important resources of affection that people want to obtain and retain throughout their lives. Data from the Generations and Gender Survey (GGS) are used to test our hypotheses. In general, our data offer more support for the idea that families are resilient than for the often heard assumption that families are in decline as a consequence of the changed family structure and composition

Human Capital Migration: A Longitudinal Perspective

Based on micro‐level administrative data this paper aims to identify the role of internal migration in shaping regional and inter‐urban contrasts in human capital stocks in the Netherlands. We follow birth cohort 1979 from age 16 until age 35 and compare spatial trajectories between university graduates(‐to‐be) and their lower educated peers. We conclude that, in a context of dominating rural‐to‐urban migration flows, the highest educated(‐to‐be) are more than others attracted to metropolitan core areas and the Randstad. Second, we aim to test whether this urban preference may be prompted by spatial variation in socio‐economic progression by comparing changes in the relative wage position of employees in different spatial settings. Metropolitan settings and the Randstad in general are found to function more than other regions as socio‐economic escalators during the first phase of the labour career. However, these effects appear to be equal among educational groups

Toenemende ruimtelijke verschillen in opleiding

Met de bloei van de Randstadmetropolen neemt in Nederland het contrast tussen grootstedelijke dertigers en hun leeftijdgenoten buiten de Randstad toe. Het kenniskapitaal en inkomen van dertigers in perifeer gelegen regio’s is de afgelopen vijftien jaar achterop geraakt bij dat van leeftijdgenoten in de Randstad. In Groot-Amsterdam is inmiddels ruim één op de vier dertigers een academicus. In de kop van Noord-Holland slechts één op de veertien