Assessment of ultrasonography and computed tomography in the diagnostic strategy of suspected appendicitis

In this thesis the assessment of ultrasonography (US) and Computed Tomography (CT) in the diagnostic strategy of suspected appendicitis is presented. The first study showed that focused single-detector helical CT as well as graded compression US performed in a general community teaching hospital by both body imaging radiologists and general radiology staff members have a similar accuracy for the diagnosis of acute appendicitis. A second study showed that in interpreting CT images the expertise of the attending radiologist should be considered. A third study showed that gender seems to affect the accuracy of US and CT in patients suspected of acute appendicitis. A fourth study showed that US as a sole imaging tool is of limited value both in women with unequivocal and in women with equivocal signs of appendicitis. A fifth study showed that US and CT implemented in a diagnostic pathway yields a high diagnostic accuracy for acute appendicitis without adverse events due to delay in treatment. A sixth study showed that for a majority of the surgeons, the diagnosis of acute appendicitis is based on clinical signs and symptoms. US and CT can be valuable in diagnosing appendicitis but further cooperation between surgeons and radiologists is required.Parfier Financieel Advies SAP Philips Healthcare Covidien Amgen Roche Johnson & Johnson Medical BV ZR-Adviseurs Den Bosch Duo-Med Pfizer Nycomed Nestlé Chipsoft Sanofi-Aventis I-FourC Stryker B.Braun Medical Baxter Pro Motion Medical B.V. 3M Bard Synthes KCI Novartis OncologyUBL - phd migration 201

Teaching Excellence Programs – Lessons Learned at two Universities

Universities are seeking novel ways to strengthen the collective educational competence of their faculty and promote educational merits. In this paper we describe and compare the experiences of two recently started initiatives for teaching excellence, the Program for Future Leaders for Strategic Educational Development at KTH Royal Institute of Technology (henceforth KTH) and the Teaching Fellowship Programme at the University of Twente. Both programs have recently completed one complete round of implementation. The programmes are similar in that the participants work on a project of their own for an extended time, while also being part of a community with regular meetings and supported by coaches. The main differences are the programme duration, number of participants, and whether the projects are in a specific theme or wholly formulated by the participants. In this study, both programs are evaluated using similar themes. We analyse this data, and reflect on the context, conditions and design of the programs and our lessons learned from these first experiences.</p

Partners in crime? De invloed van crimineel gedrag op huwelijkskansen en partnerselectie

Summary: Partners in crime? The impact of criminal behaviour on marriage formation and partner selection. Although it is well established that marriage has the potential to foster desistance from crime, little attention has been paid to offenders’ marital chances. The few studies examining the effects of criminal behaviour on marriage formation, have not taken into account the criminal behaviour of spouses. We employ data from the Criminal Career and Life-Course Study (N = 4,615) to examine the marital and criminal careers of both offenders and their marriage partners far into adulthood. The results show that a criminal history is strongly related to outcomes in the marriage market. The higher the number of offenses, the lower the odds of marrying and the higher the odds of marrying a criminal partner

Age Trajectories of the Structural Connectome in Child and Adolescent Offspring of Individuals With Bipolar Disorder or Schizophrenia

Background: Offspring of parents with severe mental illness (e.g., bipolar disorder or schizophrenia) are at elevated risk of developing psychiatric illness owing to both genetic predisposition and increased burden of environmental stress. Emerging evidence indicates a disruption of brain network connectivity in young offspring of patients with bipolar disorder and schizophrenia, but the age trajectories of these brain networks in this high-familial-risk population remain to be elucidated. Methods: A total of 271 T1-weighted and diffusion-weighted scans were obtained from 174 offspring of at least 1 parent diagnosed with bipolar disorder (n = 74) or schizophrenia (n = 51) and offspring of parents without severe mental illness (n = 49). The age range was 8 to 23 years; 97 offspring underwent 2 scans. Anatomical brain networks were reconstructed into structural connectivity matrices. Network analysis was performed to investigate anatomical brain connectivity. Results: Offspring of parents with schizophrenia had differential trajectories of connectivity strength and clustering compared with offspring of parents with bipolar disorder and parents without severe mental illness, of global efficiency compared with offspring of parents without severe mental illness, and of local connectivity compared with offspring of parents with bipolar disorder. Conclusions: The findings of this study suggest that familial high risk of schizophrenia is related to deviations in age trajectories of global structural connectome properties and local connectivity strength.</p

Age Trajectories of the Structural Connectome in Child and Adolescent Offspring of Individuals With Bipolar Disorder or Schizophrenia

Background: Offspring of parents with severe mental illness (e.g., bipolar disorder or schizophrenia) are at elevated risk of developing psychiatric illness owing to both genetic predisposition and increased burden of environmental stress. Emerging evidence indicates a disruption of brain network connectivity in young offspring of patients with bipolar disorder and schizophrenia, but the age trajectories of these brain networks in this high-familial-risk population remain to be elucidated. Methods: A total of 271 T1-weighted and diffusion-weighted scans were obtained from 174 offspring of at least 1 parent diagnosed with bipolar disorder (n = 74) or schizophrenia (n = 51) and offspring of parents without severe mental illness (n = 49). The age range was 8 to 23 years; 97 offspring underwent 2 scans. Anatomical brain networks were reconstructed into structural connectivity matrices. Network analysis was performed to investigate anatomical brain connectivity. Results: Offspring of parents with schizophrenia had differential trajectories of connectivity strength and clustering compared with offspring of parents with bipolar disorder and parents without severe mental illness, of global efficiency compared with offspring of parents without severe mental illness, and of local connectivity compared with offspring of parents with bipolar disorder. Conclusions: The findings of this study suggest that familial high risk of schizophrenia is related to deviations in age trajectories of global structural connectome properties and local connectivity strength.</p

Labor and Love: Wives' Employment and Divorce Risk in its Socio-political Context

We theorize how social policy affects marital stability vis-à-vis macro and micro effects of wives' employment on divorce risk in 11 Western countries. Correlations among 1990s aggregate data on marriage, divorce, and wives' employment rates, along with attitudinal and social policy information, seem to support specialization hypotheses that divorce rates are higher where more wives are employed and where policies support that employment. This is an ecological fallacy, however, because of the nature of the changes in specific countries. At the micro level, we harmonize national longitudinal data on the most recent cohort of wives marrying for the first time and find that the stabilizing effects of a gendered division of labor have ebbed. In the United States with its lack of policy support, a wife's employment still significantly increases the risk of divorce. A wife's employment has no significant effect on divorce risk in Australia, Flanders, France, Germany, Italy, the Netherlands, and the United Kingdom. In Finland, Norway, and Sweden, wives' employment predicts a significantly lower risk of divorce when compared with wives who are out of the labor force. The results indicate that greater policy support for equality reduces and may even reverse the relative divorce risk associated with a wife's employment.This is a pre-copy-editing, author-produced PDF of an article accepted for publication in Social Policy following peer review. The definitive publisher-authenticated version "Labor and Love: Wives' Employment and Divorce Risk in Its Socio-political Context / Lynn Prince Cooke, Jani Erola, Marie Evertsson, Michael Gähler, Juho Härkönen, Belinda Hewitt, Marika Jalovaara, Man-Yee Kan, Torkild Hovde Lyngstad, Letizia Mencarini, Jean-Francois Mignot, Dimitri Mortelmans, Anne-Rigt Poortman, Christian Schmitt, Heike Trappe. In: Social Politics 20 (2013), 4, pp. 482-509" is available online at: http://dx.doi.org/10.1093/sp/jxt01

Workplace Learning in Dual Higher Professional Education

Workplace learning is considered an effective strategy for the development of vocation, career and professional identity. Dual training programs, in which learning at a vocational school and learning at work in a company are combined, are seen as strong carriers for skill formation processes. In this study we explore workplace learning in dual training programs in Dutch higher professional education. To gain an understanding of these learning environments and processes, a qualitative multiple case study was conducted in seven sectors. The findings show substantial differences in learning environments between and within sectors. However, cooperation between school and practice is minimal in all of the cases. Although students develop personal and job-related competencies that are useful for daily work routines, they acquire hardly any profound theoretical knowledge at the workplace. School fails to direct workplace learning. Given the considerable share of workplace learning in dual training programs, and the demands to higher professional education graduates in terms of being able to solve complex problems and develop new knowledge during their career as reflective practitioners, it is important that these shortcomings are resolved. More promising alternatives for workplace learning environments and questions for further research to improve workplace learning in higher professional education are discussed

Age Trajectories of the Structural Connectome in Child and Adolescent Offspring of Individuals With Bipolar Disorder or Schizophrenia

Background: Offspring of parents with severe mental illness (e.g., bipolar disorder or schizophrenia) are at elevated risk of developing psychiatric illness owing to both genetic predisposition and increased burden of environmental stress. Emerging evidence indicates a disruption of brain network connectivity in young offspring of patients with bipolar disorder and schizophrenia, but the age trajectories of these brain networks in this high-familial-risk population remain to be elucidated. Methods: A total of 271 T1-weighted and diffusion-weighted scans were obtained from 174 offspring of at least 1 parent diagnosed with bipolar disorder (n = 74) or schizophrenia (n = 51) and offspring of parents without severe mental illness (n = 49). The age range was 8 to 23 years; 97 offspring underwent 2 scans. Anatomical brain networks were reconstructed into structural connectivity matrices. Network analysis was performed to investigate anatomical brain connectivity. Results: Offspring of parents with schizophrenia had differential trajectories of connectivity strength and clustering compared with offspring of parents with bipolar disorder and parents without severe mental illness, of global efficiency compared with offspring of parents without severe mental illness, and of local connectivity compared with offspring of parents with bipolar disorder. Conclusions: The findings of this study suggest that familial high risk of schizophrenia is related to deviations in age trajectories of global structural connectome properties and local connectivity strength