Norms and screening utility of the Dutch version of the children's depression inventory in clinical and nonclinical youths

This study aimed to (a) assess relationships between the Children's Depression Inventory (CDI) and DSM-oriented depression and anxiety scales of the Youth Self Report, (b) develop reliable norms for the CDI, and (c) determine CDI cutoff scores for selecting youngsters at risk for depression and anxiety. A total of 3,073 nonclinical and 511 clinically referred children and adolescents from The Netherlands and Belgium were included. Results showed that CDI scores were significantly related to DSM-oriented symptoms of both depression and anxiety. CDI scores correlated highly with depression symptoms and moderately with anxiety symptoms. Norms for the CDI were determined by means of multiple regression analysis and depended on sex, age, and country. CDI cutoff scores for selecting individuals at risk for depression and anxiety as measured by the DSM-oriented depression and anxiety scales of the Youth Self Report were determined by means of multiple regression analysis and receiver operating characteristic analysis. A CDI score of 16 was found to have the most optimal balance between sensitivity and specificity for depression, whereas a score of 21 provided the best sensitivity and specificity for anxiety in a subsample of children. We conclude that the CDI is an effective instrument for screening depression and to a lesser extent anxiety in primary and secondary care centers, before applying further assessment of high-risk individuals

Intensity of daily physical activity–a key component for improving physical capacity after minor stroke?

Purpose: Elucidating the complex interactions between physical activity (PA), a multidimensional concept, and physical capacity (PC) may reveal ways to improve rehabilitation interventions. This cross-sectional study aimed to explore which PA dimensions are related to PC in people after minor stroke. Materials and methods: Community dwelling individuals >6 months after minor stroke were evaluated with a 10-Meter-Walking-Test (10MWT), Timed-Up & Go, and the Mini Balance Evaluation System Test. The following PA outcomes were measured with an Activ8 accelerometer: counts per minute during walking (CPMwalking; a measure of intensity), number of active bouts (frequency), mean length of active bouts (distribution), and percentage of waking hours in upright positions (duration). Multivariable linear regression models, adjusted for age, sex and BMI, were used to assess the relationships between PC and PA outcomes. Results: Sixty-nine participants [62.2 ± 9.8 years, 61% male, 20 months post onset (IQR 13.0–53.5)] were included in the analysis. CPMwalking was significantly associated to PC in the 10MWT (std. β = 0.409, p = 0.002), whereas other associations between PA and PC were not significant. Conclusions: The PA dimension intensity of walking is significantly associated with PC, and appears to be an important tool for future interventions in rehabilitation after minor stroke.Implications for rehabilitation It is recommended to express physical activity after minor stroke in multiple dimensions such as intensity, frequency, duration and distribution. In particular, intensity of physical activity measured with accelerometer counts is most closely related to physical capacity. The findings of this study underline the importance of being physically active beyond a certain intensity. In future development of interventions and guidelines that aim to promote daily physical activity, intensity should be taken into account

The new global governors: Globalization, civil society, and the rise of private philanthropic foundations

One of the important drivers of change within contemporary global civil society is the growing power and influence of private philanthropic foundations (PPFs). In the analysis below, I consider the cases of the Bill and Melinda Gates Foundation (BMGF) and the Open Society Foundations (OSF), the largest and fourth largest PPFs in the world today by wealth or assets, and, especially, their founders. I consider their influence within global civil society, within the context of international development, and the consequences of their activities for a range of international actors. I do so in the context of debate within the literature on the activities of PPFs and I side with advocates of critical scrutiny. In developing my argument, I draw on a range of sources including the financial statements and audited accounts of PPFs, of other non-governmental organizations and of selected inter-governmental organizations. I argue that the BMGF and OSF are engines of neoliberalism and potent symbols of a second distinct ‘gilded age’ and that their influence must be restrained through anti-trust measures and through greater taxation and regulation

Increase in perceived case suspiciousness due to local contrast optimisation in digital screening mammography

Item does not contain fulltextOBJECTIVES: To determine the influence of local contrast optimisation on diagnostic accuracy and perceived suspiciousness of digital screening mammograms. METHODS: Data were collected from a screening region in the Netherlands and consisted of 263 digital screening cases (153 recalled,110 normal). Each case was available twice, once processed with a tissue equalisation (TE) algorithm and once with local contrast optimisation (PV). All cases had digitised previous mammograms. For both algorithms, the probability of malignancy of each finding was scored independently by six screening radiologists. Perceived case suspiciousness was defined as the highest probability of malignancy of all findings of a radiologist within a case. Differences in diagnostic accuracy of the processing algorithms were analysed by comparing the areas under the receiver operating characteristic curves (A(z)). Differences in perceived case suspiciousness were analysed using sign tests. RESULTS: There was no significant difference in A(z) (TE: 0.909, PV 0.917, P = 0.46). For all radiologists, perceived case suspiciousness using PV was higher than using TE more often than vice versa (ratio: 1.14-2.12). This was significant (P <0.0083) for four radiologists. CONCLUSIONS: Optimisation of local contrast by image processing may increase perceived case suspiciousness, while diagnostic accuracy may remain similar. KEY POINTS: Variations among different image processing algorithms for digital screening mammography are large. Current algorithms still aim for optimal local contrast with a low dynamic range. Although optimisation of contrast may increase sensitivity, diagnostic accuracy is probably unchanged. Increased local contrast may render both normal and abnormal structures more conspicuous.1 april 201

Using computer-aided detection in mammography as a decision support

Contains fulltext : 87548.pdf (publisher's version ) (Closed access)OBJECTIVE: To evaluate an interactive computer-aided detection (CAD) system for reading mammograms to improve decision making. METHODS: A dedicated mammographic workstation has been developed in which readers can probe image locations for the presence of CAD information. If present, CAD findings are displayed with the computed malignancy rating. A reader study was conducted in which four screening radiologists and five non-radiologists participated to study the effect of this system on detection performance. The participants read 120 cases of which 40 cases had a malignant mass that was missed at the original screening. The readers read each mammogram both with and without CAD in separate sessions. Each reader reported localized findings and assigned a malignancy score per finding. Mean sensitivity was computed in an interval of false-positive fractions less than 10%. RESULTS: Mean sensitivity was 25.1% in the sessions without CAD and 34.8% in the CAD-assisted sessions. The increase in detection performance was significant (p = 0.012). Average reading time was 84.7 +/- 61.5 s/case in the unaided sessions and was not significantly higher when interactive CAD was used (85.9 +/- 57.8 s/case). CONCLUSION: Interactive use of CAD in mammography may be more effective than traditional CAD for improving mass detection without affecting reading time.1 oktober 201

A longitudinal study on the relations among fear-enhancing parenting, cognitive biases, and anxiety symptoms in non-clinical children

This longitudinal study explored the relations between fear-enhancing parenting behaviors (modeling and threat information transmission) and children's cognitive biases and anxiety symptoms on three subsequent time points over a one-year period. Participants were 216 children aged 7-12 years (114 boys and 102 girls), and their mothers (n = 199) and/or fathers (n = 117). On each time point, children and parents completed the Parental Enhancement of Anxious Cognitions scale, which measures parental modeling and threat information transmission. Furthermore, children filled in a measure of anxiety disorder symptoms. In addition, confirmation bias and interpretation bias were measured by means of a number of computerized tasks. The results yielded support for a circular model in which cognitive biases enhanced anxiety symptoms, which in turn promoted cognitive biases on each of the three time points. However, no evidence was found for longitudinal effects of cognitive biases on anxiety or vice versa. In contrast to what we expected, cognitive biases and anxiety appeared to promote parental modeling and threat information rather than the other way around. These findings extend research on the relations between parenting behaviors, cognitive biases, and childhood anxiety symptoms, and suggest valuable leads for assessment and intervention

Milieudossier: Koppeling NO2-blootstelling aan enquête biedt inzicht in gezondheidseffecten.

Blootstelling aan vooral fijnstof en stikstofdioxide (NO2) gaat gepaard met een aanzienlijke ziektelast, ook bij de huidige in Nederland voorkomende concentraties. Met name NO2 is geschikt voor lokaal onderzoek naar mogelijke associaties tussen luchtkwaliteit en gezondheid. In de stad Utrecht wordt sinds januari 2011 op ongeveer vijftig punten NO2 gemeten. Op basis van deze meetgegevens is een ‘Land Use Regression’ (LUR)- model ontwikkeld. De modeluitkomsten zijn vervolgens gekoppeld aan de gemeentelijke gezondheidsenquête. Hierdoor konden mogelijke associaties tussen NO2 en een aantal sociaaleconomische factoren en ziekten worden geanalyseer