Evaluatie Tijdelijke wet Groningen

Het rapport evalueert de Tijdelijke wet Groningen (TwG). Het geeft belangrijke conclusies over de doelen van de TwG en de uitwerking van de wet in de praktijk

Assessing prime-ministerial performance in a multi-party democracy : the Dutch case

This article discusses the use of expert ranking methodology for assessing the performance and ‘place in history’ of heads of government, in particular prime ministers (PMs). It reports an expert ranking study of PMs in the Netherlands. Open/spontaneous as well as criteria-led, more detailed modes of performance assessment are compared. Moreover, the study’s findings, pertaining as they do to a PM hemmed in by the need to manage tenuous coalitions in a multi-party consensual democracy, are compared against those of similar exercises conducted for PMs in majoritarian, Westminster style democracies, suggesting that prime-ministerial reputations in multiparty democracies are made on the strength of their longevity in office, their coalition management skills and the policy legacy of their governments

Getting out the most of the combination of working and learning: The case of teachers-in-training in Flanders

© 2016, Instituto Superior de Psicologia Aplicada, Lisboa, Portugal and Springer Science+Business Media Dordrecht. The current study investigates the learning of student teachers in alternative programmes in which they combine a teaching job with an in-service teacher-training program at the university. The aim of this paper is to explore which work-related and training-programme related factors facilitate the learning of these teachers-in-training in the workplace. Starting from the framework of the Job-Demands-Control-Support model, a total of 11 teachers were interviewed. Results of the qualitative analyses indicated that high levels of job demands, autonomy and social support were important for in-service student teachers’ learning in the workplace. Social support and guidance from colleagues in the workplace seemed more relevant for learning than the support and guidance from the supervisors from the teaching program at the university. Implications for practice and for further research are discussed.status: publishe

Getting out the most of the combination of working and learning : the case of teachers-in-training in Flanders

status: publishe

Leicester Cough Questionnaire validation and clinically important thresholds for change in refractory or unexplained chronic cough

Introduction: The Leicester Cough Questionnaire (LCQ), a cough-specific quality-of-life measure, evaluates the impact of cough across physical, psychological, and social domains in patients with chronic cough (CC). This study assessed the psychometric properties of the LCQ. Methods: Data from a phase IIb, randomized controlled trial of the P2X3-receptor antagonist gefapixant were analyzed (NCT02612610). Subjective [Cough Severity Diary, cough severity visual analogue scale, and patient global impression of change (PGIC)] and objective (awake and 24-h cough frequency) data were used to validate the LCQ for use in patients with refractory or unexplained CC (RCC and UCC, respectively). Psychometric analyses included confirmatory factor analyses, internal consistency and test–retest reliability, validity, responsiveness, and estimated within-patient thresholds for clinically meaningful change. Results: Model-fit values for the proposed three-factor LCQ domains and most individual items were acceptable. Analyses suggest that a mean improvement ranging from 1.3 to 2.3 points for the LCQ total and ⩾0.8, ⩾0.9, and ⩾0.8 points for physical, psychological, and social domain scores, respectively, had the best sensitivity and/or specificity for predicting patient ratings of improvement on the PGIC. Conclusions: The LCQ is a valid and reliable measure to evaluate cough-specific quality of life and is a fit-for-purpose measure for use in patients with RCC or UCC. Although a single threshold for defining clinically meaningful change depends on the context of use, the results can help guide both treatment decisions and drug development. Therefore, clinicians may consider a ⩾1.3-point increase in the LCQ total score as clinically meaningful

Validation of a visual analog scale for assessing cough severity in patients with chronic cough

INTRODUCTION: Patients with chronic cough experience considerable burden. The cough severity visual analog scale (VAS) records patients’ assessment of cough severity on a 100-mm linear scale ranging from “no cough” (0 mm) to “worst cough” (100 mm). Although cough severity scales are widely used in clinical practice and research, their use in patients with refractory or unexplained chronic cough has not been formally validated. METHODS: This analysis includes data from a phase 2b randomized controlled trial of the P2X3-receptor antagonist gefapixant for treatment of refractory or unexplained chronic cough (NCT02612610). Cough severity VAS scores were assessed at baseline and Weeks 4, 8, and 12. The cough severity VAS was validated using several outcomes, including the Cough Severity Diary (CSD), Leicester Cough Questionnaire (LCQ), patient global impression of change (PGIC) scale, and objective cough frequency. Validation metrics included test–retest reliability, convergent and known-groups validity, responsiveness, and score interpretation (i.e., clinically meaningful change threshold). RESULTS: The analysis included 253 patients (median age, 61.0 years; females, 76%). Test–retest reliability of the cough severity VAS was moderate (intraclass correlation coefficient, 0.51). The cough severity VAS had acceptable convergent validity with other related measures (Pearson r of 0.53 and -0.41 for CSD and LCQ total scores, respectively; p < 0.0001 for each). Known-groups validity was supported by significant differences in mean cough severity VAS scores across severity groups defined using CSD, LCQ, and cough frequency tertiles. A large effect size was observed in patients with the greatest improvements in PGIC (Cohen d = -1.8). A ⩾ 30-mm reduction in the cough severity VAS was estimated as a clinically meaningful change threshold for clinical trials in chronic cough. CONCLUSIONS: The cough severity VAS is a valid and responsive measure. A cough severity VAS reduction of ⩾ 30 mm can discriminate clinically meaningful changes in chronic cough severity in clinical studies

High-resolution 18F-FDG PET/CT for assessing three-dimensional intraoperative margins status in malignancies of the head and neck, a proof-of-concept

The surgical treatment of head and neck malignancies relies on the complete removal of tumoral tissue, while inadequate margins necessitate the use of adjuvant therapy. However, most positive margins are identified postoperatively as deep margins, and intraoperative identification of the deep positive margins could help achieve adequate surgical margins and decrease adjuvant therapies. To improve deep-margin identification, we investigated whether the use of high-resolution preclinical PET and CT could increase certainty about the surgical margins in three dimensions. Patients with a malignancy of the head and neck planned for surgical resection were administered a clinical activity of 4MBq/kg F-18-FDG approximately one hour prior to surgical initiation. Subsequently, the resected specimen was scanned with a micro-PET-CT imaging device, followed by histopathological assessment. Eight patients were included in the study and intraoperative PET/CT-imaging of 11 tumoral specimens and lymph nodes of three patients was performed. As a result of the increased resolution, differentiation between inflamed and dysplastic tissue versus malignant tissue was complicated in malignancies with increased peritumoral inflammation. The current technique allowed the three-dimensional delineation of F-18-FDG using submillimetric PET/CT imaging. While further optimization and patient stratification is required, clinical implementation could enable deep margin assessment in head and neck resection specimens

Potential application of [18F]AlF-PSMA-11 PET/CT in radioiodine refractory thyroid carcinoma

Background Patients diagnosed with radioiodine refractory (RAI-R) thyroid carcinoma (TC) have a significantly worse prognosis than patients with radiosensitive TC. These refractory malignancies are often dedifferentiated, hindering the effectiveness of iodine-based imaging. Additionally, the role of metabolic imaging using [F-18]FDG PET/CT is also limited in these cases, making adequate staging of RAI-R TC challenging. Recent case series have shown promising results regarding the role of the prostate-specific membrane antigen (PSMA) in TC. In this study we explored the value of [F-18]AlF-PSMA-11 PET/CT in RAI-R TC. Methods In this phase II study, lesions detected on [F-18]AlF-PSMA-11 PET were compared to findings from [18F]FDG PET/CT. Additionally, the serologic soluble prostate-specific membrane antigen (sPSMA) was measured using ELISA. PSMA-expression on tumor tissue in any available resection specimens was analysed with an immunostainer. Results Eight patients were included, with a total of 39 identified lesions based on PET imaging. [18F]AlF-PSMA-11 PET identified 30 of 39 lesions, and [F-18]FDG PET identified 33 lesions, leading to a detection rate of 76.9% and 84.6%, respectively. Interestingly, while nine lesions were solely visualized on [F-18]FDG, six were uniquely seen on [F-18]AlF-PSMA-11 PET. While sPSMA was immeasurable in all female patients, no correlation was found between sPSMA in male patients and disease-related factors. In five out of eight patients immunohistology showed PSMA expression on the primary tumor. Conclusions Although not all lesions could be visualized, [F-18]PSMA-11 PET identified multiple lesions imperceptible on [F-18]FDG PET. These results display the potential additional diagnostic role of PSMA-targeted imaging in patients with RAI-R TC.Trial registration number No. EudraCT 2021-000456-19