National Planetary Health learning objectives for Germany: A steppingstone for medical education to promote transformative change.

Physicians play an important role in adapting to and mitigating the adverse health effects of the unfolding climate and ecological crises. To fully harness this potential, future physicians need to acquire knowledge, values, skills, and leadership attributes to care for patients presenting with environmental change-related conditions and to initiate and propel transformative change in healthcare and other sectors of society including, but not limited to, the decarbonization of healthcare systems, the transition to renewable energies and the transformation of transport and food systems. Despite the potential of Planetary Health Education (PHE) to support medical students in becoming agents of change, best-practice examples of mainstreaming PHE in medical curricula remain scarce both in Germany and internationally.

Functional independence of persons with long-standing motor complete spinal cord injury in the Netherlands.

Since life expectancy of persons with spinal cord injury (SCI) has improved, it is relevant to know whether this group is able to maintain functional abilities many years after onset of SCI. Objectives of this study were (1) to examine associations between time since injury (TSI) and functional independence in persons with long-standing SCI and (2) to explore associations between functional independence and level of injury, comorbidities, mental health, waist circumference and secondary health conditions (SHCs). TSI-stratified cross-sectional study.

Description of Urological Surveillance and Urologic Ultrasonography Outcomes in a Cohort of Individuals with Long-Term Spinal Cord Injury.

Individuals with spinal cord injury (SCI) have an increased risk of developing urological complications. Therefore, long-term routine urological surveillance is recommended. To describe urological surveillance in individuals with long-term SCI and to determine factors associated with urologic ultrasonography (UU) outcome.

Version 1.1 of the international spinal cord injury skin and thermoregulation function basic data set.

Objective: To describe the changes made to the international spinal cord injury (SCI) skin and thermoregulation function basic data set in version 1.1.

Setting: International.

Secondary health conditions and quality of life in persons living with spinal cord injury for at least ten years.

Objectives: To describe the prevalence of secondary health conditions among persons with long-term spinal cord injury, and the relationship between these secondary health conditions and quality of life.

Design: Multicentre, cross-sectional study.

Subjects: Individuals (n = 282) with traumatic or non-traumatic spinal cord injury for ≥ 10 years, age at injury 18-35 years, current age 28-65 years, and using a wheelchair.

In-hospital end-of-life decisions after new traumatic spinal cord injury in the Netherlands.

Study Design: Explorative retrospective files study.

Objectives: To document end-of-life decisions (ELDs) in in-hospital deaths after new traumatic spinal cord injury (TSCI).

Setting: The Netherlands.

Impact of health problems secondary to SCI one and five years after first inpatient rehabilitation.

Study Design: This is a multicenter prospective cohort study.

Objectives: The objective of this study was to describe and compare the impact of health problems secondary to spinal cord injury (SCI) on functioning at home and on social activities at 1 and 5 years after discharge from first inpatient rehabilitation.

Setting: The study was conducted in a Dutch community.

Prevalence of hypertension and associated risk factors in people with long-term spinal cord injury living in the Netherlands.

Purpose: To describe the prevalence of hypertension and associated risk factors in people with long-term spinal cord injury (SCI) and to compare the prevalence of high blood pressure and/or the use of antihypertensive drugs with the prevalence in the Dutch general population.

Method: Multicentre cross-sectional study (N = 282). Hypertension was defined as a systolic blood pressure (SBP) of ≥140 mmHg and/or a diastolic blood pressure (DBP) of ≥90 mmHg after ≥2 blood pressure measurements during ≥2 doctor visits.

Bladder-emptying methods, neurogenic lower urinary tract dysfunction and impact on quality of life in people with long-term spinal cord injury.

Objectives: To describe bladder-emptying methods used by people with long-term spinal cord injury (SCI) and to determine usage differences in relation to time since injury, sex, lesion level and completeness of lesion. Furthermore, to evaluate the relationship between bladder-emptying methods and the impact of neurogenic lower urinary tract dysfunction (NLUTD) on quality of life (QoL).

Design: Cross-sectional multicenter study.

Good validity of the international spinal cord injury quality of life basic data set.

Study Design: Cross-sectional validation study.

Objectives: To examine the construct and concurrent validity of the International Spinal Cord Injury (SCI) Quality of Life (QoL) Basic Data Set.

Setting: Dutch community.

Bedside prediction of the progress of pressure ulcer healing in patients with spinal cord injury using the 'Decu-stick'.

Study Design: This is a prospective cohort study.

Objectives: The objective of this study was to predict the progress of healing of pressure ulcers (PUs) in spinal cord injury (SCI) patients after the first 4 weeks.

Setting: The study was conducted in a specialized SCI rehabilitation unit in The Netherlands.

Outcomes of neurogenic bowel management in individuals living with a spinal cord injury for at least 10 years.

Objective: To describe bowel management and its outcomes in individuals living with a spinal cord injury (SCI) for at least 10 years.

Design: Cross-sectional multicenter study.

Setting: Dutch community.

Diagnostic accuracy of Tc-99m DMSA scintigraphy and renal ultrasonography for detecting renal scarring and relative function in patients with spinal dysraphism.

Aims: To study additional benefits of performing Tc-99m dimercaptosuccinic acid (Tc-99m-DMSA) scintigraphy as part of the follow-up of adults with spinal dysraphism (SD), compared with ultrasonography, with regard to finding renal scarring and difference in split renal function.

Methods: Between January 2011 and April 2013 every patient visiting our specialized outpatient clinic for adults with SD was invited to undergo both renal ultrasonography and Tc-99m-DMSA scintigraphy. Outcomes of both modalities were compared, with focus on renal scarring.

Causes of death following spinal cord injury during inpatient rehabilitation and the first five years after discharge. A Dutch cohort study.

Study Design: Prospective multicentre cohort study.

Objectives: To determine mortality, causes and determinants of death of individuals with spinal cord injury (SCI) within five years after first inpatient rehabilitation.

Setting: The Netherlands.

Longitudinal relationship between wheelchair exercise capacity and life satisfaction in patients with spinal cord injury: A cohort study in the Netherlands.

Objective: To examine the relationship between wheelchair exercise capacity and life satisfaction in persons with spinal cord injury from the start of active inpatient rehabilitation up to 5 years after discharge.

Design: Prospective cohort study.

Subjects: Persons with spinal cord injury, aged 18-65 years, and wheelchair dependent at least for long distances.

Cross-sectional study of determinants of upper and lower urinary tract outcomes in adults with spinal dysraphism--new recommendations for urodynamic followup guidelines?

Purpose: Although annual urodynamic study is currently recommended for all adults with spinal dysraphism, this followup might be overly intensive. Therefore, in this cross-sectional study we examine which determinants of upper and lower urinary tract outcomes are associated with relevant urodynamic findings.

Materials And Methods: All patients visiting our specialized outpatient clinic for adults with spinal dysraphism during a 26-month period underwent evaluation of the lower urinary tract by (video)urodynamic study.

Epidemiology of traumatic spinal cord injuries in The Netherlands in 2010.

Study Design: Retrospective files study.

Objective: To update epidemiological data on the incidence of traumatic spinal cord injury (TSCI) in The Netherlands.

Setting: The Netherlands.

Secondary health conditions in persons with spinal cord injury: a longitudinal study from one to five years post-discharge.

Objective: To assess the occurrence of secondary health conditions and their potential risk factors in persons with spinal cord injury from 1 to 5 years after discharge from initial inpatient rehabilitation.

Design: Multicentre longitudinal study.

Subjects: A total of 139 wheelchair-dependent persons with spinal cord injury.

Paucity of evidence for urinary tract outcomes in closed spinal dysraphism: a systematic review.

Objectives: To describe the long-term upper (UUT) and lower urinary tract (LUT) outcomes in patients with closed spinal dysraphism (CSD). CSD differs from open spinal dysraphism (OSD) by its long asymptomatic course and consequent later diagnosis. The outcome of UUT and LUT function in adults with CSD is relatively unknown.

Rehabilitation of patients with nontraumatic spinal cord injury in the Netherlands: etiology, length of stay, and functional outcome.

Background: Patients with nontraumatic spinal cord injury (NTSCI) are different from patients with traumatic spinal cord injury. A better understanding of the characteristics of NTSCI and their influence on length of stay (LOS) and functional outcome might help professionals in planning rehabilitation and predicting outcomes in NTSCI.

Objective: To describe personal and injury characteristics, etiology, LOS, and functional outcome after inpatient rehabilitation in patients with NTSCI.

Medical and psychosocial problems in middle-aged spina bifida patients: survey among members of the Dutch patients' association.

Purpose: To identify physical, emotional and psychosocial issues in the older person with spina bifida (SB).

Method: Members of the Dutch patients' association aged >25 years (n = 184) were asked to complete a questionnaire. This survey contained questions on physical and psychosocial complaints, as well as problems regarding social participation.

Wheelchair exercise capacity in spinal cord injury up to five years after discharge from inpatient rehabilitation.

Objective: To elucidate the course and determinants of wheelchair exercise capacity in spinal cord injury up to 5 years after discharge from inpatient rehabilitation, and to describe loss to follow-up.

Design: Prospective cohort study, with measurements at the start and discharge from inpatient rehabilitation, 1 and 5 years after discharge.

Subjects: A total of 225 wheelchair-dependent persons with spinal cord injury.

Urolithiasis in adult spina bifida patients: study in 260 patients and discussion of the literature.

Purpose: To describe incidence and risk factors of urinary tract stones in adult spina bifida (SB) patients. Although spina bifida patients have an allegedly higher risk of urinary tract stones, only two small non-English case series are available and do not provide adequate epidemiological data and analyses on risk factors.

Methods: A total of 260 adult SB patients followed in our centre for 10 years were retrospectively analysed for stone disease.