GPs' perspectives on diagnostic testing in children with persistent non-specific symptoms: a qualitative study.

Background: Diagnostic testing is prevalent among children with persistent non-specific symptoms (PNS), and both undertesting and overtesting have negative consequences for child and society. Research in adults with PNS has shown that GPs use diagnostic testing for reasons other than diagnosis, but comparable research has not, to the best of our knowledge, been conducted in children. Understanding GPs' perspectives of testing decisions in children could provide insights into mechanisms of undertesting and overtesting.

Association between bronchopulmonary dysplasia severity and its risk factors and long-term outcomes in three definitions: a historical cohort study.

Objective: To compare the association of the severity categories of the 2001-National Institutes of Health (NIH), the 2018-NIH and the 2019-Jensen bronchopulmonary dysplasia (BPD) definitions with neurodevelopmental and respiratory outcomes at 2 and 5 years' corrected age (CA), and several BPD risk factors.

Design: Single-centre historical cohort study with retrospective data collection.

Setting: Infants born between 2009 and 2015 at the Amsterdam University Medical Centers, location Amsterdam Medical Center.

What is important to the GP in recognizing acute appendicitis in children: a delphi study.

Background: For diagnostic research on appendicitis in registration data, insight is needed in the way GPs generate medical records. We aimed to reach a consensus on the features that GPs consider important in the consultation and medical records when evaluating a child with suspected appendicitis.

Methods: We performed a three-round Delphi study among Dutch GPs selected by purposive sampling.

Development and validation of a clinical prediction rule for acute appendicitis in children in primary care.

Background: Recognising acute appendicitis in children presenting with acute abdominal pain in primary care is challenging. General practitioners (GPs) may benefit from a clinical prediction rule.

Objectives: To develop and validate a clinical prediction rule for acute appendicitis in children presenting with acute abdominal pain in primary care.

Added value of CRP to clinical features when assessing appendicitis in children.

Background: The diagnostic value of C-reactive protein (CRP) for appendicitis in children has not been evaluated in primary care. As biochemical responses and differential diagnoses vary with age, separate evaluation in children and adults is needed.

Objectives: To determine whether adding CRP to symptoms and signs improves the diagnosis of appendicitis in children with acute abdominal pain in primary care.

Appendicitis in children with acute abdominal pain in primary care, a retrospective cohort study.

Background: General practitioners (GPs) face a diagnostic challenge when assessing acute abdominal pain in children. However, no information is available on the current diagnostic process or the diagnostic accuracy of history and physical examination in primary care settings.

Objective: To describe the diagnostic process for acute abdominal pain among children in primary care, focusing on appendicitis, and to assess the diagnostic accuracy of individual clinical features.

[From Adam to ecstacy; legal use of MDMA in the 1970s and 1980s].

MDMA is currently a controversial psychedelic in the Netherlands: it is banned under the Opium Act, but widely used as a recreational drug. According to the government, the normalization of MDMA must be combated, others argue in favour of legalization. Meanwhile, in recent years psychiatry has become interested in renewed therapeutic use of MDMA.

Transient Hepatotoxicity Induced by Vinblastine in a Young Girl with Chiasmatic Low Grade Glioma.

Background: Vinblastine (VBL) is a cytostatic drug frequently applied in children with lymphoma and progressive low-grade glioma (LGG), with hematotoxicity as the main side effect.

Case Report: Here, the case of a 7-month-old girl with tumor progression of an LGG during standard chemotherapy with carboplatin and vincristine, is presented. Switching to VBL led to a 20-30- fold increase of transaminases (grade IV CTCAE 5.

[Insulin shock treatment in The Hague from 1937 to the end of the 1950s].

Background: Insulin shock treatment began to be applied in the 1930s to patients with a clinical diagnosis of schizophrenia. Although lacking theoretical and empirical support, the therapy was received enthusiastically and applied quite frequently. However, it quietly disappeared from the treatment repertories in the 1950s.

What is a clinical skill? Searching for order in chaos through a modified Delphi process.

Background: Everybody seems to know what a clinical skill (CS) is but closer consideration shows that the concept of a CS is not as clear as might be assumed. Some seem to use "CSs" when just referring to physical examination skills, whereas others use the term to also include diagnostic, communication and practical skills. CSs are more than a simple performance, but clinicians are often not consciously aware of the complex interplay of different components of a CS that they are practicing and accordingly do not teach all these aspects to students.

[The current psychometric state of risk assessment scales for adults in the Netherlands].

Background: Although Dutch forensic psychiatry is making increasing use of structural risk assessment scales, the controversy about the value and usefulness of these instruments continues unabated.

Aim: To provide an overview of the psychometric qualities of the instruments used most often in the Netherlands for risk assessment in adults.

Method: Dutch data about the Historical, Clinical, and Risk Management (HCR-20), the Sexual Violence Risk-20 (SVR-20), the Psychopathy Checklist-Revised (PCL-R) and two Dutch instruments, the 'Historische, Klinische en Toekomstige Risico-indicatoren-30' (HKT-30) and the 'Forensisch Psychiatrische Profielen' (FP-40) were reviewed.

The impact of donor policies in Europe: a steady increase, but not everywhere.

Background: Transplantable organs are scarce everywhere. Therefore, countries have developed policies to support the efficient use of potential donors. Nevertheless, the shortage of organs remains.

Training for doctors and nurses to deal with bereaved relatives after a sudden death: evaluation of the European Donor Hospital Education Programme (EDHEP) in Germany.

The sudden death of a person is one of the most extreme and painful experiences for the relatives, and doctors require special communication skills to deal adequately with the bereaved. The Dutch European Donor Hospital Education Programme was developed to train doctors and nurses in talking to the bereaved relatives and to make the donation request. In Germany, the one-day workshop has been adapted to the German language, law, and clinical practice.

The impact of changes in practice in organ procurement on the satisfaction of donor relatives.

In the past decade several interventions have been undertaken to close the gap between demand and supply of donor organs. Family refusal is an important factor contributing to the shortage of donor organs. The importance of the quality of communication between staff and relatives has been underestimated.

Requesting organ donation: the case of self-efficacy--effects of the European Donor Hospital Education Programme (EDHEP).

One of the major reasons for the shortage of donor organs is the high number of refusals by relatives. Studies have shown that the quality of communication with bereaved relatives influences whether to object or agree to organ and/or tissue donation. Breaking news of brain stem death, approaching relatives for permission to donate organs while also appropriately managing emotional reactions of relatives are complex tasks, which require knowledge of the domains as well as adequate skills to communicate information and understanding.

The European Donor Hospital Education Programme (EDHEP): enhancing communication skills with bereaved relatives.

Intensive care medical and nursing staff self-rate their communication skills as improved following attendance at the European Donor Hospital Education Programme (EDHEP) workshop. A prospective study was conducted to determine what impact EDHEP has on communication skills. Doctor-nurse pairs from 10 experimental and 10 control Intensive Care Units undertook two standardized simulated relative encounters (Breaking Bad News and Donation Request) at three measurement points (pre, post and follow-up).

[Experiences of relatives of donors with the donation procedure; comparison between 1995 and 1998].

Objective: To determine the experience of the relatives of organ and tissue donors, immediately before, during and soon after the donation procedure.

Design: Questionnaire.

Method: At two national one-day meetings at which about 10% of the families of donors between 1991 and 1998 were represented, the participants completed a questionnaire with questions about their appreciation of the communication with the different health care professionals.

Participants' judgements of the European Donor Hospital Education Programme (EDHEP): an international comparison.

The European Donor Hospital Education Programme (EDHEP) is a one-day workshop, aimed at providing guidelines for breaking the news of the death of a relative and for raising the issue of organ donation with bereaved relatives. Participants' judgements of the workshop in the Netherlands and in the United Kingdom were compared to determine whether EDHEP meets doctors' and nurses' training needs in breaking bad news and requesting organ donation. In both countries EDHEP appears to be greatly appreciated by intensive care medical and nursing staff; the judgements are more positive in the United Kingdom than in the Netherlands.

The European Donor Hospital Education Programme (EDHEP): addressing the training needs of doctors and nurses who break bad news, care for the bereaved, and request donation.

The competence of critical care staff when it comes to death and organ donation can make the difference between a family's agreeing to or refusing the latter. Doctors and nurses often feel uncomfortable approaching relatives about donation and attribute this to a lack of training. Bereaved relatives express dissatisfaction with inappropriate communication and support when brain death is announced and thereafter when a request for donation is made.