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S Van der Linden

Publications and source records attributed to S Van der Linden.

8 recordsLinked to original sources
PubMed2005

The role of a computerised case-based testing procedure in practice performance assessment.

INTRODUCTION: For postgraduate training of doctors there is a need for valid and reliable instruments to assess their daily performance. Various instruments have been suggested, some of which use incognito simulated patients (SPs). These methods are resource intensive. Computerised Case-based testing (CCT) is logistically simpler and may still predict performance well. The research question was to evaluate the predictive validity of CCT for performance. METHODS: Seventeen rheumatologists were each visited by eight incognito SPs presenting various rheumatological complaints, and scoring the performance of the rheumatologists using a predefined checklist. From this checklist a panel of experts identified essential items. In addition the rheumatologists sat a CCT test containing 55 cases with a total of 121 items. RESULTS: Negative correlations were found between the SP scores and the CCT scores. This was unexpected. Therefore, background variables on experience were used to compare both methods. The correlation between these and CCT were high and positive and with the SP scores high and negative. This pattern did not differ when using the essential items of the checklist. Reliabilities of the SP scores were markedly high. DISCUSSION: Although CCT was not predictive of SP scores, it was related to working experience. There are good reasons to assume that although SP-scores were more authentic, they were less valid than CCT scores, mainly because they focussed more on thoroughness than on efficiency in data gathering. The results underpin the assumption that for valid performance assessment the most important issue is what information about the candidate is collected and now how authentic the method is.

Clinical Competence↗
PubMed1998

Longitudinal study of Lyme borreliosis in a high risk population in Switzerland.

Orienteers from all parts of Switzerland (n = 416) were included in a longitudinal study for Lyme borreliosis. In spring 1986, the seroprevalence was 28.1%. At the beginning of the study, 84.3% of orienteers reported a history of tick bite, and 3.8% reported a past history of Lyme borreliosis. During the first (spring 1986-autumn 1986), second (autumn 1986-spring 1987) and third (spring 1987-autumn 1987) period, rates of seroconversion were 0.6%, 2.7% and 2.1% respectively. During the first and second period, clinical incidence were 1.0% and 0.25% respectively. No active Lyme borreliosis was detected during the third period. Among orienteers who seroconverted during the study (n = 16), only two developed clinical symptoms. Hence, Borrelia burgdorferi infection is often asymptomatic.

Adult↗
PubMed1997

Corticosteroid effects on sodium and calcium currents in acutely dissociated rat CA1 hippocampal neurons.

Consequences of corticosteroid receptor activation on voltage-dependent Na+ conductances were studied in acutely dissociated CA1 hippocampal neurons. This preparation was selected because of the compact electrotonic properties of dissociated neurons, allowing reliable voltage-clamp of the large and fast Na+ currents. The Na+ currents were studied in (i) neurons of adrenalectomized animals (no steroid receptors occupied), (ii) neurons from tissue of adrenalectomized rats treated in vitro with corticosterone and the glucocorticoid receptor antagonist RU38486 (selectively occupying the mineralocorticoid receptor), (iii) corticosterone-treated neurons of adrenalectomized animals (occupying both the mineralocorticoid and glucocorticoid receptors) and (iv) neurons of sham-operated animals. Activation and steady-state inactivation properties of the Na+ current recorded in neurons of adrenalectomized animals were slightly shifted (3-5 mV) to hyperpolarized potentials as compared to the Na+ currents from neurons of the other experimental groups. Furthermore, the removal from inactivation of the Na+ current in the group of neurons of adrenalectomized animals was relatively slow. Although small, these effects could influence neuronal properties like action potential generation and accommodation. Under the present experimental conditions, no apparent differences were seen between cells with predominant mineralocorticoid receptor activation and cells where both mineralocorticoid and glucocorticoid receptors were occupied. In contrast to Na+ currents, voltage-dependent Ca2+ currents displayed no steroid-dependent shifts in voltage-dependent properties. However, Ca2+ current amplitudes were increased by approximately 160% in CA1 neurons of adrenalectomized animals as compared to Ca2+ currents from neurons of the other experimental groups. We conclude that corticosteroid receptor activation affects various properties of voltage-dependent Na+ and Ca2+ conductances in CA1 neurons, indicating that the steroid receptors are involved in the modulation of neuronal excitability in these cells.

Adrenal Cortex Hormones↗
PubMed1996

Clubbing in human immunodeficiency virus infection.

We describe two patients who developed clubbing shortly after HIV seroconversion. None of them had the full syndrome of hypertropic osteoarthropathy. Other causes of clubbing are unlikely. We suggest that clubbing may belong to the spectrum of arthropathies associated with HIV infection.

Adult↗
PubMed1994

Wrist splints in rheumatoid arthritis: a question of belief?

Wrist splints are often used in the treatment of rheumatoid arthritis (RA). We applied a questionnaire to RA patients and rheumatologists to assess wrist splint use and to assess the policy of prescription. We related the reported use to patient satisfaction, severity of disease and physician's advice. Of 44 RA patients admitted to our hospital in 1990, 32 received one or more splints. Most patients (23) had both a wrist immobilization splint and a wrist activity splint (Futuro cock-up splint). The response rate to the questionnaire sent to all (n = 109) Dutch rheumatologists was 83%; 89 of 91 rheumatologists prescribed splints. Each rheumatologist prescribed yearly a mean of 30 immobilization splints (min-max: 2-120) and 51 activity splints (min-max: 4-170). Both types were mainly prescribed to relieve pain and reduce inflammation. From the patients' point of view, only the wrist activity splints were worth regular and continued use. Our findings suggest that if one prescribed splints, more attention should be paid to patient education and compliance.

Adult↗