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Values are central to public debates today. Human values convey broad goals that serve as guiding principles in a person's life and value priorities differ across people in society. Groups in society holding opposing values (e.g., universalism versus security) will make different choices when voting in an election. Whereas over time, values are relatively stable, the number and type of political parties as well as the political values they communicate and disseminate have been changing. Groups of people holding the same human values may therefore vote for another (new) party in a later election. We focus on analyzing the relationship between human values and voting in elections, introducing a new methodology to analyze how value profiles relate to political support over time. We investigate the Dutch multi-party political system over five waves of the European Social Survey, spanning 2002 until 2010. Whilst previous research has focused on individual values separately and focused on voters only, we (1) distinguish groups holding a similar set of opposing and compatible values (value profile) instead of focusing on single values in the the entire population; (2) incorporate a correction for differences in scale use in our model; (3) compare voting over time; (4) include non-voters, a growing group in Dutch society. We find evidence that specific value profiles are related to voting for a specific set of political parties. We also find that specific value profiles distinguish non-voters from voters and that voters for populist parties resemble non-voters.

This review is an overview of the current status of the advanced practice provider (APP) working in critical care. After describing the history of the profession, the paper focuses on the literature available. Although a lot of literature is available, the papers are often heterogeneous and comparison with other clinicians remains difficult. The paper zooms in on the situation in the Netherlands and describes the training courses for the physician assistant (PA), the equivalent of the APP, together with the legislation in place. Furthermore, the review elaborates on the potential superimposed value of the PA for the ICU. Because of the limited amount of studies performed in the Dutch situation this review finishes with the conclusions of 15-year-experience and the possible issues which could arise when implementing a PA on the ICU.

INTRODUCTION: Exposure to road traffic noise may increase blood pressure and heart rate. It is unclear to what extent exposure to air pollution may influence this relationship. We investigated associations between noise, blood pressure and heart rate, with harmonized data from three European cohorts, while taking into account exposure to air pollution. METHODS: Road traffic noise exposure was assessed using a European noise model based on the Common Noise Assessment Methods in Europe framework (CNOSSOS-EU). Exposure to air pollution was estimated using a European-wide land use regression model. Blood pressure and heart rate were obtained by trained clinical professionals. Pooled cross-sectional analyses of harmonized data were conducted at the individual level and with random-effects meta-analyses. RESULTS: We analyzed data from 88,336 participants, across the three participating cohorts (mean age 47.0 (±13.9) years). Each 10dB(A) increase in noise was associated with a 0.93 (95% CI 0.76;1.11) bpm increase in heart rate, but with a decrease in blood pressure of 0.01 (95% CI -0.24;0.23) mmHg for systolic and 0.38 (95% CI -0.53; -0.24) mmHg for diastolic blood pressure. Adjustments for PM10 or NO2 attenuated the associations, but remained significant for DBP and HR. Results for BP differed by cohort, with negative associations with noise in LifeLines, no significant associations in EPIC-Oxford, and positive associations with noise >60dB(A) in HUNT3. CONCLUSIONS: Our study suggests that road traffic noise may be related to increased heart rate. No consistent evidence for a relation between noise and blood pressure was found. ; The research leading to these results has received funding from the European Union Seventh Framework Programme (FP7/2007–2013) under grant agreement no. 261433 (Biobank Standardisation and Harmonization for Research Excellence in the European Union – BioSHaRE-EU). DataSHIELD development has also been partly funded under a strategic award from MRC and Wellcome Trust underpinning the ALSPAC project (Wellcome/MRC strategic award 092731); and the Welsh and Scottish Farr Institutes funded by MRC, BBMRI-LPC (EU FP7, I3 grant). BioSHaRE, and the involved cohorts LifeLines (BRIF 4568) and HUNT3 (BRIF 2365) are engaged in a Bioresource Research Impact Factor (BRIF) policy pilot study, details of which can be found at https://www.bioshare.eu/content/bioresource-impact-factor. The Lifelines Biobank initiative has been made possible by funds from FES (Fonds Economische Structuurversterking), SNN (Samenwerkingsverband Noord Nederland) and REP (Ruimtelijk Economisch Programma). LifeLines is a facility that is open for all researchers. Information on application and data access procedure is summarized on www.lifelines.net. We thank all the participants of EPIC-Oxford and data collection teams for generously helping us in this research. EPIC-Oxford is supported by Cancer Research UK (C8221/A19170), and the UK Medical Research Council (MR/M012190). The Nord-Trøndelag Health Study (The HUNT Study) is collaboration between HUNT Research Centre (Faculty of Medicine, Norwegian University of Science and Technology NTNU), NordTrøndelag County Council, Central Norway Health Authority, and the Norwegian Institute of Public Health. P.E. is supported by the Imperial College Healthcare NHS Trust and Imperial College Biomedical Research Centre funded by the National Institute for Health Research (NIHR), the Medical Research Council and Public Health England (MRC-PHE) Centre for Environment and Health (MR/L01341X/1), the NIHR Health Protection Research Unit on Health Impact of Environmental Hazards (HPRU-2012-10030-KCL) and he is an NIHR Senior Investigator. ; Peer-reviewed ; Post-print

Background: Internet-based Cognitive Behavioural Therapy (iCBT) is found effective in treating common mental disorders. However, the use of these interventions in routine care is limited. The international ImpleMentAll study is funded by the European Union's Horizon 2020 programme. It is concerned with studying and improving methods for implementing evidence-based iCBT services for common mental disorders in routine mental health care. A digitally accessible implementation toolkit (ItFits-toolkit) will be introduced to mental health care organizations with the aim to facilitate the ongoing implementation of iCBT services within local contexts. This study investigates the effectiveness of the ItFits-toolkit by comparing it to implementation-as-usual activities. Methods: A stepped wedge cluster randomized controlled trial (SWT) design will be applied. Over a trial period of 30 months, the ItFits-toolkit will be introduced sequentially in twelve routine mental health care organizations in primary and specialist care across nine countries in Europe and Australia. Repeated measures are applied to assess change over time in the outcome variables. The effectiveness of the ItFits-toolkit will be assessed in terms of the degree of normalization of the use of the iCBT services. Several exploratory outcomes including uptake of the iCBT services will be measured to feed the interpretation of the primary outcome. Data will be collected via a centralized data collection system and analysed using generalized linear mixed modelling. A qualitative process evaluation of routine implementation activities and the use of the ItFits-toolkit will be conducted within this study. Discussion: The ImpleMentAll study is a large-scale international research project designed to study the effectiveness of tailored implementation. Using a SWT design that allows to examine change over time, this study will investigate the effect of tailored implementation on the normalization of the use of iCBT services and their uptake. It will provide a better understanding of the process and methods of tailoring implementation strategies. If found effective, the ItFits-toolkit will be made accessible for mental health care service providers, to help them overcome their context-specific implementation challenges. Trial registration: ClinicalTrials.gov NCT03652883. Retrospectively registered on 29 August 2018