• No results found

Literatuuronderzoek naar kosteneffectiviteits-aspecten van de screening van zwangeren op syfilis ter preventie van congenitale syfilis | RIVM

N/A
N/A
Protected

Academic year: 2021

Share "Literatuuronderzoek naar kosteneffectiviteits-aspecten van de screening van zwangeren op syfilis ter preventie van congenitale syfilis | RIVM"

Copied!
54
0
0

Bezig met laden.... (Bekijk nu de volledige tekst)

Hele tekst

(1)5,90UDSSRUW /LWHUDWXXURQGHU]RHNQDDUNRVWHQHIIHFWLYLWHLWV DVSHFWHQYDQGHVFUHHQLQJYDQ]ZDQJHUHQRS V\ILOLVWHUSUHYHQWLHYDQFRQJHQLWDOHV\ILOLV -16WUXLMV*$GH:LW-&-DJHU. 'LWRQGHU]RHNZHUGYHUULFKWLQRSGUDFKWHQWHQODVWHYDQKHWLQVWLWXXWYRRU0HGLFDO 7HFKQRORJ\$VVHVVPHQW L07$

(2) LQKHWNDGHUYDQSURMHFW9.RVWHQ HIIHFWLYLWHLWVDVSHFWHQYDQULFKWOLMQHQYDQSUHYHQWLHYDQLQIHFWLHPHW+,9&KODP\GLD WUDFKRPDWLVKHSDWLWLV%HQV\ILOLV 5,903RVWEXV%$%LOWKRYHQWHOHIRRQID[.

(3) 3DJYDQ. 5,90UDSSRUW.

(4) 5,905DSSRUW. 3DJYDQ. $EVWUDFW 7KLVUHSRUWSUHVHQWVWKHUHVXOWVRIDOLWHUDWXUHUHYLHZRQWKHFRVWHIIHFWLYHQHVVRIWKH VFUHHQLQJRISUHJQDQWZRPHQIRUV\SKLOLVWRSUHYHQWFRQJHQLWDOV\SKLOLVLQWKH 1HWKHUODQGV'LIIHUHQWGDWDEDVHV 0HGOLQH,1$+7$'DWDEDVH&5''DWDEDVHV +HDOWK67$51*&GDWDEDVH

(5) ZHUHXVHGWRVHDUFKIRUQDWLRQDODQGLQWHUQDWLRQDO HFRQRPLFHYDOXDWLRQVµ5HIHUHQFHWUDFNLQJ¶ZDVDOVRXVHGWRDFFHVVSXEOLFDWLRQV2XU VHDUFKHV\LHOGHGSXEOLFDWLRQVRIZKLFKZHUHJXLGHOLQHV(YHQWXDOO\ILYH SXEOLFDWLRQVGLGPHHWRXULQFOXVLRQFULWHULD$OOWKHRWKHUSXEOLFDWLRQVGLGQRWDGGUHVV WKHFRVWHIIHFWLYHQHVVRIVFUHHQLQJSUHJQDQWZRPHQIRUV\SKLOLVWRSUHYHQWFRQJHQLWDO V\SKLOLV7KHSDUDPHWHUVWKDWZHUHLQFOXGHGLQWKHUHYLHZDUHWKHW\SHRIHFRQRPLF HYDOXDWLRQWKHWDUJHWSRSXODWLRQWKHGLIIHUHQWFRVWGDWDWKHGLVFRXQWUDWHWKH VHQVLWLYLW\DQDO\VLVDQGWKHUHVXOWVRIWKHVWXGLHV 7KHUHVXOWVRIWKHVWXGLHVVKRZIDYRXUDEOHFRVWHIIHFWLYHQHVVUDWLRVIRUVFUHHQLQJLQ ERWKWKHELJFLWLHVDQGWKHUXUDODUHDVRIWKH1HWKHUODQGV$OOWKHVWXGLHVXVHGWKHVDPH GLVHDVHPRGHOEXWIDLOHGWRSHUIRUPDSURSHUVHQVLWLYLW\DQDO\VLV7KHUHIRUHLQWKLV OLWHUDWXUHUHYLHZDVHQVLWLYLW\DQDO\VLVRIWKHGLVHDVHPRGHOZDVPDGH7KHVHQVLWLYLW\ DQDO\VLVVKRZHGWKDWVFUHHQLQJRISUHJQDQWZRPHQIRUV\SKLOLVWREHFRVWHIIHFWLYH LQGHSHQGHQWRIWKHFLUFXPVWDQFHV 7KHFRQFOXVLRQRIWKHOLWHUDWXUHUHYLHZLVWKDWVFUHHQLQJRISUHJQDQWZRPHQIRU V\SKLOLVWRSUHYHQWFRQJHQLWDOV\SKLOLVLVFRVWHIIHFWLYH7KHVFUHHQLQJRISUHJQDQW ZRPHQVKRXOGEHFRQWLQXHGLQWKHELJFLWLHVDVZHOODVLQWKHUXUDODUHDVRIWKH 1HWKHUODQGV.

(6) 3DJYDQ. 5,90UDSSRUW.

(7) 5,905DSSRUW. 3DJYDQ. 9RRUZRRUG 'LWOLWHUDWXXURQGHU]RHNQDDUNRVWHQHIIHFWLYLWHLWVDVSHFWHQYDQVFUHHQLQJYDQ ]ZDQJHUHQRSV\ILOLVWHUSUHYHQWLHYDQFRQJHQLWDOHV\ILOLVLVRQGHUGHHOYDQKHW5,90 SURMHFW 'RHOPDWLJKHLGYDQLQWHUYHQWLHVLQ]RUJHQSUHYHQWLH  SURMHFWQU9

(8)  +HWGHHOSURMHFW .RVWHQHIIHFWLYLWHLWVDVSHFWHQYDQULFKWOLMQHQELMSUHYHQWLHYDQLQIHFWLH PHW+,9&KODP\GLDWUDFKRPDWLVKHSDWLWLV%HQV\ILOLV  SURMHFWQU9

(9) LV XLWJHYRHUGLQRSGUDFKWYDQKHWLQVWLWXXWYRRU0HGLFDO7HFKQRORJ\$VVHVVPHQW L07$

(10) YDQGH(UDVPXV8QLYHUVLWHLW5RWWHUGDPLQKHWNDGHUYDQKHW. 5LFKWOLMQHQSURJUDPPD 

(11) RQWZLNNHOLQJULFKWOLMQHQRSEDVLVYDQLQIRUPDWLH RYHUNRVWHQHIIHFWLYLWHLW 'LWULFKWOLMQHQSURJUDPPDEHWUHIWKHWKHULMNHQYDQULFKWOLMQHQ YRRUGHSDWLsQWHQ]RUJ ]RZHOPHGLVFKHDOVSDUDPHGLVFKHHQYHUSOHHJNXQGLJH

(12) RS EDVLVYDQLQIRUPDWLHXLWNRVWHQHIIHFWLYLWHLWVDQDO\VHVLQRSGUDFKWYDQKHW0LQLVWHULH YDQ9RONVJH]RQGKHLG:HO]LMQHQ6SRUW 9:6

(13)  +HWERYHQJHQRHPGHGHHOSURMHFWZRUGWXLWJHYRHUGLQVDPHQZHUNLQJPHWKHW *URQLQJHQ8QLYHUVLW\,QVWLWXWHIRU'UXJ([SORUDWLRQ *8,'(

(14) +HWRQGHU]RHNLV XLWJHYRHUGELMKHW&HQWUXPYDQ=RUJ2QGHU]RHN &=2

(15)  'U-&-DJHUSURMHFWOHLGHU.

(16) 3DJYDQ. 5,90UDSSRUW.

(17) 5,905DSSRUW. 3DJYDQ. ,QKRXG 6DPHQYDWWLQJ. . . ,QOHLGLQJ. . . &RQJHQLWDOH

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

(19) 3DJYDQ. 5,90UDSSRUW. %LMODJH,. 9HU]HQGOLMVW. . %LMODJH,,. 6DPHQYDWWLQJYDQGHJHVHOHFWHHUGHVWXGLHVHQULFKWOLMQHQ. . %LMODJH,,,. 'HQLHWJHVHOHFWHHUGHVWXGLHVHQULFKWOLMQHQ. %LMODJH,9. LQDOIDEHWLVFKHYROJRUGH

(20). . 6HQVLWLYLWHLWVDQDO\VHYDQKHWPRGHOYDQ6WUD\3HGHUVHQ. .

(21) 5,905DSSRUW. 3DJYDQ. 6DPHQYDWWLQJ ,Q1HGHUODQGQHHPWGHLQFLGHQWLHYDQV\ILOLVVLQGVEHJLQYDQGHMDUHQWDFKWLJDI'H. GDOLQJNDQZRUGHQWRHJHVFKUHYHQDDQHHQFRPELQDWLHYDQJHGUDJVYHUDQGHULQJHQ EHVWULMGLQJVHQVFUHHQLQJVSURJUDPPD VELMEH]RHNHUVYDQVRDSROLNOLQLHNHQHQ ]ZDQJHUHYURXZHQ,QDQGHUH(XURSHVHODQGHQZRUGWGH]HOIGHWUHQGZDDUJHQRPHQ :LMJHUJDQJV

(22) 'HYUDDJULMVWQXGDQRRNRIGHVFUHHQLQJYDQ]ZDQJHUHQRS V\ILOLVWHUSUHYHQWLHYDQFRQJHQLWDOHV\ILOLVYDQXLWNRVWHQHIIHFWLYLWHLWVRYHUZHJLQJHQ QRJZHO]LQYROLV+HWYRRUOLJJHQGHUDSSRUWWUDFKWGHYUDDJWHEHDQWZRRUGHQRIGH VFUHHQLQJYDQ]ZDQJHUHQRSV\ILOLVWHUSUHYHQWLHYDQFRQJHQLWDOHV\ILOLVELM SDVJHERUHQHQLQGHUGDDGQRJ]LQYROLV 'H]RHNVWUDWHJLHLQKHWOLWHUDWXXURQGHU]RHNOHYHUGHQLQGHYLMIJHUDDGSOHHJGH GDWDEDVHV 0HGOLQH,1$+7$'DWDEDVH&5''DWDEDVHV+HDOWK67$51*& GDWDEDVH

(23) UHIHUHQWLHVRSPHWEHWUHNNLQJWRWV\ILOLVZDDUYDQULFKWOLMQHQ9RRU QDJHQRHJDOGH]HUHIHUHQWLHVJROGGDWGH]HQLHWYROGHGHQDDQGHDOJHPHQH VHOHFWLHFULWHULDYHHODORPGDWKHWJHHQHFRQRPLVFKHHYDOXDWLHYDQVFUHHQLQJRSV\ILOLV ELM]ZDQJHUHQZDV1DGH]HHHUVWHVHOHFWLHEOHYHQVOHFKWVYLMIHFRQRPLVFKHHYDOXDWLHV RYHU ZDDUYDQWZHHHFRQRPLVFKHHYDOXDWLHVEXLWHQGH]RHNVWUDWHJLHsQRP]LMQ DFKWHUKDDOGYLDGHUHIHUHQWLHOLMVWHQYDQGHJHYRQGHQSXEOLFDWLHV UHIHUHQFHWUDFNLQJ. RIVQHHXZEDOPHWKRGH

(24) 'HJHVHOHFWHHUGHHFRQRPLVFKHHYDOXDWLHV]LMQDDQGHKDQGYDQ GHYROJHQGHDVSHFWHQV\VWHPDWLVFKEHVSURNHQKHWW\SHHFRQRPLVFKHHYDOXDWLHGH GRHOSRSXODWLHGHYHUVFKLOOHQGHNRVWHQVRRUWHQGHGLVFRQWRYRHWGHVHQVLWLYLWHLWV DQDO\VHHQGHUHVXOWDWHQHQFRQFOXVLHVOLWHUDWXXURQGHU]RHN 2QGDQNVGHYHUVFKLOOHQLQDDQQDPHVHQPHWKRGRORJLHJHYHQGHJHYRQGHQ. HFRQRPLVFKHHYDOXDWLHVHHQFRQVLVWHQWEHHOGWH]LHQQDPHOLMNGDWGHVFUHHQLQJYDQ ]ZDQJHUHQRSV\ILOLVNRVWHQHIIHFWLHILV1DDVWGHVFUHHQLQJLQGHJURWHVWHGHQEOLMNW RRNGHVFUHHQLQJRSV\ILOLVELM]ZDQJHUHQRSKHWSODWWHODQGWHUSUHYHQWLHYDQ FRQJHQLWDOHV\ILOLVNRVWHQHIIHFWLHI'HJURRWVWHRQ]HNHUKHLGELMKHWLQWHUSUHWHUHQYDQ GHUHVXOWDWHQYDQGHJHVHOHFWHHUGHVWXGLHVLVGDWDOOHVWXGLHVKHW]HOIGHPRGHOKDQWHUHQ HQJHHQYDQDOOHHHQJRHGHVHQVLWLYLWHLWVDQDO\VHYDQGLWPRGHOEHVFKULMYHQ+LHURPLV LQGH]HOLWHUDWXXUUHYLHZHHQVHQVLWLYLWHLWVDQDO\VHJHPDDNWYDQKHWJHEUXLNWHPRGHO %LMGHXLWJHYRHUGHVHQVLWLYLWHLWVDQDO\VHEOLMNHQGHRYHUJDQJVNDQVHQZHOJHYRHOLJYRRU GHUHVXOWDWHQ,QHONHVHQVLWLYLWHLWVDQDO\VHEOLMIWGHVFUHHQLQJYDQ]ZDQJHUHQRSV\ILOLV.

(25) 3DJYDQ. 5,90UDSSRUW. HFKWHUNRVWHQHIIHFWLHI7LMGHQVGLWOLWHUDWXXURQGHU]RHN]LMQJHHQDDQZLM]LQJHQ JHYRQGHQGDWGHFRQFOXVLHVYDQGHJHVHOHFWHHUGHVWXGLHVYHUDQGHUG]RXGHQ]LMQDOV JHYROJYDQUHFHQWHRQWZLNNHOLQJHQRSKHWJHELHGYDQELMYRRUEHHOGGHNRVWHQYDQGH VFUHHQLQJVWHVWHQGHLQFLGHQWLHYDQV\ILOLVELM]ZDQJHUHQHQ]2SEDVLVYDQGLW OLWHUDWXXURQGHU]RHNNDQJHFRQFOXGHHUGZRUGHQGDWGHVFUHHQLQJYDQ]ZDQJHUHQRS V\ILOLVWHUSUHYHQWLHYDQFRQJHQLWDOHV\ILOLV]LQYROLV.

(26) 5,905DSSRUW. . 3DJYDQ. ,QOHLGLQJ. &RQJHQLWDOHV\ILOLVLVHHQVHULHX]HPDDUWHYRRUNRPHQ]LHNWH'H7UHSRQHPD SDOOLGXPGHYHURRU]DNHUYDQV\ILOLVNDQGRRUHHQJHwQIHFWHHUGH]ZDQJHUHYURXZ ZRUGHQRYHUJHGUDJHQDDQGHIRHWXV'H]HWUDQVPLVVLHNDQYUXFKWGRRGRIHUQVWLJH FRQJHQLWDOHDIZLMNLQJHQYHURRU]DNHQ'RRUGH]ZDQJHUHUHHGVLQHHQYURHJVWDGLXP YDQGH]ZDQJHUVFKDSWHEHKDQGHOHQNDQLQIHFWLHYDQGHIRHWXVZRUGHQYRRUNRPHQ ,Q1HGHUODQGYLQGWVLQGVVHURORJLVFKHVFUHHQLQJRSV\ILOLVSODDWVQDKHWHHUVWH FRQWDFWPHWGH]ZDQJHUVFKDSVEHJHOHLGHU URQGGHH]ZDQJHUVFKDSVZHHN

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

(28) 3DJYDQ. 5,90UDSSRUW. +RRIGVWXNWRRQWGHUHVXOWDWHQYDQKHWOLWHUDWXXURQGHU]RHN$DQGHKDQGYDQGH YHUVFKLOOHQGHNHQPHUNHQYDQGHHFRQRPLVFKHHYDOXDWLHVZRUGHQGHJHVHOHFWHHUGH VWXGLHVEHVSURNHQ +HWOLWHUDWXXURQGHU]RHNZRUGWLQKRRIGVWXNDIJHVORWHQPHWDOJHPHQHFRQFOXVLHVHQ HHQGLVFXVVLH.

(29) 5,905DSSRUW. . 3DJYDQ. &RQJHQLWDOH

(30) V\ILOLV GH]LHNWHHHQNRUWHEHVFKULMYLQJ. %LMKHWVFKULMYHQYDQGLWKRRIGVWXNLVRDJHEUXLNJHPDDNWYDQGH5,90UDSSRUWHQ 6HNVXHHO2YHUGUDDJEDUH$DQGRHQLQJHQLQ1HGHUODQG 9DQGH/DDUHWDO

(31)  3UHYHQWLHYDQ&RQJHQLWDOH6\ILOLVHFRQRPLVFKHHYDOXDWLHPHWFLMIHUVYDQGH VWUHHNODERUDWRULDYRRUGHYRONVJH]RQGKHLG *UXWHNHHWDO

(32) HQ6HNVXHHO 2YHUGUDDJEDUH$DQGRHQLQJHQLQ1HGHUODQGXSGDWH 9DQGH/DDUHWDO

(33)  . 9HUZHNNHUHQWUDQVPLVVLH. 6\ILOLVZRUGWYHUZHNWGRRUGH7UHSRQHPDSDOOLGXP 73DOOLGXP

(34) 'H]HEDFWHULHVRRUW EHKRRUWWRWGHIDPLOLHYDQGH6SLURFKDHWDFHDH'HSDWKRJHQHVHHQGHLPPXQRELRORJLH YDQV\ILOLV]LMQQRJQLHWJHKHHORSJHKHOGHUG+HWYDULDEHOH]LHNWHYHUORRSKRXGW ZDDUVFKLMQOLMNYHUEDQGPHWGHLPPXXQVWDWXVYDQGHJHwQIHFWHHUGH,QIHFWLHPHW 73DOOLGXPOHLGWWRWHHQ]HNHUHPDWHYDQLPPXQLWHLW'HEHVFKHUPLQJWHJHQ KHULQIHFWLHLVHFKWHUYHUUHYDQYROOHGLJ 'HEDFWHULHYHUVSUHLGW]LFKRSYHUVFKLOOHQGHPDQLHUHQ'HEHODQJULMNVWHWUDQVPLVVLH URXWHYDQV\ILOLVLVYLDVHNVXHHOFRQWDFWPHWHHQJHwQIHFWHHUGHSDUWQHU KRUL]RQWDOH WUDQVPLVVLH

(35) 'HLQIHFWLHNDQZRUGHQRYHUJHGUDJHQGRRUODHVLHVLQKXLGHQ VOLMPYOLH]HQ+HWLVPLQGHUZDDUVFKLMQOLMNGDWGHWUHSRQHPD VGRRUGHLQWDFWHKXLG NXQQHQSHQHWUHUHQ 0XVKHU

(36) (HQDQGHUHEHODQJULMNHWUDQVPLVVLHURXWHLVGH RYHUGUDFKWYDQGHLQIHFWLHYDQHHQ]ZDQJHUHRSGHIRHWXV YHUWLFDOHWUDQVPLVVLH

(37) 'H GHUGHWUDQVPLVVLHURXWHLVGLHYLDEORHGWUDQVIXVLHPHWJHwQIHFWHHUGEORHG'H]H WUDQVPLVVLHNDQVLVKHWJURRWVWPHWEORHGYDQGRQRUHQPHWHHQYURHJHLQIHFWLHX]H V\ILOLVLQIHFWLHDDQJH]LHQV\ILOLVLQGLWVWDGLXPELMVHURORJLVFKHVFUHHQLQJQRJQLHW DDQWRRQEDDULV . .OLQLVFKHYHUVFKLMQVHOHQ. +LHURQGHUYROJWHHQEHNQRSWHEHVFKULMYLQJYDQGHYHUVFKLOOHQGH]LHNWHVWDGLDYDQ V\ILOLV.

(38) 3DJYDQ. 5,90UDSSRUW.  3ULPDLUHV\ILOLV 3ULPDLUHV\ILOLVJDDWYULMZHOQRRLWJHSDDUGPHWDOJHPHQH]LHNWHYHUVFKLMQVHOHQHQ ZRUGWJHNHQPHUNWGRRUHHQSULPDLUHXOFXVHQORNDOHO\PIHNOLHU]ZHOOLQJ'HSULPDLUH XOFXVPHHVWDOVROLWDLUPDQLIHVWHHUW]LFKRSGHSODDWVYDQGHHQWLQJPHHVWDO XURJHQLWDDORILQGHSXELVVWUHHN'HLQFXEDWLHWLMGGXXUWJHPLGGHOGGDJHQ PLQLPDDO HQPD[LPDDOGDJHQ

(39) 6SRQWDQHJHQH]LQJYDQGHXOFXVWUHHGWPHHVWDORSQDWRW ZHNHQ 0XVKHU

(40)  9DQ9RRUVW9DGHU

(41)   6HFXQGDLUHV\ILOLV 'HVHFXQGDLUHV\ILOLVWUHHGWRSELMYDQGHRQEHKDQGHOGHSDWLs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

(42) GHILQLHHUWGHYURHJH ODWHQWHV\ILOLVWRWppQMDDUQDHQGH:+2 :RUOG+HDOWK2UJDQL]DWLRQ

(43) WRWWZHHMDDUQD VSRQWDQHJHQH]LQJYDQVHFXQGDLUHV\ILOLV 'HYROOHGLJV\PSWRRPOR]HSHULRGHGDDUQDQRHPWPHQODWHODWHQWHV\ILOLV/DWHODWHQWH V\ILOLVNDQPDDQGHQWRWMDUHQGXUHQYRRUGDWWHUWLDLUHV\ILOLV]LFKHYHQWXHHO PDQLIHVWHHUW/DWHQWHV\ILOLVJDDWGDQRYHULQHHQWRHVWDQGYDQSHUVLVWHUHQGHODWHQWLH ZDDUELMGHVSHFLILHNHDQWLVWRIIHQSRVLWLHIEOLMYHQ &ODUN

(44) .

(45) 5,905DSSRUW. 3DJYDQ.  7HUWLDLUHV\ILOLV %LMWHUWLDLUHV\ILOLVNXQQHQ]LFKWLHQWDOOHQMDUHQQDGHSULPDLUHLQIHFWLHYHUVFKLMQVHOHQ YRRUGRHQDDQKXLGPRQGVOLMPYOLHVJHKHPHOWHVWURWWHQKRRIGQHXVWXVVHQVFKRWVNHOHW FDUGLRYDVFXODLUV\VWHHP V\PSWRPDWLVFKHFDUGLRYDVFXODLUHV\ILOLV

(46) HQFHQWUDDO ]HQXZVWHOVHO V\PSWRPDWLVFKHQHXURV\ILOLV

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

(48)   &RQJHQLWDOHV\ILOLV &RQJHQLWDOHV\ILOLVRQWVWDDWGRRURYHUGUDFKWYDQGHLQIHFWLHYDQGH]ZDQJHUHYURXZ QDDUGHIRHWXV3DVVDJHYLDGHSODFHQWDNDQSODDWVYLQGHQYDQDIGHQHJHQGHZHHNPDDU VFKDGHDDQGHYUXFKWWUHHGWSDVRSYDQDIGHYLHUGHPDDQGDOVKHWLPPXXQDSSDUDDW ]LFKRQWZLNNHOW +DUWHU

(49)  +HWVWDGLXPYDQLQIHFWLHYDQGHPRHGHUEHSDDOWGH YHUWLFDOH

(50) WUDQVPLVVLHNDQV :DQQHHUGHPRHGHUHHQSULPDLUHLQIHFWLHGRRUPDDNWLVGHNDQVRSFRQJHQLWDOHV\ILOLV ZDQQHHUGHPRHGHUHHQYURHJHODWHQWHV\ILOLVRIHHQODWHODWHQWHV\ILOLV GRRUPDDNW]LMQGH]HNDQVHQUHVSHFWLHYHOLMNHQ )LXPDUDHWDO

(51)  2SJURQGYDQGHNOLQLVFKHYHUVFKLMQVHOHQZRUGWRQGHUVFKHLGJHPDDNWLQYURHJH FRQJHQLWDOHV\ILOLVHQODWHFRQJHQLWDOHV\ILOLV.LQGHUHQPHWYURHJHFRQJHQLWDOHV\ILOLV KHEEHQV\PSWRPHQYDQV\ILOLVLQGHHHUVWHZHNHQHQPDDQGHQQDGHJHERRUWH(HQ DDQWDOYDQGH]HNLQGHUHQRQWZLNNHOWIXOPLQDQWHFRQJHQLWDOHV\ILOLVPHWIDWDOHDIORRS 'HV\PSWRPHQEHVWDDQXLWDIZLMNLQJHQDDQGHKXLGHQRIVOLMPYOLH]HQERWDIZLMNLQJHQ HQKHSDWRVSOHQRPHJDOLH YHUJURWLQJYDQOHYHUHQPLOW

(52)  'HODWHFRQJHQLWDOHV\ILOLVELMSDVJHERUHQHQODDW]LFKTXDV\PSWRPHQYHUJHOLMNHQPHW WHUWLDLUHV\ILOLVELMYROZDVVHQHQ1HXURV\ILOLVNRPWELMFRQJHQLWDOHV\ILOLVYDNHUYRRU GDQELMYROZDVVHQHQPHWV\ILOLV7XVVHQGHHQYDQGHNLQGHUHQPHW.

(53) 3DJYDQ. 5,90UDSSRUW. FRQJHQLWDOHV\ILOLV]DOODWHUQHXURV\ILOLVRQWZLNNHOHQ'HYHUVFKLMQVHOHQYDQODWH FRQJHQLWDOHV\ILOLV]LMQRQGHUDQGHUHERWDIZLMNLQJHQOHLGHQGWRWHHQ]DGHOQHXVHQ VSHFLILHNHDIZLMNLQJHQYDQERYHQVWHVQLMWDQGHQ ]RJHQDDPGH+XWFKLQVRQWDQGHQ

(54)  EOLQGKHLGGRRUDWURILHYDQGHQHUYXVRSWLFXVPHQWDOHUHWDUGDWLHGRRIKHLGGRRUDWURILH YDQGHQHUYXVDFXVWLFXVHQRQWVWHNLQJYDQKHWKRRUQYOLHV LQWHUVWLWLsOHNHUDWLWLV

(55)  9HUGHUZRUGWDDQJHQRPHQGDWNLQGHUHQPHWFRQJHQLWDOHV\ILOLVRSVFKRROHQZHUN PLQGHUSUHVWHUHQGDQJH]RQGHOHHIWLMGVJHQRWHQ . 'LDJQRVWLHN. 'HGLDJQRVHV\ILOLV SULPDLUVHFXQGDLUODWHQWWHUWLDLURIFRQJHQLWDDO

(56) ZRUGWYDVW JHVWHOGRSEDVLVYDQDQDPQHVHOLFKDPHOLMNRQGHU]RHNHQODERUDWRULXPRQGHU]RHN /DWHQWHV\ILOLVLVXLWVOXLWHQGPHWEHKXOSYDQVHURORJLVFKRQGHU]RHNWHGLDJQRVWLFHUHQ ,Q1HGHUODQGZRUGHQ]ZDQJHUHQRQGHU]RFKWRSV\ILOLVWHUSUHYHQWLHYDQFRQJHQLWDOH V\ILOLV=ZDQJHUHQEHKRUHQYURHJLQGH]ZDQJHUVFKDSWHZRUGHQRQGHU]RFKW,QGH SUDNWLMNJHEHXUWGLWQDKHWHHUVWHFRQWDFWWXVVHQGH]ZDQJHUHHQKDDU]ZDQJHUVFKDSV EHJHOHLGHU%LMGH]ZDQJHUHZRUGWEORHGDIJHQRPHQHQLQHHQODERUDWRULXP RQGHU]RFKWRSV\ILOLV ,QGHODERUDWRULDZRUGWYRRUDOOH]ZDQJHUHYURXZHQHHQ73+$ 7UHSRQHPD3DOOLGXP +DHPDJJOXWLQDWLRQ$VVD\

(57) XLWJHYRHUG,QGLHQGH]H73+$QHJDWLHILVZRUGW DDQJHQRPHQGDWGH]ZDQJHUHYURXZQRRLWPHWV\ILOLVLQFRQWDFWLVJHNRPHQ+HW RQGHU]RHNZRUGWGDDUPHHDIJHURQG(HQDIZLMNHQGUHVXOWDDWYDQGH73+$ VFUHHQLQJVWHVWZRUGWGLUHFWJHUDSSRUWHHUGHQJHYROJGGRRUQDGHURQGHU]RHNRS KHW]HOIGHEORHGPRQVWHU'H]HDDQYXOOHQGHRQGHU]RHNHQ]LMQGH9'5/ 9HQHUDO 'LVHDVH5HVHDUFK/DERUDWRU\

(58) WHVWHQGH)7$DEV )OXRUHVFHQW7UHSRQHPDO$QWLERG\ DEVRUSWLRQ

(59) WHVW'H)7$DEVWHVWVWHOWYDVWRIGHYURXZRRLWPHWV\ILOLVEHVPHWLV'H 9'5/WHVWEHSDDOWRIHUVSUDNHLVYDQHHQDFWLHYHV\ILOLV,QHQNHOHODERUDWRULDZRUGW LQSODDWVYDQGH9'5/WHVWJHEUXLNJHPDDNWYDQGH535 5DSLG3ODVPD5HDJLQFDUG

(60) WHVW,QGHSUDNWLMNZRUGHQGH)7$DEVWHVWHQGH9'5/WHVWJHOLMNWLMGLJXLWJHYRHUG RPGHUHVXOWDWHQ]RVQHOPRJHOLMNDDQGH]ZDQJHUVFKDSVEHJHOHLGHUWHNXQQHQPHOGHQ ,QGLHQGHXLWVODJHQGXELHXVRIWHJHQVWULMGLJ]LMQGLHQWQDHQNHOHZHNHQKHW]HOIGH VFUHHQLQJVWUDMHFWKHUKDDOGWHZRUGHQ'H73+$HQ)7$DEVWHVW]LMQWHVWHQGLHDQWL WUHSRQHPDOHDQWLVWRIIHQDDQWRQHQ'H73+$ZRUGWRRNELMEORHGGRQRUHQJHEUXLNWDOV.

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ppQ MDDUGHILQLWLHIXLWWHVOXLWHQZDQQHHUGH73+$)7$DEVHQGH9'5/QHJDWLHI]LMQ JHZRUGHQ'RRUYHUVFKLOOHQGHRQGHU]RHNVJURHSHQLVGHEHYLQGLQJJHGDDQGDW DOWHUQDWLHYH,J0LPPXQRDVVD\VHHQEHWHUHVHQVLWLYLWHLWKHEEHQPHWHHQJHOLMN EOLMYHQGHVSHFLILFLWHLWGDQGH6,J0)7$DEVWHVW9RRUDOVQRJZRUGWGHPRHLOLMN XLWYRHUEDUH6,J0)7$DEVWHVW RDGRRUGH&'&

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

(63) SHQLFLOOLQHRSGDJHQ 9DQ9RRUVW9DGHUHW DO

(64) 9RRU]ZDQJHUHQNLQGHUHQMRQJHUGDQMDDUHQSHUVRQHQPHWRYHU JHYRHOLJKHLGYRRUSHQLFLOOLQHZRUGHQDQGHUHEHKDQGHOLQJVVFKHPD VDDQEHYROHQ'H EHKDQGHOLQJPHWDQWLELRWLFDLV]HHUHIIHFWLHI'HODHVLHVJHQH]HQVQHOHQYROOHGLJ,Q VOHFKWVHHQNOHLQHPLQGHUKHLG 

(65) YDQGHJHYDOOHQLVHHQWZHHGHEHKDQGHOLQJ QRRG]DNHOLMN 3DWLsQWHQPRHWHQHONHGULHPDDQGHQWRW]HVPDDQGHQJHGXUHQGHWZHHMDDUQDGH EHKDQGHOLQJJHFRQWUROHHUGZRUGHQRS EOLMYHQGH

(66) DDQZH]LJKHLGYDQV\ILOLV9RRU.

(67) 3DJYDQ. 5,90UDSSRUW. +,9JHwQIHFWHHUGHQSDWLsQWHQJHOGWHHQDIZLMNHQGFRQWUROHEHOHLG 9DQ9RRUVW9DGHU HWDO

(68)  &RQJHQLWDOHV\ILOLVHQQHXURV\ILOLV ,QJHYDOYDQFRQJHQLWDOHV\ILOLVHQQHXURV\ILOLVZRUGWHHQLQWHQVLHYHULQWUDYHQHXV EHKDQGHOLQJVVFKHPDJHYROJGYHUGHHOGRYHUGULH SDVJHERUHQHQ

(69) WRW]HV YROZDVVHQHQ

(70) GRVHVSHUGDJJHGXUHQGHWRWGDJHQ 9DQ9RRUVW9DGHUHWDO

(71)  . 5LVLFRIDFWRUHQ. 5LVLFRJURHSHQYRRUV\ILOLV]LMQSHUVRQHQPHWYHHOZLVVHOHQGHVHNVXHOHFRQWDFWHQ ]RDOVSURVWLWXHHVSURVWLWXDQWHQKRPRHQELVHNVXHOHPDQQHQHQLQWUDYHQHX]H GUXJVJHEUXLNHUV,Q1HGHUODQGZRUGWKHWJURRWVWHGHHOYDQGHV\ILOLVJHYDOOHQ ZDDUJHQRPHQLQGHJURWHVWHGHQ $PVWHUGDP5RWWHUGDPHQ'HQ+DDJ

(72) WHYHQVLV PHHUGDQGHKHOIWYDQGHSDWLsQWHQPHWSULPDLUHRIVHFXQGDLUHV\ILOLVYDQQLHW 1HGHUODQGVHQDWLRQDOLWHLW 9HUGHULVGHLQWHUDFWLHPHW+,9FRPSOH[(QHU]LMGVKHEEHQGHSDWLsQWHQPHWV\ILOLV HHQYHUJURWHNDQVRSKHWYHUZHUYHQYDQHHQ+,9LQIHFWLHDQGHU]LMGVNDQGH SURJUHVVLHYDQ+,9ZRUGHQEHwQYORHGGRRUKHWGRRUPDNHQYDQRIKHWKHEEHQ GRRUJHPDDNWYDQHHQV\ILOLVLQIHFWLH . (SLGHPLRORJLH. ,Q1HGHUODQGQHHPWGHLQFLGHQWLHYDQV\ILOLVVLQGVEHJLQMDUHQWDFKWLJDIPHWHHQ VFKHUSHGDOLQJVLQGV'HGDOLQJYLQGWYRRUDOSODDWVELMPDQQHQ'HGDOLQJNDQ ZRUGHQWRHJHVFKUHYHQDDQHHQFRPELQDWLHYDQJHGUDJVYHUDQGHULQJ DOVJHYROJYDQGH $,'6HSLGHPLH

(73) EHVWULMGLQJVHQVFUHHQLQJVSURJUDPPD VELMEH]RHNHUVYDQVRD SROLNOLQLHNHQHQ]ZDQJHUHYURXZHQ ,QDQGHUH(XURSHVHODQGHQZRUGWHHQ]HOIGHWUHQGZDDUJHQRPHQ'LWLQWHJHQVWHOOLQJ WRWGH9HUHQLJGH6WDWHQZDDUWRWHHQWRHQDPHWH]LHQZDV :LMJHUJDQJV

(74)  +HWDDQWDODDQJHJHYHQJHYDOOHQYDQFRQJHQLWDOHV\ILOLVLQGHSHULRGHYDQDSULO WRWHQPHWDSULOEHGURHJ1DDSULOLVGHQLHXZHLQIHFWLH]LHNWHZHWLQ ZHUNLQJJHWUHGHQ+LHUGRRULVGHDDQJLIWHSOLFKWYRRUV\ILOLVHQFRQJHQLWDOHV\ILOLVSHU DSULOYHUYDOOHQ ,*=

(75) $OVJHYROJKLHUYDQ]LMQHUJHHQYROOHGLJH RYHU]LFKWHQYRRUYDQKHWDDQWDOV\ILOLVJHYDOOHQLQ1HGHUODQGEHVFKLNEDDU.

(76) 5,905DSSRUW. 3DJYDQ. 'HSROLNOLQLHNYRRUVHNVXHHORYHUGUDDJEDUHDDQGRHQLQJHQ VRD

(77) YDQGH$PVWHUGDPVH ** *'UHJLVWUHHUWKHWDDQWDOJHYDOOHQYDQSULPDLUHHQVHFXQGDLUHV\ILOLVHFKWHUQRJ VWHHGV8LWGH]HVRDVXUYHLOODQFHEOLMNWGDWHULQ$PVWHUGDPLQHHQVWHUNH WRHQDPHZDVYDQKHWDDQWDOV\ILOLVJHYDOOHQPHWQDPHRQGHUKRPRVHNVXHOHPDQQHQ +HWWRWDDODDQWDOJHYDOOHQYDQLQIHFWLHX]HV\ILOLVEHGURHJLQHHQWRHQDPHYDQ WHQRS]LFKWHYDQKHWMDDUGDDUYRRU )HQQHPDHWDO

(78) 2QGHUPDQQHQPHW KRPRVHNVXHOHFRQWDFWHQQDPKHWDDQWDOJHYDOOHQYDQLQIHFWLHX]HV\ILOLVWRHYDQLQ QDDULQ'H]HWRHQDPHZRUGWZDDUVFKLMQOLMNYHURRU]DDNWGRRUHHQ WRHQDPHYDQKHWDDQWDORQEHVFKHUPGHVHNVXHOHFRQWDFWHQ )HQQHPDHWDO

(79) .

(80) 3DJYDQ. 5,90UDSSRUW.

(81) 5,905DSSRUW. . 3DJYDQ. 2S]HWHQGRHOVWHOOLQJ YDQKHWOLWHUDWXXURQGHU]RHN. +HWOLWHUDWXXURQGHU]RHNKHHIWDOVGRHOLQ]LFKWWHYHUNULMJHQLQGHPHWKRGHQHQ UHVXOWDWHQYDQHHUGHUHJHSXEOLFHHUGHHFRQRPLVFKHHYDOXDWLHVPHWEHWUHNNLQJWRWGH VFUHHQLQJYDQ]ZDQJHUHQRSV\ILOLVWHUSUHYHQWLHYDQFRQJHQLWDOHV\ILOLV 'HHFRQRPLVFKHHYDOXDWLHVGLHELMKHWOLWHUDWXXURQGHU]RHNZHUGHQJHYRQGHQ]LMQ JHVHOHFWHHUGRSEDVLVYDQHHQDDQWDODOJHPHQHFULWHULD KHWRQGHUZHUSYDQGHSXEOLFDWLHPRHWHHQHFRQRPLVFKHHYDOXDWLH]LMQGHYDQ. œ. VFUHHQLQJYDQ]ZDQJHUHQRSV\ILOLVWHUSUHYHQWLHYDQFRQJHQLWDOHV\ILOLV œ. GHSXEOLFDWLHGLHQWLQ1HGHUODQGV(QJHOV'XLWVRI)UDQVWH]LMQJHVFKUHYHQ. œ. GHSXEOLFDWLHGLHQWLQ1HGHUODQGVHELEOLRWKHNHQEHVFKLNEDDUWH]LMQ. 2SEDVLVYDQGHUHIHUHQWLHOLMVWHQYDQGHJHYRQGHQDUWLNHOHQZHUGYHUGHUJH]RFKWQDDU UHOHYDQWJHDFKWHOLWHUDWXXU VQHHXZEDOPHWKRGHRI UHIHUHQFHWUDFNLQJ

(82)  . *HEUXLNWHGDWDEDVHV. 9RRUKHWVHOHFWHUHQHQYHU]DPHOHQYDQGHVWXGLHVWHQEHKRHYHYDQGLW OLWHUDWXXURQGHU]RHN]LMQGHYROJHQGHEURQQHQJHEUXLNW 0HGOLQH 'H]HGDWDEDVHYDQGH8QLWHG6WDWHV1DWLRQDO/LEUDU\RI0HGLFLQHLVGRRU]RFKWPHW EHKXOSYDQKHW]RHNSURJUDPPD:LQVSLUVRYHUGHSHULRGHYDQWRWHQPHWPDDUW +HW]RHNSURILHOOXLGGHDOVYROJW6\SKLOLV DOOVXEKHDGLQJV

(83) :,7+&RVWVDQG &RVWDQDO\VLV DOOVXEKHDGLQJV

(84) 25(FRQRPLFV DOOVXEKHDGLQJV

(85) 253UHYHQWLRQDQG FRQWURO DOOVXEKHDGLQJV

(86)  ,1$+7$'DWDEDVH +HW,QWHUQDWLRQDO1HWZRUNRI$JHQFLHVRI+HDOWK7HFKQRORJ\$VVHVVPHQW ,1$+7$

(87) EHKHHUWHHQGDWDEDVHPHWSXEOLFDWLHVYDQGHOHGHQYDQGH]HRUJDQLVDWLH2RNGH]H.

(88) 3DJYDQ. 5,90UDSSRUW. GDWDEDVHLVWRHJDQNHOLMNYLDLQWHUQHW>ZZZLQDKWDRUJ@+HW]RHNSURILHOOXLGGHDOV YROJW6\SKLOLV25&RQJHQLWDOV\SKLOLV &5''DWDEDVHV 'HZHEVLWHYDQKHW&HQWUHIRU5HYLHZVDQG'LVVHPLQDWLRQ &5'

(89) JHHIWWRHJDQJWRWGH YROJHQGHGDWDEDVHVGHGDWDEDVHRI$EVWUDFWVRI5HYLHZVRI(IIHFWLYHQHVV '$5(

(90)  'H1+6(FRQRPLF(YDOXDWLRQ'DWDEDVH 1+6(('

(91) HQGH+HDOWK7HFKQRORJ\ $VVHVVPHQW +7$

(92) 'DWDEDVH'H]HGDWDEDVHV]LMQYLDKHWLQWHUQHW >KWWSQKVFUG\RUNDFXN@PHWGHYROJHQGH]RHNWHUPHQGRRU]RFKW6\SKLOLV25 &RQJHQLWDOV\SKLOLV +HDOWK67$5 'H+HDOWK67$5 +HDOWK6HUYLFHV7HFKQRORJ\$GPLQLVWUDWLRQDQG5HVHDUFK

(93) EHVWDDW XLWGHYRRUPDOLJH+HDOWK +HDOWK3ODQQLQJDQG$GPLQLVWUDWLRQ

(94) HQ+67$5 +HDOWK 6HUYLFHV7HFKQRORJ\$VVHVVPHQW5HVHDUFK

(95) GDWDEDVHV2RNGH+HDOWK67$5GDWDEDVH LVYLDLQWHUQHW>KWWSLJPQOPQLKJRY@WRHJDQNHOLMN'HKLHUELMJHEUXLNWH]RHNWHUP ZDV6\SKLOLV25&RQJHQLWDOV\SKLOLV$1'&RVWV25&RVWDQDO\VLV25(FRQRPLFV $1'([FOXGH0HGOLQHUHIHUHQFHV 1*&GDWDEDVH 'H1DWLRQDO*XLGHOLQH&OHDULQJKRXVH 1*&

(96) GDWDEDVHEHYDW HYLGHQFHEDVHG. NOLQLVFKHULFKWOLMQHQ2RNGH]HGDWDEDVHLVWRHJDQNHOLMNYLDLQWHUQHW >ZZZJXLGHOLQHJRY@'H]RHNWHUPOXLGGHDOVYROJW6\SKLOLV25&RQJHQLWDOV\SKLOLV.

(97) 5,905DSSRUW. . 3DJYDQ. 5HVXOWDWHQYDQGHVHOHFWLHSURFHGXUH. 'H]RHNWHUPHQ]RDOVEHVFKUHYHQLQKRRIGVWXNOHYHUGHQLQGHYLMIJHUDDGSOHHJGH GDWDEDVHVUHIHUHQWLHVRSZDDUYDQULFKWOLMQHQ9RRUQDJHQRHJDOGH]HUHIHUHQWLHV JROGGDWGH]HQLHWYROGHGHQDDQGHDOJHPHQHVHOHFWLHFULWHULD]RDOVEHVFKUHYHQLQ KRRIGVWXNYHHODORPGDWKHWJHHQHFRQRPLVFKHHYDOXDWLHYDQVFUHHQLQJRSV\ILOLVELM ]ZDQJHUHQZDV . 'HYHUJHOLMNLQJYDQGHJHVHOHFWHHUGHVWXGLHV. 1DGH]HHHUVWHVHOHFWLHEOHYHQVOHFKWVYLMIHFRQRPLVFKHHYDOXDWLHVRYHU ZDDUYDQWZHH EXLWHQGH]RHNVWUDWHJLHsQRP]LMQDFKWHUKDDOG

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

(99) 3DJYDQ. 5,90UDSSRUW.  %RQW-&DLUR,YDQ'RRUQXP*--&RXWLQKR5$%OHHNHU23+HWQXWWLJHIIHFW YDQVHURORJLVFKHVFUHHQLQJRSV\ILOLVLQGH]ZDQJHUVFKDSLQGHUHJLR$PVWHUGDP 1HG7LMGVFKU*HQHHVNXQG +LHUQD]XOOHQGHJHVHOHFWHHUGHVWXGLHVDDQGHKDQGYDQHHQDDQWDODVSHFWHQYDQ HFRQRPLVFKHHYDOXDWLHVZRUGHQEHVSURNHQ'H]HDVSHFWHQ]LMQW\SHHFRQRPLVFKH HYDOXDWLHJHNR]HQSHUVSHFWLHIRQGHU]RFKWHSRSXODWLHGHNRVWHQVRRUWHQGLH]LMQ PHHJHQRPHQLQKHWRQGHU]RHNGHGLVFRQWRYRHWYDQGHNRVWHQ HQHIIHFWHQ

(100) YDQGH VFUHHQLQJHQGHVHQVLWLYLWHLWVDQDO\VH  7\SHHFRQRPLVFKHHYDOXDWLH (U]LMQW\SHQ YROOHGLJH

(101) HFRQRPLVFKHHYDOXDWLHV'LW]LMQGHNRVWHQPLQLPDOLVDWLH DQDO\VHGHNRVWHQEDWHQDQDO\VHGHNRVWHQHIIHFWLYLWHLWVDQDO\VHHQGHNRVWHQ XWLOLWHLWVDQDO\VH œ. .RVWHQPLQLPDOLVDWLHDQDO\VH .0$

(102)  (HQ.0$RQGHU]RHNWYHUVFKLOOHQGHDOWHUQDWLHYHQPHWHHQJHOLMNHHIIHFWLYLWHLW. ]RGDWDOOHHQGHNRVWHQYDQGH]HLQWHUYHQWLHVKRHYHQWHZRUGHQRQGHU]RFKW œ. .RVWHQEDWHQDQDO\VH .%$

(103)  ,QHHQ.%$ZRUGHQDOOHNRVWHQHQDOOHEDWHQLQJHOGJHZDDUGHHUG,QGH]H. EHQDGHULQJVZLM]HGLHQHQGHHIIHFWHQ ]RDOVJHZRQQHQOHYHQVMDUHQHQNZDOLWHLWYDQ OHYHQ

(104) LQJHOGWHZRUGHQXLWJHGUXNW œ. .RVWHQHIIHFWLYLWHLWVDQDO\VH .($

(105)  ,QHHQ.($ZRUGHQGHYHUVFKLOOHQGHDOWHUQDWLHYHQYHUJHOHNHQLQUHODWLHWRWHHQ. VSHFLILHNHRSEUHQJVWELMYRRUEHHOGNRVWHQSHUYyyUNRPHQLQIHFWLHRINRVWHQSHU JHZRQQHQOHYHQVMDDU œ. .RVWHQXWLOLWHLWVDQDO\VH .8$

(106)  ,QGH]HEHQDGHULQJVZLM]HNXQQHQ]RZHOGHOHYHQVYHUOHQJHQGHDOVGH. NZDOLWHLWVYHUKRJHQGHDVSHFWHQYDQHHQLQWHUYHQWLHZRUGHQXLWJHGUXNWLQHHQ XQLIRUPHRSEUHQJVWPDDW(HQYRRUEHHOGKLHUYDQLVGH4$/< 4XDOLW\$GMXVWHG /LIH<HDU

(107) HHQYRRUNZDOLWHLWJHFRUULJHHUGOHYHQVMDDU'HUHVXOWDWHQZRUGHQGDQ XLWJHGUXNWLQNRVWHQSHU4$/<  'DDUQDDVW]LMQRRNQRJSDUWLsOHHYDOXDWLHVPRJHOLMN]RDOVELMYRRUEHHOGGHNRVWHQ. DQDO\VH 'UXPPRQGHWDO

(108) +LHUELMZRUGHQXLWVOXLWHQGGHILQDQFLsOHNRVWHQHQ GH ILQDQFLsOH

(109) HIIHFWHQZHHUJHJHYHQ'LWW\SHDQDO\VHPDDNWKHWPRJHOLMNHHQ.

(110) 5,905DSSRUW. 3DJYDQ. YHUKRXGLQJVJHWDOWXVVHQGHNRVWHQYDQHHQSURJUDPPDHQGHEHVSDULQJHQDOVJHYROJ YDQGLWSURJUDPPDWHEHUHNHQHQ  2QGHUVWDDQGHWDEHOJHHIWDDQZHONW\SHHFRQRPLVFKHHYDOXDWLHGRRUGHJHVHOHFWHHUGH. VWXGLHVLVJHEUXLNW9RRUGHWHUPLQRORJLHLVJHEUXLNJHPDDNWYDQWDEHOYDQ 'UXPPRQGHWDO 

(111) 7HYHQVJHHIWWDEHOKHWSXEOLFDWLHMDDUKHWUHIHUHQWLHMDDUHQ KHWODQGZDDUGHVWXGLHLVXLWJHYRHUGZHHU$OVODDWVWHZRUGWLQGH]HWDEHODDQJHJHYHQ ZDWKHWJHNR]HQSHUVSHFWLHIYDQGHVWXGLHVZDV'LWLVYDQEHODQJRPWHDFKWHUKDOHQ ZHONHNRVWHQ]LMQPHHJHQRPHQLQGHEHUHNHQLQJHQ  7DEHO. 7\SHHFRQRPLVFKHHYDOXDWLHSXEOLFDWLHHQUHIHUHQWLHMDDUHQJHNR]HQ SHUVSHFWLHIYDQGHHYDOXDWLH. (HUVWHDXWHXU. SXEOLFDWLHMDDU

(112) 6WUD\3HGHUVHQ. 7\SH. HFRQRPLVFKH HYDOXDWLH .RVWHQDQDO\VH. 5HIHUHQWLHMDDU. /DQG. *HNR]HQ SHUVSHFWLHI. . 1RRUZHJHQ. 0DDWVFKDSSHOLMN. 

(113) *UXWHNH 

(114). .($. . 1HGHUODQG. 0DDWVFKDSSHOLMN. %LQGHOV 

(115). .RVWHQDQDO\VH. . 1HGHUODQG. 0DDWVFKDSSHOLMN. *UXWHNH 

(116). .($. . 1HGHUODQG. 0DDWVFKDSSHOLMN. %RQW 

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sQWHQ] *ROG

(118) 'HIDUPDFRHFRQRPLVFKH ULFKWOLMQHQ &9=

(119) QHPHQKHWPDDWVFKDSSHOLMNSHUVSHFWLHIDOVXLWJDQJVSXQW.

(120) 3DJYDQ. 5,90UDSSRUW. +HWPDDWVFKDSSHOLMNSHUVSHFWLHIKRXGWUHNHQLQJPHWDOOHDFWRUHQLQGHVDPHQOHYLQJ. 'LWEHWHNHQWGDWDOOHNRVWHQ yyNGHNRVWHQEXLWHQGHJH]RQGKHLGV]RUJ

(121) LQGHHYDOXDWLH PRHWHQZRUGHQPHHJHQRPHQ +RHZHODOOHYLMIGHVWXGLHVLQSULQFLSHWUDFKWHQHHQPDDWVFKDSSHOLMNSHUVSHFWLHIWH. NLH]HQNRPWGLWQLHWDOWLMGHYHQJRHGXLWGHYHUI=RQHPHQDOOHVWXGLHVZHOGH LQGLUHFWHNRVWHQEXLWHQGHJH]RQGKHLGV]RUJPHH VSHFLDDORQGHUZLMV

(122) PDDUGH SURGXFWLYLWHLWVYHUOLH]HQZRUGHQPHHVWDOEXLWHQEHVFKRXZLQJJHODWHQ3DUDJUDDI EHVWHHGWPHHUDDQGDFKWDDQGHNRVWHQVRRUWHQGLHLQGHHYDOXDWLHV]LMQPHHJHQRPHQ  . 'RHOSRSXODWLH. +HWYRRUNRPHQYDQV\ILOLVYHUVFKLOWVWHUNWXVVHQGHJURWHVWHGHQ $PVWHUGDPHQ. 5RWWHUGDP

(123) HQKHWSODWWHODQG GHUHVWYDQ1HGHUODQG

(124) 'HVSHFLILHNHSRSXODWLHVLQGH YHUVFKLOOHQGHRQGHU]RHNHQEHSDOHQGHUHVXOWDWHQYDQGHYHUVFKLOOHQGHNRVWHQ HIIHFWLYLWHLWVUDWLR VVWHUN2PGH]HUHGHQLVKHWYDQEHODQJRPGHYHUVFKLOOHQGH SRSXODWLHV]RDOVGH]H]LMQRQGHU]RFKWLQGHJHVHOHFWHHUGHHFRQRPLVFKHHYDOXDWLHV JRHGLQNDDUWWHEUHQJHQ  DEHOWRRQWHHQRYHU]LFKWYDQGHYHUVFKLOOHQGHGRHOSRSXODWLHV 7  2YHU]LFKWYDQGHYHUVFKLOOHQGHGRHOSRSXODWLHV 7DEHO (HUVWHDXWHXU. 'RHOSRSXODWLH]ZDQJHUHQ. 2SPHUNLQJHQ. 6WUD\3HGHUVHQ. 1RRUZHJHQ. œ. 2SEDVLVYDQXLWVODJHQYDQVHUD. *UXWHNH 

(125). 1HGHUODQG RQGHUVFKHLG. œ. 6FKDWWLQJV\ILOLVLQFLGHQWLHRQGHU. JURWHVWHGHQHQUHVWYDQ. ]ZDQJHUHQRSEDVLVYDQDDQJLIWHFLMIHUV. 1HGHUODQG

(126). YDQGH*HQHHVNXQGLJH+RRIGLQVSHFWLHLQ 1HGHUODQGLQ. %LQGHOV. $PVWHUGDP. œ. 2SEDVLVYDQXLWVODJHQYDQVHUDV\ILOLV VFUHHQLQJJHGXUHQGH. *UXWHNH 

(127). %RQW. 1HGHUODQG RQGHUVFKHLG. œ. 2SEDVLVYDQJHUDSSRUWHHUGHXLWVODJHQ. JURWHVWHGHQHQUHVWYDQ. YDQGHV\ILOLVVFUHHQLQJYRRUGH6WUHHN. 1HGHUODQG

(128). ODERUDWRULDJHGXUHQGH. $PVWHUGDP. œ. 6FKDWWLQJRSEDVLVYDQLQJH]RQGHQVHUD V\ILOLVVFUHHQLQJJHGXUHQGH. .

(129) 5,905DSSRUW. 3DJYDQ. $OOHHQLQGHWZHHVWXGLHVYDQ*UXWHNH]LMQDOVSRSXODWLH]ZDQJHUHQXLWJHKHHO. 1HGHUODQGPHHJHQRPHQ,QGHUHVXOWDWHQYDQGH]HWZHHVWXGLHZRUGHQGDQRRNQDDVW GHEDWHQNRVWHQUDWLR VYDQGHJURWHVWHGHQ $PVWHUGDPHQ5RWWHUGDP

(130) RRNGHEDWHQ NRVWHQUDWLR VYRRUGHUHVWYDQ1HGHUODQGZHHUJHJHYHQ 6WUD\3HGHUVHQRQGHU]RFKWDOOH]ZDQJHUHQXLWXLWJHKHHO1RRUZHJHQ]RQGHU. RQGHUYHUGHOLQJYDQPDWHYDQVWHGHOLMNKHLG%LQGHOVHQ%RQWKDGGHQDOOHHQGH ]ZDQJHUHQLQ$PVWHUGDPDOVGRHOSRSXODWLH  . .RVWHQVRRUWHQ. ,QHFRQRPLVFKHHYDOXDWLHNXQQHQYHUVFKLOOHQGHNRVWHQZRUGHQRQGHUVFKHLGHQGLUHFWH. NRVWHQLQGLUHFWHNRVWHQHQLQWDQJLEOHV 'UXPPRQGHWDO

(131)  2QGHUGLUHFWHNRVWHQZRUGHQYHUVWDDQGHNRVWHQYDQ LQGLWJHYDO

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

(133). -D. 1HH. 1HH. %LQGHOV. -D. 1HH. 1HH. *UXWHNH 

(134). -D. 1HH. 1HH. %RQW. -D. 1HH. 1HH.

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wQYHVWHHUGZRUGHQLQGHVFUHHQLQJYRRUGDWGHHIIHFWHQ KHWDDQWDOYyyUNRPHQ JHYDOOHQYDQFRQJHQLWDOHV\ILOLV

(136) NXQQHQZRUGHQJHUHDOLVHHUG(FRQRPHQ]LMQKHW HURYHUHHQVGDWPHWGH]HWLMGVYRRUNHXUUHNHQLQJPRHWZRUGHQJHKRXGHQGLWQRHPW PHQGLVFRQWHULQJ'HKRRJWHYDQGH]HGLVFRQWRYRHWLVWLMGVDIKDQNHOLMNHQYDULHHUWSHU ODQG,QWHUQDWLRQDDOZRUGHQYHUVFKLOOHQGHSHUFHQWDJHVDOVEDVLVYRRUGLVFRQWHULQJ JHKDQWHHUG2SGLWPRPHQWLVKHWJHOGHQGHGLVFRQWHULQJVSHUFHQWDJHLQ1HGHUODQG &9=

(137)  2YHUKHWGLVFRQWHUHQYDQHIIHFWHQEHVWDDWZHOHHQFRQWURYHUVH5HFHQWH1HGHUODQGVH. ULFKWOLMQHQJHYHQDDQGDWWRHNRPVWLJHXLWNRPVWHQHQHIIHFWHQPHWKHW]HOIGHSHUFHQWDJH PRHWHQZRUGHQJHGLVFRQWHHUG &9=

(138)   7DEHO. *HEUXLNWHGLVFRQWRYRHWYRRUGHNRVWHQHQHIIHFWHQ. (HUVWHDXWHXU. 'LVFRQWHUHQNRVWHQ. 'LVFRQWHUHQ. 'LVFRQWRYRHW. HIIHFWHQ 6WUD\3HGHUVHQ. -D. 1YW. . *UXWHNH 

(139). -D. -D. . %LQGHOV. -D. 1YW. . *UXWHNH 

(140). -D. 1HH. . %RQW. -D. 1YW. . 2PGDWJHHQHIIHFWHQ]LMQRSJHQRPHQLQGH]HDQDO\VH V

(141).

(142) 5,905DSSRUW. 3DJYDQ. 7DEHOWRRQWGHYHUVFKLOOHQGHGLVFRQWRSHUFHQWDJHVYDQGHYLMIJHVHOHFWHHUGHVWXGLHV. +HWJHEUXLNYDQDQGHUHGLVFRQWRSHUFHQWDJHVKHHIWXLWHUDDUGLQYORHGRSGHXLWNRPVWHQ YDQGHYHUVFKLOOHQGHVWXGLHV +HWGLVFRQWHUHQYDQGHNRVWHQLVLQDOOHVWXGLHVJHEHXUG'HGLVFRQWRYRHWELMDOOH. 1HGHUODQGVHVWXGLHVZDV+HWGLVFRQWRSHUFHQWDJHLQGH1RRUVHVWXGLHZDV  'HVWXGLHYDQ*UXWHNH 

(143) JHHIWHHQQLHWJHGLVFRQWHHUGHHQHHQJHGLVFRQWHHUGH. YDULDQW+HWDDQWDOJHZRQQHQOHYHQVMDUHQZRUGHQJHGLVFRQWHHUGPHW+HWUDSSRUW YDQ*UXWHNH 

(144) JHHIWDOOHHQHHQQLHWJHGLVFRQWHHUGHYDULDQWDDQ  . 6HQVLWLYLWHLWVDQDO\VH. (HQVHQVLWLYLWHLWVDQDO\VHRQGHU]RHNWGHLQYORHGYDQGHJHPDDNWHYHURQGHUVWHOOLQJHQ. HQGHJHNR]HQSDUDPHWHUZDDUGHQRSGHUHVXOWDWHQpQPDDNWLQ]LFKWHOLMNZHONH YHURQGHUVWHOOLQJHQRISDUDPHWHUZDDUGHQKHWPHHVWYDQLQYORHG]LMQRSGHUHVXOWDWHQ 7DEHOJHHIWHHQRYHU]LFKWYDQGHVHQVLWLYLWHLWVDQDO\VHVLQGHJHVHOHFWHHUGHVWXGLHV  7DEHO. 2YHU]LFKWVHQVLWLYLWHLWVDQDO\VHVYDQGHJHVHOHFWHHUGHVWXGLHV. (HUVWHDXWHXU. 6HQVLWLYLWHLWV. *HYDULHHUGHSDUDPHWHUV. DQDO\VH. 0HHVWH. LQYORHGULMNH SDUDPHWHU. 6WUD\3HGHUVHQ. -D. œ. 'LVFRQWRYRHW. œ. ,QFLGHQWLHV\ILOLV. œ. 7UDQVPLVVLHNDQV. œ. 6HQVLWLYLWHLWHQVSHFLILFLWHLW. œ. :RUGWQLHW EHVFKUHYHQ. VFUHHQLQJVWHVW *UXWHNH 

(145). -D. œ. 'LVFRQWRYRHW. 1YW. %LQGHOV. 1HH. 1YW. 1YW. *UXWHNH 

(146). 1HH. 1YW. 1YW. %RQW. 1HH. 1YW. 1YW.  $OOHHQGHVWXGLHYDQ6WUD\3HGHUVHQEHVFKULMIWHHQVXPPLHUHVHQVLWLYLWHLWVDQDO\VH'H. RYHULJHVWXGLHVEHVFKULMYHQHLJHQOLMNLQ]LMQJHKHHOJHHQVHQVLWLYLWHLWVDQDO\VH*UXWHNH.

(147) 3DJYDQ. 5,90UDSSRUW. 

(148) YDULHHUWDOOHHQPHWGHGLVFRQWRYRHW$OOHHQKHWYDULs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sUHQYDQGHRYHUJDQJVNDQVHQLQKHW]LHNWHPRGHOWHQDOOHWLMGHQNRVWHQ HIIHFWLHIGDWZLO]HJJHQGDWGHEDWHQGHNRVWHQYULMZHODOWLMGGHNRVWHQRYHUWUHIIHQ 9RRUHHQXLWJHEUHLGHEHVFKULMYLQJYDQGHVHQVLWLYLWHLWVDQDO\VHZRUGWYHUZH]HQQDDU ELMODJH,9 .

(149) 5HVXOWDWHQHQFRQFOXVLHVOLWHUDWXXURQGHU]RHN. 3DJYDQ. . œ. œ. *UXWHNH. 

(150). . œ. œ.  . 

(151) . ¦YRRUJHKHHO1HGHUODQG ¦YRRUGHUHVWYDQ 1/. ¦ JHGLVFRQWHHUG

(152) YRRUJHKHHO1/ ¦ QLHWJHGLVFRQWHHUG

(153) YRRUJHKHHO1/. .RVWHQHIIHFWLYLWHLWVUDWLR V NSJO. œ. œ. œ. œ. œ. œ. œ. œ. LQJHKHHO 1HGHUODQG LQ$PVWHUGDP LQ5RWWHUGDP LQUHVWYDQ 1HGHUODQG. LQ$PVWHUGDP HQ5RWWHUGDP LQUHVWYDQ 1HGHUODQG  LQ$PVWHUGDP

(154). LQJHKHHO 1RRUZHJHQ. %DWHQNRVWHQUDWLR V. . œ. œ. œ. œ. œ. œ. œ. œ. œ. œ. œ. 2YHUGHSHULRGH *H]RQGKHLGVHIIHFWHQQLHWPHHJHQRPHQ *HHQLQGLUHFWHNRVWHQ .RVWHQJHGLVFRQWHHUGPHW 2YHUGHWZHHGHKHOIWYDQHQ .RVWHQJHGLVFRQWHHUGPHW. .RVWHQZRUGHQJHGLVFRQWHHUGPHW =RZHOGLUHFWHDOVLQGLUHFWHNRVWHQ]LMQ PHHJHQRPHQ *H]RQGKHLGVHIIHFWHQQLHWPHHJHQRPHQ 2YHUGHSHULRGH .RVWHQHQHIIHFWHQJHGLVFRQWHHUGPHW. 2SPHUNLQJHQ. 2YHU]LFKWYDQGHYHUVFKLOOHQGHUDWLR VYDQGHJHVHOHFWHHUGHVWXGLHV. %LQGHOV. 

(155). *UXWHNH. DXWHXU 6WUD\ 3HGHUVHQ. (HUVWH. 7DEHO. 'HUHVXOWDWHQYDQGHYHUVFKLOOHQGHVWXGLHVZRUGHQLQWDEHOZHHUJHJHYHQ. *UXWHNH*UXWHNH

(156) JHYHQGHUHVXOWDWHQ]RZHOLQEDWHQNRVWHQUDWLR VDOVLQNRVWHQSHUJHZRQQHQOHYHQVMDDU. 3HGHUVHQ%LQGHOV%RQW

(157) GUXNNHQGHJHYRQGHQUHVXOWDWHQXLWLQHHQEDWHQNRVWHQUDWLR'HNRVWHQHIIHFWLYLWHLWVDQDO\VHV. 'HUHVXOWDWHQYDQGHVWXGLHVZRUGHQDIKDQNHOLMNYDQKHWW\SHHFRQRPLVFKHHYDOXDWLHLQHHQRSEUHQJVWPDDWXLWJHGUXNW'HNRVWHQDQDO\VHV 6WUD\. . 5,905DSSRUW.

(158) . NSJO NRVWHQSHUJHZRQQHQOHYHQVMDDU. %RQW. 3DJYDQ.  QLHWJHGHILQLHHUG. œ. œ. œ. œ. œ. 2YHUGHSHULRGH .RVWHQJHGLVFRQWHHUGPHW *H]RQGKHLGVHIIHFWHQQLHWPHHJHQRPHQ *HHQLQGLUHFWHNRVWHQ. UDWLRGHILQDQFLsOHNRVWHQRYHUWUHIIHQGHEDWHQ.  UDWLR!GHILQDQFLsOHEDWHQRYHUWUHIIHQGHNRVWHQ. LQ$PVWHUGDP. 5,90UDSSRUW.

(159) 5,90UDSSRUW. 3DJYDQ. 2QGDQNVGHYHUVFKLOOHQGHJHEUXLNWHPHWKRGLHNHQYRRUKHWEHUHNHQHQYDQGHUDWLR V]RDOV. EHVFKUHYHQLQGHYRRUJDDQGHSDUDJUDIHQYDQKRRIGVWXNWRRQWWDEHOHHQHHQGXLGLJEHHOG QDPHOLMNGDWGHVFUHHQLQJYDQ]ZDQJHUHQRSV\ILOLVWHUSUHYHQWLHYDQFRQJHQLWDOHV\ILOLV JXQVWLJHUDWLR VRSOHYHUWGDWZLO]HJJHQGDWGHILQDQFLsOHEDWHQJURWHU]LMQGDQGHNRVWHQ 'HVWXGLHYDQ6WUD\3HGHUVHQEHVFKULMIWHHQEDWHQNRVWHQUDWLRYDQ'HVWXGLHYDQ*UXWHNH. 

(160) EHVFKULMIWGDWLQGHJURWHVWHGHQGHVFUHHQLQJHHQNRVWHQEHVSDUHQGHLQWHUYHQWLHLV,Q GHUHVWYDQ1HGHUODQGLVGLWLQGH]HVWXGLHQLHWKHWJHYDO'HEDWHQNRVWHQUDWLRNRPWGDQXLW RS'HNRVWHQSHUJHZRQQHQOHYHQVMDDUEHGUDJHQ¦ QLHWJHGLVFRQWHHUG

(161) HQ LQGLHQGHHIIHFWHQJHGLVFRQWHHUGZRUGHQ¦ 2RNGHVWXGLHYDQ%LQGHOVEHVFKULMIWHHQJXQVWLJHEDWHQNRVWHQUDWLRYDQYRRUGH. VFUHHQLQJYDQ]ZDQJHUHQLQ$PVWHUGDP 'HWZHHGHVWXGLHYDQ*UXWHNHHWDO 

(162) JHHIWHHQEDWHQNRVWHQUDWLRYDQYRRUKHHO. 1HGHUODQG'HNRVWHQSHUJHZRQQHQOHYHQVMDDUEHGUDJHQYRRUJHKHHO1HGHUODQG¦ JHGLVFRQWHHUG

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

(164) RYHUVWLMJHQGHNRVWHQYDQGHVFUHHQLQJUXLPGULHPDDOGH RSEUHQJVWHQYDQGHVFUHHQLQJWHUZLMOGHXSGDWHYDQGH]HVWXGLHXLWHHQSRVLWLHYH YHUKRXGLQJYDQGHILQDQFLs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wQYORHGWWH]LMQGRRUGHRQJXQVWLJHDDQQDPHRYHUKHWYRRUNRPHQYDQV\ILOLVLQGHUHVW YDQ1HGHUODQG.

(165) 3DJYDQ. 5,90UDSSRUW. %LMKHWLQWHUSUHWHUHQYDQGH]HUHVXOWDWHQPRHWppQJURWHNDQWWHNHQLQJZRUGHQJHPDDNW. QDPHOLMNGDWKHWJHEUXLNWHPRGHOHHQRQ]HNHUHIDFWRULVRPGDWJHHQYDQGHYLMIVWXGLHVKHW ]LHNWHPRGHOYDOLGHHUW%LMGHVHQVLWLYLWHLWVDQDO\VHLQELMODJH,9EOLMNWGDWKHWYDULsUHQYDQGH SDUDPHWHUZDDUGHQDDQ]LHQOLMNHZLM]LJLQJHQJHYHQWHQRS]LFKWHQYDQGHEDVLVUDPLQJ(FKWHU ELMHONHVHQVLWLYLWHLWVDQDO\VHLQELMODJH,9EOLMIWGHVFUHHQLQJYDQ]ZDQJHUHQRSV\ILOLVNRVWHQ HIIHFWLHI.

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yyUNRPHQ NRVWHQYDQGHODQJHWHUPLMQJHYROJHQYDQGHJHwQIHFWHHUGHPRHGHU'RRUGHPRHGHUHHQ DGHTXDWHEHKDQGHOLQJWHJHYHQZRUGHQGHODQJHWHUPLMQJHYROJHQYDQV\ILOLVYyyUNRPHQ 'H]HQLHWEHUHNHQGHNRVWHQKHEEHQHHQJXQVWLJHIIHFWRSGHUHVXOWDWHQ'HNRVWHQ HIIHFWLYLWHLWLVZDDUVFKLMQOLMNQRJJXQVWLJHUGDQEHVFKUHYHQLQGHYLMIVWXGLHV .

(167) 3DJYDQ. 5,90UDSSRUW. 5HFHQWLVHHQWRHQDPHYDQGHLQFLGHQWLHYDQV\ILOLV LQ$PVWHUGDP

(168) EHVFKUHYHQGRRU. )HQQHPDHWDO

(169) :DQQHHUGHLQFLGHQWLHYDQV\ILOLVRQGHU]ZDQJHUHQWRHQHHPW]DORRN GHNRVWHQHIIHFWLYLWHLWYDQLQWHUYHQWLHVWHUYRRUNRPLQJYDQ FRQJHQLWDOH

(170) V\ILOLVJXQVWLJHU ZRUGHQ  7LMGHQVGLWOLWHUDWXXURQGHU]RHN]LMQJHHQDDQZLM]LQJHQJHYRQGHQGDWGHFRQFOXVLHVYDQGH. JHVHOHFWHHUGHVWXGLHVYHUDQGHUG]RXGHQ]LMQDOVJHYROJYDQUHFHQWHRQWZLNNHOLQJHQRSKHW JHELHGYDQELMYRRUEHHOGGHNRVWHQYDQGHVFUHHQLQJVWHVWHQGHLQFLGHQWLHYDQV\ILOLVELM ]ZDQJHUHQHQ]2SEDVLVYDQGLWOLWHUDWXXURQGHU]RHNNDQJHFRQFOXGHHUGZRUGHQGDWGH VFUHHQLQJYDQ]ZDQJHUHQRSV\ILOLVWHUSUHYHQWLHYDQFRQJHQLWDOHV\ILOLV]LQYROLV .

(171) 5,90UDSSRUW. 3DJYDQ. /LWHUDWXXU  œ. %LQGHOV3-(3RVWPD0-3HHERRPV3*+&RXWLQKR5$YDQGHQ+RHN-$5+HWQXWWLJ HIIHFWYDQKHWVHURORJLVFKVFUHHQLQJVSURJUDPPDYRRUOXHVELM]ZDQJHUHYURXZHQLQ $PVWHUGDPLQGHSHULRGH1HG7LMGVFKU*HHVNXQG.  œ. &ODUN(*'DQEROW17KH2VORVWXG\RIWKHQDWXUHNFRXUVHRIXQWUHDWHGV\SKLOLVDQ HSLGHPLRORJLFDOLQYHVWLJDWLRQEDVHGRQDUHVWXG\RIWKH%RHFN%UXXVNJDDUGPDWHULDO 0HG&OLQ1RUWK$P.  œ. &9= &ROOHJHYRRU=RUJYHU]HNHULQJHQ

(172) 5LFKWOLMQHQYRRUIDUPDFRHFRQRPLVFKH RQGHU]RHN$PVWHOYHHQ&ROOHJHYRRU=RUJYHU]HNHULQJHQ.  œ. 'UXPPRQG0)2 %ULHQ%6WRGGDUW*/7RUUDQFH*:0HWKRGVIRUWKH(FRQRPLF (YDOXDWLRQRI+HDOWK&DUH3URJUDPPHV6HFRQGHGLWLRQ2[IRUG2[IRUG8QLYHUVLW\ 3UHVV.  œ. )HQQHPD-6$&DLUR,&RXWLQKR5$6WHUNHWRHQDPHYDQJRQRUURHHQV\ILOLVRQGHU EH]RHNHUVYDQGH$PVWHUGDPVH62$SROLNOLQLHN1HG7LMGVFKU*HQHHVNXQG .  œ. )LXPDUD1-)OHPLQJ:/'RZQLQJ-**RRG)/7KHLQFLGHQFHRISUHQDWDOV\SKLOLVDW WKH%RVWRQ&LW\+RVSLWDO(QJ-0HG.  œ. *ROG056LHJHO5XVVHOO/%HWDO&RVWHIIHFWLYHQHVVLQ+HDOWKDQG0HGLFLQH(HUVWH GUXN1HZ<RUN2[IRUG8QLYHUVLW\3UHVV. œ. *UXWHNH33RVWPD0--DJHU-&/RHEHU-*9DQGH/DDU0-:&RQ\QYDQ6SDHQGRQFN 0$(3UHYHQWLHYDQFRQJHQLWDOHV\ILOLVHHQLQYHQWDULVHUHQGRQGHU]RHNQDDUGHYUDDJRI GHVFUHHQLQJYDQV\ILOLVPRHWZRUGHQYRRUWJH]HW5,90UDSSRUW%LOWKRYHQ 5LMNVLQVWLWXXWYRRU9RONVJH]RQGKHLGHQ0LOLHX.

(173) 3DJYDQ. œ. 5,90UDSSRUW. *UXWHNH33RVWPD0-*URVKHLGH30-DJHU-&&RQ\QYDQ6SDHQGRQFN0$(/RHEHU -*3UHYHQWLHYDQ&RQJHQLWDOHV\ILOLVHFRQRPLVFKHHYDOXDWLHPHWFLMIHUVYDQGH 6WUHHNODERUDWRULDYRRUGHYRONVJH]RQGKHLG5,90UDSSRUW%LOWKRYHQ 5LMNVLQVWLWXXWYRRUGH9RONVJH]RQGKHLGHQ0LOLHX.  œ. +DUWHU&$%HQLVUVFKH.)HWDOV\SKLOLVLQWKHILUVWWULPHVWHU$P-2EVWHW*\QHFRO . œ. +HULQJD03&RPSXWHURQGHUVWHXQGHVFUHHQLQJLQGHSUHQDWDOH]RUJ3URHIVFKULIW 5LMNVXQLYHUVLWHLW*URQLQJHQ*URQLQJHQ. œ. ,QVSHFWLHYRRUGH*H]RQGKHLGV]RUJ,QIHFWLH]LHNWHZHW,*=%XOOHWLQ'HQ+DDJ. œ. /DDU0-:YDQGHHWDO6HNVXHHO2YHUGUDDJEDUH$DQGRHQLQJHQLQ1HGHUODQG5,90 UDSSRUW%LOWKRYHQ5LMNVLQVWLWXXWYRRU9RONVJH]RQGKHLGHQ0LOLHX.  œ. /DDU0-:YDQGHQ2VVHZDDUGH-0 UHG

(174) 6HNVXHHO2YHUGUDDJEDUH$DQGRHQLQJHQLQ 1HGHUODQGXSGDWHWRWHQPHW5,90UDSSRUW%LOWKRYHQ5LMNVLQVWLWXXW YRRU9RONVJH]RQGKHLGHQ0LOLHX.  œ. 0XVKHU'0%LRORJ\RI7UHSRQHPD3DOOLGXP,Q6H[XDOO\7UDQVPLWWHG'LVHDVHV(GV +ROPHV..0nUGK3$6SDUOLQJ3):LHVQHU0F*UDZ+LOOSS.  œ. 6FKHOOHNHQV-)36FKRXOV/09DQGH/DDU0-:6\ILOLV,Q9DQGH/DDU0-: UHG

(175)  6HNVXHHORYHUGUDDJEDUHDDQGRHQLQJHQLQ1HGHUODQGKRRIGVWXN5DSSRUWQXPPHU %LOWKRYHQ5LMNVLQVWLWXXWYRRU9RONVJH]RQGKHLGHQ0LOLHX.  œ. 6WUD\3HGHUVHQ%(FRQRPLFHYDOXDWLRQRIPDWHUQDOVFUHHQLQJWRSUHYHQWFRQJHQLWDO V\ILOLV6H[7UDQVP'LV. .

(176) 5,90UDSSRUW. œ. 3DJYDQ. 9RRUVW9DGHU3&YDQ%XUJHU&:9DQGHU0HLMGHQ:,%OHNHU23&DLUR,0HUNXV -0:07KLR+%0RXULWV0-(YDQ'RRUQXP*--2VVHZDDUGH-0UHGDFWLH62$ 'LDJQRVWLHN 7KHUDSLH5LFKWOLMQHQH KHU]LHQH

(177) GUXN8WUHFKW1HGHUODQGVH 9HUHQLJLQJYRRU'HUPDWRORJLHHQ9HQHUHRORJLH. œ. œ. :ROWHUV(&7UHDWPHQWRI1HXURV\SKLOLV&OLQ1HXURSKDUPDFRO :LMJHUJDQJV/05LMODDUVGDP-/DDU0-:YDQGH'HDDQJLIWHYDQJRQRUURHHQV\ILOLVLQ GHSHULRGH,QIHFWLH]LHNWHQEXOOHWLQ 

(178) .

(179) 3DJYDQ. 5,90UDSSRUW.

(180) 5,90UDSSRUW. %LMODJH, 1 2 3 4 5 6 7 8 9 10 11 12-13 14 15-50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76. 3DJYDQ. 9HU]HQGOLMVW Directeur-Generaal van de Volksgezondheid, drs. N.C. Oudendijk (wnd.) Directeur Gezondheidsbeleid, drs.A.A.W. Kalis, arts Hoofdinspecteur voor de Gezondheidszorg (plaatsvervanger), prof. dr. Kingma Inspecteur Infectieziekten van de Inspectie Gezondheidszorg, J.K. van Wijngaarden, arts Voorzitter van de Gezondheidsraad, prof. dr. J.A. Knottnerus Ministerie van VWS, drs. M. Esveld Ministerie van VWS, drs. G. van ‘t Bosch Ministerie van VWS, drs. R. Schaafsma Ministerie van VWS, drs. W. Reimerink Landelijke Vereniging van GGD’s Landelijke Coördinatiestructuur Infectieziektenbestrijding, drs. J.E. van Steenbergen Stichting soa-bestrijding, T. Coenen Bestuur Nederlandse Vereniging voor Studie van soa Leden soa-commissie CBO Instituut voor Medische Technology Assessment, Erasmus Universiteit Rotterdam, prof. dr. F.F.H. Rutten ,QVWLWXXWYRRU0HGLVFKH7HFKQRORJ\$VVHVVPHQW(UDVPXV8QLYHUVLWHLW 5RWWHUGDPGU030+5XWWHQYDQ0|ONHQ Instituut voor Medische Technology Assessment, Erasmus Universiteit Rotterdam, dr. E. Grijsseels Instituut voor Medische Technology Assessment, Erasmus Universiteit Rotterdam, dr. L. Hakkaart-van Roijen Instituut voor Medische Technology Assessment, Erasmus Universiteit Rotterdam, drs. P. Verboom Erasmus universiteit, Erasmus Universtiteit European monitoring centre on drugs and drug addiction (EMCDDA) te Lissabon, drs. L. Wiessing Stichting Sanquin, prof. dr. E.J. Ruitenberg Academisch Ziekenhuis Rotterdam, dr. W.I. van der Meijden GG & GD Amsterdam, prof. dr. R.A. Coutinho GG & GD Amsterdam, dr. J.A.R. van den Hoek Academisch Medisch Centrum Amsterdam, prof. dr. O.P. Bleker Depot Nederlandse Publikaties en Nederlandse Bibliografie Directie RIVM Directeur Sector Volksgezondheid RIVM, prof. dr. D. Kromhout Hoofd Centrum voor ZorgOnderzoek, prof. dr. G.A.M. van den Bos Hoofd Centrum voor Volksgezondheid Toekomstverkenningen, dr. D. Ruwaard Hoofd Centrum voor Infectieziekten Epidemiologie, drs. J. Kool Hoofd Centrum voor Chronische Ziekten Epidemiologie, prof. dr. J. Seidell Hoofd Laboratorium voor Infectieziekten Screening, dr. J.G. Loeber Hoofd Laboratorium voor Infectieziekten Onderzoek, dr. T.G. Kimman Hoofd Laboratorium voor Microbiologische Gezondheidsbescherming, dr. A.H. Henken dr. M. van den Hoop, SBD dr. M.J.W. van de Laar, CIE dr. M.A.E. Conyn-van Spaendonck, CIE dr. J.F.P. Schellekens, LIS.

(181) 3DJYDQ. 77 78 79-82 83 84 85 86-95 96-110. 5,90UDSSRUW. dr. L.M. Schouls, LIO medewerkers CZO auteurs SBD/Voorlichting & Public Relations Bureau Rapportenregistratie Bibliotheek RIVM Bureau Rapportenbeheer Reserve-exemplaren.

(182) 5,90UDSSRUW. 3DJYDQ. %LMODJH,, 6DPHQYDWWLQJYDQGHJHVHOHFWHHUGHVWXGLHVHQULFKWOLMQHQ  +LHURQGHU]XOOHQGHYLMIJHVHOHFWHHUGHHFRQRPLVFKHHYDOXDWLHVNRUWZRUGHQEHVSURNHQ  œ. 6WUD\3HGHUVHQ%(FRQRPLFHYDOXDWLRQRIPDWHUQDOVFUHHQLQJWRSUHYHQWFRQJHQLWDO V\ILOLV6H[7UDQVP'LV. ,QGH]HNRVWHQDQDO\VHXLWJHYRHUGLQ1RRUZHJHQLQKHWEHJLQYDQGHMDUHQWDFKWLJZRUGWHHQ. HFRQRPLVFKHYDOXDWLHPRGHOJHwQWURGXFHHUG+HW]LHNWHPRGHOEHVFKULMIWGHJHYROJHQYRRUGH NLQGHUHQYDQGHPHWV\ILOLVJHwQIHFWHHUGH]ZDQJHUHQ GXVLQGLHQHHQ]ZDQJHUHUHHGVLV EHVPHW

(183) 'HWUDQVPLVVLHNDQVYDQHHQJHwQIHFWHHUGH]ZDQJHUHRPGHLQIHFWLHRYHUWHGUDJHQ DDQGHIRHWXVZHUGLQGLW]LHNWHPRGHORSJHVFKDW+HW]LHNWHPRGHOJLQJYDQGHYROJHQGH YHURQGHUVWHOOLQJHQXLWYDQGHJHwQIHFWHHUGHSDVJHERUHQHQLVJH]RQGLVWHYURHJ JHERUHQPDDUJH]RQGKHHIWFRQJHQLWDOHV\ILOLVHQRYHUOLMGW9HUGHUZHUG YHURQGHUVWHOGGDWYDQGHNLQGHUHQPHWFRQJHQLWDOHV\ILOLV YDQGHJHwQIHFWHHUGH SDVJHERUHQHQ

(184) GHKHOIWVSHFLDDORQGHUZLMVQRGLJKHHIWHQGHDQGHUHKHOIWODQJGXULJ LQWUDPXUDOH]RUJYRRUYHUVWDQGHOLMNJHKDQGLFDSWHQQRGLJKHHIW 'LWRQGHU]RHNZDVJHEDVHHUGRSVFUHHQLQJHQYDQ]ZDQJHUHQRSV\ILOLV'HEDWHQ. NRVWHQUDWLRYDQGHVFUHHQLQJLQGLWRQGHU]RHNZDV  œ. *UXWHNH33RVWPD0--DJHU-&/RHEHU-*9DQGH/DDU0-:&RQ\QYDQ6SDHQGRQFN 0$(3UHYHQWLHYDQFRQJHQLWDOHV\ILOLVHHQLQYHQWDULVHUHQGRQGHU]RHNQDDUGHYUDDJRI GHVFUHHQLQJYDQV\ILOLVPRHWZRUGHQYRRUWJH]HW5,90UDSSRUW%LOWKRYHQ 5LMNVLQVWLWXXWYRRU9RONVJH]RQGKHLGHQ0LOLHX. 'H]HNRVWHQHIIHFWLYLWHLWVDQDO\VHJHHIWDOOHUHHUVWHHQNRUWHEHVFKULMYLQJYDQNOLQLVFKH. ODERUDWRULXPWHFKQLVFKHHQHSLGHPLRORJLVFKHDVSHFWHQYDQV\ILOLVHQFRQJHQLWDOHV\ILOLV+HW UDSSRUWPDDNWJHEUXLNYDQKHWPRGHOYDQFRQJHQLWDOHV\ILOLVYDQ6WUD\3HGHUVHQ 6WUD\ 3HGHUVHQ

(185) $DQGHKDQGYDQFLMIHUVYDQGH** *'YDQ$PVWHUGDPZRUGWHHQ YRRUORSLJHVFKDWWLQJJHPDDNWYDQGHNRVWHQHQGHEDWHQYDQKHWVFUHHQLQJVSURJUDPPDWHU SUHYHQWLHYDQFRQJHQLWDOHV\ILOLV'HNRVWHQSHUJHZRQQHQOHYHQVMDDUZRUGWRSEDVLVYDQGH]H EHUHNHQLQJHQLQJHVFKDWRS¦+LHUELM]LMQ]RZHOGHNRVWHQDOVGHHIIHFWHQ JHGLVFRQWHHUGPHW$IVFKDIILQJYDQKHWVFUHHQLQJVSURJUDPPDZRUGWLQKHWUDSSRUWDOV QLHWZHQVHOLMNEHVFKRXZGDDQJH]LHQJHHQDOWHUQDWLHIYDQKHWVFUHHQLQJVSURJUDPPDLV.

(186) 3DJYDQ. 5,90UDSSRUW. RSJHVWHOG$DQEHYROHQZRUGWRPGHUHVXOWDWHQYDQVFUHHQLQJYDQ]ZDQJHUHQODQGHOLMNYDVWWH OHJJHQRPHHQEHWHUHNRVWHQHIIHFWLYLWHLWVDQDO\VHLQGHWRHNRPVWPRJHOLMNWHPDNHQ2SGH]H PDQLHULVPHQEHWHULQVWDDWRPGHV\ILOLVLQFLGHQWLHRQGHU]ZDQJHUHQWHEHSDOHQ  œ. %LQGHOV3-(3RVWPD0-3HHUERRPV3*+&RXWLQKR5$9DQGHQ+RHN-$5+HWQXWWLJ HIIHFWYDQVFUHHQLQJYRRUOXHVELM]ZDQJHUHYURXZHQLQ$PVWHUGDPLQGHSHULRGH 1HG7LMGVFKU*HHVNXQG. 'H]HNRVWHQDQDO\VHEHVSUHHNWKHWVHURORJLVFKVFUHHQLQJVSURJUDPPDDDQGHKDQGYDQ. JHJHYHQVYDQGH$PVWHUGDPVH** *'+HWWRWDDODDQWDOVHUDGDWZHUGJHVFUHHQGRSV\ILOLV LQGLWRQGHU]RHNZDVLQGHSHULRGHYDQ%LM 

(187) YDQGH]HYURXZHQ ZDUHQGHVFUHHQLQJVWHVWHQSRVLWLHIYRRUV\ILOLV+HWVFUHHQLQJVSURJUDPPDYyyUNZDPQDDU VFKDWWLQJWZHHJHYDOOHQYDQFRQJHQLWDOHV\ILOLV'H]HNRVWHQDQDO\VHPDDNWHRRNJHEUXLNYDQ KHWPRGHOYDQ6WUD\3HGHUVHQ'LWPRGHOZHUGHQLJV]LQVDDQJHSDVWGHNDQVGDWHHQ JHwQIHFWHHUGH]ZDQJHUHGHLQIHFWLHRYHUGUDDJWDDQGHIRHWXVZRUGWDIKDQNHOLMNYDQKHW ]LHNWHVWDGLXPZDDULQGHPRHGHU]LFKEHYLQGW'HUHVXOWDWHQYDQKHWRQGHU]RHNZHUGHQ XLWJHGUXNWLQEDWHQHQNRVWHQYDQKHWVFUHHQLQJVSURJUDPPD'H]HEDWHQNRVWHQUDWLREHGURHJ YRRUGHUHJLR$PVWHUGDP  œ. *UXWHNH33RVWPD0-*URVKHLGH30-DJHU-&&RQ\QYDQ6SDHQGRQFN0$(/RHEHU -*3UHYHQWLHYDQFRQJHQLWDOHV\ILOLVHFRQRPLVFKHHYDOXDWLHPHWFLMIHUVYDQGH 6WUHHNODERUDWRULDYRRUGHYRONVJH]RQGKHLG5,90UDSSRUW%LOWKRYHQ 5LMNVLQVWLWXXWYRRU9RONVJH]RQGKHLGHQ0LOLHX. 'LWUDSSRUWLVHHQXSGDWHYDQKHWKLHUERYHQEHVFKUHYHQUDSSRUWXLW *UXWHNH

(188) 'LW. UDSSRUWJHEUXLNWGHDDQWDOOHQHQGHUHVXOWDWHQYDQGHVHURORJLVFKHVFUHHQLQJVWHVWHQRSV\ILOLV YDQ]ZDQJHUHQLQHQXLWGHYHUVFKLOOHQGHVWUHHNODERUDWRULD2RNPDDNWGLWUDSSRUW JHEUXLNYDQKHWPRGHOYDQ6WUD\3HGHUVHQ,QWRWDDO]LMQLQGH]HVWXGLHVHUD JHVFUHHQGRSV\ILOLV+HWDDQWDOSRVLWLHYHXLWVODJHQZDV+HWDDQWDOGRRUGHVFUHHQLQJ DFKWHUKDDOGHYURXZHQPHWHHQXLWVODJEHKRUHQGHELMHHQDFWLHYHV\ILOLVZRUGWJHVFKDWRSj YURXZHQ 'HNRVWHQSHUJHZRQQHQOHYHQVMDDUEHGUDJHQLQGH]HEHUHNHQLQJHQ¦RSODQGHOLMN. QLYHDXHQ¦EXLWHQGHJURWHVWHGHQ 5RWWHUGDPHQ$PVWHUGDP

(189) +HWVFUHHQLQJV SURJUDPPDLQ$PVWHUGDPHQ5RWWHUGDPLVNRVWHQEHVSDUHQG .

(190) 5,90UDSSRUW. œ. 3DJYDQ. %RQW-&DLUR,9DQ'RRUQXP*--&RXWLQKR5$%OHHNHU23+HWQXWWLJHIIHFWYDQ VHURORJLVFKHVFUHHQLQJRSV\ILOLVLQGH]ZDQJHUVFKDSLQGHUHJLR$PVWHUGDP 1HG7LMGVFKU*HQHHVNG 

(191) . 'LWRQGHU]RHNJHHIWHHQNRVWHQEDWHQDQDO\VHYDQKHWVFUHHQLQJVSURJUDPPDYDQ]ZDQJHUHQ PHWEHKXOSYDQVHUDYDQ]ZDQJHUHQXLWGHSHULRGHYDQLQGHUHJLR$PVWHUGDP +HWDDQWDOLQJH]RQGHQEORHGPRQVWHUVZDV+HWDDQWDOGRRUGHVFUHHQLQJDFKWHUKDDOGH ]ZDQJHUHQPHWHHQSRVLWLHYHXLWVODJZDV+HWDDQWDOYyyUNRPHQJHYDOOHQYDQFRQJHQLWDOH V\ILOLVZHUGJHVFKDWRS'HNRVWHQDQDO\VHZHUGXLWJHYRHUGPHWEHKXOSYDQGH]HOIGH PHWKRGHGLH%LQGHOVHWDO %LQGHOVHWDO

(192) WRHSDVWHQLQGHDQDO\VHRYHUGHSHULRGH %LMGHNRVWHQDQDO\VHLVGXVHLJHQOLMNJHEUXLNJHPDDNWYDQHHQDDQJHSDVWHYHUVLH YDQKHW6WUD\3HGHUVHQPRGHO,QKHWRQGHU]RHNZRUGHQGHNRVWHQHQEDWHQQLHWXLWJHGUXNWLQ NRVWHQSHUJHZRQQHQOHYHQVMDDU(ULVZHOYROGRHQGHLQIRUPDWLHRPGHNRVWHQSHUJHZRQQHQ OHYHQVMDDUWHKHUEHUHNHQHQ'HZHOEHQRHPGHEDWHQNRVWHQUDWLREHGUDDJW.

(193) 3DJYDQ. 5,90UDSSRUW. %LMODJH,,, 'HQLHWJHVHOHFWHHUGHVWXGLHV LQDOIDEHWLVFKHYROJRUGH

(194) 

(195)  $UDO627KHVRFLDOFRQWH[WRIV\SKLOLVSHUVLVWHQFHLQWKHVRXWKHDVWHUQ8QLWHG6WDWHV6H[ 7UDQVP'LV 

(196)  %DQJHU02OEULFK+0)XFKV6*DVWSDU0&RVWHIIHFWLYHQHVVRIV\SKLOLVVFUHHQLQJLQD FOLQLFIRUJHQHUDOSV\FKLDWU\1HUYHQDU]W 

(197)  %DWHPDQ'$3KLEEV&6-R\FH7+HDJDUW\0&7KHKRVSLWDOFRVWRIFRQJHQLWDOV\SKLOLV -3HGLDWU 

(198)  &DQFUH1%RLV)*UHVHQJXHW*)UHW]&)RXUQHO--%HOHF/6FUHHQLQJEORRGGRQDWLRQV IRUKHSDWLWLV&LQ&HQWUDO$IULFDDQDO\VLVRIDULVNDQGFRVWEDVHGGHFLVLRQWUHH0HG 'HFLV0DNLQJ 

(199)  &KHVVRQ+:3LQNHUWRQ6',UZLQ./5HLQ'.DVVOHU:-1HZ+,9FDVHVDWWULEXWDEOHWR V\SKLOLVLQWKH86$HVWLPDWHVIURPDVLPSOLILHGWUDQVPLVVLRQPRGHO$,'6  

(200)  &KLVKROP&$.DW]9/0F'RQDOG7/%RZHV:$-U3HQLFLOOLQGHVHQVLWL]DWLRQLQWKH WUHDWPHQWRIV\SKLOLVGXULQJSUHJQDQF\$P-3HULQDWRO 

(201)  &ROHV)%0XVH$*+LSS66,PSDFWRIDPDQGDWRU\V\SKLOLVGHOLYHU\WHVWRQUHSRUWHG FDVHVRIFRQJHQLWDOV\SKLOLV8SVWDWH1HZ<RUN-3XEOLF+HDOWK0DQDJ3UDFW 

(202)  (QJHOJDX00:RHUQOH&+5ROIV57*UHHQVSDQ-52 &DLQ0*RUVN\5'&RQWURORI HSLGHPLFHDUO\V\SKLOLVWKHUHVXOWVRIDQLQWHUYHQWLRQFDPSDLJQXVLQJVRFLDOQHWZRUNV 6H[7UDQVP'LV 

(203)  )LQHOOL/&UD\QH(06SLWDOQ\.&7UHDWPHQWRILQIDQWVZLWKUHDFWLYHV\SKLOLVVHURORJ\ 1HZ-HUVH\WR3HGLDWULFVH 

(204) +ROPHV..3X]LVV05HFRPPHQGDWLRQVRIWKHVWXG\JURXSIRUUHVHDUFKDQGWUDLQLQJLQ VH[XDOO\WUDQVPLWWHGGLVHDVHV>QHZV@-,QIHFW'LV 

(205) -HQQLVNHQV)2EZDND(.LULVXDK60RVHV6<XVXIDOL)0$FKROD-2)UDQVHQ//DJD 07HPPHUPDQ06\SKLOLVFRQWUROLQSUHJQDQF\GHFHQWUDOL]DWLRQRIVFUHHQLQJIDFLOLWLHV WRSULPDU\FDUHOHYHODGHPRQVWUDWLRQSURMHFWLQ1DLUREL.HQ\D,QW-*\QDHFRO2EVWHW 6 

(206) .KDOHPLQ,$.DJDQRYLFK(/%DQQLNRY($(YVLQD3,'HWHUPLQDWLRQRIWKHHFRQRPLF FRVWVRIV\SKLOLVWUHDWPHQW9HVWQ'HUPDWRO9HQHURO.

(207) 5,90UDSSRUW. 3DJYDQ. 

(208) .ULYRUXFKNR=$5DIDOLXN1,D6KXVWHU/$'LVSXWDEOHDQGXQVROYHGDVSHFWVRIPDVV VFUHHQLQJ6RY=GUDYRRNKU 

(209) /LVVRYR\*GH=HQLOPDQ-1HOVRQ.($KPHG)&HOHQWDQR''7KHFRVWRID SUHYHQWDEOHGLVHDVHHVWLPDWHG86QDWLRQDOPHGLFDOH[SHQGLWXUHVIRUFRQJHQLWDOV\SKLOLV 3XEOLF+HDOWK5HS 

(210) /XJHU$'LIIHUHQWLDOHYDOXDWLRQRIVHURORJLFV\SKLOLVUHDFWLRQVLQWKH8QLWHG6WDWHVDQG (XURSH+DXWDU]W 

(211) 0DFUHDG\17ULDORI'HQYHUQXUVHVSRLQWVXSV\VWHPIODZV250DQDJHU 

(212) 0F1HHOH\6*+HQGUL[6/0D]]RQL00.PDN'&5DQVRP6%0HGLFDOO\VRXQG FRVWHIIHFWLYHWUHDWPHQWIRUSHOYLFLQIODPPDWRU\GLVHDVHDQGWXERRYDULDQDEVFHVV $PHULFDQ-RXUQDORI2EVWHWULFV *\QHFRORJ\ 

(213) $QRQ(YDOXDWLRQRIFRQJHQLWDOV\SKLOLVVXUYHLOODQFHV\VWHP1HZ-HUVH\0RUE 0RUWDO:NO\5HS 

(214) 2[PDQ$'6FRWW($6HOORUV-:&ODUNH-+0LOOVRQ0(5DVRRO\,)UDQN-:1DXV 0*ROGEODWW(3DUWQHUQRWLILFDWLRQIRUVH[XDOO\WUDQVPLWWHGGLVHDVHVDQRYHUYLHZRIWKH HYLGHQFH&DQ-3XEOLF+HDOWK66 

(215) 3HWHUPDQ7$7RRPH\.('LFNHU/:=DLGL$$:URWHQ-(&DUROLQD-3DUWQHU QRWLILFDWLRQIRUV\SKLOLVDUDQGRPL]HGFRQWUROOHGWULDORIWKUHHDSSURDFKHV6H[7UDQVP 'LV 

(216) 6FKPXQLV*$=LFNHU)3LQKHLUR)%UDQGOLQJ%HQQHWW'5LVNIRUWUDQVIXVLRQWUDQVPLWWHG LQIHFWLRXVGLVHDVHVLQ&HQWUDODQG6RXWK$PHULFD(PHUJ,QI'LV 

(217) 6WROO%-*ORYHU6)UHHG*1DKPLDV$-&RVWRIFRQJHQLWDOV\SKLOLV3HGLDWU,QIHFW'LV 

(218) :DONHU*-$$QWLELRWLFVIRUV\SKLOLVGLDJQRVHGGXULQJSUHJQDQF\ SURWRFRO

(219) $QWLELRWLFV IRUV\SKLOLVGLDJQRVHGGXULQJSUHJQDQF\ 3URWRFROIRUD&RFKUDQH5HYLHZ

(220) ,Q7KH &RFKUDQH/LEUDU\,VVXH2[IRUG8SGDWH6RIWZDUH 

Referenties

GERELATEERDE DOCUMENTEN

The fact that respondents do not clearly state this as being the case, is yet another clue that points the researcher in the direction of concluding that South African

• Een kind in stuitligging kan vaak gewoon, vaginaal geboren worden waarbij de billen of voeten als eerste worden geboren.. Onvolkomen stuitligging:

De inventarisatie is eind 1998 uitgevoerd door alle eerste- en tweedelijns laboratoria, die zijn aangesloten bij de Nederlandse Vereniging voor Kli- nische Chemie (NVKC), te

Mede omdat mensen met een verstandelijke beperking vaak moeilijk slikken en de inname procedure altijd afhankelijk is van begeleiders komt deze bijwerking mogelijk meer voor dan

Het is welhaast overbodig op te merken dat de huidige techniek ondenkbaar is zonder beoefening van wetenschap, zo goed als ook beoefening van weten- schap meer en meer

CJSM, VDAB, Agentschap I&amp;I Verantwoordelijke minister: Minister bevoegd voor Binnenlands Bestuur, Stedenbeleid, Integratie en Inburgering, Minister bevoegd voor Welzijn,

Kleine veldjes hebben dit voor, dat men veel veldjes in korten tijd kan (2) A.. afdoen en de totale oppervlakte voor een proefveld beperkt blijft. Dit laatste is een voordeel in

Dertien artikelen werden verwijderd op grond van een foute setting (reden D) en 30 artikelen werden verwijderd, omdat ze geen implementatie of aspect van gedrag bevatten of