Public Delegate Function GetRefreshNeed( _
   ByVal mode As Integer, _
   ByVal maxAge As Integer, _
   ByRef numHandles As Integer, _
   ByRef AppItemHandles As IntPtr _
) As Integer

Dim instance As New GetRefreshNeed(AddressOf HandlerMethod)

public delegate int GetRefreshNeed( 
   int mode,
   int maxAge,
   out int numHandles,
   out IntPtr AppItemHandles
)

public: __gc __delegate int GetRefreshNeed( 
   int mode,
   int maxAge,
   [PARAMFLAG::Out] int numHandles,
   [PARAMFLAG::Out] IntPtr AppItemHandles
)

public delegate int GetRefreshNeed( 
   int mode,
   int maxAge,
   [Out] int numHandles,
   [Out] IntPtr AppItemHandles
)