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Wimalaratne, Inoka Koshali, Jane McCarthy, Birit F. P. Broekman, Klaas Nauta, Samudra Kathriarachchi, Anuprabha Wickramasinghe, Alexander Merkin, et al. "General hospital specialists’ attitudes toward psychiatry: a cross-sectional survey in seven countries." BMJ Open 11, no. 11 (November 2021): e054173. http://dx.doi.org/10.1136/bmjopen-2021-054173.
Повний текст джерелаАнотація:
ObjectivePsychiatric comorbidities are common in physical illness and significantly affect health outcomes. Attitudes of general hospital doctors toward psychiatry are important as they influence referral patterns and quality of care. Little is known about these attitudes and their cultural correlates. The aim of this study was to identify attitudes toward psychiatry among general hospital specialists in relation to culture of the practice setting and other clinician factors (gender, age, seniority and specialty).MethodsA cross-sectional, descriptive study was carried out in seven countries (New Zealand, China, Sri Lanka, Russia, Israel, Brazil, the Netherlands). Data were collected from senior medical staff of various disciplines using an updated version of Mayou and Smith’s (1986) self-administered questionnaire.ResultsA total of 889 hospital doctors participated. While favourable attitudes toward both psychiatric consultation and management were endorsed by a majority, significant differences were also observed between countries. Subgroup differences were mostly confined to gender, acuity of practice setting and specialty. For example, female doctors in Russia (χ2=7.7, p=0.0056), China (χ2=9.2, p=0.0025) and the Netherlands (χ2=5.7, p=0.0174) endorsed more positive attitudes compared with their male counterparts, but this gender effect was not replicated in the total sample. Chronic care specialists were overall more inclined to manage patients’ emotional problems compared with those working in acute care (χ2=70.8, p (adjusted)<0.0001), a significant finding seen also in individual countries (China, New Zealand, the Netherlands, Russia). Physicians were more favourably disposed toward psychiatry compared with other specialists, especially surgeons, in all countries except Israel.ConclusionsThis study adds to evidence for the association of medical attitudes with individual clinician factors and demonstrates that the influence of these factors varies by country. Understanding these issues may help to overcome barriers and improve quality of care provided to general hospital patients.
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Keuper, Jelle, Ronald Batenburg, Lilian van Tuyl, and Robert Verheij. "General Practices’ Experiences With Patients’ Web-Based Access to Medical Records: Survey Study." Journal of Medical Internet Research 25 (April 7, 2023): e41832. http://dx.doi.org/10.2196/41832.
Повний текст джерелаАнотація:
Background Patients’ web-based access to their medical records is expected to promote their role and responsibility in managing their own health and treatments and supporting shared decision-making. As of July 2020, general practices in the Netherlands are legally obliged to provide their patients access to their electronic medical records. Web-based access provision is facilitated and stimulated through a national support program named OPEN. Objective We aimed to investigate general practice staff experiences with providing web-based access; investigate its impact on patient consultations, administrative actions, and patient inquiries; and investigate how it affects routine general practice workflow processes. Methods In October 2021, a total of 3813 general practices in the Netherlands were invited to complete a web-based survey that included questions regarding their experiences with the provision of web-based access to medical records and how it affects routine general practice workflow. Responses of general practices that started providing web-based access before 2020, in 2020, or in 2021 were analyzed to identify trends. Results Of 3813 invited general practices, 523 (13.72%) completed the survey. Approximately all responding general practices (487/523, 93.1%) indicated that they provide web-based access. Experiences with patients’ web-based access were diverse, with 36.9% (178/482) primarily positive, 8.1% (39/482) primarily negative, 42.3% (204/482) neutral, and 12.7% (61/482) could not (yet) indicate how they experienced web-based access. Of the total, two-thirds (311/473, 65.8%) reported an increase in e-consultations and a similar percentage (302/474, 63.7%) indicated an increase in administrative actions associated with web-based access provision. A small proportion of the practices (≤10%) experienced a decrease in patient contacts. Earlier adoption of web-based access was associated with a more positive attitude toward web-based access and more positive experienced effects related to patient contacts and general practice workflow. Conclusions The surveyed general practices mainly experienced providing web-based access as either neutral or mostly positive, despite an increased number of patient contacts and administrative burden that were associated with its adoption. Periodic monitoring of experiences is needed to understand the temporal or structural nature of both the intended and unintended effects of patients’ web-based access to medical records for general practices and their staff.
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Reynaers, Anne-Marie. "Public private partnerships in the Netherlands: a love that’s here to stay." Bestuurskunde 31, no. 1 (April 2022): 106–10. http://dx.doi.org/10.5553/bk/092733872022031001008.
Повний текст джерела
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Smets, Tinne, Lara Pivodic, Ruth Piers, H. Roeline W. Pasman, Yvonne Engels, Katarzyna Szczerbińska, Marika Kylänen, et al. "The palliative care knowledge of nursing home staff: The EU FP7 PACE cross-sectional survey in 322 nursing homes in six European countries." Palliative Medicine 32, no. 9 (July 4, 2018): 1487–97. http://dx.doi.org/10.1177/0269216318785295.
Повний текст джерелаАнотація:
Background: The provision of high-quality palliative care in nursing homes (NHs) is a major challenge and places demands on the knowledge and skills of the staff. Aim: This study assesses the palliative care knowledge of staff in NHs in Europe. Design: Cross-sectional study using structured survey Setting/participants: Nurses and care assistants working in 322 representative samples of NHs in Belgium, the Netherlands, England, Finland, Poland and Italy. Palliative care knowledge is measured with the Palliative Care Survey. Scores on the scales range between 0 and 1; higher scores indicate more knowledge. Results: A total of 3392 NH-staff were given a questionnaire, and 2275 responded (67%). Knowledge of basic palliative care issues ranged between 0.20 in Poland (95% confidence interval (CI) 0.19; 0.24) and 0.61 in Belgium (95% CI 0.59; 0.63), knowledge of physical aspects that can contribute to pain ranged between 0.81 in Poland (95% CI 0.79; 0.84) and 0.91 in the Netherlands (95% CI 0.89; 0.93), and knowledge of psychological reasons that can contribute to pain ranged between 0.56 in England (95% CI 0.50; 0.62) and 0.87 in Finland (95% CI 0.83; 0.90). Factors associated with knowledge were country, professional role and having undertaken formal training in palliative care. Conclusions: Knowledge of nurses and care assistants concerning basic palliative care issues appears to be suboptimal in all participating countries, although there is substantial heterogeneity. Education of nursing staff needs to be improved across, but each country may require its own strategy to address the unique and specific knowledge gaps.
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Balqis, Putroe, and Rahmat Yanuar. "Daya Saing Ekspor Lada Indonesia di Pasar Amerika dan Eropa." Forum Agribisnis 11, no. 2 (September 24, 2021): 182–94. http://dx.doi.org/10.29244/fagb.11.2.182-194.
Повний текст джерелаАнотація:
As a major producing country, Indonesia is one of the world's largest pepper exporters where America and some European Union countries have become the destinations of its exports. The purposes of this study are to analyze the performance of Indonesian pepper and the development of its exports and to analyze the competitiveness of Indonesian pepper exports in American and European markets, especially in the period 2004-2018. This research used descriptive analysis from the trade data period 2004-2018, to analyze the performance of Indonesian pepper. From the same data set, this study used competitiveness analysis with the Revealed Comparative Advantage (RCA) method, Export Product Dynamics (EPD), and Trade Specialization Index (ISP). The results showed that the area of cropland and production of Indonesian pepper had decreased, the development of Indonesian pepper exports was also quite volatile. Based on the calculation of RCA, Indonesia has competitiveness or comparative advantage for exports to Germany, the Netherlands, France, Italy and Belgium. The EPD value showed Indonesia was in a Retreat position in the Netherlands, Germany and Belgium. While Indonesia is in the position of Rising Star in Italy, Falling Star in France, and Lost Opportunity in America. Finally, The ISP value showed that Indonesia has strong competitiveness as an exporter of whole pepper.
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Vreugdenhil, Maria MT, Rudolf B. Kool, Kees van Boven, Willem JJ Assendelft, and Jan AM Kremer. "Use and Effects of Patient Access to Medical Records in General Practice Through a Personal Health Record in the Netherlands: Protocol for a Mixed-Methods Study." JMIR Research Protocols 7, no. 9 (September 21, 2018): e10193. http://dx.doi.org/10.2196/10193.
Повний текст джерелаАнотація:
Background In the Dutch health care system, general practitioners hold a central position. They store information from all health care providers who are involved with their patients in their electronic health records. Web-based access to the summary record in general practice through a personal health record (PHR) may increase patients’ insight into their medical conditions and help them to be involved in their care. Objective We describe the protocol that we will use to investigate the utilization of patients’ digital access to the summary of their medical records in general practice through a PHR and its effects on the involvement of patients in their care. Methods We will conduct a multilevel mixed-methods study in which the PHR and Web-based access to the summary record will be offered for 6 months to a random sample of 500 polypharmacy patients, 500 parents of children aged <4 years, and 500 adults who do not belong to the former two groups. At the patient level, a controlled before-after study will be conducted using surveys, and concurrently, qualitative data will be collected from focus group discussions, think-aloud observations, and semistructured interviews. At the general practice staff (GP staff) level, focus group discussions will be conducted at baseline and Q-methodology inquiries at the end of the study period. The primary outcomes at the patient level are barriers and facilitators for using the PHR and summary records and changes in taking an active role in decision making and care management and medication adherence. Outcomes at the GP staff level are attitudes before and opinions after the implementation of the intervention. Patient characteristics and changes in outcomes related to patient involvement during the study period will be compared between the users and nonusers of the intervention using chi-square tests and t tests. A thematic content analysis of the qualitative data will be performed, and the results will be used to interpret quantitative findings. Results Enrollment was completed in May 2017 and the possibility to view GP records through the PHR was implemented in December 2017. Data analysis is currently underway and the first results are expected to be submitted for publication in autumn 2019. Conclusions We expect that the findings of this study will be useful to health care providers and health care organizations that consider introducing the use of PHR and Web-based access to records and to those who have recently started using these. Trial Registration Netherlands Trial Registry NTR6395; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=6395 (Archived by WebCite at http://www.webcitation.org/71nc8jzwM) Registered Report Identifier RR1-10.2196/10193
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Zakharov, Anton O. "THE GUERILLA STAR OF INDONESIA — BINTANG GERILYA." Journal of the Institute of Oriental Studies RAS, no. 1 (19) (2022): 171–83. http://dx.doi.org/10.31696/2618-7302-2022-1-171-183.
Повний текст джерелаАнотація:
The award system of Indonesia reflects its state developments, including the formation and transformations of the Indonesian Armed Forces (Tentara Nasional Indonesia). The Republic of Indonesia was formed as a result of its struggle for independence against the Netherlands Colonial Empire. Many islands of Indonesia, their equatorial and tropical climate, as well as technical backwardness of the Indonesian society in the 1940s were among the main factors of the guerilla warfare against the Dutch. Guerilla squads were the main part of the People’s Security Army (Tentara Keamanan Rakyat), later named the Republic of Indonesia Army (Tentara Republik Indonesia). Its victory over the Dutch in 1949 helped instituting of the first Order of Indonesia — Bintang Gerilja, or Bintang Gerilya in modern spelling — The Guerilla Star. The paper sums up the laws and acts of the Indonesian State concerning the Guerilla Star, as well as the data from open sources, like media and Wikipedia, about its awardees. These data are checked through the official reference books issued by the Service of History of the Indonesian Army (Dinas Sejarah Angkatan Darat). The paper focuses on the statute, description and bestowals of the Guerilla Star of Indonesia. The Order is an award to all Indonesians who fought for their Independence against the Dutch. The form of the Guerilla Star is like the Gallipoli Star of the Ottoman Empire. In 2009, the statute of the Guerilla Star was changed by the Indonesian Government. Now it may be bestowed for any guerilla defense of Indonesian interests.
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De Jong, Folkert. "All on Board, Take Off! An Example of Practitioner’s Research on Teachers’ Professional Well-being in Higher Education in Their Early Career Stages." Journal of Management and Strategy 14, no. 1 (May 11, 2023): 31. http://dx.doi.org/10.5430/jms.v14n1p31.
Повний текст джерелаАнотація:
Organisations compete on the labour market for highly educated staff and put a lot of effort in attracting new employees. However, high percentages of newly recruited employees leave the organisation within one year. Good onboarding practices and good practices in the stage after onboarding, the take-off stage, could increase retention rates in the early career stages of professionals.In this study an example of practitioner’s research is presented on newly hired teachers’ professional well-being in higher education in their early career stages. Two batches of newly hired teachers at NHL Stenden University of Applied Sciences in the Netherlands were studied in the context of improving HR practices.Research on newly hired teachers revealed the importance of good onboarding practices and the crucial role of team leaders in retaining and motivating newly hired teaching staff.
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Seror, R., G. Baron, M. Camus, D. Cornec, E. Perrodeau, S. J. Bowman, M. Bombardieri, et al. "OP0286 DEVELOPMENT AND PRELIMINARY VALIDATION OF THE SJÖGREN’S TOOL FOR ASSESSING RESPONSE (STAR): A CONSENSUAL COMPOSITE SCORE FOR ASSESSING TREATMENT EFFECT IN PRIMARY SJÖGREN’S SYNDROME." Annals of the Rheumatic Diseases 81, Suppl 1 (May 23, 2022): 189.2–190. http://dx.doi.org/10.1136/annrheumdis-2022-eular.2583.
Повний текст джерелаАнотація:
BackgroundToday, there are still no DMARDs licensed for primary Sjögren Syndrome (pSS) patients. Among the explanations, are the limitations of current outcome measures used as primary endpoints: e.g; high placebo response rate, evaluation of either symptoms or systemic activity, and important features not being assessed. The NECESSITY consortium (https://www.necessity-h2020.eu/), including pSS experts from academia, pharmaceutical industry and patient groups formed to develop a new composite responder index, the Sjögren’s Tool for Assessing Response (STAR) that solve the issues of current outcome measures in pSS and is intended for use in clinical trials as an efficacy endpoint.ObjectivesTo develop a composite responder index in primary Sjögren’s syndrome (pSS): the STAR.MethodsTo develop the STAR, the NECESSITY consortium used data-driven methods, based on 9 randomized controlled trials (RCTs), and consensus techniques, involving 78 experts and 20 patients. Based on reanalysis of rituximab trials (TRACTISS and TEARS) and literature review, the Delphi panel identified a core set of domains to include in the STAR, with their respective outcome measures. STAR options combining these domains were designed and proposed to the panel to select and improve them. For each STAR option, sensitivity to change was estimated by the C-index (derived from Effect size) in all 9 RCTs. Delphi rounds were run for selecting STAR among these options. The Delphi panel also voted to classify trials as positive, negative or “in between” in regards to primary but also key secondary endpoints. For the options remaining before the final vote, meta-analyses of the RCTs were performed separately for positive and “in between” trials together, and for negative trials.ResultsThe Delphi panel identified 5 core domains (systemic activity, patient symptoms, lachrymal gland function, salivary gland function and biological parameters), and 227 STAR options, combining these domains, were selected to be tested for sensitivity to change. After two Delphi rounds, meta-analyses of the 20 remaining options were performed. The candidate STAR was selected by a final vote based on metrological properties and clinical relevance. In positive/in between trials, candidate STAR detected a difference between arms (OR 3.29, 95%-CI [2.07;5.22], whereas it did not in negative trials (OR 1.53, 95%-CI [0.81;2.91]).ConclusionThe candidate STAR is a composite responder index, including in a single tool all main disease features, and is designed for use as a primary endpoint in pSS RCTs. Its rigorous and consensual development process ensures its face and content validity. The candidate STAR showed good sensitivity and specificity to change. The candidate STAR will be prospectively validated in a dedicated three arms RCT of the NECESSITY consortium that will evaluate combination of synthetic DMARDs (hydroxychloroquine + lefunomide or hydroxychloroquine + mycophenolate vs placebo). We encourage the use of STAR in any ongoing and future trials.Table 1.Candidate STARDomainPointDefinition of responseSystemic activity3Decrease of clinESSDAI ≥ 3Patient reported outcome3Decrease of ESSPRI ≥ 1 point or ≥ 15%Lachrymal gland function1Schirmer:If abnormal score at baseline: increase ≥ 5 mm from baselineIf normal score at baseline: no change to abnormalOrOcular Staining Score:If abnormal score at baseline: decrease ≥ 2 points from baselineIf normal score at baseline: no change to abnormalSalivary gland function1Unstimulated Whole Salivary Flow:If score > 0 at baseline: increase ≥ 25% from baselineIf score is 0 at baseline: any increase from baselineorUltrasound:Decrease ≥ 25% in total Hocevar score from baselineBiological1Serum IgG levels: decrease ≥ 10%orRheumatoid Factor levels: decrease ≥ 25%Candidate STAR responder≥ 5 pointsESSDAI: EULAR Sjögren syndrome disease activity index; ESSPRI: EULAR Sjögren syndrome patient reported index; IgG: Immunoglobulin G;AcknowledgementsNECESSITY WP5 STAR development participants: Suzanne Arends (University Medical Center Groningen, Department of Rheumatology and Clinical Immunology, Groningen 9700 RB, Netherlands), Francesca Barone (Centre for Translational Inflammation Research, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK), Albin Björk (Division of Rheumatology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden), Coralie Bouillot (Association Française du Gougerot Sjögren et des Syndromes Secs, France), Guillermo Carvajal Alegria (University of Brest, Inserm, CHU de Brest, LBAI, UMR1227, Brest, France; Service de Rhumatologie, Centre de Référence Maladies Autoimmunes Rares CERAINO, CHU Cavale Blanche, Brest, France), Wen-Hung Chen (GlaxoSmithKline, Research Triangle Park, North Carolina, USA), Kenneth Clark (GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire SG1 2NY, United Kingdom), Konstantina Delli (Department of Oral and Maxillofacial Surgery, University Medical Center Groningen (UMCG), University of Groningen, The Netherlands), Salvatore de Vita (Rheumatology Clinic, University Hospital of Udine, Italy), Liseth de Wolff (University Medical Center Groningen, Department of Rheumatology and Clinical Immunology, Groningen 9700 RB, Netherlands), Jennifer Evans (Novartis Pharmaceuticals corporation USA), Stéphanie Galtier (Institut de Recherches Internationales Servier (IRIS), Suresnes Cedex, France), Saviana Gandolfo (Rheumatology Clinic, Department of Medical area, University of Udine, ASUFC, 33100 Udine, Italy), Mickael Guedj (Institut de Recherches Internationales Servier (IRIS), Suresnes Cedex, France), Dewi Guellec (CHU de Brest, Service de Rhumatologie, Inserm, CIC 1412, Brest, France), Safae Hamkour (Center of Translational Immunology, Department of Immunology, University Medical Center Utrecht, Utrecht 3584 GA, Netherlands), Dominik Hartl (Novartis Institutes for BioMedical Research, Basel, Switzerland), Malin Jonsson (Section for Oral and Maxillofacial Radiology, Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Norway), Roland Jonsson (Broegelmann Research Laboratory, Department of Clinical Science, University of Bergen, Department of Rheumatology, Haukeland University Hospital, Bergen, Norway), Frans Kroese (University Medical Center Groningen, Department of Rheumatology and Clinical Immunology, Groningen 9700 RB, Netherlands), Aike Albert Kruize (University Medical Center Utrecht, Department Rheumatology and Clinical Immunology, Utrecht, Netherlands), Laurence Laigle (Institut de Recherches Internationales Servier (IRIS), Suresnes Cedex, France), Véronique Le Guern (AP-HP, Hôpital Cochin, Centre de référence maladies auto-immunes et systémiques rares, service de médecine interne, Paris, France), Wen-Lin Luo (Department of Biometrics and Statistical Science, Novartis Pharmaceuticals, East Hanover, New Jersey), Esther Mossel (University Medical Center Groningen, Department of Rheumatology and Clinical Immunology, Groningen 9700 RB, Netherlands), Wan-Fai Ng (Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne NE2 4HH, UK), Gaëtane Nocturne (Department of Rheumatology, Université Paris-Saclay, INSERM U1184: Centre for Immunology of Viral Infections and Autoimmune Diseases, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin Bicêtre, Paris, France), Marleen Nys (Global Biometric Sciences, Bristol Myers Squibb, Braine L’Alleud, Belgium), Roald Omdal (Clinical Immunology Unit, Department of Internal Medicine, Stavanger University Hospital, PO Box 8100, 4068, Stavanger, Norway), Jacques-Olivier Pers (LBAI, UMR1227, University of Brest, Inserm, Brest, France and CHU de Brest, Brest, France), Maggy Pincemin (Association Française du Gougerot Sjögren et des Syndromes Secs, France), Manel Ramos-Casals (Department of Autoimmune Diseases, Hospital Clinic de Barcelona Institut Clinic de Medicinai Dermatologia, Barcelona, Catalunya, Spain), Philippe Ravaud (Centre d’Epidémiologie Clinique, Hôpital Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris, Paris, France), Neelanjana Ray (Global Drug Development - Immunology, Bristol Myers Squibb Company, Princeton, New Jersey, USA), Alain Saraux (HU de Brest, Service de Rhumatologie, Univ Brest, Inserm, UMR1227, Lymphocytes B et Autoimmunité, Univ Brest, Inserm, LabEx IGO, Brest, France), Athanasios Tzioufas (Rheumatology Clinic, Department of Medical area, University of Udine, ASUFC, 33100 Udine, Italy), Gwenny Verstappen (University Medical Center Groningen, Department of Rheumatology and Clinical Immunology, Groningen 9700 RB, Netherlands), Arjan Vissink, Marie Wahren-Herlenius (Division of Rheumatology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden). We thank the following experts: Esen Karamursel Akpek, Alan Baer, Chiara Baldini, Elena Bartoloni, Marí-Alfonso Begona, Johan Brun, Vatinee Bunya, Laurent Chiche, Troy Daniels, Paul Emery, Robert Fox, Roberto Giacomelli, John Gonzales, John Greenspan, Robert Moots, Susumu Nishiyama, Elizabeth Price, Christophe Richez, Caroline Shiboski, Roser Solans Laque, Muthiah Srinivasan, Peter Olsson, Tsutomu Takeuchi, Frederick Vivino, Paraskevi Voulgari, Daniel Wallace, Ava Wu, Wen Zhang. We thank the anonymous patients from the NECESSITY Patient Advisory Group and the Sjögren Foundation for their valuable contribution to the Delphi process. We thank EW StClair and AN Baer who generated the baminercept data and made them publicly available.Disclosure of InterestsRaphaèle Seror Consultant of: GlaxoSmithKline, Boehringer, Janssen and Novartis, Grant/research support from: GlaxoSmithKline and Amgen, Gabriel Baron: None declared, Marine Camus: None declared, Divi Cornec Consultant of: GlaxoSmithKline, Bristol Myers Squibb, Janssen, Amgen, Pfizer and Roche, Elodie Perrodeau: None declared, Simon J. Bowman Consultant of: Abbvie, Astra Zeneca, Galapagos and Novartis Pharmaceuticals, Michele Bombardieri Consultant of: UCB, Amgen/Medimmune, Janssen, and GlaxoSmithKline, Grant/research support from: Amgen/Medimmune, Janssen, and GlaxoSmithKline, Hendrika Bootsma: None declared, Jacques-Eric Gottenberg Consultant of: AbbVie, Bristol Myers Squibb, Eli Lilly, Galapagos, Gilead, Pfizer, Roche, Sanofi, Novartis, MSD, CSL-Behring and Genzyme, Grant/research support from: Bristol Myers Squibb, Benjamin Fisher Speakers bureau: Bristol Myers Squibb and Novartis, Consultant of: Novartis, Bristol Myers Squibb, Janssen and Servier, Grant/research support from: Servier, Galapagos and Janssen, Wolfgang Hueber Shareholder of: Novartis Pharma, Employee of: Novartis Pharma, Joel van Roon: None declared, Valerie Devauchelle-Pensec: None declared, Peter Gergely Shareholder of: Novartis Pharma, Employee of: Novartis Pharma, Xavier Mariette Consultant of: Bristol Myers Squibb, Galapagos, GlaxoSmithKline, Janssen, Novartis, Pfizer and UCB, Grant/research support from: Ose Pharmaceuticals, Raphaël Porcher: None declared
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Zakharov, Anton O. "THE NATIONAL POLICE MERITORIOUS SERVICE STAR OF INDONESIA — BINTANG BHAYANGKARA." Journal of the Institute of Oriental Studies RAS, no. 2 (16) (2021): 246–55. http://dx.doi.org/10.31696/2618-7302-2021-2-246-255.
Повний текст джерелаАнотація:
The award system of Indonesia has formed since the War of Independence against the Netherlands. The first Order — Bintang Gerilya, or the Guerilla Star — was instituted in 1949. Several years later, the Indonesian Army managed to suppress separatist and autonomist movements in various parts of Indonesia. The Indonesian military obtained control over nationalized businesses of the Dutch in the later fifties. It gave the Army a leading role in social and political spheres of the Indonesian state. In 1958, the Indonesian Government instituted two military Orders — Bintang Sakti, or the Sacred Star, and Bintang Dharma, or the Military Distinguished Service Star. In 1959, the Indonesian Government instituted the highest Orders of the State — Bintang Republik Indonesia, or the Star of the Republic of Indonesia, and Bintang Mahaputera, or the Star of Great Son of Nation. The National Police of Indonesia was formed in 1945 or, formally, in 1946. It obtained its own professional Order — Bintang Bhayangkara, or the National Police Meritorious Service Star — in 1961. A year later, the National Police turned a branch of the National Armed Forces of Indonesia. The National Police became separated from the National Armed Forces in 1999, during the democratization since the fall of Suharto’s ‘New Order’ in 1998. The paper focuses on the statute of Bintang Bhayangkara and its functioning among current Indonesian elites. The President and Vice-President of Indonesia have this Order ex officio. Bintang Bhayangkara is regularly bestowed to the high-ranking officers of the National Police and National Armed Forces of Indonesia.
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Thuy, Ben, Lea Numberger-Thuy, and John W. M. Jagt. "A new ophiacanthid brittle star (Echinodermata, Ophiuroidea) from sublittoral crinoid and seagrass communities of late Maastrichtian age in the southeast Netherlands." PeerJ 8 (August 24, 2020): e9671. http://dx.doi.org/10.7717/peerj.9671.
Повний текст джерелаАнотація:
A new species of brittle star, Ophiomitrella floorae, is recorded from the lower two meters of the Gronsveld Member (Maastricht Formation), of late Maastrichtian age (c. 66.7 Ma). These relatively fine-grained biocalcarenites reflect shallow-water deposition in a sheltered setting with a relatively firm sea floor and clear waters, under middle sublittoral and subtropical conditions. Associated echinoderm taxa comprise more robust, sturdy-plated ophiomusaid and ophiodermatid brittle stars and numerous bourgueticrinine sea lilies. The new brittle star described herein belongs to a family whose present-day members are predominantly restricted to bathyal depths. Its small size and the exceptional preservation of a single articulated specimen partially wrapped around the stalk of a bourgueticrinine suggest that O. floorae n. sp. was probably epizoic and specifically associated with stalked crinoids.
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Speelman, Craig P. "Development Support of Early Career Researchers in the Netherlands: Lessons for Australia." SAGE Open 11, no. 3 (July 2021): 215824402110475. http://dx.doi.org/10.1177/21582440211047564.
Повний текст джерелаАнотація:
Australian universities are faced with the imminent retirement of a large proportion of their researchers. One way to avoid a decrement in research performance is to consider greater support for early career researchers (ECRs). To investigate how another university system that is ranked high in research performance supports its ECRs several universities in the Netherlands were visited. Seventeen senior academic staff in these universities were interviewed to examine their perceptions of the support that is provided for the development of ECRs, and the nature of the research environment in which they are employed. Interviews were recorded, transcribed, and coded using a thematic analysis procedure that was guided by the IPA framework to identify common themes amongst the views of the interviewees. Several features of the Dutch university system were identified as different to the Australian system and which the interviewees suggested were responsible for the high level research performance exhibited by their universities. These include the organization of universities by chair groups that are responsible for both research and teaching in a subject area, tenure track systems, and generous financial and material support for developmental activities. On the basis of these findings, I recommend Australian universities consider revising the support they provide to ECRs to be more aligned with what is provided in the Dutch system.
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Chen, Zhong-Jie, Jin Huo, Xiao-Yu Wang, Yi Zhang, Jing Hu, Qi Gao, Xiao-Dong Wu, and Jing-Jing Wang. "Investigation and Analysis of the Key Objectives of WFAS “Technical Specifications of Acupuncture and Moxibustion: General Rules for the Drafting”." Evidence-Based Complementary and Alternative Medicine 2021 (September 22, 2021): 1–9. http://dx.doi.org/10.1155/2021/9508061.
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Objective. To determine the key objectives of WFAS “Technical Specifications of Acupuncture and Moxibustion: General Rules for the Drafting” (hereinafter referred to as General Rules). Methods. From the medical institutions, colleges, and scientific research organizations at major levels in China and overseas, leading researchers and experts in the field of acupuncture-moxibustion standardization, as well as some experienced foreign specialists in acupuncture-moxibustion, were selected as the respondents. The questionnaire was prepared by using the website of Questionnaire Star, and 60 links of the questionnaire were sent out through e-mail. Excel was used to set up the database and conduct statistical analysis. Results. Fifty-one valid questionnaires were collected with effective recovery rate of 85%, involving 9 countries (China, South Korea, Italy, Spain, Sweden, Norway, Netherlands, United States, and Canada) from 3 continents. Most experts agreed with us on the target people, structural elements, and text structure proposed in General Rules and held that the General Rules should emphasize the safety and international applicability and should stipulate in details the common problems (contraindications, indications, taboo crowd, target people, therapeutic effects) of various techniques and the specific contents of technical operation (manipulating techniques, selection of patient’s body position and treated areas, disinfection and environmental requirements, selection of acupuncture-moxibustion instruments, cautions, needle retention time, treatment frequency, precise location of the acupoints, treatment course) in order to enhance the practicality and operability. Conclusion. The key objectives of General Rules mainly include target people, structural elements, text structure, safety requirements, common technical problems of acupuncture-moxibustion, and specific details of technical manipulations.
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Verkaik, Renate, Paulien van Antwerpen-Hoogenraad, Anke de Veer, Anneke Francke, and Judith Huis in het Veld. "Self-management-support in dementia care: A mixed methods study among nursing staff." Dementia 16, no. 8 (February 22, 2016): 1032–44. http://dx.doi.org/10.1177/1471301216632416.
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Background Self-management in patients and family caregivers confronted with dementia is not self-evident. Self-management skills may be limited because of the progressive cognitive decline of the patient and because family caregivers are often also very aged. Self-management support by nursing staff is therefore of paramount importance. Objectives To gain insight into how nursing staff perceive their self-management support tasks, and how they put them into practice. Research questions are: ‘What are the opinions and experiences of Dutch nursing staff working in home care or residential elderly care regarding self-management support for people with dementia and their family caregivers?' and ‘Do nursing staff feel sufficiently trained and skilled for self-management support?’. Methods A mixed methods approach was used, combining cross-sectional quantitative survey data from 206 Dutch nursing professionals with qualitative interviews among 12 nursing staff working in home care or residential elderly care in The Netherlands. Results Nursing staff working in home care experienced self-management support of people with dementia as a part of their job and as an attractive task. They consider ‘helping people with dementia to maintain control over their lives by involving them in decisions in daily care’ the essence of self-management support. Nursing staff saw family caregivers as their main partners in providing self-management support to the patient. They were less aware that family caregivers themselves might also need self-management support. Nursing staff often felt insufficiently trained to give adequate self-management support. RN’s and CNA’s did not differ in their opinions, experiences and training needs. Conclusions Nursing staff in home care do consider self-management support an important and attractive task in dementia care. Their skills for providing self-management support to patients with dementia and family caregivers need improvement. Recommendations Nursing staff need sufficient training to enable the proper provision of self-management support for people with dementia. More attention should also be given to the support of self-management for family caregivers.
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Nieuwenhuis, Jeanet Grietje, Peter Lepping, Cornelis Lambert Mulder, Henk Liewellyn Inge Nijman, and Eric Onno Noorthoorn. "Aggressive behaviour of psychiatric patients with mild and borderline intellectual disabilities in general mental health care." PLOS ONE 17, no. 10 (October 3, 2022): e0272502. http://dx.doi.org/10.1371/journal.pone.0272502.
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Purpose Little is known about the associations between mild intellectual disability (MID), borderline intellectual functioning (BIF) and aggressive behaviour in general mental health care. The study aims to establish the association between aggressive behaviour and MID/BIF, analysing patient characteristics and diagnoses. Method 1174 out of 1565 consecutive in-and outpatients were screened for MID/BIF with the Screener for Intelligence and Learning Disabilities (SCIL) in general mental health care in The Netherlands. During treatment, aggressive behaviour was assessed with the Staff Observation Aggression Scale-Revised (SOAS-R). We calculated odds ratios and performed a logistic and poisson regression to calculate the associations of MID/ BIF, patient characteristics and diagnoses with the probability of aggression. Results Forty-one percent of participating patients were screened positive for MID/BIF. Patients with assumed MID/BIF showed significantly more aggression at the patient and sample level (odds ratio (OR) of 2.50 for aggression and 2.52 for engaging in outwardly directed physical aggression). The proportion of patients engaging in 2–5 repeated aggression incidents was higher in assumed MID (OR = 3.01, 95% CI 1.82–4.95) and MID/BIF (OR = 4.20, 95% CI 2.45–7.22). Logistic regression showed that patients who screened positive for BIF (OR 2,0 95% CL 1.26–3.17), MID (OR 2.89, 95% CI 1.87–4.46), had a bipolar disorder (OR 3.07, 95% CI 1.79–5.28), schizophrenia (OR 2.75, 95% CI 1.80–4.19), and younger age (OR 1.69, 95% CI 1.15–2.50), were more likely to have engaged in any aggression. Poisson regression underlined these findings, showing a SCIL of 15 and below (β = 0.61, p<0.001) was related to more incidents. Conclusions We found an increased risk for aggression and physical aggression in patients with assumed MID/BIF. We recommend screening for intellectual functioning at the start of treatment and using measures to prevent and manage aggressive behaviour that fits patients with MID/BIF.
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Crone, Vincent C. A. "“I Try Not to Be a ‘Neutral Teacher’”: Teacher Identity Formation of Non-Tenured Early-Career Academics in the Humanities." Humanities 12, no. 1 (January 28, 2023): 16. http://dx.doi.org/10.3390/h12010016.
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With internationally growing attention to the quality of higher education, a formal teaching qualification has become at many universities a requirement for non-tenured staff to be eligible for tenure. To obtain a qualification, participants in this case study reflect in a portfolio on their teacher identity by describing what they think is important and what guides the choices they make. Based on a thematic analysis of 47 portfolios by aspiring non-tenured early-career humanities scholars in The Netherlands, I will describe the recurring stories about beliefs, values, and commitments toward being a teacher in the humanities. The analysis will provide insight into how teacher identity is determined by the cultural rules of their disciplinary community to which they want to gain access as non-tenured academics.
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Jarosz*, Iga, Julia Lo, and Jan Lijs. "Investigating the role of Non-Technical Skills in Railway Traffic Operations through Expert Knowledge Elicitation." Proceedings of the Human Factors and Ergonomics Society Annual Meeting 65, no. 1 (September 2021): 262–66. http://dx.doi.org/10.1177/1071181321651181.
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Many high-risk industries identify non-technical skills as safety-critical abilities of the operational staff that have a protective function against human fallibility. Based on an established non-technical skills classification system, methods for expert knowledge elicitation were used to describe non-technical skills in the specific context of train traffic control in the Netherlands. The findings offer insights regarding the skill importance for good operational outcomes, skill difficulty, categorization, and attitudes based on subject matter experts’ opinions. Substantial overlap between the employed non-technical skills framework and the observed expert classification was found, which might indicate that the experts utilize a mental model of nontechnical skills similar to the one used. Furthermore, considerations concerning the organizational culture and the attitudes towards change provide a promising outlook when introducing novel solutions to non-technical skill training and assessment.
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Stubbe, Janine H., Anne-Marie M. C. van Beijsterveldt, Sissi van der Knaap, Jasper Stege, Evert A. Verhagen, Willem van Mechelen, and Frank J. G. Backx. "Injuries in Professional Male Soccer Players in the Netherlands: A Prospective Cohort Study." Journal of Athletic Training 50, no. 2 (February 1, 2015): 211–16. http://dx.doi.org/10.4085/1062-6050-49.3.64.
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Context: Injuries are a major adverse event in a soccer player's career. Reducing injury incidence requires a thorough knowledge of the epidemiology of soccer injuries. Objective: To investigate the incidence and characteristics of injuries in the Dutch premier soccer league. Design: Cohort study. Setting: The Dutch premier soccer league. Patients or Other Participants: During the 2009–2010 soccer season, a total of 217 professional soccer players from 8 teams were prospectively followed. Main Outcome Measure(s): The medical staff recorded time-loss injuries, including information on injuries (ie, type, body part, duration) and exposure data for training sessions and matches. Results: A total of 286 injuries were recorded, affecting 62.7% of the players. The overall injury incidence was 6.2 injuries per 1000 player-hours, 2.8 in training sessions and 32.8 in matches. Most of the recorded injuries were acute (68.5%). Eight percent of the injuries were classified as recurrent. Injuries were most likely to be located in the lower extremities (82.9%). Injury time loss ranged from 1 to 752 days, with a median of 8 days. Knee injuries had the greatest consequences in terms of days of absence from soccer play (on average, 45 days). The most common diagnosis was muscle/tendon injury of the lower extremities (32.9%). Conclusions: Injury risk in the Dutch premier soccer league is high, especially during matches. Preventive measures should focus on the most common diagnoses, namely, muscle/tendon injuries of the lower extremities.
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Van der Moeren, Nathalie, Veronica A. T. C. Weterings, Suzan D. Pas, Jaco J. Verweij, Wouter van den Bijllaardt, Joyce Geurts, Vivian F. Zwart, et al. "SARS-CoV-2 Alpha-Variant Outbreak Amongst a Partially Vaccinated Long-Term Care Facility Population in The Netherlands—Phylogenetic Analysis and Infection Control Observations." Pathogens 11, no. 10 (September 20, 2022): 1070. http://dx.doi.org/10.3390/pathogens11101070.
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Despite extensive vaccination and booster programs, SARS-CoV-2 outbreaks in long-term care facilities (LTCF) continue to occur. We retrospectively describe a SARS-CoV-2 outbreak amongst a partially vaccinated LTCF population in The Netherlands which occurred in March 2021. The facility comprised three floors functioning as separate wards. Nasopharyngeal swabs for SARS-CoV-2 qRT-PCR were obtained from residents and staff presenting with COVID-19-like symptoms and from all residents and staff during two point prevalence screenings (PPS). Samples meeting technical criteria were included for phylogenetic analysis. Positive SARS-CoV-2 qRT-PCR were obtained from 11 (18%) of 61 residents and 8 (7%) of 110 staff members between March 8 and March 25. Seven (37%) cases and five (63%) vaccinated cases were diagnosed through PPS. Cases were found on all wards. Phylogenetic analysis (n = 11) showed a maximum difference of four nucleotides between sequences on the outer branches of the tree, but identified two identical sequences on the root differing maximum two nucleotides from all other sequences, suggesting all did belong to the same cluster. Our results imply that PPS is useful in containing SARS-CoV-2 outbreaks amongst (vaccinated) LTCF populations, as an entire LTCF might behave as a single epidemiological unit and it is preferable to maximize the number of samples included for phylogenetic analysis.
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Weltens, Irene, Marjan Drukker, T. van Amelsvoort, and Maarten Bak. "Staff and ward factors associated with aggression development on an acute closed psychiatric ward: an experience sampling method study." BMJ Open 13, no. 2 (February 2023): e067943. http://dx.doi.org/10.1136/bmjopen-2022-067943.
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Aggression on psychiatric wards develops under influence of patient, staff and ward factors. Assessment of naturalistic derived staff and ward factors might increase better understanding of how aggressive incidents develop on psychiatric wards.ObjectiveStudying staff and ward factors including interactions between patients and nurses prior and after development of aggression, within a naturalistic closed ward setting.DesignA prospective naturalistic experience sampling method (ESM) study.Setting and participantsA high intensive care unit of a mental health institution in The Netherlands where 29 nurses answered beeps generated by an app during approximately 7 consecutive days with questions regarding their subjective feelings, ward atmosphere, location, interaction they had with patients and their colleagues and whether an incident took place.Main outcome measuresAssociations were established between different staff and ward factors and the occurrence of aggressive incidents on the ward.ResultsRisk for aggression was associated with the nurse being with a patient (OR=2.26, 95% CI 0.99 to 5.15, p=0.05). No significant association was found between discussing with the patient and setting a limit or physical absence of the nurse on the one hand and aggression on the other. More experienced nurses encountered more aggression (OR=3.5, 95% CI 1.32 to 8.26, p=0.01). Age and gender of the nurse were not associated with aggression development. Exceeding the maximum bed capacity was associated with a greater risk for aggression (OR=5.36, 95% CI 1.69 to 16.99, p=0.004). There was no significant association when analysing a more positive atmosphere on the ward or positive affect of the nurse, but negative affect of the nurses showed a trend for an association with less aggression.ConclusionAggression is a problem that should be managed from a multidimensional perspective. The quality of interaction between nurses and patients is crucial. Exceeding the maximum bed capacity is likely associated with more aggression.
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Deleanu, Lorena, Viorel Totolici Rusu, George Ghiocel Ojoc, George Catalin Cristea, Mihail Boțan, Alexandru Viorel Vasiliu, and Christian Popescu. "The Behaviour of Stratified Fabrics of Aramid Fibres under Stabbing Conditions." Polymers 16, no. 7 (March 23, 2024): 882. http://dx.doi.org/10.3390/polym16070882.
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This paper presents research on several factors influencing the stabbing behaviour of stratified panels made of aramid fabric Twaron® SRM509 Teijin Aramid BV (Arnhem, The Netherlands). The inputs in the test campaign were the number of layers, the impact energy, and the sample size. Tests were performed on small samples (130 mm × 130 mm) on an Instron® CEAST 9350 drop-tower impact system (Norwood, MA, USA) and on larger samples (400 mm × 400 mm) using a test installation with the same values of the impact energy. Knife type S1 was used, with the geometry recommended in NIJ Standard 0115.00 Stab Resistance of Body Armor SEM, and macro photography investigations revealed the failure mechanisms of panel, layers and fibres. A very important conclusion of this study regarding the stabbing performance of fabric Twaron® SRM 509 in particular, but also in general for panels for body protection is that a research study could start on small size samples, with an accurately instrumented machine, in order to establish the influence of significant factors of stab resistance (energy level, number of layers in a panel, etc.), as these samples are less expensive and less time consuming, but the study should be continued to examine larger size samples. The obtained data are useful for the prototype.
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Bogers, Jan P. A. M., Jasper A. Blömer, and Lieuwe de Haan. "Cognitive Effects of Reducing First-Generation Antipsychotic Dose Compared to Switching to Ziprasidone in Long-Stay Patients with Schizophrenia." Journal of Clinical Medicine 13, no. 7 (April 4, 2024): 2112. http://dx.doi.org/10.3390/jcm13072112.
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Cognitive impairment is a core symptom of schizophrenia and is associated with functional outcomes. Improving cognitive function is an important treatment goal. Studies have reported beneficial cognitive effects of the second-generation antipsychotic (SGA) ziprasidone. Reducing the dose of first-generation antipsychotics (FGA) might also improve cognitive function. This study compared the cognitive effects in long-stay patients who were randomized to groups who underwent FGA dose reduction or switched to ziprasidone. Methods: High-dose FGA was reduced to an equivalent of 5 mg of haloperidol in 10 patients (FGA-DR-condition), and 13 patients switched to ziprasidone 80 mg b.i.d. (ZIPRA condition). Five domains of cognitive function were assessed before dose reduction or switching (T0) and after 1 year (T1). This study was approved by the ethics committee of the Open Ankh (CCMO number 338) and registered at the Netherlands Trial Register (code 5864). Results: Non-significant deterioration was seen in all cognitive domains studied in the FGA-DR condition, whereas there was a non-significant improvement in all cognitive domains in the ZIPRA condition. The most robust difference between conditions, in favor of ziprasidone, was in executive function. Conclusion: In patients with severe chronic schizophrenia, ziprasidone had a non-significant and very modest beneficial effect on cognitive function compared with FGA dose reduction. Larger trials are needed to further investigate this effect.
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van Eijk, Jorna, Kim Luijken, Tiny Jaarsma, Johannes B. Reitsma, Ewoud Schuit, Geert W. J. Frederix, Lineke Derks, et al. "RELEASE-HF study: a protocol for an observational, registry-based study on the effectiveness of telemedicine in heart failure in the Netherlands." BMJ Open 14, no. 1 (January 2024): e078021. http://dx.doi.org/10.1136/bmjopen-2023-078021.
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IntroductionMeta-analyses show postive effects of telemedicine in heart failure (HF) management on hospitalisation, mortality and costs. However, these effects are heterogeneous due to variation in the included HF population, the telemedicine components and the quality of the comparator usual care. Still, telemedicine is gaining acceptance in HF management. The current nationwide study aims to identify (1) in which subgroup(s) of patients with HF telemedicine is (cost-)effective and (2) which components of telemedicine are most (cost-)effective.Methods and analysisThe RELEASE-HF (‘REsponsible roLl-out of E-heAlth through Systematic Evaluation – Heart Failure’) study is a multicentre, observational, registry-based cohort study that plans to enrol 6480 patients with HF using data from the HF registry facilitated by the Netherlands Heart Registration. Collected data include patient characteristics, treatment information and clinical outcomes, and are measured at HF diagnosis and at 6 and 12 months afterwards. The components of telemedicine are described at the hospital level based on closed-ended interviews with clinicians and at the patient level based on additional data extracted from electronic health records and telemedicine-generated data. The costs of telemedicine are calculated using registration data and interviews with clinicians and finance department staff. To overcome missing data, additional national databases will be linked to the HF registry if feasible. Heterogeneity of the effects of offering telemedicine compared with not offering on days alive without unplanned hospitalisations in 1 year is assessed across predefined patient characteristics using exploratory stratified analyses. The effects of telemedicine components are assessed by fitting separate models for component contrasts.Ethics and disseminationThe study has been approved by the Medical Ethics Committee 2021 of the University Medical Center Utrecht (the Netherlands). Results will be published in peer-reviewed journals and presented at (inter)national conferences. Effective telemedicine scenarios will be proposed among hospitals throughout the country and abroad, if applicable and feasible.Trial registration numberNCT05654961.
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Luimstra, Jolien J., Rüya G. Koçer, Alexander Jerman, Jacqueline Klein Gunnewiek, Karlijn Gijzen, Leo H. J. Jacobs, and Ayşe Y. Demir. "Current state of the morphological assessment of urinary erythrocytes in The Netherlands: a nation-wide questionnaire." Clinical Chemistry and Laboratory Medicine (CCLM) 58, no. 11 (October 25, 2020): 1891–900. http://dx.doi.org/10.1515/cclm-2020-0236.
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AbstractBackgroundThe morphological assessment of urinary erythrocytes (uRBC) is a convenient screening tool for the differentiation of nephrological (dysmorphic) and urological (isomorphic) causes of hematuria. Considering the morphological heterogeneity, this analysis is often perceived as difficult. There is no clear (inter)national consensus and there is a lack of external quality assessment programs. To gain insight into the heterogeneity within and between laboratories, we scrutinized the current state of this analysis in Dutch medical laboratories.MethodsThe laboratories, affiliated with the Dutch Foundation for Quality Assessment in Medical Laboratories, were invited to participate in a web-based survey, consisting of two questionnaires. The first one provided information about the institution and laboratory organization, and the second explored the variability in the morphological analysis of uRBC on the basis of categorization of 160 uRBC images. Statistical analysis was premised on binomial significance testing and principal component analysis.ResultsNearly one third of the Dutch medical laboratories (65/191) with 167 staff members participated in the survey. Most of these laboratories (83%) were an integral part of secondary care. The statistical analysis of the evaluations of the participants in comparison to the consensus (three experts from two different medical laboratories) suggested a great degree of heterogeneity in the agreement. Nearly half of the participants consciously disagreed with the consensus, whereas one fifth demonstrated a random relationship with it.ConclusionsIn Dutch medical laboratories, results from morphological analysis of uRBC are heterogeneous, which point out the necessity for standardization and harmonization.
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Feuth, Sander, and Leonie Claes. "Introducing clinical pathways as a strategy for improving care." Journal of integrated Care Pathways 12, no. 2 (September 2008): 56–60. http://dx.doi.org/10.1258/jicp.2008.008008.
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This article describes the way in which Catharina Hospital introduced clinical pathways to its workforce. The hospital, one of the largest non-academic teaching hospitals in The Netherlands, developed the first clinical pathway in 2004. Since then, clinical pathways have been presented as a strategic tool for improving care. In preparation for an organization-wide project, a team investigated and adapted the methodology as designed by the Clinical Pathway Network to the specific situation of Catharina Hospital. Staff were educated, which in return provided project teams with methodology and tools for development. Started small, the aim of the project is to achieve a snowball effect in the use of clinical pathways. Having started in 2006, six pathways are currently under construction, more of which are considered for development. An evaluation of the methodology and results in the summer of 2007, showed that the method was of great help in optimizing care processes and developing multidisciplinary agreements.
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Richardson, Naomi A., Jackie A. Cassell, Michael G. Head, Stefania Lanza, Corinna Schaefer, Stephen L. Walker, and Jo Middleton. "Scabies outbreak management in refugee/migrant camps in Europe 2014–2017: a retrospective qualitative interview study of healthcare staff experiences and perspectives." BMJ Open 13, no. 11 (November 2023): e075103. http://dx.doi.org/10.1136/bmjopen-2023-075103.
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ObjectivesProvide insights into the experiences and perspectives of healthcare staff who treated scabies or managed outbreaks in formal and informal refugee/migrant camps in Europe 2014–2017.DesignRetrospective qualitative study using semistructured telephone interviews and framework analysis. Recruitment was done primarily through online networks of healthcare staff involved in medical care in refugee/migrant settings.SettingFormal and informal refugee/migrant camps in Europe 2014–2017.ParticipantsTwelve participants (four doctors, four nurses, three allied health workers, one medical student) who had worked in camps (six in informal camps, nine in formal ones) across 15 locations within seven European countries (Greece, Serbia, Macedonia, Turkey, France, the Netherlands, Belgium).ResultsParticipants reported that in camps they had worked, scabies diagnosis was primarily clinical (without dermatoscopy), and treatment and outbreak management varied highly. Seven stated scabicides were provided, while five reported that only symptomatic management was offered. They described camps as difficult places to work, with poor living standards for residents. Key perceived barriers to scabies control were (1) lack of water, sanitation and hygiene, specifically: absent/limited showers (difficult to wash off topical scabicides), and inability to wash clothes and bedding (may have increased transmission/reinfestation); (2) social factors: language, stigma, treatment non-compliance and mobility (interfering with contact tracing and follow-up treatments); (3) healthcare factors: scabicide shortages and diversity, lack of examination privacy and staff inexperience; (4) organisational factors: overcrowding, ineffective interorganisational coordination, and lack of support and maltreatment by state authorities (eg, not providing basic facilities, obstruction of self-care by camp residents and non-governmental organisation (NGO) aid).ConclusionsWe recommend development of accessible scabies guidelines for camps, use of consensus diagnostic criteria and oral ivermectin mass treatments. In addition, as much of the work described was by small, volunteer-staffed NGOs, we in the wider healthcare community should reflect how to better support such initiatives and those they serve.
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Ham, Anita. "Social Processes Affecting the Workforce Integration of First-Generation Immigrant Health Care Professionals in Aging Citizens in the Netherlands." Journal of Transcultural Nursing 31, no. 5 (September 18, 2019): 460–67. http://dx.doi.org/10.1177/1043659619875196.
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Introduction: Within a Dutch nursing home, the prevailing workforce culture was challenged by new personnel, which caused institutional change, which in turn, affected workforce integration. The purpose of this study was to examine social processes affecting workforce integration of first-generation immigrant health care professionals in aging citizens in a Dutch health institution in the Netherlands. Method: A purposive sample of 10 immigrants and 10 established nurses was recruited. Ethnography was used to guide this study. 105 hours of participant observation, 8 semistructured interviews with 4 immigrants and 4 established nurses, and 2 focus-group discussions with 8 immigrants and 6 established nurses. Results: The study identified various processes that affect culturally congruent care in the nursing home, like the imposing professional norms, the use of “weapons of the weak,” mutual suspicions of indifference, and collective images of “us” versus “them.” Both groups conceived the “others” as the source of their discomfort, however, both had pain of not mattering. Discussion: When recruiting international educated nurses “all nursing staff” face difficulties when going through the precarious process of mutual integration in daily care practices. We recommend that nurse leaders facilitate positive intergroup interactions that promotes reciprocity for all groups of nurses for better health care outcomes for all.
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Elissen, Arianne Mathilda Josephus, Gertjan Sebastiaan Verhoeven, Maud Hortense de Korte, Anne Odilia Emile van den Bulck, Silke Friederike Metzelthin, Lieuwe Christiaan van der Weij, Jaap Stam, Dirk Ruwaard, and Misja Chiljon Mikkers. "Development of a casemix classification to predict costs of home care in the Netherlands: a study protocol." BMJ Open 10, no. 2 (February 2020): e035683. http://dx.doi.org/10.1136/bmjopen-2019-035683.
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IntroductionCompared with fee-for-service systems, prospective payment based on casemix classification is thought to promote more efficient, needs-based care provision. We aim to develop a casemix classification to predict the costs of home care in the Netherlands.Methods and analysisThe research is designed as a multicentre, cross-sectional cohort study using quantitative methods to identify the relative cost predictors of home care and combine these into a casemix classification, based on individual episodes of care. The dependent variable in the analyses is the cost of home care utilisation, which is operationalised through various measures of formal and informal care, weighted by the relative wage rates of staff categories. As independent variables, we will use data from a recently developed Casemix Short-Form questionnaire, combined with client information from participating home care providers’ (nursing) classification systems and data on demographics and care category (ie, a classification mandated by health insurers). Cost predictors are identified using random forest variable importance measures, and then used to build regression tree models. The casemix classification will consist of the leaves of the (pruned) regression tree. Internal validation is addressed by using cross-validation at various stages of the modelling pathways. The Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis statement was used to prepare this study protocol.Ethics and disseminationThe study was classified by an accredited Medical Research Ethics Committee as not subject to the Dutch Medical Research Involving Human Subjects Act. Findings are expected in 2020 and will serve as input for the development of a new payment system for home care in the Netherlands, to be implemented at the discretion of the Dutch Ministry of Health, Welfare and Sports. The results will also be published in peer-reviewed publications and policy briefs, and presented at (inter)national conferences.
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Dancet, Eline A. F., Thomas M. D’Hooghe, Felicia Dreischor, Madelon van Wely, Ellen T. M. Laan, Cornelius B. Lambalk, Sjoerd Repping, and Inge M. Custers. "The ‘Pleasure&Pregnancy’ web-based interactive educational programme versus expectant management in the treatment of unexplained subfertility: protocol for a randomised controlled trial." BMJ Open 9, no. 7 (July 2019): e025845. http://dx.doi.org/10.1136/bmjopen-2018-025845.
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IntroductionMany subfertile couples are diagnosed with (relatively) unexplained subfertility and a good prognosis. National professional guidelines (eg, the Netherlands and UK) advise ‘expectant management (EM)’ for 6–12 months, in which no interaction with healthcare staff is offered. Underpowered studies indicate that face-to-face sex-counselling increases the ongoing pregnancy rates of these couples. In patients with other conditions, web-based interactive educational programmes have the same effect on sexual functioning as face-to-face sex counselling. The ‘Pleasure&Pregnancy randomised controlled trial (RCT)’ will examine in couples with unexplained subfertility and a good prognosis whether a new web-based interactive educational programme results in a higher chance of naturally conceiving an ongoing pregnancy within 6 months as compared with EM.Methods and analysisA multicentre RCT with cost-effectiveness analysis will include heterosexual couples diagnosed with (relatively) unexplained subfertility and a good prognosis in Dutch and Belgian secondary or tertiary fertility clinics. Couples will be randomised between 6 months of EM and 6 months of the Pleasure&Pregnancy-programme. This new web-based interactive educational programme includes eight progressive modules of information (on the biology of conception and pleasurable sex) and sensate focus, couple communication and mindfulness exercises. Couples are offered interaction with their coaches via email and can take part in three moderated chat sessions with peers. The primary outcome of this RCT is the probability of naturally conceiving an ongoing pregnancy within 6 months after randomisation. Secondary outcomes include time-to-pregnancy, live birth rate, costs, sexual functioning and personal and relational well-being. Analysis will be according to intention to treat.Ethics and disseminationThis study has been approved by the Medical Ethical Committees of the Academic Medical Centre (the Netherlands) and the Leuven University Hospital (Belgium). The findings of this RCT will be disseminated through presentations at international scientific meetings and peer-reviewed publications.Trail registration numberNTR5709; Pre-results.
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Azahari, D. H., H. J. Purba, Erwidodo, V. Darwis, F. B. M. Dabukke, J. Hestina, and E. S. Yusuf. "The competitiveness of Indonesia’s pepper export and its challenges." IOP Conference Series: Earth and Environmental Science 892, no. 1 (November 1, 2021): 012074. http://dx.doi.org/10.1088/1755-1315/892/1/012074.
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Abstract Indonesia is the second-largest pepper (Piper Nigrum L) producer country after Vietnam and followed by India, Brazil, and Malaysia. While Vietnam is the largest black pepper producer, Indonesia is recognized as the largest white pepper-producing country. With the increasing market competition among them in the international market, Indonesia has to increase the market competitiveness of its pepper exports against its competitors. This study aims to analyze the competitiveness of Indonesian pepper exports in the international market by using secondary data from various sources, including from the Indonesian Ministry of Agriculture and the International Pepper Community for the year 2018. It focuses on Pepper beans (HS 0900411) and Pepper Powder (HS090412) and uses two methods, namely Revealed Comparative Advantage (RCA) and Export Products Dynamic (EPD). The RCA analysis shows that Indonesia has a comparative advantage as a pepper exporter on the international market, both for pepper beans and powder. However, the results of the EPD analysis revealed that such an advantage is declining. For example, the study revealed that the export of pepper beans from Indonesia to the United Stated is in the lost opportunity position, and to Vietnam and Singapore are in the falling star position. A similar situation occurs for pepper powder where Indonesia’s export to Japan, Netherlands, and Germany are all in the falling star position. Such situations are caused by some challenges Indonesian pepper exports face, including the fulfillment of the good agriculture practices (GAP) in the upstream sector and compliance to international standards.
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Van Der Vlegel-Brouwer, Wilma. "An evaluation of a transitional care programme for older adults in a general hospital in the Netherlands: Needs, preferences, and perspectives of the average old and the oldest old." International Journal of Integrated Care 23, S1 (December 28, 2023): 26. http://dx.doi.org/10.5334/ijic.icic23317.
Повний текст джерелаАнотація:
Aim: This research aimed to evaluate a transitional care programme for older adults who were acutely admitted to a general hospital, with a special focus on health outcomes and healthcare utilisation for the oldest patients and to clarify patients’ and health care providers’ perspectives on the care provided.
Background: Populations around the world are ageing, and many older adults have complex health problems owing to multimorbidity. Consequently, they experience many transitions in care. During the past decade, transitional care for older adults has become increasingly important in terms of safe transitions and prevention of adverse events during transitions.Research however, often leaves the oldest old and the most vulnerable out of scope.
Methodology and methods: A mixed methods research design, based upon pragmatism and critical realism, was used in a parallel convergent design study. Measurements in the quantitative phase of the study were based on the The Older Persons and Informal Caregivers Survey Minimal Dataset (TOPICS-MDS). Data from the hospital registry and questionnaires were used. In the qualitative phase of the study reflexive thematic analysis was used on data gathered in interviews with patients, hospital nurses and community nurses and two focus group meetings with the geriatric team, and staff and managers from the home care organisations.
Findings: The quantitative part of the study did not show any significant results of the effect of the Transitional Care Bridge (TCB) programme on the prevention of functional decline, health care utilisation and other health outcomes. However, the study revealed an increase in preventive care in the more frail TCB group. The qualitative part of the study reveals the programme was valued by patients, family members and professionals. The familiarity with the programme and personal attitudes of professionals may have influenced expectations and outcomes. Many patients enrolled in the programme were very frail and often unaware of the programme. As they often already received some kind of home care, patients were initially referred to the usual carers. The assessment of the care needs of the oldest patients to some extent fail to recognise what would contribute most to ageing well at home. Professionals in hospital as well as home care organisations struggled with motivation towards the programme and felt they still remained working within their silos. Professional roles were not always clearly defined, valued and reflected upon, and outcomes relating to collaboration reveal a gap between the different worlds of hospital and home.
Discussion: Different contexts, organisational interests, personal attitudes and lack of reflection have influenced collaboration and the delivery of the programme. Transitional care interventions should be redeveloped for and with the oldest adults and their informal caregivers and address their needs during the period shortly after discharge, and help them build structure into their daily routines, and resume activities and exercise. Reflective practices on shared values, implications and outcomes should be developed as a competence within and between all involved organisations of transitional care. More reflective and emergent research approaches are needed to inform policies on ageing well in place and prevention.
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Collingridge Moore, Danni, Sheila Payne, Thomas Keegan, Lieve Van den Block, Luc Deliens, Giovanni Gambassi, Rauha Heikkila, et al. "Length of stay in long-term care facilities: a comparison of residents in six European countries. Results of the PACE cross-sectional study." BMJ Open 10, no. 3 (March 2020): e033881. http://dx.doi.org/10.1136/bmjopen-2019-033881.
Повний текст джерелаАнотація:
ObjectivesThis paper aims to investigate resident, facility and country characteristics associated with length of stay in long-term care facilities (LTCFs) across six European countries.SettingData from a cross-sectional study of deceased residents, conducted in LTCFs in Belgium, England, Finland, Italy, the Netherlands and Poland.ParticipantsAll residents aged 65 years and older at admission who died in a 3-month period residing in a proportional random sample of LTCFs were included.Primary and secondary outcome measuresThe primary outcome was length of stay in days, calculated from date of admission and date of death. Resident, facility and country characteristics were included in a proportional hazards model.ResultsThe proportion of deaths within 1 year of admission was 42% (range 32%–63%). Older age at admission (HR 1.04, 95% CI 1.03 to 1.06), being married/in a civil partnership at time of death (HR 1.47, 95% CI 1.13 to 1.89), having cancer at time of death (HR 1.60, 95% CI 1.22 to 2.10) and admission from a hospital (HR 1.84, 95% CI 1.43 to 2.37) or another LTCF (HR 1.81, 95% CI 1.37 to 2.40) were associated with shorter lengths of stay across all countries. Being female (HR 0.72, 95% CI 0.57 to 0.90) was associated with longer lengths of stay.ConclusionsLength of stay varied significantly between countries. Factors prior to LTCF admission, in particular the availability of resources that allow an older adult to remain living in the community, appear to influence length of stay. Further research is needed to explore the availability of long-term care in the community prior to admission and its influence on the trajectories of LTCF residents in Europe.
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Ghielen, Janine, Sezgin Cihangir, Karin Hekkert, Ine Borghans, and Rudolf Bertijn Kool. "Can differences in length of stay between Dutch university hospitals and other hospitals be explained by patient characteristics? A cross-sectional study." BMJ Open 9, no. 2 (February 2019): e021851. http://dx.doi.org/10.1136/bmjopen-2018-021851.
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ObjectivesThe indicator unexpectedly long length of stay (UL-LOS) is used to gain insight into quality and safety of care in hospitals. The calculation of UL-LOS takes patients’ age, main diagnosis and main procedure into account. University hospitals have relatively more patients with a UL-LOS than other hospitals. Our main research question is whether the high number of patients with a UL-LOS in university hospitals is caused by differences in additional patient characteristics between university hospitals and other hospitals.DesignWe performed a cross-sectional study and used administrative data from 1 510 627 clinical admissions in 87 Dutch hospitals. Patients who died in hospital, stayed in hospital for 100 days or longer or whose country of residence was not the Netherlands were excluded from the UL-LOS indicator. We identified which patient groups were treated only in university hospitals or only in other hospitals and which were treated in both hospital types. For these last patient groups, we added supplementary patient characteristics to the current model to determine the effect on the UL-LOS model.ResultsPatient groups treated in both hospital types differed in terms of detailed primary diagnosis, socioeconomic status, source of admission, type of admission and amount of Charlson comorbidities. Nevertheless, when adding these characteristics to the current model, university hospitals still have a significantly higher mean UL-LOS score compared with other hospitals (p<0.001).ConclusionsThe difference in UL-LOS scores between both hospital types remains after adding patient characteristics in which both hospital types differ. We conclude that the high UL-LOS scores in university hospitals are not caused by the investigated additional patient characteristics that differ between university and other hospitals. Patients might stay relatively longer in university hospitals due to differences in work processes because of their education and research tasks or financing differences of both hospital types.
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Decorte, Tom. "Problems, needs and service provision related to stimulant use in European prisons." International Journal of Prisoner Health 3, no. 1 (January 1, 2007): 29–42. http://dx.doi.org/10.1080/17449200601149122.
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Objective. The objective of this study was to examine practices and policies in place for the provision of targeted prevention and treatment of cocaine and Amphetamine Type Stimulant (ATS) users in prison in nine European countries. Methodology. Across nine European member states (Belgium, the Netherlands, Czech Republic, Lithuania, Slovenia, Sweden, Malta, Ireland and Portugal), interviews were conducted with ministerial representatives and professionals (i.e. service providers and security officials) working in prisons and a total of 16 focus groups with a total of 125 prisoners. Results. The use of stimulants in prison is associated with aggression and violence, financial problems, and psychological and physical problems in prisoners (depression, anxiety and psychological craving). Both security and healthcare staff in prison often feel ill‐equipped to deal with stimulant‐related problems, leading to a lack of equivalence of care for stimulant users in prison, therefore the variety and quality of drug services outside is not reflected sufficiently inside prison. There is a need for more specific product information and harm reduction material on stimulants, for clear guidelines for the management of acute stimulant intoxication and stimulant withdrawal, for structural adjustments to improve potential diagnosis of personality and psychiatric disorders, for more non‐pharmacological treatment strategies and more opportunities for prisoners to engage in purposeful activities.
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De Klerk, Nico. "Dismantling the Dispositif: Social Science Experiments in the Classroom." TMG Journal for Media History 26, no. 1 (June 5, 2023): 1–23. http://dx.doi.org/10.18146/tmg.831.
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The following is a case study of a series of pioneering tests with visual teaching aids in elementary and secondary schools in the United States, conducted between 1920 and 1923. As it happened, these tests coincided with similar experiments in the Netherlands. Although unbeknown to each other, the innovative aspect of both studies consisted in taking their research into the classroom. With this measure experimenters in both countries hoped to collect well-founded evidence to refute what appeared to them as unfounded or overstated claims about photography-based, visual teaching aids, film in particular. While the experimenters forwent a controlled lab situation, by entering the classroom they nonetheless introduced adjustments into everyday educational practice, whether it concerned the activities required of pupils, staff, the interactions between them, and/or the composition of test groups. Thus, they changed what today one would call the educational dispostif: the arrangement of a presentation (a lesson by staff) in a designated space (a classroom with its equipment) before an assemblage of attendees (a class of pupils). Although the term educational dispositif was not current at the time, the experimenters did comment on the elements that constitute it. And given elementary and secondary education’s time-honoured routines, they were bound to stumble upon these elements’ interdependence and reconsider, albeit not in so many words, their conception of what goes on in a class. I largely focus on the American experimentsbecause they are more numerous, more invasive, and more extensively discussed in the 1924 book Visual education. The Dutch experiments, on which I published elsewhere, consisted of two, less invasive series, conducted in one secondary school, and were reported on in two articles, in 1923, and one English translation, in 1924.
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Wielenga, Joke M., Bert J. Smit, and Karel A. Unk. "A Survey on Job Satisfaction Among Nursing Staff Before and After Introduction of the NIDCAP Model of Care in a Level III NICU in the Netherlands." Advances in Neonatal Care 8, no. 4 (August 2008): 237–45. http://dx.doi.org/10.1097/01.anc.0000333712.91140.84.
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Medjedović, Edin, Fahira Imamović, Amela Hajdarević, Sabaheta Jonuzovic – Prosic, Alma Suljević, Amer Iglica, Edin Begić, Zlatan Zvizdic, Sabina Sehic -Krslak, and Asim Kurjak. "LEAN concept - possibilities of implementation and improvement of business processes in public healthcare organizations." Journal of applied health sciences 9, no. 1 (March 22, 2023): 32–41. http://dx.doi.org/10.24141/1/9/1/4.
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Introduction: The basic postulate of the lean concept is that greater efficiency of the work process can be achieved through a process of continuous improvement,which aims to eliminate waste and maximize activities that add value.The Netherlands, Great Britain, Italy and the United States were examples of healthcare systems that implemented the lean concept.Aim: To examine the opinion of health workers of a public hospital in the Sarajevo area about the possibilities of improving business processes by implementing thelean concept.Method: The cross-sectional study was conducted using a questionnaire. The questionnaire was sent to the e-mail addresses of health workers of public health organizations. 91 respondents of both sexes (doctors ofmedicine, residents, registered nurses, nurses and administrative staff) were included.Results: A positive correlation was establishedin the attitude toward the effectiveness and efficiency of business processes. According to the participant’s opinion, the greater effectiveness of business processes contributes to greater efficiency (r=0.846; p<0,05). Spearman’s coefficient rs=0.81 shows a strong connection between the effectiveness and efficiency of business processes.Conclusion: The study showed that there is a positive attitude towards the impact of the lean concept on improving the efficiency of business processes. The reducexpected positive effects of the implementation of the lean concept are manifested through faster provision of services to patients, reduction of service waiting times and general improvement of business processes.
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Puhachova, M. V. "Registers of the Education System in European Countries: Useful Practices for Ukraine." Statistics of Ukraine 91, no. 1 (March 1, 2021): 56–68. http://dx.doi.org/10.31767/su.1(92)2021.01.06.
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Education sectors at country level rely on the circulation of large scopes of information pertaining to education institutions, research institutions, pupils and students, teaching staff, researchers, education diploma or certificates etc. Therefore, the register systems allowing to systematize this information, file it in a convenient form, edit and communicate to physical persons whom these data belong, and to support administrative decision making constitute a necessary tool for the satisfaction of information needs of the modern society. The registers (databases) of the education sector are integral components of the online information resource system in developed countries, which usually consists of the two subsystems: registers containing information about the population, and business registers.
The greatest progress in creating online information resource system, according to experts from international organizations, has been achieved in North European countries. These countries have also become pioneers in carrying out population censuses on the basis of registers, including ones in the education sector.
The article’s objective is to sum up the practices of North European countries in creating and operating electronic information resource systems in the education sector for its adaptation in the Ukrainian realities.
The education registers (databases) of Denmark, the Netherlands, Norway, and Estonia are discussed, with making comparison of register systems in six North European countries. It is stressed that Denmark has created the most elaborate register system operated by the line ministry and the statistical office, in the Netherlands and Norway only two education registers exist, containing the necessary information on all the education levels of the population, Estonia has the single information system for the education, and in Sweden and Finland separate registers for each education level have been created. All the above mentioned register systems in education have sufficient information content, and they are continuously improved. And most importantly, these education registers (databases) in all the studied countries are linked by personal identifiers of individuals with other registers containing information about the population.
The process of creating the Unified State Electronic Database on Education in Ukraine is analyzed, with elaborating on the registers included in this system and their content. Conclusions and recommendations on improvements and further developments in education registers of Ukraine and their links with other population-specific registers are made by summing up the practices of creating electronic information resource systems in North European countries.
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Hartigan, Irene, Kevin Brazil, Sharon Kaasalainen, Tamara Sussman, Jenny Van Der Steen, Martin Loucka, Paola Di Giulio, and Nicola Cornally. "333 A Transnational Effectiveness-Implementation Study of the Family Carer Decision Support Intervention to Improve End of Life Care in Long-Term Care." Age and Ageing 48, Supplement_3 (September 2019): iii17—iii65. http://dx.doi.org/10.1093/ageing/afz103.216.
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Abstract Background The Family Carer Decision Support (FCDS) intervention has been designed to inform family carers about end of life care options available to a person living with advanced dementia. The FCDS intervention demonstrated a statistically significant impact in reducing family carer decision uncertainty on establishing goals of care at the end of life and, improved family carer satisfaction on quality of care in a study conducted in the United Kingdom. Methods The aim of this research is to adapt the application of the FCDS for use in different countries. Funding supported through the EU Joint Programme – Neurodegenerative Disease Research (JPND) project has supported the scaling up of the FCDS transnationally in the United Kingdom; Republic of Ireland; Netherlands; Canada; Czech Republic ; and, Italy. Launched in April 2019, this presentation will report on present activities including: a) description of the FCDS intervention; b) strategy for implementing the FCDS in care homes; c) study design employed for the evaluation of the FCDS; and d) work packages and that will be deployed to achieve intended outcomes Results Expected project outcomes of this work will include a) develop guidelines to facilitate transnational use of the FCDS within care homes; (b) staff education material including web learning resources; (c) family carer informational material including web learning resources; (d) measures and tools to evaluate the uptake and outcome of the FCDS intervention; (e) establish a transnational FCDS community of practice across study care homes; (f) estimated costs of providing the FCDS intervention; (g) evidence of enhancing decision making among family members regarding resident care and satisfaction with care. Conclusion Recent research revealed that care home structures and staff play an important role in the successful implementation and adoption of innovations such as the FCDS intervention, this is further examined in this transnational study.
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den Boer, Maria C., Mirjam Houtlosser, Elizabeth E. Foglia, Enrico Lopriore, Martine Charlotte de Vries, Dirk P. Engberts, and Arjan B. te Pas. "Deferred consent for delivery room studies: the providers’ perspective." Archives of Disease in Childhood - Fetal and Neonatal Edition 105, no. 3 (August 19, 2019): 310–15. http://dx.doi.org/10.1136/archdischild-2019-317280.
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ObjectiveTo gain insight into neonatal care providers’ perceptions of deferred consent for delivery room (DR) studies in actual scenarios.MethodsWe conducted semistructured interviews with 46 neonatal intensive care unit (NICU) staff members of the Leiden University Medical Center (the Netherlands) and the Hospital of the University of Pennsylvania (USA). At the time interviews were conducted, both NICUs conducted the same DR studies, but differed in their consent approaches. Interviews were audio-recorded, transcribed and analysed using the qualitative data analysis software Atlas.ti V.7.0.ResultsAlthough providers reported to regard the prospective consent approach as the most preferable consent approach, they acknowledged that a deferred consent approach is needed for high-quality DR management. However, providers reported concerns about parental autonomy, approaching parents for consent and ethical review of study protocols that include a deferred consent approach. Providers furthermore differed in perceived appropriateness of a deferred consent approach for the studies that were being conducted at their NICUs. Providers with first-hand experience with deferred consent reported positive experiences that they attributed to appropriate communication and timing of approaching parents for consent.ConclusionInsight into providers’ perceptions of deferred consent for DR studies in actual scenarios suggests that a deferred consent approach is considered acceptable, but that actual usage of the approach for DR studies can be improved on.
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Colson, A., M. Heumüller, and E. Abbentheren. "THE WOODEN TRACKWAY PR6, ASCHENER BOG, LOWER-SAXONY, GERMANY." ISPRS Annals of the Photogrammetry, Remote Sensing and Spatial Information Sciences X-M-1-2023 (June 23, 2023): 41–46. http://dx.doi.org/10.5194/isprs-annals-x-m-1-2023-41-2023.
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Abstract. In northern Europe, wetlands hold valuable cultural heritage and enable the conservation of organic material. The region of Lower-Saxony (Germany) boarders the Netherlands in the West and the North Sea in the North. Until the era of cultivation and drainage large parts of northern Lower-Saxony were covered by bogs. Human populations have been living in this environment and developed strategies for crossings since the Neolithic period. There are about 500 wooden trackways listed in Lower-Saxony and several of them have been excavated.The wooden trackway PR6 located in the Aschener Bog, district of Diepholz has been excavated from 2019 to 2021 in cooperation with the natural park Dümmer and the Lower-Saxony State Service for Cultural Heritage (NLD). The project aimed to study a segment of about 550m, which was endangered by peat mining.The company DENKMAL3D (D3D) was contracted for the project and conducted the excavation on site supervised by Dr. M. Heumüller (NLD). Additionally, several staff members from D3D were involved in different capacity: 3D documentation, surveying, and conservation-restoration. This contribution shows the importance of interdisciplinarity in an archaeological research project involving organic material, which is very challenging to excavated and to conserve long-term. Which ethical decision had to be made and how did 3D documentation played a central role in supporting this process? The technical details will be presented as well as future perspective will be discussed and the following research project shortly mentioned.
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Aaron, Maria, Adam Webb, and Ulemu Luhanga. "A Narrative Review of Strategies to Increase Patient Safety Event Reporting by Residents." Journal of Graduate Medical Education 12, no. 4 (August 1, 2020): 415–24. http://dx.doi.org/10.4300/jgme-d-19-00649.1.
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ABSTRACT Background Because residents are often on the frontlines of patient care and are likely to witness adverse events firsthand, it is critical they report patient safety events. They may, however, be underreporting. Objective We examined the current literature to identify strategies to increase patient safety event reporting by residents. Methods We used CINAHL (EBSCO Information Services, Ipswich, MA), EMBASE (Elsevier, Amsterdam, the Netherlands), PsycINFO (APA Publishing, Washington, DC), and PubMed (National Center for Biotechnology Information, Bethesda, MD) databases. The search was limited to English-language articles published in peer-reviewed journals through March 2020. Key terms included “residents, trainees, fellows, interns, graduate medical education, house staff, event reporting, patient safety reporting, incident reporting, adverse event, and medical error.” To organize findings, we adapted a published framework of strategies for encouraging self-protective behavior. Results We identified 68 articles that described strategies used to increase event reporting. The most sustainable interventions used a combination of 3 of the 5 strategies: behavior modeling, surveys and messaging, and required limited financial support. The survey creates awareness; the behavior modeling is critical for educational purposes, and the reminders help to reinforce the new behavior and embed it into routine patient care activities. We noted a dearth of studies involving trainees in root cause analysis following submission of event reports. Conclusions The most successful sustainable interventions were those that combined strategies that minimized time for busy physicians, incorporated accessible event reporting in already existing medical records, and became part of a normal workflow in patient care.
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van Dijk, Manon D., Ed F. van Beeck, Anita Huis, Bernardina TF van der Gun, Suzanne Polinder, Rianne AM van Eijsden, Alex Burdorf, Margreet C. Vos, and Vicki Erasmus. "Effects of a management team training intervention on the compliance with a surgical site infection bundle: a before–after study in operating theatres in the Netherlands." BMJ Open 13, no. 4 (April 2023): e073137. http://dx.doi.org/10.1136/bmjopen-2023-073137.
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ObjectivesTo assess the effects of a quality improvement (QI) team training intervention, by measuring the intervention fidelity and the compliance with a surgical site infection (SSI) bundle in the operating theatre (OT).DesignMulticentre before–after study.SettingThis study was performed in four Dutch hospitals.InterventionThe QI team training intervention consisted of four sessions per hospital and stimulated participants to set culture norms and targets, identify barriers, and formulate management activities to improve compliance with four standard operating procedures (SOPs) of a SSI bundle in the OT. Participants were executive board members, top-level managers, leading clinicians and support staff. The four SOPs were: (1) reducing door movements; (2) preoperative antibiotic prophylaxis prescribing; (3) preoperative shaving; and (4) postoperative normothermia.Poissonand logistic regression analyses were performed to analyse the effect of the intervention on compliance with the individual SOPs (primary outcome measure) and on the influence of medical specialty, time of day the procedure took place and time in the OT (secondary outcome measures).ResultsNot all management layers were successfully involved during all sessions in the hospitals. Top-level managers were best represented in all hospitals, leading clinicians the least. The number of implemented improvement activities was low, ranging between 2 and 14. The team training intervention we developed was not associated with improvements in the compliance with the four SOP of the SSI bundle. Medical specialty, time of day, and time in OT were associated with median number of door movements, and preoperative antibiotic prophylaxis administration.ConclusionThis study showed that after the QI team training intervention the overall compliance with the four SOPs did not improve. Minimal involvement of leading clinicians and a low number of self-initiated activities after the team training were important barriers for compliance.
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Flander, Louisa, Evelien Dekker, Berit Andersen, Mette Bach Larsen, Robert J. Steele, Nea Malila, Tytti Sarkeala, et al. "What can We Learn From High-Performing Screening Programs to Increase Bowel Cancer Screening Participation in Australia?" Cancer Control 29 (January 2022): 107327482211213. http://dx.doi.org/10.1177/10732748221121383.
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Background Colorectal cancer (CRC) is the second most diagnosed cancer in men and women and second most common cause of cancer death in Australia; Australia’s CRC incidence and mortality are among the world’s highest. The Australian National Bowel Cancer Screening Program began in 2006; however, only 33% of those approached for the first time by the Program between 2018 and 2019 returned the kit. Of the 5.7 million kits sent during this period, only 44% were returned. Our aim was to identify practices and features of national bowel cancer screening programs in countries with similar programs but higher screening participation, to identify potential interventions for optimising Australian CRC screening participation. Methods We searched published and grey literature for CRC screening programs reporting at least 50% screening participation using postal invitation and free return of iFOBT home kits. Interviews were conducted with cancer registry staff and academic researchers, focused on participant and practitioner engagement in screening. Results National programs in Netherlands, Scotland, Denmark, and Finland reported over 50% screening participation rates for all invitation rounds. Shared characteristics include small populations within small geographic areas relative to Australia; relatively high literacy; a one-sample iFOBT kit; national registration systems for population cancer screening research; and screening program research including randomised trials of program features. Conclusions Apart from the one-sample kit, we identified no single solution to persistent Australian low uptake of screening. Research including randomised trials within the program promises to increase participation. Impact This screening program comparison suggests that within-program intervention trials will lead to increased Australian screening participation.
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den Boer, Maria C., Mirjam Houtlosser, Elizabeth E. Foglia, Ratna N. G. B. Tan, Dirk P. Engberts, and Arjan B. te Pas. "Benefits of recording and reviewing neonatal resuscitation: the providers’ perspective." Archives of Disease in Childhood - Fetal and Neonatal Edition 104, no. 5 (December 1, 2018): F528—F534. http://dx.doi.org/10.1136/archdischild-2018-315648.
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ObjectiveTo assess benefits of recording and reviewing neonatal resuscitation as experienced by neonatal care providers.DesignA qualitative study using semistructured interviews questioning neonatal care providers about their experiences with recording and reviewing neonatal resuscitation. Data were analysed using the qualitative data analysis software Atlas.ti V.7.0.SettingNeonatal care providers working at neonatal intensive care units (NICUs) of the Leiden University Medical Center, the Netherlands, and the University of Pennsylvania School of Medicine, USA, participated in this study.ResultsIn total, 48 NICU staff members were interviewed. Reported experiences and attitudes are broadly similar for both NICUs. All interviewed providers reported positive experiences and benefits, with special emphasis on educational benefits. Recording and reviewing neonatal resuscitation is used for various learning activities, such as plenary review meetings and as tool for objective feedback. Providers reported to learn from reviewing their own performance during resuscitation, as well as from reviewing performances of others. Improved time perception, reflection on guideline compliance and acting less invasively during resuscitations were often mentioned as learning outcomes. All providers would recommend other NICUs to implement recording and reviewing neonatal resuscitation, as it is a powerful tool for learning and improving. However, they emphasised preconditions for successful implementation, such as providing information, not being punitive and focusing on the benefits for learning and improving.ConclusionRecording and reviewing neonatal resuscitation is considered highly beneficial for learning and improving resuscitation skills and is recommended by providers participating in it.
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Bunn, Mary, Charles Goesel, Mélodie Kinet, and Faith Ray. "Group treatment for survivors of torture and severe violence: A literature review." Torture Journal 26, no. 1 (September 6, 2018): 23. http://dx.doi.org/10.7146/torture.v26i1.108062.
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Methods: The authors conducted a systematic review of scholarly journals and manuscripts. The search was limited to articles published in English that focused on group treatment with torture survivors.
Findings: The authors identified 36 articles and chapters for review describing a variety of group interventions for survivors of torture, including:
Supportive Group Therapy
Empowerment Workshops
Group Treatment for Sleep Disorders
Den Bosch model
Wraparound approach
Stage-oriented model
The literature examined varied in approach and format: present-day and past-focused groups; structured, time-limited groups; and flexible, ongoing support groups.
The studies took place in diverse locations, including Denmark, Germany, Guinea, Namibia, the Netherlands, Palestine, Serbia, the U.S., the UK, and Zimbabwe, and, in conflict, post-conflict and/or humanitarian settings. The interventions were facilitated by licensed mental health professionals, paraprofessionals, and bilingual/bicultural staff – or a combination of the latter two.
Interpretations: Group treatment is an approach which can be administered to larger groups of survivors to address a range of treatment issues. The authors examined key clinical practice issues for group treatment including group composition and content, facilitation and measurement strategies. While the literature does provide a compelling conceptual rationale for using group treatment, the empirical literature is in fact very limited at this time and needs to be strengthened in order to build confidence in outcomes across contexts and survivor communities.
Conclusions: This paper points to a growing interest in the topic of group treatment for survivors of torture and severe violence, providing a comprehensive picture of group-based interventions and highlighting the need for additional research and knowledge-building.
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Schreurs, A. M. F., M. C. I. LIER, D. B. M. Koning, C. W. A. Brals, M. A. De Boer, C. B. Lambalk, M. De Wit, and V. Mijatovic. "Severe psychological impact and impaired quality of life after a spontaneous haemoperitoneum in pregnancy in women with endometriosis and their partners." Facts, Views and Vision in ObGyn 13, no. 2 (June 30, 2021): 159–68. http://dx.doi.org/10.52054/fvvo.13.2.021.
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Background: Spontaneous Haemoperitoneum in Pregnancy (SHiP) is a rare, but life-threatening complication of pregnancy that occurs predominantly in the third trimester of pregnancy and is associated with adverse pregnancy outcomes. Recently the largest case series in literature was published describing 11 Dutch cases of SHiP in women with endometriosis. Purpose: To investigate experiences, psychological impact, and quality of life after SHiP. Methods: A mixed-methods study was performed in women with a history of SHiP and their partners, including all known cases in the Netherlands between 2007 to 2015. Semi-structured in-depth interviews were organized between 2016 and 2017 and analysed thematically with a framework approach. Participants were asked to complete questionnaires investigating the impact of the event (Impact of Event Scale) and Quality of Life (RAND-36). Results: Out of a total of 11 known cases, 7 women agreed for be individually interviewed. From these, all women described a freeze response at the moment of SHiP, combined with either an anxious reaction or a survival mode mind-set. All women received psychological help after SHiP. Still, the feeling of not being heard by the medical staff was present in all women. Other themes such as postpartum period, bonding with their child, effect on daily life, reviving the event, and future pregnancies were also identified in the interviews. In regard to their partners, 3 were interviewed, hence no saturation was achieved. Finally, the questionnaires showed lower Quality of Life and an impact score of ≥ 8/10. Conclusion: SHiP had a profound impact on women and their partners. Dedicated psychological help should be offered to all women after experiencing SHiP.
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Beardsall, Kathryn, Lynn Thomson, Catherine Guy, Mirjam M. van Weissenbruch, Isabel Iglesias, Priya Muthukumar, Sateesh Kumar Somisetty, Simon Bond, Stavros Petrou, and David Dunger. "Protocol of a randomised controlled trial of real-time continuous glucose monitoring in neonatal intensive care ‘REACT’." BMJ Open 8, no. 6 (June 2018): e020816. http://dx.doi.org/10.1136/bmjopen-2017-020816.
Повний текст джерелаАнотація:
IntroductionHyperglycaemia is common in the very preterm infant and has been associated with adverse outcomes. Preventing hyperglycaemia without increasing the risk of hypoglycaemia has proved challenging. The development of real-time continuous glucose monitors (CGM) to inform treatment decisions provides an opportunity to reduce this risk. This study aims to assess the feasibility of CGM combined with a specifically designed paper guideline to target glucose control in the preterm infant.Methods and analysesThe Real Time Continuous Glucose Monitoring in Neonatal Intensive Care (REACT) trial is an international multicentre randomised controlled trial. 200 preterm infants ≤1200 g and ≤24 hours of age will be randomly allocated to either real-time CGM or standard care (with blinded CGM data collection). The primary outcome is time in target 2.6–10 mmol/L during the study intervention assessed using CGM. Secondary outcomes include efficacy relating to glucose control, utility including staff acceptability, safety outcomes relating to incidence and prevalence of hypoglycaemia and health economic analyses.Ethics and disseminationThe REACT trial has been approved by the National Health Service Health Research Authority National Research Ethics Service Committee East of England (Cambridge Central); Medical Ethics Review Committee, VU University Medical Centre, Amsterdam, The Netherlands and the Research Ethics Committee, Sant Joan de Déu Research Foundation, Barcelona, Spain. Recruitment began in July 2016 and will continue until mid-2018. The trial has been adopted by the National Institute of Health Research Clinical Research Network portfolio (ID: 18826) and is registered with anInternational Standard Randomised Control Number (ISRCTN registry ID: 12793535). Dissemination plans include presentations at scientific conferences, scientific publications and efforts at stakeholder engagement.Trial registration numberISRCTNNCT12793535Pre-results.
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Stoorvogel, Hester H., Marlies E. J. L. Hulscher, Heiman F. L. Wertheim, Ed P. F. Yzerman, Maarten Scholing, Jeroen A. Schouten, and Jaap ten ten Oever. "Current Practices and Opportunities for Outpatient Parenteral Antimicrobial Therapy in Hospitals: A National Cross-Sectional Survey." Antibiotics 11, no. 10 (October 1, 2022): 1343. http://dx.doi.org/10.3390/antibiotics11101343.
Повний текст джерелаАнотація:
This nationwide study assessed how outpatient parenteral antimicrobial therapy (OPAT) is organised by Dutch acute care hospitals, the barriers experienced, and how an OPAT program affects the way hospitals organised OPAT care. We systematically developed and administered a survey to all 71 Dutch acute care hospitals between November 2021 and February 2022. Analyses were primarily descriptive and included a comparison between hospitals with and without an OPAT program. Sixty of the 71 hospitals (84.5%) responded. Fifty-five (91.7%) performed OPAT, with a median number of 20.8 (interquartile range [IQR] 10.3–29.7) patients per 100 hospital beds per year. Of these 55 hospitals, 31 (56.4%) had selection criteria for OPAT and 34 (61.8%) had a protocol for laboratory follow-up. Sixteen hospitals (29.1%) offered self-administered OPAT (S-OPAT), with a median percentage of 5.0% of patients (IQR: 2.3%–10.0%) actually performing self-administration. Twenty-five hospitals (45.5%) had an OPAT-related outcome registration. The presence of an OPAT program (22 hospitals, 40.0%) was significantly associated with aspects of well-organised OPAT care. The most commonly experienced barriers to OPAT implementation were a lack of financial, administrative, and IT support and insufficient time of healthcare staff. Concluding, hospital-initiated OPAT is widely available in the Netherlands, but various aspects of well-organised OPAT care can be improved. Implementation of a team-based OPAT program can contribute to such improvements. The observed variation provides leads for further scientific research, guidelines, and practical implementation programs.
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Roseveare, Chris. "Editorial." Acute Medicine Journal 15, no. 1 (January 1, 2016): 2. http://dx.doi.org/10.52964/amja.0592.
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Clinicians working in acute medicine will be familiar with change. The speciality and the environment we work in has changed continually over the past 15 years – I often reflect that no two years have been the same since I started working in the field back in 1999. Change is important, in order to achieve best practice, but sustaining such improvements can be an enormous challenge. The regular turnover of medical staff, local management restructuring and the constantly shifting National goal posts often conspire against us. It is easy for ‘changefatigue’ to set in. Submissions to this journal often describe local audits and service improvement projects which have raised standards: a low baseline may result in a statistically significant improvement from a relatively small intervention – often an education programme or poster campaign to raise awareness of the problem. However, what happens next is far more important: can the improvement be sustained when the key driver behind the project – the enthusiast – moves on, after their 4 month block of acute medicine comes to an end? One year on, we are often back where we started. Two articles in this edition appear to have achieved the Holy Grail of sustainability. In the paper by Joanne Botten from Musgrove Park, door to antibiotic time was improved for patients with neutopaenic sepsis by introducing a system whereby the antibiotics could be administered without waiting for a prescription to be written. The combination of a neutropaenic sepsis alert card and a patient-specific direction empowered the nurses and patients to ensure administration within an hour of arrival in over 90% of cases, a figure which has been sustained for over a year. Sustainable change is often facilitated by modifications in paperwork, but crucially the project’s success was not reliant on a single individual. The value of engaging with the wider team is also shown in Gary Misselbook’s paper describing sustained improvement in the layout and utility of an AMU procedure room. The authors describe how repeated attempts by different registrars had failed to achieve more than temporary reorganisation; the change was only sustained when nursing, infection control and administrative staff became involved in the process. The multiprofessional nature of the AMU is one of its greatest assets – we would all do well to remember this when instigating change. On a similar note, observant readers may have noticed some changes to the editorial board of this journal – I am delighted to welcome Dr Tim Cooksley, acute physician from Manchester and Dr Prabath Nanayakkara from the VUMC in the Netherlands. Tim came through the acute medicine training programme in the North West and his role in the acute oncology service at the Christie Hospital as well as his active involvement in the SAMBA project over recent years brings an important perspective to the editorial team. Prabath has been heavily involved with the development of acute medicine in the Netherlands and co-hosted the successful SAMSTERDAM meeting in 2014. His international perspective will be welcome as we attempt to extend the reach of Acute Medicine to our European neighbours over the coming years. I am very grateful to Nik Patel, Mark Jackson and Ashwin Pinto for their help and support during the past decade and wish them well for the future.