Continuous monitoring, continuous auditing and continuous assurance are three methods that utilize a high degree of business intelligence and analytics. The increased interest in the three methods has led to multiple studies that analyze each method or a combination of methods from a micro-level. However, limited studies have focused on the perceived usage scenarios of the three methods from a macro level through the eyes of the end-user. In this study, we bridge the gap by identifying the different usage scenarios for each of the methods according to the end-users, the accountants. Data has been collected through a survey, which is analyzed by applying a nominal analysis and a process mining algorithm. Results show that respondents indicated 13 unique usage scenarios, while not one of the three methods is included in all of the 13 scenarios, which illustrates the diversity of opinions in accountancy practice in the Netherlands.
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Background: In 2009, the Steering Committee for Pregnancy and Childbirth in the Netherlands recommended the implementation of continuous care during labor in order to improve perinatal outcomes. However, in current care, routine maternity caregivers are unable to provide this type of care, resulting in an implementation rate of less than 30%. Maternity care assistants (MCAs), who already play a nursing role in low risk births in the second stage of labor and in homecare during the postnatal period, might be able to fill this gap. In this study, we aim to explore the (cost) effectiveness of adding MCAs to routine first- and second-line maternity care, with the idea that these MCAs would offer continuous care to women during labor. Methods: A randomized controlled trial (RCT) will be performed comparing continuous care (CC) with care-as-usual (CAU). All women intending to have a vaginal birth, who have an understanding of the Dutch language and are > 18 years of age, will be eligible for inclusion. The intervention consists of the provision of continuous care by a trained MCA from the moment the supervising maternity caregiver establishes that labor has started. The primary outcome will be use of epidural analgesia (EA). Our secondary outcomes will be referrals from primary care to secondary care, caesarean delivery, instrumental delivery, adverse outcomes associated with epidural (fever, augmentation of labor, prolonged labor, postpartum hemorrhage, duration of postpartum stay in hospital for mother and/or newborn), women’s satisfaction with the birth experience, cost-effectiveness, and a budget impact analysis. Cost effectiveness will be calculated by QALY per prevented EA based on the utility index from the EQ-5D and the usage of healthcare services. A standardized sensitivity analysis will be carried out to quantify the outcome in addition to a budget impact analysis. In order to show a reduction from 25 to 17% in the primary outcome (alpha 0.05 and bèta 0.20), taking into account an extra 10% sample size for multi-level analysis and an attrition rate of 10%, 2 × 496 women will be needed (n = 992). Discussion: We expect that adding MCAs to the routine maternity care team will result in a decrease in the use of epidural analgesia and subsequent costs without a reduction in patient satisfaction. It will therefore be a costeffective intervention. Trial registration: Trial Registration: Netherlands Trial Register, NL8065. Registered 3 October 2019 - Retrospectively registered.
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Due to the changing technological possibilities of services, the demands that society places on the level of service provided by the Dutch Central Government (DCG) are changing rapidly. To accommodate this, the Dutch government is improving its processes in such a way that they become more agile and are continuously improved. However, the DCG struggles with the implementation of improvement tools that can support this. The research described in this paper aims to deliver key factors that influence the adoption of tools that improve the agile way of working and continuous improvement at the DCG. Therefore, a literature review has been conducted, from which 24 factors have been derived. Subsequently, 9 semi structured interviews have been conducted to emphasize the perspective of employees at the DCG. In total, 7 key factors have been derived from the interviews. The interviewees consisted of both employees from departments who already worked with tools to improve agile working and continuous improvement as well as employees from departments who haven’t used such tools yet. An important insight based on this research is that the aims, way of working and scope of the improvement tools must be clear for all the involved co-workers
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The Internet offers many opportunities to provide parenting support. An overview of empirical studies in this domain is lacking, and little is known about the design of webbased parenting resources and their evaluations, raising questions about its position in the context of parenting intervention programs. This article is a systematic review of empirical studies (n = 75), published between 1998 and 2010, that describe resources of peer and professional online support for parents. These studies generally report positive outcomes of online parenting support. A number of recent experimental studies evaluated effects, including randomized controlled trials and quasi-experimental designs (totaling 1,615 parents and 740 children). A relatively large proportion of the studies in our sample reported a content analysis of emails and posts (totaling 15,059 coded messages). The results of this review show that the Internet offers a variety of opportunities for sharing peer support and consulting professionals. The fi eld of study refl ects an emphasis on online resources for parents of preschool children, concerning health topics and providing professional support. A range of technologies to facilitate online communication is applied in evaluated websites, although the combination of multiple components in one resource is not very common. The fi rst generation of online resources has already changed parenting and parenting support for a large group of parents and professionals. Suggestions for future development and research are discussed.
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BACKGROUND: In critical care patients, reaching optimal β-lactam concentrations poses challenges, as infections are caused more often by microorganisms associated with higher MICs, and critically ill patients typically have an unpredictable pharmacokinetic/pharmacodynamic profile. Conventional intermittent dosing frequently yields inadequate drug concentrations, while continuous dosing might result in better target attainment. Few studies address cefotaxime concentrations in this population.OBJECTIVES: To assess total and unbound serum levels of cefotaxime and an active metabolite, desacetylcefotaxime, in critically ill patients treated with either continuously or intermittently dosed cefotaxime.METHODS: Adult critical care patients with indication for treatment with cefotaxime were randomized to treatment with either intermittent dosing (1 g every 6 h) or continuous dosing (4 g/24 h, after a loading dose of 1 g). We defined a preset target of reaching and maintaining a total cefotaxime concentration of 4 mg/L from 1 h after start of treatment. CCMO trial registration number NL50809.042.14, Clinicaltrials.gov NCT02560207.RESULTS: Twenty-nine and 30 patients, respectively, were included in the continuous dosing group and the intermittent dosing group. A total of 642 samples were available for analysis. In the continuous dosing arm, 89.3% met our preset target, compared with 50% in the intermittent dosing arm. Patients not reaching this target had a significantly higher creatinine clearance on the day of admission.CONCLUSIONS: These results support the application of a continuous dosing strategy of β-lactams in critical care patients and the practice of therapeutic drug monitoring in a subset of patients with higher renal clearance and need for prolonged treatment for further optimization, where using total cefotaxime concentrations should suffice.
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Behaviour Change Support Systems (BCSS), already running for the 10th time at Persuasive Technology, is a workshop that builds around the concept of systems that are specifically designed to help and support behaviour change in individuals or groups. The highly multi-disciplinary nature of designing and implementing behaviour change strategies and systems for the strategies has been in the forefront of this workshop from the very beginning. The persuasive technology field is becoming a linking pin connecting natural and social sciences, requiring a holistic view on persuasive technologies, as well as multi-disciplinary approach for design, implementation, and evaluation. So far, the capacities of technologies to change behaviours and to continuously monitor the progress and effects of interventions are not being used to its full potential. The use of technologies as persuaders may shed a new light on the interaction process of persuasion, influencing attitudes and behaviours. Yet, although human- computer interaction is social in nature and people often do see computers as social actors, it is still unknown how these interactions re-shape attitude, beliefs, and emotions, or how they change behaviour, and what the drawbacks are for persuasion via technologies. Humans re-shape technology, changing their goals during usage. This means that persuasion is not a static ad hoc event but an ongoing process. Technology has the capacity to create smart (virtual) persuasive environments that provide simultaneously multimodal cues and psycho-physiological feedback for personal change by strengthening emotional, social, and physical presence. An array of persuasive applications has been developed over the past decade with an aim to induce desirable behaviour change. Persuasive applications have shown promising results in motivating and supporting people to change or adopt new behaviours and attitudes in various domains such as health and wellbeing, sustainable energy, education, and marketing. This workshop aims at connecting multidisciplinary researchers, practitioners and experts from a variety of scientific domains, such as information sciences, human-computer interaction, industrial design, psychology and medicine. This interactive workshop will act as a forum where experts from multiple disciplines can present their work, and can discuss and debate the pillars for persuasive technology.
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The Internet offers many opportunities to provide parenting support. An overview of empirical studies in this domain is lacking, and little is known about the design of web based parenting resources and their evaluations, raising questions about its position in the context of parenting intervention programs. This article is a systematic review of empirical studies (n = 75), published between 1998 and 2010, that describe resources of peer and professional online support for parents. These studies generally report positive outcomes of online parenting support. A number of recent experimental studies evaluated effects, including randomized controlled trials and quasi-experimental designs (totaling 1,615 parents and 740 children). A relatively large proportion of the studies in our sample reported a content analysis of e-mails and posts (totaling 15,059 coded messages). The results of this review show that the Internet offers a variety of opportunities for sharing peer support and consulting professionals. The field of study reflects an emphasis on online resources for parents of preschool children, concerning health topics and providing professional support. A range of technologies to facilitate online communication is applied in evaluated Web sites, although the combination of multiple components in one resource is not very common. The first generation of online resources has already changed parenting and parenting support for a large group of parents and professionals. Suggestions for future development and research are discussed.
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This report maps different programs that supportrefugees on the road to entrepreneurship. The municipality of The Hague, along with the refugee and migrant support organization EnterStart (MigrantINC) asked for an evaluation of the program The Hague Test Garden (from now on called The Test Garden) where refugees can ask for help starting their own businesses. The evaluation is not just based on the experiences in The Test Garden; other programs have been included in the evaluation to come to a broader view of the road to entrepreneurship and the obstacles encountered. The increased inflow of refugees in Dutch society and on the Dutch labor market has generated different support programs for starting-up a business. Some of these programs already existed but shifted to accommodate the needs of this specific target group. Other programs were initiated to support refugees because of perceived barriers in Dutch society. Most programs are private initiatives, funded on a project basis. In the Netherlands, refugees that hold a residence permit are called ‘status holders’. Upon arrival, they received a temporary permit for at least five years. They need to follow a civic integration and language program and they are expected to be part of the (regular) education system or labor market as soon as possible. The Test Garden started in 2016, a time when multiple support systems for refugee-entrepreneurs began their programs. This report starts with a short overview ofrefugee flows to the Netherlands. The main part of the report consists of the comparison and evaluation of the different programs. The information was gathered through literature, websites, and in-depth interviews with program managers and others involved. Interviews with the participants are only included for The Test Garden (Appendix 1 gives an overview of the meetings and interviews). LinkedIn: https://www.linkedin.com/in/karijn-nijhoff-89589316/
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During the past two decades the implementation and adoption of information technology has rapidly increased. As a consequence the way businesses operate has changed dramatically. For example, the amount of data has grown exponentially. Companies are looking for ways to use this data to add value to their business. This has implications for the manner in which (financial) governance needs to be organized. The main purpose of this study is to obtain insight in the changing role of controllers in order to add value to the business by means of data analytics. To answer the research question a literature study was performed to establish a theoretical foundation concerning data analytics and its potential use. Second, nineteen interviews were conducted with controllers, data scientists and academics in the financial domain. Thirdly, a focus group with experts was organized in which additional data were gathered. Based on the literature study and the participants responses it is clear that the challenge of the data explosion consist of converting data into information, knowledge and meaningful insights to support decision-making processes. Performing data analyses enables the controller to support rational decision making to complement the intuitive decision making by (senior) management. In this way, the controller has the opportunity to be in the lead of the information provision within an organization. However, controllers need to have more advanced data science and statistic competences to be able to provide management with effective analysis. Specifically, we found that an important skill regarding statistics is the visualization and communication of statistical analysis. This is needed for controllers in order to grow in their role as business partner..
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Clinical decision support systems (CDSSs) have gained prominence in health care, aiding professionals in decision-making and improving patient outcomes. While physicians often use CDSSs for diagnosis and treatment optimization, nurses rely on these systems for tasks such as patient monitoring, prioritization, and care planning. In nursing practice, CDSSs can assist with timely detection of clinical deterioration, support infection control, and streamline care documentation. Despite their potential, the adoption and use of CDSSs by nurses face diverse challenges. Barriers such as alarm fatigue, limited usability, lack of integration with workflows, and insufficient training continue to undermine effective implementation. In contrast to the relatively extensive body of research on CDSS use by physicians, studies focusing on nurses remain limited, leaving a gap in understanding the unique facilitators and barriers they encounter. This study aimed to explore the facilitators and barriers influencing the adoption and use of CDSSs by nurses in hospitals, using an extended Fit Between Individuals, Tasks, and Technology (FITT) framework.
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