A growing interest in person-centered care from a biopsychosocial perspective has led to increased attention to structural screening. The aim of this study was to develop an easy-to-comprehend screening instrument using single items to identify a broad range of health-related problems in adult burn survivors. This study builds on earlier work regarding content generation. Focus groups and expert meetings with healthcare providers informed content refinement, resulting in the Aftercare Problem List (APL). The instrument consists of 43 items divided into nine health domains: scars, daily life functioning, scars treatment, body perceptions, stigmatization, intimacy, mental health, relationships, financial concerns, and a positive coping domain. The APL also includes a Distress Thermometer and a question inquiring about preference to discuss the results with a healthcare provider. Subsequently, the APL was completed by 102 outpatients. To test face validity, a linear regression analysis showed that problems in three health domains, i.e., scars, mental health, and body perceptions, were significantly related to higher distress. Qualitative results revealed that a minority found the items difficult which led to further adjustment of the wording and the addition of illustrations. In summation, this study subscribes to the validity of using single items to screen for burn-related problems.
For deep partial-thickness burns no consensus on the optimal treatment has been reached due to conflicting study outcomes with low quality evidence. Treatment options in high- and middle-income countries include conservative treatment with delayed excision and grafting if needed; and early excision and grafting. The majority of timing of surgery studies focus on survival rather than on quality of life. This study protocol describes a study that aims to compare long-term scar quality, clinical outcomes, and patient-reported outcomes between the treatment options. A multicentre prospective study will be conducted in the three Dutch burn centres (Rotterdam, Beverwijk, and Groningen). All adult patients with acute deep-partial thickness burns, based on healing potential with Laser Doppler Imaging, are eligible for inclusion. During a nine-month baseline period, standard practice will be monitored. This includes conservative treatment with dressings and topical agents, and excision and grafting of residual defects if needed 14–21 days post-burn. The subsequent nine months, early surgery is advocated, involving excision and grafting in the first week to ten days post-burn. The primary outcome compared between the two groups is long-term scar quality assessed by the Patient and Observer Scar Assessment Scale 3.0 twelve months after discharge. Secondary outcomes include clinical outcomes and patient-reported outcomes like quality of life and return to work. The aim of the study is to assess long-term scar quality in deep partial-thickness burns after conservative treatment with delayed excision and grafting if needed, compared to early excision and grafting. Adding to the ongoing debate on the optimal treatment of these burns. The broad range of studied outcomes will be used for the development of a decision aid for deep partial-thickness burns, to fully inform patients at the point of consent to surgery and support optimal person-centred care.
BACKGROUND: In the last decades, autologous fat grafting has been used to treat adherent dermal scars. The observed regenerative and scar-reducing properties have been mainly ascribed to the tissue-derived stromal vascular fraction (tSVF) in adipose tissue. Adipose tissue's components augment local angiogenesis and mitosis in resident tissue cells. Moreover, it promotes collagen remodeling. We hypothesize that tSVF potentiates fat grafting-based treatment of adherent scars. Therefore, this study aims to investigate the effect of tSVF-enriched fat grafting on scar pliability over a 12-month period.METHODS AND DESIGN: A clinical multicenter non-randomized early phase trial will be conducted in two dedicated Dutch Burn Centers (Red Cross Hospital, Beverwijk, and Martini Hospital, Groningen). After informed consent, 46 patients (≥18 years) with adherent scars caused by burns, necrotic fasciitis, or degloving injury who have an indication for fat grafting will receive a sub-cicatricic tSVF-enriched fat graft. The primary outcome is the change in scar pliability measured by the Cutometer between pre- and 12 months post-grafting. Secondary outcomes are scar pliability (after 3 months), scar erythema, and melanin measured by the DSM II Colormeter; scar quality assessed by the patient and observer scales of the Patient and Observer Scar Assessment Scale (POSAS) 2.0; and histological analysis of scar biopsies (voluntary) and tSVF quality and composition. This study has been approved by the Dutch Central Committee for Clinical Research (CCMO), NL72094.000.20.CONCLUSION: This study will test the clinical efficacy of tSVF-enriched fat grafting to treat dermal scars while the underlying working mechanism will be probed into too.
Phosphorus is an essential element for life, whether in the agricultural sector or in the chemical industry to make products such as flame retardants and batteries. Almost all the phosphorus we use are mined from phosphate rocks. Since Europe scarcely has any mine, we therefore depend on imported phosphate, which poses a risk of supply. To that effect, Europe has listed phosphate as one of its main critical raw materials. This creates a need for the search for alternative sources of phosphate such as wastewater, since most of the phosphate we use end up in our wastewater. Additionally, the direct discharge of wastewater with high concentration of phosphorus (typically > 50 ppb phosphorus) creates a range of environmental problems such as eutrophication . In this context, the Dutch start-up company, SusPhos, created a process to produce biobased flame retardants using phosphorus recovered from municipal wastewater. Flame retardants are often used in textiles, furniture, electronics, construction materials, to mention a few. They are important for safety reasons since they can help prevent or spread fires. Currently, almost all the phosphate flame retardants in the market are obtained from phosphate rocks, but SusPhos is changing this paradigm by being the first company to produce phosphate flame retardants from waste. The process developed by SusPhos to upcycle phosphate-rich streams to high-quality flame retardant can be considered to be in the TRL 5. The company seeks to move further to a TRL 7 via building and operating a demo-scale plant in 2021/2022. BioFlame proposes a collaboration between a SME (SusPhos), a ZZP (Willem Schipper Consultancy) and HBO institute group (Water Technology, NHL Stenden) to expand the available expertise and generate the necessary infrastructure to tackle this transition challenge.
Professionals van woningbouwcorporaties en gemeentes die zich bezig houden met verduurzaming hebben vragen over hergebruik van afvalhout uit hun (renovatie) projecten. De doelstelling van dit voorstel is het onderzoeken van de mogelijkheden om hout te hergebruiken door gebruik te maken van innovatieve digitale productietechnieken, en om implementatiestrategieën hiervoor te ontwikkelen voor publieke organisaties in de bouwsector, in het bijzonder woningcorporaties en gemeentes. Strategieën omvatten concrete voorstellen om a) afvalhout van woningen in te zamelen en te verwerken; b) waarde toe te voegen aan houtafvalstromen door middel van digitale productie; c) de betrokkenheid en acceptatie van huurders te vergroten bij circulaire verwerking van hout in nieuwe toepassingen; en d) goede toepassingen voor een circulaire economie te realiseren. Het project onderzoekt aard en omvang van houtafvalstromen uit woningrenovatie en identificeert de mogelijkheden voor het hergebruik van specifieke fracties daarvan voor (lokale) toepassingen. Uit voorgaande projecten blijkt dat digitale productie mogelijkheden biedt om stedelijk afval om te zetten in zinvolle circulaire producten. Digitale productie maakt de (lokale) creatie van unieke prototypen en grootschalige toepassingen mogelijk. Het onderzoek wordt uitgevoerd in vier werkpakketten. De eerste identificeert de aard van huishoudelijk houtafval (volume, houtsoort, verzamelproces) door zorgvuldig cases van Ymere en Rochdale te bestuderen. Daarnaast worden er een raamwerk van indicatoren gedefinieerd om projectresultaten te kunnen evalueren. Het tweede werkpakket onderzoekt welke toepassingen kunnen worden bedacht, gegeven de beschikbare houtfracties. In het derde werkpakket wordt een aantal case studies uitgevoerd voor concrete projecten van de deelnemende woningcorporaties. Deze applicaties hebben als doel het potentieel van digitale productie met houtafval te laten zien, rekening houdend met het perspectief van bewoners. Het biedt belangrijke inzichten in de uitvoerbaarheid van concrete toepassingen uit teruggewonnen hout. In het vierde werkpakket worden alle projectbevindingen gecombineerd in een set implementatie strategieën voor publieke organisaties in het stedelijk domein.
In our increasingly global society, organizations face many opportunities in innovation, improved productivity and easy access to talent. At the same time, one of the greatest challenges, businesses experience nowadays, is the importance of social and/or human capital for their effectiveness and success (Backhaus and Tikoo, 2004; Mosley, 2007; Theurer et al., 2018; Tumasjan et al., 2020). High-quality employees are crucial to the competitive strength of an organization in the global economy, as these employees have a major influence on organizational reputation (Dowling at al., 2012). An important question is how, under these global circumstances, organizations and companies in the Netherlands can best be stimulated to attract and preserve social capital.Several studies have suggested the scarcity of talent and the crucial importance of gaining competitive advantage with recruitment communication to find the fit between personal and fundamental organizational characteristics and values for employees (Cable and Edwards, 2004; Bhatnagar and Srivastava, 2008; ManPower Group, 2014; European Communication Monitor (ECM), 2018). In order to become an employer of choice, organizations have to not only stand out from the crowd during the recruitment process but work on developing loyalty and a culture of trust in their relationship with employees (ECM, 2018). Employer Branding focuses on the process of promoting an organization, as the “employer of choice” to a desired target group, which an organization aims to attract and retain. This process encompasses building an identifiable and unique employer identity or, more specifically, “the promotion of a unique and attractive image” as an employer (Backhaus 2004, p. 117; Backhaus and Tikoo 2004, p. 502).One of the biggest challenges in the North of the Netherlands at the moment is the urgent need for qualified labor in the IT, energy and healthcare sectors and the excess supply of international graduates who are able to find a job in the North of the Netherlands (AWVN, 2019). Talent development, as part of the regional labor market and education policy, has been an important part of government programs and strategies in the region (VNO-NCW Noord, 2018). For instance, North Netherlands Alliance (SNN) signed a Northern Innovation Agenda for the 2014-2020 period. SNN encourages, facilitates and connects ambitions focused on the development of the Northern Netherlands. Also, the Social Economic council North Netherlands issued an advice on the labour market in the North Netherlands (SER Noord Nederland, 2017). Knowledge institutions also contribute through employability programs. Another example is the Regional Talent Agreement (Talent Akkoord) framework issued by the Groningen educational institutions, employers and employees’ organizations and regional authorities in which they jointly commit to recruiting, training, retaining and developing talent for the Northern labor market. Most of the hires with a maximum of five year of experience at companies are represented by millennials. To learn what values make an attractive brand for employees in the of the North of the Netherlands, we conducted a first study. When ranking the most important values of corporate culture which matter to young employees, they mention creative freedom, purposeful work, flexibility, work-life balance as well as personal development. Whereas attractive workplace and job security do not matter to such a degree. A positive work environment and a good relationship with colleagues are valued highly (Hein, 2019).To date, as far as we know, no other employer branding studies have been carried out for the North of the Netherlands. Further insight is needed into the role of employer branding as a powerful tool to retain talent in Northern industry in particular.The goal of this study is to provide a detailed analysis of the regional industry in the Northern Netherlands and contribute to: 1) the scientific body of knowledge about whether and how employer branding can strengthen the attractiveness of a regional industry in the labor market; 2) the application of this knowledge and insights by companies and governments in local policy development in the North of the Netherlands.
