KLM has revealed the plan to downsize the full-freight cargo fleet in Schiphol Airport, for that reason the company requires to explore the consequences of moving the cargo transported by the full freighters into the bellies of the passenger flights. In this study, the authors analyze the implications of this decision by considering the variability of the load factors and the impact that replacing old aircraft might have. The study addresses how the transition towards the belly operation should impact the current operation of KLM at Schiphol. Our study shows that the replacement of old aircraft with new 787s and 777s will have significant effect on the cargo capacity of the company. The results rise the discussion on future problems to be faced and how to make the transition from full freighter to belly operation.
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KLM has revealed the plan to downsize the full-freight cargo fleet in Schiphol Airport, for that reason the company requires to explore the consequences of moving the cargo transported by the full freighters into the bellies of the passenger flights. In this study, the authors analyze the implications of this decision by considering the variability of the load factors and the impact that replacing old aircraft might have. The study addresses how the transition towards the belly operation should impact the current operation of KLM at Schiphol. Our study show that the replacement of old aircraft with new 787s and 777s will have significant effect on the cargo capacity of the company. The results rise the discussion on future problems to be faced and how to make the transition from full freighter to belly operation.
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KLM is downsizing the full-freight cargo fleet in Schiphol Airport, for that reason it is important for the company and the airport to explore the consequences of moving the cargo transported by the full freighters into the bellies of the passenger flights. The consequences of this action in terms of capacity and requirements are still unknown. The current study illustrates how to analyse the uncertainty present in the system for identifying the limitations and potential consequences of the reduction of full freighter fleet. The options we identify for coping with the current demand is by adjusting their load factors or increase the number of flights. The current model includes the airside operation of the airport, the truck movements and the traffic that arrives at Schiphol which allows addressing the impact of uncertainties of the operation as well as the limitations and potential problems of the phasing-out action.
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Background Altered muscle-tendon properties in clubfoot patients could play a role in the occurrence of a relapse and negatively affect physical functioning. However, there is a lack of literature about muscle-tendon properties of clubfoot relapse patients. Research question The aim of this study was to determine whether the muscle architecture of the medial gastrocnemius and the morphology of the Achilles tendon differ between typically developing children (TDC) and clubfoot patients with and without a relapse clubfoot and to determine the relationships between morphological and functional gait outcomes. Methods A cross-sectional study was carried out in clubfoot patients treated according to the Ponseti method and TDC aged 4–8 years. A division between clubfoot patients with and without a relapse was made. Fifteen clubfoot patients, 10 clubfoot relapse patients and 19 TDC were included in the study. Morphologic properties of the medial head of the Gastrocnemius muscle and Achilles tendon were assessed by ultrasonography. Functional gait outcomes were assessed using three-dimensional gait analysis. Mean group differences were analysed with ANOVA and non-parametric alternatives. Relationships between functional and morphologic parameters were determined for all clubfoot patients together and for TDC with Spearman’s rank correlation. Results Morphological and functional gait parameters did not differ between clubfoot patients with and without a relapse, with exception of lower maximal dorsiflexor moment in clubfoot relapse patients. Compared to TDC, clubfoot and relapse patients did show lower functional gait outcomes, as well as shorter and more pennate muscles with a longer Achilles tendon. In all clubfoot patients, this longer relative tendon was related to higher ankle power and plantarflexor moment. Significance In clubfoot and relapse patients, abnormalities in morphology did not always relate to worse functional gait outcomes. Understanding these relationships in all clubfoot patients may improve the knowledge about clubfoot and aid future treatment planning.
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Background To gain insight into the role of plantar intrinsic foot muscles in fall-related gait parameters in older adults, it is fundamental to assess foot muscles separately. Ultrasonography is considered a promising instrument to quantify the strength capacity of individual muscles by assessing their morphology. The main goal of this study was to investigate the intra-assessor reliability and measurement error for ultrasound measures for the morphology of selected foot muscles and the plantar fascia in older adults using a tablet-based device. The secondary aim was to compare the measurement error between older and younger adults and between two different ultrasound machines. Methods Ultrasound images of selected foot muscles and the plantar fascia were collected in younger and older adults by a single operator, intensively trained in scanning the foot muscles, on two occasions, 1–8 days apart, using a tablet-based and a mainframe system. The intra-assessor reliability and standard error of measurement for the cross-sectional area and/or thickness were assessed by analysis of variance. The error variance was statistically compared across age groups and machines. Results Eighteen physically active older adults (mean age 73.8 (SD: 4.9) years) and ten younger adults (mean age 21.9 (SD: 1.8) years) participated in the study. In older adults, the standard error of measurement ranged from 2.8 to 11.9%. The ICC ranged from 0.57 to 0.97, but was excellent in most cases. The error variance for six morphology measures was statistically smaller in younger adults, but was small in older adults as well. When different error variances were observed across machines, overall, the tablet-based device showed superior repeatability. Conclusions This intra-assessor reliability study showed that a tablet-based ultrasound machine can be reliably used to assess the morphology of selected foot muscles in older adults, with the exception of plantar fascia thickness. Although the measurement errors were sometimes smaller in younger adults, they seem adequate in older adults to detect group mean hypertrophy as a response to training. A tablet-based ultrasound device seems to be a reliable alternative to a mainframe system. This advocates its use when foot muscle morphology in older adults is of interest.
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Background The global nursing shortages exacerbated by the COVID-19 pandemic necessitated a drastic reorganization in nursing practices. Work routines, the composition of teams and subsequently mundane nursing practices were all altered to sustain the accessibility and quality of care. These dramatic changes demanded a reshaping of the nurses’ work environment. The aim of this study was to explore how nurses reshaped their work environment in the early stages of the COVID-19 pandemic. Methods A descriptive study comprising 26 semi-structured interviews conducted in a large Dutch teaching hospital between June and September 2020. Participants were nurses (including intensive care unit nurses), outpatient clinic assistants, nurse managers, and management (including one member of the Nurse Practice Council). The interviews were analysed with open, axial, and selective coding. Results We identified five themes: 1) the Nursing Staff Deployment Plan created new micro-teams with complementary roles to meet the care needs of COVID-19 infected patients; 2) nurse-led adaptations effectively managed the increased workload, thereby ensuring the quality of care; 3) continuous professional development ensured adequate competence levels for all roles; 4) interprofessional collaboration resulted in experienced solidarity, a positive atmosphere, and increased autonomy for nurses; and, 5) supportive managers reduced nurses’ stress and improved work conditions. Conclusions This study showed that nurses positively reshaped their work environment during the COVID-19 pandemic. They contributed to innovative solutions in an environment of equal interprofessional collaboration, which led to greater respect for their knowledge and competencies, enhanced their autonomy and improved management support.
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Background The global nursing shortages exacerbated by the COVID-19 pandemic necessitated a drastic reorganization in nursing practices. Work routines, the composition of teams and subsequently mundane nursing practices were all altered to sustain the accessibility and quality of care. These dramatic changes demanded a reshaping of the nurses’ work environment. The aim of this study was to explore how nurses reshaped their work environment in the early stages of the COVID-19 pandemic. Methods A descriptive study comprising 26 semi-structured interviews conducted in a large Dutch teaching hospital between June and September 2020. Participants were nurses (including intensive care unit nurses), outpatient clinic assistants, nurse managers, and management (including one member of the Nurse Practice Council). The interviews were analysed with open, axial, and selective coding. Results We identified five themes: 1) the Nursing Staff Deployment Plan created new micro-teams with complementary roles to meet the care needs of COVID-19 infected patients; 2) nurse-led adaptations effectively managed the increased workload, thereby ensuring the quality of care; 3) continuous professional development ensured adequate competence levels for all roles; 4) interprofessional collaboration resulted in experienced solidarity, a positive atmosphere, and increased autonomy for nurses; and, 5) supportive managers reduced nurses’ stress and improved work conditions. Conclusions This study showed that nurses positively reshaped their work environment during the COVID-19 pandemic. They contributed to innovative solutions in an environment of equal interprofessional collaboration, which led to greater respect for their knowledge and competencies, enhanced their autonomy and improved management support.
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In reflecting on Dutch Christmas shoppers, this article will discuss environmental Kuznets curve (EKC), postmaterialist values hypothesis, and ecological modernization theory. According to the EKC hypothesis, while at the initial stages of industrialization material resources are often used unsustainably, continuing industrialization leads to a threshold after which lead to progressively more sustainable technologies. According to the postmaterialist values hypothesis, only wealthier societies can ‘afford’ to care about the environment, assuming that wealth will lead to development of greater concern about and valuation of environment. Finally, ecological modernization theory postulates that environmental conditions improve with advanced technological development and suggests that enlightened self-interest, economy and ecology can be favourably combined and that productive use of natural resources can be a source of future growth. In generalizing economic, political and social trends in relation to consumption in The Netherlands, the aim of this article is to consider the consequences of Western-style consumption for the enterprise of global development. https://doi.org/10.1016/j.scs.2013.05.004 https://www.linkedin.com/in/helenkopnina/
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Recently KLM has revealed the plan to downsize the full-freight cargo fleet in Schiphol Airport, for that reason it is important for the company and the airport to explore the consequences of moving the cargo transported by the full freighters into the bellies of the passenger flights. The consequences of this action in terms of capacity and requirements are still unknown for the stakeholders. The current study illustrates that once the freighters are phased out, the commercial traffic needs to adjust mainly their load factors in order to absorb the cargo that was previously transported by the full freighters. The current model is a version that includes the airside operation of the airport and also the vehicle movement which allows addressing the uncertainties of the operation as well as the limitations and potential problems of the phasing-out action.
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Despite the consequences for women’s health, a repeat cesarean section (CS) birth after a previous CS is common in Western countries. Vaginal Birth After Cesarean (VBAC) is recommended for most women, yet VBAC rates are decreasing and vary across maternity organizations and countries. We investigated women’s views on factors of importance for improving the rate of VBAC in countries where VBAC rates are high. We interviewed 22 women who had experienced VBAC in Finland, the Netherlands, and Sweden. We used content analysis, which revealed five categories: receiving information from supportive clinicians, receiving professional support from a calm and confident midwife/obstetrician during childbirth, knowing the advantages of VBAC, letting go of the previous childbirth in preparation for the new birth, and viewing VBAC as the first alternative for all involved when no complications are present. These findings reflect not only women’s needs but also sociocultural factors influencing their views on VBAC.
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