A culture change within an organization may be of importance in this turbulent world. An assessment of the current and desired cultural profiles can help estimate as to whether any changes are required. In this study the organizational culture of a housing association was examined from both the staff’s and external stakeholders’ perspectives. How does the current culture compare with the desired culture? Do the external stakeholders perceive the organization’s culture in a similar way? Do the staff’s and external stakeholders’ perceptions coincide with the organization’s intended image? The results demonstrate that the external stakeholders’ perceptions of the organizational culture in this case study are similar to those of the organization’s staff.
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Limited evidence is available about (non)-representativeness of participants in health-promoting interventions. The Dutch Healthy Primary School of the Future (HPSF)-study is a school-based study aiming to improve health through altering physical activity and dietary behaviour, that started in 2015 (registered in ClinicalTrials.gov on14-06-2016, NCT02800616). The study has a response rate of 60%. A comprehensive non-responder analysis was carried out, and responders were compared with schoolchildren from the region and the Netherlands using a cross-sectional design. External sources were consulted to collect non-responder, regional, and national data regarding relevant characteristics including sex, demographics, health, and lifestyle. The Chi-square test, Mann-Whitney U test, or Student's t-test were used to analyse differences.
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This paper empirically explores the relationship between the external factors within the oil and gas (O&G) industry business environment and supply chain sustainability goals to understand the factors that could drive or hinder its adoption of sustainable supply chain management (SSCM) practices. It examines the relationships between six external factors (political stability, economic stability, stakeholder pressure, competition, energy transition and regulations) and sustainability goals through multiple regression analysis, using survey data from companies that operate in the O&G industry. Data analyses reveal that there are two types of sustainability goals namely strategic goals (SGO), which are conditional for long term survival, and functional goals (FGO), which are closely related to the companies' operational processes. The analyses also show that stakeholder pressure and economic stability are the most influential factors that could affect the goals. While competition within the O&G industry has a positive effect on the FGO, competition from the broader energy industry results in a negative effect on the SGO. The influence of energy transition relates to a higher focus on SGO. The results are useful in designing SSCM strategy that could help the O&G industry address the pressure from the external factors for more sustainable supply chain practices to achieve its sustainability goals.
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Background: Advanced statistical modeling techniques may help predict health outcomes. However, it is not the case that these modeling techniques always outperform traditional techniques such as regression techniques. In this study, external validation was carried out for five modeling strategies for the prediction of the disability of community-dwelling older people in the Netherlands. Methods: We analyzed data from five studies consisting of community-dwelling older people in the Netherlands. For the prediction of the total disability score as measured with the Groningen Activity Restriction Scale (GARS), we used fourteen predictors as measured with the Tilburg Frailty Indicator (TFI). Both the TFI and the GARS are self-report questionnaires. For the modeling, five statistical modeling techniques were evaluated: general linear model (GLM), support vector machine (SVM), neural net (NN), recursive partitioning (RP), and random forest (RF). Each model was developed on one of the five data sets and then applied to each of the four remaining data sets. We assessed the performance of the models with calibration characteristics, the correlation coefficient, and the root of the mean squared error. Results: The models GLM, SVM, RP, and RF showed satisfactory performance characteristics when validated on the validation data sets. All models showed poor performance characteristics for the deviating data set both for development and validation due to the deviating baseline characteristics compared to those of the other data sets. Conclusion: The performance of four models (GLM, SVM, RP, RF) on the development data sets was satisfactory. This was also the case for the validation data sets, except when these models were developed on the deviating data set. The NN models showed a much worse performance on the validation data sets than on the development data sets.
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An on-going investigation in the learning effects of IPD projects. In three subsequent semesters the students were asked how they rated their competencies at the start of the project as well as at the end of it. Also questionnaires were filled out and students were interviewed. A lot of students tended to give themselves lower ratings in the end than in the begin. It appeared that if they met any difficulties in for instance communication or co-operation during the project, that they interpreted this as a decrease in competencies. Finally the students were explicitly asked to mention an eventual increase in competencies and also a possible contribution for this effect. Only a few factors that actually contribute to the learning effects have been defined.
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This article examines the network structure, criminal cooperation, and external interactions of cybercriminal networks. Its contribution is empirical and inductive. The core of this study involved carrying out 10 case analyses on closed cybercrime investigations – all with financial motivations on the part of the offenders - in the UK and beyond. Each analysis involved investigator interview and access to unpublished law enforcement files. The comparison of these cases resulted in a wide range of findings on these cybercriminal networks, including: a common division between the scam/attack components and the money components; the presence of offline/local elements; a broad, and sometimes blurred, spectrum of cybercriminal behaviour and organisation. An overarching theme across the cases that we observe is that cybercriminal business models are relatively stable.
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Purpose: Instability of the knee joint is reported by a majority (>65%) of patients with knee osteoarthritis (KOA) and is hypothesized to play a crucial role in the initiation and progression of KOA. A generally accepted objective metric of knee joint stability is lacking, making development of diagnostics and treatment options for knee joint instability more difficult. Such a metric should be based on how gait biomechanics and muscle activation in the unstable knee joint differ from those in a stable knee joint. To challenge knee joint instability, external perturbations during gait are needed to replicate the situations in daily life that require stability of the knee joint. Therefore, the aim of this study was to compare the responses in knee biomechanics and muscle activation patterns to different types of external perturbations during gait of patients with self-reported knee joint instability (KOA-I) versus patients reporting stable knees (KOA-S) and healthy control subjects.Methods: Forty patients (60% female) were included in this study with a mean age of 66 years (range: 52-82), body mass index of 26 (range: 19-32) and Kellgren and Lawrence grade of 2.5 (range 0-4). Patients were dichotomized in a KOA-I group (n=20) and KOA-S group (n=20) based on if they had perceived an episode of knee joint instability in the past four weeks. Furthermore, twenty age-, gender- and BMI-matched healthy control subjects were measured. The participants walked on a dual-belt instrumented treadmill while different external perturbations were applied, triggered by heel strike of the most affected leg (figure 1). The external perturbations consisted of sway left (SL) or sway right (SR) translations (4 cm) or accelerations (AC) or decelerations (DC) of one belt (1.6 m/s walking speed change in 0.23 seconds). Knee kinematics and muscle activation patterns of the perturbed gait cycles were collected using a motion capture system and surface electromyography. The three groups were compared using statistical parametric mapping (SPM) and discrete values by analysis of variance. The discrete values of the knee angles (initial contact, peak and range of motion (ROM) values) and muscle activation patterns (peak, mean and co-contraction index (CCI) values) were corrected for walking speed.Results: The SPM analysis results (example provided in figure 2) showed that in response to the SL perturbations the KOA-I group walked with greater knee flexion angles (KFA) during pre-swing compared to the control group (SPM, p<0.01) and during mid-swing compared to the KOA-S group and control group (SPM, p<0.01). Moreover, during the SR perturbed gait cycles the KOA-I group had greater KFA during mid-swing compared to the KOA-S group (SPM, p=0.01). In response to the AC perturbations the KOA-I group walked with a greater KFA during late terminal stance compared to the control group (SPM, p<0.01). Furthermore, the KOA-I group had greater KFA during the pre-swing phase of the DC perturbed gait cycles compared to the control group (SPM, p<0.01). The significant results from the comparison of the discrete values are presented in table 1. The KOA-I group had greater peak KFA during the swing phase of all perturbed gait cycles (independent of perturbation type) compared to the KOA-S group and control group (p<0.01). Moreover, during both sway perturbations (SL, SR) higher KFA ROM were observed in the KOA-I group compared to the KOA-S group (p<0.05). Besides this, the KOA-I group presented higher CCI of the medial muscles (vastus medialis and medial hamstring) compared to the KOA-S group during the DC perturbation (p=0.03). Furthermore, changes in vastus medialis and gluteus medius muscle activation in response to different external perturbations were observed in the KOA-S group compared to the control group and the KOA-I group (p<0.05).Conclusions: Patients with KOA-I walked with greater knee flexion angles during peak stance, late-terminal stance, pre-swing and mid-swing in response to different external perturbations, which could be a distinctive strategy of these patients to maintain stability of the knee joint during these phases of gait. Besides this, only few alterations were observed in the knee muscle activation patterns between the groups. This could be explained by the large variation between subjects in the muscle activations patterns which might indicate different neuromuscular strategies to respond to the external perturbations. Future studies with larger sample sizes are required to test the reliability and validity of the knee flexion angle as a candidate for the objective measurement of knee joint stability and to further investigate neuromuscular control of the unstable osteoarthritic knee.
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Background: An adaptation of multisystemic therapy (MST) was piloted to find out whether it would yield better outcomes than standard MST in families where the adolescent not only shows antisocial or delinquent behaviour, but also has an intellectual disability. Method: To establish the comparative effectiveness of MST‐ID (n = 55) versus standard MST (n = 73), treatment outcomes were compared at the end of treatment and at 6‐month follow‐up. Pre‐treatment differences were controlled for using the propensity score method. Results: Multisystemic therapy‐ID resulted in reduced police contact and reduced rule breaking behaviour that lasted up to 6 months post‐treatment. Compared to standard MST, MST‐ID more frequently resulted in improvements in parenting skills, family relations, social support, involvement with pro‐social peers and sustained positive behavioural changes. At follow‐up, more adolescents who had received MST‐ID were still living at home. Conclusions: These results support further development of and research into the MST‐ID adaptation.
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For the Dam tot damloop, a running event with 36,757 participants and 115,000 visitors, both an economic impact analysis (IEA) and a social cost benefit analysis (SCBA) are made to study the (broader) economic effects. Three overlapping geographical regions are studied and two new estimates of non-market goods are used. For the hosting cities the net social gain from the SCBA is at least three times the EIA’s economic impact. The larger the geographical area studied, the larger the differences between EIA and SCBA, because the EIA outcome falls and the SCBA outcome increases. A lower multiplier than 1 lowers the EIA much more than it lowers the SCBA. This study shows that an EIA is not suited for evaluating the welfare effects of public support for a sport event. The difference in outcome between EIA and SCBA is substantial. Valuing non-market effects is done infrequently but is crucial for understanding the welfare effects of policies supporting sport events. Organizing an event for social and city marketing benefits can be a better reason than organizing for the direct economic gains.
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Introduction: Patients with cancer receiving radio- or chemotherapy undergo many immunological stressors. Chronic regular exercise has been shown to positively influence the immune system in several populations, while exercise overload may have negative effects. Exercise is currently recommended for all patients with cancer. However, knowledge regarding the effects of exercise on immune markers in patients undergoing chemo- or radiotherapy is limited. The aim of this study is to systematically review the effects of moderate- and high-intensity exercise interventions in patients with cancer during chemotherapy or radiotherapy on immune markers. Methods: For this review, a search was performed in PubMed and EMBASE, until March 2023. Methodological quality was assessed with the PEDro tool and best-evidence syntheses were performed both per immune marker and for the inflammatory profile. Results: Methodological quality of the 15 included articles was rated fair to good. The majority of markers were unaltered, but observed effects included a suppressive effect of exercise during radiotherapy on some proinflammatory markers, a preserving effect of exercise during chemotherapy on NK cell degranulation and cytotoxicity, a protective effect on the decrease in thrombocytes during chemotherapy, and a positive effect of exercise during chemotherapy on IgA. Conclusion: Although exercise only influenced a few markers, the results are promising. Exercise did not negatively influence immune markers, and some were positively affected since suppressed inflammation might have positive clinical implications. For future research, consensus is needed regarding a set of markers that are most responsive to exercise. Next, differential effects of training types and intensities on these markers should be further investigated, as well as their clinical implications.
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