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Ethnic Differences in Colon Cancer Care in the Netherlands

Background Ethnic differences in colon cancer (CC) care were shown in the United States, but results are not directly applicable to European countries due to fundamental healthcare system differences. This is the first study addressing ethnic differences in treatment and survival for CC in the Netherlands. Methods Data of 101,882 patients diagnosed with CC in 1996–2011 were selected from the Netherlands Cancer Registry and linked to databases from Statistics Netherlands. Ethnic differences in lymph node (LN) evaluation, anastomotic leakage and adjuvant chemotherapy were analysed using stepwise logistic regression models. Stepwise Cox regression was used to examine the influence of ethnic differences in adjuvant chemotherapy on 5-year all-cause and colorectal cancer-specific survival. Results Adequate LN evaluation was significantly more likely for patients from ‘other Western’ countries than for the Dutch (OR 1.09; 95% CI 1.01–1.16). ‘Other Western’ patients had a significantly higher risk of anastomotic leakage after resection (OR 1.24; 95% CI 1.05–1.47). Patients of Moroccan origin were significantly less likely to receive adjuvant chemotherapy (OR 0.27; 95% CI 0.13–0.59). Ethnic differences were not fully explained by differences in socioeconomic and hospital-related characteristics. The higher 5-year all-cause mortality of Moroccan patients (HR 1.64; 95% CI 1.03–2.61) was statistically explained by differences in adjuvant chemotherapy receipt. Conclusion These results suggest the presence of ethnic inequalities in CC care in the Netherlands. We recommend further analysis of the role of comorbidity, communication in patient-provider interaction and patients’ health literacy when looking at ethnic differences in treatment for CC.

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Battery Supported Electric Vehicle Charging Plaza Using a Limited Capacity Grid Connection

This study used historical data from a Park & Ride facility in Amsterdam to build a validated computer (Python) model to optimize battery and grid connection sizing. The case study modelled is equipped with 8 EV chargers (16 connections), an on-site supplementary battery, and a limited capacity grid connection. This model was then used to optimize the battery energy storage capacity and grid connection capacity for minimal annualized investment, using a future proof monthly load profile. A variety of battery control strategies were simulated using both the optimal system sizing and the current system sizing. The results were compared and a recommended control strategy presented, considering a number of performance metrics.

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Battery Supported Electric Vehicle Charging Plaza Using a Limited Capacity Grid Connection

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The Network is the Message

Het tweejarige onderzoeksprogramma The Network is the Message richt zich op de effectiviteit van sociale media: wanneer zijn sociale media effectief, wat bepaalt die effectiviteit en hoe kunnen we dit meten? Startpunt in deze management summary van thema 2 ‘meten is nog niet weten’ is het inzicht dat het allemaal begint met doelstellingen. Doelstellingen zijn van essentieel belang om te kunnen bepalen of je succes hebt of niet. En bij doelstellingen horen Key Performance Indicators (KPI’s), met een set zorgvuldig geselecteerde metrics die de beste bijdrage leveren om die doelstellingen in kaart te brengen. Op die manier kun je ook bepalen of je je tijd en middelen goed inzet en je misschien effectiever zou zijn deze door deze anders te verdelen.

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Ecological momentary assessment study of exposure to radiofrequency electromagnetic fields and non-specific physical symptoms with self-declared electrosensitives

The main objective of the study is to determine if non-specific physical symptoms (NSPS) in people with self-declared sensitivity to radiofrequency electromagnetic fields (RF EMF) can be explained (across subjects) by exposure to RF EMF. Furthermore, we pioneered whether analysis at the individual level or at the group level may lead to different conclusions. By our knowledge, this is the first longitudinal study exploring the data at the individual level. A group of 57 participants was equipped with a measurement set for five consecutive days. The measurement set consisted of a body worn exposimeter measuring the radiofrequency electromagnetic field in twelve frequency bands used for communication, a GPS logger, and an electronic diary giving cues at random intervals within a two to three hour interval. At every cue, a questionnaire on the most important health complaint and nine NSPS had to be filled out. We analysed the (time-lagged) associations between RF-EMF exposure in the included frequency bands and the total number of NSPS and self-rated severity of the most important health complaint. The manifestation of NSPS was studied during two different time lags - 0–1 h, and 1–4 h - after exposure and for different exposure metrics of RF EMF. The exposure was characterised by exposure metrics describing the central tendency and the intermittency of the signal, i.e. the time-weighted average exposure, the time above an exposure level or the rate of change metric. At group level, there was no statistically significant and relevant (fixed effect) association between the measured personal exposure to RF EMF and NSPS. At individual level, after correction for multiple testing and confounding, we found significant within-person associations between WiFi (the self-declared most important source) exposure metrics and the total NSPS score and severity of the most important complaint in one participant. However, it cannot be ruled out that this association is explained by residual confounding due to imperfect control for location or activities. Therefore, the outcomes have to be regarded very prudently. The significant associations were found for the short and the long time lag, but not always concurrently, so both provide complementary information. We also conclude that analyses at the individual level can lead to different findings when compared to an analysis at group level. https://doi.org/10.1016/j.envint.2019.104948 LinkedIn: https://www.linkedin.com/in/john-bolte-0856134/

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Ecological momentary assessment study of exposure to radiofrequency electromagnetic fields and non-specific physical symptoms with self-declared electrosensitives

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Measuring safety in aviation

As part of their SMS, aviation service providers are required to develop and maintain the means to verify the safety performance of their organisation and to validate the effectiveness of safety risk controls. Furthermore, service providers must verify the safety performance of their organisation with reference to the safety performance indicators and safety performance targets of the SMS in support of their organisation’s safety objectives. However, SMEs lack sufficient data to set appropriate safety alerts and targets, or to monitor their performance, and no other objective criteria currently exist to measure the safety of their operations. The Aviation Academy of the Amsterdam University of Applied Sciences therefore took the initiative to develop alternative safety performance metrics. Based on a review of the scientific literature and a survey of existing safety metrics, we proposed several alternative safety metrics. After a review by industry and academia, we developed two alternative metrics into tools to help aviation organisations verify the safety performance of their organisations.The AVAV-SMS tool measures three areas within an organisation’s Safety Management System:• Institutionalisation (design and implementation along with time and internal/external process dependencies).• Capability (the extent to which managers have the capability to implement the SMS).• Effectiveness (the extent to which the SMS deliverables add value to the daily tasks of employees).The tool is scalable to the size and complexity of the organisation, which also makes it useful for small and medium-sized enterprises (SMEs). The AVAS-SCP tool also measures three areas in the organisation’s safety culture prerequisites to foster a positive safety culture:• Organisational plans (whether the company has designed/documented each of the safety cultureprerequisites).• Implementation (the extent to which the prerequisites are realised by the managers/supervisors acrossvarious organisational levels).• Perception (the degree to which frontline employees perceive the effects of managers’ actions relatedto safety culture).We field-tested these tools, demonstrating that they have adequate sensitivity to capture gaps between Work-as-Imagined (WaI) and Work-as-Done (WaD) across organisations. Both tools are therefore useful to organisations that want to self-assess their SMS and safety culture prerequisite levels and proceed to comparisons among various functions and levels and/or over time. Our field testing and observations during the turn-around processes of a regional airline confirm that significant differences exist between WaI and WaD. Although these differences may not automatically be detrimental to safety, gaining insight into them is clearly necessary to manage safety. We conceptually developed safety metrics based on the effectiveness of risk controls. However, these could not be fully field-tested within the scope of this research project. We recommend a continuation of research in this direction. We also explored safety metrics based on the scarcity of resources and system complexity. Again, more research is required here to determine whether these provide viable solutions.

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Safety metrics based on utilisation of resources

The objective of the study described in this paper is to define safety metrics that are based on the utilisation of resources. The background of this research is a specific need of the aviation industry where small and medium-sized enterprises lack large amounts of safety-related data to measure and demonstrate their safety performance proactively. The research department of the Aviation Academy has initiated a 4-year study, which will test the possibility to develop new safety indicators that will be able to represent safety levels proactively without the benefit of large data sets. The research team has reviewed the academic and professional literature about safety performance indicators and has performed surveys into 13 companies in order to explore what, how, and why safety performance indicators are used and whether there is a statistically linear relation between SMS process metrics and safety outcomes. The preliminary results showed that companies do not use data from all SMS processes in the development of safety performance indicators, they do not ground the selection of indicators on specific criteria, they implement SMS process in different ways, but they are eager to use alternative metrics, including ones potentially to be derived on the basis of contemporary safety models and views. As part of the development of alternative safety metrics, safety performance indicators were defined that are based on the difference between required resources and available resources. Resources are people, time, equipment and budget. This work is inspired by the general notion that a large gap between ‘work as imagined’ and ‘work as done’ has a negative influence on the level of safety. Work as imagined in this context is represented by available resources and work as done by required resources. The metrics were defined by a combination of literature research and semi-structured interviews with operational practitioners in the aviation industry. The suitability of the metrics will subsequently be tested in pilot studies within the aviation industry.

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Safety metrics based on utilisation of resources

Projecten 6

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Augmented Reality in Staged Entertainment.

The AR in Staged Entertainment project focuses on utilizing immersive technologies to strengthen performances and create resiliency in live events. In this project The Experiencelab at BUas explores this by comparing live as well as pre-recorded events that utilize Augmented Reality technology to provide an added layer to the experience of the user. Experiences will be measured among others through observational measurements using biometrics. This projects runs in the Experience lab of BUas with partners The Effenaar and 4DR Studio and is connected to the networks and goals related to Chronosphere, Digireal and Makerspace. Project is powered by Fieldlab Events (PPS / ClickNL)..

Afgerond

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BIOMETRIC DESIGN FOR CASUAL GAMES

Evaluating player game experiences through biometric measurementsThe BD4CG (Biometric Design for Casual Games project) worked in a highly interdisciplinary context with several international partners. The aim of our project was to popularize the biometric method, which is a neuro-scientific approach to evaluating the player experience. We specifically aimed at the casual games sector, where casual games can be defined as video or web-based games with simple and accessible game mechanics, non threatening themes and generally short play sessions. Popular examples of casual games are Angry Birds and FarmVille. We focussed on this sector because it is growing fast, but its methodologies have not grown with it yet. Especially the biometrics method has so far been almost exclusively used domain by the very large game developers (such as Valve and EA). The insights and scientific output of this project have been enthusiastically embraced by the international academic arena. The aim of the grant was to focus on game producers in the casual sector, and we have done so but we also established further contacts with the game sector in general. Thirty-one outputs were generated, in the form of presentations, workshops, and accepted papers in prominent academic and industry journals in the field of game studies and game user research. Partners: University of Antwerpen, RANJ, Forward Games, Double Jungle, Realgames, Dreams of Danu, Codemasters, Dezzel, Truimph Studios, Golabi Studios

Afgerond

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Measuring Safety in Aviation - Developing Metrics for Safety Management Systems

Aanleiding De luchtvaart wordt steeds veiliger. Toch zijn er alleen al in Nederland jaarlijks zo'n 11.000 issues met luchtvaartveiligheid. Wereldwijd vinden er elke dag ongelukken plaats die leiden tot schade aan vliegtuigen. Om de veiligheid verder te verbeteren is er nieuwe internationale regelgeving opgesteld. Onder deze regels moeten de maatschappijen alle incidenten en ongelukken analyseren en zo veiligheidsrisico's identificeren nog voordat deze zich voordoen. Het probleem is dat kleine en middelgrote luchtvaartmaatschappijen onvoldoende vliegbewegingen maken om genoeg goede data hiervoor te hebben. Doelstelling De centrale vraag die de onderzoekers in dit RAAK-project willen beantwoorden: Wat is de relatie tussen veiligheidsmanagement en veiligheidsperformance van luchtvaartmaatschappijen? Het onderzoek wil kleine en middelgrote luchtvaartmaatschappijen helpen bij het meten van de veiligheid van hun bedrijf, zonder dat ze grote hoeveelheden veiligheidsdata tot hun beschikking hebben. Het onderzoek zal geschikte veiligheidsindicatoren identificeren, een longlist ontwikkelen met meetwaarden voor safetymanagement, en een shortlist genereren en valideren van bruikbare meetwaarden. Deze kennis wordt vertaald in een online dashboard voor de industrie, zodat de veiligheid objectiever beoordeeld kan worden. Beoogde resultaten Een concreet resultaat van dit project is een online dashboard waarmee kleine en middelgrote luchtvaartmaatschappijen hun veiligheid kunnen beoordelen, inclusief handleiding. Er zullen masterclasses veiligheid worden georganiseerd voor de luchtvaartindustrie. Het projectteam zal de opgedane kennis verspreiden via wetenschappelijke artikelen in relevante peer-reviewed tijdschriften, een website, presentaties bij bedrijven en tijdens bijeenkomsten, en een afsluitende conferentie.

Afgerond

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SeReNity - Evidence-Based Security Response ceNters

Prompt and timely response to incoming cyber-attacks and incidents is a core requirement for business continuity and safe operations for organizations operating at all levels (commercial, governmental, military). The effectiveness of these measures is significantly limited (and oftentimes defeated altogether) by the inefficiency of the attack identification and response process which is, effectively, a show-stopper for all attack prevention and reaction activities. The cognitive-intensive, human-driven alarm analysis procedures currently employed by Security Operation Centres are made ineffective (as opposed to only inefficient) by the sheer amount of alarm data produced, and the lack of mechanisms to automatically and soundly evaluate the arriving evidence to build operable risk-based metrics for incident response. This project will build foundational technologies to achieve Security Response Centres (SRC) based on three key components: (1) risk-based systems for alarm prioritization, (2) real-time, human-centric procedures for alarm operationalization, and (3) technology integration in response operations. In doing so, SeReNity will develop new techniques, methods, and systems at the intersection of the Design and Defence domains to deliver operable and accurate procedures for efficient incident response. To achieve this, this project will develop semantically and contextually rich alarm data to inform risk-based metrics on the mounting evidence of incoming cyber-attacks (as opposed to firing an alarm for each match of an IDS signature). SeReNity will achieve this by means of advanced techniques from machine learning and information mining and extraction, to identify attack patterns in the network traffic, and automatically identify threat types. Importantly, SeReNity will develop new mechanisms and interfaces to present the gathered evidence to SRC operators dynamically, and based on the specific threat (type) identified by the underlying technology. To achieve this, this project unifies Dutch excellence in intrusion detection, threat intelligence, and human-computer interaction with an industry-leading partner operating in the market of tailored solutions for Security Monitoring.

Lopend

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The timing problem of performance feedback

Performance feedback is an important mechanism of adaptation in learning theories, as it provides one of the motivations for organizations to learn (Pettit, Crossan, and Vera 2017). Embedded in the behavioral theory of the firm, organizational learning from performance feedback predicts the probability for organizations to change with an emphasis on organizational aspirations, which serve as a threshold against which absolute performance is evaluated (Cyert and March 1963; Greve 2003). It postulates that performance becomes a ‘problem’, or the trigger to search for alternative procedures, strategies, products and behaviors, when performance is below that threshold. This search is known as problemistic search. Missing from this body of research, is empirically grounded understanding if the characteristics of performance feedback over time matter for the triggering function of the feedback. I explore this gap. This investigation adds temporality as a dimension of the performance feedback concept guided by a worldview of ongoing change and flux where conditions and choices are not given, but made relevant by actors and enacted upon (Tsoukas and Chia 2002). The general aim of the study is to complement the current knowledge of performance feedback as a trigger for problemistic search with an explicit process temporal approach. The main question guiding this project is how temporal patterns of performance feedback influence organizational change, which I answer in four chapters, each zooming into one sub-question.First, I focus on the temporal order of performance feedback by examining performance feedback and change sequences organizations go through. In this section time is under study and the goal is to explore how feedback patterns have evolved over time, just as the change states organizations pass through. Second, I focus on the plurality of performance feedback by investigating performance feedback from multiple aspiration levels (i.e. multiple qualitatively different metrics and multiple reference points) and how over time clusters of performance feedback sequences have evolved. Next, I look into the rate and scope of change relative to performance feedback sequences and add an element of signal strength to the feedback. In the last chapter, time is a predictor (in the sequences), and, it is under study (in the timing of responses). I focus on the timing of organizational responses in relation to performance feedback sequences of multiple metrics and reference points.In sum, all chapters are guided by the timing problem of performance feedback, meaning that performance feedback does not come ‘available’ at a single point in time. Similarly to stones with unequal weight dropped in the river, performance feedback with different strength comes available at multiple points in time and it is plausible that sometimes it is considered by decision-makers as problematic and sometimes it is not, because of the sequence it is part of. Overall, the investigation is grounded in the general principles of organizational learning from performance feedback, and the concept of time as duration, sequences and timing, with a focus on specification of when things happen. The context of the study is universities of applied sciences and hotels in The Netherlands. Project partner: Tilburg University, School of Social and Behavioral Sciences, Department of Organization Studies

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Producten 110

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Ethnic Differences in Colon Cancer Care in the Netherlands

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