Aim: In-hospital prescribing errors (PEs) may result in patient harm, prolonged hospitalization and hospital (re)admission. These events are associated with pressure on healthcare services and significant healthcare costs. To develop targeted interventions to prevent or reduce in-hospital PEs, identification and understanding of facilitating and protective factors influencing in-hospital PEs in current daily practice is necessary, adopting a Safety-II perspective. The aim of this systematic review was to create an overview of all factors reported in the literature, both protective and facilitating, as influencing in-hospital PEs. Methods: PubMed, EMBASE.com and the Cochrane Library (via Wiley) were searched, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement, for studies that identified factors influencing in-hospital PEs. Both qualitative and quantitative study designs were included. Results: Overall, 19 articles (6 qualitative and 13 quantitative studies) were included and 40 unique factors influencing in-hospital PEs were identified. These factors were categorized into five domains according to the Eindhoven classification (‘organization-related’, ‘prescriber-related’, ‘prescription-related’, ‘technologyrelated’ and ‘unclassified’) and visualized in an Ishikawa (Fishbone) diagram. Most of the identified factors (87.5%; n = 40) facilitated in-hospital PEs. The most frequently identified facilitating factor (39.6%; n = 19) was ‘insufficient (drug) knowledge, prescribing skills and/or experience of prescribers’. Conclusion: The findings of this review could be used to identify points of engagement for future intervention studies and help hospitals determine how to optimize prescribing. A multifaceted intervention, targeting multiple factors might help to circumvent the complex challenge of in-hospital PEs.
MULTIFILE
Titel: The Exodus from the Netherlands or Brain Circulation: Push and Pull Factors of Remigration among Highly Educated Turkish Dutch Auteurs: Gürkan Çelik and Ton Notten In: European Review, 22 (3), 2014, pp. 403-413 The exodus from the Netherlands or brain circulation: Push and pull factors of remigration among highly educated Turkish-Dutch An increasing number of Turks, the Netherlands’ largest ethnic minority, are beginning to return to their country of origin, taking with them the education and skills they have acquired abroad, as the Netherlands faces challenges from economic difficulties, social tension and increasingly powerful right wing parties. At the same time Turkey’s political, social and economic conditions have been improving, making returning home even more appealing for Turkish migrants at large. This article gives explanations about the push and pull factors of return migration. The factors influencing return to one’s country of origin are “pulls”. It is assumed that remigration is more affected by positive developments in the country of origin than by negative developments in the country of residence. Civil society, business world and the Dutch government can develop policies to bind these capable people to the Netherlands, at least in the form of “brain circulation” so that they can serve as “bridge builders” between the two countries. Keywords Return migration, integration, Turkish-Dutch, Turkish migrants, brain circulation =============================================================================== SAMENVATTING De uittocht uit Nederland of breincirculatie: Push- en pull-factoren van remigratie onder hoogopgeleide Turkse Nederlanders. In Nederland zien we een lichte toename van het aantal Turken, de grootste etnische minderheidsgroep in Nederland, die terugkeren naar hun land van herkomst. Ze exporteren daarmee goede opleidingen en vaardigheden die ze in Nederland verwierven. De oorzaken: de economische neergang, sociale spanningen en de groeiende invloed van extreemrechtse partijen. Tegelijkertijd verbeteren in Turkije de politieke, sociale en economische omstandigheden die steeds meer aantrekkingskracht uitoefenen op immigranten in dat land. Dit artikel gaat in op de push- and pull-factoren voor remigranten. Pull-factoren beinvloeden iemands terugkeer naar zijn land van herkomst. Aangenomen wordt dat zo’n remigratie sterker wordt bevorderd door positieve ontwikkelingen in het land van herkomst dan door negatieve (push-factoren) in het land waar men op dat moment woont. De civil society, het bedrijfsleven en de Nederlandse overhead kunnen een beleid ontwikkelen dat verdienstelijke inwoners weet te behouden, hen op z’n minst kan inschakelen als bruggenbouwers en aldus kenniscirculatie mogelijk maakt tussen beide landen. Trefwoorden Retourmigratie, integratie, Turkse Nederlanders, Turkse migranten, kenniscirculatie, breincirculatie
The Best of Both Worlds: Success factors of Turkish-Dutch innovative entrepreneurs In recent years, a number of countries, among them the Netherlands, attach great importance to stimulating the economic development in the country, by promoting entrepreneurship in general and within the ethnic and cultural entrepreneurial groups in particular. Innovation is generally the result of an interactive process involving synergy between the diverse backgrounds and characteristics. Based on a qualitative research, this article provides an overview of insights in the critical success factors of Turkish-Dutch innovative entrepreneurs in the Netherlands. The success factors of ethnic entrepreneurs are approached in this study from three different dimensions: individual factors, social factors, and environmental factors. The individual factors are presented as personality traits and personal motivations. The social factors are discussed from the perspective of social networks, socio-cultural and socio-economic characteristics. As for environmental factors, they are divided into regional characteristics as well as the availability of resources and the presence of opportunities. Turkish-Dutch entrepreneurs, also called “ethnic entrepreneurs”, appear proficient in linking different innovation opportunities to their own strengths. They are operating better in both worlds, and are successfully navigating between the two cultures. This article also formulates several suggestions for the Dutch government, business world and educational institutions to stimulate innovation. SAMENVATTING Het beste van beide werelden: Succesfactoren van Turks-Nederlandse innovatieve ondernemers De laatste jaren hechten vele landen, onder andere Nederland, er groot belang aan om de economische ontwikkelingen op een hoger niveau te tillen door ondernemerschap in het algemeen, en binnen de etnische en culturele groepen in het bijzonder, te stimuleren. Innovatie is een gevolg van een interactief proces waarbij synergie ontstaat tussen de diverse achtergronden en kenmerken. Gebaseerd op een kwalitatief onderzoek worden in dit artikel, aan de hand van drie verschillende dimensies, te weten individuele, sociale en omgevingsfactoren, de succesfactoren van Turks-Nederlandse innovatieve ondernemers inzichtelijk gemaakt. De Turks-Nederlandse ondernemers, ook wel “etnische ondernemers” genoemd, blijken bedreven te zijn in het koppelen van innovatiekansen aan hun eigen sterke punten. Ze komen beter tot hun recht in beide werelden, en navigeren op succesvolle wijze tussen de twee culturen door. Dit artikel formuleert een aantal aanbevelingen voor de Nederlandse overheid, het bedrijfsleven en de klanten.
The transition to a circular, resource efficient construction sector is crucial to achieve climate neutrality in 2050. Construction stillaccounts for 50% of all extracted materials, is responsible for 3% of EU’s waste and for at least 12% of Green House Gas emissions.However, this transition is lagging, the impact of circular building materials is still limited.To accelerate the positive impact of circulair building materials Circular Trust Building has analyzed partners’ circular initiatives andidentified 4 related critical success factors for circularity, re-use of waste, and lower emissions:1. Level of integration2. Organized trust3. Shared learning4. Common goalsScaling these success factors requires new solutions, skills empowering stakeholders, and joint strategies and action plans. Circular TrustBuilding will do so using the innovative sociotechnical transition theory:1.Back casting: integrating stakeholders on common goals and analyzing together what’s needed, what’s available and who cancontribute what. The result is a joint strategy and xx regional action plans.2.Agile development of missing solutions such a Circular Building Trust Framework, Regional Circular Deals, connecting digitalplatforms matching supply and demand3.Increasing institutional capacity in (de-)construction, renovation, development and regulation: trained professionals move thetransition forward.Circular Trust Building will demonstrate these in xx pilots with local stakeholders. Each pilot will at least realize a 25% reduction of thematerial footprint of construction and renovation
Huntington’s disease (HD) and various spinocerebellar ataxias (SCA) are autosomal dominantly inherited neurodegenerative disorders caused by a CAG repeat expansion in the disease-related gene1. The impact of HD and SCA on families and individuals is enormous and far reaching, as patients typically display first symptoms during midlife. HD is characterized by unwanted choreatic movements, behavioral and psychiatric disturbances and dementia. SCAs are mainly characterized by ataxia but also other symptoms including cognitive deficits, similarly affecting quality of life and leading to disability. These problems worsen as the disease progresses and affected individuals are no longer able to work, drive, or care for themselves. It places an enormous burden on their family and caregivers, and patients will require intensive nursing home care when disease progresses, and lifespan is reduced. Although the clinical and pathological phenotypes are distinct for each CAG repeat expansion disorder, it is thought that similar molecular mechanisms underlie the effect of expanded CAG repeats in different genes. The predicted Age of Onset (AO) for both HD, SCA1 and SCA3 (and 5 other CAG-repeat diseases) is based on the polyQ expansion, but the CAG/polyQ determines the AO only for 50% (see figure below). A large variety on AO is observed, especially for the most common range between 40 and 50 repeats11,12. Large differences in onset, especially in the range 40-50 CAGs not only imply that current individual predictions for AO are imprecise (affecting important life decisions that patients need to make and also hampering assessment of potential onset-delaying intervention) but also do offer optimism that (patient-related) factors exist that can delay the onset of disease.To address both items, we need to generate a better model, based on patient-derived cells that generates parameters that not only mirror the CAG-repeat length dependency of these diseases, but that also better predicts inter-patient variations in disease susceptibility and effectiveness of interventions. Hereto, we will use a staggered project design as explained in 5.1, in which we first will determine which cellular and molecular determinants (referred to as landscapes) in isogenic iPSC models are associated with increased CAG repeat lengths using deep-learning algorithms (DLA) (WP1). Hereto, we will use a well characterized control cell line in which we modify the CAG repeat length in the endogenous ataxin-1, Ataxin-3 and Huntingtin gene from wildtype Q repeats to intermediate to adult onset and juvenile polyQ repeats. We will next expand the model with cells from the 3 (SCA1, SCA3, and HD) existing and new cohorts of early-onset, adult-onset and late-onset/intermediate repeat patients for which, besides accurate AO information, also clinical parameters (MRI scans, liquor markers etc) will be (made) available. This will be used for validation and to fine-tune the molecular landscapes (again using DLA) towards the best prediction of individual patient related clinical markers and AO (WP3). The same models and (most relevant) landscapes will also be used for evaluations of novel mutant protein lowering strategies as will emerge from WP4.This overall development process of landscape prediction is an iterative process that involves (a) data processing (WP5) (b) unsupervised data exploration and dimensionality reduction to find patterns in data and create “labels” for similarity and (c) development of data supervised Deep Learning (DL) models for landscape prediction based on the labels from previous step. Each iteration starts with data that is generated and deployed according to FAIR principles, and the developed deep learning system will be instrumental to connect these WPs. Insights in algorithm sensitivity from the predictive models will form the basis for discussion with field experts on the distinction and phenotypic consequences. While full development of accurate diagnostics might go beyond the timespan of the 5 year project, ideally our final landscapes can be used for new genetic counselling: when somebody is positive for the gene, can we use his/her cells, feed it into the generated cell-based model and better predict the AO and severity? While this will answer questions from clinicians and patient communities, it will also generate new ones, which is why we will study the ethical implications of such improved diagnostics in advance (WP6).
In societies where physical activity levels are declining, stimulating sports participation in youth is vital. While sports offer numerous benefits, injuries in youth are at an all-time high with potential long-term consequences. Particularly, women football's popularity surge has led to a rise in knee injuries, notably anterior cruciate ligament (ACL) injuries, with severe long-term effects. Urgent societal attention is warranted, supported by media coverage and calls for action by professional players. This project aims to evaluate the potential of novel artificial intelligence-based technology to enhance player monitoring for injury risk, and to integrate these monitoring pathways into regular training practice. Its success may pave the way for broader applications across different sports and injuries. Implementation of results from lab-based research into practice is hindered by the lack of skills and technology needed to perform the required measurements. There is a critical need for non-invasive systems used during regular training practice and allowing longitudinal monitoring. Markerless motion capture technology has recently been developed and has created new potential for field-based data collection in sport settings. This technology eliminates the need for marker/sensor placement on the participant and can be employed on-site, capturing movement patterns during training. Since a common AI algorithm for data processing is used, minimal technical knowledge by the operator is required. The experienced PLAYSAFE consortium will exploit this technology to monitor 300 young female football players over the course of 1 season. The successful implementation of non-invasive monitoring of football players’ movement patterns during regular practice is the primary objective of this project. In addition, the study will generate key insights into risk factors associated with ACL injury. Through this approach, PLAYSAFE aims to reduce the burden of ACL injuries in female football players.
