Background: Adverse outcome pathway (AOP) networks are versatile tools in toxicology and risk assessment that capture and visualize mechanisms driving toxicity originating from various data sources. They share a common structure consisting of a set of molecular initiating events and key events, connected by key event relationships, leading to the actual adverse outcome. AOP networks are to be considered living documents that should be frequently updated by feeding in new data. Such iterative optimization exercises are typically done manually, which not only is a time-consuming effort, but also bears the risk of overlooking critical data. The present study introduces a novel approach for AOP network optimization of a previously published AOP network on chemical-induced cholestasis using artificial intelligence to facilitate automated data collection followed by subsequent quantitative confidence assessment of molecular initiating events, key events, and key event relationships. Methods: Artificial intelligence-assisted data collection was performed by means of the free web platform Sysrev. Confidence levels of the tailored Bradford-Hill criteria were quantified for the purpose of weight-of-evidence assessment of the optimized AOP network. Scores were calculated for biological plausibility, empirical evidence, and essentiality, and were integrated into a total key event relationship confidence value. The optimized AOP network was visualized using Cytoscape with the node size representing the incidence of the key event and the edge size indicating the total confidence in the key event relationship. Results: This resulted in the identification of 38 and 135 unique key events and key event relationships, respectively. Transporter changes was the key event with the highest incidence, and formed the most confident key event relationship with the adverse outcome, cholestasis. Other important key events present in the AOP network include: nuclear receptor changes, intracellular bile acid accumulation, bile acid synthesis changes, oxidative stress, inflammation and apoptosis. Conclusions: This process led to the creation of an extensively informative AOP network focused on chemical-induced cholestasis. This optimized AOP network may serve as a mechanistic compass for the development of a battery of in vitro assays to reliably predict chemical-induced cholestatic injury.
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The workshop aims to understand how a living lab network structures contribute to system innovation. Living labs as system innovation initiatives can substantially alter established network structures. Moreover, structures can undergo alterations through subtle interventions, with impact on the overall outcomes of living labs. To understand how such change occurs, we develop a multilevel network perspective to study collaborations toward system innovation. We take this perspective to help understand living lab dynamics, drawing on innovative examples and taking into consideration the multilayered structures that the collaboration comprises.
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Abstract: The typical structure of the healthcare sector involves (specialist) intertwined practices co-occurring in formal or informal networks. These practices must answer to the concerns and needs of all related stakeholders. Multimorbidity and the need to share knowledge for scientific development are among the driving factors for collaboration in healthcare. To establish and keep up a permanent collaborative link, it takes effort and understanding of the network characteristics that must be governed. It is not hard to find practices of Network Governance (NG) in a variety of industries. Still, there is a lack of insight in this subject, including knowledge on how to establish and maintain an effective healthcare network. Consequently, this study's research question is: How is network governance organized in the healthcare sector? A systematic literature study was performed to select 80 NG articles. Based on these publications the characteristics of NG are made explicit. The findings demonstrate that combinations of governance style (relational versus contractual governance) and governance structure (lead versus shared governance) lead to different network dynamics. Furthermore, the results show that in order to comprehend how networks in the healthcare sector emerge and can be regulated, it is vital to understand the current network type. Additionally, it informs us of the governing factors. Zie https://www.hbo-kennisbank.nl/details/sharekit_han:oai:surfsharekit.nl:e4f8fa3a-4af8-42ef-b2dd-c86d77b4cec6
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Abstract Healthcare organizations operate within a network of governments, insurers, inspection services and other healthcare organizations to provide clients with the best possible care. The parties involved must collaborate and are accountable to each other for the care provided. This has led to a diversity of administrative processes that are supported by a multi-system landscape, resulting in administrative burdens among healthcare professionals. Management methods, such as Enterprise Architecture (EA), should help to develop and manage such landscapes, but they are systematic, while the network of healthcare parties is dynamic. The aim of this research is therefore to develop an EA framework that fits the dynamics of network organizations (such as long-term healthcare). This research proposal outlines the practical and scientific relevance of this research and the proposed method. The current status and next steps are also described.
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Onderzoeksplatform ‘Connected Learning: ’Al ruim vijftien jaar houdt De Haagse Hogeschool zich bezig met onderzoek als deel van haar missie. Terwijl onderwijs vaak geworteld is in monodisciplinaire vakgebieden, kan met onderzoek wat makkelijker gekeken worden naar domeinen in de samenleving (zorg, veiligheid, ondernemen, etc.) waarin complexe problematiek steeds vaker wél dan niet een multidisciplinaire aanpak vereist. Bijna niemand werkt nog alleen of met alleen vakgenoten aan problemen of uitdagingen. En die veranderende beroepspraktijk is bij uitstek het domein van het hoger beroepsonderwijs. Daar leiden we voor op. Het onderzoeken van en experimenteren met nieuwe uitdagingen in de praktijk verbindt ons sterker met de samenleving, het stelt ons in staat om ons beroepsonderwijs te vernieuwen en geeft docenten, onderzoekers en studenten de kans om zich te ontwikkelen door samen te werken aan vragen en uitdagingen die de toekomst van de beroepspraktijk vorm geven. Veel onderzoek wordt uitgevoerd onder begeleiding van lectoren die samenwerken met docent-onderzoekers, studenten, en professionals in het werkveld aan veelal meerjarige onderzoeksagenda’s die lijn aanbrengen in verschillende deelactiviteiten. Een van de manieren waarop De Haagse Hogeschool onderzoek organiseert is in de vorm van onderzoeksplatforms die zich richten op verschillende domeinen van de samenleving. Wij zijn ‘Connected Learning’, een onderzoeksplatform dat zich richt op leren in de netwerksamenleving - in de samenleving zelf, maar ook in de beroepspraktijk en in ons onderwijs. Aangenaam. Wat wij doen? Daar gaat dit boek over, dus daar verklappen we hier nog niets over. Wat verwacht u als u nadenkt over onze naam? Enig idee? Geen idee? Benieuwd? Lees verder om te ontdekken wat ons inspireert, uitdaagt en nieuwsgierig maakt. Sommige van onze ideeën zijn doordacht en doorleefd omdat we er al jaren onderzoek naar doen, andere zijn nieuw en dagen ons uit om er grip op te krijgen. Wij geven met dit boek een beeld van waar we staan in 2018. Zie het als een eerste kennismaking, met de nadruk op ‘eerste’: we werken graag met veel en verschillende partners. Zie het als visitekaartje van onze onderzoeksagenda. We hopen van harte dat u zich als lezer uitgenodigd voelt om met ons samen op zoek te gaan—misschien wel naar een gezamenlijke toekomst. ‘Connected Learning’ Research Platform: For over fifteen years, The Hague University of Applied Sciences has been carrying out research as part of its mission. While education is often rooted in monodisciplinary subject areas, research allows for a broader look at areas of society (care, security, entrepreneurship etc.), where complex problems more often than not require a multidisciplinary approach. Today, barely anyone works on problems or challenges alone or solely with colleagues from within the same subject area. Universities of applied sciences are uniquely placed to deal with these changes in professional practices; after all, we train the professionals who will one day enter that field. Researching and experimenting with new challenges in professional practice allows us to connect more strongly with society, enables us to be innovative in our professional training and gives lecturers, researchers and students the opportunity to develop themselves by cooperating on the challenges and issues that will shape the future of that professional practice. Most research is carried out under the guidance of professors who cooperate with lecturers/researchers, students and the professional field, mainly on long-term research agendas that provide an outline for various sub-activities. One of the ways in which research is organised at The Hague University of Applied Sciences is in the form of research platforms that focus on various areas of society. We are ‘Connected Learning’, a research platform focusing on learning in the network society — in that society as such, but also in professional practice and our education. Nice to meet you! So, what do we do? That’s what this book is about, so we’re not going to give anything away just yet. Just thinking about our name, what do you expect we do? Any ideas? Or not a clue at all? If you’d like to find out, keep reading to find out what inspires us, what challenges we face and what drives our curiosity. Some of our ideas are well-established because we’ve been researching them for years, while other, newer ideas are more challenging to grasp. This book provides an overview of where we stand in 2018. You could see it as an initial introduction, with the emphasis on “initial”; we work with many different partners, and we enjoy doing so. Alternatively, you could see it as a calling card for our research agenda. We sincerely hope that, as a reader, you feel encouraged to join us in our quest — possibly towards a joint future.
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The operations of take-off and landing at hub airports are often subject to a wide variety of delays; the effects of these delays impact not only the related stakeholders, such as aircraft operators, air-traffic control unity and ground handlers but as part of the European network, delays are propagated through the network. As a result, Airport Collaborative Decision Making (A-CDM) is being employed as a methodology for increasing the efficiency of Air Traffic Management (ATM), through the involvement of partners within the airports. Under CDM, there are some strategic common objectives regardless the airport or the partner specific interest to improve operational efficiency, predictability and punctuality to the ATM network and airport stakeholders. Monitoring and controlling some strategic areas such as, Efficiency, Capacity, Safety and Environment is needed to achieve the benefits. Therefore, the present work aims to provide a framework to monitor the accuracy of capacity in the three main flight phases. It aims to provide a comprehensible and practical approach to monitoring capacity by identifying and proposing Key Performance Indicators (KPIs) based on the A-CDM Milestone Approach to optimise the use of available capacity. To illustrate our approach, Amsterdam Airport Schiphol is used as case study as a full A-CDM airport.
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The transition towards a sustainable and healthy food system is one of the major sustainability challenges of today, next to the energy transition and the transition from a linear to circular economy. This paper provides a timely and evidence-based contribution to better understand the complex processes of institutional change and transformative social-ecological innovation that takes place in the food transition, through a case study of an open innovation and food transition network in The Netherlands, the South-Holland Food Family (Zuid-Hollandse Voedselfamilie). This network is supported by the provincial government and many partners, with the ambition to realize more sustainable agricultural and food chains, offering healthy, sustainable and affordable food for everyone in the Province of South-Holland in five to ten years from now. This ambition cannot be achieved through optimising the current food system. A transition is needed – a fundamental change of the food system’s structure, culture and practice. The Province has adopted a transition approach in its 2016 Innovation Agenda for Sustainable Agriculture. This paper provides an institutional analysis of how the transition approach has been established and developed in practice. Our main research question is what interventions and actions have shaped the transition approach and how does the dynamic interplay between actors and institutional structures influence institutional change, by analysing a series of closely related action situations and their context, looking at 'structure' and 'agency', and at the output-outcomes-impact of these action situations. For this purpose, we use the Transformative Social-Ecological Innovation (TSEI)-framework to study the dynamic interplay between actors and institutional structures influencing institutional change. The example of TSEI-framework application in this paper shows when and how local agents change the institutional context itself, which provides relevant insights on institutional work and the mutually constitutive nature of structure and agency. Above institutional analysis also shows the pivotal role of a number of actors, such as network facilitators and provincial minister, and their capability and skills to combine formal and informal institutional environments and logics and mobilize resources, thereby legitimizing and supporting the change effort. The results are indicative of the importance of institutional structures as both facilitating (i.e., the province’s policies) and limiting (e.g. land ownership) transition dynamics.
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Purpose: The purpose of this study is to find determinants about risk resilience and develop a new risk resilience approach for (agricultural) enterprises. This approach creates the ability to respond resiliently to major environmental challenges and changes in the short term and adjust the management of the organization, and to learn and transform to adapt to the new environment in the long term while creating multiple value creation. Design/methodology: The authors present a new risk resilience approach for multiple value creation of (agricultural) enterprises, which consists of a main process starting with strategy design, followed by an environmental analysis, stakeholder collaboration, implement ESG goals, defining risk expose & response options, and report, learn & evaluate. In each step the organizational perspective, as well as the value chain/area perspective is considered and aligned. The authors have used focus groups and analysed literature from and outside the field of finance and accounting, to design this new approach. Findings: Researchers propose a new risk resilience approach for (agricultural) enterprises, based on a narrative about transforming to multiple value creation, founded determinants of risk resilience, competitive advantage and agricultural resilience. Originality and value: This study contributes by conceptualizing risk resilience for (agricultural) enterprises, by looking through a lens of multiple value creation in a dynamic context and based on insights from different fields, actual ESG knowledge, and determinants for risk resilience, competitive advantage and agricultural resilience.
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Background: Due to multimorbidity and geriatric problems, older people often require both psychosocial and medical care. Collaboration between medical and social professionals is a prerequisite to deliver high-quality care for community-living older people. Effective, safe, and person-centered care relies on skilled interprofessional collaboration and practice. Little is known about interprofessional education to increase interprofessional collaboration in practice (IPCP) in the context of community care for older people. This study examines the feasibility of the implementation of an IPCP program in three community districts and determines its potential to increase interprofessional collaboration between primary healthcare professionals caring for older people. Method: A feasibility study was conducted to determine the acceptability and feasibility of data collection and analysis regarding interprofessional collaboration in network development. A questionnaire was used to measure the learning experience and the acquisition of knowledge and skills regarding the program. Network development was assessed by distributing a social network survey among professionals attending the program as well as professionals not attending the program at baseline and 5.5 months after. Network development was determined by calculating the number, reciprocity, value, and diversity of contacts between professionals using social network analysis. Results: The IPCP program was found to be instructive and the knowledge and skills gained were applicable in practice. Social network analysis was feasible to conduct and revealed a spill-over effect regarding network development. Program participants, as well as non-program participants, had larger, more reciprocal, and more diverse interprofessional networks than they did before the program. Conclusions: This study showed the feasibility of implementing an IPCP program in terms of acceptability, feasibility of data collection, and social network analysis to measure network development, and indicated potential to increase interprofessional collaboration between primary healthcare professionals. Both program participants and non-program participants developed a larger, more collaborative, and diverse interprofessional network.
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Objectives Most complex healthcare interventions target a network of healthcare professionals. Social network analysis (SNA) is a powerful technique to study how social relationships within a network are established and evolve. We identified in which phases of complex healthcare intervention research SNA is used and the value of SNA for developing and evaluating complex healthcare interventions. Methods A scoping review was conducted using the Arksey and O’Malley methodological framework. We included complex healthcare intervention studies using SNA to identify the study characteristics,level of complexity of the healthcare interventions, reported strengths and limitations, and reported implications of SNA. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews 2018 was used to guide the reporting. Results Among 2466 identified studies, 40 studies were selected for analysis. At first, the results showed that SNA seems underused in evaluating complex intervention research. Second, SNA was not used in the development phase of the included studies. Third, the reported implications in the evaluation and implementation phase reflect the value of SNA in addressing the implementation and population complexity. Fourth, pathway complexity and contextual complexity of the included interventions were unclear or unable to access. Fifth, the use of a mixed methods approach was reported as a strength, as the combination and integration of a quantitative and qualitative method clearly establishes the results. Conclusion SNA is a widely applicable method that can be used in different phases of complex intervention research. SNA can be of value to disentangle and address the level of complexity of complex healthcare interventions. Furthermore, the routine use of SNA within a mixed method approach could yield actionable insights that would be useful in the transactional context of complex interventions.
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