De financiële dienstverlening voor mkb-bedrijven is de afgelopen jaren fundamenteel veranderd met de komst van non-bancaire financiers. Naast de traditionele bank zijn crowdfunding, leasing, factoring en andere verstrekkers van vreemd en eigen vermogen belangrijke financiers van het mkb geworden. De markt voor non-bancaire financiering wordt, in tegenstelling tot de bancaire markt, niet strikt gereguleerd. Dit heeft enerzijds bijgedragen aan de groei van de sector en het bijbehorende diverse aanbod. Anderzijds blijkt dat kleine ondernemers en hun adviseurs niet voldoende bekend zijn met al deze verschillende vormen van alternatieve financiering. Dit leidt tot een informatie-asymmetrie die de verdere groei van de non-bancaire mkb-financieringsmarkt belemmerd. Minimale kwaliteitseisen voor aanbieders van non-bancaire producten kunnen deze informatie-asymmetrie reduceren en non-bancaire financiers helpen bij het verwerven van een legitieme marktpositie.
MULTIFILE
BACKGROUND: In recent years, sustainable employability, rooted in the capability approach, has received substantial attention due to its associations with work and health-related outcomes. While previous studies have indicated that being able and enabled to achieve important work values (i.e., work capabilities) is positively associated with desirable work outcomes, most of these studies have primarily employed a cross-sectional design to explore these associations. This study aimed to examine the long-term relationships between work capabilities and work and wellbeing-related outcomes, including work ability, work engagement, task and creative performance, organizational citizenship behavior, organizational commitment, job and life satisfaction, turnover intention, and burnout symptoms.METHODS: Data were collected from 251 randomly selected Dutch employees through a two-wave survey conducted in 2021 and 2023 via the Longitudinal Internet Studies for the Social Sciences panel. Multiple linear regression analyses were performed to assess these associations while controlling for potential covariates.RESULTS: The results revealed that participants valued a diverse range of work capabilities but encountered challenges in realizing these valued capabilities. The capability set positively predicted desirable outcomes and was associated with reduced burnout over a two-year period.CONCLUSIONS: Supporting and enabling employees to realize their capabilities is essential for improving favorable work outcomes and diminishing burnout in today's volatile work environment. These findings further emphasize the importance of organizations improving conversion factors to bridge the gap between valued capabilities and their actualization.
INTRODUCTION: While prone positioning (PP) has been shown to improve patient survival in moderate to severe acute respiratory distress syndrome (ARDS) patients, the rate of application of PP in clinical practice still appears low.AIM: This study aimed to determine the prevalence of use of PP in ARDS patients (primary endpoint), the physiological effects of PP, and the reasons for not using it (secondary endpoints).METHODS: The APRONET study was a prospective international 1-day prevalence study performed four times in April, July, and October 2016 and January 2017. On each study day, investigators in each ICU had to screen every patient. For patients with ARDS, use of PP, gas exchange, ventilator settings and plateau pressure (Pplat) were recorded before and at the end of the PP session. Complications of PP and reasons for not using PP were also documented. Values are presented as median (1st-3rd quartiles).RESULTS: Over the study period, 6723 patients were screened in 141 ICUs from 20 countries (77% of the ICUs were European), of whom 735 had ARDS and were analyzed. Overall 101 ARDS patients had at least one session of PP (13.7%), with no differences among the 4 study days. The rate of PP use was 5.9% (11/187), 10.3% (41/399) and 32.9% (49/149) in mild, moderate and severe ARDS, respectively (P = 0.0001). The duration of the first PP session was 18 (16-23) hours. Measured with the patient in the supine position before and at the end of the first PP session, PaO2/FIO2 increased from 101 (76-136) to 171 (118-220) mmHg (P = 0.0001) driving pressure decreased from 14 [11-17] to 13 [10-16] cmH2O (P = 0.001), and Pplat decreased from 26 [23-29] to 25 [23-28] cmH2O (P = 0.04). The most prevalent reason for not using PP (64.3%) was that hypoxemia was not considered sufficiently severe. Complications were reported in 12 patients (11.9%) in whom PP was used (pressure sores in five, hypoxemia in two, endotracheal tube-related in two ocular in two, and a transient increase in intracranial pressure in one).CONCLUSIONS: In conclusion, this prospective international prevalence study found that PP was used in 32.9% of patients with severe ARDS, and was associated with low complication rates, significant increase in oxygenation and a significant decrease in driving pressure.