Dutch Institute Research Articles

Using system dynamics to support a functional exercise for pandemic preparedness and response

AbstractIn pandemic preparedness and response, a Functional Exercise (FX) is used to simulate a situation as close to a real‐life event as possible without the deployment of resources. Participants are drawn from public health emergency operations centres, and work through a scenario script to test possible responses to a novel pathogen outbreak. This paper summarises the role of system dynamics modelling in the design and implementation of a functional exercise, which involved the Dutch and German national public health institutes in March 2023. The findings confirm the value of the system dynamics method in integrating disease and hospital models, and also highlights how well the method aligns with modern software development processes. The paper concludes with a discussion of what worked well, and presents areas for future enhancements of management flight simulators to support functional exercises. © 2024 The Author(s). System Dynamics Review published by John Wiley & Sons Ltd on behalf of System Dynamics Society.

Minimally Invasive transCervical oEsophagectomy (MICE) for oesophageal cancer: prospective cohort study (IDEAL stage 2A).

Minimally invasive transcervical oesophagectomy is a surgical technique that offers radical oesophagectomy without the need for transthoracic access. The aim of this study was to evaluate the safety and feasibility of the minimally invasive transcervical oesophagectomy procedure and to report the refinement of this technique in a Western cohort. A single-centre prospective cohort study was designed as an IDEAL stage 2A study. Patients with oesophageal cancer (cT1b-4a N0-3 M0) who were scheduled for oesophagectomy with curative intent were eligible for inclusion in the study. The main outcome parameter was the postoperative pulmonary complication rate and the secondary outcomes were the anastomotic leakage, recurrent laryngeal nerve palsy, and R0 resection rates, as well as the lymph node yield. In total, 75 patients underwent minimally invasive transcervical oesophagectomy between January 2021 and November 2023. Several modifications to the surgical technique were registered, evaluated, and implemented in the context of IDEAL stage 2A. A total of 12 patients (16%) had postoperative pulmonary complications, including pneumonia (4 patients) and pleural effusion with drainage or aspiration (8 patients). Recurrent laryngeal nerve palsy was observed in 33 of 75 patients (44%), with recovery in 30 of 33 patients (91%). A total of 5 of 75 patients (7%) had anastomotic leakage. The median number of resected lymph nodes was 29 (interquartile range 22-37) and the R0 resection rate was 96% (72 patients). Introducing minimally invasive transcervical oesophagectomy for oesophageal cancer in a Dutch institution is associated with a low rate of postoperative pulmonary complications and a high rate of temporary recurrent laryngeal nerve palsy.

Initiation of the Dutch Inguinal Hernia Audit (DIHA): A survey on support for registration, obstacles, and possible areas of improvement

Abstract BACKGROUND: Quality assessment and improvement of surgical procedures can be achieved by clinical audits that provide feedback on benchmarking of surgical outcomes. The Dutch Institute for Clinical Auditing (DICA) has successfully initiated registries with a clear impact on healthcare quality. Currently, there is no Dutch national inguinal hernia (IH) audit. This survey aimed to investigate the opinions of Dutch surgeons regarding the registration of IH care and explore potential obstacles in the implementation of a Dutch Inguinal Hernia Audit (DIHA). MATERIALS AND METHODS: A web-based survey was sent to all (>2,000) members of the Dutch Surgical Society, including surgeons and residents. RESULTS: Two-hundred sixty-seven respondents replied between April 14 and June 26, 2022 (hospital distribution: 36% small peripheral, 44% large peripheral, 11% academic, 2% specialized clinic). Almost two-thirds (60%) agreed that the quality of IH care should be improved. Similarly, nearly two-thirds (59%) answered that this improvement could be achieved through registration of surgical outcomes. Those opposed to registration stated fear of increased administrative burden and that the quality of care is already adequate. The majority of respondents agreed that chronic postoperative inguinal pain (CPIP; 81%) and recurrence rate (81%) should be used as quality indicators of IH surgery and registered as patient-reported outcome measures (PROMs). CONCLUSION: The majority of respondents agree that the quality of IH care could potentially be improved by implementing a national IH registry, with registration of CPIP and recurrence rate as quality indicators. Collecting these PROMs in a digital, automated format will facilitate successful implementation by minimizing administrative burden.

A decade of international diversity in collaborative research published in highly ranked accounting journals

PurposeThis study examines the patterns of international diversity in collaborative research published in highly ranked accounting journals.Design/methodology/approachWe examine four types of collaborations: regional, inter-regional, European national and European international. The empirical study is based on 4,033 articles published in 13 journals between 2010 and 2019. Social network analyses were carried out for the inter-regional and the European international collaborations.FindingsThe broad analysis of the regional and inter-regional collaborations reveals not only significant differences between the non-North American journals and the North American but also important dissimilarities among the non-North American journals. The analysis of the European collaborations reveals significant differences between the journals where the UK institutions play a significant role in leading a network of European researchers and the journals where the Dutch and/or German institutions also play a significant role in another network as European leaders in terms of research.Research limitations/implicationsAlthough it reveals the patterns of internationalization of the highly ranked accounting journals, and offers some insights regarding why such patterns exist, it does not assess co-authorship networks with regard to the authors' orientation in terms of methods and research topics. We acknowledge that the networks amongst authors should also be influenced by the specific PhD-granting institutions. However, we let the data speak to these points, showing how journals differ in publication patterns. Not all highly ranked journals in accounting have the same networks and patterns of co-authorship. Another limitation pertains to the limited aspect of diversity it focuses on, that of geographical diversity. Furthermore, our analyses do not speak directly to the nationalities of the authors, but to the country in which the publication was granted at the time of the paper's publication.Practical implicationsOur findings show that the patterns of international diversity in all the types of collaborations under examination in the highly ranked accounting journals vary across different groups of journals. The “North-American or North-American inspired journals” (Guthrie et al., 2019, p. 12) have the highest level of geographical concentration and the North American universities/institutions contribute with the majority of the papers. The “non-North American journals” – the leading journals for critical, interpretive and interdisciplinary approaches (Hussain et al., 2020) and those which are more acceptive of these latter approaches – have a lower level of geographic concentration of the papers and there is a broader set of regions and countries involved, including North American countries, the UK and two Continental European countries (Germany and the Netherlands).Originality/valueOur study shows empirically that the patterns of international diversity in all the types of collaborations under examination in the highly ranked accounting journals vary across different groups of journals, revealing not only significant differences between the North American and non-North American journals in accounting, but also showcasing how the non-North American journals present a lot more heterogeneity. We also believe the analysis of the European case is a noteworthy contribution of this study given existing accounting literature fails in acknowledging European diversity.

Trusting the minister or trusting the mayor? Perceived competence and integrity of central and local Dutch institutions governing energy matters

Phasing out fossil fuels is inherent to sustainable energy transitions, but implementing energy policies related to phasing out processes involves risks that may affect their public support. Trust in institutions responsible for handling these risks is crucial for public acceptability, as it serves as a heuristic for risk assessment. In the current study, using the Dutch energy scenario, we examine how trust in institutions relates to public support for phasing out natural gas in the Netherlands. We build from previous research by examining this for the two types of trust most commonly distinguished in the literature, namely competence- and integrity-based trust, and for institutions operating at both national and local levels. Results showed that trust depends on the type of trust people evaluate and on the institution’s level of operation. Locally, institutions are seen as more honest and transparent, while nationally, they’re perceived as more skilled and having more knowledge. Further, integrity-based trust in both local and national institutions better explained public support for phasing out natural gas than competence-based trust. We discuss these results in terms of their implications for energy policy, suggesting policymakers consider trust dynamics and tailor strategies based on trust dimensions and institutional levels to facilitate phasing out processes.

Preface

The International Summer School on Vacuum, Electron and Ion Technologies (VEIT) has been organized biennially since 1978, when the series of VEIT Schools was launched by the Institute of Electronics, Bulgarian Academy of Sciences, with the aim to act as a forum for exchange and dissemination of knowledge and ideas on the latest developments in electron-, ion-, and plasma-assisted technologies. The organizers of the 2023 edition of the event were the Institute of Electronics, Bulgarian Academy of Sciences, Sofia, Bulgaria and the Dutch Institute for Fundamental Energy Research, Eindhoven, The Netherlands. The School is a major scientific event and a meeting place for young scientists involved in research and development associated with high-tech industries. Many former School participants went on to become successful scientists in their field of research in leading institutions and companies all over the world. The School Proceedings have been published in special issues of the international journals Vacuum, Plasma Processes and Polymers, Journal of Physics: Conference Series.The twenty-third edition of VEIT was held in the Black Sea resort Sozopol, Bulgaria, from 18 to 22 September 2023. It was attended by 108 participants (33 students and young researchers) from 16 countries on two continents: Belgium, Bulgaria, Czech Republic, Estonia, France, Germany, Japan, Poland, Portugal, Romania, Serbia, Slovakia, Slovenia, The Netherlands, Ukraine, UK.The School Program covered a large spectrum of fundamental problems of the nanotechnologies, the interaction of charged particles with solid surfaces, the deposition and characterization of thin films, which were balanced out by reports on a wide range of significant high-technology applications – from equipment for deposition of hard coatings or thin optical/protective films to nanostructures prepared via evaporation, sputtering or irradiation. By their subjects, the lectures and reports were grouped for presentation and discussion in three sessions, each of them including oral presentations at plenary sessions and posters.List of Chairs of the School, International Advisory Committee, Local Organizing Committee, Invited Speakers, Participants are available in the pdf.

OGC P38 The impact of hospital experience in bariatric surgery on short-term outcomes after minimally invasive oesophagectomy: a nationwide analysis

Abstract Background Minimally invasive oesophagectomy (MIO) is a technically challenging procedure with a substantial learning curve. Composite volume of upper gastrointestinal (upper GI) procedures for cancer has been previously linked to postoperative outcomes. This study aimed to investigate an association between hospital experience in bariatric surgery and short-term outcomes in MIO. Methods Data on oesophagectomy patients between 2016 and 2020 were collected from the Dutch Upper Gastrointestinal Cancer Audit, a mandatory nationwide registry. Hospitals were categorized as bariatric or non-bariatric. Dutch institutions have a mandatory annual threshold of 200 bariatric and 20 oesophagectomy procedures. Multivariable logistic regression investigated short-term postoperative outcomes, adjusting for case-mix. Results Of 3371 patients undergoing oesophagectomy in sixteen hospitals, 2450 (72.7%) underwent MIO. Bariatric hospitals (N=6) accounted for 1057 (43.1%) MIO. Overall postoperative complication rate was lower in bariatric hospitals (59.2% vs. 65.9%, P<0.001). Bariatric hospitals were associated with a reduced risk of overall complications (OR 0.72 [95%CI 0.60-0.87]), length of hospital (OR 0.73 [95%CI 0.61-0.87]) and ICU stay (OR 0.83 [95%CI 0.69-1.00] (P=0.046)) after MIO. Surgical radicality did not differ. Lymph node yield (≥15) was lower in bariatric hospitals (90.0% vs. 94.7%, P<0.001). Several short-term outcomes showed a significantly improving trend over the years in bariatric, but not non-bariatric hospitals. Conclusions In this nationwide analysis, bariatric hospitals were associated with improved short-term outcomes after MIO and further improved over the years. Characteristics of bariatric hospitals that could explain this phenomenon and whether this translates to other upper GI procedures may be warranted to identify.

Stop Auditing and Start to CARE: Paradigm Shift in Assessing and Improving Supplier Sustainability

Traditional auditing has been commonly practiced by multinational companies to monitor their suppliers for sustainability violations. Based on a collaborative supplier sustainability performance improvement program at Koninklijke (Royal) Philips N.V., we introduce a framework that offers a paradigm shift to an improvement-based proactive approach that makes use of suppliers’ self-assessments. We refer to this framework as CARE, consisting of the following phases: collecting supplier sustainability data, assessing suppliers’ sustainability levels, reacting to future violations proactively, and enhancing sustainability performance. The framework integrates analytics techniques to understand the link between the general characteristics of the carefully assessed suppliers—such as location, size, and sector—and their sustainability profile, enabling large-scale supplier assessment and improvement. This information is then used to leverage machine learning techniques to predict current and future sustainability levels of suppliers and to determine best actions for sustainability improvement using mathematical programming. The utilization of analytics constitutes a pivotal element in this endeavor and notably makes CARE highly scalable because it harnesses limited supplier data—namely, only general supplier information—while there is a need to support decision making concerning thousands of suppliers. Philips makes use of this framework and reports that the overall 2021 year-on-year improvement in sustainability performance was 24% for suppliers that entered the program in 2020, indicating the efficacy of the suggested approach. History: This paper was refereed. Funding: The authors gratefully acknowledge the support of TKI Dinalog–Dutch Institute for Advance Logistics on the project entitled “Supplier Sustainability Improvement” [Grant 2017-2-132TKI].

METHODOLOGICAL SYSTEM OF USING CLOUD-ORIENTED OPEN SCIENCE SYSTEMS IN THE PROCESS OF EDUCATION AND PROFESSIONAL DEVELOPMENT OF TEACHERS

Actual scientific researches and issues analysis. The results of the study by E. Yenen and M. Yöntem indicate that the most necessary areas of professional development of teachers are special education, methods of scientific research, participation in projects and relevant professional activities. 14 Dutch institutions of general secondary education have developed and implemented a number of measures related to the concept “School as a professional learning community”. The research of J. Imants and M. M. Van der Wal was to create a model with the potential of professional development and school reform from the position of the teacher at many levels. The research objective. To design a methodical system of using cloud-oriented systems of open science in the process of teaching and professional development of teachers. The statement of basic materials. The creation of a methodical system of training and professional development of teachers involves a number of separate methods of using cloud-oriented components of educational purposes for the formation of teachers' skills in the formation of cloud-oriented systems of open science in the process of their further professional activities. Special attention should be paid to the means of forming and developing a cloud-oriented environment for improving the qualifications of teachers, which may include various services of open science and their combination, separated into appropriate groups.

Assessment of STAT4 Variants and Risk of Hepatocellular Carcinoma in Latin Americans and Europeans.

Hepatocellular carcinoma (HCC) is the third leading cause of cancer death worldwide. The STAT4 rs7574865 genetic variant has been associated with an increased risk of developing HCC in Asian populations. However, this association has not been studied in Latin America and is poorly assessed in European populations. This case-control study investigated the association between STAT4 rs7574865 and HCC risk in these populations. We evaluated DNA samples from seven medical institutions across six Latin American countries and one Dutch institution in 1060 individuals (344 HCC and 716 controls). STAT4 rs7574865 SNP was genotyped using TaqMan-genotyping assay and analyzed using logistic regression. We found no significant association between the homozygous risk allele (G) of STAT4 and HCC development in either population, with odds ratios (OR) for GG versus TT of 0.85 (CI: 0.48-1.52, p = 0.58) and 0.81 (CI: 0.34-1.93, p = 0.67) for Latin Americans and Europeans respectively. No correlation was found between the risk allele and HCC based on underlying liver disease. However, we found that Latin Americans of European ancestry were more likely to carry the risk allele. Our results suggest that the STAT4 SNP rs7574865 does not influence the risk of developing HCC in Latin American or European populations, highlighting the importance of evaluating genetic risk factors in various ethnic groups and understanding the possible influence of ancestry on the genetic basis of disease.

Managing “Hot Moments” in Diverse Classrooms for Inclusive and Equitable Campuses

Classrooms are fundamental components of university campuses. The creation of inclusive and equitable campus environments is incumbent upon the teachers who need to navigate through “hot moments”, which typically refers to situations or incidents that generate intense emotions or strong reactions among the students or between the students and teachers. The literature suggests that many “hot moments” occur due to microaggressions in the classroom and that issues of difference, power, and privilege underlie “hot moments”. Based on qualitative research done with university teachers in a Dutch institution, our research shows that teacher-described “hot moments” can be analyzed under three interrelated dimensions: individual, interactional, and institutional. We suggest educators and higher education policy makers read through these experiences as a way to better understand the challenges their colleagues face, most often alone as the classroom’s leader; in the hope of advancing change efforts to create more inclusive and equitable class environments which will change how minoritized students experience university education.

Civic Purpose among Higher Education Students – A Study of Four Dutch and Finnish Institutions

Abstract Given the increasing interest in academic citizenship in higher education, this study examines the civic purposes of higher education students in two European countries, namely the Netherlands and Finland, and relations between students’ worldviews and their civic purposes. The majority of students was categorized as so-called disengaged or dreamers, respectively either not civically interested or active or then visioning but not actualizing civic interests. Students with a purposeful profile referring to high civic interest, action, and identity, were most prevalent among Dutch students with a humanistic worldview and Finnish students reporting religions other than Christianity. Students from both countries not identifying with any organized worldviews were more likely to be allocated to the disengaged profile. Possible explanations for differences in student profiles are discussed.

Beyond landscape experience: A systematic literature review on the concept of spatial quality in flood‐risk management

AbstractPeople often oppose the implementation of flood mitigation measures based on concerns about “spatial quality” (SQ). SQ can be an ambiguous concept, which can function as boundary object that unites stakeholders from various backgrounds. Yet, the ambiguity of SQ can also be misused to justify particular interests, result in unmet expectations and lead to miscommunication. To contribute to the understanding, communication and implementation of SQ in flood risk management projects, this study systematically reviewed the use of SQ in the literature. The first part of this review resulted in the identification of 19 aspects categorized into four dimensions of SQ: experiential, use, ecological, and long‐term quality. Based on these dimensions, we found in the second part of this review that SQ is understood either as (1) experiential quality only, (2) the combination of experiential, use, and ecological quality, and (3) the combination of all four dimensions. The review illustrates that the understanding of SQ is related to several context characteristics, including the country of author affiliation and the prominent school of thought with regards to objectivity and subjectivity. For example, only authors affiliated with Dutch institutions take into account all four dimensions of SQ. To bridge between these different understandings of SQ, this study provides a framework with a set of terms that can be used for the development of a shared language for SQ, ultimately fostering the implementation of this concept in flood risk management projects.This article is categorized under: Engineering Water > Planning Water

OC-095 DUTCH INGUINAL HERNIA AUDIT (DIHA): A SURVEY OF CURRENT REGISTRATION, OBSTACLES AND POSSIBLE AREAS OF IMPROVEMENT

Abstract Aim Quality assessment and improvement of surgical procedures can be achieved by clinical audits that provide feedback with benchmarking of surgical outcomes. The Dutch Institute for Clinical Auditing has successfully initiated multiple audits with clear impact on quality of care. Presently, there is no Dutch national inguinal hernia (IH) registry. This survey aimed to investigate current opinions of all Dutch surgeons regarding registration, and to explore potential obstacles in the implementation of a Dutch Inguinal Hernia Audit (DIHA). Material & Methods A web-based survey was sent to all (> 2.000) members of the Dutch Surgical Society, including surgeons and residents in training. Results Two-hundred sixty-seven respondents replied (hospital distribution: 33% small peripheral, 45% large peripheral, 11% academic, 11% other). Two-thirds (67%) agreed that the quality of IH care should be improved. Similarly, 66% answered that improvement could be achieved by registration of surgical outcomes. Those opposed to registration mainly stated fear of administrative burden and that the quality of care is already adequate. The vast majority of respondents agreed that chronic pain (91%) and recurrence (91%) should be used as indicators of IH surgery, which can both be collected as patient-reported outcome measures (PROMs). Conclusions A two-thirds majority of Dutch surgeons agree that the quality of inguinal care should be improved by implementing a Dutch national IH registry. Almost all agree that registration of chronic pain and recurrence as quality indicators can be registered as PROMs without increasing the administrative burden, which will facilitate successful implementation.

External validation of 18 F-FDG PET-based radiomic models on identification of residual oesophageal cancer after neoadjuvant chemoradiotherapy.

Detection of residual oesophageal cancer after neoadjuvant chemoradiotherapy (nCRT) is important to guide treatment decisions regarding standard oesophagectomy or active surveillance. The aim was to validate previously developed 18 F-FDG PET-based radiomic models to detect residual local tumour and to repeat model development (i.e. 'model extension') in case of poor generalisability. This was a retrospective cohort study in patients collected from a prospective multicentre study in four Dutch institutes. Patients underwent nCRT followed by oesophagectomy between 2013 and 2019. Outcome was tumour regression grade (TRG) 1 (0% tumour) versus TRG 2-3-4 (≥1% tumour). Scans were acquired according to standardised protocols. Discrimination and calibration were assessed for the published models with optimism-corrected AUCs >0.77. For model extension, the development and external validation cohorts were combined. Baseline characteristics of the 189 patients included [median age 66 years (interquartile range 60-71), 158/189 male (84%), 40/189 TRG 1 (21%) and 149/189 (79%) TRG 2-3-4] were comparable to the development cohort. The model including cT stage plus the feature 'sum entropy' had best discriminative performance in external validation (AUC 0.64, 95% confidence interval 0.55-0.73), with a calibration slope and intercept of 0.16 and 0.48 respectively. An extended bootstrapped LASSO model yielded an AUC of 0.65 for TRG 2-3-4 detection. The high predictive performance of the published radiomic models could not be replicated. The extended model had moderate discriminative ability. The investigated radiomic models appeared inaccurate to detect local residual oesophageal tumour and cannot be used as an adjunct tool for clinical decision-making in patients.

New Paradigm of Indonesian Islamic Education: Analysis of Changes in the Relations of Islamic Education Institutions with Post-Reform Political Power

Islamic Education Institutions (LPI) were born with different characters and ideologies from Dutch and Japanese educational institutions. This difference is still maintained even though Indonesia has declared itself independent. Only later in the reform era did the dynamics of the relationship between LPI and government power change. This study then examines changes in the relationship between the LPI and political power after the Reformation. This research will be carried out using qualitative methods and a historiographical approach. Researchers will use data on Indonesia’s social, political, and religious situation from when the Dutch colonized Indonesia until the temporary Indonesian period. This research then found a new change in the political movement of Islamic education in Indonesia in 1998. In this change, various Islamic educational institutions began to enter the political context and fill multiple positions in the government. Islamic educational institutions started to transform and become part of political power, which marked a paradigmatic change in the politics of Islamic education.

Overview of Liquid-Metal PFC R&D at the University of Illinois Urbana-Champaign

The design and implementation of future flowing liquid-lithium plasma-facing components (LLPFCs) will be dependent on several factors. Of course, one of the most important is the need to be able to deal with high heat fluxes incident on the surface of the LLPFCs, but there are also several other important liquid-metal behaviors that have been identified for their critical impact on the feasibility of a LLPFC. One of these is the ability to constantly wet 100% of the plasma-facing component area and the best way to achieve that. Another key point is knowing and understanding the erosion and corrosion of the surfaces subject to a flowing liquid-lithium system and the ability for hydrogen and helium uptake by the system. The Center for Plasma Material Interactions (CPMI) has been tasked with looking at these various issues. The Mock-up Entry module for EAST device was used to investigate wetting and erosion effects and to design a suitable distribution and collection system with a liquid-lithium loop. The vapor shielding effects of lithium on the surface were also modeled and studied. A model coupling CRANE, an open-source global reaction network solver, and Zapdos, a plasma transport solver, is being developed to better understand the dynamics of the vapor cloud. Experiments on the Magnum-PSI at the Dutch Institute for Fundamental Energy Research have been carried out to study the vapor shielding effect and obtain experimental benchmarks to verify the model. Also, initial experiments using the Hybrid Illinois Device for Research and Applications have been performed to understand the pumping effects of lithium on helium. Experiments with a drop of liquid lithium (~100 mg) into a helium plasma have shown the ability of lithium to take out the cold recycling helium gas as well as hydrogen and oxygen impurity gases. The improvement in plasma performance was significant, and further understanding of this effect will have impacts on how future LLPFCs will be designed. Further investigation into the exact mechanism for helium pumping by lithium needs to be performed in the future. This paper presents a summary of the results obtained at the CPMI.

Study on Using Linear Regression Modeling to Better Estimate Total Surgical Procedure Time

To make the most of the resources available in the operating room, careful planning of the available block time and the patient case sequences is required (OR). These planning methods will only help if the forecasts provided by TPT can be relied upon. This study makes use of linear regression models to improve TPT forecasts. These models are given estimated surgeon-controlled time (eSCT) in addition to other parameters of relevance. Surgical procedures at six Dutch institutions between 2012 and 2016 were evaluated using data from a benchmarking database. There were 79,983 contributors, which resulted in 199,772 hours of OR being reported. We analyzed the risk variables for TPT, which revealed that eSCT, patient age, surgical type, ASA physical status category, and anesthetic procedure were all contributors. During calculating the projected TPT for each file, the eSCT was multiplied by a fixed ratio model (discussed in further detail elsewhere) by a factor of 1.33. According to the findings of the research conducted by van Veen-Berkx et al., a conservative estimate of the period during which anesthesia is stable is around 33 percent of the SCT (ACT). In conclusion, we analyzed different linear regression models to predict TPT. These models included eSCT as one of the independent factors among the other covariates. In the end, each of the regression models was retested, this time to see whether or not it was possible to predict ACT reliably without using eSCT as a covariate (which leads to TPT by adding SCT). The most accurate projections of TPT were generated by a linear regression model that used eSCT, the kind of operation, the ASA classification, and the type of anesthesia. Compared to the fixed ratio model and the ACT prediction approach, the performance of this model was very satisfactory. Significant cost savings and increases in overall productivity may be realized if more accurate estimates were included in the planning and sequencing algorithms used to enhance operating room usage.

Professional support and re-entry preparedness among prisoners

Multiagency support is considered crucial in the successful resettlement of prisoners. Various prison-based and community-based professionals should each play a part in supporting prisoners through the gate regarding employment, housing, financial problems, healthcare or valid identification issues. Yet, little is known about the actual contribution of this support to a better perceived re-entry preparedness among prisoners. To examine the association between professional support and re-entry preparedness, the current study uses self-reported data from 1442 soon-to-be-released prisoners across 26 Dutch institutions. We include general satisfaction with support, and satisfaction with the specific instrumental support received, and compare prisoners who did and did not have reintegration needs prior to imprisonment. Support was positively related to re-entry preparedness for prisoners who had needs prior to imprisonment, and instrumental support from community-based professionals showed the most robust results. The implications and future recommendations are discussed.

Sustainability in Dutch and Flemish mental healthcare: A descriptive and comparative study

Introduction There is an urgent need for sustainable thinking and practices in healthcare systems to meet the challenge of climate change (Charlesworth & Jamieson, 2019; Corvalan et al., 2020; Luykx & Voetterl, 2022; Madden et al., 2020). This need is accelerated by the recent energy crisis. According to an international NGO policy paper (Karliner et al., 2019) healthcare institutions are large energy consumers and major emitters. The (mental) health sectors of the Netherlands and Flanders, the northern part of Belgium, also greatly contribute to the global climate crisis. Both regions have per capita emissions (between the 0.50t and 1t) that fall just below the world’s healthcare top emitters.ObjectivesTo evaluate the state of sustainability in Dutch and Flemish mental health institutions (including psychiatric hospitals, rehabilitation centers, and community mental health centers) and assess whether certain differences can be found in the climate policies of these institutions between both regions.Methods Board members of mental health institutions were asked to complete a 20-item online survey in which concrete actions, objectives and ambitions in the field of sustainability were questioned. Frequencies and percentages were calculated for each question. For certain topics chi-squared tests were performed to test differences in sustainability issues addressed in the questionnaire between Dutch and Flemish mental healthcare institutions.Results Survey response rates for Dutch and Flemish mental health institutions were 38% and 20%, respectively. Ninety-five percent and 38% of respectively the Dutch and Flemish institutions fully agreed that sustainability is a very important theme (χ2(1)=2,25, p=0,13). Key focus areas in both regions included sustainable energy transition (with half of the mental health institutions sourcing at least half of their energy via renewable energy resources and technologies) and recycling (almost 80% of the institutions). Statistically significant differences were found between both regions with regard to monitoring the environmental impact (Flanders 24% vs. The Netherlands 60%, χ2(1)=6,41, p=0,01) and fostering more sustainable commutes (Flanders 72% vs. The Netherlands 15%, χ2(1)=17,35, p<0,0001). The climate impact of medicines and food, as well as investments in sustainable projects, received little attention.ConclusionsAlthough a substantial part of Dutch and Flemish mental health institutions consider sustainability (very) important, a systemic ‘transformation’ will be necessary to make them climate neutral, as tenets of practicing mental healthcare sustainably include more than sustainable energy transition and recycling (Monsell et al., 2021). Moreover, a lack of sufficient investment opportunities, partly due to a lack of financial resources, seems to be the main barrier for many mental healthcare institutions for quickly reaching sustainability goals.Disclosure of InterestNone Declared