Geef docenten de ruimte! Een onderzoek naar de invloed van gespreid leiderschap op professionele ruimte van docenten in het middelbaar beroepsonderwijs

Wijngaarden-Venema, A. (2014). Geef docenten de ruimte! Een onderzoek naar de invloed van gespreid leiderschap op professionele ruimte van docenten in het middelbaar beroepsonderwijs.November, 18, 2014, Heerlen, Nederland: Open UniversiteitProfessionalisering van het onderwijs is een actueel onderwerp omdat het Nederlandse onderwijs de laatste jaren te maken heeft met problemen zoals teruglopende prestaties van leerlingen en weinig uitblinkende leerlingen (Nota werken in het onderwijs, 2012). Professionele ruimte blijkt een belangrijke voorwaarde voor professionalisering (Onderwijsinspectie, 2013). Gespreid leiderschap (Spillane,2006) kan deze professionele ruimte voor professionalisering positief beïnvloeden (Hulsbos et al. 2012). Het doel van dit onderzoek is om aan de hand van drie good practices te verkennen hoe professionele ruimte wordt ervaren en welke leiderschapsmodellen (MacBeath, 2005) hieraan ten grondslag liggen. Vervolgens is het de bedoeling dat er naar aanleiding van de bevindingen uit dit onderzoek een aantal factoren kunnen worden benoemd die gespreid leiderschap en professionele ruimte voor professionalisering positief kunnen beïnvloeden.In dit onderzoek participeerden 39 docenten en managers, verdeeld over twee teams van het Deltion College en één team van het Arcus College. De onderzoeksgroep bestond uit mannen en vrouwen met een gemiddelde leeftijd van 42 tot 48 jaar. Dit onderzoek is opgezet met behulp van een mixed methods onderzoekontwerp. Voor de verzameling en triangulatie van deze data is gebruik gemaakt van drie verschillende meetinstrumenten. Het eerste instrument is een checklist voor documentanalyse. Het tweede instrument is een digitale vragenlijst, gebaseerd op het conceptuele model van de Brabander & Martens (2010). Het derde meetinstrument tenslotte is een focusgroep interview (Centraal Begeleiding Orgaan, 2004).Het onderzoek laat zien dat alle docenten professionele ruimte ervaren. Het onderwijsteam met de meest ervaren professionele ruimte lijkt relatief meer bottom-up modellen van gespreid leiderschap herkennen dan teams die minder professionele ruimte ervaren. Teams met minder ervaren professionele ruimte ervaren vooral een minder competente omgeving en minder sociale verbondenheid. In deze context zijn ontwikkeling van expertise en wederzijds vertrouwen factoren die gespreid leiderschap en professionele ruimte in teams positief kunnen beïnvloeden. Vervolgonderzoek naar professionaliseringsvraagstukken rondom docentleiderschap kan inzichten en handvatten bieden voor ontwikkeling van gespreid leiderschap ten behoeve van professionalisering en onderwijsverbetering

Complement Is Activated During Normothermic Machine Perfusion of Porcine and Human Discarded Kidneys

Background: The gap between demand and supply of kidneys for transplantation necessitates the use of kidneys from extended criteria donors. Transplantation of these donor kidneys is associated with inferior results, reflected by an increased risk of delayed graft function. Inferior results might be explained by the higher immunogenicity of extended criteria donor kidneys. Normothermic machine perfusion (NMP) could be used as a platform to assess the quality and function of donor kidneys. In addition, it could be useful to evaluate and possibly alter the immunological response of donor kidneys. In this study, we first evaluated whether complement was activated during NMP of porcine and human discarded kidneys. Second, we examined the relationship between complement activation and pro-inflammatory cytokines during NMP. Third, we assessed the effect of complement activation on renal function and injury during NMP of porcine kidneys. Lastly, we examined local complement C3d deposition in human renal biopsies after NMP. Methods: NMP with a blood-based perfusion was performed with both porcine and discarded human kidneys for 4 and 6 h, respectively. Perfusate samples were taken every hour to assess complement activation, pro-inflammatory cytokines and renal function. Biopsies were taken to assess histological injury and complement deposition. Results: Complement activation products C3a, C3d, and soluble C5b-9 (sC5b-9) were found in perfusate samples taken during NMP of both porcine and human kidneys. In addition, complement perfusate levels positively correlated with the cytokine perfusate levels of IL-6, IL-8, and TNF during NMP of porcine kidneys. Porcine kidneys with high sC5b-9 perfusate levels had significantly lower creatinine clearance after 4 h of NMP. In line with these findings, high complement perfusate levels were seen during NMP of human discarded kidneys. In addition, kidneys retrieved from brain-dead donors had significantly higher complement perfusate levels during NMP than kidneys retrieved from donors after circulatory death. Conclusion: Normothermic kidney machine perfusion induces complement activation in porcine and human kidneys, which is associated with the release of pro-inflammatory cytokines and in porcine kidneys with lower creatinine clearance. Complement inhibition during NMP might be a promising strategy to reduce renal graft injury and improve graft function prior to transplantation

Benefits and risks of clofarabine in adult acute lymphoblastic leukemia investigated in depth by multi-state modeling

Background: We recently reported results of the prospective, open-label HOVON-100 trial in 334 adult patients with acute lymphoblastic leukemia (ALL) randomized to first-line treatment with or without clofarabine (CLO). No improvement of event-free survival (EFS) was observed, while a higher proportion of patients receiving CLO obtained minimal residual disease (MRD) negativity. Aim: In order to investigate the effects of CLO in more depth, two multi-state models were developed to identify why CLO did not show a long-term survival benefit despite more MRD-negativity. Methods: The first model evaluated the effect of CLO on going off-protocol (not due to refractory disease/relapse, completion or death) as a proxy of severe treatment-related toxicity, while the second model evaluated the effect of CLO on obtaining MRD negativity. The subsequent impact of these intermediate events on death or relapsed/refractory disease was assessed in both models. Results: Overall, patients receiving CLO went off-protocol more frequently than control patients (35/168 [21%] vs. 18/166 [11%], p = 0.019; HR 2.00 [1.13–3.52], p = 0.02), especially during maintenance (13/44 [30%] vs. 6/56 [11%]; HR 2.85 [95%CI 1.08–7.50], p = 0.035). Going off-protocol was, however, not associated with more relapse or death. Patients in the CLO arm showed a trend towards an increased rate of MRD-negativity compared with control patients (HR MRD-negativity: 1.35 [0.95–1.91], p = 0.10), which did not translate into a significant survival benefit. Conclusion: We conclude that the intermediate states, i.e., going off-protocol and MRD-negativity, were affected by adding CLO, but these transitions were not associated with subsequent survival estimates, suggesting relatively modest antileukemic activity in ALL.</p

Development of a workplace intervention for sick-listed employees with stress-related mental disorders: Intervention Mapping as a useful tool

Background. To date, mental health problems and mental workload have been increasingly related to long-term sick leave and disability. However, there is, as yet, no structured protocol available for the identification and application of an intervention for stress-related mental health problems at the workplace. This paper describes the structured development, implementation and planning for the evaluation of a return-to-work intervention for sick-listed employees with stress-related mental disorders (SMDs). The intervention is based on an existing successful return-to-work intervention for sick-listed employees with low back pain. Methods. The principles of Intervention Mapping were applied to combine theory and evidence in the development, implementation and planning for the evaluation of a participatory workplace intervention, aimed at an early return-to-work for sick-listed employees with SMDs. All stakeholders were involved in focus group interviews: i.e. employees recently sick-listed with SMDs, supervisors and occupational health professionals. Results. The development of the participatory workplace intervention according to the Intervention Mapping principles resulted in a structured return-to-work intervention, specifically tailored to the needs of sick-listed employees with SMDs. Return-to-work was proposed as a behavioural change, and the Attitude - Social influence - self-Efficacy model was identified as a theoretical framework. Stakeholder involvement in focus group interviews served to enhance the implementation. The cost-effectiveness of the intervention will be evaluated in a randomised controlled trial. Conclusion. Intervention Mapping was found to be a promising method to develop interventions tailored to a specific target group in the field of occupational health. Trial registration. ISRCTN92307123. © 2007 van Oostrom et al; licensee BioMed Central Ltd

Financing High Performance Climate Adaptation in Agriculture: Climate Bonds for Multi-Functional Water Harvesting Infrastructure on the Canadian Prairies

International capital markets are responding to the global challenge of climate change, including through the use of labeled green and climate bonds earmarked for infrastructure projects associated with de-carbonization and to a lesser extent, projects that increase resilience to the impacts of climate change. The potential to apply emerging climate bond certification standards to agricultural water management projects in major food production regions is examined with respect to a specific example of multi-functional distributed water harvesting on the Canadian Prairies, where climate impacts are projected to be high. The diverse range of co-benefits is examined using an ecosystem service lens, and they contribute to the overall value proposition of the infrastructure bond. Certification of a distributed water harvesting infrastructure bond under the Climate Bond Standard water criteria is feasible given climate bond issue precedents. The use of ecosystem service co-benefits as additional investment criteria are recommended as relevant bond certification standards continue to evolve

Development and Evaluation of a Training Program on Occupational Health Research and Surveillance in Turkey

Objectives:The aim of this study was to increase knowledge and skills regarding occupational health surveillance and research in professionals.Methods:Following the Analysis, Design, Development, Implementation, and Evaluation model, several training modules have been designed and implemented in the course of 2016. Evaluation forms were distributed to 42 participants before the start and after each training module to measure changes in knowledge, skills, and self-efficacy.Results:The majority of the participants were satisfied and found the training relevant and interesting for adult learners. The level of self-efficacy increased after the trainings. Females and occupational physicians displayed higher scores than men and other disciplines. After 1 year, the self-efficacy level decreased, but the level was still substantially higher than before the training.Conclusions:Feedback on the implemented training program was favorable. Participants were able to acquire and apply competencies in the subject matter at short and long term

What Is the Best Blood Sampling Time for Metabolic Control of Phenylalanine and Tyrosine Concentrations in Tyrosinemia Type 1 Patients?

BACKGROUND: Treatment of hereditary tyrosinemia type 1 with nitisinone and phenylalanine and tyrosine restricted diet has largely improved outcome, but the best blood sampling time for assessment of metabolic control is not known.AIM: To study diurnal and day-to-day variation of phenylalanine and tyrosine concentrations in tyrosinemia type 1 patients.METHODS: Eighteen tyrosinemia type 1 patients aged &gt;1 year (median age 7.9 years; range 1.6-20.7) were studied. Capillary blood samples were collected 4 times a day (T1: pre-breakfast, T2: pre-midday meal, T3: before evening meal, and T4: bedtime) for 3 days. Linear mixed-effect models were used to investigate diurnal and day-to-day variation of both phenylalanine and tyrosine.RESULTS: The coefficients of variation of phenylalanine and tyrosine concentrations were the lowest on T1 (13.8% and 14.1%, respectively). Tyrosine concentrations did not significantly differ between the different time points, but phenylalanine concentrations were significantly lower at T2 and T3 compared to T1 (50.1 μmol/L, 29.8 μmol/L, and 37.3 μmol/L, respectively).CONCLUSION: Our results indicated that for prevention of too low phenylalanine and too high tyrosine concentrations, measurement of phenylalanine and tyrosine pre-midday meal would be best, since phenylalanine concentrations are the lowest on that time point. Our results also indicated that whilst blood tyrosine concentrations were stable over 24 h, phenylalanine fluctuated. Day-to-day variation was most stable after an overnight fast for both phenylalanine and tyrosine. Therefore, in tyrosinemia type 1 patients the most reliable time point for measuring phenylalanine and tyrosine concentrations to enable interpretation of metabolic control is pre-breakfast.</p

Table_1_Butyrate and hexanoate-enriched triglycerides increase postprandrial systemic butyrate and hexanoate in men with overweight/obesity: A double-blind placebo-controlled randomized crossover trial.DOCX

BackgroundShort chain fatty acids (SCFA) are increasingly recognized for their potential ability to alleviate obesity-associated chronic low-grade inflammation and disturbed energy homeostasis. Evidence suggests that an increase in circulating SCFA might be necessary to induce beneficial alterations in energy metabolism.ObjectiveTo compare the bioaccessibility of two different SCFA-enriched triglycerides: Akovita SCT (butyrate and hexanoate esterified with long chain fatty acids) and tributyrin/caproin (solely butyrate and hexanoate) and investigate whether the SCFA from orally administrated Akovita SCT reach the circulation and affect postprandial metabolism in men with overweight/obesity.MethodsThe site, speed, and amount of SCFA release from Akovita SCT and tributyrin/caproin were assessed in a validated In vitro Model of the stomach and small intestine (TIM-1). Subsequently, a double-blind placebo-controlled randomized crossover study was conducted at Maastricht University with fourteen men with overweight/obesity (BMI 25–35 kg/m2) of which twelve men finished all testdays and were included for analysis. The participants received a liquid high fat mixed meal test containing either a low (650 mg), medium (1,325 mg), or high dose (2,000 mg) of Akovita SCT or a placebo (sunflower oil) in randomized order. Blood was sampled at baseline and after ingestion for 6 h for the primary outcome plasma butyrate and hexanoate concentration. Secondary outcomes included hydrogen breath, appetite, gastrointestinal complaints, circulating glucagon-like peptide 1, free fatty acids, glucose, triglycerides, insulin, and cytokines concentrations.ResultsIn TIM-1, tributyrin/caproin was rapidly cleaved in the gastric compartment whereas the release of SCFA from Akovita SCT occurred predominantly in the small intestine. In vivo, all doses were well-tolerated. The medium dose increased (P ConclusionEsterifying SCFA-enriched triglycerides with long chain fatty acids delayed SCFA release from the glycerol backbone. Akovita SCT increased postprandial circulating butyrate and hexanoate without changing metabolic parameters in men with overweight/obesity. Future randomized clinical trials should investigate whether long-term Akovita SCT supplementation can aid in the treatment or prevention of metabolic disorders.Clinical trial registrationwww.ClinicalTrials.gov, identifier: NCT04662411.</p