486 research outputs found

    Where to go in the near future: diverging perspectives on online public service delivery

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    Although the electronic government is under heavy development, a clear vision doesn’t seem to exist. In this study 20 interviews among leaders in the field of e-government in the Netherlands resulted in different perspectives on the future of electronic public service delivery. The interviews revealed different objectives and interpretations of the presuppositions regarding citizens’ desires. Opinions about channel approaches and ‘trigger services’ appeared to vary. Furthermore, the respondents didn’t agree on the number of contact moments between citizen and government, had different opinions about digital skills, pled for various designs of the electronic government and placed the responsibility for electronic service delivery in different hands. Conclusion is that there is a lack of concepts on how to do things. Everybody talks about eGovernment, but all have different interpretations. \u

    Conceptualizing throughput legitimacy: procedural mechanisms of accountability, transparency, inclusiveness and openness in EU governance

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    This symposium demonstrates the potential for throughput legitimacy as a concept for shedding empirical light on the strengths and weaknesses of multi-level governance, as well as challenging the concept theoretically. This article introduces the symposium by conceptualizing throughput legitimacy as an ‘umbrella concept’, encompassing a constellation of normative criteria not necessarily empirically interrelated. It argues that in order to interrogate multi-level governance processes in all their complexity, it makes sense for us to develop normative standards that are not naïve about the empirical realities of how power is exercised within multilevel governance, or how it may interact with legitimacy. We argue that while throughput legitimacy has its normative limits, it can be substantively useful for these purposes. While being no replacement for input and output legitimacy, throughput legitimacy offers distinctive normative criteria— accountability, transparency, inclusiveness and openness— and points towards substantive institutional reforms.Published versio

    Social determinants of content selection in the age of (mis)information

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    Despite the enthusiastic rhetoric about the so called \emph{collective intelligence}, conspiracy theories -- e.g. global warming induced by chemtrails or the link between vaccines and autism -- find on the Web a natural medium for their dissemination. Users preferentially consume information according to their system of beliefs and the strife within users of opposite narratives may result in heated debates. In this work we provide a genuine example of information consumption from a sample of 1.2 million of Facebook Italian users. We show by means of a thorough quantitative analysis that information supporting different worldviews -- i.e. scientific and conspiracist news -- are consumed in a comparable way by their respective users. Moreover, we measure the effect of the exposure to 4709 evidently false information (satirical version of conspiracy theses) and to 4502 debunking memes (information aiming at contrasting unsubstantiated rumors) of the most polarized users of conspiracy claims. We find that either contrasting or teasing consumers of conspiracy narratives increases their probability to interact again with unsubstantiated rumors.Comment: misinformation, collective narratives, crowd dynamics, information spreadin

    Implementation of GIS-Based Applications in Water Governance

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    __Abstract__ Geographical Information Systems (GIS) are computer programs that are able to bring large amounts of data of both the physical and the social system together in one comprehensive overview shown digitally. GIS occurred very rapidly on the Dutch policy agenda. In this paper we analyze how the fast introduction process of GIS-based instruments in water management and more specifically in river flood management can be explained. By applying a range of classical models on agenda-setting, we show the important contribution of GIS to the water and flood issue in current spatial planning and policy development in the Netherland

    Waiting list mortality and the potential of donation after circulatory death heart transplantations in the Netherlands

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    BACKGROUND: With more patients qualifying for heart transplantation (HT) and fewer hearts being transplanted, it is vital to look for other options. To date, only organs from brain-dead donors have been used for HT in the Netherlands. We investigated waiting list mortality in all Dutch HT centres and the potential of donation after circulatory death (DCD) HT in the Netherlands. METHODS: Two different cohorts were evaluated. One cohort was defined as patients who were newly listed or were already on the waiting list for HT between January 2013 and December 2017. Follow-up continued until September 2018 and waiting list mortality was calculated. A second cohort of all DCD donors in the Netherlands (lung, liver, kidney and pancreas) between January 2013 and December 2017 was used to calculate the potential of DCD HT. RESULTS: Out of 395 patients on the waiting list for HT, 196 (50%) received transplants after a median waiting time of 2.6 years. In total, 15% died while on the waiting list before a suitable donor heart became available. We identified 1006 DCD donors. After applying exclusion criteria and an age limit of 50 years, 122 potential heart donors remained. This number increased to 220 when the age limit was extended to 57 years. CONCLUSION: Waiting list mortality in the Netherlands is high. HT using organs from DCD donors has great potential in the Netherlands and could lead to a reduction in waiting list mortality. Cardiac screening will eventually determine the true potential

    Coexisting high-grade glandular and squamous cervical lesions and human papillomavirus infections

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    Contains fulltext : 144469.pdf (publisher's version ) (Closed access)The frequency of high-risk human papillomavirus (hr-HPV) genotypes in patients with adenocarcinoma in situ (ACIS) with coexisting cervical intraepithelial neoplasia (CIN), ACIS without coexisting CIN, and high-grade CIN (CIN II/III) was studied, in order to gain more insight into the relation between hr-HPV infections and the development of coexisting squamous and glandular lesions. The SPF(10) LiPA PCR was used to detect simultaneously 25 different HPV genotypes in biopsies obtained from 90 patients with CIN II/III, 47 patients with ACIS without coexisting CIN, and 49 patients with ACIS and coexisting CIN. hr-HPV was detected in 84 patients (93%) with CIN II/III, 38 patients (81%) with ACIS without CIN, and in 47 patients (96%) with ACIS and coexisting CIN. A total of 13 different hr-HPV genotypes were detected in patients with CIN II/III, and only five in patients with ACIS with/without coexisting CIN. HPV 31, multiple hr-HPV genotypes, and HPV genotypes other than 16, 18, and 45 were significantly more often detected in patients with CIN II/III, while HPV 18 was significantly more often detected in patients with ACIS with/without CIN. There were no significant differences in the frequency of specific hr-HPV genotypes between patients with ACIS with or without coexisting CIN. In conclusion, the frequency of specific hr-HPV genotypes is similar for patients with ACIS without CIN and patients with ACIS and coexisting CIN, but is significantly different for patients with CIN II/III without ACIS. These findings suggest that squamous lesions, coexisting with high-grade glandular lesions, are aetiologically different from squamous lesions without coexisting glandular lesions

    Microvascular damage assessed by optical coherence tomography angiography for glaucoma diagnosis: a systematic review of the most discriminative regions

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    A growing number of studies have reported a link between vascular damage and glaucoma based on optical coherence tomography angiography (OCTA) imaging. This multitude of studies focused on different regions of interest (ROIs) which offers the possibility to draw conclusions on the most discriminative locations to diagnose glaucoma. The objective of this work was to review and analyse the discriminative capacity of vascular density, retrieved from different ROIs, on differentiating healthy subjects from glaucoma patients. PubMed was used to perform a systematic review on the analysis of glaucomatous vascular damage using OCTA. All studies up to 21 April 2019 were considered. The ROIs were analysed by region (macula, optic disc and peripapillary region), layer (superficial and deep capillary plexus, avascular, whole retina, choriocapillaris and choroid) and sector (according to the Garway–Heath map). The area under receiver operator characteristic curve (AUROC) and the statistical difference (p-value) were used to report the importance of each ROI for diagnosing glaucoma. From 96 screened studies, 43 were eligible for this review. Overall, the peripapillary region showed to be the most discriminative region with the highest mean AUROC (0.80 ± 0.09). An improvement of the AUROC from this region is observed when a sectorial analysis is performed, with the highest AUROCs obtained at the inferior and superior sectors of the superficial capillary plexus in the peripapillary region (0.86 ± 0.03 and 0.87 ± 0.10, respectively). The presented work shows that glaucomatous vascular damage can be assessed using OCTA, and its added value as a complementary feature for glaucoma diagnosis depends on the region of interest. A sectorial analysis of the superficial layer at the peripapillary region is preferable for assessing glaucomatous vascular damage

    Politiebestel in balans? Politiek-bestuurlijke sturing, democratische verantwoording, samenwerking en maatschappelijke inbedding in een nationaal politiebestel

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    Op 1 januari 2013 trad de Politiewet 2012 in werking. Artikel 74 van de wet bepaalt dat de Minister van Justitie en Veiligheid binnen vijf jaar na inwerkingtreding een evaluatie van die wet aan de Staten-Generaal moet sturen over doeltreffendheid en effecten van de wet in de praktijk.In dit rapport staat de vraag centraal hoe de Politiewet 2012 in de praktijk is geïmplementeerd en welke consequenties zich voordoen voor de politieorganisatie en voor de verschillende externe partijen die bij het politiewerk betrokken zijn. De hoofdvraag die aan dit onderzoek ten grondslag ligt, luidt: Hoe kan de werking van de Politiewet 2012 inzake de thema’s (1) politiek bestuurlijke sturing en politiek-democratische verantwoording, (2) samenwerking en (3) maatschappelijke inbedding, worden geëvalueerd?Security and Global Affair

    Short-term surgical complications after radical hysterectomy - a nationwide cohort study

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    Introduction: Centralization has, among other aspects, been argued to have an impact on quality of care in terms of surgical morbidity. Next, monitoring quality of care is essential in identifying areas of improvement. This nationwide cohort study was conducted to determine the rate of short-term surgical complications and to evaluate its possible predictors in women with early-stage cervical cancer. Material and methods: Women diagnosed with early-stage cervical cancer, 2009 FIGO stages IB1 and IIA1, between 2015 and 2017 who underwent radical hysterectomy with pelvic lymphadenectomy in 1 of the 9 specialized medical centers in the Netherlands, were identified from the Netherlands Cancer Registry. Women were excluded if primary treatment consisted of hysterectomy without parametrial dissection or radical trachelectomy. Women in whom radical hysterectomy was aborted during the procedure, were also excluded. Occurrence of intraoperative and postoperative complications and type of complications, developing within 30 days after surgery, were prospectively registered. Multivariable logistic regression analysis was used to identify predictors of surgical complications. Results: A total of 472 women were selected, of whom 166 (35%) developed surgical complications within 30 days after radical hysterectomy. The most frequent complications were urinary retention with catheterization in 73 women (15%) and excessive perioperative blood loss >1000 mL in 50 women (11%). Open surgery (odds ratio [OR] 3.42; 95% CI 1.73-6.76), chronic pulmonary disease (OR 3.14; 95% CI 1.45-6.79), vascular disease (OR 1.90; 95% CI 1.07-3.38), and medical center (OR 2.83; 95% CI 1.18-6.77) emerged as independent predictors of the occurrence of complications. Body mass index (OR 0.94; 95% CI 0.89-1.00) was found as a negative predictor of urinary retention. Open surgery (OR 36.65; 95% CI 7.10-189.12) and body mass index (OR 1.15; 95% CI 1.08-1.22) were found to be independent predictors of excessive perioperative blood loss. Conclusions: Short-term surgical complications developed in 35% of the women after radical hysterectomy for early-stage cervical cancer in the Netherlands, a nation with centralized surgical care. Comorbidities predict surgical complications, and open surgery is associated with excessive perioperative blood loss

    Determining the neurotransmitter concentration profile at active synapses

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    Establishing the temporal and concentration profiles of neurotransmitters during synaptic release is an essential step towards understanding the basic properties of inter-neuronal communication in the central nervous system. A variety of ingenious attempts has been made to gain insights into this process, but the general inaccessibility of central synapses, intrinsic limitations of the techniques used, and natural variety of different synaptic environments have hindered a comprehensive description of this fundamental phenomenon. Here, we describe a number of experimental and theoretical findings that has been instrumental for advancing our knowledge of various features of neurotransmitter release, as well as newly developed tools that could overcome some limits of traditional pharmacological approaches and bring new impetus to the description of the complex mechanisms of synaptic transmission
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