European Compliance Benchmark - The Netherlands

The European Compliance Benchmark is the output of the Legal Research Group organised by ELSA International in cooperation with K&L Gates. 24 participating countries researched the national legislation concerning corporate criminal and regulatory liability covering the topics of anti-corruption, fraud, anti-money laundering, sanctions, prosecution and enforcement authorities. The Report was presented and discussed during the concluding European Compliance Conference in Brussels in September 2017

Data from: Patients’ experiences with a behaviour change intervention to enhance physical activity in primary care: a mixed methods study

Objective: To explore the experiences of patients at risk for cardiovascular disease in primary care with the Activate intervention in relation to their success in increasing their physical activity. Methods: A convergent mixed-methods design, parallel to a cluster-randomised controlled trial in primary care, using a questionnaire and semi-structured interviews was conducted. Questionnaires from 67 patients were analysed, and semi-structured interviews of 22 patients were thematically analysed. Experiences of patients who had objectively increased their physical activity (responders) were compared to those who had not (non-responders). Objective success was analysed in relation to self-perceived success. Results: The questionnaire and interview data corresponded, and no substantial differences among responders and non-responders emerged. Participating in the intervention increased their awareness of their physical activity and their physical activity level. Key components of the intervention were nurses' subsequent consultations and trustful support and the use of self-monitoring tools. Patients highly valued jointly setting goals, planning actions, receiving feedback and review on their goal attainment and jointly solving problems. Nurses' support, using self-monitoring tools, and involving others incentivised patients. Internal circumstances and external circumstances challenged patients' engagement in increasing and maintaining their physical activity. Conclusion: Patients experienced the Activate intervention as valuable to increase and maintain their physical activity, irrespective of their objective change in physical activity. The findings enable the understanding of the effectiveness of the intervention and implementation in primary care. Trial registration: ClinicalTrials.gov NCT0272520

Patients' experiences with a behaviour change intervention to enhance physical activity in primary care : A mixed methods study

Objective :To explore the experiences of patients at risk for cardiovascular disease in primary care with the Activate intervention in relation to their success in increasing their physical activity. Methods: A convergent mixed methods study was conducted, parallel to a cluster-randomised controlled trial in primary care, using a questionnaire and semi-structured interviews. Questionnaires from 67 patients were analysed, and semi-structured interviews of 22 patients were thematically analysed. Experiences of patients who had objectively increased their physical activity (responders) were compared to those who had not (non-responders). Objective success was analysed in relation to self-perceived success. Results: The questionnaire and interview data corresponded, and no substantial differences among responders and non-responders emerged. Participating in the intervention increased patients' awareness of their physical activity and their physical activity level. Key components of the intervention were the subsequent support of nurses with whom patients' have a trustful relationship and the use of self-monitoring tools. Patients highly valued jointly setting goals, planning actions, receiving feedback and review on their goal attainment and jointly solving problems. Nurses' support, the use of self-monitoring tools, and involving others incentivised patients to increase their physical activity. Internal circumstances and external circumstances challenged patients' engagement in increasing and maintaining their physical activity. Conclusion: Patients experienced the Activate intervention as valuable to increase and maintain their physical activity, irrespective of their objective change in physical activity. The findings enable the understanding of the effectiveness of the intervention and implementation in primary care

PET Imaging and Protein Expression of Prostate-Specific Membrane Antigen in Glioblastoma:A Multicenter Inventory Study

Upregulation of prostate-specific membrane antigen (PSMA) in neovasculature has been described in glioblastoma multiforme (GBM), whereas vasculature in nonaffected brain shows hardly any expression of PSMA. It is unclear whether PSMA-targeting tracer uptake on PET is based on PSMA-specific binding to neovasculature or aspecific uptake in tumor. Here, we quantified uptake of various PSMA-targeting tracers in GBM and correlated this with PSMA expression in tumor biopsy samples from the same patients. Methods: Fourteen patients diagnosed with de novo (n 5 8) or recurrent (n 5 6) GBM underwent a preoperative PET scan after injection of 1.5 MBq/kg [ 68Ga]Ga-PSMA-11 (n 5 7), 200 MBq of [ 18F]DCFpyl (n 5 3), or 200 MBq of [ 18F]PSMA-1007 (n 5 4). Uptake in tumor and tumor-to-background ratios, with contralateral nonaffected brain as background, were determined. In a subset of patients, PSMA expression levels from different regions in the tumor tissue samples (n 5 40), determined using immunohistochemistry (n 5 35) or RNA sequencing (n 5 13), were correlated with tracer uptake on PET. Results: Moderate to high (SUV max, 1.3–20.0) heterogeneous uptake was found in all tumors irrespective of the tracer type used. Uptake in nonaffected brain was low, resulting in high tumor-to-background ratios (6.1–359.0) calculated by dividing SUV max of tumor by SUV max of background. Immunohistochemistry showed variable PSMA expression on endothelial cells of tumor microvasculature, as well as on dispersed individual cells (of unknown origin), and granular staining of the neuropil. No correlation was found between in vivo uptake and PSMA expression levels (for immunohistochemistry, r 5 20.173, P 5 0.320; for RNA, r 5 20.033, P 5 0.915). Conclusion: Our results indicate the potential use of various PSMA-targeting tracers in GBM. However, we found no correlation between PSMA expression levels on immunohistochemistry and uptake intensity on PET. Whether this may be explained by methodologic reasons, such as the inability to measure functionally active PSMA with immunohistochemistry, tracer pharmacokinetics, or the contribution of a disturbed blood–brain barrier to tracer retention, should still be investigated.</p