Low Hartmann’s procedure or intersphincteric proctectomy for distal rectal cancer: a retrospective comparative cohort study

Purpose: Two non-restorative options for low rectal cancer not invading the sphincter are the low Hartmann’s procedure (LH) or intersphincteric proctectomy (IP). The aim of this study was to compare postoperative morbidity with emphasis on pelvic abscesses after LH and IP. Methods: All patients that had LH or IP for low rectal cancer were included in three centres between 2008 and 2014 in this retrospective cohort study. Follow-up was performed for at least 12 months. Results: A total of 52 patients were included: 40 LH and 12 IP. Median follow-up was 29 months (IQR 23). There were no differences between groups in gender, age and ASA classification. Seven patients in the LH group (18%) and four patients in the IP group (33%) developed a complication within 30-day postoperative with a Clavien-Dindo classification grade III or higher (P = 0.253). Four out of 40 patients (10%) in the LH group and two out of 12 patients (17%) in the IP group developed a pelvic abscess (P = 0.612). Reinterventions were performed in 11 (28%) patients in the LH group and five (42%) patients in the IP group (P = 0.478), with a total number of reinterventions of 13 and 20, respectively. Six and 15 interventions were related to pelvic abscesses, respectively. Conclusion: Pelvic abscesses seem to occur in a similar rate after both LH and IP. Previous reports from the literature suggesting that IP might be associated with less infectious pelvic complications compared to LH are not supported by this study, although numbers are small

De effectiviteit van de training ‘Coachend Leidinggeven’

Huidig onderzoek meet de effectiviteit van de training ‘Coachend Leidinggeven’ bij deelnemers van de training. Er wordt verwacht dat de deelnemers meer gebruik maken van de stijl coachend leiderschap door de training en minder gebruik maken van andere stijlen van leiderschap, zoals passief, autocratisch en transactioneel leiderschap. Er wordt tevens verwacht dat de communicatiestijl van de deelnemers verbeterd aangezien communicatie wordt behandeld in de training. Tevens worden er moderator variabelen meegenomen in het onderzoek, aangezien het leereffect per individu kan verschillen. Openheid tot ervaring wordt meegenomen als moderator variabele, waarbij er verwacht wordt dat mensen die openstaan voor nieuwe ervaringen sneller zullen leren van de training. Jongere mensen zullen, naar verwachting, meer leren van de training. En deelnemers met veel ervaring als leidinggevende en deelnemers die eerdere trainingen hebben gevolgd zullen minder veel leren ten opzichte van minder ervaren deelnemers, omdat de ervaren deelnemers al over veel kennis beschikken. Het onderzoek werd uitgevoerd een real-life setting en het onderzoek heeft in totaal acht maanden geduurd. Uit onderzoek blijkt dat deelnemers meer gebruik gaan maken van coachend leiderschapsgedrag na de training. Tevens gaan ze meer gebruik maken van transactioneel en autocratisch leiderschap. Passief leiderschap wordt na de training niet meer of minder gebruikt door de deelnemers. Het inzicht in de eigen communicatie blijft hetzelfde bij de deelnemers. Tenslotte worden er geen relaties gevonden voor de moderator variabelen. Het huidig onderzoek is beperkt, door onder andere een kleine onderzoekssample. De training heeft waarschijnlijk meer de focus op situationeel leiderschap in plaats van coachend leiderschap. Huidig onderzoek geeft veel suggesties voor vervolgonderzoek, zoals het gebruik van meerdere beoordelaars om het gedrag van deelnemers te meten

Preliminary examination of the perceptions of sustainable horse feeding practices in the Netherlands.

The purpose of this study was to determine the perception of sustainability among horse owners in the Netherlands and their willingness to switch to more sustainable feeding practices. A survey was distributed to a target group of horse owners in the Netherlands via social media channels. Data (n = 338 valid responses) were stratified based on yard type and size (small (50 horses). Most of the yards were livery yards (68 %) and they were small in size (66 %). The term most commonly associated with sustainability was low environmental impact (61.8 %). All participants (338/338) indicated that they were willing to switch to more sustainable feeding practices. Of the six options offered, the most popular was the use of plastic-free packaging products (60.5 %). This study identified that numerically the greatest change in behavior for the Dutch equestrian community would be achieved by small livery yards (P < 0.001). The potential to modify certain practices might be limited by the size of the equestrian operation, such as the available land for altering pasture management, and the financial aspects of the enterprise. Future research should investigate how the scale and economic considerations of the equestrian business influence its capacity and willingness to adopt more sustainable feeding practices.fals

The Self-Curating Musician: An Innovative Concept and an Intensive Learning Experience by Systemic Design Thinking

Self-curation is an emerging notion in the artistic practice that we propose as an alternative to the questioned notion of entrepreneurship in the realm of classical music. Systemic Design Thinking (SDT) methods helped conceptualize self-curation and develop an intensive, week-long learning experience. Participants validated the self-curation concept and its five components: activating creativity, seeking uniqueness, developing a discourse, understanding the performance practice and engaging communities. Our study further highlights that rather than suffering from a tension between arts and commerce, young (performing) musicians experience a tension between the expectation of the outside world that they need to be exceptional as an artist, and the inner desire of being a typical worker with regular working conditions and ‘normal lives’. The awareness that someone can manifest the creativity that someone already possesses and that someone belongs to an artistic community alleviates the pressure experienced in the transition from education to work. We develop insights into multifaceted and challenging self-curation careers