What makes the best performing hospital?: the IQ Joint study

In dit proefschrift werd onderzoek gedaan naar het verbeteren van feedback voor orthopedisch chirurgen met betrekking tot totale heup- en knieprothesen. Hierbij werd gebruikt gemaakt van het dataregister van de Landelijke Registratie Orthopedische Interventies (LROI). Er werd gevonden dat voor vrijwel alle ziekenhuizen die ‘’slechter’’ presteerde voor revisies binnen een jaar een onderliggende reden kon worden gevonden wat kan leiden tot gerichte kwaliteitverbeterinitiatieven. Daarnaast werd een nieuwe statistische methode getoetst waardoor ‘’beter’’ en ‘’slechter’’ presterende ziekenhuizen sneller kunnen worden geïdentificeerd. Ook werd een geordende samengestelde uitkomst ontwikkeld waardoor de geleverde kwaliteit van zorg in een uitkomst kan worden gevat. Om de effectiviteit van feedback verder te verbeteren werd onderzocht in welke uitkomsten orthopedisch chirurgen geïnteresseerd zijn en op welke manier en met welke frequentie zij de feedback toegestuurd willen krijgen. Deze bevindingen werden gecombineerd met hedendaagse theorieën over effectieve feedback om een kwaliteitverbeterinterventie te ontwikkelen en de effectiviteit te testen in een cluster gerandomiseerde en gecontroleerde trial. Ziekenhuizen die de interventie ontvingen, verbeterden met 4,3% in vergelijking met de controlegroep. Deze bevindingen ondersteunen dat frequente feedback aan chirurgische teams moet worden aangevuld met interactieve educatie en toolbox met daarin kwaliteitverbeterinitiatieven die zijn afgestemd op specifieke uitkomsten om de kwaliteit van zorg met betrekking tot THP en TKP effectief te verbeteren.Van Rens Fonds; Nederlandse Orthopaedische Vereniging; Anna FondsLUMC / Geneeskund

De vele dimensies van Europa

Er wordt op verschillende niveaus politiek bedreven: regionaal, nationaal en internationaal, met elk zijn eigen eigenschappen en actoren. Vaak is de nationale politiek bekender bij de Nederlandse burger, terwijl de internationale politiek, met name de Europese politiek, net zo belangrijk is, zo niet belangrijker. Sinds juli 2004 neemt Sophie in ´t Veld namens D66 zitting in het Europees Parlement. We hebben haar gevraagd ons een inzicht te geven in de politiek op Europees niveau

Celebrating Economies of Change: Brave Visions for Inclusive Futures

This issue has been inspired by a path-breaking conference held by the Canadian Society for Ecologi-cal Economics (CANSEE), which took place this past May 2019 in Waterloo, Ontario. Entitled Engaging Economies of Change, the conference aimed to ex-pand existing research networks in the economy-environment nexus by building connections beyond the academy in order to meaningfully engage with the practicalities of building and implementing change. This issue captures the rich content shared during the event, as well as descriptions of the pro-cesses and efforts made to create a welcoming and respectful space where academics and community activists could build alliances and discuss common challenges. The conference organizers – all graduate students and activists themselves -- called this ‘building a brave space’.This research was supported by the Social Sciences and Humanities Research Council of Canad

Using Goal- and Grip-Related Information for Understanding the Correctness of Other’s Actions: An ERP Study

Detecting errors in other’s actions is of pivotal importance for joint action, competitive behavior and observational learning. Although many studies have focused on the neural mechanisms involved in detecting low-level errors, relatively little is known about error-detection in everyday situations. The present study aimed to identify the functional and neural mechanisms whereby we understand the correctness of other’s actions involving well-known objects (e.g. pouring coffee in a cup). Participants observed action sequences in which the correctness of the object grasped and the grip applied to a pair of objects were independently manipulated. Observation of object violations (e.g. grasping the empty cup instead of the coffee pot) resulted in a stronger P3-effect than observation of grip errors (e.g. grasping the coffee pot at the upper part instead of the handle), likely reflecting a reorienting response, directing attention to the relevant location. Following the P3-effect, a parietal slow wave positivity was observed that persisted for grip-errors, likely reflecting the detection of an incorrect hand-object interaction. These findings provide new insight in the functional significance of the neurophysiological markers associated with the observation of incorrect actions and suggest that the P3-effect and the subsequent parietal slow wave positivity may reflect the detection of errors at different levels in the action hierarchy. Thereby this study elucidates the cognitive processes that support the detection of action violations in the selection of objects and grips

Conceptual knowledge for understanding other’s actions is organized primarily around action goals

Semantic knowledge about objects entails both knowing how to grasp an object (grip-related knowledge) and what to do with an object (goal-related knowledge). Considerable evidence suggests a hierarchical organization in which specific hand-grips in action execution are most often selected to accomplish a remote action goal. The present study aimed to investigate whether a comparable hierarchical organization of semantic knowledge applies to the recognition of other’s object-directed actions as well. Correctness of either the Grip (hand grip applied to the object) or the Goal (end-location at which an object was directed) were manipulated independently in two experiments. In Experiment 1, subjects were required to attend selectively to either the correctness of the grip or the goal of the observed action. Subjects were faster when attending to the goal of the action and a strong interference of goal-violations was observed when subjects attended to the grip of the action. Importantly, observation of irrelevant goal- or grip-related violations interfered with making decisions about the correctness of the relevant dimension only when the relevant dimension was correct. In contrast, in Experiment 2, when subjects attended to an action-irrelevant stimulus dimension (i.e. orientation of the object), no interference of goal- or grip-related violations was found, ruling out the possibility that interference-effects result from perceptual differences between stimuli. These findings suggest that understanding the correctness of an action selectively recruits specialized, but interacting networks, processing the correctness of goal- and grip-specific information during action observation

Children with language delay referred to Dutch speech and hearing centres: caseload characteristics

Background: Early detection and remediation of language disorders are important in helping children to establish appropriate communicative and social behaviour and acquire additional information about the world through the use of language. In the Netherlands, children with (a suspicion of) language disorders are referred to speech and hearing centres for multidisciplinary assessment. Reliable data are needed on the nature of language disorders, as well as the age and source of referral, and the effects of cultural and socioeconomic profiles of the population served in order to plan speech and language therapy service provision. Aims: To provide a detailed description of caseload characteristics of children referred with a possible language disorder by generating more understanding of factors that might influence early identification. Methods & Procedures: A database of 11,450 children was analysed consisting of data on children, aged 2–7 years (70% boys, 30% girls), visiting Dutch speech and hearing centres. The factors analysed were age of referral, ratio of boys to girls, mono- and bilingualism, nature of the language delay, and language profile of the children. Outcomes & Results: Results revealed an age bias in the referral of children with language disorders. On average, boys were referred 5 months earlier than girls, and monolingual children were referred 3 months earlier than bilingual children. In addition, bilingual children seemed to have more complex problems at referral than monolingual children. They more often had both a disorder in both receptive and expressive language, and a language disorder with additional (developmental) problems. Conclusions & Implications: This study revealed a bias in age of referral of young children with language disorders. The results implicate the need for objective language screening instruments and the need to increase the awareness of staff in primary child healthcare of red flags in language development of girls and multilingual children aiming at earlier identification of language disorders in these children. What this paper adds What is already known on the subject Identifying language disorders before children enter school can foster the initiation of early interventions before these problems interfere with formal education and behavioural adjustment. Information on caseload characteristics is important to plan speech and language therapy service provision. There are only a few studies on the caseload characteristics of children at first referral for language assessment. What this paper adds to existing knowle

Risk factors and control measures for subclinical salmonella infection in pig herds

In the last 20 years there was an enormous increase in pig production in several parts of the European Union. After entering of disease agents in such areas it is very easy for them to spread and to persist in the pig population. This has resulted in a situation in which a lot of pathogens continually occur in the pig population. The size of the pig farming operations and the small geographical distance between them makes it almost impossible to eliminate most of the disease agents from the populations. On the other hand there is a development in the EU-regulations that requires more and more guarantees with respect to the absence of some pathogens in the population in a non-vaccination policy. Only countries able to comply with these requirements have free entrance to the European market. A second development in this field is the increasing interest in a high quality standard of the products at the end of the pig production chain; first of all in relation to the safety of the product linked to residues and zoonoses, but further to the meat quality and at last the emotional quality for the consumer. These developments have lead to a health control policy in swine production that is based on two different tracks: the safeguarding strategy and the controlling strategy

Higher healing rate after meniscal repair with concomitant ACL reconstruction for tears located in vascular zone 1 compared to zone 2: a systematic review and meta-analysis

Purpose The purpose of this study was to determine and compare the percentage of completely healed meniscal tears after arthroscopic repair combined with anterior cruciate ligament reconstruction (ACLR) for the different vascular zones of the meniscus. Methods PubMed, Embase, Web of Science, Cochrane library and Emcare were searched on 19 May 2020 for articles reporting healing rates after arthroscopic meniscal repair with concomitant ACLR for the different meniscal vascular zones as assessed by second-look arthroscopy. Data on meniscal tears were extracted as located in zones 1, 2 or 3, according to the Cooper classification. Studies were graded in quality using a modified Newcastle-Ottawa Scale. Pooled analyses were performed utilizing a random-effects model. Meta-analyses were performed using R version 3.6.2 and SPSS statistical software version 25.0. The study was registered with PROSPERO (ID:CRD42020176175). Results Ten observational cohort studies met the inclusion criteria, accounting for 758 meniscal tear repairs in total. The pooled overall proportion of healing was 78% (95% CI 72-84%). The mean weighted proportion of healing was 83% (95% CI 76-90%) for studies (n = 10) reporting zone 1 tears and 69% (95% CI 59-79%) for studies (n = 9) reporting zone 2 tears. No study reported healing rates for zone 3 tears. The pooled overall odds ratio was 2.5 (95% CI 1.00-6.02), indicating zone 1 tears as 2.5 times more likely to heal than zone 2 tears. Conclusion This study demonstrates that meniscal tears localized in vascular zone 1 were more likely to heal than those in zone 2.Orthopaedics, Trauma Surgery and Rehabilitatio