Redistribution does matter

Peer reviewe

Obama en de strijd tegen IS

Plotseling stond deze zomer de wereld in brand; Oekraïne, Gaza en IS waren opeens dagelijks nieuws. Zoals wel vaker bij een internationaal conflict kijken we met z’n allen naar wat de Verenigde Staten doen. Wat moet Obama met IS en is militair ingrijpen zinvol? De Groene Amsterdammer analyseerde

Demythologizing war journalism: Motivation and role perception of Dutch war journalists

Although, in recent years, considerable research has been done on the hazardous experiences of Anglo-Saxon war journalists, Dutch war journalists have never been the focus of academic attention. The authors thought the experiences of the Dutch might put war journalism in a new light and so they conducted a series of in-depth interviews with 12 Dutch war journalists. In this article, they address two main research questions: what are war journalists’ motives for practising this dangerous occupation and how do they perceive their professional role? The authors compared their findings to previous research on Anglo-Saxon war journalists and on Dutch journalism students and journalists. The most striking conclusion is that, compared to their Anglo-Saxon colleagues, Dutch war journalists are reluctant to present their motivation and work in moral dimensions too eagerly. Instead, all the interviewees frankly acknowledge that they are excited by the experience of war or at least seeking adventure. They equally admit to having chosen the profession partly because of career opportunities. However, this rational attitude of Dutch war journalists does not deter them from moral objectives

Pricing in the hotel and catering sector

A model explaining gross margins in the hotel and catering sector is developed. A cost-mark-up model for the retail sector is used as a starting point. Although we have to reject the hypothesis of mark-up pricing in the hotel and catering sector, the model proves a useful instrument to discriminate between such influences as sales composition, costs and their various components, scale and demand conditions on price setting. Our empirical evidence stems from the Dutch hotel and catering sector (1977 through 1981)

Analysis of 105.000 patients with cancer: have they been discussed in oncologic multidisciplinary team meetings? A nationwide population-based study in the Netherlands

Contains fulltext : 208965.pdf (publisher's version ) (Open Access)INTRODUCTION: For optimal oncological care, it is recommended to discuss every patient with cancer in a multidisciplinary team meeting (MDTM). This is a time consuming and expensive practice, leading to a growing demand to change the current workflow. We aimed to investigate the number of patients discussed in MDTMs and to identify characteristics associated with not being discussed. METHODS: Data of patients with a newly diagnosed solid malignant tumour in 2015 and 2016 were analysed through the nationwide population-based Netherlands Cancer Registry (NCR). We clustered tumour types in groups that were frequently discussed within a tumour-specific MDTM. Tumour types without information about MDTMs in the NCR were excluded. Multivariable logistic regression analyses were used to analyse factors associated with not being discussed. RESULTS: Out of 105.305 patients with cancer, 91% were discussed in a MDTM, varying from 74% to 99% between the different tumour groups. Significantly less frequently discussed were patients aged >/=75 years (odds ratio [OR] = 0.7, 95% confidence interval [CI] = 0.6-0.7), patients diagnosed with disease stage I (OR = 0.5, 95% CI = 0.5-0.6), IV (OR = 0.4, 95% CI = 0.4-0.4) or unknown (OR = 0.2, 95% CI = 0.2-0.2) and patients who received no treatment (OR = 0.3, 95% CI = 0.3-0.3). Patients who received a multidisciplinary treatment were more likely to be discussed in contrary to a monodisciplinary treatment (OR = 4.6, 95% CI = 4.2-5.1). CONCLUSION: In general, most patients with cancer were actually discussed in a MDTM, although differences were observed between tumour groups. Factors associated with not being discussed may, at least partially, reflect the absence of a multidisciplinary question. These results form a starting point for debate on a more durable and efficient new MDTM strategy

Interpretation of the transpulmonary thermodilution curve in the presence of a left-to-right shunt

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Nurses’ worry or concern and early recognition of deteriorating patients on general wards in acute care hospitals: a systematic review

INTRODUCTION:Nurses often recognize deterioration in patients through intuition rather than through routine measurement of vital signs. Adding the 'worry or concern' sign to the Rapid Response System provides opportunities for nurses to act upon their intuitive feelings. Identifying what triggers nurses to be worried or concerned might help to put intuition into words, and potentially empower nurses to act upon their intuitive feelings and obtain medical assistance in an early stage of deterioration. The aim of this systematic review is to identify the signs and symptoms that trigger nurses' worry or concern about a patient's condition.METHODS:We searched the databases PubMed, CINAHL, Psychinfo and Cochrane Library (Clinical Trials) using synonyms related to the three concepts: 'nurses', 'worry/concern' and 'deterioration'. We included studies concerning adult patients on general wards in acute care hospitals. The search was performed from the start of the databases until 14 February 2014.RESULTS:The search resulted in 4,006 records, and 18 studies (five quantitative, nine qualitative and four mixed-methods designs) were included in the review. A total of 37 signs and symptoms reflecting the nature of the criterion worry or concern emerged from the data and were summarized in 10 general indicators. The results showed that worry or concern can be present with or without change in vital signs.CONCLUSIONS:The signs and symptoms we found in the literature reflect the nature of nurses' worry or concern, and nurses may incorporate these signs in their assessment of the patient and their decision to call for assistance. The fact that it is present before changes in vital signs suggests potential for improving care in an early stage of deterioration

The importance of the intensive care unit environment in sleep-A study with healthy participants

Sleep disruption is common among intensive care unit patients, with potentially detrimental consequences. Environmental factors are thought to play a central role in ICU sleep disruption, and so it is unclear why environmental interventions have shown limited improvements in objectively assessed sleep. In critically ill patients, it is difficult to isolate the influence of environmental factors from the varying contributions of non-environmental factors. We thus investigated the effects of the ICU environment on self-reported and objective sleep quality in 10 healthy nurses and doctors with no history of sleep pathology or current or past ICU employment participated. Their sleep at home, in an unfamiliar environment ('Control'), and in an active ICU ('ICU') was evaluated using polysomnography and the Richard-Campbell Sleep Questionnaire. Environmental sound, light and temperature exposure were measured continuously. We found that the control and ICU environment were noisier and warmer, but not darker than the home environment. Sleep on the ICU was perceived as qualitatively worse than in the home and control environment, despite relatively modest effects on polysomnography parameters compared with home sleep: mean total sleep times were reduced by 48 min, mean rapid eye movement sleep latency increased by 45 min, and the arousal index increased by 9. Arousability to an awake state by sound was similar. Our results suggest that the ICU environment plays a significant but partial role in objectively assessed ICU sleep impairment in patients, which may explain the limited improvement of objectively assessed sleep after environmental interventions