989 research outputs found

    Dutch role in hostage crisis

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    Dutch Amabassador, Paul Brouwer, tells in the Dutch radio programme Argos (5 November 1999) about the good cooperation between the Indonesians, Britsh and Dutch.&nbsp

    How Governance Regimes Shape the Implementation of Water Reuse Schemes

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    The governance dimensions of water reuse scheme development and operation, such as policies and regulatory frameworks, and public involvement and stakeholder collaboration, can serve to both facilitate and constrain wider adoption of water reuse practices. This paper explores the significance and underlying structure of the key governance challenges facing the water reuse sector in Europe. It presents empirical evidence from interviews and focus group sessions conducted at four water reuse schemes: an indirect potable reuse scheme at Torreele (Belgium), the urban reuse of treated municipal wastewater at the London Olympic Park (United Kingdom) and at Sabadell (Spain), and the reuse of agro-industrial effluent for irrigation at Capitanata (Italy). The findings underscore the importance of clarity in policy arrangements around water reuse, as well as of the financial competitiveness of reuse projects compared to alternative water supply options. Operators of water reuse schemes expressed a preference for water quality standards, which focus on appropriateness for use rather than over-emphasise the waters’ origin so that unnecessary treatment and costs can be avoided. Positive public support was widely acknowledged as an important factor in the success or failure of water reuse schemes. We conclude that constructive institutional relationships underpin many of the challenges faced by reuse scheme operators and that greater emphasis should be given to building confidence and gaining trust in water service providers through early identification of how governance regimes shape the viability of new scheme

    Is it really possible to build a bridge between cost-benefit analysis and cost-effectiveness analysis?

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    Cost-benefit analysis (CBA) is a recognised as the economic evaluation technique that accords most with the underlying principles of standard welfare economic theory. However, due to problems associated with the technique, economists evaluating resources allocation decisions in health care have most often used cost-effective analysis (CEA), in which health benefits are expressed in non-monetary units. As a result, attempts have been made to build a welfare economic bridge between cost-benefit analysis (CBA) and cost-effectiveness analysis (CEA). In this paper, we develops these attempts and finds that, while assumptions can be made to facilitate a constant willingness-to-pay per unit of health outcome, these restrictions are highly unrealistic. We develop an impossibility theorem that shows it is not possible to link CBA and CEA if: (i) the axioms of expected utility theory hold; (ii) the quality-adjusted life-year (QALY) model is valid in a welfare economic sense; and (iii) illness affects the ability to enjoy consumption. We conclude that, within a welfare economic framework, it would be unwise to rely on a link between CBA and CEA in economic evaluations

    Influence of social support on return to work after total hip or total knee arthroplasty:a prospective multicentre cohort study

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    OBJECTIVES: There is strong evidence that social support is an important determinant of return to work (RTW). Little is known about the role of social support in RTW after total hip or knee arthroplasty (THA/TKA). Objective was to examine the influence of preoperative and postoperative perceived social support on RTW status 6 months postoperatively. DESIGN: A prospective multicentre cohort study was conducted. SETTING: Orthopaedic departments of four Dutch medical centres; a tertiary university hospital, two large teaching hospitals and a general hospital. PARTICIPANTS: Patients planned to undergo THA/TKA, aged 18-63 and employed preoperatively were included. MAIN OUTCOME MEASURES: Questionnaires were filled out preoperatively and 3 and 6 months postoperatively and included questions to assess patients' perceived social support targeting three sources of social support: from home (friends, family), from work (coworkers, supervisors) and from healthcare (occupational physician, general practitioner, other caregivers). Control variables included age, gender, education, type of arthroplasty and comorbidities. RTW was defined as having fully returned to work 6 months postoperatively. Univariate and multivariate logistic regression analyses were conducted. RESULTS: Enrolled were 190 patients (n=77 THA, n=113 TKA, median age was 56 years, 56% women). The majority returned to work (64%). Preoperatively, social support from the occupational physician was associated with RTW (OR 2.53, 95% CI 1.15 to 5.54). Postoperatively, social support from the occupational physician (OR 3.04, 95% CI 1.43 to 6.47) and the supervisor (OR 2.56, 95% CI 1.08 to 6.06) was associated with RTW. CONCLUSIONS: This study underscores the importance of work-related social support originating from the occupational physician and supervisor in facilitating RTW after primary THA/TKA, both preoperatively and postoperatively. Further research is needed to confirm our results and to understand the facilitating role of social support in RTW, as arthroplasty is being performed on a younger population for whom work participation is critical

    Public responses to water reuse - Understanding the evidence

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    Over the years, much research has attempted to unpack what drives public responses to water reuse, using a variety of approaches. A large amount of this work was captured by an initial review that covered research undertaken up to the early 2000s (Hartley, 2006). This paper showcases post-millennium evidence and thinking around public responses to water reuse, and highlights the novel insights and shifts in emphasis that have occurred in the field. Our analysis is structured around four broad, and highly interrelated, strands of thinking: 1) work focused on identifying the range of factors that influence public reactions to the concept of water reuse, and broadly looking for associations between different factors; 2) more specific approaches rooted in the socio-psychological modelling techniques; 3) work with a particular focus on understanding the influences of trust, risk perceptions and affective (emotional) reactions; and 4) work utilising social constructivist perspectives and socio-technical systems theory to frame responses to water reuse. Some of the most significant advancements in thinking in this field stem from the increasingly sophisticated understanding of the ‘yuck factor’ and the role of such pre-cognitive affective reactions. These are deeply entrenched within individuals, but are also linked with wider societal processes and social representations. Work in this area suggests that responses to reuse are situated within an overall process of technological ‘legitimation’. These emerging insights should help stimulate some novel thinking around approaches to public engagement for water reuse

    Psychosocial Working Conditions Play an Important Role in the Return-to-Work Process After Total Knee and Hip Arthroplasty

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    Purpose Both personal and work-related factors affect return to work (RTW) after total knee arthroplasty (TKA) and total hip arthroplasty (THA). Little is known about work-related factors associated with the recovery process. This study aimed to determine which work-related factors are associated with time to RTW for both TKA and THA patients. Methods A prospective multicenter survey study was conducted that included patients aged 18-63, had a paid job and were scheduled to undergo primary TKA/THA. Surveys were completed preoperatively, 6 weeks, and 3, 6, and 12 months postoperatively, and included four domains of work-related factors: work characteristics, physical working conditions, psychosocial working conditions and work adjustments. Control variables included age, sex, education, and comorbidity. Time to RTW was defined as days from surgery until RTW. Multivariate linear regression analyses were conducted separately for TKA/THA patients. Results Enrolled were 246 patients (n = 146 TKA, n = 100 THA, median age 56 years, 57% female). Median time to RTW was 79 days (IQR 52.0-146.0). Mainly physical tasks (TKA: B 58.2, 95%CI 9.5-106.8; THA: B 52.1, 95%CI 14.1-90.2) and a combination of physical and mental tasks (TKA: B 50.2, 95%CI 6.4-94.0; THA B 54.0, 95%CI 24.2-83.7) were associated with longer time to RTW after both TKA and THA. More possibilities for personal job development (B - 12.8, 95%CI - 25.3-0.4) and more work recognition (B - 13.2, 95%CI - 25.5 to - 0.9) were significantly associated with shorter time to RTW after TKA. Higher quality of supervisor leadership (B - 14.1, 95%CI - 22.2 to - 6.0) was significantly associated with shorter time to RTW after THA. Conclusion The findings of this study stress the importance of psychosocial working conditions, besides type of job tasks, in RTW after TKA/THA. Further research on work-related factors is needed, as arthroplasty is being performed on an increasingly younger population of knee and hip OA patients for whom participating in work is of critical importance

    Preoperative characteristics of working-age patients undergoing total knee arthroplasty

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    Objective Total Knee Arthroplasty (TKA) is performed more in working-age (= 65 years) patients. Aim of this study was therefore to describe demographic, physical, psychological and social characteristics of working TKA patients and to subsequently compare these characteristics with retired TKA patients and the general population. Methods A cross-sectional analysis. Preoperative data of 152 working TKA patients was used. These data were compared with existing data of retired TKA patients in hospital registers and with normative values from literature on the general population. Demographic, physical, psychological and social (including work) characteristics were analyzed. Results The majority (83.8%) of working TKA patients was overweight (42.6%) or obese (41.2%), a majority (72.4%) was dealing with two or more comorbidities, and most (90%) had few depressive symptoms. Mean physical activity level was 2950 minutes per week. Compared to the retired TKA population, working TKA patients perceived significantly more stiffness and better physical functioning and vitality, were more physically active, and perceived better mental health. Compared to the general population working TKA patients perceived worse physical functioning, worse physical health and better mental health, and worked fewer hours. Conclusion This study shows that a majority of working TKA patients are overweight/obese, have multiple comorbidities, but are highly active in light-intensity activities and have few depressive symptoms. Working patients scored overall better on preoperative characteristics than retired patients, and except for physical activity scored overall worse than the general population

    Temperature dependence of spin-orbit torques across the magnetic compensation point in a ferrimagnetic TbCo alloy film

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    The temperature dependence of spin-orbit torques (SOTs) and spin-dependent transport parameters is measured in bilayer Ta/TbCo ferrimagnetic alloy films with bulk perpendicular magnetic anisotropy. We find that the dampinglike (DL)-SOT effective field diverges as temperature is swept through the magnetic compensation temperature (T[subscript M]), where the net magnetization vanishes due to the opposing contributions from the Tb and Co sublattices. We show that DL-SOT scales with the inverse of the saturation magnetization (M[subscript s]), whereas the spin-torque efficiency is independent of the temperature-dependent M [subscript s]. Our findings provide insight into spin transport mechanisms in ferrimagnets and highlight low-M [subscript s] rare-earth/transition-metal alloys as promising candidates for SOT device applications.National Science Foundation (U.S.) (NSF-ECCS-1408172

    Two-year recovery courses of physical and mental impairments, activity limitations, and participation restrictions after total knee arthroplasty among working-age patients.

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    Purpose: Total knee arthroplasty is increasingly performed on working-age individuals, but little is known about their recovery process. Therefore this study examined recovery courses of physical and mental impairments, activity limitations and participation restrictions among working-age total knee arthroplasty recipients. Associated sociodemographic and health-related factors were also evaluated.Materials and methods: A prospective study among working total knee arthroplasty patients (aged 6 months);Closer collaboration between occupational physicians and orthopedic surgeons might result in increased and earlier ability to work full contractual hours;Rehabilitation after TKA should focus on patients with multiple comorbidities, whereby musculoskeletal diseases may even need additional preoperative treatment to optimize outcomes and prevent work disability
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