Introduction: Retrospective studies suggest that a rapid initiation of treatment results in a better prognosis for patients in the emergency department. There could be a difference between the actual medication administration time and the documented time in the electronic health record. In this study, the difference between the observed medication administration time and documentation time was investigated. Patient and nurse characteristics were also tested for associations with observed time differences. Methods: In this prospective study, emergency nurses were followed by observers for a total of 3 months. Patient inclusion was divided over 2 time periods. The difference in the observed medication administration time and the corresponding electronic health record documentation time was measured. The association between patient/nurse characteristics and the difference in medication administration and documentation time was tested with a Spearman correlation or biserial correlation test. Results: In 34 observed patients, the median difference in administration and documentation time was 6.0 minutes (interquartile range 2.0-16.0). In 9 (26.5%) patients, the actual time of medication administration differed more than 15 minutes with the electronic health record documentation time. High temperature, lower saturation, oxygen-dependency, and high Modified Early Warning Score were all correlated with an increasing difference between administration and documentation times. Discussion: A difference between administration and documentation times of medication in the emergency department may be common, especially for more acute patients. This could bias, in part, previously reported time-to-treatment measurements from retrospective research designs, which should be kept in mind when outcomes of retrospective time-to-treatment studies are evaluated.
This paper describes the work that is done by a group of I3 students at Philips CFT in Eindhoven, Netherlands. I3 is an initiative of Fontys University of Professional Education also located in Eindhoven. The work focuses on the use of computer vision in motion control. Experiments are done with several techniques for object recognition and tracking, and with the guidance of a robot movement by means of computer vision. These experiments involve detection of coloured objects, object detection based on specific features, template matching with automatically generated templates, and interaction of a robot with a physical object that is viewed by a camera mounted on the robot.
INTRODUCTION: The aim of this study was to determine the degree of ROM limitations of extremities, joints and planes of motion after burns and its prevalence over time.METHOD: The database of a longitudinal multicenter cohort study in the Netherlands (2011-2012) was used. From patients with acute burns involving the neck, shoulder, elbow, wrist, hip, knee and ankle joints that had surgery, ROM of 17 planes of motion was assessed by goniometry at 3, 6 weeks, 3-6-9 and 12 months after burns and at discharge.RESULTS: At 12 months after injury, 12 out of 17 planes of motion demonstrated persistent joint limitations. The five unlimited planes of motion were all of the lower extremity. The most severely limited joints at 12 months were the neck, ankle, wrist and shoulder. The lower extremity was more severely limited in the early phase of recovery whereas at 12 months the upper extremity was more severely limited.CONCLUSION: The degree of ROM limitations and prevalence varied over time between extremities, joints and planes of motion. This study showed which joints and planes of motion should be watched specifically concerning the development of scar contracture.
The pipelines are buried structures. They move together with the soil during a seismic event. They are affected from ground motions. The project aims to find out the possible effects of Groningen earthquakes on pipelines of Loppersum and Slochteren.This project is devised for conducting an initial probe on the available data to see the possible actions that can be taken, initially on these two pilot villages, Loppersum and Slochteren, for detecting the potential relationship between the past damages and the seismic activity.Lifeline infrastructure, such as water mains and sewerage systems, covering our urbanised areas like a network, are most of the times, sensitive to seismic actions. This sensitivity can be in the form of extended damage during seismic events, or other collateral damages, such as what happened in Christchurch Earthquakes in 2011 in New Zealand when the sewerage system of the city was filled in with tonnes of sand due to liquefaction.Regular damage detection is one of key solutions for operational purposes. The earthquake mitigation, however, needs large scale risk studies with expected spatial distribution of damages for varying seismic hazard levels.
In our increasingly global society, organizations face many opportunities in innovation, improved productivity and easy access to talent. At the same time, one of the greatest challenges, businesses experience nowadays, is the importance of social and/or human capital for their effectiveness and success (Backhaus and Tikoo, 2004; Mosley, 2007; Theurer et al., 2018; Tumasjan et al., 2020). High-quality employees are crucial to the competitive strength of an organization in the global economy, as these employees have a major influence on organizational reputation (Dowling at al., 2012). An important question is how, under these global circumstances, organizations and companies in the Netherlands can best be stimulated to attract and preserve social capital.Several studies have suggested the scarcity of talent and the crucial importance of gaining competitive advantage with recruitment communication to find the fit between personal and fundamental organizational characteristics and values for employees (Cable and Edwards, 2004; Bhatnagar and Srivastava, 2008; ManPower Group, 2014; European Communication Monitor (ECM), 2018). In order to become an employer of choice, organizations have to not only stand out from the crowd during the recruitment process but work on developing loyalty and a culture of trust in their relationship with employees (ECM, 2018). Employer Branding focuses on the process of promoting an organization, as the “employer of choice” to a desired target group, which an organization aims to attract and retain. This process encompasses building an identifiable and unique employer identity or, more specifically, “the promotion of a unique and attractive image” as an employer (Backhaus 2004, p. 117; Backhaus and Tikoo 2004, p. 502).One of the biggest challenges in the North of the Netherlands at the moment is the urgent need for qualified labor in the IT, energy and healthcare sectors and the excess supply of international graduates who are able to find a job in the North of the Netherlands (AWVN, 2019). Talent development, as part of the regional labor market and education policy, has been an important part of government programs and strategies in the region (VNO-NCW Noord, 2018). For instance, North Netherlands Alliance (SNN) signed a Northern Innovation Agenda for the 2014-2020 period. SNN encourages, facilitates and connects ambitions focused on the development of the Northern Netherlands. Also, the Social Economic council North Netherlands issued an advice on the labour market in the North Netherlands (SER Noord Nederland, 2017). Knowledge institutions also contribute through employability programs. Another example is the Regional Talent Agreement (Talent Akkoord) framework issued by the Groningen educational institutions, employers and employees’ organizations and regional authorities in which they jointly commit to recruiting, training, retaining and developing talent for the Northern labor market. Most of the hires with a maximum of five year of experience at companies are represented by millennials. To learn what values make an attractive brand for employees in the of the North of the Netherlands, we conducted a first study. When ranking the most important values of corporate culture which matter to young employees, they mention creative freedom, purposeful work, flexibility, work-life balance as well as personal development. Whereas attractive workplace and job security do not matter to such a degree. A positive work environment and a good relationship with colleagues are valued highly (Hein, 2019).To date, as far as we know, no other employer branding studies have been carried out for the North of the Netherlands. Further insight is needed into the role of employer branding as a powerful tool to retain talent in Northern industry in particular.The goal of this study is to provide a detailed analysis of the regional industry in the Northern Netherlands and contribute to: 1) the scientific body of knowledge about whether and how employer branding can strengthen the attractiveness of a regional industry in the labor market; 2) the application of this knowledge and insights by companies and governments in local policy development in the North of the Netherlands.
In leaving the more traditional territories of the concert performance for broader societal contexts, professional musicians increasingly devise music in closer collaboration with their audience rather than present it on a stage. Although the interest for such forms of devising co-creative musicking within the (elderly) health care sector is growing, the work can be considered relatively new. In terms of research, multiple studies have sought to understand the impact of such work on musicians and participants, however little is known about what underpins the musicians’ actions in these settings. With this study, I sought to address this gap by investigating professional musicians’ emerging practices when devising co-creative musicking with elderly people. Three broad concepts were used as a theoretical background to the study: Theory of Practice, co-creative musicking, and Praxialism. Firstly, I used Theory of Practice to help understand the nature of emerging practices in a wider context of change in the field of music and habitus of musicians and participants. Theory of Practice enabled me to consider a practice as “a routinized type of behaviour which consists of several elements, interconnected to one another: forms of bodily activities, forms of mental activities, ‘things’ and their use, a background knowledge in the form of understanding, know-how, states of emotion, and motivational knowledge” (Reckwitz, 2002, p. 249). Secondly, I drew the knowledge from co-creative musicking, which is a concept I gathered from two existing concepts: co-creation and musicking. Musicking (Small, 1998), which considers music as something we do (including any mode of engagement with music), provided a holistic and inclusive way of looking at participation in music-making. The co-creation paradigm encompasses a view on enterprise that consists of bringing together parties to jointly create an outcome that is meaningful to all (Prahalad & Ramaswamy, 2004; Ramaswamy & Ozcan, 2014). The concept served as a lens to specify the jointness of the musicking and challenge issues of power in the engagement of participants in the creative-productive process. Thirdly, Praxialism considers musicking as an activity that encompasses “musical doers, musical doing, something done and contexts in which the former take place” (Elliott, 1995). Praxialism sets out a vision on music that goes beyond the musical work and includes the meanings and values of those involved (Silverman, Davis & Elliott, 2014). The concept allowed me to examine the work and emerging relationships as a result of devising co-creative musicking from an ethical perspective. Given the subject’s relative newness and rather unexplored status, I examined existing work empirically through an ethnographic approach (Hammersley & Atkinson, 2007). Four cases were selected where data was gathered through episodic interviewing (Flick, 2009) and participant observation. Elements of a constructivist Grounded Theory (Charmaz, 2014) were used for performing an abductive analysis. The analysis included initial coding, focused coding, the use of sensitizing concepts (Blumer 1969 in Hammersley, 2013) and memoing. I wrote a thick description (Geertz, 1973) for each case portraying the work from my personal experience. The descriptions are included in the dissertation as one separate chapter and foreshadow the exposition of the analysis in a next chapter. In-depth study of the creative-productive processes of the cases showed the involvement of multiple co-creative elements, such as a dialogical interaction between musicians and audience. However, participants’ contributions were often adopted implicitly, through the musicians interpreting behaviour and situations. This created a particular power dynamic and challenges as to what extent the negotiation can be considered co-creative. The implicitness of ‘making use’ of another person’s behaviour with the other not (always) being aware of this also triggered an ethical perspective, especially because some of the cases involved participants that were vulnerable. The imbalance in power made me examine the relationship that emerges between musicians and participants. As a result of a closer contact in the co-creative negotiation, I witnessed a contact of a highly personal, sometimes intimate, nature. I recognized elements of two types of connections. One type could be called ‘humanistic’, as a friendship in which there is reciprocal care and interest for the other. The other could be seen as ‘functional’, which means that the relationship is used as a resource for providing input for the creative musicking process. From this angle, I have compared the relationship with that of a relationship of an artist with a muse. After having examined the co-creative and relational sides of the interaction in the four cases, I tuned in to the musicians’ contribution to these processes and relationships. I discovered that their devising in practice consisted of a continuous double balancing act on two axes: one axis considers the other and oneself as its two ends. Another axis concerns the preparedness and unpredictability at its ends. Situated at the intersection of the two axes are the musicians’ intentionality, which is fed by their intentions, values and ethics. The implicitness of the co-creation, the two-sided relationship, the potential vulnerability of participants, and the musicians’ freedom in navigating and negotiation, together, make the devising of co-creative musicking with elderly people an activity that involves ethical challenges that are centred around a tension between prioritizing doing good for the other, associated with a eudaimonic intention, and prioritizing values of the musical art form, resembling a musicianist intention. The results therefore call for a musicianship that involves acting reflectively from an ethical perspective. Doctoral study by Karolien Dons
