Background Ethnic differences in colon cancer (CC) care were shown in the United States, but results are not directly applicable to European countries due to fundamental healthcare system differences. This is the first study addressing ethnic differences in treatment and survival for CC in the Netherlands. Methods Data of 101,882 patients diagnosed with CC in 1996–2011 were selected from the Netherlands Cancer Registry and linked to databases from Statistics Netherlands. Ethnic differences in lymph node (LN) evaluation, anastomotic leakage and adjuvant chemotherapy were analysed using stepwise logistic regression models. Stepwise Cox regression was used to examine the influence of ethnic differences in adjuvant chemotherapy on 5-year all-cause and colorectal cancer-specific survival. Results Adequate LN evaluation was significantly more likely for patients from ‘other Western’ countries than for the Dutch (OR 1.09; 95% CI 1.01–1.16). ‘Other Western’ patients had a significantly higher risk of anastomotic leakage after resection (OR 1.24; 95% CI 1.05–1.47). Patients of Moroccan origin were significantly less likely to receive adjuvant chemotherapy (OR 0.27; 95% CI 0.13–0.59). Ethnic differences were not fully explained by differences in socioeconomic and hospital-related characteristics. The higher 5-year all-cause mortality of Moroccan patients (HR 1.64; 95% CI 1.03–2.61) was statistically explained by differences in adjuvant chemotherapy receipt. Conclusion These results suggest the presence of ethnic inequalities in CC care in the Netherlands. We recommend further analysis of the role of comorbidity, communication in patient-provider interaction and patients’ health literacy when looking at ethnic differences in treatment for CC.
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This thesis focuses on the relationship between ethnic composition and both schooling outcomes and classroom behaviour, making the crucial distinction between the share of migrant-origin students and ethnic diversity. Ethnic school composition is seen as one of the explanations for the inequality of school performance between native- and migrant-origin students in Western societies. Although the use of the concept migrant origin is contested concept, the relationship between ethnic school composition and school performance is of interest to policymakers and social scientists in both the United States and Europe.
Background: Recent studies suggest that ethnic minority students underperform in standardised assessments commonly used to evaluate their progress. This disparity seems to also hold for postgraduate medical students and GP trainees, and may affect the quality of primary health care, which requires an optimally diverse workforce. Aims: To address the following: 1) to determine to what extent ethnic minority GP trainees are more at risk of being assessed as underperforming than their majority peers; 2) to investigate whether established underperformance appears in specific competence areas; and 3) to explore first and second-generation ethnic minority trainees’ deviations. Design & setting: Quantitative retrospective cohort design in Dutch GP specialty training (start years: 2015–2017). Method: In 2020–2021, the authors evaluated files on assessed underperformance of 1700 GP trainees at seven Dutch GP specialty training institutes after excluding five opt-outs and 165 incomplete datasets (17.4% ethnic minority trainees). Underperformance was defined as the occurrence of the following, which was prompted by the training institute: 1) preliminary dropout; 2) extension of the educational pathway; and/or 3) mandatory coaching pathways. Statistics Netherlands (CBS) anonymised the files and added data about ethnic group. Thereafter, the authors performed logistic regression for potential underperformance analysis and χ2 tests for competence area analysis. Results: Ethnic minority GP trainees were more likely to face underperformance assessments than the majority group (odds ratio [OR] 2.41, 95% confidence interval [CI] = 1.67 to 3.49). Underperformance was not significantly nested in particular competence areas. First-generation ethnic minority trainees seemed more at risk than their second-generation peers. Conclusion: Ethnic minority GP trainees seem more at risk of facing educational barriers than the majority group. Additional qualitative research on underlying factors is essential.
Cities across the globe are facing population ageing, which poses many unsolved challenges. Regional, national and European research strategies (including EU4Health) have a strong relation with healthy and active ageing, and stimulate the exchange of best practices to create age-inclusive societies across the continent. Over 1500 cities joined the Global Network for Age Friendly Cities and Communities of the World Health Organization (WHO), which follow a 5-year cycle of planning, implementation and evaluation in order to achieve goals. The Hague (2015) has been an active member of the Network. In the Western Balkans, only Tuzla (2023) is a member. Both the WHO and THUAS seek further expansion of their reach and want to build capacity in the Western Balkans, which is achieved through existing contacts with Mother Teresa University. The Institute for Social Activities in Skopje see THUAS’s age-friendly actions as a stepping stone for a better understanding of ageing well in their ethnically diverse city. Organisations in bordering countries have indicated their interest to join efforts during the annual Towards Sustainable Development Conference. They seek an extension to other countries of the Western Balkans that have previously largely been left out of the European research agenda. Therefore, The Age-friendly Balkans Connected Network seeks to (1) form regional knowledge and action eco-systems through capacity-building, and (2) provide cities with an instrument for a baseline assessment of their age-friendliness. For this purpose, we use the existing Age-Friendly Cities and Communities Questionnaire that was developed at THUAS in 2020 and which has been validated in Albanian and Macedonian. The Network trusts that new national ecosystems and tools can contribute to future age-friendly actions and European grant applications. In the words of Mother Teresa (born in Skopje): “Yesterday is gone. Tomorrow has not yet come. We have only today. Let us begin.”
The increasing concentration of people in urban environments in an era of globalisation means that social, economic, and environmental resources for living and working are under pressure. Urban communities experience increased stress levels due to inadequate and overburdened infrastructure and services, challenges due to ethnic and cultural diversity, socio-economic inequalities as well as the impact of environmental degradation. For these communities to build resilience under these circumstances therefore requires a multipronged approach. The underlying question this project will answer is: “What are the key characteristics of experiencescapes that contribute to resilience-building in communities?” The project will dive into the identification of building blocks of experiencescapes and roles of relevant actors that can support communities in building resilience. Within the context of a multidisciplinary approach, this project applies a range of qualitative research methods, such as in-depth interviews, focus groups, participant observation, storytelling techniques, life stories, as well as various biometric quantitative methods, available through the experience lab of BUas. The outcome of the project will enable practitioners and researchers alike in various sectors to understand what and how they can contribute to creating an environment in which people can meaningfully interact in a way that builds resilience in communities. This outcome is communicated not only through academic publications and conference contributions, but also through public reports and a handbook for practitioners and students. These reports and handbooks support identification and application of building blocks of experiencescapes that support building resilience in communities. Finally, the knowledge generated in the project will contribute to the development of curricula of various educational programmes at Breda University of Applied Sciences by expanding the scope of experience design into the area of people-to-people relationships.
