A culture change within an organization may be of importance in this turbulent world. An assessment of the current and desired cultural profiles can help estimate as to whether any changes are required. In this study the organizational culture of a housing association was examined from both the staff’s and external stakeholders’ perspectives. How does the current culture compare with the desired culture? Do the external stakeholders perceive the organization’s culture in a similar way? Do the staff’s and external stakeholders’ perceptions coincide with the organization’s intended image? The results demonstrate that the external stakeholders’ perceptions of the organizational culture in this case study are similar to those of the organization’s staff.
Background: Advanced statistical modeling techniques may help predict health outcomes. However, it is not the case that these modeling techniques always outperform traditional techniques such as regression techniques. In this study, external validation was carried out for five modeling strategies for the prediction of the disability of community-dwelling older people in the Netherlands. Methods: We analyzed data from five studies consisting of community-dwelling older people in the Netherlands. For the prediction of the total disability score as measured with the Groningen Activity Restriction Scale (GARS), we used fourteen predictors as measured with the Tilburg Frailty Indicator (TFI). Both the TFI and the GARS are self-report questionnaires. For the modeling, five statistical modeling techniques were evaluated: general linear model (GLM), support vector machine (SVM), neural net (NN), recursive partitioning (RP), and random forest (RF). Each model was developed on one of the five data sets and then applied to each of the four remaining data sets. We assessed the performance of the models with calibration characteristics, the correlation coefficient, and the root of the mean squared error. Results: The models GLM, SVM, RP, and RF showed satisfactory performance characteristics when validated on the validation data sets. All models showed poor performance characteristics for the deviating data set both for development and validation due to the deviating baseline characteristics compared to those of the other data sets. Conclusion: The performance of four models (GLM, SVM, RP, RF) on the development data sets was satisfactory. This was also the case for the validation data sets, except when these models were developed on the deviating data set. The NN models showed a much worse performance on the validation data sets than on the development data sets.
BACKGROUND: Prediction models and prognostic scores have been increasingly popular in both clinical practice and clinical research settings, for example to aid in risk-based decision making or control for confounding. In many medical fields, a large number of prognostic scores are available, but practitioners may find it difficult to choose between them due to lack of external validation as well as lack of comparisons between them.METHODS: Borrowing methodology from network meta-analysis, we describe an approach to Multiple Score Comparison meta-analysis (MSC) which permits concurrent external validation and comparisons of prognostic scores using individual patient data (IPD) arising from a large-scale international collaboration. We describe the challenges in adapting network meta-analysis to the MSC setting, for instance the need to explicitly include correlations between the scores on a cohort level, and how to deal with many multi-score studies. We propose first using IPD to make cohort-level aggregate discrimination or calibration scores, comparing all to a common comparator. Then, standard network meta-analysis techniques can be applied, taking care to consider correlation structures in cohorts with multiple scores. Transitivity, consistency and heterogeneity are also examined.RESULTS: We provide a clinical application, comparing prognostic scores for 3-year mortality in patients with chronic obstructive pulmonary disease using data from a large-scale collaborative initiative. We focus on the discriminative properties of the prognostic scores. Our results show clear differences in performance, with ADO and eBODE showing higher discrimination with respect to mortality than other considered scores. The assumptions of transitivity and local and global consistency were not violated. Heterogeneity was small.CONCLUSIONS: We applied a network meta-analytic methodology to externally validate and concurrently compare the prognostic properties of clinical scores. Our large-scale external validation indicates that the scores with the best discriminative properties to predict 3 year mortality in patients with COPD are ADO and eBODE.
The Water Framework Directive imposes challenges regarding the environmental risk of plastic pollution. The quantification, qualification, monitoring, and risk assessment of nanoplastics and small microplastic (<20 µm) is crucial. Environmental nano- and micro-plastics (NMPs) are highly diverse, accounting for this diversity poses a big challenge in developing a comprehensive understanding of NMPs detection, quantification, fate, and risks. Two major issues currently limit progress within this field: (a) validation and broadening the current analytical tools (b) uncertainty with respect to NMPs occurrence and behaviour at small scales (< 20 micron). Tracking NMPs in environmental systems is currently limited to micron size plastics due to the size detection limit of the available analytical techniques. There are currently no methods that can detect nanoplastics in real environmental systems. A major bottleneck is the incompatibility between commercially available NMPs and those generated from plastic fragments degradation in the environment. To track nanoplastics in environmental and biological systems, some research groups synthesized metal-doped nanoplastics, often limited to one polymer type and using high concentrations of surfactants, rendering these synthesized nanoplastics to not be representative of nanoplatics found in real environment. NanoManu proposes using Electrohydrodynamic Atomization to generate metal doped NMPs of different polymers types, sizes, and shapes, which will be representative of the real environmental nanoplastics. The synthesized nanoplastics will be used as model particles in environmental studies. The synthesized nanoplastics will be characterized and tested using different analytical methods, e.g., SEM-EDX, TEX, GCpyrMS, FFF, µFTIR and SP-ICP-MS. NanoManu is a first and critical step towards generating a comprehensive state-of-the-art analytical and environmental knowledge on the environmental fate and risks of nanoplastics. This knowledge impacts current risk assessment tools, efficient interventions to limit emissions and adequate regulations related to NMPs.
