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Sample records for dutch national implementation

  1. Implementation of the external cephalic version in breech delivery. Dutch national implementation study of external cephalic version.

    Science.gov (United States)

    Vlemmix, Floortje; Rosman, Ageeth N; Fleuren, Margot A H; Rijnders, Marlies E B; Beuckens, Antje; Haak, Monique C; Akerboom, Bettina M C; Bais, Joke M J; Kuppens, Simone M I; Papatsonis, Dimitri N; Opmeer, Brent C; van der Post, Joris A M; Mol, Ben Willem J; Kok, Marjolein

    2010-05-10

    Breech presentation occurs in 3 to 4% of all term pregnancies. External cephalic version (ECV) is proven effective to prevent vaginal breech deliveries and therefore it is recommended by clinical guidelines of the Royal Dutch Organisation for Midwives (KNOV) and the Dutch Society for Obstetrics and Gynaecology (NVOG). Implementation of ECV does not exceed 50 to 60% and probably less.We aim to improve the implementation of ECV to decrease maternal and neonatal morbidity and mortality due to breech presentations. This will be done by defining barriers and facilitators of implementation of ECV in the Netherlands. An innovative implementation strategy will be developed based on improved patient counselling and thorough instructions of health care providers for counselling. The ultimate purpose of this implementation study is to improve counselling of pregnant women and information of clinicians to realize a better implementation of ECV.The first phase of the project is to detect the barriers and facilitators of ECV. The next step is to develop an implementation strategy to inform and counsel pregnant women with a breech presentation, and to inform and educate care providers. In the third phase, the effectiveness of the developed implementation strategy will be evaluated in a randomised trial. The study population is a random selection of midwives and gynaecologists from 60 to 100 hospitals and practices. Primary endpoints are number of counselled women. Secondary endpoints are process indicators, the amount of fetes in cephalic presentation at birth, complications due to ECV, the number of caesarean sections and perinatal condition of mother and child. Cost effectiveness of the implementation strategy will be measured. This study will provide evidence for the cost effectiveness of a structural implementation of external cephalic versions to reduce the number of breech presentations at term. Dutch Trial Register (NTR): 1878.

  2. Implementation of the external cephalic version in breech delivery. Dutch national implementation study of external cephalic version

    Directory of Open Access Journals (Sweden)

    Papatsonis Dimitri N

    2010-05-01

    Full Text Available Abstract Background Breech presentation occurs in 3 to 4% of all term pregnancies. External cephalic version (ECV is proven effective to prevent vaginal breech deliveries and therefore it is recommended by clinical guidelines of the Royal Dutch Organisation for Midwives (KNOV and the Dutch Society for Obstetrics and Gynaecology (NVOG. Implementation of ECV does not exceed 50 to 60% and probably less. We aim to improve the implementation of ECV to decrease maternal and neonatal morbidity and mortality due to breech presentations. This will be done by defining barriers and facilitators of implementation of ECV in the Netherlands. An innovative implementation strategy will be developed based on improved patient counselling and thorough instructions of health care providers for counselling. Method/design The ultimate purpose of this implementation study is to improve counselling of pregnant women and information of clinicians to realize a better implementation of ECV. The first phase of the project is to detect the barriers and facilitators of ECV. The next step is to develop an implementation strategy to inform and counsel pregnant women with a breech presentation, and to inform and educate care providers. In the third phase, the effectiveness of the developed implementation strategy will be evaluated in a randomised trial. The study population is a random selection of midwives and gynaecologists from 60 to 100 hospitals and practices. Primary endpoints are number of counselled women. Secondary endpoints are process indicators, the amount of fetes in cephalic presentation at birth, complications due to ECV, the number of caesarean sections and perinatal condition of mother and child. Cost effectiveness of the implementation strategy will be measured. Discussion This study will provide evidence for the cost effectiveness of a structural implementation of external cephalic versions to reduce the number of breech presentations at term. Trial

  3. Implementation of the external cephalic version in breech delivery. Dutch national implementation study of external cephalic version

    NARCIS (Netherlands)

    Vlemmix, F.; Rosman, A N; Fleuren, M A H; Rijnders, M E B; Beuckens, A.; Haak, M.C.; Akerboom, B.M.C.; Bais, J.M.J.; Kuppens, S M I; Papatsonis, D.N.M.; Opmeer, Brent C; van der Post, J.A.M.; Mol, B.W.J.; Kok, M

    2010-01-01

    Background: Breech presentation occurs in 3 to 4% of all term pregnancies. External cephalic version (ECV) is proven effective to prevent vaginal breech deliveries and therefore it is recommended by clinical guidelines of the Royal Dutch Organisation for Midwives (KNOV) and the Dutch Society for

  4. Implementation of the external cephalic version in breech delivery Dutch national implementation study of external cephalic version

    NARCIS (Netherlands)

    Vlemmix, Floortje; Rosman, Ageeth N.; Fleuren, Margot A. H.; Rijnders, Marlies E. B.; Beuckens, Antje; Haak, Monique C.; Akerboom, Bettina M. C.; Bais, Joke M. J.; Kuppens, Simone M. I.; Papatsonis, Dimitri N.; Opmeer, Brent C.; van der Post, Joris A. M.; Mol, Ben Willem J.; Kok, Marjolein

    2010-01-01

    ABSTRACT: BACKGROUND: Breech presentation occurs in 3 to 4 % of all term pregnancies. External cephalic version (ECV) is proven effective to prevent vaginal breech deliveries and therefore it is recommended by clinical guidelines of the Royal Dutch Organisation for Midwives (KNOV) and the Dutch

  5. The new opt-out Dutch National Breast Implant Registry - Lessons learnt from the road to implementation.

    Science.gov (United States)

    Rakhorst, Hinne A; Mureau, Marc A M; Cooter, Rodney D; McNeil, John; van Hooff, Miranda; van der Hulst, René; Hommes, Juliette; Hoornweg, Marije; Moojen-Zaal, Laura; Liem, Patricia; Mathijssen, Irene M J

    2017-10-01

    An estimated 1-3% of all women in the Netherlands carry breast implants. Since the introduction five decades ago, problems with a variety of breast implants have emerged with direct consequences for the patients' health. Plastic surgeons worldwide reacted through campaigning for auditing on long-term implant quality, surgeon performance, and institutional outcomes in implant registries. Especially, the PIP implant scandal of 2010 demonstrated the paucity of epidemiological data and uncovered a weakness in our ability to even 'track and trace' patients. In addition, a recent report of the Dutch Institute of National Health showed a lack of compliance of 100% of breast implant producers to CE requirements. These arguments stress the need for an independent implant registry. Insufficient capture rates or dependence from the implant producers made the variety of national and international patient registries unreliable. The Dutch Breast Implant Registry (DBIR) is unique because it is an opt-out registry without the need for informed consent and thus a high capture rate. Furthermore, an estimated 95% of breast implants are implanted by board-certified plastic surgeons. Funding was received from a non-governmental organisation to increase the quality of health care in the Netherlands, and maintenance is gathered by 25 euros per implant inserted. This article describes the way the Dutch have set up their system, with special attention to the well-known hurdles of starting a patient registry. Examples include: funding, medical ethical issues, opt out system, benchmarking, quality assurance as well as governance and collaboration. The Dutch consider their experience and data shareware for others to be used globally to the benefit of patient safety and quality improvement. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  6. The Dutch National Research Agenda in Perspective

    OpenAIRE

    2017-01-01

    The Dutch National Research Agenda is a set of national priorities that are set by scientists working in conjunction with corporations, civil society organisations, and interested citizens. The agenda consolidates the questions that scientific research will be focused on in the coming year. This book covers the current status of the Dutch National Research Agenda and considers what changes and adjustments may need to be made to the process in order to keep Dutch national research at the top o...

  7. The Implementation of the AIFMD in Dutch Tax Law

    NARCIS (Netherlands)

    Vermeulen, H.; Elink Schuurman, J.H.

    2014-01-01

    In this article, the authors explain the amendments to Dutch tax law as a result of the recent implementation of the Alternative Investment Fund Managers Directive. Changes were made to the Dutch Corporate Income Tax Act, the Dutch Dividend Withholding Tax Act and the Dutch General Tax Act. Given

  8. Land use and cover change as an overarching topic in the Dutch National Research Programme on Global Air Pollution and Climate Change : issues for implementation

    NARCIS (Netherlands)

    Fresco, L.O.; Berg, van den M.M.; Zeijl-Rozema, van A.E.

    1996-01-01

    The integration study 'Land Use and Cover Change as an overarching topic in the Dutch National Research Programme on Global Air Pollution and Climate Change (NRP)' aims at identifying research fields in which the NRP can contribute most effectively to the international scientific

  9. Integrating care by implementation of bundled payments: results from a national survey on the experience of Dutch dietitians.

    Science.gov (United States)

    Tol, J; Swinkels, I C S; Struijs, J N; Veenhof, C; de Bakker, D H

    2013-01-01

    In the Netherlands, bundled payments were introduced as part of a strategy to redesign chronic care delivery. Under this strategy new entities of health care providers in primary care are negotiating with health insurers about the price for a bundle of services for several chronic conditions. This study evaluates the level of involvement of primary health care dietitians in these entities and the experienced advantages and disadvantages. In August 2011, a random sample of 800 Dutch dietitians were invited by email to complete an online questionnaire (net response rate 34%). Two-thirds participated in a diabetes disease management programme, mostly for diabetes care, financed by bundled payments (n=130). Positive experiences of working in these programmes were an increase in: multidisciplinary collaboration (68%), efficiency of health care (40%) and transparency of health care quality (25%). Negative aspects were an increase in administrative tasks (61%), absence of payment for patients with comorbidity (38%) and concerns about substitution of care (32%). Attention is needed for payment of patients with co- or multi-morbidity within the bundled fee. Substitution of dietary care by other disciplines needs to be further examined since it may negatively affect the quality of treatment. Task delegation and substitution of care may require other competencies from dietitians. Further development of coaching and negotiation skills may help dietitians prepare for the future.

  10. Integrating care by implementation of bundled payments: results from a national survey on the experience of Dutch dietitians

    Science.gov (United States)

    Tol, J.; Swinkels, I.C.S.; Struijs, J.N.; Veenhof, C.; de Bakker, D.H

    2013-01-01

    Introduction In the Netherlands, bundled payments were introduced as part of a strategy to redesign chronic care delivery. Under this strategy new entities of health care providers in primary care are negotiating with health insurers about the price for a bundle of services for several chronic conditions. This study evaluates the level of involvement of primary health care dietitians in these entities and the experienced advantages and disadvantages. Methods In August 2011, a random sample of 800 Dutch dietitians were invited by email to complete an online questionnaire (net response rate 34%). Results Two-thirds participated in a diabetes disease management programme, mostly for diabetes care, financed by bundled payments (n=130). Positive experiences of working in these programmes were an increase in: multidisciplinary collaboration (68%), efficiency of health care (40%) and transparency of health care quality (25%). Negative aspects were an increase in administrative tasks (61%), absence of payment for patients with comorbidity (38%) and concerns about substitution of care (32%). Discussion/conclusion Attention is needed for payment of patients with co- or multi-morbidity within the bundled fee. Substitution of dietary care by other disciplines needs to be further examined since it may negatively affect the quality of treatment. Task delegation and substitution of care may require other competencies from dietitians. Further development of coaching and negotiation skills may help dietitians prepare for the future. PMID:24399924

  11. Integrating care by implementation of bundled payments: results from a national survey on the experience of Dutch dietitians

    Directory of Open Access Journals (Sweden)

    Jacqueline Tol

    2013-12-01

    Full Text Available Introduction: In the Netherlands, bundled payments were introduced as part of a strategy to redesign chronic care delivery. Under this strategy new entities of health care providers in primary care are negotiating with health insurers about the price for a bundle of services for several chronic conditions. This study evaluates the level of involvement of primary health care dietitians in these entities and the experienced advantages and disadvantages.Methods: In August 2011, a random sample of 800 Dutch dietitians were invited by email to complete an online questionnaire (net response rate 34%.Results: Two-thirds participated in a diabetes disease management programme, mostly for diabetes care, financed by bundled payments (n=130. Positive experiences of working in these programmes were an increase in: multidisciplinary collaboration (68%, efficiency of health care (40% and transparency of health care quality (25%. Negative aspects were an increase in administrative tasks (61%, absence of payment for patients with comorbidity (38% and concerns about substitution of care (32%.Discussion/conclusion: Attention is needed for payment of patients with co- or multi-morbidity within the bundled fee. Substitution of dietary care by other disciplines needs to be further examined since it may negatively affect the quality of treatment. Task delegation and substitution of care may require other competencies from dietitians. Further development of coaching and negotiation skills may help dietitians prepare for the future.

  12. Integrating care by implementation of bundled payments: results from a national survey on the experience of Dutch dietitians

    Directory of Open Access Journals (Sweden)

    Jacqueline Tol

    2013-12-01

    Full Text Available Introduction: In the Netherlands, bundled payments were introduced as part of a strategy to redesign chronic care delivery. Under this strategy new entities of health care providers in primary care are negotiating with health insurers about the price for a bundle of services for several chronic conditions. This study evaluates the level of involvement of primary health care dietitians in these entities and the experienced advantages and disadvantages. Methods: In August 2011, a random sample of 800 Dutch dietitians were invited by email to complete an online questionnaire (net response rate 34%. Results: Two-thirds participated in a diabetes disease management programme, mostly for diabetes care, financed by bundled payments (n=130. Positive experiences of working in these programmes were an increase in: multidisciplinary collaboration (68%, efficiency of health care (40% and transparency of health care quality (25%. Negative aspects were an increase in administrative tasks (61%, absence of payment for patients with comorbidity (38% and concerns about substitution of care (32%. Discussion/conclusion: Attention is needed for payment of patients with co- or multi-morbidity within the bundled fee. Substitution of dietary care by other disciplines needs to be further examined since it may negatively affect the quality of treatment. Task delegation and substitution of care may require other competencies from dietitians. Further development of coaching and negotiation skills may help dietitians prepare for the future.

  13. Cholesterol management in Dutch general practice: a comparison with national guidelines.

    NARCIS (Netherlands)

    Weijden, T. van der; Hutten, J.B.F.; Brandenburg, B.J.; Grol, R.P.T.M.; Velden, K. van der

    1994-01-01

    OBJECTIVE: To examine cholesterol diagnosis and treatment by Dutch general practitioners (GPs) in the period before publication of national guidelines, in order to develop implementation strategies based on discrepancies found between daily practice and the guidelines. DESIGN: Data of the 'Dutch

  14. Implementation evaluation of the Dutch national heat plan among long-term care institutions in Amsterdam: a cross-sectional study

    NARCIS (Netherlands)

    Kunst, Anton E.; Britstra, Rieneke

    2013-01-01

    In 2007, a national heat plan was introduced in the Netherlands to effectively protect vulnerable populations (such as institutionalised elderly people) against heatwaves. The aim of this study was to assess the extent to which the measures recommended in this heat plan had been implemented, and

  15. Dutch National Plan combat nuclear accidents

    International Nuclear Information System (INIS)

    1988-01-01

    This document presents the Dutch National Plan combat nuclear accidents (NPK). Ch. 2 discusses some important starting points which are determining for the framework and the performance of the NPK, in particular the accident typology which underlies the plan. Also the new accident-classification system for the Dutch nuclear power plants, the standardization for the measures to be taken and the staging around nuclear power plants are pursued. In ch. 3 the legal framework of the combat nuclear accidents is described. In particular the Nuclear-power law, the Accident law and the Municipality law are pursued. Also the role of province and municipality are described. Ch. 4 deals with the role of the owner/licensee of the object where the accident occurs, in the combat of accident. In ch. 5 the structure of the nuclear-accident combat at national level is outlined, subdivided in alarm phase, combat phase and the winding-up phase. In ch.'s 6-12 these phases are elaborated more in detail. In ch.'s 10-13 the measures to be taken in nuclear accidents, are described. These measures are distinguished with regard to: protection of the population and medical aspects, water economy, drinking-water supply, agriculture and food supply. Ch. 14 describes the responsibility of the burgomaster. Ch.'s 15 and 16 present an overview of the personnel, material, procedural and juridical modifications and supplements of existing structures which are necessary with regard to the new and modified parts of the structure. Ch. 17 indicates how by means of the appropriate education and exercise it can be achieved that all personnel, services and institutes concerned possess the knowledge and experience necessary for the activities from the NKP to be executed as has been described. Ch. 18 contains a survey of activities to be performed and a proposal how these can be realized. (H.W.). figs.; tabs

  16. National Identification of Dutch Youth: An Exploratory Study

    Science.gov (United States)

    Oppenheimer, Louis

    2011-01-01

    246 Dutch participants aged 8, 10, 12, 14, and 16 years were presented with the Strength of Identification Scale (SoIS; Barrett, 2007) and the National Identity scale based on Cultural and Historical achievements (NICH; derived from the NATID, Keillor & Hult, 1999). The study aimed to examine the extent and nature of Dutch children and…

  17. Research paper 2000-B-6: adjustments in the Dutch domestic waste incineration sector in the context of the European directive 89/429/EEC. A case study on national implementation, environmental effectiveness, allocative efficiency, productive efficiency and administrative costs

    Energy Technology Data Exchange (ETDEWEB)

    Lulofs, K. [Twente Univ., Center for Clean Technology and Environmental Policy, Enschede (Netherlands)

    2000-07-01

    Within the context of the IMPOL project several fields of European environmental policy are studied on aspects as national implementation and environmental and efficiency outcomes. For the IMPOL project a case study was done on the transformation of the Dutch sector of domestic waste incineration in the context of the European Directive Directives 89/369/EEC and 89/429/ EEC. The case study was done and indicators for environmental effectiveness, allocative efficiency, productive efficiency and administrative costs were chosen in line with a document to coordinate the efforts in the four IMPOL countries. The European Directives 89/369/EEC and 89/429/ EEC regulate Plants for Domestic waste Incineration on the emissions of several pollutants. These emissions are relevant for air quality in general, acidification and the spreading of toxic substances. In the empirical part of this report emphasis is laid on 'existing' incineration plants, being permitted before 1990. In chapter 2 of this report the implementation of the directives 89/369/EEC and 89/429/EEC in the Netherlands is described. In section 2.1 already existing 'older' Dutch policy and regulation is presented. In paragraph 2.2 the integration of the European Directives into Dutch national law is described. In chapter 2.3 the efforts and outcomes on monitoring and enforcement are presented. Chapter 3 goes into the environmental effectiveness. Section 3.1 describes the abatement performance of the whole municipal waste incineration sector during the period of research. Section 3.2 goes into factors that explain the environmental outcomes. Within the IMPOL research-team the decision was taken to concentrate on a number of pollutants of existing waste incinerators. In section 3.3 the data for the existing incinerators are given. In chapter 4 the allocative efficiency of adjustments is elaborated. In section 4.1 the abatement patterns of existing municipal waste incineration plants are presented

  18. Developing a Service Improvement System for the National Dutch Railways

    NARCIS (Netherlands)

    Verhoef, Peter C.; Heijnsbroek, Martin; Bosma, Joost

    2017-01-01

    Customer satisfaction is essential for public and railway services, because firms in these industries have contracts with governments requiring them to achieve specific customer satisfaction targets. In this paper, we describe a National Dutch Railways project in which we identify the major

  19. Research paper 2000-B-4: adjustments in the Dutch electricity producing sector in the context of the European directive 88/609/EEC: a case study on national implementation, environmental effectiveness, allocative efficiency, productive efficiency and administrative costs

    Energy Technology Data Exchange (ETDEWEB)

    Lulofs, K. [Twente Univ., Center for Clean Technology and Environmental Policy, Enschede (Netherlands)

    2000-07-01

    Within the context of the IMPOL project several fields of European environmental policy are studied on aspects as national implementation and environmental and efficiency outcomes. For the IMPOL project a case study was done on the transformation of the Dutch electricity sector in the context of the European Directive 88/609/EEC. The indicators used in this report for environmental effectiveness, allocative efficiency, productive efficiency and administrative costs were chosen in line with a coordinating document (Eames, 1999). The European Directive 88/609/EEC regulates Large Combustion Plants on their SO{sub 2} and NO{sub x} emissions. These emissions are relevant for air quality and for the acidification problem. In the empirical part of this report emphasis is laid on the power plants as a specific sub-group of the large combustion plants. The report starts in chapter 2 with a description of the Dutch policy on acidification and regulation that existed when 88/609/EEC was issued. This way it is clarified that the formal implementation of the European Directive was done in the Netherlands with very little effort. In section 2.4 some major information on the structure of the electricity production sector is given as well as some insights into developments. In section 2.5 details on a covenant to reduce emissions from power plants is given. The electricity sector and the government agreed upon this document as a binding agenda for change. In section 2.6 information on monitoring and enforcement is given. In chapter 3, the environmental outcomes are discussed. First the emissions of all large combustion plants are presented in time series. Within the IMPOL research-team the decision was taken to concentrate on the SO{sub 2} emissions of power plants. Therefore, secondly the SO{sub 2} emissions of the power plants and the individual power plants are presented. This opens the possibility for an analysis of the found decrease of SO{sub 2} emissions. In section 3.3 the

  20. Research paper 2000-B-4: adjustments in the Dutch electricity producing sector in the context of the European directive 88/609/EEC: a case study on national implementation, environmental effectiveness, allocative efficiency, productive efficiency and administrative costs

    International Nuclear Information System (INIS)

    Lulofs, K.

    2000-01-01

    Within the context of the IMPOL project several fields of European environmental policy are studied on aspects as national implementation and environmental and efficiency outcomes. For the IMPOL project a case study was done on the transformation of the Dutch electricity sector in the context of the European Directive 88/609/EEC. The indicators used in this report for environmental effectiveness, allocative efficiency, productive efficiency and administrative costs were chosen in line with a coordinating document (Eames, 1999). The European Directive 88/609/EEC regulates Large Combustion Plants on their SO 2 and NO x emissions. These emissions are relevant for air quality and for the acidification problem. In the empirical part of this report emphasis is laid on the power plants as a specific sub-group of the large combustion plants. The report starts in chapter 2 with a description of the Dutch policy on acidification and regulation that existed when 88/609/EEC was issued. This way it is clarified that the formal implementation of the European Directive was done in the Netherlands with very little effort. In section 2.4 some major information on the structure of the electricity production sector is given as well as some insights into developments. In section 2.5 details on a covenant to reduce emissions from power plants is given. The electricity sector and the government agreed upon this document as a binding agenda for change. In section 2.6 information on monitoring and enforcement is given. In chapter 3, the environmental outcomes are discussed. First the emissions of all large combustion plants are presented in time series. Within the IMPOL research-team the decision was taken to concentrate on the SO 2 emissions of power plants. Therefore, secondly the SO 2 emissions of the power plants and the individual power plants are presented. This opens the possibility for an analysis of the found decrease of SO 2 emissions. In section 3.3 the likely causes and their

  1. Governmental point of view on the Dutch National Cooperative Programme for Air Quality

    International Nuclear Information System (INIS)

    2008-06-01

    Dutch air quality does not yet meet the European standards throughout the Netherlands. The Dutch National Cooperative Programme for Air Quality (NSL) is expected to realize improvements. This publication explains the Dutch plans for meeting the European standards for air quality in the coming years. It addresses the following subjects: the Dutch National Cooperative Programme for Air Quality (NSL); legal framework; historical development; current situation and autonomous development for PM10 and NO2; spatial projects; measure packages and financial means. [mk] [nl

  2. [The national Dutch Institute for Healthcare Improvement guidelines 'Preoperative trajectory': the essentials].

    Science.gov (United States)

    Wolff, André P; Boermeester, Marja; Janssen, Ingrid; Pols, Margreet; Damen, Johan

    2010-01-01

    In view of the shortcomings of the organisation of the perioperative process that have been ascertained by the Dutch Health Inspectorate (IGZ), the Inspectorate has requested hospitals and care professionals to implement measures to improve this situation. In response to the IGZ's first report, the Dutch Institute for Healthcare Improvement (CBO) has developed the national, multiprofessional guidelines entitled 'Preoperative Trajectory' which were published in January 2010. Implementation of these guidelines should improve communication between professionals and lead to standardization and transparency of the preoperative patient care process, with uniform handovers and clear responsibilities. These guidelines are the first to provide recommendations at process of care level which are intended to increase patient safety and reduce the risk of damage to patients.

  3. Requests for euthanasia in general practice before and after implementation of the Dutch Euthanasia Act

    Science.gov (United States)

    van Alphen, Jojanneke E; Donker, Gé A; Marquet, Richard L

    2010-01-01

    Background The Netherlands was the first country in the world to implement a Euthanasia Act in 2002. It is unknown whether legalising euthanasia under strict conditions influences the number and nature of euthanasia requests. Aim To investigate changes in the number of, and reasons for, requests for euthanasia in Dutch general practice after implementation of the Euthanasia Act. Design of study Retrospective dynamic cohort study comparing 5 years before (1998–2002) and 5 years after (2003–2007) implementation of the Act. Method Standardised registration forms were used to collect data on requests for euthanasia via the Dutch Sentinel Practice Network. This network of 45 general practices is nationally representative by age, sex, geographic distribution, and population density. Results The mean annual incidence of requests before implementation amounted to 3.1/10 000 and thereafter to 2.8/10 000 patients. However, trends differed by sex. The number of requests by males decreased significantly from 3.7/10 000 to 2.6/10 000 (P = 0.008); the requests by females increased non-significantly from 2.6/10 000 to 3.1/10 000. Before and after implementation, cancer remained the major underlying disease for requesting euthanasia: 82% versus 77% for men; 73% versus 75% for females. Pain was a major reason for a request, increasing in the period before implementation (mean 27%), but declining in the period thereafter (mean 22%). Loss of dignity became a less important reason after implementation (from 18% to 10%, P = 0.04), predominantly due to a marked decrease in the number of females citing it as a reason (from 17% to 6%, P = 0.02). Conclusion There was no increase in demand for euthanasia after implementation of the Euthanasia Act. Pain as a reason for requesting euthanasia showed an increasing trend before implementation, but declined thereafter. Loss of dignity as a reason declined, especially in females. PMID:20353671

  4. Ethnic boundaries in American, Dutch and German national literary policies, 1965-2005

    NARCIS (Netherlands)

    P.P.L. Berkers (Pauwke)

    2009-01-01

    textabstractThis article addresses the extent and ways in which ethnic diversity has been part of American, Dutch and German national literary policy from 1965 until 2005. By analyzing the content of policy documents of the National Endowment of the Arts and the Dutch and German Literary Fund, I

  5. Nation-building Behind the Dike: Dutch Nationalism and the Visual Culture of Hydraulic Engineering

    NARCIS (Netherlands)

    Ensel, R.

    2017-01-01

    This article charts a crucial chapter in the history of Dutch nationalism, i. e. the topic of ‘water management’, by delving into the debate on the construction of the Afsluitdijk. The closure of the Zuiderzee by the construction of a dike is one of the most significant infrastructural projects of

  6. Implementation of PATHS through Dutch Municipal Health Services: A Quasi-Experiment

    Directory of Open Access Journals (Sweden)

    Ferry X. Goossens

    2012-12-01

    Full Text Available Only a limited number of effectiveness studies have been performed to study the benefits of efficacious behavior problems prevention programs for children when implemented through national health service systems. This study uses a quasi-experimental design to test the effectiveness of the school-based PATHS prevention program (Providing Alternative THinking Strategies when implemented through Dutch municipal health services by health promotion professionals. A sample of 1,294 children was followed for two years: 674 children attending nine schools providing PATHS and 620 children in nine comparison schools. We hypothesized finding an intervention effect of PATHS in terms of a significant reduction in teacher- and student-rated externalizing and internalizing problem behaviors, and a significant improvement in teacher-, student-, and peer-rated social skills and emotional skills. In fact, the results show low levels of programimplementation and no intervention effects on problem behavior or social and emotional skills, suggesting that it is hard to reproduce positive intervention effects where an efficacious social-emotional prevention program is implemented through a national health service. More research is needed on the specific conditions required to implement efficacious programs effectively.

  7. The current implementation status of the integration of sports and physical activity into Dutch rehabilitation care

    NARCIS (Netherlands)

    Hoekstra, Femke; Hettinga, Florentina J; Alingh, Rolinde A; Duijf, Marjo; Dekker, Rienk; van der Woude, Lucas H V; van der Schans, Cees P

    PURPOSE: To describe the current status of the nationwide implementation process of a sports and physical activity stimulation programme to gain insight into how sports and physical activity were integrated into Dutch rehabilitation care. METHODS: The current implementation status of a sports and

  8. Prevalence of molar-incisor-hypomineralisation among children participating in the Dutch National Epidemiological Survey

    NARCIS (Netherlands)

    Jasulaityte, L.; Weerheijm, K.L.; Veerkamp, J.S.

    2008-01-01

    Aim: This was to determine the prevalence of Molar-Incisor- Hypomineralisation (MIH) among children participating in the Dutch National Epidemiological Survey of 2003 and to compare the prevalence data with that found in the previous survey of 1999 when MIH was found in 9.7% of 11-year-old Dutch

  9. Implementation of selective prevention for cardiometabolic diseases; are Dutch general practices adequately prepared?

    Science.gov (United States)

    Stol, Daphne M; Hollander, Monika; Nielen, Markus M J; Badenbroek, Ilse F; Schellevis, François G; de Wit, Niek J

    2018-03-01

    Current guidelines acknowledge the need for cardiometabolic disease (CMD) prevention and recommend five-yearly screening of a targeted population. In recent years programs for selective CMD-prevention have been developed, but implementation is challenging. The question arises if general practices are adequately prepared. Therefore, the aim of this study is to assess the organizational preparedness of Dutch general practices and the facilitators and barriers for performing CMD-prevention in practices currently implementing selective CMD-prevention. Observational study. Dutch primary care. General practices. Organizational characteristics. General practices implementing selective CMD-prevention are more often organized as a group practice (49% vs. 19%, p = .000) and are better organized regarding chronic disease management compared to reference practices. They are motivated for performing CMD-prevention and can be considered as 'frontrunners' of Dutch general practices with respect to their practice organization. The most important reported barriers are a limited availability of staff (59%) and inadequate funding (41%). The organizational infrastructure of Dutch general practices is considered adequate for performing most steps of selective CMD-prevention. Implementation of prevention programs including easily accessible lifestyle interventions needs attention. All stakeholders involved share the responsibility to realize structural funding for programmed CMD-prevention. Aforementioned conditions should be taken into account with respect to future implementation of selective CMD-prevention. Key Points   There is need for adequate CMD prevention. Little is known about the organization of selective CMD prevention in general practices.   • The organizational infrastructure of Dutch general practices is adequate for performing most steps of selective CMD prevention.   • Implementation of selective CMD prevention programs including easily accessible

  10. The implementation of psychiatric advance directives: Experiences from a Dutch crisis card initiative.

    NARCIS (Netherlands)

    van der Ham, A.J.; Voskes, Y.; van Kempen, N.; Broerse, J.E.W.; Widdershoven, G.A.

    2013-01-01

    Objective: The crisis card is a specific form of psychiatric advance directive, documenting mental clients' treatment preferences in advance of a potential psychiatric crisis. In this paper, we aim to provide insight into implementation issues surrounding the crisis card. Method: A Dutch crisis-card

  11. The actual role of general practice in the Dutch health-care system: results of the Second Dutch National Survey of General Practice.

    NARCIS (Netherlands)

    Schellevis, F.G.; Westert, G.P.; Bakker, D.H. de

    2005-01-01

    A second Dutch National Survey of General Practice was carried out in 2001 with the aim of providing actual information about the role of general practice in the Dutch health-care system for researchers and policy makers. Data were collected on different levels (patients, general practitioners,

  12. [A Matter of Balance: strategy for implementation in Dutch homecare organizations].

    Science.gov (United States)

    de Jonge, M C; van der Poel, A; van Haastregt, J C M; Du Moulin, M F T M; Zijlstra, G A R; Voordouw, I

    2013-02-01

    The Dutch version of A Matter of Balance (AMB-NL) is a cognitive behavioral group program to reduce fear of falling and related activity avoidance in community-living older persons. This paper presents the strategy for implementation of AMB-NL in Dutch homecare organizations and the outcomes of this implementation. The aim was to implement AMB-NL in at least 50 % of 64 homecare organizations in The Netherlands in 2009 and 2010. The implementation strategy was based on the four phases of the Replicating Effective Interventions: pre-conditions, pre-implementation, implementation, and maintenance and evolution. After preparing the implementation activities, such as identifying implementation barriers, consulting stakeholders, preparing the materials involved in the implementation, and training the facilitators of the program (n = 53), AMB-NL was implemented in 16 of the 64 homecare organizations (25 %). Another five homecare organizations indicated that they would shortly include AMB-NL in their care program. These organizations conducted the intervention 19 times to a total of 178 participants. After the implementation phase another 16 facilitators were trained, and program materials were successfully disseminated. The implementation of AMB-NL was well performed. The targeted aim is not fully reached within the two-year timeframe, but the program is well received by participants, trainers and homecare organizations. Further implementation and maintenance of AMB-NL in primary health care is recommended.

  13. News media coverage of euthanasia: A content analysis of Dutch national newspapers

    OpenAIRE

    Rietjens, Judith; Raijmakers, Natasja; Kouwenhoven, Pauline; Seale, Clive; Thiel, Ghislaine; Trappenburg, Margo; Delden, Hans; Heide, Agnes

    2013-01-01

    textabstractBackground: The Netherlands is one of the few countries where euthanasia is legal under strict conditions. This study investigates whether Dutch newspaper articles use the term euthanasia according to the legal definition and determines what arguments for and against euthanasia they contain. Methods. We did an electronic search of seven Dutch national newspapers between January 2009 and May 2010 and conducted a content analysis. Results: Of the 284 articles containing the term eut...

  14. The current implementation status of the integration of sports and physical activity into Dutch rehabilitation care.

    Science.gov (United States)

    Hoekstra, Femke; Hettinga, Florentina J; Alingh, Rolinde A; Duijf, Marjo; Dekker, Rienk; van der Woude, Lucas H V; van der Schans, Cees P

    2017-01-01

    To describe the current status of the nationwide implementation process of a sports and physical activity stimulation programme to gain insight into how sports and physical activity were integrated into Dutch rehabilitation care. The current implementation status of a sports and physical activity stimulation programme in 12 rehabilitation centres and 5 hospitals with a rehabilitation department was described by scoring fidelity and satisfaction. Seventy-one rehabilitation professionals filled out a questionnaire on how sports and physical activity, including stimulation activities, were implemented into rehabilitation care. Total fidelity scores (in %) were calculated for each organization. Professionals' satisfaction was rated on a scale from 1 to 10. In most organizations sports and physical activity were to some extent integrated during and after rehabilitation (fidelity scores: median = 54%, IQR = 23%). Physical activity stimulation was not always embedded as standard component of a rehabilitation treatment. Professionals' satisfaction rated a median value of 8.0 (IQR = 0.0) indicating high satisfaction rates. The fidelity outcome showed that activities to stimulate sports and physical activity during and after rehabilitation were integrated into rehabilitation care, but not always delivered as standardized component. These findings have emphasized the importance to focus on integrating these activities into routines of organizations. Implications for Rehabilitation Components of an evidence-based programme to stimulate sports and physical activity during and after rehabilitation can be used to measure the current status of the integration of sports and physical activity in rehabilitation care in a structural and effective way. The method described in the current study can be used to compare the content of the rehabilitation care regarding the integration of sports and physical activity among organizations both on a national and international level

  15. Globalisation of the National Judiciary and the Dutch Constitution

    Directory of Open Access Journals (Sweden)

    Elaine Mak

    2013-03-01

    Full Text Available This article examines the changing practices of the Dutch highest courts, the Hoge Raad and the Afdeling bestuursrechtspraak van de Raad van State, under the influence of globalisation, and the constitutional implications of this development. The increasing intertwinement of legal systems and the increasing possibilities for judges to interact with courts in foreign jurisdictions have stimulated the consideration of foreign legislation and case law in judicial decision-making in individual cases. An empirical study clarifies how the Dutch judges perceive the usefulness of legal comparisons in this context and how foreign law is used in deliberations and judgments. The constitutional implications of the changing practices of the courts are analysed in light of three aspects of the constitutional normative framework for judicial decision-making: the democratic justification of judicial decisions; legal tradition and the nature of cases; and the effectiveness and efficiency of judicial decision-making.

  16. Inventory of Dutch National Research on Global Climate Change: Inside and outside the National Research Programme

    International Nuclear Information System (INIS)

    Smythe, K.D.; Bernabo, C.; Kingma, J.; Vrakking, W.

    1993-04-01

    This summary of Dutch research on global climate change was compiled from a survey of the major research organisations in the Netherlands. The scope and structure of the survey and this report were based on a request for information from the World Meteorological Organisation for an intergovernmental meeting on the World Climate Programme (WCP) held (from 14 to 16 April 1993). The WMO request emphasized activities related to the WCP and its associated programmes. To extend the usefulness of the exercise, an attempt has been made to broaden the focus to give additional attention to the Intergovernmental Geosphere-Biosphere Programme (IGBP) and the Human Dimensions Programme (HDP). This was the first attempt to inventory the research projects on global climate change underway in the Netherlands - both inside and outside the National Research Programme. Other surveys on Dutch climate-related research have been conducted. The most extensive effort was a cataloging of publications from climate research in the Netherlands from 1981 to 1991, which was conducted by the Netherlands Royal Academy of Sciences (KNAW). That inventory is being updated to include publications through 1992. The database resulting from this exercise will be a useful tool for organisations sponsoring and conducting global climate change research in their efforts to stimulate cooperation and promote coordination among research groups in the Netherlands and abroad. There are plans to update the inventory in the future and to provide the information to participating Dutch organisations as well as research organisations in other countries. An overview of the current research is provided in Volume 1 with a list of projects

  17. The Dutch Intervention and Implementation Law. A personal intervention

    International Nuclear Information System (INIS)

    Aarts, V.P.

    2004-01-01

    The Electricity Act 1998 and the Gas Act have been changed drastically through the so-called I+I Act (Intervention and Implementation Act) of 1 July 2004. One of the changes is related to the way in which rules are set in connection with regulated third party access to the electricity and gas networks. Under the Electricity Act 1998 these rules ('codes') have traditionally been set by DTE, the energy market regulator, with the involvement of the joint network operators and market representative organisations. Pursuant to the I+I Act the DTe will have to set similar rules for regulated access to the gas networks. In addition, the I+I Act requires that the Minister of Economic affairs adopts regulations in ministerial decrees. The DTe rules must comply with these decrees. This effectively adds a regulatory layer to the existing regulatory framework for electricity and gas network rTPA. The decrees are subject to prior Parliamentary approval. After a brief overview of legal history, this contribution criticizes the introduction of an extra regulatory layer. The I+I Act has failed to specify the subjects which the ministerial decrees should address and to what extent they should contain specific norms. This results in a situation where it is effectively up to the minister to decide where and to what extent the DTe and energy market players will be made subject to superior norms. While hardly creating additional value, the new regulatory set-up threatens to cause legal uncertainty and procedural ambiguities and it provides an added platform for lobby groups to canvass their wish lists. Concluding remarks set out that the I+I Act has equipped the minister and the DTe with new powers and enhanced the ministers' accountability to Parliament, but that it has failed to mark out the norms which the legislator deems essential to the welt-functioning of the energy markets. A comprehensive approach to the respective roles of legislator, policy maker and regulator in setting

  18. The actual role of general practice in the Dutch health-care system: results of the Second Dutch National Survey of General Practice.

    OpenAIRE

    Schellevis, F.G.; Westert, G.P.; Bakker, D.H. de

    2005-01-01

    A second Dutch National Survey of General Practice was carried out in 2001 with the aim of providing actual information about the role of general practice in the Dutch health-care system for researchers and policy makers. Data were collected on different levels (patients, general practitioners, practices) and included morbidity (self-report and presented to general practitioners), diagnostic and therapeutic interventions, doctor-patient communication, and background characteristics. Compared ...

  19. Planning of and System for the Dutch National Cooperative Programme for Air Quality

    International Nuclear Information System (INIS)

    2006-06-01

    In order to deal with the emission problem of particulates and NO2 in the Netherlands in the coming five year a new program to improve the air quality in the Netherlands will be set up and implemented (NSL, abbreviated in Dutch) [nl

  20. Do general practitioners adhere to the guideline on infectious conjunctivitis? Results of the Second Dutch National Survey of General Practice

    Directory of Open Access Journals (Sweden)

    Schellevis François G

    2007-09-01

    Full Text Available Abstract Background In 1996 the guideline 'The Red Eye' was first published by the Dutch College of General Practitioners. The extent to which general practitioners adhere to this guideline is unclear. Recently, data on the management of infectious conjunctivitis by general practitioners became available from the Second Dutch National Survey of General Practice. We measured the age-specific incidence of infectious conjunctivitis, described its management by Dutch general practitioners, and then compared these findings with the recommendations made in the guideline. Methods In 2001, over a 12-month period, data from all patient contacts with 195 general practitioners were taken from electronic medical records. Registration was episode-oriented; all consultations dealing with the same health problem were grouped into disease episodes. Data concerning all episodes of infectious conjunctivitis (ICPC-code F70 and sub codes were analysed. Results Over one year, 5,213 new and recurrent episodes of infectious conjunctivitis were presented to general practitioners from a population of N = 375,899, resulting in an overall incidence rate of 13.9 per 1000 person-years, varying from more than 80/1000 py in children up to one-year old, to less than 12/1000 py in children over the age of 4. Topical ophthalmic ointments were prescribed in 87% of the episodes, of which 80% was antibiotic treatment. Fusidic acid gel was most frequently prescribed (69%. In most episodes general practitioners did not adhere to the guideline. Conclusion In 2001, the management of infectious conjunctivitis by Dutch general practitioners was not in accordance with the recommendations of the consensus-based guideline published five years previously, despite its wide distribution. In 2006 this guideline was revised. Its successful implementation requires more than distribution alone. Probably the most effective way to achieve this is by following a model for systemic implementation.

  1. Developing a national performance indicator framework for the Dutch health system

    NARCIS (Netherlands)

    ten Asbroek, A. H. A.; Arah, O. A.; Geelhoed, J.; Custers, T.; Delnoij, D. M.; Klazinga, N. S.

    2004-01-01

    Objective. To report on the first phase of the development of a national performance indicator framework for the Dutch health system. Methods. In January 2002, we initiated an informed interactive process with the intended users-policymakers at the Ministry of Health, Welfare and Sport-and academics

  2. The 2012 revised Dutch national guidelines for the treatment of chronic hepatitis B virus infection

    NARCIS (Netherlands)

    Buster, E. H. C. J.; Baak, B. C.; Bakker, C. M.; Beuers, U. H. W.; Brouwer, J. T.; Drenth, J. P. H.; van Erpecum, K. J.; van Hoek, B.; Honkoop, P.; Kerbert-Dreteler, M. J.; Koek, G. H.; van Nieuwkerk, K. M. J.; van Soest, H.; van der Spek, B. W.; Tan, A. C. I. T. L.; Vrolijk, J. M.; Janssen, H. L. A.

    2012-01-01

    In 2008, the Netherlands Association of Gastroenterologists and Hepatologists (Nederlands Vereniging van Maag-Darm-Leverartsen) published the Dutch national guidelines for the treatment of chronic hepatitis B virus infection. New insights into the treatment of chronic hepatitis B with relevance for

  3. Socio-economic status, dietary intake and 10 y trends: The Dutch National Food Consumption Survey

    NARCIS (Netherlands)

    Hulshof, K.F.A.M.; Brussaard, J.H.; Kruizinga, A.G.; Telman, J.; Löwik, M.R.H.

    2003-01-01

    Objective: To study differences in dietary intake between adults with different socioeconomic status (SES) and trends over time. Design: Cross-sectional study based on data of three Dutch National Food Consumption Surveys (DNFCS-1 1987/88; DNFCS-2 1992; DNFCS-3 1997/98), obtained from a panel by a

  4. Genetically modified organisms in food and feed : annual report 2010 of the Dutch National Reference Laboratory

    NARCIS (Netherlands)

    Scholtens-Toma, I.M.J.; Molenaar, B.; Zaaijer, S.; Voorhuijzen, M.M.; Prins, T.W.; Kok, E.J.

    2011-01-01

    This is the annual report of the Dutch National Reference Laboratory (NRL) for Genetically Modified Food and Feed (RIKILT - Institue of Food Safety). The report gives an overview of the NRL activities carried out in 2010. In 2010 RIKILT participated in one ring trial for inter laboratory validation

  5. Investigation of the conservation-treatment methods of the Dutch National Monument : The role of microscopy

    NARCIS (Netherlands)

    Larbi, J.A.; Hees, R.P.J. van

    1999-01-01

    The Dutch National Monument in Amsterdam, a World War-II memorial structure, was built with an outer face consisting of slabs of travertine. In 1995, the masonry structure forming the core of the monument showed severe deterioration. In order to determine the actual cause of deterioration and to

  6. Developing a national performance indicator framework for the Dutch health system.

    NARCIS (Netherlands)

    Asbroek, A.H.A. ten; Arah, O.A.; Geelhoed, J.; Custers, J.; Delnoij, D.M.; Klazinga, N.S.

    2004-01-01

    Objective. To report on the first phase of the development of a national performance indicator framework for the Dutch health system. Methods. In January 2002, we initiated an informed interactive process with the intended users-policymakers at the Ministry of Health, Welfare and Sport—and academics

  7. Guidance document for setting an Acute Reference Dose in Dutch national pesticide evaluations

    NARCIS (Netherlands)

    Raaij MTM van; CSR

    2001-01-01

    This report describes a proposal for the procedures for setting an Acute Reference Dose (ARfD) for pesticides evaluated in the Netherlands. This deals with both evaluations on the national level (on behalf of the Dutch Board for the Authorisation of Pesticides (CTB)) and evaluations at the European

  8. What makes a nationalist? Nationalism in the Dutch press coverage of Macedonia, 1991-1995

    NARCIS (Netherlands)

    Duynen, Michel van

    2014-01-01

    abstractThis article sheds light on the use of the words ‘nationalism’, ‘nationalist(s)’ and ‘nationalistic’in the news coverage of three Dutch newspapers about Macedonia during the breakup of Yugoslavia. A review of 280 newspaper articles shows that nationalism is often associated with extremism

  9. What makes a nationalist? : Nationalism in the Dutch press coverage of Macedonia, 1991-1995

    NARCIS (Netherlands)

    van Duijnen, M.F.

    2013-01-01

    This article sheds light on the use of the words ‘nationalism’, ‘nationalist(s)’ and ‘nationalistic’in the news coverage of three Dutch newspapers about Macedonia during the breakup of Yugoslavia. A review of 280 newspaper articles shows that nationalism is often associated with extremism and

  10. Genetically modified organisms in food and feed : annual report of the Dutch National Reference Laboratory

    NARCIS (Netherlands)

    Scholtens-Toma, I.M.J.; Molenaar, B.; Zaaijer, S.; Voorhuijzen, M.M.; Prins, T.W.; Kok, E.J.

    2012-01-01

    This is the annual report of the Dutch National Reference Laboratory (NRL) for Genetically Modified Food and Feed (RIKILT - Institute of Food Safety). The report gives an overview of the NRL activities carried out in 2011. In 2011 both RIKILT and the Routine Field Laboratory of the Netherlands Food

  11. Development and implementation of the Dutch protocol for rehabilitative management in amyotrophic lateral sclerosis.

    Science.gov (United States)

    van den Berg, J P; de Groot, I J M; Joha, B C; van Haelst, J M; van Gorcom, P; Kalmijn, S

    2004-12-01

    In the Netherlands, rehabilitation care plays an important role in the symptomatic and palliative treatment of ALS patients. However, until 1999 there were no guidelines or practice parameters available for the management of ALS. Therefore, the Dutch protocol for rehabilitative management in ALS was developed. We describe the development process, the outcome and implementation of the protocol. A concept management protocol was written and the Delphi method was selected to develop the protocol further. This method comprises repetitive discussion sessions from postulates, using a combination of written questionnaires and work-conferences. Between 80 and 90 persons (rehabilitation team members of different professional backgrounds and neurologists) were involved in this process. The protocol was implemented by sending it to all consultants in rehabilitation medicine in the Netherlands; they were asked to inform all the treatment team members about the final protocol and to implement it in their treatment of ALS patients. The protocol was developed in 1999, implemented in 2000 and evaluated in 2001. Recommendations for improvement were made during the evaluation and improvements are currently being developed by an expert group. The protocol is widely used (88.9%) by consultants in rehabilitation medicine and their treatment teams in the Netherlands. The Dutch protocol for rehabilitative management was developed to provide an optimal and adequate care plan for patients with ALS. It is widely used in the Netherlands.

  12. Preparing the Dutch delta for future droughts: model based support in the national Delta Programme

    Science.gov (United States)

    ter Maat, Judith; Haasnoot, Marjolijn; van der Vat, Marnix; Hunink, Joachim; Prinsen, Geert; Visser, Martijn

    2014-05-01

    Keywords: uncertainty, policymaking, adaptive policies, fresh water management, droughts, Netherlands, Dutch Deltaprogramme, physically-based complex model, theory-motivated meta-model To prepare the Dutch Delta for future droughts and water scarcity, a nation-wide 4-year project, called Delta Programme, is established to assess impacts of climate scenarios and socio-economic developments and to explore policy options. The results should contribute to a national adaptive plan that is able to adapt to future uncertain conditions, if necessary. For this purpose, we followed a model-based step-wise approach, wherein both physically-based complex models and theory-motivated meta-models were used. First step (2010-2011) was to make a quantitative problem description. This involved a sensitivity analysis of the water system for drought situations under current and future conditions. The comprehensive Dutch national hydrological instrument was used for this purpose and further developed. Secondly (2011-2012) our main focus was on making an inventory of potential actions together with stakeholders. We assessed efficacy, sell-by date of actions, and reassessed vulnerabilities and opportunities for the future water supply system if actions were (not) taken. A rapid assessment meta-model was made based on the complex model. The effects of all potential measures were included in the tool. Thirdly (2012-2013), with support of the rapid assessment model, we assessed the efficacy of policy actions over time for an ensemble of possible futures including sea level rise and climate and land use change. Last step (2013-2014) involves the selection of preferred actions from a set of promising actions that meet the defined objectives. These actions are all modeled and evaluated using the complex model. The outcome of the process will be an adaptive management plan. The adaptive plan describes a set of preferred policy pathways - sequences of policy actions - to achieve targets under

  13. Inventory of Dutch National Research on Global Climate Change: Inside and outside the National Research Programme

    International Nuclear Information System (INIS)

    Smythe, K.D.; Bernabo, C.; Kingma, J.; Vrakking, W.

    1993-04-01

    This report contains brief descriptions of research projects in the field of global climate change, performed both within and outside the Dutch National Research Programme on Global Air Pollution and Climate Change (NRP). The descriptions result from a survey of the major research institutions in The Netherlands, conducted by two consultancies (Science and Policy Associates, SPA and Holland Consulting Group, HCG) at the request of the NRP. The inventory had to be completed within a relatively brief period; it is thus unavoidable that one or more projects may sometimes contain inaccuracies. Taken as a whole, this report presents a good picture of the Dutch research activities in this area. The scope and structure of this survey and the contents of this report are based on a request for information from the World Meteorological Organization (WMO) for an intergovernmental meeting on the World Climate Programme (WCP), held on 14-16 April 1993. The WMO request emphasised activities related to the WCP and its associated programmes. The database resulting from this exercise will be a useful tool for organisations which sponsor and conduct research into global climate change in their efforts to stimulate cooperation and to promote coordination between the research groups in The Netherlands and abroad. There are plans to update the inventory in the future and to provide the information to participating organisations in The Netherlands, as well as to research organisations in other countries. An overview of the current research is provided in Volume 1, a list of projects being provided in Annex 3. The projects are presented according to the themes and subthemes which are used in the NRP

  14. Orange as a perceptual representation of the Dutch nation : effects on perceived national identification and color evaluation

    NARCIS (Netherlands)

    Lakens, D.

    2011-01-01

    Although it is generally accepted that colors carry meaning, experimental research about individual, situational, and cultural differences in the meaning of colors is scarce. The current research examines whether the Dutch national color functions as a perceptual representation of The Netherlands. A

  15. Assessing the EC ILUC proposal. Dutch national ILUC Impact Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Peters, D.; Toop, G.; Van den Bos, A.; Spoettle, M.

    2013-04-15

    Indirect Land Use Change (ILUC) is the effect that when existing agricultural land producing food is used for biofuel feedstock production, food production is reduced and this reduction is partially compensated by the conversion of non-agricultural land into new cropland elsewhere. ILUC can have a negative impact on the GHG performance of biofuels and can lead to loss of biodiversity. ILUC, its quantification and possible policy measures have been debated in the EU since 2008. The final legislative text to be negotiated on the basis of the ILUC proposal is likely to have a profound impact on the current EU biofuels market but especially on its future development. This report assesses the legal soundness and factual basis of the proposal. It also assesses the policy risks, effectiveness of, and economic consequences resulting from the four most important proposed measures. Alternative scenarios are explored for each of the proposed measures. The report starts with a description of the Dutch biofuels market as the current situation and future perspective of this market is naturally of specific concern for Dutch negotiators in Brussels. This report takes the IFPRI (International Food Policy Research Institute) 2011 modelling study as a starting point when assessing the ILUC impacts of EU biofuels. The IFPRI study modelling results assign high ILUC emissions to conventional biodiesel and assigns much lower ILUC emissions to conventional ethanol. The study does not model ILUC effects of advanced biofuels. The Dutch biofuels market is dominated by biodiesel, of which a large share is double counting. Following the IFPRI 2011 ILUC modelling, this means that a high share of biofuels with a high ILUC risk are supplied to the market but also a high share of advanced, double counting biofuels with a low to medium ILUC risk. The Netherlands hosts a relatively large oilseed crushing and biofuel production industry, of which an important share consists of advanced biofuel

  16. Towards local implementation of Dutch health policy guidelines: a concept-mapping approach

    NARCIS (Netherlands)

    Kuunders, T.J.M.; Bon-Martens, M.J.H. van; Goor, I.A.M. van de; Paulussen, T.G.W.M.; Oers, H.A.M. van

    2017-01-01

    To develop a targeted implementation strategy for a municipal health policy guideline, implementation targets of two guideline users [Regional Health Services (RHSs)] and guideline developers of leading national health institutes were made explicit. Therefore, characteristics of successful

  17. Towards local implementation of Dutch health policy guidelines : A concept-mapping approach

    NARCIS (Netherlands)

    Kuunders, T.J.M.; Van Bon-martens, M.J.H.; Van De Goor, L.A.M.; Paulussen, T.G.W.M.; Van Oers, J.A.M.

    To develop a targeted implementation strategy for a municipal health policy guideline, implementation targets of two guideline users [Regional Health Services (RHSs)] and guideline developers of leading national health institutes were made explicit. Therefore, characteristics of successful

  18. The Dutch 'Focus on Strength' intervention study protocol: programme design and production, implementation and evaluation plan.

    Science.gov (United States)

    Ten Hoor, G A; Kok, G; Rutten, G M; Ruiter, R A C; Kremers, S P J; Schols, A M J W; Plasqui, G

    2016-06-10

    Overweight youngsters are better in absolute strength exercises than their normal-weight counterparts; a physiological phenomenon with promising psychological impact. In this paper we describe the study protocol of the Dutch, school-based program 'Focus on Strength' that aims to improve body composition of 11-13 year old students, and with that to ultimately improve their quality of life. The development of this intervention is based on the Intervention Mapping (IM) protocol, which starts from a needs assessment, uses theory and empirical research to develop a detailed intervention plan, and anticipates program implementation and evaluation. This novel intervention targets first year students in preparatory secondary vocational education (11-13 years of age). Teachers are the program implementers. One part of the intervention involves a 30 % increase of strength exercises in the physical education lessons. The other part is based on Motivational Interviewing, promoting autonomous motivation of students to become more physically active outside school. Performance and change objectives are described for both teachers and students. The effectiveness of the intervention will be tested in a Randomized Controlled Trial in 9 Dutch high schools. Intervention Mapping is a useful framework for program planning a school-based program to improve body composition and motivation to exercise in 11-13 year old adolescents by a "Focus on Strength". NTR5676 , registered 8 February 2016 (retrospectively registered).

  19. [The foundation of the Dutch Society for Tropical Medicine: an affair of national importance].

    Science.gov (United States)

    van Bergen, Leo

    2009-01-01

    The 'Nederlandsche Vereeniging voor Tropische Geneeskunde' (Dutch Society for Tropical Medicine--in short: NVTG) was founded in 1907, a time not only of colonial expansion, but also a time in which the economic interest of the Dutch East-Indies for The Netherlands grew exceptionally. This had its effect on the motivations behind medical aid. Hygienic measures were financially backed because healthy workers had a positive effect on profits. This atmosphere of economic interest and political-military expansion had its effect on the foundation of the NVTG as well. Colonialism was generally approved of, and the goal of the society apart from sociability motives--was to support research into illnesses torturing mainly the Dutch colonies. This was in line with the reasoning that the colonies were rightfully governed by the Netherlands, because the peoples living there had proven not to be able to look after themselves in a proper manner. The foundation of the Society should have been a part of the foundation of an international society for tropical medicine, but this failed. Although internationalism generally was seen as an important feature of science and certainly of medical science, it is not strange this was not seen as a major problem. For it was national and not international reasons that had led to founding the Dutch society. It was the Dutch position as a colonial power that had convinced Dutch tropical doctors a society should be called into being. A generally shared spirit of internationalism had little to do with this unless internationalism is defined as: what others have, we need to have as well, and let us see in international conferences what could be of national benefit. That nevertheless this spirit of internationalism--and not nationalism--is commonly hailed as the main reason behind the foundation, is probably due to the fact that around 1900 nationalism was such a normal state of mind and so fully incorporated in man's way of thinking and acting

  20. Palliative sedation largely in accordance with Dutch national guideline

    NARCIS (Netherlands)

    Swart, S. J.; Rietjens, J. A.; Brinkkemper, T.; Zuylen, L. van; Burg-Verhage, W. A. van; Zuurmond, W. W.; Ribbe, M. W.; Blanker, M. H.; Perez, R. S.; Heide, A. van der

    2011-01-01

    OBJECTIVE: To evaluate the practice of continuous palliative sedation after the introduction of a national guideline. DESIGN: Investigation by questionnaire. METHOD: In 2008, 1580 physicians were asked to fill out a questionnaire regarding the last patient for whom they had prescribed continuous

  1. Treatment of chronic hepatitis B virus infection - Dutch national guidelines

    NARCIS (Netherlands)

    Buster, E. H. C. J.; van Erpecum, K. J.; Schalm, S. W.; Zaaijer, H. L.; Brouwer, J. T.; Gelderblom, H. C.; de Knegt, R. J.; Minke Bakker, C.; Reesink, H. W.; Janssen, H. L. A.; Bakker, C. M.

    2008-01-01

    The development of this guideline was initiated and coordinated by the Netherlands Association of Gastroenterologists and Hepatologists (Nederlandse Vereniging van Maag-Darm-Leverartsen). The aim is the establishment of national standards in the evaluation and antiviral treatment of patients with

  2. Dutch Lung Surgery Audit: A National Audit Comprising Lung and Thoracic Surgery Patients.

    Science.gov (United States)

    Berge, Martijn Ten; Beck, Naomi; Heineman, David Jonathan; Damhuis, Ronald; Steup, Willem Hans; van Huijstee, Pieter Jan; Eerenberg, Jan Peter; Veen, Eelco; Maat, Alexander; Versteegh, Michel; van Brakel, Thomas; Schreurs, Wilhemina Hendrika; Wouters, Michel Wilhelmus

    2018-04-21

    The nationwide Dutch Lung Surgery Audit (DLSA) started in 2012 to monitor and evaluate the quality of lung surgery in the Netherlands as an improvement tool. This outline describes the establishment, structure and organization of the audit by the Dutch Society of Lung Surgeons (NVvL) and the Dutch Society of Cardiothoracic Surgeons (NVT), in collaboration with the Dutch Institute for Clinical Auditing (DICA). In addition, first four-year results are presented. The NVvL and NVT initiated a web-based registration including weekly updated online feedback for participating hospitals. Data verification by external data managers is performed on regular basis. The audit is incorporated in national quality improvement programs and participation in the DLSA is mandatory by health insurance organizations and the National Healthcare Inspectorate. Between 1 January 2012 and 31 December 2015, all hospitals performing lung surgery participated and a total of 19,557 patients were registered from which almost half comprised lung cancer patients. Nationwide the guideline adherence increased over the years and 96.5% of lung cancer patients were discussed in preoperative multidisciplinary teams. Overall postoperative complications and mortality after non-small cell lung cancer surgery were 15.5% and 2.0%, respectively. The audit provides reliable benchmarked information for caregivers and hospital management with potential to start local, regional or national improvement initiatives. Currently, the audit is further completed with data from non-surgical lung cancer patients including treatment data from pulmonary oncologists and radiation oncologists. This will ultimately provide a comprehensive overview of lung cancer treatment in The Netherlands. Copyright © 2018. Published by Elsevier Inc.

  3. INDIGENOUS LANGUAGE IMPLEMENTATION AND NATION ...

    African Journals Online (AJOL)

    NGOZI

    language teaching and use in the early child education stages can enhance nation building. ... only assimilated the English language but have allowed it .... lead to serious economic and political disadvantages in the future: “A future in which ...

  4. Measurement strategies for the Dutch Nuclear Emergency Response System of the National Poisons Control Centre

    International Nuclear Information System (INIS)

    Van Oostrum, I.E.A.; Joore, J.C.A.; Meulenbelt, J.; Savelkoul, T.J.F.

    1997-04-01

    The measurement strategy applicable to Public Health in case of a Nuclear Emergency affecting the Netherlands is presented. Within the framework of the Dutch Nuclear Emergency Response System (NPK, abbreviated in Dutch) the National Poisons Control Centre of the RIVM/AZU has an advisory obligation towards the Ministry of Public Health, Welfare and Sports (WVS). This role comprises advice to relevant ministries, coordination of the measurement strategies and advice on persons to be reviewed, i.e. physical, biological and clinical dosimetry. The choice of dosimetric methods and measurements to be achieved in case of a larger scale nuclear emergency in the Netherlands is discussed. An actual plan of handling is presented for this measurement plan. Intervention levels defined in NPK 1991 serve as guidelines for successive actions to be performed by regional health services. 8 figs., 6 tabs., 81 refs

  5. The implementation of a quality system in the Dutch GP specialty training: barriers and facilitators; a qualitative study

    NARCIS (Netherlands)

    Buwalda, N.; Braspenning, J.C.; Roosmalen, S. van; Dijk, N. van; Visser, Machteld

    2017-01-01

    BACKGROUND: Quality assurance programs in medical education are introduced to gain insight into the quality of such programs and to trigger improvements. Although of utmost importance, research on the implementation of such programs is scarce. The Dutch General Practice (GP) specialty training

  6. The implementation of a quality system in the Dutch GP specialty training: barriers and facilitators; a qualitative study

    NARCIS (Netherlands)

    Buwalda, Nienke; Braspenning, Jozé; van Roosmalen, Sanne; van Dijk, Nynke; Visser, Mechteld

    2017-01-01

    Quality assurance programs in medical education are introduced to gain insight into the quality of such programs and to trigger improvements. Although of utmost importance, research on the implementation of such programs is scarce. The Dutch General Practice (GP) specialty training institutes used

  7. News media coverage of euthanasia: a content analysis of Dutch national newspapers.

    Science.gov (United States)

    Rietjens, Judith A C; Raijmakers, Natasja J H; Kouwenhoven, Pauline S C; Seale, Clive; van Thiel, Ghislaine J M W; Trappenburg, Margo; van Delden, Johannes J M; van der Heide, Agnes

    2013-03-06

    The Netherlands is one of the few countries where euthanasia is legal under strict conditions. This study investigates whether Dutch newspaper articles use the term 'euthanasia' according to the legal definition and determines what arguments for and against euthanasia they contain. We did an electronic search of seven Dutch national newspapers between January 2009 and May 2010 and conducted a content analysis. Of the 284 articles containing the term 'euthanasia', 24% referred to practices outside the scope of the law, mostly relating to the forgoing of life-prolonging treatments and assistance in suicide by others than physicians. Of the articles with euthanasia as the main topic, 36% described euthanasia in the context of a terminally ill patient, 24% for older persons, 16% for persons with dementia, and 9% for persons with a psychiatric disorder. The most frequent arguments for euthanasia included the importance of self-determination and the fact that euthanasia contributes to a good death. The most frequent arguments opposing euthanasia were that suffering should instead be alleviated by better care, that providing euthanasia can be disturbing, and that society should protect the vulnerable. Of the newspaper articles, 24% uses the term 'euthanasia' for practices that are outside the scope of the euthanasia law. Typically, the more unusual cases are discussed. This might lead to misunderstandings between citizens and physicians. Despite the Dutch legalisation of euthanasia, the debate about its acceptability and boundaries is ongoing and both sides of the debate are clearly represented.

  8. The Dutch Confession: Compliance, Leadership and National Identity in the Human Rights Order

    Directory of Open Access Journals (Sweden)

    Erik Larson

    2014-01-01

    Full Text Available As international human rights governance has evolved, it has regulated state action toward individuals in areas that were once at the discretion of states. This change has raised liminal questions concerning authority and leadership. To address these questions, we examine the interaction of the Netherlands and the European Court of Human Rights in cases concerning immigration and asylum. As the Netherlands has a history of self-proclaimed leadership in rights protection, an analysis of the Court’s series of rebukes of the Netherlands yields particularly insightful findings. We find that the shift in rights decision-making has enhanced lawyers’ standing in the Netherlands’ domestic context in ways that enable these actors and the Court to increase international regulation of the Dutch state and that creates greater autonomy of the law from the Dutch state. At the same time, these dynamics challenge the domestic political culture by undermining national myths of the Dutch as uniquely enlightened human rights leaders. These changes demonstrate a shift in the qualities of human rights leadership, from a moralistic posture to a confessional one. Leadership, as made tangible in the reputation and positions taken before an international judicial body, now requires a capacity to express humility and to join in in a shared human rights project.

  9. Implementing multiple intervention strategies in Dutch public health-related policy networks.

    Science.gov (United States)

    Harting, Janneke; Peters, Dorothee; Grêaux, Kimberly; van Assema, Patricia; Verweij, Stefan; Stronks, Karien; Klijn, Erik-Hans

    2017-10-13

    Improving public health requires multiple intervention strategies. Implementing such an intervention mix is supposed to require a multisectoral policy network. As evidence to support this assumption is scarce, we examined under which conditions public health-related policy networks were able to implement an intervention mix. Data were collected (2009-14) from 29 Dutch public health policy networks. Surveys were used to identify the number of policy sectors, participation of actors, level of trust, networking by the project leader, and intervention strategies implemented. Conditions sufficient for an intervention mix (≥3 of 4 non-educational strategies present) were determined in a fuzzy-set qualitative comparative analysis. A multisectoral policy network (≥7 of 14 sectors present) was neither a necessary nor a sufficient condition. In multisectoral networks, additionally required was either the active participation of network actors (≥50% actively involved) or active networking by the project leader (≥monthly contacts with network actors). In policy networks that included few sectors, a high level of trust (positive perceptions of each other's intentions) was needed-in the absence though of any of the other conditions. If the network actors were also actively involved, an extra requirement was active networking by the project leader. We conclude that the multisectoral composition of policy networks can contribute to the implementation of a variety of intervention strategies, but not without additional efforts. However, policy networks that include only few sectors are also able to implement an intervention mix. Here, trust seems to be the most important condition. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  10. The second Dutch national survey on radon in dwellings. Set-up of the project

    International Nuclear Information System (INIS)

    Hiemstra, Y.; Stoop, P.; Lembrechts, J.

    1997-03-01

    In 1994 the Dutch Ministry of Housing, Spatial Planning and the Environment (VROM) commissioned RIVM to carry out a national survey on radon in dwellings, the set-up of which is described in this report. The goals of the survey were: (a) to determine the average and the range of the radon (222Rn) concentration in Dutch dwellings built since the previous survey in 1984, and (b) to quantify the relative contribution of radon from the building materials and from the soil to the indoor radon level in dwellings built in the course of the last decade. These data will be used for the selection of possible countermeasures and as a reference for evaluating the effectiveness of final regulations on radon. Two separate random samples from the Dutch housing stock were taken to answer these questions. A sample of about 1000 dwellings built between 1985 and 1993 in 52 municipalities was taken to answer the first question. The composition of the sample differs from the Dutch housing stock for a number of characteristics, the most obvious of which is the over-representation of single-family and private homes. A sample of about 450 single-family dwellings built in 14 municipalities on different soil types was taken to answer the second question. Two groups of municipalities were distinguished because of geographic differences in building practices: those where town houses predominate and those with mainly detached and semi-detached houses. Information on radon and its sources was collected through placement of alpha track detectors, installation of so-called PFT sources and passive samplers for air infiltration measurement, collection of soil samples and completion of a questionnaire on building and ventilation characteristics. The results of the study are dealt with in RIVM report no. 610058006. 8 figs., 9 tabs., 31 refs. 4 appendices

  11. Cross-sectional study on factors hampering implementation of measles pre- and postexposure measures in Dutch hospitals during the 2013-2014 measles outbreak.

    NARCIS (Netherlands)

    Fievez, L C R; Wong, A; Ruijs, W L M; Meerstadt-Rombach, F S; Timen, A

    2017-01-01

    This study examined adherence to national recommendations on measles pre- and postexposure measures, including immunization of health care workers (HCWs) in Dutch hospitals, during a national outbreak of measles in The Netherlands. This study also investigated which hospital characteristics and

  12. The sun burns: New advice of the Dutch National Health Council on ultraviolet radiation

    International Nuclear Information System (INIS)

    Passchier, W.F.

    1994-01-01

    The aim of the advice of the Dutch National Health Council is to outline the consequences of the depleted ozone layer, and as a result the increased ultraviolet (UV) radiation, on the public health and the environment. In particular, attention is paid to the effect of UV radiation on the immune system, the increased occurrence of carcinomas, melanomas and other forms of skin cancer, the impact on the development of eye defects, and the impact on different levels of ecosystems. A brief overview is given of preventive measures. 5 figs., 1 ref

  13. Prosthesis Prescription Protocol of the Arm (PPP-Arm) : The implementation of a national prosthesis prescription protocol

    NARCIS (Netherlands)

    Wijdenes, Paula; Brouwers, Michael; van der Sluis, Corry K

    BACKGROUND AND AIM: In order to create more uniformity in the prescription of upper limb prostheses by Dutch rehabilitation teams, the development and implementation of a Prosthesis Prescription Protocol of the upper limb (PPP-Arm) was initiated. The aim was to create a national digital protocol to

  14. Defining Multidrug Resistance of Gram-Negative Bacteria in the Dutch-German Border Region-Impact of National Guidelines.

    Science.gov (United States)

    Köck, Robin; Siemer, Philipp; Esser, Jutta; Kampmeier, Stefanie; Berends, Matthijs S; Glasner, Corinna; Arends, Jan P; Becker, Karsten; Friedrich, Alexander W

    2018-01-26

    Preventing the spread of multidrug-resistant Gram-negative bacteria (MDRGNB) is a public health priority. However, the definition of MDRGNB applied for planning infection prevention measures such as barrier precautions differs depending on national guidelines. This is particularly relevant in the Dutch-German border region, where patients are transferred between healthcare facilities located in the two different countries, because clinicians and infection control personnel must understand antibiograms indicating MDRGNB from both sides of the border and using both national guidelines. This retrospective study aimed to compare antibiograms of Gram-negative bacteria and classify them using the Dutch and German national standards for MDRGNB definition. A total of 31,787 antibiograms from six Dutch and four German hospitals were classified. Overall, 73.7% were no MDRGNB according to both guidelines. According to the Dutch and German guideline, 7772/31,787 (24.5%) and 4586/31,787 (12.9%) were MDRGNB, respectively ( p Dutch-German border, as it cannot be assumed that MDRGNB requiring special hygiene precautions are marked in the transferred antibiograms in accordance with both national guidelines.

  15. First Dutch national guidelines--pharmacological care for detained opioid addicts.

    Science.gov (United States)

    Arends, M T; De Haan, H A; Van 't Hoff, G I C M

    2009-01-01

    Heterogenic care of addicted detainees in the various prisons in The Netherlands triggered the National Agency of Correctional Institutions of the Ministry of Justice, to order the Dutch Institute for Health Care Improvement (CBO) to formulate the first national guideline titled 'Pharmacological care for detained addicts'. This article presents the content of this guideline, which mainly focuses on opioid-dependent addicts. In The Netherlands, approximately 50% of the detainees are problematic substance abusers, while again half of this group suffers from psychiatric co-morbidity. In addition, somatic co-morbidity, especially infectious diseases, is also common. Due to the moderate outcome seen with voluntary drug counselling regimes in prison, there is a policy shift to extent utilization of legally enforced approaches. Continuity of care is of great importance. In case of opioid addicts this, in general, means continuation of methadone maintenance treatment. Aftercare immediately after detention and optimalization of medical information transfer is crucial. This guideline aims to realize optimal and uniform management of addiction disorders in the Dutch prison system.

  16. Weather conditions and political party vote share in Dutch national parliament elections, 1971-2010

    Science.gov (United States)

    Eisinga, Rob; Te Grotenhuis, Manfred; Pelzer, Ben

    2012-11-01

    Inclement weather on election day is widely seen to benefit certain political parties at the expense of others. Empirical evidence for this weather-vote share hypothesis is sparse however. We examine the effects of rainfall and temperature on share of the votes of eight political parties that participated in 13 national parliament elections, held in the Netherlands from 1971 to 2010. This paper merges the election results for all Dutch municipalities with election-day weather observations drawn from all official weather stations well distributed over the country. We find that the weather parameters affect the election results in a statistically and politically significant way. Whereas the Christian Democratic party benefits from substantial rain (10 mm) on voting day by gaining one extra seat in the 150-seat Dutch national parliament, the left-wing Social Democratic (Labor) and the Socialist parties are found to suffer from cold and wet conditions. Cold (5°C) and rainy (10 mm) election day weather causes the latter parties to lose one or two parliamentary seats.

  17. Best practice guidelines for the use of next-generation sequencing applications in genome diagnostics: a national collaborative study of dutch genome diagnostic laboratories

    NARCIS (Netherlands)

    Weiss, Marjan M.; van der Zwaag, Bert; Jongbloed, Jan D. H.; Vogel, Maartje J.; Brüggenwirth, Hennie T.; Lekanne Deprez, Ronald H.; Mook, Olaf; Ruivenkamp, Claudia A. L.; van Slegtenhorst, Marjon A.; van den Wijngaard, Arthur; Waisfisz, Quinten; Nelen, Marcel R.; van der Stoep, Nienke

    2013-01-01

    Next-generation sequencing (NGS) methods are being adopted by genome diagnostics laboratories worldwide. However, implementing NGS-based tests according to diagnostic standards is a challenge for individual laboratories. To facilitate the implementation of NGS in Dutch laboratories, the Dutch

  18. News media coverage of euthanasia: a content analysis of Dutch national newspapers

    Science.gov (United States)

    2013-01-01

    Background The Netherlands is one of the few countries where euthanasia is legal under strict conditions. This study investigates whether Dutch newspaper articles use the term ‘euthanasia’ according to the legal definition and determines what arguments for and against euthanasia they contain. Methods We did an electronic search of seven Dutch national newspapers between January 2009 and May 2010 and conducted a content analysis. Results Of the 284 articles containing the term ‘euthanasia’, 24% referred to practices outside the scope of the law, mostly relating to the forgoing of life-prolonging treatments and assistance in suicide by others than physicians. Of the articles with euthanasia as the main topic, 36% described euthanasia in the context of a terminally ill patient, 24% for older persons, 16% for persons with dementia, and 9% for persons with a psychiatric disorder. The most frequent arguments for euthanasia included the importance of self-determination and the fact that euthanasia contributes to a good death. The most frequent arguments opposing euthanasia were that suffering should instead be alleviated by better care, that providing euthanasia can be disturbing, and that society should protect the vulnerable. Conclusions Of the newspaper articles, 24% uses the term ‘euthanasia’ for practices that are outside the scope of the euthanasia law. Typically, the more unusual cases are discussed. This might lead to misunderstandings between citizens and physicians. Despite the Dutch legalisation of euthanasia, the debate about its acceptability and boundaries is ongoing and both sides of the debate are clearly represented. PMID:23497284

  19. Implementation of PATHS through dutch municipal health services: A quasi-experiment

    NARCIS (Netherlands)

    Goossens, F.X.; Gooren, E.M.J.C.; Castro, B.O.de; Overveld, K.W.van; Buijs, G.J.; Monshouwer, K.; Onrust, S.A.; Paulussen, T.G.W.M.

    2012-01-01

    Only a limited number of effectiveness studies have been performed to study the benefits of efficacious behavior problems prevention programs for children when implemented through national health service systems. This study uses a quasi-experimental design to test the effectiveness of the

  20. Effective Implementation of Counselling Curriculum and National ...

    African Journals Online (AJOL)

    This study looked at the effective implementation of counselling curriculum and national policy on education in Cross River State public secondary schools. It employed the descriptive survey method. It made use of three hypotheses, 230 secondary schools as its population, 1,900 students (854 boys and 1,046 girls) as ...

  1. Canada's National Implementation Strategy on Climate Change

    International Nuclear Information System (INIS)

    2000-10-01

    This document describes the national implementation strategy which is a part of the coordinated national response to climate change. The approach was developed from the National Climate Change process, established by the federal, provincial and territorial ministers responsible for energy and the environment, based on an examination of the impacts, costs and benefits of implementing the Kyoto Protocol, as well as the options for addressing climate change. The Strategy involves (1) taking action to reduce risks and to improve our understanding of risks associated with climate change, (2) institution of a national framework that includes individual and joint action, while recognizing jurisdictional flexibility in responding to unique circumstances, (3) adopting a phased approach, (4) progressive action in response to changing domestic and international circumstances, (5) clear understanding of the necessary relationship between international and national strategies, (6) developing an understanding of the implications of emission reduction targets and major options, including cross-cutting policy approaches such as emissions trading and allocation of responsibility for reducing emissions. The Strategy uses a risk-management approach that attempts to limit the risks of climate change while maximizing opportunities for Canada to contribute to global and national solutions. This approach incorporates improving scientific and analytical understanding and co-ordinating national and international action and a phased approach to implementation. This policy document focuses on Phase One actions which consist of five connected themes, i. e. enhancing awareness and understanding, promoting technology development and innovation, governments leading by example, investing in knowledge and building the foundation, and encouraging action. Future phases will be linked to greater international certainty based on ratification of the Kyoto Protocol, the actions of our trading partners

  2. Weather conditions and voter turnout in Dutch national parliament elections, 1971-2010.

    Science.gov (United States)

    Eisinga, Rob; Te Grotenhuis, Manfred; Pelzer, Ben

    2012-07-01

    While conventional wisdom assumes that inclement weather on election day reduces voter turnout, there is remarkably little evidence available to support truth to such belief. This paper examines the effects of temperature, sunshine duration and rainfall on voter turnout in 13 Dutch national parliament elections held from 1971 to 2010. It merges the election results from over 400 municipalities with election-day weather data drawn from the nearest weather station. We find that the weather parameters indeed affect voter turnout. Election-day rainfall of roughly 25 mm (1 inch) reduces turnout by a rate of one percent, whereas a 10-degree-Celsius increase in temperature correlates with an increase of almost one percent in overall turnout. One hundred percent sunshine corresponds to a one and a half percent greater voter turnout compared to zero sunshine.

  3. Laterality related to the successive selection of Dutch national youth soccer players.

    Science.gov (United States)

    Verbeek, Jan; Elferink-Gemser, Marije T; Jonker, Laura; Huijgen, Barbara C H; Visscher, Chris

    2017-11-01

    In the general population, estimates of left-foot preference are around 20%. In soccer, specific tasks create positional demands, requiring 40% of the players to be left-footed. Whether and how this is related to the selection of players is unknown. To examine the successive selection of soccer players for Dutch national youth teams in relation to foot preference, 280 youth players (age = 16.2 ± 1.08 years) were monitored from the U16 through the U19 teams over the last 5 years. No difference in successive selection between left- and right-footed players was found (p soccer teams.

  4. Factors with regard to computerisation of the Dutch and the Belgian national general practitioner sentinel networks: a comparative analysis.

    NARCIS (Netherlands)

    Schweikardt, C.; Casteren, V. van; Verheij, R.A.; Coppieters, Y.

    2013-01-01

    Background: A general practitioner (GP) sentinel network observes a sample of the population by supplying reports on the incidence and epidemiological characteristics of specific diseases and on procedures in primary health care. In the 1970s, the Dutch and the Belgian national GP sentinel networks

  5. Nation-wide development of sustainable production patterns. The case of 16 years of sustainability in Dutch residential house building

    NARCIS (Netherlands)

    Bossink, B.A.G.

    2009-01-01

    This paper integrates the interorganisational innovation process and national innovation system-approach into a new model. A case study research project that covers a 16-year period of sustainable innovations in the Dutch residential building industry applies the model. The research outcomes

  6. Implementing non-invasive prenatal testing for aneuploidy in a national healthcare system: global challenges and national solutions.

    Science.gov (United States)

    van Schendel, Rachèl V; van El, Carla G; Pajkrt, Eva; Henneman, Lidewij; Cornel, Martina C

    2017-09-19

    Since the introduction of non-invasive prenatal testing (NIPT) in 2011, mainly by commercial companies, a growing demand for NIPT from the public and healthcare professionals has been putting pressure on the healthcare systems of various countries. This study identifies the challenges of establishing a responsible implementation of NIPT for aneuploidy in prenatal healthcare, by looking at the Netherlands. A mixed methods approach involving 13 stakeholder interviews, document analysis and (participatory) observations of the Dutch NIPT Consortium meetings were used. The Diffusion of Innovation Theory and a Network of Actors model were used to interpret the findings. Implementation of NIPT was facilitated by several factors. The set-up of a national NIPT Consortium enabled discussion and collaboration between stakeholders. Moreover, it led to the plan to offer NIPT through a nationwide research setting (TRIDENT studies), which created a learning phase for careful implementation. The Dutch legal context was perceived as a delaying factor, but eventually gave room for the parties involved to organise themselves and their practices. This study shows that implementing advanced technologies with profound effects on prenatal care benefit from a learning phase that allows time to carefully evaluate the technical performance and women's experiences and to enable public debate. Such a coordinated learning phase, involving all stakeholders, will stimulate the process of responsible and sustainable implementation.

  7. ISO 14001 IMPLEMENTATION AT A NATIONAL LABORATORY

    International Nuclear Information System (INIS)

    BRIGGS, S.L.K.

    2001-01-01

    After a tumultuous year discovering serious lapses in environment, safety and health management at Brookhaven National Laboratory, the Department of Energy established a new management contract. It called for implementation of an IS0 14001 Environmental Management System and registration of key facilities. Brookhaven Science Associates, the managing contractor for the Laboratory, designed and developed a three-year project to change culture and achieve the goals of the contract. The focus of its efforts were to use IS0 14001 to integrate environmental stewardship into all facets of the Laboratory's mission, and manage its programs in a manner that protected the ecosystem and public health. A large multidisciplinary National Laboratory with over 3,000 employees and 4,000 visiting scientists annually posed significant challenges for IS0 14001 implementation. Activities with environmental impacts varied from regulated industrial waste generation, to soil activation from particle accelerator operations, to radioactive groundwater contamination from research reactors. A project management approach was taken to ensure project completion on schedule and within budget. The major work units for the Environmental Management System Project were as follows: Institutional EMS Program Requirements, Communications, Training, Laboratory-wide Implementation, and Program Assessments. To minimize costs and incorporate lessons learned before full-scale deployment throughout the Laboratory, a pilot process was employed at three facilities. Brookhaven National Laboratory has completed its second year of the project in the summer of 2000, successfully registering nine facilities and self-declaring conformance in all remaining facilities. Project controls, including tracking and reporting progress against a model, have been critical to the successful implementation. Costs summaries are lower than initial estimates, but as expected legal requirements, training, and assessments are key cost

  8. Cross-national comparison of capitation funding: the American, British and Dutch experience.

    Science.gov (United States)

    Persaud, D; Narine, L

    1999-05-01

    In this paper we review the performance of the capitation payment systems of three countries--the Adjusted Average Per Capita Cost (AAPCC) system used in the United States to reimburse Health Maintenance Organizations (HMOs) for insuring Medicare recipients, a somewhat similar system in the Netherlands which reimburses third-party payers for insuring the entire population and a weighted system utilized in Britain for regional funding. Our review revealed significant problems with the current version of the AAPCC formula as there is evidence of the biased selection of beneficiaries and actual losses to Medicare through its use. Furthermore, several studies show that the demographic adjusters utilized in the AAPCC formula are extremely poor predictors of future healthcare utilization relative to the potential of direct and indirect health status measures. The Dutch experience with capitated funding has been similar to that of the United States. While Dutch researchers have built on the work of their American counterparts they acknowledge that further work is needed before a fully functional system is implemented. Britain's weighted system has fulfilled its original mandate to redistribute healthcare resources based on population need but recent changes giving increased influence to age weighting could reverse some of these gains. A number of proposed improvements to these risk adjustment problems were reviewed including the development of diagnostic cost groups, the coexisting hierarchical conditions model and the use of community-rated high-risk pooling. The findings from this study can help others narrow the alternatives they need to consider when thinking of introducing capitation funding or refining already existing systems.

  9. Cross-sectional study on factors hampering implementation of measles pre- and postexposure measures in Dutch hospitals during the 2013-2014 measles outbreak.

    Science.gov (United States)

    Fievez, L C R; Wong, A; Ruijs, W L M; Meerstadt-Rombach, F S; Timen, A

    2017-07-01

    This study examined adherence to national recommendations on measles pre- and postexposure measures, including immunization of health care workers (HCWs) in Dutch hospitals, during a national outbreak of measles in The Netherlands. This study also investigated which hospital characteristics and organizational issues hamper implementation. This was a cross-sectional survey among all general and academic hospitals in The Netherlands. An online structured questionnaire (48 questions) was administered. Analysis was performed using descriptive statistics and logistic regression. Of 88 hospitals, 70 (79.5%) were included. Of 68 hospitals, 48 (70.6%) assessed susceptibility to measles in HCWs. Of 70 hospitals, 61 (87.1%) offered vaccination to susceptible HCWs. Of 63 hospitals, 42 (66.7%) had postexposure policies consistent with national recommendations. Of 62 hospitals, 30 (48.4%) implemented all these measures, which is the minimum set of measures considered necessary to adequately prevent measles in HCWs. Logistic regression suggests that hospitals with several locations, hospitals with more employees, and hospitals where infectious disease experts designed infection prevention policies while occupational health experts implemented the policy less often implemented this minimum set of measures (P measles outbreak, most hospitals took measures to prevent measles in HCWs, but less than half implemented the minimum set of measures required. Implementation strategies in hospitals need to be improved, especially in large-sized hospitals and hospitals with several locations, and with respect to the assignment of responsibilities for infection prevention policies. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  10. Quality systems in Dutch health care institutions.

    NARCIS (Netherlands)

    Casparie, A.F.; Sluijs, E.M.; Wagner, C.; Bakker, D.H. de

    1997-01-01

    The implementation of quality systems in Dutch health care was supervised by a national committee during 1990-1995. To monitor the progress of implementation a large survey was conducted in the beginning of 1995. The survey enclosed all subsectors in health care. A postal questionnaire-derived

  11. Implementation of integrated care for diabetes mellitus type 2 by two Dutch care groups: a case study.

    Science.gov (United States)

    Busetto, Loraine; Luijkx, Katrien; Huizing, Anna; Vrijhoef, Bert

    2015-08-21

    Even though previous research has demonstrated improved outcomes of integrated care initiatives, it is not clear why and when integrated care works. This study aims to contribute to filling this knowledge gap by examining the implementation of integrated care for type 2 diabetes by two Dutch care groups. An embedded single case study was conducted including 26 interviews with management staff, care purchasers and health professionals. The Context + Mechanism = Outcome Model was used to study the relationship between context factors, mechanisms and outcomes. Dutch integrated care involves care groups, bundled payments, patient involvement, health professional cooperation and task substitution, evidence-based care protocols and a shared clinical information system. Community involvement is not (yet) part of Dutch integrated care. Barriers to the implementation of integrated care included insufficient integration between the patient databases, decreased earnings for some health professionals, patients' insufficient medical and policy-making expertise, resistance by general practitioner assistants due to perceived competition, too much care provided by practice nurses instead of general practitioners and the funding system incentivising the provision of care exactly as described in the care protocols. Facilitators included performance monitoring via the care chain information system, increased earnings for some health professionals, increased focus on self-management, innovators in primary and secondary care, diabetes nurses acting as integrators and financial incentives for guideline adherence. Economic and political context and health IT-related barriers were discussed as the most problematic areas of integrated care implementation. The implementation of integrated care led to improved communication and cooperation but also to insufficient and unnecessary care provision and deteriorated preconditions for person-centred care. Dutch integrated diabetes care is still a

  12. Evaluation of the Dutch National Research Programme on Global Air Pollution and Climate Change. Final Report

    International Nuclear Information System (INIS)

    Guy, K.; Boekholt, P.; Kaellen, E.; Downing, T.; Verbruggen, A.

    2002-02-01

    During 2001, the second phase of the National Research Programme on Global Air Pollution and Climate Change (NOP2) has been evaluated. In the period 1995-2001 the budget for NOP was 47 million Dutch guilders, which supported over 30 organisations in 100 projects and studies spanning four main themes: (1) dynamics of the climate system and its component parts; (2) vulnerability of natural and societal systems to climate change; (3) societal causes and solutions; (4) integration and assessment. Later in the life of the programme, two themes were added to widen the scope of the programme and add value to existing activities. These covered projects concerned with 'cross-cutting' or 'over-arching' issues and those dealing with 'internationalisation', i.e. projects specifically designed to support various initiatives in the development of international programmes. A further proportion of the research budget was dedicated to direct policy support. The evaluation was primarily intended to: Assess the scientific quality of the work undertaken in the programme and the attainment of scientific and technical goals. Also attention was paid to the relevancy of projects and project outputs to national and international policy formulation (policy relevance); the structure and operation of the programme to see if it promoted coherence and synergy between the constituent parts (synergy); and recommendations concerning the form, content and direction of a new programme in the area (new directions)

  13. National prestige and economic interest : Dutch diplomacy toward Japan 1850-1863

    NARCIS (Netherlands)

    Kogure, Minori

    2008-01-01

    This thesis discusses Dutch diplomacy with respect to Japan in the period 1850-1863, predominantly on the basis of Dutch primary sources that were not widely known or not published until present. The political and economical importance of the Netherlands East Indies made Asian Affairs always

  14. Genetically modified organisms in food and feed : annual report 2012 of the Dutch National Reference Laboratory

    NARCIS (Netherlands)

    Scholtens-Toma, I.M.J.; Molenaar, B.; Zaaijer, S.; Prins, T.W.; Kok, E.J.

    2013-01-01

    This is the annual report of the Dutch Reference Laboratory (NRL) for Genetically Modified Food and Feed (RIKILT Wageningen UR). The report gives an overview of the NRL activities carried out in 2012. In 2012 the two Dutch Official Laboratories participated in several proficiency tests with good

  15. The implementation of a quality system in the Dutch GP specialty training: barriers and facilitators; a qualitative study.

    Science.gov (United States)

    Buwalda, Nienke; Braspenning, Jozé; van Roosmalen, Sanne; van Dijk, Nynke; Visser, Mechteld

    2017-07-21

    Quality assurance programs in medical education are introduced to gain insight into the quality of such programs and to trigger improvements. Although of utmost importance, research on the implementation of such programs is scarce. The Dutch General Practice (GP) specialty training institutes used an implementation strategy to implement a quality system (QS), and we aimed to study the success of this strategy and to learn about additional facilitators and barriers. Seventeen structured interviews were conducted with the directors and quality coordinators (QCs) of the eight Dutch GP training institutes. A five-stage process model of implementation was used to structure these interviews and analyze the data. Two researchers analyzed the data with a framework approach. The strategy supported the institutes in implementing the QS. However, after the introduction of the QS, staff experienced the QS as demanding, although they noticed almost no concrete short-term results. Moreover, they experienced difficulties in integrating the QS into their local situation. Collectively working with the QS and following common deadlines did create a sense of commitment towards each other that appeared to be a true stimulus to the introduction of the QS. The implementation strategy focused mainly on the introduction of the QS in the GP specialty training, and it was, as such, rather successful. An important barrier concerned the acceptance of the QS and the integration of the QS into local structures, which suggests that there is a need for guidance on the translation of the QS to local contexts. All in all, we recommend more focus on the benefits of a QS.

  16. Categorical and dimensional psychopathology in Dutch and US offspring of parents with bipolar disorder: A preliminary cross-national comparison.

    Science.gov (United States)

    Mesman, Esther; Birmaher, Boris B; Goldstein, Benjamin I; Goldstein, Tina; Derks, Eske M; Vleeschouwer, Marloes; Hickey, Mary Beth; Axelson, David; Monk, Kelly; Diler, Rasim; Hafeman, Danella; Sakolsky, Dara J; Reichart, Catrien G; Wals, Marjolein; Verhulst, Frank C; Nolen, Willem A; Hillegers, Manon H J

    2016-11-15

    Accumulating evidence suggests cross-national differences in adults with bipolar disorder (BD), but also in the susceptibility of their offspring (bipolar offspring). This study aims to explore and clarify cross-national variation in the prevalence of categorical and dimensional psychopathology between bipolar offspring in the US and The Netherlands. We compared levels of psychopathology in offspring of the Pittsburgh Bipolar Offspring Study (n=224) and the Dutch Bipolar Offspring Study (n=136) (age 10-18). Categorical psychopathology was ascertained through interviews using the Schedule for Affective Disorders and Schizophrenia for School Age Children (K-SADS-PL), dimensional psychopathology by parental reports using the Child Behavior Checklist (CBCL). Higher rates of categorical psychopathology were observed in the US versus the Dutch samples (66% versus 44%). We found no differences in the overall prevalence of mood disorders, including BD-I or -II, but more comorbidity in mood disorders in US versus Dutch offspring (80% versus 34%). The strongest predictors of categorical psychopathology were maternal BD (OR: 1.72, ppsychopathology based on CBCL reports. Preliminary measure of inter-site reliability. We found cross-national differences in prevalence of categorical diagnoses of non-mood disorders in bipolar offspring, but not in mood disorder diagnoses nor in parent-reported dimensional psychopathology. Cross-national variation was only partially explained by between-sample differences. Cultural and methodological explanations for these findings warrant further study. Copyright © 2016 Elsevier B.V. All rights reserved.

  17. Categorical and dimensional psychopathology in Dutch and US offspring of parents with bipolar disorder: A preliminary cross-national comparison✩

    Science.gov (United States)

    Mesman, Esther; Birmaher, Boris B.; Goldstein, Benjamin I.; Goldstein, Tina; Derks, Eske M.; Vleeschouwer, Marloes; Hickey, Mary Beth; Axelson, David; Monk, Kelly; Diler, Rasim; Hafeman, Danella; Sakolsky, Dara J.; Reichart, Catrien G.; Wals, Marjolein; Verhulst, Frank C.; Nolen, Willem A.; Hillegers, Manon H.J.

    2017-01-01

    Objective Accumulating evidence suggests cross-national differences in adults with bipolar disorder (BD), but also in the susceptibility of their offspring (bipolar offspring). This study aims to explore and clarify cross-national variation in the prevalence of categorical and dimensional psychopathology between bipolar offspring in the US and The Netherlands. Methods We compared levels of psychopathology in offspring of the Pittsburgh Bipolar Offspring Study (n=224) and the Dutch Bipolar Offspring Study (n=136) (age 10–18). Categorical psychopathology was ascertained through interviews using the Schedule for Affective Disorders and Schizophrenia for School Age Children (K-SADS-PL), dimensional psychopathology by parental reports using the Child Behavior Checklist (CBCL). Results Higher rates of categorical psychopathology were observed in the US versus the Dutch samples (66% versus 44%). We found no differences in the overall prevalence of mood disorders, including BD-I or -II, but more comorbidity in mood disorders in US versus Dutch offspring (80% versus 34%). The strongest predictors of categorical psychopathology were maternal BD (OR: 1.72, ppsychopathology based on CBCL reports. Limitations Preliminary measure of inter-site reliability. Conclusions We found cross-national differences in prevalence of categorical diagnoses of non-mood disorders in bipolar offspring, but not in mood disorder diagnoses nor in parent-reported dimensional psychopathology. Cross-national variation was only partially explained by between-sample differences. Cultural and methodological explanations for these findings warrant further study. PMID:27423424

  18. An e-learning supported Train-the-Trainer program to implement a suicide practice guideline. Rationale, content and dissemination in Dutch mental health care.

    NARCIS (Netherlands)

    Groot, M. de; Beurs, D.P. de; Keijser, J. de; Kerkhof, A.F.J.M.

    2015-01-01

    An e-learning supported Train-the-Trainer program was developed to implement the Dutch suicide practice guideline inmental health care. Literature on implementation strategies has been restricted to the final reporting of studieswith little opportunity to describe relevant contextual, developmental

  19. The Dutch National Research Program Global Air Pollution and Climatic Change

    International Nuclear Information System (INIS)

    Slanina, J.

    1992-01-01

    In 1991 the title program (the Dutch abbreviation is NOP-MLK) started. The development of the program has not been an ideal one. Some unfortunate, but understandable, political decisions made the coordination and integration of the NOP difficult. However, at the start a reasonable integrated program has been developed and a coherent research program has been formulated for many items, based on priorities and policy relevance. The way in which research programs have to be prepared, and the aims they should meet, are briefly discussed. In particular attention is paid to the advisability of cooperation between the participating organizations and the useful and reliable integration of and gearing to sub-sections of the programs. The final form of the NOP is elaborated in this article. The study on the greenhouse effect problemacy is subdivided into five subjects of research: the system (physical-chemical processes with regard to the greenhouse effect), the causes (greenhouse gases cycle), the impacts of the greenhouse effect, integration of models in order to define standards for atmospheric concentrations and emissions of greenhouse gases, and finally sustainable solutions to prevent emissions and to adapt to altered conditions. It is expected that the NOP will contribute significant to our knowledge of the greenhouse effect on a national level as well as an international level. 2 figs., 1 ref

  20. Where there is a will, there is a way. Advice on the Dutch National Environmental Plan 4 (NMP4)

    International Nuclear Information System (INIS)

    2001-01-01

    The fourth National Environmental Plan (NMP4) is a good start to solve the big environmental problems and must be elaborated soon, according to the VROM-Raad in it's advice to the Dutch government. The problems (loss of biological diversity, climatic change and overexploitation of natural resources) can not be solved in a conventional way. The so-called transition policy (integration of technological, economical, social-cultural and institutional changes) can be one of the solutions. refs [nl

  1. Reasons for accepting or declining Down syndrome screening in Dutch prospective mothers within the context of national policy and healthcare system characteristics : a qualitative study

    NARCIS (Netherlands)

    Crombag, Neeltje M T H; Boeije, Hennie; Iedema-Kuiper, Rita; Schielen, Peter C J I; Visser, Gerard H A; Bensing, Jozien M

    2016-01-01

    BACKGROUND: Uptake rates for Down syndrome screening in the Netherlands are low compared to other European countries. To investigate the low uptake, we explored women's reasons for participation and possible influences of national healthcare system characteristics. Dutch prenatal care is

  2. ExternE National Implementation Finland

    Energy Technology Data Exchange (ETDEWEB)

    Pingoud, K; Maelkki, H; Wihersaari, M; Pirilae, P [VTT Energy, Espoo (Finland); Hongisto, M [Imatran Voima Oy, Vantaa (Finland); Siitonen, S [Ekono Energy Ltd, Espoo (Finland); Johansson, M [Finnish Environment Institute, Helsinki (Finland)

    1999-07-01

    ExternE National Implementation is a continuation of the ExternE Project, funded in part by the European Commission's Joule III Programme. This study is the result of the ExternE National Implementation Project for Finland. Three fuel cycles were selected for the Finnish study: coal, peat and wood-derived biomass, which together are responsible for about 40% of total electricity generation in Finland and about 75% of the non-nuclear fuel based generation. The estimated external costs or damages were dominated by the global warming (GW) impacts in the coal and peat fuel cycles, but knowledge of the true GW impacts is still uncertain. From among other impacts that were valued in monetary terms the human health damages due to airborne emissions dominated in all the three fuel cycles. Monetary valuation for ecosystem impacts is not possible using the ExternE methodology at present. The Meri-Pori power station representing the coal fuel cycle is one of the world's cleanest and most efficient coal-fired power plants with a condensing turbine. The coal is imported mainly from Poland. The estimated health damages were about 4 mECU/kWh, crop damages an order of magnitude lower and damages caused to building materials two orders of magnitude lower. The power stations of the peat and biomass fuel cycles are of CHP type, generating electricity and heat for the district heating systems of two cities. Their fuels are of domestic origin. The estimated health damages allocated to electricity generation were about 5 and 6 mECU/kWh, respectively. The estimates were case-specific and thus an generalisation of the results to the whole electricity generation in Finland is unrealistic. Despite the uncertainties and limitations of the methodology, it is a promising tool in the comparison of similar kinds of fuel cycles, new power plants and pollution abatement technologies and different plant locations with each other. (orig.)

  3. Implementation of Safeguards for Romania National LOFs

    International Nuclear Information System (INIS)

    Popovici, I.

    2015-01-01

    The safe deployment of nuclear activities in Romania is provided by Law no. 111/1996. The Law was republished based on the provisions of Article II of Law no. 63/2006 for the amendment and addition and was modified and completed by the Law no. 378/2013. The competent national authority in the nuclear field, which has responsibilities of regulation, authorization and control as stipulated in this Law, is the National Commission for Nuclear Activities Control (CNCAN). According to art. 2c), provisions of the Nuclear Law shall apply to production, sitting and construction, supply, leasing, transfer, handling, possession, processing, treatment, use, temporary storage or final disposal, transport, transit, import and export of radiological installations, nuclear and radioactive materials, including nuclear fuel, radioactive waste and ionizing radiation generating devices. With regards to the small holders of nuclear materials, the Romanian legislation takes into account the following safeguards objectives: · Establishing provisions governing the possession, use, transfer, import and export of nuclear materials; · Ensuring the implementation of the safeguards system for accountancy and control of nuclear materials: · Ensuring that all nuclear materials are reported under the provisions of the Safeguards Agreement; · Ensuring that all nuclear activities are declared under the provisions of the Additional Protocol; · Developing and implementing nuclear material accounting and control procedures at all small holders of nuclear materials; · Ensuring training for safeguards staff at all small holders. Based on the provision of Law no. 111/1996 CNCAN has issued a Guidelines for applying of the safeguards by the small holders of nuclear materials from Romania. The guidelines provide specific regulations regarding the movement of the nuclear materials, the accountancy and control of nuclear materials, the containment and surveillance systems for small holders of nuclear

  4. ExternE National Implementation Finland

    International Nuclear Information System (INIS)

    Pingoud, K.; Maelkki, H.; Wihersaari, M.; Pirilae, P.; Hongisto, M.; Siitonen, S.; Johansson, M.

    1999-01-01

    ExternE National Implementation is a continuation of the ExternE Project, funded in part by the European Commission's Joule III Programme. This study is the result of the ExternE National Implementation Project for Finland. Three fuel cycles were selected for the Finnish study: coal, peat and wood-derived biomass, which together are responsible for about 40% of total electricity generation in Finland and about 75% of the non-nuclear fuel based generation. The estimated external costs or damages were dominated by the global warming (GW) impacts in the coal and peat fuel cycles, but knowledge of the true GW impacts is still uncertain. From among other impacts that were valued in monetary terms the human health damages due to airborne emissions dominated in all the three fuel cycles. Monetary valuation for ecosystem impacts is not possible using the ExternE methodology at present. The Meri-Pori power station representing the coal fuel cycle is one of the world's cleanest and most efficient coal-fired power plants with a condensing turbine. The coal is imported mainly from Poland. The estimated health damages were about 4 mECU/kWh, crop damages an order of magnitude lower and damages caused to building materials two orders of magnitude lower. The power stations of the peat and biomass fuel cycles are of CHP type, generating electricity and heat for the district heating systems of two cities. Their fuels are of domestic origin. The estimated health damages allocated to electricity generation were about 5 and 6 mECU/kWh, respectively. The estimates were case-specific and thus an generalisation of the results to the whole electricity generation in Finland is unrealistic. Despite the uncertainties and limitations of the methodology, it is a promising tool in the comparison of similar kinds of fuel cycles, new power plants and pollution abatement technologies and different plant locations with each other. (orig.)

  5. ExternE National Implementation Finland

    Energy Technology Data Exchange (ETDEWEB)

    Pingoud, K.; Maelkki, H.; Wihersaari, M.; Pirilae, P. [VTT Energy, Espoo (Finland); Hongisto, M. [Imatran Voima Oy, Vantaa (Finland); Siitonen, S. [Ekono Energy Ltd, Espoo (Finland); Johansson, M. [Finnish Environment Institute, Helsinki (Finland)

    1999-07-01

    ExternE National Implementation is a continuation of the ExternE Project, funded in part by the European Commission's Joule III Programme. This study is the result of the ExternE National Implementation Project for Finland. Three fuel cycles were selected for the Finnish study: coal, peat and wood-derived biomass, which together are responsible for about 40% of total electricity generation in Finland and about 75% of the non-nuclear fuel based generation. The estimated external costs or damages were dominated by the global warming (GW) impacts in the coal and peat fuel cycles, but knowledge of the true GW impacts is still uncertain. From among other impacts that were valued in monetary terms the human health damages due to airborne emissions dominated in all the three fuel cycles. Monetary valuation for ecosystem impacts is not possible using the ExternE methodology at present. The Meri-Pori power station representing the coal fuel cycle is one of the world's cleanest and most efficient coal-fired power plants with a condensing turbine. The coal is imported mainly from Poland. The estimated health damages were about 4 mECU/kWh, crop damages an order of magnitude lower and damages caused to building materials two orders of magnitude lower. The power stations of the peat and biomass fuel cycles are of CHP type, generating electricity and heat for the district heating systems of two cities. Their fuels are of domestic origin. The estimated health damages allocated to electricity generation were about 5 and 6 mECU/kWh, respectively. The estimates were case-specific and thus an generalisation of the results to the whole electricity generation in Finland is unrealistic. Despite the uncertainties and limitations of the methodology, it is a promising tool in the comparison of similar kinds of fuel cycles, new power plants and pollution abatement technologies and different plant locations with each other. (orig.)

  6. Quality indicators for the hospital transfusion chain : A national survey conducted in 100 dutch hospitals

    NARCIS (Netherlands)

    Zijlker-Jansen, Pauline Y.; Janssen, M. P.; van Tilborgh-de Jong, A. J W; Schipperus, M. R.; Wiersum-Osselton, J. C.

    2015-01-01

    Background: The 2011 Dutch Blood Transfusion Guideline for hospitals incorporates seven internal quality indicators for evaluation of the hospital transfusion chain. The indicators aim to measure guideline compliance as shown by the instatement of a hospital transfusion committee and transfusion

  7. Implementing Human Resources Management (HRM) within Dutch VET schools: Examining the fostering and hindering factors

    NARCIS (Netherlands)

    Runhaar, P.R.; Sanders, K.

    2013-01-01

    Vocational Education and Training (VET) Institutions face serious challenges, like the implementation of competence-based education and upcoming teacher shortages, which urge them to implement Human Resources Management policy and practices (HRM). The implementation of HRM, however, often stagnates.

  8. The complexity of national identity Construction in Curaçao, Dutch Caribbean

    Directory of Open Access Journals (Sweden)

    Rose Mary Allen

    2010-10-01

    Full Text Available Curaçao, one of the five islands of the Dutch Caribbean federation called the Netherlands Antilles, currently stands at a crossroad of constitutional reform. In the context of these changes at the political level, it is logical that national identities are being redefined and repositioned. The developments in the fashioning of national identities in Curaçao deserve attention locally but also regionally. How do people in Curaçao construct national identities in daily life? How is a national collective constructed on the one hand, and how are differences with other collectivities constructed on the other hand? The historical context of constitutional changes that have occurred over the years is considered as well as an examination of the present discourse on constitutional reform. These identity issues are then placed within a wider Caribbean context.  Resumen: La complejidad de la construcción de la identidad nacional en Curaçao,en el Caribe holandés Curaçao, una de las cinco islas de la federación caribeña neerlandesa llamada Antillas Holandesas, se encuentra hoy en día en una encrucijada de reformas constitucionales. En el contexto de estos cambios a nivel político, es lógico que las identidades nacionales sean redefinidas y reposicionadas. Los desarrollos en la formulación de identidades nacionales en Curaçao merecen atención local, y también regional. ¿Cómo construye la gente en Curaçao identidades nacionales en la vida cotidiana? ¿Cómo, por un lado, se construye el colectivo nacional y, por otro, cómo se construyen las diferencias con otras colectividades? En este análisis se estudia el contexto histórico de los cambios constitucionales que han ocurrido en el curso del tiempo y se realiza igualmente una revisión del actual discurso sobre la reforma constitucional. Estos problemas de identidad son analizados entonces en un contexto caribeño más amplio.

  9. Assessing the impact of cancer among Dutch non-Hodgkin lymphoma survivors compared with their American counterparts: a cross-national study.

    Science.gov (United States)

    Oerlemans, Simone; Smith, Sophia K; Crespi, Catherine M; Zimmerman, Sheryl; van de Poll-Franse, Lonneke V; Ganz, Patricia A

    2013-06-01

    To understand cultural differences in the impact of cancer (IOC) by (i) performing an independent psychometric evaluation of the Dutch version of the Impact of Cancer Scale version 2 (IOCv2) in a non-Hodgkin lymphoma (NHL) sample and (ii) examining differences between Dutch and American NHL survivors in perceived IOC and identifying associations with socio-demographic and clinical characteristics. Data collected from 491 Dutch and 738 American NHL survivors were used in this study. IOCv2 responses were obtained from all survivors; the Dutch survivors also completed the European Organization for Research and Treatment of Cancer Quality of Life Core questionnaire, which measures quality of life. Exploratory factor analysis of the Dutch version yielded a factor solution similar to the American structure but with some subscales merging into single factors. Internal consistency was good; Cronbach's alpha was 0.88 for the Positive and 0.94 for the Negative summary scales. Large differences were observed between survivors, whereby Dutch survivors reported fewer Positive (Δ -0.4, p Dutch sample, providing evidence that IOCv2 scales measure common and important survivor concerns across two different Western nations. Higher positive impacts for US survivors might be explained by more personal control and availability of supportive services. Future research should focus on determinants of the IOC in both Dutch and American survivors to gain better understanding of the factors that might improve it and suggest how health care may be modified toward that end. Copyright © 2012 John Wiley & Sons, Ltd.

  10. National And European Law: Problem Of Implementation

    Directory of Open Access Journals (Sweden)

    Olga M. Mesheriakova

    2014-09-01

    Full Text Available Present article is devoted to one of the main problems for all integration communities –problem of implementation of the integration law norms in the national legal system of member states. Author, on the example of certain member states of the European Union considers mechanism of the European Union law action in it's member states. In the article constitutional norms of the number of member states which set a ratio of the national and European laws are analyzed. According to the principle of competence giving, member states voluntary transfer part of the competence to the European Union. Competences which are transferred to the member states are the competences of the European Union. In the course of research author investigates opinions of scientists and analyze regulations. Author pays separate attention to the question of the European Union creation. For example, author notes that consideration by the Federal Constitutional Court in Karlsruhe of the question of compliance of the Treaty to the Constitution of Germany became neither more nor less a most important milestone on the way of Treaty on the European Union ratification by Germany. In the decision on this matter Court defined a number of reference points for the purpose of possible excise if the European integration elimination out of those limits which are set for the government of Germany by its Constitution. The decision of the Constitutional Court of Germany though meant approval of the Treaty on the European Union in the political sense, it was nevertheless unambiguously directed against broad interpretation and federalist vision of the European integration. It is obvious that states, on the basis of constitutional norms may leave contracts that are burdensome for them. It concerns not only international treaties, but also Treaties of the European Union.

  11. Energie Efficiency Directive. Article 7. Dutch implementation; Energie Efficiency Directive. Artikel 7. Nederlandse invulling

    Energy Technology Data Exchange (ETDEWEB)

    Daniels, B.; Gerdes, J.; Boonekamp, P.; Kroon, P.; Stutvoet-Mulder, K.; Tigchelaar, C.; Wetzels, W. [ECN Beleidsstudies, Petten (Netherlands)

    2013-12-15

    Article 7 of the recently adopted Energy Efficiency Directive (EED) obliges the EU member states to achieve 1.5% yearly efficiency improvements during the period 2014-2020, culminating in a cumulative savings target. This report describes the way the Netherlands intends to meet the article 7 obligations, as requested by the European Commission. The EED offers the member states various degrees of freedom with regard to the definition of the target and the way it is met. Hence, this report addresses the choices of the Netherlands and their consequences for the Dutch target and the realised energy savings. A broad-lined description of the choices and overall results is complemented by extensive annexes that offer technical descriptions and detailed numbers [Dutch] Dit rapport beschrijft de manier waarop Nederland aan haar doelstelling voor artikel 7 van de Energy Efficiency Directive (EED) denkt te voldoen. Het is gebaseerd op de interpretaties en keuzes die de Nederlandse overheid heeft gemaakt. Artikel 7 van de Energy Efficiency Directive verplicht Nederland tot het realiseren van een efficiencyverbetering van 1,5% per jaar in de periode 2014-2020, als cumulatieve doelstelling. Voor Nederland betekent dit - rekening houdend met de vrijheidsgraden van de EED - een doelstelling van minimaal 482 PJ besparing op het finaal energiegebruik. Nederland verwacht een cumulatieve besparing te bereiken tussen de 387 en 562 PJ in finale termen, waarvan 87 tot 186 PJ door nieuw beleid. Dit nieuwe beleid bestaat uit de overeengekomen beleidsmaatregelen uit het recente Energieakkoord dat onder regie van de Sociaal Economische Raad (SER) is gesloten. Het kabinet heeft dit akkoord mede ondertekend.

  12. Evaluation of early implementations of antibiotic stewardship program initiatives in nine Dutch hospitals

    NARCIS (Netherlands)

    van Limburg, Maarten; Sinha, Bhanu; Lo-Ten-Foe, Jerome R; van Gemert-Pijnen, Julia Ewc

    2014-01-01

    BACKGROUND: Antibiotic resistance is a global threat to patient safety and care. In response, hospitals start antibiotic stewardship programs to optimise antibiotic use. Expert-based guidelines recommend strategies to implement such programs, but local implementations may differ per hospital.

  13. 77 FR 15052 - National Ocean Council-National Ocean Policy Draft Implementation Plan

    Science.gov (United States)

    2012-03-14

    ... charge for Federal agencies to implement the National Ocean Policy, the National Ocean Council developed... dollars a year to the national economy, and are essential to public health and national security. Next...

  14. [Results from a general training hospital for the implementation of a diagnostic workup for pulmonary embolism according to the Dutch Institute for Health Care Improvement

    NARCIS (Netherlands)

    Kamphuisen, P.W.; Jacobs, E.M.G.; Mol, J.J.; Rijnders, A.J.; Ullmann, E.F.

    2002-01-01

    OBJECTIVE: To evaluate the active implementation of the Dutch Institute for Healthcare Improvement's guideline for the diagnostic work-up for pulmonary embolism in a general training hospital, and to analyse reasons for not following the guideline strategy. DESIGN: Partly retrospective and partly

  15. Improvements in the quality of co-ordination of nursing care following implementation of the Resident Assessment Instrument in Dutch nursing homes.

    NARCIS (Netherlands)

    Achterberg, W.P.; Holtkamp, C.C.M.; Kerkstra, A.; Pot, A.M.; Ooms, M.E.; Ribbe, M.W.

    2001-01-01

    Aim: To study the effect of implementation of the Resident Assessment Instrument (RAI) on the quality of co-ordination of nursing care in Dutch nursing homes. Background: The Resident Assessment Instrument (RAI) was designed to improve the quality of care and quality of life in nursing homes. Until

  16. Implementing Human Resources Management (HRM) within Dutch VET Institutions: Examining the Fostering and Hindering Factors

    Science.gov (United States)

    Runhaar, Piety; Sanders, Karin

    2013-01-01

    Vocational Education and Training (VET) Institutions face serious challenges, like the implementation of competence-based education and upcoming teacher shortages, which urge them to implement Human Resources Management policy and practices (HRM). The implementation of HRM, however, often stagnates. This paper describes a qualitative study--in…

  17. Total, Free, and Added Sugar Consumption and Adherence to Guidelines: The Dutch National Food Consumption Survey 2007–2010

    Science.gov (United States)

    Sluik, Diewertje; van Lee, Linde; Engelen, Anouk I.; Feskens, Edith J. M.

    2016-01-01

    A high sugar intake is a subject of scientific debate due to the suggested health implications and recent free sugar recommendations by the WHO. The objective was to complete a food composition table for added and free sugars, to estimate the intake of total sugars, free sugars, and added sugars, adherence to sugar guidelines and overall diet quality in Dutch children and adults. In all, 3817 men and women (7–69 years) from the Dutch National Food Consumption Survey 2007–2010 were studied. Added and free sugar content of products was assigned by food composition tables and using labelling and product information. Diet was assessed with two 24-h recalls. Diet quality was studied in adults with the Dutch Healthy Diet-index. Total sugar intake was 22% Total Energy (%TE), free sugars intake 14 %TE, and added sugar intake 12 %TE. Sugar consumption was higher in children than adults. Main food sources of sugars were sweets and candy, non-alcoholic beverages, dairy, and cake and cookies. Prevalence free sugar intake diet quality was similar comparing adults adherent and non-adherent to the sugar guidelines, although adherent adults had a higher intake of dietary fiber and vegetables. Adherence to the WHO free sugar guidelines of sugar guidelines was not strongly associated with higher diet quality in adults. PMID:26828518

  18. Total, Free, and Added Sugar Consumption and Adherence to Guidelines: The Dutch National Food Consumption Survey 2007-2010.

    Science.gov (United States)

    Sluik, Diewertje; van Lee, Linde; Engelen, Anouk I; Feskens, Edith J M

    2016-01-28

    A high sugar intake is a subject of scientific debate due to the suggested health implications and recent free sugar recommendations by the WHO. The objective was to complete a food composition table for added and free sugars, to estimate the intake of total sugars, free sugars, and added sugars, adherence to sugar guidelines and overall diet quality in Dutch children and adults. In all, 3817 men and women (7-69 years) from the Dutch National Food Consumption Survey 2007-2010 were studied. Added and free sugar content of products was assigned by food composition tables and using labelling and product information. Diet was assessed with two 24-h recalls. Diet quality was studied in adults with the Dutch Healthy Diet-index. Total sugar intake was 22% Total Energy (%TE), free sugars intake 14 %TE, and added sugar intake 12 %TE. Sugar consumption was higher in children than adults. Main food sources of sugars were sweets and candy, non-alcoholic beverages, dairy, and cake and cookies. Prevalence free sugar intake diet quality was similar comparing adults adherent and non-adherent to the sugar guidelines, although adherent adults had a higher intake of dietary fiber and vegetables. Adherence to the WHO free sugar guidelines of sugar guidelines was not strongly associated with higher diet quality in adults.

  19. Impact of National Culture Dimensions on Scrum Implementations

    OpenAIRE

    Zhao, Chengqian

    2015-01-01

    Context. Scrum is one of the most common used Agile method. It is based on empiricism. Scrum only provides a framework but the detailed implementations in practice are very different. and the environment has a big influence on it. National culture is proven to have an impact on Agile methodology. The implementation of Scrum practices should be influenced by national culture as well. Objectives. This paper reveals the relationship between national culture and Scrum implementation. It explores ...

  20. News media coverage of euthanasia: a content analysis of Dutch national newspapers.

    NARCIS (Netherlands)

    Rietjens, J.A.C.; Raijmakers, N.J.; Kouwenhoven, P.S.C.; Seale, C.; van Thiel, G.J.M.W.; Trappenburg, M.J.; van Delden, J.J.M.; van der Heide, A.

    2013-01-01

    Background The Netherlands is one of the few countries where euthanasia is legal under strict conditions. This study investigates whether Dutch newspaper articles use the term ‘euthanasia’ according to the legal definition and determines what arguments for and against euthanasia they contain.

  1. Fructose consumption in the Netherlands: the Dutch national food consumption survey 2007-2010

    NARCIS (Netherlands)

    Sluik, D.; Engelen, A.I.P.; Feskens, E.J.M.

    2015-01-01

    Background/objectives: Despite the worldwide scientific and media attention, the actual fructose consumption in many non-US populations is not clear. The aim of this study was to estimate the fructose consumption and its main food sources in a representative sample of the general Dutch population.

  2. News media coverage of euthanasia: a content analysis of Dutch national newspapers

    NARCIS (Netherlands)

    Rietjens, J.A.C.; Raijmakers, N.J.H.; Kouwenhoven, P.S.C.; Seale, C.; van Thiel, G.J.M.W.; Trappenburg, M.; van Delden, J.J.M.; van der Heide, A.

    2013-01-01

    Background: The Netherlands is one of the few countries where euthanasia is legal under strict conditions. This study investigates whether Dutch newspaper articles use the term ‘euthanasia’ according to the legal definition and determines what arguments for and against euthanasia they contain.

  3. News media coverage of euthanasia: a content analysis of Dutch national newspapers.

    NARCIS (Netherlands)

    Rietjens, J.A.C.; Raijmakers, N.J.H.; Kouwenhoven, P.S.C.; Seale, C.; Thiel, G.J.M.W. van; Trappenburg, M.; Delden, J.J.M. van; Heide, A. van der

    2013-01-01

    Background: The Netherlands is one of the few countries where euthanasia is legal under strict conditions. This study investigates whether Dutch newspaper articles use the term ‘euthanasia’ according to the legal definition and determines what arguments for and against euthanasia they contain.

  4. News media coverage of euthanasia: A content analysis of Dutch national newspapers

    NARCIS (Netherlands)

    J.A.C. Rietjens (Judith); N.J.H. Raijmakers (Natasja); P.S.C. Kouwenhoven (Pauline); C. Seale (Clive); G.J.M.W. van Thiel (Ghislaine); M.J. Trappenburg (Margo); J.J.M. van Delden (Hans); A. van der Heide (Agnes)

    2013-01-01

    textabstractBackground: The Netherlands is one of the few countries where euthanasia is legal under strict conditions. This study investigates whether Dutch newspaper articles use the term euthanasia according to the legal definition and determines what arguments for and against euthanasia they

  5. Educational Differences in Adolescents' Sexual Health : A Pervasive Phenomenon in a National Dutch Sample

    NARCIS (Netherlands)

    De Graaf, Hanneke; Vanwesenbeeck, Wilhelmina; Meijer, Suzanne

    2015-01-01

    Educational level is strongly associated with age of first intercourse and risk of unintended pregnancies. This study examined these associations in a large representative sample of Dutch adolescents and also included associations of educational level with other sexual health aspects. Adolescents

  6. The Process of Implementing HRM Practices : A Case Study in the Dutch Federal Government

    NARCIS (Netherlands)

    van Mierlo, Jorrit; Bondarouk, Tatiana

    2018-01-01

    Yearly, organisations create and implemented new HRM practices. To make those HRM practices work in an effective way, their implementation is of great importance. The goal of this paper is to uncover the mechanisms in which new HRM practices develop in federal governmental organisations. We do so by

  7. Evaluation of early implementations of antibiotic stewardship program initiatives in nine Dutch hospitals

    NARCIS (Netherlands)

    van Limburg, A.H.M.; Sinha, Bhanu; Lo-Ten-Foe, Jerome R.; van Gemert-Pijnen, Julia E.W.C.

    2014-01-01

    Background Antibiotic resistance is a global threat to patient safety and care. In response, hospitals start antibiotic stewardship programs to optimise antibiotic use. Expert-based guidelines recommend strategies to implement such programs, but local implementations may differ per hospital. Earlier

  8. Lesjes van de Nederlanders: Little Lessons from the Dutch to Promote Educational Quality.

    Science.gov (United States)

    Palmer, Barbara H.

    1996-01-01

    A study explored quality assessment and accountability in Dutch university education. The national system of quality assurance and various models used successfully to implement it are described, and the range of apparent effects and influences of quality assurance on Dutch higher education are examined. Comparison is made with American higher…

  9. Qualitative comparison of Dutch and Ethiopian Rose production systems. Why Dutch rose growers move to African Nations and what consequences does this migration have?

    NARCIS (Netherlands)

    Vries de, Willem

    2010-01-01

    Summary The rose cultivation is used as a study example in this report to facilitate the understanding of the overall differences between the cultivation of agricultural products in the Netherlands and those in warmer countries. The Dutch rose cultivat

  10. Design and Implementation of Business Process Management Curriculum: A Case in Dutch Higher Education

    OpenAIRE

    Ravesteyn , Pascal; Versendaal , Johan

    2010-01-01

    International audience; This paper describes a joint effort by two educational and scientific institutes, the HU University of Applied Sciences and Utrecht University, in designing a BPM course that not only transfers theoretical knowledge but lets students also experience real life BPM-systems and implementation issues. We also describe the implementation of the developed module with an indication of its success: it is now running for the fifth time, and although there continue to be points ...

  11. Biotechnology : A Dutch perspective

    NARCIS (Netherlands)

    Van Apeldoorn, J.H.F.

    1981-01-01

    Biotechnology: a Dutch Perspective assesses the future potential of biotechnology in the Netherlands. It has been published in English because it is felt that the Dutch case could be of relevance to other industrialised nations. Although the report is aimed primarily at policy planners and decision

  12. Compliance of disease awareness campaigns in printed Dutch media with national and international regulatory guidelines.

    Science.gov (United States)

    Leonardo Alves, Teresa; Martins de Freitas, Auramarina F; van Eijk, Martine E C; Mantel-Teeuwisse, Aukje K

    2014-01-01

    The European legislation prohibits prescription-only medicines' advertising but allows pharmaceutical companies to provide information to the public on health and diseases, provided there is no direct or indirect reference to a pharmaceutical product. Various forms of promotion have become increasingly common in Europe including "disease-oriented" campaigns. To explore examples of disease awareness campaigns by pharmaceutical companies in the Netherlands, by assessing their compliance with the World Health Organization (WHO) Ethical Criteria for medicinal drug promotion and the Dutch guidelines for provision of information by pharmaceutical companies. Materials referring to health/disease and treatments published in the most widely circulated newspapers and magazines were collected from March to May 2012. An evaluation tool was developed based on relevant underlying principles from the WHO ethical criteria and Dutch self-regulation guidelines. Collected disease awareness advertisements were used to pilot the evaluation tool and to explore the consistency of information provided with the WHO and Dutch criteria. Eighty materials met our inclusion criteria; 71 were published in newspapers and 9 in magazines. The large majority were news items but 21 were disease awareness advertisements, of which 5 were duplicates. Fifteen out of the 16 disease awareness campaigns were non-compliant with current guidelines mainly due to lack of balance (n = 12), absence of listed author and/or sponsor (n = 8), use of misleading or incomplete information (n = 5) and use of promotional information (n = 5). None mentioned a pharmaceutical product directly. Disease Awareness Campaigns are present in Dutch printed media. Although no brand names were mentioned, the lack of compliance of disease awareness campaigns with the current regulations is alarming. There were information deficiencies and evidence of information bias. A key concern is that the context in which the information is

  13. Compliance of disease awareness campaigns in printed Dutch media with national and international regulatory guidelines.

    Directory of Open Access Journals (Sweden)

    Teresa Leonardo Alves

    Full Text Available BACKGROUND: The European legislation prohibits prescription-only medicines' advertising but allows pharmaceutical companies to provide information to the public on health and diseases, provided there is no direct or indirect reference to a pharmaceutical product. Various forms of promotion have become increasingly common in Europe including "disease-oriented" campaigns. OBJECTIVES: To explore examples of disease awareness campaigns by pharmaceutical companies in the Netherlands, by assessing their compliance with the World Health Organization (WHO Ethical Criteria for medicinal drug promotion and the Dutch guidelines for provision of information by pharmaceutical companies. METHODS: Materials referring to health/disease and treatments published in the most widely circulated newspapers and magazines were collected from March to May 2012. An evaluation tool was developed based on relevant underlying principles from the WHO ethical criteria and Dutch self-regulation guidelines. Collected disease awareness advertisements were used to pilot the evaluation tool and to explore the consistency of information provided with the WHO and Dutch criteria. FINDINGS: Eighty materials met our inclusion criteria; 71 were published in newspapers and 9 in magazines. The large majority were news items but 21 were disease awareness advertisements, of which 5 were duplicates. Fifteen out of the 16 disease awareness campaigns were non-compliant with current guidelines mainly due to lack of balance (n = 12, absence of listed author and/or sponsor (n = 8, use of misleading or incomplete information (n = 5 and use of promotional information (n = 5. None mentioned a pharmaceutical product directly. CONCLUSION: Disease Awareness Campaigns are present in Dutch printed media. Although no brand names were mentioned, the lack of compliance of disease awareness campaigns with the current regulations is alarming. There were information deficiencies and evidence of information

  14. Objectives for an internship internal medicine : from the Dutch Blueprint (Raamplan 1994) to implementation into a practical logbook

    NARCIS (Netherlands)

    Raghoebar-Krieger, HMJ; Sleijfer, DT; Kreeftenberg, HG; Hofstee, WKB; Bender, W

    1999-01-01

    Background: The Dutch Blueprint 1994 (Raamplan 1994) describes the objectives of undergraduate medical education. The Blueprint, developed in order to improve medical education in the Netherlands, is accepted by all Dutch medical schools and has been legislated Aim: Translation of global objectives

  15. Developing a questionnaire to identify perceived barriers for implementing the Dutch physical therapy COPD clinical practice guideline.

    Science.gov (United States)

    van der Wees, Philip J; Zagers, Cor A M; de Die, Sara E; Hendriks, Erik J M; Nijhuis-van der Sanden, Maria W G; de Bie, Rob A

    2013-05-01

    Clinical practice guidelines have been developed to assist healthcare practitioners in clinical decision making. Publication of clinical practice guidelines does not automatically lead to their uptake and barrier identification has been recognized as an important step in implementation planning. This study aimed at developing a questionnaire to identify perceived barriers for implementing the Dutch COPD guideline for physical therapists and its recommended measurement instruments. An overall questionnaire, based on two existing questionnaires, was constructed to identify barriers and facilitators for implementing the COPD guideline. The construct of the questionnaire was assessed in a cross-sectional study among 246 chest physical therapists. Factor analysis was conducted to explore underlying dimensions. Psychometric properties were analyzed using Cronbach's alpha. Barriers and facilitators were assessed using descriptive statistics. Some 139 physical therapists (57%) responded. Factor analysis revealed 4-factor and 5-factor solutions with an explained variance of 36% and 39% respectively. Cronbach's alpha of the overall questionnaire was 0.90, and varied from 0.66 to 0.92 for the different factors. Underlying domains of the 5-factor solution were characterized as: attitude towards using measurement instruments, knowledge and skills of the physical therapist, applicability of the COPD guideline, required investment of time & money, and patient characteristics. Physical therapists showed a positive attitude toward using the COPD guideline. Main barriers for implementation were required time investment and financial constraints. The construct of the questionnaire revealed relevant underlying domains for the identification of barriers and facilitators for implementing the COPD guideline. The questionnaire allowed for tailoring to the target group and may be used across health care professionals as basis for in-depth analysis of barriers to specific recommendations in

  16. National Infrastructure Maintenance Strategy and its implementation

    CSIR Research Space (South Africa)

    Wall, K

    2008-10-01

    Full Text Available The National Infrastructure Maintenance Strategy (NIMS) was approved by Cabinet in 2006. This Strategy sets overarching policy for sector-based initiatives and describes the framework for a coordinated programme of actions. It is an essential part...

  17. Cross national study of leisure-time physical activity in Dutch and English populations with ethnic group comparisons.

    Science.gov (United States)

    de Munter, Jeroen S L; Agyemang, Charles; van Valkengoed, Irene G M; Bhopal, Raj; Zaninotto, Paola; Nazroo, James; Kunst, Anton E; Stronks, Karien

    2013-06-01

    Variations between countries in leisure-time physical activity (LTPA) can be used to test the convergence thesis, which expects that ethnic minority groups change towards the LTPA levels of the native population of host countries. The aim of this study was to test whether similar differences in LTPA between the native populations of England and the Netherlands are also observed among the Indian and African descent groups living in these countries. We used English and Dutch population-based health surveys that included participants aged 35-60 years of European (n(english) = 14,723, n(dutch) = 567), Indian (n(english) = 1264, n(dutch) = 370) and African-Caribbean (n(english) = 1112, n(dutch) = 689) descent. Levels of LTPA (30-minute walking, any reported cycling, gardening, dancing and playing sports) were estimated with age-sex-standardized prevalence rates. Comparisons among groups were made using adjusted Prevalence Ratios (PRs). Within both countries and compared with the European group, Indian and African groups had lower levels of gardening and cycling, whereas the African groups had higher levels of dancing. Between countries, among the European groups, the Netherlands showed higher prevalence of cycling than England, PR = 2.26 (95% CI: 2.06-2.48), and this was 2.85 (1.94-4.19) among Indian descent, and 2.77 (2.05-3.73) among African descent. For playing sports, this was PR = 1.30 (1.23-1.38), 1.43 (1.24-1.66) and 1.22 (1.10-1.34), whereas for gardening this was PR = 0.71 (0.65-0.78), 0.65 (0.52-0.81) and 0.75 (0.62-0.90), respectively. Walking and dancing showed inconsistent differences between the countries and ethnic groups. This cross-national comparison supports the expectation that LTPA of Indian and African descent groups converge towards the national levels of England and the Netherlands respectively.

  18. Outcomes of a systematically designed strategy for the implementation of sex education in Dutch secondary schools

    NARCIS (Netherlands)

    Wiefferink, C.H.; Poelman, J.; Linthorst, M.; Vanwesenbeeck, I.; Wijngaarden, J.C.M. van; Paulussen, T.G.W.M.

    2005-01-01

    This study examines the effects of a systematically designed innovation strategy on teachers' implementation of a sex education curriculum and its related determinants. A quasi-experimental group design was used to assess the effectiveness of the innovation strategy. Teachers filled in

  19. Implementation of a Personnel Management System "Beaufort": Successes and failures at a Dutch Hospital

    NARCIS (Netherlands)

    Bondarouk, Tatiana; Khosrow-Pour, M.

    2004-01-01

    This case describes a project concerning the implementation of a personnel management system - Beaufort - in Medinet, one of the larger regional general hospitals in The Netherlands. The project plan included two sequential phases: firstly, the introduction of Beaufort to the central personnel and

  20. Implementing multiple intervention strategies in Dutch public health-related policy networks

    NARCIS (Netherlands)

    Harting, Janneke; Peters, Dorothee; Grêaux, Kimberly; van Assema, Patricia; Verweij, Stefan; Stronks, Karien; Klijn, Erik-Hans

    2017-01-01

    Improving public health requires multiple intervention strategies. Implementing such an intervention mix is supposed to require a multisectoral policy network. As evidence to support this assumption is scarce, we examined under which conditions public health-related policy networks were able to

  1. Total, Free, and Added Sugar Consumption and Adherence to Guidelines: The Dutch National Food Consumption Survey 2007–2010

    Directory of Open Access Journals (Sweden)

    Diewertje Sluik

    2016-01-01

    Full Text Available A high sugar intake is a subject of scientific debate due to the suggested health implications and recent free sugar recommendations by the WHO. The objective was to complete a food composition table for added and free sugars, to estimate the intake of total sugars, free sugars, and added sugars, adherence to sugar guidelines and overall diet quality in Dutch children and adults. In all, 3817 men and women (7–69 years from the Dutch National Food Consumption Survey 2007–2010 were studied. Added and free sugar content of products was assigned by food composition tables and using labelling and product information. Diet was assessed with two 24-h recalls. Diet quality was studied in adults with the Dutch Healthy Diet-index. Total sugar intake was 22% Total Energy (%TE, free sugars intake 14 %TE, and added sugar intake 12 %TE. Sugar consumption was higher in children than adults. Main food sources of sugars were sweets and candy, non-alcoholic beverages, dairy, and cake and cookies. Prevalence free sugar intake <10 %TE was 5% in boys and girls (7–18 years, 29% in women, and 33% in men. Overall diet quality was similar comparing adults adherent and non-adherent to the sugar guidelines, although adherent adults had a higher intake of dietary fiber and vegetables. Adherence to the WHO free sugar guidelines of <5 %TE and <10 %TE was generally low in the Netherlands, particularly in children. Adherence to the added and free sugar guidelines was not strongly associated with higher diet quality in adults.

  2. Assessment of the Dutch National Air Quality Plan 2004; Beoordeling van het Nationaal Luchtkwaliteitsplan 2004

    Energy Technology Data Exchange (ETDEWEB)

    Beck, J.P.; Buringh, E.; Wieringa, K.

    2005-02-01

    The Dutch government expects that targets for the reduction of emission of particulates and nitrogen dioxide can not be reached in time. Therefore, the Netherlands is obliged to draft a plan of actions in order to realize those targets within the period that has been agreed upon in the context of the European Union air quality policy. The present plan of action has been assessed by the Netherlands Environmental Assessment Agency (MNP) with regard to the feasibility of the boundary values and the preconditions for action plans as formulated by the European Committee. Also, the plan has been assessed for the prevention or limitation of health effects and the Dutch position with regard to particulates. [Dutch] Het luchtbeleid heeft als doelstelling dat op lange termijn de gezondheidsrisico's en de effecten op ecosystemen en biodiversiteit moeten dalen tot een verwaarloosbaar niveau. Daartoe zijn in Europees verband normen voor de luchtkwaliteit vastgesteld. Nederland verwacht dat met het vastgestelde beleid niet tijdig aan de grenswaarden voor fijn stof en stikstofdioxide zal worden voldaan. Hierdoor is Nederland verplicht om een actieplan op te stellen. De uitvoering ervan zal er toe moeten leiden dat Nederland alsnog de doelen binnen de gestelde termijn haalt. Het Milieu- en Natuurplanbureau (MNP) van het RIVM heeft het actieplan getoetst aan de haalbaarheid van grenswaarden en aan de voorwaarden die door de Europese Commissie voor actieplannen zijn opgesteld. Daarnaast is het plan beoordeeld in het perspectief van de doelstelling van de richtlijn: het voorkomen of verminderen van gezondheidseffecten. Tenslotte geeft de evaluatie aanknopingspunten voor het herijken van de Nederlandse positie in de fijnstofproblematiek.

  3. Implementation of the Brazilian national repository

    International Nuclear Information System (INIS)

    Tello, Cledola Cassia Oliveira de

    2013-01-01

    Ionizing radiation in Brazil is used in electricity generation, medicine, industry, agriculture and for research and development purposes. All these activities can generate radioactive waste. At this point, in Brazil, the use of nuclear energy and radioisotopes justifies the construction of a national repository for radioactive wastes of low and intermediate-level. According to Federal Law No. 10308, Brazilian National Commission for Nuclear Energy (CNEN) is responsible for designing and constructing the intermediate and final storages for radioactive wastes. Additionally, a restriction on the construction of Angra 3 is that the repository is under construction until its operation start, attaining some requirements of the Brazilian Environmental Regulator (IBAMA). The RBMN Project (Repository for Low and Intermediate-Level Radioactive Wastes) aims at the implantation of a National Repository for disposal of low and intermediate-level of radiation wastes. This Project has some aspects that are unique in the Brazilian context, especially referring to the time between its construction and the end of its institutional period. This time is about 360 years, when the area will be released for unrestricted uses. It means that the Repository must be safe and secure for more than three hundred years, which is longer than half of the whole of Brazilian history. This aspect is very new for the Brazilian people, bringing a new dimension to public acceptance. Another point is this will be the first repository in South America, bringing a real challenge for the continent. The current status of the Project is summarized. (author)

  4. Annual incidence of non-specific low back pain as an occupational disease attributed to whole-body vibration according to the National Dutch Register 2005-2012.

    Science.gov (United States)

    Kuijer, P Paul F M; van der Molen, Henk F; Schop, Astrid; Moeijes, Fred; Frings-Dresen, Monique H W; Hulshof, Carel T J

    2015-01-01

    Non-specific low back pain (nLBP) is the second most important reason for sick leave in the Netherlands, and more than 50% of the workers on sick leave attribute these complaints to their work. To stimulate recognition and prevention, an occupational disease (OD) registration-guideline was implemented for the assessment of the work-relatedness of nLBP in the Netherlands in 2005. The aim of this study is to present the annual incidence of nLBP as an OD and specifically for whole-body vibration (WBV) including patient characteristics such as age, sick leave and actions initiated by the occupational physician (OP). The data were retrieved from the National Dutch Register for 2005-2012. Each year about 118 OPs reported 509 cases (SD 139) of nLBP as an OD in a Dutch working population of 7.5 million workers (8% of all annual reported ODs). Less than 1% of these cases were attributed to WBV: 94% were men, 45% were between 51 and 60 years and 35% were on sick leave for more than 2 weeks. Most initiated actions were ergonomic interventions (35%). The number of notified cases of nLPB as an occupational disease attributed to whole-body vibration is low with less than 1% of all cases in the Netherlands. An explanation is that other work-related risk factors for nLBP such as lifting are more frequently occurring, more visible and have a higher attributable risk than WBV. However, continuing attention for WBV remains warranted given a higher percentage of cases with sick leave of more than 2 weeks.

  5. Performing identities on a Dutch river dike: national identity and diverging lifestyles

    NARCIS (Netherlands)

    Terlouw, K.

    2013-01-01

    The creation of a national identity shared by the whole population becomes increasingly difficult in individualizing and globalizing national societies. The national population fragments into many lifestyle groups with very different social and cultural orientations. The enactment of these different

  6. The impact of national culture in MNC's home country on the strategy making process in their overseas subsidiaries: a comparison between Dutch and Japanese companies in Thailand

    NARCIS (Netherlands)

    Meekanon, K.

    2002-01-01

    The main purpose of this dissertation is to understand that the national cultures of MNCs' home countries play an important role in determining the SMPs in their overseas subsidiaries. To attain this purpose, a comparison between Dutch and

  7. Legal Deposit provision of the National Library Act: implementation ...

    African Journals Online (AJOL)

    Abstract. The Legal Deposit Act of the National Library of Nigeria is critically examined with regard to its implementation, presentation and benefits. ... The paper presents guidelines for collective drive and statutory functions and services implementations. ... for Authors · for Policy Makers · about Open Access · Journal Quality.

  8. Lesjes van de Nederlanders: Little Lessons from the Dutch to Promote Educational Quality. AIR 1995 Annual Forum Paper.

    Science.gov (United States)

    Palmer, Barbara H.

    This study explored quality assessment and accountability in Dutch university education using a case study approach. The Dutch national system of quality assurance is described, and developments since the mid-1980s are traced. The university case studies illustrate models which are being employed to implement the quality assurance system including…

  9. Implementing a lessons learned process at Sandia National Laboratories

    Energy Technology Data Exchange (ETDEWEB)

    Fosshage, Erik D.; Drewien, Celeste A.; Eras, Kenneth; Hartwig, Ronald Craig; Post, Debra S.; Stoecker, Nora Kathleen

    2016-01-01

    The Lessons Learned Process Improvement Team was tasked to gain an understanding of the existing lessons learned environment within the major programs at Sandia National Laboratories, identify opportunities for improvement in that environment as compared to desired attributes, propose alternative implementations to address existing inefficiencies, perform qualitative evaluations of alternative implementations, and recommend one or more near-term activities for prototyping and/or implementation. This report documents the work and findings of the team.

  10. Terror Management in a Multicultural Society: Effects of Mortality Salience on Attitudes to Multiculturalism Are Moderated by National Identification and Self-Esteem Among Native Dutch People.

    Science.gov (United States)

    Tjew-A-Sin, Mandy; Koole, Sander Leon

    2018-01-01

    Terror Management Theory (TMT; Greenberg et al., 1997) proposes that mortality concerns may lead people to reject other cultures than their own. Although highly relevant to multiculturalism, TMT has been rarely tested in a European multicultural society. To fill this void, two studies examined the effects of mortality salience (MS) among native Dutch people with varying levels of national identification and self-esteem. Consistent with TMT, MS led to less favorable attitudes about Muslims and multiculturalism among participants with high (rather than low) national identification and low (rather than high) self-esteem (Study 1). Likewise, MS led participants with high national identification and low self-esteem to increase their support of Sinterklaas, a traditional Dutch festivity with purported racist elements (Study 2). Together, these findings indicate that existential concerns may fuel resistance against multiculturalism, especially among people with low self-esteem who strongly identify with their nationality.

  11. The impact of EU referenda on national electoral politics: evidence from the Dutch case

    NARCIS (Netherlands)

    de Vries, C.E.

    2009-01-01

    This study deals with the issue of increasing contention regarding European matters in national arenas. Specifically, it focuses on the impact of European Union referenda on national elections. EU referenda have two important consequences for national politics: they increase inter-party conflict

  12. Culture as an explanation for substance-related problems: a cross-national study among French and Dutch adolescents.

    Science.gov (United States)

    Knibbe, Ronald Arnold; Joosten, Jan; Choquet, Marie; Derickx, Mieke; Morin, Delphine; Monshouwer, Karin

    2007-02-01

    Our main goal was to establish whether French and Dutch adolescents differ in rates of substance-related adverse events (e.g. fights, robbery), problems with peers or socializing agents even when controlling for pattern of substance use. For problems with peers and socializing agents due to alcohol we hypothesized that, because of stronger informal control of drinking in France, French adolescents are more likely to report problems with peers and socializing agents. For adverse events due to alcohol no difference was expected after controlling for consumption patterns. For drug-related problems, the hypothesis was that, due to the more restrictive drug policy in France, French adolescents are more likely to report problems with peers, socializing agents and adverse events. Comparable surveys based on samples of adolescent schoolchildren in France (n=9646) and the Netherlands (n=4291) were used. Data were analysed using multilevel logistic regression in which school, age and gender, indicators of substance use and country were used as predictors of substance-related problems. The outcomes show that French adolescents are more likely to report problems with peers and socializing agents due to alcohol even when consumption pattern is controlled for. For adverse events due to alcohol no difference was found between French and Dutch adolescents. For drug-related problems the expected differences were found; i.e. French adolescents are more likely to report problems with peers, socializing agents and adverse events even when controlling for pattern of drug use. It is concluded that there are culturally embedded differences in the rates of some types of problems due to alcohol or drug use. With respect to alcohol use, these differences are most likely due to culturally embedded differences in the informal social control of alcohol use. The differences in rates of drug-related problems are interpreted in the context of national differences in drug policy.

  13. Food Service Perspectives on National School Lunch Program Implementation.

    Science.gov (United States)

    Tabak, Rachel G; Moreland-Russell, Sarah

    2015-09-01

    Explore barriers and facilitators to implementation of the new National School Lunch Program (NSLP) policy guidelines. Interviews with eight food service directors using an interview guide informed by the Consolidated Framework for Implementation Research. Food service personnel; parents, teachers, school staff; and students were important stakeholders. Characteristics of the new NSLP policy guidelines were reported to create increased demands; resources alleviated some barriers. Directors reported increased food and labor costs, food sourcing challenges, decreased student participation, and organizational constraints as barriers to implementation. Creativity in menu planning facilitated success. Factors within the food service department, characteristics of implementing individuals and the new NSLP policy guidelines, and stakeholder involvement in the implementation process relate to successful implementation.

  14. Protocol compliance of administering parenteral medication in Dutch hospitals: an evaluation and cost-estimation of the implementation.

    NARCIS (Netherlands)

    Schilp, J.; Boot, S.; Blok, C. de; Spreeuwenberg, P.; Wagner, C.

    2014-01-01

    Objectives: Preventable adverse drug events (ADEs) are closely related to administration processes of parenteral medication. The Dutch Patient Safety Program provided a protocol for administering parenteral medication to reduce the amount of ADEs. The execution of the protocol was evaluated and a

  15. What hospitals need to know about guidelines : A mixed-method analysis of guideline implementation in Dutch hospitals

    NARCIS (Netherlands)

    Blume, L.H.K.; van Weert, N.J.H.W.; Busari, J.O.; Stoopendaal, A.M.V.; Delnoij, D.

    2017-01-01

    Rationale, aims and objectives This study provides insight into how Dutch hospitals ensure that guidelines are used in practice and identifies what key messages other hospitals can learn from existing practices. We examine current practices in handling compliance and, therefore, focus on hospitals

  16. Evaluation of a large scale implementation of disease management programmes in various Dutch regions: a study protocol.

    Science.gov (United States)

    Lemmens, Karin M M; Rutten-Van Mölken, Maureen P M H; Cramm, Jane M; Huijsman, Robbert; Bal, Roland A; Nieboer, Anna P

    2011-01-10

    Disease management programmes (DMPs) have been developed to improve effectiveness and economic efficiency within chronic care delivery by combining patient-related, professional-directed, and organisational interventions. The benefits of DMPs within different settings, patient groups, and versions remain unclear. In this article we propose a protocol to evaluate a range of current DMPs by capturing them in a single conceptual framework, employing comparable structure, process, and outcome measures, and combining qualitative and quantitative research methods. To assess DMP effectiveness a practical clinical trial will be conducted. Twenty-two disease management experiments will be studied in various Dutch regions consisting of a variety of collaborations between organisations and/or professionals. Patient cohorts include those with cardiovascular diseases, chronic obstructive pulmonary disease, diabetes, stroke, depression, psychotic diseases, and eating disorders. Our methodological approach combines qualitative and quantitative research methods to enable a comprehensive evaluation of complex programmes. Process indicators will be collected from health care providers' data registries and measured via physician and staff questionnaires. Patient questionnaires include health care experiences, health care utilisation, and quality of life. Qualitative data will be gathered by means of interviews and document analysis for an in depth description of project interventions and the contexts in which DMPs are embedded, and an ethnographic process evaluation in five DMPs. Such a design will provide insight into ongoing DMPs and demonstrate which elements of the intervention are potentially (cost)-effective for which patient populations. It will also enable sound comparison of the results of the different programmes. The study will lead to a better understanding of (1) the mechanisms of disease management, (2) the feasibility, and cost-effectiveness of a disease management

  17. Evaluation of a large scale implementation of disease management programmes in various Dutch regions: a study protocol

    Science.gov (United States)

    2011-01-01

    Background Disease management programmes (DMPs) have been developed to improve effectiveness and economic efficiency within chronic care delivery by combining patient-related, professional-directed, and organisational interventions. The benefits of DMPs within different settings, patient groups, and versions remain unclear. In this article we propose a protocol to evaluate a range of current DMPs by capturing them in a single conceptual framework, employing comparable structure, process, and outcome measures, and combining qualitative and quantitative research methods. Methods To assess DMP effectiveness a practical clinical trial will be conducted. Twenty-two disease management experiments will be studied in various Dutch regions consisting of a variety of collaborations between organisations and/or professionals. Patient cohorts include those with cardiovascular diseases, chronic obstructive pulmonary disease, diabetes, stroke, depression, psychotic diseases, and eating disorders. Our methodological approach combines qualitative and quantitative research methods to enable a comprehensive evaluation of complex programmes. Process indicators will be collected from health care providers' data registries and measured via physician and staff questionnaires. Patient questionnaires include health care experiences, health care utilisation, and quality of life. Qualitative data will be gathered by means of interviews and document analysis for an in depth description of project interventions and the contexts in which DMPs are embedded, and an ethnographic process evaluation in five DMPs. Such a design will provide insight into ongoing DMPs and demonstrate which elements of the intervention are potentially (cost)-effective for which patient populations. It will also enable sound comparison of the results of the different programmes. Discussion The study will lead to a better understanding of (1) the mechanisms of disease management, (2) the feasibility, and cost

  18. Evaluation of a large scale implementation of disease management programmes in various Dutch regions: a study protocol

    Directory of Open Access Journals (Sweden)

    Bal Roland A

    2011-01-01

    Full Text Available Abstract Background Disease management programmes (DMPs have been developed to improve effectiveness and economic efficiency within chronic care delivery by combining patient-related, professional-directed, and organisational interventions. The benefits of DMPs within different settings, patient groups, and versions remain unclear. In this article we propose a protocol to evaluate a range of current DMPs by capturing them in a single conceptual framework, employing comparable structure, process, and outcome measures, and combining qualitative and quantitative research methods. Methods To assess DMP effectiveness a practical clinical trial will be conducted. Twenty-two disease management experiments will be studied in various Dutch regions consisting of a variety of collaborations between organisations and/or professionals. Patient cohorts include those with cardiovascular diseases, chronic obstructive pulmonary disease, diabetes, stroke, depression, psychotic diseases, and eating disorders. Our methodological approach combines qualitative and quantitative research methods to enable a comprehensive evaluation of complex programmes. Process indicators will be collected from health care providers' data registries and measured via physician and staff questionnaires. Patient questionnaires include health care experiences, health care utilisation, and quality of life. Qualitative data will be gathered by means of interviews and document analysis for an in depth description of project interventions and the contexts in which DMPs are embedded, and an ethnographic process evaluation in five DMPs. Such a design will provide insight into ongoing DMPs and demonstrate which elements of the intervention are potentially (cost-effective for which patient populations. It will also enable sound comparison of the results of the different programmes. Discussion The study will lead to a better understanding of (1 the mechanisms of disease management, (2 the

  19. Theorizing government communication with regard to the Dutch nature policy

    NARCIS (Netherlands)

    Jansen, P.; Stoep, van der Jan; Jochemsen, H.

    2017-01-01

    The implementation of a National Ecological Network poses a significant challenge to the Dutch government. The establishment of this ecological network has led to conflicts among various interest groups in the public sphere, each of which defends its own interests. In this struggle for recognition

  20. The distribution of spiders and Harvestmen (Chelicerata) in the Dutch National Park "De Hoge Veluwe"

    NARCIS (Netherlands)

    Hammen, van der L.

    1983-01-01

    A preliminary study is made of the distribution of Araneida and Opilionida (Chelicerata) in a National Park in The Netherlands. Special attention is paid to the influence of vegetation structure on the distribution of the spiders.

  1. Exploring the barriers to implementing National Health Insurance in ...

    African Journals Online (AJOL)

    This article explores the challenges of implementing the proposed National Health Insurance for South Africa (SA), based on the six building blocks of the World Health Organization Health System Framework. In the context of the current SA health system, leadership, finance, workforce, technologies, information and service ...

  2. National Evaluation of Bologna Implementation in Finland: Procedures and Outcomes

    Science.gov (United States)

    Ahola, Sakari

    2012-01-01

    Finland has performed, as one of the first Bologna countries, a national evaluation of the outcomes of the implementation of the Bologna process. The evaluation was organized by the Finnish Higher Education Evaluation Council and performed by an independent expert group during 2010. In general, the reform was conceived as a significant development…

  3. Toward implementation of a national ground water monitoring network

    Science.gov (United States)

    Schreiber, Robert P.; Cunningham, William L.; Copeland, Rick; Frederick, Kevin D.

    2008-01-01

    The Federal Advisory Committee on Water Information's (ACWI) Subcommittee on Ground Water (SOGW) has been working steadily to develop and encourage implementation of a nationwide, long-term ground-water quantity and quality monitoring framework. Significant progress includes the planned submission this fall of a draft framework document to the full committee. The document will include recommendations for implementation of the network and continued acknowledgment at the federal and state level of ACWI's potential role in national monitoring toward an improved assessment of the nation's water reserves. The SOGW mission includes addressing several issues regarding network design, as well as developing plans for concept testing, evaluation of costs and benefits, and encouraging the movement from pilot-test results to full-scale implementation within a reasonable time period. With the recent attention to water resource sustainability driven by severe droughts, concerns over global warming effects, and persistent water supply problems, the SOGW mission is now even more critical.

  4. Monitoring the Implementation of State Regulation of National Economic Security

    Directory of Open Access Journals (Sweden)

    Hubarieva Iryna O.

    2018-03-01

    Full Text Available The aim of the article is to improve the methodological tools for monitoring the implementation of state regulation of national economic security. The approaches to defining the essence of the concept of “national economic security” are generalized. Assessment of the level of national economic security is a key element in monitoring the implementation of state regulation in this area. Recommendations for improving the methodology for assessing national economic security, the calculation algorithm of which includes four interrelated components (economic, political, social, spiritual one, suggests using analysis methods (correlation and cluster analysis, and taxonomy, which allows to determine the level and disproportion of development, can serve as a basis for monitoring the implementation of state regulation of national economic security. Such an approach to assessing national economic security makes it possible to determine the place (rank that a country occupies in a totality of countries, the dynamics of changing ranks over a certain period of time, to identify problem components, and monitor the effectiveness of state regulation of the national economic security. It the course of the research it was determined that the economic sphere is the main problem component of ensuring the security of Ukraine’s economy. The analysis made it possible to identify the most problematic partial indicators in the economic sphere of Ukraine: economic globalization, uneven economic development, level of infrastructure, level of financial market development, level of economic instability, macroeconomic stability. These indicators have a stable negative dynamics and a downward trend, which requires an immediate intervention of state bodies to ensure the national economic security.

  5. Character education in schools implementing national curriculum and international baccalaureate

    Directory of Open Access Journals (Sweden)

    Hotmaulina Sihotang

    2018-03-01

    Full Text Available The purpose of the study was to evaluate the implementation of the character education program of Junior and Senior High School Victory Plus School using the national curriculum and International Baccalaureate. The research method used is mix method. The result of data analysis showed that the average self-concept score was 2.65 (less good; self-management is 2.73 (good; and social services is 2.73 (good in the implementation of courageous, honest, active, mindful, innovative, open minded, and nobel (champion value. The value of champion is relevant to the value of the national curriculum character but the value of hard work, religion, democracy, the spirit of nationality, and the love of the homeland have not yet appeared. The balanced and reflective values in the learner profile are not yet visible.

  6. Antibiotics in Dutch general practice: nationwide electronic GP database and national reimbursement rates.

    NARCIS (Netherlands)

    Akkerman, A.E.; Kuyvenhoven, M.M.; Verheij, T.J.M.; Dijk, L. van

    2008-01-01

    PURPOSE: In order to assess whether different databases generate information which can be reliable compared with each other, this study aimed to assess to which degree prescribing rates for systemic antibiotics from a nationwide electronic general practitioner (GP) database correspond with national

  7. ‘Pythagoras in boots’: Johan Cruijff and the Construction of Dutch National Identity

    NARCIS (Netherlands)

    van Hilvoorde, I.M.; Stokvis, R.

    2013-01-01

    Sporting icons perform a key role in the production and reproduction of national identities. In the Netherlands, no one embodies this sentiment more appropriately than Johan Cruijff, regarded by many as one of the finest professional footballers ever to have played the game. Much of the early part

  8. The impact of national, corporate and professional cultures on innovation : German and Dutch firms compared

    NARCIS (Netherlands)

    Ulijn, J.M.; Nagel, A.P.; Liang, T.W.

    2001-01-01

    Innovation literature advocates the transition from a technological orientation to market orientation on the part of innovator and entrepreneur. However, the transition requires a change in mindset on the part of these innovation agents, who may be affected by their national contexts. This paper

  9. Ecology of national rule birth : A longitudinal study of Dutch higher educational law, 1960-2004

    NARCIS (Netherlands)

    van Witteloostuijn, A.; de Jong, G.

    To date, quantitative assessments of the evolution of national rules have only rarely been conducted, leaving many questions ill-understood and unaddressed, particularly as to the features of rule stock evolution patterns. Can such patterns be traced, and if so, can the underlying causal mechanisms

  10. Animal proteins in feed : annual report 2009-2010 of the Dutch National Reference Laboratory

    NARCIS (Netherlands)

    Raamsdonk, van L.W.D.; Scholtens-Toma, I.M.J.; Vliege, J.J.M.; Pinckaers, V.G.Z.; Groot, M.J.; Ossenkoppele, J.S.; Ruth, van S.M.

    2011-01-01

    RIKILT serves as the only official control laboratory for animal proteins in feeds in the Netherlands in the framework of Directive 882/2004/EC. As National Reference Laboratory (NRL), RIKILT participated in 2 annual proficiency tests during the reporting period, in 2 additional interlaboratory

  11. Explaining implementation behaviour of the National Incident Management System (NIMS).

    Science.gov (United States)

    Jensen, Jessica; Youngs, George

    2015-04-01

    This paper explains the perceived implementation behaviour of counties in the United States with respect to the National Incident Management System (NIMS). The system represents a massive and historic policy mandate designed to restructure, standardise and thereby unify the efforts of a wide variety of emergency management entities. Specifically, this study examined variables identified in the NIMS and policy literature that might influence the behavioural intentions and actual behaviour of counties. It found that three key factors limit or promote how counties intend to implement NIMS and how they actually implement the system: policy characteristics related to NIMS, implementer views and a measure of local capacity. One additional variable-inter-organisational characteristics-was found to influence only actual behaviour. This study's findings suggest that the purpose underlying NIMS may not be fulfilled and confirm what disaster research has long suggested: the potential for standardisation in emergency management is limited. © 2015 The Author(s). Disasters © Overseas Development Institute, 2015.

  12. Manual for national implementation of the Chemical Weapons Convention

    Energy Technology Data Exchange (ETDEWEB)

    Kellman, B. [DePaul Univ., Chicago, IL (United States); Tanzman, E.A.; Gualtieri, D.S.; Grimes, S.W. [Argonne National Lab., IL (United States)

    1993-12-01

    The Convention on the Prohibition on the Development, Production, Stockpiling and Use of Chemical Weapons and on their Destruction, opened for signature, January 13, 1993, in Paris, France (CWC), is an unprecedented multilateral effort to eradicate an entire category of weapons of mass destruction and assure their continued absence through international verification. The CWC has been signed by over 150 nations, and is expected to enter into force in 1995. With its far-reaching system to verify compliance, the CWC presages a new foundation for international security based neither on fear nor on trust, but on the rule of law. A central feature of the CWC is that it requires each State Party to take implementing measures to make the Convention operative. The CWC goes beyond all prior arms control treaties in this regard. For this approach to succeed, and to inspire the eradication of other categories of mass destruction weaponry, coordination and planning are vital to harmonize CWC national implementation among States Parties. This Manual for National Implementation of the Chemical Weapons Convention is designed to assist States Parties, duly taking into account the distinctive aspects of their legal systems, in maximizing CWC enforcement consistent with their national legal obligations.

  13. Role of radiology in a national initiative to interdict drug smuggling: the Dutch experience.

    Science.gov (United States)

    Algra, Paul R; Brogdon, Byron G; Marugg, Roque C

    2007-08-01

    The purpose of this pictorial essay is to describe the role of radiology in a national initiative to intercept illegal narcotics concealed within the bodies of human transporters. Radiologic examination is increasingly important in identifying intracorporeal drug smuggling as improved wrapping techniques undermine the usefulness of blood and urine testing and clinical observation. Detection rates of high accuracy, sensitivity, and specificity are achieved by experienced radiologists.

  14. 77 FR 472 - National Advisory Committee for Implementation of the National Forest System Land Management...

    Science.gov (United States)

    2012-01-05

    ... DEPARTMENT OF AGRICULTURE Forest Service National Advisory Committee for Implementation of the National Forest System Land Management Planning Rule; Correction AGENCY: USDA Forest Service. ACTION... for the deaf (TDD) may call the Federal Information Relay Service (FIRS) at 1 (800) 877-8339 between 8...

  15. Continuous palliative sedation until death: practice after introduction of the Dutch national guideline.

    Science.gov (United States)

    Swart, Siebe J; van der Heide, Agnes; Brinkkemper, Tijn; van Zuylen, Lia; Perez, Roberto; Rietjens, Judith

    2012-09-01

    In 2005, a national palliative guideline was launched in The Netherlands. The authors describe the practice of continuous palliative sedation until death (CPS) after the introduction of this guideline. In 2008, a random sample of physicians (n=1580) were asked to fill out a questionnaire regarding the last patient in whom they had provided CPS until death. The response was 38%. In all, 82% of the respondents were aware of the existence of the national guideline. Dyspnoea, pain and physical exhaustion were most often mentioned as decisive indications for continuous sedation. The decision to use sedation was discussed with all competent patients, but in 18% this merely involved informing the patient. Life expectancy at the start of continuous sedation was estimated to be less than 2 weeks in 97% of the cases. In 14%, the physicians had felt pressure to start the sedation, predominantly from patients and relatives. Physicians were present at the start of the sedation in 81% of the cases. Midazolam was used to induce the sedation in 92%. Overall, 41% of the physicians estimated that continuous sedation had hastened death to some extent. Most physicians thought that patients' complaints were adequately relieved by continuous sedation, that relatives were satisfied and that a good quality of dying was achieved. Continuous palliative sedation practice in The Netherlands largely reflects the recommendations from the national guideline. Issues needing further attention are the pressure felt by physicians to start continuous sedation and the potential life-shortening effect as mentioned by the physicians.

  16. An exploration of socio-economic and food characteristics of high trans fatty acid consumers in the Dutch and UK national surveys after voluntary product reformulation.

    Science.gov (United States)

    Rippin, H L; Hutchinson, J; Ocke, M; Jewell, J; Breda, J J; Cade, J E

    2017-01-01

    Trans fatty acids (TFA) increase the risk of mortality and chronic diseases. TFA intakes have fallen since reformulation, but may still be high in certain, vulnerable, groups. This paper investigates socio-economic and food consumption characteristics of high TFA consumers after voluntary reformulation in the Netherlands and UK. Post-reformulation data of adults aged 19-64 was analysed in two national surveys: the Dutch National Food Consumption Survey (DNFCS) collected 2007-2010 using 2*24hr recalls (N = 1933) and the UK National Diet and Nutrition Survey (NDNS) years 3&4 collected 2010/11 and 2011/12 using 4-day food diaries (N = 848). The socio-economic and food consumption characteristics of the top 10% and remaining 90% TFA consumers were compared. Means of continuous data were compared using t-tests and categorical data means using chi-squared tests. Multivariate logistic regression models indicated which socio-demographic variables were associated with high TFA consumption. In the Dutch analyses, women and those born outside the Netherlands were more likely to be top 10% TFA consumers than men and Dutch-born. In the UK unadjusted analyses there was no significant trend in socio-economic characteristics between high and lower TFA consumers, but there were regional differences in the multivariate logistic regression analyses. In the Netherlands, high TFA consumers were more likely to be consumers of cakes, buns & pastries; cream; and fried potato than the remaining 90%. Whereas in the UK, high TFA consumers were more likely to be consumers of lamb; cheese; and dairy desserts and lower crisps and savoury snack consumers. Some socio-demographic differences between high and lower TFA consumers were evident post-reformulation. High TFA consumers in the Dutch 2007-10 survey appeared more likely to obtain TFA from artificial sources than those in the UK survey. Further analyses using more up-to-date food composition databases may be needed.

  17. Third Dutch Process Security Control Event

    NARCIS (Netherlands)

    Luiijf, H.A.M.

    2009-01-01

    On June 4th, 2009, the third Dutch Process Control Security Event took place in Amsterdam. The event, organised by the Dutch National Infrastructure against Cybercrime (NICC), attracted both Dutch process control experts and members of the European SCADA and Control Systems Information Exchange

  18. Re-animated heritage. National project Nieuwe Hollandse Waterlinie (New Dutch Water Defence Line as a format for landscape policy

    Directory of Open Access Journals (Sweden)

    Eric Luiten

    2011-12-01

    -called National Landscape Pattern, independent, development-oriented landscape policy on a national scale ceased to exist. After a period in which physical planning described landscapes in terms like 'agricultural area with high to very high cultural-historical, scientific and/or natural heritage values' respectively, these past years two policy categories have been relied on on a government level: National Landscapes and Government Buffer Zones. After the recent change of government in 2010 landscape policy as embedded in physical planning, however, seems to have evaporated forever. The Third Policy Document on Architecture 'Designing the Netherlands' from 2001 (just as the Belvedere Policy Document from 1999 is a pragmatically composed action programme in which ten concrete spatial assignments are presented. As promised in the Policy Document, these projects would have to comply with high quality standards. One of these projects was the revitalization of the Nieuwe Hollandse Waterlinie. The purpose of this project was finding a balance between consolidation, protection, utilization and adjustment of the historical qualities of this military defence structure. In the light of the analysis of a permanently groping policy for Dutch cultural landscapes, the approach to the Nieuwe Hollandse Waterlinie is an interesting reference. After all, it concerns a concrete area with historically based boundaries, with identifiable patterns and artefacts on a regional scale. The project was initiated from an interest in increase of values and is integral in tone and ambition. In the national project Nieuwe Hollandse Waterlinie cultural heritage management, landscape protection and (landscape-architectonic quality care, region marking, recreation facilities and tourism, and water and nature policy come together. Also on the level of preservation of monuments new insights are being developed.

  19. Research lessons from implementing a national nursing workforce study.

    Science.gov (United States)

    Brzostek, T; Brzyski, P; Kózka, M; Squires, A; Przewoźniak, L; Cisek, M; Gajda, K; Gabryś, T; Ogarek, M

    2015-09-01

    National nursing workforce studies are important for evidence-based policymaking to improve nursing human resources globally. Survey instrument translation and contextual adaptation along with level of experience of the research team are key factors that will influence study implementation and results in countries new to health workforce studies. This study's aim was to describe the pre-data collection instrument adaptation challenges when designing the first national nursing workforce study in Poland while participating in the Nurse Forecasting: Human Resources Planning in Nursing project. A descriptive analysis of the pre-data collection phase of the study. Instrument adaptation was conducted through a two-phase content validity indexing process and pilot testing from 2009 to September 2010 in preparation for primary study implementation in December 2010. Means of both content validation phases were compared with pilot study results to assess for significant patterns in the data. The initial review demonstrated that the instrument had poor level of cross-cultural relevance and multiple translation issues. After revising the translation and re-evaluating using the same process, instrument scores improved significantly. Pilot study results showed floor and ceiling effects on relevance score correlations in each phase of the study. The cross-cultural adaptation process was developed specifically for this study and is, therefore, new. It may require additional replication to further enhance the method. The approach used by the Polish team helped identify potential problems early in the study. The critical step improved the rigour of the results and improved comparability for between countries analyses, conserving both money and resources. This approach is advised for cross-cultural adaptation of instruments to be used in national nursing workforce studies. Countries seeking to conduct national nursing workforce surveys to improve nursing human resources policies may

  20. Development and implementation of a lifestyle intervention to promote physical activity and healthy diet in the Dutch general practice setting: the BeweegKuur programme

    Directory of Open Access Journals (Sweden)

    de Vries Nanne K

    2010-05-01

    Full Text Available Abstract Background The number of patients with diabetes is increasing. BeweegKuur (Dutch for 'Exercise Therapy' is a Dutch lifestyle intervention which aims to effectively and feasibly promote physical activity and better dietary behaviour in primary health care to prevent diabetes. Methods The goal of this paper is to present the development process and the contents of the intervention, using a model of systematic health promotion planning. The intervention consists of a 1-year programme for diabetic and prediabetic patients. Patients are referred by their general practitioner (GP to a lifestyle advisor (LSA, usually the practice nurse or a physiotherapist. Based on specific inclusion criteria and in close collaboration with the patient, an individual exercise programme is designed and supervised by the LSA. This programme can be attended at existing local exercise facilities or (temporarily under the supervision of a specialized exercise coach or physiotherapist. All participants are also referred to a dietician and receive diet-related group education. In the first pilot year (2008, the BeweegKuur programme was implemented in 7 regions in the Netherlands (19 GP practices and health centres, while 14 regions (41 GP practices and health centres participated during the second year. The aim is to implement BeweegKuur in all regions of the Netherlands by 2012. Discussion The BeweegKuur programme was systematically developed in an evidence- and practice-based process. Formative monitoring studies and (controlled effectiveness studies are needed to examine the diffusion process and the effectiveness and cost-effectiveness of the intervention.

  1. Exploring determinants of completeness of implementation and continuation of a Dutch school-based healthy diet promotion programme

    NARCIS (Netherlands)

    Bessems, K.M.H.H.; Assema, P. van; Vries, N.K. de; Paulussen, T.W.G.M.

    2014-01-01

    Strategies to promote implementation of school-based health promotion (HP) programmes should be designed to suit determinants of implementation and continuation. This study explored determinants of completeness of teachers' implementation of a healthy diet promotion programme and of their intention

  2. Status of the implementation of Brazilian National Repository

    International Nuclear Information System (INIS)

    Tello, Cledola Cassia Oliveira de

    2015-01-01

    In Brazil, the use of nuclear energy and radioisotopes is increasing and it already justifies the construction of a national repository for radioactive wastes of low and intermediate-level. The Brazilian National Commission for Nuclear Energy (CNEN) is legally responsible for designing and constructing intermediate and final storages for radioactive wastes generated in all Country, in accordance to Federal Law No. 10308. Additionally, the Brazilian Environmental Regulator (IBAMA) lately is imposing to the implementation of new nuclear installations (e.g. Angra 3 NPP and Brazilian Multipurpose Reactor) that the National Repository should be in construction, before the start-up of those ones. In November 2009, the RBMN Project Charter was signed. The RBMN Project aims at the implantation of a National Repository to dispose the radioactive wastes of low- and intermediate-level. Some aspects about the Repository construction are very challenging, mainly due to the licensing process, which will be made for two different regulatory bodies, nuclear and environmental. The main achievements obtained till now are the establishment of the current Brazilian radioactive waste inventory, the conceptual design and the selection of candidate sites for the repository. The current status of the Project is summarized. (author)

  3. Dutch National Security Reform Under Review : Sufficient Checks and Balances in the Intelligence and Security Services Act 2017?

    NARCIS (Netherlands)

    Quirine Eijkman; Nico van Eijk; Robert van Schaik

    2018-01-01

    In May 2018, the new Dutch Intelligence and Security Services Act 2017 (Wet op de Inlichtingen- en veiligheidsdiensten, Wiv) will enter into force. It replaces the previous 2002 Act and incorporates many reforms to the information gathering powers of the two intelligence and security services as

  4. Impetigo: incidence and treatment in Dutch general practice in 1987 and 2001: results from two national surveys.

    NARCIS (Netherlands)

    Koning, S.; Mohammedamin, R.S.A.; Wouden, J.C. van der; Suijlekom-Smit, L.W.A. van; Schellevis, F.G.; Thomas, S.

    2006-01-01

    Background: Impetigo is a common skin infection in children. The epidemiology is relatively unkown, and the choice of treatment is subject to debate. Objective: The objective of our study was to determine the incidence and treatment of impetigo in Dutch general practice, and to assess trends between

  5. Parental Support and Knowledge and Adolescents' Sexual Health: Testing Two Mediational Models in a National Dutch Sample

    Science.gov (United States)

    de Graaf, Hanneke; Vanwesenbeeck, Ine; Woertman, Liesbeth; Keijsers, Loes; Meijer, Suzanne; Meeus, Wim

    2010-01-01

    This study investigated age- and gender-specific associations between parental support and parental knowledge of the child's whereabouts, on the one hand, and sexual experience and sexual health (the ability to have safe and pleasurable sexual experiences) on the other hand. A representative Dutch sample of 1,263 males and 1,353 females (aged…

  6. Scripts of sexual desire and danger in US and Dutch teen girl magazines: a cross-national content analysis

    NARCIS (Netherlands)

    Joshi, S.P.; Peter, J.; Valkenburg, P.M.

    2011-01-01

    The aim of this comparative quantitative content analysis was to investigate how US and Dutch teen girl magazines cover sexual desire (i.e., sexual wanting, and pleasure) and sexual danger (i.e., sexual risk, and negative physical/health consequences of sex). Relying on the sexual scripts framework

  7. Dutch public affairs professionals in the national and European arena : A smart mix of skills, attitude, and knowledge competences

    NARCIS (Netherlands)

    Figee, Edward L.; Gosselt, Jordi F.; Linders, Paul C.J.; de Jong, Menno D.T.

    2017-01-01

    Although the profession of public affairs (PA) is increasingly important for organizations, relatively little is known about the range of competences PA professionals need. This article presents a qualitative study among 41 experienced Dutch PA professionals and practitioners, who were interviewed

  8. 77 FR 2514 - National Ocean Council-National Ocean Policy Draft Implementation Plan

    Science.gov (United States)

    2012-01-18

    ... Ocean Council developed actions to achieve the Policy's nine priority objectives, and to address some of..., contribute trillions of dollars a year to the national economy, and are essential to public health and... departments, agencies, and offices developed the actions in the draft Implementation Plan with significant...

  9. The Fiscal Compact: Europe’s Not Always Able to Speak German: On the Dutch Implementing Act and the Hazardous Interpretation of Article 3(2) Fiscal Compact

    NARCIS (Netherlands)

    Reestman, J.H.

    2013-01-01

    Fiscal Compact: duty to implement balanced budget rule, automatic correction mechanism and independent budget supervisor in national law - The Netherlands: Act on sustainable government finances - Act does not bind the (budget) legislature - Conformity with the implementation duty in Article 3(2)

  10. Challenges in Implementing IAEA National Nuclear Safety Knowledge Platforms

    International Nuclear Information System (INIS)

    Samba, R.N.; Simo, A.

    2016-01-01

    Full text: Integrated Management Systems and human resource development of nuclear knowledge have always been a challenge for developing countries. NRPA staff when trained by IAEA return and restitute with all colleagues the themes acquired in nuclear knowledge. NRPA became a member of Forum for Nuclear Regulatory Bodies in Africa (FNRBA) in 2009. FNRBA organized with IAEA a workshop from 14th to 18th October 2013 in Nairobi, Kenya on Knowledge Safety Network. NRPA of Cameroon created the first National Nuclear Portail under FNRBA. This was linked to other national websites. During the IAEA review missions, most counterparts took opportunity from the thermatic site to share information and develop advance reference materials. The IAEA Integrated Regulatory Review Service (IRRS) team also shared materials that could not be transferred through email with national counterparts using the Global Nuclear Safety and Security Network (GNSSN) sharepoint website due to large file sizes.The regulatory documents have been uploaded on the platform and can be accessed through FNRBA and NRPA website (www.anrp.cm). UN organizations implementing projects in Cameroon are also linked to the platform. The action plans and progress reports for IAEA/AFRA projects are also available. Moreover, NRPA regulatory activities and licensing sources are available on this platform. (author

  11. Should implementation intentions interventions be implemented in obesity prevention: the impact of if-then plans on daily physical activity in Dutch adults.

    NARCIS (Netherlands)

    de Vet, E.W.M.L.; Oenema, A.; Sheeran, P.; Brug, J.

    2009-01-01

    Background: Forming implementation intentions (specifying when, where and how to act) has been proposed as a potentially effective and inexpensive intervention, but has mainly been studied in controlled settings for straightforward behaviors. Purpose: To examine if forming implementation intentions

  12. Implementing the Provisions of the National Environmental Policy Act

    Science.gov (United States)

    1988-01-01

    This handbook provides guidance and assistance to NASA officials in carrying out their responsibilities under the National Environmental Policy Act and the applicable NASA procedures (14 CFR 1216.3, Attachment A to NMI 8800.7). The handbook, as was contemplated by the regulations of the Council on Environmental Quality, stresses the need for environmental analysis from the time of early planning through environmental assessment and environmental impact statement preparation to implementation of the subject action, and provides for necessary follow up. It stresses the need for NASA officials to draw upon all the appropriate disciplines from the natural and social sciences plus the environmental design arts in planning and decision making on actions which may have an impact on the human environment. The handbook is applicable to NASA Headquarters and field installations.

  13. Developing a questionnaire to identify perceived barriers for implementing the Dutch physical therapy COPD clinical practice guideline

    NARCIS (Netherlands)

    Wees, P.J. van der; Zagers, C.A.; Die, S.E. de; Hendriks, E.J.; Nijhuis-Van der Sanden, M.W.G.; Bie, R.A. de

    2013-01-01

    BACKGROUND: Clinical practice guidelines have been developed to assist healthcare practitioners in clinical decision making. Publication of clinical practice guidelines does not automatically lead to their uptake and barrier identification has been recognized as an important step in implementation

  14. Remembering Dutch-Moluccan radicalism

    DEFF Research Database (Denmark)

    Marselis, Randi Lorenz

    2016-01-01

    This article examines memory politics in relation to radical actions of young Dutch-Moluccans, more specifically a train hijacking in 1977 at the village of De Punt in the Netherlands. The article examines how these historical events were remembered in the drama-documentary television film, De Punt...... of the web debate examines how viewers reacted to this interpretation. The web debate functioned as a participatory forum, where collective and national memories and postcolonial history were intensely discussed, and the debate made room for some degree of reconciliation between viewers of Dutch......-Moluccan and of Dutch majority background...

  15. Lessons Learned from Implementing National Nuclear Safety Knowledge Platforms

    International Nuclear Information System (INIS)

    Simo, A.

    2016-01-01

    The Integrated Nuclear Security Advisory Services (INSServ) took place in Cameroon from 21st to 25th April 2014 and the Integrated Regulatory Review Service (IRRS) from 12th to 21st October 2014. This was after the government requested the Director General of International Atomic Energy Agency (IAEA) through an official correspondence on 11th June 2013, for these missions. The main objective was to further improve the effectiveness of the Cameroon governmental, legal and regulatory framework for safety and security. Revision of the legal and regulatory framework so that all international safety and security standards are addressed in laws and statutes have been done with documents downloaded from Nuclear portal sites found in GNSSN. Establishment and implementation of integrated management systems by NRPA is being done with documentation under the National Nuclear Portal with lessons learned from the IAEA review missions. The regulatory documents have been uploaded on the platform and can be accessed through FNRBA and NRPA website (www.anrp.cm). UN organizations implementing projects in Cameroon are also linked to the platform. The action plans and progress reports for IAEA/AFRA projects are also available. Moreover, NRPA regulatory activities and licensing sources are available on this platform.

  16. A cross-national comparative study of smoking prevalence and cessation between English and Dutch South Asian and African origin populations: the role of national context

    NARCIS (Netherlands)

    Agyemang, Charles; Stronks, Karien; Tromp, Neelke; Bhopal, Raj; Zaninotto, Paola; Unwin, Nigel; Nazroo, James; Kunst, Anton E.

    2010-01-01

    Evidence suggests that Dutch people smoke substantially more than their British counterparts. These differences have been suggested to relate, in part, to the health-related policy differences between the two countries. It is unclear whether these differences affect smoking among ethnic minority

  17. A Cross-National Comparative Study of Blood Pressure and Hypertension Between English and Dutch South-Asian- and African-Origin Populations: The Role of National Context

    NARCIS (Netherlands)

    Agyemang, Charles; Kunst, Anton; Bhopal, Raj; Zaninotto, Paola; Unwin, Nigel; Nazroo, James; Nicolaou, Mary; Redekop, William Ken; Stronks, Karien

    2010-01-01

    BACKGROUND We compare patterns of blood pressure (BP) and prevalence of hypertension between white-Dutch and their South-Asian and African minority groups with their corresponding white-English and their South-Asian and African ethnic minority groups; and the contribution of physical activity, body

  18. Dutch Dwellings

    NARCIS (Netherlands)

    Vries, de B.; Zee, van der A.; Carp, J.C.; Soddu, C.

    2004-01-01

    Applying Generative Design (GD) for dwelling is not very common but it opens up the possibility to study whether GD systems can reproduce existing design typologies. Dutch dwellings as an exemplification of a design typology are analysed using the SAR methodology. Building regulations are used as

  19. Large scale implementation of clinical medication reviews in Dutch community pharmacies: Drug-related problems and interventions

    NARCIS (Netherlands)

    Kempen, Thomas G. H.; Van De Steeg-Van Gompel, Caroline H. P. A.; Hoogland, Petra; Liu, Yuqian; Bouvy, Marcel L.

    2014-01-01

    Background: Research on the benefits of clinical medication reviews (CMRs) performed by pharmacists has been conducted mostly in controlled settings and has been widely published. Less is known of the effects after large scale implementation in community pharmacies. An online CMR tool enabled the

  20. Implementation of integrated care for diabetes mellitus type 2 by two Dutch care groups : A case study

    NARCIS (Netherlands)

    Busetto, Loraine; Luijkx, Katrien; Huizing, Anna; Vrijhoef, H.J.M.

    2015-01-01

    Background Even though previous research has demonstrated improved outcomes of integrated care initiatives, it is not clear why and when integrated care works. This study aims to contribute to filling this knowledge gap by examining the implementation of integrated care for type 2 diabetes by two

  1. Should implementation intentions interventions be implemented in obesity prevention: the impact of if-then plans on daily physical activity in Dutch adults.

    NARCIS (Netherlands)

    E. Vet (Emely); A. Oenema (Anke); P. Sheeran (Paschal); J. Brug (Hans)

    2009-01-01

    textabstractBackground Forming implementation intentions (specifying when, where and how to act) has been proposed as a potentially effective and inexpensive intervention, but has mainly been studied in controlled settings for straightforward behaviors. Purpose To examine if forming

  2. Implementing the national AIGA flash flood warning system in France

    Science.gov (United States)

    Organde, Didier; Javelle, Pierre; Demargne, Julie; Arnaud, Patrick; Caseri, Angelica; Fine, Jean-Alain; de Saint Aubin, Céline

    2015-04-01

    The French national hydro-meteorological and flood forecasting centre (SCHAPI) aims to implement a national flash flood warning system to improve flood alerts for small-to-medium (up to 1000 km2) ungauged basins. This system is based on the AIGA method, co-developed by IRSTEA these last 10 years. The method, initially set up for the Mediterranean area, is based on a simple event-based hourly hydrologic distributed model run every 15 minutes (Javelle et al. 2014). The hydrologic model ingests operational radar-gauge rainfall grids from Météo-France at a 1-km² resolution to produce discharges for successive outlets along the river network. Discharges are then compared to regionalized flood quantiles of given return periods and warnings (expressed as the range of the return period estimated in real-time) are provided on a river network map. The main interest of the method is to provide forecasters and emergency services with a synthetic view in real time of the ongoing flood situation, information that is especially critical in ungauged flood prone areas. In its enhanced national version, the hourly event-based distributed model is coupled to a continuous daily rainfall-runoff model which provides baseflow and a soil moisture index (for each 1-km² pixel) at the beginning of the hourly simulation. The rainfall-runoff models were calibrated on a selection of 700 French hydrometric stations with Météo-France radar-gauge reanalysis dataset for the 2002-2006 period. To estimate model parameters for ungauged basins, the 2 hydrologic models were regionalised by testing both regressions (using different catchment attributes, such as catchment area, soil type, and climate characteristic) and spatial proximity techniques (transposing parameters from neighbouring donor catchments), as well as different homogeneous hydrological areas. The most valuable regionalisation method was determined for each model through jack-knife cross-validation. The system performance was then

  3. Direct and indirect nitrous oxide emissions from agricultural soils, 1990 - 2003. Background document on the calculation method for the Dutch National Inventory Report

    International Nuclear Information System (INIS)

    Van der Hoek, K.W.; Van Schijndel, M.W.; Kuikman, P.J.

    2007-01-01

    Since 2005 the Dutch method to calculate the nitrous oxide emissions from agricultural soils has fully complied with the Intergovernmental Panel on Climate Change (IPCC) Good Practice Guidelines. In order to meet the commitments of the Convention on Climate Change and the Kyoto Protocol, nitrous oxide emissions have to be reported annually in the Dutch National Inventory Report (NIR). Countries are encouraged to use country-specific data rather than the default values provided by the IPCC. This report describes the calculation schemes and data sources used for nitrous oxide emissions from agricultural soils in the Netherlands. The nitrous oxide emissions, which contribute to the greenhouse effect, occur due to nitrification and denitrification processes. They include direct emissions from agricultural soils due to the application of animal manure and fertilizer nitrogen and the manure production in the meadow. Also included are indirect emissions resulting from the subsequent leaching of nitrate to ground water and surface waters, and from deposition of ammonia that had volatilized as a result of agricultural activities. Before 2005 indirect emissions in the Netherlands were calculated using a method that did not compare well with IPCC definitions and categories. The elaborate explanation here should facilitate reviewing by experts. Finally, the report also presents an overview of the nitrous oxide emissions from agricultural soils and the underlying data used in the 1990 - 2003 period

  4. Swedish experiences in implementing national and international safeguards

    International Nuclear Information System (INIS)

    Nilsson, A.; Elborn, M.; Grahn, P.

    1991-01-01

    This paper reports that international safeguards have been applied in Sweden since the early 70s. Experiences have been achieved from exclusive bilateral and trilateral control followed by NPT safeguards in 1975. The Swedish State System for accountancy and Control (SSAC) includes all regulations that follows from prevailing obligations regarding the peaceful uses of nuclear material. The system has been developed in cooperation between the national authority, the Swedish Nuclear Power Inspectorate (SKI) and the Swedish nuclear industry. The paper presents experiences from the practical implementation of the SSAC and the IAEA safeguards system, gained by the SKI and the nuclear industry, respectively. Joint approaches and solutions to some significant safeguards issues are presented. The cooperation between the nuclear industry and the authority in R and D activities, in particular with respect to the Swedish Support Program is highlighted, e.g. the use of nuclear facilities in development or training tasks. some of the difficulties encountered with the system are also touched upon

  5. Experience from implementing international standards in national emergency response planning national adjustments and suggestions for improvements

    International Nuclear Information System (INIS)

    Naadland Holo, E.

    2003-01-01

    Full text: A process has been going on for some time in Norway to establish a harmonized background for emergency response planning for any kind of nuclear or radiological accident. The national emergency preparedness organisation with the crisis committee for nuclear accident, consisting of representatives from civil defence, defence, police-, health-, and food control authorities, has the authority to implement countermeasures to protect health, environment and national interests in case of an accident or in case of nuclear terrorism. However, in an early phase, the response plans need to be fully harmonized to ensure that every operational level knows their responsibility and the responsibilities of others. Our intention is to implement the IAEA standard 'preparedness and response for a nuclear or radiological emergency'. We believe this will simplify national and international communication and also simplify the crisis management if an accident occurs. In revising the national plans, and also the planning basis at regional and local level, as well as the planning basis for response to accidents at national nuclear facilities and in connection with arrival of nuclear submarines in Norwegian harbours, we have seen the need to make national adjustments to the international standards. In addition to the standard, there exist several other processes and routines for reporting different kinds of incidents. We have seen a need to coordinate this internally at the competent authority to simplify the routines. This paper will focus on the challenges we have met, our national solutions and some suggestions for simplification. National adjustments to the international standard. - Firstly, the threat categorization needs to be adjusted. First of all, we do not have nuclear power plants in Norway. In the aftermath of 11 September 2001 we also have focused more an the potential for nuclear terrorism. Nuclear terrorism is unlikely but puts up some new requirements in the

  6. The Dutch Obesity Intervention in Teenagers (DOiT) cluster controlled implementation trial: intervention effects and mediators and moderators of adiposity and energy balance-related behaviours.

    Science.gov (United States)

    van Nassau, Femke; Singh, Amika S; Cerin, Ester; Salmon, Jo; van Mechelen, Willem; Brug, Johannes; Chinapaw, Mai Jm

    2014-12-24

    The Dutch Obesity Intervention in Teenagers (DOiT) programme is an evidence-based obesity prevention programme tailored to adolescents attending the first two years of prevocational education in the Netherlands. The initial programme showed promising results during an effectiveness trial. The programme was adapted and prepared for nationwide dissemination. To gain more insight into the process of translating evidence-based approaches into 'real world' (i.e., 'natural') conditions, our research aims were to evaluate the impact of the DOiT-implementation programme on adolescents' adiposity and energy balance-related behaviours during natural dissemination and to explore the mediating and moderating factors underlying the DOiT intervention effects. We conducted a cluster-controlled implementation trial with 20 voluntary intervention schools (n=1002 adolescents) and 9 comparable control schools (n = 484 adolescents). We measured adolescents' body height and weight, skinfold thicknesses, and waist circumference. We assessed adolescents' dietary and physical activity behaviours by means of self-report. Data were collected at baseline and at 20-months follow-up. We used multivariable multilevel linear or logistic regression analyses to evaluate the intervention effects and to test the hypothesised behavioural mediating factors. We checked for potential effect modification by gender, ethnicity and education level. We found no significant intervention effects on any of the adiposity measures or behavioural outcomes. Furthermore, we found no mediating effects by any of the hypothesised behavioural mediators. Stratified analyses for gender showed that the intervention was effective in reducing sugar-containing beverage consumption in girls (B = -188.2 ml/day; 95% CI = -344.0; -32.3). In boys, we found a significant positive intervention effect on breakfast frequency (B = 0.29 days/week; 95% CI = 0.01; 0.58). Stratified analyses for education level showed

  7. Implementing primary health care: some problems of creating national programmes.

    Science.gov (United States)

    Vaughan, J P; Walt, G

    1984-07-01

    While there is a great deal of agreement about the principles underlying Primary Health Care (PHC), there exist many problems, political, planning and management, involved in putting the approach into effect. Some of these difficulties are discussed. It is clear that the PHC approach is essentially political; the way it is implemented in each country will reflect the political priorities and systems of that country. Moreover, ministries of health are not known for their strong position in the ministerial pecking order. Finance and planning ministeries would have to be won over to the importance of the concept of PHC to try to eexpand the health budget and to change the emphasis of existing resource allocation patterns. Costs incurred by a PHC approach ( e.g., expensive transport and communication systems), and resources needed to finance it may be available; however, they may not be channelled to the politically less articulate groups in rural areas. Political implications are not limited to national levels; considerable conflict may exist between different status groups and classes at the village level, thus sabotaging PHC plans. Professional politics will also be played at all levels. It is equally essential to recognize the historical context in which PHC is being introduced. Many countries have inherited colonial infrastructures. Changing the values, perceptions, expectations, administration and organization that accompany such systems is extremely hard, and to put PHC into effect demands radical changes. The planning difficulties which beset PHC are related to the still large private provision of social services like health, and to a flourishing traditional private sector in many developing countries. These may limit the implementation of a national health policy and PHC may thus result in a very patchy service throughout the country. The level of centralized planning will also affect resource allocation and therefore the policy, planning and implementation

  8. RDA Implementation at the National Autonomous University of Mexico

    Directory of Open Access Journals (Sweden)

    Filiberto Felipe Martínez Arellano

    2017-04-01

    Full Text Available The Universidad Nacional Autónoma de México (UNAM [National Autonomous University of Mexico] is the largest and most important educational institution in Mexico and Latin America. It serves more than 340,000 graduate, bachelor and high school students. It offers 41 graduate programs and 118 undergraduate ones. Moreover, the Biblioteca Nacional de México (BNM [National Library of Mexico] is into the UNAM structure, playing the role of safeguarding and preserving the bibliographical memory of Mexico, which is integrated by more than 1,250,000 books and documents that are sheltered into this library. Moreover, the Sistema Bibliotecario y de Información de la UNAM (SIBIUNAM [UNAM Library and Information System] is composed of 135 libraries with a collection of approximately 1,700.000 book titles and 6,000.000 volumes, which is coordinated by the Dirección General de Bibliotecas de la UNAM [UNAM General Directorate of Libraries]. Additionally, in the UNAM organization is placed the Instituto de Investigaciones Bibliotecológicas y de la Información (IIBI [Institute of Research in Library and Information Sciences], where theoretical and applied research projects are carried out in several research areas, being one of them the information organization, and within this one, cataloging standards are approached. This article addresses the challenges that the adoption of the new RDA cataloging standard has represented for these three UNAM organizations, as well as the actions developed in each one of them. The Biblioteca Nacional México (BNM experiences on RDA implementation are shared. Some problematic situations, as well as the solution for these ones, are presented. It is also included the BNM participation in forums, to communicate the work that was done on cataloging using the new code. It also is addressed the updating and training of staff, participation in cooperative cataloging programs and the RDA analysis in work teams, as well as the

  9. Dutch chemical producers pledge emissions cuts

    International Nuclear Information System (INIS)

    Chynoweth, E.; Schoenmakers, J.

    1993-01-01

    Dutch chemical producers have negotiated a long-term agreement with government ministries to reduce emissions of a wide range of chemicals. Industry association Vereniging van de Nederlandse Chemische Industrie (VNCI; Leidschendam) says implementing the commitment will cost companies Dfl 10 billion ($5.4 billion) between 1993 and 2000. VNCI technical director Wim Quik welcomes the accord, which he describes as a management contract, saying, Rather than have legislation, there is a certain adjustment available. Peter Santen, managing director of midsized chemicals player Cindu Chemicals (Uithoorn, the Netherlands) voices some concern about the details of the accord, but adds, we are flexible in trying to agree with the contents of the covenant [it] is better than having new rules from law. The Dutch government, traditionally eager for consensus, has struck a number of such deals with Dutch industries - including packaging, metal, and tire - to reduce emissions and set up environmental management programs. The effort is based on the government's National Environmental Policy Plans - NMP and NMP Plus. Targets for emissions reduction by the chemical industry were provided by a government-funded environmental research institute

  10. 75 FR 43528 - Seeking Public Comment on Draft National Health Security Strategy Biennial Implementation Plan

    Science.gov (United States)

    2010-07-26

    ... National Health Security Strategy Biennial Implementation Plan AGENCY: Department of Health and Human... National Health Security Strategy (NHSS) of the United States of America (2009) and build upon the NHSS Interim Implementation Guide for the National Health Security Strategy of the United States of America...

  11. Cost-effectiveness of a multifaceted implementation strategy for the Dutch multidisciplinary guideline for nonspecific low back pain: design of a stepped-wedge cluster randomised controlled trial.

    Science.gov (United States)

    Suman, Arnela; Schaafsma, Frederieke G; Elders, Petra J M; van Tulder, Maurits W; Anema, Johannes R

    2015-05-31

    Low back pain (LBP) is one of the most prevalent and expensive health care problems in industrialised countries. LBP leads to high health care utility and productivity losses; leaving the individual, the employer, and society with substantial costs. To improve the care for LBP patients and reduce the high societal and financial burden of LBP, in 2010 the 'Multidisciplinary care guideline for nonspecific low back pain' was developed in the Netherlands. The current paper describes the design of a study aiming to evaluate the (cost-) effectiveness of a multifaceted strategy to implement this guideline. In a cluster-randomised controlled trial, the (cost-) effectiveness of a multifaceted implementation strategy will be compared to passive guideline dissemination. Using a stepped-wedge approach, participating general practitioners, physiotherapists, and occupational physicians are allocated into clusters and will attend a multidisciplinary continuing medical education training session. The timing these clusters receive the training is the unit of randomisation. LBP patients visiting the participating health care providers are invited to participate in the trial and will receive access to a multimedia intervention aimed at improving beliefs, cognitions, and self-management. The primary outcome measure of this study is patient back beliefs. Secondary outcome measures on patient level include pain, functional status, quality of life, health care utility, and productivity losses. Outcome measures on professional level include knowledge and attitude towards the guideline, and guideline adherence. A process evaluation for the implementation strategy will be performed among the health care providers and the patients. Furthermore, a qualitative subgroup analysis among patients with various ethnic backgrounds will be performed. This study will give insight into the (cost-) effectiveness of a multifaceted implementation strategy for the Dutch multidisciplinary guideline for non

  12. National health insurance policy in Nepal: challenges for implementation

    Directory of Open Access Journals (Sweden)

    Shiva Raj Mishra

    2015-08-01

    Full Text Available The health system in Nepal is characterized by a wide network of health facilities and community workers and volunteers. Nepal's Interim Constitution of 2007 addresses health as a fundamental right, stating that every citizen has the right to basic health services free of cost. But the reality is a far cry. Only 61.8% of the Nepalese households have access to health facilities within 30 min, with significant urban (85.9% and rural (59% discrepancy. Addressing barriers to health services needs urgent interventions at the population level. Recently (February 2015, the Government of Nepal formed a Social Health Security Development Committee as a legal framework to start implementing a social health security scheme (SHS after the National Health Insurance Policy came out in 2013. The program has aimed to increase the access of health services to the poor and the marginalized, and people in hard to reach areas of the country, though challenges remain with financing. Several aspects should be considered in design, learning from earlier community-based health insurance schemes that suffered from low enrollment and retention of members as well as from a pro-rich bias. Mechanisms should be built for monitoring unfair pricing and unaffordable copayments, and an overall benefit package be crafted to include coverage of major health services including non-communicable diseases. Regulations should include such issues as accreditation mechanisms for private providers. Health system strengthening should move along with the roll-out of SHS. Improving the efficiency of hospital, motivating the health workers, and using appropriate technology can improve the quality of health services. Also, as currently a constitution drafting is being finalized, careful planning and deliberation is necessary about what insurance structure may suit the proposed future federal structure in Nepal.

  13. Building National Capacity To Implement National Forest Monitoring System In Africa By GLAD

    Science.gov (United States)

    Lola Amani, P. K.

    2017-12-01

    Earth Observation data provide numerous information on the earth and its phenomena from space/satellite. They also offer the ability to compile and analyze information at global or local scales in a timely manner. However, to use them, it is important to develop methods that can enable the extraction of the desired information. Such methods should be robust and consistent enough to be considered for national monitoring systems. At the University of Maryland, the Global Land Analysis and Discovery (GLAD) Laboratory, led by Dr. Hansen, has developed automatic methods using Landsat data that have been applied for the Global Forest Change (GFC) in collaboration with the World Resources Institute (WRI), Google and others to providing information on tree cover loss throughout the global on a yearly basis, and on a daily basis a tree cover loss alert system to improve transparency and accessible at GFW Initiative (Global Forest Watch) website. Following the increasing interest in utilizing the GFC data, the GLAD Laboratory is working closely with national governments of different countries to reinforce their capacities in using the data in the best way and implementing the methodological framework for supporting their national forest monitoring, notification, and reporting (MNV) system. More precisely, the Lab supports step by step the countries in developing their reference emission levels and/or forest reference levels based on the country-specific needs, goals, and requirements, including the definition of the forest. Once in place, the methodology can easily be extended to different applications, such as monitoring the droughts events, etc. Here, we present the work accomplished with the national agencies of some countries in Africa, like Cameroon, Republic of Congo and Madagascar with the support of the Silva-Carbon and USAID-CARPE Programs and WRI. These countries are mainly engaged at different levels of the REDD+ process. Keywords: Earth Observation, Landsat data

  14. Dutch ministerial visit

    CERN Multimedia

    2007-01-01

    Dutch Minister of Education, Culture and Science R. Plasterk (third from left) in the ATLAS cavern with NIKHEF Director F. Linde, CERN Chief Scientific Officer J. Engelen, Ambassador J. van Eenennaam, ATLAS Collaboration Spokesperson P. Jenni, Mission Representative G. Vrielink and ATLAS Magnet Project Leader H. ten Kate.Minister of Education, Culture and Science from the Kingdom of the Netherlands, Ronald Plasterk, visited CERN on 25th October. With Jos Engelen, CERN Scientific Director, as his guide he visited Point 1 of the LHC tunnel and ATLAS, where Nikhef (the national institute for subatomic physics, a Dutch government and university collaboration) constructed all 96 of the largest muon drift chambers in the barrel as well as parts of the magnet system, the inner detector, the DAQ and triggering. Overall the Netherlands contribute 4.5% to the annual CERN budget and the minister’s visit celebrated the contributions of the 79 ...

  15. The evaluation of a national research plan to support the implementation of computers in education in The Netherlands (ED 310737)

    NARCIS (Netherlands)

    Moonen, J.C.M.M.; Collis, Betty; Koster, Klaas

    1990-01-01

    This paper describes the evolution of a national research plan for computers and education, an approach which was initiated in the Netherlands in 1983. Two phases can be recognized in the Dutch experience: one from 1984 until 1988 and one from 1989 until 1992. Building upon the experiences of the

  16. Implementation of a national anti-tuberculosis drug resistance survey in Tanzania

    NARCIS (Netherlands)

    Chonde, Timothy M.; Doulla, Basra; van Leth, Frank; Mfinanga, Sayoki G. M.; Range, Nyagosya; Lwilla, Fred; Mfaume, Saidi M.; van Deun, Armand; Zignol, Matteo; Cobelens, Frank G.; Egwaga, Saidi M.

    2008-01-01

    BACKGROUND: A drug resistance survey is an essential public health management tool for evaluating and improving the performance of National Tuberculosis control programmes. The current manuscript describes the implementation of the first national drug resistance survey in Tanzania. METHODS:

  17. Fourth Dutch Process Security Control Event

    NARCIS (Netherlands)

    Luiijf, H.A.M.; Zielstra, A.

    2010-01-01

    On December 1st, 2009, the fourth Dutch Process Control Security Event took place in Baarn, The Netherlands. The security event with the title ‘Manage IT!’ was organised by the Dutch National Infrastructure against Cybercrime (NICC). Mid of November, a group of over thirty people participated in the

  18. National soft science research task item-organization and implementation

    International Nuclear Information System (INIS)

    Zhang Yiming

    2014-01-01

    nuclear fusion energy research development road suitable to China's situation. This report has obtained the high praise from the domestic fusion experts. At present, this item is waiting for the acceptance check organized by the Ministry of Science and Technology. It is the first time for the Division to take on such a large-scale national level soft task item. It started a good beginning for the Division to further carry out related subject research tasks and knowledge services such as the comparative analyses of the related subjects and international attractive advanced subjects in the near future, train professional talents, as well as to provide information support of making scientific research further at SWIP. This paper discussed how to organize, implement and fulfil a large-scale strategic soft science task item based on the practice and experience of the completed soft science task item. (author)

  19. Remote age verification to prevent underage alcohol sales. First results from Dutch liquor stores and the economic viability of national adoption.

    Science.gov (United States)

    van Hoof, Joris J; van Velthoven, Ben C J

    2015-04-01

    Alcohol consumption among minors is a popular topic in the public health debate, also in the Netherlands. Compliance with the legal age limits for selling alcohol proves to be rather low. Some Dutch liquor stores (outlets with an exclusive license to sell off-premise drinks with 15% alcohol or more) have recently adopted a remote age verification system. This paper discusses the first results of the use of the system. We use data from 67 liquor stores that adopted Ageviewers, a remote age verification system, in 2011. A remote validator judges the customer's age using camera footage and asks for an ID if there is any doubt. The system then sends a signal to the cash register, which approves or rejects the alcohol purchase. From the 367346 purchase attempts in the database, 8374 were rejected or aborted for age-related reasons. This figure amounts to an average ratio of 1.12 underage alcohol purchase attempts per sales day in each participating liquor store. Scaling up to a national level, the figures suggest at least 1 million underage alcohol purchase attempts per year in Dutch liquor stores. Underage alcohol purchases can be prevented by the nationwide adoption of remote age verification. However, given the lax enforcement of the age limits by the government, adopting such a system on a voluntary basis is generally not in the economic interest of the liquor stores. Obligatory installation of the system in off-premise alcohol outlets may pass a social cost-benefit test if certain conditions are fulfilled. Copyright © 2014 Elsevier B.V. All rights reserved.

  20. Motives of Dutch men who have sex with men for daily and intermittent HIV pre-exposure prophylaxis usage and preferences for implementation: A qualitative study.

    Science.gov (United States)

    Bil, Janneke P; van der Veldt, Wendy M; Prins, Maria; Stolte, Ineke G; Davidovich, Udi

    2016-09-01

    Although PrEP is not yet registered in Europe, including the Netherlands, its approval and implementation are expected in the near future. To inform future pre-exposure prophylaxis (PrEP) implementation, this study aimed to gain insight into motives and preferences for daily or intermittent PrEP use among Dutch HIV-negative men having sex with men (MSM).Between February and December 2013, semistructured interviews were conducted until data saturation was reached (N = 20). Interviews were analyzed using the Grounded Theory approach.Motives for (not) using daily PrEP were based on beliefs about PrEP efficacy and side effects, preferences for other prevention strategies, self-perceived HIV risk, self-perceived efficacy of PrEP adherence, beliefs about possible benefits (e.g., anxiety reduction, sex life improvement), and barriers of PrEP use (e.g., costs, monitoring procedures). The perceived benefits of intermittent versus daily PrEP use were the lower costs and side effects and the lower threshold to decision to start using intermittent PrEP. Barriers of intermittent PrEP versus daily PrEP use were the perceived need to plan their sex life and adhere to multiple prevention strategies. Although some perceived PrEP as a condom substitute, others were likely to combine PrEP and condoms for sexually transmitted infections (STI) prevention and increased HIV protection. Participants preferred PrEP service locations to have specialized knowledge of HIV, antiretroviral therapy, sexual behavior, STIs, patients' medical background, be easily approachable, be able to perform PrEP follow-up monitoring, and provide support.To maximize the public health impact of PrEP, ensuring high uptake among MSM at highest risk is important. Therefore, targeted information about PrEP efficacy and side effects need to be developed, barriers for accessing PrEP services should be minimized, and perceived self-efficacy to use PrEP should be addressed and improved. To prevent increases in STIs

  1. Motives of Dutch men who have sex with men for daily and intermittent HIV pre-exposure prophylaxis usage and preferences for implementation

    Science.gov (United States)

    Bil, Janneke P.; van der Veldt, Wendy M.; Prins, Maria; Stolte, Ineke G.; Davidovich, Udi

    2016-01-01

    Abstract Although PrEP is not yet registered in Europe, including the Netherlands, its approval and implementation are expected in the near future. To inform future pre-exposure prophylaxis (PrEP) implementation, this study aimed to gain insight into motives and preferences for daily or intermittent PrEP use among Dutch HIV-negative men having sex with men (MSM). Between February and December 2013, semistructured interviews were conducted until data saturation was reached (N = 20). Interviews were analyzed using the Grounded Theory approach. Motives for (not) using daily PrEP were based on beliefs about PrEP efficacy and side effects, preferences for other prevention strategies, self-perceived HIV risk, self-perceived efficacy of PrEP adherence, beliefs about possible benefits (e.g., anxiety reduction, sex life improvement), and barriers of PrEP use (e.g., costs, monitoring procedures). The perceived benefits of intermittent versus daily PrEP use were the lower costs and side effects and the lower threshold to decision to start using intermittent PrEP. Barriers of intermittent PrEP versus daily PrEP use were the perceived need to plan their sex life and adhere to multiple prevention strategies. Although some perceived PrEP as a condom substitute, others were likely to combine PrEP and condoms for sexually transmitted infections (STI) prevention and increased HIV protection. Participants preferred PrEP service locations to have specialized knowledge of HIV, antiretroviral therapy, sexual behavior, STIs, patients’ medical background, be easily approachable, be able to perform PrEP follow-up monitoring, and provide support. To maximize the public health impact of PrEP, ensuring high uptake among MSM at highest risk is important. Therefore, targeted information about PrEP efficacy and side effects need to be developed, barriers for accessing PrEP services should be minimized, and perceived self-efficacy to use PrEP should be addressed and improved. To prevent

  2. Civil Defence and National Security: Composition and Implementation Model in National Defence

    Directory of Open Access Journals (Sweden)

    Mr. Muradi

    2017-01-01

    Full Text Available Civil Defense is inherent part of every citizen in many countries anywhere in the world, which differ only in the implementation of the program. The difference depends on the threat level and needs of each country in mobilizing citizens. However, the Civil Defense’s Governance which involvement of citizens is already regulated in a number of regulations and legislation, but as one part of an integrated program linked to the involvement of citizens in the framework of national defense, civil defense program is not enough to have its own laws. So that when applied in the form of operational, interpretation of these programs tend to be not in tune and even have precisely the opposite perspective between the state and citizens. This paper argued that the Civil Defense program is part of an integrated governance program of national security. Therefore, the state should be required to ensure that the program of Civil Defense goes well. This paper is also offer the composition and program models associated with the Civil Defense, Conscription Program (draftee and Reserve Component. The argument of this paper is that the Civil Defense Program is a linear and continuous with Conscription and Reserves Programs.

  3. 2014 National Asset Management Conference and training on implementation strategies.

    Science.gov (United States)

    2014-07-01

    This report documents the major research activities conducted as part of the Federal Highway Administration (FHWA) : Transportation Pooled Fund (TPF) Program project, TPF-5(275) 2014 National Asset Management Conference and Training on : Implementati...

  4. Monitoring NSL. Progress of the Dutch National Air Quality Cooperation Programme (NSL). State of affairs 2012; Monitoringsrapportage NSL. Stand van zaken 2012 Nationaal Samenwerkingsprogamma Luchtkwaliteit

    Energy Technology Data Exchange (ETDEWEB)

    Van Zanten, M.C.; Wesseling, J.; Mooibroek, D.; Van Alphen, A.; Nguyen, L. [Rijksinstituut voor Volksgezondheid en Milieu RIVM, Bilthoven (Netherlands); Groot Wassink, H.; Verbeek, C. [InfoMil, Agentschap NL, Den Haag (Netherlands)

    2012-11-15

    The National Air Quality Cooperation Programme (NSL) has been created to facilitate improvements in air quality in the Netherlands and to ensure that the Netherlands meets the respective deadlines set for compliance to EU limit values for particulate matter (PM10) and nitrogen dioxide (NO2). Local, regional and national authorities work together within the framework of this programme to ensure that these goals will be met. A monitoring programme has been put in place to monitor progress and, if necessary, to enable timely modifications to the programme. The annual results of the monitoring programme have been bundled together by the Monitoring Bureau (collaboration between RIVM and the InfoMil Knowledge Centre) into the 2012 progress report [Dutch] Om de luchtkwaliteit te verbeteren is het Nationaal Samenwerkingsprogramma Luchtkwaliteit (NSL) opgezet. Hierin werken de Rijksoverheid en decentrale overheden samen om te zorgen dat Nederland overal tijdig aan de grenswaarden voor fijn stof en stikstofdioxide zal voldoen. Om de voortgang van dit verbeterprogramma te volgen en tijdig eventuele extra maatregelen te kunnen nemen, is aan het NSL een monitoringsprogramma verbonden. De uitvoering van de monitoring is neergelegd bij Bureau Monitoring, een samenwerkingsverband tussen het RIVM en Kenniscentrum InfoMil.

  5. Ethnic boundaries in national literary histories: Classification of ethnic minority fiction authors in American, Dutch and German anthologies and literary history books, 1978-2006

    NARCIS (Netherlands)

    P.P.L. Berkers (Pauwke)

    2009-01-01

    textabstractThis article compares the classification of ethnic minority fiction writers in American, Dutch and German literary anthologies and literary history books for the period of 1978-2006. Using content analyses, ethnic boundaries are much stronger in Dutch and German textbooks than in their

  6. Going Dutch

    Energy Technology Data Exchange (ETDEWEB)

    Hoorn, C.

    2002-09-07

    The proposal by the Dutch to extract natural gas from the 40 billion cubic metres beneath the Wadden Sea has been cited as a serious cause for concern by environmentalists. The new right wing government is less concerned than was the recently ousted left wing government and stands to gain directly through increased revenue. The Wadden Sea is a vast area of tidal channels, mudflats, shifting sandbanks, salt marshes, wet meadows and dunes, and provides a safe haven for numerous protected plants and animals. It is also a sanctuary for migrating birds and a feeding ground for herring, sole and plaice. Subsidence is cited by the environmentalists as a major potential problem and pollution is said to be always a risk.

  7. Going Dutch

    International Nuclear Information System (INIS)

    Hoorn, C.

    2002-01-01

    The proposal by the Dutch to extract natural gas from the 40 billion cubic metres beneath the Wadden Sea has been cited as a serious cause for concern by environmentalists. The new right wing government is less concerned than was the recently ousted left wing government and stands to gain directly through increased revenue. The Wadden Sea is a vast area of tidal channels, mudflats, shifting sandbanks, salt marshes, wet meadows and dunes, and provides a safe haven for numerous protected plants and animals. It is also a sanctuary for migrating birds and a feeding ground for herring, sole and plaice. Subsidence is cited by the environmentalists as a major potential problem and pollution is said to be always a risk

  8. Towards implementing a records management policy at the National ...

    African Journals Online (AJOL)

    The purpose of this study was to investigate the implementation of a proposed ... good governance in all business operations at NUST, the study sought to establish ... Using both quantitative and qualitative approaches data were collected using ... By Country · List All Titles · Free To Read Titles This Journal is Open Access.

  9. 76 FR 63763 - National Environmental Policy Act Implementing Procedures

    Science.gov (United States)

    2011-10-13

    ... sensitive resources; or involving genetically engineered organisms, unless the proposed activity would be... category, and three environmental impact statement categories. Other changes modify and clarify DOE's... document, ``existing rule'' refers to DOE's current NEPA implementing regulations (as last modified in 2003...

  10. 168 Indigenous Language Implementation and Nation Building: The ...

    African Journals Online (AJOL)

    of Nigerian indigenous language implementation and use in the ... Nigeria, it will become obvious that language is central to ... major indigenous languages. .... personality and thought pattern would be given as credit to the ... (13) The purpose of pre-primary education shall be to: .... Ado-Ekiti and sampled the five of them.

  11. Do individual characteristics matter? The quality of work during the implementation of a workflow management system in a Dutch social insurance company.

    NARCIS (Netherlands)

    Waal, B.M.E. de; Breman, P.; Batenburg, R.

    2012-01-01

    Do individual characteristics influence how the quality of work is related to the use of a workflow management system (WFM) in a Dutch social insurance organisation? This key question is addressed in this paper. Building upon DeLone and McLean’s model, we investigated the effects of gender, age,

  12. Do individual characteristics matter? The quality of work during the implementation of a workflow management system in a Dutch social insurance company

    NARCIS (Netherlands)

    Dr. Paul Breman; Benny de Waal; Ronald Batenburg

    2012-01-01

    Do individual characteristics influence how the quality of work is related to the use of a workflow management system (WFM) in a Dutch social insurance organisation? This key question is addressed in this paper. Building upon DeLone and McLean’s model, we investigated the effects of gender, age,

  13. The Dutch Obesity Intervention in Teenagers (DOiT) cluster controlled implementation trial: intervention effects and mediators and moderators of adiposity and energy balance-related behaviours

    NARCIS (Netherlands)

    van Nassau, F.; Singh, A.S.; Cerin, E.; Salmon, J.; van Mechelen, W.; Brug, J.; Chin A Paw, M.J.M.

    2014-01-01

    Background: The Dutch Obesity Intervention in Teenagers (DOiT) programme is an evidence-based obesity prevention programme tailored to adolescents attending the first two years of prevocational education in the Netherlands. The initial programme showed promising results during an effectiveness

  14. Strategies for using international domain standards within a national context: The case of the Dutch temporary staffing industry

    NARCIS (Netherlands)

    Folmer, Erwin Johan Albert; van Bekkum, Michael; Verhoosel, Jack

    2009-01-01

    This paper will discuss strategies for using international domain standards within a national context. The various strategies are illustrated by means of a case study of the temporary staffing industry.

  15. The Online Translator: Implementing National Standard 4.1.

    Science.gov (United States)

    Burton, Christine

    2003-01-01

    A pedagogical idea for addressing National Standard 4.1 (Students demonstrate understanding of the nature of language through comparisons of language studied and their own) suggests the deliberate use of the online translator to illustrate to students the syntactical errors that occur when translating idioms from one language to another. (VWL)

  16. A structured record to implement the national guidelines for diabetes ...

    African Journals Online (AJOL)

    A draft of the structured record was developed at a single-pilot CHC in the Western Cape. Focus group discussions established the core requirements for a structured record. Process, result and structural indicators in line with the national Guidelines were considered for inclusion in the draft record. This draft record was then ...

  17. Situational analysis: Implementation of the National School Nutrition ...

    African Journals Online (AJOL)

    ... National School Nutrition Programme in low socio-economic primary schools in Nelson Mandela Bay. ... Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Special Edition. ... has a PDF reader plug-in installed (for example, a recent version of Adobe Acrobat Reader).

  18. Implementation of a National Workplace Wellness Program for Health Workers in Botswana

    OpenAIRE

    Ledikwe, Jenny H.; Semo, Bazghina-werq; Sebego, Miram; Mpho, Maureen; Mothibedi, Heather; Mawandia, Shreshth; O?Malley, Gabrielle

    2017-01-01

    The Botswana workplace wellness program (WWP) for health care workers (HCWs) was initiated in 2007. WWP implementation was assessed using a sequential, explanatory, mixed methods design including a national implementation assessment (27 health districts) and in-depth interviews (n?=?38). Level of implementation varied across districts with health screening, therapeutic recreation, and health promotion implemented more frequently than occupational health activities and psychosocial services. F...

  19. [Implementation of a national training assessment programme in anaesthesiology

    DEFF Research Database (Denmark)

    Skjelsager, K.; Malling, B.; Bested, K.M.

    2008-01-01

    INTRODUCTION: In 2004, outcome-based education and in-training assessment was introduced by a reform of postgraduate medical education in Denmark. An assessment programme covering the introductory year of anaesthesiology was constructed. The purpose of this study was to explore to which degree...... this programme was implemented in daily practice in the clinical departments and whether the recommended assessment protocol was followed. MATERIALS AND METHODS: A questionnaire was distributed to 26 departments and 38 trainees. RESULTS: The response rate for both groups exceeded 90%. Individual learning plans...... were prepared by (2/3) of the trainees according to both trainees and departments. The various methods in the assessment programme were implemented to a high degree. The use of structured clinical observations was reported by more than 70% of both groups. Global assessments were applied in more than 70...

  20. Legal aspects of national implementation of the Chemical Weapons Convention transfer provisions

    International Nuclear Information System (INIS)

    1995-01-01

    The author discusses legal aspects of implementing the Chemical Weapons Convention's (CWC's) export and import provisions. These implementing measures are universal, applying not only to the few States Parties that will declare and destroy chemical weapons, but also to the many States Parties that have never had a chemical weapons program. This new need for national measures to implement multilateral arms control agreements has generated unease due to a perception that implementation may be burdensome and at odds with national law. In 1993, concerns arose that the complexity of integrating the treaty with national law would cause each nation to effectuate the Convention without regard to what other nations were doing, thereby engendering significant disparities in implementation steps among States Parties. As a result, the author and his colleagues prepared the Manual for National Implementation of the Chemical Weapons Convention. The Manual tries to increase understanding of the Convention by identifying its obligations and suggesting methods of meeting them. Here the author discusses progress among several States in actually developing implementing measures for the Convention's transfer requirements. CWC legislation from australia, Germany, Norway, South Africa, and Sweden were available at this writing in English through the Provisional Technical Secretariat. Of course, it is important to note that this brief survey necessarily omitted examination of the existing background of other, related domestic laws that these signatories might also have adopted that affect CWC implementation

  1. Young adults awareness of HPV and vaccine acceptance after introduction of the HPV vaccine in the Dutch national vaccination program

    NARCIS (Netherlands)

    Schmeink, C.E.; Gosens, K.C.; Melchers, W.J.G.; Massuger, L.F.A.G.; Bekkers, R.L.M.

    2011-01-01

    PURPOSE: To investigate the effect of implementation of the HPV vaccine on HPV knowledge and HPV vaccine acceptance. METHODS: From June until December 2009 in Nijmegen, the Netherlands, 698 male and female students aged 18-25 years were recruited and interviewed about HPV, cervical carcinoma and HPV

  2. Reasons for accepting or declining Down syndrome screening in Dutch prospective mothers within the context of national policy and healthcare system characteristics: a qualitative study.

    Science.gov (United States)

    Crombag, Neeltje M T H; Boeije, Hennie; Iedema-Kuiper, Rita; Schielen, Peter C J I; Visser, Gerard H A; Bensing, Jozien M

    2016-05-26

    Uptake rates for Down syndrome screening in the Netherlands are low compared to other European countries. To investigate the low uptake, we explored women's reasons for participation and possible influences of national healthcare system characteristics. Dutch prenatal care is characterised by an approach aimed at a low degree of medicalisation, with pregnant women initially considered to be at low risk. Prenatal screening for Down syndrome is offered to all women, with a 'right not to know' for women who do not want to be informed on this screening. At the time this study was performed, the test was not reimbursed for women aged 35 and younger. We conducted a qualitative study to explore reasons for participation and possible influences of healthcare system characteristics. Data were collected via ten semi-structured focus groups with women declining or accepting the offer of Down syndrome screening (n = 46). All focus groups were audio- and videotaped, transcribed verbatim, coded and content analysed. Women declining Down syndrome screening did not consider Down syndrome a condition severe enough to justify termination of pregnancy. Young women declining felt supported in their decision by perceived confirmation of their obstetric caregiver and reassured by system characteristics (costs and age restriction). Women accepting Down syndrome screening mainly wanted to be reassured or be prepared to care for a child with Down syndrome. By weighing up the pros and cons of testing, obstetric caregivers supported young women who accepted in the decision-making process. This was helpful, although some felt the need to defend their decision to accept the test offer due to their young age. For some young women accepting testing, costs were considered a disincentive to participate. Presentation of prenatal screening affects how the offer is attended to, perceived and utilised. By offering screening with age restriction and additional costs, declining is considered the

  3. The Social Construction of Public Infrastructure: The Case of the Dutch National Geo-information Clearinghouse Project.

    NARCIS (Netherlands)

    Koerten, Henk; Veenswijk, Marcel

    2010-01-01

    Disclosure of governmental map related information is increasingly being conceptualized as management of inter-organizational National Spatial Data Infrastructures (NSDIs). Until now, studies have been published on how NSDI projects should be designed, set up and monitored. While these approaches

  4. Defining Multidrug Resistance of Gram-Negative Bacteria in the Dutch-German Border Region-Impact of National Guidelines

    NARCIS (Netherlands)

    Köck, Robin; Siemer, Philipp; Esser, Jutta; Kampmeier, Stefanie; Berends, Matthijs S; Glasner, Corinna; Arends, Jan P; Becker, Karsten; Friedrich, Alexander W

    2018-01-01

    Preventing the spread of multidrug-resistant Gram-negative bacteria (MDRGNB) is a public health priority. However, the definition of MDRGNB applied for planning infection prevention measures such as barrier precautions differs depending on national guidelines. This is particularly relevant in the

  5. Design and Implementation of the Australian National Data Service

    Directory of Open Access Journals (Sweden)

    Andrew Treloar

    2009-06-01

    Full Text Available Normal 0 This paper will describe the genesis and realisation of the Australian National Data Service (ANDS. It will commence by outlining the context within which ANDS was conceived, both in the international research and Australian research support domains. It will then describe the process that brought about the ANDS vision and the principles that informed the realisation of that vision. The paper will then outline each of the four ANDS programs (Developing Frameworks, Providing Utilities, Seeding the Commons, and Building Capabilities while also discussing particular items of note about the approach ANDS is taking. The paper concludes by briefly examining related work in the UK and US.

  6. Drug and Therapeutics (D & T) committees in Dutch hospitals : a nation-wide survey of structure, activities, and drug selection procedures

    NARCIS (Netherlands)

    Fijn, R; Brouwers, JRBJ; Knaap, RJ; De Jong-Van den Berg, LTW

    Aims To determine structure, activities and drug selection processes used by Dutch hospital drug and therapeutics (D & T) committees. Methods A pretested structured survey questionnaire based on the Australian process and impact indicators, previous research, and consultation of professionals was

  7. Integrating care by implementation of bundled payments: results from a national survey on the experience of Dutch dietitians.

    NARCIS (Netherlands)

    Tol, J.; Swinkels, I.C.S.; Struijs, J.N.; Veenhof, C.; Bakker, D.H. de

    2013-01-01

    Introduction: In the Netherlands, bundled payments were introduced as part of a strategy to redesign chronic care delivery. Under this strategy new entities of health care providers in primary care are negotiating with health insurers about the price for a bundle of services for several chronic

  8. 76 FR 49477 - Consideration of Extenuating Circumstances for Implementation of Modification of Annual National...

    Science.gov (United States)

    2011-08-10

    ... FEDERAL FINANCIAL INSTITUTIONS EXAMINATION COUNCIL [Docket No. AS11-23] Consideration of Extenuating Circumstances for Implementation of Modification of Annual National Registry Fee AGENCY: Appraisal Subcommittee (ASC) of the Federal Financial Institutions Examination Council. ACTION: The ASC is providing...

  9. Design and implementation of speed humps: supplement to national guidelines for traffic calming

    CSIR Research Space (South Africa)

    Emslie, I

    1997-03-01

    Full Text Available This report presents guidelines to assist local authorities and traffic engineers with a uniform approach to the implementation of speed humps. It is recommended that these guidelines be read in conjunction with The National Guidelines for Traffic...

  10. Evaluation of an Implementation Model : A National Investigation of VA Residential Programs

    NARCIS (Netherlands)

    Cook, Joan M.; Dinnen, Stephanie; Coyne, James C.; Thompson, Richard; Simiola, Vanessa; Ruzek, Josef; Schnurr, Paula P.

    This national investigation utilizes qualitative data to evaluate an implementation model regarding factors influencing provider use of two evidence-based treatments for posttraumatic stress disorder (PTSD). Semi-structured qualitative interviews with 198 mental health providers from 38 Department

  11. Wilderness - between the promise of hell and paradise: A cultural-historical exploration of a Dutch National Park

    Science.gov (United States)

    Koen Arts; Anke Fischer; Rene van der Wal

    2011-01-01

    ‘Wilderness' is often seen as an ideal state in contemporary debates on ecological restoration. This paper asks what is left of ‘wilderness' in present-day Western Europe and explores this question by drawing on a case study of the Hoge Veluwe National Park in the Netherlands. An overview of intellectual histories of wilderness ideas is used as a backdrop to...

  12. Implementation of Strategies to Leverage Public and Private Resources for National Security Workforce Development

    Energy Technology Data Exchange (ETDEWEB)

    None

    2009-04-01

    This report documents implementation strategies to leverage public and private resources for the development of an adequate national security workforce as part of the National Security Preparedness Project (NSPP), being performed under a U.S. Department of Energy (DOE)/National Nuclear Security Administration (NNSA) grant. There are numerous efforts across the United States to develop a properly skilled and trained national security workforce. Some of these efforts are the result of the leveraging of public and private dollars. As budget dollars decrease and the demand for a properly skilled and trained national security workforce increases, it will become even more important to leverage every education and training dollar. This report details some of the efforts that have been implemented to leverage public and private resources, as well as implementation strategies to further leverage public and private resources.

  13. Aligning research assessment in the Humanities to the national Standard Evaluation Protocol Challenges and developments in the Dutch research landscape

    Energy Technology Data Exchange (ETDEWEB)

    Prins, A.; Spaapen, J.; Van Vree, F

    2016-07-01

    The purpose of this session is a debate about innovation in comprehensive methods for the assessment of humanities research. Input will come from preliminary outcomes of an ongoing project in the Netherlands to find adequate indicators for humanities research that will fit in the national Standard Evaluation Protocol. The project includes processes of ‘bottom up’ data collection (that is, with input coming from the research community) and discussion with Humanities researchers, investigating the specific characteristics of publication and communication cultures in the Humanities, and the prospects for the use of quantitative and qualitative indicators. (Author)

  14. 'Burnout' among Dutch midwives.

    NARCIS (Netherlands)

    Bakker, R.H.C.; Groenewegen, P.P.; Jabaaij, L.; Meijer, W.; Sixma, H.; Veer, A. de

    1996-01-01

    OBJECTIVE: to determine the effect of workload on 'burnout' having considered work capacity. DESIGN: cross-sectional study. SETTING: Dutch community midwives in independent practice. PARTICIPANTS: 200 Dutch community midwives. MEASUREMENTS: three-week diary recordings, a questionnaire on practice

  15. Implementation of an Integrated Information Management System at the National Library of Wales: A Case Study

    Science.gov (United States)

    Evans, Manon Foster; Thomas, Sian

    2007-01-01

    Purpose: This paper aims to describe the experiences of the National Library of Wales in implementing an integrated information management system. Design/methodology/approach: Discusses the stages involved in the procurement process, data migration and general system implementation. Findings: Emphasises the need for a well-prepared yet flexible…

  16. Facilitating the implementation of clinical technology in healthcare: what role does a national agency play?

    Science.gov (United States)

    Harvey, Gill; Llewellyn, Sue; Maniatopoulos, Greg; Boyd, Alan; Procter, Rob

    2018-05-10

    Accelerating the implementation of new technology in healthcare is typically complex and multi-faceted. One strategy is to charge a national agency with the responsibility for facilitating implementation. This study examines the role of such an agency in the English National Health Service. In particular, it compares two different facilitation strategies employed by the agency to support the implementation of insulin pump therapy. The research involved an empirical case study of four healthcare organisations receiving different levels of facilitation from the national agency: two received active hands-on facilitation; one was the intended recipient of a more passive, web-based facilitation strategy; the other implemented the technology without any external facilitation. The primary method of data collection was semi-structured qualitative interviews with key individuals involved in implementation. The integrated-PARIHS framework was applied as a conceptual lens to analyse the data. The two sites that received active facilitation from an Implementation Manager in the national agency made positive progress in implementing the technology. In both sites there was a high level of initial receptiveness to implementation. This was similar to a site that had successfully introduced insulin pump therapy without facilitation support from the national agency. By contrast, a site that did not have direct contact with the national agency made little progress with implementation, despite the availability of a web-based implementation resource. Clinicians expressed differences of opinion around the value and effectiveness of the technology and contextual barriers related to funding for implementation persisted. The national agency's intended roll out strategy using passive web-based facilitation appeared to have little impact. When favourable conditions exist, in terms of agreement around the value of the technology, clinician receptiveness and motivation to change, active

  17. 3 CFR - Implementation of the Executive Order, “Classified National Security Information”

    Science.gov (United States)

    2010-01-01

    ... 29, 2009 Implementation of the Executive Order, “Classified National Security Information” Memorandum..., “Classified National Security Information” (the “order”), which substantially advances my goals for reforming... or handles classified information shall provide the Director of the Information Security Oversight...

  18. Where there is a will, there is a way. Advice on the Dutch National Environmental Plan 4 (NMP4); Waar een wil is, is een weg. Advies over het NMP4

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-10-25

    The fourth National Environmental Plan (NMP4) is a good start to solve the big environmental problems and must be elaborated soon, according to the VROM-Raad in it's advice to the Dutch government. The problems (loss of biological diversity, climatic change and overexploitation of natural resources) can not be solved in a conventional way. The so-called transition policy (integration of technological, economical, social-cultural and institutional changes) can be one of the solutions. refs. [Dutch] Het vierde nationale Milieubeleidsplan biedt een goede aanzet voor het oplossen van grote milieuproblemen en moet nu snel concreet uitgewerkt worden, aldus de VROM-raad in zijn advies. De grote milieuproblemen: verlies aan biodiversiteit, klimaatverandering en overexploitatie van natuurlijke hulpbronnen kunnen niet op de traditionele manier opgelost worden. Het uitvoeren van het transitiebeleid (technologische, economische, sociaal-culturele en institutionele veranderingen) uit het NMP4 kan daarvoor een oplossing zijn. refs.

  19. Policy implementation in practice: the case of national service frameworks in general practice.

    Science.gov (United States)

    Checkland, Kath; Harrison, Stephen

    2004-10-01

    National Service Frameworks are an integral part of the government's drive to 'modernise' the NHS, intended to standardise both clinical care and the design of the services used to deliver that clinical care. This article uses evidence from qualitative case studies in three general practices to illustrate the difficulties associated with the implementation of such top-down guidelines and models of service. In these studies it was found that, while there had been little explicit activity directed at implementation overall, the National Service Framework for coronary heart disease had in general fared better than that for older people. Gunn's notion of 'perfect implementation' is used to make sense of the findings.

  20. The Politico-Economic Challenges of Ghana’s National Health Insurance Scheme Implementation

    OpenAIRE

    Adam Fusheini

    2016-01-01

    Background National/social health insurance schemes have increasingly been seen in many low- and middle-income countries (LMICs) as a vehicle to universal health coverage (UHC) and a viable alternative funding mechanism for the health sector. Several countries, including Ghana, have thus introduced and implemented mandatory national health insurance schemes (NHIS) as part of reform efforts towards increasing access to health services. Ghana passed mandatory national health insurance (NHI)...

  1. Dutch Logbooks

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Nineteenth century ship logbooks imaged by KNMI (Royal Netherlands Meteorological Institute) in 2006 as part of the RECLAIM (RECovery of Logbooks and International...

  2. Dutch hi-tech companies exhibit at CERN

    CERN Multimedia

    Roberto Cantoni

    2010-01-01

    Twenty-seven Dutch companies will present the state of the art of their technological developments at the industrial exhibition Holland @ CERN from 8 to 11 November. The exhibition is designed to help strengthen the ties between fundamental science and Dutch industry.   The exhibition, supported by the Dutch Ministry of Economic Affairs and organised by the Netherlands National Institute for Subatomic Physics (Nikhef), in cooperation with the Foundation for Fundamental Research on Matter (FOM), the FOM Institute for Plasma Physics Rijnhuizen, and Dutch Scientific, an association of manufacturers of scientific equipment, will be held in the Main Building from 8 to11 November. “The last Holland @ CERN exhibition took place fifteen years ago”, says Robert Klöpping from Nikhef, Dutch Industrial Liaison Officer for CERN and Purchasing Advisor for Grenoble ESRF. “This kind of event is very important for Dutch industry as it allows us to show what Dutch companies c...

  3. National ownership in the implementation of global climate policy in Uganda

    DEFF Research Database (Denmark)

    Olsen, K.H.

    2006-01-01

    This article explores the history, from a developing country perspective, of how external interventions to implement global policies on the Climate Convention and the Clean Development Mechanism (CDM) have been integrated into national development policy frameworks in the period 1990-2005. The main...... question asked is to what extent external interventions have formed part of a country-driven approach in Uganda. The conflicting national and global priorities concerning the need for adaptation to the impacts of climate change versus the need for global mitigation of greenhouse gases (GHGs) are explored...... first. Against this background, Uganda's policy response to climate change is reviewed. National climate policies are found not to exist, and the implementation of global policies is not integrated into national policy frameworks, partly due to conflicting national and global priorities. Given limited...

  4. Preferred providers and the credible commitment problem in health insurance: first experiences with the implementation of managed competition in the Dutch health care system.

    Science.gov (United States)

    Boonen, Lieke H H M; Schut, Frederik T

    2011-04-01

    We investigate the impact of the transition towards managed competition in the Dutch health care system on health insurers' contracting behaviour. Specifically, we examine whether insurers have been able to take up their role as prudent buyers of care and examine consumers' attitudes towards insurers' new role. Health insurers' contracting behaviour is investigated by an extensive analysis of available information on purchasing practices by health insurers and by interviews with directors of health care purchasing of the four major health insurers, accounting for 90% of the market. Consumer attitudes towards insurers' new role are investigated by surveys among a representative sample of enrollees over the period 2005-2009. During the first four years of the reform, health insurers were very reluctant to engage in selective contracting and preferred to use 'soft' positive incentives to encourage preferred provider choice rather than engaging in restrictive managed care activities. Consumer attitudes towards channelling vary considerably by type of provider but generally became more negative in the first two years after the reform. Insurers' reluctance to use selective contracting can be at least partly explained by the presence of a credible-commitment problem. Consumers do not trust that insurers with restrictive networks are committed to provide good quality care. The credible-commitment problem seems to be particularly relevant to the Netherlands, since Dutch enrollees are not used to restrictions on provider choice. Since consumers are quite sensitive to differences in provider quality, more reliable information about provider quality is required to reduce the credible-commitment problem.

  5. Implementation of a national anti-tuberculosis drug resistance survey in Tanzania

    Directory of Open Access Journals (Sweden)

    Mfaume Saidi M

    2008-12-01

    Full Text Available Abstract Background A drug resistance survey is an essential public health management tool for evaluating and improving the performance of National Tuberculosis control programmes. The current manuscript describes the implementation of the first national drug resistance survey in Tanzania. Methods Description of the implementation process of a national anti-tuberculosis drug resistance survey in Tanzania, in relation to the study protocol and Standard Operating Procedures. Results Factors contributing positively to the implementation of the survey were a continuous commitment of the key stakeholders, the existence of a well organized National Tuberculosis Programme, and a detailed design of cluster-specific arrangements for rapid sputum transportation. Factors contributing negatively to the implementation were a long delay between training and actual survey activities, limited monitoring of activities, and an unclear design of the data capture forms leading to difficulties in form-filling. Conclusion Careful preparation of the survey, timing of planned activities, a strong emphasis on data capture tools and data management, and timely supervision are essential for a proper implementation of a national drug resistance survey.

  6. Implementation of a national anti-tuberculosis drug resistance survey in Tanzania.

    Science.gov (United States)

    Chonde, Timothy M; Doulla, Basra; van Leth, Frank; Mfinanga, Sayoki G M; Range, Nyagosya; Lwilla, Fred; Mfaume, Saidi M; van Deun, Armand; Zignol, Matteo; Cobelens, Frank G; Egwaga, Saidi M

    2008-12-30

    A drug resistance survey is an essential public health management tool for evaluating and improving the performance of National Tuberculosis control programmes. The current manuscript describes the implementation of the first national drug resistance survey in Tanzania. Description of the implementation process of a national anti-tuberculosis drug resistance survey in Tanzania, in relation to the study protocol and Standard Operating Procedures. Factors contributing positively to the implementation of the survey were a continuous commitment of the key stakeholders, the existence of a well organized National Tuberculosis Programme, and a detailed design of cluster-specific arrangements for rapid sputum transportation. Factors contributing negatively to the implementation were a long delay between training and actual survey activities, limited monitoring of activities, and an unclear design of the data capture forms leading to difficulties in form-filling. Careful preparation of the survey, timing of planned activities, a strong emphasis on data capture tools and data management, and timely supervision are essential for a proper implementation of a national drug resistance survey.

  7. The WHO-ITU national eHealth strategy toolkit as an effective approach to national strategy development and implementation.

    Science.gov (United States)

    Hamilton, Clayton

    2013-01-01

    With few exceptions, national eHealth strategies are the pivotal tools upon which the launch or refocusing of national eHealth programmes is hinged. The process of their development obviates cross-sector ministerial commitment led by the Ministry of Health. Yet countries often grapple with the task of strategy development and best efforts frequently fail to address strategic components of eHealth key to ensure successful implementation and stakeholder engagement. This can result in strategies that are narrowly focused, with an overemphasis placed on achieving technical outcomes. Without a clear link to a broader vision of health system development and a firm commitment from partners, the ability of a strategy to shape development of a national eHealth framework will be undermined and crucial momentum for implementation will be lost. WHO and ITU have sought to address this issue through the development of the National eHealth Strategy Toolkit that provides a basis for the components and processes to be considered in a strategy development or refocusing exercise. We look at this toolkit and highlight those areas which the countries should consider in formulating their national eHealth strategy.

  8. Laboratory quality stepwise implementation tool: National reference TB laboratory of Iran

    OpenAIRE

    Ali Naghi Kebriaee; Donya Malekshahian; Mojtaba Ahmadi; Parissa Farnia

    2015-01-01

    Background and objective: During recent years, the World Health Organization (WHO) proposed new software for improving the tuberculosis (TB) laboratory services. The protocol is known as “quality stepwise implementation tool” and is based on enforcement of quality assurance services through accreditation by the International Organization for Standardization (ISO) 15189. As a national reference TB laboratory (NRL) of Iran, the benefit and challenges of implementing this standard were analyzed....

  9. 76 FR 81911 - National Advisory Committee for Implementation of the National Forest System Land Management...

    Science.gov (United States)

    2011-12-29

    ...; and 7. Offer recommendations for integrating the land management planning process with landscape scale... National Forest System Land Management Planning Rule AGENCY: USDA Forest Service. ACTION: Notice of intent... Management Planning Rule (Committee). In accordance with provisions of the Federal Advisory Committee Act...

  10. 78 FR 68811 - National Advisory Committee for Implementation of the National Forest System Land Management...

    Science.gov (United States)

    2013-11-15

    ... following business will be conducted: 1. Present finalized recommendations; 2. Look back on what has been... National Forest System Land Management Planning Rule AGENCY: Forest Service, USDA. ACTION: Notice of... Management Planning Rule will meet in Arlington, VA, on November 21, 2013. Attendees may also participate via...

  11. 78 FR 46565 - National Advisory Committee for Implementation of the National Forest System Land Management...

    Science.gov (United States)

    2013-08-01

    ... INFORMATION: The following business will be conducted: 1. Continue formulation of advice to the Secretary for... this meeting is to continue the formulation of advice to the Secretary on the Proposed Land Management... case-by-case basis. Dated: July 25, 2013. Greg Smith, Acting Associate Deputy Chief, National Forest...

  12. 77 FR 50985 - National Advisory Committee for Implementation of the National Forest System Land Management...

    Science.gov (United States)

    2012-08-23

    ... following business will be conducted: (1) Determine the scope and initial tasks of the committee, (2) ethics... National Forest System Land Management Planning Rule AGENCY: Forest Service, USDA. ACTION: Notice of... Management Planning Rule will meet in Washington, DC. The committee operates in compliance with the Federal...

  13. Developing the (ASTM) voluntary consensus standards required to help implement the National Energy Plan

    International Nuclear Information System (INIS)

    Anon.

    1981-01-01

    The recommended guide is the first American Society for Testing and Materials (ASTM) matrix in a family of such documents that combined, will help manage the development of the ASTM standards considered necessary to implement the current National Plan for Energy Research, Development, and Demonstration. It is expected that the guide will provide a framework for standards development to complement the nation's research and development in support of critical energy needs. The recommended guide identifies the energy-critical areas that are to be developed, the master ASTM recommended guide for developing the standards required to help the National Plan, the section in which each energy-critical area is covered, and the suggested ASTM lead committee responsible for each area (fossil, solar, geothermal, conservation, fusion, and fission reactor development). A comprehensive matrix to identify the areas of need for which ASTM standards will be required to help implement the National Energy Plan is also presented

  14. Direct and indirect nitrous oxide emissions from agricultural soils, 1990 - 2003. Background document on the calculation method for the Dutch National Inventory Report

    NARCIS (Netherlands)

    Hoek KW van der; Schijndel MW van; Kuikman PJ; MNP; Alterra; LVM

    2007-01-01

    Since 2005 the Dutch method to calculate the nitrous oxide emissions from agricultural soils has fully complied with the Intergovernmental Panel on Climate Change (IPCC) Good Practice Guidelines. In order to meet the commitments of the Convention on Climate Change and the Kyoto Protocol, nitrous

  15. Remote age verification to prevent underage alcohol sales. First results from Dutch liquor stores and the economic viability of national adoption

    NARCIS (Netherlands)

    van Hoof, Joris Jasper; Velthoven, Ben C.J.

    2015-01-01

    Objectives Alcohol consumption among minors is a popular topic in the public health debate, also in the Netherlands. Compliance with the legal age limits for selling alcohol proves to be rather low. Some Dutch liquor stores (outlets with an exclusive license to sell off-premise drinks with 15%

  16. Incidence rates and management of urinary tract infections among children in Dutch general practice: results from a nation-wide registration study.

    NARCIS (Netherlands)

    W.Y. Kwok (Wing-Yee); M.C. Kwaadsteniet (Marjolein); M. Harmsen (Mirjam); L.W.A. van Suijlekom-Smit (Lisette); F.G. Schellevis (François); J.C. van der Wouden (Hans)

    2006-01-01

    textabstractBACKGROUND: We aimed to investigate incidence rates of urinary tract infections in Dutch general practice and their association with gender, season and urbanisation level, and to analyse prescription and referral in case of urinary tract infections. METHOD: During one calendar year, 195

  17. Incidence rates and management of urinary tract infections among children in Dutch general practice: results from a nation-wide registration study.

    NARCIS (Netherlands)

    Kwok, W.Y.; Kwaadsteniet, M.C. de; Harmsen, M.; Suijlekom-Smit, L.W. van; Schellevis, F.G.; Wouden, J.C. van der

    2006-01-01

    BACKGROUND: We aimed to investigate incidence rates of urinary tract infections in Dutch general practice and their association with gender, season and urbanisation level, and to analyse prescription and referral in case of urinary tract infections. METHOD: During one calendar year, 195 general

  18. Development of a web-based register for the Dutch national study on biologicals in JIA : www.ABC-register.nl

    NARCIS (Netherlands)

    Prince, F H M; Ferket, I S; Kamphuis, S.; Armbrust, W; Ten Cate, R; Hoppenreijs, E P A H; Koopman-Keemink, Y; van Rossum, M A J; van Santen-Hoeufft, M; Twilt, M; van Suijlekom-Smit, L W A

    OBJECTIVES: Most clinical studies use paper case record forms (CRFs) to collect data. In the Dutch multi-centre observational study on biologicals we encountered several disadvantages of using the paper CRFs. These are delay in data collection, lack of overview in collected data and difficulties in

  19. A comparison of thermal treatment processes for hazardous waste : Strategic EIA for the Dutch national hazardous waste management plan 1997- 2007

    NARCIS (Netherlands)

    Tukker, A.

    1999-01-01

    This paper (the second in a series of three) compares incineration options for hazardous waste with LCA. Provided that acceptance criteria are met with regard to metals, PAHs and chlorine, Dutch Municipal Solid Waste Incinerators (MSWIs) appeared to be preferable above rotary kilns since they have a

  20. Variation in use of neoadjuvant chemotherapy in patients with stage III breast cancer : Results of the Dutch national breast cancer audit

    NARCIS (Netherlands)

    Spronk, Pauline E.R.; van Bommel, A.C.M.; Siesling, S.; Wouters, M. W.J.M.; Vrancken Peeters, M.T.F.D.; Smorenburg, Carolien H.

    2017-01-01

    Objectives Neoadjuvant chemotherapy (NAC) is important in the optimal treatment of patients with locally advanced (stage III) breast cancer (BC). The objective of this study was to examine the clinical practice of NAC for stage III BC patients in all Dutch hospitals participating in BC care.

  1. Building Nation-Wide Information Infrastructures in Healthcare through Modular Implementation Strategies

    DEFF Research Database (Denmark)

    Aanestad, Margunn; Jensen, Tina Blegind

    2011-01-01

    initiatives, where a national project failed to deliver interoperable Electronic Patient Record (EPR) systems while a small, local solution grew and now offers a nation-wide solution for sharing patient record information. We apply II theory, specifically the five design principles proposed by Hanseth...... of the installed base, which current II theory advocates. Here we articulate and exemplify a modular implementation strategy as an approach that also addresses the challenges related to mobilization and organization of multiple stakeholders....

  2. Consensus implementation of a groundwater remediation project at the Idaho National Engineering Laboratory

    International Nuclear Information System (INIS)

    Hastings, K.R.; Carlson, D.S.

    1996-01-01

    Because of significant characterization uncertainties existing when the Record of Decision was signed and the unfavorable national reputation of groundwater pump and treat remediation projects, the Test Area North (TAN) groundwater ROD includes the evaluation of five emerging technologies that show potential for treating the organic contamination in situ or reducing the toxicity of contaminants above ground. Treatability studies will be conducted to ascertain whether any may be suitable for implementation at TAN to yield more timely or cost effective restoration of the aquifer. The implementation approach established for the TAN groundwater project is a consensus approach, maximizing a partnership relation with stakeholders in constant, iterative implementation decision making

  3. Implementation Of Conservation Policy Through The Protection Of Life Support System In The Karimunjawa National Park

    Science.gov (United States)

    Ariyani, Nur Anisa Eka; Kismartini

    2018-02-01

    The Karimunjawa National Park as the only one marine protected area in Central Java, managed by zonation system has decreased natural resources in the form of decreasing mangrove forest area, coral cover, sea biota population such as clams and sea cucumbers. Conservation has been done by Karimunjawa National Park Authority through protection of life support system activities in order to protect the area from degradation. The objective of the research is to know the implementation of protection and security activities of Karimunjawa National Park Authority for the period of 2012 - 2016. The research was conducted by qualitative method, processing secondary data from Karimunjawa National Park Authority and interview with key informants. The results showed that protection and security activities in The Karimunjawa National Park were held with three activities: pre-emptive activities, preventive activities and repressive activities. Implementation of conservation policy through protection of life support system is influenced by factors of policy characteristic, resource factor and environmental policy factor. Implementation of conservation policy need support from various parties, not only Karimunjawa National Park Authority as the manager of the area, but also need participation of Jepara Regency, Central Java Provinces, communities, NGOs, researchers, developers and tourism actors to maintain and preserve existing biodiversity. Improving the quality of implementors through education and training activities, the availability of the state budget annually and the support of stakeholders is essential for conservation.

  4. Implementation of South African national credit act and its impact on home loans market: The case of First National Bank

    Directory of Open Access Journals (Sweden)

    Bathmanathan Vasie Naicker

    2013-06-01

    Full Text Available Since it has been observed that credit granting is a serious problem across the entire credit market, South Africa introduced National Credit Act 34 of 2005 in order to regulate the credit industry and protect credit consumers from becoming over-indebted. The study highlights and examines the implementation of the Act in relation to the South African home loans market, focussing on First National Bank home loans portfolio. The study documents that the current state of consumer indebtedness shows that both credit institutions and consumers were responsible for over extending retail credit. The study noticed that credit industry has significantly managed to regulate the retail credit through the implementation of the Act. Furthermore, the study finds that a new stakeholder such as a debt counsellor has been introduced into the retail credit value chain for debt counselling for over-indebted clients. However, the study recommends that internal forums within banks as well as industry-wide forums should be used in order to ensure that the implementation of a regulation that impacts the entire credit industry is implemented with all stakeholders to limit any possible misinterpretation of key sections of a new regulation.

  5. Implementation of a National Workplace Wellness Program for Health Workers in Botswana.

    Science.gov (United States)

    Ledikwe, Jenny H; Semo, Bazghina-Werq; Sebego, Miram; Mpho, Maureen; Mothibedi, Heather; Mawandia, Shreshth; O'Malley, Gabrielle

    2017-09-01

    : The Botswana workplace wellness program (WWP) for health care workers (HCWs) was initiated in 2007. WWP implementation was assessed using a sequential, explanatory, mixed methods design including a national implementation assessment (27 health districts) and in-depth interviews (n = 38). Level of implementation varied across districts with health screening, therapeutic recreation, and health promotion implemented more frequently than occupational health activities and psychosocial services. Facilitators to WWP implementation included establishment of a dedicated, diverse WWP committee; provision of administrative support, and integration of activities into organizational culture. Barriers included competing priorities related to delivery of health services to clients, limited technical ability to deliver occupation health activities and psychosocial support, receipt of health services from colleagues, and limited appreciation for personal wellness by some HCWs. Ensuring the well-being of HCWs is critical in reaching international health goals.

  6. Implementation of a National Workplace Wellness Program for Health Workers in Botswana

    Science.gov (United States)

    Ledikwe, Jenny H.; Semo, Bazghina-werq; Sebego, Miram; Mpho, Maureen; Mothibedi, Heather; Mawandia, Shreshth; O’Malley, Gabrielle

    2017-01-01

    The Botswana workplace wellness program (WWP) for health care workers (HCWs) was initiated in 2007. WWP implementation was assessed using a sequential, explanatory, mixed methods design including a national implementation assessment (27 health districts) and in-depth interviews (n = 38). Level of implementation varied across districts with health screening, therapeutic recreation, and health promotion implemented more frequently than occupational health activities and psychosocial services. Facilitators to WWP implementation included establishment of a dedicated, diverse WWP committee; provision of administrative support, and integration of activities into organizational culture. Barriers included competing priorities related to delivery of health services to clients, limited technical ability to deliver occupation health activities and psychosocial support, receipt of health services from colleagues, and limited appreciation for personal wellness by some HCWs. Ensuring the well-being of HCWs is critical in reaching international health goals. PMID:28742763

  7. Implementing national strategies on antimicrobial resistance in Thailand: potential challenges and solutions.

    Science.gov (United States)

    Sommanustweechai, A; Tangcharoensathien, V; Malathum, K; Sumpradit, N; Kiatying-Angsulee, N; Janejai, N; Jaroenpoj, S

    2018-04-01

    Thailand has developed a national strategic plan on antimicrobial resistance (NSP-AMR) and endorsed by the Cabinet in August 2016. This study reviewed the main contents of the NSP-AMR and the mandates of relevant implementing agencies and identified challenges and recommends actions to mitigate implementation gaps. This study analysed the contents of NSP-AMR, reviewed institutional mandates and assessed the implementation gaps among agencies responsible for NSP-AMR. Two of six strategies are related to monitoring and surveillance of AMR and antimicrobial consumption in human and animal. Two other strategies aim to improve antibiotic stewardship and control the spread of AMR in both clinical and farm settings. The remaining two strategies aim to increase knowledge and public awareness on AMR and establish national governance for inter-sectoral actions. Strategies to overcome implementation challenges are sustaining cross-sectoral policy commitments, effective cross-sectoral coordination using One Health approach, generating evidence which guides policy implementation, and improving enforcement capacities in regulatory authorities. To address AMR, Thailand requires significant improvements in implementation capacities in two dimensions. First, technical capacities among implementing agencies are needed to translate policies into practice. Second, governance and organizational capacities enable effective multi-sectoral actions across human, animal, and environmental sectors. Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  8. A national general pediatric clerkship curriculum: the process of development and implementation.

    Science.gov (United States)

    Olson, A L; Woodhead, J; Berkow, R; Kaufman, N M; Marshall, S G

    2000-07-01

    To describe a new national general pediatrics clerkship curriculum, the development process that built national support for its use, and current progress in implementing the curriculum in pediatric clerkships at US allopathic medical schools. CURRICULUM DEVELOPMENT: A curriculum project team of pediatric clerkship directors and an advisory committee representing professional organizations invested in pediatric student education developed the format and content in collaboration with pediatric educators from the Council on Medical Student Education in Pediatrics (COMSEP) and the Ambulatory Pediatric Association (APA). An iterative process or review by clerkship directors, pediatric departmental chairs, and students finalized the content and built support for the final product. The national dissemination process resulted in consensus among pediatric educators that this curriculum should be used as the national curricular guideline for clerkships. MONITORING IMPLEMENTATION: Surveys were mailed to all pediatric clerkship directors before dissemination (November 1994), and in the first and third academic years after national dissemination (March 1996 and September 1997). The 3 surveys assessed schools' implementation of specific components of the curriculum. The final survey also assessed ways the curriculum was used and barriers to implementation. The final curriculum provided objectives and competencies for attitudes, skills, and 18 knowledge areas of general pediatrics. A total of 216 short clinical cases were also provided as an alternative learning method. An accompanying resource manual provided suggested strategies for implementation, teaching, and evaluation. A total of 103 schools responded to survey 1; 84 schools to survey 2; and 85 schools responded to survey 3 from the 125 medical schools surveyed. Before dissemination, 16% of schools were already using the clinical cases. In the 1995-1996 academic year, 70% of schools were using some or all of the curricular

  9. Creating sport consumers in Dutch sport policy

    NARCIS (Netherlands)

    van der Roest, Jan Willem; Vermeulen, Jeroen; van Bottenburg, Maarten; LS Sportontw. & Managing Social Issues; UU LEG Research USG Public Matters Managing Social Issues; LS Management van Cultuur en Zingeving

    2014-01-01

    This article deals with the tension between the association logic and the market logic that appears in the domain of voluntary sport clubs (VSCs). We present a qualitative analysis of sport policy texts of fifteen Dutch national sport organizations (NSOs) and the national umbrella organization to

  10. National public health policy in a local context--implementation in two Swedish municipalities.

    Science.gov (United States)

    Jansson, Elisabeth; Fosse, Elisabeth; Tillgren, Per

    2011-12-01

    In 2003 the wide-ranging Swedish National Public Health Policy (SNPHP), with a focus on health determinants, was adopted by the Swedish parliament. In the context of multilevel governance, SNPHP implementation is dependent on self-governed municipalities and counties. The aim of the study is, from a municipal perspective, to investigate public-health policies in two municipalities. Content analysis of documents and interviews provided a foundation for an explorative case study. The SNPHP at national level is overriding but politically controversial. At local level, a health-determinants perspective was detectable in the policies implemented, but none regarding to health equality. At local level, the SNPHP is not regarded as implementable; rather, limited parts have, to varying degrees, been reconciled with local public-health goals, according to municipal needs and conditions. A success-promoting factor in the two municipalities was the presence of committed and knowledgeable actors/implementers. Also, the municipality with a more centrally controlled and stable party-political leadership succeeded better in implementing structural and intersectoral community-wide policies for coordinated local health promotion. The contents of national and local public-health policies differ, and municipalities that have implemented their own local health policies do not seem to regard the SNPHP as justifiable or adoptable. If the SNPHP overall aim regarding equal health is to be achieved homogeneously in Swedish municipalities, its contents and purpose need clearer management and negotiation, so that implementation of the national policy locally is understandable and motivated. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  11. Tradeable emission permits in Dutch environmental policy. A utopia?

    International Nuclear Information System (INIS)

    Schuurman, S.J.

    1997-01-01

    Because of the lack of experience with permits in the Netherlands, and in view of the similarities between various other tradeable permit systems, the functioning of Dutch systems of tradeable fish, milk and manure quotas is discussed. Evaluation of these systems is based on criteria of effectiveness, target-group efficiency and government efficiency. These systems of tradeable permits appear to constitute a successful addition to the Dutch policy of direct regulation. Considering this, and the favorable American experience with the Emissions Trading Program, tradeable emission permits deserve a chance to be implemented in Dutch environmental policy. The question remains, however, whether the Dutch government is ready for such a step. 28 refs

  12. Acute pulmonary admissions following implementation of a national workplace smoking ban.

    LENUS (Irish Health Repository)

    Kent, Brian D

    2012-09-01

    The implementation of workplace smoking bans has contributed to a significant reduction in the incidence of acute coronary syndrome admissions, but their influence on adult acute pulmonary disease admissions is unclear. We sought to assess the impact of a national smoking ban on nationwide admissions of individuals of working age with acute pulmonary illness.

  13. Good Practice in Designing and Implementing National Monitoring Systems for Adaptation to Climate Change

    DEFF Research Database (Denmark)

    Naswa, Prakriti; Trærup, Sara Lærke Meltofte; Bouroncle, Claudia

    In this report, we identify, analyse and compare international good practices in the design and implementation of national monitoring and evaluating indicator systems for climate change adaptation. This first chapter provides an introduction to the context and key terminology in the domain...

  14. Cyber security awareness toolkit for national security: an approach to South Africa's cyber security policy implementation

    CSIR Research Space (South Africa)

    Phahlamohlaka, LJ

    2011-05-01

    Full Text Available The aim of this paper is to propose an approach that South Africa could follow in implementing its proposed cyber security policy. The paper proposes a Cyber Security Awareness Toolkit that is underpinned by key National Security imperatives...

  15. National Inspection Program of Conventional Industries: implement, results and evaluation- 1981 to 1984

    International Nuclear Information System (INIS)

    Gloria, M.B.; Silva, F.C.A. da; Leocadio, J.C.; Valenca, J.R.M.; Farias, C.

    1986-01-01

    The methodology adopted by the Instutute of Radiation Protection and Dosimetry to implement the National Inspection Program of Conventional Industries is present. This methodology is being efficient because of many technical and administrative problems about radiation protection could be identified, analysed and solved gradually. Many workplaces of gammagraphy are analysed in relation to radiation safety, geographyc localization and social-economics aspects. (Author) [pt

  16. Understanding national culture effects on user behavior in integrative IS implementations

    NARCIS (Netherlands)

    Krijnse Locker, Niels; Vos, Janita F.J.; Boonstra, Albert

    2016-01-01

    This study examines how national culture manifests itself in integrative IS implementations and how it influences user behavior. Adopting a case survey approach, a sample of 70 cases encompassing 18 countries/regions, 18 industries and over 25 different integrative IT systems resulted in 481

  17. Needs and Contradictions of a Changing Field: Evidence from a National Response to Intervention Implementation Study

    Science.gov (United States)

    Patrikakou, Eva; Ockerman, Melissa S.; Hollenbeck, Amy Feiker

    2016-01-01

    As a result of the Response to Intervention (RTI) mandate in schools across many states, school counselors are well-positioned to take a leadership role. The present research study examines how school counselors across the nation perceived their training and knowledge of RTI, as well as their confidence in its implementation. Results indicate that…

  18. Mexico’s National Cancer Control Plan: From Development to Implementation

    Science.gov (United States)

    The National Cancer Institute and the Center for Global Health have had a long-standing and successful partnership with INCan, and at their request are identifying new or enhanced ways to provide technical support by way of resources, training, and collaborative programs to facilitate the implementation of the NCCP.

  19. Performing Compliance: The Work of Local Policy Workers during the Implementation of National Health Promotion Guidelines

    Science.gov (United States)

    Wimmelmann, Camila Lawaetz

    2017-01-01

    Guidelines are increasingly used to regulate how local authorities engage in practices. Focusing on the Danish national health promotion guidelines, this article reveals that the local policy workers did not implement the guidelines as proposed. Using a dramaturgical framework, it illustrates how the local policy workers front-staged some…

  20. Implementing China`s Agenda 21: From National Strategy to Local Actions

    Energy Technology Data Exchange (ETDEWEB)

    Gan, Lin

    1998-12-01

    This report analyses the process of adaptation of the Chinese governmental policy in response to sustainable development. It reviews the historical roots from which response to sustainable development arises. By examining the policy-making and implementation processes of China`s Agenda 21, the author studies (1) the dynamic forces that contribute to the establishment of the national and regional Agenda 21 and the relationships between different institutional preferences, arrangements and their obstacles, (2) the driving forces that pro-active responses to implement Agenda 21 projects, and the role of local governments in the process, (3) the relationship between international environmental aid and national capacity building for the environment, (4) the obstacles and conflicting interests that limit the implementation of Agenda 21 and sustainable development in China. 22 refs., 2 tabs.

  1. External costs related to power production technologies. ExternE national implementation for Denmark

    International Nuclear Information System (INIS)

    Schleisner, L.; Sieverts Nielsen, P.

    1997-12-01

    The objective of the ExternE National Implementation project has been to establish a comprehensive and comparable set of data on externalities of power generation for all EU member states and Norway. The tasks include the application of the ExternE methodology to the most important fuel cycles for each country as well as to update the already existing results; to aggregate these site- and technology-specific results to more general figures. The current report covers the results of the national implementation for Denmark. Three different fuel cycles have been chosen as case studies. These are fuel cycles for an offshore wind farm and a wind farm on land, a decentralised CHP plant based on natural gas and a decentralised CHP plant based on biogas. The report covers all the details of the application of the methodology to these fuel cycles aggregation to a national level. (au) EU-JOULE 3. 59 tabs., 25 ills., 61 refs

  2. Methodology for implementation of a national metrology net of radionuclides used in nuclear medicine

    International Nuclear Information System (INIS)

    Santos, Joyra Amaral dos

    2004-01-01

    The National Laboratory for Ionizing Radiation Metrology, of the Institute of Radiation Protection and Dosimetry, of the National Commission on Nuclear Energy (IRD/CNEN), comes leading a comparison program for activity measurements of radiopharmaceuticals administered to patients in the Nuclear Medicine Services (NMS) with the purpose to promote the quality control. This work presents a quality assurance program for the performance of such measurements, evaluated in the comparison runs between hospitals and LNMRI, under the statistic point of view and the compliment of regulatory authority norms. The performance of the radionuclides 67 Ga, 123 I, 131 I, 99m Tc and 210 Tl were evaluated and 201 TI have been standardized by absolute methods. Besides, it was established the traceability of the radioactivity standards used in nuclear medicine and a methodology for implementation of a national metrology net of radionuclides. The comparison results prove that the implementation of a radionuclide metrology net is viable, important and feasible. (author)

  3. External costs related to power production technologies. ExternE national implementation for Denmark

    Energy Technology Data Exchange (ETDEWEB)

    Schleisner, L; Sieverts Nielsen, P

    1997-12-01

    The objective of the ExternE National Implementation project has been to establish a comprehensive and comparable set of data on externalities of power generation for all EU member states and Norway. The tasks include the application of the ExternE methodology to the most important fuel cycles for each country as well as to update the already existing results; to aggregate these site- and technology-specific results to more general figures. The current report covers the results of the national implementation for Denmark. Three different fuel cycles have been chosen as case studies. These are fuel cycles for an offshore wind farm and a wind farm on land, a decentralised CHP plant based on natural gas and a decentralised CHP plant based on biogas. The report covers all the details of the application of the methodology to these fuel cycles aggregation to a national level. (au) EU-JOULE 3. 59 tabs., 25 ills., 61 refs.

  4. Sex differences among recipients of benzodiazepines in Dutch general practice.

    NARCIS (Netherlands)

    Waals, F.W. van der; Mohrs, J.; Foets, M.

    1993-01-01

    Objective: To analyse sex differences among recipients of benzodiazepines in Dutch general practice. Design-Study of consultations and associated interventions as recorded in the Dutch national survey of general practice. Setting: Practices of 45 general practitioners monitored during 1 April to 30

  5. Questions of legal responsibility for Srebrenica before the Dutch courts

    NARCIS (Netherlands)

    Spijkers, Otto

    This contribution provides an overview of the litigation in the Dutch civil and criminal courts concerning the Srebrenica massacre. The author maps out the Dutch courts' divergent approaches to immunity of United Nations peacekeepers, state responsibility and individual criminal responsibility for

  6. The Dutch Are Missing in the American Curriculum

    Science.gov (United States)

    Claunch, Ann

    2009-01-01

    The Dutch are missing in any U.S. history textbook, in the content standards, and in the nationally endorsed curriculum. Outside of New York State history classes, there is almost no mention of the Dutch influence in early 17th-century America. Fleeting references to the Netherlands as a staging area for the Pilgrims' famous "Mayflower"…

  7. Evaluation of the Dutch subsurface geoportal: What lies beneath?

    NARCIS (Netherlands)

    Lance, K.T.; Georgiadou, Y.; Bregt, A.K.

    2011-01-01

    This paper focuses on a geoportal from a “what lies beneath” perspective. It analyses processes of budgeting, planning, monitoring, performance measurement, and reporting of the national initiative titled Digital Information of the Dutch Subsurface (known by its Dutch acronym, DINO). The study is

  8. The Dutch nuclear programme

    International Nuclear Information System (INIS)

    1986-01-01

    Engineering Services Ltd. has, in fulfillment of its contractual commitment to the Dutch Industrial Council for Energy and Environment Technology (IREM), investigated the broad capability of the Dutch industry in playing a major role in the supply of goods and services for the construction of nuclear plants in the Netherlands. The findings are summarized in this document. 5 tabs

  9. Dutch elm disease

    Science.gov (United States)

    James W. Walters

    1992-01-01

    Since its discovery in the United States in 1930, Dutch elm disease has killed thousands of native elms. The three native elms, American, slippery, and rock, have little or no resistance to Dutch elm disease, but individual trees within each species vary in susceptibility to the disease. The most important of these, American elm, is scattered in upland stands but is...

  10. Implementation and integration of regional health care data networks in the Hellenic National Health Service.

    Science.gov (United States)

    Lampsas, Petros; Vidalis, Ioannis; Papanikolaou, Christos; Vagelatos, Aristides

    2002-12-01

    Modern health care is provided with close cooperation among many different institutions and professionals, using their specialized expertise in a common effort to deliver best-quality and, at the same time, cost-effective services. Within this context of the growing need for information exchange, the demand for realization of data networks interconnecting various health care institutions at a regional level, as well as a national level, has become a practical necessity. To present the technical solution that is under consideration for implementing and interconnecting regional health care data networks in the Hellenic National Health System. The most critical requirements for deploying such a regional health care data network were identified as: fast implementation, security, quality of service, availability, performance, and technical support. The solution proposed is the use of proper virtual private network technologies for implementing functionally-interconnected regional health care data networks. The regional health care data network is considered to be a critical infrastructure for further development and penetration of information and communication technologies in the Hellenic National Health System. Therefore, a technical approach was planned, in order to have a fast cost-effective implementation, conforming to certain specifications.

  11. Do Dutch nutrition and dietetics students meet nutritional requirements during education?

    NARCIS (Netherlands)

    van der Kruk, Joke; Jager, Harriët; Nieweg, Roos; van der Schans, Cees

    2014-01-01

    OBJECTIVES: To compare the dietary intakes of Dutch nutrition and dietetics students with the Dutch RDA and the Dutch National Food Consumption Survey (DNFCS), and to assess whether dietary intake changes during education.DESIGN: Cross-sectional and longitudinal research (2004-2010).SETTING: Data

  12. Motives of Dutch men who have sex with men for daily and intermittent HIV pre-exposure prophylaxis usage and preferences for implementation: A qualitative study

    NARCIS (Netherlands)

    Bil, Janneke P.; van der Veldt, Wendy M.; Prins, Maria; Stolte, Ineke G.; Davidovich, Udi

    2016-01-01

    Although PrEP is not yet registered in Europe, including the Netherlands, its approval and implementation are expected in the near future. To inform future pre-exposure prophylaxis (PrEP) implementation, this study aimed to gain insight into motives and preferences for daily or intermittent PrEP use

  13. Evaluating National Nuclear Safeguards System Implementation in the Republic of Moldova

    International Nuclear Information System (INIS)

    Mursa, E.; Sidorencu, A.; Vasilieva, N.; Sirbu, I.

    2015-01-01

    Strengthening the multilateral system of Nuclear Safeguards by the International Atomic Energy Agency (IAEA), imposed by the increasing cross-border illicit trafficking of nuclear material and redirecting for military purposes has led Republic of Moldova to ratify on 1 June 2012 the Additional Protocol (INFCIRC/690) to the Agreement of Nuclear Safeguards in relation with the NPT. This was followed by the adoption in the Parliament on 8 June 2012, of the new Law no. 132 of 08.06.2012 on the safe conduct of nuclear and radiological activities, which extends the power of the National Agency for Regulation of Nuclear and Radiological Activities (NARNRA) and details the measures to strengthen the Nuclear Safeguards in the country. The NARNRA implements safeguards measures in relation to nuclear materials by: – normative acts development; – establishing a system for inspecting of nuclear material; – implementing inventory-taking and reporting procedures for quantities of nuclear material; – implementing authorisation and monitoring procedures for the movements of nuclear material; – implementing procedures for reporting quantities of nuclear material to the IAEA; – maintaining and updating the national register of nuclear materials. A very important role to achieve results is the cooperation with the IAEA. Thus, was developed and agreed the Joint Action Plan for implementing the provisions of the Additional Protocol to the Safeguards Agreement, which is an essential aid in fulfilling the country’s international obligations. In this respect have been obtained some good practices: – Routinely performed national inspections; – On-line information provision from the Customs check points; – Developed special form for nuclear material in the National Register; – Systematic interaction with Ministry of Foreign Affairs, Ministry of Internal Affairs and authorisation holders; – Annual and quarterly presentation to the IAEA of the reports on SQP and the

  14. The dutch national clinical audit for lung cancer: A tool to improve clinical practice? An analysis of unforeseen ipsilateral mediastinal lymph node involvement in the Dutch Lung Surgery Audit (DLSA).

    Science.gov (United States)

    Heineman, David Jonathan; Beck, Naomi; Wouters, Michael Wilhelmus; van Brakel, Thomas Jan; Daniels, Johannes Marlene; Schreurs, Wilhelmina Hendrika; Dickhoff, Chris

    2018-06-01

    Optimal treatment selection for patients with non-small cell lung cancer (NSCLC) depends on the clinical stage of the disease. Particularly patients with mediastinal lymph node involvement (stage IIIA-N2) should be identified since they generally do not benefit from upfront surgery. Although the standardized preoperative use of PET-CT, EUS/EBUS and/or mediastinoscopy identifies most patients with mediastinal lymph node metastasis, a proportion of these patients is only diagnosed after surgery. The objective of this study was to identify all patients with unforeseen N2 disease after surgical resection for NSCLC in a large nationwide database and to evaluate the preoperative clinical staging process. Data was derived from the Dutch Lung Surgery Audit. Patients with pathological stage IIIA NSCLC after an anatomical resection between 2013 and 2015 were evaluated. Clinical and pathological TNM-stage were compared and an analysis was performed on the diagnostic work-up of patients with unforeseen N2 disease. From 3585 patients undergoing surgery for NSCLC between 2013 and 2015, a total of 527 patients with pathological stage IIIA NSCLC were included. Of all 527 patients, 254 patients were upstaged from a clinical N0 (n = 186) or N1 (n = 68) disease to a pathological N2 disease (7.1% unforeseen N2). In these 254 patients, 18 endoscopic ultrasounds, 62 endobronchial ultrasounds and 67 mediastinoscopies were performed preoperatively. In real world clinical practice in The Netherlands, the percentage of unforeseen N2 disease in patients undergoing surgery for NSCLC is seven percent. To further reduce this percentage, optimization of the standardized preoperative workup is necessary. Copyright © 2018 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

  15. Anything but engaged: user involvement in the context of a national electronic health record implementation.

    Science.gov (United States)

    Cresswell, Kathrin; Morrison, Zoe; Crowe, Sarah; Robertson, Ann; Sheikh, Aziz

    2011-01-01

    The absence of meaningful end user engagement has repeatedly been highlighted as a key factor contributing to 'failed' implementations of electronic health records (EHRs), but achieving this is particularly challenging in the context of national scale initiatives. In 2002, the National Health Service (NHS) embarked on a so-called 'top-down' national implementation strategy aimed at introducing commercial, centrally procured, EHRs into hospitals throughout England. We aimed to examine approaches to, and experiences of, user engagement in the context of a large-scale EHR implementation across purposefully selected hospital care providers implementing early versions of nationally procured software. We conducted a qualitative, case-study based, socio-technically informed, longitudinal investigation, purposefully sampling and collecting data from four hospitals. Our data comprised a total of 123 semi-structured interviews with users and managers, 15 interviews with additional stakeholders, 43 hours of non-participant observations of meetings and system use, and relevant organisation-specific documents from each case study site. Analysis was thematic, building on an existing model of user engagement that was originally developed in the context of studying the implementation of relatively simple technologies in commercial settings. NVivo8 software was used to facilitate coding. Despite an enduring commitment to the vision of shared EHRs and an appreciation of their potential benefits, meaningful end user engagement was never achieved. Hospital staff were not consulted in systems choice, leading to frustration; they were then further alienated by the implementation of systems that they perceived as inadequately customised. Various efforts to achieve local engagement were attempted, but these were in effect risk mitigation strategies. We found the role of clinical champions to be important in these engagement efforts, but progress was hampered by the hierarchical structures

  16. Implementation & Analysis of Integrated Utility System in Developing Nation like India

    Directory of Open Access Journals (Sweden)

    Rajan Gupta

    2016-07-01

    Full Text Available Public utility systems are prevalent around the world but are struggling in developing nations like India to work efficiently. Integration of different utilities can be a possible solution on the technology front, so that more requests can be handled with lesser problems. This study provides the implementation design and benefits of an already proposed integration system by the same authors. It is found that Data Storage, Access Time, Transaction Cost, security cost and server’s busy time can become more effective if the implementation of integration system can be put in place. The working prototype is based on three utilities (Gas, Power & Water of Delhi-NCR, India.

  17. Plan for the design, development, and implementation, and operation of the National Water Information System

    Science.gov (United States)

    Edwards, M.D.

    1987-01-01

    The Water Resources Division of the U.S. Geological Survey is developing a National Water Information System (NWIS) that will integrate and replace its existing water data and information systems of the National Water Data Storage and Retrieval System, National Water Data Exchange, National Water-Use Information, and Water Resources Scientific Information Center programs. It will be a distributed data system operated as part of the Division 's Distributed Information System, which is a network of computers linked together through a national telecommunication network known as GEONET. The NWIS is being developed as a series of prototypes that will be integrated as they are completed to allow the development and implementation of the system in a phased manner. It also is being developed in a distributed manner using personnel who work under the coordination of a central NWIS Project Office. Work on the development of the NWIS began in 1983 and it is scheduled for completion in 1990. This document presents an overall plan for the design, development, implementation, and operation of the system. Detailed discussions are presented on each of these phases of the NWIS life cycle. The planning, quality assurance, and configuration management phases of the life cycle also are discussed. The plan is intended to be a working document for use by NWIS management and participants in its design and development and to assist offices of the Division in planning and preparing for installation and operation of the system. (Author 's abstract)

  18. Social Acceptance of Smoking Restrictions During 10 Years of Policy Implementation, Reversal, and Reenactment in the Netherlands: Findings From a National Population Survey.

    Science.gov (United States)

    Hummel, Karin; Willemsen, Marc C; de Vries, Hein; Monshouwer, Karin; Nagelhout, Gera E

    2017-02-01

    Little is known about the extent to which smoking restrictions are socially accepted in a country such as the Netherlands where smoking restrictions have been implemented and reversed several times. The current study assessed trends as well as factors associated with two indicators of social acceptance of smoking restrictions in the Netherlands: acceptance of smoking in public places and implementation of home smoking bans. We used data from the Dutch Continuous Survey of Smoking Habits (DCSSH) between 2005 and 2014 (n = 182826). The DCSSH is a national population survey with a cross-sectional design in which respondents aged 15 years and older are surveyed weekly. Acceptance of smoking in public places decreased for six out of eight included venues, with the largest decrease for smoking in restaurants. The decrease in acceptance was larger among younger respondents and smokers. Smoking on terraces was an exception: decrease in acceptance there was larger among older respondents and ex-smokers. Implementation of home smoking bans increased over time. Having implemented a home smoking ban was associated with being male, being younger, having a high socioeconomic status, and being ex- or never smoker. Social acceptance of smoking restrictions has increased in the Netherlands, despite a suboptimal implementation process of smoking restrictions. However, there is still potential for improvement as acceptance of smoking is still quite high for some public venues like bars. It is important to strengthen smoking restrictions in order to further denormalize smoking in the Netherlands. We examined the extent to which smoking restrictions are socially accepted in the Netherlands where smoking restrictions have been implemented and reversed several times. Acceptance of smoking in public places decreased and implementation of home smoking bans increased between 2005 and 2014. Social acceptance of smoking restrictions increased in the Netherlands despite a suboptimal

  19. A qualitative study of the anticipated barriers and facilitators to the implementation of a lifestyle intervention in the dutch construction industry

    NARCIS (Netherlands)

    Tonnon, S.C.; Proper, K.I.; van der Ploeg, H.P.; Westerman, M.J.; Sijbesma, E.; van der Beek, A.J.

    2014-01-01

    Background: Lifestyle interventions have proven effective for lowering a cardiovascular risk profile by improving lifestyle behaviors, blood glucose and blood cholesterol levels. However, implementation of lifestyle interventions is often met with barriers. This qualitative study sought to determine

  20. Implementing Nepal's national building code—A case study in patience and persistence

    Science.gov (United States)

    Arendt, Lucy; Hortacsu, Ayse; Jaiswal, Kishor; Bevington, John; Shrestha, Surya; Lanning, Forrest; Mentor-William, Garmalia; Naeem, Ghazala; Thibert, Kate

    2017-01-01

    The April 2015 Gorkha Nepal earthquake revealed the relative effectiveness of the Nepal Standard, or national building code (NBC), and irregular compliance with it in different parts of Nepal. Much of the damage to more than half a million Nepal's residential structures may be attributed to the prevalence of owner-built or owner-supervised construction and the lack of owner and builder responsiveness to seismic risk and training in the appropriate means of complying with the NBC. To explain these circumstances, we review the protracted implementation of the NBC and the role played by one organization, the National Society for Earthquake Technology-Nepal (NSET), in the NBC's implementation. We also share observations on building code compliance made by individuals in Nepal participating in workshops led by the Earthquake Engineering Research Institute's 2014 class of Housner Fellows.

  1. A way to motivate Danish GPs to implement a new national service.

    Science.gov (United States)

    Kristensen, Alice; Wengler, Bente

    2012-01-01

    The Common Medicine card (CMC) is a new national service in Denmark which aim is to ensure better patient care and minimize medication errors. All health professionals as well as authorities have to use this system. CMC requires changing the organization of work for both physicians and clinical staff in General Practice (GP). Commissioning of CMC in GP requires a significant effort beyond the technical installation of the solution. Finding the right way to implement a new service in a busy GP has been the main focus of the national project organization MedCom. MedCom has in collaboration with the five regions in Denmark, established a joint plan and has created an implementation model contraining various initiatives including "after hours" meetings for each service provider of EMR (Electronic Medicine Records) in order to disseminate and support the new CMC service. This paper shows the status of the "after hours" meetings effect in dissemination of CMC from August to November 2011.

  2. Analysis of National Forest Programs for REDD+ Implementation in six South and Southeast Asia countries

    Directory of Open Access Journals (Sweden)

    Abrar J Mohammed

    2016-07-01

    Full Text Available Aim of study: To facilitate REDD+ implementation and identify relevant attributes for robust REDD+ policies, this study evaluated and synthesized information from national forest programs in South and Southeast Asian countries. Area of study: Data was collected from six countries: Sri Lanka, Indonesia, Bangladesh, Philippines, India and Thailand. Methods: The data sources for the evaluation was an in-depth desk review of relevant documents and focus group discussion among experts from each study country.   Main Results: We found out that diverse factors may influence program feasibility and the ability to achieve ‘triple benefits’: the nature of the forest targeted by the policy, the characteristics of the population affected by the policy, attributes of the policy instrument and the different actors involved. Research highlights: We argue that national policies and programs targeted for REDD+ implementation should focus on the identified features to achieve REDD+ goals. Keywords: policy evaluation; policy instruments; triple benefits; Southeast Asia.

  3. Analysis of National Forest Programs for REDD+ Implementation in six South and Southeast Asia countries

    Energy Technology Data Exchange (ETDEWEB)

    Mohammed, A.J.; Inoue, M.; Shivakoti, G.P.; Nath, T.K.; Jashimuddin, M.; Zoysa, M.D.; Kaskoyo, H.; Pulhin, J.M.; Peras, R.J.

    2016-07-01

    Aim of the study. To facilitate REDD+ implementation and identify relevant attributes for robust REDD+ policies, this study evaluated and synthesized information from national forest programs in South and Southeast Asian countries. Area of study: Data was collected from six countries: Sri Lanka, Indonesia, Bangladesh, Philippines, India and Thailand. Methods: The data sources for the evaluation was an in-depth desk review of relevant documents and focus group discussion among experts from each study country. Main Results: We found out that diverse factors may influence program feasibility and the ability to achieve ‘triple benefits’: the nature of the forest targeted by the policy, the characteristics of the population affected by the policy, attributes of the policy instrument and the different actors involved. Research highlights: We argue that national policies and programs targeted for REDD+ implementation should focus on the identified features to achieve REDD+ goals. (Author)

  4. Adherence of pharmacoeconomic studies to national guidelines in the Netherlands

    NARCIS (Netherlands)

    Atthobari, Jarir; Bos, Jasper M.; Boersma, C.; Brouwers, J.R.B.J.; de Jong-van den Berg, Lolkje T.W.; Postma, Maarten

    2005-01-01

    Objective: This study examines the adherence of Dutch pharmacoeconomic studies to the national guidelines of conducting a pharmacoeconomic evaluation. Methods: Dutch guidelines for pharmacoeconomic research were issued in 1999. All Dutch pharmacoeconomic studies that were published in English during

  5. Good governance in national solid waste management policy (NSWMP) implementation: A case study of Malaysia

    Science.gov (United States)

    Wee, Seow Ta; Abas, Muhamad Azahar; Mohamed, Sulzakimin; Chen, Goh Kai; Zainal, Rozlin

    2017-10-01

    The National Solid Waste Management Policy (NSWMP) was introduced in 2007 under the Act 672. The execution of NSWMP involves stakeholders from various government agencies and a collaboration with the private sectors. Despite the initiatives taken by the stakeholders, the objectives of NSWMP failed to materialise. One of the major constraints is weak governance among stakeholders with regards to the NSWMP implementation. This paper will explore the good governance practices implemented by the stakeholders. Identifying the current good governance practices implemented by the stakeholders is crucial as it will serve as a guideline to improve good governance practice in the future. An exploratory research approach is applied in this study through in-depth interviews with several government agencies and concessionaires involved in the NSWMP implementation. A total of six respondents took part in this study. The findings of this study show that there are several good governance practices implemented in policy promotion, participation of stakeholders, and capacity enhancement programme for the staff. This study also proposed some points on good governance practices in the context of policy promotion and staff development. A paradigm shift by the stakeholders is imperative so as to enhance the good governance practice in NSWMP implementation towards an efficient solid waste management in Malaysia.

  6. IMPLEMENTING THE COMPUTER-BASED NATIONAL EXAMINATION IN INDONESIAN SCHOOLS: THE CHALLENGES AND STRATEGIES

    Directory of Open Access Journals (Sweden)

    Heri Retnawati

    2017-12-01

    Full Text Available In line with technological development, the computer-based national examination (CBNE has become an urgent matter as its implementation faces various challenges, especially in developing countries. Strategies in implementing CBNE are thus needed to face the challenges. The aim of this research was to analyse the challenges and strategies of Indonesian schools in implementing CBNE. This research was qualitative phenomenological in nature. The data were collected through a questionnaire and a focus group discussion. The research participants were teachers who were test supervisors and technicians at junior high schools and senior high schools (i.e. Level 1 and 2 and vocational high schools implementing CBNE in Yogyakarta, Indonesia. The data were analysed using the Bogdan and Biklen model. The results indicate that (1 in implementing CBNE, the schools should initially make efforts to provide the electronic equipment supporting it; (2 the implementation of CBNE is challenged by problems concerning the Internet and the electricity supply; (3 the test supervisors have to learn their duties by themselves and (4 the students are not yet familiar with the beneficial use of information technology. To deal with such challenges, the schools employed strategies by making efforts to provide the standard electronic equipment through collaboration with the students’ parents and improving the curriculum content by adding information technology as a school subject.

  7. The Development of e-tutorial on Implementation National Curriculum 2013 for Mathematics Teacher

    Science.gov (United States)

    Roza, Yenita; Satria, Gita; Nur Siregar, Syarifah

    2017-06-01

    Curriculum 2013 is the new national Curriculum in Indonesia that is targeted to be used in all Indonesian schools in 2019. At this time the teacher training continues but the number and locations of teachers very diffuse and time constraints to be an obstacle for the government to be able to conduct training for teachers. This research resulted in the e-tutorial which is designed for mathematics teachers in studying the process of Curriculum implementation. This product will assist the government in accelerating the preparation of teachers in implementation of Curriculum 2013. This e-tutorial contains the dynamics of Curriculum development, learning model, learning assessment, lesson plan, curriculum stages of implementation and government regulation that is relevant to the implementation of Curriculum 2013. The product development started with a needs analysis through discussions with mathematics teachers about their difficulties in the implementation of the Curriculum 2013. This e-tutorial was developed using Application of Adobe Director 11. This paper discusses the results of need analysis, process development and results of product revisions made based on input from teachers during the FGD. From the discussion, it can be concluded that this e-tutorial easily understood by teachers and help them to understand the implementation of Curriculum 2013

  8. Dissemination and Implementation Research Funded by the US National Institutes of Health, 2005–2012

    OpenAIRE

    Tinkle, Mindy; Kimball, Richard; Haozous, Emily A.; Shuster, George; Meize-Grochowski, Robin

    2013-01-01

    Dissemination and implementation (D&I) research is a growing area of science focused on overcoming the science-practice gap by targeting the distribution of information and adoption of interventions to public health and clinical practice settings. This study examined D&I research projects funded under specific program announcements by the US National Institutes of Health (NIH) from 2005 to 2012. The authors described the projects' D&I strategies, funding by NIH Institute, focus, characteristi...

  9. Exploring the barriers to implementing National Health Insurance in South Africa: The people's perspective

    Directory of Open Access Journals (Sweden)

    R V Passchier

    2017-10-01

    Full Text Available This article explores the challenges of implementing the proposed National Health Insurance for South Africa (SA, based on the six building blocks of the World Health Organization Health System Framework. In the context of the current SA health system, leadership, finance, workforce, technologies, information and service delivery are explored from the perspective of the people at ground level. Through considerations such as these, the universal health coverage goals of health equity, efficiency, responsiveness and financial risk protection, might be realised.

  10. Exploring the barriers to implementing National Health Insurance in South Africa: The people's perspective.

    Science.gov (United States)

    Passchier, R V

    2017-09-22

    This article explores the challenges of implementing the proposed National Health Insurance for South Africa (SA), based on the six building blocks of the World Health Organization Health System Framework. In the context of the current SA health system, leadership, finance, workforce, technologies, information and service delivery are explored from the perspective of the people at ground level. Through considerations such as these, the universal health coverage goals of health equity, efficiency, responsiveness and financial risk protection, might be realised.

  11. Introducing gaming simulation in the Dutch railways

    NARCIS (Netherlands)

    Meijer, S.

    2012-01-01

    Innovation in the Dutch railways in the domain of capacity management and traffic control is increasingly difficult to implement because of the large interconnectedness of all processes and separation into different institutions and organizations. Meanwhile there is a push for quality improvements

  12. Performance Persistence of Dutch Pension Funds

    NARCIS (Netherlands)

    Huang, Xiaohong; Mahieu, R.

    2012-01-01

    This paper studies the investment performance of pension funds with a focus on their ability in implementing their intended investment strategy. We use a sample of Dutch industry-wide pension funds, which are obliged by law to report their investment performance according to the so-called z-score.

  13. Performance Persistence of Dutch Pension Funds

    NARCIS (Netherlands)

    Huang, Xiaohong; Mahieu, Ronald

    2010-01-01

    This paper studies the investment performance of pension funds with a focus on their ability in implementing the investment strategy. We use a sample of Dutch industry-wide pension funds, which are obliged by law to report their investment performance according to the so-called z-score. The z-score

  14. The formulation and implementation of a national helmet law: a case study from Viet Nam.

    Science.gov (United States)

    Passmore, Jonathon W; Nguyen, Lan Huong; Nguyen, Nam Phuong; Olivé, Jean-Marc

    2010-10-01

    Road traffic injuries are a leading cause of death and disability in Viet Nam. In 2008, official data reported 11 243 deaths and 7771 serious injuries on the roads, of which an estimated 60% of fatalities occur in motorcycle riders and passengers. In recognition of this problem, Viet Nam has had partial motorcycle helmet legislation since 1995. However, for a variety of reasons, implementation and enforcement have been limited. On 15 December 2007, Viet Nam's first comprehensive mandatory helmet law came into effect, covering all riders and passengers on all roads nationwide. Penalties increased ten-fold and cohorts of police were mobilized for enforcement. The Viet Nam national helmet legislation was developed and implemented by the National Traffic Safety Committee. Despite past barriers to enforcement, increased policing in 2008 led to 680 000 infringements being issued for non-helmet wearing. While changes in helmet wearing were not nationally observed, significant increases were documented in selected provinces in the first six months of the law's introduction. In Da Nang, helmet wearing increased from 27 to 99%. In the first three months after the law took effect, surveillance data from 20 urban and rural hospitals, found the risk of road traffic head injuries and deaths decreased by 16% and 18% respectively. Political leadership, intensive advanced public education and stringent enforcement have contributed to the successful implementation of the new law. Through continual monitoring of the legislation, loopholes detrimental to the effectiveness of the law have been identified and addressed.

  15. Challenges to implementing a National Health Information System in Cameroon: perspectives of stakeholders

    Directory of Open Access Journals (Sweden)

    Emmanuel Ngwakongnwi

    2014-03-01

    Full Text Available In the early 90s, the Cameroon Ministry of Health implemented a National Health Information System (NHIS based on a bottom- up approach of manually collecting and reporting health data. Little is known about the implementation and functioning of the NHIS. The purpose of this study was to assess the implementation of the NHIS by documenting experiences of individual stakeholders, and to suggest recommendations for improvement. We reviewed relevant documents and conducted face-to-face interviews (N=4 with individuals directly involved with data gathering, reporting and storage. Content analysis was used to analyze textual data. We found a stalled and inefficient NHIS characterized by general lack of personnel, a labor-intensive process, delay in reporting data, much reliance on field staff, and lack of incentives. A move to an electronic health information system without involving all stakeholders and adequately addressing the issues plaguing the current system is premature.

  16. Stakeholders' Perception on National Heatwave Plans and Their Local Implementation in Belgium and The Netherlands.

    Science.gov (United States)

    van Loenhout, Joris Adriaan Frank; Rodriguez-Llanes, Jose Manuel; Guha-Sapir, Debarati

    2016-11-10

    National heatwave plans are aimed at reducing the avoidable human health consequences due to heatwaves, by providing warnings as well as improving communication between relevant stakeholders. The objective of this study was to assess the perceptions of key stakeholders within plans in Belgium and The Netherlands on their responsibilities, the partnerships, and the effectiveness of the local implementation in Brussels and Amsterdam. Key informant interviews were held with stakeholders that had an important role in development of the heatwave plan in these countries, or its implementation in Brussels or Amsterdam. Care organisations, including hospitals and elderly care organisations, had a lack of familiarity with the national heatwave plan in both cities, and prioritised heat the lowest. Some groups of individuals, specifically socially isolated individuals, are not sufficiently addressed by the current national heatwave plans and most local plans. Stakeholders reported that responsibilities were not clearly described and that the national plan does not describe tasks on a local level. We recommend to urgently increase awareness on the impact of heat on health among care organisations. More emphasis needs to be given to the variety of heat-risk groups. Stakeholders should be involved in the development of updates of the plans.

  17. The National Implementation of Nuclear Export Controls: Developing a Best Practices Model

    Energy Technology Data Exchange (ETDEWEB)

    Viski, Andrea [European University Institute, Department of Law, Badia Fiesolana, S.Domenico di Fiesole, Firenze (Italy)

    2011-12-15

    The nuclear renaissance promises significant benefits to the international community, but also raises security challenges, particularly relating to the trade of nuclear materials and equipment. The objective of this paper is to examine how supply-side non-proliferation efforts can be strengthened by developing a best practices model for national nuclear export control implementation. In order to achieve this goal, nuclear export control measures identified by the 1540 Committee will be used as a framework from which a best practices model can be formed. Such a model concentrates specifically on national legislation and enforcement measures delineated by the Committee in order to bring countries in accordance with international law. Developing a best practices model seeks to deliver an ideal process for national export control law actualization in order to encourage the peaceful development of nuclear energy and develop the infrastructure and framework for precluding nuclear proliferation.

  18. IMPLEMENTATION OF SERIOUS GAMES INSPIRED BY BALURAN NATIONAL PARK TO IMPROVE STUDENTS’ CRITICAL THINKING ABILITY

    Directory of Open Access Journals (Sweden)

    P. D. A. Putra

    2016-04-01

    Full Text Available The purpose of this study is to implement Baluran National Park-based Serious Game to enhance the students' creative thinking skill and motivation to learn. The subject of the study were 60 students of SMP Negeri 1 Asembagus, Situbondo regency. The sample was divided into three groups. Two groups were chosen as experimental classes and the other group as the control class. Both of the experimental groups were given treatment using serious game based on Baluran National Park. The instruments used were observation sheet, pre-test, and post-test. Baluran National Parks-based serious game was effective in improving the students' creative thinking skill and motivation to learn science subjects.

  19. The Politico-Economic Challenges of Ghana’s National Health Insurance Scheme Implementation

    Directory of Open Access Journals (Sweden)

    Adam Fusheini

    2016-09-01

    Full Text Available Background National/social health insurance schemes have increasingly been seen in many low- and middle-income countries (LMICs as a vehicle to universal health coverage (UHC and a viable alternative funding mechanism for the health sector. Several countries, including Ghana, have thus introduced and implemented mandatory national health insurance schemes (NHIS as part of reform efforts towards increasing access to health services. Ghana passed mandatory national health insurance (NHI legislation (ACT 650 in 2003 and commenced nationwide implementation in 2004. Several peer review studies and other research reports have since assessed the performance of the scheme with positive rating while challenges also noted. This paper contributes to the literature on economic and political implementation challenges based on empirical evidence from the perspectives of the different category of actors and institutions involved in the process. Methods Qualitative in-depth interviews were held with 33 different category of participants in four selected district mutual health insurance schemes in Southern (two and Northern (two Ghana. This was to ascertain their views regarding the main challenges in the implementation process. The participants were selected through purposeful sampling, stakeholder mapping, and snowballing. Data was analysed using thematic grouping procedure. Results Participants identified political issues of over politicisation and political interference as main challenges. The main economic issues participants identified included low premiums or contributions; broad exemptions, poor gatekeeper enforcement system; and culture of curative and hospital-centric care. Conclusion The study establishes that political and economic factors have influenced the implementation process and the degree to which the policy has been implemented as intended. Thus, we conclude that there is a synergy between implementation and politics; and achieving UHC under

  20. The Politico-Economic Challenges of Ghana's National Health Insurance Scheme Implementation.

    Science.gov (United States)

    Fusheini, Adam

    2016-04-27

    National/social health insurance schemes have increasingly been seen in many low- and middle-income countries (LMICs) as a vehicle to universal health coverage (UHC) and a viable alternative funding mechanism for the health sector. Several countries, including Ghana, have thus introduced and implemented mandatory national health insurance schemes (NHIS) as part of reform efforts towards increasing access to health services. Ghana passed mandatory national health insurance (NHI) legislation (ACT 650) in 2003 and commenced nationwide implementation in 2004. Several peer review studies and other research reports have since assessed the performance of the scheme with positive rating while challenges also noted. This paper contributes to the literature on economic and political implementation challenges based on empirical evidence from the perspectives of the different category of actors and institutions involved in the process. Qualitative in-depth interviews were held with 33 different category of participants in four selected district mutual health insurance schemes in Southern (two) and Northern (two) Ghana. This was to ascertain their views regarding the main challenges in the implementation process. The participants were selected through purposeful sampling, stakeholder mapping, and snowballing. Data was analysed using thematic grouping procedure. Participants identified political issues of over politicisation and political interference as main challenges. The main economic issues participants identified included low premiums or contributions; broad exemptions, poor gatekeeper enforcement system; and culture of curative and hospital-centric care. The study establishes that political and economic factors have influenced the implementation process and the degree to which the policy has been implemented as intended. Thus, we conclude that there is a synergy between implementation and politics; and achieving UHC under the NHIS requires political stewardship. Political

  1. First Dutch Process Control Security Event

    NARCIS (Netherlands)

    Luiijf, H.A.M.

    2008-01-01

    On May 21st , 2008, the Dutch National Infrastructure against Cyber Crime (NICC) organised their first Process Control Security Event. Mrs. Annemarie Zielstra, the NICC programme manager, opened the event. She welcomed the over 100 representatives of key industry sectors. “Earlier studies in the

  2. 200 years of Dutch transport policy

    NARCIS (Netherlands)

    Annema, J.A.; De Wee, G.P.

    2009-01-01

    In this paper eight stories are told about Dutch passenger transport history. The first story is from 1814 about building the first national paved road network suitable for stagecoaches; the last is from 1997 and is about the decision to construct a high speed rail link from Amsterdam to the

  3. [Lessons learned in the implementation of interoperable National Health Information Systems: a systematic review].

    Science.gov (United States)

    Ovies-Bernal, Diana Paola; Agudelo-Londoño, Sandra M

    2014-01-01

    Identify shared criteria used throughout the world in the implementation of interoperable National Health Information Systems (NHIS) and provide validated scientific information on the dimensions affecting interoperability. This systematic review sought to identify primary articles on the implementation of interoperable NHIS published in scientific journals in English, Portuguese, or Spanish between 1990 and 2011 through a search of eight databases of electronic journals in the health sciences and informatics: MEDLINE (PubMed), Proquest, Ovid, EBSCO, MD Consult, Virtual Health Library, Metapress, and SciELO. The full texts of the articles were reviewed, and those that focused on technical computer aspects or on normative issues were excluded, as well as those that did not meet the quality criteria for systematic reviews of interventions. Of 291 studies found and reviewed, only five met the inclusion criteria. These articles reported on the process of implementing an interoperable NHIS in Brazil, China, the United States, Turkey, and the Semiautonomous Region of Zanzíbar, respectively. Five common basic criteria affecting implementation of the NHIS were identified: standards in place to govern the process, availability of trained human talent, financial and structural constraints, definition of standards, and assurance that the information is secure. Four dimensions affecting interoperability were defined: technical, semantic, legal, and organizational. The criteria identified have to be adapted to the actual situation in each country and a proactive approach should be used to ensure that implementation of the interoperable NHIS is strategic, simple, and reliable.

  4. How smart is smart? Theoretical and empirical considerations on implementing smart city objectives – a case study of Dutch railway station areas

    NARCIS (Netherlands)

    de Wijs, Lisanne; Witte, Patrick; Geertman, Stan

    2016-01-01

    The current widespread attention on the concept of smart city in both policy and practice has stimulated academic discussion regarding the scope and applicability of this concept. An important question is whether cities and regions are truly advanced in implementing the concept in their policies and

  5. MOOC Introduction to Dutch

    NARCIS (Netherlands)

    den Hollander, Franciscus; Piersma, Kristien

    Interview met Margriet Hidding, Birgit Lijmbach en Jeroen van Engen, medewerkers van het Talencentrum en de makers van de Massive Open Online Course (MOOC) Introduction to Dutch over het grote succes van deze cursus

  6. Reforming Dutch substance abuse treatment services.

    Science.gov (United States)

    Schippers, Gerard M; Schramade, Mark; Walburg, Jan A

    2002-01-01

    The Dutch substance abuse treatment system is in the middle of a major reorganization. The goal is to improve outcomes by redesigning all major primary treatment processes and by implementing a system of regular monitoring and feedback of clinical outcome data. The new program includes implementing standardized psychosocial behavior-oriented treatment modalities and a stepped-care patient placement algorithm in a core-shell organizational model. This article outlines the new program and presents its objectives, developmental stages, and current status.

  7. The Dutch Economy 2009

    International Nuclear Information System (INIS)

    2010-09-01

    In the series 'The Dutch Economy' the Dutch Statistical Office describes and analyzes annual developments in enterprises, households and governments, and with respect to employment and the environment. One of the subjects is 'Economy and Environment' with the sub-topics 'Resources and Energy', 'Emissions' and 'Environmental Taxes'. Furthermore, in articles on specific themes current economic issues are discussed. One of those themes has the title 'Share of renewable energy in the Netherlands is still small'. [nl

  8. INTEGRATION OF BUSINESS, EDUCATION AND SCIENCE AT THE REGIONAL LEVEL FOR IMPLEMENTING THE NATIONAL TECHNOLOGICAL INITIATIVE

    Directory of Open Access Journals (Sweden)

    Innara Lyapina

    2018-01-01

    Full Text Available Current world affairs show that the post-industrial stage of development of all mature world powers’ economies is followed by creation of a new development paradigm, which is based on the economy of knowledge, science achievements, innovations, global information and communication systems, and which leads to innovative economy formation. In the context of the national innovation economy formation in the Russian Federation, prerequisites are created for integrating the efforts of business, science and education representatives to develop, produce and market high-tech products which have significant economic or social potential. And this is not only the task announced by the Russian government, but also a natural process in the country’s economy, which contributes to the increase in the integration participants’ efficiency. The result of such integrated interaction of education, science and business consists in a synergistic effect through formation of an interactive cooperation model that involves the active use of combined knowledge, ideas, technologies and other resources during innovative projects implementation. At the same time, integration processes are diverse, complex and occur in each case taking into account the integrating parties’ activity specifics. Within this framework, the goal of the research is to characterize the impact of the education, science and business integration process, on the national technological initiative implementation in the country on the whole and to study the integrating experience of these entities at the regional level. In the course of the research, the stages of the Russian national innovation economy formation process have been studied; the role of education, science and business in the National Technological Initiative implementation has been characterized; it’s been proved that educational institutions are the key link in the integration process in the chain “education – science

  9. Implementing nationally determined contributions: building energy policies in India’s mitigation strategy

    Science.gov (United States)

    Yu, Sha; Evans, Meredydd; Kyle, Page; Vu, Linh; Tan, Qing; Gupta, Ashu; Patel, Pralit

    2018-03-01

    The Nationally Determined Contributions are allowing countries to examine options for reducing emissions through a range of domestic policies. India, like many developing countries, has committed to reducing emissions through specific policies, including building energy codes. Here we assess the potential of these sectoral policies to help in achieving mitigation targets. Collectively, it is critically important to see the potential impact of such policies across developing countries in meeting national and global emission goals. Buildings accounted for around one third of global final energy use in 2010, and building energy consumption is expected to increase as income grows in developing countries. Using the Global Change Assessment Model, this study finds that implementing a range of energy efficiency policies robustly can reduce total Indian building energy use by 22% and lower total Indian carbon dioxide emissions by 9% in 2050 compared to the business-as-usual scenario. Among various policies, energy codes for new buildings can result in the most significant savings. For all building energy policies, well-coordinated, consistent implementation is critical, which requires coordination across different departments and agencies, improving capacity of stakeholders, and developing appropriate institutions to facilitate policy implementation.

  10. Implementing genomics and pharmacogenomics in the clinic: The National Human Genome Research Institute's genomic medicine portfolio.

    Science.gov (United States)

    Manolio, Teri A

    2016-10-01

    Increasing knowledge about the influence of genetic variation on human health and growing availability of reliable, cost-effective genetic testing have spurred the implementation of genomic medicine in the clinic. As defined by the National Human Genome Research Institute (NHGRI), genomic medicine uses an individual's genetic information in his or her clinical care, and has begun to be applied effectively in areas such as cancer genomics, pharmacogenomics, and rare and undiagnosed diseases. In 2011 NHGRI published its strategic vision for the future of genomic research, including an ambitious research agenda to facilitate and promote the implementation of genomic medicine. To realize this agenda, NHGRI is consulting and facilitating collaborations with the external research community through a series of "Genomic Medicine Meetings," under the guidance and leadership of the National Advisory Council on Human Genome Research. These meetings have identified and begun to address significant obstacles to implementation, such as lack of evidence of efficacy, limited availability of genomics expertise and testing, lack of standards, and difficulties in integrating genomic results into electronic medical records. The six research and dissemination initiatives comprising NHGRI's genomic research portfolio are designed to speed the evaluation and incorporation, where appropriate, of genomic technologies and findings into routine clinical care. Actual adoption of successful approaches in clinical care will depend upon the willingness, interest, and energy of professional societies, practitioners, patients, and payers to promote their responsible use and share their experiences in doing so. Published by Elsevier Ireland Ltd.

  11. Persistent Identifiers for Dutch cultural heritage institutions

    Science.gov (United States)

    Ras, Marcel; Kruithof, Gijsbert

    2016-04-01

    Over the past years, more and more collections belonging to archives, libraries, media, museums, and knowledge institutes are being digitised and made available online. These are exciting times for ALM institutions. They are realising that, in the information society, their collections are goldmines. Unfortunately most heritage institutions in the Netherlands do not yet meet the basic preconditions for long-term availability of their collections. The digital objects often have no long lasting fixed reference yet. URL's and web addresses change. Some digital objects that were referenced in Europeana and other portals can no longer be found. References in scientific articles have a very short life span, which is damaging for scholarly research. In 2015, the Dutch Digital Heritage Network (NDE) has started a two-year work program to co-ordinate existing initiatives in order to improve the (long-term) accessibility of the Dutch digital heritage for a wide range of users, anytime, anyplace. The Digital Heritage Network is a partnership established on the initiative of the Ministry of Education, Culture and Science. The members of the NDE are large, national institutions that strive to professionally preserve and manage digital data, e.g. the National Library, The Netherlands Institute for Sound and Vision, the Netherlands Cultural Heritage Agency, the Royal Netherlands Academy of Arts and Sciences, the National Archive of the Netherlands and the DEN Foundation, and a growing number of associations and individuals both within and outside the heritage sector. By means of three work programmes the goals of the Network should be accomplished and improve the visibility, the usability and the sustainability of digital heritage. Each programme contains of a set of projects. Within the sustainability program a project on creating a model for persistent identifiers is taking place. The main goals of the project are (1) raise awareness among cultural heritage institutions on the

  12. Update on the Vienna Protocol and CSC: issues of implementation and application in national legislation

    International Nuclear Information System (INIS)

    Horbach, N. l. J. T.

    2000-01-01

    This paper aims to reflect the recent developments in respect of the 1997 Vienna Protocol (VP) and the 1997 Convention on Supplementary Compensation (CSC), i.e. the changes in signatories and ratificiations of both instruments, and the impacts these will have upon the geographical scope of nuclear liability laws of those countries covered or linked to each other within the international nuclear liability regime. To the extent that certain countries have ratified either the VP or the CSC, it is important to analyse their existing nuclear liability legislation and the manner in which it already implements or aims to implement certain crucial new elements introduced by both instruments, such as, the liability limitation in time and amount, the extension of the geographical scope to damage wherever suffered as well as in the EEZ, the extension of the definition of nuclear damage and preventive measures, and finally, the deletion of some of the exoneration of the operatos's liability. In this context, especially the concept of nuclear environmental damage and the extent to which it is currently covered by existing nuclear liability legislation or, possibly, environmental law, will be given some special attention. Finally, the paper will focus on various aspects of the implementation and application of these new elements of both 1997 instruments within some CEEC's nuclear liability regimes as an example to identify those issues that will produce special problems (e.g., administrative, legal, insurance, or political) or necessitate additional legislative efforts in respect of their implementation in national laws. (author)

  13. Economics of forest and forest carbon projects. Translating lessons learned into national REDD+ implementation

    DEFF Research Database (Denmark)

    Zaballa Romero, Mauricio Ernesto; Trærup, Sara Lærke Meltofte; Wieben, Emilie

    The financial implications of implementing a new forest management paradigm have not been well understood and have often been underestimated. Resource needs for e.g., stakeholder consultation, capacity building and addressing the political economy are seldom fully accounted for in the resource...... but also the testing of advanced market commitments as a finance option for sustainable forest management. The findings in the report underline the fact that only through sound and transparent financial information will forest projects and national forest initiatives become interesting for private...... needs estimates put forward in connection to REDD+. This report investigates the economics of implementing forest and REDD+ projects through eight case studies from Africa, Latin America and Asia, analyzing real forest and REDD+ investments. The report is part of efforts to share financial experiences...

  14. Upgraded national occupational dose registry system - implementation of Phase-II programme

    International Nuclear Information System (INIS)

    Sanaye, S.S.; Baburajan, Sujatha; Johnson, Seethal; Nalawade, S.K.; Tudu, S.C.; Khedekar, B.M.; Sapra, B.K.; Datta, D.

    2016-01-01

    National Occupational Dose Registry System (NODRS) of Bhabha Atomic Research Centre maintains and updates occupational dose data of all monitored radiation workers in the country. The registry was upgraded in 2008 by establishing networked NODRS system through which personnel monitoring labs at different nuclear installations were networked with main dose registry server using the departmental ANUNET and NPCNET facilities. This has facilitated online allotment of personal numbers, storing of biometric information as well as providing online dose information to respective Health Physics Units (HPUs). On the basis of operational experience of NODRS and its feedback from users, Phase-II program was designed, developed and implemented. The paper gives an overview of implementation of this program at various sites

  15. Implementation of ISO 10110 optics drawing standards for the National Ignition Facility

    International Nuclear Information System (INIS)

    Aikens, D. M.; English, R. E.; Wang, D. Y.

    1999-01-01

    The National Ignition Facility (NIF) project elected to implement ISO 10110 standard for the specifications of NIF optics drawings in 1996. More than 7,000 NIF large optics and 20,000 NIF small optics will be manufactured based on ISO 10110 indications. ISO 10110 standard meets many of the needs of the NIF optics specifications. It allows the optical engineer to quantify and clearly communicate the desired optical specifications. While no single drawing standard specifies all the requirements of high energy laser system, a combination of ISO 10110 standard with detailed notes make it possible to apply international drawing standards to the NIF laser system. This paper will briefly describe LLNL's interpretation and implementation of the ISO 10110 drawing standard, present some examples of NIF optics drawings, and discuss pros and cons of the indications from the perspective of this application. Emphasis will be given to the surface imperfection specifications, known as 5/, for the NIF optics

  16. Implementation of ISO 10110 optics drawing standards for the National Ignition Facility

    Science.gov (United States)

    Wang, David Y.; English, R. Edward, Jr.; Aikens, David M.

    1999-11-01

    The National Ignition Facility (NIF) project elected to implement ISO 10110 standard for the specifications of NIF optics drawings in 1996. More than 7,000 NIF large optics and 20,000 NIF small optics will be manufactured based on ISO 10110 indications. ISO 10110 standard meets many of the needs of the NIF optics specifications. It allows the optical engineer to quantify and clearly communicate the desired optical specifications. While no single drawing standard specifies all the requirements of high energy laser system, a combination of ISO 10110 standard with detailed notes make it possible to apply international drawing standards to the NIF laser system. This paper will briefly describe LLNL's interpretation and implementation of the ISO 10110 drawing standard, present some examples of NIF optics drawings, and discuss pros and cons of the indications from the perspective of this application. Emphasis will be given to the surface imperfection specifications, known as 5/, for the NIF optics.

  17. PP167. A process evaluation of an innovative implementation strategy of the Dutch guidelines on hypertensive disorders in pregnancy using a computerized decision support system

    DEFF Research Database (Denmark)

    Luitjes, S.H.E.; Mesri, K; Wouters, M

    2012-01-01

    strategy of professional audit and feedback. In this study a process evaluation of BOS has been done, analyzing its efficiency, barriers and formulate improvement points.OBJECTIVES: Gynecologists, residents and clinical midwives from seven hospitals using BOS were asked to fill in the questionnaire...... by the respondents were mainly regarding the lay-out. Most respondents (85.3%) found it useful to make a computer based support system for other guidelines and 79.4% would also use this.CONCLUSION: BOS is regarded suitable as an instrument for implementing guidelines and respondents find it useful to develop...

  18. Ethnic background and differences in health care use: a national cross-sectional study of native Dutch and immigrant elderly in the Netherlands

    Directory of Open Access Journals (Sweden)

    Foets Marleen

    2009-10-01

    Full Text Available Abstract Background Immigrant elderly are a rapidly growing group in Dutch society; little is known about their health care use. This study assesses whether ethnic disparities in health care use exist and how they can be explained. Applying an established health care access model as explanatory factors, we tested health and socio-economic status, and in view of our research population we added an acculturation variable, elaborated into several sub-domains. Methods Cross-sectional study using data from the "Social Position, Health and Well-being of Elderly Immigrants" survey, conducted in 2003 in the Netherlands. The study population consisted of first generation immigrants aged 55 years and older from the four major immigrant populations in the Netherlands and a native Dutch reference group. The average response rate to the survey was 46% (1503/3284; country of origin: Turkey n = 307, Morocco n = 284, Surinam n = 308, the Netherlands Antilles n = 300, the Netherlands n = 304. Results High ethnic disparities exist in health and health care utilisation. Immigrant elderly show a higher use of GP services and lower use of physical therapy and home care. Both self-reported health status (need factor and language competence (part of acculturation have high explanatory power for all types of health services utilisation; the additional impact of socio-economic status and education is low. Conclusion For all health services, health disparities among all four major immigrant groups in the Netherlands translate into utilisation disparities, aggravated by lack of language competence. The resulting pattern of systematic lower health services utilisation of elderly immigrants is a challenge for health care providers and policy makers.

  19. Readiness for Implementation of Lung Cancer Screening. A National Survey of Veterans Affairs Pulmonologists.

    Science.gov (United States)

    Tukey, Melissa H; Clark, Jack A; Bolton, Rendelle; Kelley, Michael J; Slatore, Christopher G; Au, David H; Wiener, Renda Soylemez

    2016-10-01

    To mitigate the potential harms of screening, professional societies recommend that lung cancer screening be conducted in multidisciplinary programs with the capacity to provide comprehensive care, from screening through pulmonary nodule evaluation to treatment of screen-detected cancers. The degree to which this standard can be met at the national level is unknown. To assess the readiness of clinical facilities in a national healthcare system for implementation of comprehensive lung cancer screening programs, as compared with the ideal described in policy recommendations. This was a cross-sectional, self-administered survey of staff pulmonologists in pulmonary outpatient clinics in Veterans Health Administration facilities. The facility-level response rate was 84.1% (106 of 126 facilities with pulmonary clinics); 88.7% of facilities showed favorable provider perceptions of the evidence for lung cancer screening, and 73.6% of facilities had a favorable provider-perceived local context for screening implementation. All elements of the policy-recommended infrastructure for comprehensive screening programs were present in 36 of 106 facilities (34.0%); the most common deficiencies were the lack of on-site positron emission tomography scanners or radiation oncology services. Overall, 26.5% of Veterans Health Administration facilities were ideally prepared for lung cancer screening implementation (44.1% if the policy recommendations for on-site positron emission tomography scanners and radiation oncology services were waived). Many facilities may be less than ideally positioned for the implementation of comprehensive lung cancer screening programs. To ensure safe, effective screening, hospitals may need to invest resources or coordinate care with facilities that can offer comprehensive care for screening through downstream evaluation and treatment of screen-detected cancers.

  20. Taking the UK's national LLW programme from strategy development to implementation - 59059

    International Nuclear Information System (INIS)

    Rossiter, David; O'Donnell, Rachel

    2012-01-01

    In 2008 UK Nuclear Waste Management Ltd (UKNWM) became the Parent Body Organisation (PBO) at the Low Level Waste Repository (LLWR) in the UK. LLWR is the primary disposal facility for the UK's LLW, supporting a wide range of industries across the nuclear power generation, reprocessing, defence, health care, education, and oil and gas sectors. One of the key tasks following the appointment of the new PBO was to work with the Nuclear Decommissioning Authority (NDA) to develop a national strategy for LLW generated in the UK, predominantly in the NDA estate. The new National Strategy for LLW was required to address the gap between the forecast waste arisings and predicted capacity at LLWR. The National Strategy for LLW Management was published in August 2010 following an 18 month development period. The main focus of the strategy is on three areas: - Application of the waste management hierarchy to extend the life of LLWR and ensure waste is managed in a risk-based, fit-for-purpose manner - Making best use of existing assets such as transport, packaging, treatment and disposal facilities - Opening up new fit-for-purpose waste management routes to divert waste away from LLWR Developing a robust strategy is vital to provide strategic direction to Government, waste producers, regulators, and stakeholders. Once the strategy is developed and approved, the key challenge is then to implement the strategy on a national scale in an efficient and cost-effective manner that delivers maximum value for money to the UK taxpayer. As well as developing the strategy, LLWR has been actively working to develop the enablers to implement the strategy. Since the publication of the strategy in August 2010 LLWR has been re-organised to reflect the shift in focus, from strategy development to implementation and delivery of the strategy. New resources have been brought in with international waste management experience to help integrate delivery with waste producers. This paper covers the

  1. Implementation of environmental compliance for operating radioactive liquid waste systems at the Oak Ridge National Laboratory

    International Nuclear Information System (INIS)

    Hooyman, J.H.; Robinson, S.M.

    1992-01-01

    This paper addresses methods being implemented at the Oak Ridge National Laboratory (ORNL) to continue operating while achieving compliance with new standards for liquid low level waste (LLLW) underground storage tank systems. The Superfund Amendment and Reauthorization Act (SARA) of the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) required that the Department of Energy (DOE) execute a Federal Facility Agreement (FFA) with the Environmental Protection Agency (EPA) within 6 months of listing of the ORNL on the National Priorities List. An FFA for ORNL became effective January 1, 1992 among the EPA, DOE, and the Tennessee Department of Environment and Conservation (TDEC). The agreement ensures that environmental impacts resulting from operations at the Oak Ridge Reservation are investigated and remediated to protect the public health, welfare, and environment

  2. Implementation of a Geographical Information System. GIS, in the Natural National Park, Cliffs of Cali

    International Nuclear Information System (INIS)

    Zapata Pardo, Maria Victoria; Martinez Zarate, Camilo; Gonzalez, Carlos A

    1999-01-01

    The objective of this project was to generate a tool to improve the handling, conservation and administration of the Park National Natural - Cliffs of Cali, belonging to the Special Administrative Unit of the System of Natural National Parks, UAESPNN, of the Ministry of the Environment. With this purpose it was implemented a System of Geographical Information, GIS, like methodological model. The GIS; Cliffs of Cali used a database relational, developed with the software ACCESS t m, compatible with the used GIS Arc/INFO t m and Arc/View t m (for work station). The data space accessed to the database were those of topography, hydrology, areas of life, geology, limit, fronts, to zone with handling ends, precipitation, indigenous occupation and municipalities; it contain related alphanumeric information, administrative, socioeconomic handling and physique among others

  3. Implementation of a near backscattering imaging system on the National Ignition Facility

    International Nuclear Information System (INIS)

    Mackinnon, A.J.; McCarville, T.; Piston, K.; Niemann, C.; Jones, G.; Reinbachs, I.; Costa, R.; Celeste, J.; Holtmeier, G.; Griffith, R.; Kirkwood, R.; MacGowan, B.; Glenzer, S.H.; Latta, M.R.

    2004-01-01

    A near backscattering imaging diagnostic system is being implemented on the first quad of beams on the National Ignition Facility. This diagnostic images diffusing scatter plates, placed around the final focus lenses on the National Ignition Facility target chamber, to quantitatively measure the fraction of light backscattered outside of the focusing cone angle of incident laser beam. A wide-angle imaging system relays an image of light scattered outside the lens onto a gated charge coupled device camera, providing 3 mm resolution over a 2 m field of view. To account for changes of the system throughput due to exposure to target debris the system will be routinely calibrated in situ at 532 and 355 nm using a dedicated pulsed laser source

  4. Implementing preventive chemotherapy through an integrated National Neglected Tropical Disease Control Program in Mali.

    Directory of Open Access Journals (Sweden)

    Massitan Dembélé

    Full Text Available BACKGROUND: Mali is endemic for all five targeted major neglected tropical diseases (NTDs. As one of the five 'fast-track' countries supported with the United States Agency for International Development (USAID funds, Mali started to integrate the activities of existing disease-specific national control programs on these diseases in 2007. The ultimate objectives are to eliminate lymphatic filariasis, onchocerciasis and trachoma as public health problems and to reduce morbidity caused by schistosomiasis and soil-transmitted helminthiasis through regular treatment to eligible populations, and the specific objectives were to achieve 80% program coverage and 100% geographical coverage yearly. The paper reports on the implementation of the integrated mass drug administration and the lessons learned. METHODOLOGY/PRINCIPAL FINDINGS: The integrated control program was led by the Ministry of Health and coordinated by the national NTD Control Program. The drug packages were designed according to the disease endemicity in each district and delivered through various platforms to eligible populations involving the primary health care system. Treatment data were recorded and reported by the community drug distributors. After a pilot implementation of integrated drug delivery in three regions in 2007, the treatment for all five targeted NTDs was steadily scaled up to 100% geographical coverage by 2009, and program coverage has since been maintained at a high level: over 85% for lymphatic filariasis, over 90% for onchocerciasis and soil-transmitted helminthiasis, around 90% in school-age children for schistosomiasis, and 76-97% for trachoma. Around 10 million people have received one or more drug packages each year since 2009. No severe cases of adverse effects were reported. CONCLUSIONS/SIGNIFICANCE: Mali has scaled up the drug treatment to national coverage through integrated drug delivery involving the primary health care system. The successes and lessons

  5. National technology needs assessment for the preparation and implementation of climate change action plans

    Energy Technology Data Exchange (ETDEWEB)

    Berkel, C.W.M. van; Blonk, T.J.; Westra, C.A.

    1996-12-31

    In the United National Framework Convention on Climate Change (FCCC) it is recognised that developed countries have a responsibility in assisting developing countries and countries in economic transition in building a national capacity for the development, acquisition and transfer of Climate-related Technologies (CTs). Such assistance is most likely to be successful once it is tailored to the results of a sound assessment of the country`s development needs and once the results of this assessment have been endorsed by the most important stakeholders in the country. Recent insight in the opportunities and constraints for National (technology) Needs Assessments (NNAs) as planning tool for both capacity building and technology transfer regarding Environmentally Sound Technologies (ESTs) is applied here to propose a participatory Climate Change Action Planning (CCAP) process. This participatory planning process is thought to serve the dual objective of defining a national Climate Change Action Plan (CCAP) while at the same time contributing to the creation of a broad supportive basis for its acceptance and implementation among stakeholders in the developing country.

  6. External costs related to power production technologies. ExternE national implementation for Denmark

    International Nuclear Information System (INIS)

    Schleisner, L.; Sieverts Nielsen, P.

    1997-12-01

    The objective of the ExternE National Implementation project has been to establish a comprehensive and comparable set of data on externalities of power generation for all EU member states and Norway. The tasks include the application of the ExternE methodology to the most important fuel cycles for each country as well as to update the already existing results, to aggregate these site- and technology-specific results to more general figures. The current report covers the detailed information concerning the ExternE methodology. Importance is attached to the computer system used in the project and the assessment of air pollution effects on health, materials and ecological effects. Also the assessment of global warming damages are described. Finally the report covers the detailed information concerning the national implementation for Denmark for an offshore wind farm and a wind farm on land, a decentralised CHP plant based on natural gas and a decentralised CHP plant base on biogas. (au) EU-JOULE 3. 79 tabs., 11 ills., 201 refs

  7. External costs related to power production technologies. ExternE national implementation for Denmark

    Energy Technology Data Exchange (ETDEWEB)

    Schleisner, L; Sieverts Nielsen, P [eds.

    1997-12-01

    The objective of the ExternE National Implementation project has been to establish a comprehensive and comparable set of data on externalities of power generation for all EU member states and Norway. The tasks include the application of the ExternE methodology to the most important fuel cycles for each country as well as to update the already existing results, to aggregate these site- and technology-specific results to more general figures. The current report covers the detailed information concerning the ExternE methodology. Importance is attached to the computer system used in the project and the assessment of air pollution effects on health, materials and ecological effects. Also the assessment of global warming damages are described. Finally the report covers the detailed information concerning the national implementation for Denmark for an offshore wind farm and a wind farm on land, a decentralised CHP plant based on natural gas and a decentralised CHP plant base on biogas. (au) EU-JOULE 3. 79 tabs., 11 ills., 201 refs.

  8. Implementing the National Council of Teachers of Mathematics Standards: A slow process

    Directory of Open Access Journals (Sweden)

    Joseph M. Furner

    2004-10-01

    Full Text Available The purpose of this study was to look at inservice teachers’ pedagogical beliefs about the National Council of Teachers of Mathematics Standards (1989 & 2000.  The Standards’ Belief Instrument (Zollman and Mason, 1992 was administered on teachers.  An ANOVA was used to look for a significant difference between teachers with five years or less experience of teaching mathematics, and those with more than five years teaching experience. One expectation was  that teachers who are recent graduates of teacher education programmes may have more training  on the NCTM Standards. Although there were no statistically significant differences between the two groups, this study did support the expectation. Current training with in-service teachers shows that many of the teachers are familiar with neither the National Council of Teachers of Mathematics nor their Standards.  It seems then from this study that the implementation process of the NCTM Standards, and  perhaps any standards or best practices and new curriculum implementation, is very sluggish.

  9. [Building and implementation of management system in laboratories of the National Institute of Hygiene].

    Science.gov (United States)

    Rozbicka, Beata; Brulińska-Ostrowska, Elzbieta

    2008-01-01

    The rules of good laboratory practice have always been observed in the laboratories of National Institute of Hygiene (NIH) and the reliability of the results has been carefully cared after when performing tests for clients. In 2003 the laboratories performing analyses related to food safety were designated as the national reference laboratories. This, added to the necessity of compliance with work standards and requirements of EU legislation and to the need of confirmation of competence by an independent organisation, led to a decision to seek accreditation of Polish Centre of Accreditation (PCA). The following stages of building and implementation of management system were presented: training, modifications of Institute's organisational structure, elaboration of management system's documentation, renovation and refurbishment of laboratory facilities, implementation of measuring and test equipment's supervision, internal audits and management review. The importance of earlier experiences and achievements with regard to validation of analytical methods and guarding of the quality of the results through organisation and participation in proficiency tests was highlighted. Current status of accreditation of testing procedures used in NIH laboratories that perform analyses in the field of chemistry, microbiology, radiobiology and medical diagnostic tests was presented.

  10. Implementation of National Science Education Standards in suburban elementary schools: Teachers' perceptions and classroom practices

    Science.gov (United States)

    Khan, Rubina Samer

    2005-07-01

    This was an interpretive qualitative study that focused on how three elementary school science teachers from three different public schools perceived and implemented the National Science Education Standards based on the Reformed Teaching Observation Protocol and individual interviews with the teachers. This study provided an understanding of the standards movement and teacher change in the process. Science teachers who were experienced with the National Science Education Standards were selected as the subjects of the study. Grounded in the theory of teacher change, this study's phenomenological premise was that the extent to which a new reform has an effect on students' learning and achievement on standardized tests depends on the content a teacher teaches as well as the style of teaching. It was therefore necessary to explore how teachers understand and implement the standards in the classrooms. The surveys, interviews and observations provided rich data from teachers' intentions, reflections and actions on the lessons that were observed while also providing the broader contextual framework for the understanding of the teachers' perspectives.

  11. Dutch School in Geneva

    CERN Multimedia

    2011-01-01

    The Dutch School in Geneva organizes Dutch education for children in the primary and secondary school. For the school year 2011-2012 the Dutch School in Geneva is looking for qualified part time teachers Dutch for the primary and secondary school. If you are interested, please send your application and curriculum vitae in Dutch by email to the NTC coordinator, Mrs. Anne Saeys (anne.saeys@free.fr). More info : www.ntcgeneve.info De vereniging Nederlandse Taal en Cultuur De Taalfontein, kortweg NTC Genève, is een oudervereniging, die tot doel heeft de Nederlandse taal en de Nederlandse en Vlaamse cultuur in de regio Genève te stimuleren. Dit geschiedt d.m.v. het organiseren van Nederlandse les voor leerlingen zowel in het basisonderwijs als het voortgezet onderwijs. Voor het volgende schooljaar zoekt NTC parttime docenten (M/V) vanaf 2 uur per week, zowel voor het Primair Onderwijs als voor het Voortgezet Onderwijs, met name voor de IB-opleiding. Voor het Primair Onderwijs dienen ge&...

  12. Using an ontology as a model for the implementation of the National Cybersecurity Policy Framework for South Africa

    CSIR Research Space (South Africa)

    Jansen van Vuuren, JC

    2014-03-01

    Full Text Available National Cybersecurity Policy Framework that is easy to understand and implement. In this paper, the authors motivate that an ontology can assist in defining a model that describes the relationships between different stakeholders and cybersecurity...

  13. DutchParl: A corpus of parliamentary documents in Dutch

    NARCIS (Netherlands)

    Marx, M.; Schuth, A.

    2010-01-01

    A corpus called DutchParl is created which aims to contain all digitally available parliamentary documents written in the Dutch language. The first version of DutchParl contains documents from the parliaments of The Netherlands, Flanders and Belgium. The corpus is divided along three dimensions: per

  14. A National Implementation Project to Prevent Catheter-Associated Urinary Tract Infection in Nursing Home Residents.

    Science.gov (United States)

    Mody, Lona; Greene, M Todd; Meddings, Jennifer; Krein, Sarah L; McNamara, Sara E; Trautner, Barbara W; Ratz, David; Stone, Nimalie D; Min, Lillian; Schweon, Steven J; Rolle, Andrew J; Olmsted, Russell N; Burwen, Dale R; Battles, James; Edson, Barbara; Saint, Sanjay

    2017-08-01

    Catheter-associated urinary tract infection (UTI) in nursing home residents is a common cause of sepsis, hospital admission, and antimicrobial use leading to colonization with multidrug-resistant organisms. To develop, implement, and evaluate an intervention to reduce catheter-associated UTI. A large-scale prospective implementation project was conducted in community-based nursing homes participating in the Agency for Healthcare Research and Quality Safety Program for Long-Term Care. Nursing homes across 48 states, Washington DC, and Puerto Rico participated. Implementation of the project was conducted between March 1, 2014, and August 31, 2016. The project was implemented over 12-month cohorts and included a technical bundle: catheter removal, aseptic insertion, using regular assessments, training for catheter care, and incontinence care planning, as well as a socioadaptive bundle emphasizing leadership, resident and family engagement, and effective communication. Urinary catheter use and catheter-associated UTI rates using National Healthcare Safety Network definitions were collected. Facility-level urine culture order rates were also obtained. Random-effects negative binomial regression models were used to examine changes in catheter-associated UTI, catheter utilization, and urine cultures and adjusted for covariates including ownership, bed size, provision of subacute care, 5-star rating, presence of an infection control committee, and an infection preventionist. In 4 cohorts over 30 months, 568 community-based nursing homes were recruited; 404 met inclusion criteria for analysis. The unadjusted catheter-associated UTI rates decreased from 6.78 to 2.63 infections per 1000 catheter-days. With use of the regression model and adjustment for facility characteristics, the rates decreased from 6.42 to 3.33 (incidence rate ratio [IRR], 0.46; 95% CI, 0.36-0.58; P project. Catheter utilization remained unchanged (4.50 at baseline, 4.45 at conclusion of project; IRR, 0

  15. Implementation of a metrology national network for radionuclides used in nuclear medicine

    International Nuclear Information System (INIS)

    Santos, J.A. dos; Lopes, R.T.; Iwahara, A.; Tauhata, L.; Nicoli, I.G.; Dias, C.M.

    2003-01-01

    The Brazilian Laboratory for Metrology of Ionizing Radiation (LNMRI), of the Radioprotection and Dosimetry Institute, owned by the National Commission of Nuclear Energy (IRD/CNEN-RJ) has conducting since 1998, a comparison program for measurements of radiopharmaceuticals activities applied to patients at Nuclear Medicine sector aiming to the assessment the quality of those measurements. In the Rio de Janeiro state this program is successfully performed existing however the necessity to implement such program all over the country. This problem is being solved through the implementation of a reference laboratories network at several points in the brazilian territory. For the establishment and good working of the network the following factors must be observed: the radionuclide calibrators at the reference laboratories must be connected to the LNMRI; the operators must be trained by the staff or the LNMRI, and the quality guarantee must be assured through a comparison program. Presently, the network point placed in Brasilia is running and covering all the center-west region. The results obtained at this region show that the implementation of the metrology network is viable, important and achievable

  16. National implementation and regional cooperation from the perspective of Ethiopia: points for discussion

    International Nuclear Information System (INIS)

    Mekuriaw, A.

    2002-01-01

    The Comprehensive Nuclear-Test-Ban Treaty (CTBT) provides for a comprehensive global verification regime that includes International Monitoring System (IMS). Ethiopia is expected to contribute to the system through a seismic station to be upgraded and a radionuclide station to be established yet. The capacity built at and the experience gained by the geographical observatory of the Addis Ababa University seismic monitoring makes it the leading institution on implementing activities related to verification of the treaty in Ethiopia. Assessment of the current situation indicates that the implementation is going on at a relatively slow rate. There is a general understanding that the country's contribution to and the benefits to be gained from the CTBT implementation related activities would be enhanced if it works in close collaborartion with other East and Southern African countries. However, this could be realised if and only if higher priorities are accorded to the establishment and strengthening of national monitoring and data processing capabilities and the cooperation program is provided with adequate funding. (author)

  17. Understanding health care providers' reluctance to adopt a national electronic patient record: an empirical and legal analysis

    NARCIS (Netherlands)

    Zwaanswijk, M.; Ploem, M. C.; Wiesman, F. J.; Verheij, R. A.; Friele, R. D.; Gevers, J. K. M.

    2013-01-01

    Several countries are implementing a national electronic patient record (n-EPR). Despite the assumed positive effects of n-EPRs on the efficiency, continuity, safety and quality of care, their overall adoption remains low and meets resistance from involved parties. The implementation of the Dutch

  18. Sector activities and lessons learned around initial implementation of the United States national physical activity plan.

    Science.gov (United States)

    Evenson, Kelly R; Satinsky, Sara B

    2014-08-01

    National plans are increasingly common but infrequently evaluated. The 2010 United States National Physical Activity Plan (NPAP) provided strategies to increase population levels of physical activity. This paper describes (i) the initial accomplishments of the NPAP sector teams, and (ii) results from a process evaluation to determine how the sectors operated, their cross-sector collaboration, challenges encountered, and positive experiences. During 2011, a quarterly reporting system was developed to capture sector-level activities. A year-end interview derived more detailed information. Interviews with 12 sector leads were recorded, transcribed verbatim, and analyzed for common themes. The 6 sectors worked on goals from the implementation plan that focused broadly on education, promotion, intervention, policy, collaboration, and evaluation. Through year-end interviews, themes were generated around operations, goal setting, and cross-sector collaboration. Challenges to the NPAP work included lack of funding and time, the need for marketing and promotion, and organizational support. Positive experiences included collaboration, efficiency of work, enhanced community dynamic, and accomplishments toward NPAP goals. These initial results on the NPAP sector teams can be used as a baseline assessment for future monitoring. The lessons learned may be useful to other practitioners developing evaluations around state- or national-level plans.

  19. An overview on the national strategy to implement a deep geological repository in Romania

    International Nuclear Information System (INIS)

    Negut, G.; Ghitescu, P.; Dupleac, D.; Prisecaru, I.

    2010-01-01

    Since 1996 in Romania was started operation Candu 700 MW Unit 1 Cernavoda Nuclear Power Station and in 2007 begun operation of the Candu 700 MW Unit 2. The energy produced by nuclear units is accompanied by radioactive waste production. According with European Union requirements in Romania was created National Agency for Radioactive Waste (ANDRAD) in 2003. ANDRAD business is radioactive waste management. ANDRAD, together with the stakeholders, worked the law of great radioactive waste generators contribution for radioactive waste management, which was approved by Governmental Ordinance in September 2007. ANDRAD is responsible manager of this fund. ANDRAD is responsible, also, with the National Strategy for radioactive waste management. Romania's National Strategy for Energy approved in 2007 by Government Ordinance says that a deep geological repository for spent fuel (SF) and High Level Waste (HLW) is to be put in operation around 2055. IAEA supported ANDRAD in a Technical Cooperation Project for a concept of a geological repository of radioactive waste. A strategy to implement o geological repository in Romania was drafted. There are problems with potential rocks and sites to host a geological repository. There are problems for funding this project and also sensitive and serious problems connected with social and political issues. Paper presents this strategy and all the problems arisen by implantation of this strategy. (authors)

  20. Social Integration and Religious Identity Expression among Dutch Muslims: The Role of Minority and Majority Group Contact

    Science.gov (United States)

    Maliepaard, Mieke; Phalet, Karen

    2012-01-01

    Against the background of contrasting religious versus secular norms in immigrant communities and in Dutch society, this study examines how religious identity expression is related to the social integration of Dutch Muslims within (a) Turkish or Moroccan minority groups and (b) Dutch majority groups. Using nationally representative survey data (N…

  1. National strategy for suicide prevention in Japan: impact of a national fund on progress of developing systems for suicide prevention and implementing initiatives among local authorities.

    Science.gov (United States)

    Nakanishi, Miharu; Yamauchi, Takashi; Takeshima, Tadashi

    2015-01-01

    In Japan, the Cabinet Office released the 'General Principles of Suicide Prevention Policy' in 2007 and suggested nine initiatives. In 2009, a national fund was launched to help prefectures (the administrative divisions of Japan) and local authorities implement five categories of suicide-prevention programs. This paper examines the impact of the national fund on the establishment of the systems for suicide prevention and the implementation of these initiatives among local authorities. The present study included 1385 local authorities (79.5%) from all 47 prefectures that responded to the cross-sectional questionnaire survey. Improved suicide-prevention systems and the implementation of nine initiatives in April 2013 were observed among 265 local authorities (19.1%) that implemented 'Training of community service providers' and 'Public awareness campaigns'; 178 local authorities (12.9%) that implemented 'Face-to-face counseling', 'Training of community service providers' and 'Public awareness campaigns'; and 324 local authorities (23.4%) that implemented 'Trauma-informed policies and practices'. There was no significant difference in suicide-prevention systems and the implementation of nine initiatives between 203 local authorities (14.7%) that implemented only 'Public awareness campaigns' and 231 local authorities (16.7%) that did not implement any suicide-prevention programs. The results of our study suggest that the national fund promoted the establishment of community systems for suicide prevention and helped implement initiatives among local authorities. The national suicide-prevention strategy in Japan should explore a standard package of programs to guide community suicide-prevention efforts with a sustained workforce among local authorities. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.

  2. Incidence rates and management of urinary tract infections among children in Dutch general practice: results from a nation-wide registration study

    Directory of Open Access Journals (Sweden)

    Schellevis François G

    2006-04-01

    Full Text Available Abstract Background We aimed to investigate incidence rates of urinary tract infections in Dutch general practice and their association with gender, season and urbanisation level, and to analyse prescription and referral in case of urinary tract infections. Method During one calendar year, 195 general practitioners in 104 practices in the Netherlands registered all their patient contacts. This study was performed by the Netherlands Institute for Health Services Research (NIVEL in 2001. Of 82,053 children aged 0 to 18 years, the following variables were collected: number of episodes per patient, number of contacts per episode, month of the year in which the diagnosis of urinary tract infection was made, age, gender, urbanisation level, drug prescription and referral. Results The overall incidence rate was 19 episodes per 1000 person years. The incidence rate in girls was 8 times as high as in boys. The incidence rate in smaller cities and rural areas was 2 times as high as in the three largest cities. Throughout the year, incidence rates varied with a decrease in summertime for children at the age of 0 to 12 years. Of the prescriptions, 66% were in accordance with current guidelines, but only 18% of the children who had an indication were actually referred. Conclusion This study shows that incidence rates of urinary tract infections are not only related to gender and season, but also to urbanisation. General practitioners in the Netherlands frequently do not follow the clinical guidelines for urinary tract infections, especially with respect to referral.

  3. Incidence rates and management of urinary tract infections among children in Dutch general practice: results from a nation-wide registration study

    Science.gov (United States)

    Kwok, Wing-Yee; de Kwaadsteniet, Marjolein CE; Harmsen, Mirjam; van Suijlekom-Smit, Lisette WA; Schellevis, François G; van der Wouden, Johannes C

    2006-01-01

    Background We aimed to investigate incidence rates of urinary tract infections in Dutch general practice and their association with gender, season and urbanisation level, and to analyse prescription and referral in case of urinary tract infections. Method During one calendar year, 195 general practitioners in 104 practices in the Netherlands registered all their patient contacts. This study was performed by the Netherlands Institute for Health Services Research (NIVEL) in 2001. Of 82,053 children aged 0 to 18 years, the following variables were collected: number of episodes per patient, number of contacts per episode, month of the year in which the diagnosis of urinary tract infection was made, age, gender, urbanisation level, drug prescription and referral. Results The overall incidence rate was 19 episodes per 1000 person years. The incidence rate in girls was 8 times as high as in boys. The incidence rate in smaller cities and rural areas was 2 times as high as in the three largest cities. Throughout the year, incidence rates varied with a decrease in summertime for children at the age of 0 to 12 years. Of the prescriptions, 66% were in accordance with current guidelines, but only 18% of the children who had an indication were actually referred. Conclusion This study shows that incidence rates of urinary tract infections are not only related to gender and season, but also to urbanisation. General practitioners in the Netherlands frequently do not follow the clinical guidelines for urinary tract infections, especially with respect to referral. PMID:16584577

  4. Implementation of computerized physician order entry in National Guard Hospitals: assessment of critical success factors.

    Science.gov (United States)

    Altuwaijri, Majid M; Bahanshal, Abdullah; Almehaid, Mona

    2011-09-01

    The purpose of this study is to describe the needs, process and experience of implementing a computerized physician order entry (CPOE) system in a leading healthcare organization in Saudi Arabia. The National Guard Health Affairs (NGHA) deployed the CPOE in a pilot department, which was the intensive care unit (ICU) in order to assess its benefits and risks and to test the system. After the CPOE was implemented in the ICU area, a survey was sent to the ICU clinicians to assess their perception on the importance of 32 critical success factors (CSFs) that was acquired from the literature. The project team also had several meetings to gather lessons learned from the pilot project in order to utilize them for the expansion of the project to other NGHA clinics and hospitals. The results of the survey indicated that the selected CSFs, even though they were developed with regard to international settings, are very much applicable for the pilot area. The top three CSFs rated by the survey respondents were: The "before go-live training", the adequate clinical resources during implementation, and the ordering time. After the assessment of the survey and the lessons learned from the pilot project, NGHA decided that the potential benefits of the CPOE are expected to be greater the risks expected. The project was then expanded to cover all NGHA clinics and hospitals in a phased approach. Currently, the project is in its final stages and expected to be completed by the end of 2011. The role of CPOE systems is very important in hospitals in order to reduce medication errors and to improve the quality of care. In spite of their great benefits, many studies suggest that a high percentage of these projects fail. In order to increase the chances of success and due to the fact that CPOE is a clinical system, NGHA implemented the system first in a pilot area in order to test the system without putting patients at risk and to learn from mistakes before expanding the system to other

  5. Implementation of computerized physician order entry in National Guard hospitals: Assessment of critical success factors

    Directory of Open Access Journals (Sweden)

    Majid M Altuwaijri

    2011-01-01

    Full Text Available Objective: The purpose of this study is to describe the needs, process and experience of implementing a computerized physician order entry (CPOE system in a leading healthcare organization in Saudi Arabia. Materials and Methods: The National Guard Health Affairs (NGHA deployed the CPOE in a pilot department, which was the intensive care unit (ICU in order to assess its benefits and risks and to test the system. After the CPOE was implemented in the ICU area, a survey was sent to the ICU clinicians to assess their perception on the importance of 32 critical success factors (CSFs that was acquired from the literature. The project team also had several meetings to gather lessons learned from the pilot project in order to utilize them for the expansion of the project to other NGHA clinics and hospitals. Results: The results of the survey indicated that the selected CSFs, even though they were developed with regard to international settings, are very much applicable for the pilot area. The top three CSFs rated by the survey respondents were: The "before go-live" training, the adequate clinical resources during implementation, and the ordering time. After the assessment of the survey and the lessons learned from the pilot project, NGHA decided that the potential benefits of the CPOE are expected to be greater the risks expected. The project was then expanded to cover all NGHA clinics and hospitals in a phased approach. Currently, the project is in its final stages and expected to be completed by the end of 2011. Conclusion: The role of CPOE systems is very important in hospitals in order to reduce medication errors and to improve the quality of care. In spite of their great benefits, many studies suggest that a high percentage of these projects fail. In order to increase the chances of success and due to the fact that CPOE is a clinical system, NGHA implemented the system first in a pilot area in order to test the system without putting patients at

  6. The implementation of research recommendations at the Walter Sisulu National Botanical Garden

    Directory of Open Access Journals (Sweden)

    Martie Mearns

    2009-09-01

    of the ideals of environmental conservation after their visit to the garden. Secondly, the study determined the spatial preferences of visitors to the garden which was thirdly correlated to the time that they spent at each area. A number of recommendations were made and a comparative study followed twelve years after the initial study in which the implementation of the resultant findings was determined through observation and a comparison of information pamphlets and garden layout maps. It was found that large-scale changes took place in line with the recommendations made after the initial study. These included the demolition of unsuccessful theme gardens and their replacement by topical theme gardens such as water-wise gardens and a garden that attracts butterflies and birds. The educational function of the Walter Sisulu National Botanical Garden was greatly improved by adding more information plaques throughout the garden, a new interpretative centre and many additional information pamphlets that had been absent during the initial study. Major structural changes were made, such as the building of an amphitheatre which reduced the negative impact of noise and disturbance surrounding the nests of the Verreaux’s eagles that breed successfully in the garden. The changes undertaken at the garden show innovative improvements in line with the con servation principles outlined by the South African National Biodiversity Institute (SANBI. The evidence of the implementation of research recommendations from the initial study could play a direct role in improving the visitor experience, which would facilitate the economic viability of the Walter Sisulu National Botanical Garden in its endeavours to reach its conservation goals. Further research is suggested to continuously determine the areas of preference of visitors in the evolving landscape of the garden to ensure renewed interest of visitors to the garden. If botanical gardens want to succeed in their goal to increase

  7. Connecting Marketing and Implementation Research and Library Program Development: A Case Study of the Implementation of [U.S.] National Guidelines and Standards.

    Science.gov (United States)

    Haycock, Ken; Cavill, Pat

    This case study examined: (1) what market research is required for planning for the implementation of "Information Power: Building Partnerships for Learning," the 1998 national guidelines for effective school library media programs; (2) what issues need to be addressed and what target audiences are required to effect change, as well as…

  8. National satellite-based humid tropical forest change assessment in Peru in support of REDD+ implementation

    Science.gov (United States)

    Potapov, P. V.; Dempewolf, J.; Talero, Y.; Hansen, M. C.; Stehman, S. V.; Vargas, C.; Rojas, E. J.; Castillo, D.; Mendoza, E.; Calderón, A.; Giudice, R.; Malaga, N.; Zutta, B. R.

    2014-12-01

    Transparent, consistent, and accurate national forest monitoring is required for successful implementation of reducing emissions from deforestation and forest degradation (REDD+) programs. Collecting baseline information on forest extent and rates of forest loss is a first step for national forest monitoring in support of REDD+. Peru, with the second largest extent of Amazon basin rainforest, has made significant progress in advancing its forest monitoring capabilities. We present a national-scale humid tropical forest cover loss map derived by the Ministry of Environment REDD+ team in Peru. The map quantifies forest loss from 2000 to 2011 within the Peruvian portion of the Amazon basin using a rapid, semi-automated approach. The available archive of Landsat imagery (11 654 scenes) was processed and employed for change detection to obtain annual gross forest cover loss maps. A stratified sampling design and a combination of Landsat (30 m) and RapidEye (5 m) imagery as reference data were used to estimate the primary forest cover area, total gross forest cover loss area, proportion of primary forest clearing, and to validate the Landsat-based map. Sample-based estimates showed that 92.63% (SE = 2.16%) of the humid tropical forest biome area within the country was covered by primary forest in the year 2000. Total gross forest cover loss from 2000 to 2011 equaled 2.44% (SE = 0.16%) of the humid tropical forest biome area. Forest loss comprised 1.32% (SE = 0.37%) of primary forest area and 9.08% (SE = 4.04%) of secondary forest area. Validation confirmed a high accuracy of the Landsat-based forest cover loss map, with a producer’s accuracy of 75.4% and user’s accuracy of 92.2%. The majority of forest loss was due to clearing (92%) with the rest attributed to natural processes (flooding, fires, and windstorms). The implemented Landsat data processing and classification system may be used for operational annual forest cover loss updates at the national level for REDD

  9. National satellite-based humid tropical forest change assessment in Peru in support of REDD+ implementation

    International Nuclear Information System (INIS)

    Potapov, P V; Dempewolf, J; Talero, Y; Hansen, M C; Stehman, S V; Vargas, C; Rojas, E J; Calderón, A; Giudice, R; Malaga, N; Zutta, B R; Castillo, D; Mendoza, E

    2014-01-01

    Transparent, consistent, and accurate national forest monitoring is required for successful implementation of reducing emissions from deforestation and forest degradation (REDD+) programs. Collecting baseline information on forest extent and rates of forest loss is a first step for national forest monitoring in support of REDD+. Peru, with the second largest extent of Amazon basin rainforest, has made significant progress in advancing its forest monitoring capabilities. We present a national-scale humid tropical forest cover loss map derived by the Ministry of Environment REDD+ team in Peru. The map quantifies forest loss from 2000 to 2011 within the Peruvian portion of the Amazon basin using a rapid, semi-automated approach. The available archive of Landsat imagery (11 654 scenes) was processed and employed for change detection to obtain annual gross forest cover loss maps. A stratified sampling design and a combination of Landsat (30 m) and RapidEye (5 m) imagery as reference data were used to estimate the primary forest cover area, total gross forest cover loss area, proportion of primary forest clearing, and to validate the Landsat-based map. Sample-based estimates showed that 92.63% (SE = 2.16%) of the humid tropical forest biome area within the country was covered by primary forest in the year 2000. Total gross forest cover loss from 2000 to 2011 equaled 2.44% (SE = 0.16%) of the humid tropical forest biome area. Forest loss comprised 1.32% (SE = 0.37%) of primary forest area and 9.08% (SE = 4.04%) of secondary forest area. Validation confirmed a high accuracy of the Landsat-based forest cover loss map, with a producer’s accuracy of 75.4% and user’s accuracy of 92.2%. The majority of forest loss was due to clearing (92%) with the rest attributed to natural processes (flooding, fires, and windstorms). The implemented Landsat data processing and classification system may be used for operational annual forest cover loss updates at the national level

  10. Implementing national nuclear safety plan at the preliminary stage of nuclear power project development

    International Nuclear Information System (INIS)

    Xue Yabin; Cui Shaozhang; Pan Fengguo; Zhang Lizhen; Shi Yonggang

    2014-01-01

    This study discusses the importance of nuclear power project design and engineering methods at the preliminary stage of its development on nuclear power plant's operational safety from the professional view. Specifically, we share our understanding of national nuclear safety plan's requirement on new reactor accident probability, technology, site selection, as well as building and improving nuclear safety culture and strengthening public participation, with a focus on plan's implications on preliminary stage of nuclear power project development. Last, we introduce China Huaneng Group's work on nuclear power project preliminary development and the experience accumulated during the process. By analyzing the siting philosophy of nuclear power plant and the necessity of building nuclear safety culture at the preliminary stage of nuclear power project development, this study explicates how to fully implement the nuclear safety plan's requirements at the preliminary stage of nuclear power project development. (authors)

  11. Implementation of the knowledge economy paradigm in the strategy of national economy development

    Directory of Open Access Journals (Sweden)

    Dmytro Lukianenko

    2013-08-01

    Full Text Available This paper studies the knowledge economy paradigm and the factors of its influence on the development of national economies in the context of transformation of the global competitive environment. It has been methodologically identified the basic categories and concepts concerning the determination of key factors and parameters of modern economic systems. It has been proved through the example of South Korea that implementation of the knowledge economy paradigm in long-term strategies initiated and supported by the state provides new opportunities of socio-economic progress. The basic problems of innovation-driven development of Ukraine’s economy through an assessment of its readiness to transition to the knowledge economy, compared with South Korea. The latter’s experience, despite the objective limitations, is regarded as an example of strategic success in formation of a creative innovation system.

  12. Revisiting the Dutch hypothesis

    NARCIS (Netherlands)

    Postma, Dirkje S.; Weiss, Scott T.; van den Berge, Maarten; Kerstjens, Huib A. M.; Koppelman, Gerard H.

    The Dutch hypothesis was first articulated in 1961, when many novel and advanced scientific techniques were not available, such as genomics techniques for pinpointing genes, gene expression, lipid and protein profiles, and the microbiome. In addition, computed tomographic scans and advanced analysis

  13. Dutch Building Decree

    NARCIS (Netherlands)

    Scholten, N.P.M.

    2000-01-01

    On the 1 October 1992 a change in the Dutch building legislation took effect: the revised Housing Act, the Building Decree and the technical documents related to this legislation came into force. This publication contains an English translation of the Building Decree. In order to give an idea of the

  14. Survival of Dutch heathlands

    NARCIS (Netherlands)

    Diemont, W.H.

    1996-01-01

    OBJECTIVES OF THE THESIS

    Heathlands in The Netherlands are vanishing due to the invasion of trees. The transition from heathland to woodland in Dutch heathlands may either proceed directly or is preceded by the development of an intermediate grass heath. These changes are due to natural

  15. Dutch surgery in Japan

    NARCIS (Netherlands)

    van Gulik, Thomas M.; Nimura, Yuji

    2005-01-01

    An isolation policy was adopted in feudal Japan from 1639 to 1853 owing to the fear of foreign influence. During those 200 years of isolation, all foreigners were withheld from the country with the exception of the Dutch, who were permitted to establish a trading post on a small island in the Bay of

  16. Dutch Risk Assessment tools

    NARCIS (Netherlands)

    Venema, A.

    2015-01-01

    The ‘Risico- Inventarisatie- en Evaluatie-instrumenten’ is the name for the Dutch risk assessment (RA) tools. A RA tool can be used to perform a risk assessment including an evaluation of the identified risks. These tools were among the first online risk assessment tools developed in Europe. The

  17. 'A Dutch Miracle'

    NARCIS (Netherlands)

    Visser, Jelle; Hemerijck, Anton

    1997-01-01

    The Dutch polder model recently dubbed a 'success story' by Bill Clinton and Jacques Delors - plays a prominent role in current discussions about possibilities for a new 'capitalism with a social face', and appeals to experts all over the world. Just ten years ago the Swedish sociologist Goran

  18. The Dutch Grey Market

    NARCIS (Netherlands)

    Renneboog, L.D.R.; Spaenjers, C.

    2008-01-01

    When-issued trading concerns transactions in securities that have not yet been issued. This type of trade often takes place in a so-called ‘grey market’, in which all contracts are conditional on the issuance of the security. In this paper, we investigate the Dutch grey market for when-issued shares

  19. The Dutch Grey Market

    NARCIS (Netherlands)

    Renneboog, L.D.R.; Spaenjers, C.

    2008-01-01

    When-issued trading concerns transactions in securities that have not yet been issued. This type of trade often takes place in a so-called 'grey market', in which all contracts are conditional on the issuance of the security. In this paper, we investigate the Dutch grey market for when-issued shares

  20. Dutch Ships and Sailors

    NARCIS (Netherlands)

    de Boer, Victor; Hoekstra, F.G.; Leinenga, Jurjen; van Rossum, Matthias

    2014-01-01

    Dutch Ships and Sailors provides an infrastructure for maritime historical datasets, linking correlating data through semantic web technology. It brings together datasets related to recruitment and shipping in the East-India trade (mainly 18th century) and in the shipping of the northern provinces

  1. Dutch medical oath

    NARCIS (Netherlands)

    Westerveld, H. E.; Briet, J. W.; Houwaart, E. S.; Legemaate, J.; Meerman, Th J. A. M.; Breetvelt, E. J.; van der Wall, E.

    2005-01-01

    In the first part of this article, the booklet Dutch Medical Oath is reviewed. The content of the new oath is discussed as are the reasons for revision of the previous version of the oath. This is followed by a short history of the oath. In the second part of the article the oath is compared with

  2. Dutch house price fundamentals

    NARCIS (Netherlands)

    Haffner, M.E.A.; de Vries, P.

    2009-01-01

    This paper discusses house price developments in the Netherlands, specifically focussing on the question whether current house prices in the Dutch owner-occupied market are likely to decrease. We analyse three aspects of the question based on a literature review: (1) whether there is a house price

  3. From national air carriers to low-cost companies: Effects of successful marketing strategy implementation

    Directory of Open Access Journals (Sweden)

    Aćimović Slobodan

    2009-01-01

    Full Text Available Huge changes in marketing strategies and, more generally - in business philosophies are not so often. During the last 20 years global and/or national companies have already defined their general approaches of marketing instruments implementation. Therefore, when a contemporary company changes something in its marketing approach, it usually only refers to 'subtle adjustment' of the already determined strategy. Another reason for changes in a particular segment of marketing is a crisis of some kind that forces firms to implement innovations, especially regarding the elements such as costs - price - or service quality. A global enterprise segment consisting of low tariff airline companies is here identified as the one that has dramatically changed its marketing approach within the last 20 years, which continually resulted in its improved market position and business results. Changes in marketing strategies of low-cost companies have truly been revolutionary and are completely the consequence of recognizing the real needs of clients who use services of air transport. The success of low-cost airline companies is forcing the traditional, classic, air carriers to adapt their marketing instruments to this new model of business management. This paper also identifies one very significant assumption of the low-cost carriers phenomenon and their marketing approach - the liberalization of the global air transport market.

  4. Hurdles in clinical implementation of academic advanced therapy medicinal products: A national evaluation.

    Science.gov (United States)

    de Wilde, Sofieke; Veltrop-Duits, Louise; Hoozemans-Strik, Merel; Ras, Thirza; Blom-Veenman, Janine; Guchelaar, Henk-Jan; Zandvliet, Maarten; Meij, Pauline

    2016-06-01

    Since the implementation of the European Union (EU) regulation for advanced therapy medicinal products (ATMPs) in 2009, only six ATMPs achieved marketing authorization approval in the EU. Recognizing the major developments in the ATMP field, starting mostly in academic institutions, we investigated which hurdles were experienced in the whole pathway of ATMP development towards clinical care. Quality interviews were executed with different stakeholders in The Netherlands involved in the ATMP development field, e.g. academic research groups, national authorities and patient organizations. Based on the hurdles mentioned in the interviews, questionnaires were subsequently sent to the academic principal investigators (PIs) and ATMP good manufacturing practice (GMP) facility managers to quantify these hurdles. Besides the familiar regulatory routes of marketing authorization (MA) and hospital exemption (HE), a part of the academic PIs perceived that ATMPs should become available by the Tissues and Cells Directive or did not anticipate on the next development steps towards implementation of their ATMP towards regular clinical care. The main hurdles identified were: inadequate financial support, rapidly evolving field, study-related problems, lacking regulatory knowledge, lack of collaborations and responsibility issues. Creating an academic environment stimulating and planning ATMP development and licensing as well as investing in expanding the relevant regulatory knowledge in academic institutions seems a prerequisite to develop ATMPs from bench to patient. Copyright © 2016 International Society for Cellular Therapy. Published by Elsevier Inc. All rights reserved.

  5. Implementing an integrated standards-based management system to ensure compliance at Los Alamos National Laboratory

    International Nuclear Information System (INIS)

    Hjeresen, D.; Roybal, S.; Bertino, P.; Gherman, C.; Hosteny, B.

    1995-01-01

    Los Alamos National Laboratory (LANL or the Laboratory) is developing and implementing a comprehensive, Integrated Standards-Based Management System (ISBMS) to enhance environmental, safety, and health (ESH) compliance efforts and streamline management of ESH throughout the Laboratory. The Laboratory recognizes that to be competitive in today's business environment and attractive to potential Partnerships, Laboratory operations must be efficient and cost-effective. The Laboratory also realizes potential growth opportunities for developing ESH as a strength in providing new or improved services to its customers. Overall, the Laboratory desires to establish and build upon an ESH management system which ensures continuous improvement in protecting public health and safety and the environment and which fosters a working relationship with stakeholders. A team of process experts from the LANL Environmental Management (EM) Program Office, worked with management system consultants, and the Department of Energy (DOE) to develop an ESH management systems process to compare current LANL ESH management Systems and programs against leading industry standards. The process enabled the Laboratory to gauge its performance in each of the following areas: Planning and Policy Setting; Systems and Procedures; Implementation and Education; and Monitoring and Reporting. The information gathered on ESH management systems enabled LANL to pinpoint and prioritize opportunities for improvement in the provision of ESH services throughout the Laboratory and ultimately overall ESH compliance

  6. Implementation of quality management systems and progress towards accreditation of National Tuberculosis Reference Laboratories in Africa

    Directory of Open Access Journals (Sweden)

    Heidi Albert

    2017-03-01

    Full Text Available Background: Laboratory services are essential at all stages of the tuberculosis care cascade, from diagnosis and drug resistance testing to monitoring response to treatment. Enabling access to quality services is a challenge in low-resource settings. Implementation of a strong quality management system (QMS and laboratory accreditation are key to improving patient care. Objectives: The study objective was to determine the status of QMS implementation and progress towards accreditation of National Tuberculosis Reference Laboratories (NTRLs in the African Region. Method: An online questionnaire was administered to NTRL managers in 47 World Health Organization Regional Office for Africa member states in the region, between February and April 2015, regarding the knowledge of QMS tools and progress toward implementation to inform strategies for tuberculosis diagnostic services strengthening in the region. Results: A total of 21 laboratories (43.0% had received SLMTA/TB-SLMTA training, of which 10 had also used the Global Laboratory Initiative accreditation tool. However, only 36.7% of NTRLs had received a laboratory audit, a first step in quality improvement. Most NTRLs participated in acid-fast bacilli microscopy external quality assurance (95.8%, although external quality assurance for other techniques was lower (60.4% for first-line drug susceptibility testing, 25.0% for second-line drug susceptibility testing, and 22.9% for molecular testing. Barriers to accreditation included lack of training and accreditation programmes. Only 28.6%of NTRLs had developed strategic plans and budgets which included accreditation. Conclusion: Good foundations are in place on the continent from which to scale up accreditation efforts. Laboratory audits should be conducted as a first step in developing quality improvement action plans. Political commitment and strong leadership are needed to drive accreditation efforts; advocacy will require clear evidence of patient

  7. Legal Analysis of the Implementation of National Health Insurance in Nganjuk

    Directory of Open Access Journals (Sweden)

    Turniani Laksmiarti

    2016-01-01

    Full Text Available Background: According to Article 22 of Law No. 32 of 2004 and the decision of the Court granting judicial review on Law No. 40 of 2004, local governments also have the authority and obligation to organize a social security system for its people, including health insurance. One of the problems faced by the local governments is in synchronizing the implementation of the local health insurance system (Jamkesda with the National Health Insurance System (JKN. This study aimed at analyzing the synchronization of implementation of the health insurance system at central and regional levels. Methods: This study was using qualitative data analysis. The data were retrieved from literary data and the results of in-depth interviews with the parties that are considered to have in-depth knowledge related to the research topic. Results: Local Government of Nganjuk has developed social security system in health sector through the free of retribution policy in health services through the Regional Health Insurance System (SJKD. This health insurance system is operated by the District Health Insurance Agency (BPJKD under the East Java Provincial Government. Since the implementation of JKN, Nganjuk Local Government has already begun to integrate this policy with JKN, but constrained by the scope of membership and dues obligations for the region. Conclusion: Nganjuk Government has conducted social service functions through a freeretribution in health services policy with some restrictions and along with East Java Provincial Government held SJKD. Synchronization of health insurance in Nganjuk could be begun with the process of integration of free retribution health services policy to SJKD and continue the health policy to cost sharing with the East Java Provincial Government to facilitate the process of integration to JKN. Recommendation: Nganjuk district in efforts to achieve universal health coverage is necessary to re-collecting and validating the data of jamkesmas

  8. The UK National DNA Database: Implementation of the Protection of Freedoms Act 2012.

    Science.gov (United States)

    Amankwaa, Aaron Opoku; McCartney, Carole

    2018-03-01

    In 2008, the European Court of Human Rights, in S and Marper v the United Kingdom, ruled that a retention regime that permits the indefinite retention of DNA records of both convicted and non-convicted ("innocent") individuals is disproportionate. The court noted that there was inadequate evidence to justify the retention of DNA records of the innocent. Since the Marper ruling, the laws governing the taking, use, and retention of forensic DNA in England and Wales have changed with the enactment of the Protection of Freedoms Act 2012 (PoFA). This Act, put briefly, permits the indefinite retention of DNA profiles of most convicted individuals and temporal retention for some first-time convicted minors and innocent individuals on the National DNA Database (NDNAD). The PoFA regime was implemented in October 2013. This paper examines ten post-implementation reports of the NDNAD Strategy Board (3), the NDNAD Ethics Group (3) and the Office of the Biometrics Commissioner (OBC) (4). Overall, the reports highlight a considerable improvement in the performance of the database, with a current match rate of 63.3%. Further, the new regime has strengthened the genetic privacy protection of UK citizens. The OBC reports detail implementation challenges ranging from technical, legal and procedural issues to sufficient understanding of the requirements of PoFA by police forces. Risks highlighted in these reports include the deletion of some "retainable" profiles, which could potentially lead to future crimes going undetected. A further risk is the illegal retention of some profiles from innocent individuals, which may lead to privacy issues and legal challenges. In conclusion, the PoFA regime appears to be working well, however, critical research is still needed to evaluate its overall efficacy compared to other retention regimes. Copyright © 2018 Elsevier B.V. All rights reserved.

  9. Dutch virtual integration of healthcare information.

    Science.gov (United States)

    de Graaf, J C; Vlug, A E; van Boven, G J

    2007-01-01

    As information technology creates opportunities for cooperation which crosses the boundaries between healthcare institutions, it will become an integral part of the Dutch healthcare system. Along with many involved organizations in healthcare the National IT Institute for Healthcare in the Netherlands (NICTIZ) is working on the realization of a national IT infrastructure for healthcare and a national electronic patient record (EPR). An underlying national architecture is designed to enable the Dutch EPR virtually, not in a national database, nor on a patient's smartcard. The required secure infrastructure provides generic functions for healthcare applications: patient identification, authentication and authorization of healthcare professionals. The first national applications in the EPR program using a national index of where patient data is stored, are the electronic medication record and the electronic record for after hours GP services. The rollout of the electronic medication record and electronic record for after hours GP services has been started in 2007. To guarantee progress of electronic data exchange in healthcare in the Netherlands we have primarily opted for two healthcare applications: the electronic medication record and the electronic record for after hours GP services. The use of a national switch-point containing the registry of where to find what information, guarantees that the professional receives the most recent information and omits large databases to contain downloaded data. Proper authorization, authentication as well as tracing by the national switchpoint also ensures a secure environment for the communication of delicate information.

  10. Implementation of environmental compliance for operating radioactive liquid waste systems at the Oak Ridge National Laboratory

    International Nuclear Information System (INIS)

    Hooyman, J.H.

    1993-01-01

    This paper addresses methods being implemented at the Oak Ridge National Laboratory (ORNL) to continue operating while achieving compliance with new standards for liquid low level waste (LLLW) underground storage tank systems. The Superfund Amendment and Reauthorization Act (SARA) of the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) required that the Department of Energy (DOE) execute a Federal Facility Agreement (FFA) with the Environmental Protection Agency (EPA) within 6 months of listing of the ORNL on the National Priorities List. An FFA for ORNL became effective January 1, 1992 among the EPA, DOE, and the Tennessee Department of Environment and Conservation (TDEC). The objective of the FFA as it relates to these tank systems is to ensure that structural integrity, containment, leak detection capability, and LLLW source control are maintained until final remedial action. The FFA requires that leaking LLLW tank systems be immediately removed from service, and that active tank systems be doubly contained, cathodically protected, and have leak detection capability. LLLW tank systems that do not meet requirements are to be either upgraded or replaced, but can remain in service if they do not leak in the interim

  11. Designing and implementing E-health Applications in the UK's National Health Service.

    Science.gov (United States)

    Bower, D Jane; Barry, Nessa; Reid, Margaret; Norrie, John

    2005-12-01

    Telemedicine/e-health applications have the potential to play an important role in Britain's National Health Service (NHS), including the NHS in Scotland. The Scottish Telemedicine Action Forum (STAF) was established by the Scottish Executive Department of Health in 1999 to take a range of applications, targeted on national priorities, into routine service. In the process it has provided insights into how advanced information and communication technologies (ICTs) can be moved from the research stage into routine service. In this article four of the projects are described and analysed focusing on the key issues that have emerged as critical for carrying projects successfully through to implementation in service as follows: 1. A multisite videoconferencing network linking 15 minor injury units to the main accident and emergency (A&E) centre. 2. A single-site neonatal intensive care "cotside" laptop system to assist communication between parents and clinical staff. 3. A single-site outpatient chronic disease management system. 4. A multisite software audit tool to support the care of cleft lip and palate patients from birth onward.

  12. [Design and Implementation of the Data Collection Tools for National Mental Health Survey of Colombia, 2015].

    Science.gov (United States)

    Rodriguez, Viviana; Moreno, Socorro; Camacho, Jhon; Gómez-Restrepo, Carlos; de Santacruz, Cecilia; Rodriguez, Maria Nelcy; Tamayo Martínez, Nathalie

    2016-12-01

    Population surveys on mental health are performed as part of the inputs required for the creation, implementation and evaluation of policies related to mental health, worldwide, and as an initiative of the World Health Organisation (WHO). was held The fourth National Survey of Mental Health (ENSM 2015) was carried out during the first half of 2015 on a representative sample of 2,727 children between 7 and 11 years of age, 1,754 adolescents, and 10, 870 adults who were selected throughout the country. To describe the selection and definition of the tools used to measure mental health (including social cognition and violence), problems, mental disorders, and the evaluation of health states, as well as to describe the process used to develop the data collection tools finally used. The measurement of mental disorders in children was performed using the Diagnostic Interview Schedule for Children (DISC), and the Composite International Diagnostic Interview (CIDI) was used for adolescents and adults. For the remaining components evaluated in the survey, a search was conducted on the tools used at a national and international level. The selection of the toos used for the evaluation was based on the questions made by each tool, as well as the scientific validity that could be obtained from the results. In some cases the complete tool (as published) was used, in other cases the tools were constructed unifying parts of different ones, or questions were written based on the concepts or characteristics to be measured. Subsequently, a validation of content, concept and semantic of every tool was carried out, including the CIDI and DISC. The resulting tools were used on a group of people with different characteristics. It was noted that further clarification was necessary for some people to fully understand what was being asked. Because the collection of all the information in the survey would be computer assisted, a stream format was generated to guide the implementation in

  13. National Qualifications Framework For Higher Education in Turkey, and Architectural Education: Problems and Challenges of Implementation

    Directory of Open Access Journals (Sweden)

    Emel AKÖZER

    2013-01-01

    Full Text Available The Council of Higher Education (CoHE adopted the National Qualifications Framework for Higher Education in Turkey (NQF-HETR in May 2009, as part of the Bologna reforms. In January 2010, the CoHE decided full implementation of the NQF-HETR at institutional and program levels and in this decision, it was foreseen that the process would be completed by the end of December 2012. The NQFHETR has been aligned both to the overarching Framework for Qualifications in the European Higher Education Area (QF-EHEA, 2005 and to the European Qualifications Framework for lifelong learning (EQF-LLL, 2008. The latter was introduced to facilitate the European cooperation in education and training, in line with the goals of the European Union's (EU Lisbon Strategy. This paper focuses on some of the problems that have become apparent during the NQF-HETR's implementation at the levels of “narrow fields of education” and architecture programs, and the challenges ahead. Following a discussion of the significance of the two European frameworks in light of the goals of the EHEA, the Education and Training 2010 work programme (ET 2010 and the strategic framework for European cooperation in Education and Training (ET 2020, it covers two problem areas concerning qualifications in architecture: i terminological and classificatory problems entailed by the NQF-HETR; ii the lack of alignment between the European qualifications frameworks and the EU Directive on the Recognition of Professional Qualifications (Directive EC/2005/36 that covers seven “sectoral professions” including architecture. The paper also reviews the latest developments for the modernization of the EU Directive in order to provide progression in forming an integrated European Higher Education Area.

  14. Development and Implementation of a Scaled Saltstone Facility at Savannah River National Laboratory - 13346

    International Nuclear Information System (INIS)

    Reigel, Marissa M.; Fowley, Mark D.; Hansen, Erich K.; Hera, Kevin R.; Marzolf, Athneal D.; Cozzi, Alex D.

    2013-01-01

    The Savannah River National Laboratory (SRNL) has supported the Saltstone Production Facility (SPF) since its conception. However, bench scaled tests have not always provided process or performance data related to the mixing, transfer, and other operations utilized in the SPF. A need was identified to better understand the SPF processes and to have the capabilities at SRNL to simulate the SPF unit operations to support an active low-level radioactive waste (LLW) processing facility. At the SPF, the dry premix is weighed, mixed and transferred to the Readco '10-inch' continuous mixer where it is mixed with the LLW salt solution from the Salt Feed Tank (SFT) to produce fresh Saltstone slurry. The slurry is discharged from the mixer into a hopper. The hopper feeds the grout pump that transfers the slurry through at least 457.2 meters of piping and discharges it into the Saltstone Disposal Units (SDU) for permanent disposal. In conjunction with testing individual SPF processes over several years, SRNL has designed and fabricated a scaled Saltstone Facility. Scaling of the system is primarily based on the volume capacity of the mixer and maintaining the same shear rate and total shear at the wall of the transfer line. At present, SRNL is utilizing the modular capabilities of the scaled Saltstone Facility to investigate the erosion issues related to the augers and paddles inside the SPF mixer. Full implementation of the scaled Saltstone Facility is still ongoing, but it is proving to be a valuable resource for testing alternate Saltstone formulations, cleaning sequences, the effect of pumping Saltstone to farther SDU's, optimization of the SPF mixer, and other operational variables before they are implemented in the SPF. (authors)

  15. Economics of forest and forest carbon projects. Translating lessons learned into national REDD+ implementation

    Energy Technology Data Exchange (ETDEWEB)

    Zaballa Romero, M.; Traerup, S.; Wieben, E.; Ravnkilde Moeller, L.; Koch, A.

    2013-01-15

    The financial implications of implementing a new forest management paradigm have not been well understood and have often been underestimated. Resource needs for e.g., stakeholder consultation, capacity building and addressing the political economy are seldom fully accounted for in the resource needs estimates put forward in connection to REDD+. This report investigates the economics of implementing forest and REDD+ projects through eight case studies from Africa, Latin America and Asia, analyzing real forest and REDD+ investments. The report is part of efforts to share financial experiences and lessons learned with policymakers, project developers and stakeholders, with the objective to inform forest project and strategy development. It presents experiences and advice on the risks, costs and revenues of forest projects, thereby informing not only the development of future REDD+ initiatives but also the testing of advanced market commitments as a finance option for sustainable forest management. The findings in the report underline the fact that only through sound and transparent financial information will forest projects and national forest initiatives become interesting for private financial institutions and comparable with other investment opportunities. It is therefore important to include robust analysis of the operations business case and its financial attractiveness to commercial investors, early in the design process. As for the economics of forest and forest carbon projects, it appears that REDD+ payments alone, especially at current prices, will not deliver the revenues that cover all expenses of transparent and long-term mitigation of forest carbon emissions. Instead the findings underline the importance of building up forest operations which effectively manages risk and delivers several revenue streams. These findings are aligned with the advocacy efforts of UNEP and the UN-REDD Programme on multiple benefits and the combination of various funding and

  16. Preparing for national implementation of an evidence-based, effective HIV prevention program among bahamian sixth-grade students.

    Science.gov (United States)

    Knowles, Valerie; Wang, Bo; Deveaux, Lynette; Lunn, Sonja; Rolle, Glenda; Jones, Giavana; Harris, Carole; Kaljee, Linda; Li, Xiaoming; Koci, Veronica; Chen, Xinguang; Marshall, Sharon; Stanton, Bonita

    2012-01-01

    Using data from the preparatory phase prior to national implementation of an effective HIV prevention program (Focus on Youth in the Caribbean; FOYC) in all Bahamian government sixth-grade classes, we describe (1) actual FOYC implementation, (2) factors that influenced implementation, and (3) the relationship of implementation with intervention outcome. Six elementary schools (with 17 grade six classrooms) were selected to participate in the preparatory phase. The 17 teachers were invited to attend a training workshop, coordinate administration of questionnaires to the students, teach the 10 sessions of FOYC and complete self-assessment checklists. A total of 395 students submitted baseline and 311 students submitted year-end questionnaires. Thirteen teachers initiated FOYC; five completed all 10 sessions. Implementation of FOYC was not related to teacher FOYC workshop experience but did cluster by school. There were significant positive correlations between improved student knowledge of HIV/AIDS, protective health skills, perceived parental monitoring and reduced risk behaviours with the number of FOYC sessions delivered. Implementation was impeded by logistics issues, structural issues with the measures, and comfort-level issues, most of which can be addressed for national implementation. Degree of FOYC implementation is correlated with positive student outcomes.

  17. The costs, effects and cost-effectiveness of counteracting overweight on a population level. A scientific base for policy targets for the Dutch national plan for action.

    NARCIS (Netherlands)

    Bemelmans, W.; Baal, van P.; Wendel-Vos, G.C.W.; Schuit, J.; Feskens, E.J.M.; Ament, A.; Hoogenveen, R.

    2008-01-01

    Objectives. To gain insight in realistic policy targets for overweight at a population level and the accompanying costs. Therefore, the effect on overweight prevalence was estimated of large scale implementation of a community intervention (applied to 90% of general population) and an intensive

  18. Implementing SLMTA in the Kenya National Blood Transfusion Service: lessons learned

    Directory of Open Access Journals (Sweden)

    Eric N. Wakaria

    2017-04-01

    Full Text Available Background: The Kenya National Blood Transfusion Service (KNBTS is mandated to provide safe and sufficient blood and blood components for the country. In 2013, the KNBTS National Testing Laboratory and the six regional blood transfusion centres were enrolled in the Strengthening Laboratory Management Toward Accreditation (SLMTA programme. The process was supported by Global Communities with funding from the United States Centers for Disease Control and Prevention. Methods: The SLMTA implementation at KNBTS followed the standard three-workshop series, on-site mentorships and audits. Baseline, midterm and exit audits were conducted at the seven facilities, using a standard checklist to measure progress. Given that SLMTA was designed for clinical and public health laboratories, key stakeholders, guided by Global Communities, tailored SLMTA materials to address blood transfusion services, and oriented trainers, auditors and mentors on the same. Results: The seven facilities moved from an average of zero stars at baseline to an average of three stars at the exit audit. The average baseline audit score was 38% (97 points, midterm 71% (183 points and exit audit 79% (205 points. The Occurrence Management and Process Improvement quality system essential had the largest improvement (at 67 percentage points, from baseline to exit, whereas Facilities and Safety had the smallest improvement (at 31 percentage points. Conclusion: SLMTA can be an effective tool for preparing a blood transfusion service for accreditation. Key success factors included customising SLMTA to blood transfusion activities; sensitising trainers, mentors and auditors on operations of blood transfusion service; creating SLMTA champions in key departments; and integrating other blood transfusion-specific accreditation standards into SLMTA.

  19. Sandia National Laboratories, Livermore Environmental Protection Implementation Plan for the period November 9, 1991--November 9, 1992

    International Nuclear Information System (INIS)

    1991-10-01

    Sandia National Laboratories, as part of the DOE complex, is committed to full compliance with all applicable environmental laws and regulations. This Environmental Protection Implementation Plan (EPIP) is intended to ensure that the environmental program objectives of DOE Order 5400.1 are achieved at SNL, Livermore. The EPIP will serve as an aid to management and staff to implement these new programs in a timely manner. 23 refs., 4 figs., 1 tab

  20. [Implementation of the National Expert Standard Prophylaxis of Pressure Ulcers in nurse practise - a cost-benefit analysis].

    Science.gov (United States)

    Wolke, R; Hennings, D; Scheu, P

    2007-06-01

    By developing evidence-based, national Expert Standards, agreed-upon by an association of nursing professionals, the German Care Science participates in the international discussion. Up to now, five National Expert Standards on relevant care-related topics have been developed and have been widely implemented in Care Practice. However, sufficient evaluations of these Expert Standards are still required, especially from an economic perspective. The following paper addresses this topic by performing a cost-benefit analysis for the National Expert Standard Prophylaxis of Pressure Ulcers. The authors demonstrate which costs are caused by the implementation of this National Expert Standard for a residential care agency providing services. The benefit of the implementation of the Expert Standard is then being compared to its cost for a period of three years. The evaluation concludes that, in consideration of opportunity costs, the introduction of the National Expert Standard Prophylaxis of Pressure Ulcers appears economically viable for the residential care agency only if the rate of pressure ulcers in the reference agency can be lowered at least by 26.48%. In this case, when exclusively considering direct benefits and direct costs, a positive impact of the implementation will be achieved.

  1. Dutch taboo norms.

    Science.gov (United States)

    Roest, Sander A; Visser, Tessa A; Zeelenberg, René

    2018-04-01

    This article provides norms for general taboo, personal taboo, insult, valence, and arousal for 672 Dutch words, including 202 taboo words. Norms were collected using a 7-point Likert scale and based on ratings by psychology students from the Erasmus University Rotterdam in The Netherlands. The sample consisted of 87 psychology students (58 females, 29 males). We obtained high reliability based on split-half analyses. Our norms show high correlations with arousal and valence ratings collected by another Dutch word-norms study (Moors et al.,, Behavior Research Methods, 45, 169-177, 2013). Our results show that the previously found quadratic relation (i.e., U-shaped pattern) between valence and arousal also holds when only taboo words are considered. Additionally, words rated high on taboo tended to be rated low on valence, but some words related to sex rated high on both taboo and valence. Words that rated high on taboo rated high on insult, again with the exception of words related to sex many of which rated low on insult. Finally, words rated high on taboo and insult rated high on arousal. The Dutch Taboo Norms (DTN) database is a useful tool for researchers interested in the effects of taboo words on cognitive processing. The data associated with this paper can be accessed via the Open Science Framework ( https://osf.io/vk782/ ).

  2. Dutch euthanasia revisited.

    Science.gov (United States)

    Fenigsen, R

    1997-01-01

    The results of a follow-up study of euthanasia by the Dutch government, five years after the first study, were published on November 26, 1996. This article provides a detailed review of the two reports comparing and contrasting the statistics cited therein. The author notes that the "rules of careful conduct" proposed by the courts and by the Royal Dutch Society of Medicine were frequently disregarded. Special topics included for the first time in the second study were the notification and non-prosecution procedure, euthanasia of newborns and infants, and assisted suicide in psychiatric practice. The authors of the follow-up report state that it would be desirable to reduce the number of "terminations of life without patients' request," but this must be the common responsibility of the doctor and the patient. They suggest that the person who does not wish to have his life terminated should declare this clearly, in advance, verbally and in writing, preferably in the form of a living will. Involuntary euthanasia was rampant in 1990 and equally rampant in 1995. The author concludes that Dutch doctors who practice euthanasia are not on the slippery slope. From the very beginning, they have been at the bottom.

  3. Implementation of the national tuberculosis guidelines on culture and drug sensitivity testing in Guatemala, 2013.

    Science.gov (United States)

    Samayoa-Peláez, Maritza; Ayala, Nancy; Yadon, Zaida E; Heldal, Einar

    2016-01-01

    Objective To assess whether the National Tuberculosis Program (NTP) guidelines for culture and drug sensitivity testing (DST) in Guatemala were successfully implemented, particularly in cases of smear-negative pulmonary tuberculosis (TB) or previously treated TB, by documenting notification rates by department (geographic area), disease type and category, and culture and DST results. Methods This was a cross-sectional, operational research study that merged and linked all patients registered by the NTP and the National Reference Laboratory in 2013, eliminating duplicates. The proportions with culture (for new smear negative pulmonary cases) and culture combined with DST (for previously treated patients) were estimated and analyzed by department. Data were analyzed using EpiData Analysis version 2.2. Results There were 3 074 patients registered with TB (all forms), for a case notification rate of 20/100 000 population. Of these, 2 842 had new TB, of which 2 167 (76%) were smear-positive pulmonary TB (PTB), 385 (14%) were smear-negative PTB, and 290 (10%) were extrapulmonary TB. There were 232 (8%) previously treated cases. Case notification rates (all forms) varied by department from 2-68 per 100 000 population, with the highest rates seen in the southwest and northeast part of Guatemala. Of new TB patients, 136 had a culture performed and 55 had DST of which the results were 33 fully sensitive, 9 monoresistant, 3 polyresistant, and 10 multidrug resistant TB (MDR-TB). Only 21 (5%) of new smear-negative PTB patients had cultures. Of 232 previously treated patients, 54 (23%) had a culture and 47 (20%) had DST, of which 29 were fully sensitive, 7 monoresistant, 2 polyresistant, and 9 MDR-TB. Of 22 departments (including the capital), culture and DST was performed in new smear-negative PTB in 7 departments (32%) and in previously treated TB in 13 departments (59%). Conclusions Despite national guidelines, only 5% of smear-negative PTB cases had a culture and only 20% of

  4. Implementation of the national tuberculosis guidelines on culture and drug sensitivity testing in Guatemala, 2013

    Directory of Open Access Journals (Sweden)

    Maritza Samayoa-Peláez

    Full Text Available ABSTRACT Objective To assess whether the National Tuberculosis Program (NTP guidelines for culture and drug sensitivity testing (DST in Guatemala were successfully implemented, particularly in cases of smear-negative pulmonary tuberculosis (TB or previously treated TB, by documenting notification rates by department (geographic area, disease type and category, and culture and DST results. Methods This was a cross-sectional, operational research study that merged and linked all patients registered by the NTP and the National Reference Laboratory in 2013, eliminating duplicates. The proportions with culture (for new smear negative pulmonary cases and culture combined with DST (for previously treated patients were estimated and analyzed by department. Data were analyzed using EpiData Analysis version 2.2. Results There were 3 074 patients registered with TB (all forms, for a case notification rate of 20/100 000 population. Of these, 2 842 had new TB, of which 2 167 (76% were smear-positive pulmonary TB (PTB, 385 (14% were smear-negative PTB, and 290 (10% were extrapulmonary TB. There were 232 (8% previously treated cases. Case notification rates (all forms varied by department from 2–68 per 100 000 population, with the highest rates seen in the southwest and northeast part of Guatemala. Of new TB patients, 136 had a culture performed and 55 had DST of which the results were 33 fully sensitive, 9 monoresistant, 3 polyresistant, and 10 multidrug resistant TB (MDR-TB. Only 21 (5% of new smear-negative PTB patients had cultures. Of 232 previously treated patients, 54 (23% had a culture and 47 (20% had DST, of which 29 were fully sensitive, 7 monoresistant, 2 polyresistant, and 9 MDR-TB. Of 22 departments (including the capital, culture and DST was performed in new smear-negative PTB in 7 departments (32% and in previously treated TB in 13 departments (59%. Conclusions Despite national guidelines, only 5% of smear-negative PTB cases had a culture and

  5. Present readiness of, and white spots in the Dutch national system for greenhouse gas reporting of the land use, land-use change and forestry sector (LULUCF)

    NARCIS (Netherlands)

    Nabuurs, G.J.; Daamen, W.P.; Dirkse, G.M.; Paasman, J.; Kuikman, P.J.; Verhagen, A.

    2003-01-01

    Current LULUCF greenhouse gas reporting by the Netherlands is incomplete. The few sections that are included in the current reporting are done at lower Tiers. Thirty nine existing monitoring systems or databases were identified as possibly relevant for setting up a national system. The systems are

  6. National Medicines Policy in retrospective: a review of (almost) 20 years of implementation.

    Science.gov (United States)

    Vasconcelos, Daniela Moulin Maciel de; Chaves, Gabriela Costa; Azeredo, Thiago Botelho; Silva, Rondineli Mendes da

    2017-08-01

    Pharmaceutical services and the formulation of a medicines policy are SUS areas ensured by the organic health care law 8,080/90. Thus, after a widely participative process, involving stakeholders, the National Medicines Policy (NMP) was approved in 1998 by Ordinance 3,916.The NMP presents directives and priorities, aligned with organic health care law, which should guide the federal, states and municipals entities actions to achieve the policy goals. Considering almost 20 years of the NMP, this paper took stock discussed some of the directives in light of the SUS principles. It was not the objective to provide an exhaustive review of all the activities performed during this period. The authors tried to get close to those that have brought advances and dilemmas, with potential risk of regression. Efforts to implement an ambitious agenda applied to pharmaceutical services were identified. This agenda tried to deal with different challenges like the dynamics of the pharmaceutical market and the operation of pharmaceutical services to guarantee the supply of medicines aligned with principles and directives of SUS.

  7. Implementing China's national energy conservation policies at state-owned electric power generation plants

    International Nuclear Information System (INIS)

    Zhao Xiaofan; Ortolano, Leonard

    2010-01-01

    China's 11th Five-Year Guideline identified energy conservation as one of the country's fundamental policies and established a mandatory target: 20% reduction in national average energy intensity by 2010. Despite the various policies, laws, and administrative reforms to support energy conservation, China fell behind schedule for meeting its conservation targets in 2006 and 2007. Using a combination of available literature and an interview-based case study, this paper examines the implementation of energy conservation and investigates impediments to achieving China's conservation goal in the electric power generation sector. Three key impediments are detailed: (1) municipal governments' incentives to overlook conservation-related central directives primarily because of budget pressures linked to financial decentralization, (2) procedural obstacles in the form of time required to obtain project approvals for high-efficiency power generation units, and (3) financial obstacles making it difficult for power generation enterprises to raise capital for energy conservation projects. An interview-based case study of a state-owned coal-fired electric power generation company demonstrates the influence of the aforementioned obstacles. While procedural obstacles are notable, they can be managed. However, electricity pricing reforms and/or stronger subsidy programs will be needed to address the financial obstacles facing Chinese power generation companies.

  8. Implementation of the Polarized HD target at the Thomas Jefferson National Accelerator Facility

    International Nuclear Information System (INIS)

    Chaden Djalali; David Tedeschi

    2007-01-01

    The original goal of this proposal was to study frozen spin polarized targets (HD target and other technologies) and produce a conceptual design report for the implementation of such a target in the HALL B detector of the Thomas Jefferson National Accelerator Facility (JLab). During the first two years of the proposal, we came to the conclusion that the best suited target for JLab was a frozen spin target and helped with the design of such a target. We have not only achieved our original goal but have exceeded it by being involved in the actual building and testing of parts the target. The main reason for this success has been the hiring of a senior research associate, Dr. Oleksandr Dzyubak, who had more than 10 years of experience in the field of frozen spin polarized targets. The current grant has allowed the USC nuclear physics group to strengthen its role in the JLab collaboration and make important contribution to both the detector development and the scientific program

  9. Implementation plans for buried transuranic waste and stored special-case waste at the Idaho National Engineering Laboratory

    International Nuclear Information System (INIS)

    Bullock, M.G.; Rodriguez, R.R.

    1987-05-01

    This document presents the current implementation plans for buried transuranic waste and stored special-case waste at the Idaho National Engineering Laboratory. Information contained in this report was also included in several Department of Energy (DOE) planning documents for the Defense Transuranic Waste Program. This information can be found in the following DOE documents: Comprehensive Implementation Plan for the DOE Defense Buried TRU Waste Program; Defense Waste Management Plan for Buried Transuranic-Contaminated Waste, Transuranic-Contaminated Waste, Transuranic-Contaminated Soil, and Difficult-to-Certify Transuranic Waste; and Defense Special-Case Transuranic Waste Implementation Plan. 11 refs

  10. The making of a nation-wide campaign fighting the nursing caries

    NARCIS (Netherlands)

    Sanden-Stoelinga, van M.S.E.; Koelen, M.A.; Hielkema-de Meij, J.E.

    2003-01-01

    Although, in the Netherlands, the fight against tooth decay has been successful over the past decades, in 1994, the incidence of nursing caries made the Ivory Cross*, the Dutch National Association for the Promotion of Oral Hygiene, decide to develop and implement a campaign to address the

  11. Workplace health promotion implementation, readiness, and capacity among midsize employers in low-wage industries: a national survey.

    Science.gov (United States)

    Hannon, Peggy A; Garson, Gayle; Harris, Jeffrey R; Hammerback, Kristen; Sopher, Carrie J; Clegg-Thorp, Catherine

    2012-11-01

    To describe workplace health promotion (WHP) implementation, readiness, and capacity among midsize employers in low-wage industries in the United States. A cross-sectional survey of a national sample of midsize employers (100 to 4999 employees) representing five low-wage industries. Employers' WHP implementation for both employees and employees' spouses and partners was low. Readiness scales showed that employers believe WHP would benefit their employees and their companies, but they were less likely to believe that WHP was feasible for their companies. Employers' capacity to implement WHP was very low; nearly half the sample reported no capacity. Midsize employers in low-wage industries implement few WHP programs; their responses to readiness and capacity measures indicate that low capacity may be one of the principal barriers to WHP implementation.

  12. Parent involvement as professionalization: professionals' struggle for power in Dutch urban deprived areas

    NARCIS (Netherlands)

    van den Berg, M.; van Reekum, R.

    2011-01-01

    Parent involvement policies have been central in the Dutch push towards educational governance. How the implementation of these policies plays out on the ground is context‐dependent. The ethnic and class cleavages impacting the Dutch educational system should be taken into account. On the basis of

  13. Determinants of successful public-private partnerships in the context of overweight prevention in Dutch youth

    NARCIS (Netherlands)

    Leenaars, K.; Jacobs-van der bruggen, M.; Renders, C.M.

    2013-01-01

    Introduction A public-private partnership (PPP) is an essential component of the Dutch community-based approach toward overweight prevention, Youth on Healthy Weight (JOGG). Beginning in 2010, 25 Dutch municipalities have implemented JOGG, but little is known about determinants of successful

  14. Choosing a health plan: are Dutch consumers loyal to their health insurer?

    NARCIS (Netherlands)

    Hendriks, M.; Groenewegen, P.P.; Delnoij, D.M.J.

    2006-01-01

    In 2006, a number of far-reaching reforms have been implemented in the Dutch health insurance system. Giving Dutch consumers the freedom to change health plans every year increases consumer mobility. The idea is that especially consumers who are dissatisfied with their insurer will decide to switch

  15. Implementing a sub-national strategic framework to reduce the illicit tobacco market to support national strategies

    Directory of Open Access Journals (Sweden)

    Ailsa Rutter

    2018-03-01

    The success of this strategic framework demonstrates that activity can be co-ordinated locally or sub-nationally to support national strategies to reduce the illicit tobacco market. Activity should always be placed within the broader context of 'all tobacco kills' and should contain measures to reduce both supply and demand. Useful resources for other programmes and settings can be found at www.illicit-tobacco.co.uk.

  16. Organizational learning in the implementation and adoption of national electronic health records: case studies of two hospitals participating in the National Programme for Information Technology in England.

    Science.gov (United States)

    Takian, Amirhossein; Sheikh, Aziz; Barber, Nicholas

    2014-09-01

    To explore the role of organizational learning in enabling implementation and supporting adoption of electronic health record systems into two English hospitals. In the course of conducting our prospective and sociotechnical evaluation of the implementation and adoption of electronic health record into 12 "early adopter" hospitals across England, we identified two hospitals implementing virtually identical versions of the same "off-the-shelf" software (Millennium) within a comparable timeframe. We undertook a longitudinal qualitative case study-based analysis of these two hospitals (referred to hereafter as Alpha and Omega) and their implementation experiences. Data included the following: 63 in-depth interviews with various groups of internal and external stakeholders; 41-h on-site observation; and content analysis of 218 documents of various types. Analysis was both inductive and deductive, the latter being informed by the "sociotechnical changing" theoretical perspective. Although Alpha and Omega shared a number of contextual similarities, our evaluation revealed fundamental differences in visions of electronic health record and the implementation strategy between the hospitals, which resulted in distinct local consequences of electronic health record implementation and impacted adoption. Both hospitals did not, during our evaluation, see the hoped-for benefits to the organization as a result of the introduction of electronic health record, such as speeding-up tasks. Nonetheless, the Millennium software worked out to be easier to use at Omega. Interorganizational learning was at the heart of this difference. Despite the turbulent overall national "roll out" of electronic health record systems into the English hospitals, considerable opportunities for organizational learning were offered by sequential delivery of the electronic health record software into "early adopter" hospitals. We argue that understanding the process of organizational learning and its

  17. The challenge of transferring an implementation strategy from academia to the field: a process evaluation of local quality improvement collaboratives in Dutch primary care using the normalization process theory.

    Science.gov (United States)

    Trietsch, Jasper; van Steenkiste, Ben; Hobma, Sjoerd; Frericks, Arnoud; Grol, Richard; Metsemakers, Job; van der Weijden, Trudy

    2014-12-01

    A quality improvement strategy consisting of comparative feedback and peer review embedded in available local quality improvement collaboratives proved to be effective in changing the test-ordering behaviour of general practitioners. However, implementing this strategy was problematic. We aimed for large-scale implementation of an adapted strategy covering both test ordering and prescribing performance. Because we failed to achieve large-scale implementation, the aim of this study was to describe and analyse the challenges of the transferring process. In a qualitative study 19 regional health officers, pharmacists, laboratory specialists and general practitioners were interviewed within 6 months after the transfer period. The interviews were audiotaped, transcribed and independently coded by two of the authors. The codes were matched to the dimensions of the normalization process theory. The general idea of the strategy was widely supported, but generating the feedback was more complex than expected and the need for external support after transfer of the strategy remained high because participants did not assume responsibility for the work and the distribution of resources that came with it. Evidence on effectiveness, a national infrastructure for these collaboratives and a general positive attitude were not sufficient for normalization. Thinking about managing large databases, responsibility for tasks and distribution of resources should start as early as possible when planning complex quality improvement strategies. Merely exploring the barriers and facilitators experienced in a preceding trial is not sufficient. Although multifaceted implementation strategies to change professional behaviour are attractive, their inherent complexity is also a pitfall for large-scale implementation. © 2014 John Wiley & Sons, Ltd.

  18. Evaluation of a cut-to-length system implementing fuel reduction treatments on the Coconino National Forest in Arizona

    Science.gov (United States)

    John Klepac; Bob Rummer; Jason Thompson

    2006-01-01

    A Cut-to-Length (CTL) system was evaluated for production and cost while implementing fuel reduction treatments in two stands on the Coconino National Forest in Arizona. Product recovery and fire behavior within each stand after treatment were also examined. Only trees less than 16 inches diameter breast height (DBH) were harvested. After logs were forwarded to a...

  19. Principal Experiences with Crisis Management Professional Development, Collaboration, and Implementation of the National Incident Management System Phases of Emergency Management

    Science.gov (United States)

    Naradko, Anthony M.

    2017-01-01

    The purpose of this qualitative single-subject case study was to identify the elements critical to crisis management professional development for school principals; the factors influencing the implementation of the National Incident Management System Phases of Emergency Management (2010) for principals; and the necessary elements for fostering…

  20. Implementation of a web-based national child health-care programme in a local context: A complex facilitator role.

    Science.gov (United States)

    Tell, Johanna; Olander, Ewy; Anderberg, Peter; Berglund, Johan Sanmartin

    2018-02-01

    The aim of this study was to investigate child health-care coordinators' experiences of being a facilitator for the implementation of a new national child health-care programme in the form of a web-based national guide. The study was based on eight remote, online focus groups, using Skype for Business. A qualitative content analysis was performed. The analysis generated three categories: adapt to a local context, transition challenges and led by strong incentives. There were eight subcategories. In the latent analysis, the theme 'Being a facilitator: a complex role' was formed to express the child health-care coordinators' experiences. Facilitating a national guideline or decision support in a local context is a complex task that requires an advocating and mediating role. For successful implementation, guidelines and decision support, such as a web-based guide and the new child health-care programme, must match professional consensus and needs and be seen as relevant by all. Participation in the development and a strong bottom-up approach was important, making the web-based guide and the programme relevant to whom it is intended to serve, and for successful implementation. The study contributes valuable knowledge when planning to implement a national web-based decision support and policy programme in a local health-care context.

  1. Cyber security awareness toolkit for national security: An approach to South Africa’s cybersecurity policy implementation

    CSIR Research Space (South Africa)

    Phahlamohlaka, LJ

    2011-05-01

    Full Text Available The aim of this paper is to propose an approach that South Africa could follow in implementing its proposed Cyber security policy. The paper proposes a Cyber Security Awareness Toolkit that is underpinned by key National Security imperatives as well...

  2. Dynamics in National Agri-environmental Policy implementation under Changing EU Policy Priorities: does one size fit all?

    DEFF Research Database (Denmark)

    Vesterager, Jens Peter; Frederiksen, Pia; Kristensen, Søren Bech Pilgaard

    2016-01-01

    by creatingan increasingly demanding set of regulations with which each member state must comply. National AEPimplementation may, however, maintain original characteristics and fail to adopt or transform as EUpolicy implementation proceeds or when EU policies develop. This creates a potential gap between...

  3. Development of a National Education and Training Data Standards Strategy and Implementation Plan. Cat. No. EDU 4

    Science.gov (United States)

    Australian Institute of Health and Welfare, 2015

    2015-01-01

    The Australian Institute of Health and Welfare developed a national data standards strategy and implementation plan to enhance the comparability, quality and coherence of information across the Australian education and training sectors, including early childhood education, school education, vocational education and training (VET) and higher…

  4. Centralization and Experimentation in the Implementation of a National Monitoring and Evaluation System: The Experience of Malawi.

    Science.gov (United States)

    Useem, Michael; Chipande, Graham

    1991-01-01

    To identify general principles of implementing a system of evaluation, the experience of Malawi in building a national system for agriculture is described. Applying principles of both centralization and decentralization and principles of trial and error has helped translate theories of evaluation into practice in Malawi. (SLD)

  5. Monitoring the Implementation of IDEA: Proceedings of the National Monitoring Conference (6th, Salt Lake City, Utah, October 2002).

    Science.gov (United States)

    Tschantz, Jennifer

    This document presents the proceedings of the sixth National Monitoring Conference concerned with implementation of the Individuals with Disabilities Education Act. Introductory material describes the purpose and background of the document and the federal monitoring of states, including the Continuous Improvement Monitoring Process (CIMP) and…

  6. Will Dutch Become Flemish? Autonomous Developments in Belgian Dutch

    Science.gov (United States)

    Van de Velde, Hans; Kissine, Mikhail; Tops, Evie; van der Harst, Sander; van Hout, Roeland

    2010-01-01

    In this paper a series of studies of standard Dutch pronunciation in Belgium and the Netherlands is presented. The research is based on two speech corpora: a diachronic corpus of radio speech (1935-1995) and a synchronic corpus of Belgian and Netherlandic standard Dutch from different regions at the turn of the millennium. It is shown that two…

  7. Implementing the Corrective Action Management Unit at Sandia National Laboratories, New Mexico

    International Nuclear Information System (INIS)

    Moore, Darlene R.; Schrader, Scott A.; King, Gabriel G.; Cormier, John

    2000-01-01

    In September 1997, following significant public and regulator interaction, Sandia Corporation (Sandia) was granted a Resource Conservation and Recovery Act (RCRA) and Hazardous Solid Waste Amendment (HSWA) permit modification allowing construction and operation of a Correction Action Management Unit (CAMU). The CAMU follows recent regulatory guidance that allows for cost-effective, expedient cleanup of contaminated sites and management of hazardous remediation wastes. The CAMU was designed to store, treat, and provide long-term management for Environmental Restoration (ER) derived wastes. The 154 square meter CAMU site at Sandia National Laboratories, New Mexico (SNL/NM), includes facilities for storing bulk soils and containerized wastes, for treatment of bulk soils, and has a containment cell for long-term disposition of waste. Proposed treatment operations include soil washing and low temperature thermal desorption. The first waste was accepted into the CAMU for temporary storage in January 1999. Construction at the CAMU was completed in March 1999, and baseline monitoring of the containment cell has commenced. At completion of operations the facility will be closed, the waste containment cell will be covered, and long-term post-closure monitoring will begin. Sandia's CAMU is the only such facility within the US Department of Energy (DOE) complex. Implementing this innovative approach to ER waste management has required successful coordination with community representatives, state and federal regulators, the DOE, Sandia corporate management, and contractors. It is expected that cost savings to taxpayers will be significant. The life-cycle CAMU project cost is currently projected to be approximately $12 million

  8. Human papillomavirus infection in Rwanda at the moment of implementation of a national HPV vaccination programme.

    Science.gov (United States)

    Ngabo, Fidele; Franceschi, Silvia; Baussano, Iacopo; Umulisa, M Chantal; Snijders, Peter J F; Uyterlinde, Anne M; Lazzarato, Fulvio; Tenet, Vanessa; Gatera, Maurice; Binagwaho, Agnes; Clifford, Gary M

    2016-05-24

    Cervical cancer is the most common female cancer in Rwanda that, in 2011, became the first African country to implement a national vaccination programme against human papillomavirus (HPV). To provide a robust baseline for future evaluations of vaccine effectiveness, cervical cell specimens were obtained from 2508 women aged 18-69 years from the general population in Kigali, Rwanda, during 2013/14. 20 % of women were HIV-positive. Samples were used for liquid-based cytology and HPV testing (44 types) with GP5+/6+ PCR. HPV prevalence was 34 %, being highest (54 %) in women ≤19 years and decreasing to 20 % at age ≥50. Prevalence of high risk (HR) HPV and cytological abnormalities was 22 and 11 % respectively (including 2 % with high-grade squamous intraepithelial lesions, HSIL) decreasing with age. Age-standardised prevalence of HR HPV was 22 % (or 19 % among HIV-negative women), and HPV16 was the most common type. Prevalence of HPV and cytological abnormalities were significantly higher in HIV-positive than HIV-negative women, and the difference increased with age. Other significant risk factors for HPV positivity in multivariate analyses were high lifetime number of sexual partners, receiving cash for sex, and being a farmer. 40 % of women with HSIL were infected with HPV16/18 and there was no significant difference between HIV-positive and HIV-negative women. This study confirms Rwanda to be a setting of high prevalence of HPV and cervical disease that is worsened by HIV. These data will serve as a robust baseline for future evaluations of HPV vaccine programme effectiveness.

  9. Implementation of national palliative care guidelines in Swedish acute care hospitals: A qualitative content analysis of stakeholders' perceptions.

    Science.gov (United States)

    Lind, S; Wallin, L; Brytting, T; Fürst, C J; Sandberg, J

    2017-11-01

    In high-income countries a large proportion of all deaths occur in hospitals. A common way to translate knowledge into clinical practice is developing guidelines for different levels of health care organisations. During 2012, national clinical guidelines for palliative care were published in Sweden. Later, guidance for palliative care was issued by the National Board of Health and Welfare. The aim of this study was two-fold: to investigate perceptions regarding these guidelines and identify obstacles and opportunities for implementation of them in acute care hospitals. Interviews were conducted with local politicians, chief medical officers and health professionals at acute care hospitals. The Consolidated Framework for Implementation Research was used in a directed content analysis approach. The results showed little knowledge of the two documents at all levels of the health care organisation. Palliative care was primarily described as end of life care and only few of the participants talked about the opportunity to integrate palliative care early in a disease trajectory. The environment and culture at hospitals, characterised by quick decisions and actions, were perceived as obstacles to implementation. Health professionals' expressed need for palliative care training is an opportunity for implementation of clinical guidelines. There is a need for further implementation of palliative care in hospitals. One option for further research is to evaluate implementation strategies tailored to acute care. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Characteristics and Outcome of Patients With AIDS in Dutch ICUs Between 1997 and 2014

    NARCIS (Netherlands)

    Huson, Michaëla A.; Bakhshi-Raiez, Ferishta; Grobusch, Martin P.; de Jonge, Evert; de Keizer, Nicolette F.; van der Poll, Tom

    2016-01-01

    Knowledge on characteristics and outcome of ICU patients with AIDS is highly limited. We aimed to determine the main reasons for admission and outcome in ICU patients with AIDS and trends over time therein. A retrospective study within the Dutch National Intensive Care Evaluation registry. Dutch

  11. Description and earlier quality review of the Dutch educational system (primary and secondary education)

    NARCIS (Netherlands)

    Scheerens, Jaap; Scheerens, J; Luyten, H.; van Ravens, J.

    2011-01-01

    The chapter starts out with a brief overview of the structure of the Dutch education system. As compared to other national educational systems the Dutch secondary school system is strongly differentiated, featuring several separate school categories and sub-categories. Next, attention is paid to

  12. Dutch Sport Federations Changing into Market Oriented Organizations: The Institutional Theory Applied on Three Case Studies

    NARCIS (Netherlands)

    Marije van 't Verlaat

    2007-01-01

    In 2005 and 2006, almost sixty Dutch National Sport Federations (NSFs) participated in a special program for creating a marketing strategy for the next four years. This program was initiated and organized by NOC*NSF (the Dutch Olympic Umbrella Sports Organization). The NSFs had to joint the project

  13. SEX-DIFFERENCES AMONG RECIPIENTS OF BENZODIAZEPINES IN DUTCH GENERAL-PRACTICE

    NARCIS (Netherlands)

    van der Waals, F. W.; Mohrs, J.; Foets, M.

    1993-01-01

    Objective-To analyse sex differences among recipients of benzodiazepines in Dutch general practice. Design-Study of consultations and associated interventions as recorded in the Dutch national survey of general practice. Setting-Practices of 45 general practitioners monitored during 1 April to 30

  14. Project New Dutch Waterline and Project Arcadian Landscapes : Guidelines for new spatial development based in heritage

    NARCIS (Netherlands)

    Verschuure, G.A.

    2014-01-01

    Fifteen years have passed since the start of the national project New Dutch Waterline, presented as an illustrative example of a renewed approach of which spatial design was cross linked to heritage, for it described in the Nota Belvedere (Feddes, 1999). From 1815 until 1940 the New Dutch Waterline

  15. Building a house on shifting sand: methodological considerations when evaluating the implementation and adoption of national electronic health record systems

    Directory of Open Access Journals (Sweden)

    Takian Amirhossein

    2012-04-01

    Full Text Available Abstract Background A commitment to Electronic Health Record (EHR systems now constitutes a core part of many governments’ healthcare reform strategies. The resulting politically-initiated large-scale or national EHR endeavors are challenging because of their ambitious agendas of change, the scale of resources needed to make them work, the (relatively short timescales set, and the large number of stakeholders involved, all of whom pursue somewhat different interests. These initiatives need to be evaluated to establish if they improve care and represent value for money. Methods Critical reflections on these complexities in the light of experience of undertaking the first national, longitudinal, and sociotechnical evaluation of the implementation and adoption of England’s National Health Service’s Care Records Service (NHS CRS. Results/discussion We advance two key arguments. First, national programs for EHR implementations are likely to take place in the shifting sands of evolving sociopolitical and sociotechnical and contexts, which are likely to shape them in significant ways. This poses challenges to conventional evaluation approaches which draw on a model of baseline operations → intervention → changed operations (outcome. Second, evaluation of such programs must account for this changing context by adapting to it. This requires careful and creative choice of ontological, epistemological and methodological assumptions. Summary New and significant challenges are faced in evaluating national EHR implementation endeavors. Based on experiences from this national evaluation of the implementation and adoption of the NHS CRS in England, we argue for an approach to these evaluations which moves away from seeing EHR systems as Information and Communication Technologies (ICT projects requiring an essentially outcome-centred assessment towards a more interpretive approach that reflects the situated and evolving nature of EHR seen within

  16. Building a house on shifting sand: methodological considerations when evaluating the implementation and adoption of national electronic health record systems.

    Science.gov (United States)

    Takian, Amirhossein; Petrakaki, Dimitra; Cornford, Tony; Sheikh, Aziz; Barber, Nicholas

    2012-04-30

    A commitment to Electronic Health Record (EHR) systems now constitutes a core part of many governments' healthcare reform strategies. The resulting politically-initiated large-scale or national EHR endeavors are challenging because of their ambitious agendas of change, the scale of resources needed to make them work, the (relatively) short timescales set, and the large number of stakeholders involved, all of whom pursue somewhat different interests. These initiatives need to be evaluated to establish if they improve care and represent value for money. Critical reflections on these complexities in the light of experience of undertaking the first national, longitudinal, and sociotechnical evaluation of the implementation and adoption of England's National Health Service's Care Records Service (NHS CRS). We advance two key arguments. First, national programs for EHR implementations are likely to take place in the shifting sands of evolving sociopolitical and sociotechnical and contexts, which are likely to shape them in significant ways. This poses challenges to conventional evaluation approaches which draw on a model of baseline operations → intervention → changed operations (outcome). Second, evaluation of such programs must account for this changing context by adapting to it. This requires careful and creative choice of ontological, epistemological and methodological assumptions. New and significant challenges are faced in evaluating national EHR implementation endeavors. Based on experiences from this national evaluation of the implementation and adoption of the NHS CRS in England, we argue for an approach to these evaluations which moves away from seeing EHR systems as Information and Communication Technologies (ICT) projects requiring an essentially outcome-centred assessment towards a more interpretive approach that reflects the situated and evolving nature of EHR seen within multiple specific settings and reflecting a constantly changing milieu of policies

  17. Developing Leadership in Managers to Facilitate the Implementation of National Guideline Recommendations: A Process Evaluation of Feasibility and Usefulness

    Directory of Open Access Journals (Sweden)

    Malin Tistad

    2016-08-01

    Full Text Available Background: Previous research supports the claim that managers are vital players in the implementation of clinical practice guidelines (CPGs, yet little is known about interventions aiming to develop managers’ leadership in facilitating implementation. In this pilot study, process evaluation was employed to study the feasibility and usefulness of a leadership intervention by exploring the intervention’s potential to support managers in the implementation of national guideline recommendations for stroke care in outpatient rehabilitation. Methods: Eleven senior and frontline managers from five outpatient stroke rehabilitation centers participated in a fourmonth leadership intervention that included workshops, seminars, and teleconferences. The focus was on developing knowledge and skills to enhance the implementation of CPG recommendations, with a particular focus on leadership behaviors. Each dyad of managers was assigned to develop a leadership plan with specific goals and leadership behaviors for implementing three rehabilitation recommendations. Feasibility and usefulness were explored through observations and interviews with the managers and staff members prior to the intervention, and then one month and one year after the intervention. Results: Managers considered the intervention beneficial, particularly the participation of both senior and frontline managers and the focus on leadership knowledge and skills for implementing CPG recommendations. All the managers developed a leadership plan, but only two units identified goals specific to implementing the three stroke rehabilitation recommendations. Of these, only one identified leadership behaviors that support implementation. Conclusion: Managers found that the intervention was delivered in a feasible way and appreciated the focus on leadership to facilitate implementation. However, the intervention appeared to have limited impact on managers’ behaviors or clinical practice at the

  18. Developing Leadership in Managers to Facilitate the Implementation of National Guideline Recommendations: A Process Evaluation of Feasibility and Usefulness

    Science.gov (United States)

    Tistad, Malin; Palmcrantz, Susanne; Wallin, Lars; Ehrenberg, Anna; Olsson, Christina B.; Tomson, Göran; Holmqvist, Lotta Widén; Gifford, Wendy; Eldh, Ann Catrine

    2016-01-01

    Background: Previous research supports the claim that managers are vital players in the implementation of clinical practice guidelines (CPGs), yet little is known about interventions aiming to develop managers’ leadership in facilitating implementation. In this pilot study, process evaluation was employed to study the feasibility and usefulness of a leadership intervention by exploring the intervention’s potential to support managers in the implementation of national guideline recommendations for stroke care in outpatient rehabilitation. Methods: Eleven senior and frontline managers from five outpatient stroke rehabilitation centers participated in a four-month leadership intervention that included workshops, seminars, and teleconferences. The focus was on developing knowledge and skills to enhance the implementation of CPG recommendations, with a particular focus on leadership behaviors. Each dyad of managers was assigned to develop a leadership plan with specific goals and leadership behaviors for implementing three rehabilitation recommendations. Feasibility and usefulness were explored through observations and interviews with the managers and staff members prior to the intervention, and then one month and one year after the intervention. Results: Managers considered the intervention beneficial, particularly the participation of both senior and frontline managers and the focus on leadership knowledge and skills for implementing CPG recommendations. All the managers developed a leadership plan, but only two units identified goals specific to implementing the three stroke rehabilitation recommendations. Of these, only one identified leadership behaviors that support implementation. Conclusion: Managers found that the intervention was delivered in a feasible way and appreciated the focus on leadership to facilitate implementation. However, the intervention appeared to have limited impact on managers’ behaviors or clinical practice at the units. Future

  19. Dutch Colonial Nostalgia Across Decolonisation

    NARCIS (Netherlands)

    Bijl, P.

    2013-01-01

    This article argues that nostalgia for colonialism in the Netherlands, the so called tempo doeloe culture, is not a specifically postcolonial phenomenon caused by the collapse of the Dutch empire in Asia. In fact, nostalgia for the Dutch East Indies can be traced back to the nineteenth century, when

  20. Income smoothing by Dutch hospitals

    NARCIS (Netherlands)

    Boterenbrood, D.R.

    2014-01-01

    Research indicates that hospitals manage their earnings. However, these findings might be influenced by methodological issues. In this study, I exploit specific features of Dutch hospitals to study income smoothing while limiting these methodological issues. The managers of Dutch hospitals have the

  1. The Dutch surgical colorectal audit

    NARCIS (Netherlands)

    van Leersum, N. J.; Snijders, H. S.; Henneman, D.; Kolfschoten, N. E.; Gooiker, G. A.; ten Berge, M. G.; Eddes, E. H.; Wouters, M. W. J. M.; Tollenaar, R. A. E. M.; Bemelman, W. A.; van Dam, R. M.; Elferink, M. A.; Karsten, Th M.; van Krieken, J. H. J. M.; Lemmens, V. E. P. P.; Rutten, H. J. T.; Manusama, E. R.; van de Velde, C. J. H.; Meijerink, W. J. H. J.; Wiggers, Th; van der Harst, E.; Dekker, J. W. T.; Boerma, D.

    2013-01-01

    In 2009, the nationwide Dutch Surgical Colorectal Audit (DSCA) was initiated by the Association of Surgeons of the Netherlands (ASN) to monitor, evaluate and improve colorectal cancer care. The DSCA is currently widely used as a blueprint for the initiation of other audits, coordinated by the Dutch

  2. 75 FR 41685 - Implementation of the National HIV/AIDS Strategy

    Science.gov (United States)

    2010-07-16

    .... The actions we take now will build upon a legacy of global leadership, national commitment, and... our national response to HIV/AIDS. Today I am releasing a National HIV/AIDS Strategy for the United..., moreover, is not enough. Success will require the commitment of all parts of society, including businesses...

  3. DoD Implementation of the National Practitioner Data Bank Guidelines

    National Research Council Canada - National Science Library

    1998-01-01

    ... of their previous damaging or incompetent performance. The primary evaluation objective was to determine the Military Departments' overall effectiveness in implementing the NPDB program guidelines...

  4. The constraints of good governance practice in national solid waste management policy (NSWMP) implementation: A case study of Malaysia

    Science.gov (United States)

    Wee, Seow Ta; Abas, Muhamad Azahar; Chen, Goh Kai; Mohamed, Sulzakimin

    2017-10-01

    Nowadays, international donors have emphasised on the adoption of good governance practices in solid waste management which include policy implementation. In Malaysia, the National Solid Waste Management Policy (NSWMP) was introduced as the main guideline for its solid waste management and the Malaysian government has adopted good governance practice in the NSMWP implementation. However, the good governance practices implemented by the Malaysian government encountered several challenges. This study was conducted to explore the good governance constraints experienced by stakeholders in the NSWMP implementation. An exploratory research approach is applied in this study through in-depth interviews with several government agencies and concessionaires that involved in the NSWMP implementation in Malaysia. A total of six respondents took part in this study. The findings revealed three main good governance constraints in the NSWMP implementation, namely inadequate fund, poor staff's competency, and ambiguity of policy implementation system. Moreover, this study also disclosed that the main constraint influenced the other constraints. Hence, it is crucial to identify the main constraint in order to minimise its impact on the other constraints.

  5. The New International Nuclear Liability Conventions: Status of their Implementation into National Legislation

    International Nuclear Information System (INIS)

    Schwartz, J.

    2008-01-01

    Protocols, it was initially hoped that they would be ratified and come into force towards the end of 2006. Those hopes have obviously not been realised but the 16 Signatories to those Protocols are clearly progressing towards ratification and implementation of those instruments into their national legislation. Complying with the financial security requirements under the PC Protocol has proved to be a particularly thorny problem, and governments, operators and the insurance industry are attempting to address this problem in various ways. The OECD/NEA is trying to help its member countries find a reasonable solution(s) to this issue but the political and financial aspects are not always easily reconciled. It is equally possible that this same problem is inhibiting states from joining the VC Protocol or the CSC, both of which contain similar financial security requirements to those found in the PC Protocol. The need for international co-operation to attract a larger number of adherents to these various instruments, to facilitate their ratification and to assist in the adoption of appropriate implementing legislation therefore remains a high priority amongst the international nuclear community.(author)

  6. Dutch radiodiagnostics viewed internationally

    International Nuclear Information System (INIS)

    Valois, J.C. de

    1990-01-01

    Dutch radiodiagnostics viewed internationally. - A quantitative description of diagnostic radiology is given in terms of radiological density (the number of radiological examinations per 1000 inhibitants), consumptions of roentgen film and contrast media. The data concerning examinations were recorded by a yearly inquiry system addressing all Dutch radiologists. The consumption of film and contrast media were derived from the data banks of the industries. In comparing these data with the data for Western Europe, Japan and the United States it is remarkable that diagnostic radiology scores lowest in regard to density, film consumption and use of contrast media. Only in the use of 35 mm cinefilm (coronary angiography) is The Netherlands number 2 on the list preceded by the United States. As a consequence radiation exposure of the population caused by diagnostic radiology is low in The Netherlands. Although the technical condition of the equipment is good due to regular and preventive service the life-span of the radiological equipment is gradually increasing beyond the limits of the normal economic depreciation. Growing arrears are found in the application of new technology: ultrasound, computer tomography and magnetic resonance imaging. The substitution of high osmolar contrast media by low osmolar media is also laggin gbehind. (author). 10 refs.; 1 fig.; 4 tab

  7. Dutch offshore skills assessed

    Energy Technology Data Exchange (ETDEWEB)

    Schaap, P

    1988-11-01

    The position is described of the different Dutch industries involved in the oil and gas exploitation business in the North Sea. Mentioned are, in the first place, the activities of towing services Smit Tak, and Wijsmuller. A well known drilling contractor is Neddrill. Drilling rigs are often designed in cooperation with consulting engineers firms Protech International, Heerema Engineering, Global Engineering, KTI, Fluor, and Tebodin. Drilling rigs constructors Grootint, Mercon Steel Structures, Heerema Havenbedrijf, HCG, Boele, and IHC have a sound name in the offshore construction scene. Offshore contractors like Heerema, Smit Tak, Volker Stevin and Allseas Engineering should be mentioned too. Special attention is given to the operation of saving drilling rigs in the Ekofisk field. Years of exploitation of oil and gas from this field resulted in subsidence of the sea floor, which endangered the drilling rigs. Hydraudyne designed the hydraulic lifter necessary for this saving operation. Dutch firms in this field have an estimated yearly turnover of Dfl 3 x 10/sup 9/. 6 figs.

  8. Evaluating the implementation of a national clinical programme for diabetes to standardise and improve services: a realist evaluation protocol.

    Science.gov (United States)

    McHugh, S; Tracey, M L; Riordan, F; O'Neill, K; Mays, N; Kearney, P M

    2016-07-28

    Over the last three decades in response to the growing burden of diabetes, countries worldwide have developed national and regional multifaceted programmes to improve the monitoring and management of diabetes and to enhance the coordination of care within and across settings. In Ireland in 2010, against a backdrop of limited dedicated strategic planning and engrained variation in the type and level of diabetes care, a national programme was established to standardise and improve care for people with diabetes in Ireland, known as the National Diabetes Programme (NDP). The NDP comprises a range of organisational and service delivery changes to support evidence-based practices and policies. This realist evaluation protocol sets out the approach that will be used to identify and explain which aspects of the programme are working, for whom and in what circumstances to produce the outcomes intended. This mixed method realist evaluation will develop theories about the relationship between the context, mechanisms and outcomes of the diabetes programme. In stage 1, to identify the official programme theories, documentary analysis and qualitative interviews were conducted with national stakeholders involved in the design, development and management of the programme. In stage 2, as part of a multiple case study design with one case per administrative region in the health system, qualitative interviews are being conducted with frontline staff and service users to explore their responses to, and reasoning about, the programme's resources (mechanisms). Finally, administrative data will be used to examine intermediate implementation outcomes such as service uptake, acceptability, and fidelity to models of care. This evaluation is using the principles of realist evaluation to examine the implementation of a national programme to standardise and improve services for people with diabetes in Ireland. The concurrence of implementation and evaluation has enabled us to produce formative

  9. Characteristics of children and adolescents in the Dutch national in- and outpatient mental health service for deaf and hard of hearing youth over a period of 15 years.

    Science.gov (United States)

    van Gent, Tiejo; Goedhart, Arnold W; Treffers, Philip D A

    2012-01-01

    In this study socio-demographic, deafness-related and diagnostic characteristics of hearing impaired children and adolescents referred to a national mental health service for deaf and hard of hearing children and adolescents were examined. Socio-demographic and diagnostic characteristics were compared to corresponding characteristics of hearing referred peers with identified mental health problems. The difference in characteristics between them and hearing referred peers with identified mental health problems was analyzed. A total of 389 deaf and hard of hearing and 3361 hearing children and adolescents was extracted from a database, all first referrals of patients of a center for child and adolescent psychiatry over a 15-year period. With deaf and hard of hearing patients we found higher rates of environmental stress, as indicated by conditions such as more one parent families (38.6% versus 25.8%), and more parents with a low educational level (44.2% versus 31.1%). Moreover, deaf and hard of hearing patients were older at their first referral (10.8 versus 9.4 years) and had higher rates of pervasive developmental disorders (23.7% versus 12.3%) and mental retardation (20.3% versus 3.9%). Within the target group of deaf and hard of hearing patients, most patients were deaf (68.9%; 22.3% was severely hard of hearing), relatively few (13.7%) had a non-syndromal hereditary hearing impairment, and more (21.3%) had a disabling physical health condition, especially those with a pervasive developmental disorder (42.6%). These findings illustrate both the complexity of the problems of deaf and hard of hearing children and adolescents referred to specialist mental health services, and the need for preventive interventions aimed at early recognition. Copyright © 2012 Elsevier Ltd. All rights reserved.

  10. Ribotype 078 Clostridium difficile infection incidence in Dutch hospitals is not associated with provincial pig farming: Results from a national sentinel surveillance, 2009-2015.

    Directory of Open Access Journals (Sweden)

    Sofie M van Dorp

    Full Text Available It has been suggested that the high incidence of ribotype 078 Clostridium difficile infections (CDI in the Netherlands is related to pig farming.We used data of hospitalised CDI patients (>2yrs of age diagnosed between May 2009 and May 2015 in 26 hospitals participating in a national sentinel surveillance. We compared clinical and geographical characteristics of 078 CDI to other CDI. We investigated the association between 078 CDI incidence and four indicators of pig farming (piglet, pig, piglet farm and pig farm density by mixed-effects Poisson regression. We used a space-time permutation model to search for community-onset 078 CDI clusters (using SaTScan.A total of 4,691 CDI were identified. Ribotype 078 was isolated in 493 of 3,756 patients (13.1% including a typing result. These patients had slightly higher community-onset disease and a 35% increase of 30-day mortality compared to non-078 CDI patients. The pooled overall and 078 incidence rates were 2.82 (95% CI, 2.42-3.29 and 0.26 (95% CI, 0.21-0.31 CDI per 10,000 patients-days respectively. Hospital 078 CDI incidence was not associated with provincial pig (IRR, 0.98; 95% CI, 0.89-1.08, piglet (IRR, 0.95; 95% CI, 0.75-1.19, pig farm (IRR, 1.08; 95% CI, 0.84-1.39, or piglet farm density (IRR, 1.00; 95% CI, 0.56-1.79. No clusters of community-onset ribotype 078 CDI were found.Our results do not indicate that the ribotype 078 CDI incidence in hospitals is related to pig (farm or piglet (farm density. However, transmission beyond provincial borders or in non-hospitalised patients cannot be excluded.

  11. Empowerment Patterns of Leaders in ICT and School Strengths Following the Implementation of National ICT Reform

    Science.gov (United States)

    Avidov-Ungar, Orit; Shamir-Inbal, Tamar

    2013-01-01

    The Ministry of Education in Israel has, over the past two years, been running an education program designed to lead the implementation of ICT (Information and Communications Technology) in schools. Implementation of the program is accompanied by training and support of teachers selected to be ICT leaders. The role of the ICT leader is divided to…

  12. Implementing CRM System in a Global Organization National vs. Organizational Culture

    DEFF Research Database (Denmark)

    Frygell, Linda; Hedman, Jonas; Carlsson, Sven

    2017-01-01

    global subsidiaries, and has planned the implementation well, the implementation was not a complete success. The study has identified that the cultural factor are important, but not stressed enough in the current CRM literature. Understanding the difference between the organizational culture in which...

  13. Gerontology and geriatrics in Dutch medical education.

    Science.gov (United States)

    Tersmette, W; van Bodegom, D; van Heemst, D; Stott, D; Westendorp, R

    2013-01-01

    The world population is ageing and healthcare services require trained staff who can address the needs of older patients. In this study we determined how current medical education prepares Dutch students of medicine in the field of Gerontology and Geriatrics (G&G). Using a checklist of the essentials of G&G, we assessed Dutch medical education on three levels. On the national level we analysed the latest National Blueprint for higher medical education (Raamplan artsopleiding 2009). On the faculty level we reviewed medical curricula on the basis of interviews with program directors and inspection of course materials. On the student level we assessed the topics addressed in the questions of the cross-institutional progress test (CIPT). The National Bluepr int contains few specific G&G objectives. Obligatory G&G courses in medical schools on average amount to 2.2% of the total curriculum measured as European Credit Transfer System units (ECTS). Only two out of eight medical schools have practical training during the Master phase in the form of a clerkship in G&G. In the CIPT, on average 1.5% of questions cover G&G. Geriatric education in the Netherlands does not seem to be in line with current demographic trends. The National Blueprint falls short of providing sufficiently detailed objectives for education on the care of older people. The geriatric content offered by medical schools is varied and incomplete, and students are only marginally tested on their knowledge of G&G in the CIPT.

  14. National measures required by the implementation of the climate convention and the Kyoto Protocol in Finland. Report by the Committee on National Climate Policy Measures

    International Nuclear Information System (INIS)

    2002-12-01

    The task of the Committee was to develop the administrative framework for the national measures that the UN Climate Convention and the implementation of the Kyoto Protocol require in Finland. The Committee proposes that a ministerial working group should continue to act in the Government to draft and implement the climate policy, assisted by a contact network representing the central ministries. The Committee recommends that Finland should have a national climate strategy that would be updated at two or three year's intervals. The drafting, implementation and monitoring of the Climate Strategy should be under the steering of the ministerial working group. In drafting and implementation of the strategy, the responsible ministry would be the one whose minister is the Chairman of the ministerial working group. The evaluation reports on the impacts of policy measures reducing greenhouse gases would be drawn up as part of the strategy's implementation. The Ministry of Trade and Industry would coordinate the scenarios that examine greenhouse gas emissions and that are required by the climate policy in practice. The drafting of the scenarios would be steered by the ministerial working group assisted by a contact network Expert institutions would participate both in the drafting and implementation of the strategy and in the follow-up of the implementation by producing the necessary surveys. In the Committee's opinion, international climate negotiations should still be under the drafting responsibility of the Ministry of the Environment. The Committee suggests that Statistics Finland should be appointed as the inventory entity of greenhouse gases and that a temporary steering group chaired by the Ministry of the Environment, representing all the central ministries and expert institutes, should be set up to assist and steer the national system calculating greenhouse gas emissions. The initial distribution according to the proposal for an EC Directive on emissions trading

  15. Soil processes as a guiding principle in precision agriculture : a case study for Dutch arable farming

    NARCIS (Netherlands)

    Alphen, van J.

    2002-01-01

    The fact that conventional agricultural practices have many detrimental effects is widely acknowledged (Rabbinge, 1997). To mitigate these effects, Dutch policy makers have implemented environmental laws that are essentially based on characteristic indicators for groundwater quality. This

  16. Opportunities for Dutch Roadmap Biorefineries

    International Nuclear Information System (INIS)

    Annevelink, E.; Broeze, J.; Van Ree, R.

    2009-09-01

    This Dutch Roadmap Biorefinery forms the framework and knowledge basis for Research, Development and Demonstration (RD and D) activities, covering both technical and non-technical issues, necessary to develop biorefinery-based value chains to such an extend that large-scale market implementation as part of the future Bio-based Economy will become a reality. The Roadmap describes the broad landscape of biorefinery options in The Netherlands. The descriptions of possible initiatives within the so called Moonshots (general biorefinery strategies containing more specific biorefinery-based value chains that will become fully operational at industrial scale in the short and midterm to facilitate the transition to a Bio-based Economy in the longer-term) deliberately do not contain the names of parties that might be involved. However, many of the current initiatives have been described in another document, the 'Status Report Biorefinery 2007'. Also the exact economics of possible initiatives have not been specified yet. These will become clearer when proposals will be submitted by consortia of the stakeholders involved.

  17. Dutch wastes in figures. Data 2006-2010; Nederlands afval in cijfers. Gegevens 2006-2010

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2013-02-15

    The progress of the implementation of the National Waste Management Plan 2009-2021 (LAP2) is presented in two separate reports: this monitoring report, with detailed justification of the numerical monitoring, and the progress report LAP, containing a representation of the implementation of the LAP and the state of affairs with regard to the policy objectives set out in the LAP [Dutch] De voortgang van de uitvoering van het Landelijk afvalbeheerplan 2009-2021 (LAP2) wordt gepresenteerd in twee afzonderlijke rapportages: deze monitoringrapportage, met in detail een verantwoording van de getalsmatige monitoring, en de voortgangsrapportage LAP, met daarin een weergave van de uitvoering van het LAP en de stand van zaken met betrekking tot de in het LAP gestelde beleidsdoelen.

  18. Fundamental bases to implementation the specific national norm for nuclear gauges

    International Nuclear Information System (INIS)

    Ferreira, L.C.; Silva, E.R.; Ferreira, R.; Peixoto, J.G.P.

    2017-01-01

    The aims of this work is to provide grounds for creation a national standard practice security and responsibility in the use of nuclear gauges in accordance with the national recommendation already exist, following the basic security principles, responsibilities of these involved in the acquisition, operation, storage, maintenance and post-emergency on use of nuclear gauges. (author)

  19. [An overview of the definition and implementation of the Brazilian National Policy on Health Data and Information Technology].

    Science.gov (United States)

    Cavalcante, Ricardo Bezerra; Kerr-Pinheiro, Marta Macedo; Guimarães, Eliete Albano de Azevedo; Miranda, Richardson Machado

    2015-05-01

    The This qualitative study aimed to analyze the development and implementation of the Brazilian National Policy on Health Data and Information Technology (NPIIH). We analyzed documents and applied an online questionnaire to the experts involved in developing the policy. The data were submitted to content analysis using the categorical thematic modality. The PNIIS is the target of debate and proposals at various levels. Provisions have appeared in parallel to regulate measures on health data and information technology. Community participation in developing this policy and the convergence of laws, standards, resolutions, and policy-making levels in a common and broadly acknowledged and enforced policy are challenges, in addition to linking the public and private sectors. The study concludes that the National Policy on Health Data and Information Technology is making gradual progress, predominantly in theoretical debates, revisions, and updates. There are numerous challenges for its implementation and a prevailing need for legitimation.

  20. Design and implementation of a slow orbit control package at Thomas Jefferson National Accelerator Facility

    International Nuclear Information System (INIS)

    Zeijts, J. van; Witherspoon, S.; Watson, W.A.

    1997-01-01

    The authors describe the design and implementation of a C++ client/server based slow orbit and energy control package based on the CDEV software control bus. Several client applications are described and operational experience is given

  1. A review of the National pharmacovigilance system in Malta - implementing and operating a pharmacovigilance management system.

    Science.gov (United States)

    Tanti, Amy; Micallef, Benjamin; Serracino-Inglott, Anthony; Borg, John-Joseph

    2017-01-01

    Regulatory authorities have a legal mandate to implement and maintain a Pharmacovigilance System designed to monitor the safety of authorised medicinal products and detect any change to their risk-benefit balance. Areas covered: This review maps the implementation of pharmacovigilance activities in Malta since accession in the EU in mid 2004 and discusses the challenges the Maltese Regulator encountered while setting up adequate and effective systems to fulfil its legal mandate. Areas reviewed are those around ADR reporting, promotion and safety communications including rapid alerts and recalls, direct healthcare professional communications, risk minimisation measures and safety circulars and quality systems. Expert opinion: Within a ten year period, 3 EU directives on pharmacovigilance were implemented by our agency. Despite limitations to resources, based on a prioritised implementation, the legislation provisions are now fully operational with a good level of sustainability. Lessons learnt from this process are discussed in this review. The coming years will involve strengthening and consolidation of existing processes.

  2. Convention on Nuclear Safety. Second national report on the implementation by france of the obligations of the Convention

    International Nuclear Information System (INIS)

    2001-09-01

    The first national report on the implementation by france of the obligation under the Convention is structured along its Articles. the french Nuclear safety Authority ensured the co ordination of the report, with contributions from other regulators and nuclear operators. this report was distributed at the middle of April 2003 to the other Contracting party (on 3 november to 14, 2003 at the IAEA headquarters. (author)

  3. International cooperation workshop on CTBTO international cooperation and national implementation for states from East and Southern Africa

    International Nuclear Information System (INIS)

    2002-09-01

    In pursuant to its 2002 programme of work, the Provisional Technical Secretariat (PTS) of the Preparatory Commission of the Comprehensive Nuclear-Test-Ban Treaty Organization organized a workshop on CTBTO international cooperation and national implementation for states from East and Southern Africa in Nairobi, Kenya, from 18 to 20 June 2002. The summary report on the workshop has been provided, covering ways and means of promoting regional cooperation. The list of participants and the programme outline are annexed thereto

  4. International cooperation workshop on CTBTO international cooperation and national implementation for states from East and Southern Africa

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2002-09-01

    In pursuant to its 2002 programme of work, the Provisional Technical Secretariat (PTS) of the Preparatory Commission of the Comprehensive Nuclear-Test-Ban Treaty Organization organized a workshop on CTBTO international cooperation and national implementation for states from East and Southern Africa in Nairobi, Kenya, from 18 to 20 June 2002. The summary report on the workshop has been provided, covering ways and means of promoting regional cooperation. The list of participants and the programme outline are annexed thereto.

  5. Energy. Policy and Implementation

    International Nuclear Information System (INIS)

    Stroop, A.

    2006-01-01

    Why does the government have an energy policy? What form does it take? Who is involved in implementing that policy? These and similar questions are answered in the latest Energy Report. The Dutch Ministry of Economic Affairs (EZ) argues that the objectives are feasible as long as the energy policies are matched by suitable implementation measures [nl

  6. Anything but engaged: user involvement in the context of a national electronic health record implementation

    Directory of Open Access Journals (Sweden)

    Kathrin Cresswell

    2011-07-01

    Conclusions This work has allowed us to further develop an existing model of user engagement from the commercial sector and adapt it to inform user engagement in the context of large-scale eHealth implementations. By identifying key points of possible engagement, disengagement and re-engagement, this model will we hope both help those planning similar large-scale EHR implementation efforts and act as a much needed catalyst to further research in this neglected field of enquiry.

  7. Economics of forests and REDD+ projects: Translating lessons learned into national REDD+ implementation

    Energy Technology Data Exchange (ETDEWEB)

    Zaballa Romero, M.; Traerup, S.; Wieben, E.; Ravnkilde Moeller, L.; Koch, A.

    2012-11-15

    The financial implications of implementing a new forest management paradigm have not been well understood and have often been underestimated. Resource needs for e.g., stakeholder consultation, capacity building and addressing the political economy are seldom fully accounted for in the resource needs estimates put forward in connection to REDD+. This report investigates the economics of implementing forest and REDD+ projects through eight case studies from Africa, Latin America and Asia, analyzing real forest and REDD+ investments. (Author)

  8. The implementation of national and European environmental legislation in Germany: three case studies

    Energy Technology Data Exchange (ETDEWEB)

    Bueltmann, A.; Waetzold, F. [UFZ - Umweltforschungszentrum Leipzig-Halle GmbH, Leipzig (Germany). Sektion Oekonomie, Soziologie und Recht

    2000-07-01

    This report traces the implementation of the EMAS Regulation in Germany, i.e. it describes what kind of an institutional setting was chosen, in what way it was established and how it is working in practice. Moreover, the outcome of the implementation process is analysed in terms of efficiency and environmental effectiveness. To gain the relevant data and information we conducted expert interviews, reviewed the relevant literature and carried out a questionnaire survey. Chapter 2 provides some background information about EMAS, including the main contents of the EMAS Regulation and the political process that preceded the adoption of the EMAS Regulation and the implementation requirements imposed on the Member States. Chapter 3 describes the implementation of the EMAS Regulation and companies' motives to participate in the scheme. In chapter 4 the outcome of the implementation process is assessed in terms of the attainment of the Regulation's environmental goals and efficiency. To this end the criteria of efficiency (allocative, productive and administrative efficiency) and environmental effectiveness are adapted to the case of EMAS and indicators are developed for their assessment. Finally, data for the indicators are provided for Germany. Chapter 5 develops some hypotheses on how goal attainment and efficiency have been influenced by specific features of the implementation process. (orig.)

  9. The association between implementation strategy use and the uptake of hepatitis C treatment in a national sample.

    Science.gov (United States)

    Rogal, Shari S; Yakovchenko, Vera; Waltz, Thomas J; Powell, Byron J; Kirchner, JoAnn E; Proctor, Enola K; Gonzalez, Rachel; Park, Angela; Ross, David; Morgan, Timothy R; Chartier, Maggie; Chinman, Matthew J

    2017-05-11

    Hepatitis C virus (HCV) is a common and highly morbid illness. New medications that have much higher cure rates have become the new evidence-based practice in the field. Understanding the implementation of these new medications nationally provides an opportunity to advance the understanding of the role of implementation strategies in clinical outcomes on a large scale. The Expert Recommendations for Implementing Change (ERIC) study defined discrete implementation strategies and clustered these strategies into groups. The present evaluation assessed the use of these strategies and clusters in the context of HCV treatment across the US Department of Veterans Affairs (VA), Veterans Health Administration, the largest provider of HCV care nationally. A 73-item survey was developed and sent to all VA sites treating HCV via electronic survey, to assess whether or not a site used each ERIC-defined implementation strategy related to employing the new HCV medication in 2014. VA national data regarding the number of Veterans starting on the new HCV medications at each site were collected. The associations between treatment starts and number and type of implementation strategies were assessed. A total of 80 (62%) sites responded. Respondents endorsed an average of 25 ± 14 strategies. The number of treatment starts was positively correlated with the total number of strategies endorsed (r = 0.43, p strategies endorsed (p strategies, compared to 15 strategies in the lowest quartile. There were significant differences in the types of strategies endorsed by sites in the highest and lowest quartiles of treatment starts. Four of the 10 top strategies for sites in the top quartile had significant correlations with treatment starts compared to only 1 of the 10 top strategies in the bottom quartile sites. Overall, only 3 of the top 15 most frequently used strategies were associated with treatment. These results suggest that sites that used a greater number of implementation

  10. Evidence-Based Programs for Older Adults: A Disconnect Between U.S. National Strategy and Local Senior Center Implementation.

    Science.gov (United States)

    Bobitt, Julie; Schwingel, Andiara

    2017-01-01

    While U.S. national policies have been developed to support evidence-based (EB) lifestyle programs for older adults, there has been limited research to determine the extent to which these programs actually reach local communities. This study sought to identify factors that impact the implementation of EB physical activity, nutrition, and chronic disease management programs at regional (Area Agencies on Aging [AAAs]) and community levels (senior Centers [SCs]). Interviews were conducted with directors of four AAAs and 12 SCs to understand their perspectives on EB program implementation. Narratives revealed differences between AAAs and SCs regarding knowledge about EB programs and reasons to promote and adopt these programs. The only agreement occurred when discussing concerns about funding and program inflexibility. Substantial gaps exist between how EB lifestyle programs are promoted and implemented at the regional and community levels.

  11. A study on the establishment of national regulatory framework for effective implementation of exemption or clearance concept

    International Nuclear Information System (INIS)

    Cheong, J.H.; Park, S.H.; Suk, T.W.

    1998-01-01

    The concepts of exemption and clearance have a lot of advantages in the aspects of effective use of limited resources, land, and optimization of regulatory works. The exact scopes and extent of the implementation of the concepts, however, can widely vary depending upon each country's own specific situations. In order to support the political decision-making on the practical implementation, a series of possible alternatives, general methodology for decision-making, and factors to be considered were proposed. Five primary categories and subsequent nineteen secondary categories were suggested and discussed, and four-step-approach was introduced in order to show the general guidelines for establishing an appropriate national regulatory framework. Though the specific procedure for each country to get to the practical implementation of the exemption and clearance concepts was not described, it is anticipated that the basic guidelines proposed in this paper can be used as a general reference. (author)

  12. EVALUATING THE EFFECTS OF THE IMPLEMENTATION OF IRAN NATIONAL QUALITY AWARD NEW MODEL (INQA IN IRANIAN ORGANIZATIONS

    Directory of Open Access Journals (Sweden)

    Mahmoud Zamani

    2014-09-01

    Full Text Available The aim of this study is to examine the effectiveness of the Iran National Quality Award new model (INQA in corporations that have implemented this model in Iran. This research aims to reveal the effects of implementation of Iran National Quality Award (INQA New Model on seven dimensions of the Iranian companies which indeed are seven core factors of this model, i.e. Management & leadership, People, Processes, Resources, Customer & consumer results, Environment & community results, and Performance results. A mail survey was conducted on a simple random sample of 210 organizations that have achieved certification or appreciation during the implementation of INQA model in four rounds. 400 questionnaires were randomly distributed and 392 complete and correct questionnaires were returned. Descriptive and inferential statistics were employed to analyze the data.Results indicated that the highest positive impact of INQA New Model on the improvement of organizational performance of the surveyed organizations was on customers' area. Performance results, leadership and management, processes improvement, environment and society results, and finally better utilization of organizational resources were respectively other areas which are affected mostly. Also, this study found no significant relationship between the implementation of this model and the improvement of employees' conditions in the surveyed organizations.

  13. A Proposal Towards a Dutch Caribbean Marine Mammal Sanctuary

    NARCIS (Netherlands)

    Debrot, A.O.; Witte, R.H.; Scheidat, M.; Lucke, K.

    2011-01-01

    Based on the goals set forth in the Dutch Biodiversity Policy Programme, The Netherlands has a traditionally strong commitment to protect biodiversity and marine mammals both internationally and in its own national and Kingdom waters. Last year the responsible ministry, namely the Netherlands

  14. Time for EU Matters: The Europeanization of Dutch Central Government

    NARCIS (Netherlands)

    Mastenbroek, E.; Princen, S.B.M.

    2010-01-01

    To what extent does the European Union (EU) affect national governments? This article seeks to answer this question by assessing the Europeanization of Dutch central government. Using data from a large-scale survey among civil servants, we assess to what extent the EU affects the structure and

  15. A security analysis of the Dutch electronic patient record system

    NARCIS (Netherlands)

    van 't Noordende, G.

    2010-01-01

    In this article, we analyze the security architecture of the Dutch Electronic Patient Dossier (EPD) system. Intended as a national infrastructure for exchanging medical patient records among authorized parties (particularly, physicians), the EPD has to address a number of requirements, ranging from

  16. Areas with special ecological values on the Dutch Continental Shelf

    NARCIS (Netherlands)

    Lindeboom, H.J.; Kessel, J.G.; Berkenbosch, L.

    2005-01-01

    In this report we are submitting proposals for the boundaries of areas on the Dutch Continental Shelf (DCS). In the National Spatial Strategy a conservation regime has been determined for five areas in the North Sea with special ecological values. RIKZ and Alterra have formulated this report in

  17. Environmental Knowledge, Attitudes, and Behavior in Dutch Secondary Education.

    Science.gov (United States)

    Kuhlemeier, Hans; van den Bergh, Huub; Lagerweij, Nijs

    1999-01-01

    In a national assessment program, 57% of Dutch ninth-grade students had a positive attitude towards the environment and 35% were prepared to make sacrifices for the environment. Student knowledge about environmental problems, however, was fragmentary and often incorrect. Environmentally responsible behavior was more strongly connected with the…

  18. Dutch intervention programmes for children of mentally ill parents

    NARCIS (Netherlands)

    Amelsvoort, T.A.M.J. van; Santvoort, F. van; Doesum, K.T.M. van

    2016-01-01

    Purpose: This presentation will present the outcomes of a practice-based and science-based Dutch initiative to develop a comprehensive national prevention programme focused on children of parents with a mental disorder. An outline of the multicomponent programme is presented which includes a wide

  19. Dutch Culture Wars : On the politics of gutting the arts

    NARCIS (Netherlands)

    Oudenampsen, M.; Kastner, Jens; Birkenstock, Eva; Hinderer Cruz, Max Jorge

    “No one is safe.” With these words Halbe Zijlstra, the State Secretary of Education, Culture and Science, announced the slashing of the cultural budget on the Dutch national news in December 2010. Whereas cutbacks are generally accompanied by at least the pretension of reluctance or regret, Zijlstra

  20. Organizational Strategies to Implement Hospital Pressure Ulcer Prevention Programs: Findings from a National Survey

    Science.gov (United States)

    SOBAN, LYNN M.; KIM, LINDA; YUAN, ANITA H.; MILTNER, REBECCA S.

    2017-01-01

    Aim To describe the presence and operationalization of organizational strategies to support implementation of pressure ulcer prevention programs across acute care hospitals in a large, integrated healthcare system. Background Comprehensive pressure ulcer programs include nursing interventions such as use of a risk assessment tool and organizational strategies such as policies and performance monitoring to embed these interventions into routine care. The current literature provides little detail about strategies used to implement pressure ulcer prevention programs. Methods Data were collected by an email survey to all Chief Nursing Officers in Veterans Health Administration acute care hospitals. Descriptive and bivariate statistics were used to summarize survey responses and evaluate relationships between some variables. Results Organizational strategies that support pressure ulcer prevention program implementation (policy, committee, staff education, wound care specialists, and use of performance data) were reported at high levels. Considerable variations were noted in how these strategies were operationalized within individual hospitals. Conclusion Organizational strategies to support implementation of pressure ulcer preventive programs are often not optimally operationalized to achieve consistent, sustainable performance. Implications for Nursing Management The results of this study highlight the role and influence of nurse leaders on pressure ulcer prevention program implementation. PMID:27487972