232451 research outputs found
Sort by
Healthcare utilization and costs for cardiovascular diseases across different levels of bundled payment adoption in general practice: A data linkage study
No full textBackground: Bundled payments for patients with cardiovascular diseases (CVD) aim to enhance primary care utilization in the Netherlands.Objective: This study assesses changes in healthcare utilization patterns and costs for CVD between 2014 and 2019, while investigating the potential association with bundled payment adoption.Method: We studied patients at very high risk for CVD with routinely recorded nationwide healthcare data, using an observational study design. Multilevel logistic- and gamma regressions were conducted to assess healthcare utilizations patterns between 2014 and 2019, and the impact of bundled payments on the likelihood of receiving medical specialist care and the height of associated costs.Results: The odds of medical specialist involvement declined over time for the 152,591 unique patients included in our study. Practices with a higher level of bundled payments had lower odds of medical specialist involvement. Medical specialist costs did also significantly decrease between 2014 and 2019, and patients in practices with the highest level of bundled payments had significantly lower medical specialist costs. When general practice costs were included however, healthcare costs per patient stayed the same, both over time and stratified by use of bundled payments.Conclusion: Our findings suggest an association between bundled payments and specialized healthcare use, potentially facilitating the transition to primary care. While we found no evidence for costs savings, our findings do suggest that due to bundled payments more patients are actively monitored
Facial expression of anger and self-reported anger in patients with functional neurological disorder
No full textObjective: Little is known about the way patients with FND express anger and to what extent self-reported anger differs from facially expressed anger. This study investigates whether patients with FND differ from healthy controls in facial anger expression and self-reported anger in response to anger-provoking situations. It also investigates the extent to which there is a mismatch in these responses. In addition, this study explores patients’ ability to intentionally express emotions.Methods: This case-control study is based on the EMIN-FND study (OnderzoekMetMensen.nl registration identifier: NL8004). In this study, video recordings of participants’ faces were made during an anger recall task and analyzed for facial anger expression using FaceReader software. Participants also reported how much anger they felt during the task. The extent of mismatch was calculated using the z-scores of the self-reported anger and facially expressed anger. The ability to intentionally express facial emotions was examined by analyzing 5-second expression periods.Results: Data of 66 patients with FND [mean age=42.3 (SD=16.3) y, 68.2% women] and 37 healthy controls [mean age=40.8 (SD=16.4) y, 56.8% women] revealed no differences in facial anger expression (P=.20), self-reported anger (P=.80), or mismatch (P=.19). Patients with FND were less able to intentionally express anger (U=934.5, z=1.971, P=.049), sadness (U=745.5, z=3.182, P=.001), and to show a neutral facial expression (U=880.0, z=2.245, P=.025).Conclusions: There was no significant difference between facially expressed and self-reported anger between patients with FND versus controls. Intentional expression of an angry, sad, or neutral face was attenuated in patients with FND
On relative income and life datisfaction: The moderating role of GDP per capita, culture and income inequality
No full textIn his seminal book ‘Social limits to growth’ Hirsch argues that the importance of positional goods (those things of which the value depends on how much other people own) increases with economic welfare. This would suggest that relative income affects subjective well-being more in rich countries than in poor countries. This paper tests this hypothesis by analysing the effect of relative income on life satisfaction in 101 countries using a comprehensive dataset from the Integrated World Values Survey and the World Bank. The results contradict the hypothesis of Hirsch: life satisfaction in rich countries is less affected by relative income and more affected by absolute income than in poor countries. The results are robust when splitting the sample into four sub samples for high, middle-high, middle-low-, and low-income countries, using alternative measures of relative income, tests for over-control bias, and bounds analysis. Delving into factors that explain these results, we find that national culture, measured by individualism and generalized trust, negatively and income inequality positively moderate the relationship between relative income and life satisfaction
Interesting facts Charities Autumn 2025 – an update
No full textHet jaar 2025 bracht veel nieuws voor algemeen nut beogende instellingen (anbi’s): het onderzoek naar familiestichtingen, de evaluatie van de anbi-regeling en de kabinetsreactie op beide onderzoeken, het nieuwe Besluit ANBI, de wettelijke regeling voor de twee portals in het door de Tweede Kamer aangenomen wetsvoorstel Fiscale verzamelwet 2026, het door de Tweede Kamer aangenomen wetsvoorstel Wet transparantie en tegengaan ondermijning door maatschappelijke organisaties en het terugdraaien van de btw-verhoging voor cultuur in het wetsvoorstel Wet behoud verlaagd btw-tarief op cultuur, media en sport (pakket Belastingplan 2026). Deze bijdrage is gewijd aan al deze voor de praktijk relevante fiscale ontwikkelingen die anbi’s raken
Plaatsing van transgender en non-binaire personen in Nederlandse penitentiaire inrichtingen:Juridische kaders, empirische bevindingen en beleidsopties
No full textThe role of health literacy in perceived information provision, satisfaction, and health-related quality of life among rare and common cancer patients:A population-based registry study
No full textHealth literacy (HL) has been found to affect perceived information provision (PIP), satisfaction with information provision, and health-related quality of life (HRQoL) in patients with cancer. Patients with a rare cancer are confronted with challenges, such as a lack of information. The aim of this study was to explore the impact of HL on PIP, satisfaction with information provision, and on HRQoL in rare compared to common cancer patients.A population-based study was conducted using the PROFILES registry. Patients with rare (n = 385) and common (n = 1,692) cancer were included. Within group associations (low/medium HL, high HL, rare cancer, common cancer) were assessed. Regression analyses were used to assess associations between HL, PIP, satisfaction, and HRQoL, taking cancer group into account.Within the low/medium HL group, no statistically significant differences were found between rare and common cancer patients. Yet, within the high HL group, rare cancer patients scored significantly lower on all PIP-categories (except PIP-medical tests), satisfaction and HRQoL. Within the rare cancer group, patients with low/medium HL scored lower, compared to those with high HL, on PIP-medical tests and PIP-treatment, while within the common cancer group, patients with low/medium HL scored lower on all PIP-categories, satisfaction and HRQoL (all: p<0.05).Information needs might vary between patients with a different HL level and/or cancer group. Healthcare professionals should take individual needs into account, with a special focus on patients with a rare cancer and low/medium HL, in order to convey information in an understandable, patient-tailored way
Editorial to “The role of belief updating in psychopathology:Relevance, mechanisms, and clinical implications
No full textA new perspective on traumatic spleen injury:Quality of life after traumatic spleen injury & MR imaging after splenic artery embolization
No full textWhat happens to people who suffer injury to their spleen after an accident? And how do they experience their recovery, both physically and mentally? This dissertation explores exactly that: how people recover from traumatic spleen injury (TSI), and which treatment options lead to the best outcomes. Not just to survive, but also to improve long-term quality of life. Why this research?Most studies on serious trauma focus on physical recovery and survival rates. But we still know very little about how patients actually feel afterwards: how their mental health evolves, how they function in daily life, and what their quality of life is. It is also unclear which treatment is best in the long run: surgery to remove the spleen (splenectomy), a minimally invasive procedure to preserve the spleen (embolization), or no procedure at all, but instead close monitoring (non-operative management).How was the study conducted?The SPLENIQ study consisted of two parts. The first (retrospective) part analyzed data from 181 people who had previously sustained TSI. Of these, 52 patients completed questionnaires and 14 underwent an MRI scan of their spleen. In the second (prospective) part, 116 patients were actively followed for one year in ten hospitals across the Netherlands. Their medical data were analyzed; among them, 50 completed follow-up questionnaires about their recovery, and 22 underwent MRI scans. The study also examined the costs and benefits of the different treatment options.What are the key findings?• Mental health in patients with spleen injury is often reduced for a long time, even when physical recovery goes well.• The type of treatment had little effect on quality of life one year after the injury. Other factors, such as injury severity and social support, played a greater role in recovery.• Preserving the spleen through embolization is safe and effective. MRI scans showed that spleen tissue remained intact in most cases.• Embolization was also shown to be cost-effective in this study: it improved survival while keeping healthcare costs within acceptable limits.What can we do with these findings?Doctors can better inform patients about the full impact of their treatment: not just on their physical recovery, but also on their well-being and daily life. Hospitals may also consider implementing policies to use embolization more often, where medically appropriate.Recommendations for the futureFurther research is needed into the actual immune function of the spleen after embolization, to determine whether additional vaccinations are still necessary. Quality of life should also become a standard part of trauma care evaluation, because recovery is not only about survival, but also about living well afterwards___Wat gebeurt er met mensen die ernstig letsel aan hun milt oplopen na een ongeluk? En hoe ervaren zij hun herstel, zowel lichamelijk als mentaal? Dit proefschrift onderzoekt precies dat: hoe mensen herstellen na traumatisch miltletsel (TML) en wat de beste behandelmogelijkheden zijn. Niet alleen om te overleven, maar ook om de kwaliteit van leven op lange termijn te verbeteren.Waarom dit onderzoek?De meeste studies naar ernstige ongevallen (trauma) richten zich op lichamelijk herstel en overlevingskansen, maar we weten nog weinig over hoe patiënten zich écht voelen na afloop: hoe het gaat met hun mentale gezondheid, hun dagelijks functioneren en hun kwaliteit van leven. Ook is het onduidelijk welke behandeling op lange termijn het beste is voor de patiënt: een operatie waarbij de milt wordt verwijderd (splenectomie), een behandeling via de bloedvaten om de milt te behouden (embolisatie), of juist géén ingreep maar nauwkeurige monitoring (non-operatief beleid).Hoe is het onderzoek uitgevoerd?De SPLENIQ-studie bestond uit twee onderdelen. In het eerste (retrospectieve) deel werden de gegevens geanalyseerd van 181 mensen die in het verleden TML hadden opgelopen. Hiervan vulden 52 patiënten vragenlijsten in en ondergingen 14 patiënten een MRI-scan van hun milt. In het tweede (prospectieve) deel werden 116 patiënten één jaar lang actief gevolgd in tien Nederlandse ziekenhuizen. Hun medische gegevens werden geanalyseerd; van deze groep vulden 50 patiënten vragenlijsten in over hun herstel enondergingen 22 patiënten MRI-scans van hun milt. Ook werd gekeken naar de kosten en baten van de verschillende behandelingen.Wat zijn de belangrijkste bevindingen?• De mentale gezondheid van mensen met miltletsel is vaak langdurig verminderd, ook als het lichamelijk goed gaat.• De keuze voor een bepaalde behandeling had weinig invloed op de ervaren kwaliteit van leven na een jaar. Andere factoren, zoals de ernst van het letsel of sociale steun, bleken belangrijker voor het herstel.• Behoud van de milt met embolisatie is veilig en effectief. Op MRI-scans is te zien dat het miltweefsel bij deze patiënten behouden blijft.• Embolisatie bleek in deze studie bovendien kosteneffectief: het leidt tot betere overleving tegen aanvaardbare zorgkosten.Wat kunnen we ermee?Artsen kunnen patiënten beter informeren over de gevolgen van hun behandeling: niet alleen voor hun lichaam, maar ook voor hun leven en welzijn. Ook kunnen ziekenhuizen beleid ontwikkelen waarbij embolisatie vaker wordt ingezet, mits dat medisch verantwoord is.Aanbeveling voor de toekomstEr is meer onderzoek nodig naar de daadwerkelijke werking van de milt na embolisatie, om te bepalen of patiënten na deze behandeling wel of geen extra vaccinaties nodig hebben. Ook zou kwaliteit van leven standaard moeten worden meegenomen bij traumazorg, zodat herstel niet alleen draait om overleven, maar ook om goed leven daarn
Introduction
No full textThis Chapter introduces the framework of analysis used in the Handbook to study legal strategies that aim to strengthen sustainability in global value chains (GVCs) and harness responsible business conduct. The contributions are structured in seven Parts, each addressing a key dimension of the legal and institutional challenges of governing sustainability in GVCs. Across these Parts, the chapters engage with questions of inter alia corporate accountability, responsibility and liability, regulatory design and legal interventions. The Handbook moves from theoretical perspectives (Part I), through analyses of corporate governance (Part II), mandatory due diligence law in Europe (Part III), to civil liability in global value chains (Part IV). Subsequently, the Handbook addresses the law and governance of labour relations (Part V) and taxation (Part VI) across GVCs, to conclude with a discussion of sector-specific regulation in mining, data and textile value chains (Part VII)
Perceived stress, adherence to dietary guidelines and incident cardiovascular disease:findings from the Australian longitudinal study on women's fealth
No full textPrevious research suggests perceived stress and healthy eating are associated with cardiovascular disease (CVD) risk, but studies investigating their combined association are lacking. The aim was to assess associations between stress, adherence to dietary guidelines and CVD, individually and combined. Data from the Australian Longitudinal Study on Women's Health (ALSWH) including 9303 women (52 ± 2 y) without history of CVD were analysed. Dietary and perceived stress data were collected with validated questionnaires, respectively, with the 74 item food frequency questionnaire and a questionnaire addressing 10 different life domains. Adherence to dietary guidelines was defined by using two guideline indices, the Australian Dietary Guidelines Index (DGI) and the food-based Dutch Healthy Diet Index-15 (DHD-15). Hard incident CVD events were collected from linked hospital physician diagnosis data. Cox proportional hazards models were performed adjusted for multiple covariates, being demographic, socioeconomic, health and behavioural factors. During 15 years follow-up 1091 CVD incident events occurred. Higher compared to lower perceived stress at baseline was significantly associated with higher incidence of CVD both in crude (HR = 1.32, 95%CI: 1.13, 1.54) and adjusted (HR = 1.30, 95%CI: 1.10, 1.52) models. No associations between neither the DGI-2013 score nor the DHD15 index score and CVD incidence were found. Also, no interaction between perceived stress and adherence to dietary guidelines was shown. The current study underscores the importance of perceived stress levels as an independent risk factor for CVD incidence among women. Thus, stress management could be important for CVD risk reduction