BackgroundWhile night shifts are crucial for patient care, they threaten doctors' well-being and performance. Knowledge of how the impact of night shifts differs for doctors is needed to attenuate... Show moreBackgroundWhile night shifts are crucial for patient care, they threaten doctors' well-being and performance. Knowledge of how the impact of night shifts differs for doctors is needed to attenuate the adverse effects of night shifts. This study aimed to obtain more precise insight into doctors' feelings surrounding night shift by: identifying profiles based on doctors' alertness, contentedness and calmness scores before and after night shifts (research question (RQ) 1); assessing how doctors' pre- and post-shift profiles change (RQ2); and determining associations of doctors' demographics and shift circumstances with alertness, contentedness and calmness change (RQ3).MethodsLatent Profile Analysis using doctors' pre- and post-shift self-rated alertness, contentedness and calmness scores was employed to identify pre- and post-shift profiles (RQ1). A cross-tabulation revealed pre- and post-shift profile changes (RQ2). Multiple regressions determined associations of demographics (i.e. age, sex, specialty) and night shift circumstances (i.e. hours worked pre-call, hours awake pre-call, shift duration, number of consecutive shifts, total hours of sleep) with alertness, contentedness and calmness change (RQ3).ResultsIn total, 211 doctors participated with a mean age of 39.8 & PLUSMN; 10 years; 47.4% was male. The participants included consultants (46.4%) and trainees (53.6%) of the specialties surgery (64.5%) and obstetrics/gynaecology (35.5%). Three pre-shift (Indifferent, Ready, Engaged) and four post-shift profiles (Lethargic, Tired but satisfied, Excited, Mindful) were found. Most doctors changed from Ready to Tired but satisfied, with alertness reducing most. Age, specialty, sleep, shift duration and the number of consecutive shifts associated with alertness, contentedness and calmness changes.ConclusionsThe results provided nuanced insight into doctors' feelings before and after night shifts. Future research may assess whether specific subgroups benefit from tailored interventions. Show less
Today, knowledge is the most crucial element to stimulate organizational competitiveness and economic development. The ability of a firm to quickly recognize, assimilate, and utilize external... Show moreToday, knowledge is the most crucial element to stimulate organizational competitiveness and economic development. The ability of a firm to quickly recognize, assimilate, and utilize external knowledge is one of the core capabilities that bring organizational competitive advantages. Such an ability is called absorptive capacity (AC). This study focuses on three AC-related topics in the context of Chinese SMEs: 1) How do SMEs absorb external knowledge in terms of its recognition, assimilation, and utilization? 2) What challenges do SMEs face when absorbing external knowledge? And, 3)Which knowledge assimilation mechanisms do have an impact on the performance of SMEs? Show less
A New Technology-Based Firm (NTBF) is a significant enabler of job creation and a driver of the economy through stimulating innovation. In the last two decades, we have seen an enormous development... Show moreA New Technology-Based Firm (NTBF) is a significant enabler of job creation and a driver of the economy through stimulating innovation. In the last two decades, we have seen an enormous development of the NTBFs. However, the liability of smallness, newness, and weak networking ties are three important obstacles in the early stages of an NTBF’s lifecycle. Consequently, there is a high rate of failure among NTBFs.A remedy to avoid these failures is in using the support and resources by Business Incubators (BIs). BIs provide supportive services to promote the NTBFs capabilities and to help them address their liabilities.So far, there is almost no reliable evidence on the effectiveness of BIs on the performance of NTBFs. Therefore, we aim to identify the supportive activities by BIs and, to understand to what extent the supports by them have a serious impact on the performance of their NTBFs. Building on qualitative and quantitative research methods, a model to measure the impact of support by BIs on the performances of NTBFs is developed, and tested among Dutch and German NTBFs. The research results provide practical guidelines for the management teams of the incubators, which can increase the effectiveness of their performances. Show less
Beulens, J.W.J.; Yauw, J.S.; Elders, P.J.M.; Feenstra, T.; Herings, R.; Slieker, R.C.; ... ; Heijden, A.A. van der 2021
Aims/hypothesis Approximately 25% of people with type 2 diabetes experience a foot ulcer and their risk of amputation is 10-20 times higher than that of people without type 2 diabetes. Prognostic... Show moreAims/hypothesis Approximately 25% of people with type 2 diabetes experience a foot ulcer and their risk of amputation is 10-20 times higher than that of people without type 2 diabetes. Prognostic models can aid in targeted monitoring but an overview of their performance is lacking. This study aimed to systematically review prognostic models for the risk of foot ulcer or amputation and quantify their predictive performance in an independent cohort.Methods A systematic review identified studies developing prognostic models for foot ulcer or amputation over minimal 1 year follow-up applicable to people with type 2 diabetes. After data extraction and risk of bias assessment (both in duplicate), selected models were externally validated in a prospective cohort with a 5 year follow-up in terms of discrimination (C statistics) and calibration (calibration plots).Results We identified 21 studies with 34 models predicting polyneuropathy, foot ulcer or amputation. Eleven models were validated in 7624 participants, of whom 485 developed an ulcer and 70 underwent amputation. The models for foot ulcer showed C statistics (95% CI) ranging from 0.54 (0.54, 0.54) to 0.81 (0.75, 0.86) and models for amputation showed C statistics (95% CI) ranging from 0.63 (0.55, 0.71) to 0.86 (0.78, 0.94). Most models underestimated the ulcer or amputation risk in the highest risk quintiles. Three models performed well to predict a combined endpoint of amputation and foot ulcer (C statistics >0.75).Conclusions/interpretation Thirty-four prognostic models for the risk of foot ulcer or amputation were identified. Although the performance of the models varied considerably, three models performed well to predict foot ulcer or amputation and may be applicable to clinical practice. Show less
Huizinga, C.R.H.; Tummers, F.H.M.P.; Marang-van de Mheen, P.J.; Cohen, A.E.; Bogt, K.E.A. van der 2019
The need for data to study the relationship between fatigued healthcare professionals and performance outcomes is evident, however, it is unclear which methodology is most appropriate to provide... Show moreThe need for data to study the relationship between fatigued healthcare professionals and performance outcomes is evident, however, it is unclear which methodology is most appropriate to provide these insights. To address this issue, we performed a systematic review of relevant articles by searching the MEDLINE, EMBASE, Cochrane, Web of Science, and CINAHL databases. The literature search identified 2960 unique references, of which 82 were identified eligible. The impact on performance was studied on clinical outcomes, medical simulation, neurocognitive performance, sleep quantification and subjective assessment. In general results on performance are conflicting; impairment, no effect, and improvement were found. This review outlines the various methods currently available for assessing fatigue-impaired performance. The contrasting outcomes can be attributed to three main factors: differences in the operationalisation of fatigue, incomplete control data, and the wide variety in the methods used. We recommend the implementation of a clinically applicable tool that can provide uniform data. Until these data become available, caution should be used when developing regulations that can have implications for physicians, education, manpower planning, and - ultimately - patient care. (C) 2019 Elsevier Ltd. All rights reserved. Show less
Within the higher education context, peer feedback is frequently applied as an instructional method. Research on the learning mechanisms involved in the peer feedback process has covered aspects of... Show moreWithin the higher education context, peer feedback is frequently applied as an instructional method. Research on the learning mechanisms involved in the peer feedback process has covered aspects of both providing and receiving feedback. However, a direct comparison of the impact that providing and receiving peer feedback has on students’ writing performance is still lacking. The current study compared the writing performance of undergraduate students (N = 83) who either provided or received anonymous written peer feedback in the context of an authentic academic writing task. In addition, we investigated whether students’ peer feedback perceptions were related to the nature of the peer feedback they received and to writing performance. Results showed that both providing and receiving feedback led to similar improvements of writing performance. The presence of explanatory comments positively related both to how adequate students perceived the peer feedback to be, as well as to students’ willingness to improve based upon it. However, no direct relation was found between these peer feedback perceptions and students’ writing performance increase. Show less
Students in secondary education inevitably favour some subjects more than other subjects. This appraisal may affect how motivation relates to performance in these subjects. Whereas autonomous... Show moreStudents in secondary education inevitably favour some subjects more than other subjects. This appraisal may affect how motivation relates to performance in these subjects. Whereas autonomous motivation is generally linked to positive school outcomes, the effect of controlled motivation is less clear. This study specifically focused on the associations of controlled motivation with performance in the context of favoured and disfavoured subjects. In the present study, secondary school students (N = 918) identified 2 favoured and 2 disfavoured subjects. Hierarchical linear modelling was performed to investigate the relationship of autonomous and controlled motivation with performance in these subjects. Results showed that autonomous motivation positively related to performance in both types of subjects. The association of controlled motivation with performance was negative in both contexts, and more negative in disfavoured subjects. For teaching practice, this means that teachers should always stimulate autonomous motivation, even for negatively appraised subjects. Show less
Producing the local: Javanese performance on Indonesian television explores how television represents Javaneseness, as a factor designed to catch and keep the attention of its putative... Show moreProducing the local: Javanese performance on Indonesian television explores how television represents Javaneseness, as a factor designed to catch and keep the attention of its putative audiences. Central is the question of how people make use of national, regional, local, public and private television in Indonesia – each in their own way and with their own goals – to represent the local and, in particular, how they construct images of Javaneseness through the production and dissemination of performance. Performance in Javanese has been used by the Indonesian television industry to achieve various purposes: to entertain and inform its audiences, to represent the local/the regional, to preserve and nurture the traditional and to build national culture, for persuasive (commercial or propaganda) aims, as a counter-voice of diversification towards global or Jakartan influences, and to express multiculturalism. These issues have been put into the framework of discursive practices about local, national and global cultures in the electronic audiovisual media in Indonesia. Three main themes structure the study: representing tradition, localizing persuasion and mediating the local. Above all, this dissertation is a plea for a more thorough study of the role of proximity in the production, dissemination and reception of local television programmes. Show less
In art history, performance is categorized as performance art and defined as live-act. However, performance is no longer conceived of by artists as live-act only. Rather, the art of producing... Show moreIn art history, performance is categorized as performance art and defined as live-act. However, performance is no longer conceived of by artists as live-act only. Rather, the art of producing performances, according to artists, also includes considerations of their documentation and mediatization. In these contexts a paratextual perspective would enable considering documentation practices as part of performance art, which would also mean to acknowledge that performance is a practice associated with other practices that go beyond the enactment or staging which precedes or follows it. It is my claim that the potential of performance in visual art lies exactly in this ability to divest itself of a stable medial identity. This is to say that performance does not only have the practical need, but also the general potential to connect itself with other media, such as texts and audiovisual records. I think that contemporary performances in visual art cannot be viewed as distinct from the intermedial and paratextual issues with which they are connected. They engage, intermingle and enter into reciprocal relationships with these issues. So, I propose to understand performances in and through their relations to texts. Show less
The southern campaigns were a series of military endeavors, undertaken by Russia against the Ottoman and Safavid empires between 1695 and 1739. These campaigns played a vital role in the... Show moreThe southern campaigns were a series of military endeavors, undertaken by Russia against the Ottoman and Safavid empires between 1695 and 1739. These campaigns played a vital role in the military evolution of early modern Russia and influenced the reform policy, carried out by the tsars in order to restructure the old Muscovite army into a new, imperial one. The dissertation aims at depicting and defining the interrelation between reform and battlefield performance in the case to eighteenth-century Russia and also to outline the main factors, which influenced the development and conduct to the tsarist forces. Show less
Public organizations are responsible for the delivery and provision of public services on which citizens rely. To maintain the quality of or improve these services, public organizations... Show more Public organizations are responsible for the delivery and provision of public services on which citizens rely. To maintain the quality of or improve these services, public organizations must exploit resources from the environment of the organization. To attain a predictable and controllable flow of resources, public managers must interact with a wide array of different organizations and actors in the organization’s environment that are potential sources of support. The main question of this dissertation concerns the conditions under which public managers’ interactions with organizations and actors in the environments of their organizations contribute to organizational performance. The context of this study is Dutch primary education. Specifically, we study the networking activities of Dutch primary school principals. One of the main conclusions of this dissertation is that specific managerial networking activities moderate the negative effect of specific environmental challenges. We find, for example, that the negative effect of red tape on school performance is attenuated by school principals’ networking activities with external organizations, such as local- and national government organizations and interest groups. Insights into the conditions under which specific managerial networking activities are beneficial can help public managers make strategic decisions about which networking activities to prioritize in certain situations. Show less
Bautista-Molano, W.; Landewe, R.B.M.; Londono, J.; Romero-Sanchez, C.; Valle-Onate, R.; Heijde, D. van der 2016
Performances of solo keyboard repertoire can sound more or less polyphonic depending on the performer’s use of divergence in expression. Rather than being a purely cerebral experience, this... Show morePerformances of solo keyboard repertoire can sound more or less polyphonic depending on the performer’s use of divergence in expression. Rather than being a purely cerebral experience, this expressive divergence is situated in an ecological relationship between keyboard and player where the gestural dynamics of technique and musicianship overlap. Specific body schemata relating to expressive divergence are therefore foundational to the interpretive freedom of the performer in creating polyphonic expression, and feature transparently in the musical result. This dissertation theorises expressive divergence by examining the embodiment of single voices through the hierarchical structuring of coarticulation, and by showing how these multi-layered gestures combine in the polyphony of expression. This performative view of polyphony is contextualised not only in musical practice, but also in the wider interdisciplinary use of polyphony as a metaphor. Single-player polyphonic expression is shown to enact or demonstrate an inner experience of the plurality of subjective agency, an experience made possible by its embodied dimension. Besides verbalising and theorising polyphonic expression, this dissertation provides experiments and exercises useful for developing such a practice, as well as examples of its application in concert Show less
