Search Results (1,952)

Floating solar technology has gained significant attention as part of the global expansion of renewable energy due to its potential for installation in underutilized water bodies. Several countries, including the Netherlands, have initiated efforts to extend this technology from inland freshwater applications to open offshore environments, particularly within offshore wind farm areas. This development is motivated by the synergistic benefits of increasing site energy density and leveraging the existing offshore grid infrastructure. The deployment of offshore floating photovoltaic (OFPV) systems involves assembling multiple modular units in a marine environment, introducing operational risks that may give rise to safety concerns. To mitigate these risks, weather windows must be considered prior to the task execution to ensure continuity between weather-sensitive activities, which can also lead to additional time delays and increased costs. Consequently, optimizing marine logistics becomes crucial to achieving the cost reductions necessary for making OFPV technology economically viable. This study employs a simulation-based approach to estimate the installation duration of a 5 MWp OFPV plant at a Dutch offshore wind farm site, started in different months and under three distinct risk management scenarios. Based on 20 years of hindcast wave data, the results reveal the impacts of campaign start months and risk management policies on installation duration. Across all the scenarios, the installation duration during the autumn and winter period is 160% longer than the one in the spring and summer period. The average installation durations, based on results from 12 campaign start months, are 70, 80, and 130 days for the three risk management policies analyzed. The result variation highlights the additional time required to mitigate operational risks arising from potential discontinuity between highly interdependent tasks (e.g., offshore platform assembly and mooring). Additionally, it is found that the weather-induced delays are mainly associated with the campaigns of pre-laying anchors and platform and mooring line installation compared with the other campaigns. In conclusion, this study presents a logistics modeling methodology for OFPV systems, demonstrated through a representative case study based on a state-of-the-art truss-type design. The primary contribution lies in providing a framework to quantify the performance of OFPV installation strategies at an early design stage. The findings of this case study further highlight that marine installation logistics are highly sensitive to local marine conditions and the chosen installation strategy, and should be integrated early in the OFPV design process to help reduce the levelized cost of electricity. Full article

Background/Objectives: In many parts of the world, pharmacists hold the primary responsibility for providing safe and effective pharmacotherapy. A key aspect is the availability of appropriate medicines for each individual patient. When industrially manufactured medicines are unsuitable or unavailable, pharmacists can prepare tailor-made medicines. While this principle applies globally, practices vary between countries. In the Netherlands, the preparation of medicines in pharmacies is well-established and integrated into routine healthcare. This narrative review explores the role and significance of extemporaneous compounding, pharmacy preparations and related product care in the Netherlands. Methods: Pharmacists involved in pharmacy preparations across various professional sectors, including community and hospital pharmacies, central compounding facilities, academia, and the professional pharmacists’ organisation, provided detailed and expert insights based on the literature and policy documents while also sharing their critical perspectives. Results: We present arguments supporting the need for pharmacy preparations and examine their position and role in community and hospital pharmacies in the Netherlands. Additional topics are discussed, including the regulatory and legal framework, outsourcing, quality assurance, standardisation, education, and international context. Specific pharmacy preparation topics, often with a research component and a strong focus on product care, are highlighted, including paediatric dosage forms, swallowing difficulties and feeding tubes, hospital-at-home care, reconstitution of oncolytic drugs and biologicals, total parenteral nutrition (TPN), advanced therapy medicinal products (ATMPs), radiopharmaceuticals and optical tracers, clinical trial medication, robotisation in reconstitution, and patient-centric solid oral dosage forms. Conclusions: The widespread acceptance of pharmacy preparations in the Netherlands is the result of a unique combination of strict adherence to tailored regulations that ensure quality and safety, and patient-oriented flexibility in design, formulation, and production. This approach is further reinforced by the standardisation of a broad range of formulations and procedures across primary, secondary and tertiary care, as well as by continuous research-driven innovation to develop new medicines, formulations, and production methods. Full article

Burn injuries are complex and require effective wound management strategies. Traditional treatments, such as dermal templates, are limited by simplified extracellular matrix (ECM) composition (e.g., collagen-elastin or collagen-glycosaminoglycan), sheet-based formats, and frequent use of animal-derived materials. These limitations can reduce wound conformity, biocompatibility, and integration with host tissue. Functional hydrogels are being explored as alternatives due to properties such as high water content, biodegradability, adhesiveness, antimicrobial activity, and support for angiogenesis. Unlike standard templates, hydrogels can adapt to irregular wound shapes as in burn wounds and reach deeper tissue layers, supporting moisture retention, cell migration, and controlled drug delivery. These features may improve the wound environment and support healing in burns of varying severity. This review outlines recent developments in functional hydrogel technologies and compares them to current clinical treatments for burn care. Emphasis is placed on the structural and biological features that influence performance, including material composition, bioactivity, and integration capacity. Through an exploration of key mechanisms of action and clinical applications, this review highlights the benefits and challenges associated with hydrogel technology, providing insights into its future role in burn care. Full article

Background/Objectives: The aim of this study was to systematically assess Adverse Events Following Immunization (AEFI) among children following administration of the human papillomavirus (HPV) vaccine (Cervarix^®) included in the Dutch National Immunization Program (NIP) and to characterize the pattern and recurrence risk of AEFI after HPV revaccination. Methods: A longitudinal cohort event monitoring study, using patient-reported outcomes was used among recipients of the HPV vaccine at 10 years of age. Data were available for 3063 children following the first HPV vaccination and for 2209 children following the second HPV vaccination. Results: The most commonly reported AEFI following HPV vaccination were injection site reactions—reported by 46.5% of participants after the first dose and 31.9% after the second dose—followed by headache (8.2% and 3.9%, respectively) and joint pain (4.5% and 3.7%, respectively). Participants who received both HPV vaccine doses reported more AEFI after the first dose than after the second. Among girls, 61.2% reported at least one AEFI following the first dose, compared to 44.2% after the second dose. For boys, these percentages were 55.3% and 38.5%, respectively. This difference was statistically significant (p = 0.002). For some AEFI, such as injection site reactions, there appears to be a potential increased risk of recurrence following the second dose. Conclusions: This prospective longitudinal cohort event monitoring study showed that AEFI were more frequent after the first HPV dose and more frequent for girls compared to boys. An increased risk of recurrence was seen for AEFI, such as injection site reactions and headache. Furthermore, this study provides insight into the course of AEFI and the extent to which children were affected by these symptoms based on real-world data. Full article

The IREQ (Insulation REQuired) index is the only reliable and effective model for predicting and evaluating the protection given by a clothing ensemble in cold environments. Even with the growth of studies aimed at assessing the thermophysical characteristics of clothing, IREQ remained unaltered from Holmér’s original formulation four decades prior. This paper focuses on the effect of the evaluation of the clothing area factor and the resultant vapour resistance on the assessment of cold environments via IREQ. Obtained results reveal meaningful variations in the duration limit exposure (up to 5 h), whereas IREQ values remain unchanged. Observed phenomena could be interesting when discussing the revision of the ISO 11079 standard, which prescribes using IREQ for the determination and interpretation of cold stress. Full article

The etiology of schizophrenia remains poorly understood. Although certain risk factors have been identified, effective preventive measures are still lacking. This study investigates potential preventive methods while focusing on the role of vitamin D and its status. The role of malnutrition in schizophrenia risk was first identified in studies on the Dutch Hunger Winter. Vitamin D deficiency was hypothesized as a contributing factor shortly thereafter. This review aims to explore the correlations between vitamin D deficiency at various life stages (maternal, neonatal, adult) and schizophrenia risk, as well as its effects on pharmacokinetics, neurobiology, bone health, and metabolic syndrome. The studies were retrieved from two indexed databases, PubMed and Web of Science, following PRISMA guidelines and included studies published between 2000 and 2024. No correlation was found between maternal vitamin D levels and schizophrenia in offspring while a positive correlation was observed between low neonatal vitamin D levels and schizophrenia in later life. Approximately half of the studies on adults reported mean vitamin D concentrations of below 20 ng/mL which were negatively correlated with gray matter volume and bone health while positively correlated with the prevalence of metabolic syndrome. Additionally, vitamin D levels were also found to correlate with antipsychotic drug concentrations. Full article

Background/Objective: Sarcopenia is a predictor of poor surgical outcomes in older adults. The Psoas Muscle Index (PMI), calculated from routine preoperative CT scans, has been proposed as an imaging-based marker of physiological reserve, but its diagnostic utility in vascular surgery remains unclear. We aimed to assess the predictive value of PMI for early complications following elective abdominal aortic aneurysm (AAA) repair in two European centers. Methods: We retrospectively analyzed 245 patients who underwent open or endovascular AAA repair between 2018 and 2022 in Poland and The Netherlands. PMI was measured at the level of third lumbar vertebrae (L3) level, normalized to height, and stratified into center-specific tertiles. Early complications were compared across tertiles, procedures, and centers. Multivariate logistic regression was used to adjust for age, comorbidities, and procedure type. Results: Low PMI was significantly associated with early complications in EVAR patients at the Polish center (p = 0.004). No associations were found in open repair or at the Dutch center. Mean PMI values did not differ significantly between centers. Conclusions: PMI may serve as a context-dependent imaging biomarker for early risk stratification following AAA repair, particularly in endovascular cases. Its predictive value is influenced by institutional and procedural factors, highlighting the need for prospective validation and standardization before clinical adoption. Full article

Since the start of the energy crisis in 2020, the Dutch government has introduced various programmes aimed at alleviating energy poverty among low-income households. This research examines the effects of three specific interventions—energy coaching, home renovations, and white goods schemes—on a range of energy poverty-related aspects, including living comfort, physical and mental health, energy costs, financial concerns, social connection, neighbourhood involvement, and sustainable behaviour. While previous studies have mostly investigated these interventions in isolation, this research offers a comparative analysis to explore how their impacts differ and how they may complement one another. This research, comparing an intervention group and control, shows that energy coaches, renovations, and white goods schemes each have positive effects on various aspects of energy poverty. However, the nature and magnitude of these effects differ by type of support measure. Renovations are the most effective overall, significantly improving living comfort, physical health, and reducing energy costs. White goods schemes primarily reduce moisture and mould in dwellings and have a notable positive impact on mental health. Energy coaches contribute to improved living comfort, lower energy costs, and uniquely enhance community involvement. The complementary nature of these interventions highlights the potential added value of integrated or combined approaches to tackling energy poverty. Full article

This article examines the accessibility of public space for individuals with disabilities in the Netherlands, as well as the relevant legal frameworks intended to promote accessibility. It discusses the Convention on the Rights of Persons with Disabilities (UN CRPD) and efforts to implement its provisions at the local level. The article first provides an overview of Dutch legislation and regulations concerning accessibility in public spaces. It then presents an analysis of the experiences of individuals with disabilities in navigating streets and pavements in two Dutch cities, Utrecht and Almere. The central question is to what extent equal participation in public space has been realised. The findings indicate that national legislation remains inadequate in addressing the accessibility of streets and pavements. Despite the constitutional amendment in January 2023, which prohibits discrimination on the grounds of disability, substantive equality is largely dependent on the individual policies and bylaws of the 342 municipalities. The involvement of individuals with disabilities in shaping the inclusive use of public space is therefore crucial at the local level. This article highlights local initiatives that have successfully drawn the attention of municipal policymakers and civil servants to the importance of accessible streets. Full article

The European Health Technology Assessment (HTA) regulation (HTAR) came into effect in January 2025 and impacts the HTA process in all European Member States. Member States must give due consideration to the joint clinical assessment (JCA) report. This may require adaptations at the national level. This paper describes the anticipated changes to the Dutch national HTA process and how the Dutch National Health Care Institute (Zorginstituut Nederland, ZIN) prepared for this, because sharing experience between Member States can be of general interest for future expansion of the EU HTAR. ZIN’s implementation activities were facilitated by a project-governance structure and by a continuous gap analysis of the current national assessment and appraisal process of medicinal products, resulting in a concrete action plan. The implementation of the HTAR has two major implications for ZIN’s HTA process, namely that the scoping phase starts much earlier and that the JCA report is the starting point for the national assessment. Gaps, challenges and issues were identified in the categories: information and knowledge, IT and template, communication and stakeholder engagement, capacity and resources, and financial aspects. Based on a thorough and well-defined implementation plan, ZIN is ready to implement the HTAR in national HTA processes and to take on (co-)assessor roles for JCA of medicinal products in 2025. Full article

This study investigates how differing national research governance models impact academic performance by comparing European Research Council (ERC) grant winners in the social sciences and humanities from France and the Netherlands. Situated within the broader context of centralized versus decentralized research systems, the analysis aims to understand how these structures shape publication trends, thematic diversity, and collaboration patterns. Drawing on Scopus and SciVal data covering 9996 publications by 305 ERC winners between 2019 and 2023, we employed a multi-method approach, including latent Dirichlet allocation for topic modeling, compound annual growth rate analysis, and co-authorship network analysis. The results show that neuroscience, climate change, and psychology are dominant domains, with language and linguistics particularly prevalent in France and law and political science in the Netherlands. French ERC winners are more likely to be affiliated with national or sectoral institutions, whereas in the Netherlands, elite universities dominate. Collaboration emerged as a key success factor, with an average of four co-authors per publication and network analyses revealing central figures who bridge topical clusters. International collaborations were consistently linked with higher visibility, while single-authored publications showed limited impact. These findings suggest that institutional context and collaborative practices significantly shape research performance in both countries. Full article

Background: Promoting sustainable eating is gaining increasing attention, yet the transition from intentions to actual behaviors remains unclear. This study compares the theory of planned behavior (TPB) and the theory of behavioral choice (TBC) in predicting such intentions and examines the moderating role of distress, psychological well-being, and dysfunctional eating styles in the intention–behavior relationship. Methods: A total of 223 participants from the general population (29.49 ± 9.30 years; 68.6% females) completed an online survey assessing TPB and TBC predictors, the Sustainable and Healthy Dietary Behaviors (SHDB) questionnaire, the Depression and Anxiety Stress Scale (DASS-21), the Psychological Well-Being Scale (PWBS), and the Dutch Eating Behavior Questionnaire (DEBQ). Results: The TBC model explained a significantly greater variance in intention (R² = 0.45, ΔR² = 0.28, F(215,4) = 27.27, p < 0.001) compared to the TPB, with TBC-affect (β = 0.48, p < 0.001) and felt obligation (β = 0.23, p < 0.001) being the strongest predictors. Moderation analyses revealed that the intention–behavior link was stronger in participants with lower external eating and autonomy. Conclusions: Both internal and external factors play a crucial role in predicting intentions. In addition, the intention–behavior link is stronger in individuals who are less reactive to external food stimuli and more influenced by social pressure. Promoting more balanced psychological well-being and functional eating habits may foster more sustainable diets. Full article

Dutch elm disease is one of the most devastating plant diseases, primarily spread through bark beetles. Scolytus scolytus is a key vector of this disease. In this study, distribution data of S. scolytus were collected and filtered. Combined with environmental and climatic variables, an ensemble model was developed using the Biomod2 platform to predict its potential geographical distribution in China. The selection of climate variables was critical for accurate prediction. Eight bioclimatic factors with high importance were selected from 19 candidate variables. Among these, the three most important factors are the minimum temperature of the coldest month (bio6), precipitation seasonality (bio15), and precipitation in the driest quarter (bio17). Under current climate conditions, suitable habitats for S. scolytus are mainly located in the temperate regions between 30° and 60° N latitude. These include parts of Europe, East Asia, eastern and northwestern North America, and southern and northeastern South America. In China, the low-suitability area was estimated at 37,883.39 km², and the medium-suitability area at 251.14 km². No high-suitability regions were identified. However, low-suitability zones were widespread across multiple provinces. Under future climate scenarios, low-suitability areas are still projected across China. Medium-suitability areas are expected to increase under SSP370 and SSP585, particularly along the eastern coastal regions, peaking between 2041 and 2060. High-suitability zones may also emerge under these two scenarios, again concentrated in coastal areas. These findings provide a theoretical basis for entry quarantine measures and early warning systems aimed at controlling the spread of S. scolytus in China. Full article

Background: Dietary assessment in inflammatory bowel disease (IBD) is moving away from individual food and nutrient analyses and towards dietary patterns (e.g., Mediterranean diet, Western diet) and diet quality assessment that are increasingly implicated in IBD onset and course. However, an IBD-specific diet quality index (DQI) does not exist. This review aimed to identify current DQIs and assess their suitability for an IBD population. Methods: MEDLINE and EmCare databases were systematically searched for a-priori, food-based DQI reflecting current dietary guidelines and/or nutrition science. Data extracted were adapted from optimal DQI criteria, including quality measures of adequacy, moderation, variety and balance and DQI evaluation. Results: Twenty-four DQI were identified. No DQI included all optimal DQI criteria. The Dietary Guideline Index 2013 (DGI-2013) most closely met the criteria, followed by the Dutch Healthy Diet Index-2015 (DHD-Index 2015), Planetary Health Diet Index (PHDI) and Healthy Eating Index for Australian Adults-2013 (HEIFA-2013). Most DQI assessed adequacy (22/24, 92%) and moderation (21/24, 88%), half assessed balance (12/24) while few assessed variety (8/24, 33%). Application of other optimal DQI criteria varied. Food frequency questionnaire (13/24) and 24 h diet recall (12/24) were the most common dietary assessment methods used. Most DQI (17/24, 71%) were validated; however, not for an IBD population. Few were evaluated for reliability (6/24) or reproducibility (1/24). Conclusions: No DQI meets all optimal criteria for an IBD-specific DQI. The DGI-2013 met the most criteria, followed by the DHD Index-2015, PHDI and HEIFA-2013 and may be most appropriate for an IBD population. An IBD-specific DQI is lacking and needed. Full article

Introduction: Assessing the quality of patient care within healthcare systems remains a multifaceted challenge due to varying definitions of “quality” and the complexity of care delivery structures worldwide. Patient-centeredness, institutional responsiveness, and contextual adaptability are increasingly recognized as core pillars in quality assessment. Objective: This narrative literature review aims to explore conceptual models and practical frameworks for evaluating healthcare quality, emphasizing tools that integrate technical, functional, and emotional dimensions and proposing a comprehensive model adaptable to diverse health system contexts. Methodology: A systematic literature search was conducted in the PubMed, Scopus, and Cochrane Library databases, covering the years 2000 to 2024. Studies were selected based on relevance to quality assessment models, patient satisfaction, accreditation, and strategic improvement methodologies. The review followed a thematic synthesis approach, integrating structural, process-based, and outcome-driven perspectives. Results: Core frameworks such as Donabedian’s model and balancing measures were reviewed alongside evaluation tools like the Dutch Consumer Quality Index, SERVQUAL, and Importance–Performance Analysis (IPA). These models revealed significant gaps between patient expectations and actual service delivery, especially in functional and emotional quality dimensions. This review also identified limitations related to contextual generalizability and bias. A novel integrative model is proposed, emphasizing the dynamic interaction between institutional structure, clinical processes, and patient experience. Conclusions: High-quality healthcare demands a multidimensional approach. Integrating conceptual frameworks with context-sensitive strategies enables healthcare systems to align technical performance with patient-centered outcomes. The proposed model offers a foundation for future empirical validation, particularly in resource-limited or hybrid settings. Full article