TNO Management Consultants

ObjectivesTo describe the frequency, type, and severity of health problems in long-track speed skating to inform injury prevention strategies.MethodsWe prospectively collected weekly health and sport exposure data on 84 highly trained Dutch athletes aged 15–21 years during the 2019/2020 season using the Oslo Sports Trauma Research Centre questionnaire on Health Problems and the trainers’ documentation. We categorised health problems into acute or repetitive mechanisms of injury or illness and calculated incidences (per 1000 sports exposure hours), weekly prevalence and burden (days of time loss per 1000 sports exposure hours) related to the affected body region.ResultsWe registered 283 health problems (187 injuries, 96 illnesses), yielding an average weekly prevalence of health problems of 30.5% (95% CI 28.7% to 32.2%). Incidence rates were 2.0/1000 hours for acute mechanism injuries (95% CI 1.5 to 2.5) and 3.2/1000 hours for illnesses (95% CI 2.6 to 3.9). For acute mechanism injuries the head, shoulder and lumbosacral region had the highest injury burden of 5.6 (95% CI 4.8 to 6.5), 2.9 (95% CI 2.3 to 3.5) and 2.2 (95% CI 1.7 to 2.8) days of time loss/1000 hours, respectively. For repetitive mechanism injuries, the knee, thoracic spine, lower leg and lumbosacral region had the highest injury burden, with 11.0 (95% CI 9.8 to 12.2), 6.8 (95% CI 5.9 to 7.7), 3.9 (95% CI 3.2 to 4.6) and 2.5 (95% CI 1.9 to 3.1) days of time loss/1000 hours, respectively.ConclusionOur study demonstrated a high prevalence of acute and repetitive mechanism injuries in speed skating. These results can guide future research and priorities for injury prevention.

PurposeOptimizing return to work after knee arthroplasty is becoming more important because of the growing incidence of KA among workers and poor return to work outcomes. The purpose of this study is to investigate the feasibility of Back At work After Surgery (BAAS): an integrated clinical pathway for return to work after knee arthroplasty.MethodWorking patients who received unicompartmental knee arthroplasty (UKA) or total knee arthroplasty (TKA) between January 2021 and November 2021, younger than 65 years and motivated to return to work were eligible to participate. Feasibility was investigated on five domains: reach, dose delivered, dose received, fidelity and patients’ attitudes. These outcomes were obtained by a patient‐reported questionnaire and an interview with the occupational case manager and medical case manager.ResultsOf the eligible 29 patients, eleven were willing to participate (response rate 38%; due to travel distance to and from the hospital). The dose delivered was between 91 and 100%, except information given about return to work from the orthopedic surgeon which was 18%. The dose received was 100%. For fidelity, case managers reported nine shortcomings for which five solutions were mentioned. In terms of patients’ attitude, all patients were satisfied and one patient mentioned an improvement.ConclusionsIn terms of reach, participation was low: only 29%. The BAAS clinical pathway seems feasible based on dose delivered, dose received, fidelity and patient attitudes. The next step is to assess the effectiveness of the BAAS clinical pathway for return to work.

The 'developmental origins of health and disease' hypothesis proposes not only that we are what we eat, but also that we could be what our parents ate. Here, we aimed to improve health and performance of young piglets via maternal diets based on the hypothesis that maternal nutritional interventions change metabolic programming in piglets, reflected by differential gene expression early in life. Therefore, sows were fed either a regular diet, based on barley, wheat and wheat by-products, sugar beet pulp, palm oil and oilseed meal, or a high-fat (HF) diet consisting of the regular diet supplemented with an additional amount of 3.5% soybean oil and 1% fish oil at the expense of palm oil and wheat. Performance results, physiological parameters and gene expression in liver of piglets and blood of piglets and sows at day 7 after farrowing from both diet groups were compared. The HF diet tended to enhance growth rate of the offspring in the first week of life. No significant differences in gene expression in liver tissue and blood could be detected between the two groups, neither with whole-genome microarray analysis, nor with gene specific qPCR analysis. In this study, the feeding of a high-fat diet with increased amounts of polyunsaturated fatty acid (PUFA) to gestating sows under practical farm settings did not induce significant changes in gene expression in sows and offspring.

All over the world, prevalence and incidence rates of type 2 diabetes mellitus are rising rapidly. Several trials have demonstrated that prevention by lifestyle intervention is (cost-) effective. This calls for translation of these trials to primary health care. This article gives an overview of the translation of the SLIM diabetes prevention intervention to a Dutch real-life setting and discusses the role of primary health care in implementing lifestyle intervention programmes. Currently, a 1-year pilot study, consisting of a dietary and physical activity part, performed by three GPs, three practice nurses, three dieticians and four physiotherapists is being conducted. The process of translating the SLIM lifestyle intervention to regular primary health care is measured by means of the process indicators: reach, acceptability, implementation integrity, applicability and key factors for success and failure of the intervention. Data will be derived from programme records, observations, focus groups and interviews. Based on these results, our programme will be adjusted to fit the role conception of the professionals and the organization structure in which they work.

In this study two desalination technologies have been compared by means of LCA with the focus on energy supply with a variety of scenarios based on different assumptions. The studied technologies are reverse osmosis and the newly developed technology Memstill where electrical energy demand is reduced by using external thermal energy source and use of chemicals is reduced. The scenarios are chosen to simulate different locations of sea water desalination plants and to demonstrate the impact of energy demand and energy source, chemical use and longer components' life times on the environment. The results show the dominant impact of energy demand on the overall results for all applied environmental impact assessment methods; transports, material and even chemical use are of negligible impact on the total score. The use of waste heat in case of Memstill offers a great opportunity to reduce the negative environmental impacts related to energy use. As the LCA analysis tool the GaBi software has been applied with the Ecoindicator99, CML 2001 and Ecopoints environmental impact assessment methods.

'Queen Bees' are senior women in masculine organizational cultures who have fulfilled their career aspirations by dissociating themselves from their gender while simultaneously contributing to the gender stereotyping of other women. It is often assumed that this phenomenon contributes to gender discrimination in organizations, and is inherent to the personalities of successful career women. We argue for a social identity explanation and examine organizational conditions that foster the Queen Bee phenomenon. Participants were 94 women holding senior positions in diverse companies in The Netherlands who participated in an on-line survey. In line with predictions, indicators of the Queen Bee phenomenon (increased gender stereotyping and masculine self-descriptions) were found mostly among women who indicated they had started their career with low gender identification and who had subsequently experienced a high degree of gender discrimination on their way up. By contrast, the experience of gender discrimination was unrelated to signs of the Queen Bee phenomenon among women who indicated to be highly identified when they started their career. Results are discussed in light of social identity theory, interpreting the Queen Bee phenomenon as an individual mobility response of low gender identified women to the gender discrimination they encounter in their work.

Abstract The product quality of energetic materials is predominantly determined by the crystallization process applied to produce these materials. It has been demonstrated in the past that the higher the product quality of the solid energetic ingredients, the less sensitive a plastic bonded explosive containing these energetic materials becomes. The application of submicron or nanometric energetic materials is generally considered to further decrease the sensitiveness of explosives. In order to assess the product quality of energetic materials, a range of analytical techniques is available. Recent attempts within the Reduced‐sensitivity RDX Round Robin (R4) have provided the EM community a better insight into these analytical techniques and in some cases a correlation between product quality and shock initiation of plastic bonded explosives containing (RS‐)RDX was identified, which would provide a possibility to discriminate between conventional and reduced sensitivity grades.