Modeling the Adenoma and Serrated Pathway to Colorectal CAncer (ASCCA)

Several colorectal cancer (CRC) screening models have been developed describing the progression of adenomas to CRC. Currently, there is increasing evidence that serrated lesions can also develop into CRC. It is not clear whether screening tests have the same test characteristics for serrated lesions as for adenomas, but lower sensitivities have been suggested. Models that ignore this type of colorectal lesions may provide overly optimistic predictions of the screen‐induced reduction in CRC incidence. To address this issue, we have developed the Adenoma and Serrated pathway to Colorectal CAncer (ASCCA) model that includes the adenoma‐carcinoma pathway and the serrated pathway to CRC as well as characteristics of colorectal lesions. The model structure and the calibration procedure are described in detail. Calibration resulted in 19 parameter sets for the adenoma‐carcinoma pathway and 13 for the serrated pathway that match the age‐ and sex‐specific adenoma and serrated lesion prevalence in the COlonoscopy versus COlonography Screening (COCOS) trial, Dutch CRC incidence and mortality rates, and a number of other intermediate outcomes concerning characteristics of colorectal lesions. As an example, we simulated outcomes for a biennial fecal immunochemical test screening program and a hypothetical one‐time colonoscopy screening program. Inclusion of the serrated pathway influenced the predicted effectiveness of screening when serrated lesions are associated with lower screening test sensitivity or when they are not removed. To our knowledge, this is the first model that explicitly includes the serrated pathway and characteristics of colorectal lesions. It is suitable for the evaluation of the (cost)effectiveness of potential screening strategies for CRC.     

Power and dependence perspectives on outsourcing decisions

Since the 1980s outsourcing has been a major topic in both economic and management literature. Economic literature tends to focus on the transaction cost perspective. In management literature the core competence approach prevails. An emerging alternative view on outsourcing is the power and dependence perspective. Aspects of power and dependence become visible in four case studies involving the maintenance of capital assets. In each instance both the buyer and supplier sides of the dyad are examined. The paper concludes with managerial implications and research opportunities.     

A lost family-planning regime in eighteenth-century Ceylon

Based on Dutch colonial registers (thombos), this paper reconstructs fertility for two districts in Ceylon, 1756–68. It overcomes challenges in data quality by establishing the outer bounds of plausible estimates in a series of scenarios. Among these, total fertility rates (TFRs) averaged 5.5 in one district, but only 2.7 in the other. These figures exclude the victims of infanticide, a custom noted in European travelogues between about 1660 and 1820. Sex ratios among children differed depending on the number of older siblings, and overall, 27?per cent of girls are missing in one district and 57?per cent in the other. There was little significant variation either in the TFR or the sex ratio by socio-economic status, suggesting that poverty was not a key factor in motivating infanticides. Instead, we argue that at least parts of Ceylon had a forward-looking culture of family planning in the eighteenth century, which was lost in subsequent decades.     

The amount of ergonomics and user involvement in 151 design processes

Ergonomics, usability and user-centered design are terms that are well known among designers. Yet, products often seem to fail to meet the users' needs, resulting in a gap between expected and experienced usability. To understand the possible causes of this gap the actions taken by the designer during the design process are studied in this paper. This can show whether and how certain actions influence the user-friendliness of the design products. The aim of this research was to understand whether ergonomic principles and methods are included in the design process, whether users are involved in this process and whether the experience of the designer (in ergonomics/user involvement) has an effect on the end product usability. In this study the design processes of 151 tangible products of students in design were analyzed. It showed that in 75% of the cases some ergonomic principles were applied. User involvement was performed in only 1/3 of the design cases. Hardly any correlation was found between the designers' experience in ergonomic principles and the way they applied it and no correlations were found between the designers' experience in user involvement and the users' involvement in the design process.     

Turkey's physicians' attitudes toward euthanasia: a brief research report

Euthanasia and assisted suicide are subject to an ongoing debate and discussed with various aspects. Because physicians are in a profession closely related to euthanasia, their attitudes toward this subject are significant. Thus, research intending to explore their opinions is carried out in many countries. In this study, opinions of the physicians regarding euthanasia's definition, contents, legal aspects, and acceptable conditions for its application are addressed. The questionnaire was given to 949 physicians, more than 1% of the total working in Turkey. Of the physicians who participated in the study, 49.9% agreed with the opinion that euthanasia should be legal in certain circumstances. In addition, 19% had come across a euthanasia request and the majority of physicians (55.9%) believed that euthanasia is applied secretly in the country despite the prohibitory legislation. In conclusion, the authors infer from the study itself and believe that euthanasia should be legal in certain circumstances and that the subject, which is not in the agenda of the Turkish population, should continue to be examined.     

The Safeguarding Effect of Governance Mechanisms in Inter‐firm Exchange: The Decisive Role of Mutual Opportunism

This study empirically investigates the safeguarding effect of (1) administrative control, (2) a dominant power position and (3) relational norms, on opportunistic behaviour of suppliers, by means of a survey among 624 information and communication technology professionals in Dutch municipalities. The findings indicate that individual effectiveness of relational norms, particularly in terms of flexibility and solidarity, was most prominent. Administrative control and power did not show a significant impact on supplier opportunism in our sample. Research into the simultaneous use of several safeguards against opportunism generated the finding that different relational norms fortify each other's safeguarding effect. Furthermore, we demonstrate that supplier opportunism is only mitigated by a dominant power position when the buyer does not exploit its favourable position and the buyer does not behave opportunistically. Hence, power seems to have a safeguarding effect only when it is not used.     

Network and Health Changes Among Older Dutch Adults

A negative effect of good health on the instrumental support received can be viewed as an effect of the mobilization of helpers. A positive effect of good health on the personal network size and the instrumental support given demonstrates that people in poor health have difficulty actively maintaining their relationships. Furthermore, the support received and given is positively related to the support given and received in the past. In four waves of a seven–year longitudinal study, personal interviews were conducted with 2,302 older Dutch adults (aged 60 to 85) who live on their own. The hypotheses have been confirmed. An implication is that investing in relationships by giving support might pay off in times of need.     

Tin recycling: Awareness,comprehension, attitude,intention and behavior

Which factors inhibit or facilitate participation in a tin-recycling program? In this study three theoretical points of view are integrated in a slepwise model of participation: (a) attitude change through communication, (b) the relationships between belief. attitude, intention and behavior, and (c) acceptance of responsibility. The variables in the model were measured by means of mailed questionnaires completed by 586 female inhabitants of a middle-sized town in The Netherlands. The results confirm the model. Facilitating and inhibiting factors are presented in detail. The theoretical points of view are discussed and practical recommendations are given to increase and facilitate participation in the recycling program.     

Exploring death anxiety among elderly people: a literature review and empirical investigation

Given the growing number of elderly persons in society and concerns about their health and well-being, the aim was to review the available literature on their death anxiety, and to explore features of this experience among a small sample of older men and women in care facilities. In both the review and empirical parts of this study, components and correlates of death anxiety were investigated. The review revealed limited research focus on death anxiety among the elderly, particularly among those in institutions, but suggested both components and correlates for inclusion in our empirical study. Results showed that, among our elderly participants in an assisted living facility (N = 49; age range: 60-96 years), there were higher levels of fear for others and of the dying process than for fear of the unknown. Notably, among the correlates identified, fear for significant others was associated with poor physical health; fear of the dying process was related to low self-esteem, little purpose in life, and poor mental well-being. Gender differences in death anxiety were found: women showed greater fear for the death of loved ones and for the consequences of their own death on these loved ones, than did men. These patterns are discussed in the light of concerns about the welfare of elderly persons; scientific implications are also considered.