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Interest in higher education institutions (HEIs) as instruments for development has increased in recent years. The main objective of this paper is to address the contribution of HEIs to development through their missions, models, and challenges. With this purpose, we perform a historical analysis and characterise higher-education systems through the perspective of university models and missions, noticing relevant aspects regarding the evolution of this institution over time, as well as the transformations undergone. We also consider the main challenges that current higher education systems face in the 21st century. As methodological approaches, we carry out a literature review complemented by a comparative analysis based on data from the higher education systems of ten European countries. The findings show that HEIs can contribute to development through their missions, which are related to the models of higher education. Their first mission (teaching) contributes to improving human capital and attracting highly qualified people to their regions; the second mission (research) improves scientific knowledge which can foster innovative activities; and the third mission (community service) acts as a link between research and business, including patents, business incubators, and collaboration agreements. We also conclude that the challenges of higher education in the 21st century can be categorised essentially in three main areas: (1) globalisation and massification of higher education, as well as the internationalisation of HEIs' missions and diversification of the educational supply to attract new students; (2) new technologies related to the digitalisation of teaching and distance learning; and (3) higher education entrepreneurship, showing the importance of university-company relationships. This paper provides a global setting for a reflection on the role of HEIs in the 21st century, given their connection with society and the need for a more effective contribution to socio-economic development.

Purpose: The purpose of this paper is to explore the characteristics of talent in relation to international business to facilitate selection and development of talent in human resources (HR) and human resource development (HRD). Design/methodology/approach: A mixed method design was used: focus groups with business professionals to identify the characteristics of highly talented international business professionals (HTIBP), resulting in a concept profile; Delphi study for validation; systematic comparison of the open coding results to existing literature to identify characteristics of talent. Findings: A specific and concise profile of HTIBP has been developed. This profile has five domains: achieving results; communicating; innovating; self-reflecting; seeing patterns and interrelationships in a global context. From literature cross-referencing, we have identified innovating, being creative and having a drive to achieve results are most distinguishing for HTIBP. Practical implications: The paper facilitates an ongoing discussion about what constitutes talent, and offers new perspectives for companies to consider when selecting and developing talent. Originality/value: The conceptual contribution of the paper offers a fresh and practical empirical perspective on what talent entails.

New approaches are needed to achieve the scale and standard of building retrofit required to meet climate targets. Transition experiments are innovation projects that take a societal challenge as their starting point; they can be both top-down (government led) and bottom-up (civil society led). However, such experiments often remain isolated events that have little impact on delivering systemic change. There is limited knowledge on why this is so and what can be done to increase the success of experiments. The paper therefore compares the top-down approach to piloting Local Heat and Energy Efficiency Strategies (LHEES) in Scotland with the bottom-up strategy used for the Social Innovation Labs for a Zero Energy Housing Stock (SMILE) in the Netherlands. The different approaches are compared using three mechanisms to characterise systemic change: deepening, broadening and scaling up. Using data from interviews with local authority and citizen actors, the paper shows that neither top-down nor bottom-up experiments are sufficient in themselves to foster the new norms, information-sharing or legislative mechanisms needed to reach climate targets. The paper specifies elements of top-down and bottom-up experiments which can usefully be incorporated for achieving systemic change in energy retrofitting. [ABSTRACT FROM AUTHOR]

The article deals with the topical issue of R&D tax incentives and their impact on the level of innovation development and macroeconomic stability. The research is based on causality analysis and estimation of the strength, time lags and directions of mutual influence of R&D tax incentives and macro indicators. Systematization literary sources and approaches for solving this problem indicates that R&D tax incentives are studied in fragments in the context of macroeconomic stability. The research's main purpose is to improve the methodological bases of substantiation of the choice of relevant instruments of innovation stimulation considering causal relations of R&D tax incentives and macro indicators. The paper presents the results of dynamic analysis of R&D tax incentives in 13 European countries, for which OECD statistics for 2007-2017 are freely available. The significance, strength, and nature of the relationship between these indicators and the following macro indicators are determined: the level of the country's innovation development, the share of investment in GDP (in general and in the corporate sector in particular), net international investment position, the share of the business sector in the cost structure of R&D. Pearson and Spearman correlation coefficients were calculated depending on the variable subordination to the law of normal distribution (verified by the Shapiro - Wilk test) on the admissible calculation interval taking into account time lags from 0 years to 3 years. The causality of the studied indicators was established using the Granger causality test. The calculations are important for the prioritization of instruments for the implementation of innovation support. The highest priority should be given to the establishment of tax incentives for R&D, as this tool's impact on all studied macro indicators in most countries was direct. Its effect was manifested in the shortest possible time (with a lag of 0-3 years). The second priority should be given to setting hidden rates of business tax subsidies on R&D, as this indicator's impact on most of the studied indicators was statistically significant and direct with a time lag of 0-3 years. The paper substantiates the inefficiency of direct public financial support, as the impact of this indicator on most of the analyzed macro-indicators was reversed with a lag of 0-2 years. Thus, it is more expedient for the state to help entrepreneurs by providing tax benefits to provide innovation development and macro stability than through direct reimbursement of costs. Moreover, lag regression models were built for those countries where identified links were the most important (Belgium, Denmark, the Netherlands, and the Czech Republic). They take into account inflation rates and interest rates on long-term liabilities and the number of labour resources in the country as control variables. [ABSTRACT FROM AUTHOR]

There is growing recognition that traditional dementia care models fall short for people with dementia and their family caregivers. This has led to a call for new dementia care approaches. In response to this call, innovations in long-term dementia care are taking place both in the community and in residential care. One of these innovations is the care concept called "care farming." Care farms are farms that combine agricultural activities with care and support services for a variety of client groups, including people with dementia. Although the concept is being implemented in an increasing number of countries, the Netherlands and Norway are still front-runners in providing and researching this innovative dementia care approach. Over the last couple of years, several research projects have been carried out in these countries addressing a wide range of issues related to dementia care provision at care farms and using a wide range of research methods. This paper synthesizes the knowledge that has been generated in these research projects. By sharing the knowledge obtained in the Netherlands and Norway, we hope to inspire leaders in healthcare undertaking similar efforts to innovate care for the increasing number of people with dementia. By providing starting-points for future research, we additionally hope to contribute to a research agenda to further advance the field. [ABSTRACT FROM AUTHOR]

This paper highlights the relationship between knowledge and economic development. The study considers nine countries grouped in three different development models: 1)the Asian model includes Japan, the Republic of Korea, and Singapore; 2) the Anglo-Saxon model includes the United Kingdom, the United States, and Canada and 3)the European model includes Germany, France, and the Netherlands. The data was sourced from the Global Competitiveness Report of the World Economic Forum, the PISA reports, the Academic Ranking of World Universities (ARWU) and the Global Innovation Index of the World Bank. The Asian group ranked highest for innovation as shown through the applicati on of patents; they also obtained the highest scores in the PISA test. The Anglo Saxon group stood out by having a good institutionalized knowledge system. From the European group, Germany is recognized by its innovation capabilities and the Netherlands by the quality of its higher education. [ABSTRACT FROM AUTHOR]

Background: Cognitive impairment occurs in up to 65% of people with multiple sclerosis (PwMS), negatively affecting daily functioning and health-related quality of life. In general, neuropsychological testing is not part of standard MS-care due to insufficient time and trained personnel. Consequently, a baseline assessment of cognitive functioning is often lacking, hampering early identification of cognitive decline and change within a person over time. To assess cognitive functioning in PwMS in a time-efficient manner, a BICAMS-based self-explanatory digital screening tool called the Multiple Screener©, has recently been developed. The aim of the current study is to validate the Multiple Screener© in a representative sample of PwMS in the Netherlands. Additionally, we aim to investigate how cognitive functioning is related to psychological factors, and both work and societal participation. Methods: In this cross-sectional multicentre study, 750 PwMS (aged 18–67 years) are included. To obtain a representative sample, PwMS are recruited via 12 hospitals across the Netherlands. They undergo assessment with the Minimal Assessment of Cognitive Functioning in MS (MACFIMS; reference-standard) and the Multiple Screener©. Sensitivity, specificity, and predictive values for identifying (mild) cognitive impairment are determined in a subset of 300 participants. In a second step, the identified cut-off values are tested in an independent subset of at least 150 PwMS. Moreover, test–retest reliability for the Multiple Screener© is determined in 30 PwMS. Information on psychological and work-related factors is assessed with questionnaires. Discussion: Validating the Multiple Screener© in PwMS and investigating cognition and its determinants will further facilitate early identification and adequate monitoring of cognitive decline in PwMS. [ABSTRACT FROM AUTHOR]

The wavelet analysis is used to examine the wavelet coherence and phase variation in circular economy and emissions in the presence of technological innovation. The findings reveal a time and spectral correlation between them in the short term but an inverse link in the long and medium term. Similarly, the circular economy leads technology innovation in the short term and vice versa in the medium to short term, caused by infrastructure development and business models. The carbon emissions lead technology innovation in the short term and vice versa in the medium run. Furthermore, the existence of technological innovation alters the connection between the circular economy and carbon emissions. The study suggests that upgrading existing infrastructure will enable sectors to produce minimal waste that affects emissions. Technology innovation assists in developing appropriate strategies to solve environmental concerns. The circular economy may be accomplished relatively swiftly and offer greater environmental and economic benefits if businesses and technological developers work together. [ABSTRACT FROM AUTHOR]

Introduction: Integral obstetric care is currently being implemented in the Netherlands in various models of care. In the Netherlands pregnant women are primarily cared for by midwifes and depending on the obstetrical healthcare plan of the women the gynecologist has a larger or smaller involvement. Short description of practice change implemented: We developed an eHealth application to manage obstetrical healthcare plans based on local protocols. Targeted population and stakeholders: All women participating community and hospital based obstetrical healthcare can make use of this application, to facilitate coordinated protocolized care by multiple professionals and to empower patients to be a partner in deciding on and carrying out their healthcare plan. Aim: The aim of the app is to provide patients and health care providers assistance in administering obstetrical healthcare management plans based on over 50 regional protocols developed by a collaborative of primary and secondary obstetrical caregivers. The app offers an overview for patients and their health care providers. Specific individualized patient information is offered at an appropriate time in pregnancy, allowing patients to access information independently from health care visits. Moreover, healthcare providers receive reminders of appropriate steps in health management plans and have access to actions that previous providers have already discussed or completed. Thereby, the app enhances transfer of complete and up-to-date interdisciplinary patient information, resulting in improved situational awareness and the flexibility to adapt the individuals' healthcare plan accordingly during the pregnancy. Timeline & highlights: The application was implemented in the region Kennemerland in the Netherlands yearly 3000 pregnancies in October 2017. In the third quarter of 2017 we assessed patient and health care provider healthcare satisfaction with a questionnaire on paper. In February and March 2018 we will assess the usability of the app using patient focus groups. Furthermore, we will determine whether the eHealth application has improved the healthcare provider satisfaction and communication. Patient satisfaction cannot yet be reported since as only few women will have completed the full 9-month trajectory of the app. Results will be presented at the congress. [ABSTRACT FROM AUTHOR]

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Background: Implementing innovative health service models in existing service systems is complicated and context dependent. Flexible assertive community treatment (FACT) is a multidisciplinary service model aimed at providing integrated care for people with severe mental illness. The model was developed in the Netherlands and is now used in several countries, such as Norway. The Norwegian service system is complex and fragmented, with challenges in collaboration. Limited research has been performed on FACT teams and other new integrative health service models as part of such systems. However, such knowledge is important for future adjustments of innovation processes and service systems. Our aim was to explore how FACT teams are integrated into the existing formal public service system, how they function and affect the system, and describe some influencing factors to this. We sought to address how service providers in the existing service system experience the functioning of FACT teams in the system. Methods: Five focus group interviews were undertaken 3 years after the FACT teams were implemented. Forty service providers representing different services from both levels of administration (primary and specialist healthcare) from different Norwegian regions participated in this study. Team leaders of the FACT teams also participated. Service providers were recruited through purposeful sampling. Interviews were analysed using thematic text analysis. Results: The analysis revealed five main themes regarding FACT teams: (1) They form a bridge between different services; (2) They collaborate with other services; (3) They undertake responsibility and reassure other services; (4) They do not close all gaps in service systems; and (5) They are part of a service system that hampers their functioning. Conclusions: The FACT teams in this study contributed to positive changes in the existing service system. They largely contributed to less complex and fragmented systems by forming a bridge and undertaking responsibility in the system and by collaborating with and reassuring other services; this has reduced some gaps in the system. The way FACT teams function and needs of the existing system appear to have contributed positively to these findings. However, complexity and fragmentation of the system partly hamper functioning of the FACT teams. [ABSTRACT FROM AUTHOR]

Background: Under a constrained health care budget, cost-increasing technologies may displace funds from existing health services. However, it is unknown what services are displaced and how such displacement takes place in practice. The aim of our study was to investigate how the Dutch hospital sector has dealt with the introduction of cost-increasing health technologies, and to present evidence of the relative importance of three main options to deal with cost-increases in health care: increased spending, increased efficiency, or displacement of other services.Methods: We conducted six case-studies and interviewed 84 professionals with various roles and responsibilities (practitioners, heads of clinical department, board of directors, insurers, and others) to investigate how they experienced decision making in response to the cost pressure of cost-increasing health technologies. Transcripts were analyzed thematically in Atlas.ti on the basis of an item list.Results: Direct displacement of high-value care due to the introduction of new technologies was not observed; respondents primarily pointed to increased spending and efficiency measures to accommodate the introduction of the cost-increasing technologies. Respondents found it difficult to identify the opportunity costs; partly due to limited transparency in the internal allocation of funds within a hospital. Furthermore, respondents experienced the entry of new technologies and cost-containment as two parallel processes that are generally not causally linked: cost containment was experienced as a permanent issue to level costs and revenues, independent from entry of new technologies. Furthermore, the way of financing was found important in displacement in the Netherlands, especially as there is a separate budget for expensive drugs. This budget pressure was found to be reallocated horizontally across departments, whereas the budget pressure of other services is primarily reallocated vertically within departments or divisions. Respondents noted that hospitals have reacted to budget pressures primarily through a narrowing in the portfolio of their services, and a range of (other) efficiency measures. The board of directors is central in these processes, insurers are involved only to a limited extent.Conclusions: Our findings indicate that new technologies were generally accommodated by greater efficiency and increased spending, and that hospitals sought savings or efficiency measures in response to cumulative cost pressures rather than in response to single cost-increasing technologies. [ABSTRACT FROM AUTHOR]

Innovation projects are prone to 'escalation of commitment' (the tendency to continue projects even if it is clear that they will be unsuccessful). In this study, we introduce a construct measuring the escalation prevention potential (EPP) of innovation projects as perceived by individuals in the organization. EPP consists of three components: (i) goals, (ii) process, and (iii) ability, to shield projects from escalation to commitment. A survey was conducted among 1062 clinicians working in hospitals implementing Electronic Medical Records. The empirical results show that the three theoretical components of EPP sum up to a single measure. Four organizational characteristics of organizations (organizational routines, authentic leadership, employee involvement and support staff quality) explain a large share of the variation in EPP. [ABSTRACT FROM AUTHOR]

Background: Since the introduction of non-invasive prenatal testing (NIPT) in 2011, mainly by commercial companies, a growing demand for NIPT from the public and healthcare professionals has been putting pressure on the healthcare systems of various countries. This study identifies the challenges of establishing a responsible implementation of NIPT for aneuploidy in prenatal healthcare, by looking at the Netherlands.Methods: A mixed methods approach involving 13 stakeholder interviews, document analysis and (participatory) observations of the Dutch NIPT Consortium meetings were used. The Diffusion of Innovation Theory and a Network of Actors model were used to interpret the findings.Results: Implementation of NIPT was facilitated by several factors. The set-up of a national NIPT Consortium enabled discussion and collaboration between stakeholders. Moreover, it led to the plan to offer NIPT through a nationwide research setting (TRIDENT studies), which created a learning phase for careful implementation. The Dutch legal context was perceived as a delaying factor, but eventually gave room for the parties involved to organise themselves and their practices.Conclusions: This study shows that implementing advanced technologies with profound effects on prenatal care benefit from a learning phase that allows time to carefully evaluate the technical performance and women's experiences and to enable public debate. Such a coordinated learning phase, involving all stakeholders, will stimulate the process of responsible and sustainable implementation. [ABSTRACT FROM AUTHOR]

Background. Gaming simulation allows decision-makers to experiment with sociotechnical systems, similar to computer simulation. However, the value of these tools in comparison with each other remains uncertain, especially when focusing on their real-life application in systemic innovation processes.Aim. This article builds a framework based on the literature related to innovation of complex systems in a multi-actor environment and intends to use this framework to differentiate between the value of computer simulation and gaming simulation in innovation processes.Method. Using a case study of the introduction of gaming simulation to ProRail, the Dutch railway infrastructure manager, this article explores the advantages and disadvantages of using the two tools in situations where radical innovations need to be invented, explored, tested, and implemented in an incumbent system.Results.Computer simulations, as closed exercises, allow for more radical innovations to be studied. The openness of gaming sessions as well as the need for gamers to interact with a recognizable system inhibit the use of gaming simulation in envisioning radical innovations. However, they are more suitable for the joint commissioning of research and the stepwise testing of small-scale improvements. Gaming simulation is therefore a more appropriate tool for planning a concerted transition in a multi-actor setting.Conclusion.Computer simulation better allows for the building of experimental niches, and gaming simulation better helps in the concerted planning of the implementation of innovations. The article ends with concrete directions for further research as well as ideas about combining the two tools. [ABSTRACT FROM AUTHOR]