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Background: Advanced statistical modeling techniques may help predict health outcomes. However, it is not the case that these modeling techniques always outperform traditional techniques such as regression techniques. In this study, external validation was carried out for five modeling strategies for the prediction of the disability of community-dwelling older people in the Netherlands., Methods: We analyzed data from five studies consisting of community-dwelling older people in the Netherlands. For the prediction of the total disability score as measured with the Groningen Activity Restriction Scale (GARS), we used fourteen predictors as measured with the Tilburg Frailty Indicator (TFI). Both the TFI and the GARS are self-report questionnaires. For the modeling, five statistical modeling techniques were evaluated: general linear model (GLM), support vector machine (SVM), neural net (NN), recursive partitioning (RP), and random forest (RF). Each model was developed on one of the five data sets and then applied to each of the four remaining data sets. We assessed the performance of the models with calibration characteristics, the correlation coefficient, and the root of the mean squared error., Results: The models GLM, SVM, RP, and RF showed satisfactory performance characteristics when validated on the validation data sets. All models showed poor performance characteristics for the deviating data set both for development and validation due to the deviating baseline characteristics compared to those of the other data sets., Conclusion: The performance of four models (GLM, SVM, RP, RF) on the development data sets was satisfactory. This was also the case for the validation data sets, except when these models were developed on the deviating data set. The NN models showed a much worse performance on the validation data sets than on the development data sets., Competing Interests: The authors declare that they have no competing interests., (© 2023 van der Ploeg et al.)

A century after the Spanish Flu, the COVID-19 pandemic has brought renewed attention to socioeconomic and occupational differences in mortality in the earlier pandemic. The magnitude of these differences and the pathways between occupation and increased mortality remain unclear, however. In this paper, we explore the relation between occupational characteristics and excess mortality among men during the Spanish Flu pandemic in the Netherlands. By creating a new occupational coding for exposure to disease at work, we separate social status and occupational conditions for viral transmission. We use a new data set based on men's death certificates to calculate excess mortality rates by region, age group, and occupational group. Using OLS regression models, we estimate whether social position, regular interaction in the workplace, and working in an enclosed space affected excess mortality among men in the Netherlands in the autumn of 1918. We find some evidence that men with occupations that featured high levels of social contact had higher mortality in this period. Above all, however, we find a strong socioeconomic gradient to excess mortality among men during the Spanish Flu pandemic, even after accounting for exposure in the workplace., (Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)

Purpose : Self-reliance and social participation are strongly promoted by social policy. Both concepts are linked to the concept of vulnerability, for people who do not meet these standards are labelled "vulnerable people". In this paper, the insider's perspective takes central stage by seeking to explore what it means to be labelled a "vulnerable person", and through this to further our insight into the meaning of the concept of vulnerability. Method : Thirty-three in-depth interviews were conducted with 16 allegedly vulnerable people. The data were subjected to thematic content analysis. Results : Our analysis revealed three main dimensions and eight sub-dimensions of perceived vulnerability, outlining an insider's concept of vulnerability. This concept includes manifestations of vulnerability, feelings coexisting with vulnerability, and the image of vulnerable people. Conclusion : The perception of vulnerability changes when interacting with others in society, especially with social policy implementers. In this interaction, the perceived vulnerability increases and becomes societal vulnerability. It concerns a dependency situation in which one's strength and self-determination are not recognized, and the help needed is not provided. By acknowledging the insider's perspective, social policy can fulfil a more empowering role towards "vulnerable people" and contribute to people's well-being.

The greying of the population and trends that will change the future institutional context have implications for the social care for people with dementia and their caregivers. Based on the data of services provided by 50 organisations in a region in the South of the Netherlands, an organisational analysis revealed that better coordinated care is needed to fit the changing needs of clients in different phases of the disease process.

Purpose: To assess the relationship between quality management and employee commitment., Design/methodology/approach: Analysis of the state of affairs with respect to (TQM) programs in The Netherlands based on the literature and interviews with key informants., Findings: Description of an approach that tries to integrate employee commitment and quality management based on the concept of employees' psychological contracts with their organization (ideas about mutual obligations between them and their employer)., Research Limitations/implications: The interviews with key informants provide limited information; the study is done in only one country. Research in a broader context and on a larger scale would give a more general overview., Practical Implications: The crucial factor in making quality management work can be better described by "quality fails when employees' psychological contracts are neglected" than by "quality fails when system fails"., Originality/value: This paper highlights the essential relationship between quality management and employee commitment and offers suggestions on how to approach this issue.

Purpose: To assess the relationship between quality management and employee commitment., Design/methodology/approach: Analysis of the state of affairs with respect to (T)QM programs in The Netherlands based on the literature and interviews with key informants., Findings: Description of an approach that tries to integrate employee commitment and quality management based on the concept of employees' psychological contracts with their organization (ideas about mutual obligations between them and their employer)., Research Limitations/implications: The interviews with key informants provide limited information: the study is done in only one country. Research in a broader context and on a larger scale would give a more general overview., Practical Implications: The crucial factor in making quality management work can better be described by "quality fails when employees' psychological contracts are neglected" than by "quality fails when the system fails"., Originality/value: This paper highlights the essential relationship between quality management and employee commitment and offers suggestions on how to approach this issue.