bluuebunny/crossref_metadata_2025 huggingface dataset:
Implementing AI-Driven Transaction Security Protocols and Automation in Next-Gen FinTech Solutions
Authors: Bayya Anil Kumar
Published: January 2025

The FinTech industry, characterized by rapid innovation and digital transformation, necessitates adopting robust security measures to safeguard financial transactions and enhance operational efficiency. This paper examines the integration of artificial intelligence (AI) into security frameworks, focusing on automation strategies and advanced solutions to mitigate risks, improve user experience, and reinforce trust in modern financial systems. AI technologies such as predictive threat analysis, real-time fraud detection, and adaptive learning models are at the forefront of combating the dynamic and sophisticated nature of cyber threats. Predictive threat analysis facilitates the early identification of vulnerabilities, enabling proactive measures to thwart potential breaches. Real-time fraud detection leverages machine learning algorithms to analyze transactional patterns and detect anomalies, preventing unauthorized activities. Adaptive learning models continuously evolve with emerging threat landscapes, enhancing the resilience of security protocols. Beyond risk mitigation, artificial intelligence (AI)-driven systems optimize user experiences by streamlining authentication processes, minimizing false positives, and expediting secure transactions. The deployment of these technologies not only fortifies data integrity but also fosters greater trust among users by demonstrating an uncompromising commitment to cybersecurity. This paper presents empirical evidence and case studies highlighting the transformative impact of AI on financial security. By addressing critical vulnerabilities and enhancing system capabilities, AI establishes itself as a cornerstone of innovation in the FinTech sector, driving the creation of secure, adaptive, and user-focused financial ecosystems. Our findings underscore AI's pivotal role in shaping the future of resilient and trustworthy financial platforms.
Remote Sensing and Automated Monitoring Systems for Insect Pest Detection and Surveillance
Authors: Saran Saty , Hiremath Shivanand S. , Kumar Akhilesh , P Ashoka, , Singh Harpal , Chakraborty Shaon , Kashyap Vivek , Tiwari Awanindra Kumar , Pandey Shivam Kumar
Published: January 2025

Insect pests pose a significant threat to agricultural production, requiring effective monitoring and management strategies. Recent advancements in remote sensing and automated monitoring technologies offer promising solutions for early detection and surveillance of insect pests in agricultural systems. This review paper explores the current state-of-the-art remote sensing and automated monitoring approaches for insect pest detection, including satellite imagery, unmanned aerial vehicles (UAVs), wireless sensor networks, and machine learning algorithms. We discuss the advantages, limitations, and potential applications of these technologies in precision agriculture and integrated pest management. Case studies highlighting successful implementations of remote sensing and automated monitoring systems for major insect pests are presented. Furthermore, we outline future research directions and challenges in developing cost-effective, scalable, and reliable pest monitoring solutions. The integration of remote sensing and automated monitoring systems with decision support tools and precision pest control strategies holds great promise for improving crop protection and ensuring sustainable food production in the face of increasing pest pressures.
A study on securing national safety services for vulnerable elderly people
Authors:   The Korean Society of Private Security, Lim Sungeun
Published: January 2025

Due to the rapid aging of the population in Korea, social problems related to the elderly are intensifying, and criminal victimization of isolated elderly people is becoming a serious social problem. In terms of crime, isolated elderly people are increasingly exposed to criminal activities due to economic poverty, emotional isolation, and psychological vulnerability, and the number of criminal victimization cases is also increasing.
Therefore, this study aims to analyze the characteristics of isolated elderly people and propose tailored public safety services. To this end, the study was conducted mainly through literature review and case analysis, and endeavored to derive effective policy alternatives.
The study proposed the following measures to overcome the vulnerability of the isolated elderly to crime: First, it proposed to promote the economic and emotional stability of the isolated elderly by establishing a communitycentered integrated social support system. Second, it is proposed to expand customized safety education programs to strengthen crime prevention and self-protection skills. Third, it was suggested that a technology-based security system be implemented, using advanced technology to establish a rapid and efficient response system. Finally, it was proposed to establish a continuous and systematic safety net by strengthening policy support for isolated elderly people and establishing a legal protection system.
The Effect of Adolescents' Social Withdrawal on Aggression: The Longitudinal Mediating Effect of Smartphone Dependency
Authors:   The Korean Society of Private Security, Kim Sung Min , Cho Young Il
Published: January 2025

This study aimed to provide empirical evidence for the prevention and intervention of adolescent aggression. To this end, it examined the mediating effect of smartphone dependency on the relationship between social withdrawal and aggression among adolescents in South Korea. The study utilized data from the Korea Youth Policy Institute's Korean Children and Youth Panel Survey (KCYPS), specifically responses from 7,304 middle school students collected over three waves from 2018 to 2020.
To analyze the longitudinal mediating effects among the variables, a Cross-Lagged Autoregressive Model was employed. The estimation of parameters was conducted using SPSS 25.0 and Mplus ver.8. The results revealed that social withdrawal, aggression, and smartphone dependency were all positively correlated. Social withdrawal in the first year significantly influenced smartphone dependency in the following year. Furthermore, smartphone dependency in the second year significantly influenced aggression in the third year, confirming the longitudinal mediating effect.
These findings suggest that social withdrawal over time influences smartphone dependency, which subsequently predicts future aggression. Based on these results, the study provided implications for interventions targeting adolescent aggression. Lastly, it discussed the study's limitations and proposed directions for future research.
A study on the Role of Intelligence Police during International Events: Focusing on the 2024 Busan World Table Tennis Championships
Authors:   The Korean Society of Private Security, Park Man Bok , Joo Seong Bhin
Published: January 2025

This study examines the role and importance of information police in sporting events, focusing on the 2024 Busan World Table Tennis Championships. Sports events must be held successfully to enhance the national image and ensure the well-being of the people, and in this process, the intelligence police's prior information collection and terrorism prevention activities are essential. Through literature research and case analysis, various risk factors that can occur at international events were identified, and the specific role of the intelligence police and improvement measures to respond to them were presented. In particular, the aim was to suggest a direction for sports event safety management by analyzing the activities performed by the intelligence police during the preparation and operation of the Busan World Table Tennis Championships.
Through this, the role of the intelligence police was examined in various aspects, including personal protection of key personnel and participating athletes, strengthening the cooperation system to prevent terrorism, and checking the safety of event venues and accommodations. Furthermore, we discuss legal and institutional improvement measures against the threat of terrorism at international events, and emphasize the importance of a cooperative system between the intelligence police and related organizations. Through this, we aim to provide policy implications for holding safe and successful international events.
The effect of Court Security Officer's Empowerment on Security Performance: around Job Engagement of mediated effect
Authors:   The Korean Society of Private Security, Chae Jeong Seok , Shin So Young
Published: January 2025

In modern society, the quality of life has improved due to the progress of the 4th industrial revolution, however, concerns about public safety have been issued attributed to the increase in violent crimes. To correspond to the violent crimes in court buildings, it has been emphasized for the court security officers to have enhancement of role and expertise. Accordingly, this study aims to analyze the effects of empowerment and job engagement on the security performance of court security officers and derive policy implications based on the results. Research survey was implemented to the court security officers working in the Daegu, Suwon, Seoul, and Busan High Courts, and 210 data were used for analysis. The results of the study showed that empowerment is related to job engagement, and job engagement is related to security performance. On the other hand, empowerment did not have a direct effect on security performance, but exhibited a complete mediating effect through job engagement. Based on this, various measures were proposed to strengthen empowerment, such as providing Tasers and granting legal authority to court security officers, expanding the authority under Article 64 Paragraph 2 of the Court Organization Act to the security management position, introducing a special promotion system, and sharing job-related know-how. From these findings, this study is significant in that it provides basic data for the security and improvement of court security officers and suggests policy directions to strengthen the security system of the judiciary.
A Study on Crime Victimization Prevention for Youth Transitioning Out of Care
Authors:   The Korean Society of Private Security, Lee Sang Hun , Kim Dong Rok
Published: January 2025

This study aims to analyze the crime victimization experiences of youth transitioning out of care (YTC) and to propose measures for their prevention. YTC are a particularly vulnerable group to crime victimization as they begin independent living after exiting care, often facing economic hardship, psychological isolation, and a lack of social support networks. This study examines the definitions and characteristics of YTC, identifies the major types of crimes they experience and their pathways to victimization, and compares domestic and international cases to derive effective crime prevention policies and programs.
The findings reveal that YTC are exposed to a variety of crimes, including violence, economic exploitation, and sexual offenses, with many incidents occurring within trusted relationships. Such victimization disrupts their economic and psychological stability during the transition to independence, further exacerbating their social isolation and vulnerability.
Based on advanced international examples, this study proposes a multifaceted approach to prevent crime victimization among YTC. This includes implementing tailored education and training programs, establishing community-based support networks, providing psychological counseling and support services, and strengthening legal protection systems. These measures aim to create a safer environment for YTC, enabling them to achieve independence and integrate as healthy members of society.
This study provides a practical foundation for policies and systems to prevent and address crime victimization among YTC, serving as a basis for further research and implementation in the future.
A Study on Security Management System of Massive Citizen Participation Event
Authors:   The Korean Society of Private Security, Lee Chi Young , Cho Yong Hoon
Published: January 2025

The private security sector, which provides security, order, safety and security activities at the request of beneficiaries (clients) to prevent criminal damage, has been proposed as a promising way to overcome the limitations of the police force.
Although about 50 years have passed since the establishment of the security industry, the question of what caused the growth of the security industry is necessary to identify the foothold on which the current security industry has grown.
To answer the research question, this study conducts an empirical analysis of how the Korean security industry can be explained by the growth theories and characteristics of the private security industry based on economic reductionism, communization theory, and interest group theory, which are currently presented as theories of the growth of the private security industry.
Based on the national statistical data from 1976 to 2023, when the Service Security Industry Act, the parent law of the Security Industry Act, was enacted, we set up hypotheses on the causes and effects of the quantitative growth of the security industry by setting the representative variables explained by each theory as follows, and conducted correlation analysis and multiple regression analysis among the variables, and found that the unemployment rate, police force, and number of crimes do not affect the growth of the private security industry. Based on the results, it can be said that the representative growth theories of the private security industry (economic reductionism, communization theory, and interest group theory) are somewhat unfounded when applied to the Korean private security market. In particular, the economic reduction theory is based on empirical facts in the United States in the 1960s and 70s and lacks a theoretical basis, and the communization theory is based on cultural and legal restrictions, regulations, and lack of authority in Korea, which means that private security cannot take over the role of public security. In addition, the interest group theory is based on the theory that private security grows naturally with the demand for security (profit), but it is not simply that the demand increases as the number of crimes increases, but it requires the analysis of other factors such as personal experiences and situations such as income level and experience of crime victimization. Therefore, further research should be conducted to explore the factors of private security growth.
Empirical Validation of Adolescent Status Offenses: Focusing on the Mediating Effect of Depression
Authors:   The Korean Society of Private Security, Lee Seung-Hyun , Hwang Sunghyun
Published: January 2025

The main purpose of this study was to determine how school factors outside the home and parental factors inside the home, which are representative personal environmental factors of Korean adolescents, affect adolescent status offenses. In particular, this study analyzed whether school and parental factors directly affect adolescent status behavior or indirectly affect it by mediating depression, and whether the direct or indirect effects of the independent variables are greater. The analysis used data from the 2021 Mental Health Survey of Teenagers conducted by the Korea Youth Policy Research Institute as secondary data. The results of the structural model analysis showed that adolescents who were not well adjusted in school or experienced parental abuse at home were more likely to be depressed and more likely to smoke, drink, truancy, and run away to relieve their depression. In addition, adolescents who were not interested in school, did not trust teachers, or did not follow school rules were more likely to directly commit status offenses, and adolescents who were abused by their parents at home were more likely to directly commit status offenses than those who were not abused by their parents. This study has important academic significance because it empirically validates the mechanisms by which school and parental factors influence adolescent status delinquency, two of the most influential personal environmental factors on adolescent mental health.
The Role of Parents in the Emotional and Social Development of Children in the Digital Era
Authors: Wulan Sari Dwi , Putri Yulita , Rahmawati Huzdaeini , Putri Luqyana azmiya
Published: January 2025

The sophistication of technology that continues to develop can have a positive and negative impact on children's development.  Parents in facilitating the development of children have a very large influence and are responsible in providing guidance, asuhan and educating. The purpose of this study is to describe the role of parents in the emotional and social development of children in the digital era.  The research method used is qualitative with the type of literature review research.  The results of the research show that the role of parents in the emotional and social development of children is needed. There are several tasks of parents in the emotional and social development of children. First, understands that parenting is an obligation and need. Secondly, well-established communication between parents and children.  Third, parents play a role in socializing and providing social skills to children.  Fourth, parents can provide non-formal education to the child conducted in the family before the child enters a formal institution. The application of democratic parenting patterns can be used to educate children in the digital era. This is in line with his form of parenting that does not coerce, punish, or curb the child.
Improving Students Writing Skills Through Canva Application at SMP Muhammadiyah Imogiri Yogyakarta
Authors: Fitri Andriyanti  , Dwiyani Pratiwi  , Dede Yunda
Published: January 2025

The objective of this study was to improve the writing abilities of students in Class VII E at SMP Muhammadiyah Imogiri, Yogyakarta by utilizing the CANVA application to write recount text. However, based on observation, several issues were identified, including inadequate writing skills among students, lack of interest in writing, the teacher's writing approach, the media's role, and limited internet access due to the school's prohibition of smartphones. Based on these observations, it was found that students faced difficulties in writing, particularly in terms of the generic structure. Additionally, they lacked knowledge on identifying and rectifying errors in their writing, as their English teacher predominantly focused on directly correcting their mistakes. This action research study comprised two cycles and included 25 students from Class VII E at SMP Muhammadiyah Imogiri, Yogyakarta. The study involved one English teacher as a collaborator and the researcher herself. Qualitative data was collected for this study. However, the qualitative data was gathered through observations of the teaching and learning process during the action implementation, as well as interviews conducted with the students and the collaborator regarding the implementation actions. Moreover, the qualitative data took the form of field notes and transcripts of the interviews. The findings of this study indicate that the utilization of the CANVA application is an effective method for improving students' writing skills, as supported by the analysis of qualitative data. The learning process became more engaging, and the students actively enjoyed the writing process. By incorporating the CANVA application into the teaching-learning process and employing writing activities through this platform, the challenges faced by students in writing were successfully mitigated.
The Effectiveness of Retail Government Bond Issuance Policy Through The Electronic System as an Instrument of State Budget Financing
Authors: Yenny Ita , Umanto Umanto
Published: January 2025

Since 2006, the issuance of Indonesia’s retail government bonds, known as Surat Utang Negara (SUN) Ritel, has played an important role as an instrument in financing the budget deficit. This statement in line with the fluctuating budget deficit ratio due to the volatility in the global financial market, which necessitates the government’s adoption of effective, efficient, prudent, market-deepening, and innovative financing management strategies. With the advancement of digital technology, governance in financing management needs to adapt to the modernization of administrative system, among other changes, through an electronic system, spesifically the e-government platform. Consequently, the government has transitioned to issuing retail bonds online through an electronic system (e-Government Securities) within the domestic market. In light of this context, this study aims to analyze the effectiveness of the SUN Ritel issuance policy through an electronic system using the post positivism paradigm, employing interview data collection techniques and document studies. The authors utilize a theory for evaluating policy effectiveness based on five aspects: right policy, right implementation, right target, right environment, and right process. The results of the study demonstrate that the policy of issuing SUN Ritel electronically is conducted in an accountable and transparent manner, providing more effective services. Eventually, this policy exhibits improved effectiveness across all five aspects of the right policy.
Pharmaceutical Industry Influencers and Stock Price Analysis on the Indonesia Stock Exchange
Authors: Syaiful  , Rahmat Hidayat  , Yolanda  , Erika Putri Savira
Published: January 2025

This study explains the effect of financial ratios on stock prices in pharmaceutical companies listed on the Indonesia Stock Exchange. This study used panel regression analysis, where time series (2016-2022) and cross-section (8 Pharmaceutical companies). Data analysis techniques using Ordinary Least Squares regression (OLS) and selection of the best model through the Chow test and Hausman test with fixed effect model as the best model. Based on the results of the calcic assumption test, the selected model is appropriate and valid for analysis. The results of the analysis show that Return On Assets, Return On Equity, Net Profit Margin, and Debt to Equity Ratio to Stock Price have a positive and significant effect both simultaneously and partially. The variation in the ability of the independent variable in this study affects the stock price variable by 88.15% and the effect is strong. Recommend to the Board of Directors of Pharmaceutical Companies listed on the Indonesia Stock Exchange to introduce policies that will have a positive impact on return on equity, earnings per asset, and debt to equity that can significantly affect the stock price.
Analisis Faktor-Faktor yang mempengaruhi Niat Berkunjung Kembali Wisatawan : Sebuah Tinjauan Literature Sistematis
Authors: Pratiwi Komang Ary , I Gusti Ayu Kt .Giantari  , I Putu Gde Sukaatmadja  , Putu Yudi Setiawan
Published: January 2025

Niat untuk berkunjung kembali adalah salah satu indikator penting keberhasilan suatu destinasi wisata. Keputusan wisatawan untuk kembali dipengaruhi oleh berbagai faktor yang berkaitan dengan pengalaman mereka selama kunjungan pertama, Oleh karena itu penting memahami faktor-faktor yang mempengaruhi niat berkunjung kembali agar dapat membantu pengelola destinasi wisata dalam merancang strategi yang lebih efektif untuk meningkatkan daya tarik destinasi mereka melalui sebuah penelitian kualitatif dengan metode tinjauan literature sistematis. Adapun literature yang digunakan berbasis data SCOPUS dan data jurnal nasional akreditasi SINTA dengan rentang waktu terbit dari tahun 2018 hingga tahun 2024. Pengumpulan data dilakukan dengan menyaring judul dan abstrak, kemudian selanjutnya dilakukan analisis sesuai dengan tema penelitian. Hasil penelitian menunjukkan bahwa terdapat literature yang dianalisis dari Tahun 2018 hingga Tahun 2024 berfokus pada Niat Berkunjung Kembali Wisatawan dan faktor-faktor yang mempengaruhinya yaitu Citra destinasi dan kepuasan pengunjung, serta penerapan kearifan lokal Tri Kaya Parisudha (berpikir yang baik, berkata yang baik, bersikap yang baik). Faktor dominan yang mempengaruhi Niat berkunjung kembali pada penelitian ini yaitu kepuasan. Faktor nilai kearifan lokal ternyata memiliki kontribusi positif terhadap niat berkunjung kembali. Temuan ini sekaligus menunjukkan kebaruan penelitian yang menyatakan bahwa penerapan kearifan lokal Masyarakat turut memegang peranan penting dalam meningkatkan niat berkunjung kembali wisatawan ke suatu destinasi, dan diharapkan temuan penelitian ini berkontribusi pada dunia akademisi dengan  menggambarkan arah penelitian di masa mendatang.
Legal Protection for Children as Victims and Perpetrators of Criminal Acts in the Context of Human Rights
Authors: Siahaan Shinta Romaito , Manullang Herlina , Esther July
Published: January 2025

This research highlights critical contributions to understanding the protection of children's rights as both perpetrators and victims of criminal offenses in Indonesia, despite the presence of supportive regulations such as Law No. 35 of 2014 and Law No. 11 of 2012. It specifically identifies the barriers impeding the effective protection of children's rights within the framework of human rights. Using a normative juridical methodology and secondary data analysis from legislation and relevant literature, the study reveals three main challenges: insufficient understanding among law enforcement officials, persistent social stigma, and inadequate access to rehabilitation services. These findings emphasize the necessity of a synergistic approach involving the government, law enforcement agencies, and the community to foster greater awareness of children's rights and to ensure the practical application of human rights principles. Such efforts are vital to provide children with adequate protection and opportunities for optimal growth and development.
Soutien scientifique au Collège dOncologie
Authors: Tombal Bertrand , Vlayen Joan , Stordeur Sabine , De Meerleer Gert , Renard Laurette , Rorive Sandrine , Rottey Sylvie , Salmon Isabelle , Schrijvers Dirk , Villeirs Geert , Gil Thierry
Published: January 2025

En collaboration avec des experts de terrain, le Collège dOncologie et le Centre fédéral dexpertise des soins de santé (KCE) ont actualisé leurs recommandations pour la prise en charge diagnostique et thérapeutique du cancer du sein et du cancer du testicule. Chaque année, le nombre de nouveaux cas de cancer du sein diagnostiqués augmente, et particulièrement chez les femmes âgées de 50 à 69 ans. Dans cette tranche dâge toutefois, la mortalité diminue progressivement depuis plus de dix ans, principalement grâce à un dépistage et un diagnostic précoce ainsi quà des thérapies plus efficaces.
Terugbetalingssystemen voor geneesmiddelen
Authors: le Polain Maïté , Franken Margreet , Koopmanschap Marc , Cleemput Irina
Published: January 2025

2009-19
Homeopathy
Authors: De Gendt Tom , Desomer Anja , Goosens N. , Hanquet Germaine , Léonard Christian , Mertens Raf , Piérart Julien , Robays Jo , Roberfroid Dominique , Schmitz Olivier , Vinck Imgard , Kohn Laurence
Published: January 2025

Study : 2009-50
Pharmacological prevention of fragility fractures in Belgium
Authors: Roberfroid Dominique , Camberlin Cécile , Dubois Cécile
Published: January 2025

Stud£Y nr 2009-01 (2nd print; 1st print: 4 juillet 2011)
Organisation des soins post-aigus aux patients gravement brûlés
Authors: Christiaens Wendy , Van de Walle Elke , Devresse Sophie , Van Halewyck Dries , Dubois Cécile , Benahmed Nadia , Desomer Anja , Van de Sande Stefaan , Van Loey Nancy , Paulus Dominique , Van Den Heede Koen
Published: January 2025

1. INTRODUCTION 6 -- 1.1. PATIENTS BRÛLÉS: UNE POPULATION HÉTÉROGÈNE 6 -- 1.2. POPULATION DE PATIENTS RELATIVEMENT FAIBLE ET PEU DE DONNÉES ÉPIDÉMIOLOGIQUES 7 -- 1.3. CENTRES DE TRAITEMENT DES GRANDS BRÛLÉS: ACCENT SUR LA PHASE DES SOINS AIGUS 7 -- 1.4. NÉCESSITÉ DÉTENDRE LE SERVICE PROPOSÉ À DES SERVICES DE SOINS POST-AIGUS 8 -- 1.5. OBJECTIF: FORMULER DES POINTS DAMÉLIORATION DE LORGANISATION DES SOINS -- POST-AIGUS POUR LES PATIENTS GRAVEMENT BRÛLÉS 10 -- 2. PATIENTS GRAVEMENT BRÛLÉS DANS LES HÔPITAUX BELGES: LES BASES DE DONNÉES ACTUELLES SONT INSUFFISANTES 11 -- 3. TYPES DE PROBLÈMES 12 -- 4. RECOMMANDATIONS POUR UNE FUTURE ORGANISATION PLUS EFFICACE DES SERVICES DE SOINS POST-AIGUS DES BRÛLURES SÉVÈRES 13 -- 4.1. STRUCTURES ET ORGANISATION DES SOINS AUX PATIENTS BRÛLÉS 14 -- 4.1.1. Mise en place dune structure globale en réseau des soins aux patients brûlés 14 -- 4.1.2. Entrée dans le processus de soins (aigus) 15 -- 4.1.3. Un pont vers les soins post-aigus 17 -- 4.1.4. Éventail des structures entre le centre de soins des brûlures et le domicile 19 -- 4.2. SOUTIEN DES PATIENTS ET DE LEUR ENTOURAGE 22 -- 4.3. DÉVELOPPEMENT DE LEXPERTISE 23 -- 4.4. FINANCEMENT ET GOUVERNANCE 23 -- 4.4.1. Dun système de financement à lacte à un système de financement plus intégré 23 -- 4.4.2. Meilleure accessibilité financière pour le patient 24 -- 4.4.3. Système de registre national des soins des brûlures 26 -- 5. CONCLUSIONS 27 -- REFERENCES 30
De organisatie van de zorg na een bevalling
Authors: Benahmed Nadia , Devos Carl , San Miguel Lorena , Vinck Imgard , Vankelst Liesbeth , Verschueren Marguerite , Obyn Caroline , Paulus Dominique , Christiaens Wendy
Published: January 2025

VOORWOORD 1 -- SAMENVATTING 2 -- ACHTERGROND 2 -- DOEL 2 -- METHODEN 3 -- RESULTATEN 3 -- POSTNATALE ZORG IN BELGIË 3 -- BOUWSTENEN VOOR EEN BETERE POSTNATALE ZORG IN BELGIË 4 -- CONCLUSIE 4 -- SYNTHESE 5 -- INHOUDSTAFEL 5 -- 1. INLEIDING 7 -- 1.1. DE VERBLIJFSDUUR IN DE KRAAMKLINIEK WORDT KORTER 7 -- 1.1.1. Hoeveel geboorten zijn er in België? 7 -- 1.1.2. Definities en methoden 8 -- 2. WELKE ZIJN DE BELANGRIJKSTE PROBLEMEN IN DE ORGANISATIE VAN DE POSTNATALE ZORG IN BELGIË? 9 -- 2.1. OP MACROSCOPISCH NIVEAU 9 -- 2.2. OP LOKAAL NIVEAU 10 -- 3. AANBEVELINGEN VOOR GEÏNTEGREERDE EN CONTINUE POSTNATALE ZORG 11 -- 3.1. PLANNEN EN COÖRDINEREN VAN EEN TOTAALTRAJECT VAN ZWANGERSCHAP TOT POSTPARTUM 13 -- 3.1.1. Een multidisciplinair perinataal netwerk rond elke (toekomstige) moeder en kind 13 -- 3.1.2. Een elektronisch moederschapsdossier 13 -- 3.1.3. Een perinatale zorgcoördinator 15 -- 3.1.4. Een Nationaal Platform voor Perinatale Zorg 16 -- 3.2. REEDS VÓÓR DE GEBOORTE EEN PLAN OPSTELLEN VOOR INDIVIDUELE POSTNATALE ZORG 16 -- 3.3. MEER POSTNATALE ZORG THUIS, MINDER IN HET ZIEKENHUIS, MET EEN VERZEKERDE ZORGCONTINUÏTEIT 17 -- 3.3.1. Na een normale bevalling de postnatale zorg van het ziekenhuis naar huis verschuiven 17 -- 3.3.2. Ten minste gedurende de eerste week zorgen voor postnatale zorg aan huis 18 -- 3.3.3. Mogelijke besparingen 19 -- 3.3.4. Formaliseer het ontslag uit de kraamkliniek: naadloze zorg door middel van een klinisch zorgpad 20 -- 3.4. OPSTELLEN EN IMPLEMENTEREN VAN UNIFORME PROCEDURES VOOR DE HEROPNAME VAN PASGEBORENEN EN HUN MOEDERS 22 -- 3.5. DE KWALITEIT VAN DE POSTNATALE ZORG GARANDEREN 22 -- 3.5.1. Kwaliteitscriteria op basis van de klinische praktijkrichtlijnen 22 -- 3.5.2. De opleiding van professionele zorgverleners verbeteren en een passende opleiding voorzien voor vroedvrouwen en artsen 22 -- 3.6. OUDERS ONDERSTEUNEN IN HUN (NIEUWE) ROL 23 -- 3.6.1. De kraamhulp uitbreiden 23 -- 3.6.2. Informele steunnetwerken stimuleren 24 -- 3.7. HET FINANCIERINGSSYSTEEM AANPASSEN 25 -- 3.8. SPECIALE AANDACHT VOOR EEN GELIJKE TOEGANG TOT POSTNATALE ZORG 26 -- 3.9. ONDERZOEK IN HET DOMEIN ONDERSTEUNEN 27 -- 3.9.1. De nodige menselijke middelen plannen 27 -- 3.9.2. Statistieken verzamelen 28 -- 4. CONCLUSIE 28
Oncogenetische testen voor personen met erfelijke endocriene kankersyndromen
Authors: Vlayen Joan , Bex Marie , Bravenboer Bert , Claes Kathleen , Lapauw Bruno , Persu Alexandre , Poppe Kris , Ullman Urielle , van Maerken Tom , Vroonen Laurent , Poppe Bruce
Published: January 2025

Het huidige rapport is onderdeel van een reeks van 4 rapporten over genetische testen op erfelijke aanleg voor kanker, en gaat over endocriene kankers (Multiple Endocrine Neoplasia - MEN, von Hippel-Lindau syndroom, paragangliomen en feochromocytomen). Door de zeldzaamheid van de aandoeningen is het voor de artsen die het bestaan van zulke aandoening vermoeden, niet altijd duidelijk welke aanpak de beste is. Veel patiënten worden niet doorverwezen naar genetische centra of krijgen geen correcte informatie. Zoals in de vorige rapporten over genetische testen voor het voorspellen van kanker, legt het KCE nu ook de nadruk op de grote impact die de testen kunnen hebben op het leven van de betrokkenen en hun familie. Ze moeten dus snel psychologische ondersteuning en aangepaste informatie krijgen over alle mogelijk opties (opvolging of preventieve chirurgie). Deze begeleiding vraagt voldoende tijd, en moet door professionals worden gegeven. Daarom pleit het KCE ervoor om de rol van erfelijkheidsadviseur, die reeds bestaat in Frankrijk en Nederland, vorm te geven. In deze en in andere landen is de erfelijkheidsadviseur een volwaardig lid van de multidisciplinaire teams van de genetische centra.
Pistes voor een beter omkaderd off-label gebruik van geneesmiddelen
Authors: Vannieuwenhuysen Céline , Slegers Pierre , Neyt Mattias , Hulstaert Frank , Stordeur Sabine , Cleemput Irina , Vinck Imgard
Published: January 2025

Geneesmiddelen worden regelmatig voor een andere indicatie (bv. andere aandoening, dosering, patiëntengroep) gebruikt dan vermeld in de bijsluiter. Het gaat dus om gebruik waarvoor het geneesmiddel geen vergunning heeft. Men noemt dit off-label gebruik. Exacte cijfers voor België zijn er niet, maar geschat wordt dat in de pediatrie tot 80% en in de oncologie minstens de helft van de geneesmiddelen off-label wordt voorgeschreven. Het off-label voorschrijven behoort tot de therapeutische vrijheid van de artsen. Ze zouden dit gebruik wel zorgvuldig moeten overwegen en de patiënt moeten informeren. Er is immers vaak geen zekerheid dat het off-label gebruik wel veilig en werkzaam is. Het Federaal Kenniscentrum voor de Gezondheidszorg (KCE) ging na welke maatregelen ons land kan nemen voor een beter en verantwoord off-label gebruik. Het stelde een stappenplan op, dat door de beleidsmakers kan worden gevolgd. Bedoeling is dat er, indien mogelijk, zo snel mogelijk betrouwbaar wetenschappelijk bewijs wordt verzameld over off-label gebruik, al dan niet in samenwerking met de producent.
Multi-criteria beslissingsanalyse voor de beoordeling van medische behoeften
Authors: Cleemput Irina , Devriese Stephan , Christiaens Wendy , Kohn Laurence
Published: January 2025

In België, maar ook in andere landen, worden beslissingen tot terugbetaling van medische behandelingen nog steeds genomen zonder expliciet rekening te houden met de mening en voorkeur van burgers en patiënten. Het RIZIV wil hierin verandering brengen en daarom vroeg het in 2014 aan het Federaal Kenniscentrum voor de Gezondheidszorg (KCE) om te onderzoeken wat de bevolking het meest belangrijk vindt bij dit soort beslissingen. Het KCE stelt nu een nieuwe methode voor waarbij deze voorkeuren worden gebruikt voor het opstellen van de lijst van de onbeantwoorde medische behoeften. De KCE-methode houdt hierbij expliciet rekening met de voorkeuren van de burger en de werkelijke noden van de patiënt, terwijl de lijst nu vooral is gebaseerd op wat in de pijplijn van de industrie zit. Met dit eerste initiatief, dat hopelijk wordt uitgebreid naar alle terugbetalingsbeslissingen, is België wereldwijd bij de koplopers voor meer inbreng van patiënt en burger in het gezondheidszorgbeleid. Deze oefening in participatie wordt daarom met veel belangstelling door andere landen gevolgd.
Multi-criteria decision analysis for the appraisal of medical needs
Authors: Cleemput Irina , Devriese Stephan , Christiaens Wendy , Kohn Laurence
Published: January 2025

Study 2014-06
De financiële compensatie van de slachtoffers van transfusie-ongevallen
Authors: Léonard Christian , Mélotte Catherine , Maréchal Xavier , Vinck Imgard , Estienne Nicolas
Published: January 2025

Verschillende honderden mensen, die in de jaren 1980 in België door een bloedtransfusie werden besmet met het hepatitis C-of het HIV-virus, bleven tot op vandaag in de kou staan. De Minister van volksgezondheid vroeg het Federaal Kenniscentrum voor de Gezondheidszorg (KCE) om voor hen een oplossing uit te werken. Het KCE beveelt aan om het Fonds voor Medische Ongevallen (FMO) de slachtoffers een forfaitaire schadevergoeding te laten uitbetalen. Omdat het gaat om vrij oude feiten, beveelt het KCE ook aan dat deze mensen het oorzakelijk verband tussen de transfusie en de besmetting niet zouden moeten bewijzen. Ze zouden enkel moeten aantonen dat ze in België een bloedtransfusie kregen en dat ze besmet zijn met het virus. De directe slachtoffers zouden dan een bedrag van 20.000 ontvangen, de secundaire slachtoffers 10.000 of 5.000. Geschat wordt dat voor de uitbetaling van deze vergoedingen een budget van  67 miljoen nodig is, gespreid over een vijftiental jaren
Geplande keizersnede
Authors: Stordeur Sabine , Jonckheer Pascale , Fairon Nicolas , De Laet Chris
Published: January 2025

De laatste dertig jaar is het aantal keizersneden overal ter wereld toegenomen. In België is de ingreep goed voor ongeveer 21% van het totale aantal geboorten, maar onder de ziekenhuizen bestaan er belangrijke verschillen (van ongeveer 12 tot 33 % van de bevallingen die zij uitvoeren). Wanneer er bij moeder of kind een medisch probleem is, kan een keizersnede ongetwijfeld (zeer) ernstige gevolgen voorkomen. Maar wat als als de ingreep om niet-medische redenen wordt uitgevoerd, wat steeds meer het geval is ? Wegen de voordelen dan nog op tegen de nadelen? Het Federaal Kenniscentrum voor de Gezondheidszorg (KCE) maakt de balans op van de gevolgen voor moeder en kind, op korte en op lange termijn. Doordat talrijke studies tegenstrijdige resultaten opleveren, kunnen voor de gevolgen op lange termijn moeilijk definitieve conclusies worden getrokken. Voor de gevolgen op korte termijn worden de reeds gekende risico’s van ademhalingsproblemen bij de baby bevestigd, vooral als de keizersnede gepland is vóór de 39e week van de zwangerschap. Voor de moeder kunnen er vooral problemen optreden bij de volgende zwangerschappen, zoals een baarmoederscheur of problemen met de moederkoek (placenta). Vaak zal er dan een nieuwe keizersnede nodig zijn. Het KCE beveelt daarom aan om de toekomstige ouders over dit alles goed te informeren, en om de zorgverleners te sensibiliseren voor deze mogelijke gevolgen. Daarbij sluit het zich aan bij de Wereldgezondheidsorganisatie (WHO), die ervoor pleit om enkel een keizersnede uit te voeren als het echt nodig is.
Comment accroître le recours à la chirurgie de jour en Belgique ?
Authors: Leroy Roos , Camberlin Cécile , Lefevre Mélanie , Mistiaen Patriek , Van Den Heede Koen , Van de Sande Stefaan , Van de Voorde Carine , Beguin Claire
Published: January 2025

Les progrès médicaux permettent de faire de plus en plus appel à la chirurgie de jour et la Ministre de la Santé Maggie De Block souhaite en tenir compte dans le cadre de la réforme des hôpitaux. Le Centre fédéral dExpertise des Soins de Santé (KCE) a dressé un état des lieux de cette modalité de soins en Belgique et analysé les conditions qui favoriseraient un glissement de lhospitalisation classique vers la chirurgie de jour. Aujourdhui déjà, chez nous comme dans les autres pays, la plupart des personnes qui se font opérer de la cataracte peuvent rentrer chez elles le soir-même de lintervention. Par contre, pour dautres opérations comme lablation de la vésicule biliaire, il y a encore une large marge de progression possible. On observe également, pour beaucoup dinterventions, de très grandes variations entre hôpitaux. Le mode de financement actuel, extrêmement complexe, est assurément le principal obstacle au recours à ce type de chirurgie. Cest pourquoi le KCE recommande dinstaurer un système unique et transparent qui favorise financièrement les hospitalisations de jour.
Optimalisatie van de incontinentieforfaits
Authors: Obyn Caroline , Jespers Vicky , Camberlin Cécile
Published: January 2025

In ons land kunnen mensen met incontinentie onder bepaalde voorwaarden een jaarlijkse vaste vergoeding (forfait) van het RIZIV ontvangen. Aan het Federaal Kenniscentrum voor de Gezondheidszorg (KCE) werd gevraagd om deze voorwaarden onder de loep te nemen, zodat ze beter aan de behoeften zouden voldoen en de toegankelijkheid zouden verbeteren. In 2016 ontvingen ongeveer 108.000 personen één van deze forfaits, op ongeveer 400.000 personen met verschillende graden van incontinentie. Niet alle mensen met incontinentie hebben recht op dit forfait, maar er is nood aan verduidelijking van de criteria. Bovendien wezen de geïnterviewde zorgverleners erop dat de forfaits bepaalde mensen eerder aanzetten tot het kopen van luiers, in plaats van het volgen van een behandeling. Er bestaan nochtans vrij doeltreffende behandelingen voor (het voorkomen en verminderen van) de meeste vormen van incontinentie. Het KCE beveelt daarom aan om patiënten en zorgverleners beter te informeren over de behandelmogelijkheden, en hen hiertoe zoveel mogelijk aan te moedigen  voor zover dit mogelijk is voor de patiënt -, voordat men zijn toevlucht neemt tot absorberende bescherming
Statins for the primary prevention of cardiovascular events
Authors: Cordon Audrey , De Meester Christophe , Gerkens Sophie , Roberfroid Dominique , De Laet Chris
Published: January 2025

A healthy lifestyle remains the most effective way of avoiding cardiovascular diseases and their consequences. Yet since 2002, the annual number of people who use cholesterol-lowering drugs from the statin family increased from 400,000 to 1,500,000. Currently, 25% of the population aged 40 and above take these drugs. Despite decreases in price due to the fact that all statins now exist in generic form, their total cost still stands at 160 million euros annually. Moreover, the analysis of individual consumption shows that, in Belgium, approximately 55% of new statin users do not take this treatment correctly or abandon it along the way. By lowering the blood cholesterol level, statins supposedly decrease the risk of myocardial infarct and cerebrovascular accident in primary prevention, that is, in persons who have not yet had this type of problem. But in terms of actual benefit for health, their adverse effects must also be taken into account. These adverse effects are, in fact, few in number but they are potentially serious. Thus in individuals with a low baseline risk, the potential benefits are limited, while the risk of adverse effects remains unchanged. It is therefore necessary to weigh the pros and cons carefully before prescribing them. We are currently developing a decision-making tool (online) which will allow physicians to assess these benefits and risks with each patient, to arrive together at a joint “informed” decision. This tool will be available over the course of 2019.
Obesitaschirurgie: Organisatie en Financiering van zorg voor en na de operatie
Authors: Van Den Heede Koen , ten Geuzendam Belinda , Dossche Dorien , Janssens Sabine , Louwagie Peter , Vanderplanken Kirsten , Jonckheer Pascale
Published: January 2025

Ongeveer 1% van de Belgen heeft zich al laten opereren om gewicht te verliezen. Deze zogenaamde bariatrische ingrepen zijn doeltreffend en hebben een langdurig effect, tenminste als de patiënten nadien hun voedingsgewoonten en gedrag levenslang aanpassen. De kans op succes wordt nog groter als ze zich medisch, nutritioneel en psychologisch laten opvolgen, zowel vóór als tot minstens twee jaar na de ingreep. Het Federaal Kenniscentrum voor de Gezondheidszorg (KCE) en het Intermutualistisch Agentschap (IMA) stelden vast dat deze nazorg in ons land erg verschilt tussen de ziekenhuizen, net als de manier waarop patiënten op de operatie worden voorbereid. Het pleit voor een meer uniforme, multidisciplinaire aanpak, met een betrokkenheid en engagement van de patiënten. Verder beveelt het aan om de ingreep enkel te laten gebeuren in ziekenhuizen en door chirurgen die aan bepaalde voorwaarden voldoen, zoals een minimaal jaarlijks aantal van zulke ingrepen, zodat de expertise van de teams opgebouwd wordt en behouden blijft.
Utilisation des services e-santé par les médecins généralistes belges
Authors: Detollenaere Jens , Christiaens Wendy , Dossche Dorien , Camberlin Cécile , Lefevre Mélanie , Devriese Stephan
Published: January 2025

Tous les services fédéraux passent progressivement à lère digitale, et les soins de santé néchappent pas à ce mouvement. Pour les médecins généralistes, le passage ne se déroule cependant pas toujours aussi souplement que prévu  même si lépidémie de COVID-19 a considérablement accéléré les choses. Il a été demandé au Centre fédéral dExpertise des Soins de Santé (KCE) didentifier les facteurs susceptibles de faciliter ladoption des services eSanté par ces acteurs centraux de nos soins de santé. Après avoir écouté les médecins, analysé les données de lINAMI et étudié la littérature internationale sur ce sujet, les chercheurs ont dégagé quelques pistes damélioration : améliorer le fonctionnement, linteropérabilité et le support technique des services offerts; sensibiliser, former et soutenir financièrement les médecins, mais aussi  et cest plus inattendu  davantage les impliquer dans la conception et le développement des services dont ils seront finalement les principaux utilisateurs.
Intégration des soins aux personnes âgées fragiles en Belgique
Authors: Cornelis Justien , Desmedt Melissa , Chevalier Esther , Camaly Olivier , Christiaens Wendy
Published: January 2025

La convention Protocole 3 a été lancée en 2010 pour soutenir des projets innovants de soins à domicile pour des personnes âgées fragiles nécessitant des soins complexes. Elle a subi quelques remaniements au fil du temps, mais est restée à létat de projet pilote. LINAMI a demandé au Centre fédéral dExpertise des Soins de santé (KCE) den faire une évaluation avant de décider de son éventuelle pérennisation. Après avoir interrogé tous les acteurs impliqués ainsi que des bénéficiaires, le KCE constate que, même si les résultats sont globalement satisfaisants, les remaniements de la convention mettent en péril sa philosophie première et risquent de démotiver les soignants qui sy impliquent. Il recommande que les soins proposés dans ce cadre soient transformés en un modèle généralisé de soins intégrés et bénéficient dun cadre structurel stable. Le moment y est sans doute propice, puisque l'INAMI a fait de l'intégration des soins l'un des principaux objectifs de son tout récent budget pluriannuel.