Samenvatting:Behavioural finance maakt inzichtelijk door welke sociaal-psychologische drijfveren mensen zich laten leiden bij financiële beslissingen. In onze exploratieve studie naar financiering van het mkb laten wij zien hoe financiële professionals worden geleid door gewoonten en routines. Het blijkt dat hun afweging veel componenten kent en dat niet alleen de kapitaalkosten belangrijk zijn. Adviseurs hebben een sterke voorkeur voor reguliere bancaire producten, kiezen uit een beperkt aantal opties en worden erg gedreven door de haalbaarheid van een financieringsaanvraag en de aansluiting van de financier bij de ondernemer. Daarmee negeren zij belangrijke inzichten vanuit financieringstheorieën, zoals de Pecking Order en Growth Cycle Theory.
Purpose: Head and neck cancer (HNC) treatment often leads to physical and psychosocial impairments. Rehabilitation can overcome these limitations and improve quality of life. The aim of this study is to obtain an overview of rehabilitation care for HNC, and to investigate factors influencing rehabilitation provision, in Dutch HNC centers, and to some extent compare it to other countries. Methods: An online survey, covering five themes: organizational structure; rehabilitation interventions; financing; barriers and facilitators; satisfaction and future improvements, among HNC healthcare- and financial professionals of Dutch HNC centers. Results: Most centers (86%) applied some type of rehabilitation care, with variations in organizational structure. A speech language therapist, physiotherapist and dietitian were available in all centers, but other rehabilitation healthcare professionals in less than 60%. Facilitators for providing rehabilitation services included availability of a contact person, and positive attitude, motivation, and expertise of healthcare professionals. Barriers were lack of reimbursement, and patient related barriers including comorbidity, travel (time), low health literacy, limited financial capacity, and poor motivation. Conclusion: Although all HNC centers included offer rehabilitation services, there is substantial practice variation, both nationally and internationally. Factors influencing rehabilitation are related to the motivation and expertise of the treatment team, but also to reimbursement aspects and patient related factors. More research is needed to investigate the extent to which practice variation impacts individual patient outcomes and how to integrate HNC rehabilitation into routine clinical pathways.
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Metastructuration actions (overarching activities from (top)- management that shape and align users’ activities of IS/IT use) are often advocated to improve the success of IS/IT implementation. But is the potential of these actions situational to the interactions between different stakeholders; and if so, how can this context be taken into account? This key question is addressed in this paper. Building upon Orlikowski et al., the situational effect of metastructuration interplay concerning four key stakeholders; (top) management, users, IT department, and external service providers or consultants is explored. The empirical case context is a Dutch public healthcare organization that deployed three departmental information systems. Based on 26 qualitative stakeholder interviews, it was found that three types of metastructuration actions were critical, which are particular related to two types of stakeholder context. It is concluded that the stakeholder context is indeed conditional to metastructuration actions, and also to the success of IS/IT implementation in terms of perceived system quality and acceptance of the systems.
