Oncology healthcare professionals (HCPs) and cancer patients often have difficulties in navigating conversations about sexual changes and concerns due to cancer and its treatments. The present study draws on Discursive Psychology to analyze how the topic of sexuality is raised and managed in Dutch oncological consultations. Our corpus consists of 28 audio recordings. We analyzed the discursive practices used by cancer patients and oncology HCPs and to what effect. Patients, on the one hand, employ vagueness, pronouns, and ellipses, while HCPs attribute talk to others and use generalizations, and speech perturbations. Through these practices they collectively keep the topic of sexuality at a distance, thereby constructing it as a delicate topic. Moreover, we explicate the norms related to sexual behavior that cancer patients and oncology HCPs orient to in their talk. Finally, we address ways in which oncology HCPs can open the door on discussing sexual changes with their patients.
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Het magazine Bouwen aan Binding belicht het essentiële thema van studentenwelzijn en binding. Dit magazine biedt een diepgaande kijk op hoe we het welzijn en de binding van onze studenten kunnen versterken, door de lens van actuele projecten zoals de Studentenwelzijnsmonitor en de SaP Radar Methode voor de inzet van Students as Partners, tot initiatieven voor inclusieve Studentsucces Centra. Het benadrukt het belang van een gemeenschap waarin elke student zich gewaardeerd, gehoord en ondersteund voelt. Bouwen aan Binding is gemaakt door leden van het Inholland Consortium NPO. In deze publicatie staan de complete interviews die biij het magazine horen.
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PURPOSE: The purpose of this study was to gain insight into how low back pain (LBP) patients conceptualize the construct of expectations regarding treatment.METHODS: This study was nested within a mixed-method randomized clinical trial comparing three primary care interventions for LBP. A total of 77 participants with LBP lasting longer than 6 weeks were included; semi-structured interviews were conducted querying patients about their expectations for treatment. Also factors influencing their expectations were explored. Interviews were administered following enrollment into the study, but prior to study treatment. Two researchers independently conducted a content analysis using NVIVO 9 software.RESULTS: LBP patients' expectations could be categorized in two main domains: outcome and process expectations, each with subdomains. Patients expressed expectations in all subdomains both as values (what they hoped) and probabilities (what they thought was likely). In multiple subdomains, there were differences in the nature (positive vs. negative) and frequency of value and probability expectations. Participants reported that multiple factors influenced their expectations of which past experience with treatment appeared to be of major influence on probability expectations.CONCLUSION AND RECOMMENDATIONS: This study showed that LBP patients' expectations for treatment are multifaceted. Current measurement instruments do not cover all domains and subdomains of expectations. Therefore, we recommend the development of new or improved measures that make a distinction between value and probability expectations and assess process and/or outcome expectations covering multiple subdomains. Some of the influencing factors found in this study may be useful targets for altering patients' treatment expectations and improving health outcomes.
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In dit gesprekshulpmiddel vind je praktische tips en voorwaarden voor het gesprek met de GRZcliënt. Daarnaast vind je concrete voorbeeldvragen (onderverdeeld in zeven onderwerpen) die je aan de cliënt kunt stellen. Dit helpt jou om de persoon zelf en zijn sterke kanten beter te leren kennen. Evenals zijn behoeften, wensen, eigen mogelijkheden en andere hulpbronnen. Met deze gesprekstips kun jij de veerkracht van cliënten ondersteunen en versterken.
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Dutch National Sports Organizations (NSFs) is currently experiencing financial pressures. Two indications for this are described in this paper i.e. increased competition in the sports sector and changes in subsidy division. Decreasing incomes from subsidies can be compensated with either increasing incomes from a commercial domain or increasing incomes from member contributions. This latter solution is gaining interest as a solution for the uncertainties. Many NSFs have therefore participated in a special marketing program in order to enlarge their marketing awareness and create a marketing strategy, in order to (re)win market share on the sports participation market and gain a more stable financial situation. This paper introduces my research related to the introduction of marketing techniques within NSFs and the change-over to become market oriented. An overview of existing literature about creating marketing strategies, their implementation, and market orientation is given. This outline makes obvious that the existing literature is not sufficient for studying the implementation of marketing techniques and market orientation within NSFs. Therefore, it shows the scientific relevance of my research. The paper concludes with the chosen research methodology.
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These are hard days for companies: they have to survive in a market that has been hit by a financial crisis. Many countries in Europe have severe problems trying to overcome this financial crisis. The main remedy applied by governments is to cut back on expenditure, but on the other hand it is said that it is important for a country, and especially for companies, to invest in innovation. These innovations should lead to innovative products that will lead to profitability turnovers for these companies and, as a consequence, improve the economic conditions in a country. Universities provide students with engineering competences, like develop innovation, with which they can show a higher degree of ability to answer complex questions such as how to become players in the market again. Teaching students to become more innovative engineers, Fontys University of Applied Sciences, Department of Engineering, has designed a curriculum in which students are educated in the competence innovation. An important element in the process of teaching innovation to students is the approach of inquiring into possibilities of patents. In the second semester of the first year, students can decide to join an innovative project called: ‘The invention project’. The basis of this project is that students are given the opportunity to create their own invention and with their previously acquired knowledge and skills they design, calculate, prototype and present their invention. In a research project, the experiences of students in this Invention Project have been analysed. The goal of this study was to understand what the success factors are for such a project. The basis of this inquiry is a questionnaire to identify the opinions of students. The research was carried out in the spring semester of 2012. In total 31 students were involved in this research. The results show that there was a high degree of student satisfaction about the Invention Project focused on innovation development. Success factors for this project in the first year of the curriculum were seen: 1 to work on own inventions, 2 development of student’s perception of the total product creation process and 3 to make students see the relevance of contacts with real professionals from industry and from the patent office in their own project. Improvements can be made by: 1 helping students more during the creativity stage in the project and 2 to coach them more on the aspect of engineering a successful invention of which they can be proud. This Invention project is a interesting with which collaborations with other universities can be set up.
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In this thesis several studies are presented that have targeted decision making about case management plans in probation. In a case management plan probation officers describe the goals and interventions that should help offenders stop reoffending, and the specific measures necessary to reduce acute risks of recidivism and harm. Such a plan is embedded in a judicial framework, a sanction or advice about the sanction in which these interventions and measures should be executed. The topic of this thesis is the use of structured decision support, and the question is if this can improve decision making about case management plans in probation and subsequently improve the effectiveness of offender supervision. In this chapter we first sketch why structured decision making was introduced in the Dutch probation services. Next we describe the instrument for risk and needs assessment as well as the procedure to develop case management plans that are used by the Dutch probation services and that are investigated in this thesis. Then we describe the setting of the studies and the research questions, and we conclude with an overview of this thesis.
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Parental involvement is a crucial force in children’s development, learning and success at school and in life [1]. Participation, defined by the World Health Organization as ‘a person’s involvement in life situations’ [2] for children means involvement in everyday activities, such as recreational, leisure, school and household activities [3]. Several authors use the term social participation emphasising the importance of engagement in social situations [4, 5]. Children’s participation in daily life is vital for healthy development, social and physical competencies, social-emotional well-being, sense of meaning and purpose in life [6]. Through participation in different social contexts, children gather the knowledge and skills needed to interact, play, work, and live with other people [4, 7, 8]. Unfortunately, research shows that children with a physical disability are at risk of lower participation in everyday activities [9]; they participate less frequently in almost all activities compared with children without physical disabilities [10, 11], have fewer friends and often feel socially isolated [12-14]. Parents, in particular, positively influence the participation of their children with a physical disability at school, at home and in the community [15]. They undertake many actions to improve their child’s participation in daily life [15, 16]. However, little information is available about what parents of children with a physical disability do to enable their child’s participation, what they come across and what kind of needs they have. The overall aim of this thesis was to investigate parents’ actions, challenges, and needs while enhancing the participation of their school-aged child with a physical disability. In order to achieve this aim, two steps have been made. In the first step, the literature has been examined to explore the topic of this thesis (actions, challenges and needs) and to clarify definitions for the concepts of participation and social participation. Second, for the purposes of giving breadth and depth of understanding of the topic of this thesis a mixed methods approach using three different empirical research methods [17-19], was applied to gather information from parents regarding their actions, challenges and needs.
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In case of a major cyber incident, organizations usually rely on external providers of Cyber Incident Response (CIR) services. CIR consultants operate in a dynamic and constantly changing environment in which they must actively engage in information management and problem solving while adapting to complex circumstances. In this challenging environment CIR consultants need to make critical decisions about what to advise clients that are impacted by a major cyber incident. Despite its relevance, CIR decision making is an understudied topic. The objective of this preliminary investigation is therefore to understand what decision-making strategies experienced CIR consultants use during challenging incidents and to offer suggestions for training and decision-aiding. A general understanding of operational decision making under pressure, uncertainty, and high stakes was established by reviewing the body of knowledge known as Naturalistic Decision Making (NDM). The general conclusion of NDM research is that experts usually make adequate decisions based on (fast) recognition of the situation and applying the most obvious (default) response pattern that has worked in similar situations in the past. In exceptional situations, however, this way of recognition-primed decision-making results in suboptimal decisions as experts are likely to miss conflicting cues once the situation is quickly recognized under pressure. Understanding the default response pattern and the rare occasions in which this response pattern could be ineffective is therefore key for improving and aiding cyber incident response decision making. Therefore, we interviewed six experienced CIR consultants and used the critical decision method (CDM) to learn how they made decisions under challenging conditions. The main conclusion is that the default response pattern for CIR consultants during cyber breaches is to reduce uncertainty as much as possible by gathering and investigating data and thus delay decision making about eradication until the investigation is completed. According to the respondents, this strategy usually works well and provides the most assurance that the threat actor can be completely removed from the network. However, the majority of respondents could recall at least one case in which this strategy (in hindsight) resulted in unnecessary theft of data or damage. Interestingly, this finding is strikingly different from other operational decision-making domains such as the military, police and fire service in which there is a general tendency to act rapidly instead of searching for more information. The main advice is that training and decision aiding of (novice) cyber incident responders should be aimed at the following: (a) make cyber incident responders aware of how recognition-primed decision making works; (b) discuss the default response strategy that typically works well in several scenarios; (c) explain the exception and how the exception can be recognized; (d) provide alternative response strategies that work better in exceptional situations.
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This report describes the results of the interviews that were held with professionals, policy makers, and researchers (working in the field of sexuality and/or residential and foster care) in three countries in order to answer the following question: ‘Which competencies (i.e. knowledge, skills, and attitude) do professionals working in care need in order to support healthy sexual development of young people in care? Chapter 3 describes the characteristics of young people growing up in care. Young people in care are generally more vulnerable than their peers living in normal families since they have grown up in unsafe family environments. They are often insecurely attached, have a lack of positive role models and positive sexual experiences, have not grown up with clear norms and values concerning sexuality, have low self-esteem and little knowledge about (healthy) sexuality. This set of characteristics makes them more likely to cross their own boundaries and that of others and to make unhealthy choices with regard to sexuality. Therefore, young people in care have special needs with regard to sexuality that professionals working in care should know about and act upon. To meet the special needs of young people in care, professionals should create a safe environment and be there for the young people, in order to make them feel safe and secure again. In addition, they should act as positive role models, set boundaries, help young people to gain self-confidence, and give them space to have positive sexual experiences and to discover their own norms and values. Professionals working in care should provide sexual education that supports young people in their knowledge, skills, and attitudes concerning sexual development and teaches them to make wise and responsible decisions for themselves. Professionals need to put aside prejudices about boys and girls and treat them equally. Chapter 4 describes opportunities to start a conversation with young people in care about sex, intimacy and relationship and what professionals should teach foster parents. Opportunities to start a conversation with young people in care are: 1. When one of the boys or girls spontaneously starts to talk about sexuality; 2. When young people have discussions about boyfriends, girlfriends, or sex. 3. When young people watch clips on social media in which sexuality plays a role. Important topics to discuss are: healthy sexual behaviour, relationships, wishes, boundaries, making your own decisions, changing behaviour after regretting something, norms and values, and social media. Professionals working in foster care should teach foster parents that: 1. It is their task to speak about this topic with their foster child; 2. They should already start talking about this topic to toddlers; 3. It is normal to have difficulties talking about this topic; 4. They should not only speak about the risks of sex but also about sexual pleasure, desire, love, and respect. Chapter 5 describes the personal characteristics and general competencies that professionals working in care should have in order to support the sexual development of young people in care. These are: 1. Have a high degree of self-awareness concerning their own limits, norms and values, and how this influences the way they work, 2. Know that norms and values are dependent on time and culture, 3. Treat children, young people, and parents with respect, 4. Have a good sense of professional judgment, 5. Feel responsible for one’s actions, 6. Have knowledge about trauma theory. Chapter 6 describes what organisations can do to support healthy sexual development of young people in care. Organisations can do the following on the organizational level: 1. Provide structural resources for training and reflection, 2. Create a safe environment and reflective culture, 3. Create diversity among team members, 4. Create access to experts on the topic of sexuality, 5. Pay attention to competencies during hiring processes, 6. Have organisational and institutional policies on the topic of sexuality, 7. Have organisational structures and tools to support relationships and conversations with young people.Chapter 7 describes factors at the professional, organisational, and societal level that may contribute to sexuality-related difficulties in both residential and foster care. Some of these factors are not specifically related to residential or foster care, such as low self-efficacy of professionals, insufficient time for reflection and negative media influences. Other factors are specifically related to residential care, such as having insufficient possibilities to experiment with sexuality (in residential care) and fear of foster parents being accused (in foster care).
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