Schepen in moeilijkheden op zee leveren vaak besluitvormingsproblemen op tussen de scheepseigenaar/kapitein en de kuststaat. Kuststaten en met name de lokale overheden willen een probleem schip graag zo ver mogelijk weg sturen van hun gebied terwijl de eigenaar/kapitein zijn schip graag zo snel mogelijk naar de kust, een beschutte locatie of haven wil brengen. Het onderzoek geeft onderbouwing voor de besluitvorming rond schepen in moeilijkheden, zowel voor de zeescheepvaart als de betrokken besluitvormers van oeverstaten. Het product van het project is: een, op uitgewerkte scenario’s per scheepstype en lading gebaseerde besluitvormingsprocedure voor zeeschepen in moeilijkheden
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This study aimed to evaluate outcomes and support use in 12- to 25-year-old visitors of the @ease mental health walk-in centres, a Dutch initiative offering free counselling by trained and supervised peers.
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In the Netherlands, many parents of children with profound intellectual and multiple disabilities care for their children at home. Little is known about how parents and involved healthcare professionals share and align medical care for these children. This study aims to contribute to a better understanding of the dimensions that affect how medical care is shared and how healthcare professionals can align care with family needs. The study design was inspired by grounded theory. We analyzed in-depth interviews with 25 Dutch parents. The analysis identified five dimensions affecting how parents and professionals shared and aligned medical care: fragility, planned care, irregularities, interactions with providers, and parents’ choices. We recognized three distinctive ways these dimensions interplayed, characterizing scenarios of sharing care: dependent care, dialogical care, and autonomous care. The findings illuminated that parental distress decreased when parents could communicate about what they considered important for their child and family and its implications for sharing care. Parents developed their capacity to manage medical care and often evolved in their thinking about the quality of care and life. Sometimes this evolution was due to struggles with the care provided by professionals. Therefore, healthcare professionals may need to broaden the relational work of shared decision-making to include the sharing of medical care. Arrangements need to be continually reassessed as changes in the child’s and family’s situation trigger changes in preferred patterns of sharing care. Commitment to parents’ autonomy implies that healthcare professionals should be attentive to the parents’ emotional and relational needs.
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