Aim To provide insight into the basic characteristics of decision making in the treatment of symptomatic severe aortic stenosis (SSAS) in Dutch heart centres with specific emphasis on the evaluation of frailty, cognition, nutritional status and physical functioning/functionality in (instrumental) activities of daily living [(I)ADL]. Methods A questionnaire was used that is based on the European and American guidelines for SSAS treatment. The survey was administered to physicians and non-physicians in Dutch heart centres involved in the decision-making pathway for SSAS treatment. Results All 16 Dutch heart centres participated. Before a patient case is discussed by the heart team, heart centres rarely request data from the referring hospital regarding patients’ functionality (n = 5), frailty scores (n = 0) and geriatric consultation (n = 1) as a standard procedure. Most heart centres ‘often to always’ do their own screening for frailty (n = 10), cognition/mood (n = 9), nutritional status (n = 10) and physical functioning/functionality in (I)ADL (n = 10). During heart team meetings data are ‘sometimes to regularly’ available regarding frailty (n = 5), cognition/mood (n = 11), nutritional status (n = 8) and physical functioning/functionality in (I)ADL (n = 10). After assessment in the outpatient clinic patient cases are re-discussed ‘sometimes to regularly’ in heart team meetings (n = 10). Conclusions Dutch heart centres make an effort to evaluate frailty, cognition, nutritional status and physical functioning/functionality in (I)ADL for decision making regarding SSAS treatment. However, these patient data are not routinely requested from the referring hospital and are not always available for heart team meetings. Incorporation of these important data in a structured manner early in the decision-making process may provide additional useful information for decision making in the heart team meeting.
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News media in The Netherlands show great variety in the extent and ways, in which they realize media accountability online in terms of actor transparency, product transparency and feedback opportunities online. It is suggested that even those news rooms that seem to adhere to transparency and public accountability still need to explore the functionality and application of media accountability instruments (MAI). Both in terms of potentials and pitfalls, news rooms need to consider about what they want to be transparent and in what ways. To the extent that online innovations are visible, traditional news media seem to experiment, as is the case with newsroom blogs or the project of hyper local journalism Dichtbij.nl, part of the Telegraaf Company. Various news media have on-going projects on audience participation, online applications and distribution models. However, since many projects merely aim at finding new applications, processes, platforms and business models, it remains to be seen assess whether projects are indeed reasonably innovative and feasible at the same time. The development of an online and therefore immediate, archived, personalized and interactive context, offers practical and ethical challenges to Dutch journalism. These challenges bring shifts in its role and responsibility to society. It means that changes occur in what journalists are accountable for, as well as ways in how they are accountable. The Dutch media landscape lodges various professional accountability instruments like the press council and both profession-wide and news media specific codes of ethics, but some of these instruments receive only moderate support. Proactive openness is more an exception than the rule and may well be a distinctive indicator for quality journalism. Although news media often acknowledge the importance of media accountability offline and online, they often lack the resources or courage to use them or have different priorities. This ambiguous position may indicate that in relation to media accountability online, Dutch news media are between hope and fear: that it will either improve their relationship with the public and fuel professional quality, or ask too much of resources with too little benefit.
This article illustrates the ‘visual turn’ approach to sports history in an analysisof traditionally under-researched material from the late nineteenth century. Focusing on football (‘soccer’) action photography, we argue that interpreting this visual material contributes significantly to the exploration and interpretation of the broader social and cultural context within which sports were practised andthe visual material was produced. Regarding the latter, the photographer’s challenge was to capture the movement inherent in the practice of sports generally and of football specifically. Our analysis explains the time at which these pictures first appear as a consequence of developing possibilities and skills in ongoing photographic experimentation. This is illustrated by a case study of a football action photograph from the archives of the Noorthey Institute for boys in Voorschoten, dating from 1895-1897. There, conducting sports was seen as a way of enhancing the students’ physical and mental strengths, including improved study performance. It took place in an atmosphere of camaraderie among teachers and students, the latter acting as supervisors and teammates at the same time. Beyond the texts, the photographs visualize what this educational approach entailed in actual practice
