During the timespan of the implementation of a system, the why and what against the actual state of the system can change. This difference is referred to as the design problem. Currently, no design problems are identified in Business Rules Management (BRM) and Business Rules Management System (BRMS) literature. To solve problems with a BRMS implementation it is important that the problems solved by this implementation are known, which is not the case. A case study approach is utilized containing two phases of data collection. Phase one consisted of multiple expert interviews focused on creating a set of design problems utilizing existing literature on BRMS design problems. Then, in phase two, the set of design problems were proposed to a selection of thirteen organizations, which indicated if the design problems occurred in a BRMS implementation. This resulted in a set of 24 design problems. The identification of design problems contributes to future research in evaluating BRMS’s. Furthermore, the identification of design problems is a contribution towards situational artifact construction in the field of BRM.
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We are currently in a transition moving from a linear economy grounded on economic value maximization based on material transformation to a circular economy. Core of this transition is organising value preservation from various yet interlinked perspectives. The underlying fundamental shift is to move away from mere financial value maximization towards multiple value creation (WCED, 1987; Jonker, 2014; Raworth, 2017). This implies moving from mere economic value creation, to simultaneously and in a balanced way creating ecological and social value. A parallel development supporting this transition can be observed in accounting & control. Elkington (1994) introduced the triple bottom line (TBL) concept, referring to the economic, ecological and social impact of companies. The TBL should be seen more as a conceptual way of thinking, rather than a practical innovative accounting tool to monitor and control sustainable value (Rambaud & Richard, 2015). However, it has inspired accounting & control practitioners to develop accounting tools that not only aim at economic value (‘single capital’ accounting) but also at multiple forms of capital (‘multi capital’ accounting or integrated reporting). This has led to a variety of integrated reporting platforms such as Global Reporting Initiative (GRI), International Integrated Reporting Framework (IIRC), Dow Jones Sustainable Indexes (DJSI), True Costing, Reporting 3.0, etc. These integrated reporting platforms and corresponding accounting concepts, can be seen as a fundament for management control systems focussing on multiple value creation. This leads to the following research question: How are management control systems designed in practice to drive multiple value creation?
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Purpose: The purpose of this study is to find determinants about risk resilience and develop a new risk resilience approach for (agricultural) enterprises. This approach creates the ability to respond resiliently to major environmental challenges and changes in the short term and adjust the management of the organization, and to learn and transform to adapt to the new environment in the long term while creating multiple value creation. Design/methodology: The authors present a new risk resilience approach for multiple value creation of (agricultural) enterprises, which consists of a main process starting with strategy design, followed by an environmental analysis, stakeholder collaboration, implement ESG goals, defining risk expose & response options, and report, learn & evaluate. In each step the organizational perspective, as well as the value chain/area perspective is considered and aligned. The authors have used focus groups and analysed literature from and outside the field of finance and accounting, to design this new approach. Findings: Researchers propose a new risk resilience approach for (agricultural) enterprises, based on a narrative about transforming to multiple value creation, founded determinants of risk resilience, competitive advantage and agricultural resilience. Originality and value: This study contributes by conceptualizing risk resilience for (agricultural) enterprises, by looking through a lens of multiple value creation in a dynamic context and based on insights from different fields, actual ESG knowledge, and determinants for risk resilience, competitive advantage and agricultural resilience.
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Hematological malignancies and treatment with hematopoietic SCT are known to affect patients’ quality of life. The problem profile and care needs of this patient group need clarification, however. This study aimed to assess distress, problems and care needs after allo- or auto-SCT, and to identify risk factors for distress, problems or care needs. In this cross-sectional study, patients treated with allo-SCT or auto-SCT for hematological malignancies completed the Distress Thermometer and Problem List. Three patient groups were created: 0–1, 1–2.5 and 2.5–5.5 years after transplantation. After allo-SCT, distress and the number of problems tended to be lower with longer follow-up. After auto-SCT, distress was highest at 1–2.5 year(s). Patients mainly reported physical problems, followed by cognitive-emotional and practical problems. A minority reported care needs. Risk factors for distress as well as problems after allo-SCT included younger age, shorter time after transplantation and GVHD. A risk factor for distress as well as problems after auto-SCT was the presence of comorbid diseases. Up to 5 years after auto-SCT or allo-SCT, patients continue to experience distress and problems. Judged by prevalence, physical problems are first priority in supportive care, followed by cognitive-emotional and practical problems.
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The current study analyzed blogs written by four Dutch parents of children with profound intellectual and multiple disabilities, with the aim of deepening the understanding of the parents’ concerns. Thematic analysis was conducted and five main themes were identified: Dealing with uncertainties addressed the impact of unpredictability present in the everyday lives of parents, Love and loss described the complexity of concurrently cherishing the child and grieving various types of loss, Struggling with time, energy and finances detailed imbalances and struggles related to parents’ personal resources, Feeling included in communities and society specified social consequences, and Relating to professional care services reflected on stress and support associated with professional care delivery. The study findings demonstrate how care professionals should acknowledge parents’ vulnerabilities by being aware of their existential distress and empowering parents to exercise control of family thriving.
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Background: Art therapy (AT) is frequently offered to children and adolescents with psychosocial problems. AT is an experiential form of treatment in which the use of art materials, the process of creation in the presence and guidance of an art therapist, and the resulting artwork are assumed to contribute to the reduction of psychosocial problems. Although previous research reports positive effects, there is a lack of knowledge on which (combination of) art therapeutic components contribute to the reduction of psychosocial problems in children and adolescents. Method: A systematic narrative review was conducted to give an overview of AT interventions for children and adolescents with psychosocial problems. Fourteen databases and four electronic journals up to January 2020 were systematically searched. The applied means and forms of expression, therapist behavior, supposed mechanisms of change, and effects were extracted and coded. Results: Thirty-seven studies out of 1,299 studies met the inclusion criteria. This concerned 16 randomized controlled trials, eight controlled trials, and 13 single-group pre–post design studies. AT interventions for children and adolescents are characterized by a variety of materials/techniques, forms of structure such as giving topics or assignments, and the use of language. Three forms of therapist behavior were seen: non-directive, directive, and eclectic. All three forms of therapist behavior, in combination with a variety of means and forms of expression, showed significant effects on psychosocial problems. Conclusions: The results showed that the use of means and forms of expression and therapist behavior is applied flexibly. This suggests the responsiveness of AT, in which means and forms of expression and therapist behavior are applied to respond to the client's needs and circumstances, thereby giving positive results for psychosocial outcomes. For future studies, presenting detailed information on the potential beneficial effects of used therapeutic perspectives, means, art techniques, and therapist behavior is recommended to get a better insight into (un)successful art therapeutic elements.
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The challenges we collectively face, such as climate change, are characterized by more complexity, interdependence, and dynamism than is common for educational practice. This presents a challenge for (university) education. These transition challenges are often described as wicked or VUCA (Volatile, Uncertain, Complex, and Ambiguous) problems. In response, educational innovations that are inspired by ecology such as living labs are starting to emerge, but little is known about how learners engage within and with these more ecological forms of education. This work is an exploratory study into how learners navigate VUCA learning environments linked to tackling sustainability transition challenges, with a focus on the positive qualities of these experiences. This is done through interpretative phenomenological analysis (IPA) of seven students (using semi-structured interviews) of the MSC Metropolitan Analysis, Design and Engineering program, a joint degree from Wageningen University and Delft University of Technology in the Netherlands. The main findings, which are both psychological and educational, of this exploration include openness to new experiences (1), flexibility (2), a process appreciation of learning (3), a desire to create a positive impact on one’s direct biophysical environment (4) and society (5). In addition, we discuss the potential limitations of the malleability of these different qualities and propose future avenues for research into ecological learning for universities. This work closes by highlighting recommendations for educators to consider when designing or engaging in ecological forms of higher education that connect students to sustainability transitions.
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Little research exists on what works in the supervision of offenders with debt problems. This qualitative study aims to provide insight into the barriers probation officers and clients experience during supervision regarding debt and the support that clients need. Interviews were conducted with 33 Dutch probation officers and 16 clients. The results show that debt often negatively influences clients’ lives and hinders their resocialization. Probation officers lack effective methods to support clients with debt problems. To adequately help clients with debt problems, probation officers should obtain more knowledge about effective interventions and collaborate more closely with debt specialists from the probation supervision outset.
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Background: Multiple sclerosis often leads to fatigue and changes in physical behavior (PB). Changes in PB are often assumed as a consequence of fatigue, but effects of interventions that aim to reduce fatigue by improving PB are not sufficient. Since the heterogeneous nature of MS related symptoms, levels of PB of fatigued patients at the start of interventions might vary substantially. Better understanding of the variability by identification of PB subtypes in fatigued patients may help to develop more effective personalized rehabilitation programs in the future. This study aimed to identify PB subtypes in fatigued patients with multiple sclerosis based on multidimensional PB outcome measures. Methods: Baseline accelerometer (Actigraph) data, demographics and clinical characteristics of the TREFAMS-ACE participants (n = 212) were used for secondary analysis. All patients were ambulatory and diagnosed with severe fatigue based on a score of ≥35 on the fatigue subscale of the Checklist Individual Strength (CIS20r). Fifteen PB measures were used derived from 7 day measurements with an accelerometer. Principal component analysis was performed to define key outcome measures for PB and two-step cluster analysis was used to identify PB types. Results: Analysis revealed five key outcome measures: percentage sedentary behavior, total time in prolonged moderate-to-vigorous physical activity, number of sedentary bouts, and two types of change scores between day parts (morning, afternoon and evening). Based on these outcomes three valid PB clusters were derived. Conclusions: Patients with severe MS-related fatigue show three distinct and homogeneous PB subtypes. These PB subtypes, based on a unique set of PB outcome measures, may offer an opportunity to design more individually-tailored interventions in rehabilitation.
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The aim of the study was to evaluate whether multiple sclerosis (MS) is associated with risk of cataract or glaucoma. We conducted a population-based cohort study utilizing the UK General Practice Research Database (1987–2009) linked to the national hospital registry of England (1997–2008). Incident MS patients (5576 cases) were identified and each was matched to six patients without MS (controls) by age, gender, and practice. Cox proportional hazard models were used to estimate hazard ratios (HRs) of incident cataract and glaucoma in MS. Time-dependent adjustments were made for age, history of diseases and drug use.
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