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Discrete and portfolio choice experiments:Methodological considerations and health policy applications
No full textThe aim of this dissertation is to advance the literature on the elicitation of public preferences for health policies and, to this end, contains three more specific objectives. The first objective is to position a novel method, Participatory Value Evaluation (PVE), relative to other more commonly used multi-attribute preference-elicitation methods used in the health domain, like discrete choice experiments (DCEs). After a general introduction in Chapter 1, Chapter 2 introduces PVE in the health domain and, by comparing it conceptually to four established methods, aims to contribute to a well-informed selection of method for preference-elicitation by researchers and policymakers. The Chapter ends with recommendations for further development of PVE, in particular regarding the feasibility and validity of the method. The second objective is to examine the influence of design characteristics of a DCE or PVE on the preferences elicited with the choice experiment, which is addressed in Chapters 3 and 6. Chapter 3 discusses the findings of a review of the literature across different domains on the impact of the presentation order of alternatives, attributes and choice sets on respondents’ choices in a DCE. Chapter 6 examines whether expenditure preferences and consequentiality perceptions of respondents in a PVE are sensitive to the payment vehicle used in the experiment and to the priming of opportunity costs. The third objective is to explore public preferences for health policy alternatives from a citizen perspective using DCE and PVE, which is addressed in Chapters 4 and 5. Chapter 4 uses a DCE to elicit public preferences for collective skin cancer prevention policies in Austria, the Netherlands, and Spain. Chapter 5 uses PVE to elicit public preferences for policy action regarding long-term care (LTC) for older people in the Netherlands in 2040.Finally, Chapter 7 summarizes the main findings of Chapters 2 to 6 and discusses some strengths and limitations as well as several implications for future research and policy. In particular, the Chapter considers the validity of eliciting preferences for public policy from a citizen perspective and our current understanding of respondents’ choice processes and choice behaviours in PVE choice tasks.<br/
Experiments and insights on climate-relevant behaviours
No full textClimate change is strongly linked to human behaviour and socio-economic systems. The complexity and heterogeneity of contributing factors make each climate-relevant domain worthy of attention. This thesis focuses on understanding the incentives needed to discourage carbon-intensive behaviours and support more sustainable choices at the individual level. It explores drivers in three climate-relevant domains: food choices, greenwashing practices, and applications for green jobs. While the emphasis is on individual behaviour, the work also touches on systemic considerations and broader policy prescriptions. The research uses three different experimental methods — field, lab, and online — to explore: a) The role of social observability on food choices, through a field experiment at a large environmental and resource economics conference. Ultimately, do people care and change their food choices towards more climate-friendly options when they know that they are visible to others?; b) The impact of increased detection probability on greenwashing behaviour in a laboratory market setting, examining both sellers’ deceptive practices and buyers’ willingness to pay for potentially false green claims. Essentially, to what extent is green consumption affected when its authenticity is reasonably in doubt?; c) the existence of preferences for green jobs and how intertemporal preferences and peer pressure affect job applications through an online survey experiment. Fundamentally, what are the main determinants of preferences for green jobs, and how does social pressure affect that? Unexpected and confirmatory findings contribute to the literature on behavioural climate policy by offering novel experimental evidence that informs the design of interventions across distinct yet interrelated domains
Individualized prognostic counseling in head and neck oncology
No full textHet besluitvormingsproces in de spreekkamer is vaak complex, zeker bij levensbedreigende ziekten zoals hoofd-halskanker. Het voorlichten van patiënten vraagt om een gepersonaliseerde aanpak, afgestemd op de wensen en behoeften van de patiënt. Ons doel was om de besluitvorming te verbeteren en patiënten met hoofd-halskanker te empoweren.Artsen blijken de levensverwachting in de palliatieve fase vaak te overschatten. Daarnaast komt de prognose zelden expliciet aan bod in de spreekkamer: meestal wordt er kwalitatieve informatie gedeeld zoals “goede vooruitzichten’’. Ongeveer de helft van de patiënten ervaart na voorlichting over de mogelijke behandeling(en) beslissingsonzekerheid. Uit gesprekken met patiënten blijkt dat algemene prognostische informatie, zoals “te genezen”, vaak voldoende geruststelling biedt. Bij een slechte prognose is er wel meer behoefte aan specifieke informatie zoals overlevingskansen. Dit leidde tot de doorontwikkeling van OncologIQ, een prognostisch model dat de persoonlijke overlevingskansen berekent van patiënten met behandelbare hoofdhalskanker o.b.v. persoonlijke kenmerken zoals leeftijd en geslacht. Het model werd extern gevalideerd en er werden nieuwe predictoren toegevoegd zoals roken en BMI. Patiënten gaven de voorkeur aan een cirkeldiagram om hun overlevingskansen te weergeven. Ook werd er een separaat model voor patiënten in de palliatieve fase ontwikkeld. De implementatie van OncologIQ in de spreekkamer leidde tot een significante afname van beslissingsonzekerheid en beslissingsspijt bij patiënten. Tevens namen patiënten vaker een actieve rol in het besluitvormingsproces. Voor zorgverleners bood het model waardevolle ondersteuning bij het bespreken van complexe casuïstiek tijdens multidisciplinaire overleggen.Kortom: dit proefschrift toont hoe gepersonaliseerde prognostische informatie patiënten kan empoweren, artsen kan ondersteunen en het gezamenlijke besluitvormingsproces aanzienlijk kan verbeteren.<br/
Negotiating entrepreneurship in refugee context:Multi-level analysis of Syrian entrepreneurial activities in urban areas in Lebanon
Full text linkMultiple team membership:Embracing Influences and experiences
No full textMultiple team membership (MTM)—defined as working on more than one team at a time—is ingrained in organizational functioning worldwide. It is a practice that represents the daily reality of many employees, as organizations increasingly adopt work across multiple concurrent teams to accomplish complex tasks, achieve faster results, and leverage employees’ resources as efficiently as possible. Nevertheless, scholarly interest in MTM has gained momentum only recently, raising questions about the applicability of much of our existing knowledge derived from single-team contexts. Understanding MTM is important due to this evident disconnect between research and practice, as well as the vast opportunities MTM offers for shaping workplaces through employees’ far-reaching networks of teams. This dissertation directs attention to MTM’s influences and experiences in three chapters (i.e., chapters 2 to 4), studying them using different theoretical perspectives and methods. In chapter 2, I conducted an integrative review of the multiteaming literature to understand MTM’s influence on effectiveness outcomes. As a result of this critical evaluation of extant work, I delineated and elaborated on three sources of variance to explain the inconsistency in findings: 1) what is being studied—the aspects and nature of multiteaming; 2) how MTM is thought to affect effectiveness—the processes through which multiteaming transforms into (in)effectiveness; and 3) who are the multiteamers—the characteristics of multiteamers. In chapter 3, I studied how team MTM alters team communication and information processes. Using adaptive structuration theory as a lens, I designed a study to understand when teams organize their work more asynchronously for their members’ MTM and what are the subsequent implications of team asynchronicity on team outcomes like creativity. By showing that team asynchronicity is a common and costly remedy for MTM, I thus provided initial evidence regarding scholars’ advice on using technologies asynchronously for team MTM, directed focus to the duality of MTM and technology use that is common in practice, and shifted attention to studying team virtuality from a malleable lens. In chapter 4, I delved into knowledge workers’ accounts of MTM to uncover their rationales and approaches for multiteaming. In an inductive qualitative study, I found distinct context-based, task-based, and person-based workers’ rationales to justify MTM, and specified workers’ MTM approaches, which entailed prioritizing efforts, arranging participation across teams, and resorting to suboptimal work practices.The emergent model presented workers that adopted a person-based rationale placed greater emphasis and importance on arranging their MTM participation.Together, my work contributes to the scholarly discussion on multiteaming by (a) consolidating research insights in the literature around the relationship between MTM and effectiveness outcomes (chapter 2), (b) examining the team-level influence of MTM on underlying team communication and information processes (chapter 3), and (c) identifying the MTM rationales and approaches of knowledge workers and their intersections (chapter 4).<br/
Libyan civic contributions to development during conflict:Dynamics of actors, ambitions, and approaches
Full text linkGray Matter(s) in multicolor:Intraoperative delineation and treatment of glioblastoma and its infiltrative edge
No full textRemodeling human Th17 populations by vitamin D:mechanisms and implications in inflammatory arthritis
No full textInflammatory arthritis comprises a group of immune-mediated inflammatory diseases (IMID) primarily characterized by joint inflammation due to dysregulated activation of immune and stromal cells. Th17 cells are thought to play a critical role in these diseases by producing pro-inflammatory cytokines and interacting with other immune cells and synovial fibroblasts. Suppressing Th17 cell pathogenicity is therefore considered important for controlling inflammation and disease activity. Our previous studies demonstrated the immunoregulatory effect of active vitamin D (1,25(OH)2D3) on human memory CCR6+Th17 cells, which suppresses pro-inflammatory potential while enhancing regulatory capacity. This thesis elucidates the mechanisms by which 1,25(OH)2D3 modulates transcription and metabolic pathways to reprogram human memory CCR6+Th17 cell phenotype and function to Treg-like cells, with implications for its use in inflammatory arthritis. A coordinated regulatory network underlies the suppression of inflammatory potential and induction of regulatory features in these cells. Further in vivo and clinical investigations are needed to determine its efficacy and potential to enhance existing treatment strategies in Th17-mediated inflammatory diseases
Optimization of treatment, care and patient-centeredness in GIST and soft tissue sarcoma patients
No full textThis thesis aimed to shed light on the care pathways of patients with gastrointestinal stromal tumors (GIST) in the Netherlands and explored patient-centered approaches for individuals diagnosed with GIST and soft tissue sarcomas (STS), which served as a common thread throughout this thesis. This thesis integrated insights from clinical, registry-based, and patient-reported data, underscoring the challenges inherent in managing these rare cancer types. We demonstrated that most high-risk and metastatic GIST patients are referred to reference centers. The rare subset of patients with SDH-deficient GIST requires a different approach compared to patients with KIT-PDGFRA mutated GIST. A collaborative project with the Sarcoma Patient Advocacy Global Network (SPAGN) identified priorities for research and patient advocacy from the patients’ perspective, revealing variations across subgroups of patients. This thesis also highlighted the financial toxicity often experienced by STS patients. Finally, it emphasized the importance of PatientReported Outcomes (PROs) in guiding the decision-making process for initiating palliative chemotherapy in STS patients.<br/