431 research outputs found
The case of innovative breast cancer drug reimbursement
No full textCurrent research into patient advocacy focuses on attempts of patient groups to mobilise resources and to influence researchers, pharmaceutical companies and policy-makers. This paper adopts a ‘framing political opportunities’ approach to draw attention to other kinds of advocacy strategies. In a case study of breast cancer patient advocacy of Herceptin reimbursement, it is shown how patient groups tried to gain access to policy-making by means of three different opportunity-framing strategies. Articulation aims at creating awareness through public-agenda building. Negotiation aims at frame alignment between interdependent stakeholders by arranging meetings. Politicisation is a strategy to influence the agendas of political arenas. Patient organisations succeeded in creating awareness and support, which had a considerable impact on other stakeholders. These impacts in turn aided the politicisation of the issue. However, the final impact on reimbursement procedures was only partially achieved due to depoliticising counterstrategies based on persistent ideas buttressing a particular division of responsibilities in the organisation of healthcare. According to these ideas cost control in healthcare is a medical responsibility, not a political one
Ambiguity and Open-Endedness in Behavioural Design
No full textDesign is increasingly concerned with changing people’s behaviours. A common characteristic to behavioural design approaches is their directionality: productsprovide clarity about or guidance towards the designer’s intended behavioural outcome. In this paper we propose an alternative perspective that emphasizesambiguity (i.e. affording multiple interpretations) and open-endedness (i.e. affording multiple courses of action). We build on two design cases in pediatric healthcare inwhich the aim was to stimulate young children’s physical activity during hospitalization. Instead of commonly used exercise-based approaches, our focus wason physical activity in the form of spontaneous and unstructured play. We describe how interactions with ambiguous and open-ended playthings gave rise to intendedbehavioural outcomes. The findings are explained by drawing on Activity Theory, suggesting products can direct and leave things open on different levels of interaction.With our contribution we open up a new design space for behavioural design that reconciles designer’s intentions with end user’s appropriation.Human Information Communication DesignDesign Conceptualization and Communicatio
Positioning of systemic intermediaries in sustainability transitions : Between storylines and speech acts
No full textHow do systemic intermediaries obtain legitimate roles for themselves in innovation systems and transition processes? This is still an understudied question in the study of systemic intermediaries. We start from the observation that roles, or positions, are not given, but emerge in interactions as a negotiated set of rights and obligations. Inspired by positioning theory, which has its roots in symbolic interactionism, we analyse how positions are invoked in the actors’ various actions and statements (‘speech acts’) and how they draw from the mutually constructed narratives (‘storylines’) that enable and constrain the range of possible positions. We analyse, over time, the positioning of three Dutch systemic intermediaries in agriculture, energy production, and healthcare. We conclude that systemic intermediaries move together with the promise of the field and, as a consequence, have to reposition themselves. In different phases, they both profit and suffer from the dilemma between initiating and sustaining innovative systemic changes.</p
Learning to shield - Policy learning in socio-technical transitions
No full textThe dynamics of protection in the context of socio-technical niches have remained under-researched. In this paper we conceptualise the process of policy learning in the context of transitions. We show that a variety of actors inside and outside a technological niche have to learn about the implications and effects of regulations aimed at protection of niches. We analyse this process of policy learning in two cases: high-need drugs and electric vehicles. We conclude that both regulators and the regulated need to learn about the width and depth of protection measures, their duration, the specific set of tools used, and their legitimisation. A crucial issue of implementing protective regulation is the question on what level of aggregation protection measures need to be applied. Learning is often part of the negotiation process between the protector and the protected, but in many cases learning only takes place after policies have been implemented
The impact of patient advocacy: the case of innovative breast cancer drug reimbursement
No full textAbstract Current research into patient advocacy focuses on attempts of patient groups to mobilise resources and to influence researchers, pharmaceutical companies and policy-makers. This paper adopts a 'framing political opportunities' approach to draw attention to other kinds of advocacy strategies. In a case study of breast cancer patient advocacy of Herceptin reimbursement, it is shown how patient groups tried to gain access to policy-making by means of three different opportunity-framing strategies. Articulation aims at creating awareness through public-agenda building. Negotiation aims at frame alignment between interdependent stakeholders by arranging meetings. Politicisation is a strategy to influence the agendas of political arenas. Patient organisations succeeded in creating awareness and support, which had a considerable impact on other stakeholders. These impacts in turn aided the politicisation of the issue. However, the final impact on reimbursement procedures was only partially achieved due to depoliticising counterstrategies based on persistent ideas buttressing a particular division of responsibilities in the organisation of healthcare. According to these ideas cost control in healthcare is a medical responsibility, not a political one
Watertovenaars: Delftse ideeën voor nog 200 jaar Rijkswaterstaat
No full textEen bundel artikelen met inspiratie voor Rijkswaterstaat voor de ontwikkeling in de volgende 200 jaar. Watertovenaar of tovenaarsleerling? (K. d'Angremond, P. Huisman en G.I. Schiereek) De oudste deltawerken: dammen en duikers uit het begin van de jaartelling (T. de Ridder) Een erfenis uit de Bataafse periode (W.M. de Jong) Wat eerst: wonen, water, wegen of welvaart? (T.M. de Jong) Een nieuwe rol voor de waterstaatsingenieur (F.M. Sanders) De terugkeer van de stedenbouwkundige discipline (V.J. Meyer Water (P. Huisman, K. d'Angremond en G.J. Schiereek) Dynamische buffers in autosnelwegen (D. Westland en P.H.L. Bovy) Op de automatische piloot door de Randstad? (R. van der Heijden, V. Marchau, E. Molin en K. van Wees) Niet bruggen bouwen, maar zelf brug zijn (B. Enserink, M.P.M. van der Ploeg, WAH. Thissen en G.J. de Vreede) Nederland als vervoersemplacement? (M.P.C. Weijnen, W.A.H. Thissen en E.F. ten Heuvelhof) Immobilisatie van gevaarlijk afval (Ch.F.Hendriks) Dubbel verduurzamen van wegconstructies (A.A.A. Molenaar) Innovatie van de geometrische infrastructuur (P.J.G.Teunissen) Radarhoogtemetingen en de (voorname) rol van Delft (M. Naeije) Een hoog(water)standje (T. Rientjes, C. van den Akker en P. van der Veer) Naar één beslismodel voor de veiligheid (J.K. Vrijling en J. Stoop) De betrouwbaarheid van dijken (A. Verruijt) Windgolven, een fascinerend fenomeen (L.H. Holthuijsen en J.A. Battjes) Mijn droom: het railvaartuig (B. Boon) Een waterfilm in plaats van wielen (A. van Beek) Uren worden minuten (E.A.H. Vollebregt, H. Jansen en M.R.T. Roest) Een kwestie van schuiven (R.Brouwer, A.Hof en J. Schuurmans) Energie door vergisting van slib (M.S.M. letten en M.C.M. van Loosdrecht) Nóg een poldermodel: hoge-sterkte beton (J.C. Walraven) Atollen voor de Noordzeekust (J. Kristinsson) Van maker naar regisseur (H.A.J. de Ridder
Expert perspectives on the introduction of Triple Artemisinin-based Combination Therapies (TACTs) in Southeast Asia: a Delphi study
No full textBACKGROUND: Triple Artemisinin-based Combination Therapies (TACTs) are being developed as a response to artemisinin and partner drug resistance in Southeast Asia. However, the desirability, timing and practical feasibility of introducing TACTs in Southeast Asia is subject to debate. This study systematically assesses perspectives of malaria experts towards the introduction of TACTs as first-line treatment for uncomplicated falciparum malaria in Southeast Asia. METHODS: A two-round Delphi study was conducted. In the first round, 53 malaria experts answered open-ended questions on what they consider the most important advantages, disadvantages, and implementation barriers for introducing TACTs in Southeast Asia. In the second round, the expert panel rated the relevance of each statement on a 5-point Likert scale. RESULTS: Malaria experts identified 15 advantages, 15 disadvantages and 13 implementation barriers for introducing TACTs in Southeast Asia in the first round of data collection. In the second round, consensus was reached on 13 advantages (8 perceived as relevant, 5 as not-relevant), 12 disadvantages (10 relevant, 2 not-relevant), and 13 implementation barriers (all relevant). Advantages attributed highest relevance related to the clinical and epidemiological rationale of introducing TACTs. Disadvantages attributed highest relevance related to increased side-effects, unavailability of fixed-dose TACTs, and potential cost increases. Implementation barriers attributed highest relevance related to obtaining timely regulatory approval, timely availability of fixed-dose TACTs, and generating global policy support for introducing TACTs. CONCLUSIONS: The study provides a structured oversight of malaria experts’ perceptions on the major advantages, disadvantages and implementation challenges for introducing TACTs in Southeast Asia, over current practices of rotating ACTs when treatment failure is observed. The findings can benefit strategic decision making in the battle against drug-resistant malaria. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-022-13212-x
Memory, Mimesis, and Healing
No full textA return visit to Dhanam coincides with preparations for the ordination of her older son as a Roman Catholic priest. The elaborate celebration is both a boon and a burden to her family and her village. Both of her seminarian sons support Dhanam’s possession experiences and healing work, even as their studies are supported by the work of their parents. In finally relating the details of her first possession by Mata, Dhanam illuminates the depth of shared Hindu and Christian discourses and practices in the region. As the author tries to understand how Mātā’s possession of Dhanam is perceived by Dhanam and her community, she also examines the agency exercised in these practices. The language of possession is parsed carefully. The author also considers the impact of her presence on the field site and data.</p
Dynamic Contact Angle measurement using microfluidic experiments relevant for Hydrogen Subsurface Storage
No full textUnderground Hydrogen storage (UHS) is an attractive technology for large-scale energy storage. The UHS safety and efficiency depends highly on accurate characterization of H2 interactions with reservoir fluids, specially wettability analyses for H2/brine/rock systems. This thesis reports experimental measurements of advancing and receding contact angles of H2/water, N2/water and CO2/water systems at P = 10 bar and T = 20 °C using a microfluidic chip (channel widths: 50 - 130 μm). The results indicate strong water-wet conditions with H2/water advancing and receding contact angles of respectively 13 - 39°, and 6 - 23°. It was found that the contact angles decrease with increasing channel widths. Little hysteresis was measured, and consequently, the results are not in line with Morrow’s curve. The receding contact angle measured in the smallest channel agrees well with the literature coreflood tests. The N2/water and CO2/water systems showed similar behaviours as the H2/water system.Geo-Energy Engineerin
Desiring the east: a comparative study of Middle English romance and modern popular sheikh romance
No full textThis thesis comparatively examines a selection of twenty-first century sheikh romances and Middle English romances from the fourteenth and fifteenth centuries that imagine an erotic relationship occurring between east and west. They do so against a background of conflict, articulated in military confrontation and binary religious and ethnic division. The thesis explores the strategies used to facilitate the cross-cultural relationship across such a gulf of difference and considers what a comparison of medieval and modern romance can reveal about attitudes towards otherness in popular romance.
In Chapter 1, I analyse the construction of the east in each genre, investigating how the homogenisation of the romance east in sheikh romance distances it from the geopolitical reality of those parts of the Middle East seen, by the west, to be "other". Chapter 2 examines the articulation of gender identity and the ways in which these romances subvert and reassert binary gender difference to uphold normative heterosexual relations. Chapter 3 considers how ethnic and religious difference is nuanced, in particular through the use of fabric, breaking down the disjunction between east and west. Chapter 4 investigates the way ethnicity, religion and gender affect hierarchies of power in the abduction motif, enabling undesirable aspects of the east to be recast.
The key finding of this thesis is that both romance genres facilitate the cross-cultural erotic relationship by rewriting apparently binary differences of religion and ethnicity to create sameness. While the east is figured differently in Middle English and modern sheikh romance, the strategies they use to facilitate the cross-cultural erotic relationship are similar. The thesis concludes that the constancy of certain attitudes towards the east in both medieval and modern romance reveals a persistence of conservative values in representations of the east in romance
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