BackgroundDecision-making in initiating life-sustaining health technology is complex and often conducted at time-critical junctures in clinical care. Many of these decisions have profound, often irreversible, consequences for the child and family, as well as potential benefits for functioning, health and quality of life. Yet little is known about what influences these decisions. A systematic review of reasoning identified the range of reasons clinicians give in the literature when initiating technology dependence in a child, and as a result helps determine the (...) range of influences on these decisions.MethodsMedline, EMBASE, CINAHL, PsychINFO, Web of Science, ASSIA and Global Health Library databases were searched to identify all reasons given for the initiation of technology dependence in a child. Each reason was coded as a broad and narrow reason type, and whether it supported or rejected technology dependence.Results53 relevant papers were retained from 1604 publications, containing 116 broad reason types and 383 narrow reason types. These were grouped into broad thematic categories: clinical factors, quality of life factors, moral imperatives and duty and personal values; and whether they supported, rejected or described the initiation of technology dependence. The majority were conceptual or discussion papers, less than a third were empirical studies. Most discussed neonates and focused on end-of-life care.ConclusionsThere is a lack of empirical studies on this topic, scant knowledge about the experience of older children and their families in particular; and little written on choices made outside ‘end-of-life’ care. This review provides a sound basis for empirical research into the important influences on a child’s potential technology dependence. (shrink)

As the market and civil society sectors reflect different core logics, non-governmental organisations (NGOs) that partner with companies need strategies to cope with these differences. This paper seeks to provide insight into the coping strategies of environmental NGOs that partner with corporations. We present an assessment framework to analyse the strategies of the Environmental Defense Fund and the World Wildlife Fund for Nature Netherlands as case studies. The analysis demonstrates that the strategic options for a partnering NGO are guided and (...) constrained by the choices the NGO makes with regard to its action strategy towards companies. Although individual NGOs manage to cope adequately with the challenges that the partnership trend poses to their organisations, we argue that the partnering trend also creates challenges for the NGO field as a whole. (shrink)

In the 1990s, Dutch nature policy adopted a new policy concept, ‘nature development’, whereas, until then, ‘nature preservation’ had largely dominated both the discourses and practices of nature policy-making. Nature development can be regarded as the Dutch counterpart of concepts such as ecological restoration, emerging simultaneously in other national nature policies. This paper argues that the rise of the nature development concept in the Netherlands is mainly due to the entrepreneurial strategies of a relatively small group of individuals. To study (...) the impact of the latter’s entrepreneurial strategies on the adoption and implementation of the new concept, we first made a content analysis of nature-policy documents issued between 1977, when the concept of nature development was coined for the first time, and 2012. Next, we analysed newspaper articles covering the debate on Dutch nature policy. Third, we conducted semi-structured interviews with the key individuals involved. This article deliberately takes an agency perspective, emphasising the complementary roles that policy entrepreneurs played in the different phases of the policy change process, with concept developers, early adopters and translators, and early implementers. Their success is to be attributed to a smart combination of discursive and network strategies. (shrink)