BackgroundExtremely violent events such as terrorist attacks and mass shootings form a severe risk for the health and wellbeing of affected individuals. In this study based on a public health monitor, we focus on the health impact of the Utrecht tram shooting, which took place in the morning of March 18th 2019. A lone gunman opened fire on passengers within a moving tram. Four people died, and six people were injured in this attack. The attack resulted in nationwide commotion and (...) drew much media attention. Aim of this study was to increase insight into the health effects for the survivors, and whether they received the needed care and support.MethodsSemi-structured interviews with accompanying questionnaires were conducted at six and 18 months post-attack. Overall, 21 survivors participated in the first series of interviews, 15 in the second series. Qualitative data were analyzed using reflexive thematic analysis, quantitative data was only described because of the low sample size.ResultsAt both six and 18 months after the attack many survivors had been able to resume daily life, and most rated their overall health as good or excellent. At the same time, a substantial portion suffered from health problems such as posttraumatic stress symptoms and other complaints, and needed professional care. Furthermore, those in need did not always find their own way to appropriate care through the existing health system: half of the survivors still needed support in finding the right care 18 months later.ConclusionAlthough the design and implementation of this public health monitor were accompanied by multiple challenges, it was possible to track a portion of the survivors and gain insight in the considerable health burden of the attack. Also, it is clear in this study that the health impact of terrorism affects survivors in the long run and requires attention from health authorities and professionals, as survivors were not able to find the right care by themselves. (shrink)

Waarom komen vrouwelijke denkers in curricula, filosofische cursussen en overzichtswerken zo weinig aan bod? Door de eeuwen heen hebben talloze vrouwen zich weliswaar verdiept in een veelheid aan filosofische thema's, maar vaak zijn deze denkers onzichtbaar gebleven. Van de twaalfde-eeuwse filosofe Hildegard van Bingen zullen de meesten wel hebben gehoord, maar wat van haar tijdgenote Mechtild van Magdeburg? Uit recentere tijden is Hannah Arendt inmiddels wereldberoemd, maar de namen Gloria Anzaldúa en Werewere Liking zullen misschien alleen de specialisten bekend in (...) de oren klinken. Uitgesloten van officiële onderwijsinstellingen namen vele vrouwelijke denkers hun toevlucht tot andere vormen van filosofie bedrijven, zoals briefwisselingen. En dat levert een onschatbare rijkdom aan filosofische bronnen op, zoals dit boek laat zien. Werk van 69 vrouwelijke denkers uit 25 eeuwen wordt bij elkaar gebracht. (shrink)

Public debate on acceptable farm animal husbandry suffers from a confusion of tongues. To clarify positions of various stakeholder groups in their joint search for acceptable solutions, the concept of animal welfare was split up into three notions: no suffering, respect for intrinsic value, and non-appalling appearance of animals. This strategy was based on the hypothesis that multi-stakeholder solutions should be based on shared values rather than on compromises. The usefulness of such an artificial value distinction strategy was tested in (...) a small series of experiments. The results demonstrate that the chosen concept to distinguish between values is effective in a stakeholder context. Farmers’ views on doing good to animals appeared to be largely based on their value to prevent suffering and predominantly focused on the provision of regular care. Their priority for this value is clearly shared with other stakeholders, providing a basis for joint solutions. The concept of intrinsic value does not play a discernable role in farmers’ considerations. Based on the varying views on welfare, it can be inferred that there is a gradual rather than a principal difference between government legislation and farmers’ values, whereas public perception and acceptance of farm practices remains complicated. Distinction between value groups and focusing on a selected notion (such as no suffering) proved to be effective in bringing representatives of stakeholder groups together, but is unlikely to bridge the emotional gap between commercial farm practices and public ideals. (shrink)

Practical implementation of notions such as patient-orientation, client-centredness, and demand-driven care is far from straightforward in care and service supply to elderly clients living independently. This paper aims to provide preliminary insights into how it is possible to bridge the gap between policy intent, which reflects an increasing client orientation, and actual practice of care and service provision. Differences in personal objectives and characteristics generate different sets of needs among elderly clients that must have an appropriate response in the daily (...) routines of care and service providers. From a study of the available literature and by conceptual reasoning, we identify several important operational implications of client-oriented care and service provision. To deal with these implications the authors turn to the field of operations management. This field has deepened the understanding of translating an organisation’s policy into daily activities and working methods. More specifically, we elaborate on the concept of modularity, which stems from the field of operations management. With respect to elderly people who live independently, this concept, among others, seems to be particularly useful in providing options and variation in individual care and service packages. Based on our line of reasoning, we propose that modularity provides possibilities to enhance the provision of demand-based care and services. Furthermore, our findings offer direction on how organisations in housing, welfare and care can be guided in translating demand-based care to their operational processes. (shrink)

Public debate on acceptable farm animal husbandry suffers from a confusion of tongues. To clarify positions of various stakeholder groups in their joint search for acceptable solutions, the concept of animal welfare was split up into three notions: no suffering, respect for intrinsic value, and non-appalling appearance of animals. This strategy was based on the hypothesis that multi-stakeholder solutions should be based on shared values rather than on compromises. The usefulness of such an artificial value distinction strategy was tested in (...) a small series of experiments. The results demonstrate that the chosen concept to distinguish between values is effective in a stakeholder context. Farmers’ views on doing good to animals appeared to be largely based on their value to prevent suffering and predominantly focused on the provision of regular care. Their priority for this value is clearly shared with other stakeholders, providing a basis for joint solutions. The concept of intrinsic value does not play a discernable role in farmers’ considerations. Based on the varying views on welfare, it can be inferred that there is a gradual rather than a principal difference between government legislation and farmers’ values, whereas public perception and acceptance of farm practices remains complicated. Distinction between value groups and focusing on a selected notion (such as no suffering) proved to be effective in bringing representatives of stakeholder groups together, but is unlikely to bridge the emotional gap between commercial farm practices and public ideals. (shrink)

In this article we present a study of assessments of nanotechnology in food and agriculture. The study was conducted as a part of a project studying the need for integrated assessment of emerging science and technologies. The article first introduces central hopes and concerns regarding nanotechnology in food and agriculture, and how these are assessed in different assessment spheres. The question of whether there is a need for more integration in assessments in this field is then introduced and the multiple (...) interpretations of this notion are discussed, first in a sustainability context and then in the specific context of emerging science and technologies. This serves as the basis for analysing the current status of integration of nano-food assessments. The validity of our findings is discussed and the article ends with a summary of the main conclusions from the discussion. (shrink)

The Dutch policy objective of a fully sustainable livestock sector without mutilations by 2023 is not compatible with the routine practice of tail docking to minimize the risk of tail biting. To examine farmer attitudes towards docking, a telephone survey was conducted among 487 conventional and 33 organic Dutch pig farmers. “Biting” (of tails, ears, or limbs) was identified by the farmers as a main welfare problem in pig farming. About half of the farmers reported to have no tail biting (...) problems in their own herd. When farmers did report problems, they most often reported figures between 1 and 5 % of the animals. High incidences of tail biting were anticipated when trying to keep undocked pigs. Enrichment materials used in the conventional sector included mainly chains (52–63 % of the farms) and hanging rubber or plastic balls (22–30 %). Straw, sawdust, or wood shavings was hardly provided in conventional pig farming (2–3 %), in contrast to organic farming (88–100 % of farms). Conventional pig farmers feel a curly tail is not very important for sustainable pig farming. They consider enrichment to be less effective and tail docking to be less stressful for them and their piglets than their organic colleagues do. Pig farmers identified climate as a main risk factor for tail biting as opposed to enrichment. The objective of reducing routine tail docking requires solutions for dealing with tail biting problems at the farm level. In this process, transfer of scientific knowledge about enrichment materials and other measures to prevent and cure tail biting is critical, as is a change in farmer attitudes and awareness of the moral issues involved. (shrink)

The Dutch policy objective of a fully sustainable livestock sector without mutilations by 2023 is not compatible with the routine practice of tail docking to minimize the risk of tail biting. To examine farmer attitudes towards docking, a telephone survey was conducted among 487 conventional and 33 organic Dutch pig farmers. “Biting” (of tails, ears, or limbs) was identified by the farmers as a main welfare problem in pig farming. About half of the farmers reported to have no tail biting (...) problems in their own herd. When farmers did report problems, they most often reported figures between 1 and 5 % of the animals. High incidences of tail biting were anticipated when trying to keep undocked pigs. Enrichment materials used in the conventional sector included mainly chains (52–63 % of the farms) and hanging rubber or plastic balls (22–30 %). Straw, sawdust, or wood shavings was hardly provided in conventional pig farming (2–3 %), in contrast to organic farming (88–100 % of farms). Conventional pig farmers feel a curly tail is not very important for sustainable pig farming. They consider enrichment to be less effective and tail docking to be less stressful for them and their piglets than their organic colleagues do. Pig farmers identified climate as a main risk factor for tail biting as opposed to enrichment. The objective of reducing routine tail docking requires solutions for dealing with tail biting problems at the farm level. In this process, transfer of scientific knowledge about enrichment materials and other measures to prevent and cure tail biting is critical, as is a change in farmer attitudes and awareness of the moral issues involved. (shrink)