Government Influence on Patient Organizations

Patient organizations increasingly play an important role in health care decision-making in Western countries. The Netherlands is one of the countries where this trend has gone furthest. In the literature some problems are identified, such as instrumental use of patient organizations by care providers, health insurers and the pharmaceutical industry. To strengthen the position of patient organizations government funding is often recommended as a solution. In this paper we analyze the ties between Dutch government and Dutch patient organizations to learn more about the effects of such a relationship between government and this part of civil society. Our study is based on official government documents and existing empirical research on patient organizations. We found that government influence on patient organizations has become quite substantial with government influencing the organizational structure of patient organizations, the activities these organizations perform and even their ideology. Financing patient organizations offers the government an important means to hold them accountable. Although the ties between patient organizations and the government enable the former to play a role that can be valued as positive by both parties, we argue that they raise problems as well which warrant a discussion on how much government influence on civil society is acceptable

Computer-based tools for decision support in agroforestry: Current state and future needs

Successful design of agroforestry practices hinges on the ability to pull together very diverse and sometimes large sets of information (i.e., biophysical, economic and social factors), and then implementing the synthesis of this information across several spatial scales from site to landscape. Agroforestry, by its very nature, creates complex systems with impacts ranging from the site or practice level up to the landscape and beyond. Computer-based Decision Support Tools (DST) help to integrate information to facilitate the decision-making process that directs development, acceptance, adoption, and management aspects in agroforestry. Computer-based DSTs include databases, geographical information systems, models, knowledge-base or expert systems, and ‘hybrid’ decision support systems. These different DSTs and their applications in agroforestry research and development are described in this paper. Although agroforestry lacks the large research foundation of its agriculture and forestry counterparts, the development and use of computer-based tools in agroforestry have been substantial and are projected to increase as the recognition of the productive and protective (service) roles of these tree-based practices expands. The utility of these and future tools for decision-support in agroforestry must take into account the limits of our current scientific information, the diversity of aspects (i.e. economic, social, and biophysical) that must be incorporated into the planning and design process, and, most importantly, who the end-user of the tools will be. Incorporating these tools into the design and planning process will enhance the capability of agroforestry to simultaneously achieve environmental protection and agricultural production goals

The Evolving Role of Consumers

The culmination of the changes in healthcare, motivated in many ways by the rapid evolution of information and communication technologies in parallel with the shift toward increased patient decision-making and empowerment, has critical implications for clinical research, from recruitment and participation to, ultimately, successful outcomes. This chapter explores the developments impacting health consumers from various perspectives, with some focus on foundational issues in health communication and information behaviors as related to health consumerism. An overarching concern is the information environment within which health consumers are immersed, which is increasingly social, and underlying communication issues and emerging technologies contributing to the changing nature of patients’ information world. Not surprisingly, we will see that core findings from communication and information behavior research have relevance for our current understanding and future models of the evolving role of the health consumer