Good Governance of land and natural resources : Balancing local and global interests

This report presents the results of a seminar on ‘good governance of land and natural resources; balancing local and global interests’. Three case studies were presented on large-scale land acquisitions, biofuels – fuelling development in Brazil and governance of the mineral sector in Eastern DRC. Participants identified 6 important challenges for improving land and natural resource governance and concluded that: more research and information sharing is needed; collaborative voluntary and legally binding initiatives are needed at international level to balance local and global interests; accountability arrangements need to be set up that enable stakeholders to hold each other accountable; capacity building of all actors is needed and that each actor has its own contributions to make to good governance

More and Better Jobs in Home-Care Services

[Excerpt] This study examines recruitment and retention measures in community-based care and support services for adults with disabilities and health problems. It focuses on 10 EU Member States: Austria, Bulgaria, Denmark, France, Germany, the Netherlands, Poland, Portugal, Spain and the United Kingdom. It examines 30 case studies from these countries, analysing initiatives that were successful either in creating more jobs in the provision of health and social care for adults in the community or in improving the quality of jobs, with the aim of both attracting new recruits and retaining existing staff

Montessori’s Perspective on Citizenship Education: A View From the Netherlands

The purpose of this study is to synthesize Montessori’s writings on citizenship education to support the implementation of a Montessorian view. This synthesis demonstrates that Montessori was of the explicit conviction that a better world can be achieved through citizenship education, as it strives for a peaceful and harmonious society. We approach this topic through the Dutch context. Although schools in the Netherlands are required by law to promote active citizenship and social cohesion, this law does not stipulate which of the many different views on citizenship education schools must adhere to. Schools have the liberty to devise their own citizenship curricula if they can substantiate their views and choices. For Montessori schools, this requires insight into Montessori’s view on citizenship education. Although Montessori’s views are still largely appropriate in our time, an ongoing dialogue about citizenship education is required, as Montessori lived and worked in a specific geopolitical context. Based on our analysis, we have identified seven themes that characterize Montessori’s view on citizenship education: one common citizenship goal; preparation for independent thinking and action; image of the future citizen; adapted and critical citizens; humanity for harmony; knowledge as prerequisite, personality development as goal; and an ever-expanding worldview. The results of this study provide valuable insights for designing and teaching citizenship education through a Montessorian lens

Design of a fast in situ infrared diagnostic tool

Conventional Fourier transform IR (FTIR) spectroscopes cannot be used to perform real time in situ IR reflection absorption spectroscopy at monolayer sensitivity for high deposition rates (a couple of tens to hundreds of nm/s) which can be obtained when using an expanding thermal deposition plasma. Therefore a new anal. tool has been developed. The tool is based on a fast optical scanner in combination with conventional grating technol. This results in a loss of spectral range with respect to FTIR spectroscopes, but a significant gain is obtained in time resoln. For the combination used this makes it possible to measure at time resoln. as low as 1.3 ms and resoln. of 24 cm-1 at 1000 cm-1. The absorption sensitivity for single reflection at the best time resoln. is approx. 10-2, but can be improved by using signal enhancement techniques. Here attenuated total reflection is used and the best sensitivity obtained is approx. 10-3, which is close to monolayer sensitivity for various absorption bands in the IR spectrum of silicon oxide films. Monolayer sensitivity can be obtained by averaging multiple spectra, however this will cause the time resoln. to decreas

The Effectiveness of Treatments for Patients With Medication Overuse Headache: A Systematic Review and Meta-Analysis

© 2016 American Pain Society Worldwide, approximately 1 to 2% of the adult population suffers from chronic headache due to overuse of pain medication. Guidelines recommend acute withdrawal of medication, but the optimal treatment remains unknown. We aimed to evaluate the benefit of treatments for patients with medication overuse headache (MOH). We performed an extensive literature search until November 2015, selecting randomized controlled trials that evaluated interventions for adults with MOH. Two authors assessed the eligible trials and extracted data. We calculated effect estimates and used the random effects model for the pooled analysis. Our primary outcome measures were ‘headache days’ and ‘days with medication.’ Outcome data were categorized as short-term (up to 12 weeks) or long-term (≥12 weeks) outcomes. This review consists of 16 trials including 1,105 patients. Four trials evaluated the use of prednisone with placebo or celecoxib after medication withdrawal; 7 trials evaluated various methods of withdrawal versus other methods of withdrawal, and 5 trials evaluated prophylactic medication compared with placebo or ibuprofen. We found no significant differences in headache days between prednisone versus placebo or between outpatient versus inpatient treatment, but we found a significant difference in days with medication. Overall, we found no benefit of prophylactic medication versus placebo. We found low to very low quality of evidence of no benefit of prednisone, prophylaxis, and various withdrawal interventions. Because the burden of MOH for patients is enormous, larger and high-quality intervention trials are needed. Perspective This article presents a critical look at studies of patients with MOHs. It appears that the withdrawal strategy remains the best treatment option, although there is scant evidence on the efficacy of any treatment options

Patient-reported utilities in bilateral visual impairment from amblyopia and age-related macular degeneration

Background: Utility of visual impairment caused by amblyopia is important for the cost-effectiveness of screening for amblyopia (lazy eye, prevalence 3-3.5 %). We previously measured decrease of utility in 35-year-old persons with unilateral persistent amblyopia. The current observational case-control study aimed to measure loss of utility in patients with amblyopia with recent decrease of vision in their better eye. As these patients are rare, the sample was supplemented by patients with bilateral age-related macular degeneration with similar decrease of vision. Methods: From our out-patient department, two groups of patients with recent deterioration to bilateral visual acuity less than Snellen 0.5 (bilateral visual impairment, BVI) were recruited, with either persistent amblyopia and age-related macular degeneration (AMB + AMD), or with bilateral age-related macular degeneration (BAMD). To measure utility, the time trade-off method and the standard gamble method were applied through interviews. Correlations were sought between utility values and visual acuity, age and Visual Function Questionnaire-25 scores. Results: Seventeen AMB + AMD patients (mean age 72.9 years), and 63 BAMD patients (mean age 79.6 years) were included in the study. Among AMB + AMD, 80 % were willing to trade lifetime in exchange for cure. The overall mean time trade-off utility was 0.925. Among BAMD, 75 % were willing to trade, utility was 0.917. Among AMB + AMD, 38 % accepted risk of death in exchange for cure, overall mean standard gamble utility was 0.999. Among BAMD, 49 % accepted risk of death, utility was 0.998. Utility was not related to visual acuity but it was to age (p = 0.02). Conclusion: Elderly patients with BVI, caused by persistent amblyopia and age-related macular degeneration (AMD) or by bilateral AMD, had an approximately 8 % loss of TTO utility. Notably, the 8 % loss in elderly with BVI differs little from the 3.7 % loss we found previously in 35-year-old persons with unilateral amblyopia with good vision in the other eye. The moderate impact of BVI in senescence could be explained by adaptation, comorbidity, avoidance of risk and a changed percept of cure

First Steps Toward Positive Behavior Support in the Netherlands:A Pilot Study Exploring the Effectiveness of a Training for Staff

Despite the effectiveness of positive behavior support (PBS) in reducing challenging behaviors, the availability of PBS for individuals with intellectual disabilities is limited in many countries including the Netherlands. Training care staff supporting individuals with intellectual disabilities in PBS may be a way to improve the provision of PBS. We aimed to explore the preliminary effectiveness of a PBS training for staff in reducing challenging behaviors of individuals with intellectual disabilities. Using a one group, double pretest-posttest design, 24 staff members involved in the care of 11 adult individuals with intellectual disabilities and challenging behaviors participated. We assessed changes in challenging behaviors and quality of life of the individuals, in staff self-efficacy in dealing with challenging behaviors, and in the use of restraints, using staff rated questionnaires, structured interviews, and medical files. At posttest, we found significant reductions in challenging behaviors, improved quality of life, and increased staff self-efficacy, but no changes in the use of restraints. In contrast, no significant changes on any of the measures appeared between the two pretests. These findings suggest that a staff training in PBS may be effective for reducing challenging behaviors in individuals with intellectual disabilities

Exposure to challenging behaviours and burnout symptoms among care staff:the role of psychological resources

Background Staff supporting individuals with intellectual disabilities are at risk of burnout symptoms. Evidence suggests an association between exposure to challenging behaviours of individuals with intellectual disabilities and burnout symptoms of staff, but the protective role of staff psychological resources in this relation has been understudied. Method We investigated the association between exposure to challenging behaviours and burnout symptoms of staff and the direct and moderating effects of several psychological resources. Staff (N = 1271) completed an online survey concerning burnout symptoms (subscale Emotional Exhaustion of the Maslach Burnout Inventory), exposure to challenging behaviours and a range of potential psychological resources. We examined main and moderating effects with multilevel analyses. In order to control for the multiple comparisons, P values corrected for false discovery rate (P-FDR) were reported. Results We found a direct relation between exposure to challenging behaviours and increased levels of burnout symptoms in staff (b = .15, t(670) = 4.466, P-FDR <.0001). Perceived supervisor social support (b = -.97, t(627) = -7.562, P-FDR <.0001), staff self-efficacy (b = -.23, t(673) = -3.583, P-FDR <.0001), resilience (b = -.19, t(668) = -2.086, P-FDR <.05) and extraversion (b = -.20, t(674) = -3.514, P-FDR <.05) were associated with reduced burnout symptoms. None of the proposed psychological resources moderated the association between exposure to challenging behaviours and burnout symptoms of staff. Conclusions Of the psychological resources found to be associated with reduced risk of burnout symptoms, staff self-efficacy and access of staff to supervisor social support seem to be the factors that can be influenced best. These factors thus may be of importance in reducing the risk of developing burnout symptoms and improving staff well-being, even though the current study was not designed to demonstrate causal relations between psychological resources and burnout symptoms