Dutch Healthcare Professionals’ Opinion on the Allocation of Responsibilities concerning Prescribing and Administering Medically Indicated Vaccines to Immunocompromised Patients

Background: Specific vaccines are indicated for immunocompromised patients (ICPs) due to their vulnerability to infections. Recommendation of these vaccines by healthcare professionals (HCPs) is a crucial facilitator for vaccine uptake. Unfortunately, the responsibilities to recommend and administer these vaccines are not clearly allocated among HCPs involved in the care of adult ICPs. We aimed to evaluate HCPs’ opinions on directorship and their role in facilitating the uptake of medically indicated vaccines as a basis to improve vaccination practices. Methods: A cross-sectional survey was performed among in-hospital medical specialists (MSs), general practitioners (GPs), and public health specialists (PHSs) in the Netherlands to assess their opinion on directorship and the implementation of vaccination care. Additionally, perceived barriers, facilitators, and possible solutions to improve vaccine uptake were investigated. Results: In total, 306 HCPs completed the survey. HCPs almost unanimously (98%) reported that according to them, the primary treating physician is responsible for recommending medically indicated vaccines. Administering these vaccines was seen as a more shared responsibility. The most important barriers experienced by HCPs in recommending and administering were reimbursement problems, a lack of a national vaccination registration system, insufficient collaboration among HCPs, and logistical problems. MSs, GPs and PHSs all mentioned the same three solutions as important strategies to improve vaccination practices, i.e., reimbursement of vaccines, reliable and easily accessible registration of received vaccines, and arrangements for collaboration among the different HCPs that are involved in care. Conclusion: The improvement in vaccination practices in ICPs should focus on better collaboration among MSs, GPs, and PHSs, who should know each other’s expertise; clear agreement on responsibility; reimbursement for vaccines; and the availability of clear registration of vaccination history.</p

Dutch Healthcare Professionals' Opinion on the Allocation of Responsibilities concerning Prescribing and Administering Medically Indicated Vaccines to Immunocompromised Patients

Background: Specific vaccines are indicated for immunocompromised patients (ICPs) due to their vulnerability to infections. Recommendation of these vaccines by healthcare professionals (HCPs) is a crucial facilitator for vaccine uptake. Unfortunately, the responsibilities to recommend and administer these vaccines are not clearly allocated among HCPs involved in the care of adult ICPs. We aimed to evaluate HCPs’ opinions on directorship and their role in facilitating the uptake of medically indicated vaccines as a basis to improve vaccination practices. Methods: A cross-sectional survey was performed among in-hospital medical specialists (MSs), general practitioners (GPs), and public health specialists (PHSs) in the Netherlands to assess their opinion on directorship and the implementation of vaccination care. Additionally, perceived barriers, facilitators, and possible solutions to improve vaccine uptake were investigated. Results: In total, 306 HCPs completed the survey. HCPs almost unanimously (98%) reported that according to them, the primary treating physician is responsible for recommending medically indicated vaccines. Administering these vaccines was seen as a more shared responsibility. The most important barriers experienced by HCPs in recommending and administering were reimbursement problems, a lack of a national vaccination registration system, insufficient collaboration among HCPs, and logistical problems. MSs, GPs and PHSs all mentioned the same three solutions as important strategies to improve vaccination practices, i.e., reimbursement of vaccines, reliable and easily accessible registration of received vaccines, and arrangements for collaboration among the different HCPs that are involved in care. Conclusion: The improvement in vaccination practices in ICPs should focus on better collaboration among MSs, GPs, and PHSs, who should know each other’s expertise; clear agreement on responsibility; reimbursement for vaccines; and the availability of clear registration of vaccination history

Handling ethical problems in counterterrorism. An inventory of methods to support ethical decisionmaking

This document presents the findings of a study into methods that can help counterterrorism professionals make decisions about ethical problems. The study was commissioned by the Research and Documentation Centre (Wetenschappelijk Onderzoeken Documentatiecentrum, WODC) of the Dutch Ministry of Security and Justice (Ministerie van Veiligheid en Justitie), on behalf of the National Coordinator for Counterterrorism and Security (Nationaal Coördinator Terrorismebestrijding en Veiligheid, NCTV). The research team at RAND Europe was complemented by applied ethics expert Anke van Gorp from the Research Centre for Social Innovation (Kenniscentrum Sociale Innovatie) at Hogeschool Utrecht. The study provides an inventory of methods to support ethical decision-making in counterterrorism, drawing on the experience of other public sectors – healthcare, social work, policing and intelligence – and multiple countries, primarily the Netherlands and the United Kingdom. The report introduces the field of applied ethics; identifies key characteristics of ethical decision-making in counterterrorism; and describes methods that can help counterterrorism professionals make decisions in these situations. Finally, it explores how methods used in other sectors may be applied to ethical decision-making in counterterrorism. It also describes the level of effectiveness that may be expected from the various methods. The report is based on a structured literature search and interviews with professionals and academics with expertise in applied ethics. This report will be of interest to counterterrorism professionals who are responsible for strengthening ethical decision-making in their organisation. It may provide some insights for professionals who seek new methods to help them make ethical decisions. The findings may also be relevant for other professionals, if complemented by a review of decisionmaking characteristics in their sector of specialism

Psychosocial functioning of adult siblings of Dutch very long-term survivors of childhood cancer:DCCSS-LATER 2 psycho-oncology study

Objective: To describe psychosocial outcomes among adult siblings of very long-term childhood cancer survivors (CCS), to compare these outcomes to reference populations and to identify factors associated with siblings' psychosocial outcomes. Methods: Siblings of survivors (diagnosed &lt;18 years old, between 1963 and 2001, &gt;5 years since diagnosis) of the Dutch Childhood Cancer Survivor Study DCCSS-LATER cohort were invited to complete questionnaires on HRQoL (TNO-AZL Questionnaire for Adult's HRQoL), anxiety/depression (Hospital Anxiety and Depression Scale), post-traumatic stress (Self-Rating Scale for Post-traumatic Stress Disorder), self-esteem (Rosenberg Self-Esteem Scale) and benefit and burden (Benefit and Burden Scale for Children). Outcomes were compared to a reference group if available, using Mann-Whitney U and chi-Square tests. Associations of siblings' sociodemographic and CCS’ cancer-related characteristics with the outcomes were assessed with mixed model analysis. Results: Five hundred five siblings (response rate 34%, 64% female, mean age 37.5, mean time since diagnosis 29.5) of 412 CCS participated. Siblings had comparable HRQoL, anxiety and self-esteem to references with no or small differences (r = 0.08−0.15, p &lt; 0.05) and less depression. Proportions of symptomatic PTSD were very small (0.4%−0.6%). Effect sizes of associations of siblings' sociodemographic and CCS cancer-related characteristics were mostly small to medium (β = 0.19−0.67, p &lt; 0.05) and no clear trend was found in the studied associated factors for worse outcomes. Conclusions: On the very long-term, siblings do not have impaired psychosocial functioning compared to references. Cancer-related factors seem not to impact siblings' psychosocial functioning. Early support and education remain essential to prevent long-term consequences.</p

(Legal) constraints in terms of group targeting: Differences between EC countries in allowing the selection of specific groups for social programmes

Full text via link. It became clear early on in the SAFIRE project that different EU countries have different views on targeting groups in social work and especially with regard to preventing or countering radicalization. Consequently, a programme developed in one country to prevent radicalization cannot necessarily be used in another country, because targeting a specific group may not be allowed

'ICT-architectuur is niet ethisch neutraal'

Bij het ontwerpen en inrichten van ICT-architectuur worden beslissingen genomen die als vanzelfsprekend worden gezien, maar die wel degelijk een keuze inhouden en ethisch relevant zijn. Anke van Gorp pleit ervoor dat ICT-architecten deze keuzes ter discussie durven te stellen

Democracy and deradicalisation programmes: should a government be allowed to intervene in pre- or non-violent radicalisation?

Full text via link. Human rights safeguard that individuals can develop their ideas and identity undisturbed by government or governmental agencies. With regard to radicalisation, adopting radical ideas is not a crime. Some crimes, such as hate-speech and ideological violence, are associated with radicalisation, but when individuals or groups only develop ideas without committing crimes there is no legal ground or justification for intervening

Ethical and legal concerns

Full text via link. Project objectives Radicalisation research leads to ethical and legal questions and issues. These issues need to be addressed in way that helps the project progress in ethically and legally acceptable manner. Description of Work The legal analysis in SAFIRE addressed questions such as which behaviour associated with radicalisation is criminal behaviour. The ethical issues were addressed throughout the project in close cooperation between the ethicists and the researchers using a method called ethical parallel research. Results A legal analysis was made about criminal law and radicalisation. During the project lively discussionswere held in the research team about ethical issues. An ethical justification for interventions in radicalisation processes has been written. With regard to research ethics: An indirect informed consent procedure for interviews with (former) radicals has been designed. Practical guidelines to prevent obtaining information that could lead to indirect identification of respondents were developed

Ethische rechtvaardigingen voor preventieve interventies bij radicalisering

Full text via link. Interventies om terroristische aanslagen te voorkomen kunnen zowel juridisch als moreel gerechtvaardigd worden. Binnen de Nederlandse brede benadering tegen terrorisme wordt er ook gekeken naar radicalisering, maar de rechtvaardiging daarvoor is lastig. Als een (voormalige) radicaal om hulp vraagt of als een radicale groep een sekte wordt, laten theorieën als die van Kant en Rawls ingrijpen toe. Preventieve of deradicaliseringsinterventies zijn vanuit liberaal-democratische theorieën echter problematisch. Een rechtvaardiging van dit type interventies kan gevonden worden in de deugdethiek, adolescenten worden geholpen in hun queeste naar het goede leven. Deze rechtvaardiging leidt wel tot randvoorwaarden aan de interventies

Geen respect zonder zoeken naar waarheid

Samenvatting boek: In menige schoolklas zijn de afgelopen jaren twee werelden ontstaan. Allochtone en autochtone leerlingen mijden elkaar, contacten beperken zich tot de eigen groep. Intussen oordelen de groepen steeds harder over elkaar. Het gevolg: botsingen in de klas die de leraar in goede banen moet zien te leiden. Dat blijkt lang niet eenvoudig. Want wat doe je als een scholier tijdens de wiskundeles een foute opmerking maakt over joden of Marokkanen? Wat zeg je als een leerling roept dat alle buitenlanders het land uit moeten en daarbij een venijnige blik werpt op een klasgenoot met een kleurtje? Hoe reageer je als iemand de Holocaust ontkent? Dit boek reikt leraren, maar anderen evengoed, handvatten aan om met dergelijke extreme uitingen om te gaan. Meer dan vijfentwintig experts uit verschillende kennisinstituten en lerarenopleidingen van hogescholen en universiteiten delen hun ervaringen en hun visies. Zij bieden inzicht in polarisatie en radicalisering in voortgezet en beroepsonderwijs en geven raad over hoe je bekwaam kunt handelen om de klas, en uiteindelijk de samenleving, voorbij de verdeeldheid te krijgen