Background Engagement with smartphone‑based interventions stimulates adherence and improves the likelihood of gaining benefits from intervention content. Research often relies on system usage data... Show moreBackground Engagement with smartphone‑based interventions stimulates adherence and improves the likelihood of gaining benefits from intervention content. Research often relies on system usage data to capture engagement. However, to what extent usage data reflect engagement is still an open empirical question. We studied how usage data relate to engagement, and how both relate to intervention outcomes. Methods We drew data from a randomized controlled trial (RCT) (N = 86) evaluating a smartphone‑based intervention that aims to stimulate future self‑identification (i.e., future self vividness, valence, relatedness). General app engagement and feature‑specific engagement were retrospectively measured. Usage data (i.e., duration, number of logins, number of days used, exposure to intervention content) were unobtrusively registered. Results Engagement and usage data were not correlated. Multiple linear regression analyses revealed that general app engagement predicted future self vividness (p = .042) and relatedness (p = .004). Furthermore, engagement with several specific features also predicted aspects of future self‑identification (p = .005 – .032). For usage data, the number of logins predicted future self vividness (p = .042) and exposure to intervention content predicted future self valence (p = .002). Conclusions Usage data did not reflect engagement and the latter was the better predictor of intervention outcomes. Thus, the relation between usage data and engagement is likely to be intervention‑specific and the unqualified use of the former as an indicator of the latter may result in measurement error. We provide recommendations on how to capture engagement and app use in more valid ways. Show less
The learning of software design is known to be a difficult and challenging task for students. This dissertation studies different didactic approaches for learning software design to improve the way... Show moreThe learning of software design is known to be a difficult and challenging task for students. This dissertation studies different didactic approaches for learning software design to improve the way we teach students software design. The research in the dissertation questions whether we can assess software design skills, what guidance is needed for the improvement of students’ understanding of software design and how to motivate and engage students for learning software design. The research explores the following: an instrument for measuring software design skills based on design principles, the gamification of learning software design, revealing students’ software design strategies, the use of peer-reflection for uncovering the difficulties students have during software design tasks, the use of teaching assistants as bridge between the lecturer and the students, the automation of grading software designs with machine learning, guiding feedback by a pedagogical agent and a workshop for engaging students into the process of software development. The research contributes to the future education of software design. Show less
This thesis explains the dynamics and nature of the Kurdistan Region of Iraq’s (KRI) de facto statehood since its inception in 1991, in particular the vicissitudes de facto independence since then.... Show moreThis thesis explains the dynamics and nature of the Kurdistan Region of Iraq’s (KRI) de facto statehood since its inception in 1991, in particular the vicissitudes de facto independence since then. This dissertation characterises de facto statehood in Kurdistan, and uncovers the dynamics of de facto statehood in Iraqi Kurdistan at internal, national and international levels. Kurdistan’s de facto statehood (such as territorial control, monopoly on the use of violence, and engagement with the international community) is shown to be inherently characterised by fluidity. In this thesis, fluidity is defined as a highly unstable nature of de facto statehood in the relational context of non-recognition. The dissertation reports on interviews with a number of high profile politicians and policy makers from the region to provide unique insights, among others the three main factors at play in the fluidity of the de facto state of Iraqi Kurdistan: the balance of power between the regional capital of Erbil and the Iraqi national capital of Baghdad; the level and form of internal fragmentation; and the change of strategies to gain international recognition. Show less
Keij, S.M.; Duijn-Bakker, N. van; Stiggelbout, A.M.; Pieterse, A.H. 2021
Objectives: Shared decision making (SDM) requires an active role from patients, which might be difficult for some. We aimed to identify what patients need to be ready (i.e., well-equipped and... Show moreObjectives: Shared decision making (SDM) requires an active role from patients, which might be difficult for some. We aimed to identify what patients need to be ready (i.e., well-equipped and enabled) to participate in SDM about treatment, and what patient- and decision-related characteristics may influence readiness.Methods: We conducted semi-structured interviews with patients and professionals (physicians, nurses, general practitioners, and researchers). Interviews were analyzed inductively.Results: We identified five elements of patient readiness: 1) understanding of and attitude towards SDM, 2) health literacy, 3) skills in communicating and claiming space, 4) self-awareness, and 5) consideration skills. We identified 10 characteristics that may influence elements of readiness: 1) age, 2) cultural background, 3) educational background, 4) close relationships, 5) mental illness, 6) emotional distress, 7) acceptance of diagnosis, 8) clinician-patient relationship, 9) decision type, and 10) time.Conclusions: We identified a wide range of elements that may constitute patient readiness for SDM. Readiness might vary between and within patients. This variation may result from differences in patientand decision-related characteristics.Practice implications: Clinicians should be aware that not all patients may be ready for SDM at a given moment and may need support to enhance their readiness. (C) 2020 The Authors. Published by Elsevier B.V. Show less
The COVID-19 pandemic has caused various disruptions in the production chains of Multinational Enterprises (MNEs). Among other disruptions there is a drop of product sales, often due to lock-down... Show moreThe COVID-19 pandemic has caused various disruptions in the production chains of Multinational Enterprises (MNEs). Among other disruptions there is a drop of product sales, often due to lock-down measures, which resulted in last-minute order cancellations , non-payment of the already purchased resources and already made products, and hence terminations of employment contracts. International organisations and non-governmental organisations have called upon MNEs to take their corporate social responsibility (CSR) and honour the contracts. The aim of this article is to analyse to what extend this moral appeal is also a (quasi-)legal appeal following from international norms on CSR. After an assessment of the main labour law problems caused by the COVID-19 pandemic, an analysis follows on each of the identified problems. The conclusion of the analysis is that MNEs indeed are not only morally obliged to take their responsibility, but also based on the (quasi-)legal international CSR norms. Show less
Damme, L. van; Hoeve, M.; Vanderplasschen, W.; Vermeiren, R.; Grisso, T.; Colins, O.F. 2015
Chronic pain is a significant health problem that greatly impacts the quality of life of individual patients and imparts high costs to society. Despite intense research effort and progress in our... Show moreChronic pain is a significant health problem that greatly impacts the quality of life of individual patients and imparts high costs to society. Despite intense research effort and progress in our understanding of the mechanistic and molecular basis of pain, chronic pain remains a significant clinical problem that has few effective therapies Throughout the various chapters we have highlighted some important conceptual and experimental flaws in the way that pain signalling and pharmacological activity are characterised and translated across species and disease conditions. The common denominator of the work presented here is the requirement for accurate characterisation of exposure-response relationships, without which the dose rationale for the progression of a molecule cannot justified, whether drugs are aimed at symptomatic relief, disease modification or prophylaxis. In addition to a comprehensive review of the mechanisms underlying pain signalling and symptoms, the work developed here focuses on three different aspects of research underpinning the use of pharmacokinetic-pharmacodynamic relationships. First, we have explored the requirements for the characterisation of behavioural measures of pain during the early screening of candidate molecules, shedding light onto the shortcomings of experimental protocols commonly used in preclinical research. Then we introduced the prerequisites for the parameterisation of pain behaviour to ensure accurate translation of the pharmacological properties across species as well as for bridging across different phases of development. Lastly, an attempt was made to model clinical response in chronic inflammatory pain and to establish correlations between symptom improvement and the underlying pharmacological effects using biomarkers. In addition our work showed how clinical trial simulations can be used as a design tool, enabling the evaluation of a variety of scenarios that disentangle the contribution of pharmacology from the confounding effects of placebo and disease dynamics. Show less
The thesis presents an exploration of the relationships between students’ motivation, represented by students’ personal goals, and the quality of cooperative learning (CL) processes of first and... Show moreThe thesis presents an exploration of the relationships between students’ motivation, represented by students’ personal goals, and the quality of cooperative learning (CL) processes of first and second year students, enrolled in secondary vocational schools. Special attention has been paid to contextual factors and their influence on the quality of CL, and to differences between students that are related to their gender, program type and ethnocultural background. Students’ goal preferences contributed just weakly to the explanation of the quality of CL, whereas students’ perceptions on contextual factors were important predictors. With regard to students’ goals, social support and mastery goals were most vital in predicting the quality of CL. Especially the extent that students were taught the appropriate knowledge, skills and rules for CL was found to be a crucial -and lasting- precondition for successful CL. Also the social climate in the classroom was important. Moreover, gender, program type and ethnocultural background had no direct effect on the quality of CL. Show less
