This thesis describes the wide range of long-term consequences in stroke patients who received multidisciplinary rehabilitation.Over a third of them reported pain in the shoulder, arm, wrist or... Show moreThis thesis describes the wide range of long-term consequences in stroke patients who received multidisciplinary rehabilitation.Over a third of them reported pain in the shoulder, arm, wrist or hand. About the same percentage had low patient activation scores, which is a prerequisite for effective self-management to cope with the consequences of stroke. Almost half of patients who were working before the stroke managed to maintain paid employment for two and a half years. These patients were more satisfied with their participation than patients who did not return to work. Average independence in daily activities increased during rehabilitation. The Barthel Index was found to be more sensitive to measure change than the Utrecht Scale for Evaluation of Rehabilitation. Health-related quality of life increased on average from start of rehabilitation to one year afterwards. The average social costs in the first year were €63,045 for inpatients and €24,533 for outpatients. The burden of the nearest of stroke patients was investigated, which showed that a third of them experienced a high burden.In conclusion, the consequences of stroke can also remain present, worsen or develop in the long term and are present for the individual patient, their nearest and the healthcare system. Show less
This research project adresses the question how local and traditional European forms of parrhesiastic theater—by which I mean events, actions, and performances staged by characters who courageously... Show moreThis research project adresses the question how local and traditional European forms of parrhesiastic theater—by which I mean events, actions, and performances staged by characters who courageously speak their minds through scenes of excess and laughter, that take place in public view and incite the spectator’s agency to speak their own minds—possibly relate to and/or provide new insights into critical artistic practices today. In this context, the project also examines the place and role of caricature today.I approach the issue as an artist-researcher concerned with socially engaged artistic practices. The experience of the playful, humorous, and sharply critical attitude of Gezi Park protesters speaking their minds in Istanbul in 2013 led me to critically reconsider my own courage in positioning myself within contemporary artistic production. Throughout the dissertation I work along a Moebius strip schema, which continually shifts from me as individual artist to dialogic collaborations to writing about the process. The research subject is investigated through a circulation process within which concepts such as communication, dialogue, and listening are continuously performed and put to the test. The dissertation aspires to provide new insights into how tensions between the roles of individual and group, “I” and “we,” may open up a parrhesiastic space for critical artistic practices. Show less
This study identifies the human rights of children who live in foster care due to a family supervision order, and analyses the extent to which Dutch laws and regulations protect these rights. The... Show moreThis study identifies the human rights of children who live in foster care due to a family supervision order, and analyses the extent to which Dutch laws and regulations protect these rights. The aim of the research is to provide insight into the rights of foster children regarding four important decisions about their lives. Although the interests of the child are often taken as a starting point for these decisions, this does not do justice to the recognition of children as subjects of rights. After all, individual interpretations of the best interests of the child will inevitably depend on the normative frameworks of the decision-maker. It is argued that by identifying which children's rights can be derived from a human rights framework, children in foster care can be given stronger protection when making decisions about their life. The study concludes that the literal text of Dutch laws and regulations does not usually conflict with children's and human rights. Yet in many cases, foster children have no effective means of invoking their rights. Therefore recommendations are being made to amend the law and regulations to better protect the rights of children in foster care. Show less
The current knowledge on ABI is focused on children and the physical and cognitive outcomes. Fatigue is one of the most reported symptoms after ABI. The current thesis focuses on the adolescent... Show moreThe current knowledge on ABI is focused on children and the physical and cognitive outcomes. Fatigue is one of the most reported symptoms after ABI. The current thesis focuses on the adolescent and young adult age group and the impact of ABI on fatigue, physical activity and participation. Show less
Neonatal brachial plexus palsy (NBPP) is a nerve injury to the brachial plexus which controls arm-movements. This thesis describes the impact of this injury on the lives of patients in terms... Show moreNeonatal brachial plexus palsy (NBPP) is a nerve injury to the brachial plexus which controls arm-movements. This thesis describes the impact of this injury on the lives of patients in terms of quality of life, participation, healthcare use and treatment outcomes. Findings in this thesis have led to important insights into the care for patients with NBPP and their families. It turns out that there is considerable information need in these patients, that NBPP has impact on families of very young patients and adult patients perceive influence of NBPP on their study and career choices. This thesis also showed that when describing outcomes of shoulder surgery (tendon-transfers) it is important to take into account treatment history because outcomes differ for children with a surgical treatment history. This may help to manage patients’ outcome expectations. A recommendation in this thesis is to develop and investigate a standardized paramedic treatment protocol for the different life-phases of NBPP patients because this is not available yet. Hereby, a more strict follow-up is very important. Furthermore, better information should be developed in order to provide NBPP patients with the information they need throughout their lifespan. Findings in this thesis can be used for this. Show less
It has been well established that underserved groups have an increased risk of cardiometabolic disease and are less likely to attend health checks. This differential uptake of health checks... Show moreIt has been well established that underserved groups have an increased risk of cardiometabolic disease and are less likely to attend health checks. This differential uptake of health checks leads to suboptimal health gains from cardiometabolic screening and contributes to the widening of health inequalities in society. The cost-effectiveness of the Dutch cardiometabolic health check is still under study, but with the knowledge we already have it seems advisable to focus primarily on the underserved groups, as they have the most to gain from systematic screening. The findings described in this thesis provide strategies to optimize uptake and may be used to design future studies on this topic. In the general discussion we also advocate that the Government should invest in population-based prevention and move away from the trend of taking own responsibility as this may provide underserved groups the best possible opportunities for a healthy life(style). Show less
Indigenous peoples' rights have been on the international political agenda for over fifty years. Yet, very limited attention has been given to indigenous women. Among indigenous peoples, women are... Show moreIndigenous peoples' rights have been on the international political agenda for over fifty years. Yet, very limited attention has been given to indigenous women. Among indigenous peoples, women are one of the most vulnerable groups, because they are subject to multiple discrimination: for being a woman, indigenous, and often, because of the stigma of poverty. The absence of attention for women's issues is due to a lack of awareness and knowledge regarding the role women play in society and in the development of communities, and it illustrates the subordinated position women continue to have in society in general. This research wants to contribute to the visibility of indigenous women. Therefore, it provides an overview of some of the challenges indigenous women are still facing, focusing on the case of Mexico. It analyzes the position of indigenous women in Mexican society, to identify some of the fields in which indigenous women's rights are still not guaranteed and therefore require more action. Special attention is given to the position of indigenous women in Mexican health care, political participation, media, and education. Show less
The key objective of this research is to design a consultation model for the legislative process in fiscal matters. When tax laws are being drafted, such a model can be used as a tool to select... Show moreThe key objective of this research is to design a consultation model for the legislative process in fiscal matters. When tax laws are being drafted, such a model can be used as a tool to select the best possible consultation variant and the suitable stakeholders. I have analyzed six consultation methods with the aim of providing a framework for selecting the most effective one(s). I have described the structure and possible variants of each of these six methods and I have explained their strengths and weaknesses. Of fiscal stakeholder groups that may be consulted there are seven: taxpayers; tax consultants and their professional organizations; interest groups; academics; judges and the National Ombudsman; foreign authorities; and internal stakeholders. I have identified the consultation purposes to which the various stakeholder groups can usefully contribute as well as the considerations underlying the choice whether or not to consult a particular stakeholder group. As the manner in which a consultation procedure is executed can be a decisive success factor, the key stages of a sound consultation procedure and the considerations underlying them are also an integral part of this research. Show less
International law and state practice mirrors the recognition of children’s particular need for protection during peacetime but also in situations in which international crimes are being committed,... Show moreInternational law and state practice mirrors the recognition of children’s particular need for protection during peacetime but also in situations in which international crimes are being committed, the prosecution of international crimes committed against children before international courts and tribunals is well embedded. While international prosecutions are thus in line with the overall development of protecting children from the consequences of armed conflict and large scale violence, the involvement of the child in international criminal proceedings also gives rise to new questions which relate to the procedural involvement of the child. As child participation in the proceedings before the International Criminal Court (ICC) constitutes a matter of fact, one may raise the question whether such participation is a welcome development. This study examines the procedural implications of child participation and thereby intents to contribute legal views and perspectives to the underlying debate on the adequacy of child participation in ICC proceedings. Show less
The results of the studies included in this thesis suggest that the incidence of ABI in children and youth is considerable. Moreover, it was found that relatively many have long-term health... Show moreThe results of the studies included in this thesis suggest that the incidence of ABI in children and youth is considerable. Moreover, it was found that relatively many have long-term health problems, including limitations in psychosocial functioning, participation and QoL and that the impact on their families is substantial. These findings underscore the need for an increasing awareness for the impact of paediatric ABI. One study explored the effects of usage of serious gaming found that physical activity, the speed of information processing, attention, response inhibition, and parent-perceived Quality of life (QoL) were improved directly after the intervention. Participation is the most relevant outcome of recovery and main goal of rehabilitation. However, a better general understanding and improvements of assessment and treatment are required to decrease the impact of paediatric ABI on participation of youth and their families. Recommendations based on this thesis are: a) implement the ICF-model to improve comprehension of participation (problems) after paediatric ABI; b) measure and monitor participation after paediatric TBI and NTBI and c) develop and evaluate trajectories optimising participation. Show less
The Zimbabwean issue has often divided opinion. President Robert Mugabe's domination of the country__s political and media landscapes has attracted scrutiny and criticism from the West. The ... Show moreThe Zimbabwean issue has often divided opinion. President Robert Mugabe's domination of the country__s political and media landscapes has attracted scrutiny and criticism from the West. The "oppressed" people of Zimbabwe are said to have not had an alternative to state-sponsored TV or daily media outlets. The availability of new media vices including the Internet is being seen as offering a new platform to fight these perceived forms of dictatorships. This PhD employed qualitative methods to probe the potential of new media in sustaining democracy in Zimbabwe. Show less
Installation art is one of the most common forms of contemporary art. Installations constitute themselves both in space and time. They are made of multiple media and materials. Often they are... Show moreInstallation art is one of the most common forms of contemporary art. Installations constitute themselves both in space and time. They are made of multiple media and materials. Often they are compared to stage sets, which the viewer can enter physically. Well-known installations are the site-specific works created by Carsten Höller, Doris Salcedo and Olafur Eliasson for the Turbine Hall of London’s Tate Modern. Installation art is particularly known for the kind of spectatorship that it has brought about. Installations are said to turn passive viewers into active participants. This dissertation aims to analyze this spectatorship: How do we experience works of installation art, what is so particular about this spectatorship, and how does it reflect on the ‘experience society’ we are supposed to be living in? The aim of my research is to contribute to the theoretical reflection on spectatorship. I contend that installation art transforms the viewer into a ‘performing observer’. In experiencing an installation viewers revert to their own memories, associations, wishes and dreams. Inadvertently they are writing themselves into the ‘play’ that is suggested by the scenario in which they find themselves. Performing an installation means entering into a playful yet reflective interaction with one’s surroundings. Show less
This study examines the links between the state and civil society in Chile and the ways social policies have contributed since 1990 to the construction of democratic governance in that country. The... Show moreThis study examines the links between the state and civil society in Chile and the ways social policies have contributed since 1990 to the construction of democratic governance in that country. The main transformations in the link between the state and civil society in the period under consideration took shape in public policies, particularly in the social area. This was the top priority in government management and constituted the main difference from the previous neoliberal stance adopted by the Pinochet regime (1973-1990). On the basis of such policies, furthermore, participatory guidelines were set forth and efforts were directed to ensure social inclusion of the poorest sectors in society. The study discusses the role of public policies and the opportunities they provide for civil society in a scenario of political stability and economic growth based on opening to the foreign sector and the predominance of market economy. Given a broad notion of governance, it is argued that public policies have been the main instrument for transformation resorted to by democratic administrations since 1990 to amend the circumstances inherited from the military regime. However, the ability of these policies to expand democratic governance has proved to be limited, to the extent that such policies have become subordinate to an elitist model of democracy and adopted a restricted form of citizen participation. In this context, the following are discussed: (a) major social policy agendas; (b) selected innovations in the link between civil society and public policies; and (c) personal trajectories from civil society to positions of government power. Show less
