Initiating advance care planning on end-of-life issues in dementia: Ambiguity among UK and Dutch physicians

Background
In dementia, advance care planning (ACP) of end-of-life issues may start as early as possible in view of the patient’s decreasing ability to participate in decision making. We aimed to assess whether practicing physicians in the Netherlands and the United Kingdom who provide most of the end-of-life care, differ in finding that ACP in dementia should start at diagnosis.

Methods
In a cross-sectional study, we surveyed 188 Dutch elderly care physicians who are on the staff of nursing homes and 133 general practitioners from Northern Ireland. We compared difference by country in the outcome (perception of ACP timing), rated on a 1–5 agreement scale. Regression analyses examined whether a country difference can be explained by contrasts in demographics, presence, exposure and role perceptions.

Results
There was wide variability in agreement with the initiation of ACP at dementia diagnosis, in particular in the UK but also in the Netherlands (60.8% agreed, 25.3% disagreed and 14.0% neither agreed, nor disagreed). Large differences in physician characteristics (Dutch physicians being more present, exposed and adopting a stronger role perception) hardly explained the modest country difference. The perception that the physician should take the initiative was independently associated with agreeing with ACP at diagnosis.

Conclusions
There is considerable ambiguity about initiating ACP in dementia at diagnosis among physicians practicing in two different European health care systems and caring for different patient populations. ACP strategies should accommodate not only variations in readiness to engage in ACP early among patient and families, but also among physicians.

Troubled waters: an institutional analysis of ageing Dutch and American waterway infrastructure

Waterways are one of the oldest systems for the transportation of cargo and continue to play a vital role in the economies of some countries. Due to societal change, climate change and the ageing of assets, the conditions influencing the effective functioning of these systems seem to be changing. These changing conditions require measures to renew, adapt or renovate these waterway systems. However, measures with the sole aim of improving navigation conditions have encountered resistance, as the general public, and stakeholders in particular, value these waters in many more ways than navigation alone. Therefore, a more inclusive, integrated approach is required, rather than a sectoral one. Addressing these contemporary challenges requires a shift in the traditional waterway authorities' regimes. The aim of this study is to identify elements in the institutional setting where obstacles and opportunities for a more inclusive approach can be found. Two major waterway systems, the American and the Dutch, have been analyzed using the Institutional Analysis and Development framework to reveal those obstacles and opportunities. The results show that horizontal coordination and a low pay-off for an inclusive approach is particularly problematic. The American case also reveals a promising aspect – mandatory local co-funding for federal navigation projects acts as a stimulus for broad stakeholder involvement. Improving horizontal coordination and seizing opportunities for multifunctional development can open pathways to optimize the value of waterway systems for society.

Canções / Songs: Fernando Pessoa traduz António Botto

Dissertação apresentada com vista à obtenção do grau de Mestre em Tradução e Interpretação Especializada. Instituto Politécnico do Porto (Portaria nº 602/2003 de 21 Julho)

Cultural adaptation of websites: a comparative study of portuguese and dutch corporate websites

Master Thesis Presented at Instituto de Contabilidade e Administração do Porto for obtaining the Master’s degree in Digital Marketing under the supervision of Professor José de Freitas Santos

Understanding the Intersection of Reformed Faith and Dutch Immigrant Culture in Ontario Independent Christian Schools: Principals’ Experiences and Perspectives

In the aftermath of World War II, a wave of Dutch Reformed immigrants arrived in Ontario, many of whom joined the Christian Reformed Church. Following familiar cultural patterns, history, and their Reformed Christian faith, these immigrants settled in Ontario with remarkable institutional completeness (Breton, 1964). They quickly established independent, parent-operated Christian schools across Ontario. The primary purpose of the schools was to educate children through a comprehensive biblically based school program, yet this religious purpose often intersected with a Dutch immigrant ethnic culture. Van Dijk (2001) states that “the schools were the most important organization in maintaining the religious and ethnic identity of Calvinists” (p. 66). In this qualitative study I explore the intersection of Reformed faith and Dutch Canadian immigrant ethnic culture in Christian schools through the experiential and professional lens of eight retired principals. Employing a theoretical framework informed by Berger’s (1967) Sacred Canopy, I suggest that the intersection of faith and culture was experienced in the schools and was embodied by the schools themselves. Findings point to this intersection being located in the participants’ experience of (a) Dutchness, (b) the struggle for Christian education, (c) the ties that bound the school community together, and (d) the cloud of witnesses that founded and continues to support and encourage the Christian school community. The study offers insight into a Dutch Reformed immigrant group’s experience carving out a niche for themselves on the educational landscape in Ontario. This study also offers suggestions on how Christian schools can broaden their canopy and become more ethnically and denominationally diverse in the future.

Practice english and music with songs and games

Cuaderno de trabajo dirigido a alumnos de Ense??anza Primaria que puede ser utilizado como material de apoyo y complementario. Se presenta un total de 22 unidades organizadas en dos partes: la primera presenta la canci??n o rima y la segunda una partitura con la melod??a. Se incluye un cap??tulo dedicado a la autoevaluaci??n con un total de 100 preguntas y otro dedicado al vocabulario. Se complementa este trabajo con un CD cuyo objetivo es combinar el aprendizaje y la pr??ctica del idioma ingl??s con el uso de las nuevas tecnolog??as.

Análisis de la presencia de petroleras occidentales y la agudización de conflictos político-económicos en el Delta del Níger. Caso: la Royal Dutch Shell y el Movimiento para la Emancipación del Delta del Níger (MEND) 2006-2010

La región del Delta del Níger es uno de los territorios, sino el principal, en otorgarle a Nigeria numerosas regalías por la exportación de petróleo, sin embargo el escaso beneficio que recibe su población genera conflicto en la región. La alta contaminación provocada por empresas petroleras como la Royal Dutch Shell (RDS), la violación de Derechos Humanos y la estrecha relación que mantiene la multinacional con el Gobierno, se han convertido en los motores del conflicto. Es debido a esto que grupos armados como el Movimiento para la Emancipación del Delta del Níger (MEND), han emprendido acciones con el fin de controlar los recursos, cometiendo robos de petróleo y actos de violencia que constituyen represalias por el trato que la industria petrolera ha dado a la población del Delta. No obstante, el conflicto se ha ido alejando de sus objetivos iniciales en tanto que se ha convertido en un negocio lucrativo, ha producido mayores índices de pobreza y se ha generado un círculo de violencia entre las empresas petroleras, el gobierno nigeriano y los grupos armados. De ahí que el Delta del Níger constituya una región importante no sólo debido a sus altas producciones de petróleo, sino porque además representa una zona altamente compleja que envuelve a ciudadanos, gobiernos y petroleras.

Yasmin Levy's Ladino ballads and flamenco songs : background for students of Spanish. 'Yasmin Levy canta romances ladinos y canciones flamencas : orientación para los estudiantes de hispánicas'.

Resumen en español

50 songs for helping and enjoying... the teaching of English.

Esta recopilación pretende servir de ejemplo de distintas formas de explotación de canciones en el aula. La mayoría de las canciones seleccionadas contienen elementos para el desarrollo más amplio de ciertos temas, algunas son ejemplos para la repetición de estructuras muy básicas y útiles para los planteamientos pedagógicos. Los objetivos que se pretenden trabajar con cada una de las canciones se especifican en una ficha adjunta y son ampliables en función de las necesidades o conocimientos de la clase en que vaya a trabajarse. La aplicación de estas técnicas y actividades al Segundo Ciclo de Secundaria y BUP es muy aconsejable, ya que los intereses de los alumnos y sus conocimientos gramaticales se acercan más al mundo de la canción.

Creating chants and songs.

Los cantos y canciones son una parte esencial de la enseñanza del idioma: ayuda a la pronunciación, al aprendizaje del vocabulario y a las estructuras gramaticales, así como proporcionar variedad y diversión a la experiencia. Da modelos y sugerencias para el desempeño de la clase y a los niños oportunidades para crear sus propias canciones. Cada canto o canción incluye las actividades de orientación para el nivel apropiado: nivel 1 básico de palabras, simples estructuras de base; nivel 2 estructuras de frases de nivel básico, algunos con uso del presente; nivel 3 ampliación del vocabulario, en colaboración con tiempos del presente, pasado simple, las formas de futuro y otros patrones funcionales, como por ejemplo 'So i do'. Contiene orientación para el profesor con mas de sesenta actividades para niños de primaria, y hojas fotocopiables. Las actividades se explican con objetivos, edades y niveles claramente diferenciados. El CD de audio ofrece melodías y ritmos, y ejemplos de los cantos producidos en el libro.

Songs of ourselves : the University of Cambridge International Examinations anthology of poetry in english.

Antología de poesías pertenecientes a cien poetas de todo el mundo de habla inglesa. Es una introducción a una gran variedad de formas, estilos y contenidos de versos de los últimos cuatro siglos, desde el siglo XVI hasta la actualidad. Su contenido se adapta al estudio del CIE, IGCSE y al programa de estudios del nivel AS y nivel avanzado de literatura en inglés.