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During the last decades, there has been an increasing priority placed on shared decision making (SDM) in treatment decision making. Particularly, in Western health policy, SDM is seen as an essential process in medical practice and is being widely incorporated. Likewise in the Netherlands, policymakers make efforts to improve SDM. Despite all efforts, SDM is not routine. That not all patients experience SDM or that they experience SDM to a lower degree may be seen as something undesirable. Because, first of all, it is believed that SDM aligns with an ethical principle: respecting patients’ autonomy. Secondly, research shows that SDM contributes to benefits for patients and healthcare providers (e.g. increased patient knowledge, decisional satisfaction, reduction of unwarranted variation in healthcare (both overuse and underuse) and better healthcare alignment). To get a better understanding of the experienced level of SDM among patients, we need a better insight into possible explanations for patients’ experienced level of SDM. Therefore, we will answer the following research question: “What are possible explanations for patients’ experienced level of shared decision making?”.

This chapter investigates Dutch pamphlet coverage of the 1655 massacre of the Waldensians. Comparing textual and visual representations of the violence, the chapter argues that persecuted minorities and their advocates stepped into a complex communicative landscape when they sought publicity for foreign suffering. Close investigation of this landscape will offer insights into how early modern consumers of print media were invited to feel concern about the plight of faraway strangers.

In the early modern period, images of revolts and violence became increasingly important tools to legitimize or contest political structures. This volume offers the first in-depth analysis of how early modern people produced and consumed violent imagery, and assesses its role in memory practices, political mobilization, and the negotiation of cruelty and justice.

Medium-size telephone farmers benefit from and have the potential to support a thriving agricultural ecosystem, making use of it, but also by providing agricultural services and modern technology themselves, training their workers and helping them by subcontracting certain activities to smaller farmers and obtain contracts to sell large quantities regularly themselves. This paper analyzes the presence of an ecosystem for medium size farmers based on interviews with 50 medium size farmers and indicates the expectations of these farmers with respect to such a system.

The final chapter brings together some insights from the case studies of climate smart agriculture & water (CSA&W) in different countries presented during the MSM research seminar. We review the definitions of CSA&W and argue that different disciplines (agronomy, agricultural economics and management science) are relevant, but have different definitions and that CSA&W has a different meaning at different levels. We distinguish the macro (national), the meso (the level of the ecosystem) and the micro level of the farmers. Examples of each discipline and each level are provided to draw four conclusions: 1. CSA&W has a different meaning in different disciplines and at the macro, meso and micro level. The common element is that CSA&W has a signaling function, drawing attention to the technology that can modernize agricultural production 2. A Business school has its own contribution to make to the CSA&W debate 3. As MSM, we looked at one type of governance in CSA&W interventions in particular, the use of partnerships to introduce and exploit innovation 4. An index developed in the previous chapter for CSA&W or the presence of an ecosystem is sensitive to the indicators chosen and the method used to come up with a score.

Research among Climate Smart Agriculture (CSA) farmers and organizations in horticulture sectors of South Africa, Tanzania and Jordan demonstrates the need for creating CSA ecosystems. While being fully focused on managing their CSA innovations, few farmers have time to develop these CSA partnerships and networks. To guide these efforts, we identified the key aspects for CSA ecosystems to focus on in their support to CSA farmers. We argue that for reaching optimum results, the business model of the CSA farm should include a local ecosystem that provides support to its operations from private, public and academic stakeholders. It should be a farmer-focused ecosystem, aimed at providing local solutions for localized problems. Using the Open Innovation Ecosystem Model allows us to suggest ways to facilitate the development and coordination of such an ecosystem, either by a lead CSA farmer or by other CSA stakeholders.

Climate change and the resulting increased drought periods contribute to farmers' problems in Tanzania, but their core problem is low agricultural productivity. Between 2011 and 2014, the Swiss Capacity Building Facility (SCBF), a non -governmental organization (NGO) financed by ten private Swiss insurance companies, funded four projects in Tanzania aiming to introduce crop insurances for maize farmers in the Iringa, Mwanza and Arusha regions to help them to move from using traditional maize seeds, which they would save each year, to hybrid seeds sold by commercial companies. These seeds require expenditure on additional inputs, which means the farmers risk losing the investments if the harvest is lower than expected. The hybrid seed is available, but it requires other actors and instruments to give small-scale farmers access to these innovations. This helps to develop the necessary ecosystem for Climate Smart Agriculture and Water (CSA&W). To assess the impact of this Weather Index based crop insurance for Tanzanian maize farmers, which intended to mitigate this risk, a survey has been undertaken by the author. In total 200 farmers were interviewed, using cluster sampling. The objective is to analyze the impact of the crop insurance introduced with the support of SCBF and its effect on household's income and assets and on agricultural productivity. In this paper we also analyze to what extent the ecosystem used to introduce crop insurance was optimal and what the needs of the farmers are concerning this ecosystem. Finally, the question is asked whether this is an example of introducing Climate smart agriculture and water, using frugal innovation in a Triple Helix construction?

With a growing world population to around 9 billion people in 2050 and the rise of global warming, there are growing concerns about food security for a large part of the world population. This is compounded by other environmental disasters such as deforestation, desertification, water scarcity, pollution and loss of bio -diversity. Human activity is putting more and more pressure on the natural environment. Hence, there is widespread consensus that a more sustainable balance must be struck between human needs and the preservation of natural resources such as land, water and forests (World Resources Institute, 2019). Generally, the solution to such large and complex issues, has been to call for multi -actor collaboration at international, national and local levels. In 2015, the UN emphasized PPPs as the key vehicle to reach the sustainable development goals. Large programs such as REDD+ concerning deforestation, were set up. Multilateral organizations such as the FAO and World Bank promoted the concept of Climate -Smart Agriculture (CSA) which aims to increase agricultural productivity, enhance resilience and reduce emissions (World Bank, 2020). Management of the these “commons” is achieved through a landscape approach, which aims at multi - actor collaboration. It looks beyond agriculture, integrating it with forestry and other land uses to forge a comprehensive agenda for sustainable development to eradicate poverty, strengthen food and nutrition security (FAO, 2013). However, these big concepts also face a number of challenges. Empirical evidence about the efficiency of the landscape approach is still scarce and often not as unambiguous as underlined in theory due to many obstacles and measurement challenges (The Ministry of Foreign Affairs of the Netherlands, 2013). One particular challenge is the institutional side of the landscape approach, in terms of its legal, administrative or even political aspects. This paper dives deeper into this topic by focusing on the institutional and governance aspects of the landscape approach in CSA and compares these with another framework for multi -actor collaboration, namely High Performance Partnerships (HPP), to assess which approach might be more successful to achieve the goals of CSA.

In 1572 Mechelen was the first city to be sacked during the Dutch Revolt, by an army fighting for Philip II. The Duke of Alba punished its citizens for having opened the gates to rebels. In 1580 the city was sacked again, this time by a rebel army consisting mainly of English Protestants. This article argues that being sacked acutely raised the question of what it meant to be part of a civic community. In both cases, however, political circumstances made it difficult to communicate the memory of the violent takeover. Recollecting the so-called "Spanish Fury" ostensibly meant harking back to a rebellious past. Remembering the "English Fury", in turn, went against the Habsburg authorities' policy of oblivion - requiring reconciled cities to move on and forget the troublesome past. To better understand how atrocity shaped individual and civic identity, this article examines the strategies citizens used to make sense of painful memories in an unstable and divided political landscape.

Background: The public primary healthcare system in Greece has not been fully developed and is delivered by urban and rural health centers, outpatient departments in public hospitals and the recently established first-contact and decentralized local primary care units. The aim of this study was to develop a valid and reliable measurement tool for conducting periodic user experience evaluation surveys in public Primary HealthCare facilities in Greece such as outpatient clinics of public hospitals and health centers. Methods: A mixed methods approach was applied. In particular, the methodology of developing and validating the tools included three steps: (a) establishment of the theoretical background/literature review, (b) qualitative study: development of the tools items and establishment of the face validity and (c) quantitative study: pilot testing and establishment of the structural validity and estimation of the internal consistency of the tools. Two patient focus groups participated in qualitative study: one visiting health centres and the other visiting the outpatient clinics of public hospitals. Quantitative study included 733 Primary Health Care services' users/patients and was conducted during August-October 2017. Exploratory and confirmatory factor analysis was performed to check for structural validity of the tools, while Cronbach's alpha coefficients were estimated to check for reliability. Results: Confirmatory factor analysis confirmed almost perfectly the presumed theoretical model and the following six factors were identified through the tools: (a) accessibility (three items, e.g. opening hours), (b) continuity and coordination of care (three items, e.g. doctor asks for medical history), (c) comprehensiveness of care (three items, e.g. doctor provides advices for healthy life), (d) quality of medical care (four items, e.g. sufficient examination time), (e) facility (four items, e.g. comfortable waiting room) and (f) quality of care provided by nurses and other health professionals (four items, e.g. polite nurses). Conclusions: We have developed reliable and valid tools to measure users' experiences in public Primary HealthCare facilities in Greece. These tools could be very useful in examining differences between different types of public Primary Health Care facilities and different populations. © 2019 The Author(s).