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ObjectivesMultidisciplinary team meetings aim to facilitate efficient and accurate communication surrounding the complex process of treatment decision making for older patients with cancer. This process is even more complicated for older (≥70 years) patients as the lack of empirical evidence on treatment regimens in patients with age-related problems such as comorbidity and polypharmacy, necessitates a patient-centred approach.This study investigates the decision making process for older patients with cancer during multidisciplinary team meetings and the extent to which geriatric evaluation and geriatric expertise contribute to this process.MethodsNon-participant observations of 171 cases (≥70 years) during 30 multidisciplinary team meetings in five hospitals and systematically analysed using a medical decision making framework. All cases were in patients with colon or rectal cancer.ResultsFirst, not all steps from the medical decision making framework were followed. Second, we found limited use of patient-centred information such as (age-related) patient characteristics and patient preferences during the decision making process. Third, a geriatric perspective was largely missing in multidisciplinary team meetings.ConclusionsThis study uncovers gaps in the treatment decision making process for older patients with cancer during multidisciplinary team meetings. In particular individual vulnerabilities and patient wishes are often neglected.

Het is bekend dat veel jonge mensen met hun smartphone dag en nacht van sociale media gebruik maken. Maar wat valt er te zeggen over het sociale mediagebruik door 65-plussers in ons land? Behoren zij tot een andere technologiegeneratie waardoor het gebruik van sociale media een minder prominente rol speelt in hun dagelijks leven?

Exergames aim at stimulating healthy people or patients needing rehabilitation to do physical exercise to enhance their physical state (e.g., postural balance, muscle power). As older adults generally have more health problems than younger ones, such games could be beneficial to them. Since the introduction of the Wii gaming system by Nintendo in 2006, several literature reviews have been conducted that examine the impact of exergames on older adults’ physical well-being. However, less attention has been paid to the potential impact on their mental and social well-being. Therefore, the aim of this paper is to explore what we can learn from previously conducted empirical studies about the impact of exergaming on these kinds of well-being. Although a limited number of literature reviews show that some empirical studies have been conducted around these issues it is not clear that the results are evidence-based. The question remains whether the results can be used by rehabilitation centers and associations for senior citizens to promote exergaming among older adults also for their mental and social well-being. The purpose of this state-of-the-art paper is to present an overview to address this question and to make recommendations about guidelines for the research design of future evidence-based empirical studies.

In line with a general trend towards more responsive regulation, inspectors are expected to take inspectees’ needs and demands in account when making decisions. At the same time, inspection services increasingly apply instruments aimed at directing the inspectors’ actions. These contradictory signals can make the work of inspectors very difficult. By reviewing relevant literature, this chapter shows that not only inspectees’ behavior and characteristics, but also inspectors’ professional role identity, i.e. the way inspectors view their professional role, is critical to explain and predict decision making on the ground.

In times of a general trend towards more responsive regulation inspectors take inspectees’ needs and demands in account when making decisions. At the same time, inspection services increasingly try to steer the inspectors’ actions by a growing number of instruments. These contradictory signals can make the work of inspectors very difficult. By reviewing relevant literature this chapters illustrates that in the context of these policy developments, not only inspectees’ behavior and characteristics, but also inspectors’ professional role identity, i.e. the way inspectors view their professional role, is critical to explain and predict decision-making on the ground.

Sportverenigingen nemen een steeds stevigere positie in het sociaal domein in. In dit hoofdstuk beschouwen we de rol van sportverenigingen in het sociaal domein vanuit twee perspectieven. Ten eerste kijken we vanuit een publiek perspectief naar de gewenste maatschappelijke rol van sportverenigingen. Hoe zien overheden de rol van sportverenigingen in het sociaal domein? We onderscheiden in dit deel vier maatschappelijke rollen die sportverenigingen kunnen vervullen om een bijdrage te leveren aan vraagstukken in het sociaal domein. Ten tweede kijken we vanuit het perspectief van sportverenigingen zelf. Hoe zien zij hun maatschappelijke rol in het sociaal domein en hoe geven zij daar invulling aan? Daaruit komt naar voren dat sportverenigingen zichzelf steeds sterker zien als een maatschappelijke organisatie en dat er tegelijkertijd een differentiatie optreedt in de invulling van de maatschappelijke rol door sportverenigingen. Het hoofdstuk sluit af met een discussie over de raakvlakken en het licht tussen het beleids- en verenigingsperspectief.

In street-level bureaucracy studies, inspectors are often seen as frontline workers with individual discretion. Inspectors, however, increasingly operate in intra- or inter-organizational teams and perform joint inspections to more effectively tackle the complexity of multi-problems and wicked issues in society. Nevertheless, how street-level bureaucrats work together in teams, and how teamwork shapes decision making on the ground has not been given much scholarly attention in public administration. Based on findings from the few published studies on this topic, this chapter argues that the social dynamics and decision-making processes in joint inspections may be different than those in one-on-one inspector–inspectee encounters. It therefore calls for more research to better understand how teamwork shapes decision-making at the micro-level, and how challenges can be dealt with.

In recent decades, sport as a social practice has become relevant in many different fields: in health, economy, politics, education, work and leisure. The importance of sport transcends the confine...

Previous studies have mainly focused on tailoring message content to match individual characteristics and preferences. This study investigates the effect of a website tailored to individual preferences for the mode of information presentation, compared to 4 nontailored websites on younger and older adults' attention and recall of information, employing a 5 (condition: tailored vs. text, text with illustrations, audiovisual, combination)×2 (age: younger [25-45] vs. older [≥65] adults) design (N = 559). The mode-tailored condition (relative to nontailored conditions) improved attention to the website and, consequently, recall in older adults, but not in younger adults. Younger adults recalled more from nontailored information such as text only or text with illustrations, relative to tailored information.

Online health information tools (OHITs) have been found to be effective in improving health outcomes. However, the effectiveness of these tools for older patients has been far from clear. This systematic literature review therefore provides an overview of online health information tool effectiveness for older patients using a two-dimensional framework of OHIT functions (i.e., providing information, enhancing information exchange, and promoting self-management) and outcomes (i.e., immediate, intermediate, and long-term outcomes). Comprehensive searches of the PubMed, EMBASE, and PsycINFO databases are conducted to identify eligible studies. Articles describing outcomes of patient-directed OHITs in which a mean sample or subgroup of age ≥65 years was used are included in the literature review. A best evidence synthesis analysis provides evidence that OHITs improve self-efficacy, blood pressure, hemoglobin levels, and cholesterol levels. Limited evidence is found in support of OHIT effects on knowledge, perceived social support, health service utilization, glycemic control, self-care adherence, exercise performance, endurance, and quality of life. OHITs seem promising tools to facilitate immediate, intermediate, and long-term outcomes in older patients by providing information, enhancing information exchange, and promoting self-management. However, future studies should evaluate the effectiveness of OHITs for older patients to achieve stronger levels of evidence.

Studies on sport mega-events and their legacies often seem only loosely connected to local experiences. Stories on sport mega-event legacy appear as a setting-the-scene or function as a reference to illustrate specific types of legacy. However, stories themselves are never the primary focus in these studies. What is generally lacking from these studies is an interpretive perspective, giving voice to ordinary citizens’ everyday experiences of legacies in mundane aspects of their lives and their local environment. The article aims to add an analysis of stories to the existing body of knowledge as an innovative way of interpreting sport mega-events’ legacies. We introduce a narrative ethnographic approach for studying sport mega-event legacy, by looking at the way stories and narrative analysis are used to conceptualise legacy in the sociological subfield of ageing-studies. In our case study we show how citizens from one Johannesburg township make sense of the legacy of the 2010 FIFA World Cup one year after the event, by analysing people's stories about two sport-for-development projects. We conclude that local residents of the township of Alexandra perceive changes in public safety and the image of Alexandra as the most important positive legacy of the 2010 FIFA World Cup. At the same time they take a critical stance towards the World Cup's legacy, because personal situations and community structures were often disrupted, rather than improved. We maintain that a narrative ethnographic approach provides extensive accounts about sport mega-event legacies, which help to better understand the different faces of sport mega-events’ legacies at a micro level.

New media play an increasing role in the everyday life of older individuals. They extensively use the Internet to search for health-related information. In our systematic review we found that online health information tools have been proven to be effective in improving self-efficacy and several clinical outcomes in older (≥ 65 years) patients. The aim of this study was to evaluate the development and usability of the effective online health information tools. The reporting of the development of the online health information tools turned out to be too succinct. Moreover, we were unable to evaluate the usability of online health information tools as none of them were publicly available. We argue the need to report more detailed information about the development and usability of online health information tools in evaluation studies in order to replicate findings and to develop new evidence-based online health information tools for older patients.

Society ages and our already extensive use of a host of different portable devices continues to expand. No leap of the imagination is needed to grasp that an exponential growth of the eHealth market is at hand. While the ageing of the baby boomers will have an impact on the global economy as a whole, of particular interest is the impact this will have within the context of eHealth market development. We wish to clarify and raise the level of awareness about how older age identity is constructed in the marketer-consumer dialectic within the eHealth context and how the personas method can be used from a cultural age perspective. Our focus is on the process of third agers becoming eHealth consumers. We present an analytical framework for future studies aiming to an-alyze eHealth offerings. This will allow us to gain insight into the process of constructing the third age eHealth consumer group’s identity through multimodal communicative acts, as is the case in advertising, or in settings requiring interactivity, such as the service design process. It is through these multimodal acts that new eHealth offerings could be marketed to the third age eHealth con-sumer, focusing especially on both the written and visual language used. Our approach is meant to offer an alternative to studies in which ageing has mostly drawn upon the chronological age concept and where marketing has not been seen as a discursive practice shaping consumers’ identities.

Purpose – This paper proposes a New Literacies approach to get insight into young people’s capability to detect Fake News. Design/methodology/approach – Replication of a US empirical study in the Netherlands to examine whether schoolchildren were able to identify the spoof website Save The Pacific Northwest Tree Octopus as a fake. Findings – In the Netherlands, only 2 out of 27 school children (7%) recognized the website as being a hoax; results that are worse, even, than those of the 2007 US study, where the website was recognized as being unreliable by slightly more than 6 out of 53 school children (11%). Research limitations/implications – A similar but large scale quantitative empirical study should be conducted in several countries to see if the trends in the US and the Netherlands are indeed significant. Practical implications – It is important to start teaching children at an early age how to critically evaluate online information. Social implications – Our perceived reliability of digital information is a hot issue, given the frequency with which fake news is circulated. Being able to critically evaluate digital information will help us to have access to trustworthy information. Originality/value – Instead of using technological fact checking by Google, Facebook and Twitter, this paper suggests the adoption of a New Literacies approach, focusing on young people’s capability to detect Fake News.

This exploratory qualitative study provides insight into the role that exergames can play for seniors. Fifteen participants (aged 53–78) engaged in playing Your Shape Fitness Evolved 2 on the Xbox 360 Kinect. We conducted semi-structured interviews with each participant and we found that in all cases, their innate psychological needs of autonomy and competence (Self Determination Theory) were met. Playing the exergame not only served as a serious therapeutic instrument with positive effects on the subjective physical and social wellbeing, but it also brought entertainment, providing excitement and fun.

Kinderen die een veel hoger opleidingsniveau hebben bereikt dan hun ouders, worden aangeduid als sociale stijgers. Hun opleidingsprestatie wordt gemakkelijk gezien als een positieve conditie voor succes en well-being gedurende hun arbeidsleven. Echter, velen van hen kampen een vrij lange periode met professionele identiteitsproblemen. Zij percipiëren zichzelf als anders dan hun collega’s en ze beschouwen zich niet als ‘echte’ leden van de sociale groep waartoe ze zijn gaan behoren. Maar de onderlinge verschillen in well-being zijn nogal groot. De daarbij aansluitende vraag die in dit artikel wordt beantwoord, is: Met welke professionele identiteitsproblemen worden sociale stijgers geconfronteerd en hoe zijn onderlinge verschillen daarin te verklaren? Uitgaande van literatuur over identiteit en recent onderzoek naar sociale stijgers worden in dit artikel diverse identiteitsproblemen geconcretiseerd en wordt een theoretisch model ontwikkeld dat de verschillen tussen sociale stijgers verklaart op grond van twee modererende concepten: het ‘identity capital’ concept van Côté en het ‘identity agents’ concept van Schachter.

This study aims to investigate the effects of illustrations in online cancer information on older cancer patients' website satisfaction (i.e. satisfaction with the attractiveness, comprehensibility and emotional support from the website) and recall of information. In an online experiment, 174 younger (

Toekomstonderzoek laat o.m. toe om op een systematische manier te reflecteren over de verschillende strategische keuzes waarvoor een organisatie staat. Deze bijdrage presenteert daarvan een concreet voorbeeld: de toepassing van scenariodenken ter ondersteuning van de ontwikkeling van een visie voor de politie in 2025. In deze bijdrage wordt die oefening, waarbij ruim 65 personen (o.m. politieambtenaren, beleidsadviseurs en academici) betrokken waren, beschreven. De bijdrage vangt aan met een korte beschrijving van de praktische organisatie van de activiteiten. Vervolgens wordt toegelicht waarom voor de techniek van strategische scenario’s werd gekozen. Daarna wordt ingegaan op de twee grote stappen die werden gezet in deze visieontwikkeling: het uitwerken van de scenario’s en vervolgens het uitwerken van een visie op basis van die scenario’s. De bijdrage rondt af met enkele concrete lessen voor de praktijk, geformuleerd als succesfactoren, en een eindreflectie over het nut van de oefening.

Dutch historian Johan Huizinga [1] viewed games as a fundamental aspect of life. As long ago as 1938, he observed that, next to “homo faber” (man the maker), there is also the concept of “homo ludens” (man the player). The aim of this paper is to explore what we can learn from previously conducted empirical studies about the motivation and capability of older adults to use exergames. We were guided by the following questions. To which extent: (1) Are older adults motivated to play exergames and why is this the case?, (2) Are older adults able to play exergames and why is this the case? and (3) Can the voices of the older players be heard in the empirical studies on exergaming in later life? We conducted a narrative literature review to gain insight, not only into the factors relating to older adults’ engaging in exergames, but also into the ways older adults themselves experience playing such games. To avoid a mainly functionalist perspective on play, we will also include hedonic aspects of playing exergames.

In times of a general trend towards more responsive regulation inspectors take inspectees’ needs and demands in account when making decisions. At the same time, inspection services increasingly try to steer the inspectors’ actions by a growing number of instruments. These contradictory signals can make the work of inspectors very difficult. By reviewing relevant literature this chapters illustrates that in the context of these policy developments, not only inspectees’ behavior and characteristics, but also inspectors’ professional role identity, i.e. the way inspectors view their professional role, is critical to explain and predict decision-making on the ground.

In street-level bureaucracy studies, inspectors are often seen as frontline workers with individual discretion. Inspectors, however, increasingly operate in intra- or inter-organizational teams and perform joint inspections to more effectively tackle the complexity of multi-problems and wicked issues in society. Nevertheless, how street-level bureaucrats work together in teams, and how teamwork shapes decision making on the ground has not been given much scholarly attention in public administration. Based on findings from the few published studies on this topic, this chapter argues that the social dynamics and decision-making processes in joint inspections may be different than those in one-on-one inspector–inspectee encounters. It therefore calls for more research to better understand how teamwork shapes decision-making at the micro-level, and how challenges can be dealt with.

Sportverenigingen nemen een steeds stevigere positie in het sociaal domein in. In dit hoofdstuk beschouwen we de rol van sportverenigingen in het sociaal domein vanuit twee perspectieven. Ten eerste kijken we vanuit een publiek perspectief naar de gewenste maatschappelijke rol van sportverenigingen. Hoe zien overheden de rol van sportverenigingen in het sociaal domein? We onderscheiden in dit deel vier maatschappelijke rollen die sportverenigingen kunnen vervullen om een bijdrage te leveren aan vraagstukken in het sociaal domein. Ten tweede kijken we vanuit het perspectief van sportverenigingen zelf. Hoe zien zij hun maatschappelijke rol in het sociaal domein en hoe geven zij daar invulling aan? Daaruit komt naar voren dat sportverenigingen zichzelf steeds sterker zien als een maatschappelijke organisatie en dat er tegelijkertijd een differentiatie optreedt in de invulling van de maatschappelijke rol door sportverenigingen. Het hoofdstuk sluit af met een discussie over de raakvlakken en het licht tussen het beleids- en verenigingsperspectief.

Purpose – This paper proposes a New Literacies approach to get insight into young people’s capability to detect Fake News. Design/methodology/approach – Replication of a US empirical study in the Netherlands to examine whether schoolchildren were able to identify the spoof website Save The Pacific Northwest Tree Octopus as a fake. Findings – In the Netherlands, only 2 out of 27 school children (7%) recognized the website as being a hoax; results that are worse, even, than those of the 2007 US study, where the website was recognized as being unreliable by slightly more than 6 out of 53 school children (11%). Research limitations/implications – A similar but large scale quantitative empirical study should be conducted in several countries to see if the trends in the US and the Netherlands are indeed significant. Practical implications – It is important to start teaching children at an early age how to critically evaluate online information. Social implications – Our perceived reliability of digital information is a hot issue, given the frequency with which fake news is circulated. Being able to critically evaluate digital information will help us to have access to trustworthy information. Originality/value – Instead of using technological fact checking by Google, Facebook and Twitter, this paper suggests the adoption of a New Literacies approach, focusing on young people’s capability to detect Fake News.

Dutch historian Johan Huizinga viewed games as a fundamental aspect of life. As long ago as 1938, he observed that, next to “homo faber” (man the maker), there is also the concept of “homo ludens” (man the player). The aim of this paper is to explore what we can learn from previously conducted empirical studies about the motivation and capability of older adults to use exergames. We were guided by the following questions. To which extent: (1) Are older adults motivated to play exergames and why is this the case?, (2) Are older adults able to play exergames and why is this the case? and (3) Can the voices of the older players be heard in the empirical studies on exergaming in later life? We conducted a narrative literature review to gain insight, not only into the factors relating to older adults’ engaging in exergames, but also into the ways older adults themselves experience playing such games. To avoid a mainly functionalist perspective on play, we will also include hedonic aspects of playing exergames.

Previous studies have mainly focused on tailoring message content to match individual characteristics and preferences. This study investigates the effect of a website tailored to individual preferences for the mode of information presentation, compared to 4 nontailored websites on younger and older adults' attention and recall of information, employing a 5 (condition: tailored vs. text, text with illustrations, audiovisual, combination)×2 (age: younger [25-45] vs. older [≥65] adults) design (N = 559). The mode-tailored condition (relative to nontailored conditions) improved attention to the website and, consequently, recall in older adults, but not in younger adults. Younger adults recalled more from nontailored information such as text only or text with illustrations, relative to tailored information.

The vast majority of business offenses, whether systematic and serious or small and relatively harmless, remains undetected by public regulatory authorities. Yet, they are often witnessed in some form by employees, local residents, customers, competitors, accomplices or other parties. Reporting these signals to authorities can provide valuable information to regulatory agencies’ own detection and investigation activities, and thus contribute to more efficient and effective enforcement. Although an extensive scholarship exists on reporting, it has mainly focused on whistle-blowers: insiders who are directly part of or involved in the offending behaviour. This study focuses on one type of external witnesses, namely bystanders who maintain a professional relationship with a company. These could include suppliers, customers, and competitors. These parties distinguish themselves from whistleblowers in the sense that although they sustain a close relation with a (suspected) offending business, they are not directly part of the organization, let alone do they take part in the offense. Therefore, the name ‘bellringers’ has been suggested for this category. Building on the existing literature about whistleblowing and bell-ringing, this paper asks what motivates ‘bellringers’ to report suspected business violations to enforcement authorities, and how they experience the reporting process. To answer this question, an extensive empirical study was carried out of more than 350 reports of offenses at three inspectorates in the Netherlands, and 60 interviews with reporting business owners and representatives of business sector organizations and inspectorates.

This exploratory qualitative study provides insight into the role that exergames can play for seniors. Fifteen participants (aged 53–78) engaged in playing Your Shape Fitness Evolved 2 on the Xbox 360 Kinect. We conducted semi-structured interviews with each participant and we found that in all cases, their innate psychological needs of autonomy and competence (Self Determination Theory) were met. Playing the exergame not only served as a serious therapeutic instrument with positive effects on the subjective physical and social wellbeing, but it also brought entertainment, providing excitement and fun.

Kinderen die een veel hoger opleidingsniveau hebben bereikt dan hun ouders, worden aangeduid als sociale stijgers. Hun opleidingsprestatie wordt gemakkelijk gezien als een positieve conditie voor succes en well-being gedurende hun arbeidsleven. Echter, velen van hen kampen een vrij lange periode met professionele identiteitsproblemen. Zij percipiëren zichzelf als anders dan hun collega’s en ze beschouwen zich niet als ‘echte’ leden van de sociale groep waartoe ze zijn gaan behoren. Maar de onderlinge verschillen in well-being zijn nogal groot. De daarbij aansluitende vraag die in dit artikel wordt beantwoord, is: Met welke professionele identiteitsproblemen worden sociale stijgers geconfronteerd en hoe zijn onderlinge verschillen daarin te verklaren? Uitgaande van literatuur over identiteit en recent onderzoek naar sociale stijgers worden in dit artikel diverse identiteitsproblemen geconcretiseerd en wordt een theoretisch model ontwikkeld dat de verschillen tussen sociale stijgers verklaart op grond van twee modererende concepten: het ‘identity capital’ concept van Côté en het ‘identity agents’ concept van Schachter.

Toekomstonderzoek laat o.m. toe om op een systematische manier te reflecteren over de verschillende strategische keuzes waarvoor een organisatie staat. Deze bijdrage presenteert daarvan een concreet voorbeeld: de toepassing van scenariodenken ter ondersteuning van de ontwikkeling van een visie voor de politie in 2025. In deze bijdrage wordt die oefening, waarbij ruim 65 personen (o.m. politieambtenaren, beleidsadviseurs en academici) betrokken waren, beschreven. De bijdrage vangt aan met een korte beschrijving van de praktische organisatie van de activiteiten. Vervolgens wordt toegelicht waarom voor de techniek van strategische scenario’s werd gekozen. Daarna wordt ingegaan op de twee grote stappen die werden gezet in deze visieontwikkeling: het uitwerken van de scenario’s en vervolgens het uitwerken van een visie op basis van die scenario’s. De bijdrage rondt af met enkele concrete lessen voor de praktijk, geformuleerd als succesfactoren, en een eindreflectie over het nut van de oefening.

This study aims to investigate the effects of illustrations in online cancer information on older cancer patients' website satisfaction (i.e. satisfaction with the attractiveness, comprehensibility and emotional support from the website) and recall of information. In an online experiment, 174 younger (