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Background: In the Netherlands, the spiritual dimension in healthcare became marginal in the second part of the twentieth century. In the Dutch healthcare system, palliative care is not a medical specialization and teaching hospitals do not have specialist palliative care units with specialized palliative care teams. Palliative care in these hospitals is delivered by healthcare professionals in general departments (mainly curative focused ones), and is based on multidisciplinary guidelines supported by palliative care consultation teams. A national multidisciplinary guideline on spiritual care is included, but standardized training based on this guideline still lacks. Implementation of this guideline is expected to have a positive effect on quality of care but is in an early state, the role of the specialists in this field--the healthcare chaplains--is developing. The objective of this article is to present the protocol of this study and stimulate discussion about methods of research on spirituality and spiritual care. Methods and Findings: This action research study is planned as an explorative multicentre trial. Healthcare chaplains of ten teaching hospitals will offer training on spiritual care in palliative care for healthcare professionals. What is the effect of this intervention on the competences of clinical teams? What is the effect on the perceived care and treatment as experienced by patients? The effects of the intervention on the competences of the clinicians will be measured once pre-study and twice post-study. Effects on patients' physical symptoms and spiritual distress, and the perceived focus of caregivers on their spiritual needs or existential questions will also be measured pre- and post-study. [ABSTRACT FROM AUTHOR]

After the decline of the compartmentalization of Dutch society, where healthcare was being organized along confessional/denominational lines, spirituality became neglected or implicit for decades in the Netherlands healthcare system. During the modernization of healthcare in the 1960s, the development of professional language concerning chaplaincy and psychosocial care in a secularizing society created a blind spot for this fundamental dimension of care. From the moment palliative care in the Netherlands became part of a national programme, healthcare providers, policymakers, and researchers were presented with the challenge of reassessing this complex concept. National policy and personal initiatives on research and education connected in an inspiring process that led to a Dutch, consensus-based national guideline for multidisciplinary spiritual care as part of palliative care, the adjustment of the professional standard of healthcare chaplaincy in the Netherlands, and the initiative for a European taskforce on spiritual care. In the appendices of this paper the first English-language summary of the Dutch guideline on spiritual care and the European Association for Palliative Care (EAPC) definition of spirituality are presented. [ABSTRACT FROM AUTHOR]

Abstract--The paper addresses the question whether utility may be viewed as a completely relative concept. In a dynamic setting this means that one has to model both habit formation and utility interdependence. The resulting model contains unobservable variables and requires panel data to be estimated. Using the first two waves of an annual panel in The Netherlands, different specifications of the model are estimated, involving alternative sets of identifying restrictions. It turns out that the data are compatible with the hypothesis that utility is completely relative, but we cannot exclude the possibility that utility is partly relative and partly absolute. [ABSTRACT FROM AUTHOR]

A description of one of the world’s most innovative libraries, which aims to be the most advanced public library in the world using creativity, technical innovation and scientific understanding. The library also has a commitment to sharing ideas within a global library network and the importance of public libraries and that network for democracy. [ABSTRACT FROM AUTHOR]