In many European countries, semi-autonomous agencies have been created in health policy to safeguard general public interests. In executing their tasks, these agencies need to deal with conflicting expectations. Particularly avoiding the risk of regulatory capture and aligning with parent ministries are frequently studied challenges, even more so when complex issues such as scarcity are at stake. In this paper, we use q-methodology to provide a thorough overview of the debate regarding the role of an important agency in the Dutch healthcare system; the National Health Care Institute (Zorginstituut Nederland). We conducted 41 q-interviews with agency employees, evaluators, regulatees, ministry employees, health policy experts, members of its advisory committees, and peer agencies. We identify three viewpoints on what the agency should focus on. These are on societally relevant issues, strict package management, and efficient organisation of care. In doing so, our study shows how agencies are pulled in different directions by conflicting expectations. We show that this can be problematic because it complicates a clear role of the agency that allows addressing such issues. We thereby contribute to theories on agencies' complex relations with their external environment such as regulatory capture, tripartism, reflexive regulation, legal boundaries, and stewardship theory.

Historically, trans people have been excluded from politics. Despite political under representation, trans interests increasingly appear on the political agenda in the Netherlands and Germany. In 2021, trans women were elected to the Dutch and German parliaments for the first time. However, increased trans visibility is accompanied by backlash and transphobia. The political representation of trans people does not follow a familiar pattern from elected descriptive representatives to increased substantive representation of interests. What mechanisms shape the political representation of trans people? We argue that symbolic representation shapes possibilities for descriptive and substantive representation of trans people. The analysis of symbolic representation of transpeople draws on a combination of 1) qualitative text analysis of Dutch and German parliamentary documents, research reports, and trans activists’ publications and 2) in-depth interviews with trans andcisgender representatives, candidates, and activists. The findings demonstrate how political spaces are not only gendered, but also cisgendered and heteronormative.

A reduction in the demand for meat and particularly red meat has the potential to significantly enhance the sustainability and health of many people's diets. In the current work, I examine situational predictors of meat consumption in nationally representative nutrition surveys from three Western European countries: Switzerland, France and the Netherlands. More specifically, I examine whether the situational factors – the meal type, the day of the week and the location of the food consumption occasion – are predictive of whether meat and red meat are consumed. The results indicate that all three factors are linked to meat and red meat consumption with the patterns varying substantially across the different case study countries and in some cases also the gender of the consumer. The results emphasise the value of mapping situational correlates to inform situated interventions aimed at influencing meat consumption, while also highlighting important differences across both cultures and people.

Geothermal energy is one of the most viable sources of renewable heat. However, the potential risk of induced seismicity associated with geothermal operations may slow down the growth of the geothermal sector. Previous research has led to significant progress in understanding fluid-injection-induced seismicity in geothermal reservoirs. However, an in-depth assessment of thermal effects on the seismic risk was generally considered to be of secondary importance. This study aims to investigate the relative influence of temperature and key geological and operational parameters on the slip tendency of pre-existing faults. This is done through coupled thermo-hydro-mechanical simulations of the injection and production processes in synthetic geothermal reservoir models of the most utilized and potentially exploitable Dutch geothermal reservoir formations: Slochteren sandstone, Delft sandstone and Dinantian limestone.

In our study, changes in the slip tendency of a fault can largely be attributed to thermo-elastic effects, which confirms the findings of recent studies linking thermal stresses to induced seismicity. While the direct pore pressure effect on slip tendency tends to dominate over the early phase of the operations, once pore pressure equilibrium is established in a doublet system, it is the additional stress change associated with the growing cold-water front around the injection well that has the greatest influence. Therefore, the most significant increase in the slip tendency was observed when this low-temperature front reached the fault zone. The distance between an injection well and a pre-existing fault thus plays a pivotal role in determining the mechanical stability of a fault. A careful selection of a suitable target formation together with an appropriate planning of the operational parameters is also crucial to mitigate the risk of induced seismicity. Besides the well-known relevance of the in situ stress field and local fault geometry, rock-mechanical properties and operation conditions exert a major influence on induced stress changes and therefore on the fault (re)activation potential during geothermal operations.

Policy responses to the inflation crisis in Belgium and the Netherlands show great similarities but also significant differences. In both countries responses were quick and substantial. Measures covered prices more than household incomes while universal, not earmarked measures exceeded selective interventions. However, there were also major differences between the two countries. Because Belgium, unlike the Netherlands, could fall back on the mechanism of automatic indexation of wages and social benefits; it relied more on existing universal policy instruments while in the Netherlands more targeted ad hoc measures were taken which also allowed for innovation in policy making. These different policy paths have their origins in the 1980s when policy models began to diverge and different legacies emerged.

The COVID-19 pandemic and Black Lives Matter movement have brought ethnic and racial inequalities to the forefront of public conversation on both sides of the Atlantic. However, research shows that people routinely overestimate the progress made towards equality and underestimate disparities between racial and ethnic majority and minority groups. Common among the American public is a naive belief in equal opportunity that stands in sharp contrast to the reality of structural racial inequity. Across the Atlantic, Dutch people’s self-perception of a tolerant, progressive, and egalitarian society means that racism and discrimination are topics often avoided, rendering invisible the stigmatization of ethnic and racial minorities. The result is racism of omission: ethnic and racial disparities are minimized and attributed to factors other than discrimination, which leads to legitimize inequities and justify non-intervention. Against this background, we field an internationally comparative randomized survey experiment to study whether (willful) ignorance about racial and ethnic inequality can be addressed through the provision of information. We find that facts about ethnic and racial inequality, on the whole, (1) have the greatest impact on people’s perceptions of inequality as compared to their explanations of inequality and policy attitudes, (2) register most strongly with majority-group White participants as compared to participants from minority groups, (3) cut across partisan lines, and (4) effect belief change most consistently in the Netherlands, as compared to the United States. We make sense of these findings through the lens of how ‘shocking’ the information provided was to different groups of participants.

A growing number of organisations in residential care for older people are working towards safe and inclusive environments for LGBT residents. In the Netherlands, these efforts are supported by an LGBT inclusion scheme called ‘Pink Passkey’. Drawing on critical organisational diversity studies, the paper understands inclusion as ‘accomplished’ in interactions across difference, and as always inherently partial (i.e. exclusion-producing). Qualitative methods are used to study the implementation process of the Pink Passkey in two nursing homes during one year. In sum, the paper contributes evidence of positive change associated with the use of the Pink Passkey as an inclusion scheme characterised by a long-term, open-ended and comprehensive approach. Compared to fixed-term projects and stand-alone measures described in previous LGBT ageing literature, an inclusion scheme helps to gain sustained attention to sexual and gender diversity (despite gaps in the implementation process), to normalise it more and to overcome opposition (though this does not disappear). The inclusion accomplished is, indeed, partial: bisexual, transgender and other gender non-conforming identities are less represented than gay and lesbian identities. Also, there is an emphasis on residents' agency to disclose LGBT identities and preferences, which excludes involuntary same-sex sexual expressions caused by disinhibited behaviour. The paper ends by suggesting disinhibited behaviour in older LGBT adults as an issue of interest to the wider literature on LGBT ageing, given the increasing prevalence of dementia and Parkinson's disease. Here, the role of care professionals who are able to understand and respond to bodily cues that echo struggles with otherness merits further consideration.

A third nationally representative serosurvey was performed to study the changes in Toxoplasma gondii (T. gondii) seroprevalence in the Netherlands over a 20-year time span and to identify and confirm risk factors for acquired toxoplasmosis. This cross-sectional study (conducted in 2016/2017) was designed similarly to the previous two studies (1995/1996 and 2006/2007) and included a questionnaire and serum sampling among Dutch residents. Factors associated with seropositivity for T. gondii were determined using multivariable analysis of the questionnaire-derived data. The earlier observed decrease in T. gondii seroprevalence between 1995/1996 and 2006/2007 (from 40.5% to 26.0%) did not continue into 2016/2017 (29.9%). Similarly to the previous studies, the seroprevalence increased with age and varied among regions. In all studies, higher T. gondii seropositivity was associated with increasing age, lower educational level, not living in the Southeast, and eating raw or semi-cooked pork. The incidence of congenital toxoplasmosis was estimated at 1.3/1000 (95% CI 0.9–1.8) live-born children in 2017. As the seroprevalence of T. gondii in the Netherlands did not decrease over the last decade, an increase in public health awareness is needed and prevention measures may need to be taken to achieve a further reduction in T. gondii infections in the Netherlands.

The COVID-19 pandemic has taken a devastating toll on long-term care (LTC) residents, families, and staff. In an effort to keep residents safe from COVID-19, public health measures were implemented early in the pandemic to restrict visitation with residents in many countries, with subsequent adjustments made over the course of the pandemic. It is critical to understand the implementation process and how restrictions on visitations have impacted residents, families, and staff. This research note shares a summary of research interviews conducted with key informants in British Columbia (Canada), England (United Kingdom), and The Netherlands on the implementation of visitation programs in the COVID-19 context. It highlights leading practices and key challenges from these jurisdictions.

Interactions between social identity groups can reduce perceptions of threatening out-groups and improve inter-group attitudes. But these interactions have an inevitable side effect: while an interaction may improve attitudes among its participants, the same interaction can increase exposure to out-groups in the proximity of the interaction, leading to increased perceptions of threat among those not participating in the interaction. With such negative externalities in mind, this paper argues that the presence of a large number of out-group members both improves and aggravates native attitudes toward out-groups in the same area, which may, in the aggregate, conceal a hot spot of anti-immigration attitudes. This study examines the effects of interaction and exposure through a series of surveys of native attitudes toward Muslim immigrants in the Netherlands. While the exposure effect was not observed, empirical analyses suggest that brief interactions tend to worsen negative attitudes toward Muslims, possibly due to their physical and religious appearances. This highlights the importance of visual cues in shaping inter-group relations, as these visual cues may prompt natives to sort out interactions based on appearance, hindering efforts to promote inter-group contact between Muslims and non-Muslims.

Economic evaluations have been increasingly conducted in different countries to aid national decision-making bodies in resource allocation problems based on current and prospective evidence on costs and effects data for a set of competing health care interventions. In 2016, the Dutch National Health Care Institute issued new guidelines that aggregated and updated previous recommendations on key elements for conducting economic evaluation. However, the impact on standard practice after the introduction of the guidelines in terms of design, methodology and reporting choices, is still uncertain. To assess this impact, we examine and compare key analysis components of economic evaluations conducted in the Netherlands before (2010–2015) and after (2016–2020) the introduction of the recent guidelines. We specifically focus on two aspects of the analysis that are crucial in determining the plausibility of the results: statistical methodology and missing data handling. Our review shows how, over the last period, many components of economic evaluations have changed in accordance with the new recommendations towards more transparent and advanced analytic approaches. However, potential limitations are identified in terms of the use of less advanced statistical software together with rarely satisfactory information to support the choice of missing data methods, especially in sensitivity analysis.

The environmental assessment literature has neglected the distorting effect of cognitive and unconscious motivational biases (CUMB) in environmental assessment processes. This is problematic because CUMB are present in most, if not all, decision-making situations and can significantly distort decision-making processes. This article assesses how debiasing techniques are, or should be, incorporated in (supra)national environmental assessment legislation. The Dutch case study undertaken for this article shows that EU and Dutch legislation do not sufficiently incorporate debiasing techniques to ensure sound environmental decision making. Furthermore, the extent to which Dutch legislation incorporates debiasing techniques was found to be decreasing. Based on these findings, the article presents ways to incorporate debiasing techniques in environmental assessment legislation more generally, and in EU and Dutch legislation in particular.

This article analyzes the attitudes of Dutch employers toward social policy in the early twentieth century. Recent literature has evolved from an emphasis on power to an emphasis on preferences. Moving away from the traditional view that unions and social democrats forced social laws on employers, recent scholars suggest that firms saw specific advantages in the introduction of social laws. However, I show that the attitudes of Dutch business representatives, rather than seeking these specific advantages, merely reflected a willingness to consult, inspired by their macroeconomic view. Employers expressed the wish to attain an organized form of capitalism and accepted regulated forms of codetermination. Once the consultative platforms were in place, employers pursued strategic goals, such as labor peace and disciplining the unions. This paved the way for accepting welfare state expansion. In sum, mid-twentieth century business interests were strongly oriented toward coordinated capitalism.