Objective: The period after successfully coming off treatment (SCOT) following a childhood cancer diagnosis is known to be a vulnerable time for parents in which increased levels of distress can...Show moreObjective: The period after successfully coming off treatment (SCOT) following a childhood cancer diagnosis is known to be a vulnerable time for parents in which increased levels of distress can play a significant role. It is important to know more about the distress experienced by parents during this period to determine whether an intervention should be used to help parents return to ‘normal life’. The aim of this study was therefore to gain better understanding of parental distress and factors related to their distress during the first year after their child has successfully completed treatment. Methods: A sample of 283 parents of children who had successfully completed cancer treatment in the previous year were included in this cross-sectional study. These parents, who were part of the SCOT group, were invited to complete the Distress Thermometer for Parents (DT-P) within one year after treatment completion. The DT-P consists of a thermometer score to measure experienced distress and problem domains (practical, social, emotional, physical, cognitive, and parenting). Parents in the SCOT group were compared with parents in the general population (NORM group) to see if their distress levels were higher. In addition, the association between distress and the problem domains and child- or parent-related factors (time since the end of treatment, cancer type, child’s age, parental disease, and perceived support) was examined. Results: Parents (73.9% mothers) in the SCOT group experienced higher levels of distress in the first year after SCOT compared to the general population (fathers SCOT: M=3.5, SD=2.6 vs. fathers NORM: M=2.8, SD=2.5; p=.032; mothers SCOT: M=4.1, SD=2.7 vs. mothers NORM: M=3.5, SD=2.7; p=.001). Emotional (p<.001), practical (p=.016), and physical (p=.005) problems were predictors of higher distress levels. Parents’ perceived support from their environment contributed also to their level of distress (p<.001). Conclusions: Parents of children who have successfully completed cancer treatment experience increased levels of distress in the first year after treatment compared to parents in the general population. There may be value in developing an intervention to ease this transition that specifically addresses their emotional well-being and highlights the importance of their social network during this vulnerable period.Show less
Abstract Introduction. Sickness Presenteeism (SP) describes the phenomenon of going to work despite being ill. As SP might be related to more burnout complaints and lower general health and is...Show moreAbstract Introduction. Sickness Presenteeism (SP) describes the phenomenon of going to work despite being ill. As SP might be related to more burnout complaints and lower general health and is associated with higher job demands and lower job resources, the influences of SP were investigated. The research contributed to previous research by targeting a general, diverse population and by exclusively focusing on health instead of motivational reasons for SP. Further, research that investigated the effects of SP as a moderator between working conditions and health factors was lacking. Thus, this study hypothesized, that higher job demands, and lower job resources increase burnout complaints and decrease general health and that this association is strengthened by SP. Methods. Altogether, 115 participants participated in this correlational study. Job resources and job demands were measured with the Demand-Control-Support questionnaire. A new SP variable was created for this research and tested for internal consistency. Burnout was measured with the Burnout-Assessment-Tool and general health with a one-item question. Two multiple regression analyses were conducted. The first analysis measured if higher job demands, and lower job resources were associated with (more) burnout complaints and how this association was moderated by SP. The second analysis measured the same association but with (lower) general health as an outcome variable. Results. SP did not moderate the relationship between job demands and burnout complaints (p=.20), job resources and burnout complaints (p=.70), job demands and general health (p=.49), and job resources and general health (p=.65). Consequently, all hypotheses were rejected. Job demands were directly related to more burnout complaints (p=.005). Discussion. This study found that high job demands were associated with higher burnout complaints in a general and diverse working population, highlighting the importance of reducing workloads. This study did not find significant SP interaction effects. Possible reasons could be sample size limitations and the statistical test choice. Network analyses might better measure a construct like SP, which includes many control factors and associations. According to this study, it seems that to increase general health and decrease burnout complaints, changing working conditions is more appropriate than addressing worker´s SP.Show less
Background: Individuals with psychotic disorders (PD) often experience cognitive challenges, particularly in executive functioning (EF), crucial for daily functioning. Sleep disruptions, notably...Show moreBackground: Individuals with psychotic disorders (PD) often experience cognitive challenges, particularly in executive functioning (EF), crucial for daily functioning. Sleep disruptions, notably insomnia, are prevalent in PD, worsening symptoms and affecting overall well-being and treatment outcomes. Moreover, individuals with PD frequently engage in cannabis use, which can further impact EF. Gender differences may also play a role in how cannabis affects EF, though findings are varied. This study aims to deepen our understanding of the interplay between insomnia, EF, and cannabis use in PD individuals, while considering gender influences. We hypothesize that higher insomnia rates correlate with poorer EF in PD, with cannabis mediating this relationship. Additionally, we expect gender disparities to influence how cannabis affects EF. This study sheds light on critical factors affecting cognitive function in PD, aiding in tailored intervention strategies. Method: Data were collected from a randomly selected sample of patients (N=262) undergoing treatment at a mental health care clinic in the South-western part of the Netherlands at time of inclusion. Participants, aged between 18 and 65 at inclusion, had a primary diagnosis of a psychotic disorder. The current study utilized data from the Lichamelijke Klachten Vragenlijst (LKV), the Behavior Rating Inventory of Executive Function for Adults (BRIEF-A), and the Measurements in Addictions for Triage and Evaluation (MATE). Results: Significant correlations indicated a moderate positive association between insomnia and EF problems. However, mediation analysis did not support cannabis use as a mediator between insomnia and EF. Gender differences were explored through residual variances analysis, suggesting potential unaccounted factors impacting variability. Model fit indices revealed areas for improvement in explaining variance, warranting further examination and potential adjustments to refine the overall model fit. Conclusion: Higher rates of insomnia were related to higher rates of EF problems. There is no evidence for a mediating effect of cannabis use in this relationship. Gender differences did not seem to play a significant role in the effect of cannabis on EF. Future research should incorporate performance-based tasks alongside self-report measures to improve measurement precision. Future treatments could potentially benefit from incorporating interventions that address insomnia, as this may lead to potential enhancements in executive functioning.Show less
Background: Childhood emotional maltreatment by a primary caregiver is a key predictor for PTSD symptoms, yet limited research explores connections with specific symptoms, especially in children....Show moreBackground: Childhood emotional maltreatment by a primary caregiver is a key predictor for PTSD symptoms, yet limited research explores connections with specific symptoms, especially in children. Literature reports gender differences on emotional maltreatment and the experience of PTSD, so it is worth investigating the existence of differences when looking at separate symptoms. Objective: This study aims to investigate the correlation between childhood emotional maltreatment and PTSD symptomatology and identify gender differences in children and adolescents. Method: A sample of 237 children (mean age 15.5) with PTSD symptoms from a Dutch mental health institution (2012-2015) underwent assessment using anonymous questionnaires. Network analysis examined partial correlations between emotional abuse, neglect, intrusions, avoidance, arousal, and negative mood. Results: The network analysis showed a high correlation between emotional abuse and most PTSD symptoms. However, emotional neglect only exhibited a strong association with emotional abuse. Gender differences in how emotional maltreatment and PTSD symptoms interacted were found. Girls reported higher PTSD symptoms and emotional maltreatment than boys. Conclusions: This study highlights the important role of childhood emotional maltreatment in the development of PTSD, among children and adolescents. These results emphasize the need for the customization of PTSD treatment based on the type of maltreatment and gender.Show less
Background. Traumatic Brain Injury (TBI) is one of the most common forms of Acquired Brain Injury (ABI), and has a high incidence rate across the world. Following TBI, many patients experience...Show moreBackground. Traumatic Brain Injury (TBI) is one of the most common forms of Acquired Brain Injury (ABI), and has a high incidence rate across the world. Following TBI, many patients experience cognitive complaints, as well as physical complaints about their health. Their general wellbeing can also be an issue. Fortunately, for most patients these complaints typically improve over time. This study investigates patients’ memory, concentration, energy, as well as general wellbeing, over time. Methods. Patients received questionnaires about their health and wellbeing every three months following hospital release, with the main goal to track their health and wellbeing after TBI. That data was used for this research. Energy, concentration, and memory were all measured by one question in the questionnaire. General wellbeing was measured by taking the average ratings of all questions on the questionnaire. Analyses were done with three and six questionnaires over time, using repeated measures ANOVAs. Descriptive statistics were used from the first questionnaire. Results. This study found that while patients rated all these measures on average positively, they still did not feel the same as before the injury, and most experienced hindrances in daily life. When looking at the ANOVAs with three questionnaires, there was a significant improvement on concentration, energy, as well as general wellbeing over time. For all of these, most improvement took place between the first and the second questionnaires. Memory did not change significantly over time. None of the ANOVAs with six questionnaires had any significant changes over time. Conclusion. This study shows that patients may suffer from long-lasting effects of TBI. It questions whether more should be done for these patients following hospital release, to alleviate symptoms. This study has limitations concerning selection bias and drop out.Show less
This thesis is about the burden-sharing question concerning climate change. And whether the Structural Injustice approach can offer a more nuanced perspective. Thereby, arguing for a fourth...Show moreThis thesis is about the burden-sharing question concerning climate change. And whether the Structural Injustice approach can offer a more nuanced perspective. Thereby, arguing for a fourth principle the Imperfect responsibility to Pay Principle (IRPP).Show less
Adolescence is characterized by a prominent increase in peer orientation and high sensitivity to peer evaluations. To date, explanations for individual differences in peer evaluation sensitivity...Show moreAdolescence is characterized by a prominent increase in peer orientation and high sensitivity to peer evaluations. To date, explanations for individual differences in peer evaluation sensitivity have not been thoroughly investigated. The present study examined whether a catastrophizing emotion regulation tendency and overprotective parenting could explain why some adolescents are more sensitive to negative peer evaluation than others. Sixty-four adolescents (mean age = 14.66; 49 females) took part in a Social Evaluative Learning through Feedback (SELF-) Profile task. Participants had to predict the valence of peer feedback in a 240-trial paradigm with four fictitious peers that differed in their probability of giving positive feedback. We hypothesized that through the mediating effect of catastrophizing, parental overprotection could predict the ratio of negative predictions of peer evaluations. We also expected that adolescents scoring higher on these self-reported concepts would have a higher ratio of negative predictions for the most negative vs. the most positive peer. Similarly, it was hypothesized that adolescents with higher catastrophizing and overprotection scores would expect more negative feedback in the SELF-Profile task beforehand and also estimate them to have been high afterward. Our results showed that total parental and paternal overprotection, but not maternal, predicted catastrophizing in adolescents. However, we did not find evidence for the hypothesized mediation models or associations between the self-reported concepts and the SELF-Profile pre- and post-ratings. Together, these findings suggest that parental overprotection and catastrophizing are related concepts but they are not sufficient in explaining negative biases in social reinforcement learning in adolescence.Show less
Advance care planning (ACP) is a process in which the patient expresses their wishes regarding future medical care in the presence of their family and health care provider. ACP is generally...Show moreAdvance care planning (ACP) is a process in which the patient expresses their wishes regarding future medical care in the presence of their family and health care provider. ACP is generally accepted in Western countries and has a positive effect on end-of-life care for people with dementia. However, culture affects expectations and preferences regarding end-of-life care and decision making. This study compared the acceptability of and preference for two types of ACP interventions for patients with dementia in health care providers from the Netherlands, the US and Japan. One intervention focused on concrete treatment orders in which the patient makes specific decisions. The other focused on what the patient finds important in life, resulting in global goals of care. A total of 125 participants were assessed by means of a structured interview and a questionnaire. Participants found both types of ACP acceptable, in general and per country. A multinomial logistic regression analysis indicated no significant difference in acceptability of the concrete or the global ACP approach between countries when adjusted for age and gender. However, age was a significant predictor of acceptability of the concrete ACP approach (2 (2, 123) = 6.32, p = .042), with older participants being less likely to find it acceptable compared to not finding it acceptable (W(8) = 5.50, p = 0.019). Participants preferred the global ACP approach for patients with dementia. A multinomial logistic regression analysis indicated no significant differences in preference between countries when adjusted for age and gender in general. However, Dutch participants were less likely to prefer the global ACP approach (W(8) = 5.18, p = .023). The relationship between country and preference was not influenced by whether participants most strongly considered what the patient with dementia wants for themselves, what the patient’s family wants or what they as the health care provider want for their patient when making medical decisions. ACP is generally regarded as an acceptable form of care for patients with dementia by health care providers across countries. Future research could more specifically determine which cultural or demographic aspects affect health care providers’ views on different ACP approaches.Show less
The Clarion-Clipperton Zone (CCZ) in the Pacific Ocean holds significant reserves of polymetallic nodules, making it a potential exploitation area for deep sea mining. However, the exploitation of...Show moreThe Clarion-Clipperton Zone (CCZ) in the Pacific Ocean holds significant reserves of polymetallic nodules, making it a potential exploitation area for deep sea mining. However, the exploitation of this shared natural resource poses challenges in terms of sustainability and resource management. This thesis examines the governing framework of the International Seabed Authority (ISA) for the management of deep sea mining in the CCZ. The study draws upon the design principles for governing the commons proposed by Elinor Ostrom to analyze the policies and draft regulations of the ISA. By examining to what extent the policies and regulations of the ISA are aligned with Ostrom's principles, this research aims to evaluate the current governance framework for the management of the CCZ and its resources.Show less
This thesis sought to investigate the relationships between treatment delays in bipolar disorder (BD) and cognitive impairments which characterize the disorder, measured both objectively and...Show moreThis thesis sought to investigate the relationships between treatment delays in bipolar disorder (BD) and cognitive impairments which characterize the disorder, measured both objectively and subjectively. Previous studies have established that a long delay occurs between the onset of mood symptoms in BD and the first form of treatment received, estimates ranging between 6 and 11 years. Cognitive impairments in the domains of executive functions, processing speed and memory were found to persist in BD patients even during euthymia. Such cognitive impairments burden BD patients, prevent them from regaining an appropriate level of general functioning and diminish their quality of life. Thus, in order to determine whether treatment delay impacts the cognitive impairments present in BD, 69 participants were followed over the course of one year, at three different time points. The participants took part in clinical interviews, and then were asked to complete multiple measures, such as the YMRS, the QIDS, four WAIS subscales (Block Design, Arithmetic, Information and Digit symbol), and the Cognition subscale of the WHODAS. The average treatment delay found in the current sample was 14.53 years. The results of the current study suggest that longer treatment delays did not significantly predict worse cognitive functioning in BD patients, either when measured subjectively, or when measured objectively.Show less
