Objective: Informal caregivers of palliative care patients face many challenges and are in need of support by healthcare providers. We aim to assess the care provided to informal caregivers, the...Show moreObjective: Informal caregivers of palliative care patients face many challenges and are in need of support by healthcare providers. We aim to assess the care provided to informal caregivers, the effects of healthcare providers’ background characteristics and actions undertaken to improve the care provided in healthcare organizations. Method: A cross-sectional mixed-method approach was applied. Questionnaires were used for statistical analysis. First, the care provided to informal caregivers (i.e. basic emotional care and specific care tasks) was examined using descriptive statistics. Second, the effects of healthcare providers’ background characteristics (i.e. healthcare setting, profession, age and work experience) on the care provided were examined using bivariable analyses and general linear model (GLM). Third, actions to improve the care provided in healthcare organizations were examined using qualitative conventional content analysis. Journey mapping workshops provided input for the 19 analyzed action plan reports. Results: 586 healthcare providers and volunteers of 19 Dutch healthcare organizations completed the questionnaire (response rate: 49%). First, participants had an average basic emotional care of 6.70 (SD = 3.33, 0-10 range) and an average of specific care tasks of 8.51 (SD = 2.89, 0-13 range). Second, volunteers and paramedics scored lower than other healthcare providers on basic emotional care (p = .003, p = .012) and volunteers scored lower on specific care tasks (p = .012). The age of healthcare providers and volunteers seemed to have a quadratic effect on the basic emotional care (p = .017) with an increase until 45-55 years. The same effect was found on specific care tasks (p = 0.042) after excluding the volunteers. Third, improvement categories were derived from the action plan reports. For individual healthcare providers: care and support for informal caregivers during the illness-trajectory, bereavement care for informal caregivers, cooperation with informal caregivers, interprofessional cooperation. For healthcare organizations: organizational support. Discussion: The care provided to informal caregivers is still in need of improvement. The age and profession of healthcare providers were found to affect the care provided. The actions found to improve the care provided to informal caregivers are promising and can be a source of inspiration for healthcare organizations.Show less
Changes in social cognition, encompassing all cognitive processes that underlie social interaction, have been noted in various types of dementia. Theory of Mind (ToM) is a key aspect of social...Show moreChanges in social cognition, encompassing all cognitive processes that underlie social interaction, have been noted in various types of dementia. Theory of Mind (ToM) is a key aspect of social cognition, defined as the ability to understand the mental state of another person, including their emotions, intentions and beliefs. Cartoon tests aim to adopt humour using cartoon jokes to assess ToM. In this study, a new Dutch cartoon test aimed to be applicable in clinical assessment of dementia was developed and validated. The test includes 12 cartoons (6 requiring ToM to understand the joke and 6 that do not), which were collected through an extensive search and were rated by experts (n = 17) on content and funniness. Normative data for the selected cartoons was obtained by control participants (n = 39), through annotation of these, scoring categories were formed. The test was then validated in a clinical sample, including patients referred to a memory clinic for cognitive complaints and suspected dementia (n = 9), in an observational cross-sectional study with a case-control type selection of participants. Patients were expected to score lower on the cartoon test than controls. An ANCOVA with demographic variables as covariates was performed: no significant differences between patients (n = 9) and control participants (n = 9) were found (p > .05). Further, the internal validity (Cronbach’s α of .864 for the total cartoon test) and convergent validity of test was good. Divergent validity was found to be questionable. Regarding demographics: females were expected to score higher than males; older participants were expected to score higher than younger participants; and higher educated participants were expected to score higher than lower educated participants on the cartoon test. A Mann-Whitney U analysis showed no gender differences (p > .05); assessment of Spearman-rank order correlation coefficients showed age was significant in its negative relation to cartoon test performance (p < .05); and education level significant in its positive relation to test performance (p < .05). Future investigation with a larger patient sample including differential dementia diagnoses is recommended to substantiate the results and make the test clinically applicable.Show less
Itch is a somatosensory stimulus and could potentially alter performance of daily activities. Since itch stimuli will signal potential danger, one might want to protect oneself from potential harm...Show moreItch is a somatosensory stimulus and could potentially alter performance of daily activities. Since itch stimuli will signal potential danger, one might want to protect oneself from potential harm by adapting ones behaviour. Pleading itch stimuli demands ones attention, which can be called the attentional bias (AB). Adapting ones behaviour might influence the effectiveness of treatment, due to not paying attention to the treatment. So far, an AB has been found in healthy individuals, but evidence is mixed. In addition, it is unclear if an AB is present in patients who experience chronic itch. Therefore, this study investigated attentional bias towards itch related visual stimuli in participants who suffer from chronic itch (N=34) compared to healthy controls (N=36). Attentional bias was measured in an online study with two attention tasks, the dot-probe paradigm and the spatial-cuing paradigm using itch-related pictures. During the dot-probe task, patients with chronic itch showed the presence of an AB. Yet, the results acquired from the spatial-cuing task showed the presence of an AB in every participant in disregard of the group they were in. This is not in line with previous research. However, previous research only investigated healthy individuals. Furthermore, all participants reacted faster on invalid trials once an itch cue was presented. One might interpret this as having an attentional avoidance of threat. Yet, also healthy participants seemed to react faster, which perhaps indicates that the itch cue is an overall negative cue regardless of having a past with itch. The discrepancy between the two attention tasks is remarkable, and could perhaps be ascribed to the different processing skills the two tasks ask from the participant. Therefore, future research should focus on the different components of attentional processing. This could eventually optimize current treatment/intervention options.Show less
Central coherence is the ability to perceive, process and integrate incoming information to put it in the right context and give it meaning. Central coherence is an important skill that aids people...Show moreCentral coherence is the ability to perceive, process and integrate incoming information to put it in the right context and give it meaning. Central coherence is an important skill that aids people in understanding situations they encounter in daily life but is also an important skill to support the process of learning. After all, new information has to be processed, organised and integrated, taking into account overall context and meaning. Research into autism spectrum disorders (ASD) in the past 4 decades has provided multiple findings that indicate that people with ASD have weak central coherence skills and therefore lack the ability to create meaningful or coherent wholes, but research findings have been mixed. In this study a process-oriented dynamic version of the Rey-Osterrieth Complex Figure (ROCF), in which the training part was built up according to the ‘graduated prompts’ method, was used to measure and train central coherence. Furthermore, the potential relationship between ASD characteristics of the children in this study and central coherence or improved central coherence following training was assessed. The participants in this study consisted of 49 pupils in grade 5 or 6 of regular Dutch primary school education (M = 8.96 years, SD = .76 years). The dynamic test, including training based on the ‘graduated prompts’ method, lead to significantly more progression in structuring the drawing of the complex figure compared to the unguided control group. Regarding a potential relationship between ASD characteristics and central coherence or improved central coherence, no relationship was found in this study.Show less
In this thesis the relative spectral energy density of stochastic primordial gravitational waves is investigated. Decoupling of Standard Model particles and neutrino free-streaming affect the...Show moreIn this thesis the relative spectral energy density of stochastic primordial gravitational waves is investigated. Decoupling of Standard Model particles and neutrino free-streaming affect the expansion history of the universe and thus leave characteristic signatures on the amplitude of the gravitational wave spectrum. Adding extra light or heavy particles damps the spectrum at frequencies before the particle decouples. Including an extra neutrino species amplifies the spectrum at larger wave numbers, but damps it at shorter wave numbers. Measuring these primordial gravitational waves reveals the thermal history of the universe. One possible non-standard thermal history is early matter domination due to the inflaton. It is shown that, in this cosmology, the end of early matter domination and beginning of the radiation era depend linearly on the reheating temperature.Show less
Earlier research suggests that some exercise intensities are more beneficial to enhance creativity than others. However, if and why specific exercise intensities are related to better creativity is...Show moreEarlier research suggests that some exercise intensities are more beneficial to enhance creativity than others. However, if and why specific exercise intensities are related to better creativity is not exactly clear yet. This study aimed to gain insight into which exercise intensity is best for improving creativity and to explore the possible role of physical fitness in the relationship between exercise intensity and creativity. This is the first study in which participants were given a more objective individually-tailored instruction with regard to exercise intensity and in which four conditions (low intensity exercise, moderate-intensity exercise, high-intensity exercise and a control condition) were compared with respect to the enhancement of divergent creativity (including fluency and originality). First, it was expected that moderate-intensity is best to enhance creativity compared to low intensity exercise, highintensity exercise and no exercise. Second, it was expected that creativity is enhanced more after someone exercises at an intensity level that matches his/her level of physical fitness compared to someone exercising at an intensity level that does not match his/her physical fitness. A total of N = 73 students were studied. A between-subjects design was used in which participants were randomly assigned to one of the four conditions. The participants had to visit the lab of Leiden University twice. First they had to perform a physical fitness test and then they were randomly assigned to one of the four conditions and they had to do a task that measured divergent creativity. For the first hypothesis, the Two-Way ANOVA indicated that neither the fluency (η² = .009, p = .88) nor the originality scores (η² = .006, p = .94) differed between conditions. For the second hypothesis, the Two-Way ANOVA indicated that neither the fluency (η² = .024, p = .19) nor the originality scores (η² = .008, p = .45) differed between participants who had a match or non-match between their physical fitness level and the assigned exercise intensity. The results suggest that changing exercise intensity and matching exercise intensity to physical fitness level do not make a difference in the improvement of creativity.Show less
Aggressive behaviour is one of the most common behavioural issues in children and adolescents. Given its negative effects on social, emotional and academic development, early intervention is deemed...Show moreAggressive behaviour is one of the most common behavioural issues in children and adolescents. Given its negative effects on social, emotional and academic development, early intervention is deemed necessary. This study investigated the predictive role of emotion regulation and executive functioning, along with the mediating role of emotion regulation in the relationship between executive functioning and aggression problems. This current correlational study is part of the TRIXY project. The sample consisted of 47 children between the ages of three and seven year old. Aggression was measured using the Child Behaviour Checklist, emotion regulation was measured using the Child Behaviour Questionnaire – Very short form and the executive functions inhibition, planning ability, working memory and cognitive flexibility were measured using the Behavior Rating Inventory of Executive Functions (BRIEF) and the BRIEF-P. The findings indicated that children who experienced more difficulties in executive functioning exhibited heightened levels of aggressive behaviour. Additionally, research showed that emotion regulation is a mediating factor in the relation between executive functioning and aggression. However, the relation between these three constructs differ when splitting the sample in a group consisting of children aged three to four years of age and a group consisting of children who are five to seven years of age, indicating that the relation between these three constructs changes during development. Furthermore, research showed that inhibition, working memory, and cognitive flexibility were predictors of emotion regulation problems and aggression, with inhibition being the most significant predictor of aggression in all ages. Results showed no relation between planning ability, emotion regulation and aggression. This research contributes to the development of effective interventions and the understanding of the development of aggression.Show less
Job Burnout (JB) is a demanding syndrome that leaves employees exhausted and dealing with cognitive and emotional problems, with symptoms lasting up to 10 years. To understand why JB symptoms...Show moreJob Burnout (JB) is a demanding syndrome that leaves employees exhausted and dealing with cognitive and emotional problems, with symptoms lasting up to 10 years. To understand why JB symptoms pertain for so long, different resource theories were integrated to investigate the impact of JB on an individual gain process between job resources, personal resources, and recovery gained through physical exercise. It was predicted that skill discretion (SD), a common job resource, increases the personal resource self-efficacy (SE) which, in turn, enhances the recovery gained from physical exercise. This gain process was proposed to be dampened by JB, leaving employees with higher JB symptoms in a less advantageous position for resource gain as compared to those with lower symptoms. Using longitudinal data across three workweeks, self-report questionnaires were administered among full-time employees (N = 163). Although correlations revealed that the proposed relationships were found at specific weeks, hierarchical regression analyses revealed no across-time relationships, meaning no weekly gain process could be identified between SD, SE, and recovery gained through exercise. In addition, against expectations, no negative impact of JB on the gain process was found. Thus, the exact relationships between job resources, personal resources, recovery gained through exercise, and JB remain unclear. Future research is needed to further investigate these relationships preferably by using a different time lag than one week and by applying different roles of personal resources within the Job Demands-Resources framework.Show less
The aim of this study was to investigate the relation between parental mental well-being and parenting skills and whether this relationship differs based on the child's temperament. Parenting...Show moreThe aim of this study was to investigate the relation between parental mental well-being and parenting skills and whether this relationship differs based on the child's temperament. Parenting skills are crucial factors in a child's emotional, cognitive, social, and behavioral development. Data were collected from 20 parents of young children (3 - 5 years old). Parenting skills were assessed using self-report questionnaires regarding confidence in parenting, reflective capacity, and parental sensitivity. The child's temperament was also assessed through questionnaires filled out by the parents. All multiple regressions were non-significant, and the relationships between parental mental well-being and parenting skills were not moderated by the child's temperament. This means that parental mental well-being and the child's temperament were not sufficiently predictive of parental self-confidence, reflective capacity, and parental sensitivity in parenting. By examining the correlations, a moderate positive relationship was found between parental mental well-being and their confidence in parenting. Parents with higher mental well-being had more confidence in their parenting. Parental mental well-being was negatively associated with their reflective capacity, indicating that parents with lower mental well-being displayed higher levels of reflective capacity. A moderate positive relationship was found between the child's temperament and parental sensitivity, suggesting that parents of children with a more challenging temperament were generally more sensitive in their parenting.Show less
The intergalactic medium (IGM) contains most of the baryonic matter of the Universe and serves as a suitable environment for probing the thermal history of the Universe. The crucial moment in IGM...Show moreThe intergalactic medium (IGM) contains most of the baryonic matter of the Universe and serves as a suitable environment for probing the thermal history of the Universe. The crucial moment in IGM evolution is the Epoch of Reionization, corresponding to the transition from neutral to ionized IGM. However, due to the observational limitations, this period is still not well understood. In this thesis, we focus on constraining IGM thermal history by using Lyman-alpha forests data. This method is applicable in a wide range of temperatures, densities, and ionization fractions of cosmic gas at z about 2 − 5. Observations show that the longitudinal flux power spectrum of the Lyman-α forest exhibits a cut-off at small scales. This phenomenon is caused by thermal Doppler broadening, peculiar velocities along the line of sight (LOS), Hydrogen pressure smoothing, and warm dark matter. The first two effects act only along LOS, while the last two affect all spatial directions. To separate the one-dimensional and three-dimensional effects, we used the method of close quasar pairs, which is based on studying the correlations between Lyman-alpha forests of close quasar pairs. We used the Kolmogorov-Smirnov test to analyze the differences between distributions of phase difference, which characterizes correlations between Lyman-alpha forests. The calculations were performed for various thermal histories, parameters characterizing IGM, LOS separations, and wavenumbers, and accounting for different effects (Doppler broadening and peculiar velocities). Our results indicate that this method can distinguish various thermal histories regardless of the IGM thermal state and one-dimensional effects. Moreover, at separations of the order of pressure broadening, there is a prominent feature caused by different influences of pressure smoothing at large and small scales. In addition, this simple and powerful approach has the potential to distinguish scenarios with warm dark matter.Show less
Objective. To determine the effectiveness of a rehabilitation program including physical exercise, in improving cognition, participation, and coping in patients with a subarachnoid hemorrhage (SAH)...Show moreObjective. To determine the effectiveness of a rehabilitation program including physical exercise, in improving cognition, participation, and coping in patients with a subarachnoid hemorrhage (SAH). Secondary, it was aimed to identify the role of clinical characteristics in the effectiveness of the rehabilitation program. Methods. A longitudinal pilot intervention study was performed, with measurements before the start (T0), after three months (T1), and after six months (T2). Cognition was measured with the Montreal Cognitive Assessment, participation with the Impact on Participation and Autonomy questionnaire, and coping with the Utrecht Proactive Coping Competence Scale. Generalized Estimating Equation analyses were performed. Results. A total of 19 patients with SAH participated; 13 in the intervention group and 6 in the control group. For the intervention group, cognition improved between T0 and T2 and between T1 and T2. Participation declined between T0 and T1, but improved between T1 and T2. Proactive coping declined between T0 and T2 and between T1 and T2. Cognition of the control group did not change, but participation improved between T0 and T1 and proactive coping declined between T0 and T1. There was no significant difference between the control and intervention groups in improvements in cognition between T0 and T1 (p = 0.090). However, there was a significant difference between the control and intervention groups in changes in participation between T0 and T1 (p = 0.001) and in changes in coping between T0 and T1 (p < 0.001). The location of SAH played a role in the differences in participation, but not in cognition and coping. For treatment type and time since SAH, no significant effects were found. Conclusion. There was no effect of the rehabilitation program on cognition. The control group had a better participation level after three months and the intervention group worsened. The intervention group had a stable coping style after three months, whereas the control group declined in the use of proactive coping. Only the characteristic location of the aneurysm played a role in the participation level after three months, but not in cognition or coping. The other characteristics did not play a role in the changes. This study indicates that some long-term complaints can improve after the rehabilitation program, but more research is needed.Show less
In this thesis we present an experimental realisation of a double loop type Magnetic Paul Trap. We show that a microgram heavy NdFeB permanent magnet can stably be levitated for hours at room...Show moreIn this thesis we present an experimental realisation of a double loop type Magnetic Paul Trap. We show that a microgram heavy NdFeB permanent magnet can stably be levitated for hours at room temperature in this trap. Magnetic levitation of a magnetized particle is theoretically possible with this trap by generating opposed alternating magnetic fields. We show the fabrication of a printed circuit structure capable of producing these fields, as well as the engineering behind the realisation of the trap. Both by optical and magnetic readout we characterize the motion of the trapped magnet and show that its center of mass motion frequencies $\omega_z = 2\omega_{x,y} \approx 20Hz$. We characterize the damping on these modes and find that at low pressure the quality factor is strongly limited (to $Q \approx 90$) by coupling to the environment through generation of Eddy currents.Show less
