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Support and concerns:Dutch health care professionals' views on the use of a childhood obesity prediction toolbox
No full textBACKGROUND: Childhood obesity is a major and increasing public health concern. Early prediction of the risk of childhood obesity may lead to targeted preventative interventions. To develop a prediction-toolbox that is suitable for clinical implementation, it is imperative to align it with the perceptions of health care professionals (HCPs), but this aspect remains relatively underexplored. This study aimed to explore the perceptions of Dutch HCPs regarding the concept of a childhood obesity prediction toolbox.METHODS: A qualitative study design comprising semi-structured interviews (n=15) with Dutch HCPs was used. HCPs included youth health care practitioners, youth health care nurses and policy advisors employed at the municipal health service of Amsterdam. Perceptions were explored regarding the concept of a three-element childhood obesity prediction toolbox of the EndObesity project, which consists of a prediction tool, prevention strategies to support families of high-risk infants, and communication tips for HCPs. The data were analysed through reflexive thematic analysis.RESULTS: HCPs were positive about early identification of the risk of future childhood obesity and the support of high-risk infants. They acknowledged the potential benefits of personalized care facilitated by such risk prediction, but concerns were raised regarding its validity and its added value compared with the clinical judgement of HCPs. HCPs also expressed some negative connotations regarding risk communication e.g. making parents feel insecure or judged, especially in vulnerable situations. Finally, HCPs acknowledged the complexity of childhood obesity prevention and emphasized the need for a complementary broader approach at both the municipal and national policy levels.CONCLUSIONS: Dutch HCPs generally supported the potential use of a childhood obesity prediction toolbox, but they also expressed concerns regarding the validity, the added value of the toolbox and about risk communication. These concerns must be addressed in further development of the toolbox.</p
A Populist Axis? Analyzing Connections Between Populist, Economic, and Cultural Dimensions of Political Space
No full textWhat makes populist parties successful? What is the contribution of populist ideas to their appeal? How do they affect a voter’s choice? In this article, we treat populist orientation as just another dimension of spatial competition alongside economic and cultural dimensions, and assess its influence on vote choice. Using survey data from nine countries, we place voters and parties along the populist, economic, and cultural dimensions and estimate a spatial model of vote choice. We find that voters’ populist orientations are negatively correlated with their pro-market orientation and positively correlated with their cultural conservatism. We also find that proximity along the populist dimension has a tangible, albeit varying, weight in vote choice. This means that populist appeal can pull populist voters toward populist parties (and non-populist voters toward non-populist parties) even if they do not perfectly align with them on economic and cultural dimensions
The use of neuropsychological tasks to evaluate self-regulation in depression and anxiety during adolescence:a scoping review
No full textBACKGROUND: Self-regulation is central to adolescent emotional and cognitive development and deficits in self-regulation may associate with depression and anxiety. This scoping review maps the use of the Emotional Go/No-Go (EGNG), Delay Discounting Task (DDT), and Balloon Analogue Risk Task and Youth version (BART) in studies of adolescent depression and anxiety, examines consistency of task implementation, and identifies methodological and geographic gaps.METHODS: A PRISMA-ScR-compliant search was conducted in MEDLINE (PubMed), Scopus, and PsycINFO from database inception to 15 December 2025 (initial search: 1 December 2023; updated: 15 December 2025). Data were charted using a standardized form. Eligible studies included adolescents, employed EGNG, DDT, or BART, and assessed depressive or anxiety symptoms.RESULTS: Thirty reports were included (EGNG n = 21; DDT n = 3; BART n = 6). Twenty-six studies (87%) were conducted in high-income countries and 24 (80%) were English language. Twenty-two studies were cross-sectional (EGNG n = 18/21; DDT n = 2/3; BART n = 2/6); five employed longitudinal designs, and two employed experimental manipulations. Fourteen studies (47%) reported significant task performance associations with depression or anxiety (EGNG n = 8/21; DDT n = 2/3; BART n = 4/6); remaining studies reported no significant associations. The directionality of associations differed across study populations and methodologies.CONCLUSION: The current literature is concentrated in English-speaking higher-income contexts and has yielded few and inconsistent associations with adolescent depression and anxiety. Future research should harmonize protocols, expand evidence from low- and middle-income settings, and increase longitudinal and intervention-based studies to assess sensitivity to change and clinical utility.</p
Assessment of the Cape Blanc (northwest Africa) upwelling ecosystem response to recent climate change, using wavelet analyses on dinoflagellate cyst export
No full textAccelerated rates of change in recent climate have urged comprehensive investigations of its impact on marine ecosystems, notably those with high bio-, socio-, and economic importance, such as the upwelling ecosystem off Cape Blanc, Northwest Africa. This paper discusses how phyto- and microzooplankton export flux, represented by dinoflagellate cysts (dinocysts), in this ecosystem can be affected by variable climatic conditions prevailing between 2003 and 2020. The study area is characterised by annual permanent upwelling with cyclic intensity and strong inter-annual variability. Thus, we employed Morlet wavelet analyses to detect periodicities and interannual variations on an 18 year high-resolution sediment trap record of organic-walled dinocyst export flux and local environmental steering factors (e.g., wind direction, wind speed, Saharan dust input and sea-surface temperature). A dinocyst is a fossilisable structure produced by dinoflagellates, a plankton group containing both primary and secondary producers. Significant half-year and annual cycles in the time series of dinocyst export fluxes, upwelling winds, and the dust input time series were detected. Those cycles presented variations that were divided into three distinct phases: Phase I (2003–2008), Phase II (2009–2012), and Phase III (2013–2020). We also observed changes in the taxonomic composition of dinocyst assemblages in every phase, demonstrating their potential as bioindicators for environmental changes. The significant variations within each phase were mostly explained by changes in upwelling intensity and dust input into the area. Our results suggest that there is a strong interaction between these two factors (which depend on surface wind dynamics) and the export flux of dinocysts off Cape Blanc, highlighting the ecosystem's sensitivity to local climate variability.</p
Loneliness, solitude and self knowledege in an age of posthumanism
No full textHer (Spike Jonze, 2013) gaat over de liefde tussen een mens en een geavanceerd computersysteem dat plaatsvindt in de nabije toekomst (2025!). De film schetst een beeld van mens en samenleving dat, ruim tien jaar later, zeer herkenbaar is. In dit artikel geef ik eerst het verhaal van de film weer en bespreek vervolgens zowel wat de ontwikkeling van onze identiteit in tijden van posthumanisme kan helpen als belemmeren. Her blijkt een film te zijn die nog steeds actueel en inspirerend is
The burden of atopic dermatitis & the art of systematic reviews
No full textThis dissertation includes four chapters on the burden of atopic dermatitis (part I), and four on systematic reviews (part II). Part I – The burden of atopic dermatitis Atopic dermatitis, also called atopic eczema (AE), is a common chronic skin disease. Its burden ranks fifteenth worldwide for nonfatal diseases. Burdens addressed in these chapters: symptoms, quality of life, mood, economic burden, emotional consequences, and food choices. In chapter 2 we assessed the burden of 1189 adults with more severe AE in nine EU countries. Despite current treatment, 45% still had moderate to very severe AE assessed with the Patient-Oriented Eczema Measure. The Dermatology Life Quality Index showed moderate to extremely large impairment in 55%. On the Hospital Anxiety and Depression Scale, 10% scored on or above the threshold of eight points with signs of depressive symptoms. In chapter 3 we analysed the economic burden. The mean extra spending was €927 per patient per year for healthcare. In German participants, mean costs were higher than German adults with psoriasis or rheumatoid arthritis. Chapter 4 reported on the emotional consequences of AE. We developed a 28-item patient reported questionnaire: the Atopic Eczema Score of Emotional Consequences. More than half of the 1189 respondents were emotionally burdened. Large to very large emotional consequences were reported by 43.8% of those with currently moderate AE, 62.2% with severe AE, and 66.7% with very severe AE. In chapter 5 we addressed the differences in diet and nutritional intake between adults with and without AD. Data were available of 428 respondents (AD 240; control 188). Of those with AD, 66.3% reported that food influenced AD severity; 7.9% of them followed a cow’s milk protein free diet, versus 1.6% of controls. Part II -The art of systematic reviews This dissertation contains four systematic reviews: one on an intervention, one on outcome measures, and two on the methodological quality of clinical practice guidelines (CPGs). Chapter 6 is regarding a systematic review to assess the efficacy and safety of the use of moisturizers in eczema. We included 77 randomized controlled trials. The quality of the evidence was mainly low or moderate. With moisturizers fewer flares were seen, rate of flares was reduced, and topical treatment was more effective. No differences in adverse events were observed. Chapter 7 described a systematic review to identify and appraise a validated Patient Reported Outcome Measure on patient satisfaction in acne treatment. Only one study could be included, and this outcome measure was assessed as inadequate. Additionally, we analysed the methods of 188 studies having measured treatment satisfaction. Chapters 8 and 9 are part of the Global Guidelines in Dermatology Mapping Project (GUIDEMAP), with the aim to assess the methodological quality of CPGs on the 12 most burdensome skin diseases. We did this for AD (chapter 8) and contact dermatitis (CD; chapter 9). Chapter 8 reported on forty AD CPGs, mostly from countries with a high sociodemographic index. The reported quality varied enormously. Three CPGs scored ‘Excellent’ on all domains of the Appraisal of Guidelines for Research and Evaluation (AGREEII) Reporting Checklist. Three CPGs scored ‘Poor’ on all domains. We found no association between AGREEII-scores and a country’s gross domestic product. Overall, many CPGs for AD are not clear, unbiased, trustworthy or evidence based enough and lack applicability. In Chapter 9 we reported on twenty-three CPGs for CD, predominantly from countries with a high sociodemographic index. Three CPGs scored ‘Excellent’ on all six domains of AGREEII and one CPG scored ‘Poor’ on all domains. Areas that require improvement were ‘Strength and wording of recommendations’, ‘Applicability,’ ‘Update dates’, and ‘External review’
Labor Market Outcomes of People with HIV Pre- and Post-Diagnosis in the Netherlands
No full textIn the current era of effective antiretroviral therapy, HIV has become a manageable chronic condition. Little is known about the consequences of HIV on individuals' labor market outcomes. We study the impact of an HIV diagnosis using linked clinical data (the Dutch ATHENA cohort) and administrative data. A causal effect is estimated by comparing outcomes of people with HIV diagnosed between 2010 and 2022 (n = 5960) to a matched control group (n = 59,600) in a difference-in-difference design. We find that people with HIV are less likely to be employed, work fewer hours, earn less income, and are more likely to receive disability benefits up to 7 years after diagnosis. These effects are more pronounced for those diagnosed with late-stage HIV disease. Those with a non-late stage diagnosis experience a deterioration of socioeconomic outcomes, despite being less likely to experience clinically relevant symptoms at diagnosis. These findings highlight the need for continued efforts in prevention and early detection of HIV.</p
Rare-variant aggregation highlights disease-linked genes associated with brain volume variation
No full textDischarge time from healthcare facilities after birth in Tanzania:a secondary analysis of demographic and health surveys from 2015 to 16 and 2022
No full textBackground: Care during the immediate postpartum period is critical for women and newborn’s health. Following facility-based birth, it is recommended to monitor the health of women and newborns in the facility. In Tanzania, a third of women who give birth in a health facility report not receiving a health check during their stay. Duration of stay and factors influencing them are not well documented in Tanzania. We describe postpartum length-of-stay at two time-points, 2015/2016 and 2022 in Tanzania, and explore factors associated with early discharge. Methods: We analysed secondary data from two Demographic and Health Surveys: n = 3,582 women from 2015 to 16 and n = 4,618 from 2022 who had a livebirth in a health facility during the three years preceding the survey. Early discharge was defined as discharge < 24 h after vaginal birth and < 72 h after a caesarean birth. We describe the percentage of early discharge at both DHS time-points and explore factors associated with it using 2022 data with multivariable logistic regression, separately by mode of birth. Results: Almost half of women who had a vaginal birth were discharged early in 2015-16, compared to 30.3% in 2022. Early discharge increased among women who had a caesarean section from 17.2% in 2015-16 to 25.2% in 2022. The odds of early discharge were higher in Zanzibar compared to Eastern zone, and factors associated with early discharge included level of facility, frequency of antenatal care visits, maternal education and newborn underweight status. Conclusions: Despite progress in reducing early postpartum discharge after vaginal births, it continued to affect a third of women giving birth in Tanzania in 2022. Disparities between regions and facility levels suggest potential inconsistencies in the application of postpartum guidelines, warranting the need to determine and address the underlying causes, standardise practice and ensure equitable access to quality postpartum care.</p