Mediamusic (E-Journal)
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Policy Research Under Pressure:The Case of the Ministry of Justice in the Netherlands
No full textIn policy research, the search for the correct balance between proximity and independence has never been easy. Policymakers need proximity to the research in order to ensure that it is relevant. Yet, there are also concerns about the rigour of research. To analyze this relationship in more detail, this paper focuses on the ‘extreme case’ of the WODC in the Netherlands, an internal but formally independent research unit of the Dutch Ministry of Justice and Security. Research methods include semi-structured interviews and a survey (N = 673). We conclude that government leans on WODC researchers in all phases of the policy research process. In most cases, WODC researchers successfully resist pressure from policymakers, yet continuing pressure may easily lead to research methods, conclusions and press releases being altered for policy reasons. Finally, there are general lessons drawn from the WODC case that will assist in achieving a good balance between proximity and independence in policy research.</p
Validation of the International Classification of Functioning, Disability and Health (ICF) core set for Diabetes Mellitus from nurses’ perspective using the Delphi method
No full textPurpose: To explore content validity of the ICF core set for Diabetes Mellitus from nurses’ perspective. Materials and methods: A two-round Delphi study was conducted with nurses specialized in diabetes care, who were recruited by purposive sampling. Level of agreement on relevance of ICF categories was calculated using Item-level Content Validity Index. Results: Twenty-seven nurses judged 147 second-level ICF categories on relevance for people with Diabetes Mellitus. Agreement was reached on 65 (44.2%) categories, of which 46 were from the ICF core set for Diabetes Mellitus, 17 were from previous validation studies, and two were additional categories that were mentioned as relevant. Forty-six out of the 65 categories were derived from the component body functions and structures. No agreement was reached on 82 (55.8%) categories, of which 33 were derived from the component environmental factors. Conclusions: Content validity of the ICF core set for Diabetes Mellitus was partially supported by specialized nurses. Agreement was predominantly reached on biomedical categories. Content validity of categories derived from environmental factors received little support. Relevance: The nursing profession should be aware of a gap between the current biomedical focus and the desired biopsychosocial approach; the latter of which is recommended in chronic care.IMPLICATIONS FOR REHABILITATION The International Classification of Functioning, Disability and Health (ICF) encourages a biopsychosocial approach in health care, and ICF core sets, such as the core set for Diabetes Mellitus, are useful in identifying the needs of patients. Content validity of the ICF core set for Diabetes Mellitus was partially supported by nurses specialized in diabetes care; agreement was predominantly reached on biomedical categories. The nursing profession should be aware of a potential gap between the current biomedical focus and a desired biopsychosocial approach, which is particularly recommended in chronic care. It is recommended that nurses take part in future revisions of ICF core sets; a multidisciplinary approach enables members to learn from each other’s perspectives, including from those of patients.</p
Transdiagnostic development of internalizing psychopathology throughout the life course up to age 45:A World Mental Health Surveys report
No full textBackground Depressive and anxiety disorders are highly comorbid, which has been theorized to be due to an underlying internalizing vulnerability. We aimed to identify groups of participants with differing vulnerabilities by examining the course of internalizing psychopathology up to age 45. Methods We used data from 24158 participants (aged 45+) in 23 population-based cross-sectional World Mental Health Surveys. Internalizing disorders were assessed with the Composite International Diagnostic Interview (CIDI). We applied latent class growth analysis (LCGA) and investigated the characteristics of identified classes using logistic or linear regression. Results The best-fitting LCGA solution identified eight classes: A healthy class (81.9%), three childhood-onset classes with mild (3.7%), moderate (2.0%), or severe (1.1%) internalizing comorbidity, two puberty-onset classes with mild (4.0%) or moderate (1.4%) comorbidity, and two adult-onset classes with mild comorbidity (2.7% and 3.2%). The childhood-onset severe class had particularly unfavorable sociodemographic outcomes compared to the healthy class, with increased risks of being never or previously married (OR = 2.2 and 2.0, p < 0.001), not being employed (OR = 3.5, p < 0.001), and having a low/low-Average income (OR = 2.2, p < 0.001). Moderate or severe (v. mild) comorbidity was associated with 12-month internalizing disorders (OR = 1.9 and 4.8, p < 0.001), disability (B = 1.1-2.3, p < 0.001), and suicidal ideation (OR = 4.2, p < 0.001 for severe comorbidity only). Adult (v. childhood) onset was associated with lower rates of 12-month internalizing disorders (OR = 0.2, p < 0.001). Conclusions We identified eight transdiagnostic trajectories of internalizing psychopathology. Unfavorable outcomes were concentrated in the 1% of participants with childhood onset and severe comorbidity. Early identification of this group may offer opportunities for preventive interventions.</p
Revitalising place-based commercial heritage:A Cultural Political Economy approach to the renaissance of lambic beers in Belgium
No full textThis paper studies the intricacies related to the revitalisation of commercial products that have recently been assigned with cultural heritage values in the context of post-Fordist consumption. Underpinned by a conceptual lens that combines reflections on heritage dissonance and Cultural Political Economy (CPE), the paper describes a qualitative study of lambic beers in Belgium. After being almost wiped out by the 1990s, lambic brewing has made a spectacular recovery due to a combination of global economic drivers and local sector-wide collaboration. However, the addition of cultural heritage values to the commercial product, which fuelled the sector’s economic regeneration, brought along challenges now there is less concern about the sector’s immediate survival. Alongside governance complexities, different interpretations among stakeholders of what constitutes ‘tradition’ have complicated defining the boundaries between collective and individual interests, which runs parallel with identifying where cultural values stop and economic values begin. Heritage dissonance, in this case, centres around struggles of finding a collective semiotic response to safeguard the sector’s agency in the context of its post-Fordist embedding, including prevailing ‘craft’ cultural/ economic imaginaries. Concluding, the application of CPE to the lambic beer study reflects the framework’s value for understanding dissonant heritage values
A clinical effect of disease-modifying treatment on alloimmunisation in transfused patients with myelodysplastic syndromes:Data from a population-based study
No full textBACKGROUND: Alloimmunisation against blood products is an adverse event, causing time-consuming compatibility testing. Current literature has not yet identified the influence of treatment on the risk of alloimmunisation in patients with myelodysplastic syndromes (MDS).MATERIALS AND METHODS: An observational, population-based study, using the HemoBase registry, was performed including all transfused patients who were diagnosed with MDS between 2005 and 2017 in Friesland, a province in the Netherlands. Information about transfusion dates, types, and treatment regimens was collected from the health records. Blood products were matched for ABO and Rhesus D. The effect of disease-modifying treatment was estimated with incidence rates and a Cox time-dependent analysis.RESULTS: 233 patients were included in this study, with a median follow-up of 13.0 months. Alloimmunisation occurred in 21 patients (9.0%) and predominantly occurred early in follow-up. Three (5%) and 18 (11%) alloimmunisation events occurred in patients with and without disease-modifying treatment, respectively. The hazard ratio for alloimmunisation without treatment compared to during treatment was 2.7 (95% CI: 0.35-20.0), with incidence rates of 7.18 and 2.41 per 100 patient-years, respectively.DISCUSSION: In a non-selected real-world population of MDS patients receiving blood transfusions, the percentage of patients with alloimmunisation was below 10%. The results of this study support the hypothesis that disease-modifying treatment affects the ability of the immune system to mount an antibody response to non-self blood group antigens.</p
An evaluation of the efficacy of two add-on ecological momentary intervention modules for depression in a pragmatic randomized controlled trial (ZELF-i)
No full textBACKGROUND: Depression treatment might be enhanced by ecological momentary interventions (EMI) based on self-monitoring and person-specific feedback. This study is the first to examine the efficacy of two different EMI modules for depression in routine clinical practice.METHODS: Outpatients starting depression treatment at secondary mental health services (N = 161; MIDS-DEPRESSION = 35.9, s.d. = 10.7; MAGE = 32.8, s.d. = 12.1; 46% male) participated in a pragmatic randomized controlled trial with three arms. Two experimental groups engaged in 28 days of systematic self-monitoring (5 times per day), and received weekly feedback on either positive affect and activities (Do-module) or negative affect and thinking patterns (Think-module). The control group received no additional intervention. Participants completed questionnaires on depressive symptoms (primary outcome), social functioning, and empowerment before and after the intervention period, and at four measurements during a 6-month follow-up period.RESULTS: Of the 90 (out of 110) participants who completed the intervention, 86% would recommend it. However, the experimental groups did not show significantly more or faster changes over time than the control group in terms of depressive symptoms, social functioning, and empowerment. Furthermore, the trajectories of the two EMI modules were very similar.CONCLUSIONS: We did not find statistical evidence that this type of EMI augments the efficacy of regular depression treatment, regardless of module content. We cannot rule out that EMIs have a positive impact on other domains or provide a more efficient way of delivering care. Nonetheless, EMI's promise of effectiveness has not materialized yet.</p
Applying Immunomodulation to Promote Longevity of Immunoisolated Pancreatic Islet Grafts
No full textIslet transplantation is a promising therapy for insulin-dependent diabetes, but large-scale application is hampered by the lack of a consistent source of insulin-producing cells and need for lifelong administration of immunosuppressive drugs, which are associated with severe side effects. To avoid chronic immunosuppression, islet grafts can be enveloped in immunoisolating polymeric membranes. These immunoisolating polymeric membranes protect islet grafts from cell-mediated rejection while allowing diffusion of oxygen, nutrients, and insulin. Although clinical trials have shown the safety and feasibility of encapsulated islets to control glucose homeostasis, the strategy does up till now not support long-term graft survival. This partly can be explained by a significant loss of insulin-producing cells in the immediate period after implantation. The loss can be prevented by combining immunoisolation with immunomodulation, such as combined administration of immunomodulating cytokines or coencapsulation of immunomodulating cell types such as regulatory T cells, mesenchymal stem cells, or Sertoli cells. Also, administration of specific antibodies or apoptotic donor leucocytes is considered to create a tolerant microenvironment around immunoisolated grafts. In this review, we describe the outcomes and limitations of these approaches, as well as the recent progress in immunoisolating devices.Impact statementImmunoisolation by enveloping islets in semipermeable membranes allows for successful transplantation of islet grafts in the absence of chronic immunosuppression, but the duration of graft survival is still not permanent. The reasons for long-term final graft failure is not fully understood, but combining immunoisolation with immunomodulation of tissues or host immune system has been proposed to enhance the longevity of grafts. This article reviews the recent progress and challenges of immunoisolation, as well as the benefits and feasibility of combining encapsulation approaches with immunomodulation to promote longevity of encapsulated grafts.</p
Psychometric properties of the ABSI-id, an adapted measure for anger-related interoceptive awareness in individuals with mild intellectual disabilities or borderline intellectual functioning
No full textBackground: The present study examined the psychometric properties of the Anger Bodily Sensations Interview - intellectual disabilities (ABSI-id), an adapted instrument to measure anger-related interoceptive awareness (IA) in individuals with mild intellectual disabilities or borderline intellectual functioning (MID-BIF).Method: The ABSI-id was individually administered to 208 clients (51% male) with MID-BIF in residential facilities.Results: An EFA and CFA showed a two-factor structure of the ABSI-id, including nine items. The ABSI-id had moderate to good reliability, with an internal consistency ranging from acceptable to good, a test-retest reliability ranging from moderate to good and an adequate convergent validity. There was no significant difference in ABSI-id scores between individuals with MID and BIF.Conclusion: The ABSI-id is a promising instrument for measuring anger-related IA, additional research is needed on validity and sensitivity of change.</p
The Spiritual is Political:The Pilsen Via Crucis as a Path to Resistance
No full textThis chapters reveals the political nature of the annual Via Crucis, or Living Stations of the Cross, performed in the Pilsen neighborhood of Chicago by ethnic Mexicans and other Latines. The annual procession, first performed in 1977, brings communities together to share the burdens of their day-to-day suffering in racially fraught circumstances. The Via Crucis draws attention to drug use, gentrification, poverty, labor abuses, poor housing, and other social ills damaging the fabric of Mexican Chicago. The procession serves to remind gentrifiers, city, and church officials that Pilsen is still Mexican, and to remind Mexicans that they are not alone; they do not suffer alone. Jesus, and their fellow community members, are there in solidarity