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Uncertainties in Modeling Psychological Symptom Networks:The Case of Suicide
No full text In psychological research, network models are widely used to study symptoms of mental health disorders. However, these models often fail to account for uncertainty, leading to potentially misleading inferences. To address this issue, this study examines the robustness of psychological networks by analyzing a dataset of risk factors for suicidal behavior with multiple network algorithms. We compare two causal discovery algorithms—Hill Climbing (HC) and TABU search—and the Gaussian Graphical Model (GGM), a widely used statistical network model in psychology. Uncertainty is assessed along two dimensions: (1) the impact of noise, by introducing varying levels of white noise into the dataset, and (2) the effect of sample size reduction, by systematically decreasing the number of observations. Our results indicate that both HC and TABU search are highly sensitive to noise and sample size, with HC slightly outperforming TABU in terms of precision and recall. GGM performance declines gradually with increasing noise and sample size reduction, leading to sparser networks. For all algorithms, recall declined at a faster rate than precision. Finally, we examine the robustness of edges leading to suicidal ideation, finding that the edge from Depression to suicidal ideation remains relatively stable across conditions. This is a promising result, since many suicide interventions are based on treating depressive mood. Our results emphasize the importance of considering uncertainty in network-based psychological research, particularly when applying causal discovery algorithms.</p
Climate Litigation before International Courts:Conclusive Remarks on a Comparative Study
No full textThis chapter builds on the previous chapters in this book and provides concluding remarks on international climate litigation. A comparative narrative is created around the agents behind climate litigation, resulting from access to court rules and the fragmentation and cross-interpretation legal phenomena affecting a very diversified set of legal grounds in international climate cases. This narrative is built on a systematised summary of the main findings on existing environmental and climate cases before the United Nations system – including the International Court of Justice, the International Tribunal for the Law of the Sea, and human rights bodies – the African, European, and Inter-American human rights regional systems, and the Court of Justice of the European Union. We conclude that regional cultural contexts are determinant factors in the outcomes of legal cases, with Latin American and African systems emphasising collective rights, while the European approach remains individual-centred. The upcoming ICJ advisory opinion on climate change will be a critical moment in determining how these contrasting worldviews will be reconciled on a global scale
Plea bargaining in Europa geactualiseerd:Een blik op waarheidsvinding, de bekentenis en de rol van de rechter
No full textVanuit een modelmatig geschetst kader analyseert dit artikel de werking van Europese plea bargaining-varianten als legal transplants binnen drie civil law- stelsels – Duitsland, Zwitserland en Frankrijk – met aandacht voor waarheidsvinding, bekentenis en de rol van de rechter, mede op basis van empirische inzichten. Het laat zien hoe deze varianten veranderingen teweegbrengen in procesrollen, rechterlijke toetsing en de (functie van) bekentenis, en hoe zich een meer relationeel, consensueel waarheidsbegrip kan ontwikkelen. Daarmee worden systemische en rechtsculturele implicaties zichtbaar die ook inzicht bieden voor de zich in Nederland ontwikkelende rechtsfiguur
Advancinc gastric cancer care:Insights into staging, preoperative treatment, and surgical techniques
Get PDFGastric cancer is among the most common malignancies worldwide and remains a leading cause of cancer-related mortality. In the Netherlands, approximately 1,000 patients are diagnosed each year, of whom around 400 are eligible for potentially curative treatment. Managing gastric cancer involves a series of decisions that must balance oncological outcomes with patient resilience, biological variability, safety and practical feasibility. This thesis set out to examine some of the most pressing questions in that continuum: how to stage disease more accurately, how to apply systemic therapy in older patients, and how to refine surgical techniques. In doing so, it highlights the enduring value of staging laparoscopy, but also its potential limitations, calling attention to the need for more sensitive tools, such as fluorescence-guided imaging. It examines real-world treatment allocation in older patients, revealing both the rationale and the potential risks of current clinical decision-making. It challenges the routine practice of omentectomy, arguing for evidence rather than tradition, and demonstrated that while minimally invasive subtotal gastrectomy has matured into a safe and effective approach, minimally invasive total gastrectomy may still require caution and further refinement. Taken together, this thesis offers a contribution to modern gastric cancer care: grounded in clinical reality, informed by evidence, and open to innovations
Drafting EU soft law instruments as persuasive governance tools
No full textThe main aim of this chapter is to identify, define and operationalize drafting criteria and guidelines for EU soft law instruments. Despite their common usage and influence in a wide area of policies, and despite a core preoccupation with the quality of EU legal acts in general, most prominently in the context of the ‘better lawmaking’ initiatives, the drafting of these instruments has hardly been a concern for EU drafters. This chapter first highlights the unique attributes of EU soft law instruments as persuasive governance tools. Next, concrete guidelines for a proper drafting of EU soft law instruments are outlined and explained against the background of several argumentative and legal parameters used to assess the persuasive force of these governance tools
Knowing better is doing better?:A comprehensive evaluation of sports-based intervention to prevent juvenile delinquency
Get PDFSportgerichte interventies worden steeds vaker naar voren geschoven als een geschikte strengths-based benadering, maar de effecten van deze interventies blijken vaak bescheiden (e.g., Jugl et al., 2023). Mogelijke verklaringen zijn dat (a) interventies in de praktijk niet altijd worden uitgevoerd zoals bedoeld, (b) coaches moeite kunnen hebben om hun pedagogische taken goed te vervullen, en (c) de doelgroep sterk uiteenloopt in achtergrond en behoeften. Om meer inzichten te verkrijgen in deze verklaringen is in het huidige proefschrift een onderzoek uitgevoerd naar één specifieke gedragsinterventie: ‘Alleen Jij Bepaalt wie je bent’ (AJB; Hartog et al., 2017). In dit proefschrift onderzochten we: (1) de implementatiegetrouwheid van AJB, (2) de mate waarin de sportcoaches een therapeutische alliantie met de jongeren wisten op te bouwen en (3) de effecten van AJB op delinquent gedrag en op risico- en beschermende factoren voor jeugddelinquentie, met bijzondere aandacht voor de heterogeniteit binnen de doelgroep. Het onderzoek combineerde verschillende soorten meetmethoden én verzamelde informatie bij meerdere betrokkenen.Onze bevindingen benadrukken de meerwaarde van het combineren van kwantitatieve en kwalitatieve methoden, vooral bij het evalueren van complexe psychosociale interventies binnen een sterk heterogene doelgroep. De uitgebreide evaluatie van AJB vergrootte ons inzicht in hoe de interventie in de praktijk werd geïmplementeerd, welke bevorderende en belemmerende factoren hierbij een rol speelden, en voor welke jongeren AJB beter lijkt te werken dan voor anderen. Daarnaast bood het onderzoek concrete handvatten voor het verbeteren van de effectiviteit van AJB. Zo slaagden coaches er goed in een veilige en ondersteunende omgeving te creëren, maar werden er ook moeilijkheden gezien in het consequent toepassen van gepersonaliseerde, doelgerichte strategieën die essentieel zijn voor gedragsverandering.<br/
Adverse effects of infusion therapy in anesthesia and intensive care
Get PDFIn this thesis we investigated adverse events following transfusion and infusion therapy during anesthesia and intensive care. We focussed on a selection of different aspects in patients in the operation room, intensive care and on the ward. First, we sought to provide insights for which patients the risk of a common transfusion complication, transfusion-associated circulatory overload (TACO), outweighs the potential benefit of a transfusion. Second, we explored possible mechanisms underlying the development of TACO. Third, we searched for ways to optimize infusion therapy in the perioperative period. Our research suggests alternative mechanisms than just hydrostatic pressure overload for the development of TACO. Risk factors for TACO in comparison to patients developing circulatory overload without receiving transfusion products, COP of transfusion products, and clinical research on the effect of transfusion on hydrostatic pressure support a different pathogenesis. Our data helped put together one part of the puzzle. Future studies on TACO pathogenesis should focus on the effect of transfusion products on the endothelial barrier, and how an inflammatory process is part of this effect. Furthermore, we aimed to optimize perioperative infusion therapy. We showed a restrictive infusion regimen is associated with a reduction in complications. We developed a novel method of non-invasive CO monitoring derived from CCA flow. However, this method is not accurate and not precise
Shared Stories:On Lessons of Wisdom and Great Expectations
No full textThis book is a reconstruction of the formation of the largest publishing firm in the Netherland of general books: VBK-publishers. VBK is a merger of several smaller imprints that all have a long history. This history, as well as the developments after the merger in 2001, are sketched in this book
Polyfunctional antibodies in viral disease:Detecting, controlling and preventing infections with antiviral antibodies
Get PDFViral diseases still cause major consequences to our health, society and the global economy, despite the development of a multitude of vaccines and treatments. Viruses such as the human immunodeficiency virus-1 (HIV-1), respiratory syncytial virus (RSV) and the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cause mortality and morbidity across the world. There is still much we can learn from the immune system’s response to viruses. Antibodies against viral glycoproteins are often a crucial aspect of this immune response. In the first chapters of this thesis, we focused on the role of antibodies as markers for respiratory virus infections and for population immunity screening. We investigated the functionality and breadth of antiviral antibodies to gain insight that may guide work towards improved vaccines and therapies. Moreover, we assessed the immune response to SARS-CoV-2 vaccination in vulnerable populations. Finally, we assessed experimental vaccines for SARS-CoV-2 and HIV-1 to investigate how to further steer vaccine-induced immunity. Collectively, this thesis describes novel findings on the role of polyfunctional antibodies in detecting, controlling and preventing viral infections. Increased knowledge on immunity to viruses may lead to increasingly effective antiviral strategies and reduce the burden of viral disease on human health
Green and atmospheric water:An interdisciplinary perspective on governance for the anthropocene
Get PDFThe research in this thesis explores and assembles a framework for governance of green and atmospheric water. Conventional water governance literature has mostly focused on blue surface and ground water, while green water and atmospheric water have remained largely out of sight. Green water is the water in the first layers of the soil that is used by plants to produce biomass, while atmospheric water refers to all the gaseous and liquid water in the atmosphere. Scientific research increasingly shows how these elements of the hydrological cycle are crucial regulators of various Earth System processes, while they are also increasingly at risk from anthropogenic disturbances, with cascading impacts on people and nature. This poses the question ‘How do we govern green and atmospheric water in the Anthropocene?’. Using an institutional approach to the DPSIR framework, this thesis maps out the various drivers and pressures on the resources. It assesses the current state of green water using the planetary boundary framework, and identifies the range of social-ecological impacts, and policy responses in the current global environmental governance framework. It evaluates available policy instruments for governance, and uses a case study for the Great Green Wall in Sub-Saharan Africa to show that current water- and environmental governance does not properly cover the functions of green and atmospheric water. In doing so, it identifies major challenges and opportunities of multi-level governance of green and atmospheric water in the Anthropocene