340880 research outputs found
Sort by
Education Shapes Future Legal Practitioners' Evaluation of Legal Cases
No full textPeople oftentimes have misconceptions related to different legal psychological phenomena. These misconceptions can be potentially deleterious when they influence legal decisions. We examined whether these beliefs can be corrected with education. In Study 1, participants provided their agreement for statements related to four case vignettes about different kinds of psychology and law phenomena. Participants were also asked to write the reasons why they provided such an evaluation. In Study 2, we added one additional case vignette. Students improved their beliefs and knowledge concerning the majority of the investigated legal psychological topics after attending the course, except for the evaluation of recidivism risk. Our findings encourage the introduction of courses in legal psychology for students who will become legal practitioners
Evaluation of Short- and Long-Term Outcomes After Resection in Patients with Locally Advanced versus (Borderline) Resectable Pancreatic Cancer
No full textObjective: To evaluate short and long-term outcomes after pancreatectomy in patients with locally advanced pancreatic cancer (LAPC) compared with patients with (borderline) resectable pancreatic cancer [(B)RPC]. Background: Selected patients diagnosed with LAPC are increasingly undergoing resection after induction chemotherapy. To evaluate the benefit of this treatment approach, it is helpful to compare outcomes in resected patients with primary LAPC to outcomes in resected patients with primary (B)RPC. Methods: Two prospectively maintained nationwide databases were used for this study. Patients with (B)RPC undergoing upfront tumor resection and patients with resected LAPC after induction therapy were included. Outcomes were postoperative pancreas-specific complications, 90-day mortality, pathologic outcomes, disease-free interval, and overall survival. Results: Overall, 879 patients were included; 103 with LAPC (12%) and 776 with (B)RPC (88%). Patients with LAPC had a lower World Health Organization performance score and ageadjusted Charlson Comorbidity Index. Postoperative pancreas-specific complications were comparable between groups, except delayed gastric emptying grade C, which occurred more often in patients with LAPC (9% vs 3%, P = 0.03). Ninety-day mortality was comparable. About half of the patients in both groups [54% in LAPC vs 48% in (B)RPC, P = 0.21] had a radical resection (R0). Disease-free interval was 13 months in both groups (P = 0.12) and overall survival from the date of diagnosis was 24 months in patients with LAPC and 19 months in patients with (B)RPC (P = 0.34). Conclusions: In our nationwide prospective databases, pancreas-specific complications, mortality, and survival in patients with LAPC after pancreatectomy are comparable with those undergoing resection for (B)RPC. These outcomes suggest that postoperative morbidity and mortality after tumor resection in carefully selected patients with LAPC are acceptable.</p
How to (mis)align participatory approaches with the everyday life? Construction of an improved cookstove in India
No full textImproved cookstoves aimed at reducing exposure to indoor air pollution have had a lasting presence in development and health discussions. Through this article we contribute to current debates in the field by reflecting on our experiences during a cookstove participatory project in two 'non-notified' communities, or 'slums,' in Bangalore, India. We interrogate the alignment between some of the central tenets and methods of participation and the lived experiences of participating communities. The current predominant recommendations focus on developing and implementing cookstoves tailored for user needs. Yet, the project implementation entered a space of uncertainty where the priorities and needs of participants were diverse and changing. While urban infrastructures related to housing and work security, drainage systems, access to health care, and aspects of governance, citizenship and rights, may seem to fall outside the scope of ICS projects, our experiences show how inescapably they shape participatory processes and technologies. We highlight the need to take a closer look at how we can include these broader and changing priorities and needs in our methodologies and reflect on how we can better respond and align them with the ways in which people live
Use and experienced effectiveness of non-pharmacological treatments for chronic spinal cord injury related pain in The Netherlands:A cross-sectional survey
No full textContext/Objective: Chronic pain is a common secondary condition in spinal cord injury (SCI). Pharmacological interventions to reduce pain are associated with side effects. The reported effects of non-pharmacological treatments are unclear. This study aims to examine the self-reported presence and type of pain, and the use, effectiveness and side effects of non-pharmacological treatments for pain. Design: Cross-sectional survey regarding SCI-related pain and non-pharmacological treatments. Setting: Community, the Netherlands. Participants: Outpatients with SCI from two rehabilitation centers. Interventions: Not applicable. Outcome measures: Self-reported presence and type of pain, use, effectiveness and side effects of non-pharmacological treatments. Results: A total of 371 patients (41.5%) returned the questionnaire. Median time since onset of SCI was 7 years. Pain following SCI was reported by 262 patients (70.6%). Neuropathic pain was reported most often (74.4%), followed by musculoskeletal pain (51.5%). Of patients with pain, 204 (77.9%) reported past or current use of non-pharmacological treatments. Non-pharmacological treatments used most were physiotherapy (67.6%), physical exercise (44.7%) and massage (22.5%). Of patients using non-pharmacological treatments, 152 patients (74.5%) reported the effect of their treatment. Most treatments for which the effect was reported, were described as moderately effective. Most side effects were reported for cannabis. Conclusion: Patients with SCI experiencing pain often use non-pharmacological treatments. Most treatments were described as moderately effective. Research on specific non-pharmacological treatments and different types of pain separately is needed to further determine the effectiveness of non-pharmacological treatments
Perineural Invasion is an Important Prognostic Factor in Patients With Radically Resected (R0) and Node-negative (pN0) Pancreatic Cancer
No full textOBJECTIVE: To investigate the association between perineural invasion (PNI) and overall survival (OS) in a nationwide cohort of patients with resected pancreatic ductal adenocarcinoma (PDAC), stratified for margin negative (R0) or positive (R1) resection and absence or presence of lymph node metastasis (pN0 or pN1-pN2, respectively). BACKGROUND: Patients with R0 and pN0 resected PDAC have a relatively favorable prognosis. As PNI is associated with worse OS, this might be a useful factor to provide further prognostic information for patients counselling. METHODS: A nationwide observational cohort study was performed including all patients who underwent PDAC resection in the Netherlands (2014-2019) with complete information on relevant pathologic features (PNI, R status, and N status). OS was assessed using Kaplan-Meier curves, and Cox-proportional hazard analyses were performed to calculate hazard ratios (HRs) with corresponding 95% CIs. RESULTS: In total, 1630 patients were included with a median follow-up of 43 (interquartile range: 33-58) months. PNI was independently associated with worse OS in both R0 patients [HR: 1.49 (95% CI: 1.18-1.88); P < 0.001] and R1 patients [HR: 1.39 (95% CI: 1.06-1.83); P = 0.02], as well as in pN0 patients [HR: 1.75 (95% CI: 1.27-2.41); P < 0.001] and pN1-N2 patients [HR: 1.35 (95% CI: 1.10-1.67); P < 0.01]. In 315 patients with R0N0, multivariable analysis showed that PNI was the strongest predictor of OS [HR: 2.24 (95% CI: 1.52-3.30); P < 0.001]. CONCLUSIONS: PNI is strongly associated with worse survival in patients with resected PDAC, in particular in patients with relatively favorable pathologic features. These findings may aid patient stratification and counseling and help guide treatment strategies.</p
Infant ustekinumab Clearance, Risk of Infection, and Development after exposure during pregnancy
No full textBackground: Evidence on ustekinumab safety in pregnancy is gradually expanding, but its clearance in the postnatal period is unknown. The aim of this study was to investigate ustekinumab concentrations in umbilical cord blood and rates of clearance after birth, as well as how these correlate with maternal drug concentrations, risk of infection, and developmental milestones during the first year of life. Methods: Pregnant women with inflammatory bowel disease were prospectively recruited from 19 hospitals in Denmark and the Netherlands between 2018 and 2022. Infant infections leading to hospitalization/antibiotics and developmental milestones were assessed. Serum ustekinumab concentrations were measured at delivery and specific time points. Nonlinear regression analysis was applied to estimate clearance. Results: In 78 live-born infants from 76 pregnancies, we observed a low risk of adverse pregnancy outcomes and normal developmental milestones. At birth, the median infant-mother ustekinumab ratio was 2.18 (95% confidence interval, 1.69–2.81). Mean time to infant clearance was 6.7 months (95% confidence interval, 6.1–7.3 months). One in 4 infants at 6 months had an extremely low median concentration of 0.015 μg/mL (range 0.005–0.12 μg/mL). No variation in median ustekinumab concentration was noted between infants with (2.8 [range 0.4–6.9] μg/mL) and without (3.1 [range 0.7–11.0] μg/mL) infections during the first year of life (P = .41). Conclusions: No adverse signals after intrauterine exposure to ustekinumab were observed with respect to pregnancy outcome, infections, or developmental milestones during the first year of life. Infant ustekinumab concentration was not associated with risk of infections. With the ustekinumab clearance profile, live attenuated vaccination from 6 months of age seems of low risk.</p
Brief Report:Determinants of Potential Sexual Activity Reduction in the Face of the Mpox Epidemic
Get PDFBackground: The current mpox epidemic is most prevalent among men-who-have-sex-with-men (MSM). Vaccination programs are being rolled-out to curb the epidemic. Behavioural measures have been called for as well, for example, by the WHO and national public health authorities to reduce the number of sexual partners and sexual activity. We investigated intentions and determinants among Dutch MSM to follow such behavioural measures. Methods: Early in July 2022, in the context of a dynamic ongoing epidemic, 394 MSM answered an online questionnaire investigating concepts such as perceived mpox risk, vaccination and behavioural change intentions and collecting socio-demographic and sexual behaviour information. Results: The overall intentions to reduce number of partners and sexual activity were high, but only a minority had developed definite intentions. Determinant analysis revealed that dating/open relationship status was a positive predictor; vaccination intentions did not predict sexual behaviour change; those not on PrEP were more likely to change their sexual behaviour. Mpox infection concern was the main predictor for behaviour change intentions. Conclusions: Our results show that behavioural measures to avoid an mpox infection are present in majority of participants in our survey, but high intentions are held by a minority. Taking the historic complexity of behavioural change pleas among MSM into account sensitive, additional public health measures are necessary to reach and to inform MSM about potential benefits of sexual behaviour change
On patience and trust
No full textWe show that variation in trust is crucial to explain variation in patience. The unconditional correlation between trust and patience is 0.190 across 76 countries based on the outcomes of a survey among 80,000 individuals. Controlling for variations in country-level early agricultural development by means of heteroskedastic linear maximum likelihood regression resolves the data's heteroscedasticity and raises the correlation to 0.345. Two-stage least squares estimation, with Genetic Distance - a descriptor of within country homogeneity - as its most valuable exogenous instrumental variable, removes endogeneity bias from the empirical relationship, and results in a robust final correlation of 0.754. Our study underlines the importance of proper econometric analysis as a prerequisite to accurately measure the extent of the relationship between patience and trust, two cultural variables that are seen as important determinants of economic development
Measured and predicted resting metabolic rate of Dutch and Norwegian Paralympic athletes
No full textBackground: Although resting metabolic rate (RMR) is crucial for understanding athletes’ energy requirements, limited information is available on the RMR of Paralympic athletes. Objective: The aim of this study was to determine RMR and its predictors in a diverse cohort of Paralympic athletes and evaluate the agreement between measured and predicted RMR from both newly developed and pre-existing equations. Design: This cross-sectional study, conducted between September 2020 and September 2022 in the Netherlands and Norway, assessed RMR in Paralympic athletes by means of ventilated hood indirect calorimetry and body composition by means of dual-energy x-ray absorptiometry. Participants: Sixty-seven Paralympic athletes (male: n = 37; female: n = 30) competing in various sports, with a spinal cord disorder (n = 22), neurologic condition (n = 8), limb deficiency (n = 18), visual or hearing impairment (n = 7), or other disability (n = 12) participated. Main outcome measures: RMR, fat-free mass (FFM), body mass, and triiodothyronine (T3) concentrations were assessed. Statistical analyses: Multiple regression analyses were conducted with height, FFM, body mass, sex, T3 concentration, and disabilities as potential predictors of RMR. Differences between measured and predicted RMRs were analyzed for individual accuracy, root mean square error, and intraclass correlation. Results: Mean ± SD RMR was 1386 ± 258 kcal/d for females and 1686 ± 302 kcal/d for males. Regression analysis identified FFM, T3 concentrations, and the presence of a spinal cord disorder, as the main predictors of RMR (adjusted R 2 = 0.71; F = 50.3; P < .001). The novel prediction equations based on these data, as well as pre-existing equations of Chun and colleagues and Nightingale and Gorgey performed well on accuracy (>60% of participants within 10% of measured RMR), had good reliability (intraclass correlation >0.78), and low root mean square error (≤141 kcal). Conclusions: FFM, total T3 concentrations, and presence of spinal cord disorder are the main predictors of RMR in Paralympic athletes. Both the current study's prediction equations and those from Chun and colleagues and Nightingale and Gorgey align well with measured RMR, offering accurate prediction equations for the RMR of Paralympic athletes.</p
Challenging the Diagnostic Value of Theta/Beta Ratio:Insights From an EEG Subtyping Meta-Analytical Approach in ADHD
Get PDFThe frequently reported high theta/beta ratio (TBR) in the electroencephalograms (EEGs) of children with attention-deficit/hyperactivity disorder (ADHD) has been suggested to include at least two distinct neurophysiological subgroups, a subgroup with high TBR and one with slow alpha peak frequency, overlapping the theta range. We combined three large ADHD cohorts recorded under standardized procedures and used a meta-analytical approach to leverage the large sample size (N = 417; age range: 6-18 years), classify these EEG subtypes and investigate their behavioral correlates to clarify their brain-behavior relationships. To control for the fact that slow alpha might contribute to theta power, three distinct EEG subgroups (non-slow-alpha TBR (NSAT) subgroup, slow alpha peak frequency (SAF) subgroup, not applicable (NA) subgroup) were determined, based on a halfway cut-off in age- and sex-normalized theta and alpha, informed by previous literature. For the meta-analysis, Cohen's d was calculated to assess the differences between EEG subgroups for baseline effects, using means and standard deviations of baseline inattention and hyperactivity-impulsivity scores. Non-significant, small Grand Mean effect sizes (-0.212 < d < 0.218) were obtained when comparing baseline behavioral scores between the EEG subgroups. This study could not confirm any association of EEG subtype with behavioral traits. This confirms previous findings suggesting that TBR has no diagnostic value for ADHD. TBR could, however, serve as an aid to stratify patients between neurofeedback protocols based on baseline TBR. A free online tool was made available for clinicians to calculate age- and sex-corrected TBR decile scores (Brainmarker-IV) for stratification of neurofeedback protocols