The recreational use of nitrous oxide (N2O; laughing gas) has largely expanded in recent years. Although incidental use of nitrous oxide hardly causes any health damage, problematic or heavy use of nitrous oxide can lead to serious adverse effects. Amsterdam care centres noticed that Moroccan–Dutch young adults reported neurological symptoms, including severe paralysis, as a result of problematic nitrous oxide use. In this qualitative exploratory study, thirteen young adult Moroccan–Dutch excessive nitrous oxide users were interviewed. The determinants of problematic nitrous oxide use in this ethnic group are discussed, including their low treatment demand with respect to nitrous oxide abuse related medical–psychological problems. Motives for using nitrous oxide are to relieve boredom, to seek out relaxation with friends and to suppress psychosocial stress and negative thoughts. Other motives are depression, discrimination and conflict with friends or parents. The taboo culture surrounding substance use—mistrust, shame and macho culture—frustrates timely medical/psychological treatment of Moroccan–Dutch problematic nitrous oxide users. It is recommended to use influencers in media campaigns with the aim to decrease the risks of heavy nitrous oxide use and improve treatment access. Outreach youth workers can also play an important role in motivating socially isolated users to seek medical and or psychological help.
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Introduction: Over the past decade, frequent use of large quantities of nitrous oxide (N2O) has become more common in the Netherlands. Although N2O poses several negative health consequences for a subgroup of problematic N2O users, there is a lack of knowledge on what characterizes these intensive users. This study therefore aims to provide the demographic and substance use characteristics and experiences during treatment of treatment seeking problematic N2O users and to compare this with a matched group of treatment-seeking problematic cocaine users. Methods: A retrospective chart review was performed of patients who were referred for treatment of problematic N2O use at a large Dutch addiction care facility from January 2020 to September 2022, extracting demographics, pattern of use and follow-up data. Additionally, a subgroup of N2O users was propensity-score matched (1:1) with a subgroup of treatment seeking problematic cocaine users, both groups excluding users with substance use disorders or frequent use of substances other than N2O and cocaine, respectively. Results: 128 patients with a N2O use disorder were included in the total sample and a subgroup of 77 N2O-only users was propensity-score matched on age and sex to 77 cocaine-only users. N2O users were typically young (mean age 26.2 years), male (66.4%), unmarried (82.9%), with a low education level (59.0%) and born in the Netherlands (88.2%), with parents born in Morocco (45.3%). N2O was used intermittently (median 10 days/month, IQR 4.0–17.5 days) and often in very large quantities (median 5 kg [ca. 750 balloons] per average using day, IQR 2–10 kg). Compared to the patients with a cocaine use disorder, matched N2O users were lower educated, more often from Moroccan descent, and less likely to be alcohol or polysubstance users. Despite receiving similar treatments, N2O users were twice as likely to discontinue treatment before completion compared to cocaine users (63 vs. 35%, p = 0.004). Conclusion: Treatment-seeking problematic N2O users are demographically different from treatment-seeking problematic cocaine users and are much more likely to dropout from psychological treatment. Further research is needed into the needs and other factors of problematic N2O users that relate to poor treatment adherence in problematic N2O users.
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Background: Since 2000, the prevalence of recreational nitrous oxide (N 2O) use has increased in the Western world. Although N 2O is a relatively safe drug, the overall increase in the use of N 2O has concomitantly also initiated a modest but important increase in the number of young excessive users. The recent introduction of large 2 kg N 2O tanks, allowing high and prolonged dosing, has facilitated this excessive use. This is of concern, because repeated exposure to high doses of N 2O for a prolonged time is known to induce neurological damage, such as (irreversible) neuropathy and paralysis due to N 2O-induced vitamin B 12 deficiency. The increasing trend of recreational users with N 2O-induced neurological damage at emergency departments confirms the urgency of this development. Objective/Methods: This narrative review describes recent trends in N 2O use and misuse, the adverse health effects associated with excessive use and the risk factors of excessive use. Results: Considering the rising trend in N 2O use, particularly among young and other vulnerable people, we propose to take legislative action to limit the availability of N 2O, and also advocate for better and timely education of non-users, users and medical professionals about the serious side-effects associated with excessive N 2O use. Conclusion: It is concluded that the increase in excessive N 2O use is of serious concern.
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Snelle technologische ontwikkelingen bieden kansen voor de maritieme sector. Zij maken de scheepvaart efficiënter, veiliger en schoner. De techniek heeft regelgeving en professionals nodig die ook klaar zijn voor de toekomst. Het lectoraat Maritime Law voert praktijkgericht onderzoek uit op de scheidslijn van recht en (maritieme) techniek samen met studenten, docenten, het bedrijfsleven en kennisinstellingen.
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Social issues are becoming increasingly pressing. From dementia to climate change to corona; we as people, citizens, residents and city users - through our own experience or otherwise - have a sense of them. However, truly understanding and addressing these issues is difficult because there is no single owner. Everything is related, intertwined and also changing. Getting an overview and deciding together on necessary steps proves difficult. Complex issues thus become orphaned. Design and more specifically co-design - creative collaboration with others - is increasingly seen as a possible approach to these such issues and collaborations because it can deal with complexity and uncertainty, is optimistic and investigative in nature. With a co-design approach, we can find a shared desire and with that we connect with each other. By then searching together for mechanisms that can lead to the desired values, we gain insights on how to tilt a problematic situation. That enables us to imagine alternative futures. These help us on our way to a better, greener and more social world and social change.
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Background: In the past years, a mobile health (mHealth) app called the Dutch Talking Touch Screen Questionnaire (DTTSQ) was developed in The Netherlands. The aim of development was to enable Dutch physical therapy patients to autonomously complete a health-related questionnaire regardless of their level of literacy and digital skills. Objective: The aim of this study was to evaluate the usability (defined as the effectiveness, efficiency, and satisfaction) of the prototype of the DTTSQ for Dutch physical therapy patients with diverse levels of experience in using mobile technology. Methods: The qualitative Three-Step Test-Interview method, including both think-aloud and retrospective probing techniques, was used to gain insight into the usability of the DTTSQ. A total of 24 physical therapy patients were included. The interview data were analyzed using a thematic content analysis approach aimed at analyzing the accuracy and completeness with which participants completed the questionnaire (effectiveness), the time it took the participants to complete the questionnaire (efficiency), and the extent to which the participants were satisfied with the ease of use of the questionnaire (satisfaction). The problems encountered by the participants in this study were given a severity rating that was used to provide a rough estimate of the need for additional usability efforts. Results: All participants within this study were very satisfied with the ease of use of the DTTSQ. Overall, 9 participants stated that the usability of the app exceeded their expectations. The group of 4 average-/high-experienced participants encountered only 1 problem in total, whereas the 11 little-experienced participants encountered an average of 2 problems per person and the 9 inexperienced participants an average of 3 problems per person. A total of 13 different kind of problems were found during this study. Of these problems, 4 need to be addressed before the DTTSQ will be released because they have the potential to negatively influence future usage of the tool. The other 9 problems were less likely to influence future usage of the tool substantially. Conclusions: The usability of the DTTSQ needs to be improved before it can be released. No problems were found with satisfaction or efficiency during the usability test. The effectiveness needs to be improved by (1) making it easier to navigate through screens without the possibility of accidentally skipping one, (2) enabling the possibility to insert an answer by tapping on the text underneath a photograph instead of just touching the photograph itself, and (3) making it easier to correct wrong answers. This study shows the importance of including less skilled participants in a usability study when striving for inclusive design and the importance of measuring not just satisfaction but also efficiency and effectiveness during such studies.
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Human and plant relationships are described within the rich tradition of multispecies ethnography, ethnobotany, and political ecology. In theorizing this relationship, the issues of functionalism, and interconnectivity are raised. This article aims to re-examine the position of plants in the context of contemporary urban spaces through the prism of environmental ethics. Despite conceptual plurality and socio-cultural complexity of human–plant relationships, social scientists fail to note how the perception of ‘greenery’ has objectified plants in urban environment. Without seriously considering bioethics, theories of human–plant relationship might fail to note exploitive anthropocentric relationship between humans and plants in urban spaces. The article is inspired by reflections of urban flora in Amsterdam, The Netherlands. https://doi.org/10.1016/j.scs.2013.01.007 https://www.linkedin.com/in/helenkopnina/
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Proefschrift over de rol van spiritualiteit in de gezondheidszorg en de effecten van scholing van verpleegkundigen op hun competentie voor het verlenen van spirituele zorg. Proefschrift Rijksuniversiteit Groningen.
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(‘Co’-)Designing for healthy behaviour greatly benefits from integrating insights about individual behaviour and systemic influences. This study reports our experiences in using insights about individual and systemic determinants of behaviour to inform a large co-design project. To do so, we used two design tools that encourage focusing on individual determinants (Behavioural Lenses Approach) and social / systemic aspects of behaviour (Socionas). We performed a qualitative analysis to identify 1) when and how the team applied the design tools, and 2) how the tools supported or obstructed the design process. The results show that both tools had their distinctive uses during the process. Both tools improved the co-design process by deepening the conversations and underpinnings of the prototypes. Using the Behavioural Lenses under the guidance of a behavioural expert proved most beneficial. Furthermore, the Socionas showed the most potential when interacting with stakeholders, i.c. parents and PPTs.
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