Zoekresultaten

Cannabis users and stigma: A comparison of users from European countries with different cannabis policies

Cannabis is commonly characterized as the most normalized illicit drug. However, it remains a prohibited substance in most parts of the world, including Europe, and users can still be subject to stigmatization. The objective of this study is to assess to what extent and how cannabis users in different countries with different cannabis policies perceive, experience and respond to stigmatization. We conducted a survey in the Dutch coffeeshops among 1225 last year cannabis users from seven European countries, with national cannabis policies ranging from relatively liberal to punitive. Three dimensions of cannabis-related stigma were investigated (discrimination, perceived devaluation and alienation) and a sum score was used to reflect the general level of stigmatization. Perceived devaluation was the highest-scoring dimension of stigma and discrimination the lowest-scoring. The general level of stigmatization was lowest in the Netherlands and highest in Greece. This indicates that punitive cannabis policy is associated with stigma and liberal cannabis policy is associated with de-stigmatization. Besides country, daily cannabis use was also found to be a significant predictor of stigma, but gender, age, household type and employment status were not.

(Eye)tracking users’ patterns

Experiential knowledge of mental health professionals

Introduction: Nowadays the Western mental health system is in transformation to recovery-oriented and trauma informed care in which experiential knowledge becomes incorporated. An important development in this context is that traditional mental health professionals came to the fore with their lived experiences. From 2017 to 2021, a research project was conducted in the Netherlands in three mental health organizations, focussing on how service users perceive the professional use of experiential knowledge. Aims: This paper aims to explore service users’ perspectives regarding their healthcare professionals’ use of experiential knowledge and the users’ perceptions of how this contributes to their personal recovery. Methods: As part of the qualitative research, 22 service users were interviewed. A thematic analysis was employed to derive themes and patterns from the interview transcripts. Results: The use of experiential knowledge manifests in the quality of a compassionate user-professional relationship in which personal disclosures of the professional’s distress and resilience are embedded. This often stimulates users’ recovery process. Conclusions: Findings suggest that the use of experiential knowledge by mental health professionals like social workers, nurses and humanistic counselors, demonstrates an overall positive value as an additional (re)source.

Determinants of dietary behaviour in wheelchair users with spinal cord injury or lower limb amputation

Objective This study aims to identify determinants of dietary behaviour in wheelchair users with spinal cord injury or lower limb amputation, from the perspectives of both wheelchair users and rehabilitation professionals. The findings should contribute to the field of health promotion programs for wheelchair users. Methods Five focus groups were held with wheelchair users (n = 25), and two with rehabilitation professionals (n = 11). A thematic approach was used for data analysis in which the determinants were categorized using an integrated International Classification of Functioning, Disability and Health and Attitude, Social influence and self-Efficacy model. Results Reported personal factors influencing dietary behaviour in wheelchair users were knowledge, boredom, fatigue, stage of life, habits, appetite, self-control, multiple lifestyle problems, intrinsic motivation, goal setting, monitoring, risk perception, positive experiences, suffering, action planning, health condition, function impairments, attitude and self-efficacy. Reported environmental factors influencing dietary behaviour in wheelchair users were unadjusted kitchens, monitoring difficulties, eating out, costs, unfavourable food supply, nutrition education/counselling, access to simple healthy recipes, eating together, cooking for others, and awareness and support of family and friends. Conclusions Important modifiable determinants of dietary behaviour in wheelchair users that might be influenced in lifestyle interventions are knowledge, fatigue, habits, self-control, intrinsic motivation, risk perception, attitude and self-efficacy. It is recommended to involve relatives, since they appear to significantly influence dietary behaviour.

Treatment Seeking Nitrous Oxide Users in Addiction Care

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.

(Eye)tracking users’ patterns

Over the next 10 years, the City of Amsterdam plans to develop major housing schemes provide 90,000 new homes within the existing urban fabric. At the same time, an urban renewal program is being launched to revitalize the most deprived neighbourhoods. Together, these challenges call for more evidence based designprinciples to secure liveable places. Recent development in neuroscience, provides innovative tools to examine in a measurable, cause-effect way, the relationships between the physical fabric, users’ (visual) experience and their behavior in public spaces. In neuroscience, eye-tracking technology (ET) complements brain and behavioral measures (for overview see Eckstein et al. 2017). ET is already used to evaluate the spatial orienting of attention, behavioral response and emotional and cognitive impact in neuroscience, psychology and market research (Popa et al. 2015). ET may also radically change the way we (re)design and thus, experience cities (Sita et al. 2016; Andreani 2017). Until now, eye-tracking pilot studies collected eye fixation patterns of architecture using images in a lab-setting (Lebrun 2016).In our research project Sensing Streetscapes, we take eye-tracking outdoors and explore the potential ET may offer for city design. In collaboration with the municipality of Amsterdam and the local community, the H-neighborhood is used as a single case study. The main focus for urban renewal lies in the “transition-spaces”. They connect the neighborhood with the rapidly developing adjacent areas and are vital for improving the weak social-economic status. The commonly used design principles are validated (Alexander et al. 1977; Gehl 2011, 2014; Pallasmaa 2012) and the consistency of ET is tested, alongside (walk along) interviews and behavioral observations. In the next phase, the data will be analyzed by a panel of applied psychologists and urban designers. The initial results provide valuable lessons for the use of eye-tracking in urban design research. For example, a visual pattern analysis offers more accurate images of the spatial key-elements that matter when moving through transition spaces. More sensory-based city design research is needed to gather a full understanding of the relationships between the configuration of space, users’ (visual) experience, behavioral responses and in turn, perceptual decision making.