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3This research focuses on dinner conversations in family-style group care. Children, who cannot live with their biological families anymore, are given shelter in these family-style group care settings. For the development of an attachment relationship between children and their Professional Foster Parents (PFPs), it is important that the children feel that they are listened to in order to get an affective and intimate relationship with the parents. In this conversation-analytic research we analysed PFPs’ involvement in multiple activities simultaneously, namely listening and eating, which is referred to as ‘multi-activity’. The analyses have shown systematic ways in which PFPs coordinate their involvement in the activities of ‘doing’ listening and eating, which are (i) when parents avert their gaze from the telling child, they break the social rule which states that hearers need to look at speakers during the telling. We found that when averting their gaze, PFPs do head nods and linguistic means or positioning their bodies in the direction of the telling child. This research contributes to knowledge about interaction between adolescents and PFPs. It further contributes to knowledge about how human beings are able to coordinate multiple activities simultaneously. This is the accepted version (post-print) of the article.
ARTIKEL
Out-of-home placed children or adolescents can be placed in family-style group care, a promising alternative youth care setting. It provides children and Professional Foster Parents (PFPs) with the opportunity to create a continuous relationship. This relationship, in turn, is an important factor in building and maintaining attachment. Scientific literature shows that sensitivity and responsivity are crucial interactional elements for building and maintaining an attachment relationship, but little knowledge is available on how those concepts are displayed in mundane interactions. Therefore this dissertation studies dinner conversations between experienced PFPs and adolescents in family-style group care to find out how sensitivity and responsivity unfold in these conversations. The data consist of 300 hours of videorecordings coming from six family-style group care settings. The method of Conversation Analysis was used to analyse the conversations in detail. On the basis of four studies a better understanding is gained into how the dyadic concepts sensitivity and responsivity are displayed in daily interactions between PFPs and adolescents in family-style group care. The analysis of these specific phenomena disclose the PFPadolescent interaction from different perspectives: the verbal and non-verbal actions of both PFPs and adolescents and how PFPs and adolescents align. In short, this dissertation provides a detailed analysis of interaction and improves the understanding of the dyadic concepts sensitivity and responsivity. It reveals that adolescents are active participants in interactions and shows that PFPs are inventive in their conversations with the adolescents.
PROEFSCHRIFT
Criminologists have frequently debated whether offenders are specialists, in that they consistently perform either one offense or similar offenses, or versatile by performing any crime based on opportunities and situational provocations. Such foundational research has yet to be developed regarding cybercrimes, or offenses enabled by computer technology and the Internet. This study address this issue using a sample of 37 offender networks. The results show variations in the offending behaviors of those involved in cybercrime. Almost half of the offender networks in this sample appeared to be cybercrime specialists, in that they only performed certain forms of cybercrime. The other half performed various types of crimes on and offline. The relative equity in specialization relative to versatility, particularly in both on and offline activities, suggests that there may be limited value in treating cybercriminals as a distinct offender group. Furthermore, this study calls to question what factors influence an offender's pathway into cybercrime, whether as a specialized or versatile offender. The actors involved in cybercrime networks, whether as specialists or generalists, were enmeshed into broader online offender networks who may have helped recognize and act on opportunities to engage in phishing, malware, and other economic offenses.
ARTIKEL
PURPOSE: The main objective of this study was to determine the relationship between quality of life, social functioning, depressive symptoms, self-efficacy, physical function, and socioeconomic status (SES) in community-dwelling older adults.
METHODS: A cross-sectional design was used to examine the relationships. A sample of 193 community-dwelling older adults completed the measurements. Structural equation modeling with full information maximum likelihood in LISREL was used to evaluate the relationships between the latent variables (SES, social functioning, depressive symptoms, self-efficacy, physical function, and quality of life).
RESULTS: The path analysis exhibited significant effects of SES on physical function, social functioning, depressive symptoms, and self-efficacy (γ = 0.42-0.73), and significant effects in regard to social functioning, depressive symptoms, and self-efficacy on quality of life (γ = 0.27-0.61). There was no direct effect of SES on the quality of life. The model fit indices demonstrated a reasonable fit (χ (2) = 98.3, df = 48, p < 0.001), matching the relative Chi-square criterion and the RMSEA criterion. The model explained 55.5 % of the variance of quality of life.
CONCLUSIONS: The path analysis indicated an indirect effect of SES on the quality of life by social functioning, depressive symptoms, and self-efficacy in community-dwelling older adults. Physical function did not have a direct effect on the quality of life. To improve the quality of life in older adults, additional focus is required on the socioeconomic psychosocial differences in the community-dwelling older population.
ARTIKEL
One in three university students experiences mental health problems during their study. A similar percentage leaves higher education without obtaining the degree for which they enrolled. Research suggests that both mental health problems and academic underperformance could be caused by students lacking control and purpose while they are adjusting to tertiary education. Currently, universities are not designed to cater to all the personal needs and mental health problems of large numbers of students at the start of their studies. Within the literature aimed at preventing mental health problems among students (e.g., anxiety or depression), digital forms of therapy recently have been suggested as potentially scalable solutions to address these problems. Integrative psychological artificial intelligence (AI) in the form of a chatbot, for example, shows great potential as an evidence-based solution. At the same time, within the literature aimed at improving academic performance, the online life-crafting intervention in which students write about values and passions, goals, and goal-attainment plans has shown to improve the academic performance and retention rates of students. Because the life-crafting intervention is delivered through the curriculum and doesn’t bear the stigma that is associated with therapy, it can reach larger populations of students. But life-crafting lacks the means for follow-up or the interactiveness that online AI-guided therapy can offer. In this narrative review, we propose to integrate the current literature on chatbot interventions aimed at the mental health of students with research about a life-crafting intervention that uses an inclusive curriculum-wide approach. When a chatbot asks students to prioritize both academic as well as social and health-related goals and provides personalized follow-up coaching, this can prevent -often interrelated- academic and mental health problems. Right on-time delivery, and personalized follow-up questions enhance the effects of both -originally separated- intervention types. Research on this new combination of interventions should use design principles that increase user-friendliness and monitor the technology acceptance of its participants.
ARTIKEL
Discussions on policy and management initiatives to facilitate individuals throughout working careers take place without sufficient insight into how career paths are changing, how these changes are related to a modernization of life course biographies, and whether this leads to increased labour market transitions. This paper asks how new, flexible labour market patterns can best be analyzed using an empirical, quantitative approach. The data used are from the career module of the Panel Study of Belgian Households (PSBH). This module, completed by almost 4500 respondents consists of retrospective questions tracing lengthy and even entire working life histories. To establish any changes in career patterns over such extended periods of time, we compare two evolving methodologies: Optimal Matching Analysis (OMA) and Latent Class Regression Analysis (LCA). The analyses demonstrate that both methods show promising potential in discerning working life typologies and analyzing sequence trajectories. However, particularities of the methods demonstrate that not all research questions are suitable for each method. The OMA methodology is appropriate when the analysis concentrates on the labour market statuses and is well equipped to make clear and interpretable differentiations if there is relative stability in career paths during the period of observation but not if careers become less stable. Latent Class has the strength of adopting covariates in the clustering allowing for more historically connected types than the other methodology. The clustering is denser and the technique allows for more detailed model fitting controls than OMA. However, when incorporating covariates in a typology, the possibilities of using the typology in later, causal, analyses is somewhat reduced.
ARTIKEL
OBJECTIVE: To examine how a healthy lifestyle is related to life expectancy that is free from major chronic diseases.
DESIGN: Prospective cohort study.
SETTING AND PARTICIPANTS: The Nurses' Health Study (1980-2014; n=73 196) and the Health Professionals Follow-Up Study (1986-2014; n=38 366).
MAIN EXPOSURES: Five low risk lifestyle factors: never smoking, body mass index 18.5-24.9, moderate to vigorous physical activity (≥30 minutes/day), moderate alcohol intake (women: 5-15 g/day; men 5-30 g/day), and a higher diet quality score (upper 40%).
MAIN OUTCOME: Life expectancy free of diabetes, cardiovascular diseases, and cancer.
RESULTS: The life expectancy free of diabetes, cardiovascular diseases, and cancer at age 50 was 23.7 years (95% confidence interval 22.6 to 24.7) for women who adopted no low risk lifestyle factors, in contrast to 34.4 years (33.1 to 35.5) for women who adopted four or five low risk factors. At age 50, the life expectancy free of any of these chronic diseases was 23.5 (22.3 to 24.7) years among men who adopted no low risk lifestyle factors and 31.1 (29.5 to 32.5) years in men who adopted four or five low risk lifestyle factors. For current male smokers who smoked heavily (≥15 cigarettes/day) or obese men and women (body mass index ≥30), their disease-free life expectancies accounted for the lowest proportion (≤75%) of total life expectancy at age 50.
CONCLUSION: Adherence to a healthy lifestyle at mid-life is associated with a longer life expectancy free of major chronic diseases.
ARTIKEL
For this research project I had the opportunity to join home nurses on their rounds for participant observations. Nurses are confronted with older patient’s meaning in life (MiL), or the lack thereof, on a daily basis. However, knowledge about these situations, and education regarding this subject, is largely missing until now. Nurses of a homecare provider in Rotterdam (the Netherlands) realised that they felt incompetent in situations where patient’s MiL came to the front. They had many questions: What could they say? What could they observe? What could they do? Was it right what they did? And, who could help them? The nurses turned to spiritual counsellors of a nursing home, asking them if they could provide support. This PhD project started in practice, like many projects in applied science, with nurses, spiritual counsellors and researchers who wanted to improve practice. In this project two spiritual counsellors provided education to home nurses, in order to make them more sensitive and competent in attuning care to patient’s MiL, which was a novel practice in the Netherlands in 2015. Research was part of the project from the outset. I was the main researcher in a research team and participated in the project group. And so our journey started. The name of my thesis ‘At home with meaning’, not only refers to MiL of older adults ageing in place but also to the aim of the project: the wish that home nurses should feel more at home, more confident, in providing good care when they find themselves confronted with older patients’ MiL.
NIET BEKEND
Daily wheelchair ambulation is seen as a risk factor for shoulder problems, which are prevalent in manual wheelchair users. To examine the long-term effect of shoulder load from daily wheelchair ambulation on shoulder problems, quantification is required in real-life settings. In this study, we describe and validate a comprehensive and unobtrusive methodology to derive clinically relevant wheelchair mobility metrics (WCMMs) from inertial measurement systems (IMUs) placed on the wheelchair frame and wheel in real-life settings. The set of WCMMs includes distance covered by the wheelchair, linear velocity of the wheelchair, number and duration of pushes, number and magnitude of turns and inclination of the wheelchair when on a slope. Data are collected from ten able-bodied participants, trained in wheelchair-related activities, who followed a 40 min course over the campus. The IMU-derived WCMMs are validated against accepted reference methods such as Smartwheel and video analysis. Intraclass correlation (ICC) is applied to test the reliability of the IMU method. IMU-derived push duration appeared to be less comparable with Smartwheel estimates, as it measures the effect of all energy applied to the wheelchair (including thorax and upper extremity movements), whereas the Smartwheel only measures forces and torques applied by the hand at the rim. All other WCMMs can be reliably estimated from real-life IMU data, with small errors and high ICCs, which opens the way to further examine real-life behavior in wheelchair ambulation with respect to shoulder loading. Moreover, WCMMs can be applied to other applications, including health tracking for individual interest or in therapy settings.
ARTIKEL
Breast cancer is the most prevalent form of cancer that affects women worldwide, posing a significant burden on public health. While advancements in early detection and improved treatments have led to a remarkable 90% five-year survival rate and an 83% ten-year survival rate, this has also resulted in more prophylactic mastectomies being performed. Despite advancements in breast-conserving techniques, immunotherapy, and hormone therapy, many women still undergo mastectomies as part of their cancer treatment. In all cases, this results in scarring, and additional side effects from treatment modalities may arise. The loss of a breast can profoundly impact health-related quality of life (HRQoL). Although HRQoL has improved greatly during the recent years, systematic and local therapy having side effects is not uncommon, and this needs more attention.
PROEFSCHRIFT
