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In this chapter, we will offer a new way of analysing the syntax and semantics of the mass/count distinction at the syntax-semantics interface, by synthesising the constructionist framework originating in Borer (2005) with the (lexicalist) `iceberg semantics' proposed in Landman (2011, 2016. We believe that this synthesis has several conceptual and empirical advantages over existing frameworks. It combines the flexibility and morphosyntax-driven nature of constructivism with an explicit role for human conceptual categories such as INDIVIDUAL and SUBSTANCE. It allows us to distinguish between different kinds of mass/count shifts and makes explicit why some of them are harder than others. Furthermore, it clarifies the distinction between stuff-reference, number neutrality and non-countability, three distinct (although interdependent) nominal properties that are often explicitly or implicitly conflated in existing accounts of the mass/count distinction.
Observational studies suggest that hormonal contraceptive use may increase depressive symptoms in women, but it is unclear whether the effect is causal.
To quantitatively examine the evidence from randomised clinical trials for the link between hormonal contraceptive use and depressive symptoms.
We performed a systematic review and network meta-analysis of randomised clinical trials comparing women randomised to any form of a hormonal contraceptive with women randomised to any other form of a (non-)hormonal contraceptive or placebo. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Web of Science, PsycINFO, EMCare and EMBASE, from inception to 1 May 2020. Certainty of the evidence was assessed with the Grading of Recommendations Assessment, Development and Evaluation approach. A random-effect Bayesian network meta-analysis was conducted, with change in depressive symptoms between baseline and three cycles as outcome.
This review identified 3492 records, of which 14 trials were eligible and 12 could be included in the network meta-analysis. These trials included 5833 participants (mean age per study range: 16.8–32.4 years) and compared 10 different interventions. Compared with placebo, hormonal contraceptive use did not cause worsening of depressive symptoms (standardised mean difference: median, −0.04; range, −0.17 [95% credible interval −0.46 to 0.13] to 0.13 [95% credible interval −0.28 to 0.56]).
This study suggests that hormonal contraceptive use does not lead to an increase in depressive symptoms in adult women. Future studies should include first-time users, to confirm the results in young women.
To expedite the use of evidence-based smoking cessation interventions (EBSCIs) in primary care and to thereby increase the number of successful quit attempts, a referral aid was developed. This aid aims to optimize the referral to and use of EBSCIs in primary care and to increase adherence to Dutch guidelines for smoking cessation.
Practice nurses (PNs) will be randomly allocated to an experimental condition or control condition, and will then recruit smoking patients who show a willingness to quit smoking within six months. PNs allocated to the experimental condition will provide smoking cessation guidance in accordance with the referral aid. Patients from both conditions will receive questionnaires at baseline and after six months. Cessation effectiveness will be tested via multilevel logistic regression analyses. Multiple imputations as well as intention to treat analysis will be performed. Intervention appreciation and level of informed decision-making will be compared using analysis of (co)variance. Predictors for appreciation and informed decision-making will be assessed using multiple linear regression analysis and/or structural equation modeling. Finally, a cost-effectiveness study will be conducted.
This paper describes the study design for the development and evaluation of an information and decision tool to support PNs in their guidance of smoking patients and their referral to EBSCIs. The study aims to provide insight into the (cost) effectiveness of an intervention aimed at expediting the use of EBSCIs in primary care.
FFQ assess habitual dietary intake and are relatively inexpensive to process, but may take up to 60 min to complete. This article describes the validation of the Flower-FFQ, which consists of four short FFQ measuring the intake of energy and macronutrients or specific (micro)nutrients/foods that can be merged into one complete daily assessment using predefined algorithms.
Participants completed the Flower-FFQ and validated regular-FFQ (n 401). Urinary N (n 242) and K excretions (n 361) were measured. We evaluated: (1) group-level bias, (2) correlations and (3) cross-classification.
Dutch adults, 54 ± 11 (mean ± SD) years.
Flower-FFQ1, Flower-FFQ2, Flower-FFQ3 and Flower-FFQ4 were completed in ±24, 9, 8 and 9 min (±50 min total), respectively. The regular-FFQ was completed in ±43 min. Mean energy (flower v. regular: 7953 v. 8718 kJ/d) and macronutrient intakes (carbohydrates: 204 v. 222 g/d; protein: 75 v. 76 g/d; fat: 74 v. 83 g/d; ethanol: 8 v. 12 g/d) were comparatively similar. Spearman correlations between Flower-FFQ and regular-FFQ ranged from 0·60 to 0·80 for macronutrients and from 0·40 to 0·80 for micronutrients and foods. For all micronutrients and foods, ≥ 78 % of the participants classified in the same/adjacent quartile. The Flower-FFQ underestimated urinary N and K excretions by 24 and 18 %; 75 and 73 % of the participants ranked in the same/adjacent quartile.
Completing the Flower-FFQ required 50 min with a maximum of 25 min per short FFQ. The Flower-FFQ has a moderate to good ranking ability for most nutrients and foods and performs sufficiently to study diet–disease associations.
Annual resolution sediment layers, known as varves, can provide continuous and high-resolution chronologies of sedimentary sequences. In addition, varve counting is not burdened with the high laboratory costs of geochronological analyses. Despite a more than 100-year history of use, many existing varve counting techniques are time consuming and difficult to reproduce. We present countMYvarves, a varve counting toolbox which uses sliding-window autocorrelation to count the number of repeated patterns in core scans or outcrop photos. The toolbox is used to build an annually-resolved record of sedimentation rates, which are depth-integrated to provide ages. We validate the model with repeated manual counts of a high sedimentation rate lake with biogenic varves (Herd Lake, USA) and a low sedimentation rate glacial lake (Lago Argentino, Argentina). In both cases, countMYvarves is consistent with manual counts and provides additional sedimentation rate data. The toolbox performs multiple simultaneous varve counts, enabling uncertainty to be quantified and propagated into the resulting age-depth model. The toolbox also includes modules to automatically exclude non-varved portions of sediment and interpolate over missing or disrupted sediment. CountMYvarves is open source, runs through a graphical user interface, and is available online for download for use on Windows, macOS or Linux at https://doi.org/10.5281/zenodo.4031811.
Creativity – the ability to generate original productions that are meaningful in their context – is a culturally embedded phenomenon. It may involve a person or a group of people who create. The cultural context in which the creative act occurs (with its physical and social facets) has many levels, ranging from the family, school, and work-organizational settings to local community, regional, national, or transnational ones. Culture, as a social environment, can be defined as “an historically transmitted pattern of meanings visible and tangible in symbols. A system of conceptions is inherited and expressed in symbolic forms. These forms are the means by which men and women (or human beings) communicate, continue their culture, and develop their knowledge about and attitudes toward life” (Geertz, 1973, p. 89). In the GLOBE international research program, House and Javidan (2004, p. 15) defined culture as “shared motives, values, beliefs, identities, and interpretations or meanings of significant events that result from common experiences of members of collectives and are transmitted across age generations.”
Drug use disorder is a major public health problem. Once people who use drugs (PWUD) are referred to treatment, addressing their lifestyle practices and improving their quality of life improves treatment outcomes. The present study assessed the nutritional status and lifestyle practices among PWUD undergoing treatment for recovery in Lebanon. Furthermore, it explored significant differences in these parameters depending on the offered treatment modality, namely opioid substitution treatment (OST) and rehabilitation. In total, 187 PWUD undergoing treatment for recovery participated in this cross-sectional study. Nutritional status and anthropometrics, dietary intake, nutrition knowledge, food addiction, biochemical parameters, sleep and physical activity were measured using validated tools. Of the participants, 88⋅8 % were well nourished based on the Subjective Global Assessment. In total, 67 % gained weight during treatment placing them in the overweight category. This increase in weight was significantly higher in the rehabilitation group. It came in parallel with higher protein and energy intakes, higher rate of food addiction, and poor nutrition knowledge. Biochemical parameters, including fasting blood sugar, total protein, lipid profile and white blood cell count, were in the normal ranges. Moreover, the majority of participants exhibited poor quality sleep that was accentuated among the participants undergoing rehabilitation, in addition to activity levels that were mainly low in the OST group. PWUD undergoing treatment for recovery in Lebanon are subject to various vulnerability factors creating challenges to treatment. Longitudinal assessments to better understand health problems arising during treatment and to identify the components of a comprehensive health promotion intervention during treatment for recovery are needed.
The COVID-19 pandemic is an unparalleled global crisis. Yet, despite the grave adversity faced by citizens, incumbents around the world experienced a boost in popularity during the onset of the outbreak. In this study, we examine how the response to the COVID-19 outbreak in one country affected incumbent support in other countries. Specifically, we leverage the fact that the first country-wide lockdown on European soil, in Italy on 9 March 2020, happened during the fieldwork of surveys conducted in four other European countries, France, Germany, Poland and Spain. This allows us to examine how an event abroad that alerted citizens to an imminent crisis—prior to a similar domestic government response—influenced incumbent support. Our results indicate a crisis signal effect of Italy's COVID-19 lockdown, as support for the incumbent increased domestically in other European countries after the lockdown. Importantly, these findings suggest that incumbents can benefit from a crisis unfolding in other countries, even when their own performance in response to the same crisis is not yet fully clear. They illustrate the importance of developments abroad for incumbent approval and the difficulty facing citizens seeking to disentangle performance signals from exogenous shocks.
International institutions are increasingly being challenged by domestic opposition and nationalist political forces. Yet, levels of politicization differ significantly across countries facing the same international authority as well as within countries over time. This raises the question of when and why the mass public poses a challenge to international cooperation. In this article, we develop a theoretical framework for understanding the nature and implications of politicization of international cooperation, outlining three scope conditions: the nature of public contestation, the activities of political entrepreneurs, and the permissiveness of political opportunity structures. By empirically examining these scope conditions, we demonstrate that politicization can have both stabilizing and destabilizing effects on international cooperation. Highlighting the systemic implications of politicization for international cooperation has important implications for international relations scholarship. Although international organizations may face challenges, they also have ways of being remarkably resilient.
Over the past 15 years, productivity growth in advanced economies has significantly slowed, giving rise to the productivity paradox of the New Digital Economy – that is, the notion of increased business spending on information and communication technology assets and digital services without a noticeable increase in productivity. We argue that time lags are the most important reason for the slow emergence of the productivity effects from digital transformation. This paper provides evidence that underneath the slowing productivity growth rates at the macro level, signs of structural improvements can be detected. In the United States most of the positive contribution to productivity growth is coming from the digital producing sector. The Euro Area and the United Kingdom show larger productivity contributions from the most intensive digital-using sectors, although the United Kingdom also had a fairly large number of less intensive digital-using industries which showed productivity declines. We also find that increases in innovation competencies of the workforce are concentrated in industries showing faster growth in labor productivity, even though more research is needed to identify causality. Finally, we speculate that as the recovery from the COVID-19 recession gets underway the potential for significant productivity gains from digital transformation in the medium term is larger than during the past 15 years.
Providing alcohol screening and brief advice (SBA) in primary health care (PHC) can be an effective measure to reduce alcohol consumption. To aid successful implementation in an upper middle-income country context, this study investigates the perceived appropriateness of the programme and the perceived barriers to its implementation in PHC settings in three Latin American countries: Colombia, Mexico and Peru, as part of larger implementation study (SCALA).
An online survey based on the Tailored Implementation for Chronic Diseases (TICD) implementation framework was disseminated in the three countries to key stakeholders with experience in the topic and/or setting (both health professionals and other roles, for example regional health administrators and national experts). In total, 55 respondents participated (66% response rate). For responses to both appropriateness and barriers questions, frequencies were computed, and country comparisons were made using Chi square and Kruskal–Wallis non-parametric tests.
Alcohol SBA was seen as an appropriate programme to reduce heavy alcohol use in PHC and a range of providers were considered suitable for its delivery, such as general practitioners, nurses, psychologists and social workers. Contextual factors such as patients’ normalised perception of their heavy drinking, lack of on-going support for providers, difficulty of accessing referral services and lenient alcohol control laws were the highest rated barriers. Country differences were found for two barriers: Peruvian respondents rated SBA guidelines as less clear than Mexican (Mann–Whitney U = −18.10, P = 0.001), and more strongly indicated lack of available screening instruments than Colombian (Mann–Whitney U = −12.82, P = 0.035) and Mexican respondents (Mann–Whitney U = −13.56, P = 0.018).
The study shows the need to address contextual factors for successful implementation of SBA in practice. General congruence between the countries suggests that similar approaches can be used to encourage widespread implementation of SBA in all three studied countries, with minor tailoring based on the few country-specific barriers.
This chapter argues that non-discrimination law can and should offer enhanced protection against legal ‘othering’ of foreign nationals in the EU. It starts from the premise that some states offer much better value, in terms of rights, resources, and ultimately life chances, than others. Once this unequal distribution is brought into the picture, it becomes clear that nationality functions as a mechanism of exclusion vis-à-vis nationals of ‘low value’ states (and stateless persons) whose access to rights and resources is limited both in countries of origin and in ‘high value’ states where they are not recognised as (full) members. Relying on recent theories of non-discrimination law that focus on stigmatisation as a root cause of discrimination, this chapter proposes to combine increased scrutiny of nationality as a stigma-carrying attribute with due regard for its legitimate function in maintaining viable political communities.
Depressive and anxiety disorders are highly comorbid, which has been theorized to be due to an underlying internalizing vulnerability. We aimed to identify groups of participants with differing vulnerabilities by examining the course of internalizing psychopathology up to age 45.
We used data from 24158 participants (aged 45+) in 23 population-based cross-sectional World Mental Health Surveys. Internalizing disorders were assessed with the Composite International Diagnostic Interview (CIDI). We applied latent class growth analysis (LCGA) and investigated the characteristics of identified classes using logistic or linear regression.
The best-fitting LCGA solution identified eight classes: a healthy class (81.9%), three childhood-onset classes with mild (3.7%), moderate (2.0%), or severe (1.1%) internalizing comorbidity, two puberty-onset classes with mild (4.0%) or moderate (1.4%) comorbidity, and two adult-onset classes with mild comorbidity (2.7% and 3.2%). The childhood-onset severe class had particularly unfavorable sociodemographic outcomes compared to the healthy class, with increased risks of being never or previously married (OR = 2.2 and 2.0, p < 0.001), not being employed (OR = 3.5, p < 0.001), and having a low/low-average income (OR = 2.2, p < 0.001). Moderate or severe (v. mild) comorbidity was associated with 12-month internalizing disorders (OR = 1.9 and 4.8, p < 0.001), disability (B = 1.1–2.3, p < 0.001), and suicidal ideation (OR = 4.2, p < 0.001 for severe comorbidity only). Adult (v. childhood) onset was associated with lower rates of 12-month internalizing disorders (OR = 0.2, p < 0.001).
We identified eight transdiagnostic trajectories of internalizing psychopathology. Unfavorable outcomes were concentrated in the 1% of participants with childhood onset and severe comorbidity. Early identification of this group may offer opportunities for preventive interventions.
This study determined the gluten content of foods and meals consumed by coeliac disease (CD) patients who adhere to a gluten-free diet, and to estimate the total daily intake of gluten of these patients. CD patients fulfilling defined inclusion criteria were preselected and approached for participation in the study. Duplicate portions (DP) of foods and mixed dishes were collected from the CD patients for evaluating complete daily food intake during two individual days. Also, for these days, written food records were completed by the participants. From each DP, a laboratory sample was prepared and analysed for its gluten concentration and total daily gluten intake was calculated. Each individual’s total daily intakes of energy and macronutrients were calculated using the Dutch food composition database. In total, twenty-seven CD patients participated, seven males and twenty females, aged between 21 and 64 years. In thirty-two (6 %) of 499 food samples collected in total, more than 3 mg/kg gluten was present. In four of these thirty-two samples, the gluten concentration was above the European legal limit of 20 mg/kg and three of the four samples had a gluten-free label. The maximal gluten intake was 3·3 mg gluten/d. The gluten tolerance for sensitive CD patients (>0·75 mg/d) was exceeded on at least six out of fifty-four study days. To also protect these sensitive CD patients, legal thresholds should be re-evaluated and the detection limit of analytical methods for gluten analysis lowered.
This paper aimed to: retrospectively analyse single-centre results in terms of surgical success, respiratory outcomes and adverse events after short-term follow up in obstructive sleep apnoea patients treated with upper airway stimulation; and evaluate the correlation between pre-operative drug-induced sleep endoscopy findings and surgical success.
A retrospective descriptive cohort study was conducted, including a consecutive series of obstructive sleep apnoea patients undergoing implantation of an upper airway stimulation system.
Forty-four patients were included. The total median Apnoea–Hypopnea Index and oxygen desaturation index significantly decreased from 37.6 to 8.3 events per hour (p < 0.001) and from 37.1 to 15.9 events per hour (p < 0.001), respectively. The surgical success rate was 88.6 per cent, and did not significantly differ between patients with or without complete collapse at the retropalatal level (p = 0.784). The most common therapy-related adverse event reported was (temporary) stimulation-related discomfort.
Upper airway stimulation is an effective and safe treatment in obstructive sleep apnoea patients with continuous positive airway pressure intolerance or failure. There was no significant difference in surgical outcome between patients with tongue base collapse with or without complete anteroposterior collapse at the level of the palate.
Recent surveys show a steady increase in infectious syphilis incidence among sexual transmitted infection clinic visitors in many industrialized countries. Untreated, 30% of patients develop symptomatic neurosyphilis, possibly presenting with a variety of behavioral en neurological symptoms. Neurosyphilis is diagnosed on specific abnormalities in cerebrospinal fluid (CSF).
Case reports on neurosyphilis in Dutch patients prompted us to explore the epidemiology of neurosyphilis with psychiatric co morbidity.
To estimate the incidence of neurosyphilis and psychiatric co morbidity in the Netherlands based on data of hospitalizations in general hospitals from 1999-2007.
Hospitalization data were collected from the Dutch National Medical Register. We included all records on hospitalizations with any kind of neurosyphilis, except congenital neurosyphilis, as discharge- or secondary diagnosis (ICD9-code 094 and subcategory codes).
Between 1999 and 2007, 542 cases of neurosyphilis were registered, approximately 60 cases per year. Of all cases, 76% were male. Co-infection with HIV was seen in 74 (14%) of hospitalized cases of whom 91% were male. In 35 (6%) cases one or more concurrent psychiatric disorders were diagnosed, including 10 organic psychiatric disorders, 8 dementia cases, 6 substance abuses, 4 affective disorders, 7 psychotic disorders, 2 personality disorders and 8 miscellaneous diagnoses.
Neurosyphilis is still diagnosed in patients admitted to Dutch general hospitals. Under diagnosis due to unfamiliarity with the recent syphilis surge is possible. Over reporting is also possible due to incorrect diagnosis not based on CSF results. The reemerging syphilis epidemic may result in an increasing neurosyphilis incidence.
This study investigated the association between the religiosity of parents and pre-adolescents, and pre-adolescents’ psychiatric problems.
In a clinic-referred cohort of 543 pre-adolescents at least once referred to a mental health outpatient clinic mental health problems were assessed using self-reports (Youth Self-Report; YSR), parent reports (Child Behavior Checklist; CBCL), and teacher reports (Teacher's Report Form; TRF) of child behavioral and emotional problems. Paternal, maternal, and pre-adolescent religiosity were assessed by self-report. MANCOVAs were performed for internalizing and externalizing problems as dependent variables, with maternal religiosity, paternal religiosity, pre-adolescent religiosity, parental religious harmony, and gender as independent variables, and socioeconomic status and divorce as covariates.
Internalizing problems. Pre-adolescents of actively religious mothers had more internalizing symptoms than pre-adolescents of nonreligious mothers. Harmony and gender did not significantly affect the association between maternal religiosity and internalizing problems. Externalizing problems. No associations between religiosity of pre-adolescents, religiosity of mothers, religiosity of fathers and/or harmony of parents and externalizing problem behavior have been found.
Discussion and conclusions:
Overall, associations between mental health and religiosity were modest to absent. Results are discussed in the context of a clinic-referred cohort, the quest phase of internalizing religious beliefs and role modeling of parents.
Research concerning the psychometric properties of the WHO Quality of Life Assessment Instrument (WHOQOL-100) in general populations of psychiatric outpatients has not been performed systematically.
To examine the content validity, construct validity, and reliability of the WHOQOL-100 in a general population of Dutch adult psychiatric outpatients.
A total of 533 psychiatric outpatients entered the study (438 randomly selected, 85 internally referred). Participants completed self-administered questionnaires for measuring quality of life (WHOQOL-100), psychopathological symptoms (SCL-90), and perceived social support (PSSS). In addition, they underwent two semi-structured interviews in order to obtain Axis-I and Axis-II diagnoses, according to DSM-IV.
The drop-out percentage was low (7.1%). Of the 24 facets of the WHOQOL-100, 22 had a good distribution of scores, leaving out the facets physical environment and transport. Exploratory factor analysis revealed a four-factor structure, which was similar to earlier findings in patients with specific somatic diseases and depressive disorders. Various—a priori expected—positive and negative correlations were found between facets and domains of the WHOQOL-100, and dimensions of the SCL-90 and the PSSS-score, indicating good construct validity of the WHOQOL-100. The internal consistency of all facets and the four domains of the WHOQOL-100 was good (Cronbach’s alpha’s ranging from 0.62 to 0.93 and 0.64 to 0.84, respectively). Sparse and relatively low correlations were found between demographic characteristics (age and sex) and WHOQOL-100 scores.
Content validity, construct validity, and reliability of the WHOQOL-100 in a population of adult Dutch psychiatric outpatients are good. The WHOQOL-100 appears to be a suitable instrument for measuring quality of life in adult psychiatric outpatients.