This dissertation is a call to place the health of adults with autistic traits and autism-caregivers higher on the agenda of clinicians, researchers, policymakers, and autistic adults and autism... Show moreThis dissertation is a call to place the health of adults with autistic traits and autism-caregivers higher on the agenda of clinicians, researchers, policymakers, and autistic adults and autism-caregivers themselves. Primarily, clinicians should be educated about the increased health risks in autistic adults and autism-caregivers, in order to be able to prevent or recognize these comorbidities timely. This is relevant because of the higher prevalence of both metabolic syndrome and gastrointestinal symptoms in adults from the general population with higher levels of autistic traits, as shown in this dissertation. The associations we found between biopsychosocial factors and respectively metabolic syndrome and gastrointestinal symptoms ask for more psychiatric and somatic integrated care for autistic adults. Future research could use the associations we found between the biopsychosocial model and autistic traits to develop preventive interventions specifically targeted for adults with autism (or higher levels of autistic traits). To make sure future preventive measures and the treatment of physical health problems are effective for this target population to improve their health, barriers in the healthcare for autistic people should be reduced. Therefore, this dissertation also offers recommendations for improvement of primary care, the gatekeeper of adequate healthcare for autistic adults. Show less
Background Pregnancy is often associated with a change in health behaviors, leading some to suggest that pregnancy could be a teachable moment for lifestyle change. However, the prevalence and... Show moreBackground Pregnancy is often associated with a change in health behaviors, leading some to suggest that pregnancy could be a teachable moment for lifestyle change. However, the prevalence and underlying mechanism of this phenomenon is not well understood. The aim of this study is to explore the prevalence of a teachable moment during pregnancy, the psychosocial factors that are associated with experiencing such a moment, and its association with actual health behaviors. Methods In this cross-sectional study, 343 pregnant Dutch women completed an online questionnaire. Participants reported on their intentions to change lifestyle due to pregnancy, their current health behaviors, and several psychosocial factors that were assumed to be linked to perceiving a teachable moment during pregnancy: perceived risk, affective impact, changed self-concept, and social support. Multivariable linear and logistic regression were applied to the data analysis. Results Results demonstrate that 56% of the women experienced a teachable moment based on intentions to change their health behavior. Multivariate regression analyses revealed that changed self-concept (β=0.21; CI=0.11– 0.31), positive affect (positive β=0.28; CI=0.21–0.48), and negative affect (β=0.12; CI=0.00-0.15) were associated with higher intentions to change health behavior. Conversely, more perceived risk was associated with lower intentions to change health behavior (β=-0.29; CI=0.31−0.13). Multivariate regression analyses showed a positive association between intentions to change health behavior and diet quality (β=0.11; CI=0.82–1.64) and physical activity (OR=2.88; CI=1.66-5.00). Conclusions This study suggests that pregnancy may be experienced as a teachable moment, therefore providing an important window of opportunity for healthcare professionals to efficiently improve health behaviors and health in pregnant women and their children. Results suggest that healthcare professionals should link communication about pregnancy-related health behaviors to a pregnant women’s change in identity, affective impact (predominantly positive affective impact) and risk perception to stimulate the motivation to change healthy behavior positively. Show less
This special issue of the Frontiers Report focuses on the potential environmental, health, social and animal welfare implications of the uptake of novel meat and dairy alternatives, in particular... Show moreThis special issue of the Frontiers Report focuses on the potential environmental, health, social and animal welfare implications of the uptake of novel meat and dairy alternatives, in particular novel plant-based, fermentation-derived and cultivated products. A team of interdisciplinary experts has assessed the available evidence on the impacts of these alternatives in comparison with their conventional counterparts, identifying pertinent considerations for policymakers involved in regulating, investing in or providing other support for novel meat and dairy products and highlighting research gaps. Show less
Aim: This paper aims to better understand the relationship between homicide and other public health outcomes, by studying their trends over time.Subject and Methods: Research in both criminology... Show moreAim: This paper aims to better understand the relationship between homicide and other public health outcomes, by studying their trends over time.Subject and Methods: Research in both criminology and public health has long identified that crime and violence tend to cluster together with adverse phenomena in the social and the health domain. However, such work has relied primarily on cross-sectional analyses. Here, we instead study trends over time. We take data from the Netherlands, between 2000 and 2020, and ask whether homicide shows similar trends over time as other public health phenomena – such as smoking behaviour, alcohol use, child mortality, adolescent pregnancies and suicide.Results: We observe, first, that all of the phenomena – with the exception of suicide – declined over the period under study. We then employ a time series analysis to examine whether these trends arise independently, or whether they are the result of structural similarities between phenomena. Results showed that the decline in homicide rates is linked to a similar decline in adolescent pregnancies – the rates of these phenomena “move together” during the period under study.Conclusion: This work shows that the phenomenon of homicide shares structural similarities with teenage pregnancies – a decline in one is linked to a similar decline in the other. More generally, the current work furthers our understanding of the place of homicide in the domain of (public) health. Show less
Heteren, F. van; Raaphorst, N.; Groeneveld, S.; Bussemaker, J. 2023
Background: The care of clients with complex psychosocial problems involves diverse frontline professionals such as general practitioners, psychiatric nurses, police officers, social support... Show moreBackground: The care of clients with complex psychosocial problems involves diverse frontline professionals such as general practitioners, psychiatric nurses, police officers, social support consultants and debt counselors. As these professionals have different professional backgrounds and work in different organizations, their health conceptions, or beliefs about what constitutes health and how this should be pursued, may also differ. Having an understanding of various frontline professionals' health conceptions is relevant, as these may affect interprofessional collaboration in their work with clients with psychosocial problems. Objective: To understand various frontline professionals' health conceptions. Design: Inductive qualitative approach. Setting: The Hague, the Netherlands. Participants: Various frontline professionals from social welfare, general healthcare and mental healthcare, working with clients with complex psychosocial problems. Methods: Between September 2020 and April 2021, 23 in-depth semi-structured interviews were conducted with frontline professionals in social welfare, general healthcare and mental healthcare. Based on these interviews, this paper analyzes frontline professionals' health conceptions. After transcription, all interviews were imported into ATLAS.ti for analysis. An iterative process of thematic analysis was used to identify health conception dimensions. Results: The paper found that frontline professionals' health conceptions differ in three main aspects: 1) health definitions, 2) alignment with clients and 3) contextualization of clients' health. Conclusions: The main implication of this research is that this inductive analysis of health conceptions provides a first building block in theorizing frontline professionals' health promotion practices. Tweetable abstract: Knowing about professional's health conceptions gives insight into how health is understood and how good health can best be achieved, which is important in caring for vulnerable clients. Show less
Political scientists have studied extensively the gap between winners and losers of democratic elections with regard to satisfaction with democracy. We ask whether the winner–loser gap extends... Show morePolitical scientists have studied extensively the gap between winners and losers of democratic elections with regard to satisfaction with democracy. We ask whether the winner–loser gap extends beyond the political domain to subjective health and well-being as well. Building on insights from biology and coalitional psychology, we hypothesize that winning and losing elections could affect one’s outlook on life, happiness, and subjective health. We comprehensively test these theoretical propositions with cross-sectional data from the 2012 and 2018 waves of the European Social Survey. We document significant gaps between winners and losers with respect to measures of subjective personal well-being. To further probe the causal nature of these winner–loser effects, we trace changes in well-being following election wins and losses using a panel dataset from the Netherlands, where we find weaker supportive evidence. Overall, our results suggest that winning and losing democratic elections can have much wider-reaching consequences than previously recognized. Show less
Hof, S. van der; Hilten, S.R. van; Ouburg, S.L.; Birk, M.V.; Rooij, A.J. van 2022
Gaming is an important pastime for young people to relax, socialize and have fun, but also to be challenged, show creativity and work together to achieve goals. The design of games can have an... Show moreGaming is an important pastime for young people to relax, socialize and have fun, but also to be challenged, show creativity and work together to achieve goals. The design of games can have an impact on their behavior. With the changing revenue models of games, we see that game design is increasingly taking forms that do not always have a positive impact on children and may interfere with, or even violate, children's rights. This article examines how evolving revenue models of games impact user's behavior via game design. Behavioral design in games thus raises questions about children's rights to play and recreation, to health, to protection from economic exploitation and to data protection. Show less
Goijaerts, J.; Zwan, N. van der; Bussemaker, J. 2022
This paper calls on social policy scholars to approach health differently in their research. Our goal is to bring core insights from social epidemiology into conversation with welfare state and... Show moreThis paper calls on social policy scholars to approach health differently in their research. Our goal is to bring core insights from social epidemiology into conversation with welfare state and social policy research. We argue that the social investment framework has the most potential for this integration. The objective of social investment policies is to keep modern welfare states sustainable through high employment and strong human capital. This requires not only a large and well-educated workforce, but also a healthy one. Specifically, we encourage social policy scholars to engage with the social determinants of health literature by studying health not as outcome of the healthcare sector but of the welfare state as a whole. We argue that the social investment framework facilitates these endeavours and we offer suggestions for future research. Health should not just be seen as an outcome of specific policies, but rather as input for a sustainable welfare state. Show less
This paper examines the development of Nietzsche’s thought on pessimism in the light of his own reflections. Drawing on GT, the late prefaces he wrote around 1886 (GT, MA, M, FW), the fifth book of... Show moreThis paper examines the development of Nietzsche’s thought on pessimism in the light of his own reflections. Drawing on GT, the late prefaces he wrote around 1886 (GT, MA, M, FW), the fifth book of FW, and unpublished notes, it reconstructs the several meanings that Nietzsche attributes to ‘pessimism’. It focuses on the complex relation between ‘romantic’ and ‘Dionysian’ pessimism. It is shown that these two forms of pessimism are rooted in Nietzsche’s ambivalent metaphysical pessimism in GT, which is influenced by Schopenhauer and the tragic Greeks. This approach is distinguished from the later Nietzsche who attempts to redefine his struggle with pessimism in order to ‘forget’ the metaphysical background, and to understand pessimism as a symptom of historical and psychological conditions. Nietzsche consequently understands his own thought as a continuation of Schopenhauer’s critique of the Christian worldview, which leads to the problem of nihilism. Nietzsche attempts to show how it is possible to overcome romantic pessimism and European morality, if he also suffers the consequences of nihilism. In order to tackle this problem, Nietzsche formulates a dynamic of self-overcoming which needs both strength and weakness, health and sickness. Show less
Background and Objectives: In this study, we examine the experience of aging and subjective views of what it means to age well among older adults with a migrant background in the Netherlands. We... Show moreBackground and Objectives: In this study, we examine the experience of aging and subjective views of what it means to age well among older adults with a migrant background in the Netherlands. We embed the study within the successful aging debate and tackle two of its most persistent critiques: the failure to adequately include subjective views in the definition of aging well and the failure to recognize that the process of aging is culturally determined.Research Design and Methods: The research draws on qualitative data collected through eight focus-group discussions with the six largest migrant groups in the Netherlands, namely Indo-Dutch and Moluccans, and migrants with Western, Surinamese, Antillean, Turkish, and Moroccan background.Results: The study findings show that in general older migrants experience aging more positively than commonly assumed. Nevertheless, some negative aspects of aging were also mentioned. These together with fears about the future underpin participants' perceptions about aging well. Key aspects of successful aging include remaining healthy, independent, and engaged. Differences between and within groups exist in the meaning given to these concepts and the extent to which other specific aging-related wishes were mentioned. These differences are rooted in participants' experiences of the migration event, employment history, and their current socioeconomic conditions.Discussion and Implications: We conclude that the life course perspective is essential in understanding migrants' aging process and their views on successful aging, and suggest that policies and interventions which promote disease prevention and tackle social exclusion will be beneficial for older adults with a migration background. Show less
Smits J., Permanyer I., Wildeman J., Dietz A.J. 2020
Research on the psychological and physiological stress-responses have been unable to fully clarify the underlying relationship. The unconscious stress hypothesis proposes that stress-related... Show moreResearch on the psychological and physiological stress-responses have been unable to fully clarify the underlying relationship. The unconscious stress hypothesis proposes that stress-related processes outside of awareness may negatively affect cardiovascular (CV) health by activating and even prolonging physiological stress-responses. This thesis provides a starting point in the exploration of the role of processes outside of awareness in cardiovascular stress research. The eight chapters discuss the findings of a systematic review and a series of experiments, using subliminal priming paradigms and fear conditioning, and address various theoretical and methodological issues to benefit future studies in this area. It seems evident that what is outside of awareness may influence the physiological state, but not necessarily all health-relevant parameters. The physiological changes related to unconscious stress appears to differ between the various stressful stimuli and stressors used. Show less
With this thesis the PhD-candidate aims to enrich the body of evidence concerning the relation between stress and health, and the mediating role of (un)conscious perseverative cognitions (which is... Show moreWith this thesis the PhD-candidate aims to enrich the body of evidence concerning the relation between stress and health, and the mediating role of (un)conscious perseverative cognitions (which is captured in the extended perseverative cognition hypothesis). The main aim of this thesis was to find direct evidence for the extended PC hypothesis in real life. She examined whether reducing (un)conscious perseverative cognitions, or worry, improved stress-related physiological activity and subjective health complaints. Show less
Eikendal, A.L.M.; Ruijter, H.M. den; Haaring, C.; Saam, T.; Geest, R.J. van der; Westenberg, J.J.M.; ... ; Leiner, T. 2018
Many hunter-gatherer groups live on the outskirts of wider society, experiencing poor health outcomes with little access to medical care. From a development perspective, key interventions include... Show moreMany hunter-gatherer groups live on the outskirts of wider society, experiencing poor health outcomes with little access to medical care. From a development perspective, key interventions include the sedentarisation of these mobile peoples into camps nearby larger towns with sanitation infrastructure and medical care, as increased access to services is assumed to improve outcomes. However, recent research in the Agta (Philippine foragers from North-east Luzon) has demonstrated that individuals residing in more ‘developed’ communities suffer from increased morbidity and mortality. Here, using quantitative and ethnographic data on health collected between 2002 and 2014, we explore why this trend occurs by examining the relationship between key development initiatives with self-reported illness and the uptake of medical interventions with 415 Agta men, women and children. We demonstrate that health outcomes worsen as sedentarisation progresses, despite some increases in medical access. We argue this is because the development paradigm is not evidence-based, but rather stems from an ideological dislike of mobile hunter-gatherer lifestyles. Compounded by cultural insensitivity and daily discrimination, current interventions are ill-suited to the unique needs of hunter-gatherers, and thus ineffective. Based on our findings we offer future short and long-term policy suggestions which seek to reduce the Agta's vulnerability, rather than increase it. Show less
