While cyberspace as a globally interconnected network offers economic, social and informational potential, at the same time this space also produces a wide variety of risks, for which no easy... Show moreWhile cyberspace as a globally interconnected network offers economic, social and informational potential, at the same time this space also produces a wide variety of risks, for which no easy solutions exist. For the international community, for nation states, for organizations and even for individuals, uncertainty is a common thread for interaction, communication and the general use of (systems connected to) cyberspace. This research shows that there are five different common reactions to dealing with this uncertainty in cyberspace: (1) using risk management to control uncertainty; (2) recovering from uncertainty through resilience; (3) influencing uncertainty with laws and regulation; suspending uncertainty by engaging in trust; and (5) ignoring uncertainty through inaction. Some of these approaches are used more often than others. For instance, risk management is currently the dominant way of responding to uncertainty in cyberspace, with resilience gaining prominence. Other strategies, such as relying on trust or inaction, are less common. Oftentimes, using a mixture of strategies may be helpful, because some strategies may strengthen one another, for instance when a combination of risk management and resilience approaches is used. Each strategy has particular use for specific contexts, but since we lack an overview of which strategies are being used, we also cannot establish under which conditions which strategy is most beneficial. Solving this lack of knowledge can help us be more effective in dealing with uncertainties of a wide variety in cyberspace. Show less
Weenink, J.W.; Tresfon, J.; Voort, I. van de; Muijden, T. van; Hamming, J.; Bal, R. 2023
BackgroundCentral to Safety-II is promoting resilience of healthcare practices. In the "Room for Resilience" research project we focus on the role of horizontal and vertical accountability in... Show moreBackgroundCentral to Safety-II is promoting resilience of healthcare practices. In the "Room for Resilience" research project we focus on the role of horizontal and vertical accountability in healthcare teams and aim to discover how the relation between the two impacts team reflections and discussions. In this article, we report on an explorative study at the start of the project which aimed to assess the structures and dynamics of horizontal and vertical accountability.MethodsA qualitative study in six teams in three hospitals in the Netherlands. For the project, each team selected a specific clinical process to work on (e.g. pain assessment). We interviewed healthcare professionals, managers, and quality advisors about these processes, how they are discussed in practice and how teams need to account for them. Additionally, we observed the processes and how teams discuss them in practice. In total, we conducted 35 interviews and 67.5 h of observation. Transcripts and field notes were analyzed using thematic analysis.ResultsProfessionals at times varied in what they considered the right approach in the clinical process, with differing views on the importance of certain actions. When processes were discussed, this mostly was done during clinical work, and it often concerned reflections about the care for a specific patient instead of reflecting on the team's general approach of the clinical process. Organized reflections on the processes were sparse. How processes were conducted in practice deviated from guidelines, mainly due to staff shortages, a perceived lack of value of a guideline, equipment issues, and collaboration issues. For most processes, accountability to hierarchical layers consisted of quality indicator scores. Professionals were tasked with registering indicator data but did not find this meaningful for their work.ConclusionsThe observed different perspectives within teams on what good quality care is show the importance of having team reflections about these processes. How vertical accountability was organized at times impacted the conditions for teams to discuss resilient performance. Following these findings, we recommend that reflection on resilient practice and the role of accountability processes is organized on all levels in (and outside) the organization. Show less
The overall aim of this dissertation was to study the contribution of a syndemics framework to understanding and addressing persistent health disparities. Departing from an interdisciplinary... Show moreThe overall aim of this dissertation was to study the contribution of a syndemics framework to understanding and addressing persistent health disparities. Departing from an interdisciplinary approach, the dissertation attends to research questions on syndemics indicators, contextual drivers for syndemics, the intergenerational nature of syndemics, and possibilities for early public health interventions in Katwijk, a former fishing town in the Netherlands. An epidemiological study described the three most prevalent disease clusters in Katwijk. A qualitative life course study found a first indication that syndemic vulnerability is potentially intergenerational, and that syndemic processes can be countered. A mixed method study showed that while challenging, a family-engagement approach can elicit positive effects on families’ health and wellbeing. The ethnographic study described the hurdles for implementing family-focused health promotion for multifaceted health conditions, such as childhood obesity. This dissertation establishes that the syndemics framework provides tools to identify past and present factors on the complex pathways to persistent poor health, which in turn point at directions for breaking patterns of generational health. The findings highlight a need for multisystem approaches in which stakeholders develop a thorough understanding of a community’s history and past legacies with institutions, and professionals are equipped with the necessary knowledge, attitudes and skills for community-based and family-focused interventions. Show less
Daskalakis, N.P.; Meijer, O.C.; Kloet, E.R. de 2022
'You can't roll the clock back and reverse the effects of experiences' Bruce McEwen used to say when explaining how allostasis labels the adaptive process. Here we will for once roll the clock back... Show more'You can't roll the clock back and reverse the effects of experiences' Bruce McEwen used to say when explaining how allostasis labels the adaptive process. Here we will for once roll the clock back to the times that the science of the glucocorticoid hormone was honored with a Nobel prize and highlight the discovery of their receptors in the hippocampus as inroad to its current status as master regulator in control of stress coping and adaptation. Glucocorticoids operate in concert with numerous neurotransmitters, neuropeptides, and other hormones with the aim to facilitate processing of information in the neurocircuitry of stress, from anticipation and perception of a novel experience to behavioral adaptation and memory storage. This action, exerted by the glucocorticoids, is guided by two complementary receptor systems, mineralocorticoid receptors (MR) and glucocorticoid receptors (GR), that need to be balanced for a healthy stress response pattern. Here we discuss the cellular, neuroendocrine, and behavioral studies underlying the MR:GR balance concept, highlight the relevance of hypothalamic pituitary-adrenal (HPA)-axis patterns and note the limited understanding yet of sexual dimorphism in glucocorticoid actions. We conclude with the prospect that (i) genetically and epigenetically regulated receptor variants dictate cell-type-specific transcriptome signatures of stress-related neuropsychiatric symptoms and (ii) selective receptor modulators are becoming available for more targeted treatment. These two new developments to 'restart the clock' with the to resilience. Show less
This qualitative case study uses a life-course approach to explore syndemic vulnerability in a former fishing village in the Netherlands. Building on four years of fieldwork in a low-income... Show moreThis qualitative case study uses a life-course approach to explore syndemic vulnerability in a former fishing village in the Netherlands. Building on four years of fieldwork in a low-income neighborhood, we explored salient themes between and across families and generations. Elderly community members (> 65 years) were interviewed to map village history and explore how contextual factors have affected family life, health, and wellbeing since the 1940s. We systematically traced and compared processes leading to or from syndemic vulnerability by studying seven families across three generations. Adults with at least one of clustering diseases, their parents (when possible), and their children participated in semi-structured life-course interviews. A complex interaction of endemic social conditions, sociocultural normative processes, learned health be-haviors, and disheartening life events shaped families' predispositions for a syndemic of psychological distress, cardiometabolic conditions, and musculoskeletal pain. Educational attainment, continued social support, and aspirational capabilities emerged as themes related to decreasing syndemic vulnerability. This study demonstrates that syndemic vulnerability is potentially intergenerational and reveals the need for culturally sensitive and family-focused syndemic interventions. Future longitudinal research should focus on unravelling the pathogenesis of the clustering of psychological distress, cardiometabolic conditions, and musculoskeletal pain among young people. Show less
‘Resilience’ is trending in development theory and practice, where it is often measured using countable socio-economic outcomes. This paper draws on ethnographic research with South Sudanese Zande... Show more‘Resilience’ is trending in development theory and practice, where it is often measured using countable socio-economic outcomes. This paper draws on ethnographic research with South Sudanese Zande refugees in Kiryandongo Refugee Settlement, Uganda, to show a different and often overlooked perspective; that of elderly refugee women. Having lived through decades of war and displacement, these women have developed a rich body of knowledge about suffering, coping, and resilience. Mixing idioms, folktales, and anecdotes, they teach youth not to focus on outcomes or ‘big dreams’, but on a stoic acceptance of loss and perpetual precarity. They advise actions like farming, childcare, and faith. Even so, suffering and coping are socially conditioned and policed, and the intimate circle harbours both protection and dangers, like witchcraft. The women’s accounts contrast bleakly with up-beat neoliberal developmentalism which sees cash-infused ‘resilience’ as the key to refugees’ self-reliant futures. Show less
Singhvi, A.; Luijendijk, A.P.; Oudenhoven, A.P.E. van 2022
In the face of uncertainties around coastal management and climate change, coastal engineering interventions need to be able to adapt to changing conditions. Nature-based solutions and other non... Show moreIn the face of uncertainties around coastal management and climate change, coastal engineering interventions need to be able to adapt to changing conditions. Nature-based solutions and other non-traditional, integrated interventions are gaining traction. However, system-based views are not yet embedded into coastal management strategies. Moreover, the differences in coastal interventions, ranging from hard (‘grey’) to nature-based (‘green’) infrastructure remain understudied. In coastal management it is therefore challenging to work with the grey-green spectrum of interventions with clarity and focus, and to produce results that can be evaluated. The objective of this paper was to examine whether there is a common understanding of: the characteristics and differences between grey and green infrastructure, where interventions sit on this spectrum, and the resilience of grey versus green infrastructure. We conducted an integrative literature review of the grey-green spectrum of coastal infrastructure. We examined 105 coastal protection case studies and expanded the double-insurance framework to ensure an integrative approach, looking at both external and internal factors of resilience. Our review showed that external factors are typically used to characterise the grey-green spectrum. However, although useful, they do not facilitate a holistic comparison of alternative interventions. The additional consideration of internal factors (response diversity, multifunctionality, modularity and adaptive, participatory governance) bridges this gap. The review showed that dikes, reefs, saltmarshes, sand nourishment and dunes span a wider segment of the grey-green spectrum than they are generally categorised in. Furthermore, resilient solutions for adaptation are unlikely to be exclusively engineered or natural, but tend to be a mix of the two at different spatial scales (micro, meso, macro and mega). Our review therefore suggests that coastal planners benefit from a more diverse range of options when they consider the incorporation of grey and green interventions in the context of each spatial scale. We propose that internal resilience should be accounted for when infrastructure options are comparatively evaluated. This consideration brings attention to the ways in which the grey-hybrid-green spectrum of infrastructure enhances value for people. Show less
Strengthening the societal position of at-risk youth is challenging though necessary in order to create better opportunities for them to participate in society. Work is an important means to that... Show moreStrengthening the societal position of at-risk youth is challenging though necessary in order to create better opportunities for them to participate in society. Work is an important means to that end, enabling young people to live independently. Work also plays a role in the psychological need to express your vocational identity: who you are as a worker. Having a vocational identity means that you are aware of your capabilities, ambitions and values concerning work. A strong vocational identity helps to make choices and acts as a guide throughout working life. At-risk youth have vulnerable school careers and are at risk of dropping out. They attend programs at a low educational level and are at greater risk of unemployment. A strong vocational identity may counterbalance these risks as it can ensure these young people to learn about the work they could and want to do, and can provide for better work prospects. Special curricula and social programs for at-risk youth seek approaches to fostering vocational identity. This dissertation focuses on the relationships between individual characteristics of at-risk youth and their vocational identity, concentrates on the possible contribution of malleable characteristics, and provides insights into the treatment by mentors during individual mentoring. Show less
Keijzer, R.; Rijst, R.M. van der; Schooten, E. van; Admiraal, W.F. 2021
The way at-risk students see themselves as workers, their vocational identity, is important for their career development. Special programs for heterogeneous groups of at-risk students in the... Show moreThe way at-risk students see themselves as workers, their vocational identity, is important for their career development. Special programs for heterogeneous groups of at-risk students in the Netherlands aim to foster students’ vocational identity and their task may be eased by stimulating resilience. Therefore this cross-sectional study explored whether differences in at-risk students’ individual characteristics moderate the relationship between their resilience and vocational identity. In general, resilient students often have strong vocational identities compared to less resilient students. However, the strength of the relationships vary with varying personal characteristics. Results enable educational programs to attune to at-risk students with the strongest relationships between resilience and vocational identity: males, younger subgroups, and those experiencing less motivation and low school engagement. Show less
Western Europe has been confronted with several terrorist attacks over the past years. This dissertation investigates what happens after such attacks. Scholars emphasise that terrorism is not just... Show moreWestern Europe has been confronted with several terrorist attacks over the past years. This dissertation investigates what happens after such attacks. Scholars emphasise that terrorism is not just about killing, as terrorists want to capture the attention of the audience. Yet, what these audiences do after attacks has remained understudied. This dissertation looks into the meaning-making process after jihadist attacks in Brussels, Nice, Berlin and Manchester (2016-2017). The study focuses on two core actors groups - the authorities and citizens - and the use of frames, rituals and symbols. Special attention is paid to the first day, the first week and the first anniversary of the attack, for which the author has visited the commemorations. Overall, this dissertation shows how terrorism is not a successful communication strategy. After performing the opening acts, the terrorists are quickly pushed off stage, doomed to stand behind the curtains and watch a different play unfold. Show less
Murphy, M.; Hernandez-Duran, S.; Kim, E.; Al-Shehhi, N.; Broekman, M.; Praeter, M. de; ... ; Rosseau, G. 2021
A collaborative global working group of women neurosurgeons in multiple countries at different stages of their neurosurgical careers undertook the task of researching the history of European women... Show moreA collaborative global working group of women neurosurgeons in multiple countries at different stages of their neurosurgical careers undertook the task of researching the history of European women in neurosurgery. While doing so, we happened upon many remarkable female neurosurgeons who overcame great adversity, made tremendous contributions to society and institutional neurosurgery, and displayed numerous talents beyond the operating room. In the first part of this paper, we recounted a chronology of female neurosurgeons in Europe, highlighting the most remarkable achievements of women in every decade, from the 1920 & rsquo;s to 2020. In this paper, we honor fascinating women in European neurosurgery, both historical characters and living legends. These women have overcome great adversity and have also excelled in a huge variety of pursuits. While some were themselves refugees, we also have uncovered noteworthy examples of women who immersed themselves in humanitarian missions and who tried to better the world through political action. There are stories of women beating the odds, taking on biased institutions and proving their worth, in spite of the prevailing system. Most inspirational, we have discovered through our comprehensive research on the history of women in European neurosurgery that the future is increasingly female.CO 2021 Elsevier Ltd. All rights reserved. Show less
Keijzer, R.; Rijst, R.M. van der; van Schooten, E.; Admiraal, W.F. 2021
The way at-risk students see themselves as workers, their vocational identity, is important for their career development. Special programs for heterogeneous groups of at-risk students in the... Show moreThe way at-risk students see themselves as workers, their vocational identity, is important for their career development. Special programs for heterogeneous groups of at-risk students in the Netherlands aim to foster students' vocational identity and their task may be eased by stimulating resilience. Therefore this cross-sectional study explored whether differences in at-risk students' individual characteristics moderate the relationship between their resilience and vocational identity. In general, resilient students often have strong vocational identities compared to less resilient students. However, the strength of the relationships vary with varying personal characteristics. Results enable educational programs to attune to at-risk students with the strongest relationships between resilience and vocational identity: males, younger subgroups, and those experiencing less motivation and low school engagement. Show less
When disaster strikes, urban planners often rely on feedback and guidance from committees of officials, residents, and interest groups when crafting reconstruction policy. Focusing on recovery... Show moreWhen disaster strikes, urban planners often rely on feedback and guidance from committees of officials, residents, and interest groups when crafting reconstruction policy. Focusing on recovery planning committees after Japan's 2011 earthquake, tsunami, and nuclear disasters, we compile and analyze a dataset on committee membership patterns across 39 committees with 657 members. Using descriptive statistics and social network analysis, we examine 1) how community representation through membership varied among committees, and 2) in what ways did committees share members, interlinking members from certain interests groups. This study finds that community representation varies considerably among committees, negatively related to the prevalence of experts, bureaucrats, and business interests. Committee membership overlap occurred heavily along geographic boundaries, bridged by engineers and government officials. Engineers and government bureaucrats also tend to be connected to more members of the committee network than community representatives, giving them prized positions to disseminate ideas about best practices in recovery. This study underscores the importance of diversity and community representation in disaster recovery planning to facilitate equal participation, information access, and policy implementation across communities. Show less
Vinkers, C.H.; Amelsvoort, T. van; Bisson, J.I.; Branchi, I.; Cryan, J.F.; Domschke, K.; ... ; Wee, N.J.A. van der 2020
The epidemic of the 2019 novel coronavirus SARS-CoV-2, causing the coronavirus disease 2019 (COVID-19) is a global public health emergency with multifaceted severe consequences for people's lives... Show moreThe epidemic of the 2019 novel coronavirus SARS-CoV-2, causing the coronavirus disease 2019 (COVID-19) is a global public health emergency with multifaceted severe consequences for people's lives and their mental health. In this article, as members of the European College of Neuropsychopharmacology (ECNP) Resilience, we will discuss the urgent need for a focus on resilience during the current coronavirus pandemic. Resilience is pivotal to cope with stress and vital to stay in balance. We will discuss the importance of resilience at the individual and societal level, but also the implication for patients with a psychiatric condition and health care workers. We not only advocate for an increased focus on mental health during the coronavirus pandemic but also highlight the urgent need of augmenting our focus on resilience and on strategies to enhance it. (C) 2020 The Authors. Published by Elsevier B.V. Show less
The human body is inherently designed to be able to adapt to challenging situations. However, some experiences are so severe that they can lead to substantial and longerlasting disturbances in an... Show moreThe human body is inherently designed to be able to adapt to challenging situations. However, some experiences are so severe that they can lead to substantial and longerlasting disturbances in an individuals’ behavioral, psychological and physiological functioning. Importantly, there is a degree of inter-individual variation, as not all individuals show similar reactions to severe stress. Neuroimaging techniques can help to unravel the brain characteristics related to vulnerability and resilience to severe stress. In the research for this dissertation several neuroimaging modalities were used to further explore the brain characteristics related to (dys)function after exposure to severe stress and after exposure to hypercortisolism, such as voxel-based morphometry and diffusion tensor imaging to study the structure of gray and white matter in the brain, and resting-state fMRI to study functional connectivity patterns. We studied brain characteristics in several groups consisting of: patients in long-term remission of Cushing’s disease, and individuals with a history of childhood emotional maltreatment to examine the effects of hypercortisolism and severe stress on the brain. In addition, we studied a group of police officers and a group of individuals with a history of childhood maltreatment to investigate the brain characteristics related to resilience to stress. Show less
This dissertation is the culmination of over four years research on the rare earth element neodymium in the context of the 2010 REE crisis. Neodymium is a generally recognized ‘critical’... Show more This dissertation is the culmination of over four years research on the rare earth element neodymium in the context of the 2010 REE crisis. Neodymium is a generally recognized ‘critical’ material with a relevant application in the form of NdFeB magnets, both for sustainable energy technologies as well as the wider economy. This dissertation answers four main research questions: 1. What are the material flows of neodymium for NdFeB magnets, and how much can be made available for recycling? 2. What are the environmental burdens of NdFeB production, and how does recycling alleviate this burden? 3. What type of mechanisms along the NdFeB supply chain provide resilience in response to supply constraints and disruptions 4. Of all the possible resilience mechanisms, which played the largest role in the aftermath of the 2010 REE crisis? Besides directly answering the research question, this dissertation also reflects on the broader question of how actors in the NdFeB supply chain can change their behavior to limit their exposure to an unforeseen yet inevitable future crisis. Show less
