The effectiveness of Grief-Help, a cognitive behavioural treatment for prolonged grief in children: study protocol for a randomised controlled trial

BACKGROUND: There is growing recognition of a syndrome of disturbed grief referred to as prolonged grief disorder (PGD). PGD is mostly studied in adults, but clinically significant PGD symptoms have also been observed in children and adolescents. Yet, to date no effective treatment for childhood PGD exists. The aims of this study are: (1) to investigate the effectiveness of Grief-Help, a nine-session cognitive-behavioural treatment for childhood PGD, combined with five sessions of parental counselling, immediately after the treatment and at three, six and twelve months follow-up; (2) to examine tentative mediators of the effects of Grief-Help, (i.e., maladaptive cognitions and behaviours and positive parenting), and (3) to determine whether demographic variables, child personality, as well as symptoms of PGD, anxiety, and depression in parents moderate the treatment effectiveness. METHODS/DESIGN: We will conduct a Randomised Controlled Trial (RCT) in which 160 children and adolescents aged 8–18 years are randomly allocated to cognitive behavioural Grief-Help or to a supportive counselling intervention; both treatments are combined with five sessions of parental counselling. We will recruit participants from clinics for mental health in the Netherlands. The primary outcome measure will be the severity of Prolonged Grief Disorder symptoms according to the Inventory of Prolonged Grief for Children (IPG-C). Secondary outcomes will include PTSD, depression and parent-rated internalizing and externalizing problems. Mediators like positive parenting and maladaptive cognitions and behaviours will be identified. We will also examine possible moderators including demographic variables (e.g. time since loss, cause of death), psychopathology symptoms in parents (PGD, anxiety and depression) and child personality. Assessments will take place in both groups at baseline, after the treatment-phase and three, six and twelve months after the post-treatment assessment. DISCUSSION: We aim to contribute to the improvement of mental health care for children and adolescents suffering from loss. By comparing Grief-Help with supportive counselling, and by investigating mediators and moderators of its effectiveness we hope to provide new insights in the effects of interventions for bereaved children, and their mechanisms of change. TRIAL REGISTRATION: Netherlands Trial Register NTR385

Ensembles of probability estimation trees for customer churn prediction

Customer churn prediction is one of the most, important elements tents of a company's Customer Relationship Management, (CRM) strategy In tins study, two strategies are investigated to increase the lift. performance of ensemble classification models, i.e (1) using probability estimation trees (PETs) instead of standard decision trees as base classifiers; and (n) implementing alternative fusion rules based on lift weights lot the combination of ensemble member's outputs Experiments ale conducted lot font popular ensemble strategics on five real-life chin n data sets In general, the results demonstrate how lift performance can be substantially improved by using alternative base classifiers and fusion tides However: the effect vanes lot the (Idol cut ensemble strategies lit particular, the results indicate an increase of lift performance of (1) Bagging by implementing C4 4 base classifiets. (n) the Random Subspace Method (RSM) by using lift-weighted fusion rules, and (in) AdaBoost, by implementing both

No differential susceptibility or diathesis stress to parenting in early adolescence : personality facets predicting behaviour problems

This multi-sample study investigated the main and interactive effects of parenting (responsiveness, over-reactivity) and young adolescents' personality traits (negative-affectivity: irritability and anxiety; and orienting-sensitivity) on behaviour problems during adolescence. Data from two samples (N1 = 222; girls 45.5%; Mean age = 11.54 years; N2 = 252; girls 50.4%; Mean age = 10.85 years) were analysed using a multivariate approach. Parenting and young adolescents' personality traits were assessed at Time-1 and behaviour problems were assessed 2 to 3 years later. Mothers rated their overreactive parenting practices with the Parenting-Scale (both samples); parental responsiveness was measured with the Louvain-Adolescent-Perceived-Parenting-Scale (sample-1) and the Parenting-Practices-Questionnaire (sample-2). Adolescents reported on their behaviour problems with the overlapping items of the Brief-Problem-Monitor (sample-1) and the Youth-Self-Report (sample-2). Young adolescents' personality traits were measured with the Hierarchical-Personality-Inventory-for-Children rated by mothers in sample-1 and by fathers in sample-2. No evidence supporting diathesis stress or differential susceptibility was found. Analyses revealed one interaction suggesting that adolescents with high irritability (>= 1.4 SD; 9%) with more overreactive mothers presented less internalizing behaviour, when their mothers used less overreactive parenting they showed more internalizing behaviour. High-anxiety predicted internalizing behaviour. High-irritability and low-anxiety predicted externalizing behaviour. High-irritability and orienting sensitivity predicted attention problems. No main effects of parenting on behaviour problems were observed

Postscript relating to new allegations made by Edward Hooper at The Royal Society Discussion Meeting on 11 September 2000

At The Royal Society Discussion Meeting, Origins of HIV and the AIDS epidemic, which this issue records, Edward Hooper added two new`smoking guns' to the accusations published previously in The river. These were proposed as conclusive evidence for the hypothesis that simian immunode¢ciency viruscontaminated CHAT polio vaccine caused the HIV-1 group M epidemic. We have investigated the facts in relation to these`smoking guns'

Targeted social care for highly vulnerable pregnant women: Protocol of the Mothers of Rotterdam cohort study

Introduction: Social vulnerability is known to be related to ill health. When a pregnant woman is socially vulnerable, the ill health does not only affect herself, but also the health and development of her (unborn) child. To optimise care for highly vulnerable pregnant women, in Rotterdam, a holistic programme was developed in close collaboration between the university hospital, the local government and a non-profit organisation. This programme aims to organise social and medical care from pregnancy until the second birthday of the child, while targeting adult and child issues simultaneously. In 2014, a pilot in the municipality of Rotterdam demonstrated the significance of this holistic approach for highly vulnerable pregnant women. In the Mothers of Rotterdam' study, we aim to prospectively evaluate the effectiveness of the holistic approach, referred to as targeted social care. Methods and analysis: The Mothers of Rotterdam study is a pragmatic prospective cohort study planning to include 1200 highly vulnerable pregnant women for the comparison between targeted social care and care as usual. Effectiveness will be compared on the following outcomes: (1) child development (does the child show adaptive development at year 1?) and (2) maternal mental health (is maternal distress reduced at the end of the social care programme?). Propensity scores will be used to correct for baseline differences between both social care programmes. Ethics and dissemination: The prospective cohort study was approved by the Erasmus Medical Centre Ethics Committee (ref. no. MEC-2016-012) and the first results of the study are expected to be available in the second half of 2019 through publication in peer-reviewed international journals. Trial registration number NTR6271; Pre-results

Predicting self‐declared movie watching behavior using Facebook data and information‐fusion sensitivity analysis

The main purpose of this paper is to evaluate the feasibility of predicting whether yes or no a Facebook user has self-reported to have watched a given movie genre. Therefore, we apply a data analytical framework that (1) builds and evaluates several predictive models explaining self-declared movie watching behavior, and (2) provides insight into the importance of the predictors and their relationship with self-reported movie watching behavior. For the first outcome, we benchmark several algorithms (logistic regression, random forest, adaptive boosting, rotation forest, and naive Bayes) and evaluate their performance using the area under the receiver operating characteristic curve. For the second outcome, we evaluate variable importance and build partial dependence plots using information-fusion sensitivity analysis for different movie genres. To gather the data, we developed a custom native Facebook app. We resampled our dataset to make it representative of the general Facebook population with respect to age and gender. The results indicate that adaptive boosting outperforms all other algorithms. Time- and frequency-based variables related to media (movies, videos, and music) consumption constitute the list of top variables. To the best of our knowledge, this study is the first to fit predictive models of self-reported movie watching behavior and provide insights into the relationships that govern these models. Our models can be used as a decision tool for movie producers to target potential movie-watchers and market their movies more efficiently

Early life stress and behavior problems in early childhood: Investigating the contributions of child temperament and executive functions to resilience

Funder: NWO: Nederlandse organisatie voor Wetenschappelijk Onderzoek; Id: http://dx.doi.org/10.13039/501100003246Funder: ZonMw; Id: http://dx.doi.org/10.13039/501100001826Funder: Ministry of Youth and FamiliesFunder: Fulbright U.S. Student ProgramFunder: Erasmus Medisch Centrum; Id: http://dx.doi.org/10.13039/501100003061Funder: Erasmus Universiteit Rotterdam; Id: http://dx.doi.org/10.13039/501100001828Funder: Ministerie van Volksgezondheid, Welzijn en Sport; Id: http://dx.doi.org/10.13039/501100002999Abstract: This preregistered study examined whether child temperament and executive functions moderated the longitudinal association between early life stress (ELS) and behavior problems. In a Dutch population‐based cohort (n = 2803), parents reported on multiple stressors (age 0–6 years), child temperament (age 5), and executive functions (age 4), and teachers rated child internalizing and externalizing problems (age 7). Results showed that greater ELS was related to higher levels of internalizing and externalizing problems, with betas reflecting small effects. Lower surgency buffered the positive association of ELS with externalizing problems, while better shifting capacities weakened the positive association between ELS and internalizing problems. Other child characteristics did not act as moderators. Findings underscore the importance of examining multiple protective factors simultaneously

The role of parental achievement goals in predicting autonomy-supportive and controlling parenting

Although autonomy-supportive and controlling parenting are linked to numerous positive and negative child outcomes respectively, fewer studies have focused on their determinants. Drawing on achievement goal theory and self-determination theory, we propose that parental achievement goals (i.e., achievement goals that parents have for their children) can be mastery, performance-approach or performance-avoidance oriented and that types of goals predict mothers' tendency to adopt autonomy-supportive and controlling behaviors. A total of 67 mothers (aged 30-53 years) reported their goals for their adolescent (aged 13-16 years; 19.4 % girls), while their adolescent evaluated their mothers' behaviors. Hierarchical regression analyses showed that parental performance-approach goals predict more controlling parenting and prevent acknowledgement of feelings, one autonomy-supportive behavior. In addition, mothers who have mastery goals and who endorse performance-avoidance goals are less likely to use guilt-inducing criticisms. These findings were observed while controlling for the effect of maternal anxiety

Reliability and Validity of the Supports Intensity Scale (SIS) Measured in Adults with Physical Disabilities

The objective of this study was to investigate the internal consistency and the construct validity of the Dutch version of the Supports Intensity Scale (SIS-NL1.0; Buntinx 2006) in individuals with physical disabilities (N = 65). To investigate the construct validity, the relationship between SIS subscales and practical skills (Barthel Index; BI) was calculated. Support was provided for the internal consistency. The SIS subscales (except Behavior) had moderate to high intercorrelations and the SIS was able to discriminate between groups with different number of disabilities. However, weak relationships were found between the BI and four out of eight SIS subscales. For people with physical disabilities, future revisions of the SIS should also take into consideration limitations in practical skills in other support domains