Living with a Hereditary Form of Cancer: Experiences and Needs of MEN 2 Patients and Their Families

Unlike the purely medical research done in multiple endocrine neoplasia type 2 (MEN 2) families, little work has been done on the psychosocial aspects of the disease. To assess the severely stressful influences and the consequences of that stress on the family network, a small-scale survey was carried out during a national meeting. The goal of the study was to obtain more information about the experiences and needs of MEN 2 patients and their relatives. Of the 59 respondents, 85% were satisfied with the medical information provided, 81% were satisfied with the medical knowledge of the specialist, but only 12% were satisfied with the medical knowledge of the general practitioner regarding MEN 2. Furthermore, 63% of the parents had difficulties in talking about the disease with their children. The need expressed for contact with fellow sufferers and their families is expected to lead to the establishment of an interest group for MEN 2 families

Does fear of childbirth or family history affect whether pregnant Dutch women prefer a home- or hospital birth?

Objective: it is a generally accepted idea that women who give birth at home are less fearful of giving birth than women who give birth in a hospital. We explored fear of childbirth (FOC) in relation to preferred and actual place of birth. Since the Netherlands has a long history of home birthing, we also examined how the place where a pregnant woman's mother or sisters gave birth related to the preferred place of birth. Design: a prospective cohort study. Setting: five midwifery practises in the region Leiden/Haarlem, the Netherlands. Participants: 104 low risk nulliparous and parous women. Method: questionnaires were completed in gestation week 30 (T1) and six weeks post partum (T2). Measurements and findings: no significant differences were found in antepartum FOC between those who preferred a home or a hospital birth. Women with a strong preference for either home or hospital had lower FOC (mean W-DEQ = 60.3) than those with a weak preference (mean W-DEQ= 71.0), t (102)= 2.60, p= 0.01. The place of birth of close family members predicted a higher chance (OR 3.8) of the same place being preferred by the pregnant woman. Pre- to postpartum FOC increased in women preferring home- but having hospital birth. Key conclusions: the idea that FOC is related to the choice of place of birth was not true for this low risk cohort. Women in both preference groups (home and hospital) made their decisions based on negative and positive motivations. Mentally adjusting to a different environment than that preferred, apart from the medical complications, can cause more FOC post partum. Implications for practice: the decreasing number of home births in the Netherlands will probably be a self-reinforcing effect, so in future, pregnant women will be less likely to feel supported by their family or society to give birth at home. Special attention should be given to the psychological condition of women who were referred to a place of birth and caregiver they did not prefer, by means of evaluation of the delivery and being alert to anxiety or other stress symptoms after childbirth. These women have higher chance of fear post partum which is related to a higher risk of psychiatric problems. (C) 2015 Elsevier Ltd. All rights reserved

Preferred and actual mode of delivery in relation to fear of childbirth

Purpose: This prospective cohort study aimed to investigate the interrelation between preferred/actual mode of delivery and pre- and postpartum fear of childbirth (FOC). Material and methods: Participants from 13 midwifery practices and four hospitals in Southwest Netherlands filled out questionnaires at 30 weeks gestation (n = 561) and two months postpartum (n = 463), including questions on preferred mode of delivery, the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) and Hospital Anxiety Depression Scale (HADS). Results were related to obstetric data. Results: Both severe FOC (OR 7.0, p amp;lt; .001) and previous Cesarean section (CS) (OR 16.6, p amp;lt; .001) predicted preference for CS. Severe prepartum FOC also predicted actual CS. Preferring a vaginal delivery (VD) and actually having a CS predicted higher postpartum W-DEQ scores (partial r = 0.107, p amp;lt; .05). Other significant predictors for high postpartum W-DEQ scores were high prepartum W-DEQ (partial r = 0.357) and HADS anxiety scores (partial r = 0.143) and the newborn in need of medical assistance (partial r = -0.169). Conclusions: Women preferring a VD but ending up with a CS are at risk for severe FOC postpartum, while the same risk was not demonstrated for women who preferred a CS but had a VD. Prepartum FOC is strongly associated with postpartum FOC, regardless of congruence between preferred and actual mode of delivery.Funding Agencies|Koninklijke Nederlandse Organisatie voor Verloskundigen, KNOV (Dutch royal organisation of midwives) [GR/173029/3]</p

Is fear of childbirth related to the womans preferred location for giving birth? A Dutch low-risk cohort study

Background In The Netherlands, women with low-risk pregnancy are routinely given the option of home birth, providing a unique opportunity to study the relationship between fear of childbirth (FOC) and preference for childbirth location, and whether women experience higher FOC when the actual location differs from their preference. Methods In this prospective cohort study, 331 nulliparous and parous women completed a questionnaire at gestational week 30 (T1) and two months postpartum (T2). FOC was assessed using versions A (T1) and B (T2) of the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ). Results At T1, women who preferred home birth had significantly lower FOC compared with women who preferred a hospital birth (mean +/- SD W-DEQ scores: 55 +/- 19.8 and 64 +/- 18.3, respectively, P amp;lt; .01). About 28% of women who responded at T2 gave birth at home. Congruence between the preferred and actual childbirth location was not predictive of FOC assessed at T2 when adjusted for obstetric and psychological variables. In an extended analysis, we found that except for prepartum FOC, the following variables also correlated with postpartum FOC: being referred because of complications and poor neonatal condition. Conclusions Compared to women who prefer hospital birth, women who prefer home birth have lower prepartum and postpartum FOC. Giving birth at a location other than the preferred location does not appear to affect postpartum FOC. Whether giving birth at home or in the hospital, caregivers should pay extra attention to women with high FOC because they are vulnerable to postpartum FOC, especially after a complicated birth and referral.Funding Agencies|Koninklijke Nederlandse Organisatie voor Verloskundigen (KNOV; Royal Dutch organisation of midwives) [GR/173029]</p

Cross-validated Prediction of Academic Performance of First Year University Students

Background. Early prediction of academic performance is important for student selection and support. We explored, in a multivariate approach, whether pre-entry data (e.g., expectations, capabilities, motivation, attitude) could predict university students’ first year academic performance. Methods. Pre-registered applicants for a bachelor’s program filled out the Leiden Intake Questionnaire (LIQ) before study-entry (N=739). Outcome data (first-year GPA, course credits, attrition) were obtained one year later. Results. Students who performed better in preparatory education, and students who followed a conventional educational path before entering performed better during their first year at university. Non-Dutch students were less successful than Dutch students, and students who expected to spend more time on a study organization were more successful. Conclusions. The LIQ may be used for identifying upfront who may need additional support, but is not suitable for student selection. Future work on academic performance should include cross-validation to determine how well the findings may generalize