Mijn angst belet me om voluit te leven

Anne is een meisje van 13 jaar. Ze zit in het derde jaar algemeen secundair onderwijs en volgt de richting moderne talen. Het gezin bestaat uit vader, moeder en Anne. Papa heeft een fulltime baan en moeder is niet werkzaam. Anne werd aangemeld door haar moeder omdat Anne al enkele jaren problemen heeft, maar sinds een jaar gaat dit gepaard met flauwvallen met verlies bewustzijn. Mama omschrijft de problemen van Anne als faalangst, angststoornissen en een laag zelfvertrouwen

(In)variability of attachment in middle childhood: secure base script evidence in diary data

Secure attachment is characterised by a secure base script regarding the attachment figure as a source for support. Having such a cognitive script should affect the stability of state attachment. Specifically, incongruent attachment-related information should get assimilated to this secure base script, leading to state attachment scores that hardly fluctuate. For children without a script, state attachment should vary depending on the quality of attachment-related interactions. Two diary studies were carried out in 9- to 13-year-old children. Results suggested that with assimilation: (1) securely attached children fluctuated less in their daily attachment-related appraisals; (2) fluctuations were related to conflicts with mother; (3) this relation was stronger for less securely attached children. Consequently, these studies further support the secure base script hypothesis and provide insight into the interplay of trait and state components of attachment-related appraisals

Breathing across ages: a systematic review on challenges and components of transitional care for young people with asthma

IntroductionAsthma is a chronic condition that affects millions of adolescents and young adults (AYA) worldwide. The transition from pediatric to adult care presents unique challenges for this population, affecting their self-management, quality of life and overall health outcomes. This systematic review aims to consolidate the available evidence on challenges encountered by AYA with asthma during the transition period from child to AYA and on the key elements of transitional care for AYAs with asthma including the outcomes achieved, ultimately enhancing outcomes.MethodologyA systematic literature search was performed in PubMed, Embase, Medline, Scopus, and Web of Science from their inception to October 2, 2023, to provide an overview of currently available literature. Primary quantitative and qualitative studies, published in peer-reviewed journals that focused on AYA with a confirmed diagnosis of asthma were considered if they focused on challenges encountered by AYA with asthma during the transition process and/or components of transitional care and their outcomes assessed.ResultsA total of 855 studies were initially identified and 6 articles were included in this systematic literature review. Several challenges experienced by AYA with asthma were identified including maintaining medication adherence, the need to take responsibility and being involved, understanding their condition and its severity, feeling left out of the care system, and experiencing a lack of engagement. The identified transitional care components included a standardized form for medical data transmission, a joint consultation and to offer several longer consultations.ConclusionSeveral international guidelines for asthma care recommend implementing transition programs in the care for AYA with asthma. Such transition programs should include a comprehensive and individualized approach addressing several challenges faced, to ensure optimal outcomes post-transition. However, to date, data on effective components of transitional care facilitating good outcomes were found to be limited. This systematic review underscores the need for larger studies evaluating the effect of the components of transition programs

The Development of Recommendations for Healthcare Providers to Support Patients Experiencing Medication Self-Management Problems

Medication self-management problems such as the inability to correctly obtain, understand, organize, administer or monitor medication can result in negative patient outcomes. However, supportive tools for healthcare providers to assist patients with medication self-management problems are lacking. This study aimed to develop recommendations for healthcare providers to support patients with polypharmacy who experience medication self-management problems. A three-phase study was conducted starting with (1) the mapping of medication self-management problems, followed by (2) a scoping review providing a list of relevant interventions and actions for each respective problem and (3) a three-round modified e-Delphi study with experts to reach consensus on the relevance and clarity of the recommended interventions and actions. The cut-off for consensus on the relevance and clarity of the recommendations was set at 80% expert agreement. Experts could propose additional recommendations based on their professional experience and expertise. The experts (n = 23) involved were healthcare professionals (i.e., nurses, pharmacists, and physicians) with specific expertise in medication management of patients with polypharmacy. Simultaneous with the second e-Delphi round, a panel of patients with polypharmacy (n = 8) evaluated the usefulness of recommendations. Results obtained from the patient panel were fed back to the panel of healthcare providers in the third e-Delphi round. Descriptive statistics were used for data analysis. Twenty medication self-management problems were identified. Based on the scoping review, a list of 66 recommendations for healthcare providers to support patients with the identified medication self-management problems was composed. At the end of the three-round e-Delphi study, the expert panel reached consensus on the relevance and clarity of 67 recommendations, clustered according to the six phases of the medication self-management model by Bailey et al. In conclusion, this study resulted in a guidance document including recommendations that can serve as a resource for healthcare providers to support patients with polypharmacy in case of medication self-management problems. Future research should focus on the evaluation of the feasibility and user-friendliness of the guide with recommendations in clinical practice.</p

Algoritmische beslisregels vanuit constitutioneel oogpunt:Tweedeling tussen algemene regels en concrete toepassing onder druk

Dit artikel verkent hoe algoritmische besluitvorming door de overheid bestaande constitutionele uitgangspunten onder druk zet of zelfs transformeert. De focus ligt daarbij op de fundamentele tweedeling tussen algemene regels en de concrete toepassing via individuele beslissingen alsmede, in het licht daarvan, de wisselwerking tussen normen en feiten en de gevolgen die dat heeft voor het legaliteitsbeginsel alsmede voor de democratische en rechterlijke controle op de toepassing van algemene regels

Chapter Métiers, effort and catches of a Mediterranean small-scale coastal fishery: the case of the gulf of Lion Marine Natural Parc

In the context of current fisheries crisis, this study aimed describing the characteristics of the artisanal fisheries in the Gulf of Lion Marine Natural Park located north-western Mediterranean. Catch Per Unit Effort and fishing effort were described on a spatio-temporal scale. Data were collected through questionnaires to fishers at landing sites for a one-year between 2019 and 2020. The most frequently used métiers were the hake gillnet and the sparids trammel net and gillnet, targeting two predominant species: hake (Merluccius merluccius) and gilthead seabream (Sparus aurata)