Headache in epilepsy patients: The (un)awareness of this phenomenon among Dutch neurologists

AbstractPurposeHeadache is a frequently heard complaint that can strongly influence quality of life. This is probably even more so in people with a chronic illness. Knowing that headache, and especially migraine, is more frequent among epilepsy patients, the knowledge concerning this problem has been studied among Dutch neurologists.MethodsSeven hundred and seventy two neurologists, working in 89 hospitals and two tertiary epilepsy clinics were asked to participate. Using a questionnaire, neurologists were surveyed on different subjects, e.g. whether they thought current headaches are more frequent in people with epilepsy than in the general population, their interest for epilepsy and how many patients with epilepsy visited their polyclinic per month.ResultsIn total, 334 questionnaires were returned (response rate of 43%) of which 18 were excluded. One third of neurologists responded affirmatively that current headaches are more prevalent among people with epilepsy and eight percent knows that this is, more specified, migraine. The number of years of experience does not influence knowledge on headaches in epilepsy patients. The interest in epilepsy and the number of epilepsy patients per month on the polyclinic does.ConclusionsThese results show that the occurrence of headache in people with epilepsy is underestimated by Dutch neurologists. This leaves an often bothersome and potentially treatable condition underexposed

Individual goals and social preferences in operational decisions

Purpose: The purpose of this paper is to develop propositions explaining the influence of individual goals and social preferences on human decision making in transport planning. The aim is to understand which individual goals and social preferences planners pursue and how these influence planners’ decisions. Design/methodology/approach: Propositions are developed based on investigation of decision making of transport planners in a Dutch logistics service provider using multiple data collection methods. Findings: The study shows how decision making of transport planners is motivated by individual goals as well as social preferences for reciprocity and group identity. Research limitations/implications: Further research including transaction data analysis is needed to triangulate findings and to strengthen conclusions. Propositions are developed to be tested in future research. Practical implications: Results suggest that efforts to guide planners in their decision making should go beyond traditional (monetary) incentives and consider their individual goals and social preferences. Moreover, this study provides insight into why transport planners deviate from desired behaviour. Originality/value: While individual decision making plays an essential role in operational planning, the factors influencing how individuals make operational planning decisions are not fully understood

Review of best management practices for aquatic vegetation control in stormwater ponds, wetlands, and lakes

Auckland Council (AC) is responsible for the development and operation of a stormwater network across the region to avert risks to citizens and the environment. Within this stormwater network, aquatic vegetation (including plants, unicellular and filamentous algae) can have both a positive and negative role in stormwater management and water quality treatment. The situations where management is needed to control aquatic vegetation are not always clear, and an inability to identify effective, feasible and economical control options may constrain management initiatives. AC (Infrastructure and Technical Services, Stormwater) commissioned this technical report to provide information for decision- making on aquatic vegetation management with in stormwater systems that are likely to experience vegetation-related issues. Information was collated from a comprehensive literature review, augmented by knowledge held by the authors. This review identified a wide range of management practices that could be potentially employed. It also demonstrated complexities and uncertainties relating to these options that makes the identification of a best management practice difficult. Hence, the focus of this report was to enable users to screen for potential options, and use reference material provided on each option to confirm the best practice to employ for each situation. The report identifies factors to define whether there is an aquatic vegetation problem (Section 3.0), and emphasises the need for agreed management goals for control (e.g. reduction, mitigation, containment, eradication). Resources to screen which management option(s) to employ are provided (Section 4.0), relating to the target aquatic vegetation, likely applicability of options to the system being managed, indicative cost, and ease of implementation. Initial screening allows users to shortlist potential control options for further reference (Section 5.0). Thirty-five control options are described (Section 5.0) in sufficient detail to consider applicability to individual sites and species. These options are grouped under categories of biological, chemical or physical control. Biological control options involve the use of organisms to predate, infect or control vegetation growth (e.g. classical biological control) or manipulate conditions to control algal growth (e.g. pest fish removal, microbial products). Chemical control options involve the use of pesticides and chemicals (e.g. glyphosate, diquat), or the use of flocculants and nutrient inactivation products that are used to reduce nutrient loading, thereby decreasing algal growth. Physical control options involve removing vegetation or algal biomass (e.g. mechanical or manual harvesting), or setting up barriers to their growth (e.g. shading, bottom lining, sediment capping). Preventative management options are usually the most cost effective, and these are also briefly described (Section 6.0). For example, the use of hygiene or quarantine protocols can reduce weed introductions or spread. Catchment- based practices to reduce sediment and nutrient sources to stormwater are likely to assist in the avoidance of algal and possibly aquatic plant problems. Nutrient removal may be a co-benefit where harvesting of submerged weed biomass is undertaken in stormwater systems. It should also be considered that removal of substantial amounts of submerged vegetation may result in a sudden and difficult-to-reverse s witch to a turbid, phytoplankton dominated state. Another possible solution is the conversion of systems that experience aquatic vegetation issues, to systems that are less likely to experience issues. The focus of this report is on systems that receive significant stormwater inputs, i.e. constructed bodies, including ponds, amenity lakes, wetlands, and highly-modified receiving bodies. However, some information will have application to other natural water bodies

Supporting Adolescents with Mental Health Problems in Secondary Education:Feasibility of a Supported Education Intervention

Mental health problems in adolescence can have a profound influence on school functioning, educational attainment and thus future societal participation. Supported education (SEd) is a potentially useful method for educational professionals to help adolescents with mental health problems in secondary school improve their functioning by stimulating collaboration, ownership, and participation. In this study, we examined the feasibility of SEd in secondary education by examining its acceptability, implementation, and preliminary effectiveness. We performed a mixed-methods study using quantitative data (questionnaires) and qualitative data (interviews) from educational professionals (EP) and adolescents, aged 13-17, about their experiences with a SEd intervention. Regarding the acceptability of the intervention, three main themes emerged: (a) structure, (b) autonomy, and (c) applicability of the intervention. Themes regarding the implementation were: (a) lack of time, (b) personal attitude, (c) mastery, and (d) complexity of the school environment. The findings show that, for those that followed the intervention, SEd is a promising approach to support adolescents with mental health problems to improve their functioning and participation in school. Further research is needed on the effectiveness of the intervention

Promoting Mental Health Help-Seeking Behaviors by Mental Health Literacy Interventions in Secondary Education?:Needs and Perspectives of Adolescents and Educational Professionals

Mental health literacy (MHL) interventions in secondary schools may help to improve competencies that adolescents require to stay mentally healthy and seek help if mental health problems arise. These MHL interventions should be tailored to the needs of adolescents and educational professionals (EPs) to reach sustainable implementation and long-term effectiveness. However, evidence is lacking on these needs. Thus, our aim was to explore their experiences with, and perspectives on, mental health help seeking and needs regarding MHL interventions. We performed online focus group discussions and interviews with adolescents (n = 21; 13–19 years) and EPs (n = 12) and analyzed the data using directed content analysis. We identified three themes related to mental health help seeking: (1) Limited MHL competencies of adolescents, (2) Limited competencies of EP to provide mental health support, and (3) Limited mental health promotion in the school environment. We further identified three themes regarding MHL interventions: (1) Addressing basic mental health knowledge and skills, (2) Interactive and easily accessible, and (3) Sustainable implementation. Improving the MHL competencies of adolescents and EPs, and creating a mental health-literate school environment can promote adolescents’ mental health help seeking. Our findings highlight the importance of developing MHL interventions that are tailored to both adolescents’ and EPs needs

Effectiveness of suicide prevention interventions:A systematic review and meta-analysis

Objective: This study provides an estimate of the effect size of suicide prevention interventions and evaluates the possible synergistic effects of multilevel interventions. Method: A systematic review and meta-analysis were conducted of controlled studies evaluating suicide prevention interventions versus control published between 2011 and 2017 in PubMed, PsycINFO, and Cochrane databases. Data extraction and risk of bias assessment according to ROBINS criteria were performed by independent assessors. Cohen's delta was calculated by a random meta-analysis on completed and attempted suicides as outcomes. Meta-regression explored a possible synergistic effect in multilevel interventions. PROSPERO ID number: CRD42018094373. Results: The search yielded 16 controlled studies with a total of 252,932 participants. The meta-analysis was performed in 15 studies with 29,071 participants. A significant effect was found for suicide prevention interventions on completed suicides (d = -0.535, 95% CI -0.898; -0.171, p = .004) and on suicide attempts (d = -0.449, 95% CI -0.618; -0.280, p < .001). Regarding the synergistic effect of multilevel interventions, meta-regression showed a significantly higher effect related to the number of levels of the intervention (p = .032). Conclusions: Suicide prevention interventions are effective in preventing completed and attempted suicides and should be widely implemented. Further research should focus on multilevel interventions due to their greater effects and synergistic potential. Further research is also needed into risk appraisal for completed versus attempted suicide, as the preferred intervention strategy differs with regard to both outcomes

Multiple health risk behaviors and mental health from a life course perspective:The Dutch TRAILS study

We examined trajectories of multiple health risk behavior (MHRB) patterns throughout adolescence, and changes in mental health from childhood to young adulthood. Further, we assessed how continuity or onset of MHRBs overall were associated with subsequent changes in mental health, and whether this varied by type of MHRBs. We used six waves of the prospective Dutch TRAILS study (2001-2016; n = 2229), covering ages 11 until 23. We measured MHRBs (substance use: alcohol misuse, cannabis use, smoking; and obesity-related: overweight, physical inactivity, irregular breakfast intake) at three time points during adolescence. We assessed mental health as Youth/Adult Self-report total problems at ages 11 and 23. Latent class growth analyses and ANOVA were used to examine longitudinal trajectories and associations. We identified six developmental trajectories for the total of MHRBs and mental health. Trajectories varied regarding likelihood of MHRBs throughout adolescence, mental health at baseline, and changes in mental health problems in young adulthood. We found no associations for the continuity of overall MHRBs throughout adolescence, and neither for early, mid- or late onset, with changes in mental health problems in young adulthood. However, continuity of MHRBs in the obesity-related subgroup was significantly associated with an increase in mental health problems. Adolescents with the same MHRB patterns may, when reaching adulthood, have different levels of mental health problems, with mental health at age 11 being an important predictor. Further, involvement with obesity-related MHRBs continuously throughout adolescence is associated with increased mental health problems in young adulthood