Mental health of healthcare workers during the first year of the COVID-19 pandemic in the Netherlands: a longitudinal study

PurposeIn March 2020, the WHO declared COVID-19 a pandemic. Previous virus outbreaks, such as the SARS outbreak in 2003, appeared to have a great impact on the mental health of healthcare workers. The aim of this study is to examine to what extent mental health of healthcare workers differed from non-healthcare workers during the first year of the COVID-19 pandemic.MethodsWe used data from a large-scale longitudinal online survey conducted by the Corona Behavioral Unit in the Netherlands. Eleven measurement rounds were analyzed, from April 2020 to March 2021 (N = 16,615; number of observations = 64,206). Mental health, as measured by the 5-item Mental Health Inventory, was compared between healthcare workers and non-healthcare workers over time, by performing linear GEE-analyses.ResultsMental health scores were higher among healthcare workers compared to non-healthcare workers during the first year of the pandemic (1.29 on a 0–100 scale, 95%-CI = 0.75–1.84). During peak periods of the pandemic, with over 100 hospital admissions or over 25 ICU admissions per day and subsequently more restrictive measures, mental health scores were observed to be lower in both healthcare workers and non-healthcare workers.ConclusionDuring the first year of the COVID-19 pandemic, we observed no relevant difference in mental health between healthcare workers and non-healthcare workers in the Netherlands. To be better prepared for another pandemic, future research should investigate which factors hinder and which factors support healthcare workers to maintain a good mental health

Mental models of the protein shift: Exploring consumers' perceptions of the transition

The protein transition is one of today's major societal challenges to mitigate climate change. To support lasting consumer engagement, it has been suggested to look into consumers' understanding of the protein transition to identify barriers that go beyond the practical issues of changing one's diet. The current study explored consumers' mental models of how the transition unfolds to examine which factors consumers perceive as important drivers of the transition. With a fixed set of factors and actors identified with a questionnaire, Dutch consumers (N = 214) mapped their mental models. The content and structure of the mental models were analyzed with a focus on how consumers perceive their own role. Animal well-being and environmental concerns were most often included as important drivers. The findings showed a lack of consensus about which actor(s) drive the transition (i.e., none of the actors were included by a majority of the participants). This diffusion of responsibility may be a barrier for consumers to act. Moreover, the relative simplicity of the observed mental models suggests that consumers do not yet employ systems thinking. A systems thinking mindset may help consumers understand how the system behind the transition works and how their individual contributions matter. Two avenues to encourage consumer engagement were identified: 1) emphasizing the responsibility of different actors and what consumers can contribute, and 2) encouraging a systems thinking mindset

2 days versus 5 days of postoperative antibiotics for complex appendicitis:a pragmatic, open-label, multicentre, non-inferiority randomised trial

Background: The appropriate duration of postoperative antibiotics for complex appendicitis is unclear. The increasing global threat of antimicrobial resistance warrants restrictive antibiotic use, which could also reduce side-effects, length of hospital stay, and costs. Methods: In this pragmatic, open-label, non-inferiority trial in 15 hospitals in the Netherlands, patients with complex appendicitis (aged ≥8 years) were randomly assigned (1:1) to receive 2 days or 5 days of intravenous antibiotics after appendicectomy. Randomisation was stratified by centre, and treating physicians and patients were not masked to treatment allocation. The primary endpoint was a composite endpoint of infectious complications and mortality within 90 days. The main outcome was the absolute risk difference (95% CI) in the primary endpoint, adjusted for age and severity of appendicitis, with a non-inferiority margin of 7·5%. Outcome assessment was based on electronic patient records and a telephone consultation 90 days after appendicectomy. Efficacy was analysed in the intention-to-treat and per-protocol populations. Safety outcomes were analysed in the intention-to-treat population. This trial was registered with the Netherlands Trial Register, NL5946. Findings: Between April 12, 2017, and June 3, 2021, 13 267 patients were screened and 1066 were randomly assigned, 533 to each group. 31 were excluded from intention-to-treat analysis of the 2-day group and 30 from the 5-day group owing to errors in recruitment or consent. Appendicectomy was done laparoscopically in 955 (95%) of 1005 patients. The telephone follow-up was completed in 664 (66%) of 1005 patients. The primary endpoint occurred in 51 (10%) of 502 patients analysed in the 2-day group and 41 (8%) of 503 patients analysed in the 5-day group (adjusted absolute risk difference 2·0%, 95% CI −1·6 to 5·6). Rates of complications and re-interventions were similar between trial groups. Fewer patients had adverse effects of antibiotics in the 2-day group (45 [9%] of 502 patients) than in the 5-day group (112 [22%] of 503 patients; odds ratio [OR] 0·344, 95% CI 0·237 to 0·498). Re-admission to hospital was more frequent in the 2-day group (58 [12%] of 502 patients) than in the 5-day group (29 [6%] of 503 patients; OR 2·135, 1·342 to 3·396). There were no treatment-related deaths. Interpretation: 2 days of postoperative intravenous antibiotics for complex appendicitis is non-inferior to 5 days in terms of infectious complications and mortality within 90 days, based on a non-inferiority margin of 7·5%. These findings apply to laparoscopic appendicectomy conducted in a well resourced health-care setting. Adopting this strategy will reduce adverse effects of antibiotics and length of hospital stay. Funding: The Netherlands Organization for Health Research and Development.</p

“Don’t Mind If I Do”: The Role of Behavioral Resistance in Self-Control’s Effects on Behavior

High self-control is known to be related to the performance of behaviors that have long-term benefits, such as healthy eating. Recently, studies have suggested that people with high self-control may perform goal-directed behaviors not by exerting effortful control but rather by employing smart, effortless strategies. The current paper investigates the crucial role of behavioral resistance in the relation between self-control and goal-directed behaviors: we propose that people with high self-control feel less resistance toward goal-directed behaviors compared to people with low self-control, and that this is associated with the increased frequency of performing these behaviors. Three cross-sectional studies were conducted in which participants reported on their level of self-control, behavioral resistance toward behaviors in the sustainability, healthy eating, exercise, and study/work domains, and their behavior in those domains. Findings consistently show that the relation between self-control and various behaviors is indeed partially mediated by behavioral resistance, although the study designs preclude establishing causal relations. It is implied that lower resistance makes it easier for people with higher self-control to perform the goal-directed behaviors, without requiring much effort. This notion yields an interesting, novel perspective on how people with high self-control manage to function so well

Health behavior procrastination : a novel reasoned route toward self-regulatory failure

In this paper, we highlight a novel perspective on health behavior failure by considering reasoned procrastination as a contributing factor. We argue that the failure to enact intentions does not necessarily occur because people are victims of their strong impulses, but that people may also knowingly and willfully postpone their intended actions. While procrastination is acknowledged as a factor associated with intention-behavior gaps in other domains, it has surprisingly received only very little attention in the domain of health behavior. We argue that it is particularly important to recognize the waxing and waning of intentions: rather than being truly abandoned, intentions may sometimes be temporarily put aside. This paper describes how the procrastination account relates to the intention-behavior gap as we know it, what is known about procrastination and health behavior, and what theoretical and practical implications can be derived from the addition of this novel perspective to our understanding of health behavior change

Understanding COVID-19 vaccination willingness among youth: A survey study in the Netherlands.

Vaccination of youth could be key to preventing future outbreaks of SARS-CoV-2. Given the limited direct health benefit for young people, it is important to understand how youth themselves perceive obtaining a vaccination. This survey study in a representative sample of Dutch youth aged 12–18 showed that 73% were willing to get vaccinated against COVID-19. In regression analyses, vaccination willingness was strongly related to age, perceived personal (protect own health) and societal benefits (to get rid of restrictive policies), and their peers’ and parents’ vaccination uptake. Negative associations with vaccination willingness were perceived side-effects and potential unknown long term consequences. On-going and transparent communication with up-to-date information about safety and risks, delivered by independent and trusted experts (as perceived by the recipients) seems important for addressing questions and concerns. Local information sessions for youth and parents where a vaccination can be obtained without appointment could have merit in addition to mass media communication

Bedtime Procrastination: An Exploration of the ‘Who’, ‘What’ and ‘Why’ > Part 2

In part 2 people keep a diary in which bedtime behaviour is assessed

Understanding COVID-19 vaccination willingness among youth: A survey study in the Netherlands

Vaccination of youth could be key to preventing future outbreaks of SARS-CoV-2. Given the limited direct health benefit for young people, it is important to understand how youth themselves perceive obtaining a vaccination. This survey study in a representative sample of Dutch youth aged 12–18 showed that 73% were willing to get vaccinated against COVID-19. In regression analyses, vaccination willingness was strongly related to age, perceived personal (protect own health) and societal benefits (to get rid of restrictive policies), and their peers’ and parents’ vaccination uptake. Negative associations with vaccination willingness were perceived side-effects and potential unknown long term consequences. On-going and transparent communication with up-to-date information about safety and risks, delivered by independent and trusted experts (as perceived by the recipients) seems important for addressing questions and concerns. Local information sessions for youth and parents where a vaccination can be obtained without appointment could have merit in addition to mass media communication

Understanding COVID-19 vaccination willingness among youth: A survey study in the Netherlands

Vaccination of youth could be key to preventing future outbreaks of SARS-CoV-2. Given the limited direct health benefit for young people, it is important to understand how youth themselves perceive obtaining a vaccination. This survey study in a representative sample of Dutch youth aged 12–18 showed that 73% were willing to get vaccinated against COVID-19. In regression analyses, vaccination willingness was strongly related to age, perceived personal (protect own health) and societal benefits (to get rid of restrictive policies), and their peers’ and parents’ vaccination uptake. Negative associations with vaccination willingness were perceived side-effects and potential unknown long term consequences. On-going and transparent communication with up-to-date information about safety and risks, delivered by independent and trusted experts (as perceived by the recipients) seems important for addressing questions and concerns. Local information sessions for youth and parents where a vaccination can be obtained without appointment could have merit in addition to mass media communication

Nudging healthy food choices : a field experiment at the train station

BACKGROUND: Recognizing the mindless nature of many food decisions, it has been suggested that attempts to increase healthy eating should not focus on convincing people what is 'right' but rather aim to adjust the environment such that people are automatically directed toward healthy choices. This study investigated a nudge aiming to promote healthy food choices in train station snack shops. METHODS: The nudge involved a repositioning of food products: healthy foods were placed at the cash register desk, while keeping unhealthy products available elsewhere in the shop. Three snack shops were included: a control condition; a nudge condition repositioning healthy products and a nudge + disclosure condition employing the same nudge together with an explanatory sign. Next to examining its effectiveness during 1 week, the study assessed customers' acceptance of the nudge. RESULTS: Controlling for a baseline week, more healthy (but not fewer unhealthy) products were sold in both nudge conditions, with no difference between the nudge and the nudge + disclosure condition. A majority of customers reported positive attitudes toward the nudge. CONCLUSIONS: Repositioning healthy foods is a simple, effective and well-accepted nudge to increase healthy purchases. Moreover, disclosing its purpose does not impact on effectiveness