Predicting death or long-term neurodevelopmental outcome in term newborns after hypoxic ischemic encephalopathy

Hypoxic-ischemic encephalopathy after perinatal asphyxia is a severe neonatal disease with a high mortality and morbidity rate despite recent improvements in medical care in the Neonatal Intensive Care Unit. In the diagnostic and prognostic workup of these patients, a wide range of biochemical, neurophysiological and radiological tests is performed. Although many of these predictive parameters have been studied, an internationally accepted, validated prediction model to predict the long-term neurodevelopmental outcome in this high-risk population is currently lacking. This thesis aimed to investigate and contribute to the current evidence on long-term outcome prediction of newborns with hypoxic ischemic encephalopathy treated with controlled therapeutic hypothermia. The systematic review performed confirmed that to date there is no clinically applicable multivariate prediction model available for long-term outcome in these infants. The additional studies showed that the MRI Weeke score is a reliable predictor of outcome and should be implemented in clinical practice. It was demonstrated that multiple organ dysfunction should not be taken into account when predicting or discussing the outcome of these infants. Neither the presence of seizures, nor the severity of seizures (described by the number of anti-epileptic drugs needed) are associated with the combined outcome up until the age of five years after correction for important confounders. Finally, a novel prediction model for the combined outcome death or NDI at two years of age was build and internally validated

Effects of organization and disorganization on pleasantness, calmness, and the frontal negativity in the event-related potential

A preference for organization is associated with several disorders, but is widespread in the general population as well. It remains unclear whether organization and various degrees of disorganization elicit pleasant or unpleasant feelings (i.e., valence), calming or arousing feelings (i.e., arousal), and a frontal negativity in the event-related potential (ERP) related to cognitive control. This study tested how organization, slight disorganization, and total disorganization affect valence, arousal, and the frontal negativity. Participants passively viewed organized, slightly disorganized, totally disorganized, and control pictures while their electroencephalogram was recorded. They also rated the valence and arousal elicited by each picture and completed questionnaires assessing desire for order and organization behavior. Organized pictures made participants feel most pleasant, control pictures made participants feel less pleasant, slightly disorganized pictures made participants feel even less pleasant, and totally disorganized pictures made participants feel least pleasant. There were no significant effects on arousal. Totally disorganized pictures elicited a frontal negativity in the ERP between 200–2000 ms after stimulus onset, which might reflect inhibition of rearranging behavior. Individual differences in desire for order and organization behavior did not correlate with valence, arousal, or the frontal negativity. The current study design and findings could be a starting point for examining the differences between adaptive and maladaptive preferences for organization and aversions to disorganization

Is the serotonergic system altered in romantic love? A literature review and research suggestions

Infatuated individuals think about their beloved a lot. The notions that these frequent thoughts resemble the obsessions of obsessive-compulsive disorder (OCD) patients and that those patients benefit from serotonin reuptake inhibitors (SSRIs), have led to the hypothesis that romantic love is associated with reduced central serotonin levels. In this chapter, the literature on this topic is reviewed and suggestions for future research are made. Previous studies have shown that romantic love is associated with lower blood serotonin levels and with lower serotonin transporter densities, the latter of which has also been observed in OCD patients. Further, SSRIs have been found to decrease feelings of romantic love and the serotonin 2 receptor gene has been associated with the love trait ‘mania’, which is a possessive and dependent form of love. Given that serotonin 2 receptors in the prefrontal cortex have also been implicated in impulsive aggression, this suggests that stalking behavior may be associated with these receptors. In short, the serotonergic system appears to be altered in romantic love indeed. Future research is needed to identify what parts of the serotonergic system, such as which serotonergic projections, brain areas, transmission stages and receptor types, are affected in romantic love and in what way they are altered. Furthermore, challenging the serotonergic system would be useful in determining the causal relationship between central serotonin levels and feelings of romantic love. In addition, future research should specifically investigate the different aspects of romantic love, such as state, trait, requited and unrequited love and its development in time

Airport development in Sub-Saharan Africa: opportunities for public private partnerships

Report submitted in partial fulfilment of the requirements for the degree of Master of Management in Finance and Investment Faculty of Commerce, Law and Management Wits Business School University of the Witwatersrand Johannesburg, South AfricaThe development of transportation infrastructure, including airports, plays a vital role in economic growth in emerging markets. However, government budget allocations for this purpose are often insufficient to realise the full benefits. Project finance and Public Private Partnerships (PPPs) in particular, have been used to enable private sector participation in the financing of airport development. Airports PPPs have successfully been implemented worldwide, including, to a lesser extent, in emerging markets and Sub-Saharan Africa (SSA). There is a lack of literature on the benefits, risks, challenges and opportunities associated with airport PPPs in SSA, which this research aims to address. Case studies of recent airport PPPs in Brazil and India provide an outline of the emerging market context and insight into factors that affected these airport PPPs. In-depth interviews with two representatives of governments in SSA provide a rich view on the perceived benefits, risks, challenges and opportunities associated with airport PPPs in Africa. This research has found that airport PPPs can contribute to airport developments in SSA by enabling the private funding of airport upgrades and expansions. However, governments have an important role to play in providing an enabling environment for private investors by improving investability and implementing clear and practical PPP legislation, aviation policies and economic regulation of airport services. The limited institutional capacity and domain expertise of SSA governments is perceived as a challenge to the implementation of airport PPPs in the region. The low level of air traffic and small number of airports that handle more than one million passengers per annum further limit the opportunities for airport PPPs in SSA, although strong GDP growth provides an encouraging sign. Successful airport PPPs require the participation of private consortia with expertise in airport operations, construction and infrastructure concessions. Financing of airport PPPs is done preferably from domestic sources and development finance can play an important role. There are risks associated with the foreign ownership of key national infrastructure and a reliance on private sector to provide public infrastructure. Lighter forms of PPPs that limit the private sector risk exposure may be more suitable to the low-traffic and high-risk environment in SSA.MT201

DATASET : Effects of organization and disorganization on pleasantness, calmness, and the frontal negativity in the event-related potential

A preference for organization is associated with several disorders, but is widespread in the general population as well. It remains unclear whether organization and various degrees of disorganization elicit pleasant or unpleasant feelings (i.e., valence), calming or arousing feelings (i.e., arousal), and a frontal negativity in the event-related potential (ERP) related to cognitive control. This study tested how organization, slight disorganization, and total disorganization affect valence, arousal, and the frontal negativity. Participants passively viewed organized, slightly disorganized, totally disorganized, and control pictures while their electroencephalogram was recorded. They also rated the valence and arousal elicited by each picture and completed questionnaires assessing desire for order and organization behavior. Organized pictures made participants feel most pleasant, control pictures made participants feel less pleasant, slightly disorganized pictures made participants feel even less pleasant, and totally disorganized pictures made participants feel least pleasant. There were no significant effects on arousal. Totally disorganized pictures elicited a frontal negativity in the ERP between 200±2000 ms after stimulus onset, which might reflect inhibition of rearranging behavior. Individual differences in desire for order and organization behavior did not correlate with valence, arousal, or the frontal negativity. The current study design and findings could be a starting point for examining the differences between adaptive and maladaptive preferences for organization and aversions to disorganization

DATASET : Perceived ability to regulate love

Research has shown that romantic love can be regulated. We investigated perceptions about love regulation, because these perceptions may impact mental health and influence love regulation application. Two-hundred eighty-six participants completed a series of items online via Qualtrics that assessed perceived ability to up- and down-regulate, exaggerate and suppress the expression of, and start and stop different love types. We also tested individual differences in perceived love regulation ability. Participants thought that they could up- but not down-regulate love in general and that they could up-regulate love in general more than down-regulate it. Participants thought that they could up-regulate infatuation less than attachment and sexual desire. Participants also thought that they could exaggerate and suppress expressions of infatuation, attachment, and sexual desire, but that they could not start and stop infatuation and attachment, or start sexual desire. The more participants habitually used cognitive reappraisal, the more they thought that they could up- and down-regulate infatuation and attachment and up-regulate sexual desire. The more participants were infatuated with their beloved, the more they thought that they could up- but not down-regulate infatuation, attachment, and sexual desire. Finally, participants thought that they could up- and down-regulate happiness more than infatuation. These findings are a first step toward the development of psychoeducation techniques to correct inaccurate love regulation perceptions, which may improve mental health and love regulation in daily life

Regulation of romantic love feelings: Preconceptions, strategies, and feasibility

Love feelings can be more intense than desired (e.g., after a break-up) or less intense than desired (e.g., in long-Term relationships). If only we could control our love feelings! We present the concept of explicit love regulation, which we define as the use of behavioral and cognitive strategies to change the intensity of current feelings of romantic love. We present the first two studies on preconceptions about, strategies for, and the feasibility of love regulation. Questionnaire responses showed that people perceive love feelings as somewhat uncontrollable. Still, in four open questions people reported to use strategies such as cognitive reappraisal, distraction, avoidance, and undertaking (new) activities to cope with break-ups, to maintain long-Term relationships, and to regulate love feelings. Instructed up-regulation of love using reappraisal increased subjective feelings of attachment, while love down-regulation decreased subjective feelings of infatuation and attachment. We used the late positive potential (LPP) amplitude as an objective index of regulation success. Instructed love up-regulation enhanced the LPP between 300-400 ms in participants who were involved in a relationship and in participants who had recently experienced a romantic break-up, while love down-regulation reduced the LPP between 700-3000 ms in participants who were involved in a relationship. These findings corroborate the self-reported feasibility of love regulation, although they are complicated by the finding that love up-regulation also reduced the LPP between 700-3000 ms in participants who were involved in a relationship. To conclude, although people have the preconception that love feelings are uncontrollable, we show for the first time that intentional regulation of love feelings using reappraisal, and perhaps other strategies, is feasible. Love regulation will benefit individuals and society because it could enhance positive effects and reduce negative effects of romantic love