Ik sta graag op het podium: Het KIDARTS 2.0 meetinstrument over het welzijn van kunstkinderen

Om deze meetmethode te kunnen ontwikkelen is allereerst een verkennend onderzoek gedaan naar factoren die een rol spelen bij het welzijn van kunstkinderen. Hiervoor zijn de kinderen zelf, hun ouders en diverse andere stakeholders geraadpleegd. Vervolgens is er een meetmethode ontwikkeld, die, in de vorm van een digitale vragenlijst, als pilot is getest onder 61 kinderen en hun ouders. De digitale vragenlijst (KIDARTS1.0) bleek binnen de pilottest goed ingevuld te kunnen worden door de kinderen en hun ouders en bleek een goed inzicht te kunnen geven in de belasting van de werkzaamheden en het welzijn van de kinderen verdeeld over de diverse soorten producties. Over het algemeen werd teruggevonden dat bij producties die het meeste tijd en weekenddagen hadden gekost, de kinderen en ouders positiever waren over de begeleiding (mogelijk doordat er meer tijd voor goede begeleiding was) en de kinderen vaker uitgerust waren na een productiedag. De werving voor het invullen van de vragenlijst door kinderen en ouders bleek lastig omdat dit niet via de producentenverenigingen over inspectie kon. De meeste ouders en kinderen vonden het geen probleem om de vragen in de vragenlijst te beantwoorden en vonden het goed dat hiernaar gevraagd werd. De vragenlijsten uit de pilot (KIDARTS1.0) worden in tabel 4a en 4b aangepast naar de uiteindelijke vragenlijst (KIDARTS2.0). Aan het eind van deze rapportage worden enkele conclusies getrokken uit dit onderzoek en enkele aanbevelingen gegeven voor toekomstig gebruik van KIDARTS2.0

A Systematic Review of Outcomes Following Percutaneous Transluminal Angioplasty and Stenting in the Treatment of Transplant Renal Artery Stenosis

To evaluate outcomes following treatment of transplant renal artery stenosis by percutaneous transluminal angioplasty and stent insertion. A literature search was performed using Pubmed, MEDLINE, Embase, Wiley Interscience and the Cochrane Library databases. Outcome measures were glomerular filtration rate, creatinine, blood pressure and number of antihypertensive medications. Technical and clinical success, patency and complication rates were also analysed. Thirty-two studies met the inclusion criteria, involving a total of 884 interventions including PTA, stenting, or combinations of both. Clinical success rates were in the range 65.5-94%. The majority of studies reported technical success rates higher than 90%. Patency rates were in the range of 42-100%. However, the definition and diagnostic criteria for TRAS varied widely between studies. Also, marked heterogeneity was observed in the reporting of outcome measures with no consensus in outcome criteria or follow up schedule. Outcomes following PTA and stenting for the treatment of TRAS have been shown to be favourable. However, there is a distinct lack of well designed studies assessing outcomes following intervention. Outcome reporting may be improved by the introduction of standardised outcome measures with reporting of outcomes into a multi-centre registr

Embolisation for caecal bleeding in a child with typhlitis

A 16-year-old girl being treated for a relapse of promyelocytic leukaemia developed typhlitis of the caecum and ascending colon related to Klebsiella septicaemia during the neutropenic phase, 2 weeks after the start of induction treatment with chemotherapy. After 10 days of treatment with parenteral feeding and antibiotics, massive rectal blood loss occurred, causing haemodynamic instability. Contrast-enhanced abdominal CT showed contrast extravasation in the caecal lumen. This life-threatening situation prompted visceral angiography, which confirmed a contrast blush in the caecum. Subsequent embolisation resulted in haemodynamic stabilit

Familial Aggregation of Cognitive Biases for Children with Anxiety Disorders

Previous studies described a relation between anxiety-related cognitive biases in normally developing children and parents. The current study examined the familial aggregation of cognitive biases in children with anxiety disorders (N = 55) and their parents, with possible moderators and mediators as mechanisms underlying this aggregation. Cognitive biases for children were measured by the dot-probe task for attention bias and by ambiguous stories for interpretation bias. Mothers’ (n = 50) and fathers’ (n = 30) lifetime mood and anxiety disorders were assessed, along with their attention bias (dot-probe task) and self-reported rearing styles. Results showed an association between maternal attention bias and interpretation bias of children (r = 0.31, p = 0.032). However, this association was neither moderated by maternal lifetime mood or anxiety disorders nor mediated by maternal rearing styles. The familial aggregation of maternal attention bias and children’s interpretation bias is presumably influenced by other factors than maternal mood or anxiety disorders or rearing styles

Social and academic functioning in adolescents with anxiety disorders: A systematic review

Anxiety disorders are highly prevalent during adolescence. Although literature points out that anxiety symptoms are related to problems in social and academic functioning, the extent of these problems among adolescents with clinical anxiety disorders has not been systematically reviewed before. Electronic databases were searched up to October 2017, with keywords representing anxiety disorders, adolescents, and social or academic functioning. The inclusion criteria were studies with a sample of adolescents (10-19 years) with anxiety disorders that provided data regarding their social or academic functioning. 3431 studies were examined, of which 19 met the inclusion criteria. Adolescents with anxiety disorders had a lower social competence relative to their healthy peers. They reported more negativity within interpersonal relationships, higher levels of loneliness, and victimization. Most adolescents with anxiety disorders felt impaired at school, however, findings of their average school results, compared to peers, were mixed. In addition, they had a higher risk for school refusal and entered higher education less often. Impairments in social and academic functioning differed across type and the number of anxiety disorders. Most studies examined social phobia or anxiety disorders in general and methodological approaches varied widely between studies. This systematic review indicates that adolescents with anxiety disorders experience a range of significant problems in both social and academic functioning. These findings suggest that the assessment and treatment of anxiety disorders in adolescence should focus on improving functioning across domain

The age of onset of anxiety disorders

Book cover Age of Onset of Mental Disorders pp 125–147Cite as The Age of Onset of Anxiety Disorders Jeroen S. Legerstee, Bram Dierckx, Elisabeth M. W. J. Utens, Frank C. Verhulst, Carola Zieldorff, Gwen C. Dieleman & Jasmijn M. de Lijster Chapter First Online: 12 November 2018 1043 Accesses Abstract Anxiety disorders are highly prevalent and debilitating psychiatric conditions, which often remain unrecognised and untreated. However, left untreated, anxiety disorders often persist and can contribute to the development of other psychiatric disorders. Therefore, early detection and subsequent intervention are important. Information on the age of onset (AOO) of anxiety disorders could be informative for the timing of prevention strategies. The aim of this chapter is to review and quantitatively synthesise previous findings on the AOO of anxiety disorders. We extended data of a previous meta-analysis of our research group (de Lijster et al. 2017) with a literature search of studies published between October 2014 and June 2017. Anxiety disorders in general were found to have their mean onset at 21 years, which is earlier than the average onset of mood disorders and substance use disorders. However, the age period in which anxiety disorders develops is relatively broad. Separation anxiety disorder, specific phobia and social phobia have their onset in childhood and adolescence, whereas agoraphobia, obsessive–compulsive disorder, post-traumatic stress disorder and panic disorder have their onset in early adulthood. Generalised anxiety disorder had the latest mean onset at almost 35 years

Minimally invasive surgery versus open surgery for the treatment of solid abdominal and thoracic neoplasms in children

Background Minimally invasive surgery (MIS) is an accepted surgical technique for the treatment of a variety of benign diseases. Presently, the use of MIS in patients with cancer is progressing. However, the role of MIS in children with solid neoplasms is less clear than it is in adults. Although the use of diagnostic MIS to obtain biopsy specimens for pathology is accepted in paediatric surgical oncology, there is limited evidence to support the use of MIS for the resection of malignancies. This review is the second update of a previously published Cochrane review. Objectives To ascertain differences in outcome between the minimally invasive and open surgical approaches for the treatment of solid intra-abdominal or intra-thoracic neoplasms in children. The primary outcomes of interest are OS, EFS, port-site metastases and recurrence rate; the secondary outcome of interest is surgical morbidity. Search methods We searched CENTRAL (The Cochrane Library 2014, Issue 1), MEDLINE/PubMed (from 1966 to February 2014) and EMBASE/Ovid (from 1980 to February 2014) to identify relevant studies. In addition, we searched reference lists of relevant articles and reviews and the conference proceedings of the International Society for Paediatric Oncology and the American Society of Clinical Oncology from 2003 to 2013. On 1 May 2014 we scanned the ISRCTN Register (on www.controlled-trials.com), the National Institutes of Health register (on www.controlled-trials.com and www.clinicaltrials.gov) and the World Health Organization International Clinical Trials Registry Platform (on www.apps.who.int/trialsearch) for ongoing trials. Selection criteria Randomised controlled trials (RCTs) or controlled clinical trials (CCTs) comparing MIS to open surgery for the treatment of solid intra-thoracic or intra-abdominal neoplasms in children (aged 0 to 18 years) were considered for inclusion. Data collection and analysis Two authors performed the study selection independently. Main results The literature search retrieved 542 references. After screening the titles and abstracts we excluded 534 references which clearly did not meet the inclusion criteria. We assessed eight full text studies for eligibility and all of these studies were excluded from the review because they were not RCTs or CCTs. These excluded studies included case series, retrospective chart reviews and retrospective cohort studies. The scanning of reference lists and conference proceedings did not identify any additional studies and no (ongoing trials) were identified by the searches of trial registries. No studies that met the inclusion criteria of this review were identified Authors' conclusions No RCTs or CCTs evaluating MIS for the treatment of solid intra-thoracic or intra-abdominal neoplasms in children could be identified. The current evidence base informing the use of MIS in children with solid abdominal and thoracic neoplasms is based on other study designs like case reports, retrospective chart reviews and cohort studies and should be interpreted with caution. Thus there is insufficient evidence to allow any definitive conclusions regarding the use of MIS in these patients. High quality RCTs comparing MIS to open surgery are required. To accomplish this, centres specialising in MIS in children should collaborat

Online Attention Bias Modification in Combination with Cognitive-Behavioural Therapy for Children and Adolescents with Anxiety Disorders: A Randomised Controlled Trial

Attention Bias Modification (ABM) targets attention bias (AB) towards threat, which is common in youth with anxiety disorders. Previous clinical trials showed inconsistent results regarding the efficacy of ABM, and few studies have examined the effect of online ABM and its augmented effect with cognitive behavioural therapy (CBT). The aim of the current study was to examine the efficacy of online ABM combined with CBT for children and adolescents with anxiety disorders in a randomised, double-blind, placebo-controlled trial. Children (aged 8-16 years) completed nine online sessions of ABM (n = 28) or online sessions of the Attention Control Condition (ACC; n = 27) over a period of 3 weeks (modified dot-probe task with anxiety disorder-congruent stimuli), followed by CBT. Primary outcomes were clinician-reported anxiety disorder status. Secondary outcomes were patient-reported anxiety and depression symptoms and AB. Results showed a continuous decrease across time in primary and secondary outcomes (ps .50). Baseline AB and age did not moderate treatment effects. Online ABM combined with CBT does not show different efficacy compared with online ACC with CBT for children and adolescents with anxiety disorders