Gesinsmoorde - Waar pas die kerk in?

Taking the final report of the HSRC’s exploratory study on family murder as a point of departure, the involvement of clergy and church regarding the phenomenon of family murder is discussed in this article. After highlighting some of the findings of the exploratory study, specific problematic aspects are addressed. The implications of the Christian message of hope to people in the situation of hopelessness, murder and suicide implicit in the phenomenon of family murder, are also evaluated. Likewise, the problematic relationship between the consequences of the gospel and the requirements for mental health is also touched upon. This relationship is looked at from the perspective of certain aspects of the empirical research done in this field. Furthermore, the possible supportive role of the church is stressed: this 'ecology of care’ and the church's message of hope ought to be functional in the situation of hopelessness accompanying family murder. In conclusion, certain preventative actions, in which the church may be instrumental, are pointed out

Democratic legitimacy, desirability and deficit in EU governance

In light of multiple and existential crises, longstanding concerns about the European Union’s (EU) quest for democratic legitimacy are ever more acute. Many think such concerns can be best addressed if European institutions would become better problem-solvers and more effective crisis-managers. Stronger performance by European institutions would supposedly reinforce the EU’s democratic credentials. In this article, we reject such ‘output’ oriented accounts as specious for any assessment of the EU’s democratic legitimacy. Drawing on Michael Oakeshott’s political theory, the article argues that stronger performance addresses the desirability of governing activities in the EU rather than its democratic legitimacy. Moreover, we argue that the distinction between ‘input’ and ‘throughput’ conditions of democratic legitimacy is problematic since these conditions are inextricably linked. Finally, we show that many proposals to reduce the democratic deficit in the EU merely shift the site of the alleged deficit. FSW – Publicaties zonder aanstelling Universiteit Leide

Trauma-focused treatment outcome for complex PTSD patients: results of an intensive treatment programme

Objective The objective of the current study is to determine whether individuals classified as having CPTSD can benefit from an intensive trauma-focused treatment, resulting in decreased PTSD and CPTSD symptoms, and loss of diagnoses. Method Patients diagnosed with PTSD (N = 308) took part in an intensive 8-day treatment programme combining prolonged exposure, EMDR therapy, psycho-education, and physical activity. The treatment was not phase-based in that it did not contain a stabilization phase or skill training prior to therapy. CPTSD diagnosis was assessed by means of the International Trauma Questionnaire (ITQ) and PTSD diagnosis was assessed with both the ITQ and CAPS-5. Treatment response was measured with the CAPS-5, PCL-5, and ITQ. Results Symptoms of both PTSD and CPTSD significantly decreased from pre- to post-treatment resulting in a significant loss of CAPS-5 based PTSD (74.0%) and ITQ-based PTSD and CPTSD diagnoses (85.0% and 87.7%, respectively). No adverse events occurred in terms of suicides, suicide attempts, or hospital admissions. Conclusions The results are supportive of the notion that the majority of patients classified as having CPTSD strongly benefit from an intensive trauma-focused treatment for their PTSD

Dynamics and thermalization of the nuclear spin bath in the single-molecule magnet Mn12-ac: test for the theory of spin tunneling

The description of the tunneling of a macroscopic variable in the presence of a bath of localized spins is a subject of great fundamental and practical interest, and is relevant for many solid-state qubit designs. Instead of focusing on the the "central spin" (as is most often done), here we present a detailed study of the dynamics of the nuclear spin bath in the Mn12-ac single-molecule magnet, probed by NMR experiments down to very low temperatures (T = 20 mK). We find that the longitudinal relaxation rate of the 55Mn nuclei in Mn12-ac becomes roughly T-independent below T = 0.8 K, and can be strongly suppressed with a longitudinal magnetic field. This is consistent with the nuclear relaxation being caused by quantum tunneling of the molecular spin, and we attribute the tunneling fluctuations to the minority of fast-relaxing molecules present in the sample. The transverse nuclear relaxation is also T-independent for T < 0.8 K, and can be explained qualitatively and quantitatively by the dipolar coupling between like nuclei in neighboring molecules. We also show that the isotopic substitution of 1H by 2H leads to a slower nuclear longitudinal relaxation, consistent with the decreased tunneling probability of the molecular spin. Finally, we demonstrate that, even at the lowest temperatures, the nuclear spins remain in thermal equilibrium with the lattice phonons, and we investigate the timescale for their thermal equilibration. After a review of the theory of macroscopic spin tunneling in the presence of a spin bath, we argue that most of our experimental results are consistent with that theory, but the thermalization of the nuclear spins is not.Comment: 24 pages, 18 figures. Experimental study of the spin bath dynamics in quantum nanomagnets, plus an extensive review and application of the theor

Burden of illness of hip fractures in elderly Dutch patients

Summary: Patients with hip fractures experience reduced health-related quality of life and have a reduced life expectancy. Patients’ utilization of healthcare leads to costs to society. The results of the study can be used in future economic evaluations of treatments for hip fractures. Purpose: Hip fractures are associated with high mortality, reduced quality of life, and increased healthcare utilization, leading to an economic burden to society. The purpose of this study is to determine the burden of illness of hip fractures in elderly Dutch patients for specific time periods after surgery. Methods: Patients with a hip fracture above the age of 65 were included in the study. In the 1-year period after surgery, patients were asked to complete a set of questionnaires pre-injury (retrospectively), and 1 week, 1 month, 3 months, 6 months and 12 months after surgery. The set of questionnaires included the Euroqol 5D (EQ-5D-3L), the iMTA Medical Consumption Questionnaire (iMCQ) and iMTA Productivity Cost Questionnaire (iPCQ). Health-related quality of life was calculated using Dutch tariffs. Costs were calculated using the methodology described in the Dutch costing manual. Results: Approximately 20% of patients with a hip fracture died within 1 year. Health-related quality of life was significantly reduced compared to pre-injury values, and patients did not recover to their pre-injury values within 1 year. Total costs in the first year after injury were €27,573, of which 10% were due to costs of the procedure (€2706). Total follow-up costs (€24,876) were predominantly consisting of healthcare costs. Monthly costs decreased over time. Conclusions: Hip fractures lead to a burden to patients, resulting from mortality and health-related quality of life reductions, and to society, due to (healthcare) costs. The results of this study can be used in future economic evaluations