Looking Back From the Future: Perspective Taking in Virtual Reality Increases Future Self-Continuity

In the current study, we tested a novel perspective-taking exercise aimed at increasing the connection participants felt toward their future self, i.e., future self-continuity. Participants role-played as their successful future self and answered questions about what it feels like to become their future and the path to get there. The exercise was also conducted in a virtual reality environment and in vivo to investigate the possible added value of the virtual environment with respect to improved focus, perspective-taking, and effectiveness for participants with less imagination. Results show that the perspective taking exercise in virtual reality substantially increased all four domains of future self-continuity, i.e., connectedness, similarity, vividness, and liking, while the in vivo equivalent increased only liking and vividness. Although connectedness and similarity were directionally, but not significantly different between the virtual and in vivo environments, neither the focus, perspective taking, or individual differences in imagination could explain this difference—which suggests a small, but non-significant, placebo effect of the virtual reality environment. However, lower baseline vividness in the in vivo group may explain this difference and suggests preliminary evidence for the dependency of connectedness and similarity domains upon baseline vividness. These findings show that the perspective taking exercise in a VR environment can reliably increase the future self-continuity domains

Rational misbehavior?: Affect and cognition as preditors of criminal choice

Elffers, H. [Promotor]Vries, R.E. de [Copromotor

Дефініції поняття “інтеграція” та його ролі в конкурентному ринковому процесі

Метою даної роботи є дослідження дефініцій розуміння інтеграційних процесів в аграрній сфері та їх ролі в конкурентному економічному середовищі

Development and validation of a tool to assess the risk of QT drug-drug interactions in clinical practice

Background The exact risk of developing QTc-prolongation when using a combination of QTc-prolonging drugs is still unknown, making it difficult to interpret these QT drug-drug interactions (QT-DDIs). A tool to identify high-risk patients is needed to support healthcare providers in handling automatically generated alerts in clinical practice. The main aim of this study was to develop and validate a tool to assess the risk of QT-DDIs in clinical practice. Methods A model was developed based on risk factors associated with QTc-prolongation determined in a prospective study on QT-DDIs in a university medical center inthe Netherlands. The main outcome measure was QTc-prolongation defined as a QTc interval > 450 ms for males and > 470 ms for females. Risk points were assigned to risk factors based on their odds ratios. Additional risk factors were added based on a literature review. The ability of the model to predict QTc-prolongation was validated in an independent dataset obtained from a general teaching hospital against QTc-prolongation as measured by an ECG as the gold standard. Sensitivities, specificities, false omission rates, accuracy and Youden's index were calculated. Results The model included age, gender, cardiac comorbidities, hypertension, diabetes mellitus, renal function, potassium levels, loop diuretics, and QTc-prolonging drugs as risk factors. Application of the model to the independent dataset resulted in an area under the ROC-curve of 0.54 (95% CI 0.51-0.56) when QTc-prolongation was defined as > 450/470 ms, and 0.59 (0.54-0.63) when QTc-prolongation was defined as > 500 ms. A cut-off value of 6 led to a sensitivity of 76.6 and 83.9% and a specificity of 28.5 and 27.5% respectively. Conclusions A clinical decision support tool with fair performance characteristics was developed. Optimization of this tool may aid in assessing the risk associated with QT-DDIs.Clinical Pharmacy and Toxicolog

Planning and monitoring of patients for electrical cardioversion for atrial fibrillation

This study evaluated the waiting list for elective electrical cardioversion (ECV) for persistent atrial fibrillation (AF), focusing on when and why procedures were postponed. We compared the effects of management of the waiting list conducted by physicians versus management by nurse practitioners (NPs) and we evaluated the safety of our anticoagulating policy by means of bleeding or thromboembolic complications during and after ECV. Not all patients selected for ECV receive their treatment at the first planned instance due to a variety of reasons. These reasons are still undocumented. We evaluated 250 consecutive patients with persistent AF admitted to our clinic for elective ECV. Within 5 to 6 weeks, 186 of 242 patients (77%) received ECV. The main reason for postponing an ECV was an inadequate international normalised ratio (INR); other reasons included spontaneous sinus rhythm and switch to rate control. A total of 23 of the 147 patients (16%) managed by the research physician were postponed due to an inadequate INR at admission versus 4 out of 98 patients (4%) managed by NPs (p = 0.005) An inadequate INR is the main reason for postponing an ECV. Management of ECV by NPs is safe and leads to less postponing on admission