Ouderschap en psychische aandoeningen: strategieën van ouders en externe steun

Onder de mensen met psychische aandoeningen bevinden zich veel ouders van minderjarige kinderen. Naast de behoefte aan psychiatrische en psychologische behandeling voor hun individuele problematiek,hebben veel ouders met psychische aandoeningen ook steun nodig om een gewaardeerde ouderrol in hun gezin en in de samenleving te kunnen vervullen. Deze ouders en hun kinderen zijn kwetsbaar voor stigma’s endiscriminatie (Jeffery et al., 2013). Ze krijgen soms het gevoel dat ze worden beschouwd als ongeschikte ouders. Buitenstaanders twijfelen vaak of ze wel verantwoordelijk kunnen zijn voor het maken van de juiste keuzes inzake het opvoeden van hun kinderen. Als ouders met psychische problemen wel steun krijgen, vinden ze vaak dat hulpverleners teveel controle uitoefenen op het opvoeden van hun kinderen en op het uitvoeren van andere belangrijke taken in het leven (Ackerson, 2003).Deze ouders zijn dan ook niet zelden bang voor het verlies van hun wettelijk ouderlijk gezag. Naast steun voor de ouders zelf, is de aandacht en steun voor kinderen van ouders met psychische problemen – de zogenaamde ‘kopp-kinderen’– een belangrijk punt. Deze kinderen hebben immers kans op ontwikkelingsproblemen door erfelijkheid en door psychosociale stressoren tijdens het opgroeien (Van Santvoort, Hosman, Van Doesum & Janssens,2013). Voor hen zijn er reeds verschillende effectieve interventies ontwikkeld (zie bijvoorbeeld Hosman, Van Doesum & Van Santvoort, 2009)

A Structural Model of Tenure and Specific Investments

Though a lot of work has been done on the distribution of job tenures, we are still uncertain about its main determinants. In this paper, we stress random shocks to match productivity after the start of an employment relation. The specificity of investment makes hiring and separation decisions irreversible.These decisions therefore have an option value. Assumptions on riskneutrality, efficient bargaining, and the efficient resolution of hold up problems allow investment and separation decisions to be analyzed separately from wage setting. The tenure profiles in wages implied by the model fit the observed pattern quite well. The model yields a hump shaped pattern in separation rates, similar to learning models, but with a slowerdecline after the peak. Estimation results using job tenure data from the NLSY support this humped shaped pattern and favor this model above the learning model. We develop a methodology to analyze the decomposition of shocks to match productivity into idiosyncratic and macro-level shocks.When assuming a Last-In-First-Out (LIFO) separation rule, this model of individualemployment relations is embedded in a model of firm level employment, that satisfies Gibrat’s law. The LIFO rule is interpreted as an institution protecting the property rights on specific investments of incumbentworkers against hiring new workers by the firm.option value, job tenure, tenure profiles

Reperfusion therapy for Ischemic stroke:Analysis of research methods and outcomes

For patients with ischemic stroke, early reperfusion of the brain tissue by removing the occluding thrombus is essential to limit or even reverse neurological deficits. To improve clinical and safety outcomes of patients with ischemic stroke, new interventions should be designed and evaluated in clinical trials.The overall aim of the research described in this thesis is to evaluate and improveclinical research methods and outcomes in patients treated with reperfusiontherapy for ischemic stroke.Based on the research in this thesis, we recommend use of the modified Rankin Scale score as primary outcome measure with assessment performed by central assessors in phase III trials. For phase II(b) trials of acute treatment for ischemic stroke, the NIHSS within 1 week can be used as a primary outcome measure. Presence of any ICH on MRI can be reliably used as (safety) outcome measure. For trials with subjective outcome and PROBE design, the methods and effectiveness of blinding should be assessed and reported. Whether dual thrombolytic treatment with small bolus alteplase followedby mutant pro-urokinase improves outcomes in patients with ischemic stroke needsto be assessed in larger trials in patients with larger ischemic strokes.<br/

Supporting Parents with Psychiatric Disabilities and Promoting Recovery: An International Challenge

Introduction: Parenting is a significant life role for adults with psychiatric disabilities. Not only is success in this role a normal life goal for many, but functioning as well as possible as parents would seem to be intimately related to the recovery process and successful functioning in other major life domains. Research on the prevalence and needs of parents with psychiatric disabilities in two countries, the U.S. and The Netherlands, provides the framework for developing and testing interventions. Essential program components include supports for parents in meeting their children’s needs as well as managing their own. Research Question: What are the effects of “Parenting with Success & Satisfaction?” in terms of success, satisfaction, empowerment & quality of life? Intervening variables of the intensity of support, the contact between carer & parent will be included. The design is a non-equivalent control group design, in which the outcomes for 40 parents participating in the program will be compared with outcomes for 40 parents receiving care as usual in other locations. Recommendations: Provide programs for parents in all kinds of settings; Improve communication about own problems with children; Make a plan for the support of children when psychiatric problems increase; Organize small meeting groups for parents

The development of a care-giving burden scale.

A burden scale is described that is conceptually specific by concentrating on an assessment of different aspects of distress of care-giving burden and conceptually sensitive by distinguishing two dimensions: the relationship of the carer and the care-receiver and the limitations in the personal life of the carer. To develop a burden scale an analysis was carried out on a database of an intervention study in which 89 informal caregivers of psychogeriatric patients were interviewed twice. A principal components analysis was carried out showing two main factors that could be interpreted as the two dimensions mentioned above. Reliability analysis showed a Cronbach's alpha of 0.84 for the total care-giving burden scale (13 items) and 0.77 for both subscales (7 and 6 items), confirmed in an independent sample. An analysis of the hierarchy of items (Mokken Scale Analysis) showed a strong and moderate hierarchy for the subscales and the total scale, respectively. Finally, an analysis of construct validity showed strong correlations of care-giving burden with depression of the carer and deviant behaviour of the patient

A Structural Model of Tenure and Specific Investments

Though a lot of work has been done on the distribution of job tenures, we are still uncertain about its main determinants. In this paper, we stress random shocks to match productivity after the start of an employment relation. The specificity of investment makes hiring and separation decisions irreversible. These decisions therefore have an option value. Assumptions on risk neutrality, efficient bargaining, and the efficient resolution of hold up problems allow investment and separation decisions to be analyzed separately from wage setting. The tenure profiles in wages implied by the model fit the observed pattern quite well. The model yields a hump shaped pattern in separation rates, similar to learning models, but with a slower decline after the peak. Estimation results using job tenure data from the NLSY support this humped shaped pattern and favor this model above the learning model. We develop a methodology to analyze the decomposition of shocks to match productivity into idiosyncratic and macro-level shocks. When assuming a Last-In-First-Out (LIFO) separation rule, this model of individual employment relations is embedded in a model of firm level employment, that satisfies Gibrat's law. The LIFO rule is interpreted as an institution protecting the property rights on specific investments of incumbent workers against hiring new workers by the firm

Een ondersteuningsgroep voor studenten met psychiatrische beperkingen.

In dit artikel wordt ingegaan op de ontwikkeling van een ondersteuningsgroep voor studenten met psychiatrische beperkingen. Deze is opgezet in het kader van een project Studeren met Steun. Naast deze ondersteuningsgroep zijn in dit project workshops voor docenten van hogeschool en universiteit georganiseerd en informatiebrochures voor de genoemde doelgroep gemaakt (zie www.begeleidleren.nl). Eerst worden enkele achtergrondgegevens van studenten met psychiatrische beperkingen belicht en vervolgens worden de ontwikkeling van een ondersteuningsgroep en de ervaringen daarmee beschreven. Na de discussie worden aanbevelingen gedaan