The ripple effect in family networks:Relational structures and well-being in divorced and non-divorced families.

Het aantal echtscheidingen in Europa is de afgelopen 50 jaar verdubbeld. Dit proefschrift gaat over de vraag waarom het met sommige families beter gaat na scheiding dan met andere in termen van relatiekwaliteit, conflict en welbevinden. Als ouders gaan scheiden heeft dit niet alleen gevolgen voor de relaties tussen gezinsleden, ouders en hun kind(eren), maar ook voor overige familieleden, zoals grootouders en ooms/tantes. Tegelijkertijd zijn deze familieleden een belangrijke vorm van steun voor het gezin. Ten eerste onderzochten we de aard en structuur van afhankelijkheden tussen familierelaties. We vonden dat de relatie van broers/zussen met hun ouders een belangrijke voorspeller van hun onderlinge broer-zus relatie is. Wanneer we naar het grotere familienetwerk kijken en wel/niet gescheiden families vergelijken zien we dat contact tussen de drie generaties in gescheiden families lager is dan in niet-gescheiden families. Minder contact met familie aan de ene kant van de familie gaat samen met meer contact met familie aan de andere kant, maar dit is niet sterker in gescheiden families. Ten tweede onderzochten we hoe familierelaties het welbevinden beïnvloeden. We bestudeerden ambivalente, dat wil zeggen tegelijk positieve en negatieve, familierelaties van moeders en zagen dat hoe moeders zijn ingebed in ambivalente driehoeksverhoudingen gevolgen heeft voor haar welbevinden. In een laatste studie, waarvoor familienetwerkdata onder gescheiden en niet gescheiden families in Lifelines werd verzameld, vonden we dat de combinatie van emotionele en praktische steun van anderen in de familie bijdraagt aan het welbevinden van familieleden. Ook hier vonden we geen verschillen tussen gescheiden en niet-gescheiden families.Over the last 50 years, the divorce rate in Europe has doubled. This thesis investigates why some families fare better than others after parental divorce regarding relationship quality, conflict and well-being. Parental divorce not only affects relationships in the nuclear family, i.e., parents and children, but also extended family members, i.e., grandparents and aunts/uncles. Extended family members can also be an important source of support for nuclear family members after divorce. First, we investigated the structure and nature of the interdependence of family relationships. In the nuclear family, we found that the quality of the relations between two siblings strongly depends on the relationships both siblings have with their parents. Studying the larger family network and comparing divorced and non-divorced families, we found that contact between the three generations is lower in divorced families compared to non-divorced families. Less frequent contact with one side of the family goes together with more frequent contact with the other side, similarly for divorced and non-divorced families. Second, we investigated how family relationships affect well-being. We analysed ambivalent, i.e., simultaneously positive and negative, family relationships of mothers and found that the pattern of ambivalent triads in which mothers are embedded has consequences for her well-being. In the final study, for which family network data were collected among divorced and non-divorced families in Lifelines, we showed that emotional combined with practical support from others in the family contributes to family members’ well-being. No differences were found between divorced and non-divorced families in these respects

Balance in Family Triads:How Intergenerational Relationships Affect the Adult Sibling Relationship

In order to understand the interdependency between intergenerational and adult sibling relationships, a family systems perspective is applied to identify a smaller?empirically analyzable?relational unit of analysis, that is, the sibling?parent?sibling triad. Using balance theory, triadic configurations are derived that represent enhancement, compensation, and loyalty conflicts. The hypotheses are tested for three relational dimensions: support exchange, contact, and conflict. Multilevel analyses of 549 sibling?parent?sibling triads from the Netherlands Kinship Panel data show strong evidence for enhancement, whereas some indication was obtained for sibling relationships being affected by loyalty conflicts. The results underscore and substantiate interdependency between intergenerational and adult sibling relationships

Анализ free-running автомата над конечным кольцом

Исследован аналог над конечным кольцом хаотической динамической free-running системы. С позиции теории автоматов охарактеризована структура исследуемой модели. Решены задачи параметрической идентификации и идентификации начального состояния. Охарактеризована структура множества неподвижных точек словарной функции, реализуемой инициальным автоматом.Досліджено аналог над кінцевим кільцем хаотичної динамічної free-running системи. З позиції теорії автоматів охарактеризована структура моделі, яка вивчається. Розв’язано задачі параметричної ідентифікації та ідентифікації початкового стану. Охарактеризовано структуру множини нерухомих точок словникової функції, яка реалізується ініціальним автоматом.The analog over the finite ring of chaotic dynamical free-running system is investigated. The structure of the model under investigation is characterized in terms of automaton theory. Problems of parametric identification and identification of the initial state are solved. The structure of fixed points in the mapping realized by the initial automaton is characterized

BUILDING BRIDGES FOR INNOVATION IN AGEING : SYNERGIES BETWEEN ACTION GROUPS OF THE EIP ON AHA

The Strategic Implementation Plan of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) proposed six Action Groups. After almost three years of activity, many achievements have been obtained through commitments or collaborative work of the Action Groups. However, they have often worked in silos and, consequently, synergies between Action Groups have been proposed to strengthen the triple win of the EIP on AHA. The paper presents the methodology and current status of the Task Force on EIP on AHA synergies. Synergies are in line with the Action Groups' new Renovated Action Plan (2016-2018) to ensure that their future objectives are coherent and fully connected. The outcomes and impact of synergies are using the Monitoring and Assessment Framework for the EIP on AHA (MAFEIP). Eight proposals for synergies have been approved by the Task Force: Five cross-cutting synergies which can be used for all current and future synergies as they consider overarching domains (appropriate polypharmacy, citizen empowerment, teaching and coaching on AHA, deployment of synergies to EU regions, Responsible Research and Innovation), and three cross-cutting synergies focussing on current Action Group activities (falls, frailty, integrated care and chronic respiratory diseases).Peer reviewe

Allergic Rhinitis and its Impact on Asthma (ARIA) Phase 4 (2018) : Change management in allergic rhinitis and asthma multimorbidity using mobile technology

Allergic Rhinitis and its Impact on Asthma (ARIA) has evolved from a guideline by using the best approach to integrated care pathways using mobile technology in patients with allergic rhinitis (AR) and asthma multimorbidity. The proposed next phase of ARIA is change management, with the aim of providing an active and healthy life to patients with rhinitis and to those with asthma multimorbidity across the lifecycle irrespective of their sex or socioeconomic status to reduce health and social inequities incurred by the disease. ARIA has followed the 8-step model of Kotter to assess and implement the effect of rhinitis on asthma multimorbidity and to propose multimorbid guidelines. A second change management strategy is proposed by ARIA Phase 4 to increase self-medication and shared decision making in rhinitis and asthma multimorbidity. An innovation of ARIA has been the development and validation of information technology evidence-based tools (Mobile Airways Sentinel Network [MASK]) that can inform patient decisions on the basis of a self-care plan proposed by the health care professional.Peer reviewe

Correlation between work impairment, scores of rhinitis severity and asthma using the MASK-air (R) App

Background In allergic rhinitis, a relevant outcome providing information on the effectiveness of interventions is needed. In MASK-air (Mobile Airways Sentinel Network), a visual analogue scale (VAS) for work is used as a relevant outcome. This study aimed to assess the performance of the work VAS work by comparing VAS work with other VAS measurements and symptom-medication scores obtained concurrently. Methods All consecutive MASK-air users in 23 countries from 1 June 2016 to 31 October 2018 were included (14 189 users; 205 904 days). Geolocalized users self-assessed daily symptom control using the touchscreen functionality on their smart phone to click on VAS scores (ranging from 0 to 100) for overall symptoms (global), nose, eyes, asthma and work. Two symptom-medication scores were used: the modified EAACI CSMS score and the MASK control score for rhinitis. To assess data quality, the intra-individual response variability (IRV) index was calculated. Results A strong correlation was observed between VAS work and other VAS. The highest levels for correlation with VAS work and variance explained in VAS work were found with VAS global, followed by VAS nose, eye and asthma. In comparison with VAS global, the mCSMS and MASK control score showed a lower correlation with VAS work. Results are unlikely to be explained by a low quality of data arising from repeated VAS measures. Conclusions VAS work correlates with other outcomes (VAS global, nose, eye and asthma) but less well with a symptom-medication score. VAS work should be considered as a potentially useful AR outcome in intervention studies.Peer reviewe

Adherence to treatment in allergic rhinitis using mobile technology. The MASK Study

Background: Mobile technology may help to better understand the adherence to treatment. MASK-rhinitis (Mobile Airways Sentinel NetworK for allergic rhinitis) is a patient-centred ICT system. A mobile phone app (the Allergy Diary) central to MASK is available in 22 countries. Objectives: To assess the adherence to treatment in allergic rhinitis patients using the Allergy Diary App. Methods: An observational cross-sectional study was carried out on all users who filled in the Allergy Diary from 1 January 2016 to 1 August 2017. Secondary adherence was assessed by using the modified Medication Possession Ratio (MPR) and the Proportion of days covered (PDC) approach. Results: A total of 12143 users were registered. A total of 6949 users reported at least one VAS data recording. Among them, 1887 users reported >= 7 VAS data. About 1195 subjects were included in the analysis of adherence. One hundred and thirty-six (11.28%) users were adherent (MPR >= 70% and PDC = 70% and PDC = 1.50) and 176 (14.60%) were switchers. On the other hand, 832 (69.05%) users were non-adherent to medications (MPR Conclusion and clinical relevance: Adherence to treatment is low. The relative efficacy of continuous vs on-demand treatment for allergic rhinitis symptoms is still a matter of debate. This study shows an approach for measuring retrospective adherence based on a mobile app. This also represents a novel approach for analysing medication-taking behaviour in a real-world setting.Peer reviewe

Guidance to 2018 good practice : ARIA digitally-enabled, integrated, person-centred care for rhinitis and asthma

AimsMobile Airways Sentinel NetworK (MASK) belongs to the Fondation Partenariale MACVIA-LR of Montpellier, France and aims to provide an active and healthy life to rhinitis sufferers and to those with asthma multimorbidity across the life cycle, whatever their gender or socio-economic status, in order to reduce health and social inequities incurred by the disease and to improve the digital transformation of health and care. The ultimate goal is to change the management strategy in chronic diseases.MethodsMASK implements ICT technologies for individualized and predictive medicine to develop novel care pathways by a multi-disciplinary group centred around the patients.StakeholdersInclude patients, health care professionals (pharmacists and physicians), authorities, patient's associations, private and public sectors.ResultsMASK is deployed in 23 countries and 17 languages. 26,000 users have registered.EU grants (2018)MASK is participating in EU projects (POLLAR: impact of air POLLution in Asthma and Rhinitis, EIT Health, DigitalHealthEurope, Euriphi and Vigour).Lessons learnt(i) Adherence to treatment is the major problem of allergic disease, (ii) Self-management strategies should be considerably expanded (behavioural), (iii) Change management is essential in allergic diseases, (iv) Education strategies should be reconsidered using a patient-centred approach and (v) Lessons learnt for allergic diseases can be expanded to chronic diseases.Peer reviewe