Ruling the Referendum?:European Integration Challenged by Direct Democracy

Referendums on European integration play a prominent role in the decision-making processes in current European democracies. Between 1972 and 2016, 61 EU-related referendums took place across 28 countries. In his dissertation, Joost van den Akker (1984) investigates under which conditions governments win such EU-related referendums. The fact that the government won in 46 cases demonstrates that overall governments have been quite successful in securing popular support for their EU policies. The study locates the EU-related referendum in the historical perspective of referendums in Europe after the French revolution. It develops a model to explain the current potential and practice of EU-related referendums in European democracies. The most prominent contribution lies in explaining the referendum result by politicalinstitutional and socio-economic conditions at the aggregate level. It is argued that a unifi ed majority government and economic development are the main drivers for winning referendums. If the economy is deteriorating, however, the government only wins if it is only recently in offi ce and backed by a wide consensus among elites. The dissertation explains why EU-related referendums are held, under which conditions governments win or lose them, and how governments cope with inconvenient outcomes. In this way, it contributes to the strategies which governments can deploy to win a referendum, or to deal best with a referendum defeat

Referendums on EU matters

This study was commissioned by the European Parliament’s Policy Department for Citizens’ Rights and Constitutional Affairs at the request of the Committee on Constitutional Affairs of the European Parliament. It analyses the political and legal dynamics behind referendums on EU-related matters. It argues that we have entered a period of increasing political uncertainty with regard to the European project and that this new political configuration will both affect and be affected by the politics of EU-related referendums. Such referendums have long been a risky endeavour and this has been accentuated in the wake of the Great Recession with its negative ramifications for public opinion in the European Union. It is clear that referendums on EU matters are here to stay and will continue to be central to the EU’s future as they are deployed to determine the number of Member States within the EU, its geographical reach, its constitutional evolution and adherence to EU policies. Only now they have become an even riskier endeavour

A randomized controlled trial of an Internet-based intervention for eating disorders and the added value of expert-patient support: study protocol

Background: E-mental health has become increasingly popular in interventions for individuals with eating disorders (EDs). It has the potential to offer low-threshold interventions and guide individuals to the needed care more promptly. Featback is such an Internet-based intervention and consists of psychoeducation and a fully automated monitoring and feedback system. Preliminary findings suggest Featback to be (cost-)effective in reducing ED symptomatology. Additionally, e-mail or chat support by a psychologist did not enhance the effectiveness of Featback. Support by an expert patient (someone with a lived experience of an ED) might be more effective, since that person can effectively model healthy behavior and enhance self-efficacy in individuals struggling with an ED. The present study aims to replicate and build on earlier findings by further investigating the (cost-)effectiveness of Featback and the added value of expert-patient support. Methods: The study will be a randomized controlled trial with a two-by-two factorial design with repeated measures. The four conditions will be (1) Featback, in which participants receive automated feedback on a short monitoring questionnaire weekly, (2) Featback with weekly e-mail or chat support from an expert patient, (3) weekly support from an expert patient, and (4) a waiting list. Participants who are 16 years or older and have at least mild self-reported ED symptoms receive a baseline measure. Subsequently, they are randomized to one of the four conditions for 8 weeks. Participants will be assessed again post-intervention and at 3, 6, 9, and 12 months follow-up. The primary outcome measure will be ED psychopathology. Secondary outcome measures are experienced social support, self-efficacy, symptoms of anxiety and depression, user satisfaction, intervention usage, and help-seeking attitudes and behaviors. Discussion: The current study is the first to investigate e-mental health in combination with expert-patient support for EDs and will add to the optimization of the delivery of Internet-based interventions and expert-patient support. Trial registration: Netherlands Trial Register, NTR7065. Registered on 7 June 2018

A randomized controlled trial of an Internet-based intervention for eating disorders and the added value of expert-patient support: study protocol

Background: E-mental health has become increasingly popular in interventions for individuals with eating disorders (EDs). It has the potential to offer low-threshold interventions and guide individuals to the needed care more promptly. Featback is such an Internet-based intervention and consists of psychoeducation and a fully automated monitoring and feedback system. Preliminary findings suggest Featback to be (cost-)effective in reducing ED symptomatology. Additionally, e-mail or chat support by a psychologist did not enhance the effectiveness of Featback. Support by an expert patient (someone with a lived experience of an ED) might be more effective, since that person can effectively model healthy behavior and enhance self-efficacy in individuals struggling with an ED. The present study aims to replicate and build on earlier findings by further investigating the (cost-)effectiveness of Featback and the added value of expert-patient support. Methods: The study will be a randomized controlled trial with a two-by-two factorial design with repeated measures. The four conditions will be (1) Featback, in which participants receive automated feedback on a short monitoring questionnaire weekly, (2) Featback with weekly e-mail or chat support from an expert patient, (3) weekly support from an expert patient, and (4) a waiting list. Participants who are 16 years or older and have at least mild self-reported ED symptoms receive a baseline measure. Subsequently, they are randomized to one of the four conditions for 8 weeks. Participants will be assessed again post-intervention and at 3, 6, 9, and 12 months follow-up. The primary outcome measure will be ED psychopathology. Secondary outcome measures are experienced social support, self-efficacy, symptoms of anxiety and depression, user satisfaction, intervention usage, and help-seeking attitudes and behaviors. Discussion: The current study is the first to investigate e-mental health in combination with expert-patient support for EDs and will add to the optimization of the delivery of Internet-based interventions and expert-patient support. Trial registration: Netherlands Trial Register, NTR7065. Registered on 7 June 2018

Intramyocardial stem cell injection : go(ne) with the flow

In this study, we visualize the real-time dynamics of intramyocardial stem-cell injections. This shows a massive, immediate wash-out via venous drainage, accounting for the low retention. The use of carriers reduces this outflow