Modeling the Adenoma and Serrated Pathway to Colorectal CAncer (ASCCA)

Several colorectal cancer (CRC) screening models have been developed describing the progression of adenomas to CRC. Currently, there is increasing evidence that serrated lesions can also develop into CRC. It is not clear whether screening tests have the same test characteristics for serrated lesions as for adenomas, but lower sensitivities have been suggested. Models that ignore this type of colorectal lesions may provide overly optimistic predictions of the screen‐induced reduction in CRC incidence. To address this issue, we have developed the Adenoma and Serrated pathway to Colorectal CAncer (ASCCA) model that includes the adenoma‐carcinoma pathway and the serrated pathway to CRC as well as characteristics of colorectal lesions. The model structure and the calibration procedure are described in detail. Calibration resulted in 19 parameter sets for the adenoma‐carcinoma pathway and 13 for the serrated pathway that match the age‐ and sex‐specific adenoma and serrated lesion prevalence in the COlonoscopy versus COlonography Screening (COCOS) trial, Dutch CRC incidence and mortality rates, and a number of other intermediate outcomes concerning characteristics of colorectal lesions. As an example, we simulated outcomes for a biennial fecal immunochemical test screening program and a hypothetical one‐time colonoscopy screening program. Inclusion of the serrated pathway influenced the predicted effectiveness of screening when serrated lesions are associated with lower screening test sensitivity or when they are not removed. To our knowledge, this is the first model that explicitly includes the serrated pathway and characteristics of colorectal lesions. It is suitable for the evaluation of the (cost)effectiveness of potential screening strategies for CRC.     

Uniqueness of equilibria in atomic splittable polymatroid congestion games

We study uniqueness of Nash equilibria in atomic splittable congestion games and derive a uniqueness result based on polymatroid theory: when the strategy space of every player is a bidirectional flow polymatroid, then equilibria are unique. Bidirectional flow polymatroids are introduced as a subclass of polymatroids possessing certain exchange properties. We show that important cases such as base orderable matroids can be recovered as a special case of bidirectional flow polymatroids. On the other hand we show that matroidal set systems are in some sense necessary to guarantee uniqueness of equilibria: for every atomic splittable congestion game with at least three players and non-matroidal set systems per player, there is an isomorphic game having multiple equilibria. Our results leave a gap between base orderable matroids and general matroids for which we do not know whether equilibria are unique.     

Addiction severity predictions using client network properties

By statistical analysis of client data it is shown how past or current network information together with other knowledge assesses treatment needs. The main findings are as follows. The client's previous exposure to addicts in the family has almost no influence on his or her present contacts with addicts in daily life. About 30% of the clients have experienced addicts both in family and among friends, about 30% have only family exposure, about 20% have neither kind of exposure, and about 20% have no family exposure but have current exposure to addicts. Exposure to addicts in family implies a higher risk of severe need for professional intervention than no such exposure. For the clients with no family exposure but with current exposure to addicts there is, somewhat surprisingly, a lower risk than for the other three categories of clients. This effect seems to be mainly because the psychiatric status of these clients is somewhat better than for those in the other three categories. The effect disappears if we look solely for drug addiction intervention needs; then there is a clear increase in relative treatment needs for the categories with previous or present addiction exposure compared to those without.     

Adolescents' Career Decision‐Making Process: Related to Quality of Attachment to Parents?

This longitudinal study examined how adolescents' perceptions of attachment security with parents relate to their process of choosing a major in higher education. The participants were 281 students who were investigated at the beginning, middle, and end of Grade 12. Findings showed that higher perceived security with mother, but not with father, predicted higher levels of coping with the career decisional tasks of orientation, broad and in‐depth environmental exploration, and self‐exploration in the future. However, perceived security did not relate to the degree of change in decisional tasks during Grade 12. Finally, results suggested that the association between perceived security with mother and the decisional tasks of orientation, broad and in‐depth environmental exploration, and self‐exploration was mediated by adolescents' career decision‐making self‐efficacy.     

Learning to manage and share data: jump-starting the research methods curriculum

Researchers’ responsibilities towards their research data are changing across all domains of social scientific endeavour. Government, funders and publishers expect greater transparency of, open access to, and re-use of research data, and fears over data loss call for more robust information security practices. Researchers must develop, enhance and professionalise their research data management skills to meet these challenges and to deal with a rapidly changing data sharing environment. This paper sets out how we have contributed to jump-starting the research methods training curriculum in this field by translating high-level needs into practical guidance and training activities. Our pedagogical approach involves applicable, easy-to-digest, modules based on best practice guidance for managing and sharing research data. In line with recent findings on successful practices in methods teaching, we work on the principle of embedding grounded learning activities within existing narratives of research design and implementation.     

Children's Influence on Internet Access at Home: Adoption and use in the family context

In this study, an integrated quantitative and qualitative research design was employed. From over 900 telephone interviews a typology of family types based on possession of media appliances was constructed, then divided into 'traditional' (low media density), 'intermediate' (average media density) and 'multimedia' (high media density) families. This typology was then used as a basis for selecting thirty-eight families for in-depth interviews. Of these, thirty-one contained children and it is these that form the basis for this article. The results of the family interviews indicate that children are a very important factor in the acquisition and use of the Internet. It was apparent from our interviews that Internet access and use become major issues in family discussions and conflicts - both between parents and children and between siblings.     

Return to work among employees with mental health problems: Development and validation of a self-efficacy questionnaire

Abstract

Because of the costs to both the organization and the individual, it is important that employees who are sick-listed with mental health problems are facilitated in their return to work (RTW). In order to provide adequate interventions, it is necessary to obtain a better understanding of the RTW process of people with mental health problems. Work-related self-efficacy (SE) might play a key role within this process. This paper describes the development and validation of the return-to-work self-efficacy’ scale (RTW-SE) for employees with mental health problems. Three Dutch samples of sick-listed employees were used to validate the 11-item instrument (N=2214). Based on the factor structure and reliability results, RTW-SE was conceptualized as a unitary construct. The associations with general SE, locus of control, coping, physical workload and mental health problems support the construct validity of this scale. Most importantly, RTW-SE proved to be a robust predictor of actual return to work within three months. The encouraging preliminary psychometric properties of the scale make it a potentially valuable tool in research and in clinical practice and occupational health care settings, both before and after employees have returned to work.     

Return to work: A comparison of two cognitive behavioural interventions in cases of work-related psychological complaints among the self-employed

Abstract

We investigated the effectiveness of cognitive behavioural therapy (CBT) and a combined intervention of workplace- and individual-focused techniques among self-employed people on sick leave owing to work-related psychological complaints (such as anxiety, depression, and burnout). Both interventions were based on CBT; however, one was conducted by psychotherapists and involved extensive CBT, while the other was delivered by “labour experts” and consisted of a brief CBT-derived intervention combined with both individual-focused and workplace interventions. One hundred and twenty-two self-employed people who had applied for sickness benefit from an insurance company enrolled in a randomized controlled design. These individuals were assessed before the intervention and then at 4 months and 10 months after the onset of the intervention. The outcome was assessed based on duration of sick leave until partial and full return to work and on psychological complaints. Significant effects on partial and full return were found in favour of the combined intervention: partial return occurred 17 and 30 days earlier in this group than in the CBT group and the control group, respectively. For full return to work, the difference was approximately 200 days. A decrease in psychological complaints was present in each condition but we found no significant interaction effects. The results suggest that work resumption should be addressed earlier in individuals receiving CBT. This insight is of value for the (scarce) literature concerning interventions for individuals who are on sick leave owing to work-related psychological complaints.     

How do substance abusers and their significant others experience the re‐entry phase of therapeutic community treatment: a qualitative study1

Transition to re‐entry (aftercare) is a stressful event for therapeutic community residents. While several authors agree on the importance of social support during reintegration, few studies have focused on the experiences of re‐entry clients themselves and their significant others during this period. Using a case‐study design, the present study examines the re‐entry process of four TC‐residents and three of their social network members during a six‐month period, starting at the time of their transfer to the halfway house. Clients and their significant others have mixed feelings about the reintegration period, although both are mainly positive. Clients report difficulties in leaving behind the TC‐mentality and building up a stable social network; they are surprised about the frequent contacts with substance (ab)use in mainstream society. Significant others misjudge clients’ feelings about transition and relapse. Many significant others have a positive attitude towards the use of substances. The tendency in mainstream society to increasingly accept the use of substances intensifies clients’ need for early guidance in building up stable supportive networks. Significant others need well‐grounded information on the reintegration process and on relapse.