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Background: According to the Risk-Needs-Responsivity Model (RNR-Model), substance use is one of the strongest predictors of recidivism. There is often comorbidity of symptoms of depression, anxiety and stress, but the effect of these symptoms on recidivism is still unclear., Aim: To investigate whether different types of substance use predict recidivism risk and whether symptoms of depression, anxiety and stress, and gender moderated this relation, within the forensic outpatient addiction care., Method: We used the Forensische Ambulante Risico Evaluatie (FARE; a risk assessment tool) and the Measurements in the Addictions for Triage and Evaluation (MATE; an assessment instrument for measuring type of substance use and internalizing symptoms, a.o.). Participants were 396 clients, both male and female, receiving outpatient forensic addiction treatment. The outcome was recidivism risk, with substance use and gender as predictive factors, and symptoms of depression, anxiety and stress as moderating factors., Results: The type of substance use contributed significantly to a higher recidivism risk. Specifically cocaine and opiates/sedatives contributed to a higher recidivism risk than alcohol and other substances. Men had a higher recidivism risk than women. Symptoms of depression, anxiety and stress did not significantly contribute to a difference in recidivism risk between alcohol users and users of other substances., Conclusion: Future research should focus on including offenders with and without substance use problems. In this way, it can be determined more clearly which factors influence the recidivism risk and therefore are important for forensic treatment. In addition, more research is necessary to investigate the moderating role of symptoms of depression, anxiety and stress on the relationship between different kinds of substance use and recidivism (risk), and the role of different kinds of substance use and gender on recidivism (risk), to adjust forensic treatment to clients’ treatable risk factors.

POSITIVE EXPERIENCE THROUGH INFORMAL CARE: CONSTRUCTION OF A SCALE: An 8-item scale has been developed to measure positive experiences by informal caregivers, the Positive Experiences Scale (PES). The PES is a unidimensional hierarchical Mokkenscale which varies from intrinsic satisfaction and relational enhancement to improvement of competence and social enhancement. The scale has a satisfactory Loevinger's H-value (0.37) and reliability (0.74). Furthermore, satisfying H-values are found for large groups of informal caregivers, such as carers for the elderly, the chronically ill, partners, parents and people who live in a care facility. For informal caregivers of people with dementia or mental impairments, two items do not uphold ('I received appreciation for the care I've been giving' and 'the help brought me and my family and friends closer together'. For these groups a 6-item scale is advised. Solely for informal caregivers of people with psychological impairments, the scale as a whole does not uphold. Further research will have to determine how these caregivers derive positive experiences from caregiving. The PES is recommended because of its psychometric qualities and its usefulness in different populations of informal caregivers.

An 8-item scale has been developed to measure positive experiences by informal caregivers, the Positive Experiences Scale (PES). The PES is a unidimensional hierarchical Mokkenscale which varies from intrinsic satisfaction and relational enhancement to improvement of competence and social enhancement. The scale has a satisfactory Loevinger's H-value (0.37) and reliability (0.74). Furthermore, satisfying H-values are found for large groups of informal caregivers, such as carers for the elderly, the chronically ill, partners, parents and people who live in a care facility. For informal caregivers of people with dementia or mental impairments, two items do not uphold ('I received appreciation for the care I've been giving' and 'the help brought me and my family and friends closer together'. For these groups a 6-item scale is advised. Solely for informal caregivers of people with psychological impairments, the scale as a whole does not uphold. Further research will have to determine how these caregivers derive positive experiences from caregiving. The PES is recommended because of its psychometric qualities and its usefulness in different populations of informal caregivers.

To measure the experienced burden by informal carers (N = 2.444), a 15-item Mokken scale has been developed. This concerns an extended version of the EDIZ ("Ervaren druk door Informele zorg"); several items refer to the pressure of time brought by the combination of labour and care and the consequences for the health of the informal carers are added to the EDIZ. We call this new scale the EDIZ-plus; it concerns a reliable one-dimensional and hierarchical scale which extends from o (no burden) to maximum 15 (severe burden). First, the burden manifests itself in feelings of responsibility of the carer, followed by having difficulty with combining work and family tasks and ultimately exceeding all limits due to too many obligations. In most cases this last group does not only deal with conflicts at home or at work and a decline in their own health, they also experience all other problems in the scale. The presumed limit for overburdening is enclosed by the proposition 'caring put too much pressure on me'. This is a score on the EDIZ-plus of nine or higher. Furthermore, the scale has proved to be usable for several population groups, such as carers of partners and children, parents/parents-in-law and carers of different patient populations (people with dementia, mental disability or a chronic disease). The EDIZ-plus is not only suitable because of its reasonable psychometric qualities, but also because of the usability in different populations.

Turner syndrome is the result of the complete or partial absence of one X-chromosome. As well as short stature and gonadal dysgenesis, a wide range of abnormalities which may not present themselves until adulthood, are seen in nearly every organ system. Adult women with this syndrome have a reduced estimated life expectancy due to the greatly increased risk of structural abnormalities of the heart and aorta, and of other cardiovascular disease. The latter is due to the higher prevalence of hypertension, type-2 diabetes mellitus and dyslipidaemia. Furthermore, Turner syndrome in adulthood is characterized by infertility and oestrogen substitution is often necessary. Due to the diverse and interconnected nature of these problems, women with Turner syndrome benefit from coordinated medical care provided by a multidisciplinary outpatient team including an internist-endocrinologist, a gynaecologist and a cardiologist. We advise a periodic medical screening of women with this syndrome.