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As language may be an important barrier for ethnic minority families to access health care, interpreters can be a valuable aid to reach these families. Little is known, however, about the effects of using interpreters in mental health care. The present study investigated whether the use of interpreters affected treatment outcomes of Multisystemic therapy (MST) in the Netherlands. Ninety-one cases with an interpreter were compared with 91 cases without an interpreter. The two groups were matched regarding age, gender, imposed sanction, and therapist. Each case’s progress, treatment duration, and treatment outcomes were obtained. For 61 of the matched pairs, long-term re-conviction rates were retrieved from official judicial records. Comparing the cases with interpreter and the matched controls revealed no significant differences. Moreover, the treatment outcomes were the same for professional and family interpreters. Although there was a trend toward higher recidivism rates during MST when an interpreter had been used, the long-term judicial data did not reveal any differences between the interpreter group and the matched control group. Thus, it seems that in a highly structured and goal-oriented treatment like MST, both professional and family interpreters can be used to obtain treatment outcomes comparable with those of native speakers. [ABSTRACT FROM AUTHOR]

Studies on the adoption and maintenance of group exercise behavior are scarce. The objective of this study is to test two self-efficacy based interventions to increase barrier self-efficacy and group exercise behavior. In total 122 participants (Mage 42.02 yr.; SD 12.29; 67% females) were recruited and randomly assigned to one control and two experimental groups. The control group was limited to participate in one virtual group exercise program only (group 1). The first experimental group was able to self-set their activities and participate in multiple group exercise programs (group 2). The second experimental group received an additional monthly coaching protocol to manage self-set goals (group 3). A validated scale for barrier self-efficacy was used, group exercise sessions were measured and drop-out rates were registered. An ANOVA indicated that mean amount of sessions of group 1 and 3, and 2 and 3 differed significantly (p < 0.05) in 12 weeks. Descriptive statistics demonstrate mean group exercise sessions over the total of 12 weeks of 2.7 4 (SD 4.65) in the control group; 4.75 (SD 6.08) in the first experimental group, and 12.25 (SD 9.07) for the second experimental group. Regression analysis indicated that self-efficacy at 8-weeks explained the highest variance in overall group exercise sessions (R² = 0.18; p < 0.05). Overall drop-out rates were 88% in group 1, 78% in group 2 and 48% in group 3. The results showed that group exercise behavior can significantly be improved by a coaching protocol on self-set goals. Future research should address the effectiveness of self-set activities and self-set goals for a longer period of time and in other types of exercise programs. [ABSTRACT FROM AUTHOR]

Objectives: Theory has offered suggestions on how people may adjust their personal goals after goal disturbance or altered life situations. However, the actual use of these goal adjustment strategies has rarely been studied. This study aimed to investigate whether the goal adjustment strategies identified in the literature are used in the first 6 months following a diagnosis of cancer and whether alternative strategies can be identified.Design: Exploratory design with a qualitative method of data collection.Methods: Patients were asked to list their current personal goals within a month after being diagnosed with colorectal cancer. Six months later, they were asked what had happened to each of these goals. For each goal, raters scored whether (1) it was achieved or being pursued as planned, (2) a known strategy was used, or (3) an alternative strategy was used.Results: Patients with colorectal cancer (n = 130) reported that more than half of their goals had been achieved or were being pursued as planned. The remaining goals (n = 210) required goal adjustment strategies. Patients used five of six known strategies that involved mostly limited adjustment. Additionally, they used combinations of goal adjustment strategies, and two alternative strategies were identified.Conclusions: This study found that patients with cancer use goal adjustment strategies, and it provides illustrations on how these strategies are used, thus deepening and extending existing knowledge of and theory on goal adjustment. Future studies should take the newly identified strategies into account as well as the possible use of combinations of strategies.Statement Of Contribution: What is already known on this subject? The successful pursuit of personal goals is important for maintaining well-being. However, an unexpected and serious illness such as cancer can lead to the need to adjust goals, either because they have become difficult or impossible to attain due to physical hindrance of the illness and/or its treatment, or because other goals have become important due to the confrontation with the fragility of life. Theories have proposed options of how people may deal with their personal goals, but whether these so-called goal adjustment strategies are actually used by cancer patients, and whether there are alternative strategies we need to take into account, is still unclear. What does this study add? This study employs a qualitative method of data collection to study what actually happens to cancer patients' goals during the first 6 months after diagnosis. This study found that almost all goal adjustment strategies from theory are indeed used by cancer patients and that they mostly use strategies which involve only limited adjustment and a continued focus on the original goal. We found that patients with cancer use combinations of strategies and two alternative strategies, thereby complementing and expanding theories on goal adjustment. [ABSTRACT FROM AUTHOR]

Background Goals and objectives as mentioned in Individual Support Plans (ISPs) were analysed to explore what domains of quality of life they are associated with, what support resources are referenced for achieving the goals, and how domains and resources are related to clients age, gender and intellectual disability (ID) level. Method A total of 209 ISPs for persons with ID from eight residential Dutch service provider organisations were analysed. Mixed linear regression analyses were conducted to examine the relations between client characteristics and the content of goals and support resources. Results Results showed that ISPs of people with mild and moderate ID had significantly more goals related to independence and social participation as compared to the ISPs of people with severe and profound ID. ISPs of clients with profound ID addressed quality of life factors related to 'well-being' more than ISPs of all other clients. ISPs of people aged 20-34 years had significantly more goals on independence than the two other age groups. ISPs of people under the age of 50 had significantly fewer goals with respect to well-being than found in ISPs of older people. Regarding the use of resources, 42.6% of the ISP goals were associated with resources from specialised services, 31.5% associated with natural resources and 25.9% associated with a combination of both natural and specialised services. In ISPs of people with mild ID, natural resources are more often mentioned, and specialised service-based resources are less often mentioned than for other people. Conclusions This study offers empirical feedback on ISP practices in the field of ID in the Netherlands. In light of current ISP practices, results suggest that attention should be paid to: (1) distinguishing between a 'service contract' and an ISP; (2) keeping a focus on the whole person in all age groups and levels of functioning and (3) involving the service recipient in ISP development and implementation. [ABSTRACT FROM AUTHOR]

Background: Stroke survivors encounter emotional problems in the chronic phase after stroke. Post-stroke depressive symptoms have major impact on health-related quality of life (HRQol) and lead to increased hospitalization and therefore substantial healthcare costs. We present a cost-effectiveness and cost-utility evaluation of a cognitive behavioural therapy augmented with occupational and movement therapy to support patients with a stroke with depressive symptoms in goal-setting and goal attainment (augmented CBT) in comparison with a computerized cognitive training program (CogniPlus) as a control intervention.Methods: A trial-based economic evaluation was conducted from a societal perspective with a time horizon of 12 months. Stroke patients (aged 18+ years) with signs of depression (Hospital Anxiety and Depression Scale (HADS) - subscale depression > 7) were eligible to participate. Primary outcomes were the HADS and Quality Adjusted Life Years (QALYs) based on the three-level five-dimensional EuroQol (EQ-5D-3 L). Missing data were handled through mean imputation (costs) and multiple imputation (HADS and EuroQol), and costs were bootstrapped. Sensitivity analyses were performed to test robustness of baseline assumptions.Results: Sixty-one patients were included. The average total societal costs were not significantly different between the control group (€9,998.3) and the augmented CBT group (€8,063.7), with a 95 % confidence interval (-5,284, 1,796). The augmented CBT intervention was less costly and less effective from a societal perspective on the HADS, and less costly and slightly more effective in QALYs, in comparison with the control treatment. The cost-effectiveness and cost-utility analyses provided greater effects and fewer costs for the augmented CBT group, and fewer effects and costs for the HADS. Based on a willingness to pay (WTP) level of €40,000 per QALY, the augmented CBT intervention had a 76 % chance of being cost-effective. Sensitivity analyses showed robustness of results.Conclusion: The stroke-specific augmented CBT intervention did not show convincing cost-effectiveness results. In addition to other literature, this study provided new insights into the potential cost-effectiveness of an adjusted cognitive behavioural therapy intervention. However, as our study showed a 76 % chance of being cost-effective for one outcome measure (QALY) and did not provide convincing cost-effectiveness results on the HADS we recommend further research in a larger population. [ABSTRACT FROM AUTHOR]

The aim of the current research was to examine to what degree basic personality dimensions serve as determinants of job crafting behaviour and to investigate how this behaviour can be influenced via behavioural intentions. In Study 1, we investigated the relationship of approach and avoidance temperament with job crafting in terms of seeking resources, seeking challenges, and reducing demands in a sample of 193 international employees. In Study 2 ( n = 130 employees), we experimentally manipulated the current motivational state in terms of approach/avoidance goals and measured job crafting behaviours in a follow-up survey. Results confirmed that employees scoring high on approach temperament report to seek resources and demands, whereas employees scoring high on avoidance temperament tend to reduce hindering demands in the workplace. Furthermore, the manipulation of goals had indirect effects on job crafting via behavioural intentions. Although the effects of the concentration on approach goals on job crafting were contradictory to our expectations, the pursuit of avoidance goals led to higher demands-reducing behaviour. Taking everything together, we provide important insights into the effects of basic personality dimensions on job crafting behaviour and highlight the possibilities and boundaries for managers to influence the job crafting behaviours of employees. Practitioner points Our study provides insights about which types of employees alter their job demands and resources., Employees scoring high on approach temperament seek resources and demands, whereas employees scoring high on avoidance temperament reduce demands., Managers are able to influence job crafting behaviour indirectly by stimulating the pursuit of approach and/or avoidance goals., A sole focus on (performance) approach goals might have hindering effects in terms of positive job crafting behaviours. [ABSTRACT FROM AUTHOR]

Many have claimed, but only some have shown, that the social nature of teaching and classrooms is likely to have a direct effect on students’ achievement goals. This study examined the extent to which Dutch secondary school students’ (N = 2892) achievement goals were related to the interpersonal quality of teaching. Students’ goals were examined in terms of individual student perceptions of their teacher and their teacher’s general interpersonal disposition. Multivariate multilevel models were tested, specifying the student and the teacher level and using two achievement approach and two achievement avoidance goals as dependent variables. The most remarkably finding was that students who like a generally tough teacher (Level 2 effect) better than their peers do (i.e. Level 1 effect, students who report relatively high teacher communion) were more likely to report higher levels of approach goals. In particular when considering interpersonally more ‘extreme’ teacher dispositions, effects on students’ goals were considerable. Regarding students’ goals, identifying teachers who generally convey low levels of interpersonal agency and/or communion seems worthwhile for practitioners. Also identifying students with more pronounced, interpersonally negative perceptions of their teachers may be valuable when targeting students’ achievement goals. [ABSTRACT FROM AUTHOR]

Aims and objectives. To describe goals set in individual nurse-led lifestyle counselling sessions in leg ulcer patients, and to explore patient and goal characteristics in relation to health behaviour change. Background. Goal setting is increasingly used in nurse-led counselling programmes, but the delivery is often unknown, especially in patient groups for which only recently programmes have been developed, such as patients with venous leg ulcers. Design. A secondary analysis of data collected in the intervention arm of a randomised clinical trial of counselling sessions in venous leg ulcer patients. Methods. Nursing records (n = 71) were explored for the number of goals set, topic, quality and course of goals during the trajectory. Furthermore, goals and patient characteristics were compared in relation to health behaviour change. Results. Forty-one patients (58%) succeeded in changing their behaviour after setting a goal. Setting goals for conducting leg exercises was chosen by most patients in this study, goals for adherence with compression therapy were chosen the least. Sixty-eight per cent of the goals met criteria for being Specific, Measurable and Time-bound. Patients who achieved behaviour change were significantly younger compared to the patients who did not. Except for age, there were no differences in characteristics between the group that did and did not achieve behaviour change. Conclusions. Goal setting could be improved by setting goals more Specific, Measurable and Time-bound, and by setting goals on an essential topic for behaviour change. This explorative study did not show that goal characteristics, including the quality of goals, were related to patients' behaviour change. Relevance to clinical practice. The delivery of goal setting in this programme, and most likely in similar programmes, could be improved. Regular quality checks in daily goal setting practice should be considered. More research is needed into how to best provide health promotion to frail and elderly people. [ABSTRACT FROM AUTHOR]

Objective: Patients with overweight or obesity increasingly attend general practice, which is an ideal setting for weight-loss counselling. The present study is the first to investigate the quality of weight-loss counselling provided by practice nurses in general practice to patients with overweight or obesity, in order to identify points for improvement.Design: An observational checklist was developed to assess goal and implementation intentions and 'missed opportunities for lifestyle counselling'. Comparisons were made with overall consultation goals set by practice nurses, as measured in a post-visit questionnaire.Setting: Dutch general practice.Subjects: One hundred video-taped consultations (2010/2011) between practice nurses and patients with overweight or obesity.Results: Half of the consultations contained a goal intention, of which the majority aimed to change eating behaviour. Only part of these goal intentions could be considered implementation intentions. It appeared that actions (how elements) were not often included here. Lifestyle change was more often perceived as an overall consultation goal than weight change. Regarding patterns of overall consultation goals, the majority addressed only one lifestyle factor at a time. If practice nurses formulated weight change in their overall consultation goal, they also used goal or implementation intentions, especially for weight change. In a quarter of the consultations, practice nurses did not ask any further questions about weight, nutrition or physical activity to gain insight, which is an important 'missed opportunity for lifestyle counselling'.Conclusions: Matching implementation intentions to the broader overall consultation goals of practice nurses would be meaningful, leading to desired goal-directed behaviours and subsequent goal attainment. [ABSTRACT FROM AUTHOR]

Background Together with care professionals, specific psychogeriatric care applications were developed for the seal robot Paro. Objectives This study aims to evaluate the outcomes of the developed Paro interventions, applying the robot in psychogeriatric care. Design A multicenter quasi-experimental time series ABAB study (n = 91) with within-subject comparison was conducted to assess both the short-term effects of the Paro interventions for therapeutic applications, and the facilitation of daily care activities by care providers. Setting Small-scale care units (8–10 residents each), spread over 6 different locations, in 3 Dutch care institutions for intramural psychogeriatric care. Participants A total of 91 patients with dementia, in all stages of dementia. Intervention Two user-centered intervention types were applied, one for therapeutic purposes and one for the facilitation of daily care activities. Measurements Effectiveness was measured with a goal attainment scale (IPPA) and a mood scale (Coop/Wonca), by means of a registration form. Results A total of 106 user-specific interventions were defined for 91 participants; 71 participants completed the study, 14 were men and 57 were women. All interventions combined show a significant effect ( P < .001). Conclusion Paro should be seen as a tool for care staff and not as a replacement of care. Successful implementation of Paro in daily intramural psychogeriatric care practice can increase the quality of care and the quality of life for the elderly. [ABSTRACT FROM AUTHOR]

Background: Although frail older people can be more reluctant to become involved in clinical decision making, they do want professionals to take their concerns and wishes into account. Discussing goals can help professionals to achieve this. Objective: To describe the development of a two‐step method for discussing goals with frail older people in primary care and professionals' first experiences with it. Methods: The method consisted of (i) an open‐ended question: If there is one thing we can do for you to improve your situation, what would you like? if necessary, followed by (ii) a bubble diagram with goal subject categories. We reviewed the goals elaborated with the method and surveyed professionals' (primary care nurses and social workers) experiences, using questions concerning time investment, reasons for not formulating goals, and perceived value of the method. Results: One hundred and thirty‐seven community‐dwelling frail older people described 173 goals. These most frequently concerned mobility (n = 43; 24.9%), well‐being (n = 52; 30.1%) and social context (n = 57; 32.9%). Professionals (n = 18) were generally positive about the method, as it improved their knowledge about what the frail older person valued. Not all frail older people formulated goals; reasons for this included being perfectly comfortable, not being used to discussing goals or cognitive problems limiting their ability to formulate goals. Conclusions: This two‐step method for discussing goals can assist professionals in gaining insight into what a frail older person values. This can guide professionals and frail older people in choosing the most appropriate treatment option, thus increasing frail older people's involvement in decision making. [ABSTRACT FROM AUTHOR]

This article explores a specific issue, the "legitimacy problem", in the discussion of whether or not competition authorities in the EU should, in their competition law assessment of co-operation between companies, include a weighing of non-competition elements, such as concerns for a sustainable society. The problem is that decisions in which competition authorities undertake such a weighing of competition values and non-competition values may lack legitimacy; I address it by introducing ideas for enhancing democratic legitimacy. I will do so after introducing more fully the underlying discussion of the goals of European and national competition law and the notion of legitimacy, and how this relates to the weighing oj non-economic values by competition authorities. This general discussion is not limited to the situation in the Netherlands, although this article then focuses on the institutional setting of the Dutch competition authority. This will ground the general exploration in a specific practice. The goal of this article is thus to explore whether a counter-argument to the legitimacy problem can be formulated. [ABSTRACT FROM AUTHOR]

Objective:This study examined whether: (1) the goals of adolescents with cancer at 3 months post-diagnosis (T1) and healthy peers differed in terms of content, valuation, and abstraction level, (2) the content, valuation and abstraction level of the goals of the adolescents with cancer differed between 3 and 12 months post-diagnosis (T2). Methods:Thirty-three adolescents with cancer and 66 matched controls completed the Personal Project Analysis Inventory. After nine months, the adolescents with cancer completed the measure again. Results:Compared to controls, adolescents with cancer at 3 months post-diagnosis (T1) reported more intrinsic than extrinsic goals, appraised intrinsic goals as more important than extrinsic goals and reported more concrete goals. Within the adolescents with cancer, the content, valuation and abstraction level of the goals did not differ between T1 and T2. Conclusions:Adolescents recently diagnosed with cancer set different types of goals than healthy peers and continue to set these types of goals until one year post-diagnosis. Future research can help determine how the personal goals of adolescents with cancer develop in the long term and to what extent personal goal setting during cancer influences the attainment of age-graded developmental tasks and well-being. [ABSTRACT FROM PUBLISHER]

Background and objectives: The aim of this study was to examine the efficacy of a web-assisted computer-tailored smoking cessation intervention, an action planning (AP) intervention in which potential quitters were encouraged to form action plans (e.g., plan a quit date) and execute them (e.g., remove ashtrays). We also investigated whether the AP intervention resulted in more AP and plan execution than a similar, control intervention without the supplementary AP component. Methods: In a randomized controlled trial, the AP intervention (N = 977) was compared with the control intervention (N = 1,005) in terms of self-reported continued abstinence (CA) and point prevalence abstinence (PPA) six months after baseline. AP, plan execution, and opinion of the intervention were measured one month after baseline. Results: Complete-case logistic regression analysis showed that the AP intervention had a significant effect on CA (OR = 2.01; CI 1.08–3.84, p =.02), whereas intention-to-treat analysis showed a borderline significant effect (OR = 1.68; CI.96–2.92, p =.07). Sixteen percent of the experimental group achieved CA compared to 10% of the control group. The AP intervention had no effect on PPA. The experimental group also showed significantly more AP and plan execution at one month. Execution of plans was associated with smoking cessation. Conclusions: The effects of the AP intervention on CA, AP, and execution of plans were encouraging. The potential for widespread use of web-based interventions means that even small behavioral effects may have an impact on public health. We recommend that the intervention be intensified and improved. [ABSTRACT FROM AUTHOR]

The article presents a study which investigates whether tenacity, self-efficacy, and flexibility contribute in the adaptation process and goal attainment of patients with newly acquired brain injury. The study used Life Satisfaction Questionnaire (LiSat-9) to measure quality of life and Hospital Anxiety and Depression Scale (HADS) to measure emotional distress. The study recommends the need to promote self-efficacy to optimise patients' adaptation process.

Background: Three important elements of the World Health Organization (WHO) definition of palliative care are: 1) it includes patients who may have cure or life prolongation as treatment aims besides palliative care; 2) it is not exclusively for cancer patients; and 3) it includes attention to the medical, psychological, social, and spiritual needs of the patients and their families. Case managers (nurses with expertise in palliative care) may assist generalist primary care providers in delivery of good palliative care. Objectives: This study investigates the referral of patients to case managers in primary care with regard to the three elements mentioned: diagnosis, treatment aims, and needs as reflected in reasons given for referral. Methods: In this cross-sectional survey in primary care among case managers and referrers to case management, case managers completed questionnaires for 687 patients; referrers completed 448 (65%). Results: Most patients referred have a combination of treatment aims (69%). Life expectancy and functional status of patients are lower for those with a treatment aim of palliation. Almost all (96%) of those referred are cancer patients. A need for psychosocial support is frequently given as a reason for referral (66%) regardless of treatment aim. Conclusions: Referrals to case managers reflect two of three elements of the WHO definition. Mainly, patients are referred for support complementary to medical care, and relatively early in their disease trajectory. However, most of those referred are cancer patients. Thus, to fully reflect the definition, broadening the scope to reach other patient groups is important. [ABSTRACT FROM AUTHOR]

Background: The transition from adolescence to early adulthood is a critical period in which there is a decline in physical activity (PA). College and university students make up a large segment of this age group. Smartphones may be used to promote and support PA. The purpose of this qualitative study was to explore Dutch students' preferences regarding a PA application (PA app) for smartphones. Methods: Thirty Dutch students (aged 18-25 years) used a PA app for three weeks and subsequently attended a focus group discussion (k = 5). To streamline the discussion, a discussion guide was developed covering seven main topics, including general app usage, usage and appreciation of the PA app, appreciation of and preferences for its features and the sharing of PA accomplishments through social media. The discussions were audio and video recorded, transcribed and analysed according to conventional content analysis. Results: The participants, aged 21 ± 2 years, were primarily female (67%). Several themes emerged: app usage, technical aspects, PA assessment, coaching aspects and sharing through social media. Participants most often used social networking apps (e.g., Facebook or Twitter), communication apps (e.g., WhatsApp) and content apps (e.g., news reports or weather forecasts). They preferred a simple and structured layout without unnecessary features. Ideally, the PA app should enable users to tailor it to their personal preferences by including the ability to hide features. Participants preferred a companion website for detailed information about their accomplishments and progress, and they liked tracking their workout using GPS. They preferred PA apps that coached and motivated them and provided tailored feedback toward personally set goals. They appreciated PA apps that enabled competition with friends by ranking or earning rewards, but only if the reward system was transparent. They were not willing to share their regular PA accomplishments through social media unless they were exceptionally positive. Conclusions: Participants prefer PA apps that coach and motivate them, that provide tailored feedback toward personally set goals and that allow competition with friends. [ABSTRACT FROM AUTHOR]

Objective:This study examined whether cancer patients reported increases in their goal adjustment capacities while receiving psychosocial care and whether these increases were related to changes in symptoms of depression, anxiety and fatigue. Goal adjustment was conceptualised as two independent capacities: goal disengagement (i.e. disengage from unattainable goals) and goal reengagement (i.e. reengage into new goals). Design:This naturalistic, longitudinal study focused on 241 cancer patients receiving psychosocial care at one of the seven psycho-oncology institutions in the Netherlands. Data was collected before the start of psychosocial care (T1) and nine months thereafter (T2). Hierarchical regression analysis was used to examine the research questions. Main Outcome Measures:Goal adjustment, symptoms of depression, anxiety and fatigue. Results:At group level, patients reported small increases in goal disengagement (d = .22) but no significant change in goal reengagement (d = .09). At an individual level, 34% of cancer patients reported an increase in goal disengagement and 30% reported an increase in goal reengagement. Increases in goal reengagement were significantly associated with decreases in both depressive and anxiety symptoms, but not to changes in fatigue. Conclusion:Findings indicate that particularly improvements in goal reengagement are beneficial for cancer patients’ psychological functioning. [ABSTRACT FROM PUBLISHER]

Purpose -- The purpose of this paper is to describe the development and application of the KIPP-list of care activities. The acronym KIPP stands for Knowledge and Insight into Primary Processes. The instrument is intended as a tool for family coaches to systematically report care activities conducted in the Dutch family support programme Ten for the Future (in Dutch: Tien voor Toekomst). Design/methodology/approach -- The design of the instrument was based on the components of the programme and a literature search for similar instruments used in the Netherlands, complemented by a staff survey. A series of three studies was carried out to test the instrument's validity and user-friendliness, and to assess its potential for programme evaluation. Findings -- The majority of care activities were performed in cooperation with one or both parents alone, and less frequently with children or external professionals. Although the main focus of the work of the family coaches fell into the categories of "collecting information" and "working towards (behavioural) change" with families, the relatively high frequency of all the types of care contacts emphasises the intensity of this family support programme with a complex target group. Originality/value -- Data gathered with the instrument provided meaningful information by descriptive analysis. KIPP thereby proved its general feasibility in increasing insight into service provision. The instrument can be useful in several stages and on several levels of quality assurance and service optimisation, including reflective practice, supervision, team management and research. [ABSTRACT FROM AUTHOR]

Personal growth initiative (PGI), defined as being proactive about one’s personal development, is critical to graduate students' academic success. Prior research has shown that students' PGI can be enhanced through interventions that focus on stimulating developmental activities. Within this study, we aimed to investigate whether an intervention that stimulates development in the area of one’s personal strengths (strengths intervention) has more beneficial effects on students' PGI than an intervention that stimulates development in the area of individual deficiencies (deficiency intervention). We conducted 2 longitudinal field experiments to investigate the effects of the 2 interventions on students' PGI (Experiment 1) and the potential mediating role of psychological capital (PsyCap) in this regard (Experiment 2). In Experiment 1, 105 (N = 105) university students participated in either a strengths intervention or a deficiency intervention. Results indicated that the strengths intervention increased the students' PGI in the short but not in the long term, whereas the deficiency intervention did not affect PGI. Ninety students (N = 90) participated in Experiment 2, in which we slightly refined both interventions by putting a stronger emphasis on the ongoing development of strengths (strengths intervention) or correction of deficiencies (deficiency intervention) by adding posttraining assignments. Results suggested that participating in both interventions led to increases in PGI over a 3-month period, but that these increases were bigger for the strengths intervention group. Furthermore, the relationship between the strengths intervention and PGI was mediated by hope as one component of PsyCap. [ABSTRACT FROM AUTHOR]

The complexity of the daily practice of social workers in the Netherlands has increased, while the social appreciation for their work has decreased. Stakeholders involved in social work practice agreed that a master's programme for social workers could be an important step to improve the quality of social work and enhance the professionalisation of social workers. However, stakeholders disagreed considerably on the objectives of this new programme. Hence, there was no focus for the programme or for its evaluation. In order to assess the purpose and intended goals of the master's programme in social work, a retrospective plan evaluation was conducted, consisting of a document analysis and concept-mapping procedure with thirty-nine stakeholders. The study resulted in a consensus-based conceptual framework in which practice development is considered the key domain of the programme. Practice development seems to fit the open domain of social work and meets the various and often ambivalent demands on social workers and their profession. It is regarded as a method in which the social worker with a master's degree has a new role and position in the interplay between clients, stakeholders and professionals. [ABSTRACT FROM AUTHOR]

Background: Many people with dementia die in long-term care settings. These patients may benefit from a palliative care goal, focused on comfort. Admission may be a good time to revisit or develop care plans. Objective: To describe care goals in nursing home patients with dementia and factors associated with establishing a comfort care goal. Design: We used generalized estimating equation regression analyses for baseline analyses and multinomial logistic regression analyses for longitudinal analyses. Setting: Prospective data collection in 28 Dutch facilities, mostly nursing homes (2007-2010; Dutch End of Life in Dementia study, DEOLD). Results: Eight weeks after admission (baseline), 56.7% of 326 patients had a comfort care goal. At death, 89.5% had a comfort care goal. Adjusted for illness severity, patients with a baseline comfort care goal were more likely to have a religious affiliation, to be less competent to make decisions, and to have a short survival prediction. Their families were less likely to prefer life-prolongation and more likely to be satisfied with family-physician communication. Compared with patients with a comfort care goal established later during their stay, patients with a baseline comfort care goal also more frequently had a more highly educated family member. Conclusions: Initially, over half of the patients had a care goal focused on comfort, increasing to the large majority of the patients at death. Optimizing patient-family-physician communication upon admission may support the early establishing of a comfort care goal. Patient condition and family views play a role, and physicians should be aware that religious affiliation and education may also affect the (timing of) setting a comfort care goal. [ABSTRACT FROM AUTHOR]

In the Netherlands, young adults' drinking practices have become an issue of public concern since their drinking levels are high. Heavy drinking can place young adults at an increased risk for developing short- and long-term health-related problems. Current national alcohol prevention programmes focus mainly on adolescents and their parents and paying less systematic attention to young adults. The present study describes the theory and evidence-based development of a web-based brief alcohol intervention entitled What Do You Drink (WDYD). We applied the Intervention Mapping (IM) protocol to combine theory and evidence in the development and implementation of WDYD. The WDYD intervention aims to detect and reduce heavy drinking of young adults who are willing to decrease their alcohol consumption, preferably below the Dutch guidelines of low-risk drinking. According to the IM protocol, the development of WDYD resulted in a structured intervention. Reducing heavy drinking to low-risk drinking was proposed as the behavioural outcome. Motivational interviewing principles and parts of the I-Change Model were used as methods in the development of WDYD, whereas computer tailoring was selected as main strategy. An effect and a process evaluation of the intervention will be conducted. IM was found to be a practical instrument for developing the WDYD intervention tailored to a specific target population in the area of alcohol prevention. [ABSTRACT FROM AUTHOR]

Background: In May 2013, the iTunes and Google Play stores contained 23,490 and 17,756 smartphone applications (apps) categorized as Health and Fitness, respectively. The quality of these apps, in terms of applying established health behavior change techniques, remains unclear. Methods: The study sample was identified through systematic searches in iTunes and Google Play. Search terms were based on Boolean logic and included AND combinations for physical activity, healthy lifestyle, exercise, fitness, coach, assistant, motivation, and support. Sixty-four apps were downloaded, reviewed, and rated based on the taxonomy of behavior change techniques used in the interventions. Mean and ranges were calculated for the number of observed behavior change techniques. Using nonparametric tests, we compared the number of techniques observed in free and paid apps and in iTunes and Google Play. Results: On average, the reviewed apps included 5 behavior change techniques (range 2–8). Techniques such as self-monitoring, providing feedback on performance, and goal-setting were used most frequently, whereas some techniques such as motivational interviewing, stress management, relapse prevention, self-talk, role models, and prompted barrier identification were not. No differences in the number of behavior change techniques between free and paid apps, or between the app stores were found. Conclusions: The present study demonstrated that apps promoting physical activity applied an average of 5 out of 23 possible behavior change techniques. This number was not different for paid and free apps or between app stores. The most frequently used behavior change techniques in apps were similar to those most frequently used in other types of physical activity promotion interventions. [ABSTRACT FROM AUTHOR]

Background There is a wide gap between knowledge about palliative care and its application in everyday clinical practice, affecting many patients in our ageing population. However, changing health care practice is a complex and challenging process. Therefore, the EU funded IMplementation of quality indicators in PAlliative Care sTudy (IMPACT) project aims to develop optimal implementation strategies to improve the organization of palliative care for people with cancer or with dementia in Europe. Methods and design The organization of palliative care in Europe will be mapped to develop and prepare strategies to improve it, and an overview of barriers and incentives regarding successful organizational changes in palliative care will be undertaken. A pre-test with a set of quality indicators (QIs), developed within the project, will be used to identify aspects of the organization of palliative care requiring change in hospitals, nursing homes, hospices, and primary care in five European countries. Based on the results of the pre-test, each setting will be invited to prioritise and improve aspects of their organization that appeared weak. The improvement objective they choose will be tailored to national and setting-specific barriers. Finally, a post-test with the same QIs will determine the effectiveness of the strategies used. An extensive process analysis will be conducted throughout the entire study. Discussion It is expected that the IMPACT project will provide professionals and policy makers useful tools to facilitate effective implementation of high-quality palliative cancer and dementia care in different settings in Europe. [ABSTRACT FROM AUTHOR]

As some people with profound intellectual and multiple disabilities ( PIMD) are at a high risk of developing a challenging behavior, it is useful to look at measures taken to prevent or diminish this type of behavior. The authors undertook a study of how self-injurious, stereotypical, destructive, or aggressive behaviors are addressed in daily practice in residential facilities. A stratified sample of 30 people with the most severe and frequently reported challenging behaviors was selected from a dataset of 181 children and adults with PIMD. Individual comprehensive service plans were used to determine whether challenging behaviors were present and how these problems were addressed. In total, only 51.8% of the challenging behaviors that occurred were described in the individual plans, and for 53.7% of the challenging behaviors, strategies or interventions were included in the individual service plans. Only 17.2% of the cases contained goals formulated to prevent or diminish such behavior. A significant positive relationship was found between the severity of challenging behavior and the extent to which it was described in the individual comprehensive service plans. The authors also noted that interventions that were aimed at diminishing or preventing challenging behavior were highly simplistic, and virtually no goals were formulated to document, diminish, or prevent challenging behavior in people with PIMD. [ABSTRACT FROM AUTHOR]

Introduction Overweight and obesity are associated with an increased risk of morbidity. Mindfulness training could be an effective strategy to optimize lifestyle behaviors related to body weight gain. The aim of this study was to evaluate the effectiveness of a worksite mindfulness-based multi-component intervention on vigorous physical activity in leisure time, sedentary behavior at work, fruit intake and determinants of these behaviors. The control group received information on existing lifestyle behavior- related facilities that were already available at the worksite. Methods In a randomized controlled trial design (n = 257), 129 workers received a mindfulness training, followed by e-coaching, lunch walking routes and fruit. Outcome measures were assessed at baseline and after 6 and 12 months using questionnaires. Physical activity was also measured using accelerometers. Effects were analyzed using linear mixed effect models according to the intention-to-treat principle. Linear regression models (complete case analyses) were used as sensitivity analyses. Results There were no significant differences in lifestyle behaviors and determinants of these behaviors between the intervention and control group after 6 or 12 months. The sensitivity analyses showed effect modification for gender in sedentary behavior at work at 6-month follow-up, although the main analyses did not. Conclusions This study did not show an effect of a worksite mindfulness-based multi-component intervention on lifestyle behaviors and behavioral determinants after 6 and 12 months. The effectiveness of a worksite mindfulness-based multi-component intervention as a health promotion intervention for all workers could not be established. [ABSTRACT FROM AUTHOR]

Women physicians are confronted with incompatible gendered role prescriptions, whereby the role of the ‘ideal’ mother contrasts sharply with that of the ‘ideal’ physician. This study introduces four goal frames that reflect how women physicians internalize these conflicting role prescriptions and investigates the relationship between women’s goal frames and their career motivation. It also examines the relationship between gender-equality arrangements – inspired by the same underlying ideals – and women physicians’ career motivation, and whether these arrangements moderate the relationship between goal frames and career motivation. Cross-sectional data on 1070 Dutch women physicians collected in 2008 indicate that women physicians with switching goal frames (i.e. those who want to live up to both ideals) are no less career-motivated than women with one dominant goal frame. However, gender-equality arrangements mainly seem to support women physicians who prioritize one role over the other. No evidence was found that gender-equality arrangements support those who try to combine conflicting role expectations. [ABSTRACT FROM PUBLISHER]

Objective: The main aim of this study was to investigate the relationship between acceptance and well-being in adolescents with chronic illness from a daily process perspective. Furthermore, we explored the role of daily experienced interference and facilitation of life goals by treatment goals as mediating mechanisms. Methods: Thirty-eight adolescents with cystic fibrosis (CF) or diabetes completed questionnaires assessing acceptance, negative life events and goal-related self-efficacy. Furthermore, an online diary assessing daily mood, daily experienced interference and facilitation of life goals by treatment goals was completed during three consecutive weeks. Results: Acceptance of illness was positively related to daily well-being, but unrelated to daily goal interference and facilitation. Furthermore, daily goal interference and facilitation were unrelated to same-day and next-day well-being. Conclusion: This study suggests that acceptance of illness plays an important role in the daily mood of adolescents with CF and diabetes. This relationship, however, was not mediated by daily experienced interference and facilitation of life goals by treatment goals. Further research is needed to determine whether interventions promoting acceptance are beneficial for adolescents with CF and diabetes. [ABSTRACT FROM AUTHOR]

Introduction: Recent changes in postgraduate medical training curricula usually encompass a shift towards more formative assessment, or assessment for learning. However, though theoretically well suited to postgraduate training, evidence is emerging that engaging in formative assessment in daily clinical practice is complex. Aim: We aimed to explore trainees' and supervisors' perceptions of what factors determine active engagement in formative assessment. Methods: Focus group study with postgraduate trainees and supervisors in obstetrics and gynaecology. Results: Three higher order themes emerged: individual perspectives on feedback, supportiveness of the learning environment and the credibility of feedback and/or feedback giver. Conclusion: Engaging in formative assessment with a genuine impact on learning is complex and quite a challenge to both trainees and supervisors. Individual perspectives on feedback, a supportive learning environment and credibility of feedback are all important in this process. Every one of these should be taken into account when the utility of formative assessment in postgraduate medical training is evaluated. [ABSTRACT FROM AUTHOR]

Background: While homelessness among youth is a serious problem, there is little information about evidence-based interventions for homeless youth. In cooperation with professionals and youths, Wolf (2012) developed Houvast (Dutch for 'grip'): a strengths based method grounded in scientific and practice evidence. The main aim of Houvast is to improve the quality of life of homeless youths by focusing on their strengths, thus stimulating their capacity for autonomy and self-reliance. Method/Design: The effectiveness and fidelity of Houvast will be tested in ten Dutch services for homeless youth which are randomly allocated to an intervention group (n = 5), or a control group which provides care as usual (n = 5). Measurements of both objective and subjective quality of life and secondary outcomes (mental and physical health, substance use, coping, resilience, psychological needs, care needs, working relationship with the professional and attainment of personal goals) will be conducted among homeless youths (n = 251). Youths in both groups will be interviewed by means of a structured interview at baseline, at time of ending care or after having received care for six months (T1) and at nine months after baseline (T2). Model fidelity will be tested around T1. Discussion: This study is unique as it includes a large number of homeless youths who are followed for a period of nine months, and because it focuses on a strengths based approach. If the Houvast method proves to be effective in improving quality of life it will be the first evidence-based intervention for homeless youth. [ABSTRACT FROM AUTHOR]

This research examines how group status affects the impact of individual power positions on promotion versus prevention choices in group decision making. We consider that high power not only implies control, but also indicates responsibility for the achievement of group goals. We argue that the nature of these goals depends on the current status of the group. In Experiment 1, individuals who were accorded high power showed more promotion-oriented decisions in the low group status condition while decisions were more prevention oriented under high group status. Experiment 2 replicated these effects, and further demonstrated that they only emerge when those in power are explicitly made accountable for the achievement of group goals. These results are discussed in relation to regulatory focus theory, power theories, and the role of social identities and group goals in group dynamics. [ABSTRACT FROM AUTHOR]

Although psychological theories outline that it might be beneficial to set more challenging goals, people attempting to lose weight are generally recommended to set modest weight loss goals. The present study explores whether the amount of weight loss individuals strive for is associated with more positive psychological and behavioral outcomes. Hereto, 447 overweight and obese participants trying to lose weight completed two questionnaires with a 2-month interval. Many participants set goals that could be considered unrealistically high. However, higher weight loss goals did not predict dissatisfaction but predicted more effort in the weight loss attempt, as well as more self-reported short-term weight loss when baseline commitment and motivation were controlled for. [ABSTRACT FROM AUTHOR]

Background:In pediatrics, the “best interest” standard has become the prevailing standard in decision making even though it proves difficult to apply in practice. Differences in values can lead to different views by families and physicians of what is in the interest of a child. Our aim was to gain insight into the views of parents, children, and physicians in a pediatric oncology setting.Methods: We conducted a qualitative multicenter study, using in-depth semistructured interviews, with 21 children aged 8–18 years undergoing cancer treatment, 26 parents, and 15 pediatric oncologists.Results: At the onset of treatment, parents, children, and physicians had the same views on what is in the interest of the child: survival by following the treatment protocol. In the course of treatment, however, a transition takes place. For families, what constitutes the best interests expands beyond medical considerations, to include the wish to lead a normal life, having control over certain aspects of treatment, and maintaining one's identity (e.g., through religion). These aspects sometimes collide with medical aspects, leading to different professional and familial views about what course of action is appropriate.Conclusions: In order to recognize personal views and avoid conflicts, physicians should explicitly discuss parent and family concerns and opinions in the course of treatment. We present a model of “communicative ethics” to make these issues a subject of discussion. The role of the family in determining what is in the best interest of the child should only be limited when it implies a substantial medical risk of (irreversible) harm to the child. [ABSTRACT FROM PUBLISHER]

Diabetes patients often fail to adhere to self-management activities, such as losing weight by exercising and dieting. The present study tested the efficacy of a minimalist intervention consisting of only the self-regulation strategy ‘mental contrasting’ (Oettingen, G. (2000). Expectancy effects on behavior depend on self-regulatory thought. Social Cognition, 18, 101–129) in promoting these self-management activities among a clinical sample of type 2 diabetes patients (N = 64). Half of the participants were assigned to a positive indulging condition (fantasising about positive outcomes of losing weight) and the other half of the participants were assigned to a mental contrasting condition (fantasising about positive outcomes of losing weight and then contrasting these fantasies with obstacles in the present reality). Results showed that, one month later, participants in the mental contrasting condition had improved their diabetes self-management, and in particular their dieting behaviour, by a larger extent than participants who merely indulged in the positive future. It was concluded that although more elaborate interventions may yield stronger results, adding a mental contrasting exercise to their usual care may be a highly feasible, low-cost alternative to promote diabetes self-management. [ABSTRACT FROM PUBLISHER]

Background: General practice (GP) trainers play a key role GP trainees' education. To stimulate development of trainer competencies a Personal Development Plan (PDP) can be helpful, especially when feedback is incorporated. Aims: To investigate to what extent GP trainers use feedback in PDPs. Methods: GP trainers were provided with three feedback sources: trainees' rating scores, trainees' narrative comments, and self-assessment scores. Trainers were instructed to use these while drawing up PDP goals. With quantitative analyses the extent to feedback sources were used was determined. Results: Of the trainers 93% submitted a PDP. More than 75% of goals were based on provided feedback. Multiple sources addressing the same issue increased feedback use. If two sources pointed in the same direction, feedback was used more often if one of them concerned 'narrative comments'. Ratings were lowest for GP-related Expertise and Teaching Skills. Most goals defined concerned these domains. Fewer goals regarded Personal Functioning. Proportion of feedback used concerning Personal functioning was lowest. Conclusions: GP trainers use most feedback and address issues most commented upon. Narrative comments deserve a profound place when eliciting feedback. Research into the quality with which feedback is used in PDP goals should complement these results. [ABSTRACT FROM AUTHOR]

Background Solution-focused coaching ( SFC) helps individuals or groups to achieve their preferred outcomes by evoking and co-constructing solutions. SFC has been shown to be helpful for persons with ID as well as for teams coaching people with ID. Nominal Group Technique ( NGT) helps to organize people's thoughts with regard to a single question. This study examines the perceived strengths of and recommendations for SFC for teams coaching people with ID via NGT, as well as the extent to which the NGT results reflect the results of an SFC questionnaire. Methods In total, 54 staff members participated in SFC. Of these, 18 participated in NGT, while 36 completed the SFC questionnaire. The strengths of and recommendations for SFC were obtained via NGT. Interrater agreement was calculated via Cohen's kappa. Results The strengths of SFC include 'exploring hidden successes' and 'focusing on solutions'. It was recommended that 'the results be consolidated in follow-up meetings'. The participants agreed on the content of the strengths and recommendations, but differed in terms of priorities (κ ≤ 0.1). Conclusions NGT is a valuable tool in exploring people's opinions and priorities, but further research is needed to elucidate the perceived priorities of SFC for teams coaching persons with ID. [ABSTRACT FROM AUTHOR]

This study aims to increase our knowledge of the work-life balance (WLB) of self-employed workers, a changing but often neglected group in work–family research. A growing number of women are starting their own business in order to combine paid work and family life. This interview study (N=24) examines how self-employed women with children feel they manage paid work and other life domains in the Netherlands. Autonomy appeared to be an important resource, allowing them to combine their work more easily with childcare, household duties, and social and personal life. However, the degree and nature of that autonomy and the ability to use it varied among the self-employed in this study owing to work-related factors such as sector, work location, employees, and years of experience. Another important resource leading to greater satisfaction with the WLB was the ability to define and reflect on personal goals in work and other life domains. [ABSTRACT FROM AUTHOR]

In this exploratory study, a multidimensional unfolding technique is used to visualise goal salience. A total of 1,733 students from secondary vocational education reported on the importance of 16 goals, using the GIFI, which is based on the 24 goal taxonomy proposed by Ford and Nichols (1991). Results show that students make a clear distinction between ego and non-ego goals and that non-ego goals are reported as most important by most students. Also, differences within the group of boys and the group of girls, and differences between boys and girls, are shown. The results and possibilities of multidimensional unfolding for future research on goals are discussed. [ABSTRACT FROM AUTHOR]

This study investigates the structural invariance of the Achievement Goal Questionnaire (AGQ) in American, Chinese, and Dutch college students. Using confirmatory factor analyses (CFA), the authors found evidence for the four-factor structure of achievement goals in all three samples. Subsequent multigroup CFAs supported structural invariance of the AGQ across the samples. [ABSTRACT FROM AUTHOR]

Solution-focused coaching ( SFC) represents a short-term, future-focused, and person-directed therapeutic approach that helps people focus on solutions rather than problems. Thirteen cases of SFC of staff dealing with people with severe and moderate intellectual disabilities ( S/MID) are described. In all 13 cases, the progress toward the team goal, proactive thinking of staff, and the quality of the relationship ( QOR) between staff and people with S/MID were measured directly before SFC, directly after SFC, and 6 weeks after SFC. After SFC, progress toward the team goal was found in seven out of 13 teams, improvement of proactive thinking was found in 5/10 teams and improvement of the QOR was found in 7/13 teams. With regard to individual staff members, improvement of proactive thinking was found in 12/34 staff members and improvement of the QOR was found in 22/42 staff members. The authors note that SFC stimulates dealing with support problems in a behavioral, proactive way and that SFC can be a useful approach to build useful relationships. The findings are in line with results of earlier research on the value of solution-focused brief therapy applied to carers (parents or professionals) of people with ID. Future investigation of SFC, preferably using a randomized controlled design, could test the hypothesis that SFC can increase self-efficacy and proactive thinking in teams, can positively alter staff's perceptions of people with ID, and that teams find it a useful approach. [ABSTRACT FROM AUTHOR]

While active participation is regarded essential in health promotion worldwide, its application proves to be challenging. Notably, participants' experiences are infrequently studied, and it is largely unknown why lay citizens would want to play an active role in promoting the health of the community they belong to. Aiming to produce practical insights to further the application of the participation principle, this qualitative study examined participants' driving motives in a diverse array of health promotion undertakings. Six projects in The Netherlands were used as case studies, including a community-project promoting mental health, peer education against harmful substance use, a health support group, health policy development, physical activity and healthy life style courses. The study involved 24 participants, who played a variety of active roles. Semi-structured interviews were conducted, transcribed verbatim and subjected to content analysis. We found four main motives driving lay citizens in their active participation in health promotion projects: ‘purposeful action’, ‘personal development’, ‘exemplary status’ and ‘service and reciprocity’. The motives reflected crucially distinct personal desires in the participation process, namely to produce tangible results, to experience advancements for oneself, to gain personal recognition as a role model and to have or maintain valued relationships. The implications of the findings are discussed for researchers and professionals in health promotion. [ABSTRACT FROM AUTHOR]

van Genugten L., van Empelen P. & Oenema A. (2012) From weight management goals to action planning: identification of a logical sequence from goals to actions and underlying determinants. J Hum Nutr Diet . 25, 354-364 Abstract Background: Weight gain prevention (WGP) among adults who are overweight is an important target in the prevention of obesity. However, little is known about the process from WGP as a goal to successful weight-management. The present study aimed to: (i) gain more insight into this process; (ii) identify cognitive predictors of intention for WGP; and (iii) examine WGP as a potential predictor for the intention to change weight-related behaviours [dietary intake (DI) and physical activity (PA)] and specific action planning. Methods: In this cross-sectional study, overweight adults [ n = 510; body mass index 25-30 kg m-2; mean (SD) age 48 (9.5) years; 30.8% male] completed an online questionnaire, assessing goal intention for WGP, behavioural intention for DI and PA, planning for change in DI and PA and socio-cognitive correlates. Ordinal regression analyses were used to analyse the data. Results: In 89% of the sample, (parts of) the proposed sequence from goal intention (for WGP), behavioural intention (for DI/PA) and planning (for DI/PA) was observed. Attitude, social norm and perceived control towards WGP, and perceived weight status and risk perception, were associated with intention for WGP. Behaviour-specific perceived control and preferences were more strongly associated with intention to change DI or PA and planning for change than intention for WGP was. Conclusions: Intention for WGP is important in the process toward weight-management because, for most people, intention for WGP precedes behavioural intention, which precedes planning. Intention for WGP is associated with behavioural intention but behaviour-specific factors are the strongest correlates of behavioural intention and planning. [ABSTRACT FROM AUTHOR]

Objective: To examine the effects of a neoprene thumb opponens splint on hand function during a self-selected activities of daily living task in children with unilateral spastic cerebral palsy with thumb-in-palm position of the affected hand.Design: Systematic evaluation of seven cases using a multiple baseline design across individuals.Setting: Outpatient clinic.Subjects: Seven children with unilateral cerebral palsy (2–7 years old), Manual Ability Classification System level 2–3 participated in the study.Interventions: Neoprene thumb opponens splints (McKie splint) were used. Children were followed for about four months. Baseline period ranged from 4 to 9 weeks, intervention period was two months and duration of follow-up one month.Main measures: Hand function was assessed using goal attainment scaling and visual analogue scales. Data was assessed visually.Results: In four children goal attainment scaling and/or visual analogue scale scores increased after introducing the splint. These effects remained when splints were not worn. Two children only benefited from the splint when it was worn. Thumb opponens splints were tolerated well by all children who participated in this study.Conclusions: Thumb opponens splints may have a positive effect on hand function in children with unilateral spastic cerebral palsy. [ABSTRACT FROM PUBLISHER]

The results of three experiments showed that regulatory focus influences the way in which the importance and likelihood of social change affect individuals' commitment to collective action. In Studies 1 ( N= 82) and 2 ( N= 153), the strength of participants' chronic regulatory focus was measured. In Study 3 ( N= 52), promotion or prevention focus was experimentally induced. The results showed that for individuals under promotion focus, commitment to collective action depended on the perceived likelihood that through this action important social change would be achieved. Individuals under prevention focus were willing to commit to collective action when they attached high importance to its goal, regardless of the extent to which they believed that attainment of this goal was likely. Implications of these results for work on regulatory focus and collective action are discussed. [ABSTRACT FROM AUTHOR]

Because of the complex nature of Parkinson's disease, a wide variety of health professionals are involved in care. Stepwise, we have addressed the challenges in the provision of multidisciplinary care for this patient group. As a starting point, we have gained detailed insight into the current delivery of allied healthcare, as well as the barriers and facilitators for optimal care. To overcome the identified barriers, a tertiary referral centre was founded; evidence-based guidelines were developed and costeffectively implemented within regional community networks of specifically trained allied health professionals (the Parkinson Net concept).We increasingly use ICT to bind these professional networks together and also to empower and engage patients inmaking decisions about their health. This comprehensive approach is likely to be feasible for other countries as well, so we currently collaborate in a European collaboration to improve community care for persons with Parkinson's disease. [ABSTRACT FROM AUTHOR]

Objectives: To assess the responsiveness of Goal Attainment Scaling compared with the Pediatric Evaluation of Disability Inventory (PEDI) and the 66-item Gross Motor Function Measure (GMFM-66) in multidisciplinary rehabilitation practice.Design: Observational study. Pretest–posttest design.Subjects/patients: Twenty-three children with cerebral palsy, aged 2–13 years.Methods: Goal Attainment Scaling, PEDI and GMFM-66 assessments were performed before and after six months of treatment. Physical, occupational and speech therapists constructed and scored 6-point Goal Attainment Scaling scales meeting predetermined criteria, describing the main functional goal per discipline. The contents of the three measures were compared using International Classification of Functioning, Disability and Health child and youth version (ICF-CY) codes. Spearman’s rho correlations between Goal Attainment Scaling change scores per discipline and change scores obtained with the PEDI functional skills scales and GMFM-66 were calculated. Complete goal attainment was compared with significant change in terms of the standardized measures.Results: Twenty per cent of the Goal Attainment Scaling items were not covered by items of the PEDI or the GMFM-66. Inconclusive correlations were found between Goal Attainment Scaling and PEDI change scores (r 0.28–0.64). Even after exclusion of the non-corresponding items, correlations were moderate (r 0.57–0.73). Of 39/64 Goal Attainment Scaling scales scored as complete goal attainment, 16 individual PEDI scores did not show change on the corresponding scale. Low correlation was found between Goal Attainment Scaling change scores and GMFM-66 change scores.Conclusion: Goal Attainment Scaling, PEDI and GMFM-66 were complementary in their ability to measure individual change over time in children with cerebral palsy. Using only the standardized instruments could have caused many individual rehabilitation goals actually attained being missed in the outcome evaluation. [ABSTRACT FROM PUBLISHER]

Two new psychological concepts related to relapse in smoking cessation were tested. ‘Temporal comparisons’ are ex-smokers’ evaluations of their present situation compared to their situation as a smoker. ‘Exposure evaluations’ are evaluations of situations ex-smokers encountered when they used to smoke. In a cohort study among 323 ex-smokers, both concepts significantly predicted relapse after six months. Moreover, the relationship between temporal comparisons and relapse was mediated by exposure evaluations. In addition, this relationship also depended on self-efficacy; particularly when self-efficacy was low, temporal comparisons predicted relapse. These data provide new theoretical and practical perspectives to relapse. [ABSTRACT FROM PUBLISHER]