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Despite increasing evidence that identity changes in adulthood do take place, there is little knowledge about what the process of change looks like. We perceive identity change as a change in the organization and rules that underlie identity commitments. Based on script theory (Tomkins, 1995) and on notions about the processes in adult development and clinical theories, we developed a conceptualization of this process. Conflicts are seen as the potential trigger of change. People may react to conflicts with assimilation, withdrawal, or accommodation. Accommodation implies identity change. The process of accommodation consists of increasing exploration and knowledge of oneself. We distinguish different steps in this accommodation process. In a case study, empirical evidence for these steps was found.

(2002). The Role of Higher Education in Lifelong Learning: The Dutch Case. The Journal of Continuing Higher Education: Vol. 50, No. 1, pp. 37-44.

The paper presents results of some analyses on a Dutch database that contains disaggregated data on both the traffic system input variables of the driver population (characteristics of drivers, including their annual mileage) and the output variables of the driver population in terms of habitual driving behaviour (operationalised in number of fines) and accident involvement. Accidents increased as annual mileage increased. A relationship between violations and accidents turned out to exist in different classes of annual mileage. Moreover, multivariate analyses showed that-corrected for annual mileage-male and female drivers do not differ in accident involvement; younger drivers have the highest rate of accidents and level of education is not related to accident involvement. (C) 1999 Elsevier Science Ltd. All rights reserved.

The project described in this article concerns the effects of the operation of in-vehicle information systems on traffic safety. A method is described to track down potential safety effects within a relatively short period of time to support the authorities in the decision to deny or allow the system at hand on the market. Basically the method consists of 3 steps: a checklist, a laboratory test, and guidelines for a final empirical assessment of potential safety hazards.

Temporal overlap of cognitive processes occurs when partial information about a stimulus activates associated responses before the stimulus has been fully identified. Recent evidence obtained with psychophysiological measures suggests that such overlap sometimes does, and sometimes does not occur. In this contribution, we argue that in order to understand why, we have to distinguish between selection of partial information for perception and selection of partial information for control over activation of responses. We discuss several mechanisms and factors that may modulate the temporal overlap of mental processes because they selectively influence the perceptual availability or the use of partial information.

Presentation rate of stimuli is a crucial factor in Attention-deficit Hyperactivity Disorder (ADHD), that is, especially in ADHD children without tics ( n = 24), the ability to inhibit a response decreases in conditions with fast and slow presentation rates of stimuli.

Data concerning 19 health-related behaviours and associated beliefs were collected by questionnaire from 282 students in the Netherlands on two occasions over one year. While all behaviours showed moderate stability, there were variations in the degree of change. The highest stability was reported for sleep time, tooth brushing frequency, seat belt usage and health care service utilization. The least stable behaviours included regular exercise and various dietary measures. Predictors of changes in smoking, dietary fat intake, alcohol consumption and regular exercise were analysed in detail. Beliefs assessed at year 1 in the importance of these activities for health predicted changes in behaviour over the study year independently of prior behaviour levels. Awareness of the risks associated with behaviours, and explicit wishes to modify behaviour patterns (eg stop smoking, exercise more), did not predict change from year 1 to year 2. The results indicated that health behaviours vary in their stabil...

In addition to recent meta‐analyses, the goal of this article is to give a narrative review and a meta‐analysis of 20 studies into the effectiveness of communication skills training programs, using a cumulative microtraining format (CMT). The aims of all training programs are directed at increasing knowledge of social skills, extension of the behavior repertoire and change of experience of communication situations (reduction of anxiousness and improvement of self‐confidence). Four groups of trainees are included in the study: (1) students, (2) paraprofessionals, (3) clients with problems in living, (4) communication skill trainers. The results of our meta‐analysis are comparable with the results of other meta‐analyses. The strongest effect is found for knowledge, but the effects for behavior and experience are also substantial. Explanations for the strong effects are: (1) the careful analysis of communication situations before the development of the training programs; (2) the cumulative character...

This article describes trends in the number and severity of road accidents in the Netherlands. From 1980 to 1990, accidents fell so rapidly that traffic deaths dropped 31%. This rate could not be sustained in the following decade, though deaths did fall 23% in this period. From 1998 to 2000, traffic deaths remained stable, as did the number of victims whose injuries required hospitalization, even as travel increased. The Netherlands is among the three safest countries in Europe. The greatest increase in safety has been among pedestrians and cyclists. Van and truck occupants have had a substantial increase in deaths and injuries. The Dutch safety policy is based on the concept of "sustainable safety," which uses intelligent technologies and designs to make the driving environment safer as well as education and enforcement to make drivers safer. It has a target of reducing fatalities by 50% from their 1986 level and injuries by 40% by 2010.

This paper is a response to a critique of a study which examined driver behavior in an emergency situation in the Automated Highway System (AHS). The authors defend both their choice of methodology for studying driver behavior in AHS emergency situations and their rationale for pursuing the use of driver simulators for investigating driver responses. (See PATH Database Record no. 17098 for original study.)

Since 1980, More Exercise for Seniors (MBvO in Dutch) has provided a number of special physical activities for the elderly. The aim is to improve social participation and integration, and to prevent a need for care. Despite the fact that MBvO has been active for more than 25 years, and weekly 300,000 people participate in gymnastics, swimming, dancing, etc, no effect on fitness and health has been proven to date. The study was carried out in two regions: Drenthe and Zuid-Holland. Using the GALM (Groningen Active Living Model) method, 4600 independently living people aged 65 years and older were asked to participate in a motor fitness test. Of the 721 people who participated, 386 (the least fit) were invited to take part in the study. They were than randomly divided into an experimental and a control group. The experimental group did gymnastics once or twice a week. The control group received a health educational program. Assessments were carried out at pretest and posttest (10 weeks). In the groups offered MBvO gymnastics once a week, no effects were found on subjective health, physical performance or quality of life and only minor effects on physical fitness. In the groups offered MBvO gymnastics twice a week, some beneficial quality of life effects were found in the least physically active people at baseline. It is recommended that the frequency and intensity of the regular MBvO gymnastics should be increased, to emphasize the importance of health education, and that relatively inactive and older individuals (70+) should be recruited.

Smith, E. R. (in press). What do connectionism and social psychology offer each other? Journal of Personality and Social Psychology. Taylor, D. M., & McKirnan, D. J. (1984). A five-stage model of intergroup relations. British Jourmal of Social Psychology, 23, 291-300. Turner, J. C., Oakes, P. J., Haslam, S. A., & McGarty, C. (1994). Self and collective: Cognition and social context. Personality and Social Psychology Bulletin, 20, 454-463.

This paper explores higher education reforms in China in the 1990s. Confronted with the furious conflicts and mismatch between the market economy and the highly state-controlled socialist educational system, educational reforms in China are extremely complex and difficult. The authors present a case study here telling the tragedy of a university president's reforms in China. They have unfolded how the macro system changes impacted on the micro system reforms. They point out that multilayers exist within an organizational culture. Although understanding organizational culture does not guarantee successful reform, however, a thorough understanding of the fabric of an organizational culture may become an effective lever to initiate or implement the context-fitted reforms. The authors try to describe informatively what dilemmas the Chinese IHE leaders were faced with in the 1990s. Seeking new means for school reforms in a time of turbulent policy environment, in a testing period with sharp contradictory force...

A class of statistical models is proposed for longitudinal network data. The dependent variable is the changing (or evolving) relation network, represented by two or more observations of a directed graph with a fixed set of actors. The network evolution is modeled as the consequence of the actors making new choices, or withdrawing existing choices, on the basis of functions, with fixed and random components, that the actors try to maximize. Individual and dyadic exogenous variables can be used as covariates. The change in the network is modeled as the stochastic result of network effects (reciprocity, transitivity, etc.) and these covariates. The existing network structure is a dynamic constraint for the evolution of the structure itself. The models are continuous-time Markov chain models that can be implemented as simulation models. The model parameters are estimated from observed data. For estimating and testing these models, statistical procedures are proposed that are based on the method of moments. The statistical procedures are implemented using a stochastic approximation algorithm based on computer simulations of the network evolution process.

Item does not contain fulltext An experiment was carried out in a driving simulator in order to study time-on-task effects in driving with special attention to distance keeping and hazard avoidance performance. As expected, increases of fatigue in the course of sustained performance were associated with a deterioration of perceptual-motor performance and an increase of safety margins. In general, the results indicate that performance in less central task components such as steering deteriorates in the course of time, whereas performance in high-priority sub-tasks such as hazard avoidance remains intact. Time-schedule instructions disrupted the adaptation of safety margins in prolonged driving. This study has practical implications for the design of driver impairment monitoring systems

Met nadruk op methodologische problemen wordt de effectiviteit besproken van a antipsychotica bij schizofrene psychosen, b antidepressiva bij unipolaire depressies en c anxiolytica, antidepressiva en antipsychotica bij angststoornissen. Achtereenvolgens komen aan de orde: de korte-termijneffectiviteit van acute behandelingen in vergelijking met die van een placebo; de effectiviteit op langere termijn, wanneer de behandeling voortgezet of gestaakt wordt; vergelijkingen met de effectiviteit van cognitieve gedragstherapieen (CGT). De strekking luidt als volgt: ad a Het nut bij acute behandelingen kan nauwelijks betwijfeld worden. De waarde van jarenlang gebruik is moeilijker te taxeren. De effectiviteit is afhankelijk van psychosociale karakteristieken van de omgeving van de patient. Over de algemene en blijvende effectiviteit van CGT valt nog niets te zeggen. Ad b en c Het gemiddelde verschil in effectiviteit tussen medicijnen en placebo bij acute behandelingen is klein; uitgedrukt in effectgroottes kleiner dan 0,5 bij depressies, gegeneraliseerde angststoornissen en paniekstoornissen, en misschien iets groter bij dwangstoornissen en sociale fobieen; met enkele amenderingen lijken, waar onderzocht, benzodiazepinen, antidepressiva en antipsychotica even effectief bij angststoornissen. Gezien de nadelen van de alternatieven, is een SSRI altijd een goede eerste keuze, ongeacht de diagnose. De waarde van zeer langdurige medicamenteuze behandelingen is onduidelijk. De gemiddelde effectiviteit van CGT is minstens zo groot als van medicatie en de verbeteringen beklijven minstens zo goed. Bij een ‘modale’ patient met een depressie of angststoornis valt er vooralsnog veel voor te zeggen medicatie als een optie van tweede keuze te beschouwen, mede gezien de bijwerkingen die een enkele keer zeer ernstig kunnen zijn. Meer onderzoek naar de mogelijke meerwaarde van een combinatie van psychologische en medicamenteuze behandelingen is geboden. Emphasizing methodological problems in its assessment, effectiveness is reviewed of a antipsychotics in schizophrenic psychosis, b antidepressants in unipolar depression, and c anxiolytics, antidepressants and antipsychotics in anxiety disorders. Discussed are: drug-placebo differences in acute treatment, long-term effectiveness when treatment is continued or discontinued, and comparisons with cognitive behavioural therapy (CBT). The purport is as follows. As to a, usefulness in acute treatment can hardly be doubted. The benefit of continuing treatment for years is more difficult to assess. Effectiveness is dependent on psychosocial characteristics of the patient's environment. As yet nothing can be said on the general and lasting effectiveness of CBT. As to b and c, in acute treatment, mean drug-placebo differences in effectiveness are small; expressed in effect sizes smaller than 0.5 in depression, generalized anxiety disorder and panic disorder, and perhaps somewhat larger in obsessive-compulsive disorder and social phobia; as far as investigated, benzodiazepines, antidepressants and antipsychotics seem to be, with some amendments, equally effective in anxiety disorders. In view of the disadvantages of the alternatives, an SSRI is always a good pick, irrespective of the diagnosis. The benefit of very prolonged drug treatments is unclear. Mean effectiveness of CBT is at least as great as that of medication, and improvements take root at least as well. For a ‘modal’ patient with a depression or anxiety disorder, there is a case for considering the use of medication as an option of second choice, also in view of the side-effects which occasionally can be very serious. More research is needed into possibilities of an extra benefit of combinations of psychological and drug treatments.

Objective: To study the safety and efficacy of methylphenidate in children with the dual diagnosis of epilepsy and attention deficit hyperactivity disorder (ADHD). Study design: Thirty children, aged 6.4 to 16.4 years, with epilepsy and ADHD were studied during a 4-month period. During the initial 2 months of the study, the children were treated with antiepileptic drugs (AEDs) only, and for the remaining 2 months, methylphenidate was added at a morning dose of 0.3 mg/kg. They underwent neurologic assessment, brain computed tomography, IQ testing, and assessment with the Childhood Behavior Checklist at baseline before methylphenidate therapy. Electroencephalography, AED determinations, and the continuous-performance task (CPT) test were done at baseline and after 2 months of methylphenidate therapy. A double-blind, crossover design was used to compare the effects of methylphenidate versus placebo on an electroencephalogram, AED levels, and the CPT. On the 2 days of testing, the child received AEDs and a capsule containing either placebo or methylphenidate. Results: None of the 25 children of this sample who were seizure free had attacks while taking methylphenidate. Of the 5 children with seizures, 3 had an increase in attacks, whereas the other 2 showed no change or a reduction. There were no significant changes in AED levels or electroencephalographic findings. Methylphenidate benefited 70% of children according to parental report; methylphenidate also enhanced performance on the CPT. Side effects of methylphenidate were mild and transient. Conclusion: Methylphenidate is effective in treating children with epilepsy and ADHD and safe in children who are seizure free. Caution is warranted for those still having seizures while receiving AED therapy. (J Pediatr 1997;130:40-4)

Objective –To investigate changes in attendance over the course of a population based breast screening programme. Design – Longitudinal; analysis of registered data over nine screening rounds. Setting –Subjects belong to the screening population of the Nijmegen experimental breast screening programme (1975–1990). Subjects –A cohort of 6898 women who were enrolled in 1975 at the age of 50–69 years and who were invited to nine subsequent screening rounds, irrespective of their attendance at previous rounds. Results –Attendance of women aged 50–53 years at entry was high at the initial screening (88%), decreased in the course of the programme, but remained well over 60% until round 8; 39% completed nine rounds and 24% completed seven to eight rounds. Attendance of women who were older at entry was somewhat lower at the initial screening (87%–82%) and declined more strongly. Regular compliance was also lower. Specific compliance patterns are found that can be relevant for further research. Conclusions –A substantial proportion of eligible women can be committed to mammography every two years, possibly even after reaching the age of 70, if the age at entry is around 50 and the screening programme is well established in the community. Starting a screening programme in older women seems ineffective.

The present study addresses the relationship between early rheumatoid arthritis and an element of personality i.e. the self-esteem, as an intervening variable on psychological well-being. From a sample of 292, more or less recently diagnosed RA-patients, the relationships between disease parameters, self-esteem and psychological well-being were studied. Five subgroups of patients have been formed according to the duration of the disease: from four years disease duration up to incident cases. Disease parameters such as the duration of RA or the sedimentation rate is not associated with patients' self-esteem. The self-esteem of RA-patients is negatively related to the level of joint tenderness. Also, the lower the self-esteem of patients, the lower the level of psychological well-being. Joint tenderness with the patients' level of self-esteem explain 34% of the scoring on psychological well-being.

Analysis of heart rate variability (HRV) is used to assess autonomic control of the heart. Many technical aspects may influence the outcome of the HRV analysis. One of these aspects is the accuracy of onset QRS detection. Inconsistent determination of QRS onset may result in artificial variations, especially in patients with wide QRS complexes. The purpose of the present study was to investigate the effect of QRS width on the outcome of HRV analysis. After manual correction of the onset of QRS: HRV variables averaged over 24 hours showed changes up to 10% in patients with wide QRS complexes. However, comparing single 5 minute segments before and after manual correction of onset QRS, much larger differences were observed. Especially variables reflecting beat to beat changes (time as well as frequency domain) showed substantial differences. The average effect of manual QRS onset correction in single 5 minute segments proved to be 5.3% for rMSSD, 5.2% for high frequency power (0.15-0.40 Hz) and 1.3% for low frequency power (0.04-0.15 Hz). We conclude that accurate detection of QRS onset plays an important role in the outcome of HRV analysis, especially in the analysis of short segments and patients with wide QRS complexes.