Tilburg University

Purpose Survivors of childhood cancer can suffer from long‐term sequelae or decline in quality of life (QoL), for which careful and standardized selection of outcome measures become more important. This study aims to assess different QoL‐related outcomes using three distinct questionnaires in an international study, identify the priorities of childhood ALL survivors via the administered questionnaires, and investigate potential interrelationships among QoL domains across the questionnaires. Methods Childhood ALL survivors treated according to the EORTC CLG treatment protocols 58741, 58831/2, and 58881 were recruited in Belgium and France and answered self‐report QoL questionnaires, including the Short‐Form Health Survey 12 (SF12), the Quality‐of‐Life Systemic Inventory (QLSI), and the Impact of Cancer for Childhood Cancer Survivors (IOC‐CS). To explore which scales overlapped or were novel, Pearson correlations were used to explore associations. In addition, based on the QLSI, we checked whether each of the top priorities of childhood ALL survivors were covered by the SF12 or IOC‐CS, by mapping their scales quantitatively and qualitatively. Results QoL data for 186 survivors were provided. Priority areas, as assessed by the QLSI, were vitality, physical abilities, memory, overall physical health, sleep, interaction with friends, love life. Love life was an important source of happiness (for 42%), and for some reported as the domain they were unhappiest in (13%). Quantitative mapping shows moderate correlations between the SF12 scales and IOC‐CS scales: life challenges, body and health, thinking and memory, and socializing. Qualitative mapping highlighted additional important domains, specifically family, romantic and friendship relationships, and sleep and memory. Conclusions Our findings suggest that the measures complement each other, but are less valuable in isolation for ALL survivors. Using a cancer survivorship measure, combined with some additional items covering priorities might provide a more holistic picture.

We develop a novel methodology for solving constrained optimization problems in deterministic simulation. In these problems, the goal (or objective) output is to be minimized, subject to one or more constraints for the other outputs and for the inputs. Our methododology combines the“Karush-Kuhn-Tucker”(KKT) conditions with“efficient global optimization”(EGO).These KKT conditions are well-known first-order necessary optimality conditions in white-box mathematical optimization, but our method is the first EGO method that uses these conditions. EGO is a popular type of algorithm that is closely related to“Bayesian optimization” and“active machine learning”, as they all use Gaussian processes or Kriging to approximate the input/output behavior of black-box models. We numerically compare the performance of our KKT-EGO algorithm and two alternative EGO algorithms, in several popular examples. In some examples our algorithm converges faster to the true optimum, so our algorithm may provide a suitable alternative.

Against the background of increased labor market flexibilization, health issues amongst employees have become a pressing social concern in Korea. Yet, little is known about the diversity in employment experiences and the associated health implications amongst employees. To accurately gauge labor market segmentation, whilst simultaneously accounting for health-risk factors, we employ the multidimensional Employment Quality (EQ) concept in a typological manner. This method differentiates various employment segments, with the Standard Employment Relationship (SER) serving as a benchmark. Using the 2017 Korean Working Conditions Survey (KWCS), we employ Latent Class Cluster Analysis on a sample of the salaried workforce (N = 25.376) to construct a typology of EQ. Via logistic regression, we link the EQ typology to poor mental well-being and poor self-rated general health. As a result, we find six distinct types of EQ arrangements in Korea: SER-like, Instrumental, SER Intensive, Instrumental Intensive, Precarious Intensive, and Precarious Unsustainable. We find that deviations from the SER-like segment are associated with poorer health and well-being outcomes, even when accounting for confounding factors, with precarious EQ segments showing the most pronounced adverse health and well-being associations. This study furthers our understandings of health disparities within the salaried workforce. Our findings underscore the need for targeted reforms of workplace- and employment-related health policies to foster a healthier working population in Korea.

Veterinary guidelines have been published in the Netherlands to promote antimicrobial stewardship. An evidence-based intervention program using Implementation Mapping and performance indicators was developed to enhance veterinarians’ adherence to the veterinary guideline “Streptococcus suis in weaned pigs”. The present study evaluates the effect of this eight-month intervention program in a multicenter, pragmatic, stepped-wedge cluster design trial. Of the 49 veterinarians that participated, 33 provided data from 125 S. suis problem farms. A baseline measurement (M0) before the intervention program, and two measurements during (M1) and partly after (M2) the intervention program were conducted. A significant reduction in farm-level antimicrobial use of 25% in M1 and 49% in M2 was achieved compared to M0. For the performance indicators at veterinarian level, a significant reduction (− 36%) was found for antimicrobial prescription in M2, a significant increase occurred in argumentation for 2nd choice antimicrobials (M2) and the usage of bacteriological examination (M1). Two other performance indicators (ratio of 1st to 2nd or 3rd choice antimicrobials and corticosteroids) did not change significantly. These results show how an evidence-based intervention program to foster adherence to an existing veterinary clinical practice guideline achieved a significant reduction in antimicrobial prescriptions by swine veterinarians. Supplementary Information The online version contains supplementary material available at 10.1038/s41598-024-81155-x.

In this paper it is argued that Grotius views on customary law are compatible with the concept of a ‘Grotian Moment’. However, the idea of accelerated customary international law is developed by Van Vollenhoven, who interpreted Grotius in a questionable way. Whereas Grotius qualifies as a thinker in the tradition of natural law, Van Vollenhoven should be seen as an interactionist. This is especially visible in his publications on adat law, in which he visibly belongs to a romantic, Germanist, and rather pluralist tradition of law. The idea of a Grotian Moment also fits better with this starting point than with natural law. For this reason, the ‘Grotian Moment’ should be renamed ‘Van Vollenhoven’s Moment’. It is argued that this legal theoretical position explains some of Van Vollenhoven’s rather peculiar interpretations of Grotius.

Loss-adaptation has been described as being characterized by ‘waves of grief’, which may result in a Prolonged Grief Disorder (PGD). Although this assumption about the fluctuating nature of grief is supported by theoretical work, it is not (yet) supported by empirical work. We are the first to explore to what extent PGD reactions fluctuate in everyday life and whether fluctuations in PGD reactions are related to overall PGD levels using experience sampling methodology (ESM). Data from 38 bereaved individuals (74% women, on average 6 years post-loss, 47% lost a parent) were analyzed. For two weeks, five times per day, participants reported on the severity of 11 PGD reactions in the past three hours (ESM-PGD). At baseline, overall PGD severity (B-PGD) in the past two weeks was assessed with telephone-interviews using the Traumatic Grief Inventory–Clinician Administered. Root Mean Square of Successive Differences (RMSSD) were calculated to reflect fluctuations in ESM-PGD. Spearman correlations between RMSSD values of the 11 ESM-PGD reactions and B-PGD scores were computed. Mean B-PGD scores were below the clinical cut-off. Some fluctuations in ESM-PGD reactions were found, as indicated by varying RMSSD values, but also floor effects were detected. B-PGD levels were related to RMSSD values for ESM-PGD (ρ between 0.37 and 0.68, all p <.05; and between 0.36 and 0.63 after removal of floor effects). We found that (some) ESM-PGD reactions fluctuated in everyday life. This may offer new theoretical insights into loss-adaptation, which may result in optimizing PGD treatment.

Later life is often seen as a time of losses. Through the death of loved ones and the dwindling of bodily capacities, older people are increasingly confronted with their own mortality. As losses accrue across different domains, they form a unique existential vantage point. We aim to shed light on this understudied dimension of later life by analysing older people’s everyday practices of sense-making. Drawing on the findings of a qualitative interview study (n=16, aged 65-93), we identify three distinct practices by which older people make sense of death and bereavement: timing, communing, and missing. We conceptualise these practices as “farewell ceremonies,” a term we borrow from Simone de Beauvoir. The “farewell ceremony” describes a period of incremental goodbyes, which characterised the last ten years of Jean-Paul Sartre as well as the death process of Beauvoir’s mother Françoise. Beauvoir captures these farewell ceremonies in her memoirs Adieux: A Farewell to Sartre and A Very Easy Death, which frame our philosophical reflection on practices of timing, communing, and missing. Bringing together Beauvoir’s literary and philosophical work with our empirical findings, we propose an integrated view on death and bereavement in later life that centres the intertwining perspectives of self and other.

European electricity regulation has evolved to include a novel category of binding sectoral rules known as terms, conditions, and methodologies (TCMs). These are created within a regulatory framework outlined in delegated Commission regulations by private electricity firms and approved by technocratic agencies, most notably the EU Agency for the Cooperation of Energy Regulators (ACER). Despite their technical nature, TCMs have significant economic impact. This prompts frequent appeals of ACER’s TCM decisions, questioning ACER’s role and the overall institutional equilibrium of the TCM procedure. ACER’s TCM decisions are subject to dual-level legal review – internal by ACER’s Board of Appeal and external by European Courts. This paper uses two case studies to examine how dual-level legal review impacts the institutional balance of the TCM procedure. We find that the two levels of review engage poorly, so that contrary to expectations, legal review creates uncertainty rather than clarity, allowing for considerable pragmatism. These findings show the importance of considering legal review when studying sectoral governance. Policy implications are also significant, as the identified issues inhibit innovation and problem-solving, the raison d’etre of the TCMs.

Research Summary This study explores the decision to centralize control over technological resources. We posit that opportunity costs arising from the firm's administrative structure impact this choice. These opportunity costs stem from differences in identifying and evaluating opportunity sets between the unit level (decentralized) and headquarters level (centralized). We propose that a resource's versatility increases the opportunity costs associated with decentralized control, thereby raising the likelihood of its control being centralized. Using a sample of patents acquired through corporate acquisitions in the medical device industry, we find that patents with greater technological and product‐market versatility are more likely to be reassigned to the central level. These findings contribute to elucidating the interplay between resources, strategy, and structure. Managerial Summary In the process of integrating a newly acquired firm, acquirers must decide whether to retain the resources within the acquired subsidiary or reallocate them to the headquarters. Decentralizing resources enables managers at the divisional level to spot, sort, select, and seize opportunities in their specific product‐market domains. However, centralizing resources can help exploit opportunities with a broad scope, spanning across divisions. The key consideration is determining which resources should be centralized after an acquisition? Analysis of data on 507 US acquisitions in the medical device industry undertaken between 1996 and 2015 reveals that acquirers tend to centralize versatile technological resources, especially when the acquirers themselves have a diverse technological base.

This paper proposes analytical variance estimation formulas for the estimated population mean from an extended pseudo weighting method developed by [1] (LSdW). LSdW is meant to correct selection bias in a nonprobability sample, also when the nonprobability sample or the reference probability sample has a large inclusion fraction. Since samples with large inclusion fractions often require massive computation resources, having an analytical expression for the variance will be more time-efficient compared to resampling methods. In addition, we show that LSdW is a consistent estimator of the population mean under certain assumptions. To deal with different designs of the probability sample, probability proportional to size (PPS) sampling and simple random sampling (SRS) are considered, and the variance estimator formulas are given accordingly. The proposed formulas are evaluated by a simulation study and it shows that the proposed formulas give reasonable estimates in terms of relative bias and coverage of the confidence interval.

This study analyzed the association between changes over time in illness self-management skills and personal recovery in patients with schizophrenia and other severe mental illnesses and determined the degree to which this association was mediated by changes in clinical and functional recovery. The rationale for the hypothesized directions of association and mediation originated from a recent randomized controlled trial (RCT) on Illness Management and Recovery (IMR), the relations between these concepts suggested in a conceptual framework of IMR, and from the results of three meta-analyses. Moreover, earlier studies indicated the relevance of examining personal recovery as an outcome for people with severe mental illnesses. Outpatient participants’ data were used in this RCT (N = 165). Difference scores were constructed for all concepts by subtracting scores measured at baseline (T1) from scores at follow-up measurement (T3). We used mediation analysis to describe pathways between changes in illness management (assessed using the Illness Management and Recovery scale client version) and changes in personal recovery (assessed using the Mental-Health Recovery Measure), mediated by changes in clinical (assessed using the Brief Symptom Inventory) and functional recovery (assessed using the Social Functioning Scale). We applied the baseline data of all concepts as covariates. As inferential tests to determine the significance of the indirect paths, confidence intervals were constructed using bootstrap techniques. The results showed that the improvement in overall illness management was directly associated with improvements in personal recovery (B = .30), and indirectly through improvements in clinical recovery (indirect effect = .13) and functional recovery (indirect effect = .08). The main conclusion is that self-reported illness management appears to be more strongly and directly associated with personal recovery than indirectly via clinical and functional recovery. This analysis supports the relevance of self-management interventions such as IMR for the personal recovery of people with severe mental illnesses.

We examine the generally accepted hypothesis that directed reciprocity is a powerful driver for cooperation. To do so, we consider a framework where agents situated on a circle network interact with their neighbors and have the choice to be egoistic, altruistic, or partially cooperative. We study the interaction between reciprocity, the likelihood that an agent reproduces value to the neighbor who has recently produced value for the agent, and inertia, the tendency of agents to repeat their previous choices even if other strategies are more successful. On the basis of extensive simulations, we conclude that for high levels of inertia, reciprocity enhances cooperation, while for low levels of inertia reciprocity rather subverts cooperation. For intermediate levels of inertia, we find a U-shaped effect. Reciprocity therefore interacts with the level of inertia in a non-monotonic fashion.

Aims and Objectives The aim of this introductory chapter to Effects of Limited Input, a Special Issue of the International Journal of Bilingualism, is to give a brief overview of how the topic of limited linguistic input is situated within the study of bilingualism and language contact. The seven chapters—which present samples of the varied circumstances in which bilinguals acquire, use, maintain, and sometimes suppress areas of their languages—are introduced. Research Questions The authors of this collection address the following kinds of questions: What are the circumstances—and consequences—of limited linguistic input? What kinds of changes are likely or unlikely to happen when the amount of input is low and stylistically reduced? How meager can the input be for some degree of functional bilingualism to still develop? Design/Methodology The methods used in the seven articles in this collection vary; they include case studies, observations, speech-rate measurements, oral narration tasks, comparisons of production vs. comprehension, and longitudinal approaches. Data and Analysis The studies in this collection draw from a wide variety of data sets, including bilingual corpora and naturally occurring or elicited speech. The data come from children, youth, and adults, from various languages and language contact settings, and from populations with varying degrees of bilingualism. Findings/Conclusions We argue that limited input is not restricted to bilingual situations alone; it relates also to the mastering of monolingual registers. The key argument of this introductory chapter is that limited input is the rule, not the exception, as it is very rare to find a language contact situation wherein all contact varieties are equally represented in the input that speakers receive. Therefore, we argue against the theoretical notion of “balanced bilingualism” as a realistic outcome of bilingualism and claim that variations in the circumstances of language exposure will naturally lead to different consequences and configurations in the outcomes of bilingual acquisition. One inevitable outcome is language change. Originality All the articles in this collection are original, providing new angles to the complex topic of variation in speakers’ access to their languages in contact settings. Significance The authors of this collection look at various aspects of language contact situations through the lens of limited input. This emphasis allows us to view bilingualism as a special case of monolingual register variation and reject the concept of “balanced bilingualism.”

Purpose During emotional events, people monitor the effectiveness of their emotion regulation (ER) to decide whether to keep using their current ER strategy, switch to a new strategy, or stop the regulation process. However, there is little empirical research on the monitoring phase of ER, particularly on which and how situational and individual factors influence this process. Methods We tested situational and individual factors as predictors of real-life ER monitoring decisions. 155 young adults responded to 5 prompts per day in a 7-day experience sampling protocol. At each prompt they described an emotional event, rated the intensity of event, their current emotions and perceived success in ER, and reported their decision to simply stop using their current ER strategy or to switch to a new strategy during the event. Results Multilevel modeling results showed the decision to stop using the current ER strategy was predicted by perceived success in ER after both positive and negative events, and by depressive and anxiety symptoms after positive events. The decision to switch to a new strategy was more likely when there were high negative affect after a negative event, and less likely when there was perceived success after a positive event. Conclusions These findings suggest that situational and individual factors affect people’s decisions about how to regulate emotion. Interventions addressing excessive regulatory stopping in response to positive events and their underlying causes may benefit individuals with depression or anxiety.