Dutch Participants Research Articles

From Sex Education to Sexualities Education: Navigating the Intersectionality of Queer Communities in Italy and the Netherlands

ABSTRACT This study aimed to explore the experiences, needs, and interests of queer people who are also neurodivergent, or live with a chronic illness or disability (i.e. IMMI: individuals with multi-minority identities) in Italy and the Netherlands. Five focus groups were conducted in Italy with 22 queer IMMI to identify their most relevant topics regarding and experiences with sex education. Building on the discussion topics of the focus groups, a survey in Italian and English was distributed via snowball sampling. The survey was created to explore the experiences related to sex education in the two countries. The final sample of respondents included 138 (97 Italian, 41 Dutch) queer IMMI. Results indicated that sex education received in both formal (e.g. school) and informal (e.g. family) contexts failed to include information that was sensitive and supportive of queer community’s experiences. Participants reported the need to explore more topics addressing the specific needs of different identity intersections. Cross-cultural differences related to the experiences of Italian and Dutch participants were found. Overall, current sex education in Italy and the Netherlands is far from meeting the sexual health needs of queer people living with different intersections. Practical implications are discussed.

Cross-Linguistic Recognition of Irony Through Visual and Acoustic Cues.

To avoid misunderstandings, ironic speakers may accompany their ironic remarks with a particular intonation and specific facial expressions that signal that the message should not be taken at face value. The acoustic realization of the ironic tone of voice differs from language to language, whereas the ironic face manifests the speaker's negative stance and might thus have a universal basis. We conducted a study on 574 participants speaking 6 different languages (French, German, Dutch, English, Mandarin, and Italian-the control group) to verify whether they could recognize ironic remarks uttered in Italian in three different modalities: watching muted videos, listening to audio tracks, and when both cues were present. We found that speakers of other languages could overall recognize irony uttered in Italian when all the markers were present, and they relied mostly on visual cues: In all these language groups, accuracy in the audio-only modality was always lower than accuracy in the video-only modality, although this trend was significant only for Chinese and Dutch participants. Moreover, the rate of recognition in the audio-visual modality was always significantly higher compared to the audio-only, while the difference between the audio-visual and the video-only modality was significant only for the English group. Overall, these results speak in favor of the hypothesis of a common basis for the visual expression of irony, whereas the acoustic markers alone do not constitute a reliable cue for the cross-linguistic recognition of irony.

Antihypertensive Medication Category Prescriptions and Blood Pressure Control in African Surinamese and Ghanaian Migrants with Hypertension in Amsterdam, The Netherlands: The HELIUS Study.

West African (WA) migrants in Europe have higher hypertension rates than the host populations. For African migrants, guidelines recommend diuretics and/or calcium channel blockers (CCB) for primary cardiovascular disease prevention, but data on antihypertensive medication (AHM) prescription patterns or related hypertension control rates are lacking. We assessed AHM prescription patterns and its relation to hypertension control among hypertensive WA migrants in the Netherlands compared to the host population. Cross-sectional data from WA or Dutch origin participants from the HELIUS study were used. Participants with treated hypertension and without diabetes, cardiovascular disease, or microalbuminuria were selected. We used logistic and linear regression analyses to assess the association between AHM categories and hypertension control rates (systolic blood pressure (BP) ≤ 140 mmHg and diastolic BP ≤ 90 mmHg) and the systolic BP levels. We compared 999 WA participants and 314 Dutch participants. Hypertension control rates were lower in the WA origin compared to Dutch origin participants (44.3% versus 58.0%, p < 0.001). For WA participants, prescription rates for any AHM category were: CCB (54.8%), diuretics (18.5%) beta-blocking agents (27.3%) and renin-angiotensin system blockers (52.6%). Prescription rates were higher for CCB and similar for diuretics compared to the Dutch participants. Neither CCB nor diuretics were associated with better control rates. Compared to Dutch participants, West African participants had similar diuretic prescriptions but significantly higher prescriptions for CCB. However, neither medications was associated with better hypertension control. Future research should explore physician and patient factors to improve hypertension control.

A cross-cultural comparison of intrinsic and extrinsic motivational drives for learning.

Intrinsic motivational drives, like the autonomous feeling of control, and extrinsic motivational drives, like monetary reward, can benefit learning. Extensive research has focused on neurobiological and psychological factors that affect these drives, but our understanding of the sociocultural factors is limited. Here, we compared the effects of autonomy and rewards on episodic recognition memory between students from Dutch and Chinese universities. In an exploratory learning task, participants viewed partially obscured objects that they needed to subsequently remember. We independently manipulated autonomy, as volitional control over an exploration trajectory, as well as the chance to receive monetary rewards. The learning task was followed by memory tests for objects and locations. For both cultural groups, we found that participants learned better in autonomous than non-autonomous conditions. However, the beneficial effect of reward on memory performance was stronger for Chinese than for Dutch participants. By incorporating the sociocultural brain perspective, we discuss how differences in norms and values between Eastern and Western cultures can be integrated with the neurocognitive framework about dorsal lateral and ventral medial prefrontal cortex and dopaminergic reward modulations on learning and memory. These findings have important implications for understanding the neurocognitive mechanisms in which both autonomy and extrinsic rewards are commonly used to motivate students in the realm of education and urge more attention to investigate cultural differences in learning.

The Association between Post-Traumatic Stress Disorder and Problematic Alcohol and Cannabis Use in a Multi-Ethnic Cohort in The Netherlands: The HELIUS Study.

(1) Background: Ethnic minorities exhibit a higher prevalence of post-traumatic stress disorder (PTSD), while results for problematic substance use among ethnic groups remain mixed. PTSD and problematic substance use often co-occur; however, the impact of ethnicity on this association has not yet been investigated. (2) Methods: Self-report data on problematic alcohol/cannabis use (AUDIT/CUDIT) and presence of severe PTSD symptoms (PSS-SR) of N = 22,841 participants of Dutch (n = 4610), South-Asian Surinamese (n = 3306), African Surinamese (n = 4349), Ghanaian (n = 2389), Turkish (n = 3947), and Moroccan (n = 4240) origin were available from the HELIUS study. (3) Results: We found a positive association between the presence of severe PTSD symptoms and problematic alcohol and cannabis use. Ethnicity did not moderate the association between the presence of severe PTSD symptoms and problematic alcohol/cannabis use. (4) Conclusions: We demonstrated the relationship between the presence of severe PTSD symptoms and problematic alcohol/cannabis use in a multi-ethnic sample. The relationship between the presence of severe PTSD symptoms and problematic alcohol/cannabis use was similar between ethnic groups. We recommend screening for PTSD symptoms in those exhibiting problematic substance use and vice versa, regardless of ethnic background.

Deep learning predicted perceived age is a reliable approach for analysis of facial ageing: A proof of principle study.

Perceived age (PA) has been associated with mortality, genetic variants linked to ageing and several age-related morbidities. However, estimating PA in large datasets is laborious and costly to generate, limiting its practical applicability. To determine if estimating PA using deep learning-based algorithms results in the same associations with morbidities and genetic variants as human-estimated perceived age. Self-supervised learning (SSL) and deep feature transfer (DFT) deep learning (DL) approaches were trained and tested on human-estimated PAs and their corresponding frontal face images of middle-aged to elderly Dutch participants (n = 2679) from a population-based study in the Netherlands. We compared the DL-estimated PAs with morbidities previously associated with human-estimated PA as well as genetic variants in the gene MC1R; we additionally tested the PA associations with MC1R in a new validation cohort (n = 1158). The DL approaches predicted PA in this population with a mean absolute error of 2.84 years (DFT) and 2.39 years (SSL). In the training-test dataset, we found the same significant (p < 0.05) associations for DL PA with osteoporosis, ARHL, cognition, COPD and cataracts and MC1R, as with human PA. We also found a similar but less significant association for SSL and DFT PAs (0.69 and 0.71 years per allele, p = 0.008 and 0.011, respectively) with MC1R variants in the validation dataset as that found with human, SSL and DFT PAs in the training-test dataset (0.79, 0.78 and 0.71 years per allele respectively; all p < 0.0001). Deep learning methods can automatically estimate PA from facial images with enough accuracy to replicate known links between human-estimated perceived age and several age-related morbidities. Furthermore, DL predicted perceived age associated with MC1R gene variants in a validation cohort. Hence, such DL PA techniques may be used instead of human estimations in perceived age studies thereby reducing time and costs.

Consistent social odor representation across 7 languages: the Social Odor Scale translation and validation.

The Social Odor Scale (SOS) is a 12-item questionnaire initially developed and validated in Italian and German to investigate self-reported awareness of social odors, which are odors emanating from the human body that convey diverse information and evoke various emotional responses. The scale includes a total score and 3 subscales representing social odors in the respective categories: romantic partner, familiar, and strangers. Here, we aimed to (i) replicate the validation of the Italian and German versions of the SOS, (ii) translate and validate the SOS into multiple additional languages (French, English, Dutch, Swedish, Chinese), and (iii) explore whether the factor structure of each translated version aligns with the original versions. Confirmatory Factor Analysis (CFA) supported the scale's structure, yielding a good fit across all languages. Notable differences in SOS mean scores were observed among the different languages: Swedish participants exhibited lower social odor awareness compared to the other groups, whereas Chinese participants reported higher social odor awareness compared to Dutch and Swedish participants. Furthermore, SOS scores correlated with respondents' geographical location, with higher (i.e. northern) latitudes linked to lower social odor awareness. These results corroborate the SOS as a valid and reliable instrument, especially for the SOS total score and the Familiar and Partner factors, emphasizing the influence of individual and geographic factors on social odor awareness.

Dietary Biodiversity and Diet Quality in Dutch Adults.

Dietary biodiversity, defined as the variety of consumed plants, animals and other organisms, can be measured by dietary species richness (DSR). This study investigated associations between DSR and diet quality in Dutch adults. Dietary intake data of 2078 Dutch participants, aged 19 to 79 years, were collected by the Dutch National Food Consumption Survey between 2012 and 2016 via two non-consecutive 24-h dietary recalls. DSR scores were calculated based on the total count of unique species consumed per individual over the two measurement days. An overall DSR score and separate scores for fruit and vegetable species consumption were calculated. The Dutch Healthy Diet index 2015 (DHD15-index) was used to measure diet quality. Linear regression analyses were performed to investigate associations between DSR scores and DHD15-index. Analyses were stratified by age and adjusted for relevant confounders. In total, 157 unique species were identified within the investigated food groups. On average, individuals consumed 13 unique species over two days (SD 4.55). For every additional species consumed, the DHD15-index increased by 1.40 points (95%CI 1.25-1.55). Associations between DSR and DHD15-index were higher in younger adults. DSR fruit showed the strongest associations with DHD15-index (β 4.01 [95%CI 3.65-4.38]). Higher DSR scores are associated with higher diet quality in Dutch adults. These newly developed DSR scores create opportunities for further research to explore the implications of dietary biodiversity in Western diets on health and related outcomes.

Determinants of intended prevention behaviour against mosquitoes and mosquito-borne viruses in the Netherlands and Spain using the MosquitoWise survey: cross-sectional study

BackgroundRecently, Europe has seen an emergence of mosquito-borne viruses (MBVs). Understanding citizens’ perceptions of and behaviours towards mosquitoes and MBVs is crucial to reduce disease risk. We investigated and compared perceptions, knowledge, and determinants of citizens’ behavioural intentions related to mosquitoes and MBVs in the Netherlands and Spain, to help improve public health interventions.MethodsUsing the validated MosquitoWise survey, data was collected through participant panels in Spain (N = 475) and the Netherlands (N = 438). Health Belief Model scores measuring behavioural intent, knowledge, and information scores were calculated. Confidence Interval-Based Estimation of Relevance was used, together with potential for change indexes, to identify promising determinants for improving prevention measure use.ResultsSpanish participants’ responses showed slightly higher intent to use prevention measures compared to those of Dutch participants (29.1 and 28.2, respectively, p 0.03). Most participants in Spain (92.2%) and the Netherlands (91.8%) indicated they used at least one prevention measure, but differences were observed in which types they used. More Spanish participants indicated to have received information on mosquitoes and MBVs compared to Dutch participants. Spanish participants preferred health professional information sources, while Dutch participants favoured government websites. Determinants for intent to use prevention measures included “Knowledge”, “Reminders to Use Prevention Measures”, and “Information” in the Netherlands and Spain. Determinants for repellent use included “Perceived Benefits” and “Cues to Action”, with “Perceived Benefits” having a high potential for behavioural change in both countries. “Self-Efficacy” and “Knowledge” were determinants in both countries for breeding site removal.ConclusionThis study found differences in knowledge between the Netherlands and Spain but similarities in determinants for intent to use prevention measures, intent to use repellents and intent to remove mosquito breeding sites. Identified determinants can be the focus for future public health interventions to reduce MBV risks.

Norms of equality reduce prejudice towards migrants, but only among conservatives

AbstractPeople are sensitive to norms, but under what conditions promoting anti‐prejudice norms reduce prejudice remains unclear. Three studies among Dutch participants (total N = 700) examined the effects of (in)equality norms on prejudice towards migrants. To gain greater clarity, we also examined how potential boundary conditions—namely economic and social ideologies—moderate this relationship. A norm of equality was measured (Study 1) or manipulated (Studies 2a and 2b). In Study 1, a perceived norm of equality predicted lower prejudice towards migrants, operationalised as cold feelings, social distance, and perceived outgroup threat, through the increased personal endorsement of equality, particularly among (economic) rightists. In two experiments (Studies 2a and 2b), as well as in a joint analysis of both studies, we found that inducing an equality norm (vs. not) mitigated prejudice towards migrants, but only among (social) rightists. These findings highlight the positive role of social norms promoting equality in combating prejudice and the importance of considering boundary conditions for this role, such as ideology. We discuss the implications for theory and practice regarding prejudice (reduction). Please refer to the Supplementary Material section to find this article's .

How Do Personal Opinions Relate to Online Expressions? An Experimental Study Among Muslim Minority Groups in The Netherlands

There has been much debate about how cultural differences between ethnic groups may affect the cohesion of multicultural societies. Still, we know little about the extent to which cultural differences between groups also materialize into behavioral differences, especially in online settings. To study this, we conducted an experiment in which second-generation Moroccan and Turkish Dutch participants first indicated their personal opinion on sexual liberalism, and then participated in discussions on this topic on an online platform. On the discussion platform, participants were randomly assigned to either a progressive, conservative or mixed online discussion. Overall, we found that the convergence between personal opinions and online expressions was stronger for progressive than for conservative participants. Additionally, conservatives (but not progressives) were less likely to express their personal opinions, and more likely to deviate from their personal opinions, when they were exposed to an incongruent versus congruent online environment.

Public acceptance of biomass for bioenergy: The need for feedstock differentiation and communicating a waste utilization frame

Climate change calls for an energy transition utilizing all available renewable energy resources, such as bioenergy from biomass. However, the use of biomass is debated in society, and public acceptance is low or lacking. This survey-based research demonstrates for the first time that public acceptance of bioenergy hinges on (a) the type of biomass feedstock used to generate bioenergy and (b) the perceptions of the effectiveness of bioenergy in contributing to the energy transition. A survey-embedded vignette experiment (with 409 Dutch participants) shows that public acceptance of the biomass feedstocks 'wood' and 'energy crops' is significantly lower than the acceptance of 'organic waste' and 'manure' for bioenergy. These results indicate that the biomass feedstock type should be more carefully considered and specified in future research and communication on public acceptance of bioenergy. Thematic coding and bootstrapped mediation analyses identified the perceived effectivity of bioenergy in contributing to the energy transition as a prime explanatory (i.e., mediating) variable for acceptance. A subsequent message-framing communication experiment (with 414 Dutch participants) demonstrates that emphasizing biomass feedstock as a form of waste utilization is a frame that helps to increase public acceptance of bioenergy. The waste utilization frame notably improves the perceptions of the effectiveness of bioenergy as contributing to the energy transition for the two lesser accepted biomass feedstocks. The emphasis on biomass feedstock type as a form of waste treatment can improve strategic communications on bioenergy and foster wider public acceptance of bioenergy in the transition toward a more sustainable energy system.

Autistic adults in China and the Netherlands: Proxy-reported community integration and life satisfaction.

Even though there are about 10 million Chinese autistic individuals, we know little about autistic adults in China. This study examined how well young autistic adults in China integrate into their communities (such as having a job, living independently and having friends) and how satisfied they are with their lives as reported by their caregivers. We compared them to autistic adults with similar characteristics (such as high support needs) from the Netherlands. We included 99 autistic adults in China and 109 in the Netherlands (18-30 years). In both countries, autistic adults were reported to have a hard time fitting into their communities. They often had no work, did not live on their own and had few close friends. Also, in both countries, caregivers reported that autistic adults felt low satisfaction with their life. Chinese adults were less satisfied with their life than Dutch adults, as indicated by their caregivers. This could be because of a lack of support for autistic adults in China, higher parental stress in Chinese caregivers, or general cross-country differences in happiness. Only in the Dutch group, younger compared with older adults fitted better into their communities, and adults without additional psychiatric conditions were reported to have higher life satisfaction. Country was a significant predictor of independent living only, with Dutch participants more likely living in care facilities than Chinese participants. In conclusion, our study shows that autistic adults with high support needs generally face similar challenges in both China and the Netherlands.

Fertility-Preserving Treatments and Patient- and Parental Satisfaction on Fertility Counseling in a Cohort of Newly Diagnosed Boys and Girls with Childhood Hodgkin Lymphoma.

The purpose of this study is to evaluate the use of fertility-preserving (FP) treatments and fertility counseling that was offered in a cohort of newly diagnosed children with classical Hodgkin lymphoma (cHL). In this observational study, boys and girls with cHL aged ≤ 18 years with scheduled treatment according to the EuroNet-PHL-C2 protocol were recruited from 18 sites (5 countries), between January 2017 and September 2021. In 2023, a subset of Dutch participants (aged ≥ 12 years at time of diagnosis) and parents/guardians were surveyed regarding fertility counseling. A total of 101 boys and 104 girls were included. Most post-pubertal boys opted for semen cryopreservation pre-treatment (85% of expected). Invasive FP treatments were occasionally chosen for patients at a relatively low risk of fertility based on scheduled alkylating agent exposure (4/5 testicular biopsy, 4/4 oocyte, and 11/11 ovarian tissue cryopreservation). A total of 17 post-menarchal girls (20%) received GnRH-analogue co-treatment. Furthermore, 33/84 parents and 26/63 patients responded to the questionnaire. Most reported receiving fertility counseling (97%/89%). Statements regarding the timing and content of counseling were generally positive. Parents and patients considered fertility counseling important (94%/87% (strongly agreed) and most expressed concerns about (their child's) fertility (at diagnosis 69%/46%, at present: 59%/42%). Systematic fertility counseling is crucial for all pediatric cHL patients and their families. FP treatment should be considered depending on the anticipated risk and patient factors. We encourage the development of a decision aid for FP in pediatric oncology.

Cross-border mobility in the Meuse-Rhine Euroregion: impact of COVID-19 border restrictions on everyday activities and visiting social network members.

Cross-border mobility (CBM) to visit social network members or for everyday activities is an important part of daily life for citizens in border regions, including the Meuse-Rhine Euroregion (EMR: neighboring regions from the Netherlands, Belgium, and Germany). We assessed changes in CBM during the COVID-19 pandemic and how participants experienced border restrictions. Impact of COVID-19 on the EMR' is a longitudinal study using comparative cross-border data collection. In 2021, a random sample of the EMR-population was invited for participation in online surveys to assess current and pre-pandemic CBM. Changes in CBM, experience of border restrictions, and associated factors were analyzed using multinomial and multivariable logistic regression analysis. Pre-pandemic, 82% of all 3,543 participants reported any CBM: 31% for social contacts and 79% for everyday activities. Among these, 26% decreased social CBM and 35% decreased CBM for everyday activities by autumn 2021. Negative experience of border restrictions was reported by 45% of participants with pre-pandemic CBM, and was higher (p < 0.05) in Dutch participants (compared to Belgian; aOR= 1.4), cross-border [work] commuters (aOR= 2.2), participants with cross-border social networks of friends, family or acquaintances (aOR= 1.3), and those finding the measures 'limit group size' (aOR= 1.5) and 'minimalize travel' (aOR= 2.0) difficult to adhere to and finding 'minimalize travel' (aOR= 1.6) useless. CBM for social contacts and everyday activities was substantial in EMR-citizens, but decreased during the pandemic. Border restrictions were valued as negative by a considerable portion of EMR-citizens, especially when having family or friends across the border. When designing future pandemic control strategies, policy makers should account for the negative impact of CBM restrictions on their citizens.

Willingness of people with type 2 diabetes to engage in healthy eating, physical activity and medication taking

AimTo assess the willingness of people with type 2 diabetes (T2D) to engage in healthy eating, physical activity and medication taking, and explore associated patient factors. MethodsOnline survey among recently diagnosed T2D patients recruited in the Netherlands and the United Kingdom (UK). Patient factors included general factors and behaviour-specific beliefs. Logistic regression analyses and explorative comparisons were conducted. ResultsOverall, 48% of 67 patients were willing to engage in all three management options, whereas 6% were not willing to follow any of them. 73% were willing to manage T2D with healthy eating, 73% with physical activity, and 72% with medication. Country of recruitment was significantly associated with willingness for healthy eating, with higher willingness among Dutch participants. Beliefs surrounding capability, opportunity, and motivation were significantly associated with willingness to engage in physical activity and medication taking. Many beliefs were similar regardless of willingness but those willing to engage in physical activity perceived less barriers and those willing to take medication had more positive and less negative outcome beliefs than those not willing. ConclusionsWillingness to engage in all management options was limited among recently diagnosed patients, and partly associated with behaviour-specific patient beliefs.

FACE-Q for Measuring Patient-reported Outcomes after Facial Skin Cancer Surgery: Cross-cultural Validation.

Facial skin cancer and its surgical treatment can affect health-related quality of life. The FACE-Q Skin Cancer Module is a patient-reported outcome measure that measures different aspects of health-related quality of life and has recently been translated into Dutch. This study aimed to evaluate the performance of the translated version in a Dutch cohort using modern psychometric measurement theory (Rasch). Dutch participants with facial skin cancer were prospectively recruited and asked to complete the translated FACE-Q Skin Cancer Module. The following assumptions of the Rasch model were tested: unidimensionality, local independence, and monotonicity. Response thresholds, fit statistics, internal consistency, floor and ceiling effects, and targeting were assessed for all scales and items within the scales. Responsiveness was tested for the "cancer worry" scale. In total, 259 patients completed the preoperative questionnaire and were included in the analysis. All five scales assessed showed a good or sufficient fit to the Rasch model. Unidimensionality and monotonicity were present for all scales. Some items showed a local dependency. Most of the scales demonstrate ordered item thresholds and appropriate fit statistics. The FACE-Q Skin Cancer Module is a well-designed patient-reported outcome measure that shows psychometric validity for the translated version in a Dutch cohort, using classical and modern test theory.

Unravelling consumer acceptance of local food: Physical versus social distance and the important role of social identification

Including more locally grown products in our diet is a way to reduce our diets' environmental impact. Therefore, it is important to investigate how this can be effectively communicated on food products to increase consumer acceptance. We propose that product communication that focuses on decreasing the physical and social distance between the food producer and the consumer can result in consumers identifying more with the food producer, which, in turn, can increase the buying intention of food products. The current research comprises an online survey that includes an experimental design and a real-life assessment among 825 Dutch participants. Results of the experiment show that decreasing physical distance, but not social distance, increases consumers’ intention to buy a food product. This effect can be explained by increased feelings of identification with a food producer. Moreover, the real-life assessment provides a first indication that both having a food producer living close by (physical distance) and personally knowing a food producer (social distance) might increase acceptance of the producer and the product, and highlights the relevance of perceived connection. These findings give insights into how food producers can market local food products to increase acceptance; communication on a decreased distance between consumers and the food producer is only effective when it results in more identification with the food producer. Perceived connection seems to be an essential part of the acceptance of local products.

Does the intensity of pain and disability affect health-related quality of life of older adults with back pain? Multilevel analysis between Brazil and Netherlands: a cross-sectional study of the BACE consortium

BackgroundThe prognosis of back pain (BP) in the older adults is less favorable than in younger adults and progress to adverse outcomes and consequent worsening of health-related quality of life (HRQoL). The present study aimed to verify the association between BP intensity, disability and HRQoL in older adults residents in Brazil and Netherlands, and to evaluate whether the country of residence influences the associations.MethodsData were collected from 602 Brazilian and 675 Dutch participants with a new episode of BP from the Back Complaints in Elders (BACE) consortium. For the present study, a cross section was used. Pain intensity and disability were assessed using the Numerical Rating Scale (NRS) and the Roland-Morris Disability Questionnaire (RMDQ), respectively. HRQoL was assessed using the Short Form Health Survey (SF-36) quality of life questionnaire. Age, sex, and education were descriptive variables. Pain intensity (NPS score) and country were the independent variables and quality of life assessed by each SF domain − 36 was the dependent variable. Analysis of models at the individual level was performed to verify the association between pain and disability, also HRQoL in Netherlands and Brazil in the total sample. The multilevel model was used to verify whether the older adults person’s country of residence influenced this relationship.ResultsThe average age of the participants was 67.00 (7.33) years. In the total sample, linear regression analysis adjusted for sex and age showed a significant association between BP intensity scores and HRQoL, for all domains. There was no association between disability and HRQoL. In the multilevel analysis, there was an association between BP intensity and HRQoL in all domains and an association between the country of residence and HRQoL, influencing the effect of pain, in all domains, except for the physical functioning.ConclusionSocioeconomic and cultural aspects of different countries can affect the perception of the elderly about their HRQoL in the presence of BP. Pain and disability in Brazilian and Dutch older adults ones are experienced differently in relation to their HRQoL.

Relevant dimensions to give meaning to pension decisions

Abstract Pension participants face complex decisions. Information about the decision alternatives often contains the exact monetary amounts associated with the alternatives. Grounded in Fuzzy-Trace Theory (FTT), we argue that informed decision making requires participants to (accurately) understand meaningful differences between decision alternatives, rather than to rely on purely numerical differences in amounts. The objective of this study was to identify, for three decisions Dutch participants can make regarding their old-age pension, what dimensions participants take into account when giving meaning to the decision alternatives. We conducted 39 semi-structured in-depth interviews with Dutch pension participants in which we discussed the considerations of participants to choose for the decision alternatives. These interviews were analyzed using thematic analysis. Our analysis shows that a number of dimensions are taken into account, partially overlapping for the three decisions: life expectancy, (in)sufficient income, financial maximization, work–life balance, and job satisfaction. According to FTT, participants can be supported in extracting meaningful representations by providing cues about the dimensions that might be affected by the various decision alternatives. The dimensions identified in this paper can serve as a useful starting point for such support.