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Objective Research has convincingly demonstrated that Internet interventions are effective for anxiety and depression and it is suggested that these interventions can reduce therapist time and thus save costs. Therefore, many Dutch mental health organizations have started to implement these treatments into their services. They usually apply the Internet interventions in combination with the face-to-face treatments, i.e. blended treatments. To date, no empirical work has examined if implementing blended treatments actually contributes to treatment effects and cost savings. The objective of this naturalistic study was to examine this issue, using routine mental health care data for patients with depression or anxiety. Methods All 4448 records of patients with depression or anxiety seeking help at a large mental health service between October 2009 and December 2012 were obtained. Data on GAF-index, therapist time, and therapist costs of patients who received face-to-face treatments were compared with those who received blended care, using propensity score matching. Results Blended care was applied in 3.6% of all patients and was given more frequently to younger patients and patients with an anxiety disorder. There were no significant differences in symptom severity at baseline between the two treatment groups, nor were there significant differences between the two groups in symptom improvement. Patients who received blended care had more treatment sessions (face-to-face plus online sessions) than patients who received standard treatment, which resulted in significantly more treatment time and higher costs. Conclusion Findings suggest that in this sample blended care is more expensive compared to established face-to-face treatments and doesn't lead to additional benefits in terms of general functioning. This might be caused by suboptimal implementation strateges.

The stratigraphic reconstruction of this Middle Palaeolithic assemblage from Rotselaar – Toren ter Heide previously without context, opens up various interesting perspectives. Foremost, obviously, it provides the empirical grounds to establish the age of the site with the ‘common’ degree of confidence for crossdating. Rotselaar – Toren ter Heide is now the only site from the northwestern lowland fringe of the European continent for which a precise chronostratigraphical position can be proposed on reasonably solid grounds. In that capacity it becomes relevant to historical interpretation and the site provides additional support for the claim that Neanderthals were capable of and effectively did use Eemian alluvial lowlands (Locht et al., 2016). At Rotselaar, we seem to be witnessing a spatial association with closed depressions and low levees. The precise lay-out of this site-context, obviously, has to remain elusive. In particular, it is by no means certain that the fresh artefact assemblage would actually represent one short occupation event. The stratigraphic reconstruction exercise presented here is valid in the first place for artefacts with an ironoxide deposition present and the association of the others is only an assumption. Interestingly, on the basis of the small sample of artefacts that we have still available for study there would seem to be an association of this taphonomic feature with one particular flint type. This is a fine-grained shiny grey- green flint with a dark, blackish rolled cortex. On the other hand, a large diversity of raw materials is represented in this assemblage including Wommersom quartzite, micaceous quartzite, and different flint types. Are these indications that this is a mixed assemblage of different occupation events which may have been spatially segregated? In that case Rotselaar – Toren ter Heide is a low-density site recalling the Eemian site of Caours (Antoine et al., 2006), among others, and it begs the question as to how exactly Neanderthals exploited such alluvial lowlands.