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Inclusive education has brought new challenges for teachers, including the search for a suitable place in the classroom for children with externalizing problems. In the current study, we examined whether a careful rearrangement of the classroom seats could promote social acceptance and more prosocial behaviors for children with externalizing problems, and limit the potential negative consequences for classmates sitting next to them. The sample of this randomized controlled trial consisted of 64 classrooms with 221 fourth- to sixth-grade children selected by their teachers because of elevated levels of externalizing behavior. Results showed that over time children with externalizing behavior were better liked by their seatmates and showed fewer externalizing problems according to the teacher. This was particularly the case when students sat next to a well-liked and prosocial buddy, or when they were initially disliked. Classmates who sat next to a child with externalizing problems did not become more aggressive or less prosocial over time. Yet their social status did decrease slightly over time as a result of the rearrangement. We discuss implications and future directions for research on classroom seating arrangements to support children with externalizing problems.

Introduction: Traditional iron parameters often fail to distinguish the cause of iron-restricted anemia in patients without an obvious underlying cause. We evaluated whether an oral iron absorption test (OIAT) and hepcidin measurement could be useful diagnostic tests in these patients., Methods: We retrospectively analyzed data extracted from medical records of all patients who underwent an OIAT and hepcidin measurement, noting subsequent clinical diagnosis. Δ Iron >15 µmol/L during the OIAT and a hepcidin level below the median (or suppressed ≤0.5 nm) were considered appropriate., Results: Thirty-nine adult patients were included in the study. Sixteen patients with adequate OIAT had suppressed hepcidin levels indicative of classical iron-deficiency anemia (IDA); 59% of patients had abnormal OIAT. In this group, most patients with low hepcidin levels had anemia associated with abnormalities in the gastrointestinal tract, whereas 83.3% patients with high hepcidin levels had iron-refractory iron-deficiency anemia (IRIDA), confirmed by genetic testing. Finally, transferrin/log ferritin ratio accurately identified patients with suppressed hepcidin: AUC 0.98 [95% CI: 0.95-1.02], p < 0.001., Conclusion: OIAT differentiates between classical IDA and other types of anemia caused by abnormalities in iron absorption or systemic iron availability. Additionally, elevated hepcidin in patients with oral iron malabsorption could indicate IRIDA., (© 2023 The Author(s). Published by S. Karger AG, Basel.)

Awareness that high-status adolescents can be targets of aggression has grown in recent years. However, questions remain about the associations of the confluence of victimization and popularity with adjustment. The current study fills this gap by examining the joint and unique effects of victimization and popularity on aggression and alcohol use. Participants were 804 Dutch adolescents (50.2% boys, M age  = 13.65) who were followed for one year. High-status victims were more aggressive and drank more alcohol than lower-status victims. High-status victims were also more proactively and indirectly aggressive and self-reported more bullying than high-status non-victims. Thus, the findings demonstrated a conjoined risk of victimization and popularity for some types of aggression., (© 2022. The Author(s).)

Previous studies have called attention to the fact that popular youth are not immune to peer victimization, suggesting there is heterogeneity in the popularity of victims. Yet, no study to date has determined whether victims with different levels of popularity status can be identified using person-oriented analysis. Such analysis is critically needed to confirm the existence of popular victims. Further, there remains a paucity of research on internalizing indices of such popular victims, especially compared to other victim and non-victim groups. To address this gap in the research literature, the current study used latent profile analysis to identify subgroups of victims based on victimization (self- and peer-report) and popularity (peer-report). This study sought to verify the existence of popular victims and to compare victim subgroups on loneliness and self-esteem. Participants were 804 Dutch adolescents (50.2% boys, M age  = 13.65 years, ranging from 11.29 to 16.75 years). The results revealed six subgroups, including a group of popular self-identified victims. Popular self-identified victims were generally less lonely than other victims, but had higher loneliness and lower self-esteem than non-victims. Implications are discussed for understanding the victimization experiences of high-status youth., (© 2021. The Author(s).)

Emotional eating (EE), the propensity to eat in response to emotions, is thought to have its origins in the early parent-infant relationship. This study tested the hypothesis that infant attachment insecurity results in EE in adolescence through the increased use of the emotion regulation strategy suppression of emotions and subsequent alexithymia. At the age of 15 months, parent-infant attachment security ( n = 129) was observed with two abbreviated attachment measures: the shortened strange situation procedure (SSSP), and the shortened attachment Q-set (S-AQS). At the age of 12 years, children completed self-report questionnaires to assess the suppression of emotions, alexithymia, and EE. At the age of 16 years, EE was measured again. The mediation models indicated that lower parent-infant attachment security predicted increased use of suppression of emotions, which was related to increased alexithymia, and in turn more EE at the age of 12 years. These results were similar and significant for both attachment measures, and also (marginal) significant with EE at the age of 16 years as an outcome. Lastly, when parental caregiving quality was included, the models with the SSSP as predictor remained significant, but the models with the S-AQS became insignificant. These results indicated that to a certain extent, infant attachment security could predict adolescent EE above and beyond parental caregiving quality.

Background: The Government of Vietnam has set the goal of achieving universal health coverage (UHC) by 2025. Health insurance (HI) is being considered a tool to achieve this goal. However, out-of-pocket spending and catastrophic health expenditure (CHE) remain high. Research evidence on how to reduce these expenditures to achieve UHC is essential. Therefore, this study examines the determinants of CHE, especially the HI factor., Method: To identify HI participation status and other factors associated with CHE, we use logistic regression on a dataset from the 2016 Vietnam Household Living Standards Survey., Results: The study finds that HI is a protective factor against CHE, although this result is not always statistically significant across different subsamples. Moreover, the household head's age and employment status, household size, share of the elderly above 60 years, income, illness status, healthcare utilisation, availability of hospitals, commune health stations with medical doctors and place of residence all correlate with household CHE., Conclusion: Although there has been a rise in HI coverage, the financial protection capacity of HI schemes in Vietnam remains inadequate, particularly for households living in rural areas. Further investigations of the causal effect of HI, other health system factors and CHE in rural settings are necessary to reduce the incidence of CHE. Additionally, policies aimed at groups vulnerable to CHE, such as those with higher incidences of severe illness or inpatient admissions, low income, and higher age, should be considered., (© 2020 John Wiley & Sons Ltd.)

Tissue factor (TF) is traditionally known as the initiator of blood coagulation, but TF also plays an important role in inflammatory processes. Considering the pivotal role of coagulation in inflammatory bowel disease, we assessed whether genetic ablation of TF limits experimental colitis. To this end, wild-type and TF-deficient (TFlow) mice were treated with 1.5% dextran sulfate sodium (DSS) for 7 d, and effects on disease severity, cytokine production and leukocyte recruitment were examined. Clinical and histological parameters showed that the severity of colitis was reduced in both heterozygous and homozygous TFlow mice compared with controls. Most notably, edema, granulocyte numbers at the site of inflammation and cytokine levels were reduced in TFlow mice. Although anticoagulant treatment with dalteparin of wild-type mice reduced local fibrin production and cytokine levels to a similar extent as in TFlow mice, it did not affect clinical and histological parameters of experimental colitis. Mechanistic studies revealed that TF expression did not influence the intrinsic capacity of granulocytes to migrate. Instead, TF enhanced granulocyte migration into the colon by inducing high levels of the granulocyte chemoattractant keratinocyte-derived chemokine (KC). Taken together, our data indicate that TF plays a detrimental role in experimental colitis by signal transduction-dependent KC production in colon epithelial cells, thereby provoking granulocyte influx with subsequent inflammation and organ damage.

The aim of this investigation was the description and comparison of problems of patients admitted to three geriatric wards of a mental hospital. The study took place in the geriatric units at the Vincent van Gogh Institute of psychiatry in Venray, the Netherlands and was retrospective. Data obtained from discharge letters were analysed and the relevant diagnoses and the aetiology of the problems of all patients admitted in 1994 were categorised and compared. This was done bij means of classification systems and models of Fried et al. The problems of patients admitted to the geriatric unit of a mental hospital very frequently appeared to be combined problems of a psychiatric, somatic and/or social nature. In only 58% there was a simple connection between the cause(s) and the current problems. Differences between the three wards were small and non significant. In conclusion, the problems of the patients, admitted to the geriatric units of a mental hospital, did not differ significantly between the three wards. Furthermore, they are complex in terms of diagnosis, aetiology and/or treatment.

The aim of this investigation was the comparison and description of actual problems of patients admitted to a geriatric ward of a mental hospital and patients admitted to the geriatric ward of a general hospital. The study was conducted in the geriatric unit of the Vincent van Gogh Institute of Psychiatry, in Venray and the geriatric unit in St. Maartens Gasthuis in Venio, both in the Netherlands. The design was retrospective. Data were obtained from discharge letters. The relevant diagnoses and the aetiology of the problems of all patients admitted in 1994 were categorized and compared by means of classification systems and models (medical, synergistic and causal chain model). Approximately 80 percent of the patients admitted to the geriatric unit of the mental hospital turned out to have a physical diagnosis relevant to the problems and almost every patient had a relevant psychiatric diagnosis. Life events and relationship problems played an important part. More than half of the patients admitted to the geriatric unit of the general hospital had a relevant psychiatric diagnosis and almost every patient had a physical diagnosis relevant to the problems. Mostly the aetiology of the problems of the patients of the geriatric unit of the mental hospital can be described by means of the medical model. The aetiology of the problems of the patients of the geriatric unit of the general hospital can mainly be described by the synergistic model. The causal chain model is seldom found. An event is more frequently found in the geriatric unit of the mental hospital. Often the referring Doctor could not point out adequately the underlying cause of the problems. We conclude that the problems of the patients, admitted to the geriatric unit of a mental and of a general hospital, differ substantially and in both units the problems are complex, in terms of diagnoses, aetiology and/or treatment.

A girl aged 4 weeks had persistent pulmonary hypertension of the newborn, haematological abnormalities and hepatosplenomegalia due to a cytomegalovirus (CMV) infection; thereafter she had a psychomotoric retardation. A girl aged 6 months had psychomotoric retardation and microcephaly due to a CMV infection, with epilepsy and perception deafness. A polymerase chain reaction (PCR) for CMV-DNA in the blood on the Guthrie card demonstrated retrospectively in both cases that the infection was congenital. A 4-month-old boy had parents who had both experienced a CMV infection around the birth of the child. The child was infected with CMV but the absence of CMV-DNA in the blood on the Guthrie card revealed that the infection was not congenital. Only 10% of infants with congenital CMV infection are symptomatic at birth; the prognosis is then poor. Up to 10-15% of the asymptomatic patients will develop neurological manifestations. For the diagnosis of congenital CMV infection virus isolation is required within 3 weeks after birth. However, when CMV infection is not considered during this period it is later still possible to diagnose congenital CMV infection with a PCR for CMV-DNA in blood spots of Guthrie cards taken during the first week of life.

The effect of citalopram was investigated in 20 mentally retarded patients suffering from a depressive disorder characterized by alterations in the domains of affectivity, motivation, motor activity and vital signs. The study followed a baseline-controlled open design. Citalopram was started in a daily dosage of 20 mg that was kept unchanged for 6 weeks. Thereafter dosage was adjusted to maximally 60 mg per day. Treatment effects were assessed according to the Clinical Global Improvement Scale (CGIS) after at least 6 months. In 12 of the 20 patients a moderate to marked improvement in all domains was observed upon treatment with 20-40 mg citalopram daily. Treatment for one year in the effective dose prevented recurrence of depressive symptomatology. Concomitant use of sedative anticonvulsants reduced responsiveness to treatment. No interactions were observed. It is concluded that citalopram is a well-tolerated, safe and effective antidepressant in mentally retarded subjects with depressive disorders.

Acute otitis media (AOM) is the most frequent bacterial infection in childhood. Because of the high morbidity, the costs of AOM and growing concern about increasing resistance of pneumococci, the most common bacterial cause of AOM, prevention of AOM is important. Vaccination with the recently developed pneumococcal conjugate vaccines leads to a reduction in the number of AOM cases caused by the serotypes present in the vaccine, but the reduction in overall AOM incidence is below 10%. In particular the children with recurrent episodes of AOM may benefit more from these pneumococcal conjugate vaccines.

In the training program for residents in psychiatry, scientific education and participation in research projects are relatively underdeveloped. This may result in a gap between recently acquired scientific knowledge and its implementation in clinical practice. Since the start of the residency training in psychiatry in 1989 in the Vincent van Gogh Institute for Psychiatry, several research lines have been developed especially concerning dimensional diagnostic procedures, evaluation of treatment effects, stress and psychopathology, pharmacokinetics of psychotropic compounds and disordered impulse and aggression regulation. It is concluded that active participation in research projects by both psychiatrists and residents in psychiatry is increasingly mandatory due to social-economic en scientific developments. Despite several countervailing factors, the Vincent van Gogh Institute for Psychiatry has succeeded in the creation of a scientific orientation in the residency program resulting in a number of publications.

Objective: To evaluate the course of the functional ability in daily living activities, mobility and faecal and urinary continence, and the interrelationship of these features of ability in patients admitted to the geriatric unit of a psychiatric hospital (GAPZ)., Design: Retrospective., Setting: Geriatric unit, Vincent van Gogh Institute of Psychiatry, Venray, the Netherlands., Method: Analysis of data obtained from the National Register of Clinical Gerontology from SIG Care Information in Utrecht. For all patients discharged in 1992 the level of functional ability on admission and discharge was determined and compared, using 9 variables., Results: During the stay all but one of the functional status variables improved significantly: washing of upper and lower body, dressing, going to the toilet, eating, urinary (in)continence and mobility (as measured by radius of action and assistance needed). Faecal incontinence did not improve. On average women functioned more independently than men; however, the improvement in functional status was equal for both sexes. There was a hierarchical decline in the event of decreased functional ability. This hierarchical relationship was more prominent at the time of discharge than at the time of admission., Conclusion: On average the functional status of the patients evaluated improved during their stay in the geriatric unit of the psychiatric hospital. There appears to be a hierarchy of changes in aspects of functional condition irrespective of the underlying diseases in elderly people.