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BACKGROUND: Adolescent suicidal behavior, including non-suicidal self-injury, is increasingly prevalent in Secure Residential Youth Care (SRYC) in the Netherlands. Group workers play a vital role in the well-being and functioning of adolescents in SRYC as they interact with adolescents on a daily basis. However, we have little understanding of how adolescents perceive group workers' responses to suicidal behavior and we lack knowledge about the impact of these responses on adolescents and the group climate. AIM: The aim of this study is to explore (a) how adolescents value group workers responses towards suicidal behavior and (b) the impact of these responses on adolescents, as well as (c) on the group climate. The results can be used to develop care-policy to improve care for suicidal adolescents in SYRC. METHOD: Eleven suicidal female adolescents residing in SRYC were interviewed. All adolescents had previously displayed suicidal behavior, including non-suicidal self-injury. Interviews were analyzed using grounded theory. CONCLUSION: This study presents the perceptions of suicidal female adolescents residing in SRYC about group workers' responses on suicidal behavior. Adolescents prefer group workers who react responsive to suicidal behavior. Responsive care, trust and connectedness help adolescents disclose their suicidal thoughts. Participants criticize group workers who are non-responsive as being distant, and their relationship with these group workers lacked trust, communication, a sense of connection, or personal depth. All adolescents underline the devastating impact of involuntary seclusion, and stress the importance of being able to disclose without fear of coercive consequences. Findings indicate that non-responsive reactions contribute to an increase in suicidal distress as well as a closed group climate.

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BACKGROUND: In the Netherlands, more than half of the teachers working in primary education experience high levels of work stress. Compared to other professions, teachers are more likely to drop out from work and develop mental illnesses. Almost one in five even choose a new profession within 5 years after starting as a teacher. This indicates an urgent need for interventions to reduce stress levels in teachers. However, few evidence-based effective interventions targeting stress and work-related problems in the primary educational system are available. AIM: In the current paper, we describe the protocol for a randomized controlled study (RCT) comparing an 8-week mindfulness-based stress reduction (MBSR) intervention with a wait list control condition in primary school teachers. We hypothesize that teachers who participate in the MBSR programme will report less stress (primary outcome) than those in the control group at post-test and at 3-month follow-up. We also expect a decrease in teachers' absenteeism and improvements of mental health, teacher skills, classroom climate quality and the pupil-teacher relationship (secondary outcomes). Finally, we hypothesize that self-compassion, mindfulness skills and emotion regulation skills could mediate effects. METHODS/DESIGN: A mixed-method study will be conducted among N=155 Dutch primary school teachers (grade 1 to 6). The quantitative study will be an RCT, in which teachers will be randomly allocated to the MBSR or waiting list control condition. Trial participants will not be made actively aware of their condition. The data analysts will be blinded. Online questionnaires will be sent to teachers before and after the MBSR programme, and at 3-month follow-up. Information about absenteeism will be collected. In the qualitative part of the study, we will interview teachers to examine their perceived effects of MBSR on their teaching skills, the classroom climate quality and the pupil-teacher relationship. DISCUSSION: This protocol paper describes a mixed-method study design with an RCT and a qualitative evaluation to evaluate an MBSR programme on perceived stress among primary school teachers. If the MBSR programme proves to be effective, it could be implemented as a programme to reduce stress and improve mental health and teaching outcomes in primary school teachers. TRIAL REGISTRATION: Nederland Trial Register NL. Registered on 19 November 2019-retrospectively registered, https://www.trialregister.nl/trial/8171.

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BACKGROUNDS: Developmental disabilities exert severe physical, cognitive and social-emotional consequences, such as low quality of life, not only on children but also on their families. However, the extent of the effect of such consequences on quality of life is partially dependent on how parents address the situation. AIMS: The study aimed to examine whether positive parenting mediates the link between parental resilience and quality of life of children with a developmental disability in Indonesia. METHODS AND PROCEDURES: Data were derived from a three-wave longitudinal study on 497, 224 and 209 families in waves one, two and three, respectively. The study determined parental resilience by assessing the knowledge of parents about the characteristics of their child, perceived social support and positive perception of parenting. Quality of life consisted of five aspects: material well-being, communication and influence, socio-emotional well-being, development and activity. Positive parenting was assessed through observed levels of support, encouragement and praise. CONCLUSIONS AND IMPLICATIONS: The results demonstrated that positive parenting mediated the impact of positive perception of parenting on quality of life. This finding implies that positive perception and positive parenting should be encouraged when families with children with developmental disabilities receive care or support.

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As a result of increasing digitisation of medical record keeping, electronic health records (EHRs) are an attractive source for data reuse. However, such record-based research is still suffering from poor quality of data stored in EHRs. Lack of consent for reuse of data also plays an impeding role, especially in retrospective record-based research. That said, increasing cooperation between healthcare institutions and current attention for EHR organisation also offer opportunities for record-based research. Patient data can be recorded in more standardised ways and in increasingly harmonised EHRs. In addition, if healthcare institutions were to establish a generic consent procedure - preferably with national scope - the potential of EHRs for scientific research could be exploited in considerably better ways.

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Fascioliasis is a condition caused by the trematode Fasciola hepatica. In this paper, the spatial distribution of F. hepatica in bovines in Brazil was modelled using a decision tree approach and a logistic regression, combined with a geographic information system (GIS) query. In the decision tree and the logistic model, isothermality had the strongest influence on disease prevalence. Also, the 50-year average precipitation in the warmest quarter of the year was included as a risk factor, having a negative influence on the parasite prevalence. The risk maps developed using both techniques, showed a predicted higher prevalence mainly in the South of Brazil. The prediction performance seemed to be high, but both techniques failed to reach a high accuracy in predicting the medium and high prevalence classes to the entire country. The GIS query map, based on the range of isothermality, minimum temperature of coldest month, precipitation of warmest quarter of the year, altitude and the average dailyland surface temperature, showed a possibility of presence of F. hepatica in a very large area. The risk maps produced using these methods can be used to focus activities of animal and public health programmes, even on non-evaluated F. hepatica areas.

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Leishmaniases are serious diseases caused by trypanosomatid protozoans of the genus Leishmania transmitted by the bite of phlebotomine sand flies. We analyzed records pertaining to Lutzomyia longipalpis (Lutz and Neiva, 1912) and Lutzomyia cruzi (Mangabeira, 1938) in Brazil from the following sources: the collection of phlebotomine sand flies of the Centro de Pesquisas René Rachou/Fiocruz (FIOCRUZ-COLFLEB), the "SpeciesLink" (CRIA) database, from systematic surveys of scientific articles and gray literature (dissertations, theses, and communications), and disease data obtained from the Information System for Notifiable Diseases/Ministry of Health (SINAN/MS). Environmental data and ecological niche modeling (ESMS) using the approach of MaxEnt algorithm produced maps of occurrence probability for both Lu. longipalpis and Lu. cruzi. Lutzomyia longipalpis was found in 229 Brazilian municipalities and Lu. cruzi in 27. The species were sympatric in 16 municipalities of the Central-West region of Brazil. Our results show that Lu. longipalpis is widely distributed and associated with the high number of cases of visceral leishmaniasis reported in Brazil.

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Lonely adolescents report that they have poor social skills, but it is unknown whether this is due to an accurate perception of a social skills deficit, or a biased negative perception. This is an important distinction, as actual social skills deficits require different treatments than biased negative perceptions. In this study, we compared self-reported social skills evaluations with peer-reported social skills and meta-evaluations of social skills (i.e., adolescents' perceptions of how they believe their classmates evaluate them). Based on the social skills view, we expected negative relations between loneliness and these three forms of social skills evaluations. Based on the bias view, we expected lonely adolescents to have more negative self- and meta-evaluations compared to peer-evaluations of social skills. Participants were 1342 adolescents (48.64 % male, M age = 13.95, SD = .54). All classmates rated each other in a round-robin design to obtain peer-evaluations. Self- and meta-evaluations were obtained using self-reports. Data were analyzed using polynomial regression analyses and response surface modeling. The results indicated that, when self-, peer- and meta-evaluations were similar, a greater sense of loneliness was related to poorer social skills. Loneliness was also related to larger discrepancies between self- and peer-evaluations of loneliness, but not related to the direction of these discrepancies. Thus, for some lonely adolescents, loneliness may be related to an actual social skills deficit, whereas for others a biased negative perception of one's own social skills or a mismatch with the environment may be related to their loneliness. This implies that different mechanisms may underlie loneliness, which has implications for interventions.

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Loneliness has been linked cross-sectionally to emotional skill deficits (e.g., Zysberg, 2012), but missing from the literature is a longitudinal examination of these relationships. The present study fills that gap by examining the prospective relationships between loneliness and emotional functioning in young adolescents in England. One hundred and ninety-six adolescents aged 11-13 years (90 females) took part in the study and completed the youth version of the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT-YV) and the peer-related subscale of the Loneliness and Aloneness Scale for Children and Adolescents (LACA) at two time points, which were 10 months apart. Prospective associations were obtained for male and female adolescents separately using cross-lagged statistical techniques. Our results showed prospective links between understanding and managing emotions and loneliness for both females and males. Perceiving and using emotions were prospectively linked to loneliness in males only. Possible explanations and directions for future research are discussed.

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BACKGROUND: Hereditary factors account for approximately 50% of the risk of developing alcohol dependence. Genes that affect the dopamine function in the brain have been extensively studied as candidate genes. AIM: To present the results of recent Dutch studies on the interaction between genes and their environment in relation to dopamine function and excessive alcohol use. METHOD: Two large scale research projects were recently carried out in order to study the relation between dopamine genes and excessive alcohol use in the Netherlands. The first study investigated excessive alcohol use among adolescents. The second studied alcohol dependence among adult males. RESULTS: Genes that affect the dopamine function in the brain were not directly linked to excessive alcohol use or dependence. Dopamine genes, however, do influence sensitivity to environmental risk factors for excessive alcohol use. CONCLUSION: These studies show that genetically determined dopamine function increases the risk of excessive alcohol use in the context of an adverse environment. Traumatic experiences and parenting style were both shown to be important environmental factors.

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BACKGROUND: In psychiatric research it is often assumed that detrimental effects of negative life events on mental health can be buffered by a number of positive life events. However, there is no convincing empirical evidence that this assumption is correct; it can even be argued that positive life events act as additional stressors rather than as buffers, leading to a continuation of a chaotic life course and an increase in the risk of affective disorders. AIM: To find out whether positive life events were associated with a higher risk of the occurrence of mood disorders and whether such an association could be explained by a number of negative life events that individuals had experienced. METHOD: We used data from 4,796 adults, aged 18-64, collected at two measurement moments (i.e. 1997 and 1999) of NEMESIS, a Dutch prospective-epidemiological study. As a basis for our measurements we used dsm-iii-r diagnoses of major depressive disorders and dysthymia and the Life Events and Difficulties Schedules LEDS. RESULTS: A multivariate (MPlus) path analysis demonstrated that positive life events were not, in themselves, significantly predictive of affective disorders. Positive life events were only related to the risk of mood disorders when they co-occurred with a high number of negative life events. CONCLUSIONS: In accordance with a chaotic life-course hypothesis, positive events were not found to buffer the detrimental impact of negative life events, but when they are part of an erratic course of life they can pose an extra threat to an individual's mental health.

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Association studies investigating the link between the dopamine D2 receptor gene (DRD2) and alcohol (mis)use have shown inconsistent results. This may be due to lack of attention for environmental factors. High levels of parental rule-setting are associated with lower levels of adolescent alcohol use and delay of initiation of drinking. We tested whether DRD2 TaqI A (rs1800497) genotype interacts with alcohol-specific parenting practices in predicting the uptake of regular adolescent alcohol use. Non-regular drinkers were selected from a Dutch, nationwide sample of 428 adolescents (mean age 13.4 years at baseline) and participated in a prospective, community-based study with three annual waves. Parental rule-setting was directly and inversely related to adolescent alcohol use over time. For DRD2 genotype no significant main effect was found. DRD2 genotype interacted with parental rule-setting on adolescent alcohol use over time: adolescents, with parents highly permissive toward alcohol consumption and carrying a genotype with the DRD2 A1 (rs1800497T) allele, used significantly more alcohol over time than adolescents without these characteristics. The DRD2 genotype may pose an increased risk for alcohol use and abuse, depending on the presence of environmental risk factors, such as alcohol-specific parenting.

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This longitudinal study examined the reciprocal effects of the frequency of parent-adolescent communication on tobacco-related issues (smoking-specific communication), and adolescents' smoking. Participants were 428 Dutch older and younger siblings between 13 and 16 years old. Smoking-specific communication did not affect youth smoking in general; however, among younger, but not older, siblings, smoking-specific communication was associated with a higher likelihood of smoking over time. In addition, when adolescents already smoked parents started to talk more frequently about smoking-related issues with their older and younger adolescents later on. Neither the quality of smoking-specific communication, the quality of parent-adolescent relationship, nor parental smoking moderated these reciprocal effects. In conclusion, prevention campaigns encouraging parents to undertake smoking-specific communication might not be desirable.

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In this paper, an heuristic model of the personality characteristics of adolescents and the supportive dimensions of interactions, relationships and groups is presented. The model takes the concept of developmental tasks as its starting point and it is assumed that developmental tasks can be characterized in terms of four modalities: intentions, behaviour, cognitions and affect. The same four modalities can also be used to characterize dimensions of personality and aspects of interactional and relational support. The results of several empirical studies are presented to illustrate the model. Together, these studies present a transactional picture of the personality of adolescents and their relationships in which personality and relationships influence each other and jointly determine psychosocial functioning.

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This study examines the relationship between self-efficacy and sustained smoking cessation in Dutch quitters attending a group program for smoking cessation in 1991. Increase in self-efficacy during treatment was found to be a predictor of outcome after controlling for demographic characteristics and cessation history variables. Relapsers (n = 75) showed more negative relationships between self-efficacy and withdrawal symptoms than long-term abstainers (n = 58). Relapsers who were more depressed during the attempt under study were less self-efficacious at the end of treatment. In addition, the duration of the previous attempt to quit smoking proved to be differently associated with self-efficacy for quitters and relapsers.

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In this study, the robustness of the Big Five personality factors in adolescents' self-ratings and peer nominations was investigated. Data were obtained on 2,001 adolescents attending secondary school (885 girls; 1,116 boys; M age = 14.5 years). Exploratory and confirmatory factor analyses on the self-ratings confirmed the Big Five personality factors. In contrast, exploratory analysis on the peer nominations revealed five different factors: Aggression-Inattentiveness, Achievement-Withdrawal, Self-Confidence, Sociability, and Emotionality-Nervousness. It is suggested that peers evaluate group members not in terms of their personality but in terms of their group reputation. Peer evaluations contributed substantially to the prediction of peer acceptance and rejection; the Big Five personality factors based on self-ratings did not.

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This paper attempts to analyse the impact of the regular functioning of existing health services on the control of urinary schistosomiasis in two villages in northern Cameroon. The health centres' diagnostic systems selectively recognise heavy infections. The efficacy of reaching and subsequently treating heavily infected subjects, however, is low. No more than around 5% of the heavily infected subjects in the health centres' catchments areas is reached on an annual basis. Further analysis shows that the percentage of infected and heavily infected subjects is not higher among the visitors of the health centre than in the inhabitants of the villages involved. Heavy infection is not a reason to visit the health centre, in these villages. To increase the role of the existing health structure in coping with Schistosoma haematobium infections, the diagnostic system, used in the health centres, could be improved by a standardized inclusion of laboratory examination of clinically suspected individuals. Simultaneously, the awareness of the infected population to respond to infection by visiting the health centre needs further development.

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Several studies have reported excesses of risk of melanoma in specific industries. Data from a case-control study in The Netherlands, including 140 cases with a cutaneous melanoma and 181 controls with other types of malignancy, were used to evaluate whether the reported associations with these specific industries could be reproduced. Adjustment for characteristics of pigmentation and exposure to sunlight was made. Increased risks of cutaneous melanoma were found for subjects who had ever worked in the electronics industry (odds ratio (OR) = 2.03, 95% confidence interval (95% CI) 0.63-6.62), in the metal industry (OR = 2.61, 95% CI 0.96-7.10), and in the transport and communication branch (OR = 1.92, 95% CI 0.84-4.35). These ORs were adjusted for age, sex, education, hair colour, tendency to burn, freckling, and exposure to sunlight. No increased risks were seen for workers in the chemical industry, the textile industry, and among health care workers. Analyses according to duration and latency of exposure did not give consistent results, but existing patterns may be obscured by the imprecision of the estimates.

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The neocortical EEG was quantified during sleep, while under light chloral hydrate anaesthesia, in rats ranging from 9 to 20 days of postnatal age. Continuous amplitude modulation at 0.5-1.0 min per cycle, synchronously over all frequency bands, was observed in 9- and in 10-day-old pups. By day 13, the mean amplitude had risen considerably in each of the frequency bands, and a slow fluctuation in delta-wave activity began to be discernible. Sodium glutamate injections induced EEG changes at 10 days which mimicked certain aspects of normal maturation (viz., large stereotyped potentials at irregular intervals, along with a selective increase in delta-wave activity). Natural as well as experimentally induced EEG changes were paralleled by a rise in neocortical amino acid concentrations, including glutamic acid and GABA. Delta wave amplitudes during quiet sleep increased still further between 13 and 14 days, while beta activity remained at a constant level. Between days 14 and 15 a precipitous decline in delta-wave activity was found, attributable to greater inhibition of slow waves during active sleep. No further developmental changes were noted, except for a gradual rise in the time spent in quiet sleep relative to active sleep.

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