21 research outputs found

    Enduring Effects of Infant Emotional Security on Preschooler Adaptation to Interparental Conflict

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    Emotional security theory illustrates the significance of children’s reactions to interparental conflict as a mediator of the associations between interparental conflict and children’s well-being. Less is known about infants’ emotional security. The current study assessed the stability of emotional security over infancy through preschool years. We also assessed whether infant emotional insecurity mediated between interparental conflict during infancy and preschooler adjustment. Seventy-four families with infants aged 6–14 months participated at Time 1. Parents engaged in a conflict resolution task with their infants present. Families returned when children were 3–5 years old (Time 2). Families engaged in the same conflict resolution task and parents additionally completed the Strengths and Difficulty Questionnaire to assess preschooler adjustment. Cluster analyses revealed two classes of infants based on conflict responses at Time 1: secure and insecure. The insecure group demonstrated higher levels of distress, frustration, physical frustration, and dysregulation compared to the secure group. These classifications remained relatively stable over Times 1 and 2. Infant emotional security mediated associations between Time 1 interparental conflict and preschooler adjustment, even when considering preschooler emotional security. Our results highlight the lasting legacy of destructive conflict on infants’ still developing security systems

    Health care seeking among detained undocumented migrants: a cross-sectional study

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    BACKGROUND: As in many European countries, access to care is decreased for undocumented migrants in the Netherlands due to legislation. Studies on the health of undocumented migrants in Europe are scarce and focus on care-seeking migrants. Not much is known on those who do not seek care. METHODS: This cross-sectional study includes both respondents who did and did not seek care, namely undocumented migrants who have been incarcerated in a detention centre while awaiting expulsion to their country of origin. A consecutive sample of all new arrivals was studied. Data were collected through structured interviews and reviews of medical records. RESULTS: Among the 224 male migrants who arrived at the detention centre between May and July 2008, 173 persons were interviewed. 122 respondents met inclusion criteria. Only half of the undocumented migrants in this study knew how to get access to medical care in the Netherlands if in need. Forty-six percent of respondents reported to have sought medical help during their stay in the Netherlands while having no health insurance (n = 57). Care was sought most frequently for injuries and dental problems. About 25% of these care seekers reported to have been denied care by a health care provider. Asian migrants were significantly less likely to seek care when compared to other ethnic groups, independent from age, chronic health problems and length of stay in the Netherlands. CONCLUSION: The study underlines the need for a better education of undocumented patients and providers concerning the opportunities for health care in the Netherlands. Moreover, there is a need to further clarify the reasons for the denial of care to undocumented patients, as well as the barriers to health care as perceived by undocumented migrants

    Does disaster affect immigrant victims more than non-immigrant victims in Dutch general practice: a matched cohort study

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    Background: In the literature, immigrant victims appear to be more vulnerable to health effects of a disaster than indigenous victims. Most of these studies were performed without pre-disaster measurement and without using a control group. Aim: The objective of the study is to monitor differences between two groups of victims, Turkish immigrants and indigenous Dutch, in utilization and morbidity as presented in general practice after a man-made disaster. Methods: A matched cohort study was performed with pre-disaster (1 year) and post-disaster (4 years) measurements of patients from 30 general practices in Enschede. Turkish victims (N=303) and Dutch victims (N=606), matched on age, gender and socioeconomic status, were included. Main outcome measures were psychological problems and physical symptoms as recorded by the general practitioner, using the International Classification of Primary Care (ICPC). Results: The Turkish victims showed higher utilization than the Dutch victims prior to the disaster. In the 1st post-disaster year, both groups of victims showed an increase in utilization, but the increases did not differ significantly. The Turkish group showed no significantly greater increase than the Dutch group in the five most prevalent clusters of health problems (psychological, respiratory, skin, musculoskeletal, and digestive). Conclusion: The Turkish victims in general practice were as vulnerable as the Dutch victims for the effects on their health of this man-made disaster. Differences between Turkish and native Dutch victims of this man-made disaster can largely be explained by the differences that existed already before the disaster

    Virus-like particles derived from major capsid protein VP1 of different polyomaviruses differ in their ability to induce maturation in human dendritic cells

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    AbstractAs polyomavirus major capsid protein VP1-derived virus-like particles (VLPs) have been demonstrated to be highly immunogenic, we studied their interaction with human dendritic cells (hDCs). Exposure of hDCs to VLPs originating from murine (MPyV) or hamster polyomavirus (HaPyV) induced hDC maturation. In contrast, exposure of hDCs to VLPs derived from human polyomaviruses (BK and JC) and simian virus 40 (SV40) only marginally induced DC maturation. The hDCs stimulated by HaPyV- or MPyV-derived VLPs readily produced interleukin-12 and stimulated CD8-positive T-cell responses in vitro. The highest frequencies of activated T cells were again observed after pulsing with HaPyV- and MPyV-derived VLPs. Monocyte-derived hDCs both bound and internalized the various tested polyomavirus VP1-derived VLPs with different levels of efficiency, partially explaining their individual maturation potentials. In conclusion, our data suggest a high variability in uptake of polyomavirus-derived VLPs and potency to induce hDC maturation

    Forensic expertise and child abuse: a survey among preventive child healthcare workers in Amsterdam, the Netherlands

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    In the Netherlands, preventive child healthcare workers (PCHWs) have an important role in identifying signs of abuse, because they reach virtually all children. A closer cooperation of PCHWs and forensic physicians could improve the detection of child abuse. The aim of the study was to evaluate the use of forensic expertise by PCHWs. In November 2013, a survey was distributed among PCHWs employed by the Amsterdam Public Health Service (n = 221). Forty-nine percent of PCHWs indicated suspicions of physical abuse during the last 6 months (response rate: 43 %). In all, 89 % rated the consultation of forensic physicians as useful. In a 1-year period, only three respondents sought advice from a forensic doctor. Although PCHWs regularly have suspicions of physical child abuse and have a very positive attitude towards consulting a forensic physician, consultation rates are very low. More research is needed to understand barriers to consultation of forensic physicians

    Suicide by helium inhalation in the Netherlands between 2012 and 2019

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    Introduction In 2012 and 2013 a movie and a book about a ‘dignified end of life’ were published in the Netherlands. These items described suicide using an ‘exit bag’ to establish asphyxiation using helium (the helium method). ‘Right-to-die-organisations’ inform the elderly about this method. The purpose of this study is to investigate whether the use of suicidal asphyxiation by means of the helium method substituted other, related, methods following its publication in the Netherlands. Material and methods We analysed suicides in the Netherlands over the period from 1 July 2012 to 30 June 2019. We compared the number of deaths caused by the helium method with other, related, cases. Secondly, we related these deaths to the total number of inhabitants and suicides recorded by Statistics Netherlands. Results The study showed a stable trend in the use of the helium method in the period 2012–2019 and this was the same for the other, related methods. Individuals using the helium method were significantly younger than those using other, related, methods. At the scene of death, information about suicide and suicide notes were found more often at ‘helium method’ cases than with the ‘other, related, methods’ cases. Family was significantly more often present during a helium method suicide than during suicide by other, related, methods. Discussion The number of suicides by the helium method and other, related, cases is stable in the Netherlands over the past years. Therefore, we conclude that there is no substitution effect within this category of suicides. Whilst ‘right-to-die-organisations’ strive to inform the old and sick of the helium method, it is noteworthy that the individuals using the helium method are significantly younger than the individuals who choose other, related, methods

    Health care seeking among detained undocumented migrants: a cross-sectional study

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    Abstract Background As in many European countries, access to care is decreased for undocumented migrants in the Netherlands due to legislation. Studies on the health of undocumented migrants in Europe are scarce and focus on care-seeking migrants. Not much is known on those who do not seek care. Methods This cross-sectional study includes both respondents who did and did not seek care, namely undocumented migrants who have been incarcerated in a detention centre while awaiting expulsion to their country of origin. A consecutive sample of all new arrivals was studied. Data were collected through structured interviews and reviews of medical records. Results Among the 224 male migrants who arrived at the detention centre between May and July 2008, 173 persons were interviewed. 122 respondents met inclusion criteria. Only half of the undocumented migrants in this study knew how to get access to medical care in the Netherlands if in need. Forty-six percent of respondents reported to have sought medical help during their stay in the Netherlands while having no health insurance (n = 57). Care was sought most frequently for injuries and dental problems. About 25% of these care seekers reported to have been denied care by a health care provider. Asian migrants were significantly less likely to seek care when compared to other ethnic groups, independent from age, chronic health problems and length of stay in the Netherlands. Conclusion The study underlines the need for a better education of undocumented patients and providers concerning the opportunities for health care in the Netherlands. Moreover, there is a need to further clarify the reasons for the denial of care to undocumented patients, as well as the barriers to health care as perceived by undocumented migrants.</p
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