Repository hosted by TU Delft Library

Two studies were conducted to examine the Quality of Life (QoL) of victims, bullies and bully/victims among Dutch school-aged children. Study 1 studied associations of QoL dimensions with self-reported victimisation in the Dutch sample from the KIDSCREEN Project (N = 1,669). Study 2 examined QoL of self-reported and peer-nominated victims, bullies and bully/victims using baseline data from an evaluation study of an anti-bullying intervention (N = 3,483). In both studies victimisation appeared to be consistently associated with statistically significantly poorer child and adolescent QoL in regard to all QoL dimensions measured. The strongest associations were found with the QoL dimension Moods and Emotions and least with QoL regarding Physical Well-Being. This indicates that victims of bullying are generally less happy and cheerful, feel sad and depressed more often, have a less positive perception of themselves and are less positive about going to school than non-involved children. Active bullying was only associated with decreased QoL in regard to School Environment. That is, bullies are on average less positive about going to school and attending classes than non-involved children are. Finally, QoL of bully/victims mostly resembled that of victims; whereas the association of being a bully/victim was strongest with the QoL dimension Moods and Emotions, the association with QoL regarding Physical Well-Being appeared to be statistically non-significant. © The Clifford Beers Foundation & University of Maryland.

Background: Energy restriction during childhood and adolescence is suggested to lower colorectal cancer (CRC) risk. We investigated this in the Netherlands Cohort Study. Methods: Information on diet and other risk factors was collected by a baseline questionnaire in 1986 when cohort members were 55-69 years of age (n = 120 852). Three indicators of early life exposure to energy restriction were assessed: father's employment status during the Economic Depression (1932-40), place of residence during Second World War years (1940-44) and the 'Hunger Winter' (1944-45), a severe famine. Using the case-cohort approach, incidence rate ratios (RRs) and 95% confidence intervals (CIs) were calculated for total colorectal, proximal colon, distal colon, rectosigmoid and rectal cancers, according to the three time periods of energy restriction. After 16.3 years of follow-up, 2573 cases were available for multivariate analyses. Results: Men who lived in a western city during the Hunger Winter and therefore exposed to the highest degree of energy restriction, had a lower risk of developing CRC (RR: 0.81, 95% CI: 0.68-0.98), and tumours of the proximal colon (RR: 0.72, 95% CI: 0.54-0.96) and rectum (RR: 0.71, 95% CI: 0.53-0.96). In women, non-statistically significant inverse associations were observed for tumours of the distal colon, rectosigmoid and rectum. Inverse associations were also observed between the other two exposure times and studied endpoints, though not statistically significant. Conclusions: This unique observational evidence suggests that severe energy restriction during childhood and adolescence may lower CRC risk, especially in men, thus providing insight regarding the role of energy intake during early life in CRC development. Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2010; all rights reserved.

OBJECTIVE: To estimate the prevalence of dieting and the relationship between dieting, nutritional habits, and health among young adolescents in the Netherlands. METHODS: Out of 1359 secondary school children, aged 13 through 15 y, who were invited for a routine health assessment by school doctors or nurses as part of the Child Health Monitoring System, 1279 (94%) responded and data were analyzed. RESULTS: Among secondary school children 13% of girls and 5% of boys were dieting at the time of the health assessment. Half of the dieting pupils were at risk of overweight, while the other half were within the normal weight range. The mean preferred weight of the dieting pupils was not lower than the mean actual weight of the non-dieting pupils. Dieting pupils skipped meals more often and consumed less sweets and salty snacks, soft drinks and bread than non-dieting pupils. School absence due to illness was relatively high in dieting boys, and medicine use was high in dieting girls. CONCLUSION: As in other Western countries, dieting is a common practise among young adolescents in the Netherlands, especially in girls. 'Unhealthy' dietary practices, like skipping breakfast, are already present at early age, therefore preventive programs should be targeted at young adolescents.

This study examined separate developmental trajectories of anxious and depressive symptoms from childhood to adolescence (9–15 years) in a community-based sample (N = 290). At three measurement points, mothers and fathers reported on their children's anxious and depressive symptoms, and at Time 1 they reported on lower order child personality facets and on their parenting. By means of growth mixture modeling, three developmental trajectories were identified for anxious symptoms: steady low (82%), moderate increasing–decreasing (5.9%), and high declining groups (12.1%). For depressive symptoms, two developmental trajectories were found: steady low (94.1%) and moderate increasing groups (5.9%). Higher shyness, irritability, and altruism predicted membership in more problematic anxious and depressive groups. The personality facets energy, optimism, compliance, and anxiety were unique predictors for class membership for anxious symptoms, and the effects of shyness, irritability, and compliance were moderated by overreactive parenting. Shyness and irritability increased the probability of following the moderate increasing–decreasing anxiety trajectory, but only in the context of high or average levels of overreactive parenting. Compliance increased the probability of following the moderate increasing–decreasing and high decreasing trajectories in the context of high overreactive parenting. Our results indicate that childhood personality facets differentiate trajectories of anxious and depressive symptoms in theoretically compelling ways.

This article compares data on the use of alcohol and cannabis, collected in a study on adolescent sexuality in 1995 with data collected in a similar study, five years earlier. Furthermore, data are presented concerning XTC use in 1995. Data were collected by means of written questionnaires, administered in class by school doctors and schoolnurses. The 1990 sample and the 1995 sample may both be considered as highly representative for the population of pupils in secondary education in those years. Data from 17576 pupils were available for analysis. In testing, small differences between the two samples were controlled for by using logistic regression in which both time of measurement and the relevant demographic variables (sex, age group, type of education and ethnic origin) were entered into the analysis simultaneously. The percentage of pupils who ever drank alcohol in 1995 and 64%, compared to 54% in 1990, a highly significant increase. Among pupils who ever drank, the frequency of alcohol use, also, had risen: in 1995 68% of these pupils drank alcohol at least once a week, compared to 64% in 1990. This difference is significant, too. The percentage of pupils who ever used cannabis increased from 7% to 16%, again a highly significant difference. Frequency of cannabis use among those currently using did not increase significantly between 1990 and 1995. Three percent of all pupils ever used XTC; the percentage of those using at least once a week was 1%. These figures suggest a changing, more riskier life style, which might be related to an increase in other types of risk taking, for example with regard to sexual contacts, as described in Brugman et al (1995). Some people working in education and youth health care suggest an increase in the number of pupils who are not able to concentrate in class, due to drug abuse. A study focusing on problems and risks related to the use of alcohol and drugs among Dutch pupils in secondary education may therefore be deemed appropriate at this moment.

In deze studie worden volwassenen met een milde of complexe aangeboren hartafwijking (17 tot 32 jaar) beschreven. Hun gezondheidsgerelateerde kwaliteit van leven (gemeten met de taaqol) en subjectieve gezondheidstoestand (gemeten met de sf-36) werden vergeleken met die van de algemene populatie. Tevens werd de relatie tussen deze uitkomstmaten en objectieve gezondheidstoestand bepaald. Deze gegevens kunnen gebruikt worden om ouders van patiënten beter voor te lichten. De gezondheidsgerelateerde kwaliteit van leven en subjectieve gezondheidstoestand van de groep volwassenen met een mild defect (n = 80) verschilden niet van die van de algemene populatie. Echter, de gezondheidsgerelateerde kwaliteit van leven van de patiënten met een complexe afwijking (n = 76) was significant slechter dan die in de algemene populatie voor de domeinen grove motoriek en vitaliteit (p < 0,01). Deze patiënten hadden tevens een significant slechtere subjectieve gezondheidstoestand dan de algemene populatie voor de domeinen fysiek functioneren, fysieke rolfunctie, vitaliteit en algemene gezondheidsperceptie (p < 0,01). Correlaties tussen de gezondheidsgerela-teerde kwaliteit van leven en subjectieve gezondheidstoestand enerzijds en de objectieve gezondheidstoestand anderzijds waren laag. Concluderend hebben volwassenen met een milde aangeboren hartafwijking een generieke kwaliteit van leven vergelijkbaar met de algemene bevolking. Speciale aandacht is echter nodig voor de gezondheidsgerelateerde kwaliteit van leven (en dan vooral de beleving van de fysieke aspecten) van de patiënten met een complexe afwijking. De relatie tussen kwaliteit van leven en de objectieve gezondheidstoestand is laag. Daarom is het bij evaluaties van kwaliteit van leven van belang specifieke kwaliteit-van-levenvragenlijsten (zoals de taaqol) te gebruiken.

Background. Oral contraceptives are prescribed as contraception but also as therapy for menstrual cycle disturbances and acne. We studied the prevalence of oral contraceptive (OC) use and the indications to start OC use among adolescents. Methods. A cohort consisting of ninth grade secondary school girls (mean age 15.3 ± 0.6 (s.d.) years) answered a questionnaire on their menstrual cycle. OC users were asked about duration and reasons for OC-use and the name of the preparation they used. The influence of calendar age, gynecological age and level of education on the prevalence of OC was studied by multiple logistic regression analysis. Results. The response on the questionnaire was 92%. Of 2248 responders 248 (11%) used oral contraceptives: 74% used low dose 'sub 50' preparations, 3% pills with 50 μg estrogen, 3% tri-phase preparations and 17% pills with antiandrogens. Of girls aged 14, 15 and 16 years 4%, 12% and 28% respectively used OC. Of the 15-year-olds 31% mentioned contraception as most important reason for OC use, 18% menstrual cycle irregularity, 26% dysmenorrhea, 10% acne and 5% other reasons. Calendar age, gynecological age and level of education were independent variables for OC use in general and for OC use for contraception or dysmenorrhea, but less so for OC use for menstrual cycle irregularity or acne. Conclusions. During adolescence low dose OC's were frequently used. In The Netherlands OC use among girls aged 15 and 16 years doubled in comparison with 1982. One third of the adolescent OC-users mentioned contraception as most important reason to start OC. Gynecological age (a determinant of biological maturation), calendar age (a determinant of biological maturation and lifestyle in peer groups), and level of education (a determinant of lifestyle in peer groups) were associated with OC use.

Introduction Preterm newborns are at risk of developing transient hypothyroxinemia of prematurity (THoP), which has been associated with subsequent neurodevelopmental impairments. Behavioral outcomes at adult age after THoP have never been reported. Aim To examine whether there is an association between THoP and problem behavior at young adult age. Methods This study was part of the follow-up of 19-year-old subjects born very preterm (i.e., <32 weeks) and/or with a very low birth weight (i.e., <1500 g) from the Project On Preterm and Small-for-gestational-age infants (POPS) cohort. We included 468 subjects of the POPS cohort; of whom 123 had THoP. Thyroxine (T4) concentrations were obtained through the national neonatal screening program for congenital hypothyroidism. THoP was defined as a T4 concentration <-3 SD (approximately 60 nmol/L). At age 19, behavior was assessed using the Young Adult Self Report and the Young Adult Behavioral Checklist for parents. Results THoP was associated with a 1.8 (95% confidence interval (CI): 1.01–3.4) −fold increased odds of self-reported Internalizing behavior, as well as with a 1.9 (95% CI: 1.1–3.1) −fold increased odds of parent-reported Total problem behavior. These relations persisted after correction for demographic and perinatal variables. Similar associations were absent for the other self-reported and parent-reported syndrome and problem scales. Conclusions THoP was associated with more internalizing and total problem behavior at age 19. While our observations warrant more awareness of problem behavior in preterm infants, at present, it is unclear whether these associations are causal and screening for THoP does not seem necessary.

In 1983, data of a unique nationwide cohort of 1338 very preterm (< 32 weeks of gestation) or VLBW (birth weight < 1500 g) infants in the Netherlands was collected and followed at several ages until they reached the age of 19 years. At 19 years of age a more extensive follow-up study was done, including questionnaires, tests on a computer and a full physical exam. These studies provide insight into how Dutch adolescents at 19 years of age, who were born very preterm or with a very low birth weight (VLBW), reach adulthood. At 19 years, 705 POPS participants participated (74% of 959 still alive). Outcome measures at 19 years included: physical outcomes (e.g. blood pressure), cognition, behavior, quality of life, and impact of handicaps. The POPS participants showed more impairments on most outcome measures at various ages, compared to norm data. Major handicaps remained stable as the children grew older, but minor handicaps and disabilities increased. At 19 years of age, only half (47.1%) of the survivors had no disabilities and no minor or major handicaps. Especially those born small for gestational age (SGA) seem most vulnerable. These long-term results help to support preterm and SGA born children and adolescents in reaching independent adulthood, and stress the need for long term follow-up studies and to promote prevention of disabilities and of preterm birth itself.

Smoking is a highly addictive behaviour, often initiated during adolescence. It is suggested that smoking is associated with behavioural and emotional problems. This study aims to assess the impact of psychosocial problems on smoking initiation and vice versa. Method: We obtained data on self-reported psychosocial problems and smoking of adolescents at the age of 13 years and 2 years later. The baseline questionnaire was completed by 1789 students. 68% of the baseline questionnaire could be linked to a questionnaire of the second measurement. Results: 15% smoked at baseline and 29% two years later. Respectively 8% and 9% had a clinical Externalizing problem score or a clinical Internalizing problem score at baseline, 14% had these problems two years later. Externalizing problems at baseline predicted the onset of smoking two years later. Internalizing problems only predicted smoking among girls. This association between psychosocial problems and smoking is most obvious for the onset of regularly smoking and less for the onset of experimenting. Reversibly smoking at baseline is only associated with the onset of externalizing problems two years later. Conclusion: Clinical Externalizing and Internalizing problems make the initiation of regular smoking more likely. The effects on experimental smoking are less obvious. © 2006 Elsevier Ltd. All rights reserved.

Doel. Vergelijking van zwangerschappen en bevallingen tussen tieners en vrouwen van 20-29 jaar. Opzet. Observationeel. Plaats. Nederland. Methode. Met behulp van gegevens van de Landelijke Verloskunde Registratie (LVR) van 1989 werden 4500 tienerzwangerschappen bestudeerd. Onderzocht werd of zwangerschappen en bevallingen van tieners anders verlopen dan die van vrouwen van 20-29 jaar, alsmede of laag geboortegewicht, vroeggeboorte en groeivertraging meer of minder vaak voorkomen bij tieners in vergelijking met oudere vrouwen. Resultaten. Vrouwen van 13-19 jaar hadden een 1,5 maal grotere kans op vroeggeboorte dan vrouwen van 20-29 jaar (p < 0,0001), maar geen duidelijk vergroot risico voor groeivertraging. In de groep van 13-17 jarigen bestond een 4 maal vergroot risico voor intra-uterien overlijden van het kind en in de groep van 18-19 jarigen een 2 maal vergroot risico (p < 0,0001). Deze resultaten werden bij zowel allochtone als autochtone tieners gevonden. De bevalling bij tieners verliep vaker spontaan, sneller en met minder kunstgrepen dan bij vrouwen van 20-29 jaar (p < 0,001). Conclusie. Zelfs in Nederland, met het kleinste percentage tienerzwangerschappen in de westerse wereld en een prenatale zorg die in het algemeen als adequaat wordt beoordeeld, hebben zwangerschappen van tieners slechtere uitkomsten dan die van oudere vrouwen. Aangezien wij geen gegevens hadden over leefstijl, culturele achtergrond en socio-economische status is nader onderzoek naar de invloed van deze indicatoren op de uitkomsten van tienerzwangerschappen gewenst.

The aim of this study was to evaluate interrater and intermodality agreement in assessing health status using the Health Utilities Index. A random sample from a Dutch cohort of 14-year-old Very Low Birth Weight children and their parents were invited to participate in a face-to-face (n = 150) or telephone (n = 150) interview. All 300 participants were also sent a questionnaire by mail. Response rate was 68%. Interrater and intermodality agreement were high for the physical HUI3 attributes and poor for the psychological attributes. Children and parents reported more dysfunction in the psychological attributes when interviewed than when completing the mailed questionnaire. High agreement on the physical attributes may have resulted from the fact that hardly any dysfunction was reported in these attributes, and poor agreement in the psychological attributes may have been a result of the fact that in these attributes much more dysfunction was reported. In measuring children's health status using the HUI3, the results and their interpretation vary with the source of information and the modality of administration. For maximum comparability between studies, written self-report questionnaires seem the preferred option. Copyright © 2001 Elsevier Science Inc.

BACKGROUND. This study evaluated the effects of severe undernutrition during adolescence and subsequent colon carcinoma risk. METHODS. The authors evaluated The Netherlands Cohort Study on Diet and Cancer (NLCS) among 62,573 women and 58,279 men aged 55-69 years at baseline. Information on diet and risk factors was collected by questionnaire in 1986. Additional information was collected concerning residence during the hunger winter (1944-1945), the World War II years (1940-1944), and father's employment status during the economic depression of 1932-1940, which were used as indicators of exposure. After 7.3 years of follow-up, 807 colon carcinoma cases (388 females and 419 males) were available for analysis. RESULTS. Multivariate analysis showed that both men and women who had lived in a western city in 1944-1945 had a decreased colon carcinoma risk (men: relative risk [RR] = 0.85, 95% confidence interval [CI] = 0.62-1.16; women: RR = 0.80, 95%CI = 0.59-1.09). No association between colon carcinoma risk and urban versus rural residence was found during the war years (1940-1944). Having an unemployed father during the economic depression (1932-1940) was also associated with a small decrease in colon carcinoma risk for men (RR = 0.90, 95% CI =0.62-1.31) and women (RR = 0.75, 95%CI 0.49-1.14). In subgroup analyses, a decreased colon carcinoma risk for men and women who were in their adolescent growth spurt and living in a western city during the hunger winter of 1944-1945 was noted (men: RR = 0.72, 95% CI = 0.31-1.65; women: RR = 0.88, 95% CI = 0.40-1.96). No associations were statistically significant because of the limited study size. CONCLUSIONS. In the current study, a weak inverse relation was found between energy restriction early in life and subsequent colon carcinoma risk for men and women. However, these findings need replication in a larger study. © 2003 American Cancer Society.

Objective: The collagen network in human articular cartilage experiences a large number of stress cycles during life as it shows hardly any turnover after adolescence. We hypothesized that, to withstand fatigue failure, the physical condition of the collagen network laid down at adolescence is of crucial importance for the age of onset of osteoarthritis (OA). Methods: We have compared the lysyl hydroxylation level and pyridinoline cross-link level of the collagen network of degenerated (DG) cartilage of the femoral knee condyle (representing a preclinical early stage of OA) with that of normal cartilage from the contralateral knee. The biological age of the collagen network was determined by means of pentosidine levels. For each donor, collagen modifications of normal cartilage were compared with DG cartilage that showed no significant remodeling of the collagen network (as evidenced by identical pentosidine levels). Results: DG cartilage contained significantly more hydroxylysine residues per collagen molecule in comparison with healthy cartilage from the same donor, both in the upper and lower half (the region near the articular surface and adjacent to bone, respectively). In addition, a significantly higher level of pyridinoline cross-linking was observed in the upper half of DG cartilage. Considering the biological age of the collagen network, the changes observed in DG cartilage must have been present several decades before cartilage became degenerated. Conclusions: The data suggest that high levels of lysyl hydroxylation and pyridinoline cross-linking result in a collagen network that fails mechanically in long term loading. Areas containing collagen with low hydroxylysine and pyridinoline levels are less prone to degeneration. As such, this study indicates that post-translational modifications of collagen molecules synthesized during adolescence are causally involved in the pathogenesis of OA. © 2002 OsteoArthritis Research Society International. Chemicals/CAS: Amino Acids; Arginine, 74-79-3; Collagen, 9007-34-5; Cross-Linking Reagents; Hydroxylysine, 28902-93-4; Lysine, 56-87-1; pentosidine, 124505-87-9; pyridinoline, 63800-01-1

Bone mass and bone geometry are considered to have independent effects on bone strength. The purpose of this study was to obtain data on bone mass and geometry in young female populations and how they are influenced by body size and lifestyle factors. In a cross-sectional, observational study in six European countries, 1116 healthy Caucasian girls aged 11-15 and 526 women aged 20-23 participated. Their radius was scanned at the ultradistal site and at a site approximately 30% of the radius length from the distal end with dual energy X-ray absorptiometry (DXA). The following parameters were assessed from the scans: bone mineral content (BMC), bone mineral density (BMD), cortical wall thickness (CWT), middistal diameter (D), cortical index (CI = 2CWT/D), and the Breaking Bending Resistance Index (BBRI = (D4 - [D- CWT]4/D). Calcium intake was assessed by 3-day food records and physical activity by questionnaire. Body size parameters were measured by anthropometry. All parameters showed an increasing trend with pubertal stage and age, except for physical activity and calcium intake. BMC and BMD were relatively more dependent on body weight and age at menarche, whereas variation in D and the mechanical index BBRI was better explained by differences in height and grip strength. CI and CWT were relatively independent of variation in body size, whereas BMC and BBRI especially were explained for a substantial proportion (25-33% in the young adults) by body size parameters. Dietary intake of calcium and level of physical activity seem to contribute little to variation in bone parameters. Chemicals/CAS: Calcium, Dietary

The distribution of the four macronutrients is associated with energy intake and body fatness according to short-term interventions. The present study involves macronutrient distribution in relation to energy intake and body fatness over a period of 23 years in individuals who have ad libitum access to food. Eight follow-up measurements have been performed in 168 men and 182 women who participate in the Amsterdam Growth and Health Longitudinal Study. From the age of 13 years onwards, dietary intake, physical activity and the thickness of four skinfolds have been assessed. Body fatness was assessed using dual-energy X-ray absorptiometry at the age of 36 years. Generalised estimating equation regression analyses showed that energy percentages (En%) from protein and (in men) carbohydrates were inversely related to energy intake, while the En% from fat was positively related with energy intake. The men and women with high body fatness at the age of 36 years had a 1 En% higher protein intake, and the women with high body fatness had a 2 En% lower alcohol intake at the age of 32 and 36 years. The apparent inconsistent relationships between protein and energy intake and protein and body fatness can in women be explained by reverse causation and underreporting, as in women, low energy intake could not be explained by low physical activity. In conclusion, high intake of protein and (in men) carbohydrate, and low intake of fat are inversely related to total energy intake. High body fatness at the age of 36 years is related to a higher protein intake and, in women, to a lower alcohol intake. © The Author 2008.

Background: Cobalamin deficiency is prevalent in vegetarians and has been associated with increased risk of osteoporosis. Aim of the study: To examine the association between cobalamin status and bone mineral density in adolescents formerly fed a macrobiotic diet and in their counterparts. Methods: In this cross-sectional study bone mineral density (BMD) and bone mineral content (BMC) were determined by DEXA in 73 adolescents (9-15 y) who were fed a macrobiotic diet up to the age of 6 years followed by a lacto-(-ovo-) vegetarian or omnivorous diet. Data from 94 adolescents having consumed an omnivorous diet throughout their lives were used as controls. Serum concentrations of cobalamin, methylmalonic acid (MMA) and homocysteine were measured and calcium intake was assessed by questionnaire. Analysis of covariance (MANCOVA) was performed to calculate adjusted means for vitamin B12 and MMA for low and normal BMC and BMD groups. Results: Serum cobalamin concentrations were significantly lower (geometric mean (GM) 246 pmol/L vs. 469 pmol/L) and MMA concentrations were significantly higher (GM 0.27 μmol/L vs. 0.16 μmol/L) in the formerly macrobiotic-fed adolescents compared to their counterparts. In the total study population, after adjusting for height, weight, bone area, percent lean body mass, age, puberty and calcium intake, serum MMA was significantly higher in subjects with a low BMD (p = 0.0003) than in subjects with a normal BMD. Vitamin B12 was significantly lower in the group with low BMD (p = 0.0035) or BMC (p = 0.0038) than in the group with normal BMD or BMC. When analyses were restricted to the group of formerly macrobiotic-fed adolescents, MMA concentration remained higher in the low BMD group compared to the normal BMD group. Conclusions: In adolescents, signs of an impaired cobalamin status, as judged by elevated concentrations of methylmalonic acid, were associated with low BMD. This was especially true in adolescents fed a macrobiotic diet during the first years of life, where cobalamin deficiency was more prominent. © Steinkopff Verlag 2004.