Comparisons between a group of deaf children and normal-hearing controls on an extensive test-bat... more Comparisons between a group of deaf children and normal-hearing controls on an extensive test-battery revealed that the former group was clearly inferior both in general dynamic coordination and visual-motor coordination. An experimental study, focusing on speed of motor performance, confirmed the general impression that deaf children are relatively slow performers. In particular, the execution of movements is slower in deaf children: the processes involved in this difference require further experimental research.
Pediatrics (Ed esp). 2008;65(1):5-10 5 OBJETIVOS: La detección por cribado de los pacientes con e... more Pediatrics (Ed esp). 2008;65(1):5-10 5 OBJETIVOS: La detección por cribado de los pacientes con escoliosis idiopática se realiza en una fase más precoz del curso clínico, en comparación con los casos detectados de otro modo. Debido a la falta de ensayos controlados de distribución aleatoria, no ha quedado suficientemente demostrada la eficacia del cribado para la escoliosis, con el tratamiento precoz consiguiente mediante un corsé, para reducir la necesidad de la cirugía. El objetivo del estudio consistió en poner a prueba la hipótesis de que el cribado para la escoliosis es eficaz para reducir la necesidad del tratamiento quirúrgico.
Children of asylum seekers are at risk for psychosocial problems because of their flight history ... more Children of asylum seekers are at risk for psychosocial problems because of their flight history and exceptional living circumstances. This study aims to assess the association of sociodemographic factors and asylum procedural factors with psychosocial problems of asylum seekers' children, and differences herein by informant (parents, teachers, and children). To this end, we obtained data on psychosocial problems among a random sample of 267 children aged 4 to 16, living in Dutch asylum seekers' centers, using the multi-informant Strength and Difficulties Questionnaire. The results show that the prevalence rate of psychosocial problems among asylum seekers' children was high. The occurrence was not associated with asylum-procedural variables but only with child-contextual factors such as mental health of the mother and leaving behind a parent in the country of origin. The associations varied in strength by informant. Therefore, preventive and supportive measures to improve psychosocial health of young asylumseekers should concentrate on these contextual issues. c Angola (n ϭ 42), Congo (n ϭ 6), Rwanda (n ϭ 3), Sudan (n ϭ 13), Togo (n ϭ 1). SD indicates standard deviation; p-SDQ, parent-version of the strength and difficulties questionnaire; t-SDQ, teacher-version of the strength and difficulties questionnaire; s-SDQ, self-report version of the strength and difficulties questionnaire.
Objective: While adolescents use various types of care for behavioral and emotional problems, evi... more Objective: While adolescents use various types of care for behavioral and emotional problems, evidence on age trends and determinants per type is scarce. We aimed to assess use of care by adolescents because of behavioral and emotional problems, overall and by type, and its determinants, for ages 10-19 years.
The objective of this study was to examine the effect of freely accessible consultation hours in ... more The objective of this study was to examine the effect of freely accessible consultation hours in secondary schools by youth health care departments, on population rates for suicide and parasuicide. To this end, an ecologic case-referent study design was used, with data from the Netherlands Bureau of Statistics, the National Hospital Discharge Register, the High-School Students Study, the youth health care departments in the Netherlands and relevant census. Cases were 137 suicide victims aged 15-19 y and 182 12-18 y old subjects admitted to hospital because of parasuicide and additionally coded as having had surgery as a consequence of the attempted suicide or having a pertinent psychiatric disorder. The relevant census in the regions of the participating youth health care departments served as referents. The High-School Students Study included 4997 students aged 12-18 y of which 303 reported having attempted suicide at least once. In the ecologic case-referent studies the adjusted Odds Ratio for completed suicide in regions with open consultation hours was 0.98 (95% CI 0.69-1.38) and the weighted Odds Ratio for parasuicide was 1.30 (95% CI 0.97-1.75). Analysis of the data of the High-School Students Study resulted in an Odds Ratio of 0.96 (95% CI 0.72-1.26). The overall homogeneous Odds Ratio for (para)suicide in regions with open consultation hours for all three studies was 1.00 (95% CI 0.97-1.04); the heterogeneous Odds Ratio was 1.08 (95% CI 0.95 1.09). This study does not support the hypothesis that regions, where youth health care departments have instituted freely accessible consultation hours in secondary schools, show lower rates of suicide or parasuicide compared to regions where no consultation hours were implemented.
Background In this study the effect is assessed of (repeated) well-care visits and freely accessi... more Background In this study the effect is assessed of (repeated) well-care visits and freely accessible consultation hours at secondary schools on the prevalence of adolescent healthcompromising behaviour and later obesity.
Journal of Pediatric Gastroenterology and Nutrition, 2007
To investigate, in asylum seekers' children in th... more To investigate, in asylum seekers' children in the Netherlands, biochemical iron status and the prevalence of iron deficiency (ID) and anemia in relation to age, region of origin, length of stay in the Netherlands, body mass index (BMI), and dietary iron intake. Hemoglobin (Hb) and plasma ferritin concentrations were determined in 122 asylum seekers' children (median age, 7.1 years; range, 2-12 y). ID was defined by plasma ferritin levels <15 microg/L. Anemia was defined by Hb levels <6.8 mmol/L (11 g/dL) for children <6 years of age and Hb levels <7.1 mmol/L (11.5 g/dL) for children between 6 and 12 years of age. Nutritional status of the children was assessed by BMI and dietary intake of iron was estimated by 24-hour recall. Twenty percent of the children had compromised iron status (16% with ID, 4% with ID anemia [IDA]). Another 6% of the children had anemia caused by thalassemia. ID was significantly more prevalent in children <6 years of age and in children of African origin. The iron status was not significantly correlated with the length of stay in the Netherlands (r = 0.6; P = 0.48). Higher BMI z scores were positively correlated with iron status. Adequate or marginal dietary iron intake was not significantly related to the presence of ID (r = 0.02; P = 0.9) or anemia (IDA and thalassemia; r = 0.15; P = 0.9). Iron deficiency is highly prevalent among the children of asylum seekers in the Netherlands. Our data indicate that systematic biochemical screening for ID is warranted in asylum seekers' children.
Children of asylum seekers are at risk for psychosocial problems because of their flight history ... more Children of asylum seekers are at risk for psychosocial problems because of their flight history and exceptional living circumstances. This study aims to assess the association of sociodemographic factors and asylum procedural factors with psychosocial problems of asylum seekers' children, and differences herein by informant (parents, teachers, and children). To this end, we obtained data on psychosocial problems among a random sample of 267 children aged 4 to 16, living in Dutch asylum seekers' centers, using the multi-informant Strength and Difficulties Questionnaire. The results show that the prevalence rate of psychosocial problems among asylum seekers' children was high. The occurrence was not associated with asylum-procedural variables but only with child-contextual factors such as mental health of the mother and leaving behind a parent in the country of origin. The associations varied in strength by informant. Therefore, preventive and supportive measures to improve psychosocial health of young asylumseekers should concentrate on these contextual issues. c Angola (n ϭ 42), Congo (n ϭ 6), Rwanda (n ϭ 3), Sudan (n ϭ 13), Togo (n ϭ 1). SD indicates standard deviation; p-SDQ, parent-version of the strength and difficulties questionnaire; t-SDQ, teacher-version of the strength and difficulties questionnaire; s-SDQ, self-report version of the strength and difficulties questionnaire.
Background Patients with type 2 diabetes have an increased risk of developing microvascular and m... more Background Patients with type 2 diabetes have an increased risk of developing microvascular and macrovascular complications. In routine diabetes care an adequate reduction of risk factors for these complications is often not achieved. Objective The aim of the study was to evaluate the effects of structured diabetes care on clinical outcomes of patients with type 2 diabetes in primary care. Methods We performed a quasi-experimental study on the effects of structured care consisting of organizational and educational components (n = 581) compared with careas-usual (n = 152). We assessed clinical outcomes of HbA1c, blood pressure, cholesterol, creatinine and body mass index, at baseline and after 1 year. The long-term effects in the structured care group were determined after another 2 years. Results Structured care led to improvement in HbA1c and long-term improvements in blood pressure and cholesterol compared with care-as-usual. After 1 year, the percentage of patients who did not deteriorate was higher in the structured care group, again for HbA1c, diastolic blood pressure, low-density lipoprotein cholesterol and body mass index. Conclusions Structured diabetes care consisting of multiple components has a positive effect on clinical outcomes compared with care-as-usual. Our findings support its further implementation in order to reduce complications in type 2 diabetes patients.
We compared the following parameters: glycosylated haemoglobin (HbA1c), blood pressure and lipid ... more We compared the following parameters: glycosylated haemoglobin (HbA1c), blood pressure and lipid values. These clinical outcomes are important for the management of diabetes [7-9]. A difference was considered statistically significant if P < 0.05.
Growth assessment can be used to monitor health at individual and population level. For asylum se... more Growth assessment can be used to monitor health at individual and population level. For asylum seekers&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; children with different geographic backgrounds, growth reference values are frequently not available. We assessed nutritional condition and growth of asylum seekers&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; children upon arrival and follow-up in The Netherlands, using national growth charts, and related these parameters to geographic origin. Height and weight of 135 children originating from Africa (n=47), Central Asia (n=41), and Eastern Europe (n=47), were assessed longitudinally (median follow-up 3 years, range 1-8 years). Body-mass-index (BMI) was calculated, and overweight and obesity were defined according the international BMI cut-off values for age and gender. Upon arrival at a median age of 4.5 years (range 0-11.5 years), 13% of the children were small for age (below -2 SD of the Dutch height for age reference), which decreased to 5% during follow-up (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05). During follow-up, 90% of the height measurements in boys and 85% in girls were within the normal range (+/-2 SD) of the Dutch references. The proportion of children with overweight including obesity increased from 15% at arrival to 21% during follow-up (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05). Irrespective of age, children originating from Africa were taller than children from Central Asia or Eastern Europe at follow up (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05). Overweight and obesity was most prominent among children of Eastern Europe. Dutch national reference values allow monitoring growth and the development of overweight or obesity in asylum seekers&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; children in The Netherlands. Prevention strategies to reduce the development of overweight and obesity among these children seem warranted.
The objective of the study was to examine the effect of screening programmes for adolescent idiop... more The objective of the study was to examine the effect of screening programmes for adolescent idiopathic scoliosis on population rates for adolescent idiopathic scoliosis surgery. A case-control study with data from The National Hospital Discharge Register, youth health care (YHC) departments in The Netherlands and a relevant census was used. The cases were 182 subjects aged 12-19 years, admitted to hospital in The Netherlands for surgical treatment of adolescent idiopathic scoliosis between 1990 and 1993. The total population of 12 or 13 year olds in the consecutive years of 1987-1992 in the regions of the participating YHC departments served as controls. Of the 182 patients that had surgery for adolescent idiopathic scoliosis in The Netherlands in the years [1990][1991][1992][1993]37.9% had at one time had a screening for spinal deformities at the age of 12 or 13 years as compared to 37.9% of the control subjects. The odds ratio for cases that had surgery was 1.00 (95% confidence interval: 0.74-1.35). This study does not support the view that screening for adolescent idiopathic scoliosis reduces the population rates for scoliosis surgery. As the primary aim of screening for adolescent idiopathic scoliosis is to prevent surgical intervention, this practice should be reconsidered.
Low dietary intake and limited sun exposure during Dutch winters, in particular when combined wit... more Low dietary intake and limited sun exposure during Dutch winters, in particular when combined with highly pigmented skin could compromise the vitamin D status of asylum seekers' children in The Netherlands. We determined the vitamin D status of children in The Netherlands, but originating from Africa, Central Asia, or Eastern Europe. In a subgroup, we reassessed the vitamin D status after the summer, during which the children had been assigned at random to remain unsupplemented or to receive vitamin D supplementation. In total 112 children (median age 7.1 year, range 2-12) were assessed for serum concentrations of 25-Hydroxyvitamin D [25(OH)D], intact parathyroid hormone (I-PTH) and plasma alkaline phosphatase (ALP). Vitamin D deficiency (VDD) and hypovitaminosis D were defined as 25(OH)D below 30 or 50 nmol/L, respectively. Dietary intake of vitamin D and calcium was estimated using a 24h recall interview. In mid-spring, 13% of the children had VDD, and 42% had hypovitaminosis D. I-PTH and ALP levels were significantly higher in children with VDD. The dietary intake of vitamin D was below 80% of the recommended daily allowances (RDA) in 94% of the children, but the dietary calcium intake was not significant related to the s-25(OH)D levels found. After the summer median 25(OH)D increased with +35 nmol/L (+85%) and + 19 nmol/L (+42%) in children with or without supplementation, respectively. The effect of supplementation was most prominent among African children. VDD and hypovitaminosis D are highly prevalent in mid-spring among asylum seekers' children in The Netherlands. Although 25(OH)D levels increase in African children during Dutch summer months, this does not completely correct the compromised vitamin D status. Our data indicate that children from African origin would benefit from vitamin D supplementation.
To monitor the dietary intake of energy, macro- and micronutrients in asylum seeker children. Cro... more To monitor the dietary intake of energy, macro- and micronutrients in asylum seeker children. Cross-sectional study in three asylum seeker centres in The Netherlands. Hundred and sixteen children 2-12 years old (86% of the study cohort) provided a dietary history. The dietary intake was estimated by 24 h recall, and the origin of the children was classified in three geographic regions: African (n=45), Central Asia (n=34) or Eastern Europe (n=37). The total energy intake from fat was in 24% of the children above 40En%. Seventy per cent of the children above 4 year of age had a saturated fat intake above 10En%. The children from Eastern Europe had a higher intake of fat and disaccharides than the children from the other regions. Among the children, an intake less than 80% of the recommended daily allowances of micronutrients was found for calcium (42%), iron (49%), vitamin A (45%) and vitamin D (80%). An inadequate dietary intake of iron and vitamin D was significantly more seen among the youngest children, whereas an inadequate intake of calcium and vitamin A was found more among the elder children. The dietary intake of a prominent proportion of these children contains too much fat and insufficient amounts of calcium, iron, vitamin A and vitamin D. The low micronutrient intake of the asylum seeker children can be considered as a nutritional risk. Nutritional education and strategies to improve the macro- and micronutrient intake of asylum seeker children is indicated.
Congenital colour vision defects (CVD) are common, inherited (most commonly X linked), non-progre... more Congenital colour vision defects (CVD) are common, inherited (most commonly X linked), non-progressive, and untreatable disorders. 1 2 Screening children for these disorders is established practice in the United Kingdom, primarily so that those affected can be advised about occupational preclusions. 2 Population based work on the broader impact of colour vision defects is, however, limited.
Death rates from illnesses that rely heavily on first access servicesfor example, meningococcal ... more Death rates from illnesses that rely heavily on first access servicesfor example, meningococcal disease, pneumonia, and asthma, are higher in the UK than in Sweden, France, Italy, Germany, and the Netherlands (table1⇓).8 Survival rates are lower in the UK for some ...
Comparisons between a group of deaf children and normal-hearing controls on an extensive test-bat... more Comparisons between a group of deaf children and normal-hearing controls on an extensive test-battery revealed that the former group was clearly inferior both in general dynamic coordination and visual-motor coordination. An experimental study, focusing on speed of motor performance, confirmed the general impression that deaf children are relatively slow performers. In particular, the execution of movements is slower in deaf children: the processes involved in this difference require further experimental research.
Pediatrics (Ed esp). 2008;65(1):5-10 5 OBJETIVOS: La detección por cribado de los pacientes con e... more Pediatrics (Ed esp). 2008;65(1):5-10 5 OBJETIVOS: La detección por cribado de los pacientes con escoliosis idiopática se realiza en una fase más precoz del curso clínico, en comparación con los casos detectados de otro modo. Debido a la falta de ensayos controlados de distribución aleatoria, no ha quedado suficientemente demostrada la eficacia del cribado para la escoliosis, con el tratamiento precoz consiguiente mediante un corsé, para reducir la necesidad de la cirugía. El objetivo del estudio consistió en poner a prueba la hipótesis de que el cribado para la escoliosis es eficaz para reducir la necesidad del tratamiento quirúrgico.
Children of asylum seekers are at risk for psychosocial problems because of their flight history ... more Children of asylum seekers are at risk for psychosocial problems because of their flight history and exceptional living circumstances. This study aims to assess the association of sociodemographic factors and asylum procedural factors with psychosocial problems of asylum seekers' children, and differences herein by informant (parents, teachers, and children). To this end, we obtained data on psychosocial problems among a random sample of 267 children aged 4 to 16, living in Dutch asylum seekers' centers, using the multi-informant Strength and Difficulties Questionnaire. The results show that the prevalence rate of psychosocial problems among asylum seekers' children was high. The occurrence was not associated with asylum-procedural variables but only with child-contextual factors such as mental health of the mother and leaving behind a parent in the country of origin. The associations varied in strength by informant. Therefore, preventive and supportive measures to improve psychosocial health of young asylumseekers should concentrate on these contextual issues. c Angola (n ϭ 42), Congo (n ϭ 6), Rwanda (n ϭ 3), Sudan (n ϭ 13), Togo (n ϭ 1). SD indicates standard deviation; p-SDQ, parent-version of the strength and difficulties questionnaire; t-SDQ, teacher-version of the strength and difficulties questionnaire; s-SDQ, self-report version of the strength and difficulties questionnaire.
Objective: While adolescents use various types of care for behavioral and emotional problems, evi... more Objective: While adolescents use various types of care for behavioral and emotional problems, evidence on age trends and determinants per type is scarce. We aimed to assess use of care by adolescents because of behavioral and emotional problems, overall and by type, and its determinants, for ages 10-19 years.
The objective of this study was to examine the effect of freely accessible consultation hours in ... more The objective of this study was to examine the effect of freely accessible consultation hours in secondary schools by youth health care departments, on population rates for suicide and parasuicide. To this end, an ecologic case-referent study design was used, with data from the Netherlands Bureau of Statistics, the National Hospital Discharge Register, the High-School Students Study, the youth health care departments in the Netherlands and relevant census. Cases were 137 suicide victims aged 15-19 y and 182 12-18 y old subjects admitted to hospital because of parasuicide and additionally coded as having had surgery as a consequence of the attempted suicide or having a pertinent psychiatric disorder. The relevant census in the regions of the participating youth health care departments served as referents. The High-School Students Study included 4997 students aged 12-18 y of which 303 reported having attempted suicide at least once. In the ecologic case-referent studies the adjusted Odds Ratio for completed suicide in regions with open consultation hours was 0.98 (95% CI 0.69-1.38) and the weighted Odds Ratio for parasuicide was 1.30 (95% CI 0.97-1.75). Analysis of the data of the High-School Students Study resulted in an Odds Ratio of 0.96 (95% CI 0.72-1.26). The overall homogeneous Odds Ratio for (para)suicide in regions with open consultation hours for all three studies was 1.00 (95% CI 0.97-1.04); the heterogeneous Odds Ratio was 1.08 (95% CI 0.95 1.09). This study does not support the hypothesis that regions, where youth health care departments have instituted freely accessible consultation hours in secondary schools, show lower rates of suicide or parasuicide compared to regions where no consultation hours were implemented.
Background In this study the effect is assessed of (repeated) well-care visits and freely accessi... more Background In this study the effect is assessed of (repeated) well-care visits and freely accessible consultation hours at secondary schools on the prevalence of adolescent healthcompromising behaviour and later obesity.
Journal of Pediatric Gastroenterology and Nutrition, 2007
To investigate, in asylum seekers&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; children in th... more To investigate, in asylum seekers&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; children in the Netherlands, biochemical iron status and the prevalence of iron deficiency (ID) and anemia in relation to age, region of origin, length of stay in the Netherlands, body mass index (BMI), and dietary iron intake. Hemoglobin (Hb) and plasma ferritin concentrations were determined in 122 asylum seekers&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; children (median age, 7.1 years; range, 2-12 y). ID was defined by plasma ferritin levels &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;15 microg/L. Anemia was defined by Hb levels &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;6.8 mmol/L (11 g/dL) for children &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;6 years of age and Hb levels &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;7.1 mmol/L (11.5 g/dL) for children between 6 and 12 years of age. Nutritional status of the children was assessed by BMI and dietary intake of iron was estimated by 24-hour recall. Twenty percent of the children had compromised iron status (16% with ID, 4% with ID anemia [IDA]). Another 6% of the children had anemia caused by thalassemia. ID was significantly more prevalent in children &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;6 years of age and in children of African origin. The iron status was not significantly correlated with the length of stay in the Netherlands (r = 0.6; P = 0.48). Higher BMI z scores were positively correlated with iron status. Adequate or marginal dietary iron intake was not significantly related to the presence of ID (r = 0.02; P = 0.9) or anemia (IDA and thalassemia; r = 0.15; P = 0.9). Iron deficiency is highly prevalent among the children of asylum seekers in the Netherlands. Our data indicate that systematic biochemical screening for ID is warranted in asylum seekers&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; children.
Children of asylum seekers are at risk for psychosocial problems because of their flight history ... more Children of asylum seekers are at risk for psychosocial problems because of their flight history and exceptional living circumstances. This study aims to assess the association of sociodemographic factors and asylum procedural factors with psychosocial problems of asylum seekers' children, and differences herein by informant (parents, teachers, and children). To this end, we obtained data on psychosocial problems among a random sample of 267 children aged 4 to 16, living in Dutch asylum seekers' centers, using the multi-informant Strength and Difficulties Questionnaire. The results show that the prevalence rate of psychosocial problems among asylum seekers' children was high. The occurrence was not associated with asylum-procedural variables but only with child-contextual factors such as mental health of the mother and leaving behind a parent in the country of origin. The associations varied in strength by informant. Therefore, preventive and supportive measures to improve psychosocial health of young asylumseekers should concentrate on these contextual issues. c Angola (n ϭ 42), Congo (n ϭ 6), Rwanda (n ϭ 3), Sudan (n ϭ 13), Togo (n ϭ 1). SD indicates standard deviation; p-SDQ, parent-version of the strength and difficulties questionnaire; t-SDQ, teacher-version of the strength and difficulties questionnaire; s-SDQ, self-report version of the strength and difficulties questionnaire.
Background Patients with type 2 diabetes have an increased risk of developing microvascular and m... more Background Patients with type 2 diabetes have an increased risk of developing microvascular and macrovascular complications. In routine diabetes care an adequate reduction of risk factors for these complications is often not achieved. Objective The aim of the study was to evaluate the effects of structured diabetes care on clinical outcomes of patients with type 2 diabetes in primary care. Methods We performed a quasi-experimental study on the effects of structured care consisting of organizational and educational components (n = 581) compared with careas-usual (n = 152). We assessed clinical outcomes of HbA1c, blood pressure, cholesterol, creatinine and body mass index, at baseline and after 1 year. The long-term effects in the structured care group were determined after another 2 years. Results Structured care led to improvement in HbA1c and long-term improvements in blood pressure and cholesterol compared with care-as-usual. After 1 year, the percentage of patients who did not deteriorate was higher in the structured care group, again for HbA1c, diastolic blood pressure, low-density lipoprotein cholesterol and body mass index. Conclusions Structured diabetes care consisting of multiple components has a positive effect on clinical outcomes compared with care-as-usual. Our findings support its further implementation in order to reduce complications in type 2 diabetes patients.
We compared the following parameters: glycosylated haemoglobin (HbA1c), blood pressure and lipid ... more We compared the following parameters: glycosylated haemoglobin (HbA1c), blood pressure and lipid values. These clinical outcomes are important for the management of diabetes [7-9]. A difference was considered statistically significant if P < 0.05.
Growth assessment can be used to monitor health at individual and population level. For asylum se... more Growth assessment can be used to monitor health at individual and population level. For asylum seekers&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; children with different geographic backgrounds, growth reference values are frequently not available. We assessed nutritional condition and growth of asylum seekers&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; children upon arrival and follow-up in The Netherlands, using national growth charts, and related these parameters to geographic origin. Height and weight of 135 children originating from Africa (n=47), Central Asia (n=41), and Eastern Europe (n=47), were assessed longitudinally (median follow-up 3 years, range 1-8 years). Body-mass-index (BMI) was calculated, and overweight and obesity were defined according the international BMI cut-off values for age and gender. Upon arrival at a median age of 4.5 years (range 0-11.5 years), 13% of the children were small for age (below -2 SD of the Dutch height for age reference), which decreased to 5% during follow-up (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05). During follow-up, 90% of the height measurements in boys and 85% in girls were within the normal range (+/-2 SD) of the Dutch references. The proportion of children with overweight including obesity increased from 15% at arrival to 21% during follow-up (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05). Irrespective of age, children originating from Africa were taller than children from Central Asia or Eastern Europe at follow up (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05). Overweight and obesity was most prominent among children of Eastern Europe. Dutch national reference values allow monitoring growth and the development of overweight or obesity in asylum seekers&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; children in The Netherlands. Prevention strategies to reduce the development of overweight and obesity among these children seem warranted.
The objective of the study was to examine the effect of screening programmes for adolescent idiop... more The objective of the study was to examine the effect of screening programmes for adolescent idiopathic scoliosis on population rates for adolescent idiopathic scoliosis surgery. A case-control study with data from The National Hospital Discharge Register, youth health care (YHC) departments in The Netherlands and a relevant census was used. The cases were 182 subjects aged 12-19 years, admitted to hospital in The Netherlands for surgical treatment of adolescent idiopathic scoliosis between 1990 and 1993. The total population of 12 or 13 year olds in the consecutive years of 1987-1992 in the regions of the participating YHC departments served as controls. Of the 182 patients that had surgery for adolescent idiopathic scoliosis in The Netherlands in the years [1990][1991][1992][1993]37.9% had at one time had a screening for spinal deformities at the age of 12 or 13 years as compared to 37.9% of the control subjects. The odds ratio for cases that had surgery was 1.00 (95% confidence interval: 0.74-1.35). This study does not support the view that screening for adolescent idiopathic scoliosis reduces the population rates for scoliosis surgery. As the primary aim of screening for adolescent idiopathic scoliosis is to prevent surgical intervention, this practice should be reconsidered.
Low dietary intake and limited sun exposure during Dutch winters, in particular when combined wit... more Low dietary intake and limited sun exposure during Dutch winters, in particular when combined with highly pigmented skin could compromise the vitamin D status of asylum seekers' children in The Netherlands. We determined the vitamin D status of children in The Netherlands, but originating from Africa, Central Asia, or Eastern Europe. In a subgroup, we reassessed the vitamin D status after the summer, during which the children had been assigned at random to remain unsupplemented or to receive vitamin D supplementation. In total 112 children (median age 7.1 year, range 2-12) were assessed for serum concentrations of 25-Hydroxyvitamin D [25(OH)D], intact parathyroid hormone (I-PTH) and plasma alkaline phosphatase (ALP). Vitamin D deficiency (VDD) and hypovitaminosis D were defined as 25(OH)D below 30 or 50 nmol/L, respectively. Dietary intake of vitamin D and calcium was estimated using a 24h recall interview. In mid-spring, 13% of the children had VDD, and 42% had hypovitaminosis D. I-PTH and ALP levels were significantly higher in children with VDD. The dietary intake of vitamin D was below 80% of the recommended daily allowances (RDA) in 94% of the children, but the dietary calcium intake was not significant related to the s-25(OH)D levels found. After the summer median 25(OH)D increased with +35 nmol/L (+85%) and + 19 nmol/L (+42%) in children with or without supplementation, respectively. The effect of supplementation was most prominent among African children. VDD and hypovitaminosis D are highly prevalent in mid-spring among asylum seekers' children in The Netherlands. Although 25(OH)D levels increase in African children during Dutch summer months, this does not completely correct the compromised vitamin D status. Our data indicate that children from African origin would benefit from vitamin D supplementation.
To monitor the dietary intake of energy, macro- and micronutrients in asylum seeker children. Cro... more To monitor the dietary intake of energy, macro- and micronutrients in asylum seeker children. Cross-sectional study in three asylum seeker centres in The Netherlands. Hundred and sixteen children 2-12 years old (86% of the study cohort) provided a dietary history. The dietary intake was estimated by 24 h recall, and the origin of the children was classified in three geographic regions: African (n=45), Central Asia (n=34) or Eastern Europe (n=37). The total energy intake from fat was in 24% of the children above 40En%. Seventy per cent of the children above 4 year of age had a saturated fat intake above 10En%. The children from Eastern Europe had a higher intake of fat and disaccharides than the children from the other regions. Among the children, an intake less than 80% of the recommended daily allowances of micronutrients was found for calcium (42%), iron (49%), vitamin A (45%) and vitamin D (80%). An inadequate dietary intake of iron and vitamin D was significantly more seen among the youngest children, whereas an inadequate intake of calcium and vitamin A was found more among the elder children. The dietary intake of a prominent proportion of these children contains too much fat and insufficient amounts of calcium, iron, vitamin A and vitamin D. The low micronutrient intake of the asylum seeker children can be considered as a nutritional risk. Nutritional education and strategies to improve the macro- and micronutrient intake of asylum seeker children is indicated.
Congenital colour vision defects (CVD) are common, inherited (most commonly X linked), non-progre... more Congenital colour vision defects (CVD) are common, inherited (most commonly X linked), non-progressive, and untreatable disorders. 1 2 Screening children for these disorders is established practice in the United Kingdom, primarily so that those affected can be advised about occupational preclusions. 2 Population based work on the broader impact of colour vision defects is, however, limited.
Death rates from illnesses that rely heavily on first access servicesfor example, meningococcal ... more Death rates from illnesses that rely heavily on first access servicesfor example, meningococcal disease, pneumonia, and asthma, are higher in the UK than in Sweden, France, Italy, Germany, and the Netherlands (table1⇓).8 Survival rates are lower in the UK for some ...
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Papers by P. Wiegersma