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Background Young adults in Neither in Employment, Education nor Training (NEET) are at risk of adverse labour market outcomes. Earlier studies often measured NEET status at one time point or compared persistent NEETs with non-NEETs, neglecting other patterns of NEET status. Evidence on early life factors associated with NEET patterns is lacking. This study aims to (i) identify patterns of NEET status over time and (ii) examine whether factors in childhood and adolescence are associated with these patterns. Methods Data were used from 1499 participants of the TRacking Adolescents' Individual Lives Survey (TRAILS), a Dutch prospective cohort study with 15-year follow-up. NEET status was assessed at ages 19, 22 and 26. Socioeconomic status of parents (SES), intelligence and negative life events were measured at age 11, educational attainment at age 26 and mental health problems at ages 11, 13.5 and 16. Data were analyzed using multinomial logistic regression analysis. Results Four NEET patterns were identified: (i) non-NEETs (85.2%), (ii) early NEETs (4.5%), (iii) late NEETs (5.7%) and (iv) persistent NEETs (4.5%). Reporting internalizing problems at age 11 was a risk factor for early and late NEETs [odds ratio (OR) 2.77, 95% confidence interval (CI) 1.16–6.62; OR 5.00, 95% CI 2.22–11.3, respectively]. Low parental SES, lower intelligence scores and negative life events (≥3) were risk factors for persistent NEETs (OR 4.45, 95% CI 2.00–9.91; OR 0.96, 95% CI 0.94–0.98; OR 4.42, 95% CI 1.62–12.08, respectively). Conclusions The results highlight the importance of timing and duration of NEET status and emphasize the need for tailored interventions to prevent specific NEET patterns. [ABSTRACT FROM AUTHOR]

Background Parental education is one of the best predictors of child school achievement. Higher parental education is not only associated with higher child intelligence, but children from highly educated parents also perform better in school due to other family related factors. This study evaluates the relation between parental education, child non-verbal intelligence and parenting practices with child school achievement. Methods Longitudinal data from a large population-based, multi-ethnic cohort of children in the Netherlands (63% Dutch origin) followed from birth to age 13 years (3547 children; 52.3% girls) were analyzed. School achievement was measured at the end of primary school (12 years of age) with a national Dutch academic test score. Parental education was assessed at age 3 years. The non-verbal intelligence of the child was measured at age 6 years and a full intelligence was measured at age 13 years. Maternal and paternal family routines, harsh parenting and corporal punishment were assessed in early and mid-childhood. Mediation analysis was performed with the G-formula and Structural Equation Models. Results Child intelligence partially mediated [B indirect effect =0.54 95% CI (0.46, 0.62) P  < 0.001] the association between parental education and child school achievement. Independent of intelligence, family routines [B indirect effect =0.04 95% CI (0.01, 0.07) P  < 0.01], but not harsh parenting mediated this association. Conclusions Higher parental education was associated with better school achievement through two independent mechanisms, through higher intelligence of the child and parenting practices. [ABSTRACT FROM AUTHOR]

BACKGROUND: Prenatal exposures to phthalates and bisphenols are associated with impaired brain development in animals. However, epidemiological studies investigating the association between prenatal phthalate or bisphenol exposure and cognition have produced mixed findings and mostly had modest sample sizes and measured the exposure during the third trimester. OBJECTIVE: We examined the association between pregnancy maternal urinary biomarkers of phthalate or bisphenol exposure and nonverbal intelligence quotient (IQ) in children 6 years of age. METHOD: The study sample consisted of 1,282 mother-child pairs participating in the Generation R Study, a population-based birth cohort in Rotterdam, Netherlands (enrollment 2002-2006). We measured maternal urinary concentrations of 18 phthalate metabolites and 8 bisphenols at <18, 18-25, and >25 wks of gestation. Child nonverbal IQ was measured at 6 years of age using the Snijders-Oomen Nonverbal Intelligence Test-Revised. Linear regression models were fit for each of the three collection phases separately, the three collection phases jointly, and for the averaged prenatal exposure across pregnancy. RESULTS: Higher urinary concentrations of phthalate metabolites during early pregnancy were associated with lower child nonverbal IQ score [e.g., B per 10-fold increase in summed low-molecular weight phthalates = -1.7 (95% CI: -3.1, -0.3)]. This association remained unchanged when adjusted for mid and late pregnancy exposures. We also observed an inverse association between late pregnancy di-n-octyl phthalate (DNOP) exposure and nonverbal IQ. Maternal urinary concentrations of bisphenols were not associated with child nonverbal IQ. There was no effect estimate modification by sex. CONCLUSIONS: We did not observe that maternal biomarkers of bisphenol exposure are associated with nonverbal IQ. We found that phthalate exposure in early pregnancy and DNOP exposure in late pregnancy are associated with lower nonverbal IQ scores in children. Our results might suggest that particularly early pregnancy is a sensitive window of phthalate exposure, but future studies are needed to replicate our findings. [ABSTRACT FROM AUTHOR]

Aims Limited cross-sectional studies have indicated that young children have some knowledge of the type of situations in which adults usually consume alcohol. However, it is unclear when and how this knowledge develops over time. This study tests the hypothesis that between the ages of 4 and 8, children become more knowledgeable about common drinking situations (e.g. 'partying') and uncommon situations (e.g. 'driving'). Methods Data of two independent samples were used: a cross-sectional study (parents) and a three-wave longitudinal study (children). Parents and children were recruited via a convenience and random sampling strategy, respectively. To identify common, ambivalent, and uncommon drinking situations, parents (N  = 158; 47% men) completed an online survey in which they indicated how common it is that any adult would drink alcohol in the 18 situations of the Dutch electronic appropriate beverage (eABT). Children (N  = 329; 48.9% boys) completed the Dutch eABT to assess their knowledge of situations in which adults usually consume alcohol. Results General linear model repeated measures with post-hoc pairwise comparisons showed that parents' perceptions of common, ambivalent, and uncommon situations in which adults consume alcohol predicted the initial level and the change over time in children's knowledge of adults' alcohol use in these situations. Conclusions Children aged 4–8 become increasingly knowledgeable about drinking norms in specific situations which implies that they know in what kind of situation alcohol consumption is a common human behavior. This knowledge may put them at risk for early alcohol initiation and frequent drinking later in life. [ABSTRACT FROM AUTHOR]

Earlier studies report inconsistent associations between education and cognitive aging. We assessed the association, accounting for selective dropout due to death or dementia, and, in a subsample, accounting for confounding by early-life intelligence. Data from the Danish component of the Survey of Health, Ageing and Retirement in Europe (n = 3,400) were linked to registry data (education records, dementia diagnoses, and mortality) and the Danish Conscription Database (youth intelligence measurements for 854 men). Word recall and verbal fluency were assessed up to 4 times over 10 years (2004–2013) and combined by averaging the z scores. We fitted a joint model linking a time-to-event model for dementia or death to a linear mixed-effects model for cognitive change. Rate of cognitive decline was slower among people with high education compared with low education (β = 0.112, 95% confidence interval (CI): 0.056, 0.170). Adjusting for youth intelligence did not attenuate the association between education and cognitive decline (crude β = 0.136, 95% CI: 0.028, 0.244 vs. adjusted β = 0.145, 95% CI: 0.022, 0.269). The results suggest that higher education may slow cognitive decline in later life. In this sample, results changed little when accounting for selective attrition and confounding by intelligence. [ABSTRACT FROM AUTHOR]

Aim: Mucopolysaccharidosis type II (MPS II) is caused by variants in the iduronate-2-sulphatase gene (IDS). Patients can be either neuronopathic with intellectual disability, or non-neuronopathic. Few studies have reported on the IDS genotype-phenotype relationship and on the molecular effects involved. We addressed this in a cohort study of Dutch patients with MPS II.Method: Intellectual performance was assessed for school performance, behaviour, and intelligence. Urinary glycosaminoglycans were quantified by mass spectrometry. IDS variants were analysed in expression studies for enzymatic activity and processing by immunoblotting.Results: Six patients had a non-neuronopathic phenotype and 11 a neuronopathic phenotype, three of whom had epilepsy. Total deletion of IDS invariably resulted in the neuronopathic phenotype. Phenotypes of seven known IDS variants were consistent with the literature. Expression studies of nine variants were novel and showed impaired IDS enzymatic activity, aberrant intracellular processing, and elevated urinary excretion of heparan sulphate and dermatan sulphate irrespective of the MPS II phenotype.Interpretation: We speculate that very low or cell-type-specific IDS residual activity is sufficient to prevent the neuronal phenotype of MPS II. Whereas the molecular effects of IDS variants do not distinguish between MPS II phenotypes, the IDS genotype is a strong predictor. [ABSTRACT FROM AUTHOR]

Background: The goals of intentional curative pediatric epilepsy surgery are to achieve seizure-freedom and antiepileptic drug (AED) freedom. Retrospective cohort studies have indicated that early postoperative AED withdrawal unmasks incomplete surgical success and AED dependency sooner, but not at the cost of long-term seizure outcome. Moreover, AED withdrawal seemed to improve cognitive outcome. A randomized trial is needed to confirm these findings. We hypothesized that early AED withdrawal in children is not only safe, but also beneficial with respect to cognitive functioning.Design: This is a multi-center pragmatic randomized clinical trial to investigate whether early AED withdrawal improves cognitive function, in terms of attention, executive function and intelligence, quality of life and behavior, and to confirm safety in terms of eventual seizure freedom, seizure recurrences and "seizure and AED freedom." Patients will be randomly allocated in parallel groups (1:1) to either early or late AED withdrawal. Randomization will be concealed and stratified for preoperative IQ and medical center. In the early withdrawal arm reduction of AEDs will start 4 months after surgery, while in the late withdrawal arm reduction starts 12 months after surgery, with intended complete cessation of drugs after 12 and 20 months respectively. Cognitive outcome measurements will be performed preoperatively, and at 1 and 2 years following surgery, and consist of assessment of attention and executive functioning using the EpiTrack Junior test and intelligence expressed as IQ (Wechsler Intelligence Scales). Seizure outcomes will be assessed at 24 months after surgery, and at 20 months following start of AED reduction. We aim to randomize 180 patients who underwent anticipated curative epilepsy surgery below 16 years of age, were able to perform the EpiTrack Junior test preoperatively, and have no predictors of poor postoperative seizure prognosis (multifocal magnetic resonance imaging (MRI) abnormalities, incomplete resection of the lesion, epileptic postoperative electroencephalogram (EEG) abnormalities, or more than three AEDs at the time of surgery).Discussion: Growing experience with epilepsy surgery has changed the view towards postoperative medication policy. In a European collaboration, we designed a multi-center pragmatic randomized clinical trial comparing early with late AED withdrawal to investigate benefits and safety of early AED withdrawal. The TTS trial is supported by the Dutch Epilepsy Fund (NL 08-10) ISRCTN88423240/ 08/05/2013. [ABSTRACT FROM AUTHOR]

This study investigated the combined predictive validity of intelligence and personality factors on multiple measures of academic achievement. Students in a college of higher education in the Netherlands ( N = 137) completed a survey that measured intelligence, the Big Five personality traits, motivation, and four specific personality traits. Student performance was measured with grade point average (GPA) and time to graduation, as well as with five specific performance measures: regular exams, skills training, team projects, internships, and a written thesis. Results show that 33% of the variance in GPA and 30% of the variance in time to graduation can be explained by combining intelligence, personality, and motivational predictors. Conscientiousness is the best predictor across a broad spectrum of academic achievement measures and explains five times as much variance in GPA as does intelligence. The practical implications are that institutes of higher education should collect personality data on students at the outset and then help students accordingly. Highly conscientious students who are organized and internally motivated might potentially be offered more challenging honours programs with corresponding special commendations on their diplomas, whereas students who score low on conscientious would receive more structure through student study groups, frequent deadlines, shorter assignments, group assignments, clearly defined learning goals, and less second chances for passing examinations. [ABSTRACT FROM AUTHOR]

This 2006 study investigated ethnicity-related factors contributing to sub-standard maternity care and the effects on severe maternal morbidity among immigrant women in the Netherlands. In-depth interviews were carried out with 40 immigrant and 10 native Dutch women. The immigrant women reported that health care providers often paid insufficient attention to their pregnancy-related complaints, especially in cases of pre-eclampsia. They also reported delays in receiving information about diagnosis and treatment. Obstetricians who reviewed 20 of these cases judged sub-standard care to have played a role in the development of complications in 16 of them. The women themselves had problems identifying medically significant complications, presenting their complaints to health care providers effectively, and taking an active role as patients. Even highly educated migrant women showed low health literacy skills in their interaction with doctors. Patients' perspectives are valuable as one of the tools to evaluate the quality of maternity care. Communication by maternal health professionals can be improved through more sensitivity to social factors that affect immigrant women's health problems. Women with limited health literacy should be empowered through education about danger signs in pregnancy and information about preferences and policies in obstetrics in the Netherlands. They should also be invited to participate in medical decision-making. Cette étude de 2006 s'est penchée sur les facteurs liés à l'ethnicité qui contribuent à des soins obstétricaux inférieurs à la norme et les conséquences sur la morbidité maternelle sévère chez les immigrantes aux Pays-Bas. Des entretiens approfondis ont été menés avec 40 immigrantes et 10 Néerlandaises de souche. Les immigrantes ont indiqué que, souvent, les prestataires de soins de santé n'accordaient pas suffisamment d'attention à leurs problèmes liés à la grossesse, en particulier dans les cas de pré-éclampsie. Elles ont aussi parlé de retards pour recevoir l'information sur le diagnostic et le traitement. Les obstétriciens qui ont examiné 20 des cas ont jugé que les soins inférieurs avaient joué un rôle dans l'apparition de complications dans 16 d'entre eux. Les femmes elles-mêmes peinaient à identifier des complications médicalement significatives, à présenter efficacement leurs doléances aux prestataires de santé et à jouer un rôle actif comme patientes. Même des migrantes très instruites se montraient peu informées en matière de santé dans leurs interactions avec les médecins. La perspective des patientes est précieuse comme l'un des outils d'évaluation de la qualité des soins obstétricaux. Les professionnels de la santé maternelle peuvent améliorer leur communication en étant plus sensibles aux facteurs sociaux qui touchent les problèmes de santé des immigrantes. Les femmes peu au fait des questions de santé devraient apprendre à reconnaître les signes de danger pendant la grossesse et être informées des préférences et des politiques obstétricales aux Pays-Bas. Elles devraient aussi être invitées à participer aux décisions médicales. En este estudio realizado en 2006 se investigaron los factores relacionados con etnia que contribuyen a la atención obstétrica de calidad inferior y a los efectos en morbilidad materna grave entre mujeres inmigrantes en Holanda. Se realizaron entrevistas a profundidad con 40 mujeres inmigrantes y 10 holandesas. Las inmigrantes informaron que los profesionales de la salud a menudo prestaban insuficiente atención a sus quejas referentes al embarazo, especialmente en casos de preeclampsia. Además, hablaron de demoras en recibir información sobre el diagnóstico y el tratamiento. Los obstetras que revisaron 20 de estos casos determinaron que la atención de calidad inferior contribuyó al desarrollo de complicaciones en 16 de ellos. Las mujeres tuvieron problemas identificando complicaciones de significancia médica, presentando sus quejas eficazmente al personal de salud y asumiendo un rol activo como pacientes. Incluso las inmigrantes muy cultas demostraron un bajo nivel de comprensión sobre la salud en su interacción con los médicos. Las perspectivas de las pacientes son valiosas como una de las herramientas para evaluar la calidad de la atención obstétrica. La comunicación por parte de los profesionales obstétricos puede mejorarse mediante una mayor sensibilidad a los factores sociales que afectan los problemas de salud de las inmigrantes. Las mujeres con limitada comprensión de la salud deben ser empoderadas con educación sobre los signos de alarma en el embarazo y con información sobre las preferencias y políticas de obstetricia en Holanda. Además, se recomienda invitarlas a participar en la toma de decisiones médicas. [ABSTRACT FROM AUTHOR]

Variation in peripheral nerve conduction velocity (PNCV) and intelligence was studied in 18-year-old Dutch twins. It has been suggested that both brain nerve conduction velocity and PNCV are positively correlated with intelligence (Reed, 1984) and that heritable differences in nerve conduction velocity may explain part of the well-established heritability of intelligence. The relationship among IQ, obtained with the Wechsler Adult Intelligence Scale, and median nerve PNCV was examined in 159 twin pairs. Genetic analyses showed a heritability of 81% for IQ and 66% for onset PNCV. The small but significant phenotypic correlation between IQ and onset PNCV (.15) was entirely mediated by common genetic factors. Analyses of difference scores for PNCV of this study and PNCV from the same subjects collected at age 16 suggest that there might still be development in PNCV in this age interval. This maturation is highly controlled by genetic factors. It is suggested that variation in IQ that is associated with nerve conduction velocity becomes apparent only after the developmental processes in peripheral nerves are completed. This is in line with the suggestion of increasing heritability of IQ in adulthood. [ABSTRACT FROM AUTHOR]

Objective: To evaluate at the age of 5 years the behavioral, cognitive, and motor performance and physical development of children born after testicular sperm extraction (TESE) and intracytoplasmic sperm injection (ICSI).Design: A prospective longitudinal cohort study.Setting: Two university medical centers.Patient(s): A total of 103 5-year-olds who were born after TESE-ICSI.Intervention(s): The follow-up of the children was performed by questionnaires at birth and again at 1 year and at 4 years of age. Five-year-old children were invited for individual assessment. Behavioral performance was assessed with the use of the Child Behavior Checklist for parents and teachers. Cognitive performance was assessed with the use of the Dutch Wechsler Preschool and Primary Scale of Intelligence test, 3rd version. Motor performance was assessed with the use of the Dutch Movement Assessment Battery for Children, 2nd version. Physical development was assessed by means of physical examination and medical history.Main Outcome Measure(s): Behavioral, cognitive, and motor performance and physical development.Result(s): Eighty-nine children were completely assessed, and 14 were partially assessed at the age of 5 years. The 5-year-old cohort assessed significantly better on behavioral and cognitive performance and significantly worse on motor performance-but still in the normal range-compared with the theoretic distribution in the general population. Four children (3.8%) of the 5-year-old cohort had developmental problems/delays. Two of them were previously diagnosed with a form of autism (pervasive developmental disorder-not otherwise specified). Two children had developmental problems based on our behavioral, cognitive, and/or motor assessments.Conclusion(s): The long-term effects on development and health in children born after TESE-ICSI procedures seem to be reassuring. [ABSTRACT FROM AUTHOR]