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The study aims at developing and validating a brief, easy-to-use screening instrument for teachers to predict externalizing disorders in children and recommending them for timely referral. The scores are compared between Dutch and non-Dutch immigrant children and a significant amount of cases for externalizing disorders were identified but sex and ethnicity did not contribute to this prediction.

The present study assesses the population prevalence of DSM-IV disorders among native and immigrant children living in low socio-economic status (SES) inner-city neighborhoods in the Netherlands. In the first phase of a two-phase epidemiological design, teachers screened an ethnically diverse sample of 2041 children aged 6-10 years using the Strengths and Difficulties Questionnaire (SDQ). In the second phase, a subsample of 253 children was psychiatrically examined, while their parents were interviewed. In addition, teachers completed a short questionnaire about 10 DSM-IV items. Prevalence was estimated using the best-estimate diagnosis based on parent, child and teacher information. Projected to the total population, 11% of the children had one or more impairing psychiatric disorders, which did not differ between native and non-native children. In the total group a clear relationship was observed between the prevalence of psychiatric disorders and gender, parental psychopathology, peer problems and school problems, but not among all ethnic groups separately. This study suggests that the prevalence of psychiatric disorders among non-treated minority and native children in low SES inner-city neighborhoods does not materially differ. However, associated mechanisms may be influenced by ethnicity.

Objective: First, to investigate whether non-Western children in the Netherlands are less likely to be treated for behavioral problems than Western children; second, to examine whether discrepancies in treatment status are related to differences in level of problem behavior and impairment. Method: The study included 2,185 children of the four largest ethnic groups in the Netherlands, namely, 684 Dutch, 702 Moroccan, 434 Turkish, and 365 Surinamese children from grades three to five of elementary school. Teachers completed the Strengths and Difficulties Questionnaire and five DSM-IV items on externalizing problems. In addition, they provided information on the treatment status of the child. Results: Moroccan boys displayed more problem behavior, Turkish boys less problem behavior, and Surinamese boys similar rates of problem behavior compared with Dutch boys. No difference in problem behavior was found between Western and non-Western girls. Adjusted for age, level of problem behavior, and impairment, Moroccan and Turkish children and Surinamese girls were less likely to receive treatment for problem behavior. Conclusions: The higher treatment thresholds of non-Western children compared with Western children in the Netherlands could not be explained by differences in level of problem behavior or impairment. Detection of behavioral problems in non-Western children should receive more attention. (Contains 4 tables.)

Previous research has reported lower treatment rates for externalizing disorders among non-Western children as compared to Western children. Ethnic differences in parental detection may be an explanation for this discrepancy. In a cross-sectional study among the four largest ethnic groups in the Netherlands, namely Dutch, Moroccan, Turkish and Surinamese, we examined the influence of ethnicity on parental detection of behavioural disorders. A total of 270 children (aged 6–10 years) and their parents were interviewed regarding psychiatric disorders and socio-demographic data. Sensitivity and specificity were calculated by using standard definitions, with adjustment for parental educational level. Sensitivity to detect any externalizing disorder and ADHD in particular was significantly lower among Moroccan and Surinamese parents when compared to Dutch parents. Sensitivity to detect ADHD tended to be lower among Turkish parents. Specificity to detect any externalizing disorder was higher among Moroccan and Turkish parents. Specificity to detect ADHD was higher among Moroccan parents and tended to be higher among Turkish parents. The detection rate of externalizing disorders is markedly lower among non-Dutch parents than among Dutch parents. This finding emphasizes the importance of taking parents’ cultural context into account when appraising their report on possible externalizing disorders in their children. [ABSTRACT FROM AUTHOR]

Background: Infant mortality of ethnic minorities in The Netherlands (10% of the population) is twice as high as in the indigenous Dutch population. Causes of death are different for the diverse migrant groups. Methods: Hospital records of nearly 600 infants who died in the four major cities between 1995 and 1998 were analysed according to the cause of death, ethnicity, and possible hereditarity. Results: There was a four to five times higher proportion of hereditary causes of death in the Moroccan and Turkish population, compared with the Surinamese/Antillians and indigenous Dutch. Conclusions: This might be explained by a high inbreeding coefficient as three-quarters of the marriage partners are recruited from the home villages and between a quarter and a third of these marriages are between first cousins. Health promotion activities in The Netherlands have not been successful so far. Preconception genetic counselling might help in reducing these differences. [ABSTRACT FROM AUTHOR]

Background: The decentralization of school health care policy in The Netherlands was followed by an increase in diversity, which was most often not evidence-based. This study aims to clarify the use of scientific knowledge in school health care policy-making processes: multi-actor processes in networks, trying to solve certain problems. Methods: Case-study design in four Municipal Health Service regions, using documents and half-structured interviews as data sources. Results: Scientific knowledge is used by only 42% of the actors in 58% of decision-making rounds in policy-making processes. 'Recent' regional data on health indicators are used more often than 'established' (inter)national knowledge of theoretical models. Mainly school health professionals use knowledge as a resource to influence the policy process. Other actors (e.g. managers and municipalities) use formal power, money or 'initiative' as their main resources. Powerful actors put forward less scientific knowledge than actors in dependent positions. Individual actors with a combined scientific and political frame of reference put forward knowledge most frequently, especially in complex networks with many actors, more than one powerful actor, more than one arena, more than one dominant resource and more than one dominant frame of reference. Conclusion: The use of scientific knowledge in school health care policymaking processes can and must be improved. Liaison officers can bridge the gap between doctors and policymakers, especially in complex policy networks. They combine a scientific and a political frame of reference and act upon scientific knowledge as a resource in their efforts to influence the policymaking process. [ABSTRACT FROM AUTHOR]

The article reports on the result of a study conducted which evaluates the accuracy and efficiency of a brief screening instrument used for predicting externalizing disorders among Dutch children. The inquiry was done through providing teachers with a Strengths and Difficulties Questionnaire for an ethnic diverse sample of 2,185 children. Likewise, a stepwise logistic regression was applied by means of the Hyperactivity and Conduct Problems Scale of the Strengths and Difficulties Questionnaire, for predicting best diagnosis of any externalizing disorder. The result of the assessment revealed 91 cases of externalizing disorders. It was concluded that before the internally validated prediction tool can be implemented, external validation in another sample is needed.

Objective: First, to investigate whether non-Western children in the Netherlands are less likely to be treated for behavioral problems than Western children; second, to examine whether discrepancies in treatment status are related to differences in level of problem behavior and impairment. Method: The study included 2,185 children of the four largest ethnic groups in the Netherlands, namely, 684 Dutch, 702 Moroccan, 434 Turkish, and 365 Surinamese children from grades three to five of elementary school. Teachers completed the Strengths and Difficulties Questionnaire and five DSM-IV items on externalizing problems. In addition, they provided information on the treatment status of the child. Results: Moroccan boys displayed more problem behavior, Turkish boys less problem behavior, and Surinamese boys similar rates of problem behavior compared with Dutch boys. No difference in problem behavior was found between Western and non-Western girls. Adjusted for age, level of problem behavior, and impairment, Moroccan and Turkish children and Surinamese girls were less likely to receive treatment for problem behavior. Conclusions: The higher treatment thresholds of non-Western children compared with Western children in the Netherlands could not be explained by differences in level of problem behavior or impairment. Detection of behavioral problems in non-Western children should receive more attention. [ABSTRACT FROM AUTHOR]

Many brilliant and ambitious young women lose their drive for top careers after childbirth. New maternal impulses are at odds with their original ambitions and for many mothers stress and frustration will be the result as they have to combine child care with workweeks of 60-80h to reach or remain at the top. Pregnancy hormones modify the female's brain as has been demonstrated already for decades in animals. This brain plasticity due to adult neurogenesis in the so called maternal circuitry of the limbic system is long-lasting and perhaps lifelong. In humans hormonal and neuro-imaging studies show ample evidence for fundamental and long lasting pregnancy induced brain changes, not only in the limbic system, but also in the cortical networks like theory of mind and mirror neuron system. Recent research shows pronounced and long lasting brain changes in several of these areas. It can be concluded that there exists a maternal brain that drives mother's behaviour and priorities. Research in men shows that the more fathers are involved in raising their children, the more caring behaviour they develop. Structural anatomical changes are found in neural regions involved in parental motivation. These studies show that brain plasticity in fathers is experience dependent. In Nordic countries, a policy of paid paternal leave followed by a flexible shared parental leave, stimulates fatherly behaviour. This might reduce men's eagerness for top careers, thus creating better opportunities for women. Demolition of women's glass ceiling starts with the father., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Ankyloglossia (tongue tie) in the neonate can be a cause of breastfeeding problems. Frenotomy (cutting of the frenulum linguae) had fallen into disrepute, but has regained its place as a standard medical procedure in Anglo-Saxon countries, though not in the Netherlands. We present two neonates, both boys, presenting with breastfeeding problems caused by ankyloglossia. The first baby described did not drink enough and hence did not gain any weight. The mother of the second patient experienced a great deal of pain and had cracked nipples, caused by an abnormal suckling action. Both boys underwent frenotomy with good result. Recent ultrasound studies reveal that frenotomy immediately normalizes the suckling action in babies with ankyloglossia. Randomized controlled trials show that 95% of breastfeeding problems disappear. There is sufficient evidence to state that frenotomy is a very safe and useful procedure in neonates.

Swaddling was an almost universal child-care practice before the 18th century. It is still tradition in certain parts of the Middle East and is gaining popularity in the United Kingdom, the United States, and The Netherlands to curb excessive crying. We have systematically reviewed all articles on swaddling to evaluate its possible benefits and disadvantages. In general, swaddled infants arouse less and sleep longer. Preterm infants have shown improved neuromuscular development, less physiologic distress, better motor organization, and more self-regulatory ability when they are swaddled. When compared with massage, excessively crying infants cried less when swaddled, and swaddling can soothe pain in infants. It is supportive in cases of neonatal abstinence syndrome and infants with neonatal cerebral lesions. It can be helpful in regulating temperature but can also cause hyperthermia when misapplied. Another possible adverse effect is an increased risk of the development of hip dysplasia, which is related to swaddling with the legs in extension and adduction. Although swaddling promotes the favorable supine position, the combination of swaddling with prone position increases the risk of sudden infant death syndrome, which makes it necessary to warn parents to stop swaddling if infants attempt to turn. There is some evidence that there is a higher risk of respiratory infections related to the tightness of swaddling. Furthermore, swaddling does not influence rickets onset or bone properties. Swaddling immediately after birth can cause delayed postnatal weight gain under certain conditions, but does not seem to influence breastfeeding parameters.