http://repub.eur.nl/res/aut/888/ List of Publications en http://repub.eur.nl/static-eur/img/logo.png http://repub.eur.nl http://repub.eur.nl/res/pub/26234/ 2011-06-01T00:00:00Z Background: Homosexual contact is a major risk factor for acute hepatitis B infection. This study explores how many and which men who have sex with men (MSM) are reached by the ongoing hepatitis B vaccination programme in The Netherlands (started in 2002), and investigate reasons for non-participation and non-compliance. Methods: In this cross-sectional study, on the basis of ethnographic mapping and targeted sampling, 320 MSM were interviewed at different venues in three regions in The Netherlands. Results: Of the sample, 74 reported to be aware of the opportunity to obtain free hepatitis B vaccination, and 50 reported to be vaccinated (received at least one injection). Compliance with the three-dose vaccination schedule was 84. The most important reason for non-participation in the vaccination programme was a low perceived risk of getting infected with the virus. A personal approach by STD-prevention workers, the recruitment region and having sex with casual partners were positively associated with vaccination uptake. Being bisexual was negatively associated with, and visiting gay bars/discos was positively associated with, awareness of the opportunity to obtain free hepatitis B vaccination. Conclusion: This study shows a large proportion of MSM is aware that they could opt for free hepatitis B vaccination. Future vaccination programmes should focus on a personal approach, since the use of STD prevention workers was shown to be a successful tool for participation in the vaccination programme. The personal information should focus on perceived risk of infection, since this was a major reason for vaccine refusal. http://repub.eur.nl/res/pub/26422/ 2011-05-01T00:00:00Z To review the prevalence regarding overweight and obesity among children and adolescents from migrant and native origin within Europe, a systematic review (1999-2009) was performed, using Embase, PubMed and citation snowballing. Literature research resulted in 19 manuscripts, reporting studies in six countries, mostly situated in Western and Central Europe. From this review, it appears that, in most of the European countries for which data are available, especially non-European migrant children are at higher risk for overweight and obesity than their native counterparts. The prevalence of overweight in migrant children ranged from 8.9% to 37.5% and from 8.8% to 27.3% in native children. The prevalence of obesity in migrant children ranged from 1.2% to 15.4% and from 0.6% to 11.6% in native children. Some limitations of the review are discussed, especially the problematic classification of migrant and native children. Apparently, migrant children display an even more sedentary way of life or adverse dietary patterns, as compared with native children. To what degree these differences can be explained by socioeconomic and cultural factors remains to be investigated. As overweight and obese children are at risk for many chronic health problems, further research is urgently needed in order to develop preventive interventions. © 2011 The Authors. obesity reviews http://repub.eur.nl/res/pub/34107/ 2011-01-01T00:00:00Z Aims To provide empirical data-driven identification of a group of addicted online gamers.Design Repeated cross-sectional survey study, comprising a longitudinal cohort, conducted in 2008 and 2009.Setting Secondary schools in the Netherlands.Participants Two large samples of Dutch schoolchildren (aged 13-16 years).Measurements Compulsive internet use scale, weekly hours of online gaming and psychosocial variables.Findings This study confirms the existence of a small group of addicted online gamers (3%), representing about 1.5% of all children aged 13-16 years in the Netherlands. Although these gamers report addiction-like problems, relationships with decreased psychosocial health were less evident.Conclusions The identification of a small group of addicted online gamers supports efforts to develop and validate questionnaire scales aimed at measuring the phenomenon of online video game addiction. The findings contribute to the discussion on the inclusion of non-substance addictions in the proposed unified concept of 'Addiction and Related Disorders' for the DSM-V by providing indirect identification and validation of a group of suspected online video game addicts. © 2010 The Authors, Addiction http://repub.eur.nl/res/pub/28452/ 2010-10-01T00:00:00Z In recent years, several studies have demonstrated that at least a small group of gamers has trouble controlling their online video game playing. Excessive amounts of time spent on playing online video games can be severely disruptive to school, work, and "real life" social contacts. It seems that online games, especially multiplayer online role playing games, are more often associated with video game addiction. Drawing parallels to other industriessuch as gamblingwhich are heavily regulated, the issue of social responsibility of the video game industry is explored. Presently, online video game publishers provide neither referral services nor customer care with regards to video game addiction. In our opinion, a dual approach is necessary. Firstly, consumers should be informed about potential addiction risks that can be attributed to playing online video games. Secondly, game publishers should implement proper referral services. Providing customer care and referral services might be in the best interest of the video game industry at this point, as it may very well prevent revenue restricting governmental intervention. Therefore, taking action on the issue of social responsibility will benefit both the customerwho will be informed and properly referredand the game industry alike. http://repub.eur.nl/res/pub/28262/ 2010-07-01T00:00:00Z Purpose: Increasing research on Internet addiction makes it necessary to distinguish between the medium of Internet and its specific applications. This study explores the relationship between time spent on various Internet applications (including online gaming) and Compulsive Internet Use in a large sample of adolescents. Methods: The 2007 (N = 4,920) and 2008 (N = 4,753) samples of a longitudinal survey study among adolescents were used, as well as the 2007-2008 cohort subsample (N = 1421). Compulsive Internet Use was predicted from the time spent on the various Internet applications in two cross-sectional multiple linear regression models and one longitudinal regression model in which changes in behavior were related to changes in Compulsive Internet Use. Results: In both samples, downloading, social networking, MSN use, Habbo Hotel, chatting, blogging, online games, and casual games were shown to be associated with Compulsive Internet Use. Off these, online gaming was shown to have the strongest association with Compulsive Internet Use. Moreover, changes in online gaming were most strongly associated with changes in Compulsive Internet Use over time for the longitudinal cohort. Conclusions: A clear relationship was shown between online gaming and Compulsive Internet Use. It is further argued that a subgroup of compulsive Internet users should be classified as compulsive online gamers. http://repub.eur.nl/res/pub/28211/ 2010-05-18T00:00:00Z http://repub.eur.nl/res/pub/15476/ 2009-04-10T00:00:00Z OBJECTIVES: We sought to explore the reach of a free hepatitis B vaccination program among female commercial sex workers (CSWs) within a legalized prostitution setting in the Netherlands. We also investigated the reasons for nonparticipation and noncompliance. METHODS: In this cross-sectional study based on ethnographic mapping and targeted sampling, 259 CSWs were interviewed at their work in 3 regions in the Netherlands. The semistructured interviews contained questions on sociodemographics, sexual risk behavior, sex work, awareness of the opportunity to obtain free hepatitis B vaccination, vaccination uptake, and compliance with the full vaccination schedule. RESULTS: Of our sample, 79% reported awareness of the opportunity to obtain hepatitis B vaccination, and 63% reported to be vaccinated against hepatitis B (received > or =1 vaccination). A personal approach by health professionals or was associated with vaccination uptake, when specific sociodemographic variables, sexual behavior, and sex work related covariates were controlled for in the analysis. Window prostitution and the duration of working in the region were associated with awareness of the opportunity to obtain free hepatitis B vaccination. CONCLUSIONS: The results of this study suggest that outreach activities (i.e., a personal approach) within this program are beneficial. Transient CSWs are more difficult to reach within the current vaccination program. These results can be used to increase the success of future health programs among this risk group. http://repub.eur.nl/res/pub/17044/ 2009-01-01T00:00:00Z Background: The objective of the study was to explore the reach of an ongoing hepatitis B vaccination programme in terms of awareness of the programme among drug users (DUs), vaccination uptake and compliance, as well as to investigate reasons for non-participation. Methods: Ethnographic mapping and targeted sampling were used to recruit 309 DUs in three regions in the Netherlands. Results were based on univariate statistics (Chi-square and t-tests) and multivariate logistic regression analysis. Results: Of the sample, 63% were aware of the free vaccine, and 44% said they had been vaccinated. DUs who visited drug consumption rooms were more likely to be aware of the programme than those who did not. Vaccination uptake was negatively associated with older age of onset of drug use. Uptake was positively associated with being informed personally about the free vaccination by drug service staff. A history of STD infection, and having sexual intercourse with casual partners were negatively associated with compliance with the vaccination schedule (receiving three vaccinations). Conclusion: Our results suggest that marginalised DUs have been reached by the programme. Attention should be paid to those at risk of hepatitis B infection through sexual contacts, since they are less likely to be fully vaccinated. Most importantly, our results suggest that immediate vaccination on location after personal communication is one of the most effective ways to increase vaccination uptake. http://repub.eur.nl/res/pub/30202/ 2008-06-01T00:00:00Z Most general alcohol consumption population surveys are meant to represent the year consumption, although they actually ask only for habitual drinking and/or frequencies and quantities of binge drinking in the past months. These surveys typically cover about half of the alcohol sales figures. In order to enhance sales coverage and to reduce seasonal bias, we developed a year consumption questionnaire on the basis of daily and weekly drinking adding 13 categories of less-than-weekly drinking occasions over the year. As a first test we offered the new questionnaire together with a traditional typical week questionnaire, in different modes to various groups adding up to a purposive high diversity sample of 101 drinking persons (56 women, 44 men, 16-69 years old, mean age 34 years). After correction for overlaps between weekly habits and less-than-weekly occasions, the new questionnaire produces considerably higher reports of annual consumption, compared with the typical-week-based estimates of year consumption. Limitations of the study are discussed. Copyright http://repub.eur.nl/res/pub/22143/ 2008-03-28T00:00:00Z Rede, uitgesproken ter gelegenheid van de aanvaarding van het ambt van bijzonder hoogleraar aan het Erasmus MC - faculteit van de Erasmus Universiteit - vanwege de Stichting Volksbond Rotterdam, gevestigd bij het IVO, met de leeropdracht Verslavingsonderzoek, op 28 maart 2008 http://repub.eur.nl/res/pub/10112/ 2003-01-01T00:00:00Z AIMS: According to 'the continuum of resistance model' late respondents can be used as a proxy for non-respondents in estimating non-response bias. In the present study, the validity of this model was explored and tested in three surveys on alcohol consumption. METHODS: The three studies collected their data by means of mailed questionnaires on alcohol consumption whereby two studies also performed a non-response follow-up. RESULTS: Comparisons of early respondents, late respondents and non-respondents in one study showed some support for 'the continuum of resistance model', although another study could not confirm this result. Comparison of alcohol consumption between three time response groups showed no significant linear pattern of differences between response waves. CONCLUSIONS: The hypothesis that late respondents are more similar to non-respondents than early respondents, could not be confirmed or rejected. Repeated mailings are effective in obtaining a greater sample size, but seem ineffective in improving the representativeness of alcohol consumption surveys. http://repub.eur.nl/res/pub/9896/ 2002-01-01T00:00:00Z In a non-response follow-up study, non-respondents of the original mailed questionnaire were approached again by house visits in order to compare their alcohol consumption with that of the respondents of the same mailed questionnaire. Differences in alcohol consumption between respondents and non-respondents were found. There is strong evidence for overrepresentation of non-response among abstainers, but weak evidence among frequent excessive drinkers. http://repub.eur.nl/res/pub/9291/ 2000-01-01T00:00:00Z The study objective was to assess the prevalence, level of treatment, and control of hypertension in a general elderly population according to age and sociodemographic factors. We conducted a cross-sectional analysis of 7983 participants of the Rotterdam Study who were >/=55 years old and living in a district of Rotterdam. The prevalence of hypertension was based on blood pressure levels (>/=160/95 mm Hg) and the use of blood pressure-lowering medication for the indication of hypertension, type of treatment, and control of hypertension. Systolic blood pressure rises with age, whereas diastolic blood pressure declines. The prevalence of hypertension increases with age and was higher among women (39%) than among men (31%). About 80% of the hypertensives were aware of having hypertension, and 82% of the 80% were treated. For 70% of them, treatment was adequate with reference to conservative criteria. Hypertension was more prevalent among persons not living in a home for the elderly, for more-educated men, and for less-educated women. Persons without a partner and men living in a home for the elderly had a higher risk of being unaware of or of not being treated for existing hypertension. Treatment was more often successful among those living in a home for the elderly. The prevalence of hypertension was higher among older women and increased with age in both genders. A large proportion of hypertensive elderly persons were aware and were successfully treated for hypertension. The degree of awareness and control appeared to be affected by sociodemographic factors. More importantly, the majority of hypertensives did not have their hypertension well controlled. This group requires more attention by medical practitioners to reduce the burden of cardiovascular diseases in elderly persons. http://repub.eur.nl/res/pub/9298/ 2000-01-01T00:00:00Z STUDY OBJECTIVE: To test the hypothesis that the association between socioeconomic status and mortality rates cuts across the major causes of death for middle aged and elderly men. DESIGN: 25 year follow up of mortality in relation to employment grade. SETTING: The first Whitehall study. PARTICIPANTS: 18,001 male civil servants aged 40-69 years who attended the initial screening between 1967 and 1970 and were followed up for at least 25 years. MAIN OUTCOME MEASURE: Specific causes of death. RESULTS: After more than 25 years of follow up of civil servants, aged 40-69 years at entry to the study, employment grade differences still exist in total mortality and for nearly all specific causes of death. Main risk factors (cholesterol, smoking, systolic blood pressure, glucose intolerance and diabetes) could only explain one third of this gradient. Comparing the older retired group with the younger pre-retirement group, the differentials in mortality remained but were less pronounced. The largest decline was seen for chronic bronchitis, gastrointestinal diseases and genitourinary diseases. CONCLUSIONS: Differentials in mortality persist at older ages for almost all causes of death. http://repub.eur.nl/res/pub/9410/ 2000-01-01T00:00:00Z OBJECTIVE: To examine whether eliminating smoking will lead to a reduction in the number of years lived with disability (that is, absolute compression of morbidity). DESIGN: Multistate life table calculations based on the longitudinal GLOBE study (the Netherlands) combined with the Longitudinal Study of Aging (LSOA, United States of America). SETTING: the Netherlands. SUBJECTS: Dutch nationals aged 30-74 years living in the city of Eindhoven and surrounding municipalities (GLOBE) and United States citizens age 70 and over (LSOA). MAIN OUTCOME MEASURES: Life expectancy with and without disability and total life expectancy at ages 30 and 70. RESULTS: A non-smoking population on balance spends fewer years with disability than a mixed smoking-non-smoking population. Although non-smokers have lower mortality risks and thus are exposed to disability over a longer period of time, their lower incidence of disability and higher recovery from disability yield a net reduction of the length of time spent with disability (at age 30: -0.9 years in men and -1.1 years in women) and increases the length of time lived without disability (2.5 and 1.9 years, for men and women, respectively). These outcomes indicate that elimination of smoking will extend life and the period of disability free life, and will compress disability into a shorter period. CONCLUSIONS: Eliminating smoking will not only extend life and result in an increase in the number of years lived without disability, but will also compress disability into a shorter period. This implies that the commonly found trade off between longer life and a longer period with disability does not apply. Interventions to discourage smoking should receive high priority http://repub.eur.nl/res/pub/8985/ 1999-01-01T00:00:00Z OBJECTIVE: To determine the contribution of psychological attributes (personality characteristics and coping styles) to the association between social class in childhood and adult health among men and women. DESIGN: Partly retrospective, partly cross sectional study conducted in the framework of the Dutch GLOBE study. SUBJECTS: Sample of general population from south east Netherlands consisting of 2174 men and women aged 25-74 years. Baseline self reported data from 1991 provided information on childhood and adult social class, psychological attributes, and general health. MAIN OUTCOME MEASURE: Self rated poor health. RESULTS: Independent of adult social class, low childhood social class was related to self rated poor health (odds ratio 1.67 (95% confidence interval 1.02 to 2.75) for subjects whose fathers were unskilled manual workers versus subjects whose fathers were higher grade professionals). Subjects whose fathers were manual workers generally had more unfavourable personality profiles and more negative coping styles. External locus of control, neuroticism, and the absence of active problem focused coping explained about half of the association between childhood social class and self rated poor health. The findings were independent of adult social class and height. CONCLUSIONS: A higher prevalence of negative personality profiles and adverse coping styles in subjects who grew up in lower social classes explains part of the association between social class in childhood and adult health. This finding underlines the importance of psychological mechanisms in the examination of the negative effects of adverse socioeconomic conditions in childhood. http://repub.eur.nl/res/pub/9008/ 1999-01-01T00:00:00Z BACKGROUND AND PURPOSE: We sought to assess the association between socioeconomic status and the risk of stroke among elderly women. Methods--The association between socioeconomic status and stroke emerged in cross-sectional and longitudinal data on 4274 female participants of the Rotterdam Study, a prospective, population-based, follow-up study in the Netherlands among older subjects. RESULTS: A history of stroke was more common among women in lower socioeconomic strata. The same trend was observed for the relationship between the lowest socioeconomic groups and the incidence of stroke. Risk factors for stroke were not related to socioeconomic status in a consistent manner. Smoking, history of cardiovascular diseases, and overweight were more common in lower socioeconomic groups. However, socioeconomic differences in hypertension, antihypertensive drug use, prevalence of atrial fibrillation, and prevalence of left ventricular hypertrophy were not observed. The complex of established risk factors could only partly explain the association between socioeconomic status and stroke. CONCLUSIONS: There is a strong association among elderly women between socioeconomic status and stroke. The association could only partly be explained by known risk factors. Our findings indicate that not only the actual risk profile but also risk factors earlier in life may be of importance. http://repub.eur.nl/res/pub/9067/ 1999-01-01T00:00:00Z OBJECTIVES: This study examined the role of behavioral and material factors in explaining educational differences in all-cause mortality, taking into account the overlap between both types of factors. METHODS: Prospective data were used on 15,451 participants in a Dutch longitudinal study. Relative hazards of all-cause mortality by educational level were calculated before and after adjustment for behavioral factors (alcohol intake, smoking, body mass index, physical activity, dietary habits) and material factors (financial problems, neighborhood conditions, housing conditions, crowding, employment status, a proxy of income). RESULTS: Mortality was higher in lower educational groups. Four behavioral factors (alcohol, smoking, body mass index, physical activity) and 3 material factors (financial problems, employment status, income proxy) explained part of the educational differences in mortality. With the overlap between both types of factors accounted for, material factors were more important than behavioral factors in explaining mortality differences by educational level. CONCLUSIONS: The association between educational level and mortality can be largely explained by material factors. Thus, improving the material situation of people might substantially reduce educational differences in mortality. http://repub.eur.nl/res/pub/17512/ 1998-06-17T00:00:00Z People in lower socia-economic positions are generally worse off with respect to their health than people in higher positions. These so-called socia-economic inequalities in health exist from birth to death, in youth, adulthood and in old age. Socia-economic inequalities in health in adult life have been found in many European countries over a long period of time\\,2. The question on the processes that underlie the generation of these inequalities is still largely unanswered. The influential Black Report, which was published in Great Britain in 19823, offers some explanations for these inequalities. In this report the causal explanation and the selection mechanism are the most important mechanisms. The causal explanation implies that socia-economic health inequalities are caused by the unequal distribution across socia-economic groups of lifestyle f.1.ctors, material factors or psycho-social factors. The health selection mechanism involves that health affects social mobility: healthy people may move up whereas unhealthy people may move down in the social hierarchy. The latter hypothesis is also referred to as the 'drift hypothesis'3. The Black Report stresses the importance of the causation mechanism as an explanation for socio-econOlnic inequalities in health. Although behavioural factors are said to playa role in this mechanism, the role of material factors is suggested to be greater. In the Black Report little attention has been paid to childhood conditions. http://repub.eur.nl/res/pub/8826/ 1998-01-01T00:00:00Z STUDY OBJECTIVE: To examine the contribution of childhood health to the explanation of socioeconomic inequalities in health in early adult life. DESIGN: Retrospective data were used, which were obtained from a postal survey in the baseline of a prospective cohort study (the Longitudinal Study on Socio-Economic Health Differences in the Netherlands). Adult socioeconomic status was indicated by educational level, while health was indicated by perceived general health. Childhood health was measured by self reported periods of severe disease in childhood. Relations were analysed using logistic regression models. The reduction in odds ratios of "less than good" perceived general health for different educational groups after adjustment for childhood health was used to estimate the contribution of childhood health. SETTING: The population of the city of Eindhoven and surroundings in the south east of the Netherlands in 1991. PARTICIPANTS: 2511 respondents, aged 25-34 years, men and women, of Dutch nationality, were included in the analysis. MAIN RESULTS: There was a clear association between childhood health and adult health, as well as an association between childhood health and adult socioeconomic status. Approximately 5% to 10% of the increased risk of the lower socioeconomic groups of having a "less than good" perceived general health can be explained by childhood health. CONCLUSIONS: Childhood health contributes to the explanation of socioeconomic inequalities in early adult health. Although this contribution is not very large, it cannot be ignored and has to be interpreted largely in terms of selection on health. http://repub.eur.nl/res/pub/8874/ 1998-01-01T00:00:00Z BACKGROUND: The purpose of this study is to assess to what extent the effect of childhood socioeconomic status on adult health could be explained by a higher prevalence of unhealthy behaviour among those with lower childhood socioeconomic status. METHODS: Data were obtained from the baseline of a prospective cohort study in the Netherlands (13 854 respondents, aged between 25 and 74). Childhood socioeconomic group was indicated by occupation of the father, and adult health was indicated by perceived general health, health complaints and mortality. Adult socioeconomic status was measured by current occupation. Behavioural factors were smoking, alcohol consumption, Body Mass Index and physical activity. Relations were analysed using logistic regression models. RESULTS: A clear association between childhood socioeconomic circumstances and adult health was shown, as well as an association between childhood socioeconomic circumstances and health-related behaviour, even after adjustment for current socioeconomic status. Physical activity shows the strongest relation with childhood socioeconomic circumstances. Behavioural factors explain the relation between childhood socioeconomic status and adult health for approximately 10%. CONCLUSIONS: Childhood socioeconomic circumstances have an independent effect on adult health and health-related behaviour: the risk of health problems and health damaging behaviour is higher in lower childhood socioeconomic groups. The independent effect of childhood circumstances on adult health operates for a small part through unhealthy behaviour. http://repub.eur.nl/res/pub/9048/ 1998-01-01T00:00:00Z BACKGROUND: The aim was to study the impact of different categories of working conditions on the association between occupational class and self-reported health in the working population. METHODS: Data were collected through a postal survey conducted in 1991 among inhabitants of 18 municipalities in the southeastern Netherlands. Data concerned 4521 working men and 2411 working women and included current occupational class (seven classes), working conditions (physical working conditions, job control, job demands, social support at work), perceived general health (very good or good versus less than good) and demographic confounders. Data were analysed with logistic regression techniques. RESULTS: For both men and women we observed a higher odds ratio for a less than good perceived general health in the lower occupational classes (adjusted for confounders). The odds of a less than good perceived general health was larger among people reporting more hazardous physical working conditions, lower job control, lower social support at work and among those in the highest category of job demands. Results were similar for men and women. Men and women in the lower occupational classes reported more hazardous physical working conditions and lower job control as compared to those in higher occupational classes. High job demands were more often reported in the higher occupational classes, while social support at work was not clearly related to occupational class. When physical working conditions and job control were added simultaneously to a model with occupational class and confounders, the odds ratios for occupational classes were reduced substantially. For men, the per cent change in the odds ratios for the occupational classes ranged between 35% and 83%, and for women between 35% and 46%. CONCLUSIONS: A substantial part of the association between occupational class and a less than good perceived general health in the working population could be attributed to a differential distribution of hazardous physical working conditions and a low job control across occupational classes. This suggests that interventions aimed at improving these working conditions might result in a reduction of socioeconomic inequalities in health in the working population. http://repub.eur.nl/res/pub/8702/ 1997-01-01T00:00:00Z BACKGROUND: The aim of the study was to test the hypothesis that the relatively strong association between income and health compared to that between education/occupation and health, can partly be interpreted in terms of an association between employment status and health. METHODS: Health indicators used were the prevalence of one or more chronic conditions, and perceived general health. Data were generated from a postal survey, part of the baseline data collection of a Dutch prospective cohort study on socioeconomic inequalities in health. RESULTS: After controlling for differences in other socioeconomic indicators, the association between income and health was found to be stronger than that between occupation or education and health. Most of the difference in strength was found to be due to employment status, especially among men. Controlling for employment status, and controlling for the distribution of those with a long-term work disability in particular, reduced the risks of lower income groups, whereas the risks of lower educational and occupational groups hardly changed. CONCLUSIONS: These results suggest that the relatively strong association between income and health can for a large part be interpreted in terms of an interrelationship between employment status, income and health. More specifically, it is largely due to the concentration of the long-term disabled in lower income groups. This indicates the importance of the selection mechanism, as these groups are excluded from paid employment because of their health status, leading to a lowering of income. However, income was still found to be related to perceived general health after controlling for employment status especially among women. This suggests that an explanation in terms of an effect of material factors on health may also be important.