Educational differences in acute infectious diseases in the Netherlands: results from a nationwide health survey.

BACKGROUND: It is unclear to what extent socioeconomic inequalities exist in common infectious diseases in high-income countries. We aimed to explore educational differences in five common acute infectious diseases in adults in the Netherlands. METHODS: As part of a year-round repeated cross-sectional health survey, adults aged 25 and older were asked if they had experienced acute upper or lower respiratory tract infections, acute otitis media, urinary tract infections or gastro-enteritis in the two previous months. If so, participants were asked whether they had consulted their general practitioner and if they had been unable to perform their normal daily activities. These outcomes were analyzed per highest attained level of education. RESULTS: Data of 18 629 survey respondents were used in the analyses. People with a low educational level had lower odds of upper respiratory tract infections (OR 0.88, 95% CI 0.81-0.95), but higher odds of lower respiratory tract infections (OR 1.57, 95% CI 1.16-2.11). After adjustment for several covariates, the differences in upper respiratory tract infections remained statistically significant (aOR 0.84, 95% CI 0.77-0.91). The educational differences in lower respiratory tract infections were mitigated by adjusting for chronic diseases and health behaviours. For all infectious diseases, the likelihood of general practitioner consultation was highest for the lower educated group. Inability to work or perform normal daily activities due to an infectious disease was similar across all levels of education. CONCLUSION: This study shows that educational differences in incidence and care seeking behaviours exist for common acute infectious diseases in the Netherlands.

Correction: Determinants of Health-Related Quality of Life in School-Aged Children: A General Population Study in the Netherlands.

[This corrects the article DOI: 10.1371/journal.pone.0125083.].

Determinants of health-related quality of life in school-aged children: a general population study in the Netherlands.

BACKGROUND: Health related quality of life is the functional effect of a medical condition and/or its therapy upon a patient, and as such is particularly suitable for describing the general health of children. The objective of this study was to identify and confirm potential determinants of health-related quality of life in children aged 4-11 years in the general population in the Netherlands. Understanding such determinants may provide insights into more targeted public health policy. METHODS: As part of a population based cross sectional study, the Child Health Questionnaire (CHQ) Parental Form 28 was used to measure health-related quality of life in school-aged children in a general population sample. Parents of 10,651 children aged 4-11 years were interviewed from January 2001 to December 2009. RESULTS: Multivariate and regression analyses demonstrated a declined CHQ Physical Summary score for children who had >1 conditions, disorders or acute health complaints and who were greater consumers of healthcare; children with a non-western immigrant background; and children whose parents did not work. Lower CHQ Psychosocial Summary score was reported for children who had >1 conditions, disorders or acute health complaints, boys, children of single parents and obese children. CONCLUSION: The best predictors of health-related quality of life are variables that describe use of health care and the number of disorders and health complaints. Nonetheless, a number of demographic, socio-economic and family/environmental determinants contribute to a child's health-related quality of life as well.

Depression and body mass index, a u-shaped association.

BACKGROUND: Results of studies concerning the association between obesity and depression are conflicting. Some find a positive association, some a negative association and some find no association at all. Most studies, however, examine a linear association between Body Mass Index (BMI) and depression. The present study investigates if a nonlinear (U-shaped) trend is preferable over a linear trend to describe the relationship between BMI and depression, which means that both underweight and obesity are associated with depression. METHODS: We investigated the existence of such a U-curve in a sample of 43,534 individuals, aged between 18-90 years, who participated in a cross-sectional study (Continuous Survey of Living Conditions) of physical and mental health in the general population of the Netherlands. We calculated linear and nonlinear (quadratic) ANOVA with polynomial contrast and curve fit regression statistics to investigate whether there was a U-shaped trend in the association between BMI and depression. RESULTS: We find a very significant U-shaped association between BMI categories (underweight, normal, overweight and obesity) and depression (p

Differences in AERP responses and atypical hemispheric specialization in 17-month-old children at risk of dyslexia.

To determine the auditory event-related potential (AERP) correlates of phoneme perception in 17-month-old children at risk of dyslexia and controls, AERPs were elicited by standard (/bAk/) and deviant (/dAk/) word stimuli presented in an oddball paradigm. The at-risk children tended to show delayed P1 and P2 peaks for standard stimuli. Hemispheric group differences were observed for N2 amplitude and P1 latency, suggesting atypical processing of spoken words in at-risk children. Larger P2 and to a lesser extent P1 amplitudes following deviant words occurred in the control but not in the at-risk group, this may signal poorer phoneme discrimination in at-risk children. The present AERP results offer clues to where to look for a marker to identify children at high risk of reading and writing problems at an early age to facilitate early intervention.

Cortical categorization failure in 2-month-old infants at risk for dyslexia.

Cortical auditory categorization was assessed in 2-month-old infants at genetic risk for dyslexia and controls. Manipulated /bAk/ and /dAk/ speech stimuli were used as frequently presented standards. The neuroelectric brain responses of the control infants were highly sensitive to the phoneme boundary that separated these stimuli, but the infants at risk showed no signs of cortical categorical perception. Cortical sources of the responses were predominantly found in the left hemisphere for the control infants, but mainly in the right hemisphere for the infants at risk. The results demonstrate that impaired categorical perception in dyslexia is already present in infants at risk for the disorder.

When heuristics clash with parsing routines: ERP evidence for conflict monitoring in sentence perception.

Monitoring refers to a process of quality control designed to optimize behavioral outcome. Monitoring for action errors manifests itself in an error-related negativity in event-related potential (ERP) studies and in an increase in activity of the anterior cingulate in functional magnetic resonance imaging studies. Here we report evidence for a monitoring process in perception, in particular, language perception, manifesting itself in a late positivity in the ERP. This late positivity, the P600, appears to be triggered by a conflict between two interpretations, one delivered by the standard syntactic algorithm and one by a plausibility heuristic which combines individual word meanings in the most plausible way. To resolve this conflict, we propose that the brain reanalyzes the memory trace of the perceptual input to check for the possibility of a processing error. Thus, as in Experiment 1, when the reader is presented with semantically anomalous sentences such as, "The fox that shot the poacher...," full syntactic analysis indicates a semantic anomaly, whereas the word-based heuristic leads to a plausible interpretation, that of a poacher shooting a fox. That readers actually pursue such a word-based analysis is indicated by the fact that the usual ERP index of semantic anomaly, the so-called N400 effect, was absent in this case. A P600 effect appeared instead. In Experiment 2, we found that even when the word-based heuristic indicated that only part of the sentence was plausible (e.g., "...that the elephants pruned the trees"), a P600 effect was observed and the N400 effect of semantic anomaly was absent. It thus seems that the plausibility of part of the sentence (e.g., that of pruning trees) was sufficient to create a conflict with the implausible meaning of the sentence as a whole, giving rise to a monitoring response.

An ERP study of P600 effects elicited by semantic anomalies.

Syntactic anomalies reliably elicit P600 effects. Recent studies, however, reported P600 effects to semantic anomalies. These findings are difficult to reconcile with the common view on the P600 as a purely syntactic component. The present study--carried out in Dutch--tested the possibility that a P600 to semantic anomalies would nevertheless reflect syntactic processing. We presented semantic reversal anomalies in syntactically correct and unambiguous sentences, like #The cat that fled from the mice.... If participants would use a plausibility strategy and combine the lexical items in the most plausible way, they would--in the case of the example--assume that the mice were fleeing from the cat. Furthermore, this interpretation could lead them to expect a particular inflection of the verb (here: plural inflection). The violation of this expectation could have elicited the P600 effect. Such a syntactic mismatch can occur only in sentences in which the number of theme and agent are different. Therefore, in the present study, the number of theme and agent was either different or the same. A centroparietal P600 effect was present not only in different number sentences but also in same number sentences. Consequently, the P600 effect was not due to a syntactic mismatch, thereby challenging a purely syntactic account of the P600. An alternative view concerning the functional significance of the P600 is discussed, i.e., that it reflects a monitoring component that checks upon the veridicality of ones sentence perception.

Structure and limited capacity in verbal working memory: a study with event-related potentials.

In order to test recent claims about the structure of verbal working memory, two ERP experiments with Dutch speaking participants were carried out. We compared the ERP effects of syntactic and semantic mid-sentence anomalies in subject and object relative sentences. In Experiment 1, the participants made acceptability judgments, while in Experiment 2 they read for comprehension. Syntactic anomalies concerned subject-verb disagreement, while semantic anomalies were related to implausible events (e.g., *The cat that fled from the mice ran through the room). Semantic anomalies did not elicit an N400 effect. The semantic as well as syntactic anomalies elicited P600 effects, with similar centro-parietal scalp distributions. For both kinds of anomaly, the P600 effects were modulated by syntactic complexity: they were either relatively small (Experiment 1) or absent (Experiment 2) in object relative sentences. Taken together, our results suggest that: (a) verbal working memory is a limited capacity system; (b) it is not subdivided into an interpretative and a post-interpretative component (); (c) the P600 can reflect the presence of a semantic bias in syntactically unambiguous sentences; (d) the P600 is related to language monitoring: its function is to check upon the veridicality of an unexpected (linguistic) event; (e) if such a check is made, there is no integration of the event and hence no N400 effect.

On the impact of different number representations in the number bisection task.

The number bisection task--in which the numerical middle of two other numbers has to be determined (e.g., 6 is the numerical middle of 4 and 8)--has recently been used in neuropsychological case studies in addition to the number comparison task to assess quantitative capabilities in number processing. While factors determining difficulty in normal participants have often been systematically investigated in the number comparison task, this has not yet been done in the number bisection task. Based on a pilot study by van Herten (1999), we extracted four factors that we hypothesized to modulate difficulty in a verification version of the number bisection task in normal participants: Multiplicativity (whether or not the three numbers are part of a multiplication table), range (distance between the smallest and the largest number) for bisectable number triplets as well as distance of the middle number to the numerical middle, and bisection possibility for non-bisectable triplets. In the current study, we obtained large effects for all four factors on RT and accuracy data and some interesting interactions in normal participants. In a regression analysis, we additionally observed inhibitory effects of decade crossing and of ten inclusion (whether or not one of the three numbers was a decade number). We discuss the impact of these results for the use of the number bisection task as an assessment tool in neuropsychology. Finally, we examine the consequences of these results for models of number processing.