The socioeconomic roots of shame and perceptions of social inadequacy

Introduction. Cumulating reports on the adverse health effects of income inequality hypothesise on underlying processes related to health compromising, negative social comparisons in people with a low socioeconomic status (compared to those who are socioeconomically better-off). As this hypothesis of “internalized inferiority” has not yet been examined explicitly, we set out to examine whether internalized inferiority is indeed more common in low socioeconomic status groups. Method. Dutch SMILE data on 1,477 participants, aged 58-94 in 2008 were used. Income in adulthood (measured several times between 2002 and 2008), education in adulthood (measured several times between 2002 and 2008), education of parents (measured in 2005), and poverty in childhood (measured in 2004) were related to general shame (measured in 2009) and social inadequacy (measured in 2004 and 2008), using logistic regression analyses. Results. Both education and income-related socioeconomic measures from childhood and adulthood had independent associations with social inadequacy. Poverty in childhood was related to reports of general shame. Discussion.In this cohort the socioeconomic status of middle-aged and older men and women, especially its financial component, impacts cognitions and feelings of internalized inferiority. Childhood socioeconomic circumstances, particularly experiences of poverty, contributed independently. Our findings suggest that negative social comparisons and internalized inferiority might be possible key players in the association between low socioeconomic status and poor health

In-depth Analysis of Lorlatinib-related neurocognitive Adverse Events in Patients With Non–small-cell Lung Cancer

Introduction: Lorlatinib is a potent, brain penetrant, next-generation ALK/ROS1 TKI, with high response rates and durable responses, including the brain. However, a significant drawback is the manifestation of neurocognitive adverse events (NCAEs). Despite being generally low-grade in severity, these NCAEs can be physically and mentally disabling. Extensive neurocognitive testing in this group of patients is lacking; therefore we conducted this study. Patients and methods: This observational prospective study was conducted across 3 Dutch university hospitals. Patients with metastatic NSCLC with an ALK- or ROS1-rearrangement and having an indication to start lorlatinib in daily clinical practice were eligible. The primary endpoints were to identify changes in neurocognitive functioning, measured through neurocognitive assessment at intervals of 2 weeks and 2 months after starting lorlatinib, in comparison to baseline. As a secondary endpoint, the correlation between neurocognitive impairment and self-reported neurocognitive dysfunction was examined. Results: Between June 2019 and October 2022, 22 patients were included. Among the various neurocognitive tests administered, only the Hopkins Verbal Learning Test-Revised parts b and c demonstrated a significant and clinically relevant decrease in scoring 2 weeks post initiation of lorlatinib (P = .036 and P = .003, respectively). However, these returned to baseline at the 2-month evaluation. The questionnaires did not result in significantly different outcomes over time.Conclusion: Lorlatinib treatment did not result in a sustained and significant decline within any of the specified neurocognitive domains.</p

Preimplantation genetic testing for Neurofibromatosis type 1:more than 20 years of clinical experience

Neurofibromatosis type 1 (NF1) is an autosomal dominant disorder that affects the skin and the nervous system. The condition is completely penetrant with extreme clinical variability, resulting in unpredictable manifestations in affected offspring, complicating reproductive decision-making. One of the reproductive options to prevent the birth of affected offspring is preimplantation genetic testing (PGT). We performed a retrospective review of the medical files of all couples (n = 140) referred to the Dutch PGT expert center with the indication NF1 between January 1997 and January 2020. Of the couples considering PGT, 43 opted out and 15 were not eligible because of failure to identify the underlying genetic defect or unmet criteria for in vitro fertilization (IVF) treatment. The remaining 82 couples proceeded with PGT. Fertility assessment prior to IVF treatment showed a higher percentage of male infertility in males affected with NF1 compared to the partners of affected females. Cardiac evaluations in women with NF1 showed no contraindications for IVF treatment or pregnancy. For 67 couples, 143 PGT cycles were performed. Complications of IVF treatment were not more prevalent in affected females compared to partners of affected males. The transfer of 174 (out of 295) unaffected embryos led to 42 ongoing pregnancies with a pregnancy rate of 24.1% per embryo transfer. There are no documented cases of misdiagnosis following PGT in this cohort. With these results, we aim to provide an overview of PGT for NF1 with regard to success rate and safety, to optimize reproductive counseling and PGT treatment for NF1 patients.</p

Body size, non-occupational physical activity and the chance of reaching longevity in men and women: findings from the Netherlands Cohort Study

Introduction The rising number of obese and/or physically inactive individuals might negatively impact human lifespan. This study assessed the association between height, body mass index (BMI) and nonoccupational physical activity and the likelihood of reaching 90 years of age, in both sexes separately.Methods Analyses were conducted using data from the Netherlands Cohort Study. Participants born in 19161917 (n=7807) completed a questionnaire in 1986 (at age 68-70 years) and were followed up for vital status information until the age of 90 years (2006-2007). Cox regression analyses were based on 5479 participants with complete data to calculate risk ratios (RRs) of reaching longevity (age 90 years).Results In women, we observed significant associations between reaching longevity and height (RR: 1.05 per 5 cm increment; 95% CI 1.00 to 1.09), BMI at baseline (&gt;= 30vs18.5-&lt;25 kg/m(2); RR: 0.68; 95% CI 0.54 to 0.86) and BMI change since age 20 years (= 8vs0-Conclusion This study indicates that body size and physical activity are related to the likelihood of reaching 90 years of age and that these associations differ by sex.</p

Alcohol consumption in later life and reaching longevity:the Netherlands Cohort Study

Background: whether light-to-moderate alcohol intake is related to reduced mortality remains a subject of intense research and controversy. There are very few studies available on alcohol and reaching longevity. Methods: we investigated the relationship of alcohol drinking characteristics with the probability to reach 90 years of age. Analyses were conducted using data from the Netherlands Cohort Study. Participants born in 1916-1917 (n = 7,807) completed a questionnaire in 1986 (age 68-70 years) and were followed up for vital status until the age of 90 years (2006-07). Multivariable Cox regression analyses with fixed follow-up time were based on 5,479 participants with complete data to calculate risk ratios (RRs) of reaching longevity (age 90 years). Results: we found statistically significant positive associations between baseline alcohol intake and the probability of reaching 90 years in both men and women. Overall, the highest probability of reaching 90 was found in those consuming 5- Conclusions: the highest probability of reaching 90 years was found for those drinking 5

Timing of primary three-dose hepatitis B vaccination and postvaccination serologic testing among a large cohort of healthy adults

This study evaluated the optimal timing of a primary three-dose hepatitis B vaccination and postvaccination serologic testing (PVST) among a large group of healthy naïve adults in the Netherlands. Data were collected from the Ease Travel Clinic hepatitis B vaccination database. The study population consisted of 22,997 adults who received three hepatitis B vaccinations. Seroprotection was attained in 97.3% individuals. When compared with PVST performed at 1-2 months (98.2%) after the final dose, lower seroprotection rates were observed with <1 (97.3%, p = 0.128), 3-6 (90.6%, p < 0.001), and ≥7 (88.4%, p < 0.001) months after vaccination. Among the subpopulation with a PVST 1-2 months, no statistically significant difference was observed for the various intervals between the first and second vaccination (<1, 1-2, 3-4, or ≥5 months). When compared with 4-5 months between the second and third vaccine dose, lower seroprotection rates were observed with <4 (odds ratio [OR]: 0.29, p = 0.020) and ≥12 (OR: 0.22, p < 0.001) months, although comparable rates were observed with 6-11 months interval (OR: 0.85, p = 0.262). Our data indicate that PVST should be obtained 1-2 months after the last vaccination and a delayed PVST was the major determinant of a lower seroprotection rate after primary three-dose hepatitis B vaccination schedule. Based on our data, the hepatitis B vaccination also leaves room for flexibility for the second dose and the third dose without the necessity of restarting the vaccination series or confirmation of the immune response to the vaccine

Female reproductive factors and the likelihood of reaching the age of 90 years. The Netherlands Cohort Study

Objectives The aim of this study was to prospectively assess the relationship between several reproductive factors in women and the likelihood of reaching the age of 90 years (achieving longevity). Study design For this study, data from the oldest birth cohort (1916-17) of the prospective Netherlands Cohort Study (NLCS) were used. These participants filled in a baseline questionnaire in 1986 (at age 68-70 years). Follow-up for vital status information until the age of 90 years (2006-07) was >99.9% complete. Main outcome measures Multivariable-adjusted Cox regression analyses with a fixed follow-up time were based on 2,697 women with complete exposure and co-variable data to calculate risk ratios (RR) of reaching age 90. Results No associations were observed between the likelihood of reaching the age of 90 years, and age at menarche, age at menopause, parity, menstrual lifespan, and oral contraceptive use after adjustment for potential confounders. A later age at first childbirth pointed towards a higher chance of achieving longevity (age ≥30 vs. 20-24; RR,1.17; 95%CI,0.98-1.39). Ever-use of hormone replacement therapy (HRT) was significantly associated with a higher chance of achieving longevity compared with never HRT-users, but only in women who had had an early menopause (<50 years)(RR,1.32; 95% CI, 1.07-1.61). Conclusion Age at first childbirth, and ever-use of HRT in women with an early menopause (<50 years) were associated with the likelihood of reaching the age of 90 years