Consultation with specialist palliative care services in palliative sedation: considerations of Dutch physicians.

PubMed

Koper, Ian; van der Heide, Agnes; Janssens, Rien; Swart, Siebe; Perez, Roberto; Rietjens, Judith

2014-01-01

Palliative sedation is considered a normal medical practice by the Royal Dutch Medical Association. Therefore, consultation of an expert is not considered mandatory. The European Association of Palliative Care (EAPC) framework for palliative sedation, however, is more stringent: it considers the use of palliative sedation without consulting an expert as injudicious and insists on input from a multi-professional palliative care team. This study investigates the considerations of Dutch physicians concerning consultation about palliative sedation with specialist palliative care services. Fifty-four physicians were interviewed on their most recent case of palliative sedation. Reasons to consult were a lack of expertise and the view that consultation was generally supportive. Reasons not to consult were sufficient expertise, the view that palliative sedation is a normal medical procedure, time pressure, fear of disagreement with the service and regarding consultation as having little added value. Arguments in favour of mandatory consultation were that many physicians lack expertise and that palliative sedation is an exceptional intervention. Arguments against mandatory consultation were practical obstacles that may preclude fulfilling such an obligation (i.e. lack of time), palliative sedation being a standard medical procedure, corroding a physician's responsibility and deterring physicians from applying palliative sedation. Consultation about palliative sedation with specialist palliative care services is regarded as supportive and helpful when physicians lack expertise. However, Dutch physicians have both practical and theoretical objections against mandatory consultation. Based on the findings in this study, there seems to be little support among Dutch physicians for the EAPC recommendations on obligatory consultation.

The transculturality of 'gut feelings'. Results from a French Delphi consensus survey.

PubMed

Le Reste, Jean-Yves; Coppens, Magali; Barais, Marie; Nabbe, Patrice; Le Floch, Bernard; Chiron, Benoît; Dinant, Geert Jan; Berkhout, Christophe; Stolper, Erik; Barraine, Pierre

2013-12-01

General Practitioners (GPs) sometimes base their clinical decisions on 'gut feelings.' Research into the significance of this phenomenon with focus groups and a Delphi consensus procedure in the Netherlands provided a concept of 'gut feelings:' a sense of alarm, a sense of reassurance and several determinants. The transculturality of 'gut feelings' has been examined briefly until now as the issue is complex. To determine whether a consensus on 'gut feelings' in general practice in France could be obtained. Using a similar Delphi consensus procedure and the same six initial statements as in the Netherlands, and compare the French results with the seven final Dutch consensual statements. Qualitative research, including a Delphi consensus procedure after a forward-backward translation (FBT) of the initial Dutch statements of 'gut feelings.' A heterogeneous sample of 34 French expert GPs participated. FBT of the final French statements was undertaken for a content comparison with the Dutch. After three Delphi rounds, French GPs reached agreement on nine statements. Many similarities have been found between the Dutch and the French defining statements, with reservations concerning the 'sense of reassurance,' which French GPs seemed to feel more cautious about. 'Gut feelings' are a well-defined concept in France too. The Dutch and the French consensual statements seem very close. The transculturality of the concept is confirmed, which is a new indicator that 'gut feelings' are a self-contained concept.

Does Media Use Result in More Active Communicators? Differences Between Native Dutch and Turkish-Dutch Patients in Information-Seeking Behavior and Participation During Consultations With General Practitioners.

PubMed

Schinkel, Sanne; Van Weert, Julia C M; Kester, Jorrit A M; Smit, Edith G; Schouten, Barbara C

2015-08-01

This study investigates differences between native Dutch and Turkish-Dutch patients with respect to media usage before and patient participation during medical consultations with general practitioners. In addition, the authors assessed the relation between patient participation and communication outcomes. The patients were recruited in the waiting rooms of general practitioners, and 191 patients (117 native Dutch, 74 Turkish-Dutch) completed pre- and postconsultation questionnaires. Of this sample, 120 patients (62.8%; 82 native Dutch, 38 Turkish-Dutch) agreed to have their consultations recorded to measure patient participation. Compared with Turkish-Dutch patients of similar educational levels, results showed that native Dutch patients used different media to search for information, participated to a greater extent during their consultations and were more responsive to their general practitioner. With respect to the Turkish-Dutch patients, media usage was related to increased patient participation, which was correlated with having fewer unfulfilled information needs; however, these relations were not found in the native Dutch patient sample. In conclusion, interventions that enhance participation among ethnic minority patients will better fulfill informational needs when such interventions stimulate information-seeking behavior in that group before a medical consultation.

[Unambiguous practice guidelines on urinary tract infections in primary and secondary care].

PubMed

van Asselt, Kristel M; Prins, Jan M; van der Weele, Gerda M; Knottnerus, Bart J; van Pinxteren, Bart; Geerlings, Suzanne E

2013-01-01

The Dutch College of General Practitioners (NHG) practice guideline 'Urinary tract infections' intended for primary health care and the Dutch Working Party on Antibiotic Policy (SWAB) practice guideline 'Antimicrobial therapy in complicated urinary tract infections' intended for specialists in secondary care, were reviewed together. - In the NHG guideline the differentiation between 'complicated' and 'uncomplicated' urinary tract infections has been replaced by categorisation into age, sex, risk group and the presence of fever, or invasion of tissues.- If urinary tract infection has been diagnosed, a dip slide test can be used to determine resistance.- The guidelines recommend the most narrow-spectrum antibiotic to reduce further increase in antimicrobial resistance.- A chapter about women with recurrent urinary tract infections has been added to the SWAB guideline. Amongst other things, the chapter provides information on the prescription of prophylactic lactobacillus in secondary care.

[Misleading advertisement on Opatanol].

PubMed

Timmermans, A E

2006-07-01

In an advertisement in this journal, Alcon Nederland BV has recommended Opatanol (olopatadin) as the 'first choice medication/NHG practice guideline for Red eye/Allergic conjunctivitis'. However, the practice guideline of the Dutch College of General Practitioners (NHG) mentions the following 3 antihistaminica as first choice for the treatment of red eye/allergic conjunctivitis: azelastin, levocabastin or olopatadin. Therefore, it is concluded that the Alcon advertisement is misleading.

Dutch translation and validation of the readiness for interprofessional learning scale (RIPLS) in a primary healthcare context.

PubMed

Pype, Peter; Deveugele, Myriam

2016-12-01

Interprofessional education and collaborative practice are gradually gaining importance in the context of growing healthcare complexity. The readiness for interprofessional learning scale (RIPLS) is a well-known scale that can identify attitudinal barriers and variance across professions, which may affect educational interventions. This study aims to translate the English RIPLS into Dutch and to test its reliability and validity. The scale was translated and back-translated by two pairs of people independently and tested for feasibility and comprehensibility. The translated scale was used with 219 general practitioners, 238 community nurses, and 53 palliative home-care nurses. Exploratory factor analysis was used to assess construct validity. Confirmatory factor analysis was done to generate a fit model. Cronbach's alpha was computed to evaluate internal consistency. Regression analysis was used to evaluate the effect of the RIPLS score on the level of learning through collaboration and to gauge the influence of the participants' gender, age, previous palliative care education, type of practice and years in practice. Confirmatory and exploratory factor analysis confirms the factor structure of the original version. The Dutch version shows good reliability (overall Cronbach's alpha: 0.88; intraclass correlation coefficient after test-retest: 0.718 (95%CI: 0.499-0.852). The RIPLS score correlates with the amount of workplace learning during collaboration (discriminant validity: P < 0.001). The Dutch translation of the RIPLS is now ready for comparative studies.

Diagnosing dementia in Dutch general practice: a qualitative study of GPs’ practices and views

PubMed Central

Prins, Agnes; Hemke, Feia; Pols, Jeannette; van Charante, Eric P Moll

2016-01-01

Background GPs play an important role in recognising the symptoms of dementia; however, little is known about how they perceive their actual and future role in diagnosing dementia. Aim To explore Dutch GPs’ perceptions of their current position in diagnosing dementia, their reasons for referral to secondary care, and views on the future diagnostic role of GPs. Design and setting A qualitative study among Dutch GPs. Method Eighteen GPs participated in a semi-structured interview that ranged from 20 to 60 minutes. Interviews were transcribed verbatim and thematic analysis was performed. Results GPs reported that their role in the diagnostic phase of identifying people with suspected dementia is limited to recognising cognitive problems and deciding whether a patient needs to be referred for further investigation, or whether care could be organised without specialist diagnosis. GPs indicated that they were likely to refer patients if patients/caregivers or dementia case managers requested it, or if they thought it could have consequences for treatment. Typically, GPs do not see the need for referral when their patients are very old and declining slowly. GPs would welcome a more prominent role in diagnosing dementia in their own practice. Conclusion Diagnosing dementia involves a complex balance between patient and carer preferences, the consequences for treatment and care, and the burden of referral. Dutch GPs favour a stronger involvement in diagnosing dementia provided that both resources and diagnostic algorithms are improved. PMID:27114209

Requests for euthanasia in general practice before and after implementation of the Dutch Euthanasia Act.

PubMed

van Alphen, Jojanneke E; Donker, Gé A; Marquet, Richard L

2010-04-01

The Netherlands was the first country in the world to implement a Euthanasia Act in 2002. It is unknown whether legalizing euthanasia under strict conditions influences the number and nature of euthanasia requests. To investigate changes in the number of, and reasons for, requests for euthanasia in Dutch general practice after implementation of the Euthanasia Act. Retrospective dynamic cohort study comparing 5 years before (1998-2002) and 5 years after (2003-2007) implementation of the Act. Standardised registration forms were used to collect data on requests for euthanasia via the Dutch Sentinel Practice Network. This network of 45 general practices is nationally representative by age, sex, geographic distribution, and population density. The mean annual incidence of requests before implementation amounted to 3.1/10,000 and thereafter to 2.8/10,000 patients. However, trends differed by sex. The number of requests by males decreased significantly from 3.7/10,000 to 2.6/10,000 (P = 0.008); the requests by females increased non-significantly from 2.6/10,000 to 3.1/10,000. Before and after implementation, cancer remained the major underlying disease for requesting euthanasia: 82% versus 77% for men; 73% versus 75% for females. Pain was a major reason for a request, increasing in the period before implementation (mean 27%), but declining in the period thereafter (mean 22%). Loss of dignity became a less important reason after implementation (from 18% to 10%, P = 0.04), predominantly due to a marked decrease in the number of females citing it as a reason (from 17% to 6%, P = 0.02). There was no increase in demand for euthanasia after implementation of the Euthanasia Act. Pain as a reason for requesting euthanasia showed an increasing trend before implementation, but declined thereafter. Loss of dignity as a reason declined, especially in females.

Requests for euthanasia in general practice before and after implementation of the Dutch Euthanasia Act

PubMed Central

van Alphen, Jojanneke E; Donker, Gé A; Marquet, Richard L

2010-01-01

Background The Netherlands was the first country in the world to implement a Euthanasia Act in 2002. It is unknown whether legalising euthanasia under strict conditions influences the number and nature of euthanasia requests. Aim To investigate changes in the number of, and reasons for, requests for euthanasia in Dutch general practice after implementation of the Euthanasia Act. Design of study Retrospective dynamic cohort study comparing 5 years before (1998–2002) and 5 years after (2003–2007) implementation of the Act. Method Standardised registration forms were used to collect data on requests for euthanasia via the Dutch Sentinel Practice Network. This network of 45 general practices is nationally representative by age, sex, geographic distribution, and population density. Results The mean annual incidence of requests before implementation amounted to 3.1/10 000 and thereafter to 2.8/10 000 patients. However, trends differed by sex. The number of requests by males decreased significantly from 3.7/10 000 to 2.6/10 000 (P = 0.008); the requests by females increased non-significantly from 2.6/10 000 to 3.1/10 000. Before and after implementation, cancer remained the major underlying disease for requesting euthanasia: 82% versus 77% for men; 73% versus 75% for females. Pain was a major reason for a request, increasing in the period before implementation (mean 27%), but declining in the period thereafter (mean 22%). Loss of dignity became a less important reason after implementation (from 18% to 10%, P = 0.04), predominantly due to a marked decrease in the number of females citing it as a reason (from 17% to 6%, P = 0.02). Conclusion There was no increase in demand for euthanasia after implementation of the Euthanasia Act. Pain as a reason for requesting euthanasia showed an increasing trend before implementation, but declined thereafter. Loss of dignity as a reason declined, especially in females. PMID:20353671

Factors influencing Dutch practice nurses' intention to adopt a new smoking cessation intervention.

PubMed

Leitlein, Lisa; Smit, Eline Suzanne; de Vries, Hein; Hoving, Ciska

2012-10-01

This article is a report of a study that aimed to identify factors influencing practice nurses' and nurse practitioners' intention to adopt a new smoking cessation intervention. Although effective smoking cessation interventions exist and practice nurses can offer a considerable resource in advertising patients to quit smoking, due to several reasons the majority of practice nurses do not implement these interventions. A cross-sectional study was undertaken among Dutch practice nurses and nurse practitioners working in general practices (n = 139) using electronic questionnaires. Data were collected from January until March in 2009. T-tests were used to compare adopters with non-adopters about their predisposing and motivational factors. Logistic regression analyses were conducted to assess the variation in intention explained by these factors. The majority of practice nurses did not intend to adopt the new intervention (n = 85; 61.2%). More practice nurses than nurse practitioners intended to adopt the intervention. Attitude and perceived social norms were found to be positively correlated with the intention to adopt the intervention whereas satisfaction with current smoking cessation activities was found to be negatively correlated. Important associations were found between profession, attitude, social norms and satisfaction, and the intention to adopt the new smoking cessation intervention. Practice nurses who do not intend to adopt need to be persuaded of the advantages of adopting. Perceived social norms need to be restructured and before presenting the intervention to a general practice current smoking cessation activities should be determined to increase the intervention's compatibility with these current practices. © 2011 Blackwell Publishing Ltd.

Social Workers' Orientation toward the Evidence-Based Practice Process: A Dutch Survey

ERIC Educational Resources Information Center

van der Zwet, Renske J. M.; Kolmer, Deirdre M. Beneken genaamd; Schalk, René

2016-01-01

Objectives: This study assesses social workers' orientation toward the evidence-based practice (EBP) process and explores which specific variables (e.g. age) are associated. Methods: Data were collected from 341 Dutch social workers through an online survey which included a Dutch translation of the EBP Process Assessment Scale (EBPPAS), along with…

Practice variation in the Dutch long-term care and the role of supply-sensitive care: Is access to the Dutch long-term care equitable?

PubMed

Duell, Daisy; Koolman, Xander; Portrait, France

2017-12-01

Universal access and generous coverage are important goals of the Dutch long-term care (LTC) system. It is a legal requirement that everyone eligible for LTC should be able to receive it. Institutional care (IC) made up for 90% of Dutch LTC spending. To investigate whether access to IC is as equitable as the Dutch government aspires, we explored practice variation in entitlements to IC across Dutch regions. We used a unique dataset that included all individual applications for Dutch LTC in January 2010-December 2013 (N = 3,373,358). This dataset enabled an accurate identification of the need for care. We examined the local variation in the probability of being granted long-term IC and in the intensity of the care granted given that individuals have applied for LTC. We also investigated whether the variation observed was related to differences in the local availability of care facilities. Although our analyses indicated the presence of some practice variation, its magnitude was very small by national and international standards (up to 3%). Only a minor part of the practice variation could be accounted for by local supply differences in care facilities. Overall, we conclude that, unlike many other developed countries, the Dutch system ensured equitable access to long-term IC. © 2017 The Authors. Health Economics Published by John Wiley & Sons Ltd.

Death by request in The Netherlands: facts, the legal context and effects on physicians, patients and families

PubMed Central

2010-01-01

In this article I intend to describe an issue of the Dutch euthanasia practice that is not common knowledge. After some general introductory descriptions, by way of formulating a frame of reference, I shall describe the effects of this practice on patients, physicians and families, followed by a more philosophical reflection on the significance of these effects for the assessment of the authenticity of a request and the nature of unbearable suffering, two key concepts in the procedure towards euthanasia or physician-assisted suicide. This article does not focus on the arguments for or against euthanasia and the ethical justification of physician-assisted dying. These arguments have been described extensively in Kimsma and Van Leeuwen (Asking to die. Inside the Dutch debate about euthanasia, Kluwer Academic Publishers, Dordrecht, 1998). PMID:20668949

Death by request in The Netherlands: facts, the legal context and effects on physicians, patients and families.

PubMed

Kimsma, G K

2010-11-01

In this article I intend to describe an issue of the Dutch euthanasia practice that is not common knowledge. After some general introductory descriptions, by way of formulating a frame of reference, I shall describe the effects of this practice on patients, physicians and families, followed by a more philosophical reflection on the significance of these effects for the assessment of the authenticity of a request and the nature of unbearable suffering, two key concepts in the procedure towards euthanasia or physician-assisted suicide. This article does not focus on the arguments for or against euthanasia and the ethical justification of physician-assisted dying. These arguments have been described extensively in Kimsma and Van Leeuwen (Asking to die. Inside the Dutch debate about euthanasia, Kluwer Academic Publishers, Dordrecht, 1998).

Prevalence of Psychotropic Medication Use Among Dutch Military Personnel Between 2003 and 2012 and Its Comparison to the Dutch General Population.

PubMed

Janssen, Debbie G A; Vermetten, Eric; Egberts, Toine C G; Heerdink, Eibert R

2017-01-01

The armed forces work under high pressure and in stressful environments and it is well known that being in the military is a risk factor for psychiatric problems. However, it remains unknown how prevalent psychotropic medication use is in military personnel. To assess prevalence of psychotropic medication use in Dutch military personnel and compare to the Dutch general population. Data were obtained from the military pharmacy. From 2003 to 2012, the year-prevalence of psychotropic medication use was calculated from the number of distributed psychotropic medications and the number of Dutch military personnel. For the year 2011, the year-prevalence of psychotropic medication use in the military was compared to that of the Dutch general population. The year-prevalence of psychotropic medication use increased by 55%, from 1.64% in 2003 to 2.54% in 2012 in Dutch military personnel. An increase is seen in the number of users of psychotropic medication. Also the use of antidepressants and attention deficit hyperactivity disorder medication increased. Over the last decade, there has been a 1.5-fold increase in psychotropic medication dispensed to Dutch military personnel. However, Dutch military personnel were significantly less likely to use psychotropic medications compared to the Dutch general population. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

Determining clinical practice of expert physiotherapy for patients undergoing lumbar spinal fusion: a cross-sectional survey study.

PubMed

Janssen, Esther R C; Scheijen, Elle E M; van Meeteren, Nico L U; de Bie, Rob A; Lenssen, Anton F; Willems, Paul C; Hoogeboom, Thomas J

2016-05-01

To determine the content of current Dutch expert hospital physiotherapy practice for patients undergoing lumbar spinal fusion (LSF), to gain insight into expert-based clinical practice. At each hospital where LSF is performed, one expert physiotherapist received an e-mailed questionnaire, about pre- and postoperative physiotherapy and discharge after LSF. The level of uniformity in goals and interventions was graded on a scale from no uniformity (50-60 %) to very strong uniformity (91-100 %). LSF was performed at 34 of the 67 contacted hospitals. From those 34 hospitals, 28 (82 %) expert physiotherapists completed the survey. Twenty-one percent of the respondents saw patients preoperatively, generally to provide information. Stated postoperative goals and administered interventions focused mainly on performing transfers safely and keeping the patient informed. Outcome measures were scarcely used. There was no uniformity regarding advice on the activities of daily living. Dutch perioperative expert physiotherapy for patients undergoing LSF is variable and lacks structural outcome assessment. Studies evaluating the effectiveness of best-practice physiotherapy are warranted.

Implementation of integrated care for diabetes mellitus type 2 by two Dutch care groups: a case study.

PubMed

Busetto, Loraine; Luijkx, Katrien; Huizing, Anna; Vrijhoef, Bert

2015-08-21

Even though previous research has demonstrated improved outcomes of integrated care initiatives, it is not clear why and when integrated care works. This study aims to contribute to filling this knowledge gap by examining the implementation of integrated care for type 2 diabetes by two Dutch care groups. An embedded single case study was conducted including 26 interviews with management staff, care purchasers and health professionals. The Context + Mechanism = Outcome Model was used to study the relationship between context factors, mechanisms and outcomes. Dutch integrated care involves care groups, bundled payments, patient involvement, health professional cooperation and task substitution, evidence-based care protocols and a shared clinical information system. Community involvement is not (yet) part of Dutch integrated care. Barriers to the implementation of integrated care included insufficient integration between the patient databases, decreased earnings for some health professionals, patients' insufficient medical and policy-making expertise, resistance by general practitioner assistants due to perceived competition, too much care provided by practice nurses instead of general practitioners and the funding system incentivising the provision of care exactly as described in the care protocols. Facilitators included performance monitoring via the care chain information system, increased earnings for some health professionals, increased focus on self-management, innovators in primary and secondary care, diabetes nurses acting as integrators and financial incentives for guideline adherence. Economic and political context and health IT-related barriers were discussed as the most problematic areas of integrated care implementation. The implementation of integrated care led to improved communication and cooperation but also to insufficient and unnecessary care provision and deteriorated preconditions for person-centred care. Dutch integrated diabetes care is still a work in progress, in the academic and the practice setting. This makes it difficult to establish whether overall quality of care has improved. Future efforts should focus on areas that this study found to be problematic or to not have received enough attention yet. Increased efforts are needed to improve the interoperability of the patient databases and to keep the negative consequences of the bundled payment system in check. Moreover, patient and community involvement should be incorporated.

Process evaluation of a randomised controlled trial of a diabetes prevention intervention in Dutch primary health care: the SLIMMER study.

PubMed

van Dongen, Ellen Ji; Duijzer, Geerke; Jansen, Sophia C; Ter Beek, Josien; Huijg, Johanna M; Leerlooijer, Joanne N; Hiddink, Gerrit J; Feskens, Edith Jm; Haveman-Nies, Annemien

2016-11-01

To investigate (i) how the SLIMMER intervention was delivered and received in Dutch primary health care and (ii) how this could explain intervention effectiveness. A randomised controlled trial was conducted and subjects were randomly allocated to the intervention (10-month combined dietary and physical activity intervention) or the control group. A process evaluation including quantitative and qualitative methods was conducted. Data on process indicators (recruitment, reach, dose received, acceptability, implementation integrity and applicability) were collected via semi-structured interviews with health-care professionals (n 45) and intervention participant questionnaires (n 155). SLIMMER was implemented in Dutch primary health care in twenty-five general practices, eleven dietitians, nine physiotherapist practices and fifteen sports clubs. Subjects at increased risk of developing type 2 diabetes were included. It was possible to recruit the intended high-risk population (response rate 54 %) and the SLIMMER intervention was very well received by both participants and health-care professionals (mean acceptability rating of 82 and 80, respectively). The intervention programme was to a large extent implemented as planned and was applicable in Dutch primary health care. Higher dose received and participant acceptability were related to improved health outcomes and dietary behaviour, but not to physical activity behaviour. The present study showed that it is feasible to implement a diabetes prevention intervention in Dutch primary health care. Higher dose received and participant acceptability were associated with improved health outcomes and dietary behaviour. Using an extensive process evaluation plan to gain insight into how an intervention is delivered and received is a valuable way of identifying intervention components that contribute to implementation integrity and effective prevention of type 2 diabetes in primary health care.

[E-health within the Dutch mental health services: what is the current situation?].

PubMed

Smeets, Odile; Martin Abello, Katherina; Zijlstra-Vlasveld, Moniek; Boon, Brigitte

2014-01-01

The 'e-mental health' currently available, which also covers m-health and i-health, varies from psycho-education and self-tests to self-help, treatment and contact with fellow sufferers. Many programs are based on cognitive behavioural therapy, but other types of therapy are also used. Research shows that online programs for depression, alcohol problems and anxiety can reduce these symptoms and can be cost effective. This applies to both self-help and treatment programs. Many e-programs in the Netherlands have been developed for the Dutch Association of Mental Health and Addiction Care (GGZ) and for treatment of addiction problems. One problem with e-mental-health is that provision is fragmented, and there is no national overview, while insight into quality is important for patients and professionals. The quality hallmark 'Onlinehulpstempel.nl' ('Online help hallmark') provides this insight. The use of e-mental-health within Dutch healthcare services is still in its infancy. New financing methods are stimulating general practitioners to use it. The consolidation of online and face-to-face care ('blended e-health') provides an opportunity for patients and GGZ support personnel within general practice to start to use e-health.

The incidences of and consultation rate for lower extremity complaints in general practice

PubMed Central

van der Waal, J M; Bot, S D M; Terwee, C B; van der Windt, D A W M; Schellevis, F G; Bouter, L M; Dekker, J

2006-01-01

Objective To estimate the incidence and consultation rate of lower extremity complaints in general practice. Methods Data were obtained from the Second Dutch National Survey of General Practice, in which 195 general practitioners (GPs) in 104 practices recorded all contacts with patients during 12 consecutive months in computerised patient records. GPs classified the symptoms and diagnosis for each patient at each consultation according to the International Classification of Primary Care (ICPC). Incidence densities and consultation rates for different complaints were calculated. Results During the registration period 63.2 GP consultations per 1000 person‐years were attributable to a new complaint of the lower extremities. Highest incidence densities were seen for knee complaints: 21.4 per 1000 person‐years for women and 22.8 per 1000 person‐years for men. The incidence of most lower extremity complaints was higher for women than for men and higher in older age. Conclusions Both incidences of and consultation rates for lower extremity complaints are substantial in general practice. This implies a considerable impact on the workload of the GP. PMID:16269430

Internet and social media for health-related information and communication in health care: preferences of the Dutch general population.

PubMed

Van de Belt, Tom H; Engelen, Lucien J L P G; Berben, Sivera A A; Teerenstra, Steven; Samsom, Melvin; Schoonhoven, Lisette

2013-10-02

Health care is increasingly featured by the use of Web 2.0 communication and collaborative technologies that are reshaping the way patients and professionals interact. These technologies or tools can be used for a variety of purposes: to instantly debate issues, discover news, analyze research, network with peers, crowd-source information, seek support, and provide advice. Not all tools are implemented successfully; in many cases, the nonusage attrition rates are high. Little is known about the preferences of the Dutch general population regarding the use of the Internet and social media in health care. To determine the preferences of the general population in the Netherlands regarding the use of the Internet and social media in health care. A cross-sectional survey was disseminated via a popular Dutch online social network. Respondents were asked where they searched for health-related information, how they qualified the value of different sources, and their preferences regarding online communication with health care providers. Results were weighed for the Dutch population based on gender, age, and level of education using official statistics. Numbers and percentages or means and standard deviations were presented for different subgroups. One-way ANOVA was used to test for statistical differences. The survey was completed by 635 respondents. The Internet was found to be the number one source for health-related information (82.7%), closely followed by information provided by health care professionals (71.1%). Approximately one-third (32.3%) of the Dutch population search for ratings of health care providers. The most popular information topics were side effects of medication (62.5%) and symptoms (59.7%). Approximately one-quarter of the Dutch population prefer to communicate with a health care provider via social media (25.4%), and 21.2% would like to communicate via a webcam. The Internet is the main source of health-related information for the Dutch population. One in 4 persons wants to communicate with their physician via social media channels and it is expected that this number will further increase. Health care providers should explore new ways of communicating online and should facilitate ways for patients to connect with them. Future research should aim at comparing different patient groups and diseases, describing best practices, and determining cost-effectiveness.

Internet and Social Media For Health-Related Information and Communication in Health Care: Preferences of the Dutch General Population

PubMed Central

Engelen, Lucien JLPG; Berben, Sivera AA; Teerenstra, Steven; Samsom, Melvin; Schoonhoven, Lisette

2013-01-01

Background Health care is increasingly featured by the use of Web 2.0 communication and collaborative technologies that are reshaping the way patients and professionals interact. These technologies or tools can be used for a variety of purposes: to instantly debate issues, discover news, analyze research, network with peers, crowd-source information, seek support, and provide advice. Not all tools are implemented successfully; in many cases, the nonusage attrition rates are high. Little is known about the preferences of the Dutch general population regarding the use of the Internet and social media in health care. Objective To determine the preferences of the general population in the Netherlands regarding the use of the Internet and social media in health care. Methods A cross-sectional survey was disseminated via a popular Dutch online social network. Respondents were asked where they searched for health-related information, how they qualified the value of different sources, and their preferences regarding online communication with health care providers. Results were weighed for the Dutch population based on gender, age, and level of education using official statistics. Numbers and percentages or means and standard deviations were presented for different subgroups. One-way ANOVA was used to test for statistical differences. Results The survey was completed by 635 respondents. The Internet was found to be the number one source for health-related information (82.7%), closely followed by information provided by health care professionals (71.1%). Approximately one-third (32.3%) of the Dutch population search for ratings of health care providers. The most popular information topics were side effects of medication (62.5%) and symptoms (59.7%). Approximately one-quarter of the Dutch population prefer to communicate with a health care provider via social media (25.4%), and 21.2% would like to communicate via a webcam. Conclusions The Internet is the main source of health-related information for the Dutch population. One in 4 persons wants to communicate with their physician via social media channels and it is expected that this number will further increase. Health care providers should explore new ways of communicating online and should facilitate ways for patients to connect with them. Future research should aim at comparing different patient groups and diseases, describing best practices, and determining cost-effectiveness. PMID:24088272

Incidence rates and management of urinary tract infections among children in Dutch general practice: results from a nation-wide registration study

PubMed Central

Kwok, Wing-Yee; de Kwaadsteniet, Marjolein CE; Harmsen, Mirjam; van Suijlekom-Smit, Lisette WA; Schellevis, François G; van der Wouden, Johannes C

2006-01-01

Background We aimed to investigate incidence rates of urinary tract infections in Dutch general practice and their association with gender, season and urbanisation level, and to analyse prescription and referral in case of urinary tract infections. Method During one calendar year, 195 general practitioners in 104 practices in the Netherlands registered all their patient contacts. This study was performed by the Netherlands Institute for Health Services Research (NIVEL) in 2001. Of 82,053 children aged 0 to 18 years, the following variables were collected: number of episodes per patient, number of contacts per episode, month of the year in which the diagnosis of urinary tract infection was made, age, gender, urbanisation level, drug prescription and referral. Results The overall incidence rate was 19 episodes per 1000 person years. The incidence rate in girls was 8 times as high as in boys. The incidence rate in smaller cities and rural areas was 2 times as high as in the three largest cities. Throughout the year, incidence rates varied with a decrease in summertime for children at the age of 0 to 12 years. Of the prescriptions, 66% were in accordance with current guidelines, but only 18% of the children who had an indication were actually referred. Conclusion This study shows that incidence rates of urinary tract infections are not only related to gender and season, but also to urbanisation. General practitioners in the Netherlands frequently do not follow the clinical guidelines for urinary tract infections, especially with respect to referral. PMID:16584577

Communication patterns of primary care physicians in the United States and the Netherlands.

PubMed

Bensing, Jozien M; Roter, Debra L; Hulsman, Robert L

2003-05-01

While international comparisons of medical practice have noted differences in length of visit, few studies have addressed the dynamics of visit exchange. To compare the communication of Dutch and U.S. hypertensive patients and their physicians in routine medical visits. Secondary analysis of visit audio/video tapes contrasting a Dutch sample of 102 visits with 27 general practitioners and a U.S. sample of 98 visits with 52 primary care physicians. The Roter Interaction Analysis System applied to visit audiotapes. Total visit length and duration of the physical exam were measured directly. U.S. visits were 6 minutes longer than comparable Dutch visits (15.4 vs 9.5 min, respectively), but the proportion of visits devoted to the physical examination was the same (24%). American doctors asked more questions and provided more information of both a biomedical and psychosocial nature, but were less patient-centered in their visit communication than were Dutch physicians. Cluster analysis revealed similar proportions of exam-centered (with especially long physical exam segments) and biopsychosocial visits in the 2 countries; however, 48% of the U.S. visits were biomedically intensive, while only 18% of the Dutch visits were of this type. Fifty percent of the Dutch visits were socioemotional, while this was true for only 10% of the U.S. visits. U.S. and Dutch primary care visits showed substantial differences in communication patterns and visit length. These differences may reflect country distinctions in medical training and philosophy, health care system characteristics, and cultural values and expectations relevant to the delivery and receipt of medical services.

Variation in formulary adherence in general practice over time (2003-2007).

PubMed

van Dijk, Liset; de Jong, Judith D; Westert, Gert P; de Bakker, Dinny H

2011-12-01

To study trends and variation in adherence to the main national formulary for the 20 most prevalent health problems in Dutch general practice over a 5-year period (2003-07). Routine electronic medical records from a pool of 115 representative general practices were linked to the main national formulary. Analyses included over 2 million prescriptions for 246 391 patients. The outcome variable was whether or not the prescribed medication was congruent with recommendations in the national formulary. Trends and variation were analysed using three-level multilevel logistic regression analyses (general practice, patient, and prescription). The percentage of formulary adherent prescriptions for the 20 most prevalent health problems was 73-76% between 2003 and 2007. The percentage varied considerably between guidelines. Lowest adherence rates were found for acute bronchitis and acute upper respiratory infection. Interpractice variation was constant over time. General practice information networks are useful for monitoring general patterns of formulary on a year-to-year basis. Formulary adherence is stable over time but varies across diagnoses, patients and general practices. In the past decade, efforts have been made to increase the level of formulary adherent prescribing. These general efforts managed to stabilize (variation in) adherence in a field where many other initiatives (e.g. by pharmaceutical companies) are undertaken to influence prescribing behaviour.

Importance of quality aspects of GP care among ethnic minorities: role of cultural attitudes, language and healthcare system of reference.

PubMed

Lamkaddem, Majda; Spreeuwenberg, Peter M; Devillé, Walter L; Foets, Marleen M; Groenewegen, Peter P

2012-02-01

This study examines the mechanisms responsible for ethnic differences in perceived quality of care in The Netherlands. The specific role of cultural attitudes, language proficiency, and the health system in the country of origin was examined, taking socio-demographic characteristics into account. Interview data of 1339 respondents of Moroccan, Turkish, Surinamese and Antillean origin were combined with interview data of Dutch respondents (n = 405) and of Western immigrants (n = 102) in The Netherlands and of a random sample of Dutch privately or publicly insured persons (n = 9675). Data collection took place within the Second Dutch National Survey of General Practice (DNSGP-2, 2001). Items from the QUality Of care Through the patient's Eyes (QUOTE) questionnaire were used to measure expectations, as well as items from the QUOTE-Mi (adapted version for migrant groups). Items on normative orientations were used to measure cultural attitudes. In contrast to our hypothesis, respondents with more egalitarian/modern attitudes attached less importance to quality aspects related to access and quality. Tests on the role of the health system of reference were generally conclusive, showing that respondents accustomed to (parts of) another system have different expectations regarding several aspects of general practitioner healthcare quality, e.g. access to specialist care. Besides socio-demographic characteristics, culture influences patients' expectations regarding general practitioner care quality. However, the role of culture can be more clearly ascribed to the characteristics of the health system which is held as the reference than to the general attitudes on normative orientations.

Primary care and public health a natural alliance? The introduction of the guidelines for obesity and undernutrition of the Dutch College of General Practitioners.

PubMed

van Avendonk, Mariëlle J P; Mensink, Paul A J S; Drenthen, A J M Ton; van Binsbergen, Jaap J

2012-04-01

The prevalence of obesity and overweight is increasing globally and forms a huge public health problem. On the other hand, the prevalence of malnutrition or undernutrition is substantial, especially in nursing homes or in the elderly at home. Primary care and public health are separate disciplines. But in the field of nutrition and other lifestyle-related interventions, there are many direct and indirect interfaces for over- as well as undernutrition. The Dutch College of General Practitioners (NHG) published the Practice Guideline Obesity in adults and children to lead GPs in this process and to bridge the gap with public health. The same applies for the recently published National Primary Care Cooperation Agreement Undernutrition on the collaboration of primary care workers to enhance awareness and early intervention in case of nutritional impairment. This article goes into the background as well as the content of these two NHG products and the implications for daily practice. An attempt is made to connect primary care and public health in this matter. Particularly in the case of obesity, a close relationship with public health is of vital importance.

Pressure during decision making of continuous sedation in end-of-life situations in Dutch general practice

PubMed Central

2012-01-01

Background Little is known about pressure from patients or relatives on physician’s decision making of continuous palliative sedation. We aim to describe experienced pressure by general practitioners (GPs) in cases of continuous sedation after the introduction of the Dutch practice guideline, using a questionnaire survey. Methods A sample of 918 Dutch GPs were invited to fill out a questionnaire about their last patient under continuous sedation. Cases in which GPs experienced pressure from the patient, relatives or other persons were compared to those without pressure. Results 399 of 918 invite GPs (43%) returned the questionnaire and 250 provided detailed information about their most recent case of continuous sedation. Forty-one GPs (16%) indicated to have experienced pressure from the patient, relatives or colleagues. In GPs younger than 50, guideline knowledge was not related to experienced pressure, whereas in older GPs, 15% with and 36% without guideline knowledge reported pressure. GPs experienced pressure more often when patients had psychological symptoms (compared to physical symptoms only) and when patients had a longer estimated life expectancy. A euthanasia request of the patient coincided with a higher prevalence of pressure for GPs without, but not for GPs with previous experience with euthanasia. GPs who experienced pressure had consulted a palliative consultation team more often than GPs who did not experience pressure. Conclusion One in six GPs felt pressure from patients or relatives to start sedation. This pressure was related to guideline knowledge, especially in older GPs, longer life expectancy and the presence of a euthanasia request, especially for GPs without previous experience of euthanasia. PMID:22759834

Comparability of the age and sex distribution of the UK Clinical Practice Research Datalink and the total Dutch population.

PubMed

de Jong, Roy G P J; Gallagher, Arlene M; Herrett, Emily; Masclee, Ad A M; Janssen-Heijnen, Maryska L G; de Vries, Frank

2016-12-01

The UK Clinical Practice Research Datalink (CPRD) is increasingly being used by Dutch researchers in epidemiology and pharmacoepidemiology. It is however unclear if the UK CPRD is representative of the Dutch population and whether study results would apply to the Dutch population. Therefore, as first step, our objective was to compare the age and sex distribution of the CPRD with the total Dutch population. As a measure of representativeness, the age and sex distribution of the UK CPRD were visually and numerically compared with Dutch census data from the StatLine database of the Dutch National Bureau of Statistics in 2011. The age distribution of men and women in the CPRD population was comparable to the Dutch male and female population. Differences of more than 10% only occurred in older age categories (75+ in men and 80+ in women). Results from observational studies that have used CPRD data are applicable to the Dutch population, and a useful resource for decision making in the Netherlands. Nevertheless, differences in drug exposure likelihood between countries should be kept in mind, as these could still cause variations in the actual population studied, thereby decreasing its generalizability. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

The Dutch National Atlas of Public Health.

PubMed

Zwakhals, S L N; Giesbers, H; Mac Gillavry, E; van Boven, P F; van der Veen, A A

2004-09-01

The Dutch National Atlas of Public Health (http://www.zorgatlas.nl) maps the regional distribution of demand and usage of health care, public health status and influencing factors. The Atlas provides answers to locational questions, e. g. 'Where are the highest mortality rates?', 'Where are the longest waiting lists?' and 'Where are hospitals located?' Maps play a pivotal role in the Atlas. Texts, graphics and diagrams support the interpretation of the maps. The information in the Atlas specifically targets policy makers at the Ministry of Health, Welfare and Sport. For them, the Atlas is a tool for problem detection, policy making and policy evaluation. The Atlas is also aimed at all professionals in health care. In practice, also the general public appears to access and use the Atlas. The Atlas is part of the Dutch Public Health Status and Forecasts (PHSF). The PHSF is made by the National Institute of Public Health and the Environment mandated by the Ministry of Health, Welfare and Sport.

Sports participation in adults with congenital heart disease.

PubMed

Opić, Petra; Utens, Elisabeth M W J; Cuypers, Judith A A E; Witsenburg, Maarten; van den Bosch, Annemien; van Domburg, Ron; Bogers, Ad J J C; Boersma, Eric; Pelliccia, Antonio; Roos-Hesselink, Jolien W

2015-01-01

It is unclear whether sports participation in adults with repaired congenital heart disease is safe and has benefits. Congenital heart disease (ConHD) patients who underwent corrective surgery for Atrial Septal Defect, Ventricular Septal Defect, Pulmonary Stenosis, Tetralogy of Fallot or Transposition of the Great Arteries in our center between 1968 and 1980 were included, and participated in our longitudinal follow-up study with serial evaluations in 2001 and 2011. At both time points patients filled in questionnaires on sports participation, subjective physical functioning and quality of life. Exercise testing, echocardiogram and 24-hour continuous ambulatory ECG-monitoring were performed in both 2001 and 2011. All clinical events (re-intervention, arrhythmia, heart failure) were prospectively recorded. No relationship was found between practicing sports and the occurrence of sudden death, PVCs or SVTs. Patients with moderate/complex forms of ConHD practiced fewer hours of sports compared with the general Dutch normative population. Patients with both simple and moderate/complex ConHD who practiced sports showed a higher exercise capacity. More favorable subjective physical functioning was found for moderate/complex patients who practiced sports. Adults with repaired ConHD are less often involved in sports than the Dutch general population. The patients that were engaged in sports show a higher exercise capacity than those who did not. Sports participation in patients with ConHD was not associated with an increased incidence of adverse cardiac events. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Opinions of health care professionals and the public after eight years of euthanasia legislation in the Netherlands: a mixed methods approach.

PubMed

Kouwenhoven, Pauline S C; Raijmakers, Natasja J H; van Delden, Johannes J M; Rietjens, Judith A C; Schermer, Maartje H N; van Thiel, Ghislaine J M W; Trappenburg, Margo J; van de Vathorst, Suzanne; van der Vegt, Bea J; Vezzoni, Cristiano; Weyers, Heleen; van Tol, Donald G; van der Heide, Agnes

2013-03-01

The practice of euthanasia and physician-assisted suicide (PAS) in the Netherlands has been regulated since 2002 by the Euthanasia Act. In the ongoing debate about the interpretation of this Act, comparative information about the opinions of the different stakeholders is needed. To evaluate the opinions of Dutch physicians, nurses and the general public on the legal requirements for euthanasia and PAS. A cross-sectional survey among Dutch physicians and nurses in primary and secondary care and members of the Dutch general public, followed by qualitative interviews among selected respondents. The participants were: 793 physicians, 1243 nurses and 1960 members of the general public who completed the questionnaire; 83 were interviewed. Most respondents agreed with the requirement of a patient request (64-88%) and the absence of a requirement concerning life expectancy (48-71%). PAS was thought acceptable by 24-39% of respondents for patients requesting it because of mental suffering due to loss of control, chronic depression or early dementia. In the case of severe dementia, one third of physicians, 58% of nurses and 77% of the general public agreed with performing euthanasia based on an advance directive. Interviewees illustrated these findings and supported the Act. Health care professionals and the general public mostly support the legal requirements for euthanasia and PAS. The law permits euthanasia or PAS for mental suffering but this possibility is not widely endorsed. The general public is more liberal towards euthanasia for advanced dementia than health care professionals. We conclude that there is ample support for the law after eight years of legal euthanasia.

Conditions for research in general practice. Can the Dutch and British experiences be applied to other countries, for example Spain?

PubMed

van der Zee, Jouke; Kroneman, Madelon; Bolíbar, Bonaventura

2003-06-01

The aim of this study is to identify conditions for research as part of professional development in general practice. Based on the work of Andrew Abbott, who studied the dynamics of professional development, five conditions were identified. These are: the creation of associations among professionals; control of work; the establishment of specialised education; the development of professional knowledge; and the creation of organised structures for professional work. Two countries with a well-established research tradition in general practice (the UK and the Netherlands) and one country where GP research development is still limited (Spain) were evaluated on the basis of these conditions. The conditions identified as favourable were as follows: the existence of a scientific association; a peer-reviewed journal; a defined population resulting in a population denominator for practices; a gatekeeping system; chairs and departments of general practice at universities; the integration of education centres and research centres; GPs working in group practices or health centres; a certain degree of independence from the Ministry of Health; and financial support for practicing GPs to conduct research activities. We showed that most conditions for the successful scientific progress of general practice in Spain are present. However there is still a gap between academia and general practice and a lack of research organisation and support.

Definition of colorectal anastomotic leakage: A consensus survey among Dutch and Chinese colorectal surgeons.

PubMed

van Rooijen, Stefanus J; Jongen, Audrey Chm; Wu, Zhou-Qiao; Ji, Jia-Fu; Slooter, Gerrit D; Roumen, Rudi Mh; Bouvy, Nicole D

2017-09-07

To determine the level of consensus on the definition of colorectal anastomotic leakage (CAL) among Dutch and Chinese colorectal surgeons. Dutch and Chinese colorectal surgeons were asked to partake in an online questionnaire. Consensus in the online questionnaire was defined as > 80% agreement between respondents on various statements regarding a general definition of CAL, and regarding clinical and radiological diagnosis of the complication. Fifty-nine Dutch and 202 Chinese dedicated colorectal surgeons participated in the online survey. Consensus was found on only one of the proposed elements of a general definition of CAL in both countries: 'extravasation of contrast medium after rectal enema on a CT scan'. Another two were found relevant according to Dutch surgeons: 'necrosis of the anastomosis found during reoperation', and 'a radiological collection treated with percutaneous drainage'. No consensus was found for all other proposed elements that may be included in a general definition. There is no universally accepted definition of CAL in the Netherlands and China. Diagnosis of CAL based on clinical manifestations remains a point of discussion in both countries. Dutch surgeons are more likely to report 'subclinical' leaks as CAL, which partly explains the higher reported Dutch CAL rates.

Missed opportunities to offer HIV tests to high-risk groups during general practitioners’ STI-related consultations: an observational study

PubMed Central

Joore, I K; Reukers, D F M; Donker, G A; van Sighem, A I; Op de Coul, E L M; Prins, J M; Geerlings, S E; Barth, R E; van Bergen, J E A M; van den Broek, I V

2016-01-01

Objectives Prior research has shown that Dutch general practitioners (GPs) do not always offer HIV testing and the number of undiagnosed HIV patients remains high. We aimed to further investigate the frequency and reasons for (not) testing for HIV and the contribution of GPs to the diagnosis of HIV infections in the Netherlands. Design Observational study. Setting (1) Dutch primary care network of 42–45 sentinel practices where report forms during sexually transmitted infection (STI)-related consultations were routinely collected, 2008–2013. (2) Dutch observational cohort with medical data of HIV-positive patients in HIV care, 2008–2013. Outcome measures The proportion of STI-related consultations in patients from high-risk groups tested for HIV, with additional information requested from GPs on HIV testing preconsultation or postconsultation for whom HIV testing was indicated, but not performed. Next, information was collected on the profile of HIV-positive patients entering specialised HIV care following diagnosis by GPs. Results Initially, an HIV test was reported (360/907) in 40% of STI-related consultations in high-risk groups. Additionally, in 26% of consultations an HIV test had been performed in previous or follow-up consultations or at different STI-care facilities. The main reasons for not testing were perceived insignificant risk; ‘too’ recent risk according to GPs or the reluctance of patients. The initiative of the patient was a strong determinant for HIV testing. GPs diagnosed about one third of all newly found cases of HIV. Compared with STI clinics, HIV-positive patients diagnosed in general practice were more likely to be older, female, heterosexual male or sub-Saharan African. Conclusions In one-third of the STI-related consultations of persons from high-risk groups, no HIV test was performed in primary care, which is lower than previously reported. Risk-based testing has intrinsic limitations and implementation of new additional strategies in primary care is warranted. PMID:26801464

Dutch Adolescents' Tolerance of Practices by Muslim Actors: The Effect of Issue Framing

ERIC Educational Resources Information Center

Gieling, Maike; Thijs, Jochem; Verkuyten, Maykel

2012-01-01

This research, conducted in the Netherlands, examines whether native adolescents' tolerance of practices by Muslim immigrants (e.g., the founding of Islamic schools) is affected by the type of considerations (e.g., educational freedom vs. integration of Muslims in Dutch society). Using an experimental questionnaire design (N = 970), the findings…

Definition of colorectal anastomotic leakage: A consensus survey among Dutch and Chinese colorectal surgeons

PubMed Central

van Rooijen, Stefanus J; Jongen, Audrey CHM; Wu, Zhou-Qiao; Ji, Jia-Fu; Slooter, Gerrit D; Roumen, Rudi MH; Bouvy, Nicole D

2017-01-01

AIM To determine the level of consensus on the definition of colorectal anastomotic leakage (CAL) among Dutch and Chinese colorectal surgeons. METHODS Dutch and Chinese colorectal surgeons were asked to partake in an online questionnaire. Consensus in the online questionnaire was defined as > 80% agreement between respondents on various statements regarding a general definition of CAL, and regarding clinical and radiological diagnosis of the complication. RESULTS Fifty-nine Dutch and 202 Chinese dedicated colorectal surgeons participated in the online survey. Consensus was found on only one of the proposed elements of a general definition of CAL in both countries: ‘extravasation of contrast medium after rectal enema on a CT scan’. Another two were found relevant according to Dutch surgeons: ‘necrosis of the anastomosis found during reoperation’, and ‘a radiological collection treated with percutaneous drainage’. No consensus was found for all other proposed elements that may be included in a general definition. CONCLUSION There is no universally accepted definition of CAL in the Netherlands and China. Diagnosis of CAL based on clinical manifestations remains a point of discussion in both countries. Dutch surgeons are more likely to report ‘subclinical’ leaks as CAL, which partly explains the higher reported Dutch CAL rates. PMID:28970733

'A necessary evil that does not "really" cure disease': The domestication of biomedicine by Dutch holistic general practitioners.

PubMed

Raaphorst, Nadine; Houtman, Dick

2016-05-01

Against the background of studies about the domestication of complementary and alternative medicine into biomedical settings, this article studies how biomedicine is integrated into holistic settings. Data from 19 in-depth interviews with Dutch holistic general practitioners who combine complementary and alternative medicine with conventional treatments demonstrate that they do not believe that conventional biomedicine 'really' cures patients. They feel that it merely suppresses the physical symptoms of a disease, leaving the more fundamental and non-physical causes intact. As a consequence, they use conventional biomedicine for strictly practical and instrumental reasons. This is the case in life-threatening or acute situations, understood as non-physical causes of disease having been left untreated with complementary and alternative medicine for too long. More mundane reasons for its use are the need to take patients' demands for biomedical treatment seriously or to obey authoritative rules, regulations and protocols. The integration of biomedicine into complementary and alternative medicine, then, follows the same logic of domestication of complementary and alternative medicine into biomedicine: it is made subordinate to the prevailing model of health and illness and treated as a practical add-on that does not 'really' cure people. © The Author(s) 2015.

Opinions about euthanasia and advanced dementia: a qualitative study among Dutch physicians and members of the general public.

PubMed

Kouwenhoven, Pauline S C; Raijmakers, Natasja J H; van Delden, Johannes J M; Rietjens, Judith A C; van Tol, Donald G; van de Vathorst, Suzanne; de Graeff, Nienke; Weyers, Heleen A M; van der Heide, Agnes; van Thiel, Ghislaine J M W

2015-01-28

The Dutch law states that a physician may perform euthanasia according to a written advance euthanasia directive (AED) when a patient is incompetent as long as all legal criteria of due care are met. This may also hold for patients with advanced dementia. We investigated the differing opinions of physicians and members of the general public on the acceptability of euthanasia in patients with advanced dementia. In this qualitative study, 16 medical specialists, 19 general practitioners, 16 elderly physicians and 16 members of the general public were interviewed and asked for their opinions about a vignette on euthanasia based on an AED in a patient with advanced dementia. Members of the general public perceived advanced dementia as a debilitating and degrading disease. Physicians emphasized the need for direct communication with the patient when making decisions about euthanasia. Respondent from both groups acknowledged difficulties in the assessment of patients' autonomous wishes and the unbearableness of their suffering. Legally, an AED may replace direct communication with patients about their request for euthanasia. In practice, physicians are reluctant to forego adequate verbal communication with the patient because they wish to verify the voluntariness of patients' request and the unbearableness of suffering. For this reason, the applicability of AEDs in advanced dementia seems limited.

How do Dutch primary care providers overcome barriers to advance care planning with older people? A qualitative study.

PubMed

Glaudemans, Jolien J; de Jong, Anja E; Onwuteaka Philipsen, Bregje D; Wind, Jan; Willems, Dick L

2018-06-11

Few older people benefit from advance care planning (ACP), due to several barriers related to primary care professionals, such as insufficient knowledge, negative beliefs and a lack of time. Information on overcoming these barriers is limited. We assumed primary care professionals experienced in ACP with older patients are likely to have learned how to overcome these barriers. To investigate how Dutch primary care professionals experienced in ACP with older patients overcome these barriers. A qualitative study, based on semi-structured interviews, among a purposive sample of 14 Dutch primary care professionals experienced in ACP with older people. Transcripts were thematically analysed. We interviewed eight general practitioners (GPs), three nurses and three elderly care physicians, experienced in ACP with older people. Respondents overcame their own insufficient knowledge and skills, as well as their negative attitudes and beliefs by gaining experience through practicing ACP in their daily practices, exchanging and reflecting on those experiences with peers, pursuing continuing education, teaching and participating in research. To overcome patients' and families' lack of initiative and openness to ACP, respondents prepared them for further steps in ACP. To overcome a lack of time, respondents used tools and information communication technology, delegated parts of ACP to other primary care professionals, acquired financing and systematized documentation of ACP. Primary care professionals can overcome barriers to ACP with older patients by practicing, reflecting on experiences and pursuing continuing education, by preparing patients and involving family and by investing in support to approach ACP more efficiently.

The linguistic validation of Russian version of Dutch four-dimensional symptoms questionnaire (4DSQ) for assessing distress, depression, anxiety and somatization in patients with borderline psychosomatic disorders.

PubMed

Arnautov, V S; Reyhart, D V; Smulevich, A B; Yakhno, N N; Terluin, B; Zakharova, E K; Andryushchenko, A V; Parfenov, V A; Zamergrad, M V; Romanov, D V

2015-12-12

The four-dimensional symptom questionnaire (4DSQ) is an originally Dutch self-report questionnaire that has been developed in primary care to distinguish non-specific general distress from depression, anxiety and somatization. In order to produce the appropriate translated Russian version the process of linguistic validation has been initiated. This process has been done according to the "Linguistic Validation Manual for Health Outcome Assessments" developed by MAPI institute. To produce the appropriate Russian version of the 4DSQ that is conceptually and linguistically equivalent to the original questionnaire. The original Dutch version of the 4DSQ was translated by one translator into Russian. The validated English version of the 4DSQ was translated by another translator into Russian without mutual consultation. The consensus version was created based on two translated versions. After that the back translation was performed to Dutch, some changes were implemented to the consensus Russian version and the second target version was developed based on these results. The second target version was sent to an appropriate group of reviewers. Based on their comments, the second target version was updated. After wards this version was tested in patients during cognitive interview. The study protocol was approved by the Independent Interdisciplinary Ethics Committee on Ethical Review for Clinical Studies, and in compliance with the Helsinki Declaration and ICH-GCP guidelines and local regulations. Enrolled patients provided written informed consent. After the process of forward and backward translation, consultant and developer's comments, clinicians and cognitive review the final version of Russian 4DSQ was developed for assessment of distress, depression, anxiety and somatization. The Russian 4DSQ as a result of translation procedures and cognitive interviews linguistically corresponds to the original Dutch 4DSQ and could be assessed in psychometric validation for the further using in general practice.

Radiation Protection in Pediatric Radiology: Results of a Survey Among Dutch Hospitals.

PubMed

Bijwaard, Harmen; Valk, Doreth; de Waard-Schalkx, Ischa

2016-10-01

A survey about radiation protection in pediatric radiology was conducted among 22 general and seven children's hospitals in the Netherlands. Questions concerned, for example, child protocols used for CT, fluoroscopy and x-ray imaging, number of images and scans made, radiation doses and measures taken to reduce these, special tools used for children, and quality assurance issues. The answers received from 27 hospitals indicate that radiation protection practices differ considerably between general and children's hospitals but also between the respective general and children's hospitals. It is recommended that hospitals consult each other to come up with more uniform best practices. Few hospitals were able to supply doses that can be compared to the national Diagnostic Reference Levels (DRLs). The ones that could be compared exceeded the DRLs in one in five cases, which is more than was expected beforehand.

Collaboration of general practitioners and exercise providers in promotion of physical activity a written survey among general practitioners.

PubMed

Leemrijse, C J; de Bakker, D H; Ooms, L; Veenhof, C

2015-08-06

General practitioners have an ideal position to motivate inactive patients to increase their physical activity. Most patients are able to exercise in regular local facilities outside the health care setting. The purpose of this study was to get insight into general practitioners perceptions and current practices regarding referral of patients to local exercise facilities. Furthermore, collaboration with exercise providers in the community was investigated, and motivators and barriers for referral. A written questionnaire sent to a representative random sample of 800 Dutch general practitioners. Descriptive statistics and Chi(2) tests were used. All responding general practitioners (340) recommend their patients to take more exercise when necessary and 87 % say to refer patients sometimes. Limited motivation of the patient (44 %) and reduced health status (34 %) are the most mentioned barriers for advising patients to increase physical activity. When referred, most patients are send to a physical therapist (69 %) but also local exercise facilities were mentioned (54 %). The most important barrier for referring patients to local exercise activities are patients limited financial possibilities (46 %). Restricted knowledge of local exercise- or sport facilities was an additional barrier (19 %). There is little structural collaboration between general practitioners and exercise providers, but when collaboration exists general practitioners refer more often. Positive experiences of patients (67 %), affordable offers (59 %) and information of local exercise facilities (46 %) are seen as important promoting factors for referral. Although 32 % of the general practitioners think that good collaboration would be stimulating, regular meetings with sports and exercise providers were considered the least important for increasing referral (3 %). Dutch physicians have a positive attitude towards stimulating physical activity but referral to local exercise facilities is low. Referral is partly hindered by restricted knowledge of local exercise facilities. Although general practitioners think that collaboration is important for physical activity promotion, it should not cost them much extra time. A coordinator with knowledge of the local situation can facilitate contacts between GP practices and sports providers.

Are GP patients' needs being met? Unfulfilled information needs among native-Dutch and Turkish-Dutch patients.

PubMed

Schinkel, Sanne; Schouten, Barbara C; van Weert, Julia C M

2013-02-01

This study aims to assess unfulfilled information needs of native-Dutch and Turkish-Dutch general practitioner (GP) patients in the Netherlands. In addition, the relation between perceived and recorded information provision by GPs is studied. Unfulfilled information needs of native-Dutch (N=117) and Turkish-Dutch patients (N=74) were assessed through pre- and post-consultation questionnaires. Audiotapes of GP consultations were made to code GPs' information provision. Turkish-Dutch patients experience more unfulfilled information needs than native-Dutch patients, in particular those who identify equally with Dutch and Turkish culture. Overall, perceived information provision is hardly related to recorded information provision. GPs insufficiently provide Turkish-Dutch patients and, to a lesser extent, native-Dutch patients as well, the information they need. GPs should be trained in giving adequate, tailored information to patients with various ethnic and cultural backgrounds. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Ethnic differences in mental health among incarcerated youths: do Moroccan immigrant boys show less psychopathology than native Dutch boys?

PubMed

Veen, Violaine; Stevens, Gonneke; Doreleijers, Theo; van der Ende, Jan; Vollebergh, Wilma

2010-05-01

Psychiatric disorders are highly prevalent among incarcerated youth. However, whereas ethnic minority youths are overrepresented in the juvenile justice system, limited research is available on their mental health. In this study, differences in mental health problems between incarcerated adolescents of native Dutch and Moroccan origin, were examined. Child Behavior Checklist and Youth Self-Report scores were compared between incarcerated adolescents of native Dutch and Moroccan origin. Their scores were also compared to those of native Dutch and Moroccan immigrant youths in the general, non-incarcerated population. Native Dutch incarcerated adolescents showed higher levels of various mental health problems than incarcerated adolescents with a Moroccan background. Compared to the general population, incarcerated youths showed higher levels of mental health problems, but this deviation was much larger for native Dutch than for Moroccan immigrant youths. These ethnic differences in mental health problems could not be explained by ethnic differences in socio-economic background and social desirable answering tendencies. Incarcerated youths of Moroccan origin show less psychopathology than incarcerated native Dutch youths, which might be explained by disparities in sentencing procedures.

Ethnic differences in mental health among incarcerated youths: do Moroccan immigrant boys show less psychopathology than native Dutch boys?

PubMed Central

Stevens, Gonneke; Doreleijers, Theo; van der Ende, Jan; Vollebergh, Wilma

2009-01-01

Psychiatric disorders are highly prevalent among incarcerated youth. However, whereas ethnic minority youths are overrepresented in the juvenile justice system, limited research is available on their mental health. In this study, differences in mental health problems between incarcerated adolescents of native Dutch and Moroccan origin, were examined. Child Behavior Checklist and Youth Self-Report scores were compared between incarcerated adolescents of native Dutch and Moroccan origin. Their scores were also compared to those of native Dutch and Moroccan immigrant youths in the general, non-incarcerated population. Native Dutch incarcerated adolescents showed higher levels of various mental health problems than incarcerated adolescents with a Moroccan background. Compared to the general population, incarcerated youths showed higher levels of mental health problems, but this deviation was much larger for native Dutch than for Moroccan immigrant youths. These ethnic differences in mental health problems could not be explained by ethnic differences in socio-economic background and social desirable answering tendencies. Incarcerated youths of Moroccan origin show less psychopathology than incarcerated native Dutch youths, which might be explained by disparities in sentencing procedures. PMID:20449708

Prescribing and deprescribing antihypertensive medication in older people by Dutch general practitioners: a qualitative study

PubMed Central

van Middelaar, Tessa; Ivens, Sophie D; van Peet, Petra G; Poortvliet, Rosalinde K E; Richard, Edo; Pols, A Jeannette; Moll van Charante, Eric P.

2018-01-01

Objectives To explore general practitioners’ (GPs) routines and considerations on (de)prescribing antihypertensive medication (AHM) in older patients, their judgement on usability of the current guideline and needs for future support. Design Semistructured interviews. Setting Dutch general practice. Participants Fifteen GPs were purposively sampled based on level of experience and practice characteristics until saturation was reached. Results GPs appeared reluctant to start AHM, especially in patient >80 years. High systolic blood pressure and history of cardiovascular disease or diabetes were enablers to start or intensify treatment. Reasons to refrain from this were frailty and patient preference. GPs described a tendency to continue AHM regimens unchanged, influenced by daily time constraints, automated prescription routines and anticipating discomfort when disturbing patients’ delicate balance. GPs were only inclined to deprescribe AHM in terminally ill patients or after prolonged achievement of target levels in combination with side effects or patient preference. Deprescription was facilitated when GPs had experience with patients showing increased quality of life after deprescription and was withheld by anticipated regret (ie, GPs’ fear of a stroke after deprescribing). GPs felt insufficient guidance from current guidelines, especially on deprescription. Conclusions GPs are reluctant to start or deprescribe AHM in older people and have a propensity to continue AHM within a daily routine that insufficiently supports critical medication review. (De)prescription is influenced by patient preferences and anticipated regret and current guidelines provide insufficient guidance. PMID:29678989

Clinicians' beliefs and attitudes toward patient self-management in the Netherlands; translation and testing of the American Clinician Support for Patient Activation Measure (CS-PAM).

PubMed

Rademakers, Jany; Jansen, Daphne; van der Hoek, Lucas; Heijmans, Monique

2015-04-03

The aim of this study was to test the Dutch version of the Clinician Support for Patient Activation Measure (CS-PAM), to explore the beliefs of Dutch clinicians about patients' self-management, and to establish whether there are differences in this respect between general practitioners and other primary care providers. The CS-PAM was translated in Dutch and data were collected in a sample of 489 general practitioners and other primary care providers. Statistical analyses (RASCH, Cronbach's α) were performed to establish the psychometric properties of the instrument. The psychometric scores of the Dutch CS-PAM were acceptable to good, and the difficulty level and structure was comparable to that of the original instrument. The average score of Dutch clinicians on the CS-PAM was 65.1 (SD 10.7), somewhat lower compared to their colleagues in the US (69; SD 12.1) and the UK (69, SD 12.8). Dutch general practitioners scored significantly lower on the CS-PAM compared to other primary care providers. The Dutch CS-PAM is a reliable instrument to measure beliefs of clinicians regarding patient self-management. Further validation studies are necessary to establish the distribution of scores in specific provider populations and to assess the clinical relevance of the instrument for different outcomes.

The medical practice of euthanasia in Belgium and The Netherlands: legal notification, control and evaluation procedures.

PubMed

Smets, Tinne; Bilsen, Johan; Cohen, Joachim; Rurup, Mette L; De Keyser, Els; Deliens, Luc

2009-05-01

To describe and compare current legal procedures for notifying, controlling and evaluating (NCE-procedures) euthanasia in Belgium and the Netherlands, and to discuss the implications for a safe and controllable euthanasia practice. We systematically studied and compared official documents relating to the Belgian and the Dutch NCE-procedures for euthanasia. In both countries, physicians are required to notify their cases to a review Committee, stimulating them to safeguard the quality of their euthanasia practice and to make societal control over the practice of euthanasia possible. However, the procedures in both countries differ. The main differences are that the Dutch notification and control procedures are more elaborate and transparent than the Belgian, and that the Belgian procedures are primarily anonymous, whereas the Dutch are not. Societal evaluation is made in both countries through the Committees' summary reports to Parliament. Transparent procedures like the Dutch may better facilitate societal control. Informing physicians about the law and the due care requirements for euthanasia, and systematic feedback about their medical actions are both pivotal to achieving efficient societal control and engendering the level of care needed when performing such far-reaching medical acts.

Differential Relationships between Language Skills and Working Memory in Turkish-Dutch and Native-Dutch First-Graders from Low-Income Families

ERIC Educational Resources Information Center

Bosman, Anna M. T.; Janssen, Marije

2017-01-01

In the Netherlands, Turkish-Dutch children constitute a substantial group of children who learn to speak Dutch at the age of four after they learned to speak Turkish. These children are generally academically less successful. Academic success appears to be affected by both language proficiency and working memory skill. The goal of this study was…

Healthy habits are no fun: How Dutch youth negotiate discourses about food, fit, fat, and fun.

PubMed

van Amsterdam, Noortje; Knoppers, Annelies

2018-03-01

In this article, we use the notion of "biopedagogical practices" to explore how Dutch youth respond to health messages that focus on body weight. Previous studies suggest that such health messages encourage body dissatisfaction in youth. Few studies, however, focus on the local/cultural specificity of youth's responses to these biopedagogical practices. In this article, we address questions about the re-interpretation of and resistance to health messages that Dutch youth engage in and how these can be understood in their local context. The data were drawn from two previously conducted studies in which a total of 64 Dutch teenagers (aged 12-18 years) took part. We employed a variety of qualitative data collection methods and a feminist poststructuralist perspective to analyze how Dutch youth negotiate biopedagogical practices about health. The results show that our participants constructed health in terms of appearance and reproduced negative constructions regarding fat embodiment. Yet they also often circumvented "healthy" lifestyle behaviors prescribed by biopedagogies of health. They did so first by avoiding physical activities because they were afraid of displaying fat embodiment in the settings of sport and physical education where surveillance is omnipresent. Second, they disregarded advice about healthy eating by drawing on having fun as an alternative discursive resource. We argue that having fun is both part of youth culture and characteristic of the discourse about sociability ( gezelligheid) that is a central element of Dutch culture.

Patients' priorities in assessing organisational aspects of a general dental practice.

PubMed

Sonneveld, Rutger E; Brands, Wolter G; Bronkhorst, Ewald M; Welie, Jos V M; Truin, Gert-Jan

2013-02-01

To explore which organisational aspects are considered most important by patients when assessing a general dental practice, and which patients' characteristics influence their views on these aspects by a paper questionnaire. The questionnaire was handed out to a sample of 5,000 patients in the Netherlands. The response rate was 63%. Six organisational aspects out of a list of 41 aspects were valued as most important by at least 50%. In decreasing order of importance, these were: accessibility by telephone; continuing education for general dental practitioners; Dutch-speaking general dental practitioners; in-office waiting times; information about treatments offered; and waiting lists. For four out of these six aspects, respondents' age and education significantly influenced their preferences. Aspects concerning the infrastructure of a general dental practice were chosen more often than aspects such as working to professional standards, working according to protocols and guidelines, quality assessment and guaranteed treatment outcomes. The findings will enable organisations to increase the transparency of health-care delivery systems to focus on those organisational aspects of dental practices that patients themselves consider most important. These findings can also assist general dental practitioners in adapting their organisational services to the preferences of patients or specific patient groups. © 2013 FDI World Dental Federation.

Euthanasia in The Netherlands.

PubMed Central

van der Wal, G.; Dillmann, R. J.

1994-01-01

The practice of euthanasia in the Netherlands is often used as an argument in debates outside the Netherlands--hence a clear description of the Dutch situation is important. This article summarises recent data and discusses conceptual issues and relevant characteristics of the system of health care. Special emphasis is put on regulation, including relevant data on notification and prosecution. Besides the practice of euthanasia the Dutch are confronted with the gaps in reporting of cases to the public prosecutor and the existence of cases of ending a life without an explicit request. Nevertheless, the "Dutch experiment" need not inevitably lead down the slippery slope because of the visibility and openness of this part of medical practice. This will lead to increased awareness, more safeguards, and improvement of medical decisions concerning the end of life. PMID:8019226

Euthanasia in The Netherlands.

PubMed

van der Wal, G; Dillmann, R J

1994-05-21

The practice of euthanasia in the Netherlands is often used as an argument in debates outside the Netherlands--hence a clear description of the Dutch situation is important. This article summarises recent data and discusses conceptual issues and relevant characteristics of the system of health care. Special emphasis is put on regulation, including relevant data on notification and prosecution. Besides the practice of euthanasia the Dutch are confronted with the gaps in reporting of cases to the public prosecutor and the existence of cases of ending a life without an explicit request. Nevertheless, the "Dutch experiment" need not inevitably lead down the slippery slope because of the visibility and openness of this part of medical practice. This will lead to increased awareness, more safeguards, and improvement of medical decisions concerning the end of life.

[Infection prevention in Dutch hospitals; results say more than process indicators].

PubMed

Bonten, Marc J M; Friedrich, Alexander; Kluytmans, Jan A J W; Vandenbroucke-Grauls, Christina M J E; Voss, Andreas; Vos, Margreet C

2014-01-01

The Dutch Health Care Inspectorate investigated the preparedness of Dutch hospitals for the emergence of antibiotic resistance, and concluded that hospitals are not well prepared and are insufficiently aware that infection prevention is a prerequisite for patient safety. These conclusions are based on observations of process indicators of current practice guidelines, without including the available outcome indicators that demonstrate the persistently low incidence of infections with antibiotic resistant bacteria in Dutch hospitals. The conclusions may have negative effects on the quality of infection prevention in Dutch hospitals. Therefore, it is advisable to use outcome indicators rather than process indicators to evaluate the quality of infection prevention.

Differential relationships between language skills and working memory in Turkish-Dutch and native-Dutch first-graders from low-income families.

PubMed

Bosman, Anna M T; Janssen, Marije

2017-01-01

In the Netherlands, Turkish-Dutch children constitute a substantial group of children who learn to speak Dutch at the age of four after they learned to speak Turkish. These children are generally academically less successful. Academic success appears to be affected by both language proficiency and working memory skill. The goal of this study was to investigate the relationship between language skills and working memory in Turkish-Dutch and native-Dutch children from low-income families. The findings revealed reduced Dutch language and Dutch working-memory skills for Turkish-Dutch children compared to native-Dutch children. Working memory in native-Dutch children was unrelated to their language skills, whereas in Turkish-Dutch children strong correlations were found both between Turkish language skills and Turkish working-memory performance and between Dutch language skills and Dutch working-memory performance. Reduced language proficiencies and reduced working-memory skills appear to manifest itself in strong relationships between working memory and language skills in Turkish-Dutch children. The findings seem to indicate that limited verbal working-memory and language deficiencies in bilingual children may have reciprocal effects that strongly warrants adequate language education.

Trends in suicidal behaviour in Dutch general practice 1983–2013: a retrospective observational study

PubMed Central

Hooiveld, Mariette; Korevaar, Joke C; Donker, Gé A

2016-01-01

Objectives To analyse trends in suicidal behaviour as reported by the Dutch sentinel general practices from 1983 to 2013. Second, to examine the relationship between suicidal behaviour and several patient characteristics. Finally, to compare the relationship between suicidal behaviour and patient characteristics before (1983–2007) and after (2008–2013) the start of the crisis. Setting 40 general practices in the Netherlands during the period 1983–2013. Participants Patients with an ICPC code of P77 (suicide attempt). Primary and secondary outcomes Primary outcomes were age-adjusted and gender-specific trends in reported suicides (342) and suicide attempts (1614). Secondary outcomes were the relationship between suicidal behaviour and age, household composition, history of depression, recognition of suicide ideation, treatment before the suicidal behaviour and contact within the past month before suicidal behaviour for the period 1983–2013. Additionally, separate frequencies for the periods 1983–2007 and 2008–2013 were presented. Results Join-point analyses revealed a significant rise in male suicides from 2008 (b=0.32, SE=0.1, p=0.008), and an increase in male suicide attempts since 2009 (b=0.19, SE=0.04, p<0.001). Female suicidal behaviour showed a steady decrease from 1989 to 2013(b=−0.03, SE=0.007, p<0.0001 for female suicide, b=−0.02, SE=0.002, p<0.001 for female attempts). Before 2007, a history of depression was reported in 65% (168/257) of the suicides. After the start of the recession, a depression was recognised in 44% (22/50) of the patients who died by suicide. Conclusions Since 2008, there was a rise in the male suicide rate while female suicide behaviour has continued to decline. General practitioners less often reported a history of depression within patients who died due to suicide after 2007 than before. Training in the early recognition of suicide ideation in depressive patients might improve suicide prevention in primary care. PMID:27165647

Do Dutch doctors communicate differently with immigrant patients than with Dutch patients?

PubMed

Meeuwesen, Ludwien; Harmsen, Johannes A M; Bernsen, Roos M D; Bruijnzeels, Marc A

2006-11-01

The aim of this study was to gain deeper insight into relational aspects of the medical communication pattern in intercultural consultations at GP practices in the Netherlands. We ask whether there are differences in the verbal interaction of Dutch GPs with immigrant and Dutch patients. Data were drawn from 144 adult patient interviews and video observations of consultations between the patients and 31 Dutch GPs. The patient group consisted of 61 non-Western immigrants (Turkish, Moroccan, Surinamese, Antillean, Cape Verdian) and 83 Dutch participants. Affective and instrumental aspects of verbal communication were assessed using Roter's Interaction Analysis System (RIAS). Patients' cultural background was assessed by ethnicity, language proficiency, level of education, religiosity and cultural views (in terms of being more traditional or more modern). Consultations with the non-Western immigrant patients (especially those from Turkey and Morocco) were well over 2 min shorter, and the power distance between GPs and these patients was greater when compared to the Dutch patients. Major differences in verbal interaction were observed on the affective behavior dimensions, but not on the instrumental dimensions. Doctors invested more in trying to understand the immigrant patients, while in the case of Dutch patients they showed more involvement and empathy. Dutch patients seemed to be more assertive in the medical conversation. The differences are discussed in terms of patients' ethnic background, cultural views (e.g. practicing a religion) and linguistic barriers. It is concluded that attention to cultural diversity does matter, as this leads to different medical communication patterns. A two-way strategy is recommended for improving medical communication, with implications for both doctor and patient behavior.

Development of a theory- and evidence-based intervention to enhance implementation of physical therapy guidelines for the management of low back pain

PubMed Central

2014-01-01

Background Systematic planning could improve the generally moderate effectiveness of interventions to enhance adherence to clinical practice guidelines. The aim of our study was to demonstrate how the process of Intervention Mapping was used to develop an intervention to address the lack of adherence to the national CPG for low back pain by Dutch physical therapists. Methods We systematically developed a program to improve adherence to the Dutch physical therapy guidelines for low back pain. Based on multi-method formative research, we formulated program and change objectives. Selected theory-based methods of change and practical applications were combined into an intervention program. Implementation and evaluation plans were developed. Results Formative research revealed influential determinants for physical therapists and practice quality managers. Self-regulation was appropriate because both the physical therapists and the practice managers needed to monitor current practice and make and implement plans for change. The program stimulated interaction between practice levels by emphasizing collective goal setting. It combined practical applications, such as knowledge transfer and discussion-and-feedback, based on theory-based methods, such as consciousness raising and active learning. The implementation plan incorporated the wider environment. The evaluation plan included an effect and process evaluation. Conclusions Intervention Mapping is a useful framework for formative data in program planning in the field of clinical guideline implementation. However, a decision aid to select determinants of guideline adherence identified in the formative research to analyse the problem may increase the efficiency of the application of the Intervention Mapping process. PMID:24428945

Development of a theory- and evidence-based intervention to enhance implementation of physical therapy guidelines for the management of low back pain.

PubMed

Rutten, Geert M; Harting, Janneke; Bartholomew, Leona K; Braspenning, Jozé C; van Dolder, Rob; Heijmans, Marcel Fgj; Hendriks, Erik Jm; Kremers, Stef Pj; van Peppen, Roland Ps; Rutten, Steven Tj; Schlief, Angelique; de Vries, Nanne K; Oostendorp, Rob Ab

2014-01-15

Systematic planning could improve the generally moderate effectiveness of interventions to enhance adherence to clinical practice guidelines. The aim of our study was to demonstrate how the process of Intervention Mapping was used to develop an intervention to address the lack of adherence to the national CPG for low back pain by Dutch physical therapists. We systematically developed a program to improve adherence to the Dutch physical therapy guidelines for low back pain. Based on multi-method formative research, we formulated program and change objectives. Selected theory-based methods of change and practical applications were combined into an intervention program. Implementation and evaluation plans were developed. Formative research revealed influential determinants for physical therapists and practice quality managers. Self-regulation was appropriate because both the physical therapists and the practice managers needed to monitor current practice and make and implement plans for change. The program stimulated interaction between practice levels by emphasizing collective goal setting. It combined practical applications, such as knowledge transfer and discussion-and-feedback, based on theory-based methods, such as consciousness raising and active learning. The implementation plan incorporated the wider environment. The evaluation plan included an effect and process evaluation. Intervention Mapping is a useful framework for formative data in program planning in the field of clinical guideline implementation. However, a decision aid to select determinants of guideline adherence identified in the formative research to analyse the problem may increase the efficiency of the application of the Intervention Mapping process.

[Need for clinical guidelines for chronic periodontitis in general and specialized Belgian practice].

PubMed

Cosyn, Jan; Thevissen, Eric; Reners, Michèle; Rompen, Eric; Klinge, Björn; De Bruyn, Hugo

2008-01-01

As the prevalence of periodontitis is more than 40 % in the adult Belgian population, periodontists are clearly understaffed to treat this disease in all patients. Therefore, it seems logic that mild forms of chronic periodontitis are treated by the general practitioner especially because Belgium lacks dental hygienists. Important prerequisites for organizing periodontal care as such relate to the general practitioner who should use the same techniques, have comparable communicative skills to motivate patients and create a similar amount of time for periodontal treatment as the specialist. After all, the patient has the right to qualitative treatment regardless of the level of education of the care provider. In order to guarantee this in general practice as much as possible, there is a need for clinical guidelines developed by specialists. These guidelines should not only support the general practitioner in treating disease; above all, they should assist the dentist in periodontal diagnosis. Hitherto, periodontal screening by general dentists seems to be infrequently performed even though reimbursement of the Dutch Periodontal Screening Index is implemented in the Belgian healthcare security system. In this manuscript possible explanations for this phenomenon are discussed. Apart from the need for guidelines in general practice, guidelines for surgical treatment seem compulsory to uniform treatment protocols in specialized practice. Extreme variation in the recommendation of surgery among Belgian specialists calls for consensus statements.

ContextD: an algorithm to identify contextual properties of medical terms in a Dutch clinical corpus.

PubMed

Afzal, Zubair; Pons, Ewoud; Kang, Ning; Sturkenboom, Miriam C J M; Schuemie, Martijn J; Kors, Jan A

2014-11-29

In order to extract meaningful information from electronic medical records, such as signs and symptoms, diagnoses, and treatments, it is important to take into account the contextual properties of the identified information: negation, temporality, and experiencer. Most work on automatic identification of these contextual properties has been done on English clinical text. This study presents ContextD, an adaptation of the English ConText algorithm to the Dutch language, and a Dutch clinical corpus. We created a Dutch clinical corpus containing four types of anonymized clinical documents: entries from general practitioners, specialists' letters, radiology reports, and discharge letters. Using a Dutch list of medical terms extracted from the Unified Medical Language System, we identified medical terms in the corpus with exact matching. The identified terms were annotated for negation, temporality, and experiencer properties. To adapt the ConText algorithm, we translated English trigger terms to Dutch and added several general and document specific enhancements, such as negation rules for general practitioners' entries and a regular expression based temporality module. The ContextD algorithm utilized 41 unique triggers to identify the contextual properties in the clinical corpus. For the negation property, the algorithm obtained an F-score from 87% to 93% for the different document types. For the experiencer property, the F-score was 99% to 100%. For the historical and hypothetical values of the temporality property, F-scores ranged from 26% to 54% and from 13% to 44%, respectively. The ContextD showed good performance in identifying negation and experiencer property values across all Dutch clinical document types. Accurate identification of the temporality property proved to be difficult and requires further work. The anonymized and annotated Dutch clinical corpus can serve as a useful resource for further algorithm development.

Is the role as gatekeeper still feasible? A survey among Dutch general practitioners.

PubMed

Wammes, Joost Johan Godert; Jeurissen, Patrick Paulus Theodoor; Verhoef, Lise Maria; Assendelft, Willem J J; Westert, Gert P; Faber, Marjan J

2014-10-01

In the 2012 International Health Policy Survey by the Commonwealth Fund, 57% of Dutch GPs indicated that Dutch patients receive too much health care. This is an unexpected finding, given the clear gatekeeper role of Dutch GPs and recent efforts strengthening this role. The study aims to explore where perceived overuse of care prevails and to identify factors associated with too much care at the entry point of Dutch health care. An American survey exploring perceptions of the amount of care among primary care providers was modified for relevance to the Dutch health system. We further included additional factors possibly related to overuse based on 12 interviews with Dutch GPs. The survey was sent to a random sample of 600 GPs. Dutch GPs (N = 157; response rate 26.2%) indicated that patients receive (much) too much care in general hospitals, primary care, GP cooperatives as well as private clinics. The Dutch responding GPs showed a relatively demand-satisfying attitude, which contributed to the delivery of too much care, often leading to deviation from guidelines and professional norms. The increasing availability of diagnostic facilities was identified as an additional factor contributing to the provision of unnecessary care. Finally, funding gaps between primary care and hospitals impede cooperation and coordination, provoking unnecessary care. Our results--most notably regarding the demand-satisfying attitude of responding GPs--call into question the classical view of the guidance and gatekeeper role of GPs in the Dutch health care system. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Ergonomics in gynecologists' daily practice: A nationwide survey in The Netherlands.

PubMed

Alleblas, Chantal C J; Formanoy, Margriet A G; Könemann, Reinier; Radder, Celine M; Huirne, Judith A; Nieboer, Theodoor E

2016-01-01

Gynecologists are exposed to multiple risk factors for developing physical complaints. To enhance the workplace ergonomics in gynecological practice, a more detailed insight about job content and associated demands is necessary to subsequently decrease the exposure to risk factors. The aim of this study was to investigate the prevalence of physical complaints and the presence of ergonomic constraints in Dutch gynecological practice. A questionnaire was distributed among the 1200 members of the Dutch Society of Obstetrics and Gynecology. It consisted of 52 Dutch questions derived from the validated Dutch Musculoskeletal Questionnaire. A total of 227 respondents completed the questionnaire (response rate 18.9%). Overall, 99.5% of the respondents rated their health status as reasonable or good. However, the twelve-month prevalence of physical complaints in one or more body part was 89.4%. Sustained adverse body postures were particularly reported for performing abdominal, and endoscopic surgery, and for assisting in vaginal surgery. Limited workspace, instruments, and patient size were reported by more than 60% of the respondents as constraints for adopting a neutral body posture during vaginal, endoscopic and abdominal surgery respectively. The results emphasize the necessity of enhancing ergonomics in gynecological practice. Better ergonomic circumstances will most likely benefit both the health of the gynecologists as well as the quality of surgical care.

A case-control study of acute respiratory tract infection in general practice patients in The Netherlands.

PubMed

van Gageldonk-Lafeber, Arianne B; Heijnen, Marie-Louise A; Bartelds, Aad I M; Peters, Marcel F; van der Plas, Simone M; Wilbrink, Berry

2005-08-15

Acute respiratory tract infections (ARTIs) are responsible for considerable morbidity in the community, but little is known about the presence of respiratory pathogens in asymptomatic individuals. We hypothesized that asymptomatic persons could have a subclinical infection and thus act as a source of transmission. During the period of 2000-2003, all patients with ARTI who visited their sentinel general practitioner had their data reported to estimate the incidence of ARTI in Dutch general practices. A random selection of these patients (case patients) and an equal number of asymptomatic persons visiting for other complaints (control subjects) were included in a case-control study. Nose and throat swabs of participants were tested for a broad range of pathogens. The overall incidence of ARTI was 545 cases per 10,000 person-years, suggesting that, in the Dutch population, an estimated 900,000 persons annually consult their general practitioner for respiratory complaints. Rhinovirus was most common in case patients (24%), followed by influenza virus type A (11%) and coronavirus (7%). Viruses were detected in 58% of the case patients, beta -hemolytic streptococci group A were detected in 11%, and mixed infections were detected in 3%. Pathogens were detected in approximately 30% of control subjects, particularly in the youngest age groups. This study confirms that most ARTIs are viral and supports the reserved policy of prescribing antibiotics. In both case and control subjects, rhinovirus was the most common pathogen. Of bacterial infections, only group A beta-hemolytic streptococci were more common in case patients than in control subjects. Furthermore, we demonstrated that asymptomatic persons might be a neglected source of transmission.

Cultural Diversity in Center-Based Childcare: Childrearing Beliefs of Professional Caregivers from Different Cultural Communities in the Netherlands

ERIC Educational Resources Information Center

Huijbregts, S. K.; Leseman, P. P. M.; Tavecchio, L. W. C.

2008-01-01

The present study investigated the cultural childrearing beliefs of 116 caregivers from different cultural communities in the Netherlands (Dutch, Caribbean-Dutch, and Mediterranean-Dutch), working with 2-4-year-olds in daycare centers. Cultural childrearing beliefs were assessed with standard questionnaires, focusing on general and…

The role of Harvey Cushing and Walter Dandy in the evolution of modern neurosurgery in the Netherlands, illustrated by their correspondence.

PubMed

Groen, Rob J M; Koehler, Peter J; Kloet, Alfred

2013-03-01

The development of modern neurosurgery in the Netherlands, which took place in the 1920s, was highly influenced by the personal involvement of both Harvey Cushing and Walter Dandy, each in his own way. For the present article, the authors consulted the correspondence (kept at the Cushing/Whitney Medical Library in New Haven and the Alan Mason Chesney Medical Archives in Baltimore) of Cushing and Dandy with their Dutch disciples. The correspondence provides a unique inside view into the minds of both neurosurgical giants. After the neurologist Bernard Brouwer had paved the way for sending the Dutch surgeon Ignaz Oljenick overseas, Cushing personally took the responsibility to train him (1927-1929). On his return to Amsterdam, Oljenick and Brouwer established the first neurosurgical department in the country. Encouraged by Oljenick's favorable results, a number of Dutch general surgeons started asking Cushing for support. Cushing strategically managed and deflected these requests, probably aiming to increase the advantage of Oljenick and Brouwer. However, the University Hospital in Groningen persisted in the plans to establish its own neurosurgical unit and sent Ferdinand Verbeek to the US in 1932. Although staying at Cushing's department initially, Verbeek ultimately applied to Walter Dandy for a position of visiting voluntary assistant, staying until the end of 1934. Verbeek and Dandy became lifelong friends. On his return to Groningen, Verbeek started practicing neurosurgery, isolated in the northern part of the country. He relied on the support of Dandy, with whom he kept up a regular correspondence, discussing cases and seeking advice. Dandy, on his part, used Verbeek as the ambassador in Europe for his operative innovations. At the beginning of World War II, Oljenick had to flee the country, which concluded the direct line with the Cushing school in the Netherlands. After Dandy's death (1946), Verbeek continued practicing neurosurgery following his style and philosophy. By the time Verbeek died in 1958, the strong American influence on everyday practice of Dutch neurosurgeons had been established.

[The role of gut instinct is an important subject].

PubMed

Snoek, Jos W

2010-01-01

The role of gut instinct in general practice is an important topic. The reliance on gut instinct by experienced doctors is thought to be a form of intuitive decision-making which fits in with System 1 processes in the dual process model in higher cognition. Special mention is made of the theories on intuitive decision-making by the famous Dutch psychologist De Groot, who, when investigating thought processes of chess masters more than half a century ago, developed a fundamental theory on intuitive heuristics. Further studies on the determinants and conditions under which heuristics, such as the reliance on gut instinct, are applied in clinical practice are very welcome.

Web-based tailored lifestyle programs: exploration of the target group's interests and implications for practice.

PubMed

Verheijden, Marieke W; Jans, Marielle P; Hildebrandt, Vincent H

2008-01-01

An important challenge in Web-based health promotion is to increase the reach of the target audience by taking the target groups' desires into consideration. Data from 505 members of a Dutch Internet panel (representative for Dutch Internet users) were used to asses the target group's interests and needs. 28% participated in Web-based tailored lifestyle programs, 57% expressed an interest in such programs, and 15% expressed no interest. Interest in Web-based programs was predominantly caused by a general interest in lifestyle and online tests. Participation in Web-based tailored lifestyle programs should not take more than 17 minutes per occasion. 84% were interested in follow-up testing after the initial participation. Responders were particularly interested in physical activity and nutrition. Hardly anyone was willing to pay for participation. The results from this study support the use of Web-based tailored lifestyle programs in behavior change efforts.

Cross-Cultural Study of Information Processing Biases in Chronic Fatigue Syndrome: Comparison of Dutch and UK Chronic Fatigue Patients.

PubMed

Hughes, Alicia M; Hirsch, Colette R; Nikolaus, Stephanie; Chalder, Trudie; Knoop, Hans; Moss-Morris, Rona

2018-02-01

This study aims to replicate a UK study, with a Dutch sample to explore whether attention and interpretation biases and general attentional control deficits in chronic fatigue syndrome (CFS) are similar across populations and cultures. Thirty eight Dutch CFS participants were compared to 52 CFS and 51 healthy participants recruited from the UK. Participants completed self-report measures of symptoms, functioning, and mood, as well as three experimental tasks (i) visual-probe task measuring attentional bias to illness (somatic symptoms and disability) versus neutral words, (ii) interpretive bias task measuring positive versus somatic interpretations of ambiguous information, and (iii) the Attention Network Test measuring general attentional control. Compared to controls, Dutch and UK participants with CFS showed a significant attentional bias for illness-related words and were significantly more likely to interpret ambiguous information in a somatic way. These effects were not moderated by attentional control. There were no significant differences between the Dutch and UK CFS groups on attentional bias, interpretation bias, or attentional control scores. This study replicated the main findings of the UK study, with a Dutch CFS population, indicating that across these two cultures, people with CFS demonstrate biases in how somatic information is attended to and interpreted. These illness-specific biases appear to be unrelated to general attentional control deficits.

What is the impact of innovation on output in healthcare with a special focus on treatment innovations in radiotherapy? A literature review.

PubMed

Jacobs, Maria; Boersma, Liesbeth; Dekker, Andre; Swart, Rachelle; Lambin, Philippe; de Ruysscher, Dirk; Verhaegen, Frank; Stultiens, Joost; Ramaekers, Bram; van Merode, Frits

2017-11-01

To analyse how often innovations in healthcare are evaluated regarding output, especially in radiotherapy. Output was defined as either survival, toxicity, safety, service, efficiency or cost-effectiveness. A systematic literature review was conducted, using three search strategies: (1) innovations in general healthcare; (2) radiotherapy-specific innovations, i.e. organizational innovations and general implementation of innovations; (3) innovations per tumour group/radiotherapy technique. Scientific levels were classified according to the system used in European Society for Medical Oncology guidelines. Finally, we calculated the percentage of implemented innovations in Dutch radiotherapy centres for which we found evidence regarding output in the literature review. Only 94/1072 unique articles matched the inclusion criteria. Significant results on patient outcome, service or safety were reported in 65% of papers, which rose to 76% if confined to radiotherapy reviews. A significant technological improvement was identified in 26%, cost-effectiveness in 10% and costs/efficiency in 36% of the papers. The scientific level of organizational innovations was lower than that of clinical papers. Dutch radiotherapy treatment innovations were adequately evaluated on outcome data before implementation in clinical routine in a minimum of 64-92% of cases. Only few studies report on output when considering innovations in general, but radiotherapy reviews give a reasonably good insight into innovation output effects, with a higher level of evidence. In Dutch radiotherapy centres only small improvements are possible regarding evaluation of treatment innovations before implementation. Advances in knowledge: This study is the first of its kind measuring how innovations are evaluated in scientific literature, before implementation in clinical practice.

Identity practices, ingroup projection, and the evaluation of subgroups: a study among Turkish-Dutch Sunnis.

PubMed

Lie, Jessamina Lih Yan; Verkuyten, Maykel

2012-01-01

This research focuses on religious subgroup evaluations by examining the attitude of Turkish-Dutch Sunni Muslims towards Alevi and Shiite Muslims. Following the Ingroup Projection Model, it was expected that Sunni participants who practice Islam will project their self-defining subgroup practices on the superordinate Muslim category, which will be related to more ingroup bias towards Alevis, a Muslim subgroup that performs different religious practices. Two studies yielded consistent evidence that practicing Islam increased ingroup bias towards Alevis. Furthermore, in Study 2, we found evidence that the effect of practicing Islam on ingroup bias was mediated by relative ingroup prototypicality (RIP). Moreover, practicing Islam did not affect RIP in relation to Shiites who perform the same religious practices that we examined. These findings support the Ingroup Projection Model.

Cancer incidence and mortality of Surinamese migrants in the Netherlands: in-between Surinamese and Dutch levels?

PubMed

Williams, Graciëlle; Mans, Dennis R A; Garssen, Joop; Visser, Otto; Kramer, Daniëlle; Kunst, Anton E

2013-07-01

It has been suggested that the cancer risk of migrants from low-income to high-income countries will converge toward the levels of their host country. However, comparisons with country of origin are mostly lacking. We compared cancer incidence and mortality rates of Surinamese migrants in the Netherlands to both native Dutch and Surinamese levels. Data covering the period 1995-2008 were obtained from Surinamese and Dutch national cancer registries and national cause-of-death registries. Cancer incidence was studied for 21 types of cancer and cancer mortality for nine types. We calculated age-standardized incidence/mortality ratios (SIR/SMR) for the Surinamese migrants and for Suriname, using the native Dutch population as reference. Significantly lower overall cancer incidence (SIR = 0.77, 95% CI = 0.69-0.84) and mortality rates (SMR = 0.63, 95% CI = 0.55-0.72) were found for Surinamese migrants compared to native Dutch. Generally, cancer risk was lower for most cancers (e.g., cancer of the breast, colon and rectum, lung), but higher for other cancers (e.g., cancer of the uterine cervix, liver). For most cancers, cancer risk of the Surinamese migrants was in-between Surinamese and native Dutch levels. Importantly, for many cancers, migrants' incidence and mortality rates had not closely approached native Dutch rates. For skin cancer, incidence levels for Surinamese migrants were lower than both Surinamese and native Dutch levels. The results suggest that cancer incidence and mortality rates of Surinamese migrants generally converge from Surinamese toward Dutch levels, though not for all cancer types. Overall, Surinamese migrants still had a much more favorable cancer profile than the native Dutch population.

Developing quality indicators for general practice care for vulnerable elders; transfer from US to The Netherlands.

PubMed

van der Ploeg, E; Depla, M F I A; Shekelle, P; Rigter, H; Mackenbach, J P

2008-08-01

Measurement of the quality of healthcare is a first step for quality improvement. To measure quality of healthcare, a set of quality indicators is needed. We describe the adaptation of a set of systematically developed US quality indicators for healthcare for vulnerable elders in The Netherlands. We also compare the US and the Dutch set to see if quality indicators can be transferred between countries, as has been done in two studies in the UK, with mixed results. 108 US quality indicators on GP care for vulnerable elders, covering eight conditions, were assessed by a panel of nine clinical experts in The Netherlands. A modified version of the RAND/UCLA appropriateness method was used. The panel members received US literature reviews, extended with more recent and Dutch literature, summarising the evidence for each quality indicator. 72 indicators (67% of US set) were (nearly) identical in the Dutch and US sets. For some conditions, this percentage was much lower. For undernutrition, only half of the US indicators were included in the Dutch set. For depression, many indicators were discarded or changed in a significant way, with the result that only five of the original 17 indicators (29%) are the same in the Dutch and the US set. Quality indicators can be transferred between countries, but with caution, because in two of the three studies on transferring indicators between the US and Europe, 33-44% of the indicators were discarded. For some conditions in the current study, this percentage is much higher. For undernutrition, there is hardly any evidence, and differences between the indicator sets can be attributed to differences in expert opinion between the countries. For depression, it seems that different evidence is considered important in the US and in The Netherlands, of which the Dutch body of knowledge is not known in the US.

Barriers, facilitators and attitudes influencing health promotion activities in general practice: an explorative pilot study

PubMed Central

2013-01-01

Background The number of chronically ill patients increases every year. This is partly due to an unhealthy lifestyle. However, the frequency and quality of (evidence-based) health promotion activities conducted by Dutch general practitioners (GPs) and practice nurses (PNs) are limited. The aim of this pilot study was to explore which lifestyle interventions Dutch GPs and PNs carry out in primary care, which barriers and facilitators can be identified and what main topics are with respect to attitudes towards health promoting activities. These topic areas will be identified for a future, larger scale study. Method This qualitative study consisted of 25 semi-structured interviews with sixteen GPs and nine PNs. ATLAS.ti was used to analyse the transcripts of the interviews. Results All GPs and PNs said they discuss lifestyle with their patients. Next to this, GPs and PNs counsel patients, and/or refer them to other disciplines. Only few said they refer patients to specific lifestyle programs or interventions in their own practice or in the neighbourhood. Several barriers and facilitators were identified. The main topics as barriers are: a lack of patients’ motivation to make lifestyle changes, insufficient reimbursement, a lack of proven effectiveness of interventions and a lack of overview of health promoting programs in their neighbourhood. The most cited facilitators are availability of a PN, collaboration with other disciplines and availability of interventions in their own practice. With respect to attitudes, six different types of GPs were identified reflecting the main topics that relate to attitudes, varying from ‘ignorer’ to ‘nurturer’. The topics relating to PNs attitudes towards health promotion activities, were almost unanimously positive. Conclusion GPs and PNs all say they discuss lifestyle issues with their patients, but the health promotion activities that are organized in their practice vary. Main topics that hinder or facilitate implementation are identified, including those that relate to attitudes of GPs and PNs. PMID:23394162

Nationwide prospective audit of pancreatic surgery: design, accuracy, and outcomes of the Dutch Pancreatic Cancer Audit.

PubMed

van Rijssen, L Bengt; Koerkamp, Bas G; Zwart, Maurice J; Bonsing, Bert A; Bosscha, Koop; van Dam, Ronald M; van Eijck, Casper H; Gerhards, Michael F; van der Harst, Erwin; de Hingh, Ignace H; de Jong, Koert P; Kazemier, Geert; Klaase, Joost; van Laarhoven, Cornelis J; Molenaar, I Quintus; Patijn, Gijs A; Rupert, Coen G; van Santvoort, Hjalmar C; Scheepers, Joris J; van der Schelling, George P; Busch, Olivier R; Besselink, Marc G

2017-10-01

Auditing is an important tool to identify practice variation and 'best practices'. The Dutch Pancreatic Cancer Audit is mandatory in all 18 Dutch centers for pancreatic surgery. Performance indicators and case-mix factors were identified by a PubMed search for randomized controlled trials (RCT's) and large series in pancreatic surgery. In addition, data dictionaries of two national audits, three institutional databases, and the Dutch national cancer registry were evaluated. Morbidity, mortality, and length of stay were analyzed of all pancreatic resections registered during the first two audit years. Case ascertainment was cross-checked with the Dutch healthcare inspectorate and key-variables validated in all centers. Sixteen RCT's and three large series were found. Sixteen indicators and 20 case-mix factors were included in the audit. During 2014-2015, 1785 pancreatic resections were registered including 1345 pancreatoduodenectomies. Overall in-hospital mortality was 3.6%. Following pancreatoduodenectomy, mortality was 4.1%, Clavien-Dindo grade ≥ III morbidity was 29.9%, median (IQR) length of stay 12 (9-18) days, and readmission rate 16.0%. In total 97.2% of >40,000 variables validated were consistent with the medical charts. The Dutch Pancreatic Cancer Audit, with high quality data, reports good outcomes of pancreatic surgery on a national level. Copyright © 2017 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

The construction of ethnic differences in work incapacity risks: Analysing ordering practices of physicians in the Netherlands.

PubMed

Meershoek, Agnes; Krumeich, Anja; Vos, Rein

2011-01-01

Drawing from Science and Technology Studies we investigate the consequences for social differentiation of physicians' practices in Dutch illness certification. Using participant observation methods, we followed six 'Arbodienst' physicians for two weeks each. Our analysis explores whether and how the work of Dutch physicians contributes to the appearance of a category of 'problematic migrant patients'. We present how physicians, in using instruments to distinguish plausible from implausible claims for sick leave, impose order upon reality. In particular situations this ordering involves a distinction between Dutch and migrant clients. Here ethnicity appears in physicians' practice as a separate instrument to constitute order, which in the case of migrants overrules the productive instruments that are used for 'Dutch' clients. By interpreting clients' behaviour in cultural terms and making them into strangers, physicians lose their ability to fine-tune their coaching activities to the needs of these clients. As a result migrants remain work incapacitated for a longer period, which leads to a higher risk of their ending up in the disability pension program. As a consequence migrants become visible as a problematic group in the data on work incapacity and disability. The practice to categorise migrant clients with separate instruments thus results in a 'hard' category of problematic migrant clients and leads to social differentiation. Copyright © 2010 Elsevier Ltd. All rights reserved.

Quiet is the new loud: pausing and focus in child and adult Dutch.

PubMed

Romøren, Anna Sara H; Chen, Aoju

2015-03-01

In a number of languages, prosody is used to highlight new information (or focus). In Dutch, focus is marked by accentuation, whereby focal constituents are accented and post-focal constituents are de-accented. Even if pausing is not traditionally seen as a cue to focus in Dutch, several previous studies have pointed to a possible relationship between pausing and information structure. Considering that Dutch-speaking 4 to 5 year olds are not yet completely proficient in using accentuation for focus and that children generally pause more than adults, we asked whether pausing might be an available parameter for children to manipulate for focus. Sentences with varying focus structure were elicited from 10 Dutch-speaking 4 to 5 year olds and 9 Dutch-speaking adults by means of a picture-matching game. Comparing pause durations before focal and non-focal targets showed pre-target pauses to be significantly longer when the targets were focal than when they were not. Notably, the use of pausing was more robust in the children than in the adults, suggesting that children exploit pausing to mark focus more generally than adults do, at a stage where their mastery of the canonical cues to focus is still developing.

Cardiovascular risk management after reproductive and pregnancy-related disorders: A Dutch multidisciplinary evidence-based guideline.

PubMed

Heida, Karst Y; Bots, Michiel L; de Groot, Christianne Jm; van Dunné, Frederique M; Hammoud, Nurah M; Hoek, Annemiek; Laven, Joop Se; Maas, Angela Hem; Roeters van Lennep, Jeanine E; Velthuis, Birgitta K; Franx, Arie

2016-11-01

In the past decades evidence has accumulated that women with reproductive and pregnancy-related disorders are at increased risk of developing cardiovascular disease (CVD) in the future. Up to now there is no standardised follow-up of these women becausee guidelines on cardiovascular risk management for this group are lacking. However, early identification of high-risk populations followed by prevention and treatment of CVD risk factors has the potential to reduce CVD incidence. Therefore, the Dutch Society of Obstetrics and Gynaecology initiated a multidisciplinary working group to develop a guideline for cardiovascular risk management after reproductive and pregnancy-related disorders. The guideline addresses the cardiovascular risk consequences of gestational hypertension, preeclampsia, preterm delivery, small-for-gestational-age infant, recurrent miscarriage, polycystic ovary syndrome and premature ovarian insufficiency. The best available evidence on these topics was captured by systematic review. Recommendations for clinical practice were formulated based on the evidence and consensus of expert opinion. The Dutch societies of gynaecologists, cardiologists, vascular internists, radiologists and general practitioners reviewed the guideline to ensure support for implementation in clinical practice. For all reproductive and pregnancy-related disorders a moderate increased relative risk was found for overall CVD, except for preeclampsia (relative risk 2.15, 95% confidence interval 1.76-2.61). Based on the current available evidence, follow-up is only recommended for women with a history of preeclampsia. For all reproductive and pregnancy-related disorders optimisation of modifiable cardiovascular risk factors is recommended to reduce the risk of future CVD. © The European Society of Cardiology 2016.

Local and National Effects of a Quality System in Dutch General Practitioner Specialty Training: A Qualitative Study

ERIC Educational Resources Information Center

Buwalda, Nienke; Braspenning, Jozé; van Dijk, Nynke; Visser, Mechteld

2018-01-01

A quality system (named GEAR; acronym for Combined Evaluation Audit Round in English), has been introduced in eight institutes of the Dutch general practitioner specialty training. This paper focuses on the local and national effects of GEAR. Seventeen semi-structured interviews were conducted with the directors and quality co-ordinators. At a…

Temporal Stability of the Dutch Version of the Wechsler Memory Scale-Fourth Edition (WMS-IV-NL).

PubMed

Bouman, Zita; Hendriks, Marc P H; Aldenkamp, Albert P; Kessels, Roy P C

2015-01-01

The Wechsler Memory Scale-Fourth Edition (WMS-IV) is one of the most widely used memory batteries. We examined the test-retest reliability, practice effects, and standardized regression-based (SRB) change norms for the Dutch version of the WMS-IV (WMS-IV-NL) after both short and long retest intervals. The WMS-IV-NL was administered twice after either a short (M = 8.48 weeks, SD = 3.40 weeks, range = 3-16) or a long (M = 17.87 months, SD = 3.48, range = 12-24) retest interval in a sample of 234 healthy participants (M = 59.55 years, range = 16-90; 118 completed the Adult Battery; and 116 completed the Older Adult Battery). The test-retest reliability estimates varied across indexes. They were adequate to good after a short retest interval (ranging from .74 to .86), with the exception of the Visual Working Memory Index (r = .59), yet generally lower after a long retest interval (ranging from .56 to .77). Practice effects were only observed after a short retest interval (overall group mean gains up to 11 points), whereas no significant change in performance was found after a long retest interval. Furthermore, practice effect-adjusted SRB change norms were calculated for all WMS-IV-NL index scores. Overall, this study shows that the test-retest reliability of the WMS-IV-NL varied across indexes. Practice effects were observed after a short retest interval, but no evidence was found for practice effects after a long retest interval from one to two years. Finally, the SRB change norms were provided for the WMS-IV-NL.

Developing Classroom Formative Assessment in Dutch Primary Mathematics Education

ERIC Educational Resources Information Center

van den Berg, M.; Harskamp, E. G.; Suhre, C. J. M.

2016-01-01

In the last two decades Dutch primary school students scored below expectation in international mathematics tests. An explanation for this may be that teachers fail to adequately assess their students' understanding of learning goals and provide timely feedback. To improve the teachers' formative assessment practice, researchers, curriculum…

NASA/DOD Aerospace Knowledge Diffusion Research Project. Paper 33: Technical communications practices and the use of information technologies as reported by Dutch and US aerospace engineers

NASA Technical Reports Server (NTRS)

Barclay, Rebecca O.; Pinelli, Thomas E.; Tan, Axel S. T.; Kennedy, John M.

1993-01-01

As part of Phase 4 of the NASA/DOD Aerospace Knowledge Diffusion Research Project, two studies were conducted that investigated the technical communications practices of Dutch and U.S. aerospace engineers and scientists. A self-administered questionnaire was distributed to aerospace engineers and scientists at the National Aerospace Laboratory (The Netherlands), and NASA ARC (U.S.), and NASA LaRC (U.S.). This paper presents responses of the Dutch and U.S. participants to selected questions concerning four of the seven project objectives: determining the importance of technical communications to aerospace engineering professionals, investigating the production of technical communications, examining the use and importance of computer and information technology, and exploring the use of electronic networks.

Effect of stepped care on health outcomes in patients with osteoarthritis: an observational study in Dutch general practice.

PubMed

Smink, Agnes J; van den Ende, Cornelia H M; Vliet Vlieland, Thea P M; Bijlsma, Johannes W J; Swierstra, Bart A; Kortland, Joke H; Voorn, Theo B; Teerenstra, Steven; Schers, Henk J; Dekker, Joost; Bierma-Zeinstra, Sita M A

2014-09-01

A stepped care strategy (SCS) to improve adequate healthcare use in patients with osteoarthritis was developed and implemented in a primary care region in the Netherlands. To assess the association between care that is in line with the SCS recommendations and health outcomes. Data were used from a 2-year observational study of 313 patients who had consulted their GP because of osteoarthritis. Care was considered 'SCS-consistent' if all advised modalities of the previous steps of the SCS were offered before more advanced modalities of subsequent steps. Pain and physical function were measured with the Western Ontario and McMaster Universities Osteoarthritis Index (range 0-100); active pain coping with the Pain Coping Inventory (range 10-40); and self-efficacy with the Dutch General Self-Efficacy Scale (range 12-48). Crude and adjusted associations between SCS-consistent care and outcomes were estimated with generalised estimating equations. No statistically significant differences were found in changes over a 2-year period in pain and physical function between patients who received SCS-inconsistent care (n = 163) and patients who received SCS-consistent care (n = 117). This was also the case after adjusting for possible confounders, that is, -4.3 (95% confidence interval [CI] = -10.3 to 1.7) and -1.9 (95% CI = -7.0 to 3.1), respectively. Furthermore, no differences were found in changes over time between groups in self-efficacy and pain coping. The results raised several important issues that need to be considered regarding the value of the SCS, such as the reasons that GPs provide SCS-inconsistent care, the long-term effects of the SCS, and the effects on costs and side effects. © British Journal of General Practice 2014.

Health-related quality of life, employment and disability in patients with Sjogren's syndrome.

PubMed

Meijer, Jiska M; Meiners, Petra M; Huddleston Slater, James J R; Spijkervet, Fred K L; Kallenberg, Cees G M; Vissink, Arjan; Bootsma, Hendrika

2009-09-01

To compare health-related quality of life (HR-QOL), employment and disability of primary and secondary SS (pSS and sSS, respectively) patients with the general Dutch population. HR-QOL, employment and disability were assessed in SS patients regularly attending the University Medical Center Groningen (n = 235). HR-QOL, employment and disability were evaluated with the Short Form-36 questionnaire (SF-36) and an employment and disability questionnaire. Results were compared with Dutch population data (matched for sex and age). Demographical and clinical data associated with HR-QOL, employment and disability were assessed. Response rate was 83%. SS patients scored lower on HR-QOL than the general Dutch population. sSS patients scored lower on physical functioning, bodily pain and general health than pSS patients. Predictors for reduced HR-QOL were fatigue, tendomyalgia, articular involvement, use of artificial saliva, use of anti-depressants, comorbidity, male sex and eligibility for disability compensation (DC). Employment was lower and DC rates were higher in SS patients compared with the Dutch population. SS has a large impact on HR-QOL, employment and disability.

Meaningful participation for children in the Dutch child protection system: A critical analysis of relevant provisions in policy documents.

PubMed

Bouma, Helen; López López, Mónica; Knorth, Erik J; Grietens, Hans

2018-05-01

Policymakers are increasingly focusing on the participation of children in the child protection system (CPS). However, research shows that actual practice still needs to be improved. Embedding children's participation in legislation and policy documents is one important prerequisite for achieving meaningful participation in child protection practice. In this study, the participation of children in the Dutch CPS under the new Youth Act 2015 is critically analyzed. National legislation and policy documents were studied using a model of "meaningful participation" based on article 12 of the UNCRC. Results show that the idea of children's participation is deeply embedded in the current Dutch CPS. However, Dutch policy documents do not fully cover the three dimensions of what is considered to be meaningful participation for children: informing, hearing, and involving. Furthermore, children's participation differs among the organizations included in the child protection chain. A clear overall policy concerning the participation of children in the Dutch CPS is lacking. The conclusions of this critical analysis of policy documents and the framework of meaningful participation presented may provide a basis for the embedding of meaningful participation for children in child protection systems of other countries. Copyright © 2018 Elsevier Ltd. All rights reserved.

Trends in suicidal behaviour in Dutch general practice 1983-2013: a retrospective observational study.

PubMed

de Beurs, Derek P; Hooiveld, Mariette; Kerkhof, Ad J F M; Korevaar, Joke C; Donker, Gé A

2016-05-10

To analyse trends in suicidal behaviour as reported by the Dutch sentinel general practices from 1983 to 2013. Second, to examine the relationship between suicidal behaviour and several patient characteristics. Finally, to compare the relationship between suicidal behaviour and patient characteristics before (1983-2007) and after (2008-2013) the start of the crisis. 40 general practices in the Netherlands during the period 1983-2013. Patients with an ICPC code of P77 (suicide attempt). Primary outcomes were age-adjusted and gender-specific trends in reported suicides (342) and suicide attempts (1614). Secondary outcomes were the relationship between suicidal behaviour and age, household composition, history of depression, recognition of suicide ideation, treatment before the suicidal behaviour and contact within the past month before suicidal behaviour for the period 1983-2013. Additionally, separate frequencies for the periods 1983-2007 and 2008-2013 were presented. Join-point analyses revealed a significant rise in male suicides from 2008 (b=0.32, SE=0.1, p=0.008), and an increase in male suicide attempts since 2009 (b=0.19, SE=0.04, p<0.001). Female suicidal behaviour showed a steady decrease from 1989 to 2013(b=-0.03, SE=0.007, p<0.0001 for female suicide, b=-0.02, SE=0.002, p<0.001 for female attempts). Before 2007, a history of depression was reported in 65% (168/257) of the suicides. After the start of the recession, a depression was recognised in 44% (22/50) of the patients who died by suicide. Since 2008, there was a rise in the male suicide rate while female suicide behaviour has continued to decline. General practitioners less often reported a history of depression within patients who died due to suicide after 2007 than before. Training in the early recognition of suicide ideation in depressive patients might improve suicide prevention in primary care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

[The practice of Dutch child and adolescent psychiatry - developments over the last fifteen years].

PubMed

Boer, F

2013-01-01

The child and adolescent psychiatry (cap) section of the Dutch Association for Psychiatry intends to keep track of the extent to which CAP is practised and to monitor the way in which it functions. The CAP has conducted three surveys since 1996. This paper reports on the 2012 survey. To investigate the composition (i.e. age and gender) of specialists working in child and adolescent psychiatry, to find out how much time these psychiatrists really spend on child and adolescent psychiatry and what type of work they actually do; furthermore, to make a list of specific questions such as 24-hour availability, and to note opinions regarding the planned transfer of child and adolescent mental health care facilities to town councils. A survey was conducted and an analysis was made of the data collected. The number of specialists practicing child and adolescent psychiatry in the Netherlands, expressed in full-time equivalents, has more than doubled since 1996 (from 183 in 1996 tot 389 in 2012). Compared to 1996, many more of these psychiatrists spend nearly all their time on CAP. The percentage of these specialists working only in private practice remains the same as in 1996 (19%) , although the percentage was lower in 2003 (135). Whereas in 1996 specialists in child and adolescent psychiatry worked mainly as psychotherapists, in 2012 they were working in a broader field, including assessment and pharmacotherapy. Dutch CAP has grown substantially over the past 15 years. Growth in psychiatry in general has been even more marked. Considering the current composition of the population, there is only a relatively limited amount of specialised psychiatric help available for people under the age of 20. The impending transfer of CAP mental health care facilities to town councils is a matter of deep concern to professionals and to psychiatrists in particular. Only if CAP investigations continue over the coming years will it become clear that this deep concern is entirely justified.

Dutch museum marks Einstein anniversary

NASA Astrophysics Data System (ADS)

van Calmthout, Matijn

2016-01-01

A new painting of Albert Einstein's field equation from his 1915 general theory of relativity was unveiled in a ceremony in November 2015 by the Dutch physicist Robbert Dijkgraaf, who is director of the Princeton Institute for Advanced Study in the US.

Improved Sanitation Practice for Control of Dutch Elm Disease

Treesearch

Jack H. Barger

1977-01-01

In Detroit, Michigan, 12 plots, each containing about 600 American elm trees, Ulmus americana L., were subjected for 3 years to intensive and conventional sanitation treatments to control Dutch elm disease. In the intensive treatment, three disease surveys were conducted each year; each followed by tree removal within 20 working days. In the...

The Dutch Experience with Weighted Student Funding

ERIC Educational Resources Information Center

Fiske, Edward B.; Ladd, Helen F.

2010-01-01

Weighted student funding (WSF) is used in several U.S. cities as a method for providing more funds to schools with high concentrations of disadvantaged students. The practice has been used successfully in the Netherlands since 1985. Several factors make the success of the Dutch system unlikely to transfer to the United States, including the Dutch…

Evidence for and cost-effectiveness of physiotherapy in haemophilia: a Dutch perspective.

PubMed

de Kleijn, P; Mauser-Bunschoten, E P; Fischer, K; Smit, C; Holtslag, H; Veenhof, C

2016-11-01

Musculoskeletal impact of haemophilia justifies physiotherapy throughout life. Recently the Dutch Health Care Institute constrained their 'list of chronic conditions', and withdrew financial coverage of physiotherapy for elderly persons with haemophilia (PWH). This decision was based on lack of scientific evidence and not being in accordance with 'state of science and practice'. In general, evidence regarding physiotherapy is limited, and especially in rare diseases like haemophilia. 'Evidence based medicine' classifies and recommends evidence based on meta-analyses, systematic reviews and randomized controlled trials, but also means integrating evidence with individual clinical expertise. For the evaluation of physiotherapy - usually individualized treatment - case studies, observational studies and Case Based Reasoning may be more beneficial. Overall annual treatment costs for haemophilia care in the Netherlands are estimated over 100 million Euros, of which 95% is covered by clotting factor concentrates. The cost for physiotherapy assessments in all seven Dutch HTCs (seven centres for adult PWH and seven centres for children) is limited at approximately 500 000 Euros annually. Costs of the actual physiotherapy sessions, carried out in our Dutch first-line care system, will also not exceed 500 000 Euros. Thus, implementation of physiotherapy in haemophilia care the Netherlands in a most optimal way would cost less than 1% of the total budget. The present paper describes the role of physiotherapy in haemophilia care including available evidence and providing suggestions regarding generation of evidence. Establishing the effectiveness and cost-effectiveness of physiotherapy in haemophilia care is a major topic for the next decennium. © 2016 John Wiley & Sons Ltd.

A sustainable primary care system: lessons from the Netherlands.

PubMed

Faber, Marjan J; Burgers, Jako S; Westert, Gert P

2012-01-01

The Dutch primary care system has drawn international attention, because of its high performance at low cost. Primary care practices are easily accessible during office hours and collaborate in a unique out-of-hours system. After the reforms in 2006, there are no copayments for patients receiving care in the primary care practice in which they are registered. Financial incentives support the transfer of care from hospital specialists to primary care physicians, and task delegation from primary care physicians to practice nurses. Regional collaborative care groups of primary care practices offer disease management programs. The quality assessment system and the electronic medical record system are predominantly driven by health care professionals. Bottom-up and top-down activities contributed to a successful Dutch primary care system.

Physical therapists' management of rheumatoid arthritis: results of a Dutch survey.

PubMed

Hurkmans, E J; Li, L; Verhoef, J; Vliet Vlieland, T P M

2012-09-01

For tailored implementation of evidence-based recommendations and guidelines on physical therapy in patients with rheumatoid arthritis (RA), insight into current physical therapy practice is needed. Two hundred and fifty general physical therapists and 211 specialized physical therapists with advanced arthritis training were sent a questionnaire to assess the frequency with which they applied a set of assessments (n = 10) and interventions (n = 7) included in a Dutch physical therapy guideline for RA. Differences between general and specialist physical therapists were analysed using Student's t-tests or chi-square tests where appropriate. In total, 233 physical therapists (51%) responded. Of these, 96 (41%) had completed an additional arthritis course and were designated as specialist physical therapists. Among the physical therapists who returned the questionnaire, 69% (or more) reported that they 'always' assessed limitations in daily functioning, pain, morning stiffness, muscle strength, joint range of motion, joint stability, gait and limitations in leisure activities as part of their initial assessment, and 37% and 48% reported 'always' to assess aerobic capacity and limitations in work situations, respectively. Concerning interventions, exercise therapy and education were 'always' applied by 70% and 68% of the responders, respectively. Only a minority of responders reported 'always' applying ultrasound, electrical stimulation, heat therapy, massage and passive mobilizations (0%, 0%, 5%, 5% and 14%, respectively). Apart from aerobic capacity and work limitations, all other assessments were reported as 'always' applied by significantly (p < 0.05) more specialist physical therapists than general physical therapists. Regarding interventions, significantly more specialist physical therapists reported that they 'always' applied exercise therapy and education. Significantly fewer specialist physical therapists than in the general group reported 'always' using heat therapy, massage and mobilizations (p < 0.05). The majority of physical therapists reported that they 'always' applied most of the assessments and interventions recommended in a Dutch physical therapy guideline for the management of RA. Areas for improvement include the assessment of aerobic capacity and work limitations. The observed differences between specialist and general physical therapists support the added value of advanced arthritis courses. Copyright © 2012 John Wiley & Sons, Ltd.

NASA/DoD Aerospace Knowledge Diffusion Research Project. XXXIII - Technical communications practices and the use of information technologies as reported by Dutch and U.S. aerospace engineers

NASA Technical Reports Server (NTRS)

Barclay, Rebecca O.; Pinelli, Thomas E.; Tan, Axel S. T.; Kennedy, John M.

1993-01-01

As part of Phase 4 of the NASA/DOD Aerospace Knowledge Diffusion Research Project, two studies were conducted that investigated the technical communications practices of Dutch and U.S. aerospace engineers and scientists. A self-administered questionnaire was distributed to aerospace engineers and scientists at the National Aerospace Laboratory (The Netherlands), and NASA Ames Research Center (U.S.), and the NASA Langley Research Center (U.S.). This paper presents responses of the Dutch and U.S. participants to selected questions about four of the seven project objectives: determining the importance of technical communications to aerospace engineering professionals, investigating the production of technical communications, examining the use and importance of computer and information technology, and exploring the use of electronic networks.

Psychometric properties and Dutch norm data of the PedsQL Multidimensional Fatigue Scale for Young Adults.

PubMed

Haverman, Lotte; Limperg, Perrine F; van Oers, Hedy A; van Rossum, Marion A J; Maurice-Stam, Heleen; Grootenhuis, Martha A

2014-12-01

The aim of this study was to assess internal consistency and construct validity (known-groups validity) and to provide Dutch norm data for the Dutch Pediatric Quality of Life Inventory Multidimensional Fatigue Scale for Young Adults ages 18-30 years (PedsQL fatigue_YA). A Dutch sample of 649 young adults completed online a sociodemographic questionnaire and the PedsQL fatigue_YA including three subscales: general fatigue, sleep/rest fatigue and cognitive fatigue (0-100: Higher scores indicate less fatigue symptoms). The PedsQL fatigue_YA showed satisfactory to good internal consistency (Cronbach's alpha = .70-.94), except for one scale (.68). The mean scale scores were 68.23 (SD 19.15) for 'general fatigue,' 67.04 (SD 15.54) for 'sleep/rest fatigue' and 74.62 (SD 19.02) for 'cognitive fatigue.' Men reported significantly higher scores on 'general fatigue' and 'sleep/rest fatigue' than women. The PedsQL fatigue_YA distinguished between healthy young adults and young adults with chronic health conditions, with higher scores on all scales in healthy young adults than in those with a chronic health condition. The results demonstrate good psychometric properties of the PedsQL fatigue_YA in a sample of Dutch young adults. With the current norms available, it is possible to evaluate fatigue in the Netherlands from childhood to adulthood with the PedsQL Multidimensional Fatigue Scale.

Perceived antecedents of marital satisfaction among Turkish, Turkish-Dutch, and Dutch couples.

PubMed

Celenk, Ozgur; van de Vijver, Fons J R

2013-01-01

We studied mainstream couples in The Netherlands and Turkey as well as Turkish-Dutch immigrant couples to address cultural factors associated with marital satisfaction. A total of 13 Turkish (mainstream couples living in Turkey), 19 Turkish-Dutch (Turkish immigrant couples living in The Netherlands), and 17 Dutch (mainstream couples living in The Netherlands) married dyads (total of 98 individuals) were independently interviewed about positive and negative characteristics of marriages, determinants of general marital satisfaction and dissatisfaction, spousal communication, marital conflict, and marital roles. Multivariate tests revealed ethnic group differences on all marriage-related domains except the conflict resolution strategies. However, univariate analyses showed differences in few themes within domains; main differences were assessed between the Turkish/Turkish-Dutch (who put more emphasis on children and economical aspects) and Dutch couples (who put more emphasis on behavior, and personality of the spouse, reciprocity, emotional sharing, and psychological roles). Turkish-Dutch couples were more similar to Turkish than to Dutch couples. Results were discussed in light of the socioeconomic development and cultural value theories, which are believed to provide a useful framework for understanding the role of culture in marital satisfaction.

Status Report on Speech Research. A Report on the Status and Progress of Studies on the Nature of Speech, Instrumentation for Its Investigation, and Practical Applications.

DTIC Science & Technology

1983-01-01

Satoshi Horiguchi 2 Harriet Magen Leonard Katz’ Sharon Manuel J. A. Scott Kelso Richard McGowan Andrea G. Levitt’ Daniel Recasens Isabelle Y... Martinus Nijhoff, 1959. Collier, R., & ’t Hart, J. The perceptual relevance of formant trajectories in diphthongs. In M. van den Broecke & V. van Heuven...Studies in Dutch phonology (Dutch Studies, Vol. 4). The Hague: Martinus Nijhoff, 1980. FOOTNOTES Ipossible occurrences of these diphthongs in Dutch

[Websites of dental practices evaluated].

PubMed

Poorterman, J H G; Tjiook, S P; Moeijes, S F S; Brand, H S

2014-05-01

In 2013, a dental practice without a website is almost unthinkable. Using a sample of309 dentists drawn from the list of members of the Dutch Dental Association in 2012, a study was carried out to find out whether the dental practice of the general dental practitioner had a website. The content of each website was subsequently inventoried using a questionnaire. Eighty-nine percent of the dental practices had a website. The content of the websites, however, varied enormously. An element such as the professional registration number with a reference to the professional register were absent in 73% of the websites and the date of the most recent update of the website was mentioned only once. The name of the dentist, his or her professional qualification and an email address were missing on respectively 9%, 20% and 9% of the websites. Contracts of the practice with insurance companies were rarely clearly indicated. The websites of many practices would benefit considerably from a significant improvement.

Care Model Design for E-Health: Integration of Point-of-Care Testing at Dutch General Practices.

PubMed

Verhees, Bart; van Kuijk, Kees; Simonse, Lianne

2017-12-21

Point-of-care testing (POCT)-laboratory tests performed with new mobile devices and online technologies outside of the central laboratory-is rapidly outpacing the traditional laboratory test market, growing at a rate of 12 to 15% each year. POCT impacts the diagnostic process of care providers by yielding high efficiency benefits in terms of turnaround time and related quality improvements in the reduction of errors. However, the implementation of this disruptive eHealth technology requires the integration and transformation of diagnostic services across the boundaries of healthcare organizations. Research has revealed both advantages and barriers of POCT implementations, yet to date, there is no business model for the integration of POCT within general practice. The aim of this article is to contribute with a design for a care model that enables the integration of POCT in primary healthcare. In this research, we used a design modelling toolkit for data collection at five general practices. Through an iterative design process, we modelled the actors and value transactions, and designed an optimized care model for the dynamic integration of POCTs into the GP's network of care delivery. The care model design will have a direct bearing on improving the integration of POCT through the connectivity and norm guidelines between the general practice, the POC technology, and the diagnostic centre.

Care Model Design for E-Health: Integration of Point-of-Care Testing at Dutch General Practices

PubMed Central

Verhees, Bart; van Kuijk, Kees

2017-01-01

Point-of-care testing (POCT)—laboratory tests performed with new mobile devices and online technologies outside of the central laboratory—is rapidly outpacing the traditional laboratory test market, growing at a rate of 12 to 15% each year. POCT impacts the diagnostic process of care providers by yielding high efficiency benefits in terms of turnaround time and related quality improvements in the reduction of errors. However, the implementation of this disruptive eHealth technology requires the integration and transformation of diagnostic services across the boundaries of healthcare organizations. Research has revealed both advantages and barriers of POCT implementations, yet to date, there is no business model for the integration of POCT within general practice. The aim of this article is to contribute with a design for a care model that enables the integration of POCT in primary healthcare. In this research, we used a design modelling toolkit for data collection at five general practices. Through an iterative design process, we modelled the actors and value transactions, and designed an optimized care model for the dynamic integration of POCTs into the GP’s network of care delivery. The care model design will have a direct bearing on improving the integration of POCT through the connectivity and norm guidelines between the general practice, the POC technology, and the diagnostic centre. PMID:29267224

Initiating advance care planning on end-of-life issues in dementia: Ambiguity among UK and Dutch physicians.

PubMed

van der Steen, Jenny T; Galway, Karen; Carter, Gillian; Brazil, Kevin

2016-01-01

In dementia, advance care planning (ACP) of end-of-life issues may start as early as possible in view of the patient's decreasing ability to participate in decision making. We aimed to assess whether practicing physicians in the Netherlands and the United Kingdom who provide most of the end-of-life care, differ in finding that ACP in dementia should start at diagnosis. In a cross-sectional study, we surveyed 188 Dutch elderly care physicians who are on the staff of nursing homes and 133 general practitioners from Northern Ireland. We compared difference by country in the outcome (perception of ACP timing), rated on a 1-5 agreement scale. Regression analyses examined whether a country difference can be explained by contrasts in demographics, presence, exposure and role perceptions. There was wide variability in agreement with the initiation of ACP at dementia diagnosis, in particular in the UK but also in the Netherlands (60.8% agreed, 25.3% disagreed and 14.0% neither agreed, nor disagreed). Large differences in physician characteristics (Dutch physicians being more present, exposed and adopting a stronger role perception) hardly explained the modest country difference. The perception that the physician should take the initiative was independently associated with agreeing with ACP at diagnosis. There is considerable ambiguity about initiating ACP in dementia at diagnosis among physicians practicing in two different European health care systems and caring for different patient populations. ACP strategies should accommodate not only variations in readiness to engage in ACP early among patient and families, but also among physicians. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

How to improve mental health competency in general practice training?--a SWOT analysis.

PubMed

van Marwijk, Harm

2004-06-01

It is quite evident there is room for improvement in the primary care management of common mental health problems. Patients respond positively when GPs adopt a more proactive role in this respect. The Dutch general practice curriculum is currently being renewed. The topics discussed here include the Strengths, Weaknesses, Opportunities and Threats (SWOT) of present primary mental healthcare teaching. What works well and what needs improving? Integrated teaching packages are needed to help general practice trainees manage various presentations of psychological distress. Such packages comprise training videotapes, in which models such as problem-solving treatment (PST) are demonstrated, as well as roleplaying material for new skills, self-report questionnaires for patients, and small-group video feedback of consultations. While GP trainees can effectively master such skills, it is important to query the level of proficiency required by registrars. Are these skills of use only to connoisseur GPs, or to all? More room for specialisation and differentiation among trainees may be the way forward. We have just developed a new curriculum for the obligatory three-month psychiatry housemanship. It is competency oriented, self-directed and assignment driven. This new curriculum will be evaluated in due course.

Assessment of vital exhaustion and identification of subjects at increased risk of myocardial infarction in general practice.

PubMed

Schuitemaker, G E; Dinant, G J; van der Pol, G A; Appels, A

2004-01-01

Vital exhaustion, a state characterized by unusual fatigue, loss of energy, increased irritability, and feelings of demoralization, is one of the cardiovascular risk factors. The authors investigated whether vital exhaustion contributes to the identification of subjects at increased risk of myocardial infarction in general practice. In this prospective cohort study, vital exhaustion was assessed with the Maastricht Interview on Vital Exhaustion. Other cardiovascular risk factors established were age, gender, systolic and diastolic blood pressure, total cholesterol, body mass index, smoking habits, cardiovascular disease, and diabetes mellitus. A Cox regression analysis was used. The subjects were adults (41-66 years) in an average Dutch village population. Outcome measures were fatal and nonfatal myocardial infarction. At the univariate level, vital exhaustion doubled the risk of myocardial infarction. The effect of exhaustion was confounded by gender; women had higher exhaustion scores and a lower incidence of myocardial infarction. With control for gender, age, systolic blood pressure, total cholesterol, smoking habits, self-reported cardiovascular disease, and diabetes mellitus, vital exhaustion almost tripled the risk of myocardial infarction. Assessment of vital exhaustion contributes to the identification of subjects at increased risk of myocardial infarction in general practice.

Usual care and management of fall risk increasing drugs in older dizzy patients in Dutch general practice

PubMed Central

Stam, Hanneke; Harting, Thomas; van der Sluijs, Marjolijn; van Marum, Rob; van der Horst, Henriëtte; van der Wouden, Johannes C.; Maarsingh, Otto R.

2016-01-01

Objective For general practitioners (GPs) dizziness is a challenging condition to deal with. Data on the management of dizziness in older patients are mostly lacking. Furthermore, it is unknown whether GPs attempt to decrease Fall Risk Increasing Drugs (FRIDs) use in the management of dizziness in older patients. The aim of this study is to gain more insight into GP’s management of dizziness in older patients, including FRID evaluation and adjustment. Design Data were derived from electronic medical records, obtained over a 12-month period in 2013. Setting Forty-six Dutch general practices. Patients The study sample comprised of 2812 older dizzy patients of 65 years and over. Patients were identified using International Classification of Primary Care codes and free text. Main outcome measures Usual care was categorized into wait-and-see strategy (no treatment initiated); education and advice; additional testing; medication adjustment; and referral. Results Frequently applied treatments included a wait-and-see strategy (28.4%) and education and advice (28.0%). Additional testing was performed in 26.8%; 19.0% of the patients were referred. Of the patients 87.2% had at least one FRID prescription. During the observation period, GPs adjusted the use of one or more FRIDs for 11.7% of the patients. Conclusion This study revealed a wide variety in management strategies for dizziness in older adults. The referral rate for dizziness was high compared to prior research. Although many older dizzy patients use at least one FRID, FRID evaluation and adjustment is scarce. We expect that more FRID adjustments may reduce dizziness and dizziness-related impairment. Key PointsIt is important to know how general practitioners manage dizziness in older patients in order to assess potential cues for improvement.This study revealed a wide variety in management strategies for dizziness in older patients.There was a scarcity in Fall Risk Increasing Drug (FRID) evaluation and adjustment.The referral rate for dizziness was high compared with previous research. PMID:27049170

Usual care and management of fall risk increasing drugs in older dizzy patients in Dutch general practice.

PubMed

Stam, Hanneke; Harting, Thomas; Sluijs, Marjolijn van der; Marum, Rob van; Horst, Henriëtte van der; Wouden, Johannes C van der; Maarsingh, Otto R

2016-06-01

For general practitioners (GPs) dizziness is a challenging condition to deal with. Data on the management of dizziness in older patients are mostly lacking. Furthermore, it is unknown whether GPs attempt to decrease Fall Risk Increasing Drugs (FRIDs) use in the management of dizziness in older patients. The aim of this study is to gain more insight into GP's management of dizziness in older patients, including FRID evaluation and adjustment. Data were derived from electronic medical records, obtained over a 12-month period in 2013. Forty-six Dutch general practices. The study sample comprised of 2812 older dizzy patients of 65 years and over. Patients were identified using International Classification of Primary Care codes and free text. Usual care was categorized into wait-and-see strategy (no treatment initiated); education and advice; additional testing; medication adjustment; and referral. Frequently applied treatments included a wait-and-see strategy (28.4%) and education and advice (28.0%). Additional testing was performed in 26.8%; 19.0% of the patients were referred. Of the patients 87.2% had at least one FRID prescription. During the observation period, GPs adjusted the use of one or more FRIDs for 11.7% of the patients. This study revealed a wide variety in management strategies for dizziness in older adults. The referral rate for dizziness was high compared to prior research. Although many older dizzy patients use at least one FRID, FRID evaluation and adjustment is scarce. We expect that more FRID adjustments may reduce dizziness and dizziness-related impairment. Key Points It is important to know how general practitioners manage dizziness in older patients in order to assess potential cues for improvement. This study revealed a wide variety in management strategies for dizziness in older patients. There was a scarcity in Fall Risk Increasing Drug (FRID) evaluation and adjustment. The referral rate for dizziness was high compared with previous research.

The role of general parenting and cannabis-specific parenting practices in adolescent cannabis and other illicit drug use.

PubMed

Vermeulen-Smit, E; Verdurmen, J E E; Engels, R C M E; Vollebergh, W A M

2015-02-01

To investigate general and cannabis-specific parenting practices in relation to adolescent cannabis and other illicit drug use. Data were derived from the Dutch National School Survey on Substance Use among students (N=3209; aged 12-16 years) and one of their parents in 2011. Logistic regression analyses revealed that 1) parental cannabis use was significantly related to more adolescent lifetime and recent cannabis use, and 2) restrictive cannabis-specific parental rules were associated with less adolescent recent cannabis and lifetime use of other illicit drugs, even when controlled for sociodemographic factors, general parenting, adolescent tobacco use, and tobacco-specific parenting. In addition, no significant interaction was observed between parental cannabis use and cannabis-specific rules in their relation to adolescent cannabis and other illicit drug use, indicating that cannabis rules are evenly associated with adolescent drug use for families with and without parental cannabis experience. In addition to general parenting practices, restrictive cannabis-specific rules are related to lower adolescent cannabis and other illicit drug rates. Parents who ever used cannabis have children with a higher prevalence of cannabis use. However, their restrictive cannabis-specific rules are equally related to a lower chance of adolescent cannabis use. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

[Datanet 1 and the convergence of the computer and telecommunications].

PubMed

de Wit, Onno

2008-01-01

This article describes the efforts of the Dutch national company for telecommunication, PTT, in introducing and developing a public network for data communication in the Netherlands in the last decades of the twentieth century. As early as the 1960s, private companies started to connect their local computers. As a result, small private computer networks started to emerge. As the state company offering general access to public services in telephony, the PTT strove to develop a public data network, accessible to every user and telephone subscriber. This ambition was realized with Datanet 1, the public data network which was officially opened in 1982. In the years that followed, Datanet became the dominant network for data transmission, despite competing efforts by private companies and computer manufacturers. The large-scale application of Datanet in public municipal administration serves as a case study for the development of data communication in practice, that shows that there was a gradual migration from X-25 to TCP/IP protocols. The article concludes by stating that the introduction and development of data transmission transformed the role of the PTT in Dutch society, brought new working practices, new services and new responsibilities, and resulted in a whole new phase in the history of the computer.

No Issue, No Problem? Co-Education in Dutch Secondary Physical Education during the Twentieth Century.

ERIC Educational Resources Information Center

Van Essen, Mineke

2003-01-01

Examines the development co-education in Dutch secondary physical education, suggesting that the dominant 20th century co-educational tradition in the Netherlands has influenced educational ideals and school practice with respect to physical education. Asserts that a historical lack of discussions about co-education trivializes today's problems in…

Web-based computer-tailoring for practice nurses aimed to improve smoking cessation guideline adherence: A study protocol for a randomized controlled effectiveness trial.

PubMed

de Ruijter, D; Smit, E S; de Vries, H; Hoving, C

2016-05-01

Dutch practice nurses sub-optimally adhere to evidence-based smoking cessation guidelines. Web-based computer-tailoring could be effective in improving their guideline adherence. Therefore, this paper aims to describe the development of a web-based computer-tailored program and the design of a randomized controlled trial testing its (cost-)effectiveness. Theoretically grounded in the I-Change Model and Self-Determination Theory, and based on the results of a qualitative needs assessment among practice nurses, a web-based computer-tailored program was developed including three modules with tailored advice, an online forum, modules with up-to-date information about smoking cessation, Frequently Asked Questions (FAQs) and project information, and a counseling checklist. The program's effects are assessed by comparing an intervention group (access to all modules) with a control group (access to FAQs, project information and counseling checklist only). Smoking cessation guideline adherence and behavioral predictors (i.e. intention, knowledge, attitude, self-efficacy, social influence, action and coping planning) are measured at baseline and at 6- and 12-month follow-up. Additionally, the program's indirect effects on smokers' quit rates and the number of quit attempts are assessed after 6 and 12months. This paper describes the development of a web-based computer-tailored adherence support program for practice nurses and the study design of a randomized controlled trial testing its (cost-)effectiveness. This program potentially contributes to improving the quality of smoking cessation care in Dutch general practices. If proven effective, the program could be adapted for use by other healthcare professionals, increasing the public health benefits of improved smoking cessation counseling for smokers. Copyright © 2016 Elsevier Inc. All rights reserved.

Quinine, Malaria, and the Cinchona Bureau: Marketing Practices and Knowledge Circulation in a Dutch Transoceanic Cinchona–Quinine Enterprise (1920s–30s)

PubMed Central

Roersch Van Der Hoogte, Arjo; Pieters, Toine

2016-01-01

In this study, we will show how a Dutch pharmaceutical consortium of cinchona producers and quinine manufacturers was able to capitalize on one of the first international public health campaigns to fight malaria, thereby promoting the sale of quinine, an antimalarial medicine. During the 1920s and 1930s, the international markets for quinine were controlled by this Dutch consortium, which was a transoceanic cinchona–quinine enterprise centered in the Cinchona Bureau in the Netherlands. We will argue that during the interwar period, the Cinchona Bureau became the decision-making center of this Dutch cinchona–quinine pharmaceutical enterprise and monopolized the production and trade of an essential medicine. In addition, we will argue that capitalizing on the international public health campaign in the fight against malaria by the Dutch cinchona–quinine enterprise via the Cinchona Bureau can be regarded as an early example of corporate colonization of public health by a private pharmaceutical consortium. Furthermore, we will show how commercial interests prevailed over scientific interests within the Dutch cinchona–quinine consortium, thus interfering with and ultimately curtailing the transoceanic circulation of knowledge in the Dutch empire. PMID:26054829

Datasets collected in general practice: an international comparison using the example of obesity.

PubMed

Sturgiss, Elizabeth; van Boven, Kees

2018-06-04

International datasets from general practice enable the comparison of how conditions are managed within consultations in different primary healthcare settings. The Australian Bettering the Evaluation and Care of Health (BEACH) and TransHIS from the Netherlands collect in-consultation general practice data that have been used extensively to inform local policy and practice. Obesity is a global health issue with different countries applying varying approaches to management. The objective of the present paper is to compare the primary care management of obesity in Australia and the Netherlands using data collected from consultations. Despite the different prevalence in obesity in the two countries, the number of patients per 1000 patient-years seen with obesity is similar. Patients in Australia with obesity are referred to allied health practitioners more often than Dutch patients. Without quality general practice data, primary care researchers will not have data about the management of conditions within consultations. We use obesity to highlight the strengths of these general practice data sources and to compare their differences. What is known about the topic? Australia had one of the longest-running consecutive datasets about general practice activity in the world, but it has recently lost government funding. The Netherlands has a longitudinal general practice dataset of information collected within consultations since 1985. What does this paper add? We discuss the benefits of general practice-collected data in two countries. Using obesity as a case example, we compare management in general practice between Australia and the Netherlands. This type of analysis should start all international collaborations of primary care management of any health condition. Having a national general practice dataset allows international comparisons of the management of conditions with primary care. Without a current, quality general practice dataset, primary care researchers will not be able to partake in these kinds of comparison studies. What are the implications for practitioners? Australian primary care researchers and clinicians will be at a disadvantage in any international collaboration if they are unable to accurately describe current general practice management. The Netherlands has developed an impressive dataset that requires within-consultation data collection. These datasets allow for person-centred, symptom-specific, longitudinal understanding of general practice management. The possibilities for the quasi-experimental questions that can be answered with such a dataset are limitless. It is only with the ability to answer clinically driven questions that are relevant to primary care that the clinical care of patients can be measured, developed and improved.

Psychopathology, cognition and outcome in Dutch and immigrant first-episode psychosis patients.

PubMed

Stouten, Luyken H; Veling, Wim; Laan, Winfried; Van der Gaag, Mark

2018-03-30

The primary aim was to examine differences in baseline symptom expression, neurocognition, social cognition and psychosocial functioning between Dutch, first-generation immigrants and second-generation immigrants with a first-episode psychosis (FEP). The secondary aim was to examine functional and symptomatic change and between-group differences at 12-months follow-up. Associations between migration, baseline characteristics and outcome were explored. Forty-six Dutch, 56 second-generation- and 60 first-generation immigrant patients completed baseline measures for 6 symptom dimensions (positive symptoms, negative symptoms, neurocognitive functioning, social cognitive functioning, excitement and emotional distress) and 5 domains of psychosocial functioning (general functioning, work and study, relationships, self-care and disturbing behaviour). Functioning and psychotic symptoms were assessed at baseline and 12-months follow-up. ANCOVA and t tests were used to assess between-group differences. General linear models were used to explore within-group differences. Backward-regression was used to explore predictors of outcome. Levels of positive symptoms, excitement and emotional distress did not differ between groups at baseline or follow-up. Dutch patients had lower levels of negative symptoms than both immigrant groups at follow-up. On neurocognition and social cognition, Dutch performed better than second-generation immigrants, who in turn performed better than first-generation immigrants. Psychosocial functioning across all domains at baseline and at 12-months follow-up was similar across groups. Baseline levels of general psychosocial functioning and income were the strongest predictors of outcome at follow-up. Psychosocial functioning and symptom profiles are comparable between Dutch, first-generation immigrant and second-generation immigrant FEP patients, excluding neurocognitive and social cognitive deficits. A range of baseline characteristics predicted outcome. © 2018 John Wiley & Sons Australia, Ltd.

Antidepressants during pregnancy: Guideline adherence and current practice amongst Dutch gynaecologists and midwives.

PubMed

Molenaar, Nina M; Brouwer, Marlies E; Duvekot, Johannes J; Burger, Huibert; Knijff, Esther M; Hoogendijk, Witte J; Bockting, Claudi L H; de Wolf, G S; Lambregtse-van den Berg, Mijke P

2018-06-01

prescription rates of antidepressants during pregnancy range from 2-3% in The Netherlands to 6.2% in the USA. Inconclusive evidence about harms and benefits of antidepressants during pregnancy leads to variation in advice given by gynaecologists and midwives. The objective was to investigate familiarity with, and adherence to the Dutch multidisciplinary guideline on Selective Serotonin Reuptake Inhibitor (SSRI) use during pregnancy by gynaecologists and midwives in the Netherlands. an online survey was developed and send to Dutch gynaecologists and midwives. The survey consisted mainly of multiple-choice questions addressing guideline familiarity and current practice of the respondent. Also, caregiver characteristics associated with guideline adherence were investigated. a total of 178 gynaecologists and 139 midwives responded. Overall familiarity with the Dutch guideline was 92.7%. However, current practice and advice given to patients by caregivers differed substantially, both between gynaecologists and midwives as well as within both professions. Overall guideline adherence was 13.9%. Multivariable logistic regression showed that solely caregiver profession was associated with guideline adherence, with gynaecologists having a higher adherence rate (OR 2.10, 95%CI 1.02-4.33) than midwives. although reported familiarity with the guideline is high, adherence to the guideline is low, possibly resulting in advice to patients that is inconsistent with guidelines and unwanted variation in current practice. further implementation of the recommendations as given in the guideline should be stimulated. Additional research is needed to examine how gynaecologists and midwives can be facilitated to follow the recommendations of the clinical guideline on SSRI use during pregnancy. Copyright © 2018 Elsevier Ltd. All rights reserved.

Developments in legal and medical practice regarding the unborn child and the need to expand prenatal legal protection.

PubMed

Dorscheidt, Jozef H H M

2010-12-01

Developments in legal and medical practice in the Netherlands give rise to questions regarding the legal position of the unborn child. This article provides an overview of these developments and argues--in view of developments in other countries--that current Dutch legislation regarding the unborn child is not up to date. In effect, the article challenges the idea that the actual legal protection of the unborn child under positive Dutch law can be considered proportionate, even sufficient. To support this view the author will show that abortion is not the only matter in which clarity as to the legal protection of the viable unborn child is required. This signalisation provides good cause to reconsider the Dutch perspective on the matter, thus offering a point of reference to countries with a similar interpretation of what constitutes an appropriate legal protection of the unborn child.

Social Workers' Orientation Toward the Evidence-Based Practice Process: A Dutch Survey.

PubMed

van der Zwet, Renske J M; Kolmer, Deirdre M Beneken Genaamd; Schalk, René

2016-10-01

This study assesses social workers' orientation toward the evidence-based practice (EBP) process and explores which specific variables (e.g. age) are associated. Data were collected from 341 Dutch social workers through an online survey which included a Dutch translation of the EBP Process Assessment Scale (EBPPAS), along with 13 background/demographic questions. The overall level of orientation toward the EBP process is relatively low. Although respondents are slightly familiar with it and have slightly positive attitudes about it, their intentions to engage in it and their actual engagement are relatively low. Respondents who followed a course on the EBP process as a student are more oriented toward it than those who did not. Social workers under 29 are more familiar with the EBP process than those over 29. We recommend educators to take a more active role in teaching the EBP process to students and social workers.

Burnout and engagement among resident doctors in the Netherlands: a national study.

PubMed

Prins, Jelle T; Hoekstra-Weebers, Josette E H M; Gazendam-Donofrio, Stacey M; Dillingh, Gea S; Bakker, Arnold B; Huisman, Mark; Jacobs, Bram; van der Heijden, Frank M M A

2010-03-01

This study was performed in order to gather insight into the well-being of Dutch medical residents. In 2005, all Dutch residents registered through the Medical Registration Committee (n = 5245) were sent a self-report questionnaire to assess socio-demographic and work-related characteristics, burnout and engagement. Of the 5140 eligible residents, 2115 completed the questionnaire (41%). Of those, 21% fulfilled the criteria for moderate to severe burnout and 27% were highly engaged with their work. Women reported more emotional exhaustion and less depersonalisation than men; age was weakly but significantly related to depersonalisation, and married residents and parents reported less depersonalisation than their single or childless counterparts. More men than women were found to be highly engaged and men specifically reported more vigour. Number of years in training was weakly but significantly related to absorption. With regard to occupational risk factors, significant between-group differences were found for the effects of clinical setting on emotional exhaustion, engagement, vigour and absorption. Residents in training in a mental health clinic were most emotionally exhausted and those in a rehabilitation centre were least engaged. General surgery represented the specialty with the lowest number of residents suffering from burnout, followed by obstetrics and gynaecology and any supportive specialty. General surgery residents were also found to be more highly engaged, vigorous, dedicated and absorbed than others. As more than a fifth of the medical residents who responded could be diagnosed as suffering from burnout, we conclude that this problem needs addressing in the Dutch health care system, especially given that a relationship was proven between burnout and suboptimal patient care. We must look for solutions and interventions which will improve the work situation of medical residents. Striving for healthy workers in health care has to become daily practice.

Knowledge, attitudes and preferences regarding genetic testing for smoking cessation. A cross-sectional survey among Dutch smokers

PubMed Central

Smerecnik, Chris; van Schooten, Frederik J; de Vries, Hein; van Schayck, Constant P

2012-01-01

Objectives Recent research strongly suggests that genetic variation influences smokers' ability to stop. Therefore, the use of (pharmaco) genetic testing may increase cessation rates. This study aims to assess the intention of smokers concerning undergoing genetic testing for smoking cessation and their knowledge, attitudes and preferences about this subject. Design Online cross-sectional survey. Setting Database internet research company of which every inhabitant of the Netherlands of ≥12 years with an email address and capable of understanding Dutch can become a member. Participants 587 of 711 Dutch smokers aged ≥18 years, daily smokers for ≥5 years and smoke on average ≥10 cigarettes/day (response rate=83%). Primary and secondary outcome measures Smokers' knowledge, attitudes and preferences and their intention to undergo genetic testing for smoking cessation. Results Knowledge on the influence of genetic factors in smoking addiction and cessation was found to be low. Smokers underestimated their chances of having a genetic predisposition and the influence of this on smoking cessation. Participants perceived few disadvantages, some advantages and showed moderate self-efficacy towards undergoing a genetic test and dealing with the results. Smokers were mildly interested in receiving information and participating in genetic testing, especially when offered by their general practitioner (GP). Conclusions For successful implementation of genetic testing for smoking in general practice, several issues should be addressed, such as the knowledge on smoking cessation, genetics and genetic testing (including advantages and disadvantages) and the influence of genetics on smoking addiction and cessation. Furthermore, smokers allocate their GPs a crucial role in the provision of information and the delivery of a genetic test for smoking; however, it is unclear whether GPs will be able and willing to take on this role. PMID:22223839

A "parliamentary inquiry" into alcohol and drugs: a survey of psychoactive substance use and gambling among members of the Dutch parliament.

PubMed

Hendriks, V M; Garretsen, H F; van de Goor, L A

1997-05-01

In the fall of 1994 a survey was conducted on the use of alcohol and drugs and on gambling among members of the Dutch parliament. The survey indicated that almost two-thirds of the representatives sampled supported legalization of marijuana. A smaller majority (57%) was in favor of reducing the number of coffee shops selling marijuana. At least a quarter of the members of parliament had used marijuana themselves at one time or other. Alcohol consumption could be said to be "excessive" or "very excessive" for nearly 10% of the members of parliament. In general, the nature and extent of the parliamentarians' substance use was comparable to that in the Dutch general population.

A 6-year comparative economic evaluation of healthcare costs and mortality rates of Dutch patients from conventional and CAM GPs.

PubMed

Baars, Erik W; Kooreman, Peter

2014-08-27

To compare healthcare costs and mortality rates of Dutch patients with a conventional (CON) general practitioner (GP) and patients with a GP who has additionally completed training in complementary and alternative medicine (CAM). Comparative economic evaluation. Database from the Dutch insurance company Agis. 1,521,773 patients (98.8%) from a CON practice and 18,862 patients (1.2%) from a CAM practice. Annual information on five types of healthcare costs for the years 2006-2011: care by GP, hospital care, pharmaceutical care, paramedic care and care covered by supplementary insurance. Healthcare costs in the last year of life. Mortality rates. The mean annual compulsory and supplementary healthcare costs of CON patients are respectively €1821 (95% CI 1813 to 1828) and €75.3 (95% CI 75.1 to 75.5). Compulsory healthcare costs of CAM patients are €225 (95% CI 169 to 281; p<0.001; 12.4%) lower and result mainly from lower hospital care costs (€165; 95% CI 118 to 212; p<0.001) and lower pharmaceutical care costs (€58; 95% CI 41 to 75; p<0.001), especially in the age categories 25-49 and 50-74 years. The costs in the last year of life of patients with CAM, GPs are €1161 (95% CI -138 to 2461; p<0.1) lower. This difference is entirely due to lower hospital costs (€1250; 95% CI 19 to 2481; p<0.05). The mean annual supplementary costs of CAM patients are €33 (95% CI 30 to 37; p<0.001; 44%) higher. CAM patients do not have lower or higher mortality rates than CON patients. Dutch patients whose GP additionally completed training in CAM on average have €192 (10.1%) lower annual total compulsory and supplementary healthcare costs and do not live longer or shorter than CON patients. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Treatment of hip/knee osteoarthritis in Dutch general practice and physical therapy practice: an observational study.

PubMed

Barten, Di-Janne J A; Swinkels, Llse C S; Dorsman, Sara A; Dekker, Joost; Veenhof, Cindy; de Bakker, Dinny H

2015-06-27

A multidisciplinary, guideline-based Stepped-Care-Strategy (SCS), has recently been developed to improve the management of hip and knee osteoarthritis (OA). To date, it is unknown to what extent current Dutch OA care is consistent with the SCS, both with respect to the content of care as well as the sequence of care. Furthermore, there is a lack of clarity regarding the role of different health care providers in the performance of OA care according to the SCS. Therefore, the main purpose of this study is to describe the content of primary care in patients with hip/knee OA, including the compliance to the SCS and taking into account the introduction of patient self-referral to physical therapy. Data were used from NIVEL Primary Care Database. In total, 12.118 patients with hip/knee OA who visited their GP or physical therapist were selected. Descriptive statistics were used to compare the content of care in GP-referred and self-referred patients to physical therapy. Content of care performed by GPs mostly concerned consultations, followed by NSAID prescriptions and referrals to secondary care. Both prescriptions of acetaminophen and referrals to physical therapy respectively dietary therapy were rarely mentioned. Nevertheless, still 65% of the patients in physical therapy practice were referred by their GP. Compared to GP-referred patients, self-referred patients more often presented recurrent complaints and were treated less often by activity-related exercise therapy. Education was rarely registered as singular intervention, neither in GP-referred nor in self-referred patients. In accordance with the SCS, less advanced interventions are more often applied than more advanced interventions. To optimize the adherence to the SCS, GPs could reconsider the frequent use of NSAIDs instead of analgesics and the low referral rate to allied health care. Self-referral to physical therapy partially distorts both the low referral rate in general practice and the low application rate of education as singular intervention in physical therapy practice. Further research is recommended to evaluate the effects of task-shifting in OA care, taking into account the content of the SCS.

Emotions in primary care: Are there cultural differences in the expression of cues and concerns?

PubMed

Schouten, Barbara C; Schinkel, Sanne

2015-11-01

This study compared native-Dutch and Turkish-Dutch patients' expressions of emotional cues/concerns and GPs' responses to these cues/concerns. Relations between patient's cues/concerns and GPs' perceptions of the patient's health complaint were examined too. 82 audiotaped encounters with native-Dutch and 38 with Turkish-Dutch GP patients were coded using the VR-CoDES and VR-CoDES-P. Patients filled out a survey before each consultation to assess their cultural identification, Dutch language proficiency and health-related variables. GPs filled out a survey after each consultation to assess their perceptions of the patient's health complaint. Turkish-Dutch patients expressed more cues than native-Dutch patients, which was explained by higher worries about their health and worse perceived general health. GPs responded more often with space-providing responses to Turkish-Dutch patients compared to native-Dutch patients. Turkish-Dutch patients' cue expression strongly influenced GPs' perceptions about the presence of psychosocial problems. Migrant patient-related factors influence the amount of emotional cue expression in primary care. GPs perceive these cues as indicating the presence of psychosocial problems and provide space for patients to elaborate on their emotional distress. GPs should be trained in using more affective communication techniques to enhance elicitation of the underlying reasons for migrant patients' enhanced emotional cue expression. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Early psychosocial interventions after disasters, terrorism and other shocking events: is there a gap between norms and practice in Europe?

PubMed Central

Te Brake, Hans

2013-01-01

Background Internationally, several initiatives exist to describe standards for post-disaster psychosocial care. Objective This study explored the level of consensus of experts within Europe on a set of recommendations on early psychosocial intervention after shocking events (Dutch guidelines), and to what degree these standards are implemented into mental health care practice. Methods Two hundred and six (mental) health care professionals filled out a questionnaire to assess the extent to which they consider the guidelines’ scope and recommendations relevant and part of the regular practice in their own country. Forty-five European experts from 24 EU countries discussed the guidelines at an international seminar. Results The data suggest overall agreement on the standards although many of the recommendations appear not (yet) to be embedded in everyday practice. Conclusions Although large consensus exists on standards for early psychosocial care, a chasm between norms and practice appears to exist throughout the EU, stressing the general need for investments in guideline development and implementation. PMID:23393613

Why does it run in families? Explaining family similarity in help-seeking behaviour by shared circumstances, socialisation and selection.

PubMed

Cardol, Mieke; Groenewegen, Peter P; Spreeuwenberg, Peter; Van Dijk, Liset; Van Den Bosch, Wil J H M; De Bakker, Dinny H

2006-08-01

Why do contact frequencies with general practice of family members resemble each other? Many aspects related to the clustering of health-care utilisation within families have been studied, but the underlying mechanisms have not been addressed. This article considers whether family similarity in contact frequency with general practice can be explained as (a) a result of shared circumstances, (b) through socialisation, and (c) through homogeneity of background characteristics. Data from the second Dutch national survey of general practice were used to test these mechanisms empirically. This survey recorded all consultations in 2001 for 104 general practices in the Netherlands, serving 385,461 patients. Information about socio-demographic characteristics was collected by means of a patient survey. In a random sample, an extended health interview took place (n=12,699). Overall, we were able to show that having determinants in common through socialisation and shared circumstances can explain similarity in contact frequencies within families, but not all hypotheses could be confirmed. In specific terms, this study shows that resemblances in contact frequencies within families can be best explained by spending more time together (socialisation) and parents and children consulting a general practitioner simultaneously (circumstances of the moment). For general practitioners, the mechanisms identified can serve as a framework for a family case history. The importance of the mechanism of socialisation in explaining similarities in help-seeking behaviour between family members points to the significance of knowledge and health beliefs underlying consultation behaviour. An integrated framework including these aspects can help to better explain health behaviour.

Internet-based monitoring of influenza-like illness (ILI) in the general population of the Netherlands during the 2003-2004 influenza season.

PubMed

Marquet, Richard L; Bartelds, Aad I M; van Noort, Sander P; Koppeschaar, Carl E; Paget, John; Schellevis, François G; van der Zee, Jouke

2006-10-04

An internet-based survey of influenza-like illness (ILI)--the Great Influenza Survey or GIS--was launched in the Netherlands in the 2003-2004 influenza season. The aim of the present study was to validate the representativeness of the GIS population and to compare the GIS data with the official ILI data obtained by Dutch GPs participating in the Dutch Sentinel Practice Network. Direct mailings to schools and universities, and repeated interviews on television and radio, and in newspapers were used to kindle the enthusiasm of a broad section of the public for GIS. Strict symptomatic criteria for ILI were formulated with the assistance of expert institutes and only participants who responded at least five times to weekly e-mails asking them about possible ILI symptoms were included in the survey. Validation of GIS was done at different levels: 1) some key demographic (age distribution) and public health statistics (prevalence of asthma and diabetes, and influenza vaccination rates) for the Dutch population were compared with corresponding figures calculated from GIS; 2) the ILI rates in GIS were compared with the ILI consultation rates reported by GPs participating in the Dutch Sentinel Practice Network. 13,300 persons (53% of total responders), replied at least five times to weekly e-mails and were included in the survey. As expected, there was a marked under-representation of the age groups 0-10 years and 81->90 years in the GIS population, although the similarities were remarkable for most other age groups, albeit that the age groups between 21 and 70 years were slightly overrepresented. There were striking similarities between GIS and the Dutch population with regard to the prevalence of asthma (6.4% vs. 6.9%) and the influenza vaccination rates, and to a lesser degree for diabetes (2.4% vs. 3.5%). The vaccination rates in patients with asthma or diabetes, and persons older than 65 years were 68%, 85%, and 85% respectively in GIS, while the corresponding percentages in the Dutch population were 73%, 85% and 87%. There was also a marked similarity between the seasonal course of ILI measured by GIS and the GPs. Although the ILI rate in GIS was about 10 times higher, the curves followed an almost similar pattern, with peak incidences occurring in the same week. The current study demonstrates that recruitment of a high number of persons willing to participate in on-line health surveillance is feasible. The information gathered proved to be reliable, as it paralleled the information obtained via an undisputed route. We believe that the interactive nature of GIS and the appealing subject were keys to its success.

The effect of a multifaceted evidence-based practice programme for nurses on knowledge, skills, attitudes, and perceived barriers: A cohort study.

PubMed

van der Goot, Wieke E; Keers, Joost C; Kuipers, Ruud; Nieweg, Roos M B; de Groot, Martijn

2018-04-01

The Dutch professional nursing standard of 2012 stipulates that Dutch nursing practices are to be evidence-based. Not all practicing nurses can satisfy these requirements, therefore, an educational programme about Evidence-Based Practice (EBP) was developed for a Dutch teaching hospital. The aim of this study was to measure the effects of a six month in-house EBP programme on knowledge, skills, attitudes, and perceived barriers of nurses (four European Credits equals two US Credit Hours). A multiple-cohort study was conducted with a pre-post-test design. In the period of 2011-2015, a total of 58 nurses (9 cohorts) followed the programme. Baseline and follow-up assessments consisted of three questionnaires each: the Dutch Modified Fresno, the two subscales of the McColl questionnaire, and the BARRIER scale to assess knowledge and skills, attitudes, and perceived barriers, respectively. Fifty nurses completed both assessments. The results demonstrated that actual knowledge and skills significantly increased by approximately 40%. Self-perceived knowledge increased significantly, while attitudes towards EBP remained (moderately) positive. Perceived barriers did not notably change except for the Research subscale which received many "no opinion" responses prior to the programme but fewer afterwards. Our multifaceted in-house EBP programme led to a significant improvement of approximately 40% in EBP knowledge and skills of participating nurses. Most nurses who followed the EBP programme are currently applying their knowledge and skills in practice. Managerial support and allocated time for EBP are important facilitators for its implementation. Furthermore, to maintain and expand nurses' EBP knowledge and skills and translate them into practice, follow-up interventions, such as journal clubs, may well be beneficial. Based on the positive results of our programme, we will implement it throughout the hospital with an emphasis on training more groups of nurses. Copyright © 2018 Elsevier Ltd. All rights reserved.

Dutch Elm Disease Control: Intensive Sanitation and Survey Economics

Treesearch

William N., Jr. Cannon; Jack H. Barger; David P. Worley

1977-01-01

Recent research has shown that prompt removal of diseased elms reduces the incidence of Dutch elm disease more than sanitation practice that allows diseased elms to remain standing into the dormant season. The key to prompt removal is repeated surveys to detect diseased elms as early as possible. Intensive sanitation can save more elms and cost less than the more...

NASA/DOD Aerospace Knowledge Diffusion Research Project. Paper 41: Technical communication practices of Dutch and US aerospace engineers and scientists: International perspective on aerospace

NASA Technical Reports Server (NTRS)

Barclay, Rebecca O.; Pinelli, Thomas E.; Kennedy, John M.

1994-01-01

As part of Phase 4 of the NASA/DOD Aerospace Knowledge Diffusion Research Project, studies were conducted that investigated the technical communications practices of Dutch and U.S. aerospace engineers and scientists. The studies had the following objectives: (1) to solicit the opinions of aerospace engineers and scientists regarding the importance of technical communication to their professions, (2) to determine the use and production of technical communication by aerospace engineers and scientists, (3) to investigate their use of libraries and technical information centers, (4) to investigate their use of and the importance to them of computer and information technology, (5) to examine their use of electronic networks, and (6) to determine their use of foreign and domestically produced technical reports. Self-administered (mail) questionnaires were distributed to Dutch aerospace engineers and scientists at the National Aerospace Laboratory (NLR) in the Netherlands, the NASA Ames Research Center in the U.S., and the NASA Langley Research Center in the U.S. Responses of the Dutch and U.S. participants to selected questions are presented in this paper.

Dutch euthanasia revisited.

PubMed

Fenigsen, R

1997-01-01

The results of a follow-up study of euthanasia by the Dutch government, five years after the first study, were published on November 26, 1996. This article provides a detailed review of the two reports comparing and contrasting the statistics cited therein. The author notes that the "rules of careful conduct" proposed by the courts and by the Royal Dutch Society of Medicine were frequently disregarded. Special topics included for the first time in the second study were the notification and non-prosecution procedure, euthanasia of newborns and infants, and assisted suicide in psychiatric practice. The authors of the follow-up report state that it would be desirable to reduce the number of "terminations of life without patients' request," but this must be the common responsibility of the doctor and the patient. They suggest that the person who does not wish to have his life terminated should declare this clearly, in advance, verbally and in writing, preferably in the form of a living will. Involuntary euthanasia was rampant in 1990 and equally rampant in 1995. The author concludes that Dutch doctors who practice euthanasia are not on the slippery slope. From the very beginning, they have been at the bottom.

Active euthanasia and assisted suicide: a perspective from an American abortion and Dutch euthanasia scenario.

PubMed

Musgrave, C F

1998-10-01

To discuss the critical issues involved in the legalization of active euthanasia and physician-assisted suicide. Nursing, medical, legal, and ethics literature; newspaper articles; book chapters. The major terms employed in the discussion of active euthanasia and physician-assisted suicide are defined. The implications of the recent Supreme Court decision on these practices are outlined. The Dutch euthanasia and the American abortion scenarios are used as models for the interpretation of the effects of future legislation on such practices. Oncology nurses need to be cognizant of the crucial issues involved in the practices of active euthanasia and physician-assisted suicide and determine their philosophical stance regarding the practices. If active euthanasia and physician-assisted suicide practices are legalized, oncology nurses will have to make decisions about their desired degree of involvement in acts that will end their patients' lives.

Alliances in the Dutch BeweegKuur Lifestyle Intervention

ERIC Educational Resources Information Center

den Hartog, Franciska; Wagemakers, Annemarie; Vaandrager, Lenneke; van Dijk, Marieke; Koelen, Maria A.

2014-01-01

Objective: BeweegKuur (Exercise Therapy) is a Dutch lifestyle programme in which participants are referred by a general practitioner (GP) to a lifestyle advisor. To support participants, regional and local alliances are established. The present study explored the successes and challenges associated with collaboration processes in local BeweegKuur…

Physicians' assessments of work capacity in patients with severe subjective health complaints: a cross-sectional study on differences between five European countries

PubMed Central

Werner, Erik L; Merkus, Suzanne L; Mæland, Silje; Jourdain, Maud; Schaafsma, Frederieke; Canevet, Jean Paul; Weerdesteijn, Kristel H N; Rat, Cédric; Anema, Johannes R

2016-01-01

Objectives A comparison of appraisals made by general practitioners (GPs) in France and occupational physicians (OPs) and insurance physicians (IPs) in the Netherlands with those made by Scandinavian GPs on work capacity in patients with severe subjective health complaints (SHCs). Setting GPs in France and OPs/IPs in the Netherlands gathered to watch nine authentic video recordings from a Norwegian general practice. Participants 46 GPs in France and 93 OPs/IPs in the Netherlands were invited to a 1-day course on SHC. Outcomes Recommendation of sick leave (full or partial) or no sick leave for each of the patients. Results Compared with Norwegian GPs, sick leave was less likely to be granted by Swedish GPs (OR 0.51, 95% CI 0.30 to 0.86) and by Dutch OPs/IPs (OR 0.53, 95% CI 0.37 to 0.78). The differences between Swedish and Norwegian GPs were maintained in the adjusted analyses (OR 0.43, 95% CI 0.23 to 0.79). This was also true for the differences between Dutch and Norwegian physicians (OR 0.55, 95% CI 0.36 to 0.86). Overall, compared with the GPs, the Dutch OPs/IPs were less likely to grant sick leave (OR 0.60, 95% CI 0.45 to 0.87). Conclusions Swedish GPs and Dutch OPs/IPs were less likely to grant sick leave to patients with severe SHC compared with GPs from Norway, while GPs from Denmark and France were just as likely to grant sick leave as the Norwegian GPs. We suggest that these findings may be due to the guidelines on sick-listing and on patients with severe SHC which exist in Sweden and the Netherlands, respectively. Differences in the working conditions, relationships with patients and training of specialists in occupational medicine may also have affected the results. However, a pattern was observed in which of the patients the physicians in all countries thought should be sick-listed, suggesting that the physicians share tacit knowledge regarding sick leave decision-making in patients with severe SHC. PMID:27417198

Psychological distress, burnout and personality traits in Dutch anaesthesiologists: A survey.

PubMed

van der Wal, Raymond A B; Bucx, Martin J L; Hendriks, Jan C M; Scheffer, Gert-Jan; Prins, Judith B

2016-03-01

The practice of anaesthesia comes with stress. If the demands of a stressful job exceed the resources of an individual, that person may develop burnout. Burnout poses a threat to the mental and physical health of the anaesthesiologist and therefore also to patient safety. Individual differences in stress appraisal (perceived demands) are an important factor in the risk of developing burnout. To explore this possible relationship, we assessed the prevalence of psychological distress and burnout in the Dutch anaesthesiologist population and investigated the influence of personality traits. Survey study. Data were collected in the Netherlands from July 2012 until December 2012. We sent electronic surveys to all 1955 practising resident and consultant members of the Dutch Anaesthesia Society. Of these, 655 (33.5%) were returned and could be used for analysis. Psychological distress, burnout and general personality traits were assessed using validated Dutch versions of the General Health Questionnaire (cut-off point ≥2), the Maslach Burnout Inventory and the Big Five Inventory. Sociodemographic variables and personality traits were entered into regression models as predictors for burnout and psychological distress. Respectively, psychological distress and burnout were prevalent in 39.4 and 18% of all respondents. The prevalence of burnout was significantly different in resident and consultant anaesthesiologists: 11.3% vs. 19.8% (χ 5.4; P < 0.02). The most important personality trait influencing psychological distress and burnout was neuroticism: adjusted odds ratio 6.22 (95% confidence interval 4.35 to 8.90) and 6.40 (95% confidence interval 3.98 to 10.3), respectively. The results of this study show that psychological distress and burnout have a high prevalence in residents and consultant anaesthesiologists and that both are strongly related to personality traits, especially the trait of neuroticism. This suggests that strategies to address the problem of burnout would do well to focus on competence in coping skills and staying resilient. Personality traits could be taken into consideration during the selection of residents. In future longitudinal studies the question of how personal and situational factors interact in the development of burnout should be addressed.

The 'sense of alarm' ('gut feeling') in clinical practice. A survey among European general practitioners on recognition and expression.

PubMed

Stolper, Erik; van Royen, Paul; Dinant, Geert Jan

2010-06-01

Most general practitioners in the Netherlands and Flanders (Belgium) are familiar with that special feeling during certain consultations: 'There's something wrong here, though I have no specific indications yet'. This 'sense of alarm' alerts the doctor, activates the diagnostic process and induces him to initiate specific management to prevent serious health problems. We wanted to know whether this sense of alarm is a typical phenomenon among Dutch-speaking GPs or is also recognized by GPs elsewhere in Europe. A short questionnaire survey was held among 128 GPs in 28 countries included in the European General Practitioners Research Network (EGPRN). GPs were asked if they recognized our description of the 'sense of alarm' and if they used a typical phrase in their language to express this uneasy feeling. We received 30 replies from GPs in 16 European countries, plus Israel and South-Africa. They all recognized our description and 25 GPs reported typical expressions in their own language. The GPs' uneasy feeling was sometimes perceived as a bodily sensation. The 'sense of alarm' is a familiar phenomenon in general practices in Europe. We propose to use the English phrase 'gut feelings' in further research reports.

Quinine, Malaria, and the Cinchona Bureau: Marketing Practices and Knowledge Circulation in a Dutch Transoceanic Cinchona-Quinine Enterprise (1920s-30s).

PubMed

Van Der Hoogte, Arjo Roersch; Pieters, Toine

2016-04-01

In this study, we will show how a Dutch pharmaceutical consortium of cinchona producers and quinine manufacturers was able to capitalize on one of the first international public health campaigns to fight malaria, thereby promoting the sale of quinine, an antimalarial medicine. During the 1920s and 1930s, the international markets for quinine were controlled by this Dutch consortium, which was a transoceanic cinchona-quinine enterprise centered in the Cinchona Bureau in the Netherlands. We will argue that during the interwar period, the Cinchona Bureau became the decision-making center of this Dutch cinchona-quinine pharmaceutical enterprise and monopolized the production and trade of an essential medicine. In addition, we will argue that capitalizing on the international public health campaign in the fight against malaria by the Dutch cinchona-quinine enterprise via the Cinchona Bureau can be regarded as an early example of corporate colonization of public health by a private pharmaceutical consortium. Furthermore, we will show how commercial interests prevailed over scientific interests within the Dutch cinchona-quinine consortium, thus interfering with and ultimately curtailing the transoceanic circulation of knowledge in the Dutch empire. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Depressive disorder in the last phase of life in patients with cardiovascular disease, cancer, and COPD: data from a 20-year follow-up period in general practice.

PubMed

Warmenhoven, Franca; Bor, Hans; Lucassen, Peter; Vissers, Kris; van Weel, Chris; Prins, Judith; Schers, Henk

2013-05-01

Depression is assumed to be common in chronically ill patients during their last phase of life and is associated with poorer outcomes. The prevalence of depression is widely varying in previous studies due to the use of different terminology, classification, and assessment methods. To explore the reported incidence of depressive disorder, as registered in the last phase of life of patients who died from cardiovascular disease, cancer or COPD, in a sample of primary care patients. A historic cohort study, using a 20-year period registration database of medical records in four Dutch general practices (a dynamic population based on the Continuous Morbidity Registration database). Medical history of the sample cohort was analysed for the diagnosis of a new episode of depressive disorder and descriptive statistics were used. In total 982 patients were included, and 19 patients (1.9%) were diagnosed with a new depressive disorder in the last year of their life. The lifetime prevalence of depressive disorder in this sample was 8.2%. The incidence of depressive disorder in the last phase of life is remarkably low in this study. These data were derived from actual patient care in general practice. Psychiatric diagnoses were made by GPs in the context of both patient needs and delivered care. A broader concept of depression in general practice is recommended to improve the diagnosis and treatment of mood disorders in patients in the last phase of life.

Parental and family-related influences on dental caries in children of Dutch, Moroccan and Turkish origin.

PubMed

Duijster, Denise; de Jong-Lenters, Maddelon; de Ruiter, Corine; Thijssen, Jill; van Loveren, Cor; Verrips, Erik

2015-04-01

The aim of this cross-sectional study was to investigate the relationship between parental and family-related factors and childhood dental caries in a sample of 5- to 6-year-old children of Dutch, Moroccan and Turkish origin. Furthermore, the relationship of parental and family-related factors with social class and ethnicity was examined. The study sample included 92 parent-child dyads (46 cases and 46 controls), which were recruited from a large paediatric dental centre in The Hague, the Netherlands. Cases were children with four or more decayed, missing or filled teeth, and controls were caries free. Validated questionnaires were used to collect data on sociodemographic characteristics, oral health behaviours, parents' dental self-efficacy and locus of control (LoC), parenting practices and family functioning. Parenting practices were also assessed using structured video observations of parent-child interactions. Parents of controls had a more internal LoC, and they were more likely to show positive (observed) parenting in terms of positive involvement, encouragement and problem-solving, compared to cases (P < 0.05). Lower social class was significantly associated with a lower dental self-efficacy, a more external LoC and poorer parenting practices. Furthermore, LoC was more external in Moroccan and Turkish parents, compared to Dutch parents. Parents' internal LoC and observed positive parenting practices on the dimensions positive involvement, encouragement and problem-solving were important indicators of dental health in children of Dutch, Moroccan and Turkish origin. Findings suggest that these parental factors are potential mediators of socioeconomic inequalities in children's dental health. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

[Ethnic differences in forensic psychiatry: an exploratory study at a Dutch forensic psychiatric centre].

PubMed

van der Stoep, T

Compared to the percentage of ethnic minorities in the general population, ethnic minorities are overrepresented in forensic psychiatry. If these minorities are to be treated successfully, we need to know more about this group. So far, however, little is known about the differences between mental disorders and types of offences associated with patients of non-Dutch descent and those associated with patients of Dutch descent.
AIM: To take the first steps to obtain the information we need in order to provide customised care for patients of non-Dutch descent.
METHOD: It proved possible to identify differences between patients of Dutch and non-Dutch descent with regard to treatment, diagnosis and offences committed within a group of patients who were admitted to the forensic psychiatric centre Oostvaarderskliniek during the period 2001 - 2014.
RESULTS: The treatment of patients of non-Dutch descent lasted longer than the treatment of patients of Dutch descent (8.5 year versus 6.6 year). Furthermore, patients from ethnic minority groups were diagnosed more often with schizophrenia (49.1% versus 21.4%), but less often with pervasive developmental disorders or sexual disorders. Patients of non-Dutch descent were more often convicted for sexual crimes where the victim was aged 16 years or older, whereas patients of Dutch descent were convicted of sexual crimes where the victim was under 16.
CONCLUSION: There are differences between patients of Dutch and non-Dutch descent with regard to treatment duration, diagnosis and offences they commit. Future research needs to investigate whether these results are representative for the entire field of forensic psychiatry and to discover the reasons for these differences.

Ethnic differences in prevalence and determinants of mother-child bed-sharing in early childhood.

PubMed

Luijk, Maartje P C M; Mileva-Seitz, Viara R; Jansen, Pauline W; van IJzendoorn, Marinus H; Jaddoe, Vincent W V; Raat, Hein; Hofman, Albert; Verhulst, Frank C; Tiemeier, Henning

2013-11-01

To date few studies have examined how multiple layers of influences shape the emergence of bed-sharing practices in the first 2 years postpartum. In our report, we examined bed-sharing in a large multiethnic sample, exploring the influences of three broad classes of influence on bed-sharing at single time points and across time: (1) sociodemographic and (2) contextual factors such as breastfeeding, maternal mental health and stress, and (3) child temperament and sleep habits. Frequencies of bed-sharing were assessed at two time points, 2 and 24 months, in a population-based multiethnic (Dutch, Turkish or Moroccan, and Caribbean) sample of 6309 children born in the Netherlands. In Dutch mothers, the majority of mothers did not share their beds with their child, and bed-sharing rates decreased from 2 to 24 months. Other ethnic groups showed higher bed-sharing rates, typified by both increases in bed-sharing (the Turkish and Moroccan group) and persistence of bed-sharing over time (the Caribbean group). There were few family and child characteristics associated with bed-sharing in the non-Dutch ethnic groups. In contrast, bed-sharing in Dutch mothers was associated with child temperament and sleeping problems, maternal depression, and sociodemographic variables like crowding and maternal education. Our results suggest that mothers with a Turkish and Moroccan or Caribbean background were more influenced by cultural values, whereas bed-sharing practices were more reactive in the Dutch group. Copyright © 2013 Elsevier B.V. All rights reserved.

Translating Language Policy into Practice: Language and Culture Policy at a Dutch University

ERIC Educational Resources Information Center

Haines, Kevin; Dijk, Anje

2016-01-01

The CEFR will only achieve its potential in higher education if it is embedded in a meaningful way in the wider processes of the university. One means of embedding the CEFR is through policy, and in this article we report the development of a language policy in the broader context of internationalization at a Dutch university. We describe some the…

Dutch food bank recipients have poorer dietary intakes than the general and low-socioeconomic status Dutch adult population.

PubMed

Neter, J E; Dijkstra, S C; Dekkers, A L M; Ocké, M C; Visser, M; Brouwer, I A

2017-10-03

Food-assistance program users are a specific group of nutritional concern, as they are often food insufficient and have poorer diet quality compared to non-food-assistance program users. The aim of our study was to assess dietary intake of Dutch food bank recipients (n = 167) and to compare this with dietary intake of a representative sample of the general population (Dutch National Food Consumption Survey (DNFCS-all): n = 1933), including a low-socioeconomic status (SES) sample (DNFCS-low SES: n = 312), using data from the DNFCS 2007-2010. In this cross-sectional study, 12 food banks throughout The Netherlands participated. Food bank recipients' characteristics were assessed with a self-administered questionnaire. Dietary intake data were collected through three 24-h recalls. Habitual dietary intake (mean, percentiles, and 95% CI) was estimated for all samples. Differences between samples were determined by comparing the 95% CIs. Mean age of the study population (62.9% female) was 48.6 years (SD:10.1). Mean energy intake was 1986 (95% CI 1830-2089) kcal. The majority of the Dutch food bank recipients had lower intakes than dietary reference intakes for dietary fiber, fruit, vegetables, and fish (range 86.6-99.3%), and a higher intake for saturated fat [88.1% (95% CI 84.1-98.9)]. Furthermore, mean intakes of energy, fiber, fruit, and vegetables were significantly lower in Dutch food bank recipients than in the DNFCS-all and the DNFCS-low-SES [e.g., daily mean fruit intake (g) food bank recipients 62.8 (95% CI 45.5-76.5), DNFCS-all 105.8 (95% CI 105.4-117.9), and DNFCS-low-SES 85.1 (95% CI 78.7-100.2)]. Fish intake was significantly lower compared with the DNFCS-all, but not compared with the DNFCS-low-SES. Dutch food bank recipients, who largely rely on the content of food parcels, are not able to meet the nutritional guidelines for a healthy diet, and their dietary intake is poorer than the general as well as the low-SES sample of the Dutch adult population. More research is needed on how to improve the dietary intake of this vulnerable population subgroup, by, e.g., revising the content of the food parcels, and to develop effective intervention activities.

Promotion of health-enhancing physical activity in rheumatoid arthritis: a comparative study on healthcare providers in Italy, The Netherlands and Sweden.

PubMed

Brodin, Nina; Hurkmans, Emalie; DiMatteo, Luigi; Nava, Tiziana; Vliet Vlieland, Thea; Opava, Christina H

2015-10-01

The objectives of this study were to compare attitudes, practice of advice, perceived competencies and educational needs related to health-enhancing physical activity (HEPA) in rheumatoid arthritis (RA) among Dutch, Italian and Swedish healthcare providers (HCP) and to explore associations between these factors and age, gender and HEPA levels of HCP. Questionnaires were sent to 2939 HCP, members of their national rheumatology organizations. HEPA was assessed with the Short Questionnaire to Assess Health-Enhancing Physical Activity or the International Physical Activity Questionnaire; attitudes, practice of advice, perceived competencies and educational needs with a 23-item questionnaire. Overall response rate was 33 %. Ninety-five percent of HCP agreed that HEPA is an important health goal in RA. More Swedish HCP had positive attitudes to the attainability and safety of HEPA in RA. There were no differences between countries in practice of advice on HEPA to patients with RA in general or to those with recent onset disease, but more Italian HCP were reluctant to advise HEPA to patients with established disease. Of the total HCP, 36 to 60 % used public health guidelines to advise on HEPA, with Dutch HCP taking less advantage. Still they estimated a higher proportion of patients with RA to follow such advice. Italian HCP perceived their competencies the highest, but were also more interested in education to promote HEPA. Gender, age and HEPA performance had no association with attitudes toward HEPA, while a number of associations were found between these factors and practice of advice and perceived competencies. The differences found between HCP in the three countries might indicate the need for educational initiatives to improve HEPA promotion.

Prevalence of- and risk factors for work disability in Dutch patients with inflammatory bowel disease.

PubMed

Spekhorst, Lieke M; Oldenburg, Bas; van Bodegraven, Ad A; de Jong, Dirk J; Imhann, Floris; van der Meulen-de Jong, Andrea E; Pierik, Marieke J; van der Woude, Janneke C; Dijkstra, Gerard; D'Haens, Geert; Löwenberg, Mark; Weersma, Rinse K; Festen, Eleonora A M

2017-12-14

To determine the prevalence of work disability in inflammatory bowel disease (IBD), and to assess risk factors associated with work disability. For this retrospective cohort study, we retrieved clinical data from the Dutch IBD Biobank on July 2014, containing electronic patient records of 3388 IBD patients treated in the eight University Medical Centers in the Netherlands. Prevalence of work disability was assessed in 2794 IBD patients and compared with the general Dutch population. Multivariate analyses were performed for work disability (sick leave, partial and full disability) and long-term full work disability (> 80% work disability for > 2 years). Prevalence of work disability was higher in Crohn's disease (CD) (29%) and ulcerative colitis (UC) (19%) patients compared to the general Dutch population (7%). In all IBD patients, female sex, a lower education level, and extra-intestinal manifestations, were associated with work disability. In CD patients, an age > 40 years at diagnosis, disease duration > 15 years, smoking, surgical interventions, and anti-TNFα use were associated with work disability. In UC patients, an age > 55 years, and immunomodulator use were associated with work disability. In CD patients, a lower education level (OR = 1.62, 95%CI: 1.02-2.58), and in UC patients, disease complications (OR = 3.39, 95%CI: 1.09-10.58) were associated with long-term full work disability. The prevalence of work disability in IBD patients is higher than in the general Dutch population. Early assessment of risk factors for work disability is necessary, as work disability is substantial among IBD patients.

Toddlers learn words in a foreign language: The role of native vocabulary knowledge

PubMed Central

Koenig, Melissa A.; Woodward, Amanda L.

2013-01-01

The current study examined monolingual English-speaking toddlers’ (N=50) ability to learn word-referent links from native speakers of Dutch versus English and secondly, whether children generalized or sequestered their extensions when terms were tested by a subsequent speaker of English. Overall, children performed better in the English than in the Dutch condition; however, children with high native vocabularies successfully selected the target object for terms trained in fluent Dutch. Furthermore, children with higher vocabularies did not indicate their comprehension of Dutch terms when subsequently tested by an English speaker whereas children with low vocabulary scores responded at chance levels to both the original Dutch speaker and the second English speaker. These findings demonstrate that monolingual toddlers with proficiency in their native language are capable of learning words outside of their conventional system and may be sensitive to the boundaries that exist between language systems. PMID:22310327

Sources of information and health beliefs related to SARS and avian influenza among Chinese communities in the United Kingdom and The Netherlands, compared to the general population in these countries.

PubMed

Voeten, Helene A C M; de Zwart, Onno; Veldhuijzen, Irene K; Yuen, Cicely; Jiang, Xinyi; Elam, Gillian; Abraham, Thomas; Brug, Johannes

2009-01-01

Ethnic minorities in Europe such as the Chinese may need a special strategy with regard to risk communication about emerging infectious diseases. To engage them in precautionary actions, it is important to know their information sources, knowledge, and health beliefs. This study's purpose is to study the use of information sources, knowledge, and health beliefs related to SARS and avian flu of Chinese people in the UK and The Netherlands, and to make comparisons with the general population in these countries. Results of a self-administered questionnaire among 300 British/Dutch Chinese were compared to data obtained from a computer-assisted phone survey among the general population (n = 800). British/Dutch Chinese got most information about emerging diseases from family and friends, followed by Chinese media and British/Dutch TV. They had less confidence than general groups in their doctor, government agencies, and consumer/patient interest groups. Their knowledge of SARS was high. They had a lower perceived threat than general populations with regard to SARS and avian flu due to a lower perceived severity. They had higher self-efficacy beliefs regarding SARS and avian flu. In case of new outbreaks of SARS/avian flu in China, local authorities in the UK and The Netherlands can best reach Chinese people through informal networks and British/Dutch TV, while trying to improve confidence in information from the government. In communications, the severity of the disease rather than the susceptibility appears to need most attention.

Modeling elm growth and Dutch elm disease susceptibility

Treesearch

Alberto Santini; Luisa Ghelardini

2012-01-01

Elm susceptibility to Dutch elm disease (DED) displays strong seasonal variation. The period during which elms can become infected and express DED symptoms is generally restricted to several weeks after growth resumption in spring, although it can vary among species, provenances, and environmental conditions. The reason for this phenomenon is not understood, but the...

Internalizing and Externalizing Problems in Immigrant Boys and Girls: Comparing Native Dutch and Moroccan Immigrant Adolescents across Time

ERIC Educational Resources Information Center

Paalman, Carmen; van Domburgh, Lieke; Stevens, Gonneke; Vermeiren, Robert; van de Ven, Peter; Branje, Susan; Frijns, Tom; Meeus, Wim; Koot, Hans; van Lier, Pol; Jansen, Lucres; Doreleijers, Theo

2015-01-01

This longitudinal study explores differences between native Dutch and immigrant Moroccan adolescents in the relationship between internalizing and externalizing problems across time. By using generalized estimating equations (GEE), the strength and stability of associations between internalizing and externalizing problems in 159 Moroccan and 159…

Comparison of cohort smoking intensities in Denmark and the Netherlands.

PubMed Central

Barendregt, Jan J.; Looman, Caspar W. N.; Brønnum-Hansen, Henrik

2002-01-01

OBJECTIVE: To assess the usefulness of the general framework of the smoking epidemic. METHODS: We use lung cancer mortality as an indicator for smoking intensity and employ an age-cohort model to accommodate the long-lasting and cumulative effects. RESULTS: Dutch males have higher risks than Danish males, but the risks for the younger cohorts have been declining faster in the Netherlands than in Denmark. Danish women have about twice the risk of Dutch women, and in both countries the risks for the younger cohorts are increasing. The smoking epidemic began at about the same time in Denmark and the Netherlands. Dutch males, however, seem to have smoked more but to have given up smoking more quickly than Danish males. Danish females were quicker to take up smoking than Dutch females. CONCLUSIONS: Within the general framework of the smoking epidemic, differences in timing and levels can produce large differences between countries. For the purposes of assessing smoking-related risks, including projections, the smoking epidemic framework therefore has to be tailored to each study population. PMID:11884970

[Satisfaction about physical appearance and teeth. Results of a nationwide study].

PubMed

Gresnigt-Bekker, C O V M; de Jongh, A; Vo, G; Lie, F; Oosterink-Wubbe, F M D; van Rood, Y

2008-07-01

In a study involving a group of 907 randomly selected Dutch individuals, satisfaction about one's physical appearance and satisfaction about the appearance of one's teeth were assessed. Furthermore, the relationship between body esteem and happiness was explored. Three quarters of the respondents were satisfied about their physical appearance, while 70% was satisfied about the appearance of their teeth. Women and people with a non-Dutch background were significantly less likely to be satisfied about their physical appearance than men and those with a Dutch background. Individuals 30 years old and younger were more likely to be satisfied about their teeth than those who were older. Almost two third of the respondents (64%) reported that the appearance of their teeth contributed positively to their happiness. Women and people with a non-Dutch background were most likely to indicate that the appearance of their teeth contributed to their happiness. Satisfaction about general physical appearance and appearance of the teeth were significantly associated with happiness. Prospective studies are needed to examine to what extent esthetically motivated dental treatments make people happy and enhance their general well-being.

Addressing Palliative Sedation during Expert Consultation: A Descriptive Analysis of the Practice of Dutch Palliative Care Consultation Teams.

PubMed

Hoek, Patrick; Grandjean, Ilse; Verhagen, Constans A H H V M; Jansen-Landheer, Marlies L E A; Schers, Henk J; Galesloot, Cilia; Vissers, Kris C P; Engels, Yvonne; Hasselaar, Jeroen G J

2015-01-01

Since palliative sedation is considered a complex intervention, consultation teams are increasingly established to support general practice. This study aims to offer insight into the frequency and characteristics of expert consultations regarding palliative sedation. We performed a retrospective analysis of a longitudinal database. This database contained all patient-related consultations by Dutch Palliative Care Consultation teams, that were requested between 2004 and 2011. We described the frequency and characteristics of these consultations, in particular of the subgroup of consultations in which palliative sedation was addressed (i.e. PSa consultations). We used multivariate regression analysis to explore consultation characteristics associated with a higher likelihood of PSa consultations. Of the 44,443 initial consultations, most were requested by general practitioners (73%) and most concerned patients with cancer (86%). Palliative sedation was addressed in 18.1% of all consultations. Palliative sedation was relatively more often discussed during consultations for patients with a neurologic disease (OR 1.79; 95% CI: 1.51-2.12) or COPD (OR 1.39; 95% CI: 1.15-1.69) than for patients with cancer. We observed a higher likelihood of PSa consultations if the following topics were also addressed during consultation: dyspnoea (OR 1.30; 95% CI: 1.22-1.40), agitation/delirium (OR 1.57; 95% CI: 1.47-1.68), exhaustion (OR 2.89; 95% CI: 2.61-3.20), euthanasia-related questions (OR 2.65; 95% CI: 2.37-2.96) or existential issues (OR 1.55; 95% CI: 1.31-1.83). In conclusion, PSa consultations accounted for almost one-fifth of all expert consultations and were associated with several case-related characteristics. These characteristics may help clinicians in identifying patients at risk for a more complex disease trajectory at the end of life.

Competency-Based Medical Education: Developing a Framework for Obstetrics and Gynaecology.

PubMed

Caccia, Nicolette; Nakajima, Amy; Scheele, Fedde; Kent, Nancy

2015-12-01

The development of a Canadian competency-based medical education (CBME) curriculum in obstetrics and gynaecology, slated to begin in 2017, must be rooted in, and aligned with, the principles of CanMEDS 2015 and Competence by Design. It must also reflect the unique realities of the practice of the specialty. The Dutch Society of Obstetrics and Gynaecology has been at the forefront of the movement to design and implement competency-based training for obstetrics and gynaecology. The Dutch curriculum represents a practical example of how such a program could be developed. Several CBME curricular initiatives have now also begun across Canada.

Double Dutch: A Tool for Designing Combinatorial Libraries of Biological Systems.

PubMed

Roehner, Nicholas; Young, Eric M; Voigt, Christopher A; Gordon, D Benjamin; Densmore, Douglas

2016-06-17

Recently, semirational approaches that rely on combinatorial assembly of characterized DNA components have been used to engineer biosynthetic pathways. In practice, however, it is not practical to assemble and test millions of pathway variants in order to elucidate how different DNA components affect the behavior of a pathway. To address this challenge, we apply a rigorous mathematical approach known as design of experiments (DOE) that can be used to construct empirical models of system behavior without testing all variants. To support this approach, we have developed a tool named Double Dutch, which uses a formal grammar and heuristic algorithms to automate the process of DOE library design. Compared to designing by hand, Double Dutch enables users to more efficiently and scalably design libraries of pathway variants that can be used in a DOE framework and uniquely provides a means to flexibly balance design considerations of statistical analysis, construction cost, and risk of homologous recombination, thereby demonstrating the utility of automating decision making when faced with complex design trade-offs.

Investigations of remote sensing techniques for early detection of Dutch elm disease

NASA Technical Reports Server (NTRS)

Hammerschlag, R. S.; Sopstyle, W. J.

1975-01-01

Several forms of aerial photography were pursued in quest of a technique which could provide early detection of Dutch elm disease. The two most promising techniques tested were multispectral photography with object enhancement and biband ratioing coupled with scanning microdensitometry. For practical purposes the multispectral system has the advantage of providing a readily interpretable image in a relatively short time. Laboratory studies indicated that less emphasis should be placed on the use of a red filter or the near infrared beyond 750 mm for early detection of stress within a single plant species. Color infrared film would be optimal when used for a long term detection of loss of plant vigor which results in a physical change in a plant canopy, but should find minimal practicality for early detection of specific sources of plant stress such as Dutch elm disease. Considerable discretion should be used when interpreting imagery on copy film because of loss of resolution and color definition.

Evidence-based rules from family practice to inform family practice; the learning healthcare system case study on urinary tract infections.

PubMed

Soler, Jean K; Corrigan, Derek; Kazienko, Przemyslaw; Kajdanowicz, Tomasz; Danger, Roxana; Kulisiewicz, Marcin; Delaney, Brendan

2015-05-16

Analysis of encounter data relevant to the diagnostic process sourced from routine electronic medical record (EMR) databases represents a classic example of the concept of a learning healthcare system (LHS). By collecting International Classification of Primary Care (ICPC) coded EMR data as part of the Transition Project from Dutch and Maltese databases (using the EMR TransHIS), data mining algorithms can empirically quantify the relationships of all presenting reasons for encounter (RfEs) and recorded diagnostic outcomes. We have specifically looked at new episodes of care (EoC) for two urinary system infections: simple urinary tract infection (UTI, ICPC code: U71) and pyelonephritis (ICPC code: U70). Participating family doctors (FDs) recorded details of all their patient contacts in an EoC structure using the ICPC, including RfEs presented by the patient, and the FDs' diagnostic labels. The relationships between RfEs and episode titles were studied using probabilistic and data mining methods as part of the TRANSFoRm project. The Dutch data indicated that the presence of RfE's "Cystitis/Urinary Tract Infection", "Dysuria", "Fear of UTI", "Urinary frequency/urgency", "Haematuria", "Urine symptom/complaint, other" are all strong, reliable, predictors for the diagnosis "Cystitis/Urinary Tract Infection" . The Maltese data indicated that the presence of RfE's "Dysuria", "Urinary frequency/urgency", "Haematuria" are all strong, reliable, predictors for the diagnosis "Cystitis/Urinary Tract Infection". The Dutch data indicated that the presence of RfE's "Flank/axilla symptom/complaint", "Dysuria", "Fever", "Cystitis/Urinary Tract Infection", "Abdominal pain/cramps general" are all strong, reliable, predictors for the diagnosis "Pyelonephritis" . The Maltese data set did not present any clinically and statistically significant predictors for pyelonephritis. We describe clinically and statistically significant diagnostic associations observed between UTIs and pyelonephritis presenting as a new problem in family practice, and all associated RfEs, and demonstrate that the significant diagnostic cues obtained are consistent with the literature. We conclude that it is possible to generate clinically meaningful diagnostic evidence from electronic sources of patient data.

Need for ethics support in healthcare institutions: views of Dutch board members and ethics support staff.

PubMed

Dauwerse, Linda; Abma, Tineke; Molewijk, Bert; Widdershoven, Guy

2011-08-01

The purpose of this article is to investigate the need for ethics support in Dutch healthcare institutions in order to understand why ethics support is often not used in practice and which factors are relevant in this context. This study had a mixed methods design integrating quantitative and qualitative research methods. Two survey questionnaires, two focus groups and 17 interviews were conducted among board members and ethics support staff in Dutch healthcare institutions. Most respondents see a need for ethics support. This need is related to the complexity of contemporary healthcare, the contribution of ethics support to the core business of the organisation and to the surplus value of paying structural attention to ethical issues. The need for ethics support is, however, not unconditional. Reasons for a lacking need include: aversion of innovations, negative associations with the notion of ethics support service, and organisational factors like resources and setting. There is a conditioned need for ethics support in Dutch healthcare institutions. The promotion of ethics support in healthcare can be fostered by focusing on formats which fit the needs of (practitioners in) healthcare institutions. The emphasis should be on creating a (culture of) dialogue about the complex situations which emerge daily in contemporary healthcare practice.

NASA/DOD Aerospace Knowledge Diffusion Research Project. Report 17: A comparison of the technical communication practices of Dutch and US aerospace engineers and scientists

NASA Technical Reports Server (NTRS)

Barclay, Rebecca O.; Pinelli, Thomas E.; Kennedy, John M.

1993-01-01

As part of Phase 4 of the NASA/DoD Aerospace Knowledge Diffusion Research Project, two studies were conducted that investigated the technical communications practices of Dutch and U.S. aerospace engineers and scientists. Both studies have the same seven objectives: first, to solicit the opinions of aerospace engineers and scientists regarding the importance of technical communications to their profession; second, to determine the use and production of technical communications by aerospace engineers and scientists; third, to seek their views about the appropriate content of an undergraduate course in technical communications; fourth, to determine aerospace engineers' and scientists' use of libraries, technical information centers, and on-line data bases; fifth, to determine the use and importance of computer and information technology to them; sixth, to determine their use of electronic networks; and seventh, to determine their use of foreign and domestically produced technical reports. A self-administered questionnaire was distributed to aerospace engineers and scientists at the National Aerospace Laboratory (NLR), and NASA Ames Research Center, and the NASA Langley Research Center. The completion rates for the Dutch and U.S. surveys were 55 and 61 percent, respectively. Responses of the Dutch and U.S. participants to selected questions are presented.

Cross-cultural Translation and Adaptation of the Lifestyle Assessment Questionnaire (LAQ-CP) Into Dutch: A Brief Report.

PubMed

Beckers, Laura; Speth, Lucianne; Rameckers, Eugène; Janssen-Potten, Yvonne

2017-07-01

To produce a Dutch translation of the Lifestyle Assessment Questionnaire for children with cerebral palsy (LAQ-CP), adapted for cross-cultural differences. The translation process consisted of 6 stages, following a guideline for cross-cultural adaptations including duplicate forward- and back-translations, expert group review, pilot-testing, and a process audit. Several adaptations to the questionnaire were required due to cross-cultural differences. As a result of the pilot-test, the layout was adapted to the desires of the users. The process auditor stated that the process had been comprehensive and valued the quality of the work. The project resulted in a Dutch translation of the LAQ-CP, adapted for cross-cultural differences. Validation of the translated questionnaire is required before use in clinical practice and research is recommended (Dutch abstract, Supplemental Digital Content 1, available at: http://links.lww.com/PPT/A164).

Pathways in Interactive Media Practices among Youths

ERIC Educational Resources Information Center

van den Beemt, Antoine; Akkerman, Sanne; Simons, P. Robert-Jan

2010-01-01

This qualitative study examines how 11 Dutch students aged 14-15 develop an interest in specific types of interactive media practices and how they perceive these practices in relation to others. The methods included semi-structured interviewing, autodriving visual elicitation and photo elicitation using moodboards. Our results show the importance…

Traceability of Biologics in The Netherlands: An Analysis of Information-Recording Systems in Clinical Practice and Spontaneous ADR Reports.

PubMed

Klein, Kevin; Scholl, Joep H G; Vermeer, Niels S; Broekmans, André W; Van Puijenbroek, Eugène P; De Bruin, Marie L; Stolk, Pieter

2016-02-01

Pharmacovigilance requirements for biologics mandate that EU Member States shall ensure that any biologic that is the subject of a suspected adverse drug reaction (ADR) is identifiable by brand name and batch number. Recent studies showed that brand name identification is well established, whereas batch numbers are (still) poorly reported. We evaluated information-recording systems and practices in the Dutch hospital setting to identify determinants for brand name and batch number recording as well as success factors and bottlenecks for traceability. We surveyed Dutch hospital pharmacists with an online questionnaire on systems and practices in hospitals for recording brand names and batch numbers. Additionally, we performed an analysis of the traceability of recombinant biologics in spontaneous ADR reports (received between 2009 and 2014) from the Netherlands Pharmacovigilance Centre Lareb. The survey showed that brand names are not routinely recorded in the clinical practice of Dutch hospitals, whereas batch numbers are poorly recorded. Seventy-six percent of the 1523 ADR reports for recombinant biologics had a traceable brand name whereas 5% of these reports contained a batch number. The results suggest a possible relationship between the availability of brand and batch number information in clinical practice and the inclusion of this information in ADR reports for biologics. The limited traceability of brand names and batch numbers in ADR reports may be primarily caused by the shortcomings in the recording of information in clinical practice. We recommend efforts to improve information-recording systems as a first step to improve the traceability of biologics in ADR reporting.

Consonantal and Syllabic Repairs of Arabic and Dutch Loanwords in Indonesian: A Phonological Account

ERIC Educational Resources Information Center

Batais, Saleh Saeed

2013-01-01

The dissertation study aims to contribute mainly to the field of loanword phonology in general and particularly to Indonesian and its phonology that are rarely studied to date. The study investigates what consonantal and syllabic repair strategies are employed by Indonesian in adapting Arabic and Dutch loanwords, whether these adaptation…

Strategic Decision Making in Higher Education: An Analysis of the New Planning System in Dutch Higher Education.

ERIC Educational Resources Information Center

Maassen, Peter, A. M.; Potman, Henry P.

1990-01-01

The new strategic planning system in Dutch higher education is described and the usefulness of strategic planning in higher education institutions in general is discussed. Three models are distinguished: linear, adaptive, and interpretive. Evidence suggesting the system has resulted in more homogenization than diversification is presented.…

Adaptation of a difficult-to-manage asthma programme for implementation in the Dutch context: a modified e-Delphi.

PubMed

Honkoop, Persijn J; Pinnock, Hilary; Kievits-Smeets, Regien M M; Sterk, Peter J; Dekhuijzen, P N Richard; In 't Veen, Johannes C C M

2017-02-09

Patients with difficult-to-manage asthma represent a heterogeneous subgroup of asthma patients who require extensive assessment and tailored management. The International Primary Care Respiratory Group approach emphasises the importance of differentiating patients with asthma that is difficult to manage from those with severe disease. Local adaptation of this approach, however, is required to ensure an appropriate strategy for implementation in the Dutch context. We used a modified three-round e-Delphi approach to assess the opinion of all relevant stakeholders (general practitioners, pulmonologists, practice nurses, pulmonary nurses and people with asthma). In the first round, the participants were asked to provide potentially relevant items for a difficult-to-manage asthma programme, which resulted in 67 items. In the second round, we asked participants to rate the relevance of specific items on a seven-point Likert scale, and 46 items were selected as relevant. In the third round, the selected items were categorised and items were ranked within the categories according to relevance. Finally, we created the alphabet acronym for the categories 'the A-I of difficult-to-manage asthma' to resonate with an established Dutch 'A-E acronym for determining asthma control'. This should facilitate implementation of this programme within the existing structure of educational material on asthma and chronic obstructive pulmonary disease (COPD) in primary care, with potential for improving management of difficult-to-manage asthma. Other countries could use a similar approach to create a locally adapted version of such a programme.

Time and materials needed to survey, inject systemic fungicides, and install root-graft barriers for Dutch elm disease management

Treesearch

William N., Jr. Cannon; Jack H. Barger; Charles J. Kostichka; Charles J. Kostichka

1986-01-01

Dutch elm disease control practice in 15 communities showed a wide range of time and material required to apply control methods. The median time used for each method was: sanitation survey, 9.8 hours per square mile; symptom survey, 96 hours per thousand elms; systemic fungicide injection, 1.4 hours per elm; and root-graft barrier installation, 2.2 hours per barrier (5...

The dutch national clinical audit for lung cancer: A tool to improve clinical practice? An analysis of unforeseen ipsilateral mediastinal lymph node involvement in the Dutch Lung Surgery Audit (DLSA).

PubMed

Heineman, David Jonathan; Beck, Naomi; Wouters, Michael Wilhelmus; van Brakel, Thomas Jan; Daniels, Johannes Marlene; Schreurs, Wilhelmina Hendrika; Dickhoff, Chris

2018-06-01

Optimal treatment selection for patients with non-small cell lung cancer (NSCLC) depends on the clinical stage of the disease. Particularly patients with mediastinal lymph node involvement (stage IIIA-N2) should be identified since they generally do not benefit from upfront surgery. Although the standardized preoperative use of PET-CT, EUS/EBUS and/or mediastinoscopy identifies most patients with mediastinal lymph node metastasis, a proportion of these patients is only diagnosed after surgery. The objective of this study was to identify all patients with unforeseen N2 disease after surgical resection for NSCLC in a large nationwide database and to evaluate the preoperative clinical staging process. Data was derived from the Dutch Lung Surgery Audit. Patients with pathological stage IIIA NSCLC after an anatomical resection between 2013 and 2015 were evaluated. Clinical and pathological TNM-stage were compared and an analysis was performed on the diagnostic work-up of patients with unforeseen N2 disease. From 3585 patients undergoing surgery for NSCLC between 2013 and 2015, a total of 527 patients with pathological stage IIIA NSCLC were included. Of all 527 patients, 254 patients were upstaged from a clinical N0 (n = 186) or N1 (n = 68) disease to a pathological N2 disease (7.1% unforeseen N2). In these 254 patients, 18 endoscopic ultrasounds, 62 endobronchial ultrasounds and 67 mediastinoscopies were performed preoperatively. In real world clinical practice in The Netherlands, the percentage of unforeseen N2 disease in patients undergoing surgery for NSCLC is seven percent. To further reduce this percentage, optimization of the standardized preoperative workup is necessary. Copyright © 2018 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

Higher self-reported prevalence of hypertension among Moluccan-Dutch than among the general population of The Netherlands: results from a cross-sectional survey.

PubMed

van der Wal, Junus M; Bodewes, Adee J; Agyemang, Charles O; Kunst, Anton E

2014-12-15

Several studies in The Netherlands revealed ethnic disparities in hypertension prevalence, but none have focused on the Moluccan-Dutch, a migrant group from Indonesia that settled in The Netherlands in 1951. The Moluccan-Dutch are considered to be fairly well integrated in Dutch society. The aim of this study was to compare hypertension prevalence among the Moluccan-Dutch to the native Dutch and to explore the contribution of known risk factors. A health interview survey was conducted from August 2012 till March 2013 among nineteen Moluccan neighborhoods, resulting in the inclusion of 708 participants. The primary outcome variable was self-reported prevalence of hypertension. Explanatory variables were BMI, exercise, smoking, alcohol intake and mental health status. Data on the control group was extracted from the Dutch National Health Survey 2011, using a similar questionnaire. Differences in risk factor exposure were explored using Chi-square tests and the contribution of risk factors, separately and combined, was explored using multivariate logistic regression analysis. Moluccan-Dutch showed higher odds for reporting hypertension when compared to native Dutch, after adjusting for age and level of education (OR = 1.38; 95% CI = 1.13-1.69) and additional risk factors (OR = 1.49; 95% CI = 1.19-1.88). A higher prevalence of hypertension was found in both Moluccan-Dutch men (26.4% vs. 16.7%; p < 0.001) and women (26.7% vs. 17.9%; p < 0.001), when compared to the control group. Not only middle-aged, but also young Moluccan-Dutch men showed higher prevalence of hypertension. The Moluccan-Dutch may be at increased risk for reporting hypertension. These results suggest that long-term stay over several generations does not necessarily result in similar levels of hypertension prevalence as the host population.

Vulnerability and the 'slippery slope' at the end-of-life: a qualitative study of euthanasia, general practice and home death in The Netherlands.

PubMed

Norwood, Frances; Kimsma, Gerrit; Battin, Margaret P

2009-12-01

One enduring criticism of the Dutch euthanasia policy is the 'slippery slope' argument that suggests that allowing physicians to conduct legal euthanasia or assisted suicide would eventually lead to patients being killed against their will. What we currently know about euthanasia and its practices in The Netherlands is predominantly based on retrospective quantitative or interview-based studies, but these studies fail to detail the mechanisms of day-to-day practice. To examine the practices that surround euthanasia, particularly among vulnerable patients, using qualitative observation-based data. A 15-month qualitative, observation-based study of home death and general practice in the greater Amsterdam region of The Netherlands. Study included observation and interviews with a sample of 15 (GPs and 650 of their patients, 192 of whom were living with terminal or life-threatening illness (with and without requests for euthanasia). Euthanasia practice typically involves extensive deliberations, the majority of which do not end in a euthanasia death. Euthanasia discussions or 'euthanasia talk' share at least two consequences: (i) the talk puts the onus on patients to continue discussions towards a euthanasia death and (ii) there is a socio-therapeutic component, which tends to affirm social bonds and social life. While this qualitative evidence cannot disprove existence of abuse, it suggests that euthanasia practices have evolved in such a way that patients are more likely to talk about euthanasia than to die a euthanasia death.

Evaluation of the representativeness of a Dutch non-malformed control group for the general pregnant population: are these controls useful for EUROCAT?

PubMed

Jentink, Janneke; Zetstra-van der Woude, A Priscilla; Bos, Jens; de Jong-van den Berg, Lolkje T W

2011-11-01

A case-control study is the most powerful design to test the risk of specific congenital malformations associated with a specific drug. However, malformation registries often lack non-malformed controls. For the Dutch EUROCAT, we collected a non-malformed control group: the 'Healthy Pregnant'. The aim of this study was to evaluate the representativeness of this control group for the general pregnant population in the northern part of the Netherlands. The Healthy Pregnant data set includes data from two midwife practices. The baseline characteristics of mother and child including smoking status, drinking status, body mass index, maternal age, educational level, exposures to several drugs for chronic diseases and pregnancy related symptoms were evaluated. Compared with the general population, mothers in Healthy Pregnant group (n = 556) were from either low or high education level, were more likely to have a body mass index > 25 kg/m² (26% versus 22%, p = 0.08) or to smoke (19% versus 10%, p < 0.01) but were less likely to consume alcohol (20% versus 29%, p < 0.01). The use of drugs for chronic conditions was lower in Healthy Pregnant group. Furthermore, drugs for occasional use were prescribed less frequently, and a significant underreporting of children with a low birth weight and a short duration of gestation was found. The Healthy Pregnant data set was not representative of the general pregnant population in the northern part of the Netherlands. Specifically, the exposure to (chronic) drugs was underestimated, possibly a result of second-line care on the basis of medical indication. Thus, continuous investigation of options for improvement of the Healthy Pregnant database is required. Copyright © 2011 John Wiley & Sons, Ltd.

Depressive disorder in the last phase of life in patients with cardiovascular disease, cancer, and COPD: data from a 20-year follow-up period in general practice

PubMed Central

Warmenhoven, Franca; Bor, Hans; Lucassen, Peter; Vissers, Kris; van Weel, Chris; Prins, Judith; Schers, Henk

2013-01-01

Background Depression is assumed to be common in chronically ill patients during their last phase of life and is associated with poorer outcomes. The prevalence of depression is widely varying in previous studies due to the use of different terminology, classification, and assessment methods. Aim To explore the reported incidence of depressive disorder, as registered in the last phase of life of patients who died from cardiovascular disease, cancer or COPD, in a sample of primary care patients. Design and setting A historic cohort study, using a 20-year period registration database of medical records in four Dutch general practices (a dynamic population based on the Continuous Morbidity Registration database). Method Medical history of the sample cohort was analysed for the diagnosis of a new episode of depressive disorder and descriptive statistics were used. Results In total 982 patients were included, and 19 patients (1.9%) were diagnosed with a new depressive disorder in the last year of their life. The lifetime prevalence of depressive disorder in this sample was 8.2%. Conclusion The incidence of depressive disorder in the last phase of life is remarkably low in this study. These data were derived from actual patient care in general practice. Psychiatric diagnoses were made by GPs in the context of both patient needs and delivered care. A broader concept of depression in general practice is recommended to improve the diagnosis and treatment of mood disorders in patients in the last phase of life. PMID:23643227

Establishing a European research agenda on 'gut feelings' in general practice. A qualitative study using the nominal group technique.

PubMed

Stolper, Erik; van Leeuwen, Yvonne; van Royen, Paul; van de Wiel, Margaretha; van Bokhoven, Marloes; Houben, Paul; Hobma, Sjoerd; van der Weijden, Trudy; Dinant, Geert Jan

2010-06-01

Although 'gut feelings' are perceived as playing a substantial role in the diagnostic reasoning of the general practitioner (GP), there is little evidence about their diagnostic and prognostic value. Consensus on both types of 'gut feelings' (a 'sense of alarm', a 'sense of reassurance') has enabled us to operationalize the concept. As a next step we wanted to identify research questions that are considered relevant to validate the concept of 'gut feelings' and to estimate its usefulness for daily practice and medical education. Moreover, we were interested in the study designs considered appropriate to study these research questions. The nominal group technique (NGT) is a qualitative research method of judgmental decision-making involving four phases: generating ideas, recording them, evaluation and prioritization. Dutch and Belgian academics whose subject is general practice (n = 18), attended one of three meetings during which NGT was used to produce a 'research agenda' on 'gut feelings'. NGT yielded ten research questions and nine corresponding appropriate designs on four topics, i.e. the diagnostic value of 'gut feelings', the validation of its determinants, the opportunities for integrating 'gut feelings' in medical education and a rest group. The study designs respectively included recording and follow-up of 'gut feelings', video recording of consultations with stimulated recall using simulated and real patients respectively, analysing trainees' consultation stories and videos, linguistic analyses, and vignette studies. Furthermore, two experimental designs were proposed. A European research agenda on 'gut feelings' in general practice has been established and could be used in collaborative research.

Unique disease heritage of the Dutch-German Mennonite population.

PubMed

Orton, Noelle C; Innes, A Micheil; Chudley, Albert E; Bech-Hansen, N Torben

2008-04-15

The Dutch-German Mennonites are a religious isolate with foundational roots in the 16th century. A tradition of endogamy, large families, detailed genealogical records, and a unique disease history all contribute to making this a valuable population for genetic studies. Such studies in the Dutch-German Mennonite population have already contributed to the identification of the causative genes in several conditions such as the incomplete form of X-linked congenital stationary night blindness (CSNB2; previously iCSNB) and hypophosphatasia (HOPS), as well as the discovery of founder mutations within established disease genes (MYBPC1, CYP17alpha). The Dutch-German Mennonite population provides a strong resource for gene discovery and could lead to the identification of additional disease genes with relevance to the general population. In addition, further research developments should enhance delivery of clinical genetic services to this unique community. In the current review we discuss 31 genetic conditions, including 17 with identified gene mutations, within the Dutch-German Mennonite population. Copyright 2008 Wiley-Liss, Inc.

The Integrative Model of Behavior Prediction to Explain Technology Use in Post-Graduate Teacher Education Programs in the Netherlands

ERIC Educational Resources Information Center

Admiraal, Wilfried; Lockhorst, Ditte; Smit, Ben; Weijers, Sanne

2013-01-01

This study examined technology in post-graduate teacher training programs in the Netherlands. A questionnaire was completed by 111 teacher educators from 12 Dutch universities with a post-graduate teacher training program. The general view of the use of technology in Dutch post-graduate teacher education was quite conventional. Basic technology…

An American and Dutch partnership for psychiatric mental health advance nursing practice: nurturing a relationship across the ocean.

PubMed

Maas, Lillian; Ezeobele, I Ezebuiro; Tetteroo, Marieke

2012-07-01

The purpose of this article is to discuss the challenges and rewards of developing and nurturing an international clinical psychiatric mental health advanced nursing practice exchange between the Netherlands and the United States. Since 1997, Rotterdam University of Applied Sciences in the Netherlands has been participating in international clinical experiences for their psychiatric mental health (PMH) advanced practice nursing students. The international experience is mandatory prior to graduation and is the first of its kind in Europe to mandate such a unique experience. This study sample included eight Dutch PMH advanced practice nursing students enrolled in a full-time master's in advanced nursing practice program. The descriptive study included reflective reports and one-on-one discussions over a 3-year period. With proper planning, an international nursing experience provides a unique opportunity for nurses to think beyond their own culture and healthcare system. Solving problems together through different perspectives creates opportunities for creative solutions. International partnerships within PMH advanced practice nursing promotes sharing of knowledge and solutions as patients and diseases have no border. © 2011 Wiley Periodicals, Inc.

Effectiveness of integrated disease management for primary care chronic obstructive pulmonary disease patients: results of cluster randomised trial.

PubMed

Kruis, Annemarije L; Boland, Melinde R S; Assendelft, Willem J J; Gussekloo, Jacobijn; Tsiachristas, Apostolos; Stijnen, Theo; Blom, Coert; Sont, Jacob K; Rutten-van Mölken, Maureen P H M; Chavannes, Niels H

2014-09-10

To investigate the long term effectiveness of integrated disease management delivered in primary care on quality of life in patients with chronic obstructive pulmonary disease (COPD) compared with usual care. 24 month, multicentre, pragmatic cluster randomised controlled trial 40 general practices in the western part of the Netherlands Patients with COPD according to GOLD (Global Initiative for COPD) criteria. Exclusion criteria were terminal illness, cognitive impairment, alcohol or drug misuse, and inability to fill in Dutch questionnaires. Practices were included if they were willing to create a multidisciplinary COPD team. General practitioners, practice nurses, and specialised physiotherapists in the intervention group received a two day training course on incorporating integrated disease management in practice, including early recognition of exacerbations and self management, smoking cessation, physiotherapeutic reactivation, optimal diagnosis, and drug adherence. Additionally, the course served as a network platform and collaborating healthcare providers designed an individual practice plan to integrate integrated disease management into daily practice. The control group continued usual care (based on international guidelines). The primary outcome was difference in health status at 12 months, measured by the Clinical COPD Questionnaire (CCQ); quality of life, Medical Research Council dyspnoea, exacerbation related outcomes, self management, physical activity, and level of integrated care (PACIC) were also assessed as secondary outcomes. Of a total of 1086 patients from 40 clusters, 20 practices (554 patients) were randomly assigned to the intervention group and 20 clusters (532 patients) to the usual care group. No difference was seen between groups in the CCQ at 12 months (mean difference -0.01, 95% confidence interval -0.10 to 0.08; P=0.8). After 12 months, no differences were seen in secondary outcomes between groups, except for the PACIC domain "follow-up/coordination" (indicating improved integration of care) and proportion of physically active patients. Exacerbation rates as well as number of days in hospital did not differ between groups. After 24 months, no differences were seen in outcomes, except for the PACIC follow-up/coordination domain. In this pragmatic study, an integrated disease management approach delivered in primary care showed no additional benefit compared with usual care, except improved level of integrated care and a self reported higher degree of daily activities. The contradictory findings to earlier positive studies could be explained by differences between interventions (provider versus patient targeted), selective reporting of positive trials, or little room for improvement in the already well developed Dutch healthcare system. Netherlands Trial Register NTR2268. © Kruis et al 2014.

Supervised Exercise Therapy for Intermittent Claudication Is Increasingly Endorsed by Dutch Vascular Surgeons.

PubMed

Hageman, David; Lauret, Gert-Jan; Gommans, Lindy N M; Koelemay, Mark J W; van Sambeek, Marc R H M; Scheltinga, Marc R M; Teijink, Joep A W

2018-02-01

Although supervised exercise therapy (SET) is generally accepted as an effective noninvasive treatment for intermittent claudication (IC), Dutch vascular surgeons were initially somewhat hesitant as reported by a 2011 questionnaire study. Later on, a nationwide multidisciplinary network for SET was introduced in the Netherlands. The aim of this questionnaire study was to determine possible trends in conceptions among Dutch vascular surgeons regarding the prescription of SET. In the year of 2015, Dutch vascular surgeons, fellows, and senior residents were asked to complete a 26-item questionnaire including issues that were considered relevant for prescribing SET such as patient selection criteria and comorbidity. Outcome was compared to the 2011 survey. Data of 124 respondents (82% males; mean age 46 years; 64% response rate) were analyzed. SET referral rate of new IC patients was not different over time (2015: 81% vs. 2011: 75%; P = 0.295). However, respondents were more willing to prescribe SET in IC patients with chronic obstructive pulmonary disease (2015: 86% vs. 2011: 69%; P = 0.002). Nevertheless, a smaller portion of respondents found that SET was also indicated for aortoiliac disease (2015: 63% vs. 2011: 76%; P = 0.049). Insufficient health insurance coverage and/or personal financial resources were the most important presumed barriers preventing patients from initiating SET (80% of respondents). Moreover, 94% of respondents judged that SET should be fully reimbursed by all Dutch basic health insurances. The concept of SET for IC is nowadays generally embraced by the vast majority of Dutch vascular surgeons. SET may have gained in popularity in IC patients with cardiopulmonary comorbidity. However, SET remains underutilized for aortoiliac disease. Reimbursement is considered crucial for a successful SET implementation. Copyright © 2017 Elsevier Inc. All rights reserved.

What hospitals need to know about guidelines-A mixed-method analysis of guideline implementation in Dutch hospitals.

PubMed

Blume, Louise H K; van Weert, Nico J H W; Busari, Jamiu O; Stoopendaal, Annemiek M V; Delnoij, Diana M J

2017-12-01

This study provides insight into how Dutch hospitals ensure that guidelines are used in practice and identifies what key messages other hospitals can learn from existing practices. We examine current practices in handling compliance and, therefore, focus on hospitals that reported that they do not experience problems in the implementation of guidelines. A survey of Dutch hospital boards and 9 semistructured interviews were conducted with a purposive sample of 3 hospitals. Interviews were held with 3 representatives of each hospital, specifically, with a member of the board of directors, a member of the executive medical staff, and the manager of the quality and safety department. Hospitals find guidelines necessary and useful. Hospitals have the power to improve implementation if boards of directors and medical staff are committed, intrinsically motivated, cooperate with each other, and use guidelines pragmatically. Even then, they prioritize guidelines, as resources are scarce. Despite their good work, all hospitals in this study appeared to struggle to adhere to guidelines. If hospitals experience problems with guideline implementation, they tend to focus more on external expectations, leading to defensive behaviour. Hospitals that do not experience implementation problems focus more on integrating guidelines into their own policies. © 2017 John Wiley & Sons, Ltd.

Positive ageing perceptions among migrant Turkish and native Dutch older people: a matter of culture or resources?

PubMed

Cramm, Jane M; Nieboer, Anna P

2017-07-21

This study examined ethnic differences in ageing perceptions of migrant Turkish and native Dutch elders residing in Rotterdam, and explored whether such differences could be attributed to culture or resources (personal, physical, economic and/or social). This study was based on combined data from two research projects focusing on the health and well-being of community-dwelling elderly people in Rotterdam. The first dataset contained data from 994 native Dutch elders aged 70-99 years. The Rotterdam municipal register was used to randomly sample respondents, stratified by age group (70-74, 75-79, 80-84, and ≥85 years) and neighbourhood. Of the 2593 eligible respondents, 1075 returned filled-in questionnaires (41% response rate). Of these 1075 respondents a total of 994 were natives which is the sample we selected for the current study. The second dataset contained data from 680 Turkish migrants aged 65-90 years. All Turkish people aged ≥65 years were identified using the Rotterdam municipal register and invited to participate. In total, 680 Turkish respondents returned filled-in questionnaires (32% response rate; out of 2350). Ageing perceptions were measured using the 21-item Ageing Perceptions Questionnaire-Short (APQ-S). Respondents were additionally asked about their current general health, income, education, marital status, age and gender. The results of this study clearly reveal the importance of culture for all ageing perceptions among Turkish and Dutch elders. We found that age, health, and education were also important factors. For Turkish elders, health and education were the most important resources; for Dutch elders, age and health were most important in relation to ageing perceptions. Ageing perceptions were generally more negative among Turkish than among Dutch elders. Turkish elders reported more negative awareness of ageing, felt less in control of their ageing processes, and had more negative emotional reactions to ageing. They also believed more firmly that their ageing processes would have both negative and positive effects on their lives. Results revealed poorer health, lower income and educational levels among Turkish than among Dutch elders. In addition, many more Dutch than Turkish elders were single/widowed/divorced. Physical and personal resources, in addition to culture, are most important for positive ageing perceptions among native Dutch and migrant Turkish elders residing in Rotterdam, the Netherlands. These resources are health and education for Turkish elders, and health and age for Dutch elders. Overall, ethnicity remained a significant predictor of ageing perceptions when other resources were taken into account.

Dyslexia and early intervention: what did we learn from the Dutch Dyslexia Programme?

PubMed

van der Leij, Aryan

2013-11-01

Part of the Dutch Dyslexia Programme has been dedicated to early intervention. The question of whether the genetically affected learning mechanism of children who are at familial risk (FR) of developing dyslexia could be influenced by training phoneme awareness and letter-sound associations in the prereading phase was investigated. The rationale was that intervention studies reveal insights about the weaknesses of the learning mechanisms of FR children. In addition, the studies aimed to gather practical insights to be used in the development of a system of early diagnosis and prevention. Focused on the last period of kindergarten before formal reading instruction starts in Grade 1, intervention methods with comparable samples and designs but differences in delivery mode (use of computer or manual), tutor (semi-professional or parent), location (at school or at home), and additional practices (serial rapid naming or simple word reading) have been executed to test the hypothesis that the incidence and degree of dyslexia can be reduced. The present position paper summarizes the Dutch Dyslexia Programme findings and relates them to findings of other studies. It is discussed that the Dutch studies provide evidence on why prevention of dyslexia is hard to accomplish. It is argued that effective intervention should not only start early but also be adapted to the individual and often long-lasting educational needs of children at risk of reading failure. Copyright © 2013 John Wiley & Sons, Ltd.

[The 'Osteoporosis' guideline of the Dutch College of General Practitioners. The response from internal medicine].

PubMed

Duursma, S A

1999-07-31

The Dutch College of General Practitioners published well documented guidelines for the management of osteoporosis. It is however incorrect to use the Z-score for the elderly and the T-score for other age groups. The guidelines balance the patient's and the physician's interests and the financial consequences of osteoporosis. They demand certainty about recommending the GP's interventions and accept less certainty where the influence on the GP's activities is limited. The guidelines contain weighed judgements by and for GP's; it is questionable whether they are adequate regarding the interaction with the increasingly well informed patient.

Multicultural health care in practice. An empirical exploration of multicultural care in The Netherlands.

PubMed

Olthuis, Gert; van Heteren, Godelieve

2003-09-01

This study presents a first assessment of the challenges faced by Dutch health care providers dealing with the increasing cultural diversity in Dutch society. Qualitative interviews with 24 Dutch caregivers and policy-makers point to a number of important difficulties encountered when confronted with the growing diversity of patient populations. The study focuses explicitly on the challenges health care providers perceive in their direct interactions with patients. On the basis of the observations of the 24 respondents five strategies were formulated to improve the delivery of care in a multicultural environment. Their findings were further evaluated by confronting the empirical data with care-ethical notions (attentiveness, responsibility, competence, and responsiveness) and intercultural communication-theory.

Meet meat: An explorative study on meat and cultured meat as seen by Chinese, Ethiopians and Dutch.

PubMed

Bekker, Gerben A; Tobi, Hilde; Fischer, Arnout R H

2017-07-01

In this cross-cultural study we investigated how study participants from China, Ethiopia and the Netherlands operationalize the concept of meat and to what extent cultured meat fits or does not fit into this operationalization. We argue that combining the conceptual approaches symbolic boundaries and theory of social practices helps to better understand the possibly culturally dependent operationalization of the concept meat. Ten visiting graduate students from China, 10 from Ethiopia and 10 native Dutch graduate students completed freelist tasks, a pile sort task, interview and essay task, during a single session. We found that butchered animals are at the center of the concept of meat, although depending on culture not all animals are a source of meat. Symbolic boundaries were restricted or stretched depending on social practices within countries. Ethiopian participants applied strictly defined symbolic boundaries, where Chinese and Dutch participants used more broadly defined symbolic boundaries. Cultured meat was seen as a technology for the future and was positioned across the symbolic boundaries of meat. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Comprehensive Snack Parenting Questionnaire (CSPQ): Development and Test-Retest Reliability.

PubMed

Gevers, Dorus W M; Kremers, Stef P J; de Vries, Nanne K; van Assema, Patricia

2018-04-26

The narrow focus of existing food parenting instruments led us to develop a food parenting practices instrument measuring the full range of food practices constructs with a focus on snacking behavior. We present the development of the questionnaire and our research on the test-retest reliability. The developed Comprehensive Snack Parenting Questionnaire (CSPQ) covers 21 constructs. Test-retest reliability was assessed by calculating intra class correlation coefficients and percentage agreement after two administrations of the CSPQ among a sample of 66 Dutch parents. Test-retest reliability analysis revealed acceptable intra class correlation coefficients (≥0.41) or agreement scores (≥0.60) for all items. These results, together with earlier work, suggest sufficient psychometric characteristics. The comprehensive, but brief CSPQ opens up chances for highly essential but unstudied research questions to understand and predict children’s snack intake. Example applications include studying the interactional nature of food parenting practices or interactions of food parenting with general parenting or child characteristics.

L1 and L2 reading skills in Dutch adolescents with a familial risk of dyslexia.

PubMed

van Setten, Ellie R H; Tops, Wim; Hakvoort, Britt E; van der Leij, Aryan; Maurits, Natasha M; Maassen, Ben A M

2017-01-01

The present study investigated differences in reading and spelling outcomes in Dutch and English as a second language (ESL) in adolescents with a high familial risk of dyslexia, of whom some have developed dyslexia (HRDys) while others have not (HRnonDys), in comparison to a low familial risk control group without dyslexia (LRnonDys). This allowed us to investigate the persistence of dyslexia in the first language (L1) and the effect of dyslexia on the second language (L2), which has, in this case, a lower orthographic transparency. Furthermore, the inclusion of the HRnonDys group allowed us to investigate the continuity of the familial risk of dyslexia, as previous studies observed that the HRnonDys group often scores in between the HRDys and LRnonDys group, and whether these readers without reading deficits in Dutch, have more reading difficulties in ESL. The data of three groups of adolescents were analyzed; 27 LRnonDys, 25 HRdys 25 HRnonDys. The mean age was 14;1 years; months, and 37 were male. All were native speakers of Dutch, attended regular secondary education (grade 7-10), and were non-native speakers of English. Using MANOVA the groups were compared on Dutch and English word reading fluency (WRF), spelling and vocabulary, Dutch pseudoword and loanword reading fluency, phonological awareness (PA), rapid automatized naming (RAN), and verbal short term and working memory. A repeated measures ANOVA was used to compare English and Dutch WRF, spelling and vocabulary directly within the three groups. The analyses revealed that the HRDys group had a deficit in both reading and spelling in Dutch and ESL. They also performed poorer than the LRnonDys group on all other measures. Effect sizes were especially large for pseudoword reading and the reaction times during the PA task. The HRnonDys group scored generally poorer than the LRnonDys group but this difference was only significant for Dutch pseudoword reading, PA reaction times and verbal short term memory. In general the HRDys and HRnonDys group scored similar in Dutch and English, except for English WRF where the HRDys group scored slightly better than expected based on their Dutch WRF. There was a high persistence of dyslexia. Adolescents with dyslexia had large impairments in reading and spelling, and reading related measures, both in Dutch and ESL. Despite high inter-individual differences, an overall three-step pattern was observed. Adolescents in the HRnonDys group scored in between the HRDys and LRnonDys group, supporting the polygenetic origin of dyslexia and the continuity of the familial risk of dyslexia. The lower orthographic transparency did not have a negative effect on L2 reading, spelling and vocabulary, both in the HRnonDys and HRDys group. The latter group performed slightly better than expected in L2, which may be a result of the massive exposure to English and high motivation to use English by adolescents.

Language Context Effects on Interlingual Homograph Recognition: Evidence from Event-Related Potentials and Response Times in Semantic Priming.

ERIC Educational Resources Information Center

de Bruijn, Ellen R. A.; Dijkstra, Ton; Chwilla, Dorothee J.; Schriefers, Herbert J.

2001-01-01

Dutch-English bilinguals performed a generalized lexical decision task on triplets of items, responding with "yes" if all items wee correct Dutch and/or English words, and with "no" if one or ore of the items was not a word in wither language. Semantic priming effects were found in on-line response times. Event-related…

Managing barriers to empathy in the clinical encounter: a qualitative interview study with GPs.

PubMed

Derksen, Frans Awm; Olde Hartman, Tim C; Bensing, Jozien M; Lagro-Janssen, Antoine Lm

2016-12-01

Current daily general practice has become increasingly technical and somatically oriented (where attention to patients' feelings is decreased) due to an increase in protocol-based guidelines. Priorities in GP-patient communication have shifted from a focus on listening and empathy to task-oriented communication. To explore what barriers GPs experience when applying empathy in daily practice, and how these barriers are managed. Thirty Dutch GPs with sufficient heterogeneity in sex, age, type of practice, and rural or urban setting were interviewed. The consolidated criteria for reporting qualitative research (COREQ) were applied. The verbatim transcripts were then analysed. According to participating GPs, the current emphasis on protocol-driven care can be a significant barrier to genuineness in communication. Other potential barriers mentioned were time pressures and constraints, and dealing with patients displaying 'unruly behaviour' or those with personality disorders. GPs indicated that it can be difficult to balance emotional involvement and professional distance. Longer consulting times, smaller practice populations, and efficient practice organisation were described as practical solutions. In order to focus on a patient-as-person approach, GPs strongly suggested that deviating from guidelines should be possible when necessary as an element of good-quality care. Joining intercollegiate counselling groups was also discussed. In addition to practical solutions for barriers to behaving empathically, GPs indicated that they needed more freedom to balance working with protocols and guidelines, as well as a patient-as-person and patient-as-partner approach. This balance is necessary to remain connected with patients and to deliver care that is truly personal. © British Journal of General Practice 2016.

Dutch guideline for clinical foetal-neonatal and paediatric post-mortem radiology, including a review of literature.

PubMed

Sonnemans, L J P; Vester, M E M; Kolsteren, E E M; Erwich, J J H M; Nikkels, P G J; Kint, P A M; van Rijn, R R; Klein, W M

2018-06-01

Clinical post-mortem radiology is a relatively new field of expertise and not common practice in most hospitals yet. With the declining numbers of autopsies and increasing demand for quality control of clinical care, post-mortem radiology can offer a solution, or at least be complementary. A working group consisting of radiologists, pathologists and other clinical medical specialists reviewed and evaluated the literature on the diagnostic value of post-mortem conventional radiography (CR), ultrasonography, computed tomography (PMCT), magnetic resonance imaging (PMMRI), and minimally invasive autopsy (MIA). Evidence tables were built and subsequently a Dutch national evidence-based guideline for post-mortem radiology was developed. We present this evaluation of the radiological modalities in a clinical post-mortem setting, including MIA, as well as the recently published Dutch guidelines for post-mortem radiology in foetuses, neonates, and children. In general, for post-mortem radiology modalities, PMMRI is the modality of choice in foetuses, neonates, and infants, whereas PMCT is advised in older children. There is a limited role for post-mortem CR and ultrasonography. In most cases, conventional autopsy will remain the diagnostic method of choice. Based on a literature review and clinical expertise, an evidence-based guideline was developed for post-mortem radiology of foetal, neonatal, and paediatric patients. What is Known: • Post-mortem investigations serve as a quality check for the provided health care and are important for reliable epidemiological registration. • Post-mortem radiology, sometimes combined with minimally invasive techniques, is considered as an adjunct or alternative to autopsy. What is New: • We present the Dutch guidelines for post-mortem radiology in foetuses, neonates and children. • Autopsy remains the reference standard, however minimal invasive autopsy with a skeletal survey, post-mortem computed tomography, or post-mortem magnetic resonance imaging can be complementary thereof.

Veterinary practice and occupational health. An epidemiological study of several professional groups of Dutch veterinarians. I. General physical examination and prevalence of allergy, lung function disorders, and bronchial hyperreactivity.

PubMed

Elbers, A R; Blaauw, P J; de Vries, M; van Gulick, P J; Smithuis, O L; Gerrits, R P; Tielen, M J

1996-12-01

The prevalence of allergy, lung function disorders, and bronchial hyperreactivity was studied in 102 Dutch veterinarians, subdivided into five professional groups (predominantly working with either swine, cattle, poultry, companion animals, or as a non-practitioner). The mean age of the participants was 43 years; 6 participants were females. Twenty-two per cent of the participants were overweight, and relatively more non-practitioners than practitioners were overweight. Approximately 23% of the vets reported complaints of prolonged fatigue. The data suggest a relationship between complaints of prolonged fatigue and a more than average number of daily working hours. Only a small proportion of vets were sensitized against several allergens. There were no significant differences in prevalence of distinct lung function disorders or bronchial hyperreactivity between professional groups. It is hypothesized that the respiratory complaints (chronic coughing, chronic phlegm production, stuffed nose, sneezing) reported by the vets predominantly working in swine and/or poultry practice could be caused by irritation and/or inflammation of the first part of the trachea-bronchial tree that has no measurable and permanent consequences for changes in lung function or increased bronchial hyperreactivity. The results of a skin test against allergens and determination of allergen-specific IgE in blood indicated that the respiratory complaints were probably not related to allergy against the panel of allergens tested.

Exercise self-efficacy in persons with spinal cord injury: psychometric properties of the Dutch translation of the Exercise Self-Efficacy Scale.

PubMed

Nooijen, Carla F J; Post, Marcel W M; Spijkerman, Dorien C M; Bergen, Michael P; Stam, Henk J; van den Berg-Emons, Rita J G

2013-04-01

To assess the reliability and validity of the Dutch version of the exercise self-efficacy scale (ESES) in persons with spinal cord injury. This is the first independent study of ESES psychometric properties, and the first report on ESES test-retest reliability. A total of 53 Dutch persons with spinal cord injury. Subjects completed the Dutch ESES twice, with 2 weeks between (ESES_1 and ESES_2). Subjects also completed the General self-efficacy scale (GSE), and a questionnaire regarding demographic characteristics and lesion characteristics. Psychometric properties of the Dutch translation of the ESES were assessed and compared with those of the original English-language version. The Dutch ESES was found to have good internal consistency (Cronbach's α for ESES_1 = 0.90, ESES_2 = 0.88). Test-retest reliability was adequate (intra-class correlation coefficient = 0.81, 95% confidence interval 0.70-0.89). For validity, a moderate, statistically significant correlation was found between ESES and the GSE (Spearman's ρ ESES_1 = 0.52, ESES_2 = 0.66, p < 0.01). Furthermore, the psychometric properties of the Dutch ESES were found to be similar to those of the original English version. The results of this study support the use of the ESES as a reliable and valid measure of exercise self-efficacy.

Tolerance at arm's length: the Dutch experience.

PubMed

Schuijer, J

1990-01-01

With respect to pedophilia and the age of consent, the Netherlands warrants special attention. Although pedophilia is not as widely accepted in the Netherlands as sometimes is supposed, developments in the judicial practice showed a growing reservedness. These developments are a spin-off of related developments in Dutch society. The tolerance in the Dutch society has roots that go far back in history and is also a consequence of the way this society is structured. The social changes of the sixties and seventies resulted in a "tolerance at arm's length" for pedophiles, which proved to be deceptive when the Dutch government proposed to lower the age of consent in 1985. It resulted in a vehement public outcry. The prevailing sex laws have been the prime target of protagonists of pedophile emancipation. Around 1960, organized as a group, they started to undertake several activities. In the course of their existence, they came to redefine the issue of pedophilia as one of youth emancipation.

Chronic Q Fever Diagnosis—Consensus Guideline versus Expert Opinion

PubMed Central

Wegdam-Blans, Marjolijn C.A.; Wever, Peter C.; Renders, Nicole H.M.; Delsing, Corine E.; Sprong, Tom; van Kasteren, Marjo E.E.; Bijlmer, Henk; Notermans, Daan; Oosterheert, Jan Jelrik; Stals, Frans S.; Nabuurs-Franssen, Marrigje H.; Bleeker-Rovers, Chantal P.

2015-01-01

Chronic Q fever, caused by Coxiella burnetii, has high mortality and morbidity rates if left untreated. Controversy about the diagnosis of this complex disease has emerged recently. We applied the guideline from the Dutch Q Fever Consensus Group and a set of diagnostic criteria proposed by Didier Raoult to all 284 chronic Q fever patients included in the Dutch National Chronic Q Fever Database during 2006–2012. Of the patients who had proven cases of chronic Q fever by the Dutch guideline, 46 (30.5%) would not have received a diagnosis by the alternative criteria designed by Raoult, and 14 (4.9%) would have been considered to have possible chronic Q fever. Six patients with proven chronic Q fever died of related causes. Until results from future studies are available, by which current guidelines can be modified, we believe that the Dutch literature-based consensus guideline is more sensitive and easier to use in clinical practice. PMID:26277798

Organ Donation After Euthanasia: A Dutch Practical Manual.

PubMed

Bollen, J; de Jongh, W; Hagenaars, J; van Dijk, G; Ten Hoopen, R; Ysebaert, D; Ijzermans, J; van Heurn, E; van Mook, W

2016-07-01

Many physicians and patients do not realize that it is legally and medically possible to donate organs after euthanasia. The combination of euthanasia and organ donation is not a common practice, often limited by the patient's underlying pathology, but nevertheless has been performed >40 times in Belgium and the Netherlands since 2005. In anticipation of patients' requests for organ donation after euthanasia and contributing to awareness of the possibility of this combination among general practitioners and medical specialists, the Maastricht University Medical Center and the Erasmus University Medical Center Rotterdam have developed a multidisciplinary practical manual in which the organizational steps regarding this combined procedure are described and explained. This practical manual lists the various criteria to fulfill and the rules and regulations the different stakeholders involved need to comply with to meet all due diligence requirements. Although an ethicist was involved in writing this paper, this report is not specifically meant to comprehensively address the ethical issues surrounding the topic. This paper is focused on the operational aspects of the protocol. © Copyright 2016 The American Society of Transplantation and the American Society of Transplant Surgeons.

Selecting relevant and feasible measurement instruments for the revised Dutch clinical practice guideline for physical therapy in patients after stroke.

PubMed

Otterman, Nicoline; Veerbeek, Janne; Schiemanck, Sven; van der Wees, Philip; Nollet, Frans; Kwakkel, Gert

2017-07-01

To select relevant and feasible instruments for the revision of the Dutch clinical practice guideline for physical therapy in patients with stroke. In this implementation study a comprehensive proposal for ICF categories and matching instruments was developed, based on reliability and validity. Relevant instruments were then selected in a consensus round by 11 knowledge brokers who were responsible for the implementation of the selected instruments. The feasibility of the selected instruments was tested by 36 physical therapists at different work settings within stroke services. Finally, instruments that were deemed relevant and feasible were included in the revised guideline. A total of 28 instruments were recommended for inclusion in the revised guideline. Nineteen instruments were retained from the previous guideline. Ten new instruments were tested in clinical practice, seven of which were found feasible. Two more instruments were added after critical appraisal of the set of the measurement instruments. The revised guideline contains 28 relevant and feasible instrument selected and tested in clinical practice by physical therapists. Further education and implementation is needed to integrate instruments in clinical practice. Further research is proposed for developing and implementing a core set of measurement instruments to be used at fixed time points to establish data registries that allow for continuous improvement of rehabilitation for stroke patients. Implications for Rehabilitation The revised Dutch Stroke Physical Therapy Guideline recommends a total of 28 instruments, that are relevant and feasible for clinical practice of physical therapist in the different settings of stroke rehabilitation. The selection of instrument in daily practice should be part of the clinical reasoning process of PTs and be tailored to individual patients' needs and the degree of priority of the affected ICF category. Suggested education strategies for further integration of instruments in of the daily practice of PTs in Stroke Rehabilitation are: 'Training on the job' and 'peer assessment in clinical situations'.

[The NHG guideline 'Sleep problems and sleeping pills'].

PubMed

Damen-van Beek, Zamire; Lucassen, Peter L B J; Gorgels, Wim; Smelt, Antonette F H; Knuistingh Neven, Arie; Bouma, Margriet

2015-01-01

The Dutch College of General Practitioners' (NHG) guideline 'Sleep problems and sleeping pills' provides recommendations for the diagnosis and treatment of the most prevalent sleep problems and for the management of chronic users of sleeping pills. The preferred approach for sleeplessness is not to prescribe medication but to give information and behavioural advice. Practice assistants of the Dutch Association of Mental Health and Addiction Care are also expected to be able to undertake this management. The GP may consider prescribing sleeping pills for a short period only in cases of severe insomnia with considerable distress. Chronic users of sleeping pills should be advised by the GP to stop using them or to reduce the dose gradually (controlled dose reduction). The GP may refer patients with suspected obstructive sleep apnoea (OSA) to a pulmonary or ear, nose and throat specialist or neurologist for further diagnosis depending on the regional arrangements. The GP may then consider the cardiovascular risk factors commonly present with OSA. In patients with restless legs syndrome (RLS) who continue to experience major distress despite being given advice without the prescription of medication, the GP may consider prescribing a dopamine agonist.

Dutch guidelines for physiotherapy in patients with stress urinary incontinence: an update.

PubMed

Bernards, Arnold T M; Berghmans, Bary C M; Slieker-Ten Hove, Marijke C Ph; Staal, J Bart; de Bie, Rob A; Hendriks, Erik J M

2014-02-01

Stress urinary incontinence (SUI) is the most common form of incontinence impacting on quality of life (QOL) and is associated with high financial, social, and emotional costs. The purpose of this study was to provide an update existing Dutch evidence-based clinical practice guidelines (CPGs) for physiotherapy management of patients with stress urinary incontinence (SUI) in order to support physiotherapists in decision making and improving efficacy and uniformity of care. A computerized literature search of relevant databases was performed to search for information regarding etiology, prognosis, and physiotherapy assessment and management in patients with SUI. Where no evidence was available, recommendations were based on consensus. Clinical application of CPGs and feasibility were reviewed. The diagnostic process consists of systematic history taking and physical examination supported by reliable and valid assessment tools to determine physiological potential for recovery. Therapy is related to different problem categories. SUI treatment is generally based on pelvic floor muscle exercises combined with patient education and counseling. An important strategy is to reduce prevalent SUI by reducing influencing risk factors. Scientific evidence supporting assessment and management of SUI is strong. The CPGs reflect the current state of knowledge of effective and tailor-made intervention in SUI patients.

Preferred providers and the credible commitment problem in health insurance: first experiences with the implementation of managed competition in the Dutch health care system.

PubMed

Boonen, Lieke H H M; Schut, Frederik T

2011-04-01

We investigate the impact of the transition towards managed competition in the Dutch health care system on health insurers' contracting behaviour. Specifically, we examine whether insurers have been able to take up their role as prudent buyers of care and examine consumers' attitudes towards insurers' new role. Health insurers' contracting behaviour is investigated by an extensive analysis of available information on purchasing practices by health insurers and by interviews with directors of health care purchasing of the four major health insurers, accounting for 90% of the market. Consumer attitudes towards insurers' new role are investigated by surveys among a representative sample of enrollees over the period 2005-2009. During the first four years of the reform, health insurers were very reluctant to engage in selective contracting and preferred to use 'soft' positive incentives to encourage preferred provider choice rather than engaging in restrictive managed care activities. Consumer attitudes towards channelling vary considerably by type of provider but generally became more negative in the first two years after the reform. Insurers' reluctance to use selective contracting can be at least partly explained by the presence of a credible-commitment problem. Consumers do not trust that insurers with restrictive networks are committed to provide good quality care. The credible-commitment problem seems to be particularly relevant to the Netherlands, since Dutch enrollees are not used to restrictions on provider choice. Since consumers are quite sensitive to differences in provider quality, more reliable information about provider quality is required to reduce the credible-commitment problem.

Adaptation of a difficult-to-manage asthma programme for implementation in the Dutch context: a modified e-Delphi

PubMed Central

Honkoop, Persijn J; Pinnock, Hilary; Kievits-Smeets, Regien M M; Sterk, Peter J; Dekhuijzen, P N Richard; in ’t Veen, Johannes C C M

2017-01-01

Patients with difficult-to-manage asthma represent a heterogeneous subgroup of asthma patients who require extensive assessment and tailored management. The International Primary Care Respiratory Group approach emphasises the importance of differentiating patients with asthma that is difficult to manage from those with severe disease. Local adaptation of this approach, however, is required to ensure an appropriate strategy for implementation in the Dutch context. We used a modified three-round e-Delphi approach to assess the opinion of all relevant stakeholders (general practitioners, pulmonologists, practice nurses, pulmonary nurses and people with asthma). In the first round, the participants were asked to provide potentially relevant items for a difficult-to-manage asthma programme, which resulted in 67 items. In the second round, we asked participants to rate the relevance of specific items on a seven-point Likert scale, and 46 items were selected as relevant. In the third round, the selected items were categorised and items were ranked within the categories according to relevance. Finally, we created the alphabet acronym for the categories ‘the A–I of difficult-to-manage asthma’ to resonate with an established Dutch ‘A–E acronym for determining asthma control’. This should facilitate implementation of this programme within the existing structure of educational material on asthma and chronic obstructive pulmonary disease (COPD) in primary care, with potential for improving management of difficult-to-manage asthma. Other countries could use a similar approach to create a locally adapted version of such a programme. PMID:28184039

Measuring patient activation in The Netherlands: translation and validation of the American short form Patient Activation Measure (PAM13).

PubMed

Rademakers, Jany; Nijman, Jessica; van der Hoek, Lucas; Heijmans, Monique; Rijken, Mieke

2012-07-31

The American short form Patient Activation Measure (PAM) is a 13-item instrument which assesses patient (or consumer) self-reported knowledge, skills and confidence for self-management of one's health or chronic condition. In this study the PAM was translated into a Dutch version; psychometric properties of the Dutch version were established and the instrument was validated in a panel of chronically ill patients. The translation was done according to WHO guidelines. The PAM 13-Dutch was sent to 4178 members of the Dutch National Panel of people with Chronic illness or Disability (NPCD) in April 2010 (study A) and again to a sub sample of this group (N = 973) in June 2010 (study B). Internal consistency, test-retest reliability and cross-validation with the SBSQ-D (a measure for Health literacy) were computed. The Dutch results were compared to similar Danish and American data. The psychometric properties of the PAM 13-Dutch were generally good. The level of internal consistency is good (α = 0.88) and item-rest correlations are moderate to strong. The Dutch mean PAM score (61.3) is comparable to the American (61.9) and lower than the Danish (64.2). The test-retest reliability was moderate. The association with Health literacy was weak to moderate. The PAM-13 Dutch is a reliable instrument to measure patient activation. More research is needed into the validity of the Patient Activation Measure, especially with respect to a more comprehensive measure of Health literacy.

Excellence and Diversity: The Emergence of Selective Admission Policies in Dutch Higher Education--A Case Study on Amsterdam University College. Research & Occasional Paper Series: CSHE.15.10

ERIC Educational Resources Information Center

Reumer, Christoffel; van der Wende, Marijk

2010-01-01

This paper explores the emergence of selective admission policies in Dutch university education. Such policies are being developed to promote excellence in a higher education system that is generally known to be "egalitarian" and increasingly criticized for a lack of differentiation. The changing policy context of admission in Dutch…

Validation of the King's Sarcoidosis Questionnaire (KSQ) in a Dutch sarcoidosis population.

PubMed

Van Manen, Mirjam J G; Wapenaar, Monique; Strookappe, Bert; Drent, Marjolein; Elfferich, Marjon; de Vries, Jolanda; Gosker, Harry R; Birring, Surinder S; Patel, Amit S; van den Toorn, Leon; van den Blink, Bernt; Boomars, Karin; Hoitsma, Elske; Wijsenbeek, Marlies S

2016-03-29

The King's Sarcoidosis Questionnaire (KSQ) is a brief questionnaire assessing health status using five modules (General Health Status, Lung, Eyes, Skin, Medication) in patients with sarcoidosis. The KSQ was only validated in one English sarcoidosis cohort. The aim of this study was to validate the KSQ in a Dutch sarcoidosis population. The KSQ was translated according to international guidelines and tested in interviews with patients. Consecutive outpatients completed multiple questionnaires twice, two weeks apart. Construct validity, internal consistency and repeatability were determined. Of the 98 patients included 85 had lung, 22 skin and 24 eye disease. There was good construct validity of the KSQ General Health Status module against the World Health Organization Quality of Life-BREF questionnaire. The Medication module correlated weak to moderate with most questionnaires. The correlations with organ-specific questionnaires varied from strong for Eyes (r=0.75), Skin (r=-0.62) to moderate for Lung (r=-0.45 with MRC breathlessness scale). Internal consistency was good for all KSQ modules (Cronbach's α 0.72-0.93). Intraclass correlation coefficients (0.70-0.90) and Bland-Altman plots showed good repeatability of the KSQ. The Dutch KSQ is the first translation of the English KSQ, validated in a Dutch sarcoidosis population.

Explaining use of food parenting practices: the importance of predisposing factors and parental cognitions.

PubMed

Gevers, Dorus Wm; van Assema, Patricia; de Vries, Nanne K; Kremers, Stef Pj

2017-09-01

The high energy intake from energy-dense foods among children in developed countries is undesirable. Improving food parenting practices has the potential to lower snack intakes among children. To inform the development of interventions, we aimed to predict food parenting practice patterns around snacking (i.e. 'high covert control and rewarding', 'low covert control and non-rewarding', 'high involvement and supportive' and 'low involvement and indulgent'). A cross-sectional survey was conducted. To predict the patterns of food parenting practices, multinomial logistic regression analyses were run with 888 parents. Predictors included predisposing factors (i.e. parents' and children's demographics and BMI, parents' personality, general parenting, and parenting practices used by their own parents) and parents' cognitions (i.e. perceived behaviour of other parents, subjective norms, attitudes, self-efficacy and outcome expectations). The Netherlands (October-November 2014). Dutch parents of children aged 4-12 years old. After backward elimination, nineteen factors had a statistically significant contribution to the model (Nagelkerke R 2=0·63). Overall, self-efficacy and outcome expectations were among the strongest explanatory factors. Considering the predisposing factors only, the general parenting factor nurturance most strongly predicted the food parenting clusters. Nurturance particularly distinguished highly involved parents from parents employing a pattern of low involvement. Parental cognitions and nurturance are important factors to explain the use of food parenting practices around snacking. The results suggest that intervention developers should attempt to increase self-efficacy and educate parents about what constitute effective and ineffective parenting practices. Promoting nurturance might be a prerequisite to achieve prolonged change.

The association between adolescents' health and disparities in school career: a longitudinal cohort study.

PubMed

Uiters, Ellen; Maurits, Erica; Droomers, Mariël; Zwaanswijk, Marieke; Verheij, Robert A; van der Lucht, Fons

2014-10-25

Literature suggests that children's educational achievement is associated with their health status and the socioeconomic position of their parents. Few studies have investigated this association in adolescence, while this is an important period affecting future life trajectories. Our study investigates the relationship between adolescents' health and their subsequent school career, taking into account their parents' socioeconomic position. Data of all Dutch adolescents who entered secondary education in 2003, according to the national education register, were linked to electronic health records from general practices and to data from the Dutch population register on a patient by patient basis. Secondary school career data of 2455 adolescents were available for several years, resulting in a longitudinal prospective cohort. School career was measured by the completion of secondary education within the research period. For most health problems, adolescents' health status at the moment of entering secondary education showed no association with the subsequent course of their school career. However, adolescents who had more frequent contact with their general practitioner for acute psychosocial problems (e.g. enuresis or overactive/hyperkinetic disorder), were less likely to complete their secondary education, also after adjustment for parental socioeconomic position. They were also less likely to complete their secondary education at the level of entry. Adolescents' secondary school career is negatively affected by the presence of acute psychosocial health problems, but not by the presence of physical health problems. This underlines the importance of adequately addressing mental health problems in adolescence.

Development of a Computerized Adaptive Test for Anxiety Based on the Dutch-Flemish Version of the PROMIS Item Bank.

PubMed

Flens, Gerard; Smits, Niels; Terwee, Caroline B; Dekker, Joost; Huijbrechts, Irma; Spinhoven, Philip; de Beurs, Edwin

2017-12-01

We used the Dutch-Flemish version of the USA PROMIS adult V1.0 item bank for Anxiety as input for developing a computerized adaptive test (CAT) to measure the entire latent anxiety continuum. First, psychometric analysis of a combined clinical and general population sample ( N = 2,010) showed that the 29-item bank has psychometric properties that are required for a CAT administration. Second, a post hoc CAT simulation showed efficient and highly precise measurement, with an average number of 8.64 items for the clinical sample, and 9.48 items for the general population sample. Furthermore, the accuracy of our CAT version was highly similar to that of the full item bank administration, both in final score estimates and in distinguishing clinical subjects from persons without a mental health disorder. We discuss the future directions and limitations of CAT development with the Dutch-Flemish version of the PROMIS Anxiety item bank.

Can small group education and peer review improve care for patients with asthma/chronic obstructive pulmonary disease?

PubMed Central

Smeele, I. J.; Grol, R. P.; van Schayck, C. P.; van den Bosch, W. J.; van den Hoogen, H. J.; Muris, J. W.

1999-01-01

OBJECTIVE: To study the effectiveness of an intensive small group education and peer review programme aimed at implementing national guidelines on asthma/chronic obstructive pulmonary disease (COPD) on care provision by general practitioners (GPs) and on patient outcomes. DESIGN: A randomised experimental study with pre-measurement and post- measurement (after one year) in an experimental group and a control group in Dutch general practice. SUBJECTS AND INTERVENTION: Two groups of GPs were formed and randomised. The education and peer review group (17 GPs with 210 patients) had an intervention consisting of an interactive group education and peer review programme (four sessions each lasting two hours). The control group consisted of 17 GPs with 223 patients (no intervention). MAIN OUTCOME MEASURES: Knowledge, skills, opinion about asthma and COPD care, presence of equipment in practice; actual performance about peakflow measurement, non-pharmacological and pharmacological treatment; asthma symptoms (Dutch Medical Research Council), smoking habits, exacerbation ratio, and disease specific quality of life (QOL-RIQ). Data were collected by a written questionnaire for GPs, by self recording of consultations by GPs, and by a written self administered questionnaire for adult patients with asthma/COPD. RESULTS: Data from 34 GP questionnaires, 433 patient questionnaires, and recordings from 934 consultations/visits and 350 repeat prescriptions were available. Compared with the control group there were only significant changes for self estimated skills (+16%, 95% confidence interval 4% to 26%) and presence of peakflow meters in practice (+18%, p < 0.05). No significant changes were found for provided care and patient outcomes compared with the control group. In the subgroup of more severe patients, the group of older patients, and in the group of patients not using anti-inflammatory medication at baseline, no significant changes compared with the control group were seen in patient outcomes. CONCLUSION: Except for two aspects, intensive small group education and peer review in asthma and COPD care do not seem to be effective in changing relevant aspects of the provided care by GPs in accordance with guidelines, nor in changing patients' health status. PMID:10557684

Plant quality and local adaptation undermine relocation in a bog specialist butterfly

PubMed Central

Turlure, Camille; Radchuk, Viktoriia; Baguette, Michel; Meijrink, Mark; den Burg, Arnold; Vries, Michiel Wallis; Duinen, Gert-Jan

2013-01-01

The butterfly Boloria aquilonaris is a specialist of oligotrophic ecosystems. Population viability analysis predicted the species to be stable in Belgium and to collapse in the Netherlands with reduced host plant quality expected to drive species decline in the latter. We tested this hypothesis by rearing B. aquilonaris caterpillars from Belgian and Dutch sites on host plants (the cranberry, Vaccinium oxycoccos). Dutch plant quality was lower than Belgian one conferring lower caterpillar growth rate and survival. Reintroduction and/or supplementation may be necessary to ensure the viability of the species in the Netherlands, but some traits may have been selected solely in Dutch caterpillars to cope with gradual changes in host plant quality. To test this hypothesis, the performance of Belgian and Dutch caterpillars fed with plants from both countries were compared. Dutch caterpillars performed well on both plant qualities, whereas Belgian caterpillars could not switch to lower quality plants. This can be considered as an environmentally induced plastic response of caterpillars and/or a local adaptation to plant quality, which precludes the use of Belgian individuals as a unique solution for strengthening Dutch populations. More generally, these results stress that the relevance of local adaptation in selecting source populations for relocation may be as important as restoring habitat quality. PMID:23467336

The Gender Gap in Second Language Acquisition: Gender Differences in the Acquisition of Dutch among Immigrants from 88 Countries with 49 Mother Tongues.

PubMed

van der Slik, Frans W P; van Hout, Roeland W N M; Schepens, Job J

2015-01-01

Gender differences were analyzed across countries of origin and continents, and across mother tongues and language families, using a large-scale database, containing information on 27,119 adult learners of Dutch as a second language. Female learners consistently outperformed male learners in speaking and writing proficiency in Dutch as a second language. This gender gap remained remarkably robust and constant when other learner characteristics were taken into account, such as education, age of arrival, length of residence and hours studying Dutch. For reading and listening skills in Dutch, no gender gap was found. In addition, we found a general gender by education effect for all four language skills in Dutch for speaking, writing, reading, and listening. Female language learners turned out to profit more from higher educational training than male learners do in adult second language acquisition. These findings do not seem to match nurture-oriented explanatory frameworks based for instance on a human capital approach or gender-specific acculturation processes. Rather, they seem to corroborate a nature-based, gene-environment correlational framework in which language proficiency being a genetically-influenced ability interacting with environmental factors such as motivation, orientation, education, and learner strategies that still mediate between endowment and acquiring language proficiency at an adult stage.

Willingness to pay for adverse drug event regulatory actions.

PubMed

Bouvy, Jacoline; Weemers, Just; Schellekens, Huub; Koopmanschap, Marc

2011-11-01

Regulatory requirements for the pharmaceutical industry have become increasingly demanding with respect to the safety and effectiveness of drugs. The objective of this study was to determine the willingness to pay (WTP), of both the Dutch general public and dialysis patients, for regulatory requirements related to reducing the risk of pure red cell aplasia (PRCA) associated with epoetin alpha use. A survey was carried out in April 2009. The Dutch general public (n = 422) was approached through a survey sampling agency. Patients (n = 112) were included through several Dutch dialysis clinics because they are often treated with epoetin alpha and therefore were expected to have a higher WTP than the general public. The survey aimed to determine the WTP for reducing the risk of PRCA in epoetin alpha users from 4.5 to 0 per 10 000 patients per year, based on regulatory actions that have been taken by the European Medicines Agency (EMA). WTP was determined via a payment scale and an open-ended follow-up question. Patients were asked how much extra per year they would be willing to pay for their basic healthcare insurance. We used two censored regression models to test the association between WTP and a set of independent variables: a Tobit model with the stated WTP as the dependent variable and an interval regression model with the interval between the lower and upper bounds of the payment scale as the dependent variable. The patients' mean WTP was significantly higher (€46.52) than that of the general public (€24.40). The Tobit model showed significant associations (α = 0.05) with WTP for dialysis patients, risk perception and respondents' opinions on costs of healthcare. The interval regression model showed significant associations with WTP for the same variables as the Tobit model and for one additional variable (risk aversion). Income did not significantly affect WTP. A scenario with a 10-fold larger risk reduction did not increase WTP significantly. This study is, as far as we know, one of the first attempts to analyse the WTP for drug regulation and should in future be used in studies of the societal costs of drug regulation for epoetin alpha use. Our results indicate that the Dutch general public, especially Dutch dialysis patients, are willing to pay limited amounts to reduce the risk of serious adverse events associated with drug use.

Dutch Special Education Schools for Children with Learning Disabilities in the Interwar Period

ERIC Educational Resources Information Center

van Drenth, Annemieke; van Essen, Mineke

2011-01-01

In this article Copeland's model of visualising the classification of children with learning disabilities is applied in examining the development of special education schools in the Netherlands during the interwar period. Central are three intertwined social practices: the teacher's professionalism (in pedagogic and practical concerns), the…

Genomics Education in Practice: Evaluation of a Mobile Lab Design

ERIC Educational Resources Information Center

Van Mil, Marc H. W.; Boerwinkel, Dirk Jan; Buizer-Voskamp, Jacobine E.; Speksnijder, Annelies; Waarlo, Arend Jan

2010-01-01

Dutch genomics research centers have developed the "DNA labs on the road" to bridge the gap between modern genomics research practice and secondary-school curriculum in the Netherlands. These mobile DNA labs offer upper-secondary students the opportunity to experience genomics research through experiments with laboratory equipment that…

Improving Kindergarten Teachers' Differentiation Practices to Better Anticipate Student Differences

ERIC Educational Resources Information Center

Dijkstra, Elma M.; Walraven, Amber; Mooij, Ton; Kirschner, Paul A.

2016-01-01

This article presents the findings from a teacher intervention in Dutch kindergartens aimed at improving teachers' differentiation practices (DP) to better anticipate student differences. The intervention was designed to improve the match between student levels and curricular activities, in particular for high-ability students and consists of…

News media coverage of euthanasia: a content analysis of Dutch national newspapers.

PubMed

Rietjens, Judith A C; Raijmakers, Natasja J H; Kouwenhoven, Pauline S C; Seale, Clive; van Thiel, Ghislaine J M W; Trappenburg, Margo; van Delden, Johannes J M; van der Heide, Agnes

2013-03-06

The Netherlands is one of the few countries where euthanasia is legal under strict conditions. This study investigates whether Dutch newspaper articles use the term 'euthanasia' according to the legal definition and determines what arguments for and against euthanasia they contain. We did an electronic search of seven Dutch national newspapers between January 2009 and May 2010 and conducted a content analysis. Of the 284 articles containing the term 'euthanasia', 24% referred to practices outside the scope of the law, mostly relating to the forgoing of life-prolonging treatments and assistance in suicide by others than physicians. Of the articles with euthanasia as the main topic, 36% described euthanasia in the context of a terminally ill patient, 24% for older persons, 16% for persons with dementia, and 9% for persons with a psychiatric disorder. The most frequent arguments for euthanasia included the importance of self-determination and the fact that euthanasia contributes to a good death. The most frequent arguments opposing euthanasia were that suffering should instead be alleviated by better care, that providing euthanasia can be disturbing, and that society should protect the vulnerable. Of the newspaper articles, 24% uses the term 'euthanasia' for practices that are outside the scope of the euthanasia law. Typically, the more unusual cases are discussed. This might lead to misunderstandings between citizens and physicians. Despite the Dutch legalisation of euthanasia, the debate about its acceptability and boundaries is ongoing and both sides of the debate are clearly represented.

The implementation effectiveness of the ‘Strengthen your ankle’ smartphone application for the prevention of ankle sprains: design of a randomized controlled trial

PubMed Central

2014-01-01

Background Ankle sprains continue to pose a significant burden to the individual athlete, as well as to society as a whole. However, despite ankle sprains being the single most common sports injury and despite an active approach by various Dutch organisations in implementing preventive measures, large-scale community uptake of these preventive measures, and thus actual prevention of ankle sprains, is lagging well behind. In an attempt to bridge this implementation gap, the Dutch Consumer Safety Institute VeiligheidNL developed a freely available interactive App (‘Strenghten your ankle’ translated in Dutch as: ‘Versterk je enkel; available for iOS and Android) that contains - next to general advice on bracing and taping - a proven cost-effective neuromuscular program. The ‘Strengthen your ankle’ App has not been evaluated against the ‘regular’ prevention approach in which the neuromuscular program is advocated through written material. The aim of the current project is to evaluate the implementation value of the ‘Strengthen your ankle’ App as compared to the usual practice of providing injured athletes with written materials. In addition, as a secondary outcome measure, the cost-effectiveness will be assessed against usual practice. Methods/Design The proposed study will be a randomised controlled trial. After stratification for medical caregiver, athletes will be randomised to two study groups. One group will receive a standardized eight-week proprioceptive training program that has proven to be cost-effective to prevent recurrent ankle injuries, consisting of a balance board (machU/ MSG Europe BVBA), and a traditional instructional booklet. The other group will receive the same exercise program and balance board. However, for this group the instructional booklet is exchanged by the interactive ‘Strengthen your ankle’ App. Discussion This trial is the first randomized controlled trial to study the implementation effectiveness of an App for proprioceptive balance board training program in comparison to a traditional printed instruction booklet, with the recurrence of ankle sprains among athletes as study outcome. Results of this study could possibly lead to changes in practical guidelines on the treatment of ankle sprains and in the use of mobile applications for injury prevention. Results will become available in 2014. Trial registration The Netherlands National Trial Register NTR4027. The NTR is part of the WHO Primary Registries. PMID:24393146

The implementation effectiveness of the 'Strengthen your ankle' smartphone application for the prevention of ankle sprains: design of a randomized controlled trial.

PubMed

Van Reijen, Miriam; Vriend, Ingrid I; Zuidema, Victor; van Mechelen, Willem; Verhagen, Evert A

2014-01-07

Ankle sprains continue to pose a significant burden to the individual athlete, as well as to society as a whole. However, despite ankle sprains being the single most common sports injury and despite an active approach by various Dutch organisations in implementing preventive measures, large-scale community uptake of these preventive measures, and thus actual prevention of ankle sprains, is lagging well behind. In an attempt to bridge this implementation gap, the Dutch Consumer Safety Institute VeiligheidNL developed a freely available interactive App ('Strenghten your ankle' translated in Dutch as: 'Versterk je enkel; available for iOS and Android) that contains - next to general advice on bracing and taping - a proven cost-effective neuromuscular program. The 'Strengthen your ankle' App has not been evaluated against the 'regular' prevention approach in which the neuromuscular program is advocated through written material. The aim of the current project is to evaluate the implementation value of the 'Strengthen your ankle' App as compared to the usual practice of providing injured athletes with written materials. In addition, as a secondary outcome measure, the cost-effectiveness will be assessed against usual practice. The proposed study will be a randomised controlled trial. After stratification for medical caregiver, athletes will be randomised to two study groups. One group will receive a standardized eight-week proprioceptive training program that has proven to be cost-effective to prevent recurrent ankle injuries, consisting of a balance board (machU/ MSG Europe BVBA), and a traditional instructional booklet. The other group will receive the same exercise program and balance board. However, for this group the instructional booklet is exchanged by the interactive 'Strengthen your ankle' App. This trial is the first randomized controlled trial to study the implementation effectiveness of an App for proprioceptive balance board training program in comparison to a traditional printed instruction booklet, with the recurrence of ankle sprains among athletes as study outcome. Results of this study could possibly lead to changes in practical guidelines on the treatment of ankle sprains and in the use of mobile applications for injury prevention. Results will become available in 2014. The Netherlands National Trial Register NTR4027. The NTR is part of the WHO Primary Registries.

Ideology, politics, and personality: shaping forces in Dutch psychology of religion, 1907-1957.

PubMed

Belzen, Jacob A

2009-08-01

Although the academic establishment of the psychology of religion in the Netherlands has been stronger than in any other Western country, the start of these developments has been remarkably late (in 1957), especially when taking into account that Dutch academic life: (1) before World War II modeled itself after Germany (where psychology of religion flourished); and (2) was to a considerable extent included in the system of pillarization, which characterized Dutch society at large. The general factors that can be distinguished as having played an important role in the shaping of the situation for psychology of religion in the Netherlands had different impacts in the several universities under consideration.

Teaching self-management support in Dutch Bachelor of Nursing education: A mixed methods study of the curriculum.

PubMed

van Hooft, Susanne M; Becqué, Yvonne N; Dwarswaard, Jolanda; van Staa, AnneLoes; Bal, Roland

2018-06-08

Nurses are expected to support people to self-manage. Student nurses therefore need to master competencies that include the assessment of peoples' needs and preferences, and shared decision-making, whilst respecting and enhancing peoples' autonomy. Adapting nurse education programmes to meet this goal requires insight into the practice of teaching self-management support. In order to reveal this practice, one can distinguish between the intended, the taught, and the received curriculum. This study aimed to explore how Dutch Bachelor of Nursing students are educated to support peoples' self-management in clinical practice. Mixed methods. Focus group meetings with 30 lecturers, and qualitative semi-structured interviews with four coordinators and four (associate) professors of four Dutch schools for Bachelor of Nursing. Syllabuses were screened for learning objectives related to self-management. A survey measuring self-efficacy and behaviour regarding self-management support was distributed among 444 final-year students of these schools, resulting in 238 valid responses (response rate 53.6%). Much attention is paid in the curriculum to assessment of people's preferences and healthcare education but less attention is given to teaching the arrangement of follow-up care. The study further reveals that students have problems transferring theory into practice, and that they experience conflicting values between their nurse education and internships. Currently, students are taught to provide people with self-management support by learning about theoretical models, developing communication skills, and reflecting on their internships. This approach seems inadequate to prepare students for this task in daily practice. A shared view on self-management support based on authentic situations, having role models at university and on internships and empowering students may enable them to better support people to self-manage. Copyright © 2018 Elsevier Ltd. All rights reserved.

The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) : Exploring the changes in anticoagulant practice in patients with non-valvular atrial fibrillation in the Netherlands.

PubMed

Ten Cate, V; Ten Cate, H; Verheugt, F W A

2016-10-01

There are over 385,000 cases of atrial fibrillation (AF) in the Netherlands, with over 45,000 new cases each year. Among other things, AF patients are at high risk of stroke. Patients are often prescribed oral anticoagulation, such as vitamin K antagonists (VKA), to mitigate these risks. A recently introduced class of oral anticoagulants, non-vitamin K antagonists (NOAC), is quickly gaining currency in global clinical practice. This study provides insight into the changes these new drugs will bring about in Dutch clinical practice.GARFIELD-AF is a large-scale observational AF patient registry initiated in 2009 to track the evolution of global anticoagulation practice, and to study the impact of NOAC therapy in AF in particular. The registry includes a wide array of baseline characteristics and has a particular focus on: (1) bleeding and thromboembolic events; (2) international normalised ratio fluctuations; and (3) therapy compliance and persistence patterns. The results in this paper provide the baseline characteristics of the first cohorts of Dutch participants in this registry and discuss some of the consequences of the changes in anticoagulation practice.Although VKA therapy remains overwhelmingly favoured by Dutch practitioners, NOACs are clearly gaining in popularity. Between 2011 and 2014, NOACs constituted an increasingly large proportion of prescriptions for oral anticoagulants.The insights provided by the GARFIELD-AF registry can be used by healthcare systems to inform better budgetary strategies, by practitioners to better tailor treatment pathways to patients, and finally to promote awareness of the various available treatment options and their associated risks and benefits for patients.

Development and Evaluation of an Implementation Strategy for Collecting Data in a National Registry and the Use of Patient-Reported Outcome Measures in Physical Therapist Practices: Quality Improvement Study.

PubMed

Meerhoff, Guus A; van Dulmen, Simone A; Maas, Marjo J M; Heijblom, Karin; Nijhuis-van der Sanden, Maria W G; Van der Wees, Philip J

2017-08-01

In 2013, the Royal Dutch Society for Physical Therapy launched the program "Quality in Motion." This program aims to collect data from electronic health record systems in a registry that is fed back to physical therapists, facilitating quality improvement. The purpose of this study was to describe the development of an implementation strategy for the program and to evaluate the feasibility of building a registry and implementing patient-reported outcome measures (PROMs) in physical therapist practices. A stepwise approach using mixed methods was established in 3 consecutive pilots with 355 physical therapists from 66 practices. Interim results were evaluated using quantitative data from a self-assessment questionnaire and the registry and qualitative data from 21 semistructured interviews with physical therapists. Descriptive statistics and McNemar's symmetry chi-squared test were used to summarize the feasibility of implementing PROMs. PROMs were selected for the 5 most prevalent musculoskeletal conditions in Dutch physical therapist practices. A core component of the implementation strategy was the introduction of knowledge brokers to support physical therapists in establishing the routine use of PROMs in clinical practice and to assist in executing peer assessment workshops. In February 2013, 30.3% of the physical therapist practices delivered 4.4 completed treatment episodes per physical therapist to the registry; this increased to 92.4% in November 2014, delivering 54.1 completed patient episodes per physical therapist. Pre- and posttreatment PROM use increased from 12.2% to 39.5%. It is unclear if the participating physical therapists reflect a representative sample of Dutch therapists. Building a registry and implementing PROMs in physical therapist practices are feasible. The routine use of PROMs needs to increase to ensure valid feedback of outcomes. Using knowledge brokers is promising for implementing the program via peer assessment workshops. © 2017 American Physical Therapy Association

L1 and L2 reading skills in Dutch adolescents with a familial risk of dyslexia

PubMed Central

Tops, Wim; Hakvoort, Britt E.; van der Leij, Aryan; Maurits, Natasha M.; Maassen, Ben A.M.

2017-01-01

Background The present study investigated differences in reading and spelling outcomes in Dutch and English as a second language (ESL) in adolescents with a high familial risk of dyslexia, of whom some have developed dyslexia (HRDys) while others have not (HRnonDys), in comparison to a low familial risk control group without dyslexia (LRnonDys). This allowed us to investigate the persistence of dyslexia in the first language (L1) and the effect of dyslexia on the second language (L2), which has, in this case, a lower orthographic transparency. Furthermore, the inclusion of the HRnonDys group allowed us to investigate the continuity of the familial risk of dyslexia, as previous studies observed that the HRnonDys group often scores in between the HRDys and LRnonDys group, and whether these readers without reading deficits in Dutch, have more reading difficulties in ESL. Methods The data of three groups of adolescents were analyzed; 27 LRnonDys, 25 HRdys 25 HRnonDys. The mean age was 14;1 years; months, and 37 were male. All were native speakers of Dutch, attended regular secondary education (grade 7–10), and were non-native speakers of English. Using MANOVA the groups were compared on Dutch and English word reading fluency (WRF), spelling and vocabulary, Dutch pseudoword and loanword reading fluency, phonological awareness (PA), rapid automatized naming (RAN), and verbal short term and working memory. A repeated measures ANOVA was used to compare English and Dutch WRF, spelling and vocabulary directly within the three groups. Results The analyses revealed that the HRDys group had a deficit in both reading and spelling in Dutch and ESL. They also performed poorer than the LRnonDys group on all other measures. Effect sizes were especially large for pseudoword reading and the reaction times during the PA task. The HRnonDys group scored generally poorer than the LRnonDys group but this difference was only significant for Dutch pseudoword reading, PA reaction times and verbal short term memory. In general the HRDys and HRnonDys group scored similar in Dutch and English, except for English WRF where the HRDys group scored slightly better than expected based on their Dutch WRF. Discussion There was a high persistence of dyslexia. Adolescents with dyslexia had large impairments in reading and spelling, and reading related measures, both in Dutch and ESL. Despite high inter-individual differences, an overall three-step pattern was observed. Adolescents in the HRnonDys group scored in between the HRDys and LRnonDys group, supporting the polygenetic origin of dyslexia and the continuity of the familial risk of dyslexia. The lower orthographic transparency did not have a negative effect on L2 reading, spelling and vocabulary, both in the HRnonDys and HRDys group. The latter group performed slightly better than expected in L2, which may be a result of the massive exposure to English and high motivation to use English by adolescents. PMID:29062600

Efficacy of paracetamol, diclofenac and advice for acute low back pain in general practice: design of a randomized controlled trial (PACE Plus).

PubMed

Schreijenberg, M; Luijsterburg, P A J; Van Trier, Y D M; Rizopoulos, D; Koopmanschap, M A; Voogt, L; Maher, C G; Koes, B W

2017-02-01

Low back pain is common and associated with a considerable burden to patients and society. There is uncertainty regarding the relative benefit of paracetamol and diclofenac and regarding the additional effect of pain medication compared with advice only in patients with acute low back pain. This trial will assess the effectiveness of paracetamol, diclofenac and placebo for acute low back pain over a period of 4 weeks. Furthermore, this trial will assess the additional effectiveness of paracetamol, diclofenac and placebo compared with advice only for acute low back pain over a period of 4 weeks. The PACE Plus trial is a multi-center, placebo-blinded, superiority randomized controlled trial in primary care, with a follow-up of 12 weeks. Patients with acute low back pain aged 18-60 years presenting in general practice will be included. Patients are randomized into four groups: 1) Advice only (usual care conforming with the clinical guideline of the Dutch College of General Practitioners); 2) Advice and paracetamol; 3) Advice and diclofenac; 4) Advice and placebo. The primary outcome is low back pain intensity measured with a numerical rating scale (0-10). Secondary outcomes include compliance to treatment, disability, perceived recovery, costs, adverse reactions, satisfaction, sleep quality, co-interventions and adequacy of blinding. Between group differences for low back pain intensity will be evaluated using a repeated measurements analysis with linear effects models. An economic evaluation will be performed using a cost-effectiveness analysis with low back pain intensity and a cost-utility analysis with quality of life. Explorative analyses will be performed to assess effect modification by predefined variables. Ethical approval has been granted. Trial results will be released to an appropriate peer-viewed journal. This paper presents the design of the PACE Plus trial: a multi-center, placebo-blinded, superiority randomized controlled trial in primary care that will assess the effectiveness of advice only, paracetamol, diclofenac and placebo for acute low back pain. Dutch Trial Registration NTR6089 , registered September 14th, 2016. Version 4, June 2016.

Dutch translation and cross-cultural validation of the Adult Social Care Outcomes Toolkit (ASCOT).

PubMed

van Leeuwen, Karen M; Bosmans, Judith E; Jansen, Aaltje Pd; Rand, Stacey E; Towers, Ann-Marie; Smith, Nick; Razik, Kamilla; Trukeschitz, Birgit; van Tulder, Maurits W; van der Horst, Henriette E; Ostelo, Raymond W

2015-05-13

The Adult Social Care Outcomes Toolkit was developed to measure outcomes of social care in England. In this study, we translated the four level self-completion version (SCT-4) of the ASCOT for use in the Netherlands and performed a cross-cultural validation. The ASCOT SCT-4 was translated into Dutch following international guidelines, including two forward and back translations. The resulting version was pilot tested among frail older adults using think-aloud interviews. Furthermore, using a subsample of the Dutch ACT-study, we investigated test-retest reliability and construct validity and compared response distributions with data from a comparable English study. The pilot tests showed that translated items were in general understood as intended, that most items were reliable, and that the response distributions of the Dutch translation and associations with other measures were comparable to the original English version. Based on the results of the pilot tests, some small modifications and a revision of the Dignity items were proposed for the final translation, which were approved by the ASCOT development team. The complete original English version and the final Dutch translation can be obtained after registration on the ASCOT website ( http://www.pssru.ac.uk/ascot ). This study provides preliminary evidence that the Dutch translation of the ASCOT is valid, reliable and comparable to the original English version. We recommend further research to confirm the validity of the modified Dutch ASCOT translation.

Self sufficient world

ERIC Educational Resources Information Center

George, Lynn

1974-01-01

Described the efforts of Sietze Leeflang, a Dutch scientific journalist, and his group of young scientists to take a practical stand on environmental pollution by working their small farm in innovative fashion. (RK)

Practice variation amongst preventive child healthcare professionals in the prevention of child maltreatment in the Netherlands: Qualitative and quantitative data.

PubMed

Visscher, Simeon J A; van Stel, Henk F

2017-12-01

This article provides both qualitative and quantitative data on practice variation amongst preventive child healthcare professionals in the prevention of child maltreatment in the Netherlands. Qualitative data consist of topics identified during interviews with 11 experts (with quotes), resulting in an online survey. The quantitative data are survey responses from 1104 doctors and nurses working in 29 preventive child healthcare organizations. Additionally, the interview topic list, the qualitative data analysis methodology, the survey (in English and Dutch) and anonymized raw survey data (http://hdl.handle.net/10411/5LJOGH) are provided as well. This data-in-brief article accompanies the paper "Variation in prevention of child maltreatment by Dutch child healthcare professionals" by Simeon Visscher and Henk van Stel [1].

How Dutch orthoptists deal with noncompliance with occlusion therapy for amblyopia.

PubMed

Tjiam, A M; Vukovic, E; Asjes-Tydeman, W L; Holtslag, G; Loudon, S E; Sinoo, M M; Simonsz, H J

2010-12-01

We previously found that compliance with occlusion therapy for amblyopia is poor, especially among children of non-native parents who spoke Dutch poorly and who were low educated. We investigated conception, awareness, attitude, and actions to deal with noncompliance among Dutch orthoptists. Orthoptists working in non-native, low socioeconomic status (SES) areas and a selection of orthoptists working elsewhere in the Netherlands were studied. They were observed in their practice, received a structured questionnaire, and underwent a semi-structured interview. Finally, a short survey was sent to all working orthoptists in the Netherlands. Nine orthoptists working in non-native, low-SES areas and 23 working elsewhere in the Netherlands participated. One hundred and fifty-one orthoptists returned the short survey. Major discrepancies existed in conception, awareness, and attitude. Opinions differed on what should be defined as noncompliance and on what causes noncompliance. Some orthoptists found noncompliance annoying, unpleasant, and hard to imagine, others were more understanding. Many pitied the noncompliant child. Almost all thought that the success of occlusion therapy lies both with the parents and the orthoptist, but one third thought that noncompliance was not solely their responsibility. Patients' compliance was estimated at 69.3% in non-native, low-SES areas (electronically, 52% had been measured), at 74.1% by the other 23 orthoptists, and at 73.8% in the short survey. Actions to improve compliance were diverse; some increased occlusion hours whereas others decreased them. In non-native, low-SES areas, 22% spoke Dutch moderately to none; the allotted time for a patient's first visit was 21'; the time spent on explaining to the parents was 2'30" and to the child 10". In practices of the other 23 orthoptists, 6% spoke Dutch moderately to none (P<0.0001), the time for a patient's first visit was 27'24" (P=0.47), and the periods spent explaining were 2'51" (P=0.59) and 26" (P=0.17), respectively. Conception, awareness, attitude, and actions to deal with noncompliance varied among orthoptists. In non-native, low-SES areas, time spent on explanation was shorter, despite a lower fluency in Dutch among the parents.

Informal interpreting in general practice: Are interpreters' roles related to perceived control, trust, and satisfaction?

PubMed

Zendedel, Rena; Schouten, Barbara C; van Weert, Julia C M; van den Putte, Bas

2018-06-01

The aim of this observational study was twofold. First, we examined how often and which roles informal interpreters performed during consultations between Turkish-Dutch migrant patients and general practitioners (GPs). Second, relations between these roles and patients' and GPs' perceived control, trust in informal interpreters and satisfaction with the consultation were assessed. A coding instrument was developed to quantitatively code informal interpreters' roles from transcripts of 84 audio-recorded interpreter-mediated consultations in general practice. Patients' and GPs' perceived control, trust and satisfaction were assessed in a post consultation questionnaire. Informal interpreters most often performed the conduit role (almost 25% of all coded utterances), and also frequently acted as replacers and excluders of patients and GPs by asking and answering questions on their own behalf, and by ignoring and omitting patients' and GPs' utterances. The role of information source was negatively related to patients' trust and the role of GP excluder was negatively related to patients' perceived control. Patients and GPs are possibly insufficiently aware of the performed roles of informal interpreters, as these were barely related to patients' and GPs' perceived trust, control and satisfaction. Patients and GPs should be educated about the possible negative consequences of informal interpreting. Copyright © 2018 Elsevier B.V. All rights reserved.

Addressing Palliative Sedation during Expert Consultation: A Descriptive Analysis of the Practice of Dutch Palliative Care Consultation Teams

PubMed Central

Hoek, Patrick; Grandjean, Ilse; Verhagen, Constans A. H. H. V. M.; Jansen-Landheer, Marlies L. E. A.; Schers, Henk J.; Galesloot, Cilia; Vissers, Kris C. P.; Engels, Yvonne; Hasselaar, Jeroen G.J.

2015-01-01

Main Objective Since palliative sedation is considered a complex intervention, consultation teams are increasingly established to support general practice. This study aims to offer insight into the frequency and characteristics of expert consultations regarding palliative sedation. Methods We performed a retrospective analysis of a longitudinal database. This database contained all patient-related consultations by Dutch Palliative Care Consultation teams, that were requested between 2004 and 2011. We described the frequency and characteristics of these consultations, in particular of the subgroup of consultations in which palliative sedation was addressed (i.e. PSa consultations). We used multivariate regression analysis to explore consultation characteristics associated with a higher likelihood of PSa consultations. Main Results and Their Significance Of the 44,443 initial consultations, most were requested by general practitioners (73%) and most concerned patients with cancer (86%). Palliative sedation was addressed in 18.1% of all consultations. Palliative sedation was relatively more often discussed during consultations for patients with a neurologic disease (OR 1.79; 95% CI: 1.51–2.12) or COPD (OR 1.39; 95% CI: 1.15–1.69) than for patients with cancer. We observed a higher likelihood of PSa consultations if the following topics were also addressed during consultation: dyspnoea (OR 1.30; 95% CI: 1.22–1.40), agitation/delirium (OR 1.57; 95% CI: 1.47–1.68), exhaustion (OR 2.89; 95% CI: 2.61–3.20), euthanasia-related questions (OR 2.65; 95% CI: 2.37–2.96) or existential issues (OR 1.55; 95% CI: 1.31–1.83). Conclusion In conclusion, PSa consultations accounted for almost one-fifth of all expert consultations and were associated with several case-related characteristics. These characteristics may help clinicians in identifying patients at risk for a more complex disease trajectory at the end of life. PMID:26301746

A study of the problem of designing airplanes with satisfactory inherent damping of the dutch roll oscillation

NASA Technical Reports Server (NTRS)

Campbell, John P; Mckinney, Marion O , Jr

1954-01-01

Considerable interest has recently been shown in means of obtaining satisfactory stability of the dutch roll oscillation for modern high-performance airplanes without resort to complicated artificial stabilizing devices. One approach to this problem is to lay out the airplane in the earliest stages of design so that it will have the greatest practicable inherent stability of the lateral oscillation. The present report presents some preliminary results of a theoretical analysis to determine the design features that appear most promising in providing adequate inherent stability. These preliminary results cover the case of fighter airplanes at subsonic speeds. The investigation indicated that it is possible to design fighter airplanes to have substantially better inherent stability than most current designs. Since the use of low-aspect-ratio swept-back wings is largely responsible for poor dutch roll stability, it is important to design the airplane with the maximum aspect ratio and minimum sweep that will permit attainment of the desired performance. The radius of gyration in roll should be kept as low as possible and the nose-up inclination of the principal longitudinal axis of inertia should be made as great as practicable. (author)

Variation in the prion protein sequence in Dutch goat breeds.

PubMed

Windig, J J; Hoving, R A H; Priem, J; Bossers, A; van Keulen, L J M; Langeveld, J P M

2016-10-01

Scrapie is a neurodegenerative disease occurring in goats and sheep. Several haplotypes of the prion protein increase resistance to scrapie infection and may be used in selective breeding to help eradicate scrapie. In this study, frequencies of the allelic variants of the PrP gene are determined for six goat breeds in the Netherlands. Overall frequencies in Dutch goats were determined from 768 brain tissue samples in 2005, 766 in 2008 and 300 in 2012, derived from random sampling for the national scrapie surveillance without knowledge of the breed. Breed specific frequencies were determined in the winter 2013/2014 by sampling 300 breeding animals from the main breeders of the different breeds. Detailed analysis of the scrapie-resistant K222 haplotype was carried out in 2014 for 220 Dutch Toggenburger goats and in 2015 for 942 goats from the Saanen derived White Goat breed. Nine haplotypes were identified in the Dutch breeds. Frequencies for non-wild type haplotypes were generally low. Exception was the K222 haplotype in the Dutch Toggenburger (29%) and the S146 haplotype in the Nubian and Boer breeds (respectively 7 and 31%). The frequency of the K222 haplotype in the Toggenburger was higher than for any other breed reported in literature, while for the White Goat breed it was with 3.1% similar to frequencies of other Saanen or Saanen derived breeds. Further evidence was found for the existence of two M142 haplotypes, M142 /S240 and M142 /P240 . Breeds vary in haplotype frequencies but frequencies of resistant genotypes are generally low and consequently selective breeding for scrapie resistance can only be slow but will benefit from animals identified in this study. The unexpectedly high frequency of the K222 haplotype in the Dutch Toggenburger underlines the need for conservation of rare breeds in order to conserve genetic diversity rare or absent in other breeds. © 2016 Blackwell Verlag GmbH.

Hypertension control in a large multi-ethnic cohort in Amsterdam, The Netherlands: the HELIUS study.

PubMed

Agyemang, Charles; Kieft, Suzanne; Snijder, Marieke B; Beune, Erik J; van den Born, Bert-Jan; Brewster, Lizzy M; Ujcic-Voortman, Joanne J; Bindraban, Navin; van Montfrans, Gert; Peters, Ron J; Stronks, Karien

2015-03-15

Hypertension is a major problem among European ethnic minority groups. We assessed the current situation of hypertension prevalence and its management among a multi-ethnic population in Amsterdam, The Netherlands. Data from the HELIUS study were used including 12,974 participants (1871 Ghanaian, 2184 African Surinamese, 2278 South-Asian Surinamese, 2277 Turkish, 2222 Moroccan and 2142 Dutch origin people), aged 18-70 years. Comparisons among groups were made using proportions and age-adjusted prevalence ratios (PRs). Hypertension prevalence ranged from 24% and 16% in Moroccan men and women to 52% and 62% in Ghanaian men and women. Except for Moroccan women, age-adjusted PR of hypertension was higher in all the ethnic minority groups than in Dutch. Among hypertensives, ethnic minority groups generally had higher levels of hypertension awareness and BP lowering treatment than Dutch. Moreover, prevalence rates for the prescription of more than one BP lowering drug were generally higher in African and South-Asian origin groups compared with Dutch origin people. By contrast, BP control levels were lower in all the ethnic groups than in Dutch, with control rates being significantly lower in Ghanaian men (26%, PR=0.49; 95% CI, 0.37-0.66) and women (45%, PR=0.64; 0.52-0.77), African-Surinamese men (30%, PR=0.61; 0.46-0.81) and women (45%, PR=0.72; 0.51-0.77), and South-Asian Surinamese men (43%, PR=0.77; 0.61-0.97) and women (47%, PR=0.76; 0.63-0.92) compared with Dutch men (53%) and women (61%). Our findings indicate poor BP control in ethnic minority groups despite the high treatment levels. More work is needed to unravel the potential factors contributing to the poor control in order to improve BP control in ethnic minority groups, particularly among African and South-Asian origin groups. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Dutch translation of the ICMART-WHO revised glossary on ART terminology.

PubMed

De Neubourg, D; van Duijnhoven, N T L; Nelen, W L D M; D'Hooghe, T M

2012-01-01

A standardized set of definitions was needed in the field of medically assisted reproduction (MAR) to standardize and harmonize international data acquisition and to monitor the availability, efficacy, and safety of assisted reproductive technology (ART) worldwide. In order to provide accurate national data, the use of a terminology list which was composed and negotiated by the International Committee for Monitoring Assisted Reproductive Technology (ICMART) is essential, and a translation into Dutch was crucial for its implementation in Belgium and the Netherlands. The authors of the Dutch article translated the English publication that appeared simultaneously in Human Reproduction and Fertility and Sterility in 2009. A consensus text was obtained after evaluation by experts in the field of MAR both in the Netherlands and in Belgium and then by the board of the respective organizations of obstetrics and gynecology. It was then sent to the World Health Organization (WHO) for approval of publication. A translation into Dutch of the ICMART terminology of 2009 was obtained after consensus was reached on clinical and laboratory procedures, outcome variables, and birth. The availability and use of standardized terminology and its translation into Dutch will add to a more standardized communication between professionals responsible for the practice of ART and for those responsible for national, regional, and international registries. Copyright © 2012 S. Karger AG, Basel.

Is it better to invest in place or people to maximize population health? Evaluation of the general health impact of urban regeneration in Dutch deprived neighbourhoods.

PubMed

Droomers, Mariël; Jongeneel-Grimen, Birthe; Bruggink, Jan-Willem; Kunst, Anton; Stronks, Karien

2016-09-01

To study the general health impact of urban regeneration programmes in deprived Dutch districts. We compared initiatives that focused on the improvement of place with initiatives that mainly invested in people. A quasi-experimental design compared the trend in good perceived general health in the target districts with comparison districts. Generalized general mixed models assessed the rate of change in prevalence of good health per half year during a prolonged period before and after the start of the interventions. Neither the target districts that invested mainly in place nor the ones with interventions focused on people showed trends in general health different than comparison districts (p>0.05). However, only districts with interventions focused on place showed no deterioration in general health during the intervention period. The trend change in these districts differed significantly from the change in the districts that invested mainly in people (p<0.05). Urban regeneration programmes that focus on place may be effective in promoting general health. Copyright © 2016 Elsevier Ltd. All rights reserved.

75 FR 4108 - Sunshine Act Meeting Notice; Board of Directors and Five Committees of the Board

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-26

..., Chief Administrative Officer. 8. Inspector General briefing. Jeffrey Schanz, Inspector General. 9..., Treasurer & Comptroller. Comments by Charles Jeffress, Chief Administrative Officer. 5. Presentation on LSC... (FY) 2009 Annual Financial Audit. Ronald ``Dutch'' Merryman, Assistant Inspector General for Audits...

Using simulation to study difficult clinical issues: prenatal counseling at the threshold of viability across American and Dutch cultures.

PubMed

Geurtzen, Rosa; Hogeveen, Marije; Rajani, Anand K; Chitkara, Ritu; Antonius, Timothy; van Heijst, Arno; Draaisma, Jos; Halamek, Louis P

2014-06-01

Prenatal counseling at the threshold of viability is a challenging yet critically important activity, and care guidelines differ across cultures. Studying how this task is performed in the actual clinical environment is extremely difficult. In this pilot study, we used simulation as a methodology with 2 aims as follows: first, to explore the use of simulation incorporating a standardized pregnant patient as an investigative methodology and, second, to determine similarities and differences in content and style of prenatal counseling between American and Dutch neonatologists. We compared counseling practice between 11 American and 11 Dutch neonatologists, using a simulation-based investigative methodology. All subjects performed prenatal counseling with a simulated pregnant patient carrying a fetus at the limits of viability. The following elements of scenario design were standardized across all scenarios: layout of the physical environment, details of the maternal and fetal histories, questions and responses of the standardized pregnant patient, and the time allowed for consultation. American subjects typically presented several treatment options without bias, whereas Dutch subjects were more likely to explicitly advise a specific course of treatment (emphasis on partial life support). American subjects offered comfort care more frequently than the Dutch subjects and also discussed options for maximal life support more often than their Dutch colleagues. Simulation is a useful research methodology for studying activities difficult to assess in the actual clinical environment such as prenatal counseling at the limits of viability. Dutch subjects were more directive in their approach than their American counterparts, offering fewer options for care and advocating for less invasive interventions. American subjects were more likely to offer a wider range of therapeutic options without providing a recommendation for any specific option.

Multicultural Integration in British and Dutch Societies: Education and Citizenship

ERIC Educational Resources Information Center

Bagley, Christopher Adam; Al-Refai, Nader

2017-01-01

Purpose: The purpose of this paper is to review and synthesize published studies and practice in the "integration" of ethnic and religious minorities in Britain and The Netherlands, 1965-2015, drawing out implications for current policy and practice. Design/methodology/approach: This paper is an evaluative review and report of results of…

Are Anti-Smoking Parenting Practices Related to Adolescent Smoking Cognitions and Behavior?

ERIC Educational Resources Information Center

Huver, Rose M. E.; Engels, Rutger C. M. E.; de Vries, Hein

2006-01-01

The aim of this study was to explain the effects of anti-smoking parenting practices on adolescent smoking cognitions and behavior by showing the mediating effects of cognitions. Data were gathered among Dutch high school students in the control condition of the European Smoking prevention Framework Approach (ESFA). Anti-smoking parenting…

Alcohol-Specific Socialization Practices and Alcohol Use in Dutch Early Adolescents

ERIC Educational Resources Information Center

Koning, Ina M.; Engels, Rutger C. M. E.; Verdurmen, Jacqueline E. E.; Vollebergh, Wilma A. M.

2010-01-01

The present study examined the associations of alcohol-specific socialization practices and heavy parental drinking with alcohol use in early adolescents. Cross-sectional nationwide survey data from 2599 parent-adolescent (mean age = 12.16) dyads were used to conduct logistic regression analyses. Onset of alcohol use as well as infrequent and…

The ambiguity of patient-centred practices: the case of a Dutch fertility clinic.

PubMed

Gerrits, Trudie

2014-01-01

When in-vitro fertilization (IVF) was introduced in the 1970s, doctors were criticized for not properly informing prospective users about its possible risks and limited success rates as well as for medicalizing fertility problems. Nowadays, many fertility clinics are seeking to improve their accountability to stakeholders through patient-centred practices. Based on an ethnographic study of a Dutch fertility clinic, outspoken in its aims to provide patient-centred medicine and to empower clients, this paper addresses how patient-centred medicine affects couples' decision-making to use IVF and related reproductive technologies. The author contends that while patient-centred practices facilitate informed decision-making and support couples emotionally, they may also have unintended disciplining and normalizing effects. The information and support provided, the trust couples have in clinic staff, the ongoing visualization of conception mediated by medical technology--all can be seen as practices that strengthen lay people's 'medical gaze' in how they come to view their bodies, fertility problems and possible solutions. These unintended effects are labelled 'the ambiguity of patient-centeredness' as they (may) interfere with processes of autonomous decision-making.

Dementia incidence trend over 1992-2014 in the Netherlands: Analysis of primary care data.

PubMed

van Bussel, Emma F; Richard, Edo; Arts, Derk L; Nooyens, Astrid C J; Coloma, Preciosa M; de Waal, Margot W M; van den Akker, Marjan; Biermans, Marion C J; Nielen, Markus M J; van Boven, Kees; Smeets, Hugo; Matthews, Fiona E; Brayne, Carol; Busschers, Wim B; van Gool, Willem A; Moll van Charante, Eric P

2017-03-01

Recent reports have suggested declining age-specific incidence rates of dementia in high-income countries over time. Improved education and cardiovascular health in early age have been suggested to be bringing about this effect. The aim of this study was to estimate the age-specific dementia incidence trend in primary care records from a large population in the Netherlands. A dynamic cohort representative of the Dutch population was composed using primary care records from general practice registration networks (GPRNs) across the country. Data regarding dementia incidence were obtained using general-practitioner-recorded diagnosis of dementia within the electronic health records. Age-specific dementia incidence rates were calculated for all persons aged 60 y and over; negative binomial regression analysis was used to estimate the time trend. Nine out of eleven GPRNs provided data on more than 800,000 older people for the years 1992 to 2014, corresponding to over 4 million person-years and 23,186 incident dementia cases. The annual growth in dementia incidence rate was estimated to be 2.1% (95% CI 0.5% to 3.8%), and incidence rates were 1.08 (95% CI 1.04 to 1.13) times higher for women compared to men. Despite their relatively low numbers of person-years, the highest age groups contributed most to the increasing trend. There was no significant overall change in incidence rates since the start of a national dementia program in 2003 (-0.025; 95% CI -0.062 to 0.011). Increased awareness of dementia by patients and doctors in more recent years may have influenced dementia diagnosis by general practitioners in electronic health records, and needs to be taken into account when interpreting the data. Within the clinical records of a large, representative sample of the Dutch population, we found no evidence for a declining incidence trend of dementia in the Netherlands. This could indicate true stability in incidence rates, or a balance between increased detection and a true reduction. Irrespective of the exact rates and mechanisms underlying these findings, they illustrate that the burden of work for physicians and nurses in general practice associated with newly diagnosed dementia has not been subject to substantial change in the past two decades. Hence, with the ageing of Western societies, we still need to anticipate a dramatic absolute increase in dementia occurrence over the years to come.

Pragmatics of policy: the compliance of dutch environmental policy instruments to European union standards.

PubMed

Kruitwagen, Sonja; Reudink, Melchert; Faber, Albert

2009-04-01

Despite a general decrease in Dutch environmental emission trends, it remains difficult to comply with European Union (EU) environmental policy targets. Furthermore, environmental issues have become increasingly complex and entangled with society. Therefore, Dutch environmental policy follows a pragmatic line by adopting a flexible approach for compliance, rather than aiming at further reduction at the source of emission. This may be politically useful in order to adequately reach EU targets, but restoration of environmental conditions may be delayed. However, due to the complexity of today's environmental issues, the restoration of environmental conditions might not be the only standard for a proper policy approach. Consequently this raises the question how the Dutch pragmatic approach to compliance qualifies in a broader policy assessment. In order to answer this question, we adapt a policy assessment framework, developed by Hemerijck and Hazeu (Bestuurskunde 13(2), 2004), based on the dimensions of legitimacy and policy logic. We apply this framework for three environmental policy assessments: flexible instruments in climate policy, fine-tuning of national and local measures to meet air quality standards, and derogation for the Nitrate Directive. We conclude with general assessment notes on the appliance of flexible instruments in environmental policy, showing that a broad and comprehensive perspective can help to understand the arguments to put such policy instruments into place and to identify trade-offs between assessment criteria.

The Gender Gap in Second Language Acquisition: Gender Differences in the Acquisition of Dutch among Immigrants from 88 Countries with 49 Mother Tongues

PubMed Central

van der Slik, Frans W. P.; van Hout, Roeland W. N. M.; Schepens, Job J.

2015-01-01

Gender differences were analyzed across countries of origin and continents, and across mother tongues and language families, using a large-scale database, containing information on 27,119 adult learners of Dutch as a second language. Female learners consistently outperformed male learners in speaking and writing proficiency in Dutch as a second language. This gender gap remained remarkably robust and constant when other learner characteristics were taken into account, such as education, age of arrival, length of residence and hours studying Dutch. For reading and listening skills in Dutch, no gender gap was found. In addition, we found a general gender by education effect for all four language skills in Dutch for speaking, writing, reading, and listening. Female language learners turned out to profit more from higher educational training than male learners do in adult second language acquisition. These findings do not seem to match nurture-oriented explanatory frameworks based for instance on a human capital approach or gender-specific acculturation processes. Rather, they seem to corroborate a nature-based, gene-environment correlational framework in which language proficiency being a genetically-influenced ability interacting with environmental factors such as motivation, orientation, education, and learner strategies that still mediate between endowment and acquiring language proficiency at an adult stage. PMID:26540465

The Dutch Linguistic Intraoperative Protocol: a valid linguistic approach to awake brain surgery.

PubMed

De Witte, E; Satoer, D; Robert, E; Colle, H; Verheyen, S; Visch-Brink, E; Mariën, P

2015-01-01

Intraoperative direct electrical stimulation (DES) is increasingly used in patients operated on for tumours in eloquent areas. Although a positive impact of DES on postoperative linguistic outcome is generally advocated, information about the neurolinguistic methods applied in awake surgery is scarce. We developed for the first time a standardised Dutch linguistic test battery (measuring phonology, semantics, syntax) to reliably identify the critical language zones in detail. A normative study was carried out in a control group of 250 native Dutch-speaking healthy adults. In addition, the clinical application of the Dutch Linguistic Intraoperative Protocol (DuLIP) was demonstrated by means of anatomo-functional models and five case studies. A set of DuLIP tests was selected for each patient depending on the tumour location and degree of linguistic impairment. DuLIP is a valid test battery for pre-, intraoperative and postoperative language testing and facilitates intraoperative mapping of eloquent language regions that are variably located. Copyright © 2014 Elsevier Inc. All rights reserved.

Mental health in the Dutch population and in general practice: 1987–2001

PubMed Central

Verhaak, Peter FM; Hoeymans, Nancy; Garssen, Anna A; Westert, Gert P

2005-01-01

Background In the last 15 years, both the demand for and supply of specialised mental health care increased considerably in the Netherlands. Increased demand may reflect a change in psychological morbidity, but may also be a consequence of increased supply. Specialised health care in the Netherlands is accessible only through referral by a GP, and so it is important to consider the role of primary care in the diagnosis of mental health problems. Aim The aim of this study is to achieve a better understanding of the development of mental health status in the Dutch population and the consequent help-seeking behaviour in primary care. Method Using two comparable morbidity studies carried out in the Dutch population and in primary care, we compared data from 1987 and 2001 to assess the following: possible differences in mental health between 1987 and 2001; possible differences in prevalence of mental disorder as diagnosed by GPs in 1987 and 2001; possible differences in the sociodemographic determinants of mental health and mental disorder in primary care between 1987 and 2001. Results Our results show an increase in mental and social problems in the population between 1987 and 2001. However, GPs diagnosed fewer patients as having a mental disorder in 2001 than they did in 1987. The risk of mental disorders or social problems in several sociodemographic groups remained largely the same, as did the chance of receiving a psychological or social diagnosis. Conclusion We conclude that, while mental disorder in the population is increasing, the role of primary care has changed. Although GPs diagnose a lower percentage of mental problems as such, they refer an increasingly larger proportion of these to secondary care. PMID:16212852

Three decades of eating disorders in Dutch primary care: decreasing incidence of bulimia nervosa but not of anorexia nervosa.

PubMed

Smink, F R E; van Hoeken, D; Donker, G A; Susser, E S; Oldehinkel, A J; Hoek, H W

2016-04-01

Whether the incidence of eating disorders in Western, industrialized countries has changed over time has been the subject of much debate. The purpose of this primary-care study was to examine changes in the incidence of eating disorders in The Netherlands during the 1980s, 1990s and 2000s. A nationwide network of general practitioners (GPs), serving a representative sample (~1%) of the total Dutch population, recorded newly diagnosed patients with anorexia nervosa (AN) and bulimia nervosa (BN) in their practice during 1985-1989, 1995-1999, and 2005-2009. GPs are key players in the Dutch healthcare system, as their written referral is mandatory in order to get access to specialized (mental) healthcare, covered by health insurance. Health insurance is virtually universal in The Netherlands (99% of the population). A substantial number of GPs participated in all three study periods, during which the same case identification criteria were used and the same psychiatrist was responsible for making the final diagnoses. Incidence rates were calculated and for comparison between periods, incidence rate ratios. The overall incidence rate of BN decreased significantly in the past three decades (from 8.6 per 100,000 person-years in 1985-1989 to 6.1 in 1995-1999, and 3.2 in 2005-2009). The overall incidence of AN remained fairly stable during three decades, i.e. 7.4 per 100,000 person-years in 1985-1989, 7.8 in 1995-1999, and 6.0 in 2005-2009. The incidence rate of BN decreased significantly over the past three decades, while the overall incidence rate of AN remained stable.

News media coverage of euthanasia: a content analysis of Dutch national newspapers

PubMed Central

2013-01-01

Background The Netherlands is one of the few countries where euthanasia is legal under strict conditions. This study investigates whether Dutch newspaper articles use the term ‘euthanasia’ according to the legal definition and determines what arguments for and against euthanasia they contain. Methods We did an electronic search of seven Dutch national newspapers between January 2009 and May 2010 and conducted a content analysis. Results Of the 284 articles containing the term ‘euthanasia’, 24% referred to practices outside the scope of the law, mostly relating to the forgoing of life-prolonging treatments and assistance in suicide by others than physicians. Of the articles with euthanasia as the main topic, 36% described euthanasia in the context of a terminally ill patient, 24% for older persons, 16% for persons with dementia, and 9% for persons with a psychiatric disorder. The most frequent arguments for euthanasia included the importance of self-determination and the fact that euthanasia contributes to a good death. The most frequent arguments opposing euthanasia were that suffering should instead be alleviated by better care, that providing euthanasia can be disturbing, and that society should protect the vulnerable. Conclusions Of the newspaper articles, 24% uses the term ‘euthanasia’ for practices that are outside the scope of the euthanasia law. Typically, the more unusual cases are discussed. This might lead to misunderstandings between citizens and physicians. Despite the Dutch legalisation of euthanasia, the debate about its acceptability and boundaries is ongoing and both sides of the debate are clearly represented. PMID:23497284

Prevention and treatment of exercise related leg pain in young soldiers; a review of the literature and current practice in the Dutch Armed Forces.

PubMed

Zimmermann, Wes O; Helmhout, P H; Beutler, A

2017-04-01

Overuse injuries of the leg are a common problem for young soldiers. This article reviews the literature concerning the prevention and treatment of exercise related leg pain in military settings and presents the latest developments in proposed mechanisms and treatments. Current practice and treatment protocols from the Dutch Armed Forces are reviewed, with an emphasis on the most prevalent conditions of medial tibial stress syndrome and chronic exertional compartment syndrome. The conclusion is that exercise related leg pain in the military is an occupational problem that deserves further study. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Quality indicators for the hospital transfusion chain: a national survey conducted in 100 dutch hospitals.

PubMed

Zijlker-Jansen, P Y; Janssen, M P; van Tilborgh-de Jong, A J W; Schipperus, M R; Wiersum-Osselton, J C

2015-10-01

The 2011 Dutch Blood Transfusion Guideline for hospitals incorporates seven internal quality indicators for evaluation of the hospital transfusion chain. The indicators aim to measure guideline compliance as shown by the instatement of a hospital transfusion committee and transfusion safety officer (structural indicators), observance of transfusion triggers and mandatory traceability of labile blood components (process indicators). Two voluntary online surveys were sent to all Dutch hospitals for operational years 2011 and 2012 to assess compliance with the guideline recommendations. Most hospitals had a hospital transfusion committee and had appointed a transfusion safety officer (TSO). In 2012, only 23% of hospitals complied with the recommended minimum of four annual transfusion committee meetings and 8 h/week for the TSO. Compliance with the recommended pretransfusion haemoglobin threshold for RBC transfusion was achieved by 90% of hospitals in over 80% of transfusions; 58% of hospitals measured the pretransfusion platelet count in over 80% of platelet transfusions and 87% of hospitals complied with the legally mandatory traceability of blood components in over 95% of transfusions. With the current blood transfusion indicators, it is feasible to monitor aspects of the quality of the hospital transfusion chain and blood transfusion practice and to assess guideline compliance. The results from this study suggest that there are opportunities for significant improvement in blood transfusion practice in the Netherlands. These indicators could potentially be used for national and international benchmarking of blood transfusion practice. © 2015 International Society of Blood Transfusion.

Psychometric evaluation of the Dutch version of the Subjective Opiate Withdrawal Scale (SOWS).

PubMed

Dijkstra, Boukje A G; Krabbe, Paul F M; Riezebos, Truus G M; van der Staak, Cees P F; De Jong, Cor A J

2007-01-01

To evaluate the psychometric properties of the Dutch version of the 16-item Subjective Opiate Withdrawal Scale (SOWS). The SOWS measures withdrawal symptoms at the time of assessment. The Dutch SOWS was repeatedly administered to a sample of 272 opioid-dependent inpatients of four addiction treatment centers during rapid detoxification with or without general anesthesia. Examination of the psychometric properties of the SOWS included exploratory factor analysis, internal consistency, test-retest reliability, and criterion validity. Exploratory factor analysis of the SOWS revealed a general pattern of four factors with three items not always clustered in the same factors at different points of measurement. After excluding these items from factor analysis four factors were identified during detoxification (temperature dysregulation, tractus locomotorius, tractus gastro-intestinalis and facial disinhibition). The 13-item SOWS shows high internal consistency and test-retest reliability and good validity at different stages of withdrawal. The 13-item SOWS is a reliable and valid instrument to assess opioid withdrawal during rapid detoxification. Three items were deleted because their content does not correspond directly with opioid withdrawal symptoms. Copyright (c) 2007 S. Karger AG, Basel.

Burnout, psychosomatic symptoms and job satisfaction among Dutch nurse anaesthetists: a survey.

PubMed

Meeusen, V; VAN Dam, K; Brown-Mahoney, C; VAN Zundert, A; Knape, H

2010-05-01

To meet the increasing demand for healthcare providers, it is crucial to recruit and retain more nurse anaesthetists (NAs). The majority of NAs in the Netherlands are >45 years old, and retaining them in their jobs is very important. This study investigates the relationships among burnout, physical health and job satisfaction among Dutch NAs. Two thousand NAs working in Dutch hospitals were invited to participate in this online questionnaire. We tested the relationships among burnout, psychosomatic symptoms, sickness absence, perceived general health and job satisfaction. Nine hundred and twenty-three questionnaires were completed and analysed (46% response rate). Burnout and psychosomatic symptoms were negatively associated with job satisfaction, and predicted 27% of job satisfaction. Perceived general health was positively and sickness absence was negatively related to job satisfaction. Older NAs had a higher incidence of burnout than their younger counterparts. The results confirmed the importance of a healthy psychosocial work environment for promoting job satisfaction. To prevent burnout, further research is necessary to determine the factors causing stress. These findings may also apply to anaesthesiologists who share many tasks and work in close cooperation with NAs.

Using continuous sedation until death for cancer patients: A qualitative interview study of physicians’ and nurses’ practice in three European countries

PubMed Central

Rietjens, Judith; Bruinsma, Sophie; Deliens, Luc; Sterckx, Sigrid; Mortier, Freddy; Brown, Jayne; Mathers, Nigel; van der Heide, Agnes

2015-01-01

Background: Extensive debate surrounds the practice of continuous sedation until death to control refractory symptoms in terminal cancer care. We examined reported practice of United Kingdom, Belgian and Dutch physicians and nurses. Methods: Qualitative case studies using interviews. Setting: Hospitals, the domestic home and hospices or palliative care units. Participants: In all, 57 Physicians and 73 nurses involved in the care of 84 cancer patients. Results: UK respondents reported a continuum of practice from the provision of low doses of sedatives to control terminal restlessness to rarely encountered deep sedation. In contrast, Belgian respondents predominantly described the use of deep sedation, emphasizing the importance of responding to the patient’s request. Dutch respondents emphasized making an official medical decision informed by the patient’s wish and establishing that a refractory symptom was present. Respondents employed rationales that showed different stances towards four key issues: the preservation of consciousness, concerns about the potential hastening of death, whether they perceived continuous sedation until death as an ‘alternative’ to euthanasia and whether they sought to follow guidelines or frameworks for practice. Conclusion: This qualitative analysis suggests that there is systematic variation in end-of-life care sedation practice and its conceptualization in the United Kingdom, Belgium and the Netherlands. PMID:25062816

Profiling healthy eaters. Determining factors that predict healthy eating practices among Dutch adults.

PubMed

Swan, Emily; Bouwman, Laura; Hiddink, Gerrit Jan; Aarts, Noelle; Koelen, Maria

2015-06-01

Research has identified multiple factors that predict unhealthy eating practices. However what remains poorly understood are factors that promote healthy eating practices. This study aimed to determine a set of factors that represent a profile of healthy eaters. This research applied Antonovsky's salutogenic framework for health development to examine a set of factors that predict healthy eating in a cross-sectional study of Dutch adults. Data were analyzed from participants (n = 703) who completed the study's survey in January 2013. Logistic regression analysis was performed to test the association of survey factors on the outcome variable high dietary score. In the multivariate logistic regression model, five factors contributed significantly (p < .05) to the predictive ability of the overall model: being female; living with a partner; a strong sense of coherence (construct from the salutogenic framework), flexible restraint of eating, and self-efficacy for healthy eating. Findings complement what is already known of the factors that relate to poor eating practices. This can provide nutrition promotion with a more comprehensive picture of the factors that both support and hinder healthy eating practices. Future research should explore these factors to better understand their origins and mechanisms in relation to healthy eating practices. Copyright © 2015 Elsevier Ltd. All rights reserved.

Making Markets in Long-Term Care: Or How a Market Can Work by Being Invisible.

PubMed

Grit, Kor; Zuiderent-Jerak, Teun

2017-09-01

Many Western countries have introduced market principles in healthcare. The newly introduced financial instrument of "care-intensity packages" in the Dutch long-term care sector fit this development since they have some characteristics of a market device. However, policy makers and care providers positioned these instruments as explicitly not belonging to the general trend of marketisation in healthcare. Using a qualitative case study approach, we study the work that the two providers have done to fit these instruments to their organisations and how that enables and legitimatises market development. Both providers have done various types of work that could be classified as market development, including creating accounting systems suitable for markets, redefining public values in the context of markets, and starting commercial initiatives. Paradoxically, denying the existence of markets for long-term care and thus avoiding ideological debates on the marketisation of healthcare has made the use of market devices all the more likely. Making the market invisible seems to be an operative element in making the market work. Our findings suggest that Dutch long-term care reform points to the need to study the 'making' rather than the 'liberalising' of markets and that the study of healthcare markets should not be confined to those practices that explicitly label themselves as such.

Unravelling the concept of integrated public health policy: Concept mapping with Dutch experts from science, policy, and practice.

PubMed

Tubbing, Luuk; Harting, Janneke; Stronks, Karien

2015-06-01

While expectations of integrated public health policy (IPHP) promoting public health are high, assessment is hampered by the concept's ambiguity. This paper aims to contribute to conceptual clarification of IPHP as first step in further measurement development. In an online concept mapping procedure, we invited 237 Dutch experts, 62 of whom generated statements on characteristics of IPHP. Next, 100 experts were invited, 24 of whom sorted the statements into piles according to their perceived similarity and rated the statements on relevance and measurability. Data was analyzed using concept mapping software. The concept map consisted of 97 statements, grouped into 11 clusters and five themes. Core themes were 'integration', concerning 'policy coherence' and 'organizing connections', and 'health', concerning 'positioning health' and 'addressing determinants'. Peripheral themes were 'generic aspects', 'capacities', and 'goals and setting', which respectively addressed general notions of integrated policy making, conditions for IPHP, and the variety in manifestations of IPHP. Measurability ratings were low compared to relevance. The concept map gives an overview of interrelated themes, distinguishes core from peripheral dimensions, and provides pointers for theories of the policy process. While low measurability ratings indicate measurement difficulties, the core themes provide pointers for systematic insight into IPHP through measurement. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Non-physician-assisted suicide in The Netherlands: a cross-sectional survey among the general public.

PubMed

Schoonman, Merel Kristi; van Thiel, Ghislaine José Madeleine Wilhelmien; van Delden, Johannes Jozef Marten

2014-12-01

In The Netherlands, approximately 45% of patients' requests for euthanasia are granted by a physician. After a rejected request, some patients approach non-physicians and ask them for assistance in suicide. Recently, a non-physician who assisted his mother's suicide was declared guilty without punishment. The aim of the current study was to investigate the opinion of the Dutch general public on non-physician-assisted suicide. A cross-sectional survey among the Dutch general public was performed. A total of 1113 respondents were included (response rate 80%). The survey covered two case descriptions in which a patient asks a non-physician for assisted suicide after a non-granted request for physician-assisted dying. In both cases, a son, friend or professional facilitates the suicide by either the provision of information or the purchase of lethal medication. Respondents were invited to give their opinion on these cases and in addition on 10 propositions on non-physician-assisted suicide. When a son provides information on how to acquire lethal medication in case of a patient with a terminal illness, this involvement is accepted by 62% of the respondents. The actual purchase of lethal medication receives less support (38%). If the patient suffers without a serious disease, both forms of assistance are less accepted (46% and 24%, respectively). In addition, only 21% support the legalisation of non-physician-assisted suicide. The Dutch public prefer involvement of a physician in assisted suicide (69%). The Dutch general public consider non-physician-assisted suicide in some specific cases a tolerable alternative for patients with a rejected request for physician-assisted dying if the assistance is limited to the provision of information. However, the majority do not support the legalisation of non-physician-assisted suicide. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Towards Evidence-Based, Quality-Controlled Health Promotion: The Dutch Recognition System for Health Promotion Interventions

ERIC Educational Resources Information Center

Brug, Johannes; van Dale, Djoeke; Lanting, Loes; Kremers, Stef; Veenhof, Cindy; Leurs, Mariken; van Yperen, Tom; Kok, Gerjo

2010-01-01

Registration or recognition systems for best-practice health promotion interventions may contribute to better quality assurance and control in health promotion practice. In the Netherlands, such a system has been developed and is being implemented aiming to provide policy makers and professionals with more information on the quality and…

A Survey of Secondary Mathematics Teacher Training Practices in West Germany and the Netherlands.

ERIC Educational Resources Information Center

Jansson, Lars C.

The survey, conducted during 1979-80, focused on practices in the professional component of preservice teacher education in West Germany and the Netherlands. The report is divided into four major sections: (1) the structure of the questionnaire (included in the appendix), (2) the West Germany results, (3) the Dutch results, and (4) concluding…

Practical Applications as a Source of Credibility: A Comparison of Three Fields of Dutch Academic Chemistry

ERIC Educational Resources Information Center

Hessels, Laurens K.; van Lente, Harro

2011-01-01

In many Western science systems, funding structures increasingly stimulate academic research to contribute to practical applications, but at the same time the rise of bibliometric performance assessments have strengthened the pressure on academics to conduct excellent basic research that can be published in scholarly literature. We analyze the…

Echocardiographic chamber quantification in a healthy Dutch population.

PubMed

van Grootel, R W J; Menting, M E; McGhie, J; Roos-Hesselink, J W; van den Bosch, A E

2017-12-01

For accurate interpretation of echocardiographic measurements normative data are required, which are provided by guidelines. For this article, the hypothesis was that these cannot be extrapolated to the Dutch population, since in Dutch clinical practice often higher values are found, which may not be pathological but physiological. Therefore this study aimed to 1) obtain and propose normative values for cardiac chamber quantification in a healthy Dutch population and 2) determine influences of baseline characteristics on these measurements. Prospectively recruited healthy subjects, aged 20-72 years (at least 28 subjects per age decade, equally distributed for gender) underwent physical examination and 2D and 3D echocardiography. Both ventricles and atria were assessed and volumes were calculated. 147 subjects were included (age 44 ± 14 years, 50% female). Overall, feasibility was good for both linear and volumetric measurements. Linear and volumetric parameters were consistently higher than current guidelines recommend, while functional parameters were in line with the guidelines. This was more so in the older population. 3D volumes were higher than 2D volumes. Gender dependency was seen in all body surface area (BSA) corrected volumes and with increasing age, ejection fractions decreased. This study provides 2D and 3D echocardiographic reference ranges for both ventricles and atria derived from a healthy Dutch population. BSA indexed volumes are gender-dependent, age did not influence ventricular volumes and a rise in blood pressure was independently associated with increased right ventricular volumes. The higher volumes found may be indicative for the Dutch population being the tallest in the world.

Preferred prenatal counselling at the limits of viability: a survey among Dutch perinatal professionals.

PubMed

Geurtzen, R; Van Heijst, Arno; Hermens, Rosella; Scheepers, Hubertina; Woiski, Mallory; Draaisma, Jos; Hogeveen, Marije

2018-01-03

Since 2010, intensive care can be offered in the Netherlands at 24 +0  weeks gestation (with parental consent) but the Dutch guideline lacks recommendations on organization, content and preferred decision-making of the counselling. Our aim is to explore preferred prenatal counselling at the limits of viability by Dutch perinatal professionals and compare this to current care. Online nationwide survey as part of the PreCo study (2013) amongst obstetricians and neonatologists in all Dutch level III perinatal care centers (n = 205).The survey regarded prenatal counselling at the limits of viability and focused on the domains of organization, content and decision-making in both current and preferred practice. One hundred twenty-two surveys were returned out of 205 eligible professionals (response rate 60%). Organization-wise: more than 80% of all professionals preferred (but currently missed) having protocols for several aspects of counselling, joint counselling by both neonatologist and obstetrician, and the use of supportive materials. Most professionals preferred using national or local data (70%) on outcome statistics for the counselling content, in contrast to the international statistics currently used (74%). Current decisions on initiation care were mostly made together (in 99% parents and doctor). This shared decision model was preferred by 95% of the professionals. Dutch perinatal professionals would prefer more protocolized counselling, joint counselling, supportive material and local outcome statistics. Further studies on both barriers to perform adequate counselling, as well as on Dutch outcome statistics and parents' opinions are needed in order to develop a national framework. Clinicaltrials.gov, NCT02782650 , retrospectively registered May 2016.

Ethnicity, Forms of Capital, and Educational Achievement

NASA Astrophysics Data System (ADS)

Driessen, Geert W. J. M.

2001-11-01

Bourdieu's cultural capital thesis is an attempt to explain how social class influences the transmission of educational inequality. In this article, the question of the extent to which various forms of capital also apply to ethnic minorities stands central. On the basis of Dutch and American research findings, a model is formulated and empirically tested with the aid of data from the Dutch Primary Education cohort study. Students from four ethnic groups are included: Dutch, Surinamese, Turkish, and Moroccan. The main variables are language and math test scores, socio-economic milieu, and a number of capital indicators, including financial resources, linguistic resources, parental reading behavior, and educational resources within the family. The results show no mediating effect of resources within the various ethnic groups. The findings also suggest that in research and practice it is relevant to not treat ethnic groups as one homogenous group, but to differentiate between the various groups.

General Self-Esteem of Adolescents from Ethnic Minorities in the Netherlands and the Reflected Appraisal Process.

ERIC Educational Resources Information Center

Verkuyten, Maykel

1988-01-01

Examined lack of differences in general self-esteem between adolescents of ethnic minorities and Dutch adolescents, focusing on reflected appraisal process. Found significant relationship between general self-esteem and perceived evaluation of family members (and no such relationship with nonfamily members) for ethnic minority adolescents;…

The Steep Ramp Test in Dutch white children and adolescents: age- and sex-related normative values.

PubMed

Bongers, Bart C; de Vries, Sanne I; Obeid, Joyce; van Buuren, Stef; Helders, Paul J M; Takken, Tim

2013-11-01

The Steep Ramp Test (SRT), a feasible, reliable, and valid exercise test on a cycle ergometer, may be more appealing for use in children in daily clinical practice than the traditional cardiopulmonary exercise test because of its short duration, its resemblance to children's daily activity patterns, and the fact that it does not require respiratory gas analysis. The aim of the present study was to provide sex- and age-related normative values for SRT performance in Dutch white children and adolescents who were healthy and 8 to 19 years old. This was a cross-sectional, observational study. A total of 252 Dutch white children and adolescents, 118 boys (mean age=13.4 years, SD=3.0) and 134 girls (mean age=13.4 years, SD=2.9), performed the SRT (work rate increment of 10, 15, or 20 W·10 s(-1), depending on body height) to voluntary exhaustion to assess peak work rate (WRpeak). Normative values are presented as reference centiles developed by use of generalized additive models for location, scale, and shape. Peak work rate correlated highly with age (r=.915 and r=.811), body mass (r=.870 and r=.850), body height (r=.922 and r=.896), body surface area (r=.906 and r=.885), and fat free mass (r=.930 and r=.902) in boys and girls, respectively. The reference curves demonstrated an almost linear increase in WRpeak with age in boys, even when WRpeak was normalized for body mass. In contrast, absolute WRpeak in girls increased constantly until the age of approximately 13 years, when it started to level off. Peak work rate normalized for body mass in girls showed only a slight increase with age until 14 years of age, when a slight decrease in relative WRpeak was observed. The sample may not have been entirely representative of the Dutch population. The present study provides sex- and age-related normative values for SRT performance in terms of both absolute WRpeak and relative WRpeak, thereby facilitating the interpretation of SRT results by clinicians and researchers.

Medicinal cannabis in oncology.

PubMed

Engels, Frederike K; de Jong, Floris A; Mathijssen, Ron H J; Erkens, Joëlle A; Herings, Ron M; Verweij, Jaap

2007-12-01

In The Netherlands, since September 2003, a legal medicinal cannabis product, constituting the whole range of cannabinoids, is available for clinical research, drug development strategies, and on prescription for patients. To date, this policy, initiated by the Dutch Government, has not yet led to the desired outcome; the amount of initiated clinical research is less than expected and only a minority of patients resorts to the legal product. This review aims to discuss the background for the introduction of legal medicinal cannabis in The Netherlands, the past years of Dutch clinical experience in oncology practice, possible reasons underlying the current outcome, and future perspectives.

Ethnicity in Dutch health research: situating scientific practice.

PubMed

Helberg-Proctor, Alana; Meershoek, Agnes; Krumeich, Anja; Horstman, Klasien

2016-10-01

A growing body of work is examining the role health research itself plays in the construction of 'ethnicity.' We discuss the results of our investigation as to how the political, social, and institutional dynamics of the context in which health research takes place affect the manner in which knowledge about ethnicity and health is produced. Qualitative content analysis of academic publications, interviews with biomedical and health researchers, and participant observation at various conferences and scientific events. We identified four aspects related to the context in which Dutch research takes place that we have found relevant to biomedical and health-research practices. Firstly, the 'diversity' and 'inclusion' policies of the major funding institution; secondly, the official Dutch national ethnic registration system; a third factor was the size of the Netherlands and the problem of small sample sizes; and lastly, the need for researchers to use meaningful ethnic categories when publishing in English-language journals. Our analysis facilitates the understanding of how specific ethnicities are constructed in this field and provides fruitful insight into the socio-scientific co-production of ethnicity, and specifically into the manner in which common-sense ethnic categories and hierarchies are granted scientific validity through academic publication and, are subsequently, used in clinical guidelines and policy.

Long-term mortality in miners with coal workers' pneumoconiosis in The Netherlands: a pilot study.

PubMed

Meijers, J M; Swaen, G M; Slangen, J J; van Vliet, K; Sturmans, F

1991-01-01

In order to investigate whether the prolonged exposure to coal mine dust increases the cancer risk for coal miners, a pilot study in a selected cohort of 334 Dutch miners with coal workers' pneumoconiosis (CWP), followed from 1956 until 1983, was conducted. In total, 165 miners had died (49.4%); for 162 (98.2%) the cause of death was traced. In comparison to the general Dutch male population, total mortality in the cohort was statistically significantly increased (SMR: 153). This was in general due to the significantly higher than expected cancer mortality (SMR: 163), cancer of stomach and small intestine (SMR: 401) and nonmalignant respiratory disease (SMR: 426). The lung cancer mortality was within the expected range.

Organisational aspects of dental practices: do dental students think like patients or like general dental practitioners?

PubMed

Sonneveld, R E; Brands, W G; Bronkhorst, E M; Welie, J V M; Truin, G J

2013-02-01

In view of transparency in health care, the widespread desire for more patient-centred care, and in an attempt to facilitate educational programmes that effectively respond to these changes, two research questions are formulated: (i) How do dental students rate the importance of various organisational aspects of dental practices compared with dental patients and general dental practitioners (GDPs), and what prescripts, defined as specific operational responsibilities of GDPs in these matters, do dental students propose? and (ii) In doing so, do students resemble patients or GDPs? In two survey studies, dental students (n = 198), patients (n = 3127) and GDPs (n = 303) were asked to rate by questionnaire the importance of 41 organisational aspects of a general dental practice and proposed specific operational responsibilities ('prescripts'). Seven of 41 aspects were rated as important by the majority of the students. Although in a different rank order, three aspects were predominantly selected by all three groups: continuing education, accessibility by telephone and Dutch-speaking GDP. For most aspects, significant differences were found between the prescripts proposed by students and those proposed by patients, and few differences were found between students and GDPs. The findings do not permit the general conclusion that the views of dental students resemble those of patients or GPDs. Looking at the overall rank order, the three respondent groups showed a great resemblance although significant differences were found for specific aspects. With regard to the proposed prescripts, students showed realistic views and the majority wants to participate in continuing education and work with protocols and guidelines. In this, they tend to resemble GDPs more than they resemble patients. © 2012 John Wiley & Sons A/S.

Reference values for the muscle power sprint test in 6- to 12-year-old children.

PubMed

Douma-van Riet, Danielle; Verschuren, Olaf; Jelsma, Dorothee; Kruitwagen, Cas; Smits-Engelsman, Bouwien; Takken, Tim

2012-01-01

The aims of this study were (1) to develop centile reference values for anaerobic performance of Dutch children tested using the Muscle Power Sprint Test (MPST) and (2) to examine the test-retest reliability of the MPST. Children who were developing typically (178 boys and 201 girls) and aged 6 to 12 years (mean = 8.9 years) were recruited. The MPST was administered to 379 children, and test-retest reliability was examined in 47 children. MPST scores were transformed into centile curves, which were created using generalized additive models for location, scale, and shape. Height-related reference curves were created for both genders. Excellent (intraclass correlation coefficient = 0.98) test-retest reliability was demonstrated. The reference values for the MPST of children who are developing typically and aged 6 to 12 years can serve as a clinical standard in pediatric physical therapy practice. The MPST is a reliable and practical method for determining anaerobic performance in children.

Medical psychology services in dutch general hospitals: state of the art developments and recommendations for the future.

PubMed

Soons, Paul; Denollet, Johan

2009-06-01

In this article an overview is presented of the emergence of medical psychology in the care of somatically ill patients. The situation in the Netherlands can be considered as prototypical. For 60 years, clinical psychologists have been working in general, teaching and academic hospitals. Nowadays, they are an integrated non-medical specialism working in the medical setting of hospitals in the Netherlands, and are a full-member of the medical board. This paper discusses several topics: the position of the general hospital in the health care system in the Netherlands, the emergence of medical psychology in Dutch hospitals, the role of the professional association of medical psychologists, and the characteristics of patients seen by clinical psychologists. Following the discussion about the situation of medical psychology in other countries, recommendations are formulated for the further development of medical psychology in the Netherlands as well as in other countries.

[Risk factors and protective factors relating to suicide in the Netherlands and Flanders].

PubMed

Reynders, A; Kerkhof, A J F M; Molenberghs, G; van Audenhove, C

2016-01-01

The suicide rate is 82% higher in the Flanders region of Belgium than in the Netherlands. To investigate to what extent Flanders and the Netherlands differ with regard to the risk factors and protective factors relating to suicide and attempted suicide. By means of a structured postal questionnaire, we collected data on the following topics from 2999 Flemish and Dutch people between 18 and 64 years: mental well-being and earlier attempts to commit suicide, the help they had received and their intention to seek help for psychological problems, awareness of the mental health care available, satisfaction with the help received, and attitudes to suicide. The incidence of psychological problems and suicidality did not differ significantly between Flanders and the Netherlands. Compared to Flemish people, Dutch people with psychological problems had received more psychological help and more often expressed the intention to seek help in the future. Furthermore, the Dutch were better informed about mental health care, and patient satisfaction was higher in the Netherlands. Compared to the Flemish people, the Dutch had more positive and understanding attitude to suicide. In general, risk factors for suicide were similar in the Netherlands and Flanders. However, the Dutch were characterised by more protective factors. We attempt to explain these differences and suggest ways of improving suicidal prevention policy.

Enhancing Health Communication Outcomes Among Ethnic Minority Patients: The Effects of the Match Between Participation Preferences and Perceptions and Doctor-Patient Concordance.

PubMed

Schinkel, Sanne; Schouten, Barbara C; Street, Richard L; van den Putte, Bas; van Weert, Julia C M

2016-12-01

Ethnic minority patients are less participative in medical consultations compared to ethnic majority patients. It is thus important to find effective strategies to enhance ethnic minority patients' participation and improve subsequent health outcomes. This study therefore aimed to investigate the relation between the match between patients' preferred and perceived participation and doctor-patient concordance in preferred doctor-patient relationship on patient satisfaction, fulfillment of information needs, and understanding of information among Turkish-Dutch and Dutch patients. Pre- and postconsultation questionnaires were filled out by 136 Dutch and 100 Turkish-Dutch patients in the waiting rooms of 32 general practitioners (GPs). GPs completed a questionnaire too. Results showed that a match between patients' preferred and perceived participation was related to higher patient satisfaction, more fulfillment of information needs, and more understanding of information than a mismatch for both patient groups. For doctor-patient concordance a conditional main effect on all outcome measures emerged only among Turkish-Dutch patients. That is, for patients who were discordant with their GP, higher perceived participation was related to lower satisfaction, worse fulfillment of information needs, and worse understanding of the information. In order to improve medical communication GPs should thus primarily be trained to tailor their communication styles to match patients' preferences for participation.

Quality of Co-Prescribing NSAID and Gastroprotective Medications for Elders in The Netherlands and Its Association with the Electronic Medical Record.

PubMed

Opondo, Dedan; Visscher, Stefan; Eslami, Saeid; Verheij, Robert A; Korevaar, Joke C; Abu-Hanna, Ameen

2015-01-01

To assess guideline adherence of co-prescribing NSAID and gastroprotective medications for elders in general practice over time, and investigate its potential association with the electronic medical record (EMR) system brand used. We included patients 65 years and older who received NSAIDs between 2005 and 2010. Prescription data were extracted from EMR systems of GP practices participating in the Dutch NIVEL Primary Care Database. We calculated the proportion of NSAID prescriptions with co-prescription of gastroprotective medication for each GP practice at intervals of three months. Association between proportion of gastroprotection, brand of electronic medical record (EMR), and type of GP practice were explored. Temporal trends in proportion of gastroprotection between electronic medical records systems were analyzed using a random effects linear regression model. We included 91,521 patient visits with NSAID prescriptions from 77 general practices between 2005 and 2010. Overall proportion of NSAID prescriptions to the elderly with co-prescription of gastroprotective medication was 43%. Mean proportion of gastroprotection increased from 27% (CI 25-29%) in the first quarter of 2005 with a rate of 1.2% every 3 months to 55%(CI 52-58%) at the end of 2010. Brand of EMR and type of GP practice were independently associated with co-prescription of gastroprotection. Although prescription of gastroprotective medications to elderly patients who receive NSAIDs increased in The Netherlands, they are not co-prescribed in about half of the indicated cases. Brand of EMR system is associated with differences in prescription of gastroprotective medication. Optimal design and utilization of EMRs is a potential area of intervention to improve quality of prescription.

Availability of Dutch General Practitioners for After-Hours Palliative Care.

PubMed

Plat, Fredrik M; Peters, Yvonne A S; Giesen, Paul; Smits, Marleen

2018-01-01

Continuity of care is important for palliative patients in their end of life. In the Netherlands, after-hours primary care for palliative patients is either provided by large-scale general practitioner (GP) cooperatives or GPs choose to give palliative care by themselves while they are not on duty. To examine the availability of, perceived problems by, and attitude of Dutch GPs regarding providing palliative care for their own patients outside office hours. Cross-sectional observational study among 1772 GPs from 10 Dutch regions. Online questionnaire among GPs affiliated with 10 GP cooperatives. Five hundred twenty-four (29.6%) eligible questionnaires were returned. Of the GPs, 60.8% were personally available outside office hours for their own palliative patients on their own private cell phone and performed home visits if needed. In 33.0%, GPs were willing to make home visits in private time instigated by the GP cooperative and 26.8% were only accessible for telephone consultation by the GP cooperative. In 12.2%, the GP delegated after-hours palliative care completely to the GP cooperative. The GPs predominantly reported "time pressure" problems (17.3%) as a barrier and 61.7% stated that after-hours palliative care is the responsibility of the own GP. The large majority of Dutch GPs is personally available for telephone consultation and/or willing to provide palliative care for their own patients outside office hours. For the future, it is important to maintain the willingness of GPs to remain personally available for their palliative patients.

Decreased physical activity, reduced QoL and presence of debilitating fatigue in patients with Addison's disease.

PubMed

van der Valk, Eline S; Smans, Lisanne C C J; Hofstetter, Hedwig; Stubbe, Janine H; de Vries, Marieke; Backx, Frank J G; Hermus, Ad R M M; Zelissen, Pierre M J

2016-09-01

Health-related quality of life in patients with Addison's disease has been assessed in various European countries, indicating a reduced quality of life. However, no studies have addressed the impact of Addison's disease on physical activity. The aim of this study was to investigate the quality of life in Dutch patients with Addison's disease particularly regarding the presence of fatigue and the ability to be physically active. In this cross-sectional study, a postal survey was performed among Dutch patients with Addison's disease on stable glucocorticoid replacement therapy with hydrocortisone or cortisone acetate. For quality of life and physical activity assessment, patients completed general and health-related quality of life and physical activity questionnaires, and scores were compared to Dutch controls. A total of 328 patients with Addison's disease were studied. In patients with Addison's disease, only 45·7% met the standard of physical activity (Combinorm) compared to 67·8% of Dutch controls (P < 0·01). Forty-eight per cent of patients showed abnormal fatigue, while 61% had severe fatigue. The CIS fatigue scores were significantly higher compared to controls (P < 0·01). We found reduced general subjective health-related QoL scores in both male and female patients, especially in younger patients <65 years of age. Physical activity is decreased in patients with Addison's disease, combined with a reduced subjective health-related QoL and increased fatigue. © 2016 John Wiley & Sons Ltd.

Dutch advanced nursing practice students: role development through international short-term immersion.

PubMed

Ter Maten, Ada; Garcia-Maas, Lillian

2009-04-01

At Rotterdam University in The Netherlands, the master's advanced nursing practice (ANP) program focuses on the role of the nurse practitioner (NP) and emphasizes leadership development. An international experience is compulsory and is incorporated into the leadership course. Twenty master's ANP students were surveyed before and after participating in an international exchange program. The following research questions were examined: (a) Does the international exchange program affect the vision of the NP students about their role as an NP in The Netherlands? (b) Does the international exchange program encourage students to develop the NP role? Gaining insight into a well-established NP environment can help empower Dutch NP students to create the foundations for role development to distinguish itself as an autonomous profession. An international experience fostered a new sense of pride in this relatively new ANP role in The Netherlands.

Veterinary advice for entrepreneurial Dutch dairy farmers: from curative practice to coach-consultant: what needs to be changed?

PubMed

Noordhuizen, J P T M; van Egmond, M J; Jorritsma, R; Hogeveen, H; van Werven, T; Vos, P L A M; Lievaart, J J

2008-01-01

Dairy farms are tending to become larger, with a milk quota of more than 8 tons a year, and are managed by entrepreneurial dairy farmers with their own specific characteristics and farming style. Some Dutch veterinary practices appear unable to respond to this different style and often do not serve such farms or lose them as client. Moreover, the veterinary curriculum often focuses on traditional, family-run, smaller dairy operations and not on larger farms, which raises the question whether newly qualified veterinary practitioners are adequately trained to provide these entrepreneurial farmers with the services they require. This article addresses the characteristics of entrepreneurial dairy farmers and those of cattle practitioners, to determine whether cattle practitioners need to acquire other skills to better prepare them for their coaching-consultant tasks on larger dairy farms.

Palliative sedation: not just normal medical practice. Ethical reflections on the Royal Dutch Medical Association's guideline on palliative sedation.

PubMed

Janssens, Rien; van Delden, Johannes J M; Widdershoven, Guy A M

2012-11-01

The main premise of the Royal Dutch Medical Association's (RDMA) guideline on palliative sedation is that palliative sedation, contrary to euthanasia, is normal medical practice. Although we do not deny the ethical distinctions between euthanasia and palliative sedation, we will critically analyse the guideline's argumentation strategy with which euthanasia is demarcated from palliative sedation. First, we will analyse the guideline's main premise, which entails that palliative sedation is normal medical treatment. After this, we will critically discuss three crucial propositions of the guideline that are used to support this premise: (1) the patient's life expectancy should not exceed 2 weeks; (2) the aim of the physician should be to relieve suffering and (3) expert consultation is optional. We will conclude that, if inherent problematic aspects of palliative sedation are taken seriously, palliative sedation is less normal than it is now depicted in the guideline.

Before words: reading western astronomical texts in early nineteenth-century Japan.

PubMed

Frumer, Yulia

2016-04-01

In 1803, the most prominent Japanese astronomer of his time, Takahashi Yoshitoki, received a newly imported Dutch translation of J. J. Lalande's 'Astronomie'. He could not read Dutch, yet he dedicated almost a year to a close examination of this massive work, taking notes and contemplating his own astronomical practices. How did he read a book he could not read? Following the clues Yoshitoki left in his notes, we discover that he found meanings not only in words, but also in what are often taken for granted or considered to be auxiliary tools for data manipulation, such as symbols, units, tables, and diagrams. His rendering of these non-verbal textual elements into a familiar format was crucial for Yoshitoki's reading, and constituted the initial step in the process of integrating Lalande's astronomy into Japanese astronomical practices, and the subsequent translation of the text into Japanese.

Social Workers’ Orientation Toward the Evidence-Based Practice Process

PubMed Central

Kolmer, Deirdre M. Beneken genaamd; Schalk, René

2014-01-01

Objectives: This study assesses social workers’ orientation toward the evidence-based practice (EBP) process and explores which specific variables (e.g. age) are associated. Methods: Data were collected from 341 Dutch social workers through an online survey which included a Dutch translation of the EBP Process Assessment Scale (EBPPAS), along with 13 background/demographic questions. Results: The overall level of orientation toward the EBP process is relatively low. Although respondents are slightly familiar with it and have slightly positive attitudes about it, their intentions to engage in it and their actual engagement are relatively low. Respondents who followed a course on the EBP process as a student are more oriented toward it than those who did not. Social workers under 29 are more familiar with the EBP process than those over 29. Conclusions: We recommend educators to take a more active role in teaching the EBP process to students and social workers. PMID:27630517

Gender differences in fatigue: biopsychosocial factors relating to fatigue in men and women.

PubMed

Bensing, J M; Hulsman, R L; Schreurs, K M

1999-10-01

Fatigue is a common problem, which is found more frequently among women than men. To date, neither the etiology of fatigue nor the factors that explain the gender difference in its incidence are still fully understood. In a sample of men (n = 4,681) and women (n = 4,698) (age range, 15-64 years) in the Dutch National Survey of Morbidity and Interventions in General Practice, the gender differences in the underlying biological, psychological, and social factors of fatigue were analyzed. Both general and gender-specific factors were recognized. Men and women who experience complaints of fatigue appeared to be younger and more highly educated. They had more acute health complaints and more psychosocial problems and also showed a lower level of perceived health. Among women, only gender-specific biological complaints and psychosocial problems were related to fatigue. In addition, relevant sociodemographic variables included taking care of young children and being employed. Among men, fatigue was particularly related to having handicaps and severe chronic complaints. Taking care of young children did not make a difference in the male sample. Fatigue can only be adequately understood in a multicausal model with biomedical and psychosocial factors. Complaints of fatigue are too often ignored in general practice. By adopting a patient-centered style of communication, physicians can acquire a more complete picture of the patients' fatigue.

Zuivere en toegepaste wetenschap in de tropen : biologisch onderzoek aan particuliere proefstations in Nederlands-Indië 1870-1940

NASA Astrophysics Data System (ADS)

van der Schoor, W. J.

2012-04-01

Most experiment stations originated from the cooperation between entrepreneurs and the government. From the 1890s onwards, the government, together with the well organised colonial entrepreneurs, established research departments for several plantation crops at the Botanical Gardens at Buitenzorg (now Bogor), that eventually became independent experiment stations in the first decades of the twentieth century. By the 1920s, the ‘proefstationswezen’ (experiment station system) numbered some fifteen private experiment stations or sub-stations. After the war, the private experiment stations together with the government experiment stations at Buitenzorg were to provide the backbone of Indonesian agricultural science. Dutch biologists in particular, made a striking plea for pursuing the natural sciences in the tropical colonies. First, they pointed out the scientific importance of the tropics. Secondly, they stressed the role of the natural sciences, in particular biology, as a natural ally of colonial agriculture. Pure science was seen as a leading force for technical and social progress. The third motive was the cultural value of science for the Netherlands and its colonies. The cultivation of science in the colonies gave international prestige and strengthened self-confidence in the imperial struggle around 1900. Science had a civilising effect; scientific research, however, was to remain in the hands of western, colonial scientists. From the 1880s and 1890s onward, the experiment stations in the Indies were characterised by their strategic aims and scientific orientation. Up to 1910, the ‘academic’ views of biologists like Treub and Went concerning science and practice were predominant, and research was considered to be the central aim. From 1910 onwards, advice became more central and special extension services were established at the experiment stations. Due to diverging views of science, tasks and aims became a battlefield for discussions in the next decades. In the background of these debates were the rise of Wageningen Agricultural College, the rise and institutionalisation of applied agricultural sciences and the increasing competition between Wageningen and university trained scientist. Genetics and breeding in particular were at the core of the research programmes. The practical aim of the breeding work, however, did not leave too much opportunity for more fundamental investigations. The impetus for pure research came from individual researchers. In tobacco and sugar cane breeding, new scientific theories provided inspiration, but to a large extent the practical breeding work built on nineteenth-century breeding techniques. In many respects, plant breeding and university genetics became separate disciplines. Circa one in six Dutch biologist worked for at least some time in the colony. The colonial experiment stations instilled a practical and pragmatic attitude to Dutch science into quite a number of biologists. Besides, the experiment stations system provided Dutch biologists with an extensive network and international contacts with fellow scientists, entrepreneurs and captains of industry. The scientific nationalism of Treub and Went, the bloom of the experiment stations and the ambitions of the Indies colonial elite did not result in the establishment of an independent, ‘Indische’ scientific community. Essentially, the Dutch East Indies were an exploitation province of Dutch science

Exploring Knowledge Processes Based on Teacher Research in a School-University Research Network of a Master's Program

ERIC Educational Resources Information Center

Cornelissen, Frank; van Swet, Jacqueline; Beijaard, Douwe; Bergen, Theo

2013-01-01

School-university research networks aim at closer integration of research and practice by means of teacher research. Such practice-oriented research can benefit both schools and universities. This paper reports on a multiple-case study of five participants in a school-university research network in a Dutch master's program. The research question…

The ambiguity of patient-centred practices: the case of a Dutch fertility clinic

PubMed Central

Gerrits, Trudie

2014-01-01

When in-vitro fertilization (IVF) was introduced in the 1970s, doctors were criticized for not properly informing prospective users about its possible risks and limited success rates as well as for medicalizing fertility problems. Nowadays, many fertility clinics are seeking to improve their accountability to stakeholders through patient-centred practices. Based on an ethnographic study of a Dutch fertility clinic, outspoken in its aims to provide patient-centred medicine and to empower clients, this paper addresses how patient-centred medicine affects couples’ decision-making to use IVF and related reproductive technologies. The author contends that while patient-centred practices facilitate informed decision-making and support couples emotionally, they may also have unintended disciplining and normalizing effects. The information and support provided, the trust couples have in clinic staff, the ongoing visualization of conception mediated by medical technology – all can be seen as practices that strengthen lay people's ‘medical gaze’ in how they come to view their bodies, fertility problems and possible solutions. These unintended effects are labelled ‘the ambiguity of patient-centeredness’ as they (may) interfere with processes of autonomous decision-making. PMID:24827743

Towards evidence-based, quality-controlled health promotion: the Dutch recognition system for health promotion interventions

PubMed Central

Brug, Johannes; van Dale, Djoeke; Lanting, Loes; Kremers, Stef; Veenhof, Cindy; Leurs, Mariken; van Yperen, Tom; Kok, Gerjo

2010-01-01

Registration or recognition systems for best-practice health promotion interventions may contribute to better quality assurance and control in health promotion practice. In the Netherlands, such a system has been developed and is being implemented aiming to provide policy makers and professionals with more information on the quality and effectiveness of available health promotion interventions and to promote use of good-practice and evidence-based interventions by health promotion organizations. The quality assessments are supervised by the Netherlands Organization for Public Health and the Environment and the Netherlands Youth Institute and conducted by two committees, one for interventions aimed at youth and one for adults. These committees consist of experts in the fields of research, policy and practice. Four levels of recognition are distinguished inspired by the UK Medical Research Council's evaluation framework for complex interventions to improve health: (i) theoretically sound, (ii) probable effectiveness, (iii) established effectiveness, and (iv) established cost effectiveness. Specific criteria have been set for each level of recognition, except for Level 4 which will be included from 2011. This point of view article describes and discusses the rationale, organization and criteria of this Dutch recognition system and the first experiences with the system. PMID:20841318

Treatment Targets in Inflammatory Bowel Disease: Current Status in Daily Practice.

PubMed

Römkens, Tessa E H; Gijsbers, Kim; Kievit, Wietske; Hoentjen, Frank; Drenth, Joost P H

2016-12-01

Recently, treatment goals in inflammatory bowel disease (IBD) in clinical trials have shifted from mainly symptom-based to more mucosa-driven. Real world data on treatment priorities are lacking. We aimed to investigate the current practice and most commonly used definitions of IBD treatment targets among Dutch gastroenterologists. Dutch gastroenterologists were asked to participate in a computer-based nation-wide survey. We asked questions on demographics, opinion and current practice regarding IBD treatment targets. Twenty-four percent (134/556) of the respondents completed the survey. For both Crohn's disease (CD) (47.3%, 61/129) and ulcerative colitis (UC)(45%, 58/129) the main treatment goal was to achieve and maintain deep remission, defined as clinical, biochemical and endoscopic remission. Seventy-six percent of the participants use mucosal healing (MH) as a potential treatment target for IBD, whereas 22.6% use histological remission. There is no single definition for MH in IBD. The majority use Mayo score ≤ 1 in UC (52%) and 'macroscopic normal mucosa' in CD (66%). More stringent and mucosa-driven treatment targets as 'deep remission' and 'mucosal healing' have found traction in clinical practice. The most commonly used definition for MH in routine practice is endoscopic MAYO score

Development, dissemination, and applications of a new terminological resource, the Q-Code taxonomy for professional aspects of general practice/family medicine.

PubMed

Jamoulle, Marc; Resnick, Melissa; Grosjean, Julien; Ittoo, Ashwin; Cardillo, Elena; Vander Stichele, Robert; Darmoni, Stefan; Vanmeerbeek, Marc

2018-12-01

While documentation of clinical aspects of General Practice/Family Medicine (GP/FM) is assured by the International Classification of Primary Care (ICPC), there is no taxonomy for the professional aspects (context and management) of GP/FM. To present the development, dissemination, applications, and resulting face validity of the Q-Codes taxonomy specifically designed to describe contextual features of GP/FM, proposed as an extension to the ICPC. The Q-Codes taxonomy was developed from Lamberts' seminal idea for indexing contextual content (1987) by a multi-disciplinary team of knowledge engineers, linguists and general practitioners, through a qualitative and iterative analysis of 1702 abstracts from six GP/FM conferences using Atlas.ti software. A total of 182 concepts, called Q-Codes, representing professional aspects of GP/FM were identified and organized in a taxonomy. Dissemination: The taxonomy is published as an online terminological resource, using semantic web techniques and web ontology language (OWL) ( http://www.hetop.eu/Q ). Each Q-Code is identified with a unique resource identifier (URI), and provided with preferred terms, and scope notes in ten languages (Portuguese, Spanish, English, French, Dutch, Korean, Vietnamese, Turkish, Georgian, German) and search filters for MEDLINE and web searches. This taxonomy has already been used to support queries in bibliographic databases (e.g., MEDLINE), to facilitate indexing of grey literature in GP/FM as congress abstracts, master theses, websites and as an educational tool in vocational teaching, Conclusions: The rapidly growing list of practical applications provides face-validity for the usefulness of this freely available new terminological resource.

52. Historic American Buildings Survey John O. Brostrup, Photographer August ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

52. Historic American Buildings Survey John O. Brostrup, Photographer August 12, 1936 8:55 A. M. NORTH SIDE OF DUTCH OVEN (GENERAL VIEW) - BASEMENT OF WEST WING OF UNIT B - General John Mason House, Analostan Island or Theodore Roosevelt Island, Washington, District of Columbia, DC

Subjective sexual well-being and sexual behavior in young women with breast cancer.

PubMed

Kedde, H; van de Wiel, H B M; Weijmar Schultz, W C M; Wijsen, C

2013-07-01

The aim of this study was to systematically describe the nature and context of subjective sexual well-being and sexual behavior in young women with breast cancer. Data on sexual behavior and subjective sexual well-being were collected through an internet questionnaire. Respondents were included if they had been diagnosed with breast cancer within the past 6 years and were currently 45 years of age or younger. Results were compared with a representative sample of the general Dutch population. In comparison with the general Dutch population of women, young women still undergoing breast cancer treatment are less sexually active and have a more negative experience of sexuality. While women who had already finished their treatment had more or less the same amount of sexual activity as the general Dutch population, there were still major differences in their experience of sexuality. Particularly strong associations were found between these women's sexual well-being in relation to their relationship satisfaction, and sexual interaction competence. In the wake of breast cancer treatment, young women have difficulty enjoying sex; it is evidently hard for them to resume their sex lives after breast cancer. In particular, women who find it hard to discuss sexual wishes and the possibilities and impossibilities associated with breast cancer with their partner experience negative consequences when trying to resume their sex lives.

Microscopic diagnosis of vulvovaginal candidiasis in stained vaginal smears by Dutch general practitioners.

PubMed

Engberts, Marian K; Goedbloed, Annelize F; van Haaften, Maarten; van Haaften, Mathilde; Boon, Mathilde E; Boon, Maarten E; Heintz, Peter M

2007-01-01

To determine the accuracy of the microscopic diagnosis of vulvovaginal candidiasis (presence of [pseudo] hyphae and blastospores) in stained vaginal smears in clinical practice. General practitioners trained in diagnosing vulvovaginal candidiasis performed microscopy of 324 stained vaginal smears. These smears were sent to the pathologist for confirmation of the microscopic diagnosis of the clinician; cytologic diagnosis by the pathologist was considered the gold standard. In 104 of the 342 cases Candida was established by the pathologist. The clinicians made 24 false positive and 50 false negative diagnoses of Candida. Sensitivity and specificity of the microscopic diagnoses of the clinicians were 52% and 89%, respectively. The most frequent reason for a false positive diagnosis was presence of hairs, whereas the most frequent reason for a false negative diagnosis was understaining of the smear. This study shows that even in stained smears it is difficult for clinicians to recognize blastospores and (pseudo)hyphae. Efforts are clearly needed to improve the quality of the clinical diagnosis of vulvovaginal candidiasis.

Factor Structure, Reliability and Criterion Validity of the Autism-Spectrum Quotient (AQ): A Study in Dutch Population and Patient Groups

PubMed Central

Bartels, Meike; Cath, Danielle C.; Boomsma, Dorret I.

2008-01-01

The factor structure of the Dutch translation of the Autism-Spectrum Quotient (AQ; a continuous, quantitative measure of autistic traits) was evaluated with confirmatory factor analyses in a large general population and student sample. The criterion validity of the AQ was examined in three matched patient groups (autism spectrum conditions (ASC), social anxiety disorder, and obsessive–compulsive disorder). A two factor model, consisting of a “Social interaction” factor and “Attention to detail” factor could be identified. The internal consistency and test–retest reliability of the AQ were satisfactory. High total AQ and factor scores were specific to ASC patients. Men scored higher than women and science students higher than non-science students. The Dutch translation of the AQ is a reliable instrument to assess autism spectrum conditions. PMID:18302013

Vening Meinesz—A student of the Earth

NASA Astrophysics Data System (ADS)

Vlaar, Nicolaas J.

The 1987 General Assembly of the International Union of Geodesy and Geophysics, Vancouver, Union Symposium Ul , “Quo Vadimus,” commemorated the 100th birthday of the Dutch geodesist and geophysicist Felix Andries Vening Meinesz.Vening Meinesz (1887-1966) (Figure 1) was born in a patrician family. His father was mayor of Rotterdam and later of Amsterdam. His mother descended from Dutch aristocracy. With such a background, a profession in science was not the most obvious ambition for a young man. Instead, a magistrate's career would have been more customary.

Measuring young children's language abilities.

PubMed

Zink, I; Schaerlaekens, A

2000-01-01

This article deals with the new challenges put on language diagnosis, and the growing need for good diagnostic instruments for young children. Particularly for Dutch, the original English Reynell Developmental Language Scales were adapted not only to the Dutch idiom, but some general ameliorations and changes in the original scales resulted in a new instrument named the RTOS. The new instrument was standardized on a large population, and psychometrically evaluated. In communicating the experiences with such a language/cultural/psychometric adaptation, we hope that other language-minority groups will be encouraged to undertake similar adaptations.

Outcome measures for oral health based on clinical assessments and claims data: feasibility evaluation in practice.

PubMed

Hummel, Riët; Bruers, Josef; van der Galiën, Onno; van der Sanden, Wil; van der Heijden, Geert

2017-10-05

It is well known that treatment variation exists in oral healthcare, but the consequences for oral health are unknown as the development of outcome measures is still in its infancy. The aim of this study was to identify and develop outcome measures for oral health and explore their performance using health insurance claims records and clinical data from general dental practices. The Dutch healthcare insurance company Achmea collaborated with researchers, oral health experts, and general dental practitioners (GDPs) in a proof of practice study to test the feasibility of measures in general dental practices. A literature search identified previously described outcome measures for oral healthcare. Using a structured approach, identified measures were (i) prioritized, adjusted and added to after discussion and then (ii) tested for feasibility of data collection, their face validity and discriminative validity. Data sources were claims records from Achmea, clinical records from dental practices, and prospective, pre-determined clinical assessment data obtained during routine consultations. In total eight measures (four on dental caries, one on tooth wear, two on periodontal health, one on retreatment) were identified, prioritized and tested. The retreatment measure and three measures for dental caries were found promising as data collection was feasible, they had face validity and discriminative validity. Deployment of these measures demonstrated variation in clinical practices of GDPs. Feedback of this data to GDPs led to vivid discussions on best practices and quality of care. The measure 'tooth wear' was not considered sufficiently responsive; 'changes in periodontal health score' was considered a controversial measure. The available data for the measures 'percentage of 18-year-olds with no tooth decay' and 'improvement in gingival bleeding index at reassessment' was too limited to provide accurate estimates per dental practice. The evaluated measures 'time to first restoration', 'distribution of risk categories for dental caries', 'filled-and-missing score' and 'retreatment after restoration', were considered valid and relevant measures and a proxy for oral health status. As such, they improve the transparency of oral health services delivery that can be related to oral health outcomes, and with time may serve to improve these oral health outcomes.

Alcoholic beverage preference and diet in a representative Dutch population: the Dutch national food consumption survey 2007-2010.

PubMed

Sluik, D; van Lee, L; Geelen, A; Feskens, E J

2014-03-01

The habitual consumption of a specific type of alcoholic beverage may be related to the overall dietary pattern. The objective of this cross-sectional study was to investigate associations between alcoholic beverage preference and dietary intake in The Netherlands. A total of 2100 men and women from the Dutch National Food Consumption Survey 2007-2010 were studied. A general questionnaire assessed alcoholic beverage preference and two non-consecutive 24-h dietary recalls assessed overall diet. Mean nutrient and food group intakes, and adherence to the 2006 Dutch dietary guidelines across categories of alcoholic beverage preference were compared and adjusted for age, sex, body mass index (BMI), education, smoking, physical activity, energy intake and frequency and absolute alcohol consumption. Largest differences in dietary habits were detected between persons who preferred wine and those who preferred beer. Persons with a beer preference had a higher absolute intake of meat, soft drinks, margarine and snacks. In contrast, persons with a wine preference had a higher absolute consumption of healthy foods. However, after multiple adjustments, wine consumers still consumed less energy and more vegetables and fruit juices compared with beer consumers. Adherence to the Dutch dietary guidelines did not differ between preference categories after multiple adjustments. In this cross-sectional analysis in a representative sample of the Dutch population, a beer preference was associated with less healthy dietary behaviour, especially compared with wine preference. However, these differences were largely explained by other socio-demographic and lifestyle factors. These results suggest that alcoholic beverage preference may not be independently related to diet.

Comparison of international guideline programs to evaluate and update the Dutch program for clinical guideline development in physical therapy

PubMed Central

Van der Wees, Philip J; Hendriks, Erik JM; Custers, Jan WH; Burgers, Jako S; Dekker, Joost; de Bie, Rob A

2007-01-01

Background Clinical guidelines are considered important instruments to improve quality in health care. Since 1998 the Royal Dutch Society for Physical Therapy (KNGF) produced evidence-based clinical guidelines, based on a standardized program. New developments in the field of guideline research raised the need to evaluate and update the KNGF guideline program. Purpose of this study is to compare different guideline development programs and review the KNGF guideline program for physical therapy in the Netherlands, in order to update the program. Method Six international guideline development programs were selected, and the 23 criteria of the AGREE Instrument were used to evaluate the guideline programs. Information about the programs was retrieved from published handbooks of the organizations. Also, the Dutch program for guideline development in physical therapy was evaluated using the AGREE criteria. Further comparison the six guideline programs was carried out using the following elements of the guideline development processes: Structure and organization; Preparation and initiation; Development; Validation; Dissemination and implementation; Evaluation and update. Results Compliance with the AGREE criteria of the guideline programs was high. Four programs addressed 22 AGREE criteria, and two programs addressed 20 AGREE criteria. The previous Dutch program for guideline development in physical therapy lacked in compliance with the AGREE criteria, meeting only 13 criteria. Further comparison showed that all guideline programs perform systematic literature searches to identify the available evidence. Recommendations are formulated and graded, based on evidence and other relevant factors. It is not clear how decisions in the development process are made. In particular, the process of translating evidence into practice recommendations can be improved. Conclusion As a result of international developments and consensus, the described processes for developing clinical practice guidelines have much in common. The AGREE criteria are common basis for the development of guidelines, although it is not clear how final decisions are made. Detailed comparison of the different guideline programs was used for updating the Dutch program. As a result the updated KNGF program complied with 22 AGREE criteria. International discussion is continuing and will be used for further improvement of the program. PMID:18036215

Comparison of international guideline programs to evaluate and update the Dutch program for clinical guideline development in physical therapy.

PubMed

Van der Wees, Philip J; Hendriks, Erik J M; Custers, Jan W H; Burgers, Jako S; Dekker, Joost; de Bie, Rob A

2007-11-23

Clinical guidelines are considered important instruments to improve quality in health care. Since 1998 the Royal Dutch Society for Physical Therapy (KNGF) produced evidence-based clinical guidelines, based on a standardized program. New developments in the field of guideline research raised the need to evaluate and update the KNGF guideline program. Purpose of this study is to compare different guideline development programs and review the KNGF guideline program for physical therapy in the Netherlands, in order to update the program. Six international guideline development programs were selected, and the 23 criteria of the AGREE Instrument were used to evaluate the guideline programs. Information about the programs was retrieved from published handbooks of the organizations. Also, the Dutch program for guideline development in physical therapy was evaluated using the AGREE criteria. Further comparison the six guideline programs was carried out using the following elements of the guideline development processes: Structure and organization; Preparation and initiation; Development; Validation; Dissemination and implementation; Evaluation and update. Compliance with the AGREE criteria of the guideline programs was high. Four programs addressed 22 AGREE criteria, and two programs addressed 20 AGREE criteria. The previous Dutch program for guideline development in physical therapy lacked in compliance with the AGREE criteria, meeting only 13 criteria. Further comparison showed that all guideline programs perform systematic literature searches to identify the available evidence. Recommendations are formulated and graded, based on evidence and other relevant factors. It is not clear how decisions in the development process are made. In particular, the process of translating evidence into practice recommendations can be improved. As a result of international developments and consensus, the described processes for developing clinical practice guidelines have much in common. The AGREE criteria are common basis for the development of guidelines, although it is not clear how final decisions are made. Detailed comparison of the different guideline programs was used for updating the Dutch program. As a result the updated KNGF program complied with 22 AGREE criteria. International discussion is continuing and will be used for further improvement of the program.

Physical activity measurements affected participants' behavior in a randomized controlled trial.

PubMed

van Sluijs, Esther M F; van Poppel, Mireille N M; Twisk, Jos W R; van Mechelen, Willem

2006-04-01

Assessing levels and determinants of physical activity as outcome measurements might have an independent effect on participant's physical activity behavior. The objective is to study this effect in a randomized controlled trial (RCT) promoting regular physical activity in Dutch general practice. Using a Solomon four-group design, participants were randomized twice. After randomization to a control or intervention-condition at general practice level (N = 29), participants were randomized to a group participating in measurements at baseline, 2 and 6 months (3M-group, N = 361), or a group only participating in measurements at 6 months (1M-group, N = 356). Outcome measures assessed at 6 months included: level of physical activity (self-reported and objectively measured with accelerometry), meeting ACSM/CDC guideline for regular physical activity, stage of change, and determinants of physical activity. Follow-up data on 635 participants (89%) was collected. Statistically significant measurement effects were found for meeting the ACSM/CDC guideline (self-reported), self-efficacy for resisting relapse, knowledge, and on awareness. Other outcome measures showed positive trends, except stages of change. Measurements of physical activity affect participant's physical activity behavior, possibly triggered by a raised awareness about their own physical activity level. Implications for future research are discussed, as well as methodologic limitations of the study design.

Talking about psychosocial problems: an observational study on changes in doctor-patient communication in general practice between 1977 and 2008.

PubMed

Butalid, Ligaya; Bensing, Jozien M; Verhaak, Peter F M

2014-03-01

To examine whether GPs' communication styles have changed since the introduction and implementation of clinical guidelines for psychosocial problems in Dutch general practice in the 1990s. From a database of 5184 consultations videotaped between 1977 and 2008, 512 consultations assessed by GPs as 'completely psychosocial' were coded with RIAS (Roter Interaction Analysis System). The 121 consultations prior to and 391 consultations after implementation of guidelines were analyzed whether communication styles have changed over time. We found that GPs were more likely to consider consultations to be mainly (17%) or completely (12%) psychosocial after the implementation of guidelines. They gave more biomedical and psychosocial information and advice in the second period compared to the first period. We also found that empathy decreased over time (frequency of empathic statements by GPs changed from 2.9-3.2 to 1.4-1.6 between periods). Communication in psychosocial consultations has changed; GPs have become more focused on task-oriented communication (asking questions, giving information and advice) and less on showing empathy. GPs face the challenge of integrating an evidence-based approach of applying guidelines that promote active symptom exploration with understanding patients' personal contexts and giving room to their emotions. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Influenza vaccine effectiveness estimates in the Dutch population from 2003 to 2014: The test-negative design case-control study with different control groups.

PubMed

van Doorn, Eva; Darvishian, Maryam; Dijkstra, Frederika; Donker, Gé A; Overduin, Pieter; Meijer, Adam; Hak, Eelko

2017-05-15

Information about influenza vaccine effectiveness (IVE) is important for vaccine strain selection and immunization policy decisions. The test-negative design (TND) case-control study is commonly used to obtain IVE estimates. However, the definition of the control patients may influence IVE estimates. We have conducted a TND study using the Dutch Sentinel Practices of NIVEL Primary Care Database which includes data from patients who consulted the General Practitioner (GP) for an episode of acute influenza-like illness (ILI) or acute respiratory infection (ARI) with known influenza vaccination status. Cases were patients tested positive for influenza virus. Controls were grouped into those who tested (1) negative for influenza virus (all influenza negative), (2) negative for influenza virus, but positive for respiratory syncytial virus, rhinovirus or enterovirus (non-influenza virus positive), and (3) negative for these four viruses (pan-negative). We estimated the IVE over all epidemic seasons from 2003/2004 through 2013/2014, pooled IVE for influenza vaccine partial/full matched and mismatched seasons and the individual seasons using generalized linear mixed-effect and multiple logistic regression models. The overall IVE adjusted for age, GP ILI/ARI diagnosis, chronic disease and respiratory allergy was 35% (95% CI: 15-48), 64% (95% CI: 49-75) and 21% (95% CI: -1 to 39) for all influenza negative, non-influenza virus positive and pan-negative controls, respectively. In both the main and subgroup analyses IVE estimates were the highest using non-influenza virus positive controls, likely due to limiting inclusion of controls without laboratory-confirmation of a virus causing the respiratory disease. Copyright © 2017 Elsevier Ltd. All rights reserved.

Dementia incidence trend over 1992-2014 in the Netherlands: Analysis of primary care data

PubMed Central

van Bussel, Emma F.; Richard, Edo; Coloma, Preciosa M.; de Waal, Margot W. M.; van den Akker, Marjan; Nielen, Markus M. J.; van Boven, Kees; Busschers, Wim B.; van Gool, Willem A.

2017-01-01

Background Recent reports have suggested declining age-specific incidence rates of dementia in high-income countries over time. Improved education and cardiovascular health in early age have been suggested to be bringing about this effect. The aim of this study was to estimate the age-specific dementia incidence trend in primary care records from a large population in the Netherlands. Methods and findings A dynamic cohort representative of the Dutch population was composed using primary care records from general practice registration networks (GPRNs) across the country. Data regarding dementia incidence were obtained using general-practitioner-recorded diagnosis of dementia within the electronic health records. Age-specific dementia incidence rates were calculated for all persons aged 60 y and over; negative binomial regression analysis was used to estimate the time trend. Nine out of eleven GPRNs provided data on more than 800,000 older people for the years 1992 to 2014, corresponding to over 4 million person-years and 23,186 incident dementia cases. The annual growth in dementia incidence rate was estimated to be 2.1% (95% CI 0.5% to 3.8%), and incidence rates were 1.08 (95% CI 1.04 to 1.13) times higher for women compared to men. Despite their relatively low numbers of person-years, the highest age groups contributed most to the increasing trend. There was no significant overall change in incidence rates since the start of a national dementia program in 2003 (−0.025; 95% CI −0.062 to 0.011). Increased awareness of dementia by patients and doctors in more recent years may have influenced dementia diagnosis by general practitioners in electronic health records, and needs to be taken into account when interpreting the data. Conclusions Within the clinical records of a large, representative sample of the Dutch population, we found no evidence for a declining incidence trend of dementia in the Netherlands. This could indicate true stability in incidence rates, or a balance between increased detection and a true reduction. Irrespective of the exact rates and mechanisms underlying these findings, they illustrate that the burden of work for physicians and nurses in general practice associated with newly diagnosed dementia has not been subject to substantial change in the past two decades. Hence, with the ageing of Western societies, we still need to anticipate a dramatic absolute increase in dementia occurrence over the years to come. PMID:28267788

The knowledge, attitudes and practices of wintersun vacationers to the Gambia toward prevention of malaria: is it really that bad?

PubMed Central

2014-01-01

Background Each year clusters of imported malaria cases are observed in Dutch wintersun vacationers returning from The Gambia. To gain more insight in the travel health preparation and awareness of these travellers, the knowledge, attitudes and practices (KAP) of this travel group was studied by analysing the data of the Continuous Dutch Schiphol Airport Survey. Methods In the years 2002 to 2009 a questionnaire-based survey was conducted at the Dutch Schiphol Airport with the aim to study the KAP, i.e. accuracy of risk perception (“knowledge”), intended risk-avoiding behaviour (“attitude”) and use of personal protective measures and malaria chemoprophylaxis (“practice”) toward prevention malaria in travellers to The Gambia. Travellers to other high-risk destinations served as controls. Results The KAP of travellers to The Gambia toward prevention of malaria was significantly better than that observed in other travellers. Trend analyses indicated that attitude improved over time in both groups but knowledge did not change. Only in travellers to high-risk countries other than The Gambia significant increases in protection rates were observed over time. Conclusions The KAP of travellers to The Gambia toward prevention of malaria was better than that observed in travellers to destinations other than The Gambia. Trend analyses revealed a significant improvement of intended risk avoiding behaviour but not in protection rates or risk perception. PMID:24581328

Description of movement quality in patients with low back pain: A qualitative study as a first step to a practical definition.

PubMed

van Dijk, Margriet J H; Smorenburg, Nienke T A; Visser, Bart; Nijhuis-van der Sanden, Maria W G; Heerkens, Yvonne F

2017-03-01

As a first step to formulate a practical definition for movement quality (MQ), this study aims to explore how Dutch allied health care professionals (AHCPs) describe MQ of daily life activities in patients with low back pain (LBP). In this qualitative cross-sectional digital survey study, Dutch AHCPs (n = 91) described MQ in open text (n = 91) and with three keywords (n = 90). After exploratory qualitative content analysis, the ICF linking rules (International Classification of Functioning, Disability and Health) were applied to classify MQ descriptions and keywords. The identified meaningful concepts (MCs) of the descriptions (274) and keywords (239) were linked to ICF codes (87.5% and 80.3%, respectively), Personal factors (5.8% and 5.9%, respectively), and supplementary codes (6.6% and 13.8%, respectively). The MCs were linked to a total of 31 ICF codes, especially to b760 'control of voluntary movement functions', b7602 'coordination of voluntary movements', d4 'Mobility', and d230 'carry out daily routine'. Negative and positive formulated descriptions elucidated different MQ interpretations. Descriptions of MQ given by Dutch AHCPs in patients with LBP cover all ICF components. Coordination and functional movements are seen as the most elementary concepts of MQ. Variation in MQ descriptions and interpretations hinders defining MQ and indicates the necessity of additional steps.

Neonatal euthanasia.

PubMed

Kon, Alexander A

2009-12-01

Despite advances in the care of infants, there remain many newborns whose medical conditions are incompatible with sustained life. At times, healthcare providers and parents may agree that prolonging life is not an appropriate goal of care, and they may redirect treatment to alleviate suffering. While pediatric palliative treatment protocols are gaining greater acceptance, there remain some children whose suffering is unrelenting despite maximal efforts. Due to the realization that some infants suffer unbearably (ie, the burdens of suffering outweigh the benefits of life), the Dutch have developed a protocol for euthanizing these newborns. In this review, I examine the ethical aspects of 6 forms of end of life care, explain the ethical arguments in support of euthanasia, review the history and verbiage of the United States regulations governing limiting and withdrawing life-prolonging interventions in infants, describe the 3 categories of neonates for whom the Dutch provide euthanasia, review the published analyses of the Dutch protocol, and finally present some practical considerations should some form of euthanasia ever be deemed appropriate.

[Multiresistant Brachyspira hyodysenteriae in a Dutch sow herd].

PubMed

Duinhof, T F; Dierikx, C M; Koene, M G J; van Bergen, M A P; Mevius, D J; Veldman, K T; van Beers-Schreurs, H M G; de Winne, R T J A

This case study describes the isolation ofa multiresistant strain ofBrachyspira hyodysenteriae in April 2007 in a Dutch sow herd with recurrent diarrhoea. Examination of faecal samples taken from 7-month-old breeding gilts with diarrhoea revealed the presence of resistance against tiamulin, lincomycin, tylosin, doxycycline, and tylvalosin (the active substance in Aivlosin) in four of five samples. Tiamulin resistance has not been reported in The Netherlands before. The repeated use of tiamulin on the affected farm was assumed to be the main cause of the development of resistance to the drug. The farmer was advised to adopt a medication strategy and to implement management practices that would prevent an ongoing cycle of infection on the farm. It is important that the Dutch swine industry appreciates that tiamulin-resistant strains of B. hyodysenteriae may be found on other farms as well. The appropriate and prudent use of antibiotics is essential in order to prevent the development of resistance against the last option left to cure B. hyodysenteriae infections: valnemulin.

Association between quality management and performance indicators in Dutch diabetes care groups: a cross-sectional study

PubMed Central

Campmans-Kuijpers, Marjo J E; Baan, Caroline A; Lemmens, Lidwien C; Klomp, Maarten L H; Romeijnders, Arnold C M; Rutten, Guy E H M

2015-01-01

Objectives To enhance the quality of diabetes care in the Netherlands, so-called care groups with three to 250 general practitioners emerged to organise and coordinate diabetes care. This introduced a new quality management level in addition to the quality management of separate general practices. We hypothesised that this new level of quality management might be associated with the aggregate performance indicators on the patient level. Therefore, we aimed to explore the association between quality management at the care group level and its aggregate performance indicators. Design A cross-sectional study. Setting All Dutch care groups (n=97). Participants 23 care groups provided aggregate register-based performance indicators of all their practices as well as data on quality management measured with a questionnaire filled out by 1 or 2 of their quality managers. Primary outcomes The association between quality management, overall and in 6 domains (‘organisation of care’, ‘multidisciplinary teamwork’, ‘patient centredness’, ‘performance management’, ‘quality improvement policy’ and ‘management strategies’) on the one hand and 3 process indicators (the percentages of patients with at least 1 measurement of glycated haemoglobin, lipid profile and systolic blood pressure), and 3 intermediate outcome indicators (the percentages of patients with glycated haemoglobin below 53 mmol/mol (7%); low-density lipoprotein cholesterol below 2.5 mmol/L; and systolic blood pressure below 140 mm Hg) by weighted univariable linear regression. Results The domain ‘management strategies’ was significantly associated with the percentage of patients with a glycated haemoglobin <53 mmol/mol (β 0.28 (0.09; 0.46) p=0.01) after correction for multiple testing. The other domains as well as overall quality management were not associated with aggregate process or outcome indicators. Conclusions This first exploratory study on quality management showed weak or no associations between quality management of diabetes care groups and their performance. It remains uncertain whether this second layer on quality management adds to better quality of care. PMID:25968001

Association between quality management and performance indicators in Dutch diabetes care groups: a cross-sectional study.

PubMed

Campmans-Kuijpers, Marjo J E; Baan, Caroline A; Lemmens, Lidwien C; Klomp, Maarten L H; Romeijnders, Arnold C M; Rutten, Guy E H M

2015-05-11

To enhance the quality of diabetes care in the Netherlands, so-called care groups with three to 250 general practitioners emerged to organise and coordinate diabetes care. This introduced a new quality management level in addition to the quality management of separate general practices. We hypothesised that this new level of quality management might be associated with the aggregate performance indicators on the patient level. Therefore, we aimed to explore the association between quality management at the care group level and its aggregate performance indicators. A cross-sectional study. All Dutch care groups (n=97). 23 care groups provided aggregate register-based performance indicators of all their practices as well as data on quality management measured with a questionnaire filled out by 1 or 2 of their quality managers. The association between quality management, overall and in 6 domains ('organisation of care', 'multidisciplinary teamwork', 'patient centredness', 'performance management', 'quality improvement policy' and 'management strategies') on the one hand and 3 process indicators (the percentages of patients with at least 1 measurement of glycated haemoglobin, lipid profile and systolic blood pressure), and 3 intermediate outcome indicators (the percentages of patients with glycated haemoglobin below 53 mmol/mol (7%); low-density lipoprotein cholesterol below 2.5 mmol/L; and systolic blood pressure below 140 mm Hg) by weighted univariable linear regression. The domain 'management strategies' was significantly associated with the percentage of patients with a glycated haemoglobin <53 mmol/mol (β 0.28 (0.09; 0.46) p=0.01) after correction for multiple testing. The other domains as well as overall quality management were not associated with aggregate process or outcome indicators. This first exploratory study on quality management showed weak or no associations between quality management of diabetes care groups and their performance. It remains uncertain whether this second layer on quality management adds to better quality of care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

High educational impact of a national simulation-based urological curriculum including technical and non-technical skills.

PubMed

de Vries, Anna H; Schout, Barbara M A; van Merriënboer, Jeroen J G; Pelger, Rob C M; Koldewijn, Evert L; Muijtjens, Arno M M; Wagner, Cordula

2017-02-01

Although simulation training is increasingly used to meet modern technology and patient safety demands, its successful integration within surgical curricula is still rare. The Dutch Urological Practical Skills (D-UPS) curriculum provides modular simulation-based training of technical and non-technical basic urological skills in the local hospital setting. This study aims to assess the educational impact of implementing the D-UPS curriculum in the Netherlands and to provide focus points for improvement of the D-UPS curriculum according to the participants. Educational impact was assessed by means of qualitative individual module-specific feedback and a quantitative cross-sectional survey among residents and supervisors. Twenty out of 26 Dutch teaching hospitals participated. The survey focussed on practical aspects, the D-UPS curriculum in general, and the impact of the D-UPS curriculum on the development of technical and non-technical skills. A considerable survey response of 95 % for residents and 76 % for supervisors was obtained. Modules were attended by junior and senior residents, supervised by a urologist, and peer teaching was used. Ninety percent of supervisors versus 67 % of residents judged the D-UPS curriculum as an important addition to current residency training (p = 0.007). Participants' aggregated general judgement of the modules showed a substantial percentage favorable score (M ± SE: 57 ± 4 %). The impact of training on, e.g., knowledge of materials/equipment and ability to anticipate on complications was high, especially for junior residents (77 ± 5 and 71 ± 7 %, respectively). Focus points for improvement of the D-UPS curriculum according to the participants include adaptation of the training level to residents' level of experience and focus on logistics. The simulation-based D-UPS curriculum has a high educational impact. Residents and supervisors consider the curriculum to be an important addition to current residency training. Focus points for improvement of the D-UPS curriculum according to the participants include increased attention to logistics and integration of a spiral learning approach.

How do Dutch GPs address work-related problems? A focus group study.

PubMed

de Kock, Cornelis A; Lucassen, Peter L B J; Spinnewijn, Laura; Knottnerus, J André; Buijs, Peter C; Steenbeek, Romy; Lagro-Janssen, Antoine L M

2016-09-01

In the Netherlands, there is a lack of knowledge about general practitioners' (GPs) perception of their role regarding patients' occupation and work related problems (WRP). As work and health are closely related, and patients expect help from their GPs in this area, a better understanding is needed of GPs' motivation to address WRP. To explore GPs' opinions on their role in the area of work and health. This is a qualitative study using three focus groups with Dutch GPs from the catchment area of a hospital in the Southeast of the Netherlands. The group was heterogeneous in characteristics such as sex, age, and practice setting. Three focus groups were convened with 18 GPs. The moderator used an interview guide. Two researchers analysed verbatim transcripts using constant comparative analysis. We distinguished three items: (a) work context in a GP's integrated consultation style; (b) counselling about sick leave; (c) cooperation with occupational physicians (OPs). The participants are willing to address the topic and counsel about sick leave. They consider WRP in patients with medically unexplained symptoms (MUS) challenging. They tend to advise these patients to continue working as they think this will ultimately benefit them. The participating GPs seemed well aware of the relation between work and health but need more knowledge, communication skills and better cooperation with occupational physicians to manage work-related problems. [Box: see text].

2017 Dutch Report Card+: Results From the First Physical Activity Report Card Plus for Dutch Youth With a Chronic Disease or Disability

PubMed Central

Burghard, Marcella; de Jong, Nynke B.; Vlieger, Selina; Takken, Tim

2018-01-01

Background: The Dutch Active Healthy Kids (AHK) Report Card+ (RC+) consolidates and translates research and assesses how the Netherlands is being responsible in providing physical activity (PA) opportunities for youth (< 18 years) with a chronic disease or disability. The aim of this article is to summarize the results of the Dutch RC+. Methods: Nine indicators were graded using the AHK Global Alliance RC development process, which includes a synthesis of best available research, surveillance, policy and practice findings, and expert consensus. Two additional indicators were included: weight status and sleep. Results: Grades assigned were: Overall Physical Activity, D; Organized Sports Participation, B–; Active Play, C–; Active Transportation, A–; Sedentary Behavior, C; Sleep C; For Weight Status, Family and Peers, School, Community and Built Environment, Government Strategies, and Investments all INC. Conclusions: The youth with disabilities spend a large part of the day sedentary, since only 26% of them met the PA norm for healthy physical activity. Potential avenues to improve overall physical activity are changing behaviors regarding sitting, screen time, and active play. The Netherlands is on track regarding PA opportunities for youth with disabilities, however they are currently not able to participate unlimited in sports and exercise. PMID:29761094

Validation of the Mini-TQ in a Dutch-speaking population: a rapid assessment for tinnitus-related distress.

PubMed

Vanneste, S; Plazier, M; van der Loo, E; Ost, J; Meeus, O; Van de Heyning, P; De Ridder, D

2011-01-01

Up to 30% of the adult population experiences tinnitus at some point in life. The aim of the present study was to validate the Mini-Tinnitus Questionnaire (TQ) in a Dutch-speaking population for measuring tinnitus-related distress and compare it with the extended version normally used in clinical practice and research. We assessed 181 patients at the Tinnitus Research Initiative clinic of Antwerp University Hospital. Twelve items from the TQ chosen by Hiller and Goebel based on the optimal combination of high item correlation, reliability, and sensitivity were selected and correlated to the different subscale and global scores of the TQ. Internal consistency was evaluated using Cronbach's alpha coefficient, and the Guttman split-half coefficient was used to confirm reliability. Correlation to the global TQ score was .93, internal consistency was .87, and reliability was .89. This study further revealed that the Mini-TQ correlates better with the different subscales of the TQ in the Dutch-speaking population. The convergence validity was confirmed, ensuring that this new instrument measures distress. In addition, the norms suggested by Hiller and Goebel were verified and established. Based on these results, the Mini-TQ is recommended as a valid instrument for evaluating tinnitus-related distress in Dutch-speaking populations for a compact, quick, and economical assessment.

Communication between Dutch rheumatologists and occupational physicians in the occupational rehabilitation of patients with rheumatic diseases

PubMed Central

de Buck, P D M; van Amstel, R J; Buijs, P; Maasen, J; van Dijk, F J H; Hazes, J; Vlieland, T

2002-01-01

Objective: To assess the quality and quantity of communication and cooperation between Dutch rheumatologists and occupational physicians. Methods: A postal survey among 187 Dutch rheumatologists. Results: 153/187 rheumatologists (82%) returned the questionnaire. They considered reducing pain and fatigue to be their major responsibility in the process of occupational rehabilitation, followed by improving work participation (68/153 (44%)) and quality of work (55/153 (36%)). Although 112/153 (73%) of the rheumatologists judged the communication and cooperation with occupational physicians as reasonable to good, 119/153 (78%) of them were willing to improve the collaboration. Perceived bottlenecks mentioned were a lack of clarity about the occupational physician's position and activities, and the absence of practice guidelines. The most important prerequisites for improvement were found to be guarantees about the occupational physician's professional independence and more clarity about the competence of the occupational physicians and how they used the information provided. Conclusion: Dutch rheumatologists are willing to improve cooperation and communication with occupational physicians. The perceived lack of clarity about their mutual tasks appears to be a major obstacle. Thus the development of a joint education programme and a guideline for occupational rehabilitation in rheumatic diseases may be appropriate first steps towards improvement. PMID:11779762

A cautionary note about the cross-national and clinical validity of cut-off points for the Maslach Burnout Inventory.

PubMed

Schaufeli, W B; Van Dierendonck, D

1995-06-01

In the present study, burnout scores of three samples, as measured with the Maslach Burnout Inventory, were compared: (1) the normative American sample from the test-manual (N = 10,067), (2) the normative Dutch sample (N = 3,892), and (3) a Dutch outpatient sample (N = 142). Generally, the highest burnout scores were found for the outpatient sample, followed by the American and Dutch normative samples, respectively. Slightly different patterns were noted for each of the three components. Probably sampling bias, i.e., the healthy worker effect, or cultural value patterns, i.e., femininity versus masculinity, might be responsible for the results. It is concluded that extreme caution is required when cut-off points are used to classify individuals by burnout scores; only nation-specific and clinically derived cut-off points should be employed.

Considerations affecting dietary behaviour of immigrants with type 2 diabetes: a qualitative study among Surinamese in the Netherlands.

PubMed

Kohinor, Mirjam J E; Stronks, Karien; Nicolaou, Mary; Haafkens, Joke A

2011-06-01

The purpose of this study was to explore the sociocultural factors affecting the dietary behaviour of Dutch Surinamese patients with type 2 diabetes. In this qualitative study, 32 Surinamese primary care patients with type 2 diabetes mellitus participated in semi-structured interviews (16 African Surinamese and 16 Hindustani Surinamese). Interviews were recorded and transcripts were analysed and coded into themes using principles of grounded theory and MAXQDA software. Surinamese food was eaten regularly by all respondents. Most participants were aware of the need to change their diet but reported difficulty with changing their dietary behaviour to meet dietary guidelines. Many perceived these guidelines to be based on Dutch eating habits, making it difficult to reconcile them with Surinamese cooking and eating practices. Firstly, respondents indicated that they did not choose foods based on their nutritional qualities. Instead, choices were based on Surinamese beliefs regarding 'good' (e.g., bitter vegetables) or 'bad' (e.g., spicy dishes) foods for diabetes. Secondly, respondents often perceived recommendations such as eating at fixed times as interfering with traditional values, for example hospitality. Above all, the maintenance of Surinamese cooking and eating practices was regarded as extremely important since the respondents perceived these to be a core element of their identity as Surinamese. For Surinamese diabetes patients, cooking and eating practices are related to deeply rooted cultural beliefs and values. The wish to maintain one's Surinamese identity may pose difficulty for patients' adherence to dietary guidelines, as these are perceived as being based on 'Dutch' habits. This suggests that immigrants with a long duration of residence in the host country like the Surinamese, who are seen as well integrated might benefit from culturally sensitive diabetes education that is adapted at surface and deep structure.

Comparing health-related quality of life of Dutch and Chinese patients with traumatic brain injury: do cultural differences play a role?

PubMed

Cnossen, Maryse C; Polinder, Suzanne; Vos, Pieter E; Lingsma, Hester F; Steyerberg, Ewout W; Sun, Yanming; Ye, Pengpeng; Duan, Leilei; Haagsma, Juanita A

2017-04-14

There is growing interest in health related quality of life (HRQoL) as an outcome measure in international trials. However, there might be differences in the conceptualization of HRQoL across different socio-cultural groups. The objectives of current study were: (I) to compare HRQoL, measured with the short form (SF)-36 of Dutch and Chinese traumatic brain injury (TBI) patients 1 year after injury and; (II) to assess whether differences in SF-36 profiles could be explained by cultural differences in HRQoL conceptualization. TBI patients are of particular interest because this is an important cause of diverse impairments and disabilities in functional, physical, emotional, cognitive, and social domains that may drastically reduce HRQoL. A prospective cohort study on adult TBI patients in the Netherlands (RUBICS) and a retrospective cohort study in China were used to compare HRQoL 1 year post-injury. Differences on subscales were assessed with the Mann-Whitney U-test. The internal consistency, interscale correlations, item-internal consistency and item-discriminate validity of Dutch and Chinese SF-36 profiles were examined. Confirmatory factor analysis was performed to assess whether Dutch and Chinese data fitted the SF-36 two factor-model (physical and mental construct). Four hundred forty seven Dutch and 173 Chinese TBI patients were included. Dutch patients obtained significantly higher scores on role limitations due to emotional problems (p < .001) and general health (p < .001), while Chinese patients obtained significantly higher scores on physical functioning (p < .001) and bodily pain (p = .001). Scores on these subscales were not explained by cultural differences in conceptualization, since item- and scale statistics were all sufficient. However, differences among Dutch and Chinese patients were found in the conceptualization of the domains vitality, mental health and social functioning. One year after TBI, Dutch and Chinese patients reported a different pattern of HRQoL. Further, there might be cultural differences in the conceptualization of some of the SF-36 subscales, which has implications for outcome evaluation in multi-national trials.

Cost-effectiveness of i-Sleep, a guided online CBT intervention, for patients with insomnia in general practice: protocol of a pragmatic randomized controlled trial.

PubMed

van der Zweerde, Tanja; Lancee, Jaap; Slottje, Pauline; Bosmans, Judith; Van Someren, Eus; Reynolds, Charles; Cuijpers, Pim; van Straten, Annemieke

2016-04-02

Insomnia is a highly prevalent disorder causing clinically significant distress and impairment. Furthermore, insomnia is associated with high societal and individual costs. Although cognitive behavioural treatment for insomnia (CBT-I) is the preferred treatment, it is not used often. Offering CBT-I in an online format may increase access. Many studies have shown that online CBT for insomnia is effective. However, these studies have all been performed in general population samples recruited through media. This protocol article presents the design of a study aimed at establishing feasibility, effectiveness and cost-effectiveness of a guided online intervention (i-Sleep) for patients suffering from insomnia that seek help from their general practitioner as compared to care-as-usual. In a pragmatic randomized controlled trial, adult patients with insomnia disorder recruited through general practices are randomized to a 5-session guided online treatment, which is called "i-Sleep", or to care-as-usual. Patients in the care-as-usual condition will be offered i-Sleep 6 months after inclusion. An ancillary clinician, known as the psychological well-being practitioner who works in the GP practice (PWP; in Dutch: POH-GGZ), will offer online support after every session. Our aim is to recruit one hundred and sixty patients. Questionnaires, a sleep diary and wrist actigraphy will be administered at baseline, post intervention (at 8 weeks), and at 6 months and 12 months follow-up. Effectiveness will be established using insomnia severity as the main outcome. Cost-effectiveness and cost-utility (using costs per quality adjusted life year (QALY) as outcome) will be conducted from a societal perspective. Secondary measures are: sleep diary, daytime consequences, fatigue, work and social adjustment, anxiety, alcohol use, depression and quality of life. The results of this trial will help establish whether online CBT-I is (cost-) effective and feasible in general practice as compared to care-as-usual. If it is, then quality of care might be increased because implementation of i-Sleep makes it easier to adhere to insomnia guidelines. Strengths and limitations are discussed. Netherlands Trial register NTR 5202 (registered April 17(st) 2015).

Orientation and mobility training for adults with low vision: a new standardized approach

PubMed Central

Ballemans, Judith; Kempen, Gertrudis IJM

2013-01-01

Background: Orientation and mobility training aims to facilitate independent functioning and participation in the community of people with low vision. Objective: (1) To gain insight into current practice regarding orientation and mobility training, and (2) to develop a theory-driven standardized version of this training to teach people with low vision how to orientate and be safe in terms of mobility. Study of current practice: Insight into current practice and its strengths and weaknesses was obtained via reviewing the literature, observing orientation and mobility training sessions (n = 5) and interviewing Dutch mobility trainers (n = 18). Current practice was mainly characterized by an individual, face-to-face orientation and mobility training session concerning three components: crystallizing client’s needs, providing information and training skills. A weakness was the lack of a (structured) protocol based on evidence or theory. New theory-driven training: A new training protocol comprising two face-to-face sessions and one telephone follow-up was developed. Its content is partly based on the components of current practice, yet techniques from theoretical frameworks (e.g. social-cognitive theory and self-management) are incorporated. Discussion: A standardized, tailor-made orientation and mobility training for using the identification cane is available. The new theory-driven standardized training is generally applicable for teaching the use of every low-vision device. Its acceptability and effectiveness are currently being evaluated in a randomized controlled trial. PMID:22734105

Young Dutch people's experiences of trading sex: a qualitative study.

PubMed

van de Walle, Robert; Picavet, Charles; van Berlo, Willy; Verhoeff, Arnoud

2012-01-01

In recent years, the subject of transactional sex among young Dutch people has generated a heated social debate in the Netherlands. However, accurate data on this phenomenon are scarce. This article describes the findings of a qualitative study on young Dutch people's experiences of having sex in return for money or a material reward. Thirty in-depth interviews were conducted with young Dutch men and women aged 14 to 24. Participants came from diverse backgrounds in terms of gender, ethnicity, sexual orientation, and socioeconomic status. Experiences of trading sex differed in terms of the motivation to trade sex, the presence or absence of coercion, and the availability of other options for earning money. Participants' feelings about their experiences varied. For most participants, the sex itself was unpleasant and required considerable emotion management. Still, some felt adequately compensated by the reward or felt trading sex was preferable to other jobs. Gender played an important role, with feelings of disgust or shame reported especially by female participants, whereas male participants reported more positive experiences. Interactions involving coercion or financial dependence on trading sex generally had a negative emotional impact. Participants stressed the differences between their own experiences and professional prostitution.

Language discrimination without language: Experiments on tamarin monkeys

NASA Astrophysics Data System (ADS)

Tincoff, Ruth; Hauser, Marc; Spaepen, Geertrui; Tsao, Fritz; Mehler, Jacques

2002-05-01

Human newborns can discriminate spoken languages differing on prosodic characteristics such as the timing of rhythmic units [T. Nazzi et al., JEP:HPP 24, 756-766 (1998)]. Cotton-top tamarins have also demonstrated a similar ability to discriminate a morae- (Japanese) vs a stress-timed (Dutch) language [F. Ramus et al., Science 288, 349-351 (2000)]. The finding that tamarins succeed in this task when either natural or synthesized utterances are played in a forward direction, but fail on backward utterances which disrupt the rhythmic cues, suggests that sensitivity to language rhythm may rely on general processes of the primate auditory system. However, the rhythm hypothesis also predicts that tamarins would fail to discriminate languages from the same rhythm class, such as English and Dutch. To assess the robustness of this ability, tamarins were tested on a different-rhythm-class distinction, Polish vs Japanese, and a new same-rhythm-class distinction, English vs Dutch. The stimuli were natural forward utterances produced by multiple speakers. As predicted by the rhythm hypothesis, tamarins discriminated between Polish and Japanese, but not English and Dutch. These findings strengthen the claim that discriminating the rhythmic cues of language does not require mechanisms specialized for human speech. [Work supported by NSF.

Netherlands Antilles: country profile.

PubMed

Thorndike, T

1988-03-01

The Netherlands Antilles is the former name for the 5 islands called "the Antilles of the Five" (Curacao, Bonaire, St Maarten, St Eustatius, and Saba) and the separatist (since 1986) island of Aruba, which has its own prime minister (Henny Eamon -- the prime minister of the other 5 islands is Don Martina). The total 1988 population is 264,000. They enjoy one of the highest standards of living among the developing countries, with a per capita gross national product of $1610 guilder ($15,390 (US). Health services, life expectancy, and political freedom are excellent, due mainly to Dutch standards and aid. The position of women is also generally progressive. Literacy is excellent despite the different languages used (Dutch and Papiamento in Curacao, Bonaire and Aruba; English in St Maarten, St Eustatius, and Saba). Since the 2 major industries (oil refining and offshore financial services) have collapsed, tourism is limited mainly to the Windward Islands (St Eustatius and Saba), and there is no agriculture or fishing, the country's high standard of living is due to $530 million of Dutch aid, on which the country relies. Aruba will become independent in 1996, a future opposed by nearly all the 67,000 islanders, who fear it will mean the loss of Dutch aid.

Reducing fear of falling and avoidance of activity in elderly persons: the development of a Dutch version of an American intervention.

PubMed

Zijlstra, G A Rixt; Tennstedt, Sharon L; van Haastregt, Jolanda C M; van Eijk, Jacques Th M; Kempen, Gertrudis I J M

2006-08-01

The present study reports on the development of a Dutch version of an American intervention for community-residing older persons in The Netherlands. Adaptation of this cognitive behavioural group intervention, to reduce fear of falling and avoidance of activity in older persons, was required before evaluation in a different setting. The process of adaptation consisted of defining the target population, translating the original intervention manual literally, consulting Dutch experts and a developer of the original intervention, selecting qualified facilitators and conducting a pilot study of the adapted manual. Adaptations were incorporated to improve the content, feasibility and didactic materials. The main adaptations were scheduling more time for some activities, changing session frequency from twice to once a week, adding a booster session after 6 months and adding more transparencies. A critical assessment of the appropriateness and feasibility of the original intervention provided important information to facilitate replication in the Dutch setting. Applying a systematic approach is recommended in the process of adapting an original intervention for use in a different setting. To facilitate replication, in general, more detailed information should be provided about interventions.

Management of community-acquired pneumonia in adults: 2016 guideline update from the Dutch Working Party on Antibiotic Policy (SWAB) and Dutch Association of Chest Physicians (NVALT).

PubMed

Wiersinga, W J; Bonten, M J; Boersma, W G; Jonkers, R E; Aleva, R M; Kullberg, B J; Schouten, J A; Degener, J E; van de Garde, E M W; Verheij, T J; Sachs, A P E; Prins, J M

2018-01-01

The Dutch Working Party on Antibiotic Policy in collaboration with the Dutch Association of Chest Physicians, the Dutch Society for Intensive Care and the Dutch College of General Practitioners have updated their evidence-based guidelines on the diagnosis and treatment of community-acquired pneumonia (CAP) in adults who present to the hospital. This 2016 update focuses on new data on the aetiological and radiological diagnosis of CAP, severity classification methods, initial antibiotic treatment in patients with severe CAP and the role of adjunctive corticosteroids. Other parts overlap with the 2011 guideline. Apart from the Q fever outbreak in the Netherlands (2007-2010) no other shifts in the most common causative agents of CAP or in their resistance patterns were observed in the last five years. Low-dose CT scanning may ultimately replace the conventional chest X-ray; however, at present, there is insufficient evidence to advocate the use of CT scanning as the new standard in patients evaluated for CAP. A pneumococcal urine antigen test is now recommended for all patients presenting with severe CAP; a positive test result can help streamline therapy once clinical stability has been reached and no other pathogens have been detected. Coverage for atypical microorganisms is no longer recommended in empirical treatment of severe CAP in the non-intensive care setting. For these patients (with CURB-65 score >2 or Pneumonia Severity Index score of 5) empirical therapy with a 2nd/3rd generation cephalosporin is recommended, because of the relatively high incidence of Gram-negative bacteria, and to a lesser extent S. aureus. Corticosteroids are not recommended as adjunctive therapy for CAP.

Employability in Practice.

ERIC Educational Resources Information Center

Verhaar, C. H. A.; Smulders, H. R. M.

1999-01-01

A study focused on the attitudes of Dutch dairy and horticultural workers regarding the need for training in the workplace. Results emphasize the importance of learning on the job but suggest that workers need to be made aware of the value of investment in other kinds of training. (JOW)

Reducing the use of out-of-hours primary care services: A survey among Dutch general practitioners.

PubMed

Keizer, Ellen; Maassen, Irene; Smits, Marleen; Wensing, Michel; Giesen, Paul

2016-09-01

Out-of-hours primary care services have a high general practitioner (GP) workload with increasing costs, while half of all contacts are non-urgent. To identify views of GPs to influence the use of the out-of-hours GP cooperatives. Cross-sectional survey study among a random sample of 800 GPs in the Netherlands. Of the 428 respondents (53.5% response rate), 86.5% confirmed an increase in their workload and 91.8% felt that the number of patient contacts could be reduced. A total of 75.4% GP respondents reported that the 24-h service society was a 'very important' reason why patients with non-urgent problems attended the GP cooperative; the equivalent for worry or anxiety was 65.8%, and for easy accessibility, 60.1%. Many GPs (83.9%) believed that the way telephone triage is currently performed contributes to the high use of GP cooperatives. Measures that GPs believed were both desirable and effective in reducing the use of GP cooperatives included co-payment for patients, stricter triage, and a larger role for the telephone consultation doctor. GPs considered patient education, improved telephone accessibility of daytime general practices, more possibilities for same-day appointments, as well as feedback concerning the use of GP cooperatives to practices and triage nurses also desirable, but less effective. This study provides several clues for influencing the use of GP cooperatives. Further research is needed to examine the impact and safety of these strategies. [Box: see text].

Pathways to care and psychological problems of general practice patients in a "gate keeper" and an "open access" health care system: a comparison of Germany and the Netherlands.

PubMed

Linden, M; Gothe, H; Ormel, J

2003-12-01

The comparison of different health care systems is one way to give empirical evidence to health care reform and policy. The differences between health care systems in which general practitioners serve as gate keepers in comparison to systems in which patients are free to contact every physician and specialist they like are a question of high interest. This study compares the Netherlands and Germany, two countries with very similar political, social, and health system structures, but different types of access to the health care system. While Germany offers unconstrained access to specialist ambulatory care, the Netherlands restricts health care utilization by giving primary care a 'gate keeper' function not allowing patients direct access to specialist care. Data from the WHO international collaborative study on psychological problems in general health care (Ustün and Sartorius 1995) were analysed with respect to pathways to care, treatment, and health status. In an initial cross-sectional assessment, in 3-month and 12-month follow-ups, contacts to physicians or hospital admission have also been monitored. There were only marginal differences between the Dutch and the German sample in the sociodemographic characteristics as well as in the diagnostic status with respect to mental disorders. In the Netherlands, 95.5%, and in Germany, 68.8% of the patients presented their 'reason for visit' for the first time to any physician at this index contact with a general practitioner. During the following 3 months, 24% of the Dutch patients, but 60.2% of the German patients, additionally contacted other physicians ( P < 0.001). At 12 months, this rate was 62.9% vs. 78.6% ( P < 0.001). During the 12-month follow-up period, there were 15.7 0/00 hospital admissions in Germany vs. 25.4 0/00 in the Netherlands ( P < 0.005) [corrected]. Family physicians in a gate keeper system reduce the number of contacts to other physicians and the intensity of treatment, while at the same time the rate of hospital admissions is increased.

Dutch practice guidelines for managing adjustment disorders in occupational and primary health care.

PubMed

van der Klink, Jac J L; van Dijk, Frank J H

2003-12-01

Stress-related disorders, especially adjustment disorders, are widespread among working populations and are responsible for high costs in terms of suffering, sick leave, disability, and economic losses. Despite their high prevalence, there has been relatively little research on the effectiveness of treatments in an occupational health care setting. Guidelines for occupational physicians and general practitioners in relation to mental health problems were recently developed in The Netherlands and are discussed in this article. The guidelines provide a classification based on terms that are already used in the profession and are consistent with the diagnosis "adjustment disorder". They give recommendations for guidance and treatment on the basis of existing evidence, experience in adjacent fields, and consensus procedures. They are based on cognitive behavioral principles, mainly stress inoculation training and graded activity, and aim to enhance the problem-solving capacity of patients in relation to the work environment. The aim of this paper is to contribute to the exchange of and a discussion on methods and good practices in primary and occupational health care.

Dutch Catholics on birth control and sexuality.

PubMed

Hutjes, J M

1975-01-01

This is a summary of a 1969 poll among Catholics in the Netherlands as to their views on sexuality. The 1968 papal encyclical against the use of contraceptives seems to be an example of cultural lag among these Catholics. Alienation from the official Church doctrine is widespread. Contraceptive pills were acceptable to 75% of respondents and "other methods" and coitus interruptus to 60% of respondents. It was estimated that 34-50% of respondents practiced coitus interruptus, 20-23% the pill , and 25-33% "other methods." There was more cautious acceptance of sterilization and abortion. Traditional Catholics practice proscribed contraception less and approve of it less than do Catholics for whom religion has lost much of its meaning and power, but the dichotomy is not absolute. Even among faithful Catholics, almost 50% view the pill as an acceptable method of contraceptive. There was general feeling among the respondents that the Church should cease dictating to its members in personal matters. The relational rather than the procreative , aspect of sexuality was stressed. There is even acceptance of premarital intercourse, especially among young, big city Catholics.

Challenges in the care for consanguineous couples: an exploratory interview study among general practitioners and midwives

PubMed Central

2012-01-01

Background It is often suggested that an effort must be made to increase awareness among consanguineous couples of their reproductive risk, and to refer them for genetic counseling if needed. Primary care professionals are considered most appropriate for addressing the subject and identifying couples at risk during consultations in their practice. This Dutch study aims to explore the experiences, attitudes and beliefs of such professionals regarding their care for consanguineous couples. Methods Sixteen semi-structured interviews were conducted with midwives and general practitioners. Results Although most primary care professionals considered it their task to inform couples about the risks of consanguinity, during consultations the topic was generally only briefly touched upon and quickly abandoned. Important reasons for this were professionals’ beliefs about religious and social values of couples, their low perception of the couples’ reproductive risk and expected limited feasibility of referral. Feelings of embarrassment regarding addressing consanguinity did not seem to play a significant role. Conclusions Primary care professional beliefs about their clients’ religious and social values, their attitudes toward the risk, and perceived limited options for referral seem to conflict with the professional norm to address the topic of consanguinity. PMID:23102514

Relationships of Aggression Subtypes and Peer Status among Aggressive Boys in General Education and Emotional/Behavioral Disorder (EBD) Classrooms

ERIC Educational Resources Information Center

Useche, Ana Carolina; Sullivan, Amanda L.; Merk, Welmoet; Orobio de Castro, Bram

2014-01-01

This study examines the concurrent and longitudinal relationships between reactive and proactive aggression and children's peer status. Participants were 94 Dutch elementary school-aged boys in self-contained special education classrooms for students with emotional/behavioral disorders (EBD) and 47 boys with no disabilities in general education…

Homotypic versus Heterotypic Continuity of Anxiety Symptoms in Young Adolescents: Evidence for Distinctions between DSM-IV Subtypes

ERIC Educational Resources Information Center

Ferdinand, Robert F.; Dieleman, Gwen; Ormel, Johan; Verhulst, Frank C.

2007-01-01

Objective: To investigate homotypic and heterotypic longitudinal patterns of symptoms of separation anxiety disorder (SAD), generalized anxiety disorder (GAD), social phobia (SoPh), panic disorder (PD), and obsessive compulsive disorder (OCD) in young adolescents from the Dutch general population. Method: 2,067 individuals (51.4% girls) from a…

Can physicians conceive of performing euthanasia in case of psychiatric disease, dementia or being tired of living?

PubMed

Bolt, Eva Elizabeth; Snijdewind, Marianne C; Willems, Dick L; van der Heide, Agnes; Onwuteaka-Philipsen, Bregje D

2015-08-01

Euthanasia and physician-assisted suicide (EAS) in patients with psychiatric disease, dementia or patients who are tired of living (without severe morbidity) is highly controversial. Although such cases can fall under the Dutch Euthanasia Act, Dutch physicians seem reluctant to perform EAS, and it is not clear whether or not physicians reject the possibility of EAS in these cases. To determine whether physicians can conceive of granting requests for EAS in patients with cancer, another physical disease, psychiatric disease, dementia or patients who are tired of living, and to evaluate whether physician characteristics are associated with conceivability. A cross-sectional study (survey) was conducted among 2269 Dutch general practitioners, elderly care physicians and clinical specialists. The response rate was 64% (n=1456). Most physicians found it conceivable that they would grant a request for EAS in a patient with cancer or another physical disease (85% and 82%). Less than half of the physicians found this conceivable in patients with psychiatric disease (34%), early-stage dementia (40%), advanced dementia (29-33%) or tired of living (27%). General practitioners were most likely to find it conceivable that they would perform EAS. This study shows that a minority of Dutch physicians find it conceivable that they would grant a request for EAS from a patient with psychiatric disease, dementia or a patient who is tired of living. For physicians who find EAS inconceivable in these cases, legal arguments and personal moral objections both probably play a role. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Literacy achievement of children with intellectual disabilities and differing linguistic backgrounds.

PubMed

Verhoeven, L; Vermeer, A

2006-10-01

The aim of the present study was to examine the literacy achievement of 10- to 12-year-old native and non-native children with intellectual disabilities (ID) living in the Netherlands. An intriguing question within this context was whether the second language learning non-native children with ID would show a double disadvantage when compared with their monolingual Dutch peers with no ID. Dutch literacy scores in the domains of word decoding, vocabulary, syntax and text were therefore compared for: (1) intellectually disabled native Dutch children; (2) intellectually disabled non-native children; (3) normally developing native Dutch children; and (4) normally developing non-native children. The interrelations between literacy subskills were also compared for native vs. non-native children with ID. The native and non-native students diagnosed as intellectually disabled produced substantially lower literacy scores than their non-disabled peers. The differences between the native (L1) and non-native (L2) children in regular vs. special education were found to depend on the aspect of literacy considered. Word decoding and language skills turned out to significantly predict the children's reading comprehension, although some differences in the strength of relationships could also be evidenced. The literacy achievement of intellectually disabled children with differing linguistic backgrounds generally falls behind that of their non-disabled peers. For word decoding, the non-native children in regular and special education were generally able to keep up with their native peers. For higher-order literacy abilities closely related to the mental lexicon, sentence processing and text processing, however, significant differences in the performances of the native (L1) and non-native (L2) children in regular vs. special education were found, suggesting a double disadvantage for the non-native children in special education.

Parents as moderators of longitudinal associations between sexual peer norms and Dutch adolescents' sexual initiation and intention.

PubMed

van de Bongardt, Daphne; de Graaf, Hanneke; Reitz, Ellen; Deković, Maja

2014-09-01

The present study investigated how parents and peers interact in promoting or delaying Dutch adolescents' sexual initiation and intention and focused specifically on parents as moderators of peer influence. Using a longitudinal design, two waves of online questionnaire data were collected among 900 Dutch adolescents (M = 13.8 years at T1), who were sexually inexperienced at baseline. At T1, participants reported on three types of perceived sexual peer norms: friends' sexual behaviors (descriptive norms), friends' sexual attitudes (injunctive norms), and experienced peer pressure to have sex. They also rated two parenting aspects at T1: the general quality of their relationship with parents and the frequency of sexuality-specific communication with their parents. Six months later, the participants reported on their experience with different sexual behaviors ranging from naked touching or caressing to intercourse and their intention to have sex in the next school year. Relationship quality with parents was significantly associated with both outcomes, with a higher relationship quality predicting smaller odds of sexual initiation and less intention to have sex. Two significant interaction effects showed that frequent sexual communication with parents significantly reduced the effects of sexually active friends and experienced peer pressure on adolescents' intention to have sex. Our findings show that different types of sexual peer norms and both general and sexuality-specific parenting play an important role in the early stages of Dutch adolescents' sexual trajectories. Moreover, parent-adolescent communication about sexuality can function as a buffer for the sex-stimulating effects of sexual peer norms. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Internationalization: Interpretations among Dutch Practitioners

ERIC Educational Resources Information Center

de Haan, Haijing

2014-01-01

The concept of internationalization has been seen as a buzz word and container concept. The meaning of internationalization includes everything that relates to international, meanwhile internationalization is losing its meaning. This study takes a practical approach to searching for some clarification of this concept. During the period 2009-2011,…

Test of cure, retesting and extragenital testing practices for Chlamydia trachomatis and Neisseria gonorrhoeae among general practitioners in different socioeconomic status areas: A retrospective cohort study, 2011-2016

PubMed Central

van Liere, Geneviève A. F. S.; Cals, Jochen W. L.; Dukers-Muijrers, Nicole H. T. M.

2018-01-01

Background For Chlamydia trachomatis (CT), a test of cure (TOC) within 3–5 weeks is not recommended. International guidelines differ in advising a Neisseria gonorrhoeae (NG) TOC. Retesting CT and NG positives within 3–12 months is recommended in international guidelines. We assessed TOC and retesting practices including extragenital testing in general practitioner (GP) practices located in different socioeconomic status (SES) areas to inform and optimize local test practices. Methods Laboratory data of 48 Dutch GP practices between January 2011 and July 2016 were used. Based on a patient’s first positive CT or NG test, the proportion of TOC (<3 months) and retests (3–12 months) were calculated. Patient- and GP-related factors were assessed using multivariate logistic regression analyses. Results For CT (n = 622), 20% had a TOC and 24% had a retest at the GP practice. GP practices in low SES areas were more likely to perform a CT TOC (OR:1.8;95%CI:1.1–3.1). Younger patients (<25 years) were more likely to have a CT TOC (OR:1.6;95%CI:1.0–2.4). For CT (n = 622), 2.4% had a TOC and 6.1% had a retest at another STI care provider. For NG (n = 73), 25% had a TOC and 15% had a retest at the GP practice. For NG (n = 73), 2.7% had a TOC and 12.3% had a retest at another STI care provider. In only 0.3% of the consultations patients were tested on extragenital sites. Conclusion Almost 20% of the patients returned for a CT TOC, especially at GP practices in low SES areas. For NG, 1 out of 4 patients returned for a TOC. Retesting rates were low for both CT (24%) and NG (15%), (re)infections including extragenital infections may be missed. Efforts are required to focus TOC and increase retesting practices of GPs in order to improve CT/NG control. PMID:29538469

Communication between Dutch rheumatologists and occupational physicians in the occupational rehabilitation of patients with rheumatic diseases.

PubMed

de Buck, P D M; van Amstel, R J; Buijs, P C; Maasen, J H W; van Dijk, F J H; Hazes, J M W; Vliet Vlieland, T P M

2002-01-01

Rheumatic diseases are a major cause of permanent work disability. In the process of occupational rehabilitation several health professionals may have a role. To assess the quality and quantity of communication and cooperation between Dutch rheumatologists and occupational physicians. A postal survey among 187 Dutch rheumatologists. 153/187 rheumatologists (82%) returned the questionnaire. They considered reducing pain and fatigue to be their major responsibility in the process of occupational rehabilitation, followed by improving work participation (68/153 (44%)) and quality of work (55/153 (36%)). Although 112/153 (73%) of the rheumatologists judged the communication and cooperation with occupational physicians as reasonable to good, 119/153 (78%) of them were willing to improve the collaboration. Perceived bottlenecks mentioned were a lack of clarity about the occupational physician's position and activities, and the absence of practice guidelines. The most important prerequisites for improvement were found to be guarantees about the occupational physician's professional independence and more clarity about the competence of the occupational physicians and how they used the information provided. Dutch rheumatologists are willing to improve cooperation and communication with occupational physicians. The perceived lack of clarity about their mutual tasks appears to be a major obstacle. Thus the development of a joint education programme and a guideline for occupational rehabilitation in rheumatic diseases may be appropriate first steps towards improvement.

Intergenerational Solidarity and Support between Adult Siblings

ERIC Educational Resources Information Center

Voorpostel, Marieke; Blieszner, Rosemary

2008-01-01

Using a Dutch national sample containing 1,259 triads (two siblings, one parent), we examined whether practical support and emotional support between siblings are enhanced by intergenerational solidarity and how this differs for brothers and sisters. Sibling support was affected by sibling dyad characteristics and by the relationship with the…

Regulating Collaboration in Teacher Education

ERIC Educational Resources Information Center

Dobber, Marjolein; Akkerman, Sanne F.; Verloop, Nico; Vermunt, Jan D.

2014-01-01

Collaboration in teacher education can be seen as a way to prepare student teachers for future social practices at school. When people collaborate with each other, they have to regulate their collaboration. In the Dutch teacher education programme that was investigated, student teachers were members of different types of groups, each of which had…

Empowerment through Sex Education? Rethinking Paradoxical Policies

ERIC Educational Resources Information Center

Naezer, Marijke; Rommes, Els; Jansen, Willy

2017-01-01

Youth empowerment is the main goal of sex education according to Dutch Government and NGO policies. Academics from different disciplines have argued, however, that the ideal of empowerment through education is problematic, because of the unequal power relations implicated in educational practices. Building on one-and-a-half years of online and…

Community Websites: Linking the Personal to Urban History

ERIC Educational Resources Information Center

de Wildt, Annemarie

2013-01-01

New technology enables museums and other heritage institutions to establish more personal links with their audience, and hopefully by doing so make history more compelling to them. The author explores some Dutch practices with interactive community websites and other ways of making connections between personal stories and urban history.

Guided and unguided internet-based vestibular rehabilitation versus usual care for dizzy adults of 50 years and older: a protocol for a three-armed randomised trial

PubMed Central

van der Wouden, Johannes C; Bosmans, Judith E; Smalbrugge, Martin; van Diest, Willianne; Essery, Rosie; Yardley, Lucy; van der Horst, Henriëtte E; Maarsingh, Otto R

2017-01-01

Introduction Dizziness is a common symptom in general practice with a high prevalence among older adults. The most common cause of dizziness in general practice is peripheral vestibular disease. Vestibular rehabilitation (VR) is a safe and effective treatment for peripheral vestibular disease that entails specific exercises to maximise the central nervous system compensation for the effects of vestibular pathology. An internet-based VR intervention has recently been shown to be safe and effective. Online interventions are low cost and easily accessible, but prone to attrition and non-adherence. A combination of online and face-to-face therapy, known as blended care, may balance these advantages and disadvantages. Methods and analysis A single-blind, three-arm, randomised controlled trial among patients aged 50 years and over presenting with dizziness of vestibular origin in general practice will be performed. In this study, we will compare the clinical and cost-effectiveness of stand-alone internet-based VR and internet-based VR with physiotherapeutic support (‘blended care’) with usual care during 6 months of follow-up. We will use a translated Dutch version of a British online VR intervention. Randomisation will be stratified by dizziness severity. The primary outcome measure is the Vertigo Symptoms Scale—Short Form. Intention-to-treat analysis will be performed, adjusting for confounders. The economic evaluation will be conducted from a societal perspective. We will perform an additional analysis on the data to identify predictors of successful treatment in the same population to develop a clinical decision rule for general practitioners. Ethics and dissemination The ethical committee of the VU University Medical Center approved ethics and dissemination of the study protocol. The insights and results of this study will be widely disseminated through international peer-reviewed journals and conference presentations. Trial registration number Pre-results, NTR5712. PMID:28110290

Dentists' self assessment of burnout: an internet feedback tool.

PubMed

te Brake, Hans; Eijkman, Michiel; Hoogstraten, Johan; Gorter, Ronald

2005-06-01

The Stress Thermometer is an easily accessible Internet-based instrument for feedback on work stress and burnout. The aim of this paper is to describe the development of this instrument and to determine its applicability within the dental practice. The Stress Thermometer was made accessible to all members of the Dutch Dental Association, of which 77% of all Dutch dentists are members. Frequency of use was determined, and descriptive data was collected. During an evaluation period of 5 months at least 12% of all possible respondents made use of the Stress Thermometer. Descriptive characteristics of the response group, as well as levels of burnout and work stress, corresponded with those found in the Dutch dentist population. However, some deviations were also present. Results indicate the applicability of the Stress Thermometer to a representative variety of dentists. Although the deviations found should not be ignored in future use, the Stress Thermometer was successful in reaching a population that is difficult to reach. It effectively calls attention to sensitive personal issues concerning work-related stress and burnout.

Development of quality indicators for physiotherapy for patients with PAOD in the Netherlands: a Delphi study.

PubMed

Gijsbers, H J H; Lauret, G J; van Hofwegen, A; van Dockum, T A; Teijink, J A W; Hendriks, H J M

2016-06-01

The aim of the study was to develop quality indicators (QIs) for physiotherapy management of patients with intermittent claudication (IC) in the Netherlands. As part of an international six-step method to develop QIs, an online survey Delphi-procedure was completed. After two Delphi-rounds a validation round was performed. Twenty-six experts were recruited to participate in this study. Twenty-four experts completed two Delphi-rounds. A third round was conducted inviting 1200 qualified and registered physiotherapists of the Dutch integrated care network 'Claudicationet' to validate a draft set of quality indicators. Out of 83 potential QIs in the Dutch physiotherapy guideline on 'Intermittent claudication', consensus among the experts selected nine indicators. All nine quality indicators were validated by 300 physiotherapists. A final set of nine indicators was derived from (1) a Dutch evidence-based physiotherapy guideline, (2) an expert Delphi procedure and (3) a validation by 300 physiotherapists. This set of indicators should be validated in clinical practice. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Cultural differences affecting euthanasia practice in Belgium: one law but different attitudes and practices in Flanders and Wallonia.

PubMed

Cohen, Joachim; Van Wesemael, Yanna; Smets, Tinne; Bilsen, Johan; Deliens, Luc

2012-09-01

Since 2002, Belgium has had a national law legalising euthanasia. The law prescribes several substantive due care requirements and two procedural due care requirements, i.e. consultation with an independent physician and reporting of euthanasia to a Federal Control Committee. A large discrepancy in reporting rates between the Dutch-speaking (Flanders) and the French-speaking (Wallonia) parts of Belgium has led to speculation about cultural differences affecting the practice of euthanasia in both regions. Using Belgian data from the European Values Study conducted in 2008 among a representative sample of the general public and data from a large-scale mail questionnaire survey on euthanasia of 480 physicians from Flanders and 305 from Wallonia (conducted in 2009), this study presents empirical evidence of differences between both regions in attitudes towards and practice of euthanasia. Acceptance of euthanasia by the general population was found to be slightly higher in Flanders than in Wallonia. Compared with their Flemish counterparts, Walloon physicians held more negative attitudes towards performing euthanasia and towards the reporting obligation, less often labelled hypothetical cases correctly as euthanasia, and less often defined a case of euthanasia having to be reported. A higher proportion of Flemish physicians had received a euthanasia request since the introduction of the law. In cases of a euthanasia request, Walloon physicians consulted less often with an independent physician. Requests were more often granted in Flanders than in Wallonia (51% vs 38%), and performed euthanasia cases were more often reported (73% vs 58%). The study points out some significant differences between Flanders and Wallonia in practice, knowledge and attitudes regarding euthanasia and its legal requirements which are likely to explain the discrepancy between Wallonia and Flanders in the number of euthanasia cases reported. Cultural factors seem to play an important role in the practice of (legal) euthanasia and the extent to which legal safeguards are followed. Copyright © 2012 Elsevier Ltd. All rights reserved.

Validation of the dutch version of the health education impact questionnaire (HEIQ) and comparison of the Dutch translation with the English, German and French HEIQ.

PubMed

Ammerlaan, Judy W; van Os-Medendorp, Harmieke; Sont, Jacob K; Elsworth, Gerald R; Osborne, Richard H

2017-01-31

The Health Education Impact Questionnaire (heiQ) evaluates the effectiveness of health education and self-management programs provided to people dealing with a wide range of conditions. Aim of this study was to translate, culturally adapt and validate the Dutch translation of the heiQ and to compare the results with the English, German and French translations. A systematic translation process was undertaken. Psychometric properties were studied among patients with arthritis, atopic dermatitis, food allergy and asthma (n = 286). Factorial validity using confirmatory factor analysis, item difficulty (D), item remainder correlation and composite reliability were conducted. Stability was tested using the intra-class correlation coefficient (ICC). Items were well understood and only minor language adjustments were required. Confirmatory fit indices were >0.95 and item difficulty was D ≥ 0.65 for all items in scales showing acceptable fit indices, except for the reversed Emotional distress scale. Composite reliability ranged between 0.67 and 0.85. Test-retest reliability (n = 93) ICC varied between 0.61 and 0.84. Comparisons with other translations showed comparable fit indices. A lower ICC on Self-monitoring and insight scale was observed. The Dutch translation of the heiQ was found to be well understood and user friendly by patients with Rheumatoid Arthritis, Atopic Dermatitis, Food allergy and asthma and to have robust psychometric properties for evaluating the impact of health education and self-management programs. Given the wide applications of the heiQ and the comparability of the Dutch results with the English, German and French version, the heiQ is a practical and useful questionnaire to evaluate the impact of self-management support programs in different countries and populations with different diseases.

Characterizing the genetic structure of a forensic DNA database using a latent variable approach.

PubMed

Kruijver, Maarten

2016-07-01

Several problems in forensic genetics require a representative model of a forensic DNA database. Obtaining an accurate representation of the offender database can be difficult, since databases typically contain groups of persons with unregistered ethnic origins in unknown proportions. We propose to estimate the allele frequencies of the subpopulations comprising the offender database and their proportions from the database itself using a latent variable approach. We present a model for which parameters can be estimated using the expectation maximization (EM) algorithm. This approach does not rely on relatively small and possibly unrepresentative population surveys, but is driven by the actual genetic composition of the database only. We fit the model to a snapshot of the Dutch offender database (2014), which contains close to 180,000 profiles, and find that three subpopulations suffice to describe a large fraction of the heterogeneity in the database. We demonstrate the utility and reliability of the approach with three applications. First, we use the model to predict the number of false leads obtained in database searches. We assess how well the model predicts the number of false leads obtained in mock searches in the Dutch offender database, both for the case of familial searching for first degree relatives of a donor and searching for contributors to three-person mixtures. Second, we study the degree of partial matching between all pairs of profiles in the Dutch database and compare this to what is predicted using the latent variable approach. Third, we use the model to provide evidence to support that the Dutch practice of estimating match probabilities using the Balding-Nichols formula with a native Dutch reference database and θ=0.03 is conservative. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Ethnic differences in antenatal care use in a large multi-ethnic urban population in the Netherlands.

PubMed

Choté, Anushka A; de Groot, Christianne J M; Bruijnzeels, Marc A; Redekop, Ken; Jaddoe, Vincent W V; Hofman, Albert; Steegers, Eric A P; Mackenbach, Johan P; Foets, Marleen

2011-02-01

to determine differences in antenatal care use between the native population and different ethnic minority groups in the Netherlands. the Generation R Study is a multi-ethnic population-based prospective cohort study. seven midwife practices participating in the Generation R Study conducted in the city of Rotterdam. in total 2093 pregnant women with a Dutch, Moroccan, Turkish, Cape Verdean, Antillean, Surinamese-Creole and Surinamese-Hindustani background were included in this study. to assess adequate antenatal care use, we constructed an index, including two indicators; gestational age at first visit and total number of antenatal care visits. Logistic regression analysis was used to assess differences in adequate antenatal care use between different ethnic groups and a Dutch reference group, taking into account differences in maternal age, gravidity and parity. overall, the percentages of women making adequate use are higher in nulliparae than in multiparae, except in Dutch women where no differences are present. Except for the Surinamese-Hindustani, all women from ethnic minority groups make less adequate use as compared to the native Dutch women, especially because of late entry in antenatal care. When taking into account potential explanatory factors such as maternal age, gravidity and parity, differences remain significant, except for Cape-Verdian women. Dutch-Antillean, Moroccan and Surinamese-Creole women exhibit most inadequate use of antenatal care. this study shows that there are ethnic differences in the frequency of adequate use of antenatal care, which cannot be attributed to differences in maternal age, gravidity and parity. Future research is necessary to investigate whether these differences can be explained by socio-economic and cultural factors. clinicians should inform primiparous women, and especially those from ethnic minority groups, on the importance of timely antenatal care entry. Copyright © 2009 Elsevier Ltd. All rights reserved.

Internet Services for Communicating With the General Practice: Barely Noticed and Used by Patients

PubMed Central

Vermeulen, Joan; Friele, Roland D; van Schayck, Onno CP; de Jong, Judith D; de Witte, Luc P

2015-01-01

Background The Netherlands is one of the frontrunners of eHealth in Europe. Many general practices offer Internet services, which can be used by patients to communicate with their general practice. In promoting and implementing such services, it is important to gain insight into patients’ actual use and intention toward using. Objective The objective of the study is to investigate the actual use and intention toward using Internet services to communicate with the general practice by the general practice population. The secondary objective is to study the factors and characteristics that influence their intention to use such services. Methods There were 1500 members of the Dutch Health Care Consumer Panel, age over 18 years, that were invited to participate in this cross-sectional study. People who had contacted their general practitioner at least once in the past year were included. Participants were asked to fill out a questionnaire about the following services: Internet appointment planning, asking questions on the Internet, email reminders about appointments, Internet prescription refill requests, Internet access to medical data, and Internet video consultation. Participants indicated whether they had used these services in the past year, they would like to use them, and whether they thought their general practice had these services. For the first two services, participants rated items based on the unified theory of acceptance and use of technology complemented with additional constructs. These items were divided into six subscales: effort expectancy, performance expectancy, trust, attitude, facilitating conditions, and social influence. Results There were 546 participants that were included in the analyses out of 593 who met the inclusion criteria. The participants had a mean age of 53 years (SD 15.4), 43.6% (n=238) were male, and 66.8% (n=365) had at least one chronic illness. Actual use of the services varied between 0% (n=0, video consultation) and 10.4% (n=57, requesting prescription refill by Internet). The proportion of participants with a positive intention to use the service varied between 14.7% (n=80, video consultation) and 48.7% (n=266, Internet access to medical data). For each service, approximately half indicated that they did not know whether the service was available. Univariate logistic regression analyses revealed that all the constructs as well as age, level of education, and Internet usage had a significant association with intention toward using Internet appointment planning and asking questions by Internet. Conclusions Internet communication services to contact the general practice are not yet frequently used by this population. Although a substantial number of persons have a positive intention toward using such services, not all people who receive primary care seem willing to use them. The lack of awareness of the availability and functionality of such services might play an important role. PMID:26601596

The NCS code of practice for the quality assurance and control for volumetric modulated arc therapy

NASA Astrophysics Data System (ADS)

Mans, Anton; Schuring, Danny; Arends, Mark P.; Vugts, Cornelia A. J. M.; Wolthaus, Jochem W. H.; Lotz, Heidi T.; Admiraal, Marjan; Louwe, Rob J. W.; Öllers, Michel C.; van de Kamer, Jeroen B.

2016-10-01

In 2010, the NCS (Netherlands Commission on Radiation Dosimetry) installed a subcommittee to develop guidelines for quality assurance and control for volumetric modulated arc therapy (VMAT) treatments. The report (published in 2015) has been written by Dutch medical physicists and has therefore, inevitably, a Dutch focus. This paper is a condensed version of these guidelines, the full report in English is freely available from the NCS website www.radiationdosimetry.org. After describing the transition from IMRT to VMAT, the paper addresses machine quality assurance (QA) and treatment planning system (TPS) commissioning for VMAT. The final section discusses patient specific QA issues such as the use of class solutions, measurement devices and dose evaluation methods.

Assessing the cost-effectiveness of a routine versus an extensive laboratory work-up in the diagnosis of anaemia in Dutch general practice.

PubMed

Kip, Michelle Ma; Schop, Annemarie; Stouten, Karlijn; Dekker, Soraya; Dinant, Geert-Jan; Koffijberg, Hendrik; Bindels, Patrick Je; IJzerman, Maarten J; Levin, Mark-David; Kusters, Ron

2018-01-01

Background Establishing the underlying cause of anaemia in general practice is a diagnostic challenge. Currently, general practitioners individually determine which laboratory tests to request (routine work-up) in order to diagnose the underlying cause. However, an extensive work-up (consisting of 14 tests) increases the proportion of patients correctly diagnosed. This study investigates the cost-effectiveness of this extensive work-up. Methods A decision-analytic model was developed, incorporating all societal costs from the moment a patient presents to a general practitioner with symptoms suggestive of anaemia (aged ≥ 50 years), until the patient was (correctly) diagnosed and treated in primary care, or referred to (and diagnosed in) secondary care. Model inputs were derived from an online survey among general practitioners, expert estimates and published data. The primary outcome measure was expressed as incremental cost per additional patient diagnosed with the correct underlying cause of anaemia in either work-up. Results The probability of general practitioners diagnosing the correct underlying cause increased from 49.6% (95% CI: 44.8% to 54.5%) in the routine work-up to 56.0% (95% CI: 51.2% to 60.8%) in the extensive work-up (i.e. +6.4% [95% CI: -0.6% to 13.1%]). Costs are expected to increase slightly from €842/patient (95% CI: €704 to €994) to €845/patient (95% CI: €711 to €994), i.e. +€3/patient (95% CI: €-35 to €40) in the extensive work-up, indicating incremental costs of €43 per additional patient correctly diagnosed. Conclusions The extensive laboratory work-up is more effective for diagnosing the underlying cause of anaemia by general practitioners, at a minimal increase in costs. As accompanying benefits in terms of quality of life and reduced productivity losses could not be captured in this analysis, the extensive work-up is likely cost-effective.

First Dutch national guidelines--pharmacological care for detained opioid addicts.

PubMed

Arends, M T; De Haan, H A; Van 't Hoff, G I C M

2009-01-01

Heterogenic care of addicted detainees in the various prisons in The Netherlands triggered the National Agency of Correctional Institutions of the Ministry of Justice, to order the Dutch Institute for Health Care Improvement (CBO) to formulate the first national guideline titled 'Pharmacological care for detained addicts'. This article presents the content of this guideline, which mainly focuses on opioid-dependent addicts. In The Netherlands, approximately 50% of the detainees are problematic substance abusers, while again half of this group suffers from psychiatric co-morbidity. In addition, somatic co-morbidity, especially infectious diseases, is also common. Due to the moderate outcome seen with voluntary drug counselling regimes in prison, there is a policy shift to extent utilization of legally enforced approaches. Continuity of care is of great importance. In case of opioid addicts this, in general, means continuation of methadone maintenance treatment. Aftercare immediately after detention and optimalization of medical information transfer is crucial. This guideline aims to realize optimal and uniform management of addiction disorders in the Dutch prison system.

To frame is to explain: a deductive frame-analysis of Dutch and French climate change coverage during the annual UN Conferences of the Parties.

PubMed

Dirikx, Astrid; Gelders, Dave

2010-11-01

This study examines the way Dutch and French newspapers frame climate change during the annual United Nations Conferences of the Parties. The methods used in previous studies on the framing of climate change do not allow for general cross-national comparisons. We conduct a quantitative deductive framing analysis on 257 quality Dutch and French newspaper articles between 2001 and 2007. Both countries' newspapers seem to frame climate change through mainly the same lens. The majority of the articles make reference to the consequences of the (non-)pursuit of a certain course of action and of possible losses and gains (consequences frame). Additionally, many articles mention the need for urgent actions, refer to possible solutions and suggest that governments are responsible for and/or capable of alleviating climate change problems (responsibility frame). Finally, the conflict frame was found to be used less often than the aforementioned frames, but more regularly than the human interest frame.

Development of a Computer Adaptive Test for Depression Based on the Dutch-Flemish Version of the PROMIS Item Bank.

PubMed

Flens, Gerard; Smits, Niels; Terwee, Caroline B; Dekker, Joost; Huijbrechts, Irma; de Beurs, Edwin

2017-03-01

We developed a Dutch-Flemish version of the patient-reported outcomes measurement information system (PROMIS) adult V1.0 item bank for depression as input for computerized adaptive testing (CAT). As item bank, we used the Dutch-Flemish translation of the original PROMIS item bank (28 items) and additionally translated 28 U.S. depression items that failed to make the final U.S. item bank. Through psychometric analysis of a combined clinical and general population sample ( N = 2,010), 8 added items were removed. With the final item bank, we performed several CAT simulations to assess the efficiency of the extended (48 items) and the original item bank (28 items), using various stopping rules. Both item banks resulted in highly efficient and precise measurement of depression and showed high similarity between the CAT simulation scores and the full item bank scores. We discuss the implications of using each item bank and stopping rule for further CAT development.

GPs' interactional styles in consultations with Dutch and ethnic minority patients.

PubMed

Schouten, Barbara C; Meeuwesen, Ludwien; Harmsen, Hans A M

2009-12-01

The aim of this study was to examine interactional styles of general practitioners (GPs) in consultations with Dutch patients as compared to ethnic minority patients, from the perspective of level of mutual understanding between patient and GP. Data of 103 transcripts of video-registered medical interviews were analyzed to assess GPs' communication styles in terms of involvement, detachment, shared decision-making and patient-centeredness. Surveys were used to collect data on patients' characteristics and mutual understanding. Results show that overall, GPs communicate less adequately with ethnic minority patients than with Dutch patients; they involve them less in decision-making and check their understanding of what has been discussed less often. Intercultural consultations are thus markedly distinguishable from intracultural consultations by a lack of adequate communicative behavior by GPs. As every patient has a moral and legal right to make informed decisions, it is concluded that GPs should check more often whether their ethnic minority patients have understood what has been said during the medical consultation.

Higher perceived HRQoL in Moroccan children with asthma and their parents

PubMed Central

Schie, Monique Theodora Maria Veenstra-van; Coenen, Kelly; Koopman, Hendrik Maria; Versteegh, Florens Gerard Adriaan

2015-01-01

We explored the differences in the perceived HRQoL between children with asthma from Moroccan and Dutch descent and their parents. In total 33 children (aged 6-18 years) from Moroccan (16) and Dutch descent (17) and their parents participated. All children were currently under treatment in a general hospital in the Netherlands. Generic and asthma specific HRQoL were assessed (DUX-25, DISABKIDS, PAQLQ). Significant differences were found on the DUX-25 subscales physical, emotional and home functioning. Children and parents from Dutch descent reported a lower HRQoL. The findings of this study are contrary with previous research. Results can be explained by the individualistic-collectivistic dimension, socially desirability, language and the feeling of miscomprehension. If this explanation makes sense health care workers have to invest in a good relationship with especially immigrant children and their parents, so they will have enough confidence to talk more openly about their physical as well as their psycho-social complaints. PMID:26401212

Higher perceived HRQoL in Moroccan children with asthma and their parents.

PubMed

Veenstra-van Schie, Monique Theodora Maria; Coenen, Kelly; Koopman, Hendrik Maria; Versteegh, Florens Gerard Adriaan

2015-01-01

We explored the differences in the perceived HRQoL between children with asthma from Moroccan and Dutch descent and their parents. In total 33 children (aged 6-18 years) from Moroccan (16) and Dutch descent (17) and their parents participated. All children were currently under treatment in a general hospital in the Netherlands. Generic and asthma specific HRQoL were assessed (DUX-25, DISABKIDS, PAQLQ). Significant differences were found on the DUX-25 subscales physical, emotional and home functioning. Children and parents from Dutch descent reported a lower HRQoL. The findings of this study are contrary with previous research. Results can be explained by the individualistic-collectivistic dimension, socially desirability, language and the feeling of miscomprehension. If this explanation makes sense health care workers have to invest in a good relationship with especially immigrant children and their parents, so they will have enough confidence to talk more openly about their physical as well as their psycho-social complaints.

Dutch taboo norms.

PubMed

Roest, Sander A; Visser, Tessa A; Zeelenberg, René

2018-04-01

This article provides norms for general taboo, personal taboo, insult, valence, and arousal for 672 Dutch words, including 202 taboo words. Norms were collected using a 7-point Likert scale and based on ratings by psychology students from the Erasmus University Rotterdam in The Netherlands. The sample consisted of 87 psychology students (58 females, 29 males). We obtained high reliability based on split-half analyses. Our norms show high correlations with arousal and valence ratings collected by another Dutch word-norms study (Moors et al.,, Behavior Research Methods, 45, 169-177, 2013). Our results show that the previously found quadratic relation (i.e., U-shaped pattern) between valence and arousal also holds when only taboo words are considered. Additionally, words rated high on taboo tended to be rated low on valence, but some words related to sex rated high on both taboo and valence. Words that rated high on taboo rated high on insult, again with the exception of words related to sex many of which rated low on insult. Finally, words rated high on taboo and insult rated high on arousal. The Dutch Taboo Norms (DTN) database is a useful tool for researchers interested in the effects of taboo words on cognitive processing. The data associated with this paper can be accessed via the Open Science Framework ( https://osf.io/vk782/ ).

Top–Down Modulation on the Perception and Categorization of Identical Pitch Contours in Speech and Music

PubMed Central

Weidema, Joey L.; Roncaglia-Denissen, M. P.; Honing, Henkjan

2016-01-01

Whether pitch in language and music is governed by domain-specific or domain-general cognitive mechanisms is contentiously debated. The aim of the present study was to investigate whether mechanisms governing pitch contour perception operate differently when pitch information is interpreted as either speech or music. By modulating listening mode, this study aspired to demonstrate that pitch contour perception relies on domain-specific cognitive mechanisms, which are regulated by top–down influences from language and music. Three groups of participants (Mandarin speakers, Dutch speaking non-musicians, and Dutch musicians) were exposed to identical pitch contours, and tested on their ability to identify these contours in a language and musical context. Stimuli consisted of disyllabic words spoken in Mandarin, and melodic tonal analogs, embedded in a linguistic and melodic carrier phrase, respectively. Participants classified identical pitch contours as significantly different depending on listening mode. Top–down influences from language appeared to alter the perception of pitch contour in speakers of Mandarin. This was not the case for non-musician speakers of Dutch. Moreover, this effect was lacking in Dutch speaking musicians. The classification patterns of pitch contours in language and music seem to suggest that domain-specific categorization is modulated by top–down influences from language and music. PMID:27313552

Health care ethics and health law in the Dutch discussion on end-of-life decisions: a historical analysis of the dynamics and development of both disciplines.

PubMed

Kater, Loes; Houtepen, Rob; De Vries, Raymond; Widdershoven, Guy

2003-12-01

Over the past three or four decades, the concept of medical ethics has changed from a limited set of standards to a broad field of debate and research. We define medical ethics as an arena of moral issues in medicine, rather than a specific discipline. This paper examines how the disciplines of health care ethics and health care law have developed and operated within this arena. Our framework highlights the aspects of jurisdiction (Abbott) and the assignment of responsibilities (Gusfield). This theoretical framework prompted us to study definitions and changing responsibilities in order to describe the development and interaction of health care ethics and health law. We have opted for the context of the Dutch debate about end-of-life decisions as a relevant case study. We argue that the specific Dutch definition of euthanasia as 'intentionally taking the life of another person by a physician, upon that person's request' can be seen as the result of the complex jurisdictional process. This illustrates the more general conclusion that the Dutch debate on end-of-life decisions and the development of the two disciplines must be understood in terms of mutual interaction.

Height of South Asian children in the Netherlands aged 0-20 years: secular trends and comparisons with current Asian Indian, Dutch and WHO references.

PubMed

de Wilde, Jeroen A; van Dommelen, Paula; van Buuren, Stef; Middelkoop, Barend J C

2015-01-01

People from Asian populations are generally shorter than other ethnic groups. It is unknown if current universal height references are suitable for affluent South Asian children in the Netherlands. To develop height-for-age charts for contemporary South Asian children aged 0-20 years living in the Netherlands, to evaluate secular trends, and to compare the charts with current Asian Indian, Dutch and WHO references. A population-based study measured 3315 South Asian children aged 0-20 years between 2007-2010. Among this cohort, 6876 measurements were taken. Another 7388 measurements were taken of a historical cohort of 1078 children born between 1974-1976 (aged 0-18 years). An upward trend in height was observed for South Asian children living in the Netherlands between 1992-2010. The height-for-age charts of the South Asian historical cohort were similar to current Asian Indian charts. South Asian children in the Netherlands were shorter than their Dutch contemporaries at every age; and these differences increased further during adolescence. Compared to the WHO height-for-age references, there were considerable discrepancies in height, with curves intersecting twice. The discrepancies between the South Asian and Dutch and WHO height-for-age references indicate differences in growth patterns between the source populations.

Longitudinal Associations between Perceived Parent-Adolescent Attachment Relationship Quality and Generalized Anxiety Disorder Symptoms in Adolescence

ERIC Educational Resources Information Center

van Eijck, Fenna E. A. M.; Branje, Susan J. T.; Hale, William W., III; Meeus, Wim H. J.

2012-01-01

This longitudinal study examined the direction of effects between adolescents' generalized anxiety disorder (GAD) symptoms and perceived parent-adolescent attachment relationship quality, as well as the moderating role of gender and age. 1,313 Dutch adolescents (48.5% boys) from two age cohorts of early (n = 923, M[subscript age] = 12 at W1) and…

Lay beliefs about emotional problems and attitudes toward mental health care among parents and adolescents: Exploring the impact of immigration.

PubMed

Verhulp, Esmée E; Stevens, Gonneke W J M; Pels, Trees V M; Van Weert, Caroline M C; Vollebergh, Wilma A M

2017-04-01

Individuals' lay beliefs about mental health problems and attitudes toward mental health care are thought to be influenced by the cultural background of these individuals. In the current study, we investigated differences between immigrant Dutch and native Dutch parents and adolescents in lay beliefs about emotional problems and attitudes toward mental health care. Additionally, among immigrant Dutch parents, we examined the associations between acculturation orientations and lay beliefs about emotional problems as well as attitudes toward mental health care. In total, 349 pairs of parents and their adolescent children participated in our study (95 native Dutch, 85 Surinamese-Dutch, 87 Turkish-Dutch, 82 Moroccan-Dutch). A vignette was used to examine participants' lay beliefs. Immigrant Dutch and native Dutch parents differed in their lay beliefs and attitudes toward mental health care, whereas hardly any differences were revealed among their children. Turkish-Dutch and Moroccan-Dutch parents showed more passive and fewer active solutions to emotional problems compared to native Dutch parents. Additionally, Moroccan-Dutch and Surinamese-Dutch parents reported greater fear of mental health care compared to native Dutch parents. Furthermore, the results showed that immigrant Dutch parents who were more strongly oriented toward the Dutch culture reported less fear of mental health care. Our results showed clear differences in lay beliefs and attitudes toward mental health care between immigrant Dutch and native Dutch parents but not between their children. Substantial differences were also found between parents from different immigrant Dutch populations as well as within the population of immigrant Dutch parents. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Supervised exercises for adults with acute lateral ankle sprain: a randomised controlled trial

PubMed Central

van Rijn, Rogier M; van Os, Anton G; Kleinrensink, Gert-Jan; Bernsen, Roos MD; Verhaar, Jan AN; Koes, Bart W; Bierma-Zeinstra, Sita MA

2007-01-01

Background During the recovery period after acute ankle sprain, it is unclear whether conventional treatment should be supported by supervised exercise. Aim To evaluate the short- and long-term effectiveness of conventional treatment combined with supervised exercises compared with conventional treatment alone in patients with an acute ankle sprain. Design Randomised controlled clinical trial. Setting A total of 32 Dutch general practices and the hospital emergency department. Method Adults with an acute lateral ankle sprain consulting general practices or the hospital emergency department were allocated to either conventional treatment combined with supervised exercises or conventional treatment alone. Primary outcomes were subjective recovery (0–10 point scale) and the occurrence of a re-sprain. Measurements were carried out at intake, 4 weeks, 8 weeks, 3 months, and 1 year after injury. Data were analysed using intention-to-treat analyses. Results A total of 102 patients were enrolled and randomised to either conventional treatment alone or conventional treatment combined with supervised exercise. There was no significant difference between treatment groups concerning subjective recovery or occurrence of re-sprains after 3 months and 1-year of follow-up. Conclusion Conventional treatment combined with supervised exercises compared to conventional treatment alone during the first year after an acute lateral ankle sprain does not lead to differences in the occurrence of re-sprains or in subjective recovery. PMID:17925136

Ethnic identity, externalizing problem behaviour and the mediating role of self-esteem among Dutch, Turkish-Dutch and Moroccan-Dutch adolescents.

PubMed

Wissink, Inge B; Deković, Maja; Yağmur, Sengül; Stams, Geert Jan; de Haan, Mariëtte

2008-04-01

The present study examined whether self-esteem mediates the relationship between two aspects of ethnic identity (i.e. ethnic identity exploration and ethnic identity commitment-affirmation) and externalizing problem behaviour in Dutch, Turkish-Dutch and Moroccan-Dutch adolescents living in the Netherlands. A total number of 345 adolescents (115 Dutch, 115 Turkish-Dutch, 115 Moroccan-Dutch) with a mean age of 14.5 filled in questionnaires at school. Turkish-Dutch and Moroccan-Dutch adolescents reported higher levels of both aspects of ethnic identity than their native Dutch counterparts, but there were no ethnic differences in self-esteem and externalizing problem behaviour. Only in the Moroccan-Dutch group was support found for the mediational model: stronger ethnic identity commitment-affirmation was related to a higher level of self-esteem, which, in turn, was related to a lower level of externalizing problem behaviour.

First Dutch Consensus of Pain Quality Indicators for Pain Treatment Facilities.

PubMed

de Meij, Nelleke; van Grotel, Marloes; Patijn, Jacob; van der Weijden, Trudy; van Kleef, Maarten

2016-01-01

There is a general consensus about the need to define and improve the quality of pain treatment facilities. Although guidelines and recommendations to improve the quality of pain practice management have been launched, provision of appropriate pain treatment is inconsistent and the quality of facilities varies widely. The aim of the study was to develop an expert-agreed list of quality indicators applicable to pain treatment facilities. The list was also intended to be used as the basis for a set of criteria for registered status of pain treatment facilities. The University Pain Center Maastricht at the Department of Anesthesiology and Pain Management of the Maastricht University Medical Center conducted a 3-round Delphi study in collaboration with the Board of the Pain Section of the Dutch Society of Anesthesiologists (NVA). Twenty-five quality indicators were selected as relevant to 2 types of pain treatment facilities, pain clinics and pain centers. The final expert-agreed list consisted of 22 quality indicators covering 7 quality domains: supervision, availability of care, staffing level and patient load, quality policy, multidisciplinarity, regionalization, and research and education. This set of quality indicators may facilitate organizational evaluation and improve insight into service quality from the perspectives of patients, pain specialists, and other healthcare professionals. Recommendations for improvements to the current set of quality indicators are made. In 2014 the process of registering pain treatment facilities in the Netherlands started; facilities can register as a pain clinic or pain center. © 2015 World Institute of Pain.

Euthanasia or physician-assisted suicide? A survey from the Netherlands.

PubMed

Kouwenhoven, Pauline S C; van Thiel, Ghislaine J M W; Raijmakers, Natasja J H; Rietjens, Judith A C; van der Heide, Agnes; van Delden, Johannes J M

2014-03-01

Legalizing euthanasia or physician-assisted suicide (PAS) is a current topic of debate in many countries. The Netherlands is the only country where legislation covers both. To study physicians' experiences and attitudes concerning the choice between euthanasia and PAS. A questionnaire including vignettes was sent to a random sample of 1955 Dutch general practitioners, elderly care physicians and medical specialists. In total, 793 physicians (41%) participated. There was no clear preference for euthanasia (36%) or PAS (34%). Two thirds of physicians thought that PAS underlines the autonomy and responsibility of the patient and considered this a reason to choose PAS. Reasons for not choosing PAS were expected practical problems. A minority (22%) discussed the possibility of PAS with their patient in case of a request for assistance in dying. Patients receiving PAS more often experienced psychosocial suffering in comparison with patients receiving euthanasia. In vignettes of patients with a request for assistance in dying due to psychosocial suffering, physicians agreed more often with the performance of PAS than with euthanasia. Dutch physicians perceive a difference between euthanasia and PAS. Although they believe PAS underlines patient autonomy and responsibility, the option of PAS is rarely discussed with the patient. The more psychosocial in nature the patient's suffering, the more physicians choose PAS. In these cases, PAS seems to fulfil physicians' preferences to emphasize patient autonomy and responsibility. Expected technical problems and unfamiliarity with PAS also play a role. Paradoxically, the choice for PAS is predominantly a physician's one.

Knowledge, perceptions and media use of the Dutch general public and healthcare workers regarding Ebola, 2014.

PubMed

Schol, Lianne G C; Mollers, Madelief; Swaan, Corien M; Beaujean, Desirée J M A; Wong, Albert; Timen, Aura

2018-01-08

The Ebola outbreak in West-Africa triggered risk communication activities to promote adequate preventive behaviour in the Netherlands. Our study investigated the level of knowledge, perceptions, and media use regarding Ebola. In December 2014, an online questionnaire was administered to the Dutch population (n = 526) and Health Care Workers (HCW) (n = 760). The mean knowledge score (range 0-15) of HCW (m = 13.3;SD = 1.4) was significantly higher than the general public (m = 10.8;SD = 2.0). No significant difference was found in perceived severity and susceptibility. Perceived fear of the general public (m = 2.5; SD = 0.8) was significantly higher than among HCW (m = 2.4; SD = 0.7). Respondents primarily used television to obtain information. While Ebola was perceived severe, it did not lead to excessive fear or perceived susceptibility for developing the disease. Nonetheless, our research showed that knowledge with respect to human-to-human transmission is low, while this is crucial to complying with preventive measures. Our study reveals priorities for improving risk communication.

Attitudes of patients with bipolar disorder toward the Life Chart Methodology: a phenomenological study.

PubMed

van Bendegem, Mischa A; van den Heuvel, Silvio C G H; Kramer, Laura J; Goossens, Peter J J

2014-01-01

The Dutch guideline for bipolar disorder (BD) recommends the use of the Life Chart Methodology (LCM) to help patients to monitor fluctuating mood patterns. But in practice patients show ambivalent attitudes toward this instrument. To describe attitudes and motivations of patients with BD for (non-)using the LCM. A phenomenological study with unstructured in-depth interviews of 14 patients with BD. Patient narratives were audio-taped, transcribed verbatim, analyzed, and coded inductively. The results show that despite variability in perceptions and willingness to work with the LCM, the general attitude toward this instrument was a recognized value for using the LCM. However, the emotional impact of daily mood charting was experienced as a substantial burden, particularly during the early stages of diagnosis. The impact of the diagnosis of BD needs to be taken in account when introducing the instrument for the first time to a patient. © The Author(s) 2014.

[Addicted colleagues: a blind spot amongst physicians?].

PubMed

Rode, Hans; de Rond, Marlies; Dam, Ingrid

2013-01-01

Physician impairment due to substance abuse or dependence is at least as prevalent as amongst non-physicians and is a real challenge. Not only for the impaired physicians themselves, but also for their colleagues, family members and patients. A 68-year-old physician describes her experiences of being an alcoholic as well as a patient with concomitant psychiatric disorders, including the hurdles she had to get over to deal with her disease and remain abstinent. Although colleagues knew what was going on, some of them took no action. The initial treatment by her general practitioner proved compromised. Addressing addiction amongst fellow physicians can be challenging and for this reason the Royal Dutch Medical Association (KNMG) has started the ABS Programme. On prompt and adequate intervention, treatment in specialised facilities has proved to be highly and durably effective. Addicted physicians who have been successfully treated should be monitored and supported, thus enabling their safe return to practice.

Iron and manganese removal: Recent advances in modelling treatment efficiency by rapid sand filtration.

PubMed

Vries, D; Bertelkamp, C; Schoonenberg Kegel, F; Hofs, B; Dusseldorp, J; Bruins, J H; de Vet, W; van den Akker, B

2017-02-01

A model has been developed that takes into account the main characteristics of (submerged) rapid filtration: the water quality parameters of the influent water, notably pH, iron(II) and manganese(II) concentrations, homogeneous oxidation in the supernatant layer, surface sorption and heterogeneous oxidation kinetics in the filter, and filter media adsorption characteristics. Simplifying assumptions are made to enable validation in practice, while maintaining the main mechanisms involved in iron(II) and manganese(II) removal. Adsorption isotherm data collected from different Dutch treatment sites show that Fe(II)/Mn(II) adsorption may vary substantially between them, but generally increases with higher pH. The model is sensitive to (experimentally) determined adsorption parameters and the heterogeneous oxidation rate. Model results coincide with experimental values when the heterogeneous rate constants are calibrated. Copyright © 2016 Elsevier Ltd. All rights reserved.

[Revision of the Dutch College of General Practitioners practice guideline 'Acute sore throat'].

PubMed

de Jongh, Egbert; Opstelten, Wim

2015-01-01

The aim of a diagnostic work-up in patients with acute sore throat is to exclude serious causes of tonsillitis and, in cases of a pharyngotonsillitis, to assess the degree of illness and the risk of complications. A diagnostic work-up aimed at the distinction between a viral or bacterial cause of pharyngotonsillitis does not determine initial treatment policy. Pharyngotonsillitis usually has a benign natural course; patient information and analgesia are usually sufficient treatment. Complications of an infection with group A streptococci are rare; diagnostic work-up for this bacterial cause is, therefore, not recommended. Antibiotics are only useful in cases of severe pharyngotonsillitis, increased risk of complications or a peritonsillar infiltration. The antibiotic of choice is a narrow spectrum penicillin; however, amoxicillin/clavulanate is indicated in patients with peritonsillar infiltration. If there is discrepancy in adults between the severity of symptoms and findings on physical examination, the possibility of epiglottitis should be considered.

Cross-cultural differences in parental beliefs about infant motor development: A quantitative and qualitative report of middle-class Israeli and Dutch parents.

PubMed

van Schaik, Saskia D M; Oudgenoeg-Paz, Ora; Atun-Einy, Osnat

2018-06-01

The present study explored cultural differences in parental beliefs about motor development across 2 Western cultures: Israel and the Netherlands. Can 2 cultural models be distinguished regarding infant motor development in Israel and the Netherlands or are parental beliefs about motor development similar across these cultures? Using a questionnaire containing closed and open questions, beliefs of 206 Israeli and 198 Dutch parents of first-born children between 2 and 7 months old were analyzed. Based on both quantitative and qualitative analyses, distinct cultural models were found showing that the Dutch attributed a bigger role to maturation and children's own pace than to stimulation. The Israeli parents found stimulation of motor development important and discussed active stimulation more elaborately. When discussing supportive activities, the Israeli parents mentioned specific activities, whereas the Dutch parents used more general, vague expressions about support. Moreover, the Israeli parents discussed the need for expert advice and advice from relatives and other parents more than the Dutch parents, who rely on their own observations, books, or websites more often. The cultural background was the strongest predictor of parental beliefs about motor development. Parental education, age, children's birth weight, gender, and having seen a physical therapist showed weaker relations with parental beliefs. Altogether, 2 distinguishing cultural models can be found, raising the question whether infant motor development can be approached similarly across Western cultures. Besides this implication for science, practitioners should also be aware of differences between cultures and between parents. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

The psychometric properties of the 'Hospital Survey on Patient Safety Culture' in Dutch hospitals.

PubMed

Smits, Marleen; Christiaans-Dingelhoff, Ingrid; Wagner, Cordula; Wal, Gerrit van der; Groenewegen, Peter P

2008-11-07

In many different countries the Hospital Survey on Patient Safety Culture (HSOPS) is used to assess the safety culture in hospitals. Accordingly, the questionnaire has been translated into Dutch for application in the Netherlands. The aim of this study was to examine the underlying dimensions and psychometric properties of the questionnaire in Dutch hospital settings, and to compare these results with the original questionnaire used in USA hospital settings. The HSOPS was completed by 583 staff members of four general hospitals, three teaching hospitals, and one university hospital in the Netherlands. Confirmatory factor analyses were performed to examine the applicability of the factor structure of the American questionnaire to the Dutch data. Explorative factor analyses were performed to examine whether another composition of items and factors would fit the data better. Supplementary psychometric analyses were performed, including internal consistency and construct validity. The confirmatory factor analyses were based on the 12-factor model of the original questionnaire and resulted in a few low reliability scores. 11 Factors were drawn with explorative factor analyses, with acceptable reliability scores and a good construct validity. Two items were removed from the questionnaire. The composition of the factors was very similar to that of the original questionnaire. A few items moved to another factor and two factors turned out to combine into a six-item dimension. All other dimensions consisted of two to five items. The Dutch translation of the HSOPS consists of 11 factors with acceptable reliability and good construct validity. and is similar to the original HSOPS factor structure.

Ethnic differences in the mother-son relationship of incarcerated and non-incarcerated male adolescents in the Netherlands.

PubMed

Veen, Violaine C; Stevens, Gonneke Wjm; Doreleijers, Theo Ah; Deković, Maja; Pels, Trees; Vollebergh, Wilma Am

2011-06-29

In the Netherlands, youths of Moroccan origin account for a disproportionately large percentage of the population in juvenile justice institutions. Previous research showed that Moroccan adolescents in pre-trial arrest are characterized by less serious offending behavior (i.e., primarily property-based) and lower levels of mental health problems than native Dutch adolescents in pre-trial arrest. To date, little is known about the parent-child relationship of these adolescents. This study examines the mother-son relationships of Moroccan and native Dutch delinquent adolescents and their association with adolescent delinquency. In the present study, differences in the mother-son relationship characteristics between families of incarcerated (N = 129) and non-incarcerated (N = 324) adolescents were examined, and it was analyzed if these differences between incarcerated and non-incarcerated adolescents were the same for Moroccans and native Dutch. Data collection for the incarcerated sample took place from 2006 to 2008. Comparison data were used of interviews conducted with mothers originating from former larger studies in the general Dutch population. Latent Class Analysis was performed in order to identify types of mother-son relationship. Logistic regression analyses were used to identify the relationships between mother-son relationship types, incarceration and ethnicity. A three class model of mother-son relationship types was found: a low-conflict mother-son relationship type, a high-conflict mother-son relationship type, and a neglectful mother-son relationship type. Compared to the native Dutch adolescents, Moroccans (both in the incarcerated and non-incarcerated population) more often showed a neglectful mother-son relationship type. For Moroccans, no differences in mother-son relationship types were found between the incarcerated and non-incarcerated adolescents, whereas considerable differences occurred between the native Dutch incarcerated and non-incarcerated adolescents. Our findings indicate that mother-son relationship types of incarcerated Moroccan adolescents and non-incarcerated Moroccan adolescents are rather comparable. These findings are in line with previous studies which revealed the less problematic profile of Moroccan adolescents in pre-trial arrest in the Netherlands compared to native Dutch adolescents in pre-trial arrest.

Ethnic differences in the mother-son relationship of incarcerated and non-incarcerated male adolescents in the Netherlands

PubMed Central

2011-01-01

Background In the Netherlands, youths of Moroccan origin account for a disproportionately large percentage of the population in juvenile justice institutions. Previous research showed that Moroccan adolescents in pre-trial arrest are characterized by less serious offending behavior (i.e., primarily property-based) and lower levels of mental health problems than native Dutch adolescents in pre-trial arrest. To date, little is known about the parent-child relationship of these adolescents. This study examines the mother-son relationships of Moroccan and native Dutch delinquent adolescents and their association with adolescent delinquency. Methods In the present study, differences in the mother-son relationship characteristics between families of incarcerated (N = 129) and non-incarcerated (N = 324) adolescents were examined, and it was analyzed if these differences between incarcerated and non-incarcerated adolescents were the same for Moroccans and native Dutch. Data collection for the incarcerated sample took place from 2006 to 2008. Comparison data were used of interviews conducted with mothers originating from former larger studies in the general Dutch population. Latent Class Analysis was performed in order to identify types of mother-son relationship. Logistic regression analyses were used to identify the relationships between mother-son relationship types, incarceration and ethnicity. Results A three class model of mother-son relationship types was found: a low-conflict mother-son relationship type, a high-conflict mother-son relationship type, and a neglectful mother-son relationship type. Compared to the native Dutch adolescents, Moroccans (both in the incarcerated and non-incarcerated population) more often showed a neglectful mother-son relationship type. For Moroccans, no differences in mother-son relationship types were found between the incarcerated and non-incarcerated adolescents, whereas considerable differences occurred between the native Dutch incarcerated and non-incarcerated adolescents. Conclusions Our findings indicate that mother-son relationship types of incarcerated Moroccan adolescents and non-incarcerated Moroccan adolescents are rather comparable. These findings are in line with previous studies which revealed the less problematic profile of Moroccan adolescents in pre-trial arrest in the Netherlands compared to native Dutch adolescents in pre-trial arrest. PMID:21714907

Defensive medicine among neurosurgeons in the Netherlands: a national survey.

PubMed

Yan, Sandra C; Hulsbergen, Alexander F C; Muskens, Ivo S; van Dam, Marjel; Gormley, William B; Broekman, Marike L D; Smith, Timothy R

2017-12-01

In defensive medicine, practice is motivated by legal rather than medical reasons. Previous studies have analyzed the correlation between perceived medico-legal risk and defensive behavior among neurosurgeons in the United States, Canada, and South Africa, but not yet in Europe. The aim of this study is to explore perceived liability burdens and self-reported defensive behaviors among neurosurgeons in the Netherlands and compare their practices with their non-European counterparts. A survey was sent to 136 neurosurgeons. The survey included questions from several domains: surgeon characteristics, patient demographics, type of practice, surgeon liability profile, policy coverage, defensive practices, and perception of the liability environment. Survey responses were analyzed and summarized. Forty-five neurosurgeons filled out the questionnaire (response rate of 33.1%). Almost half (n = 20) reported paying less than 5% of their income to annual malpractice premiums. Nearly all respondents view their insurance premiums as a minor or no burden (n = 42) and are confident that in their coverage is sufficient (n = 41). Most neurosurgeons (n = 38) do not see patients as "potential lawsuits". Relative to their American peers, Dutch neurosurgeons view their insurance premiums as less burdensome, their patients as a smaller legal threat, and their practice as less risky in general. They are sued less often and engage in fewer defensive behaviors than their non-European counterparts. The medico-legal climate in the Netherlands may contribute to this difference.

Palliative Sedation: An Analysis of International Guidelines and Position Statements.

PubMed

Gurschick, Lauren; Mayer, Deborah K; Hanson, Laura C

2015-09-01

To describe the suggested clinical practice of palliative sedation as it is presented in the literature and discuss available guidelines for its use. CINAHL, PubMed, and Web of Science were searched for publications since 1997 for recommended guidelines and position statements on palliative sedation as well as data on its provision. Keywords included palliative sedation, terminal sedation, guidelines, United States, and end of life. Inclusion criteria were palliative sedation policies, frameworks, guidelines, or discussion of its practice, general or oncology patient population, performance of the intervention in an inpatient unit, for humans, and in English. Exclusion criteria were palliative sedation in children, acute illness, procedural, or burns, and predominantly ethical discussions. Guidelines were published by American College of Physicians-American Society of Internal Medicine (2000), Hospice and Palliative Nurses Association (2003), American Academy of Hospice and Palliative Medicine (2006), American Medical Association (2008), Royal Dutch Medical Association (2009), European Association for Palliative Care (2009), National Hospice and Palliative Care Organization (2010), and National Comprehensive Cancer Network (2012). Variances throughout guidelines include definitions of the practice, indications for its use, continuation of life-prolonging therapies, medications used, and timing/prognosis. The development and implementation of institutional-based guidelines with clear stance on the discussed variances is necessary for consistency in practice. Data on provision of palliative sedation after implementation of guidelines needs to be collected and disseminated for a better understanding of the current practice in the United States. © The Author(s) 2014.

Thermally adapted design strategy of colonial houses in Surabaya

NASA Astrophysics Data System (ADS)

Antaryama, I. G. N.; Ekasiwi, S. N. N.; Mappajaya, A.; Ulum, M. S.

2018-03-01

Colonial buildings, including houses, have been considered as a representation of climate-responsive architecture. The design was thought to be a hybrid model of Dutch and tropical architecture. It was created by way of reinventing tropical and Dutch architecture design principles, and expressed in a new form, i.e. neither resembling Dutch nor tropical building. Aside from this new image, colonial house does show good climatic responses. Previous researches on colonial house generally focus on qualitative assessment of climate performance of the building. Yet this kind of study tends to concentrate on building elements, e.g. wall, window, etc. The present study is designed to give more complete picture of architecture design strategy of the house by exploring and analysing thermal performance of colonial buildings and their related architecture design strategies. Field measurements are conducted during the dry season in several colonial building in Surabaya. Air temperature and humidity are both taken, representing internal and external thermal conditions of the building. These data are then evaluated to determine thermal performance of the house. Finally, various design strategies are examined in order to reveal their significant contributions to its thermal performance. Results of the study in Surabaya confirm findings of the previous researches that are conducted in other locations, which stated that thermal performance of the house is generally good. Passive design strategies such as mass effect and ventilation play an important role in determining performance of the building.

Who tests whom? A comprehensive overview of Chlamydia trachomatis test practices in a Dutch region among different STI care providers for urogenital, anorectal and oropharyngeal sites in young people: a cross-sectional study.

PubMed

den Heijer, Casper D J; van Liere, G A F S; Hoebe, C J P A; van Bergen, J E A M; Cals, J W L; Stals, F S; Dukers-Muijrers, N H T M

2016-05-01

To evaluate and compare Chlamydia trachomatis (CT) diagnostic test practices of different sexually transmitted infection (STI) care providers in 16-29 year olds from one defined geographic Dutch region (280,000 inhabitants). Both number and proportion of positive CT tests (ie, test positivity) were assessed, and factors associated with these outcomes. Data on laboratory testing and diagnosis of urogenital, anorectal and oropharyngeal CT between 2006 and 2010 were retrieved from general practitioners (GPs), gynaecologists, an STI clinic and a population-based chlamydia screening programme. Multivariable regression analyses explored associations between age, sex, test year, socio-economic status (SES) and STI care provider and the outcomes being the number of tests and test positivity. Overall, 22,831 tests were performed (1868 positive; 8.2%). Extragenital (ie, anorectal and oropharyngeal) tests accounted for 4% of all tests (7.5% positive) and were almost exclusively (99%) performed by the STI clinic. STI clinics tested most men (37.2% of all tested men), whereas GPs tested most women (29.9% of all tested women). GPs and STI clinics accounted for 73.3% (1326/1808) of urogenital CT diagnoses. In women, the number of tests increased with age, whereas test positivity decreased for all STI care providers. Lower SES was associated with higher test positivity in GP and gynaecology patients. STI clinics performed most CT tests in men, whereas GPs performed most CT tests in women. GPs and STI clinics accounted for the majority of positives. Extragenital CT testing is rarely performed outside the STI clinic and needs to be promoted, especially in men who have sex with men. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Acceptance and barriers pertaining to a general practice decision support system for multiple clinical conditions: A mixed methods evaluation.

PubMed

Arts, Derk L; Medlock, Stephanie K; van Weert, Henk C P M; Wyatt, Jeremy C; Abu-Hanna, Ameen

2018-01-01

Many studies have investigated the use of clinical decision support systems as a means to improve care, but have thus far failed to show significant effects on patient-related outcomes. We developed a clinical decision support system that attempted to address issues that were identified in these studies. The system was implemented in Dutch general practice and was designed to be both unobtrusive and to respond in real time. Despite our efforts, usage of the system was low. In the current study we perform a mixed methods evaluation to identify remediable barriers which led to disappointing usage rates for our system. A mixed methods evaluation employing an online questionnaire and focus group. The focus group was organized to clarify free text comments and receive more detailed feedback from general practitioners. Topics consisted of items based on results from the survey and additional open questions. The response rate for the questionnaire was 94%. Results from the questionnaire and focus group can be summarized as follows: The system was perceived as interruptive, despite its design. Participants felt that there were too many recommendations and that the relevance of the recommendations varied. Demographic based recommendations (e.g. age) were often irrelevant, while specific risk-based recommendations (e.g. diagnosis) were more relevant. The other main barrier to use was lack of time during the patient visit. These results are likely to be useful to other researchers who are attempting to address the problems of interruption and alert fatigue in decision support.

Advance directives for euthanasia in dementia: do law-based opportunities lead to more euthanasia?

PubMed

de Boer, Marike E; Dröes, Rose-Marie; Jonker, Cees; Eefsting, Jan A; Hertogh, Cees M P M

2010-12-01

To obtain insight into current practices regarding compliance with advance directives for euthanasia (ADEs) in cases of incompetent patients with dementia in Dutch nursing homes, in light of the legal possibility offered by the new euthanasia law to perform euthanasia in these cases. A written questionnaire was completed by 434 elderly care physicians (ECPs). Over the years 2005-2006, many ECPs took care of patients with dementia and an ADE, actual life termination of these patients took place very rarely and never in incompetent patients. ECPs reported practical difficulties in determining the 'unbearableness' of the suffering and choosing the right moment of carrying out the ADE. Although the enactment of the Dutch euthanasia law in theory provided a window of opportunity for euthanasia in incompetent patients with dementia and an ADE, it has not led to obvious changes in compliance with ADEs of this patient group in practice. Crucial in the reticent attitudes of ECPs appears to be the impossibility of patient-physician communication. This raises questions on the feasibility of the law on this point. In our opinion, the role of ADEs in end-of-life care of patients with advanced dementia in the Netherlands deserves serious reconsideration. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Guideline on anterior cruciate ligament injury

PubMed Central

2012-01-01

The Dutch Orthopaedic Association has a long tradition of development of practical clinical guidelines. Here we present the recommendations from the multidisciplinary clinical guideline working group for anterior cruciate ligament injury. The following 8 clinical questions were formulated by a steering group of the Dutch Orthopaedic Association. What is the role of physical examination and additional diagnostic tools? Which patient-related outcome measures should be used? What are the relevant parameters that influence the indication for an ACL reconstruction? Which findings or complaints are predictive of a bad result of an ACL injury treatment? What is the optimal timing for surgery for an ACL injury? What is the outcome of different conservative treatment modalities? Which kind of graft gives the best result in an ACL reconstruction? What is the optimal postoperative treatment concerning rehabilitation, resumption of sports, and physiotherapy? These 8 questions were answered and recommendations were made, using the “Appraisal of Guidelines for Research and Evaluation” instrument. This instrument seeks to improve the quality and effectiveness of clinical practical guidelines by establishing a shared framework to develop, report, and assess. The steering group has also developed 7 internal indicators to aid in measuring and enhancing the quality of the treatment of patients with an ACL injury, for use in a hospital or practice. PMID:22900914

Use of Antipsychotic Drugs in Individuals with Intellectual Disability (ID) in the Netherlands: Prevalence and Reasons for Prescription

ERIC Educational Resources Information Center

de Kuijper, G.; Hoekstra, P.; Visser, F.; Scholte, F. A.; Penning, C.; Evenhuis, H.

2010-01-01

Background: We investigated antipsychotic drug prescription practice of Dutch ID physicians, studying prevalence of antipsychotic drug use, reasons for prescription and the relationship between these reasons and patient characteristics. Methods: A cross-sectional study of medical and pharmaceutical records in a population living in residential…

Revisiting Differential Grading Standards Anno 2014: An Exploration in Dutch Higher Education

ERIC Educational Resources Information Center

Godor, Brian P.

2017-01-01

The role that teachers have in assessing student coursework is crucial. Their "determination" that a particular piece of student's work is "acceptable" has many serious consequences. With a lack of debate surrounding assessment, practices may become mired in conventions and disconnected from issues such as knowledge, power and…

The Effect of Teacher Psychological and School Organizational and Leadership Factors on Teachers' Professional Learning in Dutch Schools

ERIC Educational Resources Information Center

Geijsel, Femke P.; Sleegers, Peter J. C.; Stoel, Reinoud D.; Kruger, Meta L.

2009-01-01

In this study we examined the relative importance of teachers' psychological states, school organizational conditions (teacher collaboration and participative decision making), and the leadership practices (vision, individual consideration, and intellectual stimulation) of principals at their schools in explaining variation in teachers'…

Auditing Management Practices in Schools: Recurring Communication Problems and Solutions

ERIC Educational Resources Information Center

Zwijze-Koning, Karen H.; de Jong, Menno D. T.

2009-01-01

Purpose: Over the past ten years, most Dutch high schools have been confronted with mergers, curriculum reforms, and managerial changes. As a result, the pressure on the schools' communication systems has increased and several problems have emerged. This paper aims to examine recurring clusters of communication problems in high schools.…

Implementing Human Resources Management (HRM) within Dutch VET Institutions: Examining the Fostering and Hindering Factors

ERIC Educational Resources Information Center

Runhaar, Piety; Sanders, Karin

2013-01-01

Vocational Education and Training (VET) Institutions face serious challenges, like the implementation of competence-based education and upcoming teacher shortages, which urge them to implement Human Resources Management policy and practices (HRM). The implementation of HRM, however, often stagnates. This paper describes a qualitative study--in…

The Berkeley Puppet Interview: A Screening Instrument for Measuring Psychopathology in Young Children

ERIC Educational Resources Information Center

Stone, Lisanne L.; van Daal, Carlijn; van der Maten, Marloes; Engels, Rutger C. M. E.; Janssens, Jan M. A. M.; Otten, Roy

2014-01-01

Background: While child self-reports of psychopathology are increasingly accepted, little standardized instruments are utilized for these practices. The Berkeley Puppet Interview (BPI) is an age-appropriate instrument for self-reports of problem behavior by young children. Objective: Psychometric properties of the Dutch version of the BPI will be…

Ethical and Organisational Tensions for Work-Based Learners

ERIC Educational Resources Information Center

Moore, Lesley J.

2007-01-01

Purpose: This paper aims to focus on examples of the perceived tensions of the healthcare work-based learners as they experienced paradigm shifts in both practice and education. Design/methodology/approach: Examples are drawn from a qualitative study to examine work-based learning (WBL) workshops in a Dutch healthcare setting, and a developmental…

Vaginal high-risk human papillomavirus infection in a cross-sectional study among women of six different ethnicities in Amsterdam, the Netherlands: the HELIUS study.

PubMed

Alberts, C J; Vos, R A; Borgdorff, H; Vermeulen, W; van Bergen, J; Bruisten, S M; Geerlings, S E; Snijder, M B; van Houdt, R; Morré, S A; de Vries, H J C; van de Wijgert, J H H M; Prins, M; Schim van der Loeff, M F

2016-12-01

In the Netherlands the incidence of cervical cancer is higher among ethnic minority populations compared with the general Dutch population. We investigated the prevalence of, and risk factors associated with, vaginal high-risk human papillomavirus (hrHPV) infection in women of six different ethnicities living in Amsterdam. For this cross-sectional study we selected women aged 18-34 years old of six ethnicities from the large-scale multiethnic HEalthy LIfe in an Urban Setting study. Self-collected vaginal swabs were tested for HPV DNA and genotyped using a highly sensitive PCR and reverse line blot assay (short PCR fragment (SPF)10-PCR DNA enzyme immunoassay/LiPA25-system version-1, delft diagnostic laboratory (DDL)). Participants completed a questionnaire regarding demographics and sexual behaviour. Logistic regression using generalised estimating equations was used to assess risk factors of hrHPV, and to investigate whether prevalence of hrHPV differed among ethnicities. The study population consisted of 592 women with a median age of 27 (IQR: 23-31) years. Dutch and African Surinamese women reported the highest sexual risk behaviour. HrHPV prevalence was highest in the Dutch (40%) followed by the African Surinamese (32%), Turkish (29%), Ghanaian (26%), Moroccan (26%) and South-Asian Surinamese (18%). When correcting for sexual risk behaviour, the odds to be hrHPV-positive were similar for all non-Dutch groups when compared with that of the Dutch group. We found an overall higher hrHPV prevalence and higher sexual risk behaviour in the native Dutch population. Further research is needed to unravel the complex problem concerning cervical cancer disparities, such as differences in participation in the cervical cancer screening programme, or differences in clearance and persistence of hrHPV. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Health related quality of life in Dutch infants, toddlers, and young children.

PubMed

Schepers, S A; van Oers, H A; Maurice-Stam, H; Huisman, J; Verhaak, C M; Grootenhuis, M A; Haverman, L

2017-04-24

The purpose of this study is to provide Dutch normative data and to assess internal consistency and known-groups validity for the TNO AZL Preschool Children Quality of Life (TAPQOL) and the acute version of the generic Pediatric Quality of Life Inventory (PedsQL 4.0) in Dutch young children aged 0-7 years. Participants were selected from a panel of a large Dutch market research agency. A sample of 794 parents (response rate 61%, 39% fathers) of children (53% boys) from the general Dutch population, completed an electronic version of the TAPQOL (N = 227 infants aged 0-1 years) or PedsQL 4.0 (N = 293 toddlers aged 2-4 years and N = 274 young children aged 5-7 years). Except for the 'stomach' scale (α = .39), the TAPQOL showed acceptable to excellent internal consistency (α = .60-.88). The PedsQL 4.0 showed acceptable to excellent reliability in children aged 2-4 years (α = .60-.88) and in children aged 5-7 years (α = .76-.90). Children with a chronic health condition had lower scores than healthy children on 3 out of 12 domains of the TAPQOL (p = .001-.013) and on 2 out of 6 domains of the PedsQL 4.0 for children aged 2-4 years (p = .016-.04). The PedsQL 4.0 differentiated on all domains (p < .05) between children aged 5-7 years with and without a chronic health condition. In Dutch children aged 0-7 years old, HRQoL can be relialy measured with the TAPQOL and the PedsQL 4.0. However, it remains unclear whether these HRQoL instruments can distinguish between healthy children and children with a chronic health condition under the age of 5.

Updated folate data in the Dutch Food Composition Database and implications for intake estimates

PubMed Central

Westenbrink, Susanne; Jansen-van der Vliet, Martine; van Rossum, Caroline

2012-01-01

Background and objective Nutrient values are influenced by the analytical method used. Food folate measured by high performance liquid chromatography (HPLC) or by microbiological assay (MA) yield different results, with in general higher results from MA than from HPLC. This leads to the question of how to deal with different analytical methods in compiling standardised and internationally comparable food composition databases? A recent inventory on folate in European food composition databases indicated that currently MA is more widely used than HPCL. Since older Dutch values are produced by HPLC and newer values by MA, analytical methods and procedures for compiling folate data in the Dutch Food Composition Database (NEVO) were reconsidered and folate values were updated. This article describes the impact of this revision of folate values in the NEVO database as well as the expected impact on the folate intake assessment in the Dutch National Food Consumption Survey (DNFCS). Design The folate values were revised by replacing HPLC with MA values from recent Dutch analyses. Previously MA folate values taken from foreign food composition tables had been recalculated to the HPLC level, assuming a 27% lower value from HPLC analyses. These recalculated values were replaced by the original MA values. Dutch HPLC and MA values were compared to each other. Folate intake was assessed for a subgroup within the DNFCS to estimate the impact of the update. Results In the updated NEVO database nearly all folate values were produced by MA or derived from MA values which resulted in an average increase of 24%. The median habitual folate intake in young children was increased by 11–15% using the updated folate values. Conclusion The current approach for folate in NEVO resulted in more transparency in data production and documentation and higher comparability among European databases. Results of food consumption surveys are expected to show higher folate intakes when using the updated values. PMID:22481900

Don't call me a leader, but I am one: The Dutch mayor and the tradition of bridging-and-bonding leadership in consensus democracies.

PubMed

Karsten, Niels; Hendriks, Frank

2017-04-01

In some democratic contexts, there is a strong aversion to the directive, individualistic and masculine expressions of leadership that have come to dominate the study of political leadership. Such leadership is antithetical to consensus democracies in parts of continental Europe, where the antipathy to leadership has linguistic, institutional as well as cultural dimensions. Political-administrative and socio-cultural contexts in these countries provide little room for heroic expressions of leadership. Consequently, alternative forms of leadership and associated vocabularies have developed that carry profound practical relevance but that have remained underexplored. Based on an in-depth mixed-methods study, this article presents the Dutch mayoralty as an insightful and exemplary case of what can be called 'bridging-and-bonding leadership'; it provides a clear illustration of how understandings of democratic leadership can deviate from the dominant paradigm and of how leading in a consensus context brings about unique practical challenges for office holders. The analysis shows that the important leadership task of democratic guardianship that is performed by Dutch mayors is in danger of being overlooked by scholars of political leadership, as are consensus-oriented leadership roles in other parts of the world. For that reason, a recalibration of the leadership concept is needed, developing an increased theoretical sensitivity towards the non-decisive and process-oriented aspects of the leadership phenomenon. This article specifies how the future study of leadership, as a part of the change that is advocated, can benefit from adopting additional languages of leadership.

Don’t call me a leader, but I am one: The Dutch mayor and the tradition of bridging-and-bonding leadership in consensus democracies

PubMed Central

Hendriks, Frank

2016-01-01

In some democratic contexts, there is a strong aversion to the directive, individualistic and masculine expressions of leadership that have come to dominate the study of political leadership. Such leadership is antithetical to consensus democracies in parts of continental Europe, where the antipathy to leadership has linguistic, institutional as well as cultural dimensions. Political-administrative and socio-cultural contexts in these countries provide little room for heroic expressions of leadership. Consequently, alternative forms of leadership and associated vocabularies have developed that carry profound practical relevance but that have remained underexplored. Based on an in-depth mixed-methods study, this article presents the Dutch mayoralty as an insightful and exemplary case of what can be called ‘bridging-and-bonding leadership’; it provides a clear illustration of how understandings of democratic leadership can deviate from the dominant paradigm and of how leading in a consensus context brings about unique practical challenges for office holders. The analysis shows that the important leadership task of democratic guardianship that is performed by Dutch mayors is in danger of being overlooked by scholars of political leadership, as are consensus-oriented leadership roles in other parts of the world. For that reason, a recalibration of the leadership concept is needed, developing an increased theoretical sensitivity towards the non-decisive and process-oriented aspects of the leadership phenomenon. This article specifies how the future study of leadership, as a part of the change that is advocated, can benefit from adopting additional languages of leadership. PMID:29046706

Adaptive Delta Management: cultural aspects of dealing with uncertainty

NASA Astrophysics Data System (ADS)

Timmermans, Jos; Haasnoot, Marjolijn; Hermans, Leon; Kwakkel, Jan

2016-04-01

Deltas are generally recognized as vulnerable to climate change and therefore a salient topic in adaptation science. Deltas are also highly dynamic systems viewed from physical (erosion, sedimentation, subsidence), social (demographic), economic (trade), infrastructures (transport, energy, metropolization) and cultural (multi-ethnic) perspectives. This multi-faceted dynamic character of delta areas warrants the emergence of a branch of applied adaptation science, Adaptive Delta Management, which explicitly focuses on climate adaptation of such highly dynamic and deeply uncertain systems. The application of Adaptive Delta Management in the Dutch Delta Program and its active international dissemination by Dutch professionals results in the rapid dissemination of Adaptive Delta Management to deltas worldwide. This global dissemination raises concerns among professionals in delta management on its applicability in deltas with cultural conditions and historical developments quite different from those found in the Netherlands and the United Kingdom where the practices now labelled as Adaptive Delta Management first emerged. This research develops an approach and gives a first analysis of the interaction between the characteristics of different approaches in Adaptive Delta Management and their alignment with the cultural conditions encountered in various delta's globally. In this analysis, first different management theories underlying approaches to Adaptive Delta Management as encountered in both scientific and professional publications are identified and characterized on three dimensions: The characteristics dimensions used are: orientation on today, orientation on the future, and decision making (Timmermans, 2015). The different underlying management theories encountered are policy analysis, strategic management, transition management, and adaptive management. These four management theories underlying different approaches in Adaptive Delta Management are connected to Hofstede's (1983) cultural dimensions, of which uncertainty avoidance and long-term orientation are of particular relevance for our analysis. Our conclusions comment on the suitability of approaches in Adaptive Delta Management rooted in different management theories are more suitable for specific delta countries than others. The most striking conclusion is the unsuitability of rational policy analytic approaches for The Netherlands. Although surprising this conclusion finds some support in the process dominated approach taken in the Dutch Delta Program. In addition, the divergence between Vietnam, Bangladesh and Myanmar, all located in South East Asia, is striking. References Hofstede, G. (1983). The cultural relativity of organizational practices and theories. Journal of international business studies, 75-89. Jos Timmermans, Marjolijn Haasnoot, Leon Hermans, Jan Kwakkel, Martine Rutten and Wil Thissen (2015). Adaptive Delta Management: Roots and Branches, IAHR The Hague 2015.

Ethnic differences in informed decision-making about prenatal screening for Down's syndrome.

PubMed

Fransen, Mirjam P; Essink-Bot, Marie-Louise; Vogel, Ineke; Mackenbach, Johan P; Steegers, Eric A P; Wildschut, Hajo I J

2010-03-01

The aim of this study was to assess ethnic variations in informed decision-making about prenatal screening for Down's syndrome and to examine the contribution of background and decision-making variables. Pregnant women of Dutch, Turkish and Surinamese origin were recruited between 2006 and 2008 from community midwifery or obstetrical practices in The Netherlands. Each woman was personally interviewed 3 weeks (mean) after booking for prenatal care. Knowledge, attitude and participation in prenatal screening were assessed following the 'Multidimensional Measure of Informed Choice' that has been developed and applied in the UK. In total, 71% of the Dutch women were classified as informed decision-makers, compared with 5% of the Turkish and 26% of the Surinamese women. Differences between Surinamese and Dutch women could largely be attributed to differences in educational level and age. Differences between Dutch and Turkish women could mainly be attributed to differences in language skills and gender emancipation. Women from ethnic minority groups less often made an informed decision whether or not to participate in prenatal screening. Interventions to decrease these ethnic differences should first of all be aimed at overcoming language barriers and increasing comprehension among women with a low education level. To further develop diversity-sensitive strategies for counselling, it should be investigated how women from different ethnic backgrounds value informed decision-making in prenatal screening, what decision-relevant knowledge they need and what they take into account when considering participation in prenatal screening.

The self-concept of the elderly: a cross-cultural comparison.

PubMed

Katzko, M W; Steverink, N; Dittmann-Kohli, F; Herrera, R R

1998-01-01

This study examines the self-concept of the elderly in a cross-cultural perspective. An open-ended sentence completion methodology was employed. A sample of elderly Spanish and elderly Dutch were compared to gain an idea of the cross-cultural generality of the content of the self-concept. Analysis focuses on responses to sentences which probed the respondents' motivations and future plans and goals. Differences could be interpreted as reflecting an individualistic (Dutch) vs. collectivistic (Spanish) distinction between the two cultures. Furthermore, the findings had implications for how to interpret dimensions of meaningful aging. For example, a dimension such as "purpose in life" was more generalizable across the two samples than a dimension such as "autonomy."

Cost-effectiveness of a stepped-care intervention to prevent major depression in patients with type 2 diabetes mellitus and/or coronary heart disease and subthreshold depression: design of a cluster-randomized controlled trial.

PubMed

van Dijk, Susan E M; Pols, Alide D; Adriaanse, Marcel C; Bosmans, Judith E; Elders, Petra J M; van Marwijk, Harm W J; van Tulder, Maurits W

2013-05-07

Co-morbid major depression is a significant problem among patients with type 2 diabetes mellitus and/or coronary heart disease and this negatively impacts quality of life. Subthreshold depression is the most important risk factor for the development of major depression. Given the highly significant association between depression and adverse health outcomes and the limited capacity for depression treatment in primary care, there is an urgent need for interventions that successfully prevent the transition from subthreshold depression into a major depressive disorder. Nurse led stepped-care is a promising way to accomplish this. The aim of this study is to evaluate the cost-effectiveness of a nurse-led indicated stepped-care program to prevent major depression among patients with type 2 diabetes mellitus and/or coronary heart disease in primary care who also have subthreshold depressive symptoms. An economic evaluation will be conducted alongside a cluster-randomized controlled trial in approximately thirty general practices in the Netherlands. Randomization takes place at the level of participating practice nurses. We aim to include 236 participants who will either receive a nurse-led indicated stepped-care program for depressive symptoms or care as usual. The stepped-care program consists of four sequential but flexible treatment steps: 1) watchful waiting, 2) guided self-help treatment, 3) problem solving treatment and 4) referral to the general practitioner. The primary clinical outcome measure is the cumulative incidence of major depressive disorder as measured with the Mini International Neuropsychiatric Interview. Secondary outcomes include severity of depressive symptoms, quality of life, anxiety and physical outcomes. Costs will be measured from a societal perspective and include health care utilization, medication and lost productivity costs. Measurements will be performed at baseline and 3, 6, 9 and 12 months. The intervention being investigated is expected to prevent new cases of depression among people with type 2 diabetes mellitus and/or coronary heart disease and subthreshold depression, with subsequent beneficial effects on quality of life, clinical outcomes and health care costs. When proven cost-effective, the program provides a viable treatment option in the Dutch primary care system. Dutch Trial Register NTR3715.

Vitalum study design: RCT evaluating the efficacy of tailored print communication and telephone motivational interviewing on multiple health behaviors

PubMed Central

van Keulen, Hilde M; Mesters, Ilse; Brug, Johannes; Ausems, Marlein; Campbell, Marci; Resnicow, Ken; Zwietering, Paul J; van Breukelen, Gerard; van Mechelen, Willem; Severens, Johan L; de Vries, Hein

2008-01-01

Background A large proportion of adults fail to meet public health guidelines for physical activity as well as fruit, vegetable and fat intake. Interventions are needed to improve these health behaviors. Both computer tailoring and motivational interviewing have shown themselves to be promising techniques for health behavior change. The Vitalum project aims to compare the efficacy of these techniques in improving the health behaviors of adults aged 45–70. This paper describes the design of the Vitalum study. Methods/Design Dutch general medical practices (N = 23) were recruited via a registration network or by personal invitation. The participants were then enrolled through these general practices using an invitational letter. They (n = 2,881) received a written baseline questionnaire to assess health behaviors, and potential psychosocial and socio-demographic behavioral determinants. A power analysis indicated that 1,600 participants who were failing to meet the guidelines for physical activity and either fruit or vegetable consumption were needed. Eligible participants were stratified based on hypertension status and randomized into one of four intervention groups: tailored print communication, telephone motivational interviewing, combined, and control. The first two groups either received four letters or took part in four interviews, whereas the combined group received two letters and took part in two interviews in turns at 5, 13, 30 and 43 weeks after returning the baseline questionnaire. Each letter and interview focused on physical activity or nutrition behavior. The participants also took part in a telephone survey 25 weeks after baseline to gather new information for tailoring. There were two follow-up questionnaires, at 47 and 73 weeks after baseline, to measure short- and long-term effects. The control group received a tailored letter after the last posttest. The process, efficacy and cost-effectiveness of the interventions will be examined by means of multilevel mixed regression, cost-effectiveness analyses and process evaluation. Discussion The Vitalum study simultaneously evaluates the efficacy of tailored print communication and telephone motivational interviewing, and their combined use for multiple behaviors and people with different motivational stages and education levels. The results can be used by policymakers to contribute to evidence-based prevention of chronic diseases. Trial Registration Dutch Trial Register NTR1068 PMID:18565222

To what extent do clinical notes by general practitioners reflect actual medical performance? A study using simulated patients.

PubMed Central

Rethans, J J; Martin, E; Metsemakers, J

1994-01-01

BACKGROUND. Review of clinical notes is used extensively as an indirect method of assessing doctors' performance. However, to be acceptable it must be valid. AIM. This study set out to examine the extent to which clinical notes in medical records of general practice consultations reflected doctors' actual performance during consultations. METHOD. Thirty nine general practitioners in the Netherlands were consulted by four simulated patients who were indistinguishable from real patients and who reported on the consultations. The complaints presented by the simulated patients were tension headache, acute diarrhoea and pain in the shoulder, and one presented for a check up for non-insulin dependent diabetes. Later, the doctors forwarded their medical records of these patients to the researchers. Content of consultations was measured against accepted standards for general practice and then compared with content of clinical notes. An index, or content score, was calculated as the measure of agreement between actions which had actually been recorded and actions which could have been recorded in the clinical notes. A high content score reflected a consultation which had been recorded well in the medical record. The correlation between number of actions across the four complaints recorded in the clinical notes and number of actions taken during the consultations was also calculated. RESULTS. The mean content score (interquartile range) for the four types of complaint was 0.32 (0.27-0.37), indicating that of all actions undertaken, only 32% had been recorded. However, mean content scores for the categories 'medication and therapy' and 'laboratory examination' were much higher than for the categories 'history' and 'guidance and advice' (0.68 and 0.64, respectively versus 0.29 and 0.22, respectively). The correlation between number of actions across the four complaints recorded in the clinical notes and number of actions taken during the consultations was 0.54 (P < 0.05). CONCLUSION. The use of clinical notes to audit doctors' performance in Dutch general practice is invalid. However, the use of clinical notes to rank doctors according to those who perform many or a few actions in a consultation may be justified. PMID:8185988

[Prospective comparison of the flow chart for laboratory investigations for anaemia from the Dutch College of General Practitioners' guideline 'Anaemia' with a self-developed, substantive and logistical alternative flow chart].

PubMed

Oosterhuis, W P; van der Horst, M; van Dongen, K; Ulenkate, H J L M; Volmer, M; Wulkan, R W

2007-10-20

To compare the flow diagram for the diagnosis of anaemia from the guideline 'Anaemia' from the Dutch College of General Practitioners (NHG) with a substantive and logistical alternative protocol. Prospective. For evaluation of anaemia, 124 patients from primary care reported to the laboratories of the St. Elisabeth Hospital in Tilburg (n = 94) and the Scheper Hospital in Emmen (n = 30), the Netherlands. Two flow charts were used: the NHG's flow chart and a self-developed chart in which not mean corpuscular volume, but ferritin concentration occupies the central position. All the laboratory tests mentioned in both flow charts were carried out in every patient with, for practical reasons, the exception of Hgb electrophoresis and bone marrow investigations. General practitioners were approached and patient dossiers were consulted to obtain further clinical data. According to the NHG protocol, on the grounds of the laboratory investigations, 64 (52%) of patients could not be put in a specific category. The majority were patients with normocytary anaemia who did not fulfil the criteria for iron deficiency anaemia or the anaemia of chronic disease. According to the alternative chart, in 36 (29%) patients no diagnosis was made. These were patients in whom no abnormal laboratory findings were observed, other than low haemoglobin values. The majority of the patients had normocytary anaemia, in some cases this was interpreted as the anaemia of chronic disease, but more often the anaemia could not be assigned to a particular category. A large number ofpatients had a raised creatinine value. This value did not appear in the NHG protocol. In 15% of patients, more than one cause for anaemia was found. The NHG protocol did not enable these multiple diagnoses to be made. Accordingly, the NHG protocol was difficult to implement in the laboratory. Using the NHG flow diagram a large percentage of patients could not be assigned to a particular category. Using the alternative flow diagram, which procedure is easier to carry out in the laboratory, it was possible to make multiple diagnoses.

Religion and action control: Faith-specific modulation of the Simon effect but not Stop-Signal performance.

PubMed

Hommel, Bernhard; Colzato, Lorenza S; Scorolli, Claudia; Borghi, Anna M; van den Wildenberg, Wery P M

2011-08-01

Previous findings suggest that religion has a specific impact on attentional processes. Here we show that religion also affects action control. Experiment 1 compared Dutch Calvinists and Dutch atheists, matched for age, sex, intelligence, education, and cultural and socio-economic background, and Experiment 2 compared Italian Catholics with matched Italian seculars. As expected, Calvinists showed a smaller and Catholics a larger Simon effect than nonbelievers, while performance of the groups was comparable in the Stop-Signal task. This pattern suggests that religions emphasizing individualism or collectivism affects action control in specific ways, presumably by inducing chronic biases towards a more "exclusive" or "inclusive" style of decision-making. Interestingly, there was no evidence that religious practice affects inhibitory skills. Copyright © 2011 Elsevier B.V. All rights reserved.

Sources of Dietary Protein in Relation to Blood Pressure in a General Dutch Population

PubMed Central

Altorf - van der Kuil, Wieke; Engberink, Mariëlle F.; Vedder, Moniek M.; Boer, Jolanda M. A.; Verschuren, W. M. Monique; Geleijnse, Johanna M.

2012-01-01

Background Little is known about the relation of different dietary protein types with blood pressure (BP). We examined whether intake of total, plant, animal, dairy, meat, and grain protein was related to BP in a cross sectional cohort of 20,820 Dutch adults, aged 20–65 y and not using antihypertensive medication. Design Mean BP levels were calculated in quintiles of energy-adjusted protein with adjustment for age, sex, BMI, education, smoking, and intake of energy, alcohol, and other nutrients including protein from other sources. In addition, mean BP difference after substitution of 3 en% carbohydrates or MUFA with protein was calculated. Results Total protein and animal protein were not associated with BP (ptrend = 0.62 and 0.71 respectively), both at the expense of carbohydrates and MUFA. Systolic BP was 1.8 mmHg lower (ptrend<0.01) in the highest (>36 g/d) than in the lowest (<27 g/d) quintile of plant protein. This inverse association was present both at the expense of carbohydrates and MUFA and more pronounced in individuals with untreated hypertension (−3.6 mmHg) than in those with normal (+0.1 mmHg) or prehypertensive BP (−0.3 mmHg; pinteraction<0.01). Meat and grain protein were not related to BP. Dairy protein was directly associated with systolic BP (+1.6 mmHg, ptrend<0.01), but not with diastolic BP (ptrend = 0.24). Conclusions Total protein and animal protein were not associated with BP in this general untreated Dutch population. Plant protein may be beneficial to BP, especially in people with elevated BP. However, because high intake of plant protein may be a marker of a healthy diet and lifestyle in general, confirmation from randomized controlled trials is warranted. PMID:22347387

Habitual physical activity in Dutch children and adolescents with haemophilia.

PubMed

Groen, W G; Takken, T; van der Net, J; Helders, P J M; Fischer, K

2011-09-01

For patients with haemophilia, a physically active lifestyle is important to maintain musculoskeletal health and to prevent chronic diseases, such as cardiovascular disease. Therefore, we studied physical activity levels, in Dutch children and adolescents with haemophilia as well as its association with aerobic fitness and joint health. Forty-seven boys with haemophilia (aged 8-18) participated. Physical activity was measured using the Modifiable Activity Questionnaire (MAQ) and was compared with the general population. Aerobic fitness was determined using peak oxygen uptake (VO(₂peak)). Joint health was measured using the Haemophilia Joint Health Score (HJHS). Associations between physical activity, joint health and aerobic fitness were evaluated by correlation analysis. Subjects were 12.5 (SD 2.9) years old, had a Body Mass Index (BMI) of 19.5 (SD 3.1; z-score 0.5) and a median HJHS score of 0 (range 0-6). Cycling, physical education and swimming were most frequently reported (86%, 69% and 50% respectively). Children with severe haemophilia participated significantly less in competitive soccer and more in swimming than children with non-severe haemophilia. Physical activity levels were similar across haemophilia severities and comparable to the general population. VO(₂peak) kg⁻¹ was slightly lower than healthy boys (42.9 ± 8.6 vs. 46.9 ± 1.9 mL kg⁻¹ min⁻¹; P = 0.03). Joint health, aerobic fitness and physical activity showed no correlation. Dutch children with haemophilia engaged in a wide range of activities of different intensities and showed comparable levels of physical activity to the general population. Aerobic fitness was well preserved and showed no associations with physical activity levels or joint health. © 2011 Blackwell Publishing Ltd.

The utility of online panel surveys versus computer-assisted interviews in obtaining substance-use prevalence estimates in the Netherlands.

PubMed

Spijkerman, Renske; Knibbe, Ronald; Knoops, Kim; Van De Mheen, Dike; Van Den Eijnden, Regina

2009-10-01

Rather than using the traditional, costly method of personal interviews in a general population sample, substance-use prevalence rates can be derived more conveniently from data collected among members of an online access panel. To examine the utility of this method, we compared the outcomes of an online survey with those obtained with the computer-assisted personal interviews (CAPI) method. Data were gathered from a large sample of online panellists and in a two-stage stratified sample of the Dutch population using the CAPI method. The Netherlands. Participants  The online sample comprised 57 125 Dutch online panellists (15-64 years) of Survey Sampling International LLC (SSI), and the CAPI cohort 7204 respondents (15-64 years). All participants answered identical questions about their use of alcohol, cannabis, ecstasy, cocaine and performance-enhancing drugs. The CAPI respondents were asked additionally about internet access and online panel membership. Both data sets were weighted statistically according to the distribution of demographic characteristics of the general Dutch population. Response rates were 35.5% (n = 20 282) for the online panel cohort and 62.7% (n = 4516) for the CAPI cohort. The data showed almost consistently lower substance-use prevalence rates for the CAPI respondents. Although the observed differences could be due to bias in both data sets, coverage and non-response bias were higher in the online panel survey. Despite its economic advantage, the online panel survey showed stronger non-response and coverage bias than the CAPI survey, leading to less reliable estimates of substance use in the general population. © 2009 The Authors. Journal compilation © 2009 Society for the Study of Addiction.

Is Europe putting theory into practice? A qualitative study of the level of self-management support in chronic care management approaches

PubMed Central

2013-01-01

Background Self-management support is a key component of effective chronic care management, yet in practice appears to be the least implemented and most challenging. This study explores whether and how self-management support is integrated into chronic care approaches in 13 European countries. In addition, it investigates the level of and barriers to implementation of support strategies in health care practice. Methods We conducted a review among the 13 participating countries, based on a common data template informed by the Chronic Care Model. Key informants presented a sample of representative chronic care approaches and related self-management support strategies. The cross-country review was complemented by a Dutch case study of health professionals’ views on the implementation of self-management support in practice. Results Self-management support for chronically ill patients remains relatively underdeveloped in Europe. Similarities between countries exist mostly in involved providers (nurses) and settings (primary care). Differences prevail in mode and format of support, and materials used. Support activities focus primarily on patients’ medical and behavioral management, and less on emotional management. According to Dutch providers, self-management support is not (yet) an integral part of daily practice; implementation is hampered by barriers related to, among others, funding, IT and medical culture. Conclusions Although collaborative care for chronic conditions is becoming more important in European health systems, adequate self-management support for patients with chronic disease is far from accomplished in most countries. There is a need for better understanding of how we can encourage both patients and health care providers to engage in productive interactions in daily chronic care practice, which can improve health and social outcomes. PMID:23530744

Criminal Victimisation in People with Severe Mental Illness: A Multi-Site Prevalence and Incidence Survey in the Netherlands

PubMed Central

Kamperman, Astrid M.; Henrichs, Jens; Bogaerts, Stefan; Lesaffre, Emmanuel M. E. H.; Wierdsma, André I.; Ghauharali, Razia R. R.; Swildens, Wilma; Nijssen, Yolanda; van der Gaag, Mark; Theunissen, Jan R.; Delespaul, Philippe A.; van Weeghel, Jaap; van Busschbach, Jooske T.; Kroon, Hans; Teplin, Linda A.; van de Mheen, Dike; Mulder, Cornelis L.

2014-01-01

Background Although crime victimisation is as prevalent in psychiatric patients as crime perpetration (and possibly more so), few European figures for it are available. We therefore assessed its one-year prevalence and incident rates in Dutch severely mentally ill outpatients, and compared the results with victimisation rates in the general population. Method This multisite epidemiological survey included a random sample of 956 adult severely mentally ill outpatients. Data on victimisation were obtained using the victimisation scale of the Dutch Crime and Victimisation Survey, which assesses crime victimisation over the preceding 12 months. Comparison data were derived from the nationwide survey on safety and victimisation in the Netherlands. Prevalence and incident rates were weighted for sex, age, ethnicity and socioeconomic status, and compared with a general population sample matched by region (N = 38,227). Results In the past year, almost half of the severely mentally ill outpatients (47%) had been victim of a crime. After control for demographic differences, prevalence rates of overall and specific victimisation measures were significantly higher in severely mentally ill outpatients than in the general population. The relative rates were especially high for personal crimes such as violent threats (RR = 2.12, 95% CI: 1.72–2.61), physical assaults (RR = 4.85, 95% CI: 3.69–6.39) and sexual harassment and assaults (RR = 3.94, 95% CI: 3.05–5.09). In concordance, severely mentally ill outpatients reported almost 14 times more personal crime incidents than persons from the general population (IRR = 13.68, 95% CI: 12.85–14.56). Conclusion Crime victimisation is a serious problem in Dutch severely mentally ill outpatients. Mental-healthcare institutions and clinicians should become aware of their patients’ victimisation risk, and should implement structural measures to detect and prevent (re-)victimisation. PMID:24609108

Participation and coordination in Dutch health care policy-making. A network analysis of the system of intermediate organizations in Dutch health care.

PubMed

Lamping, Antonie J; Raab, Jörg; Kenis, Patrick

2013-06-01

This study explores the system of intermediate organizations in Dutch health care as the crucial system to understand health care policy-making in the Netherlands. We argue that the Dutch health care system can be understood as a system consisting of distinct but inter-related policy domains. In this study, we analyze four such policy domains: Finances, quality of care, manpower planning and pharmaceuticals. With the help of network analytic techniques, we describe how this highly differentiated system of >200 intermediate organizations is structured and coordinated and what (policy) consequences can be observed with regard to its particular structure and coordination mechanisms. We further analyze the extent to which this system of intermediate organizations enables participation of stakeholders in policy-making using network visualization tools. The results indicate that coordination between the different policy domains within the health care sector takes place not as one would expect through governmental agencies, but through representative organizations such as the representative organizations of the (general) hospitals, the health care consumers and the employers' association. We further conclude that the system allows as well as denies a large number of potential participants access to the policy-making process. As a consequence, the representation of interests is not necessarily balanced, which in turn affects health care policy. We find that the interests of the Dutch health care consumers are well accommodated with the national umbrella organization NPCF in the lead. However, this is no safeguard for the overall community values of good health care since, for example, the interests of the public health sector are likely to be marginalized.

Reliability and validity of the Dutch version of the Consultation and Relational Empathy Measure in primary care.

PubMed

van Dijk, Inge; Scholten Meilink Lenferink, Nick; Lucassen, Peter L B J; Mercer, Stewart W; van Weel, Chris; Olde Hartman, Tim C; Speckens, Anne E M

2017-02-01

Empathy is an essential skill in doctor-patient communication with positive effects on compliance, patient satisfaction and symptom duration. There are no validated patient-rated empathy measures available in Dutch. To investigate the validity and reliability of a Dutch version of the Consultation and Relational Empathy (CARE) Measure, a widely used 10-item patient-rated questionnaire of physician empathy. After translation and back translation, the Dutch CARE Measure was distributed among patients from 19 general practitioners in 5 primary care centers. Tests of internal reliability and validity included Cronbach's alpha, item total correlations and factor analysis. Seven items of the QUality Of care Through the patient's Eyes (QUOTE) questionnaire assessing 'affective performance' of the physician were included in factor analysis and used to investigate convergent validity. Of the 800 distributed questionnaires, 655 (82%) were returned. Acceptability and face validity were supported by a low number of 'does not apply' responses (range 0.2%-11.9%). Internal reliability was high (Cronbach's alpha 0.974). Corrected item total correlations were at a minimum of 0.837. Factor analysis on the 10 items of the CARE Measure and 7 QUOTE items resulted in two factors (Eigenvalue > 1), the first containing the CARE Measure items and the second containing the QUOTE items. Convergent construct validity between the CARE Measure and QUOTE was confirmed with a modest positive correlation (r = 0.34, n = 654, P < 0.001). The findings support the preliminary validity and reliability of the Dutch CARE Measure. Future research is required to investigate divergent validity and discriminant ability between doctors. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Similarity in depressive symptom profile in a population-based study of migrants in the Netherlands.

PubMed

Schrier, Agnes C; de Wit, Matty A S; Rijmen, Frank; Tuinebreijer, Wilco C; Verhoeff, Arnoud P; Kupka, Ralph W; Dekker, Jack; Beekman, Aartjan T F

2010-10-01

Depression is a clinical syndrome developed in Western Europe and North-America. The expression of symptoms and the impact of symptoms on functioning may therefore be expected to vary across cultures and languages. Our first aim was to study differences in depressive symptom profile between indigenous and non-Western immigrant populations in the Netherlands. We hypothesized that differences in expression of depressive symptoms would be more likely in the domains of mood and cognitions, and less likely in the domains of psychomotor and vegetative symptoms. Our second aim was to study ethnic differences in the association of depressive symptoms and general functioning. In a random community sample stratified for ethnicity in Amsterdam, the Netherlands, depressive symptoms were assessed by bilingual interviewers using the Composite International Diagnostic Interview (CIDI 2.1) and the Symptom Checklist-90-Revised (SCL-90-R). Impairments in functioning were measured by the World Health Organization Disability Assessment Schedule II (WHODAS II). Results were obtained from 812 subjects: N = 321 native Dutch, N = 213 Turkish-Dutch, N = 191 Moroccan-Dutch, N = 87 Surinamese-Dutch. Differences in depressive symptom expression were tested by differential item functioning. The prevalence of DSM-IV depressive disorder and the overall level of depressive symptoms were higher in the Turkish and Moroccan immigrant groups compared to native Dutch subjects. Ethnic differences in item functioning of depressive symptoms were rare, and equally unlikely in all four symptom domains. Depression was equally associated with functional impairment across ethnic groups. Although depressive symptoms were more common among migrants than in the indigenous population, both the depressive symptom profile and the associated functional impairments were comparable. These findings may help diminishing concerns about the validity of using existing diagnostic procedures among ethnic minority groups.

Detection of the plasmid-mediated colistin-resistance gene mcr-1 in faecal metagenomes of Dutch travellers.

PubMed

von Wintersdorff, Christian J H; Wolffs, Petra F G; van Niekerk, Julius M; Beuken, Erik; van Alphen, Lieke B; Stobberingh, Ellen E; Oude Lashof, Astrid M L; Hoebe, Christian J P A; Savelkoul, Paul H M; Penders, John

2016-12-01

Recently, the first plasmid-mediated colistin-resistance gene, mcr-1, was reported. Colistin is increasingly used as an antibiotic of last resort for the treatment of infections caused by carbapenem-resistant bacteria, which have been rapidly disseminating worldwide in recent years. The reported carriage rate of mcr-1 in humans remains sporadic thus far, except for those reported in Chinese populations. We aimed to determine its presence in the faecal metagenomes of healthy Dutch travellers between 2010 and 2012. Faecal metagenomic DNA of pre- and post-travel samples from 122 healthy Dutch long-distance travellers was screened for the presence of mcr-1 using a TaqMan quantitative PCR assay, which was designed in this study. All positive samples were confirmed by sequencing of the amplicons. The mcr-1 gene was detected in 6 (4.9%, 95% CI = 2.1%-10.5%) of 122 healthy Dutch long-distance travellers after they had visited destinations in South(-east) Asia or southern Africa between 2011 and 2012. One of these participants was already found to be positive before travel. Our study highlights the potential of PCR-based targeted metagenomics as an unbiased and sensitive method to screen for the carriage of the mcr-1 gene and suggests that mcr-1 is widespread in various parts of the world. The observation that one participant was found to be positive before travel suggests that mcr-1 may already have disseminated to the microbiomes of Dutch residents at a low prevalence, warranting a more extensive investigation of its prevalence in the general population and possible sources. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Implementation of the physician assistant in Dutch health care organizations: primary motives and outcomes.

PubMed

van Vught, Anneke J A H; van den Brink, Geert T W J; Wobbes, Theo

2014-01-01

Physician assistants (PAs) are trained to perform medical procedures that were traditionally performed by medical physicians. Physician assistants seem to be deployed not only to increase efficiency but also to ensure the quality of care. What is not known is the primary motive for employing PAs within Dutch health care and whether the employment of the PAs fulfills the perceived need for them. Supervising medical specialists who used PAs in their practices were interviewed about their primary motives and outcomes. The interviews were semistructured. Two scientists coded the findings with respect to motives and outcomes. In total, 55 specialists were interviewed about their motives for employing a PA, and 15 were interviewed about the outcomes of employing a PA. With respect to the primary motives for employing a PA, the most frequent motive was to increase continuity and quality of care, followed by relieving the specialist's workload, increasing efficiency of care, and substituting for medical residents. The outcomes were found to be consistent with the motives. In conclusion, the primary motive for employing a PA in Dutch health care is to increase continuity and quality of care.

Doing Your Own Time: Peer Integration, Aggression and Mental Health in Dutch Male Detainment Facilities

PubMed Central

Kreager, Derek A.; Palmen, Hanneke; Dirkzwager, Anja J.E.; Nieuwbeerta, Paul

2016-01-01

Background Prior research demonstrates a strong positive association between social integration (e.g., strong social ties) and individual health. However, researchers also emphasize that this correlation may vary by context and potentially reverse direction under certain conditions. In this study, we draw on competing criminological theories of peer relations to examine if social integration, measured by trust in peers, is positively or negatively associated with violence and mental health of men detained in pre-trial confinement facilities. Methods We test our hypotheses with peer network and health data from 502 Dutch male pre-trial detainees. Results Results suggest that peer trust has no direct association with reported rates of peer aggression while detained and low peer trust is generally protective for mental health. Conclusions Our study thus adds to a small body of literature finding that social integration within certain correctional settings may not operate in the same way that it does in the general population and may actually contribute to adverse mental health outcomes. PMID:26794247

Level of Digitization in Dutch Hospitals and the Lengths of Stay of Patients with Colorectal Cancer.

PubMed

van Poelgeest, Rube; van Groningen, Julia T; Daniels, John H; Roes, Kit C; Wiggers, Theo; Wouters, Michel W; Schrijvers, Guus

2017-05-01

A substantial amount of research has been published on the association between the use of electronic medical records (EMRs) and quality outcomes in U.S. hospitals, while limited research has focused on the Western European experience. The purpose of this study is to explore the association between the use of EMR technologies in Dutch hospitals and length of stay after colorectal cancer surgery. Two data sets were leveraged for this study; the HIMSS Analytics Electronic Medical Record Adoption Model (EMRAM SM ) and the Dutch surgical colorectal audit (DSCA). The HIMSS Analytics EMRAM score was used to define a Dutch hospital's electronic medical records (EMR) capabilities while the DSCA was used to profile colorectal surgery quality outcomes (specifically total length of stay (LOS) in the hospital and the LOS in ICU). A total of 73 hospitals with a valid EMRAM score and associated DSCA patients (n = 30.358) during the study period (2012-2014) were included in the comparative set. A multivariate regression method was used to test differences adjusted for case mix, year of surgery, surgical technique and for complications, as well as stratifying for academic affiliated hospitals and general hospitals. A significant negative association was observed to exist between the total LOS (relative median LOS 0,974, CI 95% 0.959-0,989) of patients treated in advanced EMR hospitals (high EMRAM score cohort) versus patients treated at less advanced EMR care settings, once the data was adjusted for the case mix, year of surgery and type of surgery (laparoscopy or laparotomy). Adjusting for complications in a subgroup of general hospitals (n = 39) yielded essentially the same results (relative median LOS 0,934, CI 95% 0,915-0,954). No consistent significant associations were found with respect to LOS on the ICU. The findings of this study suggest advanced EMR capabilities support a healthcare provider's efforts to achieve desired quality outcomes and efficiency in Western European hospitals.

Netherlands.

PubMed

1987-09-01

Focus in this discussion of the Netherlands is on the following: geography; the people; history; government; political conditions; the economy; foreign relations; defense; and relations between the Netherlands and the US. The Dutch, primarily of Germanic stock with some Gallo-Celtic mixture, have clung to their small homeland against the constant threat of destruction by the North Sea and recurrent invasions by the great European powers. Religion influences Dutch history, society, institutions, and attitudes and is closely related to political life but to a diminishing degree. The present constitution dates from 1848 and has been amended several times. The government, based on the principles of ministerial responsibility and parliamentary government common to most constitutional monarchies in Western Europe, is composed of 3 basic institutions: the crown (monarch, Council of Ministers, and Council of State); the States General (Parliament); and the courts. Catholics, Protestants, Labor, and Liberals are the groups which form the historical basis for the 3 main political parties. The Dutch economy is based on private enterprise. The government has little direct ownership or participation, but it heavily influences the economy. More than 45% of the gross national product is involved in government operations and social programs. Services, which account for half of the national income, are primarily in transport and financial areas, such as banking and insurance. Industrial activity provides about 19% of the national income and is dominated by the metalworking, oil refining, chemical, and food-processing industries. In the last several years Dutch economic growth has been limited by the world's general economic slowdown. After an average 2% growth in 1984-86, real growth in 1987 is estimated at 1.5%. For much of its modern history, the Netherlands pursued a neutralist foreign policy. The good relationship between the US and the Netherlands is based on close historical and cultural ties and a common dedication to the security of the Western world.

The effects of illness beliefs and chemotherapy impact on quality of life in Japanese and Dutch patients with breast or lung cancer.

PubMed

van der Kloot, Willem A; Uchida, Yuka; Inoue, Kenichi; Kobayashi, Kunihiko; Yamaoka, Kazue; Nortier, Hans W R; Kaptein, Ad A

2016-02-01

Responses to diagnosis and treatment of cancer are mediated by a patient's illness perceptions. Such perceptions, though different among individuals, may be culturally dependent, and act upon health related quality of life (HRQOL). Over time, individual patients show different types of response trajectories. Four issues were investigated: (I) country and disease differences in illness beliefs between Japanese and Dutch patients with lung or breast cancer; (II) country and disease differences in HRQOL in early chemotherapy; (III) individual, country, and disease differences among HRQOL trajectories; (IV) the impact of illness beliefs on HRQOL trajectories. A total of 89 Japanese and Dutch patients with lung or breast cancer cooperated immediately before, one week after, and eight weeks after the start of chemotherapy. Data included the EORTC QLQ-C30 quality of life (QL) questionnaire and the Brief Illness Perception Questionnaire (B-IPQ). EORTC QLQ-C30 scales were summarized by two dimensions: generalized quality of life (GENQOL) and psychological well-being (PSYQOL). (I) Japanese patients had higher means on B-IPQ's concern and time line than Dutch patients. Japanese lung cancer patients had a higher mean on treatment control than all other patients; (II) no differences between country and cancer type occurred on the two HRQOL dimensions. First assessment HRQOL differed significantly from the second and third assessments without differences between the latter two. Between the first two assessments, a decrease in GENQOL occurred, together with an improvement in PSYQOL; (III) individual differences dominated the trajectories; (IV) negative beliefs usually coincided with lower scores on GENQOL and PSYQOL. Patients initially lower on PSYQOL generally showed larger improvement. Individual differences in HRQOL dominate differences between culture and cancer type, and illness beliefs influence HRQOL changes in individual patients. Clinical application is possible through influencing the patient's illness beliefs to create an optimal starting position for chemotherapy.

Teaching communication with ethnic minority patients: ten recommendations.

PubMed

Seeleman, Conny; Selleger, Veronica; Essink-Bot, Marie-Louise; Bonke, Benno

2011-01-01

Culturally competent communication is indispensable for medical practice in an ethnically diverse society. This article offers recommendations to teach such communication skills based on the experiences of members of a Dutch NMVO Special Interest Group on 'Diversity'. A questionnaire with three open-ended questions on recommendations for training in culturally competent communication was sent to all members (n = 35). Returned questionnaires (n = 23) were analysed qualitatively with a thematic coding framework based on educational themes emerging from the data. All students need to be educated in culturally competent communication. Teachers should stimulate awareness of personal biases and an open attitude. Teach the three core communication skills, listening, exploring and checking, and offer practice with a professional interpreter. Knowledge content should focus on mechanisms relevant to various ethnic groups. Offer students a variety of experiences in a safe environment. All involved should be aware that stereotyping is a pitfall. Training in communication skills for consultation with ethnic minority patients cannot be separated from teaching issues of awareness and knowledge. The shared views on the content of these communication trainings are in line with general patient-centred approaches. The development of proper training in this field demands specific efforts of those involved.

The Effect of Instruction Method and Relearning on Dutch Spelling Performance of Third- through Fifth-Graders

ERIC Educational Resources Information Center

Bouwmeester, Samantha; Verkoeijen, Peter P. J. L.

2011-01-01

In this study, we compared two instruction methods on spelling performance: a rewriting instruction in which children repeatedly rewrote words and an ambiguous property instruction in which children deliberately practiced on a difficult word aspect. Moreover, we examined whether the testing effect applies to spelling performance. One hundred…

Current Practice in Designing Training for Complex Skills: Implications for Design and Evaluation of ADAPT[IT].

ERIC Educational Resources Information Center

Eseryel, Deniz; Schuver-van Blanken, Marian J.; Spector, J. Michael

ADAPT[IT] (Advanced Design Approach for Personalized Training-Interactive Tools is a European project coordinated by the Dutch National Aerospace Laboratory. The aim of ADAPT[IT] is to create and validate an effective training design methodology, based on cognitive science and leading to the integration of advanced technologies, so that the…

Strengthening Ecological Mindfulness through Hybrid Learning in Vital Coalitions

ERIC Educational Resources Information Center

Sol, Jifke; Wals, Arjen E. J.

2015-01-01

In this contribution a key policy "tool" used in the Dutch Environmental Education and Learning for Sustainability Policy framework is introduced as a means to develop a sense of place and associated ecological mindfulness. The key elements of this tool, called the vital coalition, are described while an example of its use in practice,…

Pollution control: utility ships adapt for spill cleanups

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1986-02-01

A practical and cost effective approach to oil spill cleanup is being undertaken by Dutch companies. The approach involves constructing and equipping multi-use ships for pollution control. Usually, these ships are maintained in another type of service and come into use for spill cleanup only when needed. The use of these ships in pollution control is discussed.

Early Determinants of Maternal and Paternal Harsh Discipline: The Generation R Study

ERIC Educational Resources Information Center

Jansen, Pauline W.; Raat, Hein; Mackenbach, Johan P.; Hofman, Albert; Jaddoe, Vincent W. V.; Bakermans-Kranenburg, M. J.; van IJzendoorn, M. H.; Verhulst, Frank C.; Tiemeier, Henning

2012-01-01

Research described risk factors for maternal use of harsh discipline, but knowledge about determinants of paternal harsh discipline is lacking. This study aimed to identify determinants of harsh discipline and whether this differed between mothers and fathers. Harsh disciplining practices were self-reported by Dutch parents of 3-year-old children.…

Learning to Teach in Higher Education: How to Link Theory and Practice

ERIC Educational Resources Information Center

van den Bos, Paul; Brouwer, Joyce

2014-01-01

In this study the learning process of 12 Dutch novice university teachers was monitored during a five-month induction programme. The teachers were interviewed before and after the programme and were asked to fill in several email logbooks during the programme. A change process was identified, in which experiencing and experimentation played a…

Bidirectional associations between activity-related parenting practices, and child physical activity, sedentary screen-based behavior and body mass index: a longitudinal analysis.

PubMed

Sleddens, Ester F C; Gubbels, Jessica S; Kremers, Stef P J; van der Plas, Eline; Thijs, Carel

2017-07-06

It has been generally assumed that activity-related parenting practices influence children's activity behavior and weight status. However, vice versa parents may also change their parenting behaviors in response to their perceptions of their child's activity behavior and weight status. This study examined the bidirectional relationships between activity-related parenting practices, and physical activity, sedentary screen-based behavior, and body mass index (BMI) between children's age of 5 and 7 years. Three scales of the Activity-related Parenting Questionnaire (i.e. 'restriction of sedentary behavior', 'stimulation of physical activity', and 'monitoring of physical activity') were completed by 1694 parents of the Dutch KOALA Birth Cohort Study at the child's age of around 5 and again around age 7. Physical activity, sedentary screen-based behavior and BMI were measured at both ages as well. Linear regression models were used to estimate the bidirectional associations between each parenting practice and the child's physical activity levels, sedentary screen-based behavior and BMI z-scores. Several parenting practices at age 5 predicted child physical activity, sedentary screen-based behavior, and BMI z-scores at age 7. Restriction of sedentary behavior positively predicted child BMI and sedentary screen-based behavior, whereas this practice negatively predicted child physical activity. In addition, stimulation of physical activity at age 5 was significantly associated with higher levels of child physical activity at age 7. The following child factors at age 5 predicted parenting practices at age 7: Child physical activity positively predicted parental stimulation of physical activity and monitoring activities. Sedentary screen-based behavior was associated with lower parental stimulation to be active. Findings generally revealed that parents and children mutually influence each other's behavior. A reinforcing feedback loop was present between parental stimulation of physical activity and child physical activity. Bidirectional parent-child interaction should be considered in future research in order to properly inform parenting-related intervention programs aimed at preventing or treating childhood overweight or obesity. System dynamic methods to explore the existence of reinforcing or balancing loops are needed in this regard.

Cardiometabolic prevention consultation in the Netherlands: screening uptake and detection of cardiometabolic risk factors and diseases--a pilot study.

PubMed

Van der Meer, Victor; Nielen, Markus M J; Drenthen, Anton J M; Van Vliet, Mieke; Assendelft, Willem J J; Schellevis, Francois G

2013-02-26

Until now, cardiometabolic risk assessment in Dutch primary health care was directed at case-finding, and structured, programmatic prevention is lacking. Therefore, the Prevention Consultation cardiometabolic risk (PC CMR), a stepwise approach to identify and manage patients with cardiometabolic risk factors, was developed. The aim of this study was 1) to evaluate uptake rates of the two steps of the PC CMR, 2) to assess the rates of newly diagnosed hypertension, hypercholesterolemia, diabetes mellitus and chronic kidney disease and 3) to explore reasons for non-participation. Sixteen general practices throughout the Netherlands were recruited to implement the PC CMR during 6 months. In eight practices eligible patients aged between 45 and 70 years without a cardiometabolic disease were actively invited by a personal letter ('active approach') and in eight other practices eligible patients were informed about the PC CMR only by posters and leaflets in the practice ('passive approach'). Participating patients completed an online risk estimation (first step). Patients estimated as having a high risk according to the online risk estimation were advised to visit their general practice to complete the risk profile with blood pressure measurements and blood tests for cholesterol and glucose and to receive recommendations about risk lowering interventions (second step). The online risk estimation was completed by 521 (33%) and 96 (1%) of patients in the practices with an active and passive approach, respectively. Of these patients 392 (64%) were estimated to have a high risk and were referred to the practice; 142 of 392 (36%) consulted the GP. A total of 31 (22%) newly diagnosed patients were identified. Hypertension, hypercholesterolemia, diabetes and chronic kidney disease were diagnosed in 13%, 11%, 1% and 0%, respectively. Privacy risks were the most frequently mentioned reason not to participate. One third of the patients responded to an active invitation to complete an online risk estimation. A passive invitation resulted in only a small number of participating patients. Two third of the participants of the online risk estimation had a high risk, but only one third of them attended the GP office. One in five visiting patients had a diagnosed cardiometabolic risk factor or disease.

Translation, Validation, and Reliability of the Dutch Late-Life Function and Disability Instrument Computer Adaptive Test.

PubMed

Arensman, Remco M; Pisters, Martijn F; de Man-van Ginkel, Janneke M; Schuurmans, Marieke J; Jette, Alan M; de Bie, Rob A

2016-09-01

Adequate and user-friendly instruments for assessing physical function and disability in older adults are vital for estimating and predicting health care needs in clinical practice. The Late-Life Function and Disability Instrument Computer Adaptive Test (LLFDI-CAT) is a promising instrument for assessing physical function and disability in gerontology research and clinical practice. The aims of this study were: (1) to translate the LLFDI-CAT to the Dutch language and (2) to investigate its validity and reliability in a sample of older adults who spoke Dutch and dwelled in the community. For the assessment of validity of the LLFDI-CAT, a cross-sectional design was used. To assess reliability, measurement of the LLFDI-CAT was repeated in the same sample. The item bank of the LLFDI-CAT was translated with a forward-backward procedure. A sample of 54 older adults completed the LLFDI-CAT, World Health Organization Disability Assessment Schedule 2.0, RAND 36-Item Short-Form Health Survey physical functioning scale (10 items), and 10-Meter Walk Test. The LLFDI-CAT was repeated in 2 to 8 days (mean=4.5 days). Pearson's r and the intraclass correlation coefficient (ICC) (2,1) were calculated to assess validity, group-level reliability, and participant-level reliability. A correlation of .74 for the LLFDI-CAT function scale and the RAND 36-Item Short-Form Health Survey physical functioning scale (10 items) was found. The correlations of the LLFDI-CAT disability scale with the World Health Organization Disability Assessment Schedule 2.0 and the 10-Meter Walk Test were -.57 and -.53, respectively. The ICC (2,1) of the LLFDI-CAT function scale was .84, with a group-level reliability score of .85. The ICC (2,1) of the LLFDI-CAT disability scale was .76, with a group-level reliability score of .81. The high percentage of women in the study and the exclusion of older adults with recent joint replacement or hospitalization limit the generalizability of the results. The Dutch LLFDI-CAT showed strong validity and high reliability when used to assess physical function and disability in older adults dwelling in the community. © 2016 American Physical Therapy Association.

Managing barriers to empathy in the clinical encounter: a qualitative interview study with GPs

PubMed Central

Derksen, Frans AWM; Hartman, Tim C olde; Bensing, Jozien M; Lagro-Janssen, Antoine LM

2016-01-01

Background Current daily general practice has become increasingly technical and somatically oriented (where attention to patients’ feelings is decreased) due to an increase in protocol-based guidelines. Priorities in GP–patient communication have shifted from a focus on listening and empathy to task-oriented communication. Aim To explore what barriers GPs experience when applying empathy in daily practice, and how these barriers are managed. Design and setting Thirty Dutch GPs with sufficient heterogeneity in sex, age, type of practice, and rural or urban setting were interviewed. Method The consolidated criteria for reporting qualitative research (COREQ) were applied. The verbatim transcripts were then analysed. Results According to participating GPs, the current emphasis on protocol-driven care can be a significant barrier to genuineness in communication. Other potential barriers mentioned were time pressures and constraints, and dealing with patients displaying ‘unruly behaviour’ or those with personality disorders. GPs indicated that it can be difficult to balance emotional involvement and professional distance. Longer consulting times, smaller practice populations, and efficient practice organisation were described as practical solutions. In order to focus on a patient-as-person approach, GPs strongly suggested that deviating from guidelines should be possible when necessary as an element of good-quality care. Joining intercollegiate counselling groups was also discussed. Conclusion In addition to practical solutions for barriers to behaving empathically, GPs indicated that they needed more freedom to balance working with protocols and guidelines, as well as a patient-as-person and patient-as-partner approach. This balance is necessary to remain connected with patients and to deliver care that is truly personal. PMID:27884917

Neighbourhood safety and leisure-time physical activity among Dutch adults: a multilevel perspective.

PubMed

Kramer, Daniëlle; Maas, Jolanda; Wingen, Marleen; Kunst, Anton E

2013-01-28

Several neighbourhood elements have been found to be related to leisure-time walking and cycling. However, the association with neighbourhood safety remains unclear. This study aimed to assess the association of neighbourhood-level safety with leisure-time walking and cycling among Dutch adults. Data were derived from the national health survey (POLS) 2006-2009, with valid data on 20046 respondents residing in 2127 neighbourhoods. Multilevel logistic regression models were used to examine the association between neighbourhood-level safety (general safety and specific safety components: physical disorder, social disorder, crime-related fear, traffic safety) and residents' engagement in outdoor leisure-time walking and cycling for at least 30 minutes per week. An increase in neighbourhood safety (both general safety and each of the safety components) was significantly associated with an increase in leisure-time cycling participation. Associations were strongest for general safety and among older women. In the general population, neighbourhood safety was not significantly associated with leisure-time walking. However, among younger and older adult men and lower educated individuals, an increase in general safety was associated with a decrease in leisure-time walking participation. In the Netherlands, neighbourhood safety appears to be related to leisure-time cycling but not to walking. Leisure-time cycling may best be encouraged by improving different safety components at once, rather than focusing on one safety aspect such as traffic safety. Special attention is needed for older women.

The Relationship Between Early Sexual Debut and Psychosocial Outcomes: A Longitudinal Study of Dutch Adolescents

PubMed Central

Sandfort, Theo; Reitz, Ellen; Bos, Henny; Dekovic, Maja

2010-01-01

In a longitudinal dataset of 470 Dutch adolescents, the current study examined the ways in which early sexual initiation was related to subsequent attachment, self-perception, internalizing problems, and externalizing problems. For male adolescents, analyses revealed general attachment to mother and externalizing problems at Wave 1 to predict to early transition at Wave 2. However, there was no differential change in these psychosocial factors over time for early initiators of sexual intercourse and their non-initiating peers. For female adolescents, the model including psychosocial factors at Wave 1 did not predict to sexual initiation at Wave 2. However, univariate repeated measures analyses revealed early initiators to have significantly larger increases in self-concept and externalizing problems than their non-initiating female peers. While the difference between female early initiators and non-initiators were statistically significant, the mean levels of problem behaviors were very low. The findings suggest that, contrary to previous research, early sexual initiation does not seem to be clustered with problem behaviors for this sample of Dutch adolescents. PMID:20119696

Cross-cultural validity of the scale for interpersonal behavior.

PubMed

Nota, Laura; Arrindell, Willem A; Soresi, Salvatore; van der Ende, Jan; Sanavio, Ezio

2011-01-01

The Scale for Interpersonal Behavior (SIB) is a 50-item multidimensional measure of difficulty and distress in assertiveness. The SIB assesses negative assertion, expression of and dealing with personal limitations, initiating assertiveness and positive assertion. The SIB was originally developed in the Netherlands. The present study attempted to replicate the original factors with an Italian student sample (n = 995). The four distress and four performance factors were replicable across two methods of analysis (the multiple group method of confirmatory analysis and Tucker's coefficient of congruence (phi). The corresponding scales were internally consistent and showed predicted patterns of correlations with a measure of self-efficacy. Sex and age differences in assertiveness were generally negligible. Italian students had higher positive assertion-performance scores than the Dutch and comparable scores on other performance scales; by contrast, the Italian subjects had significantly higher scores on all SIB distress scales than their Dutch equivalents. This was ascribed to the stronger pressure on people in Italian society to behave assertively (Hofstede's National Masculinity score = 70) as opposed to the Dutch society (National Masculinity score = 14).

Verbal Working Memory Is Related to the Acquisition of Cross-Linguistic Phonological Regularities.

PubMed

Bosma, Evelyn; Heeringa, Wilbert; Hoekstra, Eric; Versloot, Arjen; Blom, Elma

2017-01-01

Closely related languages share cross-linguistic phonological regularities, such as Frisian -âld [ͻ:t] and Dutch -oud [ʱut], as in the cognate pairs kâld [kͻ:t] - koud [kʱut] 'cold' and wâld [wͻ:t] - woud [wʱut] 'forest'. Within Bybee's (1995, 2001, 2008, 2010) network model, these regularities are, just like grammatical rules within a language, generalizations that emerge from schemas of phonologically and semantically related words. Previous research has shown that verbal working memory is related to the acquisition of grammar, but not vocabulary. This suggests that verbal working memory supports the acquisition of linguistic regularities. In order to test this hypothesis we investigated whether verbal working memory is also related to the acquisition of cross-linguistic phonological regularities. For three consecutive years, 5- to 8-year-old Frisian-Dutch bilingual children ( n = 120) were tested annually on verbal working memory and a Frisian receptive vocabulary task that comprised four cognate categories: (1) identical cognates, (2) non-identical cognates that either do or (3) do not exhibit a phonological regularity between Frisian and Dutch, and (4) non-cognates. The results showed that verbal working memory had a significantly stronger effect on cognate category (2) than on the other three cognate categories. This suggests that verbal working memory is related to the acquisition of cross-linguistic phonological regularities. More generally, it confirms the hypothesis that verbal working memory plays a role in the acquisition of linguistic regularities.

Sex differences in obesity related cancer incidence in relation to type 2 diabetes diagnosis (ZODIAC-49).

PubMed

Schrijnders, Dennis; Hendriks, Steven H; Kleefstra, Nanne; Vissers, Pauline A J; Johnson, Jeffrey A; de Bock, Geertruida H; Bilo, Henk J G; Landman, Gijs W D

2018-01-01

Diabetes and obesity seem to be partly overlapping risk factors for the development of obesity-related cancer (mainly breast, prostate and colorectal cancer) in patients with type 2 diabetes (T2DM). In the general population, women have a lower risk for obesity-related cancer compared to men. Previous studies involving cardiovascular disease have shown that T2DM eliminates a female advantage of lower CVD risk in the general population compared to men. It is unclear whether the same could be true for obesity-related cancer. This study aimed to this investigate obesity-related cancer incidence in women and men known with T2DM as compared to the Dutch general population. This study included 69,583 patients with T2DM selected from a prospective primary care cohort, which was linked to the Dutch National Cancer Registry to obtain cancer specific data. Obesity-related cancers included liver, kidney, colorectal, gallbladder, pancreas, ovarian, endometrial, advanced prostate cancer, post-menopausal breast cancer and oesophageal adenocarcinoma. Primary outcome was sex-stratified, age and year of cancer diagnosis adjusted standardized incidence ratios (SIRs) for three time periods: 5 years before, the year after diagnosis and the next 4 years after T2DM diagnosis. The Dutch general population was used as reference group. Women with T2DM were at an increased risk for obesity-related cancer compared to women in the general population already 5 years before diabetes diagnosis (SIR 1.77; 95%CI: 1.63-1.91). In both men and women, there was a peak in obesity-related cancer incidence following diabetes diagnosis (SIR: 1.38; 95%CI 1.11-1.64 and SIR: 2.21; 95%CI 1.94-2.30, respectively). From the second to the fifth year after diabetes diagnosis the obesity-related cancer incidence was higher in women compared to women in the general population (SIR: 2.12; 95%CI 1.94-2.30). Women with T2DM seem to have a substantially higher obesity-related cancer risk. As opposed to men, in women this risk was already increased years before diabetes diagnosis. These results could imply that a relative advantage of women in the general population with regard to cancer risk is lost in women with T2DM.

Sex differences in obesity related cancer incidence in relation to type 2 diabetes diagnosis (ZODIAC-49)

PubMed Central

Hendriks, Steven H.; Kleefstra, Nanne; Vissers, Pauline A. J.; de Bock, Geertruida H.; Bilo, Henk J. G.; Landman, Gijs W. D.

2018-01-01

Background Diabetes and obesity seem to be partly overlapping risk factors for the development of obesity-related cancer (mainly breast, prostate and colorectal cancer) in patients with type 2 diabetes (T2DM). In the general population, women have a lower risk for obesity-related cancer compared to men. Previous studies involving cardiovascular disease have shown that T2DM eliminates a female advantage of lower CVD risk in the general population compared to men. It is unclear whether the same could be true for obesity-related cancer. This study aimed to this investigate obesity-related cancer incidence in women and men known with T2DM as compared to the Dutch general population. Methods This study included 69,583 patients with T2DM selected from a prospective primary care cohort, which was linked to the Dutch National Cancer Registry to obtain cancer specific data. Obesity-related cancers included liver, kidney, colorectal, gallbladder, pancreas, ovarian, endometrial, advanced prostate cancer, post-menopausal breast cancer and oesophageal adenocarcinoma. Primary outcome was sex-stratified, age and year of cancer diagnosis adjusted standardized incidence ratios (SIRs) for three time periods: 5 years before, the year after diagnosis and the next 4 years after T2DM diagnosis. The Dutch general population was used as reference group. Results Women with T2DM were at an increased risk for obesity-related cancer compared to women in the general population already 5 years before diabetes diagnosis (SIR 1.77; 95%CI: 1.63–1.91). In both men and women, there was a peak in obesity-related cancer incidence following diabetes diagnosis (SIR: 1.38; 95%CI 1.11–1.64 and SIR: 2.21; 95%CI 1.94–2.30, respectively). From the second to the fifth year after diabetes diagnosis the obesity-related cancer incidence was higher in women compared to women in the general population (SIR: 2.12; 95%CI 1.94–2.30). Conclusions Women with T2DM seem to have a substantially higher obesity-related cancer risk. As opposed to men, in women this risk was already increased years before diabetes diagnosis. These results could imply that a relative advantage of women in the general population with regard to cancer risk is lost in women with T2DM. PMID:29370205

The Four-Dimensional Symptom Questionnaire (4DSQ) in the general population: scale structure, reliability, measurement invariance and normative data: a cross-sectional survey.

PubMed

Terluin, Berend; Smits, Niels; Brouwers, Evelien P M; de Vet, Henrica C W

2016-09-15

The Four-Dimensional Symptom Questionnaire (4DSQ) is a self-report questionnaire measuring distress, depression, anxiety and somatization with separate scales. The 4DSQ has extensively been validated in clinical samples, especially from primary care settings. Information about measurement properties and normative data in the general population was lacking. In a Dutch general population sample we examined the 4DSQ scales' structure, the scales' reliability and measurement invariance with respect to gender, age and education, the scales' score distributions across demographic categories, and normative data. 4DSQ data were collected in a representative Dutch Internet panel. Confirmatory factor analysis was used to examine the scales' structure. Reliability was examined by Cronbach's alpha, and coefficients omega-total and omega-hierarchical. Differential item functioning (DIF) analysis was used to evaluate measurement invariance across gender, age and education. The total response rate was 82.4 % (n = 5273/6399). The depression scale proved to be unidimensional. The other scales were best represented as bifactor models consisting of a large general factor and one or more smaller specific factors. The general factors accounted for more than 95 % of the reliable variance of the scales. Reliability was high (≥0.85) by all estimates. The distress-, depression- and anxiety scales were invariant across gender, age and education. The somatization scale demonstrated some lack of measurement invariance as a result of decreased thresholds for some of the items in young people (16-24 years) and increased thresholds in elderly people (65+ years). The somatization scale was invariant regarding gender and education. The 4DSQ scores varied significantly across demographic categories, but the explained variance was small (<6 %). Normative data were generated for gender and age categories. Approximately 17 % of the participants scored above average on de distress scale, whereas 12 % scored above average on de somatization scale. Percentages of people scoring high enough on depression or anxiety as to suspect the presence of depressive or anxiety disorder were 4.1 and 2.5 respectively. Evidence supports reliability and measurement invariance of the 4DSQ in the general Dutch population. The normative data provided in this study can be used to compare a subject's 4DSQ scores with a general population reference group.

Health-related behavior as a mechanism behind the relationship between neighborhood social capital and individual health - a multilevel analysis

PubMed Central

2012-01-01

Background Although various studies have found a positive association between neighborhood social capital and individual health, the mechanism explaining this direct effect is still unclear. Neighborhood social capital is the access to resources that are generated by relationships between people in a friendly, well-connected and tightly knit neighborhood community. We expect that the resources generated by cohesive neighborhoods support and influence health -improving behaviors in daily life. We identify five different health-related behaviors that are likely to be affected by neighborhood social capital and test these behaviors separately as mediators. Methods The data set pertaining to individual health was taken from the 'health interview' in the 'Second Dutch national survey of general practice' (DNSGP-2, 2002). We combine these individual-level data with data from the 'Dutch housing demand survey' (WBO, 1998 and WoON, 2002) and statistical register information (1995-1999). Per neighborhood 29 WBO respondents, on average, had answered questions regarding social capital in their neighborhood. These variables have been aggregated to the neighborhood level by an ecometric methodology. In the main analysis, in which we tested the mediation, multilevel (ordered) logistic regressions were used to analyze 9253 adults (from the DNSGP-2 data set) from 672 Dutch neighborhoods. In the Netherlands, on average, neighborhoods (4-digit postcodes) comprise 4,000 inhabitants at highly variable population densities. Individual- and neighborhood-level controls have been taken into account in the analyses. Results In neighborhoods with a high level of social capital, people are more physically active and more likely to be non-smokers. These behaviors have positive effects on their health. The direct effect of neighborhood social capital on health is significantly and strongly reduced by physical activity. This study does not support nutrition and sleep habits or moderate alcohol intake as possible explanations of the effects of neighborhoods on health. Conclusions This study is one of the first to test a mechanism explaining much of the direct effect of small-area social capital on individual health. Neighborhood interventions might be most successful at improving health if they stimulate both social interaction and physical activity. PMID:22325740

Ethnic Identity, Externalizing Problem Behaviour and the Mediating Role of Self-Esteem among Dutch, Turkish-Dutch and Moroccan-Dutch Adolescents

ERIC Educational Resources Information Center

Wissink, Inge B.; Dekovic, Maja; Yagmur, Sengul; Stams, Geert Jan; de Haan, Mariette

2008-01-01

The present study examined whether self-esteem mediates the relationship between two aspects of ethnic identity (i.e. ethnic identity exploration and ethnic identity commitment-affirmation) and externalizing problem behaviour in Dutch, Turkish-Dutch and Moroccan-Dutch adolescents living in the Netherlands. A total number of 345 adolescents (115…

Ultrasound imaging to tailor the treatment of acute shoulder pain: a randomised controlled trial in general practice.

PubMed

Ottenheijm, Ramon P G; Cals, Jochen W L; Winkens, Bjorn; Weijers, René E; de Bie, Rob A; Dinant, Geert-Jan

2016-11-21

To determine the clinical effectiveness of ultrasound tailored treatment in patients with acute subacromial disorders. Pragmatic randomised controlled trial. Dutch general practice. Patients aged 18-65 years with acute (duration <3 months) unilateral shoulder pain and no previous treatment, in whom the general practitioner suspected a subacromial disorder was enrolled. All patients underwent ultrasound imaging of the affected shoulder. Patients who were still symptomatic after a qualification period of 2 weeks with standard treatment were randomised to treatment tailored to ultrasound diagnosis (disclosure of the ultrasound diagnosis) or usual care (non-disclosure of the ultrasound diagnosis). Patient-perceived recovery using the Global Perceived Effect questionnaire at 1 year. 129 patients were included. 18 patients recovered during the 2-week qualification period, resulting in 111 randomised patients; 56 were allocated to ultrasound tailored treatment and 55 to usual care. After 1 year, no statistically significant differences in recovery were found between the ultrasound tailored treatment group (72.5% (37/51)) and the usual care group (60% (30/50), OR 2.24 (95% CI 0.72 to 6.89; p=0.16)). Also, healthcare use was similar. This study has shown no clinically significant difference in the primary outcome measure between the ultrasound tailored treatment and usual care groups. Furthermore, there was no overall difference in healthcare resources used between groups. Although no formal cost data are included, one can only assume that the ultrasound examinations are additional costs for the intervention group, which cannot be justified in routine practice based on this trial. Based on this study, no change in current pragmatic guidelines to incorporate early ultrasound imaging can be recommended. NTR2403; Results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

[Drug advertising as communication between the pharmaceutical industry and the physician: advertisements for psychotropic drugs in the Dutch medical journal, Nederlands Tijdschrift voor Geneeskunde, 1900-1940].

PubMed

van der Hoogte, Arjo Roersch; Pieters, Toine

2010-01-01

In this article we explore the historical development of drug advertisements for psychotropic drugs in the leading Dutch medical journal from 1900 to 1940. The advertisements for hypnotics and sedatives, in The Nederlands Tijdschrift voor Geneeskunde (Dutch medical journal) reflected the changes in the vocabulary and image promoted by the pharmaceutical companies. In the first two decades, the advertisements were sober and to the point, and included the trademark, company name, molecular formula and therapeutic properties of the medication. The emphasis was on creating a scientific image of reliable symptom control for the therapeutic drug. In doing so, the ethical drug companies tried (successfully) to distinguish themselves from the producers of patent medicines. Once scientific credibility was established, the form and content of the advertisements changed significantly. In the late 1920s and 1930s drug companies embraced modern advertising techniques, developing a figurative language to address the changing beliefs and practices of Dutch physicians. Instead of promoting therapeutic drugs as safe and scientific, the emphasis was on their effectiveness in comparison to similar drugs. In the process, scientific information was reduced to an indispensable standardized minimum, whereby therapeutic drugs were advertised according to the latest pharmacological taxonomy rather than molecular formulas. The image-making of 'ethical marketing' began during the interwar years when marketers applied modern advertising techniques and infotainment strategies. The scanty black and white informational bulletins transitioned into colourful advertisements. The pharmaceutical companies employed the same medical language as used by physicians, so that one word or image in an advertisement would suffice for the physician to recognize a drug and its therapeutic properties. These developments show the changing relationship between the modern ethical pharmaceutical industry and Dutch doctors during the interwar years--from rapprochement towards concerted action.

A Comparison of the Technical Communications Practices of Dutch U.S. Aerospace Engineers and Scientists. Number 17

DTIC Science & Technology

1993-07-01

Thomas E.; Rebecca 0. Barclay; Michael L. Keene; Madelyn Flammia ; and John M. Kennedy. The Technical Communication Practices of Russian and U. S ...doc’.lmeflt has b൓UWSJuly 1 993 fot pub~ic ge~ea~SO Q• S •e ill a i~tzibution • s unlmite4 S •l• National Aeronautics and Space Administration...SDepartment of Defense S •’• INDIANA UNIVERSITY I I I INTRODUCTION Rapidly changing patterns of international cooperation and collaboration and revolutionary

Obstacles to Successful Implementation of eHealth Applications into Clinical Practice.

PubMed

Voogt, Marianne P; Opmeer, Brent C; Kastelein, Arnoud W; Jaspers, Monique W M; Peute, Linda W

2018-01-01

eHealth can improve healthcare worldwide, and scientific research should provide evidence on the efficacy, safety and added value of such interventions. For successful implementation of eHealth interventions into clinical practice, barriers need to be anticipated. We identified seven barriers by interviewing health professionals in the Dutch healthcare system. These barriers covered three topics: financing, human factors and organizational factors. This paper discusses their potential impact on eHealth uptake. Bridging the gap between studies to assess effective eHealth interventions and their value-based implementation in healthcare is much needed.

[Post-academic dental specialties 18. The graduate programme in periodontology].

PubMed

van der Velden, U

2008-07-01

In 1987, the Dutch Society of Periodontology (NVvP) made it possible for dentists to be recognized as specialists in periodontology. This recognition lasts for 5 years after which, on the basis of an evaluation of the Consilium Parodontologicum of the NVvP, continuation of the recognition for another period of 5 years is possible. The Academic Centre for Dentistry at the University of Amsterdam and the University Medical Centre St Radboud at Nijmegen University provide a 3 year full time specialisation programme in periodontology. These programmes are approved by the European Federation of Periodontology. After successful completion of one of these programmes, recognition as periodontist by the Dutch Society of Periodontology can be requested. Possible recognition is based on an extensive evaluation during a one day site visit in the practice by the Consilium Parodontologicum.

Veterinary Antibiotics in Young Dutch Groundwater under Intensive Livestock Farming

NASA Astrophysics Data System (ADS)

Vliet, M. V.; Kivits, T.; Broers, H. P.; Beeltje, H.; Griffioen, J.

2016-12-01

Dutch groundwater is heavily affected by nutrient loads from agricultural origin. The use of antibiotics is also widespread in Dutch farming practice, 200.000 kg active substance over 1.839.000 ha of agricultural land. National measures were established to reduce the applications. Spreading of manure over farmlands is assumed to be the main pathway for the leaching of antibiotics to groundwater, but actual numbers are lacking. We studied the occurrence of veterinary antibiotics in groundwater in two areas with intensive livestock farming, sampling existing multi-level wells that were previously age dated using tritium-helium. Wells were selected based on the following criteria: the uppermost screen is situated just below the average groundwater level, which is not deeper than 3 meters, the well is in an agricultural field where rainwater infiltrates avoiding areas adjacent to ditches or streams, the groundwater quality is known for several years and the age of the extracted water is known to be young (<25 yrs.). Twenty-two antibiotics used in in intensive livestock farming were analyzed belonging to the following groups: tetracyclines, sulfonamides, diaminopyrimidines, β-lactams, macrolides, lincosamides, quinolones and in addition nitrofurans and chloramphenicol. The samples were analyzed for antibiotics by liquid chromatography/mass spectrometry preceded by solid phase extraction (Oasis HLB cartridge). Five out of 22 antibiotics were detected: sulfamethazine, sulfadiazine, sulfamethoxazole, lincomycin, chloramphenicol in concentration ranges of 0.2 to 18 ng/l. Sulfamethazine was most frequently found, and shows a continuous concentration-depth profile in 3 out of 4 multi-level wells. Sulfonamides were found in groundwater up to 20 m. depth and in water aged between 1 and 25 years old. The study shows that sulfonamides are omnipresent in groundwater up to 25 years old, which corresponds with the known history of the use of antibiotics in veterinary practice.

A core physical examination in internal medicine: what should students do and how about their supervisors?

PubMed

Haring, Catharina M; van der Meer, Jos W M; Postma, Cornelis T

2013-09-01

Performance of a focused physical examination will induce a high cognitive load for medical students in the early phase of the clinical clerkships. To come to a workable and clinically applicable standard physical examination for medical students to be used in every new patient in the daily clinical practice of internal medicine. A questionnaire held among physicians that supervise students during the clerkship of internal medicine in one Dutch training region. Of the complete list of physical examination 55 items were considered to be an integral part of the standard general physical examination for medical students. Most emphasized were elements of the physical examination aimed at general parameters, thorax and abdomen, vascular status, lymph nodes, spinal column, skin and some parts of the neurological examination. The standard physical examinations performed by supervisors themselves contain fewer items than they expected from the students. The expectations a supervisor has towards the student correlates with the frequency with which they apply the various components in their own physical examination. This study provides us with a 'core' physical examination for medical students that can be applied in the early phase of the clinical clerkships.

Shared decision making, a buzz-word in the Netherlands, the pace quickens towards nationwide implementation….

PubMed

van der Weijden, Trudy; Post, Heleen; Brand, Paul L P; van Veenendaal, Haske; Drenthen, Ton; van Mierlo, Linda Aj; Stalmeier, Peep; Damman, Olga C; Stiggelbout, Anne

2017-06-01

Currently, shared decision making (SDM) is on the agenda among target patient representative groups, policy makers and professional bodies. Although the International Conference for Shared Decision Making (ISDM) 2011 generated a positive boost, hesitation was also felt among Dutch clinicians, who are challenged by many new tasks. No hesitation is seen among the majority of patients, opting mostly for the SDM model. We haven't reached these patients' needs fully yet, given disappointing research data on patients' experiences and professional behaviour. There is plenty of room for improvement in daily practice, for which many best practices are being designed and increasingly implemented, such as national campaigns to empower patients, central governance of patient decision aids that are developed along clinical practice guidelines, postgraduate training, collaborative learning and system changes, and merging goal setting and SDM in complex care. This is explicitly supported by the Dutch government, the Ministry of Health, patient groups, professional bodies and health insurers. The culture shift in the minds and hearts of patients and clinicians has started but is still ongoing. Enthusiasm for this way of working could be undermined if SDM is defined and implemented in a simplistic, dogmatic manner leading to irresponsible transferring of the professionals' uncertainty, responsibility, and decisional stress to patients. Copyright © 2017. Published by Elsevier GmbH.

Prescription practice of biological drugs in rheumatoid arthritis during the first 3 years of post-marketing use in Denmark and Norway: criteria are becoming less stringent

PubMed Central

Hjardem, E; Hetland, M; Ostergaard, M; Krogh, N; Kvien, T

2005-01-01

Objective: To investigate changes in prescription practice during the first 3 years of post-marketing use of biological drugs, and to determine the proportion of patients who would not have received tumour necrosis factor (TNF) blocking agents if the prescription guidelines of the UK and the Netherlands had been applied. Methods: Patients with rheumatoid arthritis (RA) receiving TNF blocking agents from Denmark (n = 823, median age 56.0, 72.2% women) and Norway (n = 371, median age 52.5, 75.4% women) were studied. Prescription guidelines in the UK and the Netherlands were applied to the data. Results: Baseline disease activity and number of previous DMARDs declined significantly during the 3 years (median baseline DAS28 decreased from 5.8 to 5.2 in Denmark (p<0.001) and from 6.0 to 5.6 in Norway (p<0.01)). 47.9% and 41.3% of the Norwegian and Danish patients, respectively, did not meet the UK criteria for using TNF blocking agents, and 10.5% and 5.7% did not meet the Dutch criteria. Conclusion: Danish and Norwegian prescription practices of biological treatments in RA were similar, and became less stringent from 2000 to 2003. Prescriptions agreed well with the Dutch guidelines, but almost half the patients did not meet the UK guidelines. PMID:15640272

Emotional Learning and Identity Development in Medicine: A Cross-Cultural Qualitative Study Comparing Taiwanese and Dutch Medical Undergraduates.

PubMed

Helmich, Esther; Yeh, Huei-Ming; Yeh, Chi-Chuan; de Vries, Joy; Fu-Chang Tsai, Daniel; Dornan, Tim

2017-06-01

Current knowledge about the interplay between emotions and professional identity formation is limited and largely based on research in Western settings. This study aimed to broaden understandings of professional identity formation cross-culturally. In fall 2014, the authors purposively sampled 22 clinical students from Taiwan and the Netherlands and asked them to keep audio diaries, narrating emotional experiences during clerkships using three prompts: What happened? What did you feel/think/do? How does this interplay with your development as a doctor? Dutch audio diaries were supplemented with follow-up interviews. The authors analyzed participants' narratives using a critical discourse analysis informed by Figured Worlds theory and Bakhtin's concept of dialogism, according to which people's spoken words create identities in imagined future worlds. Participants talked vividly, but differently, about their experiences. Dutch participants' emotions related to individual achievement and competence. Taiwanese participants' rich, emotional language reflected on becoming both a good person and a good doctor. These discourses constructed doctors' and patients' autonomy in culturally specific ways. The Dutch construct centered on "hands-on" participation, which developed the identity of a technically skilled doctor, but did not address patients' self-determination. The Taiwanese construct located physicians' autonomy within moral values more than practical proficiency, and gave patients agency to influence doctor-patient relationships. Participants' cultural constructs of physician and patient autonomy led them to construct different professional identities within different imagined worlds. The contrasting discourses show how medical students learn about different meanings of becoming doctors in culturally specific contexts.

Barriers to Communication Management in the Executive Suite.

ERIC Educational Resources Information Center

Van Ruler, Betteke; De Lange, Rob

2003-01-01

Considers how, for many years now, courses in public relations, advertising, and communication management at universities throughout Europe have been attracting more students than ever. Notes a survey among Dutch companies found that communications activities in the Netherlands are indeed coordinated in a single department that generally has a…

[The fiscal position of medical specialists].

PubMed

Stevens, S; Moors, M

2013-01-01

Independent medical specialists in the Netherlands are treated as entrepreneurs for tax purposes and therefore enjoy tax benefits. A change in the legal relationship between medical specialists and hospitals is foreseen in 2015. Independent medical specialists will then no longer be considered to be entrepreneurs. This could negatively affect their tax position. The Dutch government has adopted a policy aimed at controlling expenses arising from medical specialists' fees. According to this policy, the formation of regional practices or mega-practices of specialists will be discouraged. In contrast, the current fiscal legislation encourages medical specialists to incorporate their practice into regional practices or mega-practices or to become shareholders of their hospitals. It has been proposed that fiscal benefits be linked to certain aspects of entrepreneurship, such as investing in medical equipment or employing medical personnel.

Lifestyle counseling in hypertension-related visits – analysis of video-taped general practice visits

PubMed Central

Milder, Ivon EJ; Blokstra, Anneke; de Groot, Judith; van Dulmen, Sandra; Bemelmans, Wanda JE

2008-01-01

Background The general practitioner (GP) can play an important role in promoting a healthy lifestyle, which is especially relevant in people with an elevated risk of cardiovascular diseases due to hypertension. Therefore, the aim of this study was to determine the frequency and content of lifestyle counseling about weight loss, nutrition, physical activity, and smoking by GPs in hypertension-related visits. A distinction was made between the assessment of lifestyle (gathering information or measuring weight or waist circumference) and giving lifestyle advice (giving a specific advice to change the patient's behavior or referring the patient to other sources of information or other health professionals). Methods For this study, we observed 212 video recordings of hypertension-related visits collected within the Second Dutch National Survey of General Practice in 2000/2001. Results The mean duration of visits was 9.8 minutes (range 2.5 to 30 minutes). In 40% of the visits lifestyle was discussed (n = 84), but in 81% of these visits this discussion lasted shorter than a quarter of the visit. An assessment of lifestyle was made in 77 visits (36%), most commonly regarding body weight and nutrition. In most cases the patient initiated the discussion about nutrition and physical activity, whereas the assessment of weight and smoking status was mostly initiated by the GP. In 35 visits (17%) the GP gave lifestyle advice, but in only one fifth of these visits the patient's motivation or perceived barriers for changing behavior were assessed. Supporting factors were not discussed at all. Conclusion In 40% of the hypertension-related visits lifestyle topics were discussed. However, both the frequency and quality of lifestyle advice can be improved. PMID:18854020

A Simple and Practical Index to Measure Dementia-Related Quality of Life.

PubMed

Arons, Alexander M M; Schölzel-Dorenbos, Carla J M; Olde Rikkert, Marcel G M; Krabbe, Paul F M

2016-01-01

Research on new treatments for dementia is gaining pace worldwide in an effort to alleviate this growing health care problem. The optimal evaluation of such interventions, however, calls for a practical and credible patient-reported outcome measure. To describe the refinement of the Dementia Quality-of-life Instrument (DQI) and present its revised version. A prototype of the DQI was adapted to cover a broader range of health-related quality of life (HRQOL) and to improve consistency in the descriptions of its domains. A valuation study was then conducted to assign meaningful numbers to all DQI health states. Pairs of DQI states were presented to a sample of professionals working with people with dementia and a representative sample of the Dutch population. They had to repeatedly select the best DQI state, and their responses were statistically modeled to obtain values for each health state. In total, 207 professionals working with people with dementia and 631 members of the general population completed the paired comparison tasks. Statistically significant differences between the two samples were found for the domains of social functioning, mood, and memory. Severe problems with physical health and severe memory problems were deemed most important by the general population. In contrast, severe mood problems were considered most important by professionals working with people with dementia. The DQI is a simple and feasible measurement instrument that expresses the overall HRQOL of people suffering from dementia in a single meaningful number. Current results suggest that revisiting the discussion of using values from the general population might be warranted in the dementia context. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

[Summary of the practice guideline 'The red eye' (first revision) of the Dutch College of General Practitioners (NHG)].

PubMed

van der Weele, G M; Rietveld, R P; Wiersma, Tj; Goudswaard, A N

2007-06-02

The revised NHG-guideline 'The red eye' provides recommendations for the diagnosis and therapy in patients with a red eye. In the presence of pain, decreased visual acuity and photophobia (alarm symptoms) should be considered as sight threatening conditions. In most instances a red eye results from conjunctivitis. The complaint of (an) early morning glued eye(s) makes a bacterial origin of acute infectious conjunctivitis more likely. Itching and a history of infectious conjunctivitis make the probability of bacterial involvement less likely. The type of discharge does not help to adequately distinguish bacterial from viral conjunctivitis. Since an infectious conjunctivitis is a self-limiting condition, no treatment is necessary as a rule. Antibiotic treatment is only rational if conjunctivitis is (most probably) caused by bacteria. It has to be considered only if a patient suffers from much discomfort, if complaints do not begin to decline after 3 days and in patients with preexisting corneal defects. Because of widespread resistance to fusidic acid this should in principle not be prescribed for treatment of conjunctivitis; chloramphenicol is still the drug of choice. During revision of the guideline discussions concentrated on 2 aspects: the position of slit lamp biomicroscopy in general practice and giving a patient with keratoconjunctivitis photoelectrica the remainder of a 'minim' with anaesthetic eye drops. Regarding both topics it was decided not to change the recommendations of the former version of the guideline: the use of slit lamp biomicroscopy remains optional for general practitioners and it remains permitted to give the remainder of a 'minim' with anaesthetic eye drops to a patient with keratoconjunctivitis photoelectrica.

Helping Families Improve: An Evaluation of Two Primary Care Approaches to Parenting Support in the Netherlands

ERIC Educational Resources Information Center

de Graaf, Ireen; Onrust, Simone; Haverman, Merel; Janssens, Jan

2009-01-01

The present study evaluated two primary care parenting interventions. First, we evaluated the most widely used Dutch practices for primary care parenting support. Second, we assessed the applicability of the Primary Care Triple P approach, which is now being utilized in a wide variety of primary care settings. Both interventions target parents of…

Intercultural doctor-patient communication in daily outpatient care: relevant communication skills.

PubMed

Paternotte, Emma; Scheele, Fedde; Seeleman, Conny M; Bank, Lindsay; Scherpbier, Albert J J A; van Dulmen, Sandra

2016-10-01

Intercultural communication (ICC) between doctors and patients is often associated with misunderstandings and dissatisfaction. To develop ICC-specific medical education, it is important to find out which ICC skills medical specialists currently apply in daily clinical consultations. Doctor-patient consultations of Dutch doctors with non-Dutch patients were videotaped in a multi-ethnic hospital in the Netherlands. The consultations were analyzed using the validated MAAS-Global assessment list in combination with factors influencing ICC, as described in the literature. In total, 39 videotaped consultations were analyzed. The doctors proved to be capable of practising many communication skills, such as listening and empathic communication behaviour. Other skills were not practised, such as being culturally aware and checking the patient's language ability. We showed that doctors did practice some but not all the relevant ICC skills and that the ICC style of the doctors was mainly biomedically centred. Furthermore, we discussed the possible overlap between intercultural and patient-centred communication. Implications for practice could be to implement the relevant ICC skills in the existing communication training or develop a communication training with a patient-centred approach including ICC skills.

Neuroscientific and behavioral genetic information in criminal cases in the Netherlands.

PubMed

de Kogel, C H; Westgeest, E J M C

2015-11-01

In this contribution an empirical approach is used to gain more insight into the relationship between neuroscience and criminal law. The focus is on case law in the Netherlands. Neuroscientific information and techniques have found their way into the courts of the Netherlands. Furthermore, following an Italian case in which a mentally ill offender received a penalty reduction in part because of a 'genetic vulnerability for impulsive aggression', the expectation was expressed that such 'genetic defenses' would appear in the Netherlands too. To assess how neuroscientific and behavioral genetic information are used in criminal justice practice in the Netherlands, we systematically collect Dutch criminal cases in which neuroscientific or behavioral genetic information is introduced. Data and case law examples are presented and discussed. Although cases are diverse, several themes appear, such as prefrontal brain damage in relation to criminal responsibility and recidivism risk, and divergent views of the implications of neurobiological knowledge about addiction for judging criminal responsibility. Whereas in the international 'neurolaw literature' the emphasis is often on imaging techniques, the Dutch findings also illustrate the role of neuropsychological methods in criminal cases. Finally, there appears to be a clear need of practice oriented instruments and guidelines.

Structural validity of the Dutch-language version of the WAIS-III in a psychiatric sample.

PubMed

van der Heijden, Paul; van den Bos, Pancras; Mol, Bart; Kessels, Roy P C

2013-01-01

The Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV; Wechsler, 2008 ) no longer provides the "traditional" Verbal IQ and Performance IQ deviation scores. In the current study, we investigated the structural validity of these scores in the scale's predecessor, the WAIS-Third Edition (WAIS-III; Wechsler, 1997c ), which is still widely used in clinical practice, especially outside the United States. Confirmative (CFA) and exploratory factor analyses (EFA) were performed on WAIS-III data from a Dutch sample of 247 psychiatric patients. Four competing models were tested in the CFA on 11 subtests. The model that fit the data best was a model in which subtests loaded on the four factor indexes (i.e., 3 Verbal Comprehension subtests, 3 Perceptual Organization subtests, 3 Working Memory subtests, and 2 Processing Speed subtests) as proposed by the manual (Wechsler, 1997b ). In the EFA on 13 subtests with four factors extracted, all subtests were found to load on the factors in accordance with the WAIS-III test manual. However, Picture Arrangement, Arithmetic, and Picture Completion showed only moderate loadings on the proposed factors. Implications for clinical practice are discussed.

Frederik Kaiser (1808-1872) and the Modernisation of Dutch Astronomy

NASA Astrophysics Data System (ADS)

van der Heijden, Petra

Frederik Kaiser was the director of Leiden Observatory from 1837 until his death in 1872. Educated by his German-born uncle Johan Frederik Keyser (1766-1823), who was a proficient amateur astronomer, Kaiser proved to be a real observational talent. Despite the poor conditions in which he worked, his observations soon rivalled with the best in the world. Kaiser's contributions to astronomical practice include the foundation of a new, completely up-to-date observatory building in Leiden, and the introduction of statistics and precision measurements in daily practice at the observatory. Moreover he was the author of several bestselling books on popular astronomy. Kaiser had an extensive correspondence with colleagues all over Europe, mostly in Germany. Correpondents include Airy, Argelander, Von Auwers, Bessel, Encke, John Herschel, LeVerrier, Von Littrow, Schumacher, Otto W. Struve, as well as several geodesists and instrument makers. Preliminary research indicates that Frederik Kaiser played a crucial role in the revival of Dutch astronomy in the second half of the 19th century. This project aims at analysing and explaining Kaiser's activities in science, institutionalisation and popularisation, in the context of national and international developments in 19th-century astronomy and scientific culture.

Neuroscientific and behavioral genetic information in criminal cases in the Netherlands

PubMed Central

de Kogel, C.H.; Westgeest, E.J.M.C.

2015-01-01

In this contribution an empirical approach is used to gain more insight into the relationship between neuroscience and criminal law. The focus is on case law in the Netherlands. Neuroscientific information and techniques have found their way into the courts of the Netherlands. Furthermore, following an Italian case in which a mentally ill offender received a penalty reduction in part because of a ‘genetic vulnerability for impulsive aggression’, the expectation was expressed that such ‘genetic defenses’ would appear in the Netherlands too. To assess how neuroscientific and behavioral genetic information are used in criminal justice practice in the Netherlands, we systematically collect Dutch criminal cases in which neuroscientific or behavioral genetic information is introduced. Data and case law examples are presented and discussed. Although cases are diverse, several themes appear, such as prefrontal brain damage in relation to criminal responsibility and recidivism risk, and divergent views of the implications of neurobiological knowledge about addiction for judging criminal responsibility. Whereas in the international ‘neurolaw literature’ the emphasis is often on imaging techniques, the Dutch findings also illustrate the role of neuropsychological methods in criminal cases. Finally, there appears to be a clear need of practice oriented instruments and guidelines. PMID:27774213

Effectiveness of an online SUpport PRogramme (SUPR) for older hearing aid users: study protocol for a cluster randomised controlled trial

PubMed Central

Meijerink, Janine FJ; Pronk, Marieke; Paulissen, Bernadette; Witte, Birgit I; van der Wouden, Bregje; Jansen, Vera; Kramer, Sophia E

2017-01-01

Background An educational SUpport PRogramme called SUPR has been developed for hearing aid users (HAUs) and their communication partners (CPs) offering care beyond hearing aid fitting. SUPR teaches its users communication strategies, hearing aid handling skills and personal adjustment to hearing impairment. Methods/design Using a cluster randomised controlled trial design, 70 Dutch hearing aid dispenser practices were randomised into hearing aid fitting (care as usual, 34 practices) and hearing aid fitting including SUPR (36 practices). The aim was to recruit a total of 569 older (aged 50+ years) first-time (n=258) and experienced (n=311) HAUs and their CPs. SUPR consists of a Practical Support Booklet and online material offered via email over a period of 6–7 months. The booklet provides practical information on hearing aids, advice on communication strategies and home exercises. The online material consists of educational videos on hearing aid functionality and usage, communication strategies and peer testimonials. Finally, noncommittal email contact with the dispenser is offered. Every HAU is asked to assign a CP who is advised to be involved intensively. Effect measurements for HAUs and their CPs will occur at baseline and at 6, 12 and 18 months follow-up via online questionnaires. The primary outcomes for HAUs will be the use of communication strategies as measured by the subscales of the Communication Profile for the Hearing Impaired. A process evaluation will be performed. Ethics and dissemination The study was approved by the Dutch Institutional Review Board of the VU Medical University Center Amsterdam. This intervention could contribute to lowering the hearing impairment burden in our ageing society. The results will be disseminated through peer-reviewed publications and scientific conferences. Trial registration number ISRCTN77340339; Pre-results. PMID:28634259

Attitude of dental hygienists, general practitioners and periodontists towards preventive oral care: an exploratory study.

PubMed

Thevissen, Eric; De Bruyn, Hugo; Colman, Roos; Koole, Sebastiaan

2017-08-01

Promoting oral hygiene and stimulating patient's responsibility for his/her personal health remain challenging objectives. The presence of dental hygienists has led to delegation of preventive tasks. However, in some countries, such as Belgium, this profession is not yet legalized. The aim of this exploratory study was to compare the attitude towards oral-hygiene instructions and patient motivational actions by dental hygienists and by general practitioners/periodontists in a context without dental hygienists. A questionnaire on demographics (six items), oral-hygiene instructions (eight items) and patient motivational actions (six items) was distributed to 241 Dutch dental hygienists, 692 general practitioners and 32 periodontists in Flanders/Belgium. Statistical analysis included Fisher's exact-test, Pearson's chi-square test and multiple (multinomial) logistic regression analysis to observe the influence of profession, age, workload, practice area and chair-assistance. Significant variance was found between general practitioners and dental hygienists (in 13 of 14 items), between general practitioners and periodontists (in nine of 14 items) and between dental hygienists and periodontists (in five of 14 items). In addition to qualification, chair-assistance was also identified as affecting the attitude towards preventive oral care. The present study identified divergence in the application of, and experienced barriers and opinions about, oral-hygiene instructions and patient motivational actions between dental hygienists and general practitioners/periodontists in a context without dental hygienists. In response to the barriers reported it is suggested that preventive oriented care may benefit from the deployment of dental hygienists to increase access to qualified preventive oral care. © 2017 FDI World Dental Federation.

Chlamydia screening and prophylactic treatment in termination of pregnancy clinics in the Netherlands and Great Britain: a qualitative study.

PubMed

van den Berg, Georgina F; Picavet, Charles; Hoopman, Rianne; Lohr, Patricia A; Op de Coul, Eline L M

2016-12-01

Women having a termination of pregnancy (TOP) have higher rates of Chlamydia trachomatis (CT) than the general population. In this study, we explored CT treatment and prevention in Dutch TOP clinics in comparison to that provided in Great Britain (GB). A qualitative study including 14 semi-structured interviews with health care professionals (HCPs) in TOP clinics (the Netherlands: 9, GB: 5). Interviews were recorded, transcribed, and analysed by thematic content analysis. Prophylactic treatment with azithromycin is routinely prescribed after surgical TOP, but not after medical TOP ('abortion pill'). Sexually transmitted infections (STI) tests are offered to clients who are considered at high risk of having STI. Uptake varies according to health insurance coverage of STI testing. Some Dutch clinics are able to provide free testing for women under 25 years of age. Sexual health counselling is often limited to discussing birth control. The major difference between the Netherlands and GB is that GB TOP clinics more often offer free STI testing and prophylaxis to their clients. HCPs in Dutch TOP clinics consider STI testing an important part of their service, but financial barriers prevent testing on location. Dutch TOP clinics should offer STI tests to all women, and collaboration with public health services could improve STI testing and counselling for young people. Furthermore, clinics should treat all TOP clients with prophylactic azithromycin. This could prevent CT and other upper genital tract post-abortion infections.

The comparison of birth outcomes and birth experiences of low-risk women in different sized midwifery practices in the Netherlands.

PubMed

Fontein, Yvonne

2010-09-01

To examine maternal birth outcomes and birth experiences of low-risk women in the Netherlands in different sized midwifery practices. Descriptive study using postal questionnaires six weeks after the estimated due date. Women were recruited from urban, semi-rural and rural areas from small-sized practices (1-2 midwives), medium-sized practices (3-4 midwives) or large-sized practices (5 or more). 718 Dutch speaking women with uncomplicated pregnancies, a representative sample of women in 143 midwifery practices in the Netherlands who had given birth in the period between 20 April and 20 May 2007. Distribution of place of birth categories and intervention categories, birth experience, woman-midwife relationship and presence of own midwife after referral. Data were analyzed with Statistical Package for Social Sciences (SPSS). Women in practices with a maximum of two midwives were significantly more likely to experience lower rates of referral, interventions in general and specifically pain relief by means of pethidine, CTG registration and unplanned caesarean sections. Women with a maximum of two midwives were significantly more likely to know their midwife or midwives and were more frequently supported by their own midwife after referral in comparison to women in practices with more than two midwives. The presence of the woman's own midwife added value to the birth experience. Women with a maximum of two midwives had higher levels of a positive birth experience than women in practices with more than two midwives. Midwifery practices with a maximum of two midwives contribute to non-interventionist birth and a positive birth experience. Awareness of the study results and further study is recommended to discuss reorganization of care in order to achieve significant reductions on referral and interventions during childbirth and positive maternal birth experiences. Copyright (c) 2010 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

The STAP-study: The (cost) effectiveness of custom made orthotic insoles in the treatment for plantar fasciopathy in general practice and sports medicine: design of a randomized controlled trial.

PubMed

Rasenberg, N; Fuit, L; Poppe, E; Kruijsen-Terpstra, A J A; Gorter, K J; Rathleff, M S; van Veldhoven, P L J; Bindels, P J; Bierma-Zeinstra, S M; van Middelkoop, M

2016-01-16

Plantar fasciopathy is a common cause of foot pain, accounting for 11 to 15% of all foot symptoms requiring professional care in adults. Although many patients have complete resolution of symptoms within 12 months, many patients wish to reduce this period as much as possible. Orthotic devices are a frequently applied option of treatment in daily practice, despite a lack of evidence on the effectiveness. Therefore, the objective is to study the (cost)-effectiveness of custom made insoles by a podiatrist, compared to placebo insoles and usual care in patients with plantar fasciopathy in general practice and sports medicine clinics. This study is a multi-center three-armed participant and assessor-blinded randomized controlled trial with 6-months follow-up. Patients with plantar fasciopathy, with a minimum duration of complaints of 2 weeks and aged between 18 and 65, who visit their general practitioner or sport physician are eligible for inclusion. A total of 185 patients will be randomized into three parallel groups. One group will receive usual care by the general practitioner or sports physician alone, one group will be referred to a podiatrist and will receive a custom made insole, and one group will be referred to a podiatrist and will receive a placebo insole. The primary outcome will be the change from baseline to 12 weeks follow-up in pain severity at rest and during activity on a 0-10 numerical rating scale (NRS). Secondary outcomes include foot function (according to the Foot Function Index) at 6, 12 and 26 weeks, recovery (7-point Likert) at 6, 12 and 26 weeks, pain at rest and during activity (NRS) at 6 and 26 weeks and cost-effectiveness of the intervention at 26-weeks. Measurements will take place at baseline and at, 2, 4, 6, 12 and 26 weeks of follow-up. The treatment of plantar fasciopathy is a challenge for health care professionals. Orthotic devices are frequently applied, despite a lack of evidence of the effectiveness on patient reported outcome. The results of this randomized controlled trial will improve the evidence base for treating this troublesome condition in daily practice. Dutch Trial Registration: NTR5346 . Date of registration: August 5(th) 2015.

The Science Shop for Physics: an interface between practical problems in society and physical knowledge

NASA Astrophysics Data System (ADS)

van den Berg, G. P.

1998-03-01

Since some 20 years most Dutch universities have one or more science shops. Central shops handle research questions for all disciplines. Specialized shops are part of a department of chemistry or medicine, history, social science, etc. The shops have evolved rather differently, but their main mission still is to help social groups that lack money and have no easy access to scientific knowledge, e.g. neighbourhood, environmental, third world or patient groups. Most also help non-commercial organizations such as schools, trade unions or local authorities. Low-cost help can be provided because students do the work as part of their training, mainly in student projects (literature search, practical work, graduation, etc.). A total staff of 80, helped by 600 students, 250 voluntary and 50 paid researchers, handle 1500 questions resulting in 300 reports (estimated figures 1995). Science shops for physics (`Physics Shop', PS) have to deal with practical problems, generally involving classical physics. Major topics are noise, vibration, radiation, indoor climate and energy: most of the work lies in estimating/measuring relevant parameters, assessing impact, seeking solutions. The 3 Dutch PS's have developed in different directions. One is run entirely by students and deals with small, concrete problems. The second PS is managed by a co-ordinator who mediates between client groups and physics staff members who assist students in small and larger projects. The third has a lot of in-house expertise, and the shop staff is in direct contact with client groups as well as students who work in the PS itself. In questions submitted to the PS it is not always immediately clear what to do or how to do it because of the non-scientific phrasing of the problems and problems include non-physical (e.g. technical, health or legal) aspects. Also, difficulties in solving the problems are typically not in the underlying physics, but in the lack of accurate data and of control of the complex environment. However, these very aspects are important from an educational point of view. Through these problems students (and physicists) may gain more insight into how lay people percieve and make use of science, and into the position of science in relation to other ways in which people try to understand their world.

Job satisfaction and job content in Dutch dental hygienists.

PubMed

Jerković-Ćosić, K; van Offenbeek, M A G; van der Schans, C P

2012-08-01

This study compares the scope of practice of Dutch dental hygienists (DHs) educated through a 2- or 3-year curriculum ('old-style DHs') with that of hygienists educated through a new extended 4-year curriculum leading to a bachelor's degree ('new-style DHs'), with the aim to investigate whether an extended scope of practice positively affects perceived skill variety, autonomy and job satisfaction. The questionnaires were obtained from old- and new-style DHs (n = 413, response 38%; n = 219, response 59%, respectively), in which respondents had recorded their dental tasks, perceived skill variety, autonomy and job satisfaction. T -tests were used to analyse differences between old- and new-style DHs, and regression analyses were performed to assess the relation between scope of practice and skill variety, autonomy and job satisfaction. New-style DHs have a more extended scope of practice compared with old-style DHs. Despite their more complex jobs, which are theoretically related to higher job satisfaction, new-style DHs perceive lower autonomy and job satisfaction (P < 0.05). Skill variety is the strongest predictor for DHs' job satisfaction (β = 0.462), followed by autonomy (β = 0.202) and caries decisive tasks, the last affecting job satisfaction negatively (β = -0.149). Self-employment is the strongest significant predictor for autonomy (β = 0.272). The core business of DHs remains the prevention and periodontology services. New-style DHs combine these tasks with extended tasks in the caries field, which can lead to comparatively less job satisfaction, because of a lower experienced autonomy in performing these extended tasks. © 2012 John Wiley & Sons A/S.

Further validation of the peripheral artery questionnaire: results from a peripheral vascular surgery survey in the Netherlands.

PubMed

Smolderen, K G; Hoeks, S E; Aquarius, A E; Scholte op Reimer, W J; Spertus, J A; van Urk, H; Denollet, J; Poldermans, D

2008-11-01

Peripheral arterial disease (PAD) is associated with adverse cardiovascular events and can significantly impair patients' health status. Recently, marked methodological improvements in the measurement of PAD patients' health status have been made. The Peripheral Artery Questionnaire (PAQ) was specifically developed for this purpose. We validated a Dutch version of the PAQ in a large sample of PAD patients. Cross-sectional study. The Dutch PAQ was completed by 465 PAD patients (70% men, mean age 65+/-10 years) participating in the Euro Heart Survey Programme. Principal components analysis and reliability analyses were performed. Convergent validity was documented by comparing the PAQ with EQ-5D scales. Three factors were discerned; Physical Function, Perceived Disability, and Treatment Satisfaction (factor loadings between 0.50 and 0.90). Cronbach's alpha values were excellent (mean alpha=0.94). Shared variance of the PAQ domains with EQ-5D scales ranged from 3 to 50%. The Dutch PAQ proved to have good measurement qualities; assessment of Physical Function, Perceived Disability, and Treatment Satisfaction facilitates the monitoring of patients' perceived health in clinical research and practice. Measuring disease-specific health status in a reliable way becomes essential in times were a wide array of treatment options are available for PAD patients.

Neighbourhood safety and leisure-time physical activity among Dutch adults: a multilevel perspective

PubMed Central

2013-01-01

Background Several neighbourhood elements have been found to be related to leisure-time walking and cycling. However, the association with neighbourhood safety remains unclear. This study aimed to assess the association of neighbourhood-level safety with leisure-time walking and cycling among Dutch adults. Methods Data were derived from the national health survey (POLS) 2006–2009, with valid data on 20046 respondents residing in 2127 neighbourhoods. Multilevel logistic regression models were used to examine the association between neighbourhood-level safety (general safety and specific safety components: physical disorder, social disorder, crime-related fear, traffic safety) and residents’ engagement in outdoor leisure-time walking and cycling for at least 30 minutes per week. Results An increase in neighbourhood safety (both general safety and each of the safety components) was significantly associated with an increase in leisure-time cycling participation. Associations were strongest for general safety and among older women. In the general population, neighbourhood safety was not significantly associated with leisure-time walking. However, among younger and older adult men and lower educated individuals, an increase in general safety was associated with a decrease in leisure-time walking participation. Conclusions In the Netherlands, neighbourhood safety appears to be related to leisure-time cycling but not to walking. Leisure-time cycling may best be encouraged by improving different safety components at once, rather than focusing on one safety aspect such as traffic safety. Special attention is needed for older women. PMID:23356476

Storybridging: Four steps for constructing effective health narratives

PubMed Central

Boeijinga, Anniek; Hoeken, Hans; Sanders, José

2017-01-01

Objective: To develop a practical step-by-step approach to constructing narrative health interventions in response to the mixed results and wide diversity of narratives used in health-related narrative persuasion research. Method: Development work was guided by essential narrative characteristics as well as principles enshrined in the Health Action Process Approach. Results: The ‘storybridging’ method for constructing health narratives is described as consisting of four concrete steps: (a) identifying the stage of change, (b) identifying the key elements, (c) building the story, and (d) pre-testing the story. These steps are illustrated by means of a case study in which an effective narrative health intervention was developed for Dutch truck drivers: a high-risk, underprivileged occupational group. Conclusion: Although time and labour intensive, the Storybridging approach suggests integrating the target audience as an important stakeholder throughout the development process. Implications and recommendations are provided for health promotion targeting truck drivers specifically and for constructing narrative health interventions in general. PMID:29276232

[Physicians, books and medical knowledge in Norway around the year 1700].

PubMed

Dahl, Gina

2009-12-17

Development of medicine in the early modern period (1500-1800) formed the basis for modern medicine, in that iatrochemical and mechanistic perceptions of the human body gradually became more influential. Several different medical theories prevailed and were tested in parallel, and perceptual changes developed over time. Few studies have looked into the knowledge universe that Norwegian doctors were part of in this period. I have examined book collections owned by the physicians Jacob Woldenberg, Georg Blumenthal and Paul Dons, in order to discern how physicians practicing in Norway around 1700 responded to this particular situation of "complexity". In general, these book collections covered antique medical theories and more recent debates within the medical profession at the time. Most of the books are from Germany and the Netherlands, which means the three doctors were part of firstly a German and secondly a Dutch medical tradition. The article is based on the authors' doctoral thesis about doctors' and clergymens' book collections in the period 1650-1750.

Perceived antecedents of emotional reactions in inter-ethnic relations.

PubMed

Dijker, A J; Koomen, W; van den Heuvel, H; Frijda, N H

1996-06-01

It is argued that the aspects of intergroup relations that potentially can arouse emotions in the perceiver are likely to become central and motivationally relevant elements of group stereotypes. Asking participants to report on the perceived antecedents of their emotional reactions to in-group and out-group members should therefore be an especially useful method to reveal the content of stereotypes. Native Dutch participants reported both the frequencies with which different emotions were felt in different intergroup relations and the perceived causes of these emotions. Analysis of self-reported antecedents of emotional reactions revealed that (a) despite a general in-group favourability bias, both the in-group and the two out-groups employed arouse different kinds of negative and positive emotions; and (b) differences in emotional reactions to the two out-groups are related to salient differences in perceived antecedents between these groups. Theoretical and practical implications of the present emphasis on the cognitive foundation of emotion in intergroup relations are discussed.

[Dutch Health Care Inspectorate (IGZ) abuses its inspection authority in patient files].

PubMed

van Lessen Kloeke, Koosje

2014-01-01

For its investigation regarding the transfer of data after discharge of vulnerable elderly patients from hospital to nursing homes, care homes or home care, the Dutch Health Care Inspectorate (IGZ) demands access to patients' files, without their explicit consent. Doctors who do not cooperate run the risk of penalty payments. Since it concerns a limited number of patients per practice, it would not be unreasonably onerous for the Inspectorate to allow doctors to ask their patients' consent. Other reasons mentioned by the Inspectorate, such as possible "inappropriate correction" of data and the capability of vulnerable elderly patients to give their consent seem improper grounds to breach patients' right to privacy and to demand that doctors breach professional confidentiality. The legality of the Inspectorate's actions could be addressed in a test case and should be discussed more widely in light of the Inspectorate's work plan for 2014.

Scale, mergers and efficiency: the case of Dutch housing corporations.

PubMed

Veenstra, Jacob; Koolma, Hendrik M; Allers, Maarten A

2017-01-01

The efficiency of social housing providers is a contentious issue. In the Netherlands, there is a widespread belief that housing corporations have substantial potential for efficiency improvements. A related question is whether scale influences efficiency, since recent decades have shown a trend of mergers among corporations. This paper offers a framework to assess the effects of scale and mergers on the efficiency of Dutch housing corporations by using both a data envelopment analysis and a stochastic frontier analysis, using panel data for 2001-2012. The results indicate that most housing corporations operate under diseconomies of scale, implying that merging would be undesirable in most cases. However, merging may have beneficial effects on pure technical efficiency as it forces organizations to reconsider existing practices. A data envelopment analysis indeed confirms this hypothesis, but these results cannot be replicated by a stochastic frontier analysis, meaning that the evidence for this effect is not robust.

Balancing equity and efficiency in the Dutch basic benefits package using the principle of proportional shortfall.

PubMed

van de Wetering, E J; Stolk, E A; van Exel, N J A; Brouwer, W B F

2013-02-01

Economic evaluations are increasingly used to inform decisions regarding the allocation of scarce health care resources. To systematically incorporate societal preferences into these evaluations, quality-adjusted life year gains could be weighted according to some equity principle, the most suitable of which is a matter of frequent debate. While many countries still struggle with equity concerns for priority setting in health care, the Netherlands has reached a broad consensus to use the concept of proportional shortfall. Our study evaluates the concept and its support in the Dutch health care context. We discuss arguments in the Netherlands for using proportional shortfall and difficulties in transitioning from principle to practice. In doing so, we address universal issues leading to a systematic consideration of equity concerns for priority setting in health care. The article thus has relevance to all countries struggling with the formalization of equity concerns for priority setting.

A case against Dutch euthanasia.

PubMed

Fenigsen, Richard

1989-01-01

The growing acceptance of voluntary active euthanasia by the Dutch is examined in relation to the plastic cards requesting active euthanasia carried by many people in The Netherlands, public opinion polls, and support by leading medical figures of the movement to legalize euthanasia. The author draws upon his experience as a hospital doctor to condemn the practice of active euthanasia, arguing that its voluntariness is often counterfeit and always questionable, that it is inseparable from overtly involuntary forms of euthanasia, and that its promise of sparing the sick person agony is false. "Voluntary" euthanasia also brings an ominous change in society because of the message it sends to the elderly and sick, the weak and the dependent; because the fallibility of medical judgments are inconsistent with the irreversibility of the act; and because the fallacious reasoning of the philosophy threatens to cause irreparable damage to the medical profession.

An AIDS risk reduction program for Dutch drug users: an intervention mapping approach to planning.

PubMed

van Empelen, Pepijn; Kok, Gerjo; Schaalma, Herman P; Bartholomew, L Kay

2003-10-01

This article presents the development of a theory- and evidence-based AIDS prevention program targeting Dutch drug users and aimed at promoting condom use. The emphasis is on the development of the program using a five-step intervention development protocol called intervention mapping (IM). Preceding Step 1 of the IM process, an assessment of the HIV problem among drug users was conducted. The product of IM Step 1 was a series of program objectives specifying what drug users should learn in order to use condoms consistently. In Step 2, theoretical methods for influencing the most important determinants were chosen and translated into practical strategies that fit the program objectives. The main strategy chosen was behavioral journalism. In Step 3, leaflets with role-model stories based on authentic interviews with drug users were developed and pilot tested. Finally, the need for cooperation with program users is discussed in IM Steps 4 and 5.

Working Conditions, Occupational Injuries, and Health Among Filipino Fish Processing Workers in Dutch Harbor, Alaska

PubMed Central

Garcia, Gabriel Macasiray; de Castro, Butch

2017-01-01

This study explored how unique environmental conditions in Alaska influenced occupational health and safety for Filipino fish processing workers, many of whom migrated from warm locations (e.g., the Philippines, California, and Nevada). In-depth interviews were conducted with 26 Filipino workers in one commercial fish processing company in Dutch Harbor. Results indicated that cold weather interferes with workers’ job performance, increasing their risk for injury and illness, whereas the community’s isolation and rural nature causes loneliness and boredom, resulting in more high-risk behaviors. Other non-environmental factors affecting worker health include roommate and supervisor concerns and culture-specific practices. Findings suggest the importance of job rotation to avoid long exposures to cold temperatures, the value of a designated individual to inform workers about company and community resources that promote healthy lifestyles, and the possible utility of a joint worker–management safety committee. PMID:27729501

Working Conditions, Occupational Injuries, and Health Among Filipino Fish Processing Workers in Dutch Harbor, Alaska.

PubMed

Garcia, Gabriel Macasiray; de Castro, Butch

2017-05-01

This study explored how unique environmental conditions in Alaska influenced occupational health and safety for Filipino fish processing workers, many of whom migrated from warm locations (e.g., the Philippines, California, and Nevada). In-depth interviews were conducted with 26 Filipino workers in one commercial fish processing company in Dutch Harbor. Results indicated that cold weather interferes with workers' job performance, increasing their risk for injury and illness, whereas the community's isolation and rural nature causes loneliness and boredom, resulting in more high-risk behaviors. Other non-environmental factors affecting worker health include roommate and supervisor concerns and culture-specific practices. Findings suggest the importance of job rotation to avoid long exposures to cold temperatures, the value of a designated individual to inform workers about company and community resources that promote healthy lifestyles, and the possible utility of a joint worker-management safety committee.

Learning Styles of Chinese and Dutch Students Compared within the Context of Dutch Higher Education in Life Sciences

ERIC Educational Resources Information Center

Biemans, Harm; Van Mil, Marc

2008-01-01

This study investigated the extent to which the learning styles of Chinese students differ from those of Dutch students. The study was conducted within the context of English language Bachelor of Science programmes that Wageningen University offers together with China Agricultural University to Dutch and Chinese students. Sixteen Dutch students…

A New Approach to Property Disposal within the Federal Government

DTIC Science & Technology

2001-12-01

Royal Dutch/Shell Group, Statoil, Tosco, TotalFina Elf, and Unocal - Food and Beverage Industry, Transora.com. Partners include: Coca-Cola...Marketing Office (DRMO), where such equipment generally returns pennies on the dollar at scrap value, to the Treasury Department. v ...TO PROVIDE PROPERTY EXCHANGE SERVICES .................................52 E. SUMMARY ...........................................57 V . CONCLUSIONS

Cognitive Predictors of Language Development in Children with Specific Language Impairment (SLI)

ERIC Educational Resources Information Center

van Daal, John; Verhoeven, Ludo; van Balkom, Hans

2009-01-01

Background: Language development is generally viewed as a multifactorial process. There are increasing indications that this similarly holds for the problematic language development process. Aims: A population of 97 young Dutch children with specific language impairment (SLI) was followed over a 2-year period to provide additional evidence for the…

Rating Written Performance: What Do Raters Do and Why?

ERIC Educational Resources Information Center

Kuiken, Folkert; Vedder, Ineke

2014-01-01

This study investigates the relationship in L2 writing between raters' judgments of communicative adequacy and linguistic complexity by means of six-point Likert scales, and general measures of linguistic performance. The participants were 39 learners of Italian and 32 of Dutch, who wrote two short argumentative essays. The same writing tasks…

Collaborative Learning in Multicultural Classrooms: A Case Study of Dutch Senior Secondary Vocational Education

ERIC Educational Resources Information Center

Tielman, Kennedy; den Brok, Perry; Bolhuis, Sanneke; Vallejo, Bertha

2012-01-01

This research presents a descriptive study regarding collaborative learning in a multicultural classroom at a vocational education school in The Netherlands. The study bridges two domains of research: research on culturally diverse learning environments--which has mostly concerned primary and general secondary education--and studies on…

The Future World Champions? Ideals for Upbringing Represented in Contemporary European Advertisements

ERIC Educational Resources Information Center

Gram, Malene

2004-01-01

The general European discourse of childhood presents children as innocent and vulnerable, but within this discourse different images of "the perfect child" exist. In this article ideals for upbringing are studied as they are represented in French, German and Dutch printed advertisements for children's products. The sample consists of 290…

Students' Meaning-Making and Sense-Making of Vocational Knowledge in Dutch Senior Secondary Vocational Education

ERIC Educational Resources Information Center

Bijlsma, Nienke; Schaap, Harmen; de Bruijn, Elly

2016-01-01

Meaning-making and sense-making are generally assumed to be part of students' personal vocational knowledge development, since they contribute to both students' socialisation in a vocation and students' personalisation of concepts, values and beliefs regarding that vocation. However, how students in vocational education acquire meaning and make…

Participation in sports by Dutch persons with haemophilia.

PubMed

Heijnen, L; Mauser-Bunschoten, E P; Roosendaal, G

2000-09-01

Patients with haemophilia are now widely advised to participate in sports. However, no extensive data are available about their actual participation. A self-administered questionnaire was used to investigate sports participation by persons with haemophilia in the Netherlands. All 293 questionnaires that were distributed have been returned; 217 were from people with severe haemophilia A or B (this is 40% of the severely affected Dutch population with haemophilia). Of this group, 155 (71%) participate in one or more sports: 66 swim, 36 cycle, 21 play tennis, 18 do fitness exercises, 16 ice skate, 10 ski and 10 play table tennis; in total 44 different sports are mentioned. Of a group of 16 persons with haemophilia who are unable to run, 10 (63%) participate in sport and of a group of 91 who can only run sometimes, 64 (70%) engage in sports. This shows that there are ample opportunities for persons with haemophilia to participate in sports, even if they are unable to run. Severely affected persons with haemophilia are as active as the general Dutch population; in fact, a higher proportion swims and/or cycles. In conclusion, sports participation in the Netherlands by persons with haemophilia is in accordance with World Federation of Hemophilia directives.

Validating the Student-Teacher Relationship Scale: testing factor structure and measurement invariance across child gender and age in a Dutch sample.

PubMed

Koomen, Helma M Y; Verschueren, Karine; van Schooten, Erik; Jak, Suzanne; Pianta, Robert C

2012-04-01

The Student-Teacher Relationship Scale (STRS) is widely used to examine teachers' relationships with young students in terms of closeness, conflict, and dependency. This study aimed to verify the dimensional structure of the STRS with confirmatory factor analysis, test its measurement invariance across child gender and age, improve its measurement of the dependency construct, and extend its age range. Teachers completed a slightly adapted STRS for a Dutch sample of 2335 children aged 3 to 12. Overall, the 3-factor model showed an acceptable fit. Results indicated metric invariance across gender and age up to 8years. Scalar invariance generally did not hold. Lack of metric invariance at ages 8 to 12 primarily involved Conflict items, whereas scale differences across gender and age primarily involved Closeness items. The adapted Dependency scale showed strong invariance and higher internal consistencies than the original scale for this Dutch sample. Importantly, the revealed non-invariance for gender and age did not influence mean group comparisons. Copyright © 2011 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

Hydrology and hydraulics expertise in participatory processes for climate change adaptation in the Dutch Meuse.

PubMed

Wesselink, Anna; de Vriend, Huib; Barneveld, Hermjan; Krol, Maarten; Bijker, Wiebe

2009-01-01

Many scientists feel that scientific outcomes are not sufficiently taken into account in policy-making. The research reported in this paper shows what happens with scientific information during such a process. In 2001 the Dutch Ministry of Transport, Public Works and Water Management commissioned their regional office in Limburg to assess how flood management objectives could be achieved in future in the Dutch Meuse valley, assuming climate change will increase peak discharges. To ensure political support, regional discussion rounds were to help assess the measures previously identified. This paper discusses the ways in which hydrological and hydraulic expertise was input, understood and used in this assessment process. Project participants as a group had no trouble contesting assumptions and outcomes. Nevertheless, water expertise was generally accepted as providing facts, once basic choices such as starting situation had been discussed and agreed. The technical constraints determined that politically unacceptable measures would have to be selected to achieve the legally binding flood management objective. As a result, no additional space will be set aside for future flood management beyond the already reserved floodplain. In this case, political arguments clearly prevail over policy objectives, with hydraulic expertise providing decisive arbitration between the two.