Fear, anxiety and depression in gastrointestinal stromal tumor (GIST) patients in the Netherlands: Data from a cross-sectional multicenter study / Miedo, ansiedad y depresión en pacientes con tumores del estroma gastrointestinal (GIST) en los Países Bajos: datos de un estudio multicéntrico transversal

Background: This study aims to (1) investigate the prevalence of anxiety, depression and severe fear of cancer recurrence or progression in gastrointestinal stromal tumor (GIST) patients treated in a curative or palliative setting, (2) compare their prevalence with a norm population, (3) identify factors associated with anxiety, depression and severe fear, and (4) study the impact of these psychological symptoms on health-related quality of life (HRQoL). Methods: In a cross-sectional study, GIST patients completed the Hospital Anxiety and Depression Scale, Cancer Worry Scale, and EORTC QLQ-C30. Results: Of the 328 patients, 15% reported anxiety, 13% depression, and 43% had severe fear. Anxiety and depression levels were comparable between the norm population and patients in the curative setting, but significantly higher for patients in the palliative setting. Having other psychological symptoms was associated with anxiety, while current TKI treatment and anxiety were associated with depression. Severe fear was associated with age, female sex, palliative treatment setting, anxiety, and GIST-related concerns. Conclusion: GIST patients treated in a palliative setting are more prone to experience psychological symptoms, which can significantly impair their HRQoL. These symptoms deserve more attention in clinical practice, in which regular screening can be helpful, and appropriate interventions should be offered.(AU)

Knowledge of diagnosis and management of selected oral mucosal lesions among dentists in The Netherlands

Background: Knowledge of oral mucosal lesions (OMLs) among dentists is relevant in diagnosing potentially malignant diseases and oral cancer at an early stage. The aim of this survey was to explore dentists' knowledge about OMLs. Material and methods: Respondents to a web-based questionnaire, containing 11 clinical vignettes representing patients with various OMLs, provided a (differential) diagnosis and management for each. Information about demographics and clinical experience of the participants was acquired as well. Descriptive statistics were performed and T-tests were used to test for significant (p<0.05) differences in mean scores for correct diagnosis and management between subgroups based on demographic variables. Results: Forty-four of 500 invited dentists completed the questionnaire. For (potentially) malignant OMLs, the number of correct diagnoses ranged from 14 to 93%, whilst the number of correct management decisions ranged from 43 to 86%. For benign OMLs, the number of correct diagnoses and management decisions ranged from 32 to 100% and 9 to 48%, respectively. For 11 clinical vignettes, mean scores for correct diagnosis, correct management and correct diagnosis and management were respectively 7.2 (±1.8), 5.7 (±1.5), and 3.8 (±1.7). Conclusions: The results show that dentists in the Netherlands do not have sufficient knowledge to accurately diagnose some OMLs and to select a correct management. This may result in over-referral of benign OMLs and under-referral for (potentially) malignant OMLs. Clinical guidelines, that include standardized criteria for referral, and continuing education, may improve dentists' ability to correctly diagnose and accurately manage OMLs. (AU)

Quality of the educational environment in postgraduate community pharmacy education and the relationship with trainees’ basic psychological needs

Background: Quality of the educational environment affects trainee performance and well-being in postgraduate healthcare education. In pharmacy practice the quality of the educational environment has not been extensively studied. Self-determination Theory can assist in understanding the underlying mechanisms. Objectives: In this study, the quality of the educational environment and its relationship with satisfaction and frustration of trainees’ basic psychological needs and motivation were investigated in a Dutch community pharmacy postgraduate education programme. Methods: In a cross-sectional study, pharmacists specializing to become community pharmacists completed the Scan of Postgraduate Educational Environment Domains (SPEED), the Basic Psychological Need Satisfaction and Frustration Scale for the Work Domain, and the Academic Motivation Scale. Confirmatory factor analysis followed by path analysis was used to analyse the relationships between the variables. Results: Out of 232 trainees, 205 responded (88%). Most trainees (82%) were positive about the quality of the educational environment. The resulting path model displayed a moderate to good fit. The perceived quality of the educational environment had a moderate positive association with basic psychological needs satisfaction (Factor loading = 0.40) and a similar negative association with basic psychological needs frustration (Factor loading = -0.47). Basic psychological needs frustration had a moderate association with an increased sense of internal and external pressures also known as controlled motivation (Factor loading = 0.31). Intrinsic motivation was not affected by the perceived quality of the educational environment. (AU)

Climate Concern and Engagement: Large Face-to-Face and Online Polls by the Dutch non-profit Milieudefensie

Climate change mitigation depends on tracking public opinion across populations. Social scientists can collaborate with environmental organizations that conduct surveys among their audiences. We teamed up with the non-profit Milieudefensie, who surveyed Dutch attitudes towards climate change in 2019–2020. The large dataset had face-to-face (n = 3,102) and online interviews (n = 30,311) of urbanity, climate concern, policy preferences, interviewer-rated engagement with climate change, and behavior (whether the interviewee provided their email and phone number to the organization). To reveal the representativeness of these kinds of convenience samples, we tested whether attitudes and their associations with behaviors were similar to previous studies. Climate concern, preference for climate policy, and interviewer-rated engagement were high. In the online survey, 47% of respondents signed up for an email newsletter, and 7% provided their phone number. Higher climate concern and preference for climate policy predicted interviewer-rated engagement and behavior (weak to strong associations). Urbanity was not related to concern, policy preferences, or interviewer-rated engagement. Policy preferences did not differ between the face-to-face and online samples. The results provide convergent evidence to conventional online surveys. These Dutch residents appear slightly more engaged with systemic change to mitigate climate change than the general public. (AU)

Neuroticism, rumination, depression and suicidal ideation: A moderated serial mediation model across four countries

Background/objective: Research has highlighted the role of neuroticism, rumination, and depression in predicting suicidal thoughts, but studies on how these variables interplay are scarce. The aims of the present study were to test a model in which emotional stability (i.e., low neuroticism) would act as an antecedent and moderator of rumination and depressed mood in the prediction of suicidal ideation (i.e., moderated serial-mediation), and to explore their replicability across four countries and sex, among college students as an at-risk-group for suicide.Method: Participants were 3482 undergraduates from U.S, Spain, Argentina, and the Netherlands. Path analysis and multi-group analysis were conducted.Results: Emotional stability was indirectly linked to suicidal ideation via rumination and depressed mood. Moreover, emotional stability moderated the associations between rumination and depressed mood, and between depressed mood and suicidal ideation. Findings were consistent in males and females, and across countries studied.Discussion: Regardless of sex and country, people with low emotional stability reported higher levels of rumination, which in turn was associated with more depressed mood, and these were associated with higher reports of suicidal thoughts. This cascade of psychological risk factors for suicidal ideation seems to be more harmful in people who endorse low levels of emotional stability. (AU)

Transcranial alternating brain stimulation at alpha frequency reduces hemispatial neglect symptoms in stroke patients

Background/Objective: Non-invasive brain stimulation techniques such as transcranial alternating current stimulation (tACS) may help alleviate attention deficits in stroke patients with hemispatial neglect by modulating oscillatory brain activity. We applied high-definition (HD)-tACS at alpha frequency over the contralesional hemisphere to support unilateral oscillatory alpha activity and correct for the pathologically altered attention bias in neglect patients.Methods: We performed a within-subject, placebo-controlled study in which sixteen stroke patients with hemispatial neglect underwent 10 Hz (alpha) as well as sham (placebo) stimulation targeting the contralesional posterior parietal cortex. Attentional bias was measured with a computerized visual detection paradigm and two standard paper-and-pencil neglect tests.Results: We revealed a significant shift of attentional resources after alpha-HD-tACS, but not sham tACS, toward the ipsilateral and thus contralesional hemifield leading to a reduction in neglect symptoms, measured with a computerized visual detection paradigm and a widely used standard paper and pencil neglect tests.Conclusions: We showed a significant alpha-HD-tACS-induced shift of attentional resources toward the contralesional hemifield, thus leading to a reduction in neglect symptoms. Importantly, HD-tACS effects persisted after the stimulation itself had ended. This tACS protocol, based on intrinsic oscillatory processes, may be an effective and well-tolerated treatment option for neglect. (AU)

Enfermeros por el mundo... Haarlem / Nurses around the world... Haarlem

Maribel Viñas es una enfermera española en la ciudad holandesa de Haarlem, cercana a Ámsterdam. Emigrada a los Países Bajos en junio de 2020, en plena pandemia, cuenta que sus compañeras le facilitaron la adaptación “porque estaban siempre muy atentas y preocupadas por que pudiese seguir las conversaciones y eran muy pacientes con el tema del idioma”. Nos atiende para hablar del día a día en Holanda y de la diferencia de ejercer la profesión en Haarlem con respecto a su Andalucía natal.(AU)

Enfermeros por el mundo... Ámsterdam / Nurses around the world... Amsterdam

Helena Quintana es una enfermera española en Ámsterdam, ciudad a la que llegó en 2019, antes de la irrupción de la COVID-19, por lo que su integración no fue la que ella esperaba. “De repente el país se cerró y solo se podía ir a trabajar. Sin embargo, hice muy buenas amigas durante la pandemia que lo hicieron mucho más llevadero”. A pesar de ello, “después de un tiempo he de confesar que se vive de manera muy normal. Estoy ya bastante acostumbrada a estar aquí y siento que he encontrado mi lugar en esta ciudad”.Quintana, que llegó a Holanda por la inestabilidad laboral que le ofrecía su país, nos atiende para hablar de la situación de la Enfermería en Países Bajos, donde “hay muchos aspectos positivos como la estabilidad laboral que ya mencionaba y la formación, que muchas veces son las mismas empresas las que te la financian”. También considera que el vivir en el extranjero como experiencia te hace descubrir muchas cosas sobre ti mismo y te hace ser más independiente. Nos habla de su día a día en el extranjero y de las diferencias en la práctica enfermera en España y en Ámsterdam, país en el que, según relata, “la mayor diferencia puede ser que la enfermera también ayuda con el aseo personal. Más allá, no existe mucha disparidad en cuanto a la rutina enfermera. Aquí también se realizan muchas tareas de gestión que en España nunca tuve la oportunidad de desempeñar”.(AU)

Enfermeros por el mundo. Blaricum / Nurses around the world. Blaricum

Arianna Medina es una enfermera de Canarias que al acabar Enfermería, tras un periodo de Erasmus, decidió marcharse fuera de España para ejercer la profesión. Su destino acabó siendo una residencia de ancianos de la ciudad holandesa de Blaricum, a la que llegó en noviembre de 2020, en plena crisis de la COVID-19. Nos atiende para hablar de su adaptación al país y de sus vivencias como enfermera en Holanda.(AU)

Buurtzorg Nederland: una propuesta de atención domiciliaria dirigida por enfermeras / Buurtzorg Nederland, a proposal for nurse-led home care

Buurtzorg Nederland es una organización holandesa de atención sanitaria en la que equipos de enfermeras prestan atención domiciliaria en todas las competencias de su profesión. En este artículo se plantean algunas cuestiones relativas a aspectos internos de la organización, con base en 3dimensiones. La primera, la dimensión organizativa, según la cual los equipos están estructurados con base en 8 roles, sin jerarquías y apoyados en la filosofía del coaching. La segunda, la dimensión enfermera, en la que destaca que las enfermeras despliegan todas las competencias de su profesión, desde el cuidado básico hasta el cuidado más complejo, con el objetivo de desfragmentar la atención. Y la tercera, la dimensión económica, según la cual la sostenibilidad de la organización está en ser un sistema sin directivos, de equipos pequeños que trabajan en áreas geográficas pequeñas, con un sistema informático que da soporte a todos los asuntos organizativos, asistenciales y económicos.Las principales características de Buurtzorg Nederland son la autogestión de los equipos y la atención desfragmentada, que satisfacen tanto a la enfermera como al paciente. Sin embargo, esta desfragmentación se ha conseguido en cuanto al cuidado del paciente, al atender el mismo equipo todas las necesidades de cuidados básicos y complejos en el domicilio, pero en otros ámbitos asistenciales no se ha conseguido, y el paciente debe visitar a otros proveedores, por lo que la atención de salud en otros niveles sigue estando fragmentada.(AU)

Buurtzorg Nederland is a Dutch healthcare organization in which nursing teams provide home care in all the skills that affect their profession. This article raises some questions regarding more internal aspects of the organization based on 3dimensions. The first, the organizational dimension, in which the teams are structured based on 8 roles, without hierarchies and supported by the coaching system. The second, the nursing dimension, in which it is highlighted that nurses deal with all the competences that affect their profession, from basic care to more complex care, with the aim of defragmenting care. And the third, the economic dimension, in which it stands out that the sustainability of the organization is in being a system without managers, of small teams that work in small geographic areas, with a computer system that supports all organizational matters, healthcare and financial.The main characteristics of Buurtzorg Nederland are the self-management of the teams and the defragmented care that both the nurse and the patient satisfy. However, this defragmentation has been achieved in terms of patient care, with the same team attending to all basic and complex care needs at home, but at other levels of care it has not been achieved, and the patient must visit other providers, therefore, health care at other levels continues to be fragmented.(AU)

Focus group parental opinions regarding treatment with topical corticosteroids on children with atopic dermatitis

Introduction and objectives: Atopic dermatitis is common among children of 0-5 years old. Treatment consists of emollients and topical corticosteroids. Due to corticophobia, however, adherence to topical corticosteroids is low. Our aim was to find factors that influence opinions about topical corticosteroids among parents of children with atopic dermatitis. Methods: A qualitative focus group study in secondary care with parents of children with atopic dermatitis. Questions concerned opinions, attitude, sources of information, and the use of topical corticosteroids. Results: The parents indicated that they lack knowledge about the working mechanism and side effects of topical corticosteroids. Dermatologists and paediatricians emphasise the beneficial effects, whereas other healthcare workers and lay people often express a negative attitude. Conclusions: This study gives a complete overview of factors influencing adherence. Treatment with topical corticosteroids can be improved by better informing parents about the working mechanisms, the use, and how to reduce the dose. Healthcare professionals need to be aware of the consequences of their negative attitude concerning topical corticosteroids

No disponible

Frequency of occurrence of medication discrepancies and associated risk factors in cases of acute hospital admission

Background: Medication discrepancies are a common occurrence following hospital admission and carry the potential for causing harm. However, little is known about the potential risk factors involved in medication discrepancies. Objective: The objective of this study was to determine how frequently medication discrepancies occur and their associated risk factors, in patients hospitalized via the emergency department of the Spaarne Gasthuis Hospital, located in The Netherlands. Methods: This retrospective observational study examines 832 hospital admissions which took place between April 1st and June 30th, 2015. Medication reconciliation was performed within 24 hours of admission and medication discrepancies were registered. The primary outcome recorded in the study was the proportion of patients experiencing one or more medication discrepancies, as verified by the physician. As a secondary outcome, the association between these discrepancies and pre-specified variables was analyzed using univariate and multivariate logistic regression. Results: At least one medication discrepancy was found to have occurred with 97 of the 832 patients (11.7%), the most common discrepancies involving incorrect drug dose (44.9%) and omission of medication (36.4%). In the univariate analysis, age (OR=1.03 [95% CI 1.02:1.04] p<0.001) and number of pre-admission medications taken (OR=1.13 [95%CI 1.09:1.17] p<0.001) were revealed to be significantly associated with the risk of medication discrepancies. Sex, type of medical specialty, and surgical versus non-surgical specialty were found not to be significantly associated with discrepancies. In the multivariate analysis, both the number of pre-admission medications (OR=1.10 [95%CI 1.06:1.15] p<0.001) and age (OR=1.02 [95%CI 1.01:1.03] p=0.004) were independently associated with the risk of medication discrepancy. Conclusions: Of the total number of patients, 11.7% experienced one or more medication discrepancies following admission to the hospital. Elderly patients taking multiple drugs were found to be particularly at risk

No disponible

Exploring the role of social capital in urban citizens' initiatives in the Netherlands / Papel del capital social en las iniciativas de los ciudadanos de zonas urbanas en los Países Bajos

Objective: This research explores the role of social capital in urban citizens’ initiatives in the Netherlands, by using in-depth interviews. Method: Social capital was operationalized as shared norms and values, connectedness, trust and reciprocity. Results: The findings show that initiatives form around a shared idea or ambition (shared norms and values). An existing network of relationships (connectedness) is needed for an idea to emerge and take form. Connectedness can also increase as a result of an initiative. Some level of trust between people needs to be present from the start of the initiative. For the initiative to persist, strong in-group connections seem important, as well as a good balance between investments and returns. This reciprocity is mainly about intangible assets, such as energy and friendship. Conclusion: This study concludes that social capital within citizens’ initiatives is both a prerequisite for the formation of initiatives and a result of the existence of initiatives

Objetivo: Explorar, mediante la realización de entrevistas en profundidad, el papel del capital social en las iniciativas de los ciudadanos de zonas urbanas de los Países Bajos. Método: Se conceptualizó el capital social como normas y valores compartidos, conectividad, confianza y reciprocidad. Resultados: Las iniciativas se forman alrededor de una idea o ambición compartida (normas y valores compartidos). Es necesaria la existencia de una red de relaciones previa (conectividad) para que una idea surja y tome forma. La conectividad también puede incrementarse como resultado de la iniciativa. Desde el inicio de la iniciativa debe estar presente un nivel mínimo de confianza entre las personas. Para que la iniciativa persista, parecen importantes las conexiones fuertes dentro del grupo, así como un buen equilibrio entre los esfuerzos y los beneficios obtenidos. Esta reciprocidad se refiere principalmente a bienes inmateriales, como la energía y la amistad. Conclusión: Este estudio concluye que el papel del capital social en las iniciativas de los ciudadanos de zonas urbanas es tanto un requisito para la aparición de iniciativas como el resultado de la existencia de algunas iniciativas

Cooperación en cirugía en el siglo XXI / Cooperation in surgery of the 21st century

La necesidad de cooperación sanitaria en países de bajo desarrollo es conocida y se implementa día a día. Sin embargo, la asistencia sanitaria quirúrgica en estos países, en el siglo XXI, es más discutida, y se encuentra por debajo de niveles deseables y con soluciones más complejas. Por otra parte, el número de cirujanos que buscan implicarse aumenta progresivamente. Se analizan las causas que originan estos bajos niveles de asistencia, como la falta de personal cualificado, fuga de profesionales, coste de la asistencia o la falta de cuantificación de las necesidades. Las oportunidades de mejora, como el hermanamiento institucional, las misiones quirúrgicas de corta duración o la realización de acciones dirigidas a la educación, evaluación, evidencia y formación son algunas de las posibilidades propuestas

The need for healthcare cooperation in low- and middle-income countries is known and is implemented day by day. However, the surgical sanitary assistance in these countries in the 21st century is very controversial, as it is still below desirable levels and entails complex solutions. On the other hand, the number of surgeons seeking to get involved is increasing progressively. We analyze the causes of the low levels of medical assistance, such as the lack of qualified personnel, the brain drain of surgeons, healthcare costs or the lack of quantified needs. Opportunities for improvement, such as institutional twinning, short-term surgical missions or activities aimed at education, evaluation, evidence and training, are some of the possibilities proposed

Descripción y análisis del modelo holandés en la relación entre cannabis y psicosis / No disponible

Se describe el modelo holandés en torno al uso de cannabis y se analiza su relación con los trastornos psicóticos. Se detallan los antecedentes históricos y el ‘timeline’ de las políticas reguladoras del cannabis, los objetivos del modelo, sus contradicciones (‘the back door problem’) y aspectos determinantes como la prevalencia y edad de inicio del consumo y la potencia de la planta. Se concluye que se necesita más investigación para clarificar qué aspectos de la exposición al cannabis (edad de inicio de consumo, potencia, cantidad, frecuencia, duración) confieren los mayores riesgos (alteraciones cognitivas, psicosis) y para comprender mejor el impacto en salud pública de las políticas legislativas aplicadas

The Dutch model regarding cannabis use and its relationship with psychotic disorders are analyzed. The historical background and timeline of regulatory policies, aims of the model, contradictions (the back door problem) and determining aspects, such as prevalence, age of onset of use and cannabis potency, are described. The conclusions point out that more research is needed in order to clarify which aspects of cannabis exposure (age of onset of use, potency, amount, frequency, duration) confer the greatest risk (cognitive disorders, psychosis) and to better understand the impact of legislative policies on public health

Impact of the Directive 2011/24/EU in The Netherlands National Legal System

Directive 2011/24/EU of the European Parliament and of the Council of 9 March 2011 on the application of patients' rights in cross-border healthcare is aimed at ensuring patient mobility, establishing some rules for facilitating access to safe and high-quality healthcare and promoting cooperation on healthcare between Member States, whilst fully respecting their responsibilities in the organisation and delivery of such healthcare. In this report the impact of the aforementioned Directive in The Netherlands National Legal System is analyzed

La Directiva 2011/24/UE del Parlamento Europeo y del Consejo, de 9 de marzo de 2011, relativa a la aplicación de los derechos de los pacientes en la asistencia sanitaria transfronteriza, tiene como objetivos garantizar la movilidad de los pacientes, establecer unas reglas para facilitar su acceso a una asistencia sanitaria segura y de alta calidad en la Unión Europea, y promover la cooperación en materia de asistencia sanitaria entre los Estados miembros, respetando plenamente las responsabilidades de éstos en la organización y prestación de dicha asistencia. En este informe se analiza el impacto de dicha Directiva en el sistema jurídico de los Países Bajos

Epidemiology of ameloblastomas of the jaws; A report from the Netherlands

OBJECTIVES: To provide epidemiological data of ameloblastomas of the jaws in the Netherlands over a 25-year time period (1985-2010) and to compare these data with data from other parts of the world. MATERIAL AND METHODS: The data of all patients diagnosed with a primary ameloblastoma of the jaws in the Netherlands in the period 1985-2010 have been retrieved from the nationwide histopathology and cytopathology network and registry in the Netherlands (PALGA). The pathology reports were screened and only those cases were included in which a distinct diagnosis of primary, histopathologically benign, intraosseous ameloblastoma was rendered. The average population in The Netherlands during this period amounted approximately 15 million people. RESULTS: An annual incidence rate was approximately 1,5 per million population, the male-female ratio being 1.4: 1. The age at the time of diagnosis was 44.1 years. The average age in males was 46.3 years compared to anaverage age in females of 41.3 years, the difference being significant (p≤ 0.05). The results were compared with those available in only a small number of publications worldwide. CONCLUSIONS: There is no strong evidence for significant differences of the true incidence of ameloblastomas worldwide, neither for a gender predilection. The diagnosis is generally made at a somewhat lower age in women; this phenomenon is even much stronger in the Black population, irrespective of gender. No proper explanation for this finding can be provided

Message framing effects on breastfeeding attitude: a functional measurement experiment

Breastfeeding is generally accepted as the optimal method of infant feeding. However, many infants in the Netherlands are breastfed only for a short period. The present study aims to investigate the effect of framing breastfeeding-promoting messages in terms of the gains (advantages) associated with breastfeeding, compared with framing in terms of the losses (disadvantages) associated with the alternative behaviour, formula-feeding. The respondents, 96 women, took part in a web-based experiment, with statements of advantages of breastfeeding as well as disadvantages of formula-feeding as experimental stimuli. Stimuli were combined using a 4 (advantages)×3 (disadvantages) full factorial within subjects design, with advantages presented as either ‘benefits of breastfeeding’ or ‘disadvantages of formula-feeding’ (between subjects). Women reported their attitude towards breastfeeding on a graphical rating scale after each presentation of a combination of arguments. Three clusters of response patterns could be distinguished. There was no overall effect of message framing on breastfeeding attitude. However, there was a significant interaction between framing and the presented advantages. Gain framed messages seem to yield a more positive attitude when low impact advantages are presented, whereas loss-framed messages were more effective in high impact health advantages. This effect was only present in the cluster of women who seem to take into account both information about advantages and disadvantages in a similar way. It can be concluded th at the impact of message framing on the development of an attitude towards breastfeeding is limited and depends on the type of message presented and the information integration pattern followed by the respondent. Future brea stfeeding promotion activities a rerecommended to be tailored based on specific characteristics of the target population, to optimally enhance breastfeeding attitude in each woman (AU)

No disponible

Different sizes, similar challenges: Out of home care for youth in Germany and the Netherlands / Tamaño diferente, retos similares: Medidas de protección a la infancia con separación familiar en Alemania y Holanda

A pesar de la gran diferencia en el número de habitantes jóvenes entre Holanda y Alemania, sus estructuras de protección de la infancia son muy semejantes. Los servicios de protección de la infancia en ambos países se centran fundamentalmente en los jóvenes entre 0 y 18 años y la reglamentación va dirigida a la responsabilidad de los clientes y su compromiso activo durante el acogimiento. Los servicios de protección a los jóvenes constan de servicios comunitarios, el tratamiento de día y los servicios de proteccion con separación familiar, que abarcan el acogimiento familiar y residencial. La historia de los servicios que implican separación familiar en ambos países se caracteriza por desarrollos semejantes. En los últimos cuatro decenios han surgido tendencias semejantes en el acogimiento residencial más encaminadas a modos de acogimiento a pequeña escala, menor tamaño de los grupos residenciales y una mayor profesionalización del personal. En los dos últimos decenios puede apreciarse una tendencia comparable hacia una mayor profesionalización en el contexto del acogimiento en ambos países. En el último decenio se han llevado a cabo más estudios sobre acogimiento residencial que sobre acogimiento familiar en ambos países. A pesar de las tendencias y desarrollos semejantes en la práctica de las medidas de protección con separación familiar, la investigación muestra principalmente diferencias entre Alemania y Holanda principalmente en los temas y métodos aplicados (AU)

While there is a large difference in the number of young inhabitants in the Netherlands and Germany, their child protection frameworks are quite similar. In both countries, child protection services are mainly focused on youth aged 0 to 18 and regulations are aimed at clients' responsibility and their active involvement during care. Youth care services consist of community-based services, day treatment and outof-home care services, which include foster care and residential care. The history of out-of-home care services in both countries is characterized by similar developments. Over the last four decades, similar trends in residential care, towards more small-scale forms of residential care, smaller residential group sizes, and increasing professionalization of staff have emerged. Over the last two decades, a comparable trend towards increasing professionalization can be seen in the context of foster care in both countries. In addition, the number of youths in out-of-home care increased in both countries over the last decade, specifically in foster care. Over the last decade, more studies have been conducted in residential care than in foster care in both countries. Despite similar trends and developments in out-of-home care practice, research mainly shows differences in applied topics and methods between Germany and the Netherlands (AU)