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1.
Artículo en Inglés | PAHO-IRIS | ID: phr-52084

RESUMEN

[ABSTRACT]. Objective. To identify specific health care areas whose optimization could improve population health in the Dutch Caribbean islands of Aruba and Curaçao. Methods. Comparative observational study using mortality and population data of the Dutch Caribbean islands and the Netherlands. Mortality trends were calculated, then analyzed with Joinpoint software, for the period 1988–2014. Life expectancies were computed using abridged life tables for the most recent available data of all territories (2005–2007). Life expectancy differences between the Dutch Caribbean and the Netherlands were decomposed into cause-specific contributions using Arriaga’s method. Results. During the period 1988–2014, levels of amenable mortality have been consistently higher in Aruba and Curaçao than in the Netherlands. For Aruba, the gap in amenable mortality with the Netherlands did not significantly change during the study period, while it widened for Curaçao. If mortality from amenable causes were reduced to similar levels as in the Netherlands, men and women in Aruba would have added, respectively, 1.19 years and 0.72 years to their life expectancies during the period 2005–2007. In Curaçao, this would be 2.06 years and 2.33 years. The largest cause-specific contributions were found for circulatory diseases, breast cancer, perinatal causes, and nephritis/nephrosis (these last two causes solely in Curaçao). Conclusions. Improvements in health care services related to circulatory diseases, breast cancer, perinatal deaths, and nephritis/nephrosis in the Dutch Caribbean could substantially contribute to reducing the gap in life expectancy with the Netherlands. Based on our study, we recommend more in-depth studies to identify the specific interventions and resources needed to optimize the underlying health care areas.


[RESUMEN]. Objetivo. Determinar las áreas específicas de atención de salud cuya optimización podría mejorar la salud de la población en las islas del Caribe holandés de Aruba y Curaçao. Métodos. Estudio de observación comparativo en el que se utilizaron datos demográficos y de mortalidad de las islas del Caribe holandés y de los Países Bajos. Se calcularon las tendencias de mortalidad y luego se analizaron con programas de computación Jointpoint de regresión lineal segmentada, para el período 1988–2014. La esperanza de vida se calculó utilizando tablas de mortalidad abreviadas con los datos más recientes disponibles de todos los territorios (2005–2007). Las diferencias de esperanza de vida entre el Caribe holandés y los Países Bajos se desglosaron, usando el método de Arriaga, en contribuciones por causas específicas. Resultados. En el período 1988–2014, los niveles de mortalidad por causas evitables mediante la atención de salud han sido sistemáticamente mayores en Aruba y Curaçao que en los Países Bajos. En el caso de Aruba, la brecha en la mortalidad por causas evitables mediante la atención de salud con respecto a los Países Bajos no varió significativamente durante el período de estudio; en el caso de Curaçao, la brecha fue mayor. Si la mortalidad por causas evitables mediante la atención de salud se redujese a un nivel similar al de los Países Bajos, los hombres y las mujeres en Aruba habrían sumado, respectivamente, 1,19 años y 0,72 años a su esperanza de vida en el período 2005–2007. En Curaçao, el aumento hubiese sido de 2,06 años y de 2,33 años. Según el estudio, las causas específicas que más contribuyen a esta diferencia son las enfermedades circulatorias, el cáncer de mama, las complicaciones perinatales, y la nefritis/nefrosis (estas últimas dos causas solamente en Curaçao). Conclusiones. Una mejora en los servicios de salud en relación con las enfermedades circulatorias, el cáncer de mama, las complicaciones perinatales, y la nefritis/nefrosis en el Caribe holandés podría contribuir sustancialmente a la reducción de la brecha en la esperanza de vida con respecto a los Países Bajos. Por tanto, con base en nuestro estudio, recomendamos que se realicen más estudios exhaustivos a fin de determinar las intervenciones específicas y los recursos que se necesitan para optimizar las áreas de atención de salud involucradas.


[RESUMO]. Objetivo. Identificar áreas específicas da atenção à saúde cuja otimização poderia melhorar a saúde da população nas ilhas de Aruba e Curaçao, no Caribe holandês. Métodos. Estudo observacional comparativo baseado em dados de mortalidade e populacionais das ilhas do Caribe holandês e dos Países Baixos. As tendências de mortalidade foram calculadas e então analisadas com o software Joinpoint, no período de 1988 a 2014. As expectativas de vida foram computadas usando tábuas de mortalidade resumidas com os dados disponíveis mais recentes de todos os territórios (2005-2007). As diferenças na expectativa de vida entre o Caribe holandês e os Países Baixos foram desagregadas segundo as contribuições específicas por causa usando o método de Arriaga. Resultados. No período de 1988 a 2014, os níveis de mortalidade evitável foram consistentemente mais elevados em Aruba e Curaçao do que nos Países Baixos. Em Aruba, a diferença na mortalidade evitável em comparação com os Países Baixos não mudou significativamente durante o período do estudo, enquanto que em Curaçao a diferença aumentou. Se a mortalidade por causas evitáveis fosse reduzida a níveis semelhantes aos dos Países Baixos, os homens e mulheres de Aruba teriam aumentos respectivos de 1,19 e 0,72 anos nas suas expectativas de vida durante o período 2005-2007. Em Curaçao, o aumento seria de 2,06 e 2,33 anos. As maiores contribuições de causas específicas foram as de doenças circulatórias, câncer de mama, causas perinatais e nefrite/nefrose (estas duas últimas causas somente em Curaçao). Conclusões. Melhorias nos serviços de saúde relacionados com doenças circulatórias, câncer de mama, mortes perinatais e nefrite/nefrose no Caribe holandês poderiam contribuir substancialmente para reduzir as disparidades na expectativa de vida em comparação com os Países Baixos. Com base neste trabalho, recomendamos estudos mais aprofundados para identificar as intervenções e recursos específicos necessários para otimizar estas áreas da atenção à saúde.


Asunto(s)
Evaluación en Salud , Indicadores de Calidad de la Atención de Salud , Aruba , Curazao , Países Bajos , Evaluación en Salud , Indicadores de Calidad de la Atención de Salud , Curazao , Países Bajos , Evaluación en Salud , Indicadores de Calidad de la Atención de Salud , Curazao , Países Bajos
2.
Ned Tijdschr Geneeskd ; 1642020 Apr 02.
Artículo en Holandés | MEDLINE | ID: mdl-32391997

RESUMEN

Here we describe the characteristics of the first 100 laboratory confirmed COVID-19 patients admitted to the Elisabeth-Tweesteden Hospital (Tilburg, The Netherlands). The median age was 72 years, 67% was male, approximately 80% had co-morbidity, approximately 50% of which consisted of hypertension, cardiac and or pulmonary conditions and 25% diabetes. At admission 61% of patients had fever and about 50% presented at day 6 or more after onset of symptoms. At the time of writing 38 patients were discharged, 19 admitted to the intensive care unit (ICU) and 20 patients had died. The median age of ICU patients was 67 years and 63% had co-morbidity. The median time to discharge or to death was 6 and 5.5 days, respectively.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Mortalidad Hospitalaria , Neumonía Viral/epidemiología , Anciano , Comorbilidad , Infecciones por Coronavirus/diagnóstico , Cuidados Críticos , Femenino , Fiebre/diagnóstico , Hospitalización/estadística & datos numéricos , Humanos , Unidades de Cuidados Intensivos , Masculino , Persona de Mediana Edad , Países Bajos/epidemiología , Pandemias , Alta del Paciente/estadística & datos numéricos , Neumonía Viral/diagnóstico
3.
Ned Tijdschr Geneeskd ; 1642020 Apr 02.
Artículo en Holandés | MEDLINE | ID: mdl-32391998

RESUMEN

The SARS-CoV-2 virus and COVID-19 disease is of pandemic proportions and reached the Netherlands on February 27 2020. Here we present the first Dutch cohort of 29 hospitalized patients during the first two weeks of the epidemic in the Netherlands. Demographic characteristics of patients, clinical presentation and course of disease up to the moment of analysis showed similarity with what has been described in Chinese and Italian literature. However the higher proportion of patients presenting with gastro-intestinal symptoms and the high number of patients with overweight and obesity stood out. Based on the experience in our hospital very early on in the epidemic COVID-19 impresses as a severe illness with risk of acute respiratory deterioration.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Enfermedades Gastrointestinales/epidemiología , Neumonía Viral/epidemiología , Adulto , Anciano , Anciano de 80 o más Años , Instituciones de Atención Ambulatoria , Comorbilidad , Infecciones por Coronavirus/diagnóstico , Femenino , Enfermedades Gastrointestinales/virología , Hospitales , Humanos , Masculino , Persona de Mediana Edad , Países Bajos/epidemiología , Obesidad/epidemiología , Pandemias , Neumonía Viral/diagnóstico , Adulto Joven
4.
Ned Tijdschr Geneeskd ; 1642020 Apr 02.
Artículo en Holandés | MEDLINE | ID: mdl-32392009

RESUMEN

OBJECTIVE: To describe disease presentation and clinical characteristics of patients with COVID-19 presenting to the Emergency Department (ED) of Bernhoven hospital in Uden, the Netherlands. DESIGN: Prospective, descriptive study. METHOD: The registry focused on atypical symptoms and co-infections. We hypothesized that patients older than 70 years more often have atypical symptoms. The number of co-infections is unknown. Therefore, we prospectively registered medical history, duration of symptoms, symptoms, temperature, lab results and co-infections of patients with confirmed COVID-19 in the period March 4-16th. RESULTS: The clinical characteristics of 107 patients were registered. The average age was 71 years and 41% was female. The median duration of symptoms was 5 days. 19% of patients had not been referred to pulmonary or internal medicine. Symptoms were fever (78%), respiratory complaints (78%), chest pain (28%), abdominal pain (13%), and diarrhea (34%). In 54% of the COVID-19 patients at the ED, the temperature was ≥ 38,0°C, CRP ≥ 50 in 51%, leucocytosis in 12% and elevated LD in 61%. Of 31 patients 24 (77%) had an absolute lymphopenia. Co-infections were seen in 16% of patients. The mortality in the ED was 2% and ICU-admission 5%. On March 25th, 2020 the overall mortality was 22% and ICU-admission 15%. CONCLUSION: We have seen patients with a very serious disease resulting in a high mortality and ICU-admission. Over 35% of patient did not have the typical symptoms of fever and respiratory complaints; atypical symptoms like chest pain, abdominal pain and diarrhea are frequently seen. There is no difference between patients over and under 70 years. COVID-19 patients can present with atypical symptoms, co-infections and distributed over various medical specialties.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/diagnóstico , Servicio de Urgencia en Hospital/estadística & datos numéricos , Neumonía Viral/diagnóstico , Dolor Abdominal/diagnóstico , Adulto , Anciano , Dolor en el Pecho/diagnóstico , Comorbilidad , Infecciones por Coronavirus/epidemiología , Femenino , Fiebre/diagnóstico , Hospitalización , Humanos , Masculino , Persona de Mediana Edad , Países Bajos , Pandemias , Neumonía Viral/epidemiología , Estudios Prospectivos , Sistema de Registros/estadística & datos numéricos
5.
Ned Tijdschr Geneeskd ; 1642020 05 13.
Artículo en Holandés | MEDLINE | ID: mdl-32406637

RESUMEN

Since February, 27 2019, when the first patient with coronavirus disease 2019 (Covid-19) was identified in the Netherlands it has rapidly spread throughout the country. Exactly one month later 8603 people had been tested positive for SARS-CoV-2, 2500 patients were or had been admitted to the hospital and 456 patients died. Here the clinical data are summarized of the first 236 patients that have been admitted to hospitals in Uden, Breda and Tilburg which were all at the centre of the initial outbreak in the Netherlands. This commentary focusses on the clinical characteristics of the patients that are currently being treated on the Dutch clinical corona units, their medical management and the first clinical outcomes. Data is compared to current cohort studies from China, Italy and the United States.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/diagnóstico , Neumonía Viral/diagnóstico , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Comorbilidad , Infecciones por Coronavirus/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Países Bajos/epidemiología , Pandemias , Neumonía Viral/epidemiología , Factores de Riesgo
6.
Ann R Coll Surg Engl ; 102(5): 375-382, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32233854

RESUMEN

INTRODUCTION: Selective non-operative management (SNOM) for penetrating abdominal injury (PAI) is accepted in trauma centres in South Africa and the US. Owing to the low incidence of gunshot wounds (GSWs) in Western Europe, few are inclined to practise SNOM for such injuries although it is considered for stab wounds (SWs). This study evaluated the outcome of patients admitted to a Dutch level 1 trauma centre with PAI. METHODS: A retrospective study was undertaken of all PAI patients treated over 15 years. In order to prevent bias, patients admitted six months prior to and six months following implementation of a treatment algorithm were excluded. Data concerning type of injury, injury severity score and treatment were compared. RESULTS: A total of 393 patients were included in the study: 278 (71%) with SWs and 115 (29%) with GSWs. Of the 178 SW patients in the SNOM group, 111 were treated before and 59 after introduction of the protocol. The SNOM success rates were 90% and 88% respectively (p=0.794). There were 43 patients with GSWs in the SNOM cohort. Of these, 32 were treated before and 11 after implementation of the algorithm, with respective success rates of 94% and 100% (p=0.304).The protocol did not bring about any significant change in the rate of non-therapeutic laparotomies for SWs or GSWs. However, the rate of admission for observation for SWs increased from 83% to 100% (p<0.001). There was a decrease in ultrasonography for SWs (from 84% to 32%, p<0.001) as well as for GSWs (from 87% to 43%, p<0.001). X-ray was also used less for GSWs after the protocol was introduced (44% vs 11%, p=0.001). CONCLUSIONS: SNOM for PAI resulting from either SWs or GSWs can be safely practised in Western European trauma centres. Results are comparable with those in trauma centres that treat high volumes of PAI cases.


Asunto(s)
Traumatismos Abdominales/terapia , Tratamiento Conservador/métodos , Heridas por Arma de Fuego/terapia , Heridas Punzantes/terapia , Traumatismos Abdominales/diagnóstico , Adulto , Protocolos Clínicos , Tratamiento Conservador/efectos adversos , Tratamiento Conservador/estadística & datos numéricos , Femenino , Humanos , Puntaje de Gravedad del Traumatismo , Masculino , Persona de Mediana Edad , Países Bajos , Evaluación de Programas y Proyectos de Salud , Estudios Retrospectivos , Centros Traumatológicos/estadística & datos numéricos , Resultado del Tratamiento , Heridas por Arma de Fuego/diagnóstico , Heridas Punzantes/diagnóstico , Adulto Joven
7.
Ned Tijdschr Tandheelkd ; 127(3): 159-168, 2020 Mar.
Artículo en Holandés | MEDLINE | ID: mdl-32343276

RESUMEN

The outflow of orthodontists through retirement is an important factor in the estimation of the required training capacity for this group of professionals. From 2002 through 2018, studies of the professional activity and retirement plans of orthodontists age 55 and older have been conducted fairly frequently, the most recent one dating from 2018. Based on the findings of these surveys, 3 estimations were obtained of the outflow through retirement. These were based on answers in earlier editions, the answers of their contemporaries and on the basis of the legal retirement age in the Netherlands. The number of active orthodontists in 2018 age 55 or older is estimated respectively to be 117, 116 and 102; according to all estimations, they will have retired in 2030. The estimations predict, respectively 56, 57 and 30 orthodontists will retire before 2023. According to 2 of the estimations, the outflow of orthodontists from the field will exceed the inflow from the universities in the coming years. The present training capacity in the Netherlands is not sufficient to compensate for the outflow of the first 2 estimations.


Asunto(s)
Ortodoncistas , Jubilación , Humanos , Países Bajos , Encuestas y Cuestionarios
8.
Ned Tijdschr Tandheelkd ; 127(3): 179-187, 2020 Mar.
Artículo en Holandés | MEDLINE | ID: mdl-32343278

RESUMEN

Dentists and dental specialists are qualified to prescribe drugs. In this study, we assessed and compared the pharmacotherapeutic knowledge and skills of final year dental students, dentists and dental specialists in the Netherlands. In 2017, a random sample of these three groups was invited to complete an assessment. The knowledge assessment comprised 40 multiple choice questions covering often prescribed drugs. The skills assessment comprised three patient cases for which participants had to write a treatment plan. For the knowledge assessment, the response rates were 26 (20%) dental students, 28 (8%) dentists and 19 (19%) dental specialists, and for the skills assessment the response rates were 14 (11%) dental students, eight (2%) dentists, and eight (8%) dental specialists. On average, all three groups had inadequate knowledge scores (smaller 80%) and only a small proportion (smaller 30%) of their treatment plans was assessed as correct. These results suggest that dental students, dentists and dental specialists lack prescribing competence, which could be caused by poor pharmacotherapy education during under- and postgraduate dental training.


Asunto(s)
Odontólogos , Estudiantes de Odontología , Atención Odontológica , Humanos , Países Bajos , Encuestas y Cuestionarios
9.
Euro Surveill ; 25(16)2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32347200

RESUMEN

Healthcare workers (n = 803) with mild symptoms were tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (n = 90 positive) and asked to complete a symptom questionnaire. Anosmia, muscle ache, ocular pain, general malaise, headache, extreme tiredness and fever were associated with positivity. A predictive model based on these symptoms showed moderate discriminative value (sensitivity: 91.2%; specificity: 55.6%). While our models would not justify presumptive SARS-CoV-2 diagnosis without molecular confirmation, it can contribute to targeted screening strategies.


Asunto(s)
Infecciones por Coronavirus , Personal de Salud , Pandemias , Personal de Hospital , Neumonía Viral , Adulto , Anciano , Betacoronavirus , Estudios de Cohortes , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/diagnóstico , Tos/etiología , Dolor Ocular/etiología , Fatiga/etiología , Fiebre/etiología , Cefalea/etiología , Política de Salud , Humanos , Persona de Mediana Edad , Mialgia/etiología , Países Bajos , Aislamiento de Pacientes , Faringitis/etiología , Neumonía Viral/complicaciones , Neumonía Viral/diagnóstico , Valor Predictivo de las Pruebas , Adulto Joven
10.
Ned Tijdschr Tandheelkd ; 127(2): 109-117, 2020 Feb.
Artículo en Holandés | MEDLINE | ID: mdl-32271328

RESUMEN

This fourth in a series of 5 articles in the context of the 2017 Kies-voor-Tanden study presents the results for 17-year-olds. 34% of the 17-year-olds had flawless permanent teeth. In 2017, there were still differences in oral health among the socio-economic groups, to the advantage of the high socio-economic group. The oral health of 17-year-olds had stagnated during the previous 6 years and even appeared to be deteriorating according to some indicators. In addition, knowledge about the dental insurance system after the 18th birthday was poor. Conclusion: The oral health of 17-year-olds had not improved in the previous years. This trend must be followed by monitoring research. In addition, interventions to improve the oral health, knowledge and behaviour of adolescents should be set up and evaluated.


Asunto(s)
Caries Dental , Adolescente , Índice CPO , Dentición Permanente , Humanos , Países Bajos , Salud Bucal , Prevalencia
11.
Ned Tijdschr Tandheelkd ; 127(2): 119-125, 2020 Feb.
Artículo en Holandés | MEDLINE | ID: mdl-32271329

RESUMEN

This fifth and final in a series of 5 articles in the context of the 2017 Kies-voor-Tanden study presents the results for 23-year-olds. 21% of the 23-year-olds had flawless permanent teeth. In 2017, there were still differences in oral health among the socio-economic (SES) groups, to the advantage of the high SES group. The oral health of the low SES group had shown some improvement in the previous 6 years, while this was not the case within the high SES group. The preventive dental behaviour of 23-year-olds was not optimal and the knowledge about the dental insurance system was poor. Conclusion: the oral health of 23-year-olds had partly improved, partly stagnated. Since not everyone will be able to access information through oral care professionals, other ways of providing information to them must be considered. In the context of public health, to be able to follow trends in oral health and dental preventive behaviour of (young) adults, research monitoring oral health is of great importance.


Asunto(s)
Caries Dental , Adulto , Índice CPO , Humanos , Seguro Odontológico , Países Bajos , Salud Bucal , Prevalencia
12.
Euro Surveill ; 25(12)2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-32234115

RESUMEN

To rapidly assess possible community transmission in Noord-Brabant, the Netherlands, healthcare workers (HCW) with mild respiratory complaints and without epidemiological link (contact with confirmed case or visited areas with active circulation) were tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Within 2 days, 1,097 HCW in nine hospitals were tested; 45 (4.1%) were positive. Of six hospitals with positive HCW, two accounted for 38 positive HCW. The results informed local and national risk management.


Asunto(s)
Infecciones Comunitarias Adquiridas/transmisión , Infecciones por Coronavirus/transmisión , Personal de Salud , Neumonía Viral/transmisión , Síndrome Respiratorio Agudo Grave/epidemiología , Betacoronavirus , Infecciones Comunitarias Adquiridas/epidemiología , Coronavirus/genética , Coronavirus/aislamiento & purificación , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Brotes de Enfermedades , Humanos , Países Bajos/epidemiología , Pandemias , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Síndrome Respiratorio Agudo Grave/diagnóstico , Síndrome Respiratorio Agudo Grave/transmisión
14.
Ned Tijdschr Tandheelkd ; 127(2): 83-88, 2020 Feb.
Artículo en Holandés | MEDLINE | ID: mdl-32271324

RESUMEN

In the context of the series on education and the dentist in 2025, the directors of education and training at the 3 dentistry programmes in the Netherlands were asked about the kind of dentist they are training. If, after all, the head of a dental practice is looking for a new colleague and has 3 candidates, each from a different faculty, what can he expect of each of them and are there differences in the 'kind of dentist' they are? In the spring of 2019, Geerling Langenbach and Corine Visscher of the ACTA (Academic Centre for Dentistry Amsterdam), Nico Creugers and Ohlin Cremers of the Radboud University in Nijmegen and Luc van der Sluis and Berdien Kooistra-Akse of the Rijksuniversiteit Groningen were interviewed one after another by Denise van Diermen, guest editor of the series 'Education and the dentist in 2025'.


Asunto(s)
Odontología , Odontólogos , Educación en Odontología , Humanos , Masculino , Países Bajos
16.
Ned Tijdschr Tandheelkd ; 127(1): 42-50, 2020 Jan.
Artículo en Holandés | MEDLINE | ID: mdl-32159528

RESUMEN

In this third article in a series of 5 in the context of the 2017 Kies-voor-Tanden Study, the results for the 11-year-olds are presented. The study was conducted among 11-year-olds who lived in Alphen aan den Rijn, Gouda, Breda or Den Bosch and consisted of a clinical oral examination and a questionnaire completed by both them and their parents. Of the 11-year-olds, 61% had caries-free permanent teeth. In 2011, this percentage was 73%. In 2017, there were still differences in oral health among socio-economic groups, to the advantage of the higher socio-economic group. The conclusion is that the oral health of 11-year-olds has not improved in the last 6 years. Despite the low prevalence of DMFS, there appears to be a trend towards deterioration. For risk groups, interventions to keep the teeth intact should be aimed primarily at improving preventive behaviour and good oral health self-care.


Asunto(s)
Caries Dental , Índice CPO , Atención Odontológica , Humanos , Incidencia , Países Bajos , Salud Bucal , Prevalencia
17.
Ned Tijdschr Tandheelkd ; 127(1): 51-56, 2020 Jan.
Artículo en Holandés | MEDLINE | ID: mdl-32159529

RESUMEN

Coinciding with an increasing tendency of professionals to cross national borders, there is also an increasing need to harmonise curricula. In dentistry in Europe, this tendency is undiminished. By defining international curriculum requirements for dentists, international harmonisation can be strengthened. In the Netherlands, too, harmonisation with European standards has taken place in establishing final achievement levels for dentistry curricula, as defined in a national framework. In a working environment where oral health professionals are confronted with rapid change, for example, in the division of responsibilities, future caregivers should have an optimal educational preparation for their competences, skills and expertise.


Asunto(s)
Competencia Clínica , Educación en Odontología , Curriculum , Odontólogos , Europa (Continente) , Humanos , Países Bajos
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