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1.
BMJ Open ; 11(9): e046696, 2021 09 06.
Artigo em Inglês | MEDLINE | ID: mdl-34489272

RESUMO

OBJECTIVE: To gain insight into the process of postpartum care utilisation and in-home support among vulnerable women. DESIGN, METHOD, PARTICIPANTS AND SETTING: A qualitative interview study was conducted among 23 pregnant and postpartum vulnerable women in the Netherlands, following a grounded theory approach. Women were determined as vulnerable by their healthcare providers. Theoretical sampling of participants was applied and was alternated by data analysis to include information-rich cases until saturation was achieved. RESULTS: A conceptual framework of postpartum care utilisation was generated consisting of three phases: pregnancy, early postpartum period and late postpartum period. Within these phases, information provision, parenting self-efficacy and social network were identified as overarching themes. Perceived inadequate information on content of postpartum care posed a major barrier to forming realistic expectations during pregnancy and hindered its utilisation. Low self-efficacy facilitated postpartum care utilisation. All women experienced increased self-efficacy during and after postpartum care. Support from a social network influenced expectations regarding the added value of postpartum care during pregnancy, and lowered actual utilisation during the postpartum period. The costs of postpartum care and the role of the maternity care assistant acted as general barriers or facilitators influencing the three overarching themes and therefore postpartum care utilisation indirectly. CONCLUSIONS: Our findings suggest that postpartum care utilisation among vulnerable women may be improved by considering the particular phase and relevant themes applying to individual women, and adapt care accordingly. We recommend to provide comprehensive, understandable information and to emphasise the gains of postpartum care in improving self-efficacy for vulnerable women. Moreover, involving a woman's social network in postpartum care may add value to this care for this population.


Assuntos
Serviços de Saúde Materna , Cuidado Pós-Natal , Feminino , Humanos , Países Baixos , Período Pós-Parto , Gravidez , Pesquisa Qualitativa
2.
BMJ Open ; 11(9): e047054, 2021 09 06.
Artigo em Inglês | MEDLINE | ID: mdl-34489273

RESUMO

OBJECTIVE: To explore predictors of district nursing care utilisation for community-living (older) people in the Netherlands using claims data. To cope with growing demands in district nursing care, knowledge about the current utilisation of district nursing care is important. SETTING: District nursing care as a part of primary care. PARTICIPANTS: In this nationwide study, claims data were used from the Dutch risk adjustment system and national information system of health insurers. Samples were drawn of 5500 pairs of community-living people using district nursing care (cases) and people not using district nursing care (controls) for two groups: all ages and aged 75+ years (total N=22 000). OUTCOME MEASURES: The outcome was district nursing care utilisation and the 114 potential predictors included predisposing factors (eg, age), enabling factors (eg, socioeconomic status) and need factors (various healthcare costs). The random forest algorithm was used to predict district nursing care utilisation. The performance of the models and importance of predictors were calculated. RESULTS: For the population of people aged 75+ years, most important predictors were older age, and high costs for general practitioner consultations, aid devices, pharmaceutical care, ambulance transportation and occupational therapy. For the total population, older age, and high costs for pharmaceutical care and aid devices were the most important predictors. CONCLUSIONS: People in need of district nursing care are older, visit the general practitioner more often, and use more and/or expensive medications and aid devices. Therefore, close collaboration between the district nurse, general practitioner and the community pharmacist is important. Additional analyses including data regarding health status are recommended. Further research is needed to provide an evidence base for district nursing care to optimise the care for those with high care needs, and guide practice and policymakers' decision-making.


Assuntos
Custos de Cuidados de Saúde , Atenção Primária à Saúde , Idoso , Nível de Saúde , Humanos , Países Baixos , Encaminhamento e Consulta
3.
Euro Surveill ; 26(37)2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34533121

RESUMO

We describe two false-negative results in the detection of meticillin-resistant Staphylococcus aureus (MRSA) of sequence type 398 and spa type t011 using the Cepheid Xpert MRSA NxG assay. The isolates were recovered in late February and early March 2021 from two patients in different hospitals in the northern Netherlands. Variations between the two isolate genomes indicate that this MRSA strain might have been spreading for some time and could have disseminated to other regions of the Netherlands and other European countries.


Assuntos
Staphylococcus aureus Resistente à Meticilina , Infecções Estafilocócicas , Europa (Continente) , Humanos , Meticilina , Staphylococcus aureus Resistente à Meticilina/genética , Países Baixos/epidemiologia , Infecções Estafilocócicas/diagnóstico
4.
Euro Surveill ; 26(36)2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34505565

RESUMO

The intention to get the COVID-19 vaccine increased from 48% (November 2020) to 75% (March 2021) as national campaigning in the Netherlands commenced. Using a mixed method approach we identified six vaccination beliefs and two contextual factors informing this increase. Analysis of a national survey confirmed that shifting intentions were a function of shifting beliefs: people with stronger intention to vaccinate were most motivated by protecting others and reopening society; those reluctant were most concerned about side effects.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Humanos , Intenção , Países Baixos , SARS-CoV-2 , Vacinação
5.
Scand J Trauma Resusc Emerg Med ; 29(1): 130, 2021 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-34493310

RESUMO

PURPOSE: The coronavirus (COVID-19) pandemic has caused major healthcare challenges worldwide resulting in an exponential increase in the need for hospital- and intensive care support for COVID-19 patients. As a result, surgical care was restricted to urgent cases of surgery. However, the care for trauma patients is not suitable for reduction or delayed treatment. The influence of the pandemic on the burden of disease of trauma care remains to be elucidated. METHODS: All patients with traumatic injuries that were presented to the emergency departments (ED) of the Amsterdam University Medical Center, Location Academic Medical Center (AMC) and VU medical center (VUMC) and the Northwest Clinics (NWC) between March 10, 2019 and May 10, 2019 (non-COVID) and March 10, 2020 and May 10, 2020 (COVID-19 period) were included. The primary outcome was the difference in ED admissions for trauma patients between the non-COVID and COVID-19 study period. Additionally, patient- and injury characteristics, health care consumption, and 30-day mortality were evaluated. RESULTS: A 37% reduction of ED admissions for trauma patients was seen during the COVID-19 pandemic (non-COVID n = 2423 and COVID cohort n = 1531). Hospital admission was reduced by 1.6 trauma patients per day. Fewer patients sustained car- and sports-related injuries. Injuries after high energetic trauma were more severe in the COVID-19 period (Injury Severity Score 17.3 vs. 12.0, p = 0.006). Relatively more patients were treated operatively (21.4% vs. 16.6%, p < 0.001) during the COVID-19 period. Upper-(17.6 vs. 12.5%, p = 0.002) and lower extremity injuries (30.7 vs. 23.0%, p = 0.002) mainly accounted for this difference. The 30-day mortality rate was higher during the pandemic (1.0 vs. 2.3%, p = 0.001). CONCLUSION: The burden of disease and healthcare consumption of trauma patients remained high during the COVID-19 pandemic. Results of this study can be used to optimize the use of hospital capacity and anticipate health care planning in future outbreaks.


Assuntos
COVID-19 , Pandemias , Estudos de Coortes , Serviço Hospitalar de Emergência , Humanos , Países Baixos/epidemiologia , Estudos Retrospectivos , SARS-CoV-2 , Centros de Traumatologia
6.
Tijdschr Gerontol Geriatr ; 52(2)2021 Jun 09.
Artigo em Holandês | MEDLINE | ID: mdl-34498440

RESUMO

The prevalence of multimorbidity increases with age, with over 70% of people aged 75 years and over having three or more chronic conditions, often combined with frailty. In current medical practice, evidence-based medicine with evidence-based guidelines forms the basis for treatment. The aim of this study is to determine the practical applicability of the current medical specialist guidelines for the treatment of the heterogeneous group of older patients. All guidelines from the Dutch guidelines database were examined. Twelve guidelines identified as elderly-specific were compared with the recommendations from the 'methodology for the development of guidelines tailored to the elderly'. In 117 guidelines (54%) general terms such as 'older' or 'elderly' were found. An age limit was mentioned in 26 guidelines (12%). The term 'frailty' was mentioned in 38 guidelines (18%), the term 'comorbidity' in 107 (50%) and cognitive problems in eight (4%). Five age-specific guidelines distinguished frail from non-frail older people. Three guidelines discussed relevant outcome measures for the elderly. The results show that the practical applicability of current guidelines is not optimal for the various groups of older people. In our opinion, the improvement of the guidelines preferably by implementation of the Dutch methodology for senior-proof guidelines is a necessary first step in making the current second-line evidence-based guidelines in the Netherlands usable for the growing group of frail and multimorbid elderly.


Assuntos
Fragilidade , Idoso , Doença Crônica , Comorbidade , Idoso Fragilizado , Fragilidade/diagnóstico , Humanos , Países Baixos , Prevalência
7.
BMC Health Serv Res ; 21(1): 973, 2021 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-34530809

RESUMO

BACKGROUND: Recently, the parent-tailored telephone based smoking cessation counseling program 'Smoke-free Parents' was shown to be effective in helping parents to quit smoking. To implement this program in child healthcare settings in the Netherlands, the research team developed a proactive referral tool to refer parents to Smoke-free Parents. The aim of the present implementation study was to explore the facilitators, barriers, and suggestions for improvement in the implementation of this referral tool. METHODS: Child healthcare professionals (N = 68) were recruited via multiple strategies (e.g., social media, mailings, and word of mouth among healthcare professionals) and invited to complete two online (quantitative and qualitative) questionnaires and to participate in a telephone semi-structured qualitative interview between April 2017 and February 2019. In total, 65 child healthcare professionals were included in the analyses. After inductive coding, thematic analyses were performed on the qualitative data. Descriptive analyses were performed on the quantitative data. RESULTS: The data from both questionnaires and the telephone interview revealed that the majority of the child healthcare professionals (92.3 % female; average years of working as a healthcare professional: 23.0) found the Smoke-free Parents referral tool accessible and convenient to use. Yet there were several barriers that limited their use of the tool. The data revealed that one of the main barriers that healthcare professionals experienced was parental resistance to smoking cessation assistance. In addition, healthcare professionals noted that they experienced tension when motivating parents to quit smoking, as they were not the parent's, but the child's healthcare provider. Additionally, healthcare professionals reported being concerned about the lack of information about the costs of Smoke-free Parents, which limited professionals referring parents to the service. CONCLUSIONS: Although healthcare professionals reported rather positive experiences with the Smoke-free Parents referral tool, the use of the tool was limited due to barriers. To increase the impact of the Smoke-free Parents telephone-based smoking cessation counseling program via child healthcare settings, it is important to overcome these barriers. Suggestions for improvement in the implementation of the referral tool in child healthcare settings are discussed.


Assuntos
Abandono do Hábito de Fumar , Criança , Atenção à Saúde , Feminino , Pessoal de Saúde , Humanos , Masculino , Países Baixos , Pais , Encaminhamento e Consulta
8.
Tijdschr Gerontol Geriatr ; 52(3)2021 Sep 07.
Artigo em Holandês | MEDLINE | ID: mdl-34523852

RESUMO

Sharing data offers opportunities to make research into older person care more efficient. However, this is not yet common practice in the Netherlands. To optimally utilize the potential of data sharing, insight into factors that promote the implementation of data sharing in older person care research is important. In the TOPICS-MDS project, research data from the National Program for Older Person Care (NPO) was collected, managed and reused on a large scale. The experiences of stakeholders involved in this project can teach us more about the needs researchers have when sharing their data. For this study, we interviewed 23 people involved in different ways in data sharing in TOPICS-MDS about their experiences in the data sharing process. Thematic analysis yielded four overarching themes, which we converted into the following lessons: those who want to promote data sharing must ensure 1) visibility of the added value of data sharing, 2) trust in the database, 3) transparency of the process and 4) communication. These lessons complement the results of previous research with concrete advice. Optimizing data sharing in older person research is both promising and challenging. It requires dedication and involvement from both the researcher and the research participant, and appreciation for both.


Assuntos
Comunicação , Disseminação de Informação , Idoso , Humanos , Países Baixos
9.
Tijdschr Gerontol Geriatr ; 52(3)2021 Jul 26.
Artigo em Holandês | MEDLINE | ID: mdl-34523855

RESUMO

An increasing group of older adults living at home in the Netherlands requires proper support through the use of services. Determining important outcomes is crucial in this respect. For this specific group, broad outcomes in terms of quality of life (QoL) are relevant, focusing on the influence of services on capabilities. This article describes the development and content of the ASCOT-NL (Adult Social Care Outcomes Toolkit, Dutch version) and the EQLT (Extended Quality of Life Tool), and highlights application possibilities in the evaluation of care. Both instruments aim to measure effects of care on QoL of elderly people living at home in multiple relevant domains. The ASCOT-NL has eight domains, the EQLT includes these eight domains and adds six domains, resulting in a total of fourteen domains. The domains of the ASCOT-NL are based on the goals of social support and care; the additional domains of the EQLT are based on empirical research on QoL from the perspective of older people living at home and how care can contribute to QoL.


Assuntos
Qualidade de Vida , Apoio Social , Idoso , Grupos Étnicos , Humanos , Países Baixos , Inquéritos e Questionários
10.
Ned Tijdschr Tandheelkd ; 128(9): 435-439, 2021 Sep.
Artigo em Holandês | MEDLINE | ID: mdl-34490768

RESUMO

Oral care providers frequently prescribe analgesics for the management of dental pain. To get an overview of the analgesics prescribed in the Netherlands from 2016 through 2020, we collected data from the Stichting Farmaceutische Kengetallen (foundation [for] pharmaceutical indicators). Annually, more than 300,000 analgesics are prescribed by dentists in general practice and dental specialists. The largest group concerns NSAIDs (88%), followed by weak opioids (9%), acetaminophen (2%) and strong opioids (1%). Of the NSAIDs, ibuprofen is the most prescribed by all groups of oral care providers (84-91%). Of the weak opioids, dentists and oral and maxillofacial surgeons mainly prescribe codeine and codeine/ acetaminophen (64% and 78%, respectively), while orthodontists mainly prescribe tramadol (53%). Of the strong opioids, oxycodone is the most frequently prescribed by all groups of oral care providers (77-87%). Analgesics are a large part of the prescription medications in Dutch oral care and mainly concern NSAIDs (ibuprofen) and weak opioids (codeine/ acetaminophen). There are no major differences in prescription behaviour among different oral care providers.


Assuntos
Oxicodona , Tramadol , Analgésicos , Analgésicos Opioides , Humanos , Países Baixos
11.
Water Res ; 202: 117482, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34365321

RESUMO

Accumulation of fat, oil and grease (FOG) in the sumps of wastewater pumping stations is a common failure cause for these facilities. Floating solids are often not transported by the pump suction inlets and the individual solids can accumulate to stiff and thick FOG layers. The lack of data about the dynamics in FOG layer formation still hampers the design of effective measures towards its mitigation. In this article, we present a low-cost camera-based automated system for the observation of FOG layer dynamics in wastewater pumping stations at high-frequency (minutes) over extended time windows (months). Optical imagery is processed through a deep-learning computer vision routine that allows describing FOG layer dynamics (e.g. accumulation rate and changes in shape) and various hydraulic processes in the pump sump (e.g. the water level, surface flow velocity fields, vorticity, or circulation). Furthermore, the system can perform in-camera image processing, thus allowing the transfer of compressed-processed datasets when deployed in remote locations (Edge AI computing), which could be of great utility for the hydro-ecological monitoring community. In this study, the technology applied is illustrated with a dataset (six months, two-minute frequency) collected at a wastewater pumping station at the municipality of Rotterdam, The Netherlands. This monitoring system represents a source of information for the management of (waste)water pumping stations (e.g. detection of free-surface vortices and scheduling of sump cleaning operations) and facilitates the collection of standardized high-frequency FOG layer dynamics data for a detailed description of FOG build-up and transport processes.


Assuntos
Aprendizado Profundo , Águas Residuárias , Hidrocarbonetos , Países Baixos , Água
12.
Crit Care ; 25(1): 281, 2021 08 05.
Artigo em Inglês | MEDLINE | ID: mdl-34353339

RESUMO

BACKGROUND: Procalcitonin (PCT) and C-reactive protein (CRP) were previously shown to have value for the detection of secondary infections in critically ill COVID-19 patients. However, since the introduction of immunomodulatory therapy, the value of these biomarkers is unclear. We investigated PCT and CRP kinetics in critically ill COVID-19 patients treated with dexamethasone with or without tocilizumab, and assessed the value of these biomarkers to detect secondary bacterial infections. METHODS: In this prospective study, 190 critically ill COVID-19 patients were divided into three treatment groups: no dexamethasone, no tocilizumab (D-T-), dexamethasone, no tocilizumab (D+T-), and dexamethasone and tocilizumab (D+T+). Serial data of PCT and CRP were aligned on the last day of dexamethasone treatment, and kinetics of these biomarkers were analyzed between 6 days prior to cessation of dexamethasone and 10 days afterwards. Furthermore, the D+T- and D+T+ groups were subdivided into secondary infection and no-secondary infection groups to analyze differences in PCT and CRP kinetics and calculate detection accuracy of these biomarkers for the occurrence of a secondary infection. RESULTS: Following cessation of dexamethasone, there was a rebound in PCT and CRP levels, most pronounced in the D+T- group. Upon occurrence of a secondary infection, no significant increase in PCT and CRP levels was observed in the D+T- group (p = 0.052 and p = 0.08, respectively). Although PCT levels increased significantly in patients of the D+T+ group who developed a secondary infection (p = 0.0003), this rise was only apparent from day 2 post-infection onwards. CRP levels remained suppressed in the D+T+ group. Receiver operating curve analysis of PCT and CRP levels yielded area under the curves of 0.52 and 0.55, respectively, which are both markedly lower than those found in the group of COVID-19 patients not treated with immunomodulatory drugs (0.80 and 0.76, respectively, with p values for differences between groups of 0.001 and 0.02, respectively). CONCLUSIONS: Cessation of dexamethasone in critically ill COVID-19 patients results in a rebound increase in PCT and CRP levels unrelated to the occurrence of secondary bacterial infections. Furthermore, immunomodulatory treatment with dexamethasone and tocilizumab considerably reduces the value of PCT and CRP for detection of secondary infections in COVID-19 patients.


Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Infecções Bacterianas/diagnóstico , COVID-19/tratamento farmacológico , Coinfecção/diagnóstico , Dexametasona/uso terapêutico , Idoso , Proteína C-Reativa/análise , COVID-19/complicações , Estado Terminal , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Países Baixos , Pró-Calcitonina/análise , Estudos Prospectivos
13.
BMJ Open ; 11(8): e049675, 2021 08 04.
Artigo em Inglês | MEDLINE | ID: mdl-34348953

RESUMO

OBJECTIVES: Chronic obstructive pulmonary disease (COPD) guidelines advocate treatment with combinations of long-acting bronchodilators for patients with COPD who have persistent symptoms or continue to have exacerbations while using a single bronchodilator. This study assessed the cost-utility of the fixed dose combination of the bronchodilators tiotropium and olodaterol versus two comparators, tiotropium monotherapy and long-acting ß2 agonist/inhaled corticosteroid (LABA/ICS) combinations, in three European countries: Finland, Sweden and the Netherlands. METHODS: A previously published COPD patient-level discrete event simulation model was updated with most recent evidence to estimate lifetime quality-adjusted life years (QALYs) and costs for COPD patients receiving either tiotropium/olodaterol, tiotropium monotherapy or LABA/ICS. Treatment efficacy covered impact on trough forced expiratory volume in 1 s (FEV1), total and severe exacerbations and pneumonias. The unit costs of medication, maintenance treatment, exacerbations and pneumonias were obtained for each country. The country-specific analyses adhered to the Finnish, Swedish and Dutch pharmacoeconomic guidelines, respectively. RESULTS: Treatment with tiotropium/olodaterol gained QALYs ranging from 0.09 (Finland and Sweden) to 0.11 (the Netherlands) versus tiotropium and 0.23 (Finland and Sweden) to 0.28 (the Netherlands) versus LABA/ICS. The Finnish payer's incremental cost-effectiveness ratio (ICER) of tiotropium/olodaterol was €11 000/QALY versus tiotropium and dominant versus LABA/ICS. The Swedish ICERs were €6200/QALY and dominant, respectively (societal perspective). The Dutch ICERs were €14 400 and €9200, respectively (societal perspective). The probability that tiotropium/olodaterol was cost-effective compared with tiotropium at the country-specific (unofficial) threshold values for the maximum willingness to pay for a QALY was 84% for Finland, 98% for Sweden and 99% for the Netherlands. Compared with LABA/ICS, this probability was 100% for all three countries. CONCLUSIONS: Based on the simulations, tiotropium/olodaterol is a cost-effective treatment option versus tiotropium or LABA/ICS in all three countries. In both Finland and Sweden, tiotropium/olodaterol is more effective and cost saving (ie, dominant) in comparison with LABA/ICS.


Assuntos
Broncodilatadores , Doença Pulmonar Obstrutiva Crônica , Administração por Inalação , Corticosteroides/uso terapêutico , Agonistas de Receptores Adrenérgicos beta 2/uso terapêutico , Benzoxazinas , Broncodilatadores/uso terapêutico , Análise Custo-Benefício , Finlândia , Humanos , Países Baixos , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Suécia , Brometo de Tiotrópio/uso terapêutico , Resultado do Tratamento
14.
J Cross Cult Gerontol ; 36(3): 229-252, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34417957

RESUMO

While activity participation in later life has attracted considerable attention from policymakers and scholars, indoor and outdoor engagement among older Chinese migrants in Europe is understudied. Using in-depth interviews with 21 older Chinese migrants in the Netherlands and seven in Belgium, this study is among the first to explore older Chinese migrants' activity participation experiences from the perspective of Confucianism, the cornerstone of Chinese culture. More specifically, the impact of four acknowledged principles of Confucianism are considered: hierarchical relationships, family system, benevolence and emphasis on education. The findings show that, like a double-edged sword, these four principles have positive and negative effects on older Chinese migrants' activity participation. Hierarchical relationships promote formal organisational participation, yet concurrently dividing the Chinese community into smaller subgroups and endangering solidarity within the community. With regard to family system, which emphasizes intergenerational responsibility and obligation, older Confucianist migrants prioritise taking care of their grandchildren, resulting in less time to participate in outdoor activities. Benevolence, the third principle of Confucianism, restrains older Chinese migrants from political participation while encouraging them to attend community meetings where food is shared. Lastly, emphasis on education, of which self-cultivation is an important aspect, helps older Chinese migrants overcome feelings of loneliness and makes them prefer self-learning activity above formal learning settings (e.g. language learning) organised by the government. The article ends with policy recommendations on how to increase older Chinese migrants' outdoor activities.


Assuntos
Grupo com Ancestrais do Continente Asiático/psicologia , Relações Interpessoais , Participação Social/psicologia , Migrantes/psicologia , Idoso , Bélgica/epidemiologia , China/etnologia , Confucionismo , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Países Baixos/epidemiologia , Apoio Social
15.
Health Qual Life Outcomes ; 19(1): 200, 2021 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-34419061

RESUMO

BACKGROUND: Valid measures of the well-being of older people are important for the evaluation of health and social care services. The nine-item Well-being of Older People measure (WOOP) was based on a novel framework derived from a recent Q-methodology study, and was developed to capture a comprehensive set of well-being domains relevant to older people, as identified by themselves. This study introduces the WOOP and describes the qualitative assessment of its feasibility and content validity. METHODS: Between December 2017 and January 2018, a sampling agency retrieved data from 269 adults aged 65 years and older in the Netherlands. Using an online survey, participants were asked to complete the WOOP and to indicate the importance of each item to their well-being. Open-ended questions were used to collect information about participants' own definition of well-being, their interpretation of the items of the WOOP, and their assessment of the descriptions and response options provided with each item. Data were analysed using inductive content analysis with the software package ATLAS.ti. RESULTS: The WOOP closely resembled respondents' own description of what well-being means to them. The majority of the respondents reported no important well-being aspects to be missing from the WOOP, and indicated all WOOP items to be at least 'reasonably important' to their well-being. Many linked the WOOP items to well-being aspects as intended, and only a few had suggestions for improving the items' descriptions and response options. CONCLUSIONS: Given these results, all nine items were retained, and no items were added to the measure. Based on respondents' feedback, minor changes were made to the wording of some descriptions and response options of items. Concluding, the feasibility and content validity of the WOOP seem satisfactory. Further validation of this new measure is required, in different health and social care settings and among subgroups of older people with potentially different views on what constitutes well-being.


Assuntos
Qualidade de Vida/psicologia , Inquéritos e Questionários/normas , Idoso , Feminino , Humanos , Masculino , Países Baixos , Psicometria , Reprodutibilidade dos Testes , Apoio Social , Serviço Social
16.
Ned Tijdschr Geneeskd ; 1652021 06 03.
Artigo em Holandês | MEDLINE | ID: mdl-34346578

RESUMO

OBJECTIVE: To provide insight into the prevalence of persistent death wishes without being severely ill among Dutch older persons aged 75 and above; to describe the characteristics and circumstances of this group; to improve knowledge on the nature of their death wishes. DESIGN: Cross-sectional study. METHOD: In 2019 we conducted a large survey among a representative sample of 32,477 Dutch citizens aged 55 and above from the TNS-NIPObase. The questionnaire was completed by 21,294 respondents in April 2019 (response rate 65.6%). This article comprises a subanalysis of the respondents aged 75 and above. RESULTS: Of all 3,141 respondents aged 75 and above, 56 were identified as having a persistent death wish and no severe illness (PDW-NSI). The weighted percentage representing the Dutch population indicates PDW-NSI among 2.07% of all older persons aged 75 and above in the Netherlands. Respondents with PDW-NSI had a lower level of education, were of lower social class and lived in highly urbanized areas more often. Important aspects enhancing the death wish were dependence on others, worrying, physical or mental deterioration, health problems and loneliness. The death wish was subject to change and the intensity varied over time. CONCLUSION: Of older persons aged 75 and above with PDW-NSI, a considerable part stays out of sight of healthcare professionals because they do not communicate about their death wish. This may challenge timely support. Carefully questioning the meaning and nature of the death wish is essential to understand the background and underlying needs of the persons concerned.


Assuntos
Estudos Transversais , Idoso , Idoso de 80 Anos ou mais , Escolaridade , Humanos , Países Baixos , Prevalência , Inquéritos e Questionários
17.
Ned Tijdschr Geneeskd ; 1652021 04 29.
Artigo em Holandês | MEDLINE | ID: mdl-34346592

RESUMO

COPD is the third most common chronic disease in the Netherlands and the number of patients is still rising. This article reviews causes of COPD, assesses the role of spirometry in diagnosing COPD, and considers ways to differentiate between COPD and heart failure, which can be difficult due to overlapping symptoms. To avoid a 'one size fits all' treatment, we elaborate on treatable traits - patient characteristics leading to specific treatment options- in order to optimize treatment for each individual patient. This applies both during stable disease and during exacerbations.


Assuntos
Doença Pulmonar Obstrutiva Crônica , Doença Crônica , Humanos , Países Baixos , Fenótipo , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Espirometria
18.
Ned Tijdschr Geneeskd ; 1652021 07 22.
Artigo em Holandês | MEDLINE | ID: mdl-34346605

RESUMO

OBJECTIVE: To compare the incidence of psychosis among migrants with the incidence among the native Dutch in Amsterdam, Gouda and Voorhout. DESIGN: We identified patients with a first treated episode of psychosis (ICD-10 codes F20-F33) in 2010-2013 as part of the European Network of National Schizophrenia Networks Studying Gene-Environment Interactions (EU-GEI) study. Information on the composition of the population made it possible to calculate incidence rates. METHOD: We analyzed the Incidence Rate Ratios (IRR) of psychosis among various ethnic groups compared to the native Dutch using a Poisson model. RESULTS: The standardized rates in Amsterdam were 55.3/ 100,000 person-years (py) for migrants and 24.9/ 100,000py for native Dutch. In Gouda and Voorhout, these rates were 28.5 en 20.0/ 100,000py. We found increased rates among Moroccan males of the first (IRR=4.07 [95%-CI: 1.76-9.42]) and second generation (IRR=6.48 [3.30-12.68]) in Amsterdam. In Gouda and Voorhout, we found increased rates both among Moroccan males (IRR=3.37 [1.17-9.74]) of the first generation and Moroccan females of the second generation (IRR=7.10 [2.79-18.06]). High rates were also found in Amsterdam for male migrants from Eastern Europe (IRR=4.52 [2.24-9.11]), migrants from sub-Saharan Africa (IRR=3.15 [1.68-5.91]) and first-generation migrants, both males and females, from Surinam and the Netherlands Antilles. We found a decreased incidence for Western migrants. CONCLUSION: We found an increased incidence of psychosis among non-Western migrants and in Amsterdam also among Eastern-European migrants. The variation by region of origin and destination generation, and gender suggests that this risk is strongly influenced by the societal context.


Assuntos
Transtornos Psicóticos , Esquizofrenia , Migrantes , Feminino , Humanos , Incidência , Masculino , Países Baixos/epidemiologia , Transtornos Psicóticos/epidemiologia , Esquizofrenia/epidemiologia
19.
Ned Tijdschr Geneeskd ; 1652021 07 16.
Artigo em Holandês | MEDLINE | ID: mdl-34346621

RESUMO

Controlled human infection studies, in which small groups of health volunteers are exposed to an infectious agent, contribute significantly to the tropical infectious diseases research field. Not only can these studies be used to quickly and efficiently test new vaccines or drugs, but they can also lead to new insights into the pathophysiology and immunology of these infectious diseases. When designing a controlled human infection study, many important ethical and methodological considerations should be taken into account. In The Netherlands, different research institutes study tropical infections, such as malaria, hookworms, and schistosomiasis, using controlled human infections. These studies aimed to develop or improve infection models and have been used to test new malaria vaccines. These Dutch studies have contributed to the development of vaccines and drugs for these often underfunded and overlooked diseases.


Assuntos
Doenças Transmissíveis , Malária , Vacinas , Humanos , Países Baixos
20.
Ned Tijdschr Geneeskd ; 1652021 05 19.
Artigo em Holandês | MEDLINE | ID: mdl-34346636

RESUMO

Tonsillectomy with or without adenoidectomy (ATE) and adenoidectomy have been among the most frequently performed procedures in children for approximately 100 years. Randomized controlled trials were performed in the Netherlands to study the effectiveness of ATEs and adenoidectomies in children with upper respiratory tract infections. Subsequently, evidence-based guidelines were developed and implemented. We described changes in utilization of paediatric ATEs and adenoidectomies in the Netherlands between 2005 and 2018 using administrative databases. A significant decrease in the annual number of ATEs (-39%) and adenoidectomies (-49%) was observed in children between 0 and 15 years of age. The most pivotal change was observed between 2011 and 2012. The decrease in number of procedures led to estimated annual savings of €5.3 million on the healthcare budget and €10.4 million on societal costs. Furthermore, we observed small changes in patients' age, socioeconomic status, and registered diagnosis of surgically treated patients in the period 2012-2018 compared to 2010-2011.


Assuntos
Procedimentos Cirúrgicos Reconstrutivos , Infecções Respiratórias , Tonsilectomia , Adenoidectomia , Criança , Humanos , Países Baixos
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