Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 379
Filtrar
1.
PLoS One ; 15(3): e0230288, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32160272

RESUMO

BACKGROUND: Treponema pallidum subspecies pallidum (TPA) and subsp. endemicum (TEN) are the causative agents of syphilis and bejel, respectively. TEN shows similar clinical manifestations and is morphologically and serologically indistinguishable from TPA. Recently, bejel was found outside of its assumed endemic areas. Using molecular typing we aimed to discover bejel and characterize circulating TPA types among syphilis cases with Surinamese, Antillean and Dutch ethnicity in Amsterdam. METHODS: DNA was extracted from 137 ulcer swabs, which tested positive in the in-house diagnostic PCR targeting the polA gene. Samples were collected between 2006 and 2018 from Surinamese, Antillean and Dutch patients attending the Amsterdam STI clinic. Multilocus sequence typing was performed by partial sequence analysis of the tp0136, tp0548 and tp0705 genes. In addition, the 23S rRNA loci were analyzed for A2058G and A2059G macrolide resistance mutations. RESULTS: We found 17 distinct allelic profiles in 103/137 (75%) fully typed samples, which were all TPA and none TEN. Of the strains, 82.5% were SS14-like and 17.5% Nichols-like. The prevalence of Nichols-like strains found in this study is relatively high compared to nearby countries. The most prevalent types were 1.3.1 (42%) and 1.1.1 (19%), in concordance with similar TPA typing studies. The majority of the TPA types found were unique per country. New allelic types (7) and profiles (10) were found. The successfully sequenced 23S rRNA loci from 123/137 (90%) samples showed the presence of 79% A2058G and 2% A2059G mutations. CONCLUSIONS: No TEN was found in the samples from different ethnicities residing in Amsterdam, the Netherlands, so no misdiagnoses occurred. Bejel has thus not (yet) spread as a sexually transmitted disease in the Netherlands. The strain diversity found in this study reflects the local male STI clinic population which is a diverse, mixed group.


Assuntos
Genes Bacterianos , Sífilis/microbiologia , Treponema pallidum/genética , Adulto , Alelos , Código de Barras de DNA Taxonômico , Humanos , Países Baixos , Antilhas Holandesas , Suriname , Sífilis/epidemiologia , Sífilis/etnologia , Treponema pallidum/classificação , Treponema pallidum/patogenicidade
2.
Eur J Public Health ; 29(5): 849-855, 2019 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-31329862

RESUMO

BACKGROUND: Provision of postpartum care can support new families in adapting to a new situation. We aimed to determine whether various determinants of socioeconomic status (SES) were associated with utilization of postpartum care. In addition, to stress the relevance of increasing postpartum care uptake among low SES-groups, an assessment of the potential (cost-)effectiveness of postpartum care is required. METHODS: National retrospective cohort study using linked routinely collected healthcare data from all registered singleton deliveries (2010-13) in the Netherlands. Small-for-gestational age and preterm babies were excluded. The associations between SES and postpartum care uptake, and between uptake and health care expenditure were studied using multivariable regression analyses. RESULTS: Of all 569 921 deliveries included, 1.2% did not receive postpartum care. Among women who did receive care, care duration was below the recommended minimum of 24 h in 15.3%. All indicators of low SES were independently associated with a lack in care uptake. Extremes of maternal age, single parenthood and being of non-Dutch origin were associated with reduced uptake independent of SES determinants. No uptake of postpartum care was associated with maternal healthcare expenses in the highest quartile: aOR 1.34 (95% CI 1.10-1.67). Uptake below the recommended amount was associated with higher maternal and infant healthcare expenses: aOR 1.09 (95% CI 1.03-1.18) and aOR 1.20 (95% CI 1.13-1.27), respectively. CONCLUSION: Although uptake was generally high, low SES women less often received postpartum care, this being associated with higher subsequent healthcare expenses. Strategies to effectively reduce these substantial inequities in early life are urgently needed.


Assuntos
Gastos em Saúde/estatística & dados numéricos , Serviços de Assistência Domiciliar/estatística & dados numéricos , Cuidado Pós-Natal/estatística & dados numéricos , Adulto , Análise Custo-Benefício , Serviços de Assistência Domiciliar/economia , Humanos , Marrocos , Países Baixos , Antilhas Holandesas , Cuidado Pós-Natal/economia , Fatores Socioeconômicos , Suriname , Turquia , Adulto Jovem
3.
Tijdschr Psychiatr ; 60(11): 756-765, 2018.
Artigo em Holandês | MEDLINE | ID: mdl-30484568

RESUMO

BACKGROUND: Individuals native to Aruba, Bonaire, and Curaçao, the abc islands of the former Netherlands Antilles, often attribute their complaints to brua, although they seldom discuss this with health professionals. This may have a negative influence on the therapeutic relationship and diagnostic processes.
AIM: To explore the role of brua in the illness perception of psychiatric patients in the Netherlands who were originally from the abc islands.
METHOD: A random sample of patients under treatment at Parnassia Psychiatric Institute in The Hague were interviewed with the aid of a semi-structured questionnaire.
RESULTS: Of the 18 psychiatric patients interviewed, 10 (56%) believed in brua, and 3 (17%) considered it the cause of their disease. Although none of the interviewees admitted to an active involvement in brua, 8 (44%) had been in touch with a traditional healer and 9 (50%) possessed artifacts meant to provide protection against evil. Regarding the usefulness of discussing brua with health professionals, opinions were divided.
CONCLUSION: Psychiatric patients in the Netherlands native to the abc islands are all knowledgeable of brua, with more than half of them believing in it. Despite the fear and shame that people often experience, making brua fit for discussion in clinical practice would improve the relationship between health professional and patient, yielding further opportunities for diagnosis and treatment.


Assuntos
Etnopsicologia , Transtornos Mentais/diagnóstico , Transtornos Mentais/etnologia , Percepção , Feminino , Humanos , Masculino , Medicina Tradicional , Transtornos Mentais/terapia , Pessoa de Meia-Idade , Países Baixos/epidemiologia , Antilhas Holandesas/etnologia , Projetos Piloto , Superstições/psicologia
4.
West Indian med. j ; 67(4): 304-311, Oct.-Dec. 2018. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1045858

RESUMO

ABSTRACT Objective: To determine the relationship between severity of chronic obstructive pulmonary disease (COPD) and quality of life as well as COPD's correlation with depressive symptoms in West Indian subjects. Methods: This is a cross-sectional, observational study of outpatients with COPD in tertiary care. The severity of COPD was determined by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage, GOLD group, and body mass index, airflow obstruction, dyspnoea and exercise capacity (BODE) index. Quality of life was assessed by the St George Respiratory Questionnaire (SGRQ) and COPD Assessment Test (CAT), and depression was assessed by the Center for Epidemiologic Studies Depression Scale (CES-D). Results: A total of 105 patients (85.7% male, 37.1% Indo-Trinidadian, 42.9% Afro-Trinidadian, 64.8% primary level education) were recruited with a mean age of 66.9 years (standard deviation: 9.60 years). The median body mass index was 25 kg/m2; 26.7% were underweight. Risk factors identified were: ever-smokers (27.6%), marijuana (20%), biomass (81.9%), passive smoke (70.5%), occupational exposures (80%). The CES-D of 25% of the patients was ≥16. Co-morbidities included diabetes (22%), hypertension (29%), gastro-oesophageal reflux disease (10%) and previous myocardial infarction (15%). A total of 59% of the patients reported a monthly household income of less than US$800. Lower level of education was associated with worse SGRQ (total and impact), lower forced expiratory volume in one second, modified Medical Research Council scale (mMRC) of ≥ 2 and higher BODE index. Higher GOLD group correlated with worse SGRQ, CAT and CES-D. Higher CES-D was associated with shorter six-minute walk distance, worse SGRQ, CAT and mMRC scores, higher GOLD group and increased COPD admissions per year. Patients with a CES-D of ≥ 16 walked shorter distances. Higher BODE quartile was associated with worse SGRQ, CAT and CES-D scores. Conclusion: Higher GOLD group and higher BODE quartile were associated with worse quality of life scores and higher depression scores. Patients in higher GOLD groups should be screened for depression. Education on COPD should be targeted at those of lower socioeconomic status.


RESUMEN Objetivo: Determinar la relación entre la severidad de la enfermedad pulmonar obstructiva crónica (EPOC) y la calidad de vida, así como la correlación de la EPOC con síntomas depresivos en sujetos antillanos. Métodos: Se realizó un estudio observacional transversal de pacientes ambulatorios con EPOC en cuidados terciarios. La severidad de la EPOC fue determinada por la etapa de la Iniciativa Global para la Enfermedad Pulmonar Obstructiva Crónica (GOLD, en inglés), el grupo GOLD, así como el índice de masa corporal, la obstrucción del flujo de aire, la disnea y la capacidad de ejercicio (índice BODE). La calidad de vida fue evaluada mediante el Cuestionario Respiratorio de Saint George (CRSG) y la prueba de evaluación de la EPOC (CAT, en inglés), en tanto que la depresión fue evaluada por la Escala de Depresión del Centro de Estudios Epidemiológicos (CES-D). Resultados: Un total de 105 pacientes (85.7% varones, 37.1% indotrinitenses, 42.9% afrotrinitenses, 64.8% nivel de educación primaria) fueron reclutados con una edad promedio de 66.9 años (desviación estándar: 9.60 años). El índice de masa corporal promedio fue de 25 kg/m2; 26.7% por debajo del peso normal. Los factores de riesgo identificados fueron: fumar ocasionalmente (27.6%), marihuana (20%), biomasa (81.9%), humo pasivo (70.5%), exposición ocupacional (80%). El CES-D del 25% de los pacientes fue ≥ 16. Las comorbilidades incluyeron diabetes (22%), hipertensión (29%), enfermedad por reflujo gastroesofágico (10%), y previo infarto del miocardio (15%). Un total de 59% de los pacientes reportaron un ingreso mensual familiar de menos de $800 USD. El nivel más bajo de educación se asoció con un peor (CRSG) (total e impacto), menor volumen espiratorio forzado en un segundo, Escala del Consejo de Investigaciones Médicas modificada (mMRC) de ≥ 2, y más alto índice de BODE. Un grupo más alto de GOLD se correlacionó con peores resultados de CRSG, CAT y CES-D. El CES-D más alto se asoció con una caminata de una distancia más corta en seis minutos, peores puntuaciones de CRSG, CAT y mMRC, un grupo más alto de GOLD, y mayores ingresos de EPOC por año. Los pacientes con CES-D de ≥ 16 caminaron distancias más cortas. El cuartil más alto de BODE estuvo asociado con las puntuaciones peores de CRSG, CAT y CES-D. Conclusión: El grupo GOLD más alto y el cuartil más alto de BODE se asociaron con peores puntuaciones de calidad de vida y puntuaciones de depresión más altas. Los pacientes en los grupos de GOLD más altos deben ser tamizados para detectar si padecen depresión. La educación sobre la EPOC debe estar dirigida a aquellos que tienen una situación socioeconómica inferior.


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Idoso , Qualidade de Vida , Doença Pulmonar Obstrutiva Crônica/psicologia , Depressão/psicologia , Fatores Socioeconômicos , Estudos Transversais , Doença Pulmonar Obstrutiva Crônica/complicações , Antilhas Holandesas
5.
Int Health ; 10(4): 258-267, 2018 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-29635370

RESUMO

Background: This article examines risk factor and health differences between Antillean migrants in the Netherlands and Antillean and Dutch non-migrants, and relates these findings to four commonly used explanations for migrant health disparities. Methods: Nationally representative data from the 2012 Dutch Public Health Monitor and the 2013 National Health Survey Curaçao was used. The weighted rates were calculated and significance assessed using the χ2 test. Logistic regression analyses were used to compare health behaviours and outcomes between Antillean migrants and the non-migrant populations. Results: Overall, Antillean migrants had poorer physical and mental health than Antillean and Dutch non-migrants. For overweight/obesity and tobacco and alcohol use, Antillean migrants had rates in-between those of the Antillean and Dutch non-migrants. The poor health of Antillean migrants persisted in the second generation, who were born in the Netherlands. Conclusions: Patterns of differences in physical and mental health among the study populations were suggestive of a 'stressful environment' effect. The poorer health of Antillean migrants may be partly determined by host-country-specific stressors, such as perceived discrimination, spatial concentration in multi-ethnic neighbourhoods and reduced social mobility.


Assuntos
Disparidades nos Níveis de Saúde , Migrantes/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Países Baixos , Antilhas Holandesas/etnologia , Fatores de Risco , Migrantes/psicologia , Adulto Jovem
6.
BMC Health Serv Res ; 17(1): 350, 2017 05 15.
Artigo em Inglês | MEDLINE | ID: mdl-28506230

RESUMO

BACKGROUND: In the Netherlands, ethnic minority populations visit their general practitioner (GP) more often than the indigenous population. An explanation for this association is lacking. Recently, health literacy is suggested as a possible explaining mechanism. Internationally, associations between health literacy and health care use, and between ethnicity and health literacy have been studied separately, but, so far, have not been linked to each other. In the Netherlands, some expectations have been expressed with regard to supposed low health literacy of ethnic minority groups, however, no empirical study has been done so far. The objectives of this study are therefore to acquire insight into the level of health literacy of ethnic minorities in the Netherlands and to examine whether the relationship between ethnicity and health care use can be (partly) explained by health literacy. METHODS: A questionnaire was sent to a sample of 2.116 members of the Dutch Health Care Consumer Panel (response rate 46%, 89 respondents of non-western origin). Health literacy was measured with the Health Literacy Questionnaire (HLQ) which covers nine different domains. The health literacy levels of ethnic minority groups were compared to the indigenous population. A negative binomial regression model was used to estimate the association between ethnicity and GP visits. To examine whether health literacy is an explaining factor in this association, health literacy and interaction terms of health literacy and ethnicity were added into the model. RESULTS: Differences in levels of health literacy were only found between the Turkish population and the indigenous Dutch population. This study also found an association between ethnicity and GP visits. Ethnic minorities visit their GP 33% more often than the indigenous population. Three domains of the HLQ (the ability to navigate the health care system, the ability to find information and to read and understand health information) partly explained the association between ethnicity and GP visits. CONCLUSIONS: In general, there are no differences in health literacy between most of the ethnic minority groups in the Netherlands and the indigenous Dutch population. Only the Turkish population scored significantly lower on several health literacy domains. Some domains of health literacy do explain the association between ethnicity and higher frequency of GP visits. Further research is recommended to understand the pathways through which health literacy impacts health care use.


Assuntos
/estatística & dados numéricos , Letramento em Saúde , Atenção Primária à Saúde/estatística & dados numéricos , Idoso , Feminino , Medicina Geral/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Grupos Minoritários/estatística & dados numéricos , Marrocos/etnologia , Países Baixos , Antilhas Holandesas/etnologia , Suriname/etnologia , Inquéritos e Questionários , Turquia/etnologia
7.
J Clin Psychiatry ; 78(3): e279-e285, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28199071

RESUMO

OBJECTIVE: To test the efficacy of current treatment recommendations for parkinsonism and tardive dyskinesia (TD) severity in patients with severe mental illness (SMI). METHODS: We present an 18-year prospective study including all 223 patients with SMI (as defined by the 1987 US National Institute of Mental Health, which were based on DSM-III-R diagnostic criteria) receiving care from the only psychiatric hospital of the former Netherlands Antilles. Eight clinical assessments (1992-2009) focused on movement disorders and medication use. Tardive dyskinesia was measured by the Abnormal Involuntary Movement Scale and parkinsonism by the Unified Parkinson's Disease Rating Scale. Antipsychotics were classified into first-generation antipsychotic (FGA) versus second-generation antipsychotic (SGA) and high versus low dopamine 2 (D2) affinity categories. The effect that switching has within each category on subsequent movement scores was calculated separately by using time-lagged multilevel logistic regression models. RESULTS: There was a significant association between reduction in TD severity and starting/switching to an FGA (B = -3.54, P < .001) and starting/switching to a high D2 affinity antipsychotic (B = -2.49, P < .01). Adding an SGA to existing FGA treatment was associated with reduction in TD severity (B = -2.43, P < .01). For parkinsonism, stopping antipsychotics predicted symptom reduction (B = -7.76, P < .01 in FGA/SGA-switch model; B = -7.74, P < .01 in D2 affinity switch model), while starting a high D2 affinity antipsychotic predicted an increase in symptoms (B = 3.29, P < .05 in D2 affinity switch model). CONCLUSIONS: The results show that switching from an FGA to an SGA does not necessarily result in a reduction of TD or parkinsonism. Only stopping all antipsychotics reduces the severity of parkinsonism, and starting an FGA or a high D2 affinity antipsychotic may reduce the severity of TD.


Assuntos
Antipsicóticos/efeitos adversos , Antipsicóticos/uso terapêutico , Substituição de Medicamentos , Transtornos Mentais/tratamento farmacológico , Doença de Parkinson Secundária/induzido quimicamente , Doença de Parkinson Secundária/epidemiologia , Discinesia Tardia/epidemiologia , Adulto , Antipsicóticos/administração & dosagem , Estudos Transversais , Dopaminérgicos/efeitos adversos , Dopaminérgicos/uso terapêutico , Feminino , Fidelidade a Diretrizes , Humanos , Masculino , Transtornos Mentais/epidemiologia , Pessoa de Meia-Idade , Antilhas Holandesas , Exame Neurológico/efeitos dos fármacos , Resultado do Tratamento
8.
Tijdschr Psychiatr ; 58(11): 785-793, 2016.
Artigo em Holandês | MEDLINE | ID: mdl-27868173

RESUMO

BACKGROUND: Although Antillean suspects in the Netherlands are often diagnosed as being intellectually impaired, there are no validated tests available Papiamento (the native language) for assessing intelligence or functional impairment. AIM: To validate the use of the GIT 2 (Groninger Intelligentie Test 2) and the Barkley Functioning Impairment Scale (BFIS) for Antillean defendants detained by the Judicial Service of the Caribbean Netherlands in Bonaire. METHOD: With the approval of the publishers, the GIT 2 and the BFIS were translated in Papiamento by two independent experts. The two translations were then re-translated into Dutch by two other independent experts. Defendants with both parents born in Bonaire who had been detained for at least 18 days by the Judicial Detention Centre of the Caribbean Netherlands (JICN) in Bonaire during the period 1 January 2013 until 1 July 2014 were examined with both tests. RESULTS: The Papiamento GIT 2 and BFIS tests were taken by 23 Bonairian defendants who had been detained in the JICN in Bonaire. The internal consistency and inter-item correlation of the tests were found to be satisfactory. The IQ of 95% of the participants was reproduced as a score between 79.2 and 96.8 points. In the BFIS the question about self-care was a particularly sensitive item. The use of drugs was associated with increased functional impairment. CONCLUSION: This study seems to be a promising first step towards the validation of the GIT 2 and the BFIS. Apparently, it has now become acceptable to use written Papiamento in assessment tools.


Assuntos
Deficiência Intelectual/diagnóstico , Inquéritos e Questionários/normas , Traduções , Adolescente , Adulto , Feminino , Humanos , Inteligência , Masculino , Países Baixos , Antilhas Holandesas/etnologia , Adulto Jovem
9.
Mol Ecol ; 24(24): 6163-76, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26561985

RESUMO

Many species are expanding their range polewards, and this has been associated with rapid phenotypic change. Yet, it is unclear to what extent this reflects rapid genetic adaptation or neutral processes associated with range expansion, or selection linked to the new thermal conditions encountered. To disentangle these alternatives, we studied the genomic signature of range expansion in the damselfly Coenagrion scitulum using 4950 newly developed genomic SNPs and linked this to the rapidly evolved phenotypic differences between core and (newly established) edge populations. Most edge populations were genetically clearly differentiated from the core populations and all were differentiated from each other indicating independent range expansion events. In addition, evidence for genetic drift in the edge populations, and strong evidence for adaptive genetic variation in association with the range expansion was detected. We identified one SNP under consistent selection in four of the five edge populations and showed that the allele increasing in frequency is associated with increased flight performance. This indicates collateral, non-neutral evolutionary changes in independent edge populations driven by the range expansion process. We also detected a genomic signature of adaptation to the newly encountered thermal regimes, reflecting a pattern of countergradient variation. The latter signature was identified at a single SNP as well as in a set of covarying SNPs using a polygenic multilocus approach to detect selection. Overall, this study highlights how a strategic geographic sampling design and the integration of genomic, phenotypic and environmental data can identify and disentangle the neutral and adaptive processes that are simultaneously operating during range expansions.


Assuntos
Adaptação Fisiológica/genética , Evolução Molecular , Genética Populacional , Odonatos/genética , Animais , França , Frequência do Gene , Estudos de Associação Genética , Deriva Genética , Variação Genética , Genoma de Inseto , Genômica , Genótipo , Alemanha , Antilhas Holandesas , Fenótipo , Polimorfismo de Nucleotídeo Único , Seleção Genética , Análise de Sequência de DNA
10.
J Anim Ecol ; 84(6): 1678-89, 2015 11.
Artigo em Inglês | MEDLINE | ID: mdl-26344713

RESUMO

There has been ongoing flattening of Caribbean coral reefs with the loss of habitat having severe implications for these systems. Complexity and its structural components are important to fish species richness and community composition, but little is known about its role for other taxa or species-specific responses. This study reveals the importance of reef habitat complexity and structural components to different taxa of macrofauna, total species richness, and individual coral and fish species in the Caribbean. Species presence and richness of different taxa were visually quantified in one hundred 25-m(2) plots in three marine reserves in the Caribbean. Sampling was evenly distributed across five levels of visually estimated reef complexity, with five structural components also recorded: the number of corals, number of large corals, slope angle, maximum sponge and maximum octocoral height. Taking advantage of natural heterogeneity in structural complexity within a particular coral reef habitat (Orbicella reefs) and discrete environmental envelope, thus minimizing other sources of variability, the relative importance of reef complexity and structural components was quantified for different taxa and individual fish and coral species on Caribbean coral reefs using boosted regression trees (BRTs). Boosted regression tree models performed very well when explaining variability in total (82·3%), coral (80·6%) and fish species richness (77·3%), for which the greatest declines in richness occurred below intermediate reef complexity levels. Complexity accounted for very little of the variability in octocorals, sponges, arthropods, annelids or anemones. BRTs revealed species-specific variability and importance for reef complexity and structural components. Coral and fish species occupancy generally declined at low complexity levels, with the exception of two coral species (Pseudodiploria strigosa and Porites divaricata) and four fish species (Halichoeres bivittatus, H. maculipinna, Malacoctenus triangulatus and Stegastes partitus) more common at lower reef complexity levels. A significant interaction between country and reef complexity revealed a non-additive decline in species richness in areas of low complexity and the reserve in Puerto Rico. Flattening of Caribbean coral reefs will result in substantial species losses, with few winners. Individual structural components have considerable value to different species, and their loss may have profound impacts on population responses of coral and fish due to identity effects of key species, which underpin population richness and resilience and may affect essential ecosystem processes and services.


Assuntos
Antozoários/fisiologia , Biodiversidade , Recifes de Corais , Peixes/fisiologia , Animais , Antilhas Holandesas , Densidade Demográfica , Porto Rico , São Vicente e Granadinas
11.
Eur J Obstet Gynecol Reprod Biol ; 193: 51-60, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26232727

RESUMO

OBJECTIVE: To examine ethnic disparities in maternal prepregnancy obesity and gestational weight gain, and to examine to which extent these differences can be explained by socio-demographic, lifestyle and pregnancy related characteristics. METHODS: In a multi-ethnic population-based prospective cohort study among 6444 pregnant women in Rotterdam, the Netherlands, maternal anthropometrics were repeatedly measured throughout pregnancy. Ethnicity, socio-demographic, lifestyle and pregnancy related characteristics were assessed by physical examinations and questionnaires. RESULTS: The prevalence of prepregnancy overweight and obesity was 23.1% among Dutch-origin women. Statistically higher prevalences were observed among Dutch Antillean-origin (40.8%), Moroccan-origin (49.9%), Surinamese-Creole-origin (38.6%) and Turkish-origin (41.1%) women (all p-values <0.05). Only Dutch Antillean-origin, Moroccan-origin, Surinamese-Creole-origin and Turkish-origin women had higher risks of maternal prepregnancy overweight and obesity as compared to Dutch-origin women (p-values <0.05). Socio-demographic and lifestyle related characteristics explained up to 45% of the ethnic differences in body mass index. Compared to Dutch-origin women, total gestational weight gain was lower in all ethnic minority groups, except for Cape Verdean-origin and Surinamese-Creole-origin women (p-values <0.05). Lifestyle and pregnancy related characteristics explained up to 33% and 40% of these associations, respectively. The largest ethnic differences in gestational weight gain were observed in late pregnancy. CONCLUSION: We observed moderate ethnic differences in maternal prepregnancy overweight, obesity and gestational weight gain. Socio-demographic, lifestyle and pregnancy related characteristics partly explained these differences. Whether these differences also lead to ethnic differences in maternal and childhood outcomes should be further studied.


Assuntos
Disparidades nos Níveis de Saúde , Obesidade/etnologia , Aumento de Peso/etnologia , Adulto , Índice de Massa Corporal , Cabo Verde/etnologia , Feminino , Humanos , Estilo de Vida , Marrocos/etnologia , Países Baixos/epidemiologia , Antilhas Holandesas/etnologia , Gravidez , Prevalência , Estudos Prospectivos , Fatores Socioeconômicos , Suriname/epidemiologia , Turquia/etnologia , Adulto Jovem
12.
Tijdschr Psychiatr ; 57(5): 367-70, 2015.
Artigo em Holandês | MEDLINE | ID: mdl-26028018

RESUMO

A 26-year-old woman from the island of Aruba who had been living in the Netherlands for ten years felt she was misunderstood by the various health professionals she had consulted because of her fear that she was being poisoned and would soon die. Due to her background en her belief in brua, she attributed her symptoms and her illness to 'voodoo', allegedly practiced by members of her husband's family in connection with relationship problems. A culture-sensitive approach to the patient, along with thorough psychiatric and neurological tests, yielded a surprising result. Our findings emphasise how important it is for us as health professionals to acquaint ourselves with explanatory models of the diseases of our patients, and how vital it is for us to be aware of a patient's background, particularly if the patient is of foreign descent.


Assuntos
Transtornos Mentais/etnologia , Superstições/psicologia , Adulto , Feminino , Humanos , Medicina Tradicional , Transtornos Mentais/diagnóstico , Países Baixos/epidemiologia , Antilhas Holandesas/etnologia
13.
Transcult Psychiatry ; 52(6): 840-60, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26062555

RESUMO

Brua is an Afro-Caribbean religion and healing tradition from the southern part of the former Netherlands Antilles. Like other Caribbean healing traditions, it plays a significant role in shaping how individuals experience and express disorders which Western health professionals consider to require psychiatric care. Because little has been published on Brua, and because patients from Aruba, Bonaire, and Curaçao are often reluctant to discuss their commitment to this tradition, they are often misdiagnosed and either over- or undertreated by biomedically trained health professionals. The present paper provides a review of the literature on Brua and its relation to psychiatry. A systematic search was carried out in PubMed, the Ovid database, Google Scholar, and the historical literature. Our search yielded 35 texts on Brua, including three peer-reviewed scientific papers and eight academic theses. From those texts Brua emerges as a holistic patchwork of creolized beliefs and practices which are considered to be both cause and remedy for a wide variety of ailments. Despite the fact that tension between the Brua discourse and Western-oriented psychiatric practice is significant, adherence to Brua does not seem to cause much patient delay in help-seeking. However, belief in Brua as a possible source of mental and physical complaints, as well as patients' frequent recourse to Brua practices, including the use of hallucinogens, may affect the diagnosis and treatment of mental disorders.


Assuntos
Etnopsicologia , Medicina Tradicional , Transtornos Mentais/diagnóstico , Transtornos Mentais/terapia , Religião e Medicina , Terapias Espirituais , Humanos , Transtornos Mentais/etnologia , Transtornos Mentais/etiologia , Antilhas Holandesas/epidemiologia , Superstições/psicologia
14.
Ned Tijdschr Geneeskd ; 159: A8661, 2015.
Artigo em Holandês | MEDLINE | ID: mdl-25990329

RESUMO

On 10 October 2010, the former Netherlands Antilles was dissolved politically; Curacao and St Maarten became autonomous countries, while Bonaire, St Eustatius and Saba (the 'BES islands') joined the Netherlands with the status 'special municipalities'. At that time there was one medical school on each of the BES islands, providing medical education to students predominantly from the United States and Canada. A process was instigated for recognition and accreditation within the Netherlands system of the education provided by these schools. This article provides an overview of this process, and investigates its consequences, including admission and registration requirements, student mobility and financial aspects. The current location and status of the different educational programmes will be explained.


Assuntos
Acreditação , Educação Médica/normas , Faculdades de Medicina/normas , Humanos , Países Baixos , Antilhas Holandesas , Política , Estados Unidos
15.
J Anim Ecol ; 84(5): 1446-56, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25989511

RESUMO

1. Size and age are fundamental organismal traits, and typically, both are good predictors of mortality. For many species, however, size and age predict mortality in ontogenetically opposing directions. Specifically, mortality due to predation is often more intense on smaller individuals whereas mortality due to senescence impacts, by definition, on older individuals. 2. When size-based and age-based mortality are independent in this manner, modelling mortality in both traits is often necessary. Classical approaches, such as Leslie or Lefkovitch matrices, usually require the model to infer the state of one trait from the state of the other, for example by assuming that explicitly modelled age (or stage) class structure provides implicit information on underlying size-class structure, as is the case in many species. 3. However, the assumption that one trait informs on the other is challenged when size and age are decoupled, as often occurs in invertebrates, amphibians, fish, reptiles and plants. In these cases, age-structured models may perform poorly at capturing size-based mortality, and vice versa. 4. We offer a solution to this dilemma, relaxing the assumption that class structure in one trait is inferable from class structure in another trait. Using empirical data from a reef fish, Sparisoma viride (Scaridae), we demonstrate how an individual-based model (IBM) can be implemented to model mortality as explicit, independent and simultaneous functions of individual size and age - an approach that mimics the effects of mortality in many wild populations. By validating this 'multitrait IBM' against three independent lines of empirical data, we determine that the approach produces more convincing predictions of size-class structure, longevity and post-settlement mortality for S. viride than do the trait-independent or single-trait mortality models tested. 5. Multitrait IBMs also allow trait-based mortality to be modelled either additively or multiplicatively, and individual variability in growth rates can be accommodated. Consequently, we propose that the approach may be useful in fields that may benefit from disentangling, or investigating interactions among, size-based and age-based demographic processes, including comparative demography (e.g. life-history consequences of resource patchiness) and conservation biology (e.g. impacts of invasive predators on size structure but not life span of natives).


Assuntos
Envelhecimento , Tamanho Corporal , Demografia , Longevidade , Perciformes/fisiologia , Animais , Feminino , Masculino , Modelos Biológicos , Antilhas Holandesas , Dinâmica Populacional
16.
BMC Pregnancy Childbirth ; 15: 98, 2015 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-25895975

RESUMO

BACKGROUND: Little research into non-western women's prenatal care utilisation in industrialised western countries has taken generational differences into account. In this study we examined non-western women's prenatal care utilisation and its explanatory factors according to generational status. METHODS: Data from 3300 women participating in a prospective cohort of primary midwifery care clients (i.e. women with no complications or no increased risk for complications during pregnancy, childbirth and the puerperium who receive maternity care by autonomous midwives) in the Netherlands (the DELIVER study) was used. Gestational age at entry and the total number of prenatal visits were aggregated into an index. The extent to which potential factors explained non-western women's prenatal care utilisation was assessed by means of blockwise logistic regression analyses and percentage changes in odds ratios. RESULTS: The unadjusted odds of first and second-generation non-western women making inadequate use of prenatal care were 3.26 and 1.96 times greater than for native Dutch women. For the first generation, sociocultural factors explained 43% of inadequate prenatal care utilisation, socioeconomic factors explained 33% and demographic and pregnancy factors explained 29%. For the second generation, sociocultural factors explained 66% of inadequate prenatal care utilisation. CONCLUSION: Irrespective of generation, strategies to improve utilisation should focus on those with the following sociocultural characteristics (not speaking Dutch at home, no partner or a first-generation non-Dutch partner). For the first generation, strategies should also focus on those with the following demographic, pregnancy and socioeconomic characteristics (aged ≤ 19 or ≥ 36, unplanned pregnancies, poor obstetric histories (extra-uterine pregnancy, molar pregnancy or abortion), a low educational level, below average net household income and no supplementary insurance.


Assuntos
Barreiras de Comunicação , Cultura , Emigrantes e Imigrantes , Idioma , Tocologia , Cuidado Pré-Natal/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Estudos de Coortes , Feminino , Humanos , Renda , Seguro Saúde , Modelos Logísticos , Marrocos/etnologia , Países Baixos , Antilhas Holandesas/etnologia , Razão de Chances , Estudos Prospectivos , Fatores Socioeconômicos , Suriname/etnologia , Inquéritos e Questionários , Turquia/etnologia , Adulto Jovem
17.
J Child Sex Abus ; 24(1): 1-15, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25635895

RESUMO

In most epidemiological prevalence studies of child sexual abuse, the role of ethnicity remains unclear. This study examined the prevalence and nature of child sexual abuse in four non-Western ethnic minority groups and compared them with a native Dutch group. A sample of 3,426 young adults (aged 18-25) completed a structured, online survey on experiences of child sexual abuse. A total of 42.9% (n = 1,469) participants reported at least one form of child sexual abuse victimization before the age of 18. Surinamese and Turkish respondents' prevalence rates did not differ from the native Dutch youth. However, the Dutch Antillean respondents reported significantly higher rates of child sexual abuse on specific forms of abuse, whereas the Moroccan respondents reported lower rates compared with their native Dutch peers. With this study, we have more insight into the differences-however small they may be-between ethnic groups and native Dutch youth regarding child sexual abuse.


Assuntos
Abuso Sexual na Infância/estatística & dados numéricos , Adolescente , Adulto , Sobreviventes Adultos de Maus-Tratos Infantis/estatística & dados numéricos , Criança , Abuso Sexual na Infância/etnologia , Feminino , Humanos , Masculino , Marrocos/etnologia , Países Baixos/epidemiologia , Antilhas Holandesas/etnologia , Prevalência , Estudos Retrospectivos , Fatores Sexuais , Suriname/etnologia , Inquéritos e Questionários , Turquia/etnologia , Adulto Jovem
18.
Ethn Health ; 20(2): 194-208, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-24750018

RESUMO

OBJECTIVE: To explore similarities and differences in the use and perception of communication channels to access weight-related health promotion among women in three ethnic minority groups. The ultimate aim was to determine whether similar channels might reach ethnic minority women in general or whether segmentation to ethnic groups would be required. DESIGN: Eight ethnically homogeneous focus groups were conducted among 48 women of Ghanaian, Antillean/Aruban, or Afro-Surinamese background living in Amsterdam. Our questions concerned which communication channels they usually used to access weight-related health advice or information about programs and whose information they most valued. The content analysis of data was performed. RESULTS: The participants mentioned four channels - regular and traditional health care, general or ethnically specific media, multiethnic and ethnic gatherings, and interpersonal communication with peers in the Netherlands and with people in the home country. Ghanaian women emphasized ethnically specific channels (e.g., traditional health care, Ghanaian churches). They were comfortable with these channels and trusted them. They mentioned fewer general channels - mainly limited to health care - and if discussed, negative perceptions were expressed. Antillean women mentioned the use of ethnically specific channels (e.g., communication with Antilleans in the home country) on balance with general audience-oriented channels (e.g., regular health care). Perceptions were mixed. Surinamese participants discussed, in a positive manner, the use of general audience-oriented channels, while they said they did not use traditional health care or advice from Surinam. Local language proficiency, time resided in the Netherlands, and approaches and messages received seemed to explain channel use and perception. CONCLUSIONS: The predominant differences in channel use and perception among the ethnic groups indicate a need for channel segmentation to reach a multiethnic target group with weight-related health promotion. The study results reveal possible segmentation criteria besides ethnicity, such as local language proficiency and time since migration, worthy of further investigation.


Assuntos
Comunicação , Promoção da Saúde/métodos , Comportamento de Busca de Informação , Grupos Minoritários , Atenção Primária à Saúde , Adulto , Família , Feminino , Grupos Focais , Amigos , Gana/etnologia , Comportamentos Relacionados com a Saúde , Humanos , Medicina Tradicional , Pessoa de Meia-Idade , Países Baixos , Antilhas Holandesas/etnologia , Rádio , Suriname/etnologia , Televisão , Redução de Peso , Adulto Jovem
19.
In. Caribbean Public Health Agency. Caribbean Public Health Agency: 60th Annual Scientific Meeting. Kingston, The University of the West Indies. Faculty of Medical Sciences, 2015. p.[1-75]. (West Indian Medical Journal Supplement).
Monografia em Inglês | MedCarib | ID: med-17918

RESUMO

OBJECTIVE: The study of gangs is important to Aruba and some other Caribbean islands because gang existence is an issue at the moment and, to date, no research has been conducted on this disturbing social problem in the small Caribbean islands. DESIGN: This research is based on a qualitative research approach utilizing a single case study and is exploratory of nature. An ethnographic approach was applied. RESULTS: The study found that there are very dangerous gangs on the island, with similar structure, recruitments techniques and quitting difficulties as reflected as in the literature for other developed and developing countries. Specific findings are that some parents and trustful adults do nurture, encourage and inculcate gang attributes in their children and that members of the studied gang dropped out of school after they got involved in gang activities due to frequent gang violence at school. CONCLUSIONS: The study concludes that the one gang studied in Aruba is like a web of entrapment. This is because once you are a member of the gang, it is highly probable that you will become trapped with reduced opportunities to get out. Given the findings of the study therefore, there is a pressing need for immediate intervention to protect the island of Aruba from the detrimental effects which have the potential to ruin the image of Aruba as a tourist destination as well as to threaten the security and safety needs of its citizens.


Assuntos
Antilhas Holandesas
20.
Zootaxa ; 3881(6): 591-6, 2014 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-25543656

RESUMO

A second discovery of the echinoid associated shrimp species Diapontonia maranulus Bruce, 1986 is recorded from deep water off Curaçao, Leeward Islands of the Dutch Caribbean. The material is compared with the type description and paratypic material as well as with material of closely related species. A mtDNA COI barcode was obtained from the material. The systematic position of the genus is discussed.


Assuntos
Palaemonidae/anatomia & histologia , Palaemonidae/classificação , Animais , DNA Mitocondrial , Feminino , Masculino , Antilhas Holandesas , Palaemonidae/genética
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...