Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “NETHERLANDS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 541 records · Page 30Linked to original sources
PubMed1989

Maltreatment of children in The Netherlands: an update after ten years.

Governmental consultation and advice on child abuse and neglect in the Netherlands started in 1972 as a two-year experiment with four offices for "confidential doctors" in four major cities of the country. After these two experimental years, a governmental institute for prevention of child abuse and neglect was organized. Over the ensuing decade the number of offices increased to ten, covering the whole country. The State Department of Welfare, Public Health, and Environment collected data from the confidential doctors and their coworkers every year. This study compares the data of the first year 1974 with those of 1983 in order to detect changing patterns over a 10-year period. The major changes are as follows: a threefold increase in cases, an extraordinary increase in cases of emotional maltreatment, an increase in detection of child fatalities but decrease in severity of physical abuse. Sexual abuse was hardly recognized in 1974 but gradually was recognized more frequently during the study decade and accounted for an alarming 7.2% of detected cases of maltreatment in 1983. No change was found in the social conditions of the family and the identity of the perpetrators--primarily fathers and/or mothers. A decrease was noted in the percentage of married parents. The increased percentage of single parents was primarily represented by mothers alone. An increase in the numbers of victims residing at home and a decrease in the need for children's homes as a temporary or permanent residence is attributed to aftercare. The discrepancy between the results of this voluntary notification system in the Netherlands and the results of a mandatory reporting system as used in the U.S.A. is still very high. The hope is that the government will decide to make reporting of maltreatment mandatory for everyone.

Adolescent↗
PubMed1983

Prevalence of influenza viruses A-H1N1 and A-H3N2 in swine in the Netherlands.

In the period December 1979-May 1980 a respiratory disease spread rapidly through pig herds in The Netherlands. Surveillance of 12 pig farms resulted in isolation of 22 influenza A-Swine-H1N1 (Hsw1N1) strains from 9 pig herds. The morbidity rate was high but the mortality rate was nil. Retardation in growth was observed. Sera collected from affected pig herds showed a fourfold increase in haemagglutination inhibition (HI) titre against A-Swine-H1N1 virus. Sera collected on five farms showed a geometric mean HI titre against the A-H3N2 virus above 100. A significant HI titre increase against this virus was found in sera collected on three farms. These findings indicated a recent infection by this virus. A-H3N2 virus was not isolated. The Dutch Swine-1980 isolates showed in the cross-HI test a distant antigenic relationship with the classical A/Swine/Iowa/30 (H1N1) virus and one-sided close antigenic relationship with A/New Jersey/76 (H1N1) virus. HI antibody to A/Swine/Nederland/80 (H1N1) virus was found in 4, 0, and 44%, to A/New Jersey/76 (H1N1) virus in 0.5, 0.4, and 42%, and to A/Swine/Iowa/30 (H1N1) virus in 0.5, 1, and 30% of pig sera collected in 1976, 1977, and 1980, respectively. HI antibody to A/Hong Kong/68 (H3N2) virus was detected in 36, 56, and 68%, and to A/Victoria/75 (H3N2) virus in 38, 73, and 68% of these sera, respectively. The results of this study indicate that pigs in The Netherlands, like those in North America, Southeast Asia, Japan, and Western Europe harbour A-Swine-H1N1 and A-H3N2 influenza viruses and are thus potential reservoirs for future human pandemics.

Animals↗
PubMed1994

Salmonella enteritidis eradication programme in poultry breeder flocks in The Netherlands.

Results of a Salmonella enteritidis eradication programme in poultry breeder flocks in The Netherlands in 1989-1992 are presented. A top-down approach was performed, which means if infection is cleared out from the top end (breeding stock), and good hygiene standards are maintained throughout the industry, the infection will be progressively cleared from the whole of the national stock. Each year all poultry breeder flocks (approx. 2300) were screened for the presence of S. enteritidis by bacteriological examination of caecal droppings until 1 April 1992. After that date, screening was carried out with a 'double-antibody sandwich blocking' (DAS blocking) ELISA-method. Treatment of S. enteritidis-positive flocks, even in production, with Baytril (enrofloxacin) and competitive exclusion flora turned out to be a good alternative for slaughtering these flocks. The top-down approach seems to be successful also in relation to S. enteritidis infection in humans in The Netherlands, since no further increase of human infections has been observed during the last 3 years.

Animals↗
PubMed1992

Is the worst of the epidemic over? Back calculation of HIV seroprevalence in The Netherlands.

This article calculates back the HIV seroprevalence in the Netherlands from AIDS cases notified 1982-1990 and rates of progression from HIV to AIDS adopted from American studies. It discusses a number of problems, such as changing AIDS definitions and the possible impact of AZT treatment. We estimate that the Netherlands had approximately 6762 HIV seropositives by the end of 1988, which is considerably lower than earlier expectations. When a hypothetical decrease of 10% in the manifestation of AIDS cases due to AZT treatment was incorporated, the estimate for the end of 1988 becomes 7549. After deduction of the AIDS patients who had died by the beginning of 1989 from this estimate, the HIV seroprevalence by the end of 1988 is approximately 7000. The distribution of seroincidence over time suggests that the HIV epidemic in our country has passed its summit and that the HIV incidence is falling quickly. The question arises as to how far this fortunate development may be considered a success of the Dutch AIDS policy, a policy characterised by more openness than in many other countries. The material studied here, however, allows no definite answer to this intriguing question.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Health care technology in The Netherlands.

The Dutch health care system has been described as a 'patchwork quilt'. It is a complicated system that has evolved from a constant adding and changing of institutions, regulations and responsibilities. Every citizen of the Netherlands has an entitlement to health care. The government authorities in the Netherlands have focused on creating favourable conditions in which the already existing private sector could expand or improve services. Although health care is provided largely through private institutions and practitioners, the system is considered to have a high degree of regulation. Until the 1980s, the Dutch health care authorities had no clearly defined philosophy of controlling the development and use of health care technology. Since the mid-1980s, however, a number of initiatives have been taken, policy instruments for controlling technology have been used in a more coordinated manner, and health care technology assessment had developed rapidly. The immediate future will see increasingly explicit use of the benefit package to control introduction of new technologies, as well as a growing influence of technology assessment itself.

Delivery of Health Care↗
PubMed1995

AIDS scenarios for The Netherlands; the economic impact on hospitals.

OBJECTIVE: To assess the economic impact of HIV/AIDS on the health care system in The Netherlands. DATA AND METHODS: Two types of data are used: (i) routine surveillance data on AIDS incidence and (ii) information on hospital resource utilisation and corresponding monetary costs. Progression of disease is modelled using a multi-stage model, with stages corresponding to clinical classifications and to different phases of health care need. Economic impact is analysed for all stages in three scenarios: the reference and two alternative scenarios. RESULTS: In the year 2000 hospital bed need would reach 220 beds if yearly new HIV infections in the 1990s remain at the level estimated for the end of the 1980s, and if the intensity of hospital care remains constant. A minimum need of 125 beds is projected if no new HIV infections occur in the 1990s. Hospital costs in 1993 are estimated to amount to 33.8 million ECUs. Scenarios indicate a range of 26.7-50.7 million ECUs for the year 2000 (price level: 1993). The proportion of the costs of hospital inpatient care and cure in total hospital costs increases, whereas the proportion for outpatient services decreases. CONCLUSIONS: Projected hospital bed need of 125-220 for HIV/AIDS in the year 2000 is limited compared to the projections for coronary heart disease and stroke, but approaches that for lung cancer, pneumonia and diabetes. We estimate hospital costs to have been 85% of total health care costs for HIV/AIDS in 1993. In 1993, the estimated proportions in hospital costs are 41% for inpatient care, 20% for inpatient cure and 39% for outpatient facilities. Our scenarios indicate a decreasing share of outpatient costs--possibly to 30% of total hospital costs for HIV/AIDS in 2000--illustrating the growing relative importance of the AIDS stage for the hospital costs. We project hospital costs for HIV/AIDS in 2000 to reach up to 0.53% of projected hospital costs for all diseases. A present value of 38 million ECUs (23%) of hospital costs projected in the reference scenario might be avoidable, during the period 1994-2000. However, with unchanged treatment patterns a present value of 127 million ECUs for hospital costs during the same period is projected to represent unavoidable costs (discount rate: 5%). In The Netherlands, data needs in the field of economic impact assessment of HIV/AIDS especially refer to registrations of non-hospital outpatient resource utilisation and costs.

Acquired Immunodeficiency Syndrome↗
PubMed1988

The comparison of health care systems through regional analysis: the case of hospital admissions in Belgium and The Netherlands.

One of the problems in the international comparison of health care systems is the small number of units of analysis. Usually only a small number of systems is compared which makes cross-sectional statistical analysis impossible. The two obvious solutions to this problem--neither of which is generally feasible--are either to enlarge the number of systems being compared or to use time series on a small number of health care systems. Quite another solution is to study regional variations within and between a small number of systems. The number of regions has to be sufficiently large to make statistical analysis possible. This is the solution chosen in this article. The phenomenon which is central to our analysis is the number of hospital admissions per 1000 of the population. To explain variations in the hospital admission rate, it is hypothesized that there are a number of variables that have the same kind of influence on hospital admission rates in all western industrialized countries (such as the supply of hospital beds and the health status of the population). On the other hand there are determinants of regional variation in the number of admissions which either exert an influence dependent on the nature of the system, or are unique to a particular health care system. Concerning the first group of hypotheses (the general model), our analysis based on data for 1974 showed that the only variables to have a clear and equal influence on the regional variation in hospital admission rates in the Netherlands as well as in Belgium are the number of hospital beds per 1000 inhabitants and standardized mortality (an operationalization of the concept of health status). The influence of system-specific variables (the second group of hypotheses) has been analysed, taking the difference between the actual number of admissions and the number of admissions expected on the basis of the number of beds and mortality as the dependent variable. In the Netherlands, none of the variables appears to have a clear influence on the level of this ratio, whereas in Belgium there is a greater number of admissions than expected in regions with a higher birth-rate and a higher number of both general practitioners and specialists in the common disciplines (internal medicine, pediatrics, gynaecology) in relation to the total number of specialists.

Belgium↗
PubMed1988

Post-1950 mortality trends and medical care: gains in life expectancy due to declines in mortality from conditions amenable to medical intervention in The Netherlands.

In order to assess the impact of medical care innovations on post-1950 mortality in The Netherlands, we analysed trends in mortality from a selection of conditions suggested by Rutstein et al.'s lists of "unnecessary untimely mortality". This selection covers 11 types of innovation, and includes 35 conditions which have become amenable to medical care. Loglinear regression analysis shows that for most of these conditions mortality declined during each of two subperiods (1950-1968; 1969-1984). Mortality decline accelerated in the second subperiod for many conditions. Reductions in mortality from these conditions between 1950/54 and 1980/84 added 2.96 and 3.95 years to life expectancy at birth of Dutch males and Dutch females respectively. A priori evidence indicates that these mortality reductions are due to some extent to 'spontaneous' incidence declines. Although the exact contribution of medical care innovations to these changes in mortality thus cannot be determined, the impact of medical care on post-1950 mortality in The Netherlands could well have been substantial.

Cause of Death↗
PubMed1990

Socio-economic mortality differences in The Netherlands in 1950-1984: a regional study of cause-specific mortality.

The finding that mortality differences between occupational classes in England and Wales have widened during the postwar period raises the question whether a similar development has occurred in other industrialised countries. In this paper, a comparison is made with results from a geographical study on the Netherlands. This study compares four periods between 1950 and 1984 by means of a standard regional division, a single socio-economic index, uniform cause-of-death groups and a standard regression procedure. During the postwar period, the relationship between socio-economic level and all-cause mortality has become (more) negative. This development can to a large extent be attributed to 'negative' trends for lung cancer, diabetes mellitus, ischaemic heart disease, cerebrovascular disease and traffic accidents. High-level regions have fared better partly because favourable changes in national mortality trends seem to have begun first in these regions. The findings from this regional study agree to a large extent with evidence from Dutch studies at the individual level. It is concluded that socio-economic mortality differences in England and Wales and the Netherlands have probably developed similarly in various respects.

Cause of Death↗
PubMed1991

The management of confidentiality in general medical practice: a comparative study in the U.S.A. and The Netherlands.

This paper describes the results of two studies in New Jersey and the eastern part of the Netherlands into the management of confidentiality among physicians in general medical practice. The physicians were presented with vignettes about confidentiality and were asked what course of action they would pursue. The results suggest that the physicians in New Jersey are less willing to disclose information without the patient's consent to insurance physicians or occupational health physicians than their Dutch colleagues. However, in more conflicting situations the American physicians tend to favor more disclosure of information than their Dutch counterparts. Explanations of these differences include aspects of the legal system in New Jersey and the Netherlands.

Adult↗
PubMed1992

List size, composition of practice and general practitioners' workload in The Netherlands.

Workload of general practitioners plays an important role in discussions about list size and remuneration in health care systems with fixed patient lists and capitation payments, such as in the Netherlands and in the United Kingdom. Against the background of the fairness of differences in income level between GPs the question is posed to what extent differences in list size reflect differences in workload and to what extent differences in patient characteristics influence workload. Both list size and practice composition relate to the demand led character of general practice. Data collected in the National Study of Morbidity and Interventions in General Practice are used. Central to this study is a three month recording of all contacts of 161 general practitioners (and their locums, assistant GPs and trainees) in the Netherlands. For each practice a patient register has been made to relate contacts to the practice population. The participating GPs kept a detailed diary covering 24 hr a day during one week. As indicators of workload several contact rates, hours worked in practice per week (in direct patient care and in other activities) and average length of office consultations are used. Demand related characteristics have the strongest relation to the number of hours worked by GPs, particularly the number of hours spent in patient-related activities. Rates of contacts, with the exception of the office contact rate, are not related to list size, but mainly to practice composition. The average length of consultations is negatively related to list size and some characteristics of the practice population.

Capitation Fee↗
PubMed1994

A prospective cohort study investigating the explanation of socio-economic inequalities in health in The Netherlands.

In this paper, the objectives, design, data-collection procedures and enrollment rates of the Longitudinal Study on Socio-Economic Health Differences (LS-SEHD) are described. This study started in 1991, and is the first large-scale longitudinal study of the explanation of socio-economic inequalities in health in the Netherlands. The LS-SEHD aims at making a quantitative assessment of the contribution of different mechanisms and factors to the explanation of socio-economic inequalities in health. It is based on a research model incorporating both 'selection' and 'causation' mechanisms, and a wide range of specific factors possibly involved in these mechanisms: health-related life-style factors, structural/environmental factors, psychosocial stress-related factors, childhood environment, cultural factors, psychological factors, and health in childhood. The design of the LS-SEHD is that of a prospective cohort study. An aselect sample, stratified by age, degree of urbanization and socio-economic status, for approx. 27,000 persons was drawn from the population registers in a region in the Southeastern part of The Netherlands. The persons in this sample received a postal questionnaire. An aselect subsample of approx. 3500 persons from the respondents to the postal questionnaire was, in addition, approached for an oral interview. The follow-up of these samples will use routinely collected data (mortality by cause of death, hospital admissions by diagnosis, cancer incidence), as well as repeated postal questionnaires and oral interviews. The response rate to the base-line postal questionnaire was 70.1% (n = 18,973), and that to the base-line oral interview was 79.4% (n = 2802). If the LS-SEHD is compared to a number of frequently cited longitudinal studies of socio-economic inequalities in health from the United Kingdom, it appears that the differences with the OPCS Longitudinal Study and the birth cohort studies (such as the National Survey of Health and Development) are huge. The LS-SEHD is more akin to the Whitehall(I)-study and the West of Scotland 20-07 study. For example it has the sample size of the former but the open population and emphasis on social factors of the latter. A comparison of the results of various longitudinal studies of socio-economic inequalities in health is recommended.

Adolescent↗
PubMed1989

Asbestos: toxicology and risk assessment for the general population in The Netherlands.

Within the scope of the preparation of Integrated Criteria Documents for priority compounds in The Netherlands, the possible health effects of oral and inhalatory exposure to asbestos for the general population were evaluated. It was concluded from the results of experiments in animals that exposure to asbestos by the oral route is not carcinogenic and is not expected to present a health risk to the general population. Inhaled asbestos, however, is distinctly carcinogenic to man, giving rise to lung tumours, and mesotheliomas of the pleura and peritoneum. Chrysotile asbestos appears to be less potent in inducing mesotheliomas than the amphiboles, but all types of asbestos appear to have a similar potency for inducing lung cancer. The risk of mesothelioma is not expected to be influenced by smoking, whereas the risk of lung cancer is expected to be ten times higher in smokers than in non-smokers exposed to the same asbestos concentrations. Risk-assessment models for the inhalatory route, for the general population, are based on linear non-threshold extrapolation of occupational exposure to much lower environmental concentrations. These models give only a rough approximation of the risk of environmental exposure to asbestos. In accordance with the Air Quality Guidelines of the World Health Organization (World Health Organization, 1987), it was estimated that an extra risk of lung cancer of one in 10(6) (in the general population, with 30% smokers) may be presented by lifetime exposure to asbestos fibres longer than 5 microns, measured by electron microscopy, at concentrations of 100-1000/m3. It was further estimated that an extra risk of mesothelioma of one in 10(6) may be presented by lifetime exposure to 10-100 amphibole fibres/m3 or to a range of 100-10000 chrysotile fibres/m3 (fibres longer than 5 microns). From the current asbestos concentrations, the risk of mesothelioma for the general population in The Netherlands appears to be negligible; the extra risk of lung cancer is expected to be higher than 1 in 10(6) near asbestos sources, whereas it appears to be negligible in background areas and in most large cities and industrial areas. However, it must be borne in mind that the validity of the risk figures given is difficult to judge.

Asbestos↗
PubMed1996

A survey on (operative) laparoscopy in The Netherlands in 1992.

OBJECTIVE: A quantitative inventory of (operative) laparoscopic surgery practiced by Dutch gynecologists in 1992 was made. METHODS: A written inquiry was mailed to all 145 departments of Obstetrics and Gynecology (including 28 teaching hospitals), where all 630 practicing gynecologists in The Netherlands are established. The questionnaire included questions about diagnostic laparoscopies, sterilizations, laparoscopy for infertility reason and operative laparoscopies. General information about follow-up training of the practitioner was also collected. All data were analyzed and comparisons were made between teaching and non-teaching hospitals. Statistical significance was calculated with the chi-square test. RESULTS: The response rate was 78%. A total of 419 respondents represented in 99 clinics reported performing 33,676 laparoscopic procedures, which makes an average of 80 procedures per physician per year. Distribution of procedures showed that 36% was for diagnostic laparoscopy, 33% for tubal sterilization, 19% laparoscopy for infertility work-up and 12% counted for therapeutic laparoscopy. Comparison of procedures in teaching hospitals (n = 27) and non-teaching hospitals (n = 72) showed only slightly more diagnostic laparoscopies for infertility in the first and more tubal-sterilizations in the latter. A statistically significant difference was found for the ring or clip sterilization in teaching hospitals, compared with the coagulation technique in non-teaching departments (P < 0.001). More difficult laparoscopic procedures such as ovarian cystectomy and conservative surgery of ectopic pregnancy were more frequently performed by those who had followed additional laparoscopic training (P < 0.02). CONCLUSIONS: The results of this survey are representative for (operative) laparoscopic practice of gynecologists in the Netherlands, because of the high response rate. Relatively, a small proportion of all laparoscopic procedures performed in 1992 are due to the therapeutic laparoscopy (12%). The great majority of therapeutic laparoscopic procedures was reported by a relatively small number of practitioners. Gynecologists who followed an additional laparoscopic training (30%) performed statistically more difficult laparoscopic procedures.

Chi-Square Distribution↗
PubMed1993

Cerebral arteriovenous malformations in The Netherlands Antilles. High prevalence of hereditary hemorrhagic telangiectasia-related single and multiple cerebral arteriovenous malformations.

Seventeen patients with symptomatic cerebral arteriovenous malformations (AVMs) were diagnosed between 1980 and 1990 in the Leeward Islands of the Netherlands Antilles. Five patients had multiple AVMs. The annual incidence of symptomatic AVMs was 1.1/100,000. The mean age of presentation was 35 years. In 6 patients cerebral AVMs were associated with hereditary hemorrhagic telangiectasia (HHT); 4 of these patients had multiple AVMs. We conclude that HHT is frequently encountered in Netherlands Antillians with symptomatic and multiple cerebral AVMs.

Adolescent↗
PubMed1995

A cost-of-illness study of back pain in The Netherlands.

In this study we estimated the costs of back pain to society in The Netherlands in 1991 to be 1.7% of the GNP. The results also show that musculoskeletal diseases are the fifth most expensive disease category regarding hospital care, and the most expensive regarding work absenteeism and disablement. One-third of the hospital care costs and one-half of the costs of absenteeism and disablement due to musculoskeletal disease were due to back pain. The total direct medical costs of back pain were estimated at US$367.6 million. The total costs of hospital care due to back pain constituted the largest part of the direct medical costs and were estimated at US$200 million. The mean costs of hospital care for back pain per case were US$3856 for an inpatient and US$199 for an outpatient. The total indirect costs of back pain for the entire labour force in The Netherlands in 1991 were estimated at US$4.6 billion; US$3.1 billion was due to absenteeism and US$1.5 billion to disablement. The mean costs per case of absenteeism and disablement due to back pain were US$4622 and US$9493, respectively. The indirect costs constituted 93% of the total costs of back pain, the direct medical costs contributed only 7%. It is therefore concluded that back pain is not only a major medical problem but also a major economical problem.

Absenteeism↗
PubMed1994

The prevalence of patent lungworm infections in herds of dairy cows in The Netherlands.

The results of a survey on the prevalence of patent lungworm infections in herds of dairy cows in the Netherlands are presented. Low patent infections were recorded in February-March on six out of 40 farms in at least one out of 40 cows. Between mid-April and mid-June low patent infections were detected on 28 out of 39 of these farms in one to four of 40 cows. Two farms on which cows were positive in the first round were negative in the second round. One to three positive cows were found on six out of a total of 15 farms revisited in July-August. These results show that lungworm infections are cycled within herds of dairy cows in the Netherlands at a low level. This indicates that dairy cows are important as carriers for lungworm, particularly in spring. The increased patency of lungworm in cows from winter to spring may be explained by maturation of inhibited larvae.

Animals↗
PubMed1991

The use of enzyme-linked immunosorbent assay systems for serology and antigen detection in parvovirus, coronavirus and rotavirus infections in dogs in The Netherlands.

Complex trapping blocking (CTB) enzyme-linked immunosorbent assays (ELISAs) and indirect ELISAs for the detection of antibodies to canine parvovirus (CPV), canine coronavirus (CCV) and rotavirus in sera of dogs were established. Double antibody sandwich ELISAs for the detection of CPV-, CCV- and rotavirus antigens in fecal samples were also developed. Both the serological and antigen-detection ELISAs were used to screen samples from dogs in The Netherlands, with or without a history of acute diarrhea. It was shown that the results of the respective serological ELISAs correlated well and that CPV was the major cause of virus-induced acute diarrhea in dogs in The Netherlands.

Acute Disease↗