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PubMed1995

Estimating sample sizes for a two-stage sampling survey of seroprevalence of pseudorabies virus (PRV)-infected swine at a regional level in The Netherlands.

In the European Union, vaccination campaigns against Pseudorabies virus (PRV) in swine have been started to eradicate PRV. Specific sampling designs are needed to monitor PRV seroprevalence at a regional level. This paper demonstrates how sampling theory can be applied to design a disease seroprevalence survey, using PRV as an example. In the spring of 1994, the four regions in the Netherlands covered by the regional Animal Health Services were monitored with respect to PRV seroprevalence. Per region, blood samples from approximately 1400 herds, with two animals per herd, were collected. The sampling design accounted for stratification by fattening pig and sow population within each region. The regional PRV seroprevalence of swine in the Southern region was the highest (24.9%), closely followed by the PRV seroprevalence of swine in the Eastern region (20.5%). These regions have the highest density of swine in the Netherlands. The PRV seroprevalence in the Western and Central region (11.7%) was about half of the seroprevalence in the Southern and Eastern regions; the lowest regional PRV seroprevalence was observed in the Northern region (3.5%). The Northern part also has the lowest pig density. The PRV seroprevalence was approximately two times higher in sows than in fattening pigs.

Animals↗
PubMed1996

Potency of veterinary rabies vaccines in The Netherlands: a case for continued vigilance.

Commercial rabies vaccines, used by veterinarians in the Netherlands, were collected for testing in the mouse potency test. Of the six vaccines tested, two were clearly below the minimal requirements for potency of 1.0 IU. Of these six vaccines the rabies virus glycoprotein (GP) and nucleoprotein (NP) contents were determined in an antigen competition ELISA. The GP content proved to correlate well with the potency found in the mouse potency test (r = 0.95, p < 0.01), whereas no such correlation was found for the NP content (r approximately 0, p > 0.05). After the manufacturers were told about the results, one of the two vaccines that did not comply with the requirements was withdrawn from the market. Measurement of the GP content of a second lot of the remaining vaccines indicated that sufficiently high levels of GP were present in all five. Additional in vivo testing in mice for efficacy against intracerebral challenge with the Dutch bat rabies virus EBL1-12 resulted in acceptable levels of protection with four of these five vaccines of the second lot. The data presented illustrate the need for continued potency evaluation of veterinary rabies vaccines in the Netherlands.

Animal Diseases↗
PubMed1998

The percentage of feline, canine, avian and exotic animal consultations in veterinary practice in The Netherlands in 1994 and suggested consequences for the veterinary curriculum and residency programs.

The percentage of feline, canine, avian and exotic animal consultations in 1994 was established by means of a survey among veterinary practitioners in the Netherlands. The results from the response to a questionnaire which was sent to companion animal practitioners were compared with those of an at random telephone survey and tested for reliability. Results showed that the cat tended to be the most frequently presented species in companion animal practice in the Netherlands in 1994 (46%), followed by dogs (44%) and birds and exotic animals (10%). In mixed practices these percentages were 40%, 51%, and 9% respectively. From the 'avian and exotic animal' group the following species or orders were the most important: rabbits (32%), rodents (26%), parrots (12%), pigeons (9%), songbirds (9%), ferrets (4%), others (8%). It is concluded that the veterinary curriculum should be adapted to prepare veterinary students to deal with this greater variety in pet animals species and related problems. The need to include exotic animal medicine in resident training programmes is emphasized.

Animals↗
PubMed2003

Comparison of dioxin and PCB concentrations in human breast milk samples from Hong Kong and the Netherlands.

The adverse effects of dioxins and polychlorinated biphenyls (PCBs) on human health are of increasing concern. These lipophilic compounds are concentrated through the food chain and are present in human milk. This study compares PCB levels in human milk samples from Hong Kong and Dutch mothers. Ten breast milk samples from Hong Kong and 10 from the Netherlands were collected during home visits between 2 and 6 weeks postpartum. Total toxic equivalence (TEQ) of dioxin and PCBs were determined using the DR-CALUX(R) bioassay. The total dioxin and PCB levels in breast milk samples for Hong Kong ranged from 3.1 to 29.9 pg TEQ g(-1) lipid and for the Netherlands from 8.9 to 89.5 pg TEQ g(-1) lipid. Despite Hong Kong's high degree of industrialization, the levels of dioxin and PCBs were fourfold lower in the Hong Kong than in the Dutch samples. This may be due to a lower dietary intake of dioxins and PCBs in Hong Kong because of lower background levels of these contaminants or to different food habits.

Adult↗
PubMedDate not supplied

The occurrence of fumonisin B1 in maize-containing foods in The Netherlands.

Seventy-eight maize-containing foods obtained from retail stores in The Netherlands were analysed for fumonisin B1 contamination. Thirty-six per cent of the samples were contaminated with fumonisin B1 in the range of 8 micrograms kg-1 (limit of detection) to 1430 micrograms/kg-1. Forty-six per cent of the minimally treated maize samples (n = 39; maize for bread production, maize for popcorn, maize flour and polenta) were contaminated with fumonisin B1 in the range of 8-380 micrograms kg-1. Twenty-six per cent of the maize-containing processed foods (n = 39; tostada, canned maize, maize starch, maize bread, popped maize, flour mixes, maize chips and cornflakes) were contaminated with fumonisin B1 in the range of 8-1430 micrograms/kg-1. This survey shows that maize-containing foods in The Netherlands frequently can be contaminated with fumonisin B1.

Bread↗
PubMed2000

Drug consumption in the first years of rheumatoid arthritis in France, The Netherlands, and Norway. A longitudinal study in the early nineties.

OBJECTIVE: To analyse drug consumption in the first years of rheumatoid arthritis (RA) in France, the Netherlands, and Norway, in a longitudinal study between 1991 and 1993. PATIENTS AND METHODS: The EURIDISS cohort followed up over three years included 695 RA subjects with less than 5 years disease duration. Clinical and biological parameters, drug consumption according to ATC classification, and use of local treatment were recorded. RESULTS: In the Netherlands consumption of second-line treatment occurred early on, and remained constant over time. In France, it was consumed by half of the subjects and decreased during follow-up (p<0.001). In Norway, 50% of the subjects were on second-line treatment at the outset. NSAIDs rather than corticoids were the most widely consumed. Patients underwent frequently local treatments with decrease frequency of infiltrations over time (p<0.001). CONCLUSION: Second-line treatments were used in the first years of disease development, following varying sequences in the different countries.

Adrenal Cortex Hormones↗
PubMed1976

The secular trend in age at menarche in the Netherlands.

The mean age at menarche of girls in Utrecht city, the Netherlands, in 1971 and 1972 was estimated by probit analysis as 13-37 years with a standard deviation of 1-17 years. This result is compared with similar data obtained in the Netherlands in 1955 and 1965.

Age Factors↗
PubMed2005

Performance of clinical signs in poultry for the detection of outbreaks during the avian influenza A (H7N7) epidemic in The Netherlands in 2003.

The aim of this study was to make an inventory of the clinical signs of high-pathogenicity avian influenza (HPAI), to facilitate the development of an operational syndrome-reporting system (SRS) in The Netherlands as an early warning system for HPAI outbreaks. A total of 537 poultry flocks (240 infected and 297 non-infected) with a clinical suspicion of an infection with HPAI virus were investigated with respect to the clinical signs observed. Standardized reports were analysed with respect to observed clinical signs in the flocks. Various poultry types were distinguished. In infected commercial flocks with egg-producing chickens, the presence of increased mortality, apathy, coughing, reduction in normal vocalization, or pale eggs appeared to be overall the most sensitive indicators to detect a HPAI outbreak, matching a sensitivity of 99% with a specificity of 23%. In infected turkey flocks, the presence of apathy, decreased growth performance, reduction of normal vocalization, swollen sinuses, yawning, huddling, mucosal production from the beak, or lying down with an extended neck appeared to be overall the most sensitive indicators to detect a HPAI outbreak, matching a sensitivity of 100% with a specificity of 79%. In infected backyard/hobby flocks, increased mortality or swollen head appeared to be overall the most sensitive indicators of a HPAI outbreak, matching a sensitivity of 100% with a specificity of 26%. These results indicate that there is a solid basis for the choice of using increased mortality in the operational SRS in The Netherlands as an early warning system for HPAI outbreaks. The presence of apathy, specifically for turkeys, should be added to the SRS as an indicator.

Animals↗
PubMed2000

Lower limb deficient children in The Netherlands: epidemiological aspects.

Information on the characteristics of children with limb deficiencies and amputations in The Netherlands is largely lacking. The present study aimed to collect data about the prevalence of congenital deficiencies, the ratio of congenital to acquired limb deficiencies, types of lower leg deficiency or amputation and male/female ratios. Data were obtained from a regional birth defects registry for the northern part of The Netherlands (EUROCAT-NNL) and from a national survey. Inclusion criteria for the selection of the EUROCAT data were: children/foetuses with lower leg deficiencies born in 1981-1986. Inclusion criteria for the survey data were: children aged 1-18 years with congenital deficiencies or acquired amputations of the leg, excluding toe deficiencies/amputations. Both the regional birth defects registry and the national survey only yielded small numbers of children, which limits the validity of the authors' findings. The Eurocat data show a prevalence of lower leg deficiencies at birth of 2.07/10,000. Fifty-five (55) children/foetuses were included in the present study. The male/female ratio was 1:1. Of the live-born children, 30% also had defects of the upper limbs, while 38% had bilateral lower limb deficiencies. The national survey included 89 children, of whom 73% had congenital deficiencies, while the others had undergone amputations: of which 37% were due to malignancies, 29% to traumata, 13% to infections and 21% to other pathology. The male/female ratio was 7:3 for the children with congenital deficiencies versus 6:4 for the children with acquired amputations. In the group of congenital deficiencies, fibula deficiency was most frequently seen (36%), while in the group with acquired amputations trans-femoral amputation, knee disarticulation and trans-tibial amputation were seen with equal frequency (21%). In 40% of the children with congenital deficiency and in 8% of the children with acquired amputations the arm was also affected. Both legs were affected in 37% of the children with congenital deficiencies and in 8% of the children with acquired amputations.

Adolescent↗
PubMed2003

Prosthetic prescription in the Netherlands: an observational study.

Prosthetic prescription for lower limb amputees and the methodology used are primarily based on empirical knowledge. Clinical expertise plays an important role that can lead to an adequate prescription; however, a clear evidence based motivation for the choices made cannot be given. This can lead to local prescription variations with regard to overuse or underuse of prosthetic care and a lack of transparency for consumers and health insurance companies. Hence a clinical guideline may lead to a more consistent and efficient clinical practice and thus more uniformly high quality care. The purpose of this study was to get insight into potential similarities in prescription criteria in clinical practice in the Netherlands. Secondly, the authors were interested to know if prosthetic prescription was primarily based on the level of activity or intended use of the prosthesis. As part of the development of a consensus-based clinical guideline a multi-centred, cross-sectional study was carried out in order to observe the prosthetic prescription for a group of lower limb amputees. Therefore prescription data were collected from 151 amputees with trans-femoral amputation, knee disarticulation or trans-tibial amputation. Results of the multiple logistic regression show no relationship between the activity level and any of the variables included in the equation such as the hospital or medical doctor in Physical and Rehabilitation Medicine (MD in P&RM), prosthetic components, age of the amputee or reason of amputation. The criteria used are merely based on the clinical expertise and local experience whereas the actual prescriptions differ from location to location. In conclusion the development of a clinical guideline for prosthetic prescription in lower limb amputation is recommended. The information gained from this observational study will be used in a clinical guideline procedure for prosthetic prescription in the Netherlands.

Aged↗
PubMedDate not supplied

A "suicide pill" for older people: attitudes of physicians, the general population, and relatives of patients who died after euthanasia or physician-assisted suicide in The Netherlands.

In the Netherlands there has been ongoing debate in the past 10 years about the availability of a hypothetical "suicide pill", with which older people could end their life in a dignified way if they so wished. Data on attitudes to the suicide pill were collected in the Netherlands from 410 physicians, 1,379 members of the general population, and 87 relatives of patients who died after euthanasia or physician-assisted suicide. The general population and relatives were more in favor than physicians. Fifteen percent of the general population and 36% of the relatives thought a suicide pill should be made available.

Attitude of Health Personnel↗
PubMed1989

The right to die: the euthanasia discussion in The Netherlands.

Euthanasia is becoming an accepted procedure in The Netherlands. It can be a dignified way to end a life if administered only after a voluntary, well-considered request of long duration by a person undergoing unbearable suffering. Discussion of the patient's condition, technicalities, and judicial consequences with the next of kin, attendants, a pastor, and another physician is a necessary prelude. As defined in The Netherlands, euthanasia must bring about death, be implemented by another person, and be in response to an explicit request by a patient.

Euthanasia↗
PubMed1997

Report of an international summer school--oncology for medical students--in 1996 in Groningen, The Netherlands.

An international summer school session, Oncology for Medical Students, was held in 1996 at Groningen University Hospital in The Netherlands. It was sponsored and organized by the WHO Collaborating Centre for Cancer Education-Groningen. The central focus of the two-week course was cancer in general health care. Various teaching techniques were used, but interaction between students and patients, and students and faculty, was considered a prerequisite. The approach was multidisciplinary, with a variety of clinical disciplines participating, including patient organizations and the Comprehensive Cancer Center North Netherlands. The students, from all over the world, presented posters about oncology topics in their countries. Evaluation showed that the course was highly appreciated by the students; in particular, the students felt they had benefitted from the multidisciplinary approach, the patient encounters, the psychosocial concern, the poster sessions, the quality of the teaching, and meeting other students from all over the world.

Curriculum↗
PubMed2006

Measuring alcohol use: "quantity frequency variability" and "weekly recall" compared among Turks and Moroccans in the Netherlands.

The aim of the present study was to test the quality of the "Quantity Frequency Variability" (QFV) measure and the "Weekly Recall" (WR) measure among second-generation Turks and Moroccans in The Netherlands. Data were gathered in an experimental study conducted in 2002, in Rotterdam, the second largest city in the Netherlands. A sample of 744 second-generation Turks and 753 second-generation Moroccans, aged 16 years and older, was approached to participate in the study. The response rate was 40.3% among Turks and 37.5% among Moroccans, which resulted in 300 Turks (mean age 21.8, of which 51.7% were male) and 282 Moroccans (mean age 20.1, of which 44.9% were male) participating in the experimental study. Differences in item non-response rates and alcohol reports between both measures were analyzed among the drinking sample; i.e., 95 Turks (31.7%) and 26 Moroccans (9.2%). Data showed higher alcohol reports with the QFV measure compared to the WR measure. Furthermore, item non-response rates were significantly lower for the QFV measure compared to the WR measure. The results suggest that, compared to the WR measure, the QFV measure is a more appropriate instrument to study the prevalence of alcohol use among second-generation Turks and Moroccans. Limitations of the study are discussed.

Adolescent↗
PubMed2000

Teenage pregnancy and ethnicity in The Netherlands: frequency and obstetric outcome.

OBJECTIVES: To study differences in frequency and obstetric outcome of teenage pregnancy (not ending in induced abortion) between the main ethnic groups in The Netherlands. DESIGN: A retrospective cohort study based on the 1990-93 birth cohort in the National Obstetric Registry. SUBJECTS: A total of 10,583 teenagers and 54,501 20-24-year-old women who had a singleton pregnancy and were primiparous. MAIN OBSTETRIC OUTCOME MEASURES: These were perinatal death occurring between the 16th week of pregnancy and 24 h after birth, preterm birth and operative delivery (vaginal extraction and Cesarean section). METHOD: Comparison of the frequency of teenage pregnancy between ethnic groups and by bivariate and multivariate analysis of the three outcome measures between the teenage groups, the teenage groups and ethnically related 20-24-year-old women, and the teenage groups and Dutch 22-24-year-old women. RESULTS: A total of 55.2% of pregnant teenagers had non-Dutch ethnicity compared to 13.8% of all pregnant women. Islamic-Mediterranean teenagers constituted the largest group, one in four of all primiparous Mediterranean women being younger than 20 years of age, followed by black teenagers. Except for Hindustani teenagers, perinatal death occurred in all non-Dutch teenage groups more frequently than in Dutch teenagers, but the differences were only significant for black teenagers (odds ratios of black compared to Dutch teenagers were 2.89 (95% confidence interval (CI) 1.89-4.4) and 1.53 (95% CI 1.19-1.98), respectively). Rates for preterm birth were higher in black and Asian than in Dutch teenagers, but the difference was only significant for black teenagers (odds ratio 1.53, 95% CI 1.19-1.98). Compared to ethnically related 20-24-year-old women, rates of perinatal death and preterm birth were significantly higher in Dutch, black and Asian teenagers and, for preterm birth only, in Mediterranean teenagers. Correction for preterm birth showed that only part of these differences in perinatal death could be explained by preterm birth. Vaginal extraction and Cesarean section occurred less frequently in teenagers than in ethnically related (and in Dutch) 20-24-year-old women. Mediterranean teenagers had the lowest Cesarean section rate and Blacks the lowest vaginal extraction rate. CONCLUSION: Teenage pregnancy in The Netherlands is much more common in minority ethnic groups than in the indigenous population, particularly among Islamic-Mediterraneans and Blacks. Obstetric outcomes vary considerably, these being best in Hindustani and poorest in black teenagers, and being worse in teenagers than in 20-24-year-old women. However, teenagers less often had assisted delivery.

Adolescent↗
PubMed2004

A confidential inquiry estimating the number of patients affected with sickle cell disease and thalassemia major confirms the need for a prevention strategy in the Netherlands.

We have conducted a broad confidential inquiry among 401 hospital departments trying to estimate the number of patients affected with severe forms of hemoglobinopathies living in The Netherlands. With less than 30% response we have registered 559 patients in all age categories of whom 77.0% are affected with sickle cell disease and 17.5% with beta-thalassemia (thal) major. We estimate that the real figure could be around 800 patients, a figure more than six times higher than the number published in 1995 on which the reluctance to offer prevention was based. The actual figures and the incidence estimation of approximately 60 patients a year underline the urgent need for the official implementation of a prevention strategy in The Netherlands. During the last 5 years we have been working towards the implementation of a multi-intervention strategy for primary prevention using the existing structures of public health. The obstacles we have encountered to endorse such a strategy are discussed as a possible guide for other immigration countries.

Anemia, Sickle Cell↗
PubMed1999

Molecular epidemiology of tuberculosis in the Netherlands: a nationwide study from 1993 through 1997.

To disclose risk factors for active tuberculosis transmission in the Netherlands, restriction fragment length polymorphism (RFLP) patterns of 78% of the Mycobacterium tuberculosis isolates, from the period 1993-1997, were analyzed. Of the respective 4266 cases, 46% were found in clusters of isolates with identical RFLPs, and 35% were attributed to active transmission. The clustering percentage increased strongly with the number of isolates; taking this into account, fewer cases were clustered than has been reported in other studies. Contact investigations in the five largest clusters of 23-47 patients suggested epidemiological linkage between cases. Of patients identified through contact tracing, 91% were clustered. Demographic risk factors for active transmission of tuberculosis included male sex, urban residence, Dutch and Surinamese nationality, and long-term residence in the Netherlands. Human immunodeficiency virus infection was not an independent risk factor for active transmission. Isoniazid-resistant strains were relatively less frequently clustered, suggesting that these generated fewer secondary cases.

Adult↗
PubMed2000

Molecular epidemiology of human enteric caliciviruses in The Netherlands.

In The Netherlands, illness due to Norwalk-like viruses (NLVs) of the family Caliciviridae is quite common. NLVs cause >80% of the outbreaks of gastroenteritis reported to municipal public health centers and at least 5% of the cases of gastroenteritis for which a general practitioner is consulted. In addition, up to 18% of community cases of gastroenteritis in the 1998/1999 winter season have been attributed to NLVs. Patterns of disease activity differ remarkably, with "normal years, when outbreaks occur that are caused by different types of NLV, and "epidemic years, when outbreaks appear to be caused by a single strain. This observation suggests selection of antigenic variants with increased virulence or altered modes of transmission. In addition, since caliciviruses related to the NLVs from humans have been detected in stool specimens from calves at 45% of the dairy farms in The Netherlands, the possibility of spillover of epidemic strains from an animal reservoir to humans should be considered.

Animals↗