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PubMed2000

Sero-surveillance of wild boar in The Netherlands, 1996-1999.

From 1996 to 1999, blood samples were collected from wild boar shot during the hunting season in Crown properties, national parks and the free wildlife belt in the Netherlands. Sera were screened for the presence of antibodies against classical swine fever virus (CSFV), swine vesicular disease virus (SVDV), Aujeszky's disease virus (ADV) and Trichinella spiralis. The results of the sero-surveillance system indicate that CSFV, SVDV and ADV are uncommon within the wild boar population. Hence, the wild boar population is not thought to be an important reservoir of these viruses in the Netherlands. Infection with ADV and CSFV is endemic in the wild boar population in Germany. Since contact between the wild boar populations of Germany and the Netherlands cannot be excluded in the southern part of the Netherlands, continuation of the sero-surveillance system seems appropriate. In the decade before 1998, no antibodies to Trichinella spp. were found in the wild boar population of the Netherlands. The detection of some seropositive animals during the hunting season of 1998-1999 corresponds to the previous findings in wild boar before 1988. However, the recent data do not have consequences for the pig industry of the Netherlands, since the country has been considered Trichinella-free for many decades.

Animals↗
PubMed2001

[Implanted pacemakers in the Netherlands, 1984-1997; number, types and patient characteristics].

OBJECTIVE: To carry out a survey of the numbers of patients in the Netherlands who received a pacemaker in 1984-1997 and the types of pacemaker. DESIGN: Retrospective, descriptive. METHOD: Information on pacemaker patients and pacemakers in the Netherlands during the years 1984-1997 was obtained from the Dutch Pacemaker Patient Registration organisation and those in 15 other West-European countries from the European Working Group on Cardiac Pacing. Both organisations use the European Pacemaker Identification Card. Demographic information was collected via Statistics Netherlands. RESULTS: In the Netherlands, 23 and 28 primo-implantations/100,000 inhabitants were carried out in 1984 and 1997 respectively. The increase was primarily due to a higher number of implants in people > 65 years of age. The 1997 implant figures were lower than the average in Western Europe (34/100,000). In 1997 there was no difference in gender, mean age at the time of first implant, indications and aetiology between the Netherlands and Western Europe. With respect to the choice of type of pacemaker implanted--VVI(R) or DDD(R)-in Western Europe, the Netherlands lay in the middle. Between 1984 and 1997, the number of Dutch centres with 1-25 implants/year decreased while the number with 51-130 implants/year increased. CONCLUSION: In 1997 the number of primo-implantations at Dutch centres increased in comparison with 1984, but less than the West European average. Implants were increasingly performed in high-volume centres.

Age Factors↗
PubMed2004

[Surveillance of hepatitis A in the Netherlands 1993-2002].

OBJECTIVE: To survey trends in data on hepatitis A using information from the notification system of the Municipal Medical and Health Services 1993-2002. DESIGN: Retrospective, descriptive. METHOD: Data collected from the notification system of the Dutch Municipal and Medical Services were analyzed. RESULTS: From 1993 to 2002, 64.4%, 6.5% and 11.5% of infections were contracted in the Netherlands, Turkey and Morocco, respectively. Although the absolute number of cases was highest for young people under the age of 16 infected in the Netherlands, incidence rates showed that the children of immigrants infected in Turkey or Morocco were at highest risk, followed by adult immigrants from Turkey and Morocco. In addition, a seasonal trend was observed starting with an increase in the number of notifications of young travellers infected in Turkey and Morocco during their summer holiday, followed by a steep increase in notifications of young people infected in the Netherlands in autumn. This was followed later in the year by a slight increase in notifications of adults who acquired the infection in the Netherlands. However, between 1993-2002 the total number of notifications was halved. This decrease was mainly restricted to infections acquired in the Netherlands. In recent years, fewer outbreaks have been reported in schools, households and families. In 2001, a peak of notifications from the homosexual scene was observed. There was a continued trend in the rise of the mean age of hepatitis-A onset. CONCLUSION: Risk of hepatitis A is highest for the children of immigrants travelling to Turkey or Morocco in the summer months. Secondary cases in the Netherlands are in strong decline, especially in schools and families. However, the almost stable incidence of infections among young people of Turkish or Moroccan extraction stresses the continued importance of immunization of this group before they travel. The continuing trend in the rise of the mean age of hepatitis-A onset deserves attention because of the increasing risk of mortality of the disease amongst older people.

Adolescent↗
PubMed2006

[Results of intrauterine insemination in the Netherlands].

OBJECTIVE: To assess the results of intrauterine insemination (IUI) in the Netherlands. DESIGN: Retrospective. METHOD: Based on annual reports and individual reports from gynaecologists, we calculated the number of registered IUI cycles performed, the pregnancy rates per cycle, the ongoing pregnancy rates per cycle and the multiple pregnancy rates per ongoing pregnancy in 2003. By extrapolating these results, we estimated the total number of IUI cycles performed in 2003 in the Netherlands and the related outcomes. These results were compared with IUI pregnancy rates from the international literature and Dutch national data on in vitro fertilisation (IVF). RESULTS: In 2003, IUI was performed in 91 of the 101 hospitals in the Netherlands. Of these 91 hospitals, 58 (64%) registered their IUI results. These 58 hospitals performed 19,846 IUI cycles in 2003. The mean pregnancy rate per cycle was 9.0% and the ongoing pregnancy rate per cycle was 7.3%. Multiple pregnancies occurred in 9.5% of ongoing pregnancies. Extrapolation of the data of these 58 hospitals revealed that approximately 28,500 IUI cycles were performed in the Netherlands in 2003, of which approximately 2,000 resulted in an ongoing pregnancy. The number of multiple pregnancies following IUI was estimated to be 180 (9.0%). In the international literature, a pregnancy rate per cycle of 8.7% has been reported. According to the national IVF registry, 9,761 IVF cycles were started in 2003, resulting in 2,028 ongoing pregnancies (20.8% per cycle) and 439 twin pregnancies (21.6% per ongoing pregnancy). CONCLUSION: The pregnancy rate per IUI cycle in the Netherlands (9.0%) was comparable to that reported in the international literature (8.7%). The contribution of IUI to the number of multiple pregnancies in the Netherlands was much smaller than the contribution of IVF.

Adult↗
PubMed1982

[Diminished fertility in seals in the Netherlands, possibly resulting from exposure to large amounts of polychlorinated biphenyls (author's transl)].

The number of seals in the coastal waters of the Netherlands has been considerably reduced since 1950: in the Wadden Sea, it decreased from 3,000 to 500, in the Delta area, from 1,500 to merely a few animals. Studies on population dynamics during the period from 1974 to 1978 showed that reproduction among the seal population in the Netherlands Wadden Sea is too small compared with the stable population of Schleswig-Holstein. Investigations on the role of environmental factors in diminished reproduction centered on the factor water pollution. Analysis of the various contaminants in the tissues of seals of the Netherlands. Schleswig-Holstein and Denmark, which were found dead, showed tha particularly the concentrations of polychlorinated biphenyls in seals of the Netherlands were significantly higher than they were in German and Danish animals. The epidemiological and experimental findings on the characteristics of these contaminants, in conjunction with the high concentrations of polychlorinated biphenyls and the decrease in reproduction of seals in the Netherlands, led to the hypothesis that polychlorinated biphenyls are the cause of diminished fertility of seals in the Netherlands.

Animals↗
PubMedDate not supplied

The United States--The Netherlands Round Table Conference on immunization. Summary report.

A group of public health scientists from the United States and The Netherlands met at a Bicentennial Round Table Conference December 1-2, 1982, to discuss the latest developments in immunization against infectious diseases, focusing on pertussis, poliomyelitis, measles, and rubella. The major differences in immunization practices in the two countries are: (a) In The Netherlands, inactivated polio vaccine is used exclusively; in the United States, the oral polio vaccine is used. Polio-myelitis has virtually disappeared from both countries. (b) In The Netherlands, the pertussis component of DTP (diphtheria, tetanus, pertussis) is not given to children over the age of 1 year, whereas in the United States, it is given to children up to their seventh birthday. (c) Rubella vaccine is given only to girls at ages 11-12 years in The Netherlands, but to all children at ages 12-15 months in the United States. (d) Mumps vaccine is not administered to children in The Netherlands, but in the United States it is given routinely to children at 12-15 months (in combination with measles and rubella vaccine). The participants concluded that both the United States and The Netherlands have effective immunization programs that have significantly reduced the impact of these diseases.

Adolescent↗
PubMed1998

[Twenty years of childhood coeliac disease in the Netherlands: more diagnoses and a changed clinical picture].

OBJECTIVE: To assess the incidence of childhood coeliac disease in the Netherlands and to study the clinical features. DESIGN: Prospective. SETTING: Leiden University Medical Centre, Leiden, the Netherlands. METHOD: Cases of childhood coeliac disease in the Netherlands in 1993-1995 were identified by means of the Dutch Paediatric Surveillance Unit. Inclusion criteria were: birth in the Netherlands, diagnosis with at least one small bowel biopsy in 1993-1995 and age at diagnosis 0-14 years. The data were cross checked with the Dutch Network and National Database of Pathology and compared with data from a previous study on childhood coeliac disease, 1975-1990. RESULTS: 297 Coeliac patients were identified by means of the Surveillance Unit, another 32 through the National Database of Pathology. The mean crude incidence rate of diagnosed childhood coeliac disease was 0.51/1000 live births, which was in the range of rates found in other West European countries and significantly higher than the mean crude incidence rate of 0.18/1000 live births found in the Netherlands in 1975-1990. The clinical presentation was classic up to 1990: chronic diarrhoea, abdominal distention and growth failure. From 1993 onward, however, the number of children with chronic diarrhoea and abdominal distention decreased significantly and the number with weight loss, anaemia and abdominal pain increased. Associated disorders were present in 13.7% of the cases. CONCLUSIONS: The incidence of diagnosed childhood coeliac disease in the Netherlands showed a tendency to increase significantly during the past decade. In a period of 20 years a significant trend toward change in the clinical presentation of coeliac disease in Dutch children was observed.

Adolescent↗
PubMed1999

Living arrangements of older adults in the Netherlands and Italy: coresidence values and behaviour and their consequences for loneliness.

Value studies indicate that the process of individualization in Europe started in Sweden and Norway, and continued via France and the Netherlands; the southern European countries lag behind, and are still characterized by more traditional family orientations. Starting from this point of view, this paper investigates the effects of differences between the Netherlands and Italy in the field of living arrangements of older adults with and without partners. The consequences of living alone and of coresidence with adult children have been further investigated, using loneliness as the dependent variable. The size and support functions of the network of social relationships, socio-economic resources, health, sex and age are also taken into account. Data come from face-to-face surveys among a random sample of older adults (55- to 89-year-old women and men) in the Netherlands (n=4,494) and in Italy (n=1,570), using the same research design and questionnaire. The data show country-specific differences in household types of older adults: the proportion living alone is much higher among older people without partners in the Netherlands; the proportion coresiding with their adult children is higher in Italy than in the Netherlands. Controlled for age, health, sex, size and support of the network, and for differences in socio-economic resources, household composition is still the most important determinant of loneliness. Living without a partner in the same household as one's adult children yields country-specific correlations that correspond with differences in value orientations: less loneliness in Italy, more loneliness in the Netherlands.

Journal Article↗
PubMed1995

[Incidence and prevalence of hemoglobinopathies in children in The Netherlands].

OBJECTIVE: To evaluate the prevalence and incidence of thalassaemia major and sickle-cell disease in children. DESIGN: Descriptive nationwide epidemiological study. SETTING: Clinical Genetic Centre Utrecht. METHOD: Prevalence data were collected by a written survey among all 333 Dutch paediatricians (1992; response rate 99.1%). Incidence data are collected monthly by the Dutch Paediatric Surveillance Unit (1992/'93; response rate: 86%). RESULTS: In September 1992, 128 children were being treated by a paediatrician for sickle-cell disease. Two children had parents born in the Netherlands, but all children were of other ethnic origins, mainly from Surinam, the Dutch Antilles, Turkey and Africa; 50 children were born in the Netherlands. 31 children were under treatment for thalassaemia major, none of them of original Dutch descent; the most frequent ethnic backgrounds were Turkey and Morocco; 20 children were born in the Netherlands. From October 1992 till December 1993 (15 months) 18 children were newly diagnosed with sickle-cell disease, of whom 7 were born in the Netherlands, and 8 children were newly diagnosed with thalassaemia major, of whom 2 were born in the Netherlands. CONCLUSION: Sickle-cell disease and thalassaemia major are (still) rare diseases in the Netherlands. With the present migration and the increase of consanguineous marriage, they are expected to become a more important health issue.

Adolescent↗
PubMed1987

[West Indians in the Netherlands: prospects of return].

The return migration policy of the Netherlands and the probability of its success are assessed, with the focus on migrants from the Netherlands Antilles. Factors associated with return migration are studied using data from a sample survey and from other published sources. Age, educational status, and social welfare in the Netherlands show significant correlations with desire to return to the Netherlands Antilles. "Those who have actually returned belong to the higher social strata of the migrant group; having a job in the West Indies matters much more to them than housing conditions.... It is concluded that the Netherlands should increase their financial contribution to the system of social welfare in the West Indies and even more so to the economic development of these islands." (SUMMARY IN ENG)

Age Factors↗
PubMed2005

Cervical cancer in the Netherlands 1989-1998: Decrease of squamous cell carcinoma in older women, increase of adenocarcinoma in younger women.

Cervical cancer is a preventable disease, occurring in relatively young women. In the Netherlands, population-based cervical screening aims at women aged 30-60 years. We performed a population-based study of the incidence of invasive cervical cancer in the Netherlands to evaluate trends, with emphasis on age at time of diagnosis. Histologic diagnosis was retrieved from the Netherlands Cancer Registry for all women residing in the Netherlands with invasive cervical cancer between January 1, 1989, and December 31, 1998. In this 10-year period, the incidence rate of squamous cell carcinoma decreased significantly from 7.1/100,000 to 6.1/100,000 (p < 0.001), with the greatest decrease in women aged 60-74 (-5.5%). While the overall incidence rate of adenocarcinoma remained stable, it increased in women aged 15-29 (+15.8%) and in women aged 30-44 (+2.5%), though the number of cases was small. For squamous cell carcinoma, the incidence of stage II at diagnosis decreased most (-2.7%). There was no change in stage at diagnosis for adenocarcinoma. Most cases of cervical cancer, 60.5%, were detected between ages 30 and 60 years, i.e., the Dutch screening age interval. Cervical cancer in women below age 30 contributed 5.0% to the total incidence, with 3.0% occurring between ages 27 and 29. Thus, screening for cervical cancer in the Netherlands is associated with a decrease in the incidence of squamous cell carcinoma and adenocarcinoma incidence appears to be increasing in younger women.

Adenocarcinoma↗
PubMed2003

Height, weight, body mass index and pubertal development reference values for children of Turkish origin in the Netherlands.

UNLABELLED: The aim of this study was to provide growth and sexual maturation reference data for Turkish children living in The Netherlands. We also compared these references with the reference data of children of Dutch origin and with Turkish reference data collected in Turkey and elsewhere in Europe. Cross-sectional growth and demographic data were collected from 2,904 children of Turkish origin and 14,500 children of Dutch origin living in the Netherlands in the age range 0-20 years. Growth references for length, height, weight for height, body mass index (BMI) and head circumference were constructed with the LMS method. Reference curves for sexual maturation and menarche were estimated by a generalised additive model. Predictive variables for height and BMI were assessed by univariate and multivariate regression analyses. Young Turkish adults were 10 cm shorter than their Dutch contemporaries. Mean height was 174.0 cm for males and 160.7 cm for females. Height differences in comparison with Dutch children started at 3 years. Height SDS was predominantly associated with target height. The height of Turkish children living in the Netherlands was similar to Turkish children in Germany and to children from high socio-economic classes in Istanbul. Compared to Dutch children, maturation stages started 0.5-0.7 years later for both sexes. In girls, median age at menarche was 12.8 years, 5 months earlier than in Dutch girls. BMI of Turkish children was higher than that of Dutch children at all ages. BMI SDS was associated with birth weight and the duration of stay of the mother in the Netherlands. CONCLUSION: Turkish children are considerably shorter and more overweight than Dutch children. Separate growth charts for Turkish children in The Netherlands are useful for growth monitoring.

Adolescent↗
PubMed2004

A comparison of pressure ulcer prevalence: concerted data collection in the Netherlands and Germany.

OBJECTIVES: Because of a lack of epidemiological data of pressure ulcer (PU) among care dependent patients yearly prevalence measurements are held in the Netherlands and in Germany with identical methods. A comparison shows remarkable differences in the PU prevalence so that further analysis is needed to enlighten the reasons. DESIGN: With a standardized questionnaire all patients were examined by trained nurses of the participating facilities. SETTING: In-patients in 42 Dutch and 10 German acute care Hospitals. PARTICIPANTS: All patients who handed in their informed consent were included. In the Netherlands n = 8734, and in Germany n = 2832. MAIN OUTCOME MEASURES: For calculating the PU prevalence the sample was divided inpatients at risk and not at risk for PU in accordance to the Bradenscale. Comparisons between the Netherlands and Germany refer to population details, quota of patients at risk for PU and PU prevalence. Finally the impact of eight controlled variables on the PU occurrence was calculated in a logistic regression. RESULTS: Both samples showed the same sex distribution, the same mean age and the same distribution among the medical specialties. The share of patients at risk for PU is higher in the Netherlands (55%) than in Germany (38%). The frequency of PU is higher in the Dutch population (22%) than in the German one (12%). Regarding only the risk-patients the differences reduce. The prevalence in the Netherlands was 33%, in Germany it was 28%. The highest impact on PU occurrence had the age and the length of stay in hospital. The Country ranges on third position. CONCLUSIONS: The Dutch sample had a higher share of risk-patients and a higher PU frequency. A standardization appropriate to a risk assessment reduce the differences. For enlightening the remaining differences further research is needed.

Aged↗
PubMed1999

Monte Carlo simulation of virus introduction into the Netherlands.

In order to improve the understanding of the risk of introducing classical swine fever (CSF) and foot-and-mouth disease (FMD) into the Netherlands, a Monte Carlo simulation model was developed. The model, VIRiS (Virus Introduction Risk Simulation model) describes virus introduction into the Netherlands from outbreaks in other European countries. VIRiS is aimed at supporting decision makers involved in disease prevention. The model is based on historical and experimental data, supplemented with expert judgement, and provides the expected number, location and cause of primary outbreaks in the Netherlands. The paper gives a detailed description of the design and behaviour of VIRiS. The default outcomes of VIRiS show that in the current situation, the western and northern regions of the Netherlands are most prone to outbreaks of CSF and FMD. Most outbreaks originate from the countries neighbouring the Netherlands and the countries of southern Europe. Several alternative prevention strategies were evaluated using a combination of the VIRiS model and models describing the spread and economic consequences of outbreaks. A considerable financial window is available for measures aimed at speeding up the detection of epidemics in countries from which a Dutch outbreak may originate. Complete elimination of the risk associated with the risk factor 'returning trucks' reduces the annual losses due to FMD and CSF epidemics by approximately US$ 9 million. The approach is general and could also be applied to other diseases and countries.

Animal Husbandry↗
PubMed2001

Health technology assessment and screening in The Netherlands: case studies of mammography in breast cancer, PSA screening in prostate cancer, and ultrasound in normal pregnancy.

OBJECTIVE: To review the assessment and implementation of three screening methods: mammography for breast cancer, screening for prostate cancer, and routine use of ultrasound in pregnancy. METHODS: To review policy documents and published papers dealing with prevention and screening in the Netherlands, focusing on the three screening methods specified. RESULTS: The results indicate that the Netherlands has an active establishment devoted to health technology assessment (HTA). The Netherlands government has also made prevention a high priority in the health services system. Within prevention policy, HTA is given an important place. The general policy is that prevention programs should meet high standards of effectiveness and efficiency, as well as ethical, legal, and social acceptability. In addition, the Netherlands may be unique in the world in having a specific law requiring that proposals for population screening must be carefully assessed before they are implemented. CONCLUSIONS: The three cases examined in this paper have all been assessed, and the conclusions are similar to those presented in the synthesis published in this issue (33). In the case of mammography, the assessment was followed by a rational implementation of a national screening program for breast cancer. In the other two cases, however, despite negative conclusions from assessment, the tests are frequently carried out, especially in what has been termed opportunistic screening. Prostate cancer screening seems to be spreading rapidly. Use of ultrasound in pregnancy is frequent, not necessarily for medical reasons but because parents wish to have a picture of their fetus. The conclusion is that HTA is well established in the Netherlands, as illustrated in these three cases, and policy is based on the assessments done. However, practice is not in accord with the assessment in the cases of prostate cancer and routine ultrasound. Policies to deal effectively with opportunistic screening are difficult to imagine.

Adult↗
PubMed2005

Human papillomavirus testing as a cytology gold standard: comparing Surinam with the Netherlands.

Polymerase chain reaction to detect high-risk human papillomavirus has been suggested as a gold standard for cytology. The Netherlands and Surinam were prospectively compared in regard to the proportions of Negative, Atypical Squamous Cells of Undetermined Significance, and Squamous Intraepithelial Lesion smears that had detectable high-risk human papillomavirus. For the Netherlands, 14 600 negative, 270 Atypical Squamous Cells of Undetermined Significance and 120 Squamous Intraepithelial Lesion smears were evaluated by polymerase chain reaction. For Surinam, 150 negative, 50 Atypical Squamous Cells of Undetermined Significance, and 150 Squamous Intraepithelial Lesion smears were evaluated by polymerase chain reaction. In all, 4% of Dutch and 80% of Surinamese negative smears had detectable high-risk human papillomavirus (chi2=1313, P<0.00001). In total, 41.9% of Dutch and 84% of Surinamese Atypical Squamous Cells of Undetermined Significance smears had detectable high-risk human papillomavirus (chi2=28, P<0.00001). Totally, 67.5% of Dutch and 94% of Surinamese SIL smears had detectable high-risk human papillomavirus (chi2=30, P<0.00001). The Negative: Atypical Squamous Cells of Undetermined Significance odds ratio was 0.058 for the Netherlands and 0.762 for Surinam (chi2homog=31, P<0.00001). The Negative: Squamous Intraepithelial Lesion odds ratio was 0.020 for the Netherlands and 0.255 for Surinam (chi2homog=31, P<0.00001). The Atypical Squamous Cells of Undetermined Significance: Squamous Intraepithelial Lesion odds ratio was 0.347 for the Netherlands and 0.335 for Surinam (chi2homog=0.005, P>0.75). Human papillomavirus DNA testing may not be a suitable gold standard in general because its use would make specificity and sensitivity prevalence-dependent. A new statistic, the percent of Negative pap smears with detectable high-risk human papillomavirus, is posited, which may be important if human papillomavirus DNA testing is used clinically.

Cervix Uteri↗
PubMed2000

Comparison of diets of diabetic and non-diabetic elderly men in Finland, The Netherlands and Italy.

OBJECTIVE: To evaluate whether dietary recommendations for subjects with diabetes are met among Finnish, Dutch and Italian elderly men with diabetes, and whether the diets of diabetic and non-diabetic men differ in these three countries. DESIGN: A dietary survey using cross-check dietary history method. A cross-sectional comparison. SETTING: Thirty-year follow-up of survivors from the Finnish, Dutch and Italian cohorts of the Seven Countries Study. SUBJECTS: 227 elderly men from Finland, 537 from The Netherlands, and 417 from Italy, of whom 8-9% had diabetes. MAIN RESULTS: The diets of non-diabetic men from the three countries differed markedly from each other. In all three countries diabetic men consumed less added sugar than non-diabetic men. In Italy, in addition, diabetic men consumed more fruits and berries and vegetables. The Dutch diabetic men ate relatively more cereal products, fruits and berries, milk and milk products, cheese, and meat and meat products and drank less alcoholic beverages than non-diabetic men. The diet of both diabetic and non-diabetic Finnish and Dutch men was characterized by high fat content (41% and 40% of energy, respectively). The fat content of the diet was even higher for diabetic than non-diabetic men in Finland and The Netherlands, but not in Italy. The fibre content of the diet was the highest among Dutch men and diabetic men received more dietary fibre than non-diabetic men in The Netherlands and Italy, but not in Finland. The diet of diabetic and non-diabetic Finnish men differed little from each other and was characterized by high nutrient density of several vitamins and minerals. The proportion of protein of energy intake was higher among diabetic than non-diabetic Dutch and Italian men. CONCLUSIONS: The diet of the diabetic men from Finland, the Netherlands, and Italy resembled more the diet of non-diabetic men from the respective countries than the diet of diabetic men from the other countries. In the diet of Italian diabetic men, the proportions of fat, saturated fatty acids and carbohydrates were nearest the recommended levels. SPONSORSHIP: The National Institute on Aging, Bethesda, USA, the Dutch Prevention Foundation, the Hague, The Netherlands, the Academy of Finland, and the Sandoz Gerontological Foundation.

Aged↗
PubMed2000

Chiropractic patients in the Netherlands: a descriptive study.

BACKGROUND: Despite the worldwide popularity of chiropractic, there is still relatively little known about the patients who visit chiropractors in the Netherlands and other European countries. OBJECTIVE: To describe in-depth the patient population of new patients to chiropractors in the Netherlands. DESIGN: Study population consisted of 10 consecutive new patients per participating chiropractor. A retrospective-type questionnaire was used. SETTING: Private practice. OUTCOME MEASURES: Mode of referral, area, and nature of the complaints; related to the chief complaint: previous treatments, examinations, type of referral, days lost at work, level of pain, and treatment expectations. RESULTS: Of the 130 chiropractors registered with the Netherlands Chiropractors'Association, 94 chiropractors(78%) participated. Eight hundred thirty-three patients (89%) returned questionnaires. By far, the greatest reason that patients visit chiropractors in the Netherlands is for neuromusculoskeletal (NMS) complaints. At the time of examination, 86% of the patients had spinal-related complaints, of which 12% involved multiple areas of the spine. Non-NMS complaints are minimal (<2%). Seventy-seven percent of patients with NMS complaints have chronic complaints (>12 weeks). Three-quarters of these patients have undergone previous conservative therapy for their complaint, which includes physical and manual therapy, postural correction, and exercise therapy. Despite the chronic nature of their complaints, patients have high expectations that their treatment will be effective. CONCLUSIONS: Most patients who see chiropractors in the Netherlands have chronic NMS-related complaints. Chiropractors are not a part of the normal referral system in this country, with the result that the patients have rather long histories, including previous evaluations by medical specialists and other previous forms of (conservative) care.

Adolescent↗