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Pharmaceutical care in The Netherlands. History, definition and projects.

The evolving concept of Pharmaceutical Care knows different interpretations in different countries. In the Netherlands community pharmacists already perform several functions which may be part of the Pharmaceutical Care concept. The Dutch concept of Pharmaceutical Care is tested in the TOM and OMA-projects. Patients recognise the educational, aspects of Pharmaceutical Care and in general are content about the provision thereof.

Humans↗

The effects of alcohol and smoking upon the age, anatomic sites and stage in the development of cancer of the oral cavity and oropharynx in females in the south west Netherlands.

A retrospective review of 303 women, aged 40 or over, with squamous cell carcinomas of the oral cavity or oropharynx was conducted in the south-west Netherlands to study the effects of smoking and alcohol upon the age of onset, site and stage of disease. It was noted that patients presenting with oropharyngeal cancers were younger and had a higher incidence of smoking and history of heavy drinking. Age at presentation was also affected by the amount of alcohol and tobacco consumed with non-users presenting with tumors approximately 15 years later. A specific finding was that heavy drinkers and smokers tended to present with late-stage-disease.

Adult↗

Helminth parasites of wild foxes (Vulpes vulpes L.) in The Netherlands.

To study the helminth fauna of wild foxes (Vulpes vulpes) in The Netherlands, material was collected from 139 foxes. The following parasites were found. Cestodes: Taenia spp. 53.3%, Hymenolepis spp. 1.5%; Trematodes: Alaria alata 10.9%, Cryptocotyle lingua 3.6%, Euparyphium melis 1.5%, Apophallus donicus 0.7%; Nematodes: Toxocara canis 73.7%, Uncinaria stenocephala 59.9%, Capillaria aerophila 46.8%, C. plica 23.5%, Molineus patens 5.1%, Crenosoma vulpis 4.5%, Strongyloides spp. 0.7%. The tapeworms Mesocestoides spp. and Echinococcus spp. were not seen. No relationship was observed between worm burden and sex, time of year or place of origin.

Animals↗

The labour supply of married and cohabiting women in the Netherlands, 1981-1989.

"In this article we investigate the differences in labour supply of married women and cohabiting women in the Netherlands; we try to answer the question how these differences can be explained. From this study, it can be concluded that differences between both categories of women in participation and in weekly hours worked can predominantly be explained by differences in characteristics (e.g. age, net wage rate, and age of children), than by differences in behaviour. The empirical results indicate that cohabiting women are more economically independent than married women. However for married women we found evidence that there was increased economic independence during the eighties; i.e. their weekly hours work has become less affected by the income of their partners." (SUMMARY IN FRE)

Demography↗

The impact of population growth on the standard of living: demo-economic scenarios for the Netherlands.

"The core of the article can be comprised in the question: Will population ageing become a threat to [the] standard of living [in the Netherlands]?... In order to explore a broad range of possibilities two strongly contrasting...scenarios serve as the starting-points of the analyses.... The question of whether the ageing process will jeopardize the standard of living, is, for each of the demographic projections, answered by comparing them with three economic targets.... The most important conclusion is that in the long run neither of the scenarios developed will generate an economic growth comparable with that of the 1960s and 1970s." (SUMMARY IN FRE)

Demography↗

Professional HIV risk taking, levels of victimization, and well-being in female prostitutes in The Netherlands.

Professional HIV risk taking (nonconsistent condom use with clients) of female prostitutes in The Netherlands is addressed within the context of (early) experiences with abuse, well-being, coping behavior, job satisfaction, and financial need. Data were gathered from 127 female prostitutes on condom use, financial need, and professional attitude, and on experiences with violence and abuse, physical complaints, psychosocial problems, and coping responses. Violent traumatic experiences were found to relate to more severe complaints and problems, and a higher frequency of emotion-focused coping strategies. A risk-taking protection style (as opposed to consistent condom use and selective risk taking) appeared to be associated with more severe experiences with violence, both in childhood and in adult life, with more frequent dissociation as a coping behavior, and with more psychosomatic complaints. Of all the relationships found, more severe experiences with violence on the job were most strongly related to a higher professional HIV risk.

Adaptation, Psychological↗

Epidemiology of hip fractures in The Netherlands: women compared with men.

In this retrospective study the epidemiology of hip fractures in The Netherlands was evaluated. The number of hip fractures over the period 1972-1987 was collected from the Dutch Centre for Health Care Information (Stichting Informatiecentrum voor de Gezondheidszorg, SIG). The demographic data were collected from the Dutch Centre for Statistics (Centraal bureau voor de Statistiek, CBS). The age-adjusted incidence of hip fractures for both women and men 50 years of age and over, increased linearly over the period 1972-1987. There was also a linear rise in the age-adjusted incidence of hip fractures in women and men 65 years of age and over, but the rise in incidence was equal in both sexes. After the age of 50 years women and men showed an equal proportional increase in the age-specific incidence of hip fractures by 5-year age groups. This proportional increase was independent of the calendar year studied during the period 1972-1987. The increase over time in the age-adjusted incidence of hip fractures in inhabitants 50 years of age and over is the result of changes that act well before the age of 50 years, because the proportional increase in the age-specific incidence of these fractures after the age of 50 years did not change over the period studied. The cohort analysis showed that the age-specific incidence of hip fractures in more recently born birth cohorts is higher than that in birth cohorts born long ago. This observation agrees with the other observations.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗

Prevalence of primary Helicobacter pylori resistance to metronidazole and clarithromycin in The Netherlands.

The minimum inhibitory concentrations of metronidazole and clarithromycin were determined for 780 Helicobacter pylori strains collected in 1994 and 1995 from three different regions in The Netherlands. The overall prevalence of primary metronidazole resistance was 17%, with resistance found more frequently in women (24%) than in men (13%). There was no significant difference between the levels of resistance in the three regions. Primary clarithromycin resistance was rare (1%) and relatively infrequent as compared to that found in other countries. Four of the six strains resistant to clarithromycin were also resistant to metronidazole.

Anti-Bacterial Agents↗

Urinary tract infections with Aerococcus urinae in the south of The Netherlands.

Aerococcus urinae is an uncommon urinary tract pathogen that causes infections predominantly in elderly persons with local or general predisposing conditions. During a one-year study, the clinical features of Aerococcus urinae urinary tract infections (> or = 10(5) cfu/ml) were investigated in two large medical microbiology laboratories in the Netherlands. The incidence of Aerococcus urinae urinary tract infections ranged between 0.31 and 0.44% for the two laboratories. The median age (range 35-95 years) of patients with this infection was 82.5 years for women and 77.5 for men. Men had significantly (p < 0.01) more local predisposing conditions than did women. Underlying systemic diseases such as diabetes mellitus, malignancy, and dementia were found in 67.5% of patients. Most patients (97.5%) had the classic signs of a urinary tract infection, but none of them developed serious symptoms. All isolates tested were susceptible to penicillin, amoxicillin, and nitrofurantoin, 78.3% were susceptible to norfloxacin, and all were resistant to sulfonamides. The majority of patients were treated with amoxicillin, amoxicillin with clavulanic acid, or norfloxacin.

Abdominal Pain↗

Trends in blood pressure and the prevalence and treatment of hypertension in young adults in The Netherlands, 1974-1986.

To investigate trends in blood pressure and the prevalence and treatment of hypertension in the Netherlands between 1974 and 1986, data from two screening projects on cardiovascular risk factors were used. Between 1974 and 1980 about 30,000 men and women aged 37-43 were screened. Between 1981-1986 about 80,000 men aged 33-37 were examined. An increase in average systolic blood pressure by 2 mmHg in men in the period 1974-1980 was followed by an insignificant change during the period 1981-1986. Average diastolic blood pressure increased by 4 mmHg between 1974 and 1980 but decreased by the same amount between 1981 and 1986. The prevalence of hypertension in 40-year-old men increased from 12.7% in 1974 to 17.8% in 1980. The prevalence of hypertension in 35-year-old men did not change between 1981 and 1986 and amounted to 9.6%. Treatment of 40-year-old hypertensive men increased from 8% in 1974 to 21% in 1980 and from 9% in 1981 to 13% in 1986 among 35-year-old men. Average systolic blood pressure did not change in 40-year-old women between 1974-1980 but average diastolic blood pressure increased by 2 mmHg during that period. The percentage of hypertensive women was 8.5% and did not change between 1974 and 1980. Also, the percentage of treated hypertensive women did not change and amounted to 28%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Neuro-physio-surgery in the Netherlands since 1971.

In the Netherlands since 1971 a working group consisting of representatives of relevant specialisms actively discussed all patients in whom neuro-physio-surgery was considered. This term is used for indicating brain surgery for psychiatric or epileptic patients. The number of patients submitted is small, i.e., 123 in approximately 8 years. Of these 123 patients, after extensive discussion, 48 have been treated by neurosurgical intervention, i.e., 36 psychiatric and 12 epileptic cases. All patients who have been operated on were "hopeless" cases in whom no conventional therapy was effective. Neuro-physio-surgery (NPS) as an ultimate resort, has given relief to the majority of these patients. It is felt that the discussions by a relatively large group of specialists provide optimal protection to the patient, and that the changes are minimal that NPS would be carried out on the basis of inadequate or insufficient indications.

Brain↗

Reclassifying causes of death to study the epidemiological transition in the Netherlands,1875-1992.

"This article describes a method for reclassifying causes of death in the Netherlands for the period 1875-1992....A method developed by Vallin and Mesle (1988), which involves ¿dual correspondence tables' and ¿fundamental associations', was used to create nosologically continuous categories. These categories were tested for statistical continuity during the transition years of one ICD-revision [International Classification of Diseases] to the next, using ordinary least squares regression analysis. The reclassification procedure resulted in a nested classification consisting of three levels of refinement of causes of death: 27 causes, 1875-1992; 65 causes, 1901-1992; and 92 causes, 1931-1992. On the basis of this classification, 43% of all deaths in 1875-79 and 98% of all deaths in 1992 could be allocated to either communicable diseases, non-communicable diseases or external causes." (SUMMARY IN FRE)

Cause of Death↗

The component structure of elderly population growth in the Netherlands: 1950-1980.

"While there is no doubt about the magnitude of the growth of older age groups in industrialized nations, its structural components are less well understood. This paper examines the roles played by cohort succession and mortality in the process for the Netherlands during the period 1950 to 1980. While the size of the population aged 65 and over has increased for both males and females, increases in the size of succeeding cohorts explain all of the growth in the older male population. Reductions in mortality at the older old ages play a much greater role than do reductions at younger old ages; the latter reductions occur among females only." (SUMMARY IN FRE)

Adult↗

Late fertility decline in the Netherlands: the influence of religious denomination, socio-economic group and region.

The factors affecting the modern decline in fertility in the Netherlands are explored using data from censuses from 1930 to 1971 and additional unpublished sources. Particular attention is paid to the influence of religion, socioeconomic status, and region. The author concludes that "a theory formulated by Lesthaeghe and Wilson on the relation between modes of production and secularization and the pace of fertility decline in Western Europe offers--in combination with van Heek's views on the special position of Dutch Roman Catholicism--a starting point for an explanation of why the fertility decline of Roman Catholics, self-employed and agricultural labourers lagged behind." (summary in FRE)

Agriculture↗

Quality control of estrogen receptor assays in The Netherlands.

Lyophilized receptor-positive tissue powders and cytosols, prepared from calf uterus and human breast tumor tissue, are used to assess the validity of routine dextran-coated charcoal estrogen receptor assays. Since 1978 lyophilized reference preparations have been analyzed twice yearly by 18 laboratories in the Netherlands. During 8 consecutive trials 20 different lyophilized samples were studied. The inter-laboratory variability of estrogen receptor results decreased with time. Most laboratories found receptor values around the median value of all groups together, though some participants consistently reported estrogen receptor values that were higher or lower than the median. The variability of estrogen receptor results between labs seemed to be associated with cytosol dilution, determination of non-specific binding, concentration and volume of dextran-coated charcoal, and the use of single dose assays or Scatchard analysis. The agreement on the presence or absence of estrogen receptors was more than 98% for lyophilized reference samples with high receptor content. For samples with low receptor content 85% agreement was observed, while 12% of the assays performed on receptor-negative material were reported to be estrogen receptor-positive. The use of the same protein determination (Coomassie Brilliant Blue) and human serum albumin standard has decreased the interlaboratory variation coefficient of the protein results to 7.5%.

Animals↗

Prospective study on alcohol consumption and the risk of cancer of the colon and rectum in the Netherlands.

The association between alcohol consumption and cancer of the colon and rectum was investigated in a prospective cohort study, conducted in the Netherlands from 1986 onwards among 120,852 men and women, aged 55 to 69 years. During 3.3 years of follow-up, 312 and 166 cases of colon and rectal cancer had accumulated, respectively. After exclusion of cases diagnosed in the first year of follow-up, the analysis was based on 217 incident cases of colon cancer (107 men and 110 women) and 113 cases of rectal cancer (75 men and 38 women). For colon cancer, no association with total intake of alcohol nor with the consumption of beer and wine, specifically, could be demonstrated; for liquor intake, a significant (P = 0.04) decreasing risk with increasing consumption was observed. For rectal cancer in men, positive trends were observed for total alcohol intake (P = 0.04), beer (P = 0.05), and liquor (P = 0.06). Results for rectal cancer in women were consistent with those in men, but data were too sparse to provide stable estimates. Simultaneous adjustment for beverage type and quantity appeared to strengthen the association of rectal cancer with drinking beer (relative rate (yes/no) = 2.0, 95 percent confidence interval = 1.1-3.9), although a dose-response effect was not observed. When alcohol intake from beer, wine, and liquor were included as continuous variables, the association was somewhat stronger for liquor than for beer, but none of the associations were statistically significant. It is concluded that consumption of alcoholic beverages (beer, in particular) is associated with an increased risk for rectal but not colon cancer.

Aged↗

The work at the pharmacy: Sweden and The Netherlands compared.

At pharmacy Orden in Apeldoorn (the Netherlands) a change in the flow of filling a prescription was made, introducing the 'counter model': one person fills the prescription at the counter and is checked by another person. This change was mainly inspired by the actual working situation in Sweden. A comparison was made between pharmacy Orden and pharmacy Ekorren (Sweden) with respect to working systems, communication patterns, time spending and perceptions of the personnel. At pharmacy Orden fewer communication disturbances occurred and less advice was required to fill a prescription than at pharmacy Ekorren. The time to fill a prescription was almost two minutes shorter at pharmacy Orden. The personnel at both pharmacies was satisfied with the physical and psychological workload. The technicians at pharmacy Ekorren felt subordinate to their higher educated prescriptionist colleagues in filling a prescription.

Drug Prescriptions↗

Physiological effects of the meteorologically abnormal year 1974 observed in healthy males in the Netherlands and southern Norway.

Convincing evidence of biological effects during long-term abnormal weather conditions is very rare because usually no continuous series of physiological data from the same animals or humans (either single or in groups) have been collected over many years during the period preceding the meteorological event. Since 1955, at the Biometeorological Research centre, Leiden, about 220,000 blood data were collected from healthy male blood donors at Leiden, The Netherlands, and about 110,000 data at Oslo, Norway, since 1966. It was found that during the meteorologically abnormal year of 1974, which was abnormal in many parts of the world, both in Leiden and Oslo abnormal biological patterns occurred in blood sedimentation rate, haemoglobin, diastolic blood pressure, gamma-globulin levels, Piccardi p-test percentages and a few other biological parameters. A more complete monograph will be published at a later date.

17-Ketosteroids↗