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At least 19 recordsLinked to original sources
PubMed2003

[Incidence of cervical cancer in women in North-Holland by country of birth from 1988-1998].

OBJECTIVE: To describe the incidence of cervical cancer in women in North-Holland by country of birth. DESIGN: Descriptive epidemiological study based on data from cancer registries. METHOD: The number of cases of cervical cancer in North-Holland for the period 1988-1998 was determined using data from the regional cancer registry of the Comprehensive Cancer Centre, Amsterdam. Based on data from the Netherlands Cancer Registry, a comparison was made between the observed (O) and the expected (E) number of cases by area of residence (i.e., Amsterdam versus the rest of North-Holland) and by the woman's country of birth. RESULTS: In the period 1988-1998, the incidence of cervical cancer among women living in North-Holland was significantly higher than that of the nation as a whole (O/E-ratio: 1.2; 95% CI: 1.1-1.2). In particular, the incidence of cervical cancer for women living in Amsterdam (O/E-ratio: 1.5; 95% CI: 1.4-1.6), and for women born in Morocco (O/E-ratio: 2.1; 95% CI: 1.4-3.1) or Surinam (O/E-ratio: 1.5; 95% CI: 1.1-2.0) was much higher. The country of birth was unknown in 10% of the women. The percentage of patients with extension of the disease outside the uterus (TNM-stages II-IV) did not differ between women born in the Netherlands and those born abroad. CONCLUSION: The incidence of cervical cancer during the period 1988-1998 was significantly higher for women living in Amsterdam and for women born in Morocco or Surinam than that for the Netherlands as a whole. No significant difference in stage of disease at diagnosis was observed between women born in the Netherlands versus those born abroad.

Adolescent↗
PubMed1997

Late termination of pregnancy in North Holland.

OBJECTIVES: To estimate the extent to which late termination of pregnancy (gestational period > 24 weeks) is practised, to find out what fetal diseases and abnormalities lead to termination and to obtain insight into the clinical judgement and decision-making process by gynaecologists with regard to termination. DESIGN: A retrospective study. PLACE: Province of North Holland, The Netherlands. METHODS: An anonymous printed questionnaire, was sent to all associations or departments of gynaecology in the 21 hospitals in North Holland. The period of study covered the years 1990 to 1994. RESULTS: Completed questionnaires were received from 19 associations or departments in the 21 hospitals (90% response). In the five-year period under study in 14 of these hospitals had terminated 103 pregnancies beyond the 24th week of gestation. Antenatal sonography had been performed on all these pregnancies. Anencephaly was diagnosed before termination in 21% and severe chromosomal defects in a further 21%. Other severe abnormalities were neural groove defects, such as hydrocephaly and/or spina bifida (16%), no renal function (12%) and skeletal abnormalities (11%). In 87% the antenatal diagnosis was verified postnatally; in 78% this was done by autopsy. The diagnosis was confirmed in all these cases ('almost confirmed' in two cases). In every case the pregnant woman herself had asked for her pregnancy to be terminated. In 78% the prognosis was discussed with other medical specialists and the professionals concerned with management; there was a consultation about the termination in 91% of the cases. A report was always compiled for the medical records. CONCLUSION: Late termination of pregnancy is practised on a substantial scale in North Holland. The reasons for termination were severe structural abnormalities which, in most cases, were not compatible with survival. The gynaecologists in North Holland dealt prudently and responsibly with late termination of pregnancy, although they did not always adhere to the guidelines set out in the 1994 report of the Netherlands Association for Obstetrics and Gynaecology.

Abortion, Induced↗
PubMed1998

Cases of euthanasia and physician assisted suicide among AIDS patients reported to the Public Prosecutor in North Holland.

BACKGROUND: Euthanasia is performed relatively frequently among AIDS patients. OBJECTIVE: To examine the relationship between euthanasia and physician assisted suicide (EAS) and AIDS. METHODS: A descriptive retrospective study in which data was collected from all cases of EAS which were reported to the Public Prosecutor in North Holland between 1984 and 1993. RESULTS: In 7% of the reported cases of EAS the patient had AIDS, and in most of these cases the physician involved was a general practitioner. Both the percentage of AIDS among the cases of EAS and the percentage of EAS among all deaths due to AIDS increased over the years. In 1992, 23% of all deaths due AIDS were reported as cases of EAS. CONCLUSIONS: It seems, in recent years, that EAS has been performed on at least one out of three AIDS patients, which is a far greater percentage than found among other patients.

Acquired Immunodeficiency Syndrome↗
PubMed2004

Dynamic actor network analysis for diffuse pollution in the province of North-Holland.

Diffuse pollution problems involve numerous different organizations and this requires decision makers to involve different actors if they want to develop policies that have a chance of being implemented effectively. A first step in such interactive policy development would be to gain an overview of the different actors involved in diffuse pollution problems, as well as their views on the problem, their interests and their means to influence policy development and implementation. Dynamic Actor Network Analysis (DANA) offers a method that helps analysts in providing such an overview, and the use of this method is explored through its application to a case in the Dutch province of North Holland. The described case specifically focuses on the use of herbicides in public space and involves actors from regional water management authorities, municipalities and private sector users. An important finding is that there is an imbalance in the perceptions of actors that needs to be addressed by water management authorities. The paper concludes that DANA is a promising tool for offering new and useful insights to decision makers, although more practical experience is needed to better assess the utility of this analysis tool.

Diffusion↗
PubMed2005

Stage-specific survival of epithelial cancers in North-Holland/Flevoland, The Netherlands.

While stage is the most important factor for determining cancer survival, population-based survival data according to stage are rarely presented. We present such data for a large population diagnosed with cancer in the area covered by the Amsterdam Cancer Registry for the period 1989-2001 (n=108,251). Cases were grouped according to the TNM-classification. For all sites, a close correlation between stage at diagnosis and survival was observed. The stage-specific 5-year relative survival rate (RSR) ranged from close to 100% for stage I carcinoma of the salivary glands, thyroid, colon/rectum, skin, breast, female genitals, prostate and urethra to 1% for stage IV carcinoma of the oesophagus, stomach, liver, gallbladder, pancreas and lung. Between 1989-1991 and 1999-2001, we observed an increase in the stage-specific RSR for carcinoma of colon/rectum (stages II-IV), lung (stages I-II), breast (stages I-III) and prostate (stages II-IV). Changes in diagnostic (breast, prostate) and staging procedures (lung), surgery (rectum, prostate) and adjuvant treatment (breast, colon) are likely to have contributed to this increase.

Cause of Death↗
PubMed1996

[Late pregnancy interruption in Noord-Holland. II. Carefulness before and review afterwards].

OBJECTIVE: To gain insight into the carefulness of medical activity in late termination of pregnancy, and into gynaecologists' relevant views. DESIGN: A descriptive, partly cross-sectional, partly retrospective study. SETTING: Province of North Holland, The Netherlands. METHOD: An anonymous written inquiry was conducted among all individual obstetrically active gynaecologists and all associations/departments of gynaecology in the 21 hospitals in North Holland. The study period covered the years 1990-1994 inclusive. RESULTS: Replies were obtained from 19 associations/departments of the 21 hospitals and from 83% of the obstetrically active gynaecologists (77/93). Activity had been careful in the vast majority (93%) of the 103 reported cases of late termination of pregnancy: the diagnosis was definite prenatally and verified postnatally; consultation about termination was conducted in 91%; reports were made in all cases. Most responding gynaecologists had performed late termination of pregnancy (44/77). Sixty-eight percent of these were of the opinion that a death certificate had to be issued, as against 30% of those who had not performed late terminations of pregnancy (9/30). A death certificate was issued in 88% of the cases of termination. Sixty-eight percent of the respondents with a view to external quality control and subsequent review had opted for a national committee of experts from the profession, in some cases supplemented with experts from outside the profession, plus supervision by the Health Care Inspectorate. CONCLUSION: Gynaecologists in North Holland in general acted carefully regarding late termination of pregnancy, although they did not always observe the guidelines issued by their professional association.

Abortion, Eugenic↗
PubMed1996

[Late pregnancy interruption in Noord-Holland. I. Incidence and abnormalities].

OBJECTIVE: To gain insight into the extent to which late termination of pregnancy (gestational age > 24 weeks) is practised and to find out what foetal diseases and abnormalities lead to termination. DESIGN: An exploratory, descriptive, retrospective study. SETTING: Province of North Holland, the Netherlands. METHODS: An investigation, based on an anonymous printed questionnaire, was conducted among all associations/departments of gynaecologists in the 21 hospitals in North Holland. The period of study covered the years 1990 to 1994 inclusive. RESULTS: Replies, in the form of completed questionnaires, were received from 19 associations/departments in the 21 hospitals (90% response). In the five-year period under study 103 pregnancies in 14 of the hospitals were terminated beyond the 24th week. In 21% of the cases anencephaly was diagnosed prior to the termination; another 21% of the foetuses were diagnosed as having severe chromosomal defects. Other severe abnormalities were neural groove defects like hydrocephaly and/or spina bifida (16%), no renal function (12%) and skeletal abnormalities (11%). CONCLUSION: Late termination of pregnancy appears to be practised on a substantial scale, at any rate in North Holland. The reasons for termination are severe structural abnormalities which in most of the cases are not compatible with extrauterine survival.

Abnormalities, Multiple↗
PubMed1991

[Euthanasia and assisted suicide by physicians in the home situation. I. Diagnoses, age and sex of patients].

In order to map out morbidity, age and sex of patients with whom family doctors participated in euthanasia or assisted suicide, an exploratory, descriptive, retrospective study was carried out primarily regarding the period 1986-1989. Data were collected via an anonymous written injury among an at random sample of family doctors in North Holland (n = 521), and family doctors in the rest of the Netherlands (n = 521). In addition, police reports of euthanasia/assisted suicide administered by family doctors in North Holland (n = 263) were analysed. The inquiry included among others questions about the last case doctors had encountered. Diagnoses were classified according to the ICD-9. The results were compared with compiled mortality data relating to persons who died in their own homes. Correlations and differences were analysed by means of the chi2-test. The response to the inquiry was 67% (non-responders did not otherwise differ from responders): 228 (North Holland), 160 (rest of the Netherlands) and 263 (police reports) cases could be analysed. Of the patients, 85% suffered from a malignant neoplasm. The average age at which euthanasia or assisted suicide was practised was 63.4 years (men) and 66.1 years (women). Under the age of 30 and above 85 euthanasia or assisted suicide was administered only rarely. Proportionally these procedures were applied to the same extent to men as to women. In about 20% of the cases an important secondary diagnosis was present. In conclusion, it is especially the malignant neoplasms that cause such suffering that euthanasia or assisted suicide are practised. The average age at which they are applied is considerably lower than that of the total of people who die in their own homes.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

[The use of drugs for euthanasia and assisted suicide in family practice].

An exploratory, descriptive, retrospective study was carried out concerning the use of means for euthanasia or assisted suicide, primarily regarding the period 1986-1989. Data were collected via an anonymous written inquiry among a random sample of family physicians in North Holland (n = 521) and family physicians in the rest of the Netherlands (n = 521). The inquiry contained among others questions about the last case they had encountered. In addition, police reports of euthanasia or assisted suicide administered by family physicians in North Holland (n = 263) were analysed. The response to the inquiry was 67%; (non-respondents did not differ from respondents): 388 cases could be analysed. The use of euthanatics by family physicians in North Holland and those in the rest of the Netherlands was identical. More than 40 different euthanatics were used, most of them incidentally. The most frequently used (combination of) means were a benzodiazepine with a neuromuscular relaxant (23%), a barbiturate with a neuromuscular relaxant (20%), barbiturates (15%) and opioids (12%). Most euthanatics were given intravenously (61%, of which 5% by infusion), orally 21%, intramuscularly 12%, rectally 3% and subcutaneously 2%. The quantities applied varied greatly. The average length of time from the start of the procedure till decrease was 3.8 hours (less than or equal to 1 minute-72 hours). In 12% of the cases complications or unintended effects were reported. Comparison of inquiry and police reports showed some differences.(ABSTRACT TRUNCATED AT 250 WORDS)

Barbiturates↗
PubMed1997

Euthanasia and old age.

OBJECTIVE: to obtain insight into the relationship between euthanasia/physician-assisted suicide (EAS) and the age of patients to whom it was administered. DESIGN: a descriptive retrospective study. SAMPLE: cases of EAS reported between 1984 and 1993, in the province of North Holland in The Netherlands. These data are not available for the rest of The Netherlands. RESULTS: between 1984 and 1993, 1707 cases of EAS were reported to the Public Prosecutor in North Holland. The average age of the female patients to whom EAS was administered was 65 years; for men the average age was 62. For both men and women EAS was most frequently performed in the age-categories of 60-69 years and 70-79 years. Cancer and cerebrovascular accidents were positively related to age, while AIDS and multiple sclerosis were negatively related to age. In all physician reports the number of cases of EAS increased until the age-category of 70-79 years, after which EAS was less frequently performed by general practitioners, but more frequently by nursing-home physicians. In the age-groups of 70-79 years and 80 years and over the number of cases of EAS increased over the years. There were differences in the distribution of age between the patients to whom EAS was administered and all deaths. In the younger age-groups EAS was performed relatively more frequently, while the lowest percentage was found in the group aged 85 years and over. CONCLUSION: the suggestion that EAS is mainly performed among elderly people in The Netherlands is not supported by our study.

Age Factors↗