Tag Archives: SHARE

Functional constipation in children: a systematic review on prognosis and predictive factors

Background and Aim: Knowledge regarding prognosis and factors influencing the clinical course of functional constipation in children is important to enable general practitioners and paediatricians to give accurate patient information, to compare treat… Continue reading

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Most antidepressant use in primary care Is justified; results of the Netherlands Study of Depression and Anxiety

Background: Depression is a common illness, often treated in primary care. Many studies have reported undertreatment with antidepressants in primary care. Recently, some studies also reported overtreatment with antidepressants. The present study was d… Continue reading

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Referral of patients with depression to mental health care by Dutch general practitioners: an observational study

Background: Depression is a common illness, often treated in primary care. Guidelines provide recommendations for referral to mental health care. Several studies investigated determinants of referral, none investigated guideline criteria as possible d… Continue reading

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Guideline recommendations for long-term treatment of depression with antidepressants in primary care–a critical review

BACKGROUND: Long-term treatment with antidepressants is considered effective in preventing recurrence of major depressive disorder (MDD). It is unclear whether this is true for primary care. OBJECTIVES: We investigated whether current guideline recomm… Continue reading

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The relation between market forces and employee motivation: consequences of the introduction of market forces in the Dutch childcare sector

The Dutch childcare sector has undergone a transition from a welfare sector into a market sector. The final step in this transition process was taken with the introduction of a new Dutch Childcare Act on 1 January 2005. In discussions about the introd… Continue reading

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Degree of urbanization and gender differences in substance use among Slovak adolescents

OBJECTIVES: Substance use among adolescents varies with gender and between countries. Urbanization may contribute to this. The aim of our study is to explore the association between the degree of urbanization and gender differences in adolescent smoking, binge drinking, and cannabis use. METHODS: A cross-sectional questionnaire survey of Slovak adolescents was used (N = 3,493; mean age = 14.33), stratified by degree of urbanization. The effects of gender and urbanization of the area and their interaction on substance use (smoking, binge drinking, and cannabis) were analyzed using a logistic regression model adjusted for age. RESULTS: Gender and area and their interaction had statistically significant (p Continue reading

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The costs of guideline-concordant care and of care according to patients’ needs in anxiety and depression

Aim To describe the direct and indirect costs for people with anxiety and depressive disorders where guidelines are adhered to and patients’ perceived needs are fully met. Method Data were derived from the Netherlands Study of Depression and Anxiety. … Continue reading

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When parent and teacher ratings don’t agree: the Tracking Adolescents’ Individual Lives Survey (TRAILS)

Abstract Objectives: A commonly encountered situation for evaluating clinicians is a history of significant problems in one setting with little or no difficulties in another. This study aims to describe this phenomenon and to examine its relations wit… Continue reading

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Association between the 1291-C/G polymorphism in the adrenergic alpha-2a receptor and the metabolic syndrome

The prevalence of the metabolic syndrome is increased in patients with schizophrenia compared with the general population. The strong interindividual differences in susceptibility to developing the metabolic syndrome suggests that the genetic makeup i… Continue reading

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Patient factors associated with guideline-concordant treatment of anxiety and depression in primary care

To identify associations of patient characteristics (predisposing, enabling and need factors) with guideline-concordant care for anxiety and depression in primary care. Analysis of data from the Netherlands Study of Depression and Anxiety (NESDA). Seven hundred and twenty-one patients with a current anxiety or depressive disorder, recruited from 67 general practitioners (GPs), were included. Diagnoses according to the Diagnostic and Statistic Manual of Mental Disorders, fourth edition (DSM-IV) were made using a structured and widely validated assessment. Socio-demographic and enabling characteristics, severity of symptoms, disability, (under treatment for) chronic somatic conditions, perceived need for care, beliefs and evaluations of care were measured by questionnaires. Actual care data were derived from electronic medical records. Criteria for guideline-concordant care were based on general practice guidelines, issued by the Dutch College of General Practitioners. Two hundred and eighty-one (39%) patients received guideline-concordant care. High education level, accessibility of care, comorbidity of anxiety and depression, and severity and disability scores were positively associated with receiving guideline-concordant care in univariate analyses. In multivariate multi-level logistic regression models, significant associations with the clinical need factors disappeared. Positive evaluations of accessibility of care increased the chance (OR = 1.31; 95%-CI = 1.05-1.65; p = 0.02) of receiving guideline-concordant care, as well as perceiving any need for medication (OR = 2.99; 95%-CI = 1.84-4.85; p Continue reading

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Perceived need for mental health care and barriers to care in the Netherlands and Australia

This study of Australian and Dutch people with anxiety or depressive disorder aims to examine people’s perceived needs and barriers to care, and to identify possible similarities and differences. Data from the Australian National Survey of Mental Heal… Continue reading

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Back Complaints in the Elders (BACE); design of cohort studies in primary care: an international consortium

Background: Although back complaints are common among older people, limited information is available in the literature about the clinical course of back pain in older people and the identification of older persons at risk for the transition from acute… Continue reading

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Beta-blockers may reduce mortality and risk of exacerbations in patients with chronic obstructive pulmonary disease

Background: Physicians avoid the use of beta-blockers in patients with chronic obstructive pulmonary disease (COPD) and concurrent cardiovascular disease because of concerns about adverse pulmonary effects We assessed the long-term effect of beta-bloc… Continue reading

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Effects of pneumococcal conjugate vaccine 2 years after its introduction, the Netherlands

In the Netherlands, the 7-valent pneumococcal conjugate vaccine (PCV-7) was implemented in a 3+1-dose schedule in the national immunization program for infants born after April 1, 2006. To assess the vaccine’s effectiveness, we compared disease incide… Continue reading

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Comparability of antibody response to a booster dose of 7-valent pneumococcal conjugate vaccine in infants primed with either 2 or 3 doses

In this cohort study we compared IgG antibody levels between infants immunized with 7-valent CRM197-conjugated pneumococcal vaccine (PCV-7) at 2,4 and 11 months and at 2, 3, 4 and 11 months of age,as measured by double adsorption ELISA. Pre- and post-booster levels following the 2 + 1 – and 3 + 1-dose schedule were comparable for 5 out of 7 serotypes except for serotypes 6B and 19F. The proportion of children reaching post-booster antibody thresholds were comparable except for 6B (>= 1.0 mu g/ml and >= 5.0 mu g/ml) and 19F (>= 5.0 mu g/ml). Surveillance studies are warranted for vaccine impact on 6B and 19F disease cases after reduced-dose PCV-7 schedules. (C) 2009 Elsevier Ltd. All rights reserved Continue reading

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Childhood abdominal pain in primary care: design and patient selection of the HONEUR abdominal pain cohort

Background: Abdominal pain in children is a common complaint presented to the GP. However, the prognosis and prognostic factors of childhood abdominal pain are almost exclusively studied in referred children. This cohort study aims at describing progn… Continue reading

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Association between helicobacter pylori and gastrointestinal symptoms in children

OBJECTIVE: Recurrent abdominal pain (RAP) and other gastrointestinal (GI) symptoms are common complaints among children. The role of Helicobacter pylori in the cause of these complaints remains controversial. Nevertheless, there is an increasing press… Continue reading

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Instruments used to assess functional limitations in workers applying for disability benefit: a systematic review

Purpose. To systematically review the quality of the psychometric properties of instruments for assessing functional limitations in workers applying for disability benefit. Method. Electronic searches of Medline, Embase, CINAHL and PsycINFO were perfo… Continue reading

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Coping styles relate to health and work environment of Norwegian and Dutch hospital nurses: A comparative study

Nurses exposed to high nursing stress report no health complaints as long as they have high coping abilities. The purpose of this study was to investigate coping styles in relation to the health status and work environment of Norwegian and Dutch hospi… Continue reading

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Clinical practice. Diagnosis and treatment of functional constipation

Childhood functional constipation has an estimated prevalence of 3% in the Western world and is probably the most common gastrointestinal complaint in children. It is characterized by infrequent painful defecation, faecal incontinence and abdominal pain. Only less than 5% of children with constipation have an underlying disease. Only recently two evidence-based guidelines (the Netherlands and Great Britain) have been developed concerning the diagnostic and therapeutic approach for childhood constipation which we both discuss in this article. At present, a thorough medical history and complete physical exam are usually sufficient to confirm the diagnosis of functional constipation. Further laboratory or radiological investigations should only be performed in case of doubt, to exclude an underlying disease. Treatment of childhood constipation consists of four steps: (1) education, (2) disimpaction, (3) prevention of re-accumulation of faeces and (4) follow-up. Surprisingly, there is only limited evidence that laxative treatment is better than placebo in children with constipation. However, according to the available evidence, the Dutch guideline recommends lactulose for children Continue reading

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